The Bunny: A simulated commercial air transportation study

NASA Technical Reports Server (NTRS)

Fulton, David; Gallagher, Patrick; Grannan, William; Martin, Jennifer; Mastej, Nicole; Wujek, Brett

1993-01-01

The Bunny is a single-engine, 100 passenger commercial transport designed to serve the high density short-to-medium range markets in AEROWORLD. The aircraft's design range is 10,000 feet at a cruise velocity of 30 ft/s. The aircraft features a low wing which incorporates polyhedral for roll control. Yaw and pitch control are accomplished by a rudder and elevator, respectively. Propulsion is provided by a nose-mounted Astro 15 electric motor powered by thirteen 1.2 V, 1000 mah batteries with a Zinger 12-6 propeller. The aircraft is structurally designed with a safety factor of 1.5 and is constructed primarily of balsa, bass, and birch wood. Passenger seating is arranged on two levels, with three-abreast on the lower level and two-abreast on the upper level. The factors which had the most significant influence on the final design were the direct operating cost and the take-off distance. The primary strength of The Bunny is its ability to compete economically with the HB-40. At full capacity and mid-range fuel costs, the cost per seat per thousand feet (CPSK) of this aircraft is 25% less than the HB-40. Another principal strength is its ability to operate in all airports in AEROWORLD. Also, The Bunny's two-piece removable wing is an advantage from a transportability standpoint.

The optimality of hospital financing system: the role of physician-manager interactions.

PubMed

Crainich, David; Leleu, Hervé; Mauleon, Ana

2008-12-01

The ability of a prospective payment system to ensure an optimal level of both quality and cost reducing activities in the hospital industry has been stressed by Ma (Ma, J Econ Manage Strategy 8(2):93-112, 1994) whose analysis assumes that decisions about quality and costs are made by a single agent. This paper examines whether this result holds when the main decisions made within the hospital are shared between physicians (quality of treatment) and hospital managers (cost reduction). Ma's conclusions appear to be relevant in the US context (where the hospital managers pay the whole cost of treatment). Nonetheless, when physicians partly reimburse hospitals for the treatment cost as it is the case in many European countries, we show that the ability of a prospective payment system to achieve both objectives is sensitive to the type of interaction (simultaneous, sequential or joint decision-making) between the agents. Our analysis suggests that regulation policies in the hospital sector should not be exclusively focused on the financing system but should also take the interaction between physicians and hospital managers into account.

Multi-country analysis of treatment costs for HIV/AIDS (MATCH): facility-level ART unit cost analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia.

PubMed

Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

2014-01-01

Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. In 2010-2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2-8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77-95% alive and on treatment). This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation.

Does more mean less? The value of information for conservation planning under sea level rise.

PubMed

Runting, Rebecca K; Wilson, Kerrie A; Rhodes, Jonathan R

2013-02-01

Many studies have explored the benefits of adopting more sophisticated modelling techniques or spatial data in terms of our ability to accurately predict ecosystem responses to global change. However, we currently know little about whether the improved predictions will actually lead to better conservation outcomes once the costs of gaining improved models or data are accounted for. This severely limits our ability to make strategic decisions for adaptation to global pressures, particularly in landscapes subject to dynamic change such as the coastal zone. In such landscapes, the global phenomenon of sea level rise is a critical consideration for preserving biodiversity. Here, we address this issue in the context of making decisions about where to locate a reserve system to preserve coastal biodiversity with a limited budget. Specifically, we determined the cost-effectiveness of investing in high-resolution elevation data and process-based models for predicting wetland shifts in a coastal region of South East Queensland, Australia. We evaluated the resulting priority areas for reserve selection to quantify the cost-effectiveness of investment in better quantifying biological and physical processes. We show that, in this case, it is considerably more cost effective to use a process-based model and high-resolution elevation data, even if this requires a substantial proportion of the project budget to be expended (up to 99% in one instance). The less accurate model and data set failed to identify areas of high conservation value, reducing the cost-effectiveness of the resultant conservation plan. This suggests that when developing conservation plans in areas where sea level rise threatens biodiversity, investing in high-resolution elevation data and process-based models to predict shifts in coastal ecosystems may be highly cost effective. A future research priority is to determine how this cost-effectiveness varies among different regions across the globe. © 2012 Blackwell Publishing Ltd.

Social Studies. MicroSIFT Courseware Evaluations.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

This compilation of 11 courseware evaluations gives a general overview of available social studies microcomputer courseware for students in grades 3-12. Each evaluation lists title, date, producer, date of evaluation, evaluating institution, cost, ability level, topic, medium of transfer, required hardware, required software, instructional…

Social Studies. Microsift Courseware Evaluations.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

This compilation of 17 courseware evaluations gives a general overview of available social studies microcomputer courseware for students in grades 1-12. Each evaluation lists title, date, producer, date of evaluation, evaluating institution, cost, ability level, topic, medium of transfer, required hardware, required software, instructional…

GRIN planar waveguide concentrator used with a single axis tracker.

PubMed

Bouchard, Sébastien; Thibault, Simon

2014-03-10

It is generally accepted that small to medium level concentrators could be used as cost-competitive replacements for tracked solar panels. The objective is to design a system that can reach a good level of sun concentration with only one sun-tracking axis and is cheap to fabricate. As the most critical parameter for all concentrator designs, optical efficiency needed improvement to reduce the cost of power produced by our system. By using a graded-index planar waveguide with an index profile similar to SELFOC fiber, the ray's path can be controlled. Also, the concentrator can be fabricated in a single block, which reduces Fresnel reflections. Overall, the optical efficiency can be improved by as much as 33% compared to the same system made with a homogeneous waveguide. Furthermore, the ability to cost-effectively fabricate the concentrator by molding can be preserved, making it possible to reduce the cost of the solar power produced.

GRIN planar waveguide concentrator used with a single axis tracker.

PubMed

Bouchard, Sébastien; Thibault, Simon

2014-03-10

It is generally accepted that small to medium level concentrators could be used as cost-competitive replacements for tracked solar panels. The objective is to design a system that can reach a good level of sun concentration with only one sun-tracking axis and is cheap to fabricate. As the most critical parameter for all concentrator designs, optical efficiency needed improvement to reduce the cost of power produced by our system. By using a graded-index planar waveguide with an index profile similar to SELFOC fiber, the ray’s path can be controlled. Also, the concentrator can be fabricated in a single block, which reduces Fresnel reflections. Overall, the optical efficiency can be improved by as much as 33% compared to the same system made with a homogeneous waveguide. Furthermore, the ability to cost-effectively fabricate the concentrator by molding can be preserved, making it possible to reduce the cost of the solar power produced.

Effects of Speed and Grade Change on the Ability to Reproduce a Standard Work Effort

ERIC Educational Resources Information Center

Michael, Ernest D., Jr.; Katch, Victor

1977-01-01

While running up an incline at a speed chosen by themselves, subjects apparently will perceive the work effort to be the same as running on the level, when in fact it is costing them more energy. (MM)

A victory for genes.

PubMed

2013-07-01

The ability to patent human genes has been costly to researchers and patients, and has restricted competition in the biotech marketplace. The recent US Supreme Court decision making isolated human genes unpatentable will bring freedom of choice to the patient, and level the playing field for research and development.

Robust guaranteed cost tracking control of quadrotor UAV with uncertainties.

PubMed

Xu, Zhiwei; Nian, Xiaohong; Wang, Haibo; Chen, Yinsheng

2017-07-01

In this paper, a robust guaranteed cost controller (RGCC) is proposed for quadrotor UAV system with uncertainties to address set-point tracking problem. A sufficient condition of the existence for RGCC is derived by Lyapunov stability theorem. The designed RGCC not only guarantees the whole closed-loop system asymptotically stable but also makes the quadratic performance level built for the closed-loop system have an upper bound irrespective to all admissible parameter uncertainties. Then, an optimal robust guaranteed cost controller is developed to minimize the upper bound of performance level. Simulation results verify the presented control algorithms possess small overshoot and short setting time, with which the quadrotor has ability to perform set-point tracking task well. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

IEA Wind Task 26: The Past and Future Cost of Wind Energy, Work Package 2

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lantz, E.; Wiser, R.; Hand, M.

2012-05-01

Over the past 30 years, wind power has become a mainstream source of electricity generation around the world. However, the future of wind power will depend a great deal on the ability of the industry to continue to achieve cost of energy reductions. In this summary report, developed as part of the International Energy Agency Wind Implementing Agreement Task 26, titled 'The Cost of Wind Energy,' we provide a review of historical costs, evaluate near-term market trends, review the methods used to estimate long-term cost trajectories, and summarize the range of costs projected for onshore wind energy across an arraymore » of forward-looking studies and scenarios. We also highlight the influence of high-level market variables on both past and future wind energy costs.« less

A cost effectiveness analysis of maintenance cognitive stimulation therapy (MCST) for people with dementia: examining the influence of cognitive ability and living arrangements.

PubMed

Brown, Heather; D'Amico, Francesco; Knapp, Martin; Orrell, Martin; Rehill, Amritpal; Vale, Luke; Robinson, Louise

2018-03-12

Identify if cost-effectiveness of Maintenance Cognitive Simulation Therapy (MCST) differs by type of living arrangement and cognitive ability of the person with dementia. Next, a value of information analysis is performed to inform decisions about future research. Incremental cost-effectiveness analysis applying seemingly unrelated regressions using data from a multicentre RCT of MCST versus treatment as usual in a population which had already received 7 weeks of CST for dementia (ISRCTN: 26286067). The findings from the cost-effectiveness analysis are used to inform a value of information analysis. The results are dependent upon how quality adjusted life years (QALYs) are measured. MCST might be cost-effective compared to standard treatment for those who live alone and those with higher levels of cognitive functioning. If a further RCT was to be conducted for this sub-group of the population, value of information analysis suggests a total sample of 48 complete cases for both sub-groups would be required for a two-arm trial. The expected net gain of conducting this future research is £920 million. Preliminary results suggest that MCST may be most cost-efficient for people with dementia who live alone and/or who have higher cognition. Future research in this area is needed.

The cost of nurse-sensitive adverse events.

PubMed

Pappas, Sharon Holcombe

2008-05-01

The aim of this study was to describe the methodology for nursing leaders to determine the cost of adverse events and effective levels of nurse staffing. The growing transparency of quality and cost outcomes motivates healthcare leaders to optimize the effectiveness of nurse staffing. Most hospitals have robust cost accounting systems that provide actual patient-level direct costs. These systems allow an analysis of the cost consumed by patients during a hospital stay. By knowing the cost of complications, leaders have the ability to justify the cost of improved staffing when quality evidence shows that higher nurse staffing improves quality. An analysis was performed on financial and clinical data from hospital databases of 3,200 inpatients. The purpose was to establish a methodology to determine actual cost per case. Three diagnosis-related groups were the focus of the analysis. Five adverse events were analyzed along with the costs. A regression analysis reported that the actual direct cost of an adverse event was dollars 1,029 per case in the congestive heart failure cases and dollars 903 in the surgical cases. There was a significant increase in the cost per case in medical patients with urinary tract infection and pressure ulcers and in surgical patients with urinary tract infection and pneumonia. The odds of pneumonia occurring in surgical patients decreased with additional registered nurse hours per patient day. Hospital cost accounting systems are useful in determining the cost of adverse events and can aid in decision making about nurse staffing. Adverse events add costs to patient care and should be measured at the unit level to adjust staffing to reduce adverse events and avoid costs.

Determining your organization's 'risk capability'.

PubMed

Hannah, Bill; Hancock, Melinda

2014-05-01

An assessment of a provider's level of risk capability should focus on three key elements: Business intelligence, including sophisticated analytical models that can offer insight into the expected cost and quality of care for a given population. Clinical enterprise maturity, marked by the ability to improve health outcomes and to manage utilization and costs to drive change. Revenue transformation, emphasizing the need for a revenue cycle platform that allows for risk acceptance and management and that provides incentives for performance against defined objectives.

Amphibious Combat Vehicle: Some Acquisition Activities Demonstrate Best Practices; Attainment of Amphibious Capability to be Determined

DTIC Science & Technology

2015-10-01

it will demonstrate amphibious capability that matches the AAV, including the ability to self-deploy and swim to shore. According to DOD officials...level prototypes demonstrating the swim capability, personnel carry capability, and survivability of each company’s vehicle. The Under Secretary of...with the contractor using a 50/50 split and provide a cost ceiling of 120 percent of the target cost. FAR § 16.403. 18A firm-fixed price delivery

Commercial insurance vs community-based health plans: time for a policy option with clinical emphasis to address the cost spiral.

PubMed

Amundson, Bruce

2005-01-01

The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship between various clinical strategies and reductions in utilization and costs. This article describes the organization of health services, including integration of delivery and financing systems, at the community level as a model that effectively addresses the critical structural flaws that have frustrated control of costs. Community-based health plans (CHPs) have been developed and have demonstrated viability. The key elements of CHPs are a legal organizational structure, a full provider network, advanced care-management systems, and the ability to assume financial risk. Common misconceptions regarding obstacles to CHP development are the complexity of the undertaking, difficulty assuming the insurance function, and insured pools that are too small to be viable. The characteristics of successful CHPs and 2 case studies are described, including the types of advanced care-management systems that have resulted in strong financial performance. The demonstrated ability of CHPs to establish financial viability with small numbers of enrollees challenges the common assumption that there is a fixed relationship between health plan enrollment size and financial performance. Organizing the health system at the community/regional level provides an attractive alternative model in the health-reform debate. There is an opportunity for clinical systems and state and federal leaders to support the development of community-based integrated delivery and financing system models that, among other advantages, have significant potential to modulate the pernicious cost spiral.

Multi-Country Analysis of Treatment Costs for HIV/AIDS (MATCH): Facility-Level ART Unit Cost Analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia

PubMed Central

Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

2014-01-01

Background Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. Methods & Findings In 2010–2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2–8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77–95% alive and on treatment). Conclusions This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation. PMID:25389777

Magic Spells. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: Copyright 1981. PRODUCER: Advanced Learning Technology, Inc., 4370 Alpine Road, Portola Valley, CA 94025. EVALUATION COMPLETED: January, 1983 by the Oakland ISD, Pontiac, Michigan. COST: $45.00. ABILITY LEVEL: Grades 1 to 8. SUBJECT: Language Arts.…

Word Families. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: 1981. PRODUCER: Hartley Courseware, Inc., Box 431, Dimondale, Michigan 48821. EVALUATION COMPLETED: January, 1983 at the Clackamas County ESD in Milwaukie, Oregon. COST: $29.95. ABILITY LEVEL: Pre-school through grade 2. SUBJECT: Language Arts.…

Create Spell-It. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): Version: 1981. PRODUCER: Hartley Courseware, Inc., Box 431, Dimondale, Michigan 48821. EVALUATION COMPLETED: January, 1983 at the Clackamas County ESD, Milwaukie, Oregon. COST: $26.95. ABILITY LEVEL: Pre-school through grade 10. SUBJECT: Language Arts.…

Word Search. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: 1981. PRODUCER: Hartley Courseware, Inc., Box 431, Dimondale, Michigan 48821. EVALUATION COMPLETED: January, 1983 at the Clackamas County ESD in Milwaukie, Oregon. COST: $26.95. ABILITY LEVEL: Grades 2-6. SUBJECT: Language Arts. MEDIUM OF TRANSFER:…

Alphabet Keyboard. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): PRODUCER: Random House, Inc., School Division, 1970 Brandywine Rd., Atlanta, Georgia 30341. EVALUATION COMPLETED: June 1982 by staff of the Portland Public Schools, Oregon. COST: Cassette: $24 Disk: $34.50. ABILITY LEVEL: K-1. SUBJECT: Reading: location of…

Titration. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: 1980. PRODUCER: Mentor Software, Inc., Box 8082, St. Paul, Minn. 55113. EVALUATION COMPLETED: April 1982, by staff and constituents of the Texas Region X Educational Service Center. COST: $19.95. ABILITY LEVEL: Grades 10-14. SUBJECT: Chemistry:…

Millikan. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: Copyright 1979. PRODUCER: Mentor Software, Inc., Box 8082, St. Paul, Minnesota 55113. EVALUATION COMPLETED: March 14, 1982 by the staff and constituents of Texas Region X Educational Service Center. COST: $19.95. ABILITY LEVEL: Grade 11+. SUBJECT:…

Spelling Strategy. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: Copyright 1981. PRODUCER: Behavioral Engineering, 230 Mt. Hermon Road, Suite 207, Scotts Valley, CA 95066. EVALUATION COMPLETED: January, 1983 at the Oakland ISD in Pontiac, Michigan. COST: $45.00. ABILITY LEVEL: Grades 2 to 8. SUBJECT: Language…

Newton. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: Member's Apple Demonstration Kit. PRODUCER: Conduit, P.O. Box 388, Iowa City, Iowa 52244. EVALUATION COMPLETED: June 1982 by the staff and constituents of the Portland Public Schools, Multnomah ESD, Portland, Oregon. COST: $35.00. ABILITY LEVEL:…

Building Successful Partnerships in Health Literacy

ERIC Educational Resources Information Center

McIntyre, Sue; Dale, Helen; Gabler, Carol

2010-01-01

Health literacy, the ability to obtain and understand information and services to make good health decisions, has received much attention recently. Literacy is a stronger predictor of health status than age, income, race, ethnicity, employment status, or educational level. Inadequate health literacy costs the United States an estimated $100-$236…

Evolut. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: Conduit Demonstration Package. PRODUCER: Conduit, P. O. Box 388, Iowa City, IA 52244. EVALUATION COMPLETED: June, 1982, by staff and constituents of the Portland Public Schools, Multnomah ESD, Oregon. COST: $30.00. ABILITY LEVEL: Post-secondary,…

Sounds Like a Winner.

ERIC Educational Resources Information Center

Rittner-Heir, Robbin M.

2001-01-01

Explains how the Ocoee Middle School (Orlando, Florida) improved the ability of students to hear in their classrooms and gained improvements in their attention levels and their conduct. Specific design concepts that make Ocoee Middle School the SMART school of the future while also controlling design and construction costs are examined. (GR)

Speed Reader. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: Copyright 1981. PRODUCER: Davidson and Associates, 6069 Groveoak Place #12, Rancho Palos Verdes, CA 90274. EVALUATION COMPLETED: January, 1983 by the Oakland ISD of Pontiac, Michigan. COST: $70.00. ABILITY LEVEL: Secondary. SUBJECT: Reading. MEDIUM…

Constrained Optimization of Average Arrival Time via a Probabilistic Approach to Transport Reliability

PubMed Central

Namazi-Rad, Mohammad-Reza; Dunbar, Michelle; Ghaderi, Hadi; Mokhtarian, Payam

2015-01-01

To achieve greater transit-time reduction and improvement in reliability of transport services, there is an increasing need to assist transport planners in understanding the value of punctuality; i.e. the potential improvements, not only to service quality and the consumer but also to the actual profitability of the service. In order for this to be achieved, it is important to understand the network-specific aspects that affect both the ability to decrease transit-time, and the associated cost-benefit of doing so. In this paper, we outline a framework for evaluating the effectiveness of proposed changes to average transit-time, so as to determine the optimal choice of average arrival time subject to desired punctuality levels whilst simultaneously minimizing operational costs. We model the service transit-time variability using a truncated probability density function, and simultaneously compare the trade-off between potential gains and increased service costs, for several commonly employed cost-benefit functions of general form. We formulate this problem as a constrained optimization problem to determine the optimal choice of average transit time, so as to increase the level of service punctuality, whilst simultaneously ensuring a minimum level of cost-benefit to the service operator. PMID:25992902

Interpreting cost of ownership for mix-and-match lithography

NASA Astrophysics Data System (ADS)

Levine, Alan L.; Bergendahl, Albert S.

1994-05-01

Cost of ownership modeling is a critical and emerging tool that provides significant insight into the ways to optimize device manufacturing costs. The development of a model to deal with a particular application, mix-and-match lithography, was performed in order to determine the level of cost savings and the optimum ways to create these savings. The use of sensitivity analysis with cost of ownership allows the user to make accurate trade-offs between technology and cost. The use and interpretation of the model results are described in this paper. Parameters analyzed include several manufacturing considerations -- depreciation, maintenance, engineering and operator labor, floorspace, resist, consumables and reticles. Inherent in this study is the ability to customize this analysis for a particular operating environment. Results demonstrate the clear advantages of a mix-and-match approach for three different operating environments. These case studies also demonstrate various methods to efficiently optimize cost savings strategies.

[Pay for performance explained by transaction costs theory].

PubMed

Gorbaneff, Yuri; Cortes, Ariel; Torres, Sergio; Yepes, Francisco

2011-01-01

To evaluate the ability of transaction costs theory to explain incentives in the health care chain. We performed a case study of CPS, a health insurance company in Bogota (Colombia), which preferred not to publish its name. CPS moves in the environment of high transaction costs and uses the hybrid form of governance at the outpatient level. Incentive intensity, administrative control and the contract all agree with the theory. At the hospital level, the market is used, despite greater uncertainty. Because of the discrete form (1.0) of the incentives and the absence of administrative control, it is difficult for CPS to relate payment to hospital performance. Transaction costs theory explains the configuration of incentives. Another contribution made by this theory to the literature is the criterion to differentiate between the market and the hybrid. We propose that the market uses discrete-type (1.0) incentives, while the hybrid uses continuous, commission-like incentives. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

Volcanoes. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: 1.4E. PRODUCER: Earthware Computer Services, P.O. Box 30039, Eugene, OR 07403. EVALUATION COMPLETED: June 1982 by staff of NWREL and constituents of the Alaska Department of Education. COST: $49.50. ABILITY LEVEL: Secondary and College. SUBJECT:…

Circulation (Organs). MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): PRODUCER: Micro Power and Light Company, Keystone Park, Suite 1108, 13773 N. Central Expressway, Dallas, TX 75243. LOCAL DISTRIBUTORS: Contact producer for list. EVALUATION COMPLETED: Fall 1981. VERSION: Apple II. COST: $29.95. ABILITY LEVEL: Grades 5-12.…

Joint Venture Health Plans May Give ACOs a Run for Their Money.

PubMed

Reinke, Thomas

2016-12-01

Joint venture plans are starting to demonstrate their ability to implement clinical management and financial management reforms. A JV health plan replaces the offloading of financial risk by health plans to ill-equipped providers with an executive-level cost management committee stated jointly by the hospital and payer.

MicroSIFT Courseware Evaluations (169-198). Set 9. Including Subject and Title Indexes Covering Sets 1-9.

ERIC Educational Resources Information Center

Weaver, Dave, Ed.

This document consists of 30 microcomputer software package evaluations prepared for the MicroSIFT (Microcomputer Software and Information for Teachers) Clearinghouse at the Northwest Regional Educational Laboratory (NWREL). The concise, single-sheet resume describing and evaluating each software package includes source, cost, ability level,…

MicroSIFT Courseware Evaluations (199-222). Set 10. Including Subject and Title Indexes Covering Sets 1-10.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

This document consists of 24 microcomputer software package evaluations prepared by the MicroSIFT (Microcomputer Software and Information for Teachers) Clearinghouse at the Northwest Regional Educational Laboratory. Each software review lists source, cost, ability level, subject, topic, medium of transfer, required hardware, required software,…

Is there a general task switching ability?

PubMed

Yehene, Einat; Meiran, Nachshon

2007-11-01

Participants were tested on two analogous task switching paradigms involving Shape/Size tasks and Vertical/Horizontal tasks, respectively, and three measures of psychometric intelligence, tapping fluid, crystallized and perceptual speed abilities. The paradigms produced similar patterns of group mean reaction times (RTs) and the vast majority of the participants showed switching cost (switch RT minus repeat RT), mixing cost (repeat RT minus single-task RT) and congruency effects. The shared intra-individual variance across paradigms and with psychometric intelligence served as criteria for general ability. Structural equations modeling indicated that switching cost with ample preparation ("residual cost") and mixing cost met these criteria. However, switching cost with little preparation and congruency effects were predominantly paradigm specific.

Cost-related dental non-attendance in older adulthood: evidence from eleven European countries and Israel.

PubMed

Listl, Stefan

2016-06-01

Although relevant for health policy, so far only little is known about the extent to which persons avoid dental attendance because of associated costs. To examine the cost-relatedness of dental non-attendance in various older adulthood populations. Secondary analyses were conducted of data from wave 1 of the Survey of Health, Ageing, and Retirement in Europe (SHARE), which includes unique information on recent dental non-attendance and care foregone due to costs by persons aged 50+ from eleven European countries and Israel. Multivariate logistic regression analysis was used to detect differences in the extent to which dental non-attendance is attributable to associated costs. The study sample comprised 13 935 persons who did not access dental care within the past year. Levels of cost-related non-attendance differed between the twelve examined countries, ranging from 6.8% in Israel to 0.5% in Austria. Cost-related non-attendance was 47% less likely among persons with good as compared to compromised chewing ability (Odds Ratio: 0.53; 95% CI: 0.43-0.66). Cost-related non-attendance was 33% less likely among persons with tertiary as compared to (pre-) primary educational attainment (Odds Ratio: 0.67; 95% CI: 0.47-0.96). Cost-related dental non-attendance was significantly more likely among persons with low levels of general health (Odds Ratio for lowest vs. highest level of general health: 3.05; 95% CI: 1.88-4.95). The findings of the present study suggest that a relatively small proportion of dental non-attendance in older adulthood is cost-related. For specific population subgroups in various countries, however, dental care costs may still pose a relevant barrier to dental care. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Feasibility study of TheraDrive: a low-cost game-based environment for the delivery of upper arm stroke therapy.

PubMed

Johnson, Michelle J; Ramachandran, Brinda; Paranjape, Ruta P; Kosasih, Judith B

2006-01-01

Rising healthcare costs combined with an increase in the number of people living with disabilities due to stroke have created a need for affordable stroke therapy that can be administered in both home and clinical environments. Studies show that robot and computer-assisted devices are promising tools for rehabilitating persons with impairment and disabilities due to stroke. Studies also have shown that highly motivating therapy produces neuromotor relearning that aids the rehabilitative process. Combining these concepts, this paper discusses TheraDrive, a simple, but novel robotic system for more motivating stroke therapy. We conducted two feasibility studies. The paper discusses these studies. Findings demonstrate the ability of the system to grade therapy and the sensitivity of its metrics to the level of motor function in the impaired arm. In addition, findings confirm the ability of the system to administer fun therapy leading to improved motor performance on steering tasks. However, further work is needed to improve the system's ability to increase motor function in the impaired arm.

Compliance by Design: Influence of Acceleration Trade-offs on CO2 Emissions and Costs of Fuel Economy and Greenhouse Gas Regulations.

PubMed

Whitefoot, Kate S; Fowlie, Meredith L; Skerlos, Steven J

2017-09-19

The ability of automakers to improve the fuel economy of vehicles using engineering design modifications that compromise other performance attributes, such as acceleration, is not currently considered when setting fuel economy and greenhouse-gas emission standards for passenger cars and light trucks. We examine the role of these design trade-offs by simulating automaker responses to recently reformed vehicle standards with and without the ability to adjust acceleration performance. Results indicate that acceleration trade-offs can be important in two respects: (1) they can reduce the compliance costs of the standards, and (2) they can significantly reduce emissions associated with a particular level of the standards by mitigating incentives to shift sales toward larger vehicles and light trucks relative to passenger cars. We contrast simulation-based results with observed changes in vehicle attributes under the reformed standards. We find evidence that is consistent with firms using acceleration trade-offs to achieve compliance. Taken together, our analysis suggests that acceleration trade-offs play a role in automaker compliance strategies with potentially large implications for both compliance costs and emissions.

Reasoning about Benefits, Costs, and Risks of Chemical Substances: Mapping Different Levels of Sophistication

ERIC Educational Resources Information Center

Cullipher, S.; Sevian, H.; Talanquer, V.

2015-01-01

The ability to evaluate options and make informed decisions about problems in relevant contexts is a core competency in science education that requires the use of both domain-general and discipline-specific knowledge and reasoning strategies. In this study we investigated the implicit assumptions and modes of reasoning applied by individuals with…

Grammar Package 1. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): VERSION: TRS-80. PRODUCER: Micro Learning Ware, P.O. Box 2134, N. Mankato, MN 56001. EVALUATION COMPLETED: June 22, 1982 by the staff and constituents of the Portland Public Schools, Portland, Oregon. COST: $24.95. ABILITY LEVEL: 4-5. SUBJECT: Language arts.…

Library Skills: What's There and How to Find It. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): PRODUCER: Micro Power and Light Company, Keystone Park, Suite 1108, 13773 N. Central Expressway, Dallas, TX 75243. LOCAL DISTRIBUTORS: Contact producer for list. EVALUATION COMPLETED: Fall 1981. VERSION: Apple II. COST: $24.95. ABILITY LEVEL: Grades 4+.…

Grammar Problems for Practice: Homonyms. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): PRODUCER: Milliken Publishing Company, 1100 Research Blvd., St. Louis MO 63132. EVALUATION COMPLETED: June 1982, by staff of the Portland Public Schools, Multnomah ESD, Portland, Oregon. COST: $80 per module; $375 for series of 5 modules. ABILITY LEVEL: 3-9.…

Research on the Costs of Running Compulsory Education Standards: Comparison of Compulsory Education Internationally

ERIC Educational Resources Information Center

Jin, Yongli; Zhang, Hong

2008-01-01

Compulsory education is the fundamental education for citizens and is the source of state power, which radically determines thought level, political awareness, cultural sense and production ability of the entire nation. Therefore, to popularize compulsory education is the root of a country. This paper explains the meanings of compulsory education,…

Is Set Shifting Really Impaired in Trait Anxiety? Only When Switching Away from an Effortfully Established Task Set

PubMed Central

Gustavson, Daniel E.; Altamirano, Lee J.; Johnson, Daniel P.; Whisman, Mark A.; Miyake, Akira

2016-01-01

The current study investigated whether trait anxiety was systematically related to task-set shifting performance, using a task-switching paradigm in which one task was more attentionally demanding than the other. Specifically, taking advantage of a well-established phenomenon known as asymmetric switch costs, we tested the hypothesis that the association between trait anxiety and task-set shifting is most clearly observed when individuals must switch away from a more attentionally demanding task for which it was necessary to effortfully establish an appropriate task set. Ninety-one young adults completed an asymmetric switching task and trait-level mood questionnaires. Results indicated that higher levels of trait anxiety were systematically associated with greater asymmetry in reaction-time (RT) switch costs. Specifically, the RT costs for switching from the more attentionally demanding task to the less demanding task were significantly greater with higher levels of trait anxiety, whereas the RT costs for switching in the opposite direction were not significantly associated with trait anxiety levels. Further analyses indicated that these associations were not attributable to comorbid dysphoria or worry. These results suggest that levels of trait anxiety may not be related to general set-shifting ability per se, but, rather, that anxiety-specific effects may primarily be restricted to when one must efficiently switch away from (or let go of) an effortfully established task set. PMID:27429194

The association of consumer cost-sharing and direct-to-consumer advertising with prescription drug use.

PubMed

Hansen, Richard A; Schommer, Jon C; Cline, Richard R; Hadsall, Ronald S; Schondelmeyer, Stephen W; Nyman, John A

2005-06-01

Previous research on the impact of various cost-sharing strategies on prescription drug use has not considered the impact of direct-to-consumer (DTC) advertising. To explore the association of cost-containment strategies with prescription drug use and to determine if the association is moderated by DTC prescription drug advertising. The study population included 288 280 employees and dependents aged 18 to 65 years with employer-sponsored health insurance contributing to the MEDSTAT MarketScan administrative data set. Person-level enrollment and claims data were obtained for beneficiaries enrolled continuously during July 1997 through December 1998. Direct-to-consumer advertising data were obtained from Competitive Media Reporting and linked to the MEDSTAT enrollment files. Localized DTC advertising expenditures for one class of medication were evaluated and matched with prescription claims for eligible MEDSTAT contributors. The association of various types and levels of cost-sharing incentives with incident product use was evaluated, controlling for the level of DTC advertising, health status, and other demographic covariates. The relationship of cost-sharing amounts with drug use was modified by the level of DTC advertising in a geographic market. This relationship was dependent on the type of cost-sharing, distinguishing between co-payments for provider visits and co-payments for prescription drugs. Compared with low-advertising markets, individuals residing in markets with high levels of advertising and paying provider co-payments of $10.00 or more were more likely to use the advertised product. In the same markets, higher prescription drug co-payments were associated with a decreased likelihood of using the advertised product. A similar relationship was not observed for the nonadvertised competitor. Among insured individuals, response to cost-sharing strategies is moderated by DTC prescription drug advertising. The relative ability of cost-sharing strategies to influence drug use should be interpreted with caution in the presence of DTC advertising.

Because difficulty is not the same for everyone: the impact of complexity in working memory is associated with cannabinoid 1 receptor genetic variation in young adults.

PubMed

Ruiz-Contreras, Alejandra E; Román-López, Talía V; Caballero-Sánchez, Ulises; Rosas-Escobar, Cintia B; Ortega-Mora, E Ivett; Barrera-Tlapa, Miguel A; Romero-Hidalgo, Sandra; Carrillo-Sánchez, Karol; Hernández-Morales, Salvador; Vadillo-Ortega, Felipe; González-Barrios, Juan Antonio; Méndez-Díaz, Mónica; Prospéro-García, Oscar

2017-03-01

Individual differences in working memory ability are mainly revealed when a demanding challenge is imposed. Here, we have associated cannabinoid 1 (CB1) receptor genetic variation rs2180619 (AA, AG, GG), which is located in a potential CNR1 regulatory sequence, with performance in working memory. Two-hundred and nine Mexican-mestizo healthy young participants (89 women, 120 men, mean age: 23.26 years, SD = 2.85) were challenged to solve a medium (2-back) vs. a high (3-back) difficulty N-back tasks. All subjects responded as expected, performance was better with the medium than the high demand task version, but no differences were found among genotypes while performing each working memory (WM) task. However, the cost of the level of complexity in N-back paradigm was double for GG subjects than for AA subjects. It is noteworthy that an additive-dosage allele relation was found for G allele in terms of cost of level of complexity. These genetic variation results support that the endocannabinoid system, evaluated by rs2180619 polymorphism, is involved in WM ability in humans.

A generalized public goods game with coupling of individual ability and project benefit

NASA Astrophysics Data System (ADS)

Zhong, Li-Xin; Xu, Wen-Juan; He, Yun-Xin; Zhong, Chen-Yang; Chen, Rong-Da; Qiu, Tian; Shi, Yong-Dong; Ren, Fei

2017-08-01

Facing a heavy task, any single person can only make a limited contribution and team cooperation is needed. As one enjoys the benefit of the public goods, the potential benefits of the project are not always maximized and may be partly wasted. By incorporating individual ability and project benefit into the original public goods game, we study the coupling effect of the four parameters, the upper limit of individual contribution, the upper limit of individual benefit, the needed project cost and the upper limit of project benefit on the evolution of cooperation. Coevolving with the individual-level group size preferences, an increase in the upper limit of individual benefit promotes cooperation while an increase in the upper limit of individual contribution inhibits cooperation. The coupling of the upper limit of individual contribution and the needed project cost determines the critical point of the upper limit of project benefit, where the equilibrium frequency of cooperators reaches its highest level. Above the critical point, an increase in the upper limit of project benefit inhibits cooperation. The evolution of cooperation is closely related to the preferred group-size distribution. A functional relation between the frequency of cooperators and the dominant group size is found.

Avionics and Power Management for Low-Cost High-Altitude Balloon Science Platforms

NASA Technical Reports Server (NTRS)

Chin, Jeffrey; Roberts, Anthony; McNatt, Jeremiah

2016-01-01

High-altitude balloons (HABs) have become popular as educational and scientific platforms for planetary research. This document outlines key components for missions where low cost and rapid development are desired. As an alternative to ground-based vacuum and thermal testing, these systems can be flight tested at comparable costs. Communication, solar, space, and atmospheric sensing experiments often require environments where ground level testing can be challenging or impossible in certain cases. When performing HAB research the ability to monitor the status of the platform and gather data is key for both scientific and recoverability aspects of the mission. A few turnkey platform solutions are outlined that leverage rapidly evolving open-source engineering ecosystems. Rather than building custom components from scratch, these recommendations attempt to maximize simplicity and cost of HAB platforms to make launches more accessible to everyone.

Using risk-adjustment models to identify high-cost risks.

PubMed

Meenan, Richard T; Goodman, Michael J; Fishman, Paul A; Hornbrook, Mark C; O'Keeffe-Rosetti, Maureen C; Bachman, Donald J

2003-11-01

We examine the ability of various publicly available risk models to identify high-cost individuals and enrollee groups using multi-HMO administrative data. Five risk-adjustment models (the Global Risk-Adjustment Model [GRAM], Diagnostic Cost Groups [DCGs], Adjusted Clinical Groups [ACGs], RxRisk, and Prior-expense) were estimated on a multi-HMO administrative data set of 1.5 million individual-level observations for 1995-1996. Models produced distributions of individual-level annual expense forecasts for comparison to actual values. Prespecified "high-cost" thresholds were set within each distribution. The area under the receiver operating characteristic curve (AUC) for "high-cost" prevalences of 1% and 0.5% was calculated, as was the proportion of "high-cost" dollars correctly identified. Results are based on a separate 106,000-observation validation dataset. For "high-cost" prevalence targets of 1% and 0.5%, ACGs, DCGs, GRAM, and Prior-expense are very comparable in overall discrimination (AUCs, 0.83-0.86). Given a 0.5% prevalence target and a 0.5% prediction threshold, DCGs, GRAM, and Prior-expense captured $963,000 (approximately 3%) more "high-cost" sample dollars than other models. DCGs captured the most "high-cost" dollars among enrollees with asthma, diabetes, and depression; predictive performance among demographic groups (Medicaid members, members over 64, and children under 13) varied across models. Risk models can efficiently identify enrollees who are likely to generate future high costs and who could benefit from case management. The dollar value of improved prediction performance of the most accurate risk models should be meaningful to decision-makers and encourage their broader use for identifying high costs.

Is set shifting really impaired in trait anxiety? Only when switching away from an effortfully established task set.

PubMed

Gustavson, Daniel E; Altamirano, Lee J; Johnson, Daniel P; Whisman, Mark A; Miyake, Akira

2017-02-01

The current study investigated whether trait anxiety was systematically related to task-set shifting performance, using a task-switching paradigm in which 1 task was more attentionally demanding than the other. Specifically, taking advantage of a well-established phenomenon known as asymmetric switch costs, we tested the hypothesis that the association between trait anxiety and task-set shifting is most clearly observed when individuals must switch away from a more attentionally demanding task for which it was necessary to effortfully establish an appropriate task set. Ninety-one young adults completed an asymmetric switching task and trait-level mood questionnaires. Results indicated that higher levels of trait anxiety were systematically associated with greater asymmetry in reaction time (RT) switch costs. Specifically, the RT costs for switching from the more attentionally demanding task to the less demanding task were significantly greater with higher levels of trait anxiety, whereas the RT costs for switching in the opposite direction were not significantly associated with trait anxiety levels. Further analyses indicated that these associations were not attributable to comorbid dysphoria or worry. These results suggest that levels of trait anxiety may not be related to general set-shifting ability per se, but, rather, that anxiety-specific effects may primarily be restricted to when one must efficiently switch away from (or let go of) an effortfully established task set. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Awareness of pharmaceutical cost-assistance programs among inner-city seniors.

PubMed

Federman, Alex D; Safran, Dana Gelb; Keyhani, Salomeh; Cole, Helen; Halm, Ethan A; Siu, Albert L

2009-04-01

Lack of awareness may be a significant barrier to participation by low- and middle-income seniors in pharmaceutical cost-assistance programs. The goal of this study was to determine whether older adults' awareness of 2 major state and federal pharmaceutical cost-assistance programs was associated with the seniors' ability to access and process information about assistance programs. Data were gathered from a cross-sectional study of independently living, English- or Spanish-speaking adults aged > or =60 years. Participants were interviewed in 30 community-based settings (19 apartment complexes and 11 senior centers) in New York, New York. The analysis focused on adults aged > or =65 years who lacked Medicaid coverage. Multivariable logistic regression was used to model program awareness as a function of information access (family/social support, attendance at senior or community centers and places of worship, viewing of live health insurance presentations, instrumental activities of daily living, site of medical care, computer use, and having a proxy decision maker for health insurance matters) and information-processing ability (education level, English proficiency, health literacy, and cognitive function). The main outcome measure was awareness of New York's state pharmaceutical assistance program (Elderly Pharmaceutical Insurance Coverage [EPIC

Alzheimer disease: diagnosis, costs, and dimensions of treatment.

PubMed

DeKosky, S T; Orgogozo, J M

2001-08-01

Alzheimer disease (AD) is the most frequent cause of dementia in developed Western countries. Over time, affected patients invariably develop cognitive and functional decline, and most develop early or later behavioral disturbances. Declining cognitive and functional abilities contribute to loss of independent living and feelings of denial, confusion, fear and guilt until, finally, the patient loses most abilities to think, move, speak, or perceive. As patients' dependency on assistance increases, the level of caregiver strain rises. The caregiver may develop feelings of anger, grief, loneliness and resentment, and the health and well-being of most caregivers are often affected. Approximately 3-4 million people currently have AD in the USA, at an annual cost of up to US$100 billion, and the disease is expected to reach epidemic proportions by 2020. To achieve a clinically relevant, long-term outcome, pharmacotherapy must have sustained favorable effects on cognitive, functional and behavioral symptoms of AD. Slowing the development of these features of the disease will mean a long-term improvement in quality of life for patients and caregivers. Postponing the emergence of behavioral symptoms would bring about direct beneficial effects on patients with AD and their families, help delay long-term care placement and lower costs.

MicroSIFT Courseware Evaluation. [Set 13 (294-319), Set 14 (320-361), with Hardware (HRD) and Subject (SBJ) Indexes to Both Sets.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

This document consists of 68 microcomputer software package evaluations prepared by MicroSIFT (Microcomputer Software and Information for Teachers) Clearinghouse at the Northwest Regional Education Laboratory. There are 26 packages in set 13 and 42 in set 14. Each software review lists producer, time and place of evaluation, cost, ability level,…

Comparing the net cost of CSP-TES to PV deployed with battery storage

NASA Astrophysics Data System (ADS)

Jorgenson, Jennie; Mehos, Mark; Denholm, Paul

2016-05-01

Concentrated solar power with thermal energy storage (CSP-TES) is a unique source of renewable energy in that its energy can be shifted over time and it can provide the electricity system with dependable generation capacity. In this study, we provide a framework to determine if the benefits of CSP-TES (shiftable energy and the ability to provide firm capacity) exceed the benefits of PV and firm capacity sources such as long-duration battery storage or conventional natural gas combustion turbines (CTs). The results of this study using current capital cost estimates indicate that a combination of PV and conventional gas CTs provides a lower net cost compared to CSP-TES and PV with batteries. Some configurations of CSP-TES have a lower net cost than PV with batteries for even the lowest battery cost estimate. Using projected capital cost targets, however, some configurations of CSP-TES have a lower net cost than PV with either option for even the lowest battery cost estimate. The net cost of CSP-TES varies with configuration, and lower solar multiples coupled with less storage are more attractive at current cost levels, due to high component costs. However, higher solar multiples show a lower net cost using projected future costs for heliostats and thermal storage materials.

Playing against nature: improving earthquake hazard mitigation

NASA Astrophysics Data System (ADS)

Stein, S. A.; Stein, J.

2012-12-01

The great 2011 Tohoku earthquake dramatically demonstrated the need to improve earthquake and tsunami hazard assessment and mitigation policies. The earthquake was much larger than predicted by hazard models, and the resulting tsunami overtopped coastal defenses, causing more than 15,000 deaths and $210 billion damage. Hence if and how such defenses should be rebuilt is a challenging question, because the defences fared poorly and building ones to withstand tsunamis as large as March's is too expensive,. A similar issue arises along the Nankai Trough to the south, where new estimates warning of tsunamis 2-5 times higher than in previous models raise the question of what to do, given that the timescale on which such events may occur is unknown. Thus in the words of economist H. Hori, "What should we do in face of uncertainty? Some say we should spend our resources on present problems instead of wasting them on things whose results are uncertain. Others say we should prepare for future unknown disasters precisely because they are uncertain". Thus society needs strategies to mitigate earthquake and tsunami hazards that make economic and societal sense, given that our ability to assess these hazards is poor, as illustrated by highly destructive earthquakes that often occur in areas predicted by hazard maps to be relatively safe. Conceptually, we are playing a game against nature "of which we still don't know all the rules" (Lomnitz, 1989). Nature chooses tsunami heights or ground shaking, and society selects the strategy to minimize the total costs of damage plus mitigation costs. As in any game of chance, we maximize our expectation value by selecting the best strategy, given our limited ability to estimate the occurrence and effects of future events. We thus outline a framework to find the optimal level of mitigation by balancing its cost against the expected damages, recognizing the uncertainties in the hazard estimates. This framework illustrates the role of the uncertainties and the need to candidly assess them. It can be applied to exploring policies under various hazard scenarios and mitigating other natural hazards.ariation in total cost, the sum of expected loss and mitigation cost, as a function of mitigation level. The optimal level of mitigation, n*, minimizes the total cost. The expected loss depends on the hazard model, so the better the hazard model, the better the mitigation policy (Stein and Stein, 2012).

Implementation of a low-cost Interim 21CFR11 compliance solution for laboratory environments.

PubMed

Greene, Jack E

2003-01-01

In the recent past, compliance with 21CFR11 has become a major buzzword within the pharmaceutical and biotechnology industries. While commercial solutions exist, implementation and validation are expensive and cumbersome. Frequent implementation of new features via point releases further complicates purchasing decisions by making it difficult to weigh the risk of non-compliance against the costs of too frequent upgrades. This presentation discusses a low-cost interim solution to the problem. While this solution does not address 100% of the issues raised by 21CFR11, it does implement and validate: (1) computer system security; (2) backup and restore ability on the electronic records store; and (3) an automated audit trail mechanism that captures the date, time and user identification whenever electronic records are created, modified or deleted. When coupled with enhanced procedural controls, this solution provides an acceptable level of compliance at extremely low cost.

Enhancing managerial effectiveness in dietetics.

PubMed

Hoover, L W

1983-01-01

Environmental pressures from such sources as economic conditions, the government, third-party payers, and inter-institutional competition create managerial challenges. Although cost-containment has received considerable attention, long-term cost-effectiveness is probably the significant issue. Dietitians must become more cost-conscious and effective in resource management to attain desired performance outcomes. Some of the skills and characteristics essential to managerial effectiveness are a marketing orientation, systems design skill, quantitative operations management techniques, financial expertise, and leadership. These abilities facilitate decision-making and achievement of long-term cost-effectiveness. Curriculum enhancement and continuing education are two strategies for improving managerial competency in the dietetics profession. In dietetics education, study of management topics should be enhanced to provide more advanced coverage of management theories and quantitative models so that managerial performance can be at a higher level of sophistication and competency. To assure the viability of the dietetics profession, the emphasis on management must be more comprehensive and rigorous.

Task-switching costs promote the evolution of division of labor and shifts in individuality

PubMed Central

Goldsby, Heather J.; Dornhaus, Anna; Kerr, Benjamin; Ofria, Charles

2012-01-01

From microbes to humans, the success of many organisms is achieved by dividing tasks among specialized group members. The evolution of such division of labor strategies is an important aspect of the major transitions in evolution. As such, identifying specific evolutionary pressures that give rise to group-level division of labor has become a topic of major interest among biologists. To overcome the challenges associated with studying this topic in natural systems, we use actively evolving populations of digital organisms, which provide a unique perspective on the de novo evolution of division of labor in an open-ended system. We provide experimental results that address a fundamental question regarding these selective pressures: Does the ability to improve group efficiency through the reduction of task-switching costs promote the evolution of division of labor? Our results demonstrate that as task-switching costs rise, groups increasingly evolve division of labor strategies. We analyze the mechanisms by which organisms coordinate their roles and discover strategies with striking biological parallels, including communication, spatial patterning, and task-partitioning behaviors. In many cases, under high task-switching costs, individuals cease to be able to perform tasks in isolation, instead requiring the context of other group members. The simultaneous loss of functionality at a lower level and emergence of new functionality at a higher level indicates that task-switching costs may drive both the evolution of division of labor and also the loss of lower-level autonomy, which are both key components of major transitions in evolution. PMID:22872867

Eliciting older people's preferences for exercise programs: a best-worst scaling choice experiment.

PubMed

Franco, Marcia R; Howard, Kirsten; Sherrington, Catherine; Ferreira, Paulo H; Rose, John; Gomes, Juliana L; Ferreira, Manuela L

2015-01-01

What relative value do older people with a previous fall or mobility-related disability attach to different attributes of exercise? Prospective, best-worst scaling study. Two hundred and twenty community-dwelling people, aged 60 years or older, who presented with a previous fall or mobility-related disability. Online or face-to-face questionnaire. Utility values for different exercise attributes and levels. The utility levels were calculated by asking participants to select the attribute that they considered to be the best (ie, they were most likely to want to participate in programs with this attribute) and worst (ie, least likely to want to participate). The attributes included were: exercise type; time spent on exercise per day; frequency; transport type; travel time; out-of-pocket costs; reduction in the chance of falling; and improvement in the ability to undertake tasks inside and outside of home. The attributes of exercise programs with the highest utility values were: home-based exercise and no need to use transport, followed by an improvement of 60% in the ability to do daily tasks at home, no costs, and decreasing the chances of falling to 0%. The attributes with the lowest utility were travel time of 30 minutes or more and out-of-pocket costs of AUD50 per session. The type of exercise, travel time and costs are more highly valued by older people than the health benefits. These findings suggest that physical activity engagement strategies need to go beyond education about health benefits and focus on improving accessibility to exercise programs. Exercise that can be undertaken at or close to home without any cost is most likely to be taken up by older people with past falls and/or mobility-related disability. Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

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

PubMed

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

2009-09-18

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

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

PubMed Central

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

2009-01-01

Background The HIV epidemic in Peru is still regarded as concentrated - sentinel surveillance data shows greatest rates of infection in men who have sex with men, while much lower rates are found in female sex workers and still lower in the general population. Without an appropriate set of preventive interventions, continuing infections could present a challenge to the sustainability of the present programme of universal access to treatment. Determining how specific prevention and care strategies would impact on the health of Peruvians should be key in reshaping the national response. Methods HIV/AIDS prevalence levels for risk groups with sufficient sentinel survey data were estimated. Unit costs were calculated for a series of interventions against HIV/AIDS which were subsequently inputted into a model to assess their ability to reduce infection transmission rates. Interventions included: mass media, voluntary counselling and testing; peer counselling for female sex workers; peer counselling for men who have sex with men; peer education of youth in-school; condom provision; STI treatment; prevention of mother to child transmission; and highly active antiretroviral therapy. Impact was assessed by the ability to reduce rates of transmission and quantified in terms of cost per DALY averted. Results Results of the analysis show that in Peru, the highest levels of HIV prevalence are found in men who have sex with men. Cost effectiveness varied greatly between interventions ranging from peer education of female commercial sex workers at $US 55 up to $US 5,928 (per DALY averted) for prevention of mother to child transmission. Conclusion The results of this work add evidence-based clarity as to which interventions warrant greatest consideration when planning an intervention response to HIV in Peru. Cost effectiveness analysis provides a necessary element of transparency when facing choices about priority setting, particularly when the country plans to amplify its response through new interventions partly funded by the GFATM. PMID:19765304

Virtual Reality to Train Diagnostic Skills in Eating Disorders. Comparison of two Low Cost Systems.

PubMed

Gutiérrez-Maldonado, José; Ferrer-García, Marta; Plasanjuanelo, Joana; Andrés-Pueyo, Antonio; Talarn-Caparrós, Antoni

2015-01-01

Enhancing the ability to perform differential diagnosis and psychopathological exploration is important for students who wish to work in the clinical field, as well as for professionals already working in this area. Virtual reality (VR) simulations can immerse students totally in educational experiences in a way that is not possible using other methods. Learning in a VR environment can also be more effective and motivating than usual classroom practices. Traditionally, immersion has been considered central to the quality of a VR system; immersive VR is considered a special and unique experience that cannot achieved by three-dimensional (3D) interactions on desktop PCs. However, some authors have suggested that if the content design is emotionally engaging, immersive systems are not always necessary. The main purpose of this study is to compare the efficacy and usability of two low-cost VR systems, offering different levels of immersion, in order to develop the ability to perform diagnostic interviews in eating disorders by means of simulations of psychopathological explorations.

Personalized Vehicle Energy Efficiency & Range Predictor/MyGreenCar

DOE Office of Scientific and Technical Information (OSTI.GOV)

SAXENA, SAMVEG

MyGreenCar provides users with the ability to predict the range capabilities, fuel economy, and operating costs for any vehicle for their individual driving patterns. Users launce the MyGreeCar mobile app on their smartphones to collect their driving patterns over any duration (e.g. serval days, weeks, months, etc) using a phones's locational capabilities. Using vehicle powertrain models for any user-specified vehicle type, MyGreenCar, calculates the component-level energy and power interactions for the chosen vehicle to predict several important quantities, including: 1. For Evs: Alleviating range anxiety 2. Comparing fuel economy, operating costs, and payback time across models and types.

Can a costly intervention be cost-effective?: An analysis of violence prevention.

PubMed

Foster, E Michael; Jones, Damon

2006-11-01

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

Can a Costly Intervention Be Cost-effective?

PubMed Central

Foster, E. Michael; Jones, Damon

2009-01-01

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jorgenson, Jennie; Mehos, Mark; Denholm, Paul

Concentrated solar power with thermal energy storage (CSP-TES) is a unique source of renewable energy in that its energy can be shifted over time and it can provide the electricity system with dependable generation capacity. In this study, we provide a framework to determine if the benefits of CSP-TES (shiftable energy and the ability to provide firm capacity) exceed the benefits of PV and firm capacity sources such as long-duration battery storage or conventional natural gas combustion turbines (CTs). The results of this study using current capital cost estimates indicate that a combination of PV and conventional gas CTs providesmore » a lower net cost compared to CSP-TES and PV with batteries. Some configurations of CSP-TES have a lower net cost than PV with batteries for even the lowest battery cost estimate. Using projected capital cost targets, however, some configurations of CSP-TES have a lower net cost than PV with either option for even the lowest battery cost estimate. The net cost of CSP-TES varies with configuration, and lower solar multiples coupled with less storage are more attractive at current cost levels, due to high component costs. However, higher solar multiples show a lower net cost using projected future costs for heliostats and thermal storage materials.« less

Army ants dynamically adjust living bridges in response to a cost-benefit trade-off.

PubMed

Reid, Chris R; Lutz, Matthew J; Powell, Scott; Kao, Albert B; Couzin, Iain D; Garnier, Simon

2015-12-08

The ability of individual animals to create functional structures by joining together is rare and confined to the social insects. Army ants (Eciton) form collective assemblages out of their own bodies to perform a variety of functions that benefit the entire colony. Here we examine ‟bridges" of linked individuals that are constructed to span gaps in the colony's foraging trail. How these living structures adjust themselves to varied and changing conditions remains poorly understood. Our field experiments show that the ants continuously modify their bridges, such that these structures lengthen, widen, and change position in response to traffic levels and environmental geometry. Ants initiate bridges where their path deviates from their incoming direction and move the bridges over time to create shortcuts over large gaps. The final position of the structure depended on the intensity of the traffic and the extent of path deviation and was influenced by a cost-benefit trade-off at the colony level, where the benefit of increased foraging trail efficiency was balanced by the cost of removing workers from the foraging pool to form the structure. To examine this trade-off, we quantified the geometric relationship between costs and benefits revealed by our experiments. We then constructed a model to determine the bridge location that maximized foraging rate, which qualitatively matched the observed movement of bridges. Our results highlight how animal self-assemblages can be dynamically modified in response to a group-level cost-benefit trade-off, without any individual unit's having information on global benefits or costs.

Classification of upper limb disability levels of children with spastic unilateral cerebral palsy using K-means algorithm.

PubMed

Raouafi, Sana; Achiche, Sofiane; Begon, Mickael; Sarcher, Aurélie; Raison, Maxime

2018-01-01

Treatment for cerebral palsy depends upon the severity of the child's condition and requires knowledge about upper limb disability. The aim of this study was to develop a systematic quantitative classification method of the upper limb disability levels for children with spastic unilateral cerebral palsy based on upper limb movements and muscle activation. Thirteen children with spastic unilateral cerebral palsy and six typically developing children participated in this study. Patients were matched on age and manual ability classification system levels I to III. Twenty-three kinematic and electromyographic variables were collected from two tasks. Discriminative analysis and K-means clustering algorithm were applied using 23 kinematic and EMG variables of each participant. Among the 23 kinematic and electromyographic variables, only two variables containing the most relevant information for the prediction of the four levels of severity of spastic unilateral cerebral palsy, which are fixed by manual ability classification system, were identified by discriminant analysis: (1) the Falconer index (CAI E ) which represents the ratio of biceps to triceps brachii activity during extension and (2) the maximal angle extension (θ Extension,max ). A good correlation (Kendall Rank correlation coefficient = -0.53, p = 0.01) was found between levels fixed by manual ability classification system and the obtained classes. These findings suggest that the cost and effort needed to assess and characterize the disability level of a child can be further reduced.

The correlated evolution of antipredator defences and brain size in mammals

PubMed Central

Romero, Ashly N.

2017-01-01

Mammals that possess elaborate antipredator defences such as body armour, spines and quills are usually well protected, intermediate in size, primarily insectivorous and live in simple open environments. The benefits of such defences seem clear and may relax selection on maintaining cognitive abilities that aid in vigilance and predator recognition, and their bearers may accrue extensive production and maintenance costs. Here, in this comparative phylogenetic analysis of measurements of encephalization quotient and morphological defence scores of 647 mammal species representing nearly every order, we found that as lineages evolve stronger defences, they suffer a correlated reduction in encephalization. The only exceptions were those that live in trees—a complex three-dimensional world probably requiring greater cognitive abilities. At the proximate level, because brain tissue is extremely energetically expensive to build, mammals may be trading off spending more on elaborate defences and saving by building less powerful brains. At the ultimate level, having greater defences may also reduce the need for advanced cognitive abilities for constant assessment of environmental predation risk, especially in simple open environments. PMID:28077771

The correlated evolution of antipredator defences and brain size in mammals.

PubMed

Stankowich, Theodore; Romero, Ashly N

2017-01-11

Mammals that possess elaborate antipredator defences such as body armour, spines and quills are usually well protected, intermediate in size, primarily insectivorous and live in simple open environments. The benefits of such defences seem clear and may relax selection on maintaining cognitive abilities that aid in vigilance and predator recognition, and their bearers may accrue extensive production and maintenance costs. Here, in this comparative phylogenetic analysis of measurements of encephalization quotient and morphological defence scores of 647 mammal species representing nearly every order, we found that as lineages evolve stronger defences, they suffer a correlated reduction in encephalization. The only exceptions were those that live in trees-a complex three-dimensional world probably requiring greater cognitive abilities. At the proximate level, because brain tissue is extremely energetically expensive to build, mammals may be trading off spending more on elaborate defences and saving by building less powerful brains. At the ultimate level, having greater defences may also reduce the need for advanced cognitive abilities for constant assessment of environmental predation risk, especially in simple open environments. © 2017 The Author(s).

Adult age differences in task switching.

PubMed

Kray, J; Lindenberger, U

2000-03-01

Age differences in 2 components of task-set switching speed were investigated in 118 adults aged 20 to 80 years using task-set homogeneous (e.g., AAAA ...) and task-set heterogeneous (e.g., AABBAABB ... ) blocks. General switch costs were defined as latency differences between heterogeneous and homogeneous blocks. whereas specific switch costs were defined as differences between switch and nonswitch trials within heterogeneous blocks. Both types of costs generalized over verbal, figural, and numeric stimulus materials; were more highly correlated to fluid than to crystallized abilities; and were not eliminated after 6 sessions of practice, indicating that they reflect basic and domain-general aspects of cognitive control. Most important, age-associated increments in costs were significantly greater for general than for specific switch costs, suggesting that the ability to efficiently maintain and coordinate 2 alternating task sets in working memory instead of 1 is more negatively affected by advancing age than the ability to execute the task switch itself.

A hedging point strategy--balancing effluent quality, economy and robustness in the control of wastewater treatment plants.

PubMed

Ingildsen, P; Olsson, G; Yuan, Z

2002-01-01

An operational space map is an efficient tool to compare a large number of operational strategies to find an optimal choice of setpoints based on a multicriterion. Typically, such a multicriterion includes a weighted sum of cost of operation and effluent quality. Due to the relative high cost of aeration such a definition of optimality result in a relatively high fraction of the effluent total nitrogen in the form of ammonium. Such a strategy may however introduce a risk into operation because a low degree of ammonium removal leads to a low amount of nitrifiers. This in turn leads to a reduced ability to reject event disturbances, such as large variations in the ammonium load, drop in temperature, the presence of toxic/inhibitory compounds in the influent etc. Hedging is a risk minimisation tool, with the aim to "reduce one's risk of loss on a bet or speculation by compensating transactions on the other side" (The Concise Oxford Dictionary (1995)). In wastewater treatment plant operation hedging can be applied by choosing a higher level of ammonium removal to increase the amount of nitrifiers. This is a sensible way to introduce disturbance rejection ability into the multi criterion. In practice, this is done by deciding upon an internal effluent ammonium criterion. In some countries such as Germany, a separate criterion already applies to the level of ammonium in the effluent. However, in most countries the effluent criterion applies to total nitrogen only. In these cases, an internal effluent ammonium criterion should be selected in order to secure proper disturbance rejection ability.

An effort to assess the relation between productivity loss costs and presenteeism at work.

PubMed

Vänni, Kimmo; Neupane, Subas; Nygård, Clas-Håkan

2017-03-01

This study assesses potential presenteeism costs and the association of these with a company's business figures. We conducted the questionnaire surveys in alternate years between 2003 and 2007 and linked them to sickness absence register data. Perceived work ability levels were assessed and converted into presenteeism days using the Presenteeism Scale tool. Sickness absence and presenteeism days were converted into monetary figures using median monthly salary information. The share of presenteeism costs was constant at about 1% of annual turnover and about 3.7% of personnel costs. The lowest annual presenteeism cost per employee was EUR 986 and the highest was EUR 1302. The lowest number of presenteeism days per employee in a year was 8.7 days and the highest number was 10.4 days. Estimated losses to a company due to sickness absences and presenteeism ranged from EUR 4.6 million to EUR 5.6 million annually. The potential presenteeism costs to the company and to Finnish society were vast. Presenteeism is a costly problem but more research is needed to reveal the connections between presenteeism and a company's turnover, personnel costs and profit.

Cost/Effort Drivers and Decision Analysis

NASA Technical Reports Server (NTRS)

Seidel, Jonathan

2010-01-01

Engineering trade study analyses demand consideration of performance, cost and schedule impacts across the spectrum of alternative concepts and in direct reference to product requirements. Prior to detailed design, requirements are too often ill-defined (only goals ) and prone to creep, extending well beyond the Systems Requirements Review. Though lack of engineering design and definitive requirements inhibit the ability to perform detailed cost analyses, affordability trades still comprise the foundation of these future product decisions and must evolve in concert. This presentation excerpts results of the recent NASA subsonic Engine Concept Study for an Advanced Single Aisle Transport to demonstrate an affordability evaluation of performance characteristics and the subsequent impacts on engine architecture decisions. Applying the Process Based Economic Analysis Tool (PBEAT), development cost, production cost, as well as operation and support costs were considered in a traditional weighted ranking of the following system-level figures of merit: mission fuel burn, take-off noise, NOx emissions, and cruise speed. Weighting factors were varied to ascertain the architecture ranking sensitivities to these performance figures of merit with companion cost considerations. A more detailed examination of supersonic variable cycle engine cost is also briefly presented, with observations and recommendations for further refinements.

An Analysis of the Cost and Performance of Photovoltaic Systems as a Function of Module Area

DOE Office of Scientific and Technical Information (OSTI.GOV)

Horowitz, Kelsey A.W.; Fu, Ran; Silverman, Tim

We investigate the potential effects of module area on the cost and performance of photovoltaic systems. Applying a bottom-up methodology, we analyzed the costs associated with mc-Si and thin-film modules and systems as a function of module area. We calculate a potential for savings of up to $0.04/W, $0.10/W, and $0.13/W in module manufacturing costs for mc-Si, CdTe, and CIGS respectively, with large area modules. We also find that an additional $0.05/W savings in balance-of-systems costs may be achieved. However, these savings are dependent on the ability to maintain efficiency and manufacturing yield as area scales. Lifetime energy yield mustmore » also be maintained to realize reductions in the levelized cost of energy. We explore the possible effects of module size on efficiency and energy production, and find that more research is required to understand these issues for each technology. Sensitivity of the $/W cost savings to module efficiency and manufacturing yield is presented. We also discuss non-cost barriers to adoption of large area modules.« less

Ability grouping of gifted students: effects on academic self-concept and boredom.

PubMed

Preckel, Franzis; Götz, Thomas; Frenzel, Anne

2010-09-01

Securing appropriate challenge or preventing boredom is one of the reasons frequently used to justify ability grouping of gifted students, which has been shown to have beneficial effects for achievement. On the other hand, critics stress psychosocial costs, such as detrimental effects on academic self-concept (contrast or big-fish-little-pond effect). The effects of full-time ability grouping in special classrooms for the gifted on students' academic self-concept and their experience of boredom in mathematics classes were investigated. The sample comprised 186 ninth-grade students (106 male) from eight classes at one Austrian high school. Four of these classes were part of a gifted track beginning from school year 9 on (N=93). Students were assessed repeatedly within the first half of the school year, three times via self-report questionnaires and once by applying a standardized IQ-test. Students in gifted classes reported a decrease in maths academic self-concept which was most pronounced early in the academic year. Interventions to counterbalance the negative effect of exposure to a high-ability reference group should therefore be implemented when ability grouping begins. No evidence for the boredom hypothesis was found (higher levels of boredom among gifted students in regular classes). However, students clearly differed in the reasons they stated for experiencing boredom. Boredom attributions changed over time and supported the assumption that gifted classes provide more appropriate levels of challenge.

Effects of Agent Transparency on Multi-Robot Management Effectiveness

DTIC Science & Technology

2015-09-01

capacity was found to be a significant predictor of participants’ trust in the agent. Individual differences in spatial ability accounted for...Another concern regarding autonomous systems is operator workload, which is the cost of performing a task that reduces an individual’s ability to complete...more elaborate and costly strategy that cost additional time (Clark et al. 2011). We hypothesize, therefore, that action GE will be associated with

Strain-induced bi-thermoelectricity in tapered carbon nanotubes

NASA Astrophysics Data System (ADS)

Algharagholy, L. A. A.; Pope, T.; Lambert, C. J.

2018-03-01

We show that carbon-based nanostructured materials are a novel testbed for controlling thermoelectricity and have the potential to underpin the development of new cost-effective environmentally-friendly thermoelectric materials. In single-molecule junctions, it is known that transport resonances associated with the discrete molecular levels play a key role in the thermoelectric performance, but such resonances have not been exploited in carbon nanotubes (CNTs). Here we study junctions formed from tapered CNTs and demonstrate that such structures possess transport resonances near the Fermi level, whose energetic location can be varied by applying strain, resulting in an ability to tune the sign of their Seebeck coefficient. These results reveal that tapered CNTs form a new class of bi-thermoelectric materials, exhibiting both positive and negative thermopower. This ability to change the sign of the Seebeck coefficient allows the thermovoltage in carbon-based thermoelectric devices to be boosted by placing CNTs with alternating-sign Seebeck coefficients in tandem.

Future Missions for Space Weather Specifications and Forecasts

NASA Astrophysics Data System (ADS)

Onsager, T. G.; Biesecker, D. A.; Anthes, R. A.; Maier, M. W.; Gallagher, F. W., III; St Germain, K.

2017-12-01

The progress of technology and the global integration of our economic and security infrastructures have introduced vulnerabilities to space weather that demand a more comprehensive ability to specify and to predict the dynamics of the space environment. This requires a comprehensive network of real-time space-based and ground-based observations with long-term continuity. In order to determine the most cost effective space architectures for NOAA's weather, space weather, and environmental missions, NOAA conducted the NOAA Satellite Observing System Architecture (NSOSA) study. This presentation will summarize the process used to document the future needs and the relative priorities for NOAA's operational space-based observations. This involves specifying the most important observations, defining the performance attributes at different levels of capability, and assigning priorities for achieving the higher capability levels. The highest priority observations recommended by the Space Platform Requirements Working Group (SPRWG) for improvement above a minimal capability level will be described. Finally, numerous possible satellite architectures have been explored to assess the costs and benefits of various architecture configurations.

Dynamic cost shifting in hospitals: evidence from the 1980s and 1990s.

PubMed

Clement, J P

The purpose of this paper is to determine whether dynamic cost shifting occurred among acute care hospitals during the period from the early 1980s to the early 1990s and, if so, whether market factors affected the ability to shift costs. Evidence from this study of California acute care hospitals during three time intervals shows that the hospital did practice dynamic cost shifting, but that their ability to shift costs decreased over time. Surprisingly, hospital competition and HMO penetration did not influence cost shifting. However, increasing HMO penetration (measured as the HMO percentage of hospital discharges) did decrease both net prices and costs for the early part of the study, but later was associated with increases in both.

The impact of orthopaedic research evidence on health financing in Australia.

PubMed

Hua, Martin; Myers, Daniel; Host, Lachlan

2018-05-02

In Australia, approval by the Medical Services Advisory Committee (MSAC) is an important step in the implementation of new health technologies. The MSAC considers health technology assessments (HTA) when submitting a recommendation to the Minister of Health on a new technology's suitability for public funding. Despite being such a critical tool in formulating policy, there has been little scrutiny on the impact of limited evidence on the performance of a national HTA agency's mandate. We aim to determine the proportion of HTAs of orthopaedic technologies prepared for the MSAC that were supported by higher levels of evidence for effectiveness, and whether this affected the MSAC's ability to conclude on efficacy. We also investigated whether the availability of higher level evidence affected the performance of cost-effectiveness analyses. We performed a cohort study of all HTAs prepared for the MSAC from 1998 to 2017 with regards to new technologies in orthopaedic surgery. We identified seven HTAs encompassing nine orthopaedic technologies for inclusion. Higher levels of evidence were available for assessing the technology's effectiveness in six out of the nine technologies. The results did not show a statistically significant relationship between the availability of higher level evidence and MSAC's ability to make a clear conclusion on the assessment of effectiveness (P = 0.5). The proportion of HTAs where a cost-effectiveness analysis was performed was significantly higher (P < 0.05) when higher levels of evidence were available for the assessment of effectiveness. The results indicate that there is a paucity of high quality evidence in the formulation of health policy with regards to the implementation of new orthopaedic technologies in the public healthcare system. This represents an opportunity for strong leadership from surgeons to help develop the tools needed for effective clinical decision-making.

Developing a tool to measure pharmacoeconomic outcomes of post-surgical pain management interventions.

PubMed

Keller, Deborah S; Smalarz, Amy; Haas, Eric M

2016-01-01

Financial pressures have limited the ability of providers to use medication that may improve clinical outcomes and patient satisfaction. New interventions are often fraught with resistance from individual cost centers. A value realization tool (VRT) is essential for separate cost centers to communicate and comprehend the overall financial and clinical implications of post-surgical pain management medication interventions (PSMI). The goal was to describe development of a VRT. An evaluation of common in-patient PSMI approaches, impacts, and costs was performed. A multidisciplinary task force guided development of the VRT to ensure appropriate representation and relevance to clinical practice. The main outcome was an Excel-based tool that communicates the overall cost/benefit of PSMI for the post-operative patient encounter. The VRT aggregated input data on costs, clinical impact, and nursing burden of PSMI assessment and monitoring into two high-level outcome reports: Overall Cost Impact and Nurse & Patient Impact. Costs included PSMI specific medication, equipment, professional placement, labor, overall/opioid-related adverse events, re-admissions, and length of stay. Nursing impact included level of practice interference, job satisfaction, and patient care metrics. Patient impact included pain scores, opioid use, PACU time, and satisfaction. Reference data was provided for individual institutions that may not collect all variables included in the VRT. The VRT is a valuable way for administrators to assess PSMI cost/benefits and for individual cost centers to see the overall value of individual interventions. The user-friendly, decision-support tool allows the end-user to use built-in referenced or personalized outcome data, increasing relevance to their institutions. This broad picture could facilitate communication across cost centers and evidence-based decisions for appropriate use and impacts of PSMI.

Perceived work ability, quality of life, and fatigue in patients with rheumatoid arthritis after a 6-month course of TNF inhibitors: prospective intervention study and partial economic evaluation.

PubMed

Hoving, J L; Bartelds, G M; Sluiter, J K; Sadiraj, K; Groot, I; Lems, W F; Dijkmans, B A C; Wijbrandts, C A; Tak, P P; Nurmohamed, M T; Voskuyl, A E; Frings-Dresen, M H W

2009-01-01

The objective of this exploratory study was to evaluate the effects and costs of a 6-month course of tumour necrosis factor (TNF) inhibitors on work ability, quality of life, and fatigue in patients with rheumatoid arthritis (RA). In this prospective single-arm intervention study 59 consecutive patients of working age with established RA were recruited from an outpatient clinic in Amsterdam, the Netherlands. All patients received fortnightly subcutaneous injections of 40 mg adalimumab. The three outcomes at baseline and 6 months were: perceived work ability [Work Ability Index (WAI)], quality of life [Rheumatoid Arthritis Quality of Life instrument (RAQoL)], and fatigue [Checklist Individual Strength (CIS), Need for Recovery (NFR) scale]. Cost data of the preceding 6 months were collected using a self-administered patient questionnaire at baseline and follow-up. At 6 months, all outcomes showed a statistically significant improvement in mean scores from baseline, ranging from 10.0% (WAI), to 11.7% (RAQoL), to 15% (NFR) (subgroup paid work, n = 26). The total mean costs showed a twofold increase in mean costs per week per patient [difference EUR 169, 95% confidence interval (CI) EUR 113-226]. In this short-term exploratory evaluation, a 6-month course of TNF inhibitors improved work ability and quality of life, and reduced fatigue in patients with established RA. These effects are associated with an increase in total healthcare costs, attributable to the costs of TNF inhibitors. Randomized controlled trials with a longer follow-up are needed to show a long-term effect on work disability and the potential cost-effectiveness of TNF inhibitors.

Der Patient als Experte.

PubMed

Dubs

1998-01-01

Patients as Experts: Determining Benefit by Using Assessments of Ability (ICIDH)When health economy and quality mangement are dealing with the cost-benefit relationship, to this day description, calculation, and assessment of the benefit are missing to a great extent. Deliberations in terms of cause and effect do not go beyond the model of pathogenesis (etiology - pathology - manifestation) and descriptions on the organ level (ICD). Only the international classification of impairments, disabilities, and handicaps (ICIDH) as a separate estimation of the resulting manifestations of illness on the levels of organ, individual, and society is capable to elucidate this benefit. It is the patient who is the expert to decide what he needs, what he wants, and what he can do, thus, evaluating on an individual level his loss of capability. The ICIDH is regarded as the key for the management of chronic diseases. The characteristics of being chronically ill require the integration of salutogenesis and the consideration of the hierarchy of needs. The specially developed MARA model serves as pragmatic basis for the description of the benefits of carried out and omitted interventions as changes of abilities by using the MARA curve (mean age-related ability) as ethical guideline. In quality circles the MARA model, which is based on ICIDH, hierarchy of needs and salutogenesis, can offer apatient-oriented basis of discussion for benefit assessments, and, in a pragmatical way, it can facilitate the introduction of evidence-based medicine. By the change of view from the organ level with multifactorial aspects to the individual level, in which the abilities can be understood as a monofactor, a high consensus potential between several participants of discussion in health service is possible.

Sex differences in cognitive ageing: testing predictions derived from life-history theory in a dioecious nematode.

PubMed

Zwoinska, Martyna K; Kolm, Niclas; Maklakov, Alexei A

2013-12-01

Life-history theory maintains that organisms allocate limited resources to different traits to maximize fitness. Learning ability and memory are costly and known to trade-off with longevity in invertebrates. However, since the relationship between longevity and fitness often differs between the sexes, it is likely that sexes will differentially resolve the trade-off between learning and longevity. We used an established associative learning paradigm in the dioecious nematode Caenorhabditis remanei, which is sexually dimorphic for lifespan, to study age-related learning ability in males and females. In particular, we tested the hypothesis that females (the shorter-lived sex) show higher learning ability than males early in life but senesce faster. Indeed, young females outperformed young males in learning a novel association between an odour (butanone) and food (bacteria). However, while learning ability and offspring production declined rapidly with age in females, males maintained high levels of these traits until mid-age. These results not only demonstrate sexual dimorphism in age-related learning ability but also suggest that it conforms to predictions derived from the life-history theory. © 2013.

Standard cost elements for technology programs

NASA Technical Reports Server (NTRS)

Christensen, Carisa B.; Wagenfuehrer, Carl

1992-01-01

The suitable structure for an effective and accurate cost estimate for general purposes is discussed in the context of a NASA technology program. Cost elements are defined for research, management, and facility-construction portions of technology programs. Attention is given to the mechanisms for insuring the viability of spending programs, and the need for program managers is established for effecting timely fund disbursement. Formal, structures, and intuitive techniques are discussed for cost-estimate development, and cost-estimate defensibility can be improved with increased documentation. NASA policies for cash management are examined to demonstrate the importance of the ability to obligate funds and the ability to cost contracted funds. The NASA approach to consistent cost justification is set forth with a list of standard cost-element definitions. The cost elements reflect the three primary concerns of cost estimates: the identification of major assumptions, the specification of secondary analytic assumptions, and the status of program factors.

Brain size is correlated with endangerment status in mammals.

PubMed

Abelson, Eric S

2016-02-24

Increases in relative encephalization (RE), brain size after controlling for body size, comes at a great metabolic cost and is correlated with a host of cognitive traits, from the ability to count objects to higher rates of innovation. Despite many studies examining the implications and trade-offs accompanying increased RE, the relationship between mammalian extinction risk and RE is unknown. I examine whether mammals with larger levels of RE are more or less likely to be at risk of endangerment than less-encephalized species. I find that extant species with large levels of encephalization are at greater risk of endangerment, with this effect being strongest in species with small body sizes. These results suggest that RE could be a valuable asset in estimating extinction vulnerability. Additionally, these findings suggest that the cost-benefit trade-off of RE is different in large-bodied species when compared with small-bodied species. © 2016 The Author(s).

Evolution of mate-harm, longevity and behaviour in male fruit flies subjected to different levels of interlocus conflict.

PubMed

Nandy, Bodhisatta; Gupta, Vanika; Sen, Sharmi; Udaykumar, Niveda; Samant, Manas Arun; Ali, Syed Zeeshan; Prasad, Nagaraj Guru

2013-09-28

Interlocus conflict predicts (a) evolution of traits, beneficial to males but detrimental to females and (b) evolution of aging and life-span under the influence of the cost of bearing these traits. However, there are very few empirical investigations shedding light on these predictions. Those that do address these issues, mostly reported response of male reproductive traits or the lack of it and do not address the life-history consequence of such evolution. Here, we test both the above mentioned predictions using experimental evolution on replicate populations of Drosophila melanogaster. We present responses observed after >45 generations of altered levels of interlocus conflict (generated by varying the operational sex ratio). Males from the male biased (high conflict, M-regime) regime evolved higher spontaneous locomotor activity and courtship frequency. Females exposed to these males were found to have higher mortality rate. Males from the female biased regime (low conflict, F-regime) did not evolve altered courtship frequency and activity. However, progeny production of females continuously exposed to F-males was significantly higher than the progeny production of females exposed to M-males indicating that the F-males are relatively benign towards their mates. We found that males from male biased regime lived shorter compared to males from the female biased regime. F-males (evolving under lower levels of sexual conflict) evolved decreased mate harming ability indicating the cost of maintenance of the suit of traits that cause mate-harm. The M-males (evolving under higher levels sexual conflict) caused higher female mortality indicating that they had evolved increased mate harming ability, possibly as a by product of increased reproduction related activity. There was a correlated evolution of life-history of the M and F-males. M-regime males lived shorter compared to the males from F-regime, possibly due to the cost of investing more in reproductive traits. In combination, these results suggest that male reproductive traits and life-history traits can evolve in response to the altered levels of interlocus sexual conflict.

FM 100-11 Force Integration

DTIC Science & Technology

1998-01-01

formed or available at an Army installation. It as- sesses both the quantity and quality of service deliv- ery, such as how much service is provided...34 That is, determining how much should it cost to provide services to cus- tomers to maintain a given level of quality and still satisfy their needs. d...ence, and ability to sustain the force (judgmental). (9) Quality of soldier and family support services (judgmental). (10) Civilian and military

A measurement system for large, complex software programs

NASA Technical Reports Server (NTRS)

Rone, Kyle Y.; Olson, Kitty M.; Davis, Nathan E.

1994-01-01

This paper describes measurement systems required to forecast, measure, and control activities for large, complex software development and support programs. Initial software cost and quality analysis provides the foundation for meaningful management decisions as a project evolves. In modeling the cost and quality of software systems, the relationship between the functionality, quality, cost, and schedule of the product must be considered. This explicit relationship is dictated by the criticality of the software being developed. This balance between cost and quality is a viable software engineering trade-off throughout the life cycle. Therefore, the ability to accurately estimate the cost and quality of software systems is essential to providing reliable software on time and within budget. Software cost models relate the product error rate to the percent of the project labor that is required for independent verification and validation. The criticality of the software determines which cost model is used to estimate the labor required to develop the software. Software quality models yield an expected error discovery rate based on the software size, criticality, software development environment, and the level of competence of the project and developers with respect to the processes being employed.

Achieving a Launch on Demand Capability

NASA Astrophysics Data System (ADS)

Greenberg, Joel S.

2002-01-01

The ability to place payloads [satellites] into orbit as and when required, often referred to as launch on demand, continues to be an elusive and yet largely unfulfilled goal. But what is the value of achieving launch on demand [LOD], and what metrics are appropriate? Achievement of a desired level of LOD capability must consider transportation system thruput, alternative transportation systems that comprise the transportation architecture, transportation demand, reliability and failure recovery characteristics of the alternatives, schedule guarantees, launch delays, payload integration schedules, procurement policies, and other factors. Measures of LOD capability should relate to the objective of the transportation architecture: the placement of payloads into orbit as and when required. Launch on demand capability must be defined in probabilistic terms such as the probability of not incurring a delay in excess of T when it is determined that it is necessary to place a payload into orbit. Three specific aspects of launch on demand are considered: [1] the ability to recover from adversity [i.e., a launch failure] and to keep up with the steady-state demand for placing satellites into orbit [this has been referred to as operability and resiliency], [2] the ability to respond to the requirement to launch a satellite when the need arises unexpectedly either because of an unexpected [random] on-orbit satellite failure that requires replacement or because of the sudden recognition of an unanticipated requirement, and [3] the ability to recover from adversity [i.e., a launch failure] during the placement of a constellation into orbit. The objective of this paper is to outline a formal approach for analyzing alternative transportation architectures in terms of their ability to provide a LOD capability. The economic aspect of LOD is developed by establishing a relationship between scheduling and the elimination of on-orbit spares while achieving the desired level of on-orbit availability. Results of an analysis are presented. The implications of launch on demand are addressed for each of the above three situations and related architecture performance metrics and computer simulation models are described that may be used to evaluate the implications of architecture and policy changes in terms of LOD requirements. The models and metrics are aimed at providing answers to such questions as: How well does a specified space transportation architecture respond to satellite launch demand and changes thereto? How well does a normally functioning and apparently architecture respond to unanticipated needs? What is the effect of a modification to the architecture on its ability to respond to satellite launch demand, including responding to unanticipated needs? What is the cost of the architecture [including facilities, operations, inventory, and satellites]? What is the sensitivity of overall architecture effectiveness and cost to various transportation system delays? What is the effect of adding [or eliminating] a launch vehicle or family of vehicles to [from] the architecture on its effectiveness and cost? What is the value of improving launch vehicle and satellite compatibility and what are the effects on probability of delay statistics and cost of designing for multi-launch vehicle compatibility

Does multidisciplinary rehabilitation of tortured refugees represent 'value-for-money'? A follow-up of a Danish case-study.

PubMed

Bager, Line; Hansen, Kristian Schultz; Andersen, Carit Jacques; Wang, Shr-Jie

2018-05-18

The recent surge of asylum seekers in the European Union (EU) is raising questions about the EU's ability to integrate newcomers into the economy and into society; particularly those who need specialized services for the treatment of severe trauma. This study investigated whether rehabilitating traumatised refugees represents 'value-for-money' (VfM) in terms of intervention cost per health gain and in a long-term and societal perspective. The economic evaluation comprised a cost-utility analysis (CUA) and a partial cost-benefit analysis (CBA). The CUA incorporated data on Quality Adjusted Life Years (QALY) for 45 patients who were treated at the Rehabilitation and Research Centre for Torture Victims, Copenhagen, Denmark, in 2001-2004 and followed for up to 2 years, to determine the incremental cost effectiveness ratio (ICER). For the CBA, data was collected for 44 patients who completed treatment between 2001 and 2004 and 44 matched controls on the waiting list, for the patients' primary health care utilisation, and personal and family labour income from 2001 to 2014. This was analysed to evaluate the Net Social Benefit (NSB) of the programme. The average cost of treatment was found to be about 32,000 USD per patient (2016 prices) with an average gain in QALY of 0.82. The treatment was cost effective according to the ICER threshold suggested by the National Institute of Health and Care Excellence (UK). At the individual level, the NSB remained negative throughout the study period. However, at the family income level the intervention proved to have been beneficial after 3 years. The implication of the study is, that providing rehabilitation to severely traumatised refugee families can be an economically viable strategy, considering the economic effects observed at the family level.

Costs of introducing and delivering HPV vaccines in low and lower middle income countries: inputs for GAVI policy on introduction grant support to countries.

PubMed

Levin, Ann; Wang, Susan A; Levin, Carol; Tsu, Vivien; Hutubessy, Raymond

2014-01-01

In November 2011, the GAVI Alliance made the decision to add HPV vaccine as one of the new vaccines for which countries eligible for its funding (less than $1520 per capita income) could apply to receive support for national HPV vaccination, provided they could demonstrate the ability to deliver HPV vaccines. This paper describes the data and analysis shared with GAVI policymakers for this decision regarding GAVI HPV vaccine support. The paper reviews why strategies and costs for HPV vaccine delivery are different from other vaccines and what is known about the cost components from available data that originated primarily from HPV vaccine delivery costing studies in low and middle income-countries. Financial costs of HPV vaccine delivery were compared across three sources of data: 1) vaccine delivery costing of pilot projects in five low and lower-middle income countries; 2) cost estimates of national HPV vaccination in two low income countries; and 3) actual expenditure data from national HPV vaccine introduction in a low income country. Both costs of resources required to introduce the vaccine (or initial one-time investment, such as cold chain equipment purchases) and recurrent (ongoing costs that repeat every year) costs, such as transport and health personnel time, were analyzed. The cost per dose, cost per fully immunized girl (FIG) and cost per eligible girl were compared across studies. Costs varied among pilot projects and estimates of national programs due to differences in scale and service delivery strategy. The average introduction costs per fully immunized girl ranged from $1.49 to $18.94 while recurrent costs per girl ranged from $1.00 to $15.69, with both types of costs varying by delivery strategy and country. Evaluating delivery costs along programme characteristics as well as country characteristics (population density, income/cost level, existing service delivery infrastructure) are likely the most informative and useful for anticipating costs for HPV vaccine delivery. This paper demonstrates the importance of country level cost data to inform global donor policies for vaccine introduction support. Such data are also valuable for informing national decisions on HPV vaccine introduction.

Eastern Renewable Generation Integration Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bloom, Aaron; Townsend, Aaron; Palchak, David

2016-08-01

The Eastern Interconnection (EI) is one of the largest power systems in the world, and its size and complexity have historically made it difficult to study in high levels of detail in a modeling environment. In order to understand how this system might be impacted by high penetrations (30% of total annual generation) of wind and solar photovoltaic (PV) during steady state operations, the National Renewable Energy Laboratory (NREL) and the U.S. Department of Energy (DOE) conducted the Eastern Renewable Generation Integration Study (ERGIS). This study investigates certain aspects of the reliability and economic efficiency problem faced by power systemmore » operators and planners. Specifically, the study models the ability to meet electricity demand at a 5-minute time interval by scheduling resources for known ramping events, while maintaining adequate reserves to meet random variation in supply and demand, and contingency events. To measure the ability to meet these requirements, a unit commitment and economic dispatch (UC&ED) model is employed to simulate power system operations. The economic costs of managing this system are presented using production costs, a traditional UC&ED metric that does not include any consideration of long-term fixed costs. ERGIS simulated one year of power system operations to understand regional and sub-hourly impacts of wind and PV by developing a comprehensive UC&ED model of the EI. In the analysis, it is shown that, under the study assumptions, generation from approximately 400 GW of combined wind and PV capacity can be balanced on the transmission system at a 5-minute level. In order to address the significant computational burdens associated with a model of this detail we apply novel computing techniques to dramatically reduce simulation solve time while simultaneously increasing the resolution and fidelity of the analysis. Our results also indicate that high penetrations of wind and PV (collectively variable generation (VG)), significantly impact the operation of traditional generating resources and cause these resources to be used less frequently and operate across a broader output range because wind and PV have lower operating costs and variable output levels.« less

Physiological Costs of Repetitive Courtship Displays in Cockroaches Handicap Locomotor Performance

PubMed Central

Mowles, Sophie L.; Jepson, Natalie M.

2015-01-01

Courtship displays are typically thought to have evolved via female choice, whereby females select mates based on the characteristics of a display that is expected to honestly reflect some aspect of the male’s quality. Honesty is typically enforced by mechanistic costs and constraints that limit the level at which a display can be performed. It is becoming increasingly apparent that these costs may be energetic costs involved in the production of dynamic, often repetitive displays. A female attending to such a display may thus be assessing the physical fitness of a male as an index of his quality. Such assessment would provide information on his current physical quality as well as his ability to carry out other demanding activities, qualities with which a choosy female should want to provision her offspring. In the current study we use courtship interactions in the Cuban burrowing cockroach, Byrsotria fumigata to directly test whether courtship is associated with a signaler’s performance capacity. Males that had produced courtship displays achieved significantly lower speeds and distances in locomotor trials than non-courting control males. We also found that females mated more readily with males that produced a more vigorous display. Thus, males of this species have developed a strategy where they produce a demanding courtship display, while females choose males based on their ability to produce this display. Courtship displays in many taxa often involve dynamic repetitive actions and as such, signals of stamina in courtship may be more widespread than previously thought. PMID:26606147

An accurate cost effective DFT approach to study the sensing behaviour of polypyrrole towards nitrate ions in gas and aqueous phases.

PubMed

Wasim, Fatima; Mahmood, Tariq; Ayub, Khurshid

2016-07-28

Density functional theory (DFT) calculations have been performed to study the response of polypyrrole towards nitrate ions in gas and aqueous phases. First, an accurate estimate of interaction energies is obtained by methods calibrated against the gold standard CCSD(T) method. Then, a number of low cost DFT methods are also evaluated for their ability to accurately estimate the binding energies of polymer-nitrate complexes. The low cost methods evaluated here include dispersion corrected potential (DCP), Grimme's D3 correction, counterpoise correction of the B3LYP method, and Minnesota functionals (M05-2X). The interaction energies calculated using the counterpoise (CP) correction and DCP methods at the B3LYP level are in better agreement with the interaction energies calculated using the calibrated methods. The interaction energies of an infinite polymer (polypyrrole) with nitrate ions are calculated by a variety of low cost methods in order to find the associated errors. The electronic and spectroscopic properties of polypyrrole oligomers nPy (where n = 1-9) and nPy-NO3(-) complexes are calculated, and then extrapolated for an infinite polymer through a second degree polynomial fit. Charge analysis, frontier molecular orbital (FMO) analysis and density of state studies also reveal the sensing ability of polypyrrole towards nitrate ions. Interaction energies, charge analysis and density of states analyses illustrate that the response of polypyrrole towards nitrate ions is considerably reduced in the aqueous medium (compared to the gas phase).

Comparative effectiveness research as choice architecture: the behavioral law and economics solution to the health care cost crisis.

PubMed

Korobkin, Russell

2014-02-01

With the Patient Protection and Affordable Care Act ("ACA") set to dramatically increase access to medical care, the problem of rising costs will move center stage in health law and policy discussions. "Consumer directed health care" proposals, which provide patients with financial incentives to equate marginal costs and benefits of care at the point of treatment, demand more decisionmaking ability from consumers than is plausible due to bounded rationality. Proposals that seek to change the incentives of health care providers threaten to create conflicts of interest between doctors and patients. New approaches are desperately needed. This Article proposes a government-facilitated but market-based approach to improving efficiency in the private market for medical care that I call "relative value health insurance." This approach focuses on the "choice architecture" necessary to enable even boundedly rational patients to contract for an efficient level of health care services through their health insurance purchase decisions. It uses comparative effectiveness research, which the ACA funds at a significant level for the first time, to rate medical treatments on a scale of one to ten based on their relative value, taking into account expected costs and benefits. These relative value ratings would enable consumers to contract with insurers for different levels of medical care at different prices, reflecting different cost-quality trade-offs. The Article describes both the benefits of relative value health insurance and the impediments to its implementation. It concludes with a brief discussion of how relative value ratings could also help to rationalize expenditures on public health insurance programs.

Cost effective alternative to low irradiance measurements

NASA Technical Reports Server (NTRS)

Oleary, Scott T.

1988-01-01

Martin Marietta's Space Simulation Laboratory (SSL) has a Thermal Environment Simulator (TES) with 56 individually controlled heater zones. The TES has a temperature range of approximately minus 129 C to plus 149 C. Because of the ability of TES to provide complex irradiance distributions, it is necessary to be able to measure a wide range of irradiance levels. SSL currently uses ambient temperature controlled radiometers with the capacity to measure sink irradiance levels of approximately 42.6 mw/sq cm, sink temperature equals 21 C and up. These radiometers could not be used to accurately measure the lower irradiance levels of the TES. Therefore, it was necessary to obtain a radiometer or develop techniques which could be used to measure lower irradiance levels.

A user-friendly, open-source tool to project impact and cost of diagnostic tests for tuberculosis

PubMed Central

Dowdy, David W; Andrews, Jason R; Dodd, Peter J; Gilman, Robert H

2014-01-01

Most models of infectious diseases, including tuberculosis (TB), do not provide results customized to local conditions. We created a dynamic transmission model to project TB incidence, TB mortality, multidrug-resistant (MDR) TB prevalence, and incremental costs over 5 years after scale-up of nine alternative diagnostic strategies. A corresponding web-based interface allows users to specify local costs and epidemiology. In settings with little capacity for up-front investment, same-day microscopy had the greatest impact on TB incidence and became cost-saving within 5 years if delivered at $10/test. With greater initial investment, population-level scale-up of Xpert MTB/RIF or microcolony-based culture often averted 10 times more TB cases than narrowly-targeted strategies, at minimal incremental long-term cost. Xpert for smear-positive TB had reasonable impact on MDR-TB incidence, but at substantial price and little impact on overall TB incidence and mortality. This user-friendly modeling framework improves decision-makers' ability to evaluate the local impact of TB diagnostic strategies. DOI: http://dx.doi.org/10.7554/eLife.02565.001 PMID:24898755

An Examination of the United States Navy’s Ability to Conduct Operational Fires

DTIC Science & Technology

1992-05-12

34 18 Thus, the Allied command determined that this attempt was AFFORDABLE or that they had the ability "to manage or bear [the] cost without serious...enhance the situation, but the enormous cost of this project and the time required to generate this data still places a solution years in the future...approach the accuracy enjoyed by more sophisticated overhead imagery systems at a fraction of the cost . The Navy started RPV operations after losing

Use of information systems in Air Force medical treatment facilities in strategic planning and decision-making.

PubMed

Yap, Glenn A; Platonova, Elena A; Musa, Philip F

2006-02-01

An exploratory study used Ansoff's strategic planning model as a framework to assess perceived effectiveness of information systems in supporting strategic business plan development at Air Force medical treatment facilities (MTFs). Results showed information systems were most effective in supporting historical trend analysis, strategic business plans appeared to be a balance of operational and strategic plans, and facilities perceived a greater need for new clinical, vice administrative, information systems to support strategic planning processes. Administrators believed information systems should not be developed at the local level and perceived information systems have the greatest impact on improving clinical quality outcomes, followed by ability to deliver cost effective care and finally, ability to increase market share.

Small Multi-Purpose Research Facility (SMiRF)

NASA Image and Video Library

2015-10-15

NASA Glenn engineer Monica Guzik in the Small Multi-Purpose Research Facility (SMiRF). The facility provides the ability to simulate the environmental conditions encountered in space for a variety of cryogenic applications such as thermal protection systems, fluid transfer operations and propellant level gauging. SMiRF is a low-cost, small-scale screening facility for concept and component testing of a wide variety of hardware and is capable of testing cryogenic hydrogen, oxygen, methane and nitrogen.

Effectiveness of table top water pitcher filters to remove arsenic from drinking water.

PubMed

Barnaby, Roxanna; Liefeld, Amanda; Jackson, Brian P; Hampton, Thomas H; Stanton, Bruce A

2017-10-01

Arsenic contamination of drinking water is a serious threat to the health of hundreds of millions of people worldwide. In the United States ~3 million individuals drink well water that contains arsenic levels above the Environmental Protection Agency (EPA) maximum contaminant level (MCL) of 10μg/L. Several technologies are available to remove arsenic from well water including anion exchange, adsorptive media and reverse osmosis. In addition, bottled water is an alternative to drinking well water contaminated with arsenic. However, there are several drawbacks associated with these approaches including relatively high cost and, in the case of bottled water, the generation of plastic waste. In this study, we tested the ability of five tabletop water pitcher filters to remove arsenic from drinking water. We report that only one tabletop water pitcher filter tested, ZeroWater®, reduced the arsenic concentration, both As 3+ and As 5+ , from 1000μg/L to < 3μg/L, well below the MCL. Moreover, the amount of total dissolved solids or competing ions did not affect the ability of the ZeroWater® filter to remove arsenic below the MCL. Thus, the ZeroWater® pitcher filter is a cost effective and short-term solution to remove arsenic from drinking water and its use reduces plastic waste associated with bottled water. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

A self-adapting heuristic for automatically constructing terrain appreciation exercises

NASA Astrophysics Data System (ADS)

Nanda, S.; Lickteig, C. L.; Schaefer, P. S.

2008-04-01

Appreciating terrain is a key to success in both symmetric and asymmetric forms of warfare. Training to enable Soldiers to master this vital skill has traditionally required their translocation to a selected number of areas, each affording a desired set of topographical features, albeit with limited breadth of variety. As a result, the use of such methods has proved to be costly and time consuming. To counter this, new computer-aided training applications permit users to rapidly generate and complete training exercises in geo-specific open and urban environments rendered by high-fidelity image generation engines. The latter method is not only cost-efficient, but allows any given exercise and its conditions to be duplicated or systematically varied over time. However, even such computer-aided applications have shortcomings. One of the principal ones is that they usually require all training exercises to be painstakingly constructed by a subject matter expert. Furthermore, exercise difficulty is usually subjectively assessed and frequently ignored thereafter. As a result, such applications lack the ability to grow and adapt to the skill level and learning curve of each trainee. In this paper, we present a heuristic that automatically constructs exercises for identifying key terrain. Each exercise is created and administered in a unique iteration, with its level of difficulty tailored to the trainee's ability based on the correctness of that trainee's responses in prior iterations.

Effectiveness of Table Top Water Pitcher Filters to Remove Arsenic from Drinking Water

PubMed Central

Barnaby, Roxanna; Liefeld, Amanda; Jackson, Brian P.; Hampton, Thomas H.; Stanton, Bruce A.

2017-01-01

Arsenic contamination of drinking water is a serious threat to the health of hundreds of millions of people worldwide. In the United States ~3 million individuals drink well water that contains arsenic levels above the Environmental Protection Agency (EPA) maximum contaminant level (MCL) of 10 μg/L. Several technologies are available to remove arsenic from well water including anion exchange, adsorptive media and reverse osmosis. In addition, bottled water is an alternative to drinking well water contaminated with arsenic. However, there are several drawbacks associated with these approaches including relatively high cost and, in the case of bottled water, the generation of plastic waste. In this study, we tested the ability of five tabletop water pitcher filters to remove arsenic from drinking water. We report that only one tabletop water pitcher filter tested, ZeroWater®, reduced the arsenic concentration, both As3+ and As5+, from 1,000 μg/L to < 3 μg/L, well below the MCL. Moreover, the amount of total dissolved solids or competing ions did not affect the ability of the ZeroWater® filter to remove arsenic below the MCL. Thus, the ZeroWater® pitcher filter is a cost effective and short-term solution to remove arsenic from drinking water and its use reduces plastic waste associated with bottled water. PMID:28719869

Rapid assessment of Schistosoma mansoni: the validity, applicability and cost-effectiveness of the Lot Quality Assurance Sampling method in Uganda

PubMed Central

Brooker, Simon; Kabatereine, Narcis B.; Myatt, Mark; Stothard, J. Russell; Fenwick, Alan

2007-01-01

Summary Rapid and accurate identification of communities at highest risk of morbidity from schistosomiasis is key for sustainable control. Although school questionnaires can effectively and inexpensively identify communities with a high prevalence of Schistosoma haematobium, parasitological screening remains the preferred option for S. mansoni. To help reduce screening costs, we investigated the validity of Lot Quality Assurance Sampling (LQAS) in classifying schools according categories of S. mansoni prevalence in Uganda, and explored its applicability and cost-effectiveness. First, we evaluated several sampling plans using computer simulation and then field tested one sampling plan in 34 schools in Uganda. Finally, cost-effectiveness of different screening and control strategies (including mass treatment without prior screening) was determined, and sensitivity analysis undertaken to assess the effect of infection levels and treatment costs. In identifying schools with prevalence ≥50%, computer simulations showed that LQAS had high levels of sensitivity and specificity (>90%) at sample sizes <20. The method also provides an ability to classify communities into three prevalence categories. Field testing showed that LQAS where 15 children were sampled had excellent diagnostic performance (sensitivity: 100%, specificity: 96.4%, positive predictive value: 85.7% and negative predictive value: 92.3%). Screening using LQAS was more cost-effective than mass treating all schools (US$ 218 vs. US$ 482 / high prevalence school treated). Threshold analysis indicated that parasitological screening and mass treatment would become equivalent for settings where prevalence exceeds 50% in 75% of schools and for treatment costs of US$ 0.19 per schoolchild. We conclude that, in Uganda, LQAS provides a rapid, valid, and cost-effective method for guiding decision makers in allocating finite resources for the control of schistosomiasis. PMID:15960703

Rapid assessment of Schistosoma mansoni: the validity, applicability and cost-effectiveness of the Lot Quality Assurance Sampling method in Uganda.

PubMed

Brooker, Simon; Kabatereine, Narcis B; Myatt, Mark; Russell Stothard, J; Fenwick, Alan

2005-07-01

Rapid and accurate identification of communities at highest risk of morbidity from schistosomiasis is key for sustainable control. Although school questionnaires can effectively and inexpensively identify communities with a high prevalence of Schistosoma haematobium, parasitological screening remains the preferred option for S. mansoni. To help reduce screening costs, we investigated the validity of Lot Quality Assurance Sampling (LQAS) in classifying schools according to categories of S. mansoni prevalence in Uganda, and explored its applicability and cost-effectiveness. First, we evaluated several sampling plans using computer simulation and then field tested one sampling plan in 34 schools in Uganda. Finally, cost-effectiveness of different screening and control strategies (including mass treatment without prior screening) was determined, and sensitivity analysis undertaken to assess the effect of infection levels and treatment costs. In identifying schools with prevalences > or =50%, computer simulations showed that LQAS had high levels of sensitivity and specificity (>90%) at sample sizes <20. The method also provides an ability to classify communities into three prevalence categories. Field testing showed that LQAS where 15 children were sampled had excellent diagnostic performance (sensitivity: 100%, specificity: 96.4%, positive predictive value: 85.7% and negative predictive value: 92.3%). Screening using LQAS was more cost-effective than mass treating all schools (US$218 vs. US$482/high prevalence school treated). Threshold analysis indicated that parasitological screening and mass treatment would become equivalent for settings where prevalence > or =50% in 75% of schools and for treatment costs of US$0.19 per schoolchild. We conclude that, in Uganda, LQAS provides a rapid, valid and cost-effective method for guiding decision makers in allocating finite resources for the control of schistosomiasis.

Costs of care in a mild-to-moderate Alzheimer clinical trial sample: key resources and their determinants.

PubMed

Gustavsson, Anders; Cattelin, Francoise; Jönsson, Linus

2011-07-01

Costs of care are frequently included as secondary endpoint in Alzheimer clinical trials because payers demand evidence of the budgetary effects of novel therapies. Future clinical trial protocols can be optimized on the basis of the currently available data, including what are the key resources and how are they correlated to disease severity measures. Primary patient-level data from two 18 months clinical trials of a putative disease modifier in mild-to-moderate Alzheimer's disease (n = 2,744) were analyzed to identify key components of costs of care and their determinants in a clinical trial setting. Costs of care were assessed with the resource utilization in dementia Lite (RUD) instrument, which includes patient accommodation, informal care, community care, and hospitalizations. The contribution of each component to total costs of care and their correlation with one another and key disease severity measures (Alzheimer's Disease Assessment Scale--Cognitive Subscale, Mini-Mental State Examination, Clinical Dementia Rating-Sum of Boxes, Alzheimer's Disease Cooperative Study--Activities of Daily Living Inventory, and Neuropsychiatric Inventory Questionnaire) was explored. Informal care constituted 82% to 86% of the total costs of care over the 18-months trial and community care services and patient accommodation contributed 6% to 8% each. Informal care was positively correlated with hospitalizations but negatively to patient accommodation, indicating that these services are supplements. Informal care also had the strongest pair-wise correlation with key disease severity measures, suggesting a higher chance of identifying a treatment effect on this component. ADL-ability (Alzheimer's Disease Cooperative Study--Activities of Daily Living Inventory) was the strongest predictor of costs of care of all disease severity measures. Informal care is the most important component of costs of care in a mild-to-moderate Alzheimer clinical trial sample, and it is primarily driven by the ADL-ability of the patient. Investigators should focus on the assessment of this economic endpoint because a significant treatment effect on this resource is likely to also affect total costs of care. Copyright © 2011 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Working Memory Capacity is Associated with Optimal Adaptation of Response Bias to Perceptual Sensitivity in Emotion Perception

PubMed Central

Lynn, Spencer K.; Ibagon, Camila; Bui, Eric; Palitz, Sophie A.; Simon, Naomi M.; Barrett, Lisa Feldman

2017-01-01

Emotion perception, inferring the emotional state of another person, is a frequent judgment made under perceptual uncertainty (e.g., a scowling facial expression can indicate anger or concentration) and behavioral risk (e.g., incorrect judgment can be costly to the perceiver). Working memory capacity (WMC), the ability to maintain controlled processing in the face of competing demands, is an important component of many decisions. We investigated the association of WMC and anger perception in a task in which “angry” and “not angry” categories comprised overlapping ranges of scowl intensity, and correct and incorrect responses earned and lost points, respectively. Participants attempted to earn as many points as they could; adopting an optimal response bias would maximize decision utility. Participants with higher WMC more optimally tuned their anger perception response bias to accommodate their perceptual sensitivity (their ability to discriminate the categories) than did participants with lower WMC. Other factors that influence response bias (i.e., the relative base rate of angry vs. not angry faces and the decision costs & benefits) were ruled out as contributors to the WMC-bias relationship. Our results suggest that WMC optimizes emotion perception by contributing to perceivers’ ability to adjust their response bias to account for their level of perceptual sensitivity, likely an important component of adapting emotion perception to dynamic social interactions and changing circumstances. PMID:26461251

Inequality in Human Capital and Endogenous Credit Constraints

PubMed Central

Hai, Rong; Heckman, James J.

2017-01-01

This paper investigates the determinants of inequality in human capital with an emphasis on the role of the credit constraints. We develop and estimate a model in which individuals face uninsured human capital risks and invest in education, acquire work experience, accumulate assets and smooth consumption. Agents can borrow from the private lending market and from government student loan programs. The private market credit limit is explicitly derived by extending the natural borrowing limit of Aiyagari (1994) to incorporate endogenous labor supply, human capital accumulation, psychic costs of working, and age. We quantify the effects of cognitive ability, noncognitive ability, parental education, and parental wealth on educational attainment, wages, and consumption. We conduct counterfactual experiments with respect to tuition subsidies and enhanced student loan limits and evaluate their effects on educational attainment and inequality. We compare the performance of our model with an influential ad hoc model in the literature with education-specific fixed loan limits. We find evidence of substantial life cycle credit constraints that affect human capital accumulation and inequality. The constrained fall into two groups: those who are permanently poor over their lifetimes and a group of well-endowed individuals with rising high levels of acquired skills who are constrained early in their life cycles. Equalizing cognitive and noncognitive ability has dramatic effects on inequality. Equalizing parental backgrounds has much weaker effects. Tuition costs have weak effects on inequality. PMID:28642641

Exploring or Avoiding Novel Food Resources? The Novelty Conflict in an Invasive Bird

PubMed Central

Sol, Daniel; Griffin, Andrea S.; Bartomeus, Ignasi; Boyce, Hayley

2011-01-01

For an animal invading a novel region, the ability to develop new behaviors should facilitate the use of novel food resources and hence increase its survival in the new environment. However, the need to explore new resources may entail costs such as exposing the animal to unfamiliar predators. These two opposing forces result in an exploration-avoidance conflict, which can be expected to interfere with the acquisition of new resources. However, its consequences should be less dramatic in highly urbanized environments where new food opportunities are common and predation risk is low. We tested this hypothesis experimentally by presenting three foraging tasks to introduced common mynas (Acridotheres tristis) from environments with low and high urbanization levels from Australia. Individuals from the highly urbanized environments, where mynas are both more opportunistic when foraging and less fearful to predators, resolved a technical task faster than those from less urbanized environments. These differences did not reflect innovative ‘personalities’ and were not confounded by sex, morphology or motivational state. Rather, the principal factors underlying differences in mynas' problem-solving ability were neophobic-neophilic responses, which varied across habitats. Thus, mynas seem to modulate their problem-solving ability according to the benefits and costs of innovating in their particular habitat, which may help us understand the great success of the species in highly urbanized environments. PMID:21611168

Inequality in Human Capital and Endogenous Credit Constraints.

PubMed

Hai, Rong; Heckman, James J

2017-04-01

This paper investigates the determinants of inequality in human capital with an emphasis on the role of the credit constraints. We develop and estimate a model in which individuals face uninsured human capital risks and invest in education, acquire work experience, accumulate assets and smooth consumption. Agents can borrow from the private lending market and from government student loan programs. The private market credit limit is explicitly derived by extending the natural borrowing limit of Aiyagari (1994) to incorporate endogenous labor supply, human capital accumulation, psychic costs of working, and age. We quantify the effects of cognitive ability, noncognitive ability, parental education, and parental wealth on educational attainment, wages, and consumption. We conduct counterfactual experiments with respect to tuition subsidies and enhanced student loan limits and evaluate their effects on educational attainment and inequality. We compare the performance of our model with an influential ad hoc model in the literature with education-specific fixed loan limits. We find evidence of substantial life cycle credit constraints that affect human capital accumulation and inequality. The constrained fall into two groups: those who are permanently poor over their lifetimes and a group of well-endowed individuals with rising high levels of acquired skills who are constrained early in their life cycles. Equalizing cognitive and noncognitive ability has dramatic effects on inequality. Equalizing parental backgrounds has much weaker effects. Tuition costs have weak effects on inequality.

Need-based activation of ammonium uptake in Escherichia coli

PubMed Central

Kim, Minsu; Zhang, Zhongge; Okano, Hiroyuki; Yan, Dalai; Groisman, Alexander; Hwa, Terence

2012-01-01

The efficient sequestration of nutrients is vital for the growth and survival of microorganisms. Some nutrients, such as CO2 and NH3, are readily diffusible across the cell membrane. The large membrane permeability of these nutrients obviates the need of transporters when the ambient level is high. When the ambient level is low, however, maintaining a high intracellular nutrient level against passive back diffusion is both challenging and costly. Here, we study the delicate management of ammonium (NH4+/NH3) sequestration by E. coli cells using microfluidic chemostats. We find that as the ambient ammonium concentration is reduced, E. coli cells first maximize their ability to assimilate the gaseous NH3 diffusing into the cytoplasm and then abruptly activate ammonium transport. The onset of transport varies under different growth conditions, but always occurring just as needed to maintain growth. Quantitative modeling of known interactions reveals an integral feedback mechanism by which this need-based uptake strategy is implemented. This novel strategy ensures that the expensive cost of upholding the internal ammonium concentration against back diffusion is kept at a minimum. PMID:23010999

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dirske, R.D.; Hauck, P.C.; Kachmar, R.P.

In 1990, the federal government enacted the Clean Air Amendment. This required many public power utilities across the country to make modifications to their fossil fueled power plants to comply with the mandated emission levels by May 1995. At Pennsylvania Electric Company`s (PENELEC) Shawville Station, Units 3 and 4, the mandates established maximum nitrogen oxides (NOx) emission levels at 0.45 lbs/MMBTU. In an effort to comply with the new reduced emission levels, PENELEC chose to implement the Asea Brown Boveri-Combustion Engineering`s (ABB-CE) Low NOx Concentric Firing System III (LNCFS-III). PENELEC also took this opportunity to replace other controls because theirmore » implementation would have relatively little impact on the overall cost of the project and would enhance the ability of the operators to better control NOx emissions. This paper discusses the implementation of the new controls in a distributed control system (DCS), interfacing the DCS with the existing pneumatic combustion controls, and maintaining the boiler control benchboard as the primary operator interface, thereby, reducing the impact of the changes to the MMI and the overall cost of the project.« less

Micro-bias and macro-performance.

PubMed

Seaver, S M D; Moreira, A A; Sales-Pardo, M; Malmgren, R D; Diermeier, D; Amaral, L A N

2009-02-01

We use agent-based modeling to investigate the effect of conservatism and partisanship on the efficiency with which large populations solve the density classification task - a paradigmatic problem for information aggregation and consensus building. We find that conservative agents enhance the populations' ability to efficiently solve the density classification task despite large levels of noise in the system. In contrast, we find that the presence of even a small fraction of partisans holding the minority position will result in deadlock or a consensus on an incorrect answer. Our results provide a possible explanation for the emergence of conservatism and suggest that even low levels of partisanship can lead to significant social costs.

Healthcare technologies, quality improvement programs and hospital organizational culture in Canadian hospitals

PubMed Central

2013-01-01

Background Healthcare technology and quality improvement programs have been identified as a means to influence healthcare costs and healthcare quality in Canada. This study seeks to identify whether the ability to implement healthcare technology by a hospital was related to usage of quality improvement programs within the hospital and whether the culture within a hospital plays a role in the adoption of quality improvement programs. Methods A cross-sectional study of Canadian hospitals was conducted in 2010. The sample consisted of hospital administrators that were selected by provincial review boards. The questionnaire consisted of 3 sections: 20 healthcare technology items, 16 quality improvement program items and 63 culture items. Results Rasch model analysis revealed that a hierarchy existed among the healthcare technologies based upon the difficulty of implementation. The results also showed a significant relationship existed between the ability to implement healthcare technologies and the number of quality improvement programs adopted. In addition, culture within a hospital served a mediating role in quality improvement programs adoption. Conclusions Healthcare technologies each have different levels of difficulty. As a consequence, hospitals need to understand their current level of capability before selecting a particular technology in order to assess the level of resources needed. Further the usage of quality improvement programs is related to the ability to implement technology and the culture within a hospital. PMID:24119419

Cost Analysis of Ceramic Heads in Primary Total Hip Arthroplasty.

PubMed

Carnes, Keith J; Odum, Susan M; Troyer, Jennifer L; Fehring, Thomas K

2016-11-02

The advent of adverse local tissue reactions seen in metal-on-metal bearings, and the recent recognition of trunnionosis, have led many surgeons to recommend ceramic-on-polyethylene articulations for primary total hip arthroplasty. However, to our knowledge, there has been little research that has considered whether the increased cost of ceramic provides enough benefit over cobalt-chromium to justify its use. The primary purpose of this study was to compare the cost-effectiveness of ceramic-on-polyethylene implants and metal-on-polyethylene implants in patients undergoing total hip arthroplasty. Markov decision modeling was used to determine the ceramic-on-polyethylene implant revision rate necessary to be cost-effective compared with the revision rate of metal-on-polyethylene implants across a range of patient ages and implant costs. A different set of Markov models was used to estimate the national cost burden of choosing ceramic-on-polyethylene implants over metal-on-polyethylene implants for primary total hip arthroplasties. The Premier Research Database was used to identify 20,398 patients who in 2012 were ≥45 years of age and underwent a total hip arthroplasty with either a ceramic-on-polyethylene implant or a metal-on-polyethylene implant. The cost-effectiveness of ceramic heads is highly dependent on the cost differential between ceramic and metal femoral heads and the age of the patient. At a cost differential of $325, ceramic-on-polyethylene bearings are cost-effective for patients <85 years of age. At a cost differential of $600, it is cost-effective to utilize ceramic-on-polyethylene bearings in patients <65 years of age, and, at a differential of $1,003, ceramic-on-polyethylene bearings are not cost-effective at any age. The ability to recoup the initial increased expenditure of ceramic heads through a diminished lifetime revision cost is dependent on the price premium for ceramic and the age of the patient. A wholesale switch to ceramic bearings regardless of age or cost differential may result in an economic burden to the health system. Economic and decision analysis, Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

The magnitude and colour of noise in genetic negative feedback systems.

PubMed

Voliotis, Margaritis; Bowsher, Clive G

2012-08-01

The comparative ability of transcriptional and small RNA-mediated negative feedback to control fluctuations or 'noise' in gene expression remains unexplored. Both autoregulatory mechanisms usually suppress the average (mean) of the protein level and its variability across cells. The variance of the number of proteins per molecule of mean expression is also typically reduced compared with the unregulated system, but is almost never below the value of one. This relative variance often substantially exceeds a recently obtained, theoretical lower limit for biochemical feedback systems. Adding the transcriptional or small RNA-mediated control has different effects. Transcriptional autorepression robustly reduces both the relative variance and persistence (lifetime) of fluctuations. Both benefits combine to reduce noise in downstream gene expression. Autorepression via small RNA can achieve more extreme noise reduction and typically has less effect on the mean expression level. However, it is often more costly to implement and is more sensitive to rate parameters. Theoretical lower limits on the relative variance are known to decrease slowly as a measure of the cost per molecule of mean expression increases. However, the proportional increase in cost to achieve substantial noise suppression can be different away from the optimal frontier-for transcriptional autorepression, it is frequently negligible.

A Cost Benefit Analysis Between the Current Naval Officer Retention Bonus Plan and the Enlisted Retention Bonus Plan

DTIC Science & Technology

2016-06-01

that personnel targeted for retention had a direct ability to affect the success of the transaction and company. High potential, job function, job level...and job title rounded out the top five reasons personnel were targeted for retention . In brief, this study found that slightly more than half of...lower income may value the job security provided by service in the military, thus making retention in the military a more attractive option. 4

Loudspeaker Performance Aid

NASA Technical Reports Server (NTRS)

1980-01-01

Many manufacturers of loudspeakers are now using a magnetic liquid cooling agent known as ferrofluid. Commercialized by Ferrofluids Corporation, ferrofluid is a liquid material in which sub-microscopic particles of iron oxide are permanently suspended. Injected into the voice coil segment of speaker system, magnetic liquid serves as superior heat transfer medium for cooling the voice coil, thus substantially increasing the system's ability to handle higher power levels and decreasing chance of speaker failure. Ferrofluid offers several additional advantages which add up to improved speaker performance, lower manufacturing costs and fewer rejects.

Aircraft Transparency Failure and Logistical Cost Analysis - Supplemental Study

DTIC Science & Technology

1979-06-01

trude studies, air logistics centers, A/F operational base level, vFM\\66-1 IDC M,44s, field audits , glazing materials, sealants 26. AOSTRACT (C oInu...W. R. Marshall of Reli- ability; and R. M. Hiyvaw, Mass Properties. The author wishes to thank the field audit contacts in the Air Force, in the...obtained from ALC’s and from field , audits , etc. do provide a data base from which predominant transpar- i ency maintenance problem- can be

Cost Effectiveness of Statin Drug Therapy in the Lowering of Cholesterol in Patients at Dwight D. Eisenhower Army Medical Center

DTIC Science & Technology

2000-05-01

significant increase in the LDL-C levels of patients (p=.113 for atorvastatin to simvastatin conversion, p=.072 for pravastatin to simvastatin conversion...the ability for a patient to reach their LDL-C goal (p=.571 for atorvastatin to simvastatin conversion, p=.579 for pravastatin to simvastatin...two were available under special order criteria ( atorvastatin and fluvastatin) during the period of FY 97 to FY 99. Due to double-digit inflation in the

[Predicting individual risk of high healthcare cost to identify complex chronic patients].

PubMed

Coderch, Jordi; Sánchez-Pérez, Inma; Ibern, Pere; Carreras, Marc; Pérez-Berruezo, Xavier; Inoriza, José M

2014-01-01

To develop a predictive model for the risk of high consumption of healthcare resources, and assess the ability of the model to identify complex chronic patients. A cross-sectional study was performed within a healthcare management organization by using individual data from 2 consecutive years (88,795 people). The dependent variable consisted of healthcare costs above the 95th percentile (P95), including all services provided by the organization and pharmaceutical consumption outside of the institution. The predictive variables were age, sex, morbidity-based on clinical risk groups (CRG)-and selected data from previous utilization (use of hospitalization, use of high-cost drugs in ambulatory care, pharmaceutical expenditure). A univariate descriptive analysis was performed. We constructed a logistic regression model with a 95% confidence level and analyzed sensitivity, specificity, positive predictive values (PPV), and the area under the ROC curve (AUC). Individuals incurring costs >P95 accumulated 44% of total healthcare costs and were concentrated in ACRG3 (aggregated CRG level 3) categories related to multiple chronic diseases. All variables were statistically significant except for sex. The model had a sensitivity of 48.4% (CI: 46.9%-49.8%), specificity of 97.2% (CI: 97.0%-97.3%), PPV of 46.5% (CI: 45.0%-47.9%), and an AUC of 0.897 (CI: 0.892 to 0.902). High consumption of healthcare resources is associated with complex chronic morbidity. A model based on age, morbidity, and prior utilization is able to predict high-cost risk and identify a target population requiring proactive care. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Adapting to the 30-degree visual perspective by emulating the angled laparoscope: a simple and low-cost solution for basic surgical training.

PubMed

Daniel, Lorias Espinoza; Tapia, Fernando Montes; Arturo, Minor Martínez; Ricardo, Ordorica Flores

2014-12-01

The ability to handle and adapt to the visual perspectives generated by angled laparoscopes is crucial for skilled laparoscopic surgery. However, the control of the visual work space depends on the ability of the operator of the camera, who is often not the most experienced member of the surgical team. Here, we present a simple, low-cost option for surgical training that challenges the learner with static and dynamic visual perspectives at 30 degrees using a system that emulates the angled laparoscope. A system was developed using a low-cost camera and readily available materials to emulate the angled laparoscope. Nine participants undertook 3 tasks to test spatial adaptation to the static and dynamic visual perspectives at 30 degrees. Completing each task to a predefined satisfactory level ensured precision of execution of the tasks. Associated metrics (time and error rate) were recorded, and the performance of participants were determined. A total of 450 repetitions were performed by 9 residents at various stages of training. All the tasks were performed with a visual perspective of 30 degrees using the system. Junior residents were more proficient than senior residents. This system is a viable and low-cost alternative for developing the basic psychomotor skills necessary for the handling and adaptation to visual perspectives of 30 degrees, without depending on a laparoscopic tower, in junior residents. More advanced skills may then be acquired by other means, such as in the operating theater or through clinical experience.

A risk based approach for SSTO/TSTO comparisons

NASA Astrophysics Data System (ADS)

Greenberg, Joel S.

1996-03-01

An approach has been developed for performing early comparisons of transportation architectures explicitly taking into account quantitative measures of uncertainty and resulting risk. Risk considerations are necessary since the transportation systems are likely to have significantly different levels of risk, both because of differing degrees of freedom in achieving desired performance levels and their different states of development and utilization. The approach considers the uncertainty of achievement of technology goals, effect that the achieved technology level will have on transportation system performance and the relationship between system performance/capability and the ability to accommodate variations in payload mass. The consequences of system performance are developed in terms of nonrecurring, recurring, and the present value of transportation system life cycle costs.

Achieving network level privacy in Wireless Sensor Networks.

PubMed

Shaikh, Riaz Ahmed; Jameel, Hassan; d'Auriol, Brian J; Lee, Heejo; Lee, Sungyoung; Song, Young-Jae

2010-01-01

Full network level privacy has often been categorized into four sub-categories: Identity, Route, Location and Data privacy. Achieving full network level privacy is a critical and challenging problem due to the constraints imposed by the sensor nodes (e.g., energy, memory and computation power), sensor networks (e.g., mobility and topology) and QoS issues (e.g., packet reach-ability and timeliness). In this paper, we proposed two new identity, route and location privacy algorithms and data privacy mechanism that addresses this problem. The proposed solutions provide additional trustworthiness and reliability at modest cost of memory and energy. Also, we proved that our proposed solutions provide protection against various privacy disclosure attacks, such as eavesdropping and hop-by-hop trace back attacks.

Achieving Network Level Privacy in Wireless Sensor Networks†

PubMed Central

Shaikh, Riaz Ahmed; Jameel, Hassan; d’Auriol, Brian J.; Lee, Heejo; Lee, Sungyoung; Song, Young-Jae

2010-01-01

Full network level privacy has often been categorized into four sub-categories: Identity, Route, Location and Data privacy. Achieving full network level privacy is a critical and challenging problem due to the constraints imposed by the sensor nodes (e.g., energy, memory and computation power), sensor networks (e.g., mobility and topology) and QoS issues (e.g., packet reach-ability and timeliness). In this paper, we proposed two new identity, route and location privacy algorithms and data privacy mechanism that addresses this problem. The proposed solutions provide additional trustworthiness and reliability at modest cost of memory and energy. Also, we proved that our proposed solutions provide protection against various privacy disclosure attacks, such as eavesdropping and hop-by-hop trace back attacks. PMID:22294881

Costs of Introducing and Delivering HPV Vaccines in Low and Lower Middle Income Countries: Inputs for GAVI Policy on Introduction Grant Support to Countries

PubMed Central

Levin, Ann; Wang, Susan A.; Levin, Carol; Tsu, Vivien; Hutubessy, Raymond

2014-01-01

Background In November 2011, the GAVI Alliance made the decision to add HPV vaccine as one of the new vaccines for which countries eligible for its funding (less than $1520 per capita income) could apply to receive support for national HPV vaccination, provided they could demonstrate the ability to deliver HPV vaccines. This paper describes the data and analysis shared with GAVI policymakers for this decision regarding GAVI HPV vaccine support. The paper reviews why strategies and costs for HPV vaccine delivery are different from other vaccines and what is known about the cost components from available data that originated primarily from HPV vaccine delivery costing studies in low and middle income-countries. Methods Financial costs of HPV vaccine delivery were compared across three sources of data: 1) vaccine delivery costing of pilot projects in five low and lower-middle income countries; 2) cost estimates of national HPV vaccination in two low income countries; and 3) actual expenditure data from national HPV vaccine introduction in a low income country. Both costs of resources required to introduce the vaccine (or initial one-time investment, such as cold chain equipment purchases) and recurrent (ongoing costs that repeat every year) costs, such as transport and health personnel time, were analyzed. The cost per dose, cost per fully immunized girl (FIG) and cost per eligible girl were compared across studies. Results Costs varied among pilot projects and estimates of national programs due to differences in scale and service delivery strategy. The average introduction costs per fully immunized girl ranged from $1.49 to $18.94 while recurrent costs per girl ranged from $1.00 to $15.69, with both types of costs varying by delivery strategy and country. Evaluating delivery costs along programme characteristics as well as country characteristics (population density, income/cost level, existing service delivery infrastructure) are likely the most informative and useful for anticipating costs for HPV vaccine delivery. Conclusions This paper demonstrates the importance of country level cost data to inform global donor policies for vaccine introduction support. Such data are also valuable for informing national decisions on HPV vaccine introduction. PMID:24968002

Portuguese Family Physicians’ Awareness of Diagnostic and Laboratory Test Costs: A Cross-Sectional Study

PubMed Central

Sá, Luísa; Costa-Santos, Cristina; Teixeira, Andreia; Couto, Luciana; Costa-Pereira, Altamiro; Hespanhol, Alberto; Santos, Paulo; Martins, Carlos

2015-01-01

Background Physicians’ ability to make cost-effective decisions has been shown to be affected by their knowledge of health care costs. This study assessed whether Portuguese family physicians are aware of the costs of the most frequently prescribed diagnostic and laboratory tests. Methods A cross-sectional study was conducted in a representative sample of Portuguese family physicians, using computer-assisted telephone interviews for data collection. A Likert scale was used to assess physician’s level of agreement with four statements about health care costs. Family physicians were also asked to estimate the costs of diagnostic and laboratory tests. Each physician’s cost estimate was compared with the true cost and the absolute error was calculated. Results One-quarter (24%; 95% confidence interval: 23%–25%) of all cost estimates were accurate to within 25% of the true cost, with 55% (95% IC: 53–56) overestimating and 21% (95% IC: 20–22) underestimating the true actual cost. The majority (76%) of family physicians thought they did not have or were uncertain as to whether they had adequate knowledge of diagnostic and laboratory test costs, and only 7% reported receiving adequate education. The majority of the family physicians (82%) said that they had adequate access to information about the diagnostic and laboratory test costs. Thirty-three percent thought that costs did not influence their decision to order tests, while 27% were uncertain. Conclusions Portuguese family physicians have limited awareness of diagnostic and laboratory test costs, and our results demonstrate a need for improved education in this area. Further research should focus on identifying whether interventions in cost knowledge actually change ordering behavior, in identifying optimal methods to disseminate cost information, and on improving the cost-effectiveness of care. PMID:26356625

Integrated Analysis and Visualization of Group Differences in Structural and Functional Brain Connectivity: Applications in Typical Ageing and Schizophrenia.

PubMed

Langen, Carolyn D; White, Tonya; Ikram, M Arfan; Vernooij, Meike W; Niessen, Wiro J

2015-01-01

Structural and functional brain connectivity are increasingly used to identify and analyze group differences in studies of brain disease. This study presents methods to analyze uni- and bi-modal brain connectivity and evaluate their ability to identify differences. Novel visualizations of significantly different connections comparing multiple metrics are presented. On the global level, "bi-modal comparison plots" show the distribution of uni- and bi-modal group differences and the relationship between structure and function. Differences between brain lobes are visualized using "worm plots". Group differences in connections are examined with an existing visualization, the "connectogram". These visualizations were evaluated in two proof-of-concept studies: (1) middle-aged versus elderly subjects; and (2) patients with schizophrenia versus controls. Each included two measures derived from diffusion weighted images and two from functional magnetic resonance images. The structural measures were minimum cost path between two anatomical regions according to the "Statistical Analysis of Minimum cost path based Structural Connectivity" method and the average fractional anisotropy along the fiber. The functional measures were Pearson's correlation and partial correlation of mean regional time series. The relationship between structure and function was similar in both studies. Uni-modal group differences varied greatly between connectivity types. Group differences were identified in both studies globally, within brain lobes and between regions. In the aging study, minimum cost path was highly effective in identifying group differences on all levels; fractional anisotropy and mean correlation showed smaller differences on the brain lobe and regional levels. In the schizophrenia study, minimum cost path and fractional anisotropy showed differences on the global level and within brain lobes; mean correlation showed small differences on the lobe level. Only fractional anisotropy and mean correlation showed regional differences. The presented visualizations were helpful in comparing and evaluating connectivity measures on multiple levels in both studies.

Where do dialectal effects on speech processing come from? Evidence from a cross-dialect investigation.

PubMed

Larraza, Saioa; Samuel, Arthur G; Oñederra, Miren Lourdes

2016-07-20

Accented speech has been seen as an additional impediment for speech processing; it usually adds linguistic and cognitive load to the listener's task. In the current study we analyse where the processing costs of regional dialects come from, a question that has not been answered yet. We quantify the proficiency of Basque-Spanish bilinguals who have different native dialects of Basque on many dimensions and test for costs at each of three levels of processing-phonemic discrimination, word recognition, and semantic processing. The ability to discriminate a dialect-specific contrast is affected by a bilingual's linguistic background less than lexical access is, and an individual's difficulty in lexical access is correlated with basic discrimination problems. Once lexical access is achieved, dialectal variation has little impact on semantic processing. The results are discussed in terms of the presence or absence of correlations between different processing levels. The implications of the results are considered for how models of spoken word recognition handle dialectal variation.

Background Papers Prepared for the "Study of the Escalating Costs of Higher Education."

ERIC Educational Resources Information Center

Pelavin Associates, Inc., Washington, DC.

This report presents seven studies commissioned by the U.S. Department of Education to examine the issue of the rapid rise of college costs during the 1980s and the ability of American students and families to afford higher education. The seven papers are as follows: (1) "The Ability to Afford Higher Education: Past, Present, and Future" (Ralph M.…

Modelling the cost-effectiveness of mass screening and treatment for reducing Plasmodium falciparum malaria burden.

PubMed

Crowell, Valerie; Briët, Olivier J T; Hardy, Diggory; Chitnis, Nakul; Maire, Nicolas; Di Pasquale, Aurelio; Smith, Thomas A

2013-01-03

Past experience and modelling suggest that, in most cases, mass treatment strategies are not likely to succeed in interrupting Plasmodium falciparum malaria transmission. However, this does not preclude their use to reduce disease burden. Mass screening and treatment (MSAT) is preferred to mass drug administration (MDA), as the latter involves massive over-use of drugs. This paper reports simulations of the incremental cost-effectiveness of well-conducted MSAT campaigns as a strategy for P. falciparum malaria disease-burden reduction in settings with varying receptivity (ability of the combined vector population in a setting to transmit disease) and access to case management. MSAT incremental cost-effectiveness ratios (ICERs) were estimated in different sub-Saharan African settings using simulation models of the dynamics of malaria and a literature-based MSAT cost estimate. Imported infections were simulated at a rate of two per 1,000 population per annum. These estimates were compared to the ICERs of scaling up case management or insecticide-treated net (ITN) coverage in each baseline health system, in the absence of MSAT. MSAT averted most episodes, and resulted in the lowest ICERs, in settings with a moderate level of disease burden. At a low pre-intervention entomological inoculation rate (EIR) of two infectious bites per adult per annum (IBPAPA) MSAT was never more cost-effective than scaling up ITNs or case management coverage. However, at pre-intervention entomological inoculation rates (EIRs) of 20 and 50 IBPAPA and ITN coverage levels of 40 or 60%, respectively, the ICER of MSAT was similar to that of scaling up ITN coverage further. In all the transmission settings considered, achieving a minimal level of ITN coverage is a "best buy". At low transmission, MSAT probably is not worth considering. Instead, MSAT may be suitable at medium to high levels of transmission and at moderate ITN coverage. If undertaken as a burden-reducing intervention, MSAT should be continued indefinitely and should complement, not replace, case management and vector control interventions.

The effect of different types of employment on quality of life.

PubMed

Kober, R; Eggleton, I R C

2005-10-01

Despite research that has investigated whether the financial benefits of open employment exceed the costs, there has been scant research as to the effect sheltered and open employment have upon the quality of life of participants. The importance of this research is threefold: it investigates outcomes explicitly in terms of quality of life; the sample size is comparatively large; and it uses an established and validated questionnaire. One hundred and seventeen people with intellectual disability (ID) who were employed in either open or sheltered employment by disability employment agencies were interviewed. Quality of life was assessed using the Quality of Life Questionnaire. After making an initial assessment to see whether the outcomes achieved depended on type of employment, quality of life scores were analyzed controlling for participants' level of functional work ability (assessed via the Functional Assessment Inventory). The results showed that participants placed in open employment reported statistically significant higher quality of life scores. When the sample was split based upon participants' functional work ability, the type of employment had no effect on the reported quality of life for participants with a low functional work ability. However, for those participants with a high functional work ability, those in open employment reported statistically significantly higher quality of life. The results of this study support the placement of people with ID with high functional work ability into open employment. However, a degree of caution needs to be taken in interpreting the results presented given the disparity in income levels between the two types of employment.

Cost-effective method of manufacturing a 3D MEMS optical switch

NASA Astrophysics Data System (ADS)

Carr, Emily; Zhang, Ping; Keebaugh, Doug; Chau, Kelvin

2009-02-01

growth of data and video transport networks. All-optical switching eliminates the need for optical-electrical conversion offering the ability to switch optical signals transparently: independent of data rates, formats and wavelength. It also provides network operators much needed automation capabilities to create, monitor and protect optical light paths. To further accelerate the market penetration, it is necessary to identify a path to reduce the manufacturing cost significantly as well as enhance the overall system performance, uniformity and reliability. Currently, most MEMS optical switches are assembled through die level flip-chip bonding with either epoxies or solder bumps. This is due to the alignment accuracy requirements of the switch assembly, defect matching of individual die, and cost of the individual components. In this paper, a wafer level assembly approach is reported based on silicon fusion bonding which aims to reduce the packaging time, defect count and cost through volume production. This approach is successfully demonstrated by the integration of two 6-inch wafers: a mirror array wafer and a "snap-guard" wafer, which provides a mechanical structure on top of the micromirror to prevent electrostatic snap-down. The direct silicon-to-silicon bond eliminates the CTEmismatch and stress issues caused by non-silicon bonding agents. Results from a completed integrated switch assembly will be presented, which demonstrates the reliability and uniformity of some key parameters of this MEMS optical switch.

The methodology of multi-viewpoint clustering analysis

NASA Technical Reports Server (NTRS)

Mehrotra, Mala; Wild, Chris

1993-01-01

One of the greatest challenges facing the software engineering community is the ability to produce large and complex computer systems, such as ground support systems for unmanned scientific missions, that are reliable and cost effective. In order to build and maintain these systems, it is important that the knowledge in the system be suitably abstracted, structured, and otherwise clustered in a manner which facilitates its understanding, manipulation, testing, and utilization. Development of complex mission-critical systems will require the ability to abstract overall concepts in the system at various levels of detail and to consider the system from different points of view. Multi-ViewPoint - Clustering Analysis MVP-CA methodology has been developed to provide multiple views of large, complicated systems. MVP-CA provides an ability to discover significant structures by providing an automated mechanism to structure both hierarchically (from detail to abstract) and orthogonally (from different perspectives). We propose to integrate MVP/CA into an overall software engineering life cycle to support the development and evolution of complex mission critical systems.

Predicting space telerobotic operator training performance from human spatial ability assessment

NASA Astrophysics Data System (ADS)

Liu, Andrew M.; Oman, Charles M.; Galvan, Raquel; Natapoff, Alan

2013-11-01

Our goal was to determine whether existing tests of spatial ability can predict an astronaut's qualification test performance after robotic training. Because training astronauts to be qualified robotics operators is so long and expensive, NASA is interested in tools that can predict robotics performance before training begins. Currently, the Astronaut Office does not have a validated tool to predict robotics ability as part of its astronaut selection or training process. Commonly used tests of human spatial ability may provide such a tool to predict robotics ability. We tested the spatial ability of 50 active astronauts who had completed at least one robotics training course, then used logistic regression models to analyze the correlation between spatial ability test scores and the astronauts' performance in their evaluation test at the end of the training course. The fit of the logistic function to our data is statistically significant for several spatial tests. However, the prediction performance of the logistic model depends on the criterion threshold assumed. To clarify the critical selection issues, we show how the probability of correct classification vs. misclassification varies as a function of the mental rotation test criterion level. Since the costs of misclassification are low, the logistic models of spatial ability and robotic performance are reliable enough only to be used to customize regular and remedial training. We suggest several changes in tracking performance throughout robotics training that could improve the range and reliability of predictive models.

Consequences of sibling rivalry vary across life in a passerine bird.

PubMed

Bebbington, Kat; Kingma, Sjouke A; Fairfield, Eleanor A; Spurgin, Lewis G; Komdeur, Jan; Richardson, David S

2017-01-01

Many studies have assessed the costs of sibling rivalry in systems where offspring always have competitors, but conclusions about sibling rivalry in these species are restricted to interpreting the cost of changes in the relative level of competition and are often complicated by the expression of potentially costly rivalry related traits. Additionally, the majority of studies focus on early-life sibling rivalry, but the costs of competition can also affect later-life performance. We test a suite of hypothesized immediate (early-life body mass, telomere length, and survival) and delayed (adult reproductive potential and lifespan) costs of sibling rivalry for offspring of differing competitive ability in Seychelles warblers, where most offspring are raised singly and hence competitor success can be compared to a competition-free scenario. Compared to those raised alone, all competing nestlings had lower body mass and weaker competitors experienced reduced survival. However, the stronger competitors appeared to have longer adult breeding tenures and lifespan than those raised alone. We propose that comparisons with competition-free groups, as well as detailed fitness measures across entire lifetimes, are needed to understand the evolution of sibling rivalry and thus individual reproductive strategy in wild systems.

Consequences of sibling rivalry vary across life in a passerine bird

PubMed Central

Kingma, Sjouke A.; Fairfield, Eleanor A.; Spurgin, Lewis G.; Komdeur, Jan; Richardson, David S.

2017-01-01

Abstract Many studies have assessed the costs of sibling rivalry in systems where offspring always have competitors, but conclusions about sibling rivalry in these species are restricted to interpreting the cost of changes in the relative level of competition and are often complicated by the expression of potentially costly rivalry related traits. Additionally, the majority of studies focus on early-life sibling rivalry, but the costs of competition can also affect later-life performance. We test a suite of hypothesized immediate (early-life body mass, telomere length, and survival) and delayed (adult reproductive potential and lifespan) costs of sibling rivalry for offspring of differing competitive ability in Seychelles warblers, where most offspring are raised singly and hence competitor success can be compared to a competition-free scenario. Compared to those raised alone, all competing nestlings had lower body mass and weaker competitors experienced reduced survival. However, the stronger competitors appeared to have longer adult breeding tenures and lifespan than those raised alone. We propose that comparisons with competition-free groups, as well as detailed fitness measures across entire lifetimes, are needed to understand the evolution of sibling rivalry and thus individual reproductive strategy in wild systems. PMID:29622918

Voltage control in Z-source inverter using low cost microcontroller for undergraduate approach

NASA Astrophysics Data System (ADS)

Zulkifli, Shamsul Aizam; Sewang, Mohd Rizal; Salimin, Suriana; Shah, Noor Mazliza Badrul

2017-09-01

This paper is focussing on controlling the output voltage of Z-Source Inverter (ZSI) using a low cost microcontroller with MATLAB-Simulink that has been used for interfacing the voltage control at the output of ZSI. The key advantage of this system is the ability of a low cost microcontroller to process the voltage control blocks based on the mathematical equations created in MATLAB-Simulink. The Proportional Integral (PI) control equations are been applied and then, been downloaded to the microcontroller for observing the changes on the voltage output regarding to the changes on the reference on the PI. The system has been simulated in MATLAB and been verified with the hardware setup. As the results, the Raspberry Pi and Arduino that have been used in this work are able to respond well when there is a change of ZSI output. It proofed that, by applying/introducing this method to student in undergraduate level, it will help the student to understand more on the process of the power converter combine with a control feedback function that can be applied at low cost microcontroller.

Risk, Robustness and Water Resources Planning Under Uncertainty

NASA Astrophysics Data System (ADS)

Borgomeo, Edoardo; Mortazavi-Naeini, Mohammad; Hall, Jim W.; Guillod, Benoit P.

2018-03-01

Risk-based water resources planning is based on the premise that water managers should invest up to the point where the marginal benefit of risk reduction equals the marginal cost of achieving that benefit. However, this cost-benefit approach may not guarantee robustness under uncertain future conditions, for instance under climatic changes. In this paper, we expand risk-based decision analysis to explore possible ways of enhancing robustness in engineered water resources systems under different risk attitudes. Risk is measured as the expected annual cost of water use restrictions, while robustness is interpreted in the decision-theoretic sense as the ability of a water resource system to maintain performance—expressed as a tolerable risk of water use restrictions—under a wide range of possible future conditions. Linking risk attitudes with robustness allows stakeholders to explicitly trade-off incremental increases in robustness with investment costs for a given level of risk. We illustrate the framework through a case study of London's water supply system using state-of-the -art regional climate simulations to inform the estimation of risk and robustness.

Evolution of costly explicit memory and cumulative culture.

PubMed

Nakamaru, Mayuko

2016-06-21

Humans can acquire new information and modify it (cumulative culture) based on their learning and memory abilities, especially explicit memory, through the processes of encoding, consolidation, storage, and retrieval. Explicit memory is categorized into semantic and episodic memories. Animals have semantic memory, while episodic memory is unique to humans and essential for innovation and the evolution of culture. As both episodic and semantic memory are needed for innovation, the evolution of explicit memory influences the evolution of culture. However, previous theoretical studies have shown that environmental fluctuations influence the evolution of imitation (social learning) and innovation (individual learning) and assume that memory is not an evolutionary trait. If individuals can store and retrieve acquired information properly, they can modify it and innovate new information. Therefore, being able to store and retrieve information is essential from the perspective of cultural evolution. However, if both storage and retrieval were too costly, forgetting and relearning would have an advantage over storing and retrieving acquired information. In this study, using mathematical analysis and individual-based simulations, we investigate whether cumulative culture can promote the coevolution of costly memory and social and individual learning, assuming that cumulative culture improves the fitness of each individual. The conclusions are: (1) without cumulative culture, a social learning cost is essential for the evolution of storage-retrieval. Costly storage-retrieval can evolve with individual learning but costly social learning does not evolve. When low-cost social learning evolves, the repetition of forgetting and learning is favored more than the evolution of costly storage-retrieval, even though a cultural trait improves the fitness. (2) When cumulative culture exists and improves fitness, storage-retrieval can evolve with social and/or individual learning, which is not influenced by the degree of the social learning cost. Whether individuals socially learn a low level of culture from observing a high or the low level of culture influences the evolution of memory and learning, especially individual learning. Copyright © 2016 Elsevier Ltd. All rights reserved.

Measuring tele-ICU impact: does it optimize quality outcomes for the critically ill patient?

PubMed

Goran, Susan F

2012-04-01

To determine the relationship between tele-ICU (intensive care unit) implementations and improvement in quality measures and patient outcomes. Tele-ICUs were designed to leverage scarce critical-care experts and promised to improve patient quality. Abstracts and peer-reviewed articles were reviewed to identify the associations between tele-ICU programmes and clinical outcomes, cost savings, and customer satisfaction. Few peer-reviewed studies are available and many variables in each study limit the ability to associate study conclusions to the overall tele-ICU programme. Further research is required to explore the impact of the tele-ICU on patient/family satisfaction. Research findings are highly dependent upon the level of ICU acceptance. The tele-ICU, in collaboration with the ICU team, can be a valuable tool for the enhancement of quality goals although the ability to demonstrate cost savings is extremely complex. Studies clearly indicate that tele-ICU nursing vigilance can enhance patient safety by preventing potential patient harm. Nursing managers and leaders play a vital part in optimizing the quality role of the tele-ICU through supportive modelling and the maximization of ICU integration. © 2012 Blackwell Publishing Ltd.

Existing data sources for clinical epidemiology: Aarhus University Clinical Trial Candidate Database, Denmark.

PubMed

Nørrelund, Helene; Mazin, Wiktor; Pedersen, Lars

2014-01-01

Denmark is facing a reduction in clinical trial activity as the pharmaceutical industry has moved trials to low-cost emerging economies. Competitiveness in industry-sponsored clinical research depends on speed, quality, and cost. Because Denmark is widely recognized as a region that generates high quality data, an enhanced ability to attract future trials could be achieved if speed can be improved by taking advantage of the comprehensive national and regional registries. A "single point-of-entry" system has been established to support collaboration between hospitals and industry. When assisting industry in early-stage feasibility assessments, potential trial participants are identified by use of registries to shorten the clinical trial startup times. The Aarhus University Clinical Trial Candidate Database consists of encrypted data from the Danish National Registry of Patients allowing an immediate estimation of the number of patients with a specific discharge diagnosis in each hospital department or outpatient specialist clinic in the Central Denmark Region. The free access to health care, thorough monitoring of patients who are in contact with the health service, completeness of registration at the hospital level, and ability to link all databases are competitive advantages in an increasingly complex clinical trial environment.

The space station: Human factors and productivity

NASA Technical Reports Server (NTRS)

Gillan, D. J.; Burns, M. J.; Nicodemus, C. L.; Smith, R. L.

1986-01-01

Human factor researchers and engineers are making inputs into the early stages of the design of the Space Station to improve both the quality of life and work on-orbit. Effective integration of the human factors information related to various Intravehicular Activity (IVA), Extravehicular Activity (EVA), and teletobotics systems during the Space Station design will result in increased productivity, increased flexibility of the Space Stations systems, lower cost of operations, improved reliability, and increased safety for the crew onboard the Space Station. The major features of productivity examined include the cognitive and physical effort involved in work, the accuracy of worker output and ability to maintain performance at a high level of accuracy, the speed and temporal efficiency with which a worker performs, crewmember satisfaction with their work environment, and the relation between performance and cost.

Relationship between functional disability and costs one and two years post stroke

PubMed Central

Lekander, Ingrid; Willers, Carl; von Euler, Mia; Lilja, Mikael; Sunnerhagen, Katharina S.; Pessah-Rasmussen, Hélène; Borgström, Fredrik

2017-01-01

Background and purpose Stroke affects mortality, functional ability, quality of life and incurs costs. The primary objective of this study was to estimate the costs of stroke care in Sweden by level of disability and stroke type (ischemic (IS) or hemorrhagic stroke (ICH)). Method Resource use during first and second year following a stroke was estimated based on a research database containing linked data from several registries. Costs were estimated for the acute and post-acute management of stroke, including direct (health care consumption and municipal services) and indirect (productivity losses) costs. Resources and costs were estimated per stroke type and functional disability categorised by Modified Rankin Scale (mRS). Results The results indicated that the average costs per patient following a stroke were 350,000SEK/€37,000–480,000SEK/€50,000, dependent on stroke type and whether it was the first or second year post stroke. Large variations were identified between different subgroups of functional disability and stroke type, ranging from annual costs of 100,000SEK/€10,000–1,100,000SEK/€120,000 per patient, with higher costs for patients with ICH compared to IS and increasing costs with more severe functional disability. Conclusion Functional outcome is a major determinant on costs of stroke care. The stroke type associated with worse outcome (ICH) was also consistently associated to higher costs. Measures to improve function are not only important to individual patients and their family but may also decrease the societal burden of stroke. PMID:28384164

Cost-effectiveness analysis of implementing an antimicrobial stewardship program in critical care units.

PubMed

Ruiz-Ramos, Jesus; Frasquet, Juan; Romá, Eva; Poveda-Andres, Jose Luis; Salavert-Leti, Miguel; Castellanos, Alvaro; Ramirez, Paula

2017-06-01

To evaluate the cost-effectiveness of antimicrobial stewardship (AS) program implementation focused on critical care units based on assumptions for the Spanish setting. A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed. Model variables and costs, along with their distributions, were obtained from the literature. The study was performed from the Spanish National Health System (NHS) perspective, including only direct costs. The Incremental Cost-Effectiveness Ratio (ICER) was analysed regarding the ability of the program to reduce multi-drug resistant bacteria. Uncertainty in ICERs was evaluated with probabilistic sensitivity analyses. In the short-term, implementing an AS reduces the consumption of antimicrobials with a net benefit of €71,738. In the long-term, the maintenance of the program involves an additional cost to the system of €107,569. Cost per avoided resistance was €7,342, and cost-per-life-years gained (LYG) was €9,788. Results from the probabilistic sensitivity analysis showed that there was a more than 90% likelihood that an AS would be cost-effective at a level of €8,000 per LYG. Wide variability of economic results obtained from the implementation of this type of AS program and short information on their impact on patient evolution and any resistance avoided. Implementing an AS focusing on critical care patients is a long-term cost-effective tool. Implementation costs are amortized by reducing antimicrobial consumption to prevent infection by multidrug-resistant pathogens.

A mismatch between the perceived fighting signal and fighting ability reveals survival and physiological costs for bearers.

PubMed

González-Santoyo, Isaac; González-Tokman, Daniel M; Munguía-Steyer, Roberto E; Córdoba-Aguilar, Alex

2014-01-01

Signals of fighting indicate an animal's intention to attack and so they serve to prevent costly aggressive encounters. However, according to theory, a signal that is different in design (i.e. a novel signal) but that fails to inform fighting intentions will result in negative fitness consequences for the bearer. In the present study we used males of the territorial damselfly Hetaerina americana, which have a red wing spot during territory defense that has evolved as a signal of fighting ability. By producing a novel signal (covering the red spot with blue ink) in territory owners, we investigated: a) the behavioral responses by conspecific males; b) survival cost and c) three physiological mediators of impaired survival: muscular fat reserves, muscle mass and immune ability. We predicted that males with the novel signal would be attacked more often by conspecifics as the former would fail to convey fighting ability and intentions adequately. This will result in lower survival and physiological condition for the novel signal bearers. We found that, compared to control males (males whose red spot was not changed), experimental males had reduced survival, were less able to hold a territory, and had a reduced muscle mass. It seems that spot modified males were not able to effectively communicate their territory tenancy, which may explain why they lost their defended sites. Our results provide support for theoretical models that a novel signal that fails to informing fighting ability may lead to a fitness cost for bearers.

Positive density-dependent growth supports costs sharing hypothesis and population density sensing in a manipulative parasite.

PubMed

Gopko, Mikhail; Mikheev, Victor N; Taskinen, Jouni

2017-09-01

Parasites manipulate their hosts' phenotype to increase their own fitness. Like any evolutionary adaptation, parasitic manipulations should be costly. Though it is difficult to measure costs of the manipulation directly, they can be evaluated using an indirect approach. For instance, theory suggests that as the parasite infrapopulation grows, the investment of individual parasites in host manipulation decreases, because of cost sharing. Another assumption is that in environments where manipulation does not pay off for the parasite, it can decrease its investment in the manipulation to save resources. We experimentally infected rainbow trout Oncorhynchus mykiss with the immature larvae of the trematode Diplostomum pseudospathaceum, to test these assumptions. Immature D. pseudospathaceum metacercariae are known for their ability to manipulate the behaviour of their host enhancing its anti-predator defenses to avoid concomitant predation. We found that the growth rate of individual parasites in rainbow trout increased with the infrapopulation size (positive density-dependence) suggesting cost sharing. Moreover, parasites adjusted their growth to the intensity of infection within the eye lens where they were localized suggesting population density sensing. Results of this study support the hypothesis that macroparasites can adjust their growth rate and manipulation investment according to cost sharing level and infrapopulation size.

Financial sustainability in savings and credit programmes.

PubMed

Havers, M

1996-05-01

This article provides a framework for determining, justifying, and improving financial sustainability of savings and credit programs. Credit programs have income from interest and fees. Income must pay for the cost of funds, loan write-offs, operating costs, and inflation. Reference is made to Otero and Rhyne's four levels of self-sufficiency in credit programs. The Grameen Bank is an example of Level 3 and most credit unions are level 4. Nongovernmental groups in the United Kingdom are level 1 or 2. Experience has shown that removal of subsidies did not affect the quality of services or shift benefits away from the poor. Success in serving poorer people better is attributed 1) to more money being available for lending under tighter management practices, 2) to greater openness to a variety of clients from removal of subsidy restrictions, 3) to a shift to higher interest rates that eliminate richer borrowers, and 4) to a shift to serious collection of loans which is a disincentive to more privileged borrowers. Percentages of loan loss, administration costs, cost of funds, and inflation are useful in measuring the sustainability of credit programs. Interest and fee income must also be measured. Fee repayment rates do not have a common definition of arrears, default, and write-off. A simple measure is the percentage of total costs covered by income. The World Bank recommends the Subsidy Dependence Index. Women tend to be better at repaying loans. Loan size should be related to borrowers' ability to handle the amount of the loan. Low and subsidized interest rates deter depositors and attract richer borrowers. Poorer borrowers are attracted by access to credit and not the cost of credit. Interest rates should be based on market rates. The loan payment should be no longer than necessary. Small groups of borrowers can guarantee each others loans. Group-based loan schemes work best. NGOs must project an image of being serious about loan collections and must take action immediately when a payment is missed. Good repayers should be rewarded with quick repeat loans.

Update of a comparative analysis of cost minimization following the introduction of newly available intravenous iron therapies in hospital practice

PubMed Central

Bhandari, Sunil

2011-01-01

Background The clinical need to be able to administer high doses of intravenous iron conveniently as a rapid infusion has been addressed by the recent introduction of ferric carboxymaltose and subsequently iron isomaltoside 1000. Neither requires a test dose. The maximum dose of ferric carboxymaltose is 1000 mg. The maximum dose of iron isomaltoside 1000 is based on 20 mg/kg body weight without a specified ceiling dose, thereby increasing the scope of being able to achieve total iron repletion with a single infusion. This ability to give high doses of iron is important in the context of managing iron deficiency anemia, which is associated with a number of clinical conditions where demands for iron are high. It is also an important component of the strategy as an alternative to blood transfusion. Affordability is a key issue for health services. Recent price changes affecting iron sucrose and ferric carboxymaltose, plus modifications to the manufacturers’ prescribing information, have provoked this update. Methods This study is a comparative analysis of the costs of acquiring and administering the newly available intravenous iron formulations against standard treatments in the hospital setting. The costs include the medication, nursing costs, equipment, and patient transportation. Three dosage levels (600 mg, 1000 mg, and 1600 mg) are considered. Results and conclusion The traditional standard treatments, blood and iron sucrose, cost more than the alternative intravenous iron preparations across the dose spectrum and sensitivities. Low molecular weight iron dextran is the least expensive option at the 1600 mg dose level but has the caveat of a prolonged administration time and requirement for a test dose. At 600 mg and 1000 mg dose levels, both iron isomaltoside 1000 and ferric carboxymaltose are more economical than low molecular weight iron dextran. Iron isomaltoside 1000 is less expensive than ferric carboxymaltose at all dose levels. Newly available iron preparations appear to be clinically promising, cost effective, and practical alternatives to current standards of iron repletion. PMID:22241947

Development of techniques for the analysis of isoflavones in soy foods and nutraceuticals.

PubMed

Dentith, Susan; Lockwood, Brian

2008-05-01

For over 20 years, soy isoflavones have been investigated for their ability to prevent a wide range of cancers and cardiovascular problems, and numerous other disease states. This research is underpinned by the ability of researchers to analyse isoflavones in various forms in a range of raw materials and biological fluids. This review summarizes the techniques recently used in their analysis. The speed of high performance liquid chromatography analysis has been improved, allowing analysis of more samples, and increasing the sensitivity of detection techniques allows quantification of isoflavones down to nanomoles per litre levels in biological fluids. The combination of high-performance liquid chromatography with immunoassay has allowed identification and estimation of low-level soy isoflavones. The use of soy isoflavone supplements has shown an increase in their circulating levels in plasma and urine, aiding investigation of their biological effects. The significance of the metabolite equol has spurned research into new areas, and recently the specific enantiomers have been studied. High-performance liquid chromatography, capillary electrophoresis and gas chromatography are widely used with a range of detection systems. Increasingly, immunoassay is being used because of its high sensitivity and low cost.

Costing Hospital Surgery Services: The Method Matters

PubMed Central

Mercier, Gregoire; Naro, Gerald

2014-01-01

Background Accurate hospital costs are required for policy-makers, hospital managers and clinicians to improve efficiency and transparency. However, different methods are used to allocate direct costs, and their agreement is poorly understood. The aim of this study was to assess the agreement between bottom-up and top-down unit costs of a large sample of surgical operations in a French tertiary centre. Methods Two thousand one hundred and thirty consecutive procedures performed between January and October 2010 were analysed. Top-down costs were based on pre-determined weights, while bottom-up costs were calculated through an activity-based costing (ABC) model. The agreement was assessed using correlation coefficients and the Bland and Altman method. Variables associated with the difference between methods were identified with bivariate and multivariate linear regressions. Results The correlation coefficient amounted to 0.73 (95%CI: 0.72; 0.76). The overall agreement between methods was poor. In a multivariate analysis, the cost difference was independently associated with age (Beta = −2.4; p = 0.02), ASA score (Beta = 76.3; p<0.001), RCI (Beta = 5.5; p<0.001), staffing level (Beta = 437.0; p<0.001) and intervention duration (Beta = −10.5; p<0.001). Conclusions The ability of the current method to provide relevant information to managers, clinicians and payers is questionable. As in other European countries, a shift towards time-driven activity-based costing should be advocated. PMID:24817167

Pharmacoeconomics of inhaled anesthetic agents: considerations for the pharmacist.

PubMed

Chernin, Eric L

2004-10-15

Types of economic analyses used for inhaled anesthetic agents, factors to consider in calculating the cost of inhaled anesthetics, limitations of pharmacoeconomic studies of these agents, and strategies for controlling inhaled anesthetic costs are discussed. Inhaled anesthetic agents comprise a substantial component of drug budgets. Calculation of the cost of administering an inhaled anesthetic should take into consideration the cost per mL, potency, waste, concentration and duration of gas delivery, fresh gas flow rate, molecular weight, and density. The use of newer inhaled anesthetic agents with low solubility in blood and tissue provides a more rapid recovery from anesthesia than older, more soluble agents, and also provides the same level of control of depth of anesthesia at a lower fresh gas flow rate and possibly a lower cost than older agents at a higher fresh gas flow rate. A more rapid recovery may facilitate fast-track recovery and yield cost savings if it allows the completion of additional surgical cases or allows a reduction in personnel overtime expenses. Interpretation of pharmacoeconomic studies of inhaled anesthetics requires an appreciation of the limitations in methodology and ability to extrapolate results from one setting to another. Pharmacists' efforts to reduce anesthetic waste and collaborate with anesthesiologists to improve the use of these agents can help contain costs, but improving scheduling and efficiency in the operating room has a greater potential to reduce operating room costs. Much can be done to control costs of anesthetic agents without compromising availability of these agents and patient care.

A policy-oriented cost model for shipping commodities by truck.

DOT National Transportation Integrated Search

2009-12-01

Surprisingly, transportation planners and policy makers do not have the ability to estimate the cost of shipping a quantity of a commodity between two : locations for broad categories of goods. Costs of shipping are important components in mode, rout...

The Cost Effectivenes of the Pomona Plan.

ERIC Educational Resources Information Center

Metzler, Howard C.

1979-01-01

The cost effectiveness of the Pomona Plan, a well-established annuity and trust program, is examined. The historical development of the deferred-giving plan, its ability to elicit support, and methodologies for evaluating gift values and related costs are discussed. (Author/SF)

Building a bio-based industry in the Middle East through harnessing the potential of the Red Sea biodiversity.

PubMed

Nielsen, Jens; Archer, John; Essack, Magbubah; Bajic, Vladimir B; Gojobori, Takashi; Mijakovic, Ivan

2017-06-01

The incentive for developing microbial cell factories for production of fuels and chemicals comes from the ability of microbes to deliver these valuable compounds at a reduced cost and with a smaller environmental impact compared to the analogous chemical synthesis. Another crucial advantage of microbes is their great biological diversity, which offers a much larger "catalog" of molecules than the one obtainable by chemical synthesis. Adaptation to different environments is one of the important drives behind microbial diversity. We argue that the Red Sea, which is a rather unique marine niche, represents a remarkable source of biodiversity that can be geared towards economical and sustainable bioproduction processes in the local area and can be competitive in the international bio-based economy. Recent bioprospecting studies, conducted by the King Abdullah University of Science and Technology, have established important leads on the Red Sea biological potential, with newly isolated strains of Bacilli and Cyanobacteria. We argue that these two groups of local organisms are currently most promising in terms of developing cell factories, due to their ability to operate in saline conditions, thus reducing the cost of desalination and sterilization. The ability of Cyanobacteria to perform photosynthesis can be fully exploited in this particular environment with one of the highest levels of irradiation on the planet. We highlight the importance of new experimental and in silico methodologies needed to overcome the hurdles of developing efficient cell factories from the Red Sea isolates.

An affordable, computerised, table-based exercise system for stroke survivors.

PubMed

King, Marcus; Hale, Leigh; Pekkari, Anna; Persson, Martin; Gregorsson, Malin; Nilsson, Mikaela

2010-07-01

Loss of hand function as a result of upper limb paresis after a stroke leads to reduced independence. Robotic-assisted therapy with virtual reality leads to improvements in motor function, but there is a need to improve the cost-benefit ratio of these therapies. This case series study investigated augmented reality computer games which provided a rewarded, goal-directed task to upper limb rehabilitation via a gravity supported reaching task. A computer game was developed to motivate chronic stroke survivors to undertake gravity supported reaching tasks performed on a table, and a focus group study investigated the application of this device for rehabilitation. From the focus group, a simple device was developed to improve the quality of the exercise and a further focus group study investigated a variety of computer games to determine motivations for undertaking rehabilitation exercises. Of the four participants in the case study, two showed improvement in ability to play the game and in arm function. Participants enjoyed playing a range of computer games and felt that the system provided a worthwhile exercise. Motivation for undertaking exercise with the system included: intellectual stimulation during game play, feedback such as game score, gaining physical benefits from the exercise, the system tolerating varying levels of disability, ability to relate to the game and ability to use the system in social groups. A low-cost device has been developed which increases the exercise of gravity supported reaching movements, provides goal-directed tasks with rewards and motivates the user to undertake extended rehabilitation.

Cost Analysis of an Office-based Surgical Suite

PubMed Central

LaBove, Gabrielle

2016-01-01

Introduction: Operating costs are a significant part of delivering surgical care. Having a system to analyze these costs is imperative for decision making and efficiency. We present an analysis of surgical supply, labor and administrative costs, and remuneration of procedures as a means for a practice to analyze their cost effectiveness; this affects the quality of care based on the ability to provide services. The costs of surgical care cannot be estimated blindly as reconstructive and cosmetic procedures have different percentages of overhead. Methods: A detailed financial analysis of office-based surgical suite costs for surgical procedures was determined based on company contract prices and average use of supplies. The average time spent on scheduling, prepping, and doing the surgery was factored using employee rates. Results: The most expensive, minor procedure supplies are suture needles. The 4 most common procedures from the most expensive to the least are abdominoplasty, breast augmentation, facelift, and lipectomy. Conclusions: Reconstructive procedures require a greater portion of collection to cover costs. Without the adjustment of both patient and insurance remuneration in the practice, the ability to provide quality care will be increasingly difficult. PMID:27536482

Long-Term Cost-Effectiveness and Return-on-Investment of a Mindfulness-Based Worksite Intervention: Results of a Randomized Controlled Trial.

PubMed

van Dongen, Johanna M; van Berkel, Jantien; Boot, Cécile R L; Bosmans, Judith E; Proper, Karin I; Bongers, Paulien M; van der Beek, Allard J; van Tulder, Maurits W; van Wier, Marieke F

2016-06-01

The aim of this study was to conduct a cost-effectiveness and return-on-investment analysis comparing a mindfulness-based worksite intervention to usual practice. Two hundred fifty-seven governmental research institute employees were randomized to the intervention or control group. Intervention group participants received an eight-week mindfulness training, e-coaching, and supporting elements. Outcomes included work engagement, general vitality, job satisfaction, work ability, and costs. Cost-effectiveness analyses were conducted from the societal and employer's perspective, and a return-on-investment analysis from the employer's perspective. After 12 months, a significant but not clinically relevant adverse effect on work engagement was found (-0.19; 95% confidence interval: -0.38 to -0.01). There were no significant differences in job satisfaction, general vitality, work ability, and total costs. Probabilities of cost-effectiveness were low (≤0.25) and the intervention did not have a positive financial return to the employer. The intervention was neither cost-saving nor cost-effective. Poor e-coaching compliance might partly explain this result.

When is Testing Sufficient

NASA Technical Reports Server (NTRS)

Rosenberg, Linda H.; Arthur, James D.; Stapko, Ruth K.; Davani, Darush

1999-01-01

The Software Assurance Technology Center (SATC) at NASA Goddard Space Flight Center has been investigating how projects can determine when sufficient testing has been completed. For most projects, schedules are underestimated, and the last phase of the software development, testing, must be decreased. Two questions are frequently asked: "To what extent is the software error-free? " and "How much time and effort is required to detect and remove the remaining errors? " Clearly, neither question can be answered with absolute certainty. Nonetheless, the ability to answer these questions with some acceptable level of confidence is highly desirable. First, knowing the extent to which a product is error-free, we can judge when it is time to terminate testing. Secondly, if errors are judged to be present, we can perform a cost/benefit trade-off analysis to estimate when the software will be ready for use and at what cost. This paper explains the efforts of the SATC to help projects determine what is sufficient testing and when is the most cost-effective time to stop testing.

Correlates of Worry About Health Care Costs Among Older Adults.

PubMed

Choi, Namkee G; DiNitto, Diana M

2018-06-01

Although older adults in the United States incur more health care expenses than younger adults, little research has been done on their worry about health care costs. Using data from the 2013 National Health Interview Survey ( n = 7,253 for those 65+ years), we examined factors associated with older adults' health care cost worries, defined as at least a moderate level of worry, about ability to pay for normal health care and/or for health care due to a serious illness or accident. Bivariate analyses were used to compare worriers and nonworriers. Binary logistic regression analysis was used to examine the association of income, health status, health care service use, and insurance type with worry status. Older age and having Medicaid and Veterans Affairs (VA)/military health benefits were associated with lower odds of worry, while low income, chronic pain, functional limitations, psychological distress, and emergency department visits were associated with higher odds. Practice and policy implications for the findings are discussed.

Modelling Concentrating Solar Power with Thermal Energy Storage for Integration Studies (Presentation)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hummon, M.; Jorgenson, J.; Denholm, P.

2013-10-01

Concentrating solar power with thermal energy storage (CSP-TES) can provide multiple benefits to the grid, including low marginal cost energy and the ability to levelize load, provide operating reserves, and provide firm capacity. It is challenging to properly value the integration of CSP because of the complicated nature of this technology. Unlike completely dispatchable fossil sources, CSP is a limited energy resource, depending on the hourly and daily supply of solar energy. To optimize the use of this limited energy, CSP-TES must be implemented in a production cost model with multiple decision variables for the operation of the CSP-TES plant.more » We develop and implement a CSP-TES plant in a production cost model that accurately characterizes the three main components of the plant: solar field, storage tank, and power block. We show the effect of various modelling simplifications on the value of CSP, including: scheduled versus optimized dispatch from the storage tank and energy-only operation versus co-optimization with ancillary services.« less

Modelling Concentrating Solar Power with Thermal Energy Storage for Integration Studies: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hummon, M.; Denholm, P.; Jorgenson, J.

2013-10-01

Concentrating solar power with thermal energy storage (CSP-TES) can provide multiple benefits to the grid, including low marginal cost energy and the ability to levelize load, provide operating reserves, and provide firm capacity. It is challenging to properly value the integration of CSP because of the complicated nature of this technology. Unlike completely dispatchable fossil sources, CSP is a limited energy resource, depending on the hourly and daily supply of solar energy. To optimize the use of this limited energy, CSP-TES must be implemented in a production cost model with multiple decision variables for the operation of the CSP-TES plant.more » We develop and implement a CSP-TES plant in a production cost model that accurately characterizes the three main components of the plant: solar field, storage tank, and power block. We show the effect of various modelling simplifications on the value of CSP, including: scheduled versus optimized dispatch from the storage tank and energy-only operation versus co-optimization with ancillary services.« less

Association between work ability and fatigue in Brazilian nursing workers.

PubMed

da Silva, Fabio José; Felli, Vanda Elisa Andres; Martinez, Maria Carmen; Mininel, Vivian Aline; Ratier, Ana Paula Pelegrini

2015-01-01

Impaired work ability is associated with work-related illnesses, early retirement and rising pension costs. To investigate the association between work ability and fatigue in nursing workers. Cross-sectional study conducted with 100 nursing workers from two inpatient units at a public teaching hospital in Sao Paulo, Brazil. The data were collected by means of a socio-demographic profile questionnaire, Work Ability Index (WAI) and Chalder Fatigue Scale. The data were analyzed by means of descriptive and analytical statistical methods, tests of association and multiple linear regression. The study population was mainly composed of women (88% ), exhibited a high educational level (76% ), average age 39.4 years old (SD = 9.5) and 15 years of professional experience, on average. The average score on WAI was good (39.4 points, SD = 6.0) but surprisingly, 35% of the participants exhibited moderate to poor work ability. Fatigue was found in 52% of the participants. The score on WAI decreased in association with fatigue (p <  0.001) and longer length of work in the same workplace (p = 0.001), as well as among nursing technicians compared to nurses (p = 0.040). Fatigue, longer length of work in the same workplace and work category nursing technician were associated with decreased work ability, which emphasizes the need for investment in health and quality of work life.

Parents are a drag: long-lived birds share the cost of increased foraging effort with their offspring, but males pass on more of the costs than females.

PubMed

Jacobs, Shoshanah R; Elliott, Kyle Hamish; Gaston, Anthony J

2013-01-01

Life history theory predicts that parents will balance benefits from investment in current offspring against benefits from future reproductive investments. Long-lived organisms are therefore less likely to increase parental effort when environmental conditions deteriorate. To investigate the effect of decreased foraging capacity on parental behaviour of long-lived monogamous seabirds, we experimentally increased energy costs for chick-rearing thick-billed murres (Uria lomvia). Handicapped birds had lighter chicks and lower provisioning rates, supporting the prediction that long-lived animals would pass some of the costs of impaired foraging ability on to their offspring. Nonetheless, handicapped birds spent less time underwater, had longer inter-dive surface intervals, had lower body mass, showed lower resighting probabilities in subsequent years and consumed fewer risky prey items. Corticosterone levels were similar between control and handicapped birds. Apparently, adults shared some of the costs of impaired foraging, but those costs were not measurable in all metrics. Handicapped males had higher plasma neutral lipid concentrations (higher energy mobilisation) and their chicks exhibited lower growth rates than handicapped females, suggesting different sex-specific investment strategies. Unlike other studies of auks, partners did not compensate for handicapping, despite good foraging conditions for unhandicapped birds. In conclusion, parental murres and their offspring shared the costs of experimentally increased foraging constraints, with females investing more than males.

Parents are a Drag: Long-Lived Birds Share the Cost of Increased Foraging Effort with Their Offspring, but Males Pass on More of the Costs than Females

PubMed Central

Jacobs, Shoshanah R.; Elliott, Kyle Hamish; Gaston, Anthony J.

2013-01-01

Life history theory predicts that parents will balance benefits from investment in current offspring against benefits from future reproductive investments. Long-lived organisms are therefore less likely to increase parental effort when environmental conditions deteriorate. To investigate the effect of decreased foraging capacity on parental behaviour of long-lived monogamous seabirds, we experimentally increased energy costs for chick-rearing thick-billed murres (Uria lomvia). Handicapped birds had lighter chicks and lower provisioning rates, supporting the prediction that long-lived animals would pass some of the costs of impaired foraging ability on to their offspring. Nonetheless, handicapped birds spent less time underwater, had longer inter-dive surface intervals, had lower body mass, showed lower resighting probabilities in subsequent years and consumed fewer risky prey items. Corticosterone levels were similar between control and handicapped birds. Apparently, adults shared some of the costs of impaired foraging, but those costs were not measurable in all metrics. Handicapped males had higher plasma neutral lipid concentrations (higher energy mobilisation) and their chicks exhibited lower growth rates than handicapped females, suggesting different sex-specific investment strategies. Unlike other studies of auks, partners did not compensate for handicapping, despite good foraging conditions for unhandicapped birds. In conclusion, parental murres and their offspring shared the costs of experimentally increased foraging constraints, with females investing more than males. PMID:23382921

Economic Synergy between Dry Cow Diet Improvement and Monensin Bolus Use to Prevent Subclinical Ketosis: An Experimental Demonstration Based on Available Literature.

PubMed

Raboisson, Didier; Barbier, Maxime

2017-01-01

The prevention of subclinical ketosis (SCK) is based on maintaining adequate nutrition in dairy cows during the dry period and close to calving. Recently, an oral-route monensin bolus to prevent SCK was approved in Europe. The present study aims to define the allocation of resources for SCK management at the herd level and evaluate the profitability of administering monensin boluses in cows at risk for SCK. A stochastic model was used to calculate the total cost of SCK for a population with a given prevalence of cows at risk for SCK. This model included the ability of the farmer to correctly target and preventatively treat these cows at risk for SCK. The results clearly demonstrated economic synergy between two management practices. First, reducing the prevalence of cows at risk for SCK dramatically reduces the total cost of SCK and seems profitable in most situations. Second, monensin bolus use to reduce the occurrence of SCK in cows already at risk for SCK is cost-effective. The results also highlighted three economic strategies to manage SCK in the dairy industry in Europe. First, monensin bolus use throughout an entire herd when the prevalence of cows at risk for SCK is high is only profitable in the short-term as a tool to correct acute deterioration at the herd level. Second, decreasing the prevalence of cows at risk for SCK through adequate feeding in the dry period is of financial interest as a baseline strategy when prevalence is high, assuming moderate additional cost linked to the new diet. Third, monensin bolus use when the prevalence of cows at risk for SCK is low is also profitable as a long-term strategy when only cows at high risk for SCK (such as cows that are over-conditioned, old, or have a previous history of SCK-related disorders) are targeted for preventative treatment. Authors suggest to use the present results considering that farmers have a correct, but not perfect, ability to target animals to be preventively targeted with the monensin bolus. Further work is required to facilitate the early identification of cows at risk for SCK.

Households encountering with catastrophic health expenditures in Ferdows, Iran.

PubMed

Ghoddoosinejad, Javad; Jannati, Ali; Gholipour, Kamal; Baghban Baghestan, Elham

2014-08-01

Out-of-pocket payments are the main sources of healthcare financing in most developing countries. Healthcare services can impose a massive cost burden on households, especially in developing countries. The purpose of this study was to calculate households encountered with catastrophic healthcare expenditures in Ferdows, Iran. The sample included 100 households representing 20% of all households in Ferdows, Iran. The data were collected using self-administered questionnaire. The ability to pay of households was calculated, and then if costs of household health were at least 40% of their ability to pay, it was considered as catastrophic expenditures. Rate of households encountered to catastrophic health expenditures was estimated to be 24%, of which dentistry services had the highest part in catastrophic health expenditures. Low ability to pay of households should be supported against these expenditures. More equitable health system would solve the problem, although more financial aid should be provided for households encountered to catastrophic costs.

Natural gas price uncertainty and the cost-effectiveness of hedging against low hydropower revenues caused by drought

NASA Astrophysics Data System (ADS)

Kern, Jordan D.; Characklis, Gregory W.; Foster, Benjamin T.

2015-04-01

Prolonged periods of low reservoir inflows (droughts) significantly reduce a hydropower producer's ability to generate both electricity and revenues. Given the capital intensive nature of the electric power industry, this can impact hydropower producers' ability to pay down outstanding debt, leading to credit rating downgrades, higher interests rates on new debt, and ultimately, greater infrastructure costs. One potential tool for reducing the financial exposure of hydropower producers to drought is hydrologic index insurance, in particular, contracts structured to payout when streamflows drop below a specified level. An ongoing challenge in developing this type of insurance, however, is minimizing contracts' "basis risk," that is, the degree to which contract payouts deviate in timing and/or amount from actual damages experienced by policyholders. In this paper, we show that consideration of year-to-year changes in the value of hydropower (i.e., the cost of replacing it with an alternative energy source during droughts) is critical to reducing contract basis risk. In particular, we find that volatility in the price of natural gas, a key driver of peak electricity prices, can significantly degrade the performance of index insurance unless contracts are designed to explicitly consider natural gas prices when determining payouts. Results show that a combined index whose value is derived from both seasonal streamflows and the spot price of natural gas yields contracts that exhibit both lower basis risk and greater effectiveness in terms of reducing financial exposure.

Economic Need among Older Latinos: Applying The Elder Economic Security Standard™ Index

PubMed Central

Wallace, Steven P.; Padilla-Frausto, D. Imelda; Smith, Susan

2013-01-01

The first official U.S. federal poverty line was developed in the 1960s; since the mid-1990s the scientific consensus has been that it has become outdated and inaccurate. This article explains the key elements of the current federal measure that are inaccurate for older adults in general and older Latinos specifically. An alternative is described that addresses the key failings of the current measure. The alternative, the Elder Economic Security Standard™ Index (Elder Index), adapts a national methodology to the basic costs of living in California for 2007 using data from the American Community Survey, and other public data sources. The results show that the amount needed for basic economic security in California is higher than the federal poverty level in all counties, and averages about twice the federal level. Housing costs are the largest component of costs in most counties, although health care is the largest component for couples in lower housing cost counties. Among singles and couples age 65 and over in California, almost 60% of Latinos have incomes below the Elder Index compared to one-quarter of non-Latino whites. The rates are higher among renters, and older Latinos are more likely than non-Latino whites to rent. Applying the Elder Index in California documents the disproportionate rates of economic insecurity among older Latinos. The findings indicate that changes to public programs such as Social Security and Medicare that decrease benefits or increase costs will have disproportionately negative impact on the ability of most older Latinos to pay for basic needs. PMID:23857068

Care delivery considerations for widespread and equitable implementation of inherited cancer predisposition testing

PubMed Central

Cragun, Deborah; Kinney, Anita Y; Pal, Tuya

2017-01-01

Introduction DNA sequencing advances through next-generation sequencing (NGS) and several practice changing events, have led to shifting paradigms for inherited cancer predisposition testing. These changes necessitated a means by which to maximize health benefits without unnecessarily inflating healthcare costs and exacerbating health disparities. Areas covered NGS-based tests encompass multi-gene panel tests, whole exome sequencing, and whole genome sequencing, all of which test for multiple genes simultaneously, compared to prior sequencing practices through which testing was performed sequentially for one or two genes. Taking an ecological approach, this article synthesizes the current literature to consider the broad impact of these advances from the individual patient-, interpersonal-, organizational-, community- and policy-levels. Furthermore, the authors describe how multi-level factors that impact genetic testing and follow-up care reveal great potential to widen existing health disparities if these issues are not addressed. Expert Commentary As we consider ways to maximize patient benefit from testing in a cost effective manner, it is important to consider perspectives from multiple levels. This information is needed to guide the development of interventions such that the promise of genomic testing may be realized by all populations, regardless of race, ethnicity and ability to pay. PMID:27910721

Remote Monitoring to Reduce Heart Failure Readmissions.

PubMed

Emani, Sitaramesh

2017-02-01

Rehospitalization for heart failure remains a challenge in the treatment of affected patients. The ability to remotely monitor patients for worsening heart failure may provide an avenue through which therapeutic interventions can be made to prevent a rehospitalization. Available data on remote monitoring to reduce heart failure rehospitalizations are reviewed within. Strategies to reduce readmissions include clinical telemonitoring, bioimpedance changes, biomarkers, and remote hemodynamic monitoring. Telemonitoring is readily available, but has low sensitivity and adherence. No data exist to demonstrate the efficacy of this strategy in reducing admissions. Bioimpedance offers improved sensitivity compared to telemonitoring, but has not demonstrated an ability to reduce hospitalizations and is currently limited to those patients who have separate indications for an implantable device. Biomarker levels have shown variable results in the ability to reduce hospitalizations and remain without definitive proof supporting their utilization. Remote hemodynamic monitoring has shown the strongest ability to reduce heart failure readmissions and is currently approved for this purpose. However, remote hemodynamic monitoring requires an invasive procedure and may not be cost-effective. All currently available strategies to reduce hospitalizations with remote monitoring have drawbacks and challenges. Remote hemodynamic monitoring is currently the most efficacious based on data, but is not without its own imperfections.

An Extra Dimension to Decision-Making in Animals: The Three-way Trade-off between Speed, Effort per-Unit-Time and Accuracy

PubMed Central

de Froment, Adrian J.; Rubenstein, Daniel I.; Levin, Simon A.

2014-01-01

The standard view in biology is that all animals, from bumblebees to human beings, face a trade-off between speed and accuracy as they search for resources and mates, and attempt to avoid predators. For example, the more time a forager spends out of cover gathering information about potential food sources the more likely it is to make accurate decisions about which sources are most rewarding. However, when the cost of time spent out of cover rises (e.g. in the presence of a predator) the optimal strategy is for the forager to spend less time gathering information and to accept a corresponding decline in the accuracy of its decisions. We suggest that this familiar picture is missing a crucial dimension: the amount of effort an animal expends on gathering information in each unit of time. This is important because an animal that can respond to changing time costs by modulating its level of effort per-unit-time does not have to accept the same decrease in accuracy that an animal limited to a simple speed-accuracy trade-off must bear in the same situation. Instead, it can direct additional effort towards (i) reducing the frequency of perceptual errors in the samples it gathers or (ii) increasing the number of samples it gathers per-unit-time. Both of these have the effect of allowing it to gather more accurate information within a given period of time. We use a modified version of a canonical model of decision-making (the sequential probability ratio test) to show that this ability to substitute effort for time confers a fitness advantage in the face of changing time costs. We predict that the ability to modulate effort levels will therefore be widespread in nature, and we lay out testable predictions that could be used to detect adaptive modulation of effort levels in laboratory and field studies. Our understanding of decision-making in all species, including our own, will be improved by this more ecologically-complete picture of the three-way tradeoff between time, effort per-unit-time and accuracy. PMID:25522281

An extra dimension to decision-making in animals: the three-way trade-off between speed, effort per-unit-time and accuracy.

PubMed

de Froment, Adrian J; Rubenstein, Daniel I; Levin, Simon A

2014-12-01

The standard view in biology is that all animals, from bumblebees to human beings, face a trade-off between speed and accuracy as they search for resources and mates, and attempt to avoid predators. For example, the more time a forager spends out of cover gathering information about potential food sources the more likely it is to make accurate decisions about which sources are most rewarding. However, when the cost of time spent out of cover rises (e.g. in the presence of a predator) the optimal strategy is for the forager to spend less time gathering information and to accept a corresponding decline in the accuracy of its decisions. We suggest that this familiar picture is missing a crucial dimension: the amount of effort an animal expends on gathering information in each unit of time. This is important because an animal that can respond to changing time costs by modulating its level of effort per-unit-time does not have to accept the same decrease in accuracy that an animal limited to a simple speed-accuracy trade-off must bear in the same situation. Instead, it can direct additional effort towards (i) reducing the frequency of perceptual errors in the samples it gathers or (ii) increasing the number of samples it gathers per-unit-time. Both of these have the effect of allowing it to gather more accurate information within a given period of time. We use a modified version of a canonical model of decision-making (the sequential probability ratio test) to show that this ability to substitute effort for time confers a fitness advantage in the face of changing time costs. We predict that the ability to modulate effort levels will therefore be widespread in nature, and we lay out testable predictions that could be used to detect adaptive modulation of effort levels in laboratory and field studies. Our understanding of decision-making in all species, including our own, will be improved by this more ecologically-complete picture of the three-way tradeoff between time, effort per-unit-time and accuracy.

The predictive validity of the HERO Scorecard in determining future health care cost and risk trends.

PubMed

Goetzel, Ron Z; Henke, Rachel Mosher; Benevent, Richele; Tabrizi, Maryam J; Kent, Karen B; Smith, Kristyn J; Roemer, Enid Chung; Grossmeier, Jessica; Mason, Shawn T; Gold, Daniel B; Noeldner, Steven P; Anderson, David R

2014-02-01

To determine the ability of the Health Enhancement Research Organization (HERO) Scorecard to predict changes in health care expenditures. Individual employee health care insurance claims data for 33 organizations completing the HERO Scorecard from 2009 to 2011 were linked to employer responses to the Scorecard. Organizations were dichotomized into "high" versus "low" scoring groups and health care cost trends were compared. A secondary analysis examined the tool's ability to predict health risk trends. "High" scorers experienced significant reductions in inflation-adjusted health care costs (averaging an annual trend of -1.6% over 3 years) compared with "low" scorers whose cost trend remained stable. The risk analysis was inconclusive because of the small number of employers scoring "low." The HERO Scorecard predicts health care cost trends among employers. More research is needed to determine how well it predicts health risk trends for employees.

A model for the coevolution of immunity and immune evasion in vector-borne diseases with implications for the epidemiology of malaria.

PubMed

Koella, Jacob C; Boëte, C

2003-05-01

We describe a model of host-parasite coevolution, where the interaction depends on the investments by the host in its immune response and by the parasite in its ability to suppress (or evade) its host's immune response. We base our model on the interaction between malaria parasites and their mosquito hosts and thus describe the epidemiological dynamics with the Macdonald-Ross equation of malaria epidemiology. The qualitative predictions of the model are most sensitive to the cost of the immune response and to the intensity of transmission. If transmission is weak or the cost of immunity is low, the system evolves to a coevolutionarily stable equilibrium at intermediate levels of investment (and, generally, at a low frequency of resistance). At a higher cost of immunity and as transmission intensifies, the system is not evolutionarily stable but rather cycles around intermediate levels of investment. At more intense transmission, neither host nor parasite invests any resources in dominating its partner so that no resistance is observed in the population. These results may help to explain the lack of encapsulated malaria parasites generally observed in natural populations of mosquito vectors, despite strong selection pressure for resistance in areas of very intense transmission.

The magnitude and colour of noise in genetic negative feedback systems

PubMed Central

Voliotis, Margaritis; Bowsher, Clive G.

2012-01-01

The comparative ability of transcriptional and small RNA-mediated negative feedback to control fluctuations or ‘noise’ in gene expression remains unexplored. Both autoregulatory mechanisms usually suppress the average (mean) of the protein level and its variability across cells. The variance of the number of proteins per molecule of mean expression is also typically reduced compared with the unregulated system, but is almost never below the value of one. This relative variance often substantially exceeds a recently obtained, theoretical lower limit for biochemical feedback systems. Adding the transcriptional or small RNA-mediated control has different effects. Transcriptional autorepression robustly reduces both the relative variance and persistence (lifetime) of fluctuations. Both benefits combine to reduce noise in downstream gene expression. Autorepression via small RNA can achieve more extreme noise reduction and typically has less effect on the mean expression level. However, it is often more costly to implement and is more sensitive to rate parameters. Theoretical lower limits on the relative variance are known to decrease slowly as a measure of the cost per molecule of mean expression increases. However, the proportional increase in cost to achieve substantial noise suppression can be different away from the optimal frontier—for transcriptional autorepression, it is frequently negligible. PMID:22581772

78 FR 24765 - Notice of Intent To Close 16 Field Offices

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... in current facilities through innovative approaches to space management and alternative workplace... eliminate the cost office space leases and administrative costs, including transit, mail, copiers... is based on GSA's ability to find a replacement lessee for the office space. ii. Buyout cost...

Economic evaluations of fluticasone-propionate/salmeterol combination therapy for chronic obstructive pulmonary disease: a review of published studies.

PubMed

Roberts, M H; Borrego, M E; Kharat, A A; Marshik, P L; Mapel, D W

2016-01-01

This review identifies and evaluates the comprehensive reporting of peer-reviewed economic evaluations of the effectiveness of fluticasone-propionate/salmeterol combination (FSC) therapy for maintenance treatment of chronic obstructive pulmonary disease (COPD). Economic evaluations were included if published in English since 2003. Evaluation categories included in the review were cost-effectiveness, cost-utility, and cost-consequence analyses. FSC is cost-effective in comparison to short-acting bronchodilators (SABDs). Cost and outcome differences between FSC and other long-acting therapies were modest. Studies exhibited large variations in populations, designs and environment, limiting the ability to draw conclusions. Many new maintenance treatments for COPD have been approved since 2010. Most have yet to be compared to older treatments like FSC. Evaluations are needed that consider costs and outcomes from a societal perspective (e.g., patients' ability to keep working) and evaluations that include subgroup analyses to investigate differential impacts according to clusters of patient characteristics.

Immunocompetence of breeding females is sensitive to cortisol levels but not to communal rearing in the degu (Octodon degus).

PubMed

Ebensperger, Luis A; León, Cecilia; Ramírez-Estrada, Juan; Abades, Sebastian; Hayes, Loren D; Nova, Esteban; Salazar, Fabián; Bhattacharjee, Joydeep; Becker, María Inés

2015-03-01

One hypothesis largely examined in social insects is that cooperation in the context of breeding benefits individuals through decreasing the burden of immunocompetence and provide passive immunity through social contact. Similarly, communal rearing in social mammals may benefit adult female members of social groups by reducing the cost of immunocompetence, and through the transfer of immunological compounds during allonursing. Yet, these benefits may come at a cost to breeders in terms of a need to increase investment in individual immunocompetence. We examined how these potential immunocompetence costs and benefits relate to reproductive success and survival in a natural population of the communally rearing rodent, Octodon degus. We related immunocompetence (based on ratios of white blood cell counts, total and specific immunoglobulins of G isotype titers) and fecal glucocorticoid metabolite (FGC) levels of adults immunized with hemocyanin from the mollusk Concholepas concholepas to measures of sociality (group size) and communal rearing (number of breeding females). Offspring immunocompetence was quantified based on circulating levels of the same immune parameters. Neither female nor offspring immunocompetence was influenced by communal rearing or sociality. These findings did not support that communal rearing and sociality enhance the ability of females to respond to immunological challenges during lactation, or contribute to enhance offspring condition (based on immunocompetence) or early survival (i.e., to 3months of age). Instead, levels of humoral and cellular components of immunocompetence were associated with variation in glucorcorticoid levels of females. We hypothesize that this covariation is driven by physiological (life-history) adjustments needed to sustain breeding. Copyright © 2014 Elsevier Inc. All rights reserved.

48 CFR 736.602-3 - Evaluation board functions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... industry with respect to such factors as control of costs, quality of work, and ability to meet schedules, to the extent such information is available; (4) Ability to assign an adequate number of qualified... architect-engineer is able to perform with its own forces when required; (6) Ability of the architect...

48 CFR 736.602-3 - Evaluation board functions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... industry with respect to such factors as control of costs, quality of work, and ability to meet schedules, to the extent such information is available; (4) Ability to assign an adequate number of qualified... architect-engineer is able to perform with its own forces when required; (6) Ability of the architect...

48 CFR 736.602-3 - Evaluation board functions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... industry with respect to such factors as control of costs, quality of work, and ability to meet schedules, to the extent such information is available; (4) Ability to assign an adequate number of qualified... architect-engineer is able to perform with its own forces when required; (6) Ability of the architect...

Low-level light treatment ameliorates immune thrombocytopenia

PubMed Central

Yang, Jingke; Zhang, Qi; Li, Peiyu; Dong, Tingting; Wu, Mei X.

2016-01-01

Immune thrombocytopenia (ITP) is an immune-mediated acquired bleeding disorder characterized by abnormally low platelet counts. We reported here the ability of low-level light treatment (LLLT) to alleviate ITP in mice. The treatment is based on noninvasive whole body illumination 30 min a day for a few consecutive days by near infrared light (830 nm) transmitted by an array of light-emitting diodes (LEDs). LLLT significantly lifted the nadir of platelet counts and restored tail bleeding time when applied to two passive ITP models induced by anti-CD41 antibody. The anti-platelet antibody hindered megakaryocyte differentiation from the progenitors, impaired proplatelet and platelet formation, and induced apoptosis of platelets. These adverse effects of anti-CD41 antibody were all mitigated by LLLT to varying degrees, owing to its ability to enhance mitochondrial biogenesis and activity in megakaryocytes and preserve mitochondrial functions in platelets in the presence of the antibody. The observations argue not only for contribution of mitochondrial stress to the pathology of ITP, but also clinical potentials of LLLT as a safe, simple, and cost-effective modality of ITP. PMID:27901126

Low-level light treatment ameliorates immune thrombocytopenia

NASA Astrophysics Data System (ADS)

Yang, Jingke; Zhang, Qi; Wu, Mei X.

2017-02-01

Immune thrombocytopenia (ITP) is an immune-mediated acquired bleeding disorder characterized by abnormally low platelet counts. We reported here the ability of low-level light treatment (LLLT) to alleviate ITP in mice. The treatment is based on noninvasive whole body illumination 30 min a day for a few consecutive days by near infrared light (830 nm) transmitted by an array of light-emitting diodes (LEDs). LLLT significantly lifted the nadir of platelet counts and restored tail bleeding time when applied to two passive ITP models induced by anti-CD41 antibody. The anti-platelet antibody hindered megakaryocyte differentiation from the progenitors, impaired proplatelet and platelet formation, and induced apoptosis of platelets. These adverse effects of anti-CD41 antibody were all mitigated by LLLT to varying degrees, owing to its ability to enhance mitochondrial biogenesis and activity in megakaryocytes and preserve mitochondrial functions in platelets in the presence of the antibody. The observations argue not only for contribution of mitochondrial stress to the pathology of ITP, but also clinical potentials of LLLT as a safe, simple, and cost-effective modality of ITP.

Archipelago-wide island restoration in the Galápagos Islands: reducing costs of invasive mammal eradication programs and reinvasion risk.

PubMed

Carrion, Victor; Donlan, C Josh; Campbell, Karl J; Lavoie, Christian; Cruz, Felipe

2011-05-11

Invasive alien mammals are the major driver of biodiversity loss and ecosystem degradation on islands. Over the past three decades, invasive mammal eradication from islands has become one of society's most powerful tools for preventing extinction of insular endemics and restoring insular ecosystems. As practitioners tackle larger islands for restoration, three factors will heavily influence success and outcomes: the degree of local support, the ability to mitigate for non-target impacts, and the ability to eradicate non-native species more cost-effectively. Investments in removing invasive species, however, must be weighed against the risk of reintroduction. One way to reduce reintroduction risks is to eradicate the target invasive species from an entire archipelago, and thus eliminate readily available sources. We illustrate the costs and benefits of this approach with the efforts to remove invasive goats from the Galápagos Islands. Project Isabela, the world's largest island restoration effort to date, removed >140,000 goats from >500,000 ha for a cost of US$10.5 million. Leveraging the capacity built during Project Isabela, and given that goat reintroductions have been common over the past decade, we implemented an archipelago-wide goat eradication strategy. Feral goats remain on three islands in the archipelago, and removal efforts are underway. Efforts on the Galápagos Islands demonstrate that for some species, island size is no longer the limiting factor with respect to eradication. Rather, bureaucratic processes, financing, political will, and stakeholder approval appear to be the new challenges. Eradication efforts have delivered a suite of biodiversity benefits that are in the process of revealing themselves. The costs of rectifying intentional reintroductions are high in terms of financial and human resources. Reducing the archipelago-wide goat density to low levels is a technical approach to reducing reintroduction risk in the short-term, and is being complemented with a longer-term social approach focused on education and governance.

Archipelago-Wide Island Restoration in the Galápagos Islands: Reducing Costs of Invasive Mammal Eradication Programs and Reinvasion Risk

PubMed Central

Carrion, Victor; Donlan, C. Josh; Campbell, Karl J.; Lavoie, Christian; Cruz, Felipe

2011-01-01

Invasive alien mammals are the major driver of biodiversity loss and ecosystem degradation on islands. Over the past three decades, invasive mammal eradication from islands has become one of society's most powerful tools for preventing extinction of insular endemics and restoring insular ecosystems. As practitioners tackle larger islands for restoration, three factors will heavily influence success and outcomes: the degree of local support, the ability to mitigate for non-target impacts, and the ability to eradicate non-native species more cost-effectively. Investments in removing invasive species, however, must be weighed against the risk of reintroduction. One way to reduce reintroduction risks is to eradicate the target invasive species from an entire archipelago, and thus eliminate readily available sources. We illustrate the costs and benefits of this approach with the efforts to remove invasive goats from the Galápagos Islands. Project Isabela, the world's largest island restoration effort to date, removed >140,000 goats from >500,000 ha for a cost of US$10.5 million. Leveraging the capacity built during Project Isabela, and given that goat reintroductions have been common over the past decade, we implemented an archipelago-wide goat eradication strategy. Feral goats remain on three islands in the archipelago, and removal efforts are underway. Efforts on the Galápagos Islands demonstrate that for some species, island size is no longer the limiting factor with respect to eradication. Rather, bureaucratic processes, financing, political will, and stakeholder approval appear to be the new challenges. Eradication efforts have delivered a suite of biodiversity benefits that are in the process of revealing themselves. The costs of rectifying intentional reintroductions are high in terms of financial and human resources. Reducing the archipelago-wide goat density to low levels is a technical approach to reducing reintroduction risk in the short-term, and is being complemented with a longer-term social approach focused on education and governance. PMID:21589656

The role of inspiratory muscle training in the management of asthma and exercise-induced bronchoconstriction.

PubMed

Shei, Ren-Jay; Paris, Hunter L R; Wilhite, Daniel P; Chapman, Robert F; Mickleborough, Timothy D

2016-11-01

Asthma is a pathological condition comprising of a variety of symptoms which affect the ability to function in daily life. Due to the high prevalence of asthma and associated healthcare costs, it is important to identify low-cost alternatives to traditional pharmacotherapy. One of these low cost alternatives is the use of inspiratory muscle training (IMT), which is a technique aimed at increasing the strength and endurance of the diaphragm and accessory muscles of respiration. IMT typically consists of taking voluntary inspirations against a resistive load across the entire range of vital capacity while at rest. In healthy individuals, the most notable benefits of IMT are an increase in diaphragm thickness and strength, a decrease in exertional dyspnea, and a decrease in the oxygen cost of breathing. Due to the presence of expiratory flow limitation in asthma and exercise-induced bronchoconstriction, dynamic lung hyperinflation is common. As a result of varying operational lung volumes, due in part to hyperinflation, the respiratory muscles may operate far from the optimal portion of the length-tension curve, and thus may be forced to operate against a low pulmonary compliance. Therefore, the ability of these muscles to generate tension is reduced, and for any given level of ventilation, the work of breathing is increased as compared to non-asthmatics. Evidence that IMT is an effective treatment for asthma is inconclusive, due to limited data and a wide variation in study methodologies. However, IMT has been shown to decrease dyspnea, increase inspiratory muscle strength, and improve exercise capacity in asthmatic individuals. In order to develop more concrete recommendations regarding IMT as an effective low-cost adjunct in addition to traditional asthma treatments, we recommend that a standard treatment protocol be developed and tested in a placebo-controlled clinical trial with a large representative sample.

Uncertainty in stormwater drainage adaptation: what matters and how much is too much?

NASA Astrophysics Data System (ADS)

Stack, L. J.; Simpson, M. H.; Moore, T.; Gulliver, J. S.; Roseen, R.; Eberhart, L.; Smith, J. B.; Gruber, J.; Yetka, L.; Wood, R.; Lawson, C.

2014-12-01

Published research continues to report that long-term, local-scale precipitation forecasts are too uncertain to support local-scale adaptation. Numerous studies quantify the range of uncertainty in downscaled model output; compare this with uncertainty from other sources such as hydrological modeling; and propose circumventing uncertainty via "soft" or "low regret" actions, or adaptive management. Yet non-structural adaptations alone are likely insufficient. Structural adaptation requires quantified engineering design specifications. However, the literature does not define a tolerable level of uncertainty. Without such a benchmark, how can we determine whether the climate-change-cognizant design specifications that we are capable of, for example the climate change factors increasingly utilized in European practice, are viable? The presentation will explore this question, in the context of reporting results and observations from an ongoing ten-year program assessing local-scale stormwater drainage system vulnerabilities, required capacities, and adaptation options and costs. This program has studied stormwater systems of varying complexity in a variety of regions, topographies, and levels of urbanization, in northern-New England and the upper-Midwestern United States. These studies demonstrate the feasibility of local-scale design specifications, and provide tangible information on risk to enable valid cost/benefit decisions. The research program has found that stormwater planners and engineers have routinely accepted, in the normal course of professional practice, a level of uncertainty in hydrological modeling comparable to that in long-term precipitation projections. Moreover, the ability to quantify required capacity and related construction costs for specific climate change scenarios, the insensitivity of capacity and costs to uncertainty, and the percentage of pipes and culverts that never require upsizing, all serve to limit the impact of uncertainty inherent in climate change projections.

Magnetic Flux Compression Concept for Aerospace Propulsion and Power

NASA Technical Reports Server (NTRS)

Litchford, Ron J.; Robertson, Tony; Hawk, Clark W.; Turner, Matt; Koelfgen, Syri

2000-01-01

The objective of this research is to investigate system level performance and design issues associated with magnetic flux compression devices for aerospace power generation and propulsion. The proposed concept incorporates the principles of magnetic flux compression for direct conversion of nuclear/chemical detonation energy into electrical power. Specifically a magnetic field is compressed between an expanding detonation driven diamagnetic plasma and a stator structure formed from a high temperature superconductor (HTSC). The expanding plasma cloud is entirely confined by the compressed magnetic field at the expense of internal kinetic energy. Electrical power is inductively extracted, and the detonation products are collimated and expelled through a magnetic nozzle. The long-term development of this highly integrated generator/propulsion system opens up revolutionary NASA Mission scenarios for future interplanetary and interstellar spacecraft. The unique features of this concept with respect to future space travel opportunities are as follows: ability to implement high energy density chemical detonations or ICF microfusion bursts as the impulsive diamagnetic plasma source; high power density system characteristics constrain the size, weight, and cost of the vehicle architecture; provides inductive storage pulse power with a very short pulse rise time; multimegajoule energy bursts/terawatt power bursts; compact pulse power driver for low-impedance dense plasma devices; utilization of low cost HTSC material and casting technology to increase magnetic flux conservation and inductive energy storage; improvement in chemical/nuclear-to-electric energy conversion efficiency and the ability to generate significant levels of thrust with very high specific impulse; potential for developing a small, lightweight, low cost, self-excited integrated propulsion and power system suitable for space stations, planetary bases, and interplanetary and interstellar space travel; potential for attaining specific impulses approaching 10 (exp 6) seconds, which would enable missions to the outer planets within ten years and missions at interstellar distances within fifty years.

Control your inventory in a world of lean retailing.

PubMed

Abernathy, F H; Dunlop, J T; Hammond, J H; Weil, D

2000-01-01

As retailers adopt lean retailing practices, manufacturers are feeling the pinch. Retailers no longer place large seasonal orders for goods in advance-instead, they require ongoing replenishment of stock, forcing manufacturers to predict demand and then hold substantial inventories indefinitely. Manufacturers now carry the cost of inventory risk--the possibility that demand will dry up and goods will have to be sold below cost. And as product proliferation increases, customer demand becomes harder to predict. Most manufacturers apply one inventory policy for all stock-keeping units in a product line. But the inventory demand for SKUs within the same product line can vary significantly. SKUs with high volume typically have little variation in weekly sales, while slow-selling SKUs can vary enormously in weekly sales. The greater the variation, the larger the inventory the manufacturer must hold relative to an SKU's expected weekly sales. By differentiating inventory policies at the SKU level, manufacturers can reduce inventories for the high-volume SKUs and increase them for the low-volume ones--and thereby improve the profit-ability of the entire line. SKU-level differentiation can also be applied to sourcing strategies. Instead of producing all the SKUs for a product line at a single location, either offshore at low cost or close to market at higher cost, manufacturers can typically do better by going for a mixed allocation. Low-variation goods should be produced mainly offshore, while high-variation goods are best made close to markets.

Properties of large Li ion cells using a nickel based mixed oxide

NASA Astrophysics Data System (ADS)

Broussely, M.; Blanchard, Ph; Biensan, Ph; Planchat, J. P.; Nechev, K.; Staniewicz, R. J.

The possible use of LiNiO 2 similar to LiCoO 2, as a positive material in rechargeable lithium batteries was recognized 20 years ago and starting 10 years later, many research studies led to material improvement through substitution of some of the nickel ions by other metallic ions. These modifications improve the thermal stability at high charge level or overcharge, as well as cycling and storage properties. Commercial material is now available at large industrial scale, which allows its use in big "industrial" Li ion batteries. Using low cost raw material (Ni), it is expected to be cost competitive with the manganese based systems usually mentioned as low cost on the total cell $/Wh basis. Providing higher energy density, and demonstrating excellent behavior on storage and extended cycle life, LiNiO 2 has definite advantages over the manganese system. Thanks to their properties, these batteries have demonstrated their ability to be used in lot of applications, either for transportation or standby. Their light weight makes them attractive for powering satellites. Although safety improvements are always desirable for all non-aqueous batteries using flammable organic electrolytes, suitable battery designs allow the systems to reach the acceptable level of safety required by many users. Beside the largely distributed lead acid and nickel cadmium batteries, Li ion will found its place in the "industrial batteries" market, in a proportion directly linked to its future cost reduction.

Listening to music during electromyography does not influence the examinee's anxiety and pain levels.

PubMed

Abraham, Alon; Drory, Vivian E

2014-09-01

Listening to music is a low-cost intervention that has demonstrated ability to reduce pain and anxiety levels in various medical procedures. Subjects undergoing electrophysiological examinations were randomized into a music-listening group and a control group. Visual analog scales were used to measure anxiety and pain levels during the procedure. Thirty subjects were randomized to each group. No statistically significant difference was found in anxiety or pain levels during the procedure between groups. However, most subjects in the music-listening group reported anxiety and pain reduction and would prefer to hear music in a future examination. Although listening to music during electrophysiological examinations did not reduce anxiety or pain significantly, most subjects felt a positive effect and would prefer to hear music; therefore, we suggest that music may be offered optionally in the electromyography laboratory setting. © 2014 Wiley Periodicals, Inc.

Cost-effectiveness of medical primary prevention strategies to reduce absolute risk of cardiovascular disease in Tanzania: a Markov modelling study.

PubMed

Ngalesoni, Frida N; Ruhago, George M; Mori, Amani T; Robberstad, Bjarne; Norheim, Ole F

2016-05-17

Cardiovascular disease (CVD) is a growing cause of mortality and morbidity in Tanzania, but contextualized evidence on cost-effective medical strategies to prevent it is scarce. We aim to perform a cost-effectiveness analysis of medical interventions for primary prevention of CVD using the World Health Organization's (WHO) absolute risk approach for four risk levels. The cost-effectiveness analysis was performed from a societal perspective using two Markov decision models: CVD risk without diabetes and CVD risk with diabetes. Primary provider and patient costs were estimated using the ingredients approach and step-down methodologies. Epidemiological data and efficacy inputs were derived from systematic reviews and meta-analyses. We used disability- adjusted life years (DALYs) averted as the outcome measure. Sensitivity analyses were conducted to evaluate the robustness of the model results. For CVD low-risk patients without diabetes, medical management is not cost-effective unless willingness to pay (WTP) is higher than US$1327 per DALY averted. For moderate-risk patients, WTP must exceed US$164 per DALY before a combination of angiotensin converting enzyme inhibitor (ACEI) and diuretic (Diu) becomes cost-effective, while for high-risk and very high-risk patients the thresholds are US$349 (ACEI, calcium channel blocker (CCB) and Diu) and US$498 per DALY (ACEI, CCB, Diu and Aspirin (ASA)) respectively. For patients with CVD risk with diabetes, a combination of sulfonylureas (Sulf), ACEI and CCB for low and moderate risk (incremental cost-effectiveness ratio (ICER) US$608 and US$115 per DALY respectively), is the most cost-effective, while adding biguanide (Big) to this combination yielded the most favourable ICERs of US$309 and US$350 per DALY for high and very high risk respectively. For the latter, ASA is also part of the combination. Medical preventive cardiology is very cost-effective for all risk levels except low CVD risk. Budget impact analyses and distributional concerns should be considered further to assess governments' ability and to whom these benefits will accrue.

An exploration of parents' preferences for foot care in juvenile idiopathic arthritis: a possible role for the discrete choice experiment.

PubMed

Hendry, Gordon J; Turner, Debbie E; Gardner-Medwin, Janet; Lorgelly, Paula K; Woodburn, James

2014-02-06

An increased awareness of patients' and parents' care preferences regarding foot care is desirable from a clinical perspective as such information may be utilised to optimise care delivery. The aim of this study was to examine parents' preferences for, and valuations of foot care and foot-related outcomes in juvenile idiopathic arthritis (JIA). A discrete choice experiment (DCE) incorporating willingness-to-pay (WTP) questions was conducted by surveying 42 parents of children with JIA who were enrolled in a randomised-controlled trial of multidisciplinary foot care at a single UK paediatric rheumatology outpatients department. Attributes explored were: levels of pain; mobility; ability to perform activities of daily living (ADL); waiting time; referral route; and footwear. The DCE was administered at trial baseline. DCE data were analysed using a multinomial-logit-regression model to estimate preferences and relative importance of attributes of foot care. A stated-preference WTP question was presented to estimate parents' monetary valuation of health and service improvements. Every attribute in the DCE was statistically significant (p < 0.01) except that of cost (p = 0.118), suggesting that all attributes, except cost, have an impact on parents' preferences for foot care for their child. The magnitudes of the coefficients indicate that the strength of preference for each attribute was (in descending order): improved ability to perform ADL, reductions in foot pain, improved mobility, improved ability to wear desired footwear, multidisciplinary foot care route, and reduced waiting time. Parents' estimated mean annual WTP for a multidisciplinary foot care service was £1,119.05. In terms of foot care service provision for children with JIA, parents appear to prefer improvements in health outcomes over non-health outcomes and service process attributes. Cost was relatively less important than other attributes suggesting that it does not appear to impact on parents' preferences.

An exploration of parents’ preferences for foot care in juvenile idiopathic arthritis: a possible role for the discrete choice experiment

PubMed Central

2014-01-01

Background An increased awareness of patients’ and parents’ care preferences regarding foot care is desirable from a clinical perspective as such information may be utilised to optimise care delivery. The aim of this study was to examine parents’ preferences for, and valuations of foot care and foot-related outcomes in juvenile idiopathic arthritis (JIA). Methods A discrete choice experiment (DCE) incorporating willingness-to-pay (WTP) questions was conducted by surveying 42 parents of children with JIA who were enrolled in a randomised-controlled trial of multidisciplinary foot care at a single UK paediatric rheumatology outpatients department. Attributes explored were: levels of pain; mobility; ability to perform activities of daily living (ADL); waiting time; referral route; and footwear. The DCE was administered at trial baseline. DCE data were analysed using a multinomial-logit-regression model to estimate preferences and relative importance of attributes of foot care. A stated-preference WTP question was presented to estimate parents’ monetary valuation of health and service improvements. Results Every attribute in the DCE was statistically significant (p < 0.01) except that of cost (p = 0.118), suggesting that all attributes, except cost, have an impact on parents’ preferences for foot care for their child. The magnitudes of the coefficients indicate that the strength of preference for each attribute was (in descending order): improved ability to perform ADL, reductions in foot pain, improved mobility, improved ability to wear desired footwear, multidisciplinary foot care route, and reduced waiting time. Parents’ estimated mean annual WTP for a multidisciplinary foot care service was £1,119.05. Conclusions In terms of foot care service provision for children with JIA, parents appear to prefer improvements in health outcomes over non-health outcomes and service process attributes. Cost was relatively less important than other attributes suggesting that it does not appear to impact on parents’ preferences. PMID:24502508

Blood Glucose Monitoring Devices

MedlinePlus

... of interferences ability to transmit data to a computer cost of the meter cost of the test ... Performance FDA expands indication for continuous glucose monitoring system, first to replace fingerstick testing for diabetes treatment ...

Quantifying Energy and Water Savings in the U.S. Residential Sector.

PubMed

Chini, Christopher M; Schreiber, Kelsey L; Barker, Zachary A; Stillwell, Ashlynn S

2016-09-06

Stress on water and energy utilities, including natural resource depletion, infrastructure deterioration, and growing populations, threatens the ability to provide reliable and sustainable service. This study presents a demand-side management decision-making tool to evaluate energy and water efficiency opportunities at the residential level, including both direct and indirect consumption. The energy-water nexus accounts for indirect resource consumption, including water-for-energy and energy-for-water. We examine the relationship between water and energy in common household appliances and fixtures, comparing baseline appliances to ENERGY STAR or WaterSense appliances, using a cost abatement analysis for the average U.S. household, yielding a potential annual per household savings of 7600 kWh and 39 600 gallons, with most upgrades having negative abatement cost. We refine the national average cost abatement curves to understand regional relationships, specifically for the urban environments of Los Angeles, Chicago, and New York. Cost abatement curves display per unit cost savings related to overall direct and indirect energy and water efficiency, allowing utilities, policy makers, and homeowners to consider the relationship between energy and water when making decisions. Our research fills an important gap of the energy-water nexus in a residential unit and provides a decision making tool for policy initiatives.

A Summary of: 25 Ways to Reduce the Cost of College

ERIC Educational Resources Information Center

Center for College Affordability and Productivity (NJ1), 2010

2010-01-01

Almost everyone agrees that colleges have become costly to attend and are a growing burden on society to finance. Rising tuition costs threaten the ability and desire of students to attend college. Are there things that can be done to significantly reduce the cost of college? The answer is an emphatic "yes." The Center for College Affordability…

A proposed method to minimize waste from institutional radiation safety surveillance programs through the application of expected value statistics.

PubMed

Emery, R J

1997-03-01

Institutional radiation safety programs routinely use wipe test sampling and liquid scintillation counting analysis to indicate the presence of removable radioactive contamination. Significant volumes of liquid waste can be generated by such surveillance activities, and the subsequent disposal of these materials can sometimes be difficult and costly. In settings where large numbers of negative results are regularly obtained, the limited grouping of samples for analysis based on expected value statistical techniques is possible. To demonstrate the plausibility of the approach, single wipe samples exposed to varying amounts of contamination were analyzed concurrently with nine non-contaminated samples. Although the sample grouping inevitably leads to increased quenching with liquid scintillation counting systems, the effect did not impact the ability to detect removable contamination in amounts well below recommended action levels. Opportunities to further improve this cost effective semi-quantitative screening procedure are described, including improvements in sample collection procedures, enhancing sample-counting media contact through mixing and extending elution periods, increasing sample counting times, and adjusting institutional action levels.

Solid-Phase Extraction Coupled to a Paper-Based Technique for Trace Copper Detection in Drinking Water.

PubMed

Quinn, Casey W; Cate, David M; Miller-Lionberg, Daniel D; Reilly, Thomas; Volckens, John; Henry, Charles S

2018-03-20

Metal contamination of natural and drinking water systems poses hazards to public and environmental health. Quantifying metal concentrations in water typically requires sample collection in the field followed by expensive laboratory analysis that can take days to weeks to obtain results. The objective of this work was to develop a low-cost, field-deployable method to quantify trace levels of copper in drinking water by coupling solid-phase extraction/preconcentration with a microfluidic paper-based analytical device. This method has the advantages of being hand-powered (instrument-free) and using a simple "read by eye" quantification motif (based on color distance). Tap water samples collected across Fort Collins, CO, were tested with this method and validated against ICP-MS. We demonstrate the ability to quantify the copper content of tap water within 30% of a reference technique at levels ranging from 20 to 500 000 ppb. The application of this technology, which should be sufficient as a rapid screening tool, can lead to faster, more cost-effective detection of soluble metals in water systems.

Program Tracks Cost Of Travel

NASA Technical Reports Server (NTRS)

Mauldin, Lemuel E., III

1993-01-01

Travel Forecaster is menu-driven, easy-to-use computer program that plans, forecasts cost, and tracks actual vs. planned cost of business-related travel of division or branch of organization and compiles information into data base to aid travel planner. Ability of program to handle multiple trip entries makes it valuable time-saving device.

Toward best-practice post-disaster mental health promotion for children: Sri Lanka.

PubMed

Commers, Matthew J; Morival, Marc; Devries, Marten W

2014-03-01

There is a pressing need for low-cost intervention models to promote mental health among children in the wake of natural disasters. This article describes an evaluation of one such model: the Happy/Sad Letter Box (HSLB) Project, a mental health promotion intervention designed to minimize trauma in children, resulting from the Indian Ocean tsunami of 26 December 2004. The HSLB Project was implemented in 68 schools in Sri Lanka's Hambantota District from April 2005 forward. Methods included questionnaires (n = 203), interviews, and group consultation with schoolchildren, teachers, teacher counsellors, principals, educational zone directors and parents. The HSLB intervention was seen as relevant and non-stigmatized, cost-effective if implemented after initial recovery steps, anecdotally effective in identifying and helping resolve trauma, accommodating the full range of children's daily stressors and sustainable. Gender, children's age, school size and the level of the tsunami impact for response were found to correlate with response differences. Along four dimensions previously identified in the literature (ability to triage, matching of intervention timing and focus, ability to accommodate a range of stressors and context compatibility), the HSLB Project is a promising intervention model (1) for children; (2) at group-level; (3) relating to natural disasters. The Nairobi Call to Action [WHO (2009) Nairobi Call to Action for Closing the Implementation Gap in Health Promotion. Geneva: World Health Organization] emphasized the importance of mainstreaming health promotion into priority programme areas, specifically including mental health. The HSLB Project represents the integration of health promotion practice into disaster preparedness mental health infrastructure.

Economic Analysis of a Multi-Site Prevention Program: Assessment of Program Costs and Characterizing Site-level Variability

PubMed Central

Corso, Phaedra S.; Ingels, Justin B.; Kogan, Steven M.; Foster, E. Michael; Chen, Yi-Fu; Brody, Gene H.

2013-01-01

Programmatic cost analyses of preventive interventions commonly have a number of methodological difficulties. To determine the mean total costs and properly characterize variability, one often has to deal with small sample sizes, skewed distributions, and especially missing data. Standard approaches for dealing with missing data such as multiple imputation may suffer from a small sample size, a lack of appropriate covariates, or too few details around the method used to handle the missing data. In this study, we estimate total programmatic costs for a prevention trial evaluating the Strong African American Families-Teen program. This intervention focuses on the prevention of substance abuse and risky sexual behavior. To account for missing data in the assessment of programmatic costs we compare multiple imputation to probabilistic sensitivity analysis. The latter approach uses collected cost data to create a distribution around each input parameter. We found that with the multiple imputation approach, the mean (95% confidence interval) incremental difference was $2149 ($397, $3901). With the probabilistic sensitivity analysis approach, the incremental difference was $2583 ($778, $4346). Although the true cost of the program is unknown, probabilistic sensitivity analysis may be a more viable alternative for capturing variability in estimates of programmatic costs when dealing with missing data, particularly with small sample sizes and the lack of strong predictor variables. Further, the larger standard errors produced by the probabilistic sensitivity analysis method may signal its ability to capture more of the variability in the data, thus better informing policymakers on the potentially true cost of the intervention. PMID:23299559

Economic analysis of a multi-site prevention program: assessment of program costs and characterizing site-level variability.

PubMed

Corso, Phaedra S; Ingels, Justin B; Kogan, Steven M; Foster, E Michael; Chen, Yi-Fu; Brody, Gene H

2013-10-01

Programmatic cost analyses of preventive interventions commonly have a number of methodological difficulties. To determine the mean total costs and properly characterize variability, one often has to deal with small sample sizes, skewed distributions, and especially missing data. Standard approaches for dealing with missing data such as multiple imputation may suffer from a small sample size, a lack of appropriate covariates, or too few details around the method used to handle the missing data. In this study, we estimate total programmatic costs for a prevention trial evaluating the Strong African American Families-Teen program. This intervention focuses on the prevention of substance abuse and risky sexual behavior. To account for missing data in the assessment of programmatic costs we compare multiple imputation to probabilistic sensitivity analysis. The latter approach uses collected cost data to create a distribution around each input parameter. We found that with the multiple imputation approach, the mean (95 % confidence interval) incremental difference was $2,149 ($397, $3,901). With the probabilistic sensitivity analysis approach, the incremental difference was $2,583 ($778, $4,346). Although the true cost of the program is unknown, probabilistic sensitivity analysis may be a more viable alternative for capturing variability in estimates of programmatic costs when dealing with missing data, particularly with small sample sizes and the lack of strong predictor variables. Further, the larger standard errors produced by the probabilistic sensitivity analysis method may signal its ability to capture more of the variability in the data, thus better informing policymakers on the potentially true cost of the intervention.

The effect of misclassification errors on case mix measurement.

PubMed

Sutherland, Jason M; Botz, Chas K

2006-12-01

Case mix systems have been implemented for hospital reimbursement and performance measurement across Europe and North America. Case mix categorizes patients into discrete groups based on clinical information obtained from patient charts in an attempt to identify clinical or cost difference amongst these groups. The diagnosis related group (DRG) case mix system is the most common methodology, with variants adopted in many countries. External validation studies of coding quality have confirmed that widespread variability exists between originally recorded diagnoses and re-abstracted clinical information. DRG assignment errors in hospitals that share patient level cost data for the purpose of establishing cost weights affects cost weight accuracy. The purpose of this study is to estimate bias in cost weights due to measurement error of reported clinical information. DRG assignment error rates are simulated based on recent clinical re-abstraction study results. Our simulation study estimates that 47% of cost weights representing the least severe cases are over weight by 10%, while 32% of cost weights representing the most severe cases are under weight by 10%. Applying the simulated weights to a cross-section of hospitals, we find that teaching hospitals tend to be under weight. Since inaccurate cost weights challenges the ability of case mix systems to accurately reflect patient mix and may lead to potential distortions in hospital funding, bias in hospital case mix measurement highlights the role clinical data quality plays in hospital funding in countries that use DRG-type case mix systems. Quality of clinical information should be carefully considered from hospitals that contribute financial data for establishing cost weights.

Evaluation of a Low-Cost Bubble CPAP System Designed for Resource-Limited Settings.

PubMed

Bennett, Desmond J; Carroll, Ryan W; Kacmarek, Robert M

2018-04-01

Respiratory compromise is a leading contributor to global neonatal death. CPAP is a method of treatment that helps maintain lung volume during expiration, promotes comfortable breathing, and improves oxygenation. Bubble CPAP is an effective alternative to standard CPAP. We sought to determine the reliability and functionality of a low-cost bubble CPAP device designed for low-resource settings. The low-cost bubble CPAP device was compared to a commercially available bubble CPAP system. The devices were connected to a lung simulator that simulated neonates of 4 different weights with compromised respiratory mechanics (∼1, ∼3, ∼5, and ∼10 kg). The devices' abilities to establish and maintain pressure and flow under normal conditions as well as under conditions of leak were compared. Multiple combinations of pressure levels (5, 8, and 10 cm H 2 O) and flow levels (3, 6, and 10 L/min) were tested. The endurance of both devices was also tested by running the systems continuously for 8 h and measuring the changes in pressure and flow. Both devices performed equivalently during the no-leak and leak trials. While our testing revealed individual differences that were statistically significant and clinically important (>10% difference) within specific CPAP and flow-level settings, no overall comparisons of CPAP or flow were both statistically significant and clinically important. Each device delivered pressures similar to the desired pressures, although the flows delivered by both machines were lower than the set flows in most trials. During the endurance trials, the low-cost device was marginally better at maintaining pressure, while the commercially available device was better at maintaining flow. The low-cost bubble CPAP device evaluated in this study is comparable to a bubble CPAP system used in developed settings. Extensive clinical trials, however, are necessary to confirm its effectiveness. Copyright © 2018 by Daedalus Enterprises.

The Effects of Behavioral Health Reform on Safety-Net Institutions: A Mixed-Method Assessment in a Rural State

PubMed Central

Sommerfeld, David H.; Aarons, Gregory A.; Waitzkin, Howard

2013-01-01

In July 2005, New Mexico initiated a major reform of publicly-funded behavioral healthcare to reduce cost and bureaucracy. We used a mixed-method approach to examine how this reform impacted the workplaces and employees of service agencies that care for low-income adults in rural and urban areas. Information technology problems and cumbersome processes to enroll patients, procure authorizations, and submit claims led to payment delays that affected the financial status of the agencies, their ability to deliver care, and employee morale. Rural employees experienced lower levels of job satisfaction and organizational commitment and higher levels of turnover intentions under the reform when compared to their urban counterparts. PMID:23307162

Problem signs in law school: Fostering attorney well-being early in professional training.

PubMed

Reed, Krystia; Bornstein, Brian H; Jeon, Andrew B; Wylie, Lindsey E

2016-01-01

Attorneys suffer from high rates of stress, alcoholism, and mental health problems that are costly for the legal system and impair their abilities to serve their clients. There is some indication that these problems begin in law school. The present study assessed a cohort of law students at an American law school for their reported levels of stress, depression, anxiety, substance use, and overall adjustment/coping. Findings indicate that law students suffer from high levels of stress, anxiety, depression, and alcohol use, and that these problem behaviors fluctuate throughout the course of law school. We discuss the implications for law student/lawyer well-being and legal education. Copyright © 2016 Elsevier Ltd. All rights reserved.

Unsupervised daily routine and activity discovery in smart homes.

PubMed

Jie Yin; Qing Zhang; Karunanithi, Mohan

2015-08-01

The ability to accurately recognize daily activities of residents is a core premise of smart homes to assist with remote health monitoring. Most of the existing methods rely on a supervised model trained from a preselected and manually labeled set of activities, which are often time-consuming and costly to obtain in practice. In contrast, this paper presents an unsupervised method for discovering daily routines and activities for smart home residents. Our proposed method first uses a Markov chain to model a resident's locomotion patterns at different times of day and discover clusters of daily routines at the macro level. For each routine cluster, it then drills down to further discover room-level activities at the micro level. The automatic identification of daily routines and activities is useful for understanding indicators of functional decline of elderly people and suggesting timely interventions.

Economic impact of angioplasty salvage techniques, with an emphasis on coronary stents: a method incorporating costs, revenues, clinical effectiveness and payer mix.

PubMed

Vaitkus, P T; Witmer, W T; Brandenburg, R G; Wells, S K; Zehnacker, J B

1997-10-01

We sought to broaden assessment of the economic impact of percutaneous transluminal coronary angioplasty (PTCA) revascularization salvage strategies by taking into account costs, revenues, the off-setting effects of prevented clinical complications and the effects of payer mix. Previous economic analyses of PTCA have focused on the direct costs of treatment but have not accounted either for associated revenues or for the ability of costly salvage techniques such as coronary stenting to reduce even costlier complications. Procedural costs, revenues and contribution margins (i.e., "profit") were measured for 765 consecutive PTCA cases to assess the economic impact of salvage techniques (prolonged heparin administration, thrombolysis, intracoronary stenting or use of perfusion balloon catheters) and clinical complications (myocardial infarction, coronary artery bypass graft surgery [CABG] or acute vessel closure with repeat PTCA). To assess the economic impact of various salvage techniques for failed PTCA, we used actual 1995 financial data as well as models of various mixes of fee-for-service, diagnosis-related group (DRG) and capitated payers. Under fee-for-service arrangements, most salvage techniques were profitable for the hospital. Stents were profitable at almost any level of clinical effectiveness. Under DRG-based systems, most salvage techniques such as stenting produced a financial loss to the hospital because one complication (CABG) remained profitable. Under capitated arrangements, stenting and other salvage modalities were profitable only if they were clinically effective in preventing complications in > 50% of cases in which they were used. The economic impact of PTCA salvage techniques depends on their clinical effectiveness, costs and revenues. In reimbursement systems dominated by DRG payers, salvage techniques are not rewarded, whereas complications are. Under capitated systems, the level of clinical effectiveness needed to achieve cost savings is probably not achievable in current practice. Further studies are needed to define equitable reimbursement schedules that will promote clinically effective practice.

What does free cash flow tell us about hospital efficiency? A stochastic frontier analysis of cost inefficiency in California hospitals.

PubMed

Pratt, William R

2010-01-01

Hospitals are facing substantial financial and economic pressure as a result of health plan payment restructuring, unfunded mandates, and other factors. This article analyzes the relationship between free cash flow (FCF) and hospital efficiency given these financial challenges. Data from 270 California hospitals were used to estimate a stochastic frontier model of hospital cost efficiency that explicitly takes into account outpatient heterogeneity. The findings indicate that hospital FCF is significantly linked to firm efficiency/inefficiency. The results indicate that higher positive cash flows are related to lower cost inefficiency, but higher negative cash flows are related to higher cost inefficiency. Thus, cash flows not only impact the ability of hospitals to meet current liabilities, they are also related to the ability of the hospitals to use resources effectively.

Suture Button Fixation Versus Syndesmotic Screws in Supination-External Rotation Type 4 Injuries: A Cost-Effectiveness Analysis.

PubMed

Neary, Kaitlin C; Mormino, Matthew A; Wang, Hongmei

2017-01-01

In stress-positive, unstable supination-external rotation type 4 (SER IV) ankle fractures, implant selection for syndesmotic fixation is a debated topic. Among the available syndesmotic fixation methods, the metallic screw and the suture button have been routinely compared in the literature. In addition to strength of fixation and ability to anatomically restore the syndesmosis, costs associated with implant use have recently been called into question. This study aimed to examine the cost-effectiveness of the suture button and determine whether suture button fixation is more cost-effective than two 3.5-mm syndesmotic screws not removed on a routine postoperative basis. Economic and decision analysis; Level of evidence, 2. Studies with the highest evidence levels in the available literature were used to estimate the hardware removal and failure rates for syndesmotic screws and suture button fixation. Costs were determined by examining the average costs for patients who underwent surgery for unstable SER IV ankle fractures at a single level-1 trauma institution. A decision analysis model that allowed comparison of the 2 fixation methods was developed. Using a 20% screw hardware removal rate and a 4% suture button hardware removal rate, the total cost for 2 syndesmotic screws was US$20,836 and the total effectiveness was 5.846. This yielded a total cost of $3564 per quality-adjusted life-year (QALY) over an 8-year time period. The total cost for suture button fixation was $19,354 and the total effectiveness was 5.904, resulting in a total cost of $3294 per QALY over the same time period. A sensitivity analysis was then conducted to assess suture button fixation costs as well as screw and suture button hardware removal rates. Other possible treatment scenarios were also examined, including 1 screw and 2 suture buttons for operative fixation of the syndesmosis. To become more cost-effective, the screw hardware removal rate would have to be reduced to less than 10%. Furthermore, fixation with a single suture button continued to be the dominant treatment strategy compared with 2 suture buttons, 1 screw, and 2 screws for syndesmotic fixation. This cost-effectiveness analysis suggests that for unstable SER IV ankle fractures, suture button fixation is more cost-effective than syndesmotic screws not removed on a routine basis. Suture button fixation was a dominant treatment strategy, because patients spent on average $1482 less and had a higher quality of life by 0.058 QALYs compared with patients who received fixation with 2 syndesmotic screws. Assuming that functional outcomes and failure rates were equivalent, screw fixation only became more cost-effective when the screw hardware removal rate was reduced to less than 10% or when the suture button cost exceeded $2000. In addition, fixation with a single suture button device proved more cost-effective than fixation with either 1 or 2 syndesmotic screws.

Hospital revenue cycle management and payer mix: do Medicare and Medicaid undermine hospitals' ability to generate and collect patient care revenue?

PubMed

Rauscher, Simone; Wheeler, John R C

2010-01-01

The continuing efforts of government payers to contain hospital costs have raised concerns among hospital managers that serving publicly insured patients may undermine their ability to manage the revenue cycle successfully. This study uses financial information from two sources-Medicare cost reports for all US hospitals for 2002 to 2007 and audited financial statements for all bond-issuing, not-for-profit hospitals for 2000 to 2006 to examine the relationship between hospitals' shares of Medicare and Medicaid patients and the amount of patient care revenue they generate as well as the speed with which they collect their revenue. Hospital-level fixed effects regression analysis finds that hospitals with higher Medicare and Medicaid payer mix collect somewhat higher average patient care revenues than hospitals with more privately insured and self-pay patients. Hospitals with more Medicare patients also collect on this revenue faster; serving more Medicaid patients is not associated with the speed of patient revenue collection. For hospital managers, these findings may represent good news. They suggest that, despite increases in the number of publicly insured patients served, managers have frequently been able to generate adequate amounts of patient revenue and collect it in a timely fashion.

Central Appalachia: Production potential of low-sulfur coal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Watkins, J.

The vast preponderance of eastern US low sulfur and 1.2-lbs SO{sub 2}/MMBtu compliance coal comes from a relatively small area composed of 14 counties located in eastern Kentucky, southern West Virginia and western Virginia. These 14 counties accounted for 68% of all Central Appalachian coal production in 1989 as well as 85% of all compliance coal shipped to electric utilities from this region. A property-by-property analysis of total production potential in 10 of the 14 counties (Floyd, Knott, Letcher, Harlan, Martin and Pike in Kentucky and Boone, Kanawha, Logan and Mingo in West Virginia) resulted in the following estimates ofmore » active and yet to be developed properties: (1) total salable reserves for all sulfur levels were 5.9 billion tons and (2) 1.2-lbs. SO{sub 2}/MMBtu compliance'' reserves totaled 2.38 billion tons. This potential supply of compliance coal is adequate to meet the expanded utility demand expected under acid rain for the next 20 years. Beyond 2010, compliance supplies will begin to reach depletion levels in some areas of the study region. A review of the cost structure for all active mines was used to categorize the cost structure for developing potential supplies. FOB cash costs for all active mines in the ten counties ranged from $15 per ton to $35 per ton and the median mine cost was about $22 per ton. A total of 47 companies with the ability to produce and ship coal from owned or leased reserves are active in the ten-county region. Identified development and expansion projects controlled by active companies are capable of expanding the region's current production level by over 30 million tons per year over the next twenty years. Beyond this period the issue of reserve depletion for coal of all sulfur levels in the ten county region will become a pressing issue. 11 figs., 12 tabs.« less

Financing physical therapy doctoral education: methods used by entry-level students and the financial impact after graduation.

PubMed

Thompson, Kris; Coon, Jill; Handford, Leandrea

2011-01-01

With the move to the doctor of physical therapy (DPT) degree and increasing tuition costs, there is concern about financing entry-level education. The purposes of this study were to identify how students finance their DPT education and to describe the financial impact after graduation. A written survey was used to collect data on financing DPT education, student debt, and the financial impact on graduates. There were 92 subjects who had graduated from one program. Frequencies as well as nonparametric statistics using cross-tabulations and chi-squared statistics were calculated. The response rate was 55%. Of the respondents, 86% had student loans, 66% worked during school, 57% received some family assistance, and 21% had some scholarship support. The amount of monthly loan repayment was not statistically related to the ability to save for a house, the ability to obtain a loan for a house or car, or the decision to have children. Saving for the future (p = 0.016) and lifestyle choices (p = 0.035) were related to the amount of monthly loan repayment. Major sources of funding were student loans, employment income, and/or family assistance. Respondent's ability to save for the future and lifestyle choices were negatively impacted when loan debt increased. Physical therapist education programs should consider offering debt planning and counseling.

Low-cost functional plasticity of TRPV1 supports heat tolerance in squirrels and camels.

PubMed

Laursen, Willem J; Schneider, Eve R; Merriman, Dana K; Bagriantsev, Sviatoslav N; Gracheva, Elena O

2016-10-04

The ability to sense heat is crucial for survival. Increased heat tolerance may prove beneficial by conferring the ability to inhabit otherwise prohibitive ecological niches. This phenomenon is widespread and is found in both large and small animals. For example, ground squirrels and camels can tolerate temperatures more than 40 °C better than many other mammalian species, yet a molecular mechanism subserving this ability is unclear. Transient receptor potential vanilloid 1 (TRPV1) is a polymodal ion channel involved in the detection of noxious thermal and chemical stimuli by primary afferents of the somatosensory system. Here, we show that thirteen-lined ground squirrels (Ictidomys tridecemlineatus) and Bactrian camels (Camelus ferus) express TRPV1 orthologs with dramatically reduced temperature sensitivity. The loss of sensitivity is restricted to temperature and does not affect capsaicin or acid responses, thereby maintaining a role for TRPV1 as a detector of noxious chemical cues. We show that heat sensitivity can be reengineered in both TRPV1 orthologs by a single amino acid substitution in the N-terminal ankyrin-repeat domain. Conversely, reciprocal mutations suppress heat sensitivity of rat TRPV1, supporting functional conservation of the residues. Our studies suggest that squirrels and camels co-opt a common molecular strategy to adapt to hot environments by suppressing the efficiency of TRPV1-mediated heat detection at the level of somatosensory neurons. Such adaptation is possible because of the remarkable functional flexibility of the TRPV1 molecule, which can undergo profound tuning at the minimal cost of a single amino acid change.

Low-cost functional plasticity of TRPV1 supports heat tolerance in squirrels and camels

PubMed Central

Laursen, Willem J.; Merriman, Dana K.; Bagriantsev, Sviatoslav N.; Gracheva, Elena O.

2016-01-01

The ability to sense heat is crucial for survival. Increased heat tolerance may prove beneficial by conferring the ability to inhabit otherwise prohibitive ecological niches. This phenomenon is widespread and is found in both large and small animals. For example, ground squirrels and camels can tolerate temperatures more than 40 °C better than many other mammalian species, yet a molecular mechanism subserving this ability is unclear. Transient receptor potential vanilloid 1 (TRPV1) is a polymodal ion channel involved in the detection of noxious thermal and chemical stimuli by primary afferents of the somatosensory system. Here, we show that thirteen-lined ground squirrels (Ictidomys tridecemlineatus) and Bactrian camels (Camelus ferus) express TRPV1 orthologs with dramatically reduced temperature sensitivity. The loss of sensitivity is restricted to temperature and does not affect capsaicin or acid responses, thereby maintaining a role for TRPV1 as a detector of noxious chemical cues. We show that heat sensitivity can be reengineered in both TRPV1 orthologs by a single amino acid substitution in the N-terminal ankyrin-repeat domain. Conversely, reciprocal mutations suppress heat sensitivity of rat TRPV1, supporting functional conservation of the residues. Our studies suggest that squirrels and camels co-opt a common molecular strategy to adapt to hot environments by suppressing the efficiency of TRPV1-mediated heat detection at the level of somatosensory neurons. Such adaptation is possible because of the remarkable functional flexibility of the TRPV1 molecule, which can undergo profound tuning at the minimal cost of a single amino acid change. PMID:27638213

New indicators based on personnel cost for management efficiency in a hospital.

PubMed

Nakagawa, Yoshiaki; Yoshihara, Hiroyuki; Nakagawa, Yoshinobu

2011-08-01

A simple and fair benchmarking system or financial indicators for use on the clinical department level have been lacking to evaluate the management efficiency and activity of each clinical department or division of a hospital. New financial indicators have therefore been developed based on personnel costs. Indicator 1: The ratio of marginal profit after personnel cost per personnel cost (RMP). Indicator 2: The ratio of investment (=indirect cost) per personnel cost (RIP). The difference between RMP and RIP demonstrates the operation profit in US Dollars for personnel cost (OPP). A turning point in profitability similar to the break-even point (BEP) and break-even ratio (BER) could be also defined by the combination of the RMP and RIP. The merits of these two indicators are not only the ability to indicate the relationship between the medical profit and the investments in the hospital, but also the capability to demonstrate such indicators as BEP, BER and OPP on a single graph. The two indicators were applied to the hospitals in the National Hospital Organization and to the clinical department in one hospital. Using these two indicators, it was possible to evaluate the management efficiency and medical activity not only in the whole hospital but also in each department and DPC/DRG group. This will be of use to a manager of a hospital in checking the management efficiency of his/her hospital despite the variations among hospitals, departments and divisions.

Costs and Operating Dynamics of Integrating Distributed Energy Resources in Commercial and Industrial Buildings with Electric Vehicle Charging

NASA Astrophysics Data System (ADS)

Flores, Robert Joseph

Growing concerns over greenhouse gas and pollutant emissions have increased the pressure to shift energy conversion paradigms from current forms to more sustainable methods, such as through the use of distributed energy resources (DER) at industrial and commercial buildings. This dissertation is concerned with the optimal design and dispatch of a DER system installed at an industrial or commercial building. An optimization model that accurately captures typical utility costs and the physical constraints of a combined cooling, heating, and power (CCHP) system is designed to size and operate a DER system at a building. The optimization model is then used with cooperative game theory to evaluate the financial performance of a CCHP investment. The CCHP model is then modified to include energy storage, solar powered generators, alternative fuel sources, carbon emission limits, and building interactions with public and fleet PEVs. Then, a separate plugin electric vehicle (PEV) refueling model is developed to determine the cost to operate a public Level 3 fast charging station. The CCHP design and dispatch results show the size of the building load and consistency of the thermal loads are critical to positive financial performance. While using the CCHP system to produce cooling can provide savings, heat production drives positive financial performance. When designing the DER system to reduce carbon emissions, the use of renewable fuels can allow for a gas turbine system with heat recovery to reduce carbon emissions for a large university by 67%. Further reductions require large photovoltaic installations coupled with energy storage or the ability to export electricity back to the grid if costs are to remain relatively low. When considering Level 3 fast charging equipment, demand charges at low PEV travel levels are sufficiently high to discourage adoption. Integration of the equipment can reduce demand charge costs only if the building maximum demand does not coincide with PEV refueling. Electric vehicle refueling does not typically affect DER design at low PEV travel levels, but can as electric vehicle travel increases. However, as PEV travel increases, the stochastic nature of PEV refueling disappears, and the optimization problem may become deterministic.

Self-contained, low-cost Body-on-a-Chip systems for drug development.

PubMed

Wang, Ying I; Oleaga, Carlota; Long, Christopher J; Esch, Mandy B; McAleer, Christopher W; Miller, Paula G; Hickman, James J; Shuler, Michael L

2017-11-01

Integrated multi-organ microphysiological systems are an evolving tool for preclinical evaluation of the potential toxicity and efficacy of drug candidates. Such systems, also known as Body-on-a-Chip devices, have a great potential to increase the successful conversion of drug candidates entering clinical trials into approved drugs. Systems, to be attractive for commercial adoption, need to be inexpensive, easy to operate, and give reproducible results. Further, the ability to measure functional responses, such as electrical activity, force generation, and barrier integrity of organ surrogates, enhances the ability to monitor response to drugs. The ability to operate a system for significant periods of time (up to 28 d) will provide potential to estimate chronic as well as acute responses of the human body. Here we review progress towards a self-contained low-cost microphysiological system with functional measurements of physiological responses. Impact statement Multi-organ microphysiological systems are promising devices to improve the drug development process. The development of a pumpless system represents the ability to build multi-organ systems that are of low cost, high reliability, and self-contained. These features, coupled with the ability to measure electrical and mechanical response in addition to chemical or metabolic changes, provides an attractive system for incorporation into the drug development process. This will be the most complete review of the pumpless platform with recirculation yet written.

Introduction of automated blood pressure devices intended for a low resource setting in rural Tanzania.

PubMed

Baker, Elinor Chloe; Hezelgrave, Natasha; Magesa, Stephen M; Edmonds, Sally; de Greeff, Annemarie; Shennan, Andrew

2012-04-01

Regular blood pressure (BP) monitoring is a cost-effective means of early identification and management of hypertensive disease in pregnancy. In much of rural sub-Saharan Africa, the ability to take and act on accurate BP measurements is lacking as a result of poorly functioning or absent equipment and/or inadequate staff education. This study describes the feasibility of using validated automated BP devices suitable for low-resource settings (LRS) in primary health-care facilities in rural Tanzania. Following a primary survey, 19 BP devices were distributed to 11 clinics and re-assessed at one, three, six, 12 and 36 months. Devices were used frequently with high levels of user satisfaction and good durability. We conclude that the use of automated BP devices in LRS is feasible and sustainable. An assessment of their ability to reduce maternal and perinatal morbidity and mortality is vital.

Direct ethanol production from starch using a natural isolate, Scheffersomyces shehatae: Toward consolidated bioprocessing.

PubMed

Tanimura, Ayumi; Kikukawa, Minako; Yamaguchi, Shino; Kishino, Shigenobu; Ogawa, Jun; Shima, Jun

2015-04-22

Consolidated bioprocessing (CBP), which integrates enzyme production, saccharification and fermentation into a one-step process, is a promising strategy for cost-effective ethanol production from starchy biomass. To gain insights into starch-based ethanol production using CBP, an extensive screening was undertaken to identify naturally occurring yeasts that produce ethanol without the addition of any amylases. Three yeast strains were capable of producing a significant amount of ethanol. Quantitative assays revealed that Scheffersomyces shehatae JCM 18690 was the strain showing the highest ethanol production ability. This strain was able to utilize starch directly, and the ethanol concentration reached 9.21 g/L. We attribute the ethanol-producing ability of this strain to the high levels of glucoamylase activity, fermentation potential and ethanol stress tolerance. This study strongly suggests the possibility of starch-based ethanol production by consolidated bioprocessing using natural yeasts such as S. shehatae JCM 18690.

Direct ethanol production from starch using a natural isolate, Scheffersomyces shehatae: Toward consolidated bioprocessing

PubMed Central

Tanimura, Ayumi; Kikukawa, Minako; Yamaguchi, Shino; Kishino, Shigenobu; Ogawa, Jun; Shima, Jun

2015-01-01

Consolidated bioprocessing (CBP), which integrates enzyme production, saccharification and fermentation into a one-step process, is a promising strategy for cost-effective ethanol production from starchy biomass. To gain insights into starch-based ethanol production using CBP, an extensive screening was undertaken to identify naturally occurring yeasts that produce ethanol without the addition of any amylases. Three yeast strains were capable of producing a significant amount of ethanol. Quantitative assays revealed that Scheffersomyces shehatae JCM 18690 was the strain showing the highest ethanol production ability. This strain was able to utilize starch directly, and the ethanol concentration reached 9.21 g/L. We attribute the ethanol-producing ability of this strain to the high levels of glucoamylase activity, fermentation potential and ethanol stress tolerance. This study strongly suggests the possibility of starch-based ethanol production by consolidated bioprocessing using natural yeasts such as S. shehatae JCM 18690. PMID:25901788

Age matters: The effect of onset age of video game play on task-switching abilities.

PubMed

Hartanto, Andree; Toh, Wei Xing; Yang, Hwajin

2016-05-01

Although prior research suggests that playing video games can improve cognitive abilities, recent empirical studies cast doubt on such findings (Unsworth et al., 2015). To reconcile these inconsistent findings, we focused on the link between video games and task switching. Furthermore, we conceptualized video-game expertise as the onset age of active video-game play rather than the frequency of recent gameplay, as it captures both how long a person has played video games and whether the individual began playing during periods of high cognitive plasticity. We found that the age of active onset better predicted switch and mixing costs than did frequency of recent gameplay; specifically, players who commenced playing video games at an earlier age reaped greater benefits in terms of task switching than did those who started at a later age. Moreover, improving switch costs required a more extensive period of video-game experience than did mixing costs; this finding suggests that certain cognitive abilities benefit from different amounts of video game experience.

Radioactive Waste Characterization Strategies; Comparisons Between AK/PK, Dose to Curie Modeling, Gamma Spectroscopy, and Laboratory Analysis Methods- 12194

DOE Office of Scientific and Technical Information (OSTI.GOV)

Singledecker, Steven J.; Jones, Scotty W.; Dorries, Alison M.

2012-07-01

In the coming fiscal years of potentially declining budgets, Department of Energy facilities such as the Los Alamos National Laboratory (LANL) will be looking to reduce the cost of radioactive waste characterization, management, and disposal processes. At the core of this cost reduction process will be choosing the most cost effective, efficient, and accurate methods of radioactive waste characterization. Central to every radioactive waste management program is an effective and accurate waste characterization program. Choosing between methods can determine what is classified as low level radioactive waste (LLRW), transuranic waste (TRU), waste that can be disposed of under an Authorizedmore » Release Limit (ARL), industrial waste, and waste that can be disposed of in municipal landfills. The cost benefits of an accurate radioactive waste characterization program cannot be overstated. In addition, inaccurate radioactive waste characterization of radioactive waste can result in the incorrect classification of radioactive waste leading to higher disposal costs, Department of Transportation (DOT) violations, Notice of Violations (NOVs) from Federal and State regulatory agencies, waste rejection from disposal facilities, loss of operational capabilities, and loss of disposal options. Any one of these events could result in the program that mischaracterized the waste losing its ability to perform it primary operational mission. Generators that produce radioactive waste have four characterization strategies at their disposal: - Acceptable Knowledge/Process Knowledge (AK/PK); - Indirect characterization using a software application or other dose to curie methodologies; - Non-Destructive Analysis (NDA) tools such as gamma spectroscopy; - Direct sampling (e.g. grab samples or Surface Contaminated Object smears) and laboratory analytical; Each method has specific advantages and disadvantages. This paper will evaluate each method detailing those advantages and disadvantages including; - Cost benefit analysis (basic materials costs, overall program operations costs, man-hours per sample analyzed, etc.); - Radiation Exposure As Low As Reasonably Achievable (ALARA) program considerations; - Industrial Health and Safety risks; - Overall Analytical Confidence Level. The concepts in this paper apply to any organization with significant radioactive waste characterization and management activities working to within budget constraints and seeking to optimize their waste characterization strategies while reducing analytical costs. (authors)« less

Economic Evaluation of Low-Vision Rehabilitation for Veterans With Macular Diseases in the US Department of Veterans Affairs.

PubMed

Stroupe, Kevin T; Stelmack, Joan A; Tang, X Charlene; Wei, Yongliang; Sayers, Scott; Reda, Domenic J; Kwon, Ellen; Massof, Robert W

2018-05-01

Examining costs and consequences of different low-vision (LV) programs provides important information about resources needed to expand treatment options efficiently. To examine the costs and consequences of LV rehabilitation or basic LV services. The US Department of Veterans Affairs (VA) Low Vision Intervention Trial (LOVIT) II was conducted from September 27, 2010, to July 31, 2014, at 9 VA facilities and included 323 veterans with macular diseases and a best-corrected distance visual acuity of 20/50 to 20/200. Veterans were randomized to receive basic LV services that provided LV devices without therapy, or LV rehabilitation that added a therapist to LV services who provided instruction and homework on using LV devices, eccentric viewing, and environmental modification. We compared costs and consequences between these groups. Low-vision devices without therapy and LV devices with therapy. Costs of providing basic LV services or LV rehabilitation were assessed. We measured consequences as changes in functional visual ability from baseline to follow-up 4 months after randomization using the VA Low Vision Visual Functioning Questionnaire. Visual ability was measured in dimensionless log odds units (logits). Of 323 randomized patients, the mean (SD) age was 80 (10.5) years, 314 (97.2%) were men, and 292 (90.4%) were white. One hundred sixty (49.5%) received basic LV services and 163 (50.1%) received LV rehabilitation. The mean (SD) total direct health care costs per patient were similar between patients who were randomized to receive basic LV services ($1662 [$671]) or LV rehabilitation ($1788 [$864]) (basic LV services, $126 lower; 95% CI, $299 lower to $35 higher; P = .15). However, basic LV services required less time and had lower transportation costs. Patients receiving LV rehabilitation had greater improvements in overall visual ability, reading ability, visual information processing, and visual motor skill scores.

Abacus Training Affects Math and Task Switching Abilities and Modulates Their Relationships in Chinese Children

PubMed Central

Yao, Yuan; Weng, Jian; Hu, Yuzheng; Chen, Feiyan

2015-01-01

Our previous work demonstrated that abacus-based mental calculation (AMC), a traditional Chinese calculation method, could help children improve their math abilities (e.g. basic arithmetical ability) and executive function (e.g. working memory). This study further examined the effects of long-term AMC training on math ability in visual-spatial domain and the task switching component of executive function. More importantly, this study investigated whether AMC training modulated the relationship between math abilities and task switching. The participants were seventy 7-year-old children who were randomly assigned into AMC and control groups at primary school entry. Children in AMC group received 2-hour AMC training every week since primary school entry. On the contrary, children in the control group had never received any AMC training. Math and task switching abilities were measured one year and three years respectively after AMC training began. The results showed that AMC children performed better than their peers on math abilities in arithmetical and visual-spatial domains. In addition, AMC group responded faster than control group in the switching task, while no group difference was found in switch cost. Most interestingly, group difference was present in the relationships between math abilities and switch cost. These results implied the effect of AMC training on math abilities as well as its relationship with executive function. PMID:26444689

Abacus Training Affects Math and Task Switching Abilities and Modulates Their Relationships in Chinese Children.

PubMed

Wang, Chunjie; Geng, Fengji; Yao, Yuan; Weng, Jian; Hu, Yuzheng; Chen, Feiyan

2015-01-01

Our previous work demonstrated that abacus-based mental calculation (AMC), a traditional Chinese calculation method, could help children improve their math abilities (e.g. basic arithmetical ability) and executive function (e.g. working memory). This study further examined the effects of long-term AMC training on math ability in visual-spatial domain and the task switching component of executive function. More importantly, this study investigated whether AMC training modulated the relationship between math abilities and task switching. The participants were seventy 7-year-old children who were randomly assigned into AMC and control groups at primary school entry. Children in AMC group received 2-hour AMC training every week since primary school entry. On the contrary, children in the control group had never received any AMC training. Math and task switching abilities were measured one year and three years respectively after AMC training began. The results showed that AMC children performed better than their peers on math abilities in arithmetical and visual-spatial domains. In addition, AMC group responded faster than control group in the switching task, while no group difference was found in switch cost. Most interestingly, group difference was present in the relationships between math abilities and switch cost. These results implied the effect of AMC training on math abilities as well as its relationship with executive function.

Predictors of Medicare costs in elderly beneficiaries with breast, colorectal, lung, or prostate cancer.

PubMed

Penberthy, L; Retchin, S M; McDonald, M K; McClish, D K; Desch, C E; Riley, G F; Smith, T J; Hillner, B E; Newschaffer, C J

1999-07-01

Determining the apportionment of costs of cancer care and identifying factors that predict costs are important for planning ethical resource allocation for cancer care, especially in markets where managed care has grown. This study linked tumor registry data with Medicare administrative claims to determine the costs of care for breast, colorectal, lung and prostate cancers during the initial year subsequent to diagnosis, and to develop models to identify factors predicting costs. Patients with a diagnosis of breast (n = 1,952), colorectal (n = 2,563), lung (n = 3,331) or prostate cancer (n = 3,179) diagnosed from 1985 through 1988. The average costs during the initial treatment period were $12,141 (s.d. = $10,434) for breast cancer, $24,910 (s.d. = $14,870) for colorectal cancer, $21,351 (s.d. = $14,813) for lung cancer, and $14,361 (s.d. = $11,216) for prostate cancer. Using least squares regression analysis, factors significantly associated with cost included comorbidity, hospital length of stay, type of therapy, and ZIP level income for all four cancer sites. Access to health care resources was variably associated with costs of care. Total R2 ranged from 38% (prostate) to 49% (breast). The prediction error for the regression models ranged from < 1% to 4%, by cancer site. Linking administrative claims with state tumor registry data can accurately predict costs of cancer care during the first year subsequent to diagnosis for cancer patients. Regression models using both data sources may be useful to health plans and providers and in determining appropriate prospective reimbursement for cancer, particularly with increasing HMO penetration and decreased ability to capture complete and accurate utilization and cost data on this population.

The Cost-Effectiveness of Anterior Cruciate Ligament Reconstruction in Competitive Athletes.

PubMed

Stewart, Bruce A; Momaya, Amit M; Silverstein, Marc D; Lintner, David

2017-01-01

Competitive athletes value the ability to return to competitive play after the treatment of anterior cruciate ligament (ACL) injuries. ACL reconstruction has high success rates for return to play, but some studies indicate that patients may do well with nonoperative physical therapy treatment. To evaluate the cost-effectiveness of the treatment of acute ACL tears with either initial surgical reconstruction or physical therapy in competitive athletes. Economic and decision analysis; Level of evidence, 2. The incremental cost, incremental effectiveness, and incremental cost-effectiveness ratio (ICER) of ACL reconstruction compared with physical therapy were calculated from a cost-effectiveness analysis of ACL reconstruction compared with physical therapy for the initial management of acute ACL injuries in competitive athletes. The ACL reconstruction strategy and the physical therapy strategy were represented as Markov models. Costs and quality-adjusted life-years (QALYs) were evaluated over a 6-year time horizon and were analyzed from a societal perspective. Quality of life and probabilities of clinical outcomes were obtained from the peer-reviewed literature, and costs were compiled from a large academic hospital in the United States. One-way, 2-way, and probabilistic sensitivity analyses were used to assess the effect of uncertainty in variables on the ICER of ACL reconstruction. The ICER of ACL reconstruction compared with physical therapy was $22,702 per QALY gained. The ICER was most sensitive to the quality of life of returning to play or not returning to play, costs, and duration of follow-up but relatively insensitive to the rates and costs of complications, probabilities of return to play for both operative and nonoperative treatments, and discount rate. ACL reconstruction is a cost-effective strategy for competitive athletes with an ACL injury.

A Study of Mental Ability Testing and Its Implications for the Oklahoma City Public Schools.

ERIC Educational Resources Information Center

Hall, Janie L.

This study follows a 1980 moratorium on group mental ability testing called by the district's superintendent when questions relating to the informational value and cost-effectiveness of the Otis Lennon Mental Ability Test (OLMA) were raised by the Oklahoma City Public School District. Criticisms of intelligence tests and relevant issues are…

77 FR 59439 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-27

... Proposed Rule Change To Offer Members the Ability To Pay a Regulatory Fine Pursuant to an Installment Plan... offer members the ability to pay a regulatory fine pursuant to an installment plan, under certain... Costs; Summary Action for Failure to Pay'' to offer members the ability to pay a regulatory fine...

The importance of ecological costs for the evolution of plant defense against herbivory.

PubMed

van Velzen, Ellen; Etienne, Rampal S

2015-05-07

Plant defense against herbivory comes at a cost, which can be either direct (reducing resources available for growth and reproduction) or indirect (through reducing ecological performance, for example intraspecific competitiveness). While direct costs have been well studied in theoretical models, ecological costs have received almost no attention. In this study we compare models with a direct trade-off (reduced growth rate) to models with an ecological trade-off (reduced competitive ability), using a combination of adaptive dynamics and simulations. In addition, we study the dependence of the level of defense that can evolve on the type of defense (directly by reducing consumption, or indirectly by inducing herbivore mortality (toxicity)), and on the type of herbivore against which the plant is defending itself (generalists or specialists). We find three major results: First, for both direct and ecological costs, defense only evolves if the benefit to the plant is direct (through reducing consumption). Second, the type of cost has a major effect on the evolutionary dynamics: direct costs always lead to a single optimal strategy against herbivores, but ecological costs can lead to branching and the coexistence of non-defending and defending plants; however, coexistence is only possible when defending against generalist herbivores. Finally, we find that fast-growing plants invest less than slow-growing plants when defending against generalist herbivores, as predicted by the Resource Availability Hypothesis, but invest more than slow-growing plants when defending against specialists. Our results clearly show that assumptions about ecological interactions are crucial for understanding the evolution of defense against herbivores. Copyright © 2015 Elsevier Ltd. All rights reserved.

Technology Cost and Schedule Estimation (TCASE) Final Report

NASA Technical Reports Server (NTRS)

Wallace, Jon; Schaffer, Mark

2015-01-01

During the 2014-2015 project year, the focus of the TCASE project has shifted from collection of historical data from many sources to securing a data pipeline between TCASE and NASA's widely used TechPort system. TCASE v1.0 implements a data import solution that was achievable within the project scope, while still providing the basis for a long-term ability to keep TCASE in sync with TechPort. Conclusion: TCASE data quantity is adequate and the established data pipeline will enable future growth. Data quality is now highly dependent the quality of data in TechPort. Recommendation: Technology development organizations within NASA should continue to work closely with project/program data tracking and archiving efforts (e.g. TechPort) to ensure that the right data is being captured at the appropriate quality level. TCASE would greatly benefit, for example, if project cost/budget information was included in TechPort in the future.

A Reduced SWAP+C DC Magnetometer for Geomagnetic and Space Physics Research

NASA Astrophysics Data System (ADS)

Moldwin, M.; Ojeda, L.; Rogacki, S.; Pelloni, M.; Regoli, L.

2016-12-01

A new small, low mass, low power consumption, and low cost (reduced SWaP+C or Size, Weight and Power + Cost) magnetometer is being developed for both ground-based and future CubeSat Constellation-class missions. The University of Michigan (UM) magnetometer is based on the PNI Induction magnetometer electronics. PNI 3100 magnetometers have flight heritage on Cubesat Missions (e.g., the UM RAXs mission), but they were used primarily for attitude control. This presentation describes the modifications and performance of the magnetometer and our strategies for continued improvement in performance and its environmental testing. A description of further development of this new magnetometer with regards to its ability to measure geophysical signals up to 10 Hz is also given. Current performance has noise levels of about 1 nT/root Hz at 1 Hz, temperature stability, inherent radiation tolerance, in a 3 x 5 cm package (electronics and sensors), draws 10s of mW and costs a few hundred dollars. We will also present several strategies to reduce the noise by a factor of 5-10 that are currently being pursued.

Multi-source micro-friction identification for a class of cable-driven robots with passive backbone

NASA Astrophysics Data System (ADS)

Tjahjowidodo, Tegoeh; Zhu, Ke; Dailey, Wayne; Burdet, Etienne; Campolo, Domenico

2016-12-01

This paper analyses the dynamics of cable-driven robots with a passive backbone and develops techniques for their dynamic identification, which are tested on the H-Man, a planar cabled differential transmission robot for haptic interaction. The mechanism is optimized for human-robot interaction by accounting for the cost-benefit-ratio of the system, specifically by eliminating the necessity of an external force sensor to reduce the overall cost. As a consequence, this requires an effective dynamic model for accurate force feedback applications which include friction behavior in the system. We first consider the significance of friction in both the actuator and backbone spaces. Subsequently, we study the required complexity of the stiction model for the application. Different models representing different levels of complexity are investigated, ranging from the conventional approach of Coulomb to an advanced model which includes hysteresis. The results demonstrate each model's ability to capture the dynamic behavior of the system. In general, it is concluded that there is a trade-off between model accuracy and the model cost.

Estimating Texas motor vehicle operating costs.

DOT National Transportation Integrated Search

2009-10-01

A specific Vcost model was developed for Texas conditions based on a sophisticated fuel model for light : duty vehicles, several excellent sources of secondary vehicle cost data, and the ability to measure heavy truck fuel : consumption through both ...

Space industrialization - Education. [via communication satellites

NASA Technical Reports Server (NTRS)

Joels, K. M.

1978-01-01

The components of an educational system based on, and perhaps enhanced by, space industrialization communications technology are considered. Satellite technology has introduced a synoptic distribution system for various transmittable educational media. The cost of communications satellite distribution for educational programming has been high. It has, therefore, been proposed to utilize Space Shuttle related technology and Large Space Structures (LSS) to construct a system with a quantum advancement in communication capability and a quantum reduction in user cost. LSS for communications purposes have three basic advantages for both developed and emerging nations, including the ability to distribute signals over wide geographic areas, the reduced cost of satellite communications systems versus installation of land based systems, and the ability of a communication satellite system to create instant educational networks.

A Study on Work Ability Index and Physical Work Capacity on the Base of Fax Equation VO(2) Max in Male Nursing Hospital Staff in Isfahan, Iran.

PubMed

Habibi, Ehsanollah; Dehghan, Habibollah; Zeinodini, Mohhamad; Yousefi, Hosseinali; Hasanzadeh, Akbar

2012-11-01

The purpose of this research is to establish the ability of employees by work ability index (WAI), physical work capacity (PWC), and finding the correlation between them. Establishing the PWC index with attention to WAI values for the purpose of saving in costs and time of PWC measurements is another aim of this project. The present research is an analytic cross-sectional and one-trail study. The study population consists of 228 randomly selected registered nurses from hospitals in Isfahan (Iran). The WAI and PWC were established through WAI questionnaire and Fax equation and by using ergometer bicycle, respectively. The resulting data were analyzed using SPSS 16 software. Average WAI and PWC among the study population were 38.25±4.4 and 4.45±0.7, respectively. Pearson test results showed no significant correlation between PWC and WAI in different age groups (r=0.3 and P>0.05). Multiple linear regression analysis showed that the variables of age and diagnosed diseases were the most effective factors of WAI (β=0.18 and P>0.05). Pearson test revealed a significant correlation between the number of diagnosed diseases and PWC index in age groups of 40-49 years. Average WAI in this research, like other studies on similar jobs is in the acceptable level of >36. Work ability index and PWC index in different age groups did not show a significant correlation and this suggests that there are essential discrepancies in work ability evaluations made by each index and it is not possible to predict PWC index using WAI values. Given the PWC results and the level of nursing staff's activity (low, medium) the WAI is a suitable instrument to establish the professionals' abilities. This study revealed that 27.6% of individuals were subject to medium-low work ability risk (WAI<37), which was 1.8 times that of Finland's professional health Institute, which could be caused by shift working and increased working hours.

An effectiveness and cost-benefit analysis of a hospital-based discharge transition program for elderly Medicare recipients.

PubMed

Saleh, Shadi S; Freire, Chris; Morris-Dickinson, Gwendolyn; Shannon, Trip

2012-06-01

To investigate the business case of postdischarge care transition (PDCT) among Medicare beneficiaries by conducting a cost-benefit analysis. Randomized controlled trial. A general hospital in upstate New York State. Elderly Medicare beneficiaries being treated from October 2008 through December 2009 were randomly selected to receive services as part of a comprehensive PDCT program (intervention--173 patients) or regular discharge process (control--160 patients) and followed for 12 months. The intervention comprised five activities: development of a patient-centered health record, a structured discharge preparation checklist of critical activities, delivery of patient self-activation and management sessions, follow-up appointments, and coordination of data flow. Cost-benefit ratio of the PDCT program; self-management skills and abilities. The 1-year readmission analysis revealed that control participants were more likely to be readmitted than intervention participants (58.2% vs 48.2%; P = .08); with most of that difference observed in the 91 to 365 days after discharge. Findings from the cost-benefit analysis revealed a cost-benefit ratio of 1.09, which indicates that, for every $1 spent on the program, a saving of $1.09 was realized. In addition, participating in a care transition program significantly enhanced self-management skills and abilities. Postdischarge care transition programs have a dual benefit of enhancing elderly adults' self-management skills and abilities and producing cost savings. This study builds a case for the inclusion of PDCT programs as a reimbursable service in benefit packages. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Opportunities for Joint Water–Energy Management: Sensitivity of the 2010 Western U.S. Electricity Grid Operations to Climate Oscillations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Voisin, N.; Kintner-Meyer, M.; Wu, D.

The 2016 SECURE Water Act report’s natural water availability benchmark, combined with the 2010 level of water demand from an integrated assessment model, is used as input to drive a large-scale water management model. The regulated flow at hydropower plants and thermoelectric plants in the Western U.S. electricity grid (WECC) is translated into potential hydropower generation and generation capacity constraints. The impact on reliability (unserved energy, reserve margin) and cost (production cost, carbon emissions) of water constraints on 2010-level WECC power system operations is assessed using an electricity production cost model (PCM). Use of the PCM reveals the changes inmore » generation dispatch that reflect the inter-regional interdependencies in water-constrained generation and the ability to use other generation resources to meet all electricity loads in the WECC. August grid operational benchmarks show a range of sensitivity in production cost (-8 to +11%) and carbon emissions (-7 to 11%). The reference reserve margin threshold of 15% above peak load is maintained in the scenarios analyzed, but in 5 out of 55 years unserved energy is observed when normal operations are maintained. There is 1 chance in 10 that a year will demonstrate unserved energy in August, which defines the system’s historical performance threshold to support impact, vulnerability, and adaptation analysis. For seasonal and longer term planning, i.e., multi-year drought, we demonstrate how the Water Scarcity Grid Impact Factor and climate oscillations (ENSO, PDO) can be used to plan for joint water-electricity management to maintain grid reliability.« less

Expanding the Adoption on Private Lands : Blowing-and-Drifting Snow Control Treatments and the Cost Effectiveness of Permanent versus Non-Permanent Treatment Options

DOT National Transportation Integrated Search

2017-11-01

Previous research that estimated the costs and benefits of snow-fences for MnDOT in terms of a reduction in the costs of mitigating blowing-and-drifting snow problem areas (MN/RC 2012-03) demonstrated the ability of snow-fences to significantly lower...

10 CFR Appendix C to Part 30 - Criteria Relating to Use of Financial Tests and Self Guarantees for Providing Reasonable...

Code of Federal Regulations, 2014 CFR

2014-01-01

... furnishing its own guarantee that funds will be available for decommissioning costs and on a demonstration... materially adversely affect the company's ability to pay for decommissioning costs. The accountant must... for decommissioning costs before the self-guarantee agreement is submitted. (2) The trustee and trust...

10 CFR Appendix C to Part 30 - Criteria Relating to Use of Financial Tests and Self Guarantees for Providing Reasonable...

Code of Federal Regulations, 2013 CFR

2013-01-01

... furnishing its own guarantee that funds will be available for decommissioning costs and on a demonstration... materially adversely affect the company's ability to pay for decommissioning costs. The accountant must... for decommissioning costs before the self-guarantee agreement is submitted. (2) The trustee and trust...

National dental waitlists: what would it take to reset to zero?

PubMed

Dudko, Yevgeni; Kruger, Estie; Tennant, Marc

2016-06-01

Objective Over the years, long public dental waitlists across Australia have received much attention from the media. The issue for eligible patients, namely a further deterioration of dental health because of not being able to address dental concerns relatively quickly, has been the subject of several state and Federal initiatives. The present study provides a cost model for eliminating public dental waitlists across Australia and compares these results with the cost of contracting out public dental care to private clinics. Methods Waitlist data from across Australia were collected from publicly available sources and confirmed through direct communication with each individual State or Territory Dental Health body. Average costs associated with employing key dental personnel and performance figures were used from previously published data to estimate the potential financial commitment and probable public benefits. Results The cost model suggests that, on average, it would be more than twice as expensive to contract the work out to private dental clinics as to treat eligible patients within public dental clinics. It is estimated that the cost of eliminating the legacy dental waiting lists (over 12 months) would be between A$50 and A$100million depending on the method adopted. The effort would require some 360 dental teams. Conclusion The design of the Australian public dental care system that is targeted at meeting the needs of eligible patients into the future, in addition to being effective and sustainable, must also offer a level of protection to the taxpayer. The ability to address waitlist backlog identified in the present study clearly would require a mix of service models depending on service availability at different locations. Further research is needed to optimise the mix of service providers to address community needs. What is known about the topic? Long public dental waitlists across Australia have received much attention from the media. The topic has been the subject of debate at the government level and, over the years, has seen an increase in allocation of public funds in an effort to address the policy needs. What does this paper add? This study calculates the actual number of people on the public dental waitlist, provides a detailed analysis of the distribution of the demand for the services and offers a cost model for resetting public dental waitlists across Australia. What are the implications for practitioners? This study carries no implications for individual practitioners at the clinical level. However, at the state and national levels, this model offers direction to a more cost-effective allocation of public funds and human resources.

Army ants dynamically adjust living bridges in response to a cost–benefit trade-off

PubMed Central

Reid, Chris R.; Lutz, Matthew J.; Powell, Scott; Kao, Albert B.; Couzin, Iain D.; Garnier, Simon

2015-01-01

The ability of individual animals to create functional structures by joining together is rare and confined to the social insects. Army ants (Eciton) form collective assemblages out of their own bodies to perform a variety of functions that benefit the entire colony. Here we examine ‟bridges” of linked individuals that are constructed to span gaps in the colony’s foraging trail. How these living structures adjust themselves to varied and changing conditions remains poorly understood. Our field experiments show that the ants continuously modify their bridges, such that these structures lengthen, widen, and change position in response to traffic levels and environmental geometry. Ants initiate bridges where their path deviates from their incoming direction and move the bridges over time to create shortcuts over large gaps. The final position of the structure depended on the intensity of the traffic and the extent of path deviation and was influenced by a cost–benefit trade-off at the colony level, where the benefit of increased foraging trail efficiency was balanced by the cost of removing workers from the foraging pool to form the structure. To examine this trade-off, we quantified the geometric relationship between costs and benefits revealed by our experiments. We then constructed a model to determine the bridge location that maximized foraging rate, which qualitatively matched the observed movement of bridges. Our results highlight how animal self-assemblages can be dynamically modified in response to a group-level cost–benefit trade-off, without any individual unit’s having information on global benefits or costs. PMID:26598673

Report A : self-consolidating concrete (SCC) for infrastructure elements - shear characteristics.

DOT National Transportation Integrated Search

2012-08-01

Because of its unique ability to maintain high flow-ability and remain homogeneous, : self-consolidating concrete (SCC) has the potential to significantly reduce the costs : associated with civil infrastructure; however, the use of higher paste and l...

[Macro-economic calculation of spending versus micro-economic follow-up of costs of breast cancer].

PubMed

Borella, L; Paraponaris, A

2002-12-01

In the healthcare field, the ability to make economic forecasts requires knowledge of the costs of caring for major diseases. In the case of a semi-chronic condition like cancer, this cost covers all the episodes of care associated with a patient. An evaluation of a macro-economic method of calculating costs for treating non-metastatic cancer, covering all hospital episodes, is proposed. This method is based entirely on the use of annual hospital activity databases, linked to data concerning the incidence of cancer. It allows us to obtain the global cost of care for a neoplasm of a particular site, without the need to reconstruct the whole care pathway of the patients. The model was assessed by comparing it's own results, in the particular case of breast cancer to those issuing from a micro-economic follow-up of 115 patients. Data for macro-economic calculation are extracted from the national French hospital database for the year 1999 and from cancer incidence data. The prospective study was done in 1995, in a comprehensive cancer centre. Macro-economic calculation leads to a cost of 14,555 Euro, for primary breast cancer. Prospective follow-up showed a cost of 14,350 Euro (data corrected, 1999 value). With a difference of 1%, there was a clear cohesion of the two results, while a higher level of divergence was noticed (from 1 to 15%) in the comparison between therapeutic techniques. Accuracy and reliability of results were evaluated. This method may be extended to all types of neoplasms. This method cannot be used instead of follow-up studies, for cost-efficacy or cost-severity analysis, but may be interesting beyond economic forecasts, in the field of payment per pathology.

Quantification of uncertainty in machining operations for on-machine acceptance.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Claudet, Andre A.; Tran, Hy D.; Su, Jiann-Chemg

2008-09-01

Manufactured parts are designed with acceptance tolerances, i.e. deviations from ideal design conditions, due to unavoidable errors in the manufacturing process. It is necessary to measure and evaluate the manufactured part, compared to the nominal design, to determine whether the part meets design specifications. The scope of this research project is dimensional acceptance of machined parts; specifically, parts machined using numerically controlled (NC, or also CNC for Computer Numerically Controlled) machines. In the design/build/accept cycle, the designer will specify both a nominal value, and an acceptable tolerance. As part of the typical design/build/accept business practice, it is required to verifymore » that the part did meet acceptable values prior to acceptance. Manufacturing cost must include not only raw materials and added labor, but also the cost of ensuring conformance to specifications. Ensuring conformance is a substantial portion of the cost of manufacturing. In this project, the costs of measurements were approximately 50% of the cost of the machined part. In production, cost of measurement would be smaller, but still a substantial proportion of manufacturing cost. The results of this research project will point to a science-based approach to reducing the cost of ensuring conformance to specifications. The approach that we take is to determine, a priori, how well a CNC machine can manufacture a particular geometry from stock. Based on the knowledge of the manufacturing process, we are then able to decide features which need further measurements from features which can be accepted 'as is' from the CNC. By calibration of the machine tool, and establishing a machining accuracy ratio, we can validate the ability of CNC to fabricate to a particular level of tolerance. This will eliminate the costs of checking for conformance for relatively large tolerances.« less

Threshold level or not for low-density lipoprotein cholesterol.

PubMed

Barter, P J; Sacks, F M

2001-05-01

As drugs, such as the statins, and other therapies demonstrate the ability to significantly lower levels of low-density lipoprotein cholesterol (LDL-C), one issue is whether there is a lower threshold below which no further decline in coronary heart disease occurs. Those who evaluate the data from multiple trials and conclude that no significant decrease in coronary event rates occurs at or below 125 mg/dL suggest using this level as a guideline for clinical application of cholesterol-lowering therapy. On the other hand, analysis of the results of the same population and primary prevention studies concludes that no such threshold exists. The issues affected by the decision of whether to use a threshold include costs to the healthcare system for additional physician time, tests, and medication; unknown clinical events and safety related to very low LDL-C; and resource prioritization to an unestablished therapeutic approach.

STARS: The Space Transportation Architecture Risk System

NASA Technical Reports Server (NTRS)

Greenberg, Joel S.

1997-01-01

Because of the need to perform comparisons between transportation systems that are likely to have significantly different levels of risk, both because of differing degrees of freedom in achieving desired performance levels and their different states of development and utilization, an approach has been developed for performing early comparisons of transportation architectures explicitly taking into account quantitative measures of uncertainty and resulting risk. The approach considers the uncertainty associated with the achievement of technology goals, the effect that the achieved level of technology will have on transportation system performance and the relationship between transportation system performance/capability and the ability to accommodate variations in payload mass. The consequences of system performance are developed in terms of expected values and associated standard deviations of nonrecurring, recurring and the present value of transportation system life cycle cost. Typical results are presented to illustrate the application of the methodology.

Attention in dichoptic and binocular vision

NASA Technical Reports Server (NTRS)

Kimchi, Ruth; Rubin, Yifat; Gopher, Daniel; Raij, David

1989-01-01

The ability of human subjected to mobilize attention and cope with task requirements under dichoptic and binocular viewing was investigated in an experiment employing a target search task. Subjects were required to search for a target at either the global level, the local level, or at both levels of a compound stimulus. The tasks were performed in a focused attention condition in which subjects had to attend to the stimulus presented to one eye/field (under dichoptic and binocular viewings, respectively) and to ignore the stimulus presented to the irrelevant eye/field, and in a divided attention condition in which subjects had to attend to the stimuli presented to both eyes/fields. Subjects' performance was affected mainly by attention conditions which interacted with task requirements, rather than by viewing situation. An interesting effect of viewing was found for the local-directed search task in which the cost of dividing attention was higher under binocular than under dichoptic viewing.

Artificial selection on relative brain size in the guppy reveals costs and benefits of evolving a larger brain.

PubMed

Kotrschal, Alexander; Rogell, Björn; Bundsen, Andreas; Svensson, Beatrice; Zajitschek, Susanne; Brännström, Ioana; Immler, Simone; Maklakov, Alexei A; Kolm, Niclas

2013-01-21

The large variation in brain size that exists in the animal kingdom has been suggested to have evolved through the balance between selective advantages of greater cognitive ability and the prohibitively high energy demands of a larger brain (the "expensive-tissue hypothesis"). Despite over a century of research on the evolution of brain size, empirical support for the trade-off between cognitive ability and energetic costs is based exclusively on correlative evidence, and the theory remains controversial. Here we provide experimental evidence for costs and benefits of increased brain size. We used artificial selection for large and small brain size relative to body size in a live-bearing fish, the guppy (Poecilia reticulata), and found that relative brain size evolved rapidly in response to divergent selection in both sexes. Large-brained females outperformed small-brained females in a numerical learning assay designed to test cognitive ability. Moreover, large-brained lines, especially males, developed smaller guts, as predicted by the expensive-tissue hypothesis, and produced fewer offspring. We propose that the evolution of brain size is mediated by a functional trade-off between increased cognitive ability and reproductive performance and discuss the implications of these findings for vertebrate brain evolution. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Impact of disease progression on health status, quality of life and costs in rheumatoid arthritis in Hungary].

PubMed

Péntek, Márta; Szekanecz, Zoltán; Czirják, László; Poór, Gyula; Rojkovich, Bernadette; Polgár, Anna; Genti, György; Kiss, Csaba György; Sándor, Zsuzsa; Májer, István; Brodszky, Valentin; Gulácsi, László

2008-04-20

Rheumatoid arthritis (RA) is a chronic, progressive polyarthritis leading to substantial disability. Standardised data on consequences of disease progression are needed for clinical assessments and also for cost-effectiveness models. To analyse the impact of disease progression on health status, disease specific quality of life and costs in Hungary. A cross-sectional survey was performed between April and August, 2004, involving consecutive RA patients of 6 hospital based rheumatology outpatient centres. Self-completed questionnaires were used to assess functional (HAQ) and health status (EQ-5D), quality of life (RAQoL). Disease activity (DAS) and costs were also surveyed, statistical analysis was performed. 255 patients were involved [mean age 55.5 +/- 12.3 years; disease duration 9.0 +/- 9.3 years; HAQ 1.38 +/- 0.76; EQ-5D 0.46 +/- 0.33; RAQoL 16.2 +/- 8.1; DAS 5.09 +/- 1.42; costs 1,043,163 (+/- 844,750) HUF/patient/year, conversion 1 Euro = 250 HUF]. Correlation was significant between the parameters ( p < 0.01): EQ-5D index = 1.014 - 0.25 x HAQ-0.041 x DAS; HAQ = 0.314 + 0.065 x RAQoL. Analysis by disease severity levels (HAQ groups 0.5 difference) revealed that health status worsens (mean EQ-5D: 0.784; 0.576; 0.504; 0.367; 0.211; 0.022) and costs increase (mean 628,280; 888,187; 953,759; 1,291,218; 1,346,112; 1,371,674 HUF/patient/year) with disease progression. Minimally important worsening of functional ability (0.25 HAQ increase) corresponds to -0.0705 EQ-5D and +1.884 RAQoL change. Lower health status difference (EQ-5D -0.05725) was calculated in patients with lower disease activity (DAS < 5.1). Correlation between disease progression, health status, quality of life and costs does not differ significantly from international results. The amount of costs is much lower in all disease severity levels than in developed European countries. Our study serves baseline data for health economic analysis in RA in Hungary.

[Bayesian approach for the cost-effectiveness evaluation of healthcare technologies].

PubMed

Berchialla, Paola; Gregori, Dario; Brunello, Franco; Veltri, Andrea; Petrinco, Michele; Pagano, Eva

2009-01-01

The development of Bayesian statistical methods for the assessment of the cost-effectiveness of health care technologies is reviewed. Although many studies adopt a frequentist approach, several authors have advocated the use of Bayesian methods in health economics. Emphasis has been placed on the advantages of the Bayesian approach, which include: (i) the ability to make more intuitive and meaningful inferences; (ii) the ability to tackle complex problems, such as allowing for the inclusion of patients who generate no cost, thanks to the availability of powerful computational algorithms; (iii) the importance of a full use of quantitative and structural prior information to produce realistic inferences. Much literature comparing the cost-effectiveness of two treatments is based on the incremental cost-effectiveness ratio. However, new methods are arising with the purpose of decision making. These methods are based on a net benefits approach. In the present context, the cost-effectiveness acceptability curves have been pointed out to be intrinsically Bayesian in their formulation. They plot the probability of a positive net benefit against the threshold cost of a unit increase in efficacy.A case study is presented in order to illustrate the Bayesian statistics in the cost-effectiveness analysis. Emphasis is placed on the cost-effectiveness acceptability curves. Advantages and disadvantages of the method described in this paper have been compared to frequentist methods and discussed.

Economic Synergy between Dry Cow Diet Improvement and Monensin Bolus Use to Prevent Subclinical Ketosis: An Experimental Demonstration Based on Available Literature

PubMed Central

Raboisson, Didier; Barbier, Maxime

2017-01-01

The prevention of subclinical ketosis (SCK) is based on maintaining adequate nutrition in dairy cows during the dry period and close to calving. Recently, an oral-route monensin bolus to prevent SCK was approved in Europe. The present study aims to define the allocation of resources for SCK management at the herd level and evaluate the profitability of administering monensin boluses in cows at risk for SCK. A stochastic model was used to calculate the total cost of SCK for a population with a given prevalence of cows at risk for SCK. This model included the ability of the farmer to correctly target and preventatively treat these cows at risk for SCK. The results clearly demonstrated economic synergy between two management practices. First, reducing the prevalence of cows at risk for SCK dramatically reduces the total cost of SCK and seems profitable in most situations. Second, monensin bolus use to reduce the occurrence of SCK in cows already at risk for SCK is cost-effective. The results also highlighted three economic strategies to manage SCK in the dairy industry in Europe. First, monensin bolus use throughout an entire herd when the prevalence of cows at risk for SCK is high is only profitable in the short-term as a tool to correct acute deterioration at the herd level. Second, decreasing the prevalence of cows at risk for SCK through adequate feeding in the dry period is of financial interest as a baseline strategy when prevalence is high, assuming moderate additional cost linked to the new diet. Third, monensin bolus use when the prevalence of cows at risk for SCK is low is also profitable as a long-term strategy when only cows at high risk for SCK (such as cows that are over-conditioned, old, or have a previous history of SCK-related disorders) are targeted for preventative treatment. Authors suggest to use the present results considering that farmers have a correct, but not perfect, ability to target animals to be preventively targeted with the monensin bolus. Further work is required to facilitate the early identification of cows at risk for SCK. PMID:28382302

Decentralization in Indonesia: lessons from cost recovery rate of district hospitals.

PubMed

Maharani, Asri; Femina, Devi; Tampubolon, Gindo

2015-07-01

In 1991, Indonesia began a process of decentralization in the health sector which had implications for the country's public hospitals. The public hospitals were given greater authority to manage their own personnel, finance and procurement, with which they were allowed to operate commercial sections in addition to offering public services. These public services are subsidized by the government, although patients still pay certain proportion of fees. The main objectives of health sector decentralization are to increase the ability of public hospitals to cover their costs and to reduce government subsidies. This study investigates the consequences of decentralization on cost recovery rate of public hospitals at district level. We examine five service units (inpatient, outpatient, operating room, laboratory and radiology) in three public hospitals. We find that after 20 years of decentralization, district hospitals still depend on government subsidies, demonstrated by the fact that the cost recovery rate of most service units is less than one. The commercial sections fail to play their role as revenue generator as they are still subsidized by the government. We also find that the bulk of costs are made up of staff salaries and incentives in all units except radiology. As this study constitutes exploratory research, further investigation is needed to find out the reasons behind these results. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Costs and benefits of competitive traits in females: aggression, maternal care and reproductive success.

PubMed

Cain, Kristal E; Ketterson, Ellen D

2013-01-01

Recent research has shown that female expression of competitive traits can be advantageous, providing greater access to limited reproductive resources. In males increased competitive trait expression often comes at a cost, e.g. trading off with parental effort. However, it is currently unclear whether, and to what extent, females also face such tradeoffs, whether the costs associated with that tradeoff overwhelm the potential benefits of resource acquisition, and how environmental factors might alter those relationships. To address this gap, we examine the relationships between aggression, maternal effort, offspring quality and reproductive success in a common songbird, the dark-eyed junco (Junco hyemalis), over two breeding seasons. We found that compared to less aggressive females, more aggressive females spent less time brooding nestlings, but fed nestlings more frequently. In the year with better breeding conditions, more aggressive females produced smaller eggs and lighter hatchlings, but in the year with poorer breeding conditions they produced larger eggs and achieved greater nest success. There was no relationship between aggression and nestling mass after hatch day in either year. These findings suggest that though females appear to tradeoff competitive ability with some forms of maternal care, the costs may be less than previously thought. Further, the observed year effects suggest that costs and benefits vary according to environmental variables, which may help to account for variation in the level of trait expression.

Metrics for building performance assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koles, G.; Hitchcock, R.; Sherman, M.

This report documents part of the work performed in phase I of a Laboratory Directors Research and Development (LDRD) funded project entitled Building Performance Assurances (BPA). The focus of the BPA effort is to transform the way buildings are built and operated in order to improve building performance by facilitating or providing tools, infrastructure, and information. The efforts described herein focus on the development of metrics with which to evaluate building performance and for which information and optimization tools need to be developed. The classes of building performance metrics reviewed are (1) Building Services (2) First Costs, (3) Operating Costs,more » (4) Maintenance Costs, and (5) Energy and Environmental Factors. The first category defines the direct benefits associated with buildings; the next three are different kinds of costs associated with providing those benefits; the last category includes concerns that are broader than direct costs and benefits to the building owner and building occupants. The level of detail of the various issues reflect the current state of knowledge in those scientific areas and the ability of the to determine that state of knowledge, rather than directly reflecting the importance of these issues; it intentionally does not specifically focus on energy issues. The report describes work in progress and is intended as a resource and can be used to indicate the areas needing more investigation. Other reports on BPA activities are also available.« less

The assessment of chronic health conditions on work performance, absence, and total economic impact for employers.

PubMed

Collins, James J; Baase, Catherine M; Sharda, Claire E; Ozminkowski, Ronald J; Nicholson, Sean; Billotti, Gary M; Turpin, Robin S; Olson, Michael; Berger, Marc L

2005-06-01

The objective of this study was to determine the prevalence and estimate total costs for chronic health conditions in the U.S. workforce for the Dow Chemical Company (Dow). Using the Stanford Presenteeism Scale, information was collected from workers at five locations on work impairment and absenteeism based on self-reported "primary" chronic health conditions. Survey data were merged with employee demographics, medical and pharmaceutical claims, smoking status, biometric health risk factors, payroll records, and job type. Almost 65% of respondents reported having one or more of the surveyed chronic conditions. The most common were allergies, arthritis/joint pain or stiffness, and back or neck disorders. The associated absenteeism by chronic condition ranged from 0.9 to 5.9 hours in a 4-week period, and on-the-job work impairment ranged from a 17.8% to 36.4% decrement in ability to function at work. The presence of a chronic condition was the most important determinant of the reported levels of work impairment and absence after adjusting for other factors (P < 0.000). The total cost of chronic conditions was estimated to be 10.7% of the total labor costs for Dow in the United States; 6.8% was attributable to work impairment alone. For all chronic conditions studied, the cost associated with performance based work loss or "presenteeism" greatly exceeded the combined costs of absenteeism and medical treatment combined.

A portable low-cost long-term live-cell imaging platform for biomedical research and education.

PubMed

Walzik, Maria P; Vollmar, Verena; Lachnit, Theresa; Dietz, Helmut; Haug, Susanne; Bachmann, Holger; Fath, Moritz; Aschenbrenner, Daniel; Abolpour Mofrad, Sepideh; Friedrich, Oliver; Gilbert, Daniel F

2015-02-15

Time-resolved visualization and analysis of slow dynamic processes in living cells has revolutionized many aspects of in vitro cellular studies. However, existing technology applied to time-resolved live-cell microscopy is often immobile, costly and requires a high level of skill to use and maintain. These factors limit its utility to field research and educational purposes. The recent availability of rapid prototyping technology makes it possible to quickly and easily engineer purpose-built alternatives to conventional research infrastructure which are low-cost and user-friendly. In this paper we describe the prototype of a fully automated low-cost, portable live-cell imaging system for time-resolved label-free visualization of dynamic processes in living cells. The device is light-weight (3.6 kg), small (22 × 22 × 22 cm) and extremely low-cost (<€1250). We demonstrate its potential for biomedical use by long-term imaging of recombinant HEK293 cells at varying culture conditions and validate its ability to generate time-resolved data of high quality allowing for analysis of time-dependent processes in living cells. While this work focuses on long-term imaging of mammalian cells, the presented technology could also be adapted for use with other biological specimen and provides a general example of rapidly prototyped low-cost biosensor technology for application in life sciences and education. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Distribution System Upgrade Unit Cost Database

DOE Data Explorer

Horowitz, Kelsey

2017-11-30

This database contains unit cost information for different components that may be used to integrate distributed photovotaic (D-PV) systems onto distribution systems. Some of these upgrades and costs may also apply to integration of other distributed energy resources (DER). Which components are required, and how many of each, is system-specific and should be determined by analyzing the effects of distributed PV at a given penetration level on the circuit of interest in combination with engineering assessments on the efficacy of different solutions to increase the ability of the circuit to host additional PV as desired. The current state of the distribution system should always be considered in these types of analysis. The data in this database was collected from a variety of utilities, PV developers, technology vendors, and published research reports. Where possible, we have included information on the source of each data point and relevant notes. In some cases where data provided is sensitive or proprietary, we were not able to specify the source, but provide other information that may be useful to the user (e.g. year, location where equipment was installed). NREL has carefully reviewed these sources prior to inclusion in this database. Additional information about the database, data sources, and assumptions is included in the "Unit_cost_database_guide.doc" file included in this submission. This guide provides important information on what costs are included in each entry. Please refer to this guide before using the unit cost database for any purpose.

Dopamine function and the efficiency of human movement.

PubMed

Gepshtein, Sergei; Li, Xiaoyan; Snider, Joseph; Plank, Markus; Lee, Dongpyo; Poizner, Howard

2014-03-01

To sustain successful behavior in dynamic environments, active organisms must be able to learn from the consequences of their actions and predict action outcomes. One of the most important discoveries in systems neuroscience over the last 15 years has been about the key role of the neurotransmitter dopamine in mediating such active behavior. Dopamine cell firing was found to encode differences between the expected and obtained outcomes of actions. Although activity of dopamine cells does not specify movements themselves, a recent study in humans has suggested that tonic levels of dopamine in the dorsal striatum may in part enable normal movement by encoding sensitivity to the energy cost of a movement, providing an implicit "motor motivational" signal for movement. We investigated the motivational hypothesis of dopamine by studying motor performance of patients with Parkinson disease who have marked dopamine depletion in the dorsal striatum and compared their performance with that of elderly healthy adults. All participants performed rapid sequential movements to visual targets associated with different risk and different energy costs, countered or assisted by gravity. In conditions of low energy cost, patients performed surprisingly well, similar to prescriptions of an ideal planner and healthy participants. As energy costs increased, however, performance of patients with Parkinson disease dropped markedly below the prescriptions for action by an ideal planner and below performance of healthy elderly participants. The results indicate that the ability for efficient planning depends on the energy cost of action and that the effect of energy cost on action is mediated by dopamine.

A novel protein expression signature differentiates benign lipomas from well-differentiated liposarcomas.

PubMed

Mather, Quang; Priego, Jonathon; Ward, Kristi; Kundan, Verma; Tran, Dat; Dwivedi, Alok; Bryan, Brad A

2017-09-01

Benign lipomas and well-differentiated liposarcomas share many histological and molecular features. Due to their similarities, patients with these lipomatous tumors are misdiagnosed up to 40% of the time following radiological detection, up to 17% of the time following histological examination, and in as many as 15% of cases following fluorescent in situ hybridization for chromosomal anomalies. Incorrect classification of these two tumor types leads to increased costs to the patient and delayed accurate diagnoses. In this study, we used genomics analysis to identify several genes whose mRNA expression patterns were significantly altered between lipomas and well-differentiated liposarcomas. We confirmed our findings at the protein level using a panel of 30 human lipomatous tumors, revealing that C4BPB, class II, major histocompatibility complex, CIITA, EPHB2, HOXB7, GLS2, RBBP5, and regulator of RGS2 protein levels were increased in well-differentiated liposarcomas compared to lipomas. We developed a multi-protein model of these markers to increase discriminatory ability, finding the combined expression model with CIITA and RGS2 provided a high ability (AUC=0.93) to differentiate between lipomas and well-differentiated liposarcomas with sensitivity at 83.3% and specificity at 90.9%.

Low cost assistive technology to support educational activities for adolescents with cerebral palsy.

PubMed

da Silva, Alan Patricio; Bulle Oliveira, Acary Souza; Pinheiro Bezerra, Italla Maria; Pedrozo Campos Antunes, Thaiany; Guerrero Daboin, Blanca Elena; Raimundo, Rodrigo Daminello; Dos Santos, Vagner Rogério; de Abreu, Luiz Carlos

2017-08-30

The concept of assistive technology covers several areas of action; one of them is communication with the elaboration of accessible solutions to overcome daily difficulties. It contributes to the resumption of functional abilities, expanding and facilitating inclusion and independent living. To analyze the usability of a low cost prototype device to support educational activities of adolescents with cerebral palsy. A descriptive observational study. The evaluation of a prototype device was made through a validated questionnaire, Quest Version 2.0, on the level of the user's satisfaction with an assistive technology, composed of 12 evaluation items. The questionnaire was filled out by the educator based on the observation of four wheelchair-bound participants diagnosed with cerebral palsy according to the international classification of diseases and health-related problems, ICD-10, who attend a coexistence and teaching institution in the state of São Paulo, Brazil. The device developed was considered an assistive technology, which provided an experience with a positive level of satisfaction for the participants. The tested prototype contributes to communication and interaction allowing adolescents with cerebral palsy to participate in educational activities. Implications for Rehabilitation The device assists the individual in the educational activities and can positively influence their development, observe the individual number 5, who has an important limitation in coordination and fine movements, placing the role of the task in the vertical position offers a new perspective to perform the task, this stimulates him to try to perform the work, so the challenge was adjusted to the demands of each individual which can contribute to its neuromotor development, the amplitude of the distal movements and the manual ability, since it must look for alternatives to complete the task requested.

How to not detonate the bomb: the case of the Italian National Health Service.

PubMed

La Torre, G; Federici, A

2017-12-01

Why is Italy one of the world's highest ranked for ability and quality of healthcare in relationship to the resources invested? The last decade has been characterized by many Italian Regions with Recovery Plans, whose main focus was on short-term issues with a high impact on healthcare costs. Italy is now leaving this phase and at the regional level there will be an increase of new hirings in the healthcare sectors, as stated by the Ministry of Health. There is a large amount of scientific literature that supports the role of factors such as lifestyles, diet and genetics as the base of population health. The success of the Italian National Health Service (INHS) function is rooted in the ability of a system to adapt to evolving situations, but it is also important to ensure a mechanism of positive feedback correction. In the future, INHS will require a new set of reforms, like the redefinition of structures and mechanisms of governance, the implementation of strategic plans that conjugate better clinical and financial issues. In this context, Health Data Entanglement could be an option to improve the effectiveness of the health governance system in order to develop better quality of care. In Public Health several criticisms could detonate the bomb, and above all the decreasing levels of primary prevention in the fight to obesity (promoting the Mediterranean Diet and physical activity), to smoking and alcohol consumption, as well as to infectious diseases (promoting high vaccination rates). Secondary prevention is also key to this function as a practical experience of re-engineering of the public expense, giving much attention to what works in terms of cost effectiveness, and in particular to cancer screening. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

United States Foreign Policy in Africa: A Right Approach

DTIC Science & Technology

1990-04-01

a higher cost : Except for two of the platinum group metals (platinum and rhodium), andalusite, and a, specific type of industrial diamornd and grade...Defense Department officials, albeit at a higher cost . The Bureau of Mines report in 1988 estimated the 5-year cumulative direct economic cost of a US...the report understated the economic costs and overstated the ability of other mineral- producing nations to replace South African exports.7 Presently

Positive and cost-effectiveness effect of spa therapy on the resumption of occupational and non-occupational activities in women in breast cancer remission: a French multicentre randomised controlled trial.

PubMed

Mourgues, Charline; Gerbaud, Laurent; Leger, Stéphanie; Auclair, Candy; Peyrol, Fleur; Blanquet, Marie; Kwiatkowski, Fabrice; Leger-Enreille, Anne; Bignon, Yves-Jean

2014-10-01

The main aim was to assess the effects of a spa treatment on the resumption of occupational and non-occupational activities and the abilities of women in breast cancer remission. A cost-effectiveness analysis (CEA) was also performed. A multicentre randomised controlled trial was carried out between 2008 and 2010 in the University Hospital of Auvergne and two private hospitals in Clermont-Ferrand, France. Eligible patients were women in complete breast cancer remission without contraindication for physical activities or cognitive disorders and a body mass index between 18.5 and 40 kg/m(2). The intervention group underwent spa treatment combined with consultation with dietician whereas the control underwent consultations with the dietician only. Of the 181 patients randomised, 92 and 89 were included in the intervention and the control groups, respectively. The CEA involved 90 patients, 42 from the intervention group and 48 from the control group. The main results showed a higher rate of resumption of occupational activities in the intervention group (p = 0.0025) and a positive effect of the intervention on the women's ability to perform occupational activities 12 months after the beginning of the study (p = 0.0014), and on their ability to perform family activities (p = 0.033). The stay in a thermal centre was cost-effective at 12 months. Spa treatment is a cost-effective strategy to improve resumption of occupational and non-occupational activities and the abilities of women in breast cancer remission. Copyright © 2014 Elsevier Ltd. All rights reserved.

Market frictions: A unified model of search costs and switching costs

PubMed Central

Wilson, Chris M.

2012-01-01

It is well known that search costs and switching costs can create market power by constraining the ability of consumers to change suppliers. While previous research has examined each cost in isolation, this paper demonstrates the benefits of examining the two types of friction in unison. The paper shows how subtle distinctions between the two costs can provide important differences in their effects upon consumer behaviour, competition and welfare. In addition, the paper also illustrates a simple empirical methodology for estimating separate measures of both costs, while demonstrating a potential bias that can arise if only one cost is considered. PMID:25550674

Cost analysis of public health influenza vaccine clinics in Ontario.

PubMed

Mercer, Nicola J

2009-01-01

Public health in Ontario delivers, promotes and provides each fall the universal influenza immunization program. This paper addresses the question of whether Ontario public health agencies are able to provide the influenza immunization program within the Ministry of Health fiscal funding envelope of $5 per dose. Actual program delivery data from the 2006 influenza season of Wellington-Dufferin-Guelph Public Health (WDGPH) were used to create a model template for influenza clinics capturing all variable costs. Promotional and administrative costs were separated from clinic costs. Maximum staff workloads were estimated. Vaccine clinics were delivered by public health staff in accordance with standard vaccine administration practices. The most significant economic variables for influenza clinics are labour costs and number of vaccines given per nurse per hour. The cost of facility rental was the only other significant cost driver. The ability of influenza clinics to break even depended on the ability to manage these cost drivers. At WDGPH, weekday flu clinics required the number of vaccines per nurse per hour to exceed 15, and for weekend flu clinics this number was greater than 21. We estimate that 20 vaccines per hour is at the limit of a safe workload over several hours. Managing cost then depends on minimizing hourly labour costs. The results of this analysis suggest that by managing the labour costs along with planning the volume of patients and avoiding expensive facilities, flu clinics can just break even. However, any increased costs, including negotiated wage increases or the move to safety needles, with a fixed revenue of $5.00 per dose will negate this conclusion.

Biopsychosocial Characteristics of Community-dwelling Older Adults with Limited Ability to Walk ¼ Mile

PubMed Central

Hardy, Susan E.; McGurl, David J.; Studenski, Stephanie A.; Degenholtz, Howard B.

2010-01-01

Objectives To establish nationally representative estimates of the prevalence of self-reported difficulty and inability to walk ¼ mile among older adults and to identify the characteristics independently associated with difficulty or inability to walk ¼ mile. Design Cross-sectional analysis of data from the 2003 Cost and Use Medicare Current Beneficiary Survey. Setting Community. Participants 9563 community-dwelling Medicare beneficiaries aged 65 years or older, representing an estimated total population of 34.2 million older adults. Measurements Self-reported ability to walk ¼ mile, sociodemographics, chronic conditions, body mass index, smoking, and functional status. Results In 2003, an estimated 9.5 million aged Medicare beneficiaries had difficulty walking ¼ mile and 5.9 million were unable. Among the 20.2 million older adults with no difficulty in basic or instrumental activities of daily living (ADL), an estimated 4.3 million (21%) had limited ability to walk ¼ mile. Having difficulty or being unable to walk ¼ mile was independently associated with older age, female sex, non-Hispanic ethnicity, lower educational level, Medicaid entitlement, most chronic medical conditions, current smoking, and being overweight or obese. Conclusion Almost half of older adults, and 20% of those reporting no ADL limitations, report limited ability to walk ¼ mile. Among functionally independent older adults, reported ability to walk ¼ mile can identify vulnerable older adults with greater medical problems and fewer resources, and may be a valuable clinical marker in planning their care. Future work is needed to determine the association between ¼ mile walk ability and subsequent functional decline and healthcare utilization. PMID:20210817

31 CFR 344.2 - What general provisions apply to SLGS securities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... program to create a cost-free option; (ii) To purchase a SLGS security with any amount received from the... would result in the SLGS program being used to create a cost-free option. In addition, this practice is... ability to cancel in these circumstances would result in the SLGS program being used to create a cost-free...

31 CFR 344.2 - What general provisions apply to SLGS securities?

Code of Federal Regulations, 2013 CFR

2013-07-01

... program to create a cost-free option; (ii) To purchase a SLGS security with any amount received from the... would result in the SLGS program being used to create a cost-free option. In addition, this practice is... ability to cancel in these circumstances would result in the SLGS program being used to create a cost-free...

31 CFR 344.2 - What general provisions apply to SLGS securities?

Code of Federal Regulations, 2011 CFR

2011-07-01

... program to create a cost-free option; (ii) To purchase a SLGS security with any amount received from the... would result in the SLGS program being used to create a cost-free option. In addition, this practice is... ability to cancel in these circumstances would result in the SLGS program being used to create a cost-free...

10 CFR Appendix D to Part 30 - Criteria Relating to Use of Financial Tests and Self-Guarantee for Providing Reasonable Assurance...

Code of Federal Regulations, 2014 CFR

2014-01-01

... based on furnishing its own guarantee that funds will be available for decommissioning costs and on a... or at least 10 times the total current decommissioning cost estimate (or the current amount required... materially adversely affect the company's ability to pay for decommissioning costs. In connection with the...

10 CFR Appendix D to Part 30 - Criteria Relating to Use of Financial Tests and Self-Guarantee for Providing Reasonable Assurance...

Code of Federal Regulations, 2013 CFR

2013-01-01

... based on furnishing its own guarantee that funds will be available for decommissioning costs and on a... or at least 10 times the total current decommissioning cost estimate (or the current amount required... materially adversely affect the company's ability to pay for decommissioning costs. In connection with the...

Development and application of a probabilistic method for wildfire suppression cost modeling

Treesearch

Matthew P. Thompson; Jessica R. Haas; Mark A. Finney; David E. Calkin; Michael S. Hand; Mark J. Browne; Martin Halek; Karen C. Short; Isaac C. Grenfell

2015-01-01

Wildfire activity and escalating suppression costs continue to threaten the financial health of federal land management agencies. In order to minimize and effectively manage the cost of financial risk, agencies need the ability to quantify that risk. A fundamental aim of this research effort, therefore, is to develop a process for generating risk-based metrics for...

The Development of a Cost of Education Index: Some Empirical Estimates and Policy Issues.

ERIC Educational Resources Information Center

Chambers, Jay G.

This paper outlines an approach for adjusting state aid for differences in educational costs. The approach focuses on determinants of the variation in the prices of school inputs such as cost of heating fuel, ability of the area to attract teachers, and needs for student transportation. The system attempts to isolate that component of the…

A Cost Sharing Plan: Solutions for the Child Care Crisis.

ERIC Educational Resources Information Center

Delaware Valley Child Care Council, Philadelphia, PA.

This booklet discusses the current child care crisis and suggests a solution to the crisis. The gap between the cost of child care and parents' ability to pay is restricting the expansion and availability of child care services and undercutting the quality of child care. The average cost of full-day child care in the Delaware Valley, Pennsylvania,…

The design and construction of a cost-efficient confocal laser scanning microscope

NASA Astrophysics Data System (ADS)

Xi, Peng; Rajwa, Bartlomiej; Jones, James T.; Robinson, J. Paul

2007-03-01

The optical dissection ability of confocal microscopy makes it a powerful tool for biological materials. However, the cost and complexity of confocal scanning laser microscopy hinders its wide application in education. We describe the construction of a simplified confocal scanning laser microscope and demonstrate three-dimensional projection based on cost-efficient commercial hardware, together with available open source software.

Development and application of a model for the analysis of trades between space launch system operations and acquisition costs

NASA Astrophysics Data System (ADS)

Nix, Michael B.

2005-12-01

Early design decisions in the development of space launch systems determine the costs to acquire and operate launch systems. Some sources indicate that as much as 90% of life cycle costs are fixed by the end of the critical design review phase. System characteristics determined by these early decisions are major factors in the acquisition cost of flight hardware elements and facilities and influence operations costs through the amount of maintenance and support labor required to sustain system function. Operations costs are also dependent on post-development management decisions regarding how much labor will be deployed to meet requirements of market demand and ownership profit. The ability to perform early trade-offs between these costs is vital to the development of systems that have the necessary capacity to provide service and are profitable to operate. An Excel-based prototype model was developed for making early analyses of trade-offs between the costs to operate a space launch system and to acquire the necessary assets to meet a given set of operational requirements. The model, integrating input from existing models and adding missing capability, allows the user to make such trade-offs across a range of operations concepts (required flight rates, staffing levels, shifts per workday, workdays per week and per year, unreliability, wearout and depot maintenance) and the number, type and capability of assets (flight hardware elements, processing and supporting facilities and infrastructure). The costs and capabilities of hypothetical launch systems can be modeled as a function of interrelated turnaround times and labor resource levels, and asset loss and retirement. The number of flight components and facilities required can be calculated and the operations and acquisition costs compared for a specified scenario. Findings, based on the analysis of a hypothetical two stage to orbit, reusable, unmanned launch system, indicate that the model is suitable for the trade-off analyses desired. The minimum turnaround time/maximum labor allocation for specific hardware configurations and characteristics and corresponding asset requirements can be estimated. Either turnaround time or resources can be varied and the resulting operations and acquisition costs can be compared. Asset reliability, wearout and depot maintenance intervals and durations can be varied as well to analyze the effects on costs. Likewise, the effects on operations and acquisitions costs of the introduction of alternative technologies that affect reliability, maintainability and supportability in various hardware configurations can be evaluated.

Methodology for Calculating Cost-per-Mile for Current and Future Vehicle Powertrain Technologies, with Projections to 2024

DOE Office of Scientific and Technical Information (OSTI.GOV)

Timbario, Thomas A.; Timbario, Thomas J.; Laffen, Melissa J.

2011-04-12

Currently, several cost-per-mile calculators exist that can provide estimates of acquisition and operating costs for consumers and fleets. However, these calculators are limited in their ability to determine the difference in cost per mile for consumer versus fleet ownership, to calculate the costs beyond one ownership period, to show the sensitivity of the cost per mile to the annual vehicle miles traveled (VMT), and to estimate future increases in operating and ownership costs. Oftentimes, these tools apply a constant percentage increase over the time period of vehicle operation, or in some cases, no increase in direct costs at all overmore » time. A more accurate cost-per-mile calculator has been developed that allows the user to analyze these costs for both consumers and fleets. Operating costs included in the calculation tool include fuel, maintenance, tires, and repairs; ownership costs include insurance, registration, taxes and fees, depreciation, financing, and tax credits. The calculator was developed to allow simultaneous comparisons of conventional light-duty internal combustion engine (ICE) vehicles, mild and full hybrid electric vehicles (HEVs), and fuel cell vehicles (FCVs). Additionally, multiple periods of operation, as well as three different annual VMT values for both the consumer case and fleets can be investigated to the year 2024. These capabilities were included since today's “cost to own” calculators typically include the ability to evaluate only one VMT value and are limited to current model year vehicles. The calculator allows the user to select between default values or user-defined values for certain inputs including fuel cost, vehicle fuel economy, manufacturer's suggested retail price (MSRP) or invoice price, depreciation and financing rates.« less

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

PubMed

Sun, Li; Westerdahl, Dane; Ning, Zhi

2017-08-19

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

Increasing Influence of Societal Response Variables in Coastal Evolution Projections (Invited)

NASA Astrophysics Data System (ADS)

Gayes, P. T.; McCoy, C. A.; Pietrafesa, L. J.

2010-12-01

Recent efforts to project changes in coastal erosion and vulnerability of the state of South Carolina’s (SC’s) oceanfront for different scenarios of future sea level have reinforced the significance of the influence of societal modifications and response to past and anticipated coastal change in these systems. For large reaches of the SC coast human interactions have been a dominant signal driving coastal change across annual to decadal scales. Over the last 20 years, SC’s shoreline has been advanced seawards in many areas due to a combination of sustained societal commitment to beach nourishment and to a lull in atmospheric storms; reversing the long-term erosional trend of shoreline change. Adjacent areas not yet threatened or where coastal defense is unsupported economically have continued to migrate landwards. Locally, efforts focused on stabilizing the subaerial beach have not moderated long-term shoreward migration of the shoreface changing the overall morphology of the coastal boundary waves and currents are operating against. These societal effects, coupled with realistic, substative assessments of future atmospheric storm activity and sea level variability, both over scales of seasons to multi-decades, require consideration to realistically project future coastal behavior across time and spatial scales for planning and resource management. As with future climate and sea level variability effects on the shoreline, the scale and intensity of societal response is not static or precisely projected spatially and temporally into the future. With continued expansion of coastal development and erosion into previously lightly developed and defended coastal areas, societal influences should be expected to increase. Increasing cost of larger scale defenses will likely drive pressure for hardened structures to enhance ”softer” nourishment strategies. However, this strategy would further modify the ability of nature to respond to natural forces. Nourishment programs are strongly cyclic and can act in or out of phase with natural cyclic (inlet migration, sea level variability) or stochastic (storms) drivers with significant effects on coastal response and predictions of coastal behavior. Economic cycles and events may similarly moderate timing and scale of coastal defense relative to natural drivers. Societal decisions to not, enhance and or even abandon and remove existing engineering structures as future forces and costs increase, can result in a disproportional response and potentially failure of a section of coast. Some communities have expressed confidence in the ability to maintain the oceanfront shoreline against most projections of sea level rise over the next 100 years. The long-term trend in sea level change may be less important than naturally occurring regional scale, seasonal to inter-annual to multi-decadal variability in sea level; and these are complex but deterministic. There is less confidence, however, in the ability to combat passive submergence and associated flooding issues behind the immediate oceanfront. To the extent that may influence commitment to defend the oceanfront could strongly influence coastal behavior and stability in the long term.

Considerations for Architecture Level Trade Studies for Environmental Sensors

NASA Technical Reports Server (NTRS)

Peterson, Craig

2010-01-01

Comparisons of key characteristics of environmental sensors such as technology readiness levels, mass, power, volume, and detection capabilities are essential for initial trade studies to determine likely candidates for further development and evaluation. However, these trade studies only provide part of the information necessary to make selection decisions. Ultimately, the sensors must be judged based on the overall system architectures and operational scenarios for which they are intended. This means that additional characteristics, such as architectural needs for redundancy, operational lifetime, ability to maintain calibration, and repair and replacement strategies, among others, must also be considered. Given that these characteristics can be extremely time-consuming and costly to obtain, careful planning is essential to minimize the effort involved. In this paper, an approach is explored for determining an effective yet comprehensive set of architecture level trades which is minimally impacted by the inevitable changes in operational (mission) scenarios. The approach will also identify and integrate the various facilities and opportunities required to obtain the desired architecture level trade information.

What variables influence the ability of an AFO to improve function and when are they indicated?

PubMed

Malas, Bryan S

2011-05-01

Children with spina bifida often present with functional deficits of the lower limb associated with neurosegmental lesion levels and require orthotic management. The most used orthosis for children with spina bifida is the ankle-foot orthosis (AFO). The AFO improves ambulation and reduces energy cost while walking. Despite the apparent benefits of using an AFO, limited evidence documents the influence of factors predicting the ability of an AFO to improve function and when they are indicated. These variables include AFO design, footwear, AFO-footwear combination, and data acquisition. When these variables are not adequately considered in clinical decision-making, there is a risk the AFO will be abandoned prematurely or the patient's stability, function, and safety compromised. The purposes of this study are to (1) describe the functional deficits based on lesion levels; (2) identify and describe variables that influence the ability of an AFO to control deformities; and (3) describe what variables are indicated for the AFO to control knee flexion during stance, hyperpronation, and valgus stress at the knee. A selective literature review was undertaken searching MEDLINE and Cochrane databases using terms related to "orthosis" and "spina bifida." Based on previous studies and gait analysis data, suggestions can be made regarding material selection/geometric configuration, sagittal alignment, footplate length, and trim lines of an AFO for reducing knee flexion, hyperpronation, and valgus stress at the knee. Further research is required to determine what variables allow an AFO to improve function.

Carbon source utilization and inhibitor tolerance of 45 oleaginous yeast species

PubMed Central

Sitepu, Irnayuli; Selby, Tylan; Lin, Ting; Zhu, Shirley; Boundy-Mills, Kyria

2014-01-01

Conversion of lignocellulosic hydrolysates to lipids using oleaginous (high lipid) yeasts requires alignment of the hydrolysate composition with the characteristics of the yeast strain, including ability to utilize certain nutrients, ability to grow independently of costly nutrients such as vitamins, and ability to tolerate inhibitors. Some combination of these characteristics may be present in wild strains. In this study, 48 oleaginous yeast strains belonging to 45 species were tested for ability to utilize carbon sources associated with lignocellulosic hydrolysates, tolerate inhibitors, and grow in medium without supplemented vitamins. Some well-studied oleaginous yeast species, as well as some that have not been frequently utilized in research or industrial production, emerged as promising candidates for industrial use due to ability to utilize many carbon sources, including Cryptococcus aureus, Cryptococcus laurentii, Hanaella aff. zeae, Tremella encephala, and Trichosporon coremiiforme. Other species excelled in inhibitor tolerance, including Candida aff. tropicalis, Cyberlindnera jadinii, Metschnikowia pulcherrima Schwanniomyces occidentalis and Wickerhamomyces ciferii. No yeast tested could utilize all carbon sources and tolerate all inhibitors tested. These results indicate that yeast strains should be selected based on characteristics compatible with the composition of the targeted hydrolysate. Other factors to consider include the production of valuable co-products such as carotenoids, availability of genetic tools, biosafety level, and flocculation of the yeast strain. The data generated in this study will aid in aligning yeasts with compatible hydrolysates for conversion of carbohydrates to lipids to be used for biofuels and other oleochemicals. PMID:24818698

48 CFR 253.209-1 - Responsible prospective contractors.

Code of Federal Regulations, 2014 CFR

2014-10-01

... contracts, or contracts which provide for progress payments based on costs or on a percentage or stage of...) Packaging. An assessment of the prospective contractor's ability to meet all contractual packaging...)). (E) Plant safety. An assessment of the prospective contractor's ability to meet the safety...

Vorticity, backscatter and counter-gradient transport predictions using two-level simulation of turbulent flows

NASA Astrophysics Data System (ADS)

Ranjan, R.; Menon, S.

2018-04-01

The two-level simulation (TLS) method evolves both the large-and the small-scale fields in a two-scale approach and has shown good predictive capabilities in both isotropic and wall-bounded high Reynolds number (Re) turbulent flows in the past. Sensitivity and ability of this modelling approach to predict fundamental features (such as backscatter, counter-gradient turbulent transport, small-scale vorticity, etc.) seen in high Re turbulent flows is assessed here by using two direct numerical simulation (DNS) datasets corresponding to a forced isotropic turbulence at Taylor's microscale-based Reynolds number Reλ ≈ 433 and a fully developed turbulent flow in a periodic channel at friction Reynolds number Reτ ≈ 1000. It is shown that TLS captures the dynamics of local co-/counter-gradient transport and backscatter at the requisite scales of interest. These observations are further confirmed through a posteriori investigation of the flow in a periodic channel at Reτ = 2000. The results reveal that the TLS method can capture both the large- and the small-scale flow physics in a consistent manner, and at a reduced overall cost when compared to the estimated DNS or wall-resolved LES cost.

Cigarette Taxes, Smoking-and Exercise?

PubMed

Conway, Karen Smith; Niles, David P

2017-08-01

This research provides the first in-depth analysis of the effect that increased cigarette taxes have on exercise behavior. Smoking may diminish the ability to exercise; individuals may also use exercise to compensate for the harmful health effects of smoking or to avoid gaining weight if they cut back. Our conceptual model highlights these and several other avenues for effect and reveals that the predicted effect of cigarette costs on exercise behavior is theoretically ambiguous. To investigate the relationship empirically, 1994-2012 data from the behavioral risk factor surveillance system are combined with state level cigarette tax rates and other state level variables. Several measures of both smoking and exercise behavior are created and estimated in reduced form models. Our results suggest that both smoking and exercise are reduced by cigarette taxes. However, the effects on exercise may be more complicated as we find that certain groups, such as young adults or those who have recently quit smoking, are affected differently. Our analyses also show that the responsiveness of both smoking and exercise behavior to cigarette costs is much smaller in the 2000s, an era of high-tax increases. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Transit forecasting accuracy : ridership forecasts and capital cost estimates, final research report.

DOT National Transportation Integrated Search

2009-01-01

In 1992, Pickrell published a seminal piece examining the accuracy of ridership forecasts and capital cost estimates for fixed-guideway transit systems in the US. His research created heated discussions in the transit industry regarding the ability o...

Assessment of design parameters and construction requirements for full depth reclamation projects with cement.

DOT National Transportation Integrated Search

2015-02-01

The ability to efficiently rehabilitate and maintain the State of Vermonts Highway infrastructure in a : cost-effective manner is a daunting task. Historically, pavement overlay treatments were specified : because it was a rapid low cost solution ...

Mathematics creative thinking levels based on interpersonal intelligence

NASA Astrophysics Data System (ADS)

Kuncorowati, R. H.; Mardiyana; Saputro, D. R. S.

2017-12-01

Creative thinking ability was one of student’s ability to determine various alternative solutions toward mathematics problem. One of indicators related to creative thinking ability was interpersonal intelligence. Student’s interpersonal intelligence would influence to student’s creativity. This research aimed to analyze creative thinking ability level of junior high school students in Karanganyar using descriptive method. Data was collected by test, questionnaire, interview, and documentation. The result showed that students with high interpersonal intelligence achieved third and fourth level in creative thinking ability. Students with moderate interpersonal intelligence achieved second level in creative thinking ability and students with low interpersonal intelligence achieved first and zero level in creative thinking ability. Hence, students with high, moderate, and low interpersonal intelligence could solve mathematics problem based on their mathematics creative thinking ability.

Sublethal salinity stress contributes to habitat limitation in an endangered estuarine fish.

PubMed

Komoroske, Lisa M; Jeffries, Ken M; Connon, Richard E; Dexter, Jason; Hasenbein, Matthias; Verhille, Christine; Fangue, Nann A

2016-09-01

As global change alters multiple environmental conditions, predicting species' responses can be challenging without understanding how each environmental factor influences organismal performance. Approaches quantifying mechanistic relationships can greatly complement correlative field data, strengthening our abilities to forecast global change impacts. Substantial salinity increases are projected in the San Francisco Estuary, California, due to anthropogenic water diversion and climatic changes, where the critically endangered delta smelt (Hypomesus transpacificus) largely occurs in a low-salinity zone (LSZ), despite their ability to tolerate a much broader salinity range. In this study, we combined molecular and organismal measures to quantify the physiological mechanisms and sublethal responses involved in coping with salinity changes. Delta smelt utilize a suite of conserved molecular mechanisms to rapidly adjust their osmoregulatory physiology in response to salinity changes in estuarine environments. However, these responses can be energetically expensive, and delta smelt body condition was reduced at high salinities. Thus, acclimating to salinities outside the LSZ could impose energetic costs that constrain delta smelt's ability to exploit these habitats. By integrating data across biological levels, we provide key insight into the mechanistic relationships contributing to phenotypic plasticity and distribution limitations and advance the understanding of the molecular osmoregulatory responses in nonmodel estuarine fishes.

Locomotor Adaptation Improves Balance Control, Multitasking Ability and Reduces the Metabolic Cost of Postural Instability

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Peters, B. T.; Mulavara, A. P.; Brady, R. A.; Batson, C. D.; Miller, C. A.; Ploutz-Snyder, R. J.; Guined, J. R.; Buxton, R. E.; Cohen, H. S.

2011-01-01

During exploration-class missions, sensorimotor disturbances may lead to disruption in the ability to ambulate and perform functional tasks during the initial introduction to a novel gravitational environment following a landing on a planetary surface. The overall goal of our current project is to develop a sensorimotor adaptability training program to facilitate rapid adaptation to these environments. We have developed a unique training system comprised of a treadmill placed on a motion-base facing a virtual visual scene. It provides an unstable walking surface combined with incongruent visual flow designed to enhance sensorimotor adaptability. Greater metabolic cost incurred during balance instability means more physical work is required during adaptation to new environments possibly affecting crewmembers? ability to perform mission critical tasks during early surface operations on planetary expeditions. The goal of this study was to characterize adaptation to a discordant sensory challenge across a number of performance modalities including locomotor stability, multi-tasking ability and metabolic cost. METHODS: Subjects (n=15) walked (4.0 km/h) on a treadmill for an 8 -minute baseline walking period followed by 20-minutes of walking (4.0 km/h) with support surface motion (0.3 Hz, sinusoidal lateral motion, peak amplitude 25.4 cm) provided by the treadmill/motion-base system. Stride frequency and auditory reaction time were collected as measures of locomotor stability and multi-tasking ability, respectively. Metabolic data (VO2) were collected via a portable metabolic gas analysis system. RESULTS: At the onset of lateral support surface motion, subj ects walking on our treadmill showed an increase in stride frequency and auditory reaction time indicating initial balance and multi-tasking disturbances. During the 20-minute adaptation period, balance control and multi-tasking performance improved. Similarly, throughout the 20-minute adaptation period, VO2 gradually decreased following an initial increase after the onset of support surface motion. DISCUSSION: Resu lts confirmed that walking in discordant conditions not only compromises locomotor stability and the ability to multi-task, but comes at a quantifiable metabolic cost. Importantly, like locomotor stability and multi-tasking ability, metabolic expenditure while walking in discordant sensory conditions improved during adaptation. This confirms that sensorimotor adaptability training can benefit multiple performance parameters central to the successful completion of critical mission tasks.

Health-based risk adjustment: is inpatient and outpatient diagnostic information sufficient?

PubMed

Lamers, L M

Adequate risk adjustment is critical to the success of market-oriented health care reforms in many countries. Currently used risk adjusters based on demographic and diagnostic cost groups (DCGs) do not reflect expected costs accurately. This study examines the simultaneous predictive accuracy of inpatient and outpatient morbidity measures and prior costs. DCGs, pharmacy cost groups (PCGs), and prior year's costs improve the predictive accuracy of the demographic model substantially. DCGs and PCGs seem complementary in their ability to predict future costs. However, this study shows that the combination of DCGs and PCGs still leaves room for cream skimming.

The impact of internet-based cognitive behavior therapy on work ability in patients with depression - a randomized controlled study.

PubMed

Hange, Dominique; Ariai, Nashmil; Kivi, Marie; Eriksson, Maria Cm; Nejati, Shabnam; Petersson, Eva-Lisa

2017-01-01

The aim of this randomized controlled trial (RCT) was to investigate the effects of internet-based cognitive behavior therapy (ICBT) treatment for depression compared to treatment-as-usual (TAU) on improving work ability and quality of life in patients with mild-to-moderate depression. We also examined whether patients treated with ICBT returned to work more rapidly, that is, had fewer days of sick leave, than patients treated with TAU. This study is based on material from the PRIM-NET RCT that took place between 2010 and 2013. Primary care centers in Region Vastra Gotaland, Sweden, population about 1.6 million. A total of 77 patients with depression randomized to either ICBT (46 patients) or TAU (31 patients). Mean age of participants was 35.8 years, and 67.5% were women. Work ability was measured with the Work Ability Index, depressive symptoms with Montgomery Asberg Depression Rating Scale - self-rating version (MADRS-S), quality of life with EuroQoL-5D (EQ-5D), and number of sick leave days. Both groups showed an association between improved work ability and reduction of depressive symptoms and between improved work ability and better quality of life. ICBT could not be shown to improve work ability more than TAU among patients with mild-to-moderate depression. There were no differences between the groups concerning number of patients with sick leave or number of sick leave days. Our study indicates that a high level of work ability has an association with high health-related quality of life in patients with mild-to-moderate depression, whether they are treated with ICBT or TAU. ICBT has previously been found to be cost-effective and can be seen as a good alternative to TAU. In addition to the ICBT, an intervention oriented toward the work place might improve work ability and reduce the number of sick leave days among patients with depression.

RVU costing applications.

PubMed

Berlin, M F; Faber, B P; Berlin, L M; Budzynski, M R

1997-11-01

Relative value unit (RVU) cost accounting which uses the resource-based relative value scale (RBRVS), can be used to determine the cost to produce given services and determine appropriate physician fees. The calculations derived from RVU costing have additional applications, such as analyzing fee schedules, evaluating the profitability of third-party payer reimbursement, calculating a floor capitation rate, and allocating capitation payments within the group. The ability to produce this information can help group practice administrators determine ways to manage the cost of providing services, set more realistic fees, and negotiate more profitable contracts.

Contracting out of clinical services in Zimbabwe.

PubMed

McPake, B; Hongoro, C

1995-07-01

Contracting is increasingly recommended to developing countries as a way of improving the efficiency of the health sector. However, empirical evidence regarding its effectiveness in this respect is almost completely absent. In Zimbabwe, a long standing contract exists between the Ministry of Health and Wankie Colliery to provide clinical services in the Colliery's 400 bed hospital. This paper details a study of the Zimbabweans' experience with the contract. Its success is assessed using comparisons with a neighbouring government hospital of the price of services (vs the cost in the government hospital); the situation of hospital workers; and the quality of services delivered. The Colliery has established a monopoly position for hospital services in the district. However, it appears to offer services of at least as good quality at prices which are lower than the unit costs of the government hospital when capital costs are included. Nevertheless, the contract cannot be considered a success due to the failure to contain its total cost. Approximately 70% of provincial non-salary recurrent expenditure is consumed by the contract while only a minority of the province's population have access to the Colliery hospital. Screening patients, both with respect to their ability to pay and to their need for secondary level services does not take place with the result that utilization levels are not controlled. The study highlights a number of important issues affecting contracting in developing country setting: First, contracted institutions attain powerful bargaining positions if there are no viable competitors and the government does not itself retain capacity to offer an alternative service. Second, specific skills are needed for the management of contracts at all levels. If the process of contract development responds to a crisis driven agenda resulting from civil service retrenchment and public expenditure cuts, it is unlikely that adequate consideration will be given to the development of such skills and the retention of key personnel. If such details are neglected, otherwise feasible efficiency gains will prove elusive.

Creating value-added linkages through creative programming: a partnership for nursing education.

PubMed

Caldwell, Linda M; Luke, Gerri; Tenofsky, Linda M

2007-01-01

Academic and clinical institutions can effectively collaborate to deliver programs that enhance the educational level of the nursing staff. Creative programming, which offers flexibility and convenience, and a reasonable cost are key elements in the success of a program. Open communication and mutual recognition and respect of the talents, abilities, and values of all developers of the program are essential factors in effective collaborations leading to successful partnerships. Although clear expectations and clarity of functions are important once the partnership has developed, flexibility and a desire to "own" both the problems and the successes of a program are crucial to success.

Additive Manufacturing of Porous Metal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dehoff, Ryan R.; Kirka, Michael M.

2017-06-01

Currently, helium is obtained through separation from natural gas. The current industrial process incurs significant costs and requires large energy resources to successfully achieve separation. Through utilizing Additive Manufacturing (AM) technologies it is possible to reduce both of these burdens when refining helium gas. The ability to engineer porosity levels within Inconel 718 discs for controlled separation of helium from natural gas was investigated. Arrays of samples fabricated using the electron beam melting process were analyzed for their relative porosity density. Based upon the measurements, full scale discs were fabricated, and subsequently tested to determine their effectiveness in separating heliummore » from liquefied natural gas.« less

The impact of customer focus on program participation rates in the Virginia WIC Program (Special Supplemental Nutrition Program for Women, Infants, and Children).

PubMed

Chance, K G; Green, C G

2001-01-01

It has been shown in the for-profit sector (business, service, and manufacturing) that the success of an organization depends on its ability to satisfy customer requirements while eliminating waste and reducing costs. The purpose of this article was to examine the impact of current practices in customer focus on program participation rates in the Virginia WIC Program. The results of this study showed that the use of customer-focused strategies was correlated to program participation rates in the WIC Program. The mean data showed that teamwork and accessibility were at unsatisfactory levels in Virginia.

Intradermal Inactivated Poliovirus Vaccine: A Preclinical Dose-Finding Study

PubMed Central

Kouiavskaia, Diana; Mirochnitchenko, Olga; Dragunsky, Eugenia; Kochba, Efrat; Levin, Yotam; Troy, Stephanie; Chumakov, Konstantin

2015-01-01

Intradermal delivery of vaccines has been shown to result in dose sparing. We tested the ability of fractional doses of inactivated poliovirus vaccine (IPV) delivered intradermally to induce levels of serum poliovirus-neutralizing antibodies similar to immunization through the intramuscular route. Immunogenicity of fractional doses of IPV was studied by comparing intramuscular and intradermal immunization of Wistar rats using NanoPass MicronJet600 microneedles. Intradermal delivery of partial vaccine doses induced antibodies at titers comparable to those after immunization with full human dose delivered intramuscularly. The results suggest that intradermal delivery of IPV may lead to dose-sparing effect and reduction of the vaccination cost. PMID:25391313

Economics of wildland fire management

Treesearch

David Calkin; Krista Gebert

2009-01-01

Increased wildland fire activity and associated suppression costs over the last decade have significantly challenged federal agencies' ability to manage the nation's lands and meet public expectations. Three common factors have typically been identified to explain this increasing cost trend: 1) increased development within the wildland urban interface...

Cognitive skills and bacterial load: comparative evidence of costs of cognitive proficiency in birds

NASA Astrophysics Data System (ADS)

Soler, Juan José; Peralta-Sánchez, Juan Manuel; Martín-Vivaldi, Manuel; Martín-Platero, Antonio Manuel; Flensted-Jensen, Einar; Møller, Anders Pape

2012-02-01

Parasite-mediated selection may affect the evolution of cognitive abilities because parasites may influence development of the brain, but also learning capacity. Here, we tested some predictions of this hypothesis by analyzing the relationship between complex behaviours (feeding innovations (as a measure of behavioural flexibility) and ability to detect foreign eggs in their nests (i.e. a measure of discriminatory ability)) and abundance of microorganisms in different species of birds. A positive relationship would be predicted if these cognitive abilities implied a larger number of visited environments, while if these skills favoured detection and avoidance of risky environments, a negative relationship would be the prediction. Bacterial loads of eggshells, estimated for mesophilic and potentially pathogenic bacteria (i.e. Enterococcus, Staphylococcus and Enterobacteriaceae), were used as a surrogate of probability of contact with pathogenic bacteria. We found that bird species with higher feeding innovation rates and rejection rates of experimental brood parasitic eggs had higher density of bacteria on their eggshells than the average species. Since the analysed groups of microorganisms include pathogenic bacteria, these results suggest that both feeding innovation and ability to recognize foreign eggs are costly and highlight the importance of parasite-mediated selection in explaining the evolution of cognitive abilities in animals.

Patient-centered medical homes in Louisiana had minimal impact on Medicaid population's use of acute care and costs.

PubMed

Cole, Evan S; Campbell, Claudia; Diana, Mark L; Webber, Larry; Culbertson, Richard

2015-01-01

The patient-centered medical home model of primary care has received considerable attention for its potential to improve outcomes and reduce health care costs. Yet little information exists about the model's ability to achieve these goals for Medicaid patients. We sought to evaluate the effect of patient-centered medical home certification of Louisiana primary care clinics on the quality and cost of care over time for a Medicaid population. We used a quasi-experimental pre-post design with a matched control group to assess the effect of medical home certification on outcomes. We found no impact on acute care use and modest support for reduced costs and primary care use among medical homes serving higher proportions of chronically ill patients. These findings provide preliminary results related to the ability of the patient-centered medical home model to improve outcomes for Medicaid beneficiaries. The findings support a case-mix-adjusted payment policy for medical homes going forward. Project HOPE—The People-to-People Health Foundation, Inc.

Comprehensive U.S. Government Strategic Communication Policy: The Way Forward

DTIC Science & Technology

2009-06-12

franchised cell. It costs little, is easy to distribute, and has near- immediate worldwide impact. (White 2007) The Smith-Mundt Act The historical...lack of ability to communicate strategically. The United States‘ strategic communication failure has cost the country friends and allies, and it...to communicate strategically. The United States‘ strategic communication failure has cost the country friends and allies, and it also hurts the

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. Copyright © 2016 Elsevier Inc. All rights reserved.

Short-Term Attentional Perseveration Associated with Real-Life Creative Achievement

PubMed Central

Zabelina, Darya L.; Beeman, Mark

2013-01-01

There are at least two competing hypotheses of how attention interacts with creative cognition, although they are not mutually exclusive. The first hypothesis is that highly creative people are particularly flexible at switching their attention – that is, they adaptively shift focus among different attentional levels using cognitive control. The second, less common, view is that creative people exhibit attentional persistence, or an ability for sustained attention. We suggest these two views need not be competing, as they may both operate, but on different time scales or on different components of creativity. In the present study we examined the role of attention in real-world creative achievement and in divergent thinking. In Experiment 1 participants with high and low real-world creative achievements identified whether the stimulus contained letters S or H within hierarchically constructed letters (e.g., large S made of small Es – global level; large E made up of small Ss – local level), which were presented in blocks of eight trials per level. In Experiment 2 participants with high, medium, and low creative achievements identified the same stimulus letters, but in blocks of five, seven, and nine trials per level. Results from both experiments indicated that people with high creative achievements made significantly more errors on trials in which they had to switch the level of attention, even after controlling for general intelligence. In Experiment 2, divergent thinking was also assessed, but it was not related to switching cost. Results from both experiments demonstrate that real-world creative acts relate to increased levels of attentional persistence, even if it comes with the cost of perseveration in certain circumstances. PMID:23630508

Can exergaming contribute to improving physical activity levels and health outcomes in children?

PubMed

Daley, Amanda J

2009-08-01

Physical inactivity among children is a serious public health problem. It has been suggested that high levels of screen time are contributory factors that encourage sedentary lifestyles in young people. As physical inactivity and obesity levels continue to rise in young people, it has been proposed that new-generation active computer- and video-console games (otherwise known as "exergaming") may offer the opportunity to contribute to young people's energy expenditure during their free time. Although studies have produced some encouraging results regarding the energy costs involved in playing active video-console games, the energy costs of playing the authentic versions of activity-based video games are substantially larger, highlighting that active gaming is no substitute for real sports and activities. A small number of exergaming activities engage children in moderate-intensity activity, but most do not. Only 3 very small trials have considered the effects of exergaming on physical activity levels and/or other health outcomes in children. Evidence from these trials has been mixed; positive trends for improvements in some health outcomes in the intervention groups were noted in 2 trials. No adequately powered randomized, controlled trial has been published to date, and no trial has assessed the long-term impact of exergaming on children's health. We now need high-quality randomized, controlled trials to evaluate the effectiveness and sustainability of exergaming, as well as its clinical relevance; until such studies take place, we should remain cautious about its ability to positively affect children's health.

Crushing leads to waste disposal savings for FUSRAP

DOE Office of Scientific and Technical Information (OSTI.GOV)

Darby, J.

1997-02-01

In this article the author discusses the application of a rock crusher as a means of implementing cost savings in the remediation of FUSRAP sites. Transportation and offsite disposal costs are at present the biggest cost items in the remediation of FUSRAP sites. If these debris disposal problems can be handled in different manners, then remediation savings are available. Crushing can result in the ability to handle some wastes as soil disposal problems, which have different disposal regulations, thereby permitting cost savings.

Perturbations in reward-related decision-making induced by reduced prefrontal cortical GABA transmission: Relevance for psychiatric disorders.

PubMed

Piantadosi, Patrick T; Khayambashi, Shahin; Schluter, Magdalen G; Kutarna, Agnes; Floresco, Stan B

2016-02-01

The prefrontal cortex (PFC) is critical for higher-order cognitive functions, including decision-making. In psychiatric conditions such as schizophrenia, prefrontal dysfunction co-occurs with pronounced alterations in decision-making ability. These alterations include a diminished ability to utilize probabilistic reinforcement in guiding future choice, and a reduced willingness to expend effort to receive reward. Among the neurochemical abnormalities observed in the PFC of individuals with schizophrenia are alterations in the production and function of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). To probe how PFC GABA hypofunction may contribute to alterations in cost/benefit decision-making, we assessed the effects GABAA-receptor antagonist bicuculline (BIC; 50 ng in 0.5 μl saline/hemisphere) infusion in the medial PFC of rats during performance on a series of well-validated cost/benefit decision-making tasks. Intra-PFC BIC reduced risky choice and reward sensitivity during probabilistic discounting and decreased the preference for larger rewards associated with a greater effort cost, similar to the behavioral sequelae observed in schizophrenia. Additional experiments revealed that these treatments did not alter instrumental responding on a progressive ratio schedule, nor did they impair the ability to discriminate between reward and no reward. However, BIC induced a subtle but consistent impairment in preference for larger vs. smaller rewards of equal cost. BIC infusion also increased decision latencies and impaired the ability to "stay on task" as indexed by reduced rates of instrumental responding. Collectively, these results implicate prefrontal GABAergic dysfunction as a key contributing factor to abnormal decision-making observed in schizophrenia and other neuropsychiatric conditions with similar neurobiological and behavioral alterations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effects of the level of early productivity on the lifespan of ewes in contrasting flock environments.

PubMed

Douhard, F; Jopson, N B; Friggens, N C; Amer, P R

2016-12-01

Selection for high levels of prolificacy has allowed substantial improvements in the production efficiency of New Zealand (NZ) sheep farms, but the consequences on ewe lifetime performance are mostly unknown. In this study, the relationship between the level of prolificacy early in ewes' productive lives and their probability to survive later (i.e. stayability) was evaluated in two contrasting NZ flock environments. Records were obtained from 6605 ewes from four ram breeder flocks representing either a moderate (n=2) or a highly variable (n=2) nutritional environment. All ewes lambed for the first time at 2 years of age and were mated the following year. The number of lambs born during the first 2 years of productive life (NLB2-3) was used as a measure of early prolificacy. Effects of NLB2-3 on stayability to 4, 5, 6, 7 and 8 years old were analysed using logistic regression. Curvilinear effects (logit-transformed) were detected (P<0.05) until stayability to 6 years and to 8 years old in the highly variable and the moderate environment, respectively. The NLB2-3 that resulted in maximum expected stayability to various ages was 3.9 to 4.2, and 4.5 to 4.7 lambs in the highly variable and in the moderate flock environments, respectively. In addition, ewe stayability was reduced when the proportion of the litter that survived from birth to weaning (i.e. ewe rearing ability) was submaximal during the early productive life. High prolific ewes had a low rearing ability whatever the environment whereas the rearing ability of lowly prolific ewes was apparently more sensitive to the nutritional environment. The poor maternal performance of ewes with low levels of NLB2-3 led to a premature culling by breeders whereas the high early reproductive effort associated with high levels of NLB2-3 seemed to be at the cost of ewes' survival, even in the moderate flock environment. In conclusion, the flock environment influenced the level of early prolificacy beyond which ewe longevity was reduced. It is suggested that further selection for high and early prolificacy in NZ flocks is likely to impair ewes' lifetime productivity.

Head Lice in Norwegian Households: Actions Taken, Costs and Knowledge

PubMed Central

Rukke, Bjørn Arne; Birkemoe, Tone; Soleng, Arnulf; Lindstedt, Heidi Heggen; Ottesen, Preben

2012-01-01

Introduction Head lice infestations cause distress in many families. A well-founded strategy to reduce head lice prevalence must shorten the infectious period of individual hosts. To develop such a strategy, information about the actions taken (inspection, treatment and informing others about own infestations), level of knowledge and costs is needed. The present study is the first to consider all these elements combined. Materials and Methods A questionnaire was answered by 6203 households from five geographically separated municipalities in Norway. Results 94% of the households treated members with pediculicides when head lice were discovered. Nearly half of the households checked biannually or not at all. Previous occurrence of head lice and multiple children in a household improved both checking frequency and method. More than 90% of the households informed close contacts about their own pediculosis. Direct costs of pediculosis were low (less than €6.25 yearly) for 70% of the households, but the ability to pay for pediculicides decreased with the number of head lice infestations experienced. One in three households kept children from school because of pediculosis. Other widespread misconceptions, such as that excessive cleaning is necessary to fight head lice, may also add unnecessary burden to households. School affiliation had a significant effect on checking frequency and method, knowledge and willingness to inform others about own pediculosis. Conclusions Increased checking frequencies appear to be the most important element to reduce head lice prevalence in Norway and should be a primary focus of future strategies. National campaigns directed through schools to individual households, might be an important tool to achieve this goal. In addition to improving actions taken, such campaigns should also provide accurate information to reduce costs and enhance the level of knowledge about head lice in households. PMID:22393437

A hospital-based cost minimization study of the potential financial impact on the UK health care system of introduction of iron isomaltoside 1000.

PubMed

Bhandari, Sunil

2011-01-01

The clinical need to be able to administer high doses of intravenous iron conveniently in a single rapid infusion has been addressed by the recent introduction of ferric carboxymaltose and subsequently iron isomaltoside 1000. Neither requires a test dose. Ferric carboxymaltose can be administered at 15 mg/kg body weight to a maximum dose of 1000 mg, whereas iron isomaltoside 1000 can be administered at 20 mg/kg body weight. The ability to give high doses of iron is important in the context of managing iron deficiency anemia in a number of clinical conditions where demands for iron are high (including chronic blood loss associated with inflammatory bowel disease, menorrhagia, and chronic kidney disease). It is also an important component in the strategy as an alternative to a blood transfusion. Affordability is a key issue for health services. This study was a comparative analysis of the costs of administering the newly available intravenous iron formulations against standard practice (blood transfusion, intravenous iron sucrose) by considering the cost of this treatment option plus nursing costs associated with administration, equipment for administration, and patient transportation in the secondary care (hospital) setting across three dosage levels (600 mg, 1000 mg, and 1600 mg). The analysis indicates that the use of iron isomaltoside 1000 results in a net saving when compared with iron sucrose, blood, and ferric carboxymaltose. At 600 mg and 1000 mg doses, it is cheaper than low-molecular-weight iron dextran but more expensive at a dose of 1600 mg. However, it takes six hours to administer low-molecular-weight iron dextran at this dose level, which is inconvenient and reduces patient throughput (productivity).

Early action to reduce greenhouse gas emissions before the commitment period of the Kyoto protocol: advantages and disadvantages.

PubMed

Michaelowa, A; Rolfe, C

2001-09-01

Current "business as usual" projections suggest greenhouse gas emissions from industrialized nations will grow substantially over the next decade. However, if it comes into force, the Kyoto Protocol will require industrialized nations to reduce emissions to an average of 5% below 1990 levels in the 2008-2012 period. Taking early action to close this gap has a number of advantages. It reduces the risks of passing thresholds that trigger climate change "surprises." Early action also increases future generations' ability to choose greater levels of climate protection, and it leads to faster reductions of other pollutants. From an economic sense, early action is important because it allows shifts to less carbon-intensive technologies during the course of normal capital stock turnover. Moreover, many options for emission reduction have negative costs, and thus are economically worthwhile, because of paybacks in energy costs, healthcare costs, and other benefits. Finally, early emission reductions enhance the probability of successful ratification and lower the risk of noncompliance with the protocol. We discuss policy approaches for the period prior to 2008. Disadvantages of the current proposals for Credit for Early Action are the possibility of adverse selection due to problematic baseline calculation methods as well as the distributionary impacts of allocating a part of the emissions budget already before 2008. One simple policy without drawbacks is the so-called baseline protection, which removes the disincentive to early action due to the expectation that businesses may, in the future, receive emission rights in proportion to past emissions. It is particularly important to adopt policies that shift investment in long-lived capital stock towards less carbon-intensive technologies and to encourage innovation and technology development that will reduce future compliance costs.

Development of a case-mix funding system for adults with combined vision and hearing loss.

PubMed

Guthrie, Dawn M; Poss, Jeffrey W

2013-04-15

Adults with vision and hearing loss, or dual sensory loss (DSL), present with a wide range of needs and abilities. This creates many challenges when attempting to set the most appropriate and equitable funding levels. Case-mix (CM) funding models represent one method for understanding client characteristics that correlate with resource intensity. A CM model was developed based on a derivation sample (n = 182) and tested with a replication sample (n = 135) of adults aged 18+ with known DSL who were living in the community. All items within the CM model came from a standardized, multidimensional assessment, the interRAI Community Health Assessment and the Deafblind Supplement. The main outcome was a summary of formal and informal service costs which included intervenor and interpreter support, in-home nursing, personal support and rehabilitation services. Informal costs were estimated based on a wage rate of half that for a professional service provider ($10/hour). Decision-tree analysis was used to create groups with homogeneous resource utilization. The resulting CM model had 9 terminal nodes. The CM index (CMI) showed a 35-fold range for total costs. In both the derivation and replication sample, 4 groups (out of a total of 18 or 22.2%) had a coefficient of variation value that exceeded the overall level of variation. Explained variance in the derivation sample was 67.7% for total costs versus 28.2% in the replication sample. A strong correlation was observed between the CMI values in the two samples (r = 0.82; p = 0.006). The derived CM funding model for adults with DSL differentiates resource intensity across 9 main groups and in both datasets there is evidence that these CM groups appropriately identify clients based on need for formal and informal support.

Head lice in Norwegian households: actions taken, costs and knowledge.

PubMed

Rukke, Bjørn Arne; Birkemoe, Tone; Soleng, Arnulf; Lindstedt, Heidi Heggen; Ottesen, Preben

2012-01-01

Head lice infestations cause distress in many families. A well-founded strategy to reduce head lice prevalence must shorten the infectious period of individual hosts. To develop such a strategy, information about the actions taken (inspection, treatment and informing others about own infestations), level of knowledge and costs is needed. The present study is the first to consider all these elements combined. A questionnaire was answered by 6203 households from five geographically separated municipalities in Norway. 94% of the households treated members with pediculicides when head lice were discovered. Nearly half of the households checked biannually or not at all. Previous occurrence of head lice and multiple children in a household improved both checking frequency and method. More than 90% of the households informed close contacts about their own pediculosis. Direct costs of pediculosis were low (less than €6.25 yearly) for 70% of the households, but the ability to pay for pediculicides decreased with the number of head lice infestations experienced. One in three households kept children from school because of pediculosis. Other widespread misconceptions, such as that excessive cleaning is necessary to fight head lice, may also add unnecessary burden to households. School affiliation had a significant effect on checking frequency and method, knowledge and willingness to inform others about own pediculosis. Increased checking frequencies appear to be the most important element to reduce head lice prevalence in Norway and should be a primary focus of future strategies. National campaigns directed through schools to individual households, might be an important tool to achieve this goal. In addition to improving actions taken, such campaigns should also provide accurate information to reduce costs and enhance the level of knowledge about head lice in households.

Should intellectual property be disseminated by "forwarding" rejected letters without permission?

PubMed

Gupta, V K

1996-08-01

Substantive scientific letter writing is a cost-effective mode of complementing observational and experimental research. The value of such philosophically uncommitted and unsponsored well-balanced scientific activity has been relegated. Critical letter writing entails the abilities to: maintain rational scepticism; refuse to conform in order to explain data; persist in keeping common sense centre-stage; exercise logic to evaluate the biological significance of mathematical figures, including statistics, and the ability to sustain the will to share insights regarding disease mechanisms on an ostensibly lower research platform. During peer review, innovative letter writing may share the occasionally unfortunate fate of innovative research. Rejected scientific letters do not automatically lose copyright. Periodicals with high letter loads will see some valuable contributions wasted, but that is the price for maintaining autonomy in scientific publication. The scientific community is an integrated whole that must respect the rights of authors at all levels. Unauthorised forwarding of rejected letters sets the dangerous precedent of justifying unjust means.

A global conservation system for climate-change adaptation.

PubMed

Hannah, Lee

2010-02-01

Climate change has created the need for a new strategic framework for conservation. This framework needs to include new protected areas that account for species range shifts and management that addresses large-scale change across international borders. Actions within the framework must be effective in international waters and across political frontiers and have the ability to accommodate large income and ability-to-pay discrepancies between countries. A global protected-area system responds to these needs. A fully implemented global system of protected areas will help in the transition to a new conservation paradigm robust to climate change and will ensure the integrity of the climate services provided by carbon sequestration from the world's natural habitats. The internationally coordinated response to climate change afforded by such a system could have significant cost savings relative to a system of climate adaptation that unfolds solely at a country level. Implementation of a global system is needed very soon because the effects of climate change on species and ecosystems are already well underway.

WindWaveFloat (WWF): Final Scientific Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alla Weinstein; Roddier, Dominique; Banister, Kevin

2012-03-30

Principle Power Inc. and National Renewable Energy Lab (NREL) have completed a contract to assess the technical and economic feasibility of integrating wave energy converters into the WindFloat, resulting in a new concept called the WindWaveFloat (WWF). The concentration of several devices on one platform could offer a potential for both economic and operational advantages. Wind and wave energy converters can share the electrical cable and power transfer equipment to transport the electricity to shore. Access to multiple generation devices could be simplified, resulting in cost saving at the operational level. Overall capital costs may also be reduced, provided thatmore » the design of the foundation can be adapted to multiple devices with minimum modifications. Finally, the WindWaveFloat confers the ability to increase energy production from individual floating support structures, potentially leading to a reduction in levelized energy costs, an increase in the overall capacity factor, and greater stability of the electrical power delivered to the grid. The research conducted under this grant investigated the integration of several wave energy device types into the WindFloat platform. Several of the resulting system designs demonstrated technical feasibility, but the size and design constraints of the wave energy converters (technical and economic) make the WindWaveFloat concept economically unfeasible at this time. Not enough additional generation could be produced to make the additional expense associated with wave energy conversion integration into the WindFloat worthwhile.« less

Autonomous exoskeleton reduces metabolic cost of human walking during load carriage.

PubMed

Mooney, Luke M; Rouse, Elliott J; Herr, Hugh M

2014-05-09

Many soldiers are expected to carry heavy loads over extended distances, often resulting in physical and mental fatigue. In this study, the design and testing of an autonomous leg exoskeleton is presented. The aim of the device is to reduce the energetic cost of loaded walking. In addition, we present the Augmentation Factor, a general framework of exoskeletal performance that unifies our results with the varying abilities of previously developed exoskeletons. We developed an autonomous battery powered exoskeleton that is capable of providing substantial levels of positive mechanical power to the ankle during the push-off region of stance phase. We measured the metabolic energy consumption of seven subjects walking on a level treadmill at 1.5 m/s, while wearing a 23 kg vest. During the push-off portion of the stance phase, the exoskeleton applied positive mechanical power with an average across the gait cycle equal to 23 ± 2 W (11.5 W per ankle). Use of the autonomous leg exoskeleton significantly reduced the metabolic cost of walking by 36 ± 12 W, which was an improvement of 8 ± 3% (p = 0.025) relative to the control condition of not wearing the exoskeleton. In the design of leg exoskeletons, the results of this study highlight the importance of minimizing exoskeletal power dissipation and added limb mass, while providing substantial positive power during the walking gait cycle.

a Redundant Gnss-Ins Low-Cost Uav Navigation Solution for Professional Applications

NASA Astrophysics Data System (ADS)

Navarro, J.; Parés, M. E.; Colomina, I.; Bianchi, G.; Pluchino, S.; Baddour, R.; Consoli, A.; Ayadi, J.; Gameiro, A.; Sekkas, O.; Tsetsos, V.; Gatsos, T.; Navoni, R.

2015-08-01

This paper presents the current results for the FP7 GINSEC project. Its goal is to build a pre-commercial prototype of a low-cost, accurate and reliable system for the professional UAV market. Low-cost, in this context, stands for the use of sensors in the most affordable segment of the market, especially MEMS IMUs and GNSS receivers. Reliability applies to the ability of the autopilot to cope with situations where unfavourable GNSS reception conditions or strong electromagnetic fields make the computation of the position and / or attitude of the UAV difficult. Professional and accurate mean that, at least using post-processing techniques as PPP, it will be possible to reach cm-level precisions that open the door to a range of applications demanding high levels of quality in positioning, as precision agriculture or mapping. To achieve such goal, a rigorous sensor error modelling approach, the use of redundant IMUs and a dual-GNSS receiver setup, together with close-coupling techniques and an extended Kalman filter with self-analysis capabilities have been used. Although the project is not yet complete, the results obtained up to now prove the feasibility of the aforementioned goal, especially in those aspects related to position determination. Research work is still undergoing to estimate the heading using a dual-GNNS receiver setup; preliminary results prove the validity of this approach for relatively long baselines, although positive results are expected when these are shorter than 1 m - which is a necessary requisite for small-sized UAVs.

Honest sexual signalling mediated by parasite and testosterone effects on oxidative balance.

PubMed

Mougeot, Francois; Martínez-Padilla, Jesús; Webster, Lucy M I; Blount, Jonathan D; Pérez-Rodríguez, Lorenzo; Piertney, Stuart B

2009-03-22

Extravagant ornaments evolved to advertise their bearers' quality, the honesty of the signal being ensured by the cost paid to produce or maintain it. The oxidation handicap hypothesis (OHH) proposes that a main cost of testosterone-dependent ornamentation is oxidative stress, a condition whereby the production of reactive oxygen and nitrogen species (ROS/RNS) overwhelms the capacity of antioxidant defences. ROS/RNS are unstable, very reactive by-products of normal metabolic processes that can cause extensive damage to key biomolecules (cellular proteins, lipids and DNA). Oxidative stress has been implicated in the aetiology of many diseases and could link ornamentation and genetic variation in fitness-related traits. We tested the OHH in a free-living bird, the red grouse. We show that elevated testosterone enhanced ornamentation and increased circulating antioxidant levels, but caused oxidative damage. Males with smaller ornaments suffered more oxidative damage than those with larger ornaments when forced to increase testosterone levels, consistent with a handicap mechanism. Parasites depleted antioxidant defences, caused oxidative damage and reduced ornament expression. Oxidative damage extent and the ability of males to increase antioxidant defences also explained the impacts of testosterone and parasites on ornamentation within treatment groups. Because oxidative stress is intimately linked to immune function, parasite resistance and fitness, it provides a reliable currency in the trade-off between individual health and ornamentation. The costs induced by oxidative stress can apply to a wide range of signals, which are testosterone-dependent or coloured by pigments with antioxidant properties.

Honest sexual signalling mediated by parasite and testosterone effects on oxidative balance

PubMed Central

Mougeot, Francois; Martínez-Padilla, Jesu´s; Webster, Lucy M.I.; Blount, Jonathan D.; Pérez-Rodríguez, Lorenzo; Piertney, Stuart B.

2008-01-01

Extravagant ornaments evolved to advertise their bearers' quality, the honesty of the signal being ensured by the cost paid to produce or maintain it. The oxidation handicap hypothesis (OHH) proposes that a main cost of testosterone-dependent ornamentation is oxidative stress, a condition whereby the production of reactive oxygen and nitrogen species (ROS/RNS) overwhelms the capacity of antioxidant defences. ROS/RNS are unstable, very reactive by-products of normal metabolic processes that can cause extensive damage to key biomolecules (cellular proteins, lipids and DNA). Oxidative stress has been implicated in the aetiology of many diseases and could link ornamentation and genetic variation in fitness-related traits. We tested the OHH in a free-living bird, the red grouse. We show that elevated testosterone enhanced ornamentation and increased circulating antioxidant levels, but caused oxidative damage. Males with smaller ornaments suffered more oxidative damage than those with larger ornaments when forced to increase testosterone levels, consistent with a handicap mechanism. Parasites depleted antioxidant defences, caused oxidative damage and reduced ornament expression. Oxidative damage extent and the ability of males to increase antioxidant defences also explained the impacts of testosterone and parasites on ornamentation within treatment groups. Because oxidative stress is intimately linked to immune function, parasite resistance and fitness, it provides a reliable currency in the trade-off between individual health and ornamentation. The costs induced by oxidative stress can apply to a wide range of signals, which are testosterone-dependent or coloured by pigments with antioxidant properties. PMID:19129122

Autonomous exoskeleton reduces metabolic cost of human walking during load carriage

PubMed Central

2014-01-01

Background Many soldiers are expected to carry heavy loads over extended distances, often resulting in physical and mental fatigue. In this study, the design and testing of an autonomous leg exoskeleton is presented. The aim of the device is to reduce the energetic cost of loaded walking. In addition, we present the Augmentation Factor, a general framework of exoskeletal performance that unifies our results with the varying abilities of previously developed exoskeletons. Methods We developed an autonomous battery powered exoskeleton that is capable of providing substantial levels of positive mechanical power to the ankle during the push-off region of stance phase. We measured the metabolic energy consumption of seven subjects walking on a level treadmill at 1.5 m/s, while wearing a 23 kg vest. Results During the push-off portion of the stance phase, the exoskeleton applied positive mechanical power with an average across the gait cycle equal to 23 ± 2 W (11.5 W per ankle). Use of the autonomous leg exoskeleton significantly reduced the metabolic cost of walking by 36 ± 12 W, which was an improvement of 8 ± 3% (p = 0.025) relative to the control condition of not wearing the exoskeleton. Conclusions In the design of leg exoskeletons, the results of this study highlight the importance of minimizing exoskeletal power dissipation and added limb mass, while providing substantial positive power during the walking gait cycle. PMID:24885527

Take a Seat.

ERIC Educational Resources Information Center

Grant, Deborah R.

1999-01-01

Examines the factors involved in purchasing school furnishings that will help ensure its long-time use, safety, and ability to resist abuse. Cost and safety factors discussed include resisting trendy colors to reduce cost in furniture matching, managing computer and office wiring for safety, considering ergonomics in the purchasing decision, and…

Thermal and digestive constraints to foraging behaviour in marine mammals.

PubMed

Rosen, David A S; Winship, Arliss J; Hoopes, Lisa A

2007-11-29

While foraging models of terrestrial mammals are concerned primarily with optimizing time/energy budgets, models of foraging behaviour in marine mammals have been primarily concerned with physiological constraints. This has historically centred on calculations of aerobic dive limits. However, other physiological limits are key to forming foraging behaviour, including digestive limitations to food intake and thermoregulation. The ability of an animal to consume sufficient prey to meet its energy requirements is partly determined by its ability to acquire prey (limited by available foraging time, diving capabilities and thermoregulatory costs) and process that prey (limited by maximum digestion capacity and the time devoted to digestion). Failure to consume sufficient prey will have feedback effects on foraging, thermoregulation and digestive capacity through several interacting avenues. Energy deficits will be met through catabolism of tissues, principally the hypodermal lipid layer. Depletion of this blubber layer can affect both buoyancy and gait, increasing the costs and decreasing the efficiency of subsequent foraging attempts. Depletion of the insulative blubber layer may also increase thermoregulatory costs, which will decrease the foraging abilities through higher metabolic overheads. Thus, an energy deficit may lead to a downward spiral of increased tissue catabolism to pay for increased energy costs. Conversely, the heat generated through digestion and foraging activity may help to offset thermoregulatory costs. Finally, the circulatory demands of diving, thermoregulation and digestion may be mutually incompatible. This may force animals to alter time budgets to balance these exclusive demands. Analysis of these interacting processes will lead to a greater understanding of the physiological constraints within which the foraging behaviour must operate.

Diabetes management in Thailand: a literature review of the burden, costs, and outcomes

PubMed Central

2013-01-01

Management of diabetes represents an enormous challenge for health systems at every level of development. The latter are tested for their ability to continuously deliver high quality care to patients from the day they are diagnosed throughout their life. In this study, we review the status of diabetes management in Thailand and try to identify the key challenges the country needs to address to reduce the current (and future) medical and economic burden caused by the disease. We conducted a literature review on the burden, costs, and outcomes of diabetes in Thailand. This information was complemented by personal communication with senior officials in the Thai Ministry of Health. We identified the following priorities for the future management of diabetes in Thailand. First, increasing screening of diabetes in high risk population and promoting annual screening of diabetes complications in all diabetic patients. Second, identifying and addressing factors affecting poor treatment outcomes. Third, policy should specify clear targets and provide and use a monitoring framework to track progress. Fourth, efforts are needed to further improve data availability. Up-to-date data on the medical and economic burden of diabetes representative at the national level and at least the regional level are essential to identify needs and monitor progress towards established targets. Fifth, promotion of a healthy lifestyle for prevention of diabetes through education and quality information delivered to the public. PMID:23497447

Use of cancer performance measures in population health: a macro-level perspective.

PubMed

Clauser, Steven B

2004-01-01

The use of performance measurement to inform macro-level studies of cancer control and quality of care is receiving increasing interest at the state, national, and international level. This article describes the use of these measures to inform health policy and monitor cancer disparities and disease burden. Applications are discussed in clinical and provider-reported outcomes such as cancer incidence, mortality and survival, and outcome-linked processes of care, and patient-reported outcomes such as health-related quality of life and patient satisfaction/experience with care. The use of economic measures to monitor and evaluate the burden of illness is also discussed. The growing demand for surveillance capability coupled with the need to expand both the quality and breadth of available measure sets, suggests that there is a need to supplement traditional clinical and provider-reported process and outcomes measures with patient-reported outcomes measures such as health-related quality of life and patient satisfaction and experience with care. In addition, there is also a need to broaden and standardize outcome-linked process-of-care measures to improve the ability to measure and monitor incremental progress in improving cancer care. Finally, better measures of indirect costs of cancer care, such as loss productivity and caregiver burden among the aged, would improve national estimates of the cost of illness associated with cancer.

Development of a low cost unmanned aircraft system for atmospheric carbon dioxide leak detection

NASA Astrophysics Data System (ADS)

Mitchell, Taylor Austin

Carbon sequestration, the storage of carbon dioxide gas underground, has the potential to reduce global warming by removing a greenhouse gas from the atmosphere. These storage sites, however, must first be monitored to detect if carbon dioxide is leaking back out to the atmosphere. As an alternative to traditional large ground-based sensor networks to monitor CO2 levels for leaks, unmanned aircraft offer the potential to perform in-situ atmospheric leak detection over large areas for a fraction of the cost. This project developed a proof-of-concept sensor system to map relative carbon dioxide levels to detect potential leaks. The sensor system included a Sensair K-30 FR CO2 sensor, GPS, and altimeter connected an Arduino microcontroller which logged data to an onboard SD card. Ground tests were performed to verify and calibrate the system including wind tunnel tests to determine the optimal configuration of the system for the quickest response time (4-8 seconds based upon flowrate). Tests were then conducted over a controlled release of CO 2 in addition to over controlled rangeland fires which released carbon dioxide over a large area as would be expected from a carbon sequestration source. 3D maps of carbon dioxide were developed from the system telemetry that clearly illustrated increased CO2 levels from the fires. These tests demonstrated the system's ability to detect increased carbon dioxide concentrations in the atmosphere.

A decision analysis approach to climate adaptation: comparing multiple pathways for multi-decadal decision making

NASA Astrophysics Data System (ADS)

Lin, B. B.; Little, L.

2013-12-01

Policy planners around the world are required to consider the implications of adapting to climatic change across spatial contexts and decadal timeframes. However, local level information for planning is often poorly defined, even though climate adaptation decision-making is made at this scale. This is especially true when considering sea level rise and coastal impacts of climate change. We present a simple approach using sea level rise simulations paired with adaptation scenarios to assess a range of adaptation options available to local councils dealing with issues of beach recession under present and future sea level rise and storm surge. Erosion and beach recession pose a large socioeconomic risk to coastal communities because of the loss of key coastal infrastructure. We examine the well-known adaptation technique of beach nourishment and assess various timings and amounts of beach nourishment at decadal time spans in relation to beach recession impacts. The objective was to identify an adaptation strategy that would allow for a low frequency of management interventions, the maintenance of beach width, and the ability to minimize variation in beach width over the 2010 to 2100 simulation period. 1000 replications of each adaptation option were produced against the 90 year simulation in order to model the ability each adaptation option to achieve the three key objectives. Three sets of adaptation scenarios were identified. Within each scenario, a number of adaptation options were tested. The three scenarios were: 1) Fixed periodic beach replenishment of specific amounts at 20 and 50 year intervals, 2) Beach replenishment to the initial beach width based on trigger levels of recession (5m, 10m, 20m), and 3) Fixed period beach replenishment of a variable amount at decadal intervals (every 10, 20, 30, 40, 50 years). For each adaptation option, we show the effectiveness of each beach replenishment scenario to maintain beach width and consider the implications of more frequent replenishment with that of implementation cost. We determine that a business as usual scenario, where no adaptation is implemented, would lead to an average beach recession of 12.02 meters and a maximum beach recession of 33.23 meters during the period of 2010-2100. The best adaptation option modeled was a fixed replenishment of 5 meters every 20 years leading to 4 replenishment events with an average beach recession of 2.99 meters and a maximum beach recession of 15.02 meters during the period of 2010-2100. The presented simulations explicitly address the uncertainty of future impacts due to sea level rise and storm surge and show a range of options that could be considered by a local council to meet their policy objectives. The simulation runs provide managers the ability to consider the utility of various adaptation options and the timing and costs of implementation. Such information provides an evidence-based practice to decision-making and allows policy makers to transparently make decisions based on best estimates of modeled climate change.

Low-Cost GRIN-Lens-Based Nephelometric Turbidity Sensing in the Range of 0.1-1000 NTU.

PubMed

Metzger, Michael; Konrad, Alexander; Blendinger, Felix; Modler, Andreas; Meixner, Alfred J; Bucher, Volker; Brecht, Marc

2018-04-06

Turbidity sensing is very common in the control of drinking water. Furthermore, turbidity measurements are applied in the chemical (e.g., process monitoring), pharmaceutical (e.g., drug discovery), and food industries (e.g., the filtration of wine and beer). The most common measurement technique is nephelometric turbidimetry. A nephelometer is a device for measuring the amount of scattered light of suspended particles in a liquid by using a light source and a light detector orientated in 90° to each other. Commercially available nephelometers cost usually-depending on the measurable range, reliability, and precision-thousands of euros. In contrast, our new developed GRIN-lens-based nephelometer, called GRINephy, combines low costs with excellent reproducibility and precision, even at very low turbidity levels, which is achieved by its ability to rotate the sample. Thereby, many cuvette positions can be measured, which results in a more precise average value for the turbidity calculated by an algorithm, which also eliminates errors caused by scratches and contaminations on the cuvettes. With our compact and cheap Arduino-based sensor, we are able to measure in the range of 0.1-1000 NTU and confirm the ISO 7027-1:2016 for low turbidity values.

Sugammadex: Appropriate Use in the Context of Budgetary Constraints.

PubMed

Cammu, Guy

2018-01-01

The purpose of this review is to assess how sugammadex impacts postoperative residual curarization using appropriate doses based on neuromuscular transmission monitoring and whether the advantages of sugammadex versus neostigmine outweigh its higher cost. An accurate assessment of neuromuscular blockade with monitoring is necessary before selecting neostigmine versus sugammadex for reversal at the end of surgery to overcome incomplete neuromuscular recovery. The main advantages of sugammadex over neostigmine are its predictability and its ability to extend the range of blockade reversal. The cost of sugammadex is greater when higher doses of sugammadex are required for antagonism of deep block. Sugammadex probably has the potential to be cost-effective compared with neostigmine if its time savings are put to productive use in clinical practice. However, to date, the economic benefits of the drug are unknown. With sugammadex, almost any degree of neuromuscular block can be antagonized within 2-3 min; neostigmine is the only reversal agent effective against benzylisoquinolines and can ideally be used for reversal of lower levels of residual paralysis. The performance of the more expensive sugammadex on improving patient outcomes may depend on several elements of clinical strategy.

Bilingual processing of ASL-English code-blends: The consequences of accessing two lexical representations simultaneously

PubMed Central

Emmorey, Karen; Petrich, Jennifer; Gollan, Tamar H.

2012-01-01

Bilinguals who are fluent in American Sign Language (ASL) and English often produce code-blends - simultaneously articulating a sign and a word while conversing with other ASL-English bilinguals. To investigate the cognitive mechanisms underlying code-blend processing, we compared picture-naming times (Experiment 1) and semantic categorization times (Experiment 2) for code-blends versus ASL signs and English words produced alone. In production, code-blending did not slow lexical retrieval for ASL and actually facilitated access to low-frequency signs. However, code-blending delayed speech production because bimodal bilinguals synchronized English and ASL lexical onsets. In comprehension, code-blending speeded access to both languages. Bimodal bilinguals’ ability to produce code-blends without any cost to ASL implies that the language system either has (or can develop) a mechanism for switching off competition to allow simultaneous production of close competitors. Code-blend facilitation effects during comprehension likely reflect cross-linguistic (and cross-modal) integration at the phonological and/or semantic levels. The absence of any consistent processing costs for code-blending illustrates a surprising limitation on dual-task costs and may explain why bimodal bilinguals code-blend more often than they code-switch. PMID:22773886

Wind for Schools (Presentation)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kelly, M.

2007-06-01

Schools are key to achieving the goal of producing 20% of the nation's electricity demand. Most significantly, schools are training the scientists, technicians, businesspeople, decisionmakers, and teachers of the future. What students learn and believe about wind energy will impact the United States' ability to create markets and policy, develop and improve technology, finance and implement projects, and create change in all of our public and private institutions. In the nearer term, school districts have large facility costs, electrical loads, and utility costs. They are always in search of ways to reduce costs or obtain revenue to improve educational programs.more » Schools value teaching about the science and technology of renewable energy. They are important opinion leaders, particularly in rural communities. And their financial structures are quite different from other institutions (funding, incentives, restrictions, etc.). Learning objectives: The presentation will use case studies, project experience, and discussion with the audience to convey the current status of wind energy applications and education in U.S. schools and understanding of the elements that create a successful school wind energy project. The presentation will provide attendees with a background in the current level of knowledge and generate discussion on several themes.« less

A cross-national study of prescription nonadherence due to cost: data from the Joint Canada-United States Survey of Health.

PubMed

Kennedy, Jae; Morgan, Steve

2006-08-01

In Canada and the United States, patients who have difficulty paying for prescribed medications are less likely to obtain them and may experience increased risks for morbidity and mortality and/or increased health care costs due to nonadherence. As prescription drug costs have risen, the ability to pay for medications has emerged as a critical public health issue. The objectives of this study were to estimate the rates of cost-associated nonadherence in Canada and the United States, and to identify factors that predict cost-associated nonadherence in both countries. This original analysis used data from the 2002/2003 Joint Canada-US Survey of Health, a household phone survey jointly conducted by Statistics Canada (Ottawa, Ontario, Canada) and the US National Center for Health Statistics (Hyattsville, Maryland). The sample included 3505 adults in Canada and 5183 adults in the United States. Weighted group comparisons and logistic regression analyses were used to identify population factors predictive of cost-associated prescription nonadherence. Residents of Canada were much less likely than residents of the United States to report cost-associated nonadherence (5.1% vs 9.9%; P < 0.001). Americans without health insurance (28.2%) and Americans and Canadians without prescription-drug coverage (16.2%) were significantly more likely than those with insurance (6.2%) to report cost-associated nonadherence (P < 0.001). In addition to country of residence and insurance coverage, significant risk factors predictive of nonadherence were young age, poor health, chronic pain, and low household income. The results of this analysis suggest that people with low incomes and inadequate insurance, as well as those with poor health and/or chronic symptoms, are more likely to report failing to fill a prescription due to cost. The overall rate of cost-associated nonadherence was significantly higher in the United States than in Canada, even when other person-level factors were controlled for, including health insurance and prescription-drug coverage.

Modeling Impact and Cost-Effectiveness of Increased Efforts to Attract Voluntary Medical Male Circumcision Clients Ages 20-29 in Zimbabwe.

PubMed

Kripke, Katharine; Hatzold, Karin; Mugurungi, Owen; Ncube, Gertrude; Xaba, Sinokuthemba; Gold, Elizabeth; Ahanda, Kim Seifert; Kruse-Levy, Natalie; Njeuhmeli, Emmanuel

2016-01-01

Zimbabwe aims to increase circumcision coverage to 80% among 13- to 29-year-olds. However, implementation data suggest that high coverage among men ages 20 and older may not be achievable without efforts specifically targeted to these men, incurring additional costs per circumcision. Scale-up scenarios were created based on trends in implementation data in Zimbabwe, and the cost-effectiveness of increasing efforts to recruit clients ages 20-29 was examined. Zimbabwe voluntary medical male circumcision (VMMC) program data were used to project trends in male circumcision coverage by age into the future. The projection informed a base scenario in which, by 2018, the country achieves 80% circumcision coverage among males ages 10-19 and lower levels of coverage among men above age 20. The Zimbabwe DMPPT 2.0 model was used to project costs and impacts, assuming a US$109 VMMC unit cost in the base scenario and a 3% discount rate. Two other scenarios assumed that the program could increase coverage among clients ages 20-29 with a corresponding increase in unit cost for these age groups. When circumcision coverage among men ages 20-29 is increased compared with a base scenario reflecting current implementation trends, fewer VMMCs are required to avert one infection. If more than 50% additional effort (reflected as multiplying the unit cost by >1.5) is required to double the increase in coverage among this age group compared with the base scenario, the cost per HIV infection averted is higher than in the base scenario. Although increased investment in recruiting VMMC clients ages 20-29 may lead to greater overall impact if recruitment efforts are successful, it may also lead to lower cost-effectiveness, depending on the cost of increasing recruitment. Programs should measure the relationship between increased effort and increased ability to attract this age group.

Alterations in neural systems mediating cognitive flexibility and inhibition in mood disorders.

PubMed

Piguet, Camille; Cojan, Yann; Sterpenich, Virginie; Desseilles, Martin; Bertschy, Gilles; Vuilleumier, Patrik

2016-04-01

Impairment in mental flexibility may be a key component contributing to cardinal cognitive symptoms among mood disorders patients, particularly thought control disorders. Impaired ability to switch from one thought to another might reflect difficulties in either generating new mental states, inhibiting previous states, or both. However, the neural underpinnings of impaired cognitive flexibility in mood disorders remain largely unresolved. We compared a group of mood disorders patients (n = 29) and a group of matched healthy subjects (n = 32) on a novel task-switching paradigm involving happy and sad faces, that allowed us to separate generation of a new mental set (Switch Cost) and inhibition of the previous set during switching (Inhibition Cost), using fMRI. Behavioral data showed a larger Switch Cost in patients relative to controls, but the average Inhibition Cost did not differ between groups. At the neural level, a main effect of group was found with stronger activation of the subgenual cingulate cortex in patients. The larger Switch Cost in patients was reflected by a stronger recruitment of brain regions involved in attention and executive control, including the left intraparietal sulcus, precuneus, left inferior fontal gyrus, and right anterior cingulate. Critically, activity in the subgenual cingulate cortex was not downregulated by inhibition in patients relative to controls. In conclusion, mood disorder patients have exaggerated Switch Cost relative to controls, and this deficit in cognitive flexibility is associated with increased activation of the fronto-parietal attention networks, combined with impaired modulation of the subgenual cingulate cortex when inhibition of previous mental states is needed. © 2016 Wiley Periodicals, Inc.

Water-supply options in arsenic-affected regions in Cambodia: targeting the bottom income quintiles.

PubMed

Chamberlain, Jim F; Sabatini, David A

2014-08-01

In arsenic-affected regions of Cambodia, rural water committees and planners can choose to promote various arsenic-avoidance and/or arsenic-removal water supply systems. Each of these has different costs of providing water, subsequently born by the consumer in order to be sustainable. On a volumetric basis ($/m3-yr) and of the arsenic-avoidance options considered, small-scale public water supply - e.g., treated water provided to a central tap stand - is the most expensive option on a life-cycle cost basis. Rainwater harvesting, protected hand dug wells, and vendor-supplied water are the cheapest with a normalized present worth value, ranging from $2 to $10 per cubic meter per year of water delivered. Subsidization of capital costs is needed to make even these options affordable to the lowest (Q5) quintile. The range of arsenic-removal systems considered here, using adsorptive media, is competitive with large-scale public water supply and deep tube well systems. Both community level and household-scale systems are in a range that is affordable to the Q4 quintile, though more research and field trials are needed. At a target cost of $5.00/m3, arsenic removal systems will compete with the OpEx costs for most of the arsenic-safe water systems that are currently available. The life-cycle cost approach is a valuable method for comparing alternatives and for assessing current water supply practices as these relate to equity and the ability to pay. Copyright © 2013 Elsevier B.V. All rights reserved.

Systems Engineering Using Heritage Spacecraft Technology: Lessons Learned from Discovery and New Frontiers Deep Space Missions

NASA Technical Reports Server (NTRS)

Barley, Bryan; Newhouse, Marilyn; Clardy, Dennon

2011-01-01

In the design and development of complex spacecraft missions, project teams frequently assume the use of advanced technology or heritage systems to enable a mission or reduce the overall mission risk and cost. As projects proceed through the development life cycle, increasingly detailed knowledge of the advanced or heritage systems and the system environment identifies unanticipated issues that result in cost overruns or schedule impacts. The Discovery & New Frontiers (D&NF) Program Office recently studied cost overruns and schedule delays resulting from advanced technology or heritage assumptions for 6 D&NF missions. The goal was to identify the underlying causes for the overruns and delays, and to develop practical mitigations to assist the D&NF projects in identifying potential risks and controlling the associated impacts to proposed mission costs and schedules. The study found that the cost and schedule growth did not result from technical hurdles requiring significant technology development. Instead, systems engineering processes did not identify critical issues early enough in the design cycle to ensure project schedules and estimated costs address the inherent risks. In general, the overruns were traceable to: inadequate understanding of the heritage system s behavior within the proposed spacecraft design and mission environment; an insufficient level of experience with the heritage system; or an inadequate scoping of the system-wide impacts necessary to implement the heritage or advanced technology. This presentation summarizes the study s findings and offers suggestions for improving the project s ability to identify and manage the risks inherent in the technology and heritage design solution.

What reductions in dependency costs result from treatment in an inpatient neurological rehabilitation unit for people with stroke?

PubMed

O'Connor, Rory J; Beden, Rushdy; Pilling, Andrew; Chamberlain, M Anne

2011-02-01

This paper examines the reductions in care costs that result from inpatient multidisciplinary rehabilitation for younger people with acquired brain injury. Thirty-five consecutive patients admitted following a stroke over one year were recruited to this observational study. Physical ability, dependency and potential community care costs were measured on admission and discharge. Fifty-one community-dwelling patients were transferred to rehabilitation from acute medical wards in a large teaching hospital; 35 met the inclusion criteria. After a median of 59 days of rehabilitation, 29 patients were discharged home and six to nursing homes. Patients made highly significant gains in physical ability (median Barthel index 50 to 64; p < 0.001). Dependency decreased; median calculated costs for care were reduced from pounds 1900 to pounds 1100 per week, a saving of pounds 868 per week. Total annualised care costs reduced from pounds 3,358,056 to pounds 1,807,208, a potential saving of pounds 1,550,848. The median time to repay rehabilitation costs was 21 weeks. Savings occurred in those with moderate and severe disability and they have the potential to continue to accrue for over 12 years. Similar results will probably be found for rehabilitation in other forms of acquired brain injury.

Business, households, and governments: Health care costs, 1990

PubMed Central

Levit, Katharine R.; Cowan, Cathy A.

1991-01-01

This annual article presents information on health care costs by business, households, and government. Households funded 35 percent of expenditures in 1990, government 33 percent, and business, 29 percent. During the last decade, health care costs continued to grow at annual rates of 8 to 16 percent. Burden measures show that rapidly rising costs faced by each sponsor sector are exceeding increases in each sector's ability to fund them. Increased burden is particularly acute for business. The authors discuss the problems these rising costs pose for business, particularly small business, and some of the strategies businesses employ to constrain this cost growth. PMID:10122364

Financial aspects of veterinary herd health management programmes.

PubMed

Ifende, V I; Derks, M; Hooijer, G A; Hogeveen, H

2014-09-06

Veterinary herd health management (VHHM) programmes have been shown to be economically effective in the past. However, no current information is available on costs and benefits of these programmes. This study compared economics and farm performance between participants and non-participants in VHHM programmes in 1013 dairy farms with over 40 cows. Milk Production Registration (MPR) data and a questionnaire concerning VHHM were used. Based on the level of participation in VHHM (as indicated in the questionnaire), costs of the programmes were calculated using a normative model. The economic value of the production effects was similarly calculated using normative modelling based on MPR data. Participants in VHHM had a better performance with regard to production, but not with regard to reproduction. Over 90 per cent of the VHHM participants were visited at least once every six weeks and most participants discussed at least three topics. In most farms, the veterinarian did the pregnancy checks as part of the VHHM programmes. There was a benefit to cost ratio of about five per cow per year for VHHM participants, and a mean difference in net returns of €30 per cow per year after adjusting for the cost of the programme. This portrays that participation in a VHHM programme is cost-efficient. There is, however, much unexplained variation in the net returns, possibly due to diverse approaches by veterinarians towards VHHM or by other factors not included in this analysis, like nutritional quality or management abilities of the farmer. British Veterinary Association.

Strategy of arm movement control is determined by minimization of neural effort for joint coordination.

PubMed

Dounskaia, Natalia; Shimansky, Yury

2016-06-01

Optimality criteria underlying organization of arm movements are often validated by testing their ability to adequately predict hand trajectories. However, kinematic redundancy of the arm allows production of the same hand trajectory through different joint coordination patterns. We therefore consider movement optimality at the level of joint coordination patterns. A review of studies of multi-joint movement control suggests that a 'trailing' pattern of joint control is consistently observed during which a single ('leading') joint is rotated actively and interaction torque produced by this joint is the primary contributor to the motion of the other ('trailing') joints. A tendency to use the trailing pattern whenever the kinematic redundancy is sufficient and increased utilization of this pattern during skillful movements suggests optimality of the trailing pattern. The goal of this study is to determine the cost function minimization of which predicts the trailing pattern. We show that extensive experimental testing of many known cost functions cannot successfully explain optimality of the trailing pattern. We therefore propose a novel cost function that represents neural effort for joint coordination. That effort is quantified as the cost of neural information processing required for joint coordination. We show that a tendency to reduce this 'neurocomputational' cost predicts the trailing pattern and that the theoretically developed predictions fully agree with the experimental findings on control of multi-joint movements. Implications for future research of the suggested interpretation of the trailing joint control pattern and the theory of joint coordination underlying it are discussed.

Biopsychosocial characteristics of community-dwelling older adults with limited ability to walk one-quarter of a mile.

PubMed

Hardy, Susan E; McGurl, David J; Studenski, Stephanie A; Degenholtz, Howard B

2010-03-01

To establish nationally representative estimates of the prevalence of self-reported difficulty and inability of older adults to walk one-quarter of a mile and to identify the characteristics independently associated with difficulty or inability to walk one-quarter of a mile. Cross-sectional analysis of data from the 2003 Cost and Use Medicare Current Beneficiary Survey. Community. Nine thousand five hundred sixty-three community-dwelling Medicare beneficiaries aged 65 and older, representing an estimated total population of 34.2 million older adults. Self-reported ability to walk one-quarter of a mile, sociodemographics, chronic conditions, body mass index, smoking, functional status. In 2003, an estimated 9.5 million older Medicare beneficiaries had difficulty walking one-quarter of a mile, and 5.9 million were unable to do so. Of the 20.2 million older adults with no difficulty in activities of daily living (ADLs) or instrumental activities of daily living (IADLs), an estimated 4.3 million (21%) had limited ability to walk one-quarter of a mile. Having difficulty or being unable to walk one-quarter of a mile was independently associated with older age, female sex, non-Hispanic ethnicity, lower educational level, Medicaid entitlement, most chronic medical conditions, current smoking, and being overweight or obese. Almost half of older adults and 20% of those reporting no ADL or IADL limitations report limited ability to walk one-quarter of a mile. For functionally independent older adults, reported ability to walk one-quarter of a mile can identify vulnerable older adults with greater medical problems and fewer resources and may be a valuable clinical marker in planning their care. Future work is needed to determine the association between ability to walk one-quarter of a mile walk and subsequent functional decline and healthcare use.

Levelized Cost of Energy Calculator | Energy Analysis | NREL

Science.gov Websites

Levelized Cost of Energy Calculator Levelized Cost of Energy Calculator Transparent Cost Database Button The levelized cost of energy (LCOE) calculator provides a simple calculator for both utility-scale need to be included for a thorough analysis. To estimate simple cost of energy, use the slider controls

A Study of USN Aircrew Attitudes Regarding Technology’s Ability to Replace the Naval Flight Officer on Typical Combat Missions Carrier Based Aircraft are Tasked to Perform

DTIC Science & Technology

1993-09-01

Management, Air Force Institute of Technology (AU), Wright Patterson AFB CH, 1991. Horngren , Charles T. and George Foster. Cost Accounting : A Managerial...Submit - TotalCastOPnperewldSubmnit * s ((I eEnter this figure in column 13(c)(1) SHORE ESTAILISHMENT COST TO PREPARE AND SUBMIT PAY GRADE No OR ORYRT...W’IC QUALIT’Y TI15?SrTF-* AFIT/GSM/LAR/93S- 1 A SILMY OF USN AIRCREW ATTIU2 RECARDING TE*L ’ S ABILITY TO REPLACE THE NAVAL FLICHT OFFICER ON TYPICAL

PHENIX Work Breakdown Structure. Cost and schedule review copy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1994-02-01

The Work Breakdown Structure (WBS) Book begins with this Overview section, which contains the high-level summary cost estimate, the cost profile, and the global construction schedule. The summary cost estimate shows the total US cost and the cost in terms of PHENIX construction funds for building the PHENIX detector. All costs in the WBS book are shown in FY 1993 dollars. Also shown are the institutional and foreign contributions, the level of pre-operations funding, and the cost of deferred items. Pie charts are presented at PHENIX WBS level 1 and 2 that show this information. The PHENIX construction funds aremore » shown broken down to PHENIX WBS level 3 items per fiscal year, and the resulting profile is compared to the RHIC target profile. An accumulated difference of the two profiles is also shown. The PHENIX global construction schedule is presented at the end of the Overview section. Following the Overview are sections for each subsystem. Each subsystem section begins with a summary cost estimate, cost profile, and critical path. The total level 3 cost is broken down into fixed costs (M&S), engineering costs (EDIA) and labor costs. Costs are further broken down in terms of PHENIX construction funds, institutional and foreign contributions, pre-operations funding, and deferred items. Also shown is the contingency at level 3 and the level 4 breakdown of the total cost. The cost profile in fiscal years is shown at level 3. The subsystem summaries are followed by the full cost estimate and schedule sheets for that subsystem. These detailed sheets are typically carried down to level 7 or 8. The cost estimate shows Total, M&S, EDIA, and Labor breakdowns, as well as contingency, for each WBS entry.« less

ElectroChemical Arsenic Removal (ECAR) for Rural Bangladesh--Merging Technology with Sustainable Implementation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Addy, Susan E.A.; Gadgil, Ashok J.; Kowolik, Kristin

2009-12-01

Today, 35-77 million Bangladeshis drink arsenic-contaminated groundwater from shallow tube wells. Arsenic remediation efforts have focused on the development and dissemination of household filters that frequently fall into disuse due to the amount of attention and maintenance that they require. A community scale clean water center has many advantages over household filters and allows for both chemical and electricity-based technologies to be beneficial to rural areas. Full cost recovery would enable the treatment center to be sustainable over time. ElectroChemical Arsenic Remediation (ECAR) is compatible with community scale water treatment for rural Bangladesh. We demonstrate the ability of ECAR tomore » reduce arsenic levels> 500 ppb to less than 10 ppb in synthetic and real Bangladesh groundwater samples and examine the influence of several operating parameters on arsenic removal effectiveness. Operating cost and waste estimates are provided. Policy implication recommendations that encourage sustainable community treatment centers are discussed.« less

Laser-Stimulated Fluorescence in Paleontology

PubMed Central

Kaye, Thomas G.; Falk, Amanda R.; Pittman, Michael; Sereno, Paul C.; Burnham, David A.; Gong, Enpu; Xu, Xing; Wang, Yinan

2015-01-01

Fluorescence using ultraviolet (UV) light has seen increased use as a tool in paleontology over the last decade. Laser-stimulated fluorescence (LSF) is a next generation technique that is emerging as a way to fluoresce paleontological specimens that remain dark under typical UV. A laser’s ability to concentrate very high flux rates both at the macroscopic and microscopic levels results in specimens fluorescing in ways a standard UV bulb cannot induce. Presented here are five paleontological case histories that illustrate the technique across a broad range of specimens and scales. Novel uses such as back-lighting opaque specimens to reveal detail and detection of specimens completely obscured by matrix are highlighted in these examples. The recent cost reductions in medium-power short wavelength lasers and use of standard photographic filters has now made this technique widely accessible to researchers. This technology has the potential to automate multiple aspects of paleontology, including preparation and sorting of microfossils. This represents a highly cost-effective way to address paleontology's preparatory bottleneck. PMID:26016843

Advanced Space Transportation Program (ASTP)

NASA Image and Video Library

2003-07-21

An ion thruster is removed from a vacuum chamber at NASA's Jet Propulsion Laboratory in Pasadena, California. The thruster, a spare engine from NASA's Deep Space 1 mission, with a designed life of 8,000 hours, ran for a record 30,352 hours (nearly 5 years) giving researchers the ability to observe its performance and wear at different power levels throughout the test. This information will be vital to future missions that use ion propulsion. Ion propulsion systems can be very lightweight, rurning on just a few grams of xenon gas a day. Xenon is the same gas that is found in photo flash bulbs. This fuel efficiency can lower launch vehicle costs. The successful Deep Space 1 mission featured the first use of an ion engine as the primary means of propulsion on a NASA spacecraft. NASA's next-generation ion propulsion efforts are implemented by the Marshall Space Flight Center. The program seeks to develop advanced propulsion technologies that will significantly reduce cost, mass, or travel times.

Data-driven planning of distributed energy resources amidst socio-technical complexities

NASA Astrophysics Data System (ADS)

Jain, Rishee K.; Qin, Junjie; Rajagopal, Ram

2017-08-01

New distributed energy resources (DER) are rapidly replacing centralized power generation due to their environmental, economic and resiliency benefits. Previous analyses of DER systems have been limited in their ability to account for socio-technical complexities, such as intermittent supply, heterogeneous demand and balance-of-system cost dynamics. Here we develop ReMatch, an interdisciplinary modelling framework, spanning engineering, consumer behaviour and data science, and apply it to 10,000 consumers in California, USA. Our results show that deploying DER would yield nearly a 50% reduction in the levelized cost of electricity (LCOE) over the status quo even after accounting for socio-technical complexities. We abstract a detailed matching of consumers to DER infrastructure from our results and discuss how this matching can facilitate the development of smart and targeted renewable energy policies, programmes and incentives. Our findings point to the large-scale economic and technical feasibility of DER and underscore the pertinent role DER can play in achieving sustainable energy goals.

DO-increasing effects of a microscopic bubble generating system in a fish farm.

PubMed

Endo, Akira; Srithongouthai, Sarawut; Nashiki, Hisatsune; Teshiba, Ichiro; Iwasaki, Takaaki; Hama, Daigo; Tsutsumi, Hiroaki

2008-01-01

We have developed a "microscopic bubble generating system for the fish farm" and evaluated its ability to improve the quality of seawater and costs of it in marine cages of red sea bream (Pagrus major) in Kusuura Bay, Japan. Our results revealed that DO concentration of bubbling net pens increased and became significantly higher than the level outside the net pen (between 0.52 and 0.87 mg/L), and the whole water column was nearly saturated. Temperatures of the bubbling net pens decreased slightly between 0.08 and 0.12 degrees C in all the layers. Furthermore, micro-bubbles seemed to reach the deeper water due to the downward flow and diffusion. This study demonstrated that the microscopic bubble generating system developed in our research project could increase efficiently the dissolved oxygen concentration throughout all water layers of the fish farm. A capital and operation costs of the system is recoverable within a year.

Schweizer RU-38A Twin-Condor: covert surveillance aircraft

NASA Astrophysics Data System (ADS)

O'Toole, Michael J.; Schweizer, Paul H.

1997-11-01

The world order has changed and with it, governments are now faced with waging a new type of `ware.' Regional instability, drug trafficking, environmental issues, international terrorism, and illegal immigration are examples of escalating problems that cross international boundaries and threaten the security of nations. The first and most important element in coping with these illegal activities is the ability to detect and monitor events in a timely and secure fashion. Conventional means of gathering intelligence such as large airborne collection systems and satellites lack the flexibility, dwell times, and cost effectiveness to meet many of today's needs. There is a growing requirement for airborne platforms that can covertly perform surveillance missions during either day or night and in a cost effective manner. To meet this need, Schweizer Aircraft has recently developed the RU-38A twin-engine surveillance aircraft. This paper discusses the evolution and principle design concepts of this aircraft and how its unique performance enables the RU-38A to achieve new levels of surveillance capability.

An auto-adaptive optimization approach for targeting nonpoint source pollution control practices.

PubMed

Chen, Lei; Wei, Guoyuan; Shen, Zhenyao

2015-10-21

To solve computationally intensive and technically complex control of nonpoint source pollution, the traditional genetic algorithm was modified into an auto-adaptive pattern, and a new framework was proposed by integrating this new algorithm with a watershed model and an economic module. Although conceptually simple and comprehensive, the proposed algorithm would search automatically for those Pareto-optimality solutions without a complex calibration of optimization parameters. The model was applied in a case study in a typical watershed of the Three Gorges Reservoir area, China. The results indicated that the evolutionary process of optimization was improved due to the incorporation of auto-adaptive parameters. In addition, the proposed algorithm outperformed the state-of-the-art existing algorithms in terms of convergence ability and computational efficiency. At the same cost level, solutions with greater pollutant reductions could be identified. From a scientific viewpoint, the proposed algorithm could be extended to other watersheds to provide cost-effective configurations of BMPs.

Selective inhibition of a multicomponent response can be achieved without cost

PubMed Central

Westrick, Zachary; Ivry, Richard B.

2014-01-01

Behavioral flexibility frequently requires the ability to modify an on-going action. In some situations, optimal performance requires modifying some components of an on-going action without interrupting other components of that action. This form of control has been studied with the selective stop-signal task, in which participants are instructed to abort only one movement of a multicomponent response. Previous studies have shown a transient disruption of the nonaborted component, suggesting limitations in our ability to use selective inhibition. This cost has been attributed to a structural limitation associated with the recruitment of a cortico-basal ganglia pathway that allows for the rapid inhibition of action but operates in a relatively generic manner. Using a model-based approach, we demonstrate that, with a modest amount of training and highly compatible stimulus-response mappings, people can perform a selective-stop task without any cost on the nonaborted component. Prior reports of behavioral costs in selective-stop tasks reflect, at least in part, a sampling bias in the method commonly used to estimate such costs. These results suggest that inhibition can be selectively controlled and present a challenge for models of inhibitory control that posit the operation of generic processes. PMID:25339712

Nitrogen-doped carbon quantum dots from biomass via simple one-pot method and exploration of their application

NASA Astrophysics Data System (ADS)

Yang, Qiming; Duan, Jialong; Yang, Wen; Li, Xueming; Mo, Jinghui; Yang, Peizhi; Tang, Qunwei

2018-03-01

Pursuit of low-cost and large-scale method to prepare carbon quantum dots (CQDs) is a persistent objective in recent years. In this work, we have successfully synthesized a series of nitrogen-doped carbon quantum dots (N-CQDs) under different hydrothermal temperature employing Eichhornia crassipes (ECs) as precursors. Considering the pollution ability to water and low-cost, this study may direct the novel path to convert waste material to useful quantum dots. After measurements such as TEM, XRD, Raman, XPS, PL as well as the UV-vis absorbance ability, outstanding optical properties have been discovered. In this fashion, solar cells are tentative to be fabricated, yielding the maximized solar-to-electrical conversion efficiency of 0.17% with a good fill factor of 67%. Meanwhile, the above-mentioned quantum dots also show the up-conversion ability, suggesting the potential application in infrared detection or broadening light-absorbing devices.

Fostering change within organizational participants of multisectoral health care alliances.

PubMed

Hearld, Larry R; Alexander, Jeffrey A; Mittler, Jessica N

2012-01-01

A touted advantage of multisectoral health care alliances is their ability to coordinate diverse constituencies and pursue community health goals in ways that allow them to make greater progress than each constituency could independently. However, participating organizations may have goals that do not entirely overlap or necessarily align with the alliance's goals, which can weaken or undermine an alliance's efforts. Fostering changes within participating organizations in ways that are consistent with the alliance's goals (i.e., alliance-oriented change) may be one mechanism by which alliances can coordinate diverse activities and improve care in their local communities. We examined whether alliance-oriented change within participating organizations is associated with alliance decision-making and conflict management style, level of participation, perceptions of alliance participation benefits and costs, and awareness of alliance activities within participating organizations. The study used two rounds of survey data collected from organizational participants of 14 alliances participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality program. Alliance participants generally reported low levels of alliance-oriented change within their organizations as a result of the alliance and its activities. However, participants reporting higher levels of internal change in response to alliance activities had more positive perceptions of alliance decision-making style, higher levels of participation in alliance activities, more positive perceptions of alliance participation benefits relative to costs, and greater awareness of alliance activities across multiple levels of their respective organizations. Despite relatively low levels of alliance-oriented change within participating organizations, alliances may still have the means to align the goal orientations of a diverse membership and foster change that may extend the reach of the alliance in the community.

Evaluation of total purchasing pilots in England and Scotland and implications for primary care groups in England: personal interviews and analysis of routine data

PubMed Central

Goodwin, Nicholas; Mays, Nicholas; McLeod, Hugh; Malbon, Gill; Raftery, James

1998-01-01

Objectives: To evaluate the reported achievements of the 52 first wave total purchasing pilot schemes in 1996-7 and the factors associated with these; and to consider the implications of these findings for the development of the proposed primary care groups. Design: Face to face interviews with lead general practitioners, project managers, and health authority representatives responsible for each pilot; and analysis of hospital episode statistics. Setting: England and Scotland for evaluation of pilots; England only for consideration of implications for primary care groups. Main outcome measures: The ability of total purchasers to achieve their own objectives and their ability specifically to achieve objectives in the service areas beyond fundholding included in total purchasing. Results: The level of achievement between pilots varied widely. Achievement was more likely to be reported in primary than in secondary care. Reported achievements in reducing length of stay and emergency admissions were corroborated by analysis of hospital episode statistics. Single practice and small multipractice pilots were more likely than large multipractice projects to report achieving their objectives. Achievements were also associated with higher direct management costs per head and the ability to undertake independent contracting. Large multipractice pilots required considerable organisational development before progress could be made. Conclusion: The ability to create effective commissioning organisations the size of the proposed primary care groups should not be underestimated. To be effective commissioners, these care groups will need to invest heavily in their organisational development and in the short term are likely to need an additional development budget rather than the reduction in spending on NHS management that is planned by the government. Key messages The level of reported achievement between the total purchasing pilots in 1996-7 varied widely; achievement was more likely to occur in primary than in secondary care Single practice and small multipractice pilots were more likely than large multipractice pilots to report achieving their objectives in 1996/97; achievements were also associated with higher direct management costs per head Large multipractice pilots needed more time for organisational development before progress could be made Difficulties in creating effective commissioning organisations the size of the proposed primary care groups should not be underestimated Primary care groups will need to invest heavily in organisational development and are likely to need an additional development budget in the short term PMID:9677217

Evaluation of Uniform Cost Accounting System to Fully Capture Depot Level Repair Costs.

DTIC Science & Technology

1985-12-01

RD-RI65 522 EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM TO FULLY i/I CAPTURE DEPOT LEVEL REPAIR COSTS (U) NAVAL POSTGRADUATE SCHOOL MONTEREY CA D R...8217.LECTE B ,- THESIS EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM 0TO FULLY CAPTURE DEPOT LEVEL REPAIR COSTS Jby __jDavid Richmond O’Brien lj,,, December...Include Security Classification) EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM TO FULLY CAPTURE DEPOT LEVEL REPAIR COSTS 12 PERSONAL AUTHOR(S) O’Brien- David

Calculation of genomic predicted transmitting abilities for bovine respiratory disease complex in Holsteins

USDA-ARS?s Scientific Manuscript database

Bovine Respiratory Disease Complex is a disease that is very costly to the dairy industry. Genomic selection may be an effective tool to improve host resistance to the pathogens that cause this disease. Use of genomic predicted transmitting abilities (GPTA) for selection has had a dramatic effect on...

Equilibrium Tuition, Applications, Admissions and Enrollment in the College Market

ERIC Educational Resources Information Center

Fu, Chao

2010-01-01

I develop and structurally estimate an equilibrium model of the college market. Students, who are heterogeneous in both abilities and preferences, make college application decisions, subject to uncertainty and application costs. Colleges observe only noisy measures of student ability and set up tuition and admissions policies to compete for more…

The Social Costs of Inadequate Literacy. A Report for International Literacy Year.

ERIC Educational Resources Information Center

Hartley, Robyn

The inadequate literacy skills of some individuals in Australia: (1) restrict their ability to exercise informed citizenship, participate in their local communities, and use their abilities and talents; (2) damage their development as autonomous, competent, and confident individuals within families; (3) may be repeated in successive generations,…

Ability Grouping of Gifted Students: Effects on Academic Self-Concept and Boredom

ERIC Educational Resources Information Center

Preckel, Franzis; Gotz, Thomas; Frenzel, Anne

2010-01-01

Background: Securing appropriate challenge or preventing boredom is one of the reasons frequently used to justify ability grouping of gifted students, which has been shown to have beneficial effects for achievement. On the other hand, critics stress psychosocial costs, such as detrimental effects on academic self-concept (contrast or…

Continuities in Reading Acquisition, Reading Skill, and Reading Disability.

ERIC Educational Resources Information Center

Perfetti, Charles A.

1986-01-01

Learning to read depends on eventual mastery of coding procedures, and even skilled reading depends on coding processes low in cost to processing resources. Reading disability may be understood as a point on an ability continuum or a wide range of coding ability. Instructional goals of word reading skill, including rapid and fluent word…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The Work Breakdown Structure (WBS) Book begins with this Overview section, which contains the high-level summary cost estimate, the cost profile, and the global construction schedule. The summary cost estimate shows the total US cost and the cost in terms of PHENIX construction funds for building the PHENIX detector. All costs in the WBS book are shown in FY 1993 dollars. Also shown are the institutional and foreign contributions, the level of pre-operations funding, and the cost of deferred items. Pie charts are presented at PHENIX WBS level 1 and 2 that show this information. The PHENIX construction funds aremore » shown broken down to PHENIX WBS level 3 items per fiscal year, and the resulting profile is compared to the RHIC target profile. An accumulated difference of the two profiles is also shown. The PHENIX global construction schedule is presented at the end of the Overview section. Following the Overview are sections for each subsystem. Each subsystem section begins with a summary cost estimate, cost profile, and critical path. The total level 3 cost is broken down into fixed costs (M&S), engineering costs (EDIA) and labor costs. Costs are further broken down in terms of PHENIX construction funds, institutional and foreign contributions, pre-operations funding, and deferred items. Also shown is the contingency at level 3 and the level 4 breakdown of the total cost. The cost profile in fiscal years is shown at level 3. The subsystem summaries are followed by the full cost estimate and schedule sheets for that subsystem. These detailed sheets are typically carried down to level 7 or 8. The cost estimate Total, M&S, EDIA, and Labor breakdowns, as well as contingency, for each WBS entry.« less

Cadmium accumulation in the rootless macrophyte Wolffia globosa and its potential for phytoremediation.

PubMed

Xie, Wan-Ying; Huang, Qing; Li, Gang; Rensing, Christopher; Zhu, Yong-Guan

2013-01-01

Cadmium (Cd) pollution around the world is a serious issue demanding acceptable solutions, one of which is phytoremediation that is both cost-effective and eco-friendly. Removal of Cd from contaminated water using plants with high growth rates and sufficient Cd accumulation abilities could be an appropriate choice. Here, we investigated a potential Cd accumulator, Wolffia, a rootless duckweed with high growth rate. Cd uptake, accumulation, tolerance, and phytofiltration ability by Wolffia globosa were examined. Furthermore, the effects of arsenic (As) on Cd uptake and phytofiltration by W. globosa were also studied. Cd uptake kinetics showed a linear pattern and a hyperbolic pattern without a plateau in lower (0-2 microM) and higher (0-200 microM) Cd concentration ranges, respectively, suggesting rapid Cd uptake by W. globosa Cd accumulation ability by W. globosa was higher at Cd concentrations < 10 microM than at >10 microM. All the five species of Wolffia exposed to I microM Cd for 5 days accumulated > 500 mg Cd kg(-1) DW. Ten gram fresh W. globosa could diminish almost all the Cd (2 microM) in a 200 mL solution. This enormous accumulation ability was mostly due to passive adsorption of Cd by the apoplast. Arsenic had no significant effect on Cd uptake and phytofiltration. The fresh fronds also showed a great As extracting ability. The results indicated that Wolffia is a strong Cd accumulator and has great Cd phytoremediation potential. Therefore, this plant can be used in fresh aquatic environments co-contaminated by low-levels of Cd and As.

Urban runoff (URO) process for MODFLOW 2005: simulation of sub-grid scale urban hydrologic processes in Broward County, FL

USGS Publications Warehouse

Decker, Jeremy D.; Hughes, J.D.

2013-01-01

Climate change and sea-level rise could cause substantial changes in urban runoff and flooding in low-lying coast landscapes. A major challenge for local government officials and decision makers is to translate the potential global effects of climate change into actionable and cost-effective adaptation and mitigation strategies at county and municipal scales. A MODFLOW process is used to represent sub-grid scale hydrology in urban settings to help address these issues. Coupled interception, surface water, depression, and unsaturated zone storage are represented. A two-dimensional diffusive wave approximation is used to represent overland flow. Three different options for representing infiltration and recharge are presented. Additional features include structure, barrier, and culvert flow between adjacent cells, specified stage boundaries, critical flow boundaries, source/sink surface-water terms, and the bi-directional runoff to MODFLOW Surface-Water Routing process. Some abilities of the Urban RunOff (URO) process are demonstrated with a synthetic problem using four land uses and varying cell coverages. Precipitation from a hypothetical storm was applied and cell by cell surface-water depth, groundwater level, infiltration rate, and groundwater recharge rate are shown. Results indicate the URO process has the ability to produce time-varying, water-content dependent infiltration and leakage, and successfully interacts with MODFLOW.

Using Lego robots to estimate cognitive ability in children who have severe physical disabilities.

PubMed

Cook, Albert M; Adams, Kim; Volden, Joanne; Harbottle, Norma; Harbottle, Cheryl

2011-01-01

To determine whether low-cost robots provide a means by which children with severe disabilities can demonstrate understanding of cognitive concepts. Ten children, ages 4 to 10, diagnosed with cerebral palsy and related motor conditions, participated. Participants had widely variable motor, cognitive and receptive language skills, but all were non-speaking. A Lego Invention 'roverbot' was used to carry out a range of functional tasks from single-switch replay of pre-stored movements to total control of the movement in two dimensions. The level of sophistication achieved on hierarchically arranged play tasks was used to estimate cognitive skills. The 10 children performed at one of the six hierarchically arranged levels from 'no interaction' through 'simple cause and effect' to 'development and execution of a plan'. Teacher interviews revealed that children were interested in the robot, enjoyed interacting with it and demonstrated changes in behaviour and social and language skills following interaction. Children with severe physical disabilities can control a Lego robot to perform un-structured play tasks. In some cases, they were able to display more sophisticated cognitive skills through manipulating the robot than in traditional standardised tests. Success with the robot could be a proxy measure for children who have cognitive abilities but cannot demonstrate them in standard testing.

1995 Emerging Leaders in Healthcare. The new leaders: Gita Budd, Colene Daniel, Elizabeth Gallup, Scott Wordelman.

PubMed

Southwick, K

1995-01-01

Fierce pressures for cost containment. Demands for quality improvements. The drive toward patient-centered care. The push for community involvement. Insistent voices of payers, patients, consumers, physicians. Accumulated tensions amid the chaos of change. Balancing all of these demands while inspiring and encouraging the professionals and other workers within the healthcare organization requires a high level of leadership ability. One that insists on the best from everyone involved in a healthcare system--from physicians to staff, nurses to social workers. And then strives for more. The four young executives who are this year's Emerging Leaders in Healthcare have all pushed their systems beyond traditional boundaries into new territory, helping their patients, their employees, their physicians, and their communities rise to new levels of achievement. At the same time, these leaders emphasize teamwork and consensus-style management, so that their co-workers feel like they're participating in the changes, not being victimized by them. Gita Budd, Colene Daniel, Elizabeth Gallup, and Scott Wordelman are winners of the 1995 award from The Healthcare Forum and Korn/Ferry International that honors ¿dynamic, decisive young leaders (under 40) with the proven ability to nurture the growth of the industry.¿ Korn/Ferry International and The Healthcare Forum are proud to present 1995's Emerging Leaders.

Price tag in nanomaterials?

NASA Astrophysics Data System (ADS)

Gkika, D. A.; Vordos, N.; Nolan, J. W.; Mitropoulos, A. C.; Vansant, E. F.; Cool, P.; Braet, J.

2017-05-01

With the evolution of the field of nanomaterials in the past number of years, it has become apparent that it will be key to future technological developments. However, while there are unlimited research undertakings on nanomaterials, limited research results on nanomaterial costs exist; all in spite of the generous funding that nanotechnology projects have received. There has recently been an exponential increase in the number of studies concerning health-related nanomaterials, considering the various medical applications of nanomaterials that drive medical innovation. This work aims to analyze the effect of the cost factor on acceptability of health-related nanomaterials independently or in relation to material toxicity. It appears that, from the materials studied, those used for cancer treatment applications are more expensive than the ones for drug delivery. The ability to evaluate cost implications improves the ability to undertake research mapping and develop opinions on nanomaterials that can drive innovation.

Gratitude and prosocial behavior: helping when it costs you.

PubMed

Bartlett, Monica Y; DeSteno, David

2006-04-01

The ability of the emotion gratitude to shape costly prosocial behavior was examined in three studies employing interpersonal emotion inductions and requests for assistance. Study 1 demonstrated that gratitude increases efforts to assist a benefactor even when such efforts are costly (i.e., hedonically negative), and that this increase differs from the effects of a general positive affective state. Additionally, mediational analyses revealed that gratitude, as opposed to simple awareness of reciprocity norms, drove helping behavior. Furthering the theory that gratitude mediates prosocial behavior, Study 2 replicated the findings of Study 1 and demonstrated gratitude's ability to function as an incidental emotion by showing it can increase assistance provided to strangers. Study 3 revealed that this incidental effect dissipates if one is made aware of the true cause of the emotional state. Implications of these findings for the role of gratitude in building relationships are discussed.

Cost of curative pediatric services in a public sector setting.

PubMed

Krishnan, Anand; Arora, Narendra K; Pandav, Chandrakant S; Kapoor, Suresh K

2005-08-01

To estimate the cost of ambulatory (out-patient) and in-patient pediatric health services for the year 1999 provided by All India Institute of Medical Sciences (AIIMS) at all the three levels-primary, secondary and tertiary level. The costing module developed by Children's Vaccines Initiative (CVI) was used. This rapid assessment tool focuses on collection of data at macro level by using key informants like doctors, nursing staff, accountant, store keeper, engineer etc. Cost per beneficiary was estimated separately for in-patients and out-patients and was calculated by dividing the total cost of the services by the number of beneficiaries for the year 1999. For the out-patient, the beneficiaries were the total out-patient attendees and for the in-patient, it was the total pediatric admissions multiplied by mean duration of stay in days. The cost per out-patient visit was INR.20.2 (US0.44 dollars@1US dollars=INR.46) at primary level, higher than INR14.5 (US0.31 dollars) at the secondary level, while at tertiary level it was INR 33.8 (US 0.73 dollars). At the primary and secondary level, non-physician cost was more than the physician cost, and for tertiary level, physician cost was much higher than the other costs. There were no in-patient services at primary level. The cost of in-patient services at secondary level was estimated as INR 419.30 (US 9.1 dollars) per patient per day with a bed occupancy rate of 60%. Two-fifths of the cost was due to nursing and other supportive staff and one fifth due to the doctor costs and overhead costs. The unit cost of INR 928 (US 20.2 dollars) per patient per day incurred at AIIMS with a bed occupancy rate of 100% was almost twice that of secondary level. In contrast to the secondary level, almost half the total costs at tertiary level was due to the doctors costs. Effective use of resources at lower level of care especially ambulatory care at primary level and inpatient care at secondary level can result in much higher savings for the system and also, the society. These would need to be appropriately strengthened.

Dissociating the ability and propensity for empathy

PubMed Central

Keysers, Christian; Gazzola, Valeria

2015-01-01

Neuroimaging suggests psychopaths have reduced vicarious activations when simply witnessing pain but less so when asked to empathize. This inspired us to distinguish an ability from a propensity to empathize. We argue that (a) this ability-propensity distinction is critical to characterize empathy in psychiatric disorders such as psychopathy and autism, (b) that costly helping might be best predicted by the propensity for empathy and (c) suggest how social neuroscientists can start exploring this distinction. PMID:24484764

A cost-effective junior resident training and assessment simulator for orthopaedic surgical skills via fundamentals of orthopaedic surgery: AAOS exhibit selection.

PubMed

Lopez, Gregory; Wright, Rick; Martin, David; Jung, James; Bracey, Daniel; Gupta, Ranjan

2015-04-15

Psychomotor testing has been recently incorporated into residency training programs not only to objectively assess a surgeon's abilities but also to address current patient-safety advocacy and medicolegal trends. The purpose of this study was to develop and test a cost-effective psychomotor training and assessment tool-The Fundamentals of Orthopaedic Surgery (FORS)-for junior-level orthopaedic surgery resident education. An orthopaedic skills board was made from supplies purchased at a local hardware store with a total cost of less than $350 so as to assess six different psychomotor skills. The six skills included fracture reduction, three-dimensional drill accuracy, simulated fluoroscopy-guided drill accuracy, depth-of-plunge minimization, drill-by-feel accuracy, and suture speed and quality. Medical students, residents, and attending physicians from three orthopaedic surgery residency programs accredited by the Accreditation Council for Graduate Medical Education participated in the study. Twenty-five medical students were retained for longitudinal training and testing for four weeks. Each training session involved an initial examination followed by thirty minutes of board training. The time to perform each task was measured with accuracy measurements for the appropriate tasks. Statistical analysis was done with one-way analysis of variance, with significance set at p < 0.05. Forty-seven medical students, twenty-nine attending physicians, and fifty-eight orthopaedic surgery residents participated in the study. Stratification among medical students, junior residents, and senior residents and/or attending physicians was found in all tasks. The twenty-five medical students who were retained for longitudinal training improved significantly above junior resident level in four of the six tasks. The FORS is an effective simulator of basic motor skills that translates across a wide variety of operations and has the potential to advance junior-level participants to senior resident skill level. The FORS simulator may serve as a valuable tool for resident education. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Differential competitive ability between sexes in the dioecious Antennaria dioica (Asteraceae)

PubMed Central

Varga, Sandra; Kytöviita, Minna-Maarit

2012-01-01

Background and Aims Differences in competitive ability between the sexes of dioecious plants are expected as a result of allocation trade-offs associated with sex-differential reproductive costs. However, the available data on competitive ability in dioecious plants are scarce and contradictory. In this study sexual competition was evaluated using the dioecious plant Antennaria dioica in a common garden transplantation experiment. Methods Male and female plants were grown for 3 years either in isolation, or in competition with a plant of the same sex or the opposite sex. Flowering phenology, sexual and asexual reproduction, plant growth, nutrient content and arbuscular mycorrhizal colonization in the roots were assessed. Key Results Our results showed little evidence of sexual differences in competitive ability. Both sexes suffered similarly from competition, and competitive effects were manifested in some traits related to fitness but not in others. Survival was unaffected by competition, but competing plants reduced their vegetative growth and reproductive investment compared with non-competing plants. In addition, differences in sexual competitive ability were observed in relation to flowering frequency, an important life history trait not reported in previous studies. Conclusions The findings indicate that female and male A. dioica plants possess similar intersexual competitive abilities which may be related to the similar costs of reproduction between sexes in this species. Nevertheless, intrasexual competition is higher in females, giving support for asymmetric niche segregation between the sexes. PMID:22887023

Allergy medical care network: a new model of care for specialties.

PubMed

Ferré-Ybarz, L; Salinas Argente, R; Nevot Falcó, S; Gómez Galán, C; Franquesa Rabat, J; Trapé Pujol, J; Oliveras Alsina, P; Pons Serra, M; Corbella Virós, X

2015-01-01

In 2005 the Althaia Foundation Allergy Department performed its daily activity in the Hospital Sant Joan de Deu of Manresa. Given the increasing demand for allergy care, the department's performance was analysed and a strategic plan (SP) for 2005-2010 was designed. The main objective of the study was to assess the impact of the application of the SP on the department's operations and organisational level in terms of profitability, productivity and quality of care. Descriptive, retrospective study which evaluated the operation of the allergy department. The baseline situation was analysed and the SP was designed. Indicators were set to perform a comparative analysis after application of the SP. The indicators showed an increase in medical care activity (first visits, 34%; successive visits, 29%; day hospital treatments, 51%), high rates of resolution, reduced waiting lists. Economic analysis indicated an increase in direct costs justified by increased activity and territory attended. Cost optimisation was explained by improved patient accessibility, minimised absenteeism in the workplace and improved cost per visit. After application of the SP a networking system was established for the allergy speciality that has expanded the territory for which it provides care, increased total activity and the ability to resolve patients, optimised human resources, improved quality of care and streamlined medical costs. Copyright © 2013 SEICAP. Published by Elsevier Espana. All rights reserved.

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

PubMed Central

Sun, Li; Westerdahl, Dane; Ning, Zhi

2017-01-01

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

Hitting the Optimal Vaccination Percentage and the Risks of Error: Why to Miss Right.

PubMed

Harvey, Michael J; Prosser, Lisa A; Messonnier, Mark L; Hutton, David W

2016-01-01

To determine the optimal level of vaccination coverage defined as the level that minimizes total costs and explore how economic results change with marginal changes to this level of coverage. A susceptible-infected-recovered-vaccinated model designed to represent theoretical infectious diseases was created to simulate disease spread. Parameter inputs were defined to include ranges that could represent a variety of possible vaccine-preventable conditions. Costs included vaccine costs and disease costs. Health benefits were quantified as monetized quality adjusted life years lost from disease. Primary outcomes were the number of infected people and the total costs of vaccination. Optimization methods were used to determine population vaccination coverage that achieved a minimum cost given disease and vaccine characteristics. Sensitivity analyses explored the effects of changes in reproductive rates, costs and vaccine efficacies on primary outcomes. Further analysis examined the additional cost incurred if the optimal coverage levels were not achieved. Results indicate that the relationship between vaccine and disease cost is the main driver of the optimal vaccination level. Under a wide range of assumptions, vaccination beyond the optimal level is less expensive compared to vaccination below the optimal level. This observation did not hold when the cost of the vaccine cost becomes approximately equal to the cost of disease. These results suggest that vaccination below the optimal level of coverage is more costly than vaccinating beyond the optimal level. This work helps provide information for assessing the impact of changes in vaccination coverage at a societal level.

Unlearned History: The Ineffectual Application of U.S. Broad Economic Sanctions Against Syria

DTIC Science & Technology

2015-10-30

fundamentally due to the high cost of compliance required of Syrian leaders, external third party support sustaining the Syrian government, and the Syrian...rate, especially as applied to autocratic regimes, are the cost of compliance, access to third party support, and the ability to redistribute the...of the sanctions policy. The political cost that the target state weighs must be high enough to extract the concessions demanded of the sending

Mitigating Provider Uncertainty in Service Provision Contracts

NASA Astrophysics Data System (ADS)

Smith, Chris; van Moorsel, Aad

Uncertainty is an inherent property of open, distributed and multiparty systems. The viability of the mutually beneficial relationships which motivate these systems relies on rational decision-making by each constituent party under uncertainty. Service provision in distributed systems is one such relationship. Uncertainty is experienced by the service provider in his ability to deliver a service with selected quality level guarantees due to inherent non-determinism, such as load fluctuations and hardware failures. Statistical estimators utilized to model this non-determinism introduce additional uncertainty through sampling error. Inability of the provider to accurately model and analyze uncertainty in the quality level guarantees can result in the formation of sub-optimal service provision contracts. Emblematic consequences include loss of revenue, inefficient resource utilization and erosion of reputation and consumer trust. We propose a utility model for contract-based service provision to provide a systematic approach to optimal service provision contract formation under uncertainty. Performance prediction methods to enable the derivation of statistical estimators for quality level are introduced, with analysis of their resultant accuracy and cost.

Human interaction as environmental enrichment for pair-housed wolves and wolf-dog crosses.

PubMed

Mehrkam, Lindsay R; Verdi, Nicolle T; Wynne, Clive D L

2014-01-01

Private nonhuman animal sanctuaries are often financially limited in their ability to implement traditional environmental enrichment strategies. One possible solution may be to provide socialized animals with human interaction sessions. However, the merit of human interaction as enrichment has received little empirical attention to date. The present study aimed to evaluate whether human interaction could be enriching for socialized, pair-housed wolves and wolf-dog crosses at a private sanctuary. Observations of each subject were conducted in a reversal design to measure species-typical affiliation, activity levels, and aberrant behaviors when caretakers were both present and absent. The results demonstrate significantly higher levels of conspecific-directed affiliation and activity levels and reduced aberrant behavior when human interaction was available. Social play also increased when caregivers were present, supporting the hypothesis that play among conspecifics may be maintained by positive changes in an animal's environment. The potential for human interaction to be established as a scientifically validated, cost-effective enrichment strategy is supported by these findings.

Factors affecting radiographers' organizational commitment.

PubMed

Akroyd, Duane; Jackowski, Melissa B; Legg, Jeffrey S

2007-01-01

A variety of factors influence employees' attitudes toward their workplace and commitment to the organization that employs them. However, these factors have not been well documented among radiologic technologists. To determine the predictive ability of selected organizational, leadership, work-role and demographic variables on organizational commitment for a national sample of radiographers. Three thousand radiographers registered by the American Registry of Radiologic Technologists working full time in clinical settings were surveyed by mail regarding their commitment to their employers, leadership within the organization that employs them, employer support and demographic information. Overall, radiographers were found to have only a moderate level of commitment to their employers. Among the factors that significantly affected commitment were the radiographer's educational level, perceived level of organizational support, role clarity and organizational leadership. The results of this study could provide managers and supervisors with insights on how to empower and challenge radiographers and offer opportunities that will enhance radiographers' commitment to the organization, thus reducing costly turnover and improving employee performance.

Third-party punishment increases cooperation in children through (misaligned) expectations and conditional cooperation.

PubMed

Lergetporer, Philipp; Angerer, Silvia; Glätzle-Rützler, Daniela; Sutter, Matthias

2014-05-13

The human ability to establish cooperation, even in large groups of genetically unrelated strangers, depends upon the enforcement of cooperation norms. Third-party punishment is one important factor to explain high levels of cooperation among humans, although it is still somewhat disputed whether other animal species also use this mechanism for promoting cooperation. We study the effectiveness of third-party punishment to increase children's cooperative behavior in a large-scale cooperation game. Based on an experiment with 1,120 children, aged 7 to 11 y, we find that the threat of third-party punishment more than doubles cooperation rates, despite the fact that children are rarely willing to execute costly punishment. We can show that the higher cooperation levels with third-party punishment are driven by two components. First, cooperation is a rational (expected payoff-maximizing) response to incorrect beliefs about the punishment behavior of third parties. Second, cooperation is a conditionally cooperative reaction to correct beliefs that third party punishment will increase a partner's level of cooperation.

Bringing together integration technologies in GaAs, InP and Si to deliver low-cost high performance DWDM optoelectronic components and solutions

NASA Astrophysics Data System (ADS)

Carter, Andrew C.; Wale, Michael J.; Simmons, T.; Whitbread, Neil; Asghari, M.

2003-06-01

A key attribute emerging in the optoelectronic component supply industry is the ability to deliver 'solution level' products rather than discrete optical components to equipment manufacturers. This approach is primarily aimed at reducing cost for the equipment manufacturer both in engineering and assembly. Such 'solutions' must be designed to be cost effective - offering costs substantially below discrete components - and must be compatible with subcontract board manufacture without the traditional and expensive skills of fibre handling, splicing and management. Examples of 'solutions' in this context may be the core of a multifunctional OADM or a DWDM laser transmitter subsystem, with modulation, wavelength and power management all included in a simple to use module. Essential to the cost effective production of such solutions is a high degree of optical/optoelectronic integration. Co-packaging of discrete components and electronics into modules will not deliver the cost reduction demanded. At Bookham Technology we have brought together what we believe to be the three key integration technologies - InP for monolithic tunable sources, GaAs for high performance integrated modulation and ASOC for smart passives and hybrid platforms - which can deliver this cost reduction, together with performance enhancement, over a wide range of applications. In the paper we will demonstrate and compare our above integration approaches with the competing alternatives and seek to show how the power of integration is finally being harnessed in optoelectronics, delivering radical cost reduction as well as enabling system concepts virtually impossible to achieve with discrete components. In the paper we will demonstrate and compare our above integration approaches with the competing alternatives and seek to show how the power of integration is finally being harnessed in optoelectronics, delivering radical cost reduction as well as enabling system concepts virtually impossible to achieve with discrete components.

Technical Evaluation Report on the Flight Mechanics Panel Symposium on Flight Vehicle Development Time and Cost Reduction

DTIC Science & Technology

1988-08-01

air schtclc development time and cost v ill. unless checked, seriousl. impair our ability to afford the ne , \\-capon vs steiti , hit s lllie needed in...11(algc iio p. s S. Reasons for Increasing Dc)ecl ipmitCost it R. tat’ Wtkig Aircraft and Ideas iiiRes rseth ifcreid.. V \\on ii Icii ,\\iessersebimitit...1ninic V Zabka. Messersehnmitt-Hiilkt,ihin (imbilI. Cierniat It0, (Flow it) Face Growing IDevelt pment Costs.) C. Fleniteque. SNYUSA. F-rane It. D

Using higher-level inquiry to improve spatial ability in an introductory geology course

NASA Astrophysics Data System (ADS)

Stevens, Lacey A.

Visuo-spatial skills, the ability to visually take in information and create a mental image are crucial for success in fields involving science, technology, engineering, and math (STEM) as well as fine arts. Unfortunately, due to a lack of curriculum focused on developing spatial skills, students enrolled in introductory college-level science courses tend to have difficulty with spatially-related activities. One of the best ways to engage students in science activities is through a learning and teaching strategy called inquiry. There are lower levels of inquiry wherein learning and problem-solving are guided by instructions and higher levels of inquiry wherein students have a greater degree of autonomy in learning and creating their own problem-solving strategy. A study involving 112 participants was conducted during the fall semester in 2014 at Bowling Green State University (BGSU) in an 1040 Introductory Geology Lab to determine if a new, high-level, inquiry-based lab would increase participants' spatial skills more than the traditional, low-level inquiry lab. The study also evaluated whether a higher level of inquiry differentially affected low versus high spatial ability participants. Participants were evaluated using a spatial ability assessment, and pre- and post-tests. The results of this study show that for 3-D to 2-D visualization, the higher-level inquiry lab increased participants' spatial ability more than the lower-level inquiry lab. For spatial rotational skills, all participants' spatial ability scores improved, regardless of the level of inquiry to which they were exposed. Low and high spatial ability participants were not differentially affected. This study demonstrates that a lab designed with a higher level of inquiry can increase students' spatial ability more than a lab with a low level of inquiry. A lab with a higher level of inquiry helped all participants, regardless of their initial spatial ability level. These findings show that curriculum that incorporates a high level of inquiry that integrates practice of spatial skills can increase students' spatial abilities in Geology-related coursework.

Reciprocal Relationships between Teacher Ratings of Internalizing and Externalizing Behaviors in Adolescents with Different Levels of Cognitive Abilities.

PubMed

Morin, Alexandre J S; Arens, A Katrin; Maïano, Christophe; Ciarrochi, Joseph; Tracey, Danielle; Parker, Philip D; Craven, Rhonda G

2017-04-01

Are internalizing and externalizing behavior problems interrelated via mutually reinforcing relationships (with each behavior leading to increases over time in levels of the other behavior) or mutually suppressing relationships (with each behavior leading to decreases over time in levels of the other behavior)? Past research on the directionality of these relationships has led to ambiguous results, particularly in adolescence. Furthermore, the extent to which prior results will generalize to adolescents with low levels of cognitive abilities remains unknown. This second limit is particularly important, given that these adolescents are known to present higher levels of externalizing and internalizing behaviors than their peers with average-to-high levels of cognitive abilities, and that the mechanisms involved in the reciprocal relationships between these two types of behaviors may differ across both populations. This study examines the directionality of the longitudinal relationships between externalizing and internalizing behavior problems as rated by teachers across three measurement waves (corresponding to Grades 8-10) in matched samples of 138 adolescents (34.78 % girls) with low levels of cognitive abilities and 556 adolescents (44.88 % girls) with average-to-high levels of cognitive abilities. The results showed that the measurement structure was fully equivalent across time periods and groups of adolescents, revealing high levels of developmental stability in both types of problems, and moderately high levels of cross-sectional associations. Levels of both internalizing and externalizing behaviors were higher among adolescents with low levels of cognitive abilities relative to those with average-to-high levels of cognitive abilities. Finally, the predictive analyses revealed negative reciprocal longitudinal relationships (i.e., mutually suppressing relationships) between externalizing and internalizing problems, a result that was replicated within samples of adolescents with low, and average-to-high levels of cognitive ability.

Evaluating data worth for ground-water management under uncertainty

USGS Publications Warehouse

Wagner, B.J.

1999-01-01

A decision framework is presented for assessing the value of ground-water sampling within the context of ground-water management under uncertainty. The framework couples two optimization models-a chance-constrained ground-water management model and an integer-programing sampling network design model-to identify optimal pumping and sampling strategies. The methodology consists of four steps: (1) The optimal ground-water management strategy for the present level of model uncertainty is determined using the chance-constrained management model; (2) for a specified data collection budget, the monitoring network design model identifies, prior to data collection, the sampling strategy that will minimize model uncertainty; (3) the optimal ground-water management strategy is recalculated on the basis of the projected model uncertainty after sampling; and (4) the worth of the monitoring strategy is assessed by comparing the value of the sample information-i.e., the projected reduction in management costs-with the cost of data collection. Steps 2-4 are repeated for a series of data collection budgets, producing a suite of management/monitoring alternatives, from which the best alternative can be selected. A hypothetical example demonstrates the methodology's ability to identify the ground-water sampling strategy with greatest net economic benefit for ground-water management.A decision framework is presented for assessing the value of ground-water sampling within the context of ground-water management under uncertainty. The framework couples two optimization models - a chance-constrained ground-water management model and an integer-programming sampling network design model - to identify optimal pumping and sampling strategies. The methodology consists of four steps: (1) The optimal ground-water management strategy for the present level of model uncertainty is determined using the chance-constrained management model; (2) for a specified data collection budget, the monitoring network design model identifies, prior to data collection, the sampling strategy that will minimize model uncertainty; (3) the optimal ground-water management strategy is recalculated on the basis of the projected model uncertainty after sampling; and (4) the worth of the monitoring strategy is assessed by comparing the value of the sample information - i.e., the projected reduction in management costs - with the cost of data collection. Steps 2-4 are repeated for a series of data collection budgets, producing a suite of management/monitoring alternatives, from which the best alternative can be selected. A hypothetical example demonstrates the methodology's ability to identify the ground-water sampling strategy with greatest net economic benefit for ground-water management.

Franchise competition in the electric utility industry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vince, C.A.; Fogel, J.C.

Franchise competition is - and should be - an integral part of enhanced competition. It serves the traditional goal of encouraging lower costs through the threat of takeover or purchase. However, the issue of utility recovery for stranded costs stands as a major unresolved question affecting customers` ability to partake of this central aspect of competition.

The Impact of Changing Technology: The Case of E-Learning

ERIC Educational Resources Information Center

Yusuf, Nadia; Al-Banawi, Nisreen

2013-01-01

For centuries, education has relied on classroom methods, but technology-enhanced learning can potentially bring about a revolution in learning, making high-quality, cost-effective education available to a greater number of people. The basic advantages of e-learning include anytime-anywhere access to learning, cost reductions, ability to reach…

Business Cycles and Postsecondary School Enrollment

ERIC Educational Resources Information Center

Samitamana, Ravi

2009-01-01

Human capital theory suggests that the opportunity cost is lower during an economic recession which in turn encourages a person to enroll in a postsecondary educational institution. At the same time, the ability to pay the direct costs of education is reduced. The two effects work in an opposite direction. Using unemployment rates as a business…

MicroSensors Systems: detection of a dismounted threat

NASA Astrophysics Data System (ADS)

Davis, Bill; Berglund, Victor; Falkofske, Dwight; Krantz, Brian

2005-05-01

The Micro Sensor System (MSS) is a layered sensor network with the goal of detecting dismounted threats approaching high value assets. A low power unattended ground sensor network is dependant on a network protocol for efficiency in order to minimize data transmissions after network establishment. The reduction of network 'chattiness' is a primary driver for minimizing power consumption and is a factor in establishing a low probability of detection and interception. The MSS has developed a unique protocol to meet these challenges. Unattended ground sensor systems are most likely dependant on batteries for power which due to size determines the ability of the sensor to be concealed after placement. To minimize power requirements, overcome size limitations, and maintain a low system cost the MSS utilizes advanced manufacturing processes know as Fluidic Self-Assembly and Chip Scale Packaging. The type of sensing element and the ability to sense various phenomenologies (particularly magnetic) at ranges greater than a few meters limits the effectiveness of a system. The MicroSensor System will overcome these limitations by deploying large numbers of low cost sensors, which is made possible by the advanced manufacturing process used in production of the sensors. The MSS program will provide unprecedented levels of real-time battlefield information which greatly enhances combat situational awareness when integrated with the existing Command, Control, Communications, Computers, Intelligence, Surveillance and Reconnaissance (C4ISR) infrastructure. This system will provide an important boost to realizing the information dominant, network-centric objective of Joint Vision 2020.

Distributed Bees Algorithm Parameters Optimization for a Cost Efficient Target Allocation in Swarms of Robots

PubMed Central

Jevtić, Aleksandar; Gutiérrez, Álvaro

2011-01-01

Swarms of robots can use their sensing abilities to explore unknown environments and deploy on sites of interest. In this task, a large number of robots is more effective than a single unit because of their ability to quickly cover the area. However, the coordination of large teams of robots is not an easy problem, especially when the resources for the deployment are limited. In this paper, the Distributed Bees Algorithm (DBA), previously proposed by the authors, is optimized and applied to distributed target allocation in swarms of robots. Improved target allocation in terms of deployment cost efficiency is achieved through optimization of the DBA’s control parameters by means of a Genetic Algorithm. Experimental results show that with the optimized set of parameters, the deployment cost measured as the average distance traveled by the robots is reduced. The cost-efficient deployment is in some cases achieved at the expense of increased robots’ distribution error. Nevertheless, the proposed approach allows the swarm to adapt to the operating conditions when available resources are scarce. PMID:22346677

MESSOC capabilities and results. [Model for Estimating Space Station Opertions Costs

NASA Technical Reports Server (NTRS)

Shishko, Robert

1990-01-01

MESSOC (Model for Estimating Space Station Operations Costs) is the result of a multi-year effort by NASA to understand and model the mature operations cost of Space Station Freedom. This paper focuses on MESSOC's ability to contribute to life-cycle cost analyses through its logistics equations and databases. Together, these afford MESSOC the capability to project not only annual logistics costs for a variety of Space Station scenarios, but critical non-cost logistics results such as annual Station maintenance crewhours, upweight/downweight, and on-orbit sparing availability as well. MESSOC results using current logistics databases and baseline scenario have already shown important implications for on-orbit maintenance approaches, space transportation systems, and international operations cost sharing.

Nurse leader resilience: career defining moments.

PubMed

Cline, Susan

2015-01-01

Resilience is an essential component of effective nursing leadership. It is defined as the ability to survive and thrive in the face of adversity. Resilience can be developed and internalized as a measure to improve retention and reduce burnout. Nurse leaders at all levels should develop these competencies to survive and thrive in an increasingly complex health care environment. Building positive relationships, maintaining positivity, developing emotional insight, creating work-life balance, and reflecting on successes and challenges are effective strategies for resilience building. Nurse leaders have a professional obligation to develop resilience in themselves, the teams they supervise, and the organization as a whole. Additional benefits include reduced turnover, reduced cost, and improved quality outcomes through organizational mindfulness.

Alternative management and funding options for aeronautics programs, Task 1

NASA Technical Reports Server (NTRS)

1975-01-01

Research and technology will be at lower program levels with basic military research for aviation decreasing as fewer aircraft programs are initiated and the present new aircraft programs move into the prototype and production status. The key question is can industry take on the management and financing role and meet the criteria and characteristics considered essential for a viable research and technology program. The criteria for evaluating alternative approaches include an examination of the nature of the product to be provided, responsiveness to changing needs, efficiency in terms of costs, ability to provide leadership, and to provide impartial and independent evaluation of approaches, and to provide technological inputs for regulating functions.

Fabrication technology

NASA Astrophysics Data System (ADS)

1988-05-01

Many laboratory programs continue to need optical components of ever-increasing size and accuracy. Unfortunately, optical surfaces produced by the conventional sequence of grinding, lapping, and polishing can become prohibitively expensive. Research in the Fabrication Technology area focuses on methods of fabricating components with heretofore unrealized levels of precision. In FY87, researchers worked to determine the fundamental mechanical limits of material removal, experimented with unique material removal and deposition processes, developed servo systems for controlling the geometric position of ultraprecise machine tools, and advanced the ability to precisely measure contoured workpieces. Continued work in these areas will lead to more cost-effective processes to fabricate even higher quality optical components for advanced lasers and for visible, ultraviolet, and X-ray diagnostic systems.

A new valve-regulated lead/acid automotive battery for use in original equipment and supply to the replacement market

NASA Astrophysics Data System (ADS)

Fouache, S.; Douady, J. P.; Fossati, G.; Pascon, C.

Valve-regulated lead/acid (VRLA) batteries have been available since the beginning of the 1970s for stationary applications. Nevertheless, the development and the commercialization of VRLA starter batteries have been very slow and mainlyrestricted to certain niche markets. This is due to the difficulty in designing products that comply with the technical specificationsrequired by the operating conditions of modern cars, and that have both a high level of reliability and a cost in accordance with the needs ofthe automotive market. The STR (sealed technology with gas recombination) battery has been developed in order to place on the automotiveoriginal equipment and replacement markets a battery with the benefits of the VRLA technology, namely: absolutely no maintenance; cleanand safe; good open-circuit storage; good cycling ability; performance comparable with that of flooded batteries (i.e., cranking powerand reserve capacity, charge acceptance, rechargeability, and life). Due to the technical choices made for the components and forthe manufacturing process, the STR battery is today manufactured on a production line very similar to that for a flooded battery, with agood level of productivity and the same reliability as the best flooded batteries. For all these reasons, the STR battery is producedat a cost that is acceptable for automotive applications.

Laparoscopic Common Bile Duct Exploration Four-Task Training Model: Construct Validity

PubMed Central

Otaño, Natalia; Rodríguez, Omaira; Sánchez, Renata; Benítez, Gustavo; Schweitzer, Michael

2012-01-01

Background: Training models in laparoscopic surgery allow the surgical team to practice procedures in a safe environment. We have proposed the use of a 4-task, low-cost inert model to practice critical steps of laparoscopic common bile duct exploration. Methods: The performance of 3 groups with different levels of expertise in laparoscopic surgery, novices (A), intermediates (B), and experts (C), was evaluated using a low-cost inert model in the following tasks: (1) intraoperative cholangiography catheter insertion, (2) transcystic exploration, (3) T-tube placement, and (4) choledochoscope management. Kruskal-Wallis and Mann-Whitney tests were used to identify differences among the groups. Results: A total of 14 individuals were evaluated: 5 novices (A), 5 intermediates (B), and 4 experts (C). The results involving intraoperative cholangiography catheter insertion were similar among the 3 groups. As for the other tasks, the expert had better results than the other 2, in which no significant differences occurred. The proposed model is able to discriminate among individuals with different levels of expertise, indicating that the abilities that the model evaluates are relevant in the surgeon's performance in CBD exploration. Conclusions: Construct validity for tasks 2 and 3 was demonstrated. However, task 1 was no capable of distinguishing between groups, and task 4 was not statistically validated. PMID:22906323

Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome.

PubMed

Mizuno, Kei; Tanaka, Masaaki; Tanabe, Hiroki C; Joudoi, Takako; Kawatani, Junko; Shigihara, Yoshihito; Tomoda, Akemi; Miike, Teruhisa; Imai-Matsumura, Kyoko; Sadato, Norihiro; Watanabe, Yasuyoshi

2015-01-01

The ability to divide one's attention deteriorates in patients with childhood chronic fatigue syndrome (CCFS). We conducted a study using a dual verbal task to assess allocation of attentional resources to two simultaneous activities (picking out vowels and reading for story comprehension) and functional magnetic resonance imaging. Patients exhibited a much larger area of activation, recruiting additional frontal areas. The right middle frontal gyrus (MFG), which is included in the dorsolateral prefrontal cortex, of CCFS patients was specifically activated in both the single and dual tasks; this activation level was positively correlated with motivation scores for the tasks and accuracy of story comprehension. In addition, in patients, the dorsal anterior cingulate gyrus (dACC) and left MFG were activated only in the dual task, and activation levels of the dACC and left MFG were positively associated with the motivation and fatigue scores, respectively. Patients with CCFS exhibited a wider area of activated frontal regions related to attentional resources in order to increase their poorer task performance with massive mental effort. This is likely to be less efficient and costly in terms of energy requirements. It seems to be related to the pathophysiology of patients with CCFS and to cause a vicious cycle of further increases in fatigue.

Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome

PubMed Central

Mizuno, Kei; Tanaka, Masaaki; Tanabe, Hiroki C.; Joudoi, Takako; Kawatani, Junko; Shigihara, Yoshihito; Tomoda, Akemi; Miike, Teruhisa; Imai-Matsumura, Kyoko; Sadato, Norihiro; Watanabe, Yasuyoshi

2015-01-01

The ability to divide one's attention deteriorates in patients with childhood chronic fatigue syndrome (CCFS). We conducted a study using a dual verbal task to assess allocation of attentional resources to two simultaneous activities (picking out vowels and reading for story comprehension) and functional magnetic resonance imaging. Patients exhibited a much larger area of activation, recruiting additional frontal areas. The right middle frontal gyrus (MFG), which is included in the dorsolateral prefrontal cortex, of CCFS patients was specifically activated in both the single and dual tasks; this activation level was positively correlated with motivation scores for the tasks and accuracy of story comprehension. In addition, in patients, the dorsal anterior cingulate gyrus (dACC) and left MFG were activated only in the dual task, and activation levels of the dACC and left MFG were positively associated with the motivation and fatigue scores, respectively. Patients with CCFS exhibited a wider area of activated frontal regions related to attentional resources in order to increase their poorer task performance with massive mental effort. This is likely to be less efficient and costly in terms of energy requirements. It seems to be related to the pathophysiology of patients with CCFS and to cause a vicious cycle of further increases in fatigue. PMID:26594619

Lessons from applied ecology: cancer control using an evolutionary double bind.

PubMed

Gatenby, Robert A; Brown, Joel; Vincent, Thomas

2009-10-01

Because the metastatic cascade is largely governed by the ability of malignant cells to adapt and proliferate at the distant tissue site, we propose that disseminated cancers are analogous in many important ways to the evolutionary and ecological dynamics of exotic species. Although pests can be decimated through the application of chemical toxins, this strategy virtually never achieves robust control as evolution of resistant phenotypes typically permits population recovery to pretreatment levels. In general, biological strategies that introduce predators, parasitoids, or pathogens have achieved more durable control of pest populations even after emergence of resistant phenotypes. From this we propose that long term outcome from any treatment strategy for invasive pests, including cancer, is not limited by evolution of resistance, but rather by the phenotypic cost of that resistance. If a cancerous cell's adaptation to therapy is achieved by upregulating xenobiotic metabolism or a redundant signaling pathway, the required investment in resources is small, and the original malignant phenotype remains essentially intact. As a result, the cancer cells' initial high level of fitness is little changed and unconstrained proliferation will resume once resistance evolves. Robust population control is possible if resistance to therapy requires a substantial and costly phenotypic adaptation that also significantly reduces the organism's fitness in its original niche: an evolutionary double bind.

Unprecented syntonization and syncronization accuracy via simultaneous viewing with GPS receivers: Construction characteristics of an NBS/GPS receiver

NASA Technical Reports Server (NTRS)

Davis, D. D.; Weiss, M.; Clements, A.; Allan, D. W.

1982-01-01

The National Bureau of Standards/Global Positioning System (NBS/GPS) receiver is discussed. It is designed around the concept of obtaining high accuracy, low cost time and frequency comparisons between remote frequency standards and clocks with the intent to aid international time and frequency coordination. Preliminary tests of this comparison technique between Boulder, CO and Washington, D.C indicate the ability to do accurate time transfer to better that 10 ns, and frequency measurements to better than 1 part in 10 to the 14th power. The hardware and software of the receiver is detailed. The receiver is fully automatic with a built-in 0.1 ns resolution time interval counter. A microprocessor does data processing. Satellite signal stabilities are routinely at the 5 ns level for 15 s averages, and the internal receiver stabilities are at the 1 ns level.

Defining and using open architecture levels

NASA Astrophysics Data System (ADS)

Cramer, M. A.; Morrison, A. W.; Cordes, B.; Stack, J. R.

2012-05-01

Open architecture (OA) within military systems enables delivery of increased warfighter capabilities in a shorter time at a reduced cost.i In fact in today's standards-aware environment, solutions are often proposed to the government that include OA as one of its basics design tenets. Yet the ability to measure and assess OA in an objective manner, particularly at the subsystem/component level within a system, remains an elusive proposition. Furthermore, it is increasingly apparent that the establishment of an innovation ecosystem of an open business model that leverages thirdparty development requires more than just technical modifications that promote openness. This paper proposes a framework to migrate not only towards technical openness, but also towards enabling and facilitating an open business model, driven by third party development, for military systems. This framework was developed originally for the U.S. Navy Littoral and Mine Warfare community; however, the principles and approach may be applied elsewhere within the Navy and Department of Defense.

Action video games make dyslexic children read better.

PubMed

Franceschini, Sandro; Gori, Simone; Ruffino, Milena; Viola, Simona; Molteni, Massimo; Facoetti, Andrea

2013-03-18

Learning to read is extremely difficult for about 10% of children; they are affected by a neurodevelopmental disorder called dyslexia [1, 2]. The neurocognitive causes of dyslexia are still hotly debated [3-12]. Dyslexia remediation is far from being fully achieved [13], and the current treatments demand high levels of resources [1]. Here, we demonstrate that only 12 hr of playing action video games-not involving any direct phonological or orthographic training-drastically improve the reading abilities of children with dyslexia. We tested reading, phonological, and attentional skills in two matched groups of children with dyslexia before and after they played action or nonaction video games for nine sessions of 80 min per day. We found that only playing action video games improved children's reading speed, without any cost in accuracy, more so than 1 year of spontaneous reading development and more than or equal to highly demanding traditional reading treatments. Attentional skills also improved during action video game training. It has been demonstrated that action video games efficiently improve attention abilities [14, 15]; our results showed that this attention improvement can directly translate into better reading abilities, providing a new, fast, fun remediation of dyslexia that has theoretical relevance in unveiling the causal role of attention in reading acquisition. Copyright © 2013 Elsevier Ltd. All rights reserved.

Characterization of a Potential Probiotic Lactobacillus brevis RK03 and Efficient Production of γ-Aminobutyric Acid in Batch Fermentation.

PubMed

Wu, Chien-Hui; Hsueh, Yi-Huang; Kuo, Jen-Min; Liu, Si-Jia

2018-01-04

Lactic acid bacteria were isolated from fish and evaluated for their γ-aminobutyric acid (GABA)-producing abilities. Out of thirty-two isolates, Lactobacillus brevis RK03 showed the highest GABA production ability. The effects of various fermentation parameters including initial glutamic acid level, culture temperature, initial pH, and incubation time on GABA production were investigated via a singleparameter optimization strategy. For industrial large-scale production, a low-cost GABA producing medium (GM) broth was developed for fermentation with L. brevis RK03. We found that an optimized GM broth recipe of 1% glucose; 2.5% yeast extract; 2 ppm each of CaCO₃, MnSO₄, and Tween 80; and 10 μM pyridoxal phosphate (PLP) resulted in a maximum GABA yield of 62,523 mg/L after 88 h following the addition of 650 mM monosodium glutamate (MSG), for a conversion rate of 93.28%. Our data provide a practical approach for the highly efficient and economic production of GABA. In addition, L. brevis RK03 is highly resistant to gastric acid and bovine bile salt. Thus, the discovery of Lactobacillus strains with the ability to synthesize GABA may offer new opportunities in the design of improved health-promoting functional foods.

Characterization of a Potential Probiotic Lactobacillus brevis RK03 and Efficient Production of γ-Aminobutyric Acid in Batch Fermentation

PubMed Central

Hsueh, Yi-Huang; Kuo, Jen-Min; Liu, Si-Jia

2018-01-01

Lactic acid bacteria were isolated from fish and evaluated for their γ-aminobutyric acid (GABA)-producing abilities. Out of thirty-two isolates, Lactobacillus brevis RK03 showed the highest GABA production ability. The effects of various fermentation parameters including initial glutamic acid level, culture temperature, initial pH, and incubation time on GABA production were investigated via a singleparameter optimization strategy. For industrial large-scale production, a low-cost GABA producing medium (GM) broth was developed for fermentation with L. brevis RK03. We found that an optimized GM broth recipe of 1% glucose; 2.5% yeast extract; 2 ppm each of CaCO3, MnSO4, and Tween 80; and 10 μM pyridoxal phosphate (PLP) resulted in a maximum GABA yield of 62,523 mg/L after 88 h following the addition of 650 mM monosodium glutamate (MSG), for a conversion rate of 93.28%. Our data provide a practical approach for the highly efficient and economic production of GABA. In addition, L. brevis RK03 is highly resistant to gastric acid and bovine bile salt. Thus, the discovery of Lactobacillus strains with the ability to synthesize GABA may offer new opportunities in the design of improved health-promoting functional foods. PMID:29300336

Efficient species-level monitoring at the landscape scale.

PubMed

Noon, Barry R; Bailey, Larissa L; Sisk, Thomas D; McKelvey, Kevin S

2012-06-01

Monitoring the population trends of multiple animal species at a landscape scale is prohibitively expensive. However, advances in survey design, statistical methods, and the ability to estimate species presence on the basis of detection-nondetection data have greatly increased the feasibility of species-level monitoring. For example, recent advances in monitoring make use of detection-nondetection data that are relatively inexpensive to acquire, historical survey data, and new techniques in genetic evaluation. The ability to use indirect measures of presence for some species greatly increases monitoring efficiency and reduces survey costs. After adjusting for false absences, the proportion of sample units in a landscape where a species is detected (occupancy) is a logical state variable to monitor. Occupancy monitoring can be based on real-time observation of a species at a survey site or on evidence that the species was at the survey location sometime in the recent past. Temporal and spatial patterns in occupancy data are related to changes in animal abundance and provide insights into the probability of a species' persistence. However, even with the efficiencies gained when occupancy is the monitored state variable, the task of species-level monitoring remains daunting due to the large number of species. We propose that a small number of species be monitored on the basis of specific management objectives, their functional role in an ecosystem, their sensitivity to environmental changes likely to occur in the area, or their conservation importance. ©2012 Society for Conservation Biology.

Simple Levelized Cost of Energy (LCOE) Calculator Documentation | Energy

Science.gov Websites

Analysis | NREL Simple Levelized Cost of Energy (LCOE) Calculator Documentation Simple Levelized Cost of Energy (LCOE) Calculator Documentation Transparent Cost Database Button This is a simple : 1). Cost and Performance Adjust the sliders to suitable values for each of the cost and performance

Leisure activity associated with cognitive ability level, but not cognitive change

PubMed Central

Gow, Alan J.; Avlund, Kirsten; Mortensen, Erik L.

2014-01-01

Although activity participation is promoted as cognitively protective, critical questions of causality remain. In a cohort followed every 5 years from age 75 to 85 years, potential reciprocal associations between level and change in leisure activity participation and level and change in cognitive abilities were examined. Participants in the Glostrup 1914 Cohort, a longitudinal study of aging, completed standardized cognitive ability tests and reported their leisure activity participation (11 activities defined a leisure activity score) at ages 75, 80, and 85. Higher leisure activity was associated with higher cognitive ability (significant correlations ranged from 0.15 to 0.31, p < 0.05). Between ages 75 and 85, participation in leisure activities and cognitive ability declined significantly. Growth curve models, which provided latent variables for level of and 10-year change in both leisure activity and cognitive ability, confirmed the positive association between levels of leisure activity and cognitive ability (path coefficient = 0.36, p < 0.001); however, neither leisure activity level nor change in leisure activity were associated with cognitive change. Although a positive association between leisure activity and cognitive ability was reported—the likely precedents of this are discussed—there was no evidence that a higher level or maintenance of leisure activity was protective against cognitive decline across a 10-year follow-up. PMID:25352824

Image-Aided Navigation Using Cooperative Binocular Stereopsis

DTIC Science & Technology

2014-03-27

Global Postioning System . . . . . . . . . . . . . . . . . . . . . . . . . 1 IMU Inertial Measurement Unit...an intertial measurement unit ( IMU ). This technique capitalizes on an IMU’s ability to capture quick motion and the ability of GPS to constrain long...the sensor-aided IMU framework. Visual sensors provide a number of benefits, such as low cost and weight. These sensors are also able to measure

A Response to "Measuring Students' Writing Ability on a Computer Analytic Developmental Scale: An Exploratory Validity Study"

ERIC Educational Resources Information Center

Reutzel, D. Ray; Mohr, Kathleen A. J.

2014-01-01

In this response to "Measuring Students' Writing Ability on a Computer Analytic Developmental Scale: An Exploratory Validity Study," the authors agree that assessments should seek parsimony in both theory and application wherever possible. Doing so allows maximal dissemination and implementation while minimizing costs. The Writing…

An International Study of the Ability and Cost-Effectiveness of Advertising Methods to Facilitate Study Participant Self-Enrolment Into a Pilot Pharmacovigilance Study During Early Pregnancy

PubMed Central

2016-01-01

Background Knowledge of the fetal effects of maternal medication use in pregnancy is often inadequate and current pregnancy pharmacovigilance (PV) surveillance methods have important limitations. Patient self-reporting may be able to mitigate some of these limitations, providing an adequately sized study sample can be recruited. Objective To compare the ability and cost-effectiveness of several direct-to-participant advertising methods for the recruitment of pregnant participants into a study of self-reported gestational exposures and pregnancy outcomes. Methods The Pharmacoepidemiological Research on Outcomes of Therapeutics by a European Consortium (PROTECT) pregnancy study is a non-interventional, prospective pilot study of self-reported medication use and obstetric outcomes provided by a cohort of pregnant women that was conducted in Denmark, the Netherlands, Poland, and the United Kingdom. Direct-to-participant advertisements were provided via websites, emails, leaflets, television, and social media platforms. Results Over a 70-week recruitment period direct-to-participant advertisements engaged 43,234 individuals with the study website or telephone system; 4.78% (2065/43,234) of which were successfully enrolled and provided study data. Of these 90.4% (1867/2065) were recruited via paid advertising methods, 23.0% (475/2065) of whom were in the first trimester of pregnancy. The overall costs per active recruited participant were lowest for email (€23.24) and website (€24.41) advertisements and highest for leaflet (€83.14) and television (€100.89). Website adverts were substantially superior in their ability to recruit participants during their first trimester of pregnancy (317/668, 47.5%) in comparison with other advertising methods (P<.001). However, we identified international variations in both the cost-effectiveness of the various advertisement methods used and in their ability to recruit participants in early pregnancy. Conclusions Recruitment of a pregnant cohort using direct-to-participant advertisement methods is feasible, but the total costs incurred are not insubstantial. Future research is needed to identify advertising strategies capable of recruiting large numbers of demographically representative pregnant women, preferentially in early pregnancy. PMID:27227148

An International Study of the Ability and Cost-Effectiveness of Advertising Methods to Facilitate Study Participant Self-Enrolment Into a Pilot Pharmacovigilance Study During Early Pregnancy.

PubMed

Richardson, Jonathan Luke; Stephens, Sally; Thomas, Simon Hugh Lynton; Jamry-Dziurla, Anna; de Jong-van den Berg, Lolkje; Zetstra-van der Woude, Priscilla; Laursen, Maja; Hliva, Valerie; Mt-Isa, Shahrul; Bourke, Alison; Dreyer, Nancy A; Blackburn, Stella Cf

2016-01-01

Knowledge of the fetal effects of maternal medication use in pregnancy is often inadequate and current pregnancy pharmacovigilance (PV) surveillance methods have important limitations. Patient self-reporting may be able to mitigate some of these limitations, providing an adequately sized study sample can be recruited. To compare the ability and cost-effectiveness of several direct-to-participant advertising methods for the recruitment of pregnant participants into a study of self-reported gestational exposures and pregnancy outcomes. The Pharmacoepidemiological Research on Outcomes of Therapeutics by a European Consortium (PROTECT) pregnancy study is a non-interventional, prospective pilot study of self-reported medication use and obstetric outcomes provided by a cohort of pregnant women that was conducted in Denmark, the Netherlands, Poland, and the United Kingdom. Direct-to-participant advertisements were provided via websites, emails, leaflets, television, and social media platforms. Over a 70-week recruitment period direct-to-participant advertisements engaged 43,234 individuals with the study website or telephone system; 4.78% (2065/43,234) of which were successfully enrolled and provided study data. Of these 90.4% (1867/2065) were recruited via paid advertising methods, 23.0% (475/2065) of whom were in the first trimester of pregnancy. The overall costs per active recruited participant were lowest for email (€23.24) and website (€24.41) advertisements and highest for leaflet (€83.14) and television (€100.89). Website adverts were substantially superior in their ability to recruit participants during their first trimester of pregnancy (317/668, 47.5%) in comparison with other advertising methods (P<.001). However, we identified international variations in both the cost-effectiveness of the various advertisement methods used and in their ability to recruit participants in early pregnancy. Recruitment of a pregnant cohort using direct-to-participant advertisement methods is feasible, but the total costs incurred are not insubstantial. Future research is needed to identify advertising strategies capable of recruiting large numbers of demographically representative pregnant women, preferentially in early pregnancy.

Regional cost and experience, not size or hospital inclusion, helps predict ACO success.

PubMed

Schulz, John; DeCamp, Matthew; Berkowitz, Scott A

2017-06-01

The Medicare Shared Savings Program (MSSP) continues to expand and now includes 434 accountable care organizations (ACOs) serving more than 7 million beneficiaries. During 2014, 86 of these ACOs earned over $300 million in shared savings payments by promoting higher-quality patient care at a lower cost.Whether organizational characteristics, regional cost of care, or experience in the MSSP are associated with the ability to achieve shared savings remains uncertain.Using financial results from 2013 and 2014, we examined all 339 MSSP ACOs with a 2012, 2013, or 2014 start-date. We used a cross-sectional analysis to examine all ACOs and used a multivariate logistic model to predict probability of achieving shared savings.Experience, as measured by years in the MSSP program, was associated with success and the ability to earn shared savings varied regionally. This variation was strongly associated with differences in regional Medicare fee-for-service per capita costs: ACOs in high cost regions were more likely to earn savings. In the multivariate model, the number of ACO beneficiaries, inclusion of a hospital or involvement of an academic medical center, was not associated with likelihood of earning shared savings, after accounting for regional baseline cost variation.These results suggest ACOs are learning and improving from their experience. Additionally, the results highlight regional differences in ACO success and the strong association with variation in regional per capita costs, which can inform CMS policy to help promote ACO success nationwide.

Evaluation of ERDA-sponsored coal feed system development

NASA Technical Reports Server (NTRS)

Phen, R. L.; Luckow, W. K.; Mattson, L.; Otth, D.; Tsou, P.

1977-01-01

Coal feeders were evaluated based upon criteria such as technical feasibility, performance (i.e. ability to meet process requirements), projected life cycle costs, and projected development cost. An initial set of feeders was selected based on the feeders' cost savings potential compared with baseline lockhopper systems. Additional feeders were considered for selection based on: (1) increasing the probability of successful feeder development; (2) application to specific processes; and (3) technical merit. A coal feeder development program is outlined.

Cost Warrior Moneyball

DTIC Science & Technology

2012-10-01

program the money? That’s Army staff business in the franchise head shed, right? The truth is that we need to know its cost, afford- ability, and...address to an Armor War - fighting Conference, Gen. Peter Chiarelli said, “If you look at any one of these systems as an individual system, you can...tainment costs. The future ain’t what it used to be. Third, change takes time and patience. Over the past 10 years, big money has been flowing. It

The Necessity of Functional Analysis for Space Exploration Programs

NASA Technical Reports Server (NTRS)

Morris, A. Terry; Breidenthal, Julian C.

2011-01-01

As NASA moves toward expanded commercial spaceflight within its human exploration capability, there is increased emphasis on how to allocate responsibilities between government and commercial organizations to achieve coordinated program objectives. The practice of program-level functional analysis offers an opportunity for improved understanding of collaborative functions among heterogeneous partners. Functional analysis is contrasted with the physical analysis more commonly done at the program level, and is shown to provide theoretical performance, risk, and safety advantages beneficial to a government-commercial partnership. Performance advantages include faster convergence to acceptable system solutions; discovery of superior solutions with higher commonality, greater simplicity and greater parallelism by substituting functional for physical redundancy to achieve robustness and safety goals; and greater organizational cohesion around program objectives. Risk advantages include avoidance of rework by revelation of some kinds of architectural and contractual mismatches before systems are specified, designed, constructed, or integrated; avoidance of cost and schedule growth by more complete and precise specifications of cost and schedule estimates; and higher likelihood of successful integration on the first try. Safety advantages include effective delineation of must-work and must-not-work functions for integrated hazard analysis, the ability to formally demonstrate completeness of safety analyses, and provably correct logic for certification of flight readiness. The key mechanism for realizing these benefits is the development of an inter-functional architecture at the program level, which reveals relationships between top-level system requirements that would otherwise be invisible using only a physical architecture. This paper describes the advantages and pitfalls of functional analysis as a means of coordinating the actions of large heterogeneous organizations for space exploration programs.

Level I and Level II Abilities: Some Theoretical Reinterpretations

ERIC Educational Resources Information Center

Jarman, Ronald F.

1978-01-01

Some of the major assumptions and premises of Arthur Jensen's theory of Level I and Level II cognitive abilities are examined using a model of cognitive abilities recently proposed by Das, Kirby & Jarman (1975) and known as simultaneous and successive syntheses. Four areas are discussed: quantity versus type of information processing, internal…

Assessment of Costs for a Global Climate Fund Against Public Sector Disaster Risks

NASA Astrophysics Data System (ADS)

Hochrainer-Stigler, Stefan; Mechler, Reinhard; Pflug, Georg; Williges, Keith

2013-04-01

National governments are key actors in managing climate variability and change, yet, many countries, faced with exhausted tax bases, high levels of indebtedness and limited donor assistance, have been unable to raise sufficient and timely capital to replace or repair damaged assets and restore livelihoods following major disasters exacerbating the impacts of disaster shocks on poverty and development. For weather extremes, which form a subset of the adaptation challenge and are supposed to increase in intensity and frequency with a changing climate, we conduct an assessment of the costs of managing and financing today's public sector risks on a global scale for more than 180 countries. A countries financial vulnerability is defined as a function of its financial resilience and its exposure to disaster risk. While disaster risk is estimated in terms of asset loss distributions based on catastrophe modeling approaches, financial resilience is operationalized as the public sector's ability to pay for relief to the affected population and support the reconstruction of affected assets and infrastructure for a given event. We consider governments financially vulnerable to disasters if they cannot access sufficient funding after a disaster to cover their liabilities. We operationalize this concept by the term resource gap, which we define the net loss associated with a disaster event after exhausting all possible ex-post and ex ante financing sources. Extending this approach for all possible disaster events, the risk that a resource gap will occur over a given time-span can be calculated for each country individually and dependent on the risk level different risk instruments may have to be applied. Furthermore, our estimates may inform decisions pertaining to a "climate insurance fund" absorbing "high level" country risks exceeding the ability of any given country to pay in the case of an extreme event. Our estimates relate to today's climate, yet we suggest that estimates of current climate variability and related risks, although also associated with substantial uncertainty, can be interpreted as a baseline for very uncertain future projections.

Does the Macaque Monkey Provide a Good Model for Studying Human Executive Control? A Comparative Behavioral Study of Task Switching

PubMed Central

Caselli, Luana; Chelazzi, Leonardo

2011-01-01

The ability to swiftly and smoothly switch from one task set to another is central to intelligent behavior, because it allows an organism to flexibly adapt to ever changing environmental conditions and internal needs. For this reason, researchers interested in executive control processes have often relied on task-switching paradigms as powerful tools to uncover the underlying cognitive and brain architecture. In order to gather fundamental information at the single-cell level, it would be greatly helpful to demonstrate that non-human primates, especially the macaque monkey, share with us similar behavioral manifestations of task-switching and therefore, in all likelihood, similar underlying brain mechanisms. Unfortunately, prior attempts have provided negative results (e.g., Stoet & Snyder, 2003b), in that it was reported that macaques do not show the typical signature of task-switching operations at the behavioral level, represented by switch costs. If confirmed, this would indicate that the macaque cannot be used as a model approach to explore human executive control mechanisms by means of task-switching paradigms. We have therefore decided to re-explore this issue, by conducting a comparative experiment on a group of human participants and two macaque monkeys, whereby we measured and compared performance costs linked to task switching and resistance to interference across the two species. Contrary to what previously reported, we found that both species display robust task switching costs, thus supporting the claim that macaque monkeys provide an exquisitely suitable model to study the brain mechanisms responsible for maintaining and switching task sets. PMID:21720549

Sustained employability of workers in a production environment: design of a stepped wedge trial to evaluate effectiveness and cost-benefit of the POSE program.

PubMed

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

2012-11-20

Sustained employability and health are generating awareness of employers in an aging and more complex work force. To meet these needs, employers may offer their employees health surveillance programs, to increase opportunities to work on health and sustained employability. However, evidence for these health surveillance programs is lacking. The FLESH study (Functional Labour Evaluation for Sustained Health and employment) was developed to evaluate a comprehensive workers' health promotion program on its effectiveness, cost-benefit, and process of the intervention. The study is designed as a cluster randomised stepped wedge trial with randomisation at company plant level and is carried out in a large meat processing company. Every contracted employee is offered the opportunity to participate in the POSE program (Promotion Of Sustained Employability). The main goals of the POSE program are 1) providing employee's insight into their current employability and health status, 2) offering opportunities to improve employability and decrease health risks and 3) improving employability and health sustainably in order to keep them healthy at work. The program consists of a broad assessment followed by a counselling session and, if needed, a tailored intervention. Measurements will be performed at baseline and will be followed up at 20, 40, 60, 80, 106 and 132 weeks. The primary outcome measures are work ability, productivity and absenteeism. Secondary outcomes include health status, vitality, and psychosocial workload. A cost-benefit study will be conducted from the employers' perspective. A process evaluation will be conducted and the satisfaction of employer and employees with the program will be assessed. This study provides information on the effectiveness of the POSE program on sustained employment. When the program proves to be effective, employees benefit by improved work ability, and health. Employers benefit from healthier employees, reduced sick leave (costs) and higher productivity. The study can expose key elements for a successful implementation and execution of the POSE program and may serve as an example to other companies inside and outside the industry. The trial is registered at the Dutch Trial Register (http://www.trialregister.nl): NTR3445.

Sustained employability of workers in a production environment: design of a stepped wedge trial to evaluate effectiveness and cost-benefit of the POSE program

PubMed Central

2012-01-01

Background Sustained employability and health are generating awareness of employers in an aging and more complex work force. To meet these needs, employers may offer their employees health surveillance programs, to increase opportunities to work on health and sustained employability. However, evidence for these health surveillance programs is lacking. The FLESH study (Functional Labour Evaluation for Sustained Health and employment) was developed to evaluate a comprehensive workers’ health promotion program on its effectiveness, cost-benefit, and process of the intervention. Methods The study is designed as a cluster randomised stepped wedge trial with randomisation at company plant level and is carried out in a large meat processing company. Every contracted employee is offered the opportunity to participate in the POSE program (Promotion Of Sustained Employability). The main goals of the POSE program are 1) providing employee’s insight into their current employability and health status, 2) offering opportunities to improve employability and decrease health risks and 3) improving employability and health sustainably in order to keep them healthy at work. The program consists of a broad assessment followed by a counselling session and, if needed, a tailored intervention. Measurements will be performed at baseline and will be followed up at 20, 40, 60, 80, 106 and 132 weeks. The primary outcome measures are work ability, productivity and absenteeism. Secondary outcomes include health status, vitality, and psychosocial workload. A cost-benefit study will be conducted from the employers’ perspective. A process evaluation will be conducted and the satisfaction of employer and employees with the program will be assessed. Discussion This study provides information on the effectiveness of the POSE program on sustained employment. When the program proves to be effective, employees benefit by improved work ability, and health. Employers benefit from healthier employees, reduced sick leave (costs) and higher productivity. The study can expose key elements for a successful implementation and execution of the POSE program and may serve as an example to other companies inside and outside the industry. Trial registration The trial is registered at the Dutch Trial Register (http://www.trialregister.nl): NTR3445 PMID:23164366

The impact of internet-based cognitive behavior therapy on work ability in patients with depression – a randomized controlled study

PubMed Central

Hange, Dominique; Ariai, Nashmil; Kivi, Marie; Eriksson, Maria CM; Nejati, Shabnam; Petersson, Eva-Lisa

2017-01-01

Objectives The aim of this randomized controlled trial (RCT) was to investigate the effects of internet-based cognitive behavior therapy (ICBT) treatment for depression compared to treatment-as-usual (TAU) on improving work ability and quality of life in patients with mild-to-moderate depression. We also examined whether patients treated with ICBT returned to work more rapidly, that is, had fewer days of sick leave, than patients treated with TAU. Design This study is based on material from the PRIM-NET RCT that took place between 2010 and 2013. Setting Primary care centers in Region Vastra Gotaland, Sweden, population about 1.6 million. Patients A total of 77 patients with depression randomized to either ICBT (46 patients) or TAU (31 patients). Mean age of participants was 35.8 years, and 67.5% were women. Main outcome measures Work ability was measured with the Work Ability Index, depressive symptoms with Montgomery Asberg Depression Rating Scale – self-rating version (MADRS-S), quality of life with EuroQoL-5D (EQ-5D), and number of sick leave days. Results Both groups showed an association between improved work ability and reduction of depressive symptoms and between improved work ability and better quality of life. ICBT could not be shown to improve work ability more than TAU among patients with mild-to-moderate depression. There were no differences between the groups concerning number of patients with sick leave or number of sick leave days. Conclusion Our study indicates that a high level of work ability has an association with high health-related quality of life in patients with mild-to-moderate depression, whether they are treated with ICBT or TAU. ICBT has previously been found to be cost-effective and can be seen as a good alternative to TAU. In addition to the ICBT, an intervention oriented toward the work place might improve work ability and reduce the number of sick leave days among patients with depression. PMID:28579817

A-Priori Tuning of Modified Magnussen Combustion Model

NASA Technical Reports Server (NTRS)

Norris, A. T.

2016-01-01

In the application of CFD to turbulent reacting flows, one of the main limitations to predictive accuracy is the chemistry model. Using a full or skeletal kinetics model may provide good predictive ability, however, at considerable computational cost. Adding the ability to account for the interaction between turbulence and chemistry improves the overall fidelity of a simulation but adds to this cost. An alternative is the use of simple models, such as the Magnussen model, which has negligible computational overhead, but lacks general predictive ability except for cases that can be tuned to the flow being solved. In this paper, a technique will be described that allows the tuning of the Magnussen model for an arbitrary fuel and flow geometry without the need to have experimental data for that particular case. The tuning is based on comparing the results of the Magnussen model and full finite-rate chemistry when applied to perfectly and partially stirred reactor simulations. In addition, a modification to the Magnussen model is proposed that allows the upper kinetic limit for the reaction rate to be set, giving better physical agreement with full kinetic mechanisms. This procedure allows a simple reacting model to be used in a predictive manner, and affords significant savings in computational costs for simulations.

Determinants of reproductive costs in the long-lived Black-legged Kittiwake: A multiyear experiment

USGS Publications Warehouse

Golet, Gregory H.; Schmutz, Joel A.; Irons, David B.; Estes, James A.

2004-01-01

We studied reproductive costs of Black-legged Kittiwakes (Rissa tridactyla) in Prince William Sound, Alaska (USA) by removing entire clutches from randomly selected nests over four successive years, and then contrasting survival and fecundity of adults from manipulated and unmanipulated nests in each subsequent year. To elucidate mechanisms that lead to the expression of reproductive costs, we simultaneously characterized several behavioral and physiological parameters among adults in the two treatment groups. We also examined naturally nonbreeding adults that previously bred to determine their survival and future nonbreeding probabilities.Food availability varied during the study, being generally poor at the onset, and improving in later years. Adult nest attendance and body condition (assessed late in the chick- rearing period) varied accordingly among years, and between adults raising chicks and adults that had their eggs removed. Adults from unmanipulated nests incurred significant survival costs in all years, although fecundity costs were strongly expressed in only one of four years. Neither survival nor fecundity costs were strongly influenced by body condition or food availability, and no difference in reproductive costs was detected between the sexes. Although unmanipulated breeders survived at lower rates than manipulated breeders due to costs of reproduction, their survival rates were elevated compared to those of natural nonbreeders, presumably due to differences in individual ability. These findings indicate that models of adult survival must consider not only an organism's reproductive state, but also the factors that lead to that state.Although body condition appeared to be weakly related to survival, it was insufficient to explain the full magnitude of survival costs observed. We suggest that other parameters that were found to differ between treatment groups (e.g., rates of energy turnover, baseline levels of stress, and patterns of allocating body reserves) may be important mechanistic determinants of reproductive costs in kittiwakes, and potentially other long-lived species. Future efforts should move beyond simple assessments of body condition and toward more integrated measures of physiological condition when attempting to identify factors that influence how long-lived species balance the costs and benefits of reproduction.

Too Much of a Good Thing: Stronger Bilingual Inhibition Leads to Larger Lag-2 Task Repetition Costs

ERIC Educational Resources Information Center

Prior, Anat

2012-01-01

Inhibitory control and monitoring abilities of Hebrew-English bilingual and English monolingual university students were compared, in a paradigm requiring participants to switch between performing three distinct tasks. Inhibitory control was gauged by lag-2 task repetition costs, namely decreased performance on the final trial of sequences of type…

Perspectives on Open Access Opportunities for IS Research Publication: Potential Benefits for Researchers, Educators, and Students

ERIC Educational Resources Information Center

Woszczynski, Amy B.; Whitman, Michael E.

2016-01-01

Access to current research materials, pedagogical best practices, and relevant knowledge has become problematic as journal subscription costs have increased. Increasing delays in the traditional publication timeline, coupled with high subscription costs, have resulted in a diminished ability for IS faculty and their students to access the most…

[Effects of mental workload on work ability in primary and secondary school teachers].

PubMed

Xiao, Yuanmei; Li, Weijuan; Ren, Qingfeng; Ren, Xiaohui; Wang, Zhiming; Wang, Mianzhen; Lan, Yajia

2015-02-01

To investigate the change pattern of primary and secondary school teachers' work ability with the changes in their mental workload. A total of 901 primary and secondary school teachers were selected by random cluster sampling, and then their mental workload and work ability were assessed by National Aeronautics and Space Administration-Task Load Index (NASA-TLX) and Work Ability Index (WAI) questionnaires, whose reliability and validity had been tested. The effects of their mental workload on the work ability were analyzed. Primary and secondary school teachers' work ability reached the highest level at a certain level of mental workload (55.73< mental workload ≤ 64.10). When their mental workload was lower than the level, their work ability had a positive correlation with the mental workload. Their work ability increased or maintained stable with the increasing mental workload. Moreover, the percentage of teachers with good work ability increased, while that of teachers with moderate work ability decreased. But when their mental workload was higher than the level, their work ability had a negative correlation with the mental workload. Their work ability significantly decreased with the increasing mental workload (P < 0.01). Furthermore, the percentage of teachers with good work ability decreased, while that of teachers with moderate work ability increased (P < 0.001). Too high or low mental workload will result in the decline of primary and secondary school teachers' work ability. Moderate mental workload (55.73∼64.10) will benefit the maintaining and stabilization of their work ability.

In-Space Propulsion Program Overview and Status

NASA Technical Reports Server (NTRS)

Wercinski, Paul F.; Johnson, Les; Baggett, Randy M.

2003-01-01

NASA's In-Space Propulsion (ISP) Program is designed to develop advanced propulsion technologies that can enable or greatly enhance near and mid-term NASA science missions by significantly reducing cost, mass, and/or travel times. These technologies include: Solar Electric Propulsion, Aerocapture, Solar Sails, Momentum Exchange Tethers, Plasma Sails and other technologies such as Advanced Chemical Propulsion. The ISP Program intends to develop cost-effective propulsion technologies that will provide a broad spectrum of mission possibilities, enabling NASA to send vehicles on longer, more useful voyages and in many cases to destinations that were previously unreachable using conventional means. The ISP approach to identifying and prioritizing these most promising technologies is to use mission and system analysis and subsequent peer review. The ISP program seeks to develop technologies under consideration to Technology Readiness Level (TRL) -6 for incorporation into mission planning within 3-5 years of initiation. The NASA TRL 6 represents a level where a technology is ready for system level demonstration in a relevant environment, usually a space environment. In addition, maximum use of open competition is encouraged to seek optimum solutions under ISP. Several NASA Research Announcements (NRA's) have been released asking industry, academia and other organizations to propose propulsion technologies designed to improve our ability to conduct scientific study of the outer planets and beyond. The ISP Program is managed by NASA Headquarters Office of Space Science and implemented by the Marshall Space Flight Center in Huntsville, Alabama.

Roll-to-roll nanopatterning using jet and flash imprint lithography

NASA Astrophysics Data System (ADS)

Ahn, Sean; Ganapathisubramanian, Maha; Miller, Mike; Yang, Jack; Choi, Jin; Xu, Frank; Resnick, Douglas J.; Sreenivasan, S. V.

2012-03-01

The ability to pattern materials at the nanoscale can enable a variety of applications ranging from high density data storage, displays, photonic devices and CMOS integrated circuits to emerging applications in the biomedical and energy sectors. These applications require varying levels of pattern control, short and long range order, and have varying cost tolerances. Extremely large area R2R manufacturing on flexible substrates is ubiquitous for applications such as paper and plastic processing. It combines the benefits of high speed and inexpensive substrates to deliver a commodity product at low cost. The challenge is to extend this approach to the realm of nanopatterning and realize similar benefits. The cost of manufacturing is typically driven by speed (or throughput), tool complexity, cost of consumables (materials used, mold or master cost, etc.), substrate cost, and the downstream processing required (annealing, deposition, etching, etc.). In order to achieve low cost nanopatterning, it is imperative to move towards high speed imprinting, less complex tools, near zero waste of consumables and low cost substrates. The Jet and Flash Imprint Lithography (J-FILTM) process uses drop dispensing of UV curable resists to assist high resolution patterning for subsequent dry etch pattern transfer. The technology is actively being used to develop solutions for memory markets including Flash memory and patterned media for hard disk drives. In this paper we address the key challenges for roll based nanopatterning by introducing a novel concept: Ink Jet based Roll-to-Roll Nanopatterning. To address this challenge, we have introduced a J-FIL based demonstrator product, the LithoFlex 100. Topics that are discussed in the paper include tool design and process performance. In addition, we have used the LithoFlex 100 to fabricate high performance wire grid polarizers on flexible polycarbonate (PC) films. Transmission of better than 80% and extinction ratios on the order of 4500 have been achieved.

Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in The Netherlands: results of an economic evaluation alongside a randomized controlled trial.

PubMed

Uegaki, Kimi; Stomp-van den Berg, Suzanne G M; de Bruijne, Martine C; van Poppel, Mireille N M; Heymans, Martijn W; van Mechelen, Willem; van Tulder, Maurits W

2011-01-27

Working women of childbearing age are a vital part of the population. Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work. Currently, there is little known about cost-effective post-partum interventions to prevent work disability. The purpose of the study was to evaluate whether supervisor telephone contact (STC) during maternity leave is cost-effective from a societal perspective in reducing sick leave and improving quality-adjusted life years (QALYs) compared to common practice (CP). We conducted an economic evaluation alongside a randomized controlled trial. QALYs were measured by the EuroQol 5-D, and sick leave and presenteeism by the Health and work Performance Questionnaire. Resource use was collected by questionnaires. Data were analysed according to intention-to-treat. Missing data were imputed via multiple imputation. Uncertainty was estimated by 95% confidence intervals, cost-utility planes and curves, and sensitivity analyses. 541 working women from 15 companies participated. Response rates were above 85% at each measurement moment. At the end of the follow-up, no statistically significant between-group differences in QALYs, mean hours of sick leave or presenteeism or costs were observed. STC was found to be less effective and more costly. For willingness-to-pay levels from €0 through €50,000, the probability that STC was cost-effective compared to CP was 0.2. Overall resource use was low. Mean total costs were €3678 (95% CI: 3386; 3951). Productivity loss costs represented 37% of the total costs and of these costs, 48% was attributable to sick leave and 52% to work presenteeism. The cost analysis from a company's perspective indicated that there was a net cost associated with the STC intervention. STC was not cost-effective compared to common practice for a healthy population of working mothers; therefore, implementation is not indicated. The cost-utility of STC for working mothers with more severe post-partum health problems, however, needs to be investigated. Work presenteeism accounted for half of the total productivity loss and warrants attention in future studies. ISRCTN: ISRCTN73119486.

Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in The Netherlands: results of an economic evaluation alongside a randomized controlled trial

PubMed Central

2011-01-01

Background Working women of childbearing age are a vital part of the population. Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work. Currently, there is little known about cost-effective post-partum interventions to prevent work disability. The purpose of the study was to evaluate whether supervisor telephone contact (STC) during maternity leave is cost-effective from a societal perspective in reducing sick leave and improving quality-adjusted life years (QALYs) compared to common practice (CP). Methods We conducted an economic evaluation alongside a randomized controlled trial. QALYs were measured by the EuroQol 5-D, and sick leave and presenteeism by the Health and work Performance Questionnaire. Resource use was collected by questionnaires. Data were analysed according to intention-to-treat. Missing data were imputed via multiple imputation. Uncertainty was estimated by 95% confidence intervals, cost-utility planes and curves, and sensitivity analyses. Results 541 working women from 15 companies participated. Response rates were above 85% at each measurement moment. At the end of the follow-up, no statistically significant between-group differences in QALYs, mean hours of sick leave or presenteeism or costs were observed. STC was found to be less effective and more costly. For willingness-to-pay levels from €0 through €50,000, the probability that STC was cost-effective compared to CP was 0.2. Overall resource use was low. Mean total costs were €3678 (95% CI: 3386; 3951). Productivity loss costs represented 37% of the total costs and of these costs, 48% was attributable to sick leave and 52% to work presenteeism. The cost analysis from a company's perspective indicated that there was a net cost associated with the STC intervention. Conclusions STC was not cost-effective compared to common practice for a healthy population of working mothers; therefore, implementation is not indicated. The cost-utility of STC for working mothers with more severe post-partum health problems, however, needs to be investigated. Work presenteeism accounted for half of the total productivity loss and warrants attention in future studies. Trial registration number ISRCTN: ISRCTN73119486 PMID:21272325

Mate choice for genetic compatibility in the house mouse

PubMed Central

Lindholm, Anna K; Musolf, Kerstin; Weidt, Andrea; König, Barbara

2013-01-01

In house mice, genetic compatibility is influenced by the t haplotype, a driving selfish genetic element with a recessive lethal allele, imposing fundamental costs on mate choice decisions. Here, we evaluate the cost of genetic incompatibility and its implication for mate choice in a wild house mice population. In laboratory reared mice, we detected no fertility (number of embryos) or fecundity (ability to conceive) costs of the t, and yet we found a high cost of genetic incompatibility: heterozygote crosses produced 40% smaller birth litter sizes because of prenatal mortality. Surprisingly, transmission of t in crosses using +/t males was influenced by female genotype, consistent with postcopulatory female choice for + sperm in +/t females. Analysis of paternity patterns in a wild population of house mice showed that +/t females were more likely than +/+ females to have offspring sired by +/+ males, and unlike +/+ females, paternity of their offspring was not influenced by +/t male frequency, further supporting mate choice for genetic compatibility. As the major histocompatibility complex (MHC) is physically linked to the t, we investigated whether females could potentially use variation at the MHC to identify male genotype at the sperm or individual level. A unique MHC haplotype is linked to the t haplotype. This MHC haplotype could allow the recognition of t and enable pre- and postcopulatory mate choice for genetic compatibility. Alternatively, the MHC itself could be the target of mate choice for genetic compatibility. We predict that mate choice for genetic compatibility will be difficult to find in many systems, as only weak fertilization biases were found despite an exceptionally high cost of genetic incompatibility. PMID:23762510

Maintenance service contract model for heavy equipment in mining industry using principal agent theory

NASA Astrophysics Data System (ADS)

Pakpahan, Eka K. A.; Iskandar, Bermawi P.

2015-12-01

Mining industry is characterized by a high operational revenue, and hence high availability of heavy equipment used in mining industry is a critical factor to ensure the revenue target. To maintain high avaliability of the heavy equipment, the equipment's owner hires an agent to perform maintenance action. Contract is then used to control the relationship between the two parties involved. The traditional contracts such as fixed price, cost plus or penalty based contract studied is unable to push agent's performance to exceed target, and this in turn would lead to a sub-optimal result (revenue). This research deals with designing maintenance contract compensation schemes. The scheme should induce agent to select the highest possible maintenance effort level, thereby pushing agent's performance and achieve maximum utility for both parties involved. Principal agent theory is used as a modeling approach due to its ability to simultaneously modeled owner and agent decision making process. Compensation schemes considered in this research includes fixed price, cost sharing and revenue sharing. The optimal decision is obtained using a numerical method. The results show that if both parties are risk neutral, then there are infinite combination of fixed price, cost sharing and revenue sharing produced the same optimal solution. The combination of fixed price and cost sharing contract results in the optimal solution when the agent is risk averse, while the optimal combination of fixed price and revenue sharing contract is obtained when agent is risk averse. When both parties are risk averse, the optimal compensation scheme is a combination of fixed price, cost sharing and revenue sharing.

The impact of federalism on the healthcare system in terms of efficiency, equity, and cost containment: the case of Switzerland.

PubMed

Crivelli, Luca; Salari, Paola

2014-01-01

According to the economic theory of federalism (Oates 1999), a decentralized decision to collectively fund and supply the quantity and quality of public services will increase economic welfare as long as three conditions are fulfilled: preferences and production costs of the different local constituencies are heterogeneous; local governments are better informed than the central agency because of their proximity to the citizens; and the competition between local governments exerts a significant impact on the performance of the local administration and on the ability of public agencies to implement policy innovation. Federalism also presents some negative aspects, including the opportunity costs of decentralization, which materialize in terms of unexploited economies of scale; the emergence of spillover effects among jurisdictions; and the risk of cost-shifting exercises from one layer of the government to the other. Finally, competition between fiscal regimes can affect the level of equity. The literature considers fiscal federalism as a mechanism for controlling the size of the public sector and for constraining the development of redistributive measures. The present paper reviews the impact that federalism has on the efficiency, equity, and cost containment of the healthcare system in Switzerland, a country with a strongly decentralized political system that is based on federalism and the institutions of direct democracy, a liberal economic culture, and a well-developed tradition of mutualism and social security (generous social expenditure and welfare system). By analyzing the empirical evidence available for Switzerland, we expect to draw some general policy lessons that might also be useful for other countries.

Role of the anesthesiologist in the wider governance of healthcare and health economics.

PubMed

Martin, Janet; Cheng, Davy

2013-09-01

Healthcare resources will always be limited, and as a result, difficult decisions must be made about how to allocate limited resources across unlimited demands in order to maximize health gains per resource expended. Governments and hospitals now in severe financial deficits recognize that reengagement of physicians is central to their ability to contain the runaway healthcare costs. Health economic analysis provides tools and techniques to assess which investments in healthcare provide good value for money vs which options should be forgone. Robust decision-making in healthcare requires objective consideration of evidence in order to balance clinical and economic benefits vs risks. Surveys of the literature reveal very few economic analyses related to anesthesia and perioperative medicine despite increasing recognition of the need. Now is an opportune time for anesthesiologists to become familiar with the tools and methodologies of health economics in order to facilitate and lead robust decision-making in quality-based procedures. For most technologies used in anesthesia and perioperative medicine, the responsibility to determine cost-effectiveness falls to those tasked with the governance and stewardship of limited resources for unlimited demands using best evidence plus economics at the local, regional, and national levels. Applicable cost-effectiveness, cost-utility, and cost-benefits in health economics are reviewed in this article with clinical examples in anesthesia. Anesthesiologists can make a difference in the wider governance of healthcare and health economics if we advance our knowledge and skills beyond the technical to address the "other" dimensions of decision-making--most notably, the economic aspects in a value-based healthcare system.

On the Path to SunShot. Emerging Issues and Challenges in Integrating Solar with the Distribution System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palmintier, Bryan; Broderick, Robert; Mather, Barry

2016-05-01

This report analyzes distribution-integration challenges, solutions, and research needs in the context of distributed generation from PV (DGPV) deployment to date and the much higher levels of deployment expected with achievement of the U.S. Department of Energy's SunShot targets. Recent analyses have improved estimates of the DGPV hosting capacities of distribution systems. This report uses these results to statistically estimate the minimum DGPV hosting capacity for the contiguous United States using traditional inverters of approximately 170 GW without distribution system modifications. This hosting capacity roughly doubles if advanced inverters are used to manage local voltage and additional minor, low-cost changesmore » could further increase these levels substantially. Key to achieving these deployment levels at minimum cost is siting DGPV based on local hosting capacities, suggesting opportunities for regulatory, incentive, and interconnection innovation. Already, pre-computed hosting capacity is beginning to expedite DGPV interconnection requests and installations in select regions; however, realizing SunShot-scale deployment will require further improvements to DGPV interconnection processes, standards and codes, and compensation mechanisms so they embrace the contributions of DGPV to system-wide operations. SunShot-scale DGPV deployment will also require unprecedented coordination of the distribution and transmission systems. This includes harnessing DGPV's ability to relieve congestion and reduce system losses by generating closer to loads; minimizing system operating costs and reserve deployments through improved DGPV visibility; developing communication and control architectures that incorporate DGPV into system operations; providing frequency response, transient stability, and synthesized inertia with DGPV in the event of large-scale system disturbances; and potentially managing reactive power requirements due to large-scale deployment of advanced inverter functions. Finally, additional local and system-level value could be provided by integrating DGPV with energy storage and 'virtual storage,' which exploits improved management of electric vehicle charging, building energy systems, and other large loads. Together, continued innovation across this rich distribution landscape can enable the very-high deployment levels envisioned by SunShot.« less

Limacina retroversa's response to combined effects of ocean acidification and sea water freshening

NASA Astrophysics Data System (ADS)

Manno, C.; Morata, N.; Primicerio, R.

2012-11-01

Anthropogenic carbon dioxide emissions induce ocean acidification, thereby reducing carbonate ion concentration, which may affect the ability of calcifying organisms to build shells. Pteropods, the main planktonic producers of aragonite in the worlds' oceans, may be particularly vulnerable to changes in sea water chemistry. The negative effects are expected to be most severe at high-latitudes, where natural carbonate ion concentrations are low. In this study we investigated the combined effects of ocean acidification and freshening on Limacina retroversa, the dominant pteropod in sub polar areas. Living L. retroversa, collected in Northern Norwegian Sea, were exposed to four different pH values ranging from the pre-industrial level to the forecasted end of century ocean acidification scenario. Since over the past half-century the Norwegian Sea has experienced a progressive freshening with time, each pH level was combined with a salinity gradient in two factorial, randomized experiments investigating shell degradation, swimming behavior and survival. In addition, to investigate shell degradation without any physiologic influence, one perturbation experiments using only shells of dead pteropods was performed. Lower pH reduced shell mass whereas shell dissolution increased with pCO2. Interestingly, shells of dead organisms had a higher degree of dissolution than shells of living individuals. Mortality of Limacina retroversa was strongly affected only when both pH and salinity reduced simultaneously. The combined effects of lower salinity and lower pH also affected negatively the ability of pteropods to swim upwards. Results suggest that the energy cost of maintaining ion balance and avoiding sinking (in low salinity scenario) combined with the extra energy cost necessary to counteract shell dissolution (in high pCO2 scenario), exceed the available energy budget of this organism causing the pteropods to change swimming behavior and begin to collapse. Since L. retroversa play an important role in the transport of carbonates to the deep oceans these findings have significant implications for the mechanisms influencing the inorganic carbon cycle in the sub-polar area.

The dynamics of Machiavellian intelligence.

PubMed

Gavrilets, Sergey; Vose, Aaron

2006-11-07

The "Machiavellian intelligence" hypothesis (or the "social brain" hypothesis) posits that large brains and distinctive cognitive abilities of humans have evolved via intense social competition in which social competitors developed increasingly sophisticated "Machiavellian" strategies as a means to achieve higher social and reproductive success. Here we build a mathematical model aiming to explore this hypothesis. In the model, genes control brains which invent and learn strategies (memes) which are used by males to gain advantage in competition for mates. We show that the dynamics of intelligence has three distinct phases. During the dormant phase only newly invented memes are present in the population. During the cognitive explosion phase the population's meme count and the learning ability, cerebral capacity (controlling the number of different memes that the brain can learn and use), and Machiavellian fitness of individuals increase in a runaway fashion. During the saturation phase natural selection resulting from the costs of having large brains checks further increases in cognitive abilities. Overall, our results suggest that the mechanisms underlying the "Machiavellian intelligence" hypothesis can indeed result in the evolution of significant cognitive abilities on the time scale of 10 to 20 thousand generations. We show that cerebral capacity evolves faster and to a larger degree than learning ability. Our model suggests that there may be a tendency toward a reduction in cognitive abilities (driven by the costs of having a large brain) as the reproductive advantage of having a large brain decreases and the exposure to memes increases in modern societies.

The dynamics of Machiavellian intelligence

PubMed Central

Gavrilets, Sergey; Vose, Aaron

2006-01-01

The “Machiavellian intelligence” hypothesis (or the “social brain” hypothesis) posits that large brains and distinctive cognitive abilities of humans have evolved via intense social competition in which social competitors developed increasingly sophisticated “Machiavellian” strategies as a means to achieve higher social and reproductive success. Here we build a mathematical model aiming to explore this hypothesis. In the model, genes control brains which invent and learn strategies (memes) which are used by males to gain advantage in competition for mates. We show that the dynamics of intelligence has three distinct phases. During the dormant phase only newly invented memes are present in the population. During the cognitive explosion phase the population's meme count and the learning ability, cerebral capacity (controlling the number of different memes that the brain can learn and use), and Machiavellian fitness of individuals increase in a runaway fashion. During the saturation phase natural selection resulting from the costs of having large brains checks further increases in cognitive abilities. Overall, our results suggest that the mechanisms underlying the “Machiavellian intelligence” hypothesis can indeed result in the evolution of significant cognitive abilities on the time scale of 10 to 20 thousand generations. We show that cerebral capacity evolves faster and to a larger degree than learning ability. Our model suggests that there may be a tendency toward a reduction in cognitive abilities (driven by the costs of having a large brain) as the reproductive advantage of having a large brain decreases and the exposure to memes increases in modern societies. PMID:17075072

Is different better?: models of teaching and their influence on the net financial outcome for general practice teaching posts.

PubMed

Laurence, Caroline O; Black, Linda E; Cheah, Carolyn; Karnon, Jonathan

2011-07-12

In Australia, training for general practice (GP) occurs within private practices and their involvement in teaching can have significant financial costs. At the same time there are growing demands for clinical places for all disciplines and for GP there is concern that there are insufficient teaching practices to meet the demand at the medical student, prevocational and vocational training levels. One option to address this may be to change how teaching occurs in the practice. A question that arises in posing such an option is whether different models of teaching change the costs for a teaching practice. The aim of this study is to determine the net financial outcome of teaching models in private GP. Modelling the financial implications for a range of teaching options using a costing framework developed from a survey of teaching practices in South Australia. Each option was compared with the traditional model of teaching where one GP supervisor is singularly responsible for one learner. The main outcome measure was net financial outcome per week. Decisions on the model cost parameters were made by the study's Steering Group which comprised of experienced GP supervisors. Four teaching models are presented. Model 1 investigates the gains from teaching multiple same level learners, Models 2 and 3, the benefits of vertically integrated teaching using different permutations, and Model 4 the concept of a GP teacher who undertakes all the teaching. There was a significant increase in net benefits of Aus$547 per week (95% confidence intervals $459, $668) to the practice when a GP taught two same level learners (Model 1) and when a senior registrar participated in teaching a prevocational doctor (Model 3, Aus$263, 95% confidence intervals $80, $570). For Model 2, a practice could significantly reduce the loss if a registrar was involved in vertically integrated teaching which included the training of a medical student (Aus$551, 95% confidence intervals $419, $718). The GP teacher model resulted in a net remuneration of Aus$207,335 per year, sourced predominantly from the GP teacher activities, with no loss to the practice. Our study costed teaching options that can maximise the financial outcomes from teaching. The inclusion of GP registrars in the teaching model or the supervisor teaching more than one same level learner results in a greater financial benefit. This gain was achieved through a reduction in supervisor teaching time and the sharing of administrative and teaching activities with GP registrars. We also show that a GP teacher who carries a minimal patient load can be a sustainable option for a practice. Further, the costing framework used for the teaching models presented in this study has the ability to be applied to any number of teaching model permutations.

Balancing quality and cost for Adult Tobacco Telephone Surveys.

PubMed

Fernandez, Barbara M; Hannah, Kristie M; Wallack, Randal S Zu; Hicks, Jennifer K D; Gorrigan, Anne M; Mariolis, Peter

2007-01-01

To demonstrate the ability to cost-effectively coordinate Adult Tobacco Survey stakeholder interests while reducing the risk of potential bias. Key smoking indicators were compared across 2 surveys and analyzed based on modifications to calling protocols. Mixed results were found when comparing smoking rates across 2 surveys, by early, mid, and late respondents, and by the number of rufusals. Significant cost sayings can be obtained by reducing the number of telephone call attempts. Few significant differences may encourage reductions in protocol, but this must be weighed against the possibility of cost-saving measures resulting in biased estimates.

Economic considerations in coverting from oil/gas firing to coal

NASA Technical Reports Server (NTRS)

Rau, J. G.

1978-01-01

Economic considerations involved in fuel conversion such as from oil and/or gas firing to coal are discussed including investments costs for new facilities and equipment (including air pollution control equipment), operation and maintenance costs, and purchased fuel costs. An analytical approach to assessing the cost effectiveness of fuel conversion in terms of the annual net cost of conversion, the equivalent annual number of barrels of oil saved, and the integral rate of return of the conversion investment is presented. Illustrative numerical examples are presented for typical utility boilers and industrial boiler facilities. A further consideration addressed deals with the impacts of these costs on the overall financial structure of the firm and the ability of the firm to raise the necessary investment captial.

Does technology acceleration equate to mask cost acceleration?

NASA Astrophysics Data System (ADS)

Trybula, Walter J.; Grenon, Brian J.

2003-06-01

The technology acceleration of the ITRS Roadmap has many implications on both the semiconductor sup-plier community and the manufacturers. INTERNATIONAL SEMATECH has revaluated the projected cost of advanced technology masks. Building on the methodology developed in 1996 for mask costs, this work provided a critical review of mask yields and factors relating to the manufacture of photolithography masks. The impact of the yields provided insight into the learning curve for leading edge mask manufac-turing. The projected mask set cost was surprising, and the ability to provide first and second year cost estimates provided additional information on technology introduction. From this information, the impact of technology acceleration can be added to the projected yields to evaluate the impact on mask costs.

Positioning your business in the marketplace.

PubMed

Lachman, V D

1996-01-01

Marketing the quality, cost-effective service delivered by advanced practice nurses (APNs) requires savvy in marketing principles. The basic principles of market segmentation: target (niche) marketing; and the four Ps of marketing mix--product, price, promotion, and place. The marketing process is presented along with examples. APNs' ability to successfully market their skills requires that they "position" themselves in the prospective buyer's mind. After a brief description of the customer's mind-set, the focus shifts specifically to promotion--marketing in action. Numerous no-cost/low-cost ideas are included.

The Effect of Number of Ability Intervals on the Stability of Item Bias Detection.

ERIC Educational Resources Information Center

Loyd, Brenda

The chi-square procedure has been suggested as a viable index of test bias because it provides the best agreement with the three parameter item characteristic curve without the large sample requirement, computer complexity, and cost. This study examines the effect of using different numbers of ability intervals on the reliability of chi-square…

34 CFR 364.59 - May an individual's ability to pay be considered in determining his or her participation in the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE INDEPENDENT LIVING SERVICES PROGRAM AND CENTERS FOR... 34 Education 2 2011-07-01 2010-07-01 true May an individual's ability to pay be considered in determining his or her participation in the costs of IL services? 364.59 Section 364.59 Education Regulations...

34 CFR 364.59 - May an individual's ability to pay be considered in determining his or her participation in the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE INDEPENDENT LIVING SERVICES PROGRAM AND CENTERS FOR... 34 Education 2 2010-07-01 2010-07-01 false May an individual's ability to pay be considered in determining his or her participation in the costs of IL services? 364.59 Section 364.59 Education Regulations...

The Potential for Energy Storage to Provide Peaking Capacity in California under Increased Penetration of Solar Photovoltaics: Report Summary

DOE Office of Scientific and Technical Information (OSTI.GOV)

Denholm, Paul L; Margolis, Robert M

Opportunities to provide peaking capacity with low-cost energy storage are emerging. But adding storage changes the ability of subsequent storage additions to meet peak demand. Increasing photovoltaic (PV) deployment also affects storage's ability to provide peak capacity. This study examines storage's potential to replace conventional peak capacity in California.

The Costs and Benefits of Self-Monitoring for Higher Functioning Children and Adolescents with Autism

ERIC Educational Resources Information Center

Henderson, Heather A.; Ono, Kim E.; McMahon, Camilla M.; Schwartz, Caley B.; Usher, Lauren V.; Mundy, Peter C.

2015-01-01

The ability to regulate behaviors and emotions depends in part on the ability to flexibly monitor one's own progress toward a goal. Atypical patterns of response monitoring have been reported in individuals with autism spectrum disorders (ASD). In the current study we examined the error related negativity (ERN), an electrophysiological index…

Nocturnal hypothermia impairs flight ability in birds: a cost of being cool

PubMed Central

Carr, Jennie M.; Lima, Steven L.

2013-01-01

Many birds use regulated drops in night-time body temperature (Tb) to conserve energy critical to winter survival. However, a significant degree of hypothermia may limit a bird's ability to respond to predatory attack. Despite this likely energy–predation trade-off, the behavioural costs of avian hypothermia have yet to be examined. We thus monitored the nocturnal hypothermia of mourning doves (Zenaida macroura) in a laboratory setting in response to food deprivation. Nocturnal flight tests were used to quantify the flight ability of hypothermic doves. Many hypothermic doves (39% of tests) could not fly while carrying a small weight, but could do so after quickly warming up to typical daytime Tb. Doves that were unable to fly during their first test were more hypothermic than those that could fly, with average Tb reductions of 5.3°C and 3.3°C, respectively, but there was no overall indication of a threshold Tb reduction beyond which doves were consistently incapable of flight. These results suggest that energy-saving hypothermia interferes with avian antipredator behaviour via a reduction in flight ability, likely leading to a trade-off between energy-saving hypothermia and the risk of predation. PMID:24107528

DSM and electric utility competitiveness: An Illinois perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jackson, P.W.

1994-12-31

A predominant theme in the current electric utility industry literature is that competitive forces have emerged and may become more prominent. The wholesale bulk power market is alreadly competitive, as non-utility energy service providers already have had a significant impact on that market; this trend was accelerated by the Energy Policy Act of 1992. Although competition at the retail level is much less pervasive, electric utility customers increasingly have greater choice in selecting energy services. These choices may include, depending on the customer, the ability to self-generate, switch fuels, move to a new location, or rely more heavily on demand-sidemore » management as a means of controlling electric energy use. This paper explores the subject of how demand-side management (DSM) programs, which are often developed by a utility to satisfy resource requirements as a part of its least-cost planning process, can affect the utility`s ability to compete in the energy services marketplace. In this context, the term `DSM` is used in this paper to refer to those demand-side services and programs which provide resources to the utility`s system. Depending on one`s perspective, DSM programs (so defined) can be viewed either as an enhancement to the competitive position of a utility by enabling it to provide its customers with a broader menu of energy services, simultaneously satisfying the objectives of the utility as well as those of the customers, or as a detractor to a utility`s ability to compete. In the latter case, the concern is with respect to the potential for adverse rate impacts on customers who are not participants in DSM programs. The paper consists of an identification of the pros and cons of DSM as a competitive strategy, the tradeoff which can occur between the cost impacts and rate impacts of DSM, and an examination of alternative strategies for maximizing the utilization of DSM both as a resource and as a competitive strategy.« less

Challenges in sensor development for the electric utility industry

NASA Astrophysics Data System (ADS)

Ward, Barry H.

1999-01-01

The electric utility industry is reducing operating costs in order to prepare for deregulation. The reduction in operating cost has meant a reduction in manpower. The ability to utilize remaining maintenance staff more effectively and to stay competitive in a deregulated environment has therefore become critical. In recent years, the industry has moved away from routine or periodic maintenance to predictive or condition based maintenance. This requires the assessment of equipment condition by frequent testing and inspection; a requirement that is incompatible with cost reduction. To overcome this dilemma, industry trends are toward condition monitoring, whereby the health of apparatus is monitored continuously. This requires the installation of sensors hr transducers on power equipment and the data taken forwarded to an intelligent device for further processing. These devices then analyze the data and make evaluations based on parameter levels or trends, in an attempt to predict possible deterioration. This continuous monitoring allows the electric utility to schedule maintenance on an as needed basis. The industry has been faced with many challenges in sensor design. The measurement of physical, chemical and electrical parameters under extreme conditions of electric fields, magnetic fields, temperature, corrosion, etc. is extensive. This paper will give an overview of these challenges and the solutions adopted for apparatus such as power transformers, circuit breakers, boilers, cables, batteries, and rotating machinery.

The value of open access and a patient centric approach to oral oncolytic utilization in the treatment of Chronic Myelogenous Leukemia: A U.S. perspective.

PubMed

Das, Lopamudra; Gitlin, Matthew; Siegartel, Lisa R; Makenbaeva, Dinara

2017-04-01

Since the introduction of tyrosine kinase inhibitors (TKIs), the treatment of patients with chronic myelogenous leukemia (CML) has resulted in significant improvement in patient survival but at a higher pharmaceutical cost to payers. The recent introduction of generic imatinib presents an opportunity to lower pharmacy costs within a population that is growing due to improved survival. Recent literature has focused on the likely benefits to payers of step therapy through generic imatinib. Areas covered: This review provides a perspective that is broader than the evaluation of financial savings or narrowly defined health economic metrics by incorporating factors such as CML patient heterogeneity, including varying levels of disease progression risk, comorbidities and genetic mutation status, differences in TKI product profiles, clinical guideline recommendations, and the importance of individualized patient care. A focused literature review evaluating the real-world impact of utilization management programs is presented. Expert commentary: The findings indicate that payers can achieve substantial savings without the need to implement utilization management policies. Compromises in the ability to provide individualized patient care and unwanted economic consequences resulting from increased costs of disease progression, adverse events, and lack of response to treatment due to utilization management are summarized.

Perception without self-matching in conditional tag based cooperation.

PubMed

McAvity, David M; Bristow, Tristen; Bunker, Eric; Dreyer, Alex

2013-09-21

We consider a model for the evolution of cooperation in a population where individuals may have one of a number of different heritable and distinguishable markers or tags. Individuals interact with each of their neighbors on a square lattice by either cooperating by donating some benefit at a cost to themselves or defecting by doing nothing. The decision to cooperate or defect is contingent on each individual's perception of its interacting partner's tag. Unlike in other tag-based models individuals do not compare their own tag to that of their interaction partner. That is, there is no self-matching. When perception is perfect the cooperation rate is substantially higher than in the usual spatial prisoner's dilemma game when the cost of cooperation is high. The enhancement in cooperation is positively correlated with the number of different tags. The more diverse a population is the more cooperative it becomes. When individuals start with an inability to perceive tags the population evolves to a state where individuals gain at least partial perception. With some reproduction mechanisms perfect perception evolves, but with others the ability to perceive tags is imperfect. We find that perception of tags evolves to lower levels when the cost of cooperation is higher. Copyright © 2013 Elsevier Ltd. All rights reserved.

Implementation and utilization of a comprehensive information network in an integrated private not-for-profit regional health care system

NASA Astrophysics Data System (ADS)

Long, James M., III

1995-10-01

The capacity to access, integrate, and analyze demographic, financial, and clinical data within a regional health care system represents an opportunity to ensure and enhance clinical quality and to reduce costs in a carefully planned and controlled manner. Properly used, such capability should improve health care delivery for local populations and provide the institution with a level of integration of services achieved by few health care organizations. The Baptist Health System (BHS), based in Birmingham, Alabama, is currently standardizing operating procedures among its various components and implementing a comprehensive, enterprise-wide information network. Clinical quality improvement and case management are being promulgated throughout the enterprise using a continuum-of-care model developed internally. Having successfully completed a pilot project using teleconferences for core lectures in internal medicine between two large teaching hospitals, BHS is taking advantage of enterprise- wide teleconference capability using a combination of fiberoptic (T3) and standard digital telephone (T1) transmission to speed installation and reduce the cost of implementation into two office buildings and eleven hospitals. The information system will serve to prepare BHS for the advent of managed care and other anticipated changes in health care, while ensuring continued ability to deliver high quality, cost-effective medical and health-related services.

Camponotusfloridanus Ants Incur a Trade-Off between Phenotypic Development and Pathogen Susceptibility from Their Mutualistic Endosymbiont Blochmannia.

PubMed

Sinotte, Veronica M; Freedman, Samantha N; Ugelvig, Line V; Seid, Marc A

2018-06-01

Various insects engage in microbial mutualisms in which the reciprocal benefits exceed the costs. Ants of the genus Camponotus benefit from nutrient supplementation by their mutualistic endosymbiotic bacteria, Blochmannia , but suffer a cost in tolerating and regulating the symbiont. This cost suggests that the ants face secondary consequences such as susceptibility to pathogenic infection and transmission. In order to elucidate the symbiont's effects on development and disease defence, Blochmannia floridanus was reduced in colonies of Camponotus floridanus using antibiotics. Colonies with reduced symbiont levels exhibited workers of smaller body size, smaller colony size, and a lower major-to-minor worker caste ratio, indicating the symbiont's crucial role in development. Moreover, these ants had decreased cuticular melanisation, yet higher resistance to the entomopathogen Metarhizium brunneum , suggesting that the symbiont reduces the ants' ability to fight infection, despite the availability of melanin to aid in mounting an immune response. While the benefits of improved growth and development likely drive the mutualism, the symbiont imposes a critical trade-off. The ants' increased susceptibility to infection exacerbates the danger of pathogen transmission, a significant risk given ants' social lifestyle. Thus, the results warrant research into potential adaptations of the ants and pathogens that remedy and exploit the described disease vulnerability.

Massachusetts health reform: employers, lower-wage workers and universal coverage.

PubMed

Felland, Laurie; Draper, Debra; Liebhaber, Allison

2007-07-01

As Massachusetts' landmark effort to reach nearly universal health coverage unfolds, the state is now focusing on employers to take steps to increase coverage. All employers--except firms with fewer than 11 workers--face new requirements under the 2006 law, including establishing Section 125, or cafeteria, plans to allow workers to purchase insurance with pre-tax dollars and paying a $295 annual fee if they do not make a "fair and reasonable" contribution to the cost of workers' coverage. Through interviews with Massachusetts health care leaders (see Data Source), the Center for Studying Health System Change (HSC) examined how the law is likely to affect employer decisions to offer health insurance to workers and employee decisions to purchase coverage. Market observers believe many small firms may be unaware of specific requirements and that some could prove onerous. Moreover, the largest impact on small employers may come from the individual mandate for all residents to have a minimum level of health insurance. This mandate may add costs for firms if more workers take up coverage offers, seek more generous coverage or pressure employers to offer coverage. Despite reform of the individual and small group markets, including development of new insurance products, concerns remain about the affordability of coverage and the ability to stem rising health care costs.

Geographic Variation in Diagnostic Ability and Quality of Care Metrics: A Case Study of Ankylosing Spondylitis and Low Back Pain

PubMed Central

Shafrin, Jason; Griffith, Jenny; Shim, Jin Joo; Huber, Caroline; Ganguli, Arijit; Aubry, Wade

2017-01-01

Studies examining geographic variation in care for low back pain often focus on process and outcome measures conditional on patient diagnosis but generally do not take into account a physician’s ability to diagnose the root cause of low back pain. In our case study, we used increased detection of ankylosing spondylitis—a relatively rare inflammatory back disease—as a proxy for diagnostic ability and measured the relationship between ankylosing spondylitis detection, potentially inappropriate low back pain care, and cost. Using 5 years of health insurance claims data, we found significant variation in ankylosing spondylitis detection across metropolitan statistical areas (MSAs), with 8.1% of the variation in detection explained by a region’s racial composition. Furthermore, low back pain patients in MSAs with higher ankylosing spondylitis detection had 7.9% lower use of corticosteroids, 9.0% lower use of opioids, and 8.2% lower pharmacy cost, compared with patients living in low-detection MSAs. PMID:28548005

What Are the Costs of Trauma Center Readiness? Defining and Standardizing Readiness Costs for Trauma Centers Statewide.

PubMed

Ashley, Dennis W; Mullins, Robert F; Dente, Christopher J; Garlow, Laura; Medeiros, Regina S; Atkins, Elizabeth V; Solomon, Gina; Abston, Dena; Ferdinand, Colville H

2017-09-01

Trauma center readiness costs are incurred to maintain essential infrastructure and capacity to provide emergent services on a 24/7 basis. These costs are not captured by traditional hospital cost accounting, and no national consensus exists on appropriate definitions for each cost. Therefore, in 2010, stakeholders from all Level I and II trauma centers developed a survey tool standardizing and defining trauma center readiness costs. The survey tool underwent minor revisions to provide further clarity, and the survey was repeated in 2013. The purpose of this study was to provide a follow-up analysis of readiness costs for Georgia's Level I and Level II trauma centers. Using the American College of Surgeons Resources for Optimal Care of the Injured Patient guidelines, four readiness cost categories were identified: Administrative, Clinical Medical Staff, Operating Room, and Education/Outreach. Through conference calls, webinars and face-to-face meetings with financial officers, trauma medical directors, and program managers from all trauma centers, standardized definitions for reporting readiness costs within each category were developed. This resulted in a survey tool for centers to report their individual readiness costs for one year. The total readiness cost for all Level I trauma centers was $34,105,318 (avg $6,821,064) and all Level II trauma centers was $20,998,019 (avg $2,333,113). Methodology to standardize and define readiness costs for all trauma centers within the state was developed. Average costs for Level I and Level II trauma centers were identified. This model may be used to help other states define and standardize their trauma readiness costs.

Alpha Oscillations Are Causally Linked to Inhibitory Abilities in Ageing.

PubMed

Borghini, Giulia; Candini, Michela; Filannino, Cristina; Hussain, Masud; Walsh, Vincent; Romei, Vincenzo; Zokaei, Nahid; Cappelletti, Marinella

2018-05-02

Aging adults typically show reduced ability to ignore task-irrelevant information, an essential skill for optimal performance in many cognitive operations, including those requiring working memory (WM) resources. In a first experiment, young and elderly human participants of both genders performed an established WM paradigm probing inhibitory abilities by means of valid, invalid, and neutral retro-cues. Elderly participants showed an overall cost, especially in performing invalid trials, whereas younger participants' general performance was comparatively higher, as expected.Inhibitory abilities have been linked to alpha brain oscillations but it is yet unknown whether in aging these oscillations (also typically impoverished) and inhibitory abilities are causally linked. To probe this possible causal link in aging, we compared in a second experiment parietal alpha-transcranial alternating current stimulation (tACS) with either no stimulation (Sham) or with two control stimulation frequencies (theta- and gamma-tACS) in the elderly group while performing the same WM paradigm. Alpha- (but not theta- or gamma-) tACS selectively and significantly improved performance (now comparable to younger adults' performance in the first experiment), particularly for invalid cues where initially elderly showed the highest costs. Alpha oscillations are therefore causally linked to inhibitory abilities and frequency-tuned alpha-tACS interventions can selectively change these abilities in the elderly. SIGNIFICANCE STATEMENT Ignoring task-irrelevant information, an ability associated to rhythmic brain activity in the alpha frequency band, is fundamental for optimal performance. Indeed, impoverished inhibitory abilities contribute to age-related decline in cognitive functions like working memory (WM), the capacity to briefly hold information in mind. Whether in aging adults alpha oscillations and inhibitory abilities are causally linked is yet unknown. We experimentally manipulated frequency-tuned brain activity using transcranial alternating current stimulation (tACS), combined with a retro-cue paradigm assessing WM and inhibition. We found that alpha-tACS induced a significant improvement in target responses and misbinding errors, two indexes of inhibition. We concluded that in aging alpha oscillations are causally linked to inhibitory abilities, and that despite being impoverished, these abilities are still malleable. Copyright © 2018 the authors 0270-6474/18/384419-12$15.00/0.

A short overview of upper limb rehabilitation devices

NASA Astrophysics Data System (ADS)

Macovei, S.; Doroftei, I.

2016-08-01

As some studies show, the number of people over 65 years old increases constantly, leading to the need of solution to provide services regarding patient mobility. Diseases, accidents and neurologic problems affect hundreds of people every day, causing pain and lost of motor functions. The ability of using the upper limb is indispensable for a human being in everyday activities, making easy tasks like drinking a glass of water a real challenge. We can agree that physiotherapy promotes recovery, but not at an optimal level, due to limited financial and human resources. Hence, the need of robot-assisted rehabilitation emerges. A robot for upper-limb exercises should have a design that can accurately control interaction forces and progressively adapt assistance to the patients’ abilities and also to record the patient's motion and evolution. In this paper a short overview of upper limb rehabilitation devices is presented. Our goal is to find the shortcomings of the current developed devices in terms of utility, ease of use and costs, for future development of a mechatronic system for upper limb rehabilitation.

High Power MPD Thruster Performance Measurements

NASA Technical Reports Server (NTRS)

LaPointe, Michael R.; Strzempkowski, Eugene; Pencil, Eric

2004-01-01

High power magnetoplasmadynamic (MPD) thrusters are being developed as cost effective propulsion systems for cargo transport to lunar and Mars bases, crewed missions to Mars and the outer planets, and robotic deep space exploration missions. Electromagnetic MPD thrusters have demonstrated, at the laboratory level, the ability to process megawatts of electrical power while providing significantly higher thrust densities than electrostatic electric propulsion systems. The ability to generate higher thrust densities permits a reduction in the number of thrusters required to perform a given mission, and alleviates the system complexity associated with multiple thruster arrays. The specific impulse of an MPD thruster can be optimized to meet given mission requirements, from a few thousand seconds with heavier gas propellants up to 10,000 seconds with hydrogen propellant. In support of programs envisioned by the NASA Office of Exploration Systems, Glenn Research Center is developing and testing quasi-steady MW-class MPD thrusters as a prelude to steady state high power thruster tests. This paper provides an overview of the GRC high power pulsed thruster test facility, and presents preliminary performance data for a quasi-steady baseline MPD thruster geometry.

Joining the in vitro immunization of alpaca lymphocytes and phage display: rapid and cost effective pipeline for sdAb synthesis.

PubMed

Comor, Lubos; Dolinska, Saskia; Bhide, Katarina; Pulzova, Lucia; Jiménez-Munguía, Irene; Bencurova, Elena; Flachbartova, Zuzana; Potocnakova, Lenka; Kanova, Evelina; Bhide, Mangesh

2017-01-23

Camelids possess unique functional heavy chain antibodies, which can be produced and modified in vitro as a single domain antibody (sdAb or nanobody) with full antigen binding ability. Production of sdAb in conventional manner requires active immunization of Camelidae animal, which is laborious, time consuming, costly and in many cases not feasible (e.g. in case of highly toxic or infectious antigens). In this study, we describe an alternative pipeline that includes in vitro stimulation of naïve alpaca B-lymphocytes by antigen of interest (in this case endothelial cell binding domain of OspA of Borrelia) in the presence of recombinant alpaca interleukins 2 and 4, construction of sdAb phage library, selection of antigen specific sdAb expressed on phages (biopanning) and confirmation of binding ability of sdAb to the antigen. By joining the in vitro immunization and the phage display ten unique phage clones carrying sdAb were selected. Out of ten, seven sdAb showed strong antigen binding ability in phage ELISA. Furthermore, two soluble forms of sdAb were produced and their differential antigen binding affinity was measured with bio-layer interferometry. A proposed pipeline has potential to reduce the cost substantially required for maintenance of camelid herd for active immunization. Furthermore, in vitro immunization can be achieved within a week to enrich mRNA copies encoding antigen-specific sdAbs in B cell. This rapid and cost effective pipeline can help researchers to develop efficiently sdAb for diagnostic and therapeutic purposes.

Assessing the quality of cost management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fayne, V.; McAllister, A.; Weiner, S.B.

1995-12-31

Managing environmental programs can be effective only when good cost and cost-related management practices are developed and implemented. The Department of Energy`s Office of Environmental Management (EM), recognizing this key role of cost management, initiated several cost and cost-related management activities including the Cost Quality Management (CQM) Program. The CQM Program includes an assessment activity, Cost Quality Management Assessments (CQMAs), and a technical assistance effort to improve program/project cost effectiveness. CQMAs provide a tool for establishing a baseline of cost-management practices and for measuring improvement in those practices. The result of the CQMA program is an organization that has anmore » increasing cost-consciousness, improved cost-management skills and abilities, and a commitment to respond to the public`s concerns for both a safe environment and prudent budget outlays. The CQMA program is part of the foundation of quality management practices in DOE. The CQMA process has contributed to better cost and cost-related management practices by providing measurements and feedback; defining the components of a quality cost-management system; and helping sites develop/improve specific cost-management techniques and methods.« less

Relations between Prenatal Testosterone Levels and Cognitive Abilities at 4 Years.

ERIC Educational Resources Information Center

Finegan, Jo-Anne K.; And Others

1992-01-01

Compared children's cognitive abilities at four years and their prenatal amniotic fluid testosterone levels. For girls, prenatal testosterone levels were related in a curvilinear manner to language comprehension and classification abilities, and inversely related to counting and knowledge of number facts. For boys, no relationships were found. (BC)

Heuristics and biases: interactions among numeracy, ability, and reflectiveness predict normative responding

PubMed Central

Klaczynski, Paul A.

2014-01-01

In Stanovich's (2009a, 2011) dual-process theory, analytic processing occurs in the algorithmic and reflective minds. Thinking dispositions, indexes of reflective mind functioning, are believed to regulate operations at the algorithmic level, indexed by general cognitive ability. General limitations at the algorithmic level impose constraints on, and affect the adequacy of, specific strategies and abilities (e.g., numeracy). In a study of 216 undergraduates, the hypothesis that thinking dispositions and general ability moderate the relationship between numeracy (understanding of mathematical concepts and attention to numerical information) and normative responses on probabilistic heuristics and biases (HB) problems was tested. Although all three individual difference measures predicted normative responses, the numeracy-normative response association depended on thinking dispositions and general ability. Specifically, numeracy directly affected normative responding only at relatively high levels of thinking dispositions and general ability. At low levels of thinking dispositions, neither general ability nor numeric skills related to normative responses. Discussion focuses on the consistency of these findings with the hypothesis that the implementation of specific skills is constrained by limitations at both the reflective level and the algorithmic level, methodological limitations that prohibit definitive conclusions, and alternative explanations. PMID:25071639

Heuristics and biases: interactions among numeracy, ability, and reflectiveness predict normative responding.

PubMed

Klaczynski, Paul A

2014-01-01

In Stanovich's (2009a, 2011) dual-process theory, analytic processing occurs in the algorithmic and reflective minds. Thinking dispositions, indexes of reflective mind functioning, are believed to regulate operations at the algorithmic level, indexed by general cognitive ability. General limitations at the algorithmic level impose constraints on, and affect the adequacy of, specific strategies and abilities (e.g., numeracy). In a study of 216 undergraduates, the hypothesis that thinking dispositions and general ability moderate the relationship between numeracy (understanding of mathematical concepts and attention to numerical information) and normative responses on probabilistic heuristics and biases (HB) problems was tested. Although all three individual difference measures predicted normative responses, the numeracy-normative response association depended on thinking dispositions and general ability. Specifically, numeracy directly affected normative responding only at relatively high levels of thinking dispositions and general ability. At low levels of thinking dispositions, neither general ability nor numeric skills related to normative responses. Discussion focuses on the consistency of these findings with the hypothesis that the implementation of specific skills is constrained by limitations at both the reflective level and the algorithmic level, methodological limitations that prohibit definitive conclusions, and alternative explanations.

Managed care and hospital cost containment.

PubMed

Konetzka, R Tamara; Zhu, Jingsan; Sochalski, Julie; Volpp, Kevin G

2008-01-01

This study assesses the ability of managed care to contain hospital costs since the managed care backlash, using data from California's Office of Statewide Health Planning and Development for all acute-care hospitals in the state for the period 1991-2001. The analysis employs a long-differences design to examine cost growth before and after the managed care backlash. Results from the early 1990s are consistent with prior evidence that the combination of more competitive markets and high managed care penetration held down costs. Post-backlash, high managed care penetration no longer was associated with lower cost growth in the most competitive markets, indicating that the synergistic effects between managed care and hospital competition no longer may exist.

Potential impact of ACA-related insurance expansion on trauma care reimbursement

PubMed Central

Scott, John W; Upadhyaya, Pooja; Najjar, Peter; Tsai, Thomas C; Scott, Kirstin W; Shrime, Mark G; Cutler, David M; Salim, Ali; Haider, Adil H

2017-01-01

Introduction Nearly one-quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. Methods We abstracted nonelderly adults (ages 18–64y) admitted for trauma from the Nationwide Inpatient Sample (NIS) during 2010—the last year prior to most major ACA coverage expansion policies. We calculated national and facility-level reimbursements and trauma-related contribution margins using NIS-supplied cost-to-charge ratios and published reimbursement rates for each payer type. Using US census data, we developed a probabilistic microsimulation model to determine the proportion of pre-ACA uninsured trauma patients that would be expected to gain private insurance, Medicaid, or remain uninsured after full implementation of the ACA. We then estimated the impact of these coverage changes on national and facility-level trauma reimbursement for this population. Results 145,849 patients (representing 737,852 patients nationwide) were included. National inpatient trauma costs for 18–64y patients totaled $14.8 billion (95%CI:12.5,17.1). Pre-expansion reimbursements totaled $13.7 billion (10.8,14.7), yielding a national margin of −7.9% (−10.6, −5.1). Post-expansion projected reimbursements totaled $15.0 billion (12.7,17.3), increasing the margin by 9.3 absolute percentage-points to +1.4% (−0.3,+3.2). Of the 263 eligible facilities, 90 (34.2%) had a positive trauma-related contribution margin in 2010, which increased to 171 (65.0%) using post-expansion projections. Those facilities with the highest proportion of uninsured and racial/ethnic minorities experienced the greatest gains. Conclusion Health insurance coverage expansion for uninsured trauma patients has the potential to increase national reimbursement for inpatient trauma care by over one billion dollars and nearly double the proportion of hospitals with a positive margin for trauma care. These data suggest that insurance coverage expansion has the potential to improve trauma centers’ financial viability and their ability to provide care for their communities. Level of Evidence Level II: Sensible costs and alternatives; values obtained from limited sources; multi-way sensitivity analyses Study Type Policy Analysis / Economic Analysis PMID:28431415