Sample records for demand side financing

  1. Demand-side financing measures to increase maternal health service utilisation and improve health outcomes: a systematic review of evidence from low- and middle-income countries.

    PubMed

    Murray, Susan F; Hunter, Benjamin M; Bisht, Ramila; Ensor, Tim; Bick, Debra

    2012-01-01

    In many countries financing for health services has traditionally been disbursed directly from governmental and non-governmental funding agencies to providers of services: the 'supply-side' of healthcare markets. Demand-side financing offers a supplementary model in which some funds are instead channelled through, or to, prospective users. In this review we considered evidence on five forms of demand-side financing that have been used to promote maternal health in developing countries: OBJECTIVES: The overall review objective was to assess the effects of demand-side financing interventions on maternal health service utilisation and on maternal health outcomes in low- and middle-income countries. Broader effects on perinatal and infant health, the situation of underprivileged women and the health care system were also assessed. This review considered poor, rural or socially excluded women of all ages who were either pregnant or within 42 days of the conclusion of pregnancy, the limit for postnatal care as defined by the World Health Organization. The review also considered the providers of services.The intervention of interest was any programme that incorporated demand-side financing as a mechanism to increase the consumption of goods and services that could impact on maternal health outcomes. This included the direct consumption of maternal health care goods and services as well as related 'merit goods' such as improved nutrition. We included systems in which potential users of maternal health services are financially empowered to make restricted decisions on buying maternal health-related goods or services - sometimes known as consumer-led demand-side financing. We also included programmes that provided unconditional cash benefits to pregnant women (for example in the form of maternity allowances), or to families with children under five years of age where there was evidence concerning maternal health outcomes.We aimed to include quantitative studies (experimental, observational and descriptive), qualitative studies (including designs based on phenomenology, grounded theory, ethnography, action research and feminist research), and economic studies (cost-effectiveness, cost-utility and costs studies). The Joanna Briggs Institute methodology for mixed-method systematic reviews was adopted. A three-step systematic search strategy was used to: 1) identify key terms, 2) search bibliographic databases and 3) retrieve additional publications from reference lists and sources of grey literature. Data were extracted from papers included in the review using the standardised data extraction tools for quantitative, qualitative and economic data from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information. The quantitative and economic findings are presented in narrative form. Qualitative research findings were pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. This involved the aggregation or synthesis of findings to generate a set of statements that represent that aggregation, through assembling the findings (Level 1 findings), and categorising these findings on the basis of similarity in meaning (Level 2 findings). These categories were then subjected to a meta-synthesis in order to produce a single comprehensive set of synthesised findings (Level 3 findings) that can be used as a basis for evidence-based practice or policy. Seventy-two studies were included in the review. Drawing on work from several continents, many of the included studies were reports and evaluations for relevant government or funding agencies and represented important lesson-learning about implementation issues. However, fewer than half were published in peer reviewed journals and few were of high research quality.For three modes of demand-side financing (conditional cash transfers, payments to offset costs of access to maternal healthcare, and vouchers for maternity services) we found evidence relevant to review questions on the utilisation of maternal health services, barriers to the provision of demand-side financing and supply-side preconditions to implementing demand-side financing schemes. There was insufficient evidence to provide comprehensive answers for review questions on the effect of demand-side financing interventions on maternal, perinatal and infant health outcomes and on the social and financial situation of underprivileged women. There was also insufficient evidence on the cost-effectiveness of demand-side financing interventions and preconditions for sustainability and scale-up of demand-side financing schemes.Salient recommendations for policymakers regarding demand-side financing for maternal health derived from the current evidence are:There is a pressing need for large, robust studies on the short- and longer-term impact of demand-side financing on maternal and infant mortality and morbidity, which should also reflect 'good practice' indicators such as the uptake and duration of exclusive breastfeeding and compliance with infant immunisation programmes. It is also important that the impact on outcomes of subsequent pregnancies is evaluated. Moderate and large-sized demand-side financing programmes that have recently or will soon be scaled up, such as those in Kenya, Uganda and Bangladesh, represent the most obvious sites for such evaluations, and lessons may be learnt from Mexico's PROGRESA/ Oportunidades about how to establish a well-embedded monitoring and rigorous evaluation structure.Other important areas that require further study include.

  2. Financing pharmaceuticals in transition economies.

    PubMed

    Kanavos, P

    1999-06-01

    This paper (a) provides a methodological taxonomy of pricing, financing, reimbursement, and cost containment methodologies for pharmaceuticals; (b) analyzes complex agency relationships and the health versus industrial policy tradeoff; (c) pinpoints financing measures to balance safety and effectiveness of medicines and their affordability by publicly funded systems in transition; and (d) highlights viable options for policy-makers for the financing of pharmaceuticals in transition. Three categories of measures and their implications for pharmaceutical policy cost containing are analyzed: supply-side measures, targeting manufacturers, proxy demand-side measures, targeting physicians and pharmacists, and demand-side measures, targeting patients. In pursuing supply side measures, we explore free pricing for pharmaceuticals, direct price controls, cost-plus and cost pricing, average pricing and international price comparisons, profit control, reference pricing, the introduction of a fourth hurdle, positive and negative lists, and other price control measures. The analysis of proxy-demand measures includes budgets for physicians, generic policies, practice guidelines, monitoring the authorizing behavior of physicians, and disease management schemes. Demand-side measures explore the effectiveness of patient co-payments, the impact of allowing products over-the-counter and health promotion programs. Global policies should operate simultaneously on the supply, the proxy demand, and the demand-side. Policy-making needs to have a continuous long-term planning. The importation of policies into transition economy may require extensive and expensive adaptation, and/or lead to sub-optimal policy outcomes.

  3. Decentralisation de l'enseignement: Financements Axes sur la Demande. Le Developpement en Marche. (Decentralization of Education. Demand Side Financing. Directions in Development.)

    ERIC Educational Resources Information Center

    Patrinos, Harry Anthony; Ariasingam, David Lakshmanan

    Central governments' supply-side expansions of schooling have not equally benefited all members of society, especially girls, indigenous peoples, tribal groups, disadvantaged minorities, and the poor. Public spending on education is often inefficient, higher education is subsidized at primary education's expense, and costs are becoming…

  4. Demand-Side Financing--A Focus on Vouchers in Post-Compulsory Education and Training: Discussion Paper and Case Studies. CEDEFOP Dossier.

    ERIC Educational Resources Information Center

    West, Anne; Sparkes, Jo; Balabanov, Todor

    The use of demand-side financing mechanisms and vouchers for postcompulsory secondary-level education was examined through case studies of funding practices in the following countries: Austria; France; the United Kingdom; the United States; and Wallonia (the French community of Belgium). Different models of voucher use were identified in the…

  5. Effects of demand-side financing on utilisation, experiences and outcomes of maternity care in low- and middle-income countries: a systematic review

    PubMed Central

    2014-01-01

    Background Demand-side financing, where funds for specific services are channelled through, or to, prospective users, is now employed in health and education sectors in many low- and middle-income countries. This systematic review aimed to critically examine the evidence on application of this approach to promote maternal health in these settings. Five modes were considered: unconditional cash transfers, conditional cash transfers, short-term payments to offset costs of accessing maternity services, vouchers for maternity services, and vouchers for merit goods. We sought to assess the effects of these interventions on utilisation of maternity services and on maternal health outcomes and infant health, the situation of underprivileged women and the healthcare system. Methods The protocol aimed for collection and synthesis of a broad range of evidence from quantitative, qualitative and economic studies. Nineteen health and social policy databases, seven unpublished research databases and 27 websites were searched; with additional searches of Indian journals and websites. Studies were included if they examined demand-side financing interventions to increase consumption of services or goods intended to impact on maternal health, and met relevant quality criteria. Quality assessment, data extraction and analysis used Joanna Briggs Institute standardised tools and software. Outcomes of interest included maternal and infant mortality and morbidity, service utilisation, factors required for successful implementation, recipient and provider experiences, ethical issues, and cost-effectiveness. Findings on Effectiveness, Feasibility, Appropriateness and Meaningfulness were presented by narrative synthesis. Results Thirty-three quantitative studies, 46 qualitative studies, and four economic studies from 17 countries met the inclusion criteria. Evidence on unconditional cash transfers was scanty. Other demand-side financing modes were found to increase utilisation of maternal healthcare in the index pregnancy or uptake of related merit goods. Evidence of effects on maternal and infant mortality and morbidity outcomes was insufficient. Important implementation aspects include targeting and eligibility criteria, monitoring, respectful treatment of beneficiaries, suitable incentives for providers, quality of care and affordable referral systems. Conclusions Demand-side financing schemes can increase utilisation of maternity services, but attention must be paid to supply-side conditions, the fine-grain of implementation and sustainability. Comparative studies and research on health impact and cost-effectiveness are required. PMID:24438560

  6. Effects of demand-side financing on utilisation, experiences and outcomes of maternity care in low- and middle-income countries: a systematic review.

    PubMed

    Murray, Susan F; Hunter, Benjamin M; Bisht, Ramila; Ensor, Tim; Bick, Debra

    2014-01-17

    Demand-side financing, where funds for specific services are channelled through, or to, prospective users, is now employed in health and education sectors in many low- and middle-income countries. This systematic review aimed to critically examine the evidence on application of this approach to promote maternal health in these settings. Five modes were considered: unconditional cash transfers, conditional cash transfers, short-term payments to offset costs of accessing maternity services, vouchers for maternity services, and vouchers for merit goods. We sought to assess the effects of these interventions on utilisation of maternity services and on maternal health outcomes and infant health, the situation of underprivileged women and the healthcare system. The protocol aimed for collection and synthesis of a broad range of evidence from quantitative, qualitative and economic studies. Nineteen health and social policy databases, seven unpublished research databases and 27 websites were searched; with additional searches of Indian journals and websites. Studies were included if they examined demand-side financing interventions to increase consumption of services or goods intended to impact on maternal health, and met relevant quality criteria. Quality assessment, data extraction and analysis used Joanna Briggs Institute standardised tools and software. Outcomes of interest included maternal and infant mortality and morbidity, service utilisation, factors required for successful implementation, recipient and provider experiences, ethical issues, and cost-effectiveness. Findings on Effectiveness, Feasibility, Appropriateness and Meaningfulness were presented by narrative synthesis. Thirty-three quantitative studies, 46 qualitative studies, and four economic studies from 17 countries met the inclusion criteria. Evidence on unconditional cash transfers was scanty. Other demand-side financing modes were found to increase utilisation of maternal healthcare in the index pregnancy or uptake of related merit goods. Evidence of effects on maternal and infant mortality and morbidity outcomes was insufficient. Important implementation aspects include targeting and eligibility criteria, monitoring, respectful treatment of beneficiaries, suitable incentives for providers, quality of care and affordable referral systems. Demand-side financing schemes can increase utilisation of maternity services, but attention must be paid to supply-side conditions, the fine-grain of implementation and sustainability. Comparative studies and research on health impact and cost-effectiveness are required.

  7. Demand-Side Financing in Education: a Critical Examination of a Girls' Scholarship Program in Malawi--(Case Study)

    ERIC Educational Resources Information Center

    Sineta, Abraham

    2012-01-01

    Despite the push for universal education, many disadvantaged and poor children in developing countries still do not have access to basic education. This among other reasons is due to poverty where poor families cannot afford the cost of basic education even when it is "free" of tuition (McDonald, 2007). Demand-side financing…

  8. Decentralization of Education: Demand-Side Financing. Directions in Development.

    ERIC Educational Resources Information Center

    Patrinos, Harry A.; Ariasingam, David L.

    Central governments' supply-side expansions of schooling have not equally benefited all members of society, especially girls, indigenous peoples, tribal groups, disadvantaged minorities, and the poor. Public spending on education is often inefficient, higher education is subsidized at primary education's expense, and costs are becoming…

  9. Effective financing of maternal health services: a review of the literature.

    PubMed

    Ensor, Tim; Ronoh, Jeptepkeny

    2005-12-01

    Health care can be funded in a number of ways ranging from direct user charges (out of pocket) payments to indirect methods that pool across time (prepayment) and across different risk and wealth groups (insurance and general taxation). All these methods can be used to finance maternal health services. When assessing the impact of financing mechanisms it is important to be aware of the different ways they effect service delivery patterns and utilisation. Specifically most systems have both equity and efficiency aspects that combine to impact on health service utilisation and health status. In general indirect methods that help families to pool the costs of maternal health services are preferable to direct methods of payment. It is also clear, however, that user charges may sometimes help to mitigate deficiencies in systems of pooled funding. Available literature suggests that financing mechanisms for maternal health services could be improved by systems that increase transparency, help to mitigate demand-side costs of services and provide funding for that promote transparent charging for services. While the limited experience of demand-side mechanisms for improving access to maternal health services more evaluation is required.

  10. "De facto" Privatisation of Education and the Poor: Implications of a Study from Sub-Saharan Africa and India

    ERIC Educational Resources Information Center

    Tooley, James; Dixon, Pauline

    2006-01-01

    Three types of privatisation are identified--involving demand-side financing, reforms to the educational supply-side and "de facto" privatisation, where responsibilities are transferred to the private sector, through the rapid growth of private schools, rather than through reform or legislation. Although "de facto"…

  11. A maternal health voucher scheme: what have we learned from the demand-side financing scheme in Bangladesh?

    PubMed

    Ahmed, Shakil; Khan, M Mahmud

    2011-01-01

    It is now more than 2 years since the Ministry of Health and Family Welfare of the Government of Bangladesh implemented the Maternal Health Voucher Scheme, a specialized form of demand-side financing programme. To analyse the early lessons from the scheme, information was obtained through semi-structured interviews with stakeholders at the sub-district level. The analysis identified a number of factors affecting the efficiency and performance of the scheme in the program area: delay in the release of voucher funds, selection criteria used for enrolling pregnant women in the programme, incentives created by the reimbursement system, etc. One of the objectives of the scheme was to encourage market competition among health care providers, but it failed to increase market competitiveness in the area. The resources made available through the scheme did not attract any new providers into the market and public facilities remained the only eligible provider both before and after scheme implementation. However, incentives provided through the voucher system did motivate public providers to offer a higher level of services. The beneficiaries expressed their overall satisfaction with the scheme as well. Since the local facility was not technically ready to provide all types of maternal health care services, providing vouchers may not improve access to care for many pregnant women. To improve the performance of the demand-side strategy, it has become important to adopt some supply-side interventions. In poor developing countries, a demand-side strategy may not be very effective without significant expansion of the service delivery capacity of health facilities at the sub-district level.

  12. Descentralizacion de la educacion: Financiamiento basado en la demanda. Tendencias del Desarrollo. (Decentralization of Education: Demand-Side Financing. Directions in Development.)

    ERIC Educational Resources Information Center

    Patrinos, Harry Anthony; Ariasingam, David Lakshmanan

    Central government's supply-side expansions of schooling have not equally benefited all members of society, especially girls, indigenous peoples, tribal groups, disadvantaged minorities, and the poor. Public spending on education is often inefficient, higher education is subsidized at primary education's expense, and costs are becoming…

  13. Consumer-led demand side financing in health and education and its relevance for low and middle income countries.

    PubMed

    Ensor, Tim

    2004-01-01

    There is increasing awareness that supply subsidies for health and education services often fail to benefit those that are most vulnerable in a community. This recognition has led to a growing interest in and experimentation with, consumer-led demand side financing systems (CL-DSF). These mechanisms place purchasing power in the hands of consumers to spend on specific services at accredited facilities. International evidence in education and health sectors suggest a limited success of CL-DSF in raising the consumption of key services amongst priority groups. There is also some evidence that vouchers can be used to improve targeting of vulnerable groups. There is very little positive evidence on the effect of CL-DSF on service quality as a consequence of greater competition. Location of services relative to population means that areas with more provider choice, particularly in the private sector, tend to be dominated by higher and middle-income households. Extending CL-DSF in low-income countries requires the development of capacity in administering these financing schemes and also accrediting providers. Schemes could focus primarily on fixed packages of key services aimed at easily identifiable groups. Piloting and robust evaluation is required to fill the evidence gap on the impact of these mechanisms. Extending demand financing to less predictable services, such as hospital coverage for the population, is likely to require the development of a voucher scheme to purchase insurance. This suggests an already developed insurance market and is unlikely to be appropriate in most low-income countries for some time.

  14. Is demand-side financing equity enhancing? Lessons from a maternal health voucher scheme in Bangladesh.

    PubMed

    Ahmed, Shakil; Khan, M Mahmud

    2011-05-01

    Demand-side financing (DSF) is used in the less-developed countries of the world to improve access to healthcare and to encourage market supply. Under DSF, households receive vouchers that can be used to pay for healthcare services. This study evaluated the effects of a universal DSF on maternal healthcare service utilization in Bangladesh. A household survey was conducted in and around the voucher scheme area one year after the initiation of the project. Women who gave birth within a year prior to the survey were interviewed. The utilization rates of maternal health services were found to be higher for all socioeconomic groups in the project area than in the comparison areas. Voucher recipients in the project area were 3.6 times more likely to be assisted by skilled health personnel during delivery, 2.5 times more likely to deliver the baby in a health facility, 2.8 times more likely to receive postnatal care (PNC), 2.0 times more likely to get antenatal care (ANC) services and 1.5 times more likely to seek treatment for obstetric complications than pregnant women not in the program. The degree of socioeconomic inequality in maternal health service utilization was also lower in the project area than in the comparison area. The use of vouchers evidenced much stronger demand-increasing effects on the poor. Poor voucher recipients were 4.3 times more likely to deliver in a health facility and two times more likely to use skilled health personnel at delivery than the non-poor recipients. Contrary to the inverse equity hypothesis, the voucher scheme reduced inequality even in the short run. Despite these improvements, socioeconomic disparity in the use of maternal health services has remained pro-rich, implying that demand-side financing alone will be insufficient to achieve the Millennium Development Goal for maternal health. A comprehensive system-wide approach, including supply-side strengthening, will be needed to adequately address maternal health concerns in poor developing countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. 7 CFR 1717.852 - Financing purposes.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and energy conservation, and on-grid and off-grid renewable energy systems; (2) The purchase..., except: (i) Certain load-management equipment (see 7 CFR 1710.251(c)); (ii) Renewable energy systems and RUS-approved programs of demand side management and energy conservation; and (iii) As determined by...

  16. Managed competition in health care and the unfinished agenda

    PubMed Central

    Enthoven, Alain C.

    1986-01-01

    A market made up of health care financing and delivery plans and individual consumers, without a carefully drawn set of rules to mitigate market failures, and without mediation by collective action on the demand side, cannot produce efficiency and equity. The concept of competition that can achieve these goals, at least to a satisfactory approximation, is managed competition, with intelligent active agents on the demand side, called sponsors, that contract with the competing health care plans and continuously structure and adjust the market to overcome its tendencies to failure. A great deal remains to be done to achieve the goals envisioned by the “procompetition reformers.” PMID:10311922

  17. 7 CFR 1710.115 - Final maturity.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... maturities for loans for the implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS... finance working capital required for the initial operation of a new system are a separate class of loans...

  18. 7 CFR 1710.105 - State regulatory approvals.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

  19. 7 CFR 1710.105 - State regulatory approvals.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

  20. 7 CFR 1710.105 - State regulatory approvals.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

  1. 7 CFR 1710.105 - State regulatory approvals.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

  2. Leveraging community-based financing for women's nonmaternal health care: experiences of rural Indian women.

    PubMed

    Gopalan, Saji S; Durairaj, Varatharajan

    2015-03-01

    Given the increasing need for mainstreaming household financing for women's nonmaternal health care and evidences on community-based financing's contribution to women's health care in general, this study explored their scope for nonmaternal health care in Orissa. A qualitative assessment conducted focus group discussions with rural women who met the eligibility criteria. Community-based financing provided financial access and risk protection for women's nonmaternal health care during the previous 1 year, though not adequately. Schemes covering outpatient care (or mild illnesses) provided relatively more financial access. The major determinants of their restricted financial access were limited sum assured, noncomprehensive coverage of services, exclusion of elderly women, and the lower priority households gave to nonmaternal health care. Community-based financing requires relevant structural changes along with demand-side behavioral modifications to ensure optimal attention to women's nonmaternal health care. © 2012 APJPH.

  3. Electricity decision-making: New techniques for calculating statewide economic impacts from new power supply and demand-side management programs

    NASA Astrophysics Data System (ADS)

    Tegen, Suzanne Isabel Helmholz

    This dissertation introduces new techniques for calculating and comparing statewide economic impacts from new coal, natural gas and wind power plants, as well as from demand-side management programs. The impetus for this work was two-fold. First, reviews of current literature and projects revealed that there was no standard way to estimate statewide economic impacts from new supply- and demand-side electricity options. Second, decision-makers who were interviewed stated that they were overwhelmed with data in general, but also lacked enough specific information about economic development impacts to their states from electricity, to make informed choices. This dissertation includes chapters on electricity decision-making and on economic impacts from supply and demand. The supply chapter compares different electricity options in three states which vary in natural resource content: Arizona, Colorado and Michigan. To account for differing capacity factors, resources are compared on a per-megawatt-hour basis. The calculations of economic impacts from new supply include: materials and labor for construction, operations, maintenance, fuel extraction, fuel transport, as well as property tax, financing and landowner revenues. The demand-side chapter compares residential, commercial and industrial programs in Iowa. Impact calculations include: incremental labor and materials for program planning, installation and operations, as well as sales taxes and electricity saved. Results from supply-side calculations in the three states analyzed indicate that adding new wind power can have a greater impact to a state's economy than adding new gas or coal power due to resource location, taxes and infrastructure. Additionally, demand-side management programs have a higher relative percentage of in-state dollar flow than supply-side solutions, though demand-side programs typically involve fewer MWh and dollars than supply-side generation. Methods for this dissertation include researching existing models and data, gathering new data and interviews with industry representatives and policy makers. The new techniques are important for decision-makers, utilities, energy advocates and others who are concerned with economic development and in-state dollar flows from new electricity decisions.

  4. A study protocol: using demand-side financing to meet the birth spacing needs of the underserved in Punjab Province in Pakistan.

    PubMed

    Azmat, Syed Khurram; Ali, Moazzam; Hameed, Waqas; Mustafa, Ghulam; Abbas, Ghazanfer; Ishaque, Muhammad; Bilgrami, Mohsina; Temmerman, Marleen

    2014-05-30

    High fertility rates, unwanted pregnancies, low modern contraceptive prevalence and a huge unmet need for contraception adversely affect women's health in Pakistan and this problem is compounded by limited access to reliable information and quality services regarding birth spacing especially in rural and underserved areas. This paper presents a study protocol that describes an evaluation of a demand-side financing (DSF) voucher approach which aims to increase the uptake of modern contraception among women of the lowest two wealth quintiles in Punjab Province, Pakistan. This study will use quasi-experimental design with control arm and be implemented in: six government clinics from the Population Welfare Department; 24 social franchise facilities branded as 'Suraj' (Sun), led by Marie Stopes Society (a local non-governmental organization); and 12 private sector clinics in Chakwal, Mianwali and Bhakkar districts. The study respondents will be interviewed at baseline and endline subject to voluntary acceptance and medical eligibility. In addition, health service data will record each client visit during the study period. The study will examine the impact of vouchers in terms of increasing the uptake of modern contraception by engaging private and public sector service providers (mid-level and medical doctors). If found effective, this approach can be a viable solution to satisfying the current demand and meeting the unmet need for contraception, particularly among the poorest socio-economic group.

  5. Performance Based Financing and Uptake of Maternal and Child Health Services in Yobe Sate, Northern Nigeria

    PubMed Central

    Ashir, Garba M.; Doctor, Henry V.; Afenyadu, Godwin Y.

    2013-01-01

    Reported maternal and child health (MCH) outcomes in Nigeria are amongst the worst in the world, with Nigeria second only to India in the number of maternal deaths. At the national level, maternal mortality ratios (MMRs) are estimated at 630 deaths per 100,000 live births (LBs) but vary from as low as 370 deaths per 100,000 LBs in the southern states to over 1,000 deaths per 100,000 LBs in the northern states. We report findings from a performance based financing (PBF) pilot study in Yobe State, northern Nigeria aimed at improving MCH outcomes as part of efforts to find strategies aimed at accelerating attainment of Millennium Development Goals for MCH. Results show that the demand-side PBF led to increased utilization of key MCH services (antenatal care and skilled delivery) but had no significant effect on completion of child immunization using measles as a proxy indicator. We discuss these results within the context of PBF schemes and the need for a careful consideration of all the critical processes and risks associated with demand-side PBF schemes in improving MCH outcomes in the study area and similar settings. PMID:23618473

  6. Changes in the proportion of facility-based deliveries and related maternal health services among the poor in rural Jhang, Pakistan: results from a demand-side financing intervention.

    PubMed

    Agha, Sohail

    2011-11-30

    Demand-side financing projects are now being implemented in many developing countries, yet evidence showing that they reach the poor is scanty. A maternal health voucher scheme provided voucher-paid services in Jhang, a predominantly rural district of Pakistan, during 2010. A pre-test/post-test quasi-experimental design was used to assess the changes in the proportion of facility-based deliveries and related maternal health services among the poor. Household interviews were conducted with randomly selected women in the intervention and control union councils, before and after the intervention.A strong outreach model was used. Voucher promoters were given basic training in identification of poor women using the Poverty Scorecard for Pakistan, in the types of problems women could face during delivery, and in the promotion of antenatal care (ANC), institutional delivery and postnatal care (PNC). Voucher booklets valued at Rs. 4,000 ($48), including three ANC visits, a PNC visit, an institutional delivery, and a postnatal family planning visit, were sold for Rs. 100 ($1.2) to low-income women targeted by project outreach workers. Women suffering from complications were referred to emergency obstetric care services.Analysis was conducted at the bivariate and the multivariate levels. At the multivariate level, logistic regression analysis was conducted to determine whether the increase in institutional delivery was greater among poor women (defined for this study as women in the fourth or fifth quintiles) relative to non-poor women (defined for this study as women in the first quintile) in the intervention union councils compared to the control union councils. Bivariate analysis showed significant increases in the institutional delivery rate among women in the fourth or fifth wealth quintiles in the intervention union councils but no significant changes in this indicator among women in the same wealth quintiles in the control union councils. Multivariate analysis showed that the increase in institutional delivery among poor women relative to non-poor women was significantly greater in the intervention compared to the control union councils. Demand-side financing projects using vouchers can be an effective way of reducing inequities in institutional delivery.

  7. A study protocol: using demand-side financing to meet the birth spacing needs of the underserved in Punjab Province in Pakistan

    PubMed Central

    2014-01-01

    Background High fertility rates, unwanted pregnancies, low modern contraceptive prevalence and a huge unmet need for contraception adversely affect women’s health in Pakistan and this problem is compounded by limited access to reliable information and quality services regarding birth spacing especially in rural and underserved areas. This paper presents a study protocol that describes an evaluation of a demand-side financing (DSF) voucher approach which aims to increase the uptake of modern contraception among women of the lowest two wealth quintiles in Punjab Province, Pakistan. Methods/Design This study will use quasi-experimental design with control arm and be implemented in: six government clinics from the Population Welfare Department; 24 social franchise facilities branded as ‘Suraj’ (Sun), led by Marie Stopes Society (a local non-governmental organization); and 12 private sector clinics in Chakwal, Mianwali and Bhakkar districts. The study respondents will be interviewed at baseline and endline subject to voluntary acceptance and medical eligibility. In addition, health service data will record each client visit during the study period. Discussion The study will examine the impact of vouchers in terms of increasing the uptake of modern contraception by engaging private and public sector service providers (mid-level and medical doctors). If found effective, this approach can be a viable solution to satisfying the current demand and meeting the unmet need for contraception, particularly among the poorest socio-economic group. PMID:24885657

  8. Demand-side financing for maternal and newborn health: what do we know about factors that affect implementation of cash transfers and voucher programmes?

    PubMed

    Hunter, Benjamin M; Murray, Susan F

    2017-08-31

    Demand-side financing (DSF) interventions, including cash transfers and vouchers, have been introduced to promote maternal and newborn health in a range of low- and middle-income countries. These interventions vary in design but have typically been used to increase health service utilisation by offsetting some financial costs for users, or increasing household income and incentivising 'healthy behaviours'. This article documents experiences and implementation factors associated with use of DSF in maternal and newborn health. A secondary analysis (using an adapted Supporting the Use of Research Evidence framework - SURE) was performed on studies that had previously been identified in a systematic review of evidence on DSF interventions in maternal and newborn health. The article draws on findings from 49 quantitative and 49 qualitative studies. The studies give insights on difficulties with exclusion of migrants, young and multiparous women, with demands for informal fees at facilities, and with challenges maintaining quality of care under increasing demand. Schemes experienced difficulties if communities faced long distances to reach participating facilities and poor access to transport, and where there was inadequate health infrastructure and human resources, shortages of medicines and problems with corruption. Studies that documented improved care-seeking indicated the importance of adequate programme scope (in terms of programme eligibility, size and timing of payments and voucher entitlements) to address the issue of concern, concurrent investments in supply-side capacity to sustain and/or improve quality of care, and awareness generation using community-based workers, leaders and women's groups. Evaluations spanning more than 15 years of implementation of DSF programmes reveal a complex picture of experiences that reflect the importance of financial and other social, geographical and health systems factors as barriers to accessing care. Careful design of DSF programmes as part of broader maternal and newborn health initiatives would need to take into account these barriers, the behaviours of staff and the quality of care in health facilities. Research is still needed on the policy context for DSF schemes in order to understand how they become sustainable and where they fit, or do not fit, with plans to achieve equitable universal health coverage.

  9. Cost-effectiveness analysis of a voucher scheme combined with obstetrical quality improvements: quasi experimental results from Uganda.

    PubMed

    Alfonso, Y Natalia; Bishai, David; Bua, John; Mutebi, Aloysius; Mayora, Crispus; Ekirapa-Kiracho, Elizabeth

    2015-02-01

    The maternal mortality ratio (MMR) in Uganda has declined significantly during the last 20 years, but Uganda is not on track to reach the millennium development goal of reducing MMR by 75% by 2015. More evidence on the cost-effectiveness of supply- and demand-side financing programs to reduce maternal mortality could inform future strategies. This study analyses the cost-effectiveness of a voucher scheme (VS) combined with health system strengthening in rural Uganda against the status quo. The VS, implemented in 2010, provided vouchers for delivery services at public and private health facilities (HF), as well as round-trip transportation provided by private sector workers (bicycles or motorcycles generally). The VS was part of a quasi-experimental non-randomized control trial. Improvements in institutional delivery coverage (IDC) rates can be estimated using a difference-in-difference impact evaluation method and the number of maternal lives saved is modelled using the evidence-based Lives Saved Tool. Costs were estimated from primary and secondary data. Results show that the demand for births at HFs enrolled in the VS increased by 52.3 percentage points. Out of this value, conservative estimates indicate that at least 9.4 percentage points are new HF users. This 9.4% bump in IDC implies 20 deaths averted, which is equivalent to 1356 disability-adjusted-life years (DALYs) averted. Cost-effectiveness analysis comparing the status quo and VS's most conservative effectiveness estimates shows that the VS had an incremental cost-effectiveness ratio per DALY averted of US$302 and per death averted of US$20 756. Although there are limitations in the data measures, a favourable cost-effectiveness ratio persists even under extreme assumptions. Demand-side vouchers combined with supply-side financing programs can increase attended deliveries and reduce maternal mortality at a cost that is acceptable. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  10. Impact of health financing policies in Cambodia: A 20 year experience.

    PubMed

    Ensor, Tim; Chhun, Chhim; Kimsun, Ton; McPake, Barbara; Edoka, Ijeoma

    2017-03-01

    Improving financial access to services is an essential part of extending universal health coverage in low resource settings. In Cambodia, high out of pocket spending and low levels of utilisation have impeded the expansion of coverage and improvement in health outcomes. For twenty years a series of health financing policies have focused on mitigating costs to increase access particularly by vulnerable groups. Demand side financing policies including health equity funds, vouchers and community health insurance have been complemented by supply side measures to improve service delivery incentives through contracting. Multiple rounds of the Cambodia Socio-Economic Survey are used to investigate the impact of financing policies on health service utilisation and out of pocket payments both over time using commune panel data from 1997 to 2011 and across groups using individual data from 2004 and 2009. Policy combinations including areas with multiple interventions were examined against controls using difference-in-difference and panel estimation. Widespread roll-out of financing policies combined with user charge formalisation has led to a general reduction in health spending by the poor. Equity funds are associated with a reduction in out of pocket payments although the effect of donor schemes is larger than those financed by government. Vouchers, which are aimed only at reproductive health services, has a more modest impact that is enhanced when combined with other schemes. At the aggregate level changes are less pronounced although there is evidence that policies take a number of years to have substantial effect. Health financing policies and the supportive systems that they require provide a foundation for more radical extension of coverage already envisaged by a proposed social insurance system. A policy challenge is how disparate mechanisms can be integrated to ensure that vulnerable groups remain protected. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. A model of the demand for Islamic banks debt-based financing instrument

    NASA Astrophysics Data System (ADS)

    Jusoh, Mansor; Khalid, Norlin

    2013-04-01

    This paper presents a theoretical analysis of the demand for debt-based financing instruments of the Islamic banks. Debt-based financing, such as through baibithamanajil and al-murabahah, is by far the most prominent of the Islamic bank financing and yet it has been largely ignored in Islamic economics literature. Most studies instead have been focusing on equity-based financing of al-mudharabah and al-musyarakah. Islamic bank offers debt-based financing through various instruments derived under the principle of exchange (ukud al-mu'awadhat) or more specifically, the contract of deferred sale. Under such arrangement, Islamic debt is created when goods are purchased and the payments are deferred. Thus, unlike debt of the conventional bank which is a form of financial loan contract to facilitate demand for liquid assets, this Islamic debt is created in response to the demand to purchase goods by deferred payment. In this paper we set an analytical framework that is based on an infinitely lived representative agent model (ILRA model) to analyze the demand for goods to be purchased by deferred payment. The resulting demand will then be used to derive the demand for Islamic debt. We also investigate theoretically, factors that may have an impact on the demand for Islamic debt.

  12. Innovations in University Finance: A Growing Necessity, and Intelligent Too!

    ERIC Educational Resources Information Center

    Mason, Paul M.; Alfano, Anthony

    1986-01-01

    The characteristics, advantages, and disadvantages of two relatively new debt instruments (variable rate demand bonds and tax-exempt variable rate demand bonds) and one soon to be available (real rate bonds) for short-term institutional finance needs and for reducing financing expenses are examined. (MSE)

  13. 31 CFR 501.602 - Reports to be furnished on demand.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Reports to be furnished on demand. 501.602 Section 501.602 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY REPORTING, PROCEDURES AND PENALTIES...

  14. The effect of performance-based financing on illness, care-seeking and treatment among children: an impact evaluation in Rwanda.

    PubMed

    Skiles, Martha Priedeman; Curtis, Siân L; Basinga, Paulin; Angeles, Gustavo; Thirumurthy, Harsha

    2015-09-14

    Performance-based financing (PBF) strategies are promoted as a supply-side, results-based financing mechanism to improve primary health care. This study estimated the effects of Rwanda's PBF program on less-incentivized child health services and examined the differential program impact by household poverty. Districts were allocated to intervention and comparison for PBF implementation in Rwanda. Using Demographic Health Survey data from 2005 to 2007-08, a community-level panel dataset of 5781 children less than 5 years of age from intervention and comparison districts was created. The impacts of PBF on reported childhood illness, facility care-seeking, and treatment received were estimated using a difference-in-differences model with community fixed effects. An interaction term between poverty and the program was estimated to identify the differential effect of PBF among children from poorer families. There was no measurable difference in estimated probability of reporting illness with diarrhea, fever or acute respiratory infections between the intervention and comparison groups. Seeking care at a facility for these illnesses increased over time, however no differential effect by PBF was seen. The estimated effect of PBF on receipt of treatment for poor children is 45 percentage points higher (p = 0.047) compared to the non-poor children seeking care for diarrhea or fever. PBF, a supply-side incentive program, improved the quality of treatment received by poor children conditional on patients seeking care, but it did not impact the propensity to seek care. These findings provide additional evidence that PBF incentivizes the critical role staff play in assuring quality services, but does little to influence consumer demand for these services. Efforts to improve child health need to address both supply and demand, with additional attention to barriers due to poverty if equity in service use is a concern.

  15. 31 CFR 344.8 - What other provisions apply to subscriptions for Demand Deposit securities?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false What other provisions apply to subscriptions for Demand Deposit securities? 344.8 Section 344.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC...

  16. 31 CFR 344.8 - What other provisions apply to subscriptions for Demand Deposit securities?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false What other provisions apply to subscriptions for Demand Deposit securities? 344.8 Section 344.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC...

  17. 31 CFR 344.8 - What other provisions apply to subscriptions for Demand Deposit securities?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false What other provisions apply to subscriptions for Demand Deposit securities? 344.8 Section 344.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE FISCAL...

  18. 31 CFR 344.8 - What other provisions apply to subscriptions for Demand Deposit securities?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false What other provisions apply to subscriptions for Demand Deposit securities? 344.8 Section 344.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC...

  19. Health-system reform and universal health coverage in Latin America.

    PubMed

    Atun, Rifat; de Andrade, Luiz Odorico Monteiro; Almeida, Gisele; Cotlear, Daniel; Dmytraczenko, T; Frenz, Patricia; Garcia, Patrícia; Gómez-Dantés, Octavio; Knaul, Felicia M; Muntaner, Carles; de Paula, Juliana Braga; Rígoli, Felix; Serrate, Pastor Castell-Florit; Wagstaff, Adam

    2015-03-28

    Starting in the late 1980s, many Latin American countries began social sector reforms to alleviate poverty, reduce socioeconomic inequalities, improve health outcomes, and provide financial risk protection. In particular, starting in the 1990s, reforms aimed at strengthening health systems to reduce inequalities in health access and outcomes focused on expansion of universal health coverage, especially for poor citizens. In Latin America, health-system reforms have produced a distinct approach to universal health coverage, underpinned by the principles of equity, solidarity, and collective action to overcome social inequalities. In most of the countries studied, government financing enabled the introduction of supply-side interventions to expand insurance coverage for uninsured citizens--with defined and enlarged benefits packages--and to scale up delivery of health services. Countries such as Brazil and Cuba introduced tax-financed universal health systems. These changes were combined with demand-side interventions aimed at alleviating poverty (targeting many social determinants of health) and improving access of the most disadvantaged populations. Hence, the distinguishing features of health-system strengthening for universal health coverage and lessons from the Latin American experience are relevant for countries advancing universal health coverage. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Equity in health personnel financing after Universal Coverage: evidence from Thai Ministry of Public Health's hospitals from 2008-2012.

    PubMed

    Ruangratanatrai, Wilailuk; Lertmaharit, Somrat; Hanvoravongchai, Piya

    2015-07-18

    Shortage and maldistribution of the health workforce is a major problem in the Thai health system. The expansion of healthcare access to achieve universal health coverage placed additional demand on the health system especially on the health workers in the public sector who are the major providers of health services. At the same time, the reform in hospital payment methods resulted in a lower share of funding from the government budgetary system and higher share of revenue from health insurance. This allowed public hospitals more flexibility in hiring additional staff. Financial measures and incentives such as special allowances for non-private practice and additional payments for remote staff have been implemented to attract and retain them. To understand the distributional effect of such change in health workforce financing, this study evaluates the equity in health workforce financing for 838 hospitals under the Ministry of Public Health across all 75 provinces from 2008-2012. Data were collected from routine reports of public hospital financing from the Ministry of Public Health with specific identification on health workforce spending. The components and sources of health workforce financing were descriptively analysed based on the geographic location of the hospitals, their size and the core hospital functions. Inequalities in health workforce financing across provinces were assessed. We calculated the Gini coefficient and concentration index to explore horizontal and vertical inequity in the public sector health workforce financing in Thailand. Separate analyses were carried out for funding from government budget and funding from hospital revenue to understand the difference between the two financial sources. Health workforce financing accounted for about half of all hospital non-capital expenses in 2012, about a 30 % increase from the level of spending in 2008. Almost one third of the workforce financing came from hospital revenue, an increase from only one fourth 5 years earlier. The study reveals a big difference in health workforce expenditure per capita across provinces. Health workforce spending from government budget was less equal than that from hospital revenues as shown by the higher Gini coefficient. The concentration indices show that the financing of hospital workforce was higher per capita in lower resource provinces. Our analysis of equalities in health workforce spending shows an improving trend in equity across provinces from 2008-2012. Expansion of healthcare and health insurance coverage and financing reform towards a demand-side financing helped improve the distribution of funding for health workforce across the provinces. The findings from this study can be useful for other countries with ongoing reform towards universal health coverage.

  1. Leveraging land development returns to finance transportation infrastructure improvements.

    DOT National Transportation Integrated Search

    2011-03-01

    The United States faces a crisis in transportation finance. Increasing fuel prices coupled with increasing : demand for fuel-efficient cars is driving down fuel consumption, and the associated fuel tax revenues. At : the same time, the demand for new...

  2. Resource allocation and purchasing arrangements to improve accessibility of medicines: Evidence from Iran.

    PubMed

    Bastani, Peivand; Mehralian, Gholamhossein; Dinarvand, Rasoul

    2015-01-01

    The aim of this study was to review the current methods of pharmaceutical purchasing by Iranian insurance organizations within the World Bank conceptual framework model so as to provide applicable pharmaceutical resource allocation and purchasing (RAP) arrangements in Iran. This qualitative study was conducted through a qualitative document analysis (QDA), applying the four-step Scott method in document selection, and conducting 20 semi-structured interviews using a triangulation method. Furthermore, the data were analyzed applying five steps framework analysis using Atlas-ti software. The QDA showed that the purchasers face many structural, financing, payment, delivery and service procurement and purchasing challenges. Moreover, the findings of interviews are provided in three sections including demand-side, supply-side and price and incentive regime. Localizing RAP arrangements as a World Bank Framework in a developing country like Iran considers the following as the prerequisite for implementing strategic purchasing in pharmaceutical sector: The improvement of accessibility, subsidiary mechanisms, reimbursement of new drugs, rational use, uniform pharmacopeia, best supplier selection, reduction of induced demand and moral hazard, payment reform. It is obvious that for Iran, these customized aspects are more various and detailed than those proposed in a World Bank model for developing countries.

  3. 12 CFR 1215.7 - Serving demands and submitting requests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...: General Counsel, Federal Housing Finance Agency, Constitution Center, Eighth Floor, 400 Seventh Street SW... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Serving demands and submitting requests. 1215.7 Section 1215.7 Banks and Banking FEDERAL HOUSING FINANCE AGENCY ORGANIZATION AND OPERATIONS...

  4. Financing Capital Improvements in 2001 and Beyond.

    ERIC Educational Resources Information Center

    Ward, James Gordon

    1989-01-01

    Social, economic, and political changes will alter educational facility needs and increase the demand for financing new facilities. Anticipates the changes that may be important in planning and financing school facilities. (MLF)

  5. Financing federal-aid highways

    DOT National Transportation Integrated Search

    1999-08-01

    Because of a continuing demand for information concerning the financing of Federal-aid highways, the Federal Highway Administration (FHWA) prepared a report, "Financing Federal-Aid Highways," in January 1974 to describe the basic process involved. Th...

  6. Financing Federal-Aid Highways. August 1999 Edition

    DOT National Transportation Integrated Search

    1999-08-01

    Because of a continuing demand for information concerning the financing of Federal-aid highways, the Federal Highway Administration (FHWA) prepared a report, "Financing Federal-Aid Highways," in January 1974 to describe the basic process involved. Th...

  7. Vouchers as demand side financing instruments for health care: a review of the Bangladesh maternal voucher scheme.

    PubMed

    Schmidt, Jean-Olivier; Ensor, Tim; Hossain, Atia; Khan, Salam

    2010-07-01

    Demand side financing (DSF) mechanisms transfer purchasing power to specified groups for defined goods and services in order to increase access to specified services. This is an important innovation in health care systems where access remains poor despite substantial subsidies towards the supply side. In Bangladesh, a maternal health DSF pilot in 33 sub-districts was launched in 2007. We report the results of a rapid review of this scheme undertaken during 2008 after 1 year of its setup. Quantitative data collected by DSF committees, facilities and national information systems were assessed alongside qualitative data, i.e. key informant interviews and focus group discussions with beneficiaries and health service providers on the operation of the scheme in 6 sub-districts. The scheme provides vouchers to women distributed by health workers that entitle mainly poor women to receive skilled care at home or a facility and also provide payments for transport and food. After initial setbacks voucher distribution rose quickly. The data also suggest that the rise in facility based delivery appeared to be more rapid in DSF than in other non-DSF areas, although the methods do not allow for a strict causal attribution as there might be co-founding effects. Fears that the financial incentives for surgical delivery would lead to an over emphasis on Caesarean section appear to be unfounded although the trends need further monitoring. DSF provides substantial additional funding to facilities but remains complex to administer, requiring a parallel administrative mechanism putting additional work burden on the health workers. There is little evidence that the mechanism encourages competition due to the limited provision of health care services. The main question outstanding is whether the achievements of the DSF scheme could be achieved more efficiently by adapting the regular government funding rather than creating an entirely new mechanism. Also, improving the quality of health care services cannot be expected by the DSF mechanism alone within an environment lacking the pre-requirements for competition. Quality assurance mechanisms need to be put in place. A large-scale impact evaluation is currently underway. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  8. Resource allocation and purchasing arrangements to improve accessibility of medicines: Evidence from Iran

    PubMed Central

    Bastani, Peivand; Mehralian, Gholamhossein; Dinarvand, Rasoul

    2015-01-01

    Objective: The aim of this study was to review the current methods of pharmaceutical purchasing by Iranian insurance organizations within the World Bank conceptual framework model so as to provide applicable pharmaceutical resource allocation and purchasing (RAP) arrangements in Iran. Methods: This qualitative study was conducted through a qualitative document analysis (QDA), applying the four-step Scott method in document selection, and conducting 20 semi-structured interviews using a triangulation method. Furthermore, the data were analyzed applying five steps framework analysis using Atlas-ti software. Findings: The QDA showed that the purchasers face many structural, financing, payment, delivery and service procurement and purchasing challenges. Moreover, the findings of interviews are provided in three sections including demand-side, supply-side and price and incentive regime. Conclusion: Localizing RAP arrangements as a World Bank Framework in a developing country like Iran considers the following as the prerequisite for implementing strategic purchasing in pharmaceutical sector: The improvement of accessibility, subsidiary mechanisms, reimbursement of new drugs, rational use, uniform pharmacopeia, best supplier selection, reduction of induced demand and moral hazard, payment reform. It is obvious that for Iran, these customized aspects are more various and detailed than those proposed in a World Bank model for developing countries. PMID:25710045

  9. An evaluation of two large scale demand side financing programs for maternal health in India: the MATIND study protocol.

    PubMed

    Sidney, Kristi; de Costa, Ayesha; Diwan, Vishal; Mavalankar, Dileep V; Smith, Helen

    2012-08-27

    High maternal mortality in India is a serious public health challenge. Demand side financing interventions have emerged as a strategy to promote access to emergency obstetric care. Two such state run programs, Janani Suraksha Yojana (JSY)and Chiranjeevi Yojana (CY), were designed and implemented to reduce financial access barriers that preclude women from obtaining emergency obstetric care. JSY, a conditional cash transfer, awards money directly to a woman who delivers in a public health facility. This will be studied in Madhya Pradesh province. CY, a voucher based program, empanels private obstetricians in Gujarat province, who are reimbursed by the government to perform deliveries of socioeconomically disadvantaged women. The programs have been in operation for the last seven years. The study outlined in this protocol will assess and compare the influence of the two programs on various aspects of maternal health care including trends in program uptake, institutional delivery rates, maternal and neonatal outcomes, quality of care, experiences of service providers and users, and cost effectiveness. The study will collect primary data using a combination of qualitative and quantitative methods, including facility level questionnaires, observations, a population based survey, in-depth interviews, and focus group discussions. Primary data will be collected in three districts of each province. The research will take place at three levels: the state health departments, obstetric facilities in the districts and among recently delivered mothers in the community. The protocol is a comprehensive assessment of the performance and impact of the programs and an economic analysis. It will fill existing evidence gaps in the scientific literature including access and quality to services, utilization, coverage and impact. The implementation of the protocol will also generate evidence to facilitate decision making among policy makers and program managers who currently work with or are planning similar programs in different contexts.

  10. Economic and fiscal implications of aging for subnational American governments.

    PubMed

    Serow, W J

    2001-01-01

    This article begins with a brief review of the extensive literature dealing with the macroeconomic consequences of population aging in industrialized societies and places the question in the context of the political and economic framework of the United States. Next, we move to the fiscal ramifications of population aging for subnational units of government. The varying demographic sources of aging are then introduced and their economic implications are reviewed. The role of population aging within the context of subnational fiscal impacts is first examined by reviewing patterns of change in demand for state-government-provided public goods and services associated with an older population. These include primarily health care and income security. These considerations on the expenditure side are then extended to substate government, where primary and secondary education are easily the largest component of public budgets. Finally, the implications of demographic change on the revenue side of state and local public finances are considered, including potential impacts on sales, property, and income tax receipts.

  11. Threshold Concepts in Finance: Conceptualizing the Curriculum

    ERIC Educational Resources Information Center

    Hoadley, Susan; Tickle, Leonie; Wood, Leigh N.; Kyng, Tim

    2015-01-01

    Graduates with well-developed capabilities in finance are invaluable to our society and in increasing demand. Universities face the challenge of designing finance programmes to develop these capabilities and the essential knowledge that underpins them. Our research responds to this challenge by identifying threshold concepts that are central to…

  12. 31 CFR 901.7 - Liquidation of collateral.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... reasonable time after demand and if such action is in the best interest of the United States. Collection from... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Liquidation of collateral. 901.7 Section 901.7 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FEDERAL...

  13. Research on electricity market operation mechanism and its benefit of demand side participation

    NASA Astrophysics Data System (ADS)

    Han, Shuai; Yan, Xu; Qin, Li-juan; Lin, Xi-qiao; Zeng, Bo

    2017-08-01

    Demand response plays an important role in maintaining the economic stability of the system, and has the characteristics of high efficiency, low cost, fast response, good environmental benefits and so on. Demand side resource is an important part of electricity market. The research of demand side resources in our country is still in the initial stage, but the opening of the electricity sales side provides a broad prospect for the development of electricity market. This paper summarizes the main types of demand side resources in our country, analyzes the economic principle of demand response from the micro perspective, puts forward some suggestions on the operation mechanism of China’s demand side resources participating in the electricity market under the condition of electricity sales side opening, analyzes the current situation of pricing in the electricity wholesale market and sets up the pricing strategy of the centralized wholesale market with the demand side power supply participating in quotation, which makes the social and economic benefits reach the maximum.

  14. Design of demand side response model in energy internet demonstration park

    NASA Astrophysics Data System (ADS)

    Zhang, Q.; Liu, D. N.

    2017-08-01

    The implementation of demand side response can bring a lot of benefits to the power system, users and society, but there are still many problems in the actual operation. Firstly, this paper analyses the current situation and problems of demand side response. On this basis, this paper analyses the advantages of implementing demand side response in the energy Internet demonstration park. Finally, the paper designs three kinds of feasible demand side response modes in the energy Internet demonstration park.

  15. Financing Higher Education: Lessons from Economic Theory and Reform in England

    ERIC Educational Resources Information Center

    Barr, Nicholas

    2009-01-01

    The finance of higher education faces a clash between technological advance, driving up the demand for skills, and fiscal constraints, given competing imperatives for public spending. Paying for universities is also immensely politically sensitive. This paper sets out core lessons for financing higher education deriving from economic theory,…

  16. Demand for Long-Term Care Insurance in China.

    PubMed

    Wang, Qun; Zhou, Yi; Ding, Xinrui; Ying, Xiaohua

    2017-12-22

    The aim of this study was to estimate willingness to pay (WTP) for long-term care insurance (LTCI) and to explore the determinants of demand for LTCI in China. We collected data from a household survey conducted in Qinghai and Zhejiang on a sample of 1842 households. We relied on contingent valuation methods to elicit the demand for LTCI and random effects logistic regression to analyze the factors associated with the demand for LTCI. Complementarily, we used document analysis to compare the LTCI designed in this study and the current LTCI policies in the pilot cities. More than 90% of the respondents expressed their willingness to buy LTCI. The median WTP for LTCI was estimated at 370.14 RMB/year, accounting for 2.29% of average annual per capita disposable income. Price, age, education status, and income were significantly associated with demand for LTCI. Most pilot cities were found to mainly rely on Urban Employees Basic Medical Insurance funds as the financing source for LTCI. Considering that financing is one of the greatest challenges in the development of China's LTCI, we suggest that policy makers consider individual contribution as an important and possible option as a source of financing for LTCI.

  17. District Court Demands More State Investment ? All Our Children Deserve an Excellent, Equitable Education

    ERIC Educational Resources Information Center

    Montecel, Maria Robledo

    2004-01-01

    Texas educators and communities have long fought for educational equity. From the earliest major school finance cases, the pressing need for equity has been at the heart of school finance litigation. And the courts have affirmed through numerous cases that equity must be addressed. Recapture provisions in Texas? current school finance system are…

  18. 31 CFR 321.21 - Replacement and recovery of losses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... liability for such loss under 31 U.S.C. 3126(a), the Bureau of the Public Debt will demand that the paying... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Replacement and recovery of losses. 321.21 Section 321.21 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued...

  19. Identifying Pathways toward Sustainable Electricity Supply and Demand Using an Integrated Resource Strategic Planning Model for Saudi Arabia

    NASA Astrophysics Data System (ADS)

    Alabbas, Nabeel H.

    Despite holding 16% of proved oil reserves in the world, Saudi Arabia might be on an unsustainable path to become a net oil importer by the 2030s. Decades of domestic energy subsidies accompanied by a high population growth rate have encouraged inefficient production and high domestic consumption of fossil fuel energy, which has resulted in environmental degradation, and significant social and economic consequences. In addition, the government's dependence on oil as a main source of revenue (89%) to finance its development programs cannot be sustained due to oil's exhaustible nature and rapidly increasing domestic consumption. The electricity and water sectors consume more energy than other sectors. The literature review revealed that electricity use in Saudi Arabia is following an unsustainable path (7-8% annual growth over the last decade). The water sector is another major energy consumer due to an unprecedented demand for water in the Kingdom (18% of world's total desalinated water output with per capita consumption is twice the world average). Multiple entities have been involved in fragmented planning activities on the supply-side as well as to a certain extent on the demand-side; moreover, comprehensive integrated resource strategic plans have been lacking at the national level. This dissertation established an integrated resource strategic planning (IRSP) model for Saudi Arabia's electricity and water sectors. The IRSP can clearly determine the Kingdom's future vision of its utility sector, including goals, policies, programs, and an execution timetable, taking into consideration economic, environmental and social benefits. Also, a weather-based hybrid end-use econometric demand forecasting model was developed to project electricity demand until 2040. The analytical economic efficiency and technical assessments reveal that Saudi Arabia can supply almost 75% of its electricity from renewable energy sources with a significant achievable potential for saving 26% of peak demand by 2040. However, the development of sustainable energy systems in the country's utility sector will not occur automatically. Thus, several actions are proposed for developing the sustainable energy roadmap, strategies, and policies for Saudi Arabia's utility sector, supporting its position as a new vehicle of growth that facilitates national and socio-economic development and economic diversification plan.

  20. Towards demand-side solutions for mitigating climate change

    NASA Astrophysics Data System (ADS)

    Creutzig, Felix; Roy, Joyashree; Lamb, William F.; Azevedo, Inês M. L.; Bruine de Bruin, Wändi; Dalkmann, Holger; Edelenbosch, Oreane Y.; Geels, Frank W.; Grubler, Arnulf; Hepburn, Cameron; Hertwich, Edgar G.; Khosla, Radhika; Mattauch, Linus; Minx, Jan C.; Ramakrishnan, Anjali; Rao, Narasimha D.; Steinberger, Julia K.; Tavoni, Massimo; Ürge-Vorsatz, Diana; Weber, Elke U.

    2018-04-01

    Research on climate change mitigation tends to focus on supply-side technology solutions. A better understanding of demand-side solutions is missing. We propose a transdisciplinary approach to identify demand-side climate solutions, investigate their mitigation potential, detail policy measures and assess their implications for well-being.

  1. Sensitivity of Rooftop PV Projections in the SunShot Vision Study to Market Assumptions

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

    Drury, E.; Denholm, P.; Margolis, R.

    2013-01-01

    The SunShot Vision Study explored the potential growth of solar markets if solar prices decreased by about 75% from 2010 to 2020. The SolarDS model was used to simulate rooftop PV demand for this study, based on several PV market assumptions--future electricity rates, customer access to financing, and others--in addition to the SunShot PV price projections. This paper finds that modeled PV demand is highly sensitive to several non-price market assumptions, particularly PV financing parameters.

  2. A forecast of typhoid conjugate vaccine introduction and demand in typhoid endemic low- and middle-income countries to support vaccine introduction policy and decisions.

    PubMed

    Mogasale, Vittal; Ramani, Enusa; Park, Il Yeon; Lee, Jung Seok

    2017-09-02

    A Typhoid Conjugate Vaccine (TCV) is expected to acquire WHO prequalification soon, which will pave the way for its use in many low- and middle-income countries where typhoid fever is endemic. Thus it is critical to forecast future vaccine demand to ensure supply meets demand, and to facilitate vaccine policy and introduction planning. We forecasted introduction dates for countries based on specific criteria and estimated vaccine demand by year for defined vaccination strategies in 2 scenarios: rapid vaccine introduction and slow vaccine introduction. In the rapid introduction scenario, we forecasted 17 countries and India introducing TCV in the first 5 y of the vaccine's availability while in the slow introduction scenario we forecasted 4 countries and India introducing TCV in the same time period. If the vaccine is targeting infants in high-risk populations as a routine single dose, the vaccine demand peaks around 40 million doses per year under the rapid introduction scenario. Similarly, if the vaccine is targeting infants in the general population as a routine single dose, the vaccine demand increases to 160 million doses per year under the rapid introduction scenario. The demand forecast projected here is an upper bound estimate of vaccine demand, where actual demand depends on various factors such as country priorities, actual vaccine introduction, vaccination strategies, Gavi financing, costs, and overall product profile. Considering the potential role of TCV in typhoid control globally; manufacturers, policymakers, donors and financing bodies should work together to ensure vaccine access through sufficient production capacity, early WHO prequalification of the vaccine, continued Gavi financing and supportive policy.

  3. A forecast of typhoid conjugate vaccine introduction and demand in typhoid endemic low- and middle-income countries to support vaccine introduction policy and decisions

    PubMed Central

    Ramani, Enusa; Park, Il Yeon; Lee, Jung Seok

    2017-01-01

    ABSTRACT A Typhoid Conjugate Vaccine (TCV) is expected to acquire WHO prequalification soon, which will pave the way for its use in many low- and middle-income countries where typhoid fever is endemic. Thus it is critical to forecast future vaccine demand to ensure supply meets demand, and to facilitate vaccine policy and introduction planning. We forecasted introduction dates for countries based on specific criteria and estimated vaccine demand by year for defined vaccination strategies in 2 scenarios: rapid vaccine introduction and slow vaccine introduction. In the rapid introduction scenario, we forecasted 17 countries and India introducing TCV in the first 5 y of the vaccine's availability while in the slow introduction scenario we forecasted 4 countries and India introducing TCV in the same time period. If the vaccine is targeting infants in high-risk populations as a routine single dose, the vaccine demand peaks around 40 million doses per year under the rapid introduction scenario. Similarly, if the vaccine is targeting infants in the general population as a routine single dose, the vaccine demand increases to 160 million doses per year under the rapid introduction scenario. The demand forecast projected here is an upper bound estimate of vaccine demand, where actual demand depends on various factors such as country priorities, actual vaccine introduction, vaccination strategies, Gavi financing, costs, and overall product profile. Considering the potential role of TCV in typhoid control globally; manufacturers, policymakers, donors and financing bodies should work together to ensure vaccine access through sufficient production capacity, early WHO prequalification of the vaccine, continued Gavi financing and supportive policy. PMID:28604164

  4. 31 CFR 344.9 - How do I redeem a Demand Deposit security?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false How do I redeem a Demand Deposit...-STATE AND LOCAL GOVERNMENT SERIES Demand Deposit Securities § 344.9 How do I redeem a Demand Deposit security? (a) When must I notify Fiscal Service to redeem a security? A Demand Deposit security can be...

  5. 31 CFR 344.9 - How do I redeem a Demand Deposit security?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false How do I redeem a Demand Deposit...-STATE AND LOCAL GOVERNMENT SERIES Demand Deposit Securities § 344.9 How do I redeem a Demand Deposit security? (a) When must I notify BPD to redeem a security? A Demand Deposit security can be redeemed at the...

  6. 31 CFR 344.9 - How do I redeem a Demand Deposit security?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false How do I redeem a Demand Deposit...-STATE AND LOCAL GOVERNMENT SERIES Demand Deposit Securities § 344.9 How do I redeem a Demand Deposit security? (a) When must I notify BPD to redeem a security? A Demand Deposit security can be redeemed at the...

  7. 31 CFR 344.9 - How do I redeem a Demand Deposit security?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false How do I redeem a Demand Deposit...-STATE AND LOCAL GOVERNMENT SERIES Demand Deposit Securities § 344.9 How do I redeem a Demand Deposit security? (a) When must I notify BPD to redeem a security? A Demand Deposit security can be redeemed at the...

  8. 31 CFR 344.9 - How do I redeem a Demand Deposit security?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false How do I redeem a Demand Deposit...-STATE AND LOCAL GOVERNMENT SERIES Demand Deposit Securities § 344.9 How do I redeem a Demand Deposit security? (a) When must I notify BPD to redeem a security? A Demand Deposit security can be redeemed at the...

  9. Development of robust building energy demand-side control strategy under uncertainty

    NASA Astrophysics Data System (ADS)

    Kim, Sean Hay

    The potential of carbon emission regulations applied to an individual building will encourage building owners to purchase utility-provided green power or to employ onsite renewable energy generation. As both cases are based on intermittent renewable energy sources, demand side control is a fundamental precondition for maximizing the effectiveness of using renewable energy sources. Such control leads to a reduction in peak demand and/or in energy demand variability, therefore, such reduction in the demand profile eventually enhances the efficiency of an erratic supply of renewable energy. The combined operation of active thermal energy storage and passive building thermal mass has shown substantial improvement in demand-side control performance when compared to current state-of-the-art demand-side control measures. Specifically, "model-based" optimal control for this operation has the potential to significantly increase performance and bring economic advantages. However, due to the uncertainty in certain operating conditions in the field its control effectiveness could be diminished and/or seriously damaged, which results in poor performance. This dissertation pursues improvements of current demand-side controls under uncertainty by proposing a robust supervisory demand-side control strategy that is designed to be immune from uncertainty and perform consistently under uncertain conditions. Uniqueness and superiority of the proposed robust demand-side controls are found as below: a. It is developed based on fundamental studies about uncertainty and a systematic approach to uncertainty analysis. b. It reduces variability of performance under varied conditions, and thus avoids the worst case scenario. c. It is reactive in cases of critical "discrepancies" observed caused by the unpredictable uncertainty that typically scenario uncertainty imposes, and thus it increases control efficiency. This is obtainable by means of i) multi-source composition of weather forecasts including both historical archive and online sources and ii) adaptive Multiple model-based controls (MMC) to mitigate detrimental impacts of varying scenario uncertainties. The proposed robust demand-side control strategy verifies its outstanding demand-side control performance in varied and non-indigenous conditions compared to the existing control strategies including deterministic optimal controls. This result reemphasizes importance of the demand-side control for a building in the global carbon economy. It also demonstrates a capability of risk management of the proposed robust demand-side controls in highly uncertain situations, which eventually attains the maximum benefit in both theoretical and practical perspectives.

  10. Institutional design and organizational practice for universal coverage in lesser-developed countries: challenges facing the Lao PDR.

    PubMed

    Ahmed, Shakil; Annear, Peter Leslie; Phonvisay, Bouaphat; Phommavong, Chansaly; Cruz, Valeria de Oliveira; Hammerich, Asmus; Jacobs, Bart

    2013-11-01

    There is now widespread acceptance of the universal coverage approach, presented in the 2010 World Health Report. There are more and more voices for the benefit of creating a single national risk pool. Now, a body of literature is emerging on institutional design and organizational practice for universal coverage, related to management of the three health-financing functions: collection, pooling and purchasing. While all countries can move towards universal coverage, lower-income countries face particular challenges, including scarce resources and limited capacity. Recently, the Lao PDR has been preparing options for moving to a single national health insurance scheme. The aim is to combine four different social health protection schemes into a national health insurance authority (NHIA) with a single national fund- and risk-pool. This paper investigates the main institutional and organizational challenges related to the creation of the NHIA. The paper uses a qualitative approach, drawing on the World Health Organization's institutional and Organizational Assessment for Improving and Strengthening health financing (OASIS) conceptual framework for data analysis. Data were collected from a review of key health financing policy documents and from 17 semi-structured key informant interviews. Policy makers and advisors are confronting issues related to institutional arrangements, funding sources for the authority and government support for subsidies to the demand-side health financing schemes. Compulsory membership is proposed, but the means for covering the informal sector have not been resolved. While unification of existing schemes may be the basis for creating a single risk pool, challenges related to administrative capacity and cross-subsidies remain. The example of Lao PDR illustrates the need to include consideration of national context, the sequencing of reforms and the time-scale appropriate for achieving universal coverage. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Assessment of utility side financial benefits of demand side management considering environmental impacts

    NASA Astrophysics Data System (ADS)

    Abeygunawardane, Saranga Kumudu

    2018-02-01

    Any electrical utility prefers to implement demand side management and change the shape of the demand curve in a beneficial manner. This paper aims to assess the financial gains (or losses) to the generating sector through the implementation of demand side management programs. An optimization algorithm is developed to find the optimal generation mix that minimizes the daily total generating cost. This daily total generating cost includes the daily generating cost as well as the environmental damage cost. The proposed optimization algorithm is used to find the daily total generating cost for the base case and for several demand side management programs using the data obtained from the Sri Lankan power system. Results obtained for DSM programs are compared with the results obtained for the base case to assess the financial benefits of demand side management to the generating sector.

  12. Indiana's New and (Somewhat) Improved K-12 School Finance System. School Choice Issues in the State

    ERIC Educational Resources Information Center

    Aud, Susan L.

    2005-01-01

    Education finance policy has become an urgent concern in many state legislatures. Demands for greater equity and accountability have forced states to review, and in many cases to revise, the method by which schools are funded. This study sheds light on Indiana's financing of public K-12 education by providing a clear explanation of the components…

  13. A guide to taxable debt financing alternatives.

    PubMed

    Aderholdt, J M; Pardue, C R

    1989-07-01

    The 1986 Tax Reform Act placed new restrictions on the use of tax-exempt financing for certain healthcare projects, and policymakers are considering further restrictions. In light of these developments, financial managers should become familiar with the available taxable debt financing options. These include commercial paper, taxable variable rate demand notes, floating rate notes, medium-term notes, long-term domestic public offerings, and domestic private placements.

  14. Individual responsibility for healthcare financing: application of an analytical framework exploring the suitability of private financing of assistive devices.

    PubMed

    Tinghög, Gustav; Carlsson, Per

    2012-12-01

    To operationalise and apply a conceptual framework for exploring when health services contain characteristics that facilitate individuals' ability to take individual responsibility for health care through out-of-pocket payment. In addition, we investigate if the levels of out-of-pocket payment for assistive devices (ADs) in Sweden are in line with the proposed framework. Focus groups were used to operationalise the core concepts of sufficient knowledge, individual autonomy, positive externalities, sufficient demand, affordability, and lifestyle enhancement into a measurable and replicable rationing tool. A selection of 28 ADs were graded separately as having high, medium, or low suitability for private financing according to the measurement scale provided through the operationalised framework. To investigate the actual level of private financing, a questionnaire about the level of out-of-pocket payment for the specific ADs was administered to county councils in Sweden. Concepts were operationalised into three levels indicating possible suitability for private financing. Responses to the questionnaire indicate that financing of ADs in Sweden varies across county councils as regards co-payment, full payment, discretionary payment for certain healthcare consumer groups, and full reimbursement. According to the framework, ADs commonly funded privately were generally considered to be more suitable for private financing. Sufficient knowledge, individual autonomy, and sufficient demand did not appear to influence why certain ADs were financed out-of-pocket. The level of positive externalities, affordability, and lifestyle enhancement appeared to be somewhat higher for ADs that were financed out-of-pocket, but the differences were small. Affordability seemed to be the most influential concept.

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

    Niddrie, D.G.

    Oil companies, savings banks, public utilities, and other companies have made use of a new kind of financing technique known as lower floaters. The author describes the lower floater and its particular benefits and potential drawbacks. He concludes that, on balance, variable-rate demand bonds have been good for utilities, which have issued them in great quantity. No one knows how many they will be able to issue at acceptable rates after this year, but the answer may rest with Congress. Because of all the uncertainty, utilities in need of financing should consider issuing variable-rate demand bonds as soon as possible.

  16. [Costly drugs: analysis and proposals for the Mercosur countries].

    PubMed

    Marín, Gustavo H; Polach, María Andrea

    2011-08-01

    Determine how the Mercosur countries access, regulate, and finance costly drugs and propose joint selection and financing strategies at the subregional level. Qualitative design, using content analyses of primary and secondary sources, document reviews, interviews, focus groups, and case studies. The variables selected included: selection criteria, access, financing, and regulations in the various countries. Costly drugs were divided into those that do not alter the natural course of the disease and those with demonstrated efficacy, using the defined daily dose to compare the costs of classical treatments and those involving costly drugs. The Mercosur countries generally lack formal strategies for dealing with the demand for costly drugs, and governments and insurers wind up financing them by court order. The case studies show that there are costly drugs whose efficacy has not been established but that nonetheless generate demand. The fragmentation of procurement, international commitments with regard to intellectual property, and low negotiating power exponentially increase the price of costly drugs, putting health system finances in jeopardy. Costly drugs must be regulated and rationally selected so that only those that substantively benefit people are accepted. To finance the drugs so selected, common country strategies are needed that include such options as flexible in trade agreements, the creation of national resource funds, or joint procurement by countries to enhance their negotiating power.

  17. 12 CFR 996.3 - Demand deposit accounts.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Demand deposit accounts. 996.3 Section 996.3 Banks and Banking FEDERAL HOUSING FINANCE BOARD NON-BANK SYSTEM ENTITIES AUTHORITY FOR BANK ASSISTANCE OF THE RESOLUTION FUNDING CORPORATION § 996.3 Demand deposit accounts. Each Bank shall allow any...

  18. 22 CFR 201.66 - Side payments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Side payments. 201.66 Section 201.66 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Price Provisions § 201.66 Side payments. Any payment which an importer makes to a...

  19. 22 CFR 201.66 - Side payments.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Side payments. 201.66 Section 201.66 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Price Provisions § 201.66 Side payments. Any payment which an importer makes to a...

  20. 22 CFR 201.66 - Side payments.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Side payments. 201.66 Section 201.66 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Price Provisions § 201.66 Side payments. Any payment which an importer makes to a...

  1. 22 CFR 201.66 - Side payments.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Side payments. 201.66 Section 201.66 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Price Provisions § 201.66 Side payments. Any payment which an importer makes to a...

  2. 22 CFR 201.66 - Side payments.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Side payments. 201.66 Section 201.66 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Price Provisions § 201.66 Side payments. Any payment which an importer makes to a...

  3. Financing After-School Programs.

    ERIC Educational Resources Information Center

    Halpern, Robert; Deich, Sharon; Cohen, Carol

    The growing demands for afterschool programming for children is accompanied by an increasing understanding of the importance of quality care and activities to children's healthy development. Among the many challenges faced by the growing number of out-of-school time initiatives are developing financing plans and finding funding that will support…

  4. 7 CFR 1488.11 - Liquidated damages.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Financing of Export Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit Sales... of the financing agreement which will result in serious and substantial damage to CCC and to its... exporter shall pay to CCC promptly on demand, as reasonable compensation and not as a penalty, liquidated...

  5. 7 CFR 1488.11 - Liquidated damages.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Financing of Export Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit Sales... of the financing agreement which will result in serious and substantial damage to CCC and to its... exporter shall pay to CCC promptly on demand, as reasonable compensation and not as a penalty, liquidated...

  6. How to introduce demand side resources in the design of low-carbon power systems in China

    NASA Astrophysics Data System (ADS)

    Zhou, Pengcheng; Liu, Yiqun; Zeng, Ming; Sun, Chenjun

    2018-04-01

    Nowadays, China's energy demand sustained rapid growth, and the coal-based energy structure has adverse effects on the environment. The flexibility of demand side resource (DSR) will be greatly improved, and DSR can reduce electricity consumption actively and temporarily, and realize energy saving and emission reduction. But there are still some problems to introduce DSR in China. This paper proposes three practices for introducing demand side resources to improve the flexibility of power systems through demand resources.

  7. Nuclear Physicists in Finance

    NASA Astrophysics Data System (ADS)

    Mattoni, Carlo

    2017-01-01

    The financial services industry presents an interesting alternative career path for nuclear physicists. Careers in finance typically offer intellectual challenge, a fast pace, high caliber colleagues, merit-based compensation with substantial upside, and an opportunity to deploy skills learned as a physicist. Physicists are employed at a wide range of financial institutions on both the ``buy side'' (hedge fund managers, private equity managers, mutual fund managers, etc.) and the ``sell side'' (investment banks and brokerages). Historically, physicists in finance were primarily ``quants'' tasked with applying stochastic calculus to determine the price of financial derivatives. With the maturation of the field of derivative pricing, physicists in finance today find work in a variety of roles ranging from quantification and management of risk to investment analysis to development of sophisticated software used to price, trade, and risk manage securities. Only a small subset of today's finance careers for physicists require the use of advanced math and practically none provide an opportunity to tinker with an apparatus, yet most nevertheless draw on important skills honed during the training of a nuclear physicist. Intellectually rigorous critical thinking, sophisticated problem solving, an attention to minute detail and an ability to create and test hypotheses based on incomplete information are key to both disciplines.

  8. Financing the College in the Community.

    ERIC Educational Resources Information Center

    Adams, Frank G.

    Although off-campus or community service courses have historically been sparsely funded, these types of programs have grown more rapidly than the on-campus traditional ones, especially in response to the demands of part-time adult students. Three patterns have commonly been used to finance community services and each has shortcomings. These are…

  9. 31 CFR 29.526 - Waiver precluded.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Waiver precluded. 29.526 Section 29.526 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER... and a timely demand for repayment is made prior to the final disbursement by the administrator or...

  10. 78 FR 39957 - Availability of Non-Public Information

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-03

    ... the Office of Finance for its own business purposes that is in its possession; (2) The information is... Information for public comment in the Federal Register, 78 FR 6042 (January 29, 2013). No comments were... Finance Board handled demands and requests for information in the context of legal proceedings. Today...

  11. Education Finance Reform, Local Behavior, and Student Performance in Massachusetts

    ERIC Educational Resources Information Center

    Nguyen-Hoang, Phuong; Yinger, John

    2014-01-01

    This study examines the impact on student performance of the education finance reform enacted in 1993 in Massachusetts and of school districts' institutional structure. Estimating education expenditure and demand functions, this study presents evidence that changes in the state education aid following the education reform resulted in significantly…

  12. Accountability, efficiency, and the "bottom line" in non-profit organizations.

    PubMed

    Cutt, J

    1982-01-01

    Financial reporting by non-profit organizations deals only with accountability for propriety and regularity, and ignores output measurement. The development of output measures of a physical or index nature offers a means of relating dollar costs to output in the form of cost-efficiency or cost-effectiveness measures, but does not provide any measure of the absolute value or worthwhileness of such programs. This fundamental absolute value question should be asked of all non-profit programs and documented to the greatest possible extent in budgetary submissions, and subsequent control and audit. In public sector non-profit programs, the posing of this question requires information on consumer demand other than in aggregative and imprecise form through the political process, and much improved information on the cost side. Eliciting demand information is feasible in the case of public programs with separable benefits by the use of a variety of pricing techniques, direct or imputed, whether or not the service in question is ultimately financed on a user-pay basis. The problem of eliciting demand is more difficult in the case of public goods, but improved demand information can be obtained, ideally by an approach such as the use of a Clarke tax. The argument can be extended to encompass questions of income distribution, stabilization, regulation and tax policy. Recent developments in program evaluation in the federal government are important, but remain deficient in failing to address the question of absolute value.

  13. United States Counterterrorism Strategy In the Trans-Sahara and the Rise of Salafi-Jihadism In the Sahel

    DTIC Science & Technology

    2015-09-01

    157 “ Anti - Money Laundering /Counter Terrorist Financing ,” United States Department of State, May 10, 2015, http://www.state.gov/j/inl/c/crime...20the%20US%20Homeland.pdf. United States Department of State. “ Anti - Money Laundering /Counter Terrorist Financing ,” May 10, 2015. http://www.state.gov...state security, transnational criminal activity, and extremist financing demands regional collaboration, requiring these states to look past their

  14. Joint Planning Of Energy Storage and Transmission Considering Wind-Storage Combined System and Demand Side Response

    NASA Astrophysics Data System (ADS)

    Huang, Y.; Liu, B. Z.; Wang, K. Y.; Ai, X.

    2017-12-01

    In response to the new requirements of the operation mode of wind-storage combined system and demand side response for transmission network planning, this paper presents a joint planning of energy storage and transmission considering wind-storage combined system and demand side response. Firstly, the charge-discharge strategy of energy storage system equipped at the outlet of wind farm and demand side response strategy are analysed to achieve the best comprehensive benefits through the coordination of the two. Secondly, in the general transmission network planning model with wind power, both energy storage cost and demand side response cost are added to the objective function. Not only energy storage operation constraints and but also demand side response constraints are introduced into the constraint condition. Based on the classical formulation of TEP, a new formulation is developed considering the simultaneous addition of the charge-discharge strategy of energy storage system equipped at the outlet of the wind farm and demand side response strategy, which belongs to a typical mixed integer linear programming model that can be solved by mature optimization software. The case study based on the Garver-6 bus system shows that the validity of the proposed model is verified by comparison with general transmission network planning model. Furthermore, the results demonstrate that the joint planning model can gain more economic benefits through setting up different cases.

  15. Financing Albanian Higher Education: Growth between the Public and Private Sectors

    ERIC Educational Resources Information Center

    Pere, Engjell; Minxhozi, Luljeta

    2011-01-01

    In many countries, reforms in higher education have follow-on effects on social and economic development. This article relates mainly to economic and financial issues regarding the development of higher education. Starting from the notable increase in demand for higher education and the budgetary constraints on public education financing, we argue…

  16. Evaluation of the impact of the voucher and accreditation approach on improving reproductive health behaviors and status in Kenya.

    PubMed

    Warren, Charlotte; Abuya, Timothy; Obare, Francis; Sunday, Joseph; Njue, Rebecca; Askew, Ian; Bellows, Ben

    2011-03-23

    Alternatives to the traditional 'supply-side' approach to financing service delivery are being explored. These strategies are termed results-based finance, demand-side health financing or output-based aid which includes a range of interventions that channel government or donor subsidies to the user rather than the provider. Initial pilot assessments of reproductive health voucher programs suggest that, they can increase access and use, reducing inequities and enhancing program efficiency and service quality. However, there is a paucity of evidence describing how the programs function in different settings, for various reproductive health services. Population Council, funded by the Bill and Melinda Gates Foundation, intends to generate evidence around the 'voucher and accreditation' approaches to improving the reproductive health of low income women in Kenya. A quasi-experimental study will investigate the impact of the voucher approach on improving reproductive health behaviors, reproductive health status and reducing inequities at the population level; and assessing the effect of vouchers on increasing access to, and quality of, and reducing inequities in the use of selected reproductive health services. The study comprises of four populations: facilities, providers, women of reproductive health age using facilities and women and men who have been pregnant and/or used family planning within the previous 12 months. The study will be carried out in samples of health facilities - public, private and faith-based in: three districts; Kisumu, Kiambu, Kitui and two informal settlements in Nairobi which are accredited to provide maternal and newborn health and family planning services to women holding vouchers for the services; and compared with a matched sample of non-accredited facilities. Health facility assessments (HFA) will be conducted at two stages to track temporal changes in quality of care and utilization. Facility inventories, structured observations, and client exit interviews will be used to collect comparable data across facilities. Health providers will also be interviewed and observed providing care. A population survey of about 3000 respondents will also be carried out in areas where vouchers are distributed and similar locations where vouchers are not distributed.

  17. Exploring Tradeoffs in Demand-side and Supply-side Management of Urban Water Resources using Agent-based Modeling and Evolutionary Computation

    NASA Astrophysics Data System (ADS)

    Kanta, L.; Berglund, E. Z.

    2015-12-01

    Urban water supply systems may be managed through supply-side and demand-side strategies, which focus on water source expansion and demand reductions, respectively. Supply-side strategies bear infrastructure and energy costs, while demand-side strategies bear costs of implementation and inconvenience to consumers. To evaluate the performance of demand-side strategies, the participation and water use adaptations of consumers should be simulated. In this study, a Complex Adaptive Systems (CAS) framework is developed to simulate consumer agents that change their consumption to affect the withdrawal from the water supply system, which, in turn influences operational policies and long-term resource planning. Agent-based models are encoded to represent consumers and a policy maker agent and are coupled with water resources system simulation models. The CAS framework is coupled with an evolutionary computation-based multi-objective methodology to explore tradeoffs in cost, inconvenience to consumers, and environmental impacts for both supply-side and demand-side strategies. Decisions are identified to specify storage levels in a reservoir that trigger (1) increases in the volume of water pumped through inter-basin transfers from an external reservoir and (2) drought stages, which restrict the volume of water that is allowed for residential outdoor uses. The proposed methodology is demonstrated for Arlington, Texas, water supply system to identify non-dominated strategies for an historic drought decade. Results demonstrate that pumping costs associated with maximizing environmental reliability exceed pumping costs associated with minimizing restrictions on consumer water use.

  18. 77 FR 40144 - Adoption of the Environmental Impact Statement (EIS) and Participation in the Section 106...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-06

    ...) obligations related to MTA's request for financing for the East Side Access project through the FRA Railroad... Statement (EIS) and Participation in the Section 106 Programmatic Agreement for the East Side Access Project... adoption and recirculation of the Final Environmental Impact Statement for the East Side Access Project and...

  19. Explaining regional variations in health care utilization between Swiss cantons using panel econometric models

    PubMed Central

    2012-01-01

    Background In spite of a detailed and nation-wide legislation frame, there exist large cantonal disparities in consumed quantities of health care services in Switzerland. In this study, the most important factors of influence causing these regional disparities are determined. The findings can also be productive for discussing the containment of health care consumption in other countries. Methods Based on the literature, relevant factors that cause geographic disparities of quantities and costs in western health care systems are identified. Using a selected set of these factors, individual panel econometric models are calculated to explain the variation of the utilization in each of the six largest health care service groups (general practitioners, specialist doctors, hospital inpatient, hospital outpatient, medication, and nursing homes) in Swiss mandatory health insurance (MHI). The main data source is 'Datenpool santésuisse', a database of Swiss health insurers. Results For all six health care service groups, significant factors influencing the utilization frequency over time and across cantons are found. A greater supply of service providers tends to have strong interrelations with per capita consumption of MHI services. On the demand side, older populations and higher population densities represent the clearest driving factors. Conclusions Strategies to contain consumption and costs in health care should include several elements. In the federalist Swiss system, the structure of regional health care supply seems to generate significant effects. However, the extent of driving factors on the demand side (e.g., social deprivation) or financing instruments (e.g., high deductibles) should also be considered. PMID:22413884

  20. 31 CFR 535.420 - Transfers of accounts under § 535.508 from demand to interest-bearing status.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Transfers of accounts under § 535.508... IRANIAN ASSETS CONTROL REGULATIONS Interpretations § 535.420 Transfers of accounts under § 535.508 from demand to interest-bearing status. Section 535.508 authorizes transfer of a blocked demand deposit...

  1. 31 CFR 535.420 - Transfers of accounts under § 535.508 from demand to interest-bearing status.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Transfers of accounts under § 535.508... IRANIAN ASSETS CONTROL REGULATIONS Interpretations § 535.420 Transfers of accounts under § 535.508 from demand to interest-bearing status. Section 535.508 authorizes transfer of a blocked demand deposit...

  2. 31 CFR 535.420 - Transfers of accounts under § 535.508 from demand to interest-bearing status.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Transfers of accounts under § 535... TREASURY IRANIAN ASSETS CONTROL REGULATIONS Interpretations § 535.420 Transfers of accounts under § 535.508 from demand to interest-bearing status. Section 535.508 authorizes transfer of a blocked demand deposit...

  3. Threshold concepts in finance: conceptualizing the curriculum

    NASA Astrophysics Data System (ADS)

    Hoadley, Susan; Tickle, Leonie; Wood, Leigh N.; Kyng, Tim

    2015-08-01

    Graduates with well-developed capabilities in finance are invaluable to our society and in increasing demand. Universities face the challenge of designing finance programmes to develop these capabilities and the essential knowledge that underpins them. Our research responds to this challenge by identifying threshold concepts that are central to the mastery of finance and by exploring their potential for informing curriculum design and pedagogical practices to improve student outcomes. In this paper, we report the results of an online survey of finance academics at multiple institutions in Australia, Canada, New Zealand, South Africa and the United Kingdom. The outcomes of our research are recommendations for threshold concepts in finance endorsed by quantitative evidence, as well as a model of the finance curriculum incorporating finance, modelling and statistics threshold concepts. In addition, we draw conclusions about the application of threshold concept theory supported by both quantitative and qualitative evidence. Our methodology and findings have general relevance to the application of threshold concept theory as a means to investigate and inform curriculum design and delivery in higher education.

  4. China: Management and Finance of Higher Education. A World Bank Country Study.

    ERIC Educational Resources Information Center

    World Bank, Washington, DC.

    Key issues in higher education management and finance in China until the end of the century are examined, along with the effect of recent education reform. Attention is directed to: the government's plan for long-term expansion of higher education posed as three alternative targets for enrollment growth; estimated demand for and supply of…

  5. A new market risk model for cogeneration project financing---combined heat and power development without a power purchase agreement

    NASA Astrophysics Data System (ADS)

    Lockwood, Timothy A.

    Federal legislative changes in 2006 no longer entitle cogeneration project financings by law to receive the benefit of a power purchase agreement underwritten by an investment-grade investor-owned utility. Consequently, this research explored the need for a new market-risk model for future cogeneration and combined heat and power (CHP) project financing. CHP project investment represents a potentially enormous energy efficiency benefit through its application by reducing fossil fuel use up to 55% when compared to traditional energy generation, and concurrently eliminates constituent air emissions up to 50%, including global warming gases. As a supplemental approach to a comprehensive technical analysis, a quantitative multivariate modeling was also used to test the statistical validity and reliability of host facility energy demand and CHP supply ratios in predicting the economic performance of CHP project financing. The resulting analytical models, although not statistically reliable at this time, suggest a radically simplified CHP design method for future profitable CHP investments using four easily attainable energy ratios. This design method shows that financially successful CHP adoption occurs when the average system heat-to-power-ratio supply is less than or equal to the average host-convertible-energy-ratio, and when the average nominally-rated capacity is less than average host facility-load-factor demands. New CHP investments can play a role in solving the world-wide problem of accommodating growing energy demand while preserving our precious and irreplaceable air quality for future generations.

  6. An Analysis of Senate Bill 170, Ohio's Plan to Equalize School Finance.

    ERIC Educational Resources Information Center

    Cornett, Charles F.

    This document analyzes specific provisions of the Ohio bill that attempts to revise the state's system of school finance. The bill attempts to resolve differences in valuation, tax rate, and wealth while providing basic educational services as well as services to nonpublic schools and to handicapped and special students. On the negative side, the…

  7. Implementing demand side targeting mechanisms for maternal and child health-experiences from national health insurance fund program in Rungwe District, Tanzania.

    PubMed

    Kuwawenaruwa, August; Mtei, Gemini; Baraka, Jitihada; Tani, Kassimu

    2016-08-02

    Low and middle income countries have adopted targeting mechanisms as a means of increasing program efficiency in reaching marginalized people in the community given the available resources. Design of targeting mechanisms has been changing over time and it is important to understand implementers' experience with such targeting mechanisms since such mechanisms impact equity in access and use of maternal health care services. The case study approach was considered as appropriate method for exploring implementers' and decision-makers' experiences with the two targeting mechanisms. In-depth interviews in order to explore implementer experience with the two targeting mechanisms. A total of 10 in-depth interviews (IDI) and 4 group discussions (GDs) were conducted with implementers at national level, regional, district and health care facility level. A thematic analysis approach was adopted during data analysis. The whole process of screening and identifying poor pregnant women resulted in delay in implementation of the intervention. Individual targeting was perceived to have some form of stigmatization; hence beneficiaries did not like to be termed as poor. Geographical targeting had a few cons as health care providers experienced an increase in workload while staff remained the same and poor quality of information in the claim forms. However geographical targeting increase in the number of women going to higher level of care (district/regional referral hospital), increase in facility revenue and insurance coverage. Interventions which are using targeting mechanisms to reach poor people are useful in increasing access and use of health care services for marginalized communities so long as they are well designed and beneficiaries as well as all implementers and decision makers are involved from the very beginning. Implementation of demand side financing strategies using targeting mechanisms should go together with supply side interventions in order to achieve project objectives.

  8. Co-optimization of Energy and Demand-Side Reserves in Day-Ahead Electricity Markets

    NASA Astrophysics Data System (ADS)

    Surender Reddy, S.; Abhyankar, A. R.; Bijwe, P. R.

    2015-04-01

    This paper presents a new multi-objective day-ahead market clearing (DAMC) mechanism with demand-side reserves/demand response (DR) offers, considering realistic voltage-dependent load modeling. The paper proposes objectives such as social welfare maximization (SWM) including demand-side reserves, and load served error (LSE) minimization. In this paper, energy and demand-side reserves are cleared simultaneously through co-optimization process. The paper clearly brings out the unsuitability of conventional SWM for DAMC in the presence of voltage-dependent loads, due to reduction of load served (LS). Under such circumstances multi-objective DAMC with DR offers is essential. Multi-objective Strength Pareto Evolutionary Algorithm 2+ (SPEA 2+) has been used to solve the optimization problem. The effectiveness of the proposed scheme is confirmed with results obtained from IEEE 30 bus system.

  9. Physiological and skill demands of 'on-side' and 'off-side' games.

    PubMed

    Gabbett, Tim J; Jenkins, David G; Abernethy, Bruce

    2010-11-01

    This study investigated the physiological and skill demands of 'on-side' and 'off-side' games in elite rugby league players. Sixteen male rugby league players participated in 'on-side' and 'off-side' games. Both small-sided games were played in a 40- × 40-m playing area. The 'off-side' game permitted players to have 3 'plays' while in possession of the ball. Players were permitted to pass backward or forward (to an 'off-side' player). The 'on-side' game also permitted players to have 3 'plays' while in possession of the ball. However, players were only permitted to pass backward to players in an 'on-side' position. Heart rate and movement patterns (via global positioning system) were recorded continuously throughout both games. Data were collected on the distance covered, number of high-acceleration and velocity efforts, and recovery between efforts. Video footage was also taken to track the performance of the players. Post hoc inspection of the footage was undertaken to count the number of possessions and the number and quality of disposals. In comparison to 'on-side' games, 'off-side' games had a greater number of involvements ("touches"), passes, and effective passes. However, the cognitive demands of 'on-side' games were greater than 'off-side' games. 'Off-side' games resulted in a greater total distance covered, greater distance covered in mild and moderate accelerations, and greater distance covered in low, moderate, and high-velocity efforts. There were also a greater number of short duration recovery periods between efforts in 'off-side' games. The results of this study demonstrate that 'off-side' games provide greater physiological and skill demands than 'on-side' games. 'Off-side' games may provide a practical alternative to 'on-side' games for the development of skill and fitness in elite rugby league players.

  10. EPA'S PHOTOVOLTAIC DEMAND-SIDE MANAGEMENT COST-SHARED DEMONSTRATIONS

    EPA Science Inventory

    The paper discusses an investigation of how photovoltaics (PV) may be used as both a pollution-mitigating energy replacement for fossil fuels and a demand-side management (DSM) option to reduce peak electrical demands of commercial and residential buildings. leven electric utilit...

  11. U.S. EPA'S PHOTOVOLTAIC DEMAND-SIDE MANAGEMENT PROJECT

    EPA Science Inventory

    The paper discusses an investigation of how photovoltaic (PV) may be used as both a pollution-mitigating energy replacement for fossil fuels and a demand-side management (DSM) option to reduce peak electrical demands of commercial and residential buildings. leven electric utiliti...

  12. Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and RH status: Bangladesh

    PubMed Central

    2011-01-01

    Background Cost of delivering reproductive health services to low-income populations will always require total or partial subsidization by the government and/or development partners. Broadly termed "Demand-Side Financing" or "Output-Based Aid", includes a range of interventions that channel government or donor subsidies to the service user rather than the service provider. Initial findings from the few assessments of reproductive health voucher-and-accreditation programs suggest that, if implemented well, these programs have great potential for achieving the policy objectives of increasing access and use, reducing inequities and enhancing program efficiency and service quality. At this point in time, however, there is a paucity of evidence describing how the various voucher programs function in different settings, for various reproductive health services. Methods/Design Population Council-Nairobi, funded by the Bill and Melinda Gates Foundation, intends to address the lack of evidence around the pros and cons of 'voucher and accreditation' approaches to improving the reproductive health of low income women in five developing countries. In Bangladesh, the activities will be conducted in 11 accredited health facilities where Demand Side Financing program is being implemented and compared with populations drawn from areas served by similar non-accredited facilities. Facility inventories, client exit interviews and service provider interviews will be used to collect comparable data across each facility for assessing readiness and quality of care. In-depth interviews with key stakeholders will be conducted to gain a deeper understanding about the program. A population-based survey will also be carried out in two types of locations: areas where vouchers are distributed and similar locations where vouchers are not distributed. Discussion This is a quasi-experimental study which will investigate the impact of the voucher approach on improving maternal health behaviors and status and reducing inequities at the population level. We expect a significant increase in the utilization of maternal health care services by the accredited health facilities in the experimental areas compared to the control areas as a direct result of the interventions. If the voucher scheme in Bangladesh is found effective, it may help other countries to adopt this approach for improving utilization of maternity care services for reducing maternal mortality. PMID:21513528

  13. Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and RH status: Bangladesh.

    PubMed

    Rob, Ubaidur; Rahman, Moshiur; Bellows, Benjamin

    2011-04-22

    Cost of delivering reproductive health services to low-income populations will always require total or partial subsidization by the government and/or development partners. Broadly termed "Demand-Side Financing" or "Output-Based Aid", includes a range of interventions that channel government or donor subsidies to the service user rather than the service provider. Initial findings from the few assessments of reproductive health voucher-and-accreditation programs suggest that, if implemented well, these programs have great potential for achieving the policy objectives of increasing access and use, reducing inequities and enhancing program efficiency and service quality. At this point in time, however, there is a paucity of evidence describing how the various voucher programs function in different settings, for various reproductive health services. Population Council-Nairobi, funded by the Bill and Melinda Gates Foundation, intends to address the lack of evidence around the pros and cons of 'voucher and accreditation' approaches to improving the reproductive health of low income women in five developing countries. In Bangladesh, the activities will be conducted in 11 accredited health facilities where Demand Side Financing program is being implemented and compared with populations drawn from areas served by similar non-accredited facilities. Facility inventories, client exit interviews and service provider interviews will be used to collect comparable data across each facility for assessing readiness and quality of care. In-depth interviews with key stakeholders will be conducted to gain a deeper understanding about the program. A population-based survey will also be carried out in two types of locations: areas where vouchers are distributed and similar locations where vouchers are not distributed. This is a quasi-experimental study which will investigate the impact of the voucher approach on improving maternal health behaviors and status and reducing inequities at the population level. We expect a significant increase in the utilization of maternal health care services by the accredited health facilities in the experimental areas compared to the control areas as a direct result of the interventions. If the voucher scheme in Bangladesh is found effective, it may help other countries to adopt this approach for improving utilization of maternity care services for reducing maternal mortality.

  14. Performance-Based Financing to Strengthen the Health System in Benin: Challenging the Mainstream Approach

    PubMed Central

    Paul, Elisabeth; Lamine Dramé, Mohamed; Kashala, Jean-Pierre; Ekambi Ndema, Armand; Kounnou, Marcel; Codjovi Aïssan, Julien; Gyselinck, Karel

    2018-01-01

    Background: Performance-based financing (PBF) is often proposed as a way to improve health system performance. In Benin, PBF was launched in 2012 through a World Bank-supported project. The Belgian Development Agency (BTC) followed suit through a health system strengthening (HSS) project. This paper analyses and draws lessons from the experience of BTC-supported PBF alternative approach – especially with regards to institutional aspects, the role of demand-side actors, ownership, and cost-effectiveness – and explores the mechanisms at stake so as to better understand how the "PBF package" functions and produces effects Methods: An exploratory, theory-driven evaluation approach was adopted. Causal mechanisms through which PBF is hypothesised to impact on results were singled out and explored. This paper stems from the co-authors’ capitalisation of experiences; mixed methods were used to collect, triangulate and analyse information. Results are structured along Witter et al framework. Results: Influence of context is strong over PBF in Benin; the policy is donor-driven. BTC did not adopt the World Bank’s mainstream PBF model, but developed an alternative approach in line with its HSS support programme, which is grounded on existing domestic institutions. The main features of this approach are described (decentralised governance, peer review verification, counter-verification entrusted to health service users’ platforms), as well as its adaptive process. PBF has contributed to strengthen various aspects of the health system and led to modest progress in utilisation of health services, but noticeable improvements in healthcare quality. Three mechanisms explaining observed outcomes within the context are described: comprehensive HSS at district level; acting on health workers’ motivation through a complex package of incentives; and increased accountability by reinforcing dialogue with demand-side actors. Cost-effectiveness and sustainability issues are also discussed. Conclusion: BTC’s alternative PBF approach is both promising in terms of effects, ownership and sustainability, and less resource consuming. This experience testifies that PBF is not a uniform or rigid model, and opens the policy ground for recipient governments to put their own emphasis and priorities and design ad hoc models adapted to their context specificities. However, integrating PBF within the normal functioning of local health systems, in line with other reforms, is a big challenge. PMID:29325401

  15. Early Childhood and Basic Elementary and Secondary Education: Needs, Programs, Demands, Costs. National Educational Finance Project; Special Study No. 1.

    ERIC Educational Resources Information Center

    McLure, William P.; Pence, Audra May

    This report describes two special studies that were funded separately as components of the National Educational Finance Project: (1) Early Childhood Education and (2) Basic Elementary and Secondary Education. For conceptual and operational reasons the two studies were merged into a single study which identifies the needs of individuals in American…

  16. Total Quality Management (TQM) in Self-Financed Technical Institutions: A Quality Function Deployment (QFD) and Force Field Analysis Approach

    ERIC Educational Resources Information Center

    Thakkar, Jitesh; Deshmukh, S. G.; Shastree, Anil

    2006-01-01

    Purpose: To explore the potential for adoption of TQM in self-financed technical institutions in the light of new demands and challenges posed by customers/students and society. Design/methodology/approach: The paper presents use of quality function deployment (QFD) which prioritizes technical requirements and correlates them with various…

  17. Demand-side policies to encourage the use of generic medicines: an overview.

    PubMed

    Dylst, Pieter; Vulto, Arnold; Simoens, Steven

    2013-02-01

    Demand-side policies to encourage the use of generic medicines are important to increase their use. A plethora of different demand-side policies has already been initiated by European governments, thereby targeting physicians, pharmacists and patients. This review aims to give an overview of the different demand-side policies which governments have at their disposal and to evaluate their impact on the use of generic medicines. Positive knowledge and perceptions of physicians, pharmacists and patients of generic medicines are necessary prerequisites to increase the use of generic medicines and governments should initiate policies to achieve this. These policies should be combined with policies to increase their financial responsibility to the healthcare system and policies to facilitate the prescribing of generic medicines.

  18. Using microfinance to facilitate household investment in sanitation in rural Cambodia.

    PubMed

    Geissler, Kimberley H; Goldberg, Jeffrey; Leatherman, Sheila

    2016-11-01

    Improved sanitation access is extremely low in rural Cambodia. Non-governmental organizations have helped build local supply side latrine markets to promote household latrine purchase and use, but households cite inability to pay as a key barrier to purchase. To examine the extent to which microfinance can be used to facilitate household investment in sanitation, we applied a two-pronged assessment: (1) to address the gap between interest in and use of microfinance, we conducted a pilot study to assess microfinance demand and feasibility of integration with a sanitation marketing program and (2) using a household survey (n = 935) at latrine sales events in two rural provinces, we assessed attitudes about microfinance and financing for sanitation. We found substantial stated intent to use a microfinance institution (MFI) loan to purchase a latrine (27%). Five percent of current owners used an MFI loan for latrine purchase. Credit officers attended 159 events, with 4761 individuals attending. Actual loan applications were low, with 4% of sales events attendees applying for a loan immediately following the event (mean = 1.7 loans per event). Ongoing coordination was challenging, requiring management commitment from the sanitation marketing program and commitment to social responsibility from the MFI. Given the importance of improving sanitation coverage and concomitant health impacts, linking functional sanitation markets to already operational finance markets has the potential to give individuals and households more financial flexibility. Further product research and better integration of private vendors and financing modalities are necessary to create a scalable microfinance option for sanitation markets. © 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.

  19. [Policies and innovation in mental healthcare: limits to decoupling from the performance of the SUS].

    PubMed

    Ribeiro, José Mendes; Inglez-Dias, Aline

    2011-12-01

    We studied Brazilian policies on mental health with respect to normative, supply and demand and financing aspects. We concluded that the sustainability of innovations in psychiatric reform depends on enhanced financing and integration with primary care community services, on the overall performance of SUS and the reduction of autonomous and exclusive services in primary care. There is high and rising pressure in demand for services measured in DALY and the incidence of disease. The reduction observed in psychiatric beds was accompanied by the systemic reduction, though with selective reduction for psychiatric hospitalizations. CAPS services have institutional limits due to the model adopted of direct public administration and local government capacity. Secondary data available show that: (i) SUS has a virtual monopoly on general outpatient and hospital services; (ii) mental health specialists belong mostly to SUS; (iii) most mental health services are outpatient services; (iv) few CAPS have day-bed services available; and (v) there is reduced federal financing for these innovations.

  20. Energy Sustainability and the Green Campus.

    ERIC Educational Resources Information Center

    Simpson, Walter

    2003-01-01

    Discusses the importance of campus energy sustainability, explaining that both demand- and supply-side strategies are required. Suggests that on the demand side, an aggressive campus energy conservation program can reduce campus energy consumption by 30 percent or more. Asserts that addressing the supply side of the energy equation means shifting…

  1. Designing and Financing an Integrated Program of College Study: Lessons from the California Academy of Liberal Studies

    ERIC Educational Resources Information Center

    Goldberger, Susan; Haynes, Leslie

    2005-01-01

    This document represents the first in a series of design briefs on models for early college high schools. The briefs focus on the academic and organizational design of the college component and tie those key features to a sustainable financing model. By engaging students in up to two years of demanding college-level work while still in high…

  2. Addressing maternal healthcare through demand side financial incentives: experience of Janani Suraksha Yojana program in India.

    PubMed

    Gopalan, Saji S; Durairaj, Varatharajan

    2012-09-15

    Demand side financing (DSF) is a widely employed strategy to enhance utilization of healthcare. The impact of DSF on health care seeking in general and that of maternal care in particular is already known. Yet, its effect on financial access to care, out-of-pocket spending (OOPS) and provider motivations is not considerably established. Without such evidence, DSFs may not be recommendable to build up any sustainable healthcare delivery approach. This study explores the above aspects on India's Janani Suraksha Yojana (JSY) program. This study employed design and was conducted in three districts of Orissa, selected through a three-stage stratified sampling. The quantitative method was used to review the Health Management Information System (HMIS). The qualitative methods included focus groups discussions with beneficiaries (n = 19) and community intermediaries (n = 9), and interviews (n = 7) with Ministry of Health officials. HMIS data enabled to review maternal healthcare utilization. Group discussions and interviews explored the perceived impact of JSY on in-facility delivery, OOPS, healthcare costs, quality of care and performance motivation of community health workers. The number of institutional deliveries, ante-and post-natal care visits increased after the introduction of JSY with an annual net growth of 18.1%, 3.6% and 5% respectively. The financial incentive provided partial financial risk-protection as it could cover only 25.5% of the maternal healthcare cost of the beneficiaries in rural areas and 14.3% in urban areas. The incentive induced fresh out-of-pocket spending for some mothers and it could not address maternal care requirements comprehensively. An activity-based community worker model was encouraging to augment maternal healthcare consumption. However, the existing level of financial incentives and systemic support were inadequate to motivate the volunteers optimally on their performance. Demand side financial incentive could enhance financial access to maternal healthcare. However, it did not adequately protect households from financial risks. An effective integration of JSY with similar social protection or financial risk-protection measures may protect mothers substantially from potential out-of-pocket spending. Further, this integrated approach may help upholding more awareness on maternal health rights and entitlements. It can also address maternal health beyond 'maternal healthcare' and ensure sustainability through pooled financial and non-financial resources.

  3. Eliminating Electricity Deficit through Energy Efficiency in India: An Evaluation of Aggregate Economic and Carbon Benefits

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

    Sathaye, Jayant; Gupta, Arjun

    2010-04-30

    Electricity demand has consistently exceeded available supply in India. While the electricity deficit varies across states, nationally it was estimated to be of the order of 12percent on peak and 11percent for electricity during 2008-09. This paper explores a demand-side focused potential for energy efficiency improvement to eliminate the electricity deficit compared to a business as usual (BAU) supply-side focused scenario. The limited availability of finance and other legal and administrative barriers have constrained the construction of new power plant capacity in India. As a result, under the BAU scenario, India continues to face an electricity deficit beyond the endmore » of the Twelfth Five Year Plan. The demand-side cost-effective potential achieved through replacement of new electricity-using products, however, is large enough to eliminate the deficit as early as 2013 and subsequently reduce the future construction of power plants and thus reduce air pollutant emissions. Moreover, energy efficiency improvements cost a fraction of the cost for new supply and can lead to a substantial increase in India's economic output or gross domestic product (GDP). Eliminating the deficit permits businesses that have experienced electricity cutbacks to restore production. We estimate the size of the cumulative production increase in terms of the contribution to GDP at a $505 billion between 2009 and 2017, the end of India's Twelfth Five Year Plan, which may be compared with India's 2007-08 GDP of $911 billion. The economic output is influenced by the size of the electricity savings and rate of penetration of energy efficient technologies, and that of self-generation equipment and inverters used by businesses faced with electricity cuts. Generation and inverters are estimated to service 23percent of these customers in 2009, which increase to 48percent by 2020. The reduction in the construction and operation of new power plants reduces the cumulative CO2 emissions by 65 Mt, and those of sulfur dioxide and nitrogen oxides by 0.4 Mt each, while also reducing India's imports of coal and natural gas. By 2020, the cumulative GDP benefit increases to $608 billion, the CO2 savings expand to 333 Mt and SO2 and NOx to 2.1 Mt.« less

  4. Research on Simulation Requirements and Business Architecture of Automated Demand Response in Power Sales Side Market Liberalization

    NASA Astrophysics Data System (ADS)

    Liu, Yiqun; Zhou, Pengcheng; Zeng, Ming; Chen, Songsong

    2018-01-01

    With the gradual reform of the electricity market, the power sale side liberalization has become the focus of attention as the key task of reform. The open power market provides a good environment for DR (Demand Response). It is of great significance to research the simulation requirements and business architecture of ADR (Automatic Demand Response) in power sale side market liberalization. Firstly, this paper analyzes the simulation requirements of ADR. Secondly, it analyzes the influence factors that the business development of ADR from five aspects after power sale side market liberalization. Finally, Based on ADR technology support system, the business architecture of ADR after power sale side market liberalization is constructed.

  5. Policies to Enhance Prescribing Efficiency in Europe: Findings and Future Implications

    PubMed Central

    Godman, Brian; Shrank, William; Andersen, Morten; Berg, Christian; Bishop, Iain; Burkhardt, Thomas; Garuoliene, Kristina; Herholz, Harald; Joppi, Roberta; Kalaba, Marija; Laius, Ott; Lonsdale, Julie; Malmström, Rickard E.; Martikainen, Jaana E.; Samaluk, Vita; Sermet, Catherine; Schwabe, Ulrich; Teixeira, Inês; Tilson, Lesley; Tulunay, F. Cankat; Vlahović-Palčevski, Vera; Wendykowska, Kamila; Wettermark, Bjorn; Zara, Corinne; Gustafsson, Lars L.

    2010-01-01

    Introduction: European countries need to learn from each other to address unsustainable increases in pharmaceutical expenditures. Objective: To assess the influence of the many supply and demand-side initiatives introduced across Europe to enhance prescribing efficiency in ambulatory care. As a result provide future guidance to countries. Methods: Cross national retrospective observational study of utilization (DDDs – defined daily doses) and expenditure (Euros and local currency) of proton pump inhibitors (PPIs) and statins among 19 European countries and regions principally from 2001 to 2007. Demand-side measures categorized under the “4Es” – education engineering, economics, and enforcement. Results: Instigating supply side initiatives to lower the price of generics combined with demand-side measures to enhance their prescribing is important to maximize prescribing efficiency. Just addressing one component will limit potential efficiency gains. The influence of demand-side reforms appears additive, with multiple initiatives typically having a greater influence on increasing prescribing efficiency than single measures apart from potentially “enforcement.” There are also appreciable differences in expenditure (€/1000 inhabitants/year) between countries. Countries that have not introduced multiple demand side measures to counteract commercial pressures to enhance the prescribing of generics have seen considerably higher expenditures than those that have instigated a range of measures. Conclusions: There are considerable opportunities for European countries to enhance their prescribing efficiency, with countries already learning from each other. The 4E methodology allows European countries to concisely capture the range of current demand-side measures and plan for the future knowing that initiatives can be additive to further enhance their prescribing efficiency. PMID:21833180

  6. Supply-side and demand-side policies for biosimilars: an overview in 10 European member states.

    PubMed

    Rémuzat, Cécile; Kapuśniak, Anna; Caban, Aleksandra; Ionescu, Dan; Radière, Guerric; Mendoza, Cyril; Toumi, Mondher

    2017-01-01

    This study aimed to provide an overview of biosimilar policies in 10 EU MSs. Methods : Ten EU MS pharmaceutical markets (Belgium, France, Germany, Greece, Hungary, Italy, Poland, Spain, Sweden, and the UK) were selected. A comprehensive literature review was performed to identify supply-side and demand-side policies in place in the selected countries. Results : Supply-side policies for biosimilars commonly include price linkage, price re-evaluation, and tendering; the use of internal or external reference pricing varies between countries; health technology assessment is conducted in six countries. Regarding demand-side policies, pharmaceutical prescription budgets or quotas and monitoring of prescriptions (with potential financial incentives or penalties) are in place in eight and in seven countries respectively. Switching is generally allowed, but is solely the physician's responsibility. Automatic substitution is not recommended, or even forbidden, in most EU MSs. Prescription conditions or guidelines that apply to biosimilars are established in nearly all surveyed EU MSs. Conclusions : Important heterogeneity in policies on biosimilars was seen between (and even within) selected countries, which may partly explain variations in biosimilar uptake. Supply-side policies targeting price have been reported to limit biosimilar penetration in the long term, despite short-term savings, while demand-side policies are considered to positively impact uptake.

  7. Supply-side and demand-side policies for biosimilars: an overview in 10 European member states

    PubMed Central

    Rémuzat, Cécile; Kapuśniak, Anna; Caban, Aleksandra; Ionescu, Dan; Radière, Guerric; Mendoza, Cyril; Toumi, Mondher

    2017-01-01

    ABSTRACT Objective: This study aimed to provide an overview of biosimilar policies in 10 EU MSs. Methods: Ten EU MS pharmaceutical markets (Belgium, France, Germany, Greece, Hungary, Italy, Poland, Spain, Sweden, and the UK) were selected. A comprehensive literature review was performed to identify supply-side and demand-side policies in place in the selected countries. Results: Supply-side policies for biosimilars commonly include price linkage, price re-evaluation, and tendering; the use of internal or external reference pricing varies between countries; health technology assessment is conducted in six countries. Regarding demand-side policies, pharmaceutical prescription budgets or quotas and monitoring of prescriptions (with potential financial incentives or penalties) are in place in eight and in seven countries respectively. Switching is generally allowed, but is solely the physician’s responsibility. Automatic substitution is not recommended, or even forbidden, in most EU MSs. Prescription conditions or guidelines that apply to biosimilars are established in nearly all surveyed EU MSs. Conclusions: Important heterogeneity in policies on biosimilars was seen between (and even within) selected countries, which may partly explain variations in biosimilar uptake. Supply-side policies targeting price have been reported to limit biosimilar penetration in the long term, despite short-term savings, while demand-side policies are considered to positively impact uptake. PMID:28740617

  8. Did Project Liberty displace community-based medicaid services in New York?

    PubMed

    Gomes, Carla; McGuire, Thomas G; Foster, M Jameson; Donahue, Sheila A; Felton, Chip J; Essock, Susan M

    2006-09-01

    This study analyzed how the introduction of Project Liberty services after the September 11, 2001, terrorist attacks affected agencies' provision of community-based Medicaid mental health services in the New York metropolitan area. Provision of Medicaid mental health services was tracked between January 2000 and June 2003 for provider agencies participating in Project Liberty (N=164) and for a comparison group of mental health provider agencies that did not participate in this program (N=94). Overall, participation in Project Liberty did not significantly affect the volume of Medicaid services provided. However, for agencies with one site, a statistically significant difference was seen; compared with agencies in the comparison group, agencies that participated in Project Liberty claimed a mean+/-SE decrease of $4.66+/-3.57 less in Medicaid services per month per Project Liberty visit. Project Liberty permitted rapid expansion of the total volume of services provided by community-based organizations without interfering with the provision of traditional services, although a modest effect was seen for smaller agencies. Although the results do not imply that "supply side" planning for disaster needs would not improve system response, they do imply that implementation of flexible "demand side" financing can call forth a large volume of new services rapidly and without interfering with other community services.

  9. China's public health-care system: facing the challenges.

    PubMed Central

    Liu, Yuanli

    2004-01-01

    The severe acute respiratory syndrome (SARS) crisis in China revealed not only the failures of the Chinese health-care system but also some fundamental structural deficiencies. A decentralized and fragmented health system, such as the one found in China, is not well-suited to making a rapid and coordinated response to public health emergencies. The commercial orientation of the health sector on the supply-side and lack of health insurance coverage on the demand-side further exacerbate the problems of the under-provision of public services, such as health surveillance and preventive care. For the past 25 years, the Chinese Government has kept economic development at the top of the policy agenda at the expense of public health, especially in terms of access to health care for the 800 million people living in rural areas. A significant increase in government investment in the public health infrastructure, though long overdue, is not sufficient to solve the problems of the health-care system. China needs to reorganize its public health system by strengthening both the vertical and horizontal connections between its various public health organizations. China's recent policy of establishing a matching-fund financed rural health insurance system presents an exciting opportunity to improve people's access to health care. PMID:15500285

  10. Providing for Progress: California Higher Education Enrollment Demand and Resources into the 21st Century.

    ERIC Educational Resources Information Center

    California State Postsecondary Education Commission, Sacramento.

    This report projects 12-year enrollment demand for California's three public higher education systems, analyzes campus physical capacity and projected capital outlay costs, and discusses economic trends and California's ability to sell bonds to finance future higher education construction. The report is a major update to a 1995 report, "A…

  11. Altruism in the "Market" for Giving and Receiving: A Case of Higher Education.

    ERIC Educational Resources Information Center

    Yoo, Jang H.; Harrison, William B.

    1989-01-01

    Examines donations to colleges as an outcome of simultaneously solving supply and demand functions. Donors demand attention and prestige supplied by college fund raisers. Using data from 13 colleges, this econometric study shows that the demand side has a unitary elasticity concerning per person donations, while the supply side seems inelastic.…

  12. UNEQUAL RISK: COMBAT OCCUPATIONS IN THE VOLUNTEER MILITARY

    PubMed Central

    MacLEAN, ALAIR; PARSONS, NICHOLAS L.

    2011-01-01

    This study evaluates the characteristics of the men who served in the volunteer military in combat occupations. It examines whether these characteristics stem from supply-side or demand-side decisions, or reflect class bias. The findings suggest that, on the supply side, men who had greater academic abilities were more likely to go to college, thereby avoiding military service and the possibility of serving in a combat occupation. On the demand side, the armed forces were more likely to exclude men with lower academic abilities but were more likely to assign such men in the military to combat occupations. Net of the impacts of these supply-side and demand-side decisions, men who served in combat occupations still differed from those who did not in terms of their family background. The impact of family background was stronger on entering the military than on being assigned to combat occupations once in the military. PMID:21691446

  13. Four measures of transportation's economic importance

    DOT National Transportation Integrated Search

    2000-04-01

    As a commodity, transportation has a supply side and a demand side. Unlike many other commodities, however, transportation's supply and demand overlap extensively. A significant portion of transportation : is provided by consumers for their own use. ...

  14. Healthcare in Japan: its professionals, institutions, and financing.

    PubMed

    Al-Assaf, A F; Payne, J

    1991-01-01

    Like the United States, Japan's healthcare system is a conglomerate of government, employer, and individual financing--but that's about as far as the similarity goes. Universal access to basic healthcare has been achieved in Japan through comprehensive employer/employee plans and government subsidies. However, the United States should not be too hasty in emulating Japan, for culture plays a definite role in healthcare on both sides of the Pacific.

  15. Universal health coverage in Turkey: enhancement of equity.

    PubMed

    Atun, Rifat; Aydın, Sabahattin; Chakraborty, Sarbani; Sümer, Safir; Aran, Meltem; Gürol, Ipek; Nazlıoğlu, Serpil; Ozgülcü, Senay; Aydoğan, Ulger; Ayar, Banu; Dilmen, Uğur; Akdağ, Recep

    2013-07-06

    Turkey has successfully introduced health system changes and provided its citizens with the right to health to achieve universal health coverage, which helped to address inequities in financing, health service access, and health outcomes. We trace the trajectory of health system reforms in Turkey, with a particular emphasis on 2003-13, which coincides with the Health Transformation Program (HTP). The HTP rapidly expanded health insurance coverage and access to health-care services for all citizens, especially the poorest population groups, to achieve universal health coverage. We analyse the contextual drivers that shaped the transformations in the health system, explore the design and implementation of the HTP, identify the factors that enabled its success, and investigate its effects. Our findings suggest that the HTP was instrumental in achieving universal health coverage to enhance equity substantially, and led to quantifiable and beneficial effects on all health system goals, with an improved level and distribution of health, greater fairness in financing with better financial protection, and notably increased user satisfaction. After the HTP, five health insurance schemes were consolidated to create a unified General Health Insurance scheme with harmonised and expanded benefits. Insurance coverage for the poorest population groups in Turkey increased from 2·4 million people in 2003, to 10·2 million in 2011. Health service access increased across the country-in particular, access and use of key maternal and child health services improved to help to greatly reduce the maternal mortality ratio, and under-5, infant, and neonatal mortality, especially in socioeconomically disadvantaged groups. Several factors helped to achieve universal health coverage and improve outcomes. These factors include economic growth, political stability, a comprehensive transformation strategy led by a transformation team, rapid policy translation, flexible implementation with continuous learning, and simultaneous improvements in the health system, on both the demand side (increased health insurance coverage, expanded benefits, and reduced cost-sharing) and the supply side (expansion of infrastructure, health human resources, and health services). Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Demand Side Management: An approach to peak load smoothing

    NASA Astrophysics Data System (ADS)

    Gupta, Prachi

    A preliminary national-level analysis was conducted to determine whether Demand Side Management (DSM) programs introduced by electric utilities since 1992 have made any progress towards their stated goal of reducing peak load demand. Estimates implied that DSM has a very small effect on peak load reduction and there is substantial regional and end-user variability. A limited scholarly literature on DSM also provides evidence in support of a positive effect of demand response programs. Yet, none of these studies examine the question of how DSM affects peak load at the micro-level by influencing end-users' response to prices. After nearly three decades of experience with DSM, controversy remains over how effective these programs have been. This dissertation considers regional analyses that explore both demand-side solutions and supply-side interventions. On the demand side, models are estimated to provide in-depth evidence of end-user consumption patterns for each North American Electric Reliability Corporation (NERC) region, helping to identify sectors in regions that have made a substantial contribution to peak load reduction. The empirical evidence supports the initial hypothesis that there is substantial regional and end-user variability of reductions in peak demand. These results are quite robust in rapidly-urbanizing regions, where air conditioning and lighting load is substantially higher, and regions where the summer peak is more pronounced than the winter peak. It is also evident from the regional experiences that active government involvement, as shaped by state regulations in the last few years, has been successful in promoting DSM programs, and perhaps for the same reason we witness an uptick in peak load reductions in the years 2008 and 2009. On the supply side, we estimate the effectiveness of DSM programs by analyzing the growth of capacity margin with the introduction of DSM programs. The results indicate that DSM has been successful in offsetting the need for additional production capacity by the means of demand response measures, but the success is limited to only a few regions. The rate of progress in the future will depend on a wide range of improved technologies and a continuous government monitoring for successful adoption of demand response programs to manage growing energy demand.

  17. Optimizing Air Transportation Service to Metroplex Airports. Par 2; Analysis Using the Airline Schedule Optimization Model (ASOM)

    NASA Technical Reports Server (NTRS)

    Donoue, George; Hoffman, Karla; Sherry, Lance; Ferguson, John; Kara, Abdul Qadar

    2010-01-01

    The air transportation system is a significant driver of the U.S. economy, providing safe, affordable, and rapid transportation. During the past three decades airspace and airport capacity has not grown in step with demand for air transportation; the failure to increase capacity at the same rate as the growth in demand results in unreliable service and systemic delay. This report describes the results of an analysis of airline strategic decision-making that affects geographic access, economic access, and airline finances, extending the analysis of these factors using historic data (from Part 1 of the report). The Airline Schedule Optimization Model (ASOM) was used to evaluate how exogenous factors (passenger demand, airline operating costs, and airport capacity limits) affect geographic access (markets-served, scheduled flights, aircraft size), economic access (airfares), airline finances (profit), and air transportation efficiency (aircraft size). This analysis captures the impact of the implementation of airport capacity limits, as well as the effect of increased hedged fuel prices, which serve as a proxy for increased costs per flight that might occur if auctions or congestion pricing are imposed; also incorporated are demand elasticity curves based on historical data that provide information about how passenger demand is affected by airfare changes.

  18. Financing dengue vaccine introduction in the Americas: challenges and opportunities.

    PubMed

    Constenla, Dagna; Clark, Samantha

    2016-01-01

    Dengue has escalated in the region of the Americas unabated despite major investments in integrated vector control and prevention strategies. An effective and affordable dengue vaccine can play a critical role in reducing the human and economic costs of the disease by preventing millions around the world from getting sick. However, there are considerable challenges on the path towards vaccine introduction. These include lack of sufficient financing tools, absence of capacity within national level decision-making bodies, and demands that new vaccines place on stressed health systems. Various financing models can be used to overcome these challenges including setting up procurement mechanisms, integrating regional and domestic taxes, and setting up low interest multilateral loans. In this paper we review these challenges and opportunities of financing dengue vaccine introduction in the Americas.

  19. A 'demand side' estimate of the dollar value of the cannabis black market in New Zealand.

    PubMed

    Wilkins, Chris; Bhatta, Krishna; Casswell, Sally

    2002-06-01

    The dollar value of an illicit drug market is an important statistic in drug policy analysis. It can be used to illustrate the scale of the trade in a drug; evaluate its impact on a local community or nation; provide an indication of the level of criminality related to a drug; and can inform discussions of future drug policy options. This paper calculates the first ever demand side estimates of the New Zealand cannabis black market. The estimates produced are calculated using cannabis consumption data from the Alcohol & Public Health Research Unit's (APHRU) 1998 National Drug Survey. The wholesale value of the market is estimated to be 81.3-104.6 million dollars a year, and the retail value of the market is estimated to be 131.3-168.9 million dollars a year. These demand side estimates are much lower than the existing supply side estimates of the market calculated using police seizures of cannabis plants. The retail figure is four times lower than the lowest national supply side estimate (636 million dollars) and seven times lower than the highest national supply side estimate (1.27 billion dollars). The demand side estimates suggest a much smaller cannabis economy to fuel organized criminal activity in New Zealand than previous estimates implied.

  20. What drives public health care expenditure growth? Evidence from Swiss cantons, 1970-2012.

    PubMed

    Braendle, Thomas; Colombier, Carsten

    2016-09-01

    A better understanding of the determinants of public health care expenditures is key to designing effective health policies. We integrate demand and supply-side determinants and factors from political economy into an empirical analysis of the highly decentralized Swiss health care system and control for major health care finance reforms. We compile a novel data set of the cantonal health care expenditure in Switzerland, which currently amounts to about one fifth of total health care expenditure. We analyze the period 1970-2012 and use dynamic panel estimation methods. We find that per capita income, the unemployment rate and the share of foreigners are positively related to public health care expenditure growth. With regard to political economy aspects, public health care expenditures increase with the share of women elected to parliament. However, institutional restrictions for politicians, such as fiscal rules, do not appear to limit public health care expenditure growth. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Evaluating the administration costs of biologic drugs: development of a cost algorithm.

    PubMed

    Tetteh, Ebenezer K; Morris, Stephen

    2014-12-01

    Biologic drugs, as with all other medical technologies, are subject to a number of regulatory, marketing, reimbursement (financing) and other demand-restricting hurdles applied by healthcare payers. One example is the routine use of cost-effectiveness analyses or health technology assessments to determine which medical technologies offer value-for-money. The manner in which these assessments are conducted suggests that, holding all else equal, the economic value of biologic drugs may be determined by how much is spent on administering these drugs or trade-offs between drug acquisition and administration costs. Yet, on the supply-side, it seems very little attention is given to how manufacturing and formulation choices affect healthcare delivery costs. This paper evaluates variations in the administration costs of biologic drugs, taking care to ensure consistent inclusion of all relevant cost resources. From this, it develops a regression-based algorithm with which manufacturers could possibly predict, during process development, how their manufacturing and formulation choices may impact on the healthcare delivery costs of their products.

  2. Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health

    PubMed Central

    2013-01-01

    Background The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs. This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. Methods We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. Results We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. Conclusions The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also changed. However, as is now well-recognised in the user fee literature, co-ordination of health financing and human resource policies is essential. This appears less well recognised in the human resources literature. This coordination involves considering user charges, resource availability at health facility level, health worker pay, terms and conditions, and recruitment in tandem. All these policies need to be effectively monitored in their processes as well as outcomes, but sufficient data are not collected for this purpose. PMID:24053731

  3. Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health.

    PubMed

    McPake, Barbara; Witter, Sophie; Ensor, Tim; Fustukian, Suzanne; Newlands, David; Martineau, Tim; Chirwa, Yotamu

    2013-09-22

    The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs.This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also changed.However, as is now well-recognised in the user fee literature, co-ordination of health financing and human resource policies is essential. This appears less well recognised in the human resources literature. This coordination involves considering user charges, resource availability at health facility level, health worker pay, terms and conditions, and recruitment in tandem. All these policies need to be effectively monitored in their processes as well as outcomes, but sufficient data are not collected for this purpose.

  4. Ecosystem service markets 101: supply and demand for nature

    Treesearch

    Rhonda Mazza; Jeff Kline; Trista Patterson

    2012-01-01

    Establishing markets for ecosystem services—the benefits that nature provides, such as clean air, water, and wildlife habitat—has gained traction in some circles as a way to finance the conservation of these public goods. Market influences on supply and demand work in tandem to encourage ecosystem protection. Jeff Kline and Trista Patterson, scientists with the...

  5. Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries

    PubMed Central

    Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

    2015-01-01

    Objectives Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. Methods An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. Results How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. Conclusions The development of hospital leaders’ skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. PMID:26683885

  6. Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries.

    PubMed

    Burnett, Susan; Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

    2016-04-01

    Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. The development of hospital leaders' skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. © The Author(s) 2015.

  7. [Dealing with Waiting Times in Health Systems - An International Comparative Overview].

    PubMed

    Finkenstädt, V

    2015-10-01

    Waiting times in the health system are a form of rationing that exists in many countries. Previous studies on this topic are mainly related to the problem of international comparability of waiting times or on the presentation of national strategies as to how they should be reduced. This review adds to this analysis and examines how the OECD countries deal with waiting times in the health-care system and investigates which information is published about waiting for what purpose. Furthermore, waiting times and the type of health system financing are compared. A systematic internet research on waiting times in the health-care system was conducted on the websites of the competent authorities (Ministry of Health or other authorities and institutions). The identified publications were then examined for the purpose of their deployment. Finally, the OECD Health Data were analysed to determine the relationship between tax and contribution financing of public health care expenditure. The primary form of financing was compared with the results of the waiting time analysis. 16 OECD countries are identified which officially collect and publish administrative data on waiting times on the Internet. The data are processed differently depending on the country. By providing this information, two main objectives are pursued: a public monitoring of waiting times in the health system (14 countries) and information for patients on waiting times (9 countries). Official statistics on waiting times exist mainly in countries with tax-financed health systems, whereas this is not the case in the majority of OECD countries with health systems that are funded through contributions. The publication of administrative waiting times data is primarily intended to inform the patient and as a performance indicator in terms of access to health care. Even if data on waiting times are published, the publication of indicators and the management of waiting lists alone will not solve the problem. Rather, the analysis shows that in tax-funded health systems access to medical care is frequently rationed and the demand side is often regulated by waiting lists. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Introduction of performance-based financing in burundi was associated with improvements in care and quality.

    PubMed

    Bonfrer, Igna; Soeters, Robert; Van de Poel, Ellen; Basenya, Olivier; Longin, Gashubije; van de Looij, Frank; van Doorslaer, Eddy

    2014-12-01

    Several governments in low- and middle-income countries have adopted performance-based financing to increase health care use and improve the quality of health services. We evaluated the effects of performance-based financing in the central African nation of Burundi by exploiting the staggered rollout of this financing across provinces during 2006-10. We found that performance-based financing increased the share of women delivering their babies in an institution by 22 percentage points, which reflects a relative increase of 36 percent, and the share of women using modern family planning services by 5 percentage points, a relative change of 55 percent. The overall quality score for health care facilities increased by 45 percent during the study period, but performance-based financing was found to have no effect on the quality of care as reported by patients. We did not find strong evidence of differential effects of performance-based financing across socioeconomic groups. The performance-based financing effects on the probability of using care when ill were found to be even smaller for the poor. Our findings suggest that a supply-side intervention such as performance-based financing without accompanying access incentives for poor people is unlikely to improve equity. More research into the cost-effectiveness of performance-based financing and how best to target vulnerable populations is warranted. Project HOPE—The People-to-People Health Foundation, Inc.

  9. Planning, Managing, and Financing in the 1980s. Achieving Excellence, Diversity, and Access in the Context of Stable Resources and Demands for Increased Productivity. Proceedings of the 1977 NCHEMS National Assembly (Denver, Colorado, November 6-8, 1977).

    ERIC Educational Resources Information Center

    Western Interstate Commission for Higher Education, Boulder, CO. National Center for Higher Education Management Systems.

    The 1977 National Assembly of the National Center for Higher Education Management Systems addressed specific aspects of excellence, diversity, and access to postsecondary education and suggested ways to preserve these values in planning, managing, and financing in the 1980's. The following conference papers are presented: "Placing Value…

  10. Performance-Based Financing to Strengthen the Health System in Benin: Challenging the Mainstream Approach.

    PubMed

    Paul, Elisabeth; Lamine Dramé, Mohamed; Kashala, Jean-Pierre; Ekambi Ndema, Armand; Kounnou, Marcel; Codjovi Aïssan, Julien; Gyselinck, Karel

    2017-04-15

    Performance-based financing (PBF) is often proposed as a way to improve health system performance. In Benin, PBF was launched in 2012 through a World Bank-supported project. The Belgian Development Agency (BTC) followed suit through a health system strengthening (HSS) project. This paper analyses and draws lessons from the experience of BTC-supported PBF alternative approach - especially with regards to institutional aspects, the role of demand-side actors, ownership, and cost-effectiveness - and explores the mechanisms at stake so as to better understand how the "PBF package" functions and produces effects. An exploratory, theory-driven evaluation approach was adopted. Causal mechanisms through which PBF is hypothesised to impact on results were singled out and explored. This paper stems from the co-authors' capitalisation of experiences; mixed methods were used to collect, triangulate and analyse information. Results are structured along Witter et al framework. Influence of context is strong over PBF in Benin; the policy is donor-driven. BTC did not adopt the World Bank's mainstream PBF model, but developed an alternative approach in line with its HSS support programme, which is grounded on existing domestic institutions. The main features of this approach are described (decentralised governance, peer review verification, counter-verification entrusted to health service users' platforms), as well as its adaptive process. PBF has contributed to strengthen various aspects of the health system and led to modest progress in utilisation of health services, but noticeable improvements in healthcare quality. Three mechanisms explaining observed outcomes within the context are described: comprehensive HSS at district level; acting on health workers' motivation through a complex package of incentives; and increased accountability by reinforcing dialogue with demand-side actors. Cost-effectiveness and sustainability issues are also discussed. BTC's alternative PBF approach is both promising in terms of effects, ownership and sustainability, and less resource consuming. This experience testifies that PBF is not a uniform or rigid model, and opens the policy ground for recipient governments to put their own emphasis and priorities and design ad hoc models adapted to their context specificities. However, integrating PBF within the normal functioning of local health systems, in line with other reforms, is a big challenge. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

  11. CO2 Mitigation Measures of Power Sector and Its Integrated Optimization in China

    PubMed Central

    Dai, Pan; Chen, Guang; Zhou, Hao; Su, Meirong; Bao, Haixia

    2012-01-01

    Power sector is responsible for about 40% of the total CO2 emissions in the world and plays a leading role in climate change mitigation. In this study, measures that lower CO2 emissions from the supply side, demand side, and power grid are discussed, based on which, an integrated optimization model of CO2 mitigation (IOCM) is proposed. Virtual energy, referring to energy saving capacity in both demand side and the power grid, together with conventional energy in supply side, is unified planning for IOCM. Consequently, the optimal plan of energy distribution, considering both economic benefits and mitigation benefits, is figured out through the application of IOCM. The results indicate that development of demand side management (DSM) and smart grid can make great contributions to CO2 mitigation of power sector in China by reducing the CO2 emissions by 10.02% and 12.59%, respectively, in 2015, and in 2020. PMID:23213305

  12. Geothermal Potential for China, Poland and Turkey with/Financing Workbook

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

    Keller, J G

    This collection of documents presents the results of assessments of the geothermal power potential in three countries: China, Poland, and Turkey. Also included is a Geothermal Financing Workbook, which is intended to provide a comprehensive package of information on financing, financing plans, financial analysis, and financial sources for smaller geothermal resource developers. All three countries are facing ever increasing demands for power in the coming decades, but each has some barriers to fully developing existing resources. For Poland and Turkey, it is important that legislation specific to geothermal resource development be enacted. For China, a crucial step is to developmore » more detailed and accurate estimates of resource potential. All three countries could benefit from the expertise of U.S. geothermal companies, and this collection of material provides crucial information for those interested companies.« less

  13. An Evaluation of Alternatives for Processing of Administrative Pay Vouchers: A Simulation Approach.

    DTIC Science & Technology

    1982-09-01

    Finance Travel Voucher Q-GERT Productivity Personnel Forecasts Simulation Model 20. ABSTRACT (Continue on reverse side if necessary end Jdentfly by...Finance Office (ACF) has devised a Point System for use in determining the productivity of the ACF Travel Section (ACFTT). This Point System sets values...5 to 5+) to be assigned to incoming travel vouchers based on voucher complexity. This research had set objectives of (1) building an ACFTT model that

  14. Demand-Side Job Development and System Change.

    ERIC Educational Resources Information Center

    Gilbride, Dennis; Stensrud, Robert

    1999-01-01

    Authors discuss demand-side job development as a model for improving and providing rehabilitation services to consumers and employers. It stresses quality employment outcomes, consumer choice and empowerment, and a productive partnership between consumer and counselor. Delineates systemic challenges this model poses to traditional vocational…

  15. Day Care Centers: Profit Making Businesses?

    ERIC Educational Resources Information Center

    MacEwan, Phyllis

    1970-01-01

    Deplores promotion of day care for profit, and urges opposition to this trend. Suggests strong political demand for free centers controlled by parents and financed by public funds and perhaps taxation on large corporations. (CJ)

  16. HEW Proposals Open Door for Ms. Jock

    ERIC Educational Resources Information Center

    Klopfer, Susan

    1974-01-01

    Discusses the increased demand for women's sports programs as reflected in student publications following the signing of Title 9 of the Education Amendments Act which prohibits sex bias in federally financed education programs. (RB)

  17. Changing HIV treatment eligibility under health system constraints in sub-Saharan Africa: investment needs, population health gains, and cost-effectiveness

    PubMed Central

    Hontelez, Jan A.C.; Chang, Angela Y.; Ogbuoji, Osondu; de Vlas, Sake J.; Bärnighausen, Till; Atun, Rifat

    2016-01-01

    Objective: We estimated the investment needs, population health gains, and cost-effectiveness of different policy options for scaling-up prevention and treatment of HIV in the 10 countries that currently comprise 80% of all people living with HIV in sub-Saharan Africa (Ethiopia, Kenya, Malawi, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe). Design: We adapted the established STDSIM model to capture the health system dynamics: demand-side and supply-side constraints in the delivery of antiretroviral treatment (ART). Methods: We compared different scenarios of supply-side (i.e. health system capacity) and demand-side (i.e. health seeking behavior) constraints, and determined the impact of changing guidelines to ART eligibility at any CD4+ cell count within these constraints. Results: Continuing current scale-up would require US$178 billion by 2050. Changing guidelines to ART at any CD4+ cell count is cost-effective under all constraints tested in the model, especially in demand-side constrained health systems because earlier initiation prevents loss-to-follow-up of patients not yet eligible. Changing guidelines under current demand-side constraints would avert 1.8 million infections at US$208 per life-year saved. Conclusion: Treatment eligibility at any CD4+ cell count would be cost-effective, even under health system constraints. Excessive loss-to-follow-up and mortality in patients not eligible for treatment can be avoided by changing guidelines in demand-side constrained systems. The financial obligation for sustaining the AIDS response in sub-Saharan Africa over the next 35 years is substantial and requires strong, long-term commitment of policy-makers and donors to continue to allocate substantial parts of their budgets. PMID:27367487

  18. Changing HIV treatment eligibility under health system constraints in sub-Saharan Africa: investment needs, population health gains, and cost-effectiveness.

    PubMed

    Hontelez, Jan A C; Chang, Angela Y; Ogbuoji, Osondu; de Vlas, Sake J; Bärnighausen, Till; Atun, Rifat

    2016-09-24

    We estimated the investment needs, population health gains, and cost-effectiveness of different policy options for scaling-up prevention and treatment of HIV in the 10 countries that currently comprise 80% of all people living with HIV in sub-Saharan Africa (Ethiopia, Kenya, Malawi, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe). We adapted the established STDSIM model to capture the health system dynamics: demand-side and supply-side constraints in the delivery of antiretroviral treatment (ART). We compared different scenarios of supply-side (i.e. health system capacity) and demand-side (i.e. health seeking behavior) constraints, and determined the impact of changing guidelines to ART eligibility at any CD4 cell count within these constraints. Continuing current scale-up would require US$178 billion by 2050. Changing guidelines to ART at any CD4 cell count is cost-effective under all constraints tested in the model, especially in demand-side constrained health systems because earlier initiation prevents loss-to-follow-up of patients not yet eligible. Changing guidelines under current demand-side constraints would avert 1.8 million infections at US$208 per life-year saved. Treatment eligibility at any CD4 cell count would be cost-effective, even under health system constraints. Excessive loss-to-follow-up and mortality in patients not eligible for treatment can be avoided by changing guidelines in demand-side constrained systems. The financial obligation for sustaining the AIDS response in sub-Saharan Africa over the next 35 years is substantial and requires strong, long-term commitment of policy-makers and donors to continue to allocate substantial parts of their budgets.

  19. How much land-based greenhouse gas mitigation can be achieved without compromising food security and environmental goals?

    PubMed

    Smith, Pete; Haberl, Helmut; Popp, Alexander; Erb, Karl-Heinz; Lauk, Christian; Harper, Richard; Tubiello, Francesco N; de Siqueira Pinto, Alexandre; Jafari, Mostafa; Sohi, Saran; Masera, Omar; Böttcher, Hannes; Berndes, Göran; Bustamante, Mercedes; Ahammad, Helal; Clark, Harry; Dong, Hongmin; Elsiddig, Elnour A; Mbow, Cheikh; Ravindranath, Nijavalli H; Rice, Charles W; Robledo Abad, Carmenza; Romanovskaya, Anna; Sperling, Frank; Herrero, Mario; House, Joanna I; Rose, Steven

    2013-08-01

    Feeding 9-10 billion people by 2050 and preventing dangerous climate change are two of the greatest challenges facing humanity. Both challenges must be met while reducing the impact of land management on ecosystem services that deliver vital goods and services, and support human health and well-being. Few studies to date have considered the interactions between these challenges. In this study we briefly outline the challenges, review the supply- and demand-side climate mitigation potential available in the Agriculture, Forestry and Other Land Use AFOLU sector and options for delivering food security. We briefly outline some of the synergies and trade-offs afforded by mitigation practices, before presenting an assessment of the mitigation potential possible in the AFOLU sector under possible future scenarios in which demand-side measures codeliver to aid food security. We conclude that while supply-side mitigation measures, such as changes in land management, might either enhance or negatively impact food security, demand-side mitigation measures, such as reduced waste or demand for livestock products, should benefit both food security and greenhouse gas (GHG) mitigation. Demand-side measures offer a greater potential (1.5-15.6 Gt CO2 -eq. yr(-1) ) in meeting both challenges than do supply-side measures (1.5-4.3 Gt CO2 -eq. yr(-1) at carbon prices between 20 and 100 US$ tCO2 -eq. yr(-1) ), but given the enormity of challenges, all options need to be considered. Supply-side measures should be implemented immediately, focussing on those that allow the production of more agricultural product per unit of input. For demand-side measures, given the difficulties in their implementation and lag in their effectiveness, policy should be introduced quickly, and should aim to codeliver to other policy agenda, such as improving environmental quality or improving dietary health. These problems facing humanity in the 21st Century are extremely challenging, and policy that addresses multiple objectives is required now more than ever. © 2013 John Wiley & Sons Ltd.

  20. DEMONSTRATION OF THE ENVIRONMENTAL AND DEMAND-SIDE MANAGEMENT BENEFITS OF GRID-CONNECTED PHOTOVOLTAIC POWER SYSTEMS

    EPA Science Inventory

    This study investigated the pollutant emission reduction and demand-side management potential of 16 photovoltaic (PV) systems installed across the U.S. in 1993 and 1994. The project was sponsored by the U.S. Environmental Protection Agency (EPA) and 11 electric utilities. This ar...

  1. Energy Demand-Side Management: New Perspectives for a New Era

    ERIC Educational Resources Information Center

    Carley, Sanya

    2012-01-01

    Over the past decade and a half, state governments have assumed greater responsibility over demand-side management (DSM) operations. Whereas DSM programs formerly were initiated primarily by utilities or state public utility commissions, they are now becoming increasingly state-initiated and incentivized through funding mechanisms or…

  2. Economics and health: beyond financing.

    PubMed

    Horwitz, A

    1988-01-01

    World Bank publications have a large influence on the decisions of governments. This article analyzes the publication "Financing Health Services in Developing Countries: An Agenda for Reform" part of the World Bank Policy Studies series. This study assesses only peripheral reasons for the lack of public and private financial investments in health services. It does not include the result of economic recession, budget cutbacks, and poverty on financing systems. There has been excessive expenditure on luxury in health institutions which takes considerable finances from disease prevention and health promotion services. There is low demand for private services because of the high cost, but public health services sometimes lack tools and money necessary for adequate care. The study does not address the relationship between needs and demand and the supply of health services. It outlines "4 Policy Reforms" in which the aims are to increase to cost of curative services and to use the additional money for prevention. The World Bank favors using private sector services but does not seem to view decentralization of health care as important. Social security systems have been in place in Latin America for 63 years. These systems are funded by wage earners and do not cover lower income rural citizens. Chile was the 1st country to adopt compulsory insurance in 1924 for catastrophes and diseases. The Chilean National Health Service combines institutional and community resources to provide quality health care. Social insurance and other prepayment systems are the rational approaches for financing health care in the Americas. These systems should be based on contributions by the State, employers, and urban and rural workers. There is a need for fund redistribution from institutional curative care to community preventative care. Health care costs should reflect income proportionally. The World Bank contributes vital analysis to the problem of health service financing. Hopefully American governments will recognize the need for health care reform.

  3. When the 'soft-path' gets hard: demand management and financial instability for water utilities

    NASA Astrophysics Data System (ADS)

    Zeff, H. B.; Characklis, G. W.

    2014-12-01

    In the past, cost benefit analysis (CBA) has been viewed as an effective means of evaluating water utility strategies, particularly those that were dependent on the construction of new supply infrastructure. As water utilities have begun to embrace 'soft-path' approaches as a way to reduce the need for supply-centric development, CBA fails to recognize some important financial incentives affected by reduced water consumption. Demand management, both as a short-term response to drought and in longer-term actions to accommodate demand growth, can introduce revenue risks that adversely affect a utility's ability to repay debt, re-invest in aging infrastructure, or maintain reserve funds for use in a short-term emergency. A utility that does not generate sufficient revenue to support these functions may be subject to credit rating downgrades, which in turn affect the interest rate it pays on its debt. Interest rates are a critical consideration for utility managers in the capital-intensive water sector, where debt payments for infrastructure often account for a large portion of a utility's overall costs. Even a small increase in interest rates can add millions of dollars to the cost of new infrastructure. Recent studies have demonstrated that demand management techniques can lead to significant revenue variability, and credit rating agencies have begun to take notice of drought response plans when evaluating water utility credit ratings, providing utilities with a disincentive to fully embrace soft-path approaches. This analysis examines the impact of demand management schemes on key credit rating metrics for a water utility in Raleigh, North Carolina. The utility's consumer base is currently experiencing rapid population growth, and demand management has the potential to reduce the dependence on costly new supply infrastructure but could lead to financial instability that will significantly increase the costs of financing future projects. This work analyzes how 'soft-path' approaches might be more efficiently integrated with investment in supply-side infrastructure and suggests how financial hedging tools could be used to improve long-term utility planning objectives.

  4. Willingness to pay, borrow, and work for rural water service improvements in developing countries

    NASA Astrophysics Data System (ADS)

    Abramson, Adam; Becker, Nir; Garb, Yaakov; Lazarovitch, Naftali

    2011-11-01

    In many least developed countries, inadequate user willingness to pay (WTP) to achieve cost recovery for improvements to substandard rural water services is a major barrier to reaching targets such as the Millennium Development Goals. A meta-analysis of 21 contingent valuation studies conducted in least developed countries reveals that cost recovery from user demand is infeasible in most cases, and that rural areas are especially unwilling to pay enough to finance water service improvements. We argue that this is largely due to inability to pay cash rather than an absence of demand and propose two alternative financing approaches that may enable capital deficient communities to afford improvements. A discrete choice experiment, conducted in a rural catchment of Zambia, compares conventional cash-based WTP for different water service attributes with two alternative measures. (1) Willingness to borrow: Monthly payments in cash, with a no-interest loan given to the user. (2) Willingness to work: Instead of cash, payment in the form of contributing time devoted to unskilled labor. To different degrees, these alternatives elicit higher demand and enable cost recovery, providing evidence that demand-driven, economically sustainable water development efforts, as described here for Simango, Zambia, may be implemented for rural, resource-poor communities.

  5. Capitalist contexts for Darwinian theory: land, finance, industry and empire.

    PubMed

    Hodge, M J S

    2009-01-01

    When socio-economic contexts are sought for Darwin's science, it is customary to turn to the Industrial Revolution. However, important issues about the long run of England's capitalisms can only be recognised by taking a wider view than Industrial Revolution historiographies tend to engage. The role of land and finance capitalisms in the development of the empire is one such issue. If we historians of Darwin's science allow ourselves a distinction between land and finance capitalisms on the one hand and industrial capitalism on the other; and if we ask with which side of this divide were Darwin and his theory of branching descent by natural selection aligned, then reflection on leading features of that theory, including its Malthusian elements, suggests that the answer is often and largely, though not exclusively: on the land side. The case of Wallace, socialist opponent of land capitalism, may not be as anomalous for this suggestion as one might at first think. Social and economic historians have reached no settled consensuses on the long-run of England's capitalisms. We historians of Darwin's science would do well to import some of these unsettled states of discussion into our own work over the years to come.

  6. Who has a clue to preventing the flu? Unravelling supply and demand effects on the take-up of influenza vaccinations.

    PubMed

    Maurer, Jürgen

    2009-05-01

    Influenza is a serious disease, especially for older people, and incomplete vaccination take-up poses a major public health challenge. On both the side of physicians and patients, there could be promising channels for increasing immunization rates, but no attempt has yet been made to empirically unravel their respective influences. Using exclusion restrictions implied by an economic model of physician-patient interactions, our study quantifies the particular effects of supply and demand on influenza immunization. On the supply side, our estimates highlight the importance of physician agency and physician quality, while a patient's education and health behaviors are key demand side factors.

  7. DEMONSTRATION OF THE ENVIRONMENTAL AND DEMAND-SIDE MANAGEMENT BENEFITS OF GRID-CONNECTED PHOTOVOLTAIC POWER SYSTEMS SITED ON MILITARY BASES

    EPA Science Inventory

    The report gives results of an investigation into the pollutant emission reduction and demand-side management potential of three photovoltaic (PV) systems installed at Ft. Huachuca, AZ, Ft. Dix, NJ, and Hickam Air Force Base, HI, which began operation between January and July 199...

  8. DEMONSTRATION OF THE ENVIRONMENTAL AND DEMAND-SIDE MANAGEMENT BENEFITS OF GRID-CONNECTED PHOTOVOLTAIC POWER SYSTEMS

    EPA Science Inventory

    The report gives results of an investigation of the pollutant emission reduction and demand-side management potential of 16 photovoltaic (PV) systems installed across the U.S. in 1993 and 1994. The investigation was sponsored by the U.S. EPA and 11 electric utilities. The report ...

  9. The Road Less Travelled

    ERIC Educational Resources Information Center

    Kewin, James

    2011-01-01

    Why are progression rates for Advanced Apprentices so low? Previous research points to a range of supply-side and demand-side barriers. Fundamentally, many employers do not exhibit the sort of demand for higher-level skills that could be used to justify the level of investment required. And, in some cases, employers just don't realise their…

  10. Finding the Funds for Technology.

    ERIC Educational Resources Information Center

    Wodarz, Nan

    1996-01-01

    Describes strategies to meet the increasing demands for technological innovation in the face of increasingly severe budgetary constraints. Long-term planning is the key to a successful technological program. Describes the options of leasing, financing, and phased-in purchases. (LMI)

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

    Lindsay, I.

    The author limits his remarks to a discussion of the international generator`s marketplace, especially aimed at the developing countries. He discusses future global electricity demand, generating capacity build, its financing issues, and to the commercial generating opportunities which now abound outside the US.

  12. Too poor for transplant: finance and insurance issues in transplant ethics.

    PubMed

    Laurentine, Kyle Alexander; Bramstedt, Katrina A

    2010-06-01

    Donor organs are a scarce gift. Additionally, transplantation is very expensive and the United States lacks universal health insurance for all citizens. These facts combine to make personal finance and insurance some of the criteria for wait listing at US transplant centers. Previous research has shown that the poor and the uninsured (as well as women and nonwhites) are less likely to receive a transplant. Living donor candidates are also limited by the US insurance system. To determine the effect of finance and insurance variables on access to transplant and living donation. A qualitative descriptive study of ethics consultation data contained in a research registry approved by the institutional review board at California Pacific Medical Center. This study analyzes research registry data from a large community hospital in Northern California that serves patients from California, Oregon, and Nevada. The registry data are derived from transplant ethics consultations occurring between January 1, 2007, and June 30, 2009. This study explores the restriction of access to transplantation and of participation in living donation. More than a quarter of all transplant ethics consultation reports described the restriction of transplant-related treatment for reasons rooted in finance or insurance. Individuals on the recipient side and on the donor side were hindered with regard to access. Insurance status and personal ability to pay significantly affect access to transplantation in the United States, and this theme is a frequent feature of ethics consultations at California Pacific Medical Center.

  13. Prediction-based manufacturing center self-adaptive demand side energy optimization in cyber physical systems

    NASA Astrophysics Data System (ADS)

    Sun, Xinyao; Wang, Xue; Wu, Jiangwei; Liu, Youda

    2014-05-01

    Cyber physical systems(CPS) recently emerge as a new technology which can provide promising approaches to demand side management(DSM), an important capability in industrial power systems. Meanwhile, the manufacturing center is a typical industrial power subsystem with dozens of high energy consumption devices which have complex physical dynamics. DSM, integrated with CPS, is an effective methodology for solving energy optimization problems in manufacturing center. This paper presents a prediction-based manufacturing center self-adaptive energy optimization method for demand side management in cyber physical systems. To gain prior knowledge of DSM operating results, a sparse Bayesian learning based componential forecasting method is introduced to predict 24-hour electric load levels for specific industrial areas in China. From this data, a pricing strategy is designed based on short-term load forecasting results. To minimize total energy costs while guaranteeing manufacturing center service quality, an adaptive demand side energy optimization algorithm is presented. The proposed scheme is tested in a machining center energy optimization experiment. An AMI sensing system is then used to measure the demand side energy consumption of the manufacturing center. Based on the data collected from the sensing system, the load prediction-based energy optimization scheme is implemented. By employing both the PSO and the CPSO method, the problem of DSM in the manufacturing center is solved. The results of the experiment show the self-adaptive CPSO energy optimization method enhances optimization by 5% compared with the traditional PSO optimization method.

  14. Comparing policies to enhance prescribing efficiency in Europe through increasing generic utilization: changes seen and global implications.

    PubMed

    Godman, Brian; Shrank, William; Andersen, Morten; Berg, Christian; Bishop, Iain; Burkhardt, Thomas; Garuoliene, Kristina; Herholz, Harald; Joppi, Roberta; Kalaba, Marija; Laius, Ott; McGinn, Diane; Samaluk, Vita; Sermet, Catherine; Schwabe, Ulrich; Teixeira, Inês; Tilson, Lesley; Tulunay, F Cankat; Vlahović-Palčevski, Vera; Wendykowska, Kamila; Wettermark, Björn; Zara, Corinne; Gustafsson, Lars L

    2010-12-01

    The aim of this article was to evaluate the influence of different demand-side measures to enhance the prescribing of generics in ambulatory care based on cross-national comparisons. An observational retrospective study was conducted using administrative databases from across Europe, documenting changes in reimbursed utilization and expenditure of different proton pump inhibitors (PPIs) and statins between 2001 and 2007, alongside different reforms to enhance prescribing efficiency. Utilization was converted to defined daily doses (DDDs) and expenditures were converted to euros. Demand-side measures were collated under the '4 Es'--education, engineering, economics and enforcement--to enable comparisons on the nature and intensity of reforms between countries. There were considerable differences in the utilization of generics and patent-protected PPIs and statins among Western European countries. Decreased utilization of omeprazole and simvastatin, alongside increased utilization of esomeprazole, atorvastatin and rosuvastatin, was seen in countries with limited demand-side measures to counteract commercial pressures. Prescribing restrictions, or a combination of education, prescribing targets and financial incentives, had the greatest influence on enhancing the utilization of omeprazole and simvastatin. For example, there was a threefold reduction in the utilization of atorvastatin in Austria following prescribing restrictions. Multiple demand-side interventions generally had a greater influence than single interventions, with the impact appearing additive. Multiple interventions coupled with initiatives to lower prices of generics considerably enhanced prescribing efficiency. This cross-national study has demonstrated considerable variation in the utilization and expenditure of PPIs and statins across Europe, providing opportunities to further improve prescribing efficiency. The '4 Es' do provide an understandable methodology to document and compare the influence of different demand-side measures, with the influence varying by their extent and intensity. Further reforms are essential given current financial pressures. Consequently, further research will concentrate on the potential to develop a scoring system to help predict the possible impact of different demand-side measures on future utilization patterns.

  15. Strategies to increase demand for maternal health services in resource-limited settings: challenges to be addressed.

    PubMed

    Elmusharaf, Khalifa; Byrne, Elaine; O'Donovan, Diarmuid

    2015-09-08

    Universal health access will not be achieved unless women are cared for in their own communities and are empowered to take decisions about their own health in a supportive environment. This will only be achieved by community-based demand side interventions for maternal health access. In this review article, we highlight three common strategies to increase demand-side barriers to maternal healthcare access and identify the main challenges that still need to be addressed for these strategies to be effective. Common demand side strategies can be grouped into three categories:(i) Financial incentives/subsidies; (ii) Enhancing patient transfer, and; (iii) Community involvement. The main challenges in assessing the effectiveness or efficacy of these interventions or strategies are the lack of quality evidence on their outcome and impact and interventions not integrated into existing health or community systems. However, what is highlighted in this review and overlooked in most of the published literature on this topic is the lack of knowledge about the context in which these strategies are to be implemented. We suggest three challenges that need to be addressed to create a supportive environment in which these demand-side strategies can effectively improve access to maternal health services. These include: addressing decision-making norms, engaging in intergenerational dialogue, and designing contextually appropriate communication strategies.

  16. Effect of Game Design, Goal Type, and Player Numbers on the Physiological and Physical Demands of Hurling-Specific Small-Sided Games.

    PubMed

    Malone, Shane; Collins, Kieran D

    2017-06-01

    The current study examined the effect that game design modification, goal type, and player numbers on the running performance and physiological demands of small-sided hurling games (SSG). Forty-eight hurling players (age, 25.5 ± 3.2 years; height, 178.9 ± 3.2 cm; body mass, 78.5 ± 4.5 kg) performed 4 types of SSG (possession [P], normal play [NP], regular goals [RG] and small goals [SG]) in 4-a-side, 5-a-side, and 6-a-side formats. Heart rate (Polar Electro Oy) and global positioning system technology (VX Sport, 4-Hz, Lower Hutt) were used to analyze the physical and physiological differences between SSG. Total distance (m), high-speed running distance (m) (≥17 km·h), very-high speed running distance (≥22 km·h) (m), peak and mean velocity (km·h) were analyzed as an indicator of the physical demands of play. The 4-a-side SSG independent of game design and goal type resulted in a significantly higher relative exercise intensity compared with 5-a-side (mean change: 6 ± 2%; p = 0.001; d = 1.9 ± 0.2; large) and 6-a-side SSG independent of game design or goal type (mean change: 12 ± 2%; p = 0.001; d = 2.9 ± 0.8; very large). The 4-a-side SG (619 ± 106-m [419-735-m]) resulted in the highest distance when compared with all PP (mean change: 141 ± 9 m; p = 0.05; d = 1.9 ± 0.3; moderate) and RG (mean change: 119 ± 39 m; p = 0.004; d = 2.1 ± 0.8; large). Similar trends were observed for 5-a-side and 6-a-side games with SG resulting in increased total running performance. In conclusion, the current observations reveal that 4-a-side NP, SG, and RG have the highest physiological demands with 4-a-side SG having increased running performance in contrast to other game design and goal-type games. Furthermore, independent of game design and goal type, 4-a-side SSG show increased relative intensity compared with 5-a-side and 6-a-side SSG.

  17. Using the Stock Market to Teach Physics

    NASA Astrophysics Data System (ADS)

    Faux, David A.; Hearn, Stephen

    2004-11-01

    Students are interested in money. Personal finance is an important issue for most students, especially as they move into university education and take a greater control of their own finances. Many are also interested in stock markets and their ability to allow someone to make, and lose, large sums of money, with their interest fueled by the boom in technology-based stocks of 2000/2001 followed by their subsequent dramatic collapse and the publicizing of so-called "rogue-traders." There is also a much greater ownership of stocks by families following public offerings, stock-based savings products, and the ability to trade stocks online. Consequently, there has been a steady growth of finance and finance-related courses available within degree programs in response to the student demand, with many students motivated by the huge salaries commanded by those with a successful career in the financial sector. We report here details of a joint project between Charterhouse School and the University of Surrey designed to exploit the excitement of finance to teach elements of the high school (age 16-18) curriculum through modeling and simulation.

  18. Private sector village enterprise a new approach to sustainable financing

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

    Gay, C.F.

    1997-12-01

    This paper presents an enterprise plan for introducing solar power in a rural market, while providing economic development, and hence the ability of the user to pay for the power source. This plan is based on a product called GEEP - a solar sewing machine conversion kit. This kit can be retrofit onto pedal sewing machines and marketed to village tailors in India, as part of a marketing program which includes increased demand for tailored products which will allow the tailors to be able to finance the conversion kits.

  19. How do supply-side factors influence informal payments for healthcare? The case of HIV patients in Cameroon.

    PubMed

    Kankeu, Hyacinthe Tchewonpi; Boyer, Sylvie; Fodjo Toukam, Raoul; Abu-Zaineh, Mohammad

    2016-01-01

    Direct out-of-pocket payments for healthcare continue to be a major source of health financing in low-income and middle-income countries. Some of these direct payments take the form of informal charges paid by patients to access the needed healthcare services. Remarkably, however, little is known about the extent to which these payments are exercised and their determinants in the context of Sub-Saharan Africa. This study attempts therefore to shed light on the role of supply-side factors in the occurrence of informal payments while accounting for the demand-side factors. The study relies on data taken from a nationally representative survey conducted among people living with HIV/AIDS in Cameroon. A multilevel mixed-effect logistic model is employed to identify the factors associated with the incidence of informal payments. Results reveal that circa 3.05% of the surveyed patients incurred informal payments for the consultations made on the day of the survey. The amount paid informally represents up to four times the official tariff. Factors related to the following: (i) human resource management of the health facilities (e.g., task shifting); (ii) health professionals' perceptions vis-à-vis the remunerations of HIV care provision; and (iii) reception of patients (e.g., waiting time) significantly influence the probability of incurring informal payments. Also of note, the type of healthcare facilities is found to play a role: informal payments appear to be significantly lower in private non-profit facilities compared with those belonging to public sector. Our findings allude to some policy recommendations that can help reduce the incidence of informal payments. Copyright © 2014 John Wiley & Sons, Ltd.

  20. National health insurance reconsidered: dilemmas and opportunities.

    PubMed

    Battistella, R M; Weil, T P

    1989-01-01

    Changing social and economic constraints are precipitating a reformulation of the role of government in the provision of social welfare services. The authors conclude that government intervention in the health sector is bound to expand rather than contract because centralization is the key to reconciling otherwise divergent political demands for spending controls and greater equality of access to quality care for the increasing number of uninsured or underinsured persons. In the past eight years, the federal government has unleashed competitive market principles that have had negative side effects on the nation's health services. Payers, providers, and consumers will likely seek to protect themselves by forming coalitions, as happened recently in Massachusetts where the law now requires employers to provide minimum health insurance benefits to their employees. Escalating pressures to correct the damages from short-term piecemeal solutions to problems of health finance and delivery will provide the chief dynamic for universal health insurance in the United States. New economic, social, and political realities suggest, however, an eclectic strategy for attaining this goal that bears little resemblance to the conventional wisdom that guided health policy throughout the postwar period.

  1. Accurate Estimation of Target amounts Using Expanded BASS Model for Demand-Side Management

    NASA Astrophysics Data System (ADS)

    Kim, Hyun-Woong; Park, Jong-Jin; Kim, Jin-O.

    2008-10-01

    The electricity demand in Korea has rapidly increased along with a steady economic growth since 1970s. Therefore Korea has positively propelled not only SSM (Supply-Side Management) but also DSM (Demand-Side Management) activities to reduce investment cost of generating units and to save supply costs of electricity through the enhancement of whole national energy utilization efficiency. However study for rebate, which have influence on success or failure on DSM program, is not sufficient. This paper executed to modeling mathematically expanded Bass model considering rebates, which have influence on penetration amounts for DSM program. To reflect rebate effect more preciously, the pricing function using in expanded Bass model directly reflects response of potential participants for rebate level.

  2. Optimal Drug Policy in Low-Income Neighborhoods

    PubMed Central

    Chang, Sheng-Wen; Coulson, N. Edward; Wang, Ping

    2015-01-01

    The control of drug activity currently favors supply-side policies: drug suppliers in the U.S. face a higher arrest rate and longer sentences than demanders. We construct a simple model of drug activity with search and entry frictions in labor and drug markets. Our calibration analysis suggests a strong “dealer replacement effect.” As a result, given a variety of community objectives, it is beneficial to lower supplier arrests and raise the demand arrest rate from current values. A 10% shift from supply-side to demand-side arrests can reduce the population of potential drug dealers by 22–25,000 and raise aggregate local income by $380–400 million, at 2002 prices. (JEL Classification: D60, J60, K42, H70) PMID:27616878

  3. Scaling up access to oral rehydration solution for diarrhea: Learning from historical experience in low- and high-performing countries.

    PubMed

    Wilson, Shelby E; Morris, Saul S; Gilbert, Sarah Skye; Mosites, Emily; Hackleman, Rob; Weum, Kristoffer L M; Pintye, Jillian; Manhart, Lisa E; Hawes, Stephen E

    2013-06-01

    This paper aims to identify factors that systematically predict why some countries that have tried to scale up oral rehydration solution (ORS) have succeeded, and others have not. We examined ORS coverage over time, across countries, and through case studies. We conducted expert interviews and literature and data searches to better understand the history of ORS scale-up efforts and why they failed or succeeded in nine countries. We used qualitative, pairwise (or three-country) comparisons of geographically or otherwise similar countries that had different outcomes in terms of ORS scale-up. An algorithm was developed which scored country performance across key supply, demand and financing activities to quantitatively assess the scale-up efforts in each country. The vast majority of countries have neither particularly low nor encouragingly high ORS use rates. We observed three clearly identifiable contrasts between countries that achieved and sustained high ORS coverage and those that did not. Key partners across sectors have critical roles to play to effectively address supply- and demand-side barriers. Efforts must synchronize demand generation, private provider outreach and public sector work. Many donor funds are either suspended or redirected in the event of political instability, exacerbating the health challenges faced by countries in these contexts. We found little information on the cost of scale-up efforts. We identified a number of characteristics of successful ORS scale-up programs, including involvement of a broad range of key players, addressing supply and demand generation together, and working with both public and private sectors. Dedicated efforts are needed to launch and sustain success, including monitoring and evaluation plans to track program costs and impacts. These case studies were designed to inform programmatic decision-making; thus, rigorous academic methods to qualitatively and quantitatively evaluate country ORS scale-up programs might yield additional, critical insights and confirm our conclusions.

  4. How to optimize tourism destination supply: A case in Shanghai from perspective of supplier and demand side perception

    NASA Astrophysics Data System (ADS)

    Xue, Huaju; Fang, Chengjiang

    2018-02-01

    It is vital to assess the regional tourist supply capability by suppliers and demand groups. The supply side’s evaluation of the regional supply capacity determines the direction of the supply investment in future, the demand side’s evaluation indicates their satisfaction degree of the destination supply and also effects their revisit the tourism destination. Therefore, the assessment of the supply and demand sides is an important reference for the reform of destination supply side, which helps us find the shortage of the destination supply factors and optimize tourism destination supply promptly. This paper through investigating tourism supply and demand groups in Shanghai, used the survey data and constructed tourism supply optimization model, analyzed the current situation of tourism supply factors in Shanghai. Results showed that the environment of Shanghai should be improved first, including improving urban air and water quality, up-grading public sanitation and increasing urban green coverage. Other supply factors improved priority were information and marketing, we should improve the information consultation of scenic spots, increase the intensity of tourism promotion and provide more free travel publicity brochures.

  5. FOSSIL2 energy policy model documentation: generic structures of the FOSSIL2 model

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

    None

    1980-10-01

    This report discusses the structure, derivations, assumptions, and mathematical formulation of the FOSSIL2 model. Each major facet of the model - supply/demand interactions, industry financing, and production - has been designed to parallel closely the actual cause/effect relationships determining the behavior of the United States energy system. The data base for the FOSSIL2 program is large. When possible, all data were obtained from sources well known to experts in the energy field. Cost and resource estimates are based on DOE data whenever possible. This report presents the FOSSIL2 model at several levels. In Volume I, an overview of the basicmore » structures, assumptions, and behavior of the FOSSIL2 model is presented so that the reader can understand the results of various policy tests. The discussion covers the three major building blocks, or generic structures, used to construct the model: supply/demand balance; finance and capital formation; and energy production. These structures reflect the components and interactions of the major processes within each energy industry that directly affect the dynamics of fuel supply, demand, and price within the energy system as a whole.« less

  6. Financing reforms of public health services in China: lessons for other nations.

    PubMed

    Liu, Xingzhu; Mills, Anne

    2002-06-01

    Financing reforms of China's public health services are characterised by a reduction in government budgetary support and the introduction of charges. These reforms have changed the financing structure of public health institutions. Before the financing reforms, in 1980, government budgetary support covered the full costs of public health institutions, while after the reforms by the middle of the 1990s, the government's contribution to the institutions' revenue had fallen to 30-50%, barely covering the salaries of health workers, and the share of revenue generated from charges had increased to 50-70%. These market-oriented financing reforms improved the productivity of public health institutions, but several unintended consequences became evident. The economic incentives that were built into the financing system led to over-provision of unnecessary services, and under-provision of socially desirable services. User fees reduced the take-up of preventive services with positive externalities. The lack of government funds resulted in under-provision of services with public goods' characteristics. The Chinese experience has generated important lessons for other nations. Firstly, a decline in the role of government in financing public health services is likely to result in decreased overall efficiency of the health sector. Secondly, levying charges for public health services can reduce demand for these services and increase the risk of disease transmission. Thirdly, market-oriented financing reforms of public health services should not be considered as a policy option. Once this step is made, the unintended consequences may outweigh the intended ones. Chinese experience strongly suggests that the government should take a very active role in financing public health services.

  7. 10 CFR 960.5-2-6 - Socioeconomic impacts.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REPOSITORY Preclosure Guidelines Environment, Socioeconomics, and Transportation § 960.5-2-6 Socioeconomic... and/or economic impacts induced in communities and surrounding regions by repository siting... significant repository-related impacts on community services, housing supply and demand, and the finances of...

  8. Equity and financing for sexual and reproductive health service delivery: current innovations.

    PubMed

    Montagu, Dominic; Graff, Maura

    2009-07-01

    National and international decisions on financing for sexual and reproductive health (SRH) services have profound effects on the type, unit costs and distribution of SRH commodities and services produced, and on their availability and consumption. Much international and national funding is politically driven and is doing little for equity and quality improvement. Financing remains a significant challenge in most developing countries and demands creative responses. While no "one-size-fits-all" solution exists, there are numerous ongoing examples of successful innovations, many of which are focusing on resource pooling and on purchasing or subsidising SRH services. In this article we have used interviews, grey literature and presentations made at a range of recent public fora to identify new and innovative ways of financing SRH services so as to increase equity in developing countries. Because SRH services are often of low value as a personal good but high value as a public good, we summarise the issues from a societal perspective, highlighting the importance of financing and policy decisions for SRH services. We provide a structured overview of what novel approaches to financing appear to have positive effects in a range of developing countries. Targeting, government payment mechanisms, subsidy delivery and co-financing for sustainability are highlighted as showing particular promise. Examples are used throughout the article to illustrate innovative strategies.

  9. The macroeconomics of demographic unemployment.

    PubMed

    Carlberg, M

    1990-02-01

    "What are the macroeconomic consequences of an increase in labour supply? In the short run, unemployment occurs, due to both lack of aggregate demand and capital shortage. Demand-side policy and money wage restraint prove to be ineffective in this situation, owing to capital shortage. On the other hand, a reduction in working hours without wage compensation as well as a policy mix of both demand-side policy and investment policy turn out to be effective. The reduction in working hours lowers individual income and raises individual leisure, as compared to the policy mix." (SUMMARY IN GER) excerpt

  10. Creating a High-Skills Society during Recession: Issues for Policy Makers

    ERIC Educational Resources Information Center

    Panagiotakopoulos, Antonios

    2015-01-01

    The present study looks at the skill formation policies adopted by policy makers in Greece in order to create a high-skills society. It examines empirically the demand side of the skill creation process within 300 small enterprises in order to understand how far supply-side measures have influenced the demand for well-trained staff within small…

  11. Demand-Side Management and Integrated Resource Planning: Findings from a Survey of 24 Electric Utilities

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

    Schweitzer, M.

    1991-01-01

    Integrated resource planning differs from traditional utility planning practices primarily in its increased attention to demand-side management (DSM) programs and its integration of supply- and demand-side resources into a combined resource portfolio. This report details the findings from an Oak Ridge National Laboratory (ORNL) survey of 24 electric utilities that have well-developed integrated planning processes. These utilities account for roughly one-third of total capacity, electricity generation, and DSM-program expenditures nationwide. The ORNL survey was designed to obtain descriptive data on a national sample of utilities and to test a number of hypothesized relationships between selected utility characteristics and the mixmore » of resources selected for the integrated plan, with an emphasis on the use of DSM resources and the processes by which they are chosen. The survey solicited information on each utility's current and projected resource mix, operating environment, procedures used to screen potential DSM resources, techniques used to obtain public input and to integrate supply- and demand-side options into a unified plan, and procedures used in the final selection of resources for the plan.« less

  12. Out-of-pocket expenses for maternity care in rural Bangladesh: a public-private comparison.

    PubMed

    Rahman, Moshiur; Rob, Ubaidur; Noor, Forhana Rahman; Bellows, Benjamin

    Out-of-pocket expenses incurred by women for availing maternal healthcare services at public and private health facilities in Bangladesh were examined using a baseline household survey evaluating the impact of demand side financing vouchers on utilization and service delivery for maternal healthcare. The survey was conducted in 2010 among 3,300 women who gave birth in the previous 12 months from the start of data collection. Information on costs incurred to receive antenatal, delivery, and postnatal care services was collected. Findings reveal that the majority of women reported paying out-of-pocket expenses for availing maternal healthcare services both at public and private health facilities. Out-of-pocket expenses include registration, consultation, laboratory examination, medicine, transportation, and other associated costs incurred for receiving maternal healthcare services. On average, women paid US$3.60 out-of-pocket expenses for receiving antenatal care at public health facilities and US$12.40 at private health facilities. Similarly, women paid one and half times more for normal (US$42.30) and cesarean deliveries (US$136.20) at private health facilities compared to public health facilities. On the other hand, costs for postnatal care services did not vary significantly between public and private health facilities. Utilization of maternal healthcare services can be improved if out-of-pocket expenses can be minimized. At the same time, effective demand generation strategies are necessary to encourage women to utilize health facilities.

  13. Utility Sector Impacts of Reduced Electricity Demand

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

    Coughlin, Katie

    2014-12-01

    This report presents a new approach to estimating the marginal utility sector impacts associated with electricity demand reductions. The method uses publicly available data and provides results in the form of time series of impact factors. The input data are taken from the Energy Information Agency's Annual Energy Outlook (AEO) projections of how the electric system might evolve in the reference case, and in a number of side cases that incorporate different effciency and other policy assumptions. The data published with the AEO are used to define quantitative relationships between demand-side electricity reductions by end use and supply-side changes tomore » capacity by plant type, generation by fuel type and emissions of CO2, Hg, NOx and SO2. The impact factors define the change in each of these quantities per unit reduction in site electricity demand. We find that the relative variation in these impacts by end use is small, but the time variation can be significant.« less

  14. Cannabis Supply and Demand Reduction: Evidence from the ESPAD Study of Adolescents in 31 European Countries

    ERIC Educational Resources Information Center

    Bjarnason, Thoroddur; Steriu, Andreea; Kokkevi, Anna

    2010-01-01

    Aims: Most national drug policies target both the supply side and the demand side of illicit drug use. Although such policies are intended to affect individual choices, they by definition operate on a national level and cannot be evaluated solely on the basis of individual-level differences. This study aims to evaluate the impact of country-level…

  15. The Black-White Difference in Youth Employment: Evidence for Demand-Side Factors.

    ERIC Educational Resources Information Center

    Cain, Glen G.; Finnie, Ross

    The 1980 Census of the United States is used, first, to illustrate the serious lag in employment performance of young black men relative to young white men and, second, to test for the importance of demand-side causes of this lag. Aggregate data for 94 standard metropolitan statistical areas (SMSAs) contain data on the annual hours worked in 1979…

  16. Financing of Pharmaceutical Services in the municipal management of the Brazilian Unified Health System

    PubMed Central

    Faleiros, Daniel Resende; Acurcio, Francisco de Assis; Álvares, Juliana; do Nascimento, Renata Cristina Rezende Macedo; Costa, Ediná Alves; Guibu, Ione Aquemi; Soeiro, Orlando Mario; Leite, Silvana Nair; Karnikowski, Margô Gomes de Oliveira; Costa, Karen Sarmento; Guerra, Augusto Afonso

    2017-01-01

    ABSTRACT OBJECTIVE To discuss factors related to the financing of the Basic Component of Pharmaceutical Services within the municipal management of the Brazilian Unified Health System. METHODS The Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil – Serviços (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services) is a cross-sectional, exploratory, and evaluative study that performed an information survey in a representative sample, stratified by Brazilian regions It considered different study populations in the sampling plan, which represent primary health care services in the cities. Data were collected in 2015 by two methods: in person, by applying direct observation scripts and interviews with users, physicians, and professionals responsible for the dispensing of medicines in primary care services; by telephone interviews with municipal health managers and municipal professionals responsible for Pharmaceutical Services. The results were extracted from the questionnaires applied by telephone. RESULTS Of the sample of 600 eligible cities, we collected 369 interviews (61.5%) with secretaries and 507 (84.5%) with pharmaceutical services managers. 70.8% of the cities have a computerized management system; and 11.9% have qualification/training of professionals. More than half (51.3%) of the cities received funds for the structuring of pharmaceutical services, and almost 60% of these cities performed this type of spending. In 35.4% of cases, municipal secretaries of health said that they use resources of medicines from the Componente Básico da Assistência Farmacêutica (CBAF – Basic Component of Pharmaceutical Services) to cover demands of other medicines, but only 9.7% believed that these funds were sufficient to cover the demands. The existence of a permanent bidding committee exclusively for acquiring medicines was reported in 40.0% of the cities. CONCLUSIONS We found serious deficiencies in the public financing of medicines, as well as little concern about the formality in the use of public resources, expenses that meet individual demands to the detriment of the community, insufficient resources allocated to the Basic Component of Pharmaceutical Services, and exhaustion of the financing model. PMID:29160447

  17. Financing of Pharmaceutical Services in the municipal management of the Brazilian Unified Health System.

    PubMed

    Faleiros, Daniel Resende; Acurcio, Francisco de Assis; Álvares, Juliana; Nascimento, Renata Cristina Rezende Macedo do; Costa, Ediná Alves; Guibu, Ione Aquemi; Soeiro, Orlando Mario; Leite, Silvana Nair; Karnikowski, Margô Gomes de Oliveira; Costa, Karen Sarmento; Guerra, Augusto Afonso

    2017-11-13

    To discuss factors related to the financing of the Basic Component of Pharmaceutical Services within the municipal management of the Brazilian Unified Health System. The Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil - Serviços (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services) is a cross-sectional, exploratory, and evaluative study that performed an information survey in a representative sample, stratified by Brazilian regions It considered different study populations in the sampling plan, which represent primary health care services in the cities. Data were collected in 2015 by two methods: in person, by applying direct observation scripts and interviews with users, physicians, and professionals responsible for the dispensing of medicines in primary care services; by telephone interviews with municipal health managers and municipal professionals responsible for Pharmaceutical Services. The results were extracted from the questionnaires applied by telephone. Of the sample of 600 eligible cities, we collected 369 interviews (61.5%) with secretaries and 507 (84.5%) with pharmaceutical services managers. 70.8% of the cities have a computerized management system; and 11.9% have qualification/training of professionals. More than half (51.3%) of the cities received funds for the structuring of pharmaceutical services, and almost 60% of these cities performed this type of spending. In 35.4% of cases, municipal secretaries of health said that they use resources of medicines from the Componente Básico da Assistência Farmacêutica (CBAF - Basic Component of Pharmaceutical Services) to cover demands of other medicines, but only 9.7% believed that these funds were sufficient to cover the demands. The existence of a permanent bidding committee exclusively for acquiring medicines was reported in 40.0% of the cities. We found serious deficiencies in the public financing of medicines, as well as little concern about the formality in the use of public resources, expenses that meet individual demands to the detriment of the community, insufficient resources allocated to the Basic Component of Pharmaceutical Services, and exhaustion of the financing model.

  18. Islamic Banking: Financing Terrorism or Meeting Economic Demand

    DTIC Science & Technology

    2007-12-01

    feared financial shenanigans practiced by its countries’ government-controlled state banks. Kepel contends that the radical Islamists viewed these...10 B. THE BEGINNING OF AN ISLAMIC FINANCIAL SYSTEM................14 C. THE CREATION OF ISLAMIC FINANCIAL INSTITUTIONS...19 D. ISLAMIC FINANCIAL INSTRUMENTS..................................................26 1. Musharaka

  19. Financial Aid for Minorities in Business and Law.

    ERIC Educational Resources Information Center

    Garrett Park Press, MD.

    This directory of financial aid sources for minority students majoring in business (including accounting, finance, human relations, information services, marketing and production) or law includes the following types of information: (1) summary and description of the fields, including college enrollment statistics, demand for graduates, and…

  20. Foreign Universities in China: A Case Study

    ERIC Educational Resources Information Center

    Ennew, Christine T.; Fujia, Yang

    2009-01-01

    The international dimension of higher education has expanded rapidly in recent decades and private provision is becoming increasingly widespread in response to the diverse pressures of globalisation, rapid expansion in demand and increased pressures on public finances. As higher education has become marketised, opportunities for international…

  1. Are tax subsidies for private medical insurance self-financing? Evidence from a microsimulation model.

    PubMed

    López Nicolás, Angel; Vera-Hernández, Marcos

    2008-09-01

    This paper develops an empirical strategy to estimate whether subsidies to private medical insurance are self-financing in countries where public and private insurance coexist and the latter covers the same treatments as the former. We construct a simulation routine based on a micro-econometric discrete choice model that allows us to evaluate the impact of premium changes on the utilization of outpatient and inpatient health care services. As an application, we estimate the budgetary effects of scrapping a subsidy from the purchase of individual private policies, using micro-data from Catalonia. Our results suggest that the subsidy is not self-financing. This result is driven by the fact that private medical insurance holders make concurrent use of public and private services, and by the price inelasticity of the demand for private policies.

  2. Designing a reproductive health services package in the universal health insurance scheme in Thailand: match and mismatch of need, demand and supply.

    PubMed

    Teerawattananon, Yot; Tangcharoensathien, Viroj

    2004-10-01

    In October 2001 Thailand introduced universal healthcare coverage (UC) financed by general tax revenue. This paper aims to assess the design and content of the UC benefit package, focusing on the part of the package concerned with sexual and reproductive health (SRH). The economic concept of need, demand and supply in the process of developing the SRH package was applied to the analysis. The analysis indicated that SRH constitutes a major part of the package, including the control of communicable and non-communicable diseases, the promotion and maintenance of reproductive health, and early detection and management of reproductive health problems. In addition, the authors identified seven areas within three overlapping spheres; namely need, demand and supply. The burden of disease on reproductive conditions was used as a proxy indicator of health needs in the population; the findings of a study of private obstetric practice in public hospitals as a proxy of patients' demands; and the SRH services offered in the UC package as a proxy of general healthcare supply. The authors recommend that in order to ensure that healthcare needs match consumer demand, the inclusion of SRH services not currently offered in the package (e.g. treatment of HIV infection, abortion services) should be considered, if additional resources can be made available. Where health needs exist but consumers do not express demand, and the appropriate SRH services would provide external benefits to society (e.g. the programme for prevention of sexual and gender-related violence), policymakers are encouraged to expand and offer these services. Efforts should be made to create consumer awareness and stimulate demand. Research can play an important role in identifying the services in which supply matches demand but does not necessarily reflect the health needs of the population (e.g. unnecessary investigations and prescriptions). Where only demand or supply exists (e.g. breast cosmetic procedures and unproven effective interventions), these SRH services should be excluded from the package and left to private financing and providers, the government playing a regulatory role. Copyright 2004 Oxford University Press

  3. Economic concepts to address future water supply-demand imbalances in Iran, Morocco and Saudi Arabia

    NASA Astrophysics Data System (ADS)

    Hellegers, Petra; Immerzeel, Walter; Droogers, Peter

    2013-10-01

    In Middle East and North Africa (MENA) countries, renewable groundwater and surface water supply are limited while demand for water is growing rapidly. Climate change is expected to increase water demand even further. The main aim of this paper is to evaluate the water supply-demand imbalances in Iran, Morocco and Saudi Arabia in 2040-2050 under dry, average and wet climate change projections and to show on the basis of the marginal cost and marginal value of water the optimum mix of supply-side and demand-side adjustments to address the imbalance. A hydrological model has been used to estimate the water supply-demand imbalance. Water supply and demand curves have been used to explore for which (marginal value of) water usage the marginal cost of supply-enhancement becomes too expensive. The results indicate that in the future in all cases, except in Iran under the wet climate projection, the quantity of water demanded has to be reduced considerably to address the imbalance, which is indeed what is currently happening already.

  4. Universities Response to Oil and Gas Industry Demands in South Texas (USA) and Tamaulipas (Mexico)

    ERIC Educational Resources Information Center

    Navarro, Marco Aurelio

    2016-01-01

    Given the importance of hydrocarbons for this area, the purpose of this paper is to explore the response of universities to cope with new demands in the south of Texas and Tamaulipas, especially in relation to gas plays of Eagle Ford (Texas side) and Burgos Basin (Mexican side). To accomplish this task, in the first section of the paper a broad…

  5. Automating Finance

    ERIC Educational Resources Information Center

    Moore, John

    2007-01-01

    In past years, higher education's financial management side has been riddled with manual processes and aging mainframe applications. This article discusses schools which had taken advantage of an array of technologies that automate billing, payment processing, and refund processing in the case of overpayment. The investments are well worth it:…

  6. An Economic Evalution of Demand-side Energy Storage Systems by using a Multi-agent based Electricity Market

    NASA Astrophysics Data System (ADS)

    Furusawa, Ken; Sugihara, Hideharu; Tsuji, Kiichiro

    Opened wholesale electric power market in April 2005, deregulation of electric power industry in Japan has faced a new competitive environment. In the new environment, Independent Power Producer (: IPP), Power Producer and Supplier (: PPS), Load Service Entity (: LSE) and electric utility can trade electric energy through both bilateral contracts and single-price auction at the electricity market. In general, the market clearing price (: MCP) is largely changed by amount of total load demand in the market. The influence may cause price spike, and consequently the volatility of MCP will make LSEs and their customers to face a risk of revenue and cost. DSM is attracted as a means of load leveling, and has effect on decreasing MCP at peak load period. Introducing Energy Storage systems (: ES) is one of DSM in order to change demand profile at customer-side. In case that customers decrease their own demand at jumped MCP, a bidding strategy of generating companies may be changed their strategy. As a result, MCP is changed through such complex mechanism. In this paper the authors evaluate MCP by multi-agent. It is considered that customer-side ES has an effect on MCP fluctuation. Through numerical examples, this paper evaluates the influence on MCP by controlling customer-side ES corresponding to variation of MCP.

  7. Game Demands of Seven-A-Side Soccer in Young Players.

    PubMed

    Barbero-Alvarez, José C; Gómez-López, Maite; Castagna, Carlo; Barbero-Alvarez, Verónica; Romero, David V; Blanchfield, Anthony W; Nakamura, Fábio Y

    2017-07-01

    Barbero-Alvarez, JC, Gómez-López, M, Castagna, C, Barbero-Alvarez, V, Romero, DV, Blanchfield, AW, and Nakamura, FY. Game demands of seven-a-side soccer in young players. J Strength Cond Res 31(7): 1771-1779, 2017-The aim of this study was to examine the activity patterns and physiological demands of 7-a-side youth soccer matches across 2 chronological age categories (U12 and U14). Twenty-two soccer players of a national youth soccer academy were investigated. Players of each age category performed 2 training matches (2 × 25 minutes) and were monitored by global positioning system and heart rate monitor units. Players of both categories covered similar total distance (5,348 ± 307 m), at similar mean heart rate values (86 ± 4% of maximum). However, the number of high-intensity runs (82.5 ± 17.4 vs. 69.7 ± 15.2) and total distance covered during sprints (264 ± 207 vs. 128 ± 74 m) were significantly (p ≤ 0.05) higher in U14 compared with U12. The results suggest a highly demanding nature of 7-a-side soccer for skilled players, with physical maturity possibly influencing the match-related high-intensity performance at these ages.

  8. Market Model of Financing Higher Education in Sub-Saharan Africa: Examples from Kenya.

    ERIC Educational Resources Information Center

    Oketch, Moses O.

    2003-01-01

    Examines some of the rationales for financial diversification and partial privatization of state universities in Kenya and the different manifestations of market-driven approaches to university education. Explores whether the market model can address increased demand while maintaining educational quality. (EV)

  9. Equity for Children: Linking Education and Children's Services.

    ERIC Educational Resources Information Center

    Kirst, Michael W.

    1994-01-01

    Educational equity must be reconceptualized and merged with children's conditions and a broader concept of children's services than schooling. National goals, particularly learning readiness, demand a broader definition of children's finance and equity. School-linked services can be funded by converging existing public and private funding streams…

  10. 7 CFR 1488.11 - Liquidated damages.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit Sales Program (GSM-5... financing agreement which will result in serious and substantial damage to CCC and to its program. Since it... to CCC promptly on demand, as reasonable compensation and not as a penalty, liquidated damages in...

  11. 7 CFR 1488.11 - Liquidated damages.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit Sales Program (GSM-5... financing agreement which will result in serious and substantial damage to CCC and to its program. Since it... to CCC promptly on demand, as reasonable compensation and not as a penalty, liquidated damages in...

  12. 7 CFR 1488.11 - Liquidated damages.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit Sales Program (GSM-5... financing agreement which will result in serious and substantial damage to CCC and to its program. Since it... to CCC promptly on demand, as reasonable compensation and not as a penalty, liquidated damages in...

  13. Space Projects: Improvements Needed in Selecting Future Projects for Private Financing

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The Office of Management and Budget (OMB) and NASA jointly selected seven projects for commercialization to reduce NASA's fiscal year 1990 budget request and to help achieve the goal of increasing private sector involvement in space. However, the efforts to privately finance these seven projects did not increase the commercial sector's involvement in space to the extent desired. The General Accounting Office (GAO) determined that the projects selected were not a fair test of the potential of increasing commercial investment in space at an acceptable cost to the government, primarily because the projects were not properly screened. That is, neither their suitability for commercialization nor the economic consequences of seeking private financing for them were adequately evaluated before selection. Evaluations and market tests done after selection showed that most of the projects were not viable candidates for private financing. GAO concluded that projects should not be removed from NASA's budget for commercial development until after careful screening has been done to determine whether adequate commercial demand exists, development risks are commercially acceptable and private financing is found or judged to be highly likely, and the cost effectiveness of such a decision is acceptable. Premature removal of projects from NASA's budget ultimately can cause project delays and increased costs when unsuccessful commercialization candidates must be returned to the budget. NASA also needs to ensure appropriate comparisons of government and private financing options for future commercialization projects.

  14. Adam Smith's invisible hand is unstable: physics and dynamics reasoning applied to economic theorizing

    NASA Astrophysics Data System (ADS)

    McCauley, Joseph L.

    2002-11-01

    Neo-classical economic theory is based on the postulated, nonempiric notion of utility. Neo-classical economists assume that prices, dynamics, and market equilibria are supposed to be derived from utility. The results are supposed to represent mathematically the stabilizing action of Adam Smith's invisible hand. In deterministic excess demand dynamics, however, a utility function generally does not exist mathematically due to nonintegrability. Price as a function of demand does not exist and all equilibria are unstable. Qualitatively, and empirically, the neo-classical prediction of price as a function of demand describes neither consumer nor trader demand. We also discuss five inconsistent definitions of equilibrium used in economics and finance, only one of which is correct, and then explain the fallacy in the economists’ notion of ‘temporary price equilibria’.

  15. CO{sub 2} mitigation potential of efficient demand-side technologies: The case of Thailand

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

    Shrestha, R.M.; Biswas, W.K.; Timilsina, G.R.

    This study assesses the techno-economic potential of selected demand-side efficient appliances to mitigate CO{sub 2} emission from the power sector in Thailand under national, consumer, and utility perspectives. A key finding of this study is that about 5.5--7% of the total annual CO{sub 2} emission from the electricity sector of the country can be reduced during 1996--2011 from the national perspective.

  16. Supply and demand: negotiating the prescription drug labyrinth to reduce costs.

    PubMed

    DeStefino, Kevin

    2003-01-01

    Prescription drug costs are increasing at a rate of 15% to 17% a year and a look into the future does not bring much better news. Employers can expect to see more numbers like these as doctors more aggressively treat diseases using drug therapy, the population continues to age and pharmaceutical companies continue to spend billions of dollars on direct-to-consumer advertising aimed at consumers who are desensitized to the true costs of their prescriptions. In this environment, it is unlikely that companies can realistically expect to reverse costs of even to avoid cost increases. However, this article provides employers with a prudent approach to managing both the supply and demand sides of the prescription drug equation in order to reduce their level of increase. Supply-side management focuses on negotiations with vendors, while the demand side focuses on managing employee utilization.

  17. Urban development control based on transportation carrying capacity

    NASA Astrophysics Data System (ADS)

    Miharja, M.; Sjafruddin, A. H.

    2017-06-01

    Severe transportation problems in Indonesian urban areas are stimulated by one fundamental factor, namely lack of awareness on transportation carrying capacity in these areas development control. Urban land use development towards more physical coverage is typically not related with the capability of transportation system to accommodate additional trips volume. Lack of clear connection between development permit with its implication on the transportation side has led to a phenomenon of exceeding transport demand over supply capacity. This paper discusses the concept of urban land use development control which will be related with transport carrying capacity. The discussion would cover both supply and demand sides of transportation. From supply side, the analysis regarding the capacity of transport system would take both existing as well as potential road network capacity could be developed. From demand side, the analysis would be through the control of a maximum floor area and public transport provision. Allowed maximum floor area for development would be at the level of generating traffic at reasonable volume. Ultimately, the objective of this paper is to introduce model to incorporate transport carrying capacity in Indonesian urban land use development control.

  18. Developing Server-Side Infrastructure for Large-Scale E-Learning of Web Technology

    ERIC Educational Resources Information Center

    Simpkins, Neil

    2010-01-01

    The growth of E-business has made experience in server-side technology an increasingly important area for educators. Server-side skills are in increasing demand and recognised to be of relatively greater value than comparable client-side aspects (Ehie, 2002). In response to this, many educational organisations have developed E-business courses,…

  19. Fiscal Stress: Worldwide Trends in Higher Education Finance

    ERIC Educational Resources Information Center

    Vossensteyn, Hans

    2004-01-01

    While higher education is generally a high priority in boosting economic development, public budgets to sustain expansion of higher education systems remain limited around the globe. This fiscal stress creates an impetus for governments to develop various strategies to meet the growing demand--from both students and society--for higher education…

  20. Strategy and Finance in Higher Education. Surviving the '90s.

    ERIC Educational Resources Information Center

    Massy, William F., Ed.; Meyerson, Joel W., Ed.

    This book provides a new look at educational management in the face of mounting financial pressures. The demands for accountability that today's university administrators must face require them to apply the sophistication of modern business and institutional management while preserving the expensive and often difficult-to-measure contributions of…

  1. Capacity Issue Looms for Vouchers

    ERIC Educational Resources Information Center

    Zehr, Mary Ann

    2011-01-01

    State-level momentum in support of vouchers and tax credits that help students go to private schools highlights what has been a largely theoretical issue: private school capacity to support voucher-financed enrollment. Academics say the national supply of seats in secular and religious private schools is sufficient to meet short-term demand from…

  2. The long and winding path to private financing and regulation of toll roads

    DOT National Transportation Integrated Search

    2000-07-01

    Road transport has long been, and will be for a long time, the dominant form of transport for freight and passenger movement throughout the world. The demand for road services will continue to grow and hence so will the need for investment. From Arge...

  3. 31 CFR 900.5 - Form of payment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... payment. Claims may be paid in the form of money or, when a contractual basis exists, the Government may demand the return of specific property or the performance of specific services. ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Form of payment. 900.5 Section 900.5...

  4. LGBT Applicants and Challenges for Admission: Five Cases

    ERIC Educational Resources Information Center

    Baum, Benjamin S.

    2012-01-01

    Few professional processes are more personally intrusive than the college application. It demands information about your family, your finances, your interests, and your desires. For lesbian, gay, bisexual, and transgender (LGBT) applicants in their teenage years who may not be comfortable with their sexuality, admission officers need be sensitive…

  5. Banking/Finance Supplement to the California Business Program Guide.

    ERIC Educational Resources Information Center

    Cary, Judie; And Others

    This supplement to the California Business Education Program Guide for Office and Distributive Occupations is designed to assist office education teachers of secondary, postsecondary, and adult students to update their business education curricula in light of new technology and increasing demand for skilled office workers. Focusing on banking and…

  6. Indiana's Academic Standards: Economics--Social Studies

    ERIC Educational Resources Information Center

    Indiana Department of Education, 2004

    2004-01-01

    In this standard, students learn how economies, large and small, function. Supply and demand are covered in depth, and students learn to identify the production, consumption, and circulation of different types of resources in local, state, national, and world economies. Students also learn about employment and personal finance, as well as the…

  7. Decision models for capital investment and financing decisions in hospitals.

    PubMed Central

    Vraciu, R A

    1980-01-01

    The literature on capital investment and financing decisions for hospitals has suggested several approaches to analyzing sets of options. In this paper, I present a taxonomy of the different approaches; analyze and compare the different elements of the taxonomy; and illustrate and discuss the information that can be gained by using each approach. I view these different analytic methods as complementary rather than competing methods of providing information to decision makers, and argue that the complex nature of hospital objectives demands the use of more than one approach. Failure to do this may lead to biased evaluations and poor decision making. PMID:6768699

  8. Flipping the Business College on Its Side

    ERIC Educational Resources Information Center

    Brozik, Dallas; Cassidy, Chris

    2013-01-01

    Colleges of business are typically formed around functional divisions like accounting, finance, management, and marketing. This discipline-based structure serves to convey basic information to the students, but it is poorly suited to provide an educational experience that integrates the functional areas into a holistic framework. Efforts to refine…

  9. Modeling and Analysis of Commercial Building Electrical Loads for Demand Side Management

    NASA Astrophysics Data System (ADS)

    Berardino, Jonathan

    In recent years there has been a push in the electric power industry for more customer involvement in the electricity markets. Traditionally the end user has played a passive role in the planning and operation of the power grid. However, many energy markets have begun opening up opportunities to consumers who wish to commit a certain amount of their electrical load under various demand side management programs. The potential benefits of more demand participation include reduced operating costs and new revenue opportunities for the consumer, as well as more reliable and secure operations for the utilities. The management of these load resources creates challenges and opportunities to the end user that were not present in previous market structures. This work examines the behavior of commercial-type building electrical loads and their capacity for supporting demand side management actions. This work is motivated by the need for accurate and dynamic tools to aid in the advancement of demand side operations. A dynamic load model is proposed for capturing the response of controllable building loads. Building-specific load forecasting techniques are developed, with particular focus paid to the integration of building management system (BMS) information. These approaches are tested using Drexel University building data. The application of building-specific load forecasts and dynamic load modeling to the optimal scheduling of multi-building systems in the energy market is proposed. Sources of potential load uncertainty are introduced in the proposed energy management problem formulation in order to investigate the impact on the resulting load schedule.

  10. Virtual atmospheric mercury emission network in China.

    PubMed

    Liang, Sai; Zhang, Chao; Wang, Yafei; Xu, Ming; Liu, Weidong

    2014-01-01

    Top-down analysis of virtual atmospheric mercury emission networks can direct efficient demand-side policy making on mercury reductions. Taking China-the world's top atmospheric mercury emitter-as a case, we identify key contributors to China's atmospheric mercury emissions from both the producer and the consumer perspectives. China totally discharged 794.9 tonnes of atmospheric mercury emissions in 2007. China's production-side control policies should mainly focus on key direct mercury emitters such as Liaoning, Hebei, Shandong, Shanxi, Henan, Hunan, Guizhou, Yunnan, and Inner Mongolia provinces and sectors producing metals, nonmetallic mineral products, and electricity and heat power, while demand-side policies should mainly focus on key underlying drivers of mercury emissions such as Shandong, Jiangsu, Zhejiang, and Guangdong provinces and sectors of construction activities and equipment manufacturing. China's interregional embodied atmospheric mercury flows are generally moving from the inland to the east coast. Beijing-Tianjin (with 4.8 tonnes of net mercury inflows) and South Coast (with 3.3 tonnes of net mercury inflows) are two largest net-inflow regions, while North (with 5.3 tonnes of net mercury outflows) is the largest net-outflow region. We also identify primary supply chains contributing to China's virtual atmospheric mercury emission network, which can be used to trace the transfers of production-side and demand-side policy effects.

  11. On-demand server-side image processing for web-based DICOM image display

    NASA Astrophysics Data System (ADS)

    Sakusabe, Takaya; Kimura, Michio; Onogi, Yuzo

    2000-04-01

    Low cost image delivery is needed in modern networked hospitals. If a hospital has hundreds of clients, cost of client systems is a big problem. Naturally, a Web-based system is the most effective solution. But a Web browser could not display medical images with certain image processing such as a lookup table transformation. We developed a Web-based medical image display system using Web browser and on-demand server-side image processing. All images displayed on a Web page are generated from DICOM files on a server, delivered on-demand. User interaction on the Web page is handled by a client-side scripting technology such as JavaScript. This combination makes a look-and-feel of an imaging workstation not only for its functionality but also for its speed. Real time update of images with tracing mouse motion is achieved on Web browser without any client-side image processing which may be done by client-side plug-in technology such as Java Applets or ActiveX. We tested performance of the system in three cases. Single client, small number of clients in a fast speed network, and large number of clients in a normal speed network. The result shows that there are very slight overhead for communication and very scalable in number of clients.

  12. Modeling renewable portfolio standards for the annual energy outlook 1998 - electricity market module

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

    NONE

    The Electricity Market Module (EMM) is the electricity supply component of the National Energy Modeling System (NEMS). The EMM represents the generation, transmission, and pricing of electricity. It consists of four submodules: the Electricity Capacity Planning (ECP) Submodule, the Electricity Fuel Dispatch (EFD) Submodule, the Electricity Finance and Pricing (EFP) Submodule, and the Load and Demand-Side Management (LDSM) Submodule. For the Annual Energy Outlook 1998 (AEO98), the EMM has been modified to represent Renewable Portfolio Standards (RPS), which are included in many of the Federal and state proposals for deregulating the electric power industry. A RPS specifies that electricity suppliersmore » must produce a minimum level of generation using renewable technologies. Producers with insufficient renewable generating capacity can either build new plants or purchase {open_quotes}credits{close_quotes} from other suppliers with excess renewable generation. The representation of a RPS involves revisions to the ECP, EFD, and the EFP. The ECP projects capacity additions required to meet the minimum renewable generation levels in future years. The EFD determines the sales and purchases of renewable credits for the current year. The EFP incorporates the cost of building capacity and trading credits into the price of electricity.« less

  13. End-User Tools Towards AN Efficient Electricity Consumption: the Dynamic Smart Grid

    NASA Astrophysics Data System (ADS)

    Kamel, Fouad; Kist, Alexander A.

    2010-06-01

    Growing uncontrolled electrical demands have caused increased supply requirements. This causes volatile electrical markets and has detrimental unsustainable environmental impacts. The market is presently characterized by regular daily peak demand conditions associated with high electricity prices. A demand-side response system can limit peak demands to an acceptable level. The proposed scheme is based on energy demand and price information which is available online. An online server is used to communicate the information of electricity suppliers to users, who are able to use the information to manage and control their own demand. A configurable, intelligent switching system is used to control local loads during peak events and mange the loads at other times as necessary. The aim is to shift end user loads towards periods where energy demand and therefore also prices are at the lowest. As a result, this will flatten the load profile and avoiding load peeks which are costly for suppliers. The scheme is an endeavour towards achieving a dynamic smart grid demand-side-response environment using information-based communication and computer-controlled switching. Diffusing the scheme shall lead to improved electrical supply services and controlled energy consumption and prices.

  14. Good veterinary governance: definition, measurement and challenges.

    PubMed

    Msellati, L; Commault, J; Dehove, A

    2012-08-01

    Good veterinary governance assumes the provision of veterinary services that are sustainably financed, universally available, and provided efficiently without waste or duplication, in a manner that is transparent and free of fraud or corruption. Good veterinary governance is a necessary condition for sustainable economic development insomuch as it promotes the effective delivery of services and improves the overall performance of animal health systems. This article defines governance in Veterinary Services and proposes a framework for its measurement. It also discusses the role of Veterinary Services and analyses the governance dimensions of the performance-assessment tools developed by the World Organisation for Animal Health (OIE). These tools (OIE PVS Tool and PVS Gap Analysis) track the performance of Veterinary Services across countries (a harmonised tool) and over time (the PVS Pathway). The article shows the usefulness of the OIE PVS Tool for measuring governance, but also points to two shortcomings, namely (i) the lack of clear outcome indicators, which is an impediment to a comprehensive assessment of the performance of Veterinary Services, and (ii) the lack of specific measures for assessing the extent of corruption within Veterinary Services and the extent to which demand for better governance is being strengthened within the animal health system. A discussion follows on the drivers of corruption and instruments for perception-based assessments of country governance and corruption. Similarly, the article introduces the concept of social accountability, which is an approach to enhancing government transparency and accountability, and shows how supply-side and demand-side mechanisms complement each other in improving the governance of service delivery. It further elaborates on two instruments--citizen report card surveys and grievance redress mechanisms--because of their wider relevance and their possible applications in many settings, including Veterinary Services. Also, central to improving transparency and accountability is access to information and a discussion on the appropriate level of decentralisation of Veterinary Services. Bringing Veterinary Services into compliance with OIE international standards would contribute to improving governance and providing economic benefits through increased animal productivity, the expansion of trade and improved food security. It would also help to increase public health benefits, through greater food safety and better prevention and control of zoonoses.

  15. Economic factors influencing the implementation of community care for severely ill schizophrenic patients.

    PubMed

    Lien, Lars

    2005-01-01

    An increasing number of long-term schizophrenic patients are discharged from hospitals and taken care of in the community. This change in tendency has both a professional and economical side. The beneficial outcome of community care is well established. The aim of this paper is to appraise the economical implications and possibilities of community care compared to standard hospital care. The price elasticity for mental health services is higher than for other medical services. The demand for mental health care can not be directly compared with the demand for other types of care. This is due to lack of information on what is defined as good quality treatment in care and to define who is the demander of mental health care. Due to lack of defined demand and externalities encountered in the care for psychiatric patients, psychiatric treatment must be seen as a good that warrants government involvement in the financing and delivery of the service. The number in need of community care is estimated to be 12 per 100,000. To find the allocative efficiency in spending of resources on mental health care, it is important to look for the right balance between hospital and community care. There is evidence to assume that community care is more cost effective than hospital-based care. This does not apply to the most disabled schizophrenic patients where the costs are higher and outcome is the same. It is important to measure the costs incurred to family and friends when the total costs of community care are calculated and to find technically efficient production. The literature indicates that the physician/non-physician ratio has been too high. There are reports of dis-economies of scale, but economies of scope might be apparent. There are strong arguments in favour of state provision of psychiatric care for schizophrenic patients most in need. Otherwise the mental health care sector must be regulated with incentives that serve the need of the patients and encourage the most cost-effective treatment. Due to the risk of opportunism, specific assets and bounded rationality contracting involving clinical services should be avoided.

  16. The economic impact of assisted reproductive technology: a review of selected developed countries.

    PubMed

    Chambers, Georgina M; Sullivan, Elizabeth A; Ishihara, Osamu; Chapman, Michael G; Adamson, G David

    2009-06-01

    To compare regulatory and economic aspects of assisted reproductive technologies (ART) in developed countries. Comparative policy and economic analysis. Couples undergoing ART treatment in the United States, Canada, United Kingdom, Scandinavia, Japan, and Australia. Description of regulatory and financing arrangements, cycle costs, cost-effectiveness ratios, total expenditure, utilization, and price elasticity. Regulation and financing of ART share few general characteristics in developed countries. The cost of treatment reflects the costliness of the underlying healthcare system rather than the regulatory or funding environment. The cost (in 2006 United States dollars) of a standard IVF cycle ranged from $12,513 in the United States to $3,956 in Japan. The cost per live birth was highest in the United States and United Kingdom ($41,132 and $40,364, respectively) and lowest in Scandinavia and Japan ($24,485 and $24,329, respectively). The cost of an IVF cycle after government subsidization ranged from 50% of annual disposable income in the United States to 6% in Australia. The cost of ART treatment did not exceed 0.25% of total healthcare expenditure in any country. Australia and Scandinavia were the only country/region to reach levels of utilization approximating demand, with North America meeting only 24% of estimated demand. Demand displayed variable price elasticity. Assisted reproductive technology is expensive from a patient perspective but not from a societal perspective. Only countries with funding arrangements that minimize out-of-pocket expenses met expected demand. Funding mechanisms should maximize efficiency and equity of access while minimizing the potential harm from multiple births.

  17. 75 FR 17622 - Equal Access to Justice Act Implementation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-07

    ... enforceable by the Director of FHFA until such regulations are modified, terminated, set aside, or superseded by the Director of FHFA.\\2\\ \\2\\ See section 1302 and section 1312 of HERA. B. Equal Access to Justice... demand for a lesser amount. Director would be defined as the Director of the Federal Housing Finance...

  18. Day Care for Children in Denmark, Norway and Sweden.

    ERIC Educational Resources Information Center

    Leira, Arnlaug

    Based on information gathered in 1986, this report describes day care in Denmark, Norway, and Sweden. The focus of the report is on structural aspects of day care, including provision, management and finances, and questions concerning supply, demand, and distribution. Part I provides an introduction to the report and discusses the Scandinavian…

  19. 7 CFR 3560.73 - Subsequent loans.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... Loan requests to add units to comply with accessibility requirements may be processed as a subsequent loan; however, loan requests to add units to meet market demand will be processed as an initial loan... over a period not to exceed the lesser of the economic life of the housing being financed or 50 years...

  20. 7 CFR 3560.73 - Subsequent loans.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... Loan requests to add units to comply with accessibility requirements may be processed as a subsequent loan; however, loan requests to add units to meet market demand will be processed as an initial loan... over a period not to exceed the lesser of the economic life of the housing being financed or 50 years...

  1. 7 CFR 3560.73 - Subsequent loans.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... Loan requests to add units to comply with accessibility requirements may be processed as a subsequent loan; however, loan requests to add units to meet market demand will be processed as an initial loan... over a period not to exceed the lesser of the economic life of the housing being financed or 50 years...

  2. 7 CFR 3560.73 - Subsequent loans.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... Loan requests to add units to comply with accessibility requirements may be processed as a subsequent loan; however, loan requests to add units to meet market demand will be processed as an initial loan... over a period not to exceed the lesser of the economic life of the housing being financed or 50 years...

  3. 31 CFR 29.518 - Reporting delinquent debts to credit bureaus.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Reporting delinquent debts to credit... Collection Collection of Overpayments § 29.518 Reporting delinquent debts to credit bureaus. (a) Notice. If a debtor's response to the demand letter does not result in payment in full, payment by offset, or payment...

  4. A Comparison of Spatial Statistical Methods in a School Finance Policy Context

    ERIC Educational Resources Information Center

    Slagle, Mike

    2010-01-01

    A shortcoming of the conventional ordinary least squares (OLS) approaches for estimating median voter models of education demand is the inability to more fully explain the spatial relationships between neighboring school districts. Consequently, two school districts that appear to be descriptively similar in terms of conventional measures of…

  5. 2 CFR Appendix A to Part 225 - General Principles for Determining Allowable Costs

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... in the financing of a particular program or project. The principles are designed to provide that... its own unique combination of staff, facilities, and experience, will have the primary responsibility... services may be allocated or billed to users. 5. “Claim” means a written demand or written assertion by the...

  6. Adjusting to New Environments: Law Schools Search for Meaning in Change.

    ERIC Educational Resources Information Center

    Zimmer, Bruce I.

    1987-01-01

    To stay healthy, legal education will have to enhance greatly its information, finance, and planning capacities. In the long run, it is the interplay between the supply of aspiring students and the demand for graduates' services that provides the key to well-being of training for a profession like law. (MSE)

  7. Optimising technical skills and physical loading in small-sided basketball games.

    PubMed

    Klusemann, Markus J; Pyne, David B; Foster, Carl; Drinkwater, Eric J

    2012-01-01

    Differences in physiological, physical, and technical demands of small-sided basketball games related to the number of players, court size, and work-to-rest ratios are not well characterised. A controlled trial was conducted to compare the influence of number of players (2v2/4v4), court size (half/full court) and work-to-rest ratios (4x2.5 min/2x5 min) on the demands of small-sided games. Sixteen elite male and female junior players (aged 15-19 years) completed eight variations of a small-sided game in randomised order over a six-week period. Heart rate responses and rating of perceived exertion (RPE) were measured to assess the physiological load. Movement patterns and technical elements were assessed by video analysis. There were ∼60% more technical elements in 2v2 and ∼20% more in half court games. Heart rate (86 ± 4% & 83 ± 5% of maximum; mean ± SD) and RPE (8 ± 2 & 6 ± 2; scale 1-10) were moderately higher in 2v2 than 4v4 small-sided games, respectively. The 2v2 format elicited substantially more sprints (36 ±12%; mean ±90% confidence limits) and high intensity shuffling (75 ±17%) than 4v4. Full court games required substantially more jogging (9 ±6%) compared to half court games. Fewer players in small-sided basketball games substantially increases the technical, physiological and physical demands.

  8. Scaling up access to oral rehydration solution for diarrhea: Learning from historical experience in low– and high–performing countries

    PubMed Central

    Wilson, Shelby E.; Morris, Saul S.; Gilbert, Sarah Skye; Mosites, Emily; Hackleman, Rob; Weum, Kristoffer L.M.; Pintye, Jillian; Manhart, Lisa E.; Hawes, Stephen E.

    2013-01-01

    Aim This paper aims to identify factors that systematically predict why some countries that have tried to scale up oral rehydration solution (ORS) have succeeded, and others have not. Methods We examined ORS coverage over time, across countries, and through case studies. We conducted expert interviews and literature and data searches to better understand the history of ORS scale–up efforts and why they failed or succeeded in nine countries. We used qualitative, pairwise (or three–country) comparisons of geographically or otherwise similar countries that had different outcomes in terms of ORS scale–up. An algorithm was developed which scored country performance across key supply, demand and financing activities to quantitatively assess the scale–up efforts in each country. Results The vast majority of countries have neither particularly low nor encouragingly high ORS use rates. We observed three clearly identifiable contrasts between countries that achieved and sustained high ORS coverage and those that did not. Key partners across sectors have critical roles to play to effectively address supply– and demand–side barriers. Efforts must synchronize demand generation, private provider outreach and public sector work. Many donor funds are either suspended or redirected in the event of political instability, exacerbating the health challenges faced by countries in these contexts. We found little information on the cost of scale–up efforts. Conclusions We identified a number of characteristics of successful ORS scale–up programs, including involvement of a broad range of key players, addressing supply and demand generation together, and working with both public and private sectors. Dedicated efforts are needed to launch and sustain success, including monitoring and evaluation plans to track program costs and impacts. These case studies were designed to inform programmatic decision–making; thus, rigorous academic methods to qualitatively and quantitatively evaluate country ORS scale–up programs might yield additional, critical insights and confirm our conclusions. PMID:23826508

  9. A taxonomy and results from a comprehensive review of 28 maternal health voucher programmes.

    PubMed

    Bellows, Ben W; Conlon, Claudia M; Higgs, Elizabeth S; Townsend, John W; Nahed, Matta G; Cavanaugh, Karen; Grainger, Corinne G; Okal, Jerry; Gorter, Anna C

    2013-12-01

    It is increasingly clear that Millennium Development Goal 4 and 5 will not be achieved in many low- and middle-income countries with the weakest gains among the poor. Recognizing that there are large inequalities in reproductive health outcomes, the post-2015 agenda on universal health coverage will likely generate strategies that target resources where maternal and newborn deaths are the highest. In 2012, the United States Agency for International Development convened an Evidence Summit to review the knowledge and gaps on the utilization of financial incentives to enhance the quality and uptake of maternal healthcare. The goal was to provide donors and governments of the low- and middle-income countries with evidence-informed recommendations on practice, policy, and strategies regarding the use of financial incentives, including vouchers, to enhance the demand and supply of maternal health services. The findings in this paper are intended to guide governments interested in maternal health voucher programmes with recommendations for sustainable implementation and impact. The Evidence Summit undertook a systematic review of five financing strategies. This paper presents the methods and findings for vouchers, building on a taxonomy to catalogue knowledge about voucher programme design and functionality. More than 120 characteristics under five major categories were identified: programme principles (objectives and financing); governance and management; benefits package and beneficiary targeting; providers (contracting and service pricing); and implementation arrangements (marketing, claims processing, and monitoring and evaluation). Among the 28 identified maternal health voucher programmes, common characteristics included: a stated objective to increase the use of services among the means-tested poor; contracted-out programme management; contracting either exclusively private facilities or a mix of public and private providers; prioritizing community-based distribution of vouchers; and tracking individual claims for performance purposes. Maternal voucher programmes differed on whether contracted providers were given training on clinical or administrative issues; whether some form of service verification was undertaken at facility or community-level; and the relative size of programme management costs in the overall programme budget. Evidence suggests voucher programmes can serve populations with national-level impact. Reaching scale depends on whether the voucher programme can: (i) keep management costs low, (ii) induce a large demand-side response among the bottom two quintiles, and (iii) achieve a quality of care that translates a greater number of facility-based deliveries into a reduction in maternal morbidity and mortality.

  10. A Taxonomy and Results from a Comprehensive Review of 28 Maternal Health Voucher Programmes

    PubMed Central

    Conlon, Claudia M.; Higgs, Elizabeth S.; Townsend, John W.; Nahed, Matta G.; Cavanaugh, Karen; Grainger, Corinne G.; Okal, Jerry; Gorter, Anna C.

    2013-01-01

    It is increasingly clear that Millennium Development Goal 4 and 5 will not be achieved in many low- and middle-income countries with the weakest gains among the poor. Recognizing that there are large inequalities in reproductive health outcomes, the post-2015 agenda on universal health coverage will likely generate strategies that target resources where maternal and newborn deaths are the highest. In 2012, the United States Agency for International Development convened an Evidence Summit to review the knowledge and gaps on the utilization of financial incentives to enhance the quality and uptake of maternal healthcare. The goal was to provide donors and governments of the low- and middle-income countries with evidence-informed recommendations on practice, policy, and strategies regarding the use of financial incentives, including vouchers, to enhance the demand and supply of maternal health services. The findings in this paper are intended to guide governments interested in maternal health voucher programmes with recommendations for sustainable implementation and impact. The Evidence Summit undertook a systematic review of five financing strategies. This paper presents the methods and findings for vouchers, building on a taxonomy to catalogue knowledge about voucher programme design and functionality. More than 120 characteristics under five major categories were identified: programme principles (objectives and financing); governance and management; benefits package and beneficiary targeting; providers (contracting and service pricing); and implementation arrangements (marketing, claims processing, and monitoring and evaluation). Among the 28 identified maternal health voucher programmes, common characteristics included: a stated objective to increase the use of services among the means-tested poor; contracted-out programme management; contracting either exclusively private facilities or a mix of public and private providers; prioritizing community-based distribution of vouchers; and tracking individual claims for performance purposes. Maternal voucher programmes differed on whether contracted providers were given training on clinical or administrative issues; whether some form of service verification was undertaken at facility or community-level; and the relative size of programme management costs in the overall programme budget. Evidence suggests voucher programmes can serve populations with national-level impact. Reaching scale depends on whether the voucher programme can: (i) keep management costs low, (ii) induce a large demand-side response among the bottom two quintiles, and (iii) achieve a quality of care that translates a greater number of facility-based deliveries into a reduction in maternal morbidity and mortality.

  11. Investigating financial incentives for maternal health: an introduction.

    PubMed

    Stanton, Mary Ellen; Higgs, Elizabeth S; Koblinsky, Marge

    2013-12-01

    Projection of current trends in maternal and neonatal mortality reduction shows that many countries will fall short of the UN Millennium Development Goal 4 and 5. Underutilization of maternal health services contributes to this poor progress toward reducing maternal and neonatal morbidity and mortality. Moreover, the quality of services continues to lag in many countries, with a negative effect on the health of women and their babies, including deterring women from seeking care. To enhance the use and provision of quality maternal care, countries and donors are increasingly using financial incentives. This paper introduces the JHPN Supplement, in which each paper reviews the evidence of the effectiveness of a specific financial incentive instrument with the aim of improving the use and quality of maternal healthcare and impact. The US Agency for International Development and the US National Institutes of Health convened a US Government Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives on 24-25 April 2012 in Washington, DC. The Summit brought together leading global experts in finance, maternal health, and health systems from governments, academia, development organizations, and foundations to assess the evidence on whether financial incentives significantly and substantially increase provision, use and quality of maternal health services, and the contextual factors that impact the effectiveness of these incentives. Evidence review teams evaluated the multidisciplinary evidence of various financial mechanisms, including supply-side incentives (e.g. performance-based financing, user fees, and various insurance mechanisms) and demand-side incentives (e.g. conditional cash transfers, vouchers, user fee exemptions, and subsidies for care-seeking). At the Summit, the teams presented a synthesis of evidence and initial recommendations on practice, policy, and research for discussion. The Summit enabled structured feedback on recommendations which the teams included in their final papers appearing in this Supplement. Papers in this Supplement review the evidence for a specific financial incentive mechanism (e.g. pay for performance, conditional cash transfer) to improve the use and quality of maternal healthcare and makes recommendations for programmes and future research. While data on programmes using financial incentives for improved use and indications of the quality of maternal health services support specific conclusions and recommendations, including those for future research, data linking the use of financial incentives with improved health outcomes are minimal.

  12. Design of an impact evaluation using a mixed methods model--an explanatory assessment of the effects of results-based financing mechanisms on maternal healthcare services in Malawi.

    PubMed

    Brenner, Stephan; Muula, Adamson S; Robyn, Paul Jacob; Bärnighausen, Till; Sarker, Malabika; Mathanga, Don P; Bossert, Thomas; De Allegri, Manuela

    2014-04-22

    In this article we present a study design to evaluate the causal impact of providing supply-side performance-based financing incentives in combination with a demand-side cash transfer component on equitable access to and quality of maternal and neonatal healthcare services. This intervention is introduced to selected emergency obstetric care facilities and catchment area populations in four districts in Malawi. We here describe and discuss our study protocol with regard to the research aims, the local implementation context, and our rationale for selecting a mixed methods explanatory design with a quasi-experimental quantitative component. The quantitative research component consists of a controlled pre- and post-test design with multiple post-test measurements. This allows us to quantitatively measure 'equitable access to healthcare services' at the community level and 'healthcare quality' at the health facility level. Guided by a theoretical framework of causal relationships, we determined a number of input, process, and output indicators to evaluate both intended and unintended effects of the intervention. Overall causal impact estimates will result from a difference-in-difference analysis comparing selected indicators across intervention and control facilities/catchment populations over time.To further explain heterogeneity of quantitatively observed effects and to understand the experiential dimensions of financial incentives on clients and providers, we designed a qualitative component in line with the overall explanatory mixed methods approach. This component consists of in-depth interviews and focus group discussions with providers, service user, non-users, and policy stakeholders. In this explanatory design comprehensive understanding of expected and unexpected effects of the intervention on both access and quality will emerge through careful triangulation at two levels: across multiple quantitative elements and across quantitative and qualitative elements. Combining a traditional quasi-experimental controlled pre- and post-test design with an explanatory mixed methods model permits an additional assessment of organizational and behavioral changes affecting complex processes. Through this impact evaluation approach, our design will not only create robust evidence measures for the outcome of interest, but also generate insights on how and why the investigated interventions produce certain intended and unintended effects and allows for a more in-depth evaluation approach.

  13. An integrative assessment of the commercial air transportation system via adaptive agents

    NASA Astrophysics Data System (ADS)

    Lim, Choon Giap

    The overarching research objective is to address the tightly-coupled interactions between the demand-side and supply-side components of the United States Commercial Air Transportation System (CATS) in a time-variant environment. A system-of-system perspective is adopted, where the scope is extended beyond the National Airspace System (NAS) level to the National Transportation System (NTS) level to capture the intermodal and multimodal relationships between the NTS stakeholders. The Agent-Based Modeling and Simulation technique is employed where the NTS/NAS is treated as an integrated Multi-Agent System comprising of consumer and service provider agents, representing the demand-side and supply-side components respectively. Successful calibration and validation of both model components against the observable real world data resulted in a CATS simulation tool where the aviation demand is estimated from socioeconomic and demographic properties of the population instead of merely based on enplanement growth multipliers. This valuable achievement enabled a 20-year outlook simulation study to investigate the implications of a global fuel price hike on the airline industry and the U.S. CATS at large. Simulation outcomes revealed insights into the airline competitive behaviors and the subsequent responses from transportation consumers.

  14. The Viability of Commodity Cartels: The Case of Oil.

    ERIC Educational Resources Information Center

    Bergeijk, Peter A. G. van

    1989-01-01

    Explains the rise and fall of the oil cartel by applying an elasticity of demand analysis. Beginning from the demand side of the market, offers a simple derivation of the elasticity of demand for the cartel's product. Maintains that method helps undergraduates comprehend basic properties, requiring only an understanding of the elasticities of…

  15. 10 CFR 905.15 - What are the requirements for the small customer plan alternative?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... all reasonable opportunities to meet future energy service requirements using demand-side management... applicable, and contact person; (ii) Type of customer; (iii) Current energy and demand profiles and data on... and demand use for end-use customers; (iv) Future energy services projections; (v) How items in...

  16. The futility of utility: how market dynamics marginalize Adam Smith

    NASA Astrophysics Data System (ADS)

    McCauley, Joseph L.

    2000-10-01

    Economic theorizing is based on the postulated, nonempiric notion of utility. Economists assume that prices, dynamics, and market equilibria are supposed to be derived from utility. The results are supposed to represent mathematically the stabilizing action of Adam Smith's invisible hand. In deterministic excess demand dynamics I show the following. A utility function generally does not exist mathematically due to nonintegrable dynamics when production/investment are accounted for, resolving Mirowski's thesis. Price as a function of demand does not exist mathematically either. All equilibria are unstable. I then explain how deterministic chaos can be distinguished from random noise at short times. In the generalization to liquid markets and finance theory described by stochastic excess demand dynamics, I also show the following. Market price distributions cannot be rescaled to describe price movements as ‘equilibrium’ fluctuations about a systematic drift in price. Utility maximization does not describe equilibrium. Maximization of the Gibbs entropy of the observed price distribution of an asset would describe equilibrium, if equilibrium could be achieved, but equilibrium does not describe real, liquid markets (stocks, bonds, foreign exchange). There are three inconsistent definitions of equilibrium used in economics and finance, only one of which is correct. Prices in unregulated free markets are unstable against both noise and rising or falling expectations: Adam Smith's stabilizing invisible hand does not exist, either in mathematical models of liquid market data, or in real market data.

  17. Health financing and integration of urban and rural residents' basic medical insurance systems in China.

    PubMed

    Zhu, Kun; Zhang, Luying; Yuan, Shasha; Zhang, Xiaojuan; Zhang, Zhiruo

    2017-11-07

    China is in the process of integrating the new cooperative medical scheme (NCMS) and the urban residents' basic medical insurance system (URBMI) into the urban and rural residents' basic medical insurance system (URRBMI). However, how to integrate the financing policies of NCMS and URBMI has not been described in detail. This paper attempts to illustrate the differences between the financing mechanisms of NCMS and URBMI, to analyze financing inequity between urban and rural residents and to identify financing mechanisms for integrating urban and rural residents' medical insurance systems. Financing data for NCMS and URBMI (from 2008 to 2015) was collected from the China health statistics yearbook, the China health and family planning statistics yearbook, the National Handbook of NCMS Information, the China human resources and social security statistics yearbook, and the China social security yearbook. "Ability to pay" was introduced to measure inequity in health financing. Individual contributions to NCMS and URBMI as a function of per capita disposable income was used to analyze equity in health financing between rural and urban residents. URBMI had a financing mechanism that was similar to that used by NCMS in that public finance accounted for more than three quarters of the pooling funds. The scale of financing for NCMS was less than 5% of the per capita net income of rural residents and less than 2% of the per capita disposable income of urban residents for URBMI. Individual contributions to the NCMS and URBMI funds were less than 1% of their disposable and net incomes. Inequity in health financing between urban and rural residents in China was not improved as expected with the introduction of NCMS and URBMI. The role of the central government and local governments in financing NCMS and URBMI was oscillating in the past decade. The scale of financing for URRBMI is insufficient for the increasing demands for medical services from the insured. The pooling fund should be increased so that it can better adjust to China's rapidly aging population and epidemiological transitions as well as protect the insured from poverty due to illness. Individual contributions to the URBMI and NCMS funds were small in terms of contributors' incomes. The role of the central government and local governments in financing URRBMI was not clearly identified. Individual contributions to the URRBMI fund should be increased to ensure the sustainable development of URRBMI. Compulsory enrollment should be required so that URRBMI improves the social medical insurance system in China.

  18. 75 FR 78994 - Notice of Intent To Prepare an Environmental Assessment, Request for Comments on Environmental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

    ... project, GSA proposes to relocate its current operations from the Bannister Federal Complex in Kansas City... increment financing (TIF) district, on the East-side of downtown, in Missouri's 5th Congressional District... the proposed project. GSA will also evaluate the ``No Action'' and other reasonable alternatives to...

  19. THE SPACE STAGE--FAD OR FUTURE.

    ERIC Educational Resources Information Center

    DECHAINE, FABER

    DISSATISFACTION WITH THE PROSCENIUM ARCH THEATRE, THE NEED FOR ECONOMY IN PUBLICLY-FINANCED STRUCTURES, AND THE ADVANTAGES OF INTIMATE THEATRE, HAVE LED TO THE DEVELOPMENT OF THE SPACE STAGE, WHICH PROJECTS INTO THE AUDITORIUM AND IS SURROUNDED ON THREE SIDES BY SEATING. THE SPACE STAGE CONCEPT IS USED IN THIS EXAMPLE TO PROVIDE A PERFORMING ARTS…

  20. [Family practitioners in Switzerland by 2030: which roles for medical task delegation?].

    PubMed

    Jaccard Ruedin, Hélène; Seematter-Bagnoud, Laurence; Roth, Maik; Junod, Julien; Santos-Eggimann, Brigitte

    2009-01-01

    Due to population aging, by 2030 Switzerland may face a demand of 24 million family practitioner visits, a growth of 13 percent from the 2005 level. This result is based on the assumption that the per capita demand for doctor visits remains what was observed in 2005 by age groups and sex. During the same period, the total number of practitioners may decrease by 14 percent whereas the female proportion of such practitioners may double. These changes may cause a 33 percent decrease in the supply of physician visits to reach only 14 millions. The comparison of the demand and supply of family doctor visits reveals that by 2030, 10 million visits may be unmet which represents 40 percent of the demand. On the supply side, a full scale implementation of task delegation may partially reduce that gap (minus 2 millions). On the demand side, improved health status may bring in a larger decrease in the needs for visits (minus 4 million).

  1. A distributed algorithm for demand-side management: Selling back to the grid.

    PubMed

    Latifi, Milad; Khalili, Azam; Rastegarnia, Amir; Zandi, Sajad; Bazzi, Wael M

    2017-11-01

    Demand side energy consumption scheduling is a well-known issue in the smart grid research area. However, there is lack of a comprehensive method to manage the demand side and consumer behavior in order to obtain an optimum solution. The method needs to address several aspects, including the scale-free requirement and distributed nature of the problem, consideration of renewable resources, allowing consumers to sell electricity back to the main grid, and adaptivity to a local change in the solution point. In addition, the model should allow compensation to consumers and ensurance of certain satisfaction levels. To tackle these issues, this paper proposes a novel autonomous demand side management technique which minimizes consumer utility costs and maximizes consumer comfort levels in a fully distributed manner. The technique uses a new logarithmic cost function and allows consumers to sell excess electricity (e.g. from renewable resources) back to the grid in order to reduce their electric utility bill. To develop the proposed scheme, we first formulate the problem as a constrained convex minimization problem. Then, it is converted to an unconstrained version using the segmentation-based penalty method. At each consumer location, we deploy an adaptive diffusion approach to obtain the solution in a distributed fashion. The use of adaptive diffusion makes it possible for consumers to find the optimum energy consumption schedule with a small number of information exchanges. Moreover, the proposed method is able to track drifts resulting from changes in the price parameters and consumer preferences. Simulations and numerical results show that our framework can reduce the total load demand peaks, lower the consumer utility bill, and improve the consumer comfort level.

  2. Barriers and Opportunities to Broader Adoption of Integrated Demand Side Management at Electric Utilities: A Scoping Study

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

    Potter, Jennifer; Stuart, Elizabeth; Cappers, P

    Integrated demand-side management (IDSM) is a strategic approach to designing and delivering a portfolio of demand side management (DSM) programs to customers. IDSM typically delivers customer centric strategies with the goal of increasing the amount of DSM in the field, but doing so in a way that integrates various measures and technologies to improve their collective performance and/or penetration. Specifically, IDSM can be defined as the integrated or coordinated delivery of three or more of: (1) energy efficiency (EE), (2) demand response (DR), (3) distributed generation (DG), (4) storage, (5) electric vehicle (EV) technologies, and (6) time-based rate programs tomore » residential and commercial electric utility customers. The electric industry’s limited experience deploying IDSM to date suggests that significant barriers may exist. A Berkeley Lab report “Barriers and Opportunities to Broader Adoption of Integrated Demand Side Management at Electric Utilities: A Scoping Study” explores recent electric utility experience with IDSM to provide an assessment of the barriers and potential benefits perceived or experienced by program administrators in their attempts to implement integrated programs. The research draws on surveys and interviews with eleven staff from a sample of eight DSM program administrators and program implementers who were currently implementing or had previously attempted to implement an IDSM program or initiative. Respondents provided their perspectives on drivers for IDSM and barriers to broader deployment. They also reported on actions they had undertaken to promote expanded delivery of IDSM and provided their assessments of the most important under-tapped opportunities for expanding IDSM efforts, both for program administrator and regulatory organizations.« less

  3. Effects of dynamic-demand-control appliances on the power grid frequency.

    PubMed

    Tchuisseu, E B Tchawou; Gomila, D; Brunner, D; Colet, P

    2017-08-01

    Power grid frequency control is a demanding task requiring expensive idle power plants to adapt the supply to the fluctuating demand. An alternative approach is controlling the demand side in such a way that certain appliances modify their operation to adapt to the power availability. This is especially important to achieve a high penetration of renewable energy sources. A number of methods to manage the demand side have been proposed. In this work we focus on dynamic demand control (DDC), where smart appliances can delay their switchings depending on the frequency of the system. We introduce a simple model to study the effects of DDC on the frequency of the power grid. The model includes the power plant equations, a stochastic model for the demand that reproduces, adjusting a single parameter, the statistical properties of frequency fluctuations measured experimentally, and a generic DDC protocol. We find that DDC can reduce small and medium-size fluctuations but it can also increase the probability of observing large frequency peaks due to the necessity of recovering pending task. We also conclude that a deployment of DDC around 30-40% already allows a significant reduction of the fluctuations while keeping the number of pending tasks low.

  4. Effects of dynamic-demand-control appliances on the power grid frequency

    NASA Astrophysics Data System (ADS)

    Tchuisseu, E. B. Tchawou; Gomila, D.; Brunner, D.; Colet, P.

    2017-08-01

    Power grid frequency control is a demanding task requiring expensive idle power plants to adapt the supply to the fluctuating demand. An alternative approach is controlling the demand side in such a way that certain appliances modify their operation to adapt to the power availability. This is especially important to achieve a high penetration of renewable energy sources. A number of methods to manage the demand side have been proposed. In this work we focus on dynamic demand control (DDC), where smart appliances can delay their switchings depending on the frequency of the system. We introduce a simple model to study the effects of DDC on the frequency of the power grid. The model includes the power plant equations, a stochastic model for the demand that reproduces, adjusting a single parameter, the statistical properties of frequency fluctuations measured experimentally, and a generic DDC protocol. We find that DDC can reduce small and medium-size fluctuations but it can also increase the probability of observing large frequency peaks due to the necessity of recovering pending task. We also conclude that a deployment of DDC around 30-40% already allows a significant reduction of the fluctuations while keeping the number of pending tasks low.

  5. Integrating watershed hydrology and economics to establish a local market for water quality improvement: A field experiment.

    PubMed

    Uchida, Emi; Swallow, Stephen K; Gold, Arthur; Opaluch, James; Kafle, Achyut; Merrill, Nathaniel; Michaud, Clayton; Gill, Carrie Anne

    2018-04-01

    Innovative market mechanisms are being increasingly recognized as effective decision-making institutions to incorporate the value of ecosystem services into the economy. We present a field experiment that integrates an economic auction and a biophysical water flux model to develop a local market process consisting of both the supply and demand sides. On the supply side, we operate an auction with small-scale livestock owners who bid for contracts to implement site-specific manure management practices that reduce phosphorus loadings to a major reservoir. On the demand side, we implement a real money, multi-unit public good auction for these contracts with residents who potentially benefit from reduced water quality risks. The experiments allow us to construct supply and demand curves to find an equilibrium price for water quality improvement. The field experiments provide a proof-of-concept for practical implementation of a local market for environmental improvements, even for the challenging context of nonpoint pollution.

  6. Promoting innovation in small markets: Evidence from the market for rare and intractable diseases.

    PubMed

    Iizuka, Toshiaki; Uchida, Gyo

    2017-07-01

    In many medical care markets with limited profit potential, firms often have little incentive to innovate. These include the market for rare diseases, "neglected" tropical diseases, and personalized medicine. Governments and not-for-profit organizations promote innovation in such markets but empirical evidence on the policy effect is limited. We study this issue by analyzing the impact of a demand-side policy in Japan, which reduces the cost sharing of patients with some rare and intractable diseases and attempts to establish and promote the treatment of those diseases. Using clinical trials data taken from public registries, we identify the effect of the policy using a difference-in-difference approach. We find that the demand-side policy increased firms' incentive to innovate: firm-sponsored clinical trials increased 181% (0.16 per disease per year) when covered by the policy. This result indicates that the demand-side policy can be an important part of innovation policies in markets with limited profit potential. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. White biotechnology: ready to partner and invest in.

    PubMed

    Kircher, Manfred

    2006-01-01

    It needs three factors to build an industry: market demand, product vision and capital. White biotechnology already produces high volume products such as feed additive amino acids and specialty products like enzymes for enantioselective biocatalysis. It serves large and diverse markets in the nutrition, wellness, pharmaceutical, agricultural and chemical industry. The total volume adds up to $ 50 billion worldwide. In spite of its proven track record, white biotechnology so far did not attract as much capital as red and even green biotechnology. However, the latest finance indicators confirm the continuously growing attractiveness of investment opportunities in white biotechnology. This article discusses white biotechnology's position and potential in the finance market and success factors.

  8. Health care providers under pressure: making the most of challenging times.

    PubMed

    Davis, Scott B; Robinson, Phillip J

    2010-01-01

    Whether the slowing economic recovery, tight credit markets, increasing costs, or the uncertainty surrounding health care reform, the health care industry faces some sizeable challenges. These factors have put considerable strain on the industry's traditional financing options that the industry has relied on in the past--bonds, banks, finance companies, private equity, venture capital, real estate investment trusts, private philanthropy, and grants. At the same time, providers are dealing with rising costs, lower reimbursement rates, shrinking demand for elective procedures, higher levels of charitable care and bad debt, and increased scrutiny of tax-exempt hospitals. Providers face these challenges against a back ground of uncertainty created by health care reform.

  9. Guestworker migration, remittances and the extended family: evidence from Pakistan.

    PubMed

    Ilahi, N; Jafarey, S

    1999-04-01

    "The paper places migration in the context of the extended family. It models informal loans between migrant and extended family for financing the costs of international labor migration. To show repayments to extended family is important; we trace the effects of such loans on migrant savings and remittance to the immediate family. We employ a standard life-cycle approach, which predicts that the demand for extended family financing rises with migration costs and falls with pre-migration wealth. Remittance to the immediate family and savings retained abroad both fall with the pre-migration loan." These hypotheses are tested using data from a survey of return migrants to Pakistan carried out in 1986. excerpt

  10. Increasing the demand for childhood vaccination in developing countries: a systematic review

    PubMed Central

    2009-01-01

    Background Attempts to maintain or increase vaccination coverage almost all focus on supply side interventions: improving availability and delivery of vaccines. The effectiveness and cost-effectiveness of efforts to increase demand is uncertain. Methods We performed a systematic review of studies that provided quantitative estimates of the impact of demand side interventions on uptake of routine childhood vaccination. We retrieved studies published up to Sept 2008. Results The initial search retrieved 468 potentially eligible studies, including four systematic reviews and eight original studies of the impact of interventions to increase demand for vaccination. We identified only two randomised controlled trials. Interventions with an impact on vaccination uptake included knowledge translation (KT) (mass media, village resource rooms and community discussions) and non-KT initiatives (incentives, economic empowerment, household visits by extension workers). Most claimed to increase vaccine coverage by 20 to 30%. Estimates of the cost per vaccinated child varied considerably with several in the range of $10-20 per vaccinated child. Conclusion Most studies reviewed here represented a low level of evidence. Mass media campaigns may be effective, but the impact depends on access to media and may be costly if run at a local level. The persistence of positive effects has not been investigated. The economics of demand side interventions have not been adequately assessed, but available data suggest that some may be very cost-effective. PMID:19828063

  11. High Penetration of Electrical Vehicles in Microgrids: Threats and Opportunities

    NASA Astrophysics Data System (ADS)

    Khederzadeh, Mojtaba; Khalili, Mohammad

    2014-10-01

    Given that the microgrid concept is the building block of future electric distribution systems and electrical vehicles (EVs) are the future of transportation market, in this paper, the impact of EVs on the performance of microgrids is investigated. Demand-side participation is used to cope with increasing demand for EV charging. The problem of coordination of EV charging and discharging (with vehicle-to-grid (V2G) functionality) and demand response is formulated as a market-clearing mechanism that accepts bids from the demand and supply sides and takes into account the constraints put forward by different parts. Therefore, a day-ahead market with detailed bids and offers within the microgrid is designed whose objective is to maximize the social welfare which is the difference between the value that consumers attach to the electrical energy they buy plus the benefit of the EV owners participating in the V2G functionality and the cost of producing/purchasing this energy. As the optimization problem is a mixed integer nonlinear programming one, it is decomposed into one master problem for energy scheduling and one subproblem for power flow computation. The two problems are solved iteratively by interfacing MATLAB with GAMS. Simulation results on a sample microgrid with different residential, commercial and industrial consumers with associated demand-side biddings and different penetration level of EVs support the proposed formulation of the problem and the applied methods.

  12. The economics of public health: financing drug abuse treatment services.

    PubMed

    Cartwright, William S; Solano, Paul L

    2003-12-01

    Drug abuse treatment financing exhibits a heterogeneous set of sources from federal, state, and local governments, as well as private sources from insurance, patient out-of-pocket, and charity. A public health model of drug abuse treatment is presented for a market that can be characterized by excess demand in many communities and an implied policy of rationing. According to best estimates, as many as 6.7 million individuals may need treatment, but only an estimated 1.5 million individuals actually participated in treatment episodes. Since, as demonstrated empirically, drug abuse treatment has a robust and positive social net benefit to society, it is perplexing that treatment financing stops with a rationing outcome that inhibits social welfare. The justification for public financing is centered on the external costs of drug addiction, but subsidization is grounded in the reality that a large number of addicted individuals do not have sufficient resources to pay for treatment out-of-pocket, nor do they have private insurance coverage. Social welfare losses are generated by financial arrangements that are inconsistent with rational budgeting theory and as such would lead to non-optimal organization and management of the drug abuse treatment system.

  13. Towards Universal Design Hotels in Denmark.

    PubMed

    Grangaard, Sidse

    2016-01-01

    Based on the research project 'Accessible Hotel Rooms' that studies the balance between the experience of supply and demand regarding accessibility features in Danish hotel rooms, this paper demonstrates factors having an influence on Universal Design hotels in Denmark. The research project was financed by the Danish Transport and Construction Agency. Different notions in the hotel sector of the current supply and demand for Universal Design hotel rooms are identified, as well as future demand. Despite supplying accessible rooms, some hotels do not advertise their accessibility features on their website. There exists an attitude in the hotel sector that functions as a barrier for Universal Design: if there are enough guests, for example business travellers, then why market the hotel on Universal Design? The paper points out the coherence between the understanding of the users and the view of demand. Another important factor is Corporate Social Responsibility, which can be regarded as a strategy or platform towards Universal Design hotels.

  14. Health financing in Africa: overview of a dialogue among high level policy makers

    PubMed Central

    2011-01-01

    Background Even though Africa has the highest disease burden compared with other regions, it has the lowest per capita spending on health. In 2007, 27 (51%) out the 53 countries spent less than US$50 per person on health. Almost 30% of the total health expenditure came from governments, 50% from private sources (of which 71% was from out-of-pocket payments by households) and 20% from donors. The purpose of this article is to reflect on the proceedings of the African Union Side Event on Health Financing in the African continent. Methods Methods employed in the session included presentations, panel discussion and open public discussion with ministers of health and finance from the African continent. Discussion The current unsatisfactory state of health financing was attributed to lack of clear vision and plan for health financing; lack of national health accounts and other evidence to guide development and implementation of national health financing policies and strategies; low investments in sectors that address social determinants of health; predominance of out-of-pocket spending; underdeveloped prepaid health financing mechanisms; large informal sectors vis-à-vis small formal sectors; and unpredictability and non-alignment of majority of donor funds with national health priorities. Countries need to develop and adopt a comprehensive national health policy and a costed strategic plan; a comprehensive evidence-based health financing strategy; allocate at least 15% of the national budget to health development; use GFATM and PEPFAR funds for health systems strengthening; strengthen intersectoral collaboration to address health determinants; advocate among donors to implement the Paris Declaration on Aid Effectiveness and its Accra Agenda for Action; ensure universal access to health services for pregnant women, lactating mothers and children aged under five years; strengthen financial management capacities; and develop prepaid health financing systems, especially health insurance to complement tax funding. In addition, countries need to institutionalize national health accounts; undertake feasibility studies of various health financing mechanisms; and document and share best practices in health financing. Conclusion There was consensus that every country ought to have an evidence-based comprehensive health financing strategy with a road map for attaining universal health service coverage vision; and increase physical and financial access by pregnant women, lactating mothers and by children under five years to quality health services. PMID:21810212

  15. Health financing in Africa: overview of a dialogue among high level policy makers.

    PubMed

    Sambo, Luis Gomes; Kirigia, Joses Muthuri; Ki-Zerbo, Georges

    2011-06-13

    Even though Africa has the highest disease burden compared with other regions, it has the lowest per capita spending on health. In 2007, 27 (51%) out the 53 countries spent less than US$50 per person on health. Almost 30% of the total health expenditure came from governments, 50% from private sources (of which 71% was from out-of-pocket payments by households) and 20% from donors. The purpose of this article is to reflect on the proceedings of the African Union Side Event on Health Financing in the African continent. Methods employed in the session included presentations, panel discussion and open public discussion with ministers of health and finance from the African continent. The current unsatisfactory state of health financing was attributed to lack of clear vision and plan for health financing; lack of national health accounts and other evidence to guide development and implementation of national health financing policies and strategies; low investments in sectors that address social determinants of health; predominance of out-of-pocket spending; underdeveloped prepaid health financing mechanisms; large informal sectors vis-à-vis small formal sectors; and unpredictability and non-alignment of majority of donor funds with national health priorities.Countries need to develop and adopt a comprehensive national health policy and a costed strategic plan; a comprehensive evidence-based health financing strategy; allocate at least 15% of the national budget to health development; use GFATM and PEPFAR funds for health systems strengthening; strengthen intersectoral collaboration to address health determinants; advocate among donors to implement the Paris Declaration on Aid Effectiveness and its Accra Agenda for Action; ensure universal access to health services for pregnant women, lactating mothers and children aged under five years; strengthen financial management capacities; and develop prepaid health financing systems, especially health insurance to complement tax funding.In addition, countries need to institutionalize national health accounts; undertake feasibility studies of various health financing mechanisms; and document and share best practices in health financing. There was consensus that every country ought to have an evidence-based comprehensive health financing strategy with a road map for attaining universal health service coverage vision; and increase physical and financial access by pregnant women, lactating mothers and by children under five years to quality health services.

  16. Examining Graduate Skills in Accounting and Finance: The Perception of Middle Eastern Students

    ERIC Educational Resources Information Center

    Osmani, Mohamad; Hindi, Nitham; Al-Esmail, Rajab; Weerakkody, Vishanth

    2017-01-01

    While many universities have implemented various initiatives and teaching and learning methods to embed the most in-demand skills into their degree programmes, there is little evidence in the literature of students' opinions and awareness of these skills. The purpose of this article is to assess, through an empirical study, students' perceptions…

  17. Dropping Back In: How to Complete Your College Education Quickly & Economically. First Edition.

    ERIC Educational Resources Information Center

    Hecht, Miriam; Traub, Lillian

    A handbook for the adult student returning to college is presented. Attention is directed to the pros and cons of reentry; how to choose a program; options for financing an education; admissions applications; maximizing preentry credits; colleges, credits, and degrees; coping with academic demands such as exam-taking; and achieving a balance…

  18. Economic environment - housing bubbles: no national bubble, some regions vulnerable

    Treesearch

    Al Schuler

    2005-01-01

    Since 2001, a combination of low mortgage rates and "boring" equity markets have helped to fuel record-setting home sales, contributing to substantial price increases in the U.S. and many other parts of the world (see Table 1). Economists are concerned about riskier mortgage financing and the increasing incidence of speculative demand in some regions....

  19. Local markets for global health technologies: lessons learned from advancing 6 new products.

    PubMed

    Matthias, Dipika Mathur; Taylor, Catharine H; Sen, Debjeet; Metzler, Mutsumi

    2014-05-01

    Key components to support local institutional and consumer markets are: supply chain, finance, clinical use, and consumer use. Key lessons learned: (1) Build supply and demand simultaneously. (2) Support a lead organization to drive the introduction process. (3) Plan for scale up from the start. (4) Profitability for the private sector is an absolute.

  20. The Impact of Revenue Diversification on the Financial and Educational Outcomes of Private Colleges and Universities during the Great Recession

    ERIC Educational Resources Information Center

    Webb, James C.

    2014-01-01

    The recent economic recession threatened all traditional revenue sources possessed by colleges and universities. Resultant tuition increases have led stakeholders to demand greater accountability and fostered increased focus upon strategic financing from administrators. This dissertation examines the economic and political trends that have placed…

  1. Elite Colleges Must Stop Spurning Critiques of Higher Education

    ERIC Educational Resources Information Center

    Breneman, David

    2008-01-01

    Lawmakers have been putting increasing pressure on private colleges to spend more of their endowments on student aid. Just a few weeks ago, members of the U.S. Senate Finance Committee sent letters to dozens of institutions with endowments of at least $500-million, demanding detailed information about how they manage those endowments, how much…

  2. Emerging Issues in Nigerian Education--The Case of the Level and Scope of Growth of Nigerian Universities.

    ERIC Educational Resources Information Center

    Enaohwo, J. Okpako

    1985-01-01

    In an examination of the need for expansion in Nigeria's higher education, past trends are examined in the context of current efforts to keep up with the high demand. Finance is found to be the ultimate and critical determinant of the growth of the university system. (MSE)

  3. Making It Real: Incorporating Cost Management and Productivity Improvements into Financing Decisions

    ERIC Educational Resources Information Center

    Wellman, Jane

    2010-01-01

    Higher education is being challenged to increase access and degree attainment for all student groups--a tall order under any circumstances, but particularly daunting in the current economy. To do this, institutional and policy leaders will need to find ways to reduce costs and permanently reduce spending demands while they maintain access. This…

  4. Unemployment Insurance Financing, Short-Time Compensation, and Labor Demand. Background Paper No. 17.

    ERIC Educational Resources Information Center

    Hamermesh, Daniel S.

    Legislated and administrative changes in the unemployment insurance system during the 1980s probably reduced the program's detrimental effects on labor market efficiency. They did so without changing the nature of the federal-state relationship that makes the program so unusual. Regrettably, though, they hurt the labor market status of low-wage…

  5. 31 CFR 16.6 - Prerequisites for issuing a complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... 16.6 Section 16.6 Money and Finance: Treasury Office of the Secretary of the Treasury REGULATIONS... defined in paragraph (b) of this section), the amount of money or the value of property or services demanded or requested in violation of § 16.3(a) does not exceed $150,000. (b) For the purposes of this...

  6. Childcare in the Netherlands: Lessons in Privatisation

    ERIC Educational Resources Information Center

    Akgunduz, Yusuf Emre; Plantenga, Janneke

    2014-01-01

    In 2005 the Child Care Act was introduced in the Netherlands. The explicit objective of the childcare reform has been to stimulate the operation of market forces so that childcare services are provided in an efficient way. The change towards a demand-driven financing system implies that there is no longer public provision of childcare services in…

  7. A Graphical Exposition of the Link between Two Representations of the Excess Burden of Taxation

    ERIC Educational Resources Information Center

    Liu, Liqun; Rettenmaier, Andrew J.

    2005-01-01

    The excess burden of taxation typically has two graphical representations in undergraduate microeconomics and public finance textbooks: the IC/BC (indifference curve/budget constraint) representation and the demand/supply representation. The IC/BC representation has the advantage of showing the behavioral response to a distortionary tax and how a…

  8. Trends in the market for privately owned seasonal recreational housing

    Treesearch

    Richard L. Ragatz

    1980-01-01

    The market for privately owned seasonal recreational properties, such as vacation homes, recreational lots, and resort condominiums has encountered many peaks and declines during the past 15 years. While demand for traditional types of recreational property has recently fallen off due to inflation and lack of financing, other alternatives such as resort timesharing are...

  9. 48 CFR 52.232-29 - Terms for Financing of Purchases of Commercial Items.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... requested is properly due in accordance with this contract; the supplies deliverable or services due under... termination for cause. If this contract is terminated for cause, the Contractor shall, on demand, repay to the... other rights and remedies provided by law or this contract; and (ii) shall not be affected by delayed...

  10. Municipal Overburden: Its Influence on Education Expenditures in Cities.

    ERIC Educational Resources Information Center

    Brazer, Harvey E.; McCarty, Therese A.

    The study reported in this document found no evidence for the minicipal overburden (m/o) hypothesis of urban school finance. The theory asserts that there is a causal relationship between high levels of non-school municipal expenditure or tax rates and low levels of school spending. Demand for expenditure on education in a sample of school…

  11. The Impact of the Principles of Accounting Experience on Student Preparation for Intermediate Accounting

    ERIC Educational Resources Information Center

    Carrington, Linda G.

    2012-01-01

    Both students and instructors alike will generally agree that intermediate accounting courses are among the most difficult and demanding in an accounting or finance curriculum, and perhaps even on the college campus. Intermediate accounting contains subject matter which requires a higher level of thinking and a greater ability to process prior…

  12. 31 CFR 92.17 - Final action.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Final action. 92.17 Section 92.17... Words, Letters, Symbols, or Emblems of the United States Mint § 92.17 Final action. (a) In making a... Notice of Assessment (or on demand under paragraph (c)(3)(ii)(D) of this section), a civil action to...

  13. The Coming Revolution in Public Services, and What It Means for Cities and Universities

    ERIC Educational Resources Information Center

    Konvitz, Josef

    2016-01-01

    Long-term demographic trends, combined with low productivity and pressure on public finances have set in place the preconditions for a major revolution in public services. Governments face new demands including for security which will lead to more centralization, but social and environmental services for a more complex society call for greater…

  14. Financing the Airport of the Future: The Small Aircraft Transportation System

    NASA Technical Reports Server (NTRS)

    Bartle, John R.

    2000-01-01

    The objective of SATS is to reduce gridlock at hubs, reduce travel times, allow for personal control over travel, and anticipate demand shifts resulting from a migration from suburbs to rural places. The technology is presently available and economical to produce SATS aircraft. The public issue centers on the airports. SATS is a federal program, and many airports in the U.S. are under the control of local governments. The scope of the objective will require thousands of airports in rural and suburban areas to modify their infrastructure and increase their investment. Researchers at the University of Nebraska at Omaha (UNO), and others at other institutions, have prepared reports surveying the relevant issues of implementing SATS. Our UNO team focused on the issues of policy implementation, economic development, management, and finance specific to Nebraska. We are finding that these issues are similar to those in other states in our region and other rural states. This paper discusses how this investment might be financed.

  15. Financing the response to AIDS: some fiscal and macroeconomic considerations.

    PubMed

    Haacker, Markus

    2008-07-01

    This article examines the international response to AIDS from a fiscal perspective: first the financing of the international response to AIDS, especially the role of external financing, and second, a more comprehensive perspective on the costs of the national response to AIDS relevant for fiscal policy. The second half of the article focuses on the effectiveness of the response to AIDS. We find that there is little basis for concerns about macroeconomic constraints to scaling up, in light of the moderate scale of AIDS-related aid flows relative to overall aid. Regarding sectoral constraints, the picture is more differentiated. Many countries with high prevalence rates have also achieved high rates of access to treatment, but most of these are middle-income countries. Our econometric analysis credits external aid as a key factor that has enabled higher-prevalence countries to cope with the additional demands for health services. At the same time, gross domestic product per capita and health sector capacities are important determinants of access to treatment.

  16. The Forgotten Side of School Finance Equity: The Role of Infrastructure Funding in Student Success

    ERIC Educational Resources Information Center

    Crampton, Faith E.; Thompson, David C.; Vesely, Randall S.

    2004-01-01

    Traditionally, local school districts have shouldered the burden of funding school infrastructure in the name of local control, relying upon local property tax revenues and the willingness of local voters to approve bond issues. Given vast disparities in school districts' property wealth, gross inequities in school facilities will remain without…

  17. 77 FR 3775 - Notice of Availability of the Environmental Assessment for Proposed Federal Building Kansas City, MO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... in Kansas City, Missouri. Through the project, GSA proposes to relocate its current operations from... downtown East Village development and tax increment financing (TIF) district, on the East-side of downtown... result of the construction and operation of the proposed project. GSA also evaluates a ``No Action'' and...

  18. Private health insurance in South Korea: an international comparison.

    PubMed

    Shin, Jaeun

    2012-11-01

    The goal of this study is to present the historical and policy background of the expansion of private health insurance in South Korea in the context of the National Health Insurance (NHI) system, and to provide empirical evidence on whether the increased role of private health insurance may counterbalance government financing, social security contributions, out-of-pocket payments, and help stabilize total health care spending. Using OECD Health Data 2011, we used a fixed effects model estimation. In this model, we allow error terms to be serially correlated over time in order to capture the association of private health insurance financing with three other components of health care financing and total health care spending. The descriptive observation of the South Korean health care financing shows that social security contributions are relatively limited in South Korea, implying that high out-of-pocket payments may be alleviated through the enhancement of NHI benefit coverage and an increase in social security contributions. Estimation results confirm that private health insurance financing is unlikely to reduce government spending on health care and social security contributions. We find evidence that out-of-pocket payments may be offset by private health insurance financing, but to a limited degree. Private health insurance financing is found to have a statistically significant positive association with total spending on health care. This indicates that the duplicated coverage effect on service demand may cancel out the potential efficiency gain from market initiatives driven by the active involvement of private health insurance. This study finds little evidence for the benefit of private insurance initiatives in coping with the fiscal challenges of the South Korean NHI program. Further studies on the managerial interplay among public and private insurers and on behavioral responses of providers and patients to a given structure of private-public financing are warranted to formulate the adequate balance between private health insurance and publicly funded universal coverage. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. A Rising Tide Lifts All Boats: America's New Test of 'Supply Side' Economics. Fundamentals of Free Enterprise, No. 7.

    ERIC Educational Resources Information Center

    American Fletcher National Bank and Trust Co., Indianapolis, IN.

    Designed for high school economics students as a public service project of the American Fletcher National Bank, the booklet examines the "supply-side" philosophy of economics of the Reagan Administration as compared to the "demand-side" emphasis of the past. The manipulation of the nation's economy by raising or lowering…

  20. Institutional delivery in rural India: the relative importance of accessibility and economic status.

    PubMed

    Kesterton, Amy J; Cleland, John; Sloggett, Andy; Ronsmans, Carine

    2010-06-06

    Skilled attendance at delivery is an important indicator in monitoring progress towards Millennium Development Goal 5 to reduce the maternal mortality ratio by three quarters between 1990 and 2015. In addition to professional attention, it is important that mothers deliver their babies in an appropriate setting, where life saving equipment and hygienic conditions can also help reduce the risk of complications that may cause death or illness to mother and child. Over the past decade interest has grown in examining influences on care-seeking behavior and this study investigates the determinants of place of delivery in rural India, with a particular focus on assessing the relative importance of community access and economic status. A descriptive analysis of trends in place of delivery using data from two national representative sample surveys in 1992 and 1998 is followed by a two-level (child/mother and community) random-effects logistical regression model using the second survey to investigate the determinants. In this investigation of institutional care seeking for child birth in rural India, economic status emerges as a more crucial determinant than access. Economic status is also the strongest influence on the choice between a private-for-profit or public facility amongst institutional births. Greater availability of obstetric services will not alone solve the problem of low institutional delivery rates. This is particularly true for the use of private-for-profit institutions, in which the distance to services does not have a significant adjusted effect. In the light of these findings a focus on increasing demand for existing services seems the most rational action. In particular, financial constraints need to be addressed, and results support current trials of demand side financing in India.

  1. Projections of Demand for Waterborne Transportation, Ohio River Basin, 1980, 1990, 2000, 2020, 2040. Volume 1. Study Summary.

    DTIC Science & Technology

    1980-12-01

    NOTES 3 19. KEY WORDS (Continue on revere side If n.cessary d Identify by block number) Bulk cargo Market demand analysis Commodity resource inventory...The study included a Commodity Resource Inventory, a Modal Split Analysis and a Market Demand Analysis. The work included investigation and analyses...inventory, a modal split analysis and a market demand analysis. The work included investigation and analyses of the production, transportation, and

  2. The effects of cash transfers and vouchers on the use and quality of maternity care services: A systematic review.

    PubMed

    Hunter, Benjamin M; Harrison, Sean; Portela, Anayda; Bick, Debra

    2017-01-01

    Cash transfers and vouchers are forms of 'demand-side financing' that have been widely used to promote maternal and newborn health in low- and middle-income countries during the last 15 years. This systematic review consolidates evidence from seven published systematic reviews on the effects of different types of cash transfers and vouchers on the use and quality of maternity care services, and updates the systematic searches to June 2015 using the Joanna Briggs Institute approach for systematic reviewing. The review protocol for this update was registered with PROSPERO (CRD42015020637). Data from 51 studies (15 more than previous reviews) and 22 cash transfer and voucher programmes suggest that approaches tied to service use (either via payment conditionalities or vouchers for selected services) can increase use of antenatal care, use of a skilled attendant at birth and in the case of vouchers, postnatal care too. The strongest evidence of positive effect was for conditional cash transfers and uptake of antenatal care, and for vouchers for maternity care services and birth with a skilled birth attendant. However, effects appear to be shaped by a complex set of social and healthcare system barriers and facilitators. Studies have typically focused on an initial programme period, usually two or three years after initiation, and many lack a counterfactual comparison with supply-side investment. There are few studies to indicate that programmes have led to improvements in quality of maternity care or maternal and newborn health outcomes. Future research should use multiple intervention arms to compare cost-effectiveness with similar investment in public services, and should look beyond short- to medium-term service utilisation by examining programme costs, longer-term effects on service utilisation and health outcomes, and the equity of those effects.

  3. The demand for health insurance coverage for tobacco dependence treatments: support for a benefit mandate and willingness to pay.

    PubMed

    Halpin, Helen Ann; McMenamin, Sara B; Shade, Starley B

    2007-12-01

    One solution for reducing tobacco use is to expand health insurance coverage for tobacco dependence treatments (TDTs), but the public demand for a coverage mandate is unknown. This study finds that demand for coverage of TDTs among a random sample of adult Californians with employer-sponsored health insurance is strong, with 62% indicating that health insurers should be required to offer coverage as part of their standard plans and a majority (56%) indicating a willingness to pay $3 more for their annual health insurance premium to finance cessation coverage. Compared to never smokers, current and former smokers are no more likely to support a benefit mandate to require coverage of cessation treatments, but the adjusted odds are approximately three times greater that current and former smokers are willing to pay $3 more toward their annual premium to finance cessation coverage. Liberals had higher adjusted odds of supporting a benefit mandate and of being willing to pay a higher premium compared to conservatives. Non-whites had higher adjusted odds of supporting a mandate compared to whites, with no differences by race/ethnicity in willingness to pay a higher premium. There were no differences in preferences for a benefit mandate or willingness to pay a higher premium as a function of age, gender or income. These findings have important policy implications for a state health insurance mandate to cover tobacco dependence treatments.

  4. Managing imperfect competition by pay for performance and reference pricing.

    PubMed

    Mak, Henry Y

    2018-01-01

    I study a managed health service market where differentiated providers compete for consumers by choosing multiple service qualities, and where copayments that consumers pay and payments that providers receive for services are set by a payer. The optimal regulation scheme is two-sided. On the demand side, it justifies and clarifies value-based reference pricing. On the supply side, it prescribes pay for performance when consumers misperceive service benefits or providers have intrinsic quality incentives. The optimal bonuses are expressed in terms of demand elasticities, service technology, and provider characteristics. However, pay for performance may not outperform prospective payment when consumers are rational and providers are profit maximizing, or when one of the service qualities is not contractible. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Integrating Higher Education Financial Aid and Financing Policy: Case Studies from the "Changing Direction" Technical Assistance States

    ERIC Educational Resources Information Center

    Bell, Julie Davis; Blanco, Cheryl D.; Conger, Sharmila Basu; Lingenfelter, Paul E.; Michelau, Demaree K.; Wright, David L.

    2008-01-01

    Throughout the end of the 1990s and the early years of the current decade, states experienced severe downturns in their economies. As has happened during other recessions, higher education, often viewed as discretionary spending compared to other budget demands, was hit particularly hard. During these years of severe fiscal constraints, however, a…

  6. Cost Benefit Analysis of Distance Learning Alternatives for DOD Uniformed Personnel and Civilian Employees

    DTIC Science & Technology

    1998-06-01

    the aid of self-teaching materials (like specially prepared workbooks , textbooks, multimedia packages), WWW material, resources available in...brief introduction to microeconomics scarcity, production possibility cures, and supply and demand. IT when proceeds to topics in macroeconomics...Finance and Accounting Service and the Federal Accounting Standards Advisory Board. *MN 3140 Microeconomics Theory: This course reviews traditional

  7. The History and Current Status of Federal Legislation Pertaining to Day Care Programs.

    ERIC Educational Resources Information Center

    Searcy, Ellen O.; Ouellet, Ronald

    This report is a brief summary of the history of Federal Day Care provisions through the sixties and an analysis of the child care legislation pending in Congress during 1971. The 92nd Congress, in attempts to answer the growing demands for Federally-sponsored child care, introduced four separate bills dealing with child care financing: HR. 1…

  8. Making the Switch to Open Source Software

    ERIC Educational Resources Information Center

    Surran, Michael

    2003-01-01

    During the 2001-2002 school year the author was struck with the reality that their computer lab would not meet the demands of their school for another year. Greater Houlton Christian Academy (www.ghca.com) is a private school in Maine, and thus does not have access to state or federal funding. This meant that financing a new computer lab would be…

  9. Renewed Attention to Social Sciences in China Leads to New Partnerships with American Universities

    ERIC Educational Resources Information Center

    Hvistendahl, Mara

    2009-01-01

    Politics and a lack of money resulted in decades of neglect for the social sciences in China, by foreign and domestic institutions alike. American universities looking to establish partnerships here have focused instead on high-demand fields like finance and the hard sciences. But societal change, along with a government push to develop more…

  10. I Feel Like an Armadillo: A Look at College Seniors and Recent Graduates Using Erik Erikson's Model of "Identity Versus Role-Diffusion."

    ERIC Educational Resources Information Center

    Jaurigue, Rebecca

    Developmental psychologist Erik Erikson observed that achieving a sense of self, an identity, was the important psychosocial task facing adolescents. The conflict lies in discovering and defining that identity despite parental and societal demands, changing values and opportunities, the influence of friends, and lovers, education, and finances.…

  11. 38 CFR 36.4309 - Transfer of title by borrower or maturity by demand or acceleration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... to the housing authority restrictions. A copy of the veteran's consent statement must be forwarded with the loan application or the report of a loan processed on the automatic basis. (Authority: 38 U.S.C. 3703(c)) (c) Any housing loan which is financed under 38 U.S.C. chapter 37, and to which section...

  12. Three Essays on the Impact of Cost-Saving Strategies on Student Outcomes

    ERIC Educational Resources Information Center

    Xu, Di

    2013-01-01

    For two decades, state financing of higher education has been on the decline and the situation has exacerbated since the onset of the economic recession, where the US state systems have resorted to a substantial cut of funding for higher education. Faced with the challenges of limited resources for financial pressure and an increasing demand,…

  13. Perceptions of School Superintendents and Board Presidents on Improved Pupil Performance and Superintendent Evaluation

    ERIC Educational Resources Information Center

    Moffett, Josephine

    2011-01-01

    It is well documented that the demands on school superintendents have not only become more taxing but have also changed in recent years. The superintendent needs to possess a high degree of knowledge and skills in a diverse number of areas, including psychology, finances, personnel, and general education while functioning at a very high level in…

  14. Current Funds: Public Higher Education Finance in New England

    ERIC Educational Resources Information Center

    Lingenfelter, Paul E.

    2009-01-01

    New Englanders have been well-served by the region's higher education legacy. They tend to be better-educated and more prosperous than the rest of the nation, and the cultural life in their cities and towns is exceptionally rich. But New England dares not rest on its laurels. The growing demand for even greater levels of educational attainment in…

  15. Optimal Load-Side Control for Frequency Regulation in Smart Grids

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

    Zhao, Changhong; Mallada, Enrique; Low, Steven

    Frequency control rebalances supply and demand while maintaining the network state within operational margins. It is implemented using fast ramping reserves that are expensive and wasteful, and which are expected to become increasingly necessary with the current acceleration of renewable penetration. The most promising solution to this problem is the use of demand response, i.e., load participation in frequency control. Yet it is still unclear how to efficiently integrate load participation without introducing instabilities and violating operational constraints. In this paper, we present a comprehensive load-side frequency control mechanism that can maintain the grid within operational constraints. In particular, ourmore » controllers can rebalance supply and demand after disturbances, restore the frequency to its nominal value, and preserve interarea power flows. Furthermore, our controllers are distributed (unlike the currently implemented frequency control), can allocate load updates optimally, and can maintain line flows within thermal limits. We prove that such a distributed load-side control is globally asymptotically stable and robust to unknown load parameters. We illustrate its effectiveness through simulations.« less

  16. Assessing out-of-pocket expenditures for primary health care: how responsive is the Democratic Republic of Congo health system to providing financial risk protection?

    PubMed

    Laokri, Samia; Soelaeman, Rieza; Hotchkiss, David R

    2018-06-15

    The goal of universal health coverage is challenging for chronically under-resourced health systems. Although household out-of-pocket payments are the most important source of health financing in low-income countries, relatively little is known about the drivers of primary health care expenditure and the predictability of the burden associated with high fee-for-service payments. This study describes out-of-pocket health expenditure and investigates demand- and supply-side drivers of excessive costs in the Democratic Republic of Congo (DRC), a central African country in the midst of a process of reforming its health financing system towards universal health coverage. A population-based household survey was conducted in four provinces of the DRC in 2014. Data included type, level and utilization of health care services, accessibility to care, patient satisfaction and disaggregated health care expenditure. Multivariate logistic regressions of excessive expenditure for outpatient care using alternative thresholds were performed to explore the incidence and predictors of atypically high expenditure incurred by individuals. Over 17% (17.5%) of individuals living in sample households reported an illness or injury without being hospitalized. Of 3341 individuals reporting an event in the four-week period prior to the survey, 65.6% sought outpatient care with an average of one visit (SD = 0.0). The overall mean expenditure per visit was US$ 6.7 (SD = 10.4) with 29.4% incurring excessive expenditure. The main predictors of a financial risk burden included utilizing public services offering the complementary benefit package, dissatisfaction with care received, being a member of a large household, expenditure composition, severity of illness, residence and wealth (p < .05). The insured status influenced the expenditure level, with no association with catastrophe. Those who did not seek care when needed reported financial constraints as the major reason for postponing or foregoing care. Wealth-related inequities were found in service and population coverage and in out-of-pocket payment for outpatient care. Burdensome expenditure for primary care and its key drivers are of utmost importance. Forthcoming health financing reform agendas must incorporate a strategy for getting data used in the design of financial risk protection. Realizing equitable and efficient access to outpatient care is a vital ingredient for sustainable health systems.

  17. LMSS SERVICES FINANCIAL REPORT PROGRAM

    NASA Technical Reports Server (NTRS)

    Chamberlain, R. G.

    1994-01-01

    The objective of this Services Finance Report program is to provide a means for comparing alternative designs of LMSS systems or other services systems. This program is actually a Multiplan worksheet. The labels used in the worksheet were chosen for a satellite-based cellular communication service (LMSS - Land Mobile Satellite System) but the analysis is not restricted to such cases. A comprehensive financial model is used to calculate a 'figure of merit' which can be used to compare effects of equipment and operating costs, pricing strategy, and customer demand for different systems. The program also calculates the price that a company would have to charge customers to meet all its expenses and make a specified profit. A price estimate can be obtained for almost any service which is heavily dependent on capital investment and which has operating costs that depend on the amount of service sold. The economic analysis has two main components: supplier finances and customer finances. Supplier finances include amortization, interest, insurance, taxes, and operating and maintenance expenses. Customer finances include usage rate, subscription fees, equipment costs, and estimated traffic. Prices can defined as real or nominal to account for effects of escalation and inflation, and the profits can be regulated or unrestricted This program is written for interactive execution with Multiplan (version 1.2) and has been implemented on an IBM PC series computer operating under DOS (version 2.11). The LMSS worksheet has a space requirement of approximately 38K of 8 bit bytes. This worksheet was developed in 1984.

  18. A future Demand Side Management (DSM) opportunity for utility as variable renewable penetrate scale up using agriculture.

    NASA Astrophysics Data System (ADS)

    Ines, A.; Bhattacharjee, A.; Modi, V.; Robertson, A. W.; Lall, U.; Kocaman Ayse, S.; Chaudhary, S.; Kumar, A.; Ganapathy, A.; Kumar, A.; Mishra, V.

    2015-12-01

    Energy demand management, also known as demand side management (DSM), is the modification of consumer demand for energy through various methods such as smart metering, incentive based schemes, payments for turning off loads or rescheduling loads. Usually, the goal of demand side management is to encourage the consumer to use less power during periods of peak demand, or to move the time of energy use to off-peak times. Peak demand management does not necessarily decrease total energy consumption, but could be expected to reduce the need for investments in networks and/or power plants for meeting peak demands. Electricity use can vary dramatically on short and medium time frames, and the pricing system may not reflect the instantaneous cost as additional higher-cost that are brought on-line. In addition, the capacity or willingness of electricity consumers to adjust to prices by altering elasticity of demand may be low, particularly over short time frames. In the scenario of Indian grid setup, the retail customers do not follow real-time pricing and it is difficult to incentivize the utility companies for continuing the peak demand supply. A question for the future is how deeper penetration of renewable will be handled? This is a challenging problem since one has to deal with high variability, while managing loss of load probabilities. In the case of managing the peak demand using agriculture, in the future as smart metering matures with automatic turn on/off for a pump, it will become possible to provide an ensured amount of water or energy to the farmer while keeping the grid energized for 24 hours. Supply scenarios will include the possibility of much larger penetration of solar and wind into the grid. While, in absolute terms these sources are small contributors, their role will inevitably grow but DSM using agriculture could help reduce the capital cost. The other option is of advancing or delaying pump operating cycle even by several hours, will still ensure soil moisture requirements met while, balancing the overall system load with generation, reducing critical power mismatches. Through this presentation the author will describe different techniques and results from field experiments in India.

  19. Self-estimates of distractibility as related to performance decrement on a task requiring sustained attention.

    DOT National Transportation Integrated Search

    1972-07-01

    Increasing automation of air traffic control tasks may have the undesirable side effect of increased monotony as a result of the anticipated reduction in task demands. 50 subjects performed a monotonous, but perceptually demanding task, for approxima...

  20. Effect of a package of integrated demand- and supply-side interventions on facility delivery rates in rural Bangladesh: Implications for large-scale programs

    PubMed Central

    Choudhury, Aziz Ahmed; Khanam, Rasheda; Moin, Syed Mamun Ibne; Ahmed, Salahuddin; Begum, Nazma; Shoma, Nurun Naher; Quaiyum, Md Abdul; Baqui, Abdullah H.

    2017-01-01

    Background According to the Bangladesh Demographic and Health Survey 2014, only approximately 37 percent of women deliver in a health facility. Among the eight administrative divisions of Bangladesh, the facility delivery rate is lowest in the Sylhet division (22.6 percent) where we assessed the effect of integrated supply- and demand-side interventions on the facility-based delivery rate. Methods Population-based cohort data of pregnant women from an ongoing maternal and newborn health improvement study being conducted in a population of ~120,000 in Sylhet district were used. The study required collection and processing of biological samples immediately after delivery. Therefore, the project assembled various strategies to increase institutional delivery rates. The supply-side intervention included capacity expansion of the health facilities through service provider refresher training, 24/7 service coverage, additions of drugs and supplies, and incentives to the providers. The demand-side component involved financial incentives to cover expenses, a provision of emergency transport, and referral support to a tertiary-level hospital. We conducted a before-and-after observational study to assess the impact of the intervention in a total of 1,861 deliveries between December 2014 and November 2016. Results Overall, implementation of the intervention package was associated with 52.6 percentage point increase in the proportions of facility-based deliveries from a baseline rate of 25.0 percent to 77.6 percent in 24 months. We observed lower rates of institutional deliveries when only supply-side interventions were implemented. The proportion rose to 47.1 percent and continued increasing when the project emphasized addressing the financial barriers to accessing obstetric care in a health facility. Conclusions An integrated supply- and demand-side intervention was associated with a substantial increase in institutional delivery. The package can be tailored to identify which combination of interventions may produce the optimum result and be scaled. Rigorous implementation research studies are needed to draw confident conclusions and to provide information about the costs, feasibility for scale-up and sustainability. PMID:29073229

  1. Hydrologic considerations for estimation of storage-capacity requirements of impounding and side-channel reservoirs for water supply in Ohio

    USGS Publications Warehouse

    Koltun, G.F.

    2001-01-01

    This report provides data and methods to aid in the hydrologic design or evaluation of impounding reservoirs and side-channel reservoirs used for water supply in Ohio. Data from 117 streamflow-gaging stations throughout Ohio were analyzed by means of nonsequential-mass-curve-analysis techniques to develop relations between storage requirements, water demand, duration, and frequency. Information also is provided on minimum runoff for selected durations and frequencies. Systematic record lengths for the streamflow-gaging stations ranged from about 10 to 75 years; however, in many cases, additional streamflow record was synthesized. For impounding reservoirs, families of curves are provided to facilitate the estimation of storage requirements as a function of demand and the ratio of the 7-day, 2-year low flow to the mean annual flow. Information is provided with which to evaluate separately the effects of evaporation on storage requirements. Comparisons of storage requirements for impounding reservoirs determined by nonsequential-mass-curve-analysis techniques with storage requirements determined by annual-mass-curve techniques that employ probability routing to account for carryover-storage requirements indicate that large differences in computed required storages can result from the two methods, particularly for conditions where demand cannot be met from within-year storage. For side-channel reservoirs, tables of demand-storage-frequency information are provided for a primary pump relation consisting of one variable-speed pump with a pumping capacity that ranges from 0.1 to 20 times demand. Tables of adjustment ratios are provided to facilitate determination of storage requirements for 19 other pump sets consisting of assorted combinations of fixed-speed pumps or variable-speed pumps with aggregate pumping capacities smaller than or equal to the primary pump relation. The effects of evaporation on side-channel reservoir storage requirements are incorporated into the storage-requirement estimates. The effects of an instream-flow requirement equal to the 80-percent-duration flow are also incorporated into the storage-requirement estimates.

  2. [Economic evaluation of the demand of medical care for mental health in Mexico: schizophrenia and depression, 1996-2000].

    PubMed

    Arredondo, Armando; Ramos, René; Zúñiga, Alexis

    2003-01-01

    Financing protection for both, users and providers of health care services is one of the main objectives of National Program of Health in Mexico, 2001-2006. In fact one of the elements of the present health care reform initiatives is need for the efficient allocation of financial resources, using resource allocation schemes by specific health care demands that combine both the economic, clinical and the epidemiological perspectives. The evaluation of such schemes has been approached in several ways; however, in the case of mental health services, there is dearth of studies that use economic assessment methods. Moreover, such studies are of limited scope, often a response to unmated health needs, disregarding the economic implication for health services production and financing and ensuing medical care market imbalances. This paper presents the results of an evaluative research work aimed to assess the average cost of depression and schizophrenia case management, the financial resources required to meet the health care demands by type of institution, period 1996-2000, in Mexico by type of health care provider. The case management average cost for schizophrenia was $211.00 US, and that for depression was $221.00 US. The demand of services for both conditions in each type of institution showed that the greatest relative demands (96% of the national total for depression and 94% of the national total for schizophrenia) occur in three institutions: IMSS, SSA and ISSSTE. The greatest demand of the health services for the two study condition corresponded to those insured by the IMSS, followed by those uninsured who use the SSA services, and those insured by the ISSSTE. The case management costs for mental conditions are in the middle range between hypertension and diabetes in the upper end, pneumonia and diarrhea in the lower end. The case managment costs of health care demands for the selected tracer conditions differ considerably among institutions for insure populations and those for uninsured populations, with a greater economic impact on-the former. Independent from differences found, these results allow the identification of economic evaluation indicators that could be used to design resource allocation schemes for each of the institutions included in this study.

  3. 18 CFR 430.13 - Protected area permits for new withdrawals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... space heating or cooling that are subsequently used for commercial or industrial water supply purposes... against significant leaks of refrigerant, all ground water heat pump systems shall be equipped with an... resource requirements; evaluate supply-side and demand-side alternatives to meet water withdrawal needs...

  4. Decomposition of toxicity emission changes on the demand and supply sides: empirical study of the US industrial sector

    NASA Astrophysics Data System (ADS)

    Fujii, Hidemichi; Okamoto, Shunsuke; Kagawa, Shigemi; Managi, Shunsuke

    2017-12-01

    This study investigated the changes in the toxicity of chemical emissions from the US industrial sector over the 1998-2009 period. Specifically, we employed a multiregional input-output analysis framework and integrated a supply-side index decomposition analysis (IDA) with a demand-side structural decomposition analysis (SDA) to clarify the main drivers of changes in the toxicity of production- and consumption-based chemical emissions. The results showed that toxic emissions from the US industrial sector decreased by 83% over the studied period because of pollution abatement efforts adopted by US industries. A variety of pollution abatement efforts were used by different industries, and cleaner production in the mining sector and the use of alternative materials in the manufacture of transportation equipment represented the most important efforts.

  5. A System Dynamics Modeling of Water Supply and Demand in Las Vegas Valley

    NASA Astrophysics Data System (ADS)

    Parajuli, R.; Kalra, A.; Mastino, L.; Velotta, M.; Ahmad, S.

    2017-12-01

    The rise in population and change in climate have posed the uncertainties in the balance between supply and demand of water. The current study deals with the water management issues in Las Vegas Valley (LVV) using Stella, a system dynamics modeling software, to model the feedback based relationship between supply and demand parameters. Population parameters were obtained from Center for Business and Economic Research while historical water demand and conservation practices were modeled as per the information provided by local authorities. The water surface elevation of Lake Mead, which is the prime source of water supply to the region, was modeled as the supply side whereas the water demand in LVV was modeled as the demand side. The study was done from the period of 1989 to 2049 with 1989 to 2012 as the historical one and the period from 2013 to 2049 as the future period. This study utilizes Coupled Model Intercomparison Project data sets (2013-2049) (CMIP3&5) to model different future climatic scenarios. The model simulates the past dynamics of supply and demand, and then forecasts the future water budget for the forecasted future population and future climatic conditions. The results can be utilized by the water authorities in understanding the future water status and hence plan suitable conservation policies to allocate future water budget and achieve sustainable water management.

  6. Finance issue brief: long-term care insurance: year end report-2002.

    PubMed

    Tanner, Rachel

    2002-12-31

    A 1996 federal law made it more attractive for states to consider long-term care insurance, and states have responded by implementing policies to make the purchase of these long-term care coverage more affordable and consumer-friendly. At present, policy makers continue to debate the future role of private long-term care insurance in subsidizing the increasing demand for long-term care services.

  7. Finance issue brief: long-term care insurance: year end report-2003.

    PubMed

    Tanner, Rachel C

    2003-12-31

    A 1996 federal law made it more attractive for states to consider long-term care insurance, and states have responded by implementing policies to make the purchase of these long-term care coverage more affordable and consumer-friendly. At present, policymakers continue to debate the future role of private long-term care insurance in subsidizing the increasing demand for long-term care services.

  8. The United States School Garden Army. Bulletin, 1919, No. 26

    ERIC Educational Resources Information Center

    Francis, J. H.

    1919-01-01

    The name of the United States School Garden Army was adopted in March, 1918. The work of the organization is an expansion of work undertaken by the Bureau of Education in 1914. The scale upon which it was done was limited by the finances that could be secured for it. The acute demand for food production growing out of the war conditions made…

  9. EnergyWorks Final Report: A Better Buildings Neighborhood Program in the Five-County Greater Philadelphia Region

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

    Gajewski, Katherine

    2014-03-05

    This report covers the grant performance period of July 1, 2010-September 30, 2013 and discusses of the program design, outcomes and best practices as they relate to the following six areas: 1. Institutional Design and Business Model; 2. Program Design and Customer Experience; 3. Driving Demand; 4. Workforce Development; 5. Financing and Incentives; 6. Data and Evaluation.

  10. Long Term Care: Report to the Secretary. Service Delivery Assessment, Office of the Inspector General, December 1981.

    ERIC Educational Resources Information Center

    Department of Health and Human Services, Seattle, WA. Region 10.

    The demand for long term care is growing as the population in need of services becomes older and frailer, and as the nature of the family, the economy, and the health care system changes. To investigate the long term care system, its characteristics, trends, financing, policies, availability, and quality of care, 700 health care professionals,…

  11. Universal health coverage in Latin American countries: how to improve solidarity-based schemes.

    PubMed

    Titelman, Daniel; Cetrángolo, Oscar; Acosta, Olga Lucía

    2015-04-04

    In this Health Policy we examine the association between the financing structure of health systems and universal health coverage. Latin American health systems encompass a wide range of financial sources, which translate into different solidarity-based schemes that combine contributory (payroll taxes) and non-contributory (general taxes) sources of financing. To move towards universal health coverage, solidarity-based schemes must heavily rely on countries' capacity to increase public expenditure in health. Improvement of solidarity-based schemes will need the expansion of mandatory universal insurance systems and strengthening of the public sector including increased fiscal expenditure. These actions demand a new model to integrate different sources of health-sector financing, including general tax revenue, social security contributions, and private expenditure. The extent of integration achieved among these sources will be the main determinant of solidarity and universal health coverage. The basic challenges for improvement of universal health coverage are not only to spend more on health, but also to reduce the proportion of out-of-pocket spending, which will need increased fiscal resources. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Conflict and Education Demand in the Basque Region

    ERIC Educational Resources Information Center

    de Groot, Olaf J.; Goksel, Idil

    2011-01-01

    The relationship between conflict and education has been studied before. However, previous authors have always focused strongly on the supply-side effects, whereas this article examines the influence of conflict on the demand for education. It is theoretically shown that, under relatively general conditions, individuals living in a conflict area…

  13. Software on Demand: An Early Childhood Numeracy Partnership

    ERIC Educational Resources Information Center

    Egan, Mike; Hengst, Randy

    2012-01-01

    In collaboration with preservice elementary teachers and in-service kindergarten teachers, the authors engaged in small-scale, demand-side production of educational software focused on numeracy skills. That is, the authors built applications designed to address children's specific learning needs as they surfaced in the classroom and were…

  14. Importance of food-demand management for climate mitigation

    NASA Astrophysics Data System (ADS)

    Bajželj, Bojana; Richards, Keith S.; Allwood, Julian M.; Smith, Pete; Dennis, John S.; Curmi, Elizabeth; Gilligan, Christopher A.

    2014-10-01

    Recent studies show that current trends in yield improvement will not be sufficient to meet projected global food demand in 2050, and suggest that a further expansion of agricultural area will be required. However, agriculture is the main driver of losses of biodiversity and a major contributor to climate change and pollution, and so further expansion is undesirable. The usual proposed alternative--intensification with increased resource use--also has negative effects. It is therefore imperative to find ways to achieve global food security without expanding crop or pastureland and without increasing greenhouse gas emissions. Some authors have emphasized a role for sustainable intensification in closing global `yield gaps' between the currently realized and potentially achievable yields. However, in this paper we use a transparent, data-driven model, to show that even if yield gaps are closed, the projected demand will drive further agricultural expansion. There are, however, options for reduction on the demand side that are rarely considered. In the second part of this paper we quantify the potential for demand-side mitigation options, and show that improved diets and decreases in food waste are essential to deliver emissions reductions, and to provide global food security in 2050.

  15. Meeting China's electricity needs through clean energy sources: A 2030 low-carbon energy roadmap

    NASA Astrophysics Data System (ADS)

    Hu, Zheng

    China is undergoing rapid economic development that generates significant increase in energy demand, primarily for electricity. Energy supply in China is heavily relying on coal, which leads to high carbon emissions. This dissertation explores opportunities for meeting China's growing power demand through clean energy sources. The utilization of China's clean energy sources as well as demand-side management is still at the initial phase. Therefore, development of clean energy sources would require substantial government support in order to be competitive in the market. One of the widely used means to consider clean energy in power sector supplying is Integrated Resource Strategic Planning, which aims to minimize the long term electricity costs while screening various power supply options for the power supply and demand analysis. The IRSP tool tackles the energy problem from the perspective of power sector regulators, and provides different policy scenarios to quantify the impacts of combined incentives. Through three scenario studies, Business as Usual, High Renewable, and Renewable and Demand Side Management, this dissertation identifies the optimized scenario for China to achieve the clean energy target of 2030. The scenarios are assessed through energy, economics, environment, and equity dimensions.

  16. Intermediary Organizations in Charter School Policy Coalitions: Evidence from New Orleans

    ERIC Educational Resources Information Center

    DeBray, Elizabeth; Scott, Janelle; Lubienski, Christopher; Jabbar, Huriya

    2014-01-01

    This article develops a framework for investigating research use, using an "advocacy coalition framework" and the concepts of a "supply side" (mainly organizations) and "demand side" (policymakers). Drawing on interview data and documents from New Orleans about the charter school reforms that have developed there…

  17. Neo-Keynesian Economics Today.

    ERIC Educational Resources Information Center

    Shackleton, J. R.

    1987-01-01

    Traces the development of post-Keynesian economic theories and examines the arguments which surround current neo-Keynesian thought. Argues for an eclecticism which recognizes that both supply-side and demand-side factors have a role to play in determining levels of output and employment. Useful charts and diagrams are included. (Author/DH)

  18. Positioning hospitals for improved access to capital.

    PubMed

    Ponton, Kevin T; Sandrick, Karen M

    2002-11-01

    Hospitals need to actively position themselves in the next 18 to 24 months to ensure continued access to financing. Hospitals need to shift their focus from investment income to operations. Hospitals should recognize the importance of balance-sheet liquidity to institutional investors. Not-for-profit hospitals should focus on both sides of the balance sheet. Healthcare executives need to develop effective leadership and investor-relations skills.

  19. Financial Structure of Mining Sector Companies During an Economic Slowdown /Struktura Finansowania Przedsiębiorstw W Sektorze Górniczym I Wydobywczym W Okresie Spowolnienia Gospodarczego

    NASA Astrophysics Data System (ADS)

    Sierpińska, Maria; Bąk, Patrycja

    2012-12-01

    The global economic crisis that started in 2007 in the area of finance, expanded over the subsequent years to the business sphere, and resulted in a drop of demand and production almost in any field of business activity. Access to foreign sources of finance, especially to loans, has become more difficult and expensive. In such circumstances, enterprises have had to resort more often to their own capital generated by the issue of shares, and to retained profit. Banks have limited their loans for business entities, reduced credit periods, and raised credit margins as well as their levels of collaterals. The McKinsey research into the changes that occur in the structures of sources of finance confirms that the share of equity capital in the structure of financing of non-financial enterprises has visibly grown, and their crediting scopes have been limited all over the European Union as well as in the euro zone. The global tendencies as regards directions of changes in the structure of the sources of corporate financing have also been reflected in Poland. The economic slowdown has resulted in changes in the structures of corporate financing. Mining companies have risen the shares of their equity capital in their general sources of financing. This tendency corresponds to the changes of structure of corporate financing in Poland and Europe. Enterprises have resorted to bank loans to a lesser degree than in times of better market situation. In mining, public companies have increased their crediting, while in private sector the tendency has been reverse. Enterprises tend to use more flexible debiting forms as compared to credits by way of issue of long-term corporate bonds. Mining companies have developed issue programs that are to be implemented over three-year periods. Before, only Katowicki Holding Węglowy [Katowice Mining Holding] had issued bonds. The present publication is an attempt at assessing the changes in the structure of corporate financing within the mining sector in the circumstances of economic slowdown. The changes have been assessed against the background of changes in the structure of financing of other business entities. Three problems have been identified and subjected to research. The first concerns the increasing share of equity capital in the structure of corporate financing in mining enterprises. The second issue concerns the scope of corporate crediting. And the third issue relates to the time structure of corporate debt. The said issues have been analysed in the conditions of economic slowdown

  20. Integrating Demand-Side Resources into the Electric Grid: Economic and Environmental Considerations

    NASA Astrophysics Data System (ADS)

    Fisher, Michael J.

    Demand-side resources are taking an increasingly prominent role in providing essential grid services once provided by thermal power plants. This thesis considers the economic feasibility and environmental effects of integrating demand-side resources into the electric grid with consideration given to the diversity of market and environmental conditions that can affect their behavior. Chapter 2 explores the private economics and system-level carbon dioxide reduction when using demand response for spinning reserve. Steady end uses like lighting are more than twice as profitable as seasonal end uses because spinning reserve is needed year-round. Avoided carbon emission damages from using demand response instead of fossil fuel generation for spinning reserve are sufficient to justify incentives for demand response resources. Chapter 3 quantifies the system-level net emissions rate and private economics of behind-the-meter energy storage. Net emission rates are lower than marginal emission rates for power plants and in-line with estimates of net emission rates from grid-level storage. The economics are favorable for many buildings in regions with high demand charges like California and New York, even without subsidies. Future penetration into regions with average charges like Pennsylvania will depend greatly on installation cost reductions and wholesale prices for ancillary services. Chapter 4 outlines a novel econometric model to quantify potential revenues from energy storage that reduces demand charges. The model is based on a novel predictive metric that is derived from the building's load profile. Normalized revenue estimates are independent of the power capacity of the battery holding other performance characteristics equal, which can be used to calculate the profit-maximizing storage size. Chapter 5 analyzes the economic feasibility of flow batteries in the commercial and industrial market. Flow batteries at a 4-hour duration must be less expensive on a dollar per installed kWh basis, often by 20-30%, to break even with shorter duration li-ion or lead-acid despite allowing for deeper depth of discharge and superior cycle life. These results are robust to assumptions of tariff rates, battery round-trip efficiencies, amount of solar generation and whether the battery can participate in the wholesale energy and ancillary services markets.

  1. Demand and supply of emergency help: an economic analysis of Red Cross services.

    PubMed

    Hackl, Franz; Pruckner, Gerald Josef

    2006-08-01

    This paper analyzes supply and demand side characteristics of (voluntary) Red Cross services in Austria. The demand side analysis is based on a contingent valuation study on people's willingness to pay for emergency treatment, transportation services and disaster relief activities. The supply side is identified by a high percentage of volunteers in the Red Cross organization which makes the provision of emergency help at low cost possible. We find that aggregate benefits of Red Cross services exceed their cost of production. Policy conclusions are drawn with respect to future recruitment and funding: whereas intrinsic motivation is important for the decision to volunteer, and financial incentives play a minor role in general, the young Red Cross activists work voluntarily for self-realization reasons and to continue their education. Age-specific recruitment strategies accompanied by word-of-mouth advertising are recommended to address potential volunteers. As long as the volunteering character of Red Cross services will be maintained and cost of production will not go up an increase of funds does not seem necessary in the future. Moreover, a radical change in the structure of funding may crowd out both donations and voluntary labor supply.

  2. The effect of real-time pricing on load shifting in a highly renewable power system dominated by generation from the renewable sources of wind and photovoltaics

    NASA Astrophysics Data System (ADS)

    Kies, Alexander; Brown, Tom; Schlachtberger, David; Schramm, Stefan

    2017-04-01

    The supply-demand imbalance is a major concern in the presence of large shares of highly variable renewable generation from sources like wind and photovoltaics (PV) in power systems. Other than the measures on the generation side, such as flexible backup generation or energy storage, sector coupling or demand side management are the most likely option to counter imbalances, therefore to ease the integration of renewable generation. Demand side management usually refers to load shifting, which comprises the reaction of electricity consumers to price fluctuations. In this work, we derive a novel methodology to model the interplay of load shifting and provided incentives via real-time pricing in highly renewable power systems. We use weather data to simulate generation from the renewable sources of wind and photovoltaics, as well as historical load data, split into different consumption categories, such as, heating, cooling, domestic, etc., to model a simplified power system. Together with renewable power forecast data, a simple market model and approaches to incorporate sector coupling [1] and load shifting [2,3], we model the interplay of incentives and load shifting for different scenarios (e.g., in dependency of the risk-aversion of consumers or the forecast horizon) and demonstrate the practical benefits of load shifting. First, we introduce the novel methodology and compare it with existing approaches. Secondly, we show results of numerical simulations on the effects of load shifting: It supports the integration of PV power by providing a storage, which characteristics can be described as "daily" and provides a significant amount of balancing potential. Lastly, we propose an experimental setup to obtain empirical data on end-consumer load-shifting behaviour in response to price incentives. References [1] Brown, T., Schlachtberger, D., Kies. A., Greiner, M., Sector coupling in a highly renewable European energy system, Proc. of the 15th International Workshop on Large-Scale Integration of Wind Power into Power Systems as well as on Transmission Networks for Offshore Wind Power Plants, Vienna, Austria, 15.-17. November 2016 [2] Kleinhans, D.: Towards a systematic characterization of the potential of demand side management, arXiv preprint arXiv:1401.4121, 2014 [3] Kies, A., Schyska, B. U., von Bremen, L., The Demand Side Management Potential to Balance a Highly Renewable European Power System. Energies, 9(11), 955, 2016

  3. Demand Forecasting and Revenue Requirements, with Implications for Consideration in British Columbia,

    DTIC Science & Technology

    1983-05-01

    future financing obligations will be 782 largely determined by the conditions of the financial 783 markets , the amount of construction activity that is...L 4 w- MM t 14 * 0 00 M00 0 0 0nU M4 C? 0C 4 4 ’C) * 0 3 0 0N% AI 0 % M 41 C 0 MNl -4 N4 -4-4 0 6. n ad 4 LI L 1 4p % N 61-4 I 01 -54- t: 1% r.a -4 "E...34Residential Demand for Electricity," Quarterly Review of Economics and Business , Vol. 11, Spring 1971, pp. 7-22. Yang, Yung Y., "Temporal Stability

  4. Design and Implementation of Demand Response Information Interactive Service Platform Based on “Internet Plus” Smart Energy

    NASA Astrophysics Data System (ADS)

    Cui, Gaoying; Fan, Jie; Qin, Yuchen; Wang, Dong; Chen, Guangyan

    2017-05-01

    In order to promote the effective use of demand response load side resources, promote the interaction between supply and demand, enhance the level of customer service and achieve the overall utilization of energy, this paper briefly explain the background significance of design demand response information platform and current situation of domestic and foreign development; Analyse the new demand of electricity demand response combined with the application of Internet and big data technology; Design demand response information platform architecture, construct demand responsive system, analyse process of demand response strategy formulate and intelligent execution implement; study application which combined with the big data, Internet and demand response technology; Finally, from information interaction architecture, control architecture and function design perspective design implementation of demand response information platform, illustrate the feasibility of the proposed platform design scheme implemented in a certain extent.

  5. Banking for health: the role of financial sector actors in investing in global health

    PubMed Central

    Kickbusch, Ilona; Franz, Christian; Wells, Nadya

    2018-01-01

    The world faces multiple health financing challenges as the global health burden evolves. Countries have set an ambitious health policy agenda for the next 15 years with prioritisation of universal health coverage under the Sustainable Development Goals. The scale of investment needed for equitable access to health services means global health is one of the key economic opportunities for decades to come. New financing partnerships with the private sector are vital. The aim of this study is to unlock additional financing sources, acknowledging the imperative to link financial returns to the providers of capital, and create profitable, sustainable financing structures. This paper outlines the global health investment opportunity exploring intersections of financial and health sector interests, and the role investment in health can play in economic development. Considering increasing demand for impact investments, the paper explores responsible financing initiatives and expansion of the global movement for sustainable capital markets. Adding an explicit health component (H) to the Environmental, Social and Governance (ESG) investment criteria, creating the ESG+H initiative, could serve as catalyst for the inclusion of health criteria into mainstream financial actors’ business practices and investment objectives. The conclusion finds that health considerations directly impact profitability of the firm and therefore should be incorporated into financial analysis. Positive assessment of health impact, at a broad societal or environmental level, as well as for a firm’s employees can become a value enhancing competitive advantage. An ESG+H framework could incorporate this into mainstream financial decision-making and into scalable investment products. PMID:29736278

  6. Banking for health: the role of financial sector actors in investing in global health.

    PubMed

    Krech, Rüdiger; Kickbusch, Ilona; Franz, Christian; Wells, Nadya

    2018-01-01

    The world faces multiple health financing challenges as the global health burden evolves. Countries have set an ambitious health policy agenda for the next 15 years with prioritisation of universal health coverage under the Sustainable Development Goals. The scale of investment needed for equitable access to health services means global health is one of the key economic opportunities for decades to come. New financing partnerships with the private sector are vital. The aim of this study is to unlock additional financing sources, acknowledging the imperative to link financial returns to the providers of capital, and create profitable, sustainable financing structures. This paper outlines the global health investment opportunity exploring intersections of financial and health sector interests, and the role investment in health can play in economic development. Considering increasing demand for impact investments, the paper explores responsible financing initiatives and expansion of the global movement for sustainable capital markets. Adding an explicit health component (H) to the Environmental, Social and Governance (ESG) investment criteria, creating the ESG+H initiative, could serve as catalyst for the inclusion of health criteria into mainstream financial actors' business practices and investment objectives. The conclusion finds that health considerations directly impact profitability of the firm and therefore should be incorporated into financial analysis. Positive assessment of health impact, at a broad societal or environmental level, as well as for a firm's employees can become a value enhancing competitive advantage. An ESG+H framework could incorporate this into mainstream financial decision-making and into scalable investment products.

  7. Future of long-term care financing for the elderly in Korea.

    PubMed

    Kwon, Soonman

    2008-01-01

    With rapid aging, change in family structure, and the increase in the labor participation of women, the demand for long-term care has been increasing in Korea. Inappropriate utilization of medical care by the elderly in health care institutions, such as social admissions, also puts a financial burden on the health insurance system. The widening gap between the need for long-term care and the capacity of welfare programs to fulfill that need, along with a rather new national pension scheme and the limited economic capacity of the elderly, calls for a new public financing mechanism to provide protection for a broader range of old people from the costs of long-term care. Many important decisions are yet to be made, although Korea is likely to introduce social insurance for long-term care rather than tax-based financing, following the tradition of social health insurance. Whether it should cover only the elderly longterm care or all types of long-term care including disability of all age groups will have a critical impact on social solidarity and the financial sustainability of the new long-term care insurance. Generosity of benefits or the level of out-of-pocket payment, the role of cash benefits, and the relation with health insurance scheme all should be taken into account in the design of a new financing scheme. Lack of care personnel and facilities is also a barrier to the implementation of public long-term care financing in Korea, and the implementation strategy needs to be carved out carefully.

  8. The value-adding CFO: an interview with Disney's Gary Wilson. Interview by Geraldine E. Willigan.

    PubMed

    Wilson, G

    1990-01-01

    Financing a company is more complex than ever-and more important to its economic success. The demands on a CFO are tremendous. Optimizing capital costs requires an unprecedented level of technical sophistication. Yet the best CFOs today are not mere technicians. They are also strategists and innovators. Gary Wilson exemplifies the new CFO. In his 5 years as executive vice president and CFO of the Walt Disney Company and his 12 years at Marriott Corporation, he has shown how the finance function can add value-not just account for it. How does a CFO create value for shareholders? "Just like all the great marketing and operating executives," Wilson says, "by being creative." To Wilson, being creative means rethinking assumptions and finding clever ways to achieve financial and strategic goals. Some of Wilson's innovative deal making-like the off-balance-sheet financing he used at Marriott-is well known. At Marriott, he discovered the power of separating the ownership of an asset from its control. Marriott's strength was in operations, yet the company had a great deal of money tied up in real estate. Growth would require even more investment in real estate. Wilson's solution was to sell the hotels-in effect, removing them and the debt used to finance them from the balance sheet-and contract to operate them. In this interview, Wilson gives his view of the role of finance in today's corporation and explains the thinking behind some of the successful deals he has engineered-including Disney's Silver Screen movie-making partnerships and Euro Disneyland.

  9. Outsourcing to increase service capacity in a New Zealand hospital.

    PubMed

    Renner, C; Palmer, E

    1999-01-01

    Service firms manage variability using both demand-side tactics (levelling customer demand), and supply-side tactics (increasing available capacity). One popular way of increasing available capacity is the outsourcing of non-core services. This article uses a case study to examine the impact of an outsourced non-core service on a hospital's overall service system. Findings show that the outsourced service provides access to more sophisticated technology, increases in-house capacity and saves capital expenditure. However, the outsourcing also increases the scheduling problems that the hospital faces. These problems are largely due to communication delays from the involvement of more than one organisation. These delays decrease the response time available to match changes in demand for the outsourced service. Given the obvious benefits of such outsourcing, the article concludes that management should pay close attention to the communication pathways between organisations, in order to minimise the end effects identified in this study.

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

    Bhattarai, Bishnu; Kouzelis, Konstantinos; Mendaza, Iker

    The gradual active load penetration in low voltage distribution grids is expected to challenge their network capacity in the near future. Distribution system operators should for this reason resort to either costly grid reinforcements or to demand side management mechanisms. Since demand side management implementation is usually cheaper, it is also the favorable solution. To this end, this article presents a framework for handling grid limit violations, both voltage and current, to ensure a secure and qualitative operation of the distribution grid. This framework consists of two steps, namely a proactive centralized and subsequently a reactive decentralized control scheme. Themore » former is employed to balance the one hour ahead load while the latter aims at regulating the consumption in real-time. In both cases, the importance of fair use of electricity demand flexibility is emphasized. Thus, it is demonstrated that this methodology aids in keeping the grid status within preset limits while utilizing flexibility from all flexibility participants.« less

  11. International experiences of promoting generics use and its implications to China.

    PubMed

    Sun, Jing

    2013-05-01

    To summarize international experiences in promoting use of generics and to extract essence for China's reference. This is a commentary of two systematic reviews about policies to promote use of generics and its implications to China. Price, reimbursement, and generic substitution policies in European countries, and approaches in low and middle income countries in promoting market competition, appropriate intellectual property right protection strategy, and necessary demand side incentives, are all meaningful for China to contain soaring pharmaceutical expenditures, and to maintain the achievements and outcomes of the national health system reform. Effective promotion of generics use must be practice based on the real situation. Tailor-made and comprehensive measures are needed to address both demand and supply sides barriers before achieving tangible cost containment effect without unexpected side effects. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

  12. Climate change and Australia's healthcare system - risks, research and responses.

    PubMed

    Weaver, Haylee J; Blashki, Grant A; Capon, Anthony G; McMichael, Anthony J

    2010-11-01

    Climate change will affect human health, mostly adversely, resulting in a greater burden on the health care system, in addition to any other coexistent increases in demand (e.g. from Australia's increasingly ageing population). Understanding the extent to which health is likely to be affected by climate change will enable policy makers and practitioners to prepare for changing demands on the health care system. This will require prioritisation of key research questions and building research capacity in the field. There is an urgent need to better understand the implications of climate change for the distribution and prevalence of diseases, disaster preparedness and multidisciplinary service planning. Research is needed to understand the relationship of climate change to health promotion, policy evaluation and strategic financing of health services. Training of health care professionals about climate change and its effects will also be important in meeting long-term workforce demands.

  13. Modeling Integrated Water-User Decisions with Intermittent Supplies

    NASA Astrophysics Data System (ADS)

    Lund, J. R.; Rosenberg, D.

    2006-12-01

    We present an economic-engineering method to estimate urban water use demands with intermittent water supplies. A two-stage, probabilistic optimization formulation includes a wide variety of water supply enhancement and conservation actions that individual households can adopt to meet multiple water quality uses with uncertain water availability. We embed the optimization in Monte-Carlo simulations to show aggregate effects at a utility (citywide) scale for a population of user conditions and decisions. Parametric analysis provides derivations of supply curves to subsidize conservation, demand responses to alternative pricing, and customer willingness-to-pay to avoid shortages. Results show a good empirical fit for the average and distribution of billed residential water use in Amman, Jordan. Additional outputs give likely market penetration rates for household conservation actions, associated water savings, and subsidies required to entice further adoption. We discuss new insights to size, target, market, and finance conservation programs and interpret a demand curve with block pricing.

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

    Not Available

    The technical and economic studies were performed to examine the possible installation of a small, integral pressurized water reactor as an industrial energy source in the Duval Corporation's Frasch Process sulfur mining operation located in Culberson County, Texas. Since this is the first industrial application study attempted for this type of reactor, it has been a learning process on the nuclear plant side as well as the industrial side, particularly in the area of economic analysis. The importance of considering inflationary effects, the significance of plant financing form, and the annualized, after-tax cash flow and incremental rate-of-return methods of comparisonmore » in determing energy costs have all been recognized during the course of the study.« less

  15. How to leverage a bad inventory situation.

    PubMed

    Horsfall, G A

    1998-11-01

    Small manufacturing companies have a hard time taking advantage of the price breaks that result from large purchase orders. Besides the greater amount of money involved, purchasing large quantities of items demands additional space for storing the items. This article describes a company that created separate inventory management and finance company to provide inventory management services to itself and to market these services to other small companies in its area.

  16. Can We Defend the Defense Supply Chain Lessons Learned from Industry Leaders in Supply Chain Management

    DTIC Science & Technology

    2018-03-01

    Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and...chain, including products, services, information , finances, demand, relationships, and risks. In a more complete definition, supply chain management ...CHAIN? LESSONS LEARNED FROM INDUSTRY LEADERS IN SUPPLY CHAIN MANAGEMENT by Ronald H. Menz March 2018 Thesis Co-Advisors: Rodrigo Nieto-Gomez

  17. Electricity Market Module - NEMS Documentation

    EIA Publications

    2017-01-01

    Documents the Electricity Market Module as it was used for the Annual Energy Outlook. The Electricity Market Module (EMM) is the electricity supply component of the National Energy Modeling System (NEMS). The EMM represents the generation, transmission, and pricing of electricity. It consists of four submodules: the Electricity Capacity Planning (ECP) Submodule, the Electricity Fuel Dispatch (EFD) Submodule, the Electricity Finance and Pricing (EFP) Submodule, and the Electricity Load and Demand (ELD) Submodule.

  18. Strategic Financing: Making the Most of the State Early Childhood Comprehensive Systems Initiative. Building State Early Childhood Comprehensive Systems Series. Number 5

    ERIC Educational Resources Information Center

    Hayes, Cheryl D.; Flynn, Margaret J.; Stebbins, Helene

    2004-01-01

    Ensuring that children enter school ready to learn is now a well-established national goal. Dramatic changes over the past three decades in U.S. families and the economy, as well as emerging research on the importance of early brain development, have increased the demand for public investments in early childhood supports and services, especially…

  19. The Supply and Demand of Accounting Faculty by Interest Area.

    ERIC Educational Resources Information Center

    Norris, Daniel

    1991-01-01

    Position advertisements in "The Accounting Review" and data on numbers of doctoral accounting faculty are used to assess the accounting job market, by interest area, over the past decade. Determines that current trends in the demand side are expected to continue, with auditing and systems the "hot" areas. (Author/JOW)

  20. Health consumers and stem cell therapy innovation: markets, models and regulation.

    PubMed

    Salter, Brian; Zhou, Yinhua; Datta, Saheli

    2014-05-01

    Global health consumer demand for stem cell therapies is vibrant, but the supply of treatments from the conventional science-based model of innovation is small and unlikely to increase in the near future. At the same time, several models of medical innovation have emerged that can respond to the demand, often employing a transnational value chain to deliver the product. Much of the commentary has approached the issue from a supply side perspective, demonstrating the extent to which national and transnational regulation fails to impose what are regarded as appropriate standards on the 'illicit' supply of stem cell therapies characterized by little data and poor outcomes. By contrast, this article presents a political economic analysis with a strong demand side perspective, arguing that the problem of what is termed 'stem cell tourism' is embedded in the demand-supply relationship of the health consumer market and its engagement with different types of stem cell therapy innovation. To be meaningful, discussions of regulation must recognize that analysis or risk being sidelined by a market, which ignores their often wishful thinking.

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

    Coleman, T.S.

    In the oil and gas sector, corporations and governments face huge capital spending requirements in order to transform large resource discoveries into producing, cash-generating assets. A significant portion of this funding is expected to be done on a project finance basis, where bank lenders or bond investors take a secured position in financing a discrete project, with the expectation of being paid back by the cash flows from that project after completion. This trend is increasing demand for crediting rating services to provide credit ratings for these project financings. A key challenge is to analyze and rate credit-worthy projects inmore » countries that have relatively low foreign currency sovereign ceilings due to economic, political, and financial risks. In most cases, the credit ratings for projects financed in currencies outside the host country are capped at the country`s foreign currency ceiling. However, in a few instances, mainly in the oil and gas sector, Moody`s has pierced the foreign currency ceiling or rated certain projects above the sovereign ratings of the countries where they are domiciled. The purpose of this article is to briefly explain some of the qualitative factors and considerations that have allowed Moody`s to pierce the ceiling in the oil and gas sector, with a focus on two recent and noteworthy projects: Ras Laffan Liquefied Natural Gas in Qatar and Petrozuata in Venezuela.« less

  2. M-Learning Adoption: A Perspective from a Developing Country

    ERIC Educational Resources Information Center

    Iqbal, Shakeel; Qureshi, Ijaz A.

    2012-01-01

    M-learning is the style of learning for the new millennium. Decreases in cost and increases in capabilities of mobile devices have made this medium attractive for the dissemination of knowledge. Mobile engineers, software developers, and educationists represent the supply side of this technology, whereas students represent the demand side. In…

  3. Institutional Diversity in Russian Higher Education: Revolutions and Evolution

    ERIC Educational Resources Information Center

    Froumin, Isak; Kouzminov, Yaroslav; Semyonov, Dmitry

    2014-01-01

    This paper is devoted to changes in the structure of the higher education system in Russia, analysing both historical context and current institutional diversity. The review starts from the Soviet quasi-corporate system when the state combined demand-side and supply-side roles in higher education. The post-Soviet transformation brings new forces…

  4. Equity of access to primary healthcare for vulnerable populations: the IMPACT international online survey of innovations.

    PubMed

    Richard, Lauralie; Furler, John; Densley, Konstancja; Haggerty, Jeannie; Russell, Grant; Levesque, Jean-Frederic; Gunn, Jane

    2016-04-12

    Improving access to primary healthcare (PHC) for vulnerable populations is important for achieving health equity, yet this remains challenging. Evidence of effective interventions is rather limited and fragmented. We need to identify innovative ways to improve access to PHC for vulnerable populations, and to clarify which elements of health systems, organisations or services (supply-side dimensions of access) and abilities of patients or populations (demand-side dimensions of access) need to be strengthened to achieve transformative change. The work reported here was conducted as part of IMPACT (Innovative Models Promoting Access-to-Care Transformation), a 5-year Canadian-Australian research program aiming to identify, implement and trial best practice interventions to improve access to PHC for vulnerable populations. We undertook an environmental scan as a broad screening approach to identify the breadth of current innovations from the field. We distributed a brief online survey to an international audience of PHC researchers, practitioners, policy makers and stakeholders using a combined email and social media approach. Respondents were invited to describe a program, service, approach or model of care that they considered innovative in helping vulnerable populations to get access to PHC. We used descriptive statistics to characterise the innovations and conducted a qualitative framework analysis to further examine the text describing each innovation. Seven hundred forty-four responses were recorded over a 6-week period. 240 unique examples of innovations originating from 14 countries were described, the majority from Canada and Australia. Most interventions targeted a diversity of population groups, were government funded and delivered in a community health, General Practice or outreach clinic setting. Interventions were mainly focused on the health sector and directed at organisational and/or system level determinants of access (supply-side). Few innovations were developed to enhance patients' or populations' abilities to access services (demand-side), and rarely did initiatives target both supply- and demand-side determinants of access. A wide range of innovations improving access to PHC were identified. The access framework was useful in uncovering the disparity between supply- and demand-side dimensions and pinpointing areas which could benefit from further attention to close the equity gap for vulnerable populations in accessing PHC services that correspond to their needs.

  5. Influence of field size on the physiological and skill demands of small-sided games in junior and senior rugby league players.

    PubMed

    Gabbett, Tim J; Abernethy, Bruce; Jenkins, David G

    2012-02-01

    The purpose of this study was to investigate the effect of changes in field size on the physiological and skill demands of small-sided games in elite junior and senior rugby league players. Sixteen elite senior rugby league players ([mean ± SE] age, 23.6 ± 0.5 years) and 16 elite junior rugby league players ([mean ± SE] age, 17.3 ± 0.3 years) participated in this study. On day 1, 2 teams played an 8-minute small-sided game on a small field (10-m width × 40-m length), whereas the remaining 2 teams played the small-sided game on a larger sized field (40-m width × 70-m length). On day 2, the groups were crossed over. Movement was recorded by a global positioning system unit sampling at 5 Hz. Games were filmed to count the number of possessions and the number and quality of disposals. The games played on a larger field resulted in a greater (p < 0.05) total distance covered, and distances covered in moderate, high, and very-high velocity movement intensities. Senior players covered more distance at moderate, high, and very-high intensities, and less distance at low and very-low intensities during small-sided games than junior players. Although increasing field size had no significant influence (p > 0.05) over the duration of recovery periods for junior players, larger field size significantly reduced (p < 0.05) the amount of short-, moderate-, and long-duration recovery periods in senior players. No significant between-group differences (p > 0.05) were detected for games played on a small or large field for the number or quality of skill involvements. These results suggest that increases in field size serve to increase the physiological demands of small-sided games but have minimal influence over the volume or quality of skill executions in elite rugby league players.

  6. Optimal Multi-scale Demand-side Management for Continuous Power-Intensive Processes

    NASA Astrophysics Data System (ADS)

    Mitra, Sumit

    With the advent of deregulation in electricity markets and an increasing share of intermittent power generation sources, the profitability of industrial consumers that operate power-intensive processes has become directly linked to the variability in energy prices. Thus, for industrial consumers that are able to adjust to the fluctuations, time-sensitive electricity prices (as part of so-called Demand-Side Management (DSM) in the smart grid) offer potential economical incentives. In this thesis, we introduce optimization models and decomposition strategies for the multi-scale Demand-Side Management of continuous power-intensive processes. On an operational level, we derive a mode formulation for scheduling under time-sensitive electricity prices. The formulation is applied to air separation plants and cement plants to minimize the operating cost. We also describe how a mode formulation can be used for industrial combined heat and power plants that are co-located at integrated chemical sites to increase operating profit by adjusting their steam and electricity production according to their inherent flexibility. Furthermore, a robust optimization formulation is developed to address the uncertainty in electricity prices by accounting for correlations and multiple ranges in the realization of the random variables. On a strategic level, we introduce a multi-scale model that provides an understanding of the value of flexibility of the current plant configuration and the value of additional flexibility in terms of retrofits for Demand-Side Management under product demand uncertainty. The integration of multiple time scales leads to large-scale two-stage stochastic programming problems, for which we need to apply decomposition strategies in order to obtain a good solution within a reasonable amount of time. Hence, we describe two decomposition schemes that can be applied to solve two-stage stochastic programming problems: First, a hybrid bi-level decomposition scheme with novel Lagrangean-type and subset-type cuts to strengthen the relaxation. Second, an enhanced cross-decomposition scheme that integrates Benders decomposition and Lagrangean decomposition on a scenario basis. To demonstrate the effectiveness of our developed methodology, we provide several industrial case studies throughout the thesis.

  7. Food security and sustainable intensification.

    PubMed

    Godfray, H Charles J; Garnett, Tara

    2014-04-05

    The coming decades are likely to see increasing pressures on the global food system, both on the demand side from increasing population and per capita consumption, and on the supply side from greater competition for inputs and from climate change. This paper argues that the magnitude of the challenge is such that action is needed throughout the food system, on moderating demand, reducing waste, improving governance and producing more food. It discusses in detail the last component, arguing that more food should be produced using sustainable intensification (SI) strategies, and explores the rationale behind, and meaning of, this term. It also investigates how SI may interact with other food policy agendas, in particular, land use and biodiversity, animal welfare and human nutrition.

  8. Adaptive heat pump and battery storage demand side energy management

    NASA Astrophysics Data System (ADS)

    Sobieczky, Florian; Lettner, Christian; Natschläger, Thomas; Traxler, Patrick

    2017-11-01

    An adaptive linear model predictive control strategy is introduced for the problem of demand side energy management, involving a photovoltaic device, a battery, and a heat pump. Moreover, the heating influence of solar radiation via the glass house effect is considered. Global sunlight radiation intensity and the outside temperature are updated by weather forecast data. The identification is carried out after adapting to a time frame witch sufficiently homogeneous weather. In this way, in spite of the linearity an increase in precision and cost reduction of up to 46% is achieved. It is validated for an open and closed loop version of the MPC problem using real data of the ambient temperature and the global radiation.

  9. Integrated power sector efficiency analysis: A case study of Costa Rica

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

    Waddle, D.B.; MacDonald, J.M.

    1990-03-01

    In an effort to analyze and document the potential for power sector efficiency improvements from generation to end-use, the Agency for International Development and the Government of Costa Rica are jointly conducting an integrated power sector efficiency analysis. Potential for energy and cost savings in power plants, transmission and distribution, and demand-side management programs are being evaluated. The product of this study will be an integrated investment plan for the Instituto Costarricense de Electricidad, incorporating both supply and demand side investment options. This paper presents the methodology employed in the study, as well as preliminary estimates of the results ofmore » the study. 14 refs., 2 figs., 5 tabs.« less

  10. Modeling Framework and Validation of a Smart Grid and Demand Response System for Wind Power Integration

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

    Broeer, Torsten; Fuller, Jason C.; Tuffner, Francis K.

    2014-01-31

    Electricity generation from wind power and other renewable energy sources is increasing, and their variability introduces new challenges to the power system. The emergence of smart grid technologies in recent years has seen a paradigm shift in redefining the electrical system of the future, in which controlled response of the demand side is used to balance fluctuations and intermittencies from the generation side. This paper presents a modeling framework for an integrated electricity system where loads become an additional resource. The agent-based model represents a smart grid power system integrating generators, transmission, distribution, loads and market. The model incorporates generatormore » and load controllers, allowing suppliers and demanders to bid into a Real-Time Pricing (RTP) electricity market. The modeling framework is applied to represent a physical demonstration project conducted on the Olympic Peninsula, Washington, USA, and validation simulations are performed using actual dynamic data. Wind power is then introduced into the power generation mix illustrating the potential of demand response to mitigate the impact of wind power variability, primarily through thermostatically controlled loads. The results also indicate that effective implementation of Demand Response (DR) to assist integration of variable renewable energy resources requires a diversity of loads to ensure functionality of the overall system.« less

  11. Electric power market agent design

    NASA Astrophysics Data System (ADS)

    Oh, Hyungseon

    The electric power industry in many countries has been restructured in the hope of a more economically efficient system. In the restructured system, traditional operating and planning tools based on true marginal cost do not perform well since information required is strictly confidential. For developing a new tool, it is necessary to understand offer behavior. The main objective of this study is to create a new tool for power system planning. For the purpose, this dissertation develops models for a market and market participants. A new model is developed in this work for explaining a supply-side offer curve, and several variables are introduced to characterize the curve. Demand is estimated using a neural network, and a numerical optimization process is used to determine the values of the variables that maximize the profit of the agent. The amount of data required for the optimization is chosen with the aid of nonlinear dynamics. To suggest an optimal demand-side bidding function, two optimization problems are constructed and solved for maximizing consumer satisfaction based on the properties of two different types of demands: price-based demand and must-be-served demand. Several different simulations are performed to test how an agent reacts in various situations. The offer behavior depends on locational benefit as well as the offer strategies of competitors.

  12. Performance of fasteners in wood flour-thermoplastic composite panels

    Treesearch

    Robert H. Falk; Daniel J. Vos; Steven M. Cramer; Brent W. English

    2001-01-01

    In the building community, there is a growing demand for high-performance, low-maintenance, and low-cost building products. To meet this demand, natural fiberthermoplastic composites are being used to produce such products as decking, window and door elements, panels, roofing, and siding. In spite of the rapid growth in the use of these composites, little is known...

  13. High Expectations--High Achievement on Literacy: "What Shall We Do in This Hangman's Hour?"

    ERIC Educational Resources Information Center

    Linnakyla, Pirjo

    Finland is a country of great expectations on literacy and literacy education. High expectations and demands have, however, a darker side. High expectations of society, parents, and teachers may have an effect on the students' self-esteem. The economic recession in the early 1990s strongly accelerated the change in literacy demands and…

  14. Education: A Solution for Rural Poverty? Staff Paper 350.

    ERIC Educational Resources Information Center

    Clouser, Rodney L.

    This paper presents an overview of poverty in rural America, and examines the ways in which improved education could alleviate rural poverty. The question of education as a mechanism to reduce poverty includes issues of economic demand and supply. On the demand side, labor market projections indicate that the service sector will continue to grow,…

  15. 75 FR 18572 - Supplemental Environmental Impact Statement for Sequoyah Nuclear Plant Units 1 and 2 License...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-12

    ... the carbon emissions of its generating system and take advantage of lower carbon dioxide-emitting.... The SEIS will include examination of a range of supply-side and demand- side management options for... both the scope of alternatives and environmental issues that should be addressed as part of the SEIS...

  16. Residents and urban greenways:  Modeling support for the Atlanta BeltLine

    Treesearch

    Nathan P. Palardy; B. Bynum Boley; Cassandra Johnson Gaither

    2018-01-01

    Urban greenways have received significant attention due to their many publicized benefits and costs that make them contentious recreational developments. Most prior studies have approached urban greenways from a demand-side perspective solely focused on their users. This study adds to the literature by taking a supply-side approach to assessing resident attitudes...

  17. Disadvantaged Young People Accessing the New Urban Economies of the Post-Industrial City

    ERIC Educational Resources Information Center

    Raffo, Carlo

    2006-01-01

    The aim of the paper is to examine current and evolving supply side transition policy initiatives in the light of (a) particular demand side needs of urban young people classified as those most disadvantaged and potentially marginalized; and (b) the emerging realities of accessing and operating within particular examples of high value-added…

  18. Financing care for the uninsured: the dilemma vexes New Jersey hospitals and payers.

    PubMed

    Wells, E V

    1996-05-01

    New Jersey's diverse constituencies and special interest groups don't usually agree on a public policy issue. However, almost everyone in the public policy arena agrees that hospitals should treat people who show up in emergency departments with problems requiring medical attention. For over a decade, Garden State policymakers, payers, and providers have faced the dilemma of excess demand on hospitals that treat the uninsured. This demand has risen due to increasing health care costs, development of costly technology, state deregulation of hospital payments, and employers' reluctance to insure workers and their families coupled with a mobile workforce holding part-time and seasonal jobs. The fiscal solvency of inner-city hospitals is threatened yet the problem continues to elude resolution.

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

    Piette, Mary Ann

    California needs new, responsive, demand-side energy technologies to ensure that periods of tight electricity supply on the grid don't turn into power outages. Led by Berkeley Lab's Mary Ann Piette, the California Energy Commission (through its Public Interest Energy Research Program) has established a Demand Response Research Center that addresses two motivations for adopting demand responsiveness: reducing average electricity prices and preventing future electricity crises. The research seeks to understand factors that influence "what works" in Demand Response. Piette's team is investigating the two types of demand response, load response and price response, that may influence and reduce the usemore » of peak electric power through automated controls, peak pricing, advanced communications, and other strategies.« less

  20. Saving Power at Peak Hours (LBNL Science at the Theater)

    ScienceCinema

    Piette, Mary Ann [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2018-05-23

    California needs new, responsive, demand-side energy technologies to ensure that periods of tight electricity supply on the grid don't turn into power outages. Led by Berkeley Lab's Mary Ann Piette, the California Energy Commission (through its Public Interest Energy Research Program) has established a Demand Response Research Center that addresses two motivations for adopting demand responsiveness: reducing average electricity prices and preventing future electricity crises. The research seeks to understand factors that influence "what works" in Demand Response. Piette's team is investigating the two types of demand response, load response and price response, that may influence and reduce the use of peak electric power through automated controls, peak pricing, advanced communications, and other strategies.

  1. Financing institutional long-term care for the elderly in China: a policy evaluation of new models.

    PubMed

    Yang, Wei; Jingwei He, Alex; Fang, Lijie; Mossialos, Elias

    2016-12-01

    A rapid ageing population coupled with changes in family structure has brought about profound implications to social policy in China. Although the past decade has seen a steady increase in public funding to long-term care (LTC), the narrow financing base and vast population have created significant unmet demand, calling for reforms in financing. This paper focuses on the financing of institutional LTC care by examining new models that have emerged from local policy experiments against two policy goals: equity and efficiency. Three emerging models are explored: Social Health Insurance (SHI) in Shanghai, LTC Nursing Insurance (LTCNI) in Qingdao and a means-tested model in Nanjing. A focused systematic narrative review of academic and grey literature is conducted to identify and assess these models, supplemented with qualitative interviews with government officials from relevant departments, care home staff and service users. This paper argues that, although SHI appears to be a convenient solution to fund LTC, this model has led to systematic bias in affordable access among participants of different insurance schemes, and has created a powerful incentive for the over-provision of unnecessary services. The means-tested method has been remarkably constrained by narrow eligibility and insufficiency of funding resources. The LTCNI model is by far the most desirable policy option among the three studied here, but the narrow definition of eligibility has substantively excluded a large proportion of elders in need from access to care, which needs to be addressed in future reforms. This paper proposes three lines of LTC financing reforms for policy-makers: (1) the establishment of a prepaid financing mechanism pooled specifically for LTC costs; (2) the incorporation of more stringent eligibility rules and needs assessment; and (3) reforming the dominant fee-for-service methods in paying LTC service providers. © 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.

  2. Implementing Health Financing Reforms in Africa: Perspectives of Health System Stewards.

    PubMed

    Achoki, Tom; Lesego, Abaleng

    A majority of health systems in the sub-Saharan Africa region are faced with multiple competing priorities amid pressing resource constraints. Health financing reforms, characterized by expansion of health insurance coverage, have been proposed as promising in the quest to improve health sustainably. However, in many countries where these measures are being attempted, their broader implications have not been fully appreciated. This study was based on perspectives of 37 health system stewards from Botswana who were interviewed in order to understand opportunities and challenges that would result in the quest to expand health insurance coverage in the country. Thematic synthesis of their perspectives, focusing on the key aspects of the health systems, was done in order to draw informative lessons that could be applicable to a broader set of low- and middle-income countries. Health systems attempting to expand health insurance coverage would be faced with various opportunities and challenges that have implications on performance. By increasing the pool of resources available to spend on health, health insurance would afford health systems the opportunity to increase population access to and use of health services. However, if unchecked, this could also translate to uncontrolled demand for expensive medicines and other health technologies, leading to cost escalation and inefficiencies within the system. Therefore, the success of any health financing reform is dependent on embracing sound policies, regulations, and accountability measures. Health financing reforms have broader implications to health system performance that should be fully appreciated and anticipated before implementation. Therefore, health system leaders who are keen to improve health must view any health financing reforms through the broader framework of the health system framework in order to make progress. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Forecasting Ontario's blood supply and demand.

    PubMed

    Drackley, Adam; Newbold, K Bruce; Paez, Antonio; Heddle, Nancy

    2012-02-01

    Given an aging population that requires increased medical care, an increasing number of deferrals from the donor pool, and a growing immigrant population that typically has lower donation rates, the purpose of this article is to forecast Ontario's blood supply and demand. We calculate age- and sex-specific donation and demand rates for blood supply based on 2008 data and project demand between 2008 and 2036 based on these rates and using population data from the Ontario Ministry of Finance. Results indicate that blood demand will outpace supply as early as 2012. For instance, while the total number of donations made by older cohorts is expected to increase in the coming years, the number of red blood cell (RBC) transfusions in the 70+ age group is forecasted grow from approximately 53% of all RBC transfusions in 2008 (209,515) in 2008 to 68% (546,996) by 2036. A series of alternate scenarios, including projections based on a 2% increase in supply per year and increased use of apheresis technology, delays supply shortfalls, but does not eliminate them without active management and/or multiple methods to increase supply and decrease demand. Predictions show that demand for blood products will outpace supply in the near future given current age- and sex-specific supply and demand rates. However, we note that the careful management of the blood supply by Canadian Blood Services, along with new medical techniques and the recruitment of new donors to the system, will remove future concerns. © 2012 American Association of Blood Banks.

  4. Third-Party Finance for Commercial Photovoltaic Systems: The Rise of the PPA

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

    Bolinger, Mark A

    2009-02-15

    Installations of grid-connected photovoltaic (PV) systems in the United States have increased dramatically in recent years, growing from less than 20 MW in 2000 to nearly 500 MW at the end of 2007, a compound average annual growth rate of 59%. Of particular note is the increasing contribution of 'non-residential' grid-connected PV systems--defined here as those systems installed on the customer (rather than utility) side of the meter at commercial, institutional, non-profit, or governmental properties--to the overall growth trend. Although there is some uncertainty in the numbers, non-residential PV capacity grew from less than half of aggregate annual capacity installationsmore » in 2000-2002 to nearly two-thirds in 2007. This relative growth trend is expected to have continued through 2008. This article, which is excerpted from a longer report, focuses specifically on just one subset of the non-residential PV market: systems hosted (and perhaps owned) by commercial, tax-paying entities. Tax-exempt entities (e.g., non-profits or municipalities) face unique issues and have different financing options at their disposal; readers interested in PV financing options for tax-exempt entities can find more information in the Bolinger report.« less

  5. Influence of game format and number of players on heart rate responses and physical demands in small-sided soccer games.

    PubMed

    Castellano, Julen; Casamichana, David; Dellal, Alexandre

    2013-05-01

    The aim of the study was to examine the extent to which changing the game format (possession play vs. regulation goals and goalkeepers vs. small goals only) and the number of players (3 vs. 3, 5 vs. 5 and 7 vs. 7) influenced the physiological and physical demands of small-sided games (SSGs) in soccer in semiprofessional players. Fourteen semiprofessional male soccer players were monitored with global positioning system and heart rate devices. Heart rate, player load, distance covered, running speed, and the number of accelerations were recorded for 9 different SSGs. The results show that changes both in game format and the number of players affect the players' physiological and physical demands. Possession play places greater physiological and physical demands on players, although reducing the number of players only increases the physiological load. In the 7 vs. 7 games, changing the game format did not alter the heart rate responses. Finally, in the possession play format, changing the number of players did not produce significant differences in heart rate responses, although physical demands did decrease in line with a reduction in the number of players. These results should help coaches to understand how modifying different aspects of SSGs has a differential effect on the players' physiological and physical demands. Moreover, coaches in semiprofessional and amateur teams have now consistent information to design and optimize their training time in mixing the technical, tactical, and physical aspects.

  6. Simulation of demand management and grid balancing with electric vehicles

    NASA Astrophysics Data System (ADS)

    Druitt, James; Früh, Wolf-Gerrit

    2012-10-01

    This study investigates the potential role of electric vehicles in an electricity network with a high contribution from variable generation such as wind power. Electric vehicles are modelled to provide demand management through flexible charging requirements and energy balancing for the network. Balancing applications include both demand balancing and vehicle-to-grid discharging. This study is configured to represent the UK grid with balancing requirements derived from wind generation calculated from weather station wind speeds on the supply side and National Grid data from on the demand side. The simulation models 1000 individual vehicle entities to represent the behaviour of larger numbers of vehicles. A stochastic trip generation profile is used to generate realistic journey characteristics, whilst a market pricing model allows charging and balancing decisions to be based on realistic market price conditions. The simulation has been tested with wind generation capacities representing up to 30% of UK consumption. Results show significant improvements to load following conditions with the introduction of electric vehicles, suggesting that they could substantially facilitate the uptake of intermittent renewable generation. Electric vehicle owners would benefit from flexible charging and selling tariffs, with the majority of revenue derived from vehicle-to-grid participation in balancing markets.

  7. Smart Grid Constraint Violation Management for Balancing and Regulating Purposes

    DOE PAGES

    Bhattarai, Bishnu; Kouzelis, Konstantinos; Mendaza, Iker; ...

    2017-03-29

    The gradual active load penetration in low voltage distribution grids is expected to challenge their network capacity in the near future. Distribution system operators should for this reason resort to either costly grid reinforcements or to demand side management mechanisms. Since demand side management implementation is usually cheaper, it is also the favorable solution. To this end, this article presents a framework for handling grid limit violations, both voltage and current, to ensure a secure and qualitative operation of the distribution grid. This framework consists of two steps, namely a proactive centralized and subsequently a reactive decentralized control scheme. Themore » former is employed to balance the one hour ahead load while the latter aims at regulating the consumption in real-time. In both cases, the importance of fair use of electricity demand flexibility is emphasized. Thus, it is demonstrated that this methodology aids in keeping the grid status within preset limits while utilizing flexibility from all flexibility participants.« less

  8. Research on Operation Strategy for Bundled Wind-thermal Generation Power Systems Based on Two-Stage Optimization Model

    NASA Astrophysics Data System (ADS)

    Sun, Congcong; Wang, Zhijie; Liu, Sanming; Jiang, Xiuchen; Sheng, Gehao; Liu, Tianyu

    2017-05-01

    Wind power has the advantages of being clean and non-polluting and the development of bundled wind-thermal generation power systems (BWTGSs) is one of the important means to improve wind power accommodation rate and implement “clean alternative” on generation side. A two-stage optimization strategy for BWTGSs considering wind speed forecasting results and load characteristics is proposed. By taking short-term wind speed forecasting results of generation side and load characteristics of demand side into account, a two-stage optimization model for BWTGSs is formulated. By using the environmental benefit index of BWTGSs as the objective function, supply-demand balance and generator operation as the constraints, the first-stage optimization model is developed with the chance-constrained programming theory. By using the operation cost for BWTGSs as the objective function, the second-stage optimization model is developed with the greedy algorithm. The improved PSO algorithm is employed to solve the model and numerical test verifies the effectiveness of the proposed strategy.

  9. Medical doctors and complementary and alternative medicine: the context of holistic practice.

    PubMed

    Winnick, Terri A

    2006-04-01

    Consumers, health care financing, external and internal competition are factors identified in the medical literature as prompting change within medicine. I test these factors to determine if they also prompt regular doctors to define themselves as 'holistic MDs' and align themselves with complementary and alternative medicine (CAM). State-level regression analyses on the number of MDs advertising in referral directories for CAM therapies find holistic practice a function of practice locale. The proportion of holistic MDs increases in states with an older population, where more patients survive despite serious disabilities, and where non-physician providers pose a competitive threat. Consumer demand, specialization and licensing do not significantly influence adoption of CAM treatments in these analyses. Health care financing has disparate effects. Indemnity insurance constrains holistic practice while HMO penetration enhances it. These results suggest that holistic practice may be an integral part of the regular profession's ongoing professionalization project.

  10. Does literacy improve finance?

    PubMed

    Poon, Martha; Olen, Helaine

    2015-04-01

    When economists ask questions about basic financial principles, most ordinary people answer incorrectly. Economic experts call this condition "financial illiteracy," which suggests that poor financial outcomes are due to a personal deficit of reading-related skills. The analogy to reading is compelling because it suggests that we can teach our way out of population-wide financial failure. In this comment, we explain why the idea of literacy appeals to policy makers in the advanced industrial nations. But we also show that the narrow skill set laid out by economists does not satisfy the politically inclusive definition of literacy that literacy studies fought for. We identify several channels through which people engage with ideas about finance and demonstrate that not all forms of literacy will lead people to the educational content prescribed by academic economists. We argue that truly financial literate people can defy the demands of financial theory and financial institutions. © The Author(s) 2015.

  11. Does the Type of Higher Education Affect Labor Market Outcomes? Evidence from Egypt and Jordan

    ERIC Educational Resources Information Center

    Assaad, Ragui; Krafft, Caroline; Salehi-Isfahani, Djavad

    2018-01-01

    In Egypt and Jordan, there is a substantial mismatch between the output of the higher education system and the needs of the labor market. Both demand and supply-side factors could be driving this mismatch. This paper tests a key supply-side issue, whether differences in the institutional structures and incentives in higher education affect the…

  12. Bolsa Escola: Breaking the Cycle of Poverty, Child Labour and School Disaffection in Brazil

    ERIC Educational Resources Information Center

    Denes, Christian Andrew

    2004-01-01

    The Bolsa Escola program in Brazil presents a clear break from the economic growth models and supply-side based strategies of the past. Founded on the assumption that the supplemental income generated by child labour outweighs the potential benefits of primary education, Bolsa Escola attempts to address the demand-side component of high dropout…

  13. Flatness-based adaptive fuzzy control of chaotic finance dynamics

    NASA Astrophysics Data System (ADS)

    Rigatos, G.; Siano, P.; Loia, V.; Tommasetti, A.; Troisi, O.

    2017-11-01

    A flatness-based adaptive fuzzy control is applied to the problem of stabilization of the dynamics of a chaotic finance system, describing interaction between the interest rate, the investment demand and the price exponent. By proving that the system is differentially flat and by applying differential flatness diffeomorphisms, its transformation to the linear canonical (Brunovsky) is performed. For the latter description of the system, the design of a stabilizing state feedback controller becomes possible. A first problem in the design of such a controller is that the dynamic model of the finance system is unknown and thus it has to be identified with the use neurofuzzy approximators. The estimated dynamics provided by the approximators is used in the computation of the control input, thus establishing an indirect adaptive control scheme. The learning rate of the approximators is chosen from the requirement the system's Lyapunov function to have always a negative first-order derivative. Another problem that has to be dealt with is that the control loop is implemented only with the use of output feedback. To estimate the non-measurable state vector elements of the finance system, a state observer is implemented in the control loop. The computation of the feedback control signal requires the solution of two algebraic Riccati equations at each iteration of the control algorithm. Lyapunov stability analysis demonstrates first that an H-infinity tracking performance criterion is satisfied. This signifies elevated robustness against modelling errors and external perturbations. Moreover, the global asymptotic stability is proven for the control loop.

  14. The role of nuclear energy in mitigating greenhouse warming

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

    Krakowski, R.A.

    1997-12-31

    A behavioral, top-down, forced-equilibrium market model of long-term ({approximately} 2,100) global energy-economics interactions has been modified with a bottom-up nuclear energy model and used to construct consistent scenarios describing future impacts of civil nuclear materials flows in an expanding, multi-regional (13) world economy. The relative measures and tradeoffs between economic (GNP, tax impacts, productivity, etc.), environmental (greenhouse gas accumulations, waste accumulation, proliferation risk), and energy (resources, energy mixes, supply-side versus demand-side attributes) interactions that emerge from these analyses are focused herein on advancing understanding of the role that nuclear energy (and other non-carbon energy sources) might play in mitigating greenhousemore » warming. Two ostensibly opposing scenario drivers are investigated: (a) demand-side improvements in (non-price-induced) autonomous energy efficiency improvements; and (b) supply-side carbon-tax inducements to shift energy mixes towards reduced- or non-carbon forms. In terms of stemming greenhouse warming for minimal cost of greenhouse-gas abatement, and with the limitations of the simplified taxing schedule used, a symbiotic combination of these two approaches may offer advantages not found if each is applied separately.« less

  15. Dynamic postural control and associated attentional demands in contemporary dancers versus non-dancers

    PubMed Central

    Sirois-Leclerc, Geneviève; Remaud, Anthony

    2017-01-01

    Postural control is not a fully automatic process, but requires a certain level of attention, particularly as the difficulty of the postural task increases. This study aimed at testing whether experienced contemporary dancers, because of their specialized training involving the control of posture/balance, would present with a dual-task performance suggesting lesser attentional demands associated with dynamic postural control compared with non-dancers. Twenty dancers and 16 non-dancers performed a dynamic postural tracking task in both antero-posterior and side-to-side directions, while standing on a force platform. The postural task was performed, in turn, 1) as a stand-alone task, and concurrently with both 2) a simple reaction time task and 3) a choice reaction time task. Postural control performance was estimated through variables calculated from centre of pressure movements. Although no overall group difference was found in reaction time values, we found a better ability to control the side to side movements of the centre of pressure during the tracking task in dancers compared with non-dancers, which was dependent on the secondary task. This suggests that such increased ability is influenced by available attentional resources. PMID:28323843

  16. Dynamic postural control and associated attentional demands in contemporary dancers versus non-dancers.

    PubMed

    Sirois-Leclerc, Geneviève; Remaud, Anthony; Bilodeau, Martin

    2017-01-01

    Postural control is not a fully automatic process, but requires a certain level of attention, particularly as the difficulty of the postural task increases. This study aimed at testing whether experienced contemporary dancers, because of their specialized training involving the control of posture/balance, would present with a dual-task performance suggesting lesser attentional demands associated with dynamic postural control compared with non-dancers. Twenty dancers and 16 non-dancers performed a dynamic postural tracking task in both antero-posterior and side-to-side directions, while standing on a force platform. The postural task was performed, in turn, 1) as a stand-alone task, and concurrently with both 2) a simple reaction time task and 3) a choice reaction time task. Postural control performance was estimated through variables calculated from centre of pressure movements. Although no overall group difference was found in reaction time values, we found a better ability to control the side to side movements of the centre of pressure during the tracking task in dancers compared with non-dancers, which was dependent on the secondary task. This suggests that such increased ability is influenced by available attentional resources.

  17. Industrial demand side management: A status report

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

    Hopkins, M.F.; Conger, R.L.; Foley, T.J.

    This report provides an overview of and rationale for industrial demand side management (DSM) programs. Benefits and barriers are described, and data from the Manufacturing Energy Consumption Survey are used to estimate potential energy savings in kilowatt hours. The report presents types and examples of programs and explores elements of successful programs. Two in-depth case studies (from Boise Cascade and Eli Lilly and Company) illustrate two types of effective DSM programs. Interviews with staff from state public utility commissions indicate the current thinking about the status and future of industrial DSM programs. A comprehensive bibliography is included, technical assistance programsmore » are listed and described, and a methodology for evaluating potential or actual savings from projects is delineated.« less

  18. Food security and sustainable intensification

    PubMed Central

    Godfray, H. Charles J.; Garnett, Tara

    2014-01-01

    The coming decades are likely to see increasing pressures on the global food system, both on the demand side from increasing population and per capita consumption, and on the supply side from greater competition for inputs and from climate change. This paper argues that the magnitude of the challenge is such that action is needed throughout the food system, on moderating demand, reducing waste, improving governance and producing more food. It discusses in detail the last component, arguing that more food should be produced using sustainable intensification (SI) strategies, and explores the rationale behind, and meaning of, this term. It also investigates how SI may interact with other food policy agendas, in particular, land use and biodiversity, animal welfare and human nutrition. PMID:24535385

  19. Analysis of power sector efficiency improvements for an integrated utility planning process in Costa Rica

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

    Waddle, D.B.; MacDonald, J.M.

    1990-01-01

    In an effort to analyze and document the potential for power sector efficiency improvements from generation to end-use, the Agency for International Development and the Government of Costa Rica are jointly conducting an integrated power sector efficiency analysis. Potential for energy and cost savings in power plants, transmission and distribution, and demand-side management programs are being evaluated. The product of this study will be an integrated investment plan for the Instituto Costarricense de Electricidad, incorporating both supply and demand side investment options. This paper presents the methodology employed in the study, as well as preliminary estimates of the results ofmore » the study. 14 refs., 4 figs., 5 tabs.« less

  20. Industry Use Cases and the Underlying Content Analytics Technology used in Big Data and Predictive Analytics (Briefing Charts)

    DTIC Science & Technology

    2015-05-01

    high-demand degrees and skills, essential concepts and methodologies, and required programming languages and product knowledge Benefits • Gained...According to ·finance report I’BM Corp. ’s EPS increased by according corporation Increase 10.1% preposition noun( singular ) noun( sing ,ular...used for other languages too (e.g. French, Spanish, etc.) Need to identify phrasal expressions by scanning minimum number of tokens I Need to

  1. Developing an Empirical Test of the Impact of Vouchers on Elasticity of Demand for Post-Secondary Education and on the Financing of Higher Education; and Economic Efficiency in Post-Secondary Education. Final Project Report.

    ERIC Educational Resources Information Center

    Newton, Jan N.; And Others

    Two separate NIE research projects in higher education, closely related in substance and complementary, were undertaken in Oregon in 1973-75. During the first year, the objectives were to: (1) compute and analyze various configurations of student schooling costs and financial resources according to institutional type and to student sex and…

  2. Tailor-made finance versus tailor-made care. Can the state strengthen consumer choice in healthcare by reforming the financial structure of long-term care?

    PubMed

    Grit, K; de Bont, A

    2010-02-01

    Policy instruments based on the working of markets have been introduced to empower consumers of healthcare. However, it is still not easy to become a critical consumer of healthcare. The aim of this study is to analyse the possibilities of the state to strengthen the position of patients with the aid of a new financial regime, such as personal health budgets. Data were collected through in-depth interviews with executives, managers, professionals and client representatives of six long-term care institutions. With the introduction of individual budgets the responsibility for budgetary control has shifted from the organisational level to the individual level in the caregiver-client relationship. Having more luxurious care on offer necessitates a stronger demarcation of regular care because organisations cannot simultaneously offer extra care as part of the standard care package. New financial instruments have an impact on the culture of receiving and giving care. Distributive justice takes on new meaning with the introduction of financial market mechanisms in healthcare; the distributing principle of 'need' is transformed into the principle of 'economic demand'. Financial instruments not only act as a countervailing power against providers insufficiently client-oriented, but are also used by providers to reinforce their own positions vis-à-vis demanding clients. Tailor-made finance is not the same as tailor-made care.

  3. ECKG Kladno project: First IPP in the Czech Republic

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

    Rode, J.R.; Tichy, O.J.

    1999-07-01

    The Energy Center Kladno project is the first independent power producer (IPP) project to be financed in the Czech Republic, one of Europe's most rapidly evolving markets. The total financing is $401 million and is structured in three currencies; Czech crowns, German marks, and US dollars. This paper will focus on: Enhanced technology to meet energy demands; Execution to meet the ambitious; and Overall project status. The coal and gas fired plant will produce a total of 343 MW to provide electricity and heat to the town of Kladno, west of Prague. The new plant will be located within themore » existing ECK facility and the project encompasses demolition, upgrading, and rebuilding. The base load will be from two coal-fired 135 MW circulating fluidized bed (CFB) boilers and peaking capacity from the gas-fired combustion (66 MW) turbine. The CFB's will fire a range of low sulfur brown coal supplied from the local mining company Ceskomoravske Doly (CMD). The new CFB's were designed to meet the overall steam demands specified by ECKG. The CFB's design features include in-furnace heat transfer surface and a split backpass that utilizes a biasing damper to allow for control of both the superheat and reheat steam temperatures. The various CFB auxiliary systems will be discussed in the paper as well as the flue gas particulate collection equipment.« less

  4. Generic drug prices and policy in Australia: room for improvement? a comparative analysis with England.

    PubMed

    Mansfield, Sarah J

    2014-02-01

    To assess the degree to which reimbursement prices in Australia and England differ for a range of generic drugs, and to analyse the supply- and demand-side factors that may contribute to these differences. Australian and English reimbursement prices were compared for a range of generic drugs using pricing information obtained from government websites. Next, a literature review was conducted to identify supply- and demand-side factors that could affect generic prices in Australia and England. Various search topics were identified addressing potential supply-side (e.g. market approval, intellectual property protection of patented drugs, generic pricing policy, market size, generic supply chain and discounting practices) and demand-side (consumers, prescribers and pharmacists) factors. Related terms were searched in academic databases, official government websites, national statistical databases and internet search engines. Analysis of drug reimbursement prices for 15 generic molecules (representing 45 different drug presentations) demonstrated that Australian prices were on average over 7-fold higher than in England. Significant supply-side differences included aspects of pricing policy, the relative size of the generics markets and the use of clawback policies. Major differences in demand-side policies related to generic prescribing, pharmacist substitution and consumer incentives. Despite recent reforms, the Australian Government continues to pay higher prices than its English counterpart for many generic medications. The results suggest that particular policy areas may benefit from review in Australia, including the length of the price-setting process, the frequency of subsequent price adjustments, the extent of price competition between originators and generics, medical professionals' knowledge about generic medicines and incentives for generic prescribing. WHAT IS KNOWN ABOUT THE TOPIC? Prices of generic drugs have been the subject of much scrutiny over recent years. From 2005 to 2010 the Australian Government responded to observations that Pharmaceutical Benefits Scheme prices for many generics were higher than in numerous comparable countries by instituting several reforms aimed at reducing the prices of generics. Despite this, several studies have demonstrated that prices for generic statins (one class of cholesterol-lowering drug) are higher in Australia compared with England and many other developed countries, and prices of numerous other generics remain higher than in the USA and New Zealand. Recently there has been increasing interest in why these differences exist. WHAT DOES THIS PAPER ADD? By including a much larger range of commonly used and costly generic drugs, this paper builds significantly on the limited previous investigations of generic drug prices in Australia and England. Additionally, this is the first comprehensive investigation of multiple supply- and, in particular, demand-side factors that may explain any price differences between these countries. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Practitioners may contribute to the higher prices of generic medications in Australia compared with England through relatively low rates of generic prescribing. There are also significant implications for health policy makers, as this paper demonstrates that if Australia achieved the same prices as England for many generic drugs there could be substantial savings for the Pharmaceutical Benefits Scheme.

  5. DSM Electricity Savings Potential in the Buildings Sector in APP Countries

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

    McNeil, MIchael; Letschert, Virginie; Shen, Bo

    2011-01-12

    The global economy has grown rapidly over the past decade with a commensurate growth in the demand for electricity services that has increased a country's vulnerability to energy supply disruptions. Increasing need of reliable and affordable electricity supply is a challenge which is before every Asia Pacific Partnership (APP) country. Collaboration between APP members has been extremely fruitful in identifying potential efficiency upgrades and implementing clean technology in the supply side of the power sector as well established the beginnings of collaboration. However, significantly more effort needs to be focused on demand side potential in each country. Demand side managementmore » or DSM in this case is a policy measure that promotes energy efficiency as an alternative to increasing electricity supply. It uses financial or other incentives to slow demand growth on condition that the incremental cost needed is less than the cost of increasing supply. Such DSM measures provide an alternative to building power supply capacity The type of financial incentives comprise of rebates (subsidies), tax exemptions, reduced interest loans, etc. Other approaches include the utilization of a cap and trade scheme to foster energy efficiency projects by creating a market where savings are valued. Under this scheme, greenhouse gas (GHG) emissions associated with the production of electricity are capped and electricity retailers are required to meet the target partially or entirely through energy efficiency activities. Implementation of DSM projects is very much in the early stages in several of the APP countries or localized to a regional part of the country. The purpose of this project is to review the different types of DSM programs experienced by APP countries and to estimate the overall future potential for cost-effective demand-side efficiency improvements in buildings sectors in the 7 APP countries through the year 2030. Overall, the savings potential is estimated to be 1.7 thousand TWh or 21percent of the 2030 projected base case electricity demand. Electricity savings potential ranges from a high of 38percent in India to a low of 9percent in Korea for the two sectors. Lighting, fans, and TV sets and lighting and refrigeration are the largest contributors to residential and commercial electricity savings respectively. This work presents a first estimates of the savings potential of DSM programs in APP countries. While the resulting estimates are based on detailed end-use data, it is worth keeping in mind that more work is needed to overcome limitation in data at this time of the project.« less

  6. On-demand anakinra treatment is effective in mevalonate kinase deficiency.

    PubMed

    Bodar, E J; Kuijk, L M; Drenth, J P H; van der Meer, J W M; Simon, A; Frenkel, J

    2011-12-01

    Mevalonate kinase deficiency (MKD) is a hereditary autoinflammatory syndrome marked by recurrent attacks of fever and inflammation. Severe enzyme deficiency results in mevalonic aciduria (MA) and milder deficiency in hyperimmunoglobulin D syndrome (HIDS). Treatment remains a challenge. To observe the effect of the recombinant interleukin-1 receptor antagonist anakinra in patients with MKD. A prospective observational study was undertaken. Two patients with MA started continuous treatment with anakinra (1-2 mg/kg/day) and nine patients with HIDS chose between continuous treatment and on-demand treatment (starting at first symptoms of attack, 100 mg/day or 1 mg/kg/day for 5-7 days). Anakinra induced partial remission in one patient with MA but there was no response in the other patient with MA. In one patient with HIDS continuous treatment induced complete remission for 7 months but was stopped because of side effects. Eight patients with HIDS preferred on-demand treatment from the start. This induced a clinical response (≥50% reduction in duration) in 8 of 12 treated attacks without a change in attack frequency. Anakinra prevented fever attacks due to vaccination without inhibiting antibody induction. No major side effects were seen. On-demand treatment with anakinra in HIDS decreases the duration and severity of fever attacks. Because of the burden of daily injections and relatively long asymptomatic intervals of HIDS, all patients with HIDS preferred on-demand treatment.

  7. Mapping actions to improve access to medicines for mental disorders in low and middle income countries.

    PubMed

    Barbui, C; Dua, T; Kolappa, K; Saraceno, B; Saxena, S

    2017-10-01

    In recent years a number of intergovernmental initiatives have been activated in order to enhance the capacity of countries to improve access to essential medicines, particularly for mental disorders. In May 2013 the 66th World Health Assembly adopted the World Health Organization (WHO) Comprehensive Mental Health Action Plan 2013-2020, which builds upon the work of WHO's Mental Health Gap Action Programme. Within this programme, evidence-based guidelines for mental disorders were developed, including recommendations on appropriate use of medicines. Subsequently, the 67th World Health Assembly adopted a resolution on access to essential medicines, which urged Member States to improve national policies for the selection of essential medicines and to promote their availability, affordability and appropriate use. Following the precedent set by these important initiatives, this article presents eleven actions for improving access and appropriate use of psychotropic medicines. A 4 × 4 framework mapping actions as a function of the four components of access - selection, availability, affordability and appropriate use - and across four different health care levels, three of which belong to the supply side and one to the demand side, was developed. The actions are: developing a medicine selection process; promoting information and education activities for staff and end-users; developing a medicine regulation process; implementing a reliable supply system; implementing a reliable quality-control system; developing a community-based system of mental health care and promoting help-seeking behaviours; developing international agreements on medicine affordability; developing pricing policies and a sustainable financing system; developing or adopting evidence-based guidelines; monitoring the use of psychotropic medicines; promoting training initiatives for staff and end-users on critical appraisal of scientific evidence and appropriate use of psychotropic medicines. Activating these actions offers an unique opportunity to address the broader issue of increasing access to treatments and care for mental disorders, as current lack of attention to mental disorders is a central barrier across all domains of the 4 × 4 access framework.

  8. Where does the waiting list begin? A short review of the dynamics and organization of modern waiting lists.

    PubMed

    Rotstein, Dalia L; Alter, David A

    2006-06-01

    Waiting for medical care is the by-product of system rationing, where demand exceeds supply. In this short report we expand on the conventional concept of the queue, by focusing on the regulation of demand and by incorporating a funnel and spout analogy. Real-world examples are used to illustrate the infancy of funnel or demand-side reform initiatives targeting the queue, and the suggestion is made that policy needs to address the concept of 'waiting' much earlier in the treatment cycle.

  9. Lessons learned in shaping vaccine markets in low-income countries: a review of the vaccine market segment supported by the GAVI Alliance.

    PubMed

    Gilchrist, Shawn A N; Nanni, Angeline

    2013-12-01

    The Global Alliance for Vaccines and Immunization (GAVI) anticipated that growing demand for new vaccines could sufficiently impact the vaccines market to allow low-income countries (LICs) to self-finance new vaccines. But the time required to lower vaccine prices was underestimated and the amount that prices would decline overestimated. To better understand how prices in the LIC vaccine market can be impacted, the vaccine market was retrospectively examined. GAVI archives and the published literature on the vaccine markets in LICs were reviewed for the purpose of identifying GAVI's early assumptions for the evolution of vaccine prices, and contrasting these retrospectively with actual outcomes. The prices in Phases I and II of GAVI-supported vaccines failed to decline to a desirable level within a projected 5-year timeframe. GAVI-eligible countries were unable to sustain newly introduced vaccines without prolonged donor support. Two key lessons can be applied to future vaccine market-shaping strategies: (1) accurate demand forecasting together with committed donor funding can increase supply to the LIC vaccines market, but even greater strides can be made to increase the certainty of purchase; and (2) the expected time to lower prices took much longer than 5 years; market competition is inherently linked to the development time for new vaccines--a minimum of 5-10 or more years. Other factors that can lower vaccine prices include: large-scale production or alternate financing mechanisms that can hasten vaccine price maturation. The impacts of competition on vaccine prices in the LIC new-vaccines market occurred after almost 10 years. The time for research and development, acquisition of technological know-how and to scale production must be accounted for to more accurately predict significant declines on vaccine prices. Alternate financing mechanisms and the use of purchase agreements should also be considered for lowering prices when planning new vaccine introductions.

  10. Pharmacokinetics of Scopolamine Intranasal Gel Formulation (INSCOP) During Antiorthostatic Bedrest

    NASA Technical Reports Server (NTRS)

    Putcha, Lakshmi; Boyd, J. L.; Du, B.; Daniels, V.; Crady, C.

    2011-01-01

    Space Motion sickness (SMS) is an age old problem for space travelers on short and long duration space flight Oral antiemetics are not very effective in space due to poor bioavailability. Scopolamine (SCOP) is the most frequently used drug by recreational travelers V patch, tablets available on the market. Common side effects of antiemetics, in general, include drowsiness, sedation, dry mouth and reduced psychomotor performance. Severity and persistence of side effects are often dose related Side effects can be detrimental in high performance demanding settings, e.g. space flight, military.

  11. College as Country Club: Do Colleges Cater to Students' Preferences for Consumption? NBER Working Paper No. 18745

    ERIC Educational Resources Information Center

    Jacob, Brian; McCall, Brian; Stange, Kevin M.

    2013-01-01

    This paper investigates whether demand-side market pressure explains colleges' decisions to provide consumption amenities to their students. We estimate a discrete choice model of college demand using micro data from the high school classes of 1992 and 2004, matched to extensive information on all four year colleges in the U.S. We find that most…

  12. Valuating Ecosystem Services of Urban Ponds - case study from Bangladesh

    NASA Astrophysics Data System (ADS)

    Carle, Nina

    2016-04-01

    A climate risk assessment for the city of Barisal was carried out by a consultancy firm, financed by KfW Development Bank of Germany. Due to high dependencies on natural capital of people in developing countries they are facing high vulnerability when it comes to changes of the asset category 'natural capital' (here: urban ponds), whether due to the exposition on climate (change) related impacts, implemented measures or land use change. With a closer view on the city's assets, the question remained open to the author 1) Under current conditions, what is the demand for ecosystem services (ES) 2) What is the value of the benefits and the how much is the contribution to the city's welfare? 3) What are the future changes in the demand for ES? And what are the future changes on the supply side (pressures and threats to the ecosystem)? Methodology: The City of Barisal in Bangladesh has a calculated number of around 10.000 urban rain-fed ponds,representing 6.5% of the city area, which represents a huge natural water supply and gives the city its characteristic face. In August 2015 a user survey was conducted in the city of Barisal, in every ward (administrative unit), to determine the demand for ecosystem services related to urban ponds, evaluating over 600 ponds. The findings will present the huge variation of provisioning ecosystem services and an important regulating service, related to economic and domestic use, in a spatial resolution. It will be shown, how the importance of ES changes, by changing the unit of analysis (families or ponds or the city) and the importance for the livelihood of pond owners and users. A relationship between pond area(m2) and number of users was detected, also the role of compensation payments for the pond owners by the users. It will be shown how natural capital, privately and publicly owned,contributes in an important way in buffering unequal distribution of societies resources in the short- and long-run. However society's demand for ES will change in the future, as climate models indicate a change in precipitation patterns for Barisal. Climate change is operating multisectoral and therefore all assets have to be considered to detect the potential damage. This research can show the pathways of people depending on natural captital in developing countries, sharpening the view for vulnerable groups. Furthermore the research can deliver a contribution to the discussion on (financial) investments to build resilient futures.

  13. Patterns of control of maximum metabolic rate in humans.

    PubMed

    Hochachka, Peter W; Beatty, Cheryl L

    2003-09-01

    In this analysis, four performance phenotypes were used to compare mechanisms of control of aerobic maximum metabolic rate (MMR): (i) untrained sedentary (US) subjects, as a reference group against which to compare (ii) power trained (PT), (iii) endurance trained (ET) and (iv) high altitude adapted native (HA) subject groups. Sprinters represented the PT group; long distance runners illustrated the ET group; and Quechuas represented the HA group. Numerous recent studies have identified contributors to control on both the adenosine triphosphate (ATP) supply side and the ATP demand side of ATP turnover. Control coefficients or c(i) values were defined as fractional change in MMR/fractional change in the capacity of any given step in ATP turnover. From the best available evidence it appears that at MMR all five of the major steps in energy delivery (namely, ventilation, pulmonary diffusion, cardiac output, tissue capillary - mitochondrial O(2) transfer, and aerobic cell metabolism per se) approach an upper functional ceiling, with control strength being distributed amongst the various O(2) flux steps. On the energy demand side, the situation is somewhat simplified since at MMR approximately 90% of O(2)-based ATP synthesis is used for actomyosin (AM) and Ca(2+) ATPases; at MMR these two ATP demand rates also appear to be near an upper functional ceiling. In consequence, at MMR the control contributions or c(i) values are rather evenly divided amongst all seven major steps in ATP supply and ATP demand pathways right to the point of fatigue. Relative to US (the reference group), in PT subjects at MMR control strength shifts towards O(2) delivery steps (ventilation, pulmonary diffusion and cardiac output). In contrast in ET and HA subjects at MMR control shifts towards the energy demand steps (AM and Ca(2+) ATPases), and more control strength is focussed on tissue level ATP supply and ATP demand. One obvious advantage of the ET and HA control pattern is improved metabolite homeostasis. Another possibility is that, with some reserve capacity in the O(2) delivery steps and control focussed on ATP turnover at the tissue level, nature has designed the ideal 'endurance machine'.

  14. Control of maximum metabolic rate in humans: dependence on performance phenotypes.

    PubMed

    Hochachka, Peter W; Burelle, Yan

    2004-01-01

    Borrowing from metabolic control analysis the concept of control coefficients or ci values, defined as fractional change in MMR/fractional change in the capacity of any given step in ATP turnover, we used four performance phenotypes to compare mechanisms of control of aerobic maximum metabolic rate (MMR): (i) untrained sedentary (US) subjects, as a reference group against which to compare (ii) power trained (PT), (iii) endurance trained (ET), and (iv) high altitude adapted native (HA) subject groups. Sprinters represented the PT group; long distance runners illustrated the ET group; and Andean natives represented the HA group. Numerous recent studies have identified contributors to control on both the adenosine triphosphate (ATP) supply side and the ATP demand side of ATP turnover. From the best available evidence it appears that at MMR all five of the major steps in energy delivery (namely, ventilation, pulmonary diffusion, cardiac output, tissue capillary--mitochondrial O2 transfer, and aerobic cell metabolism per se) approach an upper functional ceiling, with control strength being distributed amongst the various O2 flux steps. On the energy demand side, the situation is somewhat simplified since at MMR approximately 90% of O2-based ATP synthesis is used for actomyosin (AM) and Ca2+ ATPases; at MMR these two ATP demand rates also appear to be near an upper functional ceiling. In consequence, at MMR the control contributions or ci values are distributed amongst all seven major steps in ATP supply and ATP demand pathways right to the point of fatigue. Relative to US (the reference group), in PT subjects at MMR control strength shifts towards O2 delivery steps (ventilation, pulmonary diffusion, and cardiac output); here physiological regulation clearly dominates MMR control. In contrast in ET and HA subjects at MMR control shifts towards the energy demand steps (AM and Ca2+ ATPases), and more control strength is focussed on tissue level ATP supply and ATP demand. One obvious advantage of the ET and HA biochemical-level control is improved metabolite homeostasis. Additionally, with some reserve capacity in the O2 delivery steps, the focussing of control on ATP turnover at the tissue level has allowed nature to improve on an 'endurance machine' design.

  15. Demand- and supply-side determinants of diphtheria-pertussis-tetanus nonvaccination and dropout in rural India.

    PubMed

    Ghosh, Arpita; Laxminarayan, Ramanan

    2017-02-15

    Although 93% of 12- to 23-month-old children in India receive at least one vaccine, typically Bacillus Calmette-Guérin, only 75% complete the recommended three doses of diphtheria-pertussis-tetanus (DPT, also referred to as DTP) vaccine. Determinants can be different for nonvaccination and dropout but have not been examined in earlier studies. We use the three-dose DPT series as a proxy for the full sequence of recommended childhood vaccines and examine the determinants of DPT nonvaccination and dropout between doses 1 and 3. We analyzed data on 75,728 6- to 23-month-old children in villages across India to study demand- and supply-side factors determining nonvaccination with DPT and dropout between DPT doses 1 and 3, using a multilevel approach. Data come from the District Level Household and Facility Survey 3 (2007-08). Individual- and household-level factors were associated with both DPT nonvaccination and dropout between doses 1 and 3. Children whose mothers had no schooling were 2.3 times more likely not to receive any DPT vaccination and 1.5 times more likely to drop out between DPT doses 1 and 3, compared with children whose mothers had 10 or more years of schooling. Although supply-side factors related to availability of public health facilities and immunization-related health workers in villages were not correlated with dropout between DPT doses 1 and 3, children in districts where 46% or more villages had a healthcare subcentre were 1.5 times more likely to receive at least one dose of DPT vaccine compared with children in districts where 30% or fewer villages had subcentres. Nonvaccination with DPT in India is influenced by village- and district-level contextual factors over and above individuals' background characteristics. Dropout between DPT doses 1 and 3 is associated more strongly with demand-side factors than with village- and district-level supply-side factors. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Price elasticity matrix of demand in power system considering demand response programs

    NASA Astrophysics Data System (ADS)

    Qu, Xinyao; Hui, Hongxun; Yang, Shengchun; Li, Yaping; Ding, Yi

    2018-02-01

    The increasing renewable energy power generations have brought more intermittency and volatility to the electric power system. Demand-side resources can improve the consumption of renewable energy by demand response (DR), which becomes one of the important means to improve the reliability of power system. In price-based DR, the sensitivity analysis of customer’s power demand to the changing electricity prices is pivotal for setting reasonable prices and forecasting loads of power system. This paper studies the price elasticity matrix of demand (PEMD). An improved PEMD model is proposed based on elasticity effect weight, which can unify the rigid loads and flexible loads. Moreover, the structure of PEMD, which is decided by price policies and load types, and the calculation method of PEMD are also proposed. Several cases are studied to prove the effectiveness of this method.

  17. Sectoral contributions to surface water stress in the coterminous United States

    NASA Astrophysics Data System (ADS)

    Averyt, K.; Meldrum, J.; Caldwell, P.; Sun, G.; McNulty, S.; Huber-Lee, A.; Madden, N.

    2013-09-01

    Here, we assess current stress in the freshwater system based on the best available data in order to understand possible risks and vulnerabilities to regional water resources and the sectors dependent on freshwater. We present watershed-scale measures of surface water supply stress for the coterminous United States (US) using the water supply stress index (WaSSI) model which considers regional trends in both water supply and demand. A snapshot of contemporary annual water demand is compared against different water supply regimes, including current average supplies, current extreme-year supplies, and projected future average surface water flows under a changing climate. In addition, we investigate the contributions of different water demand sectors to current water stress. On average, water supplies are stressed, meaning that demands for water outstrip natural supplies in over 9% of the 2103 watersheds examined. These watersheds rely on reservoir storage, conveyance systems, and groundwater to meet current water demands. Overall, agriculture is the major demand-side driver of water stress in the US, whereas municipal stress is isolated to southern California. Water stress introduced by cooling water demands for power plants is punctuated across the US, indicating that a single power plant has the potential to stress water supplies at the watershed scale. On the supply side, watersheds in the western US are particularly sensitive to low flow events and projected long-term shifts in flow driven by climate change. The WaSSI results imply that not only are water resources in the southwest in particular at risk, but that there are also potential vulnerabilities to specific sectors, even in the ‘water-rich’ southeast.

  18. David Palchak | NREL

    Science.gov Websites

    Electrical load forecasting with artificial neural networks Demand-side management optimization with Matlab -58491. D. Palchak, S. Suryanarayanan, and D. Zimmerle. "An Artificial Neural Network in Short-Term

  19. Financing strategies to improve essential public health equalization and its effects in China.

    PubMed

    Yang, Li; Sun, Li; Wen, Liankui; Zhang, Huyang; Li, Chenyang; Hanson, Kara; Fang, Hai

    2016-12-01

    In 2009, China launched a health reform to promote the equalization of national essential public health services package (NEPHSP). The present study aimed to describe the financing strategies and mechanisms to improve access to public health for all, identify the strengths and weaknesses of the different approaches, and showed evidence on equity improvement among different regions. We reviewed the relevant literatures and identified 208 articles after screening and quality assessment and conducted six key informants' interviews. Secondary data on national and local government health expenditures, NEPHSP coverage and health indicators in 2003-2014 were collected, descriptive and equity analyses were used. Before 2009, the government subsidy to primary care institutions (PCIs) were mainly used for basic construction and a small part of personnel expenses. Since 2009, the new funds for NEPHSP have significantly expanded service coverage and population coverage. These funds have been allocated by central, provincial, municipal and county governments at different proportions in China's tax distribution system. Due to the fiscal transfer payment, the Central Government allocated more subsides to less-developed western regions and all the funds were managed in a specific account. Several types of payment methods have been adopted including capitation, pay for performance (P4P), pay for service items, global budget and public health voucher, to address issues from both the supply and demand sides. The equalization of NEPHSP did well through the establishment of health records, systematic care of children and maternal women, etc. Our data showed that the gap between the eastern, central and western regions narrowed. However the coverage for migrants was still low and performance was needed improving in effectiveness of managing patients with chronic diseases. The delivery of essential public health services was highly influenced by public fiscal policy, and the implementation of health reform since 2009 has led the public health development towards the right direction. However China still needs to increase the fiscal investments to expand service coverage as well as promote the quality of public health services and equality among regions. Independent scientific monitoring and evaluation are also needed.

  20. Identifying and Reconciling Risk Across Sectors: The implications of differing views of risk in climate policy, environmental conservation, and the finance sector

    NASA Astrophysics Data System (ADS)

    Johns, T.; Henderson, I.; Thoumi, G.

    2014-12-01

    The presence and valuation of risk are commonalities that link the diverse fields of climate change science and policy, environmental conservation, and the financial/investment sector. However, the definition and perception of risks vary widely across these critically linked fields. The "Stranded Asset" concept developed by organizations like the Carbon Tracker Initiative begins to elucidate the links between climate change risk and financial risk. Stranded assets are those that may lose some or all value from climate disruption, changes in demand-side dynamics and/or a more stringent regulatory environment. In order to shift financial flows toward climate change mitigation, emissions-heavy activities that present finance and investment opportunities must also be assessed for their GHG-asset risk attributes in terms of their contribution and vulnerability to climate disruption, as well as other environmental externalities. Until the concept of GHG-asset risk in investment is reconciled with the risks of climate change and environmental conservation, it will not be possible to shift business and financial practices, and unlock private sector resources to address the climate change and conservation challenge. UNEP-FI is researching the application of the concept of Value-atRisk (VaR) to explore links between the financial sector and deforestation/REDD+. The research will test the hypothesis that climate risk is a financial risk, and propose tools to identify and quantify risks associated with unsustainable land-use investments. The tools developed in this research will help investors, managers and governments assess their exposures to the material REDD-related risks in their portfolios. This will inform the development of 'zero net deforestation' investment indices to allow investors to lower the 'deforestation' exposure of 'benchmark' financial indices used by many of the largest money managers. A VaR analysis will be performed, combining the notion of externality with the traditional approach of external (exogenous) risk analysis. The VaR component introduces probabilities for different scenarios and may ultimately lead to a full distribution for the holistic losses. These distributions are non-parametric and non-linear since climate change is an "event-risk".

  1. Performance-based financing in the context of selective free health-care: an evaluation of its effects on the use of primary health-care services in Burundi using routine data.

    PubMed

    Falisse, Jean-Benoît; Ndayishimiye, Juvenal; Kamenyero, Vincent; Bossuyt, Michel

    2015-12-01

    Performance-based financing (PBF) is an increasingly adopted strategy in low- and middle-income countries. PBF pilot projects started in Burundi in 2006, at the same time when a national policy removed user fees for pregnant women and children below 5 years old. PBF was gradually extended to the 17 provinces of the country. This roll-out and data from the national health information system are exploited to assess the impact of PBF on the use of health-care services. PBF is associated with an increase in the number of anti-tetanus vaccination of pregnant women (around +20 percentage points in target population, P < 0.10). Non-robust positive effects are also found on institutional deliveries and prenatal consultations. Changes in outpatient visits, postnatal visits and children vaccinations are not significantly correlated with PBF. It is also found that more qualified nurses headed to PBF-supported provinces. The limited quality of the data and the restricted size of the sample have to be taken into account when interpreting these results. Health facility-level figures from PBF-supported provinces show that most indicators but those relative to preventive care are growing through time. The dataset does not include indicators of the quality of care and does not allow to assess whether changes associated with PBF are resource-driven or due to the incentive mechanism itself. The results are largely consistent with other impact evaluations conducted in Burundi and Rwanda. The fact that PBF is mostly associated with positive changes in the use of services that became free suggests an important interaction effect between the two strategies. A possible explanation is that the removal of user fees increases accessibility to health care and acts on the demand side while PBF gives medical staffs incentives for improving the provision of services. More empirical research is needed to understand the sustainability of (the incentive mechanism of) PBF and the interaction between PBF and other health policies. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  2. Spending on medicines in Israel in an international context.

    PubMed

    Sax, Philip

    2005-05-01

    Like most developed countries, in the last decade Israel's healthcare system has been subject to cost-containing measures in the drug sector. To provide comparative information in an international context on the level of outpatient drug expenditures in Israel, both total and those publicly financed, and to analyze how these have changed with time during the last decade. Using definitions of the OECD (Organization of Economic Cooperation and Development), internationally comparable data on total expenditure and public expenditure on medicines in Israel are provided. The Israeli estimates are based on data from the Ministry of Health audited reports of financial activities of the health management organizations and from the family expenditure surveys carried out by the Central Bureau of Statistics. Per capita total and public expenditures in Israel are analyzed over time, as are their share of national expenditure on health and of gross domestic product. Israel expenditures are then compared with those for individual member countries of the OECD, as well as a 21 country average, from 1992 to 2002. Analysis of the Israeli expenditure data shows a considerable reduction in growth of per capita total and public expenditures on medicines since 1997. Growth in the share of total drug expenditure of NEH and of GDP has also been constrained since 1997. In an international context, per capita expenditure on medicines in Israel, particularly what is publicly financed, is one of the lowest. Furthermore, its share of NEH and GDP is also very low compared to other countries. This substantive gap in spending on medicines between Israel and other countries has increased since 1997. Israel, a medium-income country with a lower than average level of expenditure on health compared to OECD countries, has a particularly low level of expenditure on medicines. Whereas the share of health expenditure of GDP in Israel is similar to the international average, the share of drug expenditure of GDP is well below the average. In addition to structural and longer-term factors contributing to Israel's low per capita spending on medicines, such as the young population and the apparently low level of actual prices paid by most institutional purchasers, recent years are witness to the growing impact of National Health Insurance budgetary pressures on HMOs as well as continual increases in prescription cost sharing by patients. The impact is felt both on the demand side (higher copayments, administrative and prescribing restrictions) and perhaps more crucially on the supply side (price competition, mainly from generics). Substantial extra public funding for the addition of new drugs to the NHI basket in recent years has had no overall impact on these longer-term spending patterns.

  3. Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications.

    PubMed

    Godman, Brian; Wettermark, Bjorn; van Woerkom, Menno; Fraeyman, Jessica; Alvarez-Madrazo, Samantha; Berg, Christian; Bishop, Iain; Bucsics, Anna; Campbell, Stephen; Finlayson, Alexander E; Fürst, Jurij; Garuoliene, Kristina; Herholz, Harald; Kalaba, Marija; Laius, Ott; Piessnegger, Jutta; Sermet, Catherine; Schwabe, Ulrich; Vlahović-Palčevski, Vera V; Markovic-Pekovic, Vanda; Vončina, Luka; Malinowska, Kamila; Zara, Corinne; Gustafsson, Lars L

    2014-01-01

    The appreciable growth in pharmaceutical expenditure has resulted in multiple initiatives across Europe to lower generic prices and enhance their utilization. However, considerable variation in their use and prices. Assess the influence of multiple supply and demand-side initiatives across Europe for established medicines to enhance prescribing efficiency before a decision to prescribe a particular medicine. Subsequently utilize the findings to suggest potential future initiatives that countries could consider. An analysis of different methodologies involving cross national and single country retrospective observational studies on reimbursed use and expenditure of PPIs, statins, and renin-angiotensin inhibitor drugs among European countries. Nature and intensity of the various initiatives appreciably influenced prescribing behavior and expenditure, e.g., multiple measures resulted in reimbursed expenditure for PPIs in Scotland in 2010 56% below 2001 levels despite a 3-fold increase in utilization and in the Netherlands, PPI expenditure fell by 58% in 2010 vs. 2000 despite a 3-fold increase in utilization. A similar picture was seen with prescribing restrictions, i.e., (i) more aggressive follow-up of prescribing restrictions for patented statins and ARBs resulted in a greater reduction in the utilization of patented statins in Austria vs. Norway and lower utilization of patented ARBs vs. generic ACEIs in Croatia than Austria. However, limited impact of restrictions on esomeprazole in Norway with the first prescription or recommendation in hospital where restrictions do not apply. Similar findings when generic losartan became available in Western Europe. Multiple demand-side measures are needed to influence prescribing patterns. When combined with supply-side measures, activities can realize appreciable savings. Health authorities cannot rely on a "spill over" effect between classes to affect changes in prescribing.

  4. Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications

    PubMed Central

    Godman, Brian; Wettermark, Bjorn; van Woerkom, Menno; Fraeyman, Jessica; Alvarez-Madrazo, Samantha; Berg, Christian; Bishop, Iain; Bucsics, Anna; Campbell, Stephen; Finlayson, Alexander E.; Fürst, Jurij; Garuoliene, Kristina; Herholz, Harald; Kalaba, Marija; Laius, Ott; Piessnegger, Jutta; Sermet, Catherine; Schwabe, Ulrich; Vlahović-Palčevski, Vera V.; Markovic-Pekovic, Vanda; Vončina, Luka; Malinowska, Kamila; Zara, Corinne; Gustafsson, Lars L.

    2014-01-01

    Introduction: The appreciable growth in pharmaceutical expenditure has resulted in multiple initiatives across Europe to lower generic prices and enhance their utilization. However, considerable variation in their use and prices. Objective: Assess the influence of multiple supply and demand-side initiatives across Europe for established medicines to enhance prescribing efficiency before a decision to prescribe a particular medicine. Subsequently utilize the findings to suggest potential future initiatives that countries could consider. Method: An analysis of different methodologies involving cross national and single country retrospective observational studies on reimbursed use and expenditure of PPIs, statins, and renin-angiotensin inhibitor drugs among European countries. Results: Nature and intensity of the various initiatives appreciably influenced prescribing behavior and expenditure, e.g., multiple measures resulted in reimbursed expenditure for PPIs in Scotland in 2010 56% below 2001 levels despite a 3-fold increase in utilization and in the Netherlands, PPI expenditure fell by 58% in 2010 vs. 2000 despite a 3-fold increase in utilization. A similar picture was seen with prescribing restrictions, i.e., (i) more aggressive follow-up of prescribing restrictions for patented statins and ARBs resulted in a greater reduction in the utilization of patented statins in Austria vs. Norway and lower utilization of patented ARBs vs. generic ACEIs in Croatia than Austria. However, limited impact of restrictions on esomeprazole in Norway with the first prescription or recommendation in hospital where restrictions do not apply. Similar findings when generic losartan became available in Western Europe. Conclusions: Multiple demand-side measures are needed to influence prescribing patterns. When combined with supply-side measures, activities can realize appreciable savings. Health authorities cannot rely on a “spill over” effect between classes to affect changes in prescribing. PMID:24987370

  5. SEE HYDROPOWER Project, targeted to improve water resource management for a growing renewable energy production

    NASA Astrophysics Data System (ADS)

    Peviani, Maximo; Alterach, Julio; Danelli, Andrea

    2010-05-01

    The three years SEE HYDROPOWER project started on June 2009, financed by the South-East Transnational Cooperation Programme (EU), aims to a sustainable exploitation of water concerning hydropower production in SEE countries, looking up to renewable energy sources development, preserving environmental quality and preventing flood risk. Hydropower is the most important renewable resource for energy production in the SEE countries but creates ecological impacts on a local scale. If on one hand, hydroelectric production has to be maintained and likely increased following the demand trend and RES-e Directive, on the other hand, hydropower utilisation often involves severe hydrological changes, damages the connectivity of water bodies and injures river ecosystems. The project gives a strong contribution to the integration between the Water Frame and the RES-e Directives in the involved countries. The SEE HYDROPOWER project promotes the optimal use of water, as multiple natural resources, in order to face the increasing regional electrical-energy demand. Furthermore, SEE HYDROPOWER defines specific needs and test methodologies & tools, in order to help public bodies to take decisions about planning and management of water and hydropower concessions, considering all multi-purposes uses, taking into account the environmental sustainability of natural resources and flooding risks. Investigations is carried on to define common strategies & methods for preserving river with particular concerns to aquatic ecosystems, considering the required Minimum Environmental Flow, macro-habitat quality, migratory fishes and related environmental issues. Other problem addressed by the Project is the contrast between Public Administration and Environmental associations on one side and the Hydropower producers on the other side, for the exploitation of water bodies. Competition between water users (for drinking, irrigation, industrial processes, power generation, etc.) is becoming a serious problem, and there is a strong need of a more accurate planning and management optimization of the resources. The partnership includes a well balance mixing of public administrations, agencies ruling hydropower development, water bodies conservation and scientific institutions having the most advanced technology applied to water management and hydropower generation. Furthermore, a permanent "consultant panel" integrated by target groups representatives from different European countries are involved in key decisions and meetings, that guaranty a concrete regional scale participation. The present work reports the overall strategy of the project and the description of the main informatic tools that are under development and implementation in five pilot regions, located in Italy, Austria, Romania, Slovenia and Greece. Keywords: WFD Directive, RES-e Directive, water multi-purpose uses, renewable energy, small hydropower production, environmental balance, minimum environmental flow, flood protection

  6. [The Argentina State railroad and its contribution to science].

    PubMed

    Salerno, Elena

    2008-01-01

    In Argentina, the State financed, built, and ran government-own railroads based on recourse to subsidies until the first Yrigoyen administration (1916-1922), which introduced changes and shifted the direction of rail policy somewhat. The Ferrocarriles del Estado contributed to the development of science, created a demand for professionals which helped form the professional engineering field, and, by linking the capitals of central and northern provinces, facilitated both communications and scientific tasks themselves, especially research into diseases endemic to the country.

  7. The Opportunities and Challenges of Bringing New Metrology Equipment to Market

    NASA Astrophysics Data System (ADS)

    Perloff, David S.

    2005-09-01

    This paper provides an overview of the economic and technological factors which are driving the demand for new metrology and inspection equipment, the challenges and opportunities facing new companies in bringing such equipment to market, and the funding environment in which new companies must raise capital to finance their efforts. Seven metrology companies and one inspection equipment company that have received first-time venture backing since 2000 are used to illustrate how these specialized businesses are launched and funded.

  8. Lessons learned from new construction utility demand side management programs and their implications for implementing building energy codes

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

    Wise, B.K.; Hughes, K.R.; Danko, S.L.

    1994-07-01

    This report was prepared for the US Department of Energy (DOE) Office of Codes and Standards by the Pacific Northwest Laboratory (PNL) through its Building Energy Standards Program (BESP). The purpose of this task was to identify demand-side management (DSM) strategies for new construction that utilities have adopted or developed to promote energy-efficient design and construction. PNL conducted a survey of utilities and used the information gathered to extrapolate lessons learned and to identify evolving trends in utility new-construction DSM programs. The ultimate goal of the task is to identify opportunities where states might work collaboratively with utilities to promotemore » the adoption, implementation, and enforcement of energy-efficient building energy codes.« less

  9. Demand Response Compensation Methodologies: Case Studies for Mexico

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

    Gagne, Douglas A; Settle, Donald E; Aznar, Alexandra Y

    This report examines various compensation methodologies for demand response programs in Mexico. This report presents three case studies, including New England, California, and Hawaii. Demand response (DR) can refer to a variety of approaches to changing the amount and timing of customers' electricity use, allowing the electricity supplier to more easily balance electricity supply and demand. The level of compensation for a DR program will depend greatly upon both the regulatory context of the electricity supplier, as well as the economic circumstances of the DR providers. For a regulated utility, a proposed compensation level may need to pass regulatory approval.more » To determine the value of DR resources, a regulatory body typically seeks to determine the costs that the utility would avoid if demand-side resources 'produce' energy.« less

  10. Individual responsibility for what? - a conceptual framework for exploring the suitability of private financing in a publicly funded health-care system.

    PubMed

    Tinghog, Gustav; Carlsson, Per; Lyttkens, Carl H

    2010-04-01

    Policymakers in publicly funded health-care systems are frequently required to make intricate decisions on which health-care services to include or exclude from the basic health-care package. Although it seems likely that the concept of individual responsibility is an essential feature of such decisions, it is rarely explicitly articulated or evaluated in health policy. This paper presents a tentative conceptual framework for exploring when health-care services contain characteristics that facilitate individual responsibility through private financing. Six attributes for exploring the suitability of private financing for specific health-care commodities are identified: (i) it should enable individuals to value the need and quality both before and after utilization; (ii) it should be targeted toward individuals with a reasonable level of individual autonomy; (iii) it should be associated with low levels of positive externalities; (iv) it should be associated with a demand sufficient to generate a private market; (v) it should be associated with payments affordable for most individuals; and finally, (vi) it should be associated with 'lifestyle enhancements' rather than 'medical necessities'. The tentative framework enables exploration of individual responsibility connected to health care as a heterogeneous group of commodities, and allows policymakers to make decisions on rationing by design rather than default.

  11. Using the Existential Criterion for Assessing the Personality of Overprotective and Overly Demanding Parents in the Families of Patients Who Have Sought Psychological Counseling for Parent-Child Problems

    ERIC Educational Resources Information Center

    Kapustin, S. A.

    2016-01-01

    The article presents the results of applying the existential criterion of normal and abnormal personalities for assessing the personality of overprotective and overly demanding parents in 176 families of patients who have sought psychological counseling. It is shown that the position of overprotective parents is one-sided in relation to the…

  12. Participation in Non-Formal Learning in EU-15 and EU-8 Countries: Demand and Supply Side Factors

    ERIC Educational Resources Information Center

    Roosmaa, Eve-Liis; Saar, Ellu

    2012-01-01

    The main purpose of this paper is to provide an in-depth analysis of participation in non-formal learning in different European Union member states. The paper also seeks to extend analysis of the training gap by pursuing the distinction between the supply and the demand for skills. We use aggregate data from the Adult Education Survey (Eurostat)…

  13. Carbon and energy footprint of electrochemical vinegar wastewater treatment

    NASA Astrophysics Data System (ADS)

    Gerek, Emine Esra; Yilmaz, Seval; Savaş Koparal, A.; Nezih Gerek, Ömer

    2017-11-01

    Electrochemical treatment of wastewaters that are rich in organic compounds is a popular method, due to its acidic nature that avoids biological treatment. In many cases, the pollution hazard is considered as the chemical oxygen demand (COD) from active carbon, and the success of the treatment is measured in terms of how much this specific parameter is reduced. However, if electricity is used during the treatment process, the treatment "itself" has manufacturing and operational energy costs. Many of the studies consider energy utilization as a monetary cost, and try to reduce its amount. However, the energy cost of the treatment also causes emission of carbon at the energy producing side of the closed loop. This carbon emission can be converted into oxygen demand, too. Therefore, it can be argued that one must look for the total optimal carbon efficiency (or oxygen demand), while reducing the COD. We chose a highly acidic wastewater case of vinegar production, which is a popular food product in Turkey, to demonstrate the high energy consumption and carbon emission problem of the electrochemical treatment approach. A novel strategy is presented to monitor total oxygen demand simultaneously at the treatment and energy production sides. Necessity of renewable energy utilization and conditions on process termination points are discussed.

  14. The supply and demand for pollution control: Evidence from wastewater treatment

    USGS Publications Warehouse

    McConnell, V.D.; Schwarz, G.E.

    1992-01-01

    This paper analyzes the determination of pollution control from wastewater treatment plants as an economic decision facing local or regional regulators. Pollution control is measured by plant design effluent concentration levels and is fully endogenous in a supply- and-demand model of treatment choice. On the supply side, plant costs are a function of the design treatment level of the plant, and on the demand side, treatment level is a function of both the costs of control and the regional or regulatory preferences for control. We find evidence that the economic model of effluent choice by local regulators has a good deal of explanatory power. We find evidence that wastewater treatment plant removal of biological oxygen demand (BOD) is sensitive to many local factors including the size of the treatment plant, the flow rate of the receiving water, the population density of the surrounding area, regional growth, state sensitivity to environmental issues, state income, and the extent to which the damages from pollution fall on other states. We find strong evidence that regulators are sensitive to capital costs in determining the design level of BOD effluent reduction at a plant. Thus, proposed reductions in federal subsidies for wastewater treatment plant construction are likely to have significant adverse effects on water quality. ?? 1992.

  15. Encouraging the use of generic medicines: implications for transition economies.

    PubMed

    King, Derek R; Kanavos, Panos

    2002-08-01

    Generic drugs have a key role to play in the efficient allocation of financial resources for pharmaceutical medicines. Policies implemented in the countries with a high rate of generic drug use, such as Canada, Denmark, Germany, the Netherlands, the United Kingdom, and the United States, are reviewed, with consideration of the market structures that facilitate strong competition. Savings in these countries are realized through increases in the volume of generic drugs used and the frequently significant differences in the price between generic medicines and branded originator medicines. Their policy tools include the mix of supply-side measures and demand-side measures that are relevant for generic promotion and higher generic use. On the supply-side, key policy measures include generic drug marketing regulation that facilitates market entry soon after patent expiration, reference pricing, the pricing of branded originator products, and the degree of price competition in pharmaceutical markets. On the demand-side, measures typically encompass influencing prescribing and dispensing patterns as well as introducing a co-payment structure for consumers/patients that takes into consideration the difference in cost between branded and generic medicines. Quality of generic medicines is a pre-condition for all other measures discussed to take effect. The paper concludes by offering a list of policy options for decision-makers in Central and Eastern European economies in transition.

  16. Efforts to monitor Global progress on individual and community demand for immunization: Development of definitions and indicators for the Global Vaccine Action Plan Strategic Objective 2.

    PubMed

    Hickler, Benjamin; MacDonald, Noni E; Senouci, Kamel; Schuh, Holly B

    2017-06-16

    The Second Strategic Objective of the Global Vaccine Action Plan, "individuals and communities understand the value of vaccines and demand immunization as both their right and responsibility", differs from the other five in that it does not focus on supply-side aspects of immunization programs but rather on public demand for vaccines and immunization services. This commentary summarizes the work (literature review, consultations with experts, and with potential users) and findings of the UNICEF/World Health Organization Strategic Objective 2 informal Working Group on Vaccine Demand, which developed a definition for demand and indicators related to Strategic Objective 2. Demand for vaccines and vaccination is a complex concept that is not external to supply systems but rather encompasses the interaction between human behaviors and system structure and dynamics. Copyright © 2017. Published by Elsevier Ltd.

  17. The Production Rate and Employment of Ph.D. Astronomers

    NASA Astrophysics Data System (ADS)

    Metcalfe, Travis S.

    2008-02-01

    In an effort to encourage self-regulation of the astronomy job market, I examine the supply of, and demand for, astronomers over time. On the supply side, I document the production rate of Ph.D. astronomers from 1970 to 2006 using the UMI Dissertation Abstracts database, along with data from other independent sources. I compare the long-term trends in Ph.D. production with federal astronomy research funding over the same time period, and I demonstrate that additional funding is correlated with higher subsequent Ph.D. production. On the demand side, I monitor the changing patterns of employment using statistics about the number and types of jobs advertised in the AAS Job Register from 1984 to 2006. Finally, I assess the sustainability of the job market by normalizing this demand by the annual Ph.D. production. The most recent data suggest that there are now annual advertisements for about one postdoctoral job, half a faculty job, and half a research/support position for every new domestic Ph.D. recipient in astronomy and astrophysics. The average new astronomer might expect to hold up to 3 jobs before finding a steady position.

  18. Intermittent Renewable Management Pilot Phase 2

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

    Kiliccote, Sila; Homan, Gregory; Anderson, Robert

    The Intermittent Renewable Management Pilot - Phase 2 (IRM2) was designed to study the feasibility of demand-side resources to participate into the California Independent System Operator (CAISO) wholesale market as proxy demand resources (PDR). The pilot study focused on understanding the issues related with direct participation of third-parties and customers including customer acceptance; market transformation challenges (wholesale market, technology); technical and operational feasibility; and value to the rate payers, DR resource owners and the utility on providing an enabling mechanism for DR resources into the wholesale markets. The customer had the option of committing to either three contiguous hour blocksmore » for 24 days or six contiguous hours for 12 days a month with day-ahead notification that aligned with the CAISO integrated forward market. As a result of their being available, the customer was paid $10/ kilowatt (kW)-month for capacity in addition to CAISO energy settlements. The participants were limited to no more than a 2 megawatt (MW) capacity with a six-month commitment. Four participants successfully engaged in the pilot. In this report, we provide the description of the pilot, participant performance results, costs and value to participants as well as outline some of the issues encountered through the pilot. Results show that participants chose to participate with storage and the value of CAISO settlements were significantly lower than the capacity payments provided by the utility as incentive payments. In addition, this pilot revealed issues both on the participant side and system operations side. These issues are summarized in the report.The Intermittent Renewable Management Pilot - Phase 2 (IRM2) was designed to study the feasibility of demand-side resources to participate into the California Independent System Operator (CAISO) wholesale market as proxy demand resources (PDR). The pilot study focused on understanding the issues related with direct participation of third-parties and customers including customer acceptance; market transformation challenges (wholesale market, technology); technical and operational feasibility; and value to the rate payers, DR resource owners and the utility on providing an enabling mechanism for DR resources into the wholesale markets.« less

  19. A socio-technical investigation of the smart grid: Implications for demand-side activities of electricity service providers

    NASA Astrophysics Data System (ADS)

    Corbett, Jacqueline Marie

    Enabled by advanced communication and information technologies, the smart grid represents a major transformation for the electricity sector. Vast quantities of data and two-way communications abilities create the potential for a flexible, data-driven, multi-directional supply and consumption network well equipped to meet the challenges of the next century. For electricity service providers ("utilities"), the smart grid provides opportunities for improved business practices and new business models; however, a transformation of such magnitude is not without risks. Three related studies are conducted to explore the implications of the smart grid on utilities' demand-side activities. An initial conceptual framework, based on organizational information processing theory, suggests that utilities' performance depends on the fit between the information processing requirements and capacities associated with a given demand-side activity. Using secondary data and multiple regression analyses, the first study finds, consistent with OIPT, a positive relationship between utilities' advanced meter deployments and demand-side management performance. However, it also finds that meters with only data collection capacities are associated with lower performance, suggesting the presence of information waste causing operational inefficiencies. In the second study, interviews with industry participants provide partial support for the initial conceptual model, new insights are gained with respect to information processing fit and information waste, and "big data" is identified as a central theme of the smart grid. To derive richer theoretical insights, the third study employs a grounded theory approach examining the experience of one successful utility in detail. Based on interviews and documentary data, the paradox of dynamic stability emerges as an essential enabler of utilities' performance in the smart grid environment. Within this context, the frames of opportunity, control, and data limitation interact to support dynamic stability and contribute to innovation within tradition. The main contributions of this thesis include theoretical extensions to OIPT and the development of an emergent model of dynamic stability in relation to big data. The thesis also adds to the green IS literature and identifies important practical implications for utilities as they endeavour to bring the smart grid to reality.

  20. Synthesis of 3,4-dihydro-1,8-naphthyridin-2(1H)-ones via microwave-activated inverse electron-demand Diels–Alder reactions

    PubMed Central

    Fadel, Salah; Hajbi, Youssef; Khouili, Mostafa; Lazar, Said

    2014-01-01

    Summary Substituted 3,4-dihydro-1,8-naphthyridin-2(1H)-ones have been synthesized with the inverse electron-demand Diels–Alder reaction from 1,2,4-triazines bearing an acylamino group with a terminal alkyne side chain. Alkynes were first subjected to the Sonogashira cross-coupling reaction with aryl halides, the product of which then underwent an intramolecular inverse electron-demand Diels–Alder reaction to yield 5-aryl-3,4-dihydro-1,8-naphthyridin-2(1H)-ones by an efficient synthetic route. PMID:24605148

  1. Synthesis of 3,4-dihydro-1,8-naphthyridin-2(1H)-ones via microwave-activated inverse electron-demand Diels-Alder reactions.

    PubMed

    Fadel, Salah; Hajbi, Youssef; Khouili, Mostafa; Lazar, Said; Suzenet, Franck; Guillaumet, Gérald

    2014-01-01

    Substituted 3,4-dihydro-1,8-naphthyridin-2(1H)-ones have been synthesized with the inverse electron-demand Diels-Alder reaction from 1,2,4-triazines bearing an acylamino group with a terminal alkyne side chain. Alkynes were first subjected to the Sonogashira cross-coupling reaction with aryl halides, the product of which then underwent an intramolecular inverse electron-demand Diels-Alder reaction to yield 5-aryl-3,4-dihydro-1,8-naphthyridin-2(1H)-ones by an efficient synthetic route.

  2. Workforce Projections 2010-2020: Annual Supply and Demand Forecasting Models for Physical Therapists Across the United States.

    PubMed

    Landry, Michel D; Hack, Laurita M; Coulson, Elizabeth; Freburger, Janet; Johnson, Michael P; Katz, Richard; Kerwin, Joanne; Smith, Megan H; Wessman, Henry C Bud; Venskus, Diana G; Sinnott, Patricia L; Goldstein, Marc

    2016-01-01

    Health human resources continue to emerge as a critical health policy issue across the United States. The purpose of this study was to develop a strategy for modeling future workforce projections to serve as a basis for analyzing annual supply of and demand for physical therapists across the United States into 2020. A traditional stock-and-flow methodology or model was developed and populated with publicly available data to produce estimates of supply and demand for physical therapists by 2020. Supply was determined by adding the estimated number of physical therapists and the approximation of new graduates to the number of physical therapists who immigrated, minus US graduates who never passed the licensure examination, and an estimated attrition rate in any given year. Demand was determined by using projected US population with health care insurance multiplied by a demand ratio in any given year. The difference between projected supply and demand represented a shortage or surplus of physical therapists. Three separate projection models were developed based on best available data in the years 2011, 2012, and 2013, respectively. Based on these projections, demand for physical therapists in the United States outstrips supply under most assumptions. Workforce projection methodology research is based on assumptions using imperfect data; therefore, the results must be interpreted in terms of overall trends rather than as precise actuarial data-generated absolute numbers from specified forecasting. Outcomes of this projection study provide a foundation for discussion and debate regarding the most effective and efficient ways to influence supply-side variables so as to position physical therapists to meet current and future population demand. Attrition rates or permanent exits out of the profession can have important supply-side effects and appear to have an effect on predicting future shortage or surplus of physical therapists. © 2016 American Physical Therapy Association.

  3. [Structural quality in psychiatric and psychotherapeutic hospitals].

    PubMed

    Klimke, A; Godemann, F; Hauth, I; Deister, A

    2015-05-01

    The new German flat rate reimbursement system for psychiatry and psychosomatics (PEPP) is primarily based on the diagnostic classification and the costs of therapeutic processes. In 2019 the current normative standard for calculating the therapeutic staff in psychiatric clinics (Psych-PV) will be substituted by a stepwise adaptation process over 5 years. Using regionally calculated remuneration factors, all clinic budgets should eventually converge to comparable values. Major factors influencing the structural quality of therapy in psychiatric clinics are identified and recommendations are given to support the work of the Federal Joint Committee (G-BA) which has been appointed to develop new recommendations for the minimum setting of personnel requirements. The full reimbursement of the necessary staff and of the costs resulting from outsourcing of day clinics and outpatient departments in the community, including the obligation to treat psychiatric emergency patients is mandatory and currently not sufficiently guaranteed in the new PEPP system. A workflow which opens the possibility to finance therapeutic innovations (e.g. psychotherapy) and helps to overcome the financial sectorial boundaries between inpatient and outpatient treatment is also missing. A mandatory recommendation for minimum staff settings needs a guaranteed full financing from the political side. Additionally, important would be an option for financing of therapeutic innovations and increased costs because of changed patient structures with respect to diagnosis and severity. Moreover, a sufficient remuneration for regional treatment responsibilities and for additional financial outlay resulting from structural costs for regionally outsourced departments is needed to avoid supplementary financing by reducing the budget for the therapeutic staff.

  4. Access to medicines from a health system perspective

    PubMed Central

    Bigdeli, Maryam; Jacobs, Bart; Tomson, Goran; Laing, Richard; Ghaffar, Abdul; Dujardin, Bruno; Van Damme, Wim

    2013-01-01

    Most health system strengthening interventions ignore interconnections between systems components. In particular, complex relationships between medicines and health financing, human resources, health information and service delivery are not given sufficient consideration. As a consequence, populations' access to medicines (ATM) is addressed mainly through fragmented, often vertical approaches usually focusing on supply, unrelated to the wider issue of access to health services and interventions. The objective of this article is to embed ATM in a health system perspective. For this purpose, we perform a structured literature review: we examine existing ATM frameworks, review determinants of ATM and define at which level of the health system they are likely to occur; we analyse to which extent existing ATM frameworks take into account access constraints at different levels of the health system. Our findings suggest that ATM barriers are complex and interconnected as they occur at multiple levels of the health system. Existing ATM frameworks only partially address the full range of ATM barriers. We propose three essential paradigm shifts that take into account complex and dynamic relationships between medicines and other components of the health system. A holistic view of demand-side constraints in tandem with consideration of multiple and dynamic relationships between medicines and other health system resources should be applied; it should be recognized that determinants of ATM are rooted in national, regional and international contexts. These are schematized in a new framework proposing a health system perspective on ATM. PMID:23174879

  5. Effects of knowing the task duration on players' pacing patterns during soccer small-sided games.

    PubMed

    Ferraz, Ricardo; Gonçalves, Bruno; Van Den Tillaar, Roland; Jiménez Sáiz, Sergio; Sampaio, Jaime; Marques, Mário C

    2018-01-01

    The aim of this study was to identify the influence of prior knowledge of exercise duration on players' pacing patterns during soccer small-sided games. Twenty semi-professional male soccer players participated in this study. In the first game scenario, players were not informed how long they would be required to play the small-sided game and the activity was terminated after 20 min (Unknown Condition). In the second game scenario, players were told that they would play the small-sided game for 10 min, but immediately after completing the 10-min game, they were asked to complete another 10 min (Partially Condition). In the third game scenario, players were instructed that they would play the small-sided game for 20 min and then they completed the 20-min game (Known Condition). The results presented a tendency of higher values in all performance variables in the [0'-10'] min compared with the [10'-20'] min. As the players' previous knowledge about the tasks duration increased, the performance between two moments tended to be similar. Considering the entire 20-min game duration, the Partially Condition of the exercise was the most demanding condition. In conclusion, the knowledge of shorter durations of the exercise seems to lead to an increase of exercise duration demand, and longer exercise durations possibly tend to decrease differences between full knowledge and not knowing the exercise duration.

  6. Laparoscopic cholecystectomy poses physical injury risk to surgeons: analysis of hand technique and standing position.

    PubMed

    Youssef, Yassar; Lee, Gyusung; Godinez, Carlos; Sutton, Erica; Klein, Rosemary V; George, Ivan M; Seagull, F Jacob; Park, Adrian

    2011-07-01

    This study compares surgical techniques and surgeon's standing position during laparoscopic cholecystectomy (LC), investigating each with respect to surgeons' learning, performance, and ergonomics. Little homogeneity exists in LC performance and training. Variations in standing position (side-standing technique vs. between-standing technique) and hand technique (one-handed vs. two-handed) exist. Thirty-two LC procedures performed on a virtual reality simulator were video-recorded and analyzed. Each subject performed four different procedures: one-handed/side-standing, one-handed/between-standing, two-handed/side-standing, and two-handed/between-standing. Physical ergonomics were evaluated using Rapid Upper Limb Assessment (RULA). Mental workload assessment was acquired with the National Aeronautics and Space Administration-Task Load Index (NASA-TLX). Virtual reality (VR) simulator-generated performance evaluation and a subjective survey were analyzed. RULA scores were consistently lower (indicating better ergonomics) for the between-standing technique and higher (indicating worse ergonomics) for the side-standing technique, regardless of whether one- or two-handed. Anatomical scores overall showed side-standing to have a detrimental effect on the upper arms and trunk. The NASA-TLX showed significant association between the side-standing position and high physical demand, effort, and frustration (p<0.05). The two-handed technique in the side-standing position required more effort than the one-handed (p<0.05). No difference in operative time or complication rate was demonstrated among the four procedures. The two-handed/between-standing method was chosen as the best procedure to teach and standardize. Laparoscopic cholecystectomy poses a risk of physical injury to the surgeon. As LC is currently commonly performed in the United States, the left side-standing position may lead to increased physical demand and effort, resulting in ergonomically unsound conditions for the surgeon. Though further investigations should be conducted, adopting the between-standing position deserves serious consideration as it may be the best short-term ergonomic alternative.

  7. Proceedings of the conference on alternative energy sources for Texas

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

    Rothman, I.N.

    1981-01-01

    Four primary areas of study for alternative energy sources for Texas are considered. These are: energy demand supply and economics; prospects for energy resources (oil, lignite, coal, nuclear, goethermal and solar) and conservation; financial and technical constraints; and future planning. The following papers are presented: US energy outlook to 1990; energy supply and demand projections; comparative economics of solar energy in the generation of big power; gas present and future prospects; prospects for enhanced recovery of oil in Texas; the outlook for coal in USA; implementation of nuclear power in Texas; future outlook - geopressured-geothermal energy for Texas; future prospectsmore » for conservation and solar energy; financing and money supply constraints; technical constraints to energy supply increase; planning for the future - the crisis that drones on. Two papers have been abstracted separately.« less

  8. Letter from America: UK and US state-funded dental provision.

    PubMed

    Currie, R B; Pretty, I A; Tickle, M; Maupomé, G

    2012-12-01

    Current UK and US economic conditions have re-focussed attention on the need to deliver dental care with limited finance and resources. This raises hard questions determining which services will be offered and what they should achieve to satisfy public demands and needs. We consider impending dental health reforms in the US and UK within the context of contemporary experiences to identify issues and delivery goals for the two nations. The paper provides a brief history and background of the development of social dental care models in the UK and US, highlighting some differences in state-funded delivery of dental care. SHIFTING DEMAND: From the 1950s, demand for dental treatment has increased and acquired a more complex composition growing from predominantly surgical and restorative treatment to encompass preventive care and cosmetic services. PRIORITISING CARE ACCORDING TO NEED: Despite improvements in general health and technology, inequalities in access and utilisation of dental care are still experienced, primarily by groups with low socio-economic status. DELIVERY: BALANCING RESOURCES, DEMAND AND NEED: In developing and delivering reform agendas, much can be learned from previous policy interventions. Pressures of cost, coverage, and capacity, besides demand versus need must be carefully considered and balanced to deliver quality service and value for users and taxpayers. Ethical and moral consideration should be given to making services needs-driven to address high treatment requirements rather than the high care demands of the worried well. This challenge brings the additional political pressure of convincing many of the voters (and subsequent complainers) that their demands may be less important than the needs of others.

  9. EM&V for Energy Efficiency Policies and Initiatives

    EPA Pesticide Factsheets

    Learn how representatives of jurisdictions, companies, and other entities can use evaluation, measurement, and verification (EM&V) in demand-side energy efficiency (EE) investments to achieve intended environmental, energy, and economic goals.

  10. Co-Optimization of Electricity Transmission and Generation Resources for Planning and Policy Analysis: Review of Concepts and Modeling Approaches

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

    Krishnan, Venkat; Ho, Jonathan; Hobbs, Benjamin F.

    2016-05-01

    The recognition of transmission's interaction with other resources has motivated the development of co-optimization methods to optimize transmission investment while simultaneously considering tradeoffs with investments in electricity supply, demand, and storage resources. For a given set of constraints, co-optimized planning models provide solutions that have lower costs than solutions obtained from decoupled optimization (transmission-only, generation-only, or iterations between them). This paper describes co-optimization and provides an overview of approaches to co-optimizing transmission options, supply-side resources, demand-side resources, and natural gas pipelines. In particular, the paper provides an up-to-date assessment of the present and potential capabilities of existing co-optimization tools, andmore » it discusses needs and challenges for developing advanced co-optimization models.« less

  11. Future directions: Integrated resource planning

    NASA Astrophysics Data System (ADS)

    Bauer, D. C.; Eto, J.

    Integrated resource planning or IRP is the process for integrating supply- and demand-side resources to provide energy services at a cost that balances the interests of all stakeholders. It now is the resource planning process used by electric utilities in over 30 states. The goals of IRP have evolved from least cost planning and encouragement of demand-side management to broader, more complex issues including core competitive business activity, risk management and sharing, accounting for externalities, and fuel switching between gas and electricity. IRP processes are being extended to other interior regions of the country, to non-investor owned utilities, and to regional (rather than individual utility) planning bases, and to other fuels (natural gas). The comprehensive, multi-valued, and public reasoning characteristics of IRP could be extended to applications beyond energy, e.g., transportation, surface water management, and health care in ways suggested.

  12. JPRS Report West Europe

    DTIC Science & Technology

    1988-08-01

    least; but my partners will have to respect the points I value. [LE SOIR] You once compared Martens to Caligula , and here you are working side by...side with him! [Louis Tobback] I even said that Martens was worse than Caligula . But I was not comparing people, and those who only remember...to ratify a special powers act and then demanded it be ratified because the Council of State said so. Caligula once made the Roman Senate appoint

  13. Demand assessment and price-elasticity estimation of quality-improved primary health care in Palestine: a contribution from the contingent valuation method.

    PubMed

    Mataria, Awad; Luchini, Stéphane; Daoud, Yousef; Moatti, Jean-Paul

    2007-10-01

    This paper proposes a new methodology to assess demand and price-elasticity for health care, based on patients' stated willingness to pay (WTP) values for certain aspects of health care quality improvements. A conceptual analysis of how respondents consider contingent valuation (CV) questions allowed us to specify a probability density function of stated WTP values, and consequently, to model a demand function for quality-improved health care, using a parametric survival approach. The model was empirically estimated using a CV study intended to assess patients' values for improving the quality of primary health care (PHC) services in Palestine. A random sample of 499 individuals was interviewed following medical consultation in four PHC centers. Quality was assessed using a multi-attribute approach; and respondents valued seven specific quality improvements using a decomposed valuation scenario and a payment card elicitation technique. Our results suggest an inelastic demand at low user fees levels, and when the price-increase is accompanied with substantial quality-improvements. Nevertheless, demand becomes more and more elastic if user fees continue to rise. On the other hand, patients' reactions to price-increase turn out to depend on their level of income. Our results can be used to design successful health care financing strategies that include a consideration of patients' preferences and financial capacities. John Wiley & Sons, Ltd.

  14. Role of Global Alliance for Vaccines and Immunization (GAVI) in Accelerating Inactivated Polio Vaccine Introduction.

    PubMed

    Thacker, Naveen; Thacker, Deep; Pathak, Ashish

    2016-08-07

    Global Alliance for Vaccines and Immunization (GAVI, the Vaccine Alliance) is an international organization built through public-private partnership. GAVI has supported more than 200 vaccine introductions in the last 5 years by financing major proportion of costs of vaccine to 73 low-income countries using a co-financing model. GAVI has worked in close co-ordination with Global Polio Eradication Initiative (GPEI) since 2013, to strengthen health systems in countries so as to accelerate introduction of inactivated polio vaccine (IPV). GAVI is involved in many IPV related issues like demand generation, supply, market shaping, communications, country readiness etc. Most of the 73 GAVI eligible countries are also high priority countries for GPEI. GAVI support has helped India to accelerate introduction of IPV in all its states. However, GAVI faces challenges in IPV supply-related issues in the near future. It also needs to play a key role in global polio legacy planning and implementation.

  15. Financing nutrition services in a competitive market.

    PubMed

    Egan, M C; Kaufman, M

    1985-02-01

    Budget deficits and inflationary medical care costs threaten nutrition services, which until recently have been funded largely by federal, state, and local revenues. Nutritionists and dietitians responding to demands in the marketplace should develop innovative programs and pursue new sources for financing through the private sector, third-party payers, business/industry health promotion, and consumer fees for their services, as well as targeted federal, state, and locally funded food assistance, nutrition education, and health care programs. Trail-blazing dietitians are successfully offering their services in health maintenance organizations (HMOs), hospital or industry fitness programs, private practice, voluntary health agencies, and official agency programs. With the new federalism, nutritionists must articulate their role in comprehensive health care and market their services at the state and local levels in addition to the federal level. Nutrition services are defined to include assessment, planning, counseling, education, and referral to supportive agencies. Data management, managerial, and marketing skills must be developed for dietitians to compete effectively. Basic educational preparation and continuing education for practicing professionals must develop these competencies.

  16. The quotient of normal random variables and application to asset price fat tails

    NASA Astrophysics Data System (ADS)

    Caginalp, Carey; Caginalp, Gunduz

    2018-06-01

    The quotient of random variables with normal distributions is examined and proven to have power law decay, with density f(x) ≃f0x-2, with the coefficient depending on the means and variances of the numerator and denominator and their correlation. We also obtain the conditional probability densities for each of the four quadrants given by the signs of the numerator and denominator for arbitrary correlation ρ ∈ [ - 1 , 1) . For ρ = - 1 we obtain a particularly simple closed form solution for all x ∈ R. The results are applied to a basic issue in economics and finance, namely the density of relative price changes. Classical finance stipulates a normal distribution of relative price changes, though empirical studies suggest a power law at the tail end. By considering the supply and demand in a basic price change model, we prove that the relative price change has density that decays with an x-2 power law. Various parameter limits are established.

  17. Shifting the burden of health care finance: a case study of public-private partnership in Singapore.

    PubMed

    Lim, Meng-Kin

    2004-07-01

    Since becoming independent in 1965, Singapore has attained high standards in health care provision while successfully transferring a substantial portion of the health care burden to the private sector. The government's share of total health care expenditure contracted from 50% in 1965 to 25% in 2000. At first glance, the efficiency-driven health care financing reforms which emphasize individual over state responsibility appear to have been implemented at the expense of equity. On closer examination, however, Singaporeans themselves seem unconcerned about any perceived inequity of the system. Indeed, they appear content to pay part of their medical expenses, plus additional monies if they demand a higher level of services. In fact, access to needed care for the poor is explicitly guaranteed. Mechanisms also exist to protect against financial impoverishment resulting from catastrophic illness. Singapore's experience provides an interesting case study in public-private partnership, illustrating how a hard-headed approach to health policy can achieve national health goals while balancing efficiency and equity concerns.

  18. Water resources of southeastern Oahu, Hawaii

    USGS Publications Warehouse

    Takasaki, K.J.; Mink, John F.

    1982-01-01

    Southeastern Oahu comprises the eastern end of the Koolau Range and is divided into two roughly equal parts by the crest of the range. The northside of the crest is commonly called the windward side and the southside, the leeward. Precipitous cliffs aproned by a gently sloping landscape are the main topographic features on the windward side. The leeward side is a gentle lava-flow slope incised by steep narrow valleys. The main Koolau fissure zone, including the caldera, lies on the windward side. The leeward side includes minor rift zones that are perpendicular to and intersect the main fissure zone. Dikes in the main fissure zone strike from nearly east-west in the eastern end to about N. 55? W. in the western part. Dikes in the minor rift zones strike from north-south to slightly northeasterly. Water use is about 18 Mgal/d (million gallons per day) of which only 4 Mgal/d is obtained locally from ground-water sources. About a third of the 14 Mgal/d deficit is imported from sources northwest of the study area on the windward side and the remainder from sources in the Honolulu and Pearl Harbor areas on the leeward side. The 4 Mgal/d being developed represents only about 3 percent of the area's rainfall compared to a development-rainfall ratio of 20 percent for the rest of the island. Streams are short and flashy. Perennial streamflow to the sea occurs only in Maunawili Valley and in the Waimanalo area. Mean annual discharge is estimated at 20 Mgal/d in the windward side and at 15 Mgal/d on the leeward side. Low flow, expressed as the flow that is equaled or exceeded 90 percent of the time, is 5 Mgal/d windward of the crest and zero leeward of it. Most fresh ground water occurs in lava flows of the Koolau Volcanics. It is impounded by dikes in the rift zones and floats on saline ground water as lenses outside the rift zones. Small but important bodies of freshwater are perched in volcanic rocks of the Honolulu Group in Maunawili Valley. Fresh ground water occurs in near-shore calcareous sands that overlie a clay horizon in the Waimanalo area. Deeply buried talus and alluvium also carry fresh ground water in the Waimanalo area. Wells tapping saline ground water in fresh lava flows of the Honolulu Group provide water for a sea-life park in the Makapuu area. The same aquifer is tapped by wells for disposal of the saline waste water. The current development scheme in the windward side that utilizes only the free-flow equilibrium discharge of dike-impounded water is inefficient and does not cope with the annual weather cycle. The flow available for development under this scheme is greatest in the rainy winter months when demand is the lowest and least in the summer months when demand is the highest. A more optimal scheme would be to change this natural flow pattern by depleting storage by pumping to increase flow in the high-demand summer months and allowing the depleted storage to recover naturally in the low-demand winter months. Depleting storage would lower water levels which would provide more room for infiltration and provide less opportunity for evapotranspiration. The basal-water reservoir in the leeward side is isolated hydrologically from abutting reservoirs outside the area and can and should be fully exploited. The existing development of the basal-water reservoir is small compared to the natural ground-water flow and that part not being developed is wasting to the sea. Because the area is hydrologically isolated, development will not be detrimental to or reduce the ground-water supply outside the area.

  19. Benchmark of Client and Server-Side Catchment Delineation Approaches on Web-Based Systems

    NASA Astrophysics Data System (ADS)

    Demir, I.; Sermet, M. Y.; Sit, M. A.

    2016-12-01

    Recent advances in internet and cyberinfrastructure technologies have provided the capability to acquire large scale spatial data from various gauges and sensor networks. The collection of environmental data increased demand for applications which are capable of managing and processing large-scale and high-resolution data sets. With the amount and resolution of data sets provided, one of the challenging tasks for organizing and customizing hydrological data sets is delineation of watersheds on demand. Watershed delineation is a process for creating a boundary that represents the contributing area for a specific control point or water outlet, with intent of characterization and analysis of portions of a study area. Although many GIS tools and software for watershed analysis are available on desktop systems, there is a need for web-based and client-side techniques for creating a dynamic and interactive environment for exploring hydrological data. In this project, we demonstrated several watershed delineation techniques on the web with various techniques implemented on the client-side using JavaScript and WebGL, and on the server-side using Python and C++. We also developed a client-side GPGPU (General Purpose Graphical Processing Unit) algorithm to analyze high-resolution terrain data for watershed delineation which allows parallelization using GPU. The web-based real-time analysis of watershed segmentation can be helpful for decision-makers and interested stakeholders while eliminating the need of installing complex software packages and dealing with large-scale data sets. Utilization of the client-side hardware resources also eliminates the need of servers due its crowdsourcing nature. Our goal for future work is to improve other hydrologic analysis methods such as rain flow tracking by adapting presented approaches.

  20. Moving Toward Universal Health Coverage (UHC) to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience

    PubMed Central

    Xu, Ye; Huang, Cheng; Colón-Ramos, Uriyoán

    2015-01-01

    Binagwaho and colleagues’ perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries’ health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies. PMID:26673477

  1. Issues facing the future health care workforce: the importance of demand modelling

    PubMed Central

    Segal, Leonie; Bolton, Tom

    2009-01-01

    This article examines issues facing the future health care workforce in Australia in light of factors such as population ageing. It has been argued that population ageing in Australia is affecting the supply of health care professionals as the health workforce ages and at the same time increasing the demand for health care services and the health care workforce. However, the picture is not that simple. The health workforce market in Australia is influenced by a wide range of factors; on the demand side by increasing levels of income and wealth, emergence of new technologies, changing disease profiles, changing public health priorities and a focus on the prevention of chronic disease. While a strong correlation is observed between age and use of health care services (and thus health care workforce), this is mediated through illness, as typified by the consistent finding of higher health care costs in the months preceding death. On the supply side, the health workforce is highly influenced by policy drivers; both national policies (eg funded education and training places) and local policies (eg work place-based retention policies). Population ageing and ageing of the health workforce is not a dominant influence. In recent years, the Australian health care workforce has grown in excess of overall workforce growth, despite an ageing health workforce. We also note that current levels of workforce supply compare favourably with many OECD countries. The future of the health workforce will be shaped by a number of complex interacting factors. Market failure, a key feature of the market for health care services which is also observed in the health care labour market – means that imbalances between demand and supply can develop and persist, and suggests a role for health workforce planning to improve efficiency in the health services sector. Current approaches to health workforce planning, especially on the demand side, tend to be highly simplistic. These include historical allocation methods, such as the personnel-to-population ratios which are essentially circular in their rationale rather than evidence-based. This article highlights the importance of evidence-based demand modelling for those seeking to plan for the future Australian health care workforce. A model based on population health status and best practice protocols for health care is briefly outlined. PMID:19422686

  2. Issues facing the future health care workforce: the importance of demand modelling.

    PubMed

    Segal, Leonie; Bolton, Tom

    2009-05-07

    This article examines issues facing the future health care workforce in Australia in light of factors such as population ageing. It has been argued that population ageing in Australia is affecting the supply of health care professionals as the health workforce ages and at the same time increasing the demand for health care services and the health care workforce.However, the picture is not that simple. The health workforce market in Australia is influenced by a wide range of factors; on the demand side by increasing levels of income and wealth, emergence of new technologies, changing disease profiles, changing public health priorities and a focus on the prevention of chronic disease. While a strong correlation is observed between age and use of health care services (and thus health care workforce), this is mediated through illness, as typified by the consistent finding of higher health care costs in the months preceding death.On the supply side, the health workforce is highly influenced by policy drivers; both national policies (eg funded education and training places) and local policies (eg work place-based retention policies). Population ageing and ageing of the health workforce is not a dominant influence. In recent years, the Australian health care workforce has grown in excess of overall workforce growth, despite an ageing health workforce. We also note that current levels of workforce supply compare favourably with many OECD countries. The future of the health workforce will be shaped by a number of complex interacting factors.Market failure, a key feature of the market for health care services which is also observed in the health care labour market - means that imbalances between demand and supply can develop and persist, and suggests a role for health workforce planning to improve efficiency in the health services sector. Current approaches to health workforce planning, especially on the demand side, tend to be highly simplistic. These include historical allocation methods, such as the personnel-to-population ratios which are essentially circular in their rationale rather than evidence-based. This article highlights the importance of evidence-based demand modelling for those seeking to plan for the future Australian health care workforce. A model based on population health status and best practice protocols for health care is briefly outlined.

  3. Response of Bean (Vicia faba L.) Plants to Low Sink Demand by Measuring the Gas Exchange Rates and Chlorophyll a Fluorescence Kinetics

    PubMed Central

    Liu, Guo-Tian; Xu, Hong-Guo; Wang, Li-Jun; Li, Shao-Hua

    2013-01-01

    Background The decline of photosynthesis in plants under low sink demand is well known. Previous studies focused on the relationship between stomatal conductance (g s) and net photosynthetic rate (P n). These studies investigated the effect of changes in Photosystem II (PSII) function on the P n decline under low sink demand. However, little is known about its effects on different limiting steps of electron transport chain in PSII under this condition. Methodology/Principal Finding Two-month-old bean plants were processed by removing pods and flowers (low sink demand). On the 1st day after low sink demand treatment, a decline of P n was accompanied by a decrease in g s and internal-to-ambient CO2 concentration ratio (C i/C a). From the 3rd to 9th day, P n and g s declined continuously while C i/C a ratio remained stable in the treatment. Moreover, these values were lower than that of control. Wk (a parameter reflecting the damage to oxygen evolving complex of the donor side of PSII) values in the treatment were significantly higher than their corresponding control values. However, RCQA (a parameter reflecting the number of active RCs per excited cross-section of PSII) values in the treatment were significantly lower than control from the 5th day. From the 11th to 21st day, P n and g s of the treatment continued to decline and were lower than control. This was accompanied by a decrease of RCQA, and an increase of Wk. Furthermore, the quantum yield parameters φ Po, φ Eo and ψ Eo in the treatment were lower than in control; however, C i/C a values in the treatment gradually increased and were significantly higher than control on the 21st day. Conclusions Stomatal limitation during the early stage, whereas a combination of stomatal and non-stomatal limitation during the middle stage might be responsible for the reduction of P n under low sink demand. Non-stomatal limitation during the late stages after the removal of the sink of roots and pods may also cause P n reduction. The non-stomatal limitation was associated with the inhibition of PSII electron transport chain. Our data suggests that the donor side of PSII was the most sensitive to low sink demand followed by the reaction center of PSII. The acceptor side of PSII may be the least sensitive. PMID:24324626

  4. Supply- and Demand-Side Factors Influencing Utilization of Infant and Young Child Feeding Counselling Services in Viet Nam.

    PubMed

    Nguyen, Phuong H; Kim, Sunny S; Nguyen, Tuan T; Tran, Lan M; Hajeebhoy, Nemat; Frongillo, Edward A; Ruel, Marie T; Rawat, Rahul; Menon, Purnima

    2016-01-01

    Adequate utilization of services is critical to maximize the impact of counselling on infant and young child feeding (IYCF), but little is known about factors affecting utilization. Our study examined supply- and demand-side factors associated with the utilization of IYCF counselling services in Viet Nam. We used survey data from mothers with children <2y (n = 1,008) and health staff (n = 60) from the evaluation of a program that embedded IYCF counseling into the existing government health system. The frequency of never users, one-time users, repeat users, and achievers of the recommended minimum number of visits at health facilities were 45.1%, 13.0%, 28.4% and 13.5%, respectively. Poisson regression showed that demand-generation strategies, especially invitation cards, were the key factors determining one-time use (Prevalence ratio, PR 3.0, 95% CI: 2.2-4.2), repeated use (PR 3.2, 95% CI: 2.4-4.2), and achievement of minimum visits (PR 5.5, 95% CI: 3.6-8.4). Higher maternal education was associated with higher utilization both for one-time and repeated use. Being a farmer, belonging to an ethnic minority, and having a wasted child were associated with greater likelihood of achieving the minimum recommended number of visits, whereas child stunting or illness were not. Distance to health center was a barrier to repeated visits. Among supply-side factors, good counselling skills (PR: 1.3-1.8) was the most important factor associated with any service use, whereas longer employment duration and greater work pressure of health center staff were associated with lower utilization. Population attributable risk estimations showed that an additional 25% of the population would have achieved the minimum number of visits if exposed to three demand-generation strategies, and further increased to 49% if the health staff had good counseling skills and low work pressure. Our study provides evidence that demand-generation strategies are essential to increase utilization of facility-based IYCF counselling services in Viet Nam, and may be relevant for increasing and sustaining use of nutrition services in similar contexts.

  5. Supply- and Demand-Side Factors Influencing Utilization of Infant and Young Child Feeding Counselling Services in Viet Nam

    PubMed Central

    Nguyen, Phuong H.; Kim, Sunny S.; Nguyen, Tuan T.; Tran, Lan M.; Hajeebhoy, Nemat; Frongillo, Edward A.; Ruel, Marie T.; Rawat, Rahul; Menon, Purnima

    2016-01-01

    Adequate utilization of services is critical to maximize the impact of counselling on infant and young child feeding (IYCF), but little is known about factors affecting utilization. Our study examined supply- and demand-side factors associated with the utilization of IYCF counselling services in Viet Nam. We used survey data from mothers with children <2y (n = 1,008) and health staff (n = 60) from the evaluation of a program that embedded IYCF counseling into the existing government health system. The frequency of never users, one-time users, repeat users, and achievers of the recommended minimum number of visits at health facilities were 45.1%, 13.0%, 28.4% and 13.5%, respectively. Poisson regression showed that demand-generation strategies, especially invitation cards, were the key factors determining one-time use (Prevalence ratio, PR 3.0, 95% CI: 2.2–4.2), repeated use (PR 3.2, 95% CI: 2.4–4.2), and achievement of minimum visits (PR 5.5, 95% CI: 3.6–8.4). Higher maternal education was associated with higher utilization both for one-time and repeated use. Being a farmer, belonging to an ethnic minority, and having a wasted child were associated with greater likelihood of achieving the minimum recommended number of visits, whereas child stunting or illness were not. Distance to health center was a barrier to repeated visits. Among supply-side factors, good counselling skills (PR: 1.3–1.8) was the most important factor associated with any service use, whereas longer employment duration and greater work pressure of health center staff were associated with lower utilization. Population attributable risk estimations showed that an additional 25% of the population would have achieved the minimum number of visits if exposed to three demand-generation strategies, and further increased to 49% if the health staff had good counseling skills and low work pressure. Our study provides evidence that demand-generation strategies are essential to increase utilization of facility-based IYCF counselling services in Viet Nam, and may be relevant for increasing and sustaining use of nutrition services in similar contexts. PMID:26962856

  6. City of San Antonio, Texas Better Buildings Program

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

    Meyer, Liza C.; Hammer, Mary C.

    2014-06-30

    The San Antonio Better Buildings Program is a unified single-point-of-service energy efficiency delivery mechanism targeting residential, commercial, institutional, industrial and public buildings. This comprehensive and replicable energy efficiency program is designed to be an effective demand side management initiative to provide a seamless process for program participants to have turn-key access to expert analysis, support and incentives to improve the performance of their in-place energy using systems, while reducing electrical energy use and demand.

  7. Assessing demand-side barriers to uptake of intermittent preventive treatment for malaria in pregnancy: a qualitative study in two regions of Uganda.

    PubMed

    Rassi, Christian; Graham, Kirstie; King, Rebecca; Ssekitooleko, James; Mufubenga, Patrobas; Gudoi, Sam Siduda

    2016-11-04

    To prevent malaria infection during pregnancy in endemic areas in Africa, the World Health Organization recommends the administration of intermittent preventive treatment in pregnancy (IPTp) as part of the focused antenatal care package. However, IPTp uptake in most countries remains low despite generally high antenatal care coverage and increased efforts by governments to address known bottlenecks such as drug stock-outs. The study explored factors that continue to impede uptake of IPTp among women who attend antenatal care. This paper focuses on demand-side barriers with regard to accessibility, affordability and acceptability. The research was conducted in 2013/2014 and involved 46 in-depth interviews with four types of respondents: (i) seven district health officials; (ii) 15 health workers; (iii) 19 women who attended antenatal care; (iv) five opinion leaders. Interviews were conducted in Eastern and West Nile regions of Uganda. Data was analysed by thematic analysis. District health officials and health workers cited a range of barriers relating to knowledge and attitudes among pregnant women, including lack of awareness of pregnancy-related health risks, a tendency to initiate antenatal care late, reluctance to take medication and concerns about side effects of IPTp. However, women and opinion leaders expressed very positive views of antenatal care and IPTp. They also reported that the burden of travel and cost associated with antenatal care attendance was challenging, but did not keep them from accessing a service they perceived as beneficial. The role of trust in health workers' expertise was highlighted by all respondents and it was reported that women will typically accept IPTp if encouraged by a health worker. Given the positive views of antenatal care and IPTp, high antenatal care coverage and reported low refusal rates for IPTp, supply-side issues are likely to account for the majority of missed opportunities for the provision of IPTp when women attend antenatal care. However, to increase uptake of IPTp on the demand side, health workers should be encouraged to reassure eligible women that IPTp is safe.

  8. Data delivery workflow in an academic information warehouse.

    PubMed

    Erdal, Selnur; Rogers, Patrick; Santangelo, Jennifer; Buskirk, Jason; Ostrander, Michael; Liu, Jianhua; Kamal, Jyoti

    2008-11-06

    The Ohio State University Medical Center (OSUMC) Information Warehouse (IW) collects data from many systems throughout the OSUMC on load cycles ranging from real-time to on-demand. The data then is prepared for delivery to diversity of customers across the clinical, education, and research sectors of the OSUMC. Some of the data collected at the IW include patient management, billing and finance, procedures, medications, lab results, clinical reports, physician order entry, outcomes, demographics, and so on. This data is made available to the users of the IW in variety of formats and methods.

  9. Optometric supply and demand in Australia: 2011-2036.

    PubMed

    Healy, Ernest; Kiely, Patricia M; Arunachalam, Dharma

    2015-05-01

    The effective size of the optometric workforce is dependent on graduate numbers, retention rates and immigration and is influenced by age, gender and working hours of optometrists. This paper presents modelling results of the relationship between the projected Australian optometric workforce and projected demand for optometric services for the period 2011 to 2036. Nine hypothetical optometric supply-side and demand-side scenarios are presented. Data from the Australian Bureau of Statistics on age and gender of people listing optometry as their major qualification in the 2011 census were projected over a 25-year period, accounting for factors such as concordance with Health Workforce Australia figures for registered optometrists in Australia in 2011, ageing, attrition, hours worked, new graduates and immigration. Data were compared to the numbers of optometrists calculated as necessary to meet the demand for services of the Australian population to 2036 using nine different scenarios. It was estimated that there would be a surplus of over 1,200 equivalent full-time optometrists (EFTO) in 2036 for the highest service demand scenario of 13.8 million Medicare services, where 21 hours of a 38-hour week per EFTO were allowed for the provision of optometric services under Medicare. Substantial surpluses were predicted in all states and territories except Queensland, Tasmania and the Northern Territory where predicted supply was within six EFTO of predicted demand. Projections using current weightings for mortality, attrition, proportion of optometrists in active practice, working hours, immigration, new graduates and 21 hours per EFTO per week available for Medicare services indicate that in 2036, there will be excess optometrists in relation to projected demand for services, if service utilisation is maintained at current levels or increased by 10 or 20 per cent. Substantially greater excesses result if each EFTO has 28 or 35 hours per week available for Medicare services. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

  10. A historical analysis of natural gas demand

    NASA Astrophysics Data System (ADS)

    Dalbec, Nathan Richard

    This thesis analyzes demand in the US energy market for natural gas, oil, and coal over the period of 1918-2013 and examines their price relationship over the period of 2007-2013. Diagnostic tests for time series were used; Augmented Dickey-Fuller, Kwiatkowski-Phillips-Schmidt-Shin, Johansen cointegration, Granger Causality and weak exogeneity tests. Directed acyclic graphs were used as a complimentary test for endogeneity. Due to the varied results in determining endogeneity, a seemingly unrelated regression model was used which assumes all right hand side variables in the three demand equations were exogenous. A number of factors were significant in determining demand for natural gas including its own price, lagged demand, a number of structural break dummies, and trend, while oil indicate some substitutability with natural gas. An error correction model was used to examine the price relationships. Natural gas price was found not to have a significant cointegrating vector.

  11. Health care financing: recent experience in Africa.

    PubMed

    Dunlop, D W

    1983-01-01

    The economic realities of health sector development in Africa has been analyzed in this paper. Both the global and national macroeconomic context has been defined. Given the available data, it is clear that most African countries face increasingly serious economic realities, such as slow or even declining economic growth (per capita), a depressed food production situation, severe balance of payments crises, and increasing dependence on external financial assistance. Given the limited but increasingly available 1981 and 1982 data, the economic situation in many countries is more constrained than those indicated by the data contained in this paper. In this context, the potential competitive situation facing governmental health care systems was reviewed. In addition, the diversity in the sources of health expenditures between countries in Africa was highlighted. These data provide clear evidence that governments clearly do not finance the entire health care system and that individual payment for service in many countries represent an important source of revenue for many care providers in various health care systems operating in any given country. The potential for governments to finance either an expansion of or improvements to the government component of their health care systems is then reviewed. The highlights of this analysis include the following points. First, the tax structure in many African countries is highly dependent on export and import duties, which in turn creates dependency on sustained foreign demand for exports.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. How do performance-based financing programmes measure quality of care? A descriptive analysis of 68 quality checklists from 28 low- and middle-income countries

    PubMed Central

    Josephson, Erik; Gergen, Jessica; Coe, Martha; Ski, Samantha; Madhavan, Supriya; Bauhoff, Sebastian

    2017-01-01

    Abstract This paper seeks to systematically describe the length and content of quality checklists used in performance-based financing programmes, their similarities and differences, and how checklists have evolved over time. We compiled a list of supply-side, health facility-based performance-based financing (PBF) programmes in low- and lower middle-income countries based on a document review. We then solicited PBF manuals and quality checklists from implementers and donors of these PBF mechanisms. We entered each indicator from each quality checklist into a database verbatim in English, and translated into English from French where appropriate, and categorized each indicator according to the Donabedian framework and an author-derived categorization. We extracted 8,490 quality indicators from 68 quality checklists across 32 PBF implementations in 28 countries. On average, checklists contained 125 indicators; within the same program, checklists tend to grow as they are updated. Using the Donabedian framework, 80% of indicators were structure-type, 19% process-type, and less than 1% outcome-type. The author-derived categorization showed that 57% of indicators relate to availability of resources, 24% to managing the facility and 17% assess knowledge and effort. There is a high degree of similarity in a narrow set of indicators used in checklists for common service types such as maternal, neonatal and child health. We conclude that performance-based financing offers an appealing approach to targeting specific quality shortfalls and advancing toward the Sustainable Development Goals of high quality coverage. Currently most indicators focus on structural issues and resource availability. There is scope to rationalize and evolve the quality checklists of these programs to help achieve national and global goals to improve quality of care. PMID:28549142

  13. 39 CFR 3050.22 - Documentation supporting attributable cost estimates in the Postal Service's section 3652 report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., Demand Side Variability, and Network Variability studies, including input data, processing programs, and... should include the product or product groups carried under each listed contract; (k) Spreadsheets and...

  14. Demand management and case management: a conservation strategy.

    PubMed

    Bryant, C D R Anna K

    2007-01-01

    This article reviews the history and development of managed competition, and explores the possibilities of a new demand management strategy in the context of nurse case management to offer less costly, higher quality care for a greater number of patients. The article examines the history and principles of healthcare demand management, its implementation in the hospital and clinical practices of nurse case managers, and its impacts in reducing costs while maintaining care levels. The article develops and analyzes the conflicts and common ground between demand management and case management. First, demand-side strategies can be effective in reducing costs while maintaining quality of nursing care; second, nurse case managers should employ patient education, self-care, and staffing solutions to manage demand. Nurse case managers must apply demand management principles carefully. Their goal is not to restrict care, but to maintain the highest levels of care possible within the limits of their practice's resources and staffing. Two critical themes emerge: (1) demand management is a potential alternative to market-driven managed competition and (2) nursing case management can affect an effective form of demand management. However, the long-term implications of these nursing case management strategies on healthcare staffing need further exploration.

  15. Is health care a luxury or a necessity or both? Evidence from Turkey.

    PubMed

    Yavuz, Nilgun Cil; Yilanci, Veli; Ozturk, Zehra Ayca

    2013-02-01

    This study investigates the effect of per capita income on per capita health expenditures in Turkey over the period 1975-2007 by using ARDL bounds test approach to the cointegration considering both demand and supply side variables. Since we reject the null hypothesis that there is no cointegration among the series, we estimate long run and short run elasticities. The results show that while income has no effect on health expenditures in the long run, it is a necessity good in the short run that is a 1% increase in per capita income creates an 0.75% increase in per capita health expenditures. On the other hand, by examining the coefficient of demand and supply side variables, we found that average length of stay and number of physicians has negative effect, percentage of older people has positive effect and infant mortality rate has no effect on health expenditures in both short and long runs.

  16. Demand-side management: Why ratemaking should`nt control tax policy

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

    Haney, J.D.

    1995-01-01

    As utilities spend money on demand-side management (DSM) programs, they usually deduct their costs currently as ordinary and necessary business expenses. However, state regulators may force deferral of DSM costs for ratemaking purposes, with possible consequences on tax returns. When regulators defer DSM costs, the Internal Revenue Service (IRS) has offered several theories to challenge current tax deductions. One theory requires capitilization instead of a current deduction if regulators include the DSM cost in rate base and provide for a rate of return on the balance. The IRS explained this theory two years ago in a White Paper on conservationmore » expenses: The direct relationship between a rate of return allowed by the Regulator for conservation expenditures allowed in rate base and future profits establishes a prima facie case for capitalization under the future benefit standard. The authors believe that IRS policy should not be linked to ratemaking decisions.« less

  17. A demand-side view of risk adjustment.

    PubMed

    Feldman, R; Dowd, B E; Maciejewski, M

    2001-01-01

    This paper analyzes the efficient allocation of consumers to health plans. Specifically, we address the question of why employers that offer multiple health plans often make larger contributions to the premiums of the high-cost plans. Our perspective is that the subsidy for high-cost plans represents a form of demand-side risk adjustment that improves efficiency. Without such subsidies (and in the absence of formal risk adjustment), too few employees would choose the high-cost plans preferred by high-risk workers. We test the theory by estimating a model of the employer premium subsidy, using data from a survey of large public employers in 1994. Our empirical analysis shows that employers are more likely to subsidize high-cost plans when the benefits of risk adjustment are greater. The findings suggest that the premium subsidy can accomplish some of the benefits of formal risk adjustment.

  18. Demand-side management glossary

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

    Isaksen, L.; Ignelzi, P.C.

    1992-10-01

    Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

  19. Demand-side management glossary. Final report

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

    Isaksen, L.; Ignelzi, P.C.

    1992-10-01

    Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

  20. Scheduling Non-Preemptible Jobs to Minimize Peak Demand

    DOE PAGES

    Yaw, Sean; Mumey, Brendan

    2017-10-28

    Our paper examines an important problem in smart grid energy scheduling; peaks in power demand are proportionally more expensive to generate and provision for. The issue is exacerbated in local microgrids that do not benefit from the aggregate smoothing experienced by large grids. Demand-side scheduling can reduce these peaks by taking advantage of the fact that there is often flexibility in job start times. We then focus attention on the case where the jobs are non-preemptible, meaning once started, they run to completion. The associated optimization problem is called the peak demand minimization problem, and has been previously shown tomore » be NP-hard. These results include an optimal fixed-parameter tractable algorithm, a polynomial-time approximation algorithm, as well as an effective heuristic that can also be used in an online setting of the problem. Simulation results show that these methods can reduce peak demand by up to 50% versus on-demand scheduling for household power jobs.« less

  1. Scheduling Non-Preemptible Jobs to Minimize Peak Demand

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

    Yaw, Sean; Mumey, Brendan

    Our paper examines an important problem in smart grid energy scheduling; peaks in power demand are proportionally more expensive to generate and provision for. The issue is exacerbated in local microgrids that do not benefit from the aggregate smoothing experienced by large grids. Demand-side scheduling can reduce these peaks by taking advantage of the fact that there is often flexibility in job start times. We then focus attention on the case where the jobs are non-preemptible, meaning once started, they run to completion. The associated optimization problem is called the peak demand minimization problem, and has been previously shown tomore » be NP-hard. These results include an optimal fixed-parameter tractable algorithm, a polynomial-time approximation algorithm, as well as an effective heuristic that can also be used in an online setting of the problem. Simulation results show that these methods can reduce peak demand by up to 50% versus on-demand scheduling for household power jobs.« less

  2. [Total hip replacement in the G-DRG-system].

    PubMed

    Kaufmann, M M; Franz, D; Lassahn, C; Siebert, C H

    2007-01-01

    Due to the continuing increase in life expectancy, the ageing process of the German population in general and the high demands placed on activity levels and quality of life today, the demand for primary and secondary joint replacement surgery continues to increase. To distribute the economic and medical resources properly, while still making technical and surgical innovations available to a broad public, hospitals must be able to adequately finance these procedures with the help of the proper diagnosis related groups. The development of the German DRG-system over the past years, as well as the new calculation for the year 2006 are to be reviewed and analysed in this article with this in mind. An improvement in the degree of differentiation between the individual procedures can be documented. Whether or not these changes will ensure the long-term financial survival of the German health care system will remain to be seen.

  3. Exporting doctoral education: experience of a state-supported university.

    PubMed

    Stoskopf, Carleen H; Xirasagar, Sudha; Han, Whiejong M; Snowdon, Sonja

    2007-01-01

    There is a demand for non-traditional doctoral education in healthcare management and policy among many countries in support of their health system reform efforts. Healthcare professionals need retooling to provide stewardship to complex new health financing systems. Most health service leaders are mid career professionals and cannot transplant themselves to study on American university campuses. They demand high quality programs, designed to enable most coursework to be completed overseas. Aided by recent distance education technology, the University of South Carolina's Department of Health Services Policy and Management developed and provides doctoral programs for working professionals in Taiwan and South Korea with a minimal and convenient campus attendance requirement. This paper presents the experience of setting up the programs, management, quality control, and benefits for both students overseas and for our Department's mission and on-campus programs. Our experience is that there are many challenges, but it is also rewarding from academic, scholarly, and financial perspectives.

  4. The economic cost of fuel price subsidies in Ghana

    NASA Astrophysics Data System (ADS)

    Ofori, Roland Oduro

    I adapt the Harberger formula for deadweight loss to develop approximations for the deadweight loss created by multiple fuel price subsidies. I also estimate the own-price, cross-price, and income elasticities of demand for gasoline and diesel in Africa. I use data on fuel prices and sales in combination with my formulas and elasticity estimates to calculate the deadweight loss of fuel price subsidies in Ghana from 2009 to 2014. I show that the average efficiency cost of the gasoline and diesel price subsidies in Ghana is 0.8% of fuel price subsidy transfers. This result stresses the futility of basing subsidy reforms on economic efficiency losses, which are relatively small due to very inelastic energy demand, and the need for such reforms to be motivated by the poor-targeting of subsidies to low-income households and the impact of subsidies on government debt-financing.

  5. Immigration and earnings inequality in America's new small-town destinations.

    PubMed

    Hyde, Allen; Pais, Jeremy; Wallace, Michael

    2015-01-01

    Research on the relationship between immigrant population concentration and earnings inequality is divided between two perspectives. Supply-side arguments maintain that areas attracting large numbers of immigrants experience minimal wage growth at the bottom of the earnings distribution, which increases local levels of earnings inequality. Demand-side arguments contend that industrial restructuring reduces the pay of manual labor regardless of, and even prior to, the arrival of foreign-born workers. Adjudicating between these two perspectives is hindered by issues of potential endogeneity, which confound attempts to independently assess the effects of immigration on inequality or vice versa using OLS regression. We consider a third perspective called the reciprocal effects hypothesis which contends that immigrant concentration and earnings inequality emerge together through a mutually reinforcing feedback process. We explore this question in America's "new small-town destinations" using data from U.S. micropolitan statistical areas. We use three-stage least squares estimation to address the endogeneity problem and to test these three hypotheses. While we find support for both the supply- and demand-side perspectives, the results are best explained by the reciprocal effects hypothesis. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Effects of Rural Mutual Health Care on outpatient service utilization in Chinese village medical institutions: evidence from panel data.

    PubMed

    Zhou, Zhongliang; Gao, Jianmin; Xue, Qinxiang; Yang, Xiaowei; Yan, Ju'e

    2009-07-01

    To solve the problem of 'Kan bing nan, kan bing gui' (medical treatment is difficult to access and expensive), a Harvard-led research team implemented a community-based health insurance scheme known as Rural Mutual Health Care (RMHC) in Chinese rural areas from 2004 to 2006. Two major policies adopted by RMHC included insurance coverage of outpatient services (demand-side policy) and drug policy (supply-side policy). This paper focuses on the effects of these two policies on outpatient service utilization in Chinese village clinics. The data used in this study are from 3-year household follow-up surveys. A generalized negative binomial regression model and a Heckman selection model were constructed using panel data from 2005 to 2007. The results indicate that the price elasticities of demand for outpatient visits and per-visit outpatient expenses were -1.5 and -0.553, respectively. After implementing the supply-side policy, outpatient visits and per-visit outpatient expenses decreased by 94.7 and 55.9%, respectively, controlling for insurance coverage. These findings can be used to make recommendations to the Chinese government on improving the health care system.

  7. The feedback control cycle as regulator of past and future mineral supply

    NASA Astrophysics Data System (ADS)

    Wellmer, Friedrich-W.; Dalheimer, Manfred

    2012-10-01

    Mineral supply is controlled by a feedback mechanism. When there is a shortage of a commodity in a market economy, prices will rise, triggering this mechanism. The expectation of high financial returns will encourage inventiveness and creativity in the quest for new solutions. On the supply side, for primary resources, the appropriate response is to cut losses in the mining process, to lower the cut-off grade, to improve recoveries in the beneficiation and smelting processes, to expand existing production facilities, and to discover and bring into production new deposits. For secondary resources, the key to increasing the supply lies in improving recycling rates by better technology, reprocessing lower-grade scrap which becomes economic because of increased prices, and reducing downgrading to optimize the usefulness of secondary materials. On the demand side, implementation of new and more efficient processes, development of substitution technologies, material savings, and the invention of entirely new technologies that fulfill the same function without the need of using the scarce and suddenly more expensive material are effective reactions to a price rise. The effectiveness of this self-regulating mechanism can be shown by examples of historical price peaks of metals, such as Mo, Co, and Ta, and the current rare earth elements peak. Concerning supply from secondary resources, a model is developed in order to determine how far the supply from this resource domain can be achieved and how the recycling rate is influenced by growth rate and lifetime. The feedback control cycle of mineral supply is influenced on the demand side by ever shorter life cycles, by products getting more complex with ever more elements involved in their production, and by an increase in element dispersion. All these factors have an immediate effect on the feasibility of sourcing raw materials from the technosphere. The supply side of primary materials is influenced by increasing lead times for new production and by relatively low flexibility in responding to changing demand.

  8. A novel microgrid demand-side management system for manufacturing facilities

    NASA Astrophysics Data System (ADS)

    Harper, Terance J.

    Thirty-one percent of annual energy consumption in the United States occurs within the industrial sector, where manufacturing processes account for the largest amount of energy consumption and carbon emissions. For this reason, energy efficiency in manufacturing facilities is increasingly important for reducing operating costs and improving profits. Using microgrids to generate local sustainable power should reduce energy consumption from the main utility grid along with energy costs and carbon emissions. Also, microgrids have the potential to serve as reliable energy generators in international locations where the utility grid is often unstable. For this research, a manufacturing process that had approximately 20 kW of peak demand was matched with a solar photovoltaic array that had a peak output of approximately 3 KW. An innovative Demand-Side Management (DSM) strategy was developed to manage the process loads as part of this smart microgrid system. The DSM algorithm managed the intermittent nature of the microgrid and the instantaneous demand of the manufacturing process. The control algorithm required three input signals; one from the microgrid indicating the availability of renewable energy, another from the manufacturing process indicating energy use as a percent of peak production, and historical data for renewable sources and facility demand. Based on these inputs the algorithm had three modes of operation: normal (business as usual), curtailment (shutting off non-critical loads), and energy storage. The results show that a real-time management of a manufacturing process with a microgrid will reduce electrical consumption and peak demand. The renewable energy system for this research was rated to provide up to 13% of the total manufacturing capacity. With actively managing the process loads with the DSM program alone, electrical consumption from the utility grid was reduced by 17% on average. An additional 24% reduction was accomplished when the microgrid and DSM program was enabled together, resulting in a total reduction of 37%. On average, peak demand was reduced by 6%, but due to the intermittency of the renewable source and the billing structure for peak demand, only a 1% reduction was obtained. During a billing period, it only takes one day when solar irradiance is poor to affect the demand reduction capabilities. To achieve further demand reduction, energy storage should be introduced and integrated.

  9. An Integrated Hydrologic-Economic Modeling Tool for Evaluating Water Management Responses to Climate Change in the Boise River Basin

    NASA Astrophysics Data System (ADS)

    Schmidt, R. D.; Taylor, R. G.; Stodick, L. D.; Contor, B. A.

    2009-12-01

    A recent federal interagency report on climate change and water management (Brekke et. al., 2009) describes several possible management responses to the impacts of climate change on water supply and demand. Management alternatives include changes to water supply infrastructure, reservoir system operations, and water demand policies. Water users in the Bureau of Reclamation’s Boise Project (located in the Lower Boise River basin in southwestern Idaho) would be among those impacted both hydrologically and economically by climate change. Climate change and management responses to climate change are expected to cause shifts in water supply and demand. Supply shifts would result from changes in basin precipitation patterns, and demand shifts would result from higher evapotranspiration rates and a longer growing season. The impacts would also extend to non-Project water users in the basin, since most non-Project groundwater pumpers and drain water diverters rely on hydrologic externalities created by seepage losses from Boise Project water deliveries. An integrated hydrologic-economic model was developed for the Boise basin to aid Reclamation in evaluating the hydrologic and economic impacts of various management responses to climate change. A spatial, partial-equilibrium, economic optimization model calculates spatially-distinct equilibrium water prices and quantities, and maximizes a social welfare function (the sum of consumer and producers surpluses) for all agricultural and municipal water suppliers and demanders (both Project and non-Project) in the basin. Supply-price functions and demand-price functions are exogenous inputs to the economic optimization model. On the supply side, groundwater and river/reservoir models are used to generate hydrologic responses to various management alternatives. The response data is then used to develop water supply-price functions for Project and non-Project water users. On the demand side, crop production functions incorporating crop distribution, evapotranspiration rates, irrigation efficiencies, and crop prices are used to develop water demand-price functions for agricultural water users. Demand functions for municipal and industrial water users are also developed. Recent applications of the integrated model have focused on the hydrologic and economic impacts of demand management alternatives, including large-scale canal lining conservation measures, and market-based water trading between canal diverters and groundwater pumpers. A supply management alternative being investigated involves revising reservoir rule curves to compensate for climate change impacts on timing of reservoir filling.

  10. A generic hydroeconomic model to assess future water scarcity

    NASA Astrophysics Data System (ADS)

    Neverre, Noémie; Dumas, Patrice

    2015-04-01

    We developed a generic hydroeconomic model able to confront future water supply and demand on a large scale, taking into account man-made reservoirs. The assessment is done at the scale of river basins, using only globally available data; the methodology can thus be generalized. On the supply side, we evaluate the impacts of climate change on water resources. The available quantity of water at each site is computed using the following information: runoff is taken from the outputs of CNRM climate model (Dubois et al., 2010), reservoirs are located using Aquastat, and the sub-basin flow-accumulation area of each reservoir is determined based on a Digital Elevation Model (HYDRO1k). On the demand side, agricultural and domestic demands are projected in terms of both quantity and economic value. For the agricultural sector, globally available data on irrigated areas and crops are combined in order to determine irrigated crops localization. Then, crops irrigation requirements are computed for the different stages of the growing season using Allen (1998) method with Hargreaves potential evapotranspiration. Irrigation water economic value is based on a yield comparison approach between rainfed and irrigated crops. Potential irrigated and rainfed yields are taken from LPJmL (Blondeau et al., 2007), or from FAOSTAT by making simple assumptions on yield ratios. For the domestic sector, we project the combined effects of demographic growth, economic development and water cost evolution on future demands. The method consists in building three-blocks inverse demand functions where volume limits of the blocks evolve with the level of GDP per capita. The value of water along the demand curve is determined from price-elasticity, price and demand data from the literature, using the point-expansion method, and from water costs data. Then projected demands are confronted to future water availability. Operating rules of the reservoirs and water allocation between demands are based on the maximization of water benefits, over time and space. A parameterisation-simulation-optimisation approach is used. This gives a projection of future water scarcity in the different locations and an estimation of the associated direct economic losses from unsatisfied demands. This generic hydroeconomic model can be easily applied to large-scale regions, in particular developing regions where little reliable data is available. We will present an application to Algeria, up to the 2050 horizon.

  11. Managing Sustainable Demand-side Infrastructure for Power System Ancillary Services

    NASA Astrophysics Data System (ADS)

    Parkinson, Simon Christopher

    Widespread access to renewable electricity is seen as a viable method to mitigate carbon emissions, although problematic are the issues associated with the integration of the generation systems within current power system configurations. Wind power plants are the primary large-scale renewable generation technology applied globally, but display considerable short-term supply variability that is difficult to predict. Power systems are currently not designed to operate under these conditions, and results in the need to increase operating reserve in order to guarantee stability. Often, operating conventional generation as reserve is both technically and economically inefficient, which can overshadow positive benefits associated with renewable energy exploitation. The purpose of this thesis is to introduce and assess an alternative method of enhancing power system operations through the control of electric loads. In particular, this thesis focuses on managing highly-distributed sustainable demand-side infrastructure, in the form of heat pumps, electric vehicles, and electrolyzers, as dispatchable short-term energy balancing resources. The main contribution of the thesis is an optimal control strategy capable of simultaneously balancing grid- and demand-side objectives. The viability of the load control strategy is assessed through model-based simulations that explicitly track end-use functionality of responsive devices within a power systems analysis typically implemented to observe the effects of integrated wind energy systems. Results indicate that there is great potential for the proposed method to displace the need for increased reserve capacity in systems considering a high penetration of wind energy, thereby allowing conventional generation to operate more efficiently and avoid the need for possible capacity expansions.

  12. Incremental cost of increasing access to maternal health care services: perspectives from a demand and supply side intervention in Eastern Uganda.

    PubMed

    Mayora, Chrispus; Ekirapa-Kiracho, Elizabeth; Bishai, David; Peters, David H; Okui, Olico; Baine, Sebastian Olikira

    2014-01-01

    High maternal and infant mortality continue to be major challenges to the attainment of the Millennium Development Goals for many low and middle-income countries. There is now evidence that voucher initiatives can increase access to maternal health services. However, a dearth of knowledge exists on the cost implications of voucher schemes. This paper estimates the incremental costs of a demand and supply side intervention aimed at increasing access to maternal health care services. This costing study was part of a quasi-experimental voucher study conducted in two districts in Eastern Uganda to explore the impact of demand and supply - side incentives on increasing access to maternal health services. The provider's perspective was used and the ingredients approach to costing was employed. Costs were based on market prices as recorded in program records. Total, unit, and incremental costs were calculated. The estimated total financial cost of the intervention for the one year of implementation was US$525,472 (US$1 = 2200UgShs). The major cost drivers included costs for transport vouchers (35.3%), health system strengthening (29.2%) and vouchers for maternal health services (18.2%). The average cost of transport per woman to and from the health facility was US$4.6. The total incremental costs incurred on deliveries (excluding caesarean section) was US$317,157 and US$107,890 for post natal care (PNC). The incremental costs per additional delivery and PNC attendance were US$23.9 and US$7.6 respectively. Subsidizing maternal health care costs through demand and supply - side initiatives may not require significant amounts of resources contrary to what would be expected. With Uganda's Gross Domestic Product (GDP) per capita of US$55` (2012), the incremental cost per additional delivery (US$23.9) represents about 5% of GDP per capita to save a mother and probably her new born. For many low income countries, this may not be affordable, yet reliance on donor funding is often not sustainable. Alternative ways of raising additional resources for health must be explored. These include; encouraging private investments in critical sectors such as rural transport, health service provision; mobilizing households to save financial resources for preparedness, and financial targeting for the most vulnerable.

  13. Robust Unit Commitment Considering Uncertain Demand Response

    DOE PAGES

    Liu, Guodong; Tomsovic, Kevin

    2014-09-28

    Although price responsive demand response has been widely accepted as playing an important role in the reliable and economic operation of power system, the real response from demand side can be highly uncertain due to limited understanding of consumers' response to pricing signals. To model the behavior of consumers, the price elasticity of demand has been explored and utilized in both research and real practice. However, the price elasticity of demand is not precisely known and may vary greatly with operating conditions and types of customers. To accommodate the uncertainty of demand response, alternative unit commitment methods robust to themore » uncertainty of the demand response require investigation. In this paper, a robust unit commitment model to minimize the generalized social cost is proposed for the optimal unit commitment decision taking into account uncertainty of the price elasticity of demand. By optimizing the worst case under proper robust level, the unit commitment solution of the proposed model is robust against all possible realizations of the modeled uncertain demand response. Numerical simulations on the IEEE Reliability Test System show the e ectiveness of the method. Finally, compared to unit commitment with deterministic price elasticity of demand, the proposed robust model can reduce the average Locational Marginal Prices (LMPs) as well as the price volatility.« less

  14. Modeling the public health impact of malaria vaccines for developers and policymakers

    PubMed Central

    2013-01-01

    Background Efforts to develop malaria vaccines show promise. Mathematical model-based estimates of the potential demand, public health impact, and cost and financing requirements can be used to inform investment and adoption decisions by vaccine developers and policymakers on the use of malaria vaccines as complements to existing interventions. However, the complexity of such models may make their outputs inaccessible to non-modeling specialists. This paper describes a Malaria Vaccine Model (MVM) developed to address the specific needs of developers and policymakers, who need to access sophisticated modeling results and to test various scenarios in a user-friendly interface. The model’s functionality is demonstrated through a hypothetical vaccine. Methods The MVM has three modules: supply and demand forecast; public health impact; and implementation cost and financing requirements. These modules include pre-entered reference data and also allow for user-defined inputs. The model includes an integrated sensitivity analysis function. Model functionality was demonstrated by estimating the public health impact of a hypothetical pre-erythrocytic malaria vaccine with 85% efficacy against uncomplicated disease and a vaccine efficacy decay rate of four years, based on internationally-established targets. Demand for this hypothetical vaccine was estimated based on historical vaccine implementation rates for routine infant immunization in 40 African countries over a 10-year period. Assumed purchase price was $5 per dose and injection equipment and delivery costs were $0.40 per dose. Results The model projects the number of doses needed, uncomplicated and severe cases averted, deaths and disability-adjusted life years (DALYs) averted, and cost to avert each. In the demonstration scenario, based on a projected demand of 532 million doses, the MVM estimated that 150 million uncomplicated cases of malaria and 1.1 million deaths would be averted over 10 years. This is equivalent to 943 uncomplicated cases and 7 deaths averted per 1,000 vaccinees. In discounted 2011 US dollars, this represents $11 per uncomplicated case averted and $1,482 per death averted. If vaccine efficacy were reduced to 75%, the estimated uncomplicated cases and deaths averted over 10 years would decrease by 14% and 19%, respectively. Conclusions The MVM can provide valuable information to assist decision-making by vaccine developers and policymakers, information which will be refined and strengthened as field studies progress allowing further validation of modeling assumptions. PMID:23815273

  15. Modeling the public health impact of malaria vaccines for developers and policymakers.

    PubMed

    Nunes, Julia K; Cárdenas, Vicky; Loucq, Christian; Maire, Nicolas; Smith, Thomas; Shaffer, Craig; Måseide, Kårstein; Brooks, Alan

    2013-07-01

    Efforts to develop malaria vaccines show promise. Mathematical model-based estimates of the potential demand, public health impact, and cost and financing requirements can be used to inform investment and adoption decisions by vaccine developers and policymakers on the use of malaria vaccines as complements to existing interventions. However, the complexity of such models may make their outputs inaccessible to non-modeling specialists. This paper describes a Malaria Vaccine Model (MVM) developed to address the specific needs of developers and policymakers, who need to access sophisticated modeling results and to test various scenarios in a user-friendly interface. The model's functionality is demonstrated through a hypothetical vaccine. The MVM has three modules: supply and demand forecast; public health impact; and implementation cost and financing requirements. These modules include pre-entered reference data and also allow for user-defined inputs. The model includes an integrated sensitivity analysis function. Model functionality was demonstrated by estimating the public health impact of a hypothetical pre-erythrocytic malaria vaccine with 85% efficacy against uncomplicated disease and a vaccine efficacy decay rate of four years, based on internationally-established targets. Demand for this hypothetical vaccine was estimated based on historical vaccine implementation rates for routine infant immunization in 40 African countries over a 10-year period. Assumed purchase price was $5 per dose and injection equipment and delivery costs were $0.40 per dose. The model projects the number of doses needed, uncomplicated and severe cases averted, deaths and disability-adjusted life years (DALYs) averted, and cost to avert each. In the demonstration scenario, based on a projected demand of 532 million doses, the MVM estimated that 150 million uncomplicated cases of malaria and 1.1 million deaths would be averted over 10 years. This is equivalent to 943 uncomplicated cases and 7 deaths averted per 1,000 vaccinees. In discounted 2011 US dollars, this represents $11 per uncomplicated case averted and $1,482 per death averted. If vaccine efficacy were reduced to 75%, the estimated uncomplicated cases and deaths averted over 10 years would decrease by 14% and 19%, respectively. The MVM can provide valuable information to assist decision-making by vaccine developers and policymakers, information which will be refined and strengthened as field studies progress allowing further validation of modeling assumptions.

  16. Stabilizing supply of artemisinin and artemisinin-based combination therapy in an era of wide-spread scale-up.

    PubMed

    Shretta, Rima; Yadav, Prashant

    2012-12-02

    The global demand for artemisinin-based combination therapy (ACT) has grown sharply since its recommendation by the World Health Organization in 2002. However, a combination of financing and programmatic uncertainties, limited suppliers of finished products, information opacity across the different tiers in the supply chain, and widespread fluctuations in raw material prices have together contributed to a market fraught with demand and supply uncertainties and price volatility. Various short-term solutions have been deployed to alleviate supply shortages caused by these challenges; however, new mechanisms are required to build resilience into the supply chain. This review concludes that a mix of strategies is required to stabilize the artemisinin and ACT market. First, better and more effective pooling of demand and supply risks and better contracting to allow risk sharing among the stakeholders are needed. Physical and financial buffer stocks will enable better matching of demand and supply in the short and medium term. Secondly, physical buffers will allow stable supplies when there are procurement and supply management challenges while financial buffer funds will address issues around funding disruptions. Finally, in the medium to long term, significant investments in country level system strengthening will be required to minimize national level demand uncertainties. In addition a voluntary standard for extractors to ensure appropriate purchasing and sales practices as well as minimum quality and ethical standards could help stabilize the artemisinin market in the long term.

  17. Stabilizing supply of artemisinin and artemisinin-based combination therapy in an era of wide-spread scale-up

    PubMed Central

    2012-01-01

    The global demand for artemisinin-based combination therapy (ACT) has grown sharply since its recommendation by the World Health Organization in 2002. However, a combination of financing and programmatic uncertainties, limited suppliers of finished products, information opacity across the different tiers in the supply chain, and widespread fluctuations in raw material prices have together contributed to a market fraught with demand and supply uncertainties and price volatility. Various short-term solutions have been deployed to alleviate supply shortages caused by these challenges; however, new mechanisms are required to build resilience into the supply chain. This review concludes that a mix of strategies is required to stabilize the artemisinin and ACT market. First, better and more effective pooling of demand and supply risks and better contracting to allow risk sharing among the stakeholders are needed. Physical and financial buffer stocks will enable better matching of demand and supply in the short and medium term. Secondly, physical buffers will allow stable supplies when there are procurement and supply management challenges while financial buffer funds will address issues around funding disruptions. Finally, in the medium to long term, significant investments in country level system strengthening will be required to minimize national level demand uncertainties. In addition a voluntary standard for extractors to ensure appropriate purchasing and sales practices as well as minimum quality and ethical standards could help stabilize the artemisinin market in the long term. PMID:23198961

  18. Separating Myth from Reality.

    ERIC Educational Resources Information Center

    Gluckman, Ivan B.

    1985-01-01

    Civil libertarians and members of more conservative special interest groups have equally legitimate concerns for the educational needs of students attending public schools. The goals and desires of concerned citizens from both sides can be met if neither makes unreasonable demands upon each other. (MD)

  19. Information Professionals in the Digital Age.

    ERIC Educational Resources Information Center

    Cronin, Blaise

    1998-01-01

    Describes the strategic significance of information and intelligence management to socioeconomic growth. Considers implications in terms of human and structural intellectual capital development. Provides demand- and supply-side analyses of the knowledge and skills required of information professionals in the digital age. (Author)

  20. Impact of Large Scale Energy Efficiency Programs On Consumer Tariffs and Utility Finances in India

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

    Abhyankar, Nikit; Phadke, Amol

    2011-01-20

    Large-scale EE programs would modestly increase tariffs but reduce consumers' electricity bills significantly. However, the primary benefit of EE programs is a significant reduction in power shortages, which might make these programs politically acceptable even if tariffs increase. To increase political support, utilities could pursue programs that would result in minimal tariff increases. This can be achieved in four ways: (a) focus only on low-cost programs (such as replacing electric water heaters with gas water heaters); (b) sell power conserved through the EE program to the market at a price higher than the cost of peak power purchase; (c) focusmore » on programs where a partial utility subsidy of incremental capital cost might work and (d) increase the number of participant consumers by offering a basket of EE programs to fit all consumer subcategories and tariff tiers. Large scale EE programs can result in consistently negative cash flows and significantly erode the utility's overall profitability. In case the utility is facing shortages, the cash flow is very sensitive to the marginal tariff of the unmet demand. This will have an important bearing on the choice of EE programs in Indian states where low-paying rural and agricultural consumers form the majority of the unmet demand. These findings clearly call for a flexible, sustainable solution to the cash-flow management issue. One option is to include a mechanism like FAC in the utility incentive mechanism. Another sustainable solution might be to have the net program cost and revenue loss built into utility's revenue requirement and thus into consumer tariffs up front. However, the latter approach requires institutionalization of EE as a resource. The utility incentive mechanisms would be able to address the utility disincentive of forgone long-run return but have a minor impact on consumer benefits. Fundamentally, providing incentives for EE programs to make them comparable to supply-side investments is a way of moving the electricity sector toward a model focused on providing energy services rather than providing electricity.« less

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