77 FR 6865 - Pricing for 2012 Infantry Soldier Silver Dollar and 2012 Star-Spangled Banner Commemorative Coin...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... 2012 Star- Spangled Banner Commemorative Coin Products AGENCY: United States Mint, Department of the... Infantry Soldier Silver Dollar and 2012 Star-Spangled Banner Commemorative Coin products: Introductory... Uncirculated Silver 44.95 49.95 Dollar Infantry Soldier Silver Dollar Special N/A 51.95 Set Star-Spangled...

26 CFR 1.61-22 - Taxation of split-dollar life insurance arrangements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 2 2013-04-01 2013-04-01 false Taxation of split-dollar life insurance..., and Taxable Income § 1.61-22 Taxation of split-dollar life insurance arrangements. (a) Scope—(1) In general. This section provides rules for the taxation of a split-dollar life insurance arrangement for...

26 CFR 1.61-22 - Taxation of split-dollar life insurance arrangements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 2 2012-04-01 2012-04-01 false Taxation of split-dollar life insurance..., and Taxable Income § 1.61-22 Taxation of split-dollar life insurance arrangements. (a) Scope—(1) In general. This section provides rules for the taxation of a split-dollar life insurance arrangement for...

Estimating workers' marginal valuation of employer health benefits: would insured workers prefer more health insurance or higher wages?

PubMed

Royalty, Anne Beeson

2008-01-01

In recent years the cost of health insurance has been increasing much faster than wages. In the face of these rising costs, many employers will have to make difficult decisions about whether to cut back health benefits or to compensate workers with lower wages or lower wage growth. In this paper, we ask the question, "Which do workers value more -- one additional dollar's worth of health benefits or one more dollar in their pockets?" Using a new approach to obtaining estimates of insured workers' marginal valuation of health benefits this paper estimates how much, on average, employees value the marginal dollar paid by employers for their workers' health insurance. We find that insured workers value the marginal health premium dollar at significantly less than the marginal wage dollar. However, workers value insurance generosity very highly. The marginal dollar spent on health insurance that adds an additional dollar's worth of observable dimensions of plan generosity, such as lower deductibles or coverage of additional services, is valued at significantly more than one dollar.

26 CFR 1.1402(a)-18 - Split-dollar life insurance arrangements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 12 2011-04-01 2011-04-01 false Split-dollar life insurance arrangements. 1... Split-dollar life insurance arrangements. See §§ 1.61-22 and 1.7872-15 for rules relating to the treatment of split-dollar life insurance arrangements. [T.D. 9092, 68 FR 54352, Sept. 17, 2003] ...

26 CFR 1.985-6 - Transition rules for a QBU that uses the dollar approximate separate transactions method for its...

Code of Federal Regulations, 2010 CFR

2010-04-01

... section sets forth transition rules for a QBU that used the dollar approximate separate transactions... QBU must determine the dollar and hyperinflationary currency basis of its assets and the dollar and hyperinflationary currency amount of its liabilities that were acquired or incurred in taxable years beginning...

26 CFR 1.1402(a)-18 - Split-dollar life insurance arrangements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 12 2013-04-01 2013-04-01 false Split-dollar life insurance arrangements. 1... Split-dollar life insurance arrangements. See §§ 1.61-22 and 1.7872-15 for rules relating to the treatment of split-dollar life insurance arrangements. [T.D. 9092, 68 FR 54352, Sept. 17, 2003] ...

26 CFR 1.1402(a)-18 - Split-dollar life insurance arrangements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 12 2014-04-01 2014-04-01 false Split-dollar life insurance arrangements. 1... Split-dollar life insurance arrangements. See §§ 1.61-22 and 1.7872-15 for rules relating to the treatment of split-dollar life insurance arrangements. [T.D. 9092, 68 FR 54352, Sept. 17, 2003] ...

26 CFR 1.1402(a)-18 - Split-dollar life insurance arrangements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 12 2012-04-01 2012-04-01 false Split-dollar life insurance arrangements. 1... Split-dollar life insurance arrangements. See §§ 1.61-22 and 1.7872-15 for rules relating to the treatment of split-dollar life insurance arrangements. [T.D. 9092, 68 FR 54352, Sept. 17, 2003] ...

Waiting for hip arthroplasty: economic costs and health outcomes.

PubMed

Fielden, Jann M; Cumming, J M; Horne, J G; Devane, P A; Slack, A; Gallagher, L M

2005-12-01

This prospective cohort study of 153 patients aimed to determine the economic and health costs of waiting for total hip arthroplasty (THA). Health-related quality of life, using self-completed WOMAC and EQ-5D questionnaires, was assessed monthly from enrolment preoperatively to 6 months postsurgery. Monthly cost diaries were used to record costs. The mean waiting time was 5.1 months and mean total cost of waiting for surgery was NZ 4305 dollars(US 2876 dollars) per person (pp) (NZ 1 dollar = US 0.668 dollar). Waiting more than 6 months was associated with a higher total mean cost (NZ 4278 dollars/US 2858 dollars pp) than waiting less than 6 months (NZ 2828 dollars/US 1889 dollars pp; P < .01). Improvements from preoperative to postoperative WOMAC and EQ-5D scores were identified (P < or = .01). Waiting longer led to poorer physical function preoperatively (P < or = .01). Those with poor initial health status showed greater improvement in WOMAC (P = .0001) and EQ-5D (P = .003) measures by 6 months after surgery. Longer waits for total hip arthroplasty incur greater economic costs and deterioration in physical function while waiting.

A process model to estimate biodiesel production costs.

PubMed

Haas, Michael J; McAloon, Andrew J; Yee, Winnie C; Foglia, Thomas A

2006-03-01

'Biodiesel' is the name given to a renewable diesel fuel that is produced from fats and oils. It consists of the simple alkyl esters of fatty acids, most typically the methyl esters. We have developed a computer model to estimate the capital and operating costs of a moderately-sized industrial biodiesel production facility. The major process operations in the plant were continuous-process vegetable oil transesterification, and ester and glycerol recovery. The model was designed using contemporary process simulation software, and current reagent, equipment and supply costs, following current production practices. Crude, degummed soybean oil was specified as the feedstock. Annual production capacity of the plant was set at 37,854,118 l (10 x 10(6)gal). Facility construction costs were calculated to be US dollar 11.3 million. The largest contributors to the equipment cost, accounting for nearly one third of expenditures, were storage tanks to contain a 25 day capacity of feedstock and product. At a value of US dollar 0.52/kg (dollar 0.236/lb) for feedstock soybean oil, a biodiesel production cost of US dollar 0.53/l (dollar 2.00/gal) was predicted. The single greatest contributor to this value was the cost of the oil feedstock, which accounted for 88% of total estimated production costs. An analysis of the dependence of production costs on the cost of the feedstock indicated a direct linear relationship between the two, with a change of US dollar 0.020/l (dollar 0.075/gal) in product cost per US dollar 0.022/kg (dollar 0.01/lb) change in oil cost. Process economics included the recovery of coproduct glycerol generated during biodiesel production, and its sale into the commercial glycerol market as an 80% w/w aqueous solution, which reduced production costs by approximately 6%. The production cost of biodiesel was found to vary inversely and linearly with variations in the market value of glycerol, increasing by US dollar 0.0022/l (dollar 0.0085/gal) for every US dollar 0.022/kg (dollar 0.01/lb) reduction in glycerol value. The model is flexible in that it can be modified to calculate the effects on capital and production costs of changes in feedstock cost, changes in the type of feedstock employed, changes in the value of the glycerol coproduct, and changes in process chemistry and technology.

Managing prices for hospital pharmaceuticals: a successful strategy for New Zealand?

PubMed

Tordoff, June M; Norris, Pauline T; Reith, David M

2005-01-01

In 2002, as part of a National Hospital Pharmaceutical Strategy, the New Zealand (NZ) government agency PHARMAC commenced a 3-year period of negotiating prices for 90% of hospital pharmaceuticals on behalf of all NZ public hospitals. The present study was undertaken to determine the effects of this first year of "pooled procurement." Using price changes and volume data for each of their top 150 pharmaceutical items, chief pharmacists at 11 public hospitals calculated projected cost savings for the financial year July 2003 to June 2004. Researchers calculated total projected savings for all 11 hospitals, and for three types of hospitals. Estimates of projected savings were made for all 29 major public hospitals by using savings per bed and savings per bed-day. A sensitivity analysis was undertaken. Items showing savings were categorized by using the Anatomical Therapeutic Chemical classification system. For the 11 hospitals, the top 150 items comprised 612 different items. Projected savings for 2003 to 2004 were NZ dollar 2,652,814, NZ dollar 658,984, and NZ dollar 127,952 for tertiary, secondary, and rural/special hospitals, respectively. Percentage savings as a median (range) of the total top 150 expenditure were: tertiary 5.28% (3.09-16.05%), secondary 7.41% (4.67-12.85%), and rural/special 9.55% (6.27-10.09%). For all 29 hospitals, estimated projected savings were NZ dollar 5,234,919 (NZ dollar 3,304,606-NZ dollar 8,044,482) by savings per bed, and NZ dollar 5,255,781 (NZ dollar 2,936,850-NZ dollar 8,693,239) by savings per bed-day. The main contributors to savings were: agents for infections, the nervous system, musculoskeletal system, and blood/blood-forming organs. The first year of pooled procurement under the National Hospital Pharmaceutical Strategy (2002-2003) has resulted in moderate savings. For all 29 major public hospitals, savings of around NZ dollar 5.2 million (dollar 2.9 million-dollar 8.7 million) or 3.7% were projected for 2003 to 2004. Longer-term effects, however, on patient outcomes and availability of pharmaceuticals, as well as on pharmaceutical expenditure, have yet to be evaluated.

Costs and savings associated with community water fluoridation programs in Colorado.

PubMed

O'Connell, Joan M; Brunson, Diane; Anselmo, Theresa; Sullivan, Patrick W

2005-11-01

Local, state, and national health policy makers require information on the economic burden of oral disease and the cost-effectiveness of oral health programs to set policies and allocate resources. In this study, we estimate the cost savings associated with community water fluoridation programs (CWFPs) in Colorado and potential cost savings if Colorado communities without fluoridation programs or naturally high fluoride levels were to implement CWFPs. We developed an economic model to compare the costs associated with CWFPs with treatment savings achieved through averted tooth decay. Treatment savings included those associated with direct medical costs and indirect nonmedical costs (i.e., patient time spent on dental visit). We estimated program costs and treatment savings for each water system in Colorado in 2003 dollars. We obtained parameter estimates from published studies, national surveys, and other sources. We calculated net costs for Colorado water systems with existing CWFPs and potential net costs for systems without CWFPs. The analysis includes data for 172 public water systems in Colorado that serve populations of 1000 individuals or more. We used second-order Monte Carlo simulations to evaluate the inherent uncertainty of the model assumptions on the results and report the 95% credible range from the simulation model. We estimated that Colorado CWFPs were associated with annual savings of 148.9 million dollars (credible range, 115.1 million dollars to 187.2 million dollars) in 2003, or an average of 60.78 dollars per person (credible range, 46.97 dollars dollars to 76.41 dollars). We estimated that Colorado would save an additional 46.6 million dollars (credible range, 36.0 dollars to 58.6 dollars million) annually if CWFPs were implemented in the 52 water systems without such programs and for which fluoridation is recommended. Colorado realizes significant annual savings from CWFPs; additional savings and reductions in morbidity could be achieved if fluoridation programs were implemented in other areas.

The cost of diabetes in Latin America and the Caribbean.

PubMed Central

Barceló, Alberto; Aedo, Cristian; Rajpathak, Swapnil; Robles, Sylvia

2003-01-01

OBJECTIVE: To measure the economic burden associated with diabetes mellitus in Latin America and the Caribbean. METHODS: Prevalence estimates of diabetes for the year 2000 were used to calculated direct and indirect costs of diabetes mellitus. Direct costs included costs due to drugs, hospitalizations, consultations and management of complications. The human capital approach was used to calculate indirect costs and included calculations of forgone earnings due to premature mortality and disability attributed to diabetes mellitus. Mortality and disability attributed to causes other than diabetes were subtracted from estimates to consider only the excess burden due to diabetes. A 3% discount rate was used to convert future earnings to current value. FINDINGS: The annual number of deaths in 2000 caused by diabetes mellitus was estimated at 339,035. This represented a loss of 757,096 discounted years of productive life among persons younger than 65 years (> billion US dollars). Permanent disability caused a loss of 12,699,087 years and over 50 billion US dollars, and temporary disability caused a loss of 136,701 years in the working population and over 763 million US dollars. Costs associated with insulin and oral medications were 4720 million US dollars, hospitalizations 1012 million US dollars, consultations 2508 million US dollars and care for complications 2,480 million US dollars. The total annual cost associated with diabetes was estimated as 65,216 million US dollars (direct 10,721 US dollars; indirect 54,496 US dollars). CONCLUSION: Despite limitations of the data, diabetes imposes a high economic burden to individuals and society in all countries and to Latin American and the Caribbean as whole. PMID:12640472

48 CFR 201.109 - Statutory acquisition-related dollar thresholds-adjustment for inflation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REGULATIONS SYSTEM Purpose, Authority, Issuance 201.109 Statutory acquisition-related dollar thresholds... right-hand drive passenger sedans be included in the list of dollar thresholds that are subject to...

48 CFR 201.109 - Statutory acquisition-related dollar thresholds-adjustment for inflation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... REGULATIONS SYSTEM Purpose, Authority, Issuance 201.109 Statutory acquisition-related dollar thresholds... right-hand drive passenger sedans be included in the list of dollar thresholds that are subject to...

75 FR 4451 - Notification of United States Mint 2010 Commemorative Coin Pricing

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

... Dollar and the 2010 Boy Scouts of America Centennial Silver Dollar Programs. Public Laws 110-227 and 110... Scouts of America Centennial Silver Dollar Commemorative Coins, respectively. [[Page 4452

Cost of illness in the 1993 waterborne Cryptosporidium outbreak, Milwaukee, Wisconsin.

PubMed

Corso, Phaedra S; Kramer, Michael H; Blair, Kathleen A; Addiss, David G; Davis, Jeffrey P; Haddix, Anne C

2003-04-01

To assess the total medical costs and productivity losses associated with the 1993 waterborne outbreak of cryptosporidiosis in Milwaukee, Wisconsin, including the average cost per person with mild, moderate, and severe illness, we conducted a retrospective cost-of-illness analysis using data from 11 hospitals in the greater Milwaukee area and epidemiologic data collected during the outbreak. The total cost of outbreak-associated illness was 96.2 million US dollars: 31.7 million US dollars in medical costs and 64.6 million US dollars in productivity losses. The average total costs for persons with mild, moderate, and severe illness were 116 US dollars, 47 US dollars, and 7,808 US dollars, respectively. The potentially high cost of waterborne disease outbreaks should be considered in economic decisions regarding the safety of public drinking water supplies.

Dollarization In El Salvador And Ecuador: A Model Worth Following

DTIC Science & Technology

2016-03-01

Since this thesis approaches dollarization from a macroeconomic viewpoint, additional research should focus on how dollarization has affected various...positive macroeconomic outcomes. Since this thesis approaches dollarization from a macroeconomic viewpoint, additional research should focus on how... addition , I want to thank my beautiful wife for being by my side and helping me through this process; I would not have been able to do it without you

A cost-benefit analysis of physical activity using bike/pedestrian trails.

PubMed

Wang, Guijing; Macera, Caroline A; Scudder-Soucie, Barbara; Schmid, Tom; Pratt, Michael; Buchner, David

2005-04-01

From a public health perspective, a cost-benefit analysis of using bike/pedestrian trails in Lincoln, Nebraska, to reduce health care costs associated with inactivity was conducted. Data was obtained from the city's 1998 Recreational Trails Census Report and the literature. Per capita annual cost of using the trails was 209.28 U.S. dollars (59.28 U.S. dollars construction and maintenance, 150 U.S. dollars of equipment and travel). Per capita annual direct medical benefit of using the trails was 564.41 U.S. dollars. The cost-benefit ratio was 2.94, which means that every 1 U.S. dollar investment in trails for physical activity led to 2.94 U.S. dollars in direct medical benefit. The sensitivity analyses indicated the ratios ranged from 1.65 to 13.40. Therefore, building trails is cost beneficial from a public health perspective. The most sensitive parameter affecting the cost-benefit ratios were equipment and travel costs; however, even for the highest cost, every 1 U.S. dollar investment in trails resulted in a greater return in direct medical benefit.

The U.S. Trade Deficit, The Dollar, and The Price of Oil

DTIC Science & Technology

2008-09-29

dollar against other major currencies erodes the purchasing power of oil producers. The International Monetary Fund ( IMF ) has identified three...to undermine the exchange value of the dollar relative to other currencies , devaluing the dollar relative to other currencies and reducing the... currencies . For some, these two events seem to indicate a cause and effect relationship between changes in the price of oil and changes in the value

Relationship of mother and child food purchases as a function of price: a pilot study.

PubMed

Epstein, Leonard H; Dearing, Kelly K; Handley, Elizabeth A; Roemmich, James N; Paluch, Rocco A

2006-07-01

To our knowledge, there are no data on parental influences on child purchasing behavior of healthy or unhealthy foods. Mothers and children in ten families were given 5.00 US dollars to purchase portions of preferred fruits/vegetables and high energy-dense snack foods for each of ten trials of price manipulations. For five of the trials the price of the fruit/vegetable increased in price from 0.50 US dollars to 2.50 US dollars (in 0.50 US dollar increments), while the price of the energy-dense snack food remained constant at 1.00 US dollar. For the remaining five trials, the commodity that previously rose in price remained constant at 1.00 US dollars and the other commodity varied from 0.50 US dollars to 2.50 US dollars. Same-price elasticity was shown for both the child and parent purchases, and parent purchases were significantly related to child purchases of both healthy (regression estimate = 0.46, p < 0.001) and unhealthy (regression estimate = 0.12, p = 0.036) foods. Children's purchases of unhealthy snack food items were positively related to family socioeconomic status, and negatively related to child age. These results indicate that parental food choice and purchasing behaviors may play a role in the development of children's purchasing of both healthy and unhealthy foods.

Personal finances of residents at three Canadian universities.

PubMed

Teichman, Joel M H; Matsumoto, Edward; Smart, Michael; Smith, Aspen E; Tongco, Wayne; Hosking, Denis E; MacNeily, Andrew E; Jewett, Michael A S

2005-02-01

To address 3 research questions (What financial choices do residents make? Are the financial choices of residents similar to those of the general public? Are the financial choices of surgical residents reasonable?), we examined financial data from Canadian residents. A written survey was administered to 338 residents (103 of them surgical residents) at 3 Canadian training institutions (University of Toronto, Queen's University and University of Manitoba). Resident household cash flows, assets and liabilities were characterized. Finances for residents were compared with those of the general public, by means of the Survey of Household Spending and Survey of Financial Security. Median resident income was 45,000 dollars annually (Can dollars throughout). With a working spouse, median household income was 87,500 dollars. Among residents, 62% had educational debt (median 37,500 dollars), 39% maintained unpaid credit-card balances (median 1750 dollars), 36% did not budget expenses, 25% maintained cash reserves <275 dollars, and 22% contributed neither to retirement nor nonretirement investments. Residents spent more on vehicles compared with members of the general public (median 17,500 dollars v. 10,720 dollars, p = 0.002) and on monthly housing (median 875 dollars v. 729 dollars, p < 0.001), respectively. Residents were more likely to carry student loans than people in the general population (61% v. 21%), more likely to carry vehicle loans (74% v. 29%) and less likely to carry credit-card debts (39% v. 50%, respectively). Surgical residents had income expectations after graduation higher than current billings justified. Fewer surgical (69%) than anesthesiology residents (88%, p < 0.05) contributed to Registered Retirement Savings Plans. From this limited sample, residents spend more than age- and income-matched members of the general public. Many residents save too little, fail to budget, and carry high educational and credit-card debts. Surgical residents' expectations of future income may be unrealistic. Further study is warranted.

Cost-effectiveness of home-based care versus hospital care for chronically ill tuberculosis patients, Francistown, Botswana.

PubMed

Moalosi, G; Floyd, K; Phatshwane, J; Moeti, T; Binkin, N; Kenyon, T

2003-09-01

Francistown, Botswana, 1999. To determine the affordability and cost-effectiveness of home-based directly observed therapy (DOT) compared to hospital-based DOT for chronically ill tuberculosis (TB) patients, and to describe the characteristics of patients and their caregivers. Costs for each alternative strategy were analysed from the perspective of the health system and caregivers, in 1998 US dollars. Caregiver costs were assessed using a structured questionnaire administered to a sample of 50 caregivers. Health system costs were assessed using interviews with relevant staff and documentary data such as medical records and expenditure files. These data were used to calculate the average cost of individual components of care, and, for each alternative strategy, the average cost per patient treated. Cost-effectiveness was calculated as the cost per patient compliant with treatment. The characteristics of caregivers and patients were assessed using demographic and socio-economic data collected during interviews, and medical records. Overall, home-based care reduced the cost per patient treated by 44% compared with hospital-based treatment (dollars 1657 vs. dollars 2970). The cost to the caregiver was reduced by 23% (dollars 551 vs. dollars 720), while the cost to the health system was reduced by 50% (dollars 1106 vs. dollars 2206). The cost per patient complying with treatment was dollars 1726 for home-based care and dollars 2970 for hospitalisation. Caregivers were predominantly female relatives (88%), unemployed (48%), with primary school education or less (82%), and with an income of less than dollars 1000 per annum (71%). Of those patients with an HIV test result, 98% were HIV-positive. Home-based care is more affordable and cost-effective than hospital-based care for chronically ill TB patients, although costs to caregivers remain high in relation to their incomes. Structured home-based DOT should be included as a component of the National Tuberculosis Control Programme in Botswana.

Implementation of the semi-aerobic landfill system (Fukuoka method) in developing countries: a Malaysia cost analysis.

PubMed

Chong, Theng Lee; Matsufuji, Yasushi; Hassan, Mohd Nasir

2005-01-01

Most of the existing solid waste landfill sites in developing countries are practicing either open dumping or controlled dumping. Proper sanitary landfill concepts are not fully implemented due to technological and financial constraints. Implementation of a fully engineered sanitary landfill is necessary and a more economically feasible landfill design is crucial, particularly for developing countries. This study was carried out by focusing on the economics from the development of a new landfill site within a natural clay area with no cost of synthetic liner up to 10 years after its closure by using the Fukuoka method semi-aerobic landfill system. The findings of the study show that for the development of a 15-ha landfill site in Malaysia with an estimated volume of 2,000,000 m(3), the capital investment required was about US 1,312,895 dollars, or about US 0.84 dollars/tonne of waste. Assuming that the lifespan of the landfill is 20 years, the total cost of operation was about US 11,132,536 dollars or US 7.15 dollars/tonne of waste. The closure cost of the landfill was estimated to be US 1,385,526 dollars or US 0.89 dollars/tonne of waste. Therefore, the total cost required to dispose of a tonne of waste at the semi-aerobic landfill was estimated to be US 8.89 dollars. By considering an average tipping fee of about US 7.89 dollars/tonne of waste in Malaysia in the first year, and an annual increase of 3% to about US 13.84 dollars in year-20, the overall system recorded a positive revenue of US 1,734,749 dollars. This is important information for the effort of privatisation of landfill sites in Malaysia, as well as in other developing countries, in order to secure efficient and effective landfill development and management.

Could a federal program to promote influenza vaccination among elders be cost-effective?

PubMed

Patel, Mitesh S; Davis, Matthew M

2006-03-01

Influenza-related mortality predominately and disproportionately impacts the elderly. Rates of annual influenza vaccination among the elderly are approximately 65%, far below the Healthy People 2010 target of 90%. We estimated the cost-effectiveness of a 10-year federal program to promote influenza vaccine, intended to increase vaccination rates among persons > or = 65 years old. Published estimates regarding influenza-associated mortality rates and vaccine efficacy among the US elderly were used to calculate the number needed to vaccinate (NNV) to prevent one all-cause death due to influenza, as well as the mortality reduction expected from increased vaccination rates. The costs per life-year saved were estimated for a hypothetical federal promotional campaign, patterned after a direct-to-consumer (DTC) advertising program (2006-2015). The base case scenario presumed a 25-percentage-point increase in vaccination rates to 90%; in sensitivity analyses, we examined programs that increased rates by 10-20 points. The base case NNV was 1116 (95% CI: 993-1348). Over the 10-year DTC-style influenza vaccine promotion program, 6516 (5576-7435) elderly lives would be saved. The incremental cost-effectiveness (C/E) of the program was dollar 16,300 (dollar 11,347-dollar 25,174) per life-year saved in 2006 and increased to dollar 199,906 (dollar 138,613-dollar 307,423) per life-year saved by 2015. Overall, the C/E for the 10-year program was dollar 37,621 (dollar 32,644-dollar 43,939) per life-year saved. Programs that yielded a 15-percentage-point increase or less in vaccination rates would have C/E values exceeding dollar 50,000 per life-year saved and save fewer than 4000 total lives. DTC-style promotional campaigns for influenza vaccine among elders may represent a cost-effective strategy for the federal government to pursue as a means of increasing elders' vaccination rates and reducing influenza-related mortality.

Availability of Foods and Beverages in Supplemental Nutrition Assistance Program-Authorized Dollar Stores in a Region of North Carolina.

PubMed

Racine, Elizabeth F; Batada, Ameena; Solomon, Corliss A; Story, Mary

2016-10-01

There are >25,000 Supplemental Nutrition Assistance Program (SNAP)-authorized dollar stores throughout the United States; many are located in lower-income neighborhoods and provide an accessible food and beverage source for area residents. The purpose of this research was to determine the percent of food deserts within 16 counties in North Carolina that include a SNAP dollar store; examine the types of foods and beverages at SNAP dollar stores in these counties; test whether the foods and beverages offered vary by SNAP dollar store chain; and test whether the foods and beverages available differ by rural and urban location. This cross-sectional study used a combination of publicly available data and primary data to investigate the research questions. Secondary data sources were obtained from the US Department of Agriculture's SNAP retailer locator, the US Census, and the US Department of Agriculture's Food Access Research Atlas. Availability of foods and beverages was assessed among a sample of 90 SNAP dollar stores in 16 counties in southern and western sections of North Carolina. Data were collected in June 2014. About half (52%) of the food deserts in the research area included a SNAP dollar store. Most of the sampled stores sold healthier food staples, such as frozen meats, brown rice, 100% whole-wheat bread, and dried beans. None of the stores sold fresh fruits or vegetables. Some of the foods and beverages offered (eg, frozen fruit, frozen unseasoned vegetables, nonfat or low-fat milk, frozen ground beef) varied by SNAP dollar store chain. The foods and beverages offered did not differ by rural or urban county location. SNAP dollar stores offer a number of healthy food staples; however, they do not sell fresh fruits or vegetables. Further food environment research should include dollar stores. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Special Nevada Report

DTIC Science & Technology

1991-09-23

86 and FY 87, more than $3 million was spent at Indian Springs AFAF to ready the base for limited deployments. In FY 88, the main runway was...Hunters 340 6,252 3,252 36,275 Dollars spent (millions) $.163 $1.2 $.397 $13.768 Percent of State Total Dollars 1.2 8.7 2.9 100 Upland Game Days...Hunted 25,545 5,284 5,938 112,811 Dollars spent (millions) $.751 $.153 $.239 $3.581 Percent of State Total Dollars 20.9 4.2 6.6 100 Waterfowl Days Hunted

Faith community nursing demonstrates good stewardship of community benefit dollars through cost savings and cost avoidance.

PubMed

Brown, Ameldia R; Coppola, Patricia; Giacona, Marian; Petriches, Anne; Stockwell, Mary Ann

2009-01-01

Health systems seeking responsible stewardship of community benefit dollars supporting Faith Community Nursing Networks require demonstration of positive measurable health outcomes. Faith Community Nurses (FCNs) answer the call for measurable outcomes by documenting cost savings and cost avoidances to families, communities, and health systems associated with their interventions. Using a spreadsheet tool based on Medicare reimbursements and diagnostic-related groupings, 3 networks of FCNs have together shown more than 600 000 (for calendar year 2008) healthcare dollars saved by avoidance of unnecessary acute care visits and extended care placements. The cost-benefit ratio of support dollars to cost savings and cost avoidance demonstrates that support of FCNs is good stewardship of community benefit dollars.

Cost-benefit analysis of first-generation antihistamines in the treatment of allergic rhinitis.

PubMed

Sullivan, Patrick W; Follin, Sheryl L; Nichol, Michael B

2004-01-01

The majority of individuals with allergic rhinitis in the US take first-generation antihistamines (FGAs). Although FGAs have been proven effective in alleviating allergic rhinitis symptoms, they have been associated with an increased risk of motor vehicle, aviation and occupational injuries and deaths, reduced productivity and impaired learning. The objective of this analysis was to quantify the total costs and benefits of FGA use in the US from the societal perspective. We used a decision-analytic model to quantify the annual societal costs and benefits of treatment with FGAs compared with the hypothetical alternative of no treatment for the population of individuals with allergic rhinitis and taking FGAs in the US in 2001. The benefit associated with FGA use was estimated using the willingness-to-pay framework and projected to the US population using published estimates of the prevalence of allergic rhinitis. The costs of FGA-associated sedation included lost productivity and the direct and indirect cost of unintentional injuries (including motor vehicle, occupational, public and home injuries and fatalities). The incidence of injuries and fatalities associated with FGA use was estimated using the risk of injury attributable to the sedentary effects of FGAs in the allergic rhinitis population. To evaluate uncertainty in the model assumptions, a probabilistic sensitivity analysis was conducted using Bayesian second-order Monte Carlo simulation. Costs and benefits are expressed in 2001 US dollars, using a 3% discount rate. Based on current utilisation, the total societal benefit (95% credible interval) associated with the use of FGAs for the treatment of allergic rhinitis was US 7.7 billion dollars (US 1.3 billion dollars to US 21 billion dollars). The societal cost of purchasing FGAs was only US 697 million dollars. However, the societal cost of FGA-associated sedation was US 11.3 billion dollars (US 2.4 billion dollars to US 50.8 billion dollars). The annual societal net benefit of FGA use for the treatment of allergic rhinitis in the US was -US4.2 billion dollars (-US 36 billion dollars to +US 0.296 billion dollars). The net benefit was negative in 97% of the 10,000 Monte Carlo simulations. The societal benefits of FGA use in alleviating the symptoms of allergic rhinitis are significant. However, based on the assumptions, probability distributions and parameter estimate ranges used in the current model, it is very likely that the costs associated with sedation exceed the benefits of FGA use in the US. The cost of FGA-associated sedation is comparable to estimates of the cost of all medical care expenditures on respiratory conditions in the US (US 12.1 billion dollars to US 31.3 billion dollars) [1996 values] and provides compelling evidence of the economic burden of sedation associated with FGA use.

Cost-effectiveness of vaccination against invasive pneumococcal disease among people 50 through 64 years of age: role of comorbid conditions and race.

PubMed

Sisk, Jane E; Whang, William; Butler, Jay C; Sneller, Vishnu-Priya; Whitney, Cynthia G

2003-06-17

Guidelines are increasingly recommending preventive services starting at 50 years of age, and policymakers are considering such a recommendation for pneumococcal polysaccharide vaccination. The finding that pneumococcal vaccination is cost-saving for people 65 years of age or older raises the question of the vaccination's implications for other older adults, especially black people, whose disease incidence exceeds that of nonblack people, and those with high-risk conditions. To assess the implications of vaccinating black and nonblack people 50 through 64 years of age against invasive pneumococcal disease. Cost-effectiveness analysis. Published literature for vaccination effectiveness and cost estimates; data on disease incidence and case-fatality rates from the Centers for Disease Control and Prevention. Hypothetical cohort 50 through 64 years of age with the 1995 U.S. age distribution. Lifetime. Societal. Pneumococcal polysaccharide vaccination compared with no vaccination. Incremental medical costs and health effects, in quality-adjusted life-years per vaccinee. Vaccination saved medical costs and improved health among high-risk black people (27.55 dollars savings per vaccinee) and nonblack people (5.92 dollars savings per vaccinee), excluding survivors' future costs. For low-risk black and nonblack people and the overall general population, vaccination cost 2477 dollars, 8195 dollars, and 3434 dollars, respectively, to gain 1 year of healthy life. Excluding survivors' future costs, in the general immunocompetent population, cost per quality-adjusted life-year in global worst-case results ranged from 21 513 dollars for black people to 68 871 dollars for nonblack people; in the high-risk population, cost ranged from 11 548 dollars for black people to 39 000 dollars for nonblack people. In the global best case, vaccination was cost-saving for black and nonblack people in the general immunocompetent and high-risk populations, excluding survivors' future costs. The cost-effectiveness range was narrower in probabilistic sensitivity analyses, with 95% probabilistic intervals ranging from cost-saving to 1594 dollars for black people and from cost-saving to 12 273 dollars for nonblack people in the general immunocompetent population. Costs per quality-adjusted life-year for low-risk people with case-fatality rates from 1998 were 2477 dollars for black people and 8195 dollars for nonblack people, excluding survivors' medical costs. These results support the current recommendation to vaccinate high-risk people and provide useful information for considering extending the recommendation to the general population 50 through 64 years of age. Lack of evidence about the effectiveness of revaccination for people 65 years of age or older, when disease risks are higher, argues for further research to guide vaccination policy.

Do drug formulary policies reflect evidence of value?

PubMed

Neumann, Peter J; Lin, Pei-Jung; Greenberg, Dan; Berger, Marc; Teutsch, Steven; Mansley, Edward; Weinstein, Milton C; Rosen, Allison B

2006-01-01

To investigate the extent to which preferred drug lists and tiered formularies reflect evidence of value, as measured in published cost-utility analyses (CUAs). Using 1998-2001 data from a large registry of cost-effectiveness analyses, we examined the 2004 Florida Medicaid preferred drug list and the 2004 Harvard Pilgrim Pharmacy Program 3-tier formulary, and compared cost-utility ratios (standardized to 2002 US dollars) of drugs with preferred and nonpreferred status. Few drugs on the formularies had any cost-utility data available. Of those that did, median cost-utility ratios were somewhat higher (less favorable) for Florida's preferred drugs compared with the nonpreferred drugs (25,465 dollars vs 13,085 dollars; P = .09). Ratios did not differ for drugs on tiers 1 and 2 of the Harvard Pilgrim formulary, although they were higher for tier 3 and for excluded drugs (18,309 dollars, 18,846 dollars, 52,119 dollars, and 22,580 dollars, respectively; P = .01). Among therapies reported to be cost-saving or to have cost-utility ratios below 50,000 dollars, 77% had favored status in Florida Medicaid and 73% in Harvard Pilgrim. Among dominated drug interventions (reported to be more costly and less effective than alternatives), 95% had favored status in Florida Medicaid and 56% in Harvard Pilgrim. This study underscores the paucity of published cost-utility data available to formulary committees. Some discrepancies prevail between the value of drugs, as reflected in published cost-utility ratios, and the formulary placement policies of 2 large health plans.

77 FR 12930 - Federal Acquisition Regulation: Socioeconomic Program Parity

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-02

... on May 6, 2011, reinstating the Rule of Two. C. Sole Source Dollar Thresholds Vary Among the... all socioeconomic programs had the same sole source dollar threshold. Response: The sole source dollar... business socioeconomic contracting program to utilize. D. Sole Source Authority Under the SDVOSB Program...

26 CFR 1.1502-95 - Rules on ceasing to be a member of a consolidated group (or loss subgroup).

Code of Federal Regulations, 2013 CFR

2013-04-01

... nearest dollar). Seventeen dollars is the product obtained by multiplying $50 (the remaining NUBIL balance... fraction because it is not held by the P group immediately after the close of Year 3. (v) Seventeen dollars...

26 CFR 1.1502-95 - Rules on ceasing to be a member of a consolidated group (or loss subgroup).

Code of Federal Regulations, 2011 CFR

2011-04-01

... nearest dollar). Seventeen dollars is the product obtained by multiplying $50 (the remaining NUBIL balance... fraction because it is not held by the P group immediately after the close of Year 3. (v) Seventeen dollars...

26 CFR 1.1502-95 - Rules on ceasing to be a member of a consolidated group (or loss subgroup).

Code of Federal Regulations, 2014 CFR

2014-04-01

... nearest dollar). Seventeen dollars is the product obtained by multiplying $50 (the remaining NUBIL balance... fraction because it is not held by the P group immediately after the close of Year 3. (v) Seventeen dollars...

26 CFR 1.1502-95 - Rules on ceasing to be a member of a consolidated group (or loss subgroup).

Code of Federal Regulations, 2012 CFR

2012-04-01

... nearest dollar). Seventeen dollars is the product obtained by multiplying $50 (the remaining NUBIL balance... fraction because it is not held by the P group immediately after the close of Year 3. (v) Seventeen dollars...

7 CFR 457.124 - Raisin crop insurance provisions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... maximum dollar amount. The value per ton established by FCIC and shown in the actuarial documents... insured tonnage by the reference maximum dollar amount, by the coverage level percentage you elect, and by... maximum dollar amount, except if your damaged production undergoes a USDA inspection and is stored by your...

7 CFR 457.124 - Raisin crop insurance provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... maximum dollar amount. The value per ton established by FCIC and shown in the actuarial documents... insured tonnage by the reference maximum dollar amount, by the coverage level percentage you elect, and by... maximum dollar amount, except if your damaged production undergoes a USDA inspection and is stored by your...

7 CFR 457.124 - Raisin crop insurance provisions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... maximum dollar amount. The value per ton established by FCIC and shown in the actuarial documents... insured tonnage by the reference maximum dollar amount, by the coverage level percentage you elect, and by... maximum dollar amount, except if your damaged production undergoes a USDA inspection and is stored by your...

7 CFR 457.124 - Raisin crop insurance provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... maximum dollar amount—The value per ton established by FCIC and shown in the actuarial documents... insured tonnage by the reference maximum dollar amount, by the coverage level percentage you elect, and by... maximum dollar amount, except if your damaged production undergoes a USDA inspection and is stored by your...

Federal Categorical Aid Programs, 78 Fiscal Year.

ERIC Educational Resources Information Center

National Council for Resource Development, Washington, DC.

The extent to which the nation's community and junior colleges received awards in selected federal categorical aid programs for fiscal year 1978 is outlined. For each aid program the following information is provided: dollars authorized, dollars awarded, dollars obtained by community colleges, total number of proposals submitted, total number of…

Recent proposals to limit Medigap coverage and modify Medicare cost sharing.

PubMed

Linehan, Kathryn

2012-02-24

As policymakers look for savings from the Medicare program, some have proposed eliminating or discouraging "first-dollar coverage" available through privately purchased Medigap policies. Medigap coverage, which beneficiaries obtain to protect themselves from Medicare's cost-sharing requirements and its lack of a cap on out-of-pocket spending, may discourage the judicious use of medical services by reducing or eliminating beneficiary cost sharing. It is estimated that eliminating such coverage, which has been shown to be associated with higher Medicare spending, and requiring some cost sharing would encourage beneficiaries to reduce their service use and thus reduce pro­gram spending. However, eliminating first-dollar coverage could cause some beneficiaries to incur higher spending or forego necessary services. Some policy proposals to eliminate first-dollar coverage would also modify Medicare's cost sharing and add an out-of-pocket spending cap for fee-for-service Medicare. This paper discusses Medicare's current cost-sharing requirements, Medigap insurance, and proposals to modify Medicare's cost sharing and eliminate first-dollar coverage in Medigap plans. It reviews the evidence on the effects of first-dollar coverage on spending, some objections to eliminating first-dollar coverage, and results of research that has modeled the impact of eliminating first-dollar coverage, modifying Medicare's cost-sharing requirements, and adding an out-of-pocket limit on beneficiaries' spending.

Effect of an imaging-based streamlined electronic healthcare process on quality and costs.

PubMed

Bui, Alex A T; Taira, Ricky K; Goldman, Dana; Dionisio, John David N; Aberle, Denise R; El-Saden, Suzie; Sayre, James; Rice, Thomas; Kangarloo, Hooshang

2004-01-01

A streamlined process of care supported by technology and imaging may be effective in managing the overall healthcare process and costs. This study examined the effect of an imaging-based electronic process of care on costs and rates of hospitalization, emergency room (ER) visits, specialist diagnostic referrals, and patient satisfaction. A healthcare process was implemented for an employer group, highlighting improved patient access to primary care plus routine use of imaging and teleconsultation with diagnostic specialists. An electronic infrastructure supported patient access to physicians and communication among healthcare providers. The employer group, a self-insured company, manages a healthcare plan for its employees and their dependents: 4,072 employees were enrolled in the test group, and 7,639 in the control group. Outcome measures for expenses and frequency of hospitalizations, ER visits, traditional specialist referrals, primary care visits, and imaging utilization rates were measured using claims data over 1 year. Homogeneity tests of proportions were performed with a chi-square statistic, mean differences were tested by two-sample t-tests. Patient satisfaction with access to healthcare was gauged using results from an independent firm. Overall per member/per month costs post-implementation were lower in the enrolled population (126 dollars vs 160 dollars), even though occurrence of chronic/expensive diseases was higher in the enrolled group (18.8% vs 12.2%). Lower per member/per month costs were seen for inpatient (33.29 dollars vs 35.59 dollars); specialist referrals (21.36 dollars vs 26.84 dollars); and ER visits (3.68 dollars vs 5.22 dollars). Moreover, the utilization rate for hospital admissions, ER visits, and traditional specialist referrals were significantly lower in the enrolled group, although primary care and imaging utilization were higher. Comparison to similar employer groups showed that the company's costs were lower than national averages (119.24 dollars vs 146.32 dollars), indicating that the observed result was not attributable to normalization effects. Patient satisfaction with access to healthcare ranked in the top 21st percentile. A streamlined healthcare process supported by technology resulted in higher patient satisfaction and cost savings despite improved access to primary care and higher utilization of imaging.

Molecular heterotopy in the expression of Brachyury orthologs in order Clypeasteroida (irregular sea urchins) and order Echinoida (regular sea urchins).

PubMed

Hibino, Taku; Harada, Yoshito; Minokawa, Takuya; Nonaka, Masaru; Amemiya, Shonan

2004-11-01

The expression patterns of Brachyury (Bra) orthologs in the development of four species of sand dollars (order: Clypeasteroida), including a direct-developing species, and of a sea urchin species (order: Echinoida) were investigated during the period from blastula to the pluteus stage, with special attention paid to the relationship between the expression pattern and the mode of gastrulation. The sand dollar species shared two expression domains of the Bra orthologs with the Echinoida species, in the vegetal ring (the first domain) and the oral ectoderm (the second domain). The following heterotopic changes in the expression of the Bra genes were found among the sand dollar species and between the sand dollars and the Echinoida species. (1) The vegetal ring expressing Bra in the sand dollars was much wider and was located at a higher position along the AV axis, compared with that in the Echinoida species. The characteristic Bra expression in the vegetal ring of the sand dollar embryos was thought to be involved in the mode of gastrulation, in which involution continues from the beginning of invagination until the end of gastrulation. (2) Two of the three indirect-developing sand dollar species that were examined exhibited a third domain, in which Bra was expressed on the oral side of the archenteron. (3) In the direct-developing sand dollar embryos, Bra was expressed with an oral-aboral asymmetry in the vegetal ring and with a left-right asymmetry in the oral ectoderm. In the Echinoida species, Bra was expressed in the vestibule at the six-armed pluteus stage.

The economic consequences of irritable bowel syndrome: a US employer perspective.

PubMed

Leong, Stephanie A; Barghout, Victoria; Birnbaum, Howard G; Thibeault, Crystal E; Ben-Hamadi, Rym; Frech, Feride; Ofman, Joshua J

2003-04-28

The objective of this study was to measure the direct costs of treating irritable bowel syndrome (IBS) and the indirect costs in the workplace. This was accomplished through retrospective analysis of administrative claims data from a national Fortune 100 manufacturer, which includes all medical, pharmaceutical, and disability claims for the company's employees, spouses/dependents, and retirees. Patients with IBS were identified as individuals, aged 18 to 64 years, who received a primary code for IBS or a secondary code for IBS and a primary code for constipation or abdominal pain between January 1, 1996, and December 31, 1998. Of these patients with IBS, 93.7% were matched based on age, sex, employment status, and ZIP code to a control population of beneficiaries. Direct and indirect costs for patients with IBS were compared with those of matched controls. The average total cost (direct plus indirect) per patient with IBS was 4527 dollars in 1998 compared with 3276 dollars for a control beneficiary (P<.001). The average physician visit costs were 524 dollars and 345 dollars for patients with IBS and controls, respectively (P<.001). The average outpatient care costs to the employer were 1258 dollars and 742 dollars for patients with IBS and controls, respectively (P<.001). Medically related work absenteeism cost the employer 901 dollars on average per employee treated for IBS compared with 528 dollars on average per employee without IBS (P<.001). Irritable bowel syndrome is a significant financial burden on the employer that arises from an increase in direct and indirect costs compared with the control group.

Despite Downturn, Some Colleges Continue to Receive Major Gifts

ERIC Educational Resources Information Center

Shieh, David

2009-01-01

Twenty million dollars to Vanderbilt University for financial aid. Seventeen million dollars to Washington and Lee University for faculty programs. Ten million dollars to the State University of New York at Stony Brook for science research. This article reports that donations of such magnitude, all announced in December, may seem unlikely in the…

Size, Stability and Incremental Budgeting Outcomes in Public Universities.

ERIC Educational Resources Information Center

Schick, Allen G.; Hills, Frederick S.

1982-01-01

Examined the influence of relative size in the analysis of total dollar and workforce budgets, and changes in total dollar and workforce budgets when correlational/regression methods are used. Data suggested that size dominates the analysis of total budgets, and is not a factor when discretionary dollar increments are analyzed. (JAC)

26 CFR 1.1402(a)-18 - Split-dollar life insurance arrangements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 12 2010-04-01 2010-04-01 false Split-dollar life insurance arrangements. 1... life insurance arrangements. See §§ 1.61-22 and 1.7872-15 for rules relating to the treatment of split-dollar life insurance arrangements. [T.D. 9092, 68 FR 54352, Sept. 17, 2003] ...

48 CFR 1.109 - Statutory acquisition-related dollar thresholds-adjustment for inflation.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-related dollar thresholds-adjustment for inflation. 1.109 Section 1.109 Federal Acquisition Regulations..., Issuance 1.109 Statutory acquisition-related dollar thresholds—adjustment for inflation. (a) 41 U.S.C. 431a... the FAR for inflation, except as provided in paragraph (c) of this section. This adjustment is...

Effects of genotype and isolate on expression of dollar spot in seashore paspalum

USDA-ARS?s Scientific Manuscript database

Seashore paspalum (Paspalum vaginatum Swartz) is a warm-season turfgrass species primarily utilized on golf courses and athletic fields and is often impacted by dollar spot disease. Dollar spot, caused by Sclerotinia homoeocarpa F.T. Bennett, is a major fungal disease and the most common turfgrass p...

77 FR 54659 - Price for the 2012 Annual Uncirculated Dollar Coin Set

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

... DEPARTMENT OF THE TREASURY United States Mint Price for the 2012 Annual Uncirculated Dollar Coin Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing a price of $54.95 for the 2012 Annual Uncirculated Dollar Coin Set. This set...

75 FR 62413 - Notice of Proposed Information Collection: Comment Request; HUD-Owned Real Estate-Dollar Home...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-08

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5380-N-38] Notice of Proposed Information Collection: Comment Request; HUD- Owned Real Estate--Dollar Home Sales Program AGENCY: Office of... information: Title of Proposal: HUD-Owned Real Estate--Dollar Home Sales Program. OMB Control Number, if...

75 FR 5315 - Boulder Canyon Project-Rate Order No. WAPA-150

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-02

... 85005-6457, e-mail [email protected] . Written comments may also be faxed to (602) 605-2490, attention: Jack... annual base charge for electric service divided equally between capacity and energy dollars. Annual energy dollars are divided by annual energy sales, and annual capacity dollars are divided by annual...

Your Food Dollar. Money Management. [Revised].

ERIC Educational Resources Information Center

Baran, Nancy H., Ed.

This student/teacher resource booklet provides information on conserving food dollars while providing nutritious meals. The guide shows how to set up a food budget and explains how scanning the weekly food ads, planning meals around the specials, and compiling a list accordingly can also help consumers get more for their food dollars. Numerous…

17 CFR 50.4 - Classes of swaps required to be cleared.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Fixed-to-floating swap class Currency U.S. dollar (USD) Euro (EUR) Sterling (GBP) Yen (JPY). Floating.... Conditional Notional Amounts No No No No. Specification Basis swap class Currency U.S. dollar (USD) Euro (EUR... agreement class Currency U.S. dollar (USD) Euro (EUR) Sterling (GBP) Yen (JPY). Floating Rate Indexes LIBOR...

17 CFR 50.4 - Classes of swaps required to be cleared.

Code of Federal Regulations, 2013 CFR

2013-04-01

... class Currency U.S. dollar (USD) Euro (EUR) Sterling (GBP) Yen (JPY). Floating Rate Indexes LIBOR... Amounts No No No No. Specification Basis swap class Currency U.S. dollar (USD) Euro (EUR) Sterling (GBP... Currency U.S. dollar (USD) Euro (EUR) Sterling (GBP) Yen (JPY). Floating Rate Indexes LIBOR EURIBOR LIBOR...

12 CFR 8.2 - Semiannual assessment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... over— Column A Column B Column C Column D Column E Million Million Million (dollars) (dollars) (dollars... into one of the asset-size brackets denoted by Columns A and B. A bank's or Federal savings association... the lower endpoint (Column A) of the bracket in which it falls. This base amount of the assessment is...

12 CFR 8.2 - Semiannual assessment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... over— Column A Column B Column C Column D Column E Million Million Million (dollars) (dollars) (dollars... into one of the asset-size brackets denoted by Columns A and B. A bank's or Federal savings association... the lower endpoint (Column A) of the bracket in which it falls. This base amount of the assessment is...

12 CFR 8.2 - Semiannual assessment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... over— Column A Column B Column C Column D Column E Million Million Million (dollars) (dollars) (dollars... into one of the asset-size brackets denoted by Columns A and B. A bank's or Federal savings association... the lower endpoint (Column A) of the bracket in which it falls. This base amount of the assessment is...

Comparative analytical costs of central laboratory glucose and bedside glucose testing: a College of American Pathologists Q-Probes study.

PubMed

Howanitz, Peter J; Jones, Bruce A

2004-07-01

One of the major attributes of laboratory testing is cost. Although fully automated central laboratory glucose testing and semiautomated bedside glucose testing (BGT) are performed at most institutions, rigorous determinations of interinstitutional comparative costs have not been performed. To compare interinstitutional analytical costs of central laboratory glucose testing and BGT and to provide suggestions for improvement. Participants completed a demographic form about their institutional glucose monitoring practices. They also collected information about the costs of central laboratory glucose testing, BGT at a high-volume testing site, and BGT at a low-volume testing site, including specified cost variables for labor, reagents, and instruments. A total of 445 institutions enrolled in the College of American Pathologists Q-Probes program. Median cost per glucose test at 3 testing sites. The median (10th-90th percentile range) costs per glucose test were 1.18 dollars (5.59 dollars-0.36 dollars), 1.96 dollars (9.51 dollars-0.77 dollars), and 4.66 dollars (27.54 dollars-1.02 dollars) for central laboratory, high-volume BGT sites, and low-volume BGT sites, respectively. The largest percentages of the cost per test were for labor (59.3%, 72.7%, and 85.8%), followed by supplies (27.2%, 27.3%, and 13.4%) and equipment (2.1%, 0.0%, and 0.0%) for the 3 sites, respectively. The median number of patient specimens per month at the high-volume BGT sites was 625 compared to 30 at the low-volume BGT sites. Most participants did not include labor, instrument maintenance, competency assessment, or oversight in their BGT estimated costs until required to do so for the study. Analytical costs per glucose test were lower for central laboratory glucose testing than for BGT, which, in turn, was highly variable and dependent on volume. Data that would be used for financial justification for BGT were widely aberrant and in need of improvement.

The cost of HIV medication adherence support interventions: results of a cross-site evaluation.

PubMed

Schackman, B R; Finkelstein, R; Neukermans, C P; Lewis, L; Eldred, L

2005-11-01

The objective of this study was to determine the direct cost of HIV adherence support programmes participating in a cross-site evaluation in the US. Data on the frequency, type, and setting of adherence encounters; providers' professions; and adherence tools provided were collected for 1,122 patients enrolled in 13 interventions at 9 sites. The site staff estimated the average duration of each type of encounter and national wage rates were used for labour costs. The median (range) adherence encounters/year among interventions was 16.5 (4.3-104.6) per patient; encounters lasted 24.6 (8.9-40.9) minutes. Intervention direct cost was correlated with the average frequency of encounters (r = 0.57), but not with encounter duration or providers' professions. The median direct cost/month was 35 dollars(5 dollars-58 dollars) per patient, and included direct provider costs (66%); incentives (17%); reminders and other tools (8%); and direct administrative time, provider transportation, training, and home delivery (9%). The median direct cost/month from a societal perspective, which includes patient time and travel costs, was 47 dollars(24 dollars-114 dollars) per patient. Adherence interventions with moderate efficacy costing < or =100 dollars/month have been estimated to meet a cost-effectiveness threshold that is generally accepted in the US. Payers should consider enhanced reimbursement for adherence support services.

Economic analysis of conventional-dose chemotherapy compared with high-dose chemotherapy plus autologous hematopoietic stem-cell transplantation for metastatic breast cancer.

PubMed

Schulman, K A; Stadtmauer, E A; Reed, S D; Glick, H A; Goldstein, L J; Pines, J M; Jackman, J A; Suzuki, S; Styler, M J; Crilley, P A; Klumpp, T R; Mangan, K F; Glick, J H

2003-02-01

We performed an economic analysis of data from 180 women in a clinical trial of conventional-dose chemotherapy vs high-dose chemotherapy plus stem-cell transplantation for metastatic breast cancer responding to first-line chemotherapy. Data on resource use, including hospitalizations, medical procedures, medications, and diagnostic tests, were abstracted from subjects' clinical trial records. Resources were valued using the Medicare Fee Schedule for inpatient costs at one academic medical center and average wholesale prices for medications. Monthly costs were calculated and stratified by treatment group and clinical phase. Mean follow-up was 690 days in the transplantation group and 758 days in the conventional-dose chemotherapy group. Subjects in the transplantation group were hospitalized for more days (28.6 vs 17.8, P=0.0041) and incurred higher costs (US dollars 84055 vs US dollars 28169) than subjects receiving conventional-dose chemotherapy, with a mean difference of US dollars 55886 (95% CI, US dollars 47298-US dollars 63666). Sensitivity analyses resulted in cost differences between the treatment groups from US dollars 36528 to US dollars 75531. High-dose chemotherapy plus stem-cell transplantation resulted in substantial additional morbidity and costs at no improvement in survival. Neither the survival results nor the economic findings support the use of this procedure outside of the clinical trial setting.

31 CFR 535.901 - Dollar accounts at banks abroad.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Dollar accounts at banks abroad. 535... Miscellaneous Provisions § 535.901 Dollar accounts at banks abroad. Any domestic bank is hereby authorized to effect withdrawals or other transfers from any account held in the name of a non-Iranian bank located in...

31 CFR 535.901 - Dollar accounts at banks abroad.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Dollar accounts at banks abroad. 535... Miscellaneous Provisions § 535.901 Dollar accounts at banks abroad. Any domestic bank is hereby authorized to effect withdrawals or other transfers from any account held in the name of a non-Iranian bank located in...

29 CFR 779.346 - Requirements for exemption summarized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... retail establishment under section 13(a)(2); that is, 75 percent of its annual dollar volume of sales of goods must not be for resale, 75 percent of its annual dollar volume of sales of goods must be recognized as retail in its industry, over 50 percent of its annual dollar volume of sales of goods must be...

77 FR 39679 - Request for Public Comments on Shipping Tolerances for Export Licenses Issued by the Bureau of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

... the applicable ``unit,'' BIS allows either no shipping tolerance on dollar value, or up to 25 percent shipping tolerance on dollar value. The Department of State, which issues licenses for commodities identified on the USML, measures shipping tolerances based on dollar value. The Department of State applies a...

Strong Dollar, Weak Dollar: Foreign Exchange Rates and the U.S. Economy.

ERIC Educational Resources Information Center

Schilling, Tim

Many generalizations sound simple enough--for example, "strong is good, weak is bad"--but they can be confusing when talking about money. This booklet explores how the U.S. dollar and foreign currencies affect each other and how their interaction affects the individual and the economy. The booklet contains the following sections:…

13 CFR 126.601 - What additional requirements must a qualified HUBZone SBC meet to bid on a contract?

Code of Federal Regulations, 2010 CFR

2010-01-01

... Council (FAR Council) has the responsibility of adjusting each acquisition-related dollar threshold on October 1 of each year that is evenly divisible by five. Acquisition-related dollar thresholds are defined as dollar thresholds that are specified in law as a factor in defining the scope of the applicability...

12 CFR 1229.9 - Discretionary actions applicable to significantly undercapitalized Banks.

Code of Federal Regulations, 2011 CFR

2011-01-01

... absolute dollar amount, as a percentage of current obligations or in any other form chosen by the Director...-balance sheet obligations. Such reduction may be stated in an absolute dollar amount, as a percentage of... absolute dollar amount, as a percentage of current assets or in any other form chosen by the Director; (4...

12 CFR 1229.9 - Discretionary actions applicable to significantly undercapitalized Banks.

Code of Federal Regulations, 2010 CFR

2010-01-01

... absolute dollar amount, as a percentage of current obligations or in any other form chosen by the Director...-balance sheet obligations. Such reduction may be stated in an absolute dollar amount, as a percentage of... absolute dollar amount, as a percentage of current assets or in any other form chosen by the Director; (4...

38 CFR 3.405 - Filipino veterans and their survivors; benefits at the full-dollar rate.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Filipino veterans and... Compensation Effective Dates § 3.405 Filipino veterans and their survivors; benefits at the full-dollar rate... compensation at full-dollar rates to certain Filipino veterans and their survivors, are considered liberalizing...

First report of dollar spot disease, caused by Sclerotinia homoeocarpa, of Agrostis stolonifera in Sweden

USDA-ARS?s Scientific Manuscript database

Dollar spot is a destructive and widespread disease affecting most grass species grown as turf, but until recently it has been absent from the Scandinavian countries of northern Europe. In the fall of 2014, disease symptoms consistent with dollar spot were observed on a golf course fairway in Sweden...

41 CFR 102-73.40 - What happens if the dollar value of the project exceeds the prospectus threshold?

Code of Federal Regulations, 2010 CFR

2010-07-01

... dollar value of the project exceeds the prospectus threshold? 102-73.40 Section 102-73.40 Public... § 102-73.40 What happens if the dollar value of the project exceeds the prospectus threshold? Projects... the prospectus threshold. To obtain this approval, the Administrator of General Services will transmit...

41 CFR 102-73.40 - What happens if the dollar value of the project exceeds the prospectus threshold?

Code of Federal Regulations, 2011 CFR

2011-01-01

... dollar value of the project exceeds the prospectus threshold? 102-73.40 Section 102-73.40 Public... § 102-73.40 What happens if the dollar value of the project exceeds the prospectus threshold? Projects... the prospectus threshold. To obtain this approval, the Administrator of General Services will transmit...

41 CFR 102-73.40 - What happens if the dollar value of the project exceeds the prospectus threshold?

Code of Federal Regulations, 2012 CFR

2012-01-01

... dollar value of the project exceeds the prospectus threshold? 102-73.40 Section 102-73.40 Public... § 102-73.40 What happens if the dollar value of the project exceeds the prospectus threshold? Projects... the prospectus threshold. To obtain this approval, the Administrator of General Services will transmit...

Visual screening for malignant melanoma: a cost-effectiveness analysis.

PubMed

Losina, Elena; Walensky, Rochelle P; Geller, Alan; Beddingfield, Frederick C; Wolf, Lindsey L; Gilchrest, Barbara A; Freedberg, Kenneth A

2007-01-01

To evaluate the cost-effectiveness of various melanoma screening strategies proposed in the United States. We developed a computer simulation Markov model to evaluate alternative melanoma screening strategies. Hypothetical cohort of the general population and siblings of patients with melanoma. Intervention We considered the following 4 strategies: background screening only, and screening 1 time, every 2 years, and annually, all beginning at age 50 years. Prevalence, incidence, and mortality data were taken from the Surveillance, Epidemiology, and End Results Program. Sibling risk, recurrence rates, and treatment costs were taken from the literature. Outcomes included life expectancy, quality-adjusted life expectancy, and lifetime costs. Cost-effectiveness ratios were in dollars per quality-adjusted life year (US dollars/QALY) gained. In the general population, screening 1 time, every 2 years, and annually saved 1.6, 4.4, and 5.2 QALYs per 1000 persons screened, with incremental cost-effectiveness ratios of US dollars 10,100/QALY, US dollars 80,700/QALY, and US dollars 586,800/QALY, respectively. In siblings of patients with melanoma (relative risk, 2.24 compared with the general population), 1-time, every-2-years, and annual screenings saved 3.6, 9.8, and 11.4 QALYs per 1000 persons screened, with incremental cost-effectiveness ratios of US dollars 4000/QALY, US dollars 35,500/QALY, and US dollars 257,800/QALY, respectively. In higher risk siblings of patients with melanoma (relative risk, 5.56), screening was more cost-effective. Results were most sensitive to screening cost, melanoma progression rate, and specificity of visual screening. One-time melanoma screening of the general population older than 50 years is very cost-effective compared with other cancer screening programs in the United States. Screening every 2 years in siblings of patients with melanoma is also cost-effective.

Retail marijuana purchases in designer and commercial markets in New York City: sales units, weights, and prices per gram.

PubMed

Sifaneck, Stephen J; Ream, Geoffrey L; Johnson, Bruce D; Dunlap, Eloise

2007-09-01

This paper documents the bifurcation of the market for commercial marijuana from the market for designer marijuana in New York City. Commercial marijuana is usually grown outdoors, imported to NYC, and of average quality. By contrast, several varities of designer marijuana are usually grown indoors from specially bred strains and carefully handled for maximum quality. The mechanisms for marijuana sales include street/park sellers, delivery services, private sales, and storefronts. Retail sales units vary from 5 dollars to 50 dollars and more, but the actual weights and price per gram of retail marijuana purchases lacks scientific precision. Ethnographic staff recruited marijuana purchasers who used digital scales to weigh a purposive sample of 99 marijuana purchases. Results indicate clear differences in price per gram between the purchases of commercial (average 8.20 dollars/g) and designer (average 18.02 dollars/g) marijuana. Designer purchases are more likely to be made by whites, downtown (Lower East Side/Union Square area), via delivery services, and in units of 10 dollar bags, 50 dollar cubes, and eighth and quarter ounces. Commercial marijuana purchases are more likely to be made by blacks, uptown (Harlem), via street dealers, and in units of 5 dollar and 20 dollar bags. Imported commercial types Arizona and Chocolate were only found uptown, while designer brand names describing actual strains like Sour Diesel and White Widow were only found downtown. Findings indicate clear divisions between commercial and designer marijuana markets in New York City. The extent that these differences may be based upon different THC potencies is a matter for future research.

Cost calculation and prediction in adult intensive care: a ground-up utilization study.

PubMed

Moran, J L; Peisach, A R; Solomon, P J; Martin, J

2004-12-01

The ability of various proxy cost measures, including therapeutic activity scores (TISS and Omega) and cumulative daily severity of illness scores, to predict individual ICU patient costs was assessed in a prospective "ground-up" utilization costing study over a six month period in 1991. Daily activity (TISS and Omega scores) and utilization in consecutive admissions to three adult university associated ICUs was recorded by dedicated data collectors. Cost prediction used linear regression with determination (80%) and validation (20%) data sets. The cohort, 1333 patients, had a mean (SD) age 57.5 (19.4) years, (41% female) and admission APACHE III score of 58 (27). ICU length of stay and mortality were 3.9 (6.1) days and 17.6% respectively. Mean total TISS and Omega scores were 117 (157) and 72 (113) respectively. Mean patient costs per ICU episode (1991 dollar AUS) were dollar 6801 (dollar 10311), with median costs of dollar 2534, range dollar 106 to dollar 95,602. Dominant cost fractions were nursing 43.3% and overheads 16.9%. Inflation adjusted year 2002 (mean) costs were dollar 9343 (dollar AUS). Total costs in survivors were predicted by Omega score, summed APACHE III score and ICU length of stay; determination R2, 0.91; validation 0.88. Omega was the preferred activity score. Without the Omega score, predictors were age, summed APACHE III score and ICU length of stay; determination R2, 0.73; validation 0.73. In non-survivors, predictors were age and ICU length of stay (plus interaction), and Omega score (determination R2, 0.97; validation 0.91). Patient costs may be predicted by a combination of ICU activity indices and severity scores.

The "costs" of urinary incontinence for women.

PubMed

Subak, Leslee L; Brown, Jeanette S; Kraus, Stephen R; Brubaker, Linda; Lin, Feng; Richter, Holly E; Bradley, Catherine S; Grady, Deborah

2006-04-01

To estimate costs of routine care for female urinary incontinence, health-related quality of life, and willingness to pay for incontinence improvement. In a cross-sectional study at 5 U.S. sites, 293 incontinent women quantified supplies, laundry, and dry cleaning specifically for incontinence. Costs were calculated by multiplying resources used by national resource costs and presented in 2005 United States dollars (2005). Health-related quality of life was estimated with the Health Utilities Index. Participants estimated willingness to pay for 25-100% improvement in incontinence. Potential predictors of these outcomes were examined using multivariable linear regression. Mean age was 56 +/- 11 years; participants were racially diverse and had a broad range of incontinence severity. Nearly 90% reported incontinence-related costs. Median weekly cost (25%, 75% interquartile range) increased from 0.37 dollars (0, 4 dollars) for slight to 10.98 dollars (4, 21 dollars) for very severe incontinence. Costs increased with incontinence severity (P < .001). Costs were 2.4-fold higher for African American compared with white women (P < .001) and 65% higher for women with urge compared with those having stress incontinence (P < .001). More frequent incontinence was associated with lower Health Utilities Index score (mean 0.90 +/- 0.11 for weekly and 0.81 +/- 0.21 for daily incontinence; P = .02). Women were willing to pay a mean of 70 dollars +/- 64 dollars per month for complete resolution of incontinence, and willingness to pay increased with income and greater expected benefit. Women with severe urinary incontinence pay 900 dollars annually for incontinence routine care, and incontinence is associated with a significant decrement in health-related quality of life. Effective incontinence treatment may decrease costs and improve quality of life. III.

Volume associations in total hip arthroplasty: a nationwide Taiwan population-based study.

PubMed

Shi, Hon-Yi; Chang, Je-Ken; Chiu, Herng-Chia

2013-12-01

This cohort study retrospectively analyzed 78,364 THAs performed from 1998 to 2009. The mean hospital charge for all THAs performed during the study period was $4,131.9 dollars. The average hospital charges for high-volume hospitals and surgeons were 6% and 7% lower, respectively, than those for low-volume hospitals and surgeons. Analysis by propensity score matching showed that hospital charges significantly differed between THA procedures performed by high- and low-volume hospitals ($3,285.8 dollars versus $4,816.2 dollars, respectively) and between THA procedures performed by high- and low-volume surgeons, ($3,438.5 dollars versus $4,404.7 dollars, respectively) (P < 0.001). The data indicate that analysis and emulation of the treatment strategies used by high-volume hospitals and by high-volume surgeons may reduce overall hospital charges. Copyright © 2013 Elsevier Inc. All rights reserved.

78 FR 75406 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

... Shares of the WisdomTree Bloomberg U.S. Dollar Bullish Fund, WisdomTree Bloomberg U.S. Dollar Bearish Fund, and the WisdomTree Commodity Currency Bearish Fund Under NYSE Arca Equities Rule 8.600 December 5... and trade shares (``Shares'') of WisdomTree Bloomberg U.S. Dollar Bullish Fund, WisdomTree Bloomberg U...

Application of Principal Component Analysis (PCA) to Reduce Multicollinearity Exchange Rate Currency of Some Countries in Asia Period 2004-2014

ERIC Educational Resources Information Center

Rahayu, Sri; Sugiarto, Teguh; Madu, Ludiro; Holiawati; Subagyo, Ahmad

2017-01-01

This study aims to apply the model principal component analysis to reduce multicollinearity on variable currency exchange rate in eight countries in Asia against US Dollar including the Yen (Japan), Won (South Korea), Dollar (Hong Kong), Yuan (China), Bath (Thailand), Rupiah (Indonesia), Ringgit (Malaysia), Dollar (Singapore). It looks at yield…

75 FR 23829 - Self-Regulatory Organizations; National Stock Exchange, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-04

... Liquidity Adding Rebate for Securities Priced Under One Dollar April 28, 2010. Pursuant to Section 19(b)(1... securities priced under one dollar. The text of the proposed rule change is available on the Exchange's Web... Schedule to adjust the liquidity adding rebate for securities priced under one dollar in both the Automatic...

77 FR 28909 - Self-Regulatory Organizations; National Stock Exchange, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... executions in securities priced at least one dollar in the Exchange's Automatic Execution Mode of order... securities priced at least one dollar in AutoEx. Third, SR-NSX-2012-06 amended the rebate tiers applicable to order executions in securities priced at least one dollar in the Exchange's Order Delivery Mode of order...

Data from: An Analysis of Nearly One Billion Dollars of Aquaculture Grants

Science.gov Websites

Us Search  Log inRegister Home Home Datasets Data from: An Analysis of Nearly One Billion Dollars : An Analysis of Nearly One Billion Dollars of Aquaculture Grants made by the United States Federal , or other details for analysis. A limited number of umbrella grants were issued to one institution

How the Dollar's Value Affects U.S. Farm Exports to Developing Countries. Foreign Agricultural Economic Report Number 237.

ERIC Educational Resources Information Center

Burfisher, Mary E.

United States exports may not necessarily increase when the dollar falls on the world market. Conventional thinking is that a weaker dollar means more demand for U.S. products because they become less expensive than goods from countries with stronger currencies. However, developing countries whose export revenues are denominated in the weakening…

Dynamic linkages among the gold market, US dollar and crude oil market

NASA Astrophysics Data System (ADS)

Mo, Bin; Nie, He; Jiang, Yonghong

2018-02-01

This paper aims to examine the dynamic linkages among the gold market, US dollar and crude oil market. The analysis also delves more deeply into the effect of the global financial crisis on the short-term relationship. We use fractional cointegration to analyze the long-term memory feature of these volatility processes to investigate whether they are tied through a common long-term equilibrium. The DCC-MGARCH model is employed to investigate the time-varying long-term linkages among these markets. The Krystou-Labys non-linear asymmetric Granger causality method is used to examine the effect of the financial crisis. We find that (i) there is clearly a long-term dependence among these markets; (ii) the dynamic gold-oil relationship is always positive and the oil-dollar relationship is always negative; and (iii) after the crisis, we can observe evidence of a positive non-linear causal relationship from gold to US dollar and US dollar to crude oil, and a negative non-linear causal relationship from US dollar to gold. Investors who want to construct their optimal portfolios and policymakers who aim to make effective macroeconomic policies should take these findings into account.

26 CFR 1.985-2 - Election to use the United States dollar as the functional currency of a QBU.

Code of Federal Regulations, 2010 CFR

2010-04-01

... functional currency of a QBU. 1.985-2 Section 1.985-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... Election to use the United States dollar as the functional currency of a QBU. (a) Background and scope—(1... currency for taxable years beginning on or before August 24, 1994. An election to use a dollar functional...

Medical costs associated with non-Hodgkin's lymphoma in the United States during the first two years of treatment.

PubMed

Kutikova, Lucie; Bowman, Lee; Chang, Stella; Long, Stacey R; Arning, Michael; Crown, William H

2006-08-01

To determine the direct costs of medical care associated with aggressive and indolent non-Hodgkin's lymphoma (NHL) in the United States; to show how costs for aggressive NHL change over time by examining costs related to initial, secondary and palliative treatment phases; and to evaluate the economic consequences of treatment failure in aggressive NHL. A retrospective cohort analysis of 1999 - 2000 direct costs in newly diagnosed NHL patients and controls (subjects without any cancer) was conducted using the MarketScan medical and drug claims database of large employers across the United States. Treatment failure analysis was conducted for aggressive NHL patients, and was defined by the need for secondary treatment or palliative care after initial therapy. Cost of treatment failure was calculated as difference in regression-adjusted costs between patients with initial therapy only and patients experiencing initial treatment failure. Patients with aggressive (n = 356) and indolent (n = 698) NHL had significantly greater health service utilization and associated costs (all P < 05) than controls (n = 1068 for aggressive, n = 2094 for indolent). Mean monthly costs were 5871 dollars for aggressive NHL vs. 355 dollars for controls (P < 0001) and 3833 dollars for indolent NHL vs. 289 dollars for controls (P < 0001). The primary cost drivers were hospitalization (aggressive NHL = 44% of total costs, indolent NHL = 50%) and outpatient office visits (aggressive NHL = 39%, indolent NHL = 34%). For aggressive NHL, mean monthly initial treatment phase costs (10,970 dollars) and palliative care costs (9836 dollars) were higher than costs incurred during secondary phase (3302 dollars). The mean cost of treatment failure in aggressive NHL was 14,174 dollars per month, and 85,934 dollars over the study period. The treatment of NHL was associated with substantial health care costs. Patients with aggressive lymphomas tended to accrue higher costs, compared with those with indolent lymphomas. These costs varied over time, with the highest costs occurring during the initial treatment and palliative care phases. Treatment failure was the most expensive treatment pattern. New strategies to prevent or delay treatment failure in aggressive NHL could help reduce the economic burden of NHL.

Using decision modeling to determine pricing of new pharmaceuticals: the case of neurokinin-1 receptor antagonist antiemetics for cancer chemotherapy.

PubMed

Dranitsaris, George; Leung, Pauline

2004-01-01

Decision analysis is commonly used to perform economic evaluations of new pharmaceuticals. The outcomes of such studies are often reported as an incremental cost per quality-adjusted life year (QALY) gained with the new agent. Decision analysis can also be used in the context of estimating drug cost before market entry. The current study used neurokinin-1 (NK-1) receptor antagonists, a new class of antiemetics for cancer patients, as an example to illustrate the process using an incremental cost of dollars Can20,000 per QALY gained as the target threshold. A decision model was developed to simulate the control of acute and delayed emesis after cisplatin-based chemotherapy. The model compared standard therapy with granisetron and dexamethasone to the same protocol with the addition of an NK-1 before chemotherapy and continued twice daily for five days. The rates of complete emesis control were abstracted from a double-blind randomized trial. Costs of standard antiemetics and therapy for breakthrough vomiting were obtained from hospital sources. Utility estimates characterized as quality-adjusted emesis-free days were determined by interviewing twenty-five oncology nurses and pharmacists by using the Time Trade-Off technique. These data were then used to estimate the unit cost of the new antiemetic using a target threshold of dollars Can20,000 per QALY gained. A cost of dollars Can6.60 per NK-1 dose would generate an incremental cost of dollars Can20,000 per QALY. The sensitivity analysis on the unit cost identified a range from dollars Can4.80 to dollars Can10.00 per dose. For the recommended five days of therapy, the total cost should be dollars Can66.00 (dollars Can48.00-dollars Can100.00) for optimal economic efficiency relative to Canada's publicly funded health-care system. The use of decision modeling for estimating drug cost before product launch is a powerful technique to ensure value for money. Such information can be of value to both drug manufacturers and formulary committees, because it would facilitate negotiations for optimal pricing in a given jurisdiction.

House OK's Russian aid

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

Rothstein, L.

1993-09-01

This article discusses the 2.5 Billion dollar aid package to Russia which House Appropriations Foreign Operations Subcommittee Chairman David Obey successfully defended on the House floor last June. Arizona Republican Jon Kyl offered an admendment that would cut 700 million from the package and was defeated with a 118 to 140 vote. The bill is currently in the hands of the Senate. The controversy over the bill and details concerning the aid package are discussed. The aid deal includes 250 million dollars for nuclear reactor safety and energy as well as environmental technical assistance, 655 million dollars to aid privatemore » sector development, and 704 million dollars for additional technical and economic assistance.« less

Competition in Weapon Systems Acquisition: Cost Analyses of Some Issues

DTIC Science & Technology

1990-09-01

10% increments , also known as the step-ladder bids) submitted by the contractor in the first year of dual source procurement. The triangles represent...savings by subtracting annual incremental government costs, stated in constant dollars, from (3). (5) Estimate nonrecurring start-up costs, stated in...constant dollars, by fiscal year. (6) Estimate incremental logistic support costs, stated in constant dollars. by fiscal year. (7) Calculate a net

29 CFR 779.354 - Who may qualify as exempt 13(a)(2) or 13(a)(4) establishments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... not in an enterprise described in section 3(s) of the Act or, if it is, its annual dollar volume of...; and (2) More than 50 percent of the establishment's annual dollar volume of sales of goods or services... establishment's annual dollar volume of sales of goods or services (or of both) is made from sales which are not...

Prediction of the dollar to the ruble rate. A system-theoretic approach

NASA Astrophysics Data System (ADS)

Borodachev, Sergey M.

2017-07-01

Proposed a simple state-space model of dollar rate formation based on changes in oil prices and some mechanisms of money transfer between monetary and stock markets. Comparison of predictions by means of input-output model and state-space model is made. It concludes that with proper use of statistical data (Kalman filter) the second approach provides more adequate predictions of the dollar rate.

26 CFR 1.58-9 - Application of the tax benefit rule to the minimum tax for taxable years beginning prior to 1987.

Code of Federal Regulations, 2014 CFR

2014-04-01

... exceed the limitation under section 904. Example 1. In 1982 Corporation B has $17.6 million dollars in... Corporation B has $17.6 million dollars in foreign tax credits available for the taxable year. If preference... limitation under section 904. Example 1. (i) In 1982 Corporation B has $17.6 million dollars in foreign tax...

26 CFR 1.58-9 - Application of the tax benefit rule to the minimum tax for taxable years beginning prior to 1987.

Code of Federal Regulations, 2011 CFR

2011-04-01

... exceed the limitation under section 904. Example 1. In 1982 Corporation B has $17.6 million dollars in... Corporation B has $17.6 million dollars in foreign tax credits available for the taxable year. If preference... limitation under section 904. Example 1. (i) In 1982 Corporation B has $17.6 million dollars in foreign tax...

26 CFR 1.58-9 - Application of the tax benefit rule to the minimum tax for taxable years beginning prior to 1987.

Code of Federal Regulations, 2012 CFR

2012-04-01

... exceed the limitation under section 904. Example 1. In 1982 Corporation B has $17.6 million dollars in... Corporation B has $17.6 million dollars in foreign tax credits available for the taxable year. If preference... limitation under section 904. Example 1. (i) In 1982 Corporation B has $17.6 million dollars in foreign tax...

26 CFR 1.58-9 - Application of the tax benefit rule to the minimum tax for taxable years beginning prior to 1987.

Code of Federal Regulations, 2013 CFR

2013-04-01

... exceed the limitation under section 904. Example 1. In 1982 Corporation B has $17.6 million dollars in... Corporation B has $17.6 million dollars in foreign tax credits available for the taxable year. If preference... limitation under section 904. Example 1. (i) In 1982 Corporation B has $17.6 million dollars in foreign tax...

Assessing the costs and benefits of US renewable portfolio standards

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

Wiser, Ryan; Mai, Trieu T.; Millstein, Dev

In this study, renewable portfolio standards (RPS) exist in 29 US states and the District of Columbia. This article summarizes the first national-level, integrated assessment of the future costs and benefits of existing RPS policies; the same metrics are evaluated under a second scenario in which widespread expansion of these policies is assumed to occur. Depending on assumptions about renewable energy technology advancement and natural gas prices, existing RPS policies increase electric system costs by as much as 31 billion dollars, on a present-value basis over 2015-2050. The expanded renewable deployment scenario yields incremental costs that range from 23 billionmore » to 194 billion dollars, depending on the assumptions employed. The monetized value of improved air quality and reduced climate damages exceed these costs. Using central assumptions, existing RPS policies yield 97 billion dollars in air-pollution health benefits and 161 billion dollars in climate damage reductions. Under the expanded RPS case, health benefits total 558 billion dollars and climate benefits equal 599 billion dollars. These scenarios also yield benefits in the form of reduced water use. RPS programs are not likely to represent the most cost effective path towards achieving air quality and climate benefits. Nonetheless, the findings suggest that US RPS programs are, on a national basis, cost effective when considering externalities.« less

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.

Complying with a corporate global noise health surveillance procedure--do the benefits outweigh the costs?

PubMed

Bertsche, Patricia K; Mensah, Edward; Stevens, Thomas

2006-08-01

The purpose of this study was to determine whether the benefits of early identification of work-related noise-induced hearing loss outweigh the costs of complying with a Global Noise Medical Surveillance Procedure of a large corporation. Hearing is fundamental to language, communication, and socialization. Its loss is a common cause of disability, affecting an estimated 20 to 40 million individuals in the United States (Daniell et al., 1998). NIOSH reported that approximately 30 million U.S. workers are exposed to noise on the job and that noise-induced hearing loss is one of the most common occupational diseases. It is irreversible (NIOSH, 2004). The average cost of a noise-induced hearing loss is reported to range from dollars 4,726 to dollars 25,500. Corporate history indicates a range of dollars 44 to dollars 20,157 per case. During this 4-year study in one plant, the average annual cost of complying with the Global Noise Medical Surveillance Procedure was dollars 19,509 to screen an average of 390 employees, or dollars 50 per worker. The study identified 11 non-work-related standard threshold shifts. All cases were referred for appropriate early intervention. Given the results, this hearing health program is considered beneficial to the corporation for both work- and non-work-related reasons.

Assessing the costs and benefits of US renewable portfolio standards

DOE PAGES

Wiser, Ryan; Mai, Trieu T.; Millstein, Dev; ...

2017-09-26

In this study, renewable portfolio standards (RPS) exist in 29 US states and the District of Columbia. This article summarizes the first national-level, integrated assessment of the future costs and benefits of existing RPS policies; the same metrics are evaluated under a second scenario in which widespread expansion of these policies is assumed to occur. Depending on assumptions about renewable energy technology advancement and natural gas prices, existing RPS policies increase electric system costs by as much as 31 billion dollars, on a present-value basis over 2015-2050. The expanded renewable deployment scenario yields incremental costs that range from 23 billionmore » to 194 billion dollars, depending on the assumptions employed. The monetized value of improved air quality and reduced climate damages exceed these costs. Using central assumptions, existing RPS policies yield 97 billion dollars in air-pollution health benefits and 161 billion dollars in climate damage reductions. Under the expanded RPS case, health benefits total 558 billion dollars and climate benefits equal 599 billion dollars. These scenarios also yield benefits in the form of reduced water use. RPS programs are not likely to represent the most cost effective path towards achieving air quality and climate benefits. Nonetheless, the findings suggest that US RPS programs are, on a national basis, cost effective when considering externalities.« less

Economic impacts of reduced milk production associated with papillomatous digital dermatitis in dairy cows in the USA.

PubMed

Losinger, Willard C

2006-05-01

The goal of this study was to measure the economic impacts of reduced milk production associated with papillomatous digital dermatitis (PDD) in dairy cows in the USA, and of specific risk factors for PDD, in 1996. The method applied was an economic-welfare analysis of producer and consumer surplus, with the GUM Workbench used to analyse uncertainties in the measurements. Reduced milk production associated with PDD was found to reduce consumer surplus by Dollars 750 million +/- Dollars 580 million, and to increase the economic surplus of producers by Dollars 560 million +/- Dollars 470 million, with a net economic loss of Dollars 190 million +/- Dollars 130 million. An examination of the economic effects of specific epidemiologic risk factors for PDD showed that having dairy cows that were not born on the operation had important economic consequences associated with the disease, as did the type of land to which dairy cows had access during the winter months and the type of flooring on which cows walked. Washing hoof-trimming equipment between cows was an important biosecurity measure that was associated with reduced PDD. The epidemiologic model used also implicated hoof trimmers who trimmed cattle hooves on other operations as having an important economic impact associated with this disease, although this finding may have been erroneous.

Influence of clinical outcome and outcome period definitions on estimates of absolute clinical and economic benefits of influenza vaccination in community dwelling elderly persons.

PubMed

Nichol, K L; Nordin, J; Mullooly, J

2006-03-06

Studies assessing the clinical and economic benefits of vaccination in the elderly have used different clinical outcomes (e.g. hospitalizations for pneumonia or influenza versus hospitalizations for respiratory and cardiovascular causes) and different outcome periods (e.g. peak versus total influenza season) on which to base estimates of clinical effectiveness and cost effectiveness. We explored the implications of these varying approaches by comparing two health economic analysis models of influenza vaccination of community-dwelling elderly persons. We developed computerized models using clinical data from 3 large US HMOs for the 1998-1999 and 1999-2000 influenza seasons. The primary health economic model used a broad definition of clinical events and outcome period and included hospitalizations for all respiratory and cardiovascular events that occurred during the entire influenza season. The alternative model used more restrictive definitions and included pneumonia or influenza hospitalizations occurring during the peak influenza season. The results of Monte Carlo simulation showed that, with the more inclusive primary model, influenza vaccination resulted in net medical care cost savings due to fewer respiratory or cardiovascular hospitalizations of Dollars 71/person vaccinated (5th-95th percentile Dollars 32-118) and net savings of Dollars 809/year of life saved (5th-95th percentile Dollars 331-1450). In contrast, the alternate model found costs of Dollars 3.50/person vaccinated (5th-95th percentile Dollars -11 to 5) and net costs of Dollars 91/year of life saved (5th-95th percentile Dollars -309 to 126). Our findings confirm that influenza vaccination of the elderly is most likely cost saving and supports policies and programs that advocate routine immunization of all persons 65 and older. They also highlight how different outcome definitions can influence the results of health economic analyses.

The Dollar’s Vulnerability and the Threat to National Security

DTIC Science & Technology

2011-01-01

Monetary Fund (IMF) and the World Bank.31 The system attempted to lower trade barriers by reconciling exchange rate stability and domestic economic...2010). 41 Michael Mussa, " Exchange Rate Adjustments Needed to Reduce Global Payment Imbalances," In Dollar Adjustment: How Far? Against What?, by C...two scenarios for dollar depreciation that help answer this question. The first scenario occurs over 20 years at an annual depreciation rate of 1.75

Acoustic Scattering from Sand Dollars (Dendraster excentricus): Modeling as High Aspect Ratio Oblate Objects and Comparison to Experiment

DTIC Science & Technology

2008-09-01

2004), forward scattering and backscattering from a sand dollar test, a bivalve shell , and a machined aluminum disk of similar size were measured over a...Abstract Benthic shells can contribute greatly to the scattering variability of the ocean bottom, particularly at low grazing angles. Among the...effects of shell aggregates are increased scattering strength and potential subcritical angle penetration of the seafloor. Sand dollars (Dendraster

A Quantitative Analysis of the Benefits of Prototyping Fixed-Wing Aircraft

DTIC Science & Technology

2012-06-14

in then-year dollars. The RDT&E costs through FSD were provided in then-year dollars as a lump sum. Additionally, the cost of full capability ...development was available in then-year dollars as a lump sum. Full capability development was the RDT&E that continued after the completion of the FSD...contract, which ended in July 1984. In [31] [31], the authors stated that full capability development occurred through approximately 1990

Development and validation of a weather-based warning system to advise fungicide applications to control dollar spot on turfgrass.

PubMed

Smith, D L; Kerns, J P; Walker, N R; Payne, A F; Horvath, B; Inguagiato, J C; Kaminski, J E; Tomaso-Peterson, M; Koch, P L

2018-01-01

Dollar spot is one of the most common diseases of golf course turfgrass and numerous fungicide applications are often required to provide adequate control. Weather-based disease warning systems have been developed to more accurately time fungicide applications; however, they tend to be ineffective and are not currently in widespread use. The primary objective of this research was to develop a new weather-based disease warning system to more accurately advise fungicide applications to control dollar spot activity across a broad geographic and climactic range. The new dollar spot warning system was developed from data collected at field sites in Madison, WI and Stillwater, OK in 2008 and warning system validation sites were established in Madison, WI, Stillwater, OK, Knoxville, TN, State College, PA, Starkville, MS, and Storrs, CT between 2011 and 2016. A meta-analysis of all site-years was conducted and the most effective warning system for dollar spot development consisted of a five-day moving average of relative humidity and average daily temperature. Using this model the highest effective probability that provided dollar spot control similar to that of a calendar-based program across the numerous sites and years was 20%. Additional analysis found that the 20% spray threshold provided comparable control to the calendar-based program while reducing fungicide usage by up to 30%, though further refinement may be needed as practitioners implement this warning system in a range of environments not tested here. The weather-based dollar spot warning system presented here will likely become an important tool for implementing precision disease management strategies for future turfgrass managers, especially as financial and regulatory pressures increase the need to reduce pesticide usage on golf course turfgrass.

Consumer preference for dinoprostone vaginal gel using stated preference discrete choice modelling.

PubMed

Taylor, Susan; Armour, Carol

2003-01-01

To assess consumer preference for two methods of induction of labour using stated preference discrete choice modelling. The methods of induction were artificial rupture of the membranes (ARM) plus oxytocin and dinoprostone (prostaglandin E(2)) vaginal gel, followed by oxytocin if necessary. Consumer preference was measured in terms of willingness to pay for each of the attributes. These attributes were the method of administration, place of care, length of time from induction to delivery, need for epidural anaesthetic, type of delivery and cost. Levels were assigned to each of the attributes. Pregnant women attending a public hospital antenatal clinic were asked to read a description of the two methods and then to choose between them in 18 different scenarios in which the levels of the attributes were varied. Women were willing to pay 11 Australian dollars for a 1% reduction in the chance of needing oxytocin as well as the gel and 55 Australian dollars for every 1 hour reduction in the length of time from induction to delivery. For a 1% reduction in the chance of needing an epidural anaesthetic or Caesarean section, women expressed a willingness to pay of 20 Australian dollars and 90 Australian dollars, respectively. All estimates were obtained in 1998 and expressed in Australian dollars (1 Australian dollar = 0.63 US dollars). Women valued the less invasive method of administration of the gel and the associated greater freedom of movement during labour. However, they valued the shorter time from induction to delivery associated with ARM plus oxytocin more highly. A policy which allows women access to the gel for up to two doses would accommodate this consumer preference.

Development and validation of a weather-based warning system to advise fungicide applications to control dollar spot on turfgrass

PubMed Central

Smith, D. L.; Kerns, J. P.; Walker, N. R.; Payne, A. F.; Horvath, B.; Inguagiato, J. C.; Kaminski, J. E.; Tomaso-Peterson, M.

2018-01-01

Dollar spot is one of the most common diseases of golf course turfgrass and numerous fungicide applications are often required to provide adequate control. Weather-based disease warning systems have been developed to more accurately time fungicide applications; however, they tend to be ineffective and are not currently in widespread use. The primary objective of this research was to develop a new weather-based disease warning system to more accurately advise fungicide applications to control dollar spot activity across a broad geographic and climactic range. The new dollar spot warning system was developed from data collected at field sites in Madison, WI and Stillwater, OK in 2008 and warning system validation sites were established in Madison, WI, Stillwater, OK, Knoxville, TN, State College, PA, Starkville, MS, and Storrs, CT between 2011 and 2016. A meta-analysis of all site-years was conducted and the most effective warning system for dollar spot development consisted of a five-day moving average of relative humidity and average daily temperature. Using this model the highest effective probability that provided dollar spot control similar to that of a calendar-based program across the numerous sites and years was 20%. Additional analysis found that the 20% spray threshold provided comparable control to the calendar-based program while reducing fungicide usage by up to 30%, though further refinement may be needed as practitioners implement this warning system in a range of environments not tested here. The weather-based dollar spot warning system presented here will likely become an important tool for implementing precision disease management strategies for future turfgrass managers, especially as financial and regulatory pressures increase the need to reduce pesticide usage on golf course turfgrass. PMID:29522560

The value of aortic valve replacement in elderly patients: an economic analysis.

PubMed

Wu, YingXing; Grunkemeier, Gary L; Starr, Albert

2007-03-01

Economists have designed frameworks to measure the economic value of improvements in health and longevity. Heart valve replacement surgery has significantly prolonged life expectancy and quality of life. For the example of aortic valve replacement, what is its economic value according to this framework? From 1961 through 2003, a total of 4617 adult patients underwent aortic valve replacement by one team of cardiac surgeons. These patients were provided with a prospective lifetime follow-up service. As of 2005, observed follow-up was 31,671 patient-years, with a maximum of 41 years. A statistical model was used to generate the future life-years of patients currently alive. The value of life-years proposed by economists was applied to determine the economic value of the additional life given to these patients by aortic valve replacement. The total life-years after aortic valve replacement were 53,323, with a gross value of 14.6 billion dollars. The total expected life-years without surgery were 10,157, with an estimated value of 3.0 billion dollars. Thus the net life-years gained by AVR were 43,166, worth 11.6 billion dollars. Subtracting the 451 million dollars total lifetime cost of surgery, the net value of the life-years gained by AVR was 11.2 billion dollars. The mean net value decreases according to age at surgery but is still worth 600,000 dollars for octogenarians and 200,000 dollars for nonagenarians. According to the economic concept of the value of a statistical life, the return on the investment for aortic valve replacement is enormous for patients of all ages, even very elderly patients.

An Overview of the Past, Present, and Future of 3D Printing Technology with an Emphasis on the Present

ERIC Educational Resources Information Center

Snyder, Robin M.

2014-01-01

Just as the cost of high quality laser printing started in the tens of thousands of dollar and can now be purchased for under $100, so too has 3D printing technology started in the tens of thousands of dollars and is now in the thousand dollar range. Current 3D printing technology takes 2D printing into a third dimension. Many 3D printers are…

Allocation Methods for Use in the Accrual of Manpower Costs.

DTIC Science & Technology

1983-06-01

planners more frugal in their use of military manpower (OB1, 1973). Generally Accepted Accounting Principles ( GAAP ) recognize accrual basis accounting...time. Examples of this type of allocation are depreciation or amortization of long term assets (Fremgen and Liao, 1981). It is this second concept of...financing is that the relatively "soft dollars" of the future will make it easier to contribute. A "soft dollar" is the depreciated value of the dollar

Feasibility and cost-effectiveness of treating multidrug-resistant tuberculosis: a cohort study in the Philippines.

PubMed

Tupasi, Thelma E; Gupta, Rajesh; Quelapio, Ma Imelda D; Orillaza, Ruth B; Mira, Nona Rachel; Mangubat, Nellie V; Belen, Virgil; Arnisto, Nida; Macalintal, Lualhati; Arabit, Michael; Lagahid, Jaime Y; Espinal, Marcos; Floyd, Katherine

2006-09-01

Multidrug-resistant tuberculosis (MDR-TB) is an important global health problem, and a control strategy known as DOTS-Plus has existed since 1999. However, evidence regarding the feasibility, effectiveness, cost, and cost-effectiveness of DOTS-Plus is still limited. We evaluated the feasibility, effectiveness, cost, and cost-effectiveness of a DOTS-Plus pilot project established at Makati Medical Center in Manila, the Philippines, in 1999. Patients with MDR-TB are treated with regimens, including first- and second-line drugs, tailored to their drug susceptibility pattern (i.e., individualised treatment). We considered the cohort enrolled between April 1999 and March 2002. During this three-year period, 118 patients were enrolled in the project; 117 were considered in the analysis. Seventy-one patients (61%) were cured, 12 (10%) failed treatment, 18 (15%) died, and 16 (14%) defaulted. The average cost per patient treated was US3,355 dollars from the perspective of the health system, of which US1,557 dollars was for drugs, and US837 dollars from the perspective of patients. The mean cost per disability-adjusted life year (DALY) gained by the DOTS-Plus project was US242 dollars (range US85 dollars to US426 dollars). Treatment of patients with MDR-TB using the DOTS-Plus strategy and individualised drug regimens can be feasible, comparatively effective, and cost-effective in low- and middle-income countries.

Contraception and abortion coverage: What do primary care physicians think?

PubMed

Chuang, Cynthia H; Martenis, Melissa E; Parisi, Sara M; Delano, Rachel E; Sobota, Mindy; Nothnagle, Melissa; Schwarz, Eleanor Bimla

2012-08-01

Insurance coverage for family planning services has been a highly controversial element of the US health care reform debate. Whether primary care providers (PCPs) support public and private health insurance coverage for family planning services is unknown. PCPs in three states were surveyed regarding their opinions on health plan coverage and tax dollar use for contraception and abortion services. Almost all PCPs supported health plan coverage for contraception (96%) and use of tax dollars to cover contraception for low-income women (94%). A smaller majority supported health plan coverage for abortions (61%) and use of tax dollars to cover abortions for low-income women (63%). In adjusted models, support of health plan coverage for abortions was associated with female gender and internal medicine specialty, and support of using tax dollars for abortions for low-income women was associated with older age and internal medicine specialty. The majority of PCPs support health insurance coverage of contraception and abortion, as well as tax dollar subsidization of contraception and abortion services for low-income women. Copyright © 2012 Elsevier Inc. All rights reserved.

Value-based medicine and ophthalmology: an appraisal of cost-utility analyses.

PubMed

Brown, Gary C; Brown, Melissa M; Sharma, Sanjay; Brown, Heidi; Smithen, Lindsay; Leeser, David B; Beauchamp, George

2004-01-01

To ascertain the extent to which ophthalmologic interventions have been evaluated in value-based medicine format. Retrospective literature review. Papers in the healthcare literature utilizing cost-utility analysis were reviewed by researchers at the Center for Value-Based Medicine, Flourtown, Pennsylvania. A literature review of papers addressing the cost-utility analysis of ophthalmologic procedures in the United States over a 12-year period from 1992 to 2003 was undertaken using the National Library of Medicine and EMBASE databases. The cost-utility of ophthalmologic interventions in inflation-adjusted (real) year 2003 US dollars expended per quality-adjusted life-year (dollars/QALY) was ascertained in all instances. A total of 19 papers were found, including a total of 25 interventions. The median cost-utility of ophthalmologic interventions was 5,219 dollars/QALY, with a range from 746 dollars/QALY to 6.5 million dollars/QALY. The majority of ophthalmologic interventions are especially cost-effective by conventional standards. This is because of the substantial value that ophthalmologic interventions confer to patients with eye diseases for the resources expended.

26 CFR 1.985-0 - Outline of regulation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... dollar. (d) Single functional currency for a foreign corporation. (e) Translation of nonfunctional...) Scope and effective date. (b) Statement of method. (c) Translation into United States dollars. (d...

[Cost management: the implementation of the activity-based costing method in sterile processing department].

PubMed

Jericó, Marli de Carvalho; Castilho, Valéria

2010-09-01

This exploratory case study was performed aiming at implementing the Activity-based Costing (ABC) method in a sterile processing department (SPD) of a major teaching hospital. Data collection was performed throughout 2006. Documentary research techniques and non participant closed observation were used. The ABC implementation allowed for learning the activity-based costing of both the chemical and physical disinfection cycle/load: (dollar 9.95) and (dollar 12.63), respectively; as well as the cost for sterilization by steam under pressure (autoclave) (dollar 31.37) and low temperature steam and gaseous formaldehyde sterilization (LTSF) (dollar 255.28). The information provided by the ABC method has optimized the overall understanding of the cost driver process and provided the foundation for assessing performance and improvement in the SPD processes.

Lorain Harbor, Ohio. Preliminary Feasibility Study (Stage 2). Review of Reports. Volume 1. Main Report.

DTIC Science & Technology

1980-10-01

May 1980 Dollars) 93 32 Apportionment of Total Project Cost for Alternative 1, Option 1 (1,000-Footer) 94 33 Estimated Investment Cost and Annual...Costs - Alternative 2, Option 1 (1,000-Foot Vessels) (May 1980 Dollars) 101 36 Apportionment of Total Project Cost for Alternative 2, Option 1 (1,000...1 (1,000-Footer) 104 39 Estimate of Navigation Project Codes - Alternative 3, Option 1 (1,000-Foot Vessels) (May 1980 Dollars) 107 40 Apportionment of

Financial and Political Crisis in Argentina: Walking a Wobbly Tightrope

DTIC Science & Technology

2002-03-01

Background At the core of the current economic crisis is Argentina’s currency, the peso , which until recently was pegged to the U.S. dollar. In...1991, then-president Carlos Menem artificially tied the peso to the dollar at one to one parity through a currency board in order to generate financial...limited monetary growth by only allowing as many pesos to circulate in Argentina’s economy as dollars held in the Argentine Central Bank’s reserves

26 CFR 1.5000A-0 - Table of contents.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Required contribution percentage. (i) In general. (ii) Indexing. (iii) Plan year. (3) Individuals eligible...) Applicable dollar amount. (iii) Special applicable dollar amount for individuals under age 18. (iv) Indexing...

Assessing cost-effectiveness of drug interventions for schizophrenia.

PubMed

Magnus, Anne; Carr, Vaughan; Mihalopoulos, Cathrine; Carter, Rob; Vos, Theo

2005-01-01

To assess from a health sector perspective the incremental cost-effectiveness of eight drug treatment scenarios for established schizophrenia. Using a standardized methodology, costs and outcomes are modelled over the lifetime of prevalent cases of schizophrenia in Australia in 2000. A two-stage approach to assessment of health benefit is used. The first stage involves a quantitative analysis based on disability-adjusted life years (DALYs) averted, using best available evidence. The robustness of results is tested using probabilistic uncertainty analysis. The second stage involves application of 'second filter' criteria (equity, strength of evidence, feasibility and acceptability) to allow broader concepts of benefit to be considered. Replacing oral typicals with risperidone or olanzapine has an incremental cost-effectiveness ratio (ICER) of 48,000 Australian dollars and 92,000 Australian dollars/DALY respectively. Switching from low-dose typicals to risperidone has an ICER of 80,000 Australian dollars. Giving risperidone to people experiencing side-effects on typicals is more cost-effective at 20,000 Australian dollars. Giving clozapine to people taking typicals, with the worst course of the disorder and either little or clear deterioration, is cost-effective at 42,000 Australian dollars or 23,000 Australian dollars/DALY respectively. The least cost-effective intervention is to replace risperidone with olanzapine at 160,000 Australian dollars/DALY. Based on an 50,000 Australian dollars/DALY threshold, low-dose typical neuroleptics are indicated as the treatment of choice for established schizophrenia, with risperidone being reserved for those experiencing moderate to severe side-effects on typicals. The more expensive olanzapine should only be prescribed when risperidone is not clinically indicated. The high cost of risperidone and olanzapine relative to modest health gains underlie this conclusion. Earlier introduction of clozapine however, would be cost-effective. This work is limited by weaknesses in trials (lack of long-term efficacy data, quality of life and consumer satisfaction evidence) and the translation of effect size into a DALY change. Some stakeholders, including SANE Australia, argue the modest health gains reported in the literature do not adequately reflect perceptions by patients, clinicians and carers, of improved quality of life with these atypicals.

Lower extremity endovascular interventions: can we improve cost-efficiency?

PubMed

O'Brien-Irr, Monica S; Harris, Linda M; Dosluoglu, Hasan H; Dayton, Merril; Dryjski, Maciej L

2008-05-01

Management of lower extremity arterial disease with endovascular intervention is on the rise. Current practice patterns vary widely across and within specialty practices that perform endovascular intervention. This study evaluated reimbursement and costs of different approaches for offering endovascular intervention and identified strategies to improve cost-efficiency. The medical records of all patients admitted to a university health system during 2005 for an endovascular intervention were retrospectively reviewed. Procedure type, setting, admission status, and financial data were recorded. Groups were compared using analysis of variance, Student t test for independent samples, and chi2. A total of 296 endovascular interventions were completed, and 184 (62%) met inclusion criteria. Atherectomy and stenting were significantly more costly when performed in the operating room than in the radiology suite: atherectomy, dollars 6596 vs dollars 4867 (P = .002); stent, dollars 5884 vs dollars 3292, (P < .001); angioplasty, dollars 2251 vs dollars 1881 (P = .46). Reimbursement was significantly higher for inpatient vs ambulatory admissions (P < .001). Costs were lowest when the endovascular intervention was done in the radiology suite on an ambulatory basis and highest when done as an inpatient in the operating room (dollars 5714 vs dollars 12,278; P < .001). Contribution margins were significantly higher for inpatients. Net profit was appreciated only for interventions done as an inpatient in the radiology suite. Reimbursement, contribution margins, and net profit were significantly lower among private pay patients in both the ambulatory and inpatient setting. The 30-day hospital readmission after ambulatory procedures was seven patients (6%). Practice patterns for endovascular interventions differ considerably. Costs vary by procedure and setting, and reimbursement depends on admission status and accurate documentation; these dynamics affect affordability. Organizing vascular services within a hub will ensure that care is delivered in the most cost-efficient manner. Guidelines may include designating the radiology suite as the primary venue for endovascular interventions because it is less costly than the operating room. Selective stenting policies should be considered. Contracts with private insurers must include carve-outs for stent costs and commensurate reimbursement for ambulatory procedures, and Current Procedural Terminology (CPT; American Medical Association, Chicago, Ill) coding must be proficient to make ambulatory endovascular interventions fiscally acceptable.

75 FR 72793 - National Saltwater Angler Registry Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

... fifteen dollars ($15.00) for registration of anglers, spear fishers and for-hire fishing vessels to... anglers, spear fishers and for-hire fishing vessels will be fifteen dollars ($15.00). All persons...

76 FR 52384 - Indexing the Annual Operating Revenues of Railroads

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

... level for Class I railroads from $50 million (1978 dollars) to $250 million (1991 dollars), effective... Board, William F. Huneke, Director, Office of Economics. Jeffrey Herzig, Clearance Clerk. [FR Doc. 2011...

Black-white differences in the economic value of improving health.

PubMed

Murphy, Kevin M; Topel, Robert H

2005-01-01

This article examines how differences in longevity over time and across groups add to the typical measures of economic progress and intergroup differentials. We focus on gains for and differences between groups defined both by race (black and white) and by gender, relying on willingness to pay as our measure of the economic value of gains in longevity. Measured at birth, the gains for white males between 1968 and 1998 were about 245,000 dollars per person, while the gains for black males were far larger, about 390,000 dollars per person. The gains for women were somewhat smaller, with white females gaining about 150,000 dollars per person and black females gaining about 305,000 dollars per person. Our estimates suggest that differences in income explain about 1/3 to 1/2 of the current black-white gap in longevity.

The price of innovation: new estimates of drug development costs.

PubMed

DiMasi, Joseph A; Hansen, Ronald W; Grabowski, Henry G

2003-03-01

The research and development costs of 68 randomly selected new drugs were obtained from a survey of 10 pharmaceutical firms. These data were used to estimate the average pre-tax cost of new drug development. The costs of compounds abandoned during testing were linked to the costs of compounds that obtained marketing approval. The estimated average out-of-pocket cost per new drug is 403 million US dollars (2000 dollars). Capitalizing out-of-pocket costs to the point of marketing approval at a real discount rate of 11% yields a total pre-approval cost estimate of 802 million US dollars (2000 dollars). When compared to the results of an earlier study with a similar methodology, total capitalized costs were shown to have increased at an annual rate of 7.4% above general price inflation. Copyright 2003 Elsevier Science B.V.

Space tourism optimized reusable spaceplane design

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

Penn, J.P.; Lindley, C.A.

Market surveys suggest that a viable space tourism industry will require flight rates about two orders of magnitude higher than those required for conventional spacelift. Although enabling round-trip cost goals for a viable space tourism business are about {dollar_sign}240 per pound ({dollar_sign}529/kg), or {dollar_sign}72,000 per passenger round-trip, goals should be about {dollar_sign}50 per pound ({dollar_sign}110/kg) or approximately {dollar_sign}15,000 for a typical passenger and baggage. The lower price will probably open space tourism to the general population. Vehicle reliabilities must approach those of commercial aircraft as closely as possible. This paper addresses the development of spaceplanes optimized for the ultra-high flightmore » rate and high reliability demands of the space tourism mission. It addresses the fundamental operability, reliability, and cost drivers needed to satisfy this mission need. Figures of merit similar to those used to evaluate the economic viability of conventional commercial aircraft are developed, including items such as payload/vehicle dry weight, turnaround time, propellant cost per passenger, and insurance and depreciation costs, which show that infrastructure can be developed for a viable space tourism industry. A reference spaceplane design optimized for space tourism is described. Subsystem allocations for reliability, operability, and costs are made and a route to developing such a capability is discussed. The vehicle{close_quote}s ability to also satisfy the traditional spacelift market is shown. {copyright} {ital 1997 American Institute of Physics.}« less

Costs of alcohol and drug-involved crime.

PubMed

Miller, Ted R; Levy, David T; Cohen, Mark A; Cox, Kenya L C

2006-12-01

A large proportion of violent and property crimes involve alcohol or other drugs (AOD). AOD use only causes some of these crimes. This paper estimates the costs of AOD-involved and AOD-attributable crimes. Crime counts are from government statistics adjusted for underreporting. The AOD-involved portion of crime costs is estimated from inmate surveys on alcohol and illicit drug use at the time of the crime. The costs and AOD-attributable portion of AOD-involved crimes come from published studies. They include tangible medical, mental health, property loss, future earnings, public services, adjudication, and sanctioning costs, as well as the value of pain and suffering. An estimated 5.4 million violent crimes and 8 million property crimes involved AOD use in 1999. Those AOD-involved crimes cost society over 6.5 billion dollars in medical and mental health care and almost 65 billion dollars in other tangible expenses (in 1999 dollars). If the value of pain, suffering, and lost quality of life is added, AOD-involved crime costs totaled 205 billion dollars. Violent crimes accounted for more than 85% of the costs. Roughly estimated, crimes attributable to alcohol cost 84 billion dollars, more than 2 times the 38 billion dollars attributable to drugs. Although American media--news and entertainment--dwell on the links between drugs and crime, alcohol-attributable crime costs are double drug-attributable ones. Effective efforts to reduce the abuse of alcohol and illicit drugs should reduce costs associated with crime.

Evolutionary modification of T-brain (tbr) expression patterns in sand dollar.

PubMed

Minemura, Keiko; Yamaguchi, Masaaki; Minokawa, Takuya

2009-10-01

The sand dollars are a group of irregular echinoids that diverged from other regular sea urchins approximately 200 million years ago. We isolated two orthologs of T-brain (tbr), Smtbr and Pjtbr, from the indirect developing sand dollar Scaphechinus mirabilis and the direct developing sand dollar Peronella japonica, respectively. The expression patterns of Smtbr and Pjtbr during early development were examined by whole mount in situ hybridization. The expression of Smtbr was first detected in micromere descendants in early blastula stage, similar to tbr expression in regular sea urchins. However, unlike in regular sea urchin, Smtbr expression in middle blastula stage was detected in micromere-descendent cells and a subset of macromere-descendant cells. At gastrula stage, expression of Smtbr was detected in part of the archenteron as well as primary mesenchyme cells. A similar pattern of tbr expression was observed in early Peronella embryos. A comparison of tbr expression patterns between sand dollars and other echinoderm species suggested that broader expression in the endomesoderm is an ancestral character of echinoderms. In addition to the endomesoderm, Pjtbr expression was detected in the apical organ, the animal-most part of the ectoderm.

500 Contractors Receiving the Largest Dollar Volume of Prime Contract Awards for Research, Development, Test, and Evaluation, Fiscal Year 1987.

DTIC Science & Technology

1987-01-01

Headquarters Services Directorate for Information Operations and Reports D) ,( /NT IS lientitra on nn Iber for hIs bh act& r, s (i0 ’F H 7 FOREWORD 500...This report provides information on the 500 contractors that received the largest dollar volume in Department of Defense (DOD) prime contract awards... report presents summary data on the 500 prime contractors receiving the largest dollar volume in Department of Defense (DOD) awards over $25,000 for

Pheromonal Control of Metamorphosis in the Pacific Sand Dollar, Dendraster excentricus.

PubMed

Burke, R D

1984-07-27

Competent larvae are induced to undergo metamorphosis by sand from a sand dollar bed or an aqueous extract of the sand. Gel permeation chromatography and high-performance liquid chromatography of the extract yielded a 980-dalton peptide that will induce metamorphosis between 10(-6) and 10(-5) molar. Extracts of whole adults and gonads were also able to induce metamorphosis, and adults can condition substrates to induce metamorphosis. Therefore, the initiation of metamorphosis in Dendraster excentricus is controlled by a pheromone released by adult sand dollars.

Technical Considerations for Improvement of USAF Operational Training, Testing and Evaluation (OTT and E)

DTIC Science & Technology

1975-06-30

Needs 24 3-4 Needs 25 3-5 EW Scoring Considerations 28 3-6 Risk vs Benefit - Voluntary & 30 Involuntary Exposure 3-7 Mapping of Dollar Loss to the Air...method? Of this new jammer? Or this new tactic? Or this new airplane?" Can all be answer3d by showing how aircraft losses were lessened, while...30 approach does not present a cost basis to determine the dollar worth of safety improvements. Figure 3-7 shows the average dollar loss of

Exchange rate rebounds after foreign exchange market interventions

NASA Astrophysics Data System (ADS)

Hoshikawa, Takeshi

2017-03-01

This study examined the rebounds in the exchange rate after foreign exchange intervention. When intervention is strongly effective, the exchange rate rebounds at next day. The effect of intervention is reduced slightly by the rebound after the intervention. The exchange rate might have been 67.12-77.47 yen to a US dollar without yen-selling/dollar-purchasing intervention of 74,691,100 million yen implemented by the Japanese government since 1991, in comparison to the actual exchange rate was 103.19 yen to the US dollar at the end of March 2014.

Impact of traditional and novel risk factors on the relationship between socioeconomic status and incident cardiovascular events.

PubMed

Albert, Michelle A; Glynn, Robert J; Buring, Julie; Ridker, Paul M

2006-12-12

Persons of lower socioeconomic status have greater cardiovascular risk than those of higher socioeconomic status. However, the mechanism through which socioeconomic status affects cardiovascular disease (CVD) is uncertain. Virtually no data are available that examine the prospective association between novel inflammatory and hemostatic CVD risk indicators, socioeconomic status, and incident CVD events. We assessed the relationship between 2 indicators of socioeconomic status (education and income), traditional and novel CVD risk factors (high sensitivity C-reactive protein, soluble intercellular adhesion molecule-1, fibrinogen, and homocysteine), and incident CVD events among 22,688 apparently healthy female health professionals participating in the Women's Health Study. These women were followed up for 10 years for the development of myocardial infarction, ischemic stroke, coronary revascularization, and cardiovascular death. More educated women were less likely to be smokers; had a lower prevalence of hypertension, diabetes, and obesity; and were more likely to participate in vigorous physical activity than less educated women. At baseline, median total cholesterol, low-density lipoprotein, triglyceride, C-reactive protein, intercellular adhesion molecule-1, fibrinogen, and homocysteine levels for women in 5 categories of education (< 2 years of nursing education, 2 to < 4 years of nursing education, a bachelor's degree, a master's degree, and a doctoral degree) and 6 categories of income [< or = 19,999 dollars, 20,000 dollars to 29,999 dollars, 30,000 dollars to 39,999 dollars, 40,000 dollars to 49,999 dollars, 50,000 dollars to 99,999 dollars, and > or = 100,000 dollars) decreased progressively with increasing education or income levels (all P<0.001), whereas an opposite pattern was observed for high-density lipoprotein (P<0.001). Overall, in age-adjusted Cox proportional hazards models, the relative risk of incident CVD events decreased with increasing education (1.0, 0.7, 0.5, 0.4, and 0.5; P for trend <0.001) and income (1.0, 1.0, 0.9, 0.7, 0.6, and 0.4; P for trend <0.001) categories. In multivariate models that assessed the impact of traditional and novel CVD risk factors on the relationship between education/income and CVD events, the relative hazard of incident CVD associated with a 1-category-higher level of education changed from 0.79 in age- and race-adjusted analysis to 0.89 in fully adjusted analysis. The 11% lower risk per 1 category of education remained significant (P for trend=0.006), suggesting that controlling for both novel and traditional risk factors could not explain the protective effect of education. A similar analysis for income revealed that its relationship with CVD events was explained largely by these noted risk factors. In this prospective analysis, we observed a decrease in incident CVD events with increasing levels of education and income. In contrast to the relationship between income and CVD events, the relationship of CVD events with education was explained only partially by traditional and novel risk factors for CVD.

Household income differences in food sources and food items purchased.

PubMed

French, Simone A; Wall, Melanie; Mitchell, Nathan R

2010-10-26

The present study examined income-related household food purchases among a sample of 90 households from the community. Annotated food purchase receipts were collected for a four-week period by the primary household shopper. Receipt food source and foods items were classified into specific categories, and food quantities in ounces were recorded by research staff. For home sources, a limited number of food/beverage categories were recorded. For eating out sources, all food/beverage items were recorded. Median monthly per person dollars spent and per person ounces purchased were computed. Food sources and food categories were examined by household income tertile. A community-based sample of 90 households. Higher income households spent significantly more dollars per person per month from both home and eating out sources compared with lower income households ($163 versus $100, p < .001). Compared with lower income households, higher income households spent significantly more home source dollars on both fruits/vegetables (21.5 versus 10.2, p < .001) and sweets/snacks (17.3 versus 8.3, p < .001), but did not differ on home dollars spent on sugar sweetened beverages (2.0 versus 1.7, p < .46). The proportion of home beverages that were sugar sweetened beverages was significantly higher among lower income households (45% versus 26%, p < .01). Within eating out sources, lower income households spent a significantly greater percent of dollars per person at carry out places (54% versus 37%, p < .01). No income differences were observed for dollars spent at discount grocery stores, small grocery stores or convenience stores. Higher income households spent more money on both healthy and less healthy foods from a wide range of sources. Lower income households spent a larger proportion of their eating out dollars at carry out places, and a larger proportion of their home beverage purchases were sugar sweetened beverages.

Potential cost-effectiveness of maternal and infant antiretroviral interventions to prevent mother-to-child transmission during breast-feeding.

PubMed

Maclean, Courtney C; Stringer, Jeffrey S A

2005-04-15

One-third of maternal-to-child HIV transmission occurs during breast-feeding (BF). Several trials are currently evaluating the efficacy of postpartum antiretrovirals to reduce BF transmission. This study used Markov modeling to define the circumstances under which the following interventions would be cost-effective: BF for 6 months with daily infant nevirapine (NVP) prophylaxis; maternal combination antiretroviral therapy (ART) during pregnancy and for 6 months of BF; and maternal combination ART only for women who meet CD4 criteria. Each was compared to: BF for 12 months; BF for 6 months; and formula feeding for 12 months. Strategies were evaluated for a hypothetical cohort of 40,000 pregnant women in sub-Saharan Africa, in the context of available voluntary counseling and testing in antenatal care. Model estimates were derived from the literature and local sources. Sensitivity analyses were performed on uncertain estimates. The perspective used was that of a government health district. Using base case estimates, BF for 6 months was the economically preferred strategy: it cost 806,995 dollars and generated 446,208 quality-adjusted life-years (QALYs). Providing daily infant NVP cost an additional 93,638 dollars and generated 1183 additional QALYs, but its incremental cost-effectiveness ratio (ICER) of 79 dollars/QALY exceeded the standard willingness to pay (64 dollars/QALY) for most resource-poor settings. Maternal combination ART was potentially very effective but too costly for most resource-poor settings (ICER: 87 dollars/QALY). In order for daily infant NVP during BF to be preferred, it must have >/=44% relative efficacy or cost

FGC Webinar: From Fires to Floods and Everything In Between

EPA Pesticide Factsheets

Federal Green Challenge presentations from the April 2018 'Billion Dollar Weather Events' webinar From Fires to Floods and Everything in Between: How Federal Facilities Can Thrive in an Era of Billion Dollar Weather Events.

14 CFR 1274.103 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... Subcontracting dollar threshold. The dollar amount of the cooperative agreement subject to the small business subcontracting policies (includes small business, veteran-owned small business, service-disabled veteran-owned small business, historically underutilized small business, small disadvantaged business, women-owned...

I owe you: age-related similarities and differences in associative memory for gains and losses.

PubMed

Castel, Alan D; Friedman, Michael C; McGillivray, Shannon; Flores, Cynthia C; Murayama, Kou; Kerr, Tyson; Drolet, Aimee

2016-09-01

Older adults often experience associative memory impairments but can sometimes remember important information. The current experiments investigate potential age-related similarities and differences associate memory for gains and losses. Younger and older participants were presented with faces and associated dollar amounts, which indicated how much money the person "owed" the participant, and were later given a cued recall test for the dollar amount. Experiment 1 examined face-dollar amount pairs while Experiment 2 included negative dollar amounts to examine both gains and losses. While younger adults recalled more information relative to older adults, both groups were more accurate in recalling the correct value associated with high-value faces compared to lower-value faces and remembered gist-information about the values. However, negative values (losses) did not have a strong impact on recall among older adults versus younger adults, illustrating important associative memory differences between younger and older adults.

Identification of Strategies to Leverage Public and Private Resources for National Security Workforce Development

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

None

2009-02-01

This report documents the identification of strategies to leverage public and private resources for the development of an adequate national security workforce as part of the National Security Preparedness Project (NSPP).There are numerous efforts across the United States to develop a properly skilled and trained national security workforce. Some of these efforts are the result of the leveraging of public and private dollars. As budget dollars decrease and the demand for a properly skilled and trained national security workforce increases, it will become even more important to leverage every education and training dollar. The leveraging of dollars serves many purposes.more » These include increasing the amount of training that can be delivered and therefore increasing the number of people reached, increasing the number and quality of public/private partnerships, and increasing the number of businesses that are involved in the training of their future workforce.« less

Simple method for preparation of nanostructurally organized spines of sand dollar Scaphechinus mirabilis (Agassiz, 1863).

PubMed

Ehrlich, Herman; Elkin, Yury N; Artoukov, Alexandr A; Stonik, Valentin A; Safronov, Peter P; Bazhenov, Vasily V; Kurek, Denis V; Varlamov, Valery P; Born, René; Meissner, Heike; Richter, Gert

2011-06-01

Unique skeletal formations of marine invertebrates, including representatives of Echinodermata, have the unique potential to serve as templates for bio-inspired materials chemistry, biomimetics, and materials science. The sand dollar Scaphechinus mirabilis (Agassiz, 1983) is widely distributed in the northwest of the Pacific Ocean from southern Japan to the Aleutian Islands. This animal is the main source of naphtochinone-based substances. These compounds have recently drawn medical attention for their use as cardiological and ophthalmological drugs. Unfortunately, after extraction of the naphtochinones, the residual skeletons and spines of the sand dollars were usually discarded. Here, we report the first method for the preparation of nanostructurally organized spines of S. mirabilis, using a simple enzymatic and hydrogen peroxide-based treatment. Application of this method opens the way for development of non-wasteful environmentally clean technology of sand dollars as well-known industrial marine invertebrates.

Process Feasibility Study in Support of Silicon Material Task 1

NASA Technical Reports Server (NTRS)

Li, K. Y.; Hansen, K. C.; Yaws, C. L.

1979-01-01

Analysis of process system properties was continued for silicon source materials under consideration for producing silicon. The following property data are reported for dichlorosilane which is involved in processing operations for silicon: critical constants, vapor pressure, heat of vaporization, heat capacity, density, surface tension, thermal conductivity, heat of formation and Gibb's free energy of formation. The properties are reported as a function of temperature to permit rapid engineering usage. The preliminary economic analysis of the process is described. Cost analysis results for the process (case A-two deposition reactors and six electrolysis cells) are presented based on a preliminary process design of a plant to produce 1,000 metric tons/year of silicon. Fixed capital investment estimate for the plant is $12.47 million (1975 dollars) ($17.47 million, 1980 dollars). Product cost without profit is 8.63 $/kg of silicon (1975 dollars)(12.1 $/kg, 1980 dollars).

I Owe You: Age-Related Similarities and Differences in Associative Memory for Gains and Losses

PubMed Central

Castel, Alan D.; Friedman, Michael C.; McGillivray, Shannon; Flores, Cynthia C.; Murayama, Kou; Kerr, Tyson; Drolet, Aimee

2016-01-01

Older adults often experience associative memory impairments but can sometimes remember important information. The current experiments investigate potential age-related similarities and differences associate memory for gains and losses. Younger and older participants were presented with faces and associated dollar amounts, which indicated how much money the person “owed” the participant, and were later given a cued recall test for the dollar amount. Experiment 1 examined face-dollar amount pairs while Experiment 2 included negative dollar amounts to examine both gains and losses. While younger adults recalled more information relative to older adults, both groups were more accurate in recalling the correct value associated with high value faces compared to lower value faces and remembered gist-information about the values. However, negative values (losses) did not have a strong impact on recall among older adults versus younger adults, illustrating important associative memory differences between younger and older adults. PMID:26847137

Philanthro-metrics: Mining multi-million-dollar gifts

PubMed Central

2017-01-01

The Million Dollar List (MDL, online at http://www.milliondollarlist.org) is a compilation of publicly announced charitable donations of $1 million or more from across the United States since 2000; as of December 2016, the database contains close to 80,000 gifts made by U.S. individuals, corporations, foundations, and other grant-making nonprofit organizations. This paper discusses the unique value of the Million Dollar List and provides unique insights to key questions such as: How does distance affect giving? How do networks impact million-dollar-plus gifts? Understanding the geospatial and temporal dimensions of philanthropy can assist researchers and policymakers to better understand the role of private funding in innovation and discovery. Moreover, the results from the paper emphasize the importance of philanthropy for fueling research and development in science, the arts, environment, and health. The paper also includes the limitations of the presented analyses and promising future work. PMID:28552937

Philanthro-metrics: Mining multi-million-dollar gifts.

PubMed

Osili, Una O; Ackerman, Jacqueline; Kong, Chin Hua; Light, Robert P; Börner, Katy

2017-01-01

The Million Dollar List (MDL, online at http://www.milliondollarlist.org) is a compilation of publicly announced charitable donations of $1 million or more from across the United States since 2000; as of December 2016, the database contains close to 80,000 gifts made by U.S. individuals, corporations, foundations, and other grant-making nonprofit organizations. This paper discusses the unique value of the Million Dollar List and provides unique insights to key questions such as: How does distance affect giving? How do networks impact million-dollar-plus gifts? Understanding the geospatial and temporal dimensions of philanthropy can assist researchers and policymakers to better understand the role of private funding in innovation and discovery. Moreover, the results from the paper emphasize the importance of philanthropy for fueling research and development in science, the arts, environment, and health. The paper also includes the limitations of the presented analyses and promising future work.

Definition and preliminary design of the Laser Atmospheric Wind Sounder (LAWS) phase 1. Volume 3: Program cost estimates

NASA Technical Reports Server (NTRS)

1990-01-01

Cost estimates for phase C/D of the laser atmospheric wind sounder (LAWS) program are presented. This information provides a framework for cost, budget, and program planning estimates for LAWS. Volume 3 is divided into three sections. Section 1 details the approach taken to produce the cost figures, including the assumptions regarding the schedule for phase C/D and the methodology and rationale for costing the various work breakdown structure (WBS) elements. Section 2 shows a breakdown of the cost by WBS element, with the cost divided in non-recurring and recurring expenditures. Note that throughout this volume the cost is given in 1990 dollars, with bottom line totals also expressed in 1988 dollars (1 dollar(88) = 0.93 1 dollar(90)). Section 3 shows a breakdown of the cost by year. The WBS and WBS dictionary are included as an attachment to this report.

Cost-effectiveness of social marketing of insecticide-treated nets for malaria control in the United Republic of Tanzania.

PubMed Central

Hanson, Kara; Kikumbih, Nassor; Armstrong Schellenberg, Joanna; Mponda, Haji; Nathan, Rose; Lake, Sally; Mills, Anne; Tanner, Marcel; Lengeler, Christian

2003-01-01

OBJECTIVE: To assess the costs and consequences of a social marketing approach to malaria control in children by means of insecticide-treated nets in two rural districts of the United Republic of Tanzania, compared with no net use. METHODS: Project cost data were collected prospectively from accounting records. Community effectiveness was estimated on the basis of a nested case-control study and a cross-sectional cluster sample survey. FINDINGS: The social marketing approach to the distribution of insecticide-treated nets was estimated to cost 1560 US dollars per death averted and 57 US dollars per disability-adjusted life year averted. These figures fell to 1018 US dollars and 37 US dollars, respectively, when the costs and consequences of untreated nets were taken into account. CONCLUSION: The social marketing of insecticide-treated nets is an attractive intervention for preventing childhood deaths from malaria. PMID:12764493

Environmental and economic analysis of switchgrass production for water quality improvement in northeast Kansas.

PubMed

Nelson, Richard G; Ascough, James C; Langemeier, Michael R

2006-06-01

The primary objectives of this research were to determine SWAT model predicted reductions in four water quality indicators (sediment yield, surface runoff, nitrate nitrogen (NO(3)-N) in surface runoff, and edge-of-field erosion) associated with producing switchgrass (Panicum virgatum) on cropland in the Delaware basin in northeast Kansas, and evaluate switchgrass break-even prices. The magnitude of potential switchgrass water quality payments based on using switchgrass as an alternative energy source was also estimated. SWAT model simulations showed that between 527,000 and 1.27 million metric tons (Mg) of switchgrass could be produced annually across the basin depending upon nitrogen (N) fertilizer application levels (0-224 kg N ha(-1)). The predicted reductions in sediment yield, surface runoff, NO(3)-N in surface runoff, and edge-of-field erosion as a result of switchgrass plantings were 99, 55, 34, and 98%, respectively. The average annual cost per hectare for switchgrass ranged from about 190 US dollars with no N applied to around 345 US dollars at 224 kg N ha(-1) applied. Edge-of-field break-even price per Mg ranged from around 41 US dollars with no N applied to slightly less than 25 US dollars at 224 kg N ha(-1) applied. A majority of the switchgrass produced had an edge-of-field break-even price of 30 Mg(-1) US dollars or less. Savings of at least 50% in each of the four water quality indicators could be attained for an edge-of-field break-even price of 22-27.49 US dollars Mg(-1).

Evidence-based medicine is affordable: the cost-effectiveness of current compared with optimal treatment in rheumatoid and osteoarthritis.

PubMed

Andrews, Gavin; Simonella, Leonardo; Lapsley, Helen; Sanderson, Kristy; March, Lyn

2006-04-01

To determine the cost-effectiveness of averting the burden of disease. We used secondary population data and metaanalyses of various government-funded services and interventions to investigate the costs and benefits of various levels of treatment for rheumatoid arthritis (RA) and osteoarthritis (OA) in adults using a burden of disease framework. Population burden was calculated for both diseases in the absence of any treatment as years lived with disability (YLD), ignoring the years of life lost. We then estimated the proportion of burden averted with current interventions, the proportion that could be averted with optimally implemented current evidence-based guidelines, and the direct treatment cost-effectiveness ratio in dollars per YLD averted for both treatment levels. The majority of people with arthritis sought medical treatment. Current treatment for RA averted 26% of the burden, with a cost-effectiveness ratio of dollar 19,000 per YLD averted. Optimal, evidence-based treatment would avert 48% of the burden, with a cost-effectiveness ratio of dollar 12,000 per YLD averted. Current treatment of OA in Australia averted 27% of the burden, with a cost-effectiveness ratio of dollar 25,000 per YLD averted. Optimal, evidence-based treatment would avert 39% of the burden, with an unchanged cost-effectiveness ratio of dollar 25,000 per YLD averted. While the precise dollar costs in each country will differ, the relativities at this level of coverage should remain the same. There is no evidence that closing the gap between evidence and practice would result in a drop in efficiency.

Global and regional estimates of the effectiveness and cost-effectiveness of price increases and other tobacco control policies.

PubMed

Ranson, M Kent; Jha, Prabhat; Chaloupka, Frank J; Nguyen, Son N

2002-08-01

The objective of this study was to provide conservative estimates of the global and regional effectiveness and cost-effectiveness of tobacco control policies. Using a static model of the cohort of smokers alive in 1995, we estimated the number of smoking-attributable deaths that could be averted by: (1) price increases, (2) nicotine replacement therapy (NRT), and (3) a package of non-price interventions other than NRT. We calculated the cost-effectiveness of these policy interventions by weighing the approximate public-sector costs against the years of healthy life saved, measured in disability-adjusted life years, or DALYs. Even with deliberately conservative assumptions, tax increases that would raise the real price of cigarettes by 10% worldwide would prevent between 5 and 16 million tobacco-related deaths, and could cost 3-70 US dollars per DALY saved in low-income and middle-income regions. NRT and a package of non-price interventions other than NRT are also cost-effective in low-income and middle-income regions, at 280-870 US dollars per DALY and 36-710 US dollars per DALY, respectively. In high-income countries, price increases were found to have a cost-effectiveness of 83-2771 US dollars per DALY, NRT 750-7206 US dollars per DALY and other non-price interventions 696-13,924 US dollars per DALY. Tobacco control policies, particularly tax increases on cigarettes, are cost-effective relative to other health interventions. Our estimates are subject to considerable variation in actual settings; thus, local cost-effectiveness studies are required to guide local policy.

Evaluation of an emergency department-based enrollment program for uninsured children.

PubMed

Mahajan, Prashant; Stanley, Rachel; Ross, Kevin W; Clark, Linda; Sandberg, Keisha; Lichtenstein, Richard

2005-03-01

We evaluate the effectiveness of an emergency department (ED)-based outreach program in increasing the enrollment of uninsured children. The study involved placing a full-time worker trained to enroll uninsured children into Medicaid or the State Children's Health Insurance Program in an inner-city academic children's hospital ED. Analysis was carried out for outpatient ED visits by insurance status, average revenue per patient from uninsured and insured children, proportion of patients enrolled in Medicaid and State Children's Health Insurance Program through this program, estimated incremental revenue from new enrollees, and program-specific incremental costs. A cost-benefit analysis and breakeven analysis was conducted to determine the impact of this intervention on ED revenues. Five thousand ninety-four uninsured children were treated during the 10 consecutive months assessed, and 4,667 were treated during program hours. One thousand eight hundred and three applications were filed, giving a program penetration rate of 39%. Eighty-four percent of applications filed were resolved (67% of these were Medicaid). Average revenue from each outpatient ED visit for Medicaid was US135.68 dollars, other insurance was US210.43 dollars, and uninsured was US15.03 dollars. Estimated incremental revenue for each uninsured patient converted to Medicaid was US120.65 dollars. Total annualized incremental revenue was US224,474 dollars, and the net incremental revenue, after accounting for program costs, was US157,414 dollars per year. A program enrolling uninsured children at an inner-city pediatric ED into government insurance was effective and generated revenue that paid for program costs.

Do decision-analytic models identify cost-effective treatments? A retrospective look at helicobacter pylori eradication.

PubMed

Fairman, Kathleen A; Motheral, Brenda R

2003-01-01

Pharmacoeconomic models of Helicobacter (H) pylori eradication have been frequently cited but never validated. Examine retrospectively whether H pylori pharmacoeconomic models direct decision makers to cost-effective therapeutic choices. We first replicated and then validated 2 models, replacing model assumptions with empirical data from a multipayer claims database. Database subjects were 435 commercially insured U.S. patients treated with bismuthmetronidazole- tetracycline (BMT), proton pump inhibitor (PPI)-clarithromycin, or PPI-amoxicillin. Patients met >1 clinical requirement (ulcer disease, gastritis/duodenitis, stomach function disorder, abdominal pain, H pylori infection, endoscopy, or H pylori assay). Sensitivity analyses included only patients with ulcer diagnosis or gastrointestinal specialist care. Outcome measures were: (1) rates of eradication retreatment; (2) use of office visits, hospitalizations, endoscopies, and antisecretory medication; and (3) cost per effectively treated (nonretreated) patient. Model results overstated the cost-effectiveness of PPI-clarithromycin and underestimated the cost-effectiveness of BMT. Prior to empirical adjustment, costs per effectively treated patient were 1,001 US dollars, 980 US dollars, and 1,730 US dollars for BMT, PPIclarithromycin, and PPI-amoxicillin, respectively. Estimates after adjustment were US dollars for BMT, 1,118 US dollars for PPI-clarithromycin, and 1,131 US dollars for PPI-amoxicillin. Key model assumptions that proved retrospectively incorrect were largely unsupported by either empirical evidence or systematic assessment of expert opinion. Organizations with access to medical and pharmacy claims databases should test key assumptions of influential models to determine their validity. Journal peer-review processes should pay particular attention to the basis of model assumptions.

The US Medical Liability System: evidence for legislative reform.

PubMed

Guirguis-Blake, Janelle; Fryer, George E; Phillips, Robert L; Szabat, Ronald; Green, Larry A

2006-01-01

Despite state and federal efforts to implement medical malpractice reform, there is limited evidence on which to base policy decisions. The National Practitioner Data Bank (NPDB) offers an opportunity to evaluate the effects of previous malpractice tort reforms on malpractice payments and premiums. For every state and the District of Columbia, we calculated the number of malpractice payments, total amount paid, and average payment from NPDB data reported from 1999 through 2001. We analyzed 44,913 claims using logistic regression to study associations between payments, physician premiums, and 10 state statutory tort reforms. Wide variations exist in malpractice payments among states. The reforms most associated with lower payments and premiums were total and noneconomic damage caps. Mean payments were 26% lower in states with total damage caps (196,495.34 dollars vs 265,554.50 dollars, P = .001). Mean payments were 22% less in states with noneconomic damage caps (219,225.98 dollars vs 279,849.86 dollars, P = .010). Total damage caps were associated with lower mean annual premiums, especially for obstetricians (22,371.57 dollars vs 42,728.68 dollars, P <.001). Hard noneconomic damage caps were associated with premium reductions for obstetricians (30,283.75 vs 45,740.88; P = .039). Significant reductions in malpractice payments could be realized if total or noneconomic damage caps were operating nationally. Hard noneconomic damage and total damage caps could yield lower premiums. If tied to a comprehensive plan for reform, the money saved could be diverted to implement alternative approaches to patient compensation or be used to achieve other systems reform benefiting patients, employers, physicians, and hospitals.

Cost of work-related injuries in insured workplaces in Lebanon.

PubMed Central

Fayad, Rim; Nuwayhid, Iman; Tamim, Hala; Kassak, Kassem; Khogali, Mustafa

2003-01-01

OBJECTIVE: To estimate the medical and compensation costs of work-related injuries in insured workplaces in Lebanon and to examine cost distributions by worker and injury characteristics. METHODS: A total of 3748 claims for work injuries processed in 1998 by five major insurance companies in Lebanon were reviewed. Medical costs (related to emergency room fees, physician consultations, tests, and medications) and wage and indemnity compensation costs were identified from the claims. FINDINGS: The median cost per injury was US dollars 83 (mean, US dollars 198; range, US dollars 0-16,401). The overall cost for all 3748 injuries was US dollars 742,100 (76% of this was medical costs). Extrapolated to all injuries within insured workplaces, the overall cost was US dollars 4.5 million a year; this increased to US dollars 10 million-13 million when human value cost (pain and suffering) was accounted for. Fatal injuries (three, 0.1%) and those that caused permanent disabilities (nine, 0.2%) accounted for 10.4% of the overall costs and hospitalized injuries (245, 6.5%) for 45%. Cost per injury was highest among older workers and for injuries that involved falls and vehicle incidents. Medical, but not compensation, costs were higher among female workers. CONCLUSION: The computed costs of work injuries--a fraction of the real burden of occupational injuries in Lebanon--represent a considerable economic loss. This calls for a national policy to prevent work injuries, with a focus on preventing the most serious injuries. Options for intervention and research are discussed. PMID:12973643

38 CFR 3.42 - Compensation at the full-dollar rate for certain Filipino veterans residing in the United States.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Dependency and Indemnity Compensation General § 3.42 Compensation at the full-dollar rate for certain... status. (b) Eligibility requirements. Compensation and dependency and indemnity compensation is payable...

38 CFR 3.42 - Compensation at the full-dollar rate for certain Filipino veterans residing in the United States.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Dependency and Indemnity Compensation General § 3.42 Compensation at the full-dollar rate for certain... status. (b) Eligibility requirements. Compensation and dependency and indemnity compensation is payable...

38 CFR 3.42 - Compensation at the full-dollar rate for certain Filipino veterans residing in the United States.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Dependency and Indemnity Compensation General § 3.42 Compensation at the full-dollar rate for certain... status. (b) Eligibility requirements. Compensation and dependency and indemnity compensation is payable...

77 FR 17328 - Commodity Pool Operators and Commodity Trading Advisors: Compliance Obligations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-26

..., for each such retail forex transaction, by calculating the value in U.S. Dollars for such transaction... forex transaction, by calculating the value in U.S. Dollars of such transaction, at the time the...

Systematic procedures to determine incentive/disincentive dollar amounts for highway transportation construction projects.

DOT National Transportation Integrated Search

2012-06-01

The Federal Highway Administration has encouraged state transportation agencies to implement Incentive/Disincentive (I/D) contracting provisions for early project completion. Although general guidelines to determine the I/D dollar amount for a projec...

Cost-effectiveness of measuring fractional flow reserve to guide coronary interventions.

PubMed

Fearon, William F; Yeung, Alan C; Lee, David P; Yock, Paul G; Heidenreich, Paul A

2003-05-01

Most patients come to the catheterization laboratory without prior functional tests, which makes the cost-effective treatment of patients with intermediate coronary lesions a practical challenge. We developed a decision model to compare the long-term costs and benefits of 3 strategies for treating patients with an intermediate coronary lesion and no prior functional study: 1) deferring the decision for percutaneous coronary intervention (PCI) to obtain a nuclear stress imaging study (NUC strategy); 2) measuring fractional flow reserve (FFR) at the time of angiography to help guide the decision for PCI (FFR strategy); and 3) stenting all intermediate lesions (STENT strategy). On the basis of the literature, we estimated that 40% of intermediate lesions would produce ischemia, 70% of patients treated with PCI and 30% of patients treated medically would be free of angina after 4 years, and the quality-of-life adjustment for living with angina was 0.9 (1.0 = perfect health). We estimated the cost of FFR to be 761 dollars, the cost of nuclear stress imaging to be 1093 dollars, and the cost of medical treatment for angina to be 1775 dollars per year. The extra cost of splitting the angiogram and PCI as dictated by the NUC strategy was 3886 dollars by use of hospital cost-accounting data. Sensitivity and threshold analyses were performed to determine which variables affected our results. The FFR strategy saved 1795 dollars per patient compared with the NUC strategy and 3830 dollars compared with the STENT strategy. Quality-adjusted life expectancy was similar among the 3 strategies (NUC-FFR = 0.8 quality-adjusted days, FFR-STENT = 6 quality-adjusted life days). Compared with the FFR strategy, the NUC strategy was expensive (>800,000 dollars per quality-adjusted life year gained). Both screening strategies were superior to (less cost, better outcomes) the STENT strategy. Sensitivity analysis indicated that the NUC strategy would only become attractive (<50,000 dollars/quality-adjusted life years compared with FFR) if the specificity of nuclear stress imaging was >25% better than FFR. Our results were not altered significantly by changing the other assumptions. In patients with an intermediate coronary lesion and no prior functional study, measuring FFR to guide the decision to perform PCI may lead to significant cost savings compared with performing nuclear stress imaging or with simply stenting lesions in all patients.

The new economics of radical prostatectomy: cost comparison of open, laparoscopic and robot assisted techniques.

PubMed

Lotan, Yair; Cadeddu, Jeffrey A; Gettman, Matthew T

2004-10-01

We evaluated the costs components of laparoscopic (LRP) and robot assisted prostatectomy (RAP), and compared their costs to those of open radical retropubic prostatectomy (RRP). A model was created using commercially available software to compare the costs of treatment with LRP, RAP or RRP. Hospital costs were obtained from a large county hospital. A literature search was performed to determine typical (average) robot costs, length of stay and operative time for RRP, LRP and RAP. We limited our analysis to mature series and included only the most recent efforts. The cost of the robot was estimated at 1,200,000 dollars with a 100,000 dollars yearly maintenance contract. It was assumed that the robot would be used across specialities for a total of 300 cases yearly in a 7-year period. We performed a series of 1 and 2-way sensitivity analyses to evaluate the costs of LRP, RAP and RRP, while varying robot costs, the number of robotic cases, hospital length of stay, operative time and cost of laparoscopic/robotic equipment. RRP was the most cost-effective approach with a cost advantage of 487 dollars and 1,726 dollars over LRP and RAP, respectively. If we excluded the initial cost of purchasing a robot, the cost difference between RRP and RAP was 1,155 dollars. This large difference in RRP and RAP costs resulted from a cost of 857 dollars per case to pay for robot purchase and maintenance, and the high cost of 1,705 dollars for equipment per case. An even shorter RAP operative time (140 vs 160 minutes) and length of stay (1.2 vs 2.5 days) did not compensate for the added expenditure. LRP cost more than RRP primarily due to equipment costs (533 dollars) since the shorter hospital stay (1.3 vs 2.5 days) was compensated for by longer operative time (200 vs 160 minutes). The costs of new technology are typically borne out in the first years of use and RAP is no exception with high robot costs for purchase, maintenance and operative equipment overshadowing savings gained by shorter length of stay. While RRP is currently the least costly approach, LRP has proved to be almost as cost competitive as RRP, whereas RAP will require a significant decrease in the cost of the device and maintenance fees.

34 CFR 222.193 - What other limitations on grant amounts apply?

Code of Federal Regulations, 2010 CFR

2010-07-01

... cost of an approved project. (2) The total amount of grant funds may not exceed four million dollars during any four-year period. Example: An LEA that is awarded four million dollars in the first year may...

Transportation Infrastructure: Managing the Costs of Large-Dollar Highway Projects

DOT National Transportation Integrated Search

1997-02-01

The General Accounting Office (GAO) was requested to assess the effectiveness of the Federal Highway Administration's (FHWA's) oversight of the costs of large-dollar highway and bridge projects (those with a total estimated cost of over $100 million)...

Report: Improved Acquisition Planning Will Help EPA Reduce Hundreds of Millions of Dollars in High-Risk Contracts

EPA Pesticide Factsheets

Report #18-P-0038, November 15, 2017. Without improving its acquisition planning process, the EPA may continue to spend hundreds of millions of dollars on high-risk contracts that waste taxpayer resources.

State Energy Price and Expenditure Estimates

EIA Publications

2017-01-01

The State Energy Price and Expenditure Estimates provide data on energy prices in current dollars per million Btu and expenditures in current dollars, by state and for the United States, by energy source and by sector in annual time-series back to 1970

Does a fixed-dollar premium contribution lower spending?

PubMed

Buchmueller, T C

1998-01-01

In a multiple-option health benefits program, the employer's premium contribution determines the incentives facing employees and participating health plans. Advocates of managed contribution argue that a fixed-dollar contribution policy will result in lower health spending by encouraging cost-conscious choices by employees and price competition among plans. The University of California (UC), which adopted a fixed-dollar contribution policy in 1994, provides a useful case study for assessing this claim. This DataWatch documents the effect of this policy on health maintenance organization (HMO) premiums and per employee health spending in the UC health benefits program.

Optimization under variability and uncertainty: a case study for NOx emissions control for a gasification system.

PubMed

Chen, Jianjun; Frey, H Christopher

2004-12-15

Methods for optimization of process technologies considering the distinction between variability and uncertainty are developed and applied to case studies of NOx control for Integrated Gasification Combined Cycle systems. Existing methods of stochastic optimization (SO) and stochastic programming (SP) are demonstrated. A comparison of SO and SP results provides the value of collecting additional information to reduce uncertainty. For example, an expected annual benefit of 240,000 dollars is estimated if uncertainty can be reduced before a final design is chosen. SO and SP are typically applied to uncertainty. However, when applied to variability, the benefit of dynamic process control is obtained. For example, an annual savings of 1 million dollars could be achieved if the system is adjusted to changes in process conditions. When variability and uncertainty are treated distinctively, a coupled stochastic optimization and programming method and a two-dimensional stochastic programming method are demonstrated via a case study. For the case study, the mean annual benefit of dynamic process control is estimated to be 700,000 dollars, with a 95% confidence range of 500,000 dollars to 940,000 dollars. These methods are expected to be of greatest utility for problems involving a large commitment of resources, for which small differences in designs can produce large cost savings.

Tort law and medical malpractice insurance premiums.

PubMed

Kilgore, Meredith L; Morrisey, Michael A; Nelson, Leonard J

2006-01-01

This paper estimated the effects of tort law and insurer investment returns on physician malpractice insurance premiums. Data were collected on tort law from 1991 through 2004, and multivariate regression models, including fixed effects for state and year, were used to estimate the effect of changes in tort law on medical malpractice premiums. The premium consequences of national policy changes were simulated. The analysis found that the introduction of a new damage cap lowered malpractice premiums for internal medicine, general surgery, and obstetrics/gynecology by 17.3%, 20.7%, and 25.5%, respectively. Lowering damage caps by dollar 100,000 reduced premiums by 4%. Statutes of repose also resulted in lower premiums. No other tort law changes had the effect of lowering premiums. Simulation results indicate that a national cap of dollar 250,000 on awards for noneconomic damages in all states would imply premium savings of dollar 16.9 billion. Extending a dollar 250,000 cap to all states that do not currently have them would save dollar 1.4 billion annually, or about 8% of the total. A negative effect on malpractice premiums was found for the Dow Jones industrial average, but not for bond prices; effects of the Nasdaq index were not significant for internal medicine, but were marginally significant for surgery and obstetrics premiums.

Changing environments and alternative perspectives in evaluating the cost-effectiveness of new antipsychotic drugs.

PubMed

Rosenheck, Robert; Doyle, Jefferson; Leslie, Douglas; Fontana, Alan

2003-01-01

This article examines the ways in which changes in the treatment environment and in measurement perspectives can affect the evaluation of cost-effectiveness of new medications. In three studies we reexamined data from a clinical trial of haloperidol and clozapine conducted from 1993 to 1996. The results of the studies are as follows: Study 1 found that clozapine treatment was associated with significantly reduced inpatient costs, and increased outpatient costs, suggesting that as systems use less inpatient care and more outpatient care, more effective medications may increase, rather than decrease, costs in sicker patients. Study 2 found that while provider assessments and standard measures favored clozapine over haloperidol, patient responses showed little evidence of a clinical advantage for clozapine and a less favorable side-effect profile. Study 3 found that while annual drug costs in the published trial were estimated to be dollars 4,545 for a full year of clozapine treatment, atypical antipsychotic costs in 2000 were estimated to range from dollars 1,254 to dollars 3,016 in the Department of Veterans Affairs system, and from dollars 2,221 to dollars 8,147 in the private sector. In conclusion, cost-effectiveness, as evaluated in studies like CATIE, will increasingly need to be tied to service system contingencies, environments, and evaluation perspectives.

Twelve-month drug cost savings related to use of an electronic prescribing system with integrated decision support in primary care.

PubMed

McMullin, S Troy; Lonergan, Thomas P; Rynearson, Charles S

2005-05-01

We reported previously the results of a 6-month controlled trial in which the use of a commercially available electronic prescribing system with integrated clinical decision support and evidence-based message capability was associated with significantly lower primary care drug costs. The original study focused on new prescriptions, defined as claims for a medication that the patient had not received in the previous 12 months. The main objectives of this follow-up report were to (a) determine if the 6-month savings on new prescriptions were sustained during 12 months of follow-up, (b) evaluate the impact of the computerized decision support system (CDSS) on all pharmacy claims and per-member-per-month (PMPM) expenditures, and (c) evaluate the prescribing behaviors within 8 high-cost therapeutic categories that were frequently targeted by the electronic messages to prescribers to help verify that the drug cost savings were due to the recommendations in the electronic prescribing system. Two database queries were performed to identify additional pharmacy claims data for all Network Health Plan patients who were cared for by the 38 primary care clinicians (32 physicians, 4 nurse practitioners, and 2 physician assistants) included in our original 6-month study. This follow-up analysis (a) identified all new prescription claims for the 2 groups of clinicians throughout the 12-month follow-up period (June 2002 through May 2003) and (b) assessed all pharmacy claims during the same 12-month period to provide more complete savings estimates and to examine between-group differences in PMPM expenditures. During 12 months of follow-up, clinicians using the electronic prescribing system continued to have lower prescription costs than the controls. Clinicians using the electronic prescribing system had average costs for 26,674 new prescriptions that were dollar 4.12 lower (95% confidence interval, dollar 1.53-dollar 6.71; P=0.003) and PMPM expenditures that were dollar 0.57 lower than expected based on the changes observed for 24,507 new prescriptions written by clinicians in the control group. The average drug cost savings on new prescriptions were dollar 482 per prescriber per month (PPPM), based upon prescription cost and dollar 465 PPPM based upon PMPM analysis. When all pharmacy claims (156,429) were analyzed, the intervention group.s average prescription cost was dollar 2.57 lower and their PMPM expenditures were dollar 1.07 lower than expected based on the changes observed in the control group. The average drug cost savings on all pharmacy claims were dollar 863 PPPM based on average prescription cost and dollar 873 PPPM based on PMPM analysis. The proportion of prescriptions for highcost drugs that were the target of the CDSS messages to prescribers was a relative 17.5% lower among the intervention group (35.8%) compared with the control group (43.4%; P=0.03). An electronic prescribing system with integrated decision support shifted prescribing behavior away from high-cost therapies and significantly lowered prescription drug costs. The savings associated with altered prescribing behavior offset the monthly subscription cost of the system.

Isn't It Time to Turn Insurance Dollars Into Instructional Dollars?

ERIC Educational Resources Information Center

Brown, Richard, Jr.

1976-01-01

Discusses the financial advantages of insuring school property through nonprofit state insurance programs, rather than through commercial insurance companies. Summarizes experiences with existing state insurance programs in the states of South Carolina, North Dakota, Alabama, North Carolina, and Wisconsin. (JG)

Fundred Dollar Bill Project

ERIC Educational Resources Information Center

Rubin, Mary

2009-01-01

This article describes the Fundred Dollar Bill Project which is an innovative artwork made of millions of drawings. This creative collective action is intended to support Operation Paydirt, an extraordinary art/science project uniting three million children with educators, scientists, healthcare professionals, designers, urban planners, engineers,…

Federal gas tax : household expenditures from 1965 to 1995

DOT National Transportation Integrated Search

1997-08-01

While federal motor fuel taxes increased in current dollars from 4 cents per gallon in 1965 to 18.4 cents per gallon in 1995, the impact on household expenditures, in constant dollars, has actually shown a decline. This report traces household expend...

Estimating patient time costs associated with colorectal cancer care.

PubMed

Yabroff, K Robin; Warren, Joan L; Knopf, Kevin; Davis, William W; Brown, Martin L

2005-07-01

Nonmedical costs of care, such as patient time associated with travel to, waiting for, and seeking medical care, are rarely measured systematically with population-based data. The purpose of this study was to estimate patient time costs associated with colorectal cancer care. We identified categories of key medical services for colorectal cancer care and then estimated patient time associated with each service category using data from national surveys. To estimate average service frequencies for each service category, we used a nested case control design and SEER-Medicare data. Estimates were calculated by phase of care for cases and controls, using data from 1995 to 1998. Average service frequencies were then combined with estimates of patient time for each category of service, and the value of patient time assigned. Net patient time costs were calculated for each service category, summarized by phase of care, and compared with previously reported net direct costs of colorectal cancer care. Net patient time costs for the 3 phases of colorectal cancer care averaged dollar 4592 (95% confidence interval [CI] dollar 4427-4757) over the 12 months of the initial phase, dollar 2788 (95% CI dollar 2614-2963) over the 12 months of the terminal phase, and dollar 25 (95% CI: dollar 23-26) per month in the continuing phase of care. Hospitalizations accounted for more than two thirds of these estimates. Patient time costs were 19.3% of direct medical costs in the initial phase, 15.8% in the continuing phase, and 36.8% in the terminal phase of care. Patient time costs are an important component of the costs of colorectal cancer care. Application of this method to other tumor sites and inclusion of other components of the costs of medical care will be important in delineating the economic burden of cancer in the United States.

Anastrozole is cost-effective vs tamoxifen as initial adjuvant therapy in early breast cancer: Canadian perspectives on the ATAC completed-treatment analysis.

PubMed

Rocchi, A; Verma, S

2006-09-01

To conduct an economic analysis comparing tamoxifen and anastrozole (Arimidex) in the adjuvant treatment of hormone receptor-positive (HR+), post-menopausal early breast cancer patients. An economic model examined typical patients (64 years of age, HR+, 64% node negative) from the Arimidex, tamoxifen alone, or in combination (ATAC) trial over a lifetime horizon. Rates of events were derived from ATAC trial results. Post-trial event rates were drawn from the literature for tamoxifen; event rates for anastrozole were modified by the relative risks observed in the ATAC trial. Resource utilization was drawn from Statistics Canada's Population Health Model for breast cancer, supplemented by an expert panel. A public health care system perspective, 2004 Canadian prices and a 5% discount rate were employed. Anastrozole-taking patients incurred additional hormonal treatment costs compared to tamoxifen-taking patients (incremental lifetime cost, 6,974 Canadian dollars per patient), partially offset by reduced downstream recurrences of breast cancer (1,143 Canadian dollars lifetime savings per patient) for a net incremental cost of 5,796 Canadian dollars per patient on anastrozole. The anastrozole-treated patients were projected to experience a 5.6% absolute risk reduction of first breast cancer recurrence and a 2.8% absolute risk reduction in breast cancer death. This corresponded to 30,000 Canadian dollars per life year gained and 28,000 Canadian dollars per quality-adjusted life year gained (95% confidence interval, 17,428 to 54,605 Canadian dollars). The results were affected by the duration and extent of anastrozole benefit under sensitivity analysis but remained cost-effective. Compared to tamoxifen, anastrozole therapy is effective and cost-effective as initial adjuvant therapy in post-menopausal, HR+ early breast cancer patients.

Lessons learned from an emergency medical services fire safety intervention.

PubMed

Pirrallo, Ronald G; Cady, Charles E

2004-01-01

The authors conducted a pilot study, finding that many households that experienced fires had received prior emergency medical services (EMS) visits, but few had operational smoke alarms. The study hypothesis is that dwellings that received smoke alarms and/or batteries during an EMS call were more likely to have an operational alarm, less property dollar loss, and decreased morbidity and mortality at the time of a subsequent fire. Smoke detectors and batteries were provided to an urban fire department for placement in unprotected homes at the time of an EMS call from March 1, 1999, through January 31, 2001. After addressing the reason for the 911 EMS call, verification or installation of an operational smoke alarm was performed. The authors examined records for dwellings that had a subsequent fire for outcomes of smoke alarm status, estimated property dollar loss, and number of injuries and fatalities. This program placed 1,335 smoke detectors. Of these, 99 dwellings were found to have a fire or smoke condition with 20 exclusions. Our final number was 79; 28 (35%) still had an operating smoke alarm. In homes with operational alarms, the mean dollar loss was 2,870 dollars (U.S. 2001) (95% confidence interval [CI], 143-5,596). In homes without operational alarms, mean loss was 10,468 dollars (U.S. 2001) (95% CI, 5,875-15,061). No injuries or fatalities occurred in either group. This program was successful in placing 1,335 smoke alarms in at-risk dwellings and reaffirmed that an operational smoke alarm significantly decreases property dollar loss. However, if the goal is to have all homes protected by smoke alarms, this program has long-term effectiveness limitations.

Model-based estimates of risks of disease transmission and economic costs of seven injection devices in sub-Saharan Africa.

PubMed Central

Ekwueme, Donatus U.; Weniger, Bruce G.; Chen, Robert T.

2002-01-01

OBJECTIVE: To investigate and compare seven types of injection devices for their risks of iatrogenic transmission of bloodborne pathogens and their economic costs in sub-Saharan Africa. METHODS: Risk assumptions for each device and cost models were constructed to estimate the number of new hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections resulting from patient-to-patient, patient-to-health care worker, and patient-to-community transmission. Costs of device purchase and usage were derived from the literature, while costs of direct medical care and lost productivity from HBV and HIV disease were based on data collected in 1999 in Côte d'Ivoire, Ghana, and Uganda. Multivariate sensitivity analyses using Monte Carlo simulation characterized uncertainties in model parameters. Costs were summed from both the societal and health care system payer's perspectives. FINDINGS: Resterilizable and disposable needles and syringes had the highest overall costs for device purchase, usage, and iatrogenic disease: median US dollars 26.77 and US dollars 25.29, respectively, per injection from the societal perspective. Disposable-cartridge jet injectors and automatic needle-shielding syringes had the lowest costs, US dollars 0.36 and US dollars 0.80, respectively. Reusable-nozzle jet injectors and auto-disable needle and syringes were intermediate, at US dollars 0.80 and US dollars 0.91, respectively, per injection. CONCLUSION: Despite their nominal purchase and usage costs, conventional needles and syringes carry a hidden but huge burden of iatrogenic disease. Alternative injection devices for the millions of injections administered annually in sub-Saharan Africa would be of value and should be considered by policy-makers in procurement decisions. PMID:12481207

Median dermatology base incomes in senior academia and practice are comparable, but a significant income gap exists at junior levels.

PubMed

Tierney, Emily; Kimball, Alexa Boer

2006-08-01

The perception that dermatologists in practice have substantially higher incomes than in academics is often cited as the primary reason people choose to practice outside academic institutions. We sought to compare the incomes of dermatologists in academics versus various practice settings. Data from various surveys of dermatologists from 2002 to 2004 were adjusted for annual inflation to the year 2004 and compared. Benefits and bonuses were not included. The income level of clinical instructors, who are 7.0% of all academic dermatology faculty, were not available for inclusion. Median dermatology faculty income (combined average of assistant, associate, and professor levels) was 192,267 dollars, 12.0% less than the median practice income of 215,303 dollars. There was substantial variation across regions, institutions, and types of nonacademic practice. Median starting incomes for dermatology residency graduates were comparable in practice across multiple data sources (182,116 dollars-200,000 dollars) and private universities (189,336 dollars); however, both were significantly higher than median starting incomes in public universities (83,349 dollars). This study relied on self-reported data. Although all attempts were made to use comparable information, variances in how data were collected and classified may exist. Initial income for those entering practice is equivalent to those entering academia in private universities; however, incomes for both of these groups are 2- to 3-fold higher than those entering academia in public universities. This discrepancy may discourage some recent trainees, some of whom have high debt and high expenses, from entering the field of academic dermatology. Because incomes in academia increase predictably with increasing rank, overall self-reported incomes for established dermatologists in practice and senior academia are comparable.

Financial analysis of cardiovascular wellness program provided to self-insured company from pharmaceutical care provider's perspective.

PubMed

Wilson, Justin B; Osterhaus, Matt C; Farris, Karen B; Doucette, William R; Currie, Jay D; Bullock, Tammy; Kumbera, Patty

2005-01-01

To perform a retrospective financial analysis on the implementation of a self-insured company's wellness program from the pharmaceutical care provider's perspective and conduct sensitivity analyses to estimate costs versus revenues for pharmacies without resident pharmacists, program implementation for a second employer, the second year of the program, and a range of pharmacist wages. Cost-benefit and sensitivity analyses. Self-insured employer with headquarters in Canton, N.C. 36 employees at facility in Clinton, Iowa. Pharmacist-provided cardiovascular wellness program. Costs and revenues collected from pharmacy records, including pharmacy purchasing records, billing records, and pharmacists' time estimates. All costs and revenues were calculated for the development and first year of the intervention program. Costs included initial and follow-up screening supplies, office supplies, screening/group presentation time, service provision time, documentation/preparation time, travel expenses, claims submission time, and administrative fees. Revenues included initial screening revenues, follow-up screening revenues, group session revenues, and Heart Smart program revenues. For the development and first year of Heart Smart, net benefit to the pharmacy (revenues minus costs) amounted to dollars 2,413. All sensitivity analyses showed a net benefit. For pharmacies without a resident pharmacist, the net benefit was dollars 106; for Heart Smart in a second employer, the net benefit was dollars 6,024; for the second year, the projected net benefit was dollars 6,844; factoring in a lower pharmacist salary, the net benefit was dollars 2,905; and for a higher pharmacist salary, the net benefit was dollars 1,265. For the development and first year of Heart Smart, the revenues of the wellness program in a self-insured company outweighed the costs.

Pediatric traumatic amputations and hospital resource utilization in the United States, 2003.

PubMed

Conner, Kristen A; McKenzie, Lara B; Xiang, Huiyun; Smith, Gary A

2010-01-01

Despite the severity of consequences associated with traumatic amputation, little is known about the epidemiology or healthcare resource burden of amputation injuries, and even less is known about these injuries in the pediatric population. An analysis of patients aged < or =17 years hospitalized with traumatic amputations using the 2003 Healthcare Cost and Utilization Project Kids' Inpatient Database was performed. National estimates of amputation-associated hospitalizations, rates, resource use, and demographics were calculated. Potentially significant covariate associations were studied using hospital charges and length of stay (LOS). In 2003, 956 cases of traumatic amputations among children aged < or =17 years resulted in 21.6 million dollars (standard deviation [SD] = 2.2 million dollars) in inpatient charges and 3,967 days (SD = 354) of hospitalization in the United States. Finger and/or thumb amputations accounted for the majority of injuries (64.0%). Mean (SD) hospital charges and LOS were 23,157 dollars (49,018 dollars) and 4.1 (7.4) days, respectively. Traumatic leg amputations incurred the highest mean hospital charges (120,275 dollars) and longest mean LOS (18.5 days). Older children (15-17 years) experienced a higher hospitalization rate (1.84/100,000) than other age groups. Older age, amputation caused by a motorized vehicle, urban hospital location, children's hospital type, and longer LOS were associated with higher total charges. Amputation caused by lawn mower, motorized vehicle or explosives/fireworks, and children's hospital type were associated with longer LOS. Pediatric traumatic amputations contribute substantially to the health resource burden in the United States, resulting in 21 million dollars in inpatient charges annually. More effective interventions to prevent these costly injuries among children must be implemented.

Productivity, quality, and patient satisfaction: comparison of part-time and full-time primary care physicians.

PubMed

Fairchild, D G; McLoughlin, K S; Gharib, S; Horsky, J; Portnow, M; Richter, J; Gagliano, N; Bates, D W

2001-10-01

Although few data are available, many believe that part-time primary care physicians (PCPs) are less productive and provide lower quality care than full-time PCPs. Some insurers exclude part-time PCPs from their provider networks. To compare productivity, quality of preventive care, patient satisfaction, and risk-adjusted resource utilization of part-time and full-time PCPs. Retrospective cohort study. Boston. PCPs affiliated with 2 academic outpatient primary care networks. PCP productivity, patient satisfaction, resource utilization, and compliance with screening guidelines. Part-time PCP productivity was greater than that of full-time PCPs (2.1 work relative value units (RVUs)/bookable clinical hour versus 1.3 work RVUs/bookable clinical hour, P< .01). A similar proportion of part-time PCPs (80%) and full-time PCPs (75%) met targets for mammography, Pap smears, and cholesterol screening (P = .67). After adjusting for clinical case mix, practice location, gender, board certification status, and years in practice, resource utilization of part-time PCPs (138 dollars [95% confidence interval (CI), 108 dollars to 167 dollars]) was similar to that of full-time PCPs (139 dollars [95% CI, 108 dollars to 170 dollars], P = .92). Patient satisfaction was similar for part-time and full-time PCPs. In these academic primary care practices, rates of patient satisfaction, compliance with screening guidelines, and resource utilization were similar for part-time PCPs compared to full-time PCPs. Productivity per clinical hour was markedly higher for part-time PCPs. Despite study limitations, these data suggest that academic part-time PCPs are at least as efficient as full-time PCPs and that the quality of their work is similar.

Expression patterns of wnt8 orthologs in two sand dollar species with different developmental modes.

PubMed

Nakata, Hidewo; Minokawa, Takuya

2009-03-01

Two wnt8 orthologs, Smwnt8 and Pjwnt8, were isolated from an indirect developing sand dollar, Scaphechinus mirabilis, and a direct developing sand dollar, Peronella japonica, respectively. The expression patterns of two genes during early development were examined by whole mount in situ hybridization. The expression of Smwnt8 was initiated in the micromeres at the late 16-cell stage and expanded at the 64-cell stage to the whole vegetal hemisphere, including the presumptive endomesodermal regions. The timing of the initiation of Pjwnt8 transcription in the presumptive endomesoderm region was delayed by 2-3 cell cycles compared to that of Smwnt8. The delay, or molecular heterochrony, of Pjwnt8 transcription strongly suggests the existence of a substantial evolutionary change in the early endomesodermal specification of P. japonica. In addition to the endomesodermal expression during early embryogenesis, bilateral expressions were observed commonly in the ectoderm of two sand dollar species during larval stages.

A cost analysis of a smoke alarm installation and fire safety education program.

PubMed

Parmer, John E; Corso, Phaedra S; Ballesteros, Michael F

2006-01-01

While smoke alarm installation programs can help prevent residential fire injuries, the costs of running these programs are not well understood. We conducted a retrospective cost analysis of a smoke alarm installation program in 12 funded communities across four states. Costs included financial and economic resources needed for training, canvassing, installing, and following-up, within four cost categories: (a) personnel, (b) transportation, (c) facility, and (d) supplies. Local cost per completed home visit averaged 214.54 dollars, with an average local cost per alarm installed of 115.02 dollars. Combined state and local cost per alarm installed across all four states averaged 132.15 dollars. For every 1% increase in alarm installation, costs per alarm decrease by 1.32 dollars. As more smoke alarms are installed, the average installation cost per alarm decreases. By demonstrating effective economies of scale, this study suggests that smoke alarm programs can be implemented efficiently and receive positive economic returns on investment.

Estimating the Effects of Module Area on Thin-Film Photovoltaic System Costs: Preprint

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

Horowitz, Kelsey A; Fu, Ran; Silverman, Timothy J

We investigate the potential effects of module area on the cost and performance of photovoltaic systems. Applying a bottom-up methodology, we analyzed the costs associated with thin-film modules and systems as a function of module area. We calculate a potential for savings of up to 0.10 dollars/W and 0.13 dollars/W in module manufacturing costs for CdTe and CIGS respectively, with large area modules. We also find that an additional 0.04 dollars/W savings in balance-of-systems costs may be achieved. Sensitivity of the dollar/W cost savings to module efficiency, manufacturing yield, and other parameters is presented. Lifetime energy yield must also bemore » maintained to realize reductions in the levelized cost of energy; the effects of module size on energy yield for monolithic thin-film modules are not yet well understood. Finally, we discuss possible non-cost barriers to adoption of large area modules.« less

The market trend analysis and prospects of scaffolds for stem cells.

PubMed

Lee, Seou; Kwon, Taehoon; Chung, Eun Kyung; Lee, Joon Woo

2014-01-01

Scaffolds are one of the three most important elements constituting the basic concept of regenerative medicine, and are included in the core technology of regenerative medicine along with stem cells and tissue engineering. Stem cells are very important technology because they are directly responsible for the regenerative treatment of the disease and the damaged tissue, but with regards to the technology and the products that use stem cells exclusively, there is a technical limitation of limited survival rate and the engraftment rate of the transplanted cell, and rather than recovering the damaged tissue fundamentally, there is a limit that the concept is more of just another medicine treatment using cells. A scaffold is a natural or synthetic biocompatible material transplanted into a human body to be used as the exclusive treatment or as an assisted method of another treatment of a disease and for the recovery of damaged tissue. Therefore, according to the characteristics of the tissue to be applied, scaffolds must have the characteristics such as the excellent biocompatibility, biodegradability, minimum immunity and inflammation, proper mechanical strength and interaction between the material and the cells. The world stem cell market was approximately 2.715 billion dollars in 2010, and with a growth rate of 16.8% annually, a market of 6.877 billion dollars will be formed in 2016. From 2017, the expected annual growth rate is 10.6%, which would expand the market to 11.38 billion dollars by 2021. Meanwhile, the world scaffold element technology market was approximately 4.57 million dollars in 2013, and by increasing 13.4% annually, it is estimated to expand to 10.63 million dollars by 2020. The Korean scaffold element technology market was about 22 million dollars in 2013, and with a steady growth of approximately 13.4% every year, it is prospected to be about 52 million dollars by 2020. In comparison to the medical material and medicine sales growth rate, the future scaffold element technology market is judged to be higher in growth possibility.

Induction of metamorphosis in the sand dollar Peronella japonica by thyroid hormones.

PubMed

Saito, M; Seki, M; Amemiya, S; Yamasu, K; Suyemitsu, T; Ishihara, K

1998-06-01

The larva of the sand dollar Peronella japonica lacks a mouth and gut, and undergoes metamorphosis into a juvenile sand dollar without feeding. In the present study, it was found that thyroid hormones accelerate the metamorphosis of P. japonica larvae. The contents of thyroid hormones in larvae increased gradually during development. Thiourea and potassium perchlorate, inhibitors of thyroid hormone synthesis, delayed larval metamorphosis and simultaneously repressed an increase in the content of thyroxine in the larval body. These results suggest that the P. japonica larva has a system for synthesis of thyroid hormones that act as factors for inducing metamorphosis.

Characteristic time scales in the American dollar-Mexican peso exchange currency market

NASA Astrophysics Data System (ADS)

Alvarez-Ramirez, Jose

2002-06-01

Daily fluctuations of the American dollar-Mexican peso exchange currency market are studied using multifractal analysis methods. It is found evidence of multiaffinity of daily fluctuations in the sense that the qth-order (roughness) Hurst exponent Hq varies with changes in q. It is also found that there exist several characteristic time scales ranging from week to year. Accordingly, the market exhibits persistence in the sense that instabilities introduced by market events acting around the characteristic time scales (mainly, quarter and year) would propagate through the future market activity. Some implications of our results on the regulation of the dollar-mexpeso market activity are discussed.

Smart Energy Choices Free Up Dollars for Capital Improvements.

ERIC Educational Resources Information Center

Ritchey, David

2003-01-01

Describes several ways to design or renovate school building to save thousand of dollars of energy costs. Considers site design, energy-efficient building envelope, renewable energy systems, lighting and electrical systems, mechanical and ventilation systems, water conservation, and transportation. Describes how to obtain information about the…

17 CFR 4.5 - Exclusion for certain otherwise regulated persons from the definition of the term “commodity pool...

Code of Federal Regulations, 2012 CFR

2012-04-01

... retail forex transaction, by calculating the value in U.S. Dollars for such transaction, at the time the... such retail forex transaction, by calculating the value in U.S. Dollars for such transaction, at the...

48 CFR 201.109 - Statutory acquisition-related dollar thresholds-adjustment for inflation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Statutory acquisition-related dollar thresholds-adjustment for inflation. 201.109 Section 201.109 Federal Acquisition...-adjustment for inflation. (d) A matrix showing the most recent escalation adjustments of statutory...

Evaluation of seashore paspalum germplasm for resistance to dollar spot disease

USDA-ARS?s Scientific Manuscript database

Development of seashore paspalum (Paspalum vaginatum Swartz) cultivars that exhibit resistance to dollar spot disease, caused by Sclerotinia homoeocarpa F.T. Bennett, are needed. Seashore paspalum is a warm-season turfgrass often utilized on golf courses and athletic fields in the southeastern Unite...

Do You Automate? Saving Time and Dollars

ERIC Educational Resources Information Center

Carmichael, Christine H.

2010-01-01

An automated workforce management strategy can help schools save jobs, improve the job satisfaction of teachers and staff, and free up precious budget dollars for investments in critical learning resources. Automated workforce management systems can help schools control labor costs, minimize compliance risk, and improve employee satisfaction.…

36 CFR 72.32 - Funding and matching share.

Code of Federal Regulations, 2011 CFR

2011-07-01

... to 50 percent matching grants are authorized for the preparation of Recovery Action Programs (RAP..., dollar for dollar, State contributions to the local share of an Innovation or Rehabilitation grant; up to... applicants by the State, other public agencies, private organizations or individuals. The value of the...

Evaluating Efficiencies in Preventive Medicine: Comparing Approaches Between the Services

DTIC Science & Technology

2016-02-29

Prank] + Σn [(Td * L) + (Td * Pdiem)] C: Cost in dollars T: Time allocated for training in days Prank: Pay for the expected rank in dollars per...of food service facilities and storage areas, berthing spaces, childcare facilities, recreational facilities, potable water and wastewater disposal

Stretching Your Technology Dollar

ERIC Educational Resources Information Center

Johnson, Doug

2012-01-01

A school district technology director offers 10 strategies to help schools make the most of their technology dollar. These include using effective budgeting techniques, taking advantage of the buying power of groups, practicing sustainable technology, purchasing the right tool for the right job, taking advantage of free software, using cloud…

Report: EPA Can Improve Its Reporting of Dollars Leveraged From the American Recovery and Reinvestment Act Brownfields Program

EPA Pesticide Factsheets

Report #12-R-0898, Sept 27, 2012. EPA project officers verified grant recipient reported outputs and outcomes for Recovery Act brownfields assessments completed, acres ready for reuse, and cleanups completed, but did not always verify dollars leveraged.

SCIENCE, POLICY, AND PACIFIC NORTHWEST SALMON RECOVERY

EPA Science Inventory

Throughout the Pacific Northwest, since 1850, all wild salmon runs have declined and some have disappeared. Billions of dollars have been spent in a so-far failed attempt to reverse the long-term decline. Each year, hundreds of millions of dollars continue to be spent in variou...

SCIENCE, POLITICS, AND PACIFIC NORTHWEST SALMON RECOVERY

EPA Science Inventory

Throughout the Pacific Northwest, since 1850, all wild salmon runs have declined and some have disappeared. Billions of dollars have been spent in a so-far failed attempt to reverse the long-term decline. Each year, hundreds of millions of dollars continue to be spent in variou...

12 CFR 611.515 - Information statement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... estimated to be associated with the transfer. (7) A description of the type and dollar amount of any... require financial assistance during the first 3 years of operation, the estimated type and dollar amount... possible tax consequences to stockholders and whether any legal opinion, ruling or external auditor's...

Turning whine into wine: the fiscal impact of comprehensive documentation and billing for nonoperative pediatric surgical services.

PubMed

Gollin, Gerald; Moores, Donald

2006-06-01

Some pediatric surgeons rarely document nonoperative services, believing that the reimbursement provided for such care is negligible. We evaluated the impact of comprehensive documentation and billing for nonoperative, pediatric surgical care. All bills submitted for inpatient, nonoperative care for 1 year were reviewed. Total receipts for documented admissions, consultations, critical care, and daily care were determined. The Evaluation and Management code billed for each service was recorded, and the total and average payments attributable to each Evaluation and Management code were calculated. Fifty-six percent of services were covered by Medicaid and 26% by a commercial insurer. There were 607 billed admission history and physical exams for which reimbursement totaled 43,493 dollars. Critical care services were provided to 49 patients and yielded 8964 dollars in payments. Six hundred thirty-nine inpatient consultations were performed with a reimbursement of 42,830 dollars. Daily care services were billed 1044 times and produced 71,579 dollars in payments. Overall reimbursement for documented, nonoperative services was 166,866 dollars. This represented 16.2% of total, noncontracted income for the practice. Despite a payer mix heavily weighted toward Medicaid, comprehensive documentation and billing for nonoperative services increased total, noncontracted reimbursement by almost 20% over what it would have been had only operative services been billed. The yield from properly documented, nonoperative care can be substantial.

Flows of financial resources for health research and development in Brazil, 2000-2002.

PubMed

Vianna, Cid Manso de Mello; Caetano, Rosângela; Ortega, José Antonio; Façanha, Luiz Otávio de Figueiredo; Mosegui, Gabriela Bittencourt Gonzalez; Siqueira, Marien; Costa, Tiago Barros

2007-02-01

To map and measure the flows of financial resources for health research and development in Brazil for the years 2000-2002. After adapting the methodology developed for the Center for Economic Policy Research, data were collected on the sources and uses of resources for health research and development. The annual average value of resources apportioned to health research and development was approximately 573 million US dollars. The public sector as a whole invested 417.3 million US dollars and the health department 51.1 million US dollars. Expressed in percentages, the public sector invested 4.15% of the health department's budget although the Ministry of Health assigned only 0.3% of its budget to health research in the country. The universities and the research institutes are the main users of the resources allocated to health research and development, receiving 91.6% of the total public spending, while the private sector receives a small share of around 0.69% of the total. The private sector invested 135.6 million US dollars per year, and the international organizations 20.1 million US dollars per year. Besides measuring the financial resources made available for health research and development, the results allowed the filling of gaps in national information; the identification of the flows of applied financial resources; and the testing and adaptation of the proposed methodology, generating information suitable for international comparisons.

Economic contribution of draught animals to Mazahua smallholder Campesino farming systems in the highlands of Central Mexico.

PubMed

Arriaga-Jordán, C M; Pedraza-Fuentes, A M; Velázquez-Beltrán, L G; Nava-Bernal, E G; Chávez-Mejía, M C

2005-10-01

The economic contribution of draught animals to smallholder Mazahua campesino systems in two mountain villages of San Felipe del Progreso, in the central highlands of Mexico, was assessed. Campesinos rely on draught animals for cultivation tasks, as pack animals, and as transport for agricultural and domestic activities. The villages were San Pablo Tlalchichilpa (SPT) and La Concepción Mayorazgo (LCM). Twelve households that possessed draught animals were monitored from July 1999 to June 2000, nine in SPT and three in LCM, in terms of animal inventories and income from their draught animals, in cash and opportunity values. Equines in SPT have substituted bulls, and are recognized for their multipurpose contribution, while in LCM bulls are still used for ploughing the land. Overall total mean gross income was US dollar 490.78 per farm per year, plus US dollar 56 as opportunity value of the fertilizer value of manure for both villages. Deducting estimated costs, owning draught animals leaves a mean net margin of US dollar 412.50/year in SPT and of US dollar 285.64/year in LCM. There is a significant correlation (p < 0.05) between ownership of draught animals and incomes, with a regression coefficient of US dollar 279.16 per year per draught animal. Besides positive economic returns, having work animals alleviates drudgery for the campesino families.

Breakeven costs for embryo transfer in a commercial dairy herd.

PubMed

Ferris, T A; Troyer, B W

1987-11-01

Differences in Estimated Breeding Values expressed in dollars were compared by simulation of two, 100-cow, closed herds. One herd practiced normal intensity of female selection. The other herd generated various herd replacements by embryo transfer by varying 1) selection rate of embryo transfer dams and 2) numbers of daughters per dam from which embryos were transferred, while varying the merit of mates of embryo transfer dams. Estimated Breeding Value dollars were compounded each generation and regressed to remove age adjustments and added feed and health costs. Beginning values in both herds included a standard deviation of 55 Cow Index dollars, herd average of -23 Cow Index dollars, and a 120 Predicted Difference dollars for mates of dams not embryo transferred. Average merit of all sires used increased $12 per year. Herd calving rate (.70), proportion females (.5), calf loss (.15), and heifer survival rate (.83) were used. Breakeven cost per embryo transfer cow entering the milking herd was computed by Net Present Value analysis using a 10% discount rate over 10 and 20 yr. Breakeven cost or the maximum expense that would allow a 10% return on the expenditure ranged from $135 to $510 per surviving cow, $24 to $125 per transfer, $47 to $178 per pregnancy, and $81 to $357 per female calf born. As the number of replacements resulting from embryo transfer increased, breakeven cost per embryo transfer cow decreased due to diminishing return.

The Dollar Game Curriculum: Inspiring Wealth Creation in Rural Communities

ERIC Educational Resources Information Center

Braak, Willem J.; Lewin, Paul A.

2015-01-01

Rural wealth creation and local entrepreneurship are emerging economic development approaches that bring back a sense of self-determination to rural communities. However, their potential is often greatly diminished by preconceived and opposing notions within the community on what drives economic growth. The Dollar Game is an innovative curriculum…

7 CFR 457.139 - Fresh market tomato (dollar plan) crop insurance provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Fresh market tomato (dollar plan) crop insurance provisions. 457.139 Section 457.139 Agriculture Regulations of the Department of Agriculture (Continued) FEDERAL CROP INSURANCE CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.139...

31 CFR 560.516 - Payment and United States dollar clearing transactions involving Iran.

Code of Federal Regulations, 2012 CFR

2012-07-01

... clearing transactions involving Iran. 560.516 Section 560.516 Money and Finance: Treasury Regulations... Payment and United States dollar clearing transactions involving Iran. (a) United States depository institutions are authorized to process transfers of funds to or from Iran, or for the direct or indirect...

31 CFR 560.516 - Payment and United States dollar clearing transactions involving Iran.

Code of Federal Regulations, 2010 CFR

2010-07-01

... clearing transactions involving Iran. 560.516 Section 560.516 Money and Finance: Treasury Regulations... Payment and United States dollar clearing transactions involving Iran. (a) United States depository institutions are authorized to process transfers of funds to or from Iran, or for the direct or indirect...

31 CFR 560.516 - Payment and United States dollar clearing transactions involving Iran.

Code of Federal Regulations, 2011 CFR

2011-07-01

... clearing transactions involving Iran. 560.516 Section 560.516 Money and Finance: Treasury Regulations... Payment and United States dollar clearing transactions involving Iran. (a) United States depository institutions are authorized to process transfers of funds to or from Iran, or for the direct or indirect...

10 CFR Appendix B to Part 436 - Goal Setting Methodology

Code of Federal Regulations, 2013 CFR

2013-01-01

... investment program, (using where appropriate, the life cycle costing factors and methodology in subpart A of... subpart A, the dollars saved can be projected against the dollars invested. Life cycle costing methodology..., maintenance, and equipment acquisition; and phase-out schedule (of older equipment or plants which may be...

10 CFR Appendix B to Part 436 - Goal Setting Methodology

Code of Federal Regulations, 2012 CFR

2012-01-01

... investment program, (using where appropriate, the life cycle costing factors and methodology in subpart A of... subpart A, the dollars saved can be projected against the dollars invested. Life cycle costing methodology..., maintenance, and equipment acquisition; and phase-out schedule (of older equipment or plants which may be...

10 CFR Appendix B to Part 436 - Goal Setting Methodology

Code of Federal Regulations, 2011 CFR

2011-01-01

... investment program, (using where appropriate, the life cycle costing factors and methodology in subpart A of... Subpart A, the dollars saved can be projected against the dollars invested. Life cycle costing methodology..., maintenance, and equipment acquisition; and phase-out schedule (of older equipment or plants which may be...

10 CFR Appendix B to Part 436 - Goal Setting Methodology

Code of Federal Regulations, 2014 CFR

2014-01-01

... investment program, (using where appropriate, the life cycle costing factors and methodology in subpart A of... subpart A, the dollars saved can be projected against the dollars invested. Life cycle costing methodology..., maintenance, and equipment acquisition; and phase-out schedule (of older equipment or plants which may be...

Tennessee's High School Dropouts: Examining the Fiscal Consequences

ERIC Educational Resources Information Center

D'Andrea, Christian

2010-01-01

High school dropouts adversely impact the state of Tennessee each year--financially and socially. Dropouts' lower incomes, high unemployment rates, increased need for medical care, and higher propensity for incarceration create a virtual vortex that consumes Tennesseans' tax dollars at a vicious rate. Hundreds of millions of dollars are spent on…

26 CFR 1.409A-3 - Permissible payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... schedule of periodic payments on a dollar-for-dollar basis by the amount of bona fide disability pay..., objective formula limitation, if the disability payments are made pursuant to a plan sponsored by the... other change in the benefit payable under, such bona fide disability plan results in an acceleration of...

5 CFR 894.505 - Are retroactive premiums paid with pre-tax dollars (premium conversion)?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Are retroactive premiums paid with pre-tax dollars (premium conversion)? 894.505 Section 894.505 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE...

5 CFR 894.505 - Are retroactive premiums paid with pre-tax dollars (premium conversion)?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Are retroactive premiums paid with pre-tax dollars (premium conversion)? 894.505 Section 894.505 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE...

75 FR 11889 - Consumer Advisory Council; Notice of Meeting of the Consumer Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-12

...'s responsibilities under various consumer financial services laws and on other matters on which the... Affordable program, neighborhood stabilization initiatives and challenges, and other issues related to foreclosures. Short-term and small-dollar loan products. Members will discuss short-term and small-dollar loan...

49 CFR 225.25 - Recordkeeping.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Total number of cars that derailed; (20) Total amount of damage in dollars to equipment based on... damage in dollars to track, signal, way and structures based on computations as described in the “FRA... Equipment Accident/Incident Record (Form FRA F 6180.97) or an alternative railroad-designed record as...

Transforming School Funding: A Guide to Implementing Student-Based Budgeting (SBB)

ERIC Educational Resources Information Center

Rosenberg, David; Gordon, Jeff; Hsu, Betty

2014-01-01

Student-Based Budgeting (sometimes called Weighted Student Funding, or Fair Student Funding, depending on the district) differs fundamentally from the traditional funding model, which distributes resources to schools in the form of staff and dollars designated for specific purposes. Student-Based Budgeting (SBB) allocates dollars to schools based…

A New Life-Style for Persons with Severe Disabilities: Supported Independence.

ERIC Educational Resources Information Center

Marlett, N. J.; MacLean, H.

The paper presents a model which has provided extensive or partial services for 147 persons with severe and complex disabilities. The model, "Supported Independence Using Individualized Dollars" (dollars allocated to a specific client), emerged when the Calgary Association for Independent Living, a small self-help group of disabled…

Your Automobile Dollar, [Revised.] Money Management

ERIC Educational Resources Information Center

Baran, Nancy H., Ed.; Law, Jean L., Ed.

This booklet on automobile purchasing and maintenance, 1 in a series of 12, covers all the basic aspects of personal- and family-money management. Suitable for use by high school and college students as well as adults, this handbook discusses buying, maintaining, and operating cars. Section 1 discusses managing automobile dollars. Topics include…

SALMON IN CRISIS: IN SEARCH OF A SOLUTION FOR THE PACIFIC NORTHWEST

EPA Science Inventory

Throughout the Pacific Northwest, since 1850, all wild salmon runs have declined and some have disappeared. Billions of dollars have been spent in a so-far failed attempt to reverse the long-term decline. Each year, hundreds of millions of dollars continue to be spent in variou...

SALMON RESTORATION: FORMULATING GOALS WITHIN A REALISTIC SCIENCE AND POLICY CONTEXT

EPA Science Inventory

Throughout the Pacific Northwest, since 1850, all wild salmon runs have declined and some have disappeared. Billions of dollars have been spent in a so-far failed attempt to reverse the long-term decline. Each year, hundreds of millions of dollars continue to be spent in variou...

24 CFR 257.7 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of the Board of Governors of the Federal Reserve System (Federal Reserve Board), and the Chairperson...). Net worth means the total dollar amount of all liabilities subtracted from the total dollar amount of... as defined at 12 CFR 226.32(d)(6) of the Federal Reserve Board's Regulation Z (Truth in Lending...

A comparative technoeconomic analysis of renewable hydrogen production using solar energy

DOE PAGES

Shaner, Matthew R.; Atwater, Harry A.; Lewis, Nathan S.; ...

2016-05-26

A technoeconomic analysis of photoelectrochemical (PEC) and photovoltaic-electrolytic (PV-E) solar-hydrogen production of 10 000 kg H 2 day -1 (3.65 kilotons per year) was performed to assess the economics of each technology, and to provide a basis for comparison between these technologies as well as within the broader energy landscape. Two PEC systems, differentiated primarily by the extent of solar concentration (unconcentrated and 10× concentrated) and two PV-E systems, differentiated by the degree of grid connectivity (unconnected and grid supplemented), were analyzed. In each case, a base-case system that used established designs and materials was compared to prospective systems thatmore » might be envisioned and developed in the future with the goal of achieving substantially lower overall system costs. With identical overall plant efficiencies of 9.8%, the unconcentrated PEC and non-grid connected PV-E system base-case capital expenses for the rated capacity of 3.65 kilotons H 2 per year were 205 dollars MM (293 dollars per m 2 of solar collection area (m S -2 ), 14.7 W H2,P -1) and 260 dollars MM ($371 m S -2, 18.8 dollars W H2,P -1 ), respectively. The untaxed, plant-gate levelized costs for the hydrogen product (LCH) were $11.4 kg -1 and 12.1 dollars kg -1 for the base-case PEC and PV-E systems, respectively. The 10× concentrated PEC base-case system capital cost was 160 dollars MM (428 dollars m S -2, 11.5 dollars W H2,P -1) and for an efficiency of 20% the LCH was 9.2 kg -1 . Likewise, the grid supplemented base-case PV-E system capital cost was 66 dollars MM (441 dollars m S -2, 11.5 dollars W H2,P -1 ), and with solar-to-hydrogen and grid electrolysis system efficiencies of 9.8% and 61%, respectively, the LCH was 6.1 dollars kg -1 . As a benchmark, a proton-exchange membrane (PEM) based grid-connected electrolysis system was analyzed. Assuming a system efficiency of 61% and a grid electricity cost of $0.07 kWh -1 , the LCH was $5.5 kg -1 . A sensitivity analysis indicated that, relative to the base-case, increases in the system efficiency could effect the greatest cost reductions for all systems, due to the areal dependencies of many of the components. The balance-of-systems (BoS) costs were the largest factor in differentiating the PEC and PV-E systems. No single or combination of technical advancements based on currently demonstrated technology can provide sufficient cost reductions to allow solar hydrogen to directly compete on a levelized cost basis with hydrogen produced from fossil energy. Specifically, a cost of CO 2 greater than ~$800 dollars (ton CO 2 ) -1 was estimated to be necessary for base-case PEC hydrogen to reach price parity with hydrogen derived from steam reforming of methane priced at $12 GJ -1 ($1.39 (kg H 2 ) -1). A comparison with low CO 2 and CO 2 -neutral energy sources indicated that base-case PEC hydrogen is not currently cost-competitive with electrolysis using electricity supplied by nuclear power or from fossil-fuels in conjunction with carbon capture and storage. Solar electricity production and storage using either batteries or PEC hydrogen technologies are currently an order of magnitude greater in cost than electricity prices with no clear advantage to either battery or hydrogen storage as of yet. Significant advances in PEC technology performance and system cost reductions are necessary to enable cost-effective PEC-derived solar hydrogen for use in scalable grid-storage applications as well as for use as a chemical feedstock precursor to CO 2 -neutral high energy-density transportation fuels. Hence such applications are an opportunity for foundational research to contribute to the development of disruptive approaches to solar fuels generation systems that can offer higher performance at much lower cost than is provided by current embodiments of solar fuels generators. Efforts to directly reduce CO 2 photoelectrochemically or electrochemically could potentially produce products with higher value than hydrogen, but many, as yet unmet, challenges include catalytic efficiency and selectivity, and CO 2 mass transport rates and feedstock cost. Major breakthroughs are required to obtain viable economic costs for solar hydrogen production, but the barriers to achieve cost-competitiveness with existing large-scale thermochemical processes for CO 2 reduction are even greater.« less

A comparative technoeconomic analysis of renewable hydrogen production using solar energy

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

Shaner, Matthew R.; Atwater, Harry A.; Lewis, Nathan S.

A technoeconomic analysis of photoelectrochemical (PEC) and photovoltaic-electrolytic (PV-E) solar-hydrogen production of 10 000 kg H 2 day -1 (3.65 kilotons per year) was performed to assess the economics of each technology, and to provide a basis for comparison between these technologies as well as within the broader energy landscape. Two PEC systems, differentiated primarily by the extent of solar concentration (unconcentrated and 10× concentrated) and two PV-E systems, differentiated by the degree of grid connectivity (unconnected and grid supplemented), were analyzed. In each case, a base-case system that used established designs and materials was compared to prospective systems thatmore » might be envisioned and developed in the future with the goal of achieving substantially lower overall system costs. With identical overall plant efficiencies of 9.8%, the unconcentrated PEC and non-grid connected PV-E system base-case capital expenses for the rated capacity of 3.65 kilotons H 2 per year were 205 dollars MM (293 dollars per m 2 of solar collection area (m S -2 ), 14.7 W H2,P -1) and 260 dollars MM ($371 m S -2, 18.8 dollars W H2,P -1 ), respectively. The untaxed, plant-gate levelized costs for the hydrogen product (LCH) were $11.4 kg -1 and 12.1 dollars kg -1 for the base-case PEC and PV-E systems, respectively. The 10× concentrated PEC base-case system capital cost was 160 dollars MM (428 dollars m S -2, 11.5 dollars W H2,P -1) and for an efficiency of 20% the LCH was 9.2 kg -1 . Likewise, the grid supplemented base-case PV-E system capital cost was 66 dollars MM (441 dollars m S -2, 11.5 dollars W H2,P -1 ), and with solar-to-hydrogen and grid electrolysis system efficiencies of 9.8% and 61%, respectively, the LCH was 6.1 dollars kg -1 . As a benchmark, a proton-exchange membrane (PEM) based grid-connected electrolysis system was analyzed. Assuming a system efficiency of 61% and a grid electricity cost of $0.07 kWh -1 , the LCH was $5.5 kg -1 . A sensitivity analysis indicated that, relative to the base-case, increases in the system efficiency could effect the greatest cost reductions for all systems, due to the areal dependencies of many of the components. The balance-of-systems (BoS) costs were the largest factor in differentiating the PEC and PV-E systems. No single or combination of technical advancements based on currently demonstrated technology can provide sufficient cost reductions to allow solar hydrogen to directly compete on a levelized cost basis with hydrogen produced from fossil energy. Specifically, a cost of CO 2 greater than ~$800 dollars (ton CO 2 ) -1 was estimated to be necessary for base-case PEC hydrogen to reach price parity with hydrogen derived from steam reforming of methane priced at $12 GJ -1 ($1.39 (kg H 2 ) -1). A comparison with low CO 2 and CO 2 -neutral energy sources indicated that base-case PEC hydrogen is not currently cost-competitive with electrolysis using electricity supplied by nuclear power or from fossil-fuels in conjunction with carbon capture and storage. Solar electricity production and storage using either batteries or PEC hydrogen technologies are currently an order of magnitude greater in cost than electricity prices with no clear advantage to either battery or hydrogen storage as of yet. Significant advances in PEC technology performance and system cost reductions are necessary to enable cost-effective PEC-derived solar hydrogen for use in scalable grid-storage applications as well as for use as a chemical feedstock precursor to CO 2 -neutral high energy-density transportation fuels. Hence such applications are an opportunity for foundational research to contribute to the development of disruptive approaches to solar fuels generation systems that can offer higher performance at much lower cost than is provided by current embodiments of solar fuels generators. Efforts to directly reduce CO 2 photoelectrochemically or electrochemically could potentially produce products with higher value than hydrogen, but many, as yet unmet, challenges include catalytic efficiency and selectivity, and CO 2 mass transport rates and feedstock cost. Major breakthroughs are required to obtain viable economic costs for solar hydrogen production, but the barriers to achieve cost-competitiveness with existing large-scale thermochemical processes for CO 2 reduction are even greater.« less

Fluctuation Dynamics of Exchange Rates on Indian Financial Market

NASA Astrophysics Data System (ADS)

Sarkar, A.; Barat, P.

Here we investigate the scaling behavior and the complexity of the average daily exchange rate returns of the Indian Rupee against four foreign currencies namely US Dollar, Euro, Great Britain Pound and Japanese Yen. Our analysis revealed that the average daily exchange rate return of the Indian Rupee against the US Dollar exhibits a persistent scaling behavior and follow Levy stable distribution. On the contrary the average daily exchange rate returns of the other three foreign currencies show randomness and follow Gaussian distribution. Moreover, it is seen that the complexity of the average daily exchange rate return of the Indian Rupee against US Dollar is less than the other three exchange rate returns.

The ‘thousand-dollar genome': an ethical exploration

PubMed Central

Dondorp, Wybo J; de Wert, Guido M W R

2013-01-01

Sequencing an individual's complete genome is expected to be possible for a relatively low sum ‘one thousand dollars' within a few years. Sequencing refers to determining the order of base pairs that make up the genome. The result is a library of three billion letter combinations. Cheap whole-genome sequencing is of greatest importance to medical scientific research. Comparing individual complete genomes will lead to a better understanding of the contribution genetic variation makes to health and disease. As knowledge increases, the ‘thousand-dollar genome' will also become increasingly important to healthcare. The applications that come within reach raise a number of ethical questions. This monitoring report addresses the issue. PMID:23677179

Students Partner with Business, Community, and State

ERIC Educational Resources Information Center

Ussach, H. B.

2004-01-01

An effort to kick-start local education and to keep students learning and going to college came in 1958 when Fall River optometrist Irving Fradkin started a citizens-based scholarship fund to help ambitious but needy public school graduates pay college tuition and textbook costs. With literally a dollar contributed here and a dollar contributed…

Clarireedia: A new fungal genus comprising four pathogenic species responsible for dollar spot disease of turfgrass

USDA-ARS?s Scientific Manuscript database

Dollar spot is one of the most destructive and economically important fungal diseases of amenity turfgrasses. The causal agent was first described in 1937 as the ascomycete Sclerotinia homoeocarpa. However, the genus-level taxonomic placement of this fungus has been the subject of an ongoing debate ...

Failure to Learn from Failure: Evaluating Computer Systems in Medicine

PubMed Central

Grann, Richard P.

1980-01-01

Evaluation of ADP systems in medicine frequently becomes mired in problems of tenuous cost measurement, of proving illusory cost savings, of false precision, and of dubious discounting methods, while giving only superficial treatment to non-dollar benefits. It would frequently be more advantageous to study non-dollar impacts with greater care and rigor.

Bauxite and alumina

USGS Publications Warehouse

Bray, E.L.

2010-01-01

The article reports on the global market performance of bauxite and alumina in 2009 and presents an outlook for their 2010 performance. There were only several U.S. states that could produce bauxite and bauxitic clays including Georgia, Arkansas, and Alabama. The prices for imported refractory-grade calcined bauxite ranged between 426 U.S. dollars and 554 dollars per ton.

Knowledge Building in an Aboriginal Context

ERIC Educational Resources Information Center

McAuley, Alexander

2009-01-01

The report on the Royal Commission on Aboriginal Peoples (1996), the Kelowna Accord announced in 2005 (five-billion dollars) followed by its demise in 2006, and the settlement in 2006 for Aboriginal survivors of residential schools (1.9 billion dollars), are but some of the recent high-profile indicators of the challenges to Canada in dealing with…

29 CFR 794.100 - The statutory provision.

Code of Federal Regulations, 2010 CFR

2010-07-01

... petroleum products if: (A) The annual gross volume of sales of such enterprise is less than $1 million exclusive of excise taxes; (B) More than 75 per centum of such enterprise's annual dollar volume of sales is... annual dollar volume of sales of such enterprise is to customers who are engaged in the bulk distribution...

7 CFR 1425.10 - Financial ratio requirement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Financial ratio requirement. 1425.10 Section 1425.10... Financial ratio requirement. To be financially able to make advances to their members and to market their commodities, CMA's shall have a current ratio of at least 1 dollar of current assets for each 1 dollar of...

Stretching the Higher Education Dollar: How Innovation Can Improve Access, Equity, and Affordability

ERIC Educational Resources Information Center

Kelly, Andrew P., Ed.; Carey, Kevin, Ed.

2013-01-01

In this provocative volume, higher education experts explore innovative ways that colleges and universities can unbundle the various elements of the college experience while assessing costs and benefits and realizing savings. "Stretching the Higher Education Dollar" traces the reform continuum from incremental to more ambitious efforts.…

Sand dollar: a weight belt for the juvenile.

PubMed

Chia, F S

1973-07-06

Juvenile sand dollars (Dendraster excentricus) selectively ingest heavy sand grains from the substrate and store them in an intestinal diverticulum which may function as a weight belt, assisting the young animal to remain in the shifting sandy environment. The sand disappears from the diverticulum when the animal reaches the length of 30 millimeters.

76 FR 5819 - Notice of Submission of Proposed Information Collection to OMB; HUD-Owned Real Estate-Dollar Home...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-02

... Proposed Information Collection to OMB; HUD-Owned Real Estate--Dollar Home Sales Program AGENCY: Office of... organizations, and government entities. The sale of these properties under this program makes it possible for... appropriate automated collection techniques or other forms of information technology, e.g., permitting...

7 CFR 1170.7 - Reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... completed, i.e. the product is “shipped out” and title transfer occurs. Each sale shall be reported either f.o.b. plant if the product is “shipped out” from the plant or f.o.b. storage facility location if the..., address, plant location(s), quantities sold, total sales dollars, dollars per pound, and the moisture...

7 CFR 1170.7 - Reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... completed, i.e. the product is “shipped out” and title transfer occurs. Each sale shall be reported either f.o.b. plant if the product is “shipped out” from the plant or f.o.b. storage facility location if the..., address, plant location(s), quantities sold, total sales dollars, dollars per pound, and the moisture...

Bond Sales for Public School Purposes 1974-75.

ERIC Educational Resources Information Center

Barr, Richard H.

This annual report presents data on bond elections and bond sales for financing the construction of public elementary and secondary school facilities. Data, summarized by state, are presented in tables and charts containing information on the number and dollar value of bond issues voted on and passed, and the number, dollar value, and net interest…

Evaluation and Private Philanthropy: View from a Corporation.

ERIC Educational Resources Information Center

Roser, Hal

The role of evaluation in the profit and loss sector of American economy differs from its role in the nonprofit sector. Since corporate industry and private foundations contribute approximately 4.5 billion dollars to help finance the ninety-billion dollar private nonprofit sector, sound planning and evaluation activities are essential to maintain…

School Site Decisions and Dollars. Dollar Consequences of School Site Planning Decisions.

ERIC Educational Resources Information Center

Grube, Karl W.

Sufficient research has been generated to economically justify the necessary capital investment expenditures in developing the public school site into a community land asset. Open space school sites designed, developed, and maintained as community land reserves are self-liquidating economic land units because they contribute significantly to the…

31 CFR 500.580 - Authorization of U.S. dollar clearing transactions involving North Korea.

Code of Federal Regulations, 2010 CFR

2010-07-01

... transactions involving North Korea. 500.580 Section 500.580 Money and Finance: Treasury Regulations Relating to... Authorization of U.S. dollar clearing transactions involving North Korea. Banking institutions organized under... North Korea or a national thereof has an interest. Persons subject to U.S. jurisdiction who are...

78 FR 49478 - National Saltwater Angler Registry Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-14

... twenty-five dollars ($25.00) for registration of anglers, spear fishers and for-hire fishing vessels to... to twenty-five dollars ($25.00). All persons registering on or after August 1, 2013 will be required to pay that registration fee, unless they are exempt as indigenous people per the provisions of 50...

78 FR 40548 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-05

.... Dollar Claims on Foreign Residents. Form: TIC Form BQ-1. Estimated Annual Burden Hours: 1,214. (2) OMB.... Form: TIC Form BC. Estimated Annual Burden Hours: 47,847. (3) OMB Number: 1505-0018. Title: Report of Customers' U.S. Dollar Liabilities to Foreign Residents. Form: TIC Form BL-2. Estimated Annual Burden Hours...

10 CFR 430.23 - Test procedures for the measurement of energy and water consumption.

Code of Federal Regulations, 2010 CFR

2010-01-01

... nearest dollar per year. (2) The energy efficiency ratio for room air conditioners, expressed in Btu's per... one-quarter of a dollar per year. (2) The cooking efficiency for conventional cooking tops... appendix I to this subpart. The final cooking efficiency values shall be rounded off to three significant...

For Athletics, a Billion-Dollar Goal Line

ERIC Educational Resources Information Center

Wolverton, Brad

2009-01-01

The nation's biggest athletics departments are quietly trying to raise hundreds of millions of dollars for separate sports endowments, heating up the competition for donors and raising questions about institutional priorities during the economic crunch. At least eight programs hope to bring in more than $100-million each to defray the rising costs…

26 CFR 1.7872-15 - Split-dollar loans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... or indirectly by the non-owner to the owner (including a premium payment made by the non-owner...-dollar life insurance arrangement, the employer makes premium payments on this policy, there is a... paragraph (a)(2)(i) of this section, each premium payment is a loan for Federal tax purposes. Example 2. (i...

Overview of the Starkey Project: mule deer and elk research for management benefits.

Treesearch

Michael J. Wisdom; Mary M. Rowland; Bruce K. Johnson; Brian L. Dick

2004-01-01

Managers have long been concerned about the welfare of mule deer (Odocoileus hemionus) and elk (Cervus elaphus) on public lands in the western United States. These two species generate millions of dollars annually to state wildlife agencies from sales of hunting licenses, and elk viewing generates millions of additional dollars...

Dollars Works 2: The Evolution of a Financial Literacy Program

ERIC Educational Resources Information Center

Petersen, Cindy M.; Heins, Rosemary K.; Katras, Mary Jo

2013-01-01

Dollar Works 2 is a comprehensive personal financial education program to help individuals and families strengthen their skills, better manage their personal finances, and make sound decisions about money. This article chronicles the evolution of a curriculum to enhance and modify materials to improve learning and meet the needs of multiple…

The Million Dollar Difference and 21st Century Teaching Skills Project

ERIC Educational Resources Information Center

Moon, Debi; Moolenaar-Wirsiy, Pamela

2008-01-01

With a limited budget, but a critical need to develop 21st century marketplace skills, Georgia Perimeter College (GPC) developed the Million Dollar Difference Campaign. Focusing on how quality instruction affects retention and student outcomes, GPC re-energized a 1000-faculty workforce in one year through a series of innovative teaching…

U.S. Currency. A Perspective of Its Role Today.

ERIC Educational Resources Information Center

Board of Governors of the Federal Reserve System, Washington, DC.

Designed for the general public and possibly suitable also for high school economics students, this pamphlet presents a brief overview of United States currency. Separate sections discuss the role of currency today, how the dollar has evolved, how the dollar got its name, laws concerning legal tender, types of currency in circulation, the meaning…

Bringing healthcare closer to home: one province's approach to home care.

PubMed

Witmer, E

2000-01-01

Ontario is implementing a number of steps to address the growing need for home care and continuing care. One of these steps is the establishment of Ontario's network of 43 Community Care Access Centres (CCACs). Responsible for aiding Ontario residents who seek community-based long-term healthcare, CCACs coordinate access to home services such as nursing and homemaking, manage placement to long-term care facilities and provide information and referral services. In 2000/01 the Ontario government announced 92.5 million Canadian dollars in new funding for long-term community services. This new funding includes 70.1 million Canadian dollars for CCACs. During this time, the provincial government will spend more than 1.6 billion Canadian dollars for long-term-care community-based services. Of this amount, 1.1 Canadian dollars billion will go to CCACs. Community Care Access Centres served more than 400,000 people in 1998/99 and are estimated to serve more than 420,000 in 2000/01. The administrative funds saved by this province-wide system are reinvested in front-line health services.

First-dollar cost-sharing for skilled nursing facility care in medicare advantage plans.

PubMed

Keohane, Laura M; Grebla, Regina C; Rahman, Momotazur; Mukamel, Dana B; Lee, Yoojin; Mor, Vincent; Trivedi, Amal

2017-08-29

The initial days of a Medicare-covered skilled nursing facility (SNF) stay may have no cost-sharing or daily copayments depending on beneficiaries' enrollment in traditional Medicare or Medicare Advantage. Some policymakers have advocated imposing first-dollar cost-sharing to reduce post-acute expenditures. We examined the relationship between first-dollar cost-sharing for a SNF stay and use of inpatient and SNF services. We identified seven Medicare Advantage plans that introduced daily SNF copayments of $25-$150 in 2009 or 2010. Copays began on the first day of a SNF admission. We matched these plans to seven matched control plans that did not introduce first-dollar cost-sharing. In a difference-in-differences analysis, we compared changes in SNF and inpatient utilization for the 172,958 members of intervention and control plans. In intervention plans the mean annual number of SNF days per 100 continuously enrolled inpatients decreased from 768.3 to 750.6 days when cost-sharing changes took effect. Control plans experienced a concurrent increase: 721.7 to 808.1 SNF days per 100 inpatients (adjusted difference-in-differences: -87.0 days [95% CI (-112.1,-61.9)]). In intervention plans, we observed no significant changes in the probability of any SNF service use or the number of inpatient days per hospitalized member relative to concurrent trends among control plans. Among several strategies Medicare Advantage plans can employ to moderate SNF use, first-dollar SNF cost-sharing may be one influential factor. Not applicable.

Health care administration in the United States and Canada: micromanagement, macro costs.

PubMed

Woolhandler, Steffie; Campbell, Terry; Himmelstein, David U

2004-01-01

A decade ago, U.S. health administration costs greatly exceeded Canada's. Have the computerization of billing and the adoption of a more business-like approach to care cut administrative costs? For the United States and Canada, the authors calculated the 1999 administrative costs of health insurers, employers' health benefit programs, hospitals, practitioners' offices, nursing homes, and home care agencies; they analyzed published data, surveys of physicians, employment data, and detailed cost reports filed by hospitals, nursing homes, and home care agencies; they used census surveys to explore time trends in administrative employment in health care settings. Health administration costs totaled at least dollar 294.3 billion, dollar 1,059 per capita, in the United States vs. dollar 9.4 billion, dollar 307 per capita, in Canada. After exclusions, health administration accounted for 31.0 percent of U.S. health expenditures vs. 16.7 percent of Canadian. Canada's national health insurance program had an overhead of 1.3 percent, but overhead among Canada's private insurers was higher than in the U.S.: 13.2 vs. 11.7 percent. Providers' administrative costs were far lower in Canada. Between 1969 and 1999 administrative workers' share of the U.S. health labor force grew from 18.2 to 27.3 percent; in Canada it grew from 16.0 percent in 1971 to 19.1 percent in 1996. Reducing U.S. administrative costs to Canadian levels would save at least dollar 209 billion annually, enough to fund universal coverage.

Cost of an informatics-based diabetes management program.

PubMed

Blanchfield, Bonnie B; Grant, Richard W; Estey, Greg A; Chueh, Henry C; Gazelle, G Scott; Meigs, James B

2006-01-01

The relatively high cost of information technology systems may be a barrier to hospitals thinking of adopting this technology. The experiences of early adopters may facilitate decision making for hospitals less able to risk their limited resources. This study identifies the costs to design, develop, implement, and operate an innovative informatics-based registry and disease management system (POPMAN) to manage type 2 diabetes in a primary care setting. The various cost components of POPMAN were systematically identified and collected. POPMAN cost 450,000 dollars to develop and operate over 3.5 years (1999-2003). Approximately 250,000 dollars of these costs are one-time expenditures or sunk costs. Annual operating costs are expected to range from 90,000 dollars to 110,000 dollars translating to approximately 90 dollars per patient for a 1,200 patient registry. The cost of POPMAN is comparable to the costs of other quality-improving interventions for patients with diabetes. Modifications to POPMAN for adaptation to other chronic diseases or to interface with new electronic medical record systems will require additional investment but should not be as high as initial development costs. POPMAN provides a means of tracking progress against negotiated quality targets, allowing hospitals to negotiate pay for performance incentives with insurers that may exceed the annual operating cost of POPMAN. As a result, the quality of care of patients with diabetes through use of POPMAN could be improved at a minimal net cost to hospitals.

Implementing Six Sigma in The Netherlands.

PubMed

van den Heuvel, Jaap; Does, Ronald J M M; Bogers, Ad J J C; Berg, Marc

2006-07-01

Six Sigma, a process-focused strategy and methodology for business improvement, can be used to improve care processes, eliminate waste, reduce costs, and enhance patient satisfaction. Six Sigma was introduced in 2001 at the 384-bed Red Cross Hospital (Beverwijk). During the Green Belt training, every participant was required to participate in at least one Six Sigma project. The hospital's total savings in 2004 amounted to 1.4 million dollars, for an average savings of 67,000 dollars for each of the completed 21 projects. In one project, the team designed a new admission process for the operating rooms, resulting in an average starting time nine minutes earlier. This relatively minor improvement made it possible to operate on an additional 400 patients a year and to achieve a net savings of >273,000 dollars. A second project reduced the number of patients receiving intravenous (IV) antibiotics by switching to oral administration, yielding annual savings, based on medication costs alone, of >75,000 dollars. A third project reduced the length of stay in the delivery room from 11.9 to 3.4 hours, yielding an annual savings of 68,000 dollars. The "Ultimate Cure?": Six Sigma, which entails involvement of health care workers; use of improvement tools (from industry); creation of trained project teams to tackle complex, often cross-departmental processes; data analyses; and investment in quality improvement may prove the "ultimate cure" to the current cost, quality, and safety issues that challenge health care.

A model of determining a fair market value for teaching residents: who profits?

PubMed

Cullen, Edward J; Lawless, Stephen T; Hertzog, James H; Penfil, Scott; Bradford, Kathleen K; Nadkarni, Vinay M; Corddry, David H; Costarino, Andrew T

2003-07-01

Centers for Medicare & Medicaid Services (CMS) Health Resources and Services Administration Children's Hospitals Graduate Medical Education (GME) Payment Program now supports freestanding children's teaching hospitals. To analyze the fair market value impact of GME payment on resident teaching efforts in our pediatric intensive care unit (PICU). Cost-accounting model, developed from a 1-year retrospective, descriptive, single-institution, longitudinal study, applied to physician teachers, residents, and CMS. Sixteen-bed PICU in a freestanding, university-affiliated children's teaching hospital. Pediatric critical care physicians, second-year residents. Cost of physician opportunity time; CMS investment return; the teaching physicians' investment return; residents' investment return; service balance between CMS and teaching service investment margins; economic balance points; fair market value. GME payments to our hospital increased 4.8-fold from 577 886 dollars to 2 772 606 dollars during a 1-year period. Critical care physicians' teaching opportunity cost rose from 250 097 dollars to 262 215 dollars to provide 1523 educational hours (6853 relative value units). Residents' net financial value for service provided to the PICU rose from 245 964 dollars to 317 299 dollars. There is an uneven return on investment in resident education for CMS, critical care physicians, and residents. Economic balance points are achievable for the present educational efforts of the CMS, critical care physicians, and residents if the present direct medical education payment increases from 29.38% to 36%. The current CMS Health Resources and Services Administration Children's Hospitals GME Payment Program produces uneven investment returns for CMS, critical care physicians, and residents. We propose a cost-accounting model, based on perceived production capability measured in relative value units and available GME funds, that would allow a clinical service to balance and obtain a fair market value for the resident education efforts of CMS, physician teachers, and residents.

Medicare intensive care unit use: analysis of incidence, cost, and payment.

PubMed

Cooper, Liesl M; Linde-Zwirble, Walter T

2004-11-01

To determine the incidence, cost, and payment for intensive care unit services among Medicare beneficiaries. Retrospective observational database cohort study. All nonfederal hospitals with intensive care unit beds (n = 5003) paid through the inpatient prospective payment system (IPPS). We used all fiscal year 2000 Medicare IPPS hospitalizations with consistent payment information (n = 10,657,587). None. We examined the distribution of cost and payments overall, by hospital type, and by diagnosis related group. Intensive care was used in 2,353,208 cases (21.1%). The overall incidence was 59.8 cases per thousand beneficiaries in the aged (65+) population, increasing with age from 36.2 (65-69) to 91.6 (85+). Intensive care unit patients cost nearly three times floor patients (4,135 dollars vs. 5,571 dollars), with two thirds of costs associated with the intensive care unit portion of the stay, 2,278 dollars per intensive care unit day. However, intensive care unit cases were paid at a rate only twice floor cases (11,704 dollars vs. 5,835 dollars). Only 83% of costs were paid for intensive care unit patients, compared with 105% for floor patients, generating a 5.8 billion dollars loss to hospitals when intensive care unit care is required. There was a linear association between the percent intensive care unit in a diagnosis related group and the percent paid, with payment >90% of cost only in diagnosis related groups with >/=60% intensive care unit cases. We found that teaching hospitals were better paid than nonteaching hospitals (87% vs. 78% of costs, respectively), but this was only due to indirect medical education payments. Intensive care is common, expensive, and poorly paid in the Medicare population. Few diagnosis related groups have a large enough intensive care unit population to ensure adequate payment. Additional diagnosis related groups for conditions common to the intensive care unit would improve payment and enable incentives for efficiency.

Hospital economics of the hospitalist.

PubMed

Gregory, Douglas; Baigelman, Walter; Wilson, Ira B

2003-06-01

To determine the economic impact on the hospital of a hospitalist program and to develop insights into the relative economic importance of variables such as reductions in mean length of stay and cost, improvements in throughput (patients discharged per unit time), payer methods of reimbursement, and the cost of the hospitalist program. The primary data source was Tufts-New England Medical Center in Boston. Patient demographics, utilization, cost, and revenue data were obtained from the hospital's cost accounting system and medical records. The hospitalist admitted and managed all patients during a six-week period on the general medical unit of Tufts-New England Medical Center. Reimbursement, cost, length of stay, and throughput outcomes during this period were contrasted with patients admitted to the unit in the same period in the prior year, in the preceding period, and in the following period. The hospitalist group compared with the control group demonstrated: length of stay reduced to 2.19 days from 3.45 days (p<.001); total hospital costs per admission reduced to 1,775 dollars from 2,332 dollars (p<.001); costs per day increased to 811 dollars from 679 dollars (p<.001); no differences for readmission within 30 days of discharge to extended care facilities. The hospital's expected incremental profitability with the hospitalist was -1.44 dollars per admission excluding incremental throughput effects, and it was most sensitive to changes in the ratio of per diem to case rate reimbursement. Incremental throughput with the hospitalist was estimated at 266 patients annually with an associated incremental profitability of 1.3 million dollars. Hospital interventions designed to reduce length of stay, such as the hospitalist, should be evaluated in terms of cost, throughput, and reimbursement effects. Excluding throughput effects, the hospitalist program was not economically viable due to the influence of per diem reimbursement. Throughput improvements occasioned by the hospitalist program with high baseline occupancy levels are substantial and tend to favor a hospitalist program.

Use of chromium picolinate and biotin in the management of type 2 diabetes: an economic analysis.

PubMed

Fuhr, Joseph P; He, Hope; Goldfarb, Neil; Nash, David B

2005-08-01

This paper addresses the potential economic benefits of chromium picolinate plus biotin (Diachrome) use in people with Type 2 diabetes (T2DM). The economic model was developed to estimate the impact on health care systems' costs by improved HbA1C levels with chromium picolinate plus biotin (Diachrome). Lifetimes cost savings were estimated by adjusting a benchmark from the literature, using a price index to adjust for inflation. The cost of diabetes is highly dependent on the HbA1C level with higher initial levels and higher annual increments increasing the cost. Improvement in glycemic control has proven to be cost-effective in delaying the onset and progression of T2DM, reducing the risk for diabetes-associated complications and lowering utilization and cost of care. Chromium picolinate plus biotin (Diachrome) showed greater improvement of glycemic control in poorly controlled T2DM patients (HbA(1C) > or = 10%) compared to their better controlled counterparts (HbA(1C) < 10%). This improvement was additive to that achieved by oral hypoglycemic medications and correlates to calculated levels of cost savings. Average 3-year cost savings for chromium picolinate plus biotin (Diachrome) use could range from 1,636 dollars for a poorly controlled patient with diabetes without heart diseases or hypertension, to 5,435 dollars for a poorly controlled patient with diabetes, heart disease, and hypertension. Average 3-year cost savings was estimated to be between 3.9 billion dollars and 52.9 billion dollars for the 16.3 million existing patients with diabetes. Chromium picolinate plus biotin (Diachrome) use among the 1.17 million newly diagnosed patients with T2DM each year could deliver lifetime cost savings of 42 billion dollars, or 36,000 dollars per T2DM patient. Affordable, safe, and convenient, chromium picolinate plus biotin (Diachrome) could prove to be a cost-effective complement to existing pharmacological therapies for controlling T2DM.

Construction of a business model to assure financial sustainability of biobanks.

PubMed

Warth, Rainer; Perren, Aurel

2014-12-01

Biobank-suisse (BBS) is a collaborative network of biobanks in Switzerland. Since 2005, the network has worked with biobank managers towards a Swiss biobanking platform that harmonizes structures and procedures. The work with biobank managers has shown that long-term, sustainable financing is difficult to obtain. In this report, three typical biobank business models are identified and their characteristics analyzed. Five forces analysis was used to understand the competitive environment of biobanks. Data provided by OECD was used for financial estimations. The model was constructed using the business model canvas tool. The business models identified feature financing influenced by the economic situation and the research budgets in a given country. Overall, the competitive environment for biobanks is positive. The bargaining power with the buyer is negative since price setting and demand prediction is difficult. In Switzerland, the healthcare industry collects approximately 5600 U.S. dollars per person and year. If each Swiss citizen paid 0.1% (or 5 U.S. dollars) of this amount to Swiss biobanks, 45 million U.S. dollars could be collected. This compares to the approximately 10 million U.S. dollars made available for cohort studies, longitudinal studies, and pathology biobanks through science funding. With the same approach, Germany, the United States, Canada, France, and the United Kingdom could collect 361, 2634, 154, 264, and 221 million U.S. dollars, respectively. In Switzerland and in other countries, an annual fee less than 5 U.S. dollars per person is sufficient to provide biobanks with sustainable financing. This inspired us to construct a business model that not only includes the academic and industrial research sectors as customer segment, but also includes the population. The revenues would be collected as fees by the healthcare system. In Italy and Germany, a small share of healthcare spending is already used to finance selected clinical trials. The legal frameworks could serve as templates for the business model proposed here.

The Canadian Urology Fair: a model for minimizing the financial and academic costs of the residency selection process.

PubMed

Grober, Ethan D; Matsumoto, Edward D; Jewett, Michael A S; Chin, Joseph L

2003-12-01

In 1994, the Canadian urology residency training programs designed the "Canadian Urology Fair"--a single-site (Toronto, Ont.), 1-day fair to conduct the personal interview portion of the residency selection process. The objective of the current study was to evaluate the success of the Urology Fair in achieving its original goals of decreasing the financial burden and minimizing time away from medical training for applicants and faculty. Both candidates and Canadian urology training programs were surveyed regarding the financial and academic costs (days absent) of attending the 2001 Urology Fair. Data from the 2001 Canadian Resident Matching Service (CaRMS) was used to compare the financial and academic costs of attending personal interviews incurred by candidates declaring urology as their first-choice discipline to candidates interviewing with other surgical specialties throughout Canada. Financial costs incurred by candidates to attend the Urology Fair (mean Can dollar 367) were significantly lower than candidates' estimated costs of attending on-site interviews at the individual programs (mean Can dollar 2065). The financial costs of attending personal interviews by CaRMS applicants declaring urology as their first-choice discipline (mean Can dollar 2002) were significantly lower than the costs incurred by applicants interviewing with other surgical disciplines (mean Can dollar 2744). Financial costs to urology programs attending the fair (mean Can dollar 1931) were not significantly greater than the programs' estimated costs of conducting on-site interviews at their respective program locations (mean Can dollar 1825). Days absent from medical school to attend interviews were significantly lower among CaRMS applicants declaring urology as their first-choice discipline (3 d) compared with applicants who interviewed with other surgical specialties (9.1 d). The Canadian Urology Fair represents an innovative and efficient method for residency programs to conduct the personal interview portion of the residency selection process and should serve as a model for making the interview process less expensive and time-consuming for both candidates and faculty.

Repeat urethrotomy and dilation for the treatment of urethral stricture are neither clinically effective nor cost-effective.

PubMed

Greenwell, T J; Castle, C; Andrich, D E; MacDonald, J T; Nicol, D L; Mundy, A R

2004-07-01

We developed an algorithm for the management of urethral stricture based on cost-effectiveness. United Kingdom medical and hospital costs associated with the current management of urethral stricture were calculated using private medical insurance schedules of reimbursement and clean intermittent self-catheterization supply costs. These costs were applied to 126 new patients treated endoscopically for urethral stricture in a general urological setting between January 1, 1991 and December 31, 1999. Treatment failure was defined as recurrent symptomatic stricture requiring further operative intervention following initial intervention. Mean followup available was 25 months (range 1 to 132). The costs were urethrotomy/urethral dilation 2,250.00 pounds sterling (3,375.00 dollars, ratio 1.00), simple 1-stage urethroplasty 5,015.00 pounds sterling (7,522.50 dollars, ratio 2.23), complex 1-stage urethroplasty 5,335.00 pounds sterling (8,002.50 dollars, ratio 2.37) and 2-stage urethroplasty 10,370 pounds sterling (15,555.00 dollars, ratio 4.61). Of the 126 patients assessed 60 (47.6%) required more than 1 endoscopic retreatments (mean 3.13 each), 50 performed biweekly clean intermittent self-catheterization and 7 underwent urethroplasty during followup. The total cost per patient for all 126 patients for stricture treatment during followup was 6,113 pounds sterling (9,170 dollars). This cost was calculated by multiplying procedure cost by the number of procedures performed. A strategy of urethrotomy or urethral dilation as first line treatment, followed by urethroplasty for recurrence yielded a total cost per patient of 5,866 pounds sterling (8,799 dollars). A strategy of initial urethrotomy or urethral dilation followed by urethroplasty in patients with recurrent stricture proves to be the most cost-effective strategy. This financially based strategy concurs with evidence based best practice for urethral stricture management.

Health plan budget impact analysis for pimecrolimus.

PubMed

Chang, Jane; Sung, Jennifer

2005-01-01

Budget impact models are useful tools for managed care organizations to make drug formulary decisions. The objective of this study was to estimate the incremental budgetary change in per-member-per-month (PMPM) medical and pharmacy costs for atopic dermatitis (AD) or eczema after the introduction of pimecrolimus cream 1%, a topical calcineurin inhibitor. Estimates of the percentage of patients seeking care, treatment patterns, and quantities of medications dispensed for AD were measured using 2001 and 2002 medical and pharmacy records in a proprietary database for health plans distributed throughout the United States. Approximately 2.5 million health plan members had continuous health insurance coverage during the study period. Costs for medications were assigned using the 2003 wholesale acquisition cost, and costs for physician visits were based on average 2003 Medicare reimbursement rates. Efficacy data from clinical trials were used to model the impact of pimecrolimus on subsequent physician visits. Sensitivity analyses were performed to evaluate the impact of varying the percentage of patients seeking care, practice patterns, medication quantities, percentage of pimecrolimus users, and levels of patient cost sharing. The estimated percentage of health plan members seeking care for AD in 2001 was 3.2%. The estimated total cost PMPM for AD treatment prior to introduction of pimecrolimus was 0.362 dollars for all covered lives, assuming no patient cost sharing. In the year after its introduction, 5.2% of the AD population filled a prescription for pimecrolimus. The incremental increase in pharmacy benefit cost was 0.008 dollars PMPM in 2003 dollars, but the total incremental medical and pharmacy cost was 0.002 dollars PMPM after accounting for the projected reduction in physician visit costs, representing a 0.7% increase in all AD-related costs. Based on sensitivity analyses, the incremental total cost PMPM after the introduction of pimecrolimus ranged from -0.004 dollars to 0.026 dollars. Using claims data for the medical treatment of AD in 2001-2002 and the utilization of pimecrolimus, the addition of pimecrolimus as a treatment option for AD had a minimal impact on PMPM costs for AD-related care in 2003 dollars. As with all pharmacoeconomic models, health plans should perform their own budget forecasting using assumptions derived from their own pharmacy and medical claims data.

The cost-effectiveness of two strategies for vaccinating US veterans with hepatitis C virus infection against hepatitis A and hepatitis B viruses.

PubMed

Jakiche, Rita; Borrego, Matthew E; Raisch, Dennis W; Gupchup, Gireesh V; Pai, Manjunath A; Jakiche, Antoine

2007-01-01

Although hepatitis A and B vaccinations are recommended for patients with chronic hepatitis C virus (HCV), the ideal vaccination strategy has not been determined. Our objective was to model the cost-effectiveness of two strategies for vaccinating patients with HCV infection against hepatitis A (HAV) and hepatitis B (HBV) viruses. The strategies evaluated were: universal vaccination with the combined HAV and HBV vaccine, and selective vaccination based on immunity determined by blood testing. A decision tree model was constructed to compare the cost-effectiveness of the two vaccination strategies from the New Mexico Veterans Affairs Health Care System (NMVAHCS) perspective. A retrospective review of all HCV patients (2517 subjects) at the NMVAHCS was performed to extract prevalence of immunity to HAV and HBV, and prevalence of decompensated liver disease. Literature review was performed to obtain other probabilities for the model. Only direct medical costs were considered; the effectiveness measure was the number of patients immune to both HAV and HBV. Sensitivity analyses were performed to test robustness of the results to changes in input variables. All costs were in 2004 US dollars. The selective strategy was less costly but less effective, with a cost-effectiveness ratio of 105 dollars per patient immune to HAV and HBV. The universal strategy was more effective but more expensive with a cost-effectiveness ratio of 112 dollars per patient immune to HAV and HBV. Compared with the selective strategy, universal strategy was associated with an incremental cost-effectiveness (ICE) ratio of 154 dollars per additional patient immune to HAV and HBV. The universal strategy would become more cost-effective if 1) the cost of combined vaccine was reduced to less than 30.75 dollars (9.7% reduction), 2) the cost of HBV vaccine increased to greater than 34.50 dollars (25% increase), 3) the cost of blood tests for immunity increased to more than 25.25 dollars (23% increase), or (4) the prevalence of anti-HBs decreased to less than 24%. The selective vaccination strategy for HAV and HBV in our sample of patients with HCV is more cost-effective. However, the universal strategy is more effective and its ICE is minimal, thus it may be worth the additional cost.

Effect of a therapeutic maximum allowable cost (MAC) program on the cost and utilization of proton pump inhibitors in an employer-sponsored drug plan in Canada.

PubMed

Mabasa, Vincent H; Ma, Johnny

2006-06-01

Therapeutic maximum allowable cost (MAC) is a managed care intervention that uses reference pricing in a therapeutic class or category of drugs or an indication (e.g., heartburn). Therapeutic MAC has not been studied in Canada or the United States. The proton pump inhibitor (PPI) rabeprazole was used as the reference drug in this therapeutic MAC program based on prices for PPIs in the province of Ontario. No PPI is available over the counter in Canada. To evaluate the utilization and anticipated drug cost savings for PPIs in an employer-sponsored drug plan in Canada that implemented a therapeutic MAC program for PPIs. An employer group with an average of 6,300 covered members, which adopted the MAC program for PPIs in June 2003, was compared with a comparison group comprising the book of business throughout Canada (approximately 5 million lives) without a PPI MAC program (non-MAC group). Pharmacy claims for PPIs were identified using the first 6 characters of the generic product identifier (GPI 492700) for a 36-month period from June 1, 2002, through May 31, 2005. The primary comparison was the year prior to the intervention (from June 1, 2002, through May 31, 2003) and the first full year following the intervention (June 1, 2004, through May 31, 2005). Drug utilization was evaluated by comparing the market share of each of the PPIs for the 2 time periods and by the days of PPI therapy per patient per year (PPPY) and days of therapy per prescription (Rx). Drug cost was defined as the cost of the drug (ingredient cost), including allowable provincial pharmacy markup but excluding pharmacy dispense fee. Cost savings were calculated from the allowed drug cost per claim, allowed cost per day, and allowed cost PPPY. (All amounts are in Canadian dollars.) The MAC intervention group experienced an 11.7% reduction in the average cost per day of PPI drug therapy, from 2.14 US dollars in the preperiod to 1.89 US dollars in the postperiod, compared with a 3.7% reduction in the comparison group (2.16 US dollars vs. 2.08 US dollars). Utilization dropped by 11.9% in the intervention group, from 166.7 days of PPI drug therapy PPPY to 146.9 days PPPY, compared with an increase of 7.9% in the comparison group, from 136.1 days to 146.8 days PPPY. The combined effect of the decrease in drug cost per day and utilization was a 22.1% reduction in allowed drug cost PPPY in the intervention (MAC) group (from 357 US dollars to 278 US dollars PPPY) versus a 4.1% increase in the comparison group (from 293 US dollars to 305 US dollars PPPY). A MAC program for PPIs for one employer in Canada was associated with savings for the drug plan sponsor of approximately 8% in actual drug cost per day of therapy compared with the comparison group. Total savings after consideration of utilization was approximately 26% for the intervention group versus the comparison group.

The Consumer and His Dollars: A Workbook and Study Guide.

ERIC Educational Resources Information Center

Finegan, Marcella E.

This workbook and study guide for a money management curriculum in consumer education was written to accompany the textbook "The Consumer and His Dollars" and a teacher's guide, both announced in this issue as VT 017 179 and VT 017 177. Included are 16 chapters, each containing worksheets perforated for easy removal. Chapter highlights,…

78 FR 67207 - Self-Regulatory Organizations; Chicago Mercantile Exchange Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... Change Related to the Reference Rate for Singapore Dollar Denominated Interest Rate Swaps November 4... reference rate for Singapore Dollar (``SGD'') denominated interest rate swaps (``IRS''). II. Self-Regulatory... this notice to solicit comments on the proposed rule change from interested persons. \\1\\ 15 U.S.C. 78s...

17 CFR 270.10b-1 - Definition of regular broker or dealer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of the ten brokers or dealers that received the greatest dollar amount of brokerage commissions by... most recent fiscal year; (b) One of the ten brokers or dealers that engaged as principal in the largest... year; or (c) One of the ten brokers or dealers that sold the largest dollar amount of securities of the...

Real Cost-Benefit Analysis Is Needed in American Public Education

ERIC Educational Resources Information Center

Stoneberg, Bert D.

2015-01-01

Public school critics often point to rising expenditures and relatively flat test scores to justify their school reform agendas. The claims are flawed because their analyses fail to account for the difference in data types between dollars (ratio) and test scores (interval). A cost-benefit analysis using dollars as a common metric for both costs…

Restructuring Resources for High-Performing Schools: A Primer for State Policymakers. Summary

ERIC Educational Resources Information Center

Miles, Karen Hawley; Baroody, Karen

2011-01-01

Billions of education dollars are trapped each year. At this time of continued budget shortfalls when every dollar spent on education must yield maximum returns in student outcomes--states are frequently tying the hands of districts. While funding adequacy and equity must remain a priority for states, ensuring that limited resources are used as…

How Is Minnesota Spending Its Tax Dollars? Elementary and Secondary Education.

ERIC Educational Resources Information Center

Minnesota State Auditor, St. Paul. Research and Information Div.

This two-part report presents findings of a study that examined how Minnesota's tax dollars are being spent, with a focus on elementary-secondary education. Part 1 uses national indicators to compare Minnesota with other states. The second part examines actual education expenditures in Minnesota for the period betweeen 1985 and 1991. Findings show…

Sales force can lead to dollars for OH (occupational health) services.

PubMed

Snow, J L

1991-02-01

As hospitals enter the 1990s, one of the challenges they will face is finding additional sources of revenue. Occupational Health (OH) programs offer an opportunity for increased dollars--but only for hospitals willing to use sales tactics common to corporate America. In the following article, the author tells how an institution can sell OH services.

76 FR 20412 - Self-Regulatory Organizations; National Stock Exchange, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-12

... least one dollar. With respect to the rebate for Zero Display Orders that add liquidity in AutoEx that... in the Automatic Execution Mode of order interaction (``AutoEx'') \\3\\ priced at least one dollar. Certain conforming changes are also proposed for rebates for liquidity adding Zero Display Orders \\4\\ in...

The effect of exchange rates on southern pine exports

Treesearch

H.W. Wisdom; James E. Granskog

2003-01-01

Changes in exchange rates affect southern pine exports by changing the cost of southern wood in foreign markets. A strong dollar discourages exports; a weak dollar encourages exports. A simple economic export market model is developed to determine whether changes in the exchange rates in foreign markets of southern pine products have, in fact, let to significant...

75 FR 15757 - Self-Regulatory Organizations; NASDAQ OMX PHLX, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-30

... Rule Change Relating to U.S. Dollar-Settled Foreign Currency Options March 23, 2010. Pursuant to... Krone (``XDV'') to the U.S. Dollar-Settled Foreign Currency Options fees.\\3\\ While changes to the Fee... World Currency Options[supreg] (``WCOs''). The text of the proposed rule change is available on the...

76 FR 16646 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-24

...-Settled Foreign Currency Option Fees, in Section III of the Fee Schedule, with Singly Listed Options \\3...\\. The Exchange currently assesses fees for sector index options and U.S. Dollar-Settled foreign currency... U.S. Dollar-Settled Foreign Currency Option Fees.'' \\4\\ BKX represents the KBW Bank Index. \\5\\ RUT...

75 FR 56150 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

...-settled foreign currency options \\5\\ orders represented by Floor Brokers \\6\\ on the Exchange.\\7\\ The.... dollar-settled foreign currency options orders to the Exchange trading floor. \\5\\ U.S. dollar-settled foreign currency options traded on the Exchange are also known as World Currency Options (``WCO'') or...

77 FR 14600 - Pricing for 2012 Kennedy Half-Dollar Bags and Rolls, Bronze Medals, the First Spouse Bronze Medal...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-12

... DEPARTMENT OF THE TREASURY United States Mint Pricing for 2012 Kennedy Half-Dollar Bags and Rolls, Bronze Medals, the First Spouse Bronze Medal Set and the Birth Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing 2012 pricing for...

Data from: Clarireedia: A new fungal genus comprising four pathogenic species responsible for dollar spot disease of turfgrass

USDA-ARS?s Scientific Manuscript database

Dollar spot is one of the most destructive globally distributed diseases of turfgrass. The identity of the fungus responsible for the disease has been the subject of debate for more than 75 years. These datasets provide the phylogenetic evidence from three nucleotide sequence markers (CaM, ITS and M...

Successful K-12 Technology Planning: Ten Essential Elements. ERIC Digest.

ERIC Educational Resources Information Center

Barnett, Harvey

Over the last 20 years, K-12 schools have spent millions of dollars equipping their schools with the latest technologies, but often without a thoughtful plan of how their use would impact learning and teaching. What is important is how the technology is integrated with the instructional program. To ensure that technology dollars have an impact on…

We Want Our 27 Million Dollars back: Retention as a Revenue Resource

ERIC Educational Resources Information Center

Smith, Raymond T.; Liguori, Denise; O'Connor, Dianna; Postle, Monica

2009-01-01

Community colleges lose millions of dollars in potential revenue due to lackluster retention and graduation rates. It is time for change! Bergen Community College (BCC) has made a unique commitment to concentrate solely on this issue. Learn how the establishment of the Department of Retention Services, with its cutting edge initiatives, is…

77 FR 17530 - Order Granting an Application of Edward Jones & Co. LLP Exemption From Exchange Act Section 11(d...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-26

... margin on newly-purchased shares of mutual funds not managed or sponsored by Edward Jones or any affiliate of Edward Jones (``non-proprietary mutual funds'') in instances in which the customer makes a dollar-for-dollar substitution by selling an already- margined non-proprietary mutual fund and buying...

Colleges' Billion-Dollar Campaigns Feel the Economy's Sting

ERIC Educational Resources Information Center

Masterson, Kathryn

2009-01-01

The economy's collapse has caught up with the billion-dollar campaign. In the past 12 months, the amount of money raised by a dozen of the colleges engaged in higher education's biggest fund-raising campaigns fell 32 percent from the year before. The decline, which started before the worst of the recession, has forced colleges to postpone…

29 CFR 779.322 - Second requirement for qualifying as a “retail or service establishment.”

Code of Federal Regulations, 2010 CFR

2010-07-01

... concept is applicable then the second requirement for qualifying as a “retail or service establishment” within that term's statutory definition is that 75 percent of the establishment's annual dollar volume... 75 percent of annual dollar volume be from sales of goods or services “not for resale” (§ 779.329...

Knowledge Translation versus Knowledge Integration: A "Funder's" Perspective

ERIC Educational Resources Information Center

Kerner, Jon F.

2006-01-01

Each year, billions of US tax dollars are spent on basic discovery, intervention development, and efficacy research, while hundreds of billions of US tax dollars are also spent on health service delivery programs. However, little is spent on or known about how best to ensure that the lessons learned from science inform and improve the quality of…

From Petrodollars to Petroeuros: Are the Dollar’s Days as an International Reserve Currency Drawing to an End?

DTIC Science & Technology

2003-11-03

price of oil less transparent, require continuous updating to minimize currency arbitrage , and could make the market less liquid as available capital...there are plenty of cheap ways for traders to hedge against currency risk if they are concerned about movements in the dollar. Conclusions

St. Cloud State University's Impact on the Local Economy.

ERIC Educational Resources Information Center

Lange, Mark D.

The economic impact of St. Cloud State University, Minnesota, on the local economy was studied. Using models developed by the American Council on Education, estimates were made of the dollar outlays by the local economic sectors that are associated with or influenced by the university. The focus is the measurable impacts, in dollar terms, of the…

Sliding U.S. Dollar Packs a Wallop to Wallets Worldwide

ERIC Educational Resources Information Center

Bowman, Quinn

2008-01-01

The dollar, once one of the world's strongest currencies, has fallen dramatically in recent years--a development impacting attitudes from corporate boardrooms to the sets of music videos where artists are choosing to flash the euro over American cash. When measured against a collection of other leading worldwide currencies--like the European euro,…

The Economic Impact of Eight Research Universities on the Boston Region

ERIC Educational Resources Information Center

Simha, O. Robert

2005-01-01

The greater Boston region's eight research universities play a key role in the region's economic health and welfare. They are magnets for research and development talent and for billions of dollars in investment. These institutions contribute $7.4 billion dollars to the regional economy, jobs for about 50,000 university employees and 37,000…

Pennies on the Dollar: How Illinois Shortchanges Its Teachers' Retirement

ERIC Educational Resources Information Center

Kan, Leslie; Fuchs, Daniel; Aldeman, Chad

2016-01-01

Illinois' pension plans have sent the state on a downward spiral. One out of every four dollars that state taxpayers send to Springfield goes toward pensions, and the vast majority of these contributions go toward paying down large pension debt, not the actual retirement benefits given to state and local workers like teachers. The teacher pension…

The Mayors' Charter Schools

ERIC Educational Resources Information Center

Magee, Michael

2014-01-01

In 2007, the case could be made that Rhode Island had, dollar for dollar, the worst-performing public education system in the United States. Despite per-pupil expenditures ranking in the top 10 nationally, the state's 8th graders fared no better than 40th in reading and 33rd in math on the National Assessment of Educational Progress (NAEP). Only…

The cost-effectiveness of health education in improving knowledge and awareness about intestinal parasites in rural Bangladesh.

PubMed

Mascie-Taylor, C G N; Karim, R; Karim, E; Akhtar, S; Ahmed, T; Montanari, R M

2003-12-01

The impact of regular health education in improving knowledge, attitude and practices in the control of intestinal parasites was examined in four rural areas of Bangladesh; two areas received health education and the other two areas were controls. By the end of the 18-month study households receiving health education showed highly significant improvements in knowledge, water and sanitation facilities and personal hygiene compared with households in the control areas. Improving knowledge by 1% cost between US dollars 0.75 and 0.82 per household, while a 1% improvement in personal hygiene cost between US dollars 1.10 and 1.32 per household and water and sanitation between US dollars 1.39 and 1.52 per household.

Value-Based Medicine: Dollars and Sense.

PubMed

Erstad, Brian L

2016-02-01

With ever-increasing total healthcare expenditures and expenditures on new pharmaceuticals, there is a temptation to enact relatively simple silo-based, cost-control measures such as attempts to control a burgeoning health-system medication budget by limiting physician and ultimately patient access to medications without considering cost-effectiveness or overall value. Such an approach with a singular focus on dollars does not make sense. The challenge is to think beyond a pure dollars approach in a specialty of health care where the high cost of care is acknowledged but the dynamics are not always understood. This will take a thoughtful, coordinated effort by a team of dedicated health professionals that includes a clinical pharmacist with expertise in optimal and comprehensive medication management.

DRA 2005: The brave new world.

PubMed

Lewis, Richard

2006-01-01

The Deficit Reduction Act (DRA) of 2005 was signed into law to achieve 39 billion dollars in reductions from federal spending programs, 11 billion dollars from Medicare and Medicaid alone. Conservative estimates indicate that imaging alone accounts for 2.8 billion dollars of that amount. As of the writing of this article, both houses of Congress were reviewing bills with bipartisan support aimed at defusing, at least temporarily, the negative impact of the DRA; however, these bills do not affect the law in totality. Dealing with the changes that the DRA will force upon outpatient imaging practices will require all parties involved in outpatient imaging--physicians, administrators, and staff alike--to make smart, efficient, but practical changes in operational models to effectively survive in this new legislatively mandated environment.

AN INDIRECT METHOD TO ASSAY FOR MITOTIC CENTERS IN SAND DOLLAR (DENDRASTER EXCENTRICUS) EGGS

PubMed Central

Went, Hans A.

1966-01-01

It is possible consistently to induce sea urchin and sand dollar eggs to cleave directly from one cell into four cells. This is done by exposing the fertilized eggs to benzimidazole for 20 to 30 min beginning about early metaphase. The mitotic apparatus regresses, the cells do not cleave, and shortly after they are returned to normal sea water an early-prophase-appearing nucleus is present in each cell. Each cell then organizes a tetrapolar tetrahedral mitotic apparatus de novo, instead of transforming a bipolar mitotic apparatus into a tetrapolar figure, and cleaves one-to-four. In another type of experiment, it appears that sand dollar eggs exposed to mercaptoethanol during the first period of mitotic center duplication have only half as many centers by first cleavage metaphase as the normal controls. This is consistent with an earlier report by Mazia et al (1960). Using this same experimental technique, it was demonstrated that benzimidazole, on the contrary, does not interfere with mitotic center duplication in sand dollar eggs. A labeling experiment demonstrated that benzimidazole does not interfere markedly with the normal pattern of incorporation of C14-thymidine into the DNA of sea urchin eggs. The data reported here suggest that judicious treatment of sand dollar eggs (and probably sea urchin eggs, too) with benzimidazole can induce the eggs to cleave into as many cells as there were mitotic centers sometime earlier, for example at early metaphase of the first cleavage division. This provides a very useful tool for studies on the process of mitotic center duplication. PMID:6008198

An indirect method to assay for mitotic centers in sand dollar (Dendraster excentricus) eggs.

PubMed

Went, H A

1966-09-01

It is possible consistently to induce sea urchin and sand dollar eggs to cleave directly from one cell into four cells. This is done by exposing the fertilized eggs to benzimidazole for 20 to 30 min beginning about early metaphase. The mitotic apparatus regresses, the cells do not cleave, and shortly after they are returned to normal sea water an early-prophase-appearing nucleus is present in each cell. Each cell then organizes a tetrapolar tetrahedral mitotic apparatus de novo, instead of transforming a bipolar mitotic apparatus into a tetrapolar figure, and cleaves one-to-four. In another type of experiment, it appears that sand dollar eggs exposed to mercaptoethanol during the first period of mitotic center duplication have only half as many centers by first cleavage metaphase as the normal controls. This is consistent with an earlier report by Mazia et al (1960). Using this same experimental technique, it was demonstrated that benzimidazole, on the contrary, does not interfere with mitotic center duplication in sand dollar eggs. A labeling experiment demonstrated that benzimidazole does not interfere markedly with the normal pattern of incorporation of C(14)-thymidine into the DNA of sea urchin eggs. The data reported here suggest that judicious treatment of sand dollar eggs (and probably sea urchin eggs, too) with benzimidazole can induce the eggs to cleave into as many cells as there were mitotic centers sometime earlier, for example at early metaphase of the first cleavage division. This provides a very useful tool for studies on the process of mitotic center duplication.

A comparative cost analysis of insecticide-treated nets and indoor residual spraying in highland Kenya.

PubMed

Guyatt, H L; Kinnear, J; Burini, M; Snow, R W

2002-06-01

The relative cost of indoor residual house-spraying (IRS) versus insecticide-treated bednets (ITNs) forms part of decisions regarding selective malaria prevention. This paper presents a cost comparison of these two approaches as recently implemented by Merlin, a UK emergency relief organization funded through international donor support and working in the highland districts of Gucha and Kisii in Kenya. The financial costs (cash expenditures) and the economic costs (including the opportunity costs of using existing staff and volunteers, and an annualized cost for capital items) were assessed. The financial cost for IRS was US dollars 0.86 per person protected, compared with 4.21 dollars for ITNs (reducing to 3.42 dollars to the provider assuming cost recovery). The economic cost per person protected for IRS was 0.88 dollars, compared with 2.34 dollars for ITNs. The costs for ITNs were sensitive to the number of nets sold per community group ('efficiency'), as the delivery costs constituted upwards of 40% of the total cost. However, even marked increases in efficiency of these groups could not reduce the costs of ITNs to that comparable with IRS, except if more than one cycle of IRS was needed. The implications of predicted reductions in the cost of insecticide for both IRS and ITNs are also explored. The provision of itemized cost data allows predictions to be made on changes in the design of these programmes. Under almost all design scenarios, IRS would appear to be a more cost-efficient means of vector control in the Kenyan highlands.

78 FR 62751 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change To List...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... of the WisdomTree Bloomberg U.S. Dollar Bullish Fund, WisdomTree Bloomberg U.S. Dollar Bearish Fund, and the WisdomTree Commodity Currency Bearish Fund Under NYSE Arca Equities Rule 8.600 October 8, 2013... of the WisdomTree Trust (``Trust'') under NYSE Arca Equities Rule 8.600 (``Managed Fund Shares...

78 FR 35327 - Division of Coal Mine Workers' Compensation; Proposed Collection of Existing Collection; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-12

... Safety and Health Act of 1977, as amended (30 U.S.C. 901) and 20 CFR 725.535, require that DOL Black Lung... gather information to determine the amounts of Black Lung benefits paid to beneficiaries. Black Lung amounts are reduced dollar for dollar, for other Black Lung related workers' compensation awards the...

Your Automobile Dollar. Money Management.

ERIC Educational Resources Information Center

Baran, Nancy H., Ed.

This booklet is designed to help first-time car buyers determine if they can or should buy a car and how to get the most from their car-buying dollar. Leasing and renting options also are discussed. The booklet outlines the process of buying a new car, starting with a review of sizes, types, and features. This is followed by a rundown on showroom…

27 CFR 53.96 - Constructive sale price; special rule for arm's-length sales.

Code of Federal Regulations, 2010 CFR

2010-04-01

... as not being at retail or to retailers, or both, if the industry dollar volume of sales which are at retail or to retailers, or both, is less than half the total industry dollar volume of sales at all... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Constructive sale price...

Stretching the School Dollar: A Brief for State Policymakers. Policy Brief

ERIC Educational Resources Information Center

Petrilli, Michael J.; Roza, Marguerite

2011-01-01

After years of non-stop increases--national k-12 per-pupil spending is up by "one-third" in inflation-adjusted dollars since 1995--schools now face the near-certainty of repeated annual budget cuts for the first time since the Great Depression. In some states and districts, reductions will be dramatic--well into the double digits. And…

31 CFR 535.576 - Payment of non-dollar letters of credit to Iran.

Code of Federal Regulations, 2012 CFR

2012-07-01

... credit to Iran. 535.576 Section 535.576 Money and Finance: Treasury Regulations Relating to Money and... letters of credit to Iran. Notwithstanding the prohibitions of §§ 535.201 and 535.206(a)(4), payment of existing non-dollar letters of credit in favor of Iranian entities or any person in Iran by any foreign...

31 CFR 535.576 - Payment of non-dollar letters of credit to Iran.

Code of Federal Regulations, 2014 CFR

2014-07-01

... credit to Iran. 535.576 Section 535.576 Money and Finance: Treasury Regulations Relating to Money and... letters of credit to Iran. Notwithstanding the prohibitions of §§ 535.201 and 535.206(a)(4), payment of existing non-dollar letters of credit in favor of Iranian entities or any person in Iran by any foreign...

31 CFR 535.576 - Payment of non-dollar letters of credit to Iran.

Code of Federal Regulations, 2013 CFR

2013-07-01

... credit to Iran. 535.576 Section 535.576 Money and Finance: Treasury Regulations Relating to Money and... letters of credit to Iran. Notwithstanding the prohibitions of §§ 535.201 and 535.206(a)(4), payment of existing non-dollar letters of credit in favor of Iranian entities or any person in Iran by any foreign...

When Private Schools Take Public Dollars: What's the Place of Accountability in School Voucher Programs?

ERIC Educational Resources Information Center

Finn, Chester E., Jr.; Hentges, Christina M.; Petrilli, Michael J.; Winkler, Amber M.

2009-01-01

Of all the arguments that critics of school voucher programs advance, the one that may resonate loudest with the public concerns school accountability. Opponents say it's not fair to hold public schools accountable for their results (under No Child Left Behind and similar systems) and then let private schools receive taxpayer dollars--however…

78 FR 28717 - Advancing Pay Equality in the Federal Government and Learning From Successful Practices

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-15

... Act of 1963, women were paid 59 cents for every dollar paid to men. Today, women are paid 77 cents for every dollar paid to men. At the same time, nearly two-thirds of women are breadwinners or co-breadwinners for their families. Unjust pay disparities are a detriment to women, families, and our economy...

26 CFR 1.987-5 - Transition rules for certain qualified business units using a profit and loss method of...

Code of Federal Regulations, 2011 CFR

2011-04-01

... currency, this amount is translated into the QBU branch's functional currency at the spot rate (determined... into dollars at the spot rate (determined under the principles of section 988 and the regulations... transfer (other than a remittance) from the QBU branch translated into dollars at the spot rate (determined...

31 CFR 535.576 - Payment of non-dollar letters of credit to Iran.

Code of Federal Regulations, 2011 CFR

2011-07-01

... credit to Iran. 535.576 Section 535.576 Money and Finance: Treasury Regulations Relating to Money and... letters of credit to Iran. Notwithstanding the prohibitions of §§ 535.201 and 535.206(a)(4), payment of existing non-dollar letters of credit in favor of Iranian entities or any person in Iran by any foreign...

31 CFR 535.576 - Payment of non-dollar letters of credit to Iran.

Code of Federal Regulations, 2010 CFR

2010-07-01

... credit to Iran. 535.576 Section 535.576 Money and Finance: Treasury Regulations Relating to Money and... letters of credit to Iran. Notwithstanding the prohibitions of §§ 535.201 and 535.206(a)(4), payment of existing non-dollar letters of credit in favor of Iranian entities or any person in Iran by any foreign...

Food Costs...From Farm to Retail.

ERIC Educational Resources Information Center

Dunham, Denis

This report focuses on food costs for 1985. Some of the information included in the report includes an analysis of food cost trends, percentages of the food dollar that goes to the farmer, and how much of the food dollar goes to food processors and marketers. Some of the highlights of the study are the following: (1) food prices rose slowly in…

Suburb-to-suburb intercity travel: Energy, time and dollar expenditures

NASA Technical Reports Server (NTRS)

Fels, M. F.

1976-01-01

The effect of adding suburb to terminal and terminal to suburb travel is examined. The energy consumed in entire trips was estimated. The total energy costs are compared with total travel times, and dollar costs to the traveler. Trips between origins in seven suburbs of Newark, New Jersey and destinations in two Washington, D. C. suburbs are analyzed.

26 CFR 1.472-2 - Requirements incident to adoption and use of LIFO inventory method.

Code of Federal Regulations, 2012 CFR

2012-04-01

... inventory method. (ii) Any method of establishing pools for inventory under the dollar-value LIFO inventory method. (iii) Any method of determining the LIFO value of a dollar-value inventory pool, such as the... selecting a price index to be used with the index or link chain method of valuing inventory pools under the...

78 FR 10265 - Pricing for the 2013 Commemorative Coin Programs-Silver and Clad Coin Options

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

.... SUMMARY: The United States Mint is announcing prices for the 2013 Girl Scouts of the USA Centennial Silver.... Introductory Product price Regular price 2013 Girl Scouts of the USA Centennial $54.95 $59.95 Proof Silver Dollar 2013 Girl Scouts of the USA Centennial 50.95 55.95 Uncirculated Silver Dollar 2013 5-Star Generals...

Laser System Reliability

DTIC Science & Technology

1977-03-01

system acquisition cycle since they provide necessary inputs to comparative analyses, cost/benefit trade -offs, and system simulations. In addition, the...Management Program from above performs the function of analyzing the system trade -offs with respect to reliability to determine a reliability goal...one encounters the problem of comparing present dollars with future dollars. In this analysis, we are trading off costs expended initially (or at

78 FR 20947 - Notice of Lodging of Proposed Consent Decree Under the Clean Air Act (“CAA”)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-08

... pay the sum of $1.5 million dollars cash, including interest, to the United States as a civil penalty and $1.5 million dollars cash, including interest, to the Commonwealth as a civil penalty. The... Decree upon written request and payment of reproduction costs. Please mail your request and payment to...

75 FR 6423 - Self-Regulatory Organizations; National Stock Exchange, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-09

... Orders of Securities Priced Under One Dollar in the Auto Execution Mode of Order Interaction to 0.25% of... for liquidity adding displayed orders of securities priced under one dollar in the Auto Execution mode of order interaction (``AutoEx'') \\3\\ to 0.25% of trade value. \\3\\ The Exchange's two modes of order...

75 FR 18562 - Self-Regulatory Organizations; National Stock Exchange, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-12

... and higher in the Automatic Execution mode of order interaction (``AutoEx'') \\3\\. In addition, the... Rule 11.13(b). \\4\\ Id. AutoEx Take Fee for Securities Priced One Dollar and Higher For orders in securities priced one dollar and above that take liquidity in AutoEx, the proposed rule change lowers the...

Long-Term Implications of the 2013 Future Years Defense Program

DTIC Science & Technology

2012-07-01

difficult for the department to manage because it would need to be achieved in only nine months (between the cut’s tak - ing effect in January 2013 and the...Estimate of DoD’s Funding Under the BCA Caps After Automatic Reductionse 469 472 475 477 480 483 485 487 489 493 d Nominal Dollars 2013 Dollars 2022

77 FR 15440 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-15

... currencies are the euro, Japanese yen, British pound, Canadian dollar, Swedish krona, and Swiss franc. The component currencies do not have the same weight. The euro has a weighting of 57.6%, the Japanese yen a... inverse multiple of the daily performance of the Japanese yen spot price versus the U.S. dollar (``JPY/USD...

Perceptions of and preferences for fee program dollar utilization among wilderness visitors

Treesearch

Ingrid Schneider; Christopher LaPointe; Sharon Stievater

2000-01-01

The purpose of this study was to ascertain visitor perceptions of a fee program and preferences for management utilization of the fee dollars. Differences in program perceptions were examined both by activity and activity style. Wilderness visitors in the American Southwest were surveyed on-site during the 1997–1998 season. Overall, respondents moderately agreed that...

40 CFR 1515.15 - What fees may be charged, and how should they be paid?

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Five dollars per hour when the search is conducted by a clerical employee. Eight dollars per hour when... one hour. (2) Duplication of records. Records will be duplicated at a rate of $0.10 per page for... will reduce the fees, yet still meet your needs. A reformulated request shall be considered a new...

78 FR 48214 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-07

... and Rules to Certain U.S. Dollar-Settled Gold Futures Designed to Replicate Positions in the Spot... Futures That Were Based on the Value of Gold in the Spot Market With an Additional Daily Cost of Carry... Rules to certain U.S. dollar-settled gold futures designed to replicate positions in the spot market...

13 CFR 124.506 - At what dollar threshold must an 8(a) procurement be competed among eligible Participants?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false At what dollar threshold must an 8(a) procurement be competed among eligible Participants? 124.506 Section 124.506 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION 8(a) BUSINESS DEVELOPMENT/SMALL DISADVANTAGED BUSINESS STATUS DETERMINATIONS 8(a) Business Development...

13 CFR 124.506 - At what dollar threshold must an 8(a) procurement be competed among eligible Participants?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false At what dollar threshold must an 8(a) procurement be competed among eligible Participants? 124.506 Section 124.506 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION 8(a) BUSINESS DEVELOPMENT/SMALL DISADVANTAGED BUSINESS STATUS DETERMINATIONS 8(a) Business Development...

13 CFR 124.506 - At what dollar threshold must an 8(a) procurement be competed among eligible Participants?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false At what dollar threshold must an 8(a) procurement be competed among eligible Participants? 124.506 Section 124.506 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION 8(a) BUSINESS DEVELOPMENT/SMALL DISADVANTAGED BUSINESS STATUS DETERMINATIONS 8(a) Business Development...

41 CFR 102-73.40 - What happens if the dollar value of the project exceeds the prospectus threshold?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What happens if the dollar value of the project exceeds the prospectus threshold? 102-73.40 Section 102-73.40 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 73-REAL ESTATE...

13 CFR 124.506 - At what dollar threshold must an 8(a) procurement be competed among eligible Participants?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false At what dollar threshold must an 8(a) procurement be competed among eligible Participants? 124.506 Section 124.506 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION 8(a) BUSINESS DEVELOPMENT/SMALL DISADVANTAGED BUSINESS STATUS DETERMINATIONS 8(a) Business Development...

41 CFR 102-73.40 - What happens if the dollar value of the project exceeds the prospectus threshold?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What happens if the dollar value of the project exceeds the prospectus threshold? 102-73.40 Section 102-73.40 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 73-REAL ESTATE...

Cost-offsets of prescription drug expenditures: data analysis via a copula-based bivariate dynamic hurdle model.

PubMed

Deb, Partha; Trivedi, Pravin K; Zimmer, David M

2014-10-01

In this paper, we estimate a copula-based bivariate dynamic hurdle model of prescription drug and nondrug expenditures to test the cost-offset hypothesis, which posits that increased expenditures on prescription drugs are offset by reductions in other nondrug expenditures. We apply the proposed methodology to data from the Medical Expenditure Panel Survey, which have the following features: (i) the observed bivariate outcomes are a mixture of zeros and continuously measured positives; (ii) both the zero and positive outcomes show state dependence and inter-temporal interdependence; and (iii) the zeros and the positives display contemporaneous association. The point mass at zero is accommodated using a hurdle or a two-part approach. The copula-based approach to generating joint distributions is appealing because the contemporaneous association involves asymmetric dependence. The paper studies samples categorized by four health conditions: arthritis, diabetes, heart disease, and mental illness. There is evidence of greater than dollar-for-dollar cost-offsets of expenditures on prescribed drugs for relatively low levels of spending on drugs and less than dollar-for-dollar cost-offsets at higher levels of drug expenditures. Copyright © 2013 John Wiley & Sons, Ltd.

Security systems engineering overview

NASA Astrophysics Data System (ADS)

Steele, Basil J.

1997-01-01

Crime prevention is on the minds of most people today. The concern for public safety and the theft of valuable assets are being discussed at all levels of government and throughout the public sector. There is a growing demand for security systems that can adequately safeguard people and valuable assets against the sophistication of those criminals or adversaries who pose a threat. The crime in this country has been estimated at 70 billion dollars in direct costs and up to 300 billion dollars in indirect costs. Health insurance fraud alone is estimated to cost American businesses 100 billion dollars. Theft, warranty fraud, and counterfeiting of computer hardware totaled 3 billion dollars in 1994. A threat analysis is a prerequisite to any security system design to assess the vulnerabilities with respect to the anticipated threat. Having established a comprehensive definition of the threat, crime prevention, detection, and threat assessment technologies can be used to address these criminal activities. This talk will outline the process used to design a security system regardless of the level of security. This methodology has been applied to many applications including: government high security facilities; residential and commercial intrusion detection and assessment; anti-counterfeiting/fraud detection technologies; industrial espionage detection and prevention; security barrier technology.

Cross-correlations between the US monetary policy, US dollar index and crude oil market

NASA Astrophysics Data System (ADS)

Sun, Xinxin; Lu, Xinsheng; Yue, Gongzheng; Li, Jianfeng

2017-02-01

This paper investigates the cross-correlations between the US monetary policy, US dollar index and WTI crude oil market, using a dataset covering a period from February 4, 1994 to February 29, 2016. Our study contributes to the literature by examining the effect of the US monetary policy on US dollar index and WTI crude oil through the MF-DCCA approach. The empirical results show that the cross-correlations between the three sets of time series exhibit strong multifractal features with the strength of multifractality increasing over the sample period. Employing a rolling window analysis, our empirical results show that the US monetary policy operations have clear influences on the cross-correlated behavior of the three time series covered by this study.

Performance and Cost-Effectiveness of Computed Tomography Lung Cancer Screening Scenarios in a Population-Based Setting: A Microsimulation Modeling Analysis in Ontario, Canada.

PubMed

Ten Haaf, Kevin; Tammemägi, Martin C; Bondy, Susan J; van der Aalst, Carlijn M; Gu, Sumei; McGregor, S Elizabeth; Nicholas, Garth; de Koning, Harry J; Paszat, Lawrence F

2017-02-01

The National Lung Screening Trial (NLST) results indicate that computed tomography (CT) lung cancer screening for current and former smokers with three annual screens can be cost-effective in a trial setting. However, the cost-effectiveness in a population-based setting with >3 screening rounds is uncertain. Therefore, the objective of this study was to estimate the cost-effectiveness of lung cancer screening in a population-based setting in Ontario, Canada, and evaluate the effects of screening eligibility criteria. This study used microsimulation modeling informed by various data sources, including the Ontario Health Insurance Plan (OHIP), Ontario Cancer Registry, smoking behavior surveys, and the NLST. Persons, born between 1940 and 1969, were examined from a third-party health care payer perspective across a lifetime horizon. Starting in 2015, 576 CT screening scenarios were examined, varying by age to start and end screening, smoking eligibility criteria, and screening interval. Among the examined outcome measures were lung cancer deaths averted, life-years gained, percentage ever screened, costs (in 2015 Canadian dollars), and overdiagnosis. The results of the base-case analysis indicated that annual screening was more cost-effective than biennial screening. Scenarios with eligibility criteria that required as few as 20 pack-years were dominated by scenarios that required higher numbers of accumulated pack-years. In general, scenarios that applied stringent smoking eligibility criteria (i.e., requiring higher levels of accumulated smoking exposure) were more cost-effective than scenarios with less stringent smoking eligibility criteria, with modest differences in life-years gained. Annual screening between ages 55-75 for persons who smoked ≥40 pack-years and who currently smoke or quit ≤10 y ago yielded an incremental cost-effectiveness ratio of $41,136 Canadian dollars ($33,825 in May 1, 2015, United States dollars) per life-year gained (compared to annual screening between ages 60-75 for persons who smoked ≥40 pack-years and who currently smoke or quit ≤10 y ago), which was considered optimal at a cost-effectiveness threshold of $50,000 Canadian dollars ($41,114 May 1, 2015, US dollars). If 50% lower or higher attributable costs were assumed, the incremental cost-effectiveness ratio of this scenario was estimated to be $38,240 ($31,444 May 1, 2015, US dollars) or $48,525 ($39,901 May 1, 2015, US dollars), respectively. If 50% lower or higher costs for CT examinations were assumed, the incremental cost-effectiveness ratio of this scenario was estimated to be $28,630 ($23,542 May 1, 2015, US dollars) or $73,507 ($60,443 May 1, 2015, US dollars), respectively. This scenario would screen 9.56% (499,261 individuals) of the total population (ever- and never-smokers) at least once, which would require 4,788,523 CT examinations, and reduce lung cancer mortality in the total population by 9.05% (preventing 13,108 lung cancer deaths), while 12.53% of screen-detected cancers would be overdiagnosed (4,282 overdiagnosed cases). Sensitivity analyses indicated that the overall results were most sensitive to variations in CT examination costs. Quality of life was not incorporated in the analyses, and assumptions for follow-up procedures were based on data from the NLST, which may not be generalizable to a population-based setting. Lung cancer screening with stringent smoking eligibility criteria can be cost-effective in a population-based setting.

Initial results of the use of prescription order change forms to achieve dose form optimization (consolidation and tablet splitting) of SSRI antidepressants in a state Medicaid program.

PubMed

Hamer, Ann M; Hartung, Daniel M; Haxby, Dean G; Ketchum, Kathy L; Pollack, David A

2006-01-01

One method to reduce drug costs is to promote dose form optimization strategies that take advantage of the flat pricing of some drugs, i.e., the same or nearly the same price for a 100 mg tablet and a 50 mg tablet of the same drug. Dose form optimization includes tablet splitting; taking half of a higher-strength tablet; and dose form consolidation, using 1 higher-strength tablet instead of 2 lower-strength tablets. Dose form optimization can reduce the direct cost of therapy by up to 50% while continuing the same daily dose of the same drug molecule. To determine if voluntary prescription change forms for antidepressant drugs could induce dosing changes and reduce the cost of antidepressant therapy in a Medicaid population. Specific regimens of 4 selective serotonin reuptake inhibitors (SSRIs)- citalopram, escitalopram, paroxetine, and sertraline- were identified for conversion to half tablets or dose optimization. Change forms, which served as valid prescriptions, were faxed to Oregon prescribers in October 2004. The results from both the returned forms and subsequent drug claims data were evaluated using a segmented linear regression. Citalopram claims were excluded from the cost analysis because the drug became available in generic form in October 2004. A total of 1,582 change forms were sent to 556 unique prescribers; 9.2% of the change forms were for dose consolidation and 90.8% were for tablet splitting. Of the 1,118 change forms (70.7%) that were returned, 956 (60.4% of those sent and 85.5% of those returned) authorized a prescription change to a lower-cost dose regimen. The average drug cost per day declined by 14.2%, from Dollars 2.26 to Dollars 1.94 in the intervention group, versus a 1.6% increase, from Dollars 2.52 to Dollars 2.56, in the group without dose consolidation or tablet splitting of the 3 SSRIs (sertraline, escitalopram, and immediate-release paroxetine). Total drug cost for the 3 SSRIs declined by 35.6%, from Dollars 333,567 to Dollars 214,794, as a result of a 24.8% decline in the total days of SSRI drug therapy and the 14.2% decline in average SSRI drug cost per day. The estimated monthly cost avoidance from this intervention, based on pharmacy claims data, was approximately Dollars 35,285, about 2% of the entire spending on SSRI drugs each month, or about Dollars 0.09 per member per month. Program administration costs, excluding costs incurred by prescribers and pharmacy providers, were about 2% of SSRI drug cost savings. Voluntary prescription change forms appear to be an effective and well-accepted tool for obtaining dose form optimization through dose form consolidation and tablet splitting, resulting in reduction in the direct costs of SSRI antidepressant drug therapy with minimal additional program administration costs.

Cost-effectiveness of oral phenytoin, intravenous phenytoin, and intravenous fosphenytoin in the emergency department.

PubMed

Rudis, Maria I; Touchette, Daniel R; Swadron, Stuart P; Chiu, Amy P; Orlinsky, Michael

2004-03-01

Oral phenytoin, intravenous phenytoin, and intravenous fosphenytoin are all commonly used for loading phenytoin in the emergency department (ED). The cost-effectiveness of each was compared for patients presenting with seizures and subtherapeutic phenytoin concentrations. A simple decision tree was developed to determine the treatment costs associated with each of 3 loading techniques. We determined effectiveness by comparing adverse event rates and by calculating the time to safe ED discharge. Time to safe ED discharge was defined as the time at which therapeutic concentrations of phenytoin (>or=10 mg/L) were achieved with an absence of any adverse events that precluded discharge. The comparative cost-effectiveness of alternatives to oral phenytoin was determined by combining net costs and number of adverse events, expressed as cost per adverse events avoided. Cost-effectiveness was also determined by comparing the net costs of each loading technique required to achieve the time to safe ED discharge, expressed as cost per hour of ED time saved. The outcomes and costs were primarily derived from a prospective, randomized controlled trial, augmented by time-motion studies and alternate-cost sources. Costs included the cost of drugs, supplies, and personnel. Analyses were also performed in scenarios incorporating labor costs and savings from using a lower-urgency area of the ED. The mean number of adverse events per patient for oral phenytoin, intravenous phenytoin, and intravenous fosphenytoin was 1.06, 1.93, and 2.13, respectively. Mean time to safe ED discharge in the 3 groups was 6.4 hours, 1.7 hours, and 1.3 hours. Cost per patient was 2.83 dollars, 21.16 dollars, and 175.19 dollars, respectively, and did not differ substantially in the Labor and Triage (lower-urgency area of ED) scenarios. When the measure of effectiveness was adverse events, oral phenytoin dominated intravenous phenytoin and intravenous fosphenytoin, with a lower cost and number of adverse events. With time to safe ED discharge as the outcome measure, the incremental cost-effectiveness ratios were 3.90 dollars and 387.27 dollars per hour of ED time saved for oral phenytoin versus intravenous phenytoin and for intravenous fosphenytoin versus intravenous phenytoin, respectively. Oral phenytoin is the most cost-effective loading method in most settings. Intravenous phenytoin is preferred if one is willing to pay an additional 20.65 dollars to 44.25 dollars per patient and willing to have more adverse events for a quicker average time to safe ED discharge. It is unlikely that intravenous fosphenytoin is justifiable in any setting.

29 CFR 779.330 - Third requirement for qualifying as a “retail or service establishment.”

Code of Federal Regulations, 2010 CFR

2010-07-01

... annual dollar volume must be from sales of goods or of services (or of both) which are not made for..., discussed in § 779.335, the requirement that 75 percent of the establishment's dollar volume be from sales... Service Establishments Sales Not Made for Resale § 779.330 Third requirement for qualifying as a “retail...

78 FR 42436 - Procedures To Establish Appropriate Minimum Block Sizes for Large Notional Off-Facility Swaps and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... (ICE). Gold (COMEX and NYSE Liffe).. 2,500 troy oz. Goldman Sachs Commodity Index 5,000 times dollars... (NYMEX) 1,000 troy oz. PG&E Citygate Basis (ICE and 62,500 MMBtu. NYMEX). PJM Western Hub Real Time Off...). Platinum (NYMEX) 500 troy oz. Rainfall Index (CME)......... 10,000 times dollars. index. Rough Rice (CBOT...

A Portrait of School Improvement Grantees. Charts You Can Trust

ERIC Educational Resources Information Center

Jambulapati, Padmini

2011-01-01

In the last year, the federal government has invested $3.5 billion dollars in an effort to fix the nation's bottom 5 percent of public schools. In the coming months, it will roll out another $546 million dollars to do the same. The School Improvement Grant (SIG) program is the largest pot of federal funds ever aimed at improving a discrete set of…

Using the One-More-Than Technique to Teach Money Counting to Individuals with Moderate Mental Retardation: A Systematic Replication.

ERIC Educational Resources Information Center

Denny, Paula J.; Test, David W.

1995-01-01

This study extended use of the One-More-Than technique by using a "cents-pile modification"; one-, five-, and ten-dollar bills; and mixed training of all dollar amounts. Three high school students with moderate mental retardation each learned to use the technique to count out nontrained amounts and to make community purchases. (Author/PB)

The Inequities of Salary Reduction as National Child Care Policy: Where Do We Go from Here.

ERIC Educational Resources Information Center

Soloway, Ronald

The salary reduction plan for financing child care is of little benefit to taxpayers earning below 16,000 dollars because these working parents would receive equal or better value by using the child care tax credit. For income levels between 16,000 and 20,000 dollars, the salary reduction plan may have some marginal utility to working parents…

26 CFR 1.987-5 - Transition rules for certain qualified business units using a profit and loss method of...

Code of Federal Regulations, 2010 CFR

2010-04-01

... of United States persons that have a nondollar functional currency and that used a net worth method...) branches of United States persons, whose functional currency (as defined in section 985 of the Code and the regulations thereunder) is other than the United States dollar (dollar) and that used a profit and loss method...

Dollars Equal the Margin of Excellence. Southern Association of Community and Junior Colleges Occasional Paper, Volume 5, Number 2.

ERIC Educational Resources Information Center

Walters, Lex

Finding the dollars needed to operate a college is a major challenge, especially for educational leaders endeavoring to raise their institutions' overall level of excellence. In many Southeastern states, two-year colleges have responded to declines in revenue by increasing tuition and other fees and in some cases putting the cost of college beyond…

26 CFR 1.905-3T - Adjustments to United States tax liability and to the pools of post-1986 undistributed earnings...

Code of Federal Regulations, 2012 CFR

2012-04-01

... as a credit or added to post-1986 foreign income taxes. (iv) Functional currency tax liabilities. If... tax redetermination includes: accrued taxes that when paid differ from the amounts added to post-1986... the dollar value of the accrued tax and the dollar value of the tax paid attributable to fluctuations...

26 CFR 1.905-3T - Adjustments to United States tax liability and to the pools of post-1986 undistributed earnings...

Code of Federal Regulations, 2014 CFR

2014-04-01

... as a credit or added to post-1986 foreign income taxes. (iv) Functional currency tax liabilities. If... tax redetermination includes: accrued taxes that when paid differ from the amounts added to post-1986... the dollar value of the accrued tax and the dollar value of the tax paid attributable to fluctuations...

26 CFR 1.905-3T - Adjustments to United States tax liability and to the pools of post-1986 undistributed earnings...

Code of Federal Regulations, 2011 CFR

2011-04-01

... as a credit or added to post-1986 foreign income taxes. (iv) Functional currency tax liabilities. If... tax redetermination includes: accrued taxes that when paid differ from the amounts added to post-1986... the dollar value of the accrued tax and the dollar value of the tax paid attributable to fluctuations...

26 CFR 1.905-3T - Adjustments to United States tax liability and to the pools of post-1986 undistributed earnings...

Code of Federal Regulations, 2013 CFR

2013-04-01

... as a credit or added to post-1986 foreign income taxes. (iv) Functional currency tax liabilities. If... tax redetermination includes: accrued taxes that when paid differ from the amounts added to post-1986... the dollar value of the accrued tax and the dollar value of the tax paid attributable to fluctuations...

20 CFR 645.315 - What actions are to be taken if a State fails to make the required matching expenditures?

Code of Federal Regulations, 2012 CFR

2012-04-01

... Additional Formula Grant Administrative Standards and Procedures § 645.315 What actions are to be taken if a... reduced by two (2) dollars for each one (1) dollar shortfall in State matching funds) when the grant is... based on the FY formula grant award amount, as reduced under paragraph (a) of this section. ...

The Top 10 Energy Wasters in K-12 Facilities (and What to Do about Them)

ERIC Educational Resources Information Center

Leathers, Dave

2010-01-01

Every year, K-12 facilities waste millions of dollars in excess energy consumption. Those dollars may take the form of lost heat through walls, windows, doors, and roofs. Or the villain may be poorly conceived or mismanaged control systems. Those excess funds that districts are sending to the local utility companies could be invested "at home" to…

American Opportunity Credit: Key to Education for Lower and Middle Income College Students

ERIC Educational Resources Information Center

Guerrero, Robin; Tiggeman, Theresa; Edmond, Tracie

2011-01-01

The Tax Relief Act of 1997 created an important tax provision which helped taxpayers offset the cost of higher education. This provision was in the form of education tax credits. Because a tax credit is a dollar for dollar reduction in tax liability, these education credits were designed to reduce the amount of tax due for college students or…

76 FR 41838 - Order Approving Adjustment for Inflation of the Dollar Amount Tests in Rule 205-3 Under the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-15

... SECURITIES AND EXCHANGE COMMISSION [Release No. 3236/July 12, 2011] Order Approving Adjustment for Inflation of the Dollar Amount Tests in Rule 205-3 Under the Investment Advisers Act of 1940 I. Background Section 205(a)(1) of the Investment Advisers Act of 1940 (``Advisers Act'') generally prohibits an investment adviser from entering into,...

Vaccination versus treatment of influenza in working adults: a cost-effectiveness analysis.

PubMed

Rothberg, Michael B; Rose, David N

2005-01-01

To determine the cost-effectiveness of influenza vaccination, antiviral therapy, or no intervention for healthy working adults, accounting for annual variation in vaccine efficacy. We conducted a cost-effectiveness analysis based on published clinical trials of influenza vaccine and antiviral drugs, incorporating 10 years of surveillance data from the World Health Organization. We modeled influenza vaccination, treatment of influenza-like illness with antiviral drugs, or both, as compared with no intervention, targeting healthy working adults under age 50 years in the general community or workplace. Outcomes included costs, illness days, and quality-adjusted days gained. In the base case analysis, the majority of costs incurred for all strategies were related to lost productivity from influenza illness. The least expensive strategy varied from year to year. For the 10-year period, antiviral therapy without vaccination was associated with the lowest overall costs (234 US dollars per person per year). Annual vaccination cost was 239 US dollars per person, and was associated with 0.0409 quality-adjusted days saved, for a marginal cost-effectiveness ratio of 113 US dollars per quality-adjusted day gained or 41,000 US dollars per quality-adjusted life-year saved compared with antiviral therapy. No intervention was the most expensive and least effective option. In sensitivity analyses, lower vaccination costs, higher annual probabilities of influenza, and higher numbers of workdays lost to influenza made vaccination more cost-effective than treatment. If vaccination cost was less than 16 US dollars or time lost from work exceeded 2.4 days per episode of influenza, then vaccination was cost saving compared with all other strategies. Influenza vaccination for healthy working adults is reasonable economically, and under certain circumstances is cost saving. Antiviral therapy is consistently cost saving.

Cost-effectiveness analysis of trastuzumab in the adjuvant setting for treatment of HER2-positive breast cancer.

PubMed

Garrison, Louis P; Lubeck, Deborah; Lalla, Deepa; Paton, Virginia; Dueck, Amylou; Perez, Edith A

2007-08-01

Adding trastuzumab to adjuvant chemotherapy provides significant clinical benefit in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. A cost-effectiveness analysis was performed to assess clinical and economic implications of adding trastuzumab to adjuvant chemotherapy, based upon joint analysis of NSABP B-31 and NCCTG N9831 trials. A Markov model with 4 health states was used to estimate the cost utility for a 50-year-old woman on the basis of trial results through 4 years and estimates of long-term recurrence and death based on a meta-analysis of trials. From 6 years onward, rates of recurrence and death were assumed to be the same in both trastuzumab and chemotherapy-only arms. Incremental costs were estimated for diagnostic and treatment-related costs. Analyses were from payer and societal perspectives, and these analyses were projected to lifetime and 20-year horizons. Over a lifetime, the projected cost of trastuzumab per quality-adjusted life year (QALY; discount rate 3%) gained was 26,417 dollars (range 9,104 dollars-69,340 dollars under multiway sensitivity analysis). Discounted incremental lifetime cost was 44,923 dollars, and projected life expectancy was 3 years longer for patients who received trastuzumab (19.4 years vs 16.4 years). During a 20-year horizon, the projected cost of adding trastuzumab to chemotherapy was 34,201 dollars per QALY gained. Key cost-effectiveness drivers were discount rate, trastuzumab price, and probability of metastasis. The cost-effectiveness result was robust to sensitivity analysis. Trastuzumab for adjuvant treatment of early stage breast cancer was projected to be cost effective over a lifetime horizon, achieving a cost-effectiveness ratio below that of many widely accepted oncology treatments. (c) 2007 American Cancer Society.

Sclerotinia homoeocarpa Overwinters in Turfgrass and Is Present in Commercial Seed

PubMed Central

Rioux, Renée A.; Shultz, Jeanette; Garcia, Michelle; Willis, David Kyle; Casler, Michael; Bonos, Stacy; Smith, Damon; Kerns, James

2014-01-01

Dollar spot is the most economically important disease of amenity turfgrasses in the United States, yet little is known about the source of primary inoculum for this disease. With the exception of a few isolates from the United Kingdom, Sclerotinia homoeocarpa, the causal agent of dollar spot, does not produce spores. Consequently, it was assumed that overwintering of this organism in soil, thatch, and plant debris provides primary inoculum for dollar spot epidemics. Overwintering of S. homoeocarpa in roots and shoots of symptomatic and asymptomatic creeping bentgrass turfgrass was quantified over the course of a three-year field experiment. Roots did not consistently harbor S. homoeocarpa, whereas S. homoeocarpa was isolated from 30% of symptomatic shoots and 10% of asymptomatic shoots in the spring of two out of three years. The presence of stroma-like pathogen material on leaf blades was associated with an increase in S. homoeocarpa isolation and colony diameter at 48 hpi. Commercial seed has also been hypothesized to be a potential source of initial inoculum for S. homoeocarpa. Two or more commercial seed lots of six creeping bentgrass cultivars were tested for contamination with S. homoeocarpa using culture-based and molecular detection methods. A viable, pathogenic isolate of S. homoeocarpa was isolated from one commercial seed lot and contamination of this lot was confirmed with nested PCR using S. homoeocarpa specific primers. A sensitive nested PCR assay detected S. homoeocarpa contamination in eight of twelve (75%) commercial seed lots. Seed source, but not cultivar or resistance to dollar spot, influenced contamination by S. homoeocarpa. Overall, this research suggests that seeds are a potential source of initial inoculum for dollar spot epidemics and presents the need for further research in this area. PMID:25333928

Under "real world" conditions, desflurane increases drug cost without speeding discharge after short ambulatory anesthesia compared to isoflurane.

PubMed

Schwarz, Stephan K W; Butterfield, Noam N; Macleod, Bernard A; Kim, Edward Y; Franciosi, Luigi G; Ries, Craig R

2004-11-01

To compare the measured "real world" perioperative drug cost and recovery associated with desflurane- and isoflurane-based anesthesia in short (less than one hour) ambulatory surgery. We conducted a prospective, randomized, blinded trial with patients undergoing arthroscopic meniscectomy under general anesthesia. Following iv induction, patients received either isoflurane (group I; n = 25) or desflurane (group D; n = 20) for maintenance. The primary outcome variable was total perioperative drug cost per patient in Canadian dollars. Secondary outcome variables included volatile agent consumption and cost, adjuvant anesthetic and postanesthesia care unit (PACU) drug cost, readiness for PACU discharge, and incidence of adverse events. Total perioperative drug cost per patient was 14.58 +/- 6.83 Canadian dollars (mean +/- standard deviation) for group I, and 21.47 +/- 5.18 Canadian dollars for group D (P < 0.001). Isoflurane consumption per patient was 6.0 +/- 3.0 mL compared to 18.6 +/- 7.7 mL for desflurane (P < 0.0001); corresponding costs were 0.83 +/- 0.42 Canadian dollars vs 7.61 +/- 3.15 Canadian dollars (P < 0.0001). There were no differences in adjuvant anesthetic or PACU drug cost. All but one patient from each group were deemed ready for PACU discharge at 15 min postoperatively (Aldrete score >or= 9). One patient in group D experienced postoperative nausea. No other adverse events were noted. Measured total perioperative drug cost for a short ambulatory procedure (less than one hour) under general anesthesia was higher when desflurane rather than isoflurane was used for maintenance, essentially due to volatile agent cost. Desflurane use did not translate into faster PACU discharge under "real world" conditions.

Comorbidity and the concentration of healthcare expenditures in older patients with heart failure.

PubMed

Zhang, James X; Rathouz, Paul J; Chin, Marshall H

2003-04-01

To examine comorbidity and concentration of healthcare expenditures in older patients with heart failure (HF) in the Medicare program. Retrospective analysis of older fee-for-service HF patients, using the 1996 Medicare Current Beneficiary Survey and linked Medicare claims. Variety of clinical settings. One thousand two hundred sixty-six older HF patients from a nationally representative survey. Medicare expenditure per person and by types of healthcare services, prevalence of comorbid conditions, and multivariate regression on the association between comorbidities and healthcare expenditure. Medicare spent an average of 16,514 dollars on medical reimbursement for each HF patient in 1996. Eighty-one percent of patients had one or more comorbid diseases according to a 17-disease grouping index. The top 20% of HF patients accounted for 63% of total expenditure. Comorbidity was associated with significantly higher Medicare expenditure. HF patients with more-expensive comorbidities included those with peripheral vascular disease (24% of patients, mean total expenditure 26,954 dollars), myocardial infarction (16% of patients, mean total expenditure 29,867 dollars), renal disease (8% of patients, mean total expenditure 33,014 dollars), and hemiplegia or paraplegia (5% of patients, mean total expenditure 33,234 dollars). Diseases and disorders other than heart failure constituted a significant fraction of the causes of inpatient admissions. Comorbid conditions were more likely to be associated with expensive inpatient care, and patients with these diseases were more likely to spend more overall and more on other types of Medicare services including home health aid, skilled nursing facility, and hospice care. Disease management should consider comorbid conditions for improving care and reducing expenditures in older patients with HF.

Out-of-pocket health-care expenditures among older Americans with cancer.

PubMed

Langa, Kenneth M; Fendrick, A Mark; Chernew, Michael E; Kabeto, Mohammed U; Paisley, Kerry L; Hayman, James A

2004-01-01

There is currently limited information regarding the out-of-pocket expenditures (OOPE) for medical care made by elderly individuals with cancer. We sought to quantify OOPE for community-dwelling individuals age 70 or older with: 1) no cancer (No CA), 2) a history of cancer, not undergoing current treatment (CA/No Tx), and 3) a history of cancer, undergoing current treatment (CA/Tx). We used data from the 1995 Asset and Health Dynamics Study, a nationally representative survey of community-dwelling elderly individuals. Respondents identified their cancer status and reported OOPE for the prior 2 years for: 1) hospital and nursing home stays, 2) outpatient services, 3) home care, and 4) prescription medications. Using a multivariable two-part regression model to control for differences in sociodemographics, living situation, functional limitations, comorbid chronic conditions, and insurance coverage, the additional cancer-related OOPE were estimated. Of the 6370 respondents, 5382 (84%) reported No CA, 812 (13%) reported CA/No Tx, and 176 (3%) reported CA/Tx. The adjusted mean annual OOPE for the No CA, CA/No Tx, and CA/Tx groups were 1210 dollars, 1450 dollars, and 1880 dollars, respectively (P < .01). Prescription medications (1120 dollars per year) and home care services (250 dollars) accounted for most of the additional OOPE associated with cancer treatment. Low-income individuals undergoing cancer treatment spent about 27% of their yearly income on OOPE compared to only 5% of yearly income for high-income individuals with no cancer history (P < .01). Cancer treatment in older individuals results in significant OOPE, mainly for prescription medications and home care services. Economic evaluations and public policies aimed at cancer prevention and treatment should take note of the significant OOPE made by older Americans with cancer.

Evaluating industrial drying of cellulosic feedstock for bioenergy: A systems approach

DOE PAGES

Sokhansanj, Shahab; Webb, Erin

2016-01-21

Here, a large portion of herbaceous and woody biomass must be dried following harvest. Natural field drying is possible if the weather cooperates. Mechanical drying is a certain way of reducing the moisture content of biomass. This paper presents an engineering analysis applied to drying of 10 Mg h –1 (exit mass flow) of biomass with an initial moisture content ranging from 25% to 70% (wet mass basis) down to 10% exit moisture content. The requirement for hog fuel to supply heat to the dryer increases from 0.5 dry Mg to 3.8 dry Mg h –1 with the increased initialmore » moisture of biomass. The capital cost for the entire drying system including equipment for biomass size reduction, pollution control, dryer, and biomass combustor sums up to more than 4.7 million dollars. The operating cost (electricity, labor, repair, and maintenance) minus fuel cost for the dryer alone amount to 4.05 Mg –1 of dried biomass. For 50% moisture content biomass, the cost of fuel to heat the drying air is 7.41 dollars/ dry ton of biomass for a total 11.46 dollars per dry ton at 10% moisture content. The fuel cost ranges from a low of 2.21 dollars to a high of 18.54 dollars for a biomass at an initial moisture content of 25% to 75%, respectively. This wide range in fuel cost indicates the extreme sensitivity of the drying cost to initial moisture content of biomass and to ambient air humidity and temperature and highlights the significance of field drying for a cost effective drying operation.« less

Cost-effectiveness of pneumococcal conjugate vaccination in the prevention of child mortality: an international economic analysis.

PubMed

Sinha, Anushua; Levine, Orin; Knoll, Maria D; Muhib, Farzana; Lieu, Tracy A

2007-02-03

Routine vaccination of infants against Streptococcus pneumoniae (pneumococcus) needs substantial investment by governments and charitable organisations. Policymakers need information about the projected health benefits, costs, and cost-effectiveness of vaccination when considering these investments. Our aim was to incorporate these data into an economic analysis of pneumococcal vaccination of infants in countries eligible for financial support from the Global Alliance for Vaccines & Immunization (GAVI). We constructed a decision analysis model to compare pneumococcal vaccination of infants aged 6, 10, and 14 weeks with no vaccination in the 72 countries that were eligible as of 2005. We used published and unpublished data to estimate child mortality, effectiveness of pneumococcal conjugate vaccine, and immunisation rates. Pneumococcal vaccination at the rate of diptheria-tetanus-pertussis vaccine coverage was projected to prevent 262,000 deaths per year (7%) in children aged 3-29 months in the 72 developing countries studied, thus averting 8.34 million disability-adjusted life years (DALYs) yearly. If every child could be reached, up to 407,000 deaths per year would be prevented. At a vaccine cost of International 5 dollars per dose, vaccination would have a net cost of 838 million dollars, a cost of 100 dollars per DALY averted. Vaccination at this price was projected to be highly cost-effective in 68 of 72 countries when each country's per head gross domestic product per DALY averted was used as a benchmark. At a vaccine cost of between 1 dollar and 5 dollars per dose, purchase and accelerated uptake of pneumococcal vaccine in the world's poorest countries is projected to substantially reduce childhood mortality and to be highly cost-effective.

Community-based youth tobacco control interventions: cost effectiveness of the Full Court Press project.

PubMed

Ross, Hana; Powell, Lisa M; Bauer, Joseph E; Levy, David T; Peck, Richard M; Lee, Hye-Ryeon

2006-01-01

We evaluated the impact of a community-based tobacco control project that was implemented in the city of Tucson, Arizona, USA, between 1996 and 2001. The project's goal was to reduce the prevalence of youth smoking through change in social norms at schools and in communities and workplaces. As is often the case, these community-based health promotion interventions were implemented in conjunction with other broader programmes, in this case implemented on the state level. Taking into account state level interventions as well as changes in sociodemographic and economic environment over the course of the project (e.g. increases in cigarette prices), we measure the net effect of the intervention in terms of the number of people who quit or did not initiate smoking and by the discounted life-years gained. To establish the value of investing into community-based intervention, we calculated the real discounted cost per quit and per life-year gained of 3789 US dollars and 3942 US dollars, respectively. These compare favourably with the real cost per quit of 4270 US dollars when implementing the 1996 US Clinical Practice Guideline for smoking cessation but exceed the real cost of 2923 US dollars per discounted life-year gained when following the guideline. A sensitivity analysis that assumed 5% programme persistence (i.e. 5% of the programme's impact would last forever in the absence of future funding for the programme), one-third would relapse and that one-third of those who quit may have quit smoking even without the programme, suggested a lower cost per discounted life-year saved of 3476 US dollars. The cost effectiveness of this project compares favourably with other tobacco control interventions. Despite its relatively small target group, this community-based intervention was cost effective.

The cost-utility of photodynamic therapy in eyes with neovascular macular degeneration--a value-based reappraisal with 5-year data.

PubMed

Brown, Gary C; Brown, Melissa M; Campanella, Joseph; Beauchamp, George R

2005-10-01

To assess the value conferred by photodynamic therapy (PDT) and the cost-utility of PDT for the treatment of classic, subfoveal choroidal neovascularization associated with age-related macular degeneration (ARMD). Average cost-utility analysis utilizing clinical trial data, patient-based time tradeoff utility preferences, and a third party insurer cost perspective. Five-year visual acuity data from the TAP (Treatment of Age-related Macular Degeneration With Photodynamic Therapy) Investigation were modeled into a 12-year, value-based, reference case, cost-utility model utilizing year 2004 Medicare costs and an outcome of dollar/QALY (dollars/quality-adjusted life-year). Discounting of outcomes and costs using net present value analysis with a 3% annual rate was performed as recommended by the Panel for Cost-Effectiveness in Health and Medicine. PDT with verteporfin (Visudyne) dye for classic subfoveal choroidal neovascularization confers an 8.1% quality of life (value) improvement over the 12-year life expectancy of the reference case, while during the last 8 years the value improvement is 9.5%. The average cost-utility of the intervention is dollar 31,103/QALY (quality-adjusted life-year). Extensive one-way sensitivity analysis values range from dollar 20,736/QALY if treatment efficacy is increased by 50% to dollar 62,207 if treatment efficacy is decreased by 50%, indicating robustness of the model. PDT using verteporfin dye to treat classic subfoveal choroidal neovascularization is a very cost-effective treatment by conventional standards. The marked improvement in cost-effectiveness compared with a previous report results from the facts that the treatment benefit increasingly accrues during 5 years of follow-up while the number of yearly treatments diminishes markedly during that time.

Growth and survival of three marine invertebrate species in sediments from the Hudson-Raritan estuary, New York

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

Rice, C.A.; Plesha, P.D.; Casillas, E.

1995-11-01

Sediments in the Hudson-Raritan estuary are known to contain high concentrations of anthropogenic contaminants, and marine organisms from this region exhibit numerous contaminant-related effects. To assess the pattern of sediment toxicity in depositional areas of this region, and to compare lethal and sublethal end points for different bioassay organisms, three benthic marine invertebrate species were exposed to sediments from 17 sites in the Hudson-Raritan estuary. Growth and mortality of the polychaete Armandia brevis and the sand dollar Dendraster excentricus were measured in all 17 sediments, while mortality and reburial ability of the amphipod Rhepoxinius abronius were assessed in nine sediments.more » Growth of polychaetes was determined by measuring the difference in weight after a 20-d exposure, whereas growth of sand dollars was assessed by measuring the difference in length and weight after a 28-d exposure. Amphipod mortality and reburial tests were conducted using the standard 10-d sediment bioassay. Significant growth reduction of polychaetes and sand dollars occurred in 11 of 17, and 3 of 17 sediments, respectively. Polychaete weight and sand dollar length correlated inversely and significantly with total sediment concentration of polycyclic aromatic hydrocarbons, polychlorinated biphenyls, and some selected elements. In contrast, significant mortality of polychaetes and amphipods occurred in 1 of 17 and 2 of 9 sediments, respectively, and impaired reburial ability of amphipods was not observed. Results of this study demonstrate that sediment contamination at depositional sites with the Hudson-Raritan estuary has potential to cause deleterious biological effects in indigenous benthic organisms. In addition, sublethal growth bioassays using polychaetes and sand dollars appear to be more sensitive in measuring the effects of sediment contamination than does the mortality-based bioassay using the amphipod Rhepoxinius abronius.« less

NBER working paper series: oil and the dollar. Working Paper No. 554

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

Krugman, P.

1980-01-01

This paper develops a simple theoretical model of the effect of an oil price increase on exchange rates. The model shows that the direction of this effect depends on a comparison of the direct balance of payments burden of the higher oil price with the indirect balance of payments benefits of OPEC spending and investment. In the short run, what matters is whether the US share of world oil imports is more or less than its share of OPEC asset holdings; in the long run, whether its share of oil imports is more or less than its share of OPECmore » imports. Casual empiricism suggests that the initial effect and the long run effect will run in opposite directions; an oil price increase will initially lead to dollar appreciation, but eventually leads to dollar depreciation.« less

Benefits to world agriculture through remote sensing

NASA Technical Reports Server (NTRS)

Buffalano, A. C.; Kochanowski, P.

1976-01-01

Remote sensing of agricultural land permits crop classification and mensuration which can lead to improved forecasts of production. This technique is particularly important for nations which do not already have an accurate agricultural reporting system. Better forecasts have important economic effects. International grain traders can make better decisions about when to store, buy, and sell. Farmers can make better planting decisions by taking advantage of production estimates for areas out of phase with their own agricultural calendar. World economic benefits will accrue to both buyers and sellers because of increased food supply and price stabilization. This paper reviews the econometric models used to establish this scenario and estimates the dollar value of benefits for world wheat as 200 million dollars annually for the United States and 300 to 400 million dollars annually for the rest of the world.

A cost-effectiveness comparison of embryo donation with oocyte donation.

PubMed

Finger, Reginald; Sommerfelt, Carol; Freeman, Melanie; Wilson, Carrie K; Wade, Amy; Daly, Douglas

2010-02-01

To compare the cost-effectiveness of embryo donation (ED) to that of oocyte donation (OD). Calculation of cost-effectiveness ratios (costs per outcome achieved) using data derived from clinical practices. In vitro fertilization centers and embryo donation programs. Infertile couples undergoing oocyte donation or embryo donation. Oocyte donation or embryo donation cycles. Cost-effectiveness ratios. For a single cycle, ED is approximately twice as cost-effective as OD, with a cost-effectiveness ratio of $21,990 per live delivery compared to 40,600 dollars. When strategies of up to three cycles (to achieve one live delivery) are used, ED costs 13,505 dollars per live delivery compared to 31,349 dollars for OD. Cost-effectiveness is a compelling reason for infertile couples to consider embryo donation. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

45 CFR 263.8 - What happens if a State fails to meet the basic MOE requirement?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false What happens if a State fails to meet the basic... Maintenance of Effort? § 263.8 What happens if a State fails to meet the basic MOE requirement? (a) If any State fails to meet its basic MOE requirement for any fiscal year, then we will reduce dollar-for-dollar...

76 FR 45885 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change To List...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-01

... Registration Statements, the Funds face the risk of non-performance by the counterparties to over-the- counter... the Fund in a fashion such that its per Share NAV will equal, in dollar terms, the spot price of a... intend to operate the Fund in a fashion such that its per Share NAV will equal, in dollar terms, the spot...

26 CFR 1.985-6 - Transition rules for a QBU that uses the dollar approximate separate transactions method for its...

Code of Federal Regulations, 2012 CFR

2012-04-01

... corporation beginning before January 1, 1987, shall be translated into dollars at the spot exchange rate on... shall be determined by multiplying the foreign currency amount of such deficit by the spot exchange rate..., e.g., Rev. Rul. 75-106, 1975-1 C.B. 31. (See § 601.601(d)(2)(ii)(b) of this chapter). (1) Basis in...

26 CFR 1.985-6 - Transition rules for a QBU that uses the dollar approximate separate transactions method for its...

Code of Federal Regulations, 2014 CFR

2014-04-01

... corporation beginning before January 1, 1987, shall be translated into dollars at the spot exchange rate on... shall be determined by multiplying the foreign currency amount of such deficit by the spot exchange rate..., e.g., Rev. Rul. 75-106, 1975-1 C.B. 31. (See § 601.601(d)(2)(ii)(b) of this chapter). (1) Basis in...

26 CFR 1.985-6 - Transition rules for a QBU that uses the dollar approximate separate transactions method for its...

Code of Federal Regulations, 2011 CFR

2011-04-01

... corporation beginning before January 1, 1987, shall be translated into dollars at the spot exchange rate on... shall be determined by multiplying the foreign currency amount of such deficit by the spot exchange rate..., e.g., Rev. Rul. 75-106, 1975-1 C.B. 31. (See § 601.601(d)(2)(ii)(b) of this chapter). (1) Basis in...

26 CFR 1.985-6 - Transition rules for a QBU that uses the dollar approximate separate transactions method for its...

Code of Federal Regulations, 2013 CFR

2013-04-01

... corporation beginning before January 1, 1987, shall be translated into dollars at the spot exchange rate on... shall be determined by multiplying the foreign currency amount of such deficit by the spot exchange rate..., e.g., Rev. Rul. 75-106, 1975-1 C.B. 31. (See § 601.601(d)(2)(ii)(b) of this chapter). (1) Basis in...

The Magic of Energy: Oil Surely Changed the Way that Humans Value Energy

ERIC Educational Resources Information Center

Deal, Walter F., III

2005-01-01

Recently, the price of gasoline seems to keep going up and up with seemingly no limit in sight. Accordingly, the price of a barrel of oil is in excess of sixty dollars today, when just a few years ago it was around twelve to fifteen dollars a barrel. There are many intertwined answers as to why the price of oil and gasoline are increasing.…

A decision support system for technology R&D planning: connecting the dots from information to innovation

NASA Technical Reports Server (NTRS)

Smith, Jeffrey H.; Wertz, Julie; Weisbin, Charles

2004-01-01

This paper describes an information technology innovation developed to assist decision makers faced with complex R&D tasks. The decision support system (DSS) was developed and applied to the analysis of a 10-year, 700 million dollar technology program for the exploration of Mars. The technologies were to enable a 4.8 billion dollar portfolio of exploration flight missions to Mars.

Opportunities to Reduce Potential Duplication in Government Programs, Save Tax Dollars, and Enhance Revenue

DTIC Science & Technology

2011-03-03

inflation, and round appropriately, the fixed- dollar amounts of the civil penalties to account for the decrease in real value over time and so that...policy, and funding decisions. GAO’s commitment to good government is reflected in its core values of accountability , integrity, and reliability. The...United States Government Accountability Office GAO Testimony Before the House Committee on Oversight and Government Reform

Directed-Energy Weapons: Invisible and Invincible?

DTIC Science & Technology

2007-09-01

deliver kinetic energy into the target’s atomic structure and they do not direct electromagnetic waves like lasers or high- power microwaves, particle...will be the easiest tactical protection method against the low- energy and medium- energy lasers , whose kill mechanism depends on holding the beam on a...might cost around $8,000, whereas kinetic energy missiles cost hundreds of thousands of dollars or even millions of dollars, depending on their

Is DOD on the Right Path to Financial Auditability?

DTIC Science & Technology

2012-03-22

and DOD decision-making. Moreover, most of the 10 ERPs run the same software applications (i.e. SAP [Systems Applications and Programs] or PeopleSoft...Financial Readiness; GFEBS; DEAMS; Navy ERP 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF...Navy ERP CLASSIFICATION: Unclassified To make every dollar count, the Department of Defense (DOD) must be able to account for every dollar

An assessment of the risk arising from electrical effects associated with carbon fibers released from commercial aircraft fires

NASA Technical Reports Server (NTRS)

Kalelkar, A. S.; Fiksel, J.; Rosenfield, D.; Richardson, D. L.; Hagopian, J.

1980-01-01

The risks associated with electrical effects arising from carbon fibers released from commercial aviation aircraft fires were estimated for 1993. The expected annual losses were estimated to be about $470 (1977 dollars) in 1993. The chances of total losses from electrical effects exceeding $100,000 (1977 dollars) in 1993 were established to be about one in ten thousand.

75 FR 74008 - Jake's Fireworks, Inc., Far East Imports, Inc., Wholesale Fireworks Enterprises LLC, Pacific...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-30

...-810-4104 The Big Dog. 07-810-4106 One Bad Mother 16 Shot. 07-810-4111 Time Is On My Side. 07-810-4118... shall pay a civil penalty of one hundred thousand dollars ($100,000.00), for which all Respondents are... fifty thousand dollars ($750,000.00) in any one calendar year. The remedy in this paragraph shall be in...

An Update to the Budget and Economic Outlook: 2014 to 2024

DTIC Science & Technology

2014-08-01

shares of gross domestic income (GDI). In principle , GDI equals GDP because each dollar of production yields a dollar of income; in practice, they...Projected Actual Percentage of GDP Percentage of the Population 1999 20092004 CONGRESS OF THE UNITED STATES CONGRESSIONAL BUDGET OFFICE CBO An Update to...the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data

The Budget and Economic Outlook: 2015 to 2025

DTIC Science & Technology

2015-01-01

States. 19. In principle , GDI equals GDP, because each dollar of production yields a dollar of income; in practice, they differ because of diffi...Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour...and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information

Near East/South Asia Report, No. 2746.

DTIC Science & Technology

1983-04-29

cooperation among the many and varied branches of media in the Islamic states taken its intended meaning so that this utilization and cooperation is... utilization [of these resources] during 1980 and 1981. Chapter XI. Human Resources This chapter consists of a study and analysis of figures dealing with the...recurring expenditure amounts to 1.146 billion dollars and development ex- penditure 1.086 billion dollars. Among the specialized banks, the

Cost Reduction in Vertically Related Industries: Integration versus Nonlinear Pricing,

DTIC Science & Technology

1983-05-01

monopoly controlled -.0. by a welfare (profit plus consumer surplus) maximizing social planner. In the latter case (and only then), it is assumed...sufficient for both superior welfare and profit performance. Inducing the same final good implies that both consumer surplus and industry revenue will be...profits at zero, industry cost savings translate dollar for dollar into higher profits for the upstream monopolist. And, with the same consumer surplus

Surfing, self-medicating and safety: buying non-prescription and complementary medicines via the internet.

PubMed

Bessell, T L; Anderson, J N; Silagy, C A; Sansom, L N; Hiller, J E

2003-04-01

To examine whether the sale of medicines via the internet supports their safe and appropriate use. e-Pharmacy websites were identified using key words and a metasearch engine and the quality of information published on these websites was surveyed using the DISCERN tool. A case scenario and internet pharmacy practice standards were also used to evaluate the quality of care delivered. Between July and September 2001 104 websites were surveyed and 27 sent either Sudafed (pseudoephedrine HCl), St John's wort products, or both to a residential address in Melbourne, Australia. Quality of health information (DISCERN ratings), information exchanged between e-pharmacy staff and consumers, and product and delivery costs. Of 104 e-pharmacies from at least 13 different countries, 63 websites provided some health information but overall the quality of the information was poor. Only three website operators provided adequate advice to consumers to avoid a potential drug interaction. The costs for a daily dose of pseudoephedrine HCl (240 mg) ranged from 0.81 Australian dollars to 3.04 Australian dollars, and delivery costs from 3.28 Australian dollars to 62.70 Australian dollars. Consumers who self-select medicines from websites have insufficient access to information and advice at the point of ordering and on delivery to make informed decisions about their safe and appropriate use.

Productivity cost benefit to employers of treating migraine with rizatriptan: a specific worksite analysis and model.

PubMed

Gerth, William C; Sarma, Syam; Hu, X Henry; Silberstein, Stephen D

2004-01-01

Employers in the United States might not be aware of the productivity costs of migraine or the extent to which those costs can be reduced by optimal treatment. An economic model was developed to enable employers to estimate the productivity costs of migraine to their company and the savings that will accrue if those patients who suffer from migraine are treated with rizatriptan. Analyses were run for both a major financial services corporation and a representative U.S. company. The major financial services corporation, with 87,821 employees, is projected to lose 538 person-years annually, at an estimated cost of 23.8 million dollars. A representative U.S. company with 10,000 employees is projected to lose 46.0 person-years of productive effort annually as a result of migraine, valued at approximately 1.94 million dollars. The value of the annual work loss avoided if migraine is treated with rizatriptan is projected at 10.3 million dollars for the financial services corporation and 841,000 dollars for the representative U.S. company. There is a substantial productivity cost burden of migraine from a U.S. employer perspective. These productivity costs can be reduced significantly by treating migraine headaches with rizatriptan.

Prostate cancer incidence and agriculture practices in Georgia, 2000-2010.

PubMed

Welton, Michael; Robb, Sara W; Shen, Ye; Guillebeau, Paul; Vena, John

2015-01-01

Georgia has prostate cancer incidence rates consistently above the national average. A notable portion of Georgia's economy is rooted in agricultural production, and agricultural practices have been associated with an increased risk of prostate cancer. Statistical analyses considered county age-adjusted prostate cancer incidence rates as the outcome of interest and three agricultural variables (farmland as percent of county land, dollars spent per county acre on agriculture chemicals, and dollars spent per county acre on commercial fertilizers) as exposures of interest. Multivariate linear regression models analyzed for each separately. Data were obtained from National Cancer Institute Surveillance, Epidemiology and End Results (SEER) 2000-2010, United States Department of Agriculture (USDA) 1987 Agriculture Survey, and 2010 US Census. In counties with equal to or greater than Georgia counties' median percent African-American population (27%), dollars per acre spent on agriculture chemicals was significantly associated (P = 0.04) and dollars spent of commercial fertilizers was moderately associated (P = 0.07) with elevated prostate cancer incidence rates. There was no association between percent of county farmland and prostate cancer rates. This study identified associations between prostate cancer incidence rates, agriculture chemical expenditure, and commercial fertilizer expenditure in Georgia counties with a population comprised of more than 27% of African Americans.

The costs of introducing a malaria vaccine through the expanded program on immunization in Tanzania.

PubMed

Hutton, Guy; Tediosi, Fabrizio

2006-08-01

This report presents an approach to costing the delivery of a malaria vaccine through the expanded program on immunization (EPI), and presents the predicted cost per dose delivered and cost per fully immunized child (FIC) in Tanzania, which are key inputs to the cost-effectiveness analysis. The costs included in the analysis are those related to the purchase of the vaccine taking into account the wastage rate; the costs of distributing and storing the vaccine at central, zonal, district, and facility level; those of managing the vaccination program; the costs of delivery at facility level (including personnel, syringes, safety boxes, and waste management); and those of additional training of EPI personnel and of social mobilization activities. The average cost per FIC increases almost linearly from US 4.2 dollars per FIC at a vaccine price of US 1 dollars per dose to US 31.2 dollars at vaccine price of US 10 dollars per dose. The marginal cost is approximately 5% less than the average cost. Although the vaccine price still determines most of the total delivery costs, the analysis shows that other costs are relevant and should be taken into account before marketing the vaccine and planning its inclusion into the EPI.

Are services better for climate change?

PubMed

Suh, Sangwon

2006-11-01

Embodied greenhouse gas (GHG) emissions and their structure of inducement by the supply-chain networks of 480 goods and services in the United States are analyzed for 44 GHGs. Producing a dollar of a product or service generates an average of 0.36 kg of CO2 equivalent GHGs onsite, increasing to 0.83 kg when supply-chain-induced emissions are taken into account. Services produce less than 5% of total U.S. GHG emissions directly, and their direct GHG emission intensities per dollar output are much less (0.04 kg C02 equiv/dollars) than those of physical products, even when supply-chain-induced emissions are included (0.47 kg C02 equiv/dollars). When both supply-chain effects and the volume of household expenditures are taken into account, however, household consumption of services excluding electric utilities and transportation services proves to be responsible for 37.6% of total industrial GHG emissions in the United States, almost twice the amount due to household consumption of electric utility and transportation services. Given the current structure of GHG emissions, a shift to a service-oriented economy is shown to entail a decrease in GHG emission intensity per unit GDP but an increase, by necessity, in overall GHG emissions in absolute terms. The results are discussed in the context of U.S. climate change policy.

A cost-effectiveness analysis of in-vitro fertilization by maternal age and number of treatment attempts.

PubMed

Griffiths, Alison; Dyer, Suzanne M; Lord, Sarah J; Pardy, Chris; Fraser, Ian S; Eckermann, Simon

2010-04-01

The increase in use and costs of assisted reproductive therapies including in-vitro fertilization (IVF) has led to debate over public funding. A decision analytic model was designed to estimate the incremental cost-effectiveness of IVF by additional treatment programmes and maternal age. Data from the Australian and New Zealand Assisted Reproductive Database were used to estimate incremental effects (live birth and other pregnancy outcomes) and costs for cohorts of women attempting up to three treatment programmes. A treatment programme included one fresh cycle and a variable number of frozen cycles dependent on maternal age. The incremental cost per live birth ranged from AU dollars 27 373 and AU dollars 31 986 for women aged 30-33 on their first and third programmes to AU dollars 130 951 and AU dollars 187 515 for 42-45-year-old women on their first and second attempts. Overall, these trends were not affected by inclusions of costs associated with ovarian hyperstimulation syndrome or multiple births. This study suggests that cost per live birth from IVF increases with maternal age and treatment programme number and indicates that maternal age has the much greater effect. This evidence may help decisionmakers target the use of IVF services conditional on societal willingness to pay for live births and equity considerations.

Life-Cycle-Cost Analysis of the Microwave Landing System Ground and Airborne Systems

DTIC Science & Technology

1981-10-01

constant 1980 dollars, with a production rate variability. Table S-3 presents the life-cycle costs by MLS configuration and total system implementation... PRODUCTION RATE VARIABILITY OVER A THREE-YEAR PFODUCTXION RUN (MILLIONS OF CONSTANT 1980 DOLLARS) Pruduction (Juantitl•e and Costs system Typ 75...Implementation strategies * Production schedules for MLS equipment The LCC was determined to be relatively insensitive to changes in MTBF. This was expected

2005 Tri-Service Infrastructure Systems Conference and Exhibition. Volume 9, Tracks 9-11

DTIC Science & Technology

2005-08-04

Walls ETL 1110-2-563, by John D. Clarkson and Robert C. Patev Belleville Locks & Dam Barge Accident on 6 Jan 05, by John Clarkson Portugues Dam Project...Update, by Alberto Gonzalez, Jim Mangold and Dave Dollar Portugues Dam: RCC Materials Investigation, by Jim Hinds Nonlinear Incremental Thermal Stress...Strain Analysis Portugues Dam, by David Dollar, Ahmed Nisar, Paul Jacob and Charles Logie Seismic Isolation of Mission-Critical Infrastructure to

Acoustic Scattering from Sand Dollars (Dendraster excentricus): Modeling as High Aspect Ratio Oblate Objects and Comparison to Experiment

DTIC Science & Technology

2008-09-01

results. In Stanton and Chu (2004), forward scattering and backscattering from a sand dollar test, a bivalve shell , and a machined aluminum disk of...Oceanographic Institution Abstract Benthic shells can contribute greatly to the scattering variability of the ocean bottom, particularly at low...grazing angles. Among the effects of shell aggregates are increased scattering strength and potential subcritical angle penetration of the seafloor

Iran: Regional Stability

DTIC Science & Technology

1975-04-01

Iranian plan to specify the underlying development strategy , the overall development objectives, 7 and some sectoral growth targets. Iran’s Fourth Plan...current prices was estimated at 4.42 billion dollars; at the end of the decade it had more than tripled to reach a level of about 14.9 billion dollars...Military Service- 2 years. Total armed forces- 112,500. Army: 100,000. 2 amoured divisions, each of 2 armd bdes and 1 mech bde. 3 infantry divisions

Microeconomic analysis of military aircraft bearing restoration

NASA Technical Reports Server (NTRS)

Hein, G. F.

1976-01-01

The risk and cost of a bearing restoration by grinding program was analyzed. A microeconomic impact analysis was performed. The annual cost savings to U.S. Army aviation is approximately $950,000.00 for three engines and three transmissions. The capital value over an indefinite life is approximately ten million dollars. The annual cost savings for U.S. Air Force engines are approximately $313,000.00 with a capital value of approximately 3.1 million dollars.

Triangular arbitrage as an interaction among foreign exchange rates

NASA Astrophysics Data System (ADS)

Aiba, Yukihiro; Hatano, Naomichi; Takayasu, Hideki; Marumo, Kouhei; Shimizu, Tokiko

2002-07-01

We first show that there are in fact triangular arbitrage opportunities in the spot foreign exchange markets, analyzing the time dependence of the yen-dollar rate, the dollar-euro rate and the yen-euro rate. Next, we propose a model of foreign exchange rates with an interaction. The model includes effects of triangular arbitrage transactions as an interaction among three rates. The model explains the actual data of the multiple foreign exchange rates well.

An innovative program to fund health-oriented student projects and research.

PubMed

Bybee, Ronald F; Thompson, Sharon E

2004-01-01

The price of a university education has increased over the years. As a result, students often graduate with thousands of dollars of debt. Conducting research or developing class projects that require personal expenditures can be overwhelming, if not impossible. Participation in research and in developing projects can enhance a student's educational experience. In an effort to address cost issues and provide an optimal learning experience for all students through participation in projects and research, the College of Health Sciences at the University of Texas at El Paso (UTEP) collaborated with a regional foundation to fund health-oriented students' projects and research. Approximately 100 projects have been funded in amounts from 200 dollars to 10,000 dollars at UTEP. Similar programs can be replicated at other US universities. Establishing a general fund and identifying contributors may be a viable option, although finding a foundation or agency to fund the project poses a challenge.

Managing moral hazard in motor vehicle accident insurance claims.

PubMed

Ebrahim, Shanil; Busse, Jason W; Guyatt, Gordon H; Birch, Stephen

2013-05-01

Motor vehicle accident (MVA) insurance in Canada is based primarily on two different compensation systems: (i) no-fault, in which policyholders are unable to seek recovery for losses caused by other parties (unless they have specified dollar or verbal thresholds) and (ii) tort, in which policyholders may seek general damages. As insurance companies pay for MVA-related health care costs, excess use of health care services may occur as a result of consumers' (accident victims) and/or producers' (health care providers) behavior - often referred to as the moral hazard of insurance. In the United States, moral hazard is greater for low dollar threshold no-fault insurance compared with tort systems. In Canada, high dollar threshold or pure no-fault versus tort systems are associated with faster patient recovery and reduced MVA claims. These findings suggest that high threshold no-fault or pure no-fault compensation systems may be associated with improved outcomes for patients and reduced moral hazard.

Lost Dollars Threaten Research in Public Academic Health Centers.

PubMed

Bourne, Henry R; Vermillion, Eric B

2017-03-01

The decrease of federal and state support threatens long-term sustainability of research in publicly supported academic health centers. In weathering these financial threats, research at the University of California, San Francisco (UCSF), has undergone 3 substantial changes: institutional salary support goes preferentially to senior faculty, whereas the young increasingly depend on grants; private and government support for research grows apace in clinical departments but declines in basic science departments; and research is judged more on its quantity (numbers of investigators and federal and private dollars) than on its goals, achievements, or scientific quality. We propose specific measures to alleviate these problems. Other large public academic health centers probably confront similar issues, but-except for UCSF-such centers have not been subjected to detailed public analysis.-Bourne, H. R., Vermillion, E. B. Lost dollars threaten research in public academic health centers. © FASEB.

Implementation of Strategies to Leverage Public and Private Resources for National Security Workforce Development

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

None

2009-04-01

This report documents implementation strategies to leverage public and private resources for the development of an adequate national security workforce as part of the National Security Preparedness Project (NSPP), being performed under a U.S. Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant. There are numerous efforts across the United States to develop a properly skilled and trained national security workforce. Some of these efforts are the result of the leveraging of public and private dollars. As budget dollars decrease and the demand for a properly skilled and trained national security workforce increases, it will become even more important tomore » leverage every education and training dollar. This report details some of the efforts that have been implemented to leverage public and private resources, as well as implementation strategies to further leverage public and private resources.« less

Exponentially damped Lévy flights, multiscaling, and exchange rates

NASA Astrophysics Data System (ADS)

Matsushita, Raul; Gleria, Iram; Figueiredo, Annibal; Rathie, Pushpa; Da Silva, Sergio

2004-02-01

We employ our previously suggested exponentially damped Lévy flight (Physica A 326 (2003) 544) to study the multiscaling properties of 30 daily exchange rates against the US dollar together with a fictitious euro-dollar rate (Physica A 286 (2000) 353). Though multiscaling is not theoretically seen in either stable Lévy processes or abruptly truncated Lévy flights, it is even characteristic of smoothly truncated Lévy flights (Phys. Lett. A 266 (2000) 282; Eur. Phys. J. B 4 (1998) 143). We have already defined a class of “quasi-stable” processes in connection with the finding that single scaling is pervasive among the dollar price of foreign currencies (Physica A 323 (2003) 601). Here we show that the same goes as far as multiscaling is concerned. Our novel findings incidentally reinforce the case for real-world relevance of the Lévy flights for modeling financial prices.

Unaffordable or cost-effective?: introducing an emergency referral system in rural Niger.

PubMed

Bossyns, Paul; Abache, Ranaou; Abdoulaye, Mahaman Sani; Lerberghe, Wim Van

2005-09-01

An important investment was made in two health districts in Niger to organize an emergency referral system. This study estimates its impact and cost-effectiveness in relation with external determinants. After installing a solar radio network in the health centres, emergency calls and related data were monitored over 7 years and investment and recurrent costs for the system were estimated. The number of emergency calls increased significantly in both districts. In 2003, the total yearly cost for the district amounted to US dollars 14,147, the cost per useful and successful call was US dollars 49 and the cost per inhabitant and per year was about US dollars 0.06. The impressive and immediate impact on the health system, the relatively low recurrent cost and the minimal management requirements for the health service make the investment very worthwhile. Organizing emergency evacuation systems should be a priority for any health district in the world.

Reaching the hard to reach: innovative housing for homeless youth through strategic partnerships.

PubMed

Van Leeuwen, Jamie

2004-01-01

This article features three housing programs designed to target the needs of youth aging out of child welfare. One program combines housing and treatment to move substance-dependent youth off the streets; one combines the resources of Urban Peak, the only licensed homeless and runaway youth shelter in Colorado, with the Denver Department of Human Services to prevent youth in child welfare from discharging to the streets; and one addresses the intense mental health needs of this population. It costs Colorado 53,655 dollars to place a young person in youth corrections for one year and 53,527 dollars for residential treatment. It costs Urban Peak 5378 dollars to move a young person off of the streets. This article describes how data have driven program development and discusses how policy implications and relationships with the public and private sector can leverage additional resources.

Update on inflation of journal prices: medical journals, U.S. journals, and Brandon/Hill list journals.

PubMed Central

Kronenfeld, M R; Gable, S H

1989-01-01

This paper examines the increases in prices for the last twenty years for the journals listed in the 1987 Brandon/Hill list and for the last twelve years for those on a list of medical and general periodicals published annually in Library Journal. This information is compared to the general U.S. inflation rate as measured by the Consumer Price Index. Despite the decline in the general rate of inflation, the buying power of libraries has continued to dwindle. Librarians need to use this information when justifying increased budget requests. They also need to interact more effectively with publishers to resolve this problem. The buying power of the dollar (as compared to the 1975 dollar) spent on the Brandon/Hill list journals is now 59% of that of a dollar spent in the general economy. This compares to 64% in 1983, when this research was last updated. PMID:2720211

Cost of curative pediatric services in a public sector setting.

PubMed

Krishnan, Anand; Arora, Narendra K; Pandav, Chandrakant S; Kapoor, Suresh K

2005-08-01

To estimate the cost of ambulatory (out-patient) and in-patient pediatric health services for the year 1999 provided by All India Institute of Medical Sciences (AIIMS) at all the three levels-primary, secondary and tertiary level. The costing module developed by Children's Vaccines Initiative (CVI) was used. This rapid assessment tool focuses on collection of data at macro level by using key informants like doctors, nursing staff, accountant, store keeper, engineer etc. Cost per beneficiary was estimated separately for in-patients and out-patients and was calculated by dividing the total cost of the services by the number of beneficiaries for the year 1999. For the out-patient, the beneficiaries were the total out-patient attendees and for the in-patient, it was the total pediatric admissions multiplied by mean duration of stay in days. The cost per out-patient visit was INR.20.2 (US0.44 dollars@1US dollars=INR.46) at primary level, higher than INR14.5 (US0.31 dollars) at the secondary level, while at tertiary level it was INR 33.8 (US 0.73 dollars). At the primary and secondary level, non-physician cost was more than the physician cost, and for tertiary level, physician cost was much higher than the other costs. There were no in-patient services at primary level. The cost of in-patient services at secondary level was estimated as INR 419.30 (US 9.1 dollars) per patient per day with a bed occupancy rate of 60%. Two-fifths of the cost was due to nursing and other supportive staff and one fifth due to the doctor costs and overhead costs. The unit cost of INR 928 (US 20.2 dollars) per patient per day incurred at AIIMS with a bed occupancy rate of 100% was almost twice that of secondary level. In contrast to the secondary level, almost half the total costs at tertiary level was due to the doctors costs. Effective use of resources at lower level of care especially ambulatory care at primary level and inpatient care at secondary level can result in much higher savings for the system and also, the society. These would need to be appropriately strengthened.

Urologic diseases in America Project: analytical methods and principal findings.

PubMed

Litwin, Mark S; Saigal, Christopher S; Yano, Elizabeth M; Avila, Chantal; Geschwind, Sandy A; Hanley, Jan M; Joyce, Geoffrey F; Madison, Rodger; Pace, Jennifer; Polich, Suzanne M; Wang, Mingming

2005-03-01

The burden of urological diseases on the American public is immense in human and financial terms but it has been under studied. We undertook a project, Urologic Diseases in America, to quantify the burden of urological diseases on the American public. We identified public and private data sources that contain population based data on resource utilization by patients with benign and malignant urological conditions. Sources included the Centers for Medicare and Medicaid Services, National Center for Health Statistics, Medical Expenditure Panel Survey, National Health and Nutrition Examination Survey, Department of Veterans Affairs, National Association of Children's Hospitals and Related Institutions, and private data sets maintained by MarketScan Health and Productivity Management (MarketScan, Chichester, United Kingdom), Ingenix (Ingenix, Salt Lake City, Utah) and Center for Health Care Policy and Evaluation. Using diagnosis and procedure codes we described trends in the utilization of urological services. In 2000 urinary tract infections accounted for more than 6.8 million office visits and 1.3 million emergency room visits, and 245,000 hospitalizations in women with an annual cost of more than 2.4 billion dollars. Urinary tract infections accounted for more than 1.4 million office visits, 424,000 emergency room visits and 121,000 hospitalizations in men with an annual cost of more than 1 billion dollars. Benign prostatic hyperplasia was the primary diagnosis in more than 4.4 million office visits, 117,000 emergency room visits and 105,000 hospitalizations, accounting for 1.1 billion dollars in expenditures that year. Urolithiasis was the primary diagnosis for almost 2 million office visits, more than 600,000 emergency room visits, and more than 177,000 hospitalizations, totaling more than 2 billion dollars in annual expenditures. Urinary incontinence in women was the primary cause for more than 1.1 million office visits in 2000 and 452 million dollars in aggregate primary cause for more than 1.1 million office visits in 2000 and 452 million dollars in aggregate annual expenditures. Other manuscripts in this series present further detail for specific urologic conditions. Recent trends in epidemiology, practice patterns, resource utilization and costs for urological diseases have broad implications for quality of health care, access to care and the equitable allocation of scarce resources for clinical care and research.

Strengthening the Emerging American-Indian Partnership in Asia

DTIC Science & Technology

2013-05-01

the world; prior to the financial crisis in 2008, India’s "annual two-way trade more than doubled between 2004- 2008, from just under 30 billion to...India’s trade with ASEAN countries increased from $2 billion dollars to $47 billion dollars.58 Having close financial ties with nations such as...economic shenanigans ; despite China being India’s largest trading partner, the Indian government has been frustrated with Beijing’s dumping activities

The Implications of China’s Economic Statecraft

DTIC Science & Technology

2012-03-19

the U.S. Monetary Policy , Finance and U.S. Treasury Securities Closely tied to the previously discussed issue of the renminbi exchange rate is the...largely because of its exchange rate policy . In order to limit the appreciation of the renminbi against the dollar, China must purchase U.S. dollars...additional 20 years to inch from one-third to one-half.63 Over-reliance on Foreign Trade. Closely related to its currency exchange policy issues, the

Lake Erie Water Level Study. Appendix F. Environmental Effects.

DTIC Science & Technology

1981-07-01

were reevaluated with weight being placed on the most recent data. The wetland area in Pennsylvania was limited to that area on and around Presque Isle ...and East Harbor, Sandusky Bay, Northeast Yacht Club, Mentor Harbor, Presque Isle Bay, Port Dover, and Sturgeon Creek. In Lake Ontario the regulation...valued at close to 4 million dollars (Melski 1973), and the winter ice fishery was valued at 1.1 million dollars. Presque Isle Bay (which is on the

The Necessity for Smart Power: How a SWIFT Kick Hurts

DTIC Science & Technology

2013-03-01

South America. Among other investments, the Chinese are providing subsidized financing to the telecommunication company Huawei , “an opaque...April 03, 2012. http://voices.halabol.com/2012/04/02/dollar%E2%80%99s-authority-rip (accessed March 11, 2013). 14Malcolm Maiden, “ Huawei a Security...Risk By Any Gauge,” Sydney Morning Herald, March 28, 2012, http://www.smh.com.au/business/ huawei -a-security-risk-by-any-gauge-20120327- 1vwnu.html

Making Policy in the Shadow of the Future

DTIC Science & Technology

2010-01-01

dollar would be replaced as the inter- national currency by the euro; the International Monetary Fund’s synthetic blend of curren- cies, known as SDRs...Special Drawing Rights); or even the Chinese renminbi. Indeed, in June 2009, the Chinese Central Bank called for the creation of a new reserve currency ...2006.32 Nor do short-term rates reflect panic on the part of debt holders. The U.S. dollar remains the international reserve currency . The reasons

20th century U.S. mineral prices decline in constant dollars

USGS Publications Warehouse

Sullivan, Daniel E.; Sznopek, John L.; Wagner, Lorie A.

2000-01-01

Price indexes developed by the U.S. Geological Survey (USGS) indicate that the long-term constant dollar price of key U.S. mineral raw materials declined over the last century, even though the need for mineral raw materials increased during the same period. Technologies and reduced production costs have allowed mineral production to remain profitable, while lower priced mineral products from domestic and foreign sources helped fuel growth in other sectors of the economy.

Resource Management Strategy in the French Navy

DTIC Science & Technology

1991-06-01

central question is whether the French Navy will be able to both upgrade an ageing fleet, and man that projected new fleet with qualified personnel...figures are given in French francs and the dollar equivalent, using an exchange rate of 5.5 francs per dollar. In the most general terms, this thesis...hours worked. The other 240 million francs ($43.6 million) includes projected DCN work hours and the cost of outfitting the ship (i.e. radars, guns

2005 Tri-Service Infrastructure Systems Conference and Exhibition. Volume 11, Tracks 13 and 14

DTIC Science & Technology

2005-08-04

Walls ETL 1110-2-563, by John D. Clarkson and Robert C. Patev Belleville Locks & Dam Barge Accident on 6 Jan 05, by John Clarkson Portugues Dam Project...Update, by Alberto Gonzalez, Jim Mangold and Dave Dollar Portugues Dam: RCC Materials Investigation, by Jim Hinds Nonlinear Incremental Thermal Stress...Strain Analysis Portugues Dam, by David Dollar, Ahmed Nisar, Paul Jacob and Charles Logie Seismic Isolation of Mission-Critical Infrastructure to

Florida hospital saves 5.3 M dollars by adopting principles of lean manufacturing.

PubMed

2005-01-01

Florida hospital saves 5.3M dollars by adopting principles of lean manufacturing. Surgery cancellations have been slashed from 13% of cases to less than 3%, while emergency department admissions have increased by 20%. Those are just two of the results of a quality improvement project at Lee Memorial Health System in Fort Myers, FL, that focused on using the principles of lean manufacturing to improve patient flow in the five-hospital system

Bridging the Gulf: A New Paradigm for Emergency Management on America’s Third Border

DTIC Science & Technology

2012-03-01

reconnaissance, engineering assistance and security were critical to the success of the immediate response, but questions were raised on its cost ...billions of dollars of damage. Flooding, too, occurs annually, but no reliable estimates are available of the cost in human lives and property...occur so frequently that they account for hundreds of millions of dollars in damage every year. While not as spectacular, drought can be more harmful

JPRS Report, East Europe.

DTIC Science & Technology

1987-12-22

and scheduled to begin on Saturday, the 26th of this month [September]. 9853/12859 18 POLAND POLITICAL PAP CORRESPONDENT VIEWS POLISH-AMERICAN...that they do not dare to say to their wives. The Yugoslav dollar-mode dream was slightly disrupted as early as 1968, but the final wakeup call came in...Yugoslavia’s morning wakeup , following on a long dollar hangover, is not our topic. Young people as a group are sobering up in their own way: by

Improving healthcare value through clinical community and supply chain collaboration.

PubMed

Ishii, Lisa; Demski, Renee; Ken Lee, K H; Mustafa, Zishan; Frank, Steve; Wolisnky, Jean Paul; Cohen, David; Khanna, Jay; Ammerman, Joshua; Khanuja, Harpal S; Unger, Anthony S; Gould, Lois; Wachter, Patricia Ann; Stearns, Lauren; Werthman, Ronald; Pronovost, Peter

2017-03-01

We hypothesized that integrating supply chain with clinical communities would allow for clinician-led supply cost reduction and improved value in an academic health system. Three clinical communities (spine, joint, blood management) and one clinical community-like physician led team of surgeon stakeholders partnered with the supply chain team on specific supply cost initiatives. The teams reviewed their specific utilization and cost data, and the physicians led consensus-building conversations over a series of team meetings to agree to standard supply utilization. The spine and joint clinical communities each agreed upon a vendor capping model that led to cost savings of $3 million dollars and $1.5 million dollars respectively. The blood management decreased blood product utilization and achieved $1.2 million dollars savings. $5.6 million dollars in savings was achieved by a clinical community-like group of surgeon stakeholders through standardization of sutures and endomechanicals. Physician led clinical teams empowered to lead change achieved substantial supply chain cost savings in an academic health system. The model of combining clinical communities with supply chain offers hope for an effective, practical, and scalable approach to improving value and engaging physicians in other academic health systems. This clinician led model could benefit both private and academic health systems engaging in value optimization efforts. N/A. Copyright © 2016 Elsevier Inc. All rights reserved.

Outcomes of patients in clinical trials with ST-segment elevation myocardial infarction among countries with different gross national incomes.

PubMed

Orlandini, Andrés; Díaz, Rafael; Wojdyla, Daniel; Pieper, Karen; Van de Werf, Frans; Granger, Christopher B; Harrington, Robert A; Boersma, Eric; Califf, Robert M; Armstrong, Paul; White, Harvey; Simes, John; Paolasso, Ernesto

2006-03-01

To evaluate whether there is an association between 30-day mortality in patients with ST-segment elevation myocardial infarction (STEMI) included in clinical trials and country gross national income (GNI). A retrospective analysis of the databases of five randomized trials including 50 310 patients with STEMI (COBALT 7169, GIK-2 2931, HERO-2 17,089, ASSENT-2 17,005, and ASSENT-3 6116 patients) from 53 countries was performed. Countries were divided into three groups according to their GNI based on the World Bank data: low (less than 2900 US dollars), medium (between 2900 US dollars and 9000 US dollars), and high GNI (more than 9000 US dollars per capita). Baseline characteristics, in-hospital management variables, and 30-day outcomes were evaluated. A previously defined logistic regression model was used to adjust for differences in baseline characteristics and to predict mortality. The observed mortality was higher than the predicted mortality in the low (12.1 vs. 11.8%) and in the medium income groups (9.4 vs. 7.9%), whereas it was lower in the high income group (4.9 vs. 5.6%). An inverse relationship between mortality and GNI was observed in STEMI clinical trials. Most of the variability in mortality can be explained by differences in baseline characteristics; however, after adjustment, lower income countries have higher mortality than the expected.

Willingness to pay for cataract surgery in Kathmandu valley.

PubMed

Shrestha, M K; Thakur, J; Gurung, C K; Joshi, A B; Pokhrel, S; Ruit, S

2004-03-01

A cross sectional study was carried out on 78 screened cataract patients of two screening camps in Kathmandu valley, Nepal, to assess the willingness to pay for cataract surgery. A non-probability sampling technique with open ended and close ended questionnaires was used. The average age of patients was 68.8 years. The ratio of men and women was 0.9:1. 42.3% (33) of patients were willing to pay for cataract surgery. Among them 48.5% (16) of people were willing to pay less than dollars 13 and 51.5% (17) were willing to pay more than dollars 13. The mean was dollars 2.3 (SD dollars 15.5) per case. Patients with bilateral cataract were more willing to pay than unilateral cases. Poverty (44.4%, 20) was the main barrier for unwillingness to pay for cataract surgery. Other reasons were the lack of family support (28.9%, 13), lack of knowledge of surgery and belief that it was an unnecessary procedure (15.6%, seven), and waiting for a free surgical service (11.1%, five). This study clearly indicates that although there was awareness of the availability of treatment and services provided within the reach, people are not willing to pay for the surgery and use the facility primarily because of poverty. Hence, to change patients' attitudes, a more holistic approach is needed, keeping in view the cultural, social, and economic background of the society.

Institutional Venture Capital for the Space Industry: Providing Risk Capital for Space Companies that Provide Investor Returns

NASA Astrophysics Data System (ADS)

Moore, Roscoe M., III

2002-01-01

provided by an institution. Those institutions tend to be Banks, Pension Funds, Insurance Funds, Corporations, and other incorporated entities that are obligated to earn a return on their invested capital. These institutions invest in a venture capital firm for the sole purpose of getting their money back with a healthy profit - within a set period of time. The venture capital firm is responsible for investing in and managing companies whose risk and return are higher than other less risky classes of investment. The venture capital firm's primary skill is its ability to manage the high risk of its venture investments while maintaining the high return potential of its venture investments. to businesses for the purpose of providing the above-mentioned Institutions a substantial return on their invested capital. Institutional Venture Capital for the Space Industry cannot be provided to projects or companies whose philosophy or intention is not to increase shareholder equity value within a set time period. efficiently when tied up in companies that intend to spend billions of dollars before the first dollar of revenue is generated. If 2 billion dollars of venture capital is invested in the equity of a Space Company for a minority equity position, then that Space Company must build that minority shareholder's equity value to a minimum investment return of 4 to 8 billion dollars. There are not many start-up companies that are able to reach public market equity valuations in the tens of billions of dollars within reasonable time horizons. Foundations, Manufacturers, and Strategic Investors can invest in projects that cannot realistically provide a substantial return on their equity to their investors within a reasonable period (5-7 years) of time. Venture Capitalists have to make money. Venture capitalists have made money on Satellite Television, Satellite Radio, Fixed Satellite Services, and other businesses. Venture capitalists have not made money on stand-alone aerospace projects that must create new markets to generate revenue.

Oral decontamination is cost-saving in the prevention of ventilator-associated pneumonia in intensive care units.

PubMed

van Nieuwenhoven, Christianne A; Buskens, Erik; Bergmans, Dennis C; van Tiel, Frank H; Ramsay, Graham; Bonten, Marc J M

2004-01-01

Although the development of ventilator-associated pneumonia (VAP) is assumed to increase costs of intensive care unit stay, it is unknown whether prevention of VAP by means of oropharyngeal decontamination is cost-effective. Because of wide ranges of individual patient costs, crude cost comparisons did not show significant cost reductions. Based on actual cost data of 181 individual patients included in a former randomized clinical trial, cost-effectiveness of prevention of VAP was determined using a decision model and univariate sensitivity analyses, and bootstrapping was used to assess the impact of variability in the various outcomes. Published data on prevention of VAP by oropharyngeal decontamination, which resulted in a relative risk for VAP of 0.45, with a baseline rate of VAP of 29% among control patients. The mean costs of the intervention were 351 dollars per patient (32 dollars per patient per day). All other costs were derived from the hospital administrative database for all individual patients. Prevention of VAP led to mean total costs of 16,119 dollars and 18,268 dollars for patients without preventive measures administered. Thus, costs were saved and instances of VAP were prevented. Similar results were observed in terms of overall survival. Prevention of VAP remains cost-saving if the relative risk for VAP because of intervention is <0.923, the costs of the intervention are less than 2,500 dollars, and the prevalence of VAP without intervention is >4%. Bootstrapping confirmed that, with about 80% certainty, oropharyngeal decontamination results in prevention of VAP and simultaneously saves costs. In terms of a survival benefit, the results are less evident; the results indicate that with only about 60% certainty can we confirm that oropharyngeal decontamination would result in a survival benefit and simultaneously save costs. This study provides strong evidence that prevention of VAP by means of oropharyngeal decontamination is cost-effective.

Retrospective cost-effectiveness analyses for polio vaccination in the United States.

PubMed

Thompson, Kimberly M; Tebbens, Radboud J Duintjer

2006-12-01

The history of polio vaccination in the United States spans 50 years and includes different phases of the disease, multiple vaccines, and a sustained significant commitment of resources. We estimated cost-effectiveness ratios and assessed the net benefits of polio vaccination applicable at various points in time from the societal perspective and we discounted these back to appropriate points in time. We reconstructed vaccine price data from available sources and used these to retrospectively estimate the total costs of the U.S. historical polio vaccination strategies (all costs reported in year 2002 dollars). We estimate that the United States invested approximately US dollars 35 billion (1955 net present value, discount rate of 3%) in polio vaccines between 1955 and 2005 and will invest approximately US dollars 1.4 billion (1955 net present value, or US dollars 6.3 billion in 2006 net present value) between 2006 and 2015 assuming a policy of continued use of inactivated poliovirus vaccine (IPV) for routine vaccination. The historical and future investments translate into over 1.7 billion vaccinations that prevent approximately 1.1 million cases of paralytic polio and over 160,000 deaths (1955 net present values of approximately 480,000 cases and 73,000 deaths). Due to treatment cost savings, the investment implies net benefits of approximately US dollars 180 billion (1955 net present value), even without incorporating the intangible costs of suffering and death and of averted fear. Retrospectively, the U.S. investment in polio vaccination represents a highly valuable, cost-saving public health program. Observed changes in the cost-effectiveness ratio estimates over time suggest the need for living economic models for interventions that appropriately change with time. This article also demonstrates that estimates of cost-effectiveness ratios at any single time point may fail to adequately consider the context of the investment made to date and the importance of population and other dynamics, and shows the importance of dynamic modeling.

Cost effectiveness of intensive care in a low resource setting: A prospective cohort of medical critically ill patients

PubMed Central

Cubro, Hajrunisa; Somun-Kapetanovic, Rabija; Thiery, Guillaume; Talmor, Daniel; Gajic, Ognjen

2016-01-01

AIM: To calculate cost effectiveness of the treatment of critically ill patients in a medical intensive care unit (ICU) of a middle income country with limited access to ICU resources. METHODS: A prospective cohort study and economic evaluation of consecutive patients treated in a recently established medical ICU in Sarajevo, Bosnia and Herzegovina. A cost utility analysis of the intensive care of critically ill patients compared to the hospital ward treatment from the perspective of the health care system was subsequently performed. Incremental cost effectiveness was calculated using estimates of ICU vs non-ICU treatment effectiveness based on a formal systematic review of published studies. Decision analytic modeling was used to compare treatment alternatives. Sensitivity analyses of the key model parameters were performed. RESULTS: Out of 148 patients, seventy patients (47.2%) survived to one year after critical illness with a median quality of life index 0.64 [interquartile range(IQR) 0.49-0.76]. Median number of life years gained per patient was 30 (IQR 16-40) or 18 quality adjusted life years (QALYs) (IQR 7-28). The cost of treatment of critically ill patients varied between 1820 dollar and 20109 dollar per hospital survivor and between 100 dollar and 2514 dollar per QALY saved. Mean factors that influenced costs were: Age, diagnostic category, ICU and hospital length of stay and number and type of diagnostic and therapeutic interventions. The incremental cost effectiveness ratio for ICU treatment was estimated at 3254 dollar per QALY corresponding to 35% of per capita GDP or a Very Cost Effective category according to World Health Organization criteria. CONCLUSION: The ICU treatment of critically ill medical patients in a resource poor country is cost effective and compares favorably with other medical interventions. Public health authorities in low and middle income countries should encourage development of critical care services. PMID:27152258

Automatic milking systems, farm size, and milk production.

PubMed

Rotz, C A; Coiner, C U; Soder, K J

2003-12-01

Automatic milking systems (AMS) offer relief from the demanding routine of milking. Although many AMS are in use in Europe and a few are used in the United States, the potential benefit for American farms is uncertain. A farm-simulation model was used to determine the long-term, whole-farm effect of implementing AMS on farm sizes of 30 to 270 cows. Highest farm net return to management and unpaid factors was when AMS were used at maximal milking capacity. Adding stalls to increase milking frequency and possibly increase production generally did not improve net return. Compared with new traditional milking systems, the greatest potential economic benefit was a single-stall AMS on a farm size of 60 cows at a moderate milk production level (8600 kg/cow). On other farm sizes using single-stall type robotic units, losses in annual net return of 0 dollars to 300 dollars/cow were projected, with the greatest losses on larger farms and at high milk production (10,900 kg/cow). Systems with one robot serving multiple stalls provided a greater net return than single-stall systems, and this net return was competitive with traditional parlors for 50- to 130-cow farm sizes. The potential benefit of AMS was improved by 100 dollars/cow per year if the AMS increased production an additional 5%. A 20% reduction in initial equipment cost or doubling milking labor cost also improved annual net return of an AMS by up to 100 dollars/cow. Annual net return was reduced by 110 dollars/cow, though, if the economic life of the AMS was reduced by 3 yr for a more rapid depreciation than that normally used with traditional milking systems. Thus, under current assumptions, the economic return for an AMS was similar to that of new parlor systems on smaller farms when the milking capacity of the AMS was well matched to herd size and milk production level.

Problems with drugs in Croatia.

PubMed

Vrhovac, B

1997-01-01

Croatia has 4.8 million inhabitants, 11,800 physicians, 2000 pharmacists, two now shareholding, pharmaceutical companies (about 6500 employees, total sales of about 350 million US dollars). There are a number of problems due to the war (GNP fell from 3800 to about 1500 US dollars), occupation of 25% of its territory, 0.5 million refugees and lack of resources (139 US dollars/capita for health, about 40 US dollars i.e. 30%!! for drugs)--about three times less than before the aggression. The drug situation is controlled with the help of: (1) donations (approximate value of 600 million US dollars since 1991 from Europe and US), (2) (essential) drug formularies--250 for outpatients, and 580 generic names for various levels of hospital use, (3) special efforts to purchase drugs of good quality at a reasonable price (a kind of tender), (4) control of prescribing (prescriptions, specialists referral) especially by GPs. A new Medicines Act is in preparation and about 1000 generic names are on the market. DRUG EDUCATION: Pharmaca: the Croatian journal of pharmacotherapy has been published since 1962, there are several Drug bulletins (one published since 1975); special chapters on clinical pharmacology in textbooks, translation of three editions of Laurence's textbook with special commentary and adaptation to local needs; ADR spontaneous and intensive monitoring (WHO programme) with a personal feedback to the reporters and regular articles on drug use in a number of periodicals. Data on drug consumption indicates that there is room for improvement of prescribing. There is an enthusiasm for 'vasoactive drugs'--after dipirydamole came oxpentifylline and antimicrobials are always overprescribed. All these problems will hopefully decrease when the war finally stops and when industry (especially tourism) starts being fruitful again. In any case the importance of teaching of pharmacotherapy at the under- and postgraduate level should be recognized. Copyright 1997 by John Wiley & Sons, Ltd.

Out-of-pocket financial burden for low-income families with children: socioeconomic disparities and effects of insurance.

PubMed

Galbraith, Alison A; Wong, Sabrina T; Kim, Sue E; Newacheck, Paul W

2005-12-01

To determine whether socioeconomic disparities exist in the financial burden of out-of-pocket (OOP) health care expenditures for families with children, and whether health insurance coverage decreases financial burden for low-income families. The Household Component of the 2001 Medical Expenditure Panel Survey. Cross-sectional family-level analysis. We used bivariate statistics to examine whether financial burden varied by poverty level. Multivariate regression models were used to assess whether family insurance coverage was associated with level of financial burden for low-income families. The main outcome was financial burden, defined as the proportion of family income spent on OOP health care expenditures, including premiums, for all family members. We aggregated annual OOP expenditures for all members of 4,531 families with a child <18 years old. Family insurance coverage was categorized as follows: (1) all members publicly insured all year, (2) all members privately insured all year, (3) all members uninsured all year, (4) partial coverage, or (5) mix of public and private with no uninsured periods. A regressive gradient was noted for financial burden across income groups, with families with incomes <100 percent of the Federal Poverty Level (FPL) spending a mean of 119.66 US dollars OOP per 1,000 US dollars of family income and families with incomes 100-199 percent FPL spending 66.30 US dollars OOP per 1,000 US dollars, compared with 37.75 US dollars for families with incomes >400 percent FPL. For low-income families (<200 percent FPL), there was a 785 percent decrease in financial burden for those with full-year public coverage compared with those with full-year private insurance (p < .001). Socioeconomic disparities exist in the financial burden of OOP health care expenditures for families with children. For low-income families, full-year public coverage provides significantly greater protection from financial burden than full-year private coverage.

Strategy and your stronger hand.

PubMed

Moore, Geoffrey A

2005-12-01

There are two kinds of businesses in the world, says the author. Knowing what they are--and which one your company is--will guide you to the right strategic moves. One kind includes businesses that compete on a complex-systems model. These companies have large enterprises as their primary customers. They seek to grow a customer base in the thousands, with no more than a handful of transactions per customer per year (indeed, in some years there may be none), and the average price per transaction ranges from six to seven figures. In this model, 1,000 enterprises each paying dollar 1 million per year would generate dollar 1 billion in annual revenue. The other kind of business competes on a volume-operations model. Here, vendors seek to acquire millions of customers, with tens or even hundreds of transactions per customer per year, at an average price of relatively few dollars per transaction. Under this model, it would take 10 million customers each spending dollar 8 per month to generate nearly dollar 1 billion in revenue. An examination of both models shows that they could not be further apart in their approach to every step along the classic value chain. The problem, though, is that companies in one camp often attempt to create new value by venturing into the other. In doing so, they fail to realize how their managerial habits have been shaped by the model they've grown up with. By analogy, they have a "handedness"--the equivalent of a person's right- or left-hand dominance--that makes them as adroit in one mode as they are awkward in the other. Unless you are in an industry whose structure forces you to attempt ambidexterity (in which case, special efforts are required to manage the inevitable dropped balls), you'll be far more successful making moves that favor your stronger hand.

Cost-effectiveness of the implantable cardioverter defibrillator: a review of current evidence.

PubMed

Lynd, Larry D; O'Brien, Bernie J

2003-09-01

Implantable cardioverter defibrillator (ICD) therapy is indicated for patients at risk for sudden cardiac death (SCD) due to ventricular tachycardia (VT) or ventricular fibrillation (VF). The high relative cost of therapy with the ICD versus antiarrhythmic drugs has raised questions regarding its cost-effectiveness. To address these questions, we review the literature on ICD cost-effectiveness. MEDLINE and other databases were searched for articles published since 1980 reporting original data on the cost-effectiveness of ICD versus drug therapy for patients at risk for SCD. Data on costs and life-years were abstracted and studies grouped into decision analysis models and trial-based analyses. Cost-effectiveness ratios were inflated to 2002 US dollars. Thirteen economic studies were included in this review: 6 decision-analytic models, 4 economic analysis alongside randomized controlled trials, and 1 observational study. Two additional studies evaluated the cost-effectiveness of ICDs stratified by mortality risk. Studies varied in time horizon, and in all but one study ICD therapy was more costly than drug therapy. Early models assumed larger survival benefits than were observed in subsequent trials; therefore, ICDs appeared to be more cost-effective (i.e., US dollars 28000-US dollars 60000 per life-year gained). Three large clinical trial-based studies estimated that the cost per life-year gained was between US dollars 30181 and US dollars 185000. Stratified analyses show that patients at higher risk for mortality due to structural heart disease (e.g., left ventricular ejection fraction <35%) benefit more from ICD therapy, resulting in lower cost-effectiveness ratios. ICD therapy continues to evolve with changing methods of implantation and improving technology. Current evidence suggests that ICDs may be a cost-effective option in patients at high risk for VT/VF. The cost-effectiveness of ICD therapy for primary and secondary prevention of SCD depends upon patient characteristics that influence their prior risk of mortality. Further research on patient selection criteria and the measurement of health-related quality of life is required.

Type 2 diabetes in children: oxymoron or medical metamorphosis?

PubMed

Copeland, Kenneth C; Chalmers, Laura J; Brown, Ryan D

2005-09-01

The full public health effects of the new epidemic of obesity and diabetes in children and adolescents may not be known for many years but are certain to be substantial. Diagnosed diabetes, which is present in only 4.2% of the US population, along with its consequences, already represents approximately 19% of the total personal healthcare expenditures in this country. Between 1997 and 2002, the estimated direct medical cost of diabetes increased from 44 billion dollars to 92 billion dollars, a staggering increase of 8 billion dollars a year. In 2002, diabetes annual costs per capita rose by more than 30% to 13,243 dollars per person, compared with the average annual health care costs for persons without diabetes of 2560.92 dollars. An estimate from the CDC indicates that approximately one-third of children born in 2000 will develop diabetes at some time in their life, and nearly one-half of all Hispanic children born in 2000 will develop diabetes. As type 2 diabetes is being diagnosed at an earlier age, more young people can expect to live many more years with diabetes and its complications, adding even further to this already enormous health burden. An appropriate starting place is recognition of the magnitude of the problem by physicians, politicians, public health policy makers, and other healthcare workers. An aggressive approach to management of diabetes must begin well before the appearance of cardiovascular, eye, renal, and other complications of diabetes appear, and even before obesity leads to diabetes. Currently, physicians and other healthcare workers are poorly reimbursed for management of obesity, for diabetes education, and for ongoing telephone contact with diabetic patients and families, essential for optimal diabetes management. National policies and priorities must be readjusted to emphasize prevention, rather than crisis management, if we are to avoid a catastrophic public health crisis within the next several decades.

Medicare, Medicaid fraud a billion-dollar art form in the US

PubMed Central

Korcok, M

1997-01-01

Medicare and Medicaid fraud costs billions of dollars each year in the US. Investigators have shown that fraud is found in all segments of the health care system. Even though the Canadian system has stricter regulations and tighter controls, can regulators here afford to be complacent about believing that such abuse would not happen here? One province has established an antifraud unit to monitor its health insurance scheme; it already has 1 prosecution under its belt. PMID:9141996

The CRISPR Conundrum: As Millions of Dollars Flow into Developing the Gene-Editing Tool, Scientists Continue to Discover the Technology's Potential and Pitfalls.

PubMed

Bates, Mary

2016-01-01

We are in the midst of a CRISPR craze. The last five years have seen the publication of over 1,000 scientific papers, the allocation of millions of research dollars, and the establishment of four start-up companies in the United States alone. Internationally, the genome-editing market, fueled by CRISPR technology, is expected to be worth more than US$3,000 million by 2019.

A Sixty-Year Timeline of the Air Force Maui Optical and Supercomputing Site

DTIC Science & Technology

2013-01-01

19.3 million dollar contract to Contraves USA to build the AEOS 3.67-m telescope. Site Management Duffner, 2009 May 1992 The Air Force approves...system. Site Management Oder, undated Dec 18 1996 Contraves completes factory testing of AEOS telescope at its plant in Pennsylvania...States. Dec 13 1991 The Air Force awards a $19.3 million dollar contract to Contraves USA to build the AEOS 3.67-m telescope. May 1992 The Air Force

Scaling analysis on Indian foreign exchange market

NASA Astrophysics Data System (ADS)

Sarkar, A.; Barat, P.

2006-05-01

In this paper, we investigate the scaling behavior of the average daily exchange rate returns of the Indian Rupee against four foreign currencies: namely, US Dollar, Euro, Great Britain Pound and Japanese Yen. The average daily exchange rate return of the Indian Rupee against US Dollar is found to exhibit a persistent scaling behavior and follow Levy stable distribution. On the contrary, the average daily exchange rate returns of the other three foreign currencies do not show persistency or antipersistency and follow Gaussian distribution.

Presentation of the Letter of Offer and Acceptance to Iran for the F-16: A Case Study.

DTIC Science & Technology

1979-06-01

terms of man- power and/or dollars? a. Man-years $ (Contract). b. Man-years $ (In-house). 4. Often it is not possible to attach equivalent dollar...the program, as well as its recent expasion into some sensitive centers of power - iran, Israel, Saudi Arabia, Egypt-have brought arms transfers...tasks are to be performed, and how much money is involved, the LOA is a uniquely powerful document. Yet surprisingly, the first-and only--analysis and

Is Military Disability Compensation Adequate to Offset Civilian Earnings Losses from Service-Connected Disabilities?

DTIC Science & Technology

2012-01-01

Percentage of Total Tinnitus 77,486 9.5 Hearing loss 54,450 6.6 Post-traumatic stress disorder 33,129 4.0 Lumbosacral or cervical strain 30,086 3.7...monthly benefit is a function of the workers’ average indexed monthly earn- ings over his or her work history . In addition, eligibility is conditional...under age 65. SSI benefits are not predicated on work history ; however, SSI benefits are coordinated with SSDI benefits with a dollar-for-dollar offset

Subsidized then scrutinized. Reform will bring billions of dollars to the industry, but it could also deliver added examination of executive pay.

PubMed

Galloro, Vince; Vesely, Rebecca; Zigmond, Jessica

2010-08-16

With more government involvement comes more government attention. That's the lesson about executive pay healthcare CEOs could learn as the reform law and its ramifications settle into place. "It's important for the people who are scraping together the dollars to pay their health insurance premiums to know what luxurious lives these CEOs are leading. They're living in a parallel universe", says U.S. Rep. Jan Schakowsky, left.

US Advanced Freight and Passenger MAGLEV System

NASA Technical Reports Server (NTRS)

Morena, John J.; Danby, Gordon; Powell, James

1996-01-01

Japan and Germany will operate first generation Maglev passenger systems commercially shortly after 2000 A.D. The United States Maglev systems will require sophisticated freight and passenger carrying capability. The U.S. freight market is larger than passenger transport. A proposed advanced freight and passenger Maglev Project in Brevard County Florida is described. Present Maglev systems cost 30 million dollars or more per mile. Described is an advanced third generation Maglev system with technology improvements that will result in a cost of 10 million dollars per mile.

Head Start: Ensuring Dollars Benefit the Children. Hearing before the Subcommittee on Education and Early Childhood Development of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Ninth Congress, First Session (April 5, 2005). Senate Hearing 109-119

ERIC Educational Resources Information Center

US Senate, 2005

2005-01-01

In his opening statement, Senator Lamar Alexander (R-TN), chairman, Subcommittee on Education and Early Childhood Development, stated that one responsibility of Congress is to ensure that taxpayer dollars are being spent for the purposes intended and for the children intended. Between January 2003 and the first months of this year, there were…

Return on investment. What is ROI and how to use it.

PubMed

Cotter, Steve

2014-08-01

Formulated and interpreted correctly, ROI tools and techniques can be very useful for EMS managers when evaluating various competing projects and initiatives within the organization. More so, decision makers and elected bodies responsible for approving the financial support of these initiatives are demanding that they be presented with a more complete picture of the return for any dollars allocated under ever-tightening financial considerations that all organizations face today. ROI can be a powerful tool in supporting your organization when competing for limited dollars.

Low cost solar array project. Experimental process system development unit for producing semiconductor-grade silicon using the silane-to-silicon process

NASA Technical Reports Server (NTRS)

1980-01-01

Technical activities are reported in the design of process, facilities, and equipment for producing silicon at a rate and price comensurate with production goals for low cost solar cell modules. The silane-silicone process has potential for providing high purity poly-silicon on a commercial scale at a price of fourteen dollars per kilogram by 1986, (1980 dollars). Commercial process, economic analysis, process support research and development, and quality control are discussed.

Environmental Assessment of the Reduce Bird Air Strike Hazards (BASH) Along East Tollgate Creek, Buckley Air Force Base, Colorado

DTIC Science & Technology

2011-03-22

Aircraft collisions with birds and other wildlife annually cause millions of dollars in aircraft damage and may result in loss of life and aircraft...collisions with birds and other wildlife annually cause millions of dollars in aircraft damage and may result in loss of life and aircraft. More...Action would support the BASH program and meet the AF goal of reducing the loss of life and of valuable aircraft and other resources. Figure 1-2

Bottling Proliferation of the Uranium Genie: Identifying and Monitoring Clandestine Enrichment Programs

DTIC Science & Technology

2007-04-01

Separation The first method used to enrich uranium on a significant scale was developed by the United States as part of the Manhattan Project during...there does not seem to be a easy way to enrich uranium. It has been over 60 years since the 33 Manhattan Project successfully enriched U-235 to...Proliferation, 91-3. 14 The cost of $5B dollars is adjusted to FY96 dollars. Brookings Institution, “The Costs of the Manhattan Project ,” Global Politics

Minuteman 2020: Maintaining the Operational Army National Guard

DTIC Science & Technology

2013-03-01

billion dollars of that amount taken from the DOD. Furthermore, a budget super committee identified a total of 2.1 trillion dollars in cuts mandated...in the 2011 Budget Control Act. As a condition, if the super committee failed to reach a bi-partisan agreement by 31 December 2012, an additional...terms of the Defense Department…as far as our budget is concerned, as far as our ability to respond to the threats that are out there, it has a big

Unified Airport Pavement Design and Analysis Concepts Workshops Held in Cambridge, Massachusetts on 16-17 July 1991

DTIC Science & Technology

1992-07-01

researcher but have noa been used extensively for airpor pavemen analysis. Finally, thet are wodels that have been devope in otr egb elds tha c be applied...transportation network . Every year, system demands exceed capacity in many area. The capability of our airports to continually accommodate more operations...ability to produce long-lived pavement systems providing mnaximunm benefit - dollar and non-dollar - to the airpor network . This is the cenutr function

The Study of Productivity Measurement and Incentive Methodology (Phase III - Paper Test). Volume 1

DTIC Science & Technology

1986-03-14

possible to measure explicitly, in terms of dollars the profit impacts of these uncontrollable as well as controllable factors and to de - termine and...the rate of engineering changes increases. • Production processes arc be- coming less reliant on direct la - bor as the primary factor in pro...MFPMM makes it •: —.sibie to measure explicitly, in terms of dollars the profit impacts of these uncontrollable as well as controllable factors and to de

FY 1990/FY 1991 Biennial Budget Descriptive Summaries for the Strategic Defense Initiative Organization

DTIC Science & Technology

1989-01-01

size, weight , power consumption, and radiation hardness, and on software algorithm validity and efficiency. 3. (U) Collection of radar, ctical, and...which have potential to achieve cooling requirements for LWIR sensors with far smaller weight and power penalties. (U) FY1989 Planned Program: o (U...two dollars for every SDI dollar. o (U) Inverted gaili--n arsenide by growing a razor-thin layer of silicon on GaAs and thus cut power loss by two

Multifractal features in stock and foreign exchange markets

NASA Astrophysics Data System (ADS)

Kim, Kyungsik; Yoon, Seong-Min

2004-03-01

We investigate the tick dynamical behavior of three assets(the yen-dollar exchange rate, the won-dollar exchange rate, and the KOSPI) using the rescaled range analysis in stock and foreign exchange markets. The multifractal Hurst exponents with long-run memory effects can be obtained from assets, and we discuss whether it exists the crossover or not for the Hurst exponents at charateristic time scales. Particularly, we find that the probability distribution of prices is approached to a Lorentz distribution, different from fat-tailed properties.

By Deploying Weapons in Space, Is the United States Opening a Theater of Engagement That Could Disadvantage the United States in the Long Term?

DTIC Science & Technology

2001-06-01

totaled $3.48 million and included research into “power system materials, particle accelerators, platforms and theater defense architecture” (Strategic...Scowcroft, Nye, and Shear 1987, 10). In a minor conflict, destroying a multimillion -dollar satellite could increase tensions. Perry, Scowcroft, Nye and...Gabbard 1998, 40). The reprisal would not be performed because of a loss of a multimillion dollar satellite but to show will. “As the leaders in space power

The cost-effectiveness of iodine 131 scintigraphy, ultrasonography, and fine-needle aspiration biopsy in the initial diagnosis of solitary thyroid nodules.

PubMed

Khalid, Ayesha N; Hollenbeak, Christopher S; Quraishi, Sadeq A; Fan, Chris Y; Stack, Brendan C

2006-03-01

To compare the cost-effectiveness of fine-needle aspiration biopsy, iodine 131 scintigraphy, and ultrasonography for the initial diagnostic workup of a solitary palpable thyroid nodule. A deterministic cost-effectiveness analysis was conducted using a decision tree to model the diagnostic strategies. A single, mid-Atlantic academic medical center. Expected costs, expected number of cases correctly diagnosed, and incremental cost per additional case correctly diagnosed. Relative to the routine use of fine-needle aspiration biopsy, the incremental cost per case correctly diagnosed is 24,554 dollars for the iodine 131 scintigraphy strategy and 1212 dollars for the ultrasound strategy. A diagnostic strategy using initial fine-needle aspiration biopsy for palpable thyroid nodules was found to be cost-effective compared with the other approaches as long as a payor's willingness to pay for an additional correct diagnosis is less than 1212 dollars. Prospective studies are needed to validate these finding in clinical practice.

Projection display market trends

NASA Astrophysics Data System (ADS)

Mentley, David E.

1997-05-01

The projection display industry is now a multi-billion dollar market comprising an expanding variety of technologies and applications. Growth is being driven by a combination of high volume consumer products and high value business demand. After many years of marginal, but steady performance improvements, essentially all types of projectors have crossed the threshold of acceptability and are now facing accelerated continuing growth. Overall worldwide unit sales of all types of projection displays for all applications will nearly double from 1.6 million units in 1996 to 2.8 million units in 2002. By value at the end user price, the global projector market will grow modestly from 6.3 billion dollars in 1996 to 7.7 billion dollars in 2002. Consumer television will represent the largest share of unit consumption over this time period; in 1996, this application represents 72 percent of the total unit volume. The second major application category for projection displays is the business or presentation projector, representing only 14 percent of the unit shipment total in 1996, but 50 percent of the value.

Formulary decision-making about cephalosporins with similar therapeutic uses.

PubMed

Mabe, Don M

2003-05-15

The various costs and intangible factors that enter into formulary decisions in an era of increasingly frequent drug product shortages that can adversely affect patient care and increase treatment costs are described. Pharmacy administration at Carolinas HealthCare System analyzed the costs associated with making a formulary switch from the third-generation cephalosporin ceftriaxone to cefotaxime, which recently became available in generic form and has a similar spectrum of antimicrobial activity and therapeutic uses. Hard dollar costs for purchasing drugs and the supplies needed to administer them; soft dollar costs for staff time spent acquiring, preparing, and administering doses; and intangible factors were considered. A reliable supply of drug product from the manufacturer was an important intangible factor because of frequent drug shortages in the past few years and the adverse effect on patient care and the increased soft dollar costs associated with these shortages. Administrators at Carolinas HealthCare System decided not to make the proposed formulary change after weighing the many factors and costs.

Innovation in the pharmaceutical industry: New estimates of R&D costs.

PubMed

DiMasi, Joseph A; Grabowski, Henry G; Hansen, Ronald W

2016-05-01

The research and development costs of 106 randomly selected new drugs were obtained from a survey of 10 pharmaceutical firms. These data were used to estimate the average pre-tax cost of new drug and biologics development. The costs of compounds abandoned during testing were linked to the costs of compounds that obtained marketing approval. The estimated average out-of-pocket cost per approved new compound is $1395 million (2013 dollars). Capitalizing out-of-pocket costs to the point of marketing approval at a real discount rate of 10.5% yields a total pre-approval cost estimate of $2558 million (2013 dollars). When compared to the results of the previous study in this series, total capitalized costs were shown to have increased at an annual rate of 8.5% above general price inflation. Adding an estimate of post-approval R&D costs increases the cost estimate to $2870 million (2013 dollars). Copyright © 2016 Elsevier B.V. All rights reserved.

Enhanced situational technologies applied to ship channels

NASA Astrophysics Data System (ADS)

Helgeson, Michael A.; Wacker, Roger A.

1997-06-01

The Houston Ship Channel ranks as America's number one port in foreign tonnage by welcoming more than 50,000 cargo ships and barges annually. Locally 196,000 jobs, 5.5 billion dollars in business revenue and 213 million dollars in taxes are generated. Unfortunately, 32 days of each year vessel traffic stops for hours due to fog causing an estimated 40- 100 million dollars loss as ships idly wait in the channel for weather to clear. In addition, poor visibility has contributed to past vessel collisions which have resulted in channel closure, and associated damage to property and the environment. Today's imaging technology for synthetic vision systems and enhanced situational awareness systems offers a new solution to this problem. Whereas, typically these systems have been targeted at aircraft landing systems the channel navigation application provides a peripheral ground based market. This paper describes two imaging solutions to the problem. One using an active 35 GHz scanning radar and the other using a 94 GHz passive millimeter wave camera.

The impact of New York City's 1975 fiscal crisis on the tuberculosis, HIV, and homicide syndemic.

PubMed

Freudenberg, Nicholas; Fahs, Marianne; Galea, Sandro; Greenberg, Andrew

2006-03-01

In 1975, New York City experienced a fiscal crisis rooted in long-term political and economic changes in the city. Budget and policy decisions designed to alleviate this fiscal crisis contributed to the subsequent epidemics of tuberculosis, human immunodeficiency virus (HIV) infection, and homicide in New York City. Because these conditions share underlying social determinants, we consider them a syndemic, i.e., all 3 combined to create an excess disease burden on the population. Cuts in services; the dismantling of health, public safety, and social service infrastructures; and the deterioration of living conditions for vulnerable populations contributed to the amplification of these health conditions over 2 decades. We estimate that the costs incurred in controlling these epidemics exceeded 50 billion US dollars (in 2004 dollars); in contrast, the overall budgetary saving during the fiscal crisis was 10 billion US dollars. This history has implications for public health professionals who must respond to current perceptions of local fiscal crises.

Shaping the future of the international satellite organizations

NASA Astrophysics Data System (ADS)

Wright, David

Most of the world's satellite communications traffic is carried by three organizations - Intelsat, Inmarsat, and Eutelsat. These three organizations are at the heart of the multibillion dollar communications satellite industry. The international satellite organizations (ISOs) generate hundreds of millions of dollars in revenue each year. They have purchased billions of dollars worth of satellites. Manufacturers have earned more billions from the sale of earth stations and the launchers used to put the satellites into orbit. The ISOs are at the leading edge of satellite technology in one of the fastest growing sectors in one of the world's fastest growing industries. The structure of the ISOs at the heart of this huge and rapidly growing industry is now under serious review. Changes in their institutional structure could ripple far beyond the organizations themselves. This paper reviews the existing structure of the ISOs, the pressures for structural change, and some of the consequences likely to result from change. Although all three ISOs are considered, most emphasis has been placed on Inmarsat.

Effects of tunnel and station size on the costs and service of subway transit systems

NASA Technical Reports Server (NTRS)

Dayman, B., Jr.

1979-01-01

The feasibility of less spacious, less costly underground rail mass transit system designs is studied. The major cost saving expected from alternative tunnel designs results from using precast concrete segment liners in place of steel. The saying expected for a two-foot decrease in the diameter of twin, single track tunnels is about two million dollars per route mile from 13 million dollars for precast concrete segment liners (a saving of about 16%). The cost per route-mile of a double track tunnel appears to be 15 to 25% higher than for the twin, single track tunnels. The effective cost saving expected from stations with four-car train capability instead of the usual eight-car trains is nearly 25% or seven million dollars per route mile. The saving in station costs can be obtained while improving service to the user (lower transit time and less waiting for trains) up to a capacity of 36,000 riders per hour in each direction.

Cost-effectiveness of hospital pay-for-performance incentives.

PubMed

Nahra, Tammie A; Reiter, Kristin L; Hirth, Richard A; Shermer, Janet E; Wheeler, John R C

2006-02-01

One increasingly popular mechanism for stimulating quality improvements is pay-for-performance, or incentive, programs. This article examines the cost-effectiveness of a hospital incentive system for heart-related care, using a principal-agent model, where the insurer is the principal and hospitals are the agents. Four-year incentive system costsfor the payer were dollar 22,059,383, composed primarily of payments to the participating hospitals, with approximately 5 percent in administrative costs. Effectiveness is measured in stages, beginning with improvements in the processes of heart care. Care process improvements are converted into quality-adjusted life years (QALYs) gained, with reference to literatures on clinical effectiveness and survival. An estimated 24,418 patients received improved care, resulting in a range of QALYs from 733 to 1,701, depending on assumptions about clinical effectiveness. Cost per QALY was found to be between dollar 12,967 and dollar 30,081, a level well under consensus measures of the value of a QALY.

Should the implantable cardiac defibrillator be used for primary prevention of sudden death? A review of the issues relevant to hospital decision making.

PubMed

McGregor, Maurice; Chen, Jun

2004-10-01

New evidence suggests that the implantable cardiac defibrillator (ICD) may be effective for primary prevention of sudden death. High instrumental cost and the potentially large number of candidates will significantly impact hospital budgets. To review the information relevant to hospital policy decisions on the use of ICDs for primary prevention. Modelling based on an evaluation of reported studies and Canadian costs, detailed in a comprehensive review available at . Health outcomes: Two high-quality primary prevention trials suggest a reduction in annual mortality of 2.9% with bounds of probability (PB) of 2.0% to 3.8%, in early years. To undertake 100 implants per year may result in an increasing annual saving of life-years of acceptable quality, stabilizing by 15 years at 110 (PB 72 to 154) each year. Economic impact: The annual costs would stabilize at 15 years at approximately 4.3 million dollars. Cost-effectiveness: The incremental cost-effectiveness from the point of view of the health care system would be approximately 47,000 dollars (PB 35,000 dollars to 70,000 dollars), discounted at 3%. Ethical and legal issues: The decision should not be individual but institutional, using a process that is transparent, consistent and fair. The ICD can prolong life, with acceptable quality. Restriction of its use would be solely on grounds of expense.

Cost-effectiveness of targeted and tailored interventions on colorectal cancer screening use.

PubMed

Lairson, David R; DiCarlo, Melissa; Myers, Ronald E; Wolf, Thomas; Cocroft, James; Sifri, Randa; Rosenthal, Michael; Vernon, Sally W; Wender, Richard

2008-02-15

Colorectal cancer (CRC) screening is cost-effective but underused. The objective of this study was to determine the cost-effectiveness of targeted and tailored behavioral interventions to increase CRC screening use by conducting an economic analysis associated with a randomized trial among patients in a large, racially and ethnically diverse, urban family practice in Philadelphia. The incremental costs per unit increase were measured in individuals who were screened during the 24 months after intervention. Percent increase in screening was adjusted for baseline differences in the study groups. Each intervention arm received a targeted screening invitation letter, stool blood test (SBT) cards, informational booklet, and reminder letter. Tailored interventions incrementally added tailored messages and reminder telephone calls. Program costs of the targeted intervention were 42 dollars per participant. Additional costs of adding tailored print materials and of delivering a reminder telephone call were 150 dollars and 200 dollars per participant, respectively. The cost per additional individual screened was 319 dollars when comparing the no intervention group with the targeted intervention group. The targeted intervention was more effective and less costly than the tailored intervention. Although tailoring plus reminder telephone call was the most effective strategy, it was very costly per additional individual screened. Mailed SBT cards significantly boosted CRC screening use. However, going beyond the targeted intervention to include tailoring or tailoring plus reminder calls in the manner used in this study did not appear to be an economically attractive strategy. Cancer 2008. (c) 2007 American Cancer Society.

Incremental burden of congestive heart failure among elderly with Alzheimer's.

PubMed

Chhatre, Sumedha; Weiner, Mark G; Jayadevappa, Ravishankar; Johnson, Jerry C

2009-07-01

A complex relationship exists between Alzheimer's disease (AD) and other co-existing co-morbidities such as congestive heart failure (CHF) with implications for health resource utilization (HRU) and cost of care. Study objective was to assess HRU and cost of care in elderly with AD and with or without concomitant CHF. All elderly (> or =65 years) from an academic healthcare system diagnosed with AD in 1999 (n = 904) and matched AD-free controls (n = 3616). Each group was subdivided into those with and without a CHF diagnosis. Costs and HRU were obtained from Medicare databases for 1999 and 2000. Costs and HRU were compared using ANOVA and Wilcoxon rank sum tests. Regressions were used to model the effect of AD and CHF on outcomes. Mean annual cost were 20,888 US dollars for AD + CHF group, 5,473 US dollars for only AD group, 17,700 US dollars for only CHF group and 4,578 US dollars for the control group (no-AD and no-CHF). After adjusting for covariates, AD + CHF group had an eight-fold increase in total cost, while only CHF group had five-fold increase in total cost, compared to the control group. Regressions for inpatient costs, outpatient costs and inpatient pharmacy costs exhibited comparable trends. For elderly AD patients, a co-occurring diagnosis of CHF can result in a substantial increase in cost and HRU. This necessitates additional considerations if health care expenditures are to be reduced, particularly inpatient expenditure.

Analysis of cost and assessment of computerized patient record systems in Japan based on questionnaire survey.

PubMed

Zhang, W P; Yamauchi, K; Mizuno, S; Zhang, R; Huang, D M

2004-01-01

The purpose of this study was to clarify the implementation and maintenance costs of a computerized patient record (CPR) system by means of a questionnaire survey. Moreover, the benefits of CPR systems were evaluated to determine their contribution to enhancing the quality of medical care and hospital management. Data were collected by a questionnaire survey mailed out to participants. The per-bed mean cost for implementation was 14,308 dollars (range: 3538-38,077 dollars). The mean annual maintenance cost for the CPR system was 457,615 dollars (range: 39,769-2,307,692 dollars). The multivariate analysis (Hayashi's Quantification Type I) revealed high partial correlation coefficients between implementation cost and the CPR system maker. In addition, the multiple correlation coefficient for four factors (CPR system maker, number of servers, institution type and implementation date) in predicting implementation cost was 0.798. Over 60% of respondents replied that their satisfaction with the CPR system was 'very high' or 'high.' Eighty-two percent of the hospitals responded positively that CPR systems improve the quality of medical care, and 70% felt that the systems help prevent medical errors. Our findings indicate that the maker of CPR system, number of servers, institution type and implementation date had a strong influence on per-bed implementation costs in that order. Finally, it was found that CPR systems were considered effective for hospital administration and medical examinations, based on the high assessments of the results of installing a CPR system.

Efficacy of mosquito netting for sustainable small holders' cabbage production in Africa.

PubMed

Martin, T; Assogba-Komlan, F; Houndete, T; Hougard, J M; Chandre, F

2006-04-01

The efficacy of a mosquito netting to protect cabbages, Brassica oleracea L., against pests was investigated in field trials in Benin, West Africa. A polyester net covered the plants at night by using a wood armature. The net was removed during the day to prevent overheating and excessive shade, both problems of insect-proof screens used under tropical conditions. The number of all lepidopteran larvae with netting protection and foliar insecticide sprays was significantly lower than the unprotected control. The number of diamondback moth, Plutella xylostella (L.), was significantly lower with netting protection compared with foliar insecticide sprays and control. Netting treated with deltamethrin gave total protection of young plants against the aphid Lipaphis erysimi (Kaltenbach). At harvest, the number of marketable cabbages protected with untreated netting was significantly higher compared with the production with foliar insecticide sprays. The protection of cabbages with netting can be an economically viable method. Considering the price of cabbages on local markets (US dollars 1/unit), the net returns per 100 m2 were US dollars 247 by using netting, US dollars 149 by using insecticides, and US dollars 117 for controls. The net returns for using netting are based on replacing the netting each crop cycle. But netting can be reused several times, depending upon conditions, increasing the profit margin. The netting protection may be an alternative to the growing unsustainable practices of vegetable cropping in peri-urban areas of tropical countries.

OMB estimates indicate that 900,000 children will lose health insurance due to reductions in federal SCHIP funding.

PubMed

Park, Edwin; Ku, Leighton; Broaddus, Matthew

2003-01-01

Despite the success of the State Children's Health Insurance Program (SCHIP) in reducing the ranks of uninsured children, the program now faces significant financing challenges. Analysis based on a model developed by the Centers for Medicare and Medicaid Services indicates that by 2007, 20 states will have insufficient federal funding to sustain their current programs, with the first states affected in 2004. As a result, the Office of Management and Budget projected last year that SCHIP enrollment will fall by 900,000 children between 2003 and 2007. The funding shortfalls are the result of several factors. Federal SCHIP funding fell by 26 percent--by more than dollar 1 billion-in each of fiscal years 2002, 2003, and 2004; dollar 1.2 billion in SCHIP funds has already expired and reverted to the Treasury at the end of fiscal year 2002, and another dollar 1.5 billion will expire at the end of 2003. The SCHIP program also has a redistribution system with targeting and timing problems. However, proposed Congressional legislation restoring federal funding, extending the dollar 2.7 billion in expiring funds, and targeting the funds to the states that most need them could avert most, if not all, of the projected enrollment decline. On the other hand, the Bush administration proposed to extend the expiring funds but does not target them to needy states; the proposal will do little to reduce the magnitude of the decline.

Using a claims data-based sentinel system to improve compliance with clinical guidelines: results of a randomized prospective study.

PubMed

Javitt, Jonathan C; Steinberg, Gregory; Locke, Todd; Couch, James B; Jacques, Jeffrey; Juster, Iver; Reisman, Lonny

2005-02-01

To demonstrate the potential effect of deploying a sentinel system that scans administrative claims information and clinical data to detect and mitigate errors in care and deviations from best medical practices. Members (n = 39 462; age range, 12-64 years) of a midwestern managed care plan were randomly assigned to an intervention or a control group. The sentinel system was programmed with more than 1000 decision rules that were capable of generating clinical recommendations. Clinical recommendations triggered for subjects in the intervention group were relayed to treating physicians, and those for the control group were deferred to study end. Nine hundred eight clinical recommendations were issued to the intervention group. Among those in both groups who triggered recommendations, there were 19% fewer hospital admissions in the intervention group compared with the control group (P < .001). Charges among those whose recommendations were communicated were dollar 77.91 per member per month (pmpm) lower and paid claims were dollar 68.08 pmpm lower than among controls compared with the baseline values (P = .003 for both). Paid claims for the entire intervention group (with or without recommendations) were dollar 8.07 pmpm lower than those for the entire control group. In contrast, the intervention cost dollar 1.00 pmpm, suggesting an 8-fold return on investment. Ongoing use of a sentinel system to prompt clinically actionable, patient-specific alerts generated from administratively derived clinical data was associated with a reduction in hospitalization, medical costs, and morbidity.

Cost-effectiveness of treating multidrug-resistant tuberculosis.

PubMed

Resch, Stephen C; Salomon, Joshua A; Murray, Megan; Weinstein, Milton C

2006-07-01

Despite the existence of effective drug treatments, tuberculosis (TB) causes 2 million deaths annually worldwide. Effective treatment is complicated by multidrug-resistant TB (MDR TB) strains that respond only to second-line drugs. We projected the health benefits and cost-effectiveness of using drug susceptibility testing and second-line drugs in a lower-middle-income setting with high levels of MDR TB. We developed a dynamic state-transition model of TB. In a base case analysis, the model was calibrated to approximate the TB epidemic in Peru, a setting with a smear-positive TB incidence of 120 per 100,000 and 4.5% MDR TB among prevalent cases. Secondary analyses considered other settings. The following strategies were evaluated: first-line drugs administered under directly observed therapy (DOTS), locally standardized second-line drugs for previously treated cases (STR1), locally standardized second-line drugs for previously treated cases with test-confirmed MDR TB (STR2), comprehensive drug susceptibility testing and individualized treatment for previously treated cases (ITR1), and comprehensive drug susceptibility testing and individualized treatment for all cases (ITR2). Outcomes were costs per TB death averted and costs per quality-adjusted life year (QALY) gained. We found that strategies incorporating the use of second-line drug regimens following first-line treatment failure were highly cost-effective compared to strategies using first-line drugs only. In our base case, standardized second-line treatment for confirmed MDR TB cases (STR2) had an incremental cost-effectiveness ratio of 720 dollars per QALY (8,700 dollars per averted death) compared to DOTS. Individualized second-line drug treatment for MDR TB following first-line failure (ITR1) provided more benefit at an incremental cost of 990 dollars per QALY (12,000 dollars per averted death) compared to STR2. A more aggressive version of the individualized treatment strategy (ITR2), in which both new and previously treated cases are tested for MDR TB, had an incremental cost-effectiveness ratio of 11,000 dollars per QALY (160,000 dollars per averted death) compared to ITR1. The STR2 and ITR1 strategies remained cost-effective under a wide range of alternative assumptions about treatment costs, effectiveness, MDR TB prevalence, and transmission. Treatment of MDR TB using second-line drugs is highly cost-effective in Peru. In other settings, the attractiveness of strategies using second-line drugs will depend on TB incidence, MDR burden, and the available budget, but simulation results suggest that individualized regimens would be cost-effective in a wide range of situations.

Productivity of Veterans Health Administration laboratories: a College of American Pathologists Laboratory Management Index Program (LMIP) study.

PubMed

Valenstein, Paul N; Wang, Edward; O'Donohue, Tom

2003-12-01

The Veterans Health Administration (VA) operates the largest integrated laboratory network in the United States. To assess whether the unique characteristics of VA laboratories impact efficiency of operations, we compared the productivity of VA and non-VA facilities. Financial and activity data were prospectively collected from 124 VA and 131 non-VA laboratories enrolled in the College of American Pathologists Laboratory Management Index Program (LMIP) during 2002. In addition, secular trends in 5 productivity ratios were calculated for VA and non-VA laboratories enrolled in LMIP from 1997 through 2002. Veterans Health Administration and non-VA facilities did not differ significantly in size. Inpatients accounted for a lower percentage of testing at VA facilities than non-VA facilities (21.7% vs 37.3%; P <.001). Technical staff at the median VA facility were paid more than at non-VA facilities (28.11/h dollars vs 22.60/h dollars, salaries plus benefits; P <.001), VA laboratories employed a smaller percentage of nontechnical staff (30.0% vs 41.9%; P <.001), and workers at VA laboratories worked less time per hour paid (85.5% vs 88.5%; P <.001). However, labor productivity was significantly higher at VA than at non-VA facilities (30 448 test results/total full-time equivalent (FTE)/y vs 19 260 results/total FTE; P <.001), resulting in lower labor expense per on-site test at VA sites than at non-VA sites (1.79 dollars/result vs 2.08 dollars/result; P <.001). Veterans Health Administration laboratories paid less per test for consumables (P =.003), depreciation, and maintenance than their non-VA counterparts (all P <.001), resulting in lower overall cost per on-site test result (2.64 dollars vs 3.40 dollars; P <.001). Cost per referred (sent-out) test did not differ significantly between the 2 groups. Analysis of 6-year trends showed significant increases in both VA (P <.001) and non-VA (P =.02) labor productivity (on-site tests/total FTE). Expenses at VA laboratories for labor per test, consumables per test, overall expense per test, and overall laboratory expense per discharge decreased significantly during the 6-year period (P <.001), while in non-VA facilities the corresponding ratios showed no significant change. Overall productivity of VA laboratories is superior to that of non-VA facilities enrolled in LMIP. The principal advantages enjoyed by the VA are higher-than-average labor productivity (tests/FTE) and lower-than-average consumable expenses.

A Study of the Implementation of Current Cost Accounting in the Republic of Korea Army Procurement Systems.

DTIC Science & Technology

1986-06-01

financial reporting in Republic of Korea Army (ROKA) procurement. A discussion of the nature of the ROKA procurement system and two alternatives to historical cost financial statements are presented. The concepts, methods and procedures of the historical cost/constant dollars financial statements are described. The proposal for current cost/constant dollars financial statements is presented and emphasis is given to the description of four problems in existing ROKA procurement due to using inadequate accounting information. Keywords: Cost accounting, Procurement, Current

The cost of Medicaid annuities.

PubMed

Levy, Robert A; Nyman, John A; Gabay, Mary; Riley, William; Feldman, Roger

2006-01-01

Medicaid annuities are annuities that long-term care recipients use to shelter assets, thereby qualifying them early for Medicaid eligibility. As such, these annuities have the potential to increase Medicaid costs. This study estimates the cost of annuities to the Medicaid program. From a sample of Medicaid applications in five states, we found the rate at which annuities were used and simulated their cost to Medicaid. We estimated that in 2004, Medicaid annuities cost Medicaid about 197 million dollars, which represented a small proportion of Medicaid's almost 50 billion dollars cost for nursing home care.

Drilling fluids: Where should research dollars be spent

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

Sauber

This article discusses the question of where to apply research dollars in the field of drilling fluids which is gravely impacted by environmental concerns. In fact, environmental regulations are the driving force in determining the thrust of drilling fluids research. For example, use of oil-base fluids offshore have, for all practical purposes, been precluded by high disposal costs since offshore disposal has been prohibited. Consequently it must be determined if a water-base mud can be developed that has all or most of the advantages of an oil-base mud.

Under the Dragon’s Wing: A Strategic Approach to China’s Militarization Efforts of its Artificial Islands in the South China Sea

DTIC Science & Technology

2017-06-09

environments elsewhere in the world. When thinking about the SCS, it is helpful to imagine other bodies of water in the world with similar characteristics...Operation Planning. Washington, DC: Government Printing Office. Kazianis, Harry J. 2014. “America’s Dangerous $5 Trillion Dollar Bet in the South China...dollar- bet -the-south-china-10857. Kem, Jack D. 2012. Planning for Action: Campaign Concepts and Tools. Ft. Leavenworth, KS: U.S. Army Command and

Time-series analysis of foreign exchange rates using time-dependent pattern entropy

NASA Astrophysics Data System (ADS)

Ishizaki, Ryuji; Inoue, Masayoshi

2013-08-01

Time-dependent pattern entropy is a method that reduces variations to binary symbolic dynamics and considers the pattern of symbols in a sliding temporal window. We use this method to analyze the instability of daily variations in foreign exchange rates, in particular, the dollar-yen rate. The time-dependent pattern entropy of the dollar-yen rate was found to be high in the following periods: before and after the turning points of the yen from strong to weak or from weak to strong, and the period after the Lehman shock.

Department of Education's Student Loan Programs: Are Tax Dollars at Risk? Hearing before the Subcommittee on Criminal Justice, Drug Policy, and Human Resources of the Committee on Government Reform. House of Representatives, One Hundred Sixth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Government Reform.

This hearing was held to consider whether the student loan programs of the Department of Education place tax dollars at risk. In his opening remarks, Representative John L. Mica (Florida) pointed out that for nearly 10 years, the U.S. General Accounting Office has labeled these programs as a high risk for fraud, waste, abuse, and mismanagement. In…

U.S. Trade and Investment Relationship with Sub-Saharan Africa: The African Growth and Opportunity Act

DTIC Science & Technology

2009-07-24

Africa Domestic Exports, FAS value; Imports for Consumption , Customs Value; Actual U.S. dollars Trade Flow 2007 2008 Jan. – May 2008 Jan. –May 2009 U.S...first part of 2009. However, decreases in U.S. and global consumption are likely to continue to have a negative effect on most exports from the region.39...Table 3. Leading U.S. Imports from Sub-Saharan Africa U.S. Imports for Consumption , Customs Value, Actual U.S. dollars HTS Description 2007 2008

The cost of health professionals' brain drain in Kenya.

PubMed

Kirigia, Joses Muthuri; Gbary, Akpa Raphael; Muthuri, Lenity Kainyu; Nyoni, Jennifer; Seddoh, Anthony

2006-07-17

Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i) to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK) and the United States of America (USA); (ii) to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA); and (iii) to describe other losses from brain drain. The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years) and the age of retirement (62 years) in recipient countries. The total cost of educating a single medical doctor from primary school to university is 65,997 US dollars; and for every doctor who emigrates, a country loses about 517,931 US dollars worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is 43,180 US dollars; and for every nurse that emigrates, a country loses about 338,868 US dollars worth of returns from investment. Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals) from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious circle of ill-health and poverty. Therefore, both developed and developing countries need to urgently develop and implement strategies for addressing the health human resource crisis.

Domestic returns from investment in the control of tuberculosis in other countries.

PubMed

Schwartzman, Kevin; Oxlade, Olivia; Barr, R Graham; Grimard, Franque; Acosta, Ivelisse; Baez, Jeannette; Ferreira, Elizabeth; Melgen, Ricardo Elías; Morose, Willy; Salgado, Arturo Cruz; Jacquet, Vary; Maloney, Susan; Laserson, Kayla; Mendez, Ariel Pablos; Menzies, Dick

2005-09-08

We hypothesized that investments to improve the control of tuberculosis in selected high-incidence countries would prove to be cost saving for the United States by reducing the incidence of the disease among migrants. Using decision analysis, we estimated tuberculosis-related morbidity, mortality, and costs among legal immigrants and refugees, undocumented migrants, and temporary visitors from Mexico after their entry into the United States. We assessed the current strategy of radiographic screening of legal immigrants plus current tuberculosis-control programs alone and with the addition of either U.S.-funded expansion of the strategy of directly observed treatment, short course (DOTS), in Mexico or tuberculin skin testing to screen legal immigrants from Mexico. We also examined tuberculosis-related outcomes among migrants from Haiti and the Dominican Republic using the same three strategies. As compared with the current strategy, expanding the DOTS program in Mexico at a cost to the United States of 34.9 million dollars would result in 2591 fewer cases of tuberculosis in the United States, with 349 fewer deaths from the disease and net discounted savings of 108 million dollars over a 20-year period. Adding tuberculin skin testing to radiographic screening of legal immigrants from Mexico would result in 401 fewer cases of tuberculosis in the United States but would cost an additional 329 million dollars. Expansion of the DOTS program would remain cost saving even if the initial investment were doubled, if the United States paid for all antituberculosis drugs in Mexico, or if the decline in the incidence of tuberculosis in Mexico was less than projected. A 9.4 million dollars investment to expand the DOTS program in Haiti and the Dominican Republic would result in net U.S. savings of 20 million dollars over a 20-year period. U.S.-funded efforts to expand the DOTS program in Mexico, Haiti, and the Dominican Republic could reduce tuberculosis-related morbidity and mortality among migrants to the United States, producing net cost savings for the United States. Copyright 2005 Massachusetts Medical Society.

Financial anatomy of biomedical research.

PubMed

Moses, Hamilton; Dorsey, E Ray; Matheson, David H M; Thier, Samuel O

2005-09-21

Public and private financial support of biomedical research have increased over the past decade. Few comprehensive analyses of the sources and uses of funds are available. This results in inadequate information on which to base investment decisions because not all sources allow equal latitude to explore hypotheses having scientific or clinical importance and creates a barrier to judging the value of research to society. To quantify funding trends from 1994 to 2004 of basic, translational, and clinical biomedical research by principal sponsors based in the United States. Publicly available data were compiled for the federal, state, and local governments; foundations; charities; universities; and industry. Proprietary (by subscription but openly available) databases were used to supplement public sources. Total actual research spending, growth rates, and type of research with inflation adjustment. Biomedical research funding increased from 37.1 billion dollars in 1994 to 94.3 billion dollars in 2003 and doubled when adjusted for inflation. Principal research sponsors in 2003 were industry (57%) and the National Institutes of Health (28%). Relative proportions from all public and private sources did not change. Industry sponsorship of clinical trials increased from 4.0 dollars to 14.2 billion dollars (in real terms) while federal proportions devoted to basic and applied research were unchanged. The United States spent an estimated 5.6% of its total health expenditures on biomedical research, more than any other country, but less than 0.1% for health services research. From an economic perspective, biotechnology and medical device companies were most productive, as measured by new diagnostic and therapeutic devices per dollar of research and development cost. Productivity declined for new pharmaceuticals. Enhancing research productivity and evaluation of benefit are pressing challenges, requiring (1) more effective translation of basic scientific knowledge to clinical application; (2) critical appraisal of rapidly moving scientific areas to guide investment where clinical need is greatest, not only where commercial opportunity is currently perceived; and (3) more specific information about sources and uses of research funds than is generally available to allow informed investment decisions. Responsibility falls on industry, government, and foundations to bring these changes about with a longer-term view of research value.

Randomized controlled trial of a dose consolidation program.

PubMed

Delate, Thomas; Fairman, Kathleen A; Carey, Shelly M; Motheral, Brenda R

2004-01-01

To evaluate the effectiveness and financial impact of a drug dose consolidation (optimization) program using letter intervention. This pilot program in a large, mid-Atlantic health plan utilized a randomized controlled trial research design. A review of adjudicated pharmacy claims records was performed monthly for 3 consecutive months from November 2002 through February 2003 to identify inefficient (i.e., >once-daily) regimens for any one of 68 dosage strengths of 37 single-source maintenance drugs with once-daily dosing recommendations. Prescribers who had prescribed one or more inefficient regimens were identified and randomized to one of the 2 intervention arms or a control arm. Prescribers in both intervention arms were sent personalized letters with information on their patients. inefficient regimens and suggested dose consolidation options. Patients of prescribers in one intervention arm received a complementary, patient-oriented letter. Pharmacy claims for patients in all arms were examined at 180 days after the date of the letter mailing for conversion to an efficient (once-daily) regimen. Financial modeling analysis calculated net savings as changes in pharmacy expenditures minus administrative costs. A total of 2,614 inefficient regimens, representing 6.7% of claims for the targeted medications, were identified. The rate of consolidation to a suggested dosing option was lower for the Physician Letter arm (7.3%) than for the Physician/Member Letter arm (10.2%) (P = 0.046). Both intervention arms had higher consolidation rates than the Control arm (3.9%) (P = 0.018 and P = 0.000, respectively.). Approximately 30% of the regimens in each study arm were never refilled after being targeted. Financial modeling indicated that a dose consolidation intervention could save 0.03 dollars to 0.07 dollars per member per month (PMPM) in 2003 dollars with full medication compliance but only 0.02 dollars to 0.03 dollars PMPM when savings were calculated with realistic, partial compliance rates. Subanalyses performed at the drug therapy class level revealed few opportunities to justify implementing a dose consolidation program. After taking into consideration program administrative costs, high rates of refill discontinuation, and dose consolidation that occurs naturally without intervention, the results indicated that a letter-based dose consolidation program did not appreciably decrease pharmacy expenditures.