Science.gov

Sample records for cost-effective municipal applications

  1. Photovoltaics for municipal planners. Cost-effective municipal applications of photovoltaics for electric power

    SciTech Connect

    Not Available

    1993-04-01

    This booklet is intended for city and county government personnel, as well as community organizations, who deal with supplying, regulating, or recommending electric power resources. Specifically, this document deals with photovoltaic (PV) power, or power from solar cells, which is currently the most cost-effective energy source for electricity requirements that are relatively small, located in isolated areas, or difficult to serve with conventional technology. Recently, PV has been documented to be more cost-effective than conventional alternatives (such as line extensions or engine generators) in dozens of applications within the service territories of electric, gas, and communications utilities. Here, we document numerous cost-effective urban applications, chosen by planners and utilities because they were the most cost-effective option or because they were appropriate for environmental or logistical reasons. These applications occur within various municipal departments, including utility, parks and recreation, traffic engineering, transportation, and planning, and they include lighting applications, communications equipment, corrosion protection, irrigation control equipment, remote monitoring, and even portable power supplies for emergency situations.

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

    SciTech Connect

    Gropp, William Douglas

    2015-12-21

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

  3. APPLICATION OF COST EFFECTIVENESS TECHNIQUES TO SELECTION OF PREFERRED WARSHIP CHARACTERISTICS

    DTIC Science & Technology

    This paper discusses the applicability of cost effectiveness methods to the problem of determining preferred design characteristics of surface, anti...the methodology applicable to adapting cost effectiveness techniques to selection of preferred warship design characteristics. The surface anti...submarine vessel is used as a vehicle for adapting the cost effectiveness methodology ; explanations as to how the cost effectiveness model may be expanded to include other types of surface ships is included.

  4. Cost effective processes by using negative-tone development application

    NASA Astrophysics Data System (ADS)

    Yamamoto, Kei; Kato, Keita; Ou, Keiyu; Shirakawa, Michihiro; Kamimura, Sou

    2015-03-01

    The high volume manufacturing with extreme ultraviolet (EUV) lithography is delaying due to its light source issue. Therefore, ArF-immersion lithography has still been the most promising technology for down scaling of device pitch. As the limitation of ArF-immersion single patterning is considered to be nearly 40nm half pitch (hp), ArF-immersion lithography has necessity to be extended by combining processes to achieve sub- 20nm hp patterning. Recently, there are many reports about the extension of ArF-immersion lithography, e.g., self-aligned multiple patterning (SAMP) and litho-etch-litho-etch (LELE) process. These methods have been realized by the combination of lithography, deposition, and etching. On the other aspect, 1-D layout is adopted for leading devices, which contains additional cut or block litho and etch processes to form 2-D like layout. Thus, according to the progress of down scaling technologies, number of processes increases and the cost of ownership (CoO) can not be neglected. Especially, the number of lithography steps and etching steps has been expanded by the combination of processes, and it has come to occupy a large portion of total manufacturing cost. We have reported that negative tone development (NTD) system using organic solvent developer have enough resolution to achieve fine narrow trench or contact hole patterning, since negative tone imaging enables to apply bright mask for these pattern with significantly high optical image contrast compared to positive tone imaging, and it has contributed high throughput multiple patterning. On the other hand, NTD system is found to be useful not only for leading device node, but also for cost effective process. In this report, we propose the cost effective process using NTD application. In the viewpoint of cost down at exposure tool, we have developed KrF-NTD resist which is customized for organic solvent developer. Our KrF-NTD resist has resolution comparable with ArF positive tone development

  5. Compiled MPI: Cost-Effective Exascale Applications Development

    SciTech Connect

    Bronevetsky, G; Quinlan, D; Lumsdaine, A; Hoefler, T

    2012-04-10

    The complexity of petascale and exascale machines makes it increasingly difficult to develop applications that can take advantage of them. Future systems are expected to feature billion-way parallelism, complex heterogeneous compute nodes and poor availability of memory (Peter Kogge, 2008). This new challenge for application development is motivating a significant amount of research and development on new programming models and runtime systems designed to simplify large-scale application development. Unfortunately, DoE has significant multi-decadal investment in a large family of mission-critical scientific applications. Scaling these applications to exascale machines will require a significant investment that will dwarf the costs of hardware procurement. A key reason for the difficulty in transitioning today's applications to exascale hardware is their reliance on explicit programming techniques, such as the Message Passing Interface (MPI) programming model to enable parallelism. MPI provides a portable and high performance message-passing system that enables scalable performance on a wide variety of platforms. However, it also forces developers to lock the details of parallelization together with application logic, making it very difficult to adapt the application to significant changes in the underlying system. Further, MPI's explicit interface makes it difficult to separate the application's synchronization and communication structure, reducing the amount of support that can be provided by compiler and run-time tools. This is in contrast to the recent research on more implicit parallel programming models such as Chapel, OpenMP and OpenCL, which promise to provide significantly more flexibility at the cost of reimplementing significant portions of the application. We are developing CoMPI, a novel compiler-driven approach to enable existing MPI applications to scale to exascale systems with minimal modifications that can be made incrementally over the application

  6. Forest land application of municipal sludge.

    Treesearch

    D.G. Brockway

    1988-01-01

    In Michigan, 199 municipal and numerous industrial wastewater treatment facilities annually generate 222,750 dry tons of sludge, most of which is recycled on farmland. Substantial potential exists, however, to increase application on forest land in the northern two-thirds of the state (Brockway and Nguyen 1986). Although sludge application on agricultural land has...

  7. CICS Region Virtualization for Cost Effective Application Development

    ERIC Educational Resources Information Center

    Khan, Kamal Waris

    2012-01-01

    Mainframe is used for hosting large commercial databases, transaction servers and applications that require a greater degree of reliability, scalability and security. Customer Information Control System (CICS) is a mainframe software framework for implementing transaction services. It is designed for rapid, high-volume online processing. In order…

  8. CICS Region Virtualization for Cost Effective Application Development

    ERIC Educational Resources Information Center

    Khan, Kamal Waris

    2012-01-01

    Mainframe is used for hosting large commercial databases, transaction servers and applications that require a greater degree of reliability, scalability and security. Customer Information Control System (CICS) is a mainframe software framework for implementing transaction services. It is designed for rapid, high-volume online processing. In order…

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  11. Improvement Strategies, Cost Effective Production, and Potential Applications of Fungal Glucose Oxidase (GOD): Current Updates.

    PubMed

    Dubey, Manish K; Zehra, Andleeb; Aamir, Mohd; Meena, Mukesh; Ahirwal, Laxmi; Singh, Siddhartha; Shukla, Shruti; Upadhyay, Ram S; Bueno-Mari, Ruben; Bajpai, Vivek K

    2017-01-01

    Fungal glucose oxidase (GOD) is widely employed in the different sectors of food industries for use in baking products, dry egg powder, beverages, and gluconic acid production. GOD also has several other novel applications in chemical, pharmaceutical, textile, and other biotechnological industries. The electrochemical suitability of GOD catalyzed reactions has enabled its successful use in bioelectronic devices, particularly biofuel cells, and biosensors. Other crucial aspects of GOD such as improved feeding efficiency in response to GOD supplemental diet, roles in antimicrobial activities, and enhancing pathogen defense response, thereby providing induced resistance in plants have also been reported. Moreover, the medical science, another emerging branch where GOD was recently reported to induce several apoptosis characteristics as well as cellular senescence by downregulating Klotho gene expression. These widespread applications of GOD have led to increased demand for more extensive research to improve its production, characterization, and enhanced stability to enable long term usages. Currently, GOD is mainly produced and purified from Aspergillus niger and Penicillium species, but the yield is relatively low and the purification process is troublesome. It is practical to build an excellent GOD-producing strain. Therefore, the present review describes innovative methods of enhancing fungal GOD production by using genetic and non-genetic approaches in-depth along with purification techniques. The review also highlights current research progress in the cost effective production of GOD, including key advances, potential applications and limitations. Therefore, there is an extensive need to commercialize these processes by developing and optimizing novel strategies for cost effective GOD production.

  12. Cost-effectiveness analysis appraisal and application: an emergency medicine perspective.

    PubMed

    April, Michael D; Murray, Brian P

    2017-03-10

    Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policy-makers have any formal training in CEA methodology. This paper provides an introduction to the interpretation and use of CEA with a focus on application to emergency medicine problems and settings. It applies a previously-published CEA to the hypothetical case of a patient presenting to the ED with chest pain who requires risk stratification. This paper uses a widely-cited checklist to appraise the CEA. This checklist serves as a vehicle for presenting basic CEA terminology and concepts. General topics of focus include measurement of costs and outcomes, incremental analysis, and sensitivity analysis. Integrated throughout the paper are recommendations for good CEA practice with emphasis on the guidelines published by the United States Panel on Cost-Effectiveness in Health and Medicine. Unique challenges for emergency medicine CEAs discussed include the projection of long-term outcomes from emergent interventions, costing ED services, and applying study results to diverse patient populations across various ED settings. The discussion also includes an overview of the limitations inherent in applying CEA results to clinical practice to include the lack of incorporation of non-cost considerations in CEA (e.g., ethics). After reading this article, emergency medicine leaders and researchers will have an enhanced understanding of the basics of CEA critical appraisal and application. The paper concludes with an overview of economic evaluation resources for readers interested in conducting ED-based economic

  13. Application of municipal sewage sludge in forest and degraded land

    Treesearch

    D.H. Marx; C.R. Berry; Paul P. Kormanik

    1995-01-01

    Nearly 8 million dry tons of municipal sewage sludge are produced each year in the USA by the more than 15,000 publicly owned treatment plants and the tonnage is increasing.For two decades, researchers in the USA have been studying the feasibility of land application of municipal sewage sludge. Research, large-scale practical projects, and commercial ventures have...

  14. Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

    SciTech Connect

    Bill Stanley; Sandra Brown; Patrick Gonzalez; Brent Sohngen; Neil Sampson; Mark Anderson; Miguel Calmon; Sean Grimland; Zoe Kant; Dan Morse; Sarah Woodhouse Murdock; Arlene Olivero; Tim Pearson; Sarah Walker; Jon Winsten; Chris Zganjar

    2007-03-31

    The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects, providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas reductions. The research described in this report occurred between January 1st and March 31st 2007. The specific tasks discussed include: Task 1--carbon inventory advancements; Task 2--emerging technologies for remote sensing of terrestrial carbon; Task 3--baseline method development; Task 4--third-party technical advisory panel meetings; Task 5--new project feasibility studies; and Task 6--development of new project software screening tool.

  15. Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

    SciTech Connect

    Bill Stanley; Patrick Gonzalez; Sandra Brown; Jenny Henman; Zoe Kant; Sarah Woodhouse Murdock; Neil Sampson; Gilberto Tiepolo; Tim Pearson; Sarah Walker; Miguel Calmon

    2006-01-01

    The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects, providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas reductions. The research described in this report occurred between April 1st , 2005 and June 30th, 2005. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: emerging technologies for remote sensing of terrestrial carbon; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.

  16. Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

    SciTech Connect

    Bill Stanley; Patrick Gonzalez; Sandra Brown; Jenny Henman; Sarah Woodhouse Murdock; Neil Sampson; Tim Pearson; Sarah Walker; Zoe Kant; Miguel Calmon

    2006-04-01

    The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects, providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas reductions. The research described in this report occurred between January 1st and March 31st 2006. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: emerging technologies for remote sensing of terrestrial carbon; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.

  17. Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

    SciTech Connect

    Bill Stanley; Patrick Gonzalez; Sandra Brown; Sarah Woodhouse Murdock; Jenny Henman; Zoe Kant; Gilberto Tiepolo; Tim Pearson; Neil Sampson; Miguel Calmon

    2005-10-01

    The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects, providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas reductions. The research described in this report occurred between April 1st , 2005 and June 30th, 2005. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: emerging technologies for remote sensing of terrestrial carbon; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.

  18. Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

    SciTech Connect

    Bill Stanley; Sandra Brown; Patrick Gonzalez; Brent Sohngen; Neil Sampson; Mark Anderson; Miguel Calmon; Sean Grimland; Ellen Hawes; Zoe Kant; Dan Morse; Sarah Woodhouse Murdock; Arlene Olivero; Tim Pearson; Sarah Walker; Jon Winsten; Chris Zganjar

    2006-09-30

    The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects, providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas reductions. The research described in this report occurred between April 1st and July 30th 2006. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: emerging technologies for remote sensing of terrestrial carbon; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.

  19. Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

    SciTech Connect

    Bill Stanley; Sandra Brown; Patrick Gonzalez; Brent Sohngen; Neil Sampson; Mark Anderson; Miguel Calmon; Sean Grimland; Zoe Kant; Dan Morse; Sarah Woodhouse Murdock; Arlene Olivero; Tim Pearson; Sarah Walker; Jon Winsten; Chris Zganjar

    2006-12-31

    The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects, providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas reductions. The research described in this report occurred between October 1st and December 31st 2006. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: emerging technologies for remote sensing of terrestrial carbon; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.

  20. THE APPLICATION AND DEVELOPMENT OF APPROPRIATE TOOLS AND TECHNOLOGIES FOR COST-EFFECTIVE CARBON SEQUESTRATION

    SciTech Connect

    Bill Stanley; Sandra Brown; Ellen Hawes; Zoe Kant; Miguel Calmon; Gilberto Tiepolo

    2002-09-01

    The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research projects is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects, providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas impacts. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: advanced videography testing; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.

  1. Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

    SciTech Connect

    Bill Stanley; Sandra Brown; Patrick Gonzalez; Zoe Kant; Gilberto Tiepolo; Wilber Sabido; Ellen Hawes; Jenny Henman; Miguel Calmon; Michael Ebinger

    2004-07-10

    The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects, providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas impacts. The research described in this report occurred between July 1, 2002 and June 30, 2003. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: remote sensing for carbon analysis; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.

  2. APPLICATION AND DEVELOPMENT OF APPROPRIATE TOOLS AND TECHNOLOGIES FOR COST-EFFECTIVE CARBON

    SciTech Connect

    Bill Stanley; Sandra Brown; Ellen Hawes; Zoe Kant; Miguel Calmon; Patrick Gonzalez; Brad Kreps; Gilberto Tiepolo

    2003-09-01

    The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects, providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas impacts. The research described in this report occurred between July 1, 2002 and June 30, 2003. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: advanced videography testing; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.

  3. Improvement Strategies, Cost Effective Production, and Potential Applications of Fungal Glucose Oxidase (GOD): Current Updates

    PubMed Central

    Dubey, Manish K.; Zehra, Andleeb; Aamir, Mohd; Meena, Mukesh; Ahirwal, Laxmi; Singh, Siddhartha; Shukla, Shruti; Upadhyay, Ram S.; Bueno-Mari, Ruben; Bajpai, Vivek K.

    2017-01-01

    Fungal glucose oxidase (GOD) is widely employed in the different sectors of food industries for use in baking products, dry egg powder, beverages, and gluconic acid production. GOD also has several other novel applications in chemical, pharmaceutical, textile, and other biotechnological industries. The electrochemical suitability of GOD catalyzed reactions has enabled its successful use in bioelectronic devices, particularly biofuel cells, and biosensors. Other crucial aspects of GOD such as improved feeding efficiency in response to GOD supplemental diet, roles in antimicrobial activities, and enhancing pathogen defense response, thereby providing induced resistance in plants have also been reported. Moreover, the medical science, another emerging branch where GOD was recently reported to induce several apoptosis characteristics as well as cellular senescence by downregulating Klotho gene expression. These widespread applications of GOD have led to increased demand for more extensive research to improve its production, characterization, and enhanced stability to enable long term usages. Currently, GOD is mainly produced and purified from Aspergillus niger and Penicillium species, but the yield is relatively low and the purification process is troublesome. It is practical to build an excellent GOD-producing strain. Therefore, the present review describes innovative methods of enhancing fungal GOD production by using genetic and non-genetic approaches in-depth along with purification techniques. The review also highlights current research progress in the cost effective production of GOD, including key advances, potential applications and limitations. Therefore, there is an extensive need to commercialize these processes by developing and optimizing novel strategies for cost effective GOD production. PMID:28659876

  4. 76 FR 36625 - Application and Termination Notice for Municipal Securities Dealer Principal or Representative

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ... Office of Thrift Supervision Application and Termination Notice for Municipal Securities Dealer Principal.... Title of Proposal: Application and Termination Notice for Municipal Securities Dealer Principal or... certain FSA employees that act as municipal securities dealer principals or representatives, and are...

  5. Geographic Resource Allocation Based on Cost Effectiveness: An Application to Malaria Policy.

    PubMed

    Drake, Tom L; Lubell, Yoel; Kyaw, Shwe Sin; Devine, Angela; Kyaw, Myat Phone; Day, Nicholas P J; Smithuis, Frank M; White, Lisa J

    2017-02-10

    Healthcare services are often provided to a country as a whole, though in many cases the available resources can be more effectively targeted to specific geographically defined populations. In the case of malaria, risk is highly geographically heterogeneous, and many interventions, such as insecticide-treated bed nets and malaria community health workers, can be targeted to populations in a way that maximises impact for the resources available. This paper describes a framework for geographically targeted budget allocation based on the principles of cost-effectiveness analysis and applied to priority setting in malaria control and elimination. The approach can be used with any underlying model able to estimate intervention costs and effects given relevant local data. Efficient geographic targeting of core malaria interventions could significantly increase the impact of the resources available, accelerating progress towards elimination. These methods may also be applicable to priority setting in other disease areas.

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

    PubMed

    Feliciano-Ramos, Ileana; Casañas-Montes, Barbara; García-Maldonado, María M; Menéndez, Christian L; Mayol, Ana R; Díaz-Vázquez, Liz M; Cabrera, Carlos R

    2015-02-10

    Nanotechnology allows the synthesis of nanoscale catalysts, which offer an efficient alternative for fuel cell applications. In this laboratory experiment, the student selects a cost-effective anode for fuel cells by comparing three different working electrodes. These are commercially available palladium (Pd) and glassy carbon (GC) electrodes, and a carbon paste (CP) electrode that is prepared by the students in the laboratory. The GC and CP were modified with palladium nanoparticles (PdNP) suspensions. The electrodes efficiencies were studied for ethanol oxidation in alkaline solution using cyclic voltammetry techniques. The ethanol oxidation currents obtained were used to determine the current density using the geometric and surface area of each electrode. Finally, students were able to choose the best electrode and relate catalytic activity to surface area for ethanol oxidation in alkaline solution by completing a critical analysis of the cyclic voltammetry results. With this activity, fundamental electrochemical concepts were reinforced.

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

    PubMed Central

    2015-01-01

    Nanotechnology allows the synthesis of nanoscale catalysts, which offer an efficient alternative for fuel cell applications. In this laboratory experiment, the student selects a cost-effective anode for fuel cells by comparing three different working electrodes. These are commercially available palladium (Pd) and glassy carbon (GC) electrodes, and a carbon paste (CP) electrode that is prepared by the students in the laboratory. The GC and CP were modified with palladium nanoparticles (PdNP) suspensions. The electrodes efficiencies were studied for ethanol oxidation in alkaline solution using cyclic voltammetry techniques. The ethanol oxidation currents obtained were used to determine the current density using the geometric and surface area of each electrode. Finally, students were able to choose the best electrode and relate catalytic activity to surface area for ethanol oxidation in alkaline solution by completing a critical analysis of the cyclic voltammetry results. With this activity, fundamental electrochemical concepts were reinforced. PMID:25691801

  8. Cost-effective fiber multiplexing system based on low coherence interferometers and application to temperature measurement

    NASA Astrophysics Data System (ADS)

    Jiang, Meng; Zhao, Zhongze; Li, Kun; Wang, Zeming; Zhan, Yage; Zhou, Hongying; Yang, Fu

    2016-12-01

    Based on the low-coherence interferometric principles, a cost-effective all-fiber Mach-Zehnder multiplexing system is proposed and demonstrated. The system consists of two interferometers: sensing interferometer and demodulation interferometer. By scanning an optical tunable delay line back and forth constantly with a stable speed, sensing fibers with different optical paths can be temporal interrogated. The system is experimentally proved to have a high performance with a good stability and low system noises. The multiplexing capacity of the system is also investigated. An experiment of measuring the surrounding temperature is carried out. A sensitivity of 12 μm/°C is achieved within the range of 20°C to 80°C. This low cost fiber multiplexing system has a potential application in the remote monitoring of temperature and strain in building structures, such as bridges and towers.

  9. Cost-effective applications of photovoltaics for electric utilities: An overview

    SciTech Connect

    Bigger, J.E.

    1993-12-31

    Cost targets for the large-scale entry of photovoltaic (PV) systems keep moving, subject to the vagaries of global oil prices and the economic health of the world. Over the last four decades since a practical PV device was announced, costs have come down by a factor of 20 or more and this downward trend is expected to continue, albeit at a slower pace. Simultaneously, conversion efficiencies have nearly tripled. There are many applications today for which PV is cost-effective. In recognition of this, utility interest in PV is increasing and this is manifested by projects such as PVUSA and Central and South West`s renewable resource development effort. While no major technical barriers for the entry of PV systems have been uncovered, several key issues such as power quality, system reliability, ramp rates, spinning reserve requirements, and misoperation of protection schemes will have to be dealt with as the penetration of this technology increases. PV is still in the evolutionary phase and is expected to grow for several decades to come. Fueled by environmental considerations, interest in PV is showing a healthy rise both in the minds of the public and in the planning realms of the electric power community. In recognition of this, the Energy Development Subcommittee of the IEEE Energy Development and Power Generation Committee organized a Panel Session on photovoltaics applications at the 1993 International Joint Power Generation Conference held in Kansas City, Missouri. Summaries of the four presentations are assembled here for the benefit of the readers of this Review.

  10. Cognitive behavior therapy via the Internet: a systematic review of applications, clinical efficacy and cost-effectiveness.

    PubMed

    Hedman, Erik; Ljótsson, Brjánn; Lindefors, Nils

    2012-12-01

    Internet-based cognitive behavior therapy (ICBT) is a promising treatment that may increase availability of cognitive behavior therapy (CBT) for psychiatric disorders and other clinical problems. The main objective of this study was to determine the applications, clinical efficacy and cost-effectiveness of ICBT. The authors conducted a systematic review to identify randomized controlled trials investigating CBT delivered via the internet for adult patient populations. Searches to identify studies investigating cost-effectiveness of ICBT were also conducted. Evidence status for each clinical application was determined using the American Psychologist Association criteria for empirically supported treatments. Of 1104 studies reviewed, 108 met criteria for inclusion, of which 103 reported on clinical efficacy and eight on cost-effectiveness. Results showed that ICBT has been tested for 25 different clinical disorders, whereas most randomized controlled trials have been aimed at depression, anxiety disorders and chronic pain. Internet-based treatments for depression, social phobia and panic disorder were classified as well-established, that is, meeting the highest level of criteria for evidence. Effect sizes were large in the treatment of depression, anxiety disorders, severe health anxiety, irritable bowel syndrome, female sexual dysfunction, eating disorders, cannabis use and pathological gambling. For other clinical problems, effect sizes were small to moderate. Comparison to conventional CBT showed that ICBT produces equivalent effects. Cost-effectiveness data were relatively scarce but suggested that ICBT has more than 50% probability of being cost effective compared with no treatment or to conventional CBT when willingness to pay for an additional improvement is zero. Although ICBT is a promising treatment option for several disorders, it can only be regarded as a well-established treatment for depression, panic disorder and social phobia. It seems that ICBT is as

  11. Application of Bayesian Approach to Cost-Effectiveness Analysis of Antiviral Treatments in Chronic Hepatitis B.

    PubMed

    Zhang, Hua; Huo, Mingdong; Chao, Jianqian; Liu, Pei

    2016-01-01

    Hepatitis B virus (HBV) infection is a major problem for public health; timely antiviral treatment can significantly prevent the progression of liver damage from HBV by slowing down or stopping the virus from reproducing. In the study we applied Bayesian approach to cost-effectiveness analysis, using Markov Chain Monte Carlo (MCMC) simulation methods for the relevant evidence input into the model to evaluate cost-effectiveness of entecavir (ETV) and lamivudine (LVD) therapy for chronic hepatitis B (CHB) in Jiangsu, China, thus providing information to the public health system in the CHB therapy. Eight-stage Markov model was developed, a hypothetical cohort of 35-year-old HBeAg-positive patients with CHB was entered into the model. Treatment regimens were LVD100mg daily and ETV 0.5 mg daily. The transition parameters were derived either from systematic reviews of the literature or from previous economic studies. The outcome measures were life-years, quality-adjusted lifeyears (QALYs), and expected costs associated with the treatments and disease progression. For the Bayesian models all the analysis was implemented by using WinBUGS version 1.4. Expected cost, life expectancy, QALYs decreased with age. Cost-effectiveness increased with age. Expected cost of ETV was less than LVD, while life expectancy and QALYs were higher than that of LVD, ETV strategy was more cost-effective. Costs and benefits of the Monte Carlo simulation were very close to the results of exact form among the group, but standard deviation of each group indicated there was a big difference between individual patients. Compared with lamivudine, entecavir is the more cost-effective option. CHB patients should accept antiviral treatment as soon as possible as the lower age the more cost-effective. Monte Carlo simulation obtained costs and effectiveness distribution, indicate our Markov model is of good robustness.

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

    PubMed

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

    2014-02-01

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

  13. Solar thermoelectricity via advanced latent heat storage: A cost-effective small-scale CSP application

    NASA Astrophysics Data System (ADS)

    Glatzmaier, G. C.; Rea, J.; Olsen, M. L.; Oshman, C.; Hardin, C.; Alleman, J.; Sharp, J.; Weigand, R.; Campo, D.; Hoeschele, G.; Parilla, P. A.; Siegel, N. P.; Toberer, E. S.; Ginley, D. S.

    2017-06-01

    We are developing a novel concentrating solar electricity-generating technology that is both modular and dispatchable. Solar ThermoElectricity via Advanced Latent heat Storage (STEALS) uses concentrated solar flux to generate high-temperature thermal energy, which directly converts to electricity via thermoelectric generators (TEGs), stored within a phase-change material (PCM) for electricity generation at a later time, or both allowing for simultaneous charging of the PCM and electricity generation. STEALS has inherent features that drive its cost-competitive scale to be much smaller than current commercial concentrating solar power (CSP) plants. Most obvious is modularity of the solid-state TEG, which favors smaller scales in the kilowatt range as compared to CSP steam turbines, which are minimally 50 MWe for commercial power plants. Here, we present techno-economic and market analyses that show STEALS can be a cost-effective electricity-generating technology with particular appeal to small-scale microgrid applications. We evaluated levelized cost of energy (LCOE) for STEALS and for a comparable photovoltaic (PV) system with battery storage. For STEALS, we estimated capital costs and the LCOE as functions of the type of PCM including the use of recycled aluminum alloys, and evaluated the cost tradeoffs between plasma spray coatings and solution-based boron coatings that are applied to the wetted surfaces of the PCM subsystem. We developed a probabilistic cost model that accounts for uncertainties in the cost and performance inputs to the LCOE estimation. Our probabilistic model estimated LCOE for a 100-kWe STEALS system that had 5 hours of thermal storage and 8-10 hours of total daily power generation. For these cases, the solar multiple for the heliostat field varied between 1.12 and 1.5. We identified microgrids as a likely market for the STEALS system. We characterized microgrid markets in terms of nominal power, dispatchability, geographic location, and

  14. Cost-effectiveness of MODY genetic testing: translating genomic advances into practical health applications.

    PubMed

    Naylor, Rochelle N; John, Priya M; Winn, Aaron N; Carmody, David; Greeley, Siri Atma W; Philipson, Louis H; Bell, Graeme I; Huang, Elbert S

    2014-01-01

    OBJECTIVE To evaluate the cost-effectiveness of a genetic testing policy for HNF1A-, HNF4A-, and GCK-MODY in a hypothetical cohort of type 2 diabetic patients 25-40 years old with a MODY prevalence of 2%. RESEARCH DESIGN AND METHODS We used a simulation model of type 2 diabetes complications based on UK Prospective Diabetes Study data, modified to account for the natural history of disease by genetic subtype to compare a policy of genetic testing at diabetes diagnosis versus a policy of no testing. Under the screening policy, successful sulfonylurea treatment of HNF1A-MODY and HNF4A-MODY was modeled to produce a glycosylated hemoglobin reduction of -1.5% compared with usual care. GCK-MODY received no therapy. Main outcome measures were costs and quality-adjusted life years (QALYs) based on lifetime risk of complications and treatments, expressed as the incremental cost-effectiveness ratio (ICER) (USD/QALY). RESULTS The testing policy yielded an average gain of 0.012 QALYs and resulted in an ICER of 205,000 USD. Sensitivity analysis showed that if the MODY prevalence was 6%, the ICER would be ~50,000 USD. If MODY prevalence was >30%, the testing policy was cost saving. Reducing genetic testing costs to 700 USD also resulted in an ICER of ~50,000 USD. CONCLUSIONS Our simulated model suggests that a policy of testing for MODY in selected populations is cost-effective for the U.S. based on contemporary ICER thresholds. Higher prevalence of MODY in the tested population or decreased testing costs would enhance cost-effectiveness. Our results make a compelling argument for routine coverage of genetic testing in patients with high clinical suspicion of MODY.

  15. Cost-Effectiveness of MODY Genetic Testing: Translating Genomic Advances Into Practical Health Applications

    PubMed Central

    Naylor, Rochelle N.; John, Priya M.; Winn, Aaron N.; Carmody, David; Greeley, Siri Atma W.; Philipson, Louis H.; Bell, Graeme I.; Huang, Elbert S.

    2014-01-01

    OBJECTIVE To evaluate the cost-effectiveness of a genetic testing policy for HNF1A-, HNF4A-, and GCK-MODY in a hypothetical cohort of type 2 diabetic patients 25–40 years old with a MODY prevalence of 2%. RESEARCH DESIGN AND METHODS We used a simulation model of type 2 diabetes complications based on UK Prospective Diabetes Study data, modified to account for the natural history of disease by genetic subtype to compare a policy of genetic testing at diabetes diagnosis versus a policy of no testing. Under the screening policy, successful sulfonylurea treatment of HNF1A-MODY and HNF4A-MODY was modeled to produce a glycosylated hemoglobin reduction of −1.5% compared with usual care. GCK-MODY received no therapy. Main outcome measures were costs and quality-adjusted life years (QALYs) based on lifetime risk of complications and treatments, expressed as the incremental cost-effectiveness ratio (ICER) (USD/QALY). RESULTS The testing policy yielded an average gain of 0.012 QALYs and resulted in an ICER of 205,000 USD. Sensitivity analysis showed that if the MODY prevalence was 6%, the ICER would be ∼50,000 USD. If MODY prevalence was >30%, the testing policy was cost saving. Reducing genetic testing costs to 700 USD also resulted in an ICER of ∼50,000 USD. CONCLUSIONS Our simulated model suggests that a policy of testing for MODY in selected populations is cost-effective for the U.S. based on contemporary ICER thresholds. Higher prevalence of MODY in the tested population or decreased testing costs would enhance cost-effectiveness. Our results make a compelling argument for routine coverage of genetic testing in patients with high clinical suspicion of MODY. PMID:24026547

  16. Cost-effectiveness of Sativex in multiple sclerosis spasticity: new data and application to Italy.

    PubMed

    Slof, John; Ruiz, Leonardo; Vila, Carlos

    2015-06-01

    Multiple sclerosis (MS) is a chronic progressive disease that carries a high socioeconomic burden. Spasticity (rigidity and spasms) is common in MS and contributes to MS-related disability. This study aims to evaluate the cost-effectiveness of Sativex(®) (9-delta-tetrahydrocannabinol plus cannabidiol oromucosal spray) when used as add-on therapy for management of resistant MS-related spasticity in the context of the Italian healthcare system. A previously published Markov model-based analysis for the German and Spanish context was replicated, adapting it to the Italian setting. Model parameters were updated to reflect recent findings about MS-related spasticity and use of Sativex in daily clinical practice. The base case incremental cost-effectiveness ratio for Sativex use in Italy over a 5-year period was estimated to be €4968 per quality-adjusted life-year gained (year of costing: 2013). Sativex remained an efficient option in the Italian healthcare context - below the commonly accepted incremental threshold of €30,000 per quality-adjusted life-year gained - when deterministic and probabilistic sensitivity analyses were conducted. Sativex can be regarded as a cost-effective treatment option for patients with MS-related spasticity in Italy.

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

    PubMed

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

    2014-11-01

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

  18. Application of Graph Theory to Cost-Effective Fire Protection of Chemical Plants During Domino Effects.

    PubMed

    Khakzad, Nima; Landucci, Gabriele; Reniers, Genserik

    2017-09-01

    In the present study, we have introduced a methodology based on graph theory and multicriteria decision analysis for cost-effective fire protection of chemical plants subject to fire-induced domino effects. By modeling domino effects in chemical plants as a directed graph, the graph centrality measures such as out-closeness and betweenness scores can be used to identify the installations playing a key role in initiating and propagating potential domino effects. It is demonstrated that active fire protection of installations with the highest out-closeness score and passive fire protection of installations with the highest betweenness score are the most effective strategies for reducing the vulnerability of chemical plants to fire-induced domino effects. We have employed a dynamic graph analysis to investigate the impact of both the availability and the degradation of fire protection measures over time on the vulnerability of chemical plants. The results obtained from the graph analysis can further be prioritized using multicriteria decision analysis techniques such as the method of reference point to find the most cost-effective fire protection strategy. © 2016 Society for Risk Analysis.

  19. 76 FR 20820 - Application and Termination Notice for Municipal Securities Dealer Principal or Representative

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... Office of Thrift Supervision Application and Termination Notice for Municipal Securities Dealer Principal...: Application and Termination Notice for Municipal Securities Dealer Principal or Representative. OMB Number... employees that act as municipal securities dealer principals or representatives, and are submitted to OTS...

  20. Portable and cost-effective pixel super-resolution on-chip microscope for telemedicine applications.

    PubMed

    Bishara, Waheb; Sikora, Uzair; Mudanyali, Onur; Su, Ting-Wei; Yaglidere, Oguzhan; Luckhart, Shirley; Ozcan, Aydogan

    2011-01-01

    We report a field-portable lensless on-chip microscope with a lateral resolution of <1 μm and a large field-of-view of ~24 mm(2). This microscope is based on digital in-line holography and a pixel super-resolution algorithm to process multiple lensfree holograms and obtain a single high-resolution hologram. In its compact and cost-effective design, we utilize 23 light emitting diodes butt-coupled to 23 multi-mode optical fibers, and a simple optical filter, with no moving parts. Weighing only ~95 grams, we demonstrate the performance of this field-portable microscope by imaging various objects including human malaria parasites in thin blood smears.

  1. In-Office Application of Fluoride Gel or Varnish: Cost-Effectiveness and Expected Value of Perfect Information Analysis.

    PubMed

    Schwendicke, Falk; Stolpe, Michael

    2017-04-08

    Application of fluoride gel/varnish (FG/FV) reduces caries increments but generates costs. Avoiding restorative treatments by preventing caries might compensate for these costs. We assessed the cost-effectiveness of dentists applying FG/FV in office and the expected value of perfect information (EVPI). EVPI analyses estimate the economic value of having perfect knowledge, assisting research resource allocation. A mixed public-private-payer perspective in Germany was adopted. A population of 12-year-olds was followed over their lifetime, with caries increments modelled using wide intervals to reflect the uncertainty of caries risk. Biannual application of FV/FG until age 18 years was compared to no fluoride application. Effectiveness parameters and their uncertainty were derived from systematic reviews. The health outcome was caries increment (decayed, missing, or filled teeth; DMFT). Cost calculations were based on fee catalogs or microcosting, including costs for individual-prophylactic fluoridation and, for FG, an individualized tray, plus material costs. Microsimulations, sensitivity, and EVPI analyses were performed. On average and applied to a largely low-risk population, no application of fluoride was least costly but also least effective (EUR 230; 11 DMFT). FV was more costly and effective (EUR 357; 7 DMFT). FG was less effective than FV and also more costly when using individualized trays. FV was the best choice for payers willing to invest EUR 39 or more per avoided DMFT. This cost-effectiveness will differ in different settings/countries or if FG/FV is applied by other care professionals. The EVPI was mainly driven by the individual's caries risk, as FV/FG were significantly more cost-effective in high-risk populations than in low-risk ones. Future studies should focus on caries risk prediction.

  2. Tetanus Quick Stick as an applicable and cost-effective test in assessment of immunity status.

    PubMed

    Hatamabadi, Hamid Reza; Abdalvand, Ali; Safari, Saeed; Kariman, Hamid; Dolatabadi, Ali Arhami; Shahrami, Ali; Alimohammadi, Hossein; Hosseini, Mostafa

    2011-09-01

    Tetanus vaccine and immunoglobulin administration are challenging decisions mostly because of the fact that the current protocol for immunization against tetanus is based on 2 variables: the vaccination status of the patient and the nature of wound and its exposure. To solve this problem, Tetanus Quick Stick (TQS; Nephrotek Laboratory, Rungis, France), an immunochromatographic dipstick test, was developed to determine the tetanus immunity of the patients. The aim of this present study was to investigate the sensitivity, specificity, and the positive and negative predictive values and cost-effectiveness of TQS in the emergency department (ED) setting. Blood samples were collected from 200 patients presenting to our ED. Information including demographic information, tetanus immunization status, wound description, and the preventive measures taken by the emergency physician were gathered by a preeducated nurse. Tetanus Quick Stick test and enzyme-linked immunosorbent assay were performed as the standard diagnostic test by an emergency physician and a laboratory technician, respectively; and results of the 2 techniques were compared. Overall, tetanus vaccine was administered to 141(70.5%) patients and immunoglobulin to 105 (52.5%) patients. The analysis revealed 88.1% sensitivity and 97.6% specificity for the TQS test. The positive and negative predictive values of TQS test were 99.3% and 66.1%, respectively. Our analysis is also showed a significant decrease in cost when TQS was applied for patients with dirty, tetanus prone wounds or injuries and unknown or incomplete vaccination history (€ 9.48 versus € 12.1). This study revealed TQS test to be appropriate and cost-effective for ED use especially in evaluating patients who do not remember or cannot give their tetanus immunization history. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Cost effective spectral sensor solutions for hand held and field applications

    NASA Astrophysics Data System (ADS)

    Reetz, Edgar; Correns, Martin; Notni, Gunther

    2015-05-01

    Optical spectroscopy is without doubt one of the most important non-contact measurement principles. It is used in a wide range of applications from bio-medical to industrial fields. One recent trend is to miniaturize spectral sensors to address new areas of application. The most common spectral sensor type is based on diffraction gratings, while other types are based on micro mechanical systems (MEMS) or filter technologies. The authors represent the opinion that there is a potentially wide spread field of applications for spectrometers, but the market limits the range of applications since they cannot keep up with targeted cost requirements for consumer products. The present article explains an alternative approach for miniature multichannel spectrometer to enhance robustness for hand held field applications at a cost efficient price point.

  4. Cost-effective application of thermal protection on LPG road transport tanks for risk reduction due to hot BLEVE incidents.

    PubMed

    Birk, A M

    2014-06-01

    A simplified risk and cost-benefit analysis is presented for the application of thermal protection (TP) on propane and LPG highway tanker trucks operating in North America. A risk analysis is performed to determine the benefits of risk reduction by TP, relative to the costs of applying and maintaining TP on a tanker truck. The results show that TP is cost effective if the tanker truck spends enough time (or travels enough distance) in areas of moderate or high population density. The analysis is very sensitive to a number of inputs, including: (i) value of life, (ii) hot boiling liquid expanding vapor explosion frequency, (iii) public exposure to severe hazards, and (iv) life cost of TP. With this simplified analysis, it is possible to generate tanker truck exposure times to the public that justify the application of TP based on cost and benefit considerations. © 2013 Society for Risk Analysis.

  5. A Cost Effectiveness Analysis of Using Alternate Materials for Non-Skid in Shipboard Applications

    DTIC Science & Technology

    2003-06-01

    Applications By: Kurt P. Boenisch, Hector A. Cervantes , Andrew J. Clark IV, Jesse G. Espe, and Erik B. Lohrke June...AUTHOR(S) LT Kurt P. Boenisch, United States Navy, LT Andrew J. Clark IV, United States Navy, LT Hector A. Cervantes , United States Navy, LT Jesse G...MATERIALS FOR NON-SKID IN SHIPBOARD APPLICATIONS Kurt P. Boenisch, Lieutenant, United States Navy Hector A. Cervantes , Lieutenant, United States

  6. Technical Progress Report on Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

    SciTech Connect

    Bill Stanley; Patrick Gonzalez; Sandra Brown; Jenny Henman; Ben Poulter; Sarah Woodhouse Murdock; Neil Sampson; Tim Pearson; Sarah Walker; Zoe Kant; Miguel Calmon; Gilberto Tiepolo

    2006-06-30

    The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects, providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas reductions. The research described in this report occurred between April 1st and July 30th 2006. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: emerging technologies for remote sensing of terrestrial carbon; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool. Work is being carried out in Brazil, Belize, Chile, Peru and the USA.

  7. Cost-effective manufacturing of compact TDLAS sensors for hazardous area applications

    NASA Astrophysics Data System (ADS)

    Frish, Michael B.; Laderer, Mathew C.; Smith, Clinton J.; Ehid, Ryan; Dallas, Joseph

    2016-03-01

    Tunable Diode Laser Absorption Spectroscopy (TDLAS) is finding ever increasing utility for industrial process measurement and control. The technique's sensitivity and selectivity benefit continuous concentration measurements of specific gas components in complex gas mixtures which are often laden with liquids or solid particulates. Tradeoff options among optical path length, absorption linestrength, linewidth, cross-interferences, and sampling methodology enable sensor designers to optimize detection for specific applications. Emerging applications are demanding increasing numbers of distributed miniaturized sensors at diminishing costs. In these applications, the TDLAS specificity is a key attribute, and its high sensitivity enables novel sampling package designs with short optical path lengths. This paper describes a miniature hermetically-sealed backscatter TDLAS transceiver package designed for high-volume production at acceptable cost. Occupying a volume less than 1in3 and weighing less than 0.06 lb, the transceiver is a key component of TDLAS sensors intended for in-situ measurements of potentially explosive gas mixtures.

  8. Technical Report on Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

    SciTech Connect

    Bill Stanley; Sandra Brown; Zoe Kant; Patrick Gonzalez

    2009-01-07

    The Nature Conservancy participated in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project was 'Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration'. The objectives of the project were to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects, providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Final Technical Report discusses the results of the six tasks that The Nature Conservancy undertook to answer research needs while facilitating the development of real projects with measurable greenhouse gas reductions. The research described in this report occurred between July 1st 2001 and July 10th 2008. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: emerging technologies for remote sensing of terrestrial carbon; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool. The project occurred in two phases. The first was a focused exploration of specific carbon measurement and monitoring methodologies and pre-selected carbon sequestration opportunities. The second was a more systematic and comprehensive approach to compare various competing measurement and monitoring methodologies, and assessment of a variety of carbon sequestration opportunities in order to find those that are the lowest cost with the greatest combined carbon and other environmental

  9. Design investigation of a cost-effective dual-band (MWIR/LWIR) and a wide band optically athermalized application

    NASA Astrophysics Data System (ADS)

    Ding, Fujian; Washer, Joe; Morgen, Daniel

    2016-10-01

    Dual-band and wide-band lenses covering both the MWIR and LWIR spectral bands are increasingly needed as dualband MWIR/LWIR detectors have become prevalent and broadband applications have expanded. Currently in dual-band /wide-band applications, the use of more than three elements per lens group and the use of chalcogenide glass is common. This results in expensive systems. Also, many chalcogenides are available only in small diameters, which is a problem for large aperture broadband lenses. In this paper an investigation of cost-effective designs for dual-band MWIR/LWIR lens using only widely available IR materials, specifically Ge, ZnSe and ZnS were performed. An athermalized dual-band MWIR/LWIR using these three materials is presented. The performance analysis of this lens shows that this design form with these three common IR materials works well in certain applications. The required large size blanks of these materials can be easily obtained. Traditional chromatic aberration correction without diffraction for either wide-band or dual-band application was employed. In addition, the methods of harmonic diffraction for dual-band applications, especially with one narrow band, were used for two different presented designs.

  10. Report on Cost-Effectiveness and Energy Svaings from Application of Low-Cost Wireless Sensing

    SciTech Connect

    Kintner-Meyer, Michael CW; Skorpik, James R.; Reid, Larry D.

    2004-12-02

    This report characterizes commercially available wireless technologies that are already being used in building applications or that are suitable for use in commercial buildings. The discussion provides an overview of fundamental concepts of radial broadcasting systems, as well as mesh networks, and will highlight the opportunities and challenges in their integration into existing wired control networks. This report describes two demonstration projects of wireless sensors and their integration into existing control networks and discusses their cost per sensor, their ease of installation, and their reliability. It also describes the load control strategies implemented as a consequence of having the additional data provided by the wireless sensors and provides estimates of the resulting energy and cost savings. The report concludes with presentation of some general future prospects for wireless technologies in buildings applications.

  11. Phenolics for high temperature applications in small engine technologies (cost effective performance advantages)

    SciTech Connect

    Brosius, D.; Jones, R.

    1995-12-31

    Plastic materials have made significant progress in small engine components. Most of these applications have been in external parts like fan shrouds and fuel tanks. Meeting new emissions requirements, along with reducing noise and more compact engine styling will require plastic materials which perform at higher temperatures than those typically used to date, as well as materials which can replace mechanical parts now produced in metal. This paper presents mechanical performance data at temperatures up to 200 C for several engineering phenolic compounds. Also reviewed are fluid resistance, fatigue endurance, and examples of phenolics in production components in small engines.

  12. A Cost-Effective Fluorescence Mini-Microscope with Adjustable Magnifications for Biomedical Applications

    PubMed Central

    Zhang, Yu Shrike; Ribas, João; Nadhman, Akhtar; Aleman, Julio; Selimović, Šeila; Lesher-Perez, Sasha Cai; Wang, Ting; Manoharan, Vijayan; Shin, Su-Ryon; Damilano, Alessia; Annabi, Nasim; Dokmeci, Mehmet Remzi; Takayama, Shuichi; Khademhosseini, Ali

    2015-01-01

    We have designed and fabricated a miniature microscope from off-the-shelf components and webcam, with built-in fluorescence capability for biomedical applications. The mini-microscope was able to detect both biochemical parameters such as cell/tissue viability (e.g. Live/Dead assay), and biophysical properties of the microenvironment such as oxygen levels in microfabricated tissues based on an oxygen-sensitive fluorescent dye. This mini-microscope has adjustable magnifications from 8-60X, achieves a resolution as high as <2 μm, and possesses a long working distance of 4.5 mm (at a magnification of 8X). The mini-microscope was able to chronologically monitor cell migration and analyze beating of microfluidic liver and cardiac bioreactors in real time, respectively. The mini-microscope system is cheap, and its modularity allows convenient integration with a wide variety of pre-existing platforms including but not limited to, cell culture plates, microfluidic devices, and organs-on-a-chip systems. Therefore, we envision its widespread applications in cell biology, tissue engineering, biosensing, microfluidics, and organs-on-chips, which can potentially replace conventional bench-top microscopy where long-term in situ and large-scale imaging/analysis is required. PMID:26282117

  13. A cost-effective fluorescence mini-microscope for biomedical applications.

    PubMed

    Zhang, Yu Shrike; Ribas, João; Nadhman, Akhtar; Aleman, Julio; Selimović, Šeila; Lesher-Perez, Sasha Cai; Wang, Ting; Manoharan, Vijayan; Shin, Su-Ryon; Damilano, Alessia; Annabi, Nasim; Dokmeci, Mehmet Remzi; Takayama, Shuichi; Khademhosseini, Ali

    2015-01-01

    We have designed and fabricated a miniature microscope from off-the-shelf components and a webcam, with built-in fluorescence capability for biomedical applications. The mini-microscope was able to detect both biochemical parameters, such as cell/tissue viability (e.g. live/dead assay), and biophysical properties of the microenvironment such as oxygen levels in microfabricated tissues based on an oxygen-sensitive fluorescent dye. This mini-microscope has adjustable magnifications from 8-60×, achieves a resolution as high as <2 μm, and possesses a long working distance of 4.5 mm (at a magnification of 8×). The mini-microscope was able to chronologically monitor cell migration and analyze beating of microfluidic liver and cardiac bioreactors in real time, respectively. The mini-microscope system is cheap, and its modularity allows convenient integration with a wide variety of pre-existing platforms including, but not limited to, cell culture plates, microfluidic devices, and organs-on-a-chip systems. Therefore, we envision its widespread application in cell biology, tissue engineering, biosensing, microfluidics, and organs-on-chips, which can potentially replace conventional bench-top microscopy where long-term in situ and large-scale imaging/analysis is required.

  14. A new cost-effective method to mitigate ammonia loss from intensive cattle feedlots: application of lignite

    PubMed Central

    Chen, Deli; Sun, Jianlei; Bai, Mei; Dassanayake, Kithsiri B.; Denmead, Owen T.; Hill, Julian

    2015-01-01

    In open beef feedlot systems, more than 50% of dietary nitrogen (N) is lost as ammonia (NH3). Here we report an effective and economically-viable method to mitigate NH3 emissions by the application of lignite. We constructed two cattle pens (20 × 20 m) to determine the effectiveness of lignite in reducing NH3 emissions. Twenty-four steers were fed identical commercial rations in each pen. The treatment pen surface was dressed with 4.5 kg m−2 lignite dry mass while no lignite was applied in the control pen. We measured volatilised NH3 concentrations using Ecotech EC9842 NH3 analysers in conjunction with a mass balance method to calculate NH3 fluxes. Application of lignite decreased NH3 loss from the pen by approximately 66%. The cumulative NH3 losses were 6.26 and 2.13 kg N head−1 in the control and lignite treatment, respectively. In addition to the environmental benefits of reduced NH3 losses, the value of retained N nutrient in the lignite treated manure is more than $37 AUD head−1 yr−1, based on the current fertiliser cost and estimated cost of lignite application. We show that lignite application is a cost-effective method to reduce NH3 loss from cattle feedlots. PMID:26584639

  15. A new cost-effective method to mitigate ammonia loss from intensive cattle feedlots: application of lignite

    NASA Astrophysics Data System (ADS)

    Chen, Deli; Sun, Jianlei; Bai, Mei; Dassanayake, Kithsiri B.; Denmead, Owen T.; Hill, Julian

    2015-11-01

    In open beef feedlot systems, more than 50% of dietary nitrogen (N) is lost as ammonia (NH3). Here we report an effective and economically-viable method to mitigate NH3 emissions by the application of lignite. We constructed two cattle pens (20 × 20 m) to determine the effectiveness of lignite in reducing NH3 emissions. Twenty-four steers were fed identical commercial rations in each pen. The treatment pen surface was dressed with 4.5 kg m-2 lignite dry mass while no lignite was applied in the control pen. We measured volatilised NH3 concentrations using Ecotech EC9842 NH3 analysers in conjunction with a mass balance method to calculate NH3 fluxes. Application of lignite decreased NH3 loss from the pen by approximately 66%. The cumulative NH3 losses were 6.26 and 2.13 kg N head-1 in the control and lignite treatment, respectively. In addition to the environmental benefits of reduced NH3 losses, the value of retained N nutrient in the lignite treated manure is more than $37 AUD head-1 yr-1, based on the current fertiliser cost and estimated cost of lignite application. We show that lignite application is a cost-effective method to reduce NH3 loss from cattle feedlots.

  16. A new cost-effective method to mitigate ammonia loss from intensive cattle feedlots: application of lignite.

    PubMed

    Chen, Deli; Sun, Jianlei; Bai, Mei; Dassanayake, Kithsiri B; Denmead, Owen T; Hill, Julian

    2015-11-20

    In open beef feedlot systems, more than 50% of dietary nitrogen (N) is lost as ammonia (NH3). Here we report an effective and economically-viable method to mitigate NH3 emissions by the application of lignite. We constructed two cattle pens (20 × 20 m) to determine the effectiveness of lignite in reducing NH3 emissions. Twenty-four steers were fed identical commercial rations in each pen. The treatment pen surface was dressed with 4.5 kg m(-2) lignite dry mass while no lignite was applied in the control pen. We measured volatilised NH3 concentrations using Ecotech EC9842 NH3 analysers in conjunction with a mass balance method to calculate NH3 fluxes. Application of lignite decreased NH3 loss from the pen by approximately 66%. The cumulative NH3 losses were 6.26 and 2.13 kg N head(-1) in the control and lignite treatment, respectively. In addition to the environmental benefits of reduced NH3 losses, the value of retained N nutrient in the lignite treated manure is more than $37 AUD head(-1) yr(-1), based on the current fertiliser cost and estimated cost of lignite application. We show that lignite application is a cost-effective method to reduce NH3 loss from cattle feedlots.

  17. In-plane cost-effective magnetically actuated valve for microfluidic applications

    NASA Astrophysics Data System (ADS)

    Pugliese, Marco; Ferrara, Francesco; Bramanti, Alessandro Paolo; Gigli, Giuseppe; Maiorano, Vincenzo

    2017-04-01

    We present a new in-plane magnetically actuated microfluidic valve. Its simple design includes a circular area joining two channels lying on the same plane. The area is parted by a septum lying on and adhering to a magneto-active polymeric ‘floor’ membrane, keeping the channels normally separated (valve closed). Under the action of a magnetic field, the membrane collapses, letting the liquid flow below the septum (valve open). The valve was extensively characterized experimentally, and modeled and optimized theoretically. The growing interest in lab on chips, especially for diagnostics and precision medicine, is driving researchers towards smart, efficient and low cost solutions to the management of biological samples. In this context, the valve developed in this work represents a useful building-block for microfluidic applications requiring precise flow control, its main features being easy and rapid manufacturing, biocompatibility and low cost.

  18. A simple cost-effective manometric respirometer: design and application in wastewater biomonitoring

    NASA Astrophysics Data System (ADS)

    Rahman, Mohammad Shahidur; Islam, M. Akhtarul

    2015-09-01

    Application of respirometric tools in wastewater engineering fields is still not getting familiarity and acceptance by academy or industry in developing countries as compared to the use of conventional biochemical oxygen demand (BOD) approach. To justify the applicability of respirometry, a low-cost respirometric device suitable for monitoring biodegradation process in wastewater has been developed. This device contains six independently operating reactors placed in a temperature control unit for the bioassay of five wastewater samples simultaneously (along with one blank). Each reactor is equipped with a magnetic stirrer for the continuous agitation of the test sample. Six manometers, linked with the individual reactors, measure the pressure and volume changes in the headspace gas phase of the reactor. Working formulae have been derived to convert the `volume-change in gas phase' data to `the oxygen depletion in the whole liquid-gas system' data. The performance of the device has been tested with glucose-glutamic acid standard solution and found satisfactory. Conventional BOD test and the respirometric measurements were performed simultaneously and it is found that in addition to measuring the BOD of the sample, this device gives oxygen uptake profile for further analysis to determine the biokinetic coefficients. Additionally, in some cases, following a specific test protocol, the respirometer can indirectly estimate the carbon dioxide evolved during biodegradation process for calculating respiratory activity parameter such as respiratory quotient. It is concluded that the device can be used in the laboratories associated with the activated sludge plants and also for teaching and research purposes in developing countries.

  19. Compact, light-weight and cost-effective microscope based on lensless incoherent holography for telemedicine applications.

    PubMed

    Mudanyali, Onur; Tseng, Derek; Oh, Chulwoo; Isikman, Serhan O; Sencan, Ikbal; Bishara, Waheb; Oztoprak, Cetin; Seo, Sungkyu; Khademhosseini, Bahar; Ozcan, Aydogan

    2010-06-07

    Despite the rapid progress in optical imaging, most of the advanced microscopy modalities still require complex and costly set-ups that unfortunately limit their use beyond well equipped laboratories. In the meantime, microscopy in resource-limited settings has requirements significantly different from those encountered in advanced laboratories, and such imaging devices should be cost-effective, compact, light-weight and appropriately accurate and simple to be usable by minimally trained personnel. Furthermore, these portable microscopes should ideally be digitally integrated as part of a telemedicine network that connects various mobile health-care providers to a central laboratory or hospital. Toward this end, here we demonstrate a lensless on-chip microscope weighing approximately 46 grams with dimensions smaller than 4.2 cm x 4.2 cm x 5.8 cm that achieves sub-cellular resolution over a large field of view of approximately 24 mm(2). This compact and light-weight microscope is based on digital in-line holography and does not need any lenses, bulky optical/mechanical components or coherent sources such as lasers. Instead, it utilizes a simple light-emitting-diode (LED) and a compact opto-electronic sensor-array to record lensless holograms of the objects, which then permits rapid digital reconstruction of regular transmission or differential interference contrast (DIC) images of the objects. Because this lensless incoherent holographic microscope has orders-of-magnitude improved light collection efficiency and is very robust to mechanical misalignments it may offer a cost-effective tool especially for telemedicine applications involving various global health problems in resource limited settings.

  20. Compact, Light-weight and Cost-effective Microscope based on Lensless Incoherent Holography for Telemedicine Applications

    PubMed Central

    Mudanyali, Onur; Tseng, Derek; Oh, Chulwoo; Isikman, Serhan O.; Sencan, Ikbal; Bishara, Waheb; Oztoprak, Cetin; Seo, Sungkyu; Khademhosseini, Bahar; Ozcan, Aydogan

    2010-01-01

    Despite the rapid progress in optical imaging, most of the advanced microscopy modalities still require complex and costly set-ups that unfortunately limit their use beyond well equipped laboratories. In the meantime, microscopy in resource-limited settings has requirements significantly different from those encountered in advanced laboratories, and such imaging devices should be cost-effective, compact, light-weight and appropriately accurate and simple to be usable by minimally trained personnel. Furthermore, these portable microscopes should ideally be digitally integrated as part of a telemedicine network that connects various mobile health-care providers to a central laboratory or hospital. Toward this end, here we demonstrate a lensless on-chip microscope weighing ~46 grams with dimensions smaller than 4.2cm × 4.2cm × 5.8cm that achieves sub-cellular resolution over a large field of view of ~24 mm2. This compact and light-weight microscope is based on digital in-line holography and does not need any lenses, bulky optical/mechanical components or coherent sources such as lasers. Instead, it utilizes a simple light-emitting-diode (LED) and a compact opto-electronic sensor-array to record lensless holograms of the objects, which then permits rapid digital reconstruction of regular transmission or differential interference contrast (DIC) images of the objects. Because this lensless incoherent holographic microscope has orders-of-magnitude improved light collection efficiency and is very robust to mechanical misalignments it may offer a cost-effective tool especially for telemedicine applications involving various global health problems in resource limited settings. PMID:20401422

  1. Design of a Lightweight, Cost Effective Thimble-Like Sensor for Haptic Applications Based on Contact Force Sensors

    PubMed Central

    Ferre, Manuel; Galiana, Ignacio; Aracil, Rafael

    2011-01-01

    This paper describes the design and calibration of a thimble that measures the forces applied by a user during manipulation of virtual and real objects. Haptic devices benefit from force measurement capabilities at their end-point. However, the heavy weight and cost of force sensors prevent their widespread incorporation in these applications. The design of a lightweight, user-adaptable, and cost-effective thimble with four contact force sensors is described in this paper. The sensors are calibrated before being placed in the thimble to provide normal and tangential forces. Normal forces are exerted directly by the fingertip and thus can be properly measured. Tangential forces are estimated by sensors strategically placed in the thimble sides. Two applications are provided in order to facilitate an evaluation of sensorized thimble performance. These applications focus on: (i) force signal edge detection, which determines task segmentation of virtual object manipulation, and (ii) the development of complex object manipulation models, wherein the mechanical features of a real object are obtained and these features are then reproduced for training by means of virtual object manipulation. PMID:22247677

  2. An Example of the Application of Cost-Effectiveness Techniques in a Computer-Based Study Management System Evaluation.

    ERIC Educational Resources Information Center

    Stern, Hervey W.

    This paper considers some of the problems in implementing a cost-effectiveness analysis in training and education, and provides a specific example of an analysis that partially meets the cost-effectiveness analysis requirements. A computer-based study management system (SMS), which was implemented on a limited basis, was evaluated in the context…

  3. The application of cost-effective lasers in coherent UDWDM-OFDM-PON aided by effective phase noise suppression methods.

    PubMed

    Liu, Yue; Yang, Chuanchuan; Yang, Feng; Li, Hongbin

    2014-03-24

    Digital coherent passive optical network (PON), especially the coherent orthogonal frequency division multiplexing PON (OFDM-PON), is a strong candidate for the 2nd-stage-next-generation PON (NG-PON2). As is known, OFDM is very sensitive to the laser phase noise which severely limits the application of the cost-effective distributed feedback (DFB) lasers and more energy-efficient vertical cavity surface emitting lasers (VCSEL) in the coherent OFDM-PON. The current long-reach coherent OFDM-PON experiments always choose the expensive external cavity laser (ECL) as the optical source for its narrow linewidth (usually<100 KHz). To solve this problem, we introduce the orthogonal basis expansion based (OBE) phase noise suppression method to the coherent OFDM-PON and study the possibility of the application of the DFB lasers and VCSEL in coherent OFDM-PON. A typical long-reach coherent ultra dense wavelength division multiplexing (UDWDM) OFDM-PON has been set up. The numerical results prove that the OBE method can stand severe phase noise of the lasers in this architecture and the DFB lasers as well as VCSEL can be used in coherent OFDM-PON. In this paper, we have also analyzed the performance of the RF-pilot-aided (RFP) phase noise suppression method in coherent OFDM-PON.

  4. Development of a Cost-Effective Modular Pixelated NaI(Tl) Detector for Clinical SPECT Applications

    PubMed Central

    Rozler, Mike; Liang, Haoning; Chang, Wei

    2013-01-01

    A new pixelated detector for high-resolution clinical SPECT applications was designed and tested. The modular detector is based on a scintillator block comprised of 2.75×2.75×10 mm3 NaI(Tl) pixels and decoded by an array of 51 mm diameter single-anode PMTs. Several configurations, utilizing two types of PMTs, were evaluated using a collimated beam source to measure positioning accuracy directly. Good pixel separation was observed, with correct pixel identification ranging from 60 to 72% averaged over the entire area of the modules, depending on the PMT type and configuration. This translates to a significant improvement in positioning accuracy compared to continuous slab detectors of the same thickness, along with effective reduction of “dead” space at the edges. The observed 10% average energy resolution compares well to continuous slab detectors. The combined performance demonstrates the suitability of pixelated detectors decoded with a relatively small number of medium-sized PMTs as a cost-effective approach for high resolution clinical SPECT applications, in particular those involving curved detector geometries. PMID:24146436

  5. Wind Energy Applications for Municipal Water Services: Opportunities, Situation Analyses, and Case Studies; Preprint

    SciTech Connect

    Flowers, L.; Miner-Nordstrom, L.

    2006-01-01

    As communities grow, greater demands are placed on water supplies, wastewater services, and the electricity needed to power the growing water services infrastructure. Water is also a critical resource for thermoelectric power plants. Future population growth in the United States is therefore expected to heighten competition for water resources. Many parts of the United States with increasing water stresses also have significant wind energy resources. Wind power is the fastest-growing electric generation source in the United States and is decreasing in cost to be competitive with thermoelectric generation. Wind energy can offer communities in water-stressed areas the option of economically meeting increasing energy needs without increasing demands on valuable water resources. Wind energy can also provide targeted energy production to serve critical local water-system needs. The research presented in this report describes a systematic assessment of the potential for wind power to support water utility operation, with the objective to identify promising technical applications and water utility case study opportunities. The first section describes the current situation that municipal providers face with respect to energy and water. The second section describes the progress that wind technologies have made in recent years to become a cost-effective electricity source. The third section describes the analysis employed to assess potential for wind power in support of water service providers, as well as two case studies. The report concludes with results and recommendations.

  6. Ion propulsion cost effectivity

    NASA Technical Reports Server (NTRS)

    Zafran, S.; Biess, J. J.

    1978-01-01

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

  7. Global optimal vaccination in the SIR model: properties of the value function and application to cost-effectiveness analysis.

    PubMed

    Laguzet, Laetitia; Turinici, Gabriel

    2015-05-01

    This work focuses on optimal vaccination policies for an Susceptible-Infected-Recovered (SIR) model; the impact of the disease is minimized with respect to the vaccination strategy. The problem is formulated as an optimal control problem and we show that the value function is the unique viscosity solution of an Hamilton-Jacobi-Bellman (HJB) equation. This allows to find the best vaccination policy. At odds with existing literature, it is seen that the value function is not always smooth (sometimes only Lipschitz) and the optimal vaccination policies are not unique. Moreover we rigorously analyze the situation when vaccination can be modeled as instantaneous (with respect to the time evolution of the epidemic) and identify the global optimum solutions. Numerical applications illustrate the theoretical results. In addition the pertussis vaccination in adults is considered from two perspectives: first the maximization of DALY averted in presence of vaccine side-effects; then the impact of the herd immunity on the cost-effectiveness analysis is discussed on a concrete example.

  8. Photovoltaics for municipal planners

    SciTech Connect

    Not Available

    1993-04-01

    This booklet is intended for city and county government personnel, as well as community organizations, who deal with supplying, regulating, or recommending electric power resources. Specifically, this document deals with photovoltaic (PV) power, or power from solar cells, which is currently the most cost-effective energy source for electricity requirements that are relatively small, located in isolated areas, or difficult to serve with conventional technology. Recently, PV has been documented to be more cost-effective than conventional alternatives (such as line extensions or engine generators) in dozens of applications within the service territories of electric, gas, and communications utilities. Here, we document numerous cost-effective urban applications, chosen by planners and utilities because they were the most cost-effective option or because they were appropriate for environmental or logistical reasons. These applications occur within various municipal departments, including utility, parks and recreation, traffic engineering, transportation, and planning, and they include lighting applications, communications equipment, corrosion protection, irrigation control equipment, remote monitoring, and even portable power supplies for emergency situations.

  9. NOX CONTROL TECHNOLOGIES APPLICABLE TO MUNICIPAL WASTE COMBUSTION

    EPA Science Inventory

    The report documents the key design and operating parameters, commercial status, demonstrated performance, and cost of three technologies available for reducing nitrogen oxide (NOx) emissions from municipal waste combustors (MWCs), and identifies technology research and developme...

  10. NOX CONTROL TECHNOLOGIES APPLICABLE TO MUNICIPAL WASTE COMBUSTION

    EPA Science Inventory

    The report documents the key design and operating parameters, commercial status, demonstrated performance, and cost of three technologies available for reducing nitrogen oxide (NOx) emissions from municipal waste combustors (MWCs), and identifies technology research and developme...

  11. Cost-effectiveness analysis, prevention of atopic dermatitis by oral application of bacterial lysate in newborns/small children.

    PubMed

    Kiencke, Peter; Viehmann, Kristina; Rychlik, Reinhard

    2013-12-01

    The aim of this analysis was to determine the cost-effectiveness compared to placebo of prophylactic treatment with sterile bacterial lysate (Escherichia coli and Enterococcus faecalis) (verum) of newborns/small children with heredity for atopy [atopic dermatitis (AD)]. Infants were followed from the age of 5 weeks until 3 years of age. During this time, the number of children with AD who were treated with verum or placebo was observed at eight visits. Cost-effectiveness analyses were performed at different time points. A randomized, double-blind placebo-controlled clinical trial performed in Germany included 606 newborns. After randomization, n = 303 patients were classified in the placebo group and n = 303 in the verum group. A total of 119 participants left the study, so data from n = 250 patients of the placebo group and n = 237 patients of the verum group were available for analysis. At the beginning of the study, newborns were treated prophylactically with bacterial lysate or placebo for 26 weeks. After this, children were observed until the age of 3 years. A systematic literature research was done to evaluate treatment costs of atopic eczema in newborn/small children. Finally, 17 publications were included and checked for searched treatment costs of AD. A study was then initiated to evaluate the direct costs to statutory health insurance. Based on the described clinical trial, a decision tree model was developed. Using the evaluated direct costs and prevalence according to the clinical trial, the developed model can be used in cost-effectiveness analyses. The focus of the analyses was on the subgroup "single heredity for atopy" in clinical trials. Cost-effectiveness analysis showed an advantage for bacterial lysate after 3 years. To further support this result a model extension was executed; the model was expanded from 3 to 6 years. Cost-effectiveness of bacterial lysate was also proven after 6 years. Prophylactic treatment with bacterial lysate of infants

  12. Limited applicability of cost-effectiveness and cost-benefit analyses for the optimization of radon remedial measures.

    PubMed

    Jiránek, Martin; Rovenská, Katerina

    2010-10-15

    Ways of using different decision-aiding techniques for optimizing and evaluating radon remedial measures have been studied on a large set of data obtained from the remediation of 32 houses that had an original indoor radon level above 1000 Bq/m(3). Detailed information about radon concentrations before and after remediation, type of remedial measures and installation and operation costs were used as the input parameters for a comparison of costs and for determining the efficiencies, for a cost-benefit analysis and a cost-effectiveness analysis, in order to find out whether these criteria and techniques provide sufficient and relevant information for improving and optimizing remediation. Our study confirmed that the installation costs of remediation do not depend on the original indoor radon level, but on the technical state of the building. In addition, the study reveals that the efficiency of remediation does not depend on the installation costs. Cost-benefit analysis and cost-effectiveness analysis lead to the conclusion that remedial measures reducing the indoor radon concentration from values above 1000 Bq/m(3) are always acceptable and reasonable. On the other hand, these techniques can neither help the designer to choose the proper remedial measure nor provide information resulting in improved remediation.

  13. Application of kriging meteode the example Krupanj municipality, Serbia

    NASA Astrophysics Data System (ADS)

    Perovic, Veljko; Jaramaz, Darko; Saljnikov, Elmira; Cakmak, Dragan; Zivotic, Ljubomir; Mrvic, Vesna; Kostic-Kravljanac, Ljiljana

    2010-05-01

    Application of kriging meteode the example Krupanj municipality, Serbia 1Veljko Perovic, 1Darko Jaramaz, 1Elmira Saljnikov, 1Dragan Cakmak, 2Ljubomir Zivotic, 1Vesna Mrvic, 1Ljiljana Kostic - Kravljanac 1 Institute of Soil Science, Belgrade 2 Faculty of Agriculture, Belgrade keywords: kriging, geostatistics, layers The basic idea of geostatistics is the use of spatial coorelation under the spatial property which is analysed in order to improve its spatial interpolation. There is number of geostatistical methods for the interpolation of the spatial data. In the paper using of Kriging method, which belongs to the often used geostatistical techniques in cartography is discussed. Kriging as a method contains a number of techniques, such as: simple kriging, ordinary kriging, indicator kriging, universal kriging and disjunctive kriging. Kriging estimation is based on the use of data from the control points, which are assigned to the corresponding coefficients. Control points actually represent sampling sites with their characteristics. Area was explored us Krupanj, located in the western part of Serbia. Krupanj lies at 44 ° 21 '34 " latitude and 19 ° 21' 26" longitude. The area of 342 km2 was rfesearched where 800 samples of surface soil were taken for further analysis. The data obtained were proceeded to thematic maps (pH in nKCl, K2O, P2O5, and humus). During data processing we used the ArcGIS program and its extension Geostatistical Analyst. In a given extension the ordinary kriging with irregular arrangement of points was used. The technique of ordinary kriging assumes that the local mean value is not close or equal to the mean value of total nimber of sampling points. The estimation was made only based on the nearest sampling points. After the completion of the assessment in the selected grid, the determination of the predicted and actual error estimates, which convirms the reliability estimates and the spatial quality of the selected model was computed using the

  14. Using Cluster Analysis to Group Countries for Cost-Effectiveness Analysis: An Application to Sub-Saharan Africa.

    PubMed

    Russell, Louise B; Bhanot, Gyan; Kim, Sun-Young; Sinha, Anushua

    2017-08-01

    To explore the use of cluster analysis to define groups of similar countries for the purpose of evaluating the cost-effectiveness of a public health intervention-maternal immunization-within the constraints of a project budget originally meant for an overall regional analysis. We used the most common cluster analysis algorithm, K-means, and the most common measure of distance, Euclidean distance, to group 37 low-income, sub-Saharan African countries on the basis of 24 measures of economic development, general health resources, and past success in public health programs. The groups were tested for robustness and reviewed by regional disease experts. We explored 2-, 3- and 4-group clustering. Public health performance was consistently important in determining the groups. For the 2-group clustering, for example, infant mortality in Group 1 was 81 per 1,000 live births compared with 51 per 1,000 in Group 2, and 67% of children in Group 1 received DPT immunization compared with 87% in Group 2. The experts preferred four groups to fewer, on the ground that national decision makers would more readily recognize their country among four groups. Clusters defined by K-means clustering made sense to subject experts and allowed a more detailed evaluation of the cost-effectiveness of maternal immunization within the constraint of the project budget. The method may be useful for other evaluations that, without having the resources to conduct separate analyses for each unit, seek to inform decision makers in numerous countries or subdivisions within countries, such as states or counties.

  15. 78 FR 38307 - Gresham Municipal Utilities; Notice of Application Tendered for Filing With the Commission and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ...: Subsequent License. b. Project No.: 2484-018. c. Date filed: June 10, 2013. d. Applicant: Gresham Municipal Utilities. e. Name of Project: Upper Red Lake Dam Hydroelectric Project. f. Location: On Red River in... 20426. m. The application is not ready for environmental analysis at this time. n. The Upper Red...

  16. Cost-effectiveness of caries-preventive fluoride varnish applications in clinic settings among patients of low, moderate and high risk.

    PubMed

    Schwendicke, Falk; Splieth, Christian H; Thomson, William Murray; Reda, Seif; Stolpe, Michael; Foster Page, Lyndie

    2017-07-06

    The total body of evidence finds fluoride varnish effective to prevent caries. However, most trials were conducted in high-risk populations, with more recent trials on low-risk groups finding a lower efficacy. We aimed to assess the cost-effectiveness of fluoride varnish application in clinic setting in populations with different caries risk. A mixed public-private-payer perspective in the context of German health care was performed using a lifetime Markov model. Effectiveness data were derived from an update of the most recent systematic Cochrane review and synthesized in three different risk groups according to control group caries increment via random-effects meta-analysis. Varnish was assumed to be applied twice yearly between age 6 and 18 years. Teeth with carious defects would be treated restoratively and could experience further follow-up treatments. Costs were deduced from German fee item catalogues. Monte Carlo microsimulations were used for to analyse lifetime treatment costs and caries increment (Euro/Decayed, Missing, Filled Teeth (DMFT)). In low-risk groups, fluoride varnish was nearly twice as costly and minimally more effective (293 Euro, 8.1 DMFT) than no varnish (163 Euro, 8.5 DMFT). The incremental cost-effectiveness ratio (ICER) was 343 Euro spent per avoided DMFT. The ICER was lower in medium-risk (ICER 93 Euro/DMFT) and high-risk groups (8 Euro/DMFT). Application of fluoride varnish in the clinic setting is unlikely to be cost-effective in low-risk populations. There is the need to either target high-risk groups or to provide fluoride varnish at lower costs, possibly in nonclinic settings. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Cost effective lighting

    SciTech Connect

    Morse, O.; Verderber, R.

    1987-07-01

    Long-life replacement lamps for the incandescent lamp have been evaluated with regard to their cost effectiveness. The replacements include the use of energy buttons that extend lamp life as well as an adaptive fluorescent circline lamp that will fit into existing incandescent lamp sockets. The initial, operating, and replacement costs for one million lumen-hours are determined for each lamp system. We find the most important lighting cost component is the operating cost. Using lamps that are less efficient or devices that cause lamps to operate less efficiently are not cost-effective. The adaptive fluorescent circline lamp, even at an initial cost of $15.00, is the most cost effective source of illumination compared to the incandescent lamp and lamp systems examined. 3 refs., 6 tabs.

  18. Occurrence and fate of perfluorochemicals in soil following the land application of municipal biosolids.

    PubMed

    Sepulvado, Jennifer G; Blaine, Andrea C; Hundal, Lakhwinder S; Higgins, Christopher P

    2011-10-01

    The recent implementation of soil and drinking water screening guidance values for two perfluorochemicals (PFCs), perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) by the U.S. Environmental Protection Agency (EPA), reflects the growing concerns regarding the presence of these persistent and bioaccumulative chemicals in the natural environment. Previous work has established the potential risk to the environment from the land application of industrially contaminated biosolids, but studies focusing on environmental risk from land application of typical municipal biosolids are lacking. Thus, the present study investigated the occurrence and fate of PFCs from land-applied municipal biosolids by evaluating the levels, mass balance, desorption, and transport of PFCs in soils receiving application of municipal biosolids at various loading rates. This study is the first to report levels of PFCs in agricultural soils amended with typical municipal biosolids. PFOS was the dominant PFC in both biosolids (80-219 ng/g) and biosolids-amended soil (2-483 ng/g). Concentrations of all PFCs in soil increased linearly with increasing biosolids loading rate. These data were used to develop a model for predicting PFC soil concentrations in soils amended with typical municipal biosolids using cumulative biosolids loading rates. Mass balance calculations comparing PFCs applied vs those recovered in the surface soil interval indicated the potential transformation of PFC precursors. Laboratory desorption experiments indicated that the leaching potential of PFCs decreases with increasing chain length and that previously derived organic-carbon normalized partition coefficients may not be accurate predictors of the desorption of long-chain PFCs from biosolids-amended soils. Trace levels of PFCs were also detected in soil cores from biosolids-amended soils to depths of 120 cm, suggesting potential movement of these compounds within the soil profile over time and confirming the

  19. 78 FR 35618 - Three Valleys Municipal Water District; Notice of Application Accepted for Filing and Soliciting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Three Valleys Municipal Water District; Notice of Application Accepted for Filing and Soliciting Comments, Motions To Intervene, Protests, Recommendations, and Terms and Conditions Take notice that the...

  20. Cost Effective Prototyping

    NASA Technical Reports Server (NTRS)

    Wickman, Jerry L.; Kundu, Nikhil K.

    1996-01-01

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

  1. Cost Effective Prototyping

    NASA Technical Reports Server (NTRS)

    Wickman, Jerry L.; Kundu, Nikhil K.

    1996-01-01

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

  2. Application of NASA-developed technology to the automatic control of municipal sewage treatment plants

    NASA Technical Reports Server (NTRS)

    Hiser, L. L.; Herrera, W. R.

    1973-01-01

    A search was made of NASA developed technology and commercial technology for process control sensors and instrumentation which would be applicable to the operation of municipal sewage treatment plants. Several notable items were found from which process control concepts were formulated that incorporated these items into systems to automatically operate municipal sewage treatment plants. A preliminary design of the most promising concept was developed into a process control scheme for an activated sludge treatment plant. This design included process control mechanisms for maintaining constant food to sludge mass (F/M) ratio, and for such unit processes as primary sedimentation, sludge wastage, and underflow control from the final clarifier.

  3. Wood ash for application in municipal biowaste composting.

    PubMed

    Kurola, Jukka M; Arnold, Mona; Kontro, Merja H; Talves, Matti; Romantschuk, Martin

    2011-04-01

    This study aimed to clarify the impacts of pH control by wood ash amendment on biowaste composting processes. To achieve this, fresh source separated municipal biowaste was mixed with low doses (2-8% wt/vol) of wood ash and processed in a pilot and large-scale composting systems. The results indicated a correlation between a low initial pH and delay in the early rise of the process temperature. Wood ash elevated the composting temperatures and pH, and stimulated the mineralisation both in the pilot scale and the industrial large-scale processes. According to the results addition of amounts of 4-8% wood ash is sufficient for efficient biowaste composting process and yields a safe end product. However, to minimise the environmental risk for heavy metal contamination, and meet the criteria for the limit values of the impurities in wood ash, strict quality control of the applied wood ashes should be implemented. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Application of the CERCLA municipal landfill presumptive remedy to military landfills (interim guidance). Fact sheet

    SciTech Connect

    1996-04-01

    This directive highlights a step-by-step approach to determining when a specific military landfill is an appropriate site for application of the containment presumptive remedy. It identifies the characteristics of municipal landfills that are relevant to the applicability of the presumptive remedy, addresses characteristics specific to military landfills, outlines an approach to determining whether the presumptive remedy applies to a given military landfill, and discusses Administrative Record documentation requirements.

  5. Densified biomass can cost-effectively mitigate greenhouse gas emissions and address energy security in thermal applications.

    PubMed

    Wilson, Thomas O; McNeal, Frederick M; Spatari, Sabrina; G Abler, David; Adler, Paul R

    2012-01-17

    Regional supplies of biomass are currently being evaluated as feedstocks in energy applications to meet renewable portfolio (RPS) and low carbon fuel standards. We investigate the life cycle greenhouse gas (GHG) emissions and associated abatement costs resulting from using densified switchgrass for thermal and electrical energy. In contrast to the large and positive abatement costs for using biomass in electricity generation ($149/Mg CO(2)e) due to the low cost of coal and high feedstock and power plant operation costs, abatement costs for replacing fuel oil with biomass in thermal applications are large and negative (-$52 to -$92/Mg CO(2)e), resulting in cost savings. Replacing fuel oil with biomass in thermal applications results in least cost reductions compared to replacing coal in electricity generation, an alternative that has gained attention due to RPS legislation and the centralized production model most often considered in U.S. policy. Our estimates indicate a more than doubling of liquid fuel displacement when switchgrass is substituted for fuel oil as opposed to gasoline, suggesting that, in certain U.S. locations, such as the northeast, densified biomass would help to significantly decarbonize energy supply with regionally sourced feedstock, while also reducing imported oil. On the basis of supply projections from the recently released Billion Ton Report, there will be enough sustainably harvested biomass available in the northeast by 2022 to offset the entirety of heating oil demand in the same region. This will save NE consumers between $2.3 and $3.9 billion annually. Diverting the same resource to electricity generation would cost the region $7.7 billion per year. While there is great need for finding low carbon substitutes for coal power and liquid transportation fuels in the U.S., we argue that in certain regions it makes cost- (and GHG mitigation-) effective sense to phase out liquid heating fuels with locally produced biomass first.

  6. First prototypes of hybrid potassium-ion capacitor (KIC): An innovative, cost-effective energy storage technology for transportation applications

    NASA Astrophysics Data System (ADS)

    Le Comte, Annaïg; Reynier, Yvan; Vincens, Christophe; Leys, Côme; Azaïs, Philippe

    2017-09-01

    Hybrid supercapacitors, combining capacitive carbon-based positive electrode with a Li-ion battery-type negative electrode have been developed in the pursuit of increasing the energy density of conventional supercapacitor without impacting the power density. However, lithium-ion capacitors yet hardly meet the specifications of automotive sector. Herein we report for the first time the development of new hybrid potassium-ion capacitor (KIC) technology. Compared to lithium-ion capacitor (LIC) all strategic materials (lithium and copper) have been replaced. Excellent electrochemical performance have been achieved at a pouch cell scale, with cyclability superior to 55 000 cycles at high charge/discharge regime. For the same cell scale, the energy density is doubled compared to conventional supercapacitor up to high power regime (>1.5 kW kg-1). Finally, the technology was successfully scaled up to 18650 format leading to very promising prospects for transportation applications.

  7. Cost effective facile synthesis of TiO2 nanograins for flexible DSSC application using rose bengal dye

    NASA Astrophysics Data System (ADS)

    Jambure, Supriya Bapurao; Gund, Girish Sambhaji; Dubal, Deepak Prakash; Shinde, Sujata Sureshrao; Lokhande, Chandrakant Dnyandev

    2014-09-01

    Synthesis of titanium dioxide (TiO2) nanograins using economical successive ionic layer adsorption and reaction (SILAR) method has been carried out. TiO2 thin films are studied for their structural, compositional, optical and morphological properties. A layer by layer process leads to the formation of 2.4 μm thick nanocrystalline TiO2 film. The heat treated TiO2 thin films are hydrophilic in nature with contact angle of 67°. The interconnected nanograins are employed for dye sensitized solar cells (DSSC) using inexpensive Rose Bengal (RB) dye. RB dye sensitization resulted into shifting of absorption peak from UV to visible region. The photoresponce of the dye sensitized solar cell is evaluated in the polyiodide electrolyte (0.1 M KI + 0.01 M I2) at 40 mWcm-2 illumination intensity. The TiO2 nanograins accompanied with RB sensitizer showed the conversion efficiency ( η) of 0.89%. These results depict the strong assurance of TiO2 nanograins for DSSC application.

  8. Selective and cost-effective protocol to separate bioactive triterpene acids from plant matrices using alkalinized ethanol: Application to leaves of Myrtaceae species

    PubMed Central

    Lima, Adélia M. Belem; Siani, Antonio Carlos; Nakamura, Marcos Jun; D’Avila, Luiz Antonio

    2015-01-01

    Background: Triterpenes as betulinic (BA), oleanolic (OA) and ursolic acids (UA) have increasingly gained therapeutic relevance due to their wide scope of pharmacological activities. To fit large-scale demands, exploitable sources of these compounds have to be found and simple, cost-effective methods to extract them developed. Leaf material represents the best plant sustainable raw material. To obtain triterpene acid-rich extracts from leaves of Eugenia, Psidium and Syzygium species (Myrtaceae) by directly treating the dry plant material with alkalinized hydrated ethanol. This procedure was adapted from earlier methods to effect depolymerization of the leaf cutin. Materials and Methods: Extracts were prepared by shaking the milled dry leaves in freshly prepared 2% NaOH in 95% EtOH solution (1:4 w/v) at room temperature for 6 h. Working up the product in acidic aqueous medium led to clear precipitates in which BA, OA and UA were quantified by gas chromatography. Results: Pigment-free and low-polyphenol content extracts (1.2–2.8%) containing 6–50% of total triterpene acids were obtained for the six species assayed. UA (7–20%) predominated in most extracts, but BA preponderated in Eugenia florida (39%). Carried out in parallel, n-hexane defatted leaves led to up to 9% enhancement of total acids in the extracts. The hydroalcoholate treatment of Myrtaceae species dry leaves proved to be a cost-effective and environmentally friendly method to obtain triterpene acids, providing them be resistant to alkaline medium. These combined techniques might be applicable to other plant species and tissues. PMID:26246721

  9. 75 FR 24938 - City of Hamilton, Ohio American Municipal Power, Inc.; Notice of Application for Transfer of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-06

    ... February 26, 2010, City of Hamilton, Ohio (Hamilton) and American Municipal Power, Inc. (AMP) filed an... approval to transfer the license for the Meldahl Project from Hamilton to Hamilton and AMP. Applicants...

  10. 18 CFR 131.70 - Form 12 of application by State and municipal licensees for exemption from payment of annual...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... chapter.) Application by State and municipal licensees for exemption from payment of annual charges must... electric power; 9. Book cost of electric property; 10. Operating revenues; 11. Operating expenses and other...

  11. Life cycle monitoring of lithium-ion polymer batteries using cost-effective thermal infrared sensors with applications for lifetime prediction

    NASA Astrophysics Data System (ADS)

    Zhou, Xunfei; Malik, Anav; Hsieh, Sheng-Jen

    2017-05-01

    Lithium-ion batteries have become indispensable parts of our lives for their high-energy density and long lifespan. However, failure due to from abusive usage conditions, flawed manufacturing processes, and aging and adversely affect battery performance and even endanger people and property. Therefore, battery cells that are failing or reaching their end-of-life need to be replaced. Traditionally, battery lifetime prediction is achieved by analyzing data from current, voltage and impedance sensors. However, such a prognostic system is expensive to implement and requires direct contact. In this study, low-cost thermal infrared sensors were used to acquire thermographic images throughout the entire lifetime of small scale lithium-ion polymer batteries (410 cycles). The infrared system (non-destructive) took temperature readings from multiple batteries during charging and discharging cycles of 1C. Thermal characteristics of the batteries were derived from the thermographic images. A time-dependent and spatially resolved temperature mapping was obtained and quantitatively analyzed. The developed model can predict cycle number using the first 10 minutes of surface temperature data acquired through infrared imaging at the beginning of the cycle, with an average error rate of less than 10%. This approach can be used to correlate thermal characteristics of the batteries with life cycles, and to propose cost-effective thermal infrared imaging applications in battery prognostic systems.

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

    SciTech Connect

    Tidball, Rick

    2014-11-01

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

  13. Energy optimization of water and wastewater management for municipal and industrial applications conference

    SciTech Connect

    Not Available

    1980-08-01

    These proceedings document the presentations given at the Energy Optimization of Water and Wastewater Management for Municipal and Industrial Applications, Conference, sponsored by the Department of Energy (DOE). The conference was organized and coordinated by Argonne National Laboratory. The conference focused on energy use on conservation in water and wastewater. The General Session also reflects DOE's commitment to the support and development of waste and wastewater systems that are environmentally acceptable. The conference proceedings are divided into two volumes. Volume 1 contains the General Session and Sessions 1 to 5. Volume 2 covers Sessions 6 to 12. Separate abstracts are prepared for each item within the scope of the Energy Data Base.

  14. Energy optimization of water and wastewater management for municipal and industrial applications conference

    SciTech Connect

    Not Available

    1980-08-01

    These proceedings document the presentations given at the Energy Optimization of Water and Wastewater Management for Municipal and Industrial Applications Conference, sponsored by the Department of Energy (DOE). The conference was organized and coordinated by Argonne National Laboratory. The conference focused on energy use and conservation in water and wastewater. The General Session also reflects DOE's commitment to the support and development of waste and wastewater systems that are environmentally acceptable. The conference proceedings are divided into two volumes. Volume 1 contains the General Session and Sessions 1 to 5. Volume 2 covers Sessions 6 to 12. Separate abstracts are prepared for each item within the scope of the Energy Data Base.

  15. Phytase production by Sporotrichum thermophile in a cost-effective cane molasses medium in submerged fermentation and its application in bread.

    PubMed

    Singh, B; Satyanarayana, T

    2008-12-01

    Phytase production by Sporotrichum thermophile in a cost-effective cane molasses medium in submerged fermentation and its application in bread. The production of phytase by a thermophilic mould S. thermophile was investigated using free and immobilized conidiospores in cane molasses medium in shake flasks, and stirred tank and air-lift fermenters. Among surfactants tested, Tweens (Tween-20, 40 and 80) and sodium oleate increased phytase accumulation, whereas SDS and Triton X-100 inhibited the enzyme production. The mould produced phytase optimally at a(w) 0.95, and it declined sharply below this a(w) value. The enzyme production was comparable in air-lift and stirred tank reactors with a marked reduction in fermentation time. Among the matrices tried, Ca-alginate was the best for conidiospore immobilization, and fungus secreted sustained levels of enzyme titres over five cycles. The phytic acid in the dough was efficiently hydrolysed by the enzyme accompanied by the liberation of soluble phosphate in the bread. The phytase production by S. thermophile was enhanced in the presence of Tween-80 in cane molasses medium. A peak in enzyme production was attained in 48 h in the fermenter when compared with that of 96 h in shake flasks. Ca-alginate immobilized conidiospores germinated to produce fungal growth that secreted sustained levels of phytase over five cycles. The bread made with phytase contained reduced level of phytic acid and a high-soluble phosphate. The phytase accumulation by S. thermophile was increased by the surfactants. The sustainability of enzyme production in stirred tank and air-lift fermenters suggested the possibility for scaling up of phytase. The bread made with phytase contained low level of antinutrient, i.e. phytic acid.

  16. Metal concentrations in edible mushrooms following municipal sludge application on forest land.

    PubMed

    Benbrahim, Mohammed; Denaix, Laurence; Thomas, Anne-Laure; Balet, Julie; Carnus, Jean-Michel

    2006-12-01

    In the context of biosolids utilisation in forestry, effects of sludge application on mushroom metal concentration were studied in six sites of maritime pine forests in the South-West of France. Municipal sludge were applied at a rate of 6 T dry matter per hectare. Edible mushrooms were collected two years after sludge application. As, Cd, Cu, Hg, Pb, Se and Zn concentrations were determined. Results showed a high variability for trace element concentrations in mushrooms collected from control areas. No significant correlation was found between soil parameters (pH and trace elements concentrations) and mushroom trace element concentrations. Even if the concentration of trace metals increased in the soils, sludge application did not affect As, Cu, Se and Zn concentrations in carpophores but slightly increased Cd, Pb and Hg concentrations on some sites. This effect is dependent on sludge type and sites.

  17. Modeling the pH-mediated extraction of ionizable organic contaminants to improve the quality of municipal sewage sludge destined for land application.

    PubMed

    Venkatesan, Arjun K; Halden, Rolf U

    2016-04-15

    A model was developed to assess the impact of adding acids and bases to processed municipal sewage sludge (MSS) to mobilize contaminants, facilitating their removal from sludge by flushing prior to land application. Among 312 organic contaminants documented to occur in U.S. MSS, 71 or 23% were identified as ionizable organic contaminants (IOCs), contributing a disproportionately large fraction of 82% of the total mass of sludge-borne contaminants. Detected IOCs included 57 pharmaceuticals and personal care products, 12 perfluorinated compounds, one surfactant and one pesticide. Annually, about 2000t of IOCs were estimated to be released to U.S. soils via land-application of MSS. A partitioning model developed to assess the impact of pH on hydrophobic sorption revealed that between 36 and 85% of the mass of individual classes of IOCs potentially could be desorbed from MSS via pH adjustment and flushing. Thus, modeling results suggest that a sequential pH treatment [acidic (~pH2) followed by basic (~pH12) treatment] has the potential to reduce the burden of harmful IOCs in MSS applied on U.S. land by up to 40±16t annually. This approach may serve as a cost-effective treatment process that can be implemented easily in existing sludge treatment infrastructure in the U.S. and worldwide, serving to significantly improve the quality of MSS destined for land application. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Application of solar AOPs and ozonation for elimination of micropollutants in municipal wastewater treatment plant effluents.

    PubMed

    Prieto-Rodríguez, L; Oller, I; Klamerth, N; Agüera, A; Rodríguez, E M; Malato, S

    2013-03-15

    Conventional municipal wastewater treatment plants are not able to entirely degrade some organic pollutants that end up in the environment. Within this group of contaminants, Emerging Contaminants are mostly unregulated compounds that may be candidates for future regulation. In this work, different advanced technologies: solar heterogeneous photocatalysis with TiO(2), solar photo-Fenton and ozonation, are studied as tertiary treatments for the remediation of micropollutants present in real municipal wastewater treatment plants effluents at pilot plant scale. Contaminants elimination was followed by Liquid Chromatography/Quadrupole ion trap Mass Spectrometry analysis after a pre-concentration 100:1 by automatic solid phase extraction. 66 target micropollutants were identified and quantified. 16 of those contaminants at initial concentrations over 1000 ng L(-1), made up over 88% of the initial total effluent pollutant load. The order of micropollutants elimination efficiency under the experimental conditions evaluated was solar photo-Fenton > ozonation > solar heterogeneous photocatalysis with TiO(2). Toxicity analyses by Vibrio fischeri and respirometric tests showed no significant changes in the effluent toxicity after the three tertiary treatments application. Solar photo-Fenton and ozonation treatments were also compared from an economical point of view. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. [Proposal and applicability of a model to evaluate municipal management of the Brazilian National School Meal Program].

    PubMed

    Gabriel, Cristine Garcia; Calvo, Maria Cristina Marino; Ostermann, Roberta Melchioretto; Vasconcelos, Francisco de Assis Guedes de

    2014-08-01

    This article presents a model to evaluate municipal management of the Brazilian National School Meal Program (NSMP) and verifies its applicability in the ten largest cities of the State of Santa Catarina. The model was constructed during workshops with experts and was adapted using the Delphi Method, with participation by 14 collaborators. The model addresses two dimensions of municipal management: the political-organizational dimension, organized in the sub-dimensions resources, inter-sector action, and social control, and the operational-technical dimension, which involves the sub-dimensions of nutritional and feeding efficacy, nutritional monitoring, and educational activities for healthy eating. A total of 22 indicators were defined, based on interviews with nutritionists in charge of the NSMP. As for the model's applicability, the indicators appeared feasible with regard to addressing the municipality's responsibilities in the program, and the model should be employed to improve NSMP management at the local level.

  20. 40 CFR 62.15400 - When must I submit a title V permit application for my existing small municipal waste combustion...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... application for my existing small municipal waste combustion unit? 62.15400 Section 62.15400 Protection of... Combustion Units Constructed on or Before August 30, 1999 Title V Requirements § 62.15400 When must I submit a title V permit application for my existing small municipal waste combustion unit? (a) You...

  1. 40 CFR 62.15400 - When must I submit a title V permit application for my existing small municipal waste combustion...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... application for my existing small municipal waste combustion unit? 62.15400 Section 62.15400 Protection of... Combustion Units Constructed on or Before August 30, 1999 Title V Requirements § 62.15400 When must I submit a title V permit application for my existing small municipal waste combustion unit? (a) You...

  2. 40 CFR 62.15400 - When must I submit a title V permit application for my existing small municipal waste combustion...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... application for my existing small municipal waste combustion unit? 62.15400 Section 62.15400 Protection of... Combustion Units Constructed on or Before August 30, 1999 Title V Requirements § 62.15400 When must I submit a title V permit application for my existing small municipal waste combustion unit? (a) You must...

  3. 40 CFR 62.15400 - When must I submit a title V permit application for my existing small municipal waste combustion...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... application for my existing small municipal waste combustion unit? 62.15400 Section 62.15400 Protection of... Combustion Units Constructed on or Before August 30, 1999 Title V Requirements § 62.15400 When must I submit a title V permit application for my existing small municipal waste combustion unit? (a) You must...

  4. 40 CFR 62.15400 - When must I submit a title V permit application for my existing small municipal waste combustion...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... application for my existing small municipal waste combustion unit? 62.15400 Section 62.15400 Protection of... Combustion Units Constructed on or Before August 30, 1999 Title V Requirements § 62.15400 When must I submit a title V permit application for my existing small municipal waste combustion unit? (a) You must...

  5. Municipal Solid Waste Resources

    SciTech Connect

    2016-06-01

    Municipal solid waste (MSW) is a source of biomass material that can be utilized for bioenergy production with minimal additional inputs. MSW resources include mixed commercial and residential garbage such as yard trimmings, paper and paperboard, plastics, rubber, leather, textiles, and food wastes. Waste resources such as landfill gas, mill residues, and waste grease are already being utilized for cost-effective renewable energy generation. MSW for bioenergy also represents an opportunity to divert greater volumes of residential and commercial waste from landfills.

  6. A model of the health and economic impact of posttransfusion hepatitis C: application to cost-effectiveness analysis of further expansion of HCV screening protocols.

    PubMed

    Pereira, A; Sanz, C

    2000-10-01

    Cost-effectiveness analyses are needed to decide the value of further expansion of the screening protocols for HCV in blood donors. However, such analyses are hampered by imperfect knowledge of the health and economic repercussions of posttransfusion hepatitis C (PTHC). A Monte Carlo simulation of a Markov model representing the outcomes of patients transfused with HCV-infective blood was used to estimate the health and economic impact of PTHC and to calculate the cost-effectiveness ratio of various HCV screening methods. Median survival for hypothetical patients with PTHC and for controls without hepatitis was 11.25 and 11.75 years, respectively. Overall, 12.3 percent of patients receiving HCV-infective blood will develop chronic hepatitis, 9.3 percent will progress to liver failure, and 9. 25 percent will eventually die of liver disease after a median time of 20.75 years (range, 6-70). Ninety-one percent of the infected blood recipients had no reduction in life expectancy due to PTHC, and the average loss per patient was 0.754 years. The present value of the lifetime health costs incurred by patients with PTHC is $6330 per case. HCV antibody testing increases the patients' life expectancy by 20.4 hours per blood collection tested, and it results in net savings by decreasing the number of patients that will require treatment for liver disease in the future. Adding HCV NAT increases the patients' life expectancy by 0.08 hours per blood collection tested, at a cost-effectiveness ratio of $1,829,611 per QALY gained. PTHC has low health benefits because of the advanced age of many blood recipients. Testing donors for HCV antibodies results in net savings for the health care system, despite low health benefits. Adding HCV NAT would produce little additional gain at a very high cost.

  7. Demonstrating the cost effectiveness of an expert occupational and environmental health nurse: application of AAOHN's success tools. American Association of Occupational Health Nurses.

    PubMed

    Morris, J A; Smith, P S

    2001-12-01

    According to DiBenedetto, "Occupational health nurses enhance and maximize the health, safety, and productivity of the domestic and global work force" (1999b). This project clearly defined the multiple roles and activities provided by an occupational and environmental health nurse and assistant, supported by a part time contract occupational health nurse. A well defined estimate of the personnel costs for each of these roles is helpful both in demonstrating current value and in future strategic planning for this department. The model highlighted both successes and a business cost savings opportunity for integrated disability management. The AAOHN's Success Tools (1998) were invaluable in launching the development of this cost effectiveness model. The three methods were selected from several tools of varying complexities offered. Collecting available data to develop these metrics required internal consultation with finance, human resources, and risk management, as well as communication with external health, safety, and environmental providers in the community. Benchmarks, surveys, and performance indicators can be found readily in the literature and online. The primary motivation for occupational and environmental health nurses to develop cost effectiveness analyses is to demonstrate the value and worth of their programs and services. However, it can be equally important to identify which services are not cost effective so knowledge and skills may be used in ways that continue to provide value to employers (AAOHN, 1996). As evidence based health care challenges the occupational health community to demonstrate business rationale and financial return on investment, occupational and environmental health nurses must meet that challenge if they are to define their preferred future (DiBenedetto, 2000).

  8. Application of material flow analysis to municipal solid waste in Maputo City, Mozambique.

    PubMed

    Dos Muchangos, Leticia Sarmento; Tokai, Akihiro; Hanashima, Atsuko

    2017-03-01

    Understanding waste flows within an urban area is important for identifying the main problems and improvement opportunities for efficient waste management. Assessment tools such as material flow analysis (MFA), an extensively applied method in waste management studies, provide a structured and objective evaluating process to characterize the waste management system best, to identify its shortcomings and to propose suitable strategies. This paper presents the application of MFA to municipal solid waste management (MSWM) in Maputo City, the capital of Mozambique. The results included the identification and quantification of the main input and output flows of the MSWM system in 2007 and 2014, from the generation, material recovery and collection, to final disposal and the unaccounted flow of municipal solid waste (MSW). We estimated that the waste generation increased from 397×10(3) tonnes in 2007 to 437×10(3) tonnes in 2014, whereas the total material recovery was insignificant in both years - 3×10(3) and 7×10(3) tonnes, respectively. As for collection and final disposal, the official collection of waste to the local dumpsite in the inner city increased about threefold, from 76×10(3) to 253×10(6) tonnes. For waste unaccounted for, the estimates indicated a reduction during the study period from 300×10(3) to 158×10(3) tonnes, due to the increase of collection services. The emphasized aspects include the need for practical waste reduction strategies, the opportunity to explore the potential for material recovery, careful consideration regarding the growing trend of illegal dumping and the urgency in phasing-out from the harmful practice of open dumping.

  9. Combined Municipal Solid Waste and biomass system optimization for district energy applications.

    PubMed

    Rentizelas, Athanasios A; Tolis, Athanasios I; Tatsiopoulos, Ilias P

    2014-01-01

    Municipal Solid Waste (MSW) disposal has been a controversial issue in many countries over the past years, due to disagreement among the various stakeholders on the waste management policies and technologies to be adopted. One of the ways of treating/disposing MSW is energy recovery, as waste is considered to contain a considerable amount of bio-waste and therefore can lead to renewable energy production. The overall efficiency can be very high in the cases of co-generation or tri-generation. In this paper a model is presented, aiming to support decision makers in issues relating to Municipal Solid Waste energy recovery. The idea of using more fuel sources, including MSW and agricultural residue biomass that may exist in a rural area, is explored. The model aims at optimizing the system specifications, such as the capacity of the base-load Waste-to-Energy facility, the capacity of the peak-load biomass boiler and the location of the facility. Furthermore, it defines the quantity of each potential fuel source that should be used annually, in order to maximize the financial yield of the investment. The results of an energy tri-generation case study application at a rural area of Greece, using mixed MSW and biomass, indicate positive financial yield of investment. In addition, a sensitivity analysis is performed on the effect of the most important parameters of the model on the optimum solution, pinpointing the parameters of interest rate, investment cost and heating oil price, as those requiring the attention of the decision makers. Finally, the sensitivity analysis is enhanced by a stochastic analysis to determine the effect of the volatility of parameters on the robustness of the model and the solution obtained.

  10. Landfill cover soil, soil solution, and vegetation responses to municipal landfill leachate applications.

    PubMed

    Macdonald, Neil W; Rediske, Richard R; Scull, Brian T; Wierzbicki, David

    2008-01-01

    Municipal solid waste landfill leachate must be removed and treated to maintain landfill cover integrity and to prevent contamination of surface and ground waters. From 2003 to 2007, we studied an onsite disposal system in Ottawa County, Michigan, where leachate was spray irrigated on the vegetated landfill cover. We established six 20-m-diameter circular experimental plots on the landfill; three were spray irrigated as part of the operational system, and three remained as untreated control plots. We quantified the effects of leachate application on soil properties, soil solution chemistry, vegetative growth, and estimated solute leaching. The leachate had high mean levels of electrical conductivity (0.6-0.7 S m(-1)), Cl (760-900 mg L(-1)), and NH(4)-N (290-390 mg L(-1)) but was low in metals and volatile organic compounds. High rates of leachate application in 2003 (32 cm) increased soil electrical conductivity and NO(3)-N leaching, so a sequential rotation of spray areas was implemented to limit total leachate application to <9.6 cm yr(-1) per spray area. Concentrations of NO(3)-N and leaching losses remained higher on irrigated plots in subsequent years but were substantially reduced by spray area rotation. Leachate irrigation increased plant biomass but did not significantly affect soil metal concentrations, and plant metal concentrations remained within normal ranges. Rotating spray areas and timing irrigation to conform to seasonal capacities for evapotranspiration reduced the localized impacts of leachate application observed in 2003. Careful monitoring of undiluted leachate applications is required to avoid adverse impacts to vegetation or soils and elevated solute leaching losses.

  11. Community College Cost Effectiveness Study.

    ERIC Educational Resources Information Center

    Illinois Community Coll. Board, Springfield.

    In 1989, an Illinois Community College Board committee examined the issue of cost effectiveness among the state's community colleges. The individual cost categories examined for the study included direct salary, direct department, direct equipment, building rental, operation and maintenance, academic administration and planning, learning…

  12. Cost-effectiveness of statins.

    PubMed

    Huse, D M; Russell, M W; Miller, J D; Kraemer, D F; D'Agostino, R B; Ellison, R C; Hartz, S C

    1998-12-01

    Currently, 6 hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) are marketed in the United States (US). Given the wide variation in the prices and efficacy of statins, formal cost-effectiveness analysis may improve drug selection decisions. To assess the cost-effectiveness of statin therapy in primary and secondary prevention of coronary heart disease, we developed a model of the costs and consequences of lipid-regulating therapy and estimated the incremental cost-effectiveness of 5 statins (atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin) at usual starting doses versus no therapy. Drug effects on serum lipids were assessed using data approved by the US Food and Drug Administration for product labeling. Annual risks of coronary event occurrence were estimated using Framingham Heart Study coronary risk equations developed for use in this model. Current estimates of direct medical costs of coronary heart disease were used to assign costs to health states and acute coronary events. Main outcome measurements were net cost (statin therapy minus savings in coronary heart disease treatment), gain in life expectancy, and cost per life-year saved. The maximum gain in life expectancy was achieved with atorvastatin, which also had a lower net cost than lovastatin, pravastatin, and simvastatin. Compared with fluvastatin, atorvastatin's greater effectiveness is attained at a lower cost per life-year saved. The cost-effectiveness of HMG-CoA reductase inhibition in primary and secondary prevention of coronary heart disease has been improved with the introduction of atorvastatin.

  13. Combined Municipal Solid Waste and biomass system optimization for district energy applications

    SciTech Connect

    Rentizelas, Athanasios A. Tolis, Athanasios I. Tatsiopoulos, Ilias P.

    2014-01-15

    Highlights: • Combined energy conversion of MSW and agricultural residue biomass is examined. • The model optimizes the financial yield of the investment. • Several system specifications are optimally defined by the optimization model. • The application to a case study in Greece shows positive financial yield. • The investment is mostly sensitive on the interest rate, the investment cost and the heating oil price. - Abstract: Municipal Solid Waste (MSW) disposal has been a controversial issue in many countries over the past years, due to disagreement among the various stakeholders on the waste management policies and technologies to be adopted. One of the ways of treating/disposing MSW is energy recovery, as waste is considered to contain a considerable amount of bio-waste and therefore can lead to renewable energy production. The overall efficiency can be very high in the cases of co-generation or tri-generation. In this paper a model is presented, aiming to support decision makers in issues relating to Municipal Solid Waste energy recovery. The idea of using more fuel sources, including MSW and agricultural residue biomass that may exist in a rural area, is explored. The model aims at optimizing the system specifications, such as the capacity of the base-load Waste-to-Energy facility, the capacity of the peak-load biomass boiler and the location of the facility. Furthermore, it defines the quantity of each potential fuel source that should be used annually, in order to maximize the financial yield of the investment. The results of an energy tri-generation case study application at a rural area of Greece, using mixed MSW and biomass, indicate positive financial yield of investment. In addition, a sensitivity analysis is performed on the effect of the most important parameters of the model on the optimum solution, pinpointing the parameters of interest rate, investment cost and heating oil price, as those requiring the attention of the decision makers

  14. Time-Series Modeling and Simulation for Comparative Cost-Effective Analysis in Cancer Chemotherapy: An Application to Platinum-Based Regimens for Advanced Non-small Cell Lung Cancer.

    PubMed

    Chisaki, Yugo; Nakamura, Nobuhiko; Yano, Yoshitaka

    2017-01-01

    The purpose of this study was to propose a time-series modeling and simulation (M&S) strategy for probabilistic cost-effective analysis in cancer chemotherapy using a Monte-Carlo method based on data available from the literature. The simulation included the cost for chemotherapy, for pharmaceutical care for adverse events (AEs) and other medical costs. As an application example, we describe the analysis for the comparison of four regimens, cisplatin plus irinotecan, carboplatin plus paclitaxel, cisplatin plus gemcitabine (GP), and cisplatin plus vinorelbine, for advanced non-small cell lung cancer. The factors, drug efficacy explained by overall survival or time to treatment failure, frequency and severity of AEs, utility value of AEs to determine QOL, the drugs' and other medical costs in Japan, were included in the model. The simulation was performed and quality adjusted life years (QALY) and incremental cost-effectiveness ratios (ICER) were calculated. An index, percentage of superiority (%SUP) which is the rate of the increased cost vs. QALY-gained plots within the area of positive QALY-gained and also below some threshold values of the ICER, was calculated as functions of threshold values of the ICER. An M&S process was developed, and for the simulation example, the GP regimen was the most cost-effective, in case of threshold values of the ICER=$70000/year, the %SUP for the GP are more than 50%. We developed an M&S process for probabilistic cost-effective analysis, this method would be useful for decision-making in choosing a cancer chemotherapy regimen in terms of pharmacoeconomic.

  15. Guidelines for selection and application of the most cost-effective NO sub x control technologies for gas, oil and coal fired boilers

    SciTech Connect

    Czerniak, D.O.; Booth, R.B.; McDonald, B.L. ); Feenstra, D.R. )

    1991-01-01

    As a result of the new Clean Air Act, lower NO{sub x} emissions from stationary sources will be required of utilities and independent power producers that burn all fuels including gas, oil and coal. This new legislation, as well as new and more stringent NO{sub x} reduction orders imposed by state and local regulatory agencies, will require rapid evaluation, purchase, installation and start-up of a variety of control technologies. There is substantial volume of literature available discussing NO{sub x} control technologies, their control effectiveness, costs, and chemical reaction mechanisms in forming NO{sub x}. This paper, however, presents more practical aspects of developing a NO{sub x} control strategy and implementing the appropriate cost-effective control technology on a utility or industrial boiler.

  16. Bioflocculant production from Solibacillus silvestris W01 and its application in cost-effective harvest of marine microalga Nannochloropsis oceanica by flocculation.

    PubMed

    Wan, Chun; Zhao, Xin-Qing; Guo, Suo-Lian; Asraful Alam, Md; Bai, Feng-Wu

    2013-05-01

    Microalgae are widely studied for biofuel production, however, current technologies to harvest microalgae for this purpose are not well developed. In this work, a bacterial strain W01 was isolated from activated sludge and identified as Solibacillus silvestris. Bioflocculant in the culture broth of W01 showed 90% flocculating efficiency on marine microalga Nannochloropsis oceanica, and no metal ion was required for the flocculation process. Chemical analysis of the purified bioflocculant indicated that it is a proteoglycan composed of 75.1% carbohydrate and 24.9% protein (w/w). The bioflocculant exhibits no effect on the growth of microalgal cells and can be reused to for economical harvesting of N. oceanica. This is the first report that strain of S. silvestris can produce bioflocculant for microalgae harvest. The novel bioflocculant produced by W01 has the potential to harvest marine microalgae for cost-effective production of microalgal bioproducts.

  17. Cost-effectiveness of Interferon-free therapy for Hepatitis C in Germany--an application of the efficiency frontier approach.

    PubMed

    Gissel, Christian; Götz, Georg; Mahlich, Jörg; Repp, Holger

    2015-07-30

    The approval of direct-acting antivirals for Interferon-free treatment revolutionized the therapy of chronic Hepatitis C infection. As of August 2014, two treatment regimens for genotype 1 infection received conditional approval in the European Union: Sofosbuvir and Ribavirin for 24 weeks and Sofosbuvir and Simeprevir with or without Ribavirin for 12 weeks. We aim to analyze the cost-effectiveness of both regimens in Germany. We set up a Markov model with a lifetime horizon to simulate immediate treatment success and long-term disease progression for treatment-naive patients. The model analyzes both short-term and long-term costs and benefits from the perspective of the German Statutory Health Insurance. We apply the efficiency frontier method, which was suggested by German Institute for Quality and Efficiency in Health Care for cost-effectiveness analysis in Germany. The efficiency frontier is defined by dual therapy and first generation direct-acting antiviral Boceprevir, yielding a maximum of € 1,447.69 per additional percentage point of sustained virologic response gained. Even without rebates, Sofosbuvir/Simeprevir is very close with € 1,560.13 per additional percentage point. It is both more effective and less expensive than Sofosbuvir/Ribavirin. In addition to higher sustained virologic response rates, new direct-acting antivirals save long-term costs by preventing complications such as liver cirrhosis, hepatocellular carcinoma and ultimately liver transplants, thereby offsetting part of higher drug costs. Our findings are in line with the guidance published by German Society for Gastroenterology, Digestive and Metabolic Diseases, which recommends Sofosbuvir/Simeprevir for Interferon ineligible or intolerant patients.

  18. 75 FR 53686 - Gresham Municipal Utilities; Notice of Intent To File License Application, Filing of Pre...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-01

    ..., Wisconsin. No federal lands are occupied by the project works or located within the project boundary. g... Division of Hydropower Licensing, approved Gresham Municipal Utilities request to use the Traditional...

  19. Cost in Cost-Effectiveness

    DTIC Science & Technology

    2002-07-01

    Just to make sure we’re all talking about the same thing, I will run down the steps involved in conducting a cost -effectiveness study. The problem...systems, and forecasts of the costs of developing and producing the systems. Industry works closely with the prospective buying military departments...separate from the buying military department. These estimates are now done by the OSD Cost Analysis Improvement Group, a part of the OSD Staff

  20. Application of a fast and cost-effective in situ derivatization method prior to gas chromatography with mass spectrometry to monitor endocrine disruptors in water matrices.

    PubMed

    Melo, Armindo; Ferreira, Isabel M P L V O; Mansilha, Catarina

    2015-06-01

    This work deals with the optimization of a rapid, cost-effective, and eco-friendly gas chromatography with mass spectrometry method for the simultaneous determination of four endocrine disruptor compounds in water matrices: estrone, 17β-estradiol, 17α-ethinylestradiol, and bisphenol A, that are currently considered to be of main concern in the field of water policy and that could became candidates for future regulations. The method involves simultaneous derivatization and extraction of compounds by dispersive liquid-liquid microextraction followed by gas chromatography with mass spectrometry analysis. Derivatization and extraction parameters were optimized with the aid of experimental design approach. An excellent linear response was achieved for all analytes (r(2) ≥ 0.999). Limits of detection and quantification are 0.003-0.005 and 0.0094-0.0164 μg/L, respectively. Intraday precision ranged between 1.1 and 12.6%, whereas interday precision ranged between 0.5 and 14.7%. For accuracy, bias values varied between -15.0 and 13.7%. Recoveries at three concentration levels ranged from 86.4 to 118.2%. The proposed method can be applied to the routine analysis of groundwater, river, sea, tap, and mineral water samples with excellent sensitivity, precision, and accuracy.

  1. Cost effective machining and inspection of structural ceramic components for advanced high temperature application. Final CRADA report for CRADA number Y-1292-0151

    SciTech Connect

    Abbatiello, L.A.; Haselkorn, M.

    1996-11-29

    This Cooperative Research and Development Agreement (CRADA) was a mutual research and development (R and D) effort among the participants to investigate a range of advanced manufacturing technologies for two silicon nitride (Si{sub 3}N{sub 4}) ceramic materials. The general objective was to identify the most cost-effective part manufacturing processes for the ceramic materials of interest. The focus was determining the relationship between material removal rates, surface quality, and the structural characteristics of each ceramic resulting from three innovative processes. These innovated machining processes were studied using silicon nitride advanced materials. The particular (Si{sub 3}N{sub 4}) materials of interest were sintered GS-44 from the Norton Company, and reaction-bonded Ceraloy 147-3. The processes studied included the following activities: (1) direct laser machining; (2) rotary ultrasonic machining; and (3) diamond abrasive grinding, including both resinoid and vitreous-bonded grinding wheels. Both friable and non-friable diamond types were included within the abrasive grinding study. The task also conducted a comprehensive survey of European experience in use of ceramic materials, principally aluminum oxide. Originally, the effort of this task was to extend through a prototype manufacturing demonstration of selected engine components. During the execution of this program, however changes were made to the scope of the project, altering the goals. The Program goal became only the development of assessment of their impacts on product strength and surface condition.

  2. Using stated preference methods to design cost-effective subsidy programs to induce technology adoption: an application to a stove program in southern Chile.

    PubMed

    Gómez, Walter; Salgado, Hugo; Vásquez, Felipe; Chávez, Carlos

    2014-01-01

    We study the design of an economic incentive based program - a subsidy - to induce adoption of more efficient technology in a pollution reduction program in southern Chile. Stated preferences methods, contingent valuation (CV), and choice experiment (CE) are used to estimate the probability of adoption and the willingness to share the cost of a new technology by a household. The cost-effectiveness property of different subsidy schemes is explored numerically for different regulatory objectives. Our results suggest that households are willing to participate in voluntary programs and to contribute by paying a share of the cost of adopting more efficient technologies. We find that attributes of the existing and the new technology, beyond the price, are relevant determinant factors of the participation decision and payment. Limited access to credit markets for low income families can be a major barrier for an effective implementation of these types of programs. Variations in the design of the subsidy and on the regulator's objective and constraints can have significant impact on the level and the cost of reduction of aggregate emissions achieved. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Teleradiotherapy Network: Applications and Feasibility for Providing Cost-Effective Comprehensive Radiotherapy Care in Low- and Middle-Income Group Countries for Cancer Patients

    PubMed Central

    Heuser, Michael; Samiei, Massoud; Shah, Ragesh; Lutters, Gerd; Bodis, Stephan

    2015-01-01

    Abstract Globally, new cancer cases will rise by 57% within the next two decades, with the majority in the low- and middle-income countries (LMICs). Consequently, a steep increase of about 40% in cancer deaths is expected there, mainly because of lack of treatment facilities, especially radiotherapy. Radiotherapy is required for more than 50% of patients, but the capital cost for equipment often deters establishment of such facilities in LMICs. Presently, of the 139 LMICs, 55 do not even have a radiotherapy facility, whereas the remaining 84 have a deficit of 61.4% of their required radiotherapy units. Networking between centers could enhance the effectiveness and reach of existing radiotherapy in LMICs. A teleradiotherapy network could enable centers to share and optimally utilize their resources, both infrastructure and staffing. This could be in the form of a three-tier radiotherapy service consisting of primary, secondary, and tertiary radiotherapy centers interlinked through a network. The concept has been adopted in some LMICs and could also be used as a “service provider model,” thereby reducing the investments to set up such a network. Teleradiotherapy networks could be a part of the multipronged approach to address the enormous gap in radiotherapy services in a cost-effective manner and to support better accessibility to radiotherapy facilities, especially for LMICs. PMID:25763906

  4. Cost effectiveness of recycling: A systems model

    SciTech Connect

    Tonjes, David J.; Mallikarjun, Sreekanth

    2013-11-15

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

  5. Cost effectiveness of recycling: a systems model.

    PubMed

    Tonjes, David J; Mallikarjun, Sreekanth

    2013-11-01

    Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have also found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Source-separated municipal solid waste compost application to Swiss chard and basil.

    PubMed

    Zheljazkov, Valtcho D; Warman, Philip R

    2004-01-01

    A growth room experiment was conducted to evaluate the bioavailability of Cu, Mn, Zn, Ca, Fe, K, Mg, P, S, As, B, Cd, Co, Cr, Hg, Mo, Na, Ni, Pb, and Se from a sandy loam soil amended with source-separated municipal solid waste (SSMSW) compost. Basil (Ocimum basilicum L.) and Swiss chard (Beta vulgaris L.) were amended with 0, 20, 40, and 60% SSMSW compost to soil (by volume) mixture. Soils and compost were sequentially extracted to fractionate Cu, Pb, and Zn into exchangeable (EXCH), iron- and manganese-oxide-bound (FeMnOX), organic-matter (OM), and structurally bound (SB) forms. Overall, in both species, the proportion of Cu, Pb, and Zn levels in different fractions followed the sequence: SB > OM > FeMnOX > EXCH for Cu; FeMnOX = SB > OM > EXCH for Pb; and FeMnOX > SB = EXCH > OM for Zn. Application of SSMSW compost increased soil pH and electrical conductivity (EC), and increased the concentration of Cu, Pb, and Zn in all fractions, but not EXCH Pb. Basil yields were greatest in the 20% treatment, but Swiss chard yields were greater in all compost-amended soils relative to the unamended soil. Basil plants in 20 or 40% compost treatments reached flowering earlier than plants from other treatments. Additions of SSMSW compost to soil altered basil essential oil, but basil oil was free of metals. The results from this study suggest that mature SSMSW compost with concentrations of Cu, Pb, Mo, and Zn of 311, 223, 17, and 767 mg/kg, respectively, could be used as a soil conditioner without phytotoxic effects on agricultural crops and without increasing the normal range of Cu, Pb, and Zn in crop tissue. However, the long-term effect of the accumulation of heavy metals in soils needs to be carefully considered.

  7. Cost effectiveness of sonic drilling

    SciTech Connect

    Masten, D.; Booth, S.R.

    1996-03-01

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

  8. Cost-effective production of 13C, 15N stable isotope-labelled biomass from phototrophic microalgae for various biotechnological applications.

    PubMed

    Acién Fernández, F G; Fernández Sevilla, J M; Egorova-Zachernyuk, T A; Molina Grima, E

    2005-12-01

    The present study outlines a process for the cost-effective production of 13C/15N-labelled biomass of microalgae on a commercial scale. The core of the process is a bubble column photobioreactor with exhaust gas recirculation by means of a low-pressure compressor. To avoid accumulation of dissolved oxygen in the culture, the exhaust gas is bubbled through a sodium sulphite solution prior to its return to the reactor. The engineered system can be used for the production of 13C, 15N, and 13C-15N stable isotope-labelled biomass as required. To produce 13C-labelled biomass, 13CO2 is injected on demand for pH control and carbon supply, whereas for 15N-labelled biomass Na15NO3 is supplied as nitrogen source at the stochiometric concentration. The reactor is operated in semicontinuous mode at different biomass concentrations, yielding a maximum mean biomass productivity of 0.3 gL(-1) day(-1). In order to maximize the uptake efficiency of the labelled substrates, the inorganic carbon is recovered from the supernatant by acidification/desorption processes, while the nitrate is delivered at stochiometric concentration and the harvesting of biomass is performed when the 15NO3- is depleted. In these conditions, elemental analysis of both biomass and supernatant shows that 89.2% of the injected carbon is assimilated into the biomass and 6.9% remains in the supernatant. Based on elemental analysis, 97.8% of the supplied nitrogen is assimilated into the biomass and 1.3% remains in the supernatant. Stable isotope-labelling enrichment has been analysed by GC-MS results showing that the biomass is highly labelled. All the fatty acids are labelled; more than 96% of the carbon present in these fatty acids is 13C. The engineered system was stably operated for 3 months, producing over 160 g of 13C and/or 15N-labelled biomass. The engineered bioreactor can be applied for the labelling of various microalgae.

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

    PubMed

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

    2015-02-01

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

  10. 78 FR 48667 - Western Minnesota Municipal Power Agency; Notice of Application Accepted for Filing, Soliciting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-09

    ... Minnesota Municipal Power Agency e. Name of Project: Red Rock Hydroelectric Project f. Location: The project is located at the U.S. Army Corps of Engineers Lake Red Rock Dam on the Des Moines River in Marion... and reproduction at the Commission's Public Reference Room, located at 888 First Street NE., Room 2A...

  11. Direct recycling of municipal ferrous wastes for local foundry application. Final technical report

    SciTech Connect

    Not Available

    1981-01-09

    This project investigated the concept of direct recycling as an appropriate technology (AT) approach to improving resource recovery from wastes in Region III. Direct recycling is the process of bringing waste materials directly to reprocessing facilities with few or no intermediate processing steps. Municipal Ferrous Waste (MFW) was the waste material involved. The Region III states were surveyed for (a) municipal recycling systems incorporating MFW separation and (b) grey iron foundries where MFW could be utilized. Contacts and visits were made with foundry and recycling group personnel. A handbook titled Tin Cans and Trash Recovery was prepared for distribution to interested persons in Region III. This handbook delineates the direct recycling method for MFW, describes recycling potential for areas of different populations in the Region, and lists foundries, recycling groups, and resource persons for the Region. It was distributed widely in Region III and elsewhere.

  12. Development and application of the decision support system for municipal solid waste management in central Taiwan.

    PubMed

    Chang, Yao-Jen; Lin, Min-Der

    2013-05-01

    Municipal solid waste management (MSWM) is an important, practical and challenging environmental subject. The processes of a MSWM system include household collection, transportation, treatment, material recycling, compost and disposal. A regional program of MSWM is more complicated owing to the involvement of multi-municipality and multi-facility issues. Therefore, an effective decision support system capable of solving regional MSWM problems is necessary for decision-makers. This article employs linear programming techniques to establish a MSWM decision support system (MSWM-DSS) that is able to determine the least costs of regional MSWM strategies. The results of investigating a real-world case in central Taiwan indicate that a regional program is more economical and efficient. For the redeployment of MSW streams, the relatively least cost of operation for the MSWM system can still be achieved through the re-estimation of the MSWM-DSS. This tool and results are useful for MSWM policy-making in central Taiwan.

  13. Accumulation and spatial distribution of Cd, Cr, and Pb in mulberry from municipal solid waste compost following application of EDTA and (NH4)2SO4.

    PubMed

    Zhao, Shulan; Shang, Xiaojuan; Duo, Lian

    2013-02-01

    Municipal solid waste compost can be used to cropland as soil amendment to supply nutrients and improve soil physical properties. But long-term application of municipal solid waste (MSW) compost may result in accumulation of toxic metals in amended soil. Phytoremediation, especially phytoextraction, is a novel, cost-effective, and environmentally friendly approach that uses metal-accumulating plants to concentrate and remove metals from contaminated soils. Ethylenediaminetetraacetate (EDTA) was applied to metal-contaminated soil to increase the mobility and phytoavailability of metals in soil, thereby increasing the amount of toxic metals accumulated in the upper parts of phytoextracting plants. The objectives of this study were (1) to investigate the accumulation and spatial distribution of toxic metals (Cd, Cr, and Pb) in mulberry from MSW compost with the application of EDTA and (NH(4))(2)SO(4), (2) to examine the effectiveness of EDTA and (NH(4))(2)SO(4) applied together on toxic metals (Cd, Cr, and Pb) removal by mulberry under field conditions, and (3) to evaluate the potential of mulberry for phytoextraction of toxic metals from MSW compost. The tested plant-mulberry had been grown in MSW compost field for 4 years. EDTA solution at five rates (0, 50, 100, 50 mmol L(-1) + 1 g L(-1) (NH(4))(2)SO(4), and 100 mmol L(-1) + 1 g L(-1) (NH(4))(2)SO(4)) was added into mulberry root medium in September 2009. Twenty days later, the plants were harvested and separated into six parts according to plant height. Cd, Cr, and Pb contents in plant samples and MSW compost were analyzed using an atomic absorption spectrophotometer. In the same treatment, Cd, Cr, and Pb concentrations in mulberry shoot were all higher than those in root, and Cd and Pb concentrations in shoot increased from lower to upper parts, reaching the highest in leaves. Significant increases were found in toxic metal concentration in different parts of mulberry with increasing EDTA concentration

  14. Systematic, appropriate, and cost-effective application of security technologies in U.S. public schools to reduce crime, violence, and drugs

    NASA Astrophysics Data System (ADS)

    Green, Mary W.

    1997-01-01

    As problems of violence and crime become more prevalent in our schools, more and more school districts will elect to use security technologies to control these problems. While the desired change in student and community attitudes will require significant systemic change through intense US social programs, security technologies can greatly augment school staff today by providing services similar to having extra adults present. Technologies such as cameras, sensors, drug detection, biometric and personnel identification, lighting, barriers, weapon and explosives detection, anti- graffiti methods, and duress alarms can all be effective, given they are used in appropriate applications, with realistic expectations and an understanding of limitations. Similar to a high-risk government facility, schools must consider a systems approach to security, which includes the use of personnel and procedures as well as security technologies, such that the synergy created by all these elements together contributes more tot he general 'order maintenance' of the facility than could be achieved by separate measures not integrated or related.

  15. Systematic, appropriate, and cost-effective application of security technologies in U.S. public schools to reduce crime, violence, and drugs

    SciTech Connect

    Green, M.W.

    1996-12-31

    As problems of violence and crime become more prevalent in our schools (or at least the perception of their prevalence), more and more school districts will elect to use security technologies to control these problems. While the desired change in student and community attitudes will require significant systemic change through intense U.S. social programs, security technologies can greatly augment school staff today by providing services similar to having extra adults present. Technologies such as cameras, sensors, drug detection, biometric and personnel identification, lighting, barriers, weapon and explosives detection, anti-graffiti methods, and duress alarms can all be effective, given they are used in appropriate applications, with realistic expectations and an understanding of limitations. Similar to a high-risk government facility, schools must consider a systems (`big picture`) approach to security, which includes the use of personnel and procedures as well as security technologies, such that the synergy created by all these elements together contributes more to the general `order maintenance` of the facility than could be achieved by separate measures not integrated or related.

  16. Facile and cost-effective preparation of PVA/modified calcium carbonate nanocomposites via ultrasonic irradiation: Application in adsorption of heavy metal and oxygen permeation property.

    PubMed

    Mallakpour, Shadpour; Khadem, Elham

    2017-11-01

    This work is focused on the fabrication and determination of physicochemical behaviors of new poly(vinyl alcohol) (PVA) nanocomposites (NCs) containing various contents of calcium carbonate (CC) nanoparticles modified with γ-aminopropyl triethoxy silane (ATS) (henceforth designated as CC-ATS) which could be a crucial treatment for their application as gas barrier to O2 gas and uptake of metal ions in waste waters. Samples were produced through the solution casting method under ultrasound irradiation. Thermal and mechanical performances were also evaluated for all ultrasonically synthesized nanocomposites and the results indicated that thermal and mechanical stability are dramatically enhanced by addition of a small amount of modified CC-ATS within PVA up to 5wt% and higher amounts has low effect on the composite properties. The result of oxygen gas permeability of PVA showed a 25.44% reduction by adding of 5wt% of CC-ATS into polymer matrix. Experimental adsorption isotherm data indicated that PVA NC has more efficiency for Cu(II) adsorption relative to pure PVA and well simulated by Langmuir model with maximum adsorption capacity of 45.45mgg(-1). Moreover, study of sorption kinetic indicated that the solute adsorption on PVA/CC-ATS NC 5wt% was well modeled using the pseudo-second-order. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. The Nonmydriatic Fundus Camera in Diabetic Retinopathy Screening: A Cost-Effective Study with Evaluation for Future Large-Scale Application

    PubMed Central

    Scarpa, Giuseppe; Urban, Francesca; Tessarin, Michele; Gallo, Giovanni; Midena, Edoardo

    2016-01-01

    Aims. The study aimed to present the experience of a screening programme for early detection of diabetic retinopathy (DR) using a nonmydriatic fundus camera, evaluating the feasibility in terms of validity, resources absorption, and future advantages of a potential application, in an Italian local health authority. Methods. Diabetic patients living in the town of Ponzano, Veneto Region (Northern Italy), were invited to be enrolled in the screening programme. The “no prevention strategy” with the inclusion of the estimation of blindness related costs was compared with screening costs in order to evaluate a future extensive and feasible implementation of the procedure, through a budget impact approach. Results. Out of 498 diabetic patients eligible, 80% was enrolled in the screening programme. 115 patients (34%) were referred to an ophthalmologist and 9 cases required prompt treatment for either proliferative DR or macular edema. Based on the pilot data, it emerged that an extensive use of the investigated screening programme, within the Greater Treviso area, could prevent 6 cases of blindness every year, resulting in a saving of €271,543.32 (−13.71%). Conclusions. Fundus images obtained with a nonmydriatic fundus camera could be considered an effective, cost-sparing, and feasible screening tool for the early detection of DR, preventing blindness as a result of diabetes. PMID:27885337

  18. A time- and cost-effective strategy to sequence mammalian Y Chromosomes: an application to the de novo assembly of gorilla Y

    PubMed Central

    Tomaszkiewicz, Marta; Rangavittal, Samarth; Cechova, Monika; Sanchez, Rebeca Campos; Fescemyer, Howard W.; Harris, Robert; Ye, Danling; O'Brien, Patricia C.M.; Chikhi, Rayan; Ryder, Oliver A.; Ferguson-Smith, Malcolm A.; Medvedev, Paul; Makova, Kateryna D.

    2016-01-01

    The mammalian Y Chromosome sequence, critical for studying male fertility and dispersal, is enriched in repeats and palindromes, and thus, is the most difficult component of the genome to assemble. Previously, expensive and labor-intensive BAC-based techniques were used to sequence the Y for a handful of mammalian species. Here, we present a much faster and more affordable strategy for sequencing and assembling mammalian Y Chromosomes of sufficient quality for most comparative genomics analyses and for conservation genetics applications. The strategy combines flow sorting, short- and long-read genome and transcriptome sequencing, and droplet digital PCR with novel and existing computational methods. It can be used to reconstruct sex chromosomes in a heterogametic sex of any species. We applied our strategy to produce a draft of the gorilla Y sequence. The resulting assembly allowed us to refine gene content, evaluate copy number of ampliconic gene families, locate species-specific palindromes, examine the repetitive element content, and produce sequence alignments with human and chimpanzee Y Chromosomes. Our results inform the evolution of the hominine (human, chimpanzee, and gorilla) Y Chromosomes. Surprisingly, we found the gorilla Y Chromosome to be similar to the human Y Chromosome, but not to the chimpanzee Y Chromosome. Moreover, we have utilized the assembled gorilla Y Chromosome sequence to design genetic markers for studying the male-specific dispersal of this endangered species. PMID:26934921

  19. Application of constructed wetlands to the treatment of leachates from a municipal solid waste landfill in Ibadan, Nigeria.

    PubMed

    Aluko, Olufemi Oludare; Sridhar, M K C

    2005-06-01

    Leachates are wastewater generated principally from landfills and solid waste disposal sites. Leachates emanating from municipal wastes are a major source of surface and groundwater pollution worldwide. Globally, leachates have been implicated in low yield of farm produce, developmental anomalies, low birth weights, leukemia incidence, and other cancers in communities around the site. They have also been implicated in hazards to the environment, loss of biodiversity, and contamination of water sources. At Aba-Eku in Nigeria, leachates are being discharged into the Omi Stream without treatment. A study was conducted on a method of leachate treatment that passes the leachate through constructed wetlands using Ipomoea aquatica (Forsk), a locally available plant found close to the landfill site. The aim of the study was to evolve a sustainable and cost-effective method of treatment whose effluents can be discharged into the Omi Stream with no or minimal impact. The study was descriptive and analytical in design. Samples were collected and analyzed with standard methods for pH, suspended solids (SS), biochemical oxygen demand (BOD), chemical oxygen demand (COD), ammonia, nitrate, and trace metals. Raw leachates were turbid and amber in color and contained suspended solids (197.5 mg/L), ammonia (610.9 mg/L), lead (1.64 mg/L), iron (198.10 mg/L), and manganese (23.20 mg/L). When the leachates were passed through the constructed wetland with eight hours' detention time, effluents showed significant reductions in suspended solids (81.01 percent), BOD (86.03 percent), and ammonia (97.77 percent). The study shows that a constructed wetland is a feasible tool for the treatment of leachates before their disposal into the environment in Nigeria and can help safeguard environmental quality.

  20. Cost-effective endo-mannanase from Bacillus sp. CFR1601 and its application in generation of oligosaccharides from guar gum and as detergent additive.

    PubMed

    Srivastava, Praveen Kumar; Kapoor, Mukesh

    2014-01-01

    The indigenous bacteria Bacillus sp. CFR1601 produced significant levels of endo-mannanase when grown on agro-wastes, namely, green gram husk and sunflower oil cake (25.6 IU/mL), used as sole carbon and nitrogen sources, respectively. Under immobilized cell system, synthetic supports (polyurethane foam, scotch brite, polyester; up to 33.2 IU/mL) were found marginally superior as compared to natural supports (cotton and silk; up to 28.2 IU/mL) for endo-mannanase production. Cooperative interactions between L-lysine HCl (0.3% w/v), Tween 60 (0.3% v/v), and sunflower oil cake (3.0% w/v) in central composite design response surface methodology ameliorated (1.61-fold) endo-mannanase titers to 48.0 IU/mL. Partially purified endo-mannanase was tested for its ability to produce oligosaccharides from guar gum. These oligosaccharides were tested in vitro for their ability to promote growth of Lactobacillus plantarum MTCC 5422 and Lactobacillus salivarius CHS 1E. Results indicated that low-molecular-weight degraded products from guar gum were (1) able to support the growth of tested strains [increased O.D600nm up to 2.3-fold and decrease in pH (<6.3) due to production of short chain fatty acid (SCFA)] when used as sole carbon source; and (2) after purification and analysis by electron spray ionization-mass spectrometry (ESI-MS) were found to be composed of mainly disaccharide and tetrasaccharide. The compatibility of endo-mannanase with various detergents together with wash performance test confirmed its potential applicability for laundry industry.

  1. Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol.

    PubMed

    Prinja, Shankar; Nimesh, Ruby; Gupta, Aditi; Bahuguna, Pankaj; Thakur, Jarnail Singh; Gupta, Madhu; Singh, Tarundeep

    2016-01-01

    An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. A pre-post quasi-experimental design with a control group will be used to undertake difference in differences analysis for assessing the impact of intervention. The Annual Health Survey (2011) will provide pre-intervention data, and a household survey will be carried out to provide post-intervention data.Two community development blocks where the intervention was introduced will be treated as intervention blocks while two controls blocks are selected after matching with intervention blocks on three indicators: average number of antenatal care checkups, percentage of women receiving three or more antenatal checkups, and percentage of institutional deliveries. Two categories of beneficiaries will be interviewed in both areas: women with a child between 29 days and 6 months and women with a child between 12 and 23 months. Propensity score matched samples from intervention and control areas in pre-post periods will be analyzed using the difference in differences method to estimate the impact of intervention in utilization of key services.Bottom-up costing methods will be used to assess the cost of implementing intervention. A decision model will estimate long-term effects of improved health services utilization on mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per disability-adjusted life year averted and cost per unit increase in composite service coverage in intervention versus control groups. The study will generate significant evidence on impact of the m-health intervention for maternal, neonatal, and child services and on the cost of scaling up m-health technology for

  2. Cost-Effectiveness of Nitrogen Mitigation by Alternative ...

    EPA Pesticide Factsheets

    Household wastewater, especially from conventional septic systems, is a major contributor to nitrogen pollution. Alternative household wastewater management technologies provide similar sewerage management services but their life cycle costs and nitrogen flow implications remain uncertain. We seek to address two key questions: (1) what are the total costs, nitrogen mitigation potential, and cost-effectiveness of a range of conventional and alternative municipal wastewater treatment technologies, and (2) what uncertainties influence these outcomes, and how can we improve our understanding of these technologies? We estimate a household nitrogen mass balance for various household wastewater treatment systems and combine this mass balance with life cycle cost assessment to calculate the cost-effectiveness of nitrogen mitigation, which we define as nitrogen removed from the local watershed. We apply our methods to Falmouth, MA, where failing septic systems have caused heightened eutrophication in local receiving water bodies. We find that flushing and dry (composting) urine-diversion toilets paired with conventional septic systems for greywater management demonstrate the lowest life cycle cost and highest cost-effectiveness (dollars per kilogram of nitrogen removed from the watershed). Composting toilets and neighborhood-scale blackwater digesters are also attractive options in some cases, particularly best-case nitrogen mitigation; innovative/advanced septic system

  3. Application of a fully-integrated groundwater-surface water flow model in municipal asset management

    NASA Astrophysics Data System (ADS)

    Bowman, L. K.; Unger, A.; Jones, J. P.

    2014-12-01

    Access to affordable potable water is critical in the development and maintenance of urban centres. Given that water is a public good in Canada, all funds related to operation and maintenance of the drinking water and wastewater networks must come from consumers. An asset management system can be put in place by municipalities to more efficiently manage their water and wastewater distribution system to ensure proper use of these funds. The system works at the operational, tactical, and strategic levels, thus ensuring optimal scheduling of operation and maintenance activities, as well as prediction of future water demand scenarios. At the operational level, a fully integrated model is used to simulate the groundwater-surface water interaction of the Laurel Creek Watershed, of which 80% is urbanized by the City of Waterloo. Canadian municipalities typically lose 13% of their potable water through leaks in watermains and sanitary sewers, and sanitary sewers often generate substantial inflows from fractures in pipe walls. The City of Waterloo sanitary sewers carry an additional 10,000 cubic meters of water to wastewater treatment plants. Therefore, watermain and sanitary sewers present a significant impact on the groundwater-surface water interaction, as well as the affordability of the drinking water and wastewater networks as a whole. To determine areas of concern within the network, the integrated groundwater-surface water model also simulates flow through the City of Waterloo's watermain and sanitary sewer networks. The final model will be used to assess the interaction between measured losses of water from the City of Waterloo's watermain system, infiltration into the sanitary sewer system adjacent to the watermains, and the response of the groundwater system to deteriorated sanitary sewers or to pipes that have been recently renovated. This will ultimately contribute to the City of Waterloo's municipal asset management plan.

  4. Long-term growth enhancement of baldcypress (Taxodium distichum) from municipal wastewater application

    USGS Publications Warehouse

    Hesse, I.D.; Day, J.W.; Doyle, T.W.

    1998-01-01

    Tree ring analysis was used to document the long-term effects of municipal wastewater on the growth rate of baldcypress (Taxodium distichum (L.) Rich.]. The study site, a swamp in St. Martin Parish, Louisiana, has received municipal wastewater for the last 40 years. Growth chronologies from 1920 to 1992 were developed from cross-dated tree core samples taken from treated and control sites with similar size and age classes. Mean diameter increment (DINC) and mean basal area increment (BAI) chronologies were constructed separately for each stand. These chronologies were then summarized by tree and stand into seven nine-year intervals resulting in three pretreatment intervals from 1926 to 1952 and four treatment intervals from 1953 to 1988. Significant differences in growth response between sites showed a consistent pattern of growth enhancement in the treated site coincident with the onset of effluent discharge. The ratio of treated to control baldcypress growth rates (computed from DINC) averaged 0.74 during the pretreatment period and 1.53 during the treatment period. Over the period of study, control DINC decreased from 77 mm to 29 mm/nine-year interval, while treatment DINC increased slightly from 40 mm to 47 mm/nine-year interval. Control BAI did not increase significantly and averaged 192 cm2/nine-year interval. There was a significant increase in treatment BAI from 129 to 333 cm2/nine-year interval over the period of record. These results clearly demonstrate sustained long-term baldcypress growth enhancement throughout 40 years of municipal effluent discharge.

  5. Influence of municipal solid waste compost application on heavy metal content in soil.

    PubMed

    Yuksel, Orhan

    2015-06-01

    Municipal solid waste composts (MSWC) are widely used over agricultural lands as organic soil amendment and fertilizer. However, MSWC use may result in various adverse impacts over agricultural lands. Especially, heavy metal contents of MSWC should always be taken into consideration while using in agricultural practices. The present study was conducted to find out heavy metal contents of municipal solid waste compost (MSWC) and to investigate their effects on soils. Experiments were carried out in three replications as field experiments for 2 years. Dry-based MSWC was applied to each plot at the ratios of 0, 40, 80, 120, 160, 200 t ha(-1). Results revealed that heavy metal content of MSWC was within the allowable legal limits. Compost treatments significantly increased Cu, Zn, Ni, Cr, Cd, and Pb content of soils (p < 0.01). Increasing soil heavy metal contents were observed with increasing applied compost doses. Although compost treatments significantly increased soil heavy metal contents, the final contents were still within the allowable legal limits. Results showed that MSWC doses over 10 t ha(-1) may create a heavy metal risk in long term for soils with pH ≥ 7. Therefore, in MSWC use over agricultural lands, heavy metal contents should always be taken into consideration and excessive uses should be avoided.

  6. Use of thermal analysis techniques (TG-DSC) for the characterization of diverse organic municipal waste streams to predict biological stability prior to land application

    SciTech Connect

    Fernandez, Jose M.; Plaza, Cesar; Polo, Alfredo; Plante, Alain F.

    2012-01-15

    Highlights: Black-Right-Pointing-Pointer Thermal analysis was used to assess stability and composition of organic matter in three diverse municipal waste streams. Black-Right-Pointing-Pointer Results were compared with C mineralization during 90-day incubation, FTIR and {sup 13}C NMR. Black-Right-Pointing-Pointer Thermal analysis reflected the differences between the organic wastes before and after the incubation. Black-Right-Pointing-Pointer The calculated energy density showed a strong correlation with cumulative respiration. Black-Right-Pointing-Pointer Conventional and thermal methods provide complimentary means of characterizing organic wastes. - Abstract: The use of organic municipal wastes as soil amendments is an increasing practice that can divert significant amounts of waste from landfill, and provides a potential source of nutrients and organic matter to ameliorate degraded soils. Due to the high heterogeneity of organic municipal waste streams, it is difficult to rapidly and cost-effectively establish their suitability as soil amendments using a single method. Thermal analysis has been proposed as an evolving technique to assess the stability and composition of the organic matter present in these wastes. In this study, three different organic municipal waste streams (i.e., a municipal waste compost (MC), a composted sewage sludge (CS) and a thermally dried sewage sludge (TS)) were characterized using conventional and thermal methods. The conventional methods used to test organic matter stability included laboratory incubation with measurement of respired C, and spectroscopic methods to characterize chemical composition. Carbon mineralization was measured during a 90-day incubation, and samples before and after incubation were analyzed by chemical (elemental analysis) and spectroscopic (infrared and nuclear magnetic resonance) methods. Results were compared with those obtained by thermogravimetry (TG) and differential scanning calorimetry (DSC

  7. The Cost-Effectiveness of Raising Teacher Quality

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2009-01-01

    Econometric studies suggest that student achievement may be improved if high-performing teachers are substituted for low-performing teachers. Drawing upon a recent study linking teacher performance on licensure exams with gains in student achievement, an analysis was conducted to determine the cost-effectiveness of requiring teacher applicants to…

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

    ERIC Educational Resources Information Center

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

    1999-01-01

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

  9. A Departmental Cost-Effectiveness Model.

    ERIC Educational Resources Information Center

    Holleman, Thomas, Jr.

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

  10. In Search of Cost-Effective Schools.

    ERIC Educational Resources Information Center

    Raywid, Mary Anne; Shaheen, Thomas A.

    1994-01-01

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

  11. Cost-effectiveness thresholds: pros and cons.

    PubMed

    Bertram, Melanie Y; Lauer, Jeremy A; De Joncheere, Kees; Edejer, Tessa; Hutubessy, Raymond; Kieny, Marie-Paule; Hill, Suzanne R

    2016-12-01

    Cost-effectiveness analysis is used to compare the costs and outcomes of alternative policy options. Each resulting cost-effectiveness ratio represents the magnitude of additional health gained per additional unit of resources spent. Cost-effectiveness thresholds allow cost-effectiveness ratios that represent good or very good value for money to be identified. In 2001, the World Health Organization's Commission on Macroeconomics in Health suggested cost-effectiveness thresholds based on multiples of a country's per-capita gross domestic product (GDP). In some contexts, in choosing which health interventions to fund and which not to fund, these thresholds have been used as decision rules. However, experience with the use of such GDP-based thresholds in decision-making processes at country level shows them to lack country specificity and this - in addition to uncertainty in the modelled cost-effectiveness ratios - can lead to the wrong decision on how to spend health-care resources. Cost-effectiveness information should be used alongside other considerations - e.g. budget impact and feasibility considerations - in a transparent decision-making process, rather than in isolation based on a single threshold value. Although cost-effectiveness ratios are undoubtedly informative in assessing value for money, countries should be encouraged to develop a context-specific process for decision-making that is supported by legislation, has stakeholder buy-in, for example the involvement of civil society organizations and patient groups, and is transparent, consistent and fair.

  12. In Search of Cost-Effective Schools.

    ERIC Educational Resources Information Center

    Raywid, Mary Anne; Shaheen, Thomas A.

    1994-01-01

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

  13. Application of thermal plasma to vitrify fly ash from municipal solid waste incinerators.

    PubMed

    Wang, Qin; Yan, Jian-Hua; Chi, Yong; Li, Xiao-Dong; Lu, Sheng-Yong

    2010-01-01

    Several fly ash samples collected from different municipal solid waste incinerator plants were vitrified using thermal plasma furnace at 1400-1500 degrees C. After vitrification, there are obvious changes in microstructures and crystalline phases between produced slag and original ash. Toxicity characteristic leaching procedure results show that there is an excellent resistance against leaching of heavy metal ions. The residual fractions of heavy metals in slag presumably decrease in the following sequence: Cr>Ni>Cu>Zn>Pb>Cd. Almost all of PCDD/Fs could be destroyed through thermal plasma treatment. And the average decomposition efficiency of the samples vitrified by thermal plasma furnace is 100% in toxic equivalent calculations, higher than that of the samples vitrified by conventional resistance furnace. 2009 Elsevier Ltd. All rights reserved.

  14. 76 FR 4651 - Gresham Municipal Utilities; Notice of Intent To File License Application, Filing of Pre...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... Application, Filing of Pre-Application Document, and Approving Use of the Traditional Licensing Process... Utilities filed a Pre-Application Document (PAD; including a proposed process plan and schedule) with...

  15. Preparation of cross-linked cellulases and their application for the enzymatic production of glucose from municipal paper wastes.

    PubMed

    Filos, George; Tziala, Tania; Lagios, Gerassimos; Vynios, Demitrios H

    2006-01-01

    Hydrolysis of cellulosic wastes has been applied for environmental purposes and glucose production. An enzymatic process is proposed for such treatment of municipal cellulosic wastes, and the optimum conditions are described. It was found that different conditions should be applied for the treatment of soft or hard paper wastes, the most characteristic being pretreatment of wastes and temperature of the treatment process. Optimization of enzyme characteristics was also examined after stabilization of the enzymes by cross-linking. Endocellulase was better stabilized after cross-linking with EDAC whereas, exocellulase was better with glutaraldehyde. The application of cross-linked enzyme in the waste paper treatment process resulted in about a 25% increase of glucose liberation.

  16. Life-cycle assessment of municipal solid waste management alternatives with consideration of uncertainty: SIWMS development and application

    SciTech Connect

    El Hanandeh, Ali; El-Zein, Abbas

    2010-05-15

    This paper describes the development and application of the Stochastic Integrated Waste Management Simulator (SIWMS) model. SIWMS provides a detailed view of the environmental impacts and associated costs of municipal solid waste (MSW) management alternatives under conditions of uncertainty. The model follows a life-cycle inventory approach extended with compensatory systems to provide more equitable bases for comparing different alternatives. Economic performance is measured by the net present value. The model is verified against four publicly available models under deterministic conditions and then used to study the impact of uncertainty on Sydney's MSW management 'best practices'. Uncertainty has a significant effect on all impact categories. The greatest effect is observed in the global warming category where a reversal of impact direction is predicted. The reliability of the system is most sensitive to uncertainties in the waste processing and disposal. The results highlight the importance of incorporating uncertainty at all stages to better understand the behaviour of the MSW system.

  17. Use of municipal solid waste incineration bottom ashes in alkali-activated materials, ceramics and granular applications: A review.

    PubMed

    Silva, R V; de Brito, J; Lynn, C J; Dhir, R K

    2017-06-29

    This paper presents a literature review on the incorporation of municipal solid waste incinerated bottom ash as raw material in several markets, other than those where it is conventionally used, such as geotechnical applications and road pavement construction. The main findings of an ample selection of experimental investigations on the use of the bottom ash as precursor of alkali-activated materials, as an adsorbent material for the removal of hazardous elements from wastewater and landfill gases, as soil replacement in agricultural activities, as partial or complete substitute of raw materials for the manufacture of ceramic-based products, as landfill cover and as biogas production enhancer, were gathered, collated and analysed. Copyright © 2017. Published by Elsevier Ltd.

  18. Aluminium dynamics from soil to tea plant (Camellia sinensis L.): is it enhanced by municipal solid waste compost application?

    PubMed

    Karak, Tanmoy; Sonar, Indira; Paul, Ranjit K; Frankowski, Marcin; Boruah, Romesh K; Dutta, Amrit K; Das, Dilip K

    2015-01-01

    Application of municipal solid waste compost (MSWC) in tea (Camellia sinensis L.) cultivation can increase the fertility status of soils and thus enhance the plant growth. The present study attempts at application of MSWC in tea (TV1 and TV23 clones) cultivation to assess the effect of different doses of MSWC on growth and translocation potential of Al on this plant as well as fate of Al in soil, through the calculation of a risk assessment code (RAC). The sequential extraction of Al in MSWC amended soils showed that the fractionation of Al in soil changed after compost application, with an overall increase of the fractions associated to with Fe-Mn oxides, organic and of the residual fraction. The accumulation of Al in different parts ofC. sinensisL., grown on MSWC amended soil effected an overall increased growth of the plant with increasing doses of MSWC. According to RAC, Al falls in medium to high risk, though no adverse effect on plant health was observed. Tea plants were found to adapt well to MSWC amended soils. However, long term field trials are necessary to completely assess the risk of Al accumulation in soils upon MSWC application. Hierarchical cluster analysis was applied aiming to check for the presence of homogenous groups among different treatments. It was found that in both TV1 and TV23, treatments formed two different groups. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Assessment of physical vulnerability of buildings and analysis of landslide risk at the municipal scale - application to the Loures municipality, Portugal

    NASA Astrophysics Data System (ADS)

    Guillard-Gonçalves, C.; Zêzere, J. L.; Pereira, S.; Garcia, R. A. C.

    2015-09-01

    This study offers a semi-quantitative assessment of the physical vulnerability of buildings to landslides in the Loures municipality, as well as an analysis of the landslide risk computed as the product of the vulnerability by the economic value of the buildings and by the landslide hazard. The physical vulnerability assessment, which was based on a questionnaire sent to a pool of Portuguese and European researchers, and the assessment of the subjectivity of their answers are innovative contributions of this work. The generalization of the vulnerability to the smallest statistical subsection was validated by changing the map unit and applying the vulnerability to all the buildings of a test site (approximately 800 buildings), which were inventoried during fieldwork. The economic value of the buildings of the Loures municipality was calculated using an adaptation of the Portuguese Tax Services formula. The hazard was assessed by combining the susceptibility of the slopes, the spatio-temporal probability and the frequency-magnitude relationship of the landslide. Finally, the risk was mapped for different landslide magnitudes and different spatio-temporal probabilities. The highest landslide risk was found for the landslide with a depth of 3 m in the landslide body, and a height of 1m in the landslide foot.

  20. Seasonal isolation of microalgae from municipal wastewater for remediation and biofuel applications.

    PubMed

    Park, K C; Whitney, C G E; Kozera, C; O'Leary, S J B; McGinn, P J

    2015-07-01

    The objective of the study was to isolate the microalgae strains from treated municipal wastewater in both summer and winter seasons in order to identify strains better suited for nutrient remediation and biofuel production under either cooler or warmer temperatures. Fifty-six strains in total were isolated and identified by DNA sequencing from effluent samples collected from a local wastewater treatment plant during the summer and winter of 2011. Screening of 41 isolates based on the fatty acid productivity at either 22 or 10°C resulted in the selection of 12 strains organized into two groups of 6-the M (mild) and C (cool) groups, respectively. Four of the C-group strains were isolated from the winter sample, while four of the M-group isolates were isolated from the summer sample. Fatty acid pools in M-group strains were heavily regulated in response to growth temperature while C-group strains were more insensitive. In three of the six C-group strains, the rates of biomass and fatty acid productivity at 10°C exceeded the corresponding rates at 22°C. Conversely, M group were always more productive at 22 compared to 10°C. Mixotrophic strategies to enhance productivity were generally unsuccessful in M-group strains at 22°C but proved to be more effective in C-group cultures at 10°C. In general, C-group strains appeared better suited for growth in municipal wastewater at 10°C, while M-group strains were better suited at 22°C. On balance, C-group isolates were more likely to come from winter wastewater samples while M-group strains were more likely to come from the summer sample. Our results demonstrate that the effects of temperature on microalgal growth for wastewater remediation can be mitigated somewhat by isolation and careful selection of strains adapted to seasonal wastewater conditions. © 2015 Her Majesty the Queen in Right of Canada © 2015 The Society for Applied Microbiology. Reproduced with the permission of the Director General of the National

  1. Application of a gas-solid fluidized bed separator for shredded municipal bulky solid waste separation.

    PubMed

    Sekito, T; Matsuto, T; Tanaka, N

    2006-01-01

    A laboratory-scale gas-solid fluidized bed separator able to separate fractions of 5.6-50mm was used for separation of shredded municipal bulky waste (SBW) into combustibles and incombustibles. In batch-scale tests, it was found that accumulation of SBW in the bottom of the bed significantly reduced the separation efficiency. In this study, stirring was shown to be effective in preventing this accumulation. Flexible sheet materials such as paper and film plastics also significantly decreased the separation efficiency. In batch-scale tests, an overall efficiency of 90% was obtained when flexible materials such as film plastics and paper were excluded from the feed SBW. In continuous feeding tests, purities of the float and sink fractions attained 95% and 86% efficiencies, respectively, with an overall efficiency of 79%. The effect of feedstock shape on separation efficiency was also investigated. This study revealed that large particles can be properly separated on the basis of density, while the shape of the material significantly influenced behavior in the fluidizing bed.

  2. [Application of stroke rehabilitation unit in municipal hospitals during the acute phase of cerebral infarction].

    PubMed

    Wang, Zhi-min; Wang, Peng; Chen, Jie; Luo, Dan-hong; Shen, Wang-ming

    2008-07-01

    To evaluate the efficacy of stroke rehabilitation unit in municipal hospitals during the acute phase of cerebral infarction. 77 acute cerebral infarction patients were randomly assigned to stroke rehabilitation unit group and 73 to ordinary group. The NIH stroke scale (NIHSS), activities of daily living (ADL) Barthel index and average hospitalized time were compared in two groups before and after the treatment. The average NIHSS in two groups before treatment were 9.26 and 9.12 respectively (P > 0.05) but became 2.62 and 7.64 after treatment (P < 0.01). The average ADL Barthel index in two groups before the treatment were 52.04 and 53.16 (P > 0.05) but 87.26 and 64.20 after the treatment (P < 0.01). The average hospitalized time in the two groups were 22.25 and 26.67 days (P < 0.05). When stroke rehabilitation unit being applied in the acute phase of cerebral infarction, it showed positive results in the following aspects as: improving the neurological function, capabilities of managing daily life, and also shortening the days of hospitalization.

  3. Considerations on the design and financial feasibility of full-scale membrane bioreactors for municipal applications.

    PubMed

    Brepols, Ch; Schäfer, H; Engelhardt, N

    2010-01-01

    Based on the practical experience in design and operation of three full-scale membrane bioreactors (MBR) for municipal wastewater treatment that were commissioned since 1999, an overview on the different design concepts that were applied to the three MBR plants is given. The investment costs and the energy consumption of the MBRs and conventional activated sludge (CAS) plants (with and without tertiary treatment) in the Erft river region are compared. It is found that the specific investment costs of the MBR plants are lower than those of comparable CAS with tertiary treatment. A comparison of the specific energy demand of MBRs and conventional WWTPs is given. The structure of the MBRs actual operational costs is analysed. It can be seen that energy consumption is only responsible for one quarter to one third of all operational expenses. Based on a rough design and empirical cost data, a cost comparison of a full-scale MBR and a CAS is carried out. In this example the CAS employs a sand filtration and a disinfection in order to achieve comparable effluent quality. The influence of membrane lifetime on life cycle cost is assessed.

  4. NO{sub x} control technologies applicable to municipal waste combustion

    SciTech Connect

    White, D.M.; Nebel, K.L.; Gundappa, M.; Ferry, K.R.

    1994-12-01

    Nitrogen oxides (NO{sub x}) are of environmental significance because of their role as a criteria pollutant, acid gas, and ozone precursor. The current New Source Performance Standards (NSPS) for municipal waste combustors (MWCS) limit NO{sub x} emissions to a daily average of 180 parts per million (ppM) at 7% oxygen, dry basis. By comparison, typical NO{sub x} emissions from modern mass burn waterwall (MB/WW) MWCs range from 220 to 320 ppM. To comply with the NSPS, most recently built MWCs have used a combination of combustion controls to limit NO{sub x} formation and selective non-catalytic reduction (SNCR) to convert NO{sub x} to molecular nitrogen. Because of pressure to achieve even lower emission levels, questions have been raised regarding the potential for advancement in NO{sub x} control technologies. To respond to these questions, the Air and Energy Engineering Research Laboratory and the National Renewable Energy Laboratory initiated this assessment of three alternative NO{sub x} control technologies: natural gas injection (NGI), SNCR, and selective catalytic reduction (SCR). The objectives of this assessment were to (1) document the key design and operating parameters, commercial status, demonstrated performance, and cost of each technology, and (2) identify technology research and development needs.

  5. 77 FR 73632 - American Municipal Power, Inc; Notice of Application for Temporary Variance of License and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-11

    ... the Application: A copy of the application is available for inspection and reproduction at the [[Page... , for TTY, call (202) 502-8659. A copy is also available for inspection and reproduction at the...

  6. 78 FR 36179 - Carlsbad Municipal Water District; Notice of Application Accepted for Filing and Soliciting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... available for public inspection. a. Type of Application: Conduit Exemption. b. Project No.: 14501-000. c...: Federal Power Act 16 U.S.C. 791a-825r. h. Applicant Contact: Mr. William Plummer, Engineering Manager...

  7. Possible Applications of Hardening Slurries with Fly Ash from Thermal Treatment of Municipal Sewage Sludge in Environmental Protection Structures

    NASA Astrophysics Data System (ADS)

    Falacinski, Paweł; Szarek, Łukasz

    2016-06-01

    In Poland, in recent years, there has been a rapid accumulation of sewage sludge - a by-product in the treatment of urban wastewater. This has come about as a result of infrastructure renewal, specifically, the construction of modern sewage treatment plants. The more stringent regulations and strategic goals adopted for modern sewage management have necessitated the application of modern engineering methodology for the disposal of sewage sludge. One approach is incineration. As a consequence, the amount of fly ash resulting from the thermal treatment of municipal sewage sludge has grown significantly. Hence, intensive work is in progress for environmentally safe management of this type of waste. The aim of the experiment was to evaluate the possibility of using the fly ash that results from municipal sewage sludge thermal treatment (SSTT) as an additive to hardening slurries. This type of hardening slurry with various types of additives, e.g. coal combustion products, is used in the construction of cut-off walls in hydraulic structures. The article presents the technological and functional parameters of hardening slurries with an addition of fly ash obtained by SSTT. Moreover, the usefulness of these slurries is analysed on the basis of their basic properties, i.e. density, contractual viscosity, water separation, structural strength, volumetric density, hydraulic conductivity, compressive and tensile strength. The mandated requirements for slurries employed in the construction of cut-off walls in flood embankments are listed as a usefulness criteria. The article presents the potential uses of fly ash from SSTT in hardening slurry technology. It also suggests directions for further research to fully identify other potential uses of this by-product in this field.

  8. An optimization model for integrated urban planning: development and application to Algeria's Reghaïa and Heraoua municipalities.

    PubMed

    Zagonari, Fabio

    2011-05-01

    In this paper, I develop an optimization model for integrated urban planning for land use at the municipality level, in which decisions arise from an area-based weighted-GDP maximisation algorithm whose weights represent the sustainability and implementability of the land uses. The model favours the involvement of stakeholders in urban governance, but does not use complicated assessment procedures for non-economic indicators or relative weights to combine economic, social and environmental indicators; instead, the integration between economic activities and environmental status is represented objectively and non-linearly by referring to initial and sustainability conditions. The model accounts for both human and environmental dynamics by adopting a spatial structure that permits compromises between economic information (available at a macro level) and ecological information (available at a micro level). A single value is attached to each urban governance, with an elicitation of future decisions (including acceptance of the status quo) and the ability to provide an evaluation of past decisions: some environmental policies are considered. The model's predictions are based on reasonably reliable knowledge that can be easily collected, with reliability determined by calculating the confidence level. The resulting urban governance can then be presented and further analysed within a geographical information system. A case study of the model's application to Algeria's Reghaïa and Heraoua municipalities provides insights into optimal urban governance, with and without water quantity or quality policies, in terms of resource sustainability, sectoral development, and pollution sustainability. I also assess the previous master plan in terms of the land uses suggested by the model.

  9. Assessment of physical vulnerability of buildings and analysis of landslide risk at the municipal scale: application to the Loures municipality, Portugal

    NASA Astrophysics Data System (ADS)

    Guillard-Gonçalves, C.; Zêzere, J. L.; Pereira, S.; Garcia, R. A. C.

    2016-02-01

    This study offers a semi-quantitative assessment of the physical vulnerability of buildings to landslides in a Portuguese municipality (Loures), as well as the quantitative landslide risk analysis computed as the product of the landslide hazard by the vulnerability and the economic value of the buildings. The hazard was assessed by combining the spatiotemporal probability and the frequency-magnitude relationship of the landslides. The physical vulnerability assessment was based on an inquiry of a pool of European landslide experts and a sub-pool of landslide experts who know the study area, and the answers' variability was assessed with standard deviation. The average vulnerability of the basic geographic entities was compared by changing the map unit and applying the vulnerability to all the buildings of a test site, the inventory of which was listed on the field. The economic value was calculated using an adaptation of the Portuguese Tax Services approach, and the risk was computed for different landslide magnitudes and different spatiotemporal probabilities. As a rule, the vulnerability values given by the sub-pool of experts who know the study area are higher than those given by the European experts, namely for the high-magnitude landslides. The obtained vulnerabilities vary from 0.2 to 1 as a function of the structural building types and the landslide magnitude, and are maximal for 10 and 20 m landslide depths. However, the highest risk was found for the landslides that are 3 m deep, because these landslides combine a relatively high frequency in the Loures municipality with a substantial potential damage.

  10. PPBS and the Derivation of Cost Effectiveness

    ERIC Educational Resources Information Center

    Worner, Roger B.

    1973-01-01

    Educators must recognize the inadequacies of their planning, programing, evaluation, and budgeting systems. When these are redeveloped, PPBS will produce the cost/effectiveness data they are really capable of. (WM)

  11. Cost-Effective Stress Management Training.

    ERIC Educational Resources Information Center

    Shea, Gordon F.

    1980-01-01

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

  12. Cost-Effective Stress Management Training.

    ERIC Educational Resources Information Center

    Shea, Gordon F.

    1980-01-01

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

  13. [Health technology assessment: II. Cost effectiveness analysis].

    PubMed

    Secoli, Silvia Regina; Nita, Marcelo Eidi; Ono-Nita, Suzane Kioko; Nobre, Moacyr

    2010-01-01

    New health technologies have made an impact in clinical and economic outcomes. Therefore, research methodologies that allow to evaluate the efficiency of these new technologies such as cost-effectiveness analysis are necessary. Cost-effectiveness analysis assess the value of health care interventions or drugs, the technology. Cost-effectiveness analysis is also deemed a determinant of modern health care practice, because the therapeutic options available at public (SUS) or private health care system must go through a formal health technology assessment in Brazil; thus, both the health care system and the health care professionals have to reevaluate the clinical consequences and costs of their actions to assure that the most efficient technologies are the one used in the practice. In this second article about health technology assessment we review the concepts of cost-effectiveness analysis, the steps involved in performing such analysis, and the criteria most frequently used to critically review the results.

  14. Cost Effectiveness of Hybrid Solar Powerplants

    NASA Technical Reports Server (NTRS)

    Wen, L. C.; Steele, H. L.

    1983-01-01

    Report discusses cost effectiveness of high-temperature thermal storage system for representative parabolic dish solar powerplant. Economic viability of thermal storage system assesses; cost and performance projections made; cost of electricity generated by solar power plant also calculated.

  15. [Cost effectiveness of image diagnosis].

    PubMed

    Inamura, K; Kimura, M; Ito, A; Umeda, T; Kozuka, T

    1997-04-01

    First, annual cost of electronic filing of medical images were calculated and compared with that of film storage in two hospitals under different conditions. Storage of medical images using a pixel size of 100 microns x 100 microns and 2-byte depth on the 130 mm, 650 MB magneto-optical disks costs with four times as much as the cost for film storage. However, 175 microns x 175 microns 12 bits combined with implementation of lossless compression would reduce the cost to a level equal to that for films storage. Doubled or tripled densities of MOD will improve the cost ever further. Second, the effectiveness of Hospital Information System/Radiological Information System (HIS/RIS) was evaluated. Examination time, film delivery time and the total turn-around time was markedly shortened by more than 23 hours on average. Our measurement method employing IC cards in pre-post HIS/RIS/PACS procedures is generally applicable to other hospitals. Third, to determine the optimal method of maximizing the efficacy of diagnostic imaging, 260 questionnaires were sent to the staff of 13 university hospitals. Every situation was described by both a radiologist and the physician who ordered the examination and received the reports and images. The level of technical efficacy and diagnostic accuracy of radiology strongly influenced the diagnostic thought processes of the physician.

  16. [Cost-effectiveness of colorectal cancer screening].

    PubMed

    Heresbach, Denis; Manfrédi, Sylvain; Branger, Bernard; Bretagne, Jean-François

    2006-01-01

    Colorectal cancer (CRC) screening in France is based on a faecal occult blood test every two years in average risk subjects 50-74 years of age while other endoscopic or non-endoscopic screening methods are used in Europe and in the USA. Beside the reduced incidence of and mortality from CRC found in available studies, cost-effectiveness data need to be taken into account. Because of the delay between randomized controlled trials and clinical results, transitional probabilistic models of screening programs are useful for public health policy makers. The aim of the present review was to promote the implementation of cost-effectiveness studies, to provide a guide to analyze cost-effectiveness studies on CRC screening and, to propose a French cost effectiveness study comparing CRC screening strategies. Most of these trials were performed by US or UK authors and demonstrate that the incremental cost-effectiveness ratio varies between 5 000 and 15 000 US dollars/one year life gained, with wide variations: these results were highly dependent on the unit costs of the different devices as well as the predictive values of the screening tests. Although CRC screening programs have been implemented in several administrative districts of France since 2002, and the results of these randomized controlled trials using fecal occult blood have been updated, cost-effectiveness criteria need to be integrated; especially since the results of screening campaigns based on other tools such as flexible sigmoidoscopy should be available in 2007.

  17. Application of MFA as a decision support tool for waste management in small municipalities--case study of Serbia.

    PubMed

    Stanisavljevic, Nemanja; Vujovic, Svjetlana; Zivancev, Miodrag; Batinic, Bojan; Tot, Bojana; Ubavin, Dejan

    2015-06-01

    In this paper, attention is shifted from larger cities and regions to the important role of small municipalities in large-scale capacity waste management systems. The motivation of this analysis is to understand how small municipalities can be prepared for future inclusion in regional waste management. For the first time, solutions that include integrated treatment of municipal, agricultural, and industrial waste generated by small-scale municipalities are developed and assessed. For this purpose, five small Serbian municipalities with populations up to 30,000 inhabitants were chosen as case studies. The methodology integrates field data with material flow analysis (MFA) to analyze and evaluate future scenarios. A set of indicators which reflect the goals of waste management, including the total costs, was chosen for scenario comparison and evaluation. It was found that delivering generated waste to regional waste management centers can result in the most affordable environmental benefits for the representative municipalities. More advanced solutions, which include composting and joint treatment of municipal, agricultural, and industrial waste, can contribute to reaching waste management goals, but are more costly (217% and 652% comparing to delivering generated waste to regions). These results can be regarded as a representative for similar municipalities and can serve to support pre-planning decisions in other countries with problems in establishing regional waste management systems. © The Author(s) 2015.

  18. Cost-effectiveness of hemodialysis in Japan.

    PubMed

    Takura, Tomoyuki

    2015-01-01

    Evaluation of the socioeconomic value of medical intervention and establishment of the resources necessary for clinical practice are important for continued development of the medical system. The purpose of this study was to investigate the cost-effectiveness of maintenance hemodialysis (MHD) for end-stage kidney disease in Japan. There were two aims: a socioeconomic evaluation of online hemodiafiltration (HDF) in the medical system and an analysis of MHD with respect to the primary diseases of chronic kidney disease. We performed a cost-effectiveness analysis based on quality-adjusted life years (QALY) and the incremental cost-effectiveness ratio (ICER). QALY were estimated using the EuroQOL-5 dimension. Reimbursement for medical fees in the national health insurance system was used as an indicator of costs. In a comparative analysis of hemodialysis and online HDF, a total of 288 dialysis interventions were observed for 4 weeks in 3 clinics. Among the subjects, nine patients were assigned to the HDF group. Consequently, the incremental cost-effectiveness ratio of HDF to hemodialysis was 20,589 ΔUSD/ΔQALY. In a comparative analysis of diabetic nephropathy and glomerulonephritis, seventeen patients (with a total of 243 dialysis sessions and a mean age of 63.2 ± 11.7 years) who underwent MHD for end-stage kidney disease (primary diseases: chronic glomerulonephritis [64.7%], diabetic nephropathy [35.3%]) were enrolled. After stratification for primary disease, the cost-effectiveness values for diabetic nephropathy were 88,774 ± 27,801 USD/QALY for 1 month and 97,416 ± 36,156 USD/QALY for 36 months. These results suggest that HDF is a cost-effective therapy. Additionally, the cost-effectiveness after 36 months of observation increased mainly among diabetic nephropathy patients. © 2015 S. Karger AG, Basel.

  19. Municipal Wastewater Treatment Plant Biosludge Applications and Perfluoroalkyl Acid Surface Water Contamination in North Carolina

    EPA Science Inventory

    Implications and Questions- Perfluorinated compounds at high concentrations in sludges, on fields, in surface water in areas receiving sludge applications-Urban and suburban sludges typically disposed of in rural locations, usually marketed as “free fertilizer” becaus...

  20. 77 FR 40349 - Calleguas Municipal Water District; Notice of Application Accepted for Filing and Soliciting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-09

    ... would have an average annual generation of 2,620,000 kilowatt- hours. m. This filing is available for... resource agencies, and distributing and consulting on a draft exemption application. Dated: June 28,...

  1. Municipal Wastewater Treatment Plant Biosludge Applications and Perfluoroalkyl Acid Surface Water Contamination in North Carolina

    EPA Science Inventory

    Implications and Questions- Perfluorinated compounds at high concentrations in sludges, on fields, in surface water in areas receiving sludge applications-Urban and suburban sludges typically disposed of in rural locations, usually marketed as “free fertilizer” becaus...

  2. Estimating cost effectiveness of residential yard trees for improving air quality in Sacramento, California, using existing models

    NASA Astrophysics Data System (ADS)

    McPherson, E. Gregory; Scott, Klaus I.; Simpson, James R.

    The Sacramento Municipal Utility District's (SMUD) shade tree program will result in the planting of 500,000 trees and has been found to produce net benefits from air conditioning savings. In this study we assume three scenarios (base, highest, and lowest benefits) based on the SMUD program and apply Best Available Control Technology (BACT) cost analysis to determine if shade trees planted in residential yards can be a cost effective means to improve air quality. Planting and maintenance costs, pollutant deposition, and biogenic hydrocarbon emissions are estimated annually for 30 years with existing deterministic models. For the base case, the average annual dollar benefit of pollutant uptake was 895 and the cost of biogenic hydrocarbon emissions was 512, for a net pollutant uptake benefit of 383 per 100 trees planted. The uniform annual payment necessary to repay planting and maintenance costs with a 10% rate of interest was 749. When high biogenic hydrocarbon emitting tree species were replaced with low-emitters, the base case benefit-cost ratio (BCR) increased from 0.5: 1 to 0.9: l. The BCR for the "highest" and "lowest" benefit cases were 2.2:1 and -0.8:1, respectively. Although SMUD plantings produce cost effective energy savings, our application of the BACT analysis does not suggest convincing evidence that there is cost savings when only air quality benefits are considered.

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Carman, Robert A.

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  6. A Systematic Review of the Key Indicators for Assessing Telehomecare Cost-Effectiveness

    PubMed Central

    Rojas, Stephanie Vergara; Gagnon, Marie-Pierre

    2014-01-01

    Telehomecare is considered one of the most successful applications of telehealth. However, despite increasing evidence of telehomecare benefits, the diffusion of these services is still limited. Decision-makers need strong evidence in order to expand the development of telehomecare to various populations, regions, and health conditions. The objective of this review is to provide a basis for decision-making by identifying common indicators from the literature on telehomecare. A comprehensive review of the literature on the cost-effectiveness of telehomecare was conducted in specialized bibliographic databases. A total of 23 studies met the inclusion criteria. First, selected studies were analyzed to identify and classify the indicators that better addressed the cost-effectiveness impacts of telehomecare projects. Then, a synthesis of the evidence was done by exploring the relative cost-effectiveness of telehomecare applications. The analyses show that there is fair evidence of cost-effectiveness for many telehomecare applications. However, the heterogeneity among cost-effectiveness indicators in the applications reviewed and the methodological limitations of the studies impede the possibility of generalizing the findings. This suggests the need for a set of common indicators that could be applied for assessing the cost-effectiveness of telehomecare projects. This review provides knowledge on the indicators available for assessing cost-effectiveness in telehomecare projects. It appears that the specific context in which the projects take place, meaning different patients, environments, technologies, and healthcare systems, should be taken into account when selecting indicators for assessing telehomecare cost-effectiveness. PMID:19035798

  7. The cost-effectiveness of methadone maintenance.

    PubMed

    Barnett, P G; Hui, S S

    2000-01-01

    Although methadone maintenance is effective in reducing injection drug use, needle sharing, and the overall mortality associated with opiate abuse, many health plans offer little or no access to methadone, and many methadone providers do not comply with treatment guidelines regarding dose, duration of treatment, or provision of ancillary services. Moral and political judgments have helped shape the U.S. treatment system. Evaluations of methadone cost-effectiveness may play a role in changing public policy. Cost-effectiveness analysis is used to compare a change, or changes, in treatment to that of current standard care. The cost of treatment and its effect on outcomes are used to find the incremental cost-effectiveness ratio, and determine whether the change(s) should be adopted. The literature on methadone maintenance is reviewed from an economic perspective, focusing on five policy questions: (1) whether methadone should be a health care benefit; (2) what level of ancillary services is optimal; (3) what methadone dose is appropriate; (4) what length of treatment is appropriate; and (5) whether contingency contracts should be employed. Expanded access to methadone maintenance has an incremental cost-effectiveness ratio of less than $11,000 per Quality-Adjusted Life Year. This is more cost-effective than many widely used medical therapies, a finding that strongly supports the inclusion of methadone in the formulary of health care plans.Ancillary services have been shown to be an effective part of methadone maintenance therapy, especially during the beginning of a treatment episode, but there is not enough information available to tell whether the optimal amount of services is being used. There is extensive evidence that many treatment programs dispense inadequate doses of methadone. The cost of additional drugs is very small compared to the benefits of an adequate dose. Many methadone programs limit treatment to 6 months or less, but such short episodes are not

  8. Assessment of applicability index for better management of municipal solid waste: a case study of Dhanbad, India.

    PubMed

    Yadav, Pooja; Samadder, S R

    2017-06-01

    Selection of suitable municipal solid waste management (MSWM) options is one of the major challenges in urban areas of the developing countries. Success of MSWM requires accurate data of generation rate, composition and physico-chemical characteristics of solid wastes. Improper handling of solid waste can have significant environmental and aesthetical impacts. The present study proposes a new method (applicability index - Pik values) for identifying the most appropriate disposal option with the help of applicability values of Composting-CP, Incineration-IP and Landfill-LP for individual components of MSW based on the results of the physico-chemical analysis of the collected representative solid waste samples from the study area, Dhanbad, India. The mean values of moisture content, carbon, hydrogen, oxygen, nitrogen, sulfur, volatile organic carbon, fixed carbon, ash content, density and calorific values (CV) of individual components were used as input values in this process. Based on the proposed applicability index (Pik), the highest Pik values were obtained for incineration (IP) for plastics, polythene, paper, coconut shell, wood, cardboard, textile, thermocol (polystyrene), rubber, sugarcane bagasse, cow dung and leather wastes (IP > CP > LP) due to high CV of these solid waste components; the highest Pik values were obtained for composting (CP) of kitchen waste (CP > IP > LP); and the highest Pik values for inert wastes were obtained for landfill option (LP > IP > CP). The highest Pik value for a particular waste for a specific treatment option signifies that the waste is suitable for treatment/disposal using that option.

  9. Life-cycle assessment of municipal solid waste management alternatives with consideration of uncertainty: SIWMS development and application.

    PubMed

    Hanandeh, Ali El; El-Zein, Abbas

    2010-05-01

    This paper describes the development and application of the Stochastic Integrated Waste Management Simulator (SIWMS) model. SIWMS provides a detailed view of the environmental impacts and associated costs of municipal solid waste (MSW) management alternatives under conditions of uncertainty. The model follows a life-cycle inventory approach extended with compensatory systems to provide more equitable bases for comparing different alternatives. Economic performance is measured by the net present value. The model is verified against four publicly available models under deterministic conditions and then used to study the impact of uncertainty on Sydney's MSW management 'best practices'. Uncertainty has a significant effect on all impact categories. The greatest effect is observed in the global warming category where a reversal of impact direction is predicted. The reliability of the system is most sensitive to uncertainties in the waste processing and disposal. The results highlight the importance of incorporating uncertainty at all stages to better understand the behaviour of the MSW system. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  10. Municipal Sludge Application in Forests of Northern Michigan: a Case Study.

    Treesearch

    D.G. Brockway; P.V. Nguyen

    1986-01-01

    A large-scale operational demonstration and research project was cooperatively established by the US. Environmental Protection Agency, Michigan Department of Natural Resources, and Michigan State University to evaluate the practice of forest land application as an option for sludge utilization. Project objectives included completing (1) a logistic and economic...

  11. Immediately sequential bilateral cataract surgery: a cost-effective procedure.

    PubMed

    Malvankar-Mehta, Monali S; Filek, Richard; Iqbal, Munir; Shakir, Abubakar; Mao, Alex; Si, Francie; Malvankar, Madhukar G; Mehta, Siddhartha S; Hodge, William G

    2013-12-01

    The objective of this project was to perform a cost-effectiveness analysis (CEA) of immediately sequential bilateral cataract surgery (ISBCS) versus delayed sequential bilateral cataract surgery (DSBCS) to determine whether ISBCS represents an appropriate, cost-effective way to rapidly rehabilitate a patient's visual impairment. A systematic review followed by a primary economic analysis with computer-based econometric modeling. Not applicable. We constructed a decision analytic model from the perspective of the public third-party payer (i.e., the Ministry of Health) to conduct a CEA of both surgeries, ISBCS and DSBCS. Cost data consisted of the costs of the surgery, intravitreal injections, medications, and drops, all of which were obtained from a comprehensive literature search and from records at St. Joseph's Hospital, London, Ont. The effectiveness was measured by the utility values associated with visual acuity in the better seeing eye. ISBCS resulted in an incremental effectiveness of 0.08 utility at an incremental cost of $1607. Discounting the quality-adjusted life-years (QALYs) gained by an annual interest rate of 3% resulted in 0.932 QALYs gained. The cost-effectiveness of ISBCS was calculated to be $1431 per QALY gained. A 1-way sensitivity analysis was performed by varying costs, utility values, probabilities, and discounting rates. This analysis varied the incremental cost-effectiveness ratio but did not change the conclusion. Health economics assessment showed that, compared with DSBCS, ISBCS is a cost-effective procedure. This finding will be highly useful to policy-makers, decision-makers, clinicians, hospital administrators, and payers in making cost-efficient decisions. Copyright © 2013. Published by Elsevier Inc.

  12. Cost-Effectiveness Analysis of Morcellation Hysterectomy for Myomas.

    PubMed

    Bortoletto, Pietro; Einerson, Brett D; Miller, Emily S; Milad, Magdy P

    2015-01-01

    To estimate the cost-effectiveness of eliminating morcellation in the surgical treatment of leiomyomas from a societal perspective. Cost-effectiveness analysis. Not applicable. A theoretical cohort of women undergoing hysterectomy for myoma disease large enough to require morcellation. None. None. A decision analysis model was constructed using probabilities, costs, and utility data from published sources. A cost-effectiveness analysis analyzing both quality-adjusted life years (QALYs) and cases of disseminated cancer was performed to determine the incremental cost-effectiveness ratio (ICER) of eliminating morcellation as a tool in the surgical treatment of leiomyomas. Costs and utilities were discounted using standard methodology. The base case included health care system costs and costs incurred by the patient for surgery-related disability. One-way sensitivity analyses were performed to assess the effect of various assumptions. The cost to prevent 1 case of disseminated cancer was $10 540 832. A strategy of nonmorcellation hysterectomy via laparotomy costed more ($30 359.92 vs $20 853.15) and yielded more QALYs (21.284 vs 21.280) relative to morcellation hysterectomy. The ICER for nonmorcellation hysterectomy compared with morcellation hysterectomy was $2 184 172 per QALY. Health care costs (prolonged hospitalizations) and costs to patients of prolonged time away from work were the primary drivers of cost differential between the 2 strategies. Even when the incidence of occult sarcoma in leiomyoma surgery was ranged to twice that reported in the literature (.98%), the ICER for nonmorcellation hysterectomy was $644 393.30. Eliminating morcellation hysterectomy as a treatment for myomas is not cost-effective under a wide variety of probability and cost assumptions. Performing laparotomy for all patients who might otherwise be candidates for morcellation hysterectomy is a costly policy from a societal perspective. Copyright © 2015 AAGL. Published by Elsevier Inc

  13. Effectiveness and cost-effectiveness of daily all-over-body application of emollient during the first year of life for preventing atopic eczema in high-risk children (The BEEP trial): protocol for a randomised controlled trial.

    PubMed

    Chalmers, Joanne R; Haines, Rachel H; Mitchell, Eleanor J; Thomas, Kim S; Brown, Sara J; Ridd, Matthew; Lawton, Sandra; Simpson, Eric L; Cork, Michael J; Sach, Tracey H; Bradshaw, Lucy E; Montgomery, Alan A; Boyle, Robert J; Williams, Hywel C

    2017-07-21

    Atopic eczema (AE) is a common skin problem that impairs quality of life and is associated with the development of other atopic diseases including asthma, food allergy and allergic rhinitis. AE treatment is a significant cost burden for health care providers. The purpose of the trial is to investigate whether daily application of emollients for the first year of life can prevent AE developing in high-risk infants (first-degree relative with asthma, AE or allergic rhinitis). This is a protocol for a pragmatic, two-arm, randomised controlled, multicentre trial. Up to 1400 term infants at high risk of developing AE will be recruited through the community, primary and secondary care in England. Participating families will be randomised in a 1:1 ratio to receive general infant skin-care advice, or general skin-care advice plus emollients with advice to apply daily to the infant for the first year of life. Families will not be blinded to treatment allocation. The primary outcome will be a blinded assessment of AE at 24 months of age using the UK Working Party Diagnostic Criteria for Atopic Eczema. Secondary outcomes are other definitions of AE, time to AE onset, severity of AE (EASI and POEM), presence of other allergic diseases including food allergy, asthma and hay fever, allergic sensitisation, quality of life, cost-effectiveness and safety of the emollients. Subgroup analyses are planned for the primary outcome according to filaggrin genotype and the number of first-degree relatives with AE and other atopic diseases. Families will be followed up by online and postal questionnaire at 3, 6, 12 and 18 months with a face-to-face visit at 24 months. Long-term follow-up until 60 months will be via annual questionnaires. This trial will demonstrate whether skin-barrier enhancement through daily emollient for the first year of life can prevent AE from developing in high-risk infants. If effective, this simple and cheap intervention has the potential to result in

  14. Does the use of efficacy or effectiveness evidence in cost-effectiveness analysis matter?

    PubMed

    Dilokthornsakul, Piyameth; Chaiyakunapruk, Nathorn; Campbell, Jonathan D

    2017-01-02

    To test the association of clinical evidence type, efficacy-based or effectiveness-based ("E"), versus whether or not asthma interventions' cost-effectiveness findings are favorable. We conducted a systematic review of PubMed, EMBASE, Tufts CEA registry, Cochrane CENTRAL, and the UK National Health Services Economic Evaluation Database from 2009 to 2014. All cost-effectiveness studies evaluating asthma medication(s) were included. Clinical evidence type, "E," was classified as efficacy-based if the evidence was from an explanatory randomized controlled trial(s) or meta-analysis, while evidence from pragmatic trial(s) or observational study(s) was classified as effectiveness-based. We defined three times the World Health Organization cost-effectiveness willingness-to-pay (WTP) threshold or less as a favorable cost-effectiveness finding. Logistic regression tested the likelihood of favorable versus unfavorable cost-effectiveness findings against the type of "E." 25 cost-effectiveness studies were included. Ten (40.0%) studies were effectiveness-based, yet 15 (60.0%) studies were efficacy-based. Of 17 studies using endpoints that could be compared to WTP threshold, 7 out of 8 (87.5%) effectiveness-based studies yielded favorable cost-effectiveness results, whereas 4 out of 9 (44.4%) efficacy-based studies yielded favorable cost-effectiveness results. The adjusted odds ratio was 15.12 (95% confidence interval; 0.59 to 388.75) for effectiveness-based versus efficacy-based achieving favorable cost-effectiveness findings. More asthma cost-effectiveness studies used efficacy-based evidence. Studies using effectiveness-based evidence trended toward being more likely to disseminate favorable cost-effective findings than those using efficacy. Health policy decision makers should pay attention to the type of clinical evidence used in cost-effectiveness studies for accurate interpretation and application.

  15. Cost-effectiveness analysis and innovation.

    PubMed

    Jena, Anupam B; Philipson, Tomas J

    2008-09-01

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

  16. Cost-Effectiveness of Online Teacher Training

    ERIC Educational Resources Information Center

    Jung, Insung

    2005-01-01

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

  17. Cost-Effective School Nurse Practitioner Services.

    ERIC Educational Resources Information Center

    Sobolewski, Susan D.

    1981-01-01

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

  18. Transfer regulations and cost-effectiveness analysis.

    PubMed

    Posner, Eric A

    2003-12-01

    Recent scholarship on regulatory oversight has focused on cost-benefit analysis of prescriptive regulations--regulations that restrict behavior such as pollution--and their use to cure market failures, and has overlooked the vast number of transfer regulations. Transfer regulations are regulations that channel funds to beneficiaries. These regulations are authorized by statutes that establish entitlement programs like Medicare and Social Security, pay one-time distributions to victims of misfortunes such as natural disasters and the 9/11 terrorist attack, and fund pork barrel spending. Cost-benefit analysis cannot be used to evaluate transfer regulations because all transfer regulations fail cost-benefit analysis; cost-effectiveness analysis, however, can be used to evaluate transfer regulations. Although executive orders appear to require agencies to use cost-effectiveness analysis to evaluate transfer regulations that have a large economic impact, the agencies' record is dismal. Most agencies fail to perform cost-effectiveness analysis, and other agencies perform cost-effectiveness analysis incorrectly. More vigorous Office of Management and Budget and, possibly, judicial review could improve the quality of distributive regulations.

  19. Cost Effectiveness of On-Orbit Servicing

    DTIC Science & Technology

    2009-06-30

    distribution unlimited 1 AAS 09- XXX COST EFFECTIVENESS OF ON-ORBIT SERVICING Tiffany Rexius* This study was performed to model on...4,6 of total spacecraft failures and the pink line represents the model prediction of all failures. The pink “all failures” line is slightly higher

  20. The cost-effectiveness of harm reduction.

    PubMed

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

    2015-02-01

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

  1. Determining pathogen and indicator levels in class B municipal organic residuals used for land application.

    PubMed

    Rhodes, Eric R; Boczek, Laura A; Ware, Michael W; McKay, Mary; Hoelle, Jill M; Schoen, Mary; Villegas, Eric N

    2015-01-01

    Biosolids are nutrient-rich organic residuals that are currently used to amend soils for food production. Treatment requirements to inactivate pathogens for production of Class A biosolids are energy intensive. One less energy intensive alternative is to treat biosolids to Class B standards, but it could result in higher pathogen loads. Quantitative microbial risk assessments models have been developed on land application of Class B biosolids but contain many uncertainties because of limited data on specific pathogen densities and the use of fecal indicator organisms as accurate surrogates of pathogen loads. To address this gap, a 12-mo study of the levels and relationships between , , and human adenovirus (HAdV) with fecal coliform, somatic, and F-RNA coliphage levels in Class B biosolids from nine wastewater treatment plants throughout the United States was conducted. Results revealed that fecal coliform, somatic, and F-RNA coliphage densities were consistent throughout the year. More important, results revealed that HAdV ( = 2.5 × 10 genome copies dry g) and ( = 4.14 × 10 cysts dry g) were in all biosolids samples regardless of treatment processes, location, or season. oocysts were also detected (38% positive; range: 0-1.9 × 10 oocysts dry g), albeit sporadically. Positive correlations among three fecal indicator organisms and HAdV, but not protozoa, were also observed. Overall, this study reveals that high concentrations of enteric pathogens (e.g., , , and HAdV) are present in biosolids throughout the United States. Microbial densities found can further assist management and policymakers in establishing more accurate risk assessment models associated with land application of Class B biosolids.

  2. Cost-Effective TiAl based Materials

    NASA Technical Reports Server (NTRS)

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

    2003-01-01

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

  3. Above Bonneville Passage and Propagation Cost Effectiveness Analysis.

    SciTech Connect

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

    1993-05-01

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

  4. Wind energy applications for municipal water services: Opportunities, situational analyses, and case studies

    SciTech Connect

    Flowers, L.; Miner-Nordstrom, L.

    2006-01-01

    As communities grow, greater demands are placed on water supplies, wastewater services, and the electricity needed to power the growing water services infrastructure. Water is also a critical resource for thermoelectric power plants. Future population growth in the United States is therefore expected to heighten competition for water resources. Especially in arid U.S. regions, communities may soon face hard choices with respect to water and electric power. Many parts of the United States with increasing water stresses also have significant wind energy resources. Wind power is the fastest-growing electric generation source in the United States and is decreasing in cost to be competitive with thermoelectric generation. Wind energy can potentially offer communities in water-stressed areas the option of economically meeting increasing energy needs without increasing demands on valuable water resources. Wind energy can also provide targeted energy production to serve critical local water-system needs. The U.S. Department of Energy (DOE) Wind Energy Technologies Program has been exploring the potential for wind power to meet growing challenges for water supply and treatment. The DOE is currently characterizing the U.S. regions that are most likely to benefit from wind-water applications and is also exploring the associated technical and policy issues associated with bringing wind energy to bear on water resource challenges.

  5. Municipal sewage sludge application on Ohio farms: tissue metal residues and infections

    SciTech Connect

    Reddy, C.S.; Dorn, C.R.; Lamphere, D.N.; Powers, J.D.

    1985-12-01

    Transmission of infectious agents and translocation of Cd, Cu, Pb, and Zn from anaerobically digested sludge to the tissues of farm animals grazing on pastures to which sludge was applied (2-10 metric tons per hectare) were studied on eight farms. No significant health risk associated with the possible presence in sludge of Salmonella spp., or of common animal parasites including Nematodirus spp., Strongylus spp., Strongyloides spp., Trichuris spp., Eimeria spp., Ascaris spp., and Ancylostomum spp. was noted. Caudal fold as well as cervical tuberculin testing indicated no conversions from negative to positive following exposure of cattle to sludge. Significantly higher fecal Cd concentrations were detected in samples collected from cattle soon after being placed on sludge-treated pastures compared to preexposure values in the same animals. Significant Cd and Pb accumulations were found in the kidneys of calves grazing sludge-treated pastures compared to control calves. Although older cows grazing sludge-treated pastures had significantly higher blood Pb levels, no metal accumulation was observed in other tissues. Statistically significant accumulations of Cd and Pb in the kidney of calves grazing these pastures for a relatively short period suggest that caution should be exercised to avoid prolonged grazing of cattle on pastures receiving heavy sludge applications, especially with sludges containing high concentrations of heavy metals.

  6. Investigation of the application of an enzyme-based biodegradability test method to a municipal solid waste biodrying process.

    PubMed

    Wagland, S T; Godley, A R; Tyrrel, S F

    2011-07-01

    This paper presents a study to evaluate the recently developed enzymatic hydrolysis test (EHT) through its repeated application to a waste treatment process. A single waste treatment facility, involving a biodrying process, has been monitored using three different methods to assess the biodegradable content of the organic waste fractions. These test methods were the anaerobic BMc, aerobic DR4 and the EHT, which is a method based on the enzymatic hydrolysis of the cellulosic content of waste materials. The input municipal solid waste (MSW) and the output solid recovered fuel (SRF) and organic fines streams were sampled over a period of nine months from a single mechanical biological treatment (MBT) facility. The EHT was applied to each stream following grinding to <10 mm and <2 mm, in order to investigate the effect of particle size on the release of dissolved organic carbon (DOC) from enzyme hydrolysis. The output organic fines were found to more biodegradable than the MSW input and SRF output samples in each of the test methods, significantly (p<0.05) for the EHT and DR4 methods, on the basis of DOC released and oxygen consumed, respectively. The variation between sample replicates for the EHT was higher where sample sizes of <2 mm were analysed compared to sizes of <10 mm, and the DOC release at each phase of the EHT was observed to be higher when using particle sizes of <2 mm. Despite this, additional sample grinding from the <10 mm to a smaller particle size of <2 mm is not sufficiently beneficial to the analysis of organic waste fractions in the EHT method. Finally, it was concluded that as similar trends were observed for each test method, this trial confirms that EHT has the potential to be deployed as a practical operational biodegradability monitoring tool.

  7. Emergence Model of social and human capital and its application to the Healthy Municipalities project in Northeast Brazil.

    PubMed

    Yuasa, Motoyuki; de Sá, Ronice Franco; Pincovsky, Sheila; Shimanouchi, Norio

    2007-12-01

    We developed the Emergence Model and introduced the concept of social and human capital into designing and evaluating the Healthy Cities/Municipalities project to ensure health promotion infrastructure. This model hypothesizes that through the interaction and utilization of the other forms of capital, namely financial, physical and natural, the emergence of collective action takes place in the community or municipal setting. Subsequently, collective action may influence health and quality of life determinants. Once health and quality of life improvements are achieved, the enhancement of the social, human and other capital may be brought about through positive feedback, and successive collective action is thereby facilitated. According to the model, practitioners and policy makers of the Healthy Cities/Municipalities project should primarily strengthen social and human capital. The model is currently applied to designing the Healthy Municipalities project implemented in rural areas of Northeast Brazil, where infrastructure and a supportive environment to facilitate collective action for control over health and health determinant have been considerably frail due to geographical, historical, social and cultural reasons. Various interventions have been conducted in the scope of the project to enhance social and human capital on three levels, namely the state, municipality and community. Through the capacity development of health promoters, obliging volunteers and so on, the project attempts to create the social mechanism that enables people to build healthy public policies through inter- and trans-sectoral collaboration as well as to address and resolve day-to-day issues using their potentialities.

  8. Applications of Learning Technology: Progress and Problems. The Second Symposium on Cost Effective Learning Through the Application of Computer Technology (February 21-22, 1973, Washington, D.C.).

    ERIC Educational Resources Information Center

    Winkler, Stanley, Ed.

    High level officials from government, industry and the educational community met to consider the importance of technology in training and education. The symposium created a forum for the discussion of issues relating to the current state of the art of learning technology, the expanding range of applications of educational technology, the future…

  9. Cost-Effectiveness of Health Coaching: An Integrative Review.

    PubMed

    Hale, Rachel; Giese, Jeannie

    The purpose of this review was to evaluate published literature to distinguish how health coaching influences the cost of chronic disease management in insured adults with chronic conditions. An integrated literature review was conducted. MEDLINE, Business Source Complete, and OneSearch were searched for the years 2001-2016 utilizing the following key words: health coaching, health coaching AND insurance companies, health coaching AND cost, health coaching AND health insurance, and health coaching AND insurance cost. A total of 67 articles met inclusion criteria and were assessed for applicability. Of those, 27 articles were found to be relevant to the research question. The practice settings of these articles are mostly primary care and wellness programs. Throughout the literature, health coaching has been found effective in chronic disease management such as hypertension, diabetes, and hyperlipidemia. Studies evaluating the cost-effectiveness of health coaching are limited. The current literature does not clearly demonstrate that health coaching lowers expenditures and patient copayments in the short term but projects future savings. Health coaching has the potential to improve chronic disease management and lower health care expenditures. Further long-term research is needed to evaluate the cost-effectiveness of health coaching. It has been projected that the cost-effectiveness of health coaching will be long-term or over 12 months after initiating the health coaching program.

  10. A tool for cost-effectiveness analysis of field scale sediment-bound phosphorus mitigation measures and application to analysis of spatial and temporal targeting in the Lunan Water catchment, Scotland.

    PubMed

    Vinten, Andy; Sample, James; Ibiyemi, Adekunle; Abdul-Salam, Yakubu; Stutter, Marc

    2017-05-15

    The cost-effectiveness of six edge-of-field measures for mitigating diffuse pollution from sediment bound phosphorus (P) runoff from temperate arable farmland is analysed at catchment/field scales. These measures were: buffer strips, permanent grassland in the lowest 7% of arable fields, dry detention bunds, wetlands, and temporary barriers such as sediment fences. Baseline field P export was estimated using export coefficients (low risk crops) or a modified Universal Soil Loss Equation (high risk crops). The impact of measures was estimated using simple equations. Costs were estimated from gross margin losses or local data on grants. We used a net cost:benefit (NCB) factor to normalise the costs and impacts of each measure over time. Costs minimisation for target impact was done using PuLP, a linear programming module for Python, across 1634 riparian and non-riparian fields in the Lunan Water, a mixed arable catchment in Eastern Scotland. With all measures in place, average cost-effectiveness increases from £9 to £48/kg P as target P mitigation increases from 500 to 2500kg P across the catchment. Costs increase significantly when the measures available are restricted only to those currently eligible for government grants (buffers, bunds and wetlands). The assumed orientation of the average field slope makes a strong difference to the potential for storage of water by bunds and overall cost-effectiveness, but the non-funded measures can substitute for the extra expense incurred by bunds, where the slope orientation is not suitable. Economic discounting over time of impacts and costs of measures favours those measures, such as sediment fences, which are strongly targeted both spatially and temporally. This tool could be a useful guide for dialogue with land users about the potential fields to target for mitigation to achieve catchment targets. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  11. Cost effective management of space venture risks

    NASA Technical Reports Server (NTRS)

    Giuntini, Ronald E.; Storm, Richard E.

    1986-01-01

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

  12. Cost effective management of space venture risks

    NASA Technical Reports Server (NTRS)

    Giuntini, Ronald E.; Storm, Richard E.

    1986-01-01

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

  13. Theater SBI cost-effectiveness ratios

    SciTech Connect

    Canavan, G.H.

    1993-11-01

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

  14. Cost-effectiveness of root caries preventive treatments.

    PubMed

    Schwendicke, Falk; Göstemeyer, Gerd

    2017-01-01

    With a growing number of individuals retaining their teeth lifelong, often with periodontitis-induced root surface exposure, there is the need for cost-effective management strategies for root caries lesions. The present study aimed to assess the cost-effectiveness of root caries preventive treatments. Patients were simulated over 10 years using a Markov model. Four treatments were compared: No treatment, daily 225-800ppm fluoride rinses, chlorhexidine (CHX) varnish (2×/year), silver diamine fluoride (SDF) varnish (2×/year). Data from a systematic review were submitted to network meta-analysis for inferring relative efficacies of treatments. The health outcome was years of teeth being free of root caries. A mixed public-private payer perspective within 2016 German healthcare was taken, with costs being estimated from fee item catalogues or based on market prices. Populations with different numbers of teeth and tooth-level risks were modelled. Monte-Carlo microsimulations, univariate- and probabilistic sensitivity analyses were performed. In populations with 16 teeth at risk and low tooth-level risk for root caries, providing no preventive treatment was least costly, but also least effective (130 Euro, 144 years). SDF ranked next, being more costly (180 Euro), but also more effective (151 years). Payers willing to invest 8.30 Euro per root caries-free tooth-year found SDF most cost-effective. CHX varnish and fluoride rinse were not cost-effective. In populations with more teeth and high tooth-level risk, SDF was the most effective and least costly option. Root caries preventive treatments (like SDF) are effective and might even be cost-saving in high risk populations. Application of SDF can be recommended as a cost-saving treatment for prevention of root caries in patients with high risk of root caries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. An Application of Cost-Effectiveness Analysis in a Major Defense Acquisition Program: the Decision by the U.S. Department of Defense to Retain the C-17 Transport Aircraft

    DTIC Science & Technology

    2010-12-01

    alternatives fall on or below the equal cost-effectiveness ratio line that runs through Alternative 1, within statistical uncertainty.32 Figure 9...real exercises and operations. By establishing community agreement at the outset on the use of the same methodology for all aircraft, the study...intentionally blank.) Standard Form 298 Back (Rev. 8/98) R E P O R T D O C U M E N TAT I O N PAG E Form Approved OMB No. 0704-0188 Public

  16. Cost effectiveness of surveillance for GI cancers.

    PubMed

    Omidvari, Amir-Houshang; Meester, Reinier G S; Lansdorp-Vogelaar, Iris

    2016-12-01

    Gastrointestinal (GI) diseases are among the leading causes of death in the world. To reduce the burden of GI diseases, surveillance is recommended for some diseases, including for patients with inflammatory bowel diseases, Barrett's oesophagus, precancerous gastric lesions, colorectal adenoma, and pancreatic neoplasms. This review aims to provide an overview of the evidence on cost-effectiveness of surveillance of individuals with GI conditions predisposing them to cancer, specifically focussing on the aforementioned conditions. We searched the literature and reviewed 21 studies. Despite heterogeneity of studies in terms of settings, study populations, surveillance strategies and outcomes, most reviewed studies suggested at least some surveillance of patients with these GI conditions to be cost-effective. For some high-risk conditions frequent surveillance with 3-month intervals was warranted, while for other conditions, surveillance may only be cost-effective every 10 years. Further studies based on more robust effectiveness evidence are needed to inform and optimise surveillance programmes for GI cancers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Analysis of cost effective pipe insulation requirements

    SciTech Connect

    Winiarski, D.W.; Somasundaram, S.

    1997-06-01

    The proposed BRS/ASHRAE/IESNA Standard 90.1-1989R contains updated requirements for pipe insulation thicknesses developed on the basis of technical and economic principles. These requirements were determined based on computer simulations of the annual energy flow through the insulation, first cost assumptions for the insulation, and economic assumptions of discount rate and energy escalation rate. In later work, the same tools were used to analyze the sensitivity of the cost-effective insulation level for piping insulation to variations in operating hours, ambient temperature, fluid temperature, and economic assumptions. These analyses were carried out using cost data for pipe insulation averaged across several sources. The results of the sensitivity study showed that system operating hours is a critical parameter in determining the cost-effective pipe insulation thicknesses. Although there is a lack of reliable sources of typical operating hour data for heating systems, anecdotal information suggests that while most smaller, building level systems are operated only during a heating season, many site-wide steam and hot water heating systems are operated year round and insulation levels on these systems should reflect both the pipe size and the different operating schedules. In addition, the analysis showed that because of differences in private and Federal sector economics, the cost-effective pipe insulation levels appropriate for the private sector are often substantially different from those that are appropriate for the Federal sector.

  18. Are Certified Breast Centers Cost-Effective?

    PubMed Central

    Beckmann, Matthias W.; Bani, Mayada R.; Loehberg, Christian R.; Hildebrandt, Thomas; Schrauder, Michael G.; Wagner, Stefanie; Fasching, Peter A.; Lux, Michael Patrick

    2009-01-01

    Summary The German health care system has entered an era of specialist centers and certification. Hospitals are required to introduce quality management with external monitoring, refining and improving their quality of treatment. These statutory requirements can only be met through specialization, centralization, and establishing centers and networks with internal and external interdisciplinary collaboration. The breast centers certified according to the criteria of the German Cancer Society (DKG) and German Society for Mastology (DGS) are pioneers here. Simultaneously, there are increasing demands for more cost-effective medical services despite limited resources – making economic analysis of health care provision necessary. Few economic studies of the centers and certification system have been conducted, however. General long-term quality data, particularly for results, are not yet available from certified breast centers. At present, a certified breast center is not itself a proven independent prognostic parameter for treatment results. However, the individual criteria required for breast center certification show a significant positive influence on clinical efficacy. Certified breast centers involve substantial extra costs that are not reimbursed by funding bodies, so the slightest potential benefit for patients from certified centers already appears cost-effective. When the actual costs, currently usually subsidized by other departments, are considered, it is unclear whether certified breast centers remain cost-effective. PMID:20877662

  19. New municipal solid waste processing technology reduces volume and provides beneficial reuse applications for soil improvement and dust control

    USDA-ARS?s Scientific Manuscript database

    A garbage-processing technology has been developed that shreds, sterilizes, and separates inorganic and organic components of municipal solid waste. The technology not only greatly reduces waste volume, but the non-composted byproduct of this process, Fluff®, has the potential to be utilized as a s...

  20. Environmental performance evaluation of large-scale municipal solid waste incinerators using data envelopment analysis.

    PubMed

    Chen, Ho-Wen; Chang, Ni-Bin; Chen, Jeng-Chung; Tsai, Shu-Ju

    2010-07-01

    Limited to insufficient land resources, incinerators are considered in many countries such as Japan and Germany as the major technology for a waste management scheme capable of dealing with the increasing demand for municipal and industrial solid waste treatment in urban regions. The evaluation of these municipal incinerators in terms of secondary pollution potential, cost-effectiveness, and operational efficiency has become a new focus in the highly interdisciplinary area of production economics, systems analysis, and waste management. This paper aims to demonstrate the application of data envelopment analysis (DEA)--a production economics tool--to evaluate performance-based efficiencies of 19 large-scale municipal incinerators in Taiwan with different operational conditions. A 4-year operational data set from 2002 to 2005 was collected in support of DEA modeling using Monte Carlo simulation to outline the possibility distributions of operational efficiency of these incinerators. Uncertainty analysis using the Monte Carlo simulation provides a balance between simplifications of our analysis and the soundness of capturing the essential random features that complicate solid waste management systems. To cope with future challenges, efforts in the DEA modeling, systems analysis, and prediction of the performance of large-scale municipal solid waste incinerators under normal operation and special conditions were directed toward generating a compromised assessment procedure. Our research findings will eventually lead to the identification of the optimal management strategies for promoting the quality of solid waste incineration, not only in Taiwan, but also elsewhere in the world. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  1. Environmental performance evaluation of large-scale municipal solid waste incinerators using data envelopment analysis

    SciTech Connect

    Chen, H.-W.; Chang, N.-B.; Chen, J.-C.; Tsai, S.-J.

    2010-07-15

    Limited to insufficient land resources, incinerators are considered in many countries such as Japan and Germany as the major technology for a waste management scheme capable of dealing with the increasing demand for municipal and industrial solid waste treatment in urban regions. The evaluation of these municipal incinerators in terms of secondary pollution potential, cost-effectiveness, and operational efficiency has become a new focus in the highly interdisciplinary area of production economics, systems analysis, and waste management. This paper aims to demonstrate the application of data envelopment analysis (DEA) - a production economics tool - to evaluate performance-based efficiencies of 19 large-scale municipal incinerators in Taiwan with different operational conditions. A 4-year operational data set from 2002 to 2005 was collected in support of DEA modeling using Monte Carlo simulation to outline the possibility distributions of operational efficiency of these incinerators. Uncertainty analysis using the Monte Carlo simulation provides a balance between simplifications of our analysis and the soundness of capturing the essential random features that complicate solid waste management systems. To cope with future challenges, efforts in the DEA modeling, systems analysis, and prediction of the performance of large-scale municipal solid waste incinerators under normal operation and special conditions were directed toward generating a compromised assessment procedure. Our research findings will eventually lead to the identification of the optimal management strategies for promoting the quality of solid waste incineration, not only in Taiwan, but also elsewhere in the world.

  2. Cost Effective Polymer Solar Cells Research and Education

    SciTech Connect

    Sun, Sam-Shajing

    2015-10-13

    The technical or research objective of this project is to investigate and develop new polymers and polymer based optoelectronic devices for potentially cost effective (or cost competitive), durable, lightweight, flexible, and high efficiency solar energy conversion applications. The educational objective of this project includes training of future generation scientists, particularly young, under-represented minority scientists, working in the areas related to the emerging organic/polymer based solar energy technologies and related optoelectronic devices. Graduate and undergraduate students will be directly involved in scientific research addressing issues related to the development of polymer based solar cell technology.

  3. General methodology: Costing, budgeting, and techniques for benefit-cost and cost-effectiveness analysis

    NASA Technical Reports Server (NTRS)

    Stretchberry, D. M.; Hein, G. F.

    1972-01-01

    The general concepts of costing, budgeting, and benefit-cost ratio and cost-effectiveness analysis are discussed. The three common methods of costing are presented. Budgeting distributions are discussed. The use of discounting procedures is outlined. The benefit-cost ratio and cost-effectiveness analysis is defined and their current application to NASA planning is pointed out. Specific practices and techniques are discussed, and actual costing and budgeting procedures are outlined. The recommended method of calculating benefit-cost ratios is described. A standardized method of cost-effectiveness analysis and long-range planning are also discussed.

  4. Cost Effectiveness of Outpatient Asthma Clinics.

    PubMed

    Pérez de Llano, Luis A; Villoro, Renata; Merino, María; Gómez Neira, Maria del Carmen; Muñiz, Camino; Hidalgo, Álvaro

    2016-04-01

    Asthma clinics (AC) are hospital outpatient services specialising in the management of asthma. In this study, we analysed the impact of these clinics on asthma management and their cost effectiveness in comparison with standard outpatient services. A case cross-over study in which all new patients seen in the AC of Lugo in 2012 were included. The case period was defined as one year following the first visit to the AC; the control period was defined as the preceding year. We calculated changes in clinical quality indicators for asthma management, and estimated the incremental cost-effectiveness ratio (ICER) for each additional patient treated and for each quality-adjusted life year (QALY) RESULTS: The number of patients (n=83, mean age 49 ± 15.2 years; 60.2% women) managed in the AC increased from 41% to 86%. The Asthma Control Test score increased from 18.7 ± 4.6 to 22.6 ± 2.3 (p<0.05) and FEV1 increased from 81.4% ± 17.5 to 84.4% ± 16.6 (p<0.05). The number of exacerbations, hospitalisations and visits to accident and emergency fell by 75%. The number of patients given combination LABA+ICS therapy fell from 79.5% to 41%. The use of other drug therapy increased: anticholinergics, from 3.6% to 16.9%; ICS in monotherapy, from 3.6% to 45.8%; and omalizumab, from 0% to 6%. ICERs per patient managed and per QALY gained were €1,399 and €6,876, respectively (social perspective). Treatment in ACs is cost-effective and beneficial in asthma management. Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.

  5. Cost effective launch operations of the SSME

    NASA Technical Reports Server (NTRS)

    Klatt, F. P.

    1985-01-01

    The Space Shuttle Main Engine (SSME) represents the beginning of reusable rocket engine operations in the space transportation system (STS). Steps taken to reduce the overall cost of flight operations of the SSME by improving turnaround operations, extending the life of the engine, and improving the cost effectiveness of overhaul operations at the Canoga Park home plant are described. Ground certification testing to ensure safe launch operations is described, as well as certification extension testing that leads to a service life equivalent to 40 flights. The proven flight record of the SSME, which has demonstrated the utility of the SSME as a key component of America's space transportation system, is discussed.

  6. The Cost-Effective Evaluation of Syncope.

    PubMed

    Angus, Steven

    2016-09-01

    Syncope is a common clinical problem that carries a high socioeconomic burden. A structured approach in the evaluation of syncope with special emphasis on a detailed history, comprehensive physical examination that includes orthostatic vital signs, and an electrocardiogram, proves to be the most cost-effective approach. The need for additional testing and hospital admission should be based on the results of the initial evaluation and use of risk-stratification tools that help identify those syncope patients at highest risk for poor outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Cost-effectiveness as a price control.

    PubMed

    Jena, Anupam B; Philipson, Tomas

    2007-01-01

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

  8. Cost-effective lightweight mirrors for aerospace and defense

    NASA Astrophysics Data System (ADS)

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

    2015-05-01

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

  9. Estimating 'costs' for cost-effectiveness analysis.

    PubMed

    Miners, Alec

    2008-01-01

    Since 1999, the National Institute for Health and Clinical Excellence (NICE) Technology Appraisal Programme has been charged with producing guidance for the NHS in England and Wales on the appropriate use of new and existing healthcare programmes. Guidance is based on an assessment of a number of factors, including cost effectiveness. The identification, measurement and valuation of costs are important components of any cost-effectiveness analysis. However, working through these steps raises a number of important methodological questions. For example, how should 'future' resource use be estimated, and is there a need to consider all 'future' costs? Given that NICE produces national guidance, should national unit cost data be used to value resources or should local variations in negotiated prices be taken into account? This paper was initially prepared as a briefing paper as part of the process of updating NICE's 2004 Guide to the Methods of Technology Appraisal for a workshop on 'costs'. It outlines the issues that were raised in the original briefing paper and the subsequent questions that were discussed at the workshop.

  10. Schizophrenia costs and treatment cost-effectiveness.

    PubMed

    Knapp, M

    2000-01-01

    The paper sets out to summarize evidence on the costs of schizophrenia and on the cost-effectiveness of three broad treatment areas. Evidence from a number of countries was examined, both published and unpublished, and systematic reviews and meta-analyses were consulted. The costs of schizophrenia are high and wide-ranging. They fall not only to health-care agencies but also to other parts of the public sector, to families, to sufferers themselves and to the wider society. However, there are interventions--a counselling intervention to address non-compliance with medication, family interventions to reduce levels of expressed emotion, and atypical antipsychotic drugs--that have been found to be not only effective (improving patient outcomes) but also appear to be cost-effective. Resource constraints and policy pressures make it increasingly common for economic as well as clinical questions to be asked about new modes of treatment. This is the new reality of mental health practice. Reliable evidence is now available to address these economic questions and can be factored into decision-making processes.

  11. Deregulation and Nuclear Training: Cost Effective Alternatives

    SciTech Connect

    Richard P. Coe; Patricia A. Lake

    2000-11-12

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

  12. Understanding Cost-Effectiveness of Energy Efficiency Programs

    EPA Pesticide Factsheets

    This paper discusses the five standard tests used to assess the cost-effectiveness of energy efficiency, how states are using these tests, and how the tests can be used to determine the cost-effectiveness of energy efficiency measures.

  13. Cost-Effective Fuel Treatment Planning

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  14. [Intensified insulin treatment is cost-effective].

    PubMed

    Reichard, P; Alm, C; Andersson, E; Wärn, I; Rosenqvist, U

    1999-01-20

    Both the Diabetes Control and Complications Trial (DCCT) in USA/Canada, and Stockholm Diabetes Intervention Study (SDIS) showed intensified insulin treatment and reduced glycaemia to prevent complications in patients with insulin-dependent (type I) diabetes mellitus. In the DCCT, the intensified treatment was considered cost-effective. In the SDIS, investigation of the direct increase in costs due to the intensified insulin treatment showed the saving in direct costs due to the reduction in photocoagulation requirements, and in the prevalence of renal insufficiency and of amputation, to correspond to 10 years' intensive insulin treatment. Thus, as intensified insulin treatment in type I diabetes reduces direct suffering at a low cost, it may be regarded as 'evidence-based' and mandatory.

  15. Custom LSI plus hybrid equals cost effectiveness

    NASA Astrophysics Data System (ADS)

    Friedman, S. N.

    The possibility to combine various technologies, such as Bi-Polar linear and CMOS/Digital makes it feasible to create systems with a tailored performance not available on a single monolithic circuit. The custom LSI 'BLOCK', especially if it is universal in nature, is proving to be a cost effective way for the developer to improve his product. The custom LSI represents a low price part in contrast to the discrete components it will replace. In addition, the hybrid assembly can realize a savings in labor as a result of the reduced parts handling and associated wire bonds. The possibility of the use of automated system manufacturing techniques leads to greater reliability as the human factor is partly eliminated. Attention is given to reliability predictions, cost considerations, and a product comparison study.

  16. 49 CFR 639.21 - Determination of cost-effectiveness.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Determination of cost-effectiveness. 639.21... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.21 Determination of cost...-effectiveness comparison as described in this subpart, it may ask FTA to approve an alternate form of cost...

  17. 42 CFR 457.1015 - Cost-effectiveness.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Cost-effectiveness. 457.1015 Section 457.1015... Waivers: General Provisions § 457.1015 Cost-effectiveness. (a) Definition. For purposes of this subpart... may demonstrate cost-effectiveness by comparing the cost of coverage for the family to the cost of...

  18. 49 CFR 639.21 - Determination of cost-effectiveness.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Determination of cost-effectiveness. 639.21... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.21 Determination of cost...-effectiveness comparison as described in this subpart, it may ask FTA to approve an alternate form of cost...

  19. 49 CFR 639.21 - Determination of cost-effectiveness.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Determination of cost-effectiveness. 639.21... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.21 Determination of cost...-effectiveness comparison as described in this subpart, it may ask FTA to approve an alternate form of cost...

  20. 49 CFR 639.21 - Determination of cost-effectiveness.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Determination of cost-effectiveness. 639.21... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.21 Determination of cost...-effectiveness comparison as described in this subpart, it may ask FTA to approve an alternate form of cost...

  1. 42 CFR 457.1015 - Cost-effectiveness.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Cost-effectiveness. 457.1015 Section 457.1015... Waivers: General Provisions § 457.1015 Cost-effectiveness. (a) Definition. For purposes of this subpart... may demonstrate cost-effectiveness by comparing the cost of coverage for the family to the cost of...

  2. 42 CFR 457.1015 - Cost-effectiveness.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Cost-effectiveness. 457.1015 Section 457.1015... Waivers: General Provisions § 457.1015 Cost-effectiveness. (a) Definition. For purposes of this subpart... may demonstrate cost-effectiveness by comparing the cost of coverage for the family to the cost of...

  3. 49 CFR 639.21 - Determination of cost-effectiveness.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Determination of cost-effectiveness. 639.21... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.21 Determination of cost-effectiveness. (a) To qualify a lease for capital assistance, a recipient must— (1) Make a written comparison...

  4. Cost-effective ultrasound PACS solution

    NASA Astrophysics Data System (ADS)

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

    1995-05-01

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

  5. Is nuclear medicine cost-effective?

    PubMed

    Ripley, S

    1991-03-01

    Clearly, there is currently no consensus on the cost-effectiveness of nuclear medicine--or in fact any other aspect of medicine. It is hoped that common sense prevails in clinical medicine today. An appropriate case history and physical examination may negate the need for any additional investigation. From the perspective of the capital cost of equipment and supply costs, ultrasound is clearly the most cost-effective diagnostic imaging modality. But while it is useful, it does not always provide definitive answers, and other modalities must be used to arrive at a diagnosis. In comparison, the capital cost of general radiology equipment and nuclear medicine equipment is relatively equal. Radiology has more operating costs per case than nuclear medicine and requires a lower staffing component per given volume of examinations. In any given diagnostic imaging procedure, the practitioner and imagist must maintain a dialogue to ascertain the appropriateness of the study and to use the available resources in the most effective manner. This is even more imperative when CT scanning and MRI are included in the equation. The development of an investigative protocol that makes the most efficient use of the various imaging modalities without compromising the quality of care makes sense for the patient, the physician and the insurance provider. It is unreasonable to expect the physician to be aware of the optimal protocol for the diagnostic workup of every patient. The guidance of the imaging department is required to maximize the efficient use of the available facilities. A critical and exhaustive appraisal of the medical literature may be required to determine the optimal diagnostic protocol.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Lessons learned from the application of a participatory evaluation methodology to healthy municipalities, cities and communities initiatives in selected countries of the Americas.

    PubMed

    Rice, Marilyn; Franceschini, Maria Cristina

    2007-01-01

    Health promotion has made significant strides in the past few decades in the Americas. Creating a healthy and supportive setting, also known as the settings approach, continues to be one of the most widely used health promotion strategies. Interest in evaluating the effectiveness of these strategies has been increasing greatly in the past few years. Participatory evaluation holds great promise for helping to generate this evidence and promote understanding of the factors that affect, positively or negatively, the advances of health promotion in the Region. During 2004-2006, a Participatory Evaluation methodology was introduced into several countries in the Americas through formal trainings conducted by the Pan American Health Organization (PAHO) in collaboration with country partners. This article summarizes the main lessons learned from the application of the participatory evaluation methodology in various countries in Latin America and the Caribbean. Factors affecting the evaluation of the initiatives were identified at multiple levels (individual, community, organizational, political, economic, etc.). Specific issues that were addressed included the political context, turnover of personnel in key institutions, concerns related to the effectiveness of participatory processes, and the existence of strong and sustained leadership at the country level. These factors are intertwined and affect each other in very complex ways, a fact that was reflected in the municipalities' experiences with participatory evaluation. Challenges included the ability to secure resources for the evaluation, the time needed to conclude the process, and working in an intersectoral manner. However, participating municipalities reported that the process of implementing a participatory evaluation and working with various stakeholders had an empowering effect: communities and stakeholders were more willing and interested in participating in health promotion initiatives in a sustained manner

  7. Cost effective tools for soil organic carbon monitoring

    NASA Astrophysics Data System (ADS)

    Shepherd, Keith; Aynekulu, Ermias

    2013-04-01

    providing for cost-effective interpretation of soil carbon and other soil quality indicators. The measurement is has high reproducibility over time, across instruments, and across laboratories compared with conventional soil tests. We describe wide-scale application of soil infrared spectroscopy in Africa in studies designed to measure soil carbon stocks and soil quality in landscapes. Future efforts should be directed towards analyzing the decisions that soil carbon measurements are supposed to support, and quantifying uncertainties in all relevant variables affecting those decisions. Only then can truly cost-effective measurement systems be designed.

  8. Can aging in place be cost effective? A systematic review.

    PubMed

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

    2014-01-01

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

  9. Risk assessment and cost-effectiveness/utility analysis.

    PubMed

    Busch, Michael; Walderhaug, Mark; Custer, Brian; Allain, Jean-Pierre; Reddy, Ravi; McDonough, Brian

    2009-04-01

    Decision-makers at all levels of public health and transfusion medicine have always assessed the risks and benefits of their decisions. Decisions are usually guided by immediately available information and a significant amount of experience and judgment. For decisions concerning familiar situations and common problems, judgment and experience may work quite well, but this type of decision process can lack clarity and accountability. Public health challenges are changing as emerging diseases and expensive technologies complicate the decision-makers' task, confronting the decision-maker with new problems that include multiple potential solutions. Decisions regarding policies and adoption of technologies are particularly complex in transfusion medicine due to the scope of the field, implications for public health, and legal, regulatory and public expectations regarding blood safety. To assist decision-makers, quantitative risk assessment and cost-effectiveness analysis are now being more widely applied. This set of articles will introduce risk assessment and cost-effectiveness methodologies and discuss recent applications of these methods in transfusion medicine.

  10. Designing cost effective water demand management programs in Australia.

    PubMed

    White, S B; Fane, S A

    2002-01-01

    This paper describes recent experience with integrated resource planning (IRP) and the application of least cost planning (LCP) for the evaluation of demand management strategies in urban water. Two Australian case studies, Sydney and Northern New South Wales (NSW) are used in illustration. LCP can determine the most cost effective means of providing water services or alternatively the cheapest forms of water conservation. LCP contrasts to a traditional approach of evaluation which looks only at means of increasing supply. Detailed investigation of water usage, known as end-use analysis, is required for LCP. End-use analysis allows both rigorous demand forecasting, and the development and evaluation of conservation strategies. Strategies include education campaigns, increasing water use efficiency and promoting wastewater reuse or rainwater tanks. The optimal mix of conservation strategies and conventional capacity expansion is identified based on levelised unit cost. IRP uses LCP in the iterative process, evaluating and assessing options, investing in selected options, measuring the results, and then re-evaluating options. Key to this process is the design of cost effective demand management programs. IRP however includes a range of parameters beyond least economic cost in the planning process and program designs, including uncertainty, benefit partitioning and implementation considerations.

  11. Optimal routing for efficient municipal solid waste transportation by using ArcGIS application in Chennai, India.

    PubMed

    Sanjeevi, V; Shahabudeen, P

    2016-01-01

    Worldwide, about US$410 billion is spent every year to manage four billion tonnes of municipal solid wastes (MSW). Transport cost alone constitutes more than 50% of the total expenditure on solid waste management (SWM) in major cities of the developed world and the collection and transport cost is about 85% in the developing world. There is a need to improve the ability of the city administrators to manage the municipal solid wastes with least cost. Since 2000, new technologies such as geographical information system (GIS) and related optimization software have been used to optimize the haul route distances. The city limits of Chennai were extended from 175 to 426 km(2) in 2011, leading to sub-optimum levels in solid waste transportation of 4840 tonnes per day. After developing a spatial database for the whole of Chennai with 200 wards, the route optimization procedures have been run for the transport of solid wastes from 13 wards (generating nodes) to one transfer station (intermediary before landfill), using ArcGIS. The optimization process reduced the distances travelled by 9.93%. The annual total cost incurred for this segment alone is Indian Rupees (INR) 226.1 million. Savings in terms of time taken for both the current and shortest paths have also been computed, considering traffic conditions. The overall savings are thus very meaningful and call for optimization of the haul routes for the entire Chennai.

  12. Application of ANP and DEMATEL to evaluate the decision-making of municipal solid waste management in Metro Manila.

    PubMed

    Tseng, Ming-Lang

    2009-09-01

    A municipal solid waste management (MSW) expert group was consulted in order to mirror how government officials might reach an effective solution regarding municipal solid waste management in Metro Manila. A critical issue regarding this is how the expert group can better evaluate and select a favorable MSW management solution using a series of criteria. MSW management solution selection is a multiple criteria decision-making (MCDM) problem, which requires the consideration of a large number of complex criteria. A robust MCDM method should consider the interactions among these criteria. The analytic network process (ANP) is a relatively new MCDM method which can deal with all kinds of interactions systematically. The Decision Making Trial and Evaluation Laboratory (DEMATEL) not only can convert the relations between cause and effect of criteria into a structural model, but also can be used as a way to handle the inner dependences within a set of criteria. Hence, this paper applies an effective solution based on a combined ANP and DEMATEL method to assist the expert group evaluating different MSW management solutions. According to the results, the best solution is for each city to have its own type of thermal process technology and resource recovery facility before landfill rather than entering a joint venture with enterprises or going into build-operate-transfer projects in order to be able to construct thermal process technologies and resource recovery facilities.

  13. Municipal Rebate Programs for Environmental Retrofits: An Evaluation of Additionality and Cost-Effectiveness

    ERIC Educational Resources Information Center

    Bennear, Lori S.; Lee, Jonathan M.; Taylor, Laura O.

    2013-01-01

    When policies incentivize voluntary activities that also take place in the absence of the incentive, it is critical to identify the additionality of the policy--that is, the degree to which the policy results in actions that would not have occurred otherwise. Rebate programs have become a common conservation policy tool for local municipalities…

  14. Municipal Rebate Programs for Environmental Retrofits: An Evaluation of Additionality and Cost-Effectiveness

    ERIC Educational Resources Information Center

    Bennear, Lori S.; Lee, Jonathan M.; Taylor, Laura O.

    2013-01-01

    When policies incentivize voluntary activities that also take place in the absence of the incentive, it is critical to identify the additionality of the policy--that is, the degree to which the policy results in actions that would not have occurred otherwise. Rebate programs have become a common conservation policy tool for local municipalities…

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

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

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

  16. Cost Effectiveness Analysis for Nursing Research

    PubMed Central

    Bensink, Mark E.; Eaton, Linda H.; Morrison, Megan L.; Cook, Wendy A.; Curtis, R. Randall; Kundu, Anjana; Gordon, Deborah B.; Doorenbos, Ardith Z.

    2013-01-01

    Background With ever increasing pressure to reduce costs and increase quality, nurses are faced with the challenge of producing evidence that their interventions and care provide value. Cost effectiveness analysis (CEA) is a tool that can be used to provide this evidence by comparative evaluation of the costs and consequences of two or more alternatives. Objectives The aim of this article is to introduce the essential components of CEA to nurses and nurse researchers with the protocol of a recently funded cluster randomized controlled trial as an example. Methods This article provides: (a) a description of the main concepts and key steps in CEA, and (b) a summary of the background and objectives of a CEA designed to evaluate a nursing led pain and symptom management intervention in rural communities compared to current usual care. Discussion As the example highlights, incorporating CEA into nursing research studies is feasible. The burden of the additional data collection required is off-set by quantitative evidence of the given intervention's cost and impact using humanistic and economic outcomes. At a time when US health care is moving toward accountable care, the information provided by CEA will be an important additional component of the evidence produced by nursing research. PMID:23817285

  17. Cost effectiveness of robotic mitral valve surgery

    PubMed Central

    2017-01-01

    Significant technological advances have led to an impressive evolution in mitral valve surgery over the last two decades, allowing surgeons to safely perform less invasive operations through the right chest. Most new technology comes with an increased upfront cost that must be measured against postoperative savings and other advantages such as decreased perioperative complications, faster recovery, and earlier return to preoperative level of functioning. The Da Vinci robot is an example of such a technology, combining the significant benefits of minimally invasive surgery with a “gold standard” valve repair. Although some have reported that robotic surgery is associated with increased overall costs, there is literature suggesting that efficient perioperative care and shorter lengths of stay can offset the increased capital and intraoperative expenses. While data on current cost is important to consider, one must also take into account future potential value resulting from technological advancement when evaluating cost-effectiveness. Future refinements that will facilitate more effective surgery, coupled with declining cost of technology will further increase the value of robotic surgery compared to traditional approaches. PMID:28203539

  18. Cost effective mass standard calibration intervals

    SciTech Connect

    Shull, A.H.; Clark, J.P.

    1995-11-01

    National Institute of Standards and Technology (NIST) traceable standard weights serve as the foundation of mass measurement control programs. These standards are normally recalibrated annually at a cost of approximately $100 per weight. The Savannah River Site (SRS) has more than 4,000 standard weights. Most have recalibration intervals of 1 year. The cost effectiveness of the current practice was questioned. Are these mass standards being calibrated too often, and are all of these standards needed for calibration and QC activities? Statistical analyses of data from the calibration histories were performed on a random sample of eight weight sets. The analyses indicated no time effects or significant trends in the weight masses for periods of from 5 to 8 years. In other words, calibration checks were being performed too frequently. In addition, current electronic balance technology does not require a traditional set of standard weights that cover the entire weighing range of a balance. At the most, only 2 or 3 standards are needed for most weighing systems. Hence, by increasing weight set recalibration frequencies from 1 to 3 years, and by reducing the number standards calibrated by 80%, annual cost savings of over $400,000 are attainable at SRS. Details of the data analysis, technological advances, and cost savings are included in the paper.

  19. Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine.

    PubMed

    Sanders, Gillian D; Neumann, Peter J; Basu, Anirban; Brock, Dan W; Feeny, David; Krahn, Murray; Kuntz, Karen M; Meltzer, David O; Owens, Douglas K; Prosser, Lisa A; Salomon, Joshua A; Sculpher, Mark J; Trikalinos, Thomas A; Russell, Louise B; Siegel, Joanna E; Ganiats, Theodore G

    2016-09-13

    Since publication of the report by the Panel on Cost-Effectiveness in Health and Medicine in 1996, researchers have advanced the methods of cost-effectiveness analysis, and policy makers have experimented with its application. The need to deliver health care efficiently and the importance of using analytic techniques to understand the clinical and economic consequences of strategies to improve health have increased in recent years. To review the state of the field and provide recommendations to improve the quality of cost-effectiveness analyses. The intended audiences include researchers, government policy makers, public health officials, health care administrators, payers, businesses, clinicians, patients, and consumers. In 2012, the Second Panel on Cost-Effectiveness in Health and Medicine was formed and included 2 co-chairs, 13 members, and 3 additional members of a leadership group. These members were selected on the basis of their experience in the field to provide broad expertise in the design, conduct, and use of cost-effectiveness analyses. Over the next 3.5 years, the panel developed recommendations by consensus. These recommendations were then reviewed by invited external reviewers and through a public posting process. The concept of a "reference case" and a set of standard methodological practices that all cost-effectiveness analyses should follow to improve quality and comparability are recommended. All cost-effectiveness analyses should report 2 reference case analyses: one based on a health care sector perspective and another based on a societal perspective. The use of an "impact inventory," which is a structured table that contains consequences (both inside and outside the formal health care sector), intended to clarify the scope and boundaries of the 2 reference case analyses is also recommended. This special communication reviews these recommendations and others concerning the estimation of the consequences of interventions, the valuation of health

  20. Integrated cost-effectiveness analysis of agri-environmental measures for water quality.

    PubMed

    Balana, Bedru B; Jackson-Blake, Leah; Martin-Ortega, Julia; Dunn, Sarah

    2015-09-15

    This paper presents an application of integrated methodological approach for identifying cost-effective combinations of agri-environmental measures to achieve water quality targets. The methodological approach involves linking hydro-chemical modelling with economic costs of mitigation measures. The utility of the approach was explored for the River Dee catchment in North East Scotland, examining the cost-effectiveness of mitigation measures for nitrogen (N) and phosphorus (P) pollutants. In-stream nitrate concentration was modelled using the STREAM-N and phosphorus using INCA-P model. Both models were first run for baseline conditions and then their effectiveness for changes in land management was simulated. Costs were based on farm income foregone, capital and operational expenditures. The costs and effects data were integrated using 'Risk Solver Platform' optimization in excel to produce the most cost-effective combination of measures by which target nutrient reductions could be attained at a minimum economic cost. The analysis identified different combination of measures as most cost-effective for the two pollutants. An important aspect of this paper is integration of model-based effectiveness estimates with economic cost of measures for cost-effectiveness analysis of land and water management options. The methodological approach developed is not limited to the two pollutants and the selected agri-environmental measures considered in the paper; the approach can be adapted to the cost-effectiveness analysis of any catchment-scale environmental management options. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. One Health approach to cost-effective rabies control in India

    PubMed Central

    Shah, Hiral A.; Pandey, Abhishek; Bilinski, Alyssa M.; Kakkar, Manish; Clark, Andrew D.; Galvani, Alison P.

    2016-01-01

    Over 20,000 rabies deaths occur annually in India, representing one-third of global human rabies. The Indian state of Tamil Nadu has pioneered a “One Health” committee to address the challenge of rabies in dogs and humans. Currently, rabies control in Tamil Nadu involves postexposure vaccination of humans after dog bites, whereas potential supplemental approaches include canine vaccination and sterilization. We developed a data-driven rabies transmission model fit to human rabies autopsy data and human rabies surveillance data from Tamil Nadu. Integrating local estimates for canine demography and costs, we predicted the impact of canine vaccination and sterilization on human health outcomes and evaluated cost-effectiveness according to the WHO criteria for India, which correspond to thresholds of $1,582 and $4,746 per disability-adjusted life-years (DALYs) for very cost-effective and cost-effective strategies, respectively. We found that highly feasible strategies focused on stray dogs, vaccinating as few as 7% of dogs annually, could very cost-effectively reduce human rabies deaths by 70% within 5 y, and a modest expansion to vaccinating 13% of stray dogs could cost-effectively reduce human rabies by almost 90%. Through integration over parameter uncertainty, we find that, for a cost-effectiveness threshold above $1,400 per DALY, canine interventions are at least 95% likely to be optimal. If owners are willing to bring dogs to central point campaigns at double the rate that campaign teams can capture strays, expanded annual targets become cost-effective. This case study of cost-effective canine interventions in Tamil Nadu may have applicability to other settings in India and beyond. PMID:27994161

  2. Application of toxicity identification procedures to the echinoderm fertilization assay to identify toxicity in a municipal effluent

    SciTech Connect

    Bailey, H.C.; Miller, J.L.; Miller, M.J.; Dhaliwal, B.S.

    1995-12-01

    Toxicity was detected in a municipal effluent with the echinoderm fertilization assay. Dendraster excentricus appeared more sensitive to the effluent than did Strongylocentrotus purpuratus. A Phase 1 toxicity identification evaluation (TIE) was conducted using procedures adapted to the echinoderm fertilization bioassay. The Phase 1 TIE implicated cationic metals as the cause of toxicity, and follow-up investigations suggested that copper was the primary cation responsible. As part of the TIE, bioassays were conducted on ammonia and several cations. No-observable-effect concentrations for D. excentricus were > 13.4 {micro}g/L (Ag), > 9.4 {micro}g/L (Cd), 3.8 to 13.1 {micro}g/L (Cu), > 0.7 {micro}g/L (Hg), and 10 mg/L (N, as total ammonia). The data also suggested that interspecific differences in sensitivity to copper and ammonia exist between Dendraster excentricus and Strongylocentrotus purpuratus.

  3. Application of municipal solid waste compost reduces the negative effects of saline water in Hordeum maritimum L.

    PubMed

    Lakhdar, Abdelbasset; Hafsi, Chokri; Rabhi, Mokded; Debez, Ahmed; Montemurro, Francesco; Abdelly, Chedly; Jedidi, Naceur; Ouerghi, Zeineb

    2008-10-01

    The efficiency of composted municipal solid wastes (MSW) to reduce the adverse effects of salinity was investigated in Hordeum maritimum under greenhouse conditions. Plants were cultivated in pots filled with soil added with 0 and 40tha(-1) of MSW compost, and irrigated twice a week with tap water at two salinities (0 and 4gl(-1) NaCl). Harvests were achieved at 70 (shoots) and 130 (shoots and roots) days after sowing. At each cutting, dry weight (DW), NPK nutrition, chlorophyll, leaf protein content, Rubisco (ribulose-bisphosphate carboxylase/oxygenase) capacity, and contents of potential toxic elements were determined. Results showed that compost supply increased significantly the biomass production of non salt-treated plants (+80%). This was associated with higher N and P uptake in both shoots (+61% and +80%, respectively) and roots (+48% and +25%, respectively), while lesser impact was observed for K+. In addition, chlorophyll and protein contents as well as Rubisco capacity were significantly improved by the organic amendment. MSW compost mitigated the deleterious effect of salt stress on the plant growth, partly due to improved chlorophyll and protein contents and Rubisco capacity (-15%, -27% and -14%, respectively, in combined treatment, against -45%, -84% and -25%, respectively, in salt-stressed plants without compost addition), which presumably favoured photosynthesis and alleviated salt affect on biomass production by 21%. In addition, plants grown on amended soil showed a general improvement in their heavy metals contents Cu2+, Pb2+, Cd2+, and Zn2+ (in combined treatment: 190%, 53%, 168% and 174% in shoots and 183%, 42%, 42% and 114% in roots, respectively) but remained lower than phytotoxic values. Taken together, these findings suggest that municipal waste compost may be safely applied to salt-affected soils without adverse effects on plant physiology.

  4. Development of a cost effective silicon nitride powder

    SciTech Connect

    Winslow, S.G. )

    1993-04-01

    The Ceramic Technology for Advanced Heat Engines Project was initiated in 1983 to meet the ceramic materials technology needs of the Department of energy (DOE) advanced engine programs, the Advanced Gas Turbine (AGT) Program, and the Heavy Duty Transport (low-heat-rejection heavy-duty diesel) Program. The original plan for this effort was developed jointly by industry, academia, and the US Government. The plan was developed in several stages following an assessment to determine the critical-technology base needs, the potential economic value of structural ceramics, the extent of ongoing and planned R and D programs, and the estimated funding required. The program goal was to develop an industrial technology base capable of providing reliable and cost-effective structural ceramics for application in advanced heat engines. In this paper research, sponsored by the US Department of Energy, with the objective of developing an economical silicon nitride powder is described.

  5. DEVELOPMENT AND MANUFACTURE OF COST EFFECTIVE COMPOSITE DRILL PIPE

    SciTech Connect

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

    2003-03-30

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

  6. Assuring Known Good Die (KGD) for reliable, cost effective MCMs

    NASA Astrophysics Data System (ADS)

    Daskiewich, Daniel E.

    1994-10-01

    A key requirement for achieving high yield multichip modules (MCM's) is assuring that the individual dice are known good devices (KGD). A KGD is defined as a bare die available at the same quality and reliability as the equivalent single chip packaged parts. Integrated circuits (IC's) that are Known Good will function over a specified temperature range, are compatible with the MCM approach utilized, and contain no short-term or long-term reliability hazards. The application of reliability and testability techniques at all levels of MCM development, particularly at the chip level, will maximize MCM yield. Today's testing and qualification requirements, defined by MIL-STD-883 Methods 5008 and 2010, are not capable of assuring KGD as defined above. The development of cost effective requirements for achieving 99.9 percent yields poses a challenge which requires new and novel approaches and better methods for bare die testing, wafer level burn-in, tape automated bonding (TAB), temporary packaging, at-speed device testing at the wafer, die, and MCM level. Also of great importance are the methods for built-in self test (BIST), built-in test (BIT), and boundary scan. New standards in very large scale integration (VLSI) device testing must be developed in order for MCM's to be reliable and economical. Rome Laboratory (RL) has funded a program to address and develop these requirements. The objectives of the RL program are to: research and evaluate current and proposed burn-in, electrical and interconnect test techniques for assuring known good VLSI circuits at wafer and die level; and evaluate various methods of incorporating testability features which will decrease test time and cost. In addition, MCM-level reliability and performance assessment procedures will be evaluated to determine appropriate testing concepts and procedures that will assure the procurement of reliable, cost effective MCM's for DOD/NASA applications. The program consists of two phases: Phase One will

  7. [Evaluation model for municipal health planning management].

    PubMed

    Berretta, Isabel Quint; Lacerda, Josimari Telino de; Calvo, Maria Cristina Marino

    2011-11-01

    This article presents an evaluation model for municipal health planning management. The basis was a methodological study using the health planning theoretical framework to construct the evaluation matrix, in addition to an understanding of the organization and functioning designed by the Planning System of the Unified National Health System (PlanejaSUS) and definition of responsibilities for the municipal level under the Health Management Pact. The indicators and measures were validated using the consensus technique with specialists in planning and evaluation. The applicability was tested in 271 municipalities (counties) in the State of Santa Catarina, Brazil, based on population size. The proposed model features two evaluative dimensions which reflect the municipal health administrator's commitment to planning: the guarantee of resources and the internal and external relations needed for developing the activities. The data were analyzed using indicators, sub-dimensions, and dimensions. The study concludes that the model is feasible and appropriate for evaluating municipal performance in health planning management.

  8. Brominated flame retardants and perfluoroalkyl acids in groundwater, tile drainage, soil, and crop grain following a high application of municipal biosolids to a field.

    PubMed

    Gottschall, N; Topp, E; Edwards, M; Payne, M; Kleywegt, S; Lapen, D R

    2017-01-01

    Dewatered municipal biosolids (DMB) were applied at a rate of 22Mgdwha(-1) to an agricultural field in fall 2008. Concentrations of polybrominated diphenyl ethers (PBDEs; BDE-47, -99, -100, -153, -154, -183, -197, -207, -209), other brominated flame retardants (BFRs; HBB, PBEB, DBDPE, BTBPE) and perfluoroalkyl acids (PFAAs; PFHxS, PFOS, PFDS, PFOSA, PFHpA, PFOA, PFNA, PFDA, PFUnA, PFDoA, PFTA) were monitored in tile drainage, groundwater (2m, 4m and 6m depth), soil cores (0-0.3m) pre- and post-application, DMB aggregates incorporated into the soil post-application, and in wheat (Triticum spp.) planted post-application. Several compounds were detected in soil and water pre-application and on a reference field plot. PBDEs, other BFRs and PFAAs were detected in tile drainage and 2m groundwater throughout the post-application study period; a few PBDEs were also detected sporadically at lower depths in groundwater. Some of these compounds had not been detected pre-application, while some exceeded reference field plot/pre-application levels (some significantly (p<0.05) in tile drainage); both cases indicating biosolid-based water contamination. In DMB aggregates, several PBDE congeners were found to have dissipated exponentially, with reductions >90% in many of them within 1year post-application. Exponential dissipation of other BFRs and PFAAs in DMB aggregates were not significant. No PBDEs, other BFRs, or PFAAs were detected in wheat grain. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  9. The cost-effectiveness of quality improvement projects: a conceptual framework, checklist and online tool for considering the costs and consequences of implementation-based quality improvement.

    PubMed

    Thompson, Carl; Pulleyblank, Ryan; Parrott, Steve; Essex, Holly

    2016-02-01

    In resource constrained systems, decision makers should be concerned with the efficiency of implementing improvement techniques and technologies. Accordingly, they should consider both the costs and effectiveness of implementation as well as the cost-effectiveness of the innovation to be implemented. An approach to doing this effectively is encapsulated in the 'policy cost-effectiveness' approach. This paper outlines some of the theoretical and practical challenges to assessing policy cost-effectiveness (the cost-effectiveness of implementation projects). A checklist and associated (freely available) online application are also presented to help services develop more cost-effective implementation strategies. © 2015 John Wiley & Sons, Ltd.

  10. Quality of Life and Cost Effectiveness of Prostate Cancer Treatment

    DTIC Science & Technology

    2005-03-01

    AD Award Number: W81XWH-04-1-0257 TITLE: Quality of Life and Cost Effectiveness of Prostate Cancer Treatment PRINCIPAL INVESTIGATOR: Ravishankar...patients across two ethnic groups, (2) analyze and compare short and long term cost-effectiveness of prostate cancer treatment across ethnic groups; and...cost-effectiveness of prostate cancer treatment across ethnic groups; and (3) analyze and compare resource utilization patterns, treatment modalities

  11. Accounting for future costs in medical cost-effectiveness analysis.

    PubMed

    Meltzer, D

    1997-02-01

    Most medical cost-effectiveness analyses include future costs only for related illnesses, but this approach is controversial. This paper demonstrates that cost-effectiveness analysis is consistent with lifetime utility maximization only if it includes all future medical and non-medical expenditures. Estimates of the magnitude of these future costs suggest that they may substantially alter both the absolute and relative cost-effectiveness of medical interventions, particularly when an intervention increases length of life more than quality of life. In older populations, current methods overstate the cost-effectiveness of interventions which extend life compared to interventions which improve the quality of life.

  12. Cost-effective nursing practice: cost-awareness and empowerment.

    PubMed

    Fisher, P

    1993-12-01

    Cost-effective nursing practice is essential to succeed today as resources allocated to health care are declining. Realizing that any change poses a threat to our security, it is imperative that stakeholders be permitted to participate in decision-making processes affecting their work. An honest, open exchange of ideas towards cost-effective practices should be encouraged. Cost-effective behaviours are influenced significantly by negative attitudes with regard to loss of human resources, increased workload, and potential pay cuts. This article describes innovative strategies which could promote successful cost-effective nursing practice, including working smarter, not working harder. Topics addressed are attitude, awareness and empowerment.

  13. The cost-effectiveness of NBPTS teacher certification.

    PubMed

    Yeh, Stuart S

    2010-06-01

    A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of value-added statistical methods to identify effective teachers, and the implementation of systems where student performance in math and reading is rapidly assessed 2-5 times per week. The most cost-effective approach, rapid assessment, is three magnitudes as cost-effective as Board certification.

  14. Application of continuous normal-lognormal bivariate density functions in a sensitivity analysis of municipal solid waste landfill.

    PubMed

    Petrovic, Igor; Hip, Ivan; Fredlund, Murray D

    2016-09-01

    The variability of untreated municipal solid waste (MSW) shear strength parameters, namely cohesion and shear friction angle, with respect to waste stability problems, is of primary concern due to the strong heterogeneity of MSW. A large number of municipal solid waste (MSW) shear strength parameters (friction angle and cohesion) were collected from published literature and analyzed. The basic statistical analysis has shown that the central tendency of both shear strength parameters fits reasonably well within the ranges of recommended values proposed by different authors. In addition, it was established that the correlation between shear friction angle and cohesion is not strong but it still remained significant. Through use of a distribution fitting method it was found that the shear friction angle could be adjusted to a normal probability density function while cohesion follows the log-normal density function. The continuous normal-lognormal bivariate density function was therefore selected as an adequate model to ascertain rational boundary values ("confidence interval") for MSW shear strength parameters. It was concluded that a curve with a 70% confidence level generates a "confidence interval" within the reasonable limits. With respect to the decomposition stage of the waste material, three different ranges of appropriate shear strength parameters were indicated. Defined parameters were then used as input parameters for an Alternative Point Estimated Method (APEM) stability analysis on a real case scenario of the Jakusevec landfill. The Jakusevec landfill is the disposal site of the capital of Croatia - Zagreb. The analysis shows that in the case of a dry landfill the most significant factor influencing the safety factor was the shear friction angle of old, decomposed waste material, while in the case of a landfill with significant leachate level the most significant factor influencing the safety factor was the cohesion of old, decomposed waste material. The

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

    NASA Technical Reports Server (NTRS)

    Jonsson, Jonas; Mauro, David; Stupl, Jan; Nayak, Michael; Aziz, Jonathan; Cohen, Aaron; Colaprete, Anthony; Dono-Perez, Andres; Frost, Chad; Klamm, Benjamin; hide

    2015-01-01

    exploration of multiple solar system bodies in reasonable timeframes despite budgetary constraints, with only minor adaptations. The work presented here is a summary of concepts targeting icy bodies, such as Europa and Ceres, which have been developed over the last year at NASA Ames Research Center's Mission Design Division. The platforms detailed in this work are also applicable to the cost-effective exploration of many other small icy bodies in the solar system.

  16. Ferrate (Fe(VI)) application for Municipal wastewater treatment: a novel process for simultaneous micropollutant oxidation and phosphate removal.

    PubMed

    Lee, Yunho; Zimmermann, Saskia Gisela; Kieu, Anh Trung; Von Gunten, Urs

    2009-05-15

    A novel technology for enhanced municipal wasterwater treatment was assessed based on the dual functions of Fe(VI) to oxidize micropollutants and remove phosphate by formation of ferric phosphates. Second-order rate constants (k) for the reactions of selected pharmaceuticals, endocrine disruptors, and organic model compounds with Fe(VI) were in the range of 1 (trimethylamine) to 9000 M(-1) s(-1) (aniline) in the pH-range 7-8. The selected compounds contained electron-rich moieties (ERM) such as phenols, anilines, amines, and olefins. Oxidation experiments in wastewater spiked with micropollutants at concentrations in the low microM range at pH 7 and 8 showed that Fe(VI) doses higher than 5 mg Fe L(-1) are capable of eliminating various ERM-containing micropollutants by more than 85%. In comparison to ozone, Fe(VI) was as effective or slightly less effective in terms of micropollutants oxidation, with Fe(VI) having the benefit of phosphate removal. To lower phosphate from 3.5 to 0.8 mg PO4-P L(-1) (regulatory limit for wastewater discharge in Switzerland), a Fe(VI) dose of 7.5 mg Fe L(-1) was needed. Overall, this study demonstrates Fe(VI) as a promising tool for an enhanced wastewater treatment to remove micropollutants as well as to control phosphate in a single treatment step.

  17. Application of physicochemical data for water-quality assessment of watercourses in the Gdansk Municipality (South Baltic coast).

    PubMed

    Cieszynska, Monika; Wesolowski, Marek; Bartoszewicz, Maria; Michalska, Malgorzata; Nowacki, Jacek

    2012-04-01

    The paper presents water-quality evaluation based on an 8-year monitoring programme in the Gdansk Municipality region, on the Southern coast of the Baltic Sea. The studies were carried out from 2000 to 2007 by surface water analysis at 15 various sites within eight watercourses. Sampling sites included rather urbanized or developed lands, farming fields and non-polluted city recreational areas such as parks and forests. Most of the watercourses were sampled monthly at two locations, one within the upper course of the watercourse and the other near its mouth. In all samples, eight parameters of water quality were determined: total suspended solids, dissolved oxygen, water temperature, oxygen saturation, 5-day biochemical oxygen demand, chemical oxygen demand, total phosphorus and total nitrogen concentration. Interpretation of the obtained results revealed that examination of those basic physicochemical parameters permits to discriminate initially watercourses with respect to level of water contamination. During the research, a large dataset was obtained and it was described by both basic statistical parameters and chemometric method of cluster analysis. The paper presents relations between analysed parameters and influence of land exploitation mode on water quality and describes variation of the results both in space and time.

  18. Application of electron beam for the reduction of PCDD/F emission from municipal solid waste incinerators.

    PubMed

    Hirota, Koichi; Hakoda, Teruyuki; Taguchi, Mitsumasa; Takigami, Machiko; Kim, Hyonha; Kojima, Takuji

    2003-07-15

    The electron-beam technology was applied to reduce the emission of polychlorinated dibenzo-p-dioxins (PCDD) and polychlorinated dibenzofurans (PCDF) in a flue gas of 1000 m(3)N/h from the municipal solid waste incinerator (MSWI) at a temperature of 200 degrees C. More than 90% decomposition of PCDD/Fs was obtained using an electron accelerator at a dose of 14 kGy. The decomposition was initiated through reactions with OH radicals produced by the irradiation of flue gases, followed by oxidation such as the ring cleavage of the aromatic ring, the dissociation of ether bond, and dechlorination. The cost analysis estimated that the electron-beam system can cut the annualized cost by approximately 50% for the treatment of PCDD/Fs in a pre-dusted MSWI flue gas as compared with a bag-filter system when operating on electricity generated from an incineration. Electron-beam technology is an economically and technologically useful method for reducing PCDD/Fs in an incineration flue gas.

  19. Synthesis of cryptocrystalline magnesite/bentonite clay composite and its application for removal of phosphate from municipal wastewaters.

    PubMed

    Masindi, V; Gitari, W M; Pindihama, K G

    2016-01-01

    In the present study, nanocomposite of cryptocrystalline magnesite-bentonite clay was used as a novel technology for removal of phosphates from municipal effluents. Vibratory ball miller was used for fabrication of the composite. Removal of phosphate from an aqueous solution was achieved using batch experimental procedures. The parameters optimized include time, dosage, concentration and pH. An optimization experiment revealed that 30 mins of shaking time, 1 g of composite, 100 mg L(-1) of phosphate, 1: 100 S/L ratios, 250 rpm, pH 10 and room temperature are the optimum conditions for removal of phosphate. Adsorption data fitted well to the Langmuir adsorption isotherm than Freundlich adsorption isotherms, thus confirming monolayer adsorption. Adsorption kinetics data fitted well to pseudo second-order kinetics than first-order kinetics, thus suggesting chemisorption. This comparative study showed better adsorption of the composite as compared to conventional methods of phosphate removal. The results suggest that the fabricated composite has the potential for remediation of phosphate-contaminated waters.

  20. Application and evaluation of forecasting methods for municipal solid waste generation in an Eastern-European city.

    PubMed

    Rimaityte, Ingrida; Ruzgas, Tomas; Denafas, Gintaras; Racys, Viktoras; Martuzevicius, Dainius

    2012-01-01

    Forecasting of generation of municipal solid waste (MSW) in developing countries is often a challenging task due to the lack of data and selection of suitable forecasting method. This article aimed to select and evaluate several methods for MSW forecasting in a medium-scaled Eastern European city (Kaunas, Lithuania) with rapidly developing economics, with respect to affluence-related and seasonal impacts. The MSW generation was forecast with respect to the economic activity of the city (regression modelling) and using time series analysis. The modelling based on social-economic indicators (regression implemented in LCA-IWM model) showed particular sensitivity (deviation from actual data in the range from 2.2 to 20.6%) to external factors, such as the synergetic effects of affluence parameters or changes in MSW collection system. For the time series analysis, the combination of autoregressive integrated moving average (ARIMA) and seasonal exponential smoothing (SES) techniques were found to be the most accurate (mean absolute percentage error equalled to 6.5). Time series analysis method was very valuable for forecasting the weekly variation of waste generation data (r (2) > 0.87), but the forecast yearly increase should be verified against the data obtained by regression modelling. The methods and findings of this study may assist the experts, decision-makers and scientists performing forecasts of MSW generation, especially in developing countries.

  1. An inexact multi-objective dynamic model and its application in China for the management of municipal solid waste

    SciTech Connect

    Su, J. Xi, B.D.; Liu, H.L.; Jiang, Y.H.; Warith, M.A.

    2008-12-15

    With the development of science and technology, solid waste management has become a serious environmental problem for most communities all over the world. This paper presents a multi-objective optimization model for the management of municipal solid waste (MSW) via an uncertainty approach. In this model, the system cost of solid waste management and the environmental impact are considered as the main objectives, and some necessary constraints based on the characteristics of China are included; additionally, Pollution loss theory is applied to evaluate the environmental impact. This model is applied to the City of Fo Shan, China. Compared with the primary project of Fo Shan, which is provided by the government, the results of the optimization procedure show that the overall system cost could be reduced by $1-2.4/ton, i.e., $3.7 million/yr. The model presented in this paper was proven to be an effective response to the multi-objective solid waste management problem, and provides a new technique to optimize MSW management and operation. Why is the optimization result better? By analyzing the modelling with respect to function, constraints, and results, we conclude that the profit would be augmented due to the amount of the waste that would be treated by recycling technology, which would increase rapidly during the planning time; thus, the total system cost could be reduced accordingly.

  2. Surveillance for isocyanate asthma: a model based cost effectiveness analysis

    PubMed Central

    Wild, D; Redlich, C; Paltiel, A

    2005-01-01

    Aims: Because logistical and financial obstacles impede using large prospective cohort studies, surveillance decisions in occupational settings must often be made without evidence of relative benefits and costs. Using the example of isocyanate induced asthma, the most commonly reported immune mediated occupational asthma, the authors developed a model based approach to evaluate the costs and benefits of surveillance from both an employer and a societal perspective. Methods: The authors used a mathematical simulation model of isocyanate asthma to compare annual surveillance to passive case finding. Outcome measures included symptom free days (SFD), quality adjusted life years (QALY), direct costs, productivity losses, and incremental cost effectiveness ratio (CER), measured from the employer and the societal perspectives. Input data were obtained from a variety of published sources. Results: For 100 000 exposed workers, surveillance resulted in 683 fewer cases of disability over 10 years. Surveillance conferred benefits at an incremental cost of $24,000/QALY (employer perspective; $13.33/SFD) and was cost saving from the societal perspective. Results were sensitive to assumptions about sensitisation rate, removal rates, and time to diagnosis, but not to assumptions about therapy costs and disability rates. Conclusions: Baseline results placed the CER for surveillance for isocyanate asthma within the acceptable range. Costs from the societal and employer perspective differed substantially with a more attractive CER from the societal perspective, suggesting opportunities for employer/societal cost sharing. The analysis demonstrates the value of a model based approach to evaluate the cost effectiveness of surveillance programmes for isocyanate asthma, and to inform shared decision making among clinicians, patients, employers, and society. Such a modeling approach may be applicable to surveillance programmes for other work related conditions. PMID:16234399

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

    PubMed

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

    2015-03-01

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

  4. Groundwater quality impacts from the land application of treated municipal wastewater in a large karstic spring basin: Chemical and microbiological indicators

    USGS Publications Warehouse

    Katz, B.G.; Griffin, Dale W.; Davis, J.H.

    2009-01-01

    Geochemical and microbiological techniques were used to assess water-quality impacts from the land application of treated municipal wastewater in the karstic Wakulla Springs basin in northern Florida. Nitrate-N concentrations have increased from about 0.2 to as high as 1.1??mg/L (milligrams per liter) during the past 30??years in Wakulla Springs, a regional discharge point for groundwater (mean flow about 11.3??m3/s) from the Upper Floridan aquifer (UFA). A major source of nitrate to the UFA is the approximately 64??million L/d (liters per day) of treated municipal wastewater applied at a 774??ha (hectare) sprayfield farming operation. About 260 chemical and microbiological indicators were analyzed in water samples from the sprayfield effluent reservoir, wells upgradient from the sprayfield, and from 21 downgradient wells and springs to assess the movement of contaminants into the UFA. Concentrations of nitrate-N, boron, chloride, were elevated in water samples from the sprayfield effluent reservoir and in monitoring wells at the sprayfield boundary. Mixing of sprayfield effluent water was indicated by a systematic decrease in concentrations of these constituents with distance downgradient from the sprayfield, with about a 10-fold dilution at Wakulla Springs, about 15??km (kilometers) downgradient from the sprayfield. Groundwater with elevated chloride and boron concentrations in wells downgradient from the sprayfield and in Wakulla Springs had similar nitrate isotopic signatures, whereas the nitrate isotopic composition of water from other sites was consistent with inorganic fertilizers or denitrification. The sprayfield operation was highly effective in removing most studied organic wastewater and pharmaceutical compounds and microbial indicators. Carbamazepine (an anti-convulsant drug) was the only pharmaceutical compound detected in groundwater from two sprayfield monitoring wells (1-2??ppt). One other detection of carbamazepine was found in a distant well

  5. Groundwater quality impacts from the land application of treated municipal wastewater in a large karstic spring basin: chemical and microbiological indicators.

    PubMed

    Katz, Brian G; Griffin, Dale W; Davis, J Hal

    2009-04-01

    Geochemical and microbiological techniques were used to assess water-quality impacts from the land application of treated municipal wastewater in the karstic Wakulla Springs basin in northern Florida. Nitrate-N concentrations have increased from about 0.2 to as high as 1.1 mg/L (milligrams per liter) during the past 30 years in Wakulla Springs, a regional discharge point for groundwater (mean flow about 11.3 m(3)/s) from the Upper Floridan aquifer (UFA). A major source of nitrate to the UFA is the approximately 64 million L/d (liters per day) of treated municipal wastewater applied at a 774 ha (hectare) sprayfield farming operation. About 260 chemical and microbiological indicators were analyzed in water samples from the sprayfield effluent reservoir, wells upgradient from the sprayfield, and from 21 downgradient wells and springs to assess the movement of contaminants into the UFA. Concentrations of nitrate-N, boron, chloride, were elevated in water samples from the sprayfield effluent reservoir and in monitoring wells at the sprayfield boundary. Mixing of sprayfield effluent water was indicated by a systematic decrease in concentrations of these constituents with distance downgradient from the sprayfield, with about a 10-fold dilution at Wakulla Springs, about 15 km (kilometers) downgradient from the sprayfield. Groundwater with elevated chloride and boron concentrations in wells downgradient from the sprayfield and in Wakulla Springs had similar nitrate isotopic signatures, whereas the nitrate isotopic composition of water from other sites was consistent with inorganic fertilizers or denitrification. The sprayfield operation was highly effective in removing most studied organic wastewater and pharmaceutical compounds and microbial indicators. Carbamazepine (an anti-convulsant drug) was the only pharmaceutical compound detected in groundwater from two sprayfield monitoring wells (1-2 ppt). One other detection of carbamazepine was found in a distant well water

  6. 76 FR 60958 - Self-Regulatory Organizations; Municipal Securities Rulemaking Board; Notice of Withdrawal of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... Proposed Interpretive Notice Concerning the Application of Rule G-17 to Municipal Advisors September 26... interpretive notice concerning the application of MSRB Rule G-17 to municipal advisors. Notice of the proposed...

  7. 77 FR 5501 - City of Hamilton, Ohio; American Municipal Power, Inc.; Notice of Application Accepted for Filing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-03

    ... Application Accepted for Filing, Soliciting Motions To Intervene and Protests, Ready for Environmental... hydroelectric application has been filed with the Commission and is available for public inspection: a. Application Type: Amendment of license to change transmission line route. b. Project No.: 12667-031. c....

  8. Hormones, sterols, and fecal indicator bacteria in groundwater, soil, and subsurface drainage following a high single application of municipal biosolids to a field.

    PubMed

    Gottschall, N; Topp, E; Edwards, M; Payne, M; Kleywegt, S; Russell, P; Lapen, D R

    2013-04-01

    A land application of dewatered municipal biosolids (DMB) was conducted on an agricultural field in fall 2008 at a rate of 22Mg dry weight (dw) ha(-1). Pre- and post- application, hormone, sterol and fecal indicator bacteria concentrations were measured in tile drainage water, groundwater (2, 4, 6m depth), surface soil cores, and DMB aggregates incorporated in the soil (∼0.2m depth) for a period of roughly 1year post-application. Hormones and sterols were detected up to 1year post-application in soil and in DMB aggregates. Hormone (androsterone, desogestrel, estrone) contamination was detected briefly in tile water samples (22d and ∼2months post-app), at lowngL(-1) concentrations (2-34ngL(-1)). Hormones were not detected in groundwater. Sterols were detected in tile water throughout the study period post-application, and multiple fecal sterol ratios suggested biosolids as the source. Coprostanol concentrations in tile water peaked at >1000ngL(-1) (22d post-app) and were still >100ngL(-1) at 6months post-application. Fecal indicator bacteria were detected throughout the study period in tile water, groundwater (⩽2m depth), soil and DMB aggregate samples. These bacteria were strongly linearly related to coprostanol in tile water (R(2)>0.92, p<0.05). The limited transport of hormones and sterols to tile drainage networks may be attributed to a combination of the hydrophobicity of these compounds and limited macroporosity of the field soil. This transitory contamination from hormones and sterols is unlikely to result in any significant pulse exposure risk in subsurface drainage and groundwater. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

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

    PubMed Central

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

    2004-01-01

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

  10. Bayesian comparison of cost-effectiveness of different clinical approaches to diagnose coronary artery disease

    SciTech Connect

    Patterson, R.E.; Eng, C.; Horowitz, S.F.; Gorlin, R.; Goldstein, S.R.

    1984-08-01

    The objective of this study was to compare the cost-effectiveness of four clinical policies (policies I to IV) in the diagnosis of the presence or absence of coronary artery disease. A model based on Bayes theorem and published clinical data was constructed to make these comparisons. Effectiveness was defined as either the number of patients with coronary disease diagnosed or as the number of quality-adjusted life years extended by therapy after the diagnosis of coronary disease. The following conclusions arise strictly from analysis of the model and may not necessarily be applicable to all situations. As prevalence of coronary disease in the population increased, it caused a linear increase in cost per patient tested, but a hyperbolic decrease in cost per effect, that is, increased cost-effectiveness. Thus, cost-effectiveness of all policies (I to IV) was poor in populations with a prevalence of disease below 10%. Analysis of the model also indicates that at prevalences less than 80%, exercise thallium scintigraphy alone as a first test (policy II) is a more cost-effective initial test than is exercise electrocardiography alone as a first test (policy I) or exercise electrocardiography first combined with thallium imaging as a second test (policy IV). Exercise electrocardiography before thallium imaging (policy IV) is more cost-effective than exercise electrocardiography alone (policy I) at prevalences less than 80%. 4) Noninvasive exercise testing before angiography (policies I, II and IV) is more cost-effective than using coronary angiography as the first and only test (policy III) at prevalences less than 80%. 5) Above a threshold value of prevalence of 80% (for example patients with typical angina), proceeding to angiography as the first test (policy III) was more cost-effective than initial noninvasive exercise tests (policies I, II and IV).

  11. The sunk cost effect across species: A review of persistence in a course of action due to prior investment.

    PubMed

    Magalhães, Paula; Geoffrey White, K

    2016-05-01

    The sunk cost effect is the bias or tendency to persist in a course of action due to prior investments of effort, money or time. At the time of the only review on the sunk cost effect across species (Arkes & Ayton, 1999), research with nonhuman animals had been ecological in its nature, and the findings about the effect of past investments on current choice were inconclusive. However, in the last decade a new line of experimental laboratory-based research has emerged with the promise of revolutionizing the way we approach the study of the sunk cost effect in nonhumans. In the present review we challenge Arkes and Ayton's conclusion that the sunk cost effect is exclusive to humans, and describe evidence for the sunk cost effect in nonhuman animals. By doing so, we also challenge the current explanations for the sunk cost effect in humans, as they are not applicable to nonhumans. We argue that a unified theory is called for, because different independent variables, in particular, investment amount, have the same influence on the sunk cost effect across species. Finally, we suggest possible psychological mechanisms shared across different species, contrast and depreciation, that could explain the sunk cost effect.

  12. Design and characterization of electrically self-isolated GaN-on-Si junctionless fin-shaped-channel field-effect transistor with higher cost-effectiveness for low-power applications

    NASA Astrophysics Data System (ADS)

    Lee, Seongmin; Lee, Jeongmin; Cho, Seongjae

    2015-08-01

    A GaN-on-Si junctionless FET with a feasible structure is suggested and simulated. A silicon-on-insulator channel is replaced by a GaN-on-Si channel in the proposed device. The GaN-on-Si heterostructure forms an electrically self-isolated channel owing to its large band offset. Two- and three-dimensional (2D and 3D) device simulations were cooperatively performed to optimize the device in terms of gate length, channel thickness, channel doping concentration, and substrate concentration, targeting low-power applications.

  13. Low-Budget, Cost-Effective OCR: Optical Character Recognition for MS-DOS Micros.

    ERIC Educational Resources Information Center

    Perez, Ernest

    1990-01-01

    Discusses optical character recognition (OCR) for use with MS-DOS microcomputers. Cost effectiveness is considered, three types of software approaches to character recognition are explained, hardware and operation requirements are described, possible library applications are discussed, future OCR developments are suggested, and a list of OCR…

  14. Low-Budget, Cost-Effective OCR: Optical Character Recognition for MS-DOS Micros.

    ERIC Educational Resources Information Center

    Perez, Ernest

    1990-01-01

    Discusses optical character recognition (OCR) for use with MS-DOS microcomputers. Cost effectiveness is considered, three types of software approaches to character recognition are explained, hardware and operation requirements are described, possible library applications are discussed, future OCR developments are suggested, and a list of OCR…

  15. The Sunk Cost Effect in Pigeons and Humans

    ERIC Educational Resources Information Center

    Navarro, Anton D.; Fantino, Edmund

    2005-01-01

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

  16. Cost Effectiveness for Gifted and Talented Educational Programs.

    ERIC Educational Resources Information Center

    Storms, Walt W.

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

  17. Cost Effective Repair Techniques for Turbine Airfoils. Volume 2

    DTIC Science & Technology

    1979-04-01

    BLADES , *GUIDE VANES , *REPAIR, TURBOFAN ENGINES , DIFFUSION BONDING, COST EFFECTIVENESS Identifiers: (U) * Turbine vanes , TF-39 engines , Activated...REPAIR TECHNIQUES FOR TURBINE AIRFOILS J. A. WEIN W. R. YOUNG GENERAL ELECTRIC COMPANY AIRCRAFT ENGINE GROUP CINCINNATI, OHIO 45215 APRIL 1979...Author: GENERAL ELECTRIC CO CINCINNATI OH AIRCRAFT ENGINE BUSINESS GROUP Unclassified Title: (U) Cost Effective Repair Techniques for

  18. The Cost-Effectiveness of NBPTS Teacher Certification

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2010-01-01

    A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of…

  19. 10 CFR 436.13 - Presuming cost-effectiveness results.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Presuming cost-effectiveness results. 436.13 Section 436... Methodology and Procedures for Life Cycle Cost Analyses § 436.13 Presuming cost-effectiveness results. (a) If the investment and other costs for an energy or water conservation measure considered for retrofit to...

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

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2010-01-01

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

  1. The Sunk Cost Effect in Pigeons and Humans

    ERIC Educational Resources Information Center

    Navarro, Anton D.; Fantino, Edmund

    2005-01-01

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

  2. 23 CFR 635.205 - Finding of cost effectiveness.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.205 Finding of cost effectiveness. (a) It may be... highway construction project by force account when a situation exists in which the rights or... involved, it is cost effective to perform by force account the adjustment of railroad or utility...

  3. 23 CFR 635.205 - Finding of cost effectiveness.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.205 Finding of cost effectiveness. (a) It may be... highway construction project by force account when a situation exists in which the rights or... involved, it is cost effective to perform by force account the adjustment of railroad or utility...

  4. 23 CFR 635.205 - Finding of cost effectiveness.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.205 Finding of cost effectiveness. (a) It may be... highway construction project by force account when a situation exists in which the rights or... involved, it is cost effective to perform by force account the adjustment of railroad or utility...

  5. Cost-effectiveness of vaccination against herpes zoster.

    PubMed

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

    2014-01-01

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

  6. Costs and cost-effectiveness of periviable care.

    PubMed

    Caughey, Aaron B; Burchfield, David J

    2014-02-01

    With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Costs in Perspective: Understanding Cost-Effectiveness Analysis.

    PubMed

    Detsky

    1996-01-01

    This paper covers five questions: (1) What is cost-effectiveness analysis;quest; (2) How can cost-effectiveness analysis help policymakers allocate scarce resources;quest; (3) What are misconceptions about the cost effectiveness of health care interventions;quest; (4) What is an attractive cost-effectiveness ratio;quest; (5) What is the relevance of cost effectiveness to clinicians? The cost side of the equation includes more than simply the cost of the intervention, but rather the cost of all of the downstream clinical events that occur with either therapeutic alternative. Cost-effectiveness analyses are used to help decisionmakers rank programs competing for scarce resources in order to achieve the following objective: to maximize the net health benefits derived from a fixed budget for a target population. A simple example is shown. Measured cost-effectiveness ratios for selected cardiovascular interventions are displayed. The systematic use of information on effectiveness and cost effectiveness should help those involved in setting policies to have a more rational basis for funding of new programs and discontinuation of funding for old programs. In Canadian health care it is important that we use this information to make room for innovations that are effective and efficient, and to remove funding from programs that are either known to be ineffective and costly or inefficient use of resources. More energy should be put toward generating the information necessary to make these kinds of decisions.

  8. The Cost-Effectiveness of NBPTS Teacher Certification

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2010-01-01

    A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of…

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

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2010-01-01

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

  10. A cost/effective screening method for assessing the toxicity of nutrient rich effluents to algae.

    PubMed

    Carbonell, G; Fernández, C; Tarazona, J V

    2010-07-01

    Screening whole effluent toxicity tests are cost/effective methods for detecting the presence of toxic concentrations of unknown pollutants, but the application must solve the problem associated with the effect of high and variable concentrations of nutrients in the effluent on the results of algal toxicity tests. This work proposes a cost/effective test, based on three dilution levels measured at a single point time and a discriminant model for establishing if this kind of complex samples, with difficult interpretation of dilution-response curves, should be considered toxic to algae. This procedure identified properly around 85% of the samples considered toxic by expert judgement.

  11. 17 CFR 240.15Ba2-2 - Application for registration of non-bank municipal securities dealers whose business is...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of non-bank municipal securities dealers whose business is exclusively intrastate. 240.15Ba2-2... registration of non-bank municipal securities dealers whose business is exclusively intrastate. (a) An... filed with the Central Registration Depository (operated by the Financial Industry Regulatory Authority...

  12. [Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy].

    PubMed

    Machado, Flávia Mori Sarti; Simões, Arlete Naresse

    2008-02-01

    To test the use of cost-effectiveness analysis as a decision making tool in the production of meals for the inclusion of the recommendations published in the World Health Organization's Global Strategy. Five alternative options for breakfast menu were assessed previously to their adoption in a food service at a university in the state of Sao Paulo, Southeastern Brazil, in 2006. Costs of the different options were based on market prices of food items (direct cost). Health benefits were estimated based on adaptation of the Diet Quality Index (DQI). Cost-effectiveness ratios were estimated by dividing benefits by costs and incremental cost-effectiveness ratios were estimated as cost differential per unit of additional benefit. The meal choice was based on health benefit units associated to direct production cost as well as incremental effectiveness per unit of differential cost. The analysis showed the most simple option with the addition of a fruit (DQI = 64 / cost = R$ 1.58) as the best alternative. Higher effectiveness was seen in the options with a fruit portion (DQI1=64 / DQI3=58 / DQI5=72) compared to the others (DQI2=48 / DQI4=58). The estimate of cost-effectiveness ratio allowed to identifying the best breakfast option based on cost-effectiveness analysis and Diet Quality Index. These instruments allow easy application easiness and objective evaluation which are key to the process of inclusion of public or private institutions under the Global Strategy directives.

  13. Challenges from Variation across Regions in Cost Effectiveness Analysis in Multi-Regional Clinical Trials

    PubMed Central

    Chu, Yunbo; Dai, Luyan; Qi, Sheng; Smith, Matthew Lee; Huang, Hui; Li, Yang; Shen, Ye

    2016-01-01

    Economic evaluation in the form of cost-effectiveness analysis has become a popular means to inform decisions in healthcare. With multi-regional clinical trials in a global development program becoming a new venue for drug efficacy testing in recent decades, questions in methods for cost-effectiveness analysis in the multi-regional clinical trials setting also emerge. This paper addresses some challenges from variation across regions in cost effectiveness analysis in multi-regional clinical trials. Several discussion points are raised for further attention and a multi-regional clinical trial example is presented to illustrate the implications in industrial application. A general message is delivered to call for a depth discussion by all stakeholders to reach an agreement on a good practice in cost-effectiveness analysis in the multi-regional clinical trials. Meanwhile, we recommend an additional consideration of cost-effectiveness analysis results based on the clinical evidence from a certain homogeneous population as sensitivity or scenario analysis upon data availability. PMID:27840606

  14. Municipal waste processing apparatus

    DOEpatents

    Mayberry, J.L.

    1988-04-13

    This invention relates to apparatus for processing municipal waste, and more particularly to vibrating mesh screen conveyor systems for removing grit, glass, and other noncombustible materials from dry municipal waste. Municipal waste must be properly processed and disposed of so that it does not create health risks to the community. Generally, municipal waste, which may be collected in garbage trucks, dumpsters, or the like, is deposited in processing areas such as landfills. Land and environmental controls imposed on landfill operators by governmental bodies have increased in recent years, however, making landfill disposal of solid waste materials more expensive. 6 figs.

  15. Cost-effective surface modification for Galinstan® lyophobicity.

    PubMed

    Kadlaskar, Shantanu Shrikant; Yoo, Jun Hyeon; Abhijeet; Lee, Jeong Bong; Choi, Wonjae

    2017-04-15

    In this paper we investigate the feasibility of using a cost-effective fabrication method based on sandblasting, chemical etching and spray coating processes, to render common surfaces to be non-wettable by Galinstan®. Although Galinstan® is a non-toxic liquid metal alternative to mercury, the viscoelastic and extremely wetting characteristics of Galinstan® have been the major bottleneck limiting the wide applicability of the gallium-based liquid metal. This paper tries to accomplish non-wettability to Galinstan® by combining surface texture and chemistry with the unique property of Galinstan®, that is, its high surface tension and yield strength that prevent the penetration of the liquid metal into surface asperities. Fabricated surfaces resemble traditional superhydrophobic (water-repellent) surfaces, and exhibit a superior non-wettability to Galinstan® as quantified by high static and dynamic contact angles, small hysteresis, as well as impact resistance. Reported fabrication method based on sandblasting, etching and spray coating is easily applicable to various surfaces ranging from metals, ceramics, to plastics and is scalable to large surfaces. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Monitoring Bacteroides spp. markers, nutrients, metals and Escherichia coli in soil and leachate after land application of three types of municipal biosolids.

    PubMed

    McCall, Crystal A; Jordan, Katerina S; Habash, Marc B; Dunfield, Kari E

    2015-03-01

    A lysimeter-based field study was done to monitor the transfer of culturable Escherichia coli, general (ALLBAC), human (Hf183) and swine (PIG-BAC-1) specific 16S rRNA Bacteroides spp. markers, nutrients and metals through soils and leachate over time following land application of a CP1/Class A as well as two CP2/Class B municipal biosolids (MBs). Hf183 markers were detected up to six days following application in soils receiving dewatered and liquid MBs, but not in leachate, suggesting their use in source tracking is better suited for recent pollution events. The CP2/Class B biosolids and swine manure contributed the highest microbial load with E. coli loads (between 2.5 and 3.7 log CFU (100 mL)(-1)) being greater than North American concentration recommendations for safe recreational water. ALLBAC persisted in soils and leachate receiving all treatments and was detected prior to amendment application demonstrating its unsuitability for identifying the presence of fecal pollution. A significant increase in NO₃-N (for Lystek and dewatered MBs) and total-P (for dewatered and liquid MBs) in leachate was observed in plots receiving the CP1/Class A and CP2/Class B type MBs which exceeded North American guidelines, suggesting impact to surface water. Metal (As, Cd, Cr, Co, Cu, Pb, Mo, Ni, Se, Zn and Hg) transfer was negligible in soil and leachate samples receiving all treatments. This study is one of the first to examine the fate of E. coli and Bacteroides spp. markers in situ following the land application of MBs where surface runoff does not apply.

  17. Cost-effectiveness analysis of prostaglandin E2 gel for the induction of labour at term.

    PubMed

    Petrou, S; Taher, Se; Abangma, G; Eddama, O; Bennett, P

    2011-05-01

    To estimate the cost-effectiveness of prostaglandin E2 (dinoprostone) vaginal gel for the induction of labour at term from the perspective of the UK's National Health Service. Economic evaluation conducted as part of a randomised controlled trial. Maternity department at a major teaching hospital in London, UK. A cohort of 165 pregnant women presenting as cephalic between 36(+⁶) and 41(+⁶) weeks of gestation, for whom induction of labour was deemed necessary. Either 3-mg Prostin E2 vaginal tablets or 1- or 2-mg Prostin E2 vaginal gel were administered at 6-hourly intervals. Incremental cost per hour prevented between induction and delivery. The nonparametric bootstrap method was used to construct cost-effectiveness acceptability curves and estimate net benefits at alternative cost-effectiveness thresholds. Women receiving the gel accrued nonsignificantly higher costs (incremental cost £630; bootstrap 95% CI -£353, £2320; P = 0.43), and experienced a significantly reduced interval between induction and delivery (median of 1400 versus 1780 minutes; mean of 1711 versus 2765 minutes; P = 0.03). The incremental cost per hour prevented from induction of labour to delivery was estimated at £36. At a cost-effectiveness threshold of £100 per hour of care prevented, the probability that the gel is cost-effective was estimated at 0.83, and the mean net benefit to the health services was estimated at £1121 (bootstrap 95% CI -£1133, £3379). The results were sensitive to the inclusion of neonatal costs in the analysis and the value of the cost-effectiveness threshold. Notably, excluding neonatal costs increased the probability that the gel is cost-effective at a cost-effectiveness threshold of £100 per hour of care prevented to 0.99. This study suggests that prostaglandin E2 gel is probably more cost-effective than prostaglandin E2 tablets for the induction of labour at term. Given that the results are applicable to the general obstetric population requiring

  18. Is antibiotic prophylaxis for bacterial endocarditis cost-effective?

    PubMed

    Agha, Zia; Lofgren, Richard P; VanRuiswyk, Jerome V

    2005-01-01

    Antibiotic prophylaxis for bacterial endocarditis is recommended by the American Heart Association (AHA) before undergoing certain dental procedures. Whether such antibiotic prophylaxis is cost-effective is not clear. The authors' objective is to estimate the cost-effectiveness of predental antibiotic prophylaxis in patients with underlying heart disease. The authors conducted a cost-effectiveness analysis using a Markov model to compare cost-effectiveness of 7 antibiotic regimens per AHA guidelines and a no prophylaxis strategy. The study population consisted of a hypothetical cohort of 10 million patients with either a high or moderate risk for developing endocarditis. Prophylaxis for patients with moderate or high risk for endocarditis cost $88,007/quality-adjusted life years saved if clarithromycin was used. Prophylaxis with amoxicillin and ampicillin resulted in a net loss of lives. All other regimens were less cost-effective than clarithromycin. For 10 million persons, clarithromycin prophylaxis prevented 119 endocarditis cases and saved 19 lives. Predental antibiotic prophylaxis is cost-effective only for persons with moderate or high risk of developing endocarditis. Contrary to current recommendations, our data demonstrate that amoxicillin and ampicillin are not cost-effective and should not be considered the agents of choice. Clarithromycin should be considered the drug of choice and cephalexin as an alternative drug of choice. The current published guidelines and recommendations should be revised.

  19. 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

  20. Cost-effectiveness and the socialization of health care.

    PubMed

    Musgrove, P

    1995-01-01

    The more health care is socialized, the more cost-effectiveness is an appropriate criterion for expenditure. Utility-maximizing individuals, facing divisibility of health care purchases and declining marginal health gains, and complete information about probable health improvements, should buy health care according to its cost-effectiveness. Absent these features, individual health spending will not be cost-effective; and in any case, differences in personal utilities and risk aversion will not lead to the same ranking of health care interventions for everyone. Private insurance frees consumers from concern for cost, which undermines cost-effectiveness, but lets them emphasize effectiveness, which favors value for money. This is most important for costly and cost-effective interventions, especially for poor people. Cost-effectiveness is more appropriate and easier to achieve under second-party insurance. More complete socialization of health care, via public finance, can yield greater efficiency by making insurance compulsory. Cost-effectiveness is also more attractive when taxpayers subsidize others' care: needs (effectiveness) take precedence over wants (utility). The gain in effectiveness may be greater, and the welfare loss from Pareto non-optimality smaller, in poor countries than in rich ones.

  1. Cost-effectiveness of a Primary Care Depression Intervention

    PubMed Central

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

    2003-01-01

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

  2. Identification of cost effective energy conservation measures

    NASA Technical Reports Server (NTRS)

    Bierenbaum, H. S.; Boggs, W. H.

    1978-01-01

    In addition to a successful program of readily implemented conservation actions for reducing building energy consumption at Kennedy Space Center, recent detailed analyses have identified further substantial savings for buildings representative of technical facilities designed when energy costs were low. The techniques employed for determination of these energy savings consisted of facility configuration analysis, power and lighting measurements, detailed computer simulations and simulation verifications. Use of these methods resulted in identification of projected energy savings as large as $330,000 a year (approximately two year break-even period) in a single building. Application of these techniques to other commercial buildings is discussed

  3. Identification of cost effective energy conservation measures

    NASA Technical Reports Server (NTRS)

    Bierenbaum, H. S.; Boggs, W. H.

    1978-01-01

    In addition to a successful program of readily implemented conservation actions for reducing building energy consumption at Kennedy Space Center, recent detailed analyses have identified further substantial savings for buildings representative of technical facilities designed when energy costs were low. The techniques employed for determination of these energy savings consisted of facility configuration analysis, power and lighting measurements, detailed computer simulations and simulation verifications. Use of these methods resulted in identification of projected energy savings as large as $330,000 a year (approximately two year break-even period) in a single building. Application of these techniques to other commercial buildings is discussed

  4. Alum application to improve water quality in a municipal wastewater treatment wetland: effects on macrophyte growth and nutrient uptake.

    PubMed

    Malecki-Brown, Lynette M; White, John R; Brix, Hans

    2010-03-01

    Application of low doses of alum to treatment wetlands to reduce elevated outflow winter phosphorus concentrations were tested in mesocosms vegetated with either Typhadomingensis, Schoenoplectus californicus, or submerged aquatic vegetation (SAV) (Najas guadalupensis-dominated). Alum was pumped to experimental units at a rate of 0.91 g Al m(-2) d(-1) and water quality monitored for 3 months. The alum application significantly improved the outflow water quality and overall the growth of the plants was unaffected by the alum application. Biomass and growth varied between species and through time, but no significant effects of alum application were detected. The concentrations of nutrients and mineral elements in the aboveground tissues differed between species and over time, but only the concentration of Al in plant tissue was increased by alum additions. The concentration of Al was 50-fold higher in alum-treated SAV as compared to the control, and in Typha and Schoenoplectus the concentrations were 4- and 2-fold, higher, respectively. The N/P ratios in the plant tissues were low (<10) suggesting that their growth and biomass was limited by nitrogen. The research suggests that a continuous or seasonal low-dosage alum application to treatment wetlands provides an effective tool to maintain discharge concentrations within permitted values during the inefficient winter treatment times. We suggest that the use of alum should be restricted to treatment wetland areas dominated by emergent vegetation as the effects of the elevated Al concentrations in SAV needs further study. 2010 Elsevier Ltd. All rights reserved.

  5. Cost-effective forensic image enhancement

    NASA Astrophysics Data System (ADS)

    Dalrymple, Brian E.

    1998-12-01

    In 1977, a paper was presented at the SPIE conference in Reston, Virginia, detailing the computer enhancement of the Zapruder film. The forensic value of this examination in a major homicide investigation was apparent to the viewer. Equally clear was the potential for extracting evidence which is beyond the reach of conventional detection techniques. The cost of this technology in 1976, however, was prohibitive, and well beyond the means of most police agencies. Twenty-two years later, a highly efficient means of image enhancement is easily within the grasp of most police agencies, not only for homicides but for any case application. A PC workstation combined with an enhancement software package allows a forensic investigator to fully exploit digital technology. The goal of this approach is the optimization of the signal to noise ratio in images. Obstructive backgrounds may be diminished or eliminated while weak signals are optimized by the use of algorithms including Fast Fourier Transform, Histogram Equalization and Image Subtraction. An added benefit is the speed with which these processes are completed and the results known. The efficacy of forensic image enhancement is illustrated through case applications.

  6. Impact of pre-application treatment on municipal sludge composition, soil dynamics of antibiotic resistance genes, and abundance of antibiotic-resistance genes on vegetables at harvest.

    PubMed

    Lau, Calvin Ho-Fung; Li, Bing; Zhang, Tong; Tien, Yuan-Ching; Scott, Andrew; Murray, Roger; Sabourin, Lyne; Lapen, David R; Duenk, Peter; Topp, Edward

    2017-06-01

    In many jurisdictions sludge recovered from the sewage treatment process is a valued fertilizer for crop production. Pre-treatment of sewage sludge prior to land application offers the potential to abate enteric microorganisms that carry genes conferring resistance to antibiotics. Pre-treatment practices that accomplish this should have the desirable effect of reducing the risk of contamination of crops or adjacent water with antibiotic resistance genes carried in these materials. In the present study, we obtained municipal sludge that had been subjected to one of five treatments. There were, anaerobic-digestion or aerobic-digestion, in both instances with and without dewatering; and heat-treatment and pelletization. Each of the five types of biosolids was applied to an agricultural field at commercial rates, following which lettuce, carrots and radishes were planted. Based on qPCR, the estimated antibiotic gene loading rates were comparable with each of the five biosolids. However, the gene abundance in soil following application of the pelletized biosolids was anomalously lower than expected. Following application, the abundance of antibiotic resistance genes decreased in a generally coherent fashion, except sul1 which increased in abundance during the growing season in the soil fertilized with pelletized biosolids. Based on qPCR and high throughput sequencing evidence for transfer of antibiotic resistance genes from the biosolids to the vegetables at harvest was weak. Clostridia were more abundant in soils receiving any of the biosolids except the pelletized. Overall, the behavior of antibiotic resistance genes in soils receiving aerobically or anaerobically-digested biosolids was consistent and coherent with previous studies. However, dynamics of antibiotic resistance genes in soils receiving the heat treated pelletized biosolids were very different, and the underlying mechanisms merit investigation.

  7. Implant marketing: cost effective implant dentistry.

    PubMed

    Wohrle, P S; Levin, R P

    1996-01-01

    The application of the KAL-Technique to the field of implant dentistry allows both patients and dental practices to benefit. It is an exciting advance that decreases frustration and stress in providing implant procedures and lowers overall costs. Professionals using the KAL-Technique report significant predictability in achieving passive framework fit. They are also lowering overall cost of implant cases, which increases the number of patients who can accept implant treatment. It has been well established that the more individuals in a practice that receive implants, the more referrals a practice will gain. This is because implant patients find tremendous advances in the quality of life, and do not hesitate to tell others who can take advantage of this opportunity. Implant dentistry is one of the fastest growing fields in dentistry today. While some other areas of dentistry begin to decline in volume and need, implant dentistry provides the opportunity to keep practices strong and to insure long-term success.

  8. Application of multilocus sequence analysis (MLSA) for accurate identification of Legionella spp. Isolated from municipal fountains in Chengdu, China, based on 16S rRNA, mip, and rpoB genes.

    PubMed

    Guan, Wang; Xu, Ying; Chen, Da-Li; Xu, Jia-Nan; Tian, Yu; Chen, Jian-Ping

    2012-02-01

    Legionellosis (Legionnaires' disease; LD) is a form of severe pneumonia caused by species of Legionella bacteria. Because inhalation of Legionella-contaminated aerosol is considered the major infection route, routine assessments of potential infection sources such as hot water systems, air-conditioner cooling water, and municipal fountains are of great importance. In this study, we utilized in vitro culture and multilocus sequence analysis (MLSA) targeting 16S rRNA, mip, rpoB, and mip-rpoB concatenation to isolate and identify Legionella spp. from 5 municipal fountains in Chengdu City, Sichuan Province, China. Our results demonstrated that 16S rRNA was useful for initial identification, as it could recognize isolates robustly at the genus level, while the genes mip, rpoB, and mip-rpoB concatenation could confidently discriminate Legionella species. Notably, the three subspecies of L. pneumophila could be distinguished by the analysis based on rpoB. The serotyping result of strain CD-1 was consistent with genetic analysis based on the concatenation of mip and rpoB. Despite regular maintenance and sanitizing methods, 4 of the 5 municipal fountains investigated in this study were positive for Legionella contamination. Thus, regularly scheduled monitoring of municipal fountains is urgently needed as well as vigilant disinfection. Although the application of MLSA for inspection of potential sites of infection in public areas is not standard procedure, further investigations may prove its usefulness.

  9. Cost-effectiveness analysis of clinical smoking cessation interventions in Thailand.

    PubMed

    Tosanguan, Jiraboon; Chaiyakunapruk, Nathorn

    2016-02-01

    Clinical smoking cessation interventions have been found typically to be highly cost-effective in many high-income countries. There is a need to extend this to low- and middle-income countries and undertake comparative analyses. This study aimed to estimate the incremental cost-effectiveness ratio of a range of clinical smoking cessation interventions available in Thailand. Using a Markov model, cost-effectiveness, in terms of cost per quality-adjusted life years (QALY) gained, from a range of interventions was estimated from a societal perspective for males and females aged 40 years who smoke at least 10 cigarettes per day. Interventions considered were: counselling in hospital, phone counselling (Quitline) and counselling plus nicotine gum, nicotine patch, bupropion, nortriptyline or varenicline. An annual discounting rate of 3% was used. Probabilistic sensitivity analyses were conducted and a cost-effectiveness acceptability curve (CEAC) plotted. Comparisons between interventions were conducted involving application of a 'decision rule' process. Counselling with varenicline and counselling with nortriptyline were found to be cost-effective. Hospital counselling only, nicotine patch and bupropion were dominated by Quitline, nortriptyline and varenicline, respectively, according to the decision rule. When compared with unassisted cessation, probabilistic sensitivity analysis revealed that all interventions have very high probabilities (95%) of being cost-saving except for nicotine replacement therapy (NRT) patch (74%). In middle-income countries such as Thailand, nortriptyline and varenicline appear to provide cost-effective clinical options for supporting smokers to quit. © 2015 Society for the Study of Addiction.

  10. Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies.

    PubMed

    Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H

    2013-01-01

    Behavioural interventions have been widely integrated in HIV/AIDS social marketing prevention strategies and are considered valuable in settings with high levels of risk behaviours and low levels of HIV/AIDS awareness. Despite their widespread application, there is a lack of economic evaluations comparing different behaviour change communication methods. This paper analyses the costs to increase awareness and the cost-effectiveness to influence behaviour change for five interventions in Benin. Cost and cost-effectiveness analyses used economic costs and primary effectiveness data drawn from surveys. Costs were collected for provider inputs required to implement the interventions in 2009 and analysed by 'person reached'. Cost-effectiveness was analysed by 'person reporting systematic condom use'. Sensitivity analyses were performed on all uncertain variables and major assumptions. Cost-per-person reached varies by method, with public outreach events the least costly (US$2.29) and billboards the most costly (US$25.07). Influence on reported behaviour was limited: only three of the five interventions were found to have a significant statistical correlation with reported condom use (i.e. magazines, radio broadcasts, public outreach events). Cost-effectiveness ratios per person reporting systematic condom use resulted in the following ranking: magazines, radio and public outreach events. Sensitivity analyses indicate rankings are insensitive to variation of key parameters although ratios must be interpreted with caution. This analysis suggests that while individual interventions are an attractive use of resources to raise awareness, this may not translate into a cost-effective impact on behaviour change. The study found that the extensive reach of public outreach events did not seem to influence behaviour change as cost-effectively when compared with magazines or radio broadcasts. Behavioural interventions are context-specific and their effectiveness influenced by a

  11. 18 CFR 131.70 - Form 12 of application by State and municipal licensees for exemption from payment of annual...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... form may be obtained upon request from the Federal Energy Regulatory Commission. (See § 11.6 of this... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Form 12 of application... Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY...

  12. 18 CFR 131.70 - Form 12 of application by State and municipal licensees for exemption from payment of annual...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... form may be obtained upon request from the Federal Energy Regulatory Commission. (See § 11.24 of this... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Form 12 of application... Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY...

  13. 18 CFR 131.70 - Form 12 of application by State and municipal licensees for exemption from payment of annual...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... form may be obtained upon request from the Federal Energy Regulatory Commission. (See § 11.6 of this... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Form 12 of application... Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY...

  14. 18 CFR 131.70 - Form 12 of application by State and municipal licensees for exemption from payment of annual...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... form may be obtained upon request from the Federal Energy Regulatory Commission. (See § 11.6 of this... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Form 12 of application... Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY...

  15. Reliable and cost-effective serodiagnosis of rheumatoid arthritis.

    PubMed

    Meyer, Pieter W A; Ally, Mahmood M T M; Anderson, Ronald

    2016-06-01

    Early diagnosis of patients with rheumatoid arthritis (RA) optimises therapeutic benefit and the probability of achieving disease remission. Notwithstanding clinical acumen, early diagnosis is dependent on access to reliable serodiagnostic procedures, as well as on the discerning application and interpretation of these. In the case of RA, however, no disease-specific serodiagnostic procedure is available due to the multi-factorial and polygenic nature of this autoimmune disorder. This has resulted in the development of an array of serodiagnostic procedures based on the detection of autoantibodies reactive with various putative autoantigens. Other procedures based on measurement of elevations in the concentrations of systemic biomarkers of inflammation, most commonly acute phase reactants and cytokines/chemokines, are used as objective indices of disease activity. Following a brief overview of RA research in African populations, the current review is focused on those autoantibodies/biomarkers, specifically rheumatoid factor, anti-citrullinated peptide antibodies and C-reactive protein, which are currently recognised as being the most reliable and cost-effective with respect to disease prediction and diagnosis, as well as in monitoring activity and outcome.

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

    SciTech Connect

    Skinner, Kenneth M.; Salpas, Peter A.

    2007-07-01

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

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

    PubMed Central

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

    2010-01-01

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

  18. Development and Manufacture of Cost Effective Composite Drill Pipe

    SciTech Connect

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

    2002-09-29

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

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

    NASA Astrophysics Data System (ADS)

    Mosenkis, Regina

    1996-01-01

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

  20. Costs and Cost-Effectiveness of Plasmodium vivax Control

    PubMed Central

    White, Michael T.; Yeung, Shunmay; Patouillard, Edith; Cibulskis, Richard

    2016-01-01

    The continued success of efforts to reduce the global malaria burden will require sustained funding for interventions specifically targeting Plasmodium vivax. The optimal use of limited financial resources necessitates cost and cost-effectiveness analyses of strategies for diagnosing and treating P. vivax and vector control tools. Herein, we review the existing published evidence on the costs and cost-effectiveness of interventions for controlling P. vivax, identifying nine studies focused on diagnosis and treatment and seven studies focused on vector control. Although many of the results from the much more extensive P. falciparum literature can be applied to P. vivax, it is not always possible to extrapolate results from P. falciparum–specific cost-effectiveness analyses. Notably, there is a need for additional studies to evaluate the potential cost-effectiveness of radical cure with primaquine for the prevention of P. vivax relapses with glucose-6-phosphate dehydrogenase testing. PMID:28025283

  1. Pulsed excimer laser processing for cost-effective solar cells

    NASA Technical Reports Server (NTRS)

    Wong, D.

    1984-01-01

    The goal was to demonstrate the cost effectiveness feasibility of fabricating 16% efficient solar cells on 125 mm diameter Cz wafers using pulsed excimer laser for junction formation, surface passivation, and front metallization.

  2. Guidelines for Cost-Effective Training Product Development.

    ERIC Educational Resources Information Center

    Awotua-Efebo, Ebi Bio

    1984-01-01

    Presents guidelines for cost effective product development for training managers charged with quality control of products and training specialists who design materials. Discusses phases of educational product development--diagnosis, design, development, and evaluation. (MBR)

  3. Guidelines for Cost-Effective Training Product Development.

    ERIC Educational Resources Information Center

    Awotua-Efebo, Ebi Bio

    1984-01-01

    Presents guidelines for cost effective product development for training managers charged with quality control of products and training specialists who design materials. Discusses phases of educational product development--diagnosis, design, development, and evaluation. (MBR)

  4. Cost-effectiveness of viral hepatitis B & C treatment.

    PubMed

    Toy, Mehlika

    2013-12-01

    With the availability of effective antiviral therapies for chronic viral hepatitis B and C, cost-effectiveness studies have been performed to assess the outcomes and costs of these therapies to support health policy. It is now accepted that treatment of active CHB is cost-effective versus no treatment, although there are a variety of options. And with the new developments around CHC treatment and diagnostic tools it is of interest to both the clinician and policy makers to know both the costs and effects of these choices. The purpose of this article is to provide the reader with an insight into the recent treatment developments and cost-effectiveness issues related to chronic hepatitis B and C treatment, and an overview of recent cost-effectiveness studies evolving around HBV and HCV therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Cost-effectiveness analysis of different dipeptidyl-peptidase 4 inhibitor drugs for treatment of type 2 diabetes mellitus.

    PubMed

    Cazarim, Maurílio de Souza; da Cruz-Cazarim, Estael Luzia Coelho; Baldoni, André de Oliveira; Dos Santos, Thais Bueno Enes; de Souza, Paula Gonçalves; Silva, Ingrid de Almeida; Rodrigues, Roberta Niriam Reis; Maia, Alda Cristina Franco Correa; Pereira, Leonardo Régis Leira; Sanches, Cristina

    2017-07-03

    Type 2 diabetes mellitus (T2DM) has burdened health systems in the world to the value of 500 billion dollars/year. Dipeptidyl peptidase 4 inhibitors (DPP-4 Inhibitors) have been strongly associated with spending on the treatment of T2DM by the courts in Brazil. The aim of this study was to estimate the most cost-effective DPP-4 Inhibitor for T2DM treatment. A pharmacoeconomic study of cost-effectiveness was performed in a medium-sized municipality in Minas Gerais state, Brazil. The data are from legalization in municipal health in 2013. The effectiveness of DPP-4 Inhibitors was measured by the reduction in glycated hemoglobin (A1c). The direct medical costs of drug and adverse drug reactions were identified. With these data, a cost-effectiveness ratio (CER) and construction of the decision tree for sensitivity analysis were performed. The representative of the most effective in reducing A1c gliptins was sitagliptin in combination with metformin, it was able to reduce A1c by 1.16% (1.09 to 1.22, CI 95%). The drug with the lowest cost was linagliptin, with a cost per patient/year of US$ 481.42. Sensitivity analysis performed by the decision tree shows that sitagliptin in association with metformin had the CER of US$ 1,506.75 per patient/year, to reduce A1c by 1%. The most cost-effective DPP-4 Inhibitor was sitagliptin with metformin. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  6. [Cost-effectiveness of public health practices: a literature review of public health interventions from the Mesoamerican Health Initiative].

    PubMed

    Valencia-Mendoza, Atanacio; Danese-dlSantos, Laura G; Sosa-Rubí, Sandra G; Aracena-Genao, Belkis

    2011-01-01

    Present and analyze cost-effectiveness information of public health interventions proposed by the Mesoamerican Health Initiative in child nutrition, vaccination, malaria, dengue, and maternal, neonatal, and reproductive health. A systematic literature review was conducted on cost-effectiveness studies published between January 2000 and August 2009 on interventions related to the health areas previously mentioned. Studies were included if they measured effectiveness in terms of Disability-Adjusted Life Year (DALY) or death averted. Child nutrition and maternal and neonatal health interventions were found to be highly cost-effective (most of them below US$200 per DALY averted for nutritional interventions and US$100 for maternal and neonatal health). For dengue, information on cost-effectiveness was found just for application of larvicides, which resulted in a cost per DALY averted ranking from US$40.79 to US$345.06. Malarial interventions were found to be cost-effective (below US$150 per DALY averted or US$4,000 per death averted within Africa). In the case of pneumococcus and rotavirus vaccination, cost-effectiveness estimates were always above one GDP per capita per DALY averted. In Mesoamerica there are still important challenges in child nutrition, vaccination, malaria, dengue and maternal, neonatal, and reproductive health, challenges that could be addressed by scaling-up technically feasible and cost-effective interventions.

  7. Cost-effectiveness of vaccination against herpes zoster

    PubMed Central

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

    2014-01-01

    Herpes zoster (HZ) is a common disease among elderly, which may develop into a severe pain syndrome labeled postherpetic neuralgia (PHN). A live-attenuated varicella zoster virus vaccine has been shown to be effective in reducing the incidence and burden of illness of HZ and PHN, providing the opportunity to prevent significant health-related and financial consequences of HZ. In this review, we summarize the available literature on cost-effectiveness of HZ vaccination and discuss critical parameters for cost-effectiveness results. A search in PubMed and EMBASE was performed to identify full cost-effectiveness studies published before April 2013. Fourteen cost-effectiveness studies were included, all performed in western countries. All studies evaluated cost-effectiveness among elderly above 50 years and used costs per quality-adjusted life year (QALY) gained as primary outcome. The vast majority of studies showed vaccination of 60- to 75-year-old individuals to be cost-effective, when duration of vaccine efficacy was longer than 10 years. Duration of vaccine efficacy, vaccine price, HZ incidence, HZ incidence and discount rates were influential to the incremental cost-effectiveness ratio (ICER). HZ vaccination may be a worthwhile intervention from a cost-effectiveness point of view. More extensive reporting on methodology and more detailed results of sensitivity analyses would be desirable to address uncertainty and to guarantee optimal comparability between studies, for example regarding model structure, discounting, vaccine characteristics and loss of quality of life due to HZ and PHN. PMID:25424815

  8. Cost-effectiveness of opportunistic salpingectomy for ovarian cancer prevention.

    PubMed

    Dilley, Sarah E; Havrilesky, Laura J; Bakkum-Gamez, Jamie; Cohn, David E; Michael Straughn, J; Caughey, Aaron B; Rodriguez, Maria I

    2017-08-01

    Data suggesting a link between the fallopian tube and ovarian cancer have led to an increase in rates of salpingectomy at the time of pelvic surgery, a practice known as opportunistic salpingectomy (OS). However, the potential benefits, risks and costs for this new practice are not well established. Our objective was to assess the cost-effectiveness of opportunistic salpingectomy at the time of laparoscopic permanent contraception or hysterectomy for benign indications. We created two models to compare the cost-effectiveness of salpingectomy versus usual care. The hypothetical study population is 50,000 women aged 45 undergoing laparoscopic hysterectomy with ovarian preservation for benign indications, and 300,000 women aged 35 undergoing laparoscopic permanent contraception. SEER data were used for probabilities of ovarian cancer cases and deaths. The ovarian cancer risk reduction, complication rates, utilities and associated costs were obtained from published literature. Sensitivity analyses and Monte Carlo simulation were performed, and incremental cost-effectiveness ratios (ICERs) were calculated to determine the cost per quality adjusted life year (QALY) gained. In the laparoscopic hysterectomy cohort, OS is cost saving and would yield $23.9 million in health care dollars saved. In the laparoscopic permanent contraception cohort, OS is cost-effective with an ICER of $31,432/QALY compared to tubal ligation, and remains cost-effective as long as it reduces ovarian cancer risk by 54%. Monte Carlo simulation demonstrated cost-effectiveness with hysterectomy and permanent contraception in 62.3% and 55% of trials, respectively. Opportunistic salpingectomy for low-risk women undergoing pelvic surgery may be a cost-effective strategy for decreasing ovarian cancer risk at time of hysterectomy or permanent contraception. In our model, salpingectomy was cost-effective with both procedures, but the advantage greater at time of hysterectomy. Copyright © 2017. Published by

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

    PubMed

    You, Joyce

    2015-02-01

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

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

    PubMed

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

    2016-04-01

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

  11. Cost Effective Applications of High Integrity Software Processes

    DTIC Science & Technology

    2011-05-18

    Inspections/ peer reviews • Checklists • Programming Languages and Coding Standards • Static Code Analysis C d l it• o e comp ex y • Unit Testing...rom their own perspective © 2011 Lockheed Martin Corporation AER201103026 Inspection/ Peer Reviews • Reduce costly rework − Focus on defect removal... peer reviews ) to remove up to 80 percent of their defects • It doesn’t have to be hard − Reviews can be of many different types (very formal

  12. Cost effective aluminum beryllium mirrors for critical optics applications

    NASA Astrophysics Data System (ADS)

    Say, Carissa; Duich, Jack; Huskamp, Chris; White, Ray

    2013-09-01

    The unique performance of aluminum-beryllium frequently makes it an ideal material for manufacturing precision optical-grade metal mirrors. Traditional methods of manufacture utilize hot-pressed powder block in billet form which is subsequently machined to final dimensions. Complex component geometries such as lightweighted, non-plano mirrors require extensive tool path programming, fixturing, and CNC machining time and result in a high buy-to-fly ratio (the ratio of the mass of raw material purchased to the mass of the finished part). This increases the cost of the mirror structure as a significant percentage of the procurement cost is consumed in the form of machining, tooling, and scrap material that do not add value to the final part. Inrad Optics, Inc. and IBC Advanced Alloys Corp. undertook a joint study to evaluate the suitability of investment-cast Beralcast® 191 and 363 aluminum-beryllium as a precision mirror substrate material. Net shape investment castings of the desired geometry minimizes machining to just cleanup stock, thereby reducing the recurring procurement cost while still maintaining performance. The thermal stability of two mirrors, (one each of Beralcast® 191 and Beralcast® 363), was characterized from -40°F to +150°F. A representative pocketed mirror was developed, including the creation of a relevant geometry and production of a cast component to validate the approach. Information from the demonstration unit was used as a basis for a comparative cost study of the representative mirror produced in Beralcast® and one machined from a billet of AlBeMet® 162 (AlBeMet® is a registered trademark of Materion Corporation). The technical and financial results of these studies will be discussed in detail.

  13. Cost-effectiveness of periconceptional supplementation of folic acid.

    PubMed

    Postma, M J; Londeman, J; Veenstra, M; de Walle, H E K; de Jong-van den Berg, L T W

    2002-02-01

    Supplementation of folic acid prior to and in the beginning of pregnancy may prevent neural tube defects (NTDs) in newborns--such as spina bifida--and possibly other congenital malformations. To estimate cost effectiveness of periconceptional supplementation of folic acid using pharmaco-economic model calculation. Probabilities for NTDs, risk reductions through periconceptional supplementation of folic acid and lifetime costs of care for children with spina bifida were estimated using Dutch registrations and international literature. Cost effectiveness was expressed in net costs per discounted life-year gained. Cost effectiveness was calculated in the baseline and in sensitivity analysis. Estimated cost effectiveness of periconceptional supplementation of folic acid amounts to NLG 3900 ([symbol: see text] 1800) in the base case. In sensitivity analysis cost effectiveness mostly remains below NLG 10,000 ([symbol: see text] 4500). Periconceptional supplementation of folic acid shows a favorable cost effectiveness. From pharmaco-economic point of view this justifies further stimulation of folic-acid supplementation prior to pregnancy. This can be done through targeted education by health-care workers, such as pharmacists.

  14. Bayesian comparison of cost-effectiveness of different clinical approaches to diagnose coronary artery disease.

    PubMed

    Patterson, R E; Eng, C; Horowitz, S F; Gorlin, R; Goldstein, S R

    1984-08-01

    The objective of this study was to compare the cost-effectiveness of four clinical policies (policies I to IV) in the diagnosis of the presence or absence of coronary artery disease. A model based on Bayes' theorem and published clinical data was constructed to make these comparisons. Effectiveness was defined as either the number of patients with coronary disease diagnosed or as the number of quality-adjusted life years extended by therapy after the diagnosis of coronary disease. The following conclusions arise strictly from analysis of the model and may not necessarily be applicable to all situations. As prevalence of coronary disease in the population increased, it caused a linear increase in cost per patient tested, but a hyperbolic decrease in cost per effect, that is, increased cost-effectiveness. Thus, cost-effectiveness of all policies (I to IV) was poor in populations with a prevalence of disease below 10%, for example, asymptomatic people with no risk factors. Analysis of the model also indicates that at prevalences less than 80%, exercise thallium scintigraphy alone as a first test (policy II) is a more cost-effective initial test than is exercise electrocardiography alone as a first test (policy I) or exercise electrocardiography first combined with thallium imaging as a second test (policy IV). Exercise electrocardiography before thallium imaging (policy IV) is more cost-effective than exercise electrocardiography alone (policy I) at prevalences less than 80%. 4) Noninvasive exercise testing before angiography (policies I, II and IV) is more cost-effective than using coronary angiography as the first and only test (policy III) at prevalences less than 80%. 5) Above a threshold value of prevalence of 80% (for example patients with typical angina), proceeding to angiography as the first test (policy III) was more cost-effective than initial noninvasive exercise tests (policies I, II and IV). One advantage of this quantitative model is that it estimates a

  15. A criticism of applications with multi-criteria decision analysis that are used for the site selection for the disposal of municipal solid wastes

    SciTech Connect

    Kemal Korucu, M.; Erdagi, Bora

    2012-12-15

    Highlights: Black-Right-Pointing-Pointer The existing structure of the multi-criteria decision analysis for site selection is criticized. Black-Right-Pointing-Pointer Fundamental problematic points based on the critics are defined. Black-Right-Pointing-Pointer Some modifications are suggested in order to provide solutions to these problematical points. Black-Right-Pointing-Pointer A new structure for the decision making mechanism is proposed. Black-Right-Pointing-Pointer The feasibility of the new method is subjected to an evaluation process. - Abstract: The main aim of this study is to criticize the process of selecting the most appropriate site for the disposal of municipal solid wastes which is one of the problematic issues of waste management operations. These kinds of problems are pathological symptoms of existing problematical human-nature relationship which is related to the syndrome called ecological crisis. In this regard, solving the site selection problem, which is just a small part of a larger entity, for the good of ecological rationality and social justice is only possible by founding a new and extensive type of human-nature relationship. In this study, as a problematic point regarding the discussions on ecological problems, the existing structure of the applications using multi-criteria decision analysis in the process of site selection with three main criteria is criticized. Based on this critique, fundamental problematic points (to which applications are insufficient to find solutions) will be defined. Later, some modifications will be suggested in order to provide solutions to these problematical points. Finally, the criticism addressed to the structure of the method with three main criteria and the feasibility of the new method with four main criteria is subjected to an evaluation process. As a result, it is emphasized that the new structure with four main criteria may be effective in solution of the fundamental problematic points.

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

    PubMed Central

    Dobler, Claudia Caroline

    2016-01-01

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

  17. Dengue dynamics and vaccine cost-effectiveness in Brazil.

    PubMed

    Durham, David P; Ndeffo Mbah, Martial L; Medlock, Jan; Luz, Paula M; Meyers, Lauren A; Paltiel, A David; Galvani, Alison P

    2013-08-20

    Recent Phase 2b dengue vaccine trials have demonstrated the safety of the vaccine and estimated the vaccine efficacy with further trials underway. In anticipation of vaccine roll-out, cost-effectiveness analysis of potential vaccination policies that quantify the dynamics of disease transmission are fundamental to the optimal allocation of available doses. We developed a dengue transmission and vaccination model and calculated, for a range of vaccination costs and willingness-to-pay thresholds, the level of vaccination coverage necessary to sustain herd-immunity, the price at which vaccination is cost-effective and is cost-saving, and the sensitivity of our results to parameter uncertainty. We compared two vaccine efficacy scenarios, one a more optimistic scenario and another based on the recent lower-than-expected efficacy from the latest clinical trials. We found that herd-immunity may be achieved by vaccinating 82% (95% CI 58-100%) of the population at a vaccine efficacy of 70%. At this efficacy, vaccination may be cost-effective for vaccination costs up to US$ 534 (95% CI $369-1008) per vaccinated individual and cost-saving up to $204 (95% CI $39-678). At the latest clinical trial estimates of an average of 30% vaccine efficacy, vaccination may be cost-effective and cost-saving at costs of up to $237 (95% CI $159-512) and $93 (95% CI $15-368), respectively. Our model provides an assessment of the cost-effectiveness of dengue vaccination in Brazil and incorporates the effect of herd immunity into dengue vaccination cost-effectiveness. Our results demonstrate that at the relatively low vaccine efficacy from the recent Phase 2b dengue vaccine trials, age-targeted vaccination may still be cost-effective provided the total vaccination cost is sufficiently low.

  18. Cost-effectiveness of shared medical appointments for neuromuscular patients.

    PubMed

    Seesing, Femke M; Groenewoud, Hans J; Drost, Gea; van Engelen, Baziel G M; van der Wilt, Gert Jan

    2015-08-18

    To assess whether shared medical appointments (SMAs) for neuromuscular patients represent a way of using clinicians' time efficiently without compromising quality of care for patients. Patients with a chronic neuromuscular disease (NMD) (n = 272) were randomly allocated to either an SMA or a regular individual annual appointment and followed up for a period of 6 months. Data on resource utilization and quality of life (EQ-5D) were collected prospectively, using a health care perspective. Incremental costs and changes in quality-adjusted life-years (QALYs) were computed using a probabilistic decision model. Factors critical to the incremental cost-effectiveness of SMAs were explored in sensitivity analyses. No substantial differences between SMAs and individual visits in terms of costs per QALY were found (incremental cost-effectiveness ratio €-960.00; 95% confidence interval €-34,600.00, €+36,800.00). Sensitivity analyses showed that the cost-effectiveness ratio was particularly sensitive to SMA group size and proportion of patients seeing their treating neurologist. Cost-effectiveness of SMAs did not show a significant difference vs that of individual appointments based on data from our randomized controlled trial. On the other hand, we were able to show that a minimum of 6 patients per SMA and 75% of patients attending their treating neurologist are specific conditions under which SMAs qualify as a cost-effective alternative. This implies that SMAs may be a means to increase productivity of the physician without compromising quality of care. This study provides Class III evidence that SMAs are not significantly more cost-effective than individual appointments for patients with NMDs. The study lacks the precision to exclude important differences in cost-effectiveness between SMAs and individual appointments. © 2015 American Academy of Neurology.

  19. Cost effectiveness of ramipril treatment for cardiovascular risk reduction

    PubMed Central

    Malik, I; Bhatia, V; Kooner, J

    2001-01-01

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


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

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

    NASA Astrophysics Data System (ADS)

    Lam, Hwai-Tai Chen

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

  1. Cost-effectiveness analysis of sandhill crane habitat management

    USGS Publications Warehouse

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

    2013-01-01

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

  2. Understanding and improving the one and three times GDP per capita cost-effectiveness thresholds.

    PubMed

    Robinson, Lisa A; Hammitt, James K; Chang, Angela Y; Resch, Stephen

    2017-02-01

    Researchers and policymakers have long been interested in developing simple decision rules to aid in determining whether an intervention is, or is not, cost-effective. In global health, interventions that impose costs per disability-adjusted life year averted less than three and one times gross domestic product per capita are often considered cost-effective and very cost-effective, respectively. This article explores the conceptual foundation and derivation of these thresholds. Its goal is to promote understanding of how these thresholds were derived and their implications, as well as to suggest options for improvement. These thresholds are intended to reflect the monetary value of the benefits to affected individuals, based on their preferences for spending on health vs spending on other goods and services. However, the current values were not rigorously derived, which means that their application may lead to inappropriate conclusions regarding which interventions should be adopted as well as misallocation of resources across health and other investments. Improving the basis for these cost-effectiveness thresholds is of particular importance in low- and middle-income countries, given the limited resources available and the significant needs of their populations. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. The application of LiDAR to assessment of rooftop solar photovoltaic deployment potential in a municipal district unit.

    PubMed

    Nguyen, Ha T; Pearce, Joshua M; Harrap, Rob; Barber, Gerald

    2012-01-01

    A methodology is provided for the application of Light Detection and Ranging (LiDAR) to automated solar photovoltaic (PV) deployment analysis on the regional scale. Challenges in urban information extraction and management for solar PV deployment assessment are determined and quantitative solutions are offered. This paper provides the following contributions: (i) a methodology that is consistent with recommendations from existing literature advocating the integration of cross-disciplinary competences in remote sensing (RS), GIS, computer vision and urban environmental studies; (ii) a robust methodology that can work with low-resolution, incomprehensive data and reconstruct vegetation and building separately, but concurrently; (iii) recommendations for future generation of software. A case study is presented as an example of the methodology. Experience from the case study such as the trade-off between time consumption and data quality are discussed to highlight a need for connectivity between demographic information, electrical engineering schemes and GIS and a typical factor of solar useful roofs extracted per method. Finally, conclusions are developed to provide a final methodology to extract the most useful information from the lowest resolution and least comprehensive data to provide solar electric assessments over large areas, which can be adapted anywhere in the world.

  4. The Application of LiDAR to Assessment of Rooftop Solar Photovoltaic Deployment Potential in a Municipal District Unit

    PubMed Central

    Nguyen, Ha T.; Pearce, Joshua M.; Harrap, Rob; Barber, Gerald

    2012-01-01

    A methodology is provided for the application of Light Detection and Ranging (LiDAR) to automated solar photovoltaic (PV) deployment analysis on the regional scale. Challenges in urban information extraction and management for solar PV deployment assessment are determined and quantitative solutions are offered. This paper provides the following contributions: (i) a methodology that is consistent with recommendations from existing literature advocating the integration of cross-disciplinary competences in remote sensing (RS), GIS, computer vision and urban environmental studies; (ii) a robust methodology that can work with low-resolution, incomprehensive data and reconstruct vegetation and building separately, but concurrently; (iii) recommendations for future generation of software. A case study is presented as an example of the methodology. Experience from the case study such as the trade-off between time consumption and data quality are discussed to highlight a need for connectivity between demographic information, electrical engineering schemes and GIS and a typical factor of solar useful roofs extracted per method. Finally, conclusions are developed to provide a final methodology to extract the most useful information from the lowest resolution and least comprehensive data to provide solar electric assessments over large areas, which can be adapted anywhere in the world. PMID:22666044

  5. A model to predict the cost-effectiveness of disease management programs.

    PubMed

    Gandjour, Afschin

    2010-06-01

    High costs and deficits in the care of patients with chronic diseases have triggered numerous programs to improve the quality and efficiency of treatment of chronic diseases. Decision makers need to estimate the impact of a disease management program (DMP) on long-term costs and cost-effectiveness in order to decide which programs to introduce. This prediction, however, requires formalizing the relations between a variety of variables. The purpose of this paper is to formalize these relations and develop a model that enhances the quality of predictions of the costs and cost-effectiveness of a DMP. The model's cost function is able to portray a reduction both of treatment overuse and underuse by improving both physician and patient compliance. The model's applicability is demonstrated by a simulated DMP for patients with hypertension. The application example shows that implementation costs may have a larger financial impact than downstream costs.

  6. Cost-effectiveness league tables: think of the fans.

    PubMed

    Drummond, M; Mason, J; Torrance, G

    1995-03-01

    In a recent issue of Health Policy, Birch and Gafni argued against the use of cost-effectiveness league tables in health care decision making. They argued that league tables should be returned to where they are best used and understood--the sports pages. Recently the debate about the presentation and interpretation of cost-effectiveness data has been given an additional impetus in the UK through the publication, by the Department of Health, of the Register of Cost-Effectiveness Studies (RCES). During the production of the RCES, it became apparent that there were similarities between the decision makers' thirst for economic data and the sports fans' thirst for information about their team. In this paper we review the pros and cons of using published cost-effectiveness data in decision making, compared with the local team approach suggested by Birch and Gafni. We conclude that there are advantages from using published data, providing these are produced according to standardized methods and interpreted intelligently. Most importantly, cost-effectiveness data, whether published or generated locally, are unlikely to give decision makers a technical solution to the resource allocation problem. Rather, they should be viewed as a stimulus for local discussion and debate.

  7. Groundwater remediation and the cost effectiveness of phytoremediation.

    PubMed

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

    2012-10-01

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

  8. Cost-effectiveness and pricing of antibacterial drugs.

    PubMed

    Verhoef, Talitha I; Morris, Stephen

    2015-01-01

    Growing resistance to antibacterial agents has increased the need for the development of new drugs to treat bacterial infections. Given increasing pressure on limited health budgets, it is important to study the cost-effectiveness of these drugs, as well as their safety and efficacy, to find out whether or not they provide value for money and should be reimbursed. In this article, we systematically reviewed 38 cost-effectiveness analyses of new antibacterial agents. Most studies showed the new antibacterial drugs were cost-effective compared to older generation drugs. Drug pricing is a complicated process, involving different stakeholders, and has a large influence on cost-effectiveness. Value-based pricing is a method to determine the price of a drug at which it can be cost-effective. It is currently unclear what the influence of value-based pricing will be on the prices of new antibacterial agents, but an important factor will be the definition of 'value', which as well as the impact of the drug on patient health might also include other factors such as wider social impact and the health impact of disease. © 2015 The Authors. Chemical Biology & Drug Design Published by John Wiley & Sons Ltd.

  9. Cost-effectiveness and Pricing of Antibacterial Drugs

    PubMed Central

    Verhoef, Talitha I; Morris, Stephen

    2015-01-01

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

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

    PubMed

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

    2016-01-01

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

  11. [Potential cost effectiveness of a rotavirus vaccine in Chile].

    PubMed

    Constenla, Dagna; O'Ryan, Miguel; Navarrete, María S; Antil, Lynn; Rheingans, Richard D

    2006-06-01

    Cost effectiveness studies are essential to assess the real value of interventions with preventive or therapeutic objectives. To assess the theoretical cost-effectiveness of a vaccine against rotavirus in Chilean children of less than five years of age. An economic model was developed based on information on disease incidence, health care costs associated with treatment and the effectiveness and costs of vaccination. Net disease and vaccination costs were estimated from the health system perspective and were compared with life years and disability-adjusted life-years (DALYs) gained using a 3% discount rate. Local administrative and accounting hospital data and vaccine efficacy data were used to estimate healthcare costs and cost-effectiveness of vaccination. A rotavirus vaccination program would prevent 10 deaths due to rotavirus gastroenteritis, 6,245 related hospitalizations and 41,962 outpatient visits during the first five years of life, per vaccinated cohort. For every 1,000 children born, the healthcare service spends US$15,077 on treatment of gastroenteritis. From the healthcare perspective, vaccination would yield a cost-effectiveness ratio of US$11,261 per DALY when the price of the vaccine is US$24 per course. Rotavirus vaccine can effectively reduce the disease burden and healthcare costs of rotavirus gastroenteritis and can be a cost-effective investment compared to other options.

  12. Cost-Effectiveness of Antiretroviral Therapy for Prevention

    PubMed Central

    Kahn, James G; Marseille, Elliot A; Bennett, Rod; Williams, Brian G; Granich, Reuben

    2011-01-01

    Recent empirical studies and analyses have heightened interest in the use of expanded antiretroviral therapy (ART) for prevention of HIV transmission. However, ART is expensive, approximately $600 per person per year, raising issues of the cost and cost-effectiveness of ambitious ART expansion. The goal of this review is to equip the reader with the conceptual tools and substantive background needed to understand and evaluate the policy and programmatic implications of cost-effectiveness assessments of ART for prevention. We provide this review in six sections. We start by introducing and explaining basic concepts of health economics as they relate to this issue, including resources, costs, health metrics (such as Disability-Adjusted Life Years), and different types of economic analysis. We then review research on the cost and cost-effectiveness of ART as treatment, and on the cost-effectiveness of traditional HIV prevention. We describe critical issues in the epidemic impact of ART, such as suppression of transmission and the role of the acute phase of infection. We then present a conceptual model for conducting and interpreting cost-effectiveness analyses of ART as prevention, and review the existing preliminary estimates in this area. We end with a discussion of future directions for programmatic demonstrations and evaluation. PMID:21999776

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

    PubMed Central

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

    2016-01-01

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

  14. Using chemical and microbiological indicators to track the impacts from the land application of treated municipal wastewater and other sources on groundwater quality in a karstic springs basin

    USGS Publications Warehouse

    Katz, B.G.; Griffin, Dale W.

    2008-01-01

    Multiple chemical constituents (nutrients; N, O, H, C stable isotopes; 64 organic wastewater compounds, 16 pharmaceutical compounds) and microbiological indicators were used to assess the impact on groundwater quality from the land application of approximately 9.5 million liters per day of treated municipal sewage effluent to a sprayfield in the 960-km2 Ichetucknee Springs basin, northern Florida. Enriched stable isotope signatures (?? 18O and ??2H) were found in water from the effluent reservoir and a sprayfield monitoring well (MW-7) due to evaporation; however, groundwater samples downgradient from the sprayfield have ??18O and ??2H concentrations that represented recharge of meteoric water. Boron and chloride concentrations also were elevated in water from the sprayfield effluent reservoir and MW-7, but concentrations in groundwater decreased substantially with distance downgradient to background levels in the springs (about 12 km) and indicated at least a tenfold dilution factor. Nitrate-nitrogen isotope (??15N-NO3) values above 10 ??? in most water samples were indicative of organic nitrogen sources except Blue Hole Spring (??15N-NO3 = 4.6-4.9 ???), which indicated an inorganic source of nitrogen (fertilizers). The detection of low concentrations the insect repellent N,N-diethyl-metatoluamide (DEET), and other organic compounds associated with domestic wastewater in Devil's Eye Spring indicated that leakage from a nearby septic tank drainfield likely has occurred. Elevated levels of fecal coliforms and enterococci were found in Blue Hole Spring during higher flow conditions, which likely resulted from hydraulic connections to upgradient sinkholes and are consistent with previoius dye-trace studies. Enteroviruses were not detected in the sprayfield effluent reservoir, but were found in low concentrations in water samples from a downgradient well and Blue Hole Spring during high-flow conditions indicating a human wastewater source. The Upper Floridan aquifer in

  15. Using chemical and microbiological indicators to track the impacts from the land application of treated municipal wastewater and other sources on groundwater quality in a karstic springs basin

    NASA Astrophysics Data System (ADS)

    Katz, Brian G.; Griffin, Dale W.

    2008-08-01

    Multiple chemical constituents (nutrients; N, O, H, C stable isotopes; 64 organic wastewater compounds, 16 pharmaceutical compounds) and microbiological indicators were used to assess the impact on groundwater quality from the land application of approximately 9.5 million liters per day of treated municipal sewage effluent to a sprayfield in the 960-km2 Ichetucknee Springs basin, northern Florida. Enriched stable isotope signatures (δ18O and δ2H) were found in water from the effluent reservoir and a sprayfield monitoring well (MW-7) due to evaporation; however, groundwater samples downgradient from the sprayfield have δ18O and δ2H concentrations that represented recharge of meteoric water. Boron and chloride concentrations also were elevated in water from the sprayfield effluent reservoir and MW-7, but concentrations in groundwater decreased substantially with distance downgradient to background levels in the springs (about 12 km) and indicated at least a tenfold dilution factor. Nitrate-nitrogen isotope (δ15N NO3) values above 10 ‰ in most water samples were indicative of organic nitrogen sources except Blue Hole Spring (δ15N NO3 = 4.6 4.9 ‰), which indicated an inorganic source of nitrogen (fertilizers). The detection of low concentrations the insect repellent N, N-diethyl-metatoluamide (DEET), and other organic compounds associated with domestic wastewater in Devil’s Eye Spring indicated that leakage from a nearby septic tank drainfield likely has occurred. Elevated levels of fecal coliforms and enterococci were found in Blue Hole Spring during higher flow conditions, which likely resulted from hydraulic connections to upgradient sinkholes and are consistent with previoius dye-trace studies. Enteroviruses were not detected in the sprayfield effluent reservoir, but were found in low concentrations in water samples from a downgradient well and Blue Hole Spring during high-flow conditions indicating a human wastewater source. The Upper Floridan aquifer

  16. Filth flies associated with municipal solid waste and impact of delay in cover soil application on adult filth fly emergence in a sanitary landfill in Pulau Pinang, Malaysia.

    PubMed

    Nurita, A T; Hassan, A Abu

    2013-06-01

    Two types of municipal solid waste (MSW), newly arrived and 2 weeks old, were sampled from a sanitary landfill in Pulau Pinang, Malaysia at a fortnightly interval and kept under field conditions for 2 weeks. A total of 480 kg of each type of MSW was sampled to study species composition and impact of delays in cover soil applications on filth fly emergence. Out of 960 kg of MSW sampled, 9.2 ± 0.5 flies emerged per kilogram. Weekly adult fly emergence rates of newly arrived and 2-week-old waste did not differ significantly and MSW remained suitable for fly breeding for up to 1 month. Eight species of flies emerged from the MSW: namely, Musca domestica, Musca sorbens, Synthesiomyia nudiseta, Hydrotaea chalcogaster, Chrysomya megacephala, Lucilia cuprina, Hemipyrellia ligurriens and Sarcophaga sp. Newly arrived waste was determined to be the main source for M. domestica, C. megacephala and L. cuprina in the landfill owing to significantly higher mean emergence compared with 2-week-old waste. Musca sorbens was found in newly arrived waste but not in 2-week-old waste, suggesting that the species was able to survive transportation to landfill but unable to survive landfill conditions. Hemipyrellia ligurriens, H. chalcogaster and S. nudiseta were not imported into the landfill with MSW and pre-existing flies in and around the landfill itself may be their source. The results show that landfills can be a major source of fly breeding if cover soil or temporary cover is not applied daily or on a regular schedule.

  17. Effectiveness and cost-effectiveness of telehealthcare for chronic obstructive pulmonary disease: study protocol for a cluster randomized controlled trial.

    PubMed

    Udsen, Flemming Witt; Lilholt, Pernille Heyckendorff; Hejlesen, Ole; Ehlers, Lars Holger

    2014-05-21

    Several feasibility studies show promising results of telehealthcare on health outcomes and health-related quality of life for patients suffering from chronic obstructive pulmonary disease, and some of these studies show that telehealthcare may even lower healthcare costs. However, the only large-scale trial we have so far - the Whole System Demonstrator Project in England - has raised doubts about these results since it conclude that telehealthcare as a supplement to usual care is not likely to be cost-effective compared with usual care alone. The present study is known as 'TeleCare North' in Denmark. It seeks to address these doubts by implementing a large-scale, pragmatic, cluster-randomized trial with nested economic evaluation. The purpose of the study is to assess the effectiveness and the cost-effectiveness of a telehealth solution for patients suffering from chronic obstructive pulmonary disease compared to usual practice. General practitioners will be responsible for recruiting eligible participants (1,200 participants are expected) for the trial in the geographical area of the North Denmark Region. Twenty-six municipality districts in the region define the randomization clusters. The primary outcomes are changes in health-related quality of life, and the incremental cost-effectiveness ratio measured from baseline to follow-up at 12 months. Secondary outcomes are changes in mortality and physiological indicators (diastolic and systolic blood pressure, pulse, oxygen saturation, and weight). There has been a call for large-scale clinical trials with rigorous cost-effectiveness assessments in telehealthcare research. This study is meant to improve the international evidence base for the effectiveness and cost-effectiveness of telehealthcare to patients suffering from chronic obstructive pulmonary disease by implementing a large-scale pragmatic cluster-randomized clinical trial. Clinicaltrials.gov, http://NCT01984840, November 14, 2013.

  18. Cost effective propulsion systems for small satellites using butane propellant

    NASA Astrophysics Data System (ADS)

    Gibbon, D.; Underwood, C.; Sweeting, M.; Amri, R.

    2002-07-01

    This paper will describe the work performed at the Surrey Space Centre to produce cost effective propulsion systems for small spacecraft with relatively low deltaV (ΔV) requirements. Traditionally, cold gas nitrogen systems have been used for this type of application, however they have high storage volume requirements. This can be a problem on small spacecraft, which are typically volume limited. An alternative solution is to use liquefied gases, which store as liquids, hence have reasonable density levels, and can be used in a cold gas thruster. At the Surrey Space Centre, butane has been selected as the propellant of choice. Although it has slightly lower specific impulse performance than nitrogen, it has a significantly higher storage density and it stores at a very low pressure, hence no regulation system is required. On 28 th June 2000 Surrey Satellite Technology Ltd (SSTL) launched it first nanosatellite SNAP-1. This 6.5kg spacecraft was equipped with a small cold gas propulsion system utilising 32.6 grams of butane propellant. During the propulsion system operation phase the spacecraft's semi major axis was raised by nearly 4 kilometers using the propulsion system. The design of the propulsion system will be described and the low cost features highlighted. Telemetry data will be used to describe the propulsion operations and an overall mission specific impulse will be derived. SSTL are currently under contract to build three Earth observation spacecraft for a Disaster Monitoring Constellation (DMC). Each spacecraft will weigh approx 100 kg and have a ΔV requirement of 10 m/sec. A butane system has been designed and manufactured to meet the requirements of these spacecraft. The system is based very much on the flight heritage of the SNAP-1 system, with the addition of greater propellant storage capacity. The lessons learnt from the SNAP-1 operation will be reviewed and the resulting design improvements on the DMC propulsion systems will be detailed.

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

    NASA Technical Reports Server (NTRS)

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

    1975-01-01

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

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

    PubMed

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

    2013-08-15

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

  1. Are our selection and training programs cost effective

    SciTech Connect

    Wroten, S.P.

    1985-01-01

    Recently updated methods for evaluating the cost effectiveness of selection and training programs are applied in two situations. First an API-sponsored study shows that using tests to hire a board operator saves $21,000 per person per year. When these savings are accumulated over people and time, the savings total into the millions of dollars. The cost effectiveness of training programs can be similarly determined. An interpersonal skills workshop was found to have a return-on-investment of over $400,000, or over 300 percent. The savings that result from such training and selection programs definitely argue that the programs are well worthwhile and that the cost-effectiveness studies to demonstrate such savings are also well worth the investment.

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

    SciTech Connect

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

    2008-10-01

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

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

    PubMed

    Simmons, Kevin M; Sutter, Daniel

    2006-08-01

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

  4. Cost effectiveness and efficiency in assistive technology service delivery.

    PubMed

    Warren, C G

    1993-01-01

    In order to develop and maintain a viable service delivery program, the realities of cost effectiveness and cost efficiency in providing assistive technology must be addressed. Cost effectiveness relates to value of the outcome compared to the expenditures. Cost efficiency analyzes how a provider uses available resources to supply goods and services. This paper describes how basic business principles of benefit/cost analysis can be used to determine cost effectiveness. In addition, basic accounting principles are used to illustrate methods of evaluating a program's cost efficiency. Service providers are encouraged to measure their own program's effectiveness and efficiency (and potential viability) in light of current trends. This paper is meant to serve as a catalyst for continued dialogue on this topic.

  5. Cost effectiveness of long life incandescent lamps and energy buttons

    SciTech Connect

    Verderber, R.; Morse, O.

    1980-04-07

    Long-life replacement lamps for the incandescent lamp have been evaluated with regard to their cost effectiveness. The replacements include the use of energy buttons that extend lamp life as well as an adaptive fluorescent circline lamp that will fit into existing incandescent lamp sockets. The initial, operating, and replacement costs for one million lumen hours are determined for each lamp system. It is found that the most important component lighting cost is the operating cost. Using lamps that are less efficient or devices that cause lamps to operate less efficiently are not cost-effective. The adaptive fluorescent circline lamp, even at an initial unit cost of $20.00, is the most cost-effective source of illumination compared to the incandescent lamp and lamp systems examined.

  6. Ethanol from municipal cellulosic wastes

    NASA Astrophysics Data System (ADS)

    Parker, A. J., Jr.; Timbario, T. J.; Mulloney, J. A., Jr.

    This paper addresses the use of municipal cellulosic wastes as a feedstock for producing ethanol fuels, and describes the application of enzymatic hydrolysis technology for their production. The concept incorporates recent process technology developments within the framework of an existing industry familiar with large-scale ethanol fermentation (the brewing industry). Preliminary indications are that the cost of producing ethanol via enzymatic hydrolysis in an existing plant with minimal facility modifications (low capital investment) can be significantly less than that of ethanol from grain fermentation.

  7. Probabilistic assessment of wildfire hazard and municipal watershed exposure

    Treesearch

    Joe Scott; Don Helmbrecht; Matthew P. Thompson; David E. Calkin; Kate Marcille

    2012-01-01

    The occurrence of wildfires within municipal watersheds can result in significant impacts to water quality and ultimately human health and safety. In this paper, we illustrate the application of geospatial analysis and burn probability modeling to assess the exposure of municipal watersheds to wildfire. Our assessment of wildfire exposure consists of two primary...

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

    USGS Publications Warehouse

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

    2008-01-01

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

  9. Cost-effectiveness of sofosbuvir for the treatment of chronic hepatitis C-infected patients.

    PubMed

    Cure, S; Guerra, I; Dusheiko, G

    2015-11-01

    The efficacy of treatment for hepatitis C genotype 1 infection has significantly improved with the introduction of first-generation protease inhibitors. However, there remains a need for effective treatments for patients infected with other genotypes, for nonresponders and patients unsuitable for interferon. Sofosbuvir is the first nucleotide polymerase inhibitor with pan-genotypic activity. Sofosbuvir-based regimens have resulted in >90% sustained virological response across treatment-naïve genotype 1-6 patients in five phase III clinical trials of sofosbuvir administered with ribavirin or pegylated interferon and ribavirin. This analysis evaluates the cost-effectiveness of sofosbuvir within the current licensed indication, for genotype 1-6 in the UK. A Markov model followed a cohort of 10 000 patients over lifetime, with approximately 20% initiating treatment for compensated cirrhosis. Sofosbuvir-regimens were compared to telaprevir, boceprevir, pegylated interferon and ribavirin, or no treatment. Costs and outcomes were discounted at 3.5%. The cost perspective utilized costs applicable to the National Health Service in the UK. Sofosbuvir proved to be cost-effective in most patient populations with incremental cost-effectiveness ratios (ICERs) at £11 836/QALY and £7292/QALY against telaprevir and boceprevir, respectively. In genotype 3, sofosbuvir had a weighted ICER of £18 761/QALY. Sofosbuvir-based regimens are a cost-effective option for the majority of hepatitis C-infected patients in the United Kingdom although the incremental cost-effectiveness varies by genotype and regimen. Sofosbuvir and ribavirin is an alternative regimen for patients unsuitable for interferon. © 2015 Gilead Sciences Europe Ltd. Journal of Viral Hepatitis Published by John Wiley & Sons Ltd.

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

    PubMed

    Halsing, David L; Moore, Michael R

    2008-04-01

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

  11. Cost-Effectiveness of Dengue Vaccination Programs in Brazil.

    PubMed

    Shim, Eunha

    2017-05-01

    AbstractThe first approved dengue vaccine, CYD-TDV, a chimeric, live-attenuated, tetravalent dengue virus vaccine, was recently licensed in 13 countries, including Brazil. In light of recent vaccine approval, we modeled the cost-effectiveness of potential vaccination policies mathematically based on data from recent vaccine efficacy trials that indicated that vaccine efficacy was lower in seronegative individuals than in seropositive individuals. In our analysis, we investigated several vaccination programs, including routine vaccination, with various vaccine coverage levels and those with and without large catch-up campaigns. As it is unclear whether the vaccine protects against infection or just against disease, our model incorporated both direct and indirect effects of vaccination. We found that in the presence of vaccine-induced indirect protection, the cost-effectiveness of dengue vaccination decreased with increasing vaccine coverage levels because the marginal returns of herd immunity decreases with vaccine coverage. All routine dengue vaccination programs that we considered were cost-effective, reducing dengue incidence significantly. Specifically, a routine dengue vaccination of 9-year-olds would be cost-effective when the cost of vaccination per individual is less than $262. Furthermore, the combination of routine vaccination and large catch-up campaigns resulted in a greater reduction of dengue burden (by up to 93%) than routine vaccination alone, making it a cost-effective intervention as long as the cost per course of vaccination is $255 or less. Our results show that dengue vaccination would be cost-effective in Brazil even with a relatively low vaccine efficacy in seronegative individuals.

  12. Future drug prices and cost-effectiveness analyses.

    PubMed

    Hoyle, Martin

    2008-01-01

    Cost-effectiveness analyses worldwide assume that the price of any single drug increases with inflation. New guidance from the Pharmaceutical Management Agency in New Zealand suggests that, when it is known that a generic drug will be available in the near future, a best estimate of the lower price of the generic should be included in the base-case cost-effectiveness analysis. Furthermore, in the sensitivity analysis, the real prices of the new and comparator drugs should be deflated by 2% per year as a proxy for inflation. To challenge the widespread assumption that the price of any single drug increases with inflation in the UK, and to calculate the impact on the incremental cost-effectiveness ratio (ICER) of using a more realistic estimate for the future price of individual drugs. The change in the real price of 373 drugs in the UK over the period 1980-2006 was calculated. Only those drugs launched after 1984 and with more than 500 prescriptions per year were analysed. A linear model of the change in real price by drug was fitted as a function of launch year, number of prescriptions, and British National Formulary (BNF) section. The mean annual decrease in the real price of individual drugs was 3.8% (95% CI 3.4, 4.2), with a standard deviation of 2.5%. Using this value, drugs would generally appear more cost effective than as presently calculated, i.e. the ICER would generally fall. The ICER would fall substantially for drugs for chronic conditions, e.g. by 15%, from 61,900 to 52,700 pound per QALY (year 2004 values) for cinacalcet for hyperparathyroidism. It is predicted that the ratio would fall even more for longer-term conditions such as multiple sclerosis. Most of the drugs previously appraised by the National Institute for Health and Clinical Excellence (NICE) are actually more cost effective than stated by NICE. Furthermore, most or all drugs for chronic conditions are actually far more cost effective than stated by NICE. Hence, it is likely that some of

  13. Cost-effectiveness analysis of treatments for premenstrual dysphoric disorder.

    PubMed

    Rendas-Baum, Regina; Yang, Min; Gricar, Joseph; Wallenstein, Gene V

    2010-01-01

    Premenstrual syndrome (PMS) is reported to affect between 13% and 31% of women. Between 3% and 8% of women are reported to meet criteria for the more severe form of PMS, premenstrual dysphoric disorder (PMDD). Although PMDD has received increased attention in recent years, the cost effectiveness of treatments for PMDD remains unknown. To evaluate the cost effectiveness of the four medications with a US FDA-approved indication for PMDD: fluoxetine, sertraline, paroxetine and drospirenone plus ethinyl estradiol (DRSP/EE). A decision-analytic model was used to evaluate both direct costs (medication and physician visits) and clinical outcomes (treatment success, failure and discontinuation). Medication costs were based on average wholesale prices of branded products; physician visit costs were obtained from a claims database study of PMDD patients and the Agency for Healthcare Research and Quality. Clinical outcome probabilities were derived from published clinical trials in PMDD. The incremental cost-effectiveness ratio (ICER) was calculated using the difference in costs and percentage of successfully treated patients at 6 months. Deterministic and probabilistic sensitivity analyses were used to assess the impact of uncertainty in parameter estimates. Threshold values where a change in the cost-effective strategy occurred were identified using a net benefit framework. Starting therapy with DRSP/EE dominated both sertraline and paroxetine, but not fluoxetine. The estimated ICER of initiating treatment with fluoxetine relative to DRSP/EE was $US4385 per treatment success (year 2007 values). Cost-effectiveness acceptability curves revealed that for ceiling ratios>or=$US3450 per treatment success, fluoxetine had the highest probability (>or=0.37) of being the most cost-effective treatment, relative to the other options. The cost-effectiveness acceptability frontier further indicated that DRSP/EE remained the option with the highest expected net monetary benefit for

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

    NASA Technical Reports Server (NTRS)

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

    1987-01-01

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

  15. A concept for cost-effective, satellite servicing

    NASA Astrophysics Data System (ADS)

    Madison, Richard W.

    1999-01-01

    Air, land, and sea vehicles are routinely serviced to increase their availability, flexibility, capability, and life span. Servicing could extend the same benefits to satellites, but is rarely employed because current methods are cost effective only for very expensive satellites. This paper presents a concept to minimize the cost of satellite servicing. It combines requirements for a next-generation of serviceable satellites, with an infrastructure whose cost can be amortized over many servicing missions. This should make servicing cost effective for a wider range of spacecraft.

  16. Cost effectiveness of OptiMal® rapid diagnostic test for malaria in remote areas of the Amazon Region, Brazil

    PubMed Central

    2010-01-01

    Background In areas with limited structure in place for microscopy diagnosis, rapid diagnostic tests (RDT) have been demonstrated to be effective. Method The cost-effectiveness of the Optimal® and thick smear microscopy was estimated and compared. Data were collected on remote areas of 12 municipalities in the Brazilian Amazon. Data sources included the National Malaria Control Programme of the Ministry of Health, the National Healthcare System reimbursement table, hospitalization records, primary data collected from the municipalities, and scientific literature. The perspective was that of the Brazilian public health system, the analytical horizon was from the start of fever until the diagnostic results provided to patient and the temporal reference was that of year 2006. The results were expressed in costs per adequately diagnosed cases in 2006 U.S. dollars. Sensitivity analysis was performed considering key model parameters. Results In the case base scenario, considering 92% and 95% sensitivity for thick smear microscopy to Plasmodium falciparum and Plasmodium vivax, respectively, and 100% specificity for both species, thick smear microscopy is more costly and more effective, with an incremental cost estimated at US$549.9 per adequately diagnosed case. In sensitivity analysis, when sensitivity and specificity of microscopy for P. vivax were 0.90 and 0.98, respectively, and when its sensitivity for P. falciparum was 0.83, the RDT was more cost-effective than microscopy. Conclusion Microscopy is more cost-effective than OptiMal® in these remote areas if high accuracy of microscopy is maintained in the field. Decision regarding use of rapid tests for diagnosis of malaria in these areas depends on current microscopy accuracy in the field. PMID:20937094

  17. Application of gas chromatography-mass spectrometry preceded by solvent extraction to determine volatile fatty acids in wastewater of municipal, animal farm and landfill origin.

    PubMed

    Banel, Anna; Zygmunt, Bogdan

    2011-01-01

    This study describes extraction of selected volatile fatty acids (VFAs) (containing from 2 up to 8 carbon atoms) with methyl-tert-butyl ether (MTBE) from polluted aqueous samples followed by separation, identification and quantification by gas chromatography coupled with mass spectrometry (GC-MS). Extraction parameters such as time and number of extractions, volume ratio, effect of acidification and salt addition were optimized with respect to recovery, enrichment factor and repeatability. The VFAs studied were separated using an open tubular capillary column Stabilwax-DA (crossbond polyethylene glycol treated with nitroterephtalic acid). The limits of quantitation (LOQ) of the procedure developed were on the level of 0.1 to 0.5 mg L(-1). The analysis of real samples of municipal raw and treated wastewater, animal farms wastewater, and also landfill leachates showed that always dominant was acetic acid. The content of VFAs in animal farms wastewater was a few times higher than in municipal wastewater and in municipal solid waste landfill leachates. In surface and ground water close to municipal landfill only acetic acid was detected at higher concentrations in outflow than inflow water. This indicates that slight leakage from the landfill must have occurred.

  18. Cell cycle stage specific application of municipal landfill leachates to assess the genotoxicity in root meristem cells of barley (Hordeum vulgare).

    PubMed

    Srivastava, Anjil Kumar; Kumar, Ravi Ranjan; Singh, Ashok Kumar

    2014-12-01

    Municipal solid wastes (MSW) are unavoidable sources of environmental pollution. Improper disposal of municipal waste results in the leaching of toxic metals and organic chemicals, which can contaminate the surface and ground water leading to serious health hazard. In this study, the toxic effects of the leachate prepared from municipal solid waste samples were examined in root meristem cells of barley (Hordeum vulgare L.) at various stages of cell cycle, i.e., G1, S, and G2. Seeds of barley were exposed to 2.5, 5, and 10 % of leachates in soil and aqueous media in 48 h at different cell cycle stages. The physicochemical data of the present study revealed that municipal solid waste leachate contains high amount of heavy metals, which significantly affected growth and physiological activities of barley. Significant inhibition in hypocotyl length, germination, and mitotic index were observed at all concentration of leachate treatment. Induction of chromosomal aberrations (CA's) and micronuclei (MN) formation were also observed with different concentrations of leachate treatment at 7, 17, and 27 h of presoaking durations, which falls in G1, S, and G2 phase of the cell cycle, respectively. Also, exposure of leachate at S phase of the cell cycle had significant effects in barley through chromosomal aberration and micronuclei formation.

  19. The effect of broiler litter, swine effluent, and municipal biosolids land application on small plot pathogen, antibiotic resistance, and nutrient levels

    USDA-ARS?s Scientific Manuscript database

    Land applying agricultural and municipal wastes carries an inherent risk associated with nutrient and pathogen runoff and contamination, but with that risk comes a potentially sustainable process to reclaim otherwise residual waste material. Few studies compare the two residuals. The purpose of th...

  20. Some Measures of Cost Effectiveness in Library Collections.

    ERIC Educational Resources Information Center

    Hamaker, Charles A.

    1992-01-01

    Describes measures of cost effectiveness that are useful for academic library collections, based on experiences at the Louisiana State University libraries. Highlights include circulation analysis of newly cataloged books; current periodical use compared to cost; faculty ranking of journals; and circulation patterns (i.e., use versus cost and…

  1. A Cost-Effectiveness Analysis of Early Literacy Interventions

    ERIC Educational Resources Information Center

    Simon, Jessica

    2011-01-01

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

  2. Cost-Effects Analysis of Year-Round Education Programs.

    ERIC Educational Resources Information Center

    Hough, David; And Others

    This feasibility study was designed to gather and analyze data to determine the potential cost-effectiveness of year-round education (YRE) compared to traditional-schedule education in California. An expanded version of the Stanford Research Institute's cost model was used to fit a broad conceptualization that enabled school districts with…

  3. 23 CFR 635.205 - Finding of cost effectiveness.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.205 Finding of cost effectiveness. (a) It may be... highway construction project by force account when a situation exists in which the rights or... of new facilities shall be undertaken by competitive bidding except as provided in § 635.204(c...

  4. 23 CFR 635.205 - Finding of cost effectiveness.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.205 Finding of cost effectiveness. (a) It may be... highway construction project by force account when a situation exists in which the rights or... of new facilities shall be undertaken by competitive bidding except as provided in § 635.204(c...

  5. Modeling and Cost-Effectiveness in HIV Prevention

    PubMed Central

    Jacobsen, Margo M.; Walensky, Rochelle P.

    2016-01-01

    With HIV funding plateauing and the number of people living with HIV increasing due to the roll-out of life-saving antiretroviral therapy, policy makers are faced with increasingly tighter budgets to manage the ongoing HIV epidemic. Cost-effectiveness and modeling analyses can help determine which HIV interventions may be of best value. Incidence remains remarkably high in certain populations and countries, making prevention key to controlling the spread of HIV. This paper briefly reviews concepts in modeling and cost-effectiveness methodology, then examines results of recently published cost-effectiveness analyses on the following HIV prevention strategies: condoms and circumcision, behavioral or community-based interventions, prevention of mother to child transmission, HIV testing, pre-exposure prophylaxis, and treatment as prevention. We find that the majority of published studies demonstrate cost-effectiveness; however, not all interventions are affordable. We urge continued research on combination strategies and methodologies that take into account willingness to pay and budgetary impact. PMID:26830283

  6. Cost-Effectiveness of Two Methods of Job Analysis.

    ERIC Educational Resources Information Center

    Hesse, Cindy G.; Nijhof, Wim J.

    A three-phase study was conducted to compare the cost-effectiveness of two methods for determining job profiles in the publishing business and book trade--the task inventory and the Developing a Curriculum (DACUM) process. In phases 1 and 2, the task inventory and DACUM approaches were used to identify future changes in the technology used in the…

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

    PubMed

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

    2014-01-01

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

  8. Cost-Effectiveness Analysis of Regorafenib for Metastatic Colorectal Cancer

    PubMed Central

    Goldstein, Daniel A.; Ahmad, Bilal B.; Chen, Qiushi; Ayer, Turgay; Howard, David H.; Lipscomb, Joseph; El-Rayes, Bassel F.; Flowers, Christopher R.

    2015-01-01

    Purpose Regorafenib is a standard-care option for treatment-refractory metastatic colorectal cancer that increases median overall survival by 6 weeks compared with placebo. Given this small incremental clinical benefit, we evaluated the cost-effectiveness of regorafenib in the third-line setting for patients with metastatic colorectal cancer from the US payer perspective. Methods We developed a Markov model to compare the cost and effectiveness of regorafenib with those of placebo in the third-line treatment of metastatic colorectal cancer. Health outcomes were measured in life-years and quality-adjusted life-years (QALYs). Drug costs were based on Medicare reimbursement rates in 2014. Model robustness was addressed in univariable and probabilistic sensitivity analyses. Results Regorafenib provided an additional 0.04 QALYs (0.13 life-years) at a cost of $40,000, resulting in an incremental cost-effectiveness ratio of $900,000 per QALY. The incremental cost-effectiveness ratio for regorafenib was > $550,000 per QALY in all of our univariable and probabilistic sensitivity analyses. Conclusion Regorafenib provides minimal incremental benefit at high incremental cost per QALY in the third-line management of metastatic colorectal cancer. The cost-effectiveness of regorafenib could be improved by the use of value-based pricing. PMID:26304904

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

    ERIC Educational Resources Information Center

    Ashmole, R. F.; And Others

    1973-01-01

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

  10. Cost Effective Repair Techniques for Turbine Airfoils. Volume I

    DTIC Science & Technology

    1978-11-01

    Turbine blades and vanes in current engines are subjected to the most hostile environment...payoff potential in turbine vanes / blades . The criteria used included: • Incidence of damage - Scrapped or damaged turbine airfoils at the ALC centers...Corporate Author: GENERAL ELECTRIC CO CINCINNATI OHIO AIRCRAFT ENGINE GROUP Unclassified Title: (U) Cost Effective Repair Techniques for Turbine

  11. Cost-Effectiveness Analysis of School Desegregation Plans.

    ERIC Educational Resources Information Center

    Rossell, Christine H.

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

  12. A Cost-Effectiveness Analysis of Early Literacy Interventions

    ERIC Educational Resources Information Center

    Simon, Jessica

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Baacke, Clifford M.; Frankel, Steven M.

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

  14. Cost-effective critical care: cost containment and rationing.

    PubMed

    Rubenfeld, Gordon D

    2012-08-01

    Rationing occurs whenever the demand for a good or service exceeds its supply. Therefore rationing is an inevitable occurrence in medicine and in critical care where the potential demand for effective medical care will exceed supply. Although there are many strategies to allocate medical resources one that is often considered is based on cost-effectiveness. Cost-effectiveness analysis attempts to estimate the value of individual medical treatments in terms of dollars and outcomes. Allocation of medical treatments based on cost-effectiveness analysis requires valid estimates of both the costs and the effectiveness of treatments as well as some overarching body with the authority to enforce allocation based on these analyses. Limitations of allocation based on cost-effectiveness analysis in critical care include difficulties in estimating marginal costs of critical care treatments, limited evidence for any treatments with efficacy, and the ethical principle of rescuing identifiable lives in imminent risk of death. The prospect of a pandemic influenza-like infection has stimulated a lot of interest in hypothetical rationing strategies for the intensive care unit, none of which has been tested in actual pandemic scenarios. Given the burden of critical illness and the wide variation in resources a global approach to rationing is untenable. The article concludes with a vision of the future of allocation in critical care. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Cost effectiveness studies of environmental technologies: Volume 1

    SciTech Connect

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

    1994-02-01

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

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

    ERIC Educational Resources Information Center

    Kaufer, Steve

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

  17. 10 CFR 436.18 - Measuring cost-effectiveness.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  18. 10 CFR 436.18 - Measuring cost-effectiveness.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  19. 10 CFR 436.18 - Measuring cost-effectiveness.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... water system, considered in determining such matters as the optimal size of a solar energy system, the... 10 Energy 3 2010-01-01 2010-01-01 false Measuring cost-effectiveness. 436.18 Section 436.18 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and...

  20. 10 CFR 436.18 - Measuring cost-effectiveness.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... water system, considered in determining such matters as the optimal size of a solar energy system, the... 10 Energy 3 2013-01-01 2013-01-01 false Measuring cost-effectiveness. 436.18 Section 436.18 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and...

  1. 10 CFR 436.18 - Measuring cost-effectiveness.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... water system, considered in determining such matters as the optimal size of a solar energy system, the... 10 Energy 3 2011-01-01 2011-01-01 false Measuring cost-effectiveness. 436.18 Section 436.18 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and...

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

    ERIC Educational Resources Information Center

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

    2003-01-01

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

  3. Assessing the Cost-Effectiveness of Family Connections

    ERIC Educational Resources Information Center

    DePanfilis, Diane; Dubowitz, Howard; Kunz, James

    2008-01-01

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

  4. Forecasting the Cost-Effectiveness of Educational Incentives

    ERIC Educational Resources Information Center

    Abt, Clark C.

    1974-01-01

    A look at cost-effectiveness as the major characteristic for which to develop a forecasting method, because it encompasses concerns of most educators. It indicates relative costs and relative effectiveness, and provides a rational basis for optimal resource allocation. (Author)

  5. The Mexican Telesecundaria: A Cost-Effectiveness Analysis.

    ERIC Educational Resources Information Center

    Mayo, John K.; And Others

    "Telesecundaria" has for the past six years attempted to provide secondary education (grades 7-9) by television to those students who would normally not be able to continue their education beyond the primary level. The study reported here aimed to evaluate the system, especially its cost-effectiveness, suggest strategies for improvement,…

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

    PubMed Central

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

    2010-01-01

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

  7. Modeling and Cost-Effectiveness in HIV Prevention.

    PubMed

    Jacobsen, Margo M; Walensky, Rochelle P

    2016-02-01

    With HIV funding plateauing and the number of people living with HIV increasing due to the rollout of life-saving antiretroviral therapy, policy makers are faced with increasingly tighter budgets to manage the ongoing HIV epidemic. Cost-effectiveness and modeling analyses can help determine which HIV interventions may be of best value. Incidence remains remarkably high in certain populations and countries, making prevention key to controlling the spread of HIV. This paper briefly reviews concepts in modeling and cost-effectiveness methodology and then examines results of recently published cost-effectiveness analyses on the following HIV prevention strategies: condoms and circumcision, behavioral- or community-based interventions, prevention of mother-to-child transmission, HIV testing, pre-exposure prophylaxis, and treatment as prevention. We find that the majority of published studies demonstrate cost-effectiveness; however, not all interventions are affordable. We urge continued research on combination strategies and methodologies that take into account willingness to pay and budgetary impact.

  8. Comprehensive cardiac rehabilitation: is it cost-effective?

    PubMed

    Oldridge, N B

    1998-11-01

    A major challenge for all health care systems is to identify the most efficient use of limited and finite resources available for health care. Economic evaluation provides a balance sheet of the benefits, harms and costs for making choices between alternative health care services and is one strategy to assist decision-makers to make rational choices about effective and efficient health care. Cost and outcomes data collected on two or more alternatives form the basis for economic evaluations and calculating a cost-effectiveness ratio. While comprehensive cardiac rehabilitation has been shown to be an effective intervention for patients with documented heart disease, the economic evaluation data from which to determine the efficiency of cardiac rehabilitation are limited. Available economic evaluations of comprehensive cardiac rehabilitation suggest that it is a cost-effective intervention following an acute coronary event that can be economically justified. Although the majority of data from studies with less rigorous designs suggest either savings or a decrease in health care utilization, there were increased costs per quality-adjusted life year gained in the only randomized controlled trial with a cost-effectiveness analysis of cardiac rehabilitation. As the traditional delivery of cardiac rehabilitation services is undergoing re-examination, there is a need for considerably more research on the cost-effectiveness of cardiac rehabilitation before any definitive statement about reimbursement is made.

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  10. Computers and Media Centers: Services, Satisfaction, and Cost Effectiveness.

    ERIC Educational Resources Information Center

    Givens, Patsy B.

    A survey was conducted of school media centers throughout the United States to determine: (1) how computers are being utilized by these centers, (2) the levels of satisfaction with present services, and (3) whether or not the services being provided by the computer are cost effective. Responses to survey forms returned by 20 school districts and…

  11. Screening for blunt cerebrovascular injuries is cost-effective.

    PubMed

    Kaye, Deborah; Brasel, Karen J; Neideen, Todd; Weigelt, John A

    2011-05-01

    Screening for blunt carotid and vertebral injury (BCVI) is increasing without a clear understanding of whether the chosen screening approach is cost-effective. We hypothesized that screening for BCVI using computed tomography angiography (CTA) was cost-effective in populations at high risk for BCVI. A decision analysis was performed modeling current BCVI screening approaches: no screening, duplex ultrasound, magnetic resonance angiography, angiography, and CTA. Treatment options included antiplatelet therapy, anticoagulation, stents for pseudoaneurysm, and no treatment. Probability estimates for incidence of injury and stroke, sensitivity and specificity of the screening modality, and type of treatment were taken from published data. Average wholesale price and medicare reimbursement costs were used. Two populations were analyzed; high-risk and overall blunt trauma populations. Two perspectives were taken; societal (including lifetime stroke costs) and institutional (ignoring lifetime stroke costs). In the high-risk population, from a societal perspective, CTA has the lowest cost and stroke rate; $3,727 per patient screened with a 1% stroke rate. No treatment has the highest cost and stroke rate. From an institutional perspective, no screening is the least costly option but has an 11% stroke rate. Duplex ultrasound is the most cost-effective screening modality; $8,940 per stroke prevented. From the societal perspective, CTA is the most cost-effective screening strategy for patients at high risk for BCVI. From an institutional perspective, CTA prevents the most strokes at a reasonable cost.

  12. Cost-Effectiveness Analysis of Regorafenib for Metastatic Colorectal Cancer.

    PubMed

    Goldstein, Daniel A; Ahmad, Bilal B; Chen, Qiushi; Ayer, Turgay; Howard, David H; Lipscomb, Joseph; El-Rayes, Bassel F; Flowers, Christopher R

    2015-11-10

    Regorafenib is a standard-care option for treatment-refractory metastatic colorectal cancer that increases median overall survival by 6 weeks compared with placebo. Given this small incremental clinical benefit, we evaluated the cost-effectiveness of regorafenib in the third-line setting for patients with metastatic colorectal cancer from the US payer perspective. We developed a Markov model to compare the cost and effectiveness of regorafenib with those of placebo in the third-line treatment of metastatic colorectal cancer. Health outcomes were measured in life-years and quality-adjusted life-years (QALYs). Drug costs were based on Medicare reimbursement rates in 2014. Model robustness was addressed in univariable and probabilistic sensitivity analyses. Regorafenib provided an additional 0.04 QALYs (0.13 life-years) at a cost of $40,000, resulting in an incremental cost-effectiveness ratio of $900,000 per QALY. The incremental cost-effectiveness ratio for regorafenib was > $550,000 per QALY in all of our univariable and probabilistic sensitivity analyses. Regorafenib provides minimal incremental benefit at high incremental cost per QALY in the third-line management of metastatic colorectal cancer. The cost-effectiveness of regorafenib could be improved by the use of value-based pricing. © 2015 by American Society of Clinical Oncology.

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

    PubMed

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

    2013-12-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  15. Heart failure disease management programs: a cost-effectiveness analysis.

    PubMed

    Chan, David C; Heidenreich, Paul A; Weinstein, Milton C; Fonarow, Gregg C

    2008-02-01

    Heart failure (HF) disease management programs have shown impressive reductions in hospitalizations and mortality, but in studies limited to short time frames and high-risk patient populations. Current guidelines thus only recommend disease management targeted to high-risk patients with HF. This study applied a new technique to infer the degree to which clinical trials have targeted patients by risk based on observed rates of hospitalization and death. A Markov model was used to assess the incremental life expectancy and cost of providing disease management for high-risk to low-risk patients. Sensitivity analyses of various long-term scenarios and of reduced effectiveness in low-risk patients were also considered. The incremental cost-effectiveness ratio of extending coverage to all patients was $9700 per life-year gained in the base case. In aggregate, universal coverage almost quadrupled life-years saved as compared to coverage of only the highest quintile of risk. A worst case analysis with simultaneous conservative assumptions yielded an incremental cost-effectiveness ratio of $110,000 per life-year gained. In a probabilistic sensitivity analysis, 99.74% of possible incremental cost-effectiveness ratios were <$50,000 per life-year gained. Heart failure disease management programs are likely cost-effective in the long-term along the whole spectrum of patient risk. Health gains could be extended by enrolling a broader group of patients with HF in disease management.

  16. 10 CFR 455.63 - Cost-effectiveness testing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Cost-effectiveness testing. 455.63 Section 455.63 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS AND BUILDINGS OWNED BY UNITS OF LOCAL GOVERNMENT AND PUBLIC CARE INSTITUTIONS Technical Assistance Programs for...

  17. 10 CFR 455.63 - Cost-effectiveness testing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Cost-effectiveness testing. 455.63 Section 455.63 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS AND BUILDINGS OWNED BY UNITS OF LOCAL GOVERNMENT AND PUBLIC CARE INSTITUTIONS Technical Assistance Programs for...

  18. 10 CFR 455.63 - Cost-effectiveness testing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Cost-effectiveness testing. 455.63 Section 455.63 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS AND BUILDINGS OWNED BY UNITS OF LOCAL GOVERNMENT AND PUBLIC CARE INSTITUTIONS Technical Assistance Programs for...

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

    ERIC Educational Resources Information Center

    Ashmole, R. F.; And Others

    1973-01-01

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

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

    ERIC Educational Resources Information Center

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

    2003-01-01

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

  1. Assessing the Cost-Effectiveness of Family Connections

    ERIC Educational Resources Information Center

    DePanfilis, Diane; Dubowitz, Howard; Kunz, James

    2008-01-01

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

  2. HIV transmission and the cost-effectiveness of methadone maintenance.

    PubMed Central

    Zaric, G S; Barnett, P G; Brandeau, M L

    2000-01-01

    OBJECTIVES: This study determined the cost-effectiveness of expanding methadone maintenance treatment for heroin addiction, particularly its effect on the HIV epidemic. METHODS: We developed a dynamic epidemic model to study the effects of increased methadone maintenance capacity on health care costs and survival, measured as quality-adjusted life-years (QALYs). We considered communities with HIV prevalence among injection drug users of 5% and 40%. RESULTS: Additional methadone maintenance capacity costs $8200 per QALY gained in the high-prevalence community and $10,900 per QALY gained in the low-prevalence community. More than half of the benefits are gained by individuals who do not inject drugs. Even if the benefits realized by treated and untreated injection drug users are ignored, methadone maintenance expansion costs between $14,100 and $15,200 per QALY gained. Additional capacity remains cost-effective even if it is twice as expensive and half as effective as current methadone maintenance slots. CONCLUSIONS: Expansion of methadone maintenance is cost-effective on the basis of commonly accepted criteria for medical interventions. Barriers to methadone maintenance deny injection drug users access to a cost-effective intervention that generates significant health benefits for the general population. PMID:10897189

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

    ERIC Educational Resources Information Center

    Young, Andrea

    2015-01-01

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

  4. Cost-effectiveness of private umbilical cord blood banking.

    PubMed

    Kaimal, Anjali J; Smith, Catherine C; Laros, Russell K; Caughey, Aaron B; Cheng, Yvonne W

    2009-10-01

    To investigate the cost-effectiveness of private umbilical cord blood banking. A decision-analytic model was designed comparing private umbilical cord blood banking with no umbilical cord blood banking. Baseline assumptions included a cost of $3,620 for umbilical cord blood banking and storage for 20 years, a 0.04% chance of requiring an autologous stem cell transplant, a 0.07% chance of a sibling requiring an allogenic stem cell transplant, and a 50% reduction in risk of graft-versus-host disease if a sibling uses banked umbilical cord blood. Private cord blood banking is not cost-effective because it cost an additional $1,374,246 per life-year gained. In sensitivity analysis, if the cost of umbilical cord blood banking is less than $262 or the likelihood of a child needing a stem cell transplant is greater than 1 in 110, private umbilical cord blood banking becomes cost-effective. Currently, private umbilical cord blood banking is cost-effective only for children with a very high likelihood of needing a stem cell transplant. Patients considering private blood banking should be informed of the remote likelihood that a unit will be used for a child or another family member. III.

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

    PubMed

    Pauly, Mark

    2015-05-01

    The conventional model for the use of cost-effectiveness analysis for health programs involves determining whether the cost per unit of effectiveness of the program is lower than some socially determined maximum acceptable cost per unit of effectiveness. If a program is better by this criterion, the policy implication is that it should be implemented by full coverage of its cost by insurance; if not, the program should not be implemented. This paper examines the unanswered question of how cost-effectiveness analysis should be performed and interpreted when insurance coverage may involve cost sharing. It explores the question of how cost sharing should be related to the magnitude of a cost-effectiveness ratio. A common view that cost sharing should vary inversely with program cost-effectiveness is shown to be incorrect. A key issue in correct analysis is whether there is heterogeneity in marginal effectiveness of care that cannot be perceived by the social planner but is known by the demander. It is possible that some programs that would fail the social efficiency test at full coverage will be acceptable with positive cost sharing. Combining individual and social preferences affects both the choice of programs and the extent of cost sharing. Copyright © 2014 John Wiley & Sons, Ltd.

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

    PubMed Central

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

    2013-01-01

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

  7. Estimating the Cost-Effectiveness of Coordinated DSM Programs.

    ERIC Educational Resources Information Center

    Hill, Lawrence J.; Brown, Marilyn A.

    1995-01-01

    A methodology for estimating the cost-effectiveness of coordinated programs from the standpoint of an electric or gas utility is described and illustrated. The discussion focuses on demand-side management programs cofunded by the government and utilities, but it can be applied to other types of cofunded programs. (SLD)

  8. 10 CFR 436.13 - Presuming cost-effectiveness results.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  9. 10 CFR 436.13 - Presuming cost-effectiveness results.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

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

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  11. Relative Cost-Effectiveness of School Resources in Improving Achievement

    ERIC Educational Resources Information Center

    Ilon, Lynn; Normore, Anthony H.

    2006-01-01

    This study demonstrates a method for extending debates on the effectiveness of school inputs into the cost-effectiveness realm. This study uses the example of Florida's statewide initiative to reduce class sizes to determine which of many state inputs buys the most effect for the same expenditure. The method includes a three-stage process:…

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

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Young, Andrea

    2015-01-01

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

  14. [Haute Autorite de sante opinion on cost-effectiveness of health products : results and perspectives].

    PubMed

    Midy, Fabienne; Raimond, Véronique; Thébaut, Clémence; Sambuc, Cléa; Rumeau-Pichon, Catherine

    2015-01-01

    Since 3rd October 2013 in France, drug companies applying for reimbursement of an innovative and expensive drug or medical device are required to provide the French National Authority for Health (HAS) with a cost-effectiveness assessment of their product. After a methodological audit of the economic evaluation submitted by the drug company, the Health Economics and Public Health Committee (CEESP) issues an opinion on the expected or observed cost-effectiveness. This opinion is sent to the Pricing Committee (CEPS) which determines the price of the product. After summarizing the French reimburse'!lent and pricing system, the objective of this article is to review the first 22 months of activity, in which HAS issued 30 cost-effectiveness opinions. The process, based on exchanges between drug companies and HAS, allowed the pricing committee to document the economic criterion in the majority of applications, while characterizing the degree of uncertainty of the results. For ten applications, major methodological concerns led the CEESP to reject the drug company's assessment.

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

    PubMed

    Ruggeri, Matteo

    2012-01-01

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

  16. Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia.

    PubMed

    Phanthunane, Pudtan; Vos, Theo; Whiteford, Harvey; Bertram, Melanie

    2011-05-13

    Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine may be dominated and there are serious

  17. Development of Microbial Assays for Municipal Sludge

    EPA Science Inventory

    Following a review of the Federal regulations and the supporting science for land application of municipal sludge, The National Research Council (NRC) recommended that the analytical methods used for determining the density of microorganisms in biosolids be validated by multi-lab...

  18. Development of Microbial Assays for Municipal Sludge

    EPA Science Inventory

    Following a review of the Federal regulations and the supporting science for land application of municipal sludge, The National Research Council (NRC) recommended that the analytical methods used for determining the density of microorganisms in biosolids be validated by multi-lab...

  19. Cost-effectiveness of group psychotherapy for depression in Uganda.

    PubMed

    Siskind, Dan; Baingana, Florence; Kim, Jane

    2008-09-01

    Low and middle-income countries are increasingly acknowledging the potential health and economic benefits associated with treatment of depression. To aid countries in making resource-allocation decisions, there is a need for cost-effectiveness analysis of treatments for depression in developing countries. Although there are a limited number of studies from developing countries that report data on treatment efficacy and costs, these data can be leveraged to tailor mathematical models that are used to evaluate the cost-effectiveness of depression treatments in specific settings. Using data from depression studies in the published literature, as well as two studies in Uganda, we developed a decision-analytic model to evaluate the cost-effectiveness of group psychotherapy in the setting of Uganda. We developed a Markov cohort model of depression and evaluated the health benefits and costs associated with group psychotherapy with and without booster sessions for recurrent depressive episodes. We synthesized published data on the epidemiology of depression, treatment efficacy, and costs to parameterize our model, and used data from developing countries where available. Outcomes included quality-adjusted life expectancy (QALY), lifetime costs, and incremental cost-effectiveness ratios (ICER). Costs were expressed in international dollars (I$) to facilitate comparisons across settings and studies. In Uganda, group psychotherapy without booster sessions decreased average number of depressive episodes by 6.2%, compared to no intervention; with booster sessions, reduction in number of episodes increased to 15.8%. Although group psychotherapy alone was less costly than psychotherapy with booster sessions, the ICER was higher, and therefore, group psychotherapy without booster sessions was dominated. The ICER associated with psychotherapy with booster sessions was I$ 1,150 per QALY, compared to no intervention. Although higher than previously published cost-effectiveness

  20. Monoclonal surface display SELEX for simple, rapid, efficient, and cost-effective aptamer enrichment and identification.

    PubMed

    Zhu, Zhi; Song, Yanling; Li, Cong; Zou, Yuan; Zhu, Ling; An, Yuan; Yang, Chaoyong James

    2014-06-17

    A novel method, monoclonal surface display SELEX (MSD-SELEX), has been designed for simple, rapid, efficient, and cost-effective enrichment and identification of aptamers from a library of monoclonal DNA-displaying beads produced via highly parallel single-molecule emulsion PCR. The approach was successfully applied for the identification of high-affinity aptamers that bind specifically to different types of targets, including cancer biomarker protein EpCAM and small toxin molecule aflatoxin B1. Compared to the conventional sequencing-chemical synthesis-screening work flow, MSD-SELEX avoids large-scale DNA sequencing, expensive and time-consuming DNA synthesis, and labor-intensive screening of large populations of candidates, thus offering a new approach for simple, rapid, efficient, and cost-effective aptamer identification for a wide variety of applications.

  1. Cost-Effective Solar Thermal Energy Storage: Thermal Energy Storage With Supercritical Fluids

    SciTech Connect

    2011-02-01

    Broad Funding Opportunity Announcement Project: UCLA and JPL are creating cost-effective storage systems for solar thermal energy using new materials and designs. A major drawback to the widespread use of solar thermal energy is its inability to cost-effectively supply electric power at night. State-of-the-art energy storage for solar thermal power plants uses molten salt to help store thermal energy. Molten salt systems can be expensive and complex, which is not attractive from a long-term investment standpoint. UCLA and JPL are developing a supercritical fluid-based thermal energy storage system, which would be much less expensive than molten-salt-based systems. The team’s design also uses a smaller, modular, single-tank design that is more reliable and scalable for large-scale storage applications.

  2. Cost-effectiveness of drug therapies for Alzheimer’s disease: A brief review

    PubMed Central

    Geldmacher, David S

    2008-01-01

    Alzheimer’s disease (AD) is an important and rapidly expanding public health problem. Its large economic burden is a result of its disabling nature, chronicity, and high prevalence in older segments of the population. Current treatments of AD have been criticized for providing insufficient benefit to justify their costs, but variability in assessing both costs and benefits make evaluation of the existing data problematic. Inclusion of the value of caregiver time is a major driver of the determination of cost-effectiveness. Population-based studies and those based on application of economic models to other study outcomes tend to identify greater cost-effectiveness than prospectively collected data. Differences in healthcare economics across countries also limit generalization of specific study findings. The current state of evidence suggests that treatment decisions in AD should be based on assessment of benefit in individual patients rather than broader societal economic factors. PMID:18830441

  3. Cost effectiveness and reliability improvement capabilities of CHECWORKS and SWIPS based inspection and maintenance plans

    SciTech Connect

    Singh, S.; Borodotsky, A.

    1996-11-01

    CHECWORKS and SWIPS are computer programs that undertaken degradation analysis and generate prioritized lists for scheduling inspections. A simplified analysis presented in this paper demonstrates that application of such computer aided degeneration analysis and prioritized list based I and M plans can achieve full system reliability along with high cost effectiveness. For purposes of developing insight and a basic understanding, relative cost-effectiveness and system reliability improvement analysis is conducted on a small service water system for five types of inspection and maintenance plans. The following plans are considered: a full inspection plan, a random sampling plan, an experienced based sampling plan, a computer aided degeneration analysis based plan, and a superman based plan. The results obtained show that a computer aided inspection plan is the most effective of the feasible plans. For a realistic system, the plan can pay for the analysis cost and generate additional cost savings while maintaining full system reliability.

  4. 40 CFR 62.15010 - Is my municipal waste combustion unit covered by this subpart?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Is my municipal waste combustion unit... FACILITIES AND POLLUTANTS Federal Plan Requirements for Small Municipal Waste Combustion Units Constructed on or Before August 30, 1999 Applicability of This Subpart § 62.15010 Is my municipal waste...

  5. 40 CFR 62.15010 - Is my municipal waste combustion unit covered by this subpart?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 8 2011-07-01 2011-07-01 false Is my municipal waste combustion unit... FACILITIES AND POLLUTANTS Federal Plan Requirements for Small Municipal Waste Combustion Units Constructed on or Before August 30, 1999 Applicability of This Subpart § 62.15010 Is my municipal waste...

  6. 40 CFR 62.15010 - Is my municipal waste combustion unit covered by this subpart?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 9 2014-07-01 2014-07-01 false Is my municipal waste combustion unit... FACILITIES AND POLLUTANTS Federal Plan Requirements for Small Municipal Waste Combustion Units Constructed on or Before August 30, 1999 Applicability of This Subpart § 62.15010 Is my municipal waste combustion...

  7. 40 CFR 62.15010 - Is my municipal waste combustion unit covered by this subpart?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 9 2013-07-01 2013-07-01 false Is my municipal waste combustion unit... FACILITIES AND POLLUTANTS Federal Plan Requirements for Small Municipal Waste Combustion Units Constructed on or Before August 30, 1999 Applicability of This Subpart § 62.15010 Is my municipal waste combustion...

  8. 40 CFR 62.15010 - Is my municipal waste combustion unit covered by this subpart?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 9 2012-07-01 2012-07-01 false Is my municipal waste combustion unit... FACILITIES AND POLLUTANTS Federal Plan Requirements for Small Municipal Waste Combustion Units Constructed on or Before August 30, 1999 Applicability of This Subpart § 62.15010 Is my municipal waste combustion...

  9. Cost effectiveness of statins in coronary heart disease

    PubMed Central

    Franco, O.; Peeters, A.; Looman, C.; Bonneux, L.

    2005-01-01

    Introduction: Statin therapy reduces the rate of coronary heart disease, but high costs in combination with a large population eligible for treatment ask for priority setting. Although trials agree on the size of the benefit, economic analyses of statins report contradictory results. This article reviewed cost effectiveness analyses of statins and sought to synthesise cost effectiveness ratios for categories of risk of coronary heart disease and age. Methods: The review searched for studies comparing statins with no treatment for the prevention of either cardiovascular or coronary heart disease in men and presenting cost per years of life saved as outcome. Estimates were extracted, standardised for calendar year and currency, and stratified by categories of risk, age, and funding source Results: 24 studies were included (from 50 retrieved), yielding 216 cost effectiveness ratios. Estimated ratios increase with decreasing risk. After stratification by risk, heterogeneity of ratios is large varying from savings to $59 000 per life year saved in the highest risk category and from $6500 to $490 000 in the lowest category. The pooled estimates show values of $21571 per life year saved for a 10 year coronary heart disease risk of 20% and $16862 per life year saved for 10 year risk of 30%. Conclusion: Statin therapy is cost effective for high levels of risk, but inconsistencies exist at lower levels. Although the cost effectiveness of statins depends mainly on absolute risk, important heterogeneity remains after adjusting for absolute risk. Economic analyses need to increase their transparency to reduce their vulnerability to bias and increase their reproducibility. PMID:16234419

  10. The Cost-Effectiveness Analysis of Teleglaucoma Screening Device

    PubMed Central

    Thomas, Sera

    2015-01-01

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

  11. Cost-effectiveness of rotavirus vaccination programs in Taiwan.

    PubMed

    Chang, Wan-Chi; Yen, Catherine; Chi, Cheng-Liang; Wu, Fang-Tzy; Huang, Yhu-Chering; Lin, Jen-Shiou; Huang, Fu-Chen; Tate, Jacqueline E; Wu, Ho-Sheng; Hsiung, Chao A

    2013-11-04

    In Taiwan, two rotavirus vaccines are available on the private market, but are not included in the National Immunization Program (NIP). To help assess whether to include rotavirus vaccines in the NIP, we examined the potential impact and cost-effectiveness of vaccination, from the health care system perspective alone. We used a Microsoft Excel-based model to assess rotavirus vaccination impact on rotavirus disease burden and the cost-effectiveness of 2-dose and 3-dose vaccination programs among a birth cohort of Taiwanese children followed for 5 years. Principal model inputs included data on rotavirus disease burden and related healthcare costs, vaccination cost and coverage rates, and vaccine efficacy. Principal model outputs included the number of health-related events and costs averted and incremental cost per disability-adjusted life year averted. A national rotavirus vaccination program, regardless of number of doses per course, would prevent 4 deaths, >10,500 hospitalizations, and >64,000 outpatient visits due to rotavirus infection among children <5 years annually, resulting in ~80%, 90%, and 70% declines in these outcomes, respectively, and a ~$7 million decline in annual medical costs. A national 2- or 3-dose vaccination program would be cost-saving up to $13.30/dose ($26.60/course) or $7.98/dose ($23.94/course), respectively; very cost-effective up to $24.08 per dose ($48.16/course) or $15.18/dose ($45.54/course), respectively; and cost-effective up to $45.65/dose ($91.30/course) or $29.59/dose ($88.77/course), respectively. A national rotavirus vaccination program could substantially reduce rotavirus disease burden among Taiwanese children and be potentially cost-effective, depending on the vaccine price. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Cost-effectiveness of a national public access defibrillation programme.

    PubMed

    Moran, Patrick S; Teljeur, Conor; Masterson, Siobhán; O'Neill, Michelle; Harrington, Patricia; Ryan, Máirín

    2015-06-01

    Proposed Irish legislation aimed at increasing survival from out-of-hospital-cardiac-arrest (OHCA) mandates the provision of automated external defibrillators (AEDs) in a comprehensive range of publicly accessible premises in urban and rural areas. This study estimated the clinical and cost effectiveness of the legislation, compared with alternative programme configurations involving more targeted AED placement. We used a cost-utility analysis to estimate the costs and consequences of public access defibrillation (PAD) programmes from a societal perspective, based on AED deployment by building type. Comparator programmes ranged from those that only included building types with the highest incidence of OHCA, to the comprehensive programme outline in the proposed legislation. Data on OHCA incidence and outcomes were obtained from the Irish Out-of-Hospital-Cardiac-Arrest Register (OHCAR). Costs were obtained from the Irish health service, device suppliers and training providers. The incremental cost effectiveness ratio (ICER) for the most comprehensive PAD scheme was €928,450/QALY. The ICER for the most scaled-back programme involving AED placement in transport stations, medical practices, entertainment venues, schools (excluding primary) and fitness facilities was €95,640/QALY. A 40% increase in AED utilisation when OHCAs occur in a public area could potentially render this programme cost effective. National PAD programmes involving widespread deployment of static AEDs are unlikely to be cost-effective. To improve cost-effectiveness any prospective programmes should target locations with the highest incidence of OHCA and be supported by efforts to increase AED utilisation, such as improving public awareness, increasing CPR and AED training, and establishing an EMS-linked AED register. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Cost effectiveness of the implantable cardioverter defibrillator: a preliminary analysis

    PubMed Central

    O'Brien, Bernie J; Buxton, Martin J; Rushby, Julia A

    1992-01-01

    Background—An implantable cardioverter defibrillator (ICD) may be effective in reducing the risk of sudden cardiac death. The high cost of ICD treatment, however, compared with alternatives raises the question of whether this new technology is an efficient use of scarce health care resources. Objective—To estimate the incremental cost effectiveness of the implantable cardioverter defibrillator compared with drug treatment with amiodarone in the management of patients at high risk of sudden cardiac death. Design—A cost effectiveness model was constructed from data already published and other secondary sources. Differences in patient survival were calculated from life tables for comparable ICD and amiodarone patient series. Costs were based on typical patient management protocols derived from current United Kingdom practice and interviews with physicians. Main outcome measures—Cost effectiveness of ICD treatment was computed over 20 years; all future costs and effects were discounted at 6% per year. Results—Estimated life expectancy was 11·1 and 6·7 years with ICD and amiodarone respectively; the discounted 20 year difference lies in the range 1·7 to 3·7 years. Discounted 20 year treatment costs were £28 400 for the ICD and £2300 for amiodarone. Cost effectiveness of ICD treatment lies in the range of £15 400 to £8200 per life-year gained. Conclusions—Cost effectiveness of ICD treatment is similar to some existing cardiac programmes funded under the NHS but uncertainty exists due to limitations of the data. Costs of ICD treatment may fall in the future as the life of the device increases and less invasive implantation methods are needed. The effectivess of ICD compared with amiodarone is currently being studied by a randomised controlled trial. PMID:1389748

  14. Cost-effectiveness of Apligraf in the treatment of venous leg ulcers.

    PubMed

    Sibbald, R G; Torrance, G W; Walker, V; Attard, C; MacNeil, P

    2001-08-01

    Venous ulcers are the most common chronic wounds of the lower leg. Skin substitutes recently have been introduced to stimulate nonhealing wounds. To conduct an incremental cost-effectiveness analysis, a model was developed to compare the four-layer bandage system, with and without one application of skin substitute, for the outpatient treatment of venous leg ulcers. The model estimated the costs and consequences of treatment with and without the skin substitute application. Two analytic horizons were explored: 3 months and 6 months. Determined by seven physicians, data and assumptions for the 3-month model were based on information from a clinical trial, published studies, and clinical experience. Data for the 6-month model were extrapolated from the shorter model. The model results indicate that over 3 months, the use of the skin substitute provided a benefit of 22 ulcer days averted per patient at an incremental cost of $304 (societal). The incremental cost-effectiveness ratio was $14 per ulcer day averted. Over 6 months, the incremental cost-effectiveness ratio was less than $5 per ulcer-day averted. The skin substitute plus a four-layer bandage was more costly and more effective than the four-layer bandage alone. The skin substitute is increasingly cost-effective over a longer analytic horizon and in a subgroup of patients with ulcers of long duration (greater than 1-year duration at baseline). The results come from a model that is based on a series of estimates and assumptions, and accordingly, confirmation of this finding in a prospective study is encouraged.

  15. More sense for less cents: Cost effective servicing of remote sensing satellites

    NASA Technical Reports Server (NTRS)

    Lee, Jeannie; Misencik, Tom; Robertson, Bill; Sliney, Jack

    1993-01-01

    This paper addresses the design considerations for Earth observation spacecraft bus and payload subsystems such that cost-effective spacecraft maintainability is enhanced through optimized reliability and the application of robotic on-orbit support. In the past, for most satellites, maintainability has been associated with the clever application of telemetry reconfiguration and the use of redundant systems as necessary over the life cycle of the spacecraft. This presentation addresses the opportunities and challenges of leveraging the extensive work already accomplished in the development of on-orbit servicing technologies.

  16. More sense for less cents: Cost effective servicing of remote sensing satellites

    NASA Technical Reports Server (NTRS)

    Lee, Jeannie; Misencik, Tom; Robertson, Bill; Sliney, Jack

    1993-01-01

    This paper addresses the design considerations for Earth observation spacecraft bus and payload subsystems such that cost-effective spacecraft maintainability is enhanced through optimized reliability and the application of robotic on-orbit support. In the past, for most satellites, maintainability has been associated with the clever application of telemetry reconfiguration and the use of redundant systems as necessary over the life cycle of the spacecraft. This presentation addresses the opportunities and challenges of leveraging the extensive work already accomplished in the development of on-orbit servicing technologies.

  17. Cost-effectiveness of pneumococcal conjugate vaccination in Croatia.

    PubMed

    Vučina, V Višekruna; Filipović, S Kurečić; Kožnjak, N; Stamenić, V; Clark, A D; Mounaud, B; Blau, J; Hoestlandt, C; Kaić, B

    2015-05-07

    Pneumococcus is a known cause of meningitis, pneumonia, sepsis, and acute otitis media in children and adults globally. Two new vaccines for children have the potential to prevent illness, disability, and death, but these vaccines are expensive. The Croatian Ministry of Health has considered introducing the vaccine in the past, but requires economic evidence to ensure that the limited funds available for health care will be used in the most effective way. Croatia appointed a multidisciplinary team of experts to evaluate the cost-effectiveness of introducing pneumococcal conjugate vaccination (PCV) into the national routine child immunization program. Both 10-valent and 13-valent PCV (PCV10 and PCV13) were compared to a scenario assuming no vaccination. The TRIVAC decision-support model was used to estimate cost-effectiveness over the period 2014-2033. We used national evidence on demographics, pneumococcal disease incidence and mortality, the age distribution of disease in children, health service utilization, vaccine coverage, vaccine timeliness, and serotype coverage. Vaccine effectiveness was based on evidence from the scientific literature. Detailed health care costs were not available from the Croatian Institute for Health Insurance at the time of the analysis so assumptions and World Health Organization (WHO) estimates for Croatia were used. We assumed a three-dose primary vaccination schedule, and an initial price of US$ 30 per dose for PCV10 and US$ 35 per dose for PCV13. We ran univariate sensitivity analyses and multivariate scenario analyses. Either vaccine is estimated to prevent approximately 100 hospital admissions and one death each year in children younger than five in Croatia. Compared to no vaccine, the discounted cost-effectiveness of either vaccine is estimated to be around US$ 69,000-77,000 per disability-adjusted life-years (DALYs) averted over the period 2014-2033 (from the government or societal perspective). Only two alternative scenarios

  18. When cost-effective interventions are unaffordable: Integrating cost-effectiveness and budget impact in priority setting for global health programs.

    PubMed

    Bilinski, Alyssa; Neumann, Peter; Cohen, Joshua; Thorat, Teja; McDaniel, Katherine; Salomon, Joshua A

    2017-10-01

    Potential cost-effective barriers in cost-effectiveness studies mean that budgetary impact analyses should also be included in post-2015 Sustainable Development Goal projects says Joshua Salomon and colleagues.

  19. Cost-effectiveness of caries excavations in different risk groups - a micro-simulation study.

    PubMed

    Schwendicke, Falk; Paris, Sebastian; Stolpe, Michael

    2014-12-15

    Whilst being the most prevalent disease worldwide, dental caries is increasingly concentrated in high-risk populations. New caries treatments should therefore be evaluated not only in terms of their cost-effectiveness in individuals, but also their effects on the distribution of costs and benefits across different populations. To treat deep caries, there are currently three strategies: selective (one-step incomplete), stepwise (two-step incomplete) and complete excavation. Building on prior research that found selective excavation generally cost-effective, we compared the costs-effectiveness of different excavations in low- and high-risk patients, hypothesizing that selective excavation had greater cost-effectiveness-advantages in patients with high compared with low risk. An average tooth-level Markov-model was constructed following the posterior teeth in an initially 18-year old male individual, either with low or high risk, over his lifetime. Risk was assumed to be predicted by several parameters (oral hygiene, social position, dental service utilization), with evidence-based transition probabilities or hazard functions being adjusted for different risk status where applicable. Total lifetime treatment costs were estimated for German healthcare, with both mixed public-private and only private out-of-pocket costs being calculated. For cost-effectiveness-analysis, micro-simulations were performed and joint parameter uncertainty introduced by random sampling of probabilities. Cohort analyses were used for assessing the underlying reasons for potential differences between strategies and populations. Selective excavation was more effective and less costly than both alternatives regardless of an individual's risk. All three strategies were less effective and more costly in patients with high compared with low risk, whilst the differences between risk groups were smallest for selective excavation. Thus, the cost-effectiveness-advantages of selective excavation were

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

    PubMed

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

    2004-09-01

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

  1. Cost-Effectiveness of a Central Venous Catheter Care Bundle

    PubMed Central

    Halton, Kate A.; Cook, David; Paterson, David L.; Safdar, Nasia; Graves, Nicholas

    2010-01-01

    Background A bundled approach to central venous catheter care is currently being promoted as an effective way of preventing catheter-related bloodstream infection (CR-BSI). Consumables used in the bundled approach are relatively inexpensive which may lead to the conclusion that the bundle is cost-effective. However, this fails to consider the nontrivial costs of the monitoring and education activities required to implement the bundle, or that alternative strategies are available to prevent CR-BSI. We evaluated the cost-effectiveness of a bundle to prevent CR-BSI in Australian intensive care patients. Methods and Findings A Markov decision model was used to evaluate the cost-effectiveness of the bundle relative to remaining with current practice (a non-bundled approach to catheter care and uncoated catheters), or use of antimicrobial catheters. We assumed the bundle reduced relative risk of CR-BSI to 0.34. Given uncertainty about the cost of the bundle, threshold analyses were used to determine the maximum cost at which the bundle remained cost-effective relative to the other approaches to infection control. Sensitivity analyses explored how this threshold alters under different assumptions about the economic value placed on bed-days and health benefits gained by preventing infection. If clinicians are prepared to use antimicrobial catheters, the bundle is cost-effective if national 18-month implementation costs are below $1.1 million. If antimicrobial catheters are not an option the bundle must cost less than $4.3 million. If decision makers are only interested in obtaining cash-savings for the unit, and place no economic value on either the bed-days or the health benefits gained through preventing infection, these cost thresholds are reduced by two-thirds. Conclusions A catheter care bundle has the potential to be cost-effective in the Australian intensive care setting. Rather than anticipating cash-savings from this intervention, decision makers must be prepared

  2. Cost-effectiveness of norovirus vaccination in children in Peru.

    PubMed

    Mirelman, Andrew J; Ballard, Sarah Blythe; Saito, Mayuko; Kosek, Margaret N; Gilman, Robert H

    2015-06-17

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

  3. Cost-effectiveness of automated external defibrillators on airlines.

    PubMed

    Groeneveld, P W; Kwong, J L; Liu, Y; Rodriguez, A J; Jones, M P; Sanders, G D; Garber, A M

    2001-09-26

    Installation of automated external defibrillators (AEDs) on passenger aircraft has been shown to improve survival of cardiac arrest in that setting, but the cost-effectiveness of such measures has not been proven. To examine the costs and effectiveness of several different options for AED deployment in the US commercial air transportation system. Decision and cost-effectiveness analysis of a strategy of full deployment on all aircraft as well as several strategies of partial deployment only on larger aircraft, compared with a baseline strategy of no AEDs on aircraft (but training flight attendants in basic life support) for a hypothetical cohort of persons experiencing cardiac arrest aboard US commercial aircraft. Estimates for costs and outcomes were obtained from the medical literature, the Federal Aviation Administration, the Air Transport Association of America, a population-based cohort of Medicare patients, AED manufacturers, and the Bureau of Labor Statistics. Quality-adjusted survival after cardiac arrest; costs of AED deployment on aircraft and of medical care for cardiac arrest survivors. Adding AEDs on passenger aircraft with more than 200 passengers would cost $35 300 per quality-adjusted life-year (QALY) gained. Additional AEDs on aircraft with capacities between 100 and 200 persons would cost an additional $40 800 per added QALY compared with deployment on large-capacity aircraft only, and full deployment on all passenger aircraft would cost an additional $94 700 per QALY gained compared with limited deployment on aircraft with capacity greater than 100. Sensitivity analyses indicated that the quality of life, annual mortality rate, and the effectiveness of AEDs in improving survival were the most influential factors in the model. In 85% of Monte Carlo simulations, AED placement on large-capacity aircraft produced cost-effectiveness ratios of less than $50 000 per QALY. The cost-effectiveness of placing AEDs on commercial aircraft compares favorably

  4. Cost-effectiveness of human papillomavirus vaccination in Germany.

    PubMed

    Damm, Oliver; Horn, Johannes; Mikolajczyk, Rafael T; Kretzschmar, Mirjam E E; Kaufmann, Andreas M; Deleré, Yvonne; Ultsch, Bernhard; Wichmann, Ole; Krämer, Alexander; Greiner, Wolfgang

    2017-01-01

    The aim of this study was to assess the cost-effectiveness of human papillomavirus (HPV) vaccination in addition to the current cervical cancer screening programme in Germany using a dynamic transmission model. Based on a mathematical model simulating the transmission dynamics and the natural history of HPV infection and associated diseases (cervical intraepithelial neoplasia, cervical cancer, and genital warts), we estimated the epidemiological and economic consequences of HPV vaccination with both the quadrivalent and bivalent vaccines. In our base case analysis, we assessed the cost-effectiveness of vaccinating 12-year-old girls with a 3-dose schedule. In sensitivity analysis, we also evaluated the use of a 2-dose schedule and assessed the impact of vaccinating boys. From a health care payer perspective, incremental cost-effectiveness ratios (ICERs) of a 3-dose schedule were €34,249 per quality-adjusted life year (QALY) for the bivalent and €14,711 per QALY for the quadrivalent vaccine. Inclusion of indirect costs decreased ICERs by up to 40%. When adopting a health care payer perspective, ICERs of a 2-dose approach decreased to €19,450 per QALY for the bivalent and to €3645 per QALY for the quadrivalent vaccine. From a societal perspective, a 2-dose approach using the quadrivalent vaccine was a cost-saving strategy while using the bivalent vaccine resulted in an ICER of €13,248 per QALY. Irrespective of the perspective adopted, additional vaccination of boys resulted in ICERs exceeding €50,000 per QALY, except for scenarios with low coverage (20%) in girls. Our model results suggest that routine HPV vaccination of 12-year-old girls with three doses is likely to be cost-effective in Germany. Due to the additional impact on genital warts, the quadrivalent vaccine appeared to be more cost-effective than the bivalent vaccine. A 2-dose schedule of the quadrivalent vaccine might even lead to cost savings when adopting a societal perspective. The cost-effectiveness

  5. Cost-effectiveness of Bariatric Surgery in Adolescents With Obesity.

    PubMed

    Klebanoff, Matthew J; Chhatwal, Jagpreet; Nudel, Jacob D; Corey, Kathleen E; Kaplan, Lee M; Hur, Chin

    2017-02-01

    Severe obesity affects 4% to 6% of US youth and is increasing in prevalence. Bariatric surgery for the treatment of adolescents with severe obesity is becoming more common, but data on cost-effectiveness are limited. To assess the cost-effectiveness of bariatric surgery for adolescents with obesity using recently published results from the Teen-Longitudinal Assessment of Bariatric Surgery study. A state-transition model was constructed to compare 2 strategies: no surgery and bariatric surgery. In the no surgery strategy, patients remained at their initial body mass index (calculated as weight in kilograms divided by height in meters squared) over time. In the bariatric surgery strategy, patients were subjected to risks of perioperative mortality and complications as well as initial morbidity but also experienced longer-term quality-of-life improvements associated with weight loss. Cohort demographic information-of the 228 patients included, the mean (SD) age was 17 (1.6) years, the mean (range) body mass index was 53 (34-88), and 171 (75.0%) were female-surgery-related outcomes, and base case time horizon (3 years) were based on data from the Teen-Longitudinal Assessment of Bariatric Surgery study. One-way and probabilistic sensitivity analyses were performed. Quality-adjusted life-years (QALYs), total costs (in US dollars adjusted to 2015-year values using the Consumer Price Index), and incremental cost-effectiveness ratios (ICERs). A willingness-to-pay threshold of $100 000 per QALY was used to assess cost-effectiveness. After 3 years, surgery led to a gain of 0.199 QALYs compared with no surgery at an incremental cost of $30 747, yielding an unfavorable ICER of $154 684 per QALY. When the clinical study results were extrapolated to 4 years, the ICER decreased to $114 078 per QALY and became cost-effective by 5 years with an ICER of $91 032 per QALY. Outcomes were robust in most 1-way and probabilistic sensitivity analyses. Bariatric surgery incurs

  6. Wind Power for Municipal Utilities

    SciTech Connect

    Not Available

    2002-10-01

    Wind Power for Municipal Utilities is a trifold brochure that strives to educate municipal utility owners and operators about the benefits of investing in wind power development. It provides examples of municipal utilities that have successful wind energy projects and supportive statements from industry members.

  7. How EPA's Asbestos Regulations Apply to Municipal Demolition Activities

    EPA Pesticide Factsheets

    Memos about the Asbestos National Emissions Standard for Hazardous Air Pollutants provide clarification on demolition concerns such as the definition of a facility, and the applicability of asbestos NESHAP to structures demolished by municipal entities.

  8. Framework for life cycle sustainability assessment of municipal solid waste management systems with an application to a case study in Thailand.

    PubMed

    Menikpura, S N M; Gheewala, Shabbir H; Bonnet, Sébastien

    2012-07-01

    At present, there are many environmental, economic and social problems associated with poor municipal solid waste (MSW) management in Thailand. The development of sustainable solid waste management systems is a crucial aspect and should be based on an integrated approach. Therefore, an integrated system was designed for Nonthaburi Municipality incorporating recycling, anaerobic digestion, incineration and landfill technologies. In order to assess sustainability, a clear methodology was developed via life cycle thinking and a set of endpoint composite indicators has been proposed considering the most critical ultimate damages/effects of MSW management on the environment, the economy and society. The results showed that the appropriate integration of technologies offers important prospects with regards to socio-economic and environmental aspects, contributing, therefore, to improved sustainability for the overall MSW management system. The methodology and the proposed indicators would be useful in strategic planning, including decision- and policy-making with respect to the development of appropriate sustainable MSW management systems.

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

    USGS Publications Warehouse

    Waite, L.A.

    1987-01-01

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

  10. Schizophrenia interventions in Vietnam: primary results from a cost-effectiveness study.

    PubMed

    Anh, Nguyen Quynh; Linh, Bui Ngoc; Ha, Nguyen Thu; Phanthunane, Pudtan; Huong, Nguyen Thanh

    2015-01-01

    Schizophrenia is a highly disabling mental health disorder that imposes a considerable economic burden on a health care system. This paper aimed to examine the cost and effectiveness of alternative pharmaceutical interventions and the effects of family intervention (FI) for schizophrenia from the government perspective in order to introduce the most cost-effective intervention applicable to Vietnam. A Markov model was developed to estimate costs and health outcome over patients' lifetimes when using typical and atypical antipsychotic drugs, alone or in combination with family intervention. Health outcome was measured in terms of disability-adjusted life years averted. Monte Carlo simulation was used for uncertainty analysis. According to our findings, interventions using typical or atypical drugs combined with FI were found to be the most effective and least costly compared to a 'do-nothing' scenario. Interventions using atypical drugs alone were estimated to be much less favourable due to a considerably higher cost. This is a very first attempt on cost-effectiveness analysis of interventions for schizophrenia in Vietnam, and recommendations are made for future research to determine the most cost-effective intervention.

  11. Cost-effectiveness of Implantable Cardioverter-Defibrillators in Children with Dilated Cardiomyopathy

    PubMed Central

    Feingold, Brian; Arora, Gaurav; Webber, Steven A.; Smith, Kenneth J.

    2010-01-01

    Background Implantable cardioverter-defibrillators (ICDs) improve survival and are cost-effective in adults with poor left ventricular function. Because of differences in heart failure etiology, sudden death rates, and ICD complication rates, these findings may not be applicable to children. Methods and Results We developed a Markov model to compare typical management of childhood dilated cardiomyopathy with symptomatic heart failure to prophylactic ICD implantation plus typical management. Model costs included costs of outpatient care, medications, complications, and transplantation. Time horizon was up to 20 years from model entry. Total costs were $433,000 (ICD strategy) and $355,000 (typical management). Although quality adjusted survival was greater in the ICD group (6.78 vs. 6.43 quality adjusted life-years, QALYs), the incremental cost-utility ratio was $281,622/QALY saved with the ICD strategy. In sensitivity analyses, the ICD strategy cost less than the $100,000/QALY benchmark for cost-effectiveness only when the annual probability of sudden death exceeded 13% or when strong, sustained benefits in QOL due to the ICD were assumed. Conclusions Prophylactic ICD use in children with dilated cardiomyopathy, poor ventricular function, and symptomatic heart failure does not appear to be cost-effective. This is likely due to lower sudden death rates in this population. PMID:20797597

  12. Bayesian models for cost-effectiveness analysis in the presence of structural zero costs

    PubMed Central

    Baio, Gianluca

    2014-01-01

    Bayesian modelling for cost-effectiveness data has received much attention in both the health economics and the statistical literature, in recent years. Cost-effectiveness data are characterised by a relatively complex structure of relationships linking a suitable measure of clinical benefit (e.g. quality-adjusted life years) and the associated costs. Simplifying assumptions, such as (bivariate) normality of the underlying distributions, are usually not granted, particularly for the cost variable, which is characterised by markedly skewed distributions. In addition, individual-level data sets are often characterised by the presence of structural zeros in the cost variable. Hurdle models can be used to account for the presence of excess zeros in a distribution and have been applied in the context of cost data. We extend their application to cost-effectiveness data, defining a full Bayesian specification, which consists of a model for the individual probability of null costs, a marginal model for the costs and a conditional model for the measure of effectiveness (given the observed costs). We presented the model using a working example to describe its main features. © 2013 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd. PMID:24343868

  13. High-performance, cost-effective computer and video interfacing to megapixel flat panel displays (FPDs)

    NASA Astrophysics Data System (ADS)

    Wedding, Carol A.; Stoller, Ray A.

    1994-04-01

    In the Information Age of multimedia computer and presentation, video-telephone conferencing and interactive television, display designs have increased demands for even higher resolution, greater definition, increased color palette, higher speed and large size. These performance demands are required on equipment that is space efficient, transportable, and usable in commercial, industrial and military applications. FPD designs are flourishing because the CRT is neither space efficient or easily transportable, nor cost effective in larger sizes and in ruggedized form. In addition, communications and computing systems for high definition imaging information are based on digital interfacing rather than analog. A video digital interface (VDI) is therefore more cost effective and higher performance for FPDs which use data directly from the computer system and circumvent the analog and rescan conversions that occur for CRTs. Photonics has developed and produces high resolution AC plasma FPDs that can accept both in analog or digital form imaging information that is presented at up to 75 frames per second, 1280 X 1024 full color pixel resolution and 8 bits of gray scale per color channel. This paper explores cost effective and high performance capabilities of the FPD-VDI and how it integrated with high definition computer and communications systems.

  14. Bayesian models for cost-effectiveness analysis in the presence of structural zero costs.

    PubMed

    Baio, Gianluca

    2014-05-20

    Bayesian modelling for cost-effectiveness data has received much attention in both the health economics and the statistical literature, in recent years. Cost-effectiveness data are characterised by a relatively complex structure of relationships linking a suitable measure of clinical benefit (e.g. quality-adjusted life years) and the associated costs. Simplifying assumptions, such as (bivariate) normality of the underlying distributions, are usually not granted, particularly for the cost variable, which is characterised by markedly skewed distributions. In addition, individual-level data sets are often characterised by the presence of structural zeros in the cost variable. Hurdle models can be used to account for the presence of excess zeros in a distribution and have been applied in the context of cost data. We extend their application to cost-effectiveness data, defining a full Bayesian specification, which consists of a model for the individual probability of null costs, a marginal model for the costs and a conditional model for the measure of effectiveness (given the observed costs). We presented the model using a working example to describe its main features. © 2013 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

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

    PubMed

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

    2015-12-29

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

  16. Cost-effective conservation of amphibian ecology and evolution.

    PubMed

    Campos, Felipe S; Lourenço-de-Moraes, Ricardo; Llorente, Gustavo A; Solé, Mirco

    2017-06-01

    Habitat loss is the most important threat to species survival, and the efficient selection of priority areas is fundamental for good systematic conservation planning. Using amphibians as a conservation target, we designed an innovative assessment strategy, showing that prioritization models focused on functional, phylogenetic, and taxonomic diversity can include cost-effectiveness-based assessments of land values. We report new key conservation sites within the Brazilian Atlantic Forest hot spot, revealing a congruence of ecological and evolutionary patterns. We suggest payment for ecosystem services through environmental set-asides on private land, establishing potential trade-offs for ecological and evolutionary processes. Our findings introduce additional effective area-based conservation parameters that set new priorities for biodiversity assessment in the Atlantic Forest, validating the usefulness of a novel approach to cost-effectiveness-based assessments of conservation value for other species-rich regions.

  17. [Cost-effectiveness of breast cancer screening policies in Mexico].

    PubMed

    Valencia-Mendoza, Atanacio; Sánchez-González, Gilberto; Bautista-Arredondo, Sergio; Torres-Mejía, Gabriela; Bertozzi, Stefano M

    2009-01-01

    Generate cost-effectiveness information to allow policy makers optimize breast cancer (BC) policy in Mexico. We constructed a Markov model that incorporates four interrelated processes of the disease: the natural history; detection using mammography; treatment; and other competing-causes mortality, according to which 13 different strategies were modeled. Strategies (starting age, % of coverage, frequency in years)= (48, 25, 2), (40, 50, 2) and (40, 50, 1) constituted the optimal method for expanding the BC program, yielding 75.3, 116.4 and 171.1 thousand pesos per life-year saved, respectively. The strategies included in the optimal method for expanding the program produce a cost per life-year saved of less than two times the GNP per capita and hence are cost-effective according to WHO Commission on Macroeconomics and Health criteria.

  18. Power and sample size in cost-effectiveness analysis.

    PubMed

    Laska, E M; Meisner, M; Siegel, C

    1999-01-01

    For resource allocation under a constrained budget, optimal decision rules for mutually exclusive programs require that the treatment with the highest incremental cost-effectiveness ratio (ICER) below a willingness-to-pay (WTP) criterion be funded. This is equivalent to determining the treatment with the smallest net health cost. The designer of a cost-effectiveness study needs to select a sample size so that the power to reject the null hypothesis, the equality of the net health costs of two treatments, is high. A recently published formula derived under normal distribution theory overstates sample-size requirements. Using net health costs, the authors present simple methods for power analysis based on conventional normal and on nonparametric statistical theory.

  19. Development of cost-effective biocompatible packaging for microelectronic devices.

    PubMed

    Qian, Karen; Malachowski, Karl; Fiorini, Paolo; Velenis, Dimitrios; de Beeck, Maaike Op; Van Hoof, Chris

    2011-01-01

    A cost-effective, miniaturized and biocompatible packaging method for medical devices is proposed, resulting in a small, soft and comfortable implantable package. Towards this end, the barrier materials and fabrication process for the individual die encapsulation are largely explored. We demonstrate that various common clean room materials are good candidates for preventing metal leaching into body. In accelerated tests at higher temperature, several conductive barrier materials are damaged by the test bio-fluid, suggesting insufficient resistance to body fluids in long term. Covering electrodes by noble metals will solve this problem. For metallization, noble metals as Pt are best candidates. CoO calculations showed that selective plating of Pt is more cost-effective than sputtering. To reduce the cost of a sputter process, Pt recycling is very important.

  20. Methodological considerations in the analysis of cost effectiveness in dentistry.

    PubMed

    Antczak-Bouckoms, A A; Tulloch, J F; White, B A; Capilouto, E I

    1989-01-01

    Cost-effectiveness analysis is a technique applied with increasing frequency to help make rational decisions in health care resource allocation. This article reviews the ten general principles of cost-effectiveness analysis outlined by the Office of Technology Assessment of the US Congress and describes a model for such analyses used widely in medicine, but only recently applied in dentistry. The imperative for the formulation of the best current information on both the effectiveness of dental practices and their costs is made more urgent because of the now universally recognized belief that resources available to meet the demands for health care are limited. Today's environment requires critical allocation decisions within categorical health problems, across diseases, or relative to other health problems. If important health benefits or cost savings are to be realized, then these analytic approaches must become widely understood, accepted, and appropriately applied by key decision makers in the dental health sector.