Transaction costs, externalities and information technology in health care.

PubMed

Ferguson, B; Keen, J

1996-01-01

This paper discusses some of the economic issues which underpin the rationale for investment in information and communications technologies (ICTs). Information imperfections lead to significant transaction costs (search, negotiating and monitoring) which in turn confer a negative externality on parties involved in exchange. This divergence in private and social costs leads to a degree of resource misallocation (efficiency loss) which, uncorrected, results in a sub-optimal outcome. Traditional solutions to this problem are to rely upon direct government action to reduce the costs of transacting between market agents, or to employ tax/subsidy measures and other legislative action to achieve the desired market outcome. Three key policy questions are raised in the context of the NHS purchaser/provider relationship. Firstly, what is the optimum level of transaction costs; secondly, can ICTs assist in lowering the level of transaction costs to the optimum level; thirdly, who should bear the investment cost in reducing the level of transaction costs? The issue of property rights in different information systems is discussed and raises interesting policy questions about how much investment should be undertaken centrally rather than devolved to a more local level. In some ways this economic framework offers a post hoc justification of why different ICT systems have been introduced at various levels of the NHS. Essentially this reduces to the problem of externalities: providing good information confers a positive externality: not providing relevant, timely and accurate information confers a negative externality, by increasing further the level of transaction costs. The crucial role which ICT systems can play lies in attempting to reduce the level of transaction costs and driving the market towards what Dahlman has described as the transaction-cost-constrained equilibrium.

Environmental trade-offs of tunnels vs cut-and-cover subways

USGS Publications Warehouse

Walton, M.

1978-01-01

Heavy construction projects in cities entail two kinds of cost - internal cost, which can be defined in terms of payments from one set of parties to another, and external cost, which is the cost borne by the community at large as the result of disutilities entailed in construction and operation. Environmental trade-offs involve external costs, which are commonly difficult to measure. Cut-and-cover subway construction probably entails higher external and internal cost than deep tunnel construction in many urban geological environments, but uncertainty concerning the costs and environmental trade-offs of tunneling leads to limited and timid use of tunneling by American designers. Thus uncertainty becomes a major trade-off which works against tunneling. The reverse is true in Sweden after nearly 30 years of subway construction. Econometric methods for measuring external costs exist in principle, but are limited in application. Economic theory based on market pressure does not address the real problem of urban environmental trade-offs. Nevertheless, the problem of uncertainty can be addressed by comparative studies of estimated and as-built costs of cut-and-cover vs tunnel projects and a review of environmental issues associated with such construction. Such a study would benefit the underground construction industry and the design of transportation systems. It would also help solve an aspect of the urban problem. ?? 1978.

Land use changes: economic, social, and environmental impacts

Treesearch

JunJie Wu

2008-01-01

Land use provides many economic and social benefits but often comes at a substantial cost to the environment. Although most economic costs are figured into land use decisions, most environmental externalities are not. These environmental externalities cause a divergence between private and social costs for some land uses, leading to an inefficient land allocation. For...

48 CFR 231.205-70 - External restructuring costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... sale/purchase of assets. (2) External restructuring activities means restructuring activities occurring... a factor of at least two to one; or (B) The costs allowed, and the business combination will result... will exceed the costs allowed by a factor of at least two to one on a present value basis. (ii) The...

High-Speed Machining (HSM) of Space Shuttle External Tank (ET) panels

NASA Astrophysics Data System (ADS)

Miller, J. A.

1983-02-01

The External Fuel Tank (ET) of the Space Shuttle is not recovered after launch and a new one must be provided for each launch. Currently, the external ""skin'' panels of the tank are produced by machining from solid wrought 2219-T87 aluminum plate stock approximately 1-3/4 inch thick. The reduction of costs in producing External Fuel Tank panels is obviously of increasing production rates and decreasing costs of the panels through the application of high-speed machining (HSM) techniques was conducted.

High-Speed Machining (HSM) of Space Shuttle External Tank (ET) panels

NASA Technical Reports Server (NTRS)

Miller, J. A.

1983-01-01

The External Fuel Tank (ET) of the Space Shuttle is not recovered after launch and a new one must be provided for each launch. Currently, the external ""skin'' panels of the tank are produced by machining from solid wrought 2219-T87 aluminum plate stock approximately 1-3/4 inch thick. The reduction of costs in producing External Fuel Tank panels is obviously of increasing production rates and decreasing costs of the panels through the application of high-speed machining (HSM) techniques was conducted.

Economic evaluation of interventions for problem drinking and alcohol dependence: do within-family external effects make a difference?

PubMed

Mortimer, Duncan; Segal, Leonie

2006-01-01

To propose methods for the inclusion of within-family external effects in clinical and economic evaluations. To demonstrate the extent of bias due to the exclusion of within-family external effects when measuring the relative performance of interventions for problem drinking and alcohol dependence. The timing and magnitude of treatment effects are modified to accommodate the external health-related quality of life impact of having a problem or dependent drinker in the family home. The inclusion of within-family external effects reduces cost per QALY estimates of interventions for problem drinking and alcohol dependence thereby improving the performance of all evaluated interventions. In addition, the inclusion of within-family external effects improves the relative performance of interventions targeted at those with moderate-to-severe alcohol dependence as compared to interventions targeted at less severe alcohol problems. Failure to take account of external effects in clinical and economic evaluations results in an uneven playing field. Interventions with readily quantifiable health benefits (where social costs and benefits are predominantly comprised of private costs and benefits) are at a distinct advantage when competing for public funding against interventions with quantitatively important external effects.

Cost and Effectiveness of Decontamination Strategies in Radiation Contaminated Areas in Fukushima in Regard to External Radiation Dose

PubMed Central

Yasutaka, Tetsuo; Naito, Wataru; Nakanishi, Junko

2013-01-01

The objective of the present study is to evaluate the cost and effectiveness of decontamination strategies in the special decontamination areas in Fukushima in regard to external radiation dose. A geographical information system (GIS) was used to relate the predicted external dose in the affected areas to the number of potential inhabitants and the land use in the areas. A comprehensive review of the costs of various decontamination methods was conducted as part of the analysis. The results indicate that aerial decontamination in the special decontamination areas in Fukushima would be effective for reducing the air dose rate to the target level in a short period of time in some but not all of the areas. In a standard scenario, analysis of cost and effectiveness suggests that decontamination costs for agricultural areas account for approximately 80% of the total decontamination cost, of which approximately 60% is associated with storage. In addition, the costs of decontamination per person per unit area are estimated to vary greatly. Appropriate selection of decontamination methods may significantly decrease decontamination costs, allowing more meaningful decontamination in terms of the limited budget. Our analysis can help in examining the prioritization of decontamination areas from the viewpoints of cost and effectiveness in reducing the external dose. Decontamination strategies should be determined according to air dose rates and future land-use plans. PMID:24069398

Cost and effectiveness of decontamination strategies in radiation contaminated areas in Fukushima in regard to external radiation dose.

PubMed

Yasutaka, Tetsuo; Naito, Wataru; Nakanishi, Junko

2013-01-01

The objective of the present study is to evaluate the cost and effectiveness of decontamination strategies in the special decontamination areas in Fukushima in regard to external radiation dose. A geographical information system (GIS) was used to relate the predicted external dose in the affected areas to the number of potential inhabitants and the land use in the areas. A comprehensive review of the costs of various decontamination methods was conducted as part of the analysis. The results indicate that aerial decontamination in the special decontamination areas in Fukushima would be effective for reducing the air dose rate to the target level in a short period of time in some but not all of the areas. In a standard scenario, analysis of cost and effectiveness suggests that decontamination costs for agricultural areas account for approximately 80% of the total decontamination cost, of which approximately 60% is associated with storage. In addition, the costs of decontamination per person per unit area are estimated to vary greatly. Appropriate selection of decontamination methods may significantly decrease decontamination costs, allowing more meaningful decontamination in terms of the limited budget. Our analysis can help in examining the prioritization of decontamination areas from the viewpoints of cost and effectiveness in reducing the external dose. Decontamination strategies should be determined according to air dose rates and future land-use plans.

Research on the negative externality of breeding wastewater in rural construction—Taking the large-scale breeding project of Tongnan in Chongqing as an example

NASA Astrophysics Data System (ADS)

Yin, Mingqiang; Hu, Wen; Wu, Haonan

2018-03-01

The country vigorously promotes the collective operation of traditional culture, which brings a lot of negative externalities of environmental pollution. Environmental pollution causes the difference between social cost and private cost. The cost of pollution is not borne by private enterprises, it is an external cost for the polluters. This paper attempts to take the Chongqing pig farm as an example to select the COD and TN indicators in the wastewater as the focus point of the analysis. We explore the equilibrium point based on the personal cost of Party A and the public welfare cost brought by environmental pollution, and test the rationality and accuracy of the existing norms. On the basis of existing research, the end of the paper tries to explore the better solution according to the law of Pigou and the property rights delimitation.

Incorporating external evidence in trial-based cost-effectiveness analyses: the use of resampling methods

PubMed Central

2014-01-01

Background Cost-effectiveness analyses (CEAs) that use patient-specific data from a randomized controlled trial (RCT) are popular, yet such CEAs are criticized because they neglect to incorporate evidence external to the trial. A popular method for quantifying uncertainty in a RCT-based CEA is the bootstrap. The objective of the present study was to further expand the bootstrap method of RCT-based CEA for the incorporation of external evidence. Methods We utilize the Bayesian interpretation of the bootstrap and derive the distribution for the cost and effectiveness outcomes after observing the current RCT data and the external evidence. We propose simple modifications of the bootstrap for sampling from such posterior distributions. Results In a proof-of-concept case study, we use data from a clinical trial and incorporate external evidence on the effect size of treatments to illustrate the method in action. Compared to the parametric models of evidence synthesis, the proposed approach requires fewer distributional assumptions, does not require explicit modeling of the relation between external evidence and outcomes of interest, and is generally easier to implement. A drawback of this approach is potential computational inefficiency compared to the parametric Bayesian methods. Conclusions The bootstrap method of RCT-based CEA can be extended to incorporate external evidence, while preserving its appealing features such as no requirement for parametric modeling of cost and effectiveness outcomes. PMID:24888356

Incorporating external evidence in trial-based cost-effectiveness analyses: the use of resampling methods.

PubMed

Sadatsafavi, Mohsen; Marra, Carlo; Aaron, Shawn; Bryan, Stirling

2014-06-03

Cost-effectiveness analyses (CEAs) that use patient-specific data from a randomized controlled trial (RCT) are popular, yet such CEAs are criticized because they neglect to incorporate evidence external to the trial. A popular method for quantifying uncertainty in a RCT-based CEA is the bootstrap. The objective of the present study was to further expand the bootstrap method of RCT-based CEA for the incorporation of external evidence. We utilize the Bayesian interpretation of the bootstrap and derive the distribution for the cost and effectiveness outcomes after observing the current RCT data and the external evidence. We propose simple modifications of the bootstrap for sampling from such posterior distributions. In a proof-of-concept case study, we use data from a clinical trial and incorporate external evidence on the effect size of treatments to illustrate the method in action. Compared to the parametric models of evidence synthesis, the proposed approach requires fewer distributional assumptions, does not require explicit modeling of the relation between external evidence and outcomes of interest, and is generally easier to implement. A drawback of this approach is potential computational inefficiency compared to the parametric Bayesian methods. The bootstrap method of RCT-based CEA can be extended to incorporate external evidence, while preserving its appealing features such as no requirement for parametric modeling of cost and effectiveness outcomes.

737/CFM56-7 Aircraft Engine Systems

NASA Technical Reports Server (NTRS)

Wright, Steve; Shiosaki, Justin

2006-01-01

The configuration of the propulsion system engine externals must meet many airplane requirements such as cost, thrust, weight, range and systems power extraction. On the 737-700 several program requirements also played a major role in the development of the engine externals. These program goals were increased range, same cost as a 1994 737-300, 15% reduction in maintenance costs from the 737-300, and a propulsion package that appeared as if it was designed by one company. This presentation will show how these requirements shaped the design of the engine externals for the 737-700/CFM56-7B.

New Zealand Dairy Farming: Milking Our Environment for All Its Worth

NASA Astrophysics Data System (ADS)

Foote, Kyleisha J.; Joy, Michael K.; Death, Russell G.

2015-09-01

Over the past two decades there have been major increases in dairy production in New Zealand. This increase in intensity has required increased use of external inputs, in particular fertilizer, feed, and water. Intensified dairy farming thus incurs considerable environmental externalities: impacts that are not paid for directly by the dairy farmer. These externalities are left for the wider New Zealand populace to deal with, both economically and environmentally. This is counter-intuitive given the dairy industry itself relies on a `clean green' image to maximize returns. This is the first nationwide assessment of some of the environmental costs of the recent increase of dairy intensification in New Zealand. Significant costs arise from nitrate contamination of drinking water, nutrient pollution to lakes, soil compaction, and greenhouse gas emissions. At the higher end, the estimated cost of some environmental externalities surpasses the 2012 dairy export revenue of NZ11.6 billion and almost reaches the combined export revenue and dairy's contribution to Gross Domestic Product in 2010 of NZ5 billion. For the dairy industry to accurately report on its profitability and maintain its sustainable marketing label, these external costs should be reported. This assessment is in fact extremely conservative as many impacts have not been valued, thus, the total negative external impact of intensified dairying is probably grossly underestimated.

Increasing social welfare by taxing pesticide externalities in the Indian cotton sector.

PubMed

Rasche, Livia; Dietl, Alexander; Shakhramanyan, Nikolinka; Pandey, Divya; Schneider, Uwe A

2016-12-01

Pesticide use in the Indian cotton industry has decreased with the introduction of Bt cotton, but rates are still high in comparison with other countries. The adoption of alternative strategies, such as integrated pest management, has been slow, even though benefits are potentially high, more so if the full costs of the external effects of the technologies are taken into account. In order to estimate true societal benefits of different strategies, we compare their external costs and economic performance under external cost taxation, using a state-of-the-art partial equilibrium model of the Indian agricultural sector. Pesticide externalities lower social welfare in the Indian cotton sector by $US 400-2200 million, depending on the technologies employed. A full internalisation reduces producer revenues by $US 100 ha -1 if only Bt cotton is used, and by $US 30 ha -1 if IPM is another option. Consumers do not start to lose surplus until 20-70% are internalised, and losses are smaller if all technologies are available. External pesticide costs can be internalised partially without substantially affecting consumer surplus while still increasing social welfare, but producers need to have access to and the knowledge to employ all available cotton production technologies to minimise losses. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

New Zealand Dairy Farming: Milking Our Environment for All Its Worth.

PubMed

Foote, Kyleisha J; Joy, Michael K; Death, Russell G

2015-09-01

Over the past two decades there have been major increases in dairy production in New Zealand. This increase in intensity has required increased use of external inputs, in particular fertilizer, feed, and water. Intensified dairy farming thus incurs considerable environmental externalities: impacts that are not paid for directly by the dairy farmer. These externalities are left for the wider New Zealand populace to deal with, both economically and environmentally. This is counter-intuitive given the dairy industry itself relies on a 'clean green' image to maximize returns. This is the first nationwide assessment of some of the environmental costs of the recent increase of dairy intensification in New Zealand. Significant costs arise from nitrate contamination of drinking water, nutrient pollution to lakes, soil compaction, and greenhouse gas emissions. At the higher end, the estimated cost of some environmental externalities surpasses the 2012 dairy export revenue of NZ$11.6 billion and almost reaches the combined export revenue and dairy's contribution to Gross Domestic Product in 2010 of NZ$5 billion. For the dairy industry to accurately report on its profitability and maintain its sustainable marketing label, these external costs should be reported. This assessment is in fact extremely conservative as many impacts have not been valued, thus, the total negative external impact of intensified dairying is probably grossly underestimated.

Cost-effectiveness of a nurse practitioner-family physician model of care in a nursing home: controlled before and after study.

PubMed

Lacny, Sarah; Zarrabi, Mahmood; Martin-Misener, Ruth; Donald, Faith; Sketris, Ingrid; Murphy, Andrea L; DiCenso, Alba; Marshall, Deborah A

2016-09-01

To examine the cost-effectiveness of a nurse practitioner-family physician model of care compared with family physician-only care in a Canadian nursing home. As demand for long-term care increases, alternative care models including nurse practitioners are being explored. Cost-effectiveness analysis using a controlled before-after design. The study included an 18-month 'before' period (2005-2006) and a 21-month 'after' time period (2007-2009). Data were abstracted from charts from 2008-2010. We calculated incremental cost-effectiveness ratios comparing the intervention (nurse practitioner-family physician model; n = 45) to internal (n = 65), external (n = 70) and combined internal/external family physician-only control groups, measured as the change in healthcare costs divided by the change in emergency department transfers/person-month. We assessed joint uncertainty around costs and effects using non-parametric bootstrapping and cost-effectiveness acceptability curves. Point estimates of the incremental cost-effectiveness ratio demonstrated the nurse practitioner-family physician model dominated the internal and combined control groups (i.e. was associated with smaller increases in costs and emergency department transfers/person-month). Compared with the external control, the intervention resulted in a smaller increase in costs and larger increase in emergency department transfers. Using a willingness-to-pay threshold of $1000 CAD/emergency department transfer, the probability the intervention was cost-effective compared with the internal, external and combined control groups was 26%, 21% and 25%. Due to uncertainty around the distribution of costs and effects, we were unable to make a definitive conclusion regarding the cost-effectiveness of the nurse practitioner-family physician model; however, these results suggest benefits that could be confirmed in a larger study. © 2016 John Wiley & Sons Ltd.

The Cost Implications in Ontario, Alberta, and British Columbia of Early Versus Delayed External Cephalic Version in the Early External Cephalic Version 2 (EECV2) Trial.

PubMed

Ahmed, Rashid J; Gafni, Amiram; Hutton, Eileen K

2016-03-01

According to the Early External Cephalic Version (EECV2) Trial, planning external cephalic version (ECV) early in pregnancy results in fewer breech presentations at delivery compared with delayed external cephalic version. A Cochrane review conducted after the EECV2 Trial identified an increase in preterm birth associated with early ECV. We examined whether a policy of routine early ECV (i.e., before 37 weeks' gestation) is more or less costly than a policy of delayed ECV. We undertook this analysis from the perspective of a third-party payer (Ministry of Health). We applied data, using resources reported in the EECV2 Trial, to the Canadian context using 10 hospital unit costs and 17 physician service/procedure unit costs. The data were derived from the provincial health insurance plan schedule of medical benefits in three Canadian provinces (Ontario, Alberta, and British Columbia). The difference in mean total costs between study groups was tested for each province separately. We found that planning early ECV results in higher costs than planning delayed ECV. The mean costs of all physician services/procedures and hospital units for planned ECV compared with delayed ECV were $7997.32 versus $7263.04 in Ontario (P < 0.001), $8162.82 versus $7410.55 in Alberta (P < 0.001), and $8178.92 versus $7417.04 in British Columbia (P < 0.001), respectively. From the perspective of overall cost, our analyses do not support a policy of routinely planning ECV before 37 weeks' gestation. Copyright © 2016 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

Assessment of Health-Cost Externalities of Air Pollution at the National Level using the EVA Model System

NASA Astrophysics Data System (ADS)

Brandt, Jørgen; Silver, Jeremy David; Heile Christensen, Jesper; Skou Andersen, Mikael; Geels, Camilla; Gross, Allan; Buus Hansen, Ayoe; Mantzius Hansen, Kaj; Brandt Hedegaard, Gitte; Ambelas Skjøth, Carsten

2010-05-01

Air pollution has significant negative impacts on human health and well-being, which entail substantial economic consequences. We have developed an integrated model system, EVA (External Valuation of Air pollution), to assess health-related economic externalities of air pollution resulting from specific emission sources/sectors. The EVA system was initially developed to assess externalities from power production, but in this study it is extended to evaluate costs at the national level. The EVA system integrates a regional-scale atmospheric chemistry transport model (DEHM), address-level population data, exposure-response functions and monetary values applicable for Danish/European conditions. Traditionally, systems that assess economic costs of health impacts from air pollution assume linear approximations in the source-receptor relationships. However, atmospheric chemistry is non-linear and therefore the uncertainty involved in the linear assumption can be large. The EVA system has been developed to take into account the non-linear processes by using a comprehensive, state-of-the-art chemical transport model when calculating how specific changes to emissions affect air pollution levels and the subsequent impacts on human health and cost. Furthermore, we present a new "tagging" method, developed to examine how specific emission sources influence air pollution levels without assuming linearity of the non-linear behaviour of atmospheric chemistry. This method is more precise than the traditional approach based on taking the difference between two concentration fields. Using the EVA system, we have estimated the total external costs from the main emission sectors in Denmark, representing the ten major SNAP codes. Finally, we assess the impacts and external costs of emissions from international ship traffic around Denmark, since there is a high volume of ship traffic in the region.

Changes in Energy Cost and Total External Work of Muscles in Elite Race Walkers Walking at Different Speeds

PubMed Central

Chwała, Wiesław; Klimek, Andrzej; Mirek, Wacław

2014-01-01

The aim of the study was to assess energy cost and total external work (total energy) depending on the speed of race walking. Another objective was to determine the contribution of external work to total energy cost of walking at technical, threshold and racing speed in elite competitive race walkers. The study involved 12 competitive race walkers aged 24.9 4.10 years with 6 to 20 years of experience, who achieved a national or international sports level. Their aerobic endurance was determined by means of a direct method involving an incremental exercise test on the treadmill. The participants performed three tests walking each time with one of the three speeds according to the same protocol: an 8-minute walk with at steady speed was followed by a recovery phase until the oxygen debt was repaid. To measure exercise energy cost, an indirect method based on the volume of oxygen uptake was employed. The gait of the participants was recorded using the 3D Vicon opto-electronic motion capture system. Values of changes in potential energy and total kinetic energy in a gate cycle were determined based on vertical displacements of the centre of mass. Changes in mechanical energy amounted to the value of total external work of muscles needed to accelerate and lift the centre of mass during a normalised gait cycle. The values of average energy cost and of total external work standardised to body mass and distance covered calculated for technical speed, threshold and racing speeds turned out to be statistically significant (p 0.001). The total energy cost ranged from 51.2 kJ.m-1 during walking at technical speed to 78.3 kJ.m-1 during walking at a racing speed. Regardless of the type of speed, the total external work of muscles accounted for around 25% of total energy cost in race walking. Total external work mainly increased because of changes in the resultant kinetic energy of the centre of mass movement. PMID:25713673

Is ambulatory monitoring for "community-acquired" syncope economically attractive? A cost-effectiveness analysis of a randomized trial of external loop recorders versus Holter monitoring.

PubMed

Rockx, Marie Antoinette; Hoch, Jeffrey S; Klein, George J; Yee, Raymond; Skanes, Allan C; Gula, Lorne J; Krahn, Andrew D

2005-11-01

Out patient ambulatory monitoring is often performed in patients with syncope that present in the primary care setting to include or exclude an arrhythmia. The cost-effectiveness of 2 monitoring strategies was assessed in a prospective randomized trial. One hundred patients referred for ambulatory monitoring with syncope or presyncope were randomized to a 1-month external loop recorder (n = 49) or 48-hour Holter monitor (n = 51). Patients were offered crossover if there was failed activation or no symptom recurrence. The primary end point was symptom-rhythm correlation during monitoring. Direct costs were calculated based on the 2003 Ontario Health Insurance Plan fee schedule, combined with calculation of labor, materials, service, and overhead for diagnostic testing and related equipment. Before enrollment, the cost of all previous health care resource use was USD 472 +/- USD 397 (range USD 21-USD 1965). In the loop recorder group, 63% of patients had symptom recurrence and successful activation, compared with 24% in the Holter group (P < .0001). The cost per Holter was USD 177.64, and per loop recorder, USD 533.56, with a similar cost per diagnosis with the 2 techniques. The incremental cost-effectiveness ratio of the loop recorder was USD 901.74 per extra successful diagnosis. A strategy of Holter followed by offered loop recorder trended toward lower cost than initial loop recorder followed by Holter (USD 481 +/- USD 267 vs USD 551 +/- USD 83, P = .08), but was associated with a lower overall diagnostic yield (49% vs 63%) and a resultant higher cost per diagnosis (USD 982 vs USD 871, P = .08). Bootstrapping suggested that 90% of incremental cost-effectiveness ratios were less than USD 1250. Despite the increased upfront cost of external loop recorders, the marked improvement in diagnostic yield offsets the cost. External loop recorders are an economically attractive alternative. First-line use of external loop recorders in patients with "community-acquired" syncope and presyncope should be considered to optimize diagnostic yield given its value.

Assessing cost and effectiveness of radiation decontamination in Fukushima Prefecture, Japan.

PubMed

Yasutaka, Tetsuo; Naito, Wataru

2016-01-01

Despite the enormous cost of radiation decontamination in Fukushima Prefecture, it is not clear what levels of reduction in external radiation exposure are possible in the Special Decontamination Area, the Intensive Contamination Survey Areas and the whole of Fukushima. The objective of this study was to evaluate the cost and effectiveness of radiation decontamination in Fukushima Prefecture in its entirety. Using a geographic information system, we calculated the costs of removal, storage containers, transport, and temporary and interim storage facilities as well as the reduction in air dose rate for a cumulative external exposure for 9000 1 km × 1 km mesh units incorporating 51 municipalities. The decontamination cost for the basic scenario, for which forested areas within 20 m of habitation areas were decontaminated, was JPY2.53-5.12 trillion; the resulting reduction in annual external dose was about 2500 person-Sv. The transport, storage, and administrative costs of decontamination waste and removed soil reached JPY1.55-2.12 trillion under this scenario. Although implementing decontamination of all forested areas provides some major reductions in the external radiation dose for the average inhabitant, decontamination costs could potentially exceed JPY16 trillion. These results indicate that technologies for reducing the volume of decontamination waste and removed soil should be considered to reduce storage costs and that further discussions about forest decontamination policies are needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Metabolic Cost of Lateral Stabilization during Walking in People with Incomplete Spinal Cord Injury

PubMed Central

Matsubara, J.H.; Wu, M.; Gordon, K.E.

2015-01-01

People with incomplete spinal cord injury (iSCI) expend considerable energy to walk, which can lead to rapid fatigue and limit community ambulation. Selecting locomotor patterns that enhance lateral stability may contribute to this population’s elevated cost of transport. The goal of the current study was to quantify the metabolic energy demands of maintaining lateral stability during gait in people with iSCI. To quantify this metabolic cost, we observed ten individuals with iSCI walking with and without external lateral stabilization. We hypothesized that with external lateral stabilization, people with iSCI would adapt their gait by decreasing step width, which would correspond with a substantial decrease in cost of transport. Our findings support this hypothesis. Subjects significantly (p < 0.05) decreased step width by 22%, step width variability by 18%, and minimum lateral margin of stability by 25% when they walked with external lateral stabilization compared to unassisted walking. Metabolic cost of transport also decreased significantly (p < 0.05) by 10% with external lateral stabilization. These findings suggest that this population is capable of adapting their gait to meet changing demands placed on balance. The percent reduction in cost of transport when walking with external lateral stabilization was strongly correlated with functional impairment level as assessed by subjects’ scores on the Berg Balance Scale (R = 0.778) and Lower Extremity Motor Score (R = 0.728). These relationships suggest that as functional balance and strength decrease, the amount of metabolic energy used to maintain lateral stability during gait will increase. PMID:25670651

The impact of including passive benefits in cost-effectiveness analysis: the case of automated external defibrillators on commercial aircraft.

PubMed

Cram, Peter; Vijan, Sandeep; Wolbrink, Alex; Fendrick, A Mark

2003-01-01

Traditional cost-utility analysis assumes that all benefits from health-related interventions are captured by the quality-adjusted life-years (QALYs) gained by the few individuals whose outcome is improved by the intervention. However, it is possible that many individuals who do not directly benefit from an intervention receive utility, and therefore QALYs, because of the passive benefit (aka sense of security) provided by the existence of the intervention. The objective of this study was to evaluate the impact that varying quantities of passive benefit have on the cost-effectiveness of airline defibrillator programs. A decision analytic model with Markov processes was constructed to evaluate the cost-effectiveness of defibrillator deployment on domestic commercial passenger aircraft over 1 year. Airline passengers were assigned small incremental utility gains (.001-.01) during an estimated 3-hour flight to evaluate the impact of passive benefit on overall cost-effectiveness. In the base case analysis with no allowance for passive benefit, the cost-effectiveness of airline automated external defibrillator deployment was US dollars 34000 per QALY gained. If 1% of all passengers received utility gain of.01, the cost-effectiveness declined to US dollars 30000. Cost-effectiveness was enhanced when the quantity of passive benefit was raised or the percentage of individuals receiving passive benefit increased. Automated external defibrillator deployment on passenger aircraft is likely to be cost-effective. If a small percentage of airline passengers receive incremental utility gains from passive benefit of automated external defibrillator availability, the impact on overall cost-effectiveness may be substantial. Further research should attempt to clarify the magnitude and percentage of patients who receive passive benefit.

Assessment of past, present and future health-cost externalities of air pollution in Europe and the contribution from international ship traffic using the EVA model system

NASA Astrophysics Data System (ADS)

Brandt, J.; Silver, J. D.; Christensen, J. H.; Andersen, M. S.; Bønløkke, J. H.; Sigsgaard, T.; Geels, C.; Gross, A.; Hansen, A. B.; Hansen, K. M.; Hedegaard, G. B.; Kaas, E.; Frohn, L. M.

2013-03-01

An integrated model system, EVA (Economic Valuation of Air pollution), based on the impact-pathway chain has been developed, to assess the health-related economic externalities of air pollution resulting from specific emission sources or sectors. The model system can be used to support policy-making with respect to emission control. In this study, we apply the EVA system to Europe, and perform a more detailed assessment of past, present, and future health-cost externalities of the total air pollution levels in Europe (including both natural and anthropogenic sources), represented by the years 2000, 2007, 2011, and 2020. We also assess the contribution to the health-related external costs from international ship traffic with special attention to the international ship traffic in the Baltic and North Seas, since special regulatory actions on sulphur emissions, called SECA (sulphur emission control area), have been introduced in these areas,. We conclude that despite efficient regulatory actions in Europe in recent decades, air pollution still constitutes a serious problem to human health, hence the related external costs are considerable. The total health-related external costs for the whole of Europe is estimated at 803 bn Euro yr-1 for the year 2000, decreasing to 537 bn Euro yr-1 in the year 2020. We estimate the total number of premature deaths in Europe in the year 2000 due to air pollution to be around 680 000 yr-1, decreasing to approximately 450 000 in the year 2020. The contribution from international ship traffic in the Northern Hemisphere was estimated to 7% of the total health-related external costs in Europe in the year 2000, increasing to 12% in the year 2020. In contrast, the contribution from international ship traffic in the Baltic Sea and the North Sea decreases 36% due to the regulatory efforts of reducing sulphur emissions from ship traffic in SECA. Introducing this regulatory instrument for all international ship traffic in the Northern Hemisphere, or at least in areas close to Europe, would have a significant positive impact on human health in Europe.

Assessment of past, present and future health-cost externalities of air pollution in Europe and the contribution from international ship traffic using the EVA model system

NASA Astrophysics Data System (ADS)

Brandt, J.; Silver, J. D.; Christensen, J. H.; Andersen, M. S.; Bønløkke, J. H.; Sigsgaard, T.; Geels, C.; Gross, A.; Hansen, A. B.; Hansen, K. M.; Hedegaard, G. B.; Kaas, E.; Frohn, L. M.

2013-08-01

An integrated model system, EVA (Economic Valuation of Air pollution), based on the impact-pathway chain has been developed to assess the health-related economic externalities of air pollution resulting from specific emission sources or sectors. The model system can be used to support policy-making with respect to emission control. In this study, we apply the EVA system to Europe, and perform a more detailed assessment of past, present, and future health-cost externalities of the total air pollution levels in Europe (including both natural and anthropogenic sources), represented by the years 2000, 2007, 2011, and 2020. We also assess the contribution to the health-related external costs from international ship traffic with special attention to the international ship traffic in the Baltic and North seas, since special regulatory actions on sulfur emissions, called SECA (sulfur emission control area), have been introduced in these areas. We conclude that, despite efficient regulatory actions in Europe in recent decades, air pollution still constitutes a serious problem for human health. Hence the related external costs are considerable. The total health-related external costs for the whole of Europe are estimated at 803 bn euros yr-1 for the year 2000, decreasing to 537 bn euros yr-1 in the year 2020. We estimate the total number of premature deaths in Europe in the year 2000 due to air pollution to be around 680 000 yr-1, decreasing to approximately 450 000 in the year 2020. The contribution from international ship traffic in the Northern Hemisphere was estimated to 7% of the total health-related external costs in Europe in the year 2000, increasing to 12% in the year 2020. In contrast, the contribution from international ship traffic in the Baltic Sea and the North Sea decreases 36% due to the regulatory efforts of reducing sulfur emissions from ship traffic in SECA. Introducing this regulatory instrument for all international ship traffic in the Northern Hemisphere, or at least in areas close to Europe, would have a significant positive impact on human health in Europe.

Assessment of Past, Present and Future Health-Cost Ex-ternalities of Air Pollution in Europe and the contribution from International Ship Traffic using the EVA Model System

NASA Astrophysics Data System (ADS)

Brandt, Jørgen; Silver, Jeremy D.; Christensen, Jesper H.; Andersen, Mikael S.; Bønløkke, Jakob H.; Sigsgaard, Torben; Geels, Camilla; Gross, Allan; Hansen, Ayoe B.; Hansen, Kaj M.; Hedegaard, Gitte B.; Kaas, Eigil; Frohn, Lise M.

2013-04-01

An integrated model system, EVA (Economic Valuation of Air pollution), based on the impact-pathway chain has been developed, to assess the health-related economic externalities of air pollution resulting from specific emission sources or sectors. The model system can be used to support policy-making with respect to emission control. In this study, we apply the EVA system to Europe, and perform a more detailed assessment of past, present, and future health-cost externalities of the total air pollution levels in Europe (including both natural and anthropogenic sources), represented by the years 2000, 2007, 2011, and 2020. We also assess the contribution to the health-related external costs from international ship traffic with special attention to the international ship traffic in the Baltic and North Seas, since special regulatory actions on sulphur emissions, called SECA (sulphur emission control area), have been intro-duced in these areas,. We conclude that despite efficient regulatory actions in Europe in recent decades, air pollution still constitutes a serious problem to human health, hence the related external costs are considerable. The total health-related external costs for the whole of Europe is estimated at 803 bn Euro/year for the year 2000, decreasing to 537 bn Euro/year in the year 2020. We estimate the total number of premature deaths in Europe in the year 2000 due to air pollution to be around 680,000/year, decreasing to approximately 450,000 in the year 2020. The contribution from international ship traffic in the Northern Hemisphere was estimated to 7% of the total health-related external costs in Europe in the year 2000, increasing to 12% in the year 2020. In contrast, the contribution from international ship traffic in the Baltic Sea and the North Sea decreases 36% due to the regulatory efforts of reducing sulphur emissions from ship traffic in SECA. Introducing this regulatory instrument for all international ship traffic in the Northern Hemisphere, or at least in areas close to Europe, would have a significant posi-tive impact on human health in Europe.

Space shuttle phase B extension, volume 1

NASA Technical Reports Server (NTRS)

1971-01-01

In order to define a system which would significantly reduce payload delivery costs, activities were extended to modifications of the reusable space shuttle design concept. Considered were systems using orbiters with external propellant tanks and an interim expendable booster which allowed phased development of the usable orbiter and booster. Analyzed were: Merits of internal and external propellant tanks and the impact of external LH2 compared to L02 and LH2; impact of cargo bay size; impact abort; merit of expendable booster options; and merit of a phased development program. Studies showed that external L02/LH2 and the continued use of the J-2S engine on the orbiter reduced program cost and risk.

The impact of external donor support through the U.S. President’s Emergency Plan for AIDS Relief on the cost of red cell concentrate in Namibia, 2004–2011

PubMed Central

Pitman, John P.; Bocking, Adele; Wilkinson, Robert; Postma, Maarten J.; Basavaraju, Sridhar V.; von Finckenstein, Bjorn; Mataranyika, Mary; Marfin, Anthony A.; Lowrance, David W.; Sibinga, Cees Th. Smit

2015-01-01

Background External assistance can rapidly strengthen health programmes in developing countries, but such funding can also create sustainability challenges. From 2004–2011, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) provided more than $ 8 million to the Blood Transfusion Service of Namibia (NAMBTS) for supplies, equipment, and staff salaries. This analysis describes the impact that support had on actual production costs and the unit prices charged for red cell concentrate (RCC) units issued to public sector hospitals. Material and methods A costing system developed by NAMBTS to set public sector RCC unit prices was used to describe production costs and unit prices during the period of PEPFAR scale-up (2004–2009) and the 2 years in which PEPFAR support began to decline (2010–2011). Hypothetical production costs were estimated to illustrate differences had PEPFAR support not been available. Results Between 2004–2006, NAMBTS sold 22,575 RCC units to public sector facilities. During this time, RCC unit prices exceeded per unit cost-recovery targets by between 40.3% (US$ 16.75 or N$ 109.86) and 168.3% (US$ 48.72 or N$ 333.28) per year. However, revenue surpluses dwindled between 2007 and 2011, the final year of the study period, when NAMBTS sold 20,382 RCC units to public facilities but lost US$23.31 (N$ 170.43) on each unit. Discussion PEPFAR support allowed NAMBTS to leverage domestic cost-recovery revenue to rapidly increase blood collections and the distribution of RCC. However, external support kept production costs lower than they would have been without PEPFAR. If PEPFAR funds had not been available, RCC prices would have needed to increase by 20% per year to have met annual cost-recovery targets and funded the same level of investments as were made with PEPFAR support. Tracking the subsidising influence of external support can help blood services make strategic investments and plan for unit price increases as external funds are withdrawn. PMID:25369616

The impact of external donor support through the U.S. President's Emergency Plan for AIDS Relief on the cost of red cell concentrate in Namibia, 2004-2011.

PubMed

Pitman, John P; Bocking, Adele; Wilkinson, Robert; Postma, Maarten J; Basavaraju, Sridhar V; von Finckenstein, Bjorn; Mataranyika, Mary; Marfin, Anthony A; Lowrance, David W; Sibinga, Cees Th Smit

2015-04-01

External assistance can rapidly strengthen health programmes in developing countries, but such funding can also create sustainability challenges. From 2004-2011, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) provided more than $ 8 million to the Blood Transfusion Service of Namibia (NAMBTS) for supplies, equipment, and staff salaries. This analysis describes the impact that support had on actual production costs and the unit prices charged for red cell concentrate (RCC) units issued to public sector hospitals. A costing system developed by NAMBTS to set public sector RCC unit prices was used to describe production costs and unit prices during the period of PEPFAR scale-up (2004-2009) and the 2 years in which PEPFAR support began to decline (2010-2011). Hypothetical production costs were estimated to illustrate differences had PEPFAR support not been available. Between 2004-2006, NAMBTS sold 22,575 RCC units to public sector facilities. During this time, RCC unit prices exceeded per unit cost-recovery targets by between 40.3% (US$ 16.75 or N$ 109.86) and 168.3% (US$ 48.72 or N$ 333.28) per year. However, revenue surpluses dwindled between 2007 and 2011, the final year of the study period, when NAMBTS sold 20,382 RCC units to public facilities but lost US$23.31 (N$ 170.43) on each unit. PEPFAR support allowed NAMBTS to leverage domestic cost-recovery revenue to rapidly increase blood collections and the distribution of RCC. However, external support kept production costs lower than they would have been without PEPFAR. If PEPFAR funds had not been available, RCC prices would have needed to increase by 20% per year to have met annual cost-recovery targets and funded the same level of investments as were made with PEPFAR support. Tracking the subsidising influence of external support can help blood services make strategic investments and plan for unit price increases as external funds are withdrawn.

The Role of Advocacy Organizations in Reducing Negative Externalities

ERIC Educational Resources Information Center

Biglan, Anthony

2009-01-01

An externality is a cost that a corporation's actions impose on society. For example, a power plant may emit mercury but might not pay for the cost of that pollution to the people living near the plant. It is possible to analyze a diverse range of problems of society in these terms, including the health effects of corporate practices, the…

Mental states inside out: switching costs for emotional and nonemotional sentences that differ in internal and external focus.

PubMed

Oosterwijk, Suzanne; Winkielman, Piotr; Pecher, Diane; Zeelenberg, René; Rotteveel, Mark; Fischer, Agneta H

2012-01-01

Mental states-such as thinking, remembering, or feeling angry, happy, or dizzy-have a clear internal component. We feel a certain way when we are in these states. These internal experiences may be simulated when people understand conceptual references to mental states. However, mental states can also be described from an "external" perspective, for example when referring to "smiling." In those cases, simulation of visible outside features may be more relevant for understanding. In a switching costs paradigm, we presented semantically unrelated sentences describing emotional and nonemotional mental states while manipulating their internal or external focus. The results show that switching costs occur when participants shift between sentences with an internal and an external focus. This suggests that different forms of simulation underlie understanding these sentences. In addition, these effects occurred for emotional and nonemotional mental states, suggesting that they are grounded in a similar way-through the process of simulation.

Evaluation of cost-effectiveness from the funding body's point of view of ultrasound-guided central venous catheter insertion compared with the conventional technique.

PubMed

Noritomi, Danilo Teixeira; Zigaib, Rogério; Ranzani, Otavio T; Teich, Vanessa

2016-01-01

To evaluate the cost-effectiveness, from the funding body's point of view, of real-time ultrasound-guided central venous catheter insertion compared to the traditional method, which is based on the external anatomical landmark technique. A theoretical simulation based on international literature data was applied to the Brazilian context, i.e., the Unified Health System (Sistema Único de Saúde - SUS). A decision tree was constructed that showed the two central venous catheter insertion techniques: real-time ultrasonography versus external anatomical landmarks. The probabilities of failure and complications were extracted from a search on the PubMed and Embase databases, and values associated with the procedure and with complications were taken from market research and the Department of Information Technology of the Unified Health System (DATASUS). Each central venous catheter insertion alternative had a cost that could be calculated by following each of the possible paths on the decision tree. The incremental cost-effectiveness ratio was calculated by dividing the mean incremental cost of real-time ultrasound compared to the external anatomical landmark technique by the mean incremental benefit, in terms of avoided complications. When considering the incorporation of real-time ultrasound and the concomitant lower cost due to the reduced number of complications, the decision tree revealed a final mean cost for the external anatomical landmark technique of 262.27 Brazilian reals (R$) and for real-time ultrasound of R$187.94. The final incremental cost of the real-time ultrasound-guided technique was -R$74.33 per central venous catheter. The incremental cost-effectiveness ratio was -R$2,494.34 due to the pneumothorax avoided. Real-time ultrasound-guided central venous catheter insertion was associated with decreased failure and complication rates and hypothetically reduced costs from the view of the funding body, which in this case was the SUS.

Evolution of external female genital mutilation: why do males harm their mates?

PubMed

Mouginot, Pierick; Uhl, Gabriele; Fromhage, Lutz

2017-11-01

Sperm competition may select for male reproductive traits that influence female mating or oviposition rate. These traits may induce fitness costs to the female; however, they may be costly for the males as well as any decrease in female fitness also affects male fitness. Male adaptations to sperm competition manipulate females by altering not only female behaviour or physiology, but also female morphology. In orb-weaving spiders, mating may entail mutilation of external structures of the female genitalia, which prevents genital coupling with subsequent males. Here, we present a game theoretical model showing that external female genital mutilation is favoured even under relatively high costs of mutilation, and that it is favoured by a high number of mate encounters per female and last-male sperm precedence.

Evolution of external female genital mutilation: why do males harm their mates?

PubMed Central

Uhl, Gabriele

2017-01-01

Sperm competition may select for male reproductive traits that influence female mating or oviposition rate. These traits may induce fitness costs to the female; however, they may be costly for the males as well as any decrease in female fitness also affects male fitness. Male adaptations to sperm competition manipulate females by altering not only female behaviour or physiology, but also female morphology. In orb-weaving spiders, mating may entail mutilation of external structures of the female genitalia, which prevents genital coupling with subsequent males. Here, we present a game theoretical model showing that external female genital mutilation is favoured even under relatively high costs of mutilation, and that it is favoured by a high number of mate encounters per female and last-male sperm precedence. PMID:29291104

Adaptive salinity management in the Murray-Darling Basin: a transaction cost study

NASA Astrophysics Data System (ADS)

Loch, A. J.

2017-12-01

Transaction costs hinder or promote effective management of common good resource intertemporal externalities. Appropriate policy choices may reduce externalities and improve social welfare, and transaction cost analysis can help to evaluate policy choices. However, without measurement of relevant transaction costs such policy evaluation remains challenging. This article uses a time series dataset of salinity management program to test theory aimed at transaction cost-based policy evaluation and adaptive resource management over a period of 30 years worth of data. We identify peaks and troughs in transaction costs over time, lag-effects in program expenditure, and calculate the decay in transaction cost impacts. We conclude that Australian salinity management programs are achieving flexible institutional outcomes and effective policy arrangements with long-term benefits. Proposed changes to the program moving forward add weight to our assertions of adaptive strategies, and illustrate the value of the novel data-driven tracnsaction cost analysis approach for other jurisdictions.

TED-Time and life saving External Defibrillator for home-use.

PubMed

Weiss, Teddy A; Rosenheck, Shimon; Gorni, Shraga; Katz, Ioni; Mendelbaum, Mendel; Gilon, Dan

2014-06-01

Sudden Cardiac Death--SCD --is a major unmet health problem that needs urgent and prompt solution. AICDs are very expensive, risky and indicated for a small group of patients, at the highest risk. AEDs--Automatic External Defibrillators--are designed for public places and although safe, cannot enter the home-market due to their cost and need for constant, high-cost maintenance. We developed TED, a low-cost AED that derives its energy off the mains, designed for home-use, to save SCD victims' lives. Copyright © 2014 Elsevier Inc. All rights reserved.

Expanding Private Production of Defense Services,

DTIC Science & Technology

1996-01-01

the commercial firms that typi- cally come to mind as characteristic of entrepreneurial enterprise. Which bundle offers the most effective unity of... The second step toward expanded outsourcing is to identify the ac- tivities that are most cost- effective to outsource. A review of the empirical...workload between internal and external sources when the following circumstances apply: (1) an external source looks more cost- effective , but an

Expressing air pollution-induced health-related externalities in physical terms with the help of DALYs.

PubMed

Bachmann, Till M; van der Kamp, Jonathan

2017-06-01

The unintended impacts of industrial activity on human health and the environment have regularly been assessed and monetised (referred to as "external costs"). External costs are, however, a rather abstract aggregate so that decision makers cannot easily relate them to tangible impacts. At the same time, physical health impact indicators have different units that cannot readily be compared and communicated in a joint way. To support better informed decisions at policy or company level, we propose and demonstrate a way to facilitate communication on non-monetized, that is, physical health indicators quantified in studies. The concept Disability-Adjusted Life Year (DALY) is chosen as metric due to its widespread use. We establish a comprehensive and consistent set of six health endpoints caused by particles and ozone, and derive related up-to-date DALYs. Further we apply the DALY values to a French smart grid demonstration project. Owing to its size, the gains in terms of reduced DALYs are however small. In contrast to external cost assessments, in the frame of which morbidity endpoints usually contribute to around 10-15%, they are found to be insubstantial in the overall DALY score (i.e. below 1%). This is because DALYs only consider time losses weighted by severity while external costs also factor in further welfare effects, i.e. combining resource, disutility and opportunity costs of illness. As a result, methodological limitations, mainly existing for the morbidity-related DALY values, appear to be less of concern. Overall, using the DALYs with and without morbidity impacts is justifiable. Either choice in the communication of health-related physical externalities induces the need to explain the limitations in terms of the treatment of morbidity endpoints (notably their definition and the disability weights used) or their complete disregard. Copyright © 2017 Elsevier Ltd. All rights reserved.

High-resolution modelling of health impacts and related external cost from air pollution over 36 years using the integrated model system EVA

NASA Astrophysics Data System (ADS)

Brandt, Jørgen; Andersen, Mikael S.; Bønløkke, Jakob; Christensen, Jesper H.; Geels, Camilla; Hansen, Kaj M.; Hertel, Ole; Im, Ulas; Jensen, Steen S.; Ketzel, Matthias; Nielsen, Ole-Kenneth; Plejdrup, Marlene S.; Sigsgaard, Torben

2016-04-01

A high-resolution assessment of health impacts from air pollution and related external cost has been conducted for Denmark using the integrated EVA model system. The EVA system is based on the impact-pathway methodology, where the site-specific emissions will result, via atmospheric transport and chemistry, in a concentration distribution, which together with detailed population data, is used to estimate the population-level exposure. Using exposure-response functions and economic valuations, the exposure is transformed into impacts on human health and related external costs. In this study we have used a coupling of two chemistry transport models to calculate the air pollution concentration at different domain and scales; the Danish Eulerian Hemispheric Model (DEHM) to calculate the air pollution levels in the Northern Hemisphere with a resolution down to 5.6 km x 5.6 km and the Urban Background Model (UBM) to further calculate the air pollution in Denmark at 1 km x 1 km resolution using results from DEHM as boundary conditions. Both the emission data as well as the population density has been represented in the model system with the same high resolution. Previous health impact assessments related to air pollution have been made on a lower resolution. In this study, the integrated model system, EVA, has been used to estimate the health impacts and related external cost for Denmark at a 1 km x 1 km resolution. New developments of the integrated model system will be presented as well as the development of health impacts and related external costs in Europe and Denmark over a period of 36 years (1979-2014). Acknowledgements This work was funded by: DCE - National Centre for Environment and Energy. Project: "Health impacts and external costs from air pollution in Denmark over 25 years" and NordForsk under the Nordic Programme on Health and Welfare. Project: "Understanding the link between air pollution and distribution of related health impacts and welfare in the Nordic countries (NordicWelfAir)".

Environmental damage costs from airborne pollution of industrial activities in the greater Athens, Greece area and the resulting benefits from the introduction of BAT

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

Mirasgedis, S.; Hontou, V.; Georgopoulou, E.

2008-01-15

Attributing costs to the environmental impacts associated with industrial activities can greatly assist in protecting human health and the natural environment as monetary values are capable of directly influencing technological and policy decisions without changing the rules of the market. This paper attempts to estimate the external cost attributable to the atmospheric pollution from 'medium and high environmental burden' industrial activities located in the greater Athens area and the benefits from Best Available Techniques (BAT) introduction. To this end a number of typical installations were defined to be used in conjunction with the Impact Pathway Approach developed in the contextmore » of the ExternE project to model all industrial sectors/sub-sectors located in the area of interest. Total environmental externalities due to air pollutants emitted by these industrial activities were found to reach 211 M Euro per year, associated mainly with human mortality and morbidity due to PM{sub 10} emissions, as well as with climate change impacts due to CO{sub 2} emissions for which non-metallic minerals and oil processing industries are the main sources. The results obtained can be used as the basis for an integrated evaluation of potential BAT, taking into account not only private costs and benefits but also the environmental externalities, thus leading to policy decisions that maximize social welfare in each industrial sector/sub-sector.« less

[Cost comparison of three treatments for localized prostate cancer in Spain: radical prostatectomy, prostate brachytherapy and external 3D conformal radiotherapy].

PubMed

Becerra Bachino, Virginia; Cots, Francesc; Guedea, Ferran; Pera, Joan; Boladeras, Ana; Aguiló, Ferran; Suárez, José Francisco; Gallo, Pedro; Murgui, Lluis; Pont, Angels; Cunillera, Oriol; Pardo, Yolanda; Ferrer, Montserrat

2011-01-01

To compare the initial costs of the three most established treatments for clinically localized prostate cancer according to risk, age and comorbidity groups, from the healthcare provider's perspective. We carried out a cost comparison study in a sample of patients consecutively recruited between 2003 and 2005 from a functional unit for prostate cancer treatment in Catalonia (Spain). The use of services up to 6 months after the treatment start date was obtained from hospital databases and direct costs were estimated by micro-cost calculation. Information on the clinical characteristics of patients and treatments was collected prospectively. Costs were compared by using nonparametric tests comparing medians (Kruskall-Wallis) and a semi-logarithmic multiple regression model. Among the 398 patients included, the cost difference among treatments was statistically significant: medians were € 3,229.10, € 5,369.00 and € 6,265.60, respectively, for the groups of patients treated with external 3D conformal radiotherapy, brachytherapy and radical retropublic prostatectomy, (p<0.001). In the multivariate analysis (adjusted R(2)=0.8), the average costs of brachytherapy and external radiotherapy were significantly lower than that of prostatectomy (coefficient -0.212 and -0.729, respectively). Radical prostatectomy proved to be the most expensive treatment option. Overall, the estimated costs in our study were lower than those published elsewhere. Most of the costs were explained by the therapeutic option and neither comorbidity nor risk groups showed an effect on total costs independent of treatment. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Lifetime costing of the body-in-white: Steel vs. aluminum

NASA Astrophysics Data System (ADS)

Han, Helen N.; Clark, Joel P.

1995-05-01

In order to make informed material choice decisions and to derive the maximum benefit from the use of alternative materials, the automobile producer must understand the full range of costs and benefits for each material. It is becoming clear that the conventional cost-benefit analysis structure currently used by the automotive industry must be broadened to include nontraditional costs such as the environmental externalities associated with the use of existing and potential automotive technologies. This article develops a methodology for comparing the costs and benefits associated with the use of alternative materials in automotive applications by focusing on steel and aluminum in the unibody body-in-white. Authors' Note: This is the first of two articles documenting a methodology for evaluating the lifetime monetary and environmental costs of alternative materials in automotive applications. This article addresses the traditional money costs while a subsequent paper, which is planned for the August issue, will address the environmental externalities.

Analysis of strategies to increase external fixator stiffness: is double stacking worth the cost?

PubMed

Strebe, Sara; Kim, Hyunchul; Russell, Joseph P; Hsieh, Adam H; Nascone, Jason; O'Toole, Robert V

2014-07-01

We compared the mechanical benefits and costs of 3 strategies that are commonly used to increase knee-spanning external fixator stiffness (resistance to deformation): double stacking, cross-linking, and use of an oblique pin. At our academic trauma centre and biomechanical testing laboratory, we used ultra-high-molecular-weight polyethylene bone models and commercially available external fixator components to simulate knee-spanning external fixation. The models were tested in anterior-posterior bending, medial-lateral bending, axial compression, and torsion. We recorded the construct stiffness for each strategy in all loading modes and assessed a secondary outcome of cost per 10% increase in stiffness. Double stacking significantly increased construct stiffness under anterior-posterior bending (109%), medial-lateral bending (22%), axial compression (150%), and torsion (41%) (p<0.05). Use of an oblique pin significantly increased stiffness under torsion (25%) (p<0.006). Cross-linking significantly increased stiffness only under torsion (29%) (p<0.002). Double stacking increased costs by 84%, cross-linking by 28%, and use of an oblique pin by 15% relative to a standard fixator. All 3 strategies increased stiffness under torsion to varying degrees, but only double stacking increased stiffness in all 4 testing modalities (p<0.05). Double stacking is most effective in increasing resistance to bending, particularly under anterior-posterior bending and axial compression, but requires a relatively high cost increase. Clinicians can use these data to help guide the most cost-effective strategy to increase construct stiffness based on the plane in which stiffness is needed. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Cost-Effectiveness of Surgical Fixation of Distal Radial Fractures: A Computer Model-Based Evaluation of Three Operative Modalities.

PubMed

Rajan, Prashant V; Qudsi, Rameez A; Dyer, George S M; Losina, Elena

2018-02-07

There is no consensus on the optimal fixation method for patients who require a surgical procedure for distal radial fractures. We used cost-effectiveness analyses to determine which of 3 modalities offers the best value: closed reduction and percutaneous pinning, open reduction and internal fixation, or external fixation. We developed a Markov model that projected short-term and long-term health benefits and costs in patients undergoing a surgical procedure for a distal radial fracture. Simulations began at the patient age of 50 years and were run over the patient's lifetime. The analysis was conducted from health-care payer and societal perspectives. We estimated transition probabilities and quality-of-life values from the literature and determined costs from Medicare reimbursement schedules in 2016 U.S. dollars. Suboptimal postoperative outcomes were determined by rates of reduction loss (4% for closed reduction and percutaneous pinning, 1% for open reduction and internal fixation, and 11% for external fixation) and rates of orthopaedic complications. Procedural costs were $7,638 for closed reduction and percutaneous pinning, $10,170 for open reduction and internal fixation, and $9,886 for external fixation. Outputs were total costs and quality-adjusted life-years (QALYs), discounted at 3% per year. We considered willingness-to-pay thresholds of $50,000 and $100,000. We conducted deterministic and probabilistic sensitivity analyses to evaluate the impact of data uncertainty. From the health-care payer perspective, closed reduction and percutaneous pinning dominated (i.e., produced greater QALYs at lower costs than) open reduction and internal fixation and dominated external fixation. From the societal perspective, the incremental cost-effectiveness ratio for closed reduction and percutaneous pinning compared with open reduction and internal fixation was $21,058 per QALY and external fixation was dominated. In probabilistic sensitivity analysis, open reduction and internal fixation was cost-effective roughly 50% of the time compared with roughly 45% for closed reduction and percutaneous pinning. When considering data uncertainty, there is only a 5% to 10% difference in the frequency of probability combinations that find open reduction and internal fixation to be more cost-effective. The current degree of uncertainty in the data produces difficulty in distinguishing either strategy as being more cost-effective overall and thus it may be left to surgeon and patient shared decision-making. Economic Level III. See Instructions for Authors for a complete description of levels of evidence.

Anesthetic management of external cephalic version.

PubMed

Chalifoux, Laurie A; Sullivan, John T

2013-09-01

Breech presentation is common at term and its reduction through external cephalic version represents a noninvasive opportunity to avoid cesarean delivery and the associated maternal morbidity. In addition to uterine relaxants, neuraxial anesthesia is associated with increased success of version procedures when surgical anesthetic dosing is used. The intervention is likely cost effective given the effect size and the avoided high costs of cesarean delivery. Copyright © 2013 Elsevier Inc. All rights reserved.

DIDEM - An integrated model for comparative health damage costs calculation of air pollution

NASA Astrophysics Data System (ADS)

Ravina, Marco; Panepinto, Deborah; Zanetti, Maria Chiara

2018-01-01

Air pollution represents a continuous hazard to human health. Administration, companies and population need efficient indicators of the possible effects given by a change in decision, strategy or habit. The monetary quantification of health effects of air pollution through the definition of external costs is increasingly recognized as a useful indicator to support decision and information at all levels. The development of modelling tools for the calculation of external costs can provide support to analysts in the development of consistent and comparable assessments. In this paper, the DIATI Dispersion and Externalities Model (DIDEM) is presented. The DIDEM model calculates the delta-external costs of air pollution comparing two alternative emission scenarios. This tool integrates CALPUFF's advanced dispersion modelling with the latest WHO recommendations on concentration-response functions. The model is based on the impact pathway method. It was designed to work with a fine spatial resolution and a local or national geographic scope. The modular structure allows users to input their own data sets. The DIDEM model was tested on a real case study, represented by a comparative analysis of the district heating system in Turin, Italy. Additional advantages and drawbacks of the tool are discussed in the paper. A comparison with other existing models worldwide is reported.

Solar thermal electricity generation

NASA Astrophysics Data System (ADS)

Gasemagha, Khairy Ramadan

1993-01-01

This report presents the results of modeling the thermal performance and economic feasibility of large (utility scale) and small solar thermal power plants for electricity generation. A number of solar concepts for power systems applications have been investigated. Each concept has been analyzed over a range of plant power ratings from 1 MW(sub e) to 300 MW(sub e) and over a range of capacity factors from a no-storage case (capacity factor of about 0.25 to 0.30) up to intermediate load capacity factors in the range of 0.46 to 0.60. The solar plant's economic viability is investigated by examining the effect of various parameters on the plant costs (both capital and O & M) and the levelized energy costs (LEC). The cost components are reported in six categories: collectors, energy transport, energy storage, energy conversion, balance of plant, and indirect/contingency costs. Concentrator and receiver costs are included in the collector category. Thermal and electric energy transport costs are included in the energy transport category. Costs for the thermal or electric storage are included in the energy storage category; energy conversion costs are included in the energy conversion category. The balance of plant cost category comprises the structures, land, service facilities, power conditioning, instrumentation and controls, and spare part costs. The indirect/contingency category consists of the indirect construction and the contingency costs. The concepts included in the study are (1) molten salt cavity central receiver with salt storage (PFCR/R-C-Salt); (2) molten salt external central receiver with salt storage (PFCR/R-E-Salt); (3) sodium external central receiver with sodium storage (PFCR/RE-Na); (4) sodium external central receiver with salt storage (PFCR/R-E-Na/Salt); (5) water/steam external central receiver with oil/rock storage (PFCR/R-E-W/S); (6) parabolic dish with stirling engine conversion and lead acid battery storage (PFDR/SLAB); (7) parabolic dish with stirling engine conversion and redox advanced battery storage (PFDR/S-RAB); and (8) parabolic trough with oil/rock storage (LFDR/R-HT-45). Key annual efficiency and economic results of the study are highlighted in tabular format for plant sizes and capacity factor that resulted in the lowest LEC over the analysis range.

Room temperature stretch forming of scale space shuttle external tank dome gores. Volume 1: Technical

NASA Technical Reports Server (NTRS)

Blunck, R. D.; Krantz, D. E.

1974-01-01

An account of activities and data gathered in the Room Temperature Stretch Forming of One-third Scale External Tank Bulkhead Gores for space shuttle study, and a tooling design and production cost study are reported. The following study phases are described: (1) the stretch forming of three approximately one-third scale external tank dome gores from single sheets of 2219-T37 aluminum alloy; (2) the designing of a full scale production die, including a determination of tooling requirements; and (3) the determination of cost per gore at the required production rates, including manufacturing, packaging, and shipping.

Comparison of external costs between dry tomb and bioreactor landfills: taking intergenerational effects seriously.

PubMed

Méry, Jacques; Bayer, Stefan

2005-12-01

Dry tomb and bioreactor landfills were analyzed with respect to their external costs in an intergenerational cost-benefit analysis in a partial framework which enabled a sounder comparison to be carried out between these two technologies from a socio-economic viewpoint. Obviously, this approach was only a first step for building a comprehensive basis of any environmental as well as fiscal policy in the field of waste management. All external costs are identified and evaluated in three different scenarios, corresponding to a worst case, a best guess and a best case. Obviously, discounting is crucial with respect to an intergenerational perspective. Generation-adjusted discounting (GAD) was applied to take into account equity as well as efficiency criteria, in order to deal with three different types of uncertainties that are decisive in waste policy decisions: a physical uncertainty is captured by introducing our three different scenarios; a macroeconomic uncertainty is taken into consideration by calculating present values using different real growth rates; and a microeconomic uncertainty is taken into account by considering individual peculiarities reflected in their subjective time preference rate. The findings show, that whenever there is a low real GDP growth of less than 1%, the bioreactor is generally superior to the dry tomb (lower present values of external costs). This statement becomes more valid as the growth rate decreases. However, whenever there are high positive growth rates, it is the dry tomb technology which is superior to the bioreactor system.

Prescription, Dispensation, and Generic Medicine Replacement Ratios: Influence on Japanese Medicine Costs

PubMed Central

Yokoi, Masayuki; Tashiro, Takao

2016-01-01

This study used publicly available data to examine the effect of the separation of dispensing and prescribing medicines between pharmacists in pharmacies and doctors in medical institutions (the separation system) and the generic medicine replacement ratio on the cost of various medicines in Japanese prefectures. For Japanese medical institutions, participation in the separation system is optional. Consequently, the expansion rate of the separation system for each administrative district is highly variable. In our multiple regression analysis, the dependent variables were the costs of daily medicines, specifically, total, internal, external, and injection medicines, as well as medical devices, and the independent variables were the expansion rate of the separation system and generic medicine replacement ratio. The expansion rate of the separation system showed a significant negative partial correlation with the daily costs of total, internal, and injection medicines as well as medical devices. Moreover, the rate of replacing brand name medicines with generic medicines showed a significant negative partial correlation with the daily costs of total and internal medicines. However, external and injection medicines and medical devices did not because only a few or no generic products of these types were sold in the Japanese market. Otherwise, expansion of the separation system was effective in reducing medicine costs, except in the case of external medicines. This suggests that the cost efficiency effect of the separation system does not function all the time. PMID:26234979

Trade-off between speed and cost in shortcuts to adiabaticity

NASA Astrophysics Data System (ADS)

Campbell, Steve

Recent years have witnessed a surge of interest in the study of thermal nano-machines that are capable of converting disordered forms of energy into useful work. It has been shown for both classical and quantum systems that external drivings can allow a system to evolve adiabatically even when driven in finite time, a technique commonly known as shortcuts to adiabaticity. It was suggested to use such external drivings to render the unitary processes of a thermodynamic cycle quantum adiabatic, while being performed in finite time. However, implementing an additional external driving requires resources that should be accounted for. Furthermore, and in line with natural intuition, these transformations should not be achievable in arbitrarily short times. First, we will present a computable measure of the cost of a shortcut to adiabaticity. Using this, we then examine the speed with which a quantum system can be driven. As a main result, we will establish a rigorous link between this speed, the quantum speed limit, and the (energetic) cost of implementing such a shortcut to adiabaticity. Interestingly, this link elucidates a trade-off between speed and cost, namely that instantaneous manipulation is impossible as it requires an infinite cost.

Full cost accounting for the life cycle of coal.

PubMed

Epstein, Paul R; Buonocore, Jonathan J; Eckerle, Kevin; Hendryx, Michael; Stout Iii, Benjamin M; Heinberg, Richard; Clapp, Richard W; May, Beverly; Reinhart, Nancy L; Ahern, Melissa M; Doshi, Samir K; Glustrom, Leslie

2011-02-01

Each stage in the life cycle of coal-extraction, transport, processing, and combustion-generates a waste stream and carries multiple hazards for health and the environment. These costs are external to the coal industry and are thus often considered "externalities." We estimate that the life cycle effects of coal and the waste stream generated are costing the U.S. public a third to over one-half of a trillion dollars annually. Many of these so-called externalities are, moreover, cumulative. Accounting for the damages conservatively doubles to triples the price of electricity from coal per kWh generated, making wind, solar, and other forms of nonfossil fuel power generation, along with investments in efficiency and electricity conservation methods, economically competitive. We focus on Appalachia, though coal is mined in other regions of the United States and is burned throughout the world. © 2011 New York Academy of Sciences.

Capital Costs: A Conceptual Framework for Colleges and Universities

ERIC Educational Resources Information Center

Cash, Samuel G.

2004-01-01

The increased attention to costs in recent years at colleges and universities draws attention to the matter of whether all costs are reflected and accounted for in the institution's internal and external financial reports. One category--capital costs--is thought by some to be overlooked at times. The possible neglect of capital costs in…

Advanced Fuel Cycle Cost Basis – 2017 Edition

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

Dixon, B. W.; Ganda, F.; Williams, K. A.

This report, commissioned by the U.S. Department of Energy (DOE) Office of Nuclear Energy (NE), provides a comprehensive set of cost data supporting a cost analysis for the relative economic comparison of options for use in the DOE Nuclear Technology Research and Development (NTRD) Program (previously the Fuel Cycle Research and Development (FCRD) and the Advanced Fuel Cycle Initiative (AFCI)). The report describes the NTRD cost basis development process, reference information on NTRD cost modules, a procedure for estimating fuel cycle costs, economic evaluation guidelines, and a discussion on the integration of cost data into economic computer models. This reportmore » contains reference cost data for numerous fuel cycle cost modules (modules A-O) as well as cost modules for a number of reactor types (R modules). The fuel cycle cost modules were developed in the areas of natural uranium mining and milling, thorium mining and milling, conversion, enrichment, depleted uranium disposition, fuel fabrication, interim spent fuel storage, reprocessing, waste conditioning, spent nuclear fuel (SNF) packaging, long-term monitored retrievable storage, managed decay storage, recycled product storage, near surface disposal of low-level waste (LLW), geologic repository and other disposal concepts, and transportation processes for nuclear fuel, LLW, SNF, transuranic, and high-level waste. Since its inception, this report has been periodically updated. The last such internal document was published in August 2015 while the last external edition was published in December of 2009 as INL/EXT-07-12107 and is available on the Web at URL: www.inl.gov/technicalpublications/Documents/4536700.pdf. This current report (Sept 2017) is planned to be reviewed for external release, at which time it will replace the 2009 report as an external publication. This information is used in the ongoing evaluation of nuclear fuel cycles by the NE NTRD program.« less

Selling In-House Training Outside.

ERIC Educational Resources Information Center

Hequet, Marc

1991-01-01

Questions to consider before marketing in-house training externally include (1) balancing internal and external clients, accounting for costs, being concerned about proprietary information, finding the right niche, and determining whether profitability is a goal. (SK)

An uncertainty analysis of air pollution externalities from road transport in Belgium in 2010.

PubMed

Int Panis, L; De Nocker, L; Cornelis, E; Torfs, R

2004-12-01

Although stricter standards for vehicles will reduce emissions to air significantly by 2010, a number of problems will remain, especially related to particulate concentrations in cities, ground-level ozone, and CO(2). To evaluate the impacts of new policy measures, tools need to be available that assess the potential benefits of these measures in terms of the vehicle fleet, fuel choice, modal choice, kilometers driven, emissions, and the impacts on public health and related external costs. The ExternE accounting framework offers the most up to date and comprehensive methodology to assess marginal external costs of energy-related pollutants. It combines emission models, air dispersion models at local and regional scales with dose-response functions and valuation rules. Vito has extended this accounting framework with data and models related to the future composition of the vehicle fleet and transportation demand to evaluate the impact of new policy proposals on air quality and aggregated (total) external costs by 2010. Special attention was given to uncertainty analysis. The uncertainty for more than 100 different parameters was combined in Monte Carlo simulations to assess the range of possible outcomes and the main drivers of these results. Although the impacts from emission standards and total fleet mileage look dominant at first, a number of other factors were found to be important as well. This includes the number of diesel vehicles, inspection and maintenance (high-emitter cars), use of air conditioning, and heavy duty transit traffic.

Research and Development Strategies in the Semiconductor Industry

NASA Astrophysics Data System (ADS)

Bowling, Allen

2003-03-01

In the 21st Century semiconductor industry, there is a critical balance between internally funded semiconductor research and development (R) and externally funded R. External R may include jointly-funded research collaborations/partnerships with other device manufacturers, jointly-funded consortia-based R, and individually-funded research programs at universities and other contract research locations. Each of these approaches has merits and each has costs. There is a critical balance between keeping the internal research and development pipeline filled and keeping it from being overspent. To meet both competitive schedule and cost goals, a semiconductor device manufacturer must decide on a model for selection of internal versus external R. Today, one of the most critical decisions is whether or not to do semiconductor research and development on 300 mm silicon wafers. Equipment suppliers are doing first development on 300 mm equipment. So, for the device manufacturer, there is a balance between the cost of doing development on 300 mm wafers and the development time schedule driven by equipment availability. In the face of these cost and schedule elements, device manufacturers are looking to consortia such as SEMATECH, SRC, and SRC MARCO for early development and screening of new materials and device structure approaches. This also causes much more close development collaboration between device manufacturer and equipment supplier. Many device manufacturers are also making use of direct contract research with universities and other contract-research organizations, such as IMEC, LETI, and other government-funded research organizations around the world. To get the most out of these external research interactions, the company must develop a strategy for management and technology integration of external R.

Explanation of Change (EoC) Study: Considerations and Implementation Challenges

NASA Technical Reports Server (NTRS)

Bitten, Robert E.; Emmons, Debra L.; Hart, Matthew J.; Bordi, Francesco; Scolese, Christopher; Hinners, Noel

2013-01-01

This paper discusses the implementation of considerations resulting from a study investigating the cost change experienced by historical NASA science missions. The study investigated historical milestone and monthly status report documentation followed by interviews with key project personnel. The reasons for cost change were binned as being external to NASA, external to the project and internal to the project relative to the project's planning and execution. Based on the results of the binning process and the synthesis of project meetings and interviews, ten considerations were made with the objective to decrease the potential for cost change in future missions. Although no one magic bullet consideration was discovered, the considerations taken as a whole should help reduce cost and schedule change in future NASA missions.

The strategic significance of negative externalities.

DOT National Transportation Integrated Search

2012-12-01

Negative externalities have competitive relevance in a market when they have selective impacts as, for : example, when a product in use imposes greater costs on consumers of rival products than on other people. : Because managers have discretion ...

Consortium Purchases: Case Study for a Cost-Benefit Analysis.

ERIC Educational Resources Information Center

Scigliano, Marisa

2002-01-01

Discusses library cooperation and academic library consortia and presents a case study of a Canadian consortia that conducted a cost-benefit analysis for purchasing an electronic resource. Reports on member library subscription costs, external economic factors, value of patron time saved, costs and benefits for patrons, and net savings. (LRW)

Architectural Considerations of Fiber-Radio Millimeter-Wave Wireless Access Systems

NASA Astrophysics Data System (ADS)

Kitayama, Ken-Ichi

The architecture of fiber-radio mm-wave wireless access systems critically depends upon the optical mm-wave generation and transport techniques. Four optical mm-wave generation and transport techniques: 1) optical self-heterodyning, 2) external modulation, 3) up- and downconversion, and 4) optical transceiver, will be assessed. From the technical viewpoints, their advantages and disadvantages are discussed. The economical assessment, focusing on the cost of a base station BS ( ), will suggest that the optical transceiver looks the most promising in the long run, but in the near future, however, the external modulation will be cost-effective. The experimental results of 60 GHz testbeds using the external modulation will support the conclusion.

Assessing Air Pollutant-Induced, Health-Related External Costs in the Context of Nonmarginal System Changes: A Review.

PubMed

Bachmann, Till M

2015-08-18

Marginal analysis is the usual approach to environmental economic assessment, for instance, of health-related external costs due to energy-associated air pollutant emissions. However, nonlinearity exists in all steps of their assessment, i.e., atmospheric dispersion, impact assessment, and monetary valuation. Dedicated assessments thus appear necessary when evaluating large systems or their changes such as in green accounting or the implications of economy-wide energy transitions. Corresponding approaches are reviewed. Tools already exist that allow assessing a marginal change (e.g., one power plant's emissions) for different background emission scenarios that merely need to be defined and implemented. When assessing nonmarginal changes, the top-down approach is considered obsolete, and four variants of the bottom-up approach with different application domains were identified. Variants 1 and 2 use precalculated external cost factors with different levels of sophistication, suitable for energy systems modeling, optimizing for social (i.e., private and external) costs. Providing more reliable results due to more detailed modeling, emission sources are assessed individually or jointly in variants 3 and 4, respectively. Aiming at considering nonlinearity more fully and simultaneously following marginal analysis principles, I propose a variant 3-based approach, subdividing an aggregate (i.e., a nonmarginal change) into several smaller changes. Its strengths and drawbacks, notably the associated effort, are discussed.

Valuation of plug-in vehicle life-cycle air emissions and oil displacement benefits

PubMed Central

Michalek, Jeremy J.; Chester, Mikhail; Jaramillo, Paulina; Samaras, Constantine; Shiau, Ching-Shin Norman; Lave, Lester B.

2011-01-01

We assess the economic value of life-cycle air emissions and oil consumption from conventional vehicles, hybrid-electric vehicles (HEVs), plug-in hybrid-electric vehicles (PHEVs), and battery electric vehicles in the US. We find that plug-in vehicles may reduce or increase externality costs relative to grid-independent HEVs, depending largely on greenhouse gas and SO2 emissions produced during vehicle charging and battery manufacturing. However, even if future marginal damages from emissions of battery and electricity production drop dramatically, the damage reduction potential of plug-in vehicles remains small compared to ownership cost. As such, to offer a socially efficient approach to emissions and oil consumption reduction, lifetime cost of plug-in vehicles must be competitive with HEVs. Current subsidies intended to encourage sales of plug-in vehicles with large capacity battery packs exceed our externality estimates considerably, and taxes that optimally correct for externality damages would not close the gap in ownership cost. In contrast, HEVs and PHEVs with small battery packs reduce externality damages at low (or no) additional cost over their lifetime. Although large battery packs allow vehicles to travel longer distances using electricity instead of gasoline, large packs are more expensive, heavier, and more emissions intensive to produce, with lower utilization factors, greater charging infrastructure requirements, and life-cycle implications that are more sensitive to uncertain, time-sensitive, and location-specific factors. To reduce air emission and oil dependency impacts from passenger vehicles, strategies to promote adoption of HEVs and PHEVs with small battery packs offer more social benefits per dollar spent. PMID:21949359

Valuation of plug-in vehicle life-cycle air emissions and oil displacement benefits.

PubMed

Michalek, Jeremy J; Chester, Mikhail; Jaramillo, Paulina; Samaras, Constantine; Shiau, Ching-Shin Norman; Lave, Lester B

2011-10-04

We assess the economic value of life-cycle air emissions and oil consumption from conventional vehicles, hybrid-electric vehicles (HEVs), plug-in hybrid-electric vehicles (PHEVs), and battery electric vehicles in the US. We find that plug-in vehicles may reduce or increase externality costs relative to grid-independent HEVs, depending largely on greenhouse gas and SO(2) emissions produced during vehicle charging and battery manufacturing. However, even if future marginal damages from emissions of battery and electricity production drop dramatically, the damage reduction potential of plug-in vehicles remains small compared to ownership cost. As such, to offer a socially efficient approach to emissions and oil consumption reduction, lifetime cost of plug-in vehicles must be competitive with HEVs. Current subsidies intended to encourage sales of plug-in vehicles with large capacity battery packs exceed our externality estimates considerably, and taxes that optimally correct for externality damages would not close the gap in ownership cost. In contrast, HEVs and PHEVs with small battery packs reduce externality damages at low (or no) additional cost over their lifetime. Although large battery packs allow vehicles to travel longer distances using electricity instead of gasoline, large packs are more expensive, heavier, and more emissions intensive to produce, with lower utilization factors, greater charging infrastructure requirements, and life-cycle implications that are more sensitive to uncertain, time-sensitive, and location-specific factors. To reduce air emission and oil dependency impacts from passenger vehicles, strategies to promote adoption of HEVs and PHEVs with small battery packs offer more social benefits per dollar spent.

External risk factors affecting construction costs

NASA Astrophysics Data System (ADS)

Mubarak, Husin, Saiful; Oktaviati, Mutia

2017-11-01

Some risk factors can have impacts on the cost, time, and performance. Results of previous studies indicated that the external conditions are among the factors which give effect to the contractor in the completion of the project. The analysis in the study carried out by considering the conditions of the project in the last 15 years in Aceh province, divided into military conflict phase (2000-2004), post tsunami disaster rehabilitation and reconstruction phase (2005-2009), and post-rehabilitation and reconstruction phase (2010-present). This study intended to analyze the impact of external risk factors, primarily related to the impact on project costs and to investigate the influence of the risk factors and construction phases impacted the project cost. Data was collected by using a questionnaire distributed in 15 large companies qualification contractors in Aceh province. Factors analyzed consisted of socio-political, government policies, natural disasters, and monetary conditions. Data were analyzed using statistical application of severity index to measure the level of risk impact. The analysis results presented the tendency of impact on cost can generally be classified as low. There is only one variable classified as high-impact, variable `fuel price increases', which appear on the military conflict and post tsunami disaster rehabilitation and reconstruction periods. The risk impact on costs from the factors and variables classified with high intensity needs a serious attention, especially when the high level impact is followed by the high frequency of occurrences.

Valuing environmental health for informed policy-making.

PubMed

Máca, Vojtěch; Melichar, Jan; Ščasný, Milan; Kohlová, Markéta Braun

2017-03-01

Monetized environmental health impact assessments help to better evaluate the environmental burden of a wide range of economic activities. Apart from the limitations and uncertainties in physical and biological science used in such assessments, assumptions taken from economic valuation may also substantially influence subsequent policy-making considerations. This study attempts to demonstrate the impact of normative policy assumptions on quantified external costs using a case study of recently discussed variants of future coal mining and use of extracted coal in electricity and heat generation in the Czech Republic. A bottom-up impact-pathway approach is used for quantification of external costs. Several policy perspectives are elaborated for aggregating impacts that differ in geographic coverage and in how valuation of quantified impacts is adjusted in a particular perspective. We find that the fraction of monetized external impacts taken into policy-making considerations may vary according to choice of decision perspective up to a factor of 10. At present there are virtually no hard rules for defining geographical boundaries or adjusting values for a summation of monetized environmental impacts. We, however, stress that any rigorous external cost assessment should, for instance in a separate calculation, take account of impacts occurring beyond country borders.

Overhead Costs and Rates in the U.S. Defense Industrial Base. Volume 1

DTIC Science & Technology

1980-10-01

Manager rather than to establish rigidly defined cost accounting structures. The conclusions to be own from the analysis were that overhead costs have...specific costs which make up tho overhead account ; whether management is controlling them; whether these costs are "reasonable" and the external factors... cost accounting structures, . ..... ....... .... ... ............................... , , ,’" ’ .. -17- and since there is no one accounting definition of

Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing.

PubMed

Bauer-Nilsen, Kristine; Hill, Colin; Trifiletti, Daniel M; Libby, Bruce; Lash, Donna H; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N

2018-01-01

To evaluate the delivery costs, using time-driven activity-based costing, and reimbursement for definitive radiation therapy for locally advanced cervical cancer. Process maps were created to represent each step of the radiation treatment process and included personnel, equipment, and consumable supplies used to deliver care. Personnel were interviewed to estimate time involved to deliver care. Salary data, equipment purchasing information, and facilities costs were also obtained. We defined the capacity cost rate (CCR) for each resource and then calculated the total cost of patient care according to CCR and time for each resource. Costs were compared with 2016 Medicare reimbursement and relative value units (RVUs). The total cost of radiation therapy for cervical cancer was $12,861.68, with personnel costs constituting 49.8%. Brachytherapy cost $8610.68 (66.9% of total) and consumed 423 minutes of attending radiation oncologist time (80.0% of total). External beam radiation therapy cost $4055.01 (31.5% of total). Personnel costs were higher for brachytherapy than for the sum of simulation and external beam radiation therapy delivery ($4798.73 vs $1404.72). A full radiation therapy course provides radiation oncologists 149.77 RVUs with intensity modulated radiation therapy or 135.90 RVUs with 3-dimensional conformal radiation therapy, with total reimbursement of $23,321.71 and $16,071.90, respectively. Attending time per RVU is approximately 4-fold higher for brachytherapy (5.68 minutes) than 3-dimensional conformal radiation therapy (1.63 minutes) or intensity modulated radiation therapy (1.32 minutes). Time-driven activity-based costing was used to calculate the total cost of definitive radiation therapy for cervical cancer, revealing that brachytherapy delivery and personnel resources constituted the majority of costs. However, current reimbursement policy does not reflect the increased attending physician effort and delivery costs of brachytherapy. We hypothesize that the significant discrepancy between treatment costs and physician effort versus reimbursement may be a potential driver of reported national trends toward poor compliance with brachytherapy, and we suggest re-evaluation of payment policies to incentivize quality care. Copyright © 2017 Elsevier Inc. All rights reserved.

28 CFR 100.15 - Disallowed costs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... limited to: (1) Accounting and Finance, External Relations, Human Resources, Information Management, Legal...) costs are disallowed. G&A costs include, but are not limited to, any management, financial, and other... include, but are not limited to, any Marketing, Sales, Product Management, and Advertising expenses. (c...

28 CFR 100.15 - Disallowed costs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... limited to: (1) Accounting and Finance, External Relations, Human Resources, Information Management, Legal...) costs are disallowed. G&A costs include, but are not limited to, any management, financial, and other... include, but are not limited to, any Marketing, Sales, Product Management, and Advertising expenses. (c...

28 CFR 100.15 - Disallowed costs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... limited to: (1) Accounting and Finance, External Relations, Human Resources, Information Management, Legal...) costs are disallowed. G&A costs include, but are not limited to, any management, financial, and other... include, but are not limited to, any Marketing, Sales, Product Management, and Advertising expenses. (c...

28 CFR 100.15 - Disallowed costs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... limited to: (1) Accounting and Finance, External Relations, Human Resources, Information Management, Legal...) costs are disallowed. G&A costs include, but are not limited to, any management, financial, and other... include, but are not limited to, any Marketing, Sales, Product Management, and Advertising expenses. (c...

External tissue expansion for difficult wounds using a simple cost effective technique.

PubMed

Nandhagopal, Vijayaraghavan; Chittoria, Ravi Kumar; Mohapatra, Devi Prasad; Thiruvoth, Friji Meethale; Sivakumar, Dinesh Kumar; Ashokan, Arjun

2015-01-01

To study and discuss role of external tissue expansion and wound closure (ETEWC) technique using hooks and rubber bands. The present study is a retrospective analysis of nine cases of wounds of different aetiology where ETEWC technique was applied using hooks and rubber bands. All the wounds in the study healed completely without split thickness skin graft (SSG) or flap. ETEWC technique using hooks and rubber bands is a cost-effective technique which can be used for wound closure without SSG or flap.

Conceptual design study of 1985 commercial VTOL transports that utilize rotors

NASA Technical Reports Server (NTRS)

Kefford, N. F. K.; Munch, C. L.

1975-01-01

Conceptual design studies of pure and compound helicopter commercial short-haul transport aircraft for initial fabrication in 1980 were performed to determine their technical and economic feasibility. One-hundred-passenger configurations were optimized for minimum direct operating cost consistent with producibility and marketability, with emphasis on proper account of mass properties, performance and handling qualities adequacy, and suppression of internal and external noise. The effect of external noise constraints was assessed, in terms of gross weight and direct operating cost, for each aircraft.

Differences in the use of outsourcing in public and private institutions providing medical services.

PubMed

Czerw, Aleksandra I; Kowalska, Mariola; Religioni, Urszula

2014-06-29

The costs of health care in Poland are continuously increasing. Thus, almost every institution providing medical services aims at their limitation. One of the costs rationalisation methods in the health care sector is outsourcing. The study was conducted in 153 randomly selected institutions providing medical activities. The tool was a questionnaire, available via a web browser. Over 30% of public institutions identified the need for financial savings, as the main reason for outsourcing the cleaning function. Among private institutions, the dominant reason for this is too high maintenance cost of the cleaning staff (less than 40% of responses). The huge number of medical institutions use the services of an external company for laundering. Over 30% of public institutions identified as the most common reason for separation of functions laundering lack of resources to upgrade and modernize facilities. Less than 27% of public institutions indicate too high costs of kitchen staff as the main reason for ordering function of feeding. Another reason is the need for financial savings (22% response rate). Some institutions indicate a desire to focus on key areas (20% of responses) and lack of financial resources to upgrade and modernize the kitchen (20% response rate). Public and private institutions exercise control over the quality and method performed by an external service (71% of public institutions and 59% of private institutions). Private institutions often informally exercise external control (difference confirmed - Fisher's exact test). Less than 90% of public institutions indicated satisfaction with the services provided by external companies. The adaptation of outsourcing in medical facilities leads to financial efficiency improvement. Through the separation of some medical functions and entrusting their realisation to external companies, medical institutions can focus on their basic activity that is the provision of health services.

Emissions and Cost Implications of Controlled Electric Vehicle Charging in the U.S. PJM Interconnection.

PubMed

Weis, Allison; Michalek, Jeremy J; Jaramillo, Paulina; Lueken, Roger

2015-05-05

We develop a unit commitment and economic dispatch model to estimate the operation costs and the air emissions externality costs attributable to new electric vehicle electricity demand under controlled vs uncontrolled charging schemes. We focus our analysis on the PJM Interconnection and use scenarios that characterize (1) the most recent power plant fleet for which sufficient data are available, (2) a hypothetical 2018 power plant fleet that reflects upcoming plant retirements, and (3) the 2018 fleet with increased wind capacity. We find that controlled electric vehicle charging can reduce associated generation costs by 23%-34% in part by shifting loads to lower-cost, higher-emitting coal plants. This shift results in increased externality costs of health and environmental damages from increased air pollution. On balance, we find that controlled charging of electric vehicles produces negative net social benefits in the recent PJM grid but could have positive net social benefits in a future grid with sufficient coal retirements and wind penetration.

Stirling heat pump external heat systems - An appliance perspective

NASA Astrophysics Data System (ADS)

Vasilakis, Andrew D.; Thomas, John F.

A major issue facing the Stirling Engine Heat Pump is system cost, and, in particular, the cost of the External Heat System (EHS). The need for high temperature at the heater head (600 C to 700 C) results in low combustion system efficiencies unless efficient heat recovery is employed. The balance between energy efficiency and use of costly high temperature materials is critical to design and cost optimization. Blower power consumption and NO(x) emissions are also important. A new approach to the design and cost optimization of the EHS was taken by viewing the system from a natural gas-fired appliance perspective. To develop a design acceptable to gas industry requirements, American National Standards Institute (ANSI) code considerations were incorporated into the design process and material selections. A parametric engineering design and cost model was developed to perform the analysis, including the impact of design on NO(x) emissions. Analysis results and recommended EHS design and material choices are given.

Stirling heat pump external heat systems: An appliance perspective

NASA Astrophysics Data System (ADS)

Vasilakis, A. D.; Thomas, J. F.

1992-08-01

A major issue facing the Stirling Engine Heat Pump is system cost, and, in particular, the cost of the External Heat System (EHS). The need for high temperature at the heater head (600 C to 700 C) results in low combustion system efficiencies unless efficient heat recovery is employed. The balance between energy efficiency and use of costly high temperature materials is critical to design and cost optimization. Blower power consumption and NO(x) emissions are also important. A new approach to the design and cost optimization of the EHS system was taken by viewing the system from a natural gas-fired appliance perspective. To develop a design acceptable to gas industry requirements, American National Standards Institute (ANSI) code considerations were incorporated into the design process and material selections. A parametric engineering design and cost model was developed to perform the analysis, including the impact of design on NO(x) emissions. Analysis results and recommended EHS design and material choices are given.

14 CFR 1274.205 - Consortia as recipients.

Code of Federal Regulations, 2012 CFR

2012-01-01

... better share the projects financial costs (e.g., the 50 percent recipient's cost share or other costs of... issues; (8) Internal and external reporting requirements; (9) Management structure of the consortium; (10... the consortia members (12) Agreements, if any, to share existing technology and data; (13) The firm...

14 CFR 1274.205 - Consortia as recipients.

Code of Federal Regulations, 2013 CFR

2013-01-01

... better share the projects financial costs (e.g., the 50 percent recipient's cost share or other costs of... issues; (8) Internal and external reporting requirements; (9) Management structure of the consortium; (10... the consortia members (12) Agreements, if any, to share existing technology and data; (13) The firm...

14 CFR § 1274.205 - Consortia as recipients.

Code of Federal Regulations, 2014 CFR

2014-01-01

... better share the projects financial costs (e.g., the 50 percent recipient's cost share or other costs of... issues; (8) Internal and external reporting requirements; (9) Management structure of the consortium; (10... the consortia members (12) Agreements, if any, to share existing technology and data; (13) The firm...

Audio Teleconferencing: Low Cost Technology for External Studies Networking.

ERIC Educational Resources Information Center

Robertson, Bill

1987-01-01

This discussion of the benefits of audio teleconferencing for distance education programs and for business and government applications focuses on the recent experience of Canadian educational users. Four successful operating models and their costs are reviewed, and it is concluded that audio teleconferencing is cost efficient and educationally…

Application of laser technology in treatment of diseases of the external genitals

NASA Astrophysics Data System (ADS)

Wilczak, Maciej; Wozniak, Jakub; Sajdak, Stefan; Opala, Tomasz; Rabiega, Dorota

2000-11-01

Lasersurgery is the very profitable method of treatment of diseases of external sexual organs, with regard to high efficiency and little relapses. Lasersurgery is recommended especially for pregnant women considering possibility of physiological childbirth. We prefer laser CO2 in connexion with colposcope in treatment of diseases of external sexual organs. The application of this method is limited by the high cost of equipment.

Cost Studies in Higher Education. The AIR Professional File, No. 7, Fall 1980.

ERIC Educational Resources Information Center

Hample, Stephen R.

A guide to cost studies in higher education is presented, with emphasis directed to the response of a four-year public institution to an externally mandated cost study. Cost studies are usually requested to guide budget allocations, either from an internal campus need or from outside pressures. Although much effort has been expended by various…

Accountable Care Organizations and Transaction Cost Economics.

PubMed

Mick, Stephen S Farnsworth; Shay, Patrick D

2016-12-01

Using a Transaction Cost Economics (TCE) approach, this paper explores which organizational forms Accountable Care Organizations (ACOs) may take. A critical question about form is the amount of vertical integration that an ACO may have, a topic central to TCE. We posit that contextual factors outside and inside an ACO will produce variable transaction costs (the non-production costs of care) such that the decision to integrate vertically will derive from a comparison of these external versus internal costs, assuming reasonably rational management abilities. External costs include those arising from environmental uncertainty and complexity, small numbers bargaining, asset specificity, frequency of exchanges, and information "impactedness." Internal costs include those arising from human resource activities including hiring and staffing, training, evaluating (i.e., disciplining, appraising, or promoting), and otherwise administering programs. At the extreme, these different costs may produce either total vertical integration or little to no vertical integration with most ACOs falling in between. This essay demonstrates how TCE can be applied to the ACO organization form issue, explains TCE, considers ACO activity from the TCE perspective, and reflects on research directions that may inform TCE and facilitate ACO development. © The Author(s) 2016.

A Determination of Military and Civilian Personnel Costs as Related to a Member of Technical Staff

DTIC Science & Technology

1992-06-01

Costs, 1986 4 2. Direct Total Manpower Bidget Costs, 1992 5 3. Pay Raises 1985-1992 6 4. Support Costs 9 5. Internal Support Personnel 10 6. External...34 Incremental Costs of Military and Civilian Manpower in the Military Services." This docu- ment provides the basis for this section. The report assesses...6 Aug 91. MTS Workyear Cost Comparison. Internal AFSC paper, 20 November 1990. Palmer, Adele R., Osbaldeston, David J., Incremental Costs of Military

Optimal joint management of a coastal aquifer and a substitute resource

NASA Astrophysics Data System (ADS)

Moreaux, M.; Reynaud, A.

2004-06-01

This article characterizes the optimal joint management of a coastal aquifer and a costly water substitute. For this purpose we use a mathematical representation of the aquifer that incorporates the displacement of the interface between the seawater and the freshwater of the aquifer. We identify the spatial cost externalities created by users on each other and we show that the optimal water supply depends on the location of users. Users located in the coastal zone exclusively use the costly substitute. Those located in the more upstream area are supplied from the aquifer. At the optimum their withdrawal must take into account the cost externalities they generate on users located downstream. Last, users located in a median zone use the aquifer with a surface transportation cost. We show that the optimum can be implemented in a decentralized economy through a very simple Pigouvian tax. Finally, the optimal and decentralized extraction policies are simulated on a very simple example.

Potential of extensification of European agriculture for a more sustainable food system, focusing on nitrogen

NASA Astrophysics Data System (ADS)

van Grinsven, Hans J. M.; Willem Erisman, Jan; de Vries, Wim; Westhoek, Henk

2015-02-01

Most global strategies for future food security focus on sustainable intensification of production of food and involve increased use of nitrogen fertilizer and manure. The external costs of current high nitrogen (N) losses from agriculture in the European Union, are 0.3-1.9% of gross domestic product (GDP) in 2008. We explore the potential of sustainable extensification for agriculture in the EU and The Netherlands by analysing cases and scenario studies focusing on reducing N inputs and livestock densities. Benefits of extensification are higher local biodiversity and less environmental pollution and therefore less external costs for society. Extensification also has risks such as a reduction of yields and therewith a decrease of the GDP and farm income and a smaller contribution to the global food production, and potentially an i0ncrease of global demand for land. We demonstrate favourable examples of extensification. Reducing the N fertilization rate for winter wheat in Northwest Europe to 25-30% below current N recommendations accounts for the external N cost, but requires action to compensate for a reduction in crop yield by 10-20%. Dutch dairy and pig farmers changing to less intensive production maintain or even improve farm income by price premiums on their products, and/or by savings on external inputs. A scenario reducing the Dutch pig and poultry sector by 50%, the dairy sector by 20% and synthetic N fertilizer use by 40% lowers annual N pollution costs by 0.2-2.2 billion euro (40%). This benefit compensates for the loss of GDP in the primary sector but not in the supply and processing chain. A 2030 scenario for the EU27 reducing consumption and production of animal products by 50% (demitarean diet) reduces N pollution by 10% and benefits human health. This diet allows the EU27 to become a food exporter, while reducing land demand outside Europe in 2030 by more than 100 million hectares (2%), which more than compensates increased land demand when changing to organic farming. We conclude that in Europe extensification of agriculture is sustainable when combined with adjusted diets and externalization of environmental costs to food prices.

Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators.

PubMed

Shumba, Edwin; Nzombe, Phoebe; Mbinda, Absolom; Simbi, Raiva; Mangwanya, Douglas; Kilmarx, Peter H; Luman, Elizabeth T; Zimuto, Sibongile N

2014-01-01

In 2010, the Zimbabwe Ministry of Health and Child Welfare (MoHCW) adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a tool for laboratory quality systems strengthening. To evaluate the financial costs of SLMTA implementation using two models (external facilitators; and internal local or MoHCW facilitators) from the perspective of the implementing partner and to estimate resources needed to scale up the programme nationally in all 10 provinces. The average expenditure per laboratory was calculated based on accounting records; calculations included implementing partner expenses but excluded in-kind contributions and salaries of local facilitators and trainees. We also estimated theoretical financial costs, keeping all contextual variables constant across the two models. Resource needs for future national expansion were estimated based on a two-phase implementation plan, in which 12 laboratories in each of five provinces would implement SLMTA per phase; for the internal facilitator model, 20 facilitators would be trained at the beginning of each phase. The average expenditure to implement SLMTA in 11 laboratories using external facilitators was approximately US$5800 per laboratory; expenditure in 19 laboratories using internal facilitators was approximately $6000 per laboratory. The theoretical financial cost of implementing a 12-laboratory SLMTA cohort keeping all contextual variables constant would be approximately $58 000 using external facilitators; or $15 000 using internal facilitators, plus $86 000 to train 20 facilitators. The financial cost for subsequent SLMTA cohorts using the previously-trained internal facilitators would be approximately $15 000, yielding a break-even point of 2 cohorts, at $116 000 for either model. Estimated resources required for national implementation in 120 laboratories would therefore be $580 000 using external facilitators ($58 000 per province) and $322 000 using internal facilitators ($86 000 for facilitator training in each of two phases plus $15 000 for SLMTA implementation in each province). Investing in training of internal facilitators will result in substantial savings over the scale-up of the programme. Our study provides information to assist policy makers to develop strategic plans for investing in laboratory strengthening.

Quantifying the Sensitivity of the Production of Environmental Externalities to Market-Based Interventions in the Power Sector

NASA Astrophysics Data System (ADS)

Peer, R.; Sanders, K.

2017-12-01

The optimization function that governs the dispatching of power generators to meet electricity demand minimizes the marginal cost of electricity generation without regard to the environmental or public health damages caused by power production. Although technologies exist for reducing the externalities resulting from electricity generation at power plants, current solutions typically raise the cost of power production or introduce operational challenges for the grid. This research quantifies the trade-offs and couplings between the cooling water, greenhouse gas emissions, and air quality impacts of different power generating technologies under business as usual market conditions, as well as a series of market-based interventions aimed to reduce the production of those externalities. Using publicly available data from the US Environmental Protection Agency (EPA) and the US Energy Information Administration (EIA) for power plant water use and emissions, a unit commitment and dispatch power market simulation model is modified to evaluate the production of environmental externalities from power production. Scenarios are developed to apply a set of fees for cooling water, carbon dioxide, nitrous oxide and sulfur oxide emissions, respectively. Trade-offs between environmental performance, overall generation costs, and shifts in the power plants dispatched to meet demand are quantified for each power market simulation. The results from this study will provide insight into the development of a novel market-based framework that modifies the optimization algorithms governing the dispatching of electricity onto the grid in efforts to achieve cost-effective improvements in its environmental performance without the need for new infrastructure investments.

Social dilemma in the external immune system of the red flour beetle? It is a matter of time.

PubMed

Gokhale, Chaitanya S; Traulsen, Arne; Joop, Gerrit

2017-09-01

Sociobiology has revolutionized our understanding of interactions between organisms. Interactions may present a social dilemma where the interests of individual actors do not align with those of the group as a whole. Viewed through a sociobiological lens, nearly all interactions can be described regarding their costs and benefits, and a number of them then resemble a social dilemma. Numerous experimental systems, from bacteria to mammals, have been proposed as models for studying such dilemmas. Here, we make use of the external immune system of the red flour beetle, Tribolium castaneum , to investigate how the experimental duration can affect whether the external secretion comprises a social dilemma or not. Some beetles (secretors) produce a costly quinone-rich external secretion that inhibits microbial growth in the surrounding environment, providing the secretors with direct personal benefits. However, as the antimicrobial secretion acts in the environment of the beetle, it is potentially also advantageous to other beetles (nonsecretors), who avoid the cost of producing the secretion. We test experimentally if the secretion qualifies as a public good. We find that in the short term, costly quinone secretion can be interpreted as a public good presenting a social dilemma where the presence of secretors increases the fitness of the group. In the long run, the benefit to the group of having more secretors vanishes and becomes detrimental to the group. Therefore, in such seminatural environmental conditions, it turns out that qualifying a trait as social can be a matter of timing.

Walking- and cycling track networks in Norwegian cities : cost-benefit analyses including health effects and external costs of road traffic : summary

DOT National Transportation Integrated Search

2002-04-01

Cost- benefit analyses of walking- and cycling track net-works in three Norwegian cities are presented in this study. A project group working with a National Cycling Strategy in Norway initialised the study. Motivation for starting the study is the P...

Can market-based policies accomplish the optimal floodplain management? A gap between static and dynamic models.

PubMed

Mori, Koichiro

2009-02-01

The purpose of this short article is to set static and dynamic models for optimal floodplain management and to compare policy implications from the models. River floodplains are important multiple resources in that they provide various ecosystem services. It is fundamentally significant to consider environmental externalities that accrue from ecosystem services of natural floodplains. There is an interesting gap between static and dynamic models about policy implications for floodplain management, although they are based on the same assumptions. Essentially, we can derive the same optimal conditions, which imply that the marginal benefits must equal the sum of the marginal costs and the social external costs related to ecosystem services. Thus, we have to internalise the external costs by market-based policies. In this respect, market-based policies seem to be effective in a static model. However, they are not sufficient in the context of a dynamic model because the optimal steady state turns out to be unstable. Based on a dynamic model, we need more coercive regulation policies.

An Engineering Perspective of External Cardiac Loop Recorder: A Systematic Review

PubMed Central

2016-01-01

External cardiac loop recorder (ELR) is a kind of ECG monitoring system that records cardiac activities of a subject continuously for a long time. When the heart palpitations are not the frequent and nonspecific character, it is difficult to diagnose the disease. In such a case, ELR is used for long-term monitoring of heart signal of the patient. But the cost of ELR is very high. Therefore, it is not prominently available in developing countries like India. Since the design of ELR includes the ECG electrodes, instrumentation amplifier, analog to digital converter, and signal processing unit, a comparative review of each part of the ELR is presented in this paper in order to design a cost effective, low power, and compact kind of ELR. This review will also give different choices available for selecting and designing each part of the ELR system. Finally, the review will suggest the better choice for designing a cost effective external cardiac loop recorder that helps to make it available even for rural people in India. PMID:27872843

Implementing Cardiopulmonary Resuscitation Training Programs in High Schools: Iowa's Experience.

PubMed

Hoyme, Derek B; Atkins, Dianne L

2017-02-01

To understand perceived barriers to providing cardiopulmonary resuscitation (CPR) education, implementation processes, and practices in high schools. Iowa has required CPR as a graduation requirement since 2011 as an unfunded mandate. A cross-sectional study was performed through multiple choice surveys sent to Iowa high schools to collect data about school demographics, details of CPR programs, cost, logistics, and barriers to implementation, as well as automated external defibrillator training and availability. Eighty-four schools responded (26%), with the most frequently reported school size of 100-500 students and faculty size of 25-50. When the law took effect, 51% of schools had training programs already in place; at the time of the study, 96% had successfully implemented CPR training. Perceived barriers to implementation were staffing, time commitment, equipment availability, and cost. The average estimated startup cost was <$1000 US, and the yearly maintenance cost was <$500 with funds typically allocated from existing school resources. The facilitator was a school official or volunteer for 81% of schools. Average estimated training time commitment per student was <2 hours. Automated external defibrillators are available in 98% of schools, and 61% include automated external defibrillator training in their curriculum. Despite perceived barriers, school CPR training programs can be implemented with reasonable resource and time allocations. Copyright © 2016 Elsevier Inc. All rights reserved.

Implementing Cardiopulmonary Resuscitation Training Programs in High Schools: Iowa's Experience

PubMed Central

Hoyme, Derek B.; Atkins, Dianne L.

2017-01-01

Objective To understand perceived barriers to providing cardiopulmonary resuscitation (CPR) education, implementation processes, and practices in high schools. Study design Iowa has required CPR as a graduation requirement since 2011 as an unfunded mandate. A cross-sectional study was performed through multiple choice surveys sent to Iowa high schools to collect data about school demographics, details of CPR programs, cost, logistics, and barriers to implementation, as well as automated external defibrillator training and availability. Results Eighty-four schools responded (26%), with the most frequently reported school size of 100-500 students and faculty size of 25-50. When the law took effect, 51% of schools had training programs already in place; at the time of the study, 96% had successfully implemented CPR training. Perceived barriers to implementation were staffing, time commitment, equipment availability, and cost. The average estimated startup cost was <$1000 US, and the yearly maintenance cost was <$500 with funds typically allocated from existing school resources. The facilitator was a school official or volunteer for 81% of schools. Average estimated training time commitment per student was <2 hours. Automated external defibrillators are available in 98% of schools, and 61% include automated external defibrillator training in their curriculum. Conclusions Despite perceived barriers, school CPR training programs can be implemented with reasonable resource and time allocations. PMID:27852456

An Analytic Model for DoD Investment & Divestment Decisions (Briefing Charts)

DTIC Science & Technology

2015-05-01

cost drives Strategic; Performance mixed; cost drives Invest Insurance Risk Mitigation √ “Making Trade-Offs in Corporate Portfolio Decisions...Effects (SE) + Insurance Intended externalities, unintended consequences Are SE measureable? Do they add/subtract so NPV is worthwhile? Deadweight...Sustainable Cost Effective Cost is supportable, LPO outsourced, or is income Advantageous NPV? Y Y Y Y either N N N N Secondary Effects+ Insurance

Siting a municipal solid waste disposal facility, part II: the effects of external criteria on the final decision.

PubMed

Korucu, M Kemal; Karademir, Aykan

2014-02-01

The procedure of a multi-criteria decision analysis supported by the geographic information systems was applied to the site selection process of a planning municipal solid waste management practice based on twelve different scenarios. The scenarios included two different decision tree modes and two different weighting models for three different area requirements. The suitability rankings of the suitable sites obtained from the application of the decision procedure for the scenarios were assessed by a factorial experimental design concerning the effect of some external criteria on the final decision of the site selection process. The external criteria used in the factorial experimental design were defined as "Risk perception and approval of stakeholders" and "Visibility". The effects of the presence of these criteria in the decision trees were evaluated in detail. For a quantitative expression of the differentiations observed in the suitability rankings, the ranking data were subjected to ANOVA test after a normalization process. Then the results of these tests were evaluated by Tukey test to measure the effects of external criteria on the final decision. The results of Tukey tests indicated that the involvement of the external criteria into the decision trees produced statistically meaningful differentiations in the suitability rankings. Since the external criteria could cause considerable external costs during the operation of the disposal facilities, the presence of these criteria in the decision tree in addition to the other criteria related to environmental and legislative requisites could prevent subsequent external costs in the first place.

Identifying external nutrient reduction requirements and potential in the hypereutrophic Lake Taihu Basin, China.

PubMed

Peng, Jiao-Ting; Zhu, Xiao-Dong; Sun, Xiang; Song, Xiao-Wei

2018-04-01

Reducing external nutrient loads is the first step for controlling eutrophication. Here, we identified external nutrient reduction requirements and potential of strategies for achieving reductions to remediate a eutrophic water body, Lake Taihu, China. A mass balance approach based on the entire lake was used to identify nutrient reduction requirements; an empirical export coefficient approach was introduced to estimate the nutrient reduction potential of the overall program on integrated regulation of Taihu Lake Basin (hereafter referred to as the "Guideline"). Reduction requirements included external total nitrogen (TN) and total phosphorus (TP) loads, which should be reduced by 41-55 and 25-50%, respectively, to prevent nutrient accumulation in Lake Taihu and to meet the planned water quality targets. In 2010, which is the most seriously polluted calendar year during the 2008-2014 period, the nutrient reduction requirements were estimated to be 36,819 tons of N and 2442 tons of P, and the potential nutrient reduction strategies would reduce approximately 25,821 tons of N and 3024 tons of P. Since there is a net N remaining in the reduction requirements, it should be the focus and deserves more attention in identifying external nutrient reduction strategies. Moreover, abatement measures outlined in the Guideline with high P reduction potential required large monetary investments. Achieving TP reduction requirement using the cost-effective strategy costs about 80.24 million USD. The design of nutrient reduction strategies should be enacted according to regional and sectoral differences and the cost-effectiveness of abatement measures.

Differences in the use of outsourcing in public and private institutions providing medical services

PubMed Central

Kowalska, Mariola; Religioni, Urszula

2014-01-01

Introduction The costs of health care in Poland are continuously increasing. Thus, almost every institution providing medical services aims at their limitation. One of the costs rationalisation methods in the health care sector is outsourcing. Material and methods The study was conducted in 153 randomly selected institutions providing medical activities. The tool was a questionnaire, available via a web browser. Results Over 30% of public institutions identified the need for financial savings, as the main reason for outsourcing the cleaning function. Among private institutions, the dominant reason for this is too high maintenance cost of the cleaning staff (less than 40% of responses). The huge number of medical institutions use the services of an external company for laundering. Over 30% of public institutions identified as the most common reason for separation of functions laundering lack of resources to upgrade and modernize facilities. Less than 27% of public institutions indicate too high costs of kitchen staff as the main reason for ordering function of feeding. Another reason is the need for financial savings (22% response rate). Some institutions indicate a desire to focus on key areas (20% of responses) and lack of financial resources to upgrade and modernize the kitchen (20% response rate). Public and private institutions exercise control over the quality and method performed by an external service (71% of public institutions and 59% of private institutions). Private institutions often informally exercise external control (difference confirmed – Fisher's exact test). Less than 90% of public institutions indicated satisfaction with the services provided by external companies. Conclusions The adaptation of outsourcing in medical facilities leads to financial efficiency improvement. Through the separation of some medical functions and entrusting their realisation to external companies, medical institutions can focus on their basic activity that is the provision of health services. PMID:25097595

Long-Term Continuous Ambulatory ECG Monitors and External Cardiac Loop Recorders for Cardiac Arrhythmia: A Health Technology Assessment

PubMed Central

Kabali, Conrad; Xie, Xuanqian; Higgins, Caroline

2017-01-01

Background Ambulatory electrocardiography (ECG) monitors are often used to detect cardiac arrhythmia. For patients with symptoms, an external cardiac loop recorder will often be recommended. The improved recording capacity of newer Holter monitors and similar devices, collectively known as longterm continuous ambulatory ECG monitors, suggests that they will perform just as well as, or better than, external loop recorders. This health technology assessment aimed to evaluate the effectiveness, cost-effectiveness, and budget impact of longterm continuous ECG monitors compared with external loop recorders in detecting symptoms of cardiac arrhythmia. Methods Based on our systematic search for studies published up to January 15, 2016, we did not identify any studies directly comparing the clinical effectiveness of longterm continuous ECG monitors and external loop recorders. Therefore, we conducted an indirect comparison, using a 24-hour Holter monitor as a common comparator. We used a meta-regression model to control for bias due to variation in device-wearing time and baseline syncope rate across studies. We conducted a similar systematic search for cost-utility and cost-effectiveness studies comparing the two types of devices; none were found. Finally, we used historical claims data (2006–2014) to estimate the future 5-year budget impact in Ontario, Canada, of continued public funding for both types of longterm ambulatory ECG monitors. Results Our clinical literature search yielded 7,815 non-duplicate citations, of which 12 cohort studies were eligible for indirect comparison. Seven studies assessed the effectiveness of longterm continuous monitors and five assessed external loop recorders. Both types of devices were more effective than a 24-hour Holter monitor, and we found no substantial difference between them in their ability to detect symptoms (risk difference 0.01; 95% confidence interval −0.18, 0.20). Using GRADE for network meta-analysis, we evaluated the quality of the evidence as low. Our budget impact analysis showed that use of the longterm continuous monitors has grown steadily in Ontario since they became publicly funded in 2006, particularly since 2011 when monitors that can record for 14 days or longer became funded, and the use of external cardiac loop recorders has correspondingly declined. The analysis suggests that, with these trends, continued public funding of both types of longterm ambulatory ECG testing will result in additional costs ranging from $130,000 to $370,000 per year over the next 5 years. Conclusions Although both longterm continuous ambulatory ECG monitors and external cardiac loop recorders were more effective than a 24-hour Holter monitor in detecting symptoms of cardiac arrhythmia, we found no evidence to suggest that these two devices differ in effectiveness. Assuming that the use of longterm continuous monitors will continue to increase in the next 5 years, the public health care system in Ontario can expect to see added costs of $130,000 to $370,000 per year. PMID:28194254

Cost optimization for buildings with hybrid ventilation systems

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

Ji, Kun; Lu, Yan

A method including: computing a total cost for a first zone in a building, wherein the total cost is equal to an actual energy cost of the first zone plus a thermal discomfort cost of the first zone; and heuristically optimizing the total cost to identify temperature setpoints for a mechanical heating/cooling system and a start time and an end time of the mechanical heating/cooling system, based on external weather data and occupancy data of the first zone.

Student Residence.

ERIC Educational Resources Information Center

Department of Education and Science, London (England).

Principal facility requirements and costs of residential accommodations for students are discussed. After specifying the various space and facility requirements and providing cost information for the various classes of facilities, the report details requirements pertaining to external works (road access; car parking; grassing, planting, and…

Partnership and empowerment program: a model for patient-centered, comprehensive, and cost-effective care.

PubMed

Brown, Corinne; Bornstein, Elizabeth; Wilcox, Catina

2012-02-01

The Partnership and Empowerment Program model offers a comprehensive, patient-centered, and cost-effective template for coordinating care for underinsured and uninsured patients with cancer. Attention to effective coordination, including use of internal and external resources, may result in decreased costs of care and improved patient compliance and health outcomes.

Reflections on Costing, Pricing and Income Measurement at UK Higher Education Institutions

ERIC Educational Resources Information Center

Oduoza, Chike F.

2009-01-01

In these days of radical contraction of funding and expansion in student numbers, universities are under pressure to prioritise their resources, as well as to achieve effective costing and pricing to support judgement and decision making for funding and any external work undertaken. This study reviews costing, pricing and income measurement in…

Costs, needs must be balanced when buying computer systems.

PubMed

Krantz, G M; Doyle, J J; Stone, S G

1989-06-01

A healthcare institution must carefully examine its internal needs and external requirements before selecting an information system. The system's costs must be carefully weighed because significant computer cost overruns can cripple overall hospital finances. A New Jersey hospital carefully studied these issues and determined that a contract with a regional data center was its best option.

A comparison of cost effectiveness using data from randomized trials or actual clinical practice: selective cox-2 inhibitors as an example.

PubMed

van Staa, Tjeerd-Pieter; Leufkens, Hubert G; Zhang, Bill; Smeeth, Liam

2009-12-01

Data on absolute risks of outcomes and patterns of drug use in cost-effectiveness analyses are often based on randomised clinical trials (RCTs). The objective of this study was to evaluate the external validity of published cost-effectiveness studies by comparing the data used in these studies (typically based on RCTs) to observational data from actual clinical practice. Selective Cox-2 inhibitors (coxibs) were used as an example. The UK General Practice Research Database (GPRD) was used to estimate the exposure characteristics and individual probabilities of upper gastrointestinal (GI) events during current exposure to nonsteroidal anti-inflammatory drugs (NSAIDs) or coxibs. A basic cost-effectiveness model was developed evaluating two alternative strategies: prescription of a conventional NSAID or coxib. Outcomes included upper GI events as recorded in GPRD and hospitalisation for upper GI events recorded in the national registry of hospitalisations (Hospital Episode Statistics) linked to GPRD. Prescription costs were based on the prescribed number of tables as recorded in GPRD and the 2006 cost data from the British National Formulary. The study population included over 1 million patients prescribed conventional NSAIDs or coxibs. Only a minority of patients used the drugs long-term and daily (34.5% of conventional NSAIDs and 44.2% of coxibs), whereas coxib RCTs required daily use for at least 6-9 months. The mean cost of preventing one upper GI event as recorded in GPRD was US$104k (ranging from US$64k with long-term daily use to US$182k with intermittent use) and US$298k for hospitalizations. The mean costs (for GPRD events) over calendar time were US$58k during 1990-1993 and US$174k during 2002-2005. Using RCT data rather than GPRD data for event probabilities, the mean cost was US$16k with the VIGOR RCT and US$20k with the CLASS RCT. The published cost-effectiveness analyses of coxibs lacked external validity, did not represent patients in actual clinical practice, and should not have been used to inform prescribing policies. External validity should be an explicit requirement for cost-effectiveness analyses.

Proceedings: National conference on environmental externalities

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

Not Available

1990-12-31

This report is the proceedings of the National Conference on Environmental Externalities. A environmental externality is the environmental impact of a process or a plant that society must endure. It is a social cost and is paid, but not by the company who produced it or the company`s customers who endure it. The main purpose of this report is to gather the many designs and ideas of how and why to internalize the externalities into the pricing systems of the public utility commissions, especially that of the electric utilities. Economic and sociological aspects of the internalization of these externalities aremore » given in these proceedings. Individual papers are processed separately for databases. (MB)« less

Externalities from Alcohol Consumption in the 2005 US National Alcohol Survey: Implications for Policy

PubMed Central

Greenfield, Thomas K.; Ye, Yu; Kerr, William; Bond, Jason; Rehm, Jürgen; Giesbrecht, Norman

2009-01-01

A subsample (n = 2,550) of the 2005 US National Alcohol Survey of adults was used to estimate prevalence and correlates of six externalities from alcohol abuse––family problems, assaults, accompanying intoxicated driver, vehicular accident, financial problems and vandalized property––all from another’s drinking. On a lifetime basis, 60% reported externalities, with a lower 12-month rate (9%). Women reported more family/marital and financial impacts and men more assaults, accompanying drunk drivers, and accidents. Being unmarried, older, white and ever having monthly heavy drinking or alcohol problems was associated with more alcohol externalities. Publicizing external costs of drinking could elevate political will for effective alcohol controls. PMID:20049257

Costing nursing education programs. It's as easy as 1-2-3.

PubMed

Fisher, M L; Hume, R; Emerick, R

1998-01-01

Staff development departments are pressured to reveal the costs of their educational programs and to compete with outside vendors for programming. The process of implementing a spreadsheet template for costing out staff development programs is described. The template is easy to use and supports "what if" analysis. This model allows educators to evaluate cost implications of curricular decisions and to better negotiate with internal and external customers.

Systemic Obstacles to Lifelong Learning: The Influence of the Educational System Design on Learning Attitudes

ERIC Educational Resources Information Center

Lavrijsen, Jeroen; Nicaise, Ides

2017-01-01

Comparative research has often emphasized the importance of external barriers (e.g. enrolment costs) to explain inequalities in lifelong learning participation. However, individuals, in particular the low educated, are often not only prevented from participation by external barriers, but also by negative psychological dispositions about learning.…

75 FR 64773 - Study Required by Section 989G(b) of the Dodd-Frank Act Regarding Compliance With Section 404(b...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-20

..., which addresses management's responsibility for reporting on the effectiveness of internal control over...) Quantitative and qualitative information about the trends of internal and external costs of having an external... over time; (3) Characteristics of internal controls, management's evaluation process and corporate...

The cost-effectiveness of family/family-based therapy for treatment of externalizing disorders, substance use disorders and delinquency: a systematic review.

PubMed

Goorden, Maartje; Schawo, Saskia J; Bouwmans-Frijters, Clazien A M; van der Schee, Evelien; Hendriks, Vincent M; Hakkaart-van Roijen, Leona

2016-07-13

Family therapy and family-based treatment has been commonly applied in children and adolescents in mental health care and has been proven to be effective. There is an increased interest in economic evaluations of these, often expensive, interventions. The aim of this systematic review is to summarize and evaluate the evidence on cost-effectiveness of family/family-based therapy for externalizing disorders, substance use disorders and delinquency. A systematic literature search was performed in PubMed, Education Resource information Centre (ERIC), Psycinfo and Cochrane reviews including studies conducted after 1990 and before the first of August of 2013. Full economic evaluations investigating family/family-based interventions for adolescents between 10 and 20 years treated for substance use disorders, delinquency or externalizing disorders were included. Seven hundred thirty-one articles met the search criteria and 51 studies were initially selected. The final selection resulted in the inclusion of 11 studies. The quality of these studies was assessed. Within the identified studies, there was great variation in the specific type of family/family-based interventions and disorders. According to the outcomes of the checklists, the overall quality of the economic evaluations was low. Results varied by study. Due to the variations in setting, design and outcome it was not feasible to pool results using a meta-analysis. The quality of the identified economic evaluations of family/family-based therapy for treatment of externalizing disorders, adolescent substance use disorders and delinquency was insufficient to determine the cost-effectiveness. Although commonly applied, family/family-based therapy is costly and more research of higher quality is needed.

[Development of a secure and cost-effective infrastructure for the access of arbitrary web-based image distribution systems].

PubMed

Hackländer, T; Kleber, K; Schneider, H; Demabre, N; Cramer, B M

2004-08-01

To build an infrastructure that enables radiologists on-call and external users a teleradiological access to the HTML-based image distribution system inside the hospital via internet. In addition, no investment costs should arise on the user side and the image data should be sent renamed using cryptographic techniques. A pure HTML-based system manages the image distribution inside the hospital, with an open source project extending this system through a secure gateway outside the firewall of the hospital. The gateway handles the communication between the external users and the HTML server within the network of the hospital. A second firewall is installed between the gateway and the external users and builds up a virtual private network (VPN). A connection between the gateway and the external user is only acknowledged if the computers involved authenticate each other via certificates and the external users authenticate via a multi-stage password system. All data are transferred encrypted. External users get only access to images that have been renamed to a pseudonym by means of automated processing before. With an ADSL internet access, external users achieve an image load frequency of 0.4 CT images per second. More than 90 % of the delay during image transfer results from security checks within the firewalls. Data passing the gateway induce no measurable delay. Project goals were realized by means of an infrastructure that works vendor independently with any HTML-based image distribution systems. The requirements of data security were realized using state-of-the-art web techniques. Adequate access and transfer speed lead to a widespread acceptance of the system on the part of external users.

Engineering Strategies and Methods for Avoiding Air-Quality Externalities: Dispersion Modeling, Home Energy Conservation, and Scenario Planning

NASA Astrophysics Data System (ADS)

Knox, Andrew James

Energy conservation can improve air quality by reducing emissions from fuel combustion. The human health value retained through better air quality can then offset the cost of energy conservation. Through this thesis' innovative yet widely-accessible combination of air pollution dispersion modeling and atmospheric chemistry, it is estimated that the health value retained by avoiding emissions from Ontario's former coal-fired generating stations is 5.74/MWh (using an upper-bound value of 265,000 per year of life lost). This value is combined with energy modeling of homes in the first-ever assessment of the air-quality health benefits of low-energy buildings. It is shown that avoided health damages can equal 7% of additional construction costs of energy efficient buildings in Ontario. At 7%, health savings are a significant item in the cost analysis of efficient buildings. Looking to energy efficiency in the context of likely future low-resource natural gas scenarios, building efficient buildings today is shown to be more economically efficient than any building retrofit option. Considering future natural gas scarcity in the context of Ontario's Long-Term Energy Plan reveals that Ontario may be forced to return to coal-fired electricity. Projected coal use would result in externalities greater than $600 million/year; 80% more than air-quality externalities from Ontario's electricity in 1985. Radically aggressive investment in electricity conservation (75% reduction per capita by 2075) is one promising path forward that keeps air-quality externalities below 1985 levels. Non-health externalities are an additional concern, the quantification, and ultimately monetization, of which could be practical using emerging air pollution monitoring technologies. Energy, conservation, energy planning, and energy's externalities form a complex situation in which today's decisions are critical to a successful future. It is clear that reducing the demand for energy is essential and that there are economically efficient conservation opportunities, particularly in the building sector, being missed.

Is Municipal Solid Waste Recycling Economically Efficient?

NASA Astrophysics Data System (ADS)

Lavee, Doron

2007-12-01

It has traditionally been argued that recycling municipal solid waste (MSW) is usually not economically viable and that only when externalities, long-term dynamic considerations, and/or the entire product life cycle are taken into account, recycling becomes worthwhile from a social point of view. This article explores the results of a wide study conducted in Israel in the years 2000 2004. Our results reveal that recycling is optimal more often than usually claimed, even when externality considerations are ignored. The study is unique in the tools it uses to explore the efficiency of recycling: a computer-based simulation applied to an extensive database. We developed a simulation for assessing the costs of handling and treating MSW under different waste-management systems and used this simulation to explore possible cost reductions obtained by designating some of the waste (otherwise sent to landfill) to recycling. We ran the simulation on data from 79 municipalities in Israel that produce over 60% of MSW in Israel. For each municipality, we were able to arrive at an optimal method of waste management and compare the costs associated with 100% landfilling to the costs born by the municipality when some of the waste is recycled. Our results indicate that for 51% of the municipalities, it would be efficient to adopt recycling, even without accounting for externality costs. We found that by adopting recycling, municipalities would be able to reduce direct costs by an average of 11%. Through interviews conducted with representatives of municipalities, we were also able to identify obstacles to the utilization of recycling, answering in part the question of why actual recycling levels in Israel are lower than our model predicts they should be.

Strategic Planning for Health Care Cost Controls in a Constantly Changing Environment.

PubMed

Hembree, William E

2015-01-01

Health care cost increases are showing a resurgence. Despite recent years' comparatively modest increases, the projections for 2015 cost increases range from 6.6% to 7%--three to four times larger than 2015's expected underlying inflation. This resurgence is just one of many rapidly changing external and internal challenges health plan sponsors must overcome (and this resurgence advances the date when the majority of employers will trigger the "Cadillac tax"). What's needed is a planning approach that is effective in overcoming all known and yet-to-be-discovered challenges, not just affordability. This article provides detailed guidance in adopting six proven strategic planning steps. Following these steps will proactively and effectively create a flexible strategic plan for the present and future of employers' health plans that will withstand all internal and external challenges.

Congestion Pricing for Aircraft Pushback Slot Allocation.

PubMed

Liu, Lihua; Zhang, Yaping; Liu, Lan; Xing, Zhiwei

2017-01-01

In order to optimize aircraft pushback management during rush hour, aircraft pushback slot allocation based on congestion pricing is explored while considering monetary compensation based on the quality of the surface operations. First, the concept of the "external cost of surface congestion" is proposed, and a quantitative study on the external cost is performed. Then, an aircraft pushback slot allocation model for minimizing the total surface cost is established. An improved discrete differential evolution algorithm is also designed. Finally, a simulation is performed on Xinzheng International Airport using the proposed model. By comparing the pushback slot control strategy based on congestion pricing with other strategies, the advantages of the proposed model and algorithm are highlighted. In addition to reducing delays and optimizing the delay distribution, the model and algorithm are better suited for use for actual aircraft pushback management during rush hour. Further, it is also observed they do not result in significant increases in the surface cost. These results confirm the effectiveness and suitability of the proposed model and algorithm.

Economics of internal and external energy storage in solar power plant operation

NASA Technical Reports Server (NTRS)

Manvi, R.; Fujita, T.

1977-01-01

A simple approach is formulated to investigate the effect of energy storage on the bus-bar electrical energy cost of solar thermal power plants. Economic analysis based on this approach does not require detailed definition of a specific storage system. A wide spectrum of storage system candidates ranging from hot water to superconducting magnets can be studied based on total investment and a rough knowledge of energy in and out efficiencies. Preliminary analysis indicates that internal energy storage (thermal) schemes offer better opportunities for energy cost reduction than external energy storage (nonthermal) schemes for solar applications. Based on data and assumptions used in JPL evaluation studies, differential energy costs due to storage are presented for a 100 MWe solar power plant by varying the energy capacity. The simple approach presented in this paper provides useful insight regarding the operation of energy storage in solar power plant applications, while also indicating a range of design parameters where storage can be cost effective.

Rapid prototyping prosthetic hand acting by a low-cost shape-memory-alloy actuator.

PubMed

Soriano-Heras, Enrique; Blaya-Haro, Fernando; Molino, Carlos; de Agustín Del Burgo, José María

2018-06-01

The purpose of this article is to develop a new concept of modular and operative prosthetic hand based on rapid prototyping and a novel shape-memory-alloy (SMA) actuator, thus minimizing the manufacturing costs. An underactuated mechanism was needed for the design of the prosthesis to use only one input source. Taking into account the state of the art, an underactuated mechanism prosthetic hand was chosen so as to implement the modifications required for including the external SMA actuator. A modular design of a new prosthesis was developed which incorporated a novel SMA actuator for the index finger movement. The primary objective of the prosthesis is achieved, obtaining a modular and functional low-cost prosthesis based on additive manufacturing executed by a novel SMA actuator. The external SMA actuator provides a modular system which allows implementing it in different systems. This paper combines rapid prototyping and a novel SMA actuator to develop a new concept of modular and operative low-cost prosthetic hand.

Congestion Pricing for Aircraft Pushback Slot Allocation

PubMed Central

Zhang, Yaping

2017-01-01

In order to optimize aircraft pushback management during rush hour, aircraft pushback slot allocation based on congestion pricing is explored while considering monetary compensation based on the quality of the surface operations. First, the concept of the “external cost of surface congestion” is proposed, and a quantitative study on the external cost is performed. Then, an aircraft pushback slot allocation model for minimizing the total surface cost is established. An improved discrete differential evolution algorithm is also designed. Finally, a simulation is performed on Xinzheng International Airport using the proposed model. By comparing the pushback slot control strategy based on congestion pricing with other strategies, the advantages of the proposed model and algorithm are highlighted. In addition to reducing delays and optimizing the delay distribution, the model and algorithm are better suited for use for actual aircraft pushback management during rush hour. Further, it is also observed they do not result in significant increases in the surface cost. These results confirm the effectiveness and suitability of the proposed model and algorithm. PMID:28114429

Freedom Star tows a barge with an SLWT into Port Canaveral for the first time

NASA Technical Reports Server (NTRS)

1998-01-01

Freedom Star, one of NASA's two solid rocket booster recovery ships, tows a barge containing the third Space Shuttle super lightweight external tank (SLWT) into Port Canaveral. This SLWT will be used to launch the orbiter Discovery on mission STS-95 in October. This first-time towing arrangement, part of a cost savings plan by NASA to prudently manage existing resources, began June 12 from the Michoud Assembly Facility in New Orleans where the Shuttle's external tanks are manufactured. The barge will now be transported up the Banana River to the LC-39 turn basin using a conventional tugboat. Previously, NASA relied on an outside contractor to provide external tank towing services at a cost of about $120,000 per trip. The new plan allows NASA's Space Flight Operations contractor, United Space Alliance (USA), to provide the same service directly to NASA using the recovery ships during their downtime between Shuttle launches. Studies show a potential savings of about $50,000 per trip. The cost of the necessary ship modifications should be paid back by the fourteenth tank delivery. The other recovery ship, Liberty Star, has also undergone deck strengthening enhancements and will soon have the necessary towing winch installed.

Recovery Ship Freedom Star

NASA Technical Reports Server (NTRS)

1998-01-01

Freedom Star, one of NASA's two solid rocket booster recovery ships, is towing a barge containing the third Space Shuttle Super Lightweight External Tank (SLWT) into Port Canaveral. This SLWT was slated for use to launch the orbiter Discovery on mission STS-95 in October 1998. This first time towing arrangement, part of a cost saving plan by NASA to prudently manage existing resources, began June 12 from the Michoud Assembly Facility in New Orleans where the Shuttle's external tanks were manufactured. The barge was transported up Banana River to the LC-39 turn basin using a conventional tug boat. Previously, NASA relied on an outside contractor to provide external tank towing services at a cost of about $120,000 per trip. The new plan allowed NASA's Space Flight Operations contractor, United Space Alliance (USA), to provide the same service to NASA using the recovery ships during their downtime between Shuttle launches. Studies showed a potential savings of about $50,000 per trip. The cost of the necessary ship modifications would be paid back by the fourteenth tank delivery. The other recovery ship, Liberty Star, also underwent deck strengthening enhancements and had the necessary towing wench installed.

Economics of regulation: externalities and institutional issues

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

Kahn, A.E.

In two previous articles, ''Can An Economist Find Happiness Setting Public Utility Rates'' and ''Applications of Economics to Public Utility Rate Structures'', appearing in Public Utilities Fortnightly January 5 and January 19, 1978, respectively, the author summarized his experiences in applying elementary economic principles to the regulation of public utilities in New York state, specifically to setting utility rates. In this article, Mr. Kahn discusses second-best considerations and externalities. He points out that opponents of marginal-cost pricing--particularly of electricity--have in recent years become enthusiastic exponents of the theory of second best. What is required, he feels, is an examination ofmore » how other, most directly pertinent prices in the economy do actually stand relative to their marginal costs. These would be the prices of goods and services for which electricity is a substitute; with which electricity is used as a complement; in whose supply electricity is an input; and which themselves constitute inputs in the production and delivery of electricity. Oil and gas are more complicated cases. External costs, such as abatement requirements, are considered when setting rates. The author points out other regulatory issues to be considered in decision making to conclude this series of articles. (MCW)« less

The assessment of health impacts and external costs of natural gas-fired power plant of Qom.

PubMed

Fouladi Fard, Reza; Naddafi, Kazem; Yunesian, Masud; Nabizadeh Nodehi, Ramin; Dehghani, Mohammad Hadi; Hassanvand, Mohammad Sadegh

2016-10-01

The external health damage costs of the combined cycle natural gas-fired power plant of Qom were investigated via the simplified impact pathway approach. Emitted particulate matter (PM 10 ) and gaseous pollutants (NO x , CO, and SO 2 ) from the power plant stack were measured The health effects and related costs were estimated by QUERI model from AirPacts according to the emissions, source and stack parameters, pollutant depletion velocities, exposure-response functions, local and regional population density, and detailed meteorological data. The results showed that the main health effect was assigned to the nitrate as restricted activity days (RAD) with 25,240 days/year. For all pollutants, the maximum health damage costs were related to the long-term mortality (49 %), restricted activity days (27 %), and chronic bronchitis (21 %). The annual health damage costs were approximately 4.76 million US$, with the cost being 0.096 US per kWh of generating electricity. Although the health damage costs of gas-fired power plant were lower than those of other heavy fuels, it seems essential to consider the health and environmental damages and focus on the emission control strategies, particularly in site selection for the new power plants and expanding the current ones.

The social costs of homeowner decisions in fire-prone communities: information, insurance, and amenities

Treesearch

Gwenlyn Busby; Gregory S. Amacher; Robert G. Haight

2013-01-01

In this article, we consider wildfire risk management decisions using a dynamic stochastic model of homeowner interaction in a setting where spatial externalities arise. Our central objective is to apply observations from the social science literature about homeowner preferences to this economic externality problem and determine how assumptions about insurance,...

Brief report: a cost analysis of neuraxial anesthesia to facilitate external cephalic version for breech fetal presentation.

PubMed

Carvalho, Brendan; Tan, Jonathan M; Macario, Alex; El-Sayed, Yasser Y; Sultan, Pervez

2013-07-01

In this study, we sought to determine whether neuraxial anesthesia to facilitate external cephalic version (ECV) increased delivery costs for breech fetal presentation. Using a computer cost model, which considers possible outcomes and probability uncertainties at the same time, we estimated total expected delivery costs for breech presentation managed by a trial of ECV with and without neuraxial anesthesia. From published studies, the average probability of successful ECV with neuraxial anesthesia was 60% (with individual studies ranging from 44% to 87%) compared with 38% (with individual studies ranging from 31% to 58%) without neuraxial anesthesia. The mean expected total delivery costs, including the cost of attempting/performing ECV with anesthesia, equaled $8931 (2.5th-97.5th percentile prediction interval $8541-$9252). The cost was $9207 (2.5th-97.5th percentile prediction interval $8896-$9419) if ECV was attempted/performed without anesthesia. The expected mean incremental difference between the total cost of delivery that includes ECV with anesthesia and ECV without anesthesia was $-276 (2.5th-97.5th percentile prediction interval $-720 to $112). The total cost of delivery in women with breech presentation may be decreased (up to $720) or increased (up to $112) if ECV is attempted/performed with neuraxial anesthesia compared with ECV without neuraxial anesthesia. Increased ECV success with neuraxial anesthesia and the subsequent reduction in breech cesarean delivery rate offset the costs of providing anesthesia to facilitate ECV.

The Effect of Drag and Attachment Site of External Tags on Swimming Eels: Experimental Quantification and Evaluation Tool

PubMed Central

Tudorache, Christian; Burgerhout, Erik; Brittijn, Sebastiaan; van den Thillart, Guido

2014-01-01

Telemetry studies on aquatic animals often use external tags to monitor migration patterns and help to inform conservation effort. However, external tags are known to impair swimming energetics dramatically in a variety of species, including the endangered European eel. Due to their high swimming efficiency, anguilliform swimmers are very susceptibility for added drag. Using an integration of swimming physiology, behaviour and kinematics, we investigated the effect of additional drag and site of externally attached tags on swimming mode and costs. The results show a significant effect of a) attachment site and b) drag on multiple energetic parameters, such as Cost Of Transport (COT), critical swimming speed (Ucrit) and optimal swimming speed (Uopt), possibly due to changes in swimming kinematics. Attachment at 0.125 bl from the tip of the snout is a better choice than at the Centre Of Mass (0.35 bl), as it is the case in current telemetry studies. Quantification of added drag effect on COT and Ucrit show a (limited) correlation, suggesting that the Ucrit test can be used for evaluating external tags for telemetry studies until a certain threshold value. Uopt is not affected by added drag, validating previous findings of telemetry studies. The integrative methodology and the evaluation tool presented here can be used for the design of new studies using external telemetry tags, and the (re-) evaluation of relevant studies on anguilliform swimmers. PMID:25409179

The effect of drag and attachment site of external tags on swimming eels: experimental quantification and evaluation tool.

PubMed

Tudorache, Christian; Burgerhout, Erik; Brittijn, Sebastiaan; van den Thillart, Guido

2014-01-01

Telemetry studies on aquatic animals often use external tags to monitor migration patterns and help to inform conservation effort. However, external tags are known to impair swimming energetics dramatically in a variety of species, including the endangered European eel. Due to their high swimming efficiency, anguilliform swimmers are very susceptibility for added drag. Using an integration of swimming physiology, behaviour and kinematics, we investigated the effect of additional drag and site of externally attached tags on swimming mode and costs. The results show a significant effect of a) attachment site and b) drag on multiple energetic parameters, such as Cost Of Transport (COT), critical swimming speed (Ucrit) and optimal swimming speed (Uopt), possibly due to changes in swimming kinematics. Attachment at 0.125 bl from the tip of the snout is a better choice than at the Centre Of Mass (0.35 bl), as it is the case in current telemetry studies. Quantification of added drag effect on COT and Ucrit show a (limited) correlation, suggesting that the Ucrit test can be used for evaluating external tags for telemetry studies until a certain threshold value. Uopt is not affected by added drag, validating previous findings of telemetry studies. The integrative methodology and the evaluation tool presented here can be used for the design of new studies using external telemetry tags, and the (re-) evaluation of relevant studies on anguilliform swimmers.

Kids and Foreclosures: New York City

ERIC Educational Resources Information Center

Been, Vicki; Ellen, Ingrid Gould; Schwartz, Amy Ellen; Stiefel, Leanna; Weinstein, Meryle

2010-01-01

The mortgage foreclosure crisis has affected millions of households around the country. Researchers and policy makers have begun to pay attention to the external costs that these foreclosures impose on surrounding properties and neighborhoods (Schuetz et al., 2008; Harding et al., 2009). But few have considered the collateral costs for children,…

Unintended Consequences of Cost Recovery

ERIC Educational Resources Information Center

Piercey, David

2010-01-01

An Alberta school district that used a cost-recovery model to finance school services for 20 years is finding that the model produces unintended negative results. Some schools didn't spend this money on services but used it for other school operations. Some spent the money on external consultants. Professional relationships were damaged, and…

Space Shuttle - Bringing cryohydrogen technology down to earth. [details of LH2 and LO2 technology and External Tank design

NASA Technical Reports Server (NTRS)

Odom, J. B.

1978-01-01

The External Tank must provide a safe storage container for both LH2 and LO2, a means of maintaining propellant quality in order to meet the engine pump net positive suction pressure requirements, and a structural strong-back for the Space Shuttle system, all at the minimum recurring cost and weight, while maintaining quality and reliability. The present paper summarizes External Tank design features and discusses the advantages of using LH2 and LO2 for the Space Shuttle system.

Incentives for wellness: tackling issues of effectiveness, biology, scope, and cost shifting.

PubMed

Cawley, John

2014-01-01

Morgan Downey raises several interesting issues in his essay. We agree on several points, for example, that current regulations are "really quite porous," with the result that enrollees will be able to get the rewards even if they do not alter their health behaviors. There are also several areas of disagreement that merit further discussion, and I focus on those in this essay. To provide context, my position is that financial incentives for healthy behavior can improve social welfare by internalizing the external costs of risky behaviors and help people with time-inconsistent preferences to adhere to a healthier lifestyle. To achieve the goal of increasing social welfare, the penalties for risky health behaviors should be set equal to the external costs. The design of the rewards (in terms of their frequency, salience, and the amount of loss aversion they invoke) may be critical in determining their effectiveness.

Coming out ahead: the cost effectiveness of external cephalic version using spinal anesthesia

PubMed Central

2014-01-01

Breech presentation is encountered in 3 to 4% of term pregnancies and has been a significant driver of the increased rate of cesarean deliveries over the last 4 decades. External cephalic version (ECV) is recommended at term by most professional organizations in an effort to reduce the prospect of cesarean deliveries. The authors propose the use of regional anesthesia to increase efficacy and reduce cost in the care of patients who undergo ECV in an effort to convert a breech presentation to a vertex counterpart. Despite emerging evidence of the advantages, obstacles to more comprehensive implementation of this approach continue to exist, which include patient acceptance, provider experience, and safety concerns. The addition of tocolytics and use of regional anesthesia for secondary ECV efforts have also been considered as options to increase success and reduce cost. This is a commentary on http://www.ijhpr.org/content/3/1/5. PMID:24565024

External marketing. How it can build a dental practice.

PubMed

Ascher, S

1988-01-01

This article gives a general introduction to external marketing as it befits the image of the dental professional. Research and various media opportunities are discussed, highlighting their advantages and pointing out the pros and cons of each. The latest trends in advertising philosophy are intertwined with concrete advice regarding cost effectiveness. This article is helpful to solo as well as group practitioners.

Temporary clamping of external carotid artery in convexity, parasagittal and temporal base meningioma.

PubMed

Yadav, Yad Ram; Parihar, Vijay; Agarwal, Moneet; Bhatele, Pushp Raj

2012-01-01

The management of intraoperative bleeding during removal of a large hyper vascular meningioma is crucial for safe and efficient surgery. Preoperative embolization of meningioma is the best way to reduce vascularity of meningiomas but this technique is not readily available, costly and has its own limitations. The study is aimed to evaluate the use of temporary clamping of external carotid artery to reduce blood loss and operating time during excision of large convexity, parasagittal or temporal base meningiomas. A prospective study of 115 consecutively operated meningiomas of size 5 cms or more were operated from January 2002 to December2010. Temporary clamping of external carotid artery was done in 61 while 51 cases were managed without clamping. There was significant reduction of blood loss, operative time and blood transfusion given in the temporary clipping group compared to non clipping group. There was stitch abscess in two patients each in clamping, and non clamping group. There was no scalp necrosis or mortality in any of the group. Temporary clamping of external carotid artery is a safe, simple and cost-effective alternative to embolization for the surgery of large meningiomas. This can be practiced at all the centers.

The Regulation of a Spatially Heterogeneous Externality: Tradable Groundwater Permits to Protect Streams

NASA Astrophysics Data System (ADS)

Kuwayama, Y.; Brozovic, N.

2012-12-01

Groundwater pumping from aquifers can reduce the flow of surface water in nearby streams through a process known as stream depletion. In the United States, recent awareness of this externality has led to intra- and inter-state conflict and rapidly-changing water management policies and institutions. A factor that complicates the design of groundwater management policies to protect streams is the spatial heterogeneity of the stream depletion externality; the marginal damage of groundwater use on stream flows depends crucially on the location of pumping relative to streams. Under these circumstances, economic theory predicts that spatially differentiated policies can achieve an aggregate reduction in stream depletion cost effectively. However, whether spatially differentiated policies offer significant abatement cost savings and environmental improvements over simpler, alternative policies is an empirical question. In this paper, we analyze whether adopting a spatially differentiated groundwater permit system can lead to significant savings in compliance costs while meeting targets on stream protection. Using a population data set of active groundwater wells in the Nebraska portion of the Republican River Basin, we implement an optimization model of each well owner's crop choice, land use, and irrigation decisions to determine the distribution of regulatory costs. We model the externality of pumping on streams by employing an analytical solution from the hydrology literature that determines reductions in stream flow caused by groundwater pumping over space and time. The economic and hydrologic model components are then combined into one optimization framework, which allows us to measure farmer abatement costs and stream flow benefits under a constrained optimal market that features spatially differentiated, tradable groundwater permits. We compare this outcome to the efficiency of alternative second-best policies, including spatially uniform permit markets and pumping restrictions based on geographic zones. Our analysis considers static policies for which abatement is fixed over time, as well as dynamic policies that allow abatement to vary over time and future compliance costs to be subject to a discount rate. We find that if current levels of stream flow in the Republican River Basin are held fixed, regulators can generate most of the potential abatement cost savings by establishing a one-to-one tradable permit system that does not account for spatial heterogeneity. We obtain this surprising result because the agronomic and climatic parameters in our data set that determine farmer abatement costs are spatially correlated with hydrologic parameters that determine the marginal damage of groundwater use on streams. However, we also find that if future legal or ecological circumstances require regulators to increase significantly the protection of streams from current levels, spatially differentiated policies will generate sizable cost savings compared to policies that ignore spatial heterogeneity.

Efficient management of marine resources in conflict: an empirical study of marine sand mining, Korea.

PubMed

Kim, Tae-Goun

2009-10-01

This article develops a dynamic model of efficient use of exhaustible marine sand resources in the context of marine mining externalities. The classical Hotelling extraction model is applied to sand mining in Ongjin, Korea and extended to include the estimated marginal external costs that mining imposes on marine fisheries. The socially efficient sand extraction plan is compared with the extraction paths suggested by scientific research. If marginal environmental costs are correctly estimated, the developed efficient extraction plan considering the resource rent may increase the social welfare and reduce the conflicts among the marine sand resource users. The empirical results are interpreted with an emphasis on guidelines for coastal resource management policy.

Explanation of Change (EoC) Study: Approach and Findings

NASA Technical Reports Server (NTRS)

Bitten, Robert E.; Emmons, Debra L.; Bordi, Francesco; Scolese, Christopher

2013-01-01

This study investigated thirty historical NASA science missions to explain the cost change experienced. The study included investigation of historical milestone and monthly status report documentation followed by interviews with key project personnel. Based on the information collected, the reasons for cost change were binned, at the highest level, into four separate categories: NASA External, Project External, Internal Planning, and Internal Execution. The results identified that roughly a third of the change is outside of the project's control, a third is due to assumptions made in project planning, and a third is due to the inherent difficulty of building highly complex, one-of-a-kind, cutting edge, Earth and space science missions.

Cost shared wildfire risk mitigation in Log Hill Mesa, Colorado: Survey evidence on participation and willingness to pay

Treesearch

James R. Meldrum; Patricia A. Champ; Travis Warziniack; Hannah Brenkert-Smith; Christopher M. Barth; Lilia C. Falk

2014-01-01

Wildland-urban interface (WUI) homeowners who do not mitigate the wildfire risk on their properties impose a negative externality on society. To reduce the social costs of wildfire and incentivise homeowners to take action, cost sharing programs seek to reduce the barriers that impede wildfire risk mitigation. Using survey data from a WUI community in western Colorado...

Joint Direct Attack Munition (JDAM)

DTIC Science & Technology

2015-12-01

February 19, 2015 and the O&S cost are based on an ICE dated August 28, 2014 Confidence Level Confidence Level of cost estimate for current APB: 50% A...mathematically derived confidence level was not computed for this Life-Cycle Cost Estimate (LCCE). This LCCE represents the expected value, taking into...consideration relevant risks, including ordinary levels of external and unforeseen events. It aims to provide sufficient resources to execute the

Hidden Costs of Energy: Unpriced Consequences of Energy Production and Use

NASA Astrophysics Data System (ADS)

National Research Council

2011-11-01

The U.S. Congress directed the U.S. Department of the Treasury to arrange for a review by the National Academy of Sciences to define and evaluate the health, environmental, security, and infrastructural external costs and benefits associated with the production and consumption of energy--costs and benefits that are not or may not be fully incorporated into the market price of energy, into the federal tax or fee, or into other applicable revenue measures related to production and consumption of energy. In response, the National Research Council established the Committee on Health, Environmental, and Other External Costs and Benefits of Energy Production and Consumption, which prepared the report summarized in this chapter. The report estimates dollar values for several major components of these costs. The damages the committee was able to quantify were an estimated $120 billion in the U.S. in 2005, a number that reflects primarily health damages from air pollution associated with electricity generation and motor vehicle transportation. The figure does not include damages from climate change, harm to ecosystems, effects of some air pollutants such as mercury, and risks to national security, which the report examines but does not monetize.

A novel 3D imaging system for strawberry phenotyping.

PubMed

He, Joe Q; Harrison, Richard J; Li, Bo

2017-01-01

Accurate and quantitative phenotypic data in plant breeding programmes is vital in breeding to assess the performance of genotypes and to make selections. Traditional strawberry phenotyping relies on the human eye to assess most external fruit quality attributes, which is time-consuming and subjective. 3D imaging is a promising high-throughput technique that allows multiple external fruit quality attributes to be measured simultaneously. A low cost multi-view stereo (MVS) imaging system was developed, which captured data from 360° around a target strawberry fruit. A 3D point cloud of the sample was derived and analysed with custom-developed software to estimate berry height, length, width, volume, calyx size, colour and achene number. Analysis of these traits in 100 fruits showed good concordance with manual assessment methods. This study demonstrates the feasibility of an MVS based 3D imaging system for the rapid and quantitative phenotyping of seven agronomically important external strawberry traits. With further improvement, this method could be applied in strawberry breeding programmes as a cost effective phenotyping technique.

Cost-benefit analysis of water-reuse projects for environmental purposes: a case study for Spanish wastewater treatment plants.

PubMed

Molinos-Senante, M; Hernández-Sancho, F; Sala-Garrido, R

2011-12-01

Water reuse is an emerging and promising non-conventional water resource. Feasibility studies are essential tools in the decision making process for the implementation of water-reuse projects. However, the methods used to assess economic feasibility tend to focus on internal costs, while external impacts are relegated to unsubstantiated statements about the advantages of water reuse. Using the concept of shadow prices for undesirable outputs of water reclamation, the current study developed a theoretical methodology to assess internal and external economic impacts. The proposed methodological approach is applied to 13 wastewater treatment plants in the Valencia region of Spain that reuse effluent for environmental purposes. Internal benefit analyses indicated that only a proportion of projects were economically viable, while when external benefits are incorporated all projects were economically viable. In conclusion, the economic feasibility assessments of water-reuse projects should quantitatively evaluate economic, environmental and resource availability. Copyright © 2011 Elsevier Ltd. All rights reserved.

Raspberry Pi: a 35-dollar device for viewing DICOM images.

PubMed

Paiva, Omir Antunes; Moreira, Renata de Oliveira

2014-01-01

Raspberry Pi is a low-cost computer created with educational purposes. It uses Linux and, most of times, freeware applications, particularly a software for viewing DICOM images. With an external monitor, the supported resolution (1920 × 1200 pixels) allows for the set up of simple viewing workstations at a reduced cost.

Raspberry Pi: a 35-dollar device for viewing DICOM images*

PubMed Central

Paiva, Omir Antunes; Moreira, Renata de Oliveira

2014-01-01

Raspberry Pi is a low-cost computer created with educational purposes. It uses Linux and, most of times, freeware applications, particularly a software for viewing DICOM images. With an external monitor, the supported resolution (1920 × 1200 pixels) allows for the set up of simple viewing workstations at a reduced cost. PMID:25741057

A 3D paper-based enzymatic fuel cell for self-powered, low-cost glucose monitoring.

PubMed

Fischer, Christopher; Fraiwan, Arwa; Choi, Seokheun

2016-05-15

In this work, we demonstrate a novel low-cost, self-powered paper-based biosensor for glucose monitoring. The device operating mechanism is based on a glucose/oxygen enzymatic fuel cell using an electrochemical energy conversion as a transducing element for glucose monitoring. The self-powered glucose biosensor features (i) a 3D origami paper-based structure for easy system integration onto paper, (ii) an air-cathode on paper for low-cost production and easy operation, and (iii) a screen printed chitosan/glucose oxidase anode for stable current generation as an analytical signal for glucose monitoring. The sensor showed a linear range of output current at 1-5mM glucose (R(2)=0.996) with a sensitivity of 0.02 µA mM(-1). The advantages offered by such a device, including a low cost, lack of external power sources/sophisticated external transducers, and the capacity to rapidly generate reliable results, are well suited for the clinical and social settings of the developing world. Copyright © 2015 Elsevier B.V. All rights reserved.

Cost and Precision of Brownian Clocks

NASA Astrophysics Data System (ADS)

Barato, Andre C.; Seifert, Udo

2016-10-01

Brownian clocks are biomolecular networks that can count time. A paradigmatic example are proteins that go through a cycle, thus regulating some oscillatory behavior in a living system. Typically, such a cycle requires free energy often provided by ATP hydrolysis. We investigate the relation between the precision of such a clock and its thermodynamic costs. For clocks driven by a constant thermodynamic force, a given precision requires a minimal cost that diverges as the uncertainty of the clock vanishes. In marked contrast, we show that a clock driven by a periodic variation of an external protocol can achieve arbitrary precision at arbitrarily low cost. This result constitutes a fundamental difference between processes driven by a fixed thermodynamic force and those driven periodically. As a main technical tool, we map a periodically driven system with a deterministic protocol to one subject to an external protocol that changes in stochastic time intervals, which simplifies calculations significantly. In the nonequilibrium steady state of the resulting bipartite Markov process, the uncertainty of the clock can be deduced from the calculable dispersion of a corresponding current.

Sizing a rainwater harvesting cistern by minimizing costs

NASA Astrophysics Data System (ADS)

Pelak, Norman; Porporato, Amilcare

2016-10-01

Rainwater harvesting (RWH) has the potential to reduce water-related costs by providing an alternate source of water, in addition to relieving pressure on public water sources and reducing stormwater runoff. Existing methods for determining the optimal size of the cistern component of a RWH system have various drawbacks, such as specificity to a particular region, dependence on numerical optimization, and/or failure to consider the costs of the system. In this paper a formulation is developed for the optimal cistern volume which incorporates the fixed and distributed costs of a RWH system while also taking into account the random nature of the depth and timing of rainfall, with a focus on RWH to supply domestic, nonpotable uses. With rainfall inputs modeled as a marked Poisson process, and by comparing the costs associated with building a cistern with the costs of externally supplied water, an expression for the optimal cistern volume is found which minimizes the water-related costs. The volume is a function of the roof area, water use rate, climate parameters, and costs of the cistern and of the external water source. This analytically tractable expression makes clear the dependence of the optimal volume on the input parameters. An analysis of the rainfall partitioning also characterizes the efficiency of a particular RWH system configuration and its potential for runoff reduction. The results are compared to the RWH system at the Duke Smart Home in Durham, NC, USA to show how the method could be used in practice.

Evaluation of a Tool for Producing and Presenting Interactive Videodisc Job Aids

DTIC Science & Technology

1994-03-01

and MacroMind Director, which lacks some authoring capablities (Macromedia Inc, approximate cost of Sinclude systems in Macintosh format such as...HyperCair (Claris Corp., approximate cost of $199) or SuperCmd (Aldus Corp., approximate cost of $299) and systems in Windows format such as Guide 3.1...scripting language to be used with a wide variety of hardware components. The ELVIS hypermedia system uses manufaturers ’ external commands to control

Ireland and the Defense of Western Europe. Issues and Implications.

DTIC Science & Technology

1988-05-01

domestic or external pressure to do so. In fact, neutrality is widely supported and could be abandoned only at a prohibitive political cost . Many...makes the costs of Irish membership outweigh any benefits? Her geographic location, as well as certain of her physical characteristics, would make her...peacetime must be weighed against the considerable costs involved. The obvious question then is, what would Ireland do in wartime? This is a question other

Load Carriage Capacity of the Dismounted Combatant - A Commanders’ Guide

DTIC Science & Technology

2012-10-01

predictive model has been used throughout this document to predict the physiological burden (i.e. energy cost ) of representative load carriage...scenarios. As a general guide this model indicates that a 10 kg increase in external load is metabolically equivalent (i.e. energy cost ) to an increase...larger increases in energy cost for a load carriage task. The multi-factorial nature of human load carriage capacity makes it difficult to set

Unlearned History: The Ineffectual Application of U.S. Broad Economic Sanctions Against Syria

DTIC Science & Technology

2015-10-30

fundamentally due to the high cost of compliance required of Syrian leaders, external third party support sustaining the Syrian government, and the Syrian...rate, especially as applied to autocratic regimes, are the cost of compliance, access to third party support, and the ability to redistribute the...of the sanctions policy. The political cost that the target state weighs must be high enough to extract the concessions demanded of the sending

The social cost of drugs in France in 2010.

PubMed

Kopp, Pierre; Ogrodnik, Marysia

2017-09-01

The social cost of drugs is the monetary cost of both the consequences of their trade and their consumption. In this paper, drugs considered are tobacco and alcohol, which are legal, plus those that are illegal. The social cost is the sum of the external cost: value of loss in quality of life, value of years of life lost and value of loss in productivity, plus public expenditure. Public expenditure consists of public spending on medical care, prevention, and law enforcement, minus savings from unpaid pensions and taxes levied on tobacco and alcohol. The parameters for the calculations have used the recommendations of a French governmental working group (2013) Quinet, L'évaluation socioéconomique des investissements publics [Internet], Centre d'Analyse Stratégique, 2013, http://www.strategie.gouv.fr/sites/strategie.gouv.fr/files/archives/CGSP_Evaluation_socioeconomique_17092013.pdf , and the health data were derived from the scientific literature. The social costs are €122 billion for tobacco, €118 billion for alcohol, and €8.7 billion for illegal drugs. The largest fraction of the costs (53, 56, and 31 %, respectively) derives from the number of deaths, 79,000 for tobacco, 49,000 for alcohol, and 1600 for illegal drugs, given the high cost of a year of life lost (€115,000). The external cost corresponds to 86, 97, and 68 % of the social cost, respectively, for tobacco, alcohol, and illegal drugs. The annual drug-related net expenditure represents €13.9, €3.0, and €2.3 billion, respectively, for tobacco, alcohol, and illegal drugs. The tax revenues on tobacco and alcohol, €10.4 and €3.2 billion, represent less than half of the corresponding healthcare costs, which are €25.9 and €7.7 billion.

Cost and sustainability of a successful package of interventions to improve vaccination coverage for children in urban slums of Bangladesh.

PubMed

Hayford, K; Uddin, M J; Koehlmoos, T P; Bishai, D M

2014-04-25

To estimate the incremental economic costs and explore satisfaction with a highly effective intervention for improving immunization coverage among slum populations in Dhaka, Bangladesh. A package of interventions based on extended clinic hours, vaccinator training, active surveillance, and community participation was piloted in two slum areas of Dhaka, and resulted in an increase in valid fully immunized children (FIC) from 43% pre-intervention to 99% post-intervention. Cost data and stakeholder perspectives were collected January-February 2010 via document review and 10 key stakeholders interviews to estimate the financial and opportunity costs of the intervention, including uncompensated time, training and supervision costs. The total economic cost of the 1-year intervention was $18,300, comprised of external management and supervision (73%), training (11%), coordination costs (1%), uncompensated staff time and clinic costs (2%), and communications, supplies and other costs (13%). An estimated 874 additional children were correctly and fully immunized due to the intervention, at an average cost of $20.95 per valid FIC. Key stakeholders ranked extended clinic hours and vaccinator training as the most important components of the intervention. External supervision was viewed as the most important factor for the intervention's success but also the costliest. All stakeholders would like to reinstate the intervention because it was effective, but additional funding would be needed to make the intervention sustainable. Targeting slum populations with an intensive immunization intervention was highly effective but would nearly triple the amount spent on immunization per FIC in slum areas. Those committed to increasing vaccination coverage for hard-to-reach children need to be prepared for substantially higher costs to achieve results. Copyright © 2014. Published by Elsevier Ltd.

The economic aspects of artificial snow production in the perspective of climate change

NASA Astrophysics Data System (ADS)

Gonseth, C.

2012-04-01

Snowmaking is now used by ski resorts worldwide as a measure to cope with both natural snow reduction and variability. This extensive recourse casts doubt on its sustainability mainly because of the large amount of natural resources being used (energy, water). In the middle to long run, this problem is expected to increase with future climate change triggering the production of more snow. The research field that focuses on the economic aspects of artificial snow production is still in its infancy but potentially covers a wide array of issues. Among these issues, benefits and costs of snowmaking are important ones. On the one hand, benefits arise as snowmaking extends or preserves the operating period of ski areas. Several empirical studies speculate or show that snowmaking considerably reduces the sensitivity of tourism consumption to variations in snow conditions. These benefits have long been neglected in studies analyzing the consequences of climate change for the winter tourism sector. While failing to introduce these benefits, many studies have generated overly high costs of climate change. On the other hand, investments and operating costs of artificial snow production depend upon several factors, such as technology and local conditions. Consequently, costs vary considerably from one location to another and over time, yet indicative values can be found in the literature. In addition, artificial snow production generates external costs, i.e. costs that are not born by those producing it. Typical of these external costs are environmental ones that are related to CO2 emissions or biodiversity losses. To our knowledge, very little has been done so far to integrate these costs in economic studies. To the extent that vertical integration is absent, it may happen as well that snow production generates important external benefits for different stakeholders at a given ski resort. From an economic point of view, both types of externalities could lead to investment levels that are not optimal in the sense that they do not maximize social welfare. More generally, economic analysis has the potential to explain current investment and snow production levels and to determine optimal ones. It can also predict the evolution of these levels under a warmer climate. For instance, such predictions were carried out for Switzerland as well as for other Alpine countries using a computable general equilibrium model of the world economy with a time horizon up to 2050, the GEMINI-E3 model. With all these points in mind, this presentation aims at reviewing what has been done so far on the economic aspects of artificial snow production and also at identifying avenues for future research.

Methods for evaluating and ranking transportation energy conservation programs

NASA Astrophysics Data System (ADS)

Santone, L. C.

1981-04-01

The energy conservation programs are assessed in terms of petroleum savings, incremental costs to consumers probability of technical and market success, and external impacts due to environmental, economic, and social factors. Three ranking functions and a policy matrix are used to evaluate the programs. The net present value measure which computes the present worth of petroleum savings less the present worth of costs is modified by dividing by the present value of DOE funding to obtain a net present value per program dollar. The comprehensive ranking function takes external impacts into account. Procedures are described for making computations of the ranking functions and the attributes that require computation. Computations are made for the electric vehicle, Stirling engine, gas turbine, and MPG mileage guide program.

Desktop Systems for Manufacturing Carbon Nanotube Films by Chemical Vapor Deposition

DTIC Science & Technology

2007-06-01

existing low cost tube furnace designs limit the researcher’s ability to fully separate critical reaction parameters such as temperature and flow...Often heated using an external resistive heater coil, a typical configuration, shown in Figure 4, might place a tube made of a non- reactive ...researcher’s ability to fully separate critical parameters such as temperature and flow profiles. Additionally, the use of heating elements external to

Naver: a PC-cluster-based VR system

NASA Astrophysics Data System (ADS)

Park, ChangHoon; Ko, HeeDong; Kim, TaiYun

2003-04-01

In this paper, we present a new framework NAVER for virtual reality application. The NAVER is based on a cluster of low-cost personal computers. The goal of NAVER is to provide flexible, extensible, scalable and re-configurable framework for the virtual environments defined as the integration of 3D virtual space and external modules. External modules are various input or output devices and applications on the remote hosts. From the view of system, personal computers are divided into three servers according to its specific functions: Render Server, Device Server and Control Server. While Device Server contains external modules requiring event-based communication for the integration, Control Server contains external modules requiring synchronous communication every frame. And, the Render Server consists of 5 managers: Scenario Manager, Event Manager, Command Manager, Interaction Manager and Sync Manager. These managers support the declaration and operation of virtual environment and the integration with external modules on remote servers.

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova.

PubMed

Kempers, Jari; Ketting, Evert; Lesco, Galina

2014-07-21

Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result suggest that, together the three SRH components (STI, early pregnancy and contraception, and HIV) are potentially cost saving. High cost savings resulting from averted lifetime treatment cost of HIV infected persons are likely to off-set the costs of STIs and unwanted pregnancies.

The application of a low-cost 3D depth camera for patient set-up and respiratory motion management in radiotherapy

NASA Astrophysics Data System (ADS)

Tahavori, Fatemeh

Respiratory motion induces uncertainty in External Beam Radiotherapy (EBRT), which can result in sub-optimal dose delivery to the target tissue and unwanted dose to normal tissue. The conventional approach to managing patient respiratory motion for EBRT within the area of abdominal-thoracic cancer is through the use of internal radiological imaging methods (e.g. Megavoltage imaging or Cone-Beam Computed Tomography) or via surrogate estimates of tumour position using external markers placed on the patient chest. This latter method uses tracking with video-based techniques, and relies on an assumed correlation or mathematical model, between the external surrogate signal and the internal target position. The marker's trajectory can be used in both respiratory gating techniques and real-time tracking methods. Internal radiological imaging methods bring with them limited temporal resolution, and additional radiation burden, which can be addressed by external marker-based methods that carry no such issues. Moreover, by including multiple external markers and placing them closer to the internal target organs, the effciency of correlation algorithms can be increased. However, the quality of such external monitoring methods is underpinned by the performance of the associated correlation model. Therefore, several new approaches to correlation modelling have been developed as part of this thesis and compared using publicly-available datasets. Highly competitive results have been obtained when compared against state-of-the-art methods. Marker-based methods also have the disadvantages of requiring manual set-up time for marker placement and patient positioning and potential issues with reproducibility of marker placement. This motivates the investigation of non-contact marker-free methods for use in EBRT, which is the main topic of this thesis. The Microsoft Kinect is used as an example of a low-cost consumer grade 3D depth camera for capturing and analysing external respiratory motion. This thesis makes the first presentation of detailed studies of external respiratory motion captured using such low-cost technology and demonstrates its potential in a healthcare environment. Firstly, the fundamental performance of a range of Microsoft Kinect sensors is assessed for use in radiotherapy (and potentially other healthcare applications), in terms of static and dynamic performance using both phantoms and volunteers. Then external respiratory motion is captured using the above technology from a group of 32 healthy volunteers and Principal Component Analysis (PCA) is applied to a region of interest encompassing the complete anterior surface to demonstrate breathing style. This work demonstrates that this surface motion can be compactly described by the first two PCA eigenvectors. The reproducibility of subject-specific EBRT set-up using conventional laser-based alignment and marker-based Deep Inspiration Breath Hold (DIBH) methods are also studied using the Microsoft Kinect sensor. A cohort of five healthy female volunteers is repeatedly set-up for left-sided breast cancer EBRT and multiple DIBH episodes captured over five separate sessions representing multiple fractionated radiotherapy treatment sessions, but without dose delivery. This provided an independent assessment that subjects were set-up and generally achieved variations within currently accepted margins of clinical practice. Moreover, this work demonstrated the potential role of consumer-grade 3D depth camera technology as a possible replacement for marker based set-up and DIBH management procedures. This brings with it the additional benefits of low cost, and potential through-put benefits, as patient set-up could ultimately be fully automated with this technology, and DIBH could be independently monitored without requiring preparatory manual intervention.

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

Petruccelli, Umberto, E-mail: umberto.petruccelli@unibas.it

Many studies about the external costs generated by the transport system have been developed in the last twenty years. To standardize methodologies and assessment procedures to be used in the evaluation of the projects, some European countries recently have adopted specific guidelines that differ from each other in some aspects even sensibly. This paper presents a critical analysis of the British, Italian and German guidelines and is aimed at cataloguing the external cost types regarded and the assessment methods indicated as well as to highlight the differences of the results, in terms of applicability and reliability. The goal is tomore » contribute to a European standardization process that would lead to the drafting of guidelines suited for all EU countries. - Highlights: • The analyzed guidelines agree on the methods to evaluate costs from air pollution, greenhouse gases and accidents. • They recommend respectively: dose-resp. approach; costs to reduce/permit emissions; whole direct, indirect and social costs. • For noise, DE guide indicates defensive expenditure or SP methods; IT guide, SP method; UK guide, the hedonic prices one. • For on territory impact, DE guide regards only the barrier effect; the IT one, also the soil consumption and system effects. • British guide proposes a qualitative methodology to estimate the impact on various landscapes and environments.« less

Recruitment of mental health survey participants using Internet advertising: content, characteristics and cost effectiveness.

PubMed

Batterham, Philip J

2014-06-01

Postal and telephone survey research is threatened by declining response rates and high cost. Online recruitment is becoming more popular, although there is little empirical evidence about its cost-effectiveness or the representativeness of online samples. There is also limited research on optimal strategies for developing advertising content for online recruitment. The present study aimed to assess these aspects of online recruitment. Two mental health surveys used advertisements within a social network website (Facebook) to recruit adult Australian participants. The initial survey used advertisements linking directly to an external survey website, and recruited 1283 participants at $9.82 per completed survey. A subsequent survey used advertisements linking to a Facebook page that featured links to the external survey, recruiting 610 participants at $1.51 per completion. Both surveys were more cost-effective than similar postal surveys conducted previously, which averaged $19.10 per completion. Online and postal surveys both had somewhat unrepresentative samples. However, online surveys tended to be more successful in recruiting hard-to-reach populations. Advertising using "problem" terminology was more effective than "positive" terminology, while there was no significant effect of altruistic versus self-gain terminology. Online recruitment is efficient, flexible and cost-effective, suggesting that online recruitment has considerable potential for specific research designs. Copyright © 2014 John Wiley & Sons, Ltd.

Freedom Star tows a barge with an SLWT into Port Canaveral for the first time

NASA Technical Reports Server (NTRS)

1998-01-01

Freedom Star, one of NASA's two solid rocket booster recovery ships, tows a barge containing the third Space Shuttle super lightweight external tank (SLWT) into Port Canaveral. This SLWT will be used to launch the orbiter Discovery on mission STS-95 in October. This first-time towing arrangement, part of a cost savings plan by NASA to prudently manage existing resources, began June 12 from the Michoud Assembly Facility in New Orleans where the Shuttle's external tanks are manufactured. The barge will now be transported up the Banana River to the LC-39 turn basin using a conventional tugboat. Previously, NASA relied on an outside contractor to provide external tank towing services at a cost of about $120,000 per trip. The new plan allows NASA's Space Flight Operations contractor, United Space Alliance (USA), to provide the same service directly to NASA using the recovery ships during their downtime between Shuttle launches. Studies show a potential savings of about $50,000 per trip. The cost of the necessary ship modifications should be paid back by the fourteenth tank delivery. The other recovery ship, Liberty Star, has also undergone deck strengthening enhancements and will soon have the necessary towing winch installed. The other recovery vessel, Liberty Star, has undergone deck strengthening enhancements along with Freedom Star and will soon have the necessary towing winch installed.

Audit of the annual reports of directors of public health: production methods.

PubMed

Sidhu, K S

1992-07-01

An audit of production methods used for the Directors of Public Health (DsPH) Annual Report of the health of their local population. Postal questionnaire survey. 23 Departments of Public Health in the West Midlands Region. Costs and problems relating to different production techniques used. The majority of DsPH favoured reports with figures and graphs. This led to most DsPH using in-house desktop publishing or employing external graphic designers. Those using the former technique had more problems related to computers and felt they spent too much medical time working on the document. However, they also valued the relative low cost, editorial freedom and the ability to correct mistakes easily. Departments which employed external graphic designers generally paid more, but appreciated the extra time made available by delegating the work. They also felt that the expertise was valuable in document design. However, inaccuracies were cited as being more difficult to correct. Perhaps the best way of producing an annual report is to amalgamate the two commonest production techniques (i.e. external graphic design and in-house desktop publishing).

Selecting and Improving Quasi-Experimental Designs in Effectiveness and Implementation Research.

PubMed

Handley, Margaret A; Lyles, Courtney R; McCulloch, Charles; Cattamanchi, Adithya

2018-04-01

Interventional researchers face many design challenges when assessing intervention implementation in real-world settings. Intervention implementation requires holding fast on internal validity needs while incorporating external validity considerations (such as uptake by diverse subpopulations, acceptability, cost, and sustainability). Quasi-experimental designs (QEDs) are increasingly employed to achieve a balance between internal and external validity. Although these designs are often referred to and summarized in terms of logistical benefits, there is still uncertainty about (a) selecting from among various QEDs and (b) developing strategies to strengthen the internal and external validity of QEDs. We focus here on commonly used QEDs (prepost designs with nonequivalent control groups, interrupted time series, and stepped-wedge designs) and discuss several variants that maximize internal and external validity at the design, execution and implementation, and analysis stages.

Large-Scale Physical Models of Thermal Remediation of DNAPL Source Zones in Aquitards

DTIC Science & Technology

2009-05-01

pressure at the bottom of the tank. The higher pressure is reflected in higher measured water levels in external gauges . Figure 63: 3D Cross...than atmospheric. This higher pressure can raise the apparent water level in a sight gauge or external overflow and can even drive more fluid through...the water table. All met or exceeded their goals. Typical turnkey unit costs (including design, permitting, fabrication, mobilization, drilling

Clinical and economic consequences of antibiotic-impregnated cerebrospinal fluid shunt catheters.

PubMed

Eymann, Regina; Chehab, Somar; Strowitzki, Martin; Steudel, Wolf-Ingo; Kiefer, Michael

2008-06-01

The authors evaluated the safety and efficacy of antibiotic-impregnated shunt catheters (AISCs) and determined the cost-benefit ratio related to the fact that AISCs increase the implant costs of a shunt procedure by approximately $400 per patient. The control group comprised 98 adults with chronic hydrocephalus and 22 children, who were treated without AISCs (non-AISCs). In the treatment group, AISCs (Bactiseal, Codman, Johnson & Johnson) were implanted in 171 adults and 26 children. The minimum follow-up period was 6 months. Important risk factors for shunt infections (such as age, comorbidity, cause of hydrocephalus, operating time, and duration of external cerebrospinal fluid drainage prior to shunt placement) did not differ between the study and control groups. In the pediatric AISC group, the frequency of premature, shunt-treated infants and the incidence of external ventricular drainage prior to shunt insertion were actually higher than those in the non-AISC group. When using AISCs, the shunt infection rate dropped from 4 to 0.6% and from 13.6 to 3.8% in the adult and the pediatric cohort, respectively. Overall the infection rate decreased from 5.8 to 1%, which was statistically significant (p = 0.0145). The average costs of a single shunt infection were $17,300 and $13,000 in children and adults, respectively. The cost-benefit calculation assumed to have saved shunt infection-related costs of approximately $50,000 in 197 AISC-treated patients due to the reduction in shunt infection rate in this group compared with costs in the control group. Despite the incremental implant costs associated with the use of AISCs, the overall reduction in infection-related costs made the use of AISCs cost beneficial in the authors' department. From clinical and economic perspectives, AISCs are seemingly a valuable addition in hydrocephalus therapy.

A Total Cost of Ownership Model for Low Temperature PEM Fuel Cells in Combined Heat and Power and Backup Power Applications

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

University of California, Berkeley; Wei, Max; Lipman, Timothy

2014-06-23

A total cost of ownership model is described for low temperature proton exchange membrane stationary fuel cell systems for combined heat and power (CHP) applications from 1-250kW and backup power applications from 1-50kW. System designs and functional specifications for these two applications were developed across the range of system power levels. Bottom-up cost estimates were made for balance of plant costs, and detailed direct cost estimates for key fuel cell stack components were derived using design-for-manufacturing-and-assembly techniques. The development of high throughput, automated processes achieving high yield are projected to reduce the cost for fuel cell stacks to the $300/kWmore » level at an annual production volume of 100 MW. Several promising combinations of building types and geographical location in the U.S. were identified for installation of fuel cell CHP systems based on the LBNL modelling tool DER CAM. Life-cycle modelling and externality assessment were done for hotels and hospitals. Reduced electricity demand charges, heating credits and carbon credits can reduce the effective cost of electricity ($/kWhe) by 26-44percent in locations such as Minneapolis, where high carbon intensity electricity from the grid is displaces by a fuel cell system operating on reformate fuel. This project extends the scope of existing cost studies to include externalities and ancillary financial benefits and thus provides a more comprehensive picture of fuel cell system benefits, consistent with a policy and incentive environment that increasingly values these ancillary benefits. The project provides a critical, new modelling capacity and should aid a broad range of policy makers in assessing the integrated costs and benefits of fuel cell systems versus other distributed generation technologies.« less

Characteristics of the Single-Longitudinal-Mode Planar-Waveguide External Cavity Diode Laser at 1064 nm

NASA Technical Reports Server (NTRS)

Numata, Kenji; Alalusi, Mazin; Stolpner, Lew; Margaritis, Georgios; Camp, Jordan; Krainak, Michael

2014-01-01

We describe the characteristics of the planar-waveguide external cavity diode laser (PW-ECL). To the best of our knowledge, it is the first butterfly-packaged 1064 nm semiconductor laser that is stable enough to be locked to an external frequency reference. We evaluated its performance from the viewpoint of precision experiments. Using a hyperfine absorption line of iodine, we suppressed its frequency noise by a factor of up to 104 at 10 mHz. The PWECL's compactness and low cost make it a candidate to replace traditional Nd:YAG nonplanar ring oscillators and fiber lasers in applications that require a single longitudinal mode.

P-8A Poseidon Multi Mission Maritime Aircraft (P-8A)

DTIC Science & Technology

2015-12-01

focus also includes procurement of depot and intermediate level maintenance capabilities, full scale fatigue testing, and continued integration and... Level Confidence Level of cost estimate for current APB: 50% The current APB cost estimate provided sufficient resources to execute the program under...normal conditions, encountering average levels of technical, schedule, and programmatic risk and external interference. It was consistent with

Economic valuation of a mangrove ecosystem threatened by shrimp aquaculture in Sri Lanka.

PubMed

Gunawardena, M; Rowan, J S

2005-10-01

Mangrove ecosystems in Sri Lanka are increasingly under threat from development projects, especially aquaculture. An economic assessment is presented for a relatively large (42 ha) shrimp culture development proposed for the Rekawa Lagoon system in the south of Sri Lanka, which involved an extended cost-benefit analysis of the proposal and an estimate of the "total economic value" (TEV) of a mangrove ecosystem. The analysis revealed that the internal benefits of developing the shrimp farm are higher than the internal costs in the ratio of 1.5:1. However, when the wider environmental impacts are more comprehensively evaluated, the external benefits are much lower than the external costs in a ratio that ranges between 1:6 and 1:11. In areas like Rekawa, where agriculture and fisheries are widely practiced at subsistence levels, shrimp aquaculture developments have disproportionately large impacts on traditional livelihoods and social welfare. Thus, although the analysis retains considerable uncertainties, more explicit costing of the environmental services provided by mangrove ecosystems demonstrates that low intensity, but sustainable, harvesting has far greater long-term value to local stakeholders and the wider community than large shrimp aquaculture developments.

Study of alternate space shuttle concepts

NASA Technical Reports Server (NTRS)

1971-01-01

A study of alternate space shuttle concepts was conducted to examine the stage-and-one-half concept and its potential for later conversion and use in the two stage reusable shuttle system. A study of external hydrogen tank concepts was conducted to determine the issues involved in the design and production of a low-cost expendable tank system. The major objectives of the study were to determine: (1) realistic drop tank program cost estimates, (2) estimated drop tank program cost for selected specific designs, and (3) change in program cost due to variations in design and manufacturing concepts and changes in program assumptions.

Why Educational Vouchers May Be Bad Economics.

ERIC Educational Resources Information Center

Krashinsky, Michael

1986-01-01

Arguments for and against educational vouchers are examined by looking at underlying economic assumptions. It is argued that externalities and transaction costs have often been ignored by voucher advocates. (MT)

When and why do old adults outsource control to the environment?

PubMed

Mayr, Ulrich; Spieler, Daniel H; Hutcheon, Thomas G

2015-09-01

Old adults' tendency to rely on information present in the environment rather than internal representations has been frequently noted, but is not well understood. The fade-out paradigm provides a useful model situation to study this internal-to-external shift across the life span: Subjects need to transition from an initial, cued task-switching phase to a fade-out phase where only 1 task remains relevant. Old adults exhibit large response-time "fade-out costs," mainly because they continue to consult the task cues. Here we show that age differences in fade-out costs remain very large even when we insert between the task-switching and the fade-out phase 20 single-task trials without task cues (during which even old adults' performance becomes highly fluent; Experiment 1), but costs in old adults are eliminated when presenting an on-screen instruction to focus on the 1 remaining task at the transition point between the task-switching and fade-out phase (Experiment 2). Furthermore, old adults, but not young adults, also exhibited "fade-in costs" when they were instructed to perform an initial single-task phase that would be followed by the cued task-switching phase (Experiment 3). Combined, these results show that old adults' tendency to overutilize external support is not a problem of perseverating earlier-relevant control settings. Instead, old adults seem less likely to initiate the necessary reconfiguration process when transitioning from 1 phase to the next because they use underspecified task models that lack the higher-level distinction between those contexts that do and that do not require external support. (c) 2015 APA, all rights reserved).

Life cycle costing of waste management systems: overview, calculation principles and case studies.

PubMed

Martinez-Sanchez, Veronica; Kromann, Mikkel A; Astrup, Thomas Fruergaard

2015-02-01

This paper provides a detailed and comprehensive cost model for the economic assessment of solid waste management systems. The model was based on the principles of Life Cycle Costing (LCC) and followed a bottom-up calculation approach providing detailed cost items for all key technologies within modern waste systems. All technologies were defined per tonne of waste input, and each cost item within a technology was characterised by both a technical and an economic parameter (for example amount and cost of fuel related to waste collection), to ensure transparency, applicability and reproducibility. Cost items were classified as: (1) budget costs, (2) transfers (for example taxes, subsidies and fees) and (3) externality costs (for example damage or abatement costs related to emissions and disamenities). Technology costs were obtained as the sum of all cost items (of the same type) within a specific technology, while scenario costs were the sum of all technologies involved in a scenario. The cost model allows for the completion of three types of LCC: a Conventional LCC, for the assessment of financial costs, an Environmental LCC, for the assessment of financial costs whose results are complemented by a Life Cycle Assessment (LCA) for the same system, and a Societal LCC, for socio-economic assessments. Conventional and Environmental LCCs includes budget costs and transfers, while Societal LCCs includes budget and externality costs. Critical aspects were found in the existing literature regarding the cost assessment of waste management, namely system boundary equivalency, accounting for temporally distributed emissions and impacts, inclusions of transfers, the internalisation of environmental impacts and the coverage of shadow prices, and there was also significant confusion regarding terminology. The presented cost model was implemented in two case study scenarios assessing the costs involved in the source segregation of organic waste from 100,000 Danish households and the subsequent co-digestion of organic waste with animal manure. Overall, source segregation resulted in higher financial costs than the alternative of incinerating the organic waste with the residual waste: 1.6 M€/year, of which 0.9 M€/year was costs for extra bins and bags used by the households, 1.0 M€/year for extra collections and -0.3 M€/year saved on incineration. Copyright © 2014 Elsevier Ltd. All rights reserved.

Investigation of availability and accessibility of community automated external defibrillators in a territory in Hong Kong.

PubMed

Ho, C L; Lui, C T; Tsui, K L; Kam, C W

2014-10-01

To evaluate the availability and accessibility of community automated external defibrillators in a territory in Hong Kong. Cross-sectional study. Two public hospitals in New Territories West Cluster in Hong Kong. Information about the locations of community automated external defibrillators was obtained from automated external defibrillator suppliers and through community search. Data on locations of out-of-hospital cardiac arrests from August 2010 to September 2013 were obtained from the local cardiac arrest registry of the emergency departments of two hospitals. Sites of both automated external defibrillators and out-of-hospital cardiac arrests were geographically coded and mapped. The number of out-of-hospital cardiac arrests within 100 m of automated external defibrillators per year and the proportion of out-of-hospital cardiac arrests with accessible automated external defibrillators (100 m) were calculated. The number of community automated external defibrillators per 10,000 population and public access defibrillation rate were also calculated and compared with those in other countries. There were a total of 207 community automated external defibrillators in the territory. The number of automated external defibrillators per 10,000 population was 1.942. All facilities with automated external defibrillators in this territory had more than 0.2 out-of-hospital cardiac arrests per automated external defibrillator per year within 100 m. Among all out-of-hospital cardiac arrests, 25.2% could have an automated external defibrillator reachable within 100 m. The public access defibrillation rate was 0.168%. The number and accessibility of community automated external defibrillators in this territory are comparable to those in other developed countries. The placement site of community automated external defibrillators is cost-effective. However, the public access defibrillation rate is low.

External human factors in incident management team decisionmaking and their effect on large fire suppression expenditures

Treesearch

Janie Canton-Tompson; Krista M. Gebert; Brooke Thompson; Greg Jones; David Calkin; Geoff Donovan

2008-01-01

Large wildland fires are complex, costly events influenced by a vast array of physical, climatic, and social factors. Changing climate, fuel buildup due to past suppression, and increasing populations in the wildland-urban interface have all been blamed for the extreme fire seasons and rising suppression expenditures of recent years. With each high-cost year comes a...

Correlating mechanical work with energy consumption during gait throughout pregnancy.

PubMed

Krkeljas, Zarko; Moss, Sarah Johanna

2015-11-20

Measures of mechanical work may be useful in evaluating efficiency of walking during pregnancy. Various adaptations in the body during pregnancy lead to altered gait, consequently contributing to the total energy cost of walking. Measures of metabolic energy expenditure may not be reliable for measuring energetic cost of gait during pregnancy as pregnancy results in numerous metabolic changes resulting from foetal development. Therefore, the aim of this study is to determine if mechanical work prediction equations correlate with the metabolic energy cost of gait during pregnancy. Thirty-five (35) women (27.5 ± 6.1 years) gave informed consent for participation in the study at different weeks of gestation pregnancy. Gas exchange and gait data were recorded while walking at a fixed self-selected walking speed. External (Wext) work was estimated assuming no energy transfer between segments, while internal work (Wint) assumed energy transfer between segments. Hence total energy of the body (Wtot) was calculated based on the segmental changes relative to the surrounding, and relative to the centre of mass of the whole body. Equations for mechanical work were correlated with net and gross O2 rate, and O2 cost. External, internal and total mechanical energy showed significant positive relationship with gross O2 rate (r = 0.48, r = 0.35; and r = 0.49 respectively), and gross O2 cost (r = 0.42; r = 0.70, and r = 0.62, respectively). In contrast, external, internal and total mechanical energy had no significant relationship with net O2 rate (r = 0.19, r = 0.24, and r = 0.24, respectively). Net O2 cost was significant related Wext (r = 0.49) Wint (r = 0.66) and Wtot (r = 0.62). Energy recovery improved with increase in gait speed. Measures of mechanical work, when adjusted for resting energy expenditure, and walking speed may be useful in comparing metabolic energy consumption between women during pregnancy, or assessment or gait changes of the same individual throughout pregnancy.

DORCA computer program. Volume 1: User's guide

NASA Technical Reports Server (NTRS)

Wray, S. T., Jr.

1971-01-01

The Dynamic Operational Requirements and Cost Analysis Program (DORCA) was written to provide a top level analysis tool for NASA. DORCA relies on a man-machine interaction to optimize results based on external criteria. DORCA relies heavily on outside sources to provide cost information and vehicle performance parameters as the program does not determine these quantities but rather uses them. Given data describing missions, vehicles, payloads, containers, space facilities, schedules, cost values and costing procedures, the program computes flight schedules, cargo manifests, vehicle fleet requirements, acquisition schedules and cost summaries. The program is designed to consider the Earth Orbit, Lunar, Interplanetary and Automated Satellite Programs. A general outline of the capabilities of the program are provided.

EoC Study Update to Examine the Cost, Schedule and Technical Changes to NASA Projects

NASA Technical Reports Server (NTRS)

Bitten, Bob; Emmons, Debra; Shinn, Stephen; Scolese, Chris

2018-01-01

The original National Aeronautics and Space Administration (NASA) Explanation of Change (EoC) study was conducted in 2010 to understand the underlying causes of cost and schedule growth. The first study consisted of 25 missions launched from 2000 to 2010 and looked at the events that led to growth. These events were categorized into different bins that were rolled up to quantify whether the growth was due to internal planning, or internal execution, or from external forces and found that the growth was evenly distributed among those three categories. The result of the study presented nine considerations focused at reducing growth due to project external events and internal planning events. Although no one 'magic bullet' consideration was discovered in the previous work, the nine considerations taken as a whole were postulated to help reduce cost and schedule change in future NASA missions. A recent update was conducted that included investigating 8 missions developed since the previous study to determine if the results were different. Cost, schedule, and mass increases were analyzed from the start of Phase B through Preliminary Design Review and Critical Design Review to Launch. As shown in this paper, the results are better with overall cost and schedule growth being reduced. The paper will show a comparison of the previous results to the updated results to show specific reductions and provide an explanation of which recommendations were followed.

Automated external defibrillators in schools?

PubMed

Cornelis, Charlotte; Calle, Paul; Mpotos, Nicolas; Monsieurs, Koenraad

2015-06-01

Automated external defibrillators (AEDs) placed in public locations can save lives of cardiac arrest victims. In this paper, we try to estimate the cost-effectiveness of AED placement in Belgian schools. This would allow school policy makers to make an evidence-based decision about an on-site AED project. We developed a simple mathematical model containing literature data on the incidence of cardiac arrest with a shockable rhythm; the feasibility and effectiveness of defibrillation by on-site AEDs and the survival benefit. This was coupled to a rough estimation of the minimal costs to initiate an AED project. According to the model described above, AED projects in all Belgian schools may save 5 patients annually. A rough estimate of the minimal costs to initiate an AED project is 660 EUR per year. As there are about 6000 schools in Belgium, a national AED project in all schools would imply an annual cost of at least 3960 000 EUR, resulting in 5 lives saved. As our literature survey shows that AED use in schools is feasible and effective, the placement of these devices in all Belgian schools is undoubtedly to be considered. The major counter-arguments are the very low incidence and the high costs to set up a school-based AED programme. Our review may fuel the discussion about Whether or not school-based AED projects represent good value for money and should be preferred above other health care interventions.

Economics and Environmental Compatibility of Fusion Reactors —Its Analysis and Coming Issues— 4.Economic Effect of Fusion in Energy Market 4.2Various Externalities of Energy Systems and the Integrated Evaluation

NASA Astrophysics Data System (ADS)

Ito, Keishiro

The primacy of a nuclear fusion reactor in a competitive energy market remarkably depends on to what extent the reactor contributes to reduce the externalities of energy. The reduction effects are classified into two effects, which have quite dissimilar characteristics. One is an effect of environmental dimensions. The other is related to energy security. In this study I took up the results of EC's Extern Eproject studies as are presentative example of the former effect. Concerning the latter effect, I clarified the fundamental characteristics of externalities related to energy security and the conceptual framework for the purpose of evaluation. In the socio-economical evaluation of research into and development investments in nuclear fusions reactors, the public will require the development of integrated evaluation systems to support the cost-effect analysis of how well the reduction effects of externalities have been integrated with the effects of technological innovation, learning, spillover, etc.

A Prospective Randomized Trial to Assess Fixation Strategies for Severe Open Tibia Fractures: Modern Ring External Fixators Versus Internal Fixation (FIXIT Study).

PubMed

OʼToole, Robert V; Gary, Joshua L; Reider, Lisa; Bosse, Michael J; Gordon, Wade T; Hutson, James; Quinnan, Stephen M; Castillo, Renan C; Scharfstein, Daniel O; MacKenzie, Ellen J

2017-04-01

The treatment of high-energy open tibia fractures is challenging in both the military and civilian environments. Treatment with modern ring external fixation may reduce complications common in these patients. However, no study has rigorously compared outcomes of modern ring external fixation with commonly used internal fixation approaches. The FIXIT study is a prospective, multicenter randomized trial comparing 1-year outcomes after treatment of severe open tibial shaft fractures with modern external ring fixation versus internal fixation among men and women of ages 18-64. The primary outcome is rehospitalization for major limb complications. Secondary outcomes include infection, fracture healing, limb function, and patient-reported outcomes including physical function and pain. One-year treatment costs and patient satisfaction will be compared between the 2 groups, and the percentage of Gustilo IIIB fractures that can be salvaged without soft tissue flap among patients receiving external fixation will be estimated.

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova

PubMed Central

2014-01-01

Background Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Methods Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Results Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. Conclusions The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result suggest that, together the three SRH components (STI, early pregnancy and contraception, and HIV) are potentially cost saving. High cost savings resulting from averted lifetime treatment cost of HIV infected persons are likely to off-set the costs of STIs and unwanted pregnancies. PMID:25047074

Characteristics of the Single-Longitudinal-Mode Planar-Waveguide External Cavity Diode Laser at 1064 nm

NASA Technical Reports Server (NTRS)

Numata, Kenji; Alalusi, Mazin; Stolpner, Lew; Margaritis, Georgios; Camp, Jordan B.; Krainak, Michael A.

2014-01-01

We describe the characteristics of the planar-waveguide external cavity diode laser (PW-ECL). To the best of our knowledge, it is the first butterfly-packaged 1064-nm semiconductor laser that is stable enough to be locked to an external frequency reference. We evaluated its performance from the viewpoint of precision experiments. Especially, using a hyperfine absorption line of iodine, we suppressed its frequency noise by a factor of up to104 at 10 mHz. The PW-ECLs compactness and low cost make it a candidate to replace traditional Nd:YAGnon-planar ring oscillators and fiber lasers in applications which require a single longitudinal-mode.

78 FR 37537 - Centralized Capacity Markets in Regional Transmission Organizations and Independent System...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-21

... existing centralized capacity markets (e.g., resource adequacy, long-term price signals, fixed-cost[email protected] . Sarah McKinley (Logistical Information), Office of External Affairs, Federal Energy...

Visual display and alarm system for wind tunnel static and dynamic loads

NASA Technical Reports Server (NTRS)

Hanly, Richard D.; Fogarty, James T.

1987-01-01

A wind tunnel balance monitor and alarm system developed at NASA Ames Research Center will produce several beneficial results. The costs of wind tunnel delays because of inadvertent balance damage and the costs of balance repair or replacement can be greatly reduced or eliminated with better real-time information on the balance static and dynamic loading. The wind tunnel itself will have enhanced utility with the elimination of overly cautious limits on test conditions. The microprocessor-based system features automatic scaling and 16 multicolored LED bargraphs to indicate both static and dynamic components of the signals from eight individual channels. Five individually programmable alarm levels are available with relay closures for internal or external visual and audible warning devices and other functions such as automatic activation of external recording devices, model positioning mechanisms, or tunnel shutdown.

Visual display and alarm system for wind tunnel static and dynamic loads

NASA Technical Reports Server (NTRS)

Hanly, Richard D.; Fogarty, James T.

1987-01-01

A wind tunnel balance monitor and alarm system developed at NASA Ames Research Center will produce several beneficial results. The costs of wind tunnel delays because of inadvertent balance damage and the costs of balance repair or replacement can be greatly reduced or eliminated with better real-time information on the balance static and dynamic loading. The wind tunnel itself will have enhanced utility with the elimination of overly cautious limits on test conditions. The microprocessor-based system features automatic scaling and 16 multicolored LED bargraphs to indicate both static and dynamic components of the signals from eight individual channels. Five individually programmable alarm levels are available with relay closures for internal or external visual and audible warning devices and other functions such as automatic activation of external recording devices, model positioning mechanism, or tunnel shutdown.

An economy of scales: A selective review of obesity's economic causes, consequences, and solutions.

PubMed

Cawley, John

2015-09-01

This paper reviews the economic research on obesity, covering topics such as the measurement of, and trends in, obesity, the economic causes of obesity (e.g. the monetary price and time cost of food, food assistance programs, income, education, macroeconomic conditions, and peer effects), and the economic consequences of obesity (e.g. lower wages, a lower probability of employment, and higher medical care costs). It also examines the extent to which obesity imposes negative externalities, and economic interventions that could potentially internalize such externalities, such as food taxes, subsidies for school-based physical activity programs, and financial rewards for weight loss. It discusses other economic rationales for government intervention with respect to obesity, such as imperfect information, time inconsistent preferences, and irrational behavior. It concludes by proposing a research agenda for the field. Overall, the evidence suggests that there is no single dominant economic cause of obesity; a wide variety of factors may contribute a modest amount to the risk. There is consistent evidence regarding the economic consequences of obesity, which are lower wages and higher medical care costs that impose negative externalities through health insurance. Studies of economic approaches to preventing obesity, such as menu labeling, taxes on energy-dense foods, and financial rewards for weight loss find only modest effects on weight and thus a range of policies may be necessary to have a substantial effect on the prevalence of obesity. Copyright © 2015. Published by Elsevier B.V.

Activity-based analyses lead to better decision making.

PubMed

Player, S

1998-08-01

Activity-based costing (ABC) and activity-based management (ABM) are cost-management tools that are relatively new to the healthcare industry. ABC is used for strategic decision making. It assesses the costs associated with specific activities and resources and links those costs to specific internal and external customers of the healthcare enterprise (e.g., patients, service lines, and physician groups) to determine the costs associated with each customer. This cost information then can be adjusted to account for anticipated changes and to predict future costs. ABM, on the other hand, supports operations by focusing on the causes of costs and how costs can be reduced. It assesses cost drivers that directly affect the cost of a product or service, and uses performance measures to evaluate the financial or nonfinancial benefit an activity provides. By identifying each cost driver and assessing the value the element adds to the healthcare enterprise, ABM provides a basis for selecting areas that can be changed to reduce costs.

Synfuel program analysis. Volume 2: VENVAL users manual

NASA Astrophysics Data System (ADS)

Muddiman, J. B.; Whelan, J. W.

1980-07-01

This volume is intended for program analysts and is a users manual for the VENVAL model. It contains specific explanations as to input data requirements and programming procedures for the use of this model. VENVAL is a generalized computer program to aid in evaluation of prospective private sector production ventures. The program can project interrelated values of installed capacity, production, sales revenue, operating costs, depreciation, investment, dent, earnings, taxes, return on investment, depletion, and cash flow measures. It can also compute related public sector and other external costs and revenues if unit costs are furnished.

Manufacturing Process for OLED Integrated Substrate

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

Hung, Cheng-Hung; McCamy, James; Ashtosh, Ganjoo

2017-01-27

The primary objective of this project is to demonstrate manufacturing processes for technologies that will enable commercialization of a large-area and low-cost “integrated substrate” product for rigid OLED SSL lighting. The integrated substrate product will consist of a low cost, float glass substrate combined with a transparent conductive anode film layer, and light out-coupling (internal and external extraction layers) structures. In combination, these design elements will enable an integrated substrate meeting or exceeding 2015 performance targets for cost ($60/m2), extraction efficiency (50%) and sheet resistance (<10 ohm/sq).

Development of novel 3D-printed robotic prosthetic for transradial amputees.

PubMed

Gretsch, Kendall F; Lather, Henry D; Peddada, Kranti V; Deeken, Corey R; Wall, Lindley B; Goldfarb, Charles A

2016-06-01

Upper extremity myoelectric prostheses are expensive. The Robohand demonstrated that three-dimensional printing reduces the cost of a prosthetic extremity. The goal of this project was to develop a novel, inexpensive three-dimensional printed prosthesis to address limitations of the Robohand. The prosthesis was designed for patients with transradial limb amputation. It is shoulder-controlled and externally powered with an anthropomorphic terminal device. The user can open and close all five fingers, and move the thumb independently. The estimated cost is US$300. After testing on a patient with a traumatic transradial amputation, several advantages were noted. The independent thumb movement facilitated object grasp, the device weighed less than most externally powered prostheses, and the size was easily scalable. Limitations of the new prosthetic include low grip strength and decreased durability compared to passive prosthetics. Most children with a transradial congenital or traumatic amputation do not use a prosthetic. A three-dimensional printed shoulder-controlled robotic prosthesis provides a cost effective, easily sized and highly functional option which has been previously unavailable. © The International Society for Prosthetics and Orthotics 2015.

A Web-based cost-effective training tool with possible application to brain injury rehabilitation.

PubMed

Wang, Peijun; Kreutzer, Ina Anna; Bjärnemo, Robert; Davies, Roy C

2004-06-01

Virtual reality (VR) has provoked enormous interest in the medical community. In particular, VR offers therapists new approaches for improving rehabilitation effects. However, most of these VR assistant tools are not very portable, extensible or economical. Due to the vast amount of 3D data, they are not suitable for Internet transfer. Furthermore, in order to run these VR systems smoothly, special hardware devices are needed. As a result, existing VR assistant tools tend to be available in hospitals but not in patients' homes. To overcome these disadvantages, as a case study, this paper proposes a Web-based Virtual Ticket Machine, called WBVTM, using VRML [VRML Consortium, The Virtual Reality Modeling Language: International Standard ISO/IEC DIS 14772-1, 1997, available at ], Java and EAI (External Authoring Interface) [Silicon Graphics, Inc., The External Authoring Interface (EAI), available at ], to help people with acquired brain injury (ABI) to relearn basic living skills at home at a low cost. As these technologies are open standard and feature usability on the Internet, WBVTM achieves the goals of portability, easy accessibility and cost-effectiveness.

Aiding troubled employees: the prevalence, cost, and characteristics of employee assistance programs in the United States.

PubMed

Hartwell, T D; Steele, P; French, M T; Potter, F J; Rodman, N F; Zarkin, G A

1996-06-01

Employee assistance programs (EAPs) are job-based programs designed to identify and assist troubled employees. This study determines the prevalence, cost, and characteristics of these programs in the United States by worksite size, industry, and census region. A stratified national probability sample of more than 6400 private, nonagricultural US worksites with 50 or more full-time employees was contacted with a computer-assisted telephone interviewing protocol. More than 3200 worksites responded and were eligible, with a response rate of 90%. Approximately 33% of all private, nonagricultural worksites with 50 or more full-time employees currently offer EAP services to their employees, an 8.9% increase over 1985. These programs are more likely to be found in larger worksites and in the communications/utilities/transportation industries. The most popular model is an external provider, and the median annual cost per eligible employee for internal and external programs was $21.83 and $18.09, respectively. EAPs are becoming a more prevalent point of access to health care for workers with personal problems such as substance abuse, family problems, or emotional distress.

Variable polarity plasma arc welding on the Space Shuttle external tank

NASA Technical Reports Server (NTRS)

Nunes, A. C., Jr.; Bayless, E. O., Jr.; Jones, C. S., III; Munafo, P. M.; Biddle, A. P.; Wilson, W. A.

1984-01-01

Variable polarity plasma arc (VPPA) techniques used at NASA's Marshall Space Flight Center for the fabrication of the Space Shuttle External Tank are presentedd. The high plasma arc jet velocities of 300-2000 m/s are produced by heating the plasma gas as it passes through a constraining orifice, with the plasma arc torch becoming a miniature jet engine. As compared to the GTA jet, the VPPA has the following advantages: (1) less sensitive to contamination, (2) a more symmetrical fusion zone, and (3) greater joint penetration. The VPPA welding system is computerized, operating with a microprocessor, to set welding variables in accordance with set points inputs, including the manipulator and wire feeder, as well as torch control and power supply. Some other VPPA welding technique advantages are: reduction in weld repair costs by elimination of porosity; reduction of joint preparation costs through elimination of the need to scrape or file faying surfaces; reduction in depeaking costs; eventual reduction of the 100 percent-X-ray inspection requirements. The paper includes a series of schematic and block diagrams.

High-speed machining of Space Shuttle External Tank (ET) panels

NASA Technical Reports Server (NTRS)

Miller, J. A.

1983-01-01

Potential production rates and project cost savings achieved by converting the conventional machining process in manufacturing shuttle external tank panels to high speed machining (HSM) techniques were studied. Savings were projected from the comparison of current production rates with HSM rates and with rates attainable on new conventional machines. The HSM estimates were also based on rates attainable by retrofitting existing conventional equipment with high speed spindle motors and rates attainable using new state of the art machines designed and built for HSM.

Laboratory manager's financial handbook. Cost accounting: the road map to financial success.

PubMed

Travers, E M

1996-01-01

Cost accounting is the most basic element of the laboratory's financial management structure. Historically, cost accounting in the nonmedical world referred to accumulating and assigning costs to units of production and departments, primarily for inventory valuation and income determination. In the health industry, microcost accounting is distinguishable from macrocost (management/internal) accounting and serves multiple purposes. Microcost accounting pertains to gathering and providing information for decision making. The range of decisions include managing recurring operations, making nonrecurring strategic decisions, and formulating major organizational policies. Macrocost accounting fulfills the legal requirements of reporting to stockholders, auditors, governmental agencies, and other external parties.

Global economic evaluations of rotavirus vaccines: A systematic review.

PubMed

Kotirum, Surachai; Vutipongsatorn, Naaon; Kongpakwattana, Khachen; Hutubessy, Raymond; Chaiyakunapruk, Nathorn

2017-06-08

World Health Organization (WHO) recommends Rotavirus vaccines to prevent and control rotavirus infections. Economic evaluations (EE) have been considered to support decision making of national policy. Summarizing global experience of the economic value of rotavirus vaccines is crucial in order to encourage global WHO recommendations for vaccine uptake. Therefore, a systematic review of economic evaluations of rotavirus vaccine was conducted. We searched Medline, Embase, NHS EED, EconLit, CEA Registry, SciELO, LILACS, CABI-Global Health Database, Popline, World Bank - e-Library, and WHOLIS. Full economic evaluations studies, published from inception to November 2015, evaluating Rotavirus vaccines preventing Rotavirus infections were included. The methods, assumptions, results and conclusions of the included studies were extracted and appraised using WHO guide for standardization of EE of immunization programs. 104 relevant studies were included. The majority of studies were conducted in high-income countries. Cost-utility analysis was mostly reported in many studies using incremental cost-effectiveness ratio per DALY averted or QALY gained. Incremental cost per QALY gained was used in many studies from high-income countries. Mass routine vaccination against rotavirus provided the ICERs ranging from cost-saving to highly cost-effective in comparison to no vaccination among low-income countries. Among middle-income countries, vaccination offered the ICERs ranging from cost-saving to cost-effective. Due to low- or no subsidized price of rotavirus vaccines from external funders, being not cost-effective was reported in some high-income settings. Mass vaccination against rotavirus was generally found to be cost-effective, particularly in low- and middle-income settings according to the external subsidization of vaccine price. On the other hand, it may not be a cost-effective intervention at market price in some high-income settings. This systematic review provides supporting information to health policy-makers and health professionals when considering rotavirus vaccination as a national program. Copyright © 2017 Elsevier Ltd. All rights reserved.

Biomedical Waste Management : An Infrastructural Survey of Hospitals.

PubMed

Rao, Skm; Ranyal, R K; Bhatia, S S; Sharma, V R

2004-10-01

The Ministry of Environment & Forests notified the Biomedical Waste (management & handling) Rules, 1998" (BMW Mgt) in July 1998. In accordance with the rules, every hospital generating BMW needs to set up requisite BMW treatment facilities on site or ensure requisite treatment of waste at common treatment facility. No untreated BMW shall be kept stored beyond a period of 48 hours. The cost of construction, operation and maintenance of system for managing BMW represents a significant part of overall budget of a hospital if the BMW rules have to be implemented in their true spirit. Two types of costs are required to be incurred by hospitals for BMW Mgt, internal and external. Internal cost is the cost for segregation, mutilation, disinfection, internal storage and transportation including hidden cost of protective equipment. External costs are off site transportation, treatment and final disposal. A study of hospitals was carried out from various sectors like Govt, Private, Charitable institutions etc. to assess the infrastructural requirement for BMW Mgt. Cost was worked out for a hospital where all the infrastructure as per each and every requirement of BMW rules had been implemented and then it was compared with other hospitals where hospitals have made compromises on each stage of BMW Mgt. Capital cost incurred by benchmarked hospital of 1047 beds was Rs.3 lakh 59 thousand excluding cost of incinerator and hospital is incurring Rs. 656/- per day as recurring expenditure. Pune city has common regional facility for BMW final disposal. Facility is charging Rs.20 per kg of infectious waste. As on Dec 2001 there were 400 institutions including nursing homes, labs and blood banks which were registered. After analyzing the results of study it was felt that there is an urgent need to standardize the infrastructural requirement so that hospitals following BMW rules strictly do not suffer additional costs.

Acute skin toxicity-related, out-of-pocket expenses in patients with breast cancer treated with external beam radiotherapy: a descriptive, exploratory study.

PubMed

Schnur, Julie B; Graff Zivin, Joshua; Mattson, David M K; Green, Sheryl; Jandorf, Lina H; Wernicke, A Gabriella; Montgomery, Guy H

2012-12-01

Acute skin toxicity is one of the most common side effects of breast cancer radiotherapy. To date, no one has estimated the nonmedical out-of-pocket expenses associated with this side effect. The primary aim of the present descriptive, exploratory study was to assess the feasibility of a newly developed skin toxicity costs questionnaire. The secondary aims were to: (1) estimate nonmedical out-of-pocket costs, (2) examine the nature of the costs, (3) explore potential background predictors of costs, and (4) explore the relationship between patient-reported dermatologic quality of life and expenditures. A total of 50 patients (mean age = 54.88, Stage 0-III) undergoing external beam radiotherapy completed a demographics/medical history questionnaire as well as a seven-item Skin Toxicity Costs (STC) questionnaire and the Skindex-16 in week 5 of treatment. Mean skin toxicity costs were $131.64 (standard error [SE] = $23.68). Most frequently incurred expenditures were new undergarments and products to manage toxicity. Education was a significant unique predictor of spending, with more educated women spending more money. Greater functioning impairment was associated with greater costs. The STC proved to be a practical, brief measure which successfully indicated specific areas of patient expenditures and need. Results reveal the nonmedical, out-of-pocket costs associated with acute skin toxicity in the context of breast cancer radiotherapy. To our knowledge, this study is the first to quantify individual costs associated with this treatment side effect, as well as the first to present a scale specifically designed to assess such costs. In future research, the STC could be used as an outcome variable in skin toxicity prevention and control research, as a behavioral indicator of symptom burden, or as part of a needs assessment.

Part Count: Monolithic Part Effects On Manufacturing Labor Cost, An Aircraft Applied Model

DTIC Science & Technology

2010-03-01

Fulfillment of the Requirements for the Degree of Master of Science in Financial Analysis Aaron M. Lemke, BS Captain, USAF March 2010... ACCA ), provides substantial support for the impact of part size on life cycle cost for payload aircraft. This research evaluates select methods used...1: Boeing 787 External Skin Materials (Boeing, 2010) ..........................................9 Figure 2: ACCA Task Sequence (Neumeier et al, 2009

Effect of a food waste disposer policy on solid waste and wastewater management with economic implications of environmental externalities.

PubMed

Maalouf, Amani; El-Fadel, Mutasem

2017-11-01

In this study, the carbon footprint of introducing a food waste disposer (FWD) policy was examined in the context of its implications on solid waste and wastewater management with economic assessment of environmental externalities emphasizing potential carbon credit and increased sludge generation. For this purpose, a model adopting a life cycle inventory approach was developed to integrate solid waste and wastewater management processes under a single framework and test scenarios for a waste with high organic food content typical of developing economies. For such a waste composition, the results show that a FWD policy can reduce emissions by nearly ∼42% depending on market penetration, fraction of food waste ground, as well as solid waste and wastewater management schemes, including potential energy recovery. In comparison to baseline, equivalent economic gains can reach ∼28% when environmental externalities including sludge management and emissions variations are considered. The sensitivity analyses on processes with a wide range in costs showed an equivalent economic impact thus emphasizing the viability of a FWD policy although the variation in the cost of sludge management exhibited a significant impact on savings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Potential approaches to the management of third-party impacts from groundwater transfers

NASA Astrophysics Data System (ADS)

Skurray, James H.; Pannell, David J.

2012-08-01

Groundwater extraction can have varied and diffuse effects. Negative external effects may include costs imposed on other groundwater users and on surrounding ecosystems. Environmental damages are commonly not reflected in market transactions. Groundwater transfers have the potential to cause spatial redistribution, concentration, and qualitative transformation of the impacts from pumping. An economically and environmentally sound groundwater transfer scheme would ensure that marginal costs from trades do not exceed marginal benefits, accounting for all third-party impacts, including those of a non-monetary nature as well as delayed effects. This paper proposes a menu of possible management strategies that would help preclude unacceptable impacts by restricting transfers with certain attributes, ideally ensuring that permitted transfers are at least welfare-neutral. Management tools would require that transfers limit or reduce environmental impacts, and provide for the compensation of financial impacts. Three management tools are described. While these tools can limit impacts from a given level of extraction, they cannot substitute for sustainable overall withdrawal limits. Careful implementation of transfer limits and exchange rates, and the strategic use of management area boundaries, may enable a transfer system to restrict negative externalities mainly to monetary costs. Provision for compensation of these costs could be built into the system.

Epidemiological game-theory dynamics of chickenpox vaccination in the USA and Israel

PubMed Central

Liu, Jingzhou; Kochin, Beth F.; Tekle, Yonas I.; Galvani, Alison P.

2012-01-01

The general consensus from epidemiological game-theory studies is that vaccination coverage driven by self-interest (Nash vaccination) is generally lower than group-optimal coverage (utilitarian vaccination). However, diseases that become more severe with age, such as chickenpox, pose an exception to this general consensus. An individual choice to be vaccinated against chickenpox has the potential to harm those not vaccinated by increasing the average age at infection and thus the severity of infection as well as those already vaccinated by increasing the probability of breakthrough infection. To investigate the effects of these externalities on the relationship between Nash and utilitarian vaccination coverages for chickenpox, we developed a game-theory epidemic model that we apply to the USA and Israel, which has different vaccination programmes, vaccination and treatment costs, as well as vaccination coverage levels. We find that the increase in chickenpox severity with age can reverse the typical relationship between utilitarian and Nash vaccination coverages in both the USA and Israel. Our model suggests that to obtain herd immunity of chickenpox vaccination, subsidies or external regulation should be used if vaccination costs are high. By contrast, for low vaccination costs, improving awareness of the vaccine and the potential cost of chickenpox infection is crucial. PMID:21632611

Epidemiological game-theory dynamics of chickenpox vaccination in the USA and Israel.

PubMed

Liu, Jingzhou; Kochin, Beth F; Tekle, Yonas I; Galvani, Alison P

2012-01-07

The general consensus from epidemiological game-theory studies is that vaccination coverage driven by self-interest (Nash vaccination) is generally lower than group-optimal coverage (utilitarian vaccination). However, diseases that become more severe with age, such as chickenpox, pose an exception to this general consensus. An individual choice to be vaccinated against chickenpox has the potential to harm those not vaccinated by increasing the average age at infection and thus the severity of infection as well as those already vaccinated by increasing the probability of breakthrough infection. To investigate the effects of these externalities on the relationship between Nash and utilitarian vaccination coverages for chickenpox, we developed a game-theory epidemic model that we apply to the USA and Israel, which has different vaccination programmes, vaccination and treatment costs, as well as vaccination coverage levels. We find that the increase in chickenpox severity with age can reverse the typical relationship between utilitarian and Nash vaccination coverages in both the USA and Israel. Our model suggests that to obtain herd immunity of chickenpox vaccination, subsidies or external regulation should be used if vaccination costs are high. By contrast, for low vaccination costs, improving awareness of the vaccine and the potential cost of chickenpox infection is crucial.

Evolutionary vaccination dynamics with internal support mechanisms

NASA Astrophysics Data System (ADS)

Tang, Guo-Mei; Cai, Chao-Ran; Wu, Zhi-Xi

2017-05-01

This paper reports internal support mechanisms (i.e., without external intervention) to enhance the vaccine coverage in the evolutionary vaccination dynamics. We present two internal support mechanisms, one is global support mechanism in which each individual pays a support cost to build up a public fund and then the public fund is divided by all vaccinated individuals, while another is local support mechanism in which each individual pays a support cost and then this support cost will be divided by its immediate vaccinated neighbors. By means of extensive computer simulations, we show that, in the same strength of support cost, the heterogeneous (local) support mechanism can encourage more people to take vaccination than the homogeneous (global) support mechanism. And then, we study the most general case that includes supporters and troublemakers together, where supporters (troublemakers) mean that the individuals join (do not join) the internal support mechanism, in the population. We surprisingly find that, in scale-free networks, the voluntary vaccination dynamics with the local support mechanism will not degrade into the original voluntary vaccination dynamics, and the vaccination level can still be effectively improved. In view of most social networks are of scale-free degree distribution, we study further in empirical networks and find that the vaccination level can still be improved in the absence of external intervention.

Job Analysis: A Local Government's Experience.

ERIC Educational Resources Information Center

Urbanek, Steve J.

1997-01-01

A county personnel department undertook reclassification of all positions by collecting and using job analysis data to rewrite job descriptions. External pay equity and validated selection procedures resulted with only a modest increase in payroll costs. (SK)

Noise requirements from a military point of view

NASA Technical Reports Server (NTRS)

Crawford, C. C., Jr.

1978-01-01

External and internal aircraft noise requirements are discussed in terms of application to military helicopters. The impact of the application of noise reduction technology to comply with FAA standards on cost and performance is emphasized.

Improved Nitrogen Removal Effect In Continuous Flow A2/O Process Using Typical Extra Carbon Source

NASA Astrophysics Data System (ADS)

Wu, Haiyan; Gao, Junyan; Yang, Dianhai; Zhou, Qi; Cai, Bijing

2010-11-01

In order to provide a basis for optimal selection of carbon source, three typical external carbon sources (i.e. methanol, sodium acetate and leachate) were applied to examine nitrogen removal efficiency of continuous flow A2/O system with the influent from the effluent of grit chamber in the second Kunming wastewater treatment plant. The best dosage was determined, and the specific nitrogen removal rate and carbon consumption rate were calculated with regard to individual external carbon source in A2/O system. Economy and technology analysis was also conducted to select the suitable carbon source with a low operation cost. Experimental results showed that the external typical carbon source caused a remarkable enhancement of system nitrate degradation ability. In comparison with the blank test, the average TN and NH3-N removal efficiency of system with different dosing quantities of external carbon source was improved by 15.2% and 34.2%, respectively. The optimal dosage of methanol, sodium acetate and leachate was respectively up to 30 mg/L, 40 mg/L and 100 mg COD/L in terms of a high nitrogen degradation effect. The highest removal efficiency of COD, TN and NH3-N reached respectively 92.3%, 73.9% and 100% with methanol with a dosage of 30 mg/L. The kinetic analysis and calculation revealed that the greatest denitrification rate was 0.0107 mg TN/mg MLVSSṡd with sodium acetate of 60 mg/L. As to carbon consumption rate, however, the highest value occurred in the blank test with a rate of 0.1955 mg COD/mg MLVSSṡd. Also, further economic analysis proved leachate to be pragmatic external carbon source whose cost was far cheaper than methanol.

Satellite Power Systems (SPS) space transportation cost analysis and evaluation

NASA Technical Reports Server (NTRS)

1980-01-01

A picture of Space Power Systems space transportation costs at the present time is given with respect to accuracy as stated, reasonableness of the methods used, assumptions made, and uncertainty associated with the estimates. The approach used consists of examining space transportation costs from several perspectives to perform a variety of sensitivity analyses or reviews and examine the findings in terms of internal consistency and external comparison with analogous systems. These approaches are summarized as a theoretical and historical review including a review of stated and unstated assumptions used to derive the costs, and a performance or technical review. These reviews cover the overall transportation program as well as the individual vehicles proposed. The review of overall cost assumptions is the principal means used for estimating the cost uncertainty derived. The cost estimates used as the best current estimate are included.

Stay Focused! The Effects of Internal and External Focus of Attention on Movement Automaticity in Patients with Stroke

PubMed Central

Kal, E. C.; van der Kamp, J.; Houdijk, H.; Groet, E.; van Bennekom, C. A. M.; Scherder, E. J. A.

2015-01-01

Dual-task performance is often impaired after stroke. This may be resolved by enhancing patients’ automaticity of movement. This study sets out to test the constrained action hypothesis, which holds that automaticity of movement is enhanced by triggering an external focus (on movement effects), rather than an internal focus (on movement execution). Thirty-nine individuals with chronic, unilateral stroke performed a one-leg-stepping task with both legs in single- and dual-task conditions. Attentional focus was manipulated with instructions. Motor performance (movement speed), movement automaticity (fluency of movement), and dual-task performance (dual-task costs) were assessed. The effects of focus on movement speed, single- and dual-task movement fluency, and dual-task costs were analysed with generalized estimating equations. Results showed that, overall, single-task performance was unaffected by focus (p = .341). Regarding movement fluency, no main effects of focus were found in single- or dual-task conditions (p’s ≥ .13). However, focus by leg interactions suggested that an external focus reduced movement fluency of the paretic leg compared to an internal focus (single-task conditions: p = .068; dual-task conditions: p = .084). An external focus also tended to result in inferior dual-task performance (β = -2.38, p = .065). Finally, a near-significant interaction (β = 2.36, p = .055) suggested that dual-task performance was more constrained by patients’ attentional capacity in external focus conditions. We conclude that, compared to an internal focus, an external focus did not result in more automated movements in chronic stroke patients. Contrary to expectations, trends were found for enhanced automaticity with an internal focus. These findings might be due to patients’ strong preference to use an internal focus in daily life. Future work needs to establish the more permanent effects of learning with different attentional foci on re-automating motor control after stroke. PMID:26317437

The effects of a prelicensure extern program and nurse residency program on new graduate outcomes and retention.

PubMed

Friday, Laura; Zoller, James S; Hollerbach, Ann D; Jones, Katherine; Knofczynski, Greg

2015-01-01

Organizations are looking to new graduate nurses to fill expected staffing shortages over the next decade. Creative and effective onboarding programs will determine the success or failure of these graduates as they transition from student to professional nurse. This longitudinal quantitative study with repeated measures used the Casey-Fink Graduate Nurse Experience Survey to investigate the effects of offering a prelicensure extern program and postlicensure residency program on new graduate nurses and organizational outcomes versus a residency program alone. Compared with the nurse residency program alone, the combination of extern program and nurse residency program improved neither the transition factors most important to new nurse graduates during their first year of practice nor a measure important to organizations, retention rates. The additional cost of providing an extern program should be closely evaluated when making financially responsible decisions.

Inducing Peer Pressure to Promote Cooperation

PubMed Central

Mani, Ankur; Rahwan, Iyad; Pentland, Alex

2013-01-01

Cooperation in a large society of self-interested individuals is notoriously difficult to achieve when the externality of one individual's action is spread thin and wide on the whole society. This leads to the ‘tragedy of the commons’ in which rational action will ultimately make everyone worse-off. Traditional policies to promote cooperation involve Pigouvian taxation or subsidies that make individuals internalize the externality they incur. We introduce a new approach to achieving global cooperation by localizing externalities to one's peers in a social network, thus leveraging the power of peer-pressure to regulate behavior. The mechanism relies on a joint model of externalities and peer-pressure. Surprisingly, this mechanism can require a lower budget to operate than the Pigouvian mechanism, even when accounting for the social cost of peer pressure. Even when the available budget is very low, the social mechanisms achieve greater improvement in the outcome. PMID:23619166

Inducing peer pressure to promote cooperation.

PubMed

Mani, Ankur; Rahwan, Iyad; Pentland, Alex

2013-01-01

Cooperation in a large society of self-interested individuals is notoriously difficult to achieve when the externality of one individual's action is spread thin and wide on the whole society. This leads to the 'tragedy of the commons' in which rational action will ultimately make everyone worse-off. Traditional policies to promote cooperation involve Pigouvian taxation or subsidies that make individuals internalize the externality they incur. We introduce a new approach to achieving global cooperation by localizing externalities to one's peers in a social network, thus leveraging the power of peer-pressure to regulate behavior. The mechanism relies on a joint model of externalities and peer-pressure. Surprisingly, this mechanism can require a lower budget to operate than the Pigouvian mechanism, even when accounting for the social cost of peer pressure. Even when the available budget is very low, the social mechanisms achieve greater improvement in the outcome.

Inducing Peer Pressure to Promote Cooperation

NASA Astrophysics Data System (ADS)

Mani, Ankur; Rahwan, Iyad; Pentland, Alex

2013-04-01

Cooperation in a large society of self-interested individuals is notoriously difficult to achieve when the externality of one individual's action is spread thin and wide on the whole society. This leads to the `tragedy of the commons' in which rational action will ultimately make everyone worse-off. Traditional policies to promote cooperation involve Pigouvian taxation or subsidies that make individuals internalize the externality they incur. We introduce a new approach to achieving global cooperation by localizing externalities to one's peers in a social network, thus leveraging the power of peer-pressure to regulate behavior. The mechanism relies on a joint model of externalities and peer-pressure. Surprisingly, this mechanism can require a lower budget to operate than the Pigouvian mechanism, even when accounting for the social cost of peer pressure. Even when the available budget is very low, the social mechanisms achieve greater improvement in the outcome.

Life cycle costing of waste management systems: Overview, calculation principles and case studies

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

Martinez-Sanchez, Veronica, E-mail: vems@env.dtu.dk; Kromann, Mikkel A.; Astrup, Thomas Fruergaard

2015-02-15

Highlights: • We propose a comprehensive model for cost assessment of waste management systems. • The model includes three types of LCC: Conventional, Environmental and Societal LCCs. • The applicability of the proposed model is tested with two case studies. - Abstract: This paper provides a detailed and comprehensive cost model for the economic assessment of solid waste management systems. The model was based on the principles of Life Cycle Costing (LCC) and followed a bottom-up calculation approach providing detailed cost items for all key technologies within modern waste systems. All technologies were defined per tonne of waste input, andmore » each cost item within a technology was characterised by both a technical and an economic parameter (for example amount and cost of fuel related to waste collection), to ensure transparency, applicability and reproducibility. Cost items were classified as: (1) budget costs, (2) transfers (for example taxes, subsidies and fees) and (3) externality costs (for example damage or abatement costs related to emissions and disamenities). Technology costs were obtained as the sum of all cost items (of the same type) within a specific technology, while scenario costs were the sum of all technologies involved in a scenario. The cost model allows for the completion of three types of LCC: a Conventional LCC, for the assessment of financial costs, an Environmental LCC, for the assessment of financial costs whose results are complemented by a Life Cycle Assessment (LCA) for the same system, and a Societal LCC, for socio-economic assessments. Conventional and Environmental LCCs includes budget costs and transfers, while Societal LCCs includes budget and externality costs. Critical aspects were found in the existing literature regarding the cost assessment of waste management, namely system boundary equivalency, accounting for temporally distributed emissions and impacts, inclusions of transfers, the internalisation of environmental impacts and the coverage of shadow prices, and there was also significant confusion regarding terminology. The presented cost model was implemented in two case study scenarios assessing the costs involved in the source segregation of organic waste from 100,000 Danish households and the subsequent co-digestion of organic waste with animal manure. Overall, source segregation resulted in higher financial costs than the alternative of incinerating the organic waste with the residual waste: 1.6 M€/year, of which 0.9 M€/year was costs for extra bins and bags used by the households, 1.0 M€/year for extra collections and −0.3 M€/year saved on incineration.« less

Implantable or external defibrillators for individuals at increased risk of cardiac arrest: where cost-effectiveness hits fiscal reality.

PubMed

Cram, Peter; Katz, David; Vijan, Sandeep; Kent, David M; Langa, Kenneth M; Fendrick, A Mark

2006-01-01

Implantable cardioverter defibrillators (ICDs) are highly effective at preventing cardiac arrest, but their availability is limited by high cost. Automated external defibrillators (AEDs) are likely to be less effective, but also less expensive. We used decision analysis to evaluate the clinical and economic trade-offs of AEDs, ICDs, and emergency medical services equipped with defibrillators (EMS-D) for reducing cardiac arrest mortality. A Markov model was developed to compare the cost-effectiveness of three strategies in adults meeting entry criteria for the MADIT II Trial: strategy 1, individuals experiencing cardiac arrest are treated by EMS-D; strategy 2, individuals experiencing cardiac arrest are treated with an in-home AED; and strategy 3, individuals receive a prophylactic ICD. The model was then used to quantify the aggregate societal benefit of these three strategies under the conditions of a constrained federal budget. Compared with EMS-D, in-home AEDs produced a gain of 0.05 quality-adjusted life-years (QALYs) at an incremental cost of $5225 ($104,500 per QALY), while ICDs produced a gain of 0.90 QALYs at a cost of $114,660 ($127,400 per QALY). For every $1 million spent on defibrillators, 1.7 additional QALYs are produced by purchasing AEDs (9.6 QALYs/$million) instead of ICDs (7.9 QALYs/$million). Results were most sensitive to defibrillator complication rates and effectiveness, defibrillator cost, and adults' risk of cardiac arrest. Both AEDs and ICDs reduce cardiac arrest mortality, but AEDs are significantly less expensive and less effective. If financial constraints were to lead to rationing of defibrillators, it might be preferable to provide more people with a less effective and less expensive intervention (in-home AEDs) instead of providing fewer people with a more effective and more costly intervention (ICDs).

Diagnostic Yield and Economic Assessment of a Diagnostic Protocol With Systematic Use of an External Loop Recorder for Patients With Palpitations.

PubMed

Francisco-Pascual, Jaume; Santos-Ortega, Alba; Roca-Luque, Ivo; Rivas-Gándara, Nuria; Pérez-Rodón, Jordi; Milà-Pascual, Laia; García-Dorado, David; Moya-Mitjans, Àngel

2018-05-24

To assess the diagnostic yield and cost-effectiveness of a diagnostic protocol based on the systematic use of latest-generation external loop recorders (ELRs) compared with the classic diagnostic strategy for patients with recurrent unexplained palpitations. Two cohorts of consecutive patients referred for diagnosis of unexplained palpitations to the outpatient clinic of the arrhythmia unit were compared: a prospective cohort after the implementation of a new diagnostic protocol based on the systematic use of ELRs, and another, retrospective, cohort before the implementation of the protocol. The cost of diagnosis was calculated based on the number of complementary examinations, visits to outpatient clinics, or emergency department visits required to reach a diagnosis, and its costs according the prices published for the local health system. One hundred and forty-nine patients were included (91 in the ELR group, 58 in the control group). The diagnostic yield was higher in the ELR group (79 [86.8%] definitive diagnoses in the ELR group vs 12 [20.7%] in the control group, P < .001). The cost per diagnosis was €375.13 in the ELR group and €5184.75 in the control group (P < .001). The cost-effectiveness study revealed that the systematic use of ELR resulted in a cost reduction of €11.30 for each percentage point of increase in diagnosis yield. In patients with recurrent unexplained palpitations, evaluation by means of a study protocol that considers the systematic use of a latest-generation ELR increases diagnostic yield while reducing the cost per diagnosis. Copyright © 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Assessment of feasibility of running RSNA's MIRC on a Raspberry Pi: a cost-effective solution for teaching files in radiology.

PubMed

Pereira, Andre; Atri, Mostafa; Rogalla, Patrik; Huynh, Thien; O'Malley, Martin E

2015-11-01

The value of a teaching case repository in radiology training programs is immense. The allocation of resources for putting one together is a complex issue, given the factors that have to be coordinated: hardware, software, infrastructure, administration, and ethics. Costs may be significant and cost-effective solutions are desirable. We chose Medical Imaging Resource Center (MIRC) to build our teaching file. It is offered by RSNA for free. For the hardware, we chose the Raspberry Pi, developed by the Raspberry Foundation: a small control board developed as a low cost computer for schools also used in alternative projects such as robotics and environmental data collection. Its performance and reliability as a file server were unknown to us. For the operational system, we chose Raspbian, a variant of Debian Linux, along with Apache (web server), MySql (database server) and PHP, which enhance the functionality of the server. A USB hub and an external hard drive completed the setup. Installation of software was smooth. The Raspberry Pi was able to handle very well the task of hosting the teaching file repository for our division. Uptime was logged at 100 %, and loading times were similar to other MIRC sites available online. We setup two servers (one for backup), each costing just below $200.00 including external storage and USB hub. It is feasible to run RSNA's MIRC off a low-cost control board (Raspberry Pi). Performance and reliability are comparable to full-size servers for the intended purpose of hosting a teaching file within an intranet environment.

The role, costs and value for money of external consultancies in the health sector: A study of New Zealand's District Health Boards.

PubMed

Penno, Erin; Gauld, Robin

2017-04-01

Public spending on external consultancies, particularly within the health sector, is highly controversial in many countries. Yet, despite the apparently large sums of money involved, there is little international analysis surrounding the scope of activities of consultants, meaning there is little understanding of how much is spent, for what purpose and with what result. This paper examines spending on external consultancies in each of New Zealand's 20 District Health Boards (DHB). Using evidence obtained from DHBs, it provides an insight into the cost and activities of consultants within the New Zealand health sector, the policies behind their engagement and the processes in place to ensure value for money. It finds that DHB spending on external consultants is substantial, at $NZ10-60 million annually. However, few DHBs had policies governing when consultants should be engaged and many were unable to easily identify the extent or purpose of consultancies within their organisation, making it difficult to derive an accurate picture of consultant activity throughout the DHB sector. Policies surrounding value for money were uncommon and, where present, were rarely applied. Given the large sums being spent by New Zealand's DHBs, and assuming expenditure is similar in other health systems, our findings point to the need for greater accountability for expenditure and better evidence of value for money of consultancies within publicly funded health systems. Copyright © 2017 Elsevier B.V. All rights reserved.

Reflections on Reference Services.

ERIC Educational Resources Information Center

Brandt, Kerryn A.; And Others

1996-01-01

Describes programmatic changes in reference services at the Johns Hopkins University (Maryland) medical library and speculates on the future. Topics include institutional restructuring and consolidation; improvements in technology infrastructure; external economic pressure; and fiscal accountability, including library funding and cost center…

Cost-effectiveness of external cephalic version for term breech presentation.

PubMed

Tan, Jonathan M; Macario, Alex; Carvalho, Brendan; Druzin, Maurice L; El-Sayed, Yasser Y

2010-01-21

External cephalic version (ECV) is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc.) was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery), utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY) was used to determine cost-effectiveness. The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion to breech, successful second ECV trial, or adverse outcome from emergency cesarean. From society's perspective, ECV trial is cost-effective when compared to a scheduled cesarean for breech presentation provided the probability of successful ECV is > 32%. Improved algorithms are needed to more precisely estimate the likelihood that a patient will have a successful ECV.

RT-Syn: A real-time software system generator

NASA Technical Reports Server (NTRS)

Setliff, Dorothy E.

1992-01-01

This paper presents research into providing highly reusable and maintainable components by using automatic software synthesis techniques. This proposal uses domain knowledge combined with automatic software synthesis techniques to engineer large-scale mission-critical real-time software. The hypothesis centers on a software synthesis architecture that specifically incorporates application-specific (in this case real-time) knowledge. This architecture synthesizes complex system software to meet a behavioral specification and external interaction design constraints. Some examples of these external constraints are communication protocols, precisions, timing, and space limitations. The incorporation of application-specific knowledge facilitates the generation of mathematical software metrics which are used to narrow the design space, thereby making software synthesis tractable. Success has the potential to dramatically reduce mission-critical system life-cycle costs not only by reducing development time, but more importantly facilitating maintenance, modifications, and extensions of complex mission-critical software systems, which are currently dominating life cycle costs.

Enhanced hydrolysis of cellulose hydrogels by morphological modification.

PubMed

Alfassi, Gilad; Rein, Dmitry M; Cohen, Yachin

2017-11-01

Cellulose is one of the most abundant bio-renewable materials on earth, yet the potential of cellulosic bio-fuels is not fully exploited, primarily due to the high costs of conversion. Hydrogel particles of regenerated cellulose constitute a useful substrate for enzymatic hydrolysis, due to their porous and amorphous structure. This article describes the influence of several structural aspects of the cellulose hydrogel on its hydrolysis. The hydrogel density was shown to be directly proportional to the cellulose concentration in the initial solution, thus affecting its hydrolysis rate. Using high-resolution scanning electron microscopy, we show that the hydrogel particles in aqueous suspension exhibit a dense external surface layer and a more porous internal network. Elimination of the external surface layer accelerated the hydrolysis rate by up to sixfold and rendered the process nearly independent of cellulose concentration. These findings may be of practical relevance to saccharification processing costs, by reducing required solvent quantities and enzyme load.

[Making a low cost IPSec router on Linux and the assessment for practical use].

PubMed

Amiki, M; Horio, M

2001-09-01

We installed Linux and FreeS/WAN on a PC/AT compatible machine to make an IPSec router. We measured the time of ping/ftp, only in the university, between the university and the external network. Between the university and the external network (the Internet), there were no differences. Therefore, we concluded that CPU load was not remarkable at low speed networks, because packets exchanged via the Internet are small, or compressions of VPN are more effective than encoding and decoding. On the other hand, in the university, the IPSec router performed down about 20-30% compared with normal IP communication, but this is not a serious problem for practical use. Recently, VPN machines are becoming cheaper, but they do not function sufficiently to create a fundamental VPN environment. Therefore, if one wants a fundamental VPN environment at a low cost, we believe you should select a VPN router on Linux.

Arduino: a low-cost multipurpose lab equipment.

PubMed

D'Ausilio, Alessandro

2012-06-01

Typical experiments in psychological and neurophysiological settings often require the accurate control of multiple input and output signals. These signals are often generated or recorded via computer software and/or external dedicated hardware. Dedicated hardware is usually very expensive and requires additional software to control its behavior. In the present article, I present some accuracy tests on a low-cost and open-source I/O board (Arduino family) that may be useful in many lab environments. One of the strengths of Arduinos is the possibility they afford to load the experimental script on the board's memory and let it run without interfacing with computers or external software, thus granting complete independence, portability, and accuracy. Furthermore, a large community has arisen around the Arduino idea and offers many hardware add-ons and hundreds of free scripts for different projects. Accuracy tests show that Arduino boards may be an inexpensive tool for many psychological and neurophysiological labs.

Principles and methods of managerial cost-accounting systems.

PubMed

Suver, J D; Cooper, J C

1988-01-01

An introduction to cost-accounting systems for pharmacy managers is provided; terms are defined and examples of specific applications are given. Cost-accounting systems determine, record, and report the resources consumed in providing services. An effective cost-accounting system must provide the information needed for both internal and external reports. In accounting terms, cost is the value given up to secure an asset. In determining how volumes of activity affect costs, fixed costs and variable costs are calculated; applications include pricing strategies, cost determinations, and break-even analysis. Also discussed are the concepts of direct and indirect costs, opportunity costs, and incremental and sunk costs. For most pharmacy department services, process costing, an accounting of intermediate outputs and homogeneous units, is used; in determining the full cost of providing a product or service (e.g., patient stay), job-order costing is used. Development of work-performance standards is necessary for monitoring productivity and determining product costs. In allocating pharmacy department costs, a ratio of costs to charges can be used; this method is convenient, but microcosting (specific identification of the costs of products) is more accurate. Pharmacy managers can use cost-accounting systems to evaluate the pharmacy's strategies, policies, and services and to improve budgets and reports.

Closing the gap between socioeconomic and financial implications of residential and community level hydrogen-based energy systems: Incentives needed for a bridge to the future

NASA Astrophysics Data System (ADS)

Verduzco, Laura E.

The use of hydrogen as an energy carrier has the potential to decrease the amount of pollutants emitted to the atmosphere, significantly reduce our dependence on imported oil and resolve geopolitical issues related to energy consumption. The current status of hydrogen technology makes it prohibitive and financially risky for most investors to commit the money required for large-scale hydrogen production. Therefore, alternative strategies such as small and medium-scale hydrogen applications should be implemented during the early stages of the transition to the hydrogen economy in order to test potential markets and technology readiness. While many analysis tools have been built to estimate the requirements of the transition to a hydrogen economy, few have focused on small and medium-scale hydrogen production and none has paired financial with socioeconomic costs at the residential level. The computer-based tool (H2POWER) presented in this study calculates the capacity, cost and socioeconomic impact of the systems needed to meet the energy demands of a home or a community using home and neighborhood refueling units, which are systems that can provide electricity and heat to meet the energy demands of either (1) a home and automobile or (2) a cluster of homes and a number of automobiles. The financial costs of the production, processing and delivery sub-systems that conform the refueling units are calculated using cost data of existing technology and normalizing them to calculate capital and net present cost. The monetary value of the externalities (socioeconomic analysis) caused by each system is calculated by H2POWER through a statistical analysis of the cost associated to various externalities. Additionally, H2POWER calculates the financial impact of different penalties and incentives (such as net metering, low interest loans, fuel taxes, and emission penalties) on the cost of the system from the point of view of a developer and a homeowner. In order to assess the benefits and costs of hydrogen-based alternatives, H2POWER compares the financial and socioeconomic costs of home and neighborhood refueling units to a baseline of "conventional" sources of residential electricity, space heat, water heat, and vehicle fuel. The model can also calculate the "gap" between the financial cost of the technology and the environmental cost of the externalities that are generated using conventional energy sources. H2POWER is a flexible, user-friendly tool that allows the user to specify different production pathways, supplemental power sources (renewable and non-renewable), component characteristics, electricity mixes, and other analysis parameters in order to customize the results to specific projects. The model has also built-in default values for each of the input fields based on national averages, standard technology specifications and input from experts.

Spectra Optia® for Automated Red Blood Cell Exchange in Patients with Sickle Cell Disease: A NICE Medical Technology Guidance.

PubMed

Willits, Iain; Cole, Helen; Jones, Roseanne; Carter, Kimberley; Arber, Mick; Jenks, Michelle; Craig, Joyce; Sims, Andrew

2017-08-01

The Spectra Optia ® automated apheresis system, indicated for red blood cell exchange in people with sickle cell disease, underwent evaluation by the National Institute for Health and Care Excellence, which uses its Medical Technologies Advisory Committee to make recommendations. The company (Terumo Medical Corporation) produced a submission making a case for adoption of its technology, which was critiqued by the Newcastle and York external assessment centre. Thirty retrospective observational studies were identified in their clinical submission. The external assessment centre considered these were of low methodological and reporting quality. Most were single-armed studies, with only six studies providing comparative data. The available data showed that, compared with manual red blood cell exchange, Spectra Optia reduces the frequency of exchange procedures as well as their duration, but increases the requirement for donor blood. However, other clinical and patient benefits were equivocal because of an absence of robust clinical evidence. The company provided a de novo model to support the economic proposition of the technology, and reported that in most scenarios Spectra Optia was cost saving, primarily through reduced requirement of chelation therapy to manage iron overload. The external assessment centre considered that although the cost-saving potential of Spectra Optia was plausible, the model and its clinical inputs were not sufficiently robust to demonstrate this. However, taking the evidence together with expert and patient advice, the Medical Technologies Advisory Committee considered Spectra Optia was likely to save costs, provide important patient benefits, and reduce inequality, and gave the technology a positive recommendation in Medical Technology Guidance 28.

A decision-aid framework to provide guidance for the enhanced use of best available techniques in industry.

PubMed

Georgopoulou, E; Mirasgedis, S; Sarafidis, Y; Hontou, V; Gakis, N; Lalas, D P; Loukatos, A; Gargoulas, N; Mentzis, A; Economidis, D; Triantafilopoulos, T; Korizi, K; Mavrotas, G

2007-09-01

Best Available Techniques (BATs) contribute significantly to the reduction of industrial environmental burdens with respect to air pollution, wastewater, and solid wastes. In Europe, the application of BATs is prescribed by Directive 96/61/EC, which, however, leaves the selection of specific BATs to plant operators. In making their choices, installations have to consider not only the environmental benefits of BATs, but also all relevant cost components. In assessing the economic attractiveness of potential BATs and their combinations, as well as incentives and disincentives to be instituted, the cost of environmental externalities, usually not reflected in market prices, should be taken into account. In this paper, a decision-aid framework combining an assessment of environmental externalities and the utilization of multicriteria methods and, more specifically, Multiobjective Mathematical Programming, capable of addressing all these issues in a comprehensive and coherent manner, is presented. This is illustrated by its application for the region of Attica in Greece, where over 50% of the industrial basis and Athens, with its 4 million inhabitants, are located. The implementation of the framework and its associated tools to 800 installations led to the identification of the specific BATs, alone or in combination, that provide the most cost-effective reductions of four air pollutants (PM10, SO(2), NO(x), VOC) and CO(2). The results also clearly demonstrate the increased pollution reductions that would result from the adoption of BATs made economically attractive by the inclusion of externalities. Estimates of investments and net present values with and without incentives/disincentives are also provided.

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.

Designing a mathematical model for integrating dynamic cellular manufacturing into supply chain system

NASA Astrophysics Data System (ADS)

Aalaei, Amin; Davoudpour, Hamid

2012-11-01

This article presents designing a new mathematical model for integrating dynamic cellular manufacturing into supply chain system with an extensive coverage of important manufacturing features consideration of multiple plants location, multi-markets allocation, multi-period planning horizons with demand and part mix variation, machine capacity, and the main constraints are demand of markets satisfaction in each period, machine availability, machine time-capacity, worker assignment, available time of worker, production volume for each plant and the amounts allocated to each market. The aim of the proposed model is to minimize holding and outsourcing costs, inter-cell material handling cost, external transportation cost, procurement & maintenance and overhead cost of machines, setup cost, reconfiguration cost of machines installation and removal, hiring, firing and salary worker costs. Aimed to prove the potential benefits of such a design, presented an example is shown using a proposed model.

Variation in the cost of care for primary total knee arthroplasties.

PubMed

Haas, Derek A; Kaplan, Robert S

2017-03-01

The study examined the cost variation across 29 high-volume US hospitals and their affiliated orthopaedic surgeons for delivering a primary total knee arthroplasty without major complicating conditions. The hospitals had similar patient demographics, and more than 80% of them had statistically-similar Medicare risk-adjusted readmission and complication rates. Hospital and physician personnel costs were calculated using time-driven activity-based costing. Consumable supply costs, such as the prosthetic implant, were calculated using purchase prices, and postacute care costs were measured using either internal costs or external claims as reported by each hospital. Despite having similar patient demographics and readmission and complication rates, the average cost of care for total knee arthroplasty across the hospitals varied by a factor of about 2 to 1. Even after adjusting for differences in internal labor cost rates, the hospital at the 90th percentile of cost spent about twice as much as the one at the 10th percentile of cost. The large variation in costs among sites suggests major and multiple opportunities to transfer knowledge about process and productivity improvements that lower costs while simultaneously maintaining or improving outcomes.

External costs of transport in central and eastern Europe : final report

DOT National Transportation Integrated Search

2003-08-08

Current and projected transport trends in Central and Eastern Europe are not sustainable and cause severe damage to human health and the environment. Transport-related accidents, air pollution, noise, climate change impacts, etc. generate large socia...

Methanol Fuel Cell

NASA Technical Reports Server (NTRS)

Voecks, G. E.

1985-01-01

In proposed fuel-cell system, methanol converted to hydrogen in two places. External fuel processor converts only part of methanol. Remaining methanol converted in fuel cell itself, in reaction at anode. As result, size of fuel processor reduced, system efficiency increased, and cost lowered.

EPA Traceability Protocol for Assay and Certification of Gaseous Calibration Standards

EPA Pesticide Factsheets

EPA's air monitoring regulations require the use of Protocol Gases to set air pollution monitors. This protocol balances the government's need for accuracy with the producers' need for flexibility, low cost, and minimum external oversight.

Optimal External Wrench Distribution During a Multi-Contact Sit-to-Stand Task.

PubMed

Bonnet, Vincent; Azevedo-Coste, Christine; Robert, Thomas; Fraisse, Philippe; Venture, Gentiane

2017-07-01

This paper aims at developing and evaluating a new practical method for the real-time estimate of joint torques and external wrenches during multi-contact sit-to-stand (STS) task using kinematics data only. The proposed method allows also identifying subject specific body inertial segment parameters that are required to perform inverse dynamics. The identification phase is performed using simple and repeatable motions. Thanks to an accurately identified model the estimate of the total external wrench can be used as an input to solve an under-determined multi-contact problem. It is solved using a constrained quadratic optimization process minimizing a hybrid human-like energetic criterion. The weights of this hybrid cost function are adjusted and a sensitivity analysis is performed in order to reproduce robustly human external wrench distribution. The results showed that the proposed method could successfully estimate the external wrenches under buttocks, feet, and hands during STS tasks (RMS error lower than 20 N and 6 N.m). The simplicity and generalization abilities of the proposed method allow paving the way of future diagnosis solutions and rehabilitation applications, including in-home use.

Ultra-Low-Dropout Linear Regulator

NASA Technical Reports Server (NTRS)

Thornton, Trevor; Lepkowski, William; Wilk, Seth

2011-01-01

A radiation-tolerant, ultra-low-dropout linear regulator can operate between -150 and 150 C. Prototype components were demonstrated to be performing well after a total ionizing dose of 1 Mrad (Si). Unlike existing components, the linear regulator developed during this activity is unconditionally stable over all operating regimes without the need for an external compensation capacitor. The absence of an external capacitor reduces overall system mass/volume, increases reliability, and lowers cost. Linear regulators generate a precisely controlled voltage for electronic circuits regardless of fluctuations in the load current that the circuit draws from the regulator.

Prediction of risk of recurrence of venous thromboembolism following treatment for a first unprovoked venous thromboembolism: systematic review, prognostic model and clinical decision rule, and economic evaluation.

PubMed

Ensor, Joie; Riley, Richard D; Jowett, Sue; Monahan, Mark; Snell, Kym Ie; Bayliss, Susan; Moore, David; Fitzmaurice, David

2016-02-01

Unprovoked first venous thromboembolism (VTE) is defined as VTE in the absence of a temporary provoking factor such as surgery, immobility and other temporary factors. Recurrent VTE in unprovoked patients is highly prevalent, but easily preventable with oral anticoagulant (OAC) therapy. The unprovoked population is highly heterogeneous in terms of risk of recurrent VTE. The first aim of the project is to review existing prognostic models which stratify individuals by their recurrence risk, therefore potentially allowing tailored treatment strategies. The second aim is to enhance the existing research in this field, by developing and externally validating a new prognostic model for individual risk prediction, using a pooled database containing individual patient data (IPD) from several studies. The final aim is to assess the economic cost-effectiveness of the proposed prognostic model if it is used as a decision rule for resuming OAC therapy, compared with current standard treatment strategies. Standard systematic review methodology was used to identify relevant prognostic model development, validation and cost-effectiveness studies. Bibliographic databases (including MEDLINE, EMBASE and The Cochrane Library) were searched using terms relating to the clinical area and prognosis. Reviewing was undertaken by two reviewers independently using pre-defined criteria. Included full-text articles were data extracted and quality assessed. Critical appraisal of included full texts was undertaken and comparisons made of model performance. A prognostic model was developed using IPD from the pooled database of seven trials. A novel internal-external cross-validation (IECV) approach was used to develop and validate a prognostic model, with external validation undertaken in each of the trials iteratively. Given good performance in the IECV approach, a final model was developed using all trials data. A Markov patient-level simulation was used to consider the economic cost-effectiveness of using a decision rule (based on the prognostic model) to decide on resumption of OAC therapy (or not). Three full-text articles were identified by the systematic review. Critical appraisal identified methodological and applicability issues; in particular, all three existing models did not have external validation. To address this, new prognostic models were sought with external validation. Two potential models were considered: one for use at cessation of therapy (pre D-dimer), and one for use after cessation of therapy (post D-dimer). Model performance measured in the external validation trials showed strong calibration performance for both models. The post D-dimer model performed substantially better in terms of discrimination (c = 0.69), better separating high- and low-risk patients. The economic evaluation identified that a decision rule based on the final post D-dimer model may be cost-effective for patients with predicted risk of recurrence of over 8% annually; this suggests continued therapy for patients with predicted risks ≥ 8% and cessation of therapy otherwise. The post D-dimer model performed strongly and could be useful to predict individuals' risk of recurrence at any time up to 2-3 years, thereby aiding patient counselling and treatment decisions. A decision rule using this model may be cost-effective for informing clinical judgement and patient opinion in treatment decisions. Further research may investigate new predictors to enhance model performance and aim to further externally validate to confirm performance in new, non-trial populations. Finally, it is essential that further research is conducted to develop a model predicting bleeding risk on therapy, to manage the balance between the risks of recurrence and bleeding. This study is registered as PROSPERO CRD42013003494. The National Institute for Health Research Health Technology Assessment programme.

A multi-methodological approach to study the temporal and spatial distribution of air quality related to road transport emissions in Madrid, Spain

NASA Astrophysics Data System (ADS)

Perez, Pedro; Miranda, Regina

2013-04-01

The traffic-related atmospheric emissions, composition and transport of greenhouse gases (GHGs) and air toxic pollutants (ATPs), are an important environmental problem that affect climate change and air pollution in Madrid, Spain. Carbon dioxide (CO2) affects the regional weather and particularly fine particle matter (PM) translocate to the people resulting in local health problems. As the main source of emissions comes from road transport, and subsequent combustion of fossil fuels, air quality deterioration may be elevated during weekdays and peak hours. We postulate that traffic-related air quality (CO2, methane CH4, PM, volatile organic compounds VOCs, nitrogen oxides NOx and carbon monoxide CO contents) impairs epidemiology in part via effects on health and disease development, likely increasing the external costs of transport in terms of climate change and air pollution. First, the paper intends to estimate the local air quality related to the road transport emissions of weeks over a domain covering Madrid (used as a case study). The local air quality model (LAQM) is based on gridded and shaped emission fields. The European Environmental Agency (EEA) COPERT modeling system will provide GHGs and ATPs gridded and shaped emission data and mobile source parameters, available for Madrid from preliminary emission inventory records of the Municipality of Madrid and from disaggregated traffic counts of the Traffic Engineering Company and the Metropolitan Company of Metro (METRO-Madrid). The paper intends to obtain estimates of GHGs and ATPs concentrations commensurate with available ground measurements, 24-hour average values, from the Municipality of Madrid. The comparison between estimated concentrations and measurements must show small errors (e.g. fractional error, fractional bias and coefficient of determination). The paper's expected results must determine spatial and temporal patterns in Madrid. The estimates will be used to cross check the primary local emission inventory, together with the mobile source's parameters and the disaggregated transport activity data. The paper will also identify emission and concentration differences and gradients of certain magnitude/factor (e.g. comparison between estimated ATPs hourly concentrations in Madrid City Center and in the peripheries). Furthermore, because of the higher contribution of road mobile sources to GHGs and ATPs emissions in Madrid, small gradients between urban highways and residential areas will be expected. Second, the paper objectives are to develop valid methods and approaches to measure air quality and to develop valid road transport emission inventories to assess correlations between external costs, epidemiology and emissions in order to reveal how traffic pollution affects people exposure to key contaminants and disease development, and identify susceptible emission scenarios and health impacts. We have conducted general emission inventory studies providing preliminary evidence of regional road transport air pollution impacts on external cost growth and disease development. Third, we also aim to demonstrate short and long-term impacts of road transport emissions on external costs development using innovative multi-methodological methods interfaced with environmental chemistry and meteorology following meteorological and chemical fields with contrasting high/low traffic emissions in several linked components involving: air pollutant assessment using local measurements, height of the boundary layer, meteorological environment interactions on external costs and epidemiology, mapping of Madrid (identifying gradients of emissions), integrative causal modeling using statistical models, and trend and scenario analyses on external costs and impacts on human health. Meteorological and chemical fields will be obtained from local records collected by surface meteorological and air quality stations. These two sets of fields define the horizontal and vertical profiles of GHGs and ATPs of Madrid based on air quality ground (initial conditions) and vertical (boundary conditions) measurements and modulate air concentration estimates

A cluster randomized trial to evaluate external support for the implementation of positive behavioral interventions and supports by school personnel

PubMed Central

2014-01-01

Background Urban schools lag behind non-urban schools in attending to the behavioral health needs of their students. This is especially evident with regard to the level of use of evidence-based interventions with school children. Increased used of evidence-based interventions in urban schools would contribute to reducing mental health services disparities in low-income communities. School-wide positive behavioral interventions and supports (SWPBIS) is a service delivery framework that can be used to deliver universal preventive interventions and evidence-based behavioral health treatments, such as group cognitive behavioral therapy. In this article, we describe our ongoing research on creating internal capacity for program implementation. We also examine the cost-effectiveness and resulting school climate when two different levels of external support are provided to personnel as they implement a two-tier SWPBIS program. Methods/Design The study follows six K – 8 schools in the School District of Philadelphia randomly assigned to consultation support or consultation-plus-coaching support. Participants are: approximately 48 leadership team members, 180 school staff and 3,900 students in Tier 1, and 12 counselors, and 306 child participants in Tier 2. Children who meet inclusion criteria for Tier 2 will participate in group cognitive behavioral therapy for externalizing or anxiety disorders. The study has three phases, baseline/training, implementation, and sustainability. We will measure implementation outcomes, service outcomes, child outcomes, and cost. Discussion Findings from this study will provide evidence as to the appropriateness of school-wide prevention and treatment service delivery models for addressing services disparities in schools. The effectiveness and cost-effectiveness analyses of the two levels of training and consultation should help urban school districts and policymakers with the planning and deployment of cost-effective strategies for the implementation of evidence-based interventions for some of the most common behavioral health problems in school children. Trial registration ClinicalTrials.gov identifier: NCT01941069 PMID:24428904

A cluster randomized trial to evaluate external support for the implementation of positive behavioral interventions and supports by school personnel.

PubMed

Eiraldi, Ricardo; McCurdy, Barry; Khanna, Muniya; Mautone, Jennifer; Jawad, Abbas F; Power, Thomas; Cidav, Zuleyha; Cacia, Jaclyn; Sugai, George

2014-01-15

Urban schools lag behind non-urban schools in attending to the behavioral health needs of their students. This is especially evident with regard to the level of use of evidence-based interventions with school children. Increased used of evidence-based interventions in urban schools would contribute to reducing mental health services disparities in low-income communities. School-wide positive behavioral interventions and supports (SWPBIS) is a service delivery framework that can be used to deliver universal preventive interventions and evidence-based behavioral health treatments, such as group cognitive behavioral therapy. In this article, we describe our ongoing research on creating internal capacity for program implementation. We also examine the cost-effectiveness and resulting school climate when two different levels of external support are provided to personnel as they implement a two-tier SWPBIS program. The study follows six K - 8 schools in the School District of Philadelphia randomly assigned to consultation support or consultation-plus-coaching support. Participants are: approximately 48 leadership team members, 180 school staff and 3,900 students in Tier 1, and 12 counselors, and 306 child participants in Tier 2. Children who meet inclusion criteria for Tier 2 will participate in group cognitive behavioral therapy for externalizing or anxiety disorders. The study has three phases, baseline/training, implementation, and sustainability. We will measure implementation outcomes, service outcomes, child outcomes, and cost. Findings from this study will provide evidence as to the appropriateness of school-wide prevention and treatment service delivery models for addressing services disparities in schools. The effectiveness and cost-effectiveness analyses of the two levels of training and consultation should help urban school districts and policymakers with the planning and deployment of cost-effective strategies for the implementation of evidence-based interventions for some of the most common behavioral health problems in school children. ClinicalTrials.gov identifier: NCT01941069.

Aiding troubled employees: the prevalence, cost, and characteristics of employee assistance programs in the United States.

PubMed Central

Hartwell, T D; Steele, P; French, M T; Potter, F J; Rodman, N F; Zarkin, G A

1996-01-01

OBJECTIVES: Employee assistance programs (EAPs) are job-based programs designed to identify and assist troubled employees. This study determines the prevalence, cost, and characteristics of these programs in the United States by worksite size, industry, and census region. METHODS: A stratified national probability sample of more than 6400 private, nonagricultural US worksites with 50 or more full-time employees was contacted with a computer-assisted telephone interviewing protocol. More than 3200 worksites responded and were eligible, with a response rate of 90%. RESULTS: Approximately 33% of all private, nonagricultural worksites with 50 or more full-time employees currently offer EAP services to their employees, an 8.9% increase over 1985. These programs are more likely to be found in larger worksites and in the communications/utilities/transportation industries. The most popular model is an external provider, and the median annual cost per eligible employee for internal and external programs was $21.83 and $18.09, respectively. CONCLUSIONS: EAPs are becoming a more prevalent point of access to health care for workers with personal problems such as substance abuse, family problems, or emotional distress. PMID:8659653

Design of a colorimetric sensing platform using reflection mode plasmonic colour filters

NASA Astrophysics Data System (ADS)

Mudachathi, Renilkumar; Tanaka, Takuo

2017-08-01

Plasmonic nano structures fabricated using inexpensive and abundant aluminum metal shows intense narrow reflection peaks with strong response to the external stimuli, provides a simple yet powerful detection mechanism that is well suited for the development of low cost and low power sensors, such as colorimetric sensors, which transduces external stimuli or environmental changes in to visible colour changes. Such low cost and disposable sensors have huge demands in the point-of-care and home health care diagnostic applications. We present the design of a colorimetric sensing platform based on reflection mode plasmonic colour filters on both silicon and glass substrate, which demonstrate a sharp colour change for varying ambient refractive index. The sensor is essentially a plasmonic metamaterial in which the aluminum square plate hovering on a PMMA nano pillar in the background of a perforated aluminum reflector forms the unit cell which is arranged periodically in a 2D square lattice. The meta-surface has two distinct absorption peaks in the visible region leaving a strong reflection band, which strongly responds to the ambient refractive index change, provides a means for the realization of low cost colorimetric sensing platform.

Survival and health care costs until hospital discharge of patients treated with onsite, dispatched or without automated external defibrillator.

PubMed

Berdowski, Jocelyn; Kuiper, Mathijs J; Dijkgraaf, Marcel G W; Tijssen, Jan G P; Koster, Rudolph W

2010-08-01

This study aimed to determine whether automated external defibrillator (AED) use during resuscitation is associated with lower in-hospital health care costs. For this observational prospective study, we included all treated out-of-hospital cardiac arrests of suspected cardiac cause. Clinical, survival and cost data were collected from July 2005 until March 2008. Cost data were based on hospital transport, duration of admission in hospital wards, diagnostics and interventions. We divided the study population in three groups based on AED use: (1) onsite AED, (2) dispatched AED, (3) no AED. The endpoint was survival to discharge. P<0.05 is indicated by *. Of the 2126 included patients, 136 were treated with an onsite AED, 365 with a dispatched AED and 1625 without AED. Overall (95% confidence interval [CI]) survival rate was 43% (35-51%), 16% (13-20%) and 14% (12-16%), respectively*. Per 100 survivors, the mean duration admitted at intensive care unit [ICU] were 267 (166-374), 495 (344-658), and 537 (450-609) days, respectively*; total duration of hospital admission was 2188 (1800-2594), 3132 (2573-3797), and 2765 (2519-3050) days, respectively*. Mean costs per survivor for hospital stay were euro9233 (euro7351-euro11,280), euro14,194 (euro11,656-euro17,254), and euro13,693 (euro12,226-euro15,166), respectively*; total health care costs were euro29,575 (euro24,695-euro34,183), euro34,533 (euro29,832-euro39,487) and euro31,772 (euro29,217-euro34,385), respectively. For both survivors and non-survivors, total costs per patient were euro14,727 (euro11,957-euro18,324), euro7703 (euro6141-euro9366) and euro6580 (euro5875-euro7238), respectively*. Onsite AED use was associated with higher survival rates. Surviving patients of the onsite AED group had lower total costs, mainly due to the shorter ICU stay. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

An initial comparative assessment of orbital and terrestrial central power systems

NASA Technical Reports Server (NTRS)

Caputo, R.

1977-01-01

A silicon photovoltaic orbital power system, which is constructed from an earth source of materials, is compared to likely terrestrial (fossil, nuclear, and solar) approaches to central power generation around the year 2000. A total social framework is used that considers not only the projection of commercial economics (direct or in internal costs), but also considers external impacts such as research and development investment, health impacts, resource requirements, environment effects, and other social costs.

Grabbing the Air Force by the Tail: Applying Strategic Cost Analytics to Understand and Manage Indirect Cost Behavior

DTIC Science & Technology

2015-09-17

impact influenced by its internal and external supply chain activities. This starts with understanding how we currently apply advanced analytic techniques... minimalistic model provides for sufficient degrees of freedom to guard against overfitting. Second, to guard against the possibility of an over-trained model in... starting with 1*. 201* All Military compensation EEICs starting with 201*. Facility Sustainment 52* & 56* All facility maintenance, repair and minor

Comparing the Efficacy of Triple Nerve Transfers with Nerve Graft Reconstruction in Upper Trunk Obstetric Brachial Plexus Injury.

PubMed

O'Grady, Kathleen M; Power, Hollie A; Olson, Jaret L; Morhart, Michael J; Harrop, A Robertson; Watt, M Joe; Chan, K Ming

2017-10-01

Upper trunk obstetric brachial plexus injury can cause profound shoulder and elbow dysfunction. Although neuroma excision with interpositional sural nerve grafting is the current gold standard, distal nerve transfers have a number of potential advantages. The goal of this study was to compare the clinical outcomes and health care costs between nerve grafting and distal nerve transfers in children with upper trunk obstetric brachial plexus injury. In this prospective cohort study, children who underwent triple nerve transfers were followed with the Active Movement Scale for 2 years. Their outcomes were compared to those of children who underwent nerve graft reconstruction. To assess health care use, a cost analysis was also performed. Twelve patients who underwent nerve grafting were compared to 14 patients who underwent triple nerve transfers. Both groups had similar baseline characteristics and showed improved shoulder and elbow function following surgery. However, the nerve transfer group displayed significantly greater improvement in shoulder external rotation and forearm supination 2 years after surgery (p < 0.05). The operative time and length of hospital stay were significantly lower (p < 0.05), and the overall cost was approximately 50 percent less in the nerve transfer group. Triple nerve transfer for upper trunk obstetric brachial plexus injury is a feasible option, with better functional shoulder external rotation and forearm supination, faster recovery, and lower cost compared with traditional nerve graft reconstruction. Therapeutic, II.

Time-of-Flight Measurement of Sound Speed in Air

ERIC Educational Resources Information Center

Ganci, Salvatore

2011-01-01

This paper describes a set of simple experiments with a very low cost using a notebook as a measuring instrument without external hardware. The major purpose is to provide demonstration experiments for schools with very low budgets. (Contains 6 figures.)

Detecting Developmental Neurotoxicants Using Zebrafish Embryos

EPA Science Inventory

As part of EPA’s program on the screening and prioritization of chemicals for developmental neurotoxicity, a rapid, cost-effective in vivo vertebrate screen is being developed using an alternative species approach. Zebrafish (Danio rerio), a small freshwater fish with external f...

76 FR 67729 - Information Collection Being Submitted for Review and Approval to the Office of Management and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-02

... operators submit this form to local franchising authorities or the Commission, in situations where the FCC... changes in external costs. Cable operators submit FCC Form 1240 to their respective local franchising...

External breast prostheses in post-mastectomy care: women's qualitative accounts.

PubMed

Gallagher, P; Buckmaster, A; O'Carroll, S; Kiernan, G; Geraghty, J

2010-01-01

A good-quality external breast prosthesis and prosthesis-fitting service is an integral part of the recovery process post-mastectomy. However, this is an area of care that has minimal information or research available. The aim of this research was to investigate women's experience of the provision, fitting, supply and use of breast prostheses in Ireland. To ascertain women's own personal and subjective experiences, five focus groups with 47 women recruited through national cancer advocacy/support organizations and four Follow-up Breast Clinics throughout Ireland were conducted. As a result, five main themes emerged: (1) The fitting experience--Fitting? (2) Post-mastectomy products--Having? (3) Cost--Affording? (4) Information--Knowing? and (5) Adaptation--Accepting? The emerging themes pinpointed the impact of the fitting experience, fitting environment and the qualities of a prosthesis fitter on a woman's experience in obtaining a first or replacement breast prosthesis; the importance of the physical characteristics of the prosthesis and mastectomy bras; cost, affordability and entitlements; a lack of and perceived difficulty in getting information; and the myriad of personal and social impacts of a breast prosthesis for the woman. These findings are integral for the development of standards of practice in the fitting and supply of external breast prostheses in post-mastectomy care.

Frontier battery development for hybrid vehicles

PubMed Central

2012-01-01

Background Interest in hybrid-electric vehicles (HEVs) has recently spiked, partly due to an increasingly negative view toward the U.S. foreign oil dependency and environmental concerns. Though HEVs are becoming more common, they have a significant price premium over gasoline-powered vehicles. One of the primary drivers of this “hybrid premium” is the cost of the vehicles’ batteries. This paper focuses on these batteries used in hybrid vehicles, examines the types of batteries used for transportation applications and addresses some of the technological, environmental and political drivers in battery development and the deployment of HEVs. Methods This paper examines the claim, often voiced by HEV proponents, that by taking into account savings on gasoline and vehicle maintenance, hybrid cars are cheaper than traditional gasoline cars. This is done by a quantitative benefit-cost analysis, in addition to qualitative benefit-cost analysis from political, technological and environmental perspectives. Results The quantitative benefit-cost analysis shows that, taking account of all costs for the life of the vehicle, hybrid cars are in fact more expensive than gasoline-powered vehicles; however, after five years, HEVs will break even with gasoline cars. Conclusions Our results show that it is likely that after 5 years, using hybrid vehicles should be cheaper in effect and yield a positive net benefit to society. There are a number of externalities that could significantly impact the total social cost of the car. These externalities can be divided into four categories: environmental, industrial, R&D and political. Despite short-term implications and hurdles, increased HEV usage forecasts a generally favorable long-term net benefit to society. Most notably, increasing HEV usage could decrease greenhouse gas emissions, while also decreasing U.S. dependence on foreign oil. PMID:22540987

Frontier battery development for hybrid vehicles.

PubMed

Lewis, Heather; Park, Haram; Paolini, Maion

2012-04-23

Interest in hybrid-electric vehicles (HEVs) has recently spiked, partly due to an increasingly negative view toward the U.S. foreign oil dependency and environmental concerns. Though HEVs are becoming more common, they have a significant price premium over gasoline-powered vehicles. One of the primary drivers of this "hybrid premium" is the cost of the vehicles' batteries. This paper focuses on these batteries used in hybrid vehicles, examines the types of batteries used for transportation applications and addresses some of the technological, environmental and political drivers in battery development and the deployment of HEVs. This paper examines the claim, often voiced by HEV proponents, that by taking into account savings on gasoline and vehicle maintenance, hybrid cars are cheaper than traditional gasoline cars. This is done by a quantitative benefit-cost analysis, in addition to qualitative benefit-cost analysis from political, technological and environmental perspectives. The quantitative benefit-cost analysis shows that, taking account of all costs for the life of the vehicle, hybrid cars are in fact more expensive than gasoline-powered vehicles; however, after five years, HEVs will break even with gasoline cars. Our results show that it is likely that after 5 years, using hybrid vehicles should be cheaper in effect and yield a positive net benefit to society. There are a number of externalities that could significantly impact the total social cost of the car. These externalities can be divided into four categories: environmental, industrial, R&D and political. Despite short-term implications and hurdles, increased HEV usage forecasts a generally favorable long-term net benefit to society. Most notably, increasing HEV usage could decrease greenhouse gas emissions, while also decreasing U.S. dependence on foreign oil.

Stationary turbine component with laminated skin

DOEpatents

James, Allister W [Orlando, FL

2012-08-14

A stationary turbine engine component, such as a turbine vane, includes a internal spar and an external skin. The internal spar is made of a plurality of spar laminates, and the external skin is made of a plurality of skin laminates. The plurality of skin laminates interlockingly engage the plurality of spar laminates such that the external skin is located and held in place. This arrangement allows alternative high temperature materials to be used on turbine engine components in areas where their properties are needed without having to make the entire component out of such material. Thus, the manufacturing difficulties associated with making an entire component of such a material and the attendant high costs are avoided. The skin laminates can be made of advanced generation single crystal superalloys, intermetallics and refractory alloys.

Prospective memory in an air traffic control simulation: External aids that signal when to act

PubMed Central

Loft, Shayne; Smith, Rebekah E.; Bhaskara, Adella

2011-01-01

At work and in our personal life we often need to remember to perform intended actions at some point in the future, referred to as Prospective Memory. Individuals sometimes forget to perform intentions in safety-critical work contexts. Holding intentions can also interfere with ongoing tasks. We applied theories and methods from the experimental literature to test the effectiveness of external aids in reducing prospective memory error and costs to ongoing tasks in an air traffic control simulation. Participants were trained to accept and hand-off aircraft, and to detect aircraft conflicts. For the prospective memory task participants were required to substitute alternative actions for routine actions when accepting target aircraft. Across two experiments, external display aids were provided that presented the details of target aircraft and associated intended actions. We predicted that aids would only be effective if they provided information that was diagnostic of target occurrence and in this study we examined the utility of aids that directly cued participants when to allocate attention to the prospective memory task. When aids were set to flash when the prospective memory target aircraft needed to be accepted, prospective memory error and costs to ongoing tasks of aircraft acceptance and conflict detection were reduced. In contrast, aids that did not alert participants specifically when the target aircraft were present provided no advantage compared to when no aids we used. These findings have practical implications for the potential relative utility of automated external aids for occupations where individuals monitor multi-item dynamic displays. PMID:21443381

Prospective memory in an air traffic control simulation: external aids that signal when to act.

PubMed

Loft, Shayne; Smith, Rebekah E; Bhaskara, Adella

2011-03-01

At work and in our personal life we often need to remember to perform intended actions at some point in the future, referred to as Prospective Memory. Individuals sometimes forget to perform intentions in safety-critical work contexts. Holding intentions can also interfere with ongoing tasks. We applied theories and methods from the experimental literature to test the effectiveness of external aids in reducing prospective memory error and costs to ongoing tasks in an air traffic control simulation. Participants were trained to accept and hand-off aircraft and to detect aircraft conflicts. For the prospective memory task, participants were required to substitute alternative actions for routine actions when accepting target aircraft. Across two experiments, external display aids were provided that presented the details of target aircraft and associated intended actions. We predicted that aids would only be effective if they provided information that was diagnostic of target occurrence, and in this study, we examined the utility of aids that directly cued participants when to allocate attention to the prospective memory task. When aids were set to flash when the prospective memory target aircraft needed to be accepted, prospective memory error and costs to ongoing tasks of aircraft acceptance and conflict detection were reduced. In contrast, aids that did not alert participants specifically when the target aircraft were present provided no advantage compared to when no aids were used. These findings have practical implications for the potential relative utility of automated external aids for occupations where individuals monitor multi-item dynamic displays.

A 5-Fr Externalized Nephroureteral Catheter as the Sole Protective Device for Pediatric Pyeloplasty: The Experiences of 142 Patients.

PubMed

Mollaeian, Mansour; Ghavami-Adel, Maryam; Eskandari, Farid; Mollaeian, Arash

2016-10-01

Pyeloplasty for ureteropelvic junction obstruction correction is a common procedure, but the optimal method for protective diversion after pyeloplasty is still a matter of debate. Here, we present our clinical trial experience using a single percutaneous externalized nephroureteral (NU) 5-Fr catheter (infant feeding tube) with multiple side holes as the sole instrument of drainage to provide a protective mechanism. In this prospective study, we analyzed the charts of 142 patients who underwent pyeloplasty from August 2001 through October 2008. We used a single externalized NU 5-Fr catheter with multiple side holes for postoperative upper tract diversion. The catheter was removed in the office after 10 - 14 days. Complications from the use of this catheter, including poor catheter function, premature dislodgement, urinary tract infection, leakage, urinoma, and anastomotic stenosis, were evaluated. The operations were performed by two surgeons at two separate centers. In all, 148 pyeloplasty procedures were performed on 142 patients. The mean hospital stay length was 2 (1 - 3) days. A contrast study through a catheter demonstrated excellent drainage with no leakage in all patients. Immediately after catheter removal, febrile urinary tract infection and transient obstructive symptoms and signs occurred in 15 patients. Using a percutaneous externalized NU 5-Fr catheter was sufficient as a protective measure after open pyeloplasty. It costs less than other diverting systems, such as DJ, and can be removed in the office. Therefore, it can be a safe and cost effective procedure, especially in developing countries where cystoscopic set ups are not readily available. There were only a few notable complications.

Tracking Dissipation Reduction, Externalities, Stability and Sustainability for Environmental Management of New Orleans

NASA Astrophysics Data System (ADS)

McNamara, D.; Werner, B. T.

2014-12-01

Sustainability requires stability, but in promoting economic development, modern economies and political systems reduce stabilizing dissipation by facilitating use and management of the environment through engineered mitigation of disturbances, which externalizes dissipation over the short to medium term. To quantitatively investigate the relationship between a range of environmental management approaches and sustainability, and the implications for Earth's future, we track the impact of management strategies on dissipation within the system and its externalities in a numerical model for the coupled economic, political/management and flooding dynamics of New Orleans. The model simulates river floods, hurricane storm-surge-induced floods, subsidence, and agent-based market interactions leading to development of port services, hotels, homes and labor relations. Flood protection decisions for levee construction based on the baseline case of cost-benefit analyses designed to prevent short-term economic loss from future floods qualitatively reproduce historical expansion of New Orleans and increases in levee height. Alternative management strategies explored include majority voting, consensus-based decision-making, and variations in discounting of costs and benefits. Enhanced dissipation is measured relative to optimal economic development without floods. The focus of modern economies on commodification is exploited to track dissipation as a scalar representing value or power, but this approach might not be applicable to more complicated traditional/indigenous cultures or cultures of resistance. For the baseline case, short-to-medium-term reductions in dissipation destabilize the coupled system, resulting in episodic bursts of externalized dissipation during flooding. Comparisons of results for a range of management options and generalizations of this approach for alternative cultural systems will be discussed.

Categorization of potential project cost overrun factors in construction industry

NASA Astrophysics Data System (ADS)

Karunakaran, P.; Abdullah, A. H.; Nagapan, S.; Sohu, S.; Kasvar, K. K.

2018-04-01

Cost overrun has been severely hit down the economy and reputations for many construction industry around the world. Many project management tools developed to control the budget of a project. However, the cost management is still considered poor as there are many cost overrun issues occurred in the construction industry. Thus, this paper aims to identify and cluster the potential construction project cost overrun factors according to their originating groups using the thematic approach. Basically, through literature review, all the potential factors that may cause cost overrun were screened thoroughly before they were clustered into seven (7) groups of the originating factors, namely project, contract, client, contractor, consultant, labour and external. Each potential factor was explained clearly with some examples based on the Malaysian case studies to illustrate the cost overrun scenario. These findings may aid in the future to highlight on how to mitigate the critical potential factors of cost overrun to reduce or overcome its impact on all the stakeholders involved.

Microcomputer software to facilitate costing in pathology laboratories.

PubMed Central

Stilwell, J A; Woodford, F P

1987-01-01

A software program is described which will enable laboratory managers to calculate, for their laboratory over a 12 month period, the cost of each test or investigation and of components of that cost. These comprise the costs of direct labour, consumables, equipment maintenance and depreciation; allocated costs of intermediate operations--for example, specimen procurement, reception, and data processing; and apportioned indirect costs such as senior staff time as well as external overheads such as telephone charges, rent, and rates. Total annual expenditure on each type of test is also calculated. The principles on which the program is based are discussed. Considered in particular, are the problems of apportioning indirect costs (which are considerable in clinical laboratory work) over different test costs, and the merits of different ways of estimating the amount or fraction of staff members' time spent on each kind of test. The computer program is Crown copyright but is available under licence from one of us (JAS). PMID:3654982

[Analysis of state costs of the social security benefits provided to the insured presenting with lung cancer and pulmonary diseases caused by external factors].

PubMed

Kuklińska-Janiak, Dorota

2013-12-01

Lung cancer and pneumoconioses constitute two serious problems of contemporary medicine and a public health system. To analyze the costs associated with social security benefits provided to the insured presenting with lung cancer and pulmonary diseases (including pneumoconioses) caused by external factors. The analysis was based on the data obtained from the Department of Statistics and Actuarial Forecasts of the Social Insurance Institution (SlI) in Warsaw. Structural diversity of the costs of the separate benefits available within the national health insurance system has been considered. Based on the data available in Poland costs associated with the incidence of lung cancer and pneumoconiosis were assessed taking into account sex and age of the insured as well as the administrative division of Poland. Additionally, mortality rates from the selected pulmonary diseases were analyzed. Costs of the pensions paid to the insured presenting with lung cancer amount to 81.11% of the total social security costs associated with these diseases, while the sick leave money paid to the insured lung cancer patients equal to 15.5% of the total costs. In the insured women, costs of the pensions paid due to occupational pulmonary diseases (predominantly pneumoconioses) constitute 41.1% and in the insured men--11.5% of the total 'occupational' pensions. Although the maximal incidence of lung cancer occurs in both men and women above their retirement ages the costs of the work incapacity pensions paid to lung cancer patients still exceed 81% of the total social security costs associated with these diseases. In the insured women, the cost of pensions paid due to occupational pulmonary diseases, most of which are pneumoconioses, ranks first among the costs of 'occupational' pensions received by these subjects, while in the insured men the respective cost ranks third (after injuries plus intoxications and cardiovascular diseases) among their 'occupational' pensions. Moreover, the results of the performed analyses indicate that data on the social insurance money allow to comprehensively evaluate the health status of the insured men and women as well as their quality of life and therapeutical, rehabilitational and prophylactic needs. These data can and should, therefore, be utilized in both clinical practice and for accomplishment of the public health tasks.

Cost benefits of advanced software: A review of methodology used at Kennedy Space Center

NASA Technical Reports Server (NTRS)

Joglekar, Prafulla N.

1993-01-01

To assist rational investments in advanced software, a formal, explicit, and multi-perspective cost-benefit analysis methodology is proposed. The methodology can be implemented through a six-stage process which is described and explained. The current practice of cost-benefit analysis at KSC is reviewed in the light of this methodology. The review finds that there is a vicious circle operating. Unsound methods lead to unreliable cost-benefit estimates. Unreliable estimates convince management that cost-benefit studies should not be taken seriously. Then, given external demands for cost-benefit estimates, management encourages software enginees to somehow come up with the numbers for their projects. Lacking the expertise needed to do a proper study, courageous software engineers with vested interests use ad hoc and unsound methods to generate some estimates. In turn, these estimates are unreliable, and the cycle continues. The proposed methodology should help KSC to break out of this cycle.

The user cost of energy resource and its reasonable tax rate-A case of oil

NASA Astrophysics Data System (ADS)

Lifan, Liu

2017-12-01

The development and use of natural resources bring about the externality of resources depletion, especially for non-renewable resources. This paper takes oil as an example to analyze the user cost of energy resource with EI Serafy User cost method, and discusses the rationality of the resource tax. Meanwhile, this paper determines oil resource tax rate in consideration of resource sustainable development. The results show that, the user cost of oil isn’t compensated fully, it is too low to make compensation to the environment and the profit of future generation, and the resource tax is a little low. At last of the paper, some conclusions and policy suggestions on resource tax reform are given.

Toward a Broader Concept of Value: Identifying and Defining Elements for an Expanded Cost-Effectiveness Analysis.

PubMed

Garrison, Louis P; Kamal-Bahl, Sachin; Towse, Adrian

2017-02-01

This commentary identifies and defines potentially useful expansions to traditional cost-effectiveness analysis as often used in health technology assessment. Since the seminal 1977 article by Weinstein and Stason, the recommended approach has been the use of the incremental cost-effectiveness ratio based on the metric of the cost per quality-adjusted life-year gained, allowing comparisons across different technologies. An expanded framework, incorporating a wider range of the elements of value, is proposed. In addition to the core value drivers of health gain and other health system cost savings (if any), we propose adding other less recognized elements related to the value of knowing and informational externalities. We describe each of five factors related to the value of knowing: 1) a reduction in uncertainty, reflecting the benefit of a companion diagnostic increasing the certainty of a patient׳s response to a medicine; 2) insurance value related to greater peace of mind due to protection against catastrophic health and financial loss; 3) the value of hope for a "cure," leading individuals to become risk seekers in some circumstances; 4) real option value due to life extension opening possibilities for individuals to benefit from future innovation; and 5) spillovers or externalities arising from benefits of scientific advances that cannot be entirely appropriated by those making the advances. Further thought and research are needed on how best to measure and integrate these elements into an incremental value framework and on coverage and pricing decisions. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Cost-effectiveness of In-home Automated External Defibrillators for Individuals at Increased Risk of Sudden Cardiac Death

PubMed Central

Cram, Peter; Vijan, Sandeep; Katz, David; Fendrick, A Mark

2005-01-01

BACKGROUND/OBJECTIVE In-home automated external defibrillators (AEDs) are increasingly recommended as a means for improving survival of cardiac arrests that occur at home. The current study was conducted to explore the relationship between individuals' risk of cardiac arrest and cost-effectiveness of in-home AED deployment. DESIGN Markov decision model employing a societal perspective. PATIENTS Four hypothetical cohorts of American adults 60 years of age at progressively greater risk for sudden cardiac death (SCD): 1) all adults (annual probability of SCD 0.4%); 2) adults with multiple SCD risk factors (probability 2%); 3) adults with previous myocardial infarction (probability 4%); and 4) adults with ischemic cardiomyopathy unable to receive an implantable defibrillator (probability 6%). INTERVENTION Strategy 1: individuals suffering an in-home cardiac arrest were treated with emergency medical services equipped with AEDs (EMS-D). Strategy 2: individuals suffering an in-home cardiac arrest received initial treatment with an in-home AED, followed by EMS. RESULTS Assuming cardiac arrest survival rates of 15% with EMS-D and 30% with AEDs, the cost per quality-adjusted life-year gained (QALY) of providing in-home AEDs to all adults 60 years of age is $216,000. Costs of providing in-home AEDs to adults with multiple risk factors (2% probability of SCD), previous myocardial infarction (4% probability), and ischemic cardiomyopathy (6% probability) are $132,000, $104,000, and $88,000, respectively. CONCLUSIONS The cost-effectiveness of in-home AEDs is intimately linked to individuals' risk of SCD. However, providing in-home AEDs to all adults over age 60 appears relatively expensive. PMID:15836529

Peer Review Report for the Draft EPA Handbook on the Benefits, Costs and Impacts of Land Cleanup and Reuse (2011)

EPA Pesticide Factsheets

This external review has several objectives including to assess whether the literature summarized is comprehensive and accurate as of 2010, and whether the Handbook’s original portions are sound and useful.

48 CFR 231.205-70 - External restructuring costs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... subsection: (1) Business combination means a transaction whereby assets or operations of two or more... after a business combination that affect the operations of companies not previously under common ownership or control. They do not include restructuring activities occurring after a business combination...

48 CFR 231.205-70 - External restructuring costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... subsection: (1) Business combination means a transaction whereby assets or operations of two or more... after a business combination that affect the operations of companies not previously under common ownership or control. They do not include restructuring activities occurring after a business combination...

48 CFR 231.205-70 - External restructuring costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... subsection: (1) Business combination means a transaction whereby assets or operations of two or more... after a business combination that affect the operations of companies not previously under common ownership or control. They do not include restructuring activities occurring after a business combination...

48 CFR 231.205-70 - External restructuring costs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... subsection: (1) Business combination means a transaction whereby assets or operations of two or more... after a business combination that affect the operations of companies not previously under common ownership or control. They do not include restructuring activities occurring after a business combination...

Highly accelerated lifetime for externally applied bond critical fiber-reinforced polymer (FRP) infrastructure materials : [summary].

DOT National Transportation Integrated Search

2014-03-01

The Florida Department of Transportation (FDOT) uses fiber-reinforced polymer (FRP) composites to repair bridges and strengthen bridge decks. Proven mechanical characteristics make FRP composites cost-effective in extending the life span of bridges o...

A Microcomputer Interface for External Circuit Control.

ERIC Educational Resources Information Center

Gorham, D. A.

1983-01-01

Describes an interface designed to meet the requirements of an instrumentation teaching laboratory, particularly to develop computer-controlled digital circuitry while exploiting electrical drive properties of common transistor-transistor logic (TTL) devices, minimizing cost/number of components. Discusses decoding for Pet, switches, lights, and…

Study of methane fuel for subsonic transport aircraft

NASA Technical Reports Server (NTRS)

Carson, L. K.; Davis, G. W.; Versaw, E. F.; Cunnington, G. R., Jr.; Daniels, E. J.

1980-01-01

The cost and performance were defined for commercial transport using liquid methane including its fuel system and the ground facility complex required for the processing and storage of methane. A cost and performance comparison was made with Jet A and hydrogen powered aircraft of the same payload and range capability. Extensive design work was done on cryogenic fuel tanks, insulation systems as well as the fuel system itself. Three candidate fuel tank locations were evaluated, i.e., fuselage tanks, wing tanks or external pylon tanks.

Conceptual engineering design studies of 1985-era commercial VTOL and STOL transports that utilize rotors

NASA Technical Reports Server (NTRS)

Magee, J. P.; Clark, R. D.; Widdison, C. A.

1975-01-01

Conceptual design studies are summarized of tandem-rotor helicopter and tilt-rotor aircraft for a short haul transport mission in the 1985 time frame. Vertical takeoff designs of both configurations are discussed, and the impact of external noise criteria on the vehicle designs, performance, and costs are shown. A STOL design for the tilt-rotor configuration is reported, and the effect of removing the vertical takeoff design constraints on the design parameters, fuel economy, and operating cost is discussed.

Performance measurement: integrating quality management and activity-based cost management.

PubMed

McKeon, T

1996-04-01

The development of an activity-based management system provides a framework for developing performance measures integral to quality and cost management. Performance measures that cross operational boundaries and embrace core processes provide a mechanism to evaluate operational results related to strategic intention and internal and external customers. The author discusses this measurement process that allows managers to evaluate where they are and where they want to be, and to set a course of action that closes the gap between the two.

Cost-effectiveness of external cephalic version for term breech presentation

PubMed Central

2010-01-01

Background External cephalic version (ECV) is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. Methods A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc.) was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery), utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY) was used to determine cost-effectiveness. Results The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion to breech, successful second ECV trial, or adverse outcome from emergency cesarean. Conclusions From society's perspective, ECV trial is cost-effective when compared to a scheduled cesarean for breech presentation provided the probability of successful ECV is > 32%. Improved algorithms are needed to more precisely estimate the likelihood that a patient will have a successful ECV. PMID:20092630

Flight Testing and Real-Time System Identification Analysis of a UH-60A Black Hawk Helicopter with an Instrumented External Sling Load

NASA Technical Reports Server (NTRS)

McCoy, Allen H.

1998-01-01

Helicopter external air transportation plays an important role in today's world. For both military and civilian helicopters, external sling load operations offer an efficient and expedient method of handling heavy, oversized cargo. With the ability to reach areas otherwise inaccessible by ground transportation, helicopter external load operations are conducted in industries such as logging, construction, and fire fighting, as well as in support of military tactical transport missions. Historically, helicopter and load combinations have been qualified through flight testing, requiring considerable time and cost. With advancements in simulation and flight test techniques there is potential to substantially reduce costs and increase the safety of helicopter sling load certification. Validated simulation tools make possible accurate prediction of operational flight characteristics before initial flight tests. Real time analysis of test data improves the safety and efficiency of the testing programs. To advance these concepts, the U.S. Army and NASA, in cooperation with the Israeli Air Force and Technion, under a Memorandum of Agreement, seek to develop and validate a numerical model of the UH-60 with sling load and demonstrate a method of near real time flight test analysis. This thesis presents results from flight tests of a U.S. Army Black Hawk helicopter with various external loads. Tests were conducted as the U.S. first phase of this MOA task. The primary load was a container express box (CONEX) which contained a compact instrumentation package. The flights covered the airspeed range from hover to 70 knots. Primary maneuvers were pitch and roll frequency sweeps, steps, and doublets. Results of the test determined the effect of the suspended load on both the aircraft's handling qualities and its control system's stability margins. Included were calculations of the stability characteristics of the load's pendular motion. Utilizing CIFER(R) software, a method for near-real time system identification was also demonstrated during the flight test program.

Web-Enabled Systems for Student Access.

ERIC Educational Resources Information Center

Harris, Chad S.; Herring, Tom

1999-01-01

California State University, Fullerton is developing a suite of server-based, Web-enabled applications that distribute the functionality of its student information system software to external customers without modifying the mainframe applications or databases. The cost-effective, secure, and rapidly deployable business solution involves using the…

Value and Pricing of MOOCs

ERIC Educational Resources Information Center

Baker, Rose M.; Passmore, David L.

2016-01-01

Reviewed in this article is the potential for Massive Open Online Courses (MOOCs) to transform higher education delivery, accessibility, and costs. Next, five major value propositions for MOOCs are considered (headhunting, certification, face-to-face learning, personalized learning, integration with services external to the MOOC, marketing). Then,…

Organizational theory for dissemination and implementation research.

PubMed

Birken, Sarah A; Bunger, Alicia C; Powell, Byron J; Turner, Kea; Clary, Alecia S; Klaman, Stacey L; Yu, Yan; Whitaker, Daniel J; Self, Shannon R; Rostad, Whitney L; Chatham, Jenelle R Shanley; Kirk, M Alexis; Shea, Christopher M; Haines, Emily; Weiner, Bryan J

2017-05-12

Even under optimal internal organizational conditions, implementation can be undermined by changes in organizations' external environments, such as fluctuations in funding, adjustments in contracting practices, new technology, new legislation, changes in clinical practice guidelines and recommendations, or other environmental shifts. Internal organizational conditions are increasingly reflected in implementation frameworks, but nuanced explanations of how organizations' external environments influence implementation success are lacking in implementation research. Organizational theories offer implementation researchers a host of existing, highly relevant, and heretofore largely untapped explanations of the complex interaction between organizations and their environment. In this paper, we demonstrate the utility of organizational theories for implementation research. We applied four well-known organizational theories (institutional theory, transaction cost economics, contingency theories, and resource dependency theory) to published descriptions of efforts to implement SafeCare, an evidence-based practice for preventing child abuse and neglect. Transaction cost economics theory explained how frequent, uncertain processes for contracting for SafeCare may have generated inefficiencies and thus compromised implementation among private child welfare organizations. Institutional theory explained how child welfare systems may have been motivated to implement SafeCare because doing so aligned with expectations of key stakeholders within child welfare systems' professional communities. Contingency theories explained how efforts such as interagency collaborative teams promoted SafeCare implementation by facilitating adaptation to child welfare agencies' internal and external contexts. Resource dependency theory (RDT) explained how interagency relationships, supported by contracts, memoranda of understanding, and negotiations, facilitated SafeCare implementation by balancing autonomy and dependence on funding agencies and SafeCare developers. In addition to the retrospective application of organizational theories demonstrated above, we advocate for the proactive use of organizational theories to design implementation research. For example, implementation strategies should be selected to minimize transaction costs, promote and maintain congruence between organizations' dynamic internal and external contexts over time, and simultaneously attend to organizations' financial needs while preserving their autonomy. We describe implications of applying organizational theory in implementation research for implementation strategies, the evaluation of implementation efforts, measurement, research design, theory, and practice. We also offer guidance to implementation researchers for applying organizational theory.

Physician perspectives and compliance with patient advance directives: the role external factors play on physician decision making.

PubMed

Burkle, Christopher M; Mueller, Paul S; Swetz, Keith M; Hook, C Christopher; Keegan, Mark T

2012-11-21

Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians' decisions to honor or forgo previously established advance directives (ADs). In addition, physician views regarding legal risk, patients' ability to comprehend complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents' perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Three hundred eighty-eight of 951 surveys were completed (41% response rate). Eighty percent reported they were likely to honor a patient's AD despite its 5 year age. Fewer than half (41%) would honor the AD of a patient in ventricular fibrillation who had expressed a desire to "pass away in peace." Few (17%) would forgo an AD following a family's request for continued resuscitative treatment. A majority (52%) considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage (74%) disagreed that patients could not appreciate complexities surrounding their care while 69% agreed that costs should never impact a physician's decision as to whether to comply with a patient's AD. Our findings highlight the impact, albeit small, external factors have on physician AD compliance. Most respondents based their decision on the clinical situation at hand and interpretation of the patient's initial wishes and preferences expressed by the AD.

Structural Tailoring of Advanced Turboprops (STAT). Theoretical manual

NASA Technical Reports Server (NTRS)

Brown, K. W.

1992-01-01

This manual describes the theories in the Structural Tailoring of Advanced Turboprops (STAT) computer program, which was developed to perform numerical optimizations on highly swept propfan blades. The optimization procedure seeks to minimize an objective function, defined as either direct operating cost or aeroelastic differences between a blade and its scaled model, by tuning internal and external geometry variables that must satisfy realistic blade design constraints. The STAT analyses include an aerodynamic efficiency evaluation, a finite element stress and vibration analysis, an acoustic analysis, a flutter analysis, and a once-per-revolution (1-p) forced response life prediction capability. The STAT constraints include blade stresses, blade resonances, flutter, tip displacements, and a 1-P forced response life fraction. The STAT variables include all blade internal and external geometry parameters needed to define a composite material blade. The STAT objective function is dependent upon a blade baseline definition which the user supplies to describe a current blade design for cost optimization or for the tailoring of an aeroelastic scale model.

Structural Tailoring of Advanced Turboprops (STAT). Theoretical manual

NASA Astrophysics Data System (ADS)

Brown, K. W.

1992-10-01

This manual describes the theories in the Structural Tailoring of Advanced Turboprops (STAT) computer program, which was developed to perform numerical optimizations on highly swept propfan blades. The optimization procedure seeks to minimize an objective function, defined as either direct operating cost or aeroelastic differences between a blade and its scaled model, by tuning internal and external geometry variables that must satisfy realistic blade design constraints. The STAT analyses include an aerodynamic efficiency evaluation, a finite element stress and vibration analysis, an acoustic analysis, a flutter analysis, and a once-per-revolution (1-p) forced response life prediction capability. The STAT constraints include blade stresses, blade resonances, flutter, tip displacements, and a 1-P forced response life fraction. The STAT variables include all blade internal and external geometry parameters needed to define a composite material blade. The STAT objective function is dependent upon a blade baseline definition which the user supplies to describe a current blade design for cost optimization or for the tailoring of an aeroelastic scale model.

Liquid-state carbon-13 hyperpolarization generated in an MRI system for fast imaging

PubMed Central

Schmidt, A. B.; Berner, S.; Schimpf, W.; Müller, C.; Lickert, T.; Schwaderlapp, N.; Knecht, S.; Skinner, J. G.; Dost, A.; Rovedo, P.; Hennig, J.; von Elverfeldt, D.; Hövener, J. -B.

2017-01-01

Hyperpolarized (HP) tracers dramatically increase the sensitivity of magnetic resonance imaging (MRI) to monitor metabolism non-invasively and in vivo. Their production, however, requires an extra polarizing device (polarizer) whose complexity, operation and cost can exceed that of an MRI system itself. Furthermore, the lifetime of HP tracers is short and some of the enhancement is lost during transfer to the application site. Here, we present the production of HP tracers in water without an external polarizer: by Synthesis Amid the Magnet Bore, A Dramatically Enhanced Nuclear Alignment (SAMBADENA) is achieved within seconds, corresponding to a hyperpolarization of ∼20%. As transfer of the tracer is no longer required, SAMBADENA may permit a higher polarization at the time of detection at a fraction of the cost and complexity of external polarizers. This development is particularly promising in light of the recently extended portfolio of biomedically relevant para-hydrogen-tracers and may lead to new diagnostic applications. PMID:28262691

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2016-04-01

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

The cost-effectiveness of parasitologic diagnosis for malaria-suspected patients in an era of combination therapy.

PubMed

Lubell, Yoel; Reyburn, Hugh; Mbakilwa, Hilda; Mwangi, Rose; Chonya, Kini; Whitty, Christopher J M; Mills, Anne

2007-12-01

The introduction of artemisinin-based combination therapy in sub-Saharan Africa has prompted calls for increased use of parasitologic diagnosis for malaria. We evaluated the cost-effectiveness of rapid diagnostic tests (RDTs) in comparison to microscopy in guiding treatment of non-severe febrile illness at varying levels of malaria endemicity using data on test accuracy and costs collected as part of a Tanzanian trial. If prescribers complied with current guidelines, microscopy would give rise to lower average costs per patient correctly treated than RDTs in areas of both high and low transmission. RDT introduction would result in an additional 2.3% and 9.4% of patients correctly treated, at an incremental cost of $25 and $7 in the low and high transmission settings, respectively. Cost-effectiveness would be worse if prescribers do not comply with test results. The cost of this additional benefit may be higher than many countries can afford without external assistance or lower RDT prices.

[Quality management in a public health agency].

PubMed

Villalbí, Joan R; Ballestín, Manuela; Casas, Conrad; Subirana, Teresa

2012-01-01

This article describes the introduction of quality improvement actions in a public health organization. After ISO 17025 accreditation, which was legally mandated, was granted to the official control laboratory, the management decided to expand a quality policy in 2003, through a series of actions based on process analysis and proposals for improvement, further definition of standard operating procedures, exploration of users' opinions, the creation of improvement groups, and external audits or certification. The organizational response to these initiatives was diverse. External audit or certification of services seems to be the most powerful tool for change. Costing studies showed that up to 75% of the total expenditure of the agency in 2010 was spent on public health services subject to external audit or certification. Copyright © 2011 SESPAS. Published by Elsevier España, S.L. All rights reserved.

Impact of traffic composition on accessibility as indicator of transport sustainability

NASA Astrophysics Data System (ADS)

Nahdalina; Hadiwardoyo, S. P.; Nahry

2017-05-01

Sustainable transport is closely related to quality of life in the community at present and in the future. Some indicators of transport sustainability are accessibility measurement of origin/destination, the operating costs of transport (vehicle operating cost or VOC) and external transportation costs (emission cost). The indicators could be combined into accessibility measurement model. In other case, almost traffic congestion occurred on the condition of mixed traffic. This paper aimed to analyse the indicator of transport sustainability through simulation under condition of various traffic composition. Various composition of truck to total traffic flow are 0%, 10% and 20%. Speed and V/C are calculated from traffic flow to estimate the VOC and emission cost. 5 VOC components and 3 types of emission cost (CO2, CH4 and N2O) are counted to be a travel cost. Accessibility measurement was calculated using travel cost and gravity model approaches. Result of the research shows that the total traffic flow has indirect impact on accessibility measurement if using travel cost approach. Meanwhile, the composition of traffic flow has an affect on accessibility measurement if using gravity model approach.

Hip protector compliance: a 13-month study on factors and cost in a long-term care facility.

PubMed

Burl, Jeffrey B; Centola, James; Bonner, Alice; Burque, Colleen

2003-01-01

To determine if a high compliance rate for wearing external hip protectors could be achieved and sustained in a long-term care population. A 13-month prospective study of daytime use of external hip protectors in an at-risk long-term care population. One hundred-bed not-for-profit long-term care facility. Thirty-eight ambulatory residents having at least 1 of 4 risk factors (osteoporosis, recent fall, positive fall screen, previous fracture). The rehabilitation department coordinated an implementation program. Members of the rehabilitation team met with eligible participants, primary caregivers, families, and other support staff for educational instruction and a description of the program. The rehabilitation team assumed overall responsibility for measuring and ordering hip protectors and monitoring compliance. By the end of the third month, hip protector compliance averaged greater than 90% daily wear. The average number of falls per month in the hip protector group was 3.9 versus 1.3 in nonparticipants. Estimated total indirect staff time was 7.75 hours. The total cost of the study (hip protectors and indirect staff time) was 6,300 US dollars. High hip protector compliance is both feasible and sustainable in an at-risk long-term care population. Achieving high compliance requires an interdisciplinary approach with one department acting as a champion. The cost of protectors could be a barrier to widespread use. Facilities might be unable to cover the cost until the product is paid for by third-party payers.

Low-Cost Bio-Based Phase Change Materials as an Energy Storage Medium in Building Envelopes

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

Biswas, Kaushik; Abhari, Mr. Ramin; Shukla, Dr. Nitin

2015-01-01

A promising approach to increasing the energy efficiency of buildings is the implementation of phase change material (PCM) in building envelope systems. Several studies have reported the energy saving potential of PCM in building envelopes. However, wide application of PCMs in building applications has been inhibited, in part, by their high cost. This article describes a novel paraffin product made of naturally occurring fatty acids/glycerides trapped into high density polyethylene (HDPE) pellets and its performance in a building envelope application, with the ultimate goal of commercializing a low-cost PCM platform. The low-cost PCM pellets were mixed with cellulose insulation, installedmore » in external walls and field-tested under natural weatherization conditions for a period of several months. In addition, several PCM samples and PCM-cellulose samples were prepared under controlled conditions for laboratory-scale testing. The laboratory tests were performed to determine the phase change properties of PCM-enhanced cellulose insulation both at microscopic and macroscopic levels. This article presents the data and analysis from the exterior test wall and the laboratory-scale test data. PCM behavior is influenced by the weather and interior conditions, PCM phase change temperature and PCM distribution within the wall cavity, among other factors. Under optimal conditions, the field data showed up to 20% reduction in weekly heat transfer through an external wall due to the PCM compared to cellulose-only insulation.« less

Construction bidding cost of KSC's space shuttle facilities

NASA Technical Reports Server (NTRS)

Brown, Joseph Andrew

1977-01-01

The bidding cost of the major Space Transportation System facilities constructed under the responsibility of the John F. Kennedy Space Center (KSC) is described and listed. These facilities and Ground Support Equipment (GSE) are necessary for the receiving, assembly, testing, and checkout of the Space Shuttle for launch and landing missions at KSC. The Shuttle launch configuration consists of the Orbiter, the External Tank, and the Solid Rocket Boosters (SRB). The reusable Orbiter and SRB's is the major factor in the program that will result in lowering space travel costs. The new facilities are the Landing Facility; Orbiter Processing Facility; Orbiter Approach and Landing Test Facility (Dryden Test Center, California); Orbiter Mating Devices; Sound Suppression Water System; and Emergency Power System for LC-39. Also, a major factor was to use as much Apollo facilities and hardware as possible to reduce the facilities cost. The alterations to existing Apollo facilities are the VAB modifications; Mobile Launcher Platforms; Launch Complex 39 Pads A and B (which includes a new concept - the Rotary Service Structure), which was featured in ENR, 3 Feb. 1977, 'Hinged Space Truss will Support Shuttle Cargo Room'; Launch Control Center mods; External Tank and SRB Processing and Storage; Fluid Test Complex mods; O&C Spacelab mods; Shuttle mods for Parachute Facility; SRB Recovery and Disassembly Facility at Hangar 'AF'; and an interesting GSE item - the SRB Dewatering Nozzle Plug Sets (Remote Controlled Submarine System) used to inspect and acquire for reuse of SRB's.

The costs and outcomes of treating a deep pressure ulcer in a patient with quadriplegia .

PubMed

Schessel, Eli S; Ger, Ralph; Oddsen, Robert

2012-02-01

 The cost of pressure ulcers, especially Stage III and Stage IV ulcers, is substantial. A 27-year-old man with a 6-year history of quadriplegia developed an ischial pressure ulcer. Twelve months of treatment with wet-to-dry dressings were followed by admission to several facilities and 15 months of care with biological dressings and negative pressure wound therapy (NPWT). When admitted to the authors' wound care center, the wound measured 4.5 cm x 3.2 cm with exposed bone. A review of his insurance records showed that paid claims totaled $242,350, including $52,992 for NPWT rental costs. The patient was considered a good candidate for minimally invasive surgical intervention with external tissue expanders. Following a 14-day course of antibiotics to treat his infection, the wound was debrided and the tissue expanders applied. After 16 days, the wound was closed. The patient returned to work 6 weeks after the procedure. At the 23-month follow-up, the wound remained closed. Insurance payments for the care that resulted in wound closure totaled $43,814. This case study illustrates the potential of the external tissue expansion technique to close deep pressure ulcers within a relatively short amount of time at comparatively lower cost. Studies including control treatments are needed to confirm these conclusions.

Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

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

Kim, Hayeon, E-mail: kimh2@upmc.edu; Rajagopalan, Malolan S.; Beriwal, Sushil

Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction)more » with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100,000 per QALY gained, suggesting that selective SBRT use in patients with longer expected survival may be the most cost-effective approach.« less

Estimated medical cost savings in Massachusetts by implementation of a primary seat belt law

DOT National Transportation Integrated Search

2008-12-01

This report examines 2006 hospital discharge data reporting cases where the external cause of injury to a vehicle occupant was a motor vehicle crash to predict the estimated savings to Massachusetts if a primary seat belt law is implemented. The savi...

Leveraging Small Aquarium Fishes to Advance Understanding of Environmentally Influenced Human Disorders and Diseases

EPA Science Inventory

Small aquarium fishes provide a model organism that recapitulates the development, physiology and specific disease processes present in humans without the many limitations of rodent-based models currently in use. Fish models offer advantages in cost, rapid life-cycles, and extern...

Militarism Versus Development. Teaching Global Issues.

ERIC Educational Resources Information Center

Gage, Susan

1988-01-01

Articles and activities written for the senior secondary level explore the complex links between militarization and underdevelopment. The articles discuss choices between missiles and food in developing countries, the internal and external causes of militarism, and the hidden costs of militarism. Case studies of the Kwajalein Atoll and Ethiopia…

Estimating Impacts Across the Life Cycle of Corn Ethanol and Gasoline

EPA Science Inventory

Direct emissions from transportation are responsible for roughly one-quarter of the total US greenhouse gas emissions (EPA 2011). U.S. oil use is also associated with a relatively high degree of externality cost (Michalek, Chester et al. 2011). Under the Energy Independence and...

A MULTIFACETED, MEDIUM-THROUGHPUT APPROACH FOR DETECTING AND CHARACTERIZING DEVELOPMENTAL NEUROTOXICITY USING ZEBRAFISH.

EPA Science Inventory

To address the EPA's need to prioritize hundreds to thousands of chemicals for testing, we are developing a rapid, cost-effective in vivo screen for developmental neurotoxicity using zebrafish (Danio rerio), a small freshwater fish with external fertilization. Zebrafish embryos d...

Problems and Opportunities in School Financial Management: A Consultant's Perspective.

ERIC Educational Resources Information Center

Chabotar, Kent John

1987-01-01

Summarizes major problems in school financial management and suggests practical improvements to aid external reporting of financial data and internal management. Sections of the article describe these categories of problems: (1) budget presentation; (2) management control; (3) cost accounting; and (4) financial reporting. (PS)

Quality of Life and Cost Effectiveness of Prostate Cancer Treatment

DTIC Science & Technology

2006-03-01

Visser AP, Hulshof MC, Horenblas S, Kurth KH. Health-related quality of life and psychosocial factors in patients with prostate cancer scheduled for...Andel G, Visser AP, Zwinderman AH, Hulshof MC, Horenblas S, Kurth KH. A prospective longitudinal study comparing the impact of external radiation

Low-cost, digital lock-in module with external reference for coating glass transmission/reflection spectrophotometer

NASA Astrophysics Data System (ADS)

Alonso, R.; Villuendas, F.; Borja, J.; Barragán, L. A.; Salinas, I.

2003-05-01

A versatile, low-cost, digital signal processor (DSP) based lock-in module with external reference is described. This module is used to implement an industrial spectrophotometer for measuring spectral transmission and reflection of automotive and architectonic coating glasses over the ultraviolet, visible and near-infrared wavelength range. The light beams are modulated with an optical chopper. A digital phase-locked loop (DPLL) is used to lock the lock-in to the chop frequency. The lock-in rejects the ambient radiation and permits the spectrophotometer to work in the presence of ambient light. The algorithm that implements the dual lock-in and the DPLL in the DSP56002 evaluation module from Motorola is described. The use of a DSP allows implementation of the lock-in and DPLL by software, which gives flexibility and programmability to the system. Lock-in module cost, under 300 euro, is an important parameter taking into account that two modules are used in the system. Besides, the algorithms implemented in this DSP can be directly implemented in the latest DSP generations. The DPLL performance and the spectrophotometer are characterized. Capture and lock DPLL ranges have been measured and checked to be greater than the chop frequency drifts. The lock-in measured frequency response shows that the lock-in performs as theoretically predicted.

Nottingham Health Science Biobank: a sustainable bioresource.

PubMed

Matharoo-Ball, Balwir; Thomson, Brian J

2014-10-01

Nottingham Health Science Biobank (NHSB) was established in 2011 by a 3-year "pump priming" grant from the United Kingdom National Institute of Health Research. Before biobanking operations began, NHSB commissioned a financial report on the full costs of biobanking and worked with key stakeholders and external consultants to develop a business plan with the aim of achieving financial and operational sustainability. The plan included: scanning published information, telephone interviews with commercial companies, Freedom of Information Requests, dialogue with prospective customers, and a market analysis of global trends in the use of human tissue samples in research. Our financial report provided a comprehensive and structured costing template for biobanking and confirmed the absolute requirement to ensure cost-efficient processes, careful staff utilization, and maximization of sample turnover. Together with our external consultants, we developed a business model responsive to global interest in healthcare founded on i) identification of key therapeutic areas that mapped to the strengths of the NHSB; ii) a systematic approach to identifying companies operating in these therapy areas; iii) engagement with noncommercial stakeholders to agree strategically aligned sample collection with the aim of ensuring the value of our tissue resource. By adopting this systematic approach to business modelling, the NHSB has achieved sustainability after less than 3 years of operation.

Tissue expanders with a focus on extremity reconstruction.

PubMed

Arain, Abdul R; Cole, Keegan; Sullivan, Christopher; Banerjee, Samik; Kazley, Jillian; Uhl, Richard L

2018-02-01

Acute traumatic or surgical wounds that cannot be primarily closed often cause substantial morbidity and mortality. This often leads to increased costs from higher material expenses, more involved nursing care, and longer hospital stays. Advancements in soft tissue expansion has made it a popular alternative to facilitate early closure without the need for more complicated plastic surgical procedures. Areas covered: In this review, we briefly elaborate on the history and biomechanics of tissue expansion and provide comprehensive descriptions of traditional internal tissue expanders and a variety of contemporary external tissue expanders. We describe their uses, advantages, disadvantages, and clinical outcomes. The majority of articles reviewed include case series with level IV evidence. Outcome data was collected for studies after 1990 using PubMed database. Expert commentary: An overall reduction in cost, time-to-wound closure, hospital length-of-stay, and infection rate may be expected with most tissue expanders. However, further studies comparing outcomes and cost-effectiveness of various expanders may be beneficial. Surgeons should be aware of the wide array of tissue expanders that are commercially available to individualize treatment based on thorough understanding of their advantages and disadvantages to optimize outcomes. We predict the use of external expanders to increase in the future and the need for more invasive procedures such as flaps to decrease.

Mechanical work for step-to-step transitions is a major determinant of the metabolic cost of human walking.

PubMed

Donelan, J Maxwell; Kram, Rodger; Kuo, Arthur D

2002-12-01

In the single stance phase of walking, center of mass motion resembles that of an inverted pendulum. Theoretically, mechanical work is not necessary for producing the pendular motion, but work is needed to redirect the center of mass velocity from one pendular arc to the next during the transition between steps. A collision model predicts a rate of negative work proportional to the fourth power of step length. Positive work is required to restore the energy lost, potentially exacting a proportional metabolic cost. We tested these predictions with humans (N=9) walking over a range of step lengths (0.4-1.1 m) while keeping step frequency fixed at 1.8 Hz. We measured individual limb external mechanical work using force plates, and metabolic rate using indirect calorimetry. As predicted, average negative and positive external mechanical work rates increased with the fourth power of step length (from 1 W to 38 W; r(2)=0.96). Metabolic rate also increased with the fourth power of step length (from 7 W to 379 W; r(2)=0.95), and linearly with mechanical work rate. Mechanical work for step-to-step transitions, rather than pendular motion itself, appears to be a major determinant of the metabolic cost of walking.

Reactive granular optics for passive tracking of the sun

NASA Astrophysics Data System (ADS)

Frenkel, I.; Niv, A.

2017-08-01

The growing need for cost-effective renewable energy sources is hampered by the stagnation in solar cell technology, thus preventing a substantial reduction in the module and energy-production price. Lowering the energy-production cost could be achieved by using modules with efficiency. One of the possible means for increasing the module efficiency is concentrated photovoltaics (CPV). CPV, however, requires complex and accurate active tracking of the sun that reduces much of its cost-effectiveness. Here, we propose a passive tracking scheme based on a reactive optical device. The optical reaction is achieved by a new kind of light activated mechanical force that acts on micron-sized particles. This optical force allows the formation of granular disordered optical media that can be switched from being opaque to become transparent based on the intensity of light it interacts with. Such media gives rise to an efficient passive tracking scheme that when combined with an external optical cavity forms a new solar power conversion approach. Being external to the cell itself, this approach is indifferent to the type of semiconducting material that is used, as well as to other aspects of the cell design. This, in turn, liberates the cell layout from its optical constraints thus paving the way to higher efficiencies at lower module price.

Decision rules for spaceborne operations planning

NASA Technical Reports Server (NTRS)

Smith, Jeffrey H.

1992-01-01

Recent study of Space Station Freedom requirements for extravehicular activity (EVA) to perform external maintenance tasks emphasize an oversubscription of resources for performing on-orbit tasks. Extravehicular robotics (EVR) and cooperative EVA combined with EVR (using crew and robots synergistically to perform tasks) have been suggested as a part of the solution to reduce EVA. The question remains however, 'Under what conditions is it cost-effective to use the EVA and/or EVR resource.' The answer to such a question also has implications for the Space Station Freedom and its external maintenance as well as the Space Exploration Initiative (SEI) where the issue of work-system allocation is magnified by the long distances and scope of EVA work. This paper describes a simple technique of interest to operational planners and robot technology planners for determining in an economic context whether to use EVA alone, EVR alone, or Cooperative EVA. It is also shown that given: (1) the task times for these alternatives; and (2) the marginal costs of EVA, EVR, and IVA, the appropriate work system for performing the task can be identified. The paper illustrates how the work system choice is based on the ratio of costs. An example using Space Station Freedom data is presented to illustrate the trade-offs among alternative work-systems.

Ventriculostomy Simulation Using Patient-Specific Ventricular Anatomy, 3D Printing, and Hydrogel Casting.

PubMed

Ryan, Justin R; Chen, Tsinsue; Nakaji, Peter; Frakes, David H; Gonzalez, L Fernando

2015-11-01

Educational simulators provide a means for students and experts to learn and refine surgical skills. Educators can leverage the strengths of medical simulators to effectively teach complex and high-risk surgical procedures, such as placement of an external ventricular drain. Our objective was to develop a cost-effective, patient-derived medical simulacrum for cerebral lateral ventriculostomy. A cost-effective, patient-derived medical simulacrum was developed for placement of an external lateral ventriculostomy. Elastomeric and gel casting techniques were used to achieve realistic brain geometry and material properties. 3D printing technology was leveraged to develop accurate cranial properties and dimensions. An economical, gravity-driven pump was developed to provide normal and abnormal ventricular pressures. A small pilot study was performed to gauge simulation efficacy using a technology acceptance model. An accurate geometric representation of the brain was developed with independent lateral cerebral ventricular chambers. A gravity-driven pump pressurized the ventricular cavities to physiologic values. A qualitative study illustrated that the simulation has potential as an educational tool to train medical professionals in the ventriculostomy procedure. The ventricular simulacrum can improve learning in a medical education environment. Rapid prototyping and multi-material casting techniques can produce patient-derived models for cost-effective and realistic surgical training scenarios. Copyright © 2015 Elsevier Inc. All rights reserved.

Obesity does not increase External Mechanical Work per kilogram body mass during Walking

PubMed Central

Browning, Raymond C.; McGowan, Craig P.; Kram, Rodger

2009-01-01

Walking is the most common type of physical activity prescribed for the treatment of obesity. The net metabolic rate during level walking (Watts/kg) is ~10% greater in obese vs. normal weight adults. External mechanical work (Wext) is one of the primary determinants of the metabolic cost of walking, but the effects of obesity on Wext have not been clearly established. The purpose of this study was to compare Wext between obese and normal weight adults across a range of walking speeds. We hypothesized that Wext (J/step) would be greater in obese adults but Wext normalized to body mass would be similar in obese and normal weight adults. We collected right leg three-dimensional ground reaction forces (GRF) while twenty adults (10 obese, BMI=35.6 kg/m2 and 10 normal weight, BMI=22.1 kg/m2) walked on a level, dual-belt force measuring treadmill at six speeds (0.50–1.75 m/s). We used the individual limb method (ILM) to calculate external work done on the center of mass. Absolute Wext (J/step) was greater in obese vs. normal weight adults at each walking speed, but relative Wext (J/step/kg) was similar between the groups. Step frequencies were not different. These results suggest that Wext is not responsible for the greater metabolic cost of walking (W/kg) in moderately obese adults. PMID:19646701

Treatment Patterns, Survival, and Healthcare Costs of Patients with Malignant Gliomas in a Large US Commercially Insured Population

PubMed Central

Ray, Saurabh; Bonafede, Machaon M.; Mohile, Nimish A.

2014-01-01

Background Glioblastoma multiforme is the most common malignant primary brain tumor in adults and is associated with poor survival rates. Symptoms often include headaches; nausea and vomiting; and progressive memory, personality, or neurologic deficits. The treatment remains a challenge, and despite the approval of multiple new therapies in the past decade, survival has not improved. Objective To describe treatment patterns, survival, and healthcare costs of patients with incident glioblastoma in a large US population. Methods For this population-based study, adult patients (aged ≥18 years) with incident malignant brain neoplasm who had undergone brain surgery between January 1, 2006, and December 31, 2010, were identified in the Truven Health Analytics MarketScan Research Databases. The patients were stratified into 4 cohorts based on the use of temozolomide and/or external beam radiation therapy within 90 days after brain surgery (ie, the index event). Treatment patterns, survival, and healthcare costs were assessed until patient death, disenrollment, or the end-of-study period. Results A total of 2272 patients met the inclusion criteria; of these, 37% received temozolomide and radiation therapy, 13.8% received radiation alone, 3.9% received temozolomide alone, and 45.3% of patients received neither. The average patient age ranged from 55.3 years to 59.8 years across the study cohorts; between 29.8% and 44% of patients in each cohort were female. The duration of temozolomide use was similar between the temozolomide-only cohort and patients receiving temozolomide with external beam radiation; approximately 76% of patients received temozolomide at least 60 days, dropping to 48.1% and 23% at 180 days and 360 days of follow-up, respectively. The median survival was 456 days, ranging from 331 days in the temozolomide-only cohort to 529 days in the cohort that received neither temozolomide nor external beam radiation. The average total costs in the 6 months postindex were $106,896, from $79,099 for patients who received neither temozolomide nor radiation to $138,767 for those who received both therapies. Conclusion The survival patterns of patients with glioblastoma seen in this real-world study of current treatments in a clinical setting is similar to the survival rate reported in clinical trials. However, further cost-effectiveness and quality-of-life analyses will be critical to better understand the role of temozolomide therapy in this patient population, considering its considerable cost burden and potential negative impact on survival seen in this study. PMID:24991398

NASAwide electronic publishing system: Electronic printing and duplicating, stage-2 evaluation report (GSFC)

NASA Technical Reports Server (NTRS)

Tuey, Richard C.; Lane, Robert; Hart, Susan V.

1995-01-01

The NASA Scientific and Technical Information Office was assigned the responsibility to continue with the expansion of the NASAwide networked electronic duplicating effort by including the Goddard Space Flight Center (GSFC) as an additional node to the existing configuration of networked electronic duplicating systems within NASA. The subject of this report is the evaluation of a networked electronic duplicating system which meets the duplicating requirements and expands electronic publishing capabilities without increasing current operating costs. This report continues the evaluation reported in 'NASA Electronic Publishing System - Electronic Printing and Duplicating Evaluation Report' (NASA TM-106242) and 'NASA Electronic Publishing System - Stage 1 Evaluation Report' (NASA TM-106510). This report differs from the previous reports through the inclusion of an external networked desktop editing, archival, and publishing functionality which did not exist with the previous networked electronic duplicating system. Additionally, a two-phase approach to the evaluation was undertaken; the first was a paper study justifying a 90-day, on-site evaluation, and the second phase was to validate, during the 90-day evaluation, the cost benefits and productivity increases that could be achieved in an operational mode. A benchmark of the functionality of the networked electronic publishing system and external networked desktop editing, archival, and publishing system was performed under a simulated daily production environment. This report can be used to guide others in determining the most cost effective duplicating/publishing alternative through the use of cost/benefit analysis and return on investment techniques. A treatise on the use of these techniques can be found by referring to 'NASA Electronic Publishing System -Cost/Benefit Methodology' (NASA TM-106662).

Antibiotic Impregnated External Ventricular Drains: Meta and Cost Analysis.

PubMed

Root, Brandon K; Barrena, Benjamin G; Mackenzie, Todd A; Bauer, David F

2016-02-01

To determine whether antibiotic impregnated external ventricular drains (AI-EVDs) are effective in preventing ventriculostomy associated infection (VAI), and to examine their cost effectiveness. A comprehensive literature search was performed for published data through May 2014, including randomized controlled trials and observational cohort studies comparing AI-EVDs with nonimpregnated controls. A meta-analysis of included studies was performed using a random effects model. Historical data at the authors' institution were used to estimate both the incremental price of AI-EVDs and the hospital expenses associated with VAI. Three randomized controlled trials and 5 observational studies met inclusion criteria. The analysis demonstrated a statistically significant protective effect of AI-EVDs against VAI (risk ratio = 0.31 [0.15-0.64]; P = 0.002), although there was significant heterogeneity (χ(2) = 18.08; P = 0.01; I(2) = 61%). The number of AI-EVDs needed to prevent one infection (Number needed to treat [NNT]) was 19. Based on $100 as the incremental price, and $30,000 as the estimated expense of one episode of VAI, AI-EVDs would result in an overall savings estimate of $28,100 (range, $26,400-$28,500) per NNT. If a hospital places 150 AI-EVDs annually, savings could range from $109,292 to $278,577 per year. Meta-analysis demonstrated a significant protective benefit of AI-EVDs against VAI, and this benefit is likely associated with cost savings. However, current data on AI-EVDs are limited, and overall hospital costs will vary among institutions. Although both the efficacy and cost effectiveness of AI-EVDs are supported by this analysis, further study of AI-EVDs is clearly warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

New reflective symmetry design capability in the JPL-IDEAS Structure Optimization Program

NASA Technical Reports Server (NTRS)

Strain, D.; Levy, R.

1986-01-01

The JPL-IDEAS antenna structure analysis and design optimization computer program was modified to process half structure models of symmetric structures subjected to arbitrary external static loads, synthesize the performance, and optimize the design of the full structure. Significant savings in computation time and cost (more than 50%) were achieved compared to the cost of full model computer runs. The addition of the new reflective symmetry analysis design capabilities to the IDEAS program allows processing of structure models whose size would otherwise prevent automated design optimization. The new program produced synthesized full model iterative design results identical to those of actual full model program executions at substantially reduced cost, time, and computer storage.

Determination and Applications of Environmental Costs at Different Sized Airports: Aircraft Noise and Engine Emissions

NASA Technical Reports Server (NTRS)

Lu, Cherie; Lierens, Abigail

2003-01-01

With the increasing trend of charging for externalities and the aim of encouraging the sustainable development of the air transport industry, there is a need to evaluate the social costs of these undesirable side effects, mainly aircraft noise and engine emissions, for different airports. The aircraft noise and engine emissions social costs are calculated in monetary terms for five different airports, ranging from hub airports to small regional airports. The number of residences within different levels of airport noise contours and the aircraft noise classifications are the main determinants for accessing aircraft noise social costs. Whist, based on the damages of different engine pollutants on the human health, vegetation, materials, aquatic ecosystem and climate, the aircraft engine emissions social costs vary from engine types to aircraft categories. The results indicate that the relationship appears to be curvilinear between environmental costs and the traffic volume of an airport. The results and methodology of environmental cost calculation could input for to the proposed European wide harmonized noise charges as well as the social cost benefit analysis of airports.

The Paper River: A Demonstration of Externalities and Coase's Theorem.

ERIC Educational Resources Information Center

Hoyt, Gail M.; Ryan, Patricia L.; Houston, Robert G., Jr.

1999-01-01

Presents a classroom simulation in which one firm pollutes the water used by another. Includes a detailed outline and discussion of the preparations and materials required, and the procedure for running the simulation. Argues that students learn how property rights provide a market solution to pollution costs. (DSK)

15 CFR 291.4 - National industry-specific pollution prevention and environmental compliance resource centers.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., external evaluation for assessing outcomes of the activity, and “customer satisfaction” measures of... requirements. (d) Project customers. (1) The customers for this center will be the businesses in the industrial...) The center should assist the customer in choosing the most cost- effective, environmentally sound...

77 FR 9179 - Medicare Program; Reporting and Returning of Overpayments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-16

...'s name, number and tax identification number; and the date of service. The voluntary refund process... reporting form include: (1) Accountants and auditors (external and in-house); and (2) miscellaneous in-house... accountant). Consequently, in order to determine the burden cost, we utilize the average hourly wage of these...

Estimated medical cost savings in New Hampshire by implementation of a primary seat belt law

DOT National Transportation Integrated Search

2008-03-01

This report examines 2005 hospital discharge data reporting cases where the external cause of injury to a vehicle occupant was a motor vehicle crash to predict the estimated savings to the State of New Hampshire if a primary seat belt law is implemen...

Pre- and Post-Planned Evaluation: Which Is Preferable?

ERIC Educational Resources Information Center

Strasser, Stephen; Deniston, O. Lynn

1978-01-01

Factors involved in pre-planned and post-planned evaluation of program effectiveness are compared: (1) reliability and cost of data; (2) internal and external validity; (3) obtrusiveness and threat; (4) goal displacement and program direction. A model to help program administrators decide which approach is more appropriate is presented. (Author/MH)

75 FR 40039 - Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

... external defibrillator AFROC Association of Freestanding Radiation Oncology Centers AHA American Heart... Procedure Coding System HCRIS Healthcare Cost Report Information System HDRT High dose radiation therapy HH... rule with comment period IMRT Intensity-Modulated Radiation Therapy IPPE Initial preventive physical...

Forecasting Mental Health Care Cost for OIF and OEF Veterans

DTIC Science & Technology

2006-06-01

event. Diminished responsiveness to the external world, referred to as “ psychic numbing” or “emotional anesthesia”, usually begins soon after the...member with one child develops PTSD to the degree of being unemployed , then that individual could receive compensation payments from the VA of over

The R&D Boundaries of the Firm: An Empirical Analysis.

ERIC Educational Resources Information Center

Pisano, Gary P.

1990-01-01

Examines how two sources of transaction costs, small-numbers bargaining hazards and appropriability concerns, may affect established firms' choices between inhouse and external sources of research and development when technological change shifts the locus of R & D expertise from established enterprises to new entrants, and established…

The Audioconference: Delivering Continuing Education for Addictions Workers in Canada.

ERIC Educational Resources Information Center

Burge, E. J.; And Others

1993-01-01

Used audio conferencing for continuing education of Francophone and Anglophone addictions workers across Canada. Evaluation revealed that program design enabled cost-effective, real-time linking of local groups of professionals with their peers and with external expert colleagues. Found that such contact promoted social goals of networking and…

Estimated medical cost savings in Utah by implementation of a primary seat belt law

DOT National Transportation Integrated Search

2010-05-01

This report examines 2007 hospital discharge data reporting cases where the external cause of injury to : a vehicle occupant was a motor vehicle crash to predict the estimated savings to Utah if a primary seat : belt law is implemented. The savings a...

Estimated medical cost savings in Rhode Island by implementation of a primary seat belt law

DOT National Transportation Integrated Search

2008-09-01

This report examines 2006 hospital discharge data reporting cases where the external cause of injury to a vehicle occupant was a motor vehicle crash to predict the estimated savings to Rhode Island if a primary seat belt law is implemented. The savin...

Estimated medical cost savings in Nevada by implementation of a primary seat belt law

DOT National Transportation Integrated Search

2008-09-01

This report examines 2007 hospital discharge data reporting cases where the external cause of injury to a vehicle occupant was a motor vehicle crash to predict the estimated savings to Nevada if a primary seat belt law is implemented. The savings are...

Estimated medical cost savings in Vermont by implementation of a primary seat belt law

DOT National Transportation Integrated Search

2008-09-01

This report examines 2005 hospital discharge data reporting cases where the external cause of injury to a vehicle occupant was a motor vehicle crash to predict the estimated savings to the State of Vermont if a primary seat belt law is implemented. T...

The vulnerability of US apple (Malus) genetic resources

USDA-ARS?s Scientific Manuscript database

Apple is one of the top three U.S. fruit crops in production and value. Apple production has high costs for land, labor and inputs, and orchards are a long-term commitment. Production is dominated by only a few apple scion cultivars and rootstocks, which increases susceptibility to dynamic external ...

Solar Glazing Tips for School Construction

ERIC Educational Resources Information Center

Smith, Jonathan

2012-01-01

Glazing can be optimized to enhance passive solar heating and daylight harvesting by exceeding the prescriptive limits of the energy code. This savings can be garnered without the high cost of external overhangs or expensive glazing products. The majority of savings from solar glazing are attributable to the increase in solar heating and…

The Cost of Fad Treatments in Autism

ERIC Educational Resources Information Center

Zane, Thomas; Davis, Cheryl; Rosswurm, Mary

2008-01-01

With the increase in the incidence of autism, there has been a corresponding increase in the number of treatments for this disorder. Professionals generally recognize the need for effective treatments. Effectiveness is typically considered to mean the use of quality research with good control over internal and external validity threats. Thus, only…

Faculty Compensation Systems: Impact on the Quality of Higher Education. ERIC Digest.

ERIC Educational Resources Information Center

Sutton, Terry P.; Bergerson, Peter J.

Faculty compensation is a critical management tool for increasing faculty productivity, improving cost efficiency, and enhancing an institution's public image. Factors that determine faculty compensation include academic rank, faculty productivity, discipline market pay, ability to obtain external grants, seniority or length of service, service in…

Quality of Life and Cost Effectiveness of Prostate Cancer Treatment

DTIC Science & Technology

2007-03-01

quality of life for patients with localized prostate cancer: data from CaPSURE. J Urol 2004; 172: 1830–4 19 Van Andel G, Visser AP, Hulshof MC...Zwinderman AH, Hulshof MC, Horenblas S, Kurth KH. A prospective longitudinal study comparing the impact of external radiation therapy with radical

Spreadsheet Analysis of Harvesting Systems

Treesearch

R.B. Rummer; B.L. Lanford

1987-01-01

Harvesting systems can be modeled and analyzed on microcomputers using commercially available "spreadsheet" software. The effect of system or external variables on the production rate or system cost can be evaluated and alternative systems can be easily examined. The tedious calculations associated with such analyses are performed by the computer. For users...

Thermal Energy Briefing with FPL

NASA Image and Video Library

2017-02-17

Bart Gaetjens, Florida Power & Light's FPL area external affairs manager, addresses the news media and NASA Social about the new Thermal Energy Storage (TES) tank Feb. 17. The TES tank works like a giant battery and is saving the center utility cost. These savings will be applied to new sustainable projects at Kennedy.

Beyond Civil Service: The Changing Face of Public Personnel Management.

ERIC Educational Resources Information Center

Klingner, Donald E.; Lynn, Dahlia Bradshaw

1997-01-01

Today, public services are often delivered by purchase-of-service agreements, privatization, franchising, vouchers, or other alternatives to civil service. Public personnel managers must now deal with broader policy issues, relationships with external organizations, and tighter focus on cost control, requiring new knowledge, skills, and abilities.…

Economic Analysis of Apixaban Therapy for Patients With Atrial Fibrillation From a US Perspective: Results From the ARISTOTLE Randomized Clinical Trial.

PubMed

Cowper, Patricia A; Sheng, Shubin; Lopes, Renato D; Anstrom, Kevin J; Stafford, Judith A; Davidson-Ray, Linda; Al-Khatib, Sana M; Ansell, Jack; Dorian, Paul; Husted, Steen; McMurray, John J V; Steg, P Gabriel; Alexander, John H; Wallentin, Lars; Granger, Christopher B; Mark, Daniel B

2017-05-01

The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial reported that apixaban therapy was superior to warfarin therapy in preventing stroke and all-cause death while causing significantly fewer major bleeds. To establish the value proposition of substituting apixiban therapy for warfarin therapy in patients with atrial fibrillation, we performed a cost-effectiveness analysis using patient-level data from the ARISTOTLE trial. To assess the cost and cost-effectiveness of apixaban therapy compared with warfarin therapy in patients with atrial fibrillation from the perspective of the US health care system. This economic analysis uses patient-level resource use and clinical data collected in the ARISTOTLE trial, a multinational randomized clinical trial that observed 18 201 patients (3417 US patients) for a median of 1.8 years between 2006 and 2011. Apixaban therapy vs warfarin therapy. Within-trial resource use and cost were compared between treatments, using externally derived US cost weights. Life expectancies for US patients were estimated according to their baseline risk and treatment using time-based and age-based survival models developed using the overall ARISTOTLE population. Quality-of-life adjustment factors were obtained from external sources. Cost-effectiveness (incremental cost per quality-adjusted life-year gained) was evaluated from a US perspective, and extensive sensitivity analyses were performed. Of the 3417 US patients enrolled in ARISTOTLE, the mean (SD) age was 71 (10) years; 2329 (68.2%) were male and 3264 (95.5%) were white. After 2 years of anticoagulation therapy, health care costs (excluding the study drug) of patients treated with apixaban therapy and warfarin therapy were not statistically different (difference, -$60; 95% CI, -$2728 to $2608). Life expectancy, modeled from ARISTOTLE outcomes, was significantly longer with apixaban therapy vs warfarin therapy (7.94 vs 7.54 quality-adjusted life years). The incremental cost, including cost of anticoagulant and monitoring, of achieving these benefits was within accepted US norms ($53 925 per quality-adjusted life year, with 98% likelihood of meeting a $100 000 willingness-to-pay threshold). Results were generally consistent when model assumptions were varied, with lifetime cost-effectiveness most affected by the price of apixaban and the time horizon. Apixaban therapy for ARISTOTLE-eligible patients with atrial fibrillation provides clinical benefits at an incremental cost that represents reasonable value for money judged using US benchmarks for cost-effectiveness. clinicaltrials.gov Identifier: NCT00412984.

Economic Analysis of Apixaban Therapy for Patients With Atrial Fibrillation From a US Perspective

PubMed Central

Sheng, Shubin; Lopes, Renato D.; Anstrom, Kevin J.; Stafford, Judith A.; Davidson-Ray, Linda; Al-Khatib, Sana M.; Ansell, Jack; Dorian, Paul; Husted, Steen; McMurray, John J. V.; Steg, P. Gabriel; Alexander, John H.; Wallentin, Lars; Granger, Christopher B.; Mark, Daniel B.

2017-01-01

Importance The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial reported that apixaban therapy was superior to warfarin therapy in preventing stroke and all-cause death while causing significantly fewer major bleeds. To establish the value proposition of substituting apixiban therapy for warfarin therapy in patients with atrial fibrillation, we performed a cost-effectiveness analysis using patient-level data from the ARISTOTLE trial. Objective To assess the cost and cost-effectiveness of apixaban therapy compared with warfarin therapy in patients with atrial fibrillation from the perspective of the US health care system. Design, Setting, and Participants This economic analysis uses patient-level resource use and clinical data collected in the ARISTOTLE trial, a multinational randomized clinical trial that observed 18 201 patients (3417 US patients) for a median of 1.8 years between 2006 and 2011. Interventions Apixaban therapy vs warfarin therapy. Main Outcomes and Measures Within-trial resource use and cost were compared between treatments, using externally derived US cost weights. Life expectancies for US patients were estimated according to their baseline risk and treatment using time-based and age-based survival models developed using the overall ARISTOTLE population. Quality-of-life adjustment factors were obtained from external sources. Cost-effectiveness (incremental cost per quality-adjusted life-year gained) was evaluated from a US perspective, and extensive sensitivity analyses were performed. Results Of the 3417 US patients enrolled in ARISTOTLE, the mean (SD) age was 71 (10) years; 2329 (68.2%) were male and 3264 (95.5%) were white. After 2 years of anticoagulation therapy, health care costs (excluding the study drug) of patients treated with apixaban therapy and warfarin therapy were not statistically different (difference, −$60; 95% CI, −$2728 to $2608). Life expectancy, modeled from ARISTOTLE outcomes, was significantly longer with apixaban therapy vs warfarin therapy (7.94 vs 7.54 quality-adjusted life years). The incremental cost, including cost of anticoagulant and monitoring, of achieving these benefits was within accepted US norms ($53 925 per quality-adjusted life year, with 98% likelihood of meeting a $100 000 willingness-to-pay threshold). Results were generally consistent when model assumptions were varied, with lifetime cost-effectiveness most affected by the price of apixaban and the time horizon. Conclusions and Relevance Apixaban therapy for ARISTOTLE-eligible patients with atrial fibrillation provides clinical benefits at an incremental cost that represents reasonable value for money judged using US benchmarks for cost-effectiveness. Trial Registration clinicaltrials.gov Identifier: NCT00412984 PMID:28355434

Cost-effectiveness of breech version by acupuncture-type interventions on BL 67, including moxibustion, for women with a breech foetus at 33 weeks gestation: a modelling approach.

PubMed

van den Berg, Ineke; Kaandorp, Guido C; Bosch, Johanna L; Duvekot, Johannes J; Arends, Lidia R; Hunink, M G Myriam

2010-04-01

To assess, using a modelling approach, the effectiveness and costs of breech version with acupuncture-type interventions on BL67 (BVA-T), including moxibustion, compared to expectant management for women with a foetal breech presentation at 33 weeks gestation. A decision tree was developed to predict the number of caesarean sections prevented by BVA-T compared to expectant management to rectify breech presentation. The model accounted for external cephalic versions (ECV), treatment compliance, and costs for 10,000 simulated breech presentations at 33 weeks gestational age. Event rates were taken from Dutch population data and the international literature, and the relative effectiveness of BVA-T was based on a specific meta-analysis. Sensitivity analyses were conducted to evaluate the robustness of the results. We calculated percentages of breech presentations at term, caesarean sections, and costs from the third-party payer perspective. Odds ratios (OR) and cost differences of BVA-T versus expectant management were calculated. (Probabilistic) sensitivity analysis and expected value of perfect information analysis were performed. The simulated outcomes demonstrated 32% breech presentations after BVA-T versus 53% with expectant management (OR 0.61, 95% CI 0.43, 0.83). The percentage caesarean section was 37% after BVA-T versus 50% with expectant management (OR 0.73, 95% CI 0.59, 0.88). The mean cost-savings per woman was euro 451 (95% CI euro 109, euro 775; p=0.005) using moxibustion. Sensitivity analysis showed that if 16% or more of women offered moxibustion complied, it was more effective and less costly than expectant management. To prevent one caesarean section, 7 women had to use BVA-T. The expected value of perfect information from further research was euro0.32 per woman. The results suggest that offering BVA-T to women with a breech foetus at 33 weeks gestation reduces the number of breech presentations at term, thus reducing the number of caesarean sections, and is cost-effective compared to expectant management, including external cephalic version. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Robust and efficient anomaly detection using heterogeneous representations

NASA Astrophysics Data System (ADS)

Hu, Xing; Hu, Shiqiang; Xie, Jinhua; Zheng, Shiyou

2015-05-01

Various approaches have been proposed for video anomaly detection. Yet these approaches typically suffer from one or more limitations: they often characterize the pattern using its internal information, but ignore its external relationship which is important for local anomaly detection. Moreover, the high-dimensionality and the lack of robustness of pattern representation may lead to problems, including overfitting, increased computational cost and memory requirements, and high false alarm rate. We propose a video anomaly detection framework which relies on a heterogeneous representation to account for both the pattern's internal information and external relationship. The internal information is characterized by slow features learned by slow feature analysis from low-level representations, and the external relationship is characterized by the spatial contextual distances. The heterogeneous representation is compact, robust, efficient, and discriminative for anomaly detection. Moreover, both the pattern's internal information and external relationship can be taken into account in the proposed framework. Extensive experiments demonstrate the robustness and efficiency of our approach by comparison with the state-of-the-art approaches on the widely used benchmark datasets.

Benefits and disadvantages of self-regulation of environmental noise from military training

NASA Astrophysics Data System (ADS)

Luz, George A.

2002-05-01

In a 1981 Executive decision, the Administration's Office of Management and Budget (OMB) told the Environmental Protection Agency to end funding of the Office of Noise Abatement and Control (ONAC). This decision, coupled with a specific exemption for military equipment contained in the Noise Control Act of 1972, ensured that the military departments would be self-regulating in regard to noise. This self-regulation for noise stands in contrast to the external regulation of other pollutants, such as air and water emissions. Two possible disadvantages of self-regulation are (1) reduced funding for noise management compared with funding for externally regulated pollutants, and (2) lack of an independent and external set of standards for determining acceptable limits on community noise exposure. Three possible benefits are (1) avoiding the costs of mitigating trivial violations of external standards, (2) maintaining a long-standing policy of preventing noise problems through land use planning, and (3) enabling negotiated solutions between installations and their neighboring communities. The paper ends with an examination of a negotiated solution for a community subjected to noise from the detonation of obsolete ammunition.

An update of preliminary perspectives gained from Individual Plant Examination of External Events (IPEEE) submittal reviews

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

Rubin, A.M.; Chen, J.T.; Chokshi, N.

1998-03-01

As a result of the US Nuclear Regulatory Commission (USNRC) initiated Individual Plant Examination of External Events (IPEEE) program, virtually every operating commercial nuclear power reactor in the US has performed an assessment of severe accident risk due to external events. To date, the USNRC staff has received 63 IPEEE submittals and will receive an additional 11 by mid 1998. Currently, 49 IPEEE submittals are under various stages ore view. This paper is based on the information available for those 41 plants for which at least preliminary Technical Evaluation Reports have been prepared by the review teams. The goal ofmore » the review is to ascertain whether the licensee`s IPEEE process is capable of identifying external events-induced severe accident vulnerabilities and cost-effective safety improvements to either eliminate or reduce the impact of these vulnerabilities. The review does not, however, attempt to validate or verify the results of the licensee`s IPEEE. The primary objective of this paper is to provide an update on the preliminary perspectives and insights gained from the IPEEE process.« less

A cost-benefit analysis of a deposit-refund program for beverage containers in Israel.

PubMed

Lavee, Doron

2010-02-01

The paper presents a full cost-benefit analysis of a deposit-refund program for beverage containers in Israel. We examine all cost elements of the program--storage, collection, and treatment costs of empty containers, and all potential benefits--savings in alternative treatment costs (waste collection and landfill disposal), cleaner public spaces, reduction of landfill volumes, energy-savings externalities associated with use of recycled materials, and creation of new workplaces. A wide variety of data resources is employed, and some of the critical issues are examined via several approaches. The main finding of the paper is that the deposit-refund program is clearly economically worthwhile. The paper contributes to the growing body of literature on deposit-refund programs by its complete and detailed analysis of all relevant factors of such a program, and also specifically in its analysis of the savings in alternative waste management costs. This analysis reveals greater savings than are usually assumed, and thus shows the deposit-refund program to be highly efficient.

Space Transportatioin System (STS) propellant scavenging system study. Volume 3: Cost and work breakdown structure-dictionary

NASA Technical Reports Server (NTRS)

1985-01-01

Fundamentally, the volumes of the oxidizer and fuel propellant scavenged from the orbiter and external tank determine the size and weight of the scavenging system. The optimization of system dimensions and weights is stimulated by the requirement to minimize the use of partial length of the orbiter payload bay. Thus, the cost estimates begin with weights established for the optimum design. Both the design, development, test, and evaluation and theoretical first unit hardware production costs are estimated from parametric cost weight scaling relations for four subsystems. For cryogenic propellants, the widely differing characteristics of the oxidizer and the fuel lead to two separate tank subsystems, in addition to the electrical and instrumentation subsystems. Hardwares costs also involve quantity, as an independent variable, since the number of production scavenging systems is not firm. For storable propellants, since the tankage volume of the oxidizer and fuel are equal, the hardware production costs for developing these systems are lower than for cryogenic propellants.

[Costs and benefits of quality management].

PubMed

Schroeder-Printzen, I

2014-01-01

The establishment of quality management (QM) has been mandatory for health care providers of the national health insurance since 2004; however, certification is so far only compulsory for rehabilitation clinics. The costs have so far only been quantified in a few medical studies, while they are widely known in business administration with a basic distinction made between planning, steering, auditing, and declaration costs. Another business economics approach differentiates between prevention, appraisal, and non-conformance costs. The benefits of QM relates to customers, employees, external service providers, and health insurance providers. Also important in our consideration of the patient as a customer is that they should not be considered a customer in the usual business sense because the patient is in an emergency situation and can not freely decide. Improvements in treatment quality and in reducing the rate of adverse events make up the largest portion of the benefits of QM. Furthermore, QM can have a positive influence on motivation and employee recruitment. In addition, the cost savings that result despite costs for QM must not be forgotten.

Statewide Implementation of Parenting with Love and Limits Among Youth with Co-Existing Internalizing and Externalizing Functional Impairments Reduces Return to Service Rates and Treatment Costs.

PubMed

Sterrett-Hong, Emma M; Karam, Eli; Kiaer, Lynn

2017-09-01

Many community mental health (CMH) systems contain inefficiencies, contributing to unmet need for services among youth. Using a quasi-experimental research design, we examined the implementation of an adapted structural-strategic family intervention, Parenting with Love and Limits, in a state CMH system to increase efficiency of services to youth with co-existing internalizing and externalizing functional impairments (PLL n = 296; Treatment-As-Usual n = 296; 54% male; 81% Caucasian). Youth receiving PLL experienced shorter treatment durations and returned to CMH services at significantly lower rates than youth receiving treatment-as-usual. They also demonstrated significant decreases in internalizing and externalizing symptoms over time. Findings lay the foundation for further examination of the role of an adapted structural-strategic family treatment in increasing the efficiency of CMH systems.

Pigouvian taxation of energy for flow and stock externalities and strategic, noncompetitive energy pricing

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

Wirl, F.

1994-01-01

The literature on energy and carbon taxes is by and large concerned about the derivation of (globally) efficient strategies. In contrast, this paper considers the dynamic interactions between cartelized energy suppliers and a consumers' government that collectively taxes energy carriers for Pigouvian motives. Two different kinds of external costs are associated with energy consumption: flow (e.g., acid rain) and stock externalities (e.g., global warming). The dynamic interactions between a consumers' government and a producers' cartel are modeled as a differential game with a subgame perfect Nash equilibrium in linear and nonlinear Markov strategies. The major implications are that the nonlinearmore » solutions are Pareto-inferior to the linear strategies and energy suppliers may preempt energy taxation and thereby may raise the price at front; however, this effect diminishes over time because the producers' price declines, while taxes increase. 22 refs., 5 figs., 1 tab.« less

Air Force Operational Medicine: Using the Enterprise Estimating Supplies Program to Develop Materiel Solutions for the Medical Neurosurgical Team (FFNEU)

DTIC Science & Technology

2010-11-18

6515014978131 CRANIOTOMY -LAMINECTOMY CUSTOM PK FOR NEUROSURG MMS & CSG DEPMEP 30 30 105.00 7.50 17,131.80 105.00 7.50 17,131.80 D 6515003225550 CURETTE MASTOID...6515NCM040995 ASPEN CERVICAL COLLAR ADU 10 1 0.00 0.00 1,250.00 0.00 0.00 125.00 C 6515014687080 BAG DRAINAGE VENTRICULAR USED W/EXTERNAL DRAINAGE SYSTEM 5S 3...EESP cost A 6515013587147 DRAINAGE UNIT EXTERNAL 75ML DRIP CHAMBER W/ANTI REFLUX VALVE 2 2 4.00 0.80 388.80 4.00 0.80 388.80 B 6515015497613 DURAL

Addiction as a market failure: using rational addiction results to justify tobacco regulation.

PubMed

Laux, F L

2000-07-01

Tobacco regulation efforts have been criticized by some academic economists for failing to provide adequate welfare-analytic justification. This paper attempts to address these criticisms. Unlike previous research that has discussed second-hand smoke and health care financing externalities, this paper develops the logic for identifying the much larger market failures attributable to the failure of smokers to fully internalize the costs of their addictive behavior. The focus is on teen addiction as a form of "intrapersonal" externality and observed adult consumption behavior consistent with partial myopia. The importance of peer effects, in the consideration of welfare impacts, is also emphasized.

Tunable External Cavity Quantum Cascade Lasers (EC-QCL): an application field for MOEMS based scanning gratings

NASA Astrophysics Data System (ADS)

Grahmann, Jan; Merten, André; Ostendorf, Ralf; Fontenot, Michael; Bleh, Daniela; Schenk, Harald; Wagner, Hans-Joachim

2014-03-01

In situ process information in the chemical, pharmaceutical or food industry as well as emission monitoring, sensitive trace detection and biological sensing applications would increasingly rely on MIR-spectroscopic anal­ysis in the 3 μm - 12 μm wavelength range. However, cost effective, portable, low power consuming and fast spectrometers with a wide tuning range are not available so far. To provide these MIR-spectrometer properties, the combination of quantum cascade lasers with a MOEMS scanning grating as wavelength selective element in the external cavity is addressed to provide a very compact and fast tunable laser source for spectroscopic analysis.

Insurers’ Negotiating Leverage and the External Effects of Medicare Part D*

PubMed Central

Lakdawalla, Darius; Yin, Wesley

2014-01-01

By influencing the size and bargaining power of private insurers, public subsidization of private health insurance may project effects beyond the subsidized population. We test for such spillovers by analyzing how increases in insurer size resulting from the implementation of Medicare Part D affected drug prices negotiated in the non-Medicare commercial market. On average, Part D lowered prices for commercial enrollees by 3.7%. The external commercial market savings amount to $1.5 billion per year, which, if passed to consumers, approximates the internal cost-savings of newly-insured subsidized beneficiaries. If retained by insurers, it corresponds to a 5% average increase in profitability. PMID:25937676

High power densities from high-temperature material interactions. [in thermionic energy conversion and metallic fluid heat pipes

NASA Technical Reports Server (NTRS)

Morris, J. F.

1981-01-01

Thermionic energy conversion (TEC) and metallic-fluid heat pipes (MFHPs), offering unique advantages in terrestrial and space energy processing by virtue of operating on working-fluid vaporization/condensation cycles that accept great thermal power densities at high temperatures, share complex materials problems. Simplified equations are presented that verify and solve such problems, suggesting the possibility of cost-effective applications in the near term for TEC and MFHP devices. Among the problems discussed are: the limitation of alkali-metal corrosion, protection against hot external gases, external and internal vaporization, interfacial reactions and diffusion, expansion coefficient matching, and creep deformation.

Use of Treated Municipal Wastewater as Power Plant Cooling System Makeup Water: Tertiary Treatment versus Expanded Chemical Regimen for Recirculating Water Quality Management

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

David Dzombak; Radisav Vidic; Amy Landis

Treated municipal wastewater is a common, widely available alternative source of cooling water for thermoelectric power plants across the U.S. However, the biodegradable organic matter, ammonia-nitrogen, carbonate and phosphates in the treated wastewater pose challenges with respect to enhanced biofouling, corrosion, and scaling, respectively. The overall objective of this study was to evaluate the benefits and life cycle costs of implementing tertiary treatment of secondary treated municipal wastewater prior to use in recirculating cooling systems. The study comprised bench- and pilot-scale experimental studies with three different tertiary treated municipal wastewaters, and life cycle costing and environmental analyses of various tertiarymore » treatment schemes. Sustainability factors and metrics for reuse of treated wastewater in power plant cooling systems were also evaluated. The three tertiary treated wastewaters studied were: secondary treated municipal wastewater subjected to acid addition for pH control (MWW_pH); secondary treated municipal wastewater subjected to nitrification and sand filtration (MWW_NF); and secondary treated municipal wastewater subjected nitrification, sand filtration, and GAC adsorption (MWW_NFG). Tertiary treatment was determined to be essential to achieve appropriate corrosion, scaling, and biofouling control for use of secondary treated municipal wastewater in power plant cooling systems. The ability to control scaling, in particular, was found to be significantly enhanced with tertiary treated wastewater compared to secondary treated wastewater. MWW_pH treated water (adjustment to pH 7.8) was effective in reducing scale formation, but increased corrosion and the amount of biocide required to achieve appropriate biofouling control. Corrosion could be adequately controlled with tolytriazole addition (4-5 ppm TTA), however, which was the case for all of the tertiary treated waters. For MWW_NF treated water, the removal of ammonia by nitrification helped to reduce the corrosivity and biocide demand. Also, the lower pH and alkalinity resulting from nitrification reduced the scaling to an acceptable level, without the addition of anti-scalant chemicals. Additional GAC adsorption treatment, MWW_NFG, yielded no net benefit. Removal of organic matter resulted in pitting corrosion in copper and cupronickel alloys. Negligible improvement was observed in scaling control and biofouling control. For all of the tertiary treatments, biofouling control was achievable, and most effectively with pre-formed monochloramine (2-3 ppm) in comparison with NaOCl and ClO2. Life cycle cost (LCC) analyses were performed for the tertiary treatment systems studied experimentally and for several other treatment options. A public domain conceptual costing tool (LC3 model) was developed for this purpose. MWW_SF (lime softening and sand filtration) and MWW_NF were the most cost-effective treatment options among the tertiary treatment alternatives considered because of the higher effluent quality with moderate infrastructure costs and the relatively low doses of conditioning chemicals required. Life cycle inventory (LCI) analysis along with integration of external costs of emissions with direct costs was performed to evaluate relative emissions to the environment and external costs associated with construction and operation of tertiary treatment alternatives. Integrated LCI and LCC analysis indicated that three-tiered treatment alternatives such as MWW_NSF and MWW_NFG, with regular chemical addition for treatment and conditioning and/or regeneration, tend to increase the impact costs and in turn the overall costs of tertiary treatment. River water supply and MWW_F alternatives with a single step of tertiary treatment were associated with lower impact costs, but the contribution of impact costs to overall annual costs was higher than all other treatment alternatives. MWW_NF and MWW_SF alternatives exhibited moderate external impact costs with moderate infrastructure and chemical conditioner dosing, which makes them (especially MWW_NF) better treatment alternatives from the environmental sustainability perspective since they exhibited minimal contribution to environmental damage from emissions.« less

Economics of mining law

USGS Publications Warehouse

Long, K.R.

1995-01-01

Modern mining law, by facilitating socially and environmentally acceptable exploration, development, and production of mineral materials, helps secure the benefits of mineral production while minimizing environmental harm and accounting for increasing land-use competition. Mining investments are sunk costs, irreversibly tied to a particular mineral site, and require many years to recoup. Providing security of tenure is the most critical element of a practical mining law. Governments owning mineral rights have a conflict of interest between their roles as a profit-maximizing landowner and as a guardian of public welfare. As a monopoly supplier, governments have considerable power to manipulate mineral-rights markets. To avoid monopoly rent-seeking by governments, a competitive market for government-owned mineral rights must be created by artifice. What mining firms will pay for mineral rights depends on expected exploration success and extraction costs. Landowners and mining firms will negotlate respective shares of anticipated differential rents, usually allowing for some form of risk sharing. Private landowners do not normally account for external benefits or costs of minerals use. Government ownership of mineral rights allows for direct accounting of social prices for mineral-bearing lands and external costs. An equitable and efficient method is to charge an appropriate reservation price for surface land use, net of the value of land after reclamation, and to recover all or part of differential rents through a flat income or resource-rent tax. The traditional royalty on gross value of production, essentially a regressive income tax, cannot recover as much rent as a flat income tax, causes arbitrary mineral-reserve sterilization, and creates a bias toward development on the extensive margin where marginal environmental costs are higher. Mitigating environmental costs and resolving land-use conflicts require local evaluation and planning. National oversight ensures that the relative global avaliability of minerals and other values are considered, and can also promote adaptive efficiency by publicizing creative local solutions, providing technical support, and funding useful research. ?? 1995 Oxford University Press.

[Radiology in managed care environment: opportunities for cost savings in an HMO].

PubMed

Schmidt, C; Mohr, A; Möller, J; Levin-Scherz, J; Heller, M

2003-09-01

A large regional health plan in the Northeastern United States noted that its radiology costs were increasing more than it anticipated in its pricing, and noted further that other similar health plans in markets with high managed care penetration had significantly lower expenses for radiology services. This study describes the potential areas of improvement and managed care techniques that were implemented to reduce costs and reform processes. We performed an in-depth analysis of financial data, claims logic, contracting with provider units and conducted interviews with employees, to identify potential areas of improvement and cost reduction. A detailed market analysis of the environment, competitors and vendors was accompanied by extensive literature, Internet and Medline search for comparable projects. All data were docu-mented in Microsoft Excel(R) and analyzed by non-parametric tests using SPSS(R) 8.0 (Statistical Package for the Social Sciences) for Windows(R). The main factors driving the cost increases in radiology were divided into those internal or external to the HMO. Among the internal factors, the claims logic was allowing overpayment due to limitations of the IT system. Risk arrangements between insurer and provider units (PU) as well as the extent of provider unit management and administration showed a significant correlation with financial performance in terms of variance from budget. Among the external factors, shared risk arrangements between HMO and provider unit were associated with more efficient radiology utilization and overall improvement in financial performance. PU with full-time management had significantly less variance from their budget than those without. Finally, physicians with imaging equipment in their offices ordered up to 4 to 5 times more imaging procedures than physicians who did not perform imaging studies themselves. We identified initiatives with estimated potential savings of approximately $ 5.5 million. Some of these initiatives are similar to the reforms to reduce cost and improve quality that are already implemented or proposed within the German healthcare system.

The effect of normative social forces on managed care organizations: implications for strategic management.

PubMed

Kirby, E G; Sebastian, J G

1998-01-01

Drawing on institutional theory, this study examines how adherence to a number of "institutional" and "technical" environmental forces can influence the business success of managed care organizations (MCOs). The standards studied include: (1) institutional forces: socially accepted procedures for delivering care (access to quality care, availability of information, and delivery of care in a personal manner); and (2) technical forces: industry standards for cost control and efficient use of financial and medical resources. The most significant finding is that successful MCOs must conform to both institutional and technical forces to be successful. MCOs that conform to either one or the other type of standard were no more successful than those that conformed to neither. These findings have several important implications for MCO strategy. First, to be successful, MCO executives must understand the external environment in which they operate. They must anticipate and respond to shifts in that environment. Second, this understanding of the external environment must place equal emphasis on societal demands (e.g., for accessible care and information) and on technical demands (e.g., for cost-efficient care). These findings may well reflect that once managed care penetration reaches relatively high levels, marketshare can no longer be gained through cost-efficiency alone; rather, enrollee satisfaction based on societal demands becomes a key factor in maintaining and gaining marketshare. Institutional theory provides' some strategies for accomplishing these goals. Cost-containment strategies include implementing policies for cutting costs in areas that do not affect the quality of care, such as using generic drugs and reducing administrative excesses and redundancies. At the same time, MCOs must implement strategies aimed at improving conformity to prevailing societal perceptions of appropriate care, including providing patients more freedom to choose their physicians and encouraging and rewarding care providers for being friendly and personable. An MCO should work to inform the public of the organization's efforts to provide high-quality, low-cost medical care in a friendly, convenient manner.

Mechanics and Energetics of Excavation by Burrowing Wolf Spiders, Geolycosa spp.

PubMed Central

Suter, Robert B.; Stratton, Gail E.; Miller, Patricia R.

2011-01-01

Burrowing wolf spiders, Geolycosa sp. (Araneae:Lycosidae), excavate vertical burrows and inhabit them throughout their lives or, in the case of males, until they mature and wander in search of mates. Three species: G. fatifera Kurata, G. missouriensis Banks, and G. rogersi Wallace were studied to understand how and at what expense the burrowing is accomplished. Normal and high-speed videography coupled with scanning electron microscopy revealed (a) that the convex surfaces of the two fangs, together, constitute the digging tool, (b) that boluses of soil are transported to the burrow entrance on the anterior surfaces of the chelicerae held there by the pedipalps, and (c) that each bolus is either incorporated into the growing turret or flung away, propelled by the forelegs. To elucidate the energetics of burrow construction, burrow volumes were calculated and then the costs associated with dislodging, elevating, and throwing the known volumes of soil were measured. A typical Geolycosa burrow, at a volume of 23.6 ± 2.0 ml and a depth of 13.2 ± 0.7 cm, required the removal of 918 boluses each weighing about 34 mg. The aggregate dislodging cost was close to 1.9 Joules in sand/sandy loam and 5.6 J in clayey subsoil, the work against gravity necessary to raise all of the boluses to the surface was about 0.13 J, and the aggregate cost of flinging the boluses was close to 0.014 J. Assuming that the ratio of external work to metabolic cost of external work is between 0.20 and 0.25 in spiders, the real cost of burrow construction would be between 8 J and 29 J, depending primarily on soil type. This is a small but not negligible cost when placed in the context of reproductive effort: a single Geolycosa egg, dozens to hundreds of which are produced in a clutch, contains about 10 J. PMID:21529154

The perverse impact of external reference pricing (ERP): a comparison of orphan drugs affordability in 12 European countries. A call for policy change

PubMed Central

Young, K. E.; Soussi, I.; Toumi, M.

2017-01-01

ABSTRACT Objective: The study compared the relative cost differences of similar orphan drugs among high and low GDP countries in Europe: Bulgaria, France, Germany, Greece, Hungary, Italy, Norway, Poland, Romania, Spain, Sweden, UK. Methods: Annual treatment costs per patient were calculated. Relative costs were computed by dividing the costs by each economic parameter: nominal GDP per capita, GDP in PPP per capita, % GDP contributed by the government, government budget per inhabitant, % GDP spent on healthcare, % GDP spent on pharmaceuticals, and average annual salary. An international comparison of the relative costs was done using UK as the reference country and results were analysed descriptively. Results: 120 orphan drugs were included. The median annual costs of orphan drugs in all countries varied minimally (cost ratios: 0.87 to 1.08). When the costs were adjusted using GDP per capita, the EU-5 and Nordic countries maintained minimal difference in median cost. However, the lower GDP countries showed three to six times higher relative costs. The same pattern was evident when costs were adjusted using the other economic parameters. Conclusion: When the country’s ability to pay is taken into consideration, lower GDP countries pay relatively higher costs for similarly available orphan drugs in Europe. PMID:29081920

Decision-makers' preferences for approving new medicines in Wales: a discrete-choice experiment with assessment of external validity.

PubMed

Linley, Warren G; Hughes, Dyfrig A

2013-04-01

Few studies to date have explored the stated preferences of national decision makers for health technology adoption criteria, and none of these have compared stated decision-making behaviours against actual behaviours. Assessment of the external validity of stated preference studies, such as discrete-choice experiments (DCEs), remains an under-researched area. The primary aim was to explore the preferences of All Wales Medicines Strategy Group (AWMSG) appraisal committee and appraisal sub-committee (the New Medicines Group) members ('appraisal committees') for specific new medicines adoption criteria. Secondary aims were to explore the external validity of respondents' stated preferences and the impact of question choice options upon preference structures in DCEs. A DCE was conducted to estimate appraisal committees members' preferences for incremental cost effectiveness, quality-adjusted life-years (QALYs) gained, annual number of patients expected to be treated, the impact of the disease on patients before treatment, and the assessment of uncertainty in the economic evidence submitted for new medicines compared with current UK NHS treatment. Respondents evaluated 28 pairs of hypothetical new medicines, making a primary forced choice between each pair and a more flexible secondary choice, which permitted either, neither or both new medicines to be chosen. The performance of the resultant models was compared against previous AWMSG decisions. Forty-one out of a total of 80 past and present members of AWMSG appraisal committees completed the DCE. The incremental cost effectiveness of new medicines, and the QALY gains they provide, significantly (p < 0.0001) influence recommendations. Committee members were willing to accept higher incremental cost-effectiveness ratios and lower QALY gains for medicines that treat disease impacting primarily upon survival rather than quality of life, and where uncertainty in the cost-effectiveness estimates has been thoroughly explored. The number of patients to be treated by the new medicine did not exert a significant influence upon recommendations. The use of a flexible-choice question format revealed a different preference structure to the forced-choice format, but the performance of the two models was similar. Aggregate decisions of the AWMSG were well predicted by both models, but their sensitivity (64 %, 68 %) and specificity (55 %, 64 %) were limited. A willingness to trade the cost effectiveness and QALY gains against other factors indicates that economic efficiency and QALY maximisation are not the only considerations of committee members when making recommendations on the use of medicines in Wales. On average, appraisal committee members' stated preferences appear consistent with their actual decision-making behaviours, providing support for the external validity of our DCEs. However, as health technology assessment involves complex decision-making processes, and each individual recommendation may be influenced to varying degrees by a multitude of different considerations, the ability of our models to predict individual medicine recommendations is more limited.

An Approach for Economic Analysis of Intermodal Transportation

PubMed Central

Sahin, Bahri; Ust, Yasin; Guneri, Ali Fuat; Gulsun, Bahadir; Turan, Eda

2014-01-01

A different intermodal transportation model based on cost analysis considering technical, economical, and operational parameters is presented. The model consists of such intermodal modes as sea-road, sea-railway, road-railway, and multimode of sea-road-railway. A case study of cargo transportation has been carried out by using the suggested model. Then, the single road transportation mode has been compared to intermodal modes in terms of transportation costs. This comparison takes into account the external costs of intermodal transportation. The research reveals that, in the short distance transportation, single transportation modes always tend to be advantageous. As the transportation distance gets longer, intermodal transportation advantages begin to be effective on the costs. In addition, the proposed method in this study leads to determining the fleet size and capacity for transportation and the appropriate transportation mode. PMID:25152919

An approach for economic analysis of intermodal transportation.

PubMed

Sahin, Bahri; Yilmaz, Huseyin; Ust, Yasin; Guneri, Ali Fuat; Gulsun, Bahadir; Turan, Eda

2014-01-01

A different intermodal transportation model based on cost analysis considering technical, economical, and operational parameters is presented. The model consists of such intermodal modes as sea-road, sea-railway, road-railway, and multimode of sea-road-railway. A case study of cargo transportation has been carried out by using the suggested model. Then, the single road transportation mode has been compared to intermodal modes in terms of transportation costs. This comparison takes into account the external costs of intermodal transportation. The research reveals that, in the short distance transportation, single transportation modes always tend to be advantageous. As the transportation distance gets longer, intermodal transportation advantages begin to be effective on the costs. In addition, the proposed method in this study leads to determining the fleet size and capacity for transportation and the appropriate transportation mode.

Material and energy recovery in integrated waste management systems: a life-cycle costing approach.

PubMed

Massarutto, Antonio; de Carli, Alessandro; Graffi, Matteo

2011-01-01

A critical assumption of studies assessing comparatively waste management options concerns the constant average cost for selective collection regardless the source separation level (SSL) reached, and the neglect of the mass constraint. The present study compares alternative waste management scenarios through the development of a desktop model that tries to remove the above assumption. Several alternative scenarios based on different combinations of energy and materials recovery are applied to two imaginary areas modelled in order to represent a typical Northern Italian setting. External costs and benefits implied by scenarios are also considered. Scenarios are compared on the base of the full cost for treating the total waste generated in the area. The model investigates the factors that influence the relative convenience of alternative scenarios. Copyright © 2011 Elsevier Ltd. All rights reserved.

Open innovation and external sources of innovation. An opportunity to fuel the R&D pipeline and enhance decision making?

PubMed

Schuhmacher, Alexander; Gassmann, Oliver; McCracken, Nigel; Hinder, Markus

2018-05-08

Historically, research and development (R&D) in the pharmaceutical sector has predominantly been an in-house activity. To enable investments for game changing late-stage assets and to enable better and less costly go/no-go decisions, most companies have employed a fail early paradigm through the implementation of clinical proof-of-concept organizations. To fuel their pipelines, some pioneers started to complement their internal R&D efforts through collaborations as early as the 1990s. In recent years, multiple extrinsic and intrinsic factors induced an opening for external sources of innovation and resulted in new models for open innovation, such as open sourcing, crowdsourcing, public-private partnerships, innovations centres, and the virtualization of R&D. Three factors seem to determine the breadth and depth regarding how companies approach external innovation: (1) the company's legacy, (2) the company's willingness and ability to take risks and (3) the company's need to control IP and competitors. In addition, these factors often constitute the major hurdles to effectively leveraging external opportunities and assets. Conscious and differential choices of the R&D and business models for different companies and different divisions in the same company seem to best allow a company to fully exploit the potential of both internal and external innovations.

Nurse manager succession planning: A cost-benefit analysis.

PubMed

Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R

2018-03-01

This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.

Replacing Ambulatory Surgical Follow-Up Visits With Mobile App Home Monitoring: Modeling Cost-Effective Scenarios

PubMed Central

Semple, John L; Coyte, Peter C

2014-01-01

Background Women’s College Hospital (WCH) offers specialized surgical procedures, including ambulatory breast reconstruction in post-mastectomy breast cancer patients. Most patients receiving ambulatory surgery have low rates of postoperative events necessitating clinic visits. Increasingly, mobile monitoring and follow-up care is used to overcome the distance patients must travel to receive specialized care at a reduced cost to society. WCH has completed a feasibility study using a mobile app (QoC Health Inc, Toronto) that suggests high patient satisfaction and adequate detection of postoperative complications. Objective The proposed cost-effectiveness study models the replacement of conventional, in-person postoperative follow-up care with mobile app follow-up care following ambulatory breast reconstruction in post-mastectomy breast cancer patients. Methods This is a societal perspective cost-effectiveness analysis, wherein all costs are assessed irrespective of the payer. The patient/caregiver, health care system, and externally borne costs are calculated within the first postoperative month based on cost information provided by WCH and QoC Health Inc. The effectiveness of telemedicine and conventional follow-up care is measured as successful surgical outcomes at 30-days postoperative, and is modeled based on previous clinical trials containing similar patient populations and surgical risks. Results This costing assumes that 1000 patients are enrolled in bring-your-own-device (BYOD) mobile app follow-up per year and that 1.64 in-person follow-ups are attended in the conventional arm within the first month postoperatively. The total cost difference between mobile app and in-person follow-up care is $245 CAD ($223 USD based on the current exchange rate), with in-person follow-up being more expensive ($381 CAD) than mobile app follow-up care ($136 CAD). This takes into account the total of health care system, patient, and external borne costs. If we examine health care system costs alone, in-person follow-up is $38 CAD ($35 USD) more expensive than mobile app follow-up care over the first postoperative month. The baseline difference in effect is modeled to be zero based on clinical trials examining the effectiveness of telephone follow-up care in similar patient populations. An incremental cost-effectiveness ratio (ICER) is not reportable in this scenario. An incremental net benefit (INB) is reportable, and reflects merely the cost difference between the two interventions for any willingness-to-pay value (INB=$245 CAD). The cost-effectiveness of mobile app follow-up even holds in scenarios where all mobile patients attend one in-person follow-up. Conclusions Mobile app follow-up care is suitably targeted to low-risk postoperative ambulatory patients. It can be cost-effective from a societal and health care system perspective. PMID:25245774

Taxation of United States general aviation

NASA Astrophysics Data System (ADS)

Sobieralski, Joseph Bernard

General aviation in the United States has been an important part of the economy and American life. General aviation is defined as all flying excluding military and scheduled airline operations, and is utilized in many areas of our society. The majority of aircraft operations and airports in the United States are categorized as general aviation, and general aviation contributes more than one percent to the United States gross domestic product each year. Despite the many benefits of general aviation, the lead emissions from aviation gasoline consumption are of great concern. General aviation emits over half the lead emissions in the United States or over 630 tons in 2005. The other significant negative externality attributed to general aviation usage is aircraft accidents. General aviation accidents have caused over 8000 fatalities over the period 1994-2006. A recent Federal Aviation Administration proposed increase in the aviation gasoline tax from 19.4 to 70.1 cents per gallon has renewed interest in better understanding the implications of such a tax increase as well as the possible optimal rate of taxation. Few studies have examined aviation fuel elasticities and all have failed to study general aviation fuel elasticities. Chapter one fills that gap and examines the elasticity of aviation gasoline consumption in United States general aviation. Utilizing aggregate time series and dynamic panel data, the price and income elasticities of demand are estimated. The price elasticity of demand for aviation gasoline is estimated to range from -0.093 to -0.185 in the short-run and from -0.132 to -0.303 in the long-run. These results prove to be similar in magnitude to automobile gasoline elasticities and therefore tax policies could more closely mirror those of automobile tax policies. The second chapter examines the costs associated with general aviation accidents. Given the large number of general aviation operations as well as the large number of fatalities and injuries attributed to general aviation accidents in the United States, understanding the costs to society is of great importance. This chapter estimates the direct and indirect costs associated with general aviation accidents in the United States. The indirect costs are estimated via the human capital approach in addition to the willingness-to-pay approach. The average annual accident costs attributed to general aviation are found to be 2.32 billion and 3.81 billion (2006 US) utilizing the human capital approach and willingness-to-pay approach, respectively. These values appear to be fairly robust when subjected to a sensitivity analysis. These costs highlight the large societal benefits from accident and fatality reduction. The final chapter derives a second-best optimal aviation gasoline tax developed from previous general equilibrium frameworks. This optimal tax reflects both the lead pollution and accident externalities, as well as the balance between excise taxes and labor taxes to finance government spending. The calculated optimal tax rate is 4.07 per gallon, which is over 20 times greater than the current tax rate and 5 times greater than the Federal Aviation Administration proposed tax rate. The calculated optimal tax rate is also over 3 times greater than automobile gasoline optimal tax rates calculated by previous studies. The Pigovian component is 1.36, and we observe that the accident externality is taxed more severely than the pollution externality. The largest component of the optimal tax rate is the Ramsey component. At 2.70, the Ramsey component reflects the ability of the government to raise revenue aviation gasoline which is price inelastic. The calculated optimal tax is estimated to reduce lead emissions by over 10 percent and reduce accidents by 20 percent. Although unlikely to be adopted by policy makers, the optimal tax benefits are apparent and it sheds light on the need to reduce these negative externalities via policy changes.

Development and validation of a Markov microsimulation model for the economic evaluation of treatments in osteoporosis.

PubMed

Hiligsmann, Mickaël; Ethgen, Olivier; Bruyère, Olivier; Richy, Florent; Gathon, Henry-Jean; Reginster, Jean-Yves

2009-01-01

Markov models are increasingly used in economic evaluations of treatments for osteoporosis. Most of the existing evaluations are cohort-based Markov models missing comprehensive memory management and versatility. In this article, we describe and validate an original Markov microsimulation model to accurately assess the cost-effectiveness of prevention and treatment of osteoporosis. We developed a Markov microsimulation model with a lifetime horizon and a direct health-care cost perspective. The patient history was recorded and was used in calculations of transition probabilities, utilities, and costs. To test the internal consistency of the model, we carried out an example calculation for alendronate therapy. Then, external consistency was investigated by comparing absolute lifetime risk of fracture estimates with epidemiologic data. For women at age 70 years, with a twofold increase in the fracture risk of the average population, the costs per quality-adjusted life-year gained for alendronate therapy versus no treatment were estimated at €9105 and €15,325, respectively, under full and realistic adherence assumptions. All the sensitivity analyses in terms of model parameters and modeling assumptions were coherent with expected conclusions and absolute lifetime risk of fracture estimates were within the range of previous estimates, which confirmed both internal and external consistency of the model. Microsimulation models present some major advantages over cohort-based models, increasing the reliability of the results and being largely compatible with the existing state of the art, evidence-based literature. The developed model appears to be a valid model for use in economic evaluations in osteoporosis.

Who pays for obesity?

PubMed

Bhattacharya, Jay; Sood, Neeraj

2011-01-01

Adult obesity is a growing problem. From 1962 to 2006, obesity prevalence nearly tripled to 35.1 percent of adults. The rising prevalence of obesity is not limited to a particular socioeconomic group and is not unique to the United States. Should this widespread obesity epidemic be a cause for alarm? From a personal health perspective, the answer is an emphatic "yes." But when it comes to justifications of public policy for reducing obesity, the analysis becomes more complex. A common starting point is the assertion that those who are obese impose higher health costs on the rest of the population—a statement which is then taken to justify public policy interventions. But the question of who pays for obesity is an empirical one, and it involves analysis of how obese people fare in labor markets and health insurance markets. We will argue that the existing literature on these topics suggests that obese people on average do bear the costs and benefits of their eating and exercise habits. We begin by estimating the lifetime costs of obesity. We then discuss the extent to which private health insurance pools together obese and thin, whether health insurance causes obesity, and whether being fat might actually cause positive externalities for those who are not obese. If public policy to reduce obesity is not justified on the grounds of external costs imposed on others, then the remaining potential justification would need to be on the basis of helping people to address problems of ignorance or self-control that lead to obesity. In the conclusion, we offer a few thoughts about some complexities of such a justification.

Outsourcing Instruction: Issues for Public Colleges and Universities. Policy Matters: A Higher Education Policy Brief

ERIC Educational Resources Information Center

Russell, Alene

2010-01-01

Outsourcing--defined as an "institution's decision to contract with an external organization to provide a traditional function or service" (IHEP, 2005)--is nothing new to higher education. For decades, institutions have been "contracting out" or "privatizing" a variety of operational functions, hoping to reduce costs,…

Ecosystem Decision Support: A Living Database of Existing Tools, Approaches and Techniques for Supporting Decisions Related to Ecosystem Services

EPA Science Inventory

Planners and decision makers are challenged to consider not only direct market costs, but also ecological externalities. There is an increasing emphasis on ecosystem services in the context of human well-being, and therefore the valuation and accounting of ecosystem services is b...

Honeycomb chassis for electronic components

NASA Technical Reports Server (NTRS)

Read, W. S.; Stebbins, B. W.

1977-01-01

In new electronic chassis support, machined honeycomb members are used to change basic relationship between chassis and support structure. Improved chassis combines internal and external support and heat dissipation by altering chassis internal geometry. Honeycomb materials allow mechanical support and thermal load sharing to be combined at lower weight and lower cost than previous equipment.

76 FR 75922 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... portfolios holding equity securities will bear an external cost burden of $1,000 per portfolio to prepare and... a small business investment company registered on Form N-5 (``Funds''), to file Form N- PX not later... comprised of 6,200 portfolios holding equity securities and 3,800 portfolios holding no equity securities...

Blood Lifestyle: Externalizing the Cost of Human Life

ERIC Educational Resources Information Center

Model, David

2012-01-01

To build postsecondary institutions that educate responsible citizens as well as competent employees and consumers, it is important that people must teach and learn themselves about the context--domestic and global--in which work is to be done, and the purposes which economic and technological development serve. One aspect of that context is the…

78 FR 31860 - Airworthiness Directives; Bell Helicopter Textron, Inc., Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-28

... altitude between the pick-up and drop-off point. We have determined that other external load lift... following costs in order to comply with this AD. It would take about 1 work-hour for the record keeping... would not have federalism implications under Executive Order 13132. This proposed AD would not have a...

An Investigation of the Perceptions of Business Students Regarding Non-Traditional Business Education Formats.

ERIC Educational Resources Information Center

Barnes, John W.; Hadjimarcou, John

1999-01-01

A survey of 118 undergraduate business students at a major southwestern university found that most consider non-traditional education as a viable option to traditional education. However, respondents also identified disadvantages of non-traditional programs, such as cost, external validity of degrees, and impersonalized learning environment.…

Internal and External Regulation to Support Knowledge Construction and Convergence in Computer Supported Collaborative Learning (CSCL)

ERIC Educational Resources Information Center

Romero, Margarida; Lambropoulos, Niki

2011-01-01

Computer Supported Collaborative Learning (CSCL) activities aim to promote collaborative knowledge construction and convergence. During the CSCL activity, the students should regulate their learning activity, at the individual and collective level. This implies an organisation cost related to the coordination of the activity with the team-mates…

Family Business or Social Problem? The Cost of Unreported Domestic Violence

ERIC Educational Resources Information Center

Carrell, Scott E.; Hoekstra, Mark

2012-01-01

Social interest in problems such as domestic violence is typically motivated by concerns regarding equity, rather than efficiency. However, we document that taking steps to reduce domestic violence by reporting it yields substantial benefits to external parties. Specifically, we find that although children exposed to as-yet-unreported domestic…

Dikin-type algorithms for dextrous grasping force optimization

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

Buss, M.; Faybusovich, L.; Moore, J.B.

1998-08-01

One of the central issues in dextrous robotic hand grasping is to balance external forces acting on the object and at the same time achieve grasp stability and minimum grasping effort. A companion paper shows that the nonlinear friction-force limit constraints on grasping forces are equivalent to the positive definiteness of a certain matrix subject to linear constraints. Further, compensation of the external object force is also a linear constraint on this matrix. Consequently, the task of grasping force optimization can be formulated as a problem with semidefinite constraints. In this paper, two versions of strictly convex cost functions, onemore » of them self-concordant, are considered. These are twice-continuously differentiable functions that tend to infinity at the boundary of possible definiteness. For the general class of such cost functions, Dikin-type algorithms are presented. It is shown that the proposed algorithms guarantee convergence to the unique solution of the semidefinite programming problem associated with dextrous grasping force optimization. Numerical examples demonstrate the simplicity of implementation, the good numerical properties, and the optimality of the approach.« less

A beamline systems model for Accelerator-Driven Transmutation Technology (ADTT) facilities

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

Todd, A.M.M.; Paulson, C.C.; Peacock, M.A.

1995-10-01

A beamline systems code, that is being developed for Accelerator-Driven Transmutation Technology (ADTT) facility trade studies, is described. The overall program is a joint Grumman, G.H. Gillespie Associates (GHGA) and Los Alamos National Laboratory effort. The GHGA Accelerator Systems Model (ASM) has been adopted as the framework on which this effort is based. Relevant accelerator and beam transport models from earlier Grumman systems codes are being adapted to this framework. Preliminary physics and engineering models for each ADTT beamline component have been constructed. Examples noted include a Bridge Coupled Drift Tube Linac (BCDTL) and the accelerator thermal system. A decisionmore » has been made to confine the ASM framework principally to beamline modeling, while detailed target/blanket, balance-of-plant and facility costing analysis will be performed externally. An interfacing external balance-of-plant and facility costing model, which will permit the performance of iterative facility trade studies, is under separate development. An ABC (Accelerator Based Conversion) example is used to highlight the present models and capabilities.« less

A beamline systems model for Accelerator-Driven Transmutation Technology (ADTT) facilities

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

Todd, Alan M. M.; Paulson, C. C.; Peacock, M. A.

1995-09-15

A beamline systems code, that is being developed for Accelerator-Driven Transmutation Technology (ADTT) facility trade studies, is described. The overall program is a joint Grumman, G. H. Gillespie Associates (GHGA) and Los Alamos National Laboratory effort. The GHGA Accelerator Systems Model (ASM) has been adopted as the framework on which this effort is based. Relevant accelerator and beam transport models from earlier Grumman systems codes are being adapted to this framework. Preliminary physics and engineering models for each ADTT beamline component have been constructed. Examples noted include a Bridge Coupled Drift Tube Linac (BCDTL) and the accelerator thermal system. Amore » decision has been made to confine the ASM framework principally to beamline modeling, while detailed target/blanket, balance-of-plant and facility costing analysis will be performed externally. An interfacing external balance-of-plant and facility costing model, which will permit the performance of iterative facility trade studies, is under separate development. An ABC (Accelerator Based Conversion) example is used to highlight the present models and capabilities.« less

International Microgrid Assessment. Governance, INcentives, and Experience (IMAGINE)

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

Marnay, Chris; Zhou, Nan; Qu, Min

Microgrids can provide an avenue for increasing the amount of distributed generation and delivery of electricity, where control is more dispersed and quality of service is locally tailored to end-use requirements. Much of this functionality is very different from the predominant utility model to date of centralized power production which is then transmitted and distributed across long distances with a uniform quality of service. This different functionality holds much promise for positive change, in terms of increasing reliability, energy efficiency, and renewable energy while decreasing and carbon emissions. All of these functions should provide direct cost savings for customers andmore » utilities as well as positive externalities for society. As we have seen from the international experience, allowing microgrids to function in parallel with the grid requires some changes in electricity governance and incentives to capture cost savings and actively price in positive externalities. If China can manage to implement these governance changes and create those incentive policies, it will go beyond the establishment of a successful microgrid demonstration program and become an international leader in microgrid deployment.« less

A Novel Intracranial Pressure Readout Circuit for Passive Wireless LC Sensor.

PubMed

Wang, Fa; Zhang, Xuan; Shokoueinejad, Mehdi; Iskandar, Bermans J; Medow, Joshua E; Webster, John G

2017-10-01

We present a wide frequency range, low cost, wireless intracranial pressure monitoring system, which includes an implantable passive sensor and an external reader. The passive sensor consists of two spiral coils and transduces the pressure change to a resonant frequency shift. The external portable reader reads out the sensor's resonant frequency over a wide frequency range (35 MHz-2.7 GHz). We propose a novel circuit topology, which tracks the system's impedance and phase change at a high frequency with low-cost components. This circuit is very simple and reliable. A prototype has been developed, and measurement results demonstrate that the device achieves a suitable measurement distance (>2 cm), sufficient sample frequency (>6 Hz), fine resolution, and good measurement accuracy for medical practice. Responsivity of this prototype is 0.92 MHz/mmHg and resolution is 0.028 mmHg. COMSOL specific absorption rate simulation proves that this system is safe. Considerations to improve the device performance have been discussed, which include the size of antenna, the power radiation, the Analog-to-digital converter (ADC) choice, and the signal processing algorithm.

United States biomass energy: An assessment of costs and infrastructure for alternative uses of biomass energy crops as an energy feedstock

NASA Astrophysics Data System (ADS)

Morrow, William Russell, III

Reduction of the negative environmental and human health externalities resulting from both the electricity and transportation sectors can be achieved through technologies such as clean coal, natural gas, nuclear, hydro, wind, and solar photovoltaic technologies for electricity; reformulated gasoline and other fossil fuels, hydrogen, and electrical options for transportation. Negative externalities can also be reduced through demand reductions and efficiency improvements in both sectors. However, most of these options come with cost increases for two primary reasons: (1) most environmental and human health consequences have historically been excluded from energy prices; (2) fossil energy markets have been optimizing costs for over 100 years and thus have achieved dramatic cost savings over time. Comparing the benefits and costs of alternatives requires understanding of the tradeoffs associated with competing technology and lifestyle choices. As bioenergy is proposed as a large-scale feedstock within the United States, a question of "best use" of bioenergy becomes important. Bioenergy advocates propose its use as an alternative energy resource for electricity generation and transportation fuel production, primarily focusing on ethanol. These advocates argue that bioenergy offers environmental and economic benefits over current fossil energy use in each of these two sectors as well as in the U.S. agriculture sector. Unfortunately, bioenergy research has offered very few comparisons of these two alternative uses. This thesis helps fill this gap. This thesis compares the economics of bioenergy utilization by a method for estimating total financial costs for each proposed bioenergy use. Locations for potential feedstocks and bio-processing facilities (co-firing switchgrass and coal in existing coal fired power plants and new ethanol refineries) are estimated and linear programs are developed to estimate large-scale transportation infrastructure costs for each sector. Each linear program minimizes required bioenergy distribution and infrastructure costs. Truck and rail are the only two transportation modes allowed as they are the most likely bioenergy transportation modes. Switchgrass is chosen as a single bioenergy feedstock. All resulting costs are presented in units which reflect current energy markets price norms (¢/kWh, $/gal). The use of a common metric, carbon-dioxide emissions, allows a comparison of the two proposed uses. Additional analysis is provided to address aspects of each proposed use which are not reflected by a carbon-dioxide reduction metric. (Abstract shortened by UMI.)

Causes analysis on the serious defect of enterprise environmental responsibility—Based on the perspective of law and economics

NASA Astrophysics Data System (ADS)

Fa, L. N.

2017-11-01

As the important Environmental Interests of Subjects, enterprises behoove to undertake the corresponding responsibility of Pollution Control and Environmental Protection. The current situations in our country, however, appear as the serious lack of enterprise environmental responsibility. Based on the analysis of law and economics, this article reaches the conclusion through game analysis and cost-benefit analysis that the prisoners dilemma of environmental interest game between enterprises is the inherent causes for the serious defect of enterprise environmental responsibility. Meanwhile, at the point of cost-benefit, the externality of environment illegal act results in the imbalanced cost-benefit, lacking of the motivation to control pollution and protect environment in an active way.

Mechanical work and energy consumption in children with cerebral palsy after single-event multilevel surgery.

PubMed

Marconi, Valeria; Hachez, Hélèn; Renders, Anne; Docquier, Pierre-Louis; Detrembleur, Chrisitine

2014-09-01

Multilevel surgery is commonly performed to improve walking in children with cerebral palsy (CP). Classical gait analysis (kinetics, kinematics) demonstrated positive outcomes after this intervention, however it doesn't give global indication about gait's features. The assessment of energy cost and mechanical work of locomotion can provide an overall description of walking functionality. Therefore, we propose to describe the effects of multilevel surgery in children with CP, considering energetics, mechanical work, kinetic and kinematic of walking. We measured external, internal, total work, energy cost, recovery, efficiency, kinetic and kinematic of walking in 10 children with CP (4 girls, 6 boys; 13 years ± 2) before and 1 year after multilevel surgery. Kinetic and kinematic results are partially comparable to previous findings, energy cost of walking is significantly reduced (p < 0.05); external, internal, total work, recovery, efficiency are not significantly different (p = 0.129; p = 0.147; p = 0.795; p = 0.119; p = 0.21). The improvement of the walking's energy consumption is not accompanied by a corresponding improvement of mechanical work. Therefore it is conceivable that the improvement of walking economy depend on a reduced effort of the muscle to maintain the posture, rather then to an improvement of the mechanism of energy recovery typical of human locomotion. Copyright © 2014 Elsevier B.V. All rights reserved.

Antimicrobial sensitivity--A natural resource to be protected by a Pigouvian tax?

PubMed

Vågsholm, Ivar; Höjgård, Sören

2010-08-01

Since their discovery more than 70 years ago antibiotic drugs have been efficient tools for treating bacterial infections, and their use has reduced the number of fatalities and the suffering from bacterial diseases. However, the use of antibiotics may lead to resistance to the same or other antibiotics. The risk of resistance appears to be larger in veterinary medicine, since antibiotics have been given as feed-additives in animal production, the amounts given are larger, and the risk of selecting the wrong antibiotic is higher due to lack of diagnostic facilities. Historically, as resistance developed, new classes of antibiotics were developed, but today however, the flow of new substances has slowed. The resistance that arises from antibiotic use is a negative externality or a cost that is not included in the price of antibiotics since it affects the public good of antibiotic sensitivity. The negative externality implies that antibiotic consumption becomes too high. Antibiotic use can be restricted by e.g., prohibiting the use in animal feeding stuffs, prescription only use, or banning the use for animals or by using economic incentives, but restrictions on antibiotic use could have negative effects on the development of new antimicrobials since restrictions might reduce the profitability of such efforts to the pharmaceutical industry. It is therefore of interest to see what economic theory can contribute towards a solution. The objective of this study is to examine if a Pigouvian tax is an option for balancing the externalities and incentives for veterinary drug use. However, as a practical solution, it is suggested to use the costs of developing new antibiotics for determining the tax. The magnitude the tax based on European Union numbers ranges between 29 and 287euro per kilogram active substance or between 9 and 86% of the average price of commonly used antibiotics depending on the foreseen period in years (1-10 years) between the development of a new antibiotic drug. Hence, the sensitivity of bacteria to antibiotics should be managed as a finite natural resource. A tax based on the expected costs of development new antibiotic substances may offer a practical option for balancing the incentives and externalities of antibiotic use and development. Copyright 2010 Elsevier B.V. All rights reserved.

Capturing the externalities: National and watershed scale damages from release of reactive nitrogen beyond the farm, factory, tailpipe and table

NASA Astrophysics Data System (ADS)

Compton, J.; Sobota, D. J.; McCrackin, M. L.; Harrison, J.

2014-12-01

Human demand for food, fuel, and industrial products results in the release of 61% of the newly fixed anthropogenic N to the environment in the US each year. This 15.8 Tg N yr-1 input to air, land and water has important social, economic and environmental consequences, yet little research clearly links this N release to the full suite of effects. Here we connect the biogeochemical fluxes of N with existing data on N-associated damages in order to quantify the externalities of N release related to human health, ecosystems and climate regulation for the US at national and watershed scales. Release of N to the environment was estimated circa 2000 with models describing N inputs by source, nutrient uptake efficiency, leaching losses, and gaseous emissions at the scale of 8-digit US Geologic Survey Hydrologic Unit Codes (HUC8s). Potential damages or benefits of anthropogenic N leaked to the environment were calculated by scaling specific N fluxes with the costs associated with human health, agriculture, ecosystems, and the climate system. For the US, annual damage costs of anthropogenic N leaked to the environment in 2000 totaled 289 billion USD. Approximately 57% of the total damages were associated with fossil fuel combustion, driven by the human respiratory health impacts of NOx as a precursor of ozone and a component of particulates. Another 37% of the damage costs were associated with agricultural N. Damages associated with agriculture were 85.5 billion, largely through eutrophication and harmful effects on aquatic habitat. Through aggressive but tangible improvements in atmospheric emissions, agricultural N use and wastewater treatment, we could reduce N export to the coast by nearly 25% within 30 years. These improvements would reduce the externalities associated with the leakage of N beyond its intended uses in agriculture, transportation and energy with minimal impact to these sectors dependent on anthropogenic N fixation.

Effect of day-night cycle on distribution of food intake and economic choice among imposed food opportunities in mice.

PubMed

Minaya, Dulce M; Rowland, Neil E; Robertson, Kimberly L

2016-10-01

We have shown previously that mice given access to four discrete feeding opportunities (FOs) per day show a characteristic sequence of sizes across ordinal FOs. The purpose of the present experiments was to determine the relative contributions of external and internal factors on the sequencing of FO size. The external factors were the light:dark Zeitgeber and the cost of food, imposed via different fixed unit prices (FUP) in a closed operant economy, and the internal factors were signals relating to energy status including time since last food and weight loss. In the first experiment, mice were given 4 FOs spaced 4-h apart, but with the timing of the FOs relative to the Zeitgeber altered by a 4-h Zeitgeber advance or delay of the cycle. Food intake, and associated body weight, declined as price increased, but the temporal order of FO size was invariant within a Zeitgeber condition. The Zeitgeber advanced group showed clear evidence of a shift in meal sequence relating to the light:dark cycle. Thus, external factors seem to be a more important determinant of total intake and sequencing than internal factors. In the second experiment, mice were given the choice between continuous costly (CC) and intermittent inexpensive (II) food. II food was available for four-15min intervals every 4-h, and the timing of the 15min intervals was varied relative to the Zeitgeber cycle. In spite of a 20-fold difference in price between CC and II food, mice took approximately equal amounts from each, and all food intake took place during the dark phase. Mice consumed II food only if it was available during the dark phase. Food intake was strongly linked to the light:dark cycle, largely independent of food cost. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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

2017-01-01

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

Simultaneous signal transmission of different data-rates in a DWDM system employing external injection locking technique

NASA Astrophysics Data System (ADS)

Das, Anindya Sundar; Patra, Ardhendu Sekhar

2014-12-01

A novel architecture of DWDM-PON is proposed and demonstrated for downlink transmission of different data-rates of 622 Mbps, 1 Gbps, 1.25 Gbps and 2.5 Gbps simultaneously over a long-haul single mode fiber (SMF). The data rates are directly modulated by Fabry-Pérot laser diodes (FPLD), which are externally injection locked by asynchronous spontaneous emission (ASE) source. The transmission performances are checked by the bit error rate (BER), Quality (Q) factor and clear eye-diagrams. Since this proposed system consists of one ASE source, FPLDs and depends on the direct modulation technique, it reveals a prominent alternative with advantages in simplicity and cost.

Applying Organization Theory to Understanding the Adoption and Implementation of Accountable Care Organizations: Commentary.

PubMed

Shortell, Stephen M

2016-12-01

This commentary highights the key arguments and contributions of institutional thoery, transaction cost economics (TCE) theory, high reliability theory, and organizational learning theory to understanding the development and evolution of Accountable Care Organizations (ACOs). Institutional theory and TCE theory primarily emphasize the external influences shaping ACOs while high reliability theory and organizational learning theory underscore the internal fctors influencing ACO perfromance. A framework based on Implementation Science is proposed to conside the multiple perspectives on ACOs and, in particular, their abiity to innovate to achieve desired cost, quality, and population health goals. © The Author(s) 2016.

Use of optimization to predict the effect of selected parameters on commuter aircraft performance

NASA Technical Reports Server (NTRS)

Wells, V. L.; Shevell, R. S.

1982-01-01

An optimizing computer program determined the turboprop aircraft with lowest direct operating cost for various sets of cruise speed and field length constraints. External variables included wing area, wing aspect ratio and engine sea level static horsepower; tail sizes, climb speed and cruise altitude were varied within the function evaluation program. Direct operating cost was minimized for a 150 n.mi typical mission. Generally, DOC increased with increasing speed and decreasing field length but not by a large amount. Ride roughness, however, increased considerably as speed became higher and field length became shorter.

Net widens for funding of arXiv preprint server

NASA Astrophysics Data System (ADS)

Cartwright, Jon

2010-03-01

Librarians at Cornell University in the US want more external funding to support their popular arXiv preprint server because the running costs are now "beyond a single institution's resources". The open-access server, which received more than 60 000 new submissions last year and has about 400 000 registered users, is expanding so fast that the budget for staff and running costs is expected to rise by a fifth to 500 000 by 2012. Although most of the top 25 institutional users have already made financial commitments, Cornell now wants several hundred others to pledge support too.

In Brief: Hidden environment and health costs of energy

NASA Astrophysics Data System (ADS)

Showstack, Randy

2009-10-01

The hidden costs of energy production and use in the United States amounted to an estimated $120 billion in 2005, according to a 19 October report by the U.S. National Research Council. The report, “Hidden Costs of Energy: Unpriced Consequences of Energy Production and Use,” examines hidden costs, including the cost of air pollution damage to human health, which are not reflected in market prices of energy sources, electricity, or gasoline. The report found that in 2005, the total annual external damages from sulfur dioxide, nitrogen oxides, and particulate matter created by coal-burning power plants that produced 95% of the nation's coal-generated electricity were about $62 billion, with nonclimate damages averaging about 3.2 cents for every kilowatt-hour of energy produced. It is estimated that by 2030, nonclimate damages will fall to 1.7 cents per kilowatt-hour. The 2030 figure assumes that new policies already slated for implementation are put in place.

A variation reduction allocation model for quality improvement to minimize investment and quality costs by considering suppliers’ learning curve

NASA Astrophysics Data System (ADS)

Rosyidi, C. N.; Jauhari, WA; Suhardi, B.; Hamada, K.

2016-02-01

Quality improvement must be performed in a company to maintain its product competitiveness in the market. The goal of such improvement is to increase the customer satisfaction and the profitability of the company. In current practice, a company needs several suppliers to provide the components in assembly process of a final product. Hence quality improvement of the final product must involve the suppliers. In this paper, an optimization model to allocate the variance reduction is developed. Variation reduction is an important term in quality improvement for both manufacturer and suppliers. To improve suppliers’ components quality, the manufacturer must invest an amount of their financial resources in learning process of the suppliers. The objective function of the model is to minimize the total cost consists of investment cost, and quality costs for both internal and external quality costs. The Learning curve will determine how the employee of the suppliers will respond to the learning processes in reducing the variance of the component.

Farther on down the road: transport costs, trade and urban growth in sub-Saharan Africa

PubMed Central

2018-01-01

This paper investigates the role of inter-city transport costs in determining the income of sub-Saharan African cities. In particular, focusing on fifteen countries whose largest city is a port, I find that an oil price increase of the magnitude experienced between 2002 and 2008 induces the income of cities near that port to increase by 7 percent relative to otherwise identical cities 500 kilometers farther away. Combined with external estimates, this implies an elasticity of city economic activity with respect to transport costs of −0.28 at 500 kilometers from the port. Moreover, the effect differs by the surface of roads between cities. Cities connected to the port by paved roads are chiefly affected by transport costs to the port, while cities connected to the port by unpaved roads are more affected by connections to secondary centers. PMID:29743731

The cost of noise reduction in commercial tilt rotor aircraft

NASA Technical Reports Server (NTRS)

Faulkner, H. B.

1974-01-01

The relationship between direct operating cost (DOC) and departure noise annoyance was developed for commercial tilt rotor aircraft. This was accomplished by generating a series of tilt rotor aircraft designs to meet various noise goals at minimum DOC. These vehicles were spaced across the spectrum of possible noise levels from completely unconstrained to the quietest vehicle that could be designed within the study ground rules. A group of optimization parameters were varied to find the minimum DOC while other inputs were held constant and some external constraints were met. This basic variation was then extended to different aircraft sizes and technology time frames. It was concluded that reducing noise annoyance by designing for lower rotor tip speeds is a very promising avenue for future research and development. It appears that the cost of halving the annoyance compared to an unconstrained design is insignificant and the cost of halving the annoyance again is small.

More quality measures versus measuring what matters: a call for balance and parsimony

PubMed Central

Nelson, Eugene C; Pryor, David B; James, Brent; Swensen, Stephen J; Kaplan, Gary S; Weissberg, Jed I; Bisognano, Maureen; Yates, Gary R; Hunt, Gordon C

2012-01-01

External groups requiring measures now include public and private payers, regulators, accreditors and others that certify performance levels for consumers, patients and payers. Although benefits have accrued from the growth in quality measurement, the recent explosion in the number of measures threatens to shift resources from improving quality to cover a plethora of quality-performance metrics that may have a limited impact on the things that patients and payers want and need (ie, better outcomes, better care, and lower per capita costs). Here we propose a policy that quality measurement should be: balanced to meet the need of end users to judge quality and cost performance and the need of providers to continuously improve the quality, outcomes and costs of their services; and parsimonious to measure quality, outcomes and costs with appropriate metrics that are selected based on end-user needs. PMID:22893696

Designing Ratchets in Ultra-cold Atoms for the Advanced Undergraduate Laboratory

NASA Astrophysics Data System (ADS)

Hachtel, Andrew; Gillette, Matthew; Clements, Ethan; Zhong, Shan; Ducay, Rey; Bali, Samir

2014-05-01

We propose to perform ratchet experiments in cold Rubidium atoms using state-of-the-art home-built tapered amplifier and imaging systems. Our tapered amplifier system amplifies the output from home-built external cavity tunable diode lasers up to a factor 100 and costs less than 5,000, in contrast to commercial tapered amplifier systems, which cost upward of 20,000. We have developed an imaging system with LabVIEW integration, which allows for approximately 2 millisecond exposures and microsecond control of experimental parameters. Our imaging system also costs less than 5,000 in comparison to commercial options, which cost between 40-50,000. Progress toward implementation of a one-dimensional rocking ratchet is described. We gratefully acknowledge funding from the American Chemical Society Petroleum Research Fund and Miami University. We also acknowledge the Miami University Instrumentation Laboratory for their invaluable contributions.

More quality measures versus measuring what matters: a call for balance and parsimony.

PubMed

Meyer, Gregg S; Nelson, Eugene C; Pryor, David B; James, Brent; Swensen, Stephen J; Kaplan, Gary S; Weissberg, Jed I; Bisognano, Maureen; Yates, Gary R; Hunt, Gordon C

2012-11-01

External groups requiring measures now include public and private payers, regulators, accreditors and others that certify performance levels for consumers, patients and payers. Although benefits have accrued from the growth in quality measurement, the recent explosion in the number of measures threatens to shift resources from improving quality to cover a plethora of quality-performance metrics that may have a limited impact on the things that patients and payers want and need (ie, better outcomes, better care, and lower per capita costs). Here we propose a policy that quality measurement should be: balanced to meet the need of end users to judge quality and cost performance and the need of providers to continuously improve the quality, outcomes and costs of their services; and parsimonious to measure quality, outcomes and costs with appropriate metrics that are selected based on end-user needs.

Recovery Act: Low Cost Integrated Substrate for OLED Lighting Development

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

Benton, Scott; Bhandari, Abhinav

2012-12-26

PPG pursued the development of an integrated substrate, including the anode, external, and internal extraction layers. The objective of PPG's program was to achieve cost reductions by displacing the existing expensive borosilicate or double-side polished float glass substrates and developing alternative electrodes and scalable light extraction layer technologies through focused and short-term applied research. One of the key highlights of the project was proving the feasibility of using PPG's high transmission Solarphire® float glass as a substrate to consistently achieve organic lightemitting diode (OLED) devices with good performance and high yields. Under this program, four low-cost alternatives to the Indiummore » Tin Oxide (ITO) anode were investigated using pilot-scale magnetron sputtered vacuum deposition (MSVD) and chemical vapor deposition (CVD) technologies. The anodes were evaluated by fabricating small and large phosphorescent organic lightemitting diode (PHOLED) devices at Universal Display Corporation (UDC). The device performance and life-times comparable to commercially available ITO anodes were demonstrated. A cost-benefit analysis was performed to down-select two anodes for further low-cost process development. Additionally, PPG developed and evaluated a number of scalable and compatible internal and external extraction layer concepts such as scattering layers on the outside of the glass substrate or between the transparent anode and the glass interface. In one external extraction layer (EEL) approach, sol-gel sprayed pyrolytic coatings were deposited using lab scale equipment by hand or automated spraying of sol-gel solutions on hot glass, followed by optimizing of scattering with minimal absorption. In another EEL approach, PPG tested large-area glass texturing by scratching a glass surface with an abrasive roller and acid etching. Efficacy enhancements of 1.27x were demonstrated using white PHOLED devices for 2.0mm substrates which are at par with the standard diffuser sheets used by OLED manufacturers. For an internal extraction layer (IEL), PPG tested two concepts combining nanoparticles either in a solgel coating inserted between the anode and OLED or anode and glass interface, or incorporated into the internal surface of the glass. Efficacy enhancements of 1.31x were demonstrated using white PHOLED devices for the IEL by itself and factors of 1.73x were attained for an IEL in combination of thick acrylic block as an EEL. Recent offline measurements indicate that, with further optimization, factors over 2.0x could be achieved through an IEL alone.« less

[Cost of hospitalization by the Activity Based Costing method in the neonatal department of Principal Hospital of Dakar].

PubMed

Tchamdja, T; Balaka, A; Tchandana, M; Agbétra, A

2015-01-01

To determine the cost of hospitalization per day in the neonatal department of Principal Hospital of Dakar. This prospective study took place during the month of July 2011 in the newborn unit. The activity-based costing method was used to analyze costs. During the study period, 52 newborns were hospitalized for a total of 590 days. The cost of the human resources during that month was 9,907,832 FCFA (US $ 19,815.66), the cost of depreciation of fixed assets was estimated at 571,952 FCFA (US $ 1143.90), and supplies at 112,084 FCFA (US $ 224.17). External services cost 386,753 FCFA (US $ 773.51) and support services 6,917,380.65 FCFA (US $ 13,834.7613). The monthly expenses incurred for the hospitalization of newborns totaled 17,896,002 FCFA (US $ 35,792), for a cost per patient per day of 30,332.20 FCFA (US $ 60.66) and an average cost of hospitalization 334,153.88 FCFA (US $ 668,31). This study is the first of its kind in Senegal and neighboring countries. By applying the ABC approach, we can obtain a more detailed and precise estimate of the cost of activities and services. Process improvements and corrective actions should make it possible to identify cost drivers, such as time.

[Outsourcing. Advantages and disadvantages of these processes with regard to the management from the view of the technical services in a hospital].

PubMed

Chen, B

1999-01-01

Cost effectiveness and improvement of service quality are the main reasons for outsourcing in hospitals. Long term relationships and customer satisfaction confirm the concept of providing complex services from external specialized companies. There is no standard guideline to determine whether outsourcing should be preferred to inhouse service. Outsourcing is not a guarantee for improved service and a lot of promoted advantages could theoretically also be provided by inhouse service departments. But the effectiveness of inhouse services has to be proven in comparison and competition to external providers. The often named disadvantages of outsourcing have to be considered. Nevertheless they are also not only subject to outsourcing and can also be a problem in inhouse organisations. Furthermore a proper controlling is an important tool to eliminate most of the difficulties in outsourcing projects. In the competition between internal and external service providers concepts of service partnerships that integrate internal and external resources will be the successful ones in the long run. The main potential for improvement is the optimization of the whole process of maintenance management, instead of the mere reduction of head count.

Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving?

PubMed Central

2014-01-01

Background External cephalic version (ECV) is infrequently performed and 98% of breech presenting fetuses are delivered surgically. Neuraxial analgesia can increase the success rate of ECV significantly, potentially reducing cesarean delivery rates for breech presentation. The current study aims to determine whether the additional cost to the hospital of spinal anesthesia for ECV is offset by cost savings generated by reduced cesarean delivery. Methods In our tertiary hospital, three variables manpower, disposables, and fixed costs were calculated for ECV, ECV plus anesthetic doses of spinal block, vaginal delivery and cesarean delivery. Total procedure costs were compared for possible delivery pathways. Manpower data were obtained from management payroll, fixed costs by calculating cost/lifetime usage rate and disposables were micro-costed in 2008, expressed in 2013 NIS. Results Cesarean delivery is the most expensive option, 11670.54 NIS and vaginal delivery following successful ECV under spinal block costs 5497.2 NIS. ECV alone costs 960.21 NIS, ECV plus spinal anesthesia costs 1386.97 NIS. The highest individual cost items for vaginal, cesarean delivery and ECV were for manpower. Expensive fixed costs for cesarean delivery included operating room trays and postnatal hospitalization (minimum 3 days). ECV with spinal block is cheaper due to lower expected cesarean delivery rate and its lower associated costs. Conclusions The additional cost of the spinal anesthesia is offset by increased success rates for the ECV procedure resulting in reduction in the cesarean delivery rate. PMID:24564984

Behavioral and Nondirective Guided Self-Help for Parents of Children with Externalizing Behavior: Mediating Mechanisms in a Head-To-Head Comparison.

PubMed

Katzmann, Josepha; Hautmann, Christopher; Greimel, Lisa; Imort, Stephanie; Pinior, Julia; Scholz, Kristin; Döpfner, Manfred

2017-05-01

Parent training (PT) delivered as a guided self-help intervention may be a cost- and time-effective intervention in the treatment of children with externalizing disorders. In face-to-face PT, parenting strategies have repeatedly been identified as mediating mechanisms for the decrease of children's problem behavior. Few studies have examined possible mediating effects in guided self-help interventions for parents. The present study aimed to investigate possible mediating variables of a behaviorally oriented guided self-help program for parents of children with externalizing problems compared to a nondirective intervention in a clinical sample. A sample of 110 parents of children with externalizing disorders (80 % boys) were randomized to either a behaviorally oriented or a nondirective guided self-help program. Four putative mediating variables were examined simultaneously in a multiple mediation model using structural equation modelling. The outcomes were child symptoms of ADHD and ODD as well as child externalizing problems, assessed at posttreatment. Analyses showed a significant indirect effect for dysfunctional parental attributions in favor of the group receiving the behavioral program, and significant effects of the behavioral program on positive and negative parenting and parental self-efficacy, compared to the nondirective intervention. Our results indicate that a decrease of dysfunctional parental attributions leads to a decrease of child externalizing problems when parents take part in a behaviorally oriented guided self-help program. However, none of the putative mediating variables could explain the decrease in child externalizing behavior problems in the nondirective group. A change in dysfunctional parental attributions should be considered as a possible mediator in the context of PT.

An experimental investigation for external RC shear wall applications

NASA Astrophysics Data System (ADS)

Kaltakci, M. Y.; Ozturk, M.; Arslan, M. H.

2010-09-01

The strength and rigidity of most reinforced concrete (RC) buildings in Turkey, which are frequently hit by destructive earthquakes, is not at a sufficient level. Therefore, the result of earthquakes is a significant loss of life and property. The strengthening method most commonly preferred for these type of RC buildings is the application of RC infilled walls (shear walls) in the frame openings of the building. However, since the whole building has to be emptied and additional heavy costs arise during this type of strengthening, users prefer not to strengthen their buildings despite the heavy risk they are exposed to. Therefore, it is necessary to develop easier-to-apply and more effective methods for the rapid strengthening of housing and the heavily-used public buildings which cannot be emptied during the strengthening process (such as hospitals and schools). This study empirically analyses the different methods of a new system which can meet this need. In this new system, named "external shear wall application", RC shear walls are applied on the external surface of the building, along the frame plane rather than in the building. To this end, 7 test samples in 1/2 and 1/3 geometrical scale were designed to analyse the efficiency of the strengthening technique where the shear wall leans on the frame from outside of the building (external shear wall application) and of the strengthening technique where a specific space is left between the frame and the external shear wall by using a coupling beam to connect elements (application of external shear wall with coupling beam). Test results showed that the maximum lateral load capacity, initial rigidity and energy dissipation behaviours of the samples strengthened with external shear wall were much better than those of the bare frames.

A cost-benefit analysis of a deposit-refund program for beverage containers in Israel

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

Lavee, Doron, E-mail: doron@pareto.co.i

2010-02-15

The paper presents a full cost-benefit analysis of a deposit-refund program for beverage containers in Israel. We examine all cost elements of the program - storage, collection, and treatment costs of empty containers, and all potential benefits - savings in alternative treatment costs (waste collection and landfill disposal), cleaner public spaces, reduction of landfill volumes, energy-savings externalities associated with use of recycled materials, and creation of new workplaces. A wide variety of data resources is employed, and some of the critical issues are examined via several approaches. The main finding of the paper is that the deposit-refund program is clearlymore » economically worthwhile. The paper contributes to the growing body of literature on deposit-refund programs by its complete and detailed analysis of all relevant factors of such a program, and also specifically in its analysis of the savings in alternative waste management costs. This analysis reveals greater savings than are usually assumed, and thus shows the deposit-refund program to be highly efficient.« less

Three essays on environmental and natural resource economics

NASA Astrophysics Data System (ADS)

Wang, Qiong (Juliana)

The doctoral dissertation is composed of three chapters on the governance of water and electricity infrastructure in China. All three chapters focus on the nexus of economy, environment, and energy. The first chapter studies the relationship of decentralization policies and the provision of public goods in the context of urban water services in China. Different degree of externalities of the public goods may affect the efficacy of decentralization policies. Using a comprehensive 2004 dataset for all the 661 cities, I measure how the clean water supply coverage rate and the wastewater treatment rate respond to these policies respectively. Results show that cities respond positively in their piped water supply coverage but not as well in their wastewater treatment, whereas they both respond positively to the mandatory information disclosure policy. The efficacy of decentralization policy is indeed compromised when externalities exist beyond the jurisdiction as suggested by the case of wastewater. Information disclosure policy, a motivational tool tied to the promotion of local officials, is shown to provide strong incentives for water services irrespective of their externalities. Private sector participation lowers the amount of government grant in the water sector but increases the tariff charged to customers. The second chapter of the dissertation examines whether competition reduces cost in the restructuring of the Chinese power sector. Although competition may reduce cost through technological innovation and advancement and diversification of ownership, higher transaction cost and price control may hinder its effectiveness. In this chapter, I describe the various restructuring programs over the years that affect the power plants. Then, I evaluate their impacts on the cost efficiency, measured by the factor demand of the power plants - labor, energy and materials. Using an industrial dataset from 1997 to 2004 of energy consuming coal power plants from the National Statistics Bureau, I first estimate the factor demand equations following the model developed in Fabrizio et al. (2007) to compare with the results from similar studies in the United States. Further, I model the cost structure of Chinese power plants using a more flexible translog specification. The results from these two models confirm the validity of the assumptions made based on the industry characteristics. The power plants located in the South reduced their labor demand after the Southern Grid separated from the National Grid in 2002. The third chapter examines how the unreliability of inputs affects productivity. Specifically, it studies how Chinese industrial enterprises respond to the unreliability of electric power. Since 2002, electricity blackouts have been hampering the industrial customers in China. Using a survey dataset of the National Statistics Bureau on eleven industries across the nation from 1999 to 2004 and an electricity dataset compiled from Electricity Yearbooks, my co-authors and I estimate the cost of power unreliability by quantifying the factor-neutral and the factor-biased productivity effects. Incorporating unreliability proxies into a flexible translog cost function and the value share equations, we estimate the whole system using seemingly unrelated regressions (SUREG) with cross equation constraints. We also calculate the marginal effect of factor unreliability on cost and on carbon emissions based on these estimates.

Who Should Bear the Cost of Convenience? A Cost-effectiveness Analysis Comparing External Beam and Brachytherapy Radiotherapy Techniques for Early Stage Breast Cancer.

PubMed

McGuffin, M; Merino, T; Keller, B; Pignol, J-P

2017-03-01

Standard treatment for early breast cancer includes whole breast irradiation (WBI) after breast-conserving surgery. Recently, accelerated partial breast irradiation (APBI) has been proposed for well-selected patients. A cost and cost-effectiveness analysis was carried out comparing WBI with two APBI techniques. An activity-based costing method was used to determine the treatment cost from a societal perspective of WBI, high dose rate brachytherapy (HDR) and permanent breast seed implants (PBSI). A Markov model comparing the three techniques was developed with downstream costs, utilities and probabilities adapted from the literature. Sensitivity analyses were carried out for a wide range of variables, including treatment costs, patient costs, utilities and probability of developing recurrences. Overall, HDR was the most expensive ($14 400), followed by PBSI ($8700), with WBI proving the least expensive ($6200). The least costly method to the health care system was WBI, whereas PBSI and HDR were less costly for the patient. Under cost-effectiveness analyses, downstream costs added about $10 000 to the total societal cost of the treatment. As the outcomes are very similar between techniques, WBI dominated under cost-effectiveness analyses. WBI was found to be the most cost-effective radiotherapy technique for early breast cancer. However, both APBI techniques were less costly to the patient. Although innovation may increase costs for the health care system it can provide cost savings for the patient in addition to convenience. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

An automatic tracking system for phase-noise measurement.

PubMed

Yuen, Chung Ming; Tsang, Kim Fung

2005-05-01

A low cost, automatic tracking system for phase noise measurement has been implemented successfully. The tracking system is accomplished by applying a charge pump phase-locked loop as an external reference source to a digital spectrum analyzer. Measurement of a 2.5 GHz, free-running, voltage-controlled oscillator demonstrated the tracking accuracy, thus verifying the feasibility of the system.

Development of a Browser-Based Mobile Audience Response System for Large Classrooms

ERIC Educational Resources Information Center

Andergassen, Monika; Guerra, Victor; Ledermüller, Karl; Neumann, Gustaf

2013-01-01

Didactical advantages of audience response systems (ARS) have been discussed extensively ever since they have been used in classes. However, conventional ARS bear some drawbacks, such as requiring specific hardware, generating costs (text messaging based and web service fees) and creating a dependency on external hosts. In this paper we present a…

Environmental Accounting Coverage in the Accounting Curriculum: A Survey of U.S. Universities and Colleges.

ERIC Educational Resources Information Center

Yakhou, Mehenna; Dorweiler, Vernon P.

2002-01-01

In a survey of accounting department chairs (122 of 660 responded), only 11% thought that environmental issues should be a standalone course; only four schools had such a course. Environmental topics rated highest were managerial and cost accounting and external reporting and auditing. Respondents believed that integrating topics into courses…

Development and External Debt: Friend or Foe? Academy for Educational Development 25th Anniversary Seminar Series.

ERIC Educational Resources Information Center

Hope, Nicholas C.

Arguing that the benefits from borrowing abroad exceed the costs recently imposed on countries through debt-servicing difficulties, this paper defines debt as an engine of growth, forcing the borrower to produce goods efficiently, export them, and function competitively in the international market. Debt-servicing difficulties of developing nations…

Ecosystem Services Decision Support: A Living Database of Existing Tools, Approaches and Techniques for Supporting Decisions Related to Ecosystem Services (Poster)

EPA Science Inventory

Planners and decision makers are challenged to consider not only direct market costs, but also ecological externalities. There is an increasing emphasis on ecosystem services in the context of human well-being, and therefore the valuation and accounting of ecosystem services is b...

Window Treatment Phase I and Other Energy II Conservation Measures.

ERIC Educational Resources Information Center

Donohue, Philip E.

Six different energy-saving treatments for large window areas were tested by Tompkins-Cortland Community College (TCCC) to coordinate energy saving with building design. The TCCC building has an open space design with 33,000 square feet of external glass and other features causing heating problems and high energy costs. Phase I of the…

Finding Terrestrial Planets Using External Occulters

NASA Technical Reports Server (NTRS)

Heap, Sara

2007-01-01

In order to identify a detected exoplanet as an Earth-like (habitable) planet, we must obtain its spectrum to verify that its atmosphere shows evidence of water vapor. We argue that a regular, optical telescope combined with a large occulter to block light from the star offers the most promising, cost-effective way to detect and characterize exoplanets.

Faculty Productivity and Costs at the University of Texas at Austin: A Preliminary Analysis

ERIC Educational Resources Information Center

Vedder, Richard; Matgouranis, Christopher; Robe, Jonathan

2011-01-01

In this report, the authors examine recently released preliminary data concerning faculty compensation, teaching loads and external research grant awards at one of the nation's largest college campuses, The University of Texas at Austin. The authors use these data to assess faculty productivity (in terms of both teaching and research), and their…

Internalizing versus Externalizing Control: Different Ways to Perform a Time-Based Prospective Memory Task

ERIC Educational Resources Information Center

Huang, Tracy; Loft, Shayne; Humphreys, Michael S.

2014-01-01

"Time-based prospective memory" (PM) refers to performing intended actions at a future time. Participants with time-based PM tasks can be slower to perform ongoing tasks (costs) than participants without PM tasks because internal control is required to maintain the PM intention or to make prospective-timing estimates. However, external…

Gravity Acceleration Measurements Using a Soundcard

ERIC Educational Resources Information Center

Abellan-Garcia, Francisco J.; Garcia-Gamuz, Jose Antonio; Valerdi-Perez, Ramon P.; Ibanez-Mengual, Jose A.

2012-01-01

The aim of this paper is to determine the acceleration due to gravity "g", using a simple and low-cost experimental device. The time taken for a metallic ball to travel a predetermined distance is measured and recorded by a series of optical sensors. Four pairs of sensors are placed along the external surface of a vertical methacrylate tube at…

Single-Case Experimental Designs for the Evaluation of Treatments for Self-Injurious and Suicidal Behaviors

ERIC Educational Resources Information Center

Rizvi, Shireen L.; Nock, Matthew K.

2008-01-01

Single-case experimental designs (SCEDs) provide a time- and cost-effective alternative to randomized clinical trials and offer significant advantages in terms of internal and external validity. A brief history and primer on SCEDs is provided, specifically for use in suicide intervention research. Various SCED methodologies, such as AB, ABAB,…

Validation of an internal hardwood log defect prediction model

Treesearch

R. Edward Thomas

2011-01-01

The type, size, and location of internal defects dictate the grade and value of lumber sawn from hardwood logs. However, acquiring internal defect knowledge with x-ray/computed-tomography or magnetic-resonance imaging technology can be expensive both in time and cost. An alternative approach uses prediction models based on correlations among external defect indicators...

Estimating preferences for treatments in patients with localized prostate cancer.

PubMed

Ávila, Mónica; Becerra, Virginia; Guedea, Ferran; Suárez, José Francisco; Fernandez, Pablo; Macías, Víctor; Mariño, Alfonso; Hervás, Asunción; Herruzo, Ismael; Ortiz, María José; Ponce de León, Javier; Sancho, Gemma; Cunillera, Oriol; Pardo, Yolanda; Cots, Francesc; Ferrer, Montse

2015-02-01

Studies of patients' preferences for localized prostate cancer treatments have assessed radical prostatectomy and external radiation therapy, but none of them has evaluated brachytherapy. The aim of our study was to assess the preferences and willingness to pay of patients with localized prostate cancer who had been treated with radical prostatectomy, external radiation therapy, or brachytherapy, and their related urinary, sexual, and bowel side effects. This was an observational, prospective cohort study with follow-up until 5 years after treatment. A total of 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited from 2003 to 2005. The estimation of preferences was conducted using time trade-off, standard gamble, and willingness-to-pay methods. Side effects were measured with the Expanded Prostate Index Composite (EPIC), a prostate cancer-specific questionnaire. Tobit models were constructed to assess the impact of treatment and side effects on patients' preferences. Propensity score was applied to adjust for treatment selection bias. Of the 580 patients reporting preferences, 165 were treated with radical prostatectomy, 152 with external radiation therapy, and 263 with brachytherapy. Both time trade-off and standard gamble results indicated that the preferences of patients treated with brachytherapy were 0.06 utilities higher than those treated with radical prostatectomy (P=.01). Similarly, willingness-to-pay responses showed a difference of €57/month (P=.004) between these 2 treatments. Severe urinary incontinence presented an independent impact on the preferences elicited (P<.05), whereas no significant differences were found by bowel and sexual side effects. Our findings indicate that urinary incontinence is the side effect with the highest impact on preferences and that brachytherapy and external radiation therapy are more valued than radical prostatectomy. These time trade-off and standard gamble preference assessments as well as the willingness-to-pay estimation could be useful to perform respectively cost-utility or cost-benefit analyses, which can guide health policy decisions. Copyright © 2015 Elsevier Inc. All rights reserved.

Estimating Preferences for Treatments in Patients With Localized Prostate Cancer

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

Ávila, Mónica; CIBER en Epidemiología y Salud Pública; Universitat Pompeu Fabra, Barcelona

Purpose: Studies of patients' preferences for localized prostate cancer treatments have assessed radical prostatectomy and external radiation therapy, but none of them has evaluated brachytherapy. The aim of our study was to assess the preferences and willingness to pay of patients with localized prostate cancer who had been treated with radical prostatectomy, external radiation therapy, or brachytherapy, and their related urinary, sexual, and bowel side effects. Methods and Materials: This was an observational, prospective cohort study with follow-up until 5 years after treatment. A total of 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited from 2003more » to 2005. The estimation of preferences was conducted using time trade-off, standard gamble, and willingness-to-pay methods. Side effects were measured with the Expanded Prostate Index Composite (EPIC), a prostate cancer-specific questionnaire. Tobit models were constructed to assess the impact of treatment and side effects on patients' preferences. Propensity score was applied to adjust for treatment selection bias. Results: Of the 580 patients reporting preferences, 165 were treated with radical prostatectomy, 152 with external radiation therapy, and 263 with brachytherapy. Both time trade-off and standard gamble results indicated that the preferences of patients treated with brachytherapy were 0.06 utilities higher than those treated with radical prostatectomy (P=.01). Similarly, willingness-to-pay responses showed a difference of €57/month (P=.004) between these 2 treatments. Severe urinary incontinence presented an independent impact on the preferences elicited (P<.05), whereas no significant differences were found by bowel and sexual side effects. Conclusions: Our findings indicate that urinary incontinence is the side effect with the highest impact on preferences and that brachytherapy and external radiation therapy are more valued than radical prostatectomy. These time trade-off and standard gamble preference assessments as well as the willingness-to-pay estimation could be useful to perform respectively cost-utility or cost-benefit analyses, which can guide health policy decisions.« less

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version.

PubMed

Vlemmix, Floortje; Rosman, Ageeth N; Fleuren, Margot A H; Rijnders, Marlies E B; Beuckens, Antje; Haak, Monique C; Akerboom, Bettina M C; Bais, Joke M J; Kuppens, Simone M I; Papatsonis, Dimitri N; Opmeer, Brent C; van der Post, Joris A M; Mol, Ben Willem J; Kok, Marjolein

2010-05-10

Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less.We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV.The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Dutch Trial Register (NTR): 1878.

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

PubMed Central

2010-01-01

Background Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less. We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. Method/design The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV. The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. Discussion This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Trial Registration Dutch Trial Register (NTR): 1878 PMID:20459717

Variation in costs of cone beam CT examinations among healthcare systems.

PubMed

Christell, H; Birch, S; Hedesiu, M; Horner, K; Ivanauskaité, D; Nackaerts, O; Rohlin, M; Lindh, C

2012-10-01

To analyse the costs of cone beam CT (CBCT) in different healthcare systems for patients with different clinical conditions. Costs were calculated for CBCT performed in Cluj (Romania), Leuven (Belgium), Malmö (Sweden) and Vilnius (Lithuania) on patients with (i) a maxillary canine with eruption disturbance, (ii) an area with tooth loss prior to implant treatment or (iii) a lower wisdom tooth planned for removal. The costs were calculated using an approach based on the identification, measurement and valuation of all resources used in the delivery of the service that combined direct costs (capital equipment, accommodation, labour) with indirect costs (patients' and accompanying persons' time, "out of pocket" costs for examination fee and visits). The estimates for direct and indirect costs varied among the healthcare systems, being highest in Malmö and lowest in Leuven. Variation in direct costs was mainly owing to different capital costs for the CBCT equipment arising from differences in purchase prices (range €148 000-227 000). Variation in indirect costs were mainly owing to examination fees (range €0-102.02). Cost analysis provides an important input for economic evaluations of diagnostic methods in different healthcare systems and for planning of service delivery. Additionally, it enables decision-makers to separate variations in costs between systems into those due to external influences and those due to policy decisions. A cost evaluation of a dental radiographic method cannot be generalized from one healthcare system to another, but must take into account these specific circumstances.

Effects of Magnetic Nanoparticles and External Magnetostatic Field on the Bulk Heterojunction Polymer Solar Cells

DOE PAGES

Wang, Kai; Yi, Chao; Liu, Chang; ...

2015-03-18

The price of energy to separate tightly bound electron-hole pair (or charge-transfer state) and extract freely movable charges from low-mobility materials represents fundamental losses for many low-cost photovoltaic devices. In bulk heterojunction (BHJ) polymer solar cells (PSCs), approximately 50% of the total efficiency lost among all energy loss pathways is due to the photogenerated charge carrier recombination within PSCs and low charge carrier mobility of disordered organic materials. To address these issues, we introduce magnetic nanoparticles (MNPs) and orientate these MNPS within BHJ composite by an external magnetostatic field. Over 50% enhanced efficiency was observed from BHJ PSCs incorporated withmore » MNPs and an external magnetostatic field alignment when compared to the control BHJ PSCs. The optimization of BHJ thin film morphology, suppression of charge carrier recombination, and enhancement in charge carrier collection result in a greatly increased short-circuit current density and fill factor, as a result, enhanced power conversion efficiency.« less

Simultaneous Calibration: A Joint Optimization Approach for Multiple Kinect and External Cameras.

PubMed

Liao, Yajie; Sun, Ying; Li, Gongfa; Kong, Jianyi; Jiang, Guozhang; Jiang, Du; Cai, Haibin; Ju, Zhaojie; Yu, Hui; Liu, Honghai

2017-06-24

Camera calibration is a crucial problem in many applications, such as 3D reconstruction, structure from motion, object tracking and face alignment. Numerous methods have been proposed to solve the above problem with good performance in the last few decades. However, few methods are targeted at joint calibration of multi-sensors (more than four devices), which normally is a practical issue in the real-time systems. In this paper, we propose a novel method and a corresponding workflow framework to simultaneously calibrate relative poses of a Kinect and three external cameras. By optimizing the final cost function and adding corresponding weights to the external cameras in different locations, an effective joint calibration of multiple devices is constructed. Furthermore, the method is tested in a practical platform, and experiment results show that the proposed joint calibration method can achieve a satisfactory performance in a project real-time system and its accuracy is higher than the manufacturer's calibration.

Simultaneous Calibration: A Joint Optimization Approach for Multiple Kinect and External Cameras

PubMed Central

Liao, Yajie; Sun, Ying; Li, Gongfa; Kong, Jianyi; Jiang, Guozhang; Jiang, Du; Cai, Haibin; Ju, Zhaojie; Yu, Hui; Liu, Honghai

2017-01-01

Camera calibration is a crucial problem in many applications, such as 3D reconstruction, structure from motion, object tracking and face alignment. Numerous methods have been proposed to solve the above problem with good performance in the last few decades. However, few methods are targeted at joint calibration of multi-sensors (more than four devices), which normally is a practical issue in the real-time systems. In this paper, we propose a novel method and a corresponding workflow framework to simultaneously calibrate relative poses of a Kinect and three external cameras. By optimizing the final cost function and adding corresponding weights to the external cameras in different locations, an effective joint calibration of multiple devices is constructed. Furthermore, the method is tested in a practical platform, and experiment results show that the proposed joint calibration method can achieve a satisfactory performance in a project real-time system and its accuracy is higher than the manufacturer’s calibration. PMID:28672823

Influence of energy alternatives and carbon emissions on an institution's green reputation.

PubMed

Komarek, Timothy M; Lupi, Frank; Kaplowitz, Michael D; Thorp, Laurie

2013-10-15

Institutions' reputation for being environmentally friendly or 'green' can come from many sources. This paper examines how the attributes of alternative energy management plans impact an institutions' 'green' reputation by focusing on the interaction between 'external' and 'internal' influences. Some 'external' influences on environmental reputation we studied include the institution's mix of fuels, energy conservation effort, carbon emissions targets, investment time-frame, and program cost. The 'internal' influences on institutions' green reputation we examined include altruism (respondents' concern for the welfare of others) and environmentalism (respondents' concern for the environment). Using a stated-preference conjoint survey, we empirically examine how attributes of alternative energy management plans influence a large, research university's 'green' reputation. Our results show that constituents benefit from their institution's green reputation and that the energy management choices of the institution can significantly influence its perceived green reputation. Furthermore, integrating internal and external influences on reputation can create more informative models and better decision-making. Copyright © 2013 Elsevier Ltd. All rights reserved.

Diluted povidone-iodine versus saline for dressing metal-skin interfaces in external fixation.

PubMed

Chan, C K; Saw, A; Kwan, M K; Karina, R

2009-04-01

To compare infection rates associated with 2 dressing solutions for metal-skin interfaces. 60 patients who underwent distraction osteogenesis with external fixators were equally randomised into 2 dressing solution groups (diluted povidone-iodine vs. saline). Fixations were attained using either rigid stainless steel 5-mm diameter half pins or smooth stainless steel 1.8-mm diameter wires. Half-pin fixation had one metal-skin interface, whereas wire fixation had 2 interfaces. Patients were followed up every 2 weeks for 6 months. Of all 788 metal-skin interfaces, 143 (18%) were infected: 72 (19%) of 371 in the diluted povidone-iodine group and 71 (17%) of 417 in the saline group. Dressing solution and patient age did not significantly affect infection rates. Half-pin fixation was more likely to become infected than wire fixation (25% vs 15%). Saline is as effective as diluted povidone-iodine as a dressing solution for metal-skin interfaces of external fixators. Saline is recommended in view of its easy availability and lower costs.

MISSE-X: An ISS External Platform for Space Environmental Studies in the Post-Shuttle Era

NASA Technical Reports Server (NTRS)

Thibeault, Sheila A.; Cooke, Stuart A.; Ashe, Melissa P.; Saucillo, Rudolph J.; Murphy, Douglas G.; deGroh, Kim K.; Jaworske, Donald A.; Nguyen, Quang-Viet

2011-01-01

Materials International Space Station Experiment-X (MISSE-X) is a proposed International Space Station (ISS) external platform for space environmental studies designed to advance the technology readiness of materials and devices critical for future space exploration. The MISSE-X platform will expand ISS utilization by providing experimenters with unprecedented low-cost space access and return on investment (ROI). As a follow-on to the highly successful MISSE series of ISS experiments, MISSE-X will provide advances over the original MISSE configurations including incorporation of plug-and-play experiments that will minimize return mass requirements in the post-Shuttle era, improved active sensing and monitoring of the ISS external environment for better characterization of environmental effects, and expansion of the MISSE-X user community through incorporation of new, customer-desired capabilities. MISSE-X will also foster interest in science, technology, engineering, and math (STEM) in primary and secondary schools through student collaboration and participation.1,2

Video-based measurements for wireless capsule endoscope tracking

NASA Astrophysics Data System (ADS)

Spyrou, Evaggelos; Iakovidis, Dimitris K.

2014-01-01

The wireless capsule endoscope is a swallowable medical device equipped with a miniature camera enabling the visual examination of the gastrointestinal (GI) tract. It wirelessly transmits thousands of images to an external video recording system, while its location and orientation are being tracked approximately by external sensor arrays. In this paper we investigate a video-based approach to tracking the capsule endoscope without requiring any external equipment. The proposed method involves extraction of speeded up robust features from video frames, registration of consecutive frames based on the random sample consensus algorithm, and estimation of the displacement and rotation of interest points within these frames. The results obtained by the application of this method on wireless capsule endoscopy videos indicate its effectiveness and improved performance over the state of the art. The findings of this research pave the way for a cost-effective localization and travel distance measurement of capsule endoscopes in the GI tract, which could contribute in the planning of more accurate surgical interventions.

The advantages of cost plus award fee contracts

NASA Technical Reports Server (NTRS)

Keathley, William C.

1994-01-01

A Cost Plus Award Fee contract is the best procurement vehicle for the high-tech, one-of-a-kind, development projects that constitute most of NASA'S projects. The use of this type of contract requires more government and contractor effort than any other forms of contracts. An award fee contract is described as an arrangement whereby the government periodically awards a fee consistent with the cost, schedule and technical performance that is achieved by a contractor during a preset period with preset award fee pools. It's the only contracting method where both the government and contractor goals are closely linked. It also has a built-in mechanism to conveniently alter and emphasize program events in order to current external and internal situations. The award fee process also demands good communication between government and contractor participants.

Compact dry chemistry instruments.

PubMed

Terashima, K; Tatsumi, N

1999-01-01

Compact dry chemistry instruments are designed for use in point-of-care-testing (POCT). These instruments have a number of advantages, including light weight, compactness, ease of operation, and the ability to provide accurate results in a short time with a very small sample volume. On the other hand, reagent costs are high compared to liquid method. Moreover, differences in accuracy have been found between dry chemistry and the liquid method in external quality assessment scheme. This report examines reagent costs and shows how the total running costs associated with dry chemistry are actually lower than those associated with the liquid method. This report also describes methods for minimizing differences in accuracy between dry chemistry and the liquid method. Use of these measures is expected to increase the effectiveness of compact dry chemistry instruments in POCT applications.

Biomechanical and Cost Comparisons of Near-Far and Pin-Bar Constructs.

PubMed

Whitney Kluk, Augusta; Zhang, Tina; Russell, Joseph P; Kim, Hyunchul; Hsieh, Adam H; O'Toole, Robert V

2017-03-01

Orthopedic dogma states that external fixator stiffness is improved by placing 1 pin close to the fracture and 1 as distant as possible ("near-far"). This fixator construct is thought to be less expensive than placing pins a shorter distance apart and using "pin-bar" clamps that attach pins to outriggers. The authors therefore hypothesized that the near-far construct is stiffer and less expensive. They compared mechanical stiffness and costs of near-far and pin-bar constructs commonly used for temporary external fixation of femoral shaft fractures. Their testing model simulated femoral shaft fractures in damage control situations. Fourth-generation synthetic femora (n=18) were used. The near-far construct had 2 pins that were 106 mm apart, placed 25 mm from the gap on each side of the fracture. The pin-bar construct pins were 55 mm apart, placed 40 mm from the gap. Mechanical testing was performed on a material test system machine. Stiffness was determined in the linear portion of the load-displacement curve for both constructs in 4 modes: axial compression, torsional loading, frontal plane 3-point bending, and sagittal plane 3-point bending. Costs were determined from a 2012 price guide. Compared with the near-far construct, the pin-bar construct had stiffness increased by 58% in axial compression (P<.05) and by 52% in torsional loading (P<.05). The pin-bar construct increased cost by 11%. In contrast to the authors' hypothesis and existing orthopedic dogma, the near-far construct was less stiff than the pin-bar construct and was similarly priced. Use of the pin-bar construct is mechanically and economically reasonable. [Orthopedics. 2017; 40(2):e238-e241.]. Copyright 2016, SLACK Incorporated.

Sequence Effect in Parkinson’s Disease Is Related to Motor Energetic Cost

PubMed Central

Tinaz, Sule; Pillai, Ajay S.; Hallett, Mark

2016-01-01

Bradykinesia is the most disabling motor symptom of Parkinson’s disease (PD). The sequence effect (SE), a feature of bradykinesia, refers to the rapid decrement in amplitude and speed of repetitive movements (e.g., gait, handwriting) and is a major cause of morbidity in PD. Previous research has revealed mixed results regarding the role of dopaminergic treatment in the SE. However, external cueing has been shown to improve it. In this study, we aimed to characterize the SE systematically and relate this phenomenon to the energetic cost of movement within the context of cost–benefit framework of motor control. We used a dynamic isometric motor task with auditory pacing to assess the SE in motor output during a 15-s task segment in PD patients and matched controls. All participants performed the task with both hands, and without and with visual feedback (VF). Patients were also tested in “on”- and “off”-dopaminergic states. Patients in the “off” state did not show higher SE compared to controls, partly due to large variance in their performance. However, patients in the “on” state and in the absence of VF showed significantly higher SE compared to controls. Patients expended higher total motor energy compared to controls in all conditions and regardless of their medication status. In this experimental situation, the SE in PD is associated with the cumulative energetic cost of movement. Dopaminergic treatment, critical for internal triggering of movement, fails to maintain the motor vigor across responses. The high motor cost may be related to failure to incorporate limbic/motivational cues into the motor plan. VF may facilitate performance by shifting the driving of movement from internal to external or, alternatively, by functioning as a motivational cue. PMID:27252678

Cardiopulmonary resuscitation and automatic external defibrillator training in schools: "is anyone learning how to save a life?".

PubMed

Hart, Devin; Flores-Medrano, Oscar; Brooks, Steve; Buick, Jason E; Morrison, Laurie J

2013-09-01

Bystander resuscitation efforts, such as cardiopulmonary resuscitation (CPR) and use of an automatic external defibrillator (AED), save lives in cardiac arrest cases. School training in CPR and AED use may increase the currently low community rates of bystander resuscitation. The study objective was to determine the rates of CPR and AED training in Toronto secondary schools and to identify barriers to training and training techniques. This prospective study consisted of telephone interviews conducted with key school staff knowledgeable about CPR and AED teaching. An encrypted Web-based tool with prespecified variables and built-in logic was employed to standardize data collection. Of 268 schools contacted, 93% were available for interview and 83% consented to participate. Students and staff were trained in CPR in 51% and 80% of schools, respectively. Private schools had the lowest training rate (39%). Six percent of schools provided AED training to students and 47% provided AED training to staff. Forty-eight percent of schools had at least one AED installed, but 25% were unaware if their AED was registered with emergency services dispatch. Cost (17%), perceived need (11%), and school population size (10%) were common barriers to student training. Frequently employed training techniques were interactive (32%), didactic instruction (30%) and printed material (16%). CPR training rates for staff and students were moderate overall and lowest in private schools, whereas training rates in AED use were poor in all schools. Identified barriers to training include cost and student population size (perceived to be too small to be cost-effective or too large to be implemented). Future studies should assess the application of convenient and cost-effective teaching alternatives not presently in use.

Microwave power transmission system studies. Volume 4: Sections 9 through 14 with appendices. [ground tests and antenna design

NASA Technical Reports Server (NTRS)

Maynard, O. E.; Brown, W. C.; Edwards, A.; Haley, J. T.; Meltz, G.; Howell, J. M.; Nathan, A.

1975-01-01

The microwave rectifier technology, approaches to the receiving antenna, topology of rectenna circuits, assembly and construction, ROM cost estimates are discussed. Analyses and cost estimates for the equipment required to transmit the ground power to an external user. Noise and harmonic considerations are presented for both the amplitron and klystron and interference limits are identified and evaluated. The risk assessment discussion is discussed wherein technology risks are rated and ranked with regard to their importance in impacting the microwave power transmission system. The system analyses and evaluation are included of parametric studies of system relationships pertaining to geometry, materials, specific cost, specific weight, efficiency, converter packing, frequency selection, power distribution, power density, power output magnitude, power source, transportation and assembly. Capital costs per kW and energy costs as a function of rate of return, power source and transportation costs as well as build cycle time are presented. The critical technology and ground test program are discussed along with ROM costs and schedule. The orbital test program with associated critical technology and ground based program based on full implementation of the defined objectives is discussed.

Options for refuelling hydrogen fuel cell vehicles in Italy

NASA Astrophysics Data System (ADS)

Mercuri, R.; Bauen, A.; Hart, D.

Hydrogen fuel cell vehicle (H 2 FCV) trials are taking place in a number of cities around the world. In Italy, Milan and Turin are the first to have demonstration projects involving hydrogen-fuelled vehicles, in part to satisfy increasing consumer demand for improved environmental performance. The Italian transport plan specifically highlights the potential for FCVs to enter into the marketplace from around 2005. A scenario for FCV penetration into Italy, developed using projected costs for FCV and hydrogen fuel, suggests that by 2015, 2 million Italian cars could be powered by fuel cells. By 2030, 60% of the parc could be FCVs. To develop an infrastructure to supply these vehicles, a variety of options is considered. Large-scale steam reforming, on-site reforming and electrolysis options are analysed, with hydrogen delivered both in liquid and gaseous form. Assuming mature technologies, with over 10,000 units produced, on-site steam reforming provides the most economic hydrogen supply to the consumer, at US 2.6/kg. However, in the early stages of the infrastructure development there is a clear opportunity for on-site electrolysis and for production of hydrogen at centralised facilities, with delivery in the form of liquid hydrogen. This enables additional flexibility, as the hydrogen may also be used for fuel refining or for local power generation. In the current Italian context, energy companies could have a significant role to play in developing a hydrogen infrastructure. The use of hydrogen FCVs can substantially reduce emissions of regulated pollutants and greenhouse gases. Using externality costs for regulated pollutants, it is estimated that the use of hydrogen fuel cell buses in place of 5% of diesel buses in Milan could avoid US 2 million per year in health costs. The addition of even very low externality costs to fuel prices makes the use of untaxed hydrogen in buses and cars, which is slightly more expensive for the motorist than untaxed gasoline or diesel, competitive on a social cost basis.

Tuning in to the Voices: A Multisite fMRI Study of Auditory Hallucinations

PubMed Central

Ford, Judith M.; Roach, Brian J.; Jorgensen, Kasper W.; Turner, Jessica A.; Brown, Gregory G.; Notestine, Randy; Bischoff-Grethe, Amanda; Greve, Douglas; Wible, Cynthia; Lauriello, John; Belger, Aysenil; Mueller, Bryon A.; Calhoun, Vincent; Preda, Adrian; Keator, David; O'Leary, Daniel S.; Lim, Kelvin O.; Glover, Gary; Potkin, Steven G.; Mathalon, Daniel H.

2009-01-01

Introduction: Auditory hallucinations or voices are experienced by 75% of people diagnosed with schizophrenia. We presumed that auditory cortex of schizophrenia patients who experience hallucinations is tonically “tuned” to internal auditory channels, at the cost of processing external sounds, both speech and nonspeech. Accordingly, we predicted that patients who hallucinate would show less auditory cortical activation to external acoustic stimuli than patients who did not. Methods: At 9 Functional Imaging Biomedical Informatics Research Network (FBIRN) sites, whole-brain images from 106 patients and 111 healthy comparison subjects were collected while subjects performed an auditory target detection task. Data were processed with the FBIRN processing stream. A region of interest analysis extracted activation values from primary (BA41) and secondary auditory cortex (BA42), auditory association cortex (BA22), and middle temporal gyrus (BA21). Patients were sorted into hallucinators (n = 66) and nonhallucinators (n = 40) based on symptom ratings done during the previous week. Results: Hallucinators had less activation to probe tones in left primary auditory cortex (BA41) than nonhallucinators. This effect was not seen on the right. Discussion: Although “voices” are the anticipated sensory experience, it appears that even primary auditory cortex is “turned on” and “tuned in” to process internal acoustic information at the cost of processing external sounds. Although this study was not designed to probe cortical competition for auditory resources, we were able to take advantage of the data and find significant effects, perhaps because of the power afforded by such a large sample. PMID:18987102

Essays on Environmental Economics and Policy

NASA Astrophysics Data System (ADS)

Walker, W. Reed

A central feature of modern government is its role in designing welfare improving policies to address and correct market failures stemming from externalities and public goods. The rationale for most modern environmental regulations stems from the failure of markets to efficiently allocate goods and services. Yet, as with any policy, distributional effects are important there exist clear winners and losers. Despite the clear theoretical justification for environmental and energy policy, empirical work credibly identifying both the source and consequences of these externalities as well as the distributional effects of existing policies remains in its infancy. My dissertation focuses on the development of empirical methods to investigate the role of environmental and energy policy in addressing market failures as well as exploring the distributional implications of these policies. These questions are important not only as a justification for government intervention into markets but also for understanding how distributional consequences may shape the design and implementation of these policies. My dissertation investigates these questions in the context of programs and policies that are important in their own right. Chapters 1 and 2 of my dissertation explore the economic costs and distributional implications associated with the largest environmental regulatory program in the United States, the Clean Air Act. Chapters 3 and 4 examine the social costs of air pollution in the context of transportation externalities, showing how effective transportation policy has additional co-benefits in the form of environmental policy. My dissertation remains unified in both its subject matter and methodological approach -- using unique sources of data and sound research designs to understand important issues in environmental policy.

Smart Markets for Transferable Pumping Rights

NASA Astrophysics Data System (ADS)

Brozovic, N.; Young, R.

2016-12-01

While no national policy on groundwater use exists in the United States, local groundwater management is emerging across the country in response to concerns and conflicts over declining well yields, land subsidence, and the depletion of hydrologically connected surface waters. Management strategies include well drilling moratoria, pumping restrictions, and restrictions on the expansion of irrigated land. To provide flexibility to groundwater users, local regulatory authorities increasingly have begun to allow the transfer of groundwater rights as a cost-effective management tool. Markets can be a versatile risk management tool, helping communities to cope with scarcity, to meet goals for sustainability, and to grow resilient local economies. For example, active groundwater rights transfers exist in the High Plains region of the United States. Yet, several barriers to trade exist: high search costs for interested parties, complicated requirements for regulatory compliance, and reluctance to share sensitive financial information. Additionally, groundwater pumping leads to several kinds of spatial and intertemporal externalities such as stream depletion. Indeed, groundwater management schemes that reallocate water between alternate pumping locations are often explicitly designed to change the distribution and magnitude of pumping externalities. Reallocation may be designed to minimize unwanted impacts on third parties or to encourage trades that reduce the magnitude of externalities. We discuss how smart markets can deal with complex biophysical constraints while also encouraging active trading, therefore ensuring local goals for aquifer sustainability while growing local economies. Smart markets address these issues by providing a centralized hub for trading, automating the process of regulatory compliance by only matching buyers and sellers eligible to trade as specified in the regulations, and maintaining anonymous, confidential bidding.

Automatic system for 3D reconstruction of the chick eye based on digital photographs.

PubMed

Wong, Alexander; Genest, Reno; Chandrashekar, Naveen; Choh, Vivian; Irving, Elizabeth L

2012-01-01

The geometry of anatomical specimens is very complex and accurate 3D reconstruction is important for morphological studies, finite element analysis (FEA) and rapid prototyping. Although magnetic resonance imaging, computed tomography and laser scanners can be used for reconstructing biological structures, the cost of the equipment is fairly high and specialised technicians are required to operate the equipment, making such approaches limiting in terms of accessibility. In this paper, a novel automatic system for 3D surface reconstruction of the chick eye from digital photographs of a serially sectioned specimen is presented as a potential cost-effective and practical alternative. The system is designed to allow for automatic detection of the external surface of the chick eye. Automatic alignment of the photographs is performed using a combination of coloured markers and an algorithm based on complex phase order likelihood that is robust to noise and illumination variations. Automatic segmentation of the external boundaries of the eye from the aligned photographs is performed using a novel level-set segmentation approach based on a complex phase order energy functional. The extracted boundaries are sampled to construct a 3D point cloud, and a combination of Delaunay triangulation and subdivision surfaces is employed to construct the final triangular mesh. Experimental results using digital photographs of the chick eye show that the proposed system is capable of producing accurate 3D reconstructions of the external surface of the eye. The 3D model geometry is similar to a real chick eye and could be used for morphological studies and FEA.

Authentication of organic feed by near-infrared spectroscopy combined with chemometrics: a feasibility study.

PubMed

Tres, A; van der Veer, G; Perez-Marin, M D; van Ruth, S M; Garrido-Varo, A

2012-08-22

Organic products tend to retail at a higher price than their conventional counterparts, which makes them susceptible to fraud. In this study we evaluate the application of near-infrared spectroscopy (NIRS) as a rapid, cost-effective method to verify the organic identity of feed for laying hens. For this purpose a total of 36 organic and 60 conventional feed samples from The Netherlands were measured by NIRS. A binary classification model (organic vs conventional feed) was developed using partial least squares discriminant analysis. Models were developed using five different data preprocessing techniques, which were externally validated by a stratified random resampling strategy using 1000 realizations. Spectral regions related to the protein and fat content were among the most important ones for the classification model. The models based on data preprocessed using direct orthogonal signal correction (DOSC), standard normal variate (SNV), and first and second derivatives provided the most successful results in terms of median sensitivity (0.91 in external validation) and median specificity (1.00 for external validation of SNV models and 0.94 for DOSC and first and second derivative models). A previously developed model, which was based on fatty acid fingerprinting of the same set of feed samples, provided a higher sensitivity (1.00). This shows that the NIRS-based approach provides a rapid and low-cost screening tool, whereas the fatty acid fingerprinting model can be used for further confirmation of the organic identity of feed samples for laying hens. These methods provide additional assurance to the administrative controls currently conducted in the organic feed sector.

External Validation Study of First Trimester Obstetric Prediction Models (Expect Study I): Research Protocol and Population Characteristics.

PubMed

Meertens, Linda Jacqueline Elisabeth; Scheepers, Hubertina Cj; De Vries, Raymond G; Dirksen, Carmen D; Korstjens, Irene; Mulder, Antonius Lm; Nieuwenhuijze, Marianne J; Nijhuis, Jan G; Spaanderman, Marc Ea; Smits, Luc Jm

2017-10-26

A number of first-trimester prediction models addressing important obstetric outcomes have been published. However, most models have not been externally validated. External validation is essential before implementing a prediction model in clinical practice. The objective of this paper is to describe the design of a study to externally validate existing first trimester obstetric prediction models, based upon maternal characteristics and standard measurements (eg, blood pressure), for the risk of pre-eclampsia (PE), gestational diabetes mellitus (GDM), spontaneous preterm birth (PTB), small-for-gestational-age (SGA) infants, and large-for-gestational-age (LGA) infants among Dutch pregnant women (Expect Study I). The results of a pilot study on the feasibility and acceptability of the recruitment process and the comprehensibility of the Pregnancy Questionnaire 1 are also reported. A multicenter prospective cohort study was performed in The Netherlands between July 1, 2013 and December 31, 2015. First trimester obstetric prediction models were systematically selected from the literature. Predictor variables were measured by the Web-based Pregnancy Questionnaire 1 and pregnancy outcomes were established using the Postpartum Questionnaire 1 and medical records. Information about maternal health-related quality of life, costs, and satisfaction with Dutch obstetric care was collected from a subsample of women. A pilot study was carried out before the official start of inclusion. External validity of the models will be evaluated by assessing discrimination and calibration. Based on the pilot study, minor improvements were made to the recruitment process and online Pregnancy Questionnaire 1. The validation cohort consists of 2614 women. Data analysis of the external validation study is in progress. This study will offer insight into the generalizability of existing, non-invasive first trimester prediction models for various obstetric outcomes in a Dutch obstetric population. An impact study for the evaluation of the best obstetric prediction models in the Dutch setting with respect to their effect on clinical outcomes, costs, and quality of life-Expect Study II-is being planned. Netherlands Trial Registry (NTR): NTR4143; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4143 (Archived by WebCite at http://www.webcitation.org/6t8ijtpd9). ©Linda Jacqueline Elisabeth Meertens, Hubertina CJ Scheepers, Raymond G De Vries, Carmen D Dirksen, Irene Korstjens, Antonius LM Mulder, Marianne J Nieuwenhuijze, Jan G Nijhuis, Marc EA Spaanderman, Luc JM Smits. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 26.10.2017.

Contraction coupling efficiency of human first dorsal interosseous muscle.

PubMed

Jubrias, Sharon A; Vollestad, Nina K; Gronka, Rod K; Kushmerick, Martin J

2008-04-01

During working contractions, chemical energy in the form of ATP is converted to external work. The efficiency of this conversion, called 'contraction coupling efficiency', is calculated by the ratio of work output to energy input from ATP splitting. Experiments on isolated muscles and permeabilized fibres show the efficiency of this conversion has a wide range, 0.2-0.7. We measured the work output in contractions of a single human hand muscle in vivo and of the ATP cost of that work to calculate the contraction coupling efficiency of the muscle. Five subjects performed six bouts of rapid voluntary contractions every 1.5 s for 42 s (28 contractions, each with time to peak force < 150 ms). The bouts encompassed a 7-fold range of workloads. The ATP cost during work was quantified by measuring the extent of chemical changes within the muscle from (31)P magnetic resonance spectra. Contraction coupling efficiency was determined as the slope of paired measurements of work output and ATP cost at the five graded work loads. The results show that 0.68 of the chemical energy available from ATP splitting was converted to external work output. A plausible mechanism to account for this high value is a substantially lower efficiency for mitochondrial ATP synthesis. The method described here can be used to analyse changes in the overall efficiency determined from oxygen consumption during exercise that can occur in disease or with age, and to test the hypothesis that such changes are due to reduced contraction coupling efficiency.

The coal-fired gas turbine locomotive - A new look

NASA Technical Reports Server (NTRS)

Liddle, S. G.; Bonzo, B. B.; Purohit, G. P.

1983-01-01

Advances in turbomachine technology and novel methods of coal combustion may have made possible the development of a competitive coal fired gas turbine locomotive engine. Of the combustor, thermodynamic cycle, and turbine combinations presently assessed, an external combustion closed cycle regenerative gas turbine with a fluidized bed coal combustor is judged to be the best suited for locomotive requirements. Some merit is also discerned in external combustion open cycle regenerative systems and internal combustion open cycle regenerative gas turbine systems employing a coal gasifier. The choice of an open or closed cycle depends on the selection of a working fluid and the relative advantages of loop pressurization, with air being the most attractive closed cycle working fluid on the basis of cost.

Internal and external scope in willingness-to-pay estimates for threatened and endangered wildlife

USGS Publications Warehouse

Giraud, K.L.; Loomis, J.B.; Johnson, R.L.

1999-01-01

Economic theory suggests willingness-to-pay (WTP) should be significantly higher for a comprehensive good than for a subset of that good. We tested this using both a split sample design (external scope test) and paired responses (internal scope test) for WTP for several endangered fish and wildlife species in the US. In the paired response case we corrected for correlation of willingness-to-pay responses using a bivariate probit model. Surprisingly, the independent split samples passed the scope test but the paired samples did not. As the results contradict each other, questions of validity for policy implications are raised. However, using either approach, the benefit of maintaining critical habitat for these species exceeds the costs.

Alignment-stabilized interference filter-tuned external-cavity quantum cascade laser.

PubMed

Kischkat, Jan; Semtsiv, Mykhaylo P; Elagin, Mikaela; Monastyrskyi, Grygorii; Flores, Yuri; Kurlov, Sergii; Peters, Sven; Masselink, W Ted

2014-12-01

A passively alignment-stabilized external cavity quantum cascade laser (EC-QCL) employing a "cat's eye"-type retroreflector and an ultra-narrowband transmissive interference filter for wavelength selection is demonstrated and experimentally investigated. Compared with conventional grating-tuned ECQCLs, the setup is nearly two orders of magnitude more stable against misalignment of the components, and spectral fluctuation is reduced by one order of magnitude, allowing for a simultaneously lightweight and fail-safe construction, suitable for applications outdoors and in space. It also allows for a substantially greater level of miniaturization and cost reduction. These advantages fit in well with the general properties of modern QCLs in the promise to deliver useful and affordable mid-infrared-light sources for a variety of spectroscopic and imaging applications.

Overcoming Molehills and Mountains Implementing a New Program

NASA Technical Reports Server (NTRS)

Salute, Joan; McDougal, John; Stephens, Karen

2011-01-01

This slide presentation reviews some of the challenges and accomplishments of implementing a new program. The purpose of the presentation is to: (1) Share the challenges that were encountered formulating a new program concurrent with formulating & implementing new spacecraft development projects: (a) Immature mission concepts put on the fast track (b) Need to reconcile ambitious objectives with cost and budget reality (c) Changes of major stakeholders (d) Timing, timing, timing (e) Changing ground rules, assumptions, and risk tolerance (f) The role of centers, (2) Share the successes to date despite the challenges (3) Demonstrate how interdependencies between the program, projects, NASA HQ environment, and external political forces affect the process, and how expectations must be managed while dealing with external factors and great change.

Thermal design of the space shuttle external tank

NASA Technical Reports Server (NTRS)

Bachrtel, F. D.; Vaniman, J. L.; Stuckey, J. M.; Gray, C.; Widofsky, B.

1985-01-01

The shuttle external tank thermal design presents many challenges in meeting the stringent requirements established by the structures, main propulsion systems, and Orbiter elements. The selected thermal protection design had to meet these requirements, and ease of application, suitability for mass production considering low weight, cost, and high reliability. This development led to a spray-on-foam (SOFI) which covers the entire tank. The need and design for a SOFI material with a dual role of cryogenic insulation and ablator, and the development of the SOFI over SLA concept for high heating areas are discussed. Further issuses of minimum surface ice/frost, no debris, and the development of the TPS spray process considering the required quality and process control are examined.

Commercial Aircraft Maintenance Experience Relating to Engine External Hardware

NASA Technical Reports Server (NTRS)

Soditus, Sharon M.

2006-01-01

Airlines are extremely sensitive to the amount of dollars spent on maintaining the external engine hardware in the field. Analysis reveals that many problems revolve around a central issue, reliability. Fuel and oil leakage due to seal failure and electrical fault messages due to wire harness failures play a major role in aircraft delays and cancellations (D&C's) and scheduled maintenance. Correcting these items on the line requires a large investment of engineering resources and manpower after the fact. The smartest and most cost effective philosophy is to build the best hardware the first time. The only way to do that is to completely understand and model the operating environment, study the field experience of similar designs and to perform extensive testing.

Health economics and outcomes research within drug development: challenges and opportunities for reimbursement and market access within biopharma research.

PubMed

van Nooten, Floortje; Holmstrom, Stefan; Green, Julia; Wiklund, Ingela; Odeyemi, Isaac A O; Wilcox, Teresa K

2012-06-01

Healthcare decision makers who determine funding for new medical technologies depend on manufacturers to provide evidence of the technology's efficacy, safety and cost-effectiveness. Constrained budgets and increasing reliance on formal health technology assessment (HTA) have created an abundance of external hurdles that manufacturers must navigate to ensure successful product commercialization. These demands have pushed pharmaceutical companies to adjust their internal structures to coordinate generation of appropriate evidence. In this article we summarize internal and external opportunities for manufacturers to establish a foundation of evidence for successful market access, starting in Phase I of development and continuing throughout the post-approval product lifecycle. Copyright © 2012 Elsevier Ltd. All rights reserved.

Asymmetric wave transmission in a diatomic acoustic/elastic metamaterial

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

Li, Bing; Tan, K. T., E-mail: ktan@uakron.edu

2016-08-21

Asymmetric acoustic/elastic wave transmission has recently been realized using nonlinearity, wave diffraction, or bias effects, but always at the cost of frequency distortion, direction shift, large volumes, or external energy. Based on the self-coupling of dual resonators, we propose a linear diatomic metamaterial, consisting of several small-sized unit cells, to realize large asymmetric wave transmission in low frequency domain (below 1 kHz). The asymmetric transmission mechanism is theoretically investigated, and numerically verified by both mass-spring and continuum models. This passive system does not require any frequency conversion or external energy, and the asymmetric transmission band can be theoretically predicted andmore » mathematically controlled, which extends the design concept of unidirectional transmission devices.« less

Train integrity detection risk analysis based on PRISM

NASA Astrophysics Data System (ADS)

Wen, Yuan

2018-04-01

GNSS based Train Integrity Monitoring System (TIMS) is an effective and low-cost detection scheme for train integrity detection. However, as an external auxiliary system of CTCS, GNSS may be influenced by external environments, such as uncertainty of wireless communication channels, which may lead to the failure of communication and positioning. In order to guarantee the reliability and safety of train operation, a risk analysis method of train integrity detection based on PRISM is proposed in this article. First, we analyze the risk factors (in GNSS communication process and the on-board communication process) and model them. Then, we evaluate the performance of the model in PRISM based on the field data. Finally, we discuss how these risk factors influence the train integrity detection process.

Trends in Local Therapy Utilization and Cost for Early-Stage Breast Cancer in Older Women: Implications for Payment and Policy Reform

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

Shirvani, Shervin M.; Department of Radiation Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona; Jiang, Jing

Purpose: Older women with early-stage disease constitute the most rapidly growing breast cancer demographic, yet it is not known which local therapy strategies are most favored by this population in the current era. Understanding utilization trends and cost of local therapy is important for informing the design of bundled payment models as payers migrate away from fee-for-service models. We therefore used the Surveillance, Epidemiology, and End Results Medicare database to determine patterns of care and costs for local therapy among older women with breast cancer. Methods and Materials: Treatment strategy and covariables were determined in 55,327 women age ≥66 withmore » Tis-T2N0-1M0 breast cancer who underwent local therapy between 2000 and 2008. Trends in local therapy were characterized using Joinpoint. Polychotomous logistic regression determined predictors of local therapy. The median aggregate cost over the first 24 months after diagnosis was determined from Medicare claims through 2010 and reported in 2014 dollars. Results: The median age was 75. Local therapy distribution was as follows: 27,896 (50.3%) lumpectomy with external beam radiation, 18,356 (33.1%) mastectomy alone, 6159 (11.1%) lumpectomy alone, 1488 (2.7%) mastectomy with reconstruction, and 1455 (2.6%) lumpectomy with brachytherapy. Mastectomy alone declined from 39.0% in 2000 to 28.2% in 2008, and the use of breast conserving local therapies rose from 58.7% to 68.2%. Mastectomy with reconstruction was more common among the youngest, healthiest patients, whereas mastectomy alone was more common among patients living in rural low-income regions. By 2008, the costs were $36,749 for lumpectomy with brachytherapy, $35,030 for mastectomy with reconstruction, $31,388 for lumpectomy with external beam radiation, $21,993 for mastectomy alone, and $19,287 for lumpectomy alone. Conclusions: The use of mastectomy alone in older women declined in favor of breast conserving strategies between 2000 and 2008. Using these cost estimates, price points for local therapy bundles can be constructed to incentivize the treatment strategies that confer the highest value.« less

Using stochastic dynamic programming to support catchment-scale water resources management in China

NASA Astrophysics Data System (ADS)

Davidsen, Claus; Pereira-Cardenal, Silvio Javier; Liu, Suxia; Mo, Xingguo; Rosbjerg, Dan; Bauer-Gottwein, Peter

2013-04-01

A hydro-economic modelling approach is used to optimize reservoir management at river basin level. We demonstrate the potential of this integrated approach on the Ziya River basin, a complex basin on the North China Plain south-east of Beijing. The area is subject to severe water scarcity due to low and extremely seasonal precipitation, and the intense agricultural production is highly dependent on irrigation. Large reservoirs provide water storage for dry months while groundwater and the external South-to-North Water Transfer Project are alternative sources of water. An optimization model based on stochastic dynamic programming has been developed. The objective function is to minimize the total cost of supplying water to the users, while satisfying minimum ecosystem flow constraints. Each user group (agriculture, domestic and industry) is characterized by fixed demands, fixed water allocation costs for the different water sources (surface water, groundwater and external water) and fixed costs of water supply curtailment. The multiple reservoirs in the basin are aggregated into a single reservoir to reduce the dimensions of decisions. Water availability is estimated using a hydrological model. The hydrological model is based on the Budyko framework and is forced with 51 years of observed daily rainfall and temperature data. 23 years of observed discharge from an in-situ station located downstream a remote mountainous catchment is used for model calibration. Runoff serial correlation is described by a Markov chain that is used to generate monthly runoff scenarios to the reservoir. The optimal costs at a given reservoir state and stage were calculated as the minimum sum of immediate and future costs. Based on the total costs for all states and stages, water value tables were generated which contain the marginal value of stored water as a function of the month, the inflow state and the reservoir state. The water value tables are used to guide allocation decisions in simulation mode. The performance of the operation rules based on water value tables was evaluated. The approach was used to assess the performance of alternative development scenarios and infrastructure projects successfully in the case study region.

Caring about carepaths.

PubMed

Pearson, J B; Macintosh, D J

2001-01-01

This short paper describes an experiment in the use of clinical pathways for orthopaedic patients at Cairns Base Hospital. We rapidly found they improved the management of cost and quality, and that there were many beneficial side-effects. Our approach was subsequently adopted in other departments. Unfortunately, external support for further developments has not been forthcoming and we argue that this may be an unwise move.

Predictive Game Theory

NASA Technical Reports Server (NTRS)

Wolpert, David H.

2005-01-01

Probability theory governs the outcome of a game; there is a distribution over mixed strat.'s, not a single "equilibrium". To predict a single mixed strategy must use our loss function (external to the game's players. Provides a quantification of any strategy's rationality. Prove rationality falls as cost of computation rises (for players who have not previously interacted). All extends to games with varying numbers of players.

Institutional Assessment of Research and Studies: Inevitable Feature of a Modern State or One More Bureaucratic Whim in Lithuania?

ERIC Educational Resources Information Center

Dienys, Vincentas; Pukelis, Kestutis; Ziliukas, Pranas

2005-01-01

A number of small countries face similar problems while organising external assessment of higher education institutions: how to select proper experts, how to prepare them and maintain? How to avoid bias or interest conflict between experts who evaluate the institution and the institution being evaluated? How to reduce the financial costs of…

Accuracy and Precision of a Custom Camera-Based System for 2-D and 3-D Motion Tracking during Speech and Nonspeech Motor Tasks

ERIC Educational Resources Information Center

Feng, Yongqiang; Max, Ludo

2014-01-01

Purpose: Studying normal or disordered motor control requires accurate motion tracking of the effectors (e.g., orofacial structures). The cost of electromagnetic, optoelectronic, and ultrasound systems is prohibitive for many laboratories and limits clinical applications. For external movements (lips, jaw), video-based systems may be a viable…

Handbook for the Commonwealth of Learning Review and Improvement Model: Making Quality Work in Higher Education

ERIC Educational Resources Information Center

Commonwealth of Learning, 2010

2010-01-01

The Commonwealth of Learning Review and Improvement Model (COL RIM) was developed by the Commonwealth of Learning in response to two key drivers: (1) Increased global emphasis on the quality of higher education; and (2) Rising concern about the high cost and uncertain benefits of conventional approaches to external quality assurance. Any…

Commentary on "Making Evidence-Based Decisions about Child Language Intervention in Schools" by Gillam and Gillam

ERIC Educational Resources Information Center

Fey, Marc E.

2006-01-01

Purpose: This paper is a personal reaction to Gillam and Gillam's treatise on evidence-based decision making in schools. This evaluation focuses principally on the costs and benefits of clinicians' search for external evidence, potential problems associated with efforts to grade that evidence, and the integration of this evidence with "internal"…

Case Study: Applying the Theory of Planned Behavior as Interventions to Increase Sponsored Project Proposal Submissions from Liberal Arts Faculty

ERIC Educational Resources Information Center

Hartmann, Anita

2011-01-01

In the current economic climate, many colleges and universities face similar challenges: the need to increase external sponsorship for research activities and the need to benefit from additional indirect cost recovery. Preparing funding proposals for submission to sponsors is a faculty behavior that can be modified by applying behavioral theory to…

Doing the Basics Better in Africa: How School Support, Autonomy, and Accountability Improved Outcomes for Girls in PEAS Schools

ERIC Educational Resources Information Center

Hills, Libby

2017-01-01

Promoting Equality in African Schools (PEAS) seeks to expand access to sustainably delivered, quality secondary education in Africa. PEAS builds and runs chains of not-for-profit, low-cost private schools in public-private partnership with governments. External evaluation data show that PEAS schools in Uganda are delivering higher quality…

Durability as integral characteristic of concrete

NASA Astrophysics Data System (ADS)

Suleymanova, L. A.; Pogorelova, I. A.; Suleymanov, K. A.; Kirilenko, S. V.; Marushko, M. V.

2018-03-01

The carried-out research provides insight into the internal bonds energy in material as the basis of its durability, deformability, integrity and resistance to different factors (combined effects of external loadings and (or) environment), into the limits of technical possibilities, durability and physical reality of the process of concrete deterioration, which allows designing reliable and cost-effective ferroconcrete constructions for different purposes.

Multiyear Subcontractor Selection Criteria Analysis.

DTIC Science & Technology

1983-09-01

advancement are program instability, higher costs, and increased lead-times. Compounding the instability created by advancing technology are changes in...drive smaller firms out of business (17:46). Technology is advancing at an ever increasing pace, demanding higher performance and larger amounts of engi...Process Adding to the external factors mentioned above, the weapon systems acquisition process tends to retard pro- ductivity advancements by its very

Finding External Indicators of Load on a Web Server via Analysis of Black-Box Performance Measurements

ERIC Educational Resources Information Center

Chiarini, Marc A.

2010-01-01

Traditional methods for system performance analysis have long relied on a mix of queuing theory, detailed system knowledge, intuition, and trial-and-error. These approaches often require construction of incomplete gray-box models that can be costly to build and difficult to scale or generalize. In this thesis, we present a black-box analysis…

Energy Conversion Alternatives Study (ECAS), Westinghouse phase 1. Volume 9: Closed-cycle MHD. [energy conversion efficiency of electric power plants using magnetohydrodynamics

NASA Technical Reports Server (NTRS)

Tsu, T. C.

1976-01-01

A closed-cycle MHD system for an electric power plant was studied. It consists of 3 interlocking loops, an external heating loop, a closed-cycle cesium seeded argon nonequilibrium ionization MHD loop, and a steam bottomer. A MHD duct maximum temperature of 2366 K (3800 F), a pressure of 0.939 MPa (9.27 atm) and a Mach number of 0.9 are found to give a topping cycle efficiency of 59.3%; however when combined with an integrated gasifier and optimistic steam bottomer the coal to bus bar efficiency drops to 45.5%. A 1978 K (3100 F) cycle has an efficiency of 55.1% and a power plant efficiency of 42.2%. The high cost of the external heating loop components results in a cost of electricity of 21.41 mills/MJ (77.07 mills/kWh) for the high temperature system and 19.0 mills/MJ (68.5 mills/kWh) for the lower temperature system. It is, therefore, thought that this cycle may be more applicable to internally heated systems such as some futuristic high temperature gas cooled reactor.

A wearable pressure sensor based on ultra-violet/ozone microstructured carbon nanotube/polydimethylsiloxane arrays for electronic skins.

PubMed

Yu, Guohui; Hu, Jingdong; Tan, Jianping; Gao, Yang; Lu, Yongfeng; Xuan, Fuzhen

2018-03-16

Pressure sensors with high performance (e.g., a broad pressure sensing range, high sensitivities, rapid response/relaxation speeds, temperature-stable sensing), as well as a cost-effective and highly efficient fabrication method are highly desired for electronic skins. In this research, a high-performance pressure sensor based on microstructured carbon nanotube/polydimethylsiloxane arrays was fabricated using an ultra-violet/ozone (UV/O 3 ) microengineering technique. The UV/O 3 microengineering technique is controllable, cost-effective, and highly efficient since it is conducted at room temperature in an ambient environment. The pressure sensor offers a broad pressure sensing range (7 Pa-50 kPa), a sensitivity of ∼ -0.101 ± 0.005 kPa -1 (<1 kPa), a fast response/relaxation speed of ∼10 ms, a small dependence on temperature variation, and a good cycling stability (>5000 cycles), which is attributed to the UV/O 3 engineered microstructures that amplify and transfer external applied forces and rapidly store/release the energy during the PDMS deformation. The sensors developed show the capability to detect external forces and monitor human health conditions, promising for the potential applications in electronic skin.

A wearable pressure sensor based on ultra-violet/ozone microstructured carbon nanotube/polydimethylsiloxane arrays for electronic skins

NASA Astrophysics Data System (ADS)

Yu, Guohui; Hu, Jingdong; Tan, Jianping; Gao, Yang; Lu, Yongfeng; Xuan, Fuzhen

2018-03-01

Pressure sensors with high performance (e.g., a broad pressure sensing range, high sensitivities, rapid response/relaxation speeds, temperature-stable sensing), as well as a cost-effective and highly efficient fabrication method are highly desired for electronic skins. In this research, a high-performance pressure sensor based on microstructured carbon nanotube/polydimethylsiloxane arrays was fabricated using an ultra-violet/ozone (UV/O3) microengineering technique. The UV/O3 microengineering technique is controllable, cost-effective, and highly efficient since it is conducted at room temperature in an ambient environment. The pressure sensor offers a broad pressure sensing range (7 Pa-50 kPa), a sensitivity of ˜ -0.101 ± 0.005 kPa-1 (<1 kPa), a fast response/relaxation speed of ˜10 ms, a small dependence on temperature variation, and a good cycling stability (>5000 cycles), which is attributed to the UV/O3 engineered microstructures that amplify and transfer external applied forces and rapidly store/release the energy during the PDMS deformation. The sensors developed show the capability to detect external forces and monitor human health conditions, promising for the potential applications in electronic skin.

The mini-O, a digital superhet, or a truly low-cost Omega navigation receiver

NASA Technical Reports Server (NTRS)

Burhans, R. W.

1975-01-01

A quartz tuning fork filter circuit and some unique CMOS clock logic methods provide a very simple OMEGA-VLF receiver with true hyperbolic station pair phase difference outputs. An experimental system was implemented on a single battery-operated circuit board requiring only an external antenna preamplifier, and LOP output recorder. A bench evaluation and preliminary navigation tests indicate the technique is viable and can provide very low-cost OMEGA measurement systems. The method is promising for marine use with small boats in the present form, but might be implemented in conjunction with digital microprocessors for airborne navigation aids.

Development and characterization of a snapshot Mueller matrix polarimeter for the determination of cervical cancer risk in the low resource setting

NASA Astrophysics Data System (ADS)

Ramella-Roman, Jessica C.; Gonzalez, Mariacarla; Chue-Sang, Joseph; Montejo, Karla; Krup, Karl; Srinivas, Vijaya; DeHoog, Edward; Madhivanan, Purnima

2018-04-01

Mueller Matrix polarimetry can provide useful information about the function and structure of the extracellular matrix. Mueller Matrix systems are sophisticated and costly optical tools that have been used primarily in the laboratory or in hospital settings. Here we introduce a low-cost snapshot Mueller Matrix polarimeter that that does not require external power, has no moving parts, and can acquire a full Mueller Matrix in less than 50 milliseconds. We utilized this technology in the study of cervical cancer in Mysore India, yet the system could be translated in multiple diagnostic applications.

Automotive Stirling reference engine design report

NASA Technical Reports Server (NTRS)

1981-01-01

The reference Stirling engine system is described which provides the best possible fuel economy while meeting or exceeding all other program objectives. The system was designed to meet the requirements of a 1984 Pontiac Phoenix (X-body). This design utilizes all new technology that can reasonably be expected to be developed by 1984 and that is judged to provide significant improvement, relative to development risk and cost. Topics covered include: (1) external heat system; (2) hot engine system; (3) cold engine system; (4) engine drive system; (5) power control system and auxiliaries; (6) engine instalation; (7) optimization and vehicle simulation; (8) engine materials; and (9) production cost analysis.

Satellite Power System (SPS)

NASA Technical Reports Server (NTRS)

Edler, H. G.

1978-01-01

Potential organizational options for a solar power satellite system (SPS) were investigated. Selection and evaluation criteria were determined to include timeliness, reliability, and adequacy to contribute meaningfully to the U.S. supply; political feasibility (both national and international); and cost effectiveness (including environmental and other external costs). Based on these criteria, four organizational alternatives appeared to offer reasonable promise as potential options for SPS. A large number of key issues emerged as being factors which would influence the final selection process. Among these issues were a variety having to do with international law, international institutions, environmental controls, economics, operational flexibility, congressional policies, commercial-vs-governmental ownership, national dedication, and national and operational stategic issues.

Towards canine rabies elimination: Economic comparisons of three project sites.

PubMed

Elser, J L; Hatch, B G; Taylor, L H; Nel, L H; Shwiff, S A

2018-02-01

An appreciation of the costs of implementing canine rabies control in different settings is important for those planning new or expanded interventions. Here we compare the costs of three canine rabies control projects in South Africa, the Philippines and Tanzania to identify factors that influence the overall costs of rabies control efforts. There was considerable variation in the cost of vaccinating each dog, but across the sites these were lower where population density was higher, and later in the projects when dog vaccination coverage was increased. Transportation costs comprised a much higher proportion of total costs in rural areas and where house-to-house vaccination campaigns were necessary. The association between the cost of providing PEP and human population density was less clear. The presence of a pre-existing national rabies management programme had a marked effect on keeping infrastructure and equipment costs for the project low. Finally, the proportion of the total costs of the project provided by the external donor was found to be low for the projects in the Philippines and South Africa, but likely covered close to the complete costs of the project in Tanzania. The detailed economic evaluation of three recent large-scale rabies control pilot projects provides the opportunity to examine economic costs across these different settings and to identify factors influencing rabies control costs that could be applied to future projects. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.