Science.gov

Sample records for external costs related

  1. Health-related external cost assessment in Europe: methodological developments from ExternE to the 2013 Clean Air Policy Package.

    PubMed

    van der Kamp, Jonathan; Bachmann, Till M

    2015-03-03

    "Getting the prices right" through internalizing external costs is a guiding principle of environmental policy making, one recent example being the EU Clean Air Policy Package released at the end of 2013. It is supported by impact assessments, including monetary valuation of environmental and health damages. For over 20 years, related methodologies have been developed in Europe in the Externalities of Energy (ExternE) project series and follow-up activities. In this study, we aim at analyzing the main methodological developments over time from the 1990s until today with a focus on classical air pollution-induced human health damage costs. An up-to-date assessment including the latest European recommendations is also applied. Using a case from the energy sector, we identify major influencing parameters: differences in exposure modeling and related data lead to variations in damage costs of up to 21%; concerning risk assessment and monetary valuation, differences in assessing long-term exposure mortality risks together with assumptions on particle toxicity explain most of the observed changes in damage costs. These still debated influencing parameters deserve particular attention when damage costs are used to support environmental policy making.

  2. 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.

  3. Cost of external fixation vs external fixation then nailing in bone infection

    PubMed Central

    Emara, Khaled Mohamed; Diab, Ramy Ahmed; Ghafar, Khaled Abd EL

    2015-01-01

    AIM: To study the cost benefit of external fixation vs external fixation then nailing in treatment of bone infection by segment transfer. METHODS: Out of 71 patients with infected nonunion tibia treated between 2003 and 2006, 50 patients fitted the inclusion criteria (26 patients were treated by external fixation only, and 24 patients were treated by external fixation early removal after segment transfer and replacement by internal fixation). Cost of inpatient treatment, total cost of inpatient and outpatient treatment till full healing, and the weeks of absence from school or work were calculated and compared between both groups. RESULTS: The cost of hospital stay and surgery in the group of external fixation only was 22.6 ± 3.3 while the cost of hospital stay and surgery in the group of early external fixation removal and replacement by intramedullary nail was 26.0 ± 3.2. The difference was statistically significant regarding the cost of hospital stay and surgery in favor of the group of external fixation only. The total cost of medical care (surgery, hospital stay, treatment outside the hospital including medications, dressing, physical therapy, outpatient laboratory work, etc.) in group of external fixation only was 63.3 ± 15.1, and total absence from work was 38.6 ± 6.6 wk. While the group of early removal of external fixation and replacement by IM nail, total cost of medical care was 38.3 ± 6.4 and total absence from work or school was 22.7 ± 4.1. The difference was statistically significant regarding the total cost and absence from work in favor of the group of early removal and replacement by IM nail. CONCLUSION: Early removal of external fixation and replacement by intramedullary nail in treatment of infected nonunion showed more cost effectiveness. Orthopaedic society needs to show the cost effectiveness of different procedures to the community, insurance, and health authorities. PMID:25621219

  4. External Communities of Practice and Relational Capital

    ERIC Educational Resources Information Center

    Dewhurst, Frank W.; Navarro, Juan G. Cegarra

    2004-01-01

    External communities of practice are groups formed by company clients and employees based on common interests, commitment, mutual trust and collaboration whose members regularly share knowledge and learning. This paper examines how external communities of practice contribute to the creation of relational capital through an empirical investigation…

  5. Applying environmental externalities to US Clean Coal Technologies for Asia. [Including external environmental costs

    SciTech Connect

    Szpunar, C.B.; Gillette, J.L.

    1993-01-01

    The United States is well positioned to play an expanding role in meeting the energy technology demands of the Asian Pacific Basin, including Indonesia, Thailand, and the Republic of China (ROC-Taiwan). The US Department of Energy Clean Coal Technology (CCT) Demonstration Program provides a proving ground for innovative coal-related technologies that can be applied domestically and abroad. These innovative US CCTs are expected to satisfy increasingly stringent environmental requirements while substantially improving power generation efficiencies. They should also provide distinct advantages over conventional pulverized coal-fired combustors. Finally, they are expected to be competitive with other energy options currently being considered in the region. This paper presents potential technology scenarios for Indonesia, Thailand, and the ROC-Taiwan and considers an environmental cost-benefit approach employing a newly developed method of applying environmental externalities. Results suggest that the economic benefits from increased emission control can indeed be quantified and used in cost-benefit comparisons, and that US CCTs can be very cost effective in reducing emissions.

  6. 48 CFR 231.205-70 - External restructuring costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... companies not previously under common ownership or control are combined, whether by merger, acquisition, or... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false External restructuring costs. 231.205-70 Section 231.205-70 Federal Acquisition Regulations System DEFENSE...

  7. 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

  8. Comparative analysis of monetary estimates of external environmental costs associated with combustion of fossil fuels

    SciTech Connect

    Koomey, J.

    1990-07-01

    Public utility commissions in a number of states have begun to explicitly treat costs of environmental externalities in the resource planning and acquisition process (Cohen et al. 1990). This paper compares ten different estimates and regulatory determinations of external environmental costs associated with fossil fuel combustion, using consistent assumptions about combustion efficiency, emissions factors, and resource costs. This consistent comparison is useful because it makes explicit the effects of various assumptions. This paper uses the results of the comparison to illustrate pitfalls in calculation of external environmental costs, and to derive lessons for design of policies to incorporate these externalities into resource planning. 38 refs., 2 figs., 10 tabs.

  9. 48 CFR 231.205-70 - External restructuring costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... present value basis, for DoD resulting from the restructuring will exceed either— (A) The costs allowed by... will exceed the costs allowed by a factor of at least two to one on a present value basis. (ii) The... to DoD, and the audited projected savings for DoD will exceed the costs allowed on a present...

  10. Relations between Internalizing and Externalizing Problems in Early Childhood

    ERIC Educational Resources Information Center

    Stone, Lisanne L.; Otten, Roy; Engels, Rutger C. M. E.; Kuijpers, Rowella C. W. M.; Janssens, Jan M. A. M.

    2015-01-01

    Background: Childhood internalizing and externalizing problems are closely related and often co-occur. Directional models have been employed to test how these problems are related, while few studies have tested a third variables model. Objective: This study investigates whether internalizing and externalizing problems are reciprocally or…

  11. Incorporating Externalities and Uncertainty into Life-Cycle Cost Analysis

    DTIC Science & Technology

    2012-03-01

    production of too much pollution, a lack of incentive to search for ways to yield less pollution per unit of output, and discouragement of reuse or...that basic water efficiency measures (high-efficiency water fixtures) were cost effective even under subsidized pricing of water, but that greywater ...to say how these results would have changed had the full-cost pricing been used as Rogers et al. (1998) define it. It is possible that greywater

  12. 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

  13. Evaluation of Externality Costs in Life-Cycle Optimization of Municipal Solid Waste Management Systems.

    PubMed

    Martinez-Sanchez, Veronica; Levis, James W; Damgaard, Anders; DeCarolis, Joseph F; Barlaz, Morton A; Astrup, Thomas F

    2017-03-21

    The development of sustainable solid waste management (SWM) systems requires consideration of both economic and environmental impacts. Societal life-cycle costing (S-LCC) provides a quantitative framework to estimate both economic and environmental impacts, by including "budget costs" and "externality costs". Budget costs include market goods and services (economic impact), whereas externality costs include effects outside the economic system (e.g., environmental impact). This study demonstrates the applicability of S-LCC to SWM life-cycle optimization through a case study based on an average suburban U.S. county of 500 000 people generating 320 000 Mg of waste annually. Estimated externality costs are based on emissions of CO2, CH4, N2O, PM2.5, PM10, NOx, SO2, VOC, CO, NH3, Hg, Pb, Cd, Cr (VI), Ni, As, and dioxins. The results indicate that incorporating S-LCC into optimized SWM strategy development encourages the use of a mixed waste material recovery facility with residues going to incineration, and separated organics to anaerobic digestion. Results are sensitive to waste composition, energy mix and recycling rates. Most of the externality costs stem from SO2, NOx, PM2.5, CH4, fossil CO2, and NH3 emissions. S-LCC proved to be a valuable tool for policy analysis, but additional data on key externality costs such as organic compounds emissions to water would improve future analyses.

  14. Pricing landfill externalities: Emissions and disamenity costs in Cape Town, South Africa

    SciTech Connect

    Nahman, Anton

    2011-09-15

    Highlights: > The paper estimates landfill externalities associated with emissions, disamenities and transport. > Transport externalities vary from 24.22 to 31.42 Rands per tonne. > Costs of emissions (estimated using benefits transfer) vary from 0.07 to 28.91 Rands per tonne. > Disamenities (estimated using hedonic pricing) vary from 0.00 to 57.46 Rands per tonne. > Overall, external costs for urban landfills exceed those of a regional landfill. - Abstract: The external (environmental and social) costs of landfilling (e.g. emissions to air, soil and water; and 'disamenities' such as odours and pests) are difficult to quantify in monetary terms, and are therefore not generally reflected in waste disposal charges or taken into account in decision making regarding waste management options. This results in a bias against alternatives such as recycling, which may be more expensive than landfilling from a purely financial perspective, but preferable from an environmental and social perspective. There is therefore a need to quantify external costs in monetary terms, so that different disposal options can be compared on the basis of their overall costs to society (financial plus external costs). This study attempts to estimate the external costs of landfilling in the City of Cape Town for different scenarios, using the benefits transfer method (for emissions) and the hedonic pricing method (for disamenities). Both methods (in particular the process of transferring and adjusting estimates from one study site to another) are described in detail, allowing the procedures to be replicated elsewhere. The results show that external costs are currently R111 (in South African Rands, or approximately US$16) per tonne of waste, although these could decline under a scenario in which energy is recovered, or in which the existing urban landfills are replaced with a new regional landfill.

  15. The relative cost of biomass energy transport.

    PubMed

    Searcy, Erin; Flynn, Peter; Ghafoori, Emad; Kumar, Amit

    2007-04-01

    Logistics cost, the cost of moving feedstock or products, is a key component of the overall cost of recovering energy from biomass. In this study, we calculate for small- and large-project sizes, the relative cost of transportation by truck, rail, ship, and pipeline for three biomass feedstocks, by truck and pipeline for ethanol, and by transmission line for electrical power. Distance fixed costs (loading and unloading) and distance variable costs (transport, including power losses during transmission), are calculated for each biomass type and mode of transportation. Costs are normalized to a common basis of a giga Joules of biomass. The relative cost of moving products vs feedstock is an approximate measure of the incentive for location of biomass processing at the source of biomass, rather than at the point of ultimate consumption of produced energy. In general, the cost of transporting biomass is more than the cost of transporting its energy products. The gap in cost for transporting biomass vs power is significantly higher than the incremental cost of building and operating a power plant remote from a transmission grid. The cost of power transmission and ethanol transport by pipeline is highly dependent on scale of project. Transport of ethanol by truck has a lower cost than by pipeline up to capacities of 1800 t/d. The high cost of transshipment to a ship precludes shipping from being an economical mode of transport for distances less than 800 km (woodchips) and 1500 km (baled agricultural residues).

  16. Pesticide Environmental Accounting: a method for assessing the external costs of individual pesticide applications.

    PubMed

    Leach, A W; Mumford, J D

    2008-01-01

    The Pesticide Environmental Accounting (PEA) tool provides a monetary estimate of environmental and health impacts per hectare-application for any pesticide. The model combines the Environmental Impact Quotient method and a methodology for absolute estimates of external pesticide costs in UK, USA and Germany. For many countries resources are not available for intensive assessments of external pesticide costs. The model converts external costs of a pesticide in the UK, USA and Germany to Mediterranean countries. Economic and policy applications include estimating impacts of pesticide reduction policies or benefits from technologies replacing pesticides, such as sterile insect technique. The system integrates disparate data and approaches into a single logical method. The assumptions in the system provide transparency and consistency but at the cost of some specificity and precision, a reasonable trade-off for a method that provides both comparative estimates of pesticide impacts and area-based assessments of absolute impacts.

  17. Assessment of health-cost externalities of air pollution at the national level using the EVA model system

    NASA Astrophysics Data System (ADS)

    Brandt, J.; Frohn, L. M.; Christensen, J. H.; Andersen, M. S.; Hertel, O.; Geels, C.; Buus Hansen, A.; Hansen, K. M.; Hedegaard, G. B.; Skjøth, C. A.

    2009-04-01

    An integrated model system EVA (Economic Valuation of Air pollution) has been developed to assess external costs related to air pollution from individual sources as specific power plants or different emission sectors, as e.g. power production, road traffic, farming etc. The EVA system is based on the impact pathway chain and consists of a regional scale non-linear Eulerian atmospheric transport-chemistry model including detailed emissions inventories (the Danish Eulerian Hemispheric Model, DEHM), address-level or gridded population data, state-of-the-art exposure-response functions and monetary valuation of the impacts from air pollution. The first general assessment of health-cost externalities at the national level using the EVA system is presented here. Health-cost externalities from different emission sectors in Denmark e.g. power production, road traffic, as well as all sectors simultaneously have been calculated. Furthermore, the heath-cost externalities based on emissions from international ship traffic in the Baltic Sea as well as the North Sea have been estimated. Examples of delta functions, human exposure levels and the total costs of impacts from different chemical species are given. The work is partly carried out within the Centre for Energy, Environment and Health (www.CEEH.dk), which is a Danish strategic research centre funded by the Danish Council for Strategic Research. The mission of the centre is to develop a system to support planning of future energy systems in Denmark, where both direct and indirect costs related to environment, climate and health are considered.

  18. On the Development of Schools' External Public Relations in China.

    ERIC Educational Resources Information Center

    Tianping, Yang

    2003-01-01

    Public relations is a basic function of a modern school's management, while external public relationship is a basic principle and component of it. To develop a school's public relationship, efforts should focus on its key publics, strengthening its coordination and communication with governments, education departments, and local communities.…

  19. Damage costs produced by electric power plants: an externality valuation in the Mexico City Metropolitan Area.

    PubMed

    Macías, P; Islas, J

    2010-09-15

    This paper presents an estimate of the externalities produced in the Mexico City Metropolitan Area (MCMA) through the impacts on health caused by secondary pollutants attributed to seven electric power plants located outside this area. An original method was developed to make possible a simplified application of the impact pathway approach to estimate the damage costs in the specified area. Our estimate shows that the annual costs attributed to secondary pollutants total 71 million USD (min/max 20/258 million USD). Finally, this paper discusses basic ideas on the implications for energy policy arising from this exercise in externality valuation.

  20. 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.

  1. Changes in kinematics, metabolic cost and external work during walking with a forward assistive force.

    PubMed

    Zirker, Christopher A; Bennett, Bradford C; Abel, Mark F

    2013-08-01

    We examined how the application of a forward horizontal force applied at the waist alters the metabolic cost, kinematics, and external work of gait. Horizontal assist forces of 4%, 8% and 12% of a subject's body weight were applied via our testing apparatus while subjects walked at comfortable walking speed on a level treadmill. Kinematic and metabolic parameters were measured using motion capture and ergospirometry respectively on a group of 10 healthy male subjects. Changes in kinematic and metabolic parameters were quantified and found similar to walking downhill at varying grades. A horizontal assist force of 8% resulted in the greatest reduction of metabolic cost. Changes in recovery factor, external work, and center of mass (COM) movement did not correlate with changes in metabolic rate and therefore were not driving the observed reductions in cost. The assist force may have performed external work by providing propulsion as well as raising the COM as it pivots over the stance leg. Assist forces may decrease metabolic cost by reducing the concentric work required for propulsion while increasing the eccentric work of braking. These findings on the effects of assist forces suggest novel mobility aids for individuals with gait disorders and training strategies for athletes.

  2. Assessment of external costs for transport project evaluation: Guidelines in some European countries

    SciTech Connect

    Petruccelli, Umberto

    2015-09-15

    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 to 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.

  3. Leading multiple teams: average and relative external leadership influences on team empowerment and effectiveness.

    PubMed

    Luciano, Margaret M; Mathieu, John E; Ruddy, Thomas M

    2014-03-01

    External leaders continue to be an important source of influence even when teams are empowered, but it is not always clear how they do so. Extending research on structurally empowered teams, we recognize that teams' external leaders are often responsible for multiple teams. We adopt a multilevel approach to model external leader influences at both the team level and the external leader level of analysis. In doing so, we distinguish the influence of general external leader behaviors (i.e., average external leadership) from those that are directed differently toward the teams that they lead (i.e., relative external leadership). Analysis of data collected from 451 individuals, in 101 teams, reporting to 25 external leaders, revealed that both relative and average external leadership related positively to team empowerment. In turn, team empowerment related positively to team performance and member job satisfaction. However, while the indirect effects were all positive, we found that relative external leadership was not directly related to team performance, and average external leadership evidenced a significant negative direct influence. Additionally, relative external leadership exhibited a significant direct positive influence on member job satisfaction as anticipated, whereas average external leadership did not. These findings attest to the value in distinguishing external leaders' behaviors that are exhibited consistently versus differentially across empowered teams. Implications and future directions for the study and management of external leaders overseeing multiple teams are discussed.

  4. 75 FR 52597 - Availability of Interim Procedures for Federal External Review and Model Notices Relating to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-26

    ... Federal External Review and Model Notices Relating to Internal Claims and Appeals and External Review Under the Patient Protection and Affordable Care Act; Notice AGENCY: Internal Revenue Service... external review process and model notices both for internal claims and appeals and for external...

  5. Some Simple Arguments about Cost Externalization and its Relevance to the Price of Fusion Energy

    SciTech Connect

    Budny, R.; Winfree, R.

    1999-09-27

    The primary goal of fusion energy research is to develop a source of energy that is less harmful to the environment than are the present sources. A concern often expressed by critics of fusion research is that fusion energy will never be economically competitive with fossil fuels, which in 1997 provided 75% of the world's energy. And in fact, studies of projected fusion electricity generation generally project fusion costs to be higher than those of conventional methods. Yet it is widely agreed that the environmental costs of fossil fuel use are high. Because these costs aren't included in the market price, and furthermore because many governments subsidize fossil fuel production, fossil fuels seem less expensive than they really are. Here we review some simple arguments about cost externalization which provide a useful background for discussion of energy prices. The collectively self-destructive behavior that is the root of many environmental problems, including fossil fuel use, was termed ''the tragedy of the commons'' by the biologist G. Hardin. Hardin's metaphor is that of a grazing commons that is open to all. Each herdsman, in deciding whether to add a cow to his herd, compares the benefit of doing so, which accrues to him alone, to the cost, which is shared by all the herdsmen using the commons, and therefore adds his cow. In this way individually rational behavior leads to the collective destruction of the shared resource. As Hardin pointed out, pollution is one kind of tragedy of the commons. CO{sub 2} emissions and global warming are in this sense classic tragedies.

  6. Stressful life experiences and peer externalizing behaviors mediate the relation between reduced family support and externalizing symptoms in low-income urban youth.

    PubMed

    Davis, Trina M; Wagstaff, Amanda E; Grant, Kathryn E; Taylor, Jeremy A; Carleton, Russell A; Masini, Olivia

    2014-01-01

    Family support, urban stressors, and peer behavior were examined in relation to externalizing symptoms in 605 predominantly low-income urban sixth through eighth grade adolescents. Mother and father support were each associated with lower levels of externalizing symptoms in both males and females. For males, father absence was associated with increased peer externalizing behavior and heightened rates of youth externalizing symptoms. Stress (in the form of major life events, daily hassles, and exposure to violence) and peer externalizing behavior were examined as mediators of the relation between parent support and youth externalizing symptoms. Increased stress exposure mediated the relation between weak mother and father support and youth externalizing symptoms. Additionally, for females, peer externalizing behavior mediated the relation between weak mother support and youth externalizing symptoms.

  7. Evaluation of activity-based costing versus resource-based relative value costing.

    PubMed

    Berlin, Mark F; Smith, Tommy H

    2004-01-01

    Activity-based costing (ABC) and relative value units costing (RVU) are two approaches that a practice manager can use to determine the cost of physician services. Each costing approach has features that provide distinction as well as differentiation in the cost estimates that are estimated. This paper will provide cost estimates under each approach along with cost estimates under a hybrid approach that merges features from each costing approach known as the ABC-RVU costing technique. A comparison of the results will be provided.

  8. 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

  9. Sex Differences in the Longitudinal Relations among Family Risk Factors and Childhood Externalizing Symptoms

    ERIC Educational Resources Information Center

    Blatt-Eisengart, Ilana; Drabick, Deborah A. G.; Monahan, Kathryn C.; Steinberg, Laurence

    2009-01-01

    Despite potential sex differences in base rates, predictors, and maintaining processes for children's externalizing behaviors, little prospective research has examined sex differences in the relations between concurrent, proximal family risk factors and children's externalizing behaviors. The current study examined the relations among maternal…

  10. 77 FR 36534 - Third External Review Draft Integrated Science Assessment for Ozone and Related Photochemical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... AGENCY Third External Review Draft Integrated Science Assessment for Ozone and Related Photochemical... External Review Draft Integrated Science Assessment for Ozone and Related Photochemical Oxidants'' (EPA/600... Standards (NAAQS) for ozone. EPA is releasing this draft document to seek review by the Clean Air...

  11. Environmental externalities: Applying the concept to Asian coal-based power generation. [Includes external environmental and societal costs and methods of evaluating them

    SciTech Connect

    Szpunar, C.B.; Gillette, J.L.

    1993-03-01

    This report examines the concept of environmental externality. It discusses various factors -- the atmospheric transformations, relationship of point-source emissions to ambient air quality, dose-response relationships, applicable cause-and-effect principles, and risk and valuation research -- that are considered by a number of state utilities when they apply the environmental externality concept to energy resource planning. It describes a methodology developed by Argonne National Laboratory for general use in resource planning, in combination with traditional methods that consider the cost of electricity production. Finally, it shows how the methodology can be applied in Indonesia, Thailand, and Taiwan to potential coal-fired power plant projects that will make use of clean coal technologies.

  12. 42 CFR 413.17 - Cost to related organizations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Cost to related organizations. 413.17 Section 413... Rules § 413.17 Cost to related organizations. (a) Principle. Except as provided in paragraph (d) of this section, costs applicable to services, facilities, and supplies furnished to the provider by...

  13. Information and issues related to the quantification of environmental externalities for new powerplants

    SciTech Connect

    Lee, A.D.; Callaway, J.M.; Glantz, C.S.; Baechler, M.C.; Foley, L.O.

    1990-10-01

    This report provides background information for the Bonneville Power Administration (Bonneville) in its efforts to quantify the environmental externalities associated with new electricity resources. A more detailed companion document has been provided to Bonneville for internal use. This report defines what is meant by externalities, particularly in the context of electricity resources. It outlines the economics issues associated with assigning an economic value, such as cents per kilowatt hour, to the residual environmental impacts of electricity powerplants. It examines two generic theoretical approaches for estimating such values and discusses their advantages and disadvantages. The report also addresses the need to include relevant stages in the fuel cycle in estimating the costs of externalities. The fuel-cycle concept is defined and its importance is discussed. The approaches used by several states to quantify externalities are described. A review of the valuation efforts of various states and utilities indicates that three states have actually developed methodologies for assigning economic values to externalities. Information that Bonneville may need to request from resource developers to quantify externalities is discussed, and an appendix presents suggested forms for obtaining the required information. Summary information also is presented on models for analyzing the dispersion of powerplant plumes for the purpose of estimating environmental externality costs. 34 refs., 1 fig., 4 tabs.

  14. Cost Curves and How They Relate.

    ERIC Educational Resources Information Center

    Mixon, J. Wilson; Tohemy, Soumaya M.

    2002-01-01

    Describes a Web site that contains Microsoft Excel workbooks that draft consistent short-run and long-run cost curves and the text describing them. Details a common error in representing the curves. Reports that the Web site also presents revenues and profits for a price taker and a price maker. (JEH)

  15. The relation between attachment, personality, internalizing, and externalizing dimensions in adolescents with borderline personality disorder.

    PubMed

    Ramos, Vera; Canta, Guilherme; de Castro, Filipa; Leal, Isabel

    2016-01-01

    The relation between attachment and personality features is an important field to explore in adolescent borderline personality disorder (BPD), and previous research has shown that personality features may be conceptualized within latent internalizing and externalizing dimensions. This cross-sectional study used a structural equation model to examine the association between the BPD participants' perception of attachment and personality features, mediated by the underlying internalizing/externalizing personality dimensions. Data were analyzed for 60 adolescents, ages 15 to 18 years, diagnosed with BPD who completed attachment and personality self-report measures. The authors' results showed a good fit of the model, suggesting a significant association between attachment and the internalizing/externalizing dimensions, which simultaneously congregate and influence personality traits. The perception of attachment anxiety was positively related to the internalizing dimension and at the same time negatively related to the externalizing dimension. However, the perception of attachment avoidance was not related to internalizing or externalizing personality dimensions.

  16. Comparing External Ventricular Drains-Related Ventriculitis Surveillance Definitions.

    PubMed

    Reyes, Maria M; Munigala, Satish; Church, Emily L; Kulik, Tobias B; Keyrouz, Salah G; Zipfel, Gregory J; Warren, David K

    2017-02-21

    OBJECTIVE To evaluate the agreement between the current National Healthcare Safety Network (NHSN) definition for ventriculitis and others found in the literature among patients with an external ventricular drain (EVD) DESIGN Retrospective cohort study from January 2009 to December 2014 SETTING Neurology and neurosurgery intensive care unit of a large tertiary-care center PATIENTS Patients with an EVD were included. Patients with an infection prior to EVD placement or a permanent ventricular shunt were excluded. METHODS We reviewed the charts of patients with positive cerebrospinal fluid (CSF) cultures and/or abnormal CSF results while they had an EVD in place and applied various ventriculitis definitions. RESULTS We identified 48 patients with a total of 52 cases of ventriculitis (41 CSF culture-positive cases and 11 cases based on abnormal CSF test results) using the NHSN definition. The most common organisms causing ventriculitis were gram-positive commensals (79.2%); however, 45% showed growth of only 1 colony on 1 piece of media. Approximately 60% of the ventriculitis cases by the NHSN definition met the Honda criteria, approximately 56% met the Gozal criteria, and 23% met Citerio's definition. Cases defined using Honda versus Gozal definitions had a moderate agreement (κ=0.528; P<.05) whereas comparisons of Honda versus Citerio definitions (κ=0.338; P<.05) and Citerio versus Gozal definitions (κ=0.384; P<.05) had only fair agreements. CONCLUSIONS The agreement between published ventriculostomy-associated infection (VAI) definitions in this cohort was moderate to fair. A VAI surveillance definition that better defines contaminants is needed for more homogenous application of surveillance definitions between institutions and better comparison of rates. Infect Control Hosp Epidemiol 2017;1-6.

  17. Conscientiousness and externalizing psychopathology: overlap, developmental patterns, and etiology of two related constructs.

    PubMed

    Roberts, Brent W; Jackson, Joshua J; Berger, Jessica M; Burger, Jessica; Trautwein, Ulrich

    2009-01-01

    The present paper focuses on the trait domain of conscientiousness, its development, and its relation to psychopathology. The definition of conscientiousness and its interface with specific forms of psychopathology, such as externalizing psychopathology, are discussed first. Then an overview of the known developmental changes in conscientiousness across the life course is provided, as well as the potential shared developmental etiology of conscientiousness and externalizing psychopathology. Given the lack of data, testing etiological factors that may contribute to the development of both conscientiousness and externalizing disorders, we report on three studies examining the childhood experiences associated with both conscientiousness and externalizing behaviors. Last, future directions are discussed.

  18. Mathematics Achievement and Anxiety and Their Relation to Internalizing and Externalizing Behaviors

    ERIC Educational Resources Information Center

    Wu, Sarah S.; Willcutt, Erik G.; Escovar, Emily; Menon, Vinod

    2014-01-01

    Although behavioral difficulties are well documented in reading disabilities, little is known about the relationship between math ability and internalizing and externalizing behaviors. Here, we use standardized measures to investigate the relation among early math ability, math anxiety, and internalizing and externalizing behaviors in a group of…

  19. Are Externalizing and Internalizing Difficulties of Young Children with Spelling Impairment Related to Their ADHD Symptoms?

    ERIC Educational Resources Information Center

    Rietz, Chantal Sabrina; Hasselhorn, Marcus; Labuhn, Andju Sara

    2012-01-01

    Children with literacy difficulties often suffer from a variety of co-occurring externalizing and internalizing difficulties, as well as comorbid ADHD. Therefore, these externalizing and internalizing problems might be more related to comorbid ADHD, rather than being a correlate of literacy difficulties per se. In the present study, we…

  20. Reciprocal Relations between Student-Teacher Conflict, Children's Social Skills and Externalizing Behavior

    ERIC Educational Resources Information Center

    Skalická, Vera; Stenseng, Frode; Wichstrøm, Lars

    2015-01-01

    Research suggests that the relation between student-teacher conflict and children's externalizing behavior might be reciprocal, and possibly also between student-teacher conflict and children's social skills. Because children with externalizing behavior also tend to display low levels of social skills, we do not know if one or both of these…

  1. Managing External Relations: The Lifeblood of Mission Success

    NASA Technical Reports Server (NTRS)

    Dumbacher, Daniel L.

    2007-01-01

    The slide presentation examines the role of customer and stakeholder relations in the success of space missions. Topics include agency transformation; an overview of project and program experience with a discussion of positions, technical accomplishments, and management lessons learned; and approaches to project success with emphasis on communication. Projects and programs discussed include the Space Shuttle Main Engine System, DC-XA Flight Demonstrator, X-33 Flight Demonstrator, Space Launch Initiative/2nd Generation Reusable Launch Vehicle, X-37 Flight Demonstrator, Constellation (pre Dr. Griffin), Safety and Mission Assurance, and Exploration Launch Projects.

  2. Characterization of a Low-Cost Optical Flow Sensor When Using an External Laser as a Direct Illumination Source

    PubMed Central

    Font, Davinia; Tresanchez, Marcel; Pallejà, Tomàs; Teixidó, Mercè; Palacín, Jordi

    2011-01-01

    In this paper, a low cost optical flow sensor is combined with an external laser device to measure surface displacements and mechanical oscillations. The measurement system is based on applying coherent light to a diffuser surface and using an optical flow sensor to analyze the reflected and transferred light to estimate the displacement of the surface or the laser spot. This work is focused on the characterization of this measurement system, which can have the optical flow sensor placed at different angles and distances from the diffuser surface. The results have shown that the displacement of the diffuser surface is badly estimated when the optical mouse sensor is placed in front of the diffuser surface (angular orientation >150°) while the highest sensitivity is obtained when the sensor is located behind the diffuser surface and on the axis of the laser source (angular orientation 0°). In this case, the coefficient of determination of the measured displacement, R2, was very high (>0.99) with a relative error of less than 1.29%. Increasing the distance between the surface and the sensor also increased the sensitivity which increases linearly, R2 = 0.99. Finally, this measurement setup was proposed to measure very low frequency mechanical oscillations applied to the laser device, up to 0.01 Hz in this work. The results have shown that increasing the distance between the surface and the optical flow sensor also increases the sensitivity and the measurement range. PMID:22247696

  3. The mediational role of parenting on the longitudinal relation between child personality and externalizing behavior.

    PubMed

    Prinzie, Peter; van der Sluis, Cathy M; de Haan, Amaranta D; Deković, Maja

    2010-08-01

    Building on prior cross-sectional work, this longitudinal study evaluated the proposition that maternal and paternal overreactive and authoritative parenting mediates the effect of child personality characteristics on externalizing behavior. Data from the Flemish Study on Parenting, Personality, and Problem Behavior were used in a moderated mediation analysis (N=434). Teachers rated children's Big Five characteristics, fathers and mothers rated their parenting, and 3 years later, children rated their externalizing behavior. Mediational analysis revealed both direct and indirect effects. Higher levels of Extraversion and lower levels of Benevolence were related directly to higher levels of child externalizing behavior. Higher levels of paternal authoritative parenting and lower levels of maternal overreactivity were related to lower scores on externalizing behavior. In addition, the relation between Benevolence, Emotional Stability, and externalizing behavior was partially mediated by parental overreactivity. Conscientiousness had an indirect effect on externalizing behavior through paternal authoritative parenting. Relations were not moderated by child gender. This study is of theoretical interest because the results demonstrate that parenting is a mediating mechanism that accounts for associations between personality and externalizing behavior.

  4. Utility planning using least-cost principles and the role of externalities - staff report on a Keystone policy dialogue

    SciTech Connect

    1996-05-01

    For over two years, The Keystone Center facilitated a two-phase dialogue on Utility Planning Using Least-Cost Principles and, in the second phase, on the role of Externalities. The intent of this report is to assist policy-makers faced with decisions about changes to traditional utility regulation and planning. This report is not a consensus document, rather it is staff written summary of two years of discussion on the issues. As a concept, least-cost planning has been discussed since the 1970`s and many states have implemented such programs since the mid-1980`s. Yet, the actual goals and objectives of least-cost planning remain a source of controversy between affected interest groups. Some industry observers believe that least-cost planning can help reconcile the often conflicting demands between increased capacity requirements and concerns about the external costs of power production. In traditional utility regulation practices, capital investments are rewarded and revenue is a direct function of sales. However, a number state public utility commissions have altered their practices to allow for returns on investments in more efficient end-use equipment (also known as ratebasing conservation) and adjusting revenues to account for sales lost due to utility conservation programs. Other states are planning these types of changes. Still others are observing the impacts of the changes before they commit.

  5. Externalizing symptoms, effortful control, and intrusive parenting: A test of bidirectional longitudinal relations during early childhood.

    PubMed

    Eisenberg, Nancy; Taylor, Zoe E; Widaman, Keith F; Spinrad, Tracy L

    2015-11-01

    At approximately 30, 42, and 54 months of age (N = 231), the relations among children's externalizing symptoms, intrusive maternal parenting, and children's effortful control (EC) were examined. Both intrusive parenting and low EC have been related to psychopathology, but children's externalizing problems and low EC might affect the quality of parenting and one another. Mothers' intrusive behavior with their children was assessed with observations, children's EC was measured with mothers' and caregivers' reports, and children's externalizing symptoms were assessed with mothers', fathers', and caregivers' reports. In a structural equation panel model, bidirectional relations between intrusive parenting and EC were found: EC at 30 and 42 months predicted low levels of intrusive parenting a year later, controlling for prior levels of parenting and vice versa. Moreover, high levels of children's externalizing problems at both 30 and 42 months negatively predicted EC a year later, controlling for prior levels of EC. Although externalizing problems positively predicted high EC over time, this appeared to be a suppression effect because these variables had a strong negative pattern in the zero-order correlations. Moreover, when controlling for the stability of intrusive parenting, EC, and externalizing (all exhibited significant stability across time) and the aforementioned cross-lagged predictive paths, EC and externalizing problems were still negatively related within the 54-month assessment. The findings are consistent with the view that children's externalizing behavior undermines their EC and contributes to intrusive mothering and that relations between intrusive parenting and EC are bidirectional across time. Thus, interventions that focus on modifying children's externalizing problems (as well as the quality of parenting) might affect the quality of parenting they receive and, hence, subsequent problems with adjustment.

  6. Alcohol-related genes show an enrichment of associations with a persistent externalizing factor.

    PubMed

    Ashenhurst, James R; Harden, K Paige; Corbin, William R; Fromme, Kim

    2016-10-01

    Research using twins has found that much of the variability in externalizing phenotypes-including alcohol and drug use, impulsive personality traits, risky sex, and property crime-is explained by genetic factors. Nevertheless, identification of specific genes and variants associated with these traits has proven to be difficult, likely because individual differences in externalizing are explained by many genes of small individual effect. Moreover, twin research indicates that heritable variance in externalizing behaviors is mostly shared across the externalizing spectrum rather than specific to any behavior. We use a longitudinal, "deep phenotyping" approach to model a general externalizing factor reflecting persistent engagement in a variety of socially problematic behaviors measured at 11 assessment occasions spanning early adulthood (ages 18 to 28). In an ancestrally homogenous sample of non-Hispanic Whites (N = 337), we then tested for enrichment of associations between the persistent externalizing factor and a set of 3,281 polymorphisms within 104 genes that were previously identified as associated with alcohol-use behaviors. Next, we tested for enrichment among domain-specific factors (e.g., property crime) composed of residual variance not accounted for by the common factor. Significance was determined relative to bootstrapped empirical thresholds derived from permutations of phenotypic data. Results indicated significant enrichment of genetic associations for persistent externalizing, but not for domain-specific factors. Consistent with twin research findings, these results suggest that genetic variants are broadly associated with externalizing behaviors rather than unique to specific behaviors. (PsycINFO Database Record

  7. Relations Among Internalizing and Externalizing Symptoms and Drinking Frequency During Adolescence

    PubMed Central

    Jun, Hyun-Jin; Sacco, Paul; Bright, Charlotte Lyn; Camlin, Elizabeth A. S.

    2016-01-01

    Background In adolescence, internalizing (e.g., anxious, depressive, and withdrawn) and externalizing (e.g., aggressive, oppositional, delinquent, and hyper-active) symptoms are related with alcohol use. However, the directionality among internalizing symptoms, externalizing symptoms, and alcohol use during adolescence is equivocal. Moreover, gender differences and similarities among these behaviors are not definitive in existing literature. Objectives This study examined longitudinal relationships between internalizing and externalizing symptoms and past-month alcohol use among adolescent boys and girls. Methods Using longitudinal survey data from a study of community-dwelling adolescents (n = 724), we estimated cross-lagged structural equation models to test relations between internalizing and externalizing symptoms (as measured by the Youth Self Report, YSR [Achenbach, 1991]) and self-report alcohol use in the past month among adolescents. Gender differences were tested in a multiple group structural equation model. Results Alcohol use at age 12 was a predictor of internalizing and externalizing symptoms at age 15 for both boys and girls. With regard to gender differences, girls demonstrated an association between internalizing symptoms and drinking at age 12, whereas boys showed a stronger association between externalizing symptoms and drinking at age 18. Conclusions/Importance Early alcohol use is problematic for youth, and results of this study lend support to prevention programs for youth. Preventing or curbing early drinking may offset later externalizing and internalizing symptoms, as well as ongoing alcohol use, regardless of gender. PMID:26646723

  8. Income-related cost sharing in health insurance.

    PubMed

    Rice, T; Thorpe, K E

    1993-01-01

    The vast majority of health plans in the United States require patients to meet cost-sharing requirements that are unrelated to income. Because this is highly inequitable, the authors propose a new system in which cost sharing is explicitly linked to income levels. This proposal differs from earlier proposals to relate cost sharing to income, which relied on the federal income tax system. In this plan, employers and insurers (both public and private) would collect the information necessary to relate cost sharing amounts to income. The proposal could be applied to nearly any health system reform proposal currently under discussion. The authors examine the experience of a number of U.S. firms that have already incorporated income-related cost sharing, as possible models to apply to health insurance nationwide.

  9. 42 CFR 413.17 - Cost to related organizations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Cost to related organizations. 413.17 Section 413.17 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE...

  10. 42 CFR 413.17 - Cost to related organizations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Cost to related organizations. 413.17 Section 413.17 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE...

  11. 42 CFR 413.17 - Cost to related organizations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Cost to related organizations. 413.17 Section 413.17 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE...

  12. 42 CFR 413.9 - Cost related to patient care.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Cost related to patient care. 413.9 Section 413.9 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE...

  13. 42 CFR 413.9 - Cost related to patient care.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Cost related to patient care. 413.9 Section 413.9 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE...

  14. 42 CFR 413.9 - Cost related to patient care.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Cost related to patient care. 413.9 Section 413.9 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE...

  15. 42 CFR 413.9 - Cost related to patient care.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Cost related to patient care. 413.9 Section 413.9 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE...

  16. 42 CFR 413.17 - Cost to related organizations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Cost to related organizations. 413.17 Section 413.17 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE...

  17. 42 CFR 413.9 - Cost related to patient care.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Cost related to patient care. 413.9 Section 413.9 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE...

  18. The cost of applying current helicopter external noise reduction methods while maintaining realistic vehicle performance

    NASA Technical Reports Server (NTRS)

    Bowes, M. A.

    1978-01-01

    Analytical methods were developed and/or adopted for calculating helicopter component noise, and these methods were incorporated into a unified total vehicle noise calculation model. Analytical methods were also developed for calculating the effects of noise reduction methodology on helicopter design, performance, and cost. These methods were used to calculate changes in noise, design, performance, and cost due to the incorporation of engine and main rotor noise reduction methods. All noise reduction techniques were evaluated in the context of an established mission performance criterion which included consideration of hovering ceiling, forward flight range/speed/payload, and rotor stall margin. The results indicate that small, but meaningful, reductions in helicopter noise can be obtained by treating the turbine engine exhaust duct. Furthermore, these reductions do not result in excessive life cycle cost penalties. Currently available main rotor noise reduction methodology, however, is shown to be inadequate and excessively costly.

  19. Is the societal approach wide enough to include relatives? Incorporating relatives' costs and effects in a cost-effectiveness analysis.

    PubMed

    Davidson, Thomas; Levin, Lars-Ake

    2010-01-01

    It is important for economic evaluations in healthcare to cover all relevant information. However, many existing evaluations fall short of this goal, as they fail to include all the costs and effects for the relatives of a disabled or sick individual. The objective of this study was to analyse how relatives' costs and effects could be measured, valued and incorporated into a cost-effectiveness analysis. In this article, we discuss the theories underlying cost-effectiveness analyses in the healthcare arena; the general conclusion is that it is hard to find theoretical arguments for excluding relatives' costs and effects if a societal perspective is used. We argue that the cost of informal care should be calculated according to the opportunity cost method. To capture relatives' effects, we construct a new term, the R-QALY weight, which is defined as the effect on relatives' QALY weight of being related to a disabled or sick individual. We examine methods for measuring, valuing and incorporating the R-QALY weights. One suggested method is to estimate R-QALYs and incorporate them together with the patient's QALY in the analysis. However, there is no well established method as yet that can create R-QALY weights. One difficulty with measuring R-QALY weights using existing instruments is that these instruments are rarely focused on relative-related aspects. Even if generic quality-of-life instruments do cover some aspects relevant to relatives and caregivers, they may miss important aspects and potential altruistic preferences. A further development and validation of the existing caregiving instruments used for eliciting utility weights would therefore be beneficial for this area, as would further studies on the use of time trade-off or Standard Gamble methods for valuing R-QALY weights. Another potential method is to use the contingent valuation method to find a monetary value for all the relatives' costs and effects. Because cost-effectiveness analyses are used for

  20. Elbow joint stability in relation to forced external rotation: An experimental study of the osseous constraint.

    PubMed

    Deutch, Søren R; Jensen, Steen L; Olsen, Bo S; Sneppen, Otto

    2003-01-01

    The objective of this study was to evaluate the osseous constraint related to forced forearm external rotation as the initial stage in a posterior elbow dislocation. Six joint specimens without soft tissues were examined in a joint analysis system developed for simulation of dislocation. The osseous stability, expressed as the maximal torque needed for pathologic external forearm rotation, increased from varus to valgus stress (P =.0001) and from 10 degrees to 90 degrees of elbow flexion (P =.012) and also tended to increase from forearm supination to pronation. The work of pathologic external forearm rotation until the point of maximal torque decreased from a maximum in full extension to a minimum at 30 degrees of elbow flexion (P =.03). The elbow in a slightly flexed position, varus stress, and forearm external rotation trauma might be the important biomechanical factors in the posterior elbow dislocation, and they might serve as guidelines during clinical investigation for posterolateral instability.

  1. Reciprocal Relations Between Harsh Discipline and Children's Externalizing Behavior in China: A 5-Year Longitudinal Study.

    PubMed

    Wang, Meifang; Liu, Li

    2017-02-01

    This research examined the overtime reciprocal relations between maternal and paternal harsh discipline and children's externalizing behavior. Seven hundred two father-mother dyads of children (6-9 years of age at baseline) completed measures of parental harsh discipline and children's externalizing behavior at five time points, 1 year apart. Autoregressive latent trajectory models revealed that maternal and paternal corporal punishment predicted subsequent children's externalizing behavior (parent-driven effects), whereas children's externalizing behavior predicted subsequent maternal and paternal psychological aggression (child-driven effects). The parent-driven effects became stronger, whereas the child-driven effects were equally strong across time. Furthermore, the parent-driven effects for corporal punishment were found for both boys and girls, whereas the child-driven effects for psychological aggression were found only for boys.

  2. Coparenting Behavior Moderates Longitudinal Relations between Effortful Control and Preschool Children’s Externalizing Behavior

    PubMed Central

    Schoppe-Sullivan, Sarah J.; Weldon, Arielle H.; Cook, J. Claire; Davis, Evan F.; Buckley, Catherine K.

    2010-01-01

    Background Temperamental effortful control involves the voluntary control of attention and behavior. Deficits in effortful control put children at risk for developing externalizing behavior problems. Coparenting behavior, or the extent to which parents support or undermine each other’s parenting efforts, has also been identified as an important correlate of children’s socioemotional adjustment. The present study tested whether coparenting behavior moderated longitudinal relations between preschool children’s effortful control and their externalizing behavior. Methods Ninety-two families (mother, father, 4-year-old child) participated. Parents’ coparenting behavior was observed during family interaction, and children’s effortful control was rated by parents. At that time and one year later, mothers and teachers reported on children’s externalizing behavior. Results Supportive coparenting behavior moderated longitudinal relations between children’s effortful control and mothers’ and teachers’ reports of their externalizing behavior, even when taking into account initial levels of externalizing behavior. Conclusions Effective coparenting served as a buffer for children, such that when parents displayed high levels of supportive coparenting behavior, the link between low effortful control and increases in externalizing behavior was not observed. PMID:19207627

  3. Tightly Linked Systems: Reciprocal Relations Between Maternal Depressive Symptoms And Maternal Reports of Adolescent Externalizing Behavior

    PubMed Central

    Allen, Joseph P.; Manning, Nell; Meyer, Jess

    2010-01-01

    The frequently observed link between maternal depressive symptoms and heightened maternal reporting of adolescent externalizing behavior was examined from an integrative, systems perspective using a community sample of 180 adolescents, their mothers, fathers, and close peers, assessed twice over a three-year period. Consistent with this perspective, the maternal depression-adolescent externalizing link was found to reflect not simply maternal reporting biases, but heightened maternal sensitivity to independently observable teen misbehavior as well as long-term, predictive links between maternal symptoms and teen behavior. Maternal depressive symptoms predicted relative increases over time in teen externalizing behavior. Child effects were also found, however, in which teen externalizing behavior predicted future relative increases in maternal depressive symptoms. Findings are interpreted as revealing a tightly-linked behavioral-affective system in families with mothers experiencing depressive symptoms and teens engaged in externalizing behavior, and further suggest that research on depressive symptoms in women with adolescent offspring should now consider offspring externalizing behaviors as a significant risk factor. PMID:21090880

  4. Standards-Based External Exams and Students' Science-Related Career Expectations: An International Perspective

    ERIC Educational Resources Information Center

    Han, Seong Won

    2016-01-01

    Students' science-related career expectations are important for predicting their future science, technology, engineering, and mathematics (STEM)-related educational and occupational attainments. This study examines the degree to which standards-based external examinations are associated with a student's propensity for pursuing science-related…

  5. Parenting Practices and Adolescent Internalizing and Externalizing Problems: Moderating Effects of Socially Demanding Kin Relations

    ERIC Educational Resources Information Center

    Taylor, Ronald D.; Lopez, Elizabeth I.; Budescu, Mia; McGill, Rebecca Kang

    2012-01-01

    Association of socially demanding kin relations, mother's emotional support, behavioral control/monitoring, family organization and psychological control with adolescent's internalizing and externalizing problems were assessed in 200 economically disadvantaged, African American mothers and adolescents. Demanding kin relations and mother's…

  6. The Feasibility of a Land Ferry System to Reduce Highway Maintenance Cost and Associated Externalities

    PubMed Central

    Merrill, Steve J.; Paz, Alexander; Molano, Victor; Shrestha, Pramen P.; Maheshwari, Pankaj; Stephen, Haroon

    2016-01-01

    This study provides an economic evaluation for a Land Ferry, which is a rail system capable of carrying trucks and all other types of vehicles, passengers, and cargo. The Land Ferry system involves a sliding loading system to roll heavy loads onto a flatbed; as a result, loading and unloading of all vehicles and cargo could be accomplished simultaneously. The evaluation for this system included (1) the design of a new track alignment over which the Land Ferry system would run, (2) evaluation of various sources of power, (3) estimation of how many local jobs the Land Ferry would generate, and (4) a benefit-cost analysis. It was estimated that the Land Ferry would create over 45,788 temporary jobs in Nevada during the three-year construction period and 318 permanent jobs during operation. The majority of the benefits were attributed to savings in travel time ($356.4 M), vehicle operating costs ($1000.4 M), reduction of accidents ($544.6 M), and pavement maintenance ($503.2 M). These benefits would be a consequence of the shift of trucks from the highway, thus resulting in higher speeds, decrease fuel consumption, and decrease vehicle maintenance costs. The overall benefit-cost ratio of 1.7 implies a cost-effective project. PMID:27419201

  7. Cost of Crashes Related to Road Conditions, United States, 2006

    PubMed Central

    Zaloshnja, Eduard; Miller, Ted R.

    2009-01-01

    This is the first study to estimate the cost of crashes related to road conditions in the U.S. To model the probability that road conditions contributed to the involvement of a vehicle in the crash, we used 2000–03 Large Truck Crash Causation Study (LTCCS) data, the only dataset that provides detailed information whether road conditions contributed to crash occurrence. We applied the logistic regression results to a costed national crash dataset in order to calculate the probability that road conditions contributed to the involvement of a vehicle in each crash. In crashes where someone was moderately to seriously injured (AIS-2-6) in a vehicle that harmfully impacted a large tree or medium or large non-breakaway pole, or if the first harmful event was collision with a bridge, we changed the calculated probability of being road-related to 1. We used the state distribution of costs of fatal crashes where road conditions contributed to crash occurrence or severity to estimate the respective state distribution of non-fatal crash costs. The estimated comprehensive cost of traffic crashes where road conditions contributed to crash occurrence or severity was $217.5 billion in 2006. This represented 43.6% of the total comprehensive crash cost. The large share of crash costs related to road design and conditions underlines the importance of these factors in highway safety. Road conditions are largely controllable. Road maintenance and upgrading can prevent crashes and reduce injury severity. PMID:20184840

  8. Estimating the mission-related costs of teaching hospitals.

    PubMed

    Koenig, Lane; Dobson, Allen; Ho, Silver; Siegel, Jonathan M; Blumenthal, David; Weissman, Joel S

    2003-01-01

    Academic health centers and other teaching hospitals face higher patient care costs than nonteaching community hospitals face, because of their missions of graduate medical education (GME), biomedical research, and the maintenance of standby capacity for medically complex patients. We estimate that total mission-related costs were dollar 27 billion in 2002 for all teaching hospitals, with GME (including indirect and direct GME) and standby capacity accounting for roughly 60 and 35 percent of these costs, respectively. To assure their continued ability to perform important social missions in a competitive environment, it may be necessary to reassess the way in which these activities are financed.

  9. Integrated Science Assessment (ISA) of Ozone and Related Photochemical Oxidants (First External Review Draft, Feb 2011)

    EPA Science Inventory

    EPA announced that the First External Review Draft of the Integrated Science Assessment for Ozone and Related Photochemical Oxidants has been made available for independent peer review and public review. This draft document represents a concise synthesis and evaluation of ...

  10. Integrated Science Assessment (ISA) of Ozone and Related Photochemical Oxidants (Third External Review Draft, Jun 2012)

    EPA Science Inventory

    EPA has released the Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Third External Review Draft) for independent peer review and public review. This draft document represents a concise synthesis and evaluation of the most policy-relevant science...

  11. Integrated Science Assessment (ISA) of Ozone and Related Photochemical Oxidants (Second External Review Draft, Sep 2011)

    EPA Science Inventory

    EPA has released the Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Second External Review Draft) for independent peer review and public review. This draft document represents a concise synthesis and evaluation of the most policy-relevant scienc...

  12. Air Quality Criteria for Ozone and Related Photochemical Oxidants (Second External Review Draft)

    EPA Science Inventory

    This second external review draft of the Air Quality Criteria for Ozone and Related Photochemical Oxidants, Volumes I-III (Ozone Criteria Document) is being released for public comment and for review by EPA's Clean Air Scientific Advisory Committee (CASAC) r...

  13. Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Second External Review Draft)

    EPA Science Inventory

    EPA has released the Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Second External Review Draft) for independent peer review and public review. This draft document represents a concise synthesis and evaluation of the most policy-relevant scienc...

  14. Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Third External Review Draft)

    EPA Science Inventory

    EPA has released the Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Third External Review Draft) for independent peer review and public review. This draft document represents a concise synthesis and evaluation of the most policy-relevant science...

  15. Externalizing and Internalizing Problems in Relation to Autonomic Function: A Population-Based Study in Preadolescents

    ERIC Educational Resources Information Center

    Dietrich, Andrea; Riese, Harriette; Sondeijker, Frouke E. P. L.; Greaves-Lord, Kirstin; van Roon, Arie M.; Ormel, Johan; Neeleman, Jan; Rosmalen, Judith G. M.

    2007-01-01

    Objective: To investigate whether externalizing and internalizing problems are related to lower and higher heart rate (HR), respectively, and to explore the relationship of these problems with respiratory sinus arrhythmia (RSA) and baroreflex sensitivity (BRS). Moreover, to study whether problems present at both preschool and preadolescent age…

  16. Air Quality Criteria for Ozone and Related Photochemical Oxidants (First External Review Draft)

    EPA Science Inventory

    This first external review draft of the Air Quality Criteria for Ozone and Related Photochemical Oxidants (Ozone Criteria Document) is being released in January 2005 for public comment and for review by EPA's Clean A...

  17. The Impact of External Environment on Service-Related Decisions of Juvenile Courts.

    ERIC Educational Resources Information Center

    Breda, Carolyn S.

    This report describes outcomes of a survey that investigated the external environment of juvenile courts and whether this environment relates to the treatment of young offenders or custody decisions. In 1997, a statewide survey was administered to all courts with juvenile jurisdiction in a Mid-Southern state. This research was based on 71 courts…

  18. Integrated Science Assessment of Ozone and Related Photochemical Oxidants (First External Review Draft)

    EPA Science Inventory

    EPA announced that the First External Review Draft of the Integrated Science Assessment for Ozone and Related Photochemical Oxidants has been made available for independent peer review and public review. This draft document represents a concise synthesis and evaluation of ...

  19. The Relation between Dimensions of Attachment and Internalizing or Externalizing Problems during Adolescence

    ERIC Educational Resources Information Center

    Ronnlund, Michael; Karlsson, Erika

    2006-01-01

    The authors examined the relation between dimensions of attachment and internalizing and externalizing problems in 15- to 16-year-old adolescents (n = 62) who completed the Attachment Style Questionnaire (ASQ; J. Feeney, P. Noller, & M. Hanrahan, 1994) and the Youth Self-Report (YSR; T. M. Achenbach, 1991). In total, the ASQ dimensions…

  20. Influences of external vs. core-shell mixing on aerosol optical properties at various relative humidities.

    PubMed

    Ramachandran, S; Srivastava, Rohit

    2013-05-01

    Aerosol optical properties of external and core-shell mixtures of aerosol species present in the atmosphere are calculated in this study for different relative humidities. Core-shell Mie calculations are performed using the values of radii, refractive indices and densities of aerosol species that act as core and shell, and the core-shell radius ratio. The single scattering albedo (SSA) is higher when the absorbing species (black carbon, BC) is the core, while for a sulfate core SSA does not vary significantly as the BC in the shell dominates the absorption. Absorption gets enhanced in core-shell mixing of absorbing and scattering aerosols when compared to their external mixture. Thus, SSA is significantly lower for a core-shell mixture than their external mixture. SSA is more sensitive to core-shell ratio than mode radius when BC is the core. The extinction coefficient, SSA and asymmetry parameter are higher for external mixing when compared to BC (core)-water soluble aerosol (shell), and water soluble aerosol (core)-BC (shell) mixtures in the relative humidity range of 0 to 90%. Spectral SSA exhibits the behaviour of the species which acts as a shell in core-shell mixing. The asymmetry parameter for an external mixture of water soluble aerosol and BC is higher than BC (core)-water soluble aerosol (shell) mixing and increases as function of relative humidity. The asymmetry parameter for the water soluble aerosol (core)-BC (shell) is independent of relative humidity as BC is hydrophobic. The asymmetry parameter of the core-shell mixture decreases when BC aerosols are involved in mixing, as the asymmetry parameter of BC is lower. Aerosol optical depth (AOD) of core-shell mixtures increases at a higher rate when the relative humidity exceeds 70% in continental clean and urban aerosol models, whereas AOD remains the same when the relative humidity exceeds 50% in maritime aerosol models. The SSA for continental aerosols varies for core-shell mixing of water soluble

  1. Reciprocal relations between parents' physical discipline and children's externalizing behavior during middle childhood and adolescence.

    PubMed

    Lansford, Jennifer E; Criss, Michael M; Laird, Robert D; Shaw, Daniel S; Pettit, Gregory S; Bates, John E; Dodge, Kenneth A

    2011-02-01

    Using data from two long-term longitudinal projects, we investigated reciprocal relations between maternal reports of physical discipline and teacher and self-ratings of child externalizing behavior, accounting for continuity in both discipline and externalizing over time. In Study 1, which followed a community sample of 562 boys and girls from age 6 to 9, high levels of physical discipline in a given year predicted high levels of externalizing behavior in the next year, and externalizing behavior in a given year predicted high levels of physical discipline in the next year. In Study 2, which followed an independent sample of 290 lower income, higher risk boys from age 10 to 15, mother-reported physical discipline in a given year predicted child ratings of antisocial behavior in the next year, but child antisocial behavior in a given year did not predict parents' use of physical discipline in the next year. In neither sample was there evidence that associations between physical discipline and child externalizing changed as the child aged, and findings were not moderated by gender, race, socioeconomic status, or the severity of the physical discipline. Implications for the reciprocal nature of the socialization process and the risks associated with physical discipline are discussed.

  2. Development and application of performance and cost models for the externally-fired combined cycle. Task 1, Volume 2. Topical report, June 1995

    SciTech Connect

    Agarwal, P.; Frey, H.; Rubin, E.S.

    1995-07-01

    Increasing restrictions on emission of pollutants from conventional pulverized coal fired steam (PCFS) plant generating electrical power is raising capital and operating cost of these plants and at the same time lowering plant efficiency. This is creating a need for alternative technologies which result in lower emissions of regulated pollutants and which are thermally more efficient. Natural gas-fired combined cycle power generation systems have lower capital cost and higher efficiencies than conventional coal fired steam plants, and at this time they are the leading contender for new power plant construction in the U.S. But the intermediate and long term cost of these fuels is high and there is uncertainty regarding their long-term price and availability. Coal is a relatively low cost fuel which will be abundantly available in the long term. This has motivated the development of advanced technologies for power production from coal which will have advantages of other fuels. The Externally Fired Combined Cycle (EFCC) is one such technology. Air pollution control/hot gas cleanup issues associated with this technology are described.

  3. Relations of Parenting to Adolescent Externalizing and Internalizing Distress Moderated by Perception of Neighborhood Danger.

    PubMed

    Goldner, Jonathan S; Quimby, Dakari; Richards, Maryse H; Zakaryan, Arie; Miller, Steve; Dickson, Daniel; Chilson, Jessica

    2016-01-01

    Parental monitoring and warmth have traditionally been studied in the context of White, middle-class families. This article explores optimal levels of these parenting behaviors in preventing adolescent psychopathology in impoverished, urban high-crime areas while accounting for child perceptions of neighborhood danger. In this study, data were collected longitudinally at 2 time points 1 year apart from a sample of 254 African American young adolescents (T1: M age = 12.6 years, 41% male) and their parents. Parental monitoring and warmth, child perception of neighborhood danger, and child internalizing and externalizing behaviors were measured using questionnaires. Child internalizing behaviors were also measured using a time sampling technique capturing in vivo accounts of daily distress. Findings indicated associations between parental monitoring and children's externalizing behaviors along with linear and quadratic associations between parental monitoring and internalizing behaviors. Monitoring and warmth were differentially related to symptoms depending on neighborhood danger level. When children perceived less danger, more monitoring related to less externalizing. When children perceived more danger, more warmth related to less internalizing. In addition, adolescents' perceptions of neighborhood danger emerged as equally strong as monitoring and warmth in predicting symptoms. This study underscores the influence of carefully considering parenting approaches and which techniques optimally prevent adolescents' externalizing, as well as prevent internalizing difficulties. It also highlights how context affects mental health, specifically how perceptions of danger negatively influence adolescents' psychopathology, emphasizing the importance of initiatives to reduce violence in communities.

  4. Local muscle oxygen consumption related to external and joint specific power.

    PubMed

    Skovereng, Knut; Ettema, Gertjan; van Beekvelt, Mireille

    2016-02-01

    The purpose of the present study was to examine the effects of external work rate on joint specific power and the relationship between knee extension power and vastus lateralis muscle oxygen consumption (mVO2). We measured kinematics and pedal forces and used inverse dynamics to calculate joint power for the hip, knee and ankle joints during an incremental cycling protocol performed by 21 recreational cyclists. Vastus lateralis mVO2 was estimated using near-infrared spectroscopy with an arterial occlusion. The main finding was a non-linear relationship between vastus lateralis mVO2 and external work rate that was characterised by an increase followed by a tendency for a levelling off (R(2)=0.99 and 0.94 for the quadratic and linear models respectively, p<0.05). When comparing 100W and 225W, there was a ∼43W increase in knee extension but still a ∼9% decrease in relative contribution of knee extension to external work rate resulting from a ∼47W increase in hip extension. When vastus lateralis mVO2 was related to knee extension power, the relationship was still non-linear (R(2)=0.99 and 0.97 for the quadratic and linear models respectively, p<0.05). These results demonstrate a non-linear response in mVO2 relative to a change in external work rate. Relating vastus lateralis mVO2 to knee extension power showed a better fit to a linear equation compared to external work rate, but it is not a straight line.

  5. Mathematics achievement and anxiety and their relation to internalizing and externalizing behaviors.

    PubMed

    Wu, Sarah S; Willcutt, Erik G; Escovar, Emily; Menon, Vinod

    2014-01-01

    Although behavioral difficulties are well documented in reading disabilities, little is known about the relationship between math ability and internalizing and externalizing behaviors. Here, we use standardized measures to investigate the relation among early math ability, math anxiety, and internalizing and externalizing behaviors in a group of 366 second and third graders. Math achievement was significantly correlated with attentional difficulties and social problems but not with internalizing symptoms. The relation between math achievement and externalizing behavioral problems was stronger in girls than in boys. Math achievement was not correlated with trait anxiety but was negatively correlated with math anxiety. Critically, math anxiety differed significantly between children classified as math learning disabled (MLD), low achieving (LA), and typically developing (TD), with math anxiety significantly higher in the MLD and LA groups compared to the TD group. Our findings suggest that, even in nonclinical samples, math difficulties at the earliest stages of formal math learning are associated with attentional difficulties and domain-specific anxiety. These findings underscore the need for further examination of the shared cognitive, neural, and genetic influences underlying problem solving and nonverbal learning difficulties and accompanying internalizing and externalizing behaviors.

  6. Are externalizing and internalizing difficulties of young children with spelling impairment related to their ADHD symptoms?

    PubMed

    Rietz, Chantal Sabrina; Hasselhorn, Marcus; Labuhn, Andju Sara

    2012-08-01

    Children with literacy difficulties often suffer from a variety of co-occurring externalizing and internalizing difficulties, as well as comorbid ADHD. Therefore, these externalizing and internalizing problems might be more related to comorbid ADHD, rather than being a correlate of literacy difficulties per se. In the present study, we investigated the occurrence of externalizing and internalizing difficulties in elementary school children (third grade) with and without spelling impairment. Taking the high rate of comorbidity between literacy difficulties and ADHD into account, we investigated whether co-occurring difficulties are associated with spelling impairment per se or with comorbid ADHD symptoms. Results indicated that these young children with spelling impairment showed more co-occurring difficulties compared with children without spelling impairment. Hierarchical regression analysis indicated that occurrence of externalizing symptoms is more strongly related to comorbid ADHD symptoms than to spelling impairment per se. The pattern of results concerning internalizing problems was not as distinct but showed a similar trend. Preferably, carers and educators should be aware of co-occurring socio-emotional and behavioural problems in children with spelling impairment. Particularly children with spelling impairment and comorbid ADHD symptoms seem to have an increased risk of encountering further co-occurring difficulties.

  7. The Relation among Sleep, Routines, and Externalizing Behavior in Children with an Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Henderson, Jill A.; Barry, Tammy D.; Bader, Stephanie H.; Jordan, Sara Sytsma

    2011-01-01

    The present study examined relations among sleep, routines, and externalizing behavior (based on parent report) in 115 children ages 6 to 12 years in two groups: 58 children with an autism spectrum disorder (age M = 9.0, SD = 2.09) and 57 non-ASD children (age M = 8.25, SD = 1.98). Within the ASD group, sleep hygiene and sleep quality were related…

  8. Relations of Parenting and Temperament to Chinese Children’s Experience of Negative Life Events, Coping Efficacy, and Externalizing Problems

    PubMed Central

    Zhou, Qing; Wang, Yun; Deng, Xianli; Eisenberg, Nancy; Wolchik, Sharlene A.; Tein, Jenn-Yun

    2009-01-01

    The relations of parenting and temperament (effortful control and anger/frustration) to children’s externalizing problems were examined in a 3.8-year longitudinal study of 425 native Chinese children (6 – 9 years) from Beijing. Children’s experience of negative life events and coping efficacy were examined as mediators in the parenting and temperament-externalizing relations. Parents reported on their own parenting. Parents and teachers rated temperament. Children reported on negative life events and coping efficacy. Parents, teachers, children, or peers rated children’s externalizing problems. Authoritative and authoritarian parenting and anger/frustration uniquely predicted externalizing problems. The relation between authoritarian parenting and externalizing was mediated by children’s coping efficacy and negative school events. The results suggest there is some cross-cultural universality in the developmental pathways for externalizing problems. PMID:18489409

  9. Sequence Effect in Parkinson's Disease Is Related to Motor Energetic Cost.

    PubMed

    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.

  10. Differential relations between youth internalizing/externalizing problems and cortisol responses to performance vs. interpersonal stress.

    PubMed

    Laurent, Heidemarie; Vergara-Lopez, Chrystal; Stroud, Laura R

    2016-09-01

    Efforts to define hypothalamic-pituitary-adrenal (HPA) axis profiles conferring risk for psychopathology have yielded inconclusive results, perhaps in part due to limited assessment of the stress response. In particular, research has typically focused on HPA responses to performance tasks, while neglecting the interpersonal stressors that become salient during adolescence. In this study we investigated links between psychosocial adjustment - youth internalizing and externalizing problems, as well as competence - and HPA responses to both performance and interpersonal stressors in a normative sample of children and adolescents. Participants (n = 59) completed a set of performance (public speaking, mental arithmetic, mirror tracing) and/or interpersonal (peer rejection) tasks and gave nine saliva samples, which were assayed for cortisol. Hierarchical linear models of cortisol response trajectories in relation to child behavior checklist (CBCL) scores revealed stressor- and sex-specific associations. Whereas internalizing problems related to earlier peaking, less dynamic cortisol responses to interpersonal stress (across males and females), externalizing problems related to lower, earlier peaking and less dynamic cortisol responses to performance stress for males only, and competence-related to later peaking cortisol responses to interpersonal stress for females only. Implications for understanding contextual stress profiles underlying different forms of psychopathology are discussed.

  11. Practical and fast quantum random number generation based on photon arrival time relative to external reference

    NASA Astrophysics Data System (ADS)

    Nie, You-Qi; Zhang, Hong-Fei; Zhang, Zhen; Wang, Jian; Ma, Xiongfeng; Zhang, Jun; Pan, Jian-Wei

    2014-02-01

    We present a practical high-speed quantum random number generator, where the timing of single-photon detection relative to an external time reference is measured as the raw data. The bias of the raw data can be substantially reduced compared with the previous realizations. The raw random bit rate of our generator can reach 109 Mbps. We develop a model for the generator and evaluate the min-entropy of the raw data. Toeplitz matrix hashing is applied for randomness extraction, after which the final random bits are able to pass the standard randomness tests.

  12. 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

  13. The Differential Relations Between Empathy and Internalizing and Externalizing Symptoms in Inpatient Adolescents.

    PubMed

    Gambin, Malgorzata; Sharp, Carla

    2016-12-01

    Impaired empathy is associated with a variety of psychiatric conditions; however, little is known about the differential relations between certain forms of psychopathology and cognitive and affective empathy in adolescent girls and boys. The aim of this study was to examine the relations between externalizing and internalizing disorders and cognitive and affective empathy, respectively, while controlling for covariance among different forms of psychopathology, separately in girls and boys. A total of 507 inpatient adolescents (319 girls and 188 boys) in the age range of 12-17 years completed the Basic Empathy Scale that measures affective and cognitive empathy. The Youth Self-Report Form and Child Behavior Checklist were used to assess the severity of psychopathological symptoms. Results demonstrated that affective and cognitive empathy were negatively associated with conduct problems only in girls, but not in boys. Affective empathy was positively related to internalizing problems observed by parents and youths and self-reported ADHD symptoms in girls and boys. The clinical implications of these differential relationships for externalizing versus internalizing symptoms and empathy are discussed.

  14. Using Dominance Analysis to Decompose Narcissism and Its Relation to Aggression and Externalizing Outcomes.

    PubMed

    Vize, Colin E; Collison, Katherine L; Crowe, Michael L; Campbell, W Keith; Miller, Joshua D; Lynam, Donald R

    2017-01-01

    Research on narcissism has shown it to be multidimensional construct. As such, the relations the larger construct bear with certain outcomes may mask heterogeneity apparent at the more basic trait level. This article used the Five Factor Narcissism Inventory, a Five-Factor Model-based measure of narcissism that allows for multiple levels of analysis, to examine the relative importance of narcissistic traits in relation to aggression, externalizing behavior, and self-esteem outcomes in two independent samples. The relative importance of the narcissism factors was determined through the use of dominance analysis-a relatively underused method for determining relative importance among a set of related predictors. The results showed that antagonism, compared with agentic extraversion and neuroticism, was the dominant predictor across all forms of aggressive behavior. Additional analyses showed that subscales within the broader factor of antagonism also showed differential importance relative to one another for certain aggression outcomes. The results are discussed in the context of the relation between narcissism and aggression and highlight the utility of using extensions of regression-based analyses to explore the heterogeneity within personality constructs.

  15. Technical Aspects of Interfacing MUMPS to an External SQL Relational Database Management System

    PubMed Central

    Kuzmak, Peter M.; Walters, Richard F.; Penrod, Gail

    1988-01-01

    This paper describes an interface connecting InterSystems MUMPS (M/VX) to an external relational DBMS, the SYBASE Database Management System. The interface enables MUMPS to operate in a relational environment and gives the MUMPS language full access to a complete set of SQL commands. MUMPS generates SQL statements as ASCII text and sends them to the RDBMS. The RDBMS executes the statements and returns ASCII results to MUMPS. The interface suggests that the language features of MUMPS make it an attractive tool for use in the relational database environment. The approach described in this paper separates MUMPS from the relational database. Positioning the relational database outside of MUMPS promotes data sharing and permits a number of different options to be used for working with the data. Other languages like C, FORTRAN, and COBOL can access the RDBMS database. Advanced tools provided by the relational database vendor can also be used. SYBASE is an advanced high-performance transaction-oriented relational database management system for the VAX/VMS and UNIX operating systems. SYBASE is designed using a distributed open-systems architecture, and is relatively easy to interface with MUMPS.

  16. Relating costs to the user value of farmland biodiversity measurements.

    PubMed

    Targetti, S; Herzog, F; Geijzendorffer, I R; Pointereau, P; Viaggi, D

    2016-01-01

    The impact of agricultural management on global biodiversity highlights the need for farm-scale monitoring programmes capable of determining the performance of agriculture practices. Yet the identification of appropriate indicators is a challenging process and one that involves considering a number of different aspects and requirements. Besides the attention given to scientific effectiveness, relevant but less studied issues related to biodiversity measurements include the economic feasibility of monitoring programmes and the relevance of indicators for different end-users. In this paper, we combine an analytic assessment of costs and a stakeholder-based evaluation of the usefulness of a set of biodiversity-related parameters (habitat mapping, vegetation, bees, earthworms, spiders, and a farmer questionnaire) tested for scientific consistency in 12 European case studies and on more than 14,000 ha of farmland. The results point to the possibility of meeting the expectations of different end-users (administrators, farmers and consumers) with a common indicator set. Combining costs and usefulness also suggests the possibility of designing more efficient monitoring approaches involving private agencies and networks of volunteers and farmers for the field data collection at different stages of a monitoring programme. Although complex, such an approach would make it possible to enhance the effectiveness of available funds for farmland biodiversity monitoring.

  17. Mechanisms in the relation between GABRA2 and adolescent externalizing problems

    PubMed Central

    Wang, Frances L.; Chassin, Laurie; Geiser, Christian; Lemery-Chalfant, Kathryn

    2015-01-01

    Conduct problems, alcohol problems and hyperactive–inattentive symptoms co-occur at a high rate and are heritable in adolescence. The γ-aminobutyric acid A receptor, α2 gene (GABRA2) is associated with a broad spectrum of externalizing problems and disinhibitory-related traits. The current study tested whether two important forms of disinhibition in adolescence, impulsivity and sensation seeking, mediated the effects of GABRA2 on hyperactive–inattentive symptoms, conduct problems, and alcohol problems. Participants were assessed at two waves (11–17 and 12–18 years old; N = 292). Analyses used the GABRA2 SNP, rs279858, which tags the two complementary (yin–yang) GABRA2 haplotypes. Multiple informants reported on adolescents’ impulsivity and sensation seeking and adolescents self-reported their hyperactive–inattentive symptoms, conduct problems and lifetime alcohol problems. Impulsivity mediated the effect of GABRA2 on alcohol problems, hyperactive–inattentive symptoms, and conduct problems, whereas sensation seeking mediated the effect of GABRA2 on alcohol problems (AA/AG geno-types conferred risk). GABRA2 directly predicted adolescent alcohol problems, but the GG genotype conferred risk. Results suggest that there may be multiple pathways of risk from GABRA2 to adolescent externalizing problems, and suggest important avenues for future research. PMID:25804982

  18. Iliofemoral Venous Thrombosis Mainly Related to Iliofemoral Venous Obstruction by External Tumor Compression in Cancer Patients

    PubMed Central

    Liao, Tzu-Yao; Hsu, Hui-Ching; Wen, Min-Sheng; Juan, Yu-Hsiang; Hung, Yu-Hsin; Liaw, Chuang-Chi

    2016-01-01

    Background To study iliofemoral venous thrombosis related to iliofemoral venous obstruction in cancer patients. Methods In this case series study, 829 cancer patients were surveyed for iliofemoral obstruction/thrombosis within 10 years. The criteria for inclusion were: (1) presence of unilateral lower-extremity swelling; (2) computed tomography (CT) scans showing a tumor with external compression of the iliac or femoral vein, and (3) duplex ultrasound scans showing venous thrombosis or venous flow insufficiency over a femoral vein or saphenous vein. Results Sixty-three patients (8%) developed an iliofemoral venous obstruction. The presence of iliofemoral venous thrombosis was detected in 21 of these patients (33%). The rate of iliofemoral venous thrombosis was significantly higher in patients with an invasion of the inguinal region, D-dimer levels >3,000 ng/ml, gastrointestinal cancer, or invasion of the inguinal lymph nodes. However, none of our patients with iliofemoral venous thrombosis had a detection of iliofemoral venous obstruction. Improved lower-extremity swelling was reported in 84% of the patients following combination therapy involving low-molecular-weight heparin (LMWH) and systemic therapy. Conclusion Patients with an iliofemoral venous thrombosis mainly had iliofemoral venous obstruction by external tumor compression. Combination therapy with LMWH and systemic therapy were mandatory for these patients. PMID:27990113

  19. Relation optimization of the starting and main stages of rockets with short-running engine on the external oxidizer

    NASA Astrophysics Data System (ADS)

    Ustinov, L. A.; Zelenkov, P. V.; Kovalev, I. V.

    2016-11-01

    The paper considers an optimal choice of the mass relation of the starting and main stages of the rocket with a short-running engine on the external oxidizer from the point of view of achieving the maximum firing range.

  20. Longitudinal relations between parental media monitoring and adolescent aggression, prosocial behavior, and externalizing problems.

    PubMed

    Padilla-Walker, Laura M; Coyne, Sarah M; Collier, Kevin M

    2016-01-01

    The current study examined longitudinal relations between parental media monitoring and adolescent behavior, and explored indirect effects via sympathy and self-regulation. A sample of adolescents and their mothers from Northwestern and Mountain West cities in the USA participated in a study at three time points, approximately one year apart (N = 681; M age of child at Time 3 = 13.33, SD = 1.06; 51% female; 73% European American, 9% African American, 17% Multi-ethnic). Though findings varied by reporter, results suggested that restrictive and active media monitoring were indirectly associated with adolescents' prosocial behavior, aggression, and externalizing behavior, with restrictive monitoring being somewhat maladaptive and active monitoring adaptive. The discussion focuses on the need to examine multiple aspects of media monitoring, and highlights implications of findings for parents.

  1. Negative emotional reactivity moderates the relations between family cohesion and internalizing and externalizing symptoms in adolescence.

    PubMed

    Rabinowitz, Jill A; Osigwe, Ijeoma; Drabick, Deborah A G; Reynolds, Maureen D

    2016-12-01

    Lower family cohesion is associated with adolescent internalizing and externalizing problems. However, there are likely individual differences in youth's responses to family processes. For example, adolescents higher in negative emotional reactivity, who often exhibit elevated physiological responsivity to context, may be differentially affected by family cohesion. We explored whether youth's negative emotional reactivity moderated the relation between family cohesion and youth's symptoms and tested whether findings were consistent with the diathesis-stress model or differential susceptibility hypothesis. Participants were 651 adolescents (M = 12.99 ± .95 years old; 72% male) assessed at two time points (Time 1, ages 12-14; Time 2, age 16) in Pittsburgh, PA. At Time 1, mothers reported on family cohesion and youth reported on their negative emotional reactivity. At Time 2, youth reported on their symptoms. Among youth higher in negative emotional reactivity, lower family cohesion predicted higher symptoms than higher family cohesion, consistent with the diathesis-stress model.

  2. Interrelation between external oscillatory muscle coupling amplitude and in vivo intramedullary pressure related bone adaptation.

    PubMed

    Hu, Minyi; Cheng, Jiqi; Bethel, Neville; Serra-Hsu, Frederick; Ferreri, Suzanne; Lin, Liangjun; Qin, Yi-Xian

    2014-09-01

    Interstitial bone fluid flow (IBFF) is suggested as a communication medium that bridges external physical signals and internal cellular activities in the bone, which thus regulates bone remodeling. Intramedullary pressure (ImP) is one main regulatory factor of IBFF and bone adaptation related mechanotransduction. Our group has recently observed that dynamic hydraulic stimulation (DHS), as an external oscillatory muscle coupling, was able to induce local ImP with minimal bone strain as well as to mitigate disuse bone loss. The current study aimed to evaluate the dose dependent relationship between DHS's amplitude, i.e., 15 and 30mmHg, and in vivo ImP induction, as well as this correlation on bone's phenotypic change. Simultaneous measurements of ImP and DHS cuff pressures were obtained from rats under DHS with various magnitudes and a constant frequency of 2Hz. ImP inductions and cuff pressures upon DHS loading showed a positively proportional response over the amplitude sweep. The relationship between ImP and DHS cuff pressure was evaluated and shown to be proportional, in which ImP was raised with increases of DHS cuff pressure amplitudes (R(2)=0.98). A 4-week in vivo experiment using a rat hindlimb suspension model demonstrated that the mitigation effect of DHS on disuse trabecular bone was highly dose dependent and related to DHS's amplitude, where a higher ImP led to a higher bone volume. This study suggested that sufficient physiological DHS is needed to generate ImP. Oscillatory DHS, potentially induces local fluid flow, has shown dose dependence in attenuation of disuse osteopenia.

  3. Major Trends and Portents Related to Information Costs.

    ERIC Educational Resources Information Center

    Wilson, John H., Jr.

    Managers' having to account for cost of information activities is here to stay. Budgeting is going to become more stringent and imaginative. Costs should not be equated with human values--psychological and subjective--which apparently many managers do, feeling that having to cost information activities is degrading. Some trends are: Buy products…

  4. Instructional Support Costs Related to Faculty Salary Costs. Report No. 79-02.

    ERIC Educational Resources Information Center

    Hample, Stephen R.

    Nonfaculty salary (instructional support) costs for Montana State University (MSU) are examined with specific reference to the adequacy of the 25 percent nonfaculty salary allowance for other costs. Two concepts are examined: nonfaculty salary expenses within the instruction program (direct instructional support costs) and both direct support…

  5. 48 CFR 1631.205-70 - FEHBP public relations and advertising costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... relations and advertising costs. (a) The cost of media messages that are directed at advising current FEHBP... advertising costs. 1631.205-70 Section 1631.205-70 Federal Acquisition Regulations System OFFICE OF PERSONNEL... cost of the message. (b) Costs of media messages not provided for in paragraph (a) of this section...

  6. Validity of the Externalizing Spectrum Inventory in a criminal offender sample: relations with disinhibitory psychopathology, personality, and psychopathic features.

    PubMed

    Venables, Noah C; Patrick, Christopher J

    2012-03-01

    The Externalizing Spectrum Inventory (ESI; Krueger, Markon, Patrick, Benning, & Kramer, 2007) provides a self-report based method for indexing a range of correlated problem behaviors and traits in the domain of deficient impulse control. The ESI organizes lower order behaviors and traits of this kind around higher order factors encompassing general disinhibitory proneness, callous-aggression, and substance abuse. In the current study, we used data from a male prisoner sample (N = 235) to evaluate the validity of ESI total and factor scores in relation to external criterion measures consisting of externalizing disorder symptoms (including child and adult antisocial deviance and substance-related problems) assessed via diagnostic interviews, personality traits assessed with self-reports, and psychopathic features as assessed with both interviews and self-reports. Results provide evidence for the validity of the ESI measurement model and point to its potential usefulness as a referent for research on the neurobiological correlates and etiological bases of externalizing proneness.

  7. [Unified National Health System costs in São José dos Campos, São Paulo State, Brazil, for hospital admissions due to external causes].

    PubMed

    Melione, Luís Paulo Rodrigues; Mello-Jorge, Maria Helena Prado de

    2008-08-01

    The objective of this study was to identify direct expenditures for hospitalizations due to external causes in the Unified National Health System (SUS) in the city of São José dos Campos, São Paulo State, Brazil. Admissions to the Dr. José de Carvalho Florence Municipal Hospital resulting from external causes or injuries - ICD-10, chapters XIX and XX respectively - were analyzed for the first semester of 2003. 976 patient admission forms were analyzed, after data evaluation. Admissions with the highest total cost were those resulting from motor vehicle accidents and falls. The highest mean cost for hospitalization for injury was due to motor vehicle accidents (BRL 614.63), followed by assault (BRL 594.90). The highest mean cost for hospitalization due to injury was for cervical fractures (BRL 1,191.42) and head injuries (BRL 1,000.44). Hospitalizations with the highest daily cost were skull and facial fractures (BRL 166.72) and abdominal trauma (BRL 148.26). The study confirmed that motor vehicle accidents, falls, and assault are an important source of costs due to hospitalization for injuries.

  8. External Visual Representations in Science Learning: The case of relations among system components

    NASA Astrophysics Data System (ADS)

    Eilam, Billie; Poyas, Yael

    2010-11-01

    How do external visual representations (e.g., graph, diagram) promote or constrain students' ability to identify system components and their interrelations, to reinforce a systemic view through the application of the STS approach? University students (N = 150) received information cards describing cellphones' communication system and its subsystem components. One group (n = 82) received a display of cards presenting this information in rich and diverse visual representations and a few text cards. Another group (n = 68) received a single representation display, of text only. Using these card sets, students were asked to identify the cellular systems' components and relations, and to construct new interrelations. Findings showed that, mostly, multimedia enabled better identification and construction of relations of higher component diversity, accuracy, description, and novelty, using a larger number of information cards than did the textual display. Generally, findings suggested that components' saliency and distinctiveness in the visual display afforded a better systemic view. However, curriculum designers and teachers should be aware of cases in which rich multimedia constrained performance.

  9. Employment and residential characteristics in relation to automated external defibrillator locations

    PubMed Central

    Griffis, Heather M.; Band, Roger A; Ruther, Matthew; Harhay, Michael; Asch, David A.; Hershey, John C.; Hill, Shawndra; Nadkarni, Lindsay; Kilaru, Austin; Branas, Charles C.; Shofer, Frances; Nichol, Graham; Becker, Lance B.; Merchant, Raina M.

    2015-01-01

    Background Survival from out-of-hospital cardiac arrest (OHCA) is generally poor and varies by geography. Variability in automated external defibrillator (AED) locations may be a contributing factor. To inform optimal placement of AEDs, we investigated AED access in a major US city relative to demographic and employment characteristics. Methods and Results This was a retrospective analysis of a Philadelphia AED registry (2,559 total AEDs). The 2010 US Census and the Local Employment Dynamics (LED) database by ZIP code was used. AED access was calculated as the weighted areal percentage of each ZIP code covered by a 400 meter radius around each AED. Of 47 ZIP codes, only 9%(4) were high AED service areas. In 26%(12) of ZIP codes, less than 35% of the area was covered by AED service areas. Higher AED access ZIP codes were more likely to have a moderately populated residential area (p=0.032), higher median household income (p=0.006), and higher paying jobs (p=008). Conclusions The locations of AEDs vary across specific ZIP codes; select residential and employment characteristics explain some variation. Further work on evaluating OHCA locations, AED use and availability, and OHCA outcomes could inform AED placement policies. Optimizing the placement of AEDs through this work may help to increase survival. PMID:26856232

  10. Motor neuron targeting of IGF-1 attenuates age-related external Ca2+-dependent skeletal muscle contraction in senescent mice.

    PubMed

    Payne, Anthony M; Messi, María Laura; Zheng, Zhenlin; Delbono, Osvaldo

    2007-04-01

    A population of fast muscle fibers from aging mice is dependent on external Ca(2+) to maintain tetanic force during repeated contractions. We hypothesized that age-related denervation in muscle fibers plays a role in initiating this contractile deficit, and that prevention of denervation by IGF-1 overexpression would prevent external Ca(2+)-dependent contraction in aging mice. IGF-1 overexpression in skeletal muscle prevents age-related denervation, and prevented external Ca(2+)-dependent contraction in this work. To determine if the effects of IGF-1 overexpression are on muscle or nerve, aging mice were injected with a tetanus toxin fragment-C (TTC) fusion protein that targets IGF-1 to spinal cord motor neurons. This treatment prevented external Ca(2+)-dependent contraction. We also show evidence that injections of the IGF-1-TTC fusion protein prevent age-related alterations to the nerve terminals at the neuromuscular junctions. We conclude that the slow age-related denervation of fast muscle fibers underlies dependence on external Ca(2+) to maintain tetanic force in a population of muscle fibers from senescent mice.

  11. Parental corporal punishment in relation to children's executive function and externalizing behavior problems in China.

    PubMed

    Xing, Xiaopei; Wang, Meifang; Wang, Zhengyan

    2016-11-21

    The current study examined the relationship among paternal and maternal corporal punishment (CP), children's executive function (EF), and children's externalizing behavior problems. In total, 328 Chinese preschool-aged children and their parents and teachers participated. Paternal and maternal CP was assessed by father-reports and by mother-reports, respectively. Children's EF was assessed by the Executive Function Touch program. Children's externalizing behavior problems were assessed by mother-reports and by teacher-reports. The results of structural equation modeling generally supported working memory as a mediator linking paternal CP and children's externalizing behaviors and inhibitory control as a mediator linking maternal CP and children's externalizing behaviors. No differences by children's gender were found. The current findings highlight the importance of EF in behavioral outcomes of children who experience parental CP.

  12. Different patterns of boys' externalizing behavior and their relation to risk factors: a longitudinal study of preschool children.

    PubMed

    Stemmler, M; Lösel, F

    2010-01-01

    Childrens' externalizing behaviors such as aggression, delinquency and impulsivity are serious problems in many societies. In previous person-oriented analyses we found two types of externalizing problems in boys. One pattern contained externalizing problems only, whereas the other type showed both externalizing and internalizing problems (anxiety, depression etc.). The present study addressed these two groups in a prospective longitudinal design. It was investigated whether the previous descriptive findings remained stable over time and, in particular, whether the two types differed in important risk factors for antisocial behavior. The sample consisted of 198 boys from the Erlangen-Nuremberg Development and Prevention Study. The first assessment took place in kindergarten and the second 3.4 years later in elementary school. The behavior problems were assessed by ratings of kindergarten teachers and elementary school teachers using the Social Behavior Questionnaire (SBQ). The risk factors were low socio-economic status of the family, birth complications, physical punishment in parenting behavior, difficult temperament, low intelligence, and aggression-prone social information processing of the child. Approximately 15% of the boys revealed externalizing behavior problems. A variable-oriented analysis showed significant stability over time. In a person-oriented Configural Frequency Analysis the 'externalizing only' and the 'combined externalizing and internalizing' pattern could be replicated. For five of the six risk factors we found significant differences between the boys with behavior problems and a non-deviant group. However, the two different patterns of externalizing problems differed only in intelligence (lower for the group with combined problems). The results confirm models of cumulative biological, psychological and social risks for antisocial behavior over time. Furthermore, specified analyses of the two types and their relation to proactive and reactive

  13. Relations between parenting and externalizing and internalizing problem behaviour in early adolescence: child behaviour as moderator and predictor.

    PubMed

    Reitz, E; Deković, M; Meijer, A M

    2006-06-01

    In this longitudinal study we investigated relations between parenting and externalizing and internalizing problem behaviour during early adolescence. First, we examined parenting effects on problem behaviour, including child behaviour as a moderator. Second, we examined child behaviour as predictor of parenting, also including moderator effects. A total of 650 13- to 14-year-olds filled out the Youth Self-Report and questionnaires about parenting at two times within a one-year interval. Relations between parenting and problem behaviour appeared to be stronger for externalizing than for internalizing problem behaviour. Both parenting effects and child effects were found. Parenting significantly predicted an increase in externalizing problem behaviour one year later. Adolescent's previous level of problem behaviour predicted changes in parenting (involvement and decisional autonomy granting). In addition, parental and child characteristics interacted in predicting outcome.

  14. 48 CFR 231.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... advertising costs. 231.205-1 Section 231.205-1 Federal Acquisition Regulations System DEFENSE ACQUISITION... PROCEDURES Contracts With Commercial Organizations 231.205-1 Public relations and advertising costs. (e) See... public relations and advertising costs also include monies paid to the Government associated with...

  15. 48 CFR 231.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... advertising costs. 231.205-1 Section 231.205-1 Federal Acquisition Regulations System DEFENSE ACQUISITION... PROCEDURES Contracts With Commercial Organizations 231.205-1 Public relations and advertising costs. (e) See... public relations and advertising costs also include monies paid to the Government associated with...

  16. 48 CFR 1631.205-70 - FEHBP public relations and advertising costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true FEHBP public relations and advertising costs. 1631.205-70 Section 1631.205-70 Federal Acquisition Regulations System OFFICE OF PERSONNEL... relations and advertising costs. (a) The cost of media messages that are directed at advising current...

  17. Relations of Parenting and Temperament to Chinese Children's Experience of Negative Life Events, Coping Efficacy, and Externalizing Problems

    ERIC Educational Resources Information Center

    Zhou, Qing; Wang, Yun; Deng, Xianli; Eisenberg, Nancy; Wolchik, Sharlene A.; Tein, Jenn-Yun

    2008-01-01

    The relations of parenting and temperament (effortful control and anger/frustration) to children's externalizing problems were examined in a 3.8-year longitudinal study of 425 native Chinese children (6-9 years) from Beijing. Children's experience of negative life events and coping efficacy were examined as mediators in the parenting- and…

  18. Longitudinal Relations of Children's Effortful Control, Impulsivity, and Negative Emotionality to Their Externalizing, Internalizing, and Co-Occurring Behavior Problems

    ERIC Educational Resources Information Center

    Eisenberg, Nancy; Valiente, Carlos; Spinrad, Tracy L.; Cumberland, Amanda; Liew, Jeffrey; Reiser, Mark; Zhou, Qing; Losoya, Sandra H.

    2009-01-01

    The purpose of the study was to examine the relations of effortful control (EC), impulsivity, and negative emotionality to at least borderline clinical levels of symptoms and change in maladjustment over four years. Children's (N = 214; 77% European American; M age = 73 months) externalizing and internalizing symptoms were rated by parents and…

  19. Does Parental Psychological Control Relate to Internalizing and Externalizing Problems in Early Childhood? An Examination Using the Berkeley Puppet Interview

    ERIC Educational Resources Information Center

    Stone, Lisanne L.; Otten, Roy; Janssens, Jan M. A. M.; Soenens, Bart; Kuntsche, Emmanuel; Engels, Rutger C. M. E.

    2013-01-01

    Parental psychological control has been linked to symptoms of psychopathology in adolescence, yet less is known about its correlates in childhood. The current study is among the first to address whether psychological control is related to internalizing and externalizing problems in early childhood. A community sample of 298 children aged 7.04…

  20. EPA's Reanalysis of Key Issues Related to Dioxin Toxicity and Response to NAS Comments (External Review Draft)

    EPA Science Inventory

  1. An Evaluation of the WSSC (Weapon System Support Cost) Cost Allocation Algorithms. VII. Quantitative and Data-Related Topics.

    DTIC Science & Technology

    1985-02-01

    implies that only one - 23 - p 5 .. . . " . - . , " i . , . . . . . allocation variable (the first selected) is required. On the other hand, if the...COST ALLOCATION AL..(U) DESMATICS INC STATE COLLEGE PA G J ZUNIC ET AL. FEB 85 TR-i± 5 -i F33608-80-C-0554 UNCLASSIFIED F/G W4i N Ehhmhommhhhhhum~hhh...CATEGORIES .. ............ 5 F. VOLUME VI -PERSONNEL RELATED CATEGORIES. .. ........ 6 III. THE IDENTIFICATION OF FIXED INSTALLATION SUPPORT COSTS

  2. Developmental Changes in the Relations between Inhibitory Control and Externalizing Problems during Early Childhood

    ERIC Educational Resources Information Center

    Utendale, William T.; Hastings, Paul D.

    2011-01-01

    Deficits in executive function, and in particular, reduced capacity to inhibit a dominant action, are a risk factor for externalizing problems (EP). Inhibitory control (IC) develops in the later preschool and early childhood periods, such that IC might not regulate EP in toddlers and younger preschoolers. Aggression was observed during peer play…

  3. The Relations between Autonomy and Control in the Management of External Consultants and Organizational Learning.

    ERIC Educational Resources Information Center

    Halvari, Hallgeir; Johansen, Are; Sorhaug, Tore

    1998-01-01

    Sources of organizational learning were studied for 131 employees, 109 of whom were managers, who participated in projects with external consultants in a large public-transport company in Norway. A multiple regression analysis explained 69% of organizational learning as a function of attitude toward learning. Differences between managers and other…

  4. 42 CFR 438.358 - Activities related to external quality review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review § 438.358... quality of care. (3) Calculation of performance measures in addition to those reported by an MCO or PIHP... conducted by an MCO or PIHP and validated by an EQRO. (5) Conduct of studies on quality that focus on...

  5. External Visual Representations in Science Learning: The Case of Relations among System Components

    ERIC Educational Resources Information Center

    Eilam, Billie; Poyas, Yael

    2010-01-01

    How do external visual representations (e.g., graph, diagram) promote or constrain students' ability to identify system components and their interrelations, to reinforce a systemic view through the application of the STS approach? University students (N = 150) received information cards describing cellphones' communication system and its subsystem…

  6. The relative importance of external and internal features of facial composites.

    PubMed

    Frowd, Charlie; Bruce, Vicki; McIntyre, Alex; Hancock, Peter

    2007-02-01

    Three experiments are reported that compare the quality of external with internal regions within a set of facial composites using two matching-type tasks. Composites are constructed with the aim of triggering recognition from people familiar with the targets, and past research suggests internal face features dominate representations of familiar faces in memory. However the experiments reported here show that the internal regions of composites are very poorly matched against the faces they purport to represent, while external feature regions alone were matched almost as well as complete composites. In Experiments 1 and 2 the composites used were constructed by participant-witnesses who were unfamiliar with the targets and therefore were predicted to demonstrate a bias towards the external parts of a face. In Experiment 3 we compared witnesses who were familiar or unfamiliar with the target items, but for both groups the external features were much better reproduced in the composites, suggesting it is the process of composite construction itself which is responsible for the poverty of the internal features. Practical implications of these results are discussed.

  7. Relationship between the P3 event-related potential, its associated time-frequency components, and externalizing psychopathology.

    PubMed

    Gilmore, Casey S; Malone, Stephen M; Bernat, Edward M; Iacono, William G

    2010-01-01

    P3 amplitude reduction (P3-AR) is associated with biological vulnerability to a spectrum of externalizing disorders, such as ADHD, conduct disorder, and substance use disorders. P3, however, is generally characterized as a broad activation involving multiple neurophysiological processes. One approach to separating P3-related processes is time-frequency (TF) analysis. The current study used a novel PCA-based TF analysis method to investigate relationships between P3, its associated TF components, and externalizing in a community-based sample of adolescent males. Results showed that 1) alone, P3 and each TF-PCA derived component could successfully discriminate diagnostic groups from controls, and 2) delta components in specific time ranges accounted for variance beyond that accounted for by P3. One delta component was associated with all diagnostic groups, suggesting it may represent a more parsimonious endophenotype for externalizing than P3-AR.

  8. External forcing as a source for the observed multi-decadal relation between AMV and the Indian summer monsoon

    NASA Astrophysics Data System (ADS)

    Svendsen, Lea; Luo, Feifei; Sankar, Syam; Gao, Yongqi; Keenlyside, Noel; Vareed Joseph, Porathur; Johannessen, Ola

    2016-04-01

    The instrumental records show a significant positive correlation between the Atlantic multi-decadal variability (AMV) and the Indian summer monsoon (ISM) rainfall, where a positive (negative) AMV is associated with more (less) ISM rainfall. We have used both proxy reconstruction and twelve models from the Coupled Model Intercomparison Project Phase 5 (CMIP5) to investigate if the observed AMV-ISM relation is a persistent internal climate signal or externally forced. A comparison of several annual resolution proxy records both from the Atlantic and for the ISM show that the multi-decadal variability in both indices is persistent, but the link between them is not. The correlation between the two regions is weak, and even negative in some periods, before the instrumental time period. The analysis of CMIP5 simualtions is consistent with these results. While none of the CMIP5 models investigated simulate the significant AMV-ISM connection in the pre-industrial control simulations with fixed external forcing, three of the models reproduce the relation in the 20th century historical simulations with transient forcing. In these models external forcing is linked to the mid-to-upper tropospheric temperature pattern with a strengthened land-ocean contrast over South Asia, consistent with an enhanced ISM, as well as the evolution of AMV. We conclude that the significant AMV-ISM relation found in the observations after the industrial revolution may be associated with external forcing, rather than being internal climate variability.

  9. Costing in Radiology and Health Care: Rationale, Relativity, Rudiments, and Realities.

    PubMed

    Rubin, Geoffrey D

    2017-02-01

    Costs direct decisions that influence the effectiveness of radiology in the care of patients on a daily basis. Yet many radiologists struggle to harness the power of cost measurement and cost management as a critical path toward establishing their value in patient care. When radiologists cannot articulate their value, they risk losing control over how imaging is delivered and supported. In the United States, recent payment trends directing value-based payments for bundles of care advance the imperative for radiology providers to articulate their value. This begins with the development of an understanding of the providers' own costs, as well as the complex interrelationships and imaging-associated costs of other participants across the imaging value chain. Controlling the costs of imaging necessitates understanding them at a procedural level and quantifying the costs of delivering specific imaging services. Effective product-level costing is dependent on a bottom-up approach, which is supported through recent innovations in time-dependent activity-based costing. Once the costs are understood, they can be managed. Within the high fixed cost and high overhead cost environment of health care provider organizations, stakeholders must understand the implications of misaligned top-down cost management approaches that can both paradoxically shift effort from low-cost workers to much costlier professionals and allocate overhead costs counterproductively. Radiology's engagement across a broad spectrum of care provides an excellent opportunity for radiology providers to take a leading role within the health care organizations to enhance value and margin through principled and effective cost management. Following a discussion of the rationale for measuring costs, this review contextualizes costs from the perspectives of a variety of stakeholders (relativity), discusses core concepts in how costs are classified (rudiments), presents common and improved methods for measuring

  10. 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.

  11. 48 CFR 31.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... advertising costs. 31.205-1 Section 31.205-1 Federal Acquisition Regulations System FEDERAL ACQUISITION... Organizations 31.205-1 Public relations and advertising costs. (a) Public relations means all functions and... such as advertising, customer relations, etc. (b) Advertising means the use of media to promote...

  12. 48 CFR 31.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... advertising costs. 31.205-1 Section 31.205-1 Federal Acquisition Regulations System FEDERAL ACQUISITION... Organizations 31.205-1 Public relations and advertising costs. (a) Public relations means all functions and... such as advertising, customer relations, etc. (b) Advertising means the use of media to promote...

  13. 48 CFR 31.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... advertising costs. 31.205-1 Section 31.205-1 Federal Acquisition Regulations System FEDERAL ACQUISITION... Organizations 31.205-1 Public relations and advertising costs. (a) Public relations means all functions and... such as advertising, customer relations, etc. (b) Advertising means the use of media to promote...

  14. 48 CFR 31.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... advertising costs. 31.205-1 Section 31.205-1 Federal Acquisition Regulations System FEDERAL ACQUISITION... Organizations 31.205-1 Public relations and advertising costs. (a) Public relations means all functions and... such as advertising, customer relations, etc. (b) Advertising means the use of media to promote...

  15. 48 CFR 231.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Public relations and... PROCEDURES Contracts With Commercial Organizations 231.205-1 Public relations and advertising costs. (e) See... public relations and advertising costs also include monies paid to the Government associated with...

  16. Measuring PM and related air pollutants using low-cost ...

    EPA Pesticide Factsheets

    Emerging air quality sensors may play a key role in better characterizing levels of air pollution in a variety of settings There are a wide range of low-cost (< $500 US) sensors on the market, but few have been characterized. If accurate, this new generation of inexpensive sensors can potentially allow larger fleets of monitors to be deployed to better study the spatial and temporal variability of pollutants. The small size and light weight of these sensors also allows for the possibility of wearable or drone applications. Sensor networks will very likely play a key role in future estimates of human health impacts of pollutants, in particular particulate matter (PM), and will allow for the better characterization of pollutant sources and source regions.We will present measurements from an assortment of sensors, costing $20-$700, that have been used to measure air pollution in the US, India, and China with a focus on estimating PM concentrations. Their performance has been evaluated in these very different settings with low concentrations seen in the US (up to approximately 20 ug m-3) and much higher concentrations measured in India and China (up to approximately 300 ug m-3). Based on these studies the optimal concentration ranges of these sensors have been determined. Used in conjunction with data from a carbon dioxide sensor, emissions factors were estimated in some of the locations. In addition temperature and humidity sensors can be used to calculate c

  17. The health effects of cost-related treatment delays.

    PubMed

    Chen, Jie; Rizzo, John A; Rodriguez, Hector P

    2011-01-01

    The number of Americans who report delaying or forgoing necessary medical care because of cost concerns has increased markedly in recent years. Delaying or forgoing treatment may result in negative health effects, but empirical evidence is scarce. Using the merged data set of the Medical Expenditure Panel Survey and the National Health Interview Survey 2002-2006, the effect of delaying or forgoing medical care on ex post health status was estimated. Results indicate that people who delayed or forwent medical treatment were significantly less likely to report having excellent or very good ex post health status and had significantly lower quality-of-life scores compared with people who never delayed or forwent necessary medical care, controlling for socioeconomic and demographic factors, chronic medical conditions, and baseline health status. The Blinder-Oaxaca decomposition results suggest that expanding health insurance coverage can prevent 9% to 12% of the health decrements associated with delaying or forgoing medical treatment.

  18. PR for Pennies: Low-Cost Library Public Relations.

    ERIC Educational Resources Information Center

    Baeckler, Virginia Van Wynen

    This manual is designed to demystify a number of public relations techniques for those who wish to start producing their own materials with a minimum of time and money. Chapters focus on public relations; the library stereotype; words, ideas, and pictures; offset printing; creative print distribution; exhibits and posters; public speaking; and the…

  19. Perceived health status and environmental quality in the assessment of external costs of waste disposal facilities. An empirical investigation.

    PubMed

    Giaccaria, Sergio; Frontuto, Vito

    2012-08-01

    Taxation for urban waste management has been reformed in Italy by the introduction of an environmental law in 2006. In the planning phase of waste management, externalities generated by new facilities remain widely unaccounted, with a consequent distortion for prices, often raising local conflicts. The paper presents a survey based on the choice modelling methodology, aimed to evaluate on a monetary scale the disamenity effect perceived by incinerator and landfills in an Italian urban context: the city of Turin. In a random utility framework the behaviour of respondents, whose choices are found to be driven by the endowment of information about technological options, socio-economic characteristics as income, education, family composition, and also by their health status was modelled. Furthermore, empirical evidence that the behaviour in residential location choices is affected by different aspects of the respondent life and in particular by the health status was found. Distinct estimates of willingness to accept compensation for disamenity effects of incinerator (Euro 2670) and landfill (Euro 3816) are elicited. The effect of health status of the respondents, their level of information about the waste disposal infrastructure, the presence of a subjective strong aversion (NIMBY) and the actual endowment and concentration of infrastructures are demonstrated to be significant factors determining the choice behaviour, but differentiated and specific for incinerators and landfills.

  20. Trajectories of Religious Coping from Adolescence into Early Adulthood: Their Form and Relations to Externalizing Problems and Prosocial Behavior

    PubMed Central

    Eisenberg, Nancy; Castellani, Valeria; Panerai, Laura; Eggum, Natalie D.; Cohen, Adam B.; Pastorelli, Concetta; Caprara, Gian Vittorio

    2011-01-01

    Little is known about changes in religious coping and their relations to adolescents’ and young adults’ functioning. In 686 Italian youths, trajectories of religious coping were identified from age 16–17 years to age 22–23 years; cohorts of youths reported at three of the four assessments. Four trajectories of religious coping were identified: decreasing, low stable, high stable, and increasing. A decline in religious coping was associated with high levels of externalizing problems at age 16–17, whereas an increase in religious coping was associated with higher externalizing problems at ages 18–19 and 20–21 years, and with relatively high involvement with deviant peers. High stable religious copers were high in prosocial behavior at three ages; low stable religious copers were higher than people undergoing change in their religious coping from mid-adolescence into early adulthood. These results can expand our current thinking about religious coping and adolescent adjustment. PMID:21682728

  1. Maximality of shoulder external rotation effort in patients presenting with work related injury: the clinical applicability of the DEC parameter.

    PubMed

    Chaler, Joaquim; Pujol, Eduard; Unyó, Carme; Quintana, Salvador; Müller, Bertram; Garreta, Roser; Javierre, Casimiro; Dvir, Zeevi

    2013-08-01

    The aim of the present study is to examine the applicability of the isokinetic DEC parameter for identifying submaximal effort in workers with potential weakness of the shoulder external rotators. A previous study indicated that the DEC was a powerful identifier of submaximal effort of shoulder external rotation in normal volunteers. Its applicability in shoulder injury patients is of specific interest. Thus, a retrospective study of 74 (33 female and 41 male) patients who claimed compensation for work-related shoulder injury was designed. 52 patients had their injured side DEC values within the normal range and were thus labeled as maximal performers. Ten patients had higher than cutoff DEC values, indicating submaximal effort whereas 12 patients had exceedingly low DEC values. Gender comparison showed a significantly different proportion of maximal performers. Strength deficits registered in patients demonstrating maximal performance correlated with the final outcome. The findings support the application of the DEC for determination of the extent of weakness of shoulder external rotators in male patients. In terms of shoulder external rotators status in male worker injury, the results support the application of isokinetic tests both in the clinical and medicolegal sense. However, the gender discrepancy warrants further research.

  2. Launching Payloads Into Orbit at Relatively Low Cost

    NASA Technical Reports Server (NTRS)

    Wilcox, Brian

    2007-01-01

    A report proposes the development of a system for launching payloads into orbit at about one-fifth the cost per unit payload weight of current systems. The PILOT system was a solid-fuel, aerodynamically spun and spin-stabilized, five-stage rocket with onboard controls including little more than an optoelectronic horizon sensor and a timer for triggering the second and fifth stages, respectively. The proposal calls for four improvements over the PILOT system to enable control of orbital parameters: (1) the aerodynamic tipover of the rocket at the top of the atmosphere could be modeled as a nonuniform gyroscopic precession and could be controlled by selection of the initial rocket configuration and launch conditions; (2) the attitude of the rocket at the top of the first-stage trajectory could be measured by use of radar tracking or differential Global Positioning System receivers to determine when to trigger the second stage; (3) the final-stage engines could be configured around the payload to enhance spin stabilization during a half-orbit coast up to apoapsis where the final stage would be triggered; and (4) the final payload stage could be equipped with a "beltline" of small thrusters for correcting small errors in the trajectory as measured by an off-board tracking subsystem.

  3. The Relative Efficiency of Charter Schools: A Cost Frontier Approach

    ERIC Educational Resources Information Center

    Gronberg, Timothy J.; Jansen, Dennis W.; Taylor, Lori L.

    2012-01-01

    Charters represent an expansion of public school choice, offering free, publicly funded educational alternatives to traditional public schools. One relatively unexplored research question concerning charter schools asks whether charter schools are more efficient suppliers of educational services than are traditional public schools. The potential…

  4. 42 CFR 457.224 - FFP: Conditions relating to cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false FFP: Conditions relating to cost sharing. 457.224 Section 457.224 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Claims; Reduction of Federal Medical Payments § 457.224 FFP: Conditions relating to cost sharing. (a)...

  5. 48 CFR 2131.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Public relations and advertising costs. 2131.205-1 Section 2131.205-1 Federal Acquisition Regulations System OFFICE OF PERSONNEL... relations and advertising costs. The provisions of FAR 31.205-1 shall be modified to include the...

  6. 48 CFR 2131.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Public relations and advertising costs. 2131.205-1 Section 2131.205-1 Federal Acquisition Regulations System OFFICE OF PERSONNEL... relations and advertising costs. The provisions of FAR 31.205-1 shall be modified to include the...

  7. 48 CFR 31.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... such as advertising, customer relations, etc. (b) Advertising means the use of media to promote the... what will appear, the media in which it will appear, and when it will appear. Advertising media include... relations and advertising costs include the costs of media time and space, purchased services performed...

  8. 42 CFR 422.6 - Cost-sharing in enrollment-related costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... assistance program) and section 1860D-1(c) of the Act (relating to dissemination of enrollment information... which enrollment is effected or coordinated under section 1851 of the Act. (d) Collection of fees—(1... under title XVIII. (f) Assessment methodology. (1) The amount of the applicable portion of the user...

  9. 42 CFR 422.6 - Cost-sharing in enrollment-related costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... assistance program) and section 1860D-1(c) of the Act (relating to dissemination of enrollment information... which enrollment is effected or coordinated under section 1851 of the Act. (d) Collection of fees—(1... under title XVIII. (f) Assessment methodology. (1) The amount of the applicable portion of the user...

  10. Development of Relativization in Korean as a Foreign Language: The Noun Phrase Accessibility Hierarchy in Head-Internal and Head-External Relative Clauses

    ERIC Educational Resources Information Center

    Jeon, K. Seon; Kim, Hae-Young

    2007-01-01

    This study examines how Keenan and Comrie's (1977) noun phrase accessibility hierarchy (NPAH) intersects with the typological characteristics of Korean in the acquisition of relative clauses (RCs). Korean has two types of RC constructions: head-external and head-internal. The head-external relative has its head to the right of the RC, whereas the…

  11. The External Degree.

    ERIC Educational Resources Information Center

    Houle, Cyril O.

    This book examines the external degree in relation to the extremes of attitudes, myths, and data. Emphasis is placed on the emergence of the American external degree, foreign external-degree programs, the purpose of the external degree, the current scene, institutional issues, and problems of general policy. (MJM)

  12. Food Insecurity and Cost-Related Medication Underuse Among Nonelderly Adults in a Nationally Representative Sample

    PubMed Central

    Afulani, Patience; Coleman-Jensen, Alisha; Harrison, Gail G.

    2015-01-01

    Objectives. We investigated whether nonelderly US adults (aged 18–64 years) in food-insecure households are more likely to report cost-related medication underuse than the food-secure, and whether the relationship between food insecurity and cost-related medication underuse differs by gender, chronic disease, and health insurance status. Methods. We analyzed data from the 2011 and 2012 National Health Interview Survey (n = 67 539). We examined the relationship between food insecurity and cost-related medication underuse with the χ2 test and multivariate logistic regression with interaction terms. Results. Bivariate and multivariate analyses showed a dose–response relationship between food insecurity and cost-related medication underuse, with an increasing likelihood of cost-related medication underuse with increasing severity of food insecurity (P < .001). This association was conditional on health insurance status, but not substantially different by gender or chronic disease status. Being female, low-income, having no or partial health insurance, chronic conditions, functional limitations, or severe mental illness were positively associated with cost-related medication underuse. Conclusions. Using food insecurity as a risk factor to assess cost-related medication underuse could help increase identification of individuals who may need assistance purchasing medications and improve health for those in food-insecure households. PMID:26270308

  13. A Facile and Low-Cost Method to Enhance the Internal Quantum Yield and External Light-Extraction Efficiency for Flexible Light-Emitting Carbon-Dot Films

    PubMed Central

    Jiang, Z. C.; Lin, T. N.; Lin, H. T.; Talite, M. J.; Tzeng, T. T.; Hsu, C. L.; Chiu, K. P.; Lin, C. A. J.; Shen, J. L.; Yuan, C. T.

    2016-01-01

    Solution-processed, non-toxic carbon dots (CDs) have attracted much attention due to their unique photoluminescence (PL) properties. They are promising emissive layers for flexible light-emitting devices. To this end, the CDs in pristine aqueous solutions need to be transferred to form solid-state thin films without sacrificing their original PL characteristics. Unfortunately, solid-state PL quenching induced by extra non-radiative (NR) energy transfer among CDs would significantly hinder their practical applications in optoelectronics. Here, a facile, low-cost and effective method has been utilized to fabricate high-performance CD/polymer light-emitting flexible films with submicron-structured patterns. The patterned polymers can serve as a solid matrix to disperse and passivate CDs, thus achieving high internal quantum yields of 61%. In addition, they can act as an out-coupler to mitigate the waveguide-mode losses, approximately doubling the external light-extraction efficiency. Such CD/polymer composites also exhibit good photo-stability, and thus can be used as eco-friendly, low-cost phosphors for solid-state lighting. PMID:26822337

  14. HPV-related external genital lesions among men residing in Brazil.

    PubMed

    Silva, Roberto J C; Sudenga, Staci L; Sichero, Laura; Baggio, Maria Luiza; Galan, Lenice; Cintra, Ricardo; Torres, B Nelson; Stoler, Mark; Giuliano, Anna R; Villa, Luisa L

    2017-04-08

    The aims of this study were to determine the incidence of external genital lesions (EGLs), specifically histologically confirmed condyloma (genital warts) and Penile Intraepithelial Neoplasia (PeIN), and genital HPV infection progression to EGLs among healthy men aged 18-73 residing in Brazil. Subjects included 1118 men enrolled in the HPV Infection in Men (HIM) study between July 2005 and June 2009. At each visit, EGLs were biopsied and subjected to pathological evaluation. HPV status in genital swabs and biopsies was determined by Linear Array and INNO-LiPA, respectively. Age-specific EGLs incidence and the proportion and median time to EGL development were estimated. Kaplan-Meier cumulative incidence rates at 6, 12, and 24 months were determined. During follow-up, 73 men developed an incident EGL. Men could develop multiple EGLs and there were 36 men with condyloma, 27 men with lesions suggestive of condyloma, six men with PeIN, and 20 men with non-HPV lesions. HPV-positive men who developed EGLs were younger (p=0.002) than men that did not develop lesions. Among the 815 men with HPV infection, 4% progressed to EGL with the same HPV detected in the swab. During follow up, 15.7% of genital HPV-6 and HPV-11 infections progressed to condyloma (median progression time of nine months for HPV-6 versus 6.8 months for HPV-11). Approximately 1% of HPV-16 infections progressed to PeIN with a median progression time of 25 months. HPV types covered by the 4-valent HPV vaccine were detected in 82.3% and 83.3% of condyloma and PeIN, respectively. The high burden of HPV and high frequency of progression to disease underscores the need to offer HPV prophylactic vaccination to men to reduce the overall burden of infection and diseases caused by HPV.

  15. Differences in Health Care Costs and Utilization among Adults with Selected Lifestyle-Related Risk Factors.

    ERIC Educational Resources Information Center

    Tucker, Larry A.; Clegg, Alan G.

    2002-01-01

    Examined the relationship between lifestyle-related health risks and health care costs and utilization among young adults. Data collected at a primarily white collar worksite in over 2 years indicated that health risks, particularly obesity, stress, and general lifestyle, were significant predictors of health care costs and utilization among these…

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

    PubMed Central

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

    2003-01-01

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

  17. External and internal controls of lunar-related reproductive rhythms in fishes.

    PubMed

    Takemura, A; Rahman, M S; Park, Y J

    2010-01-01

    Reproductive activities of many fish species are, to some extent, entrained to cues from the moon. During the spawning season, synchronous spawning is repeated at intervals of c. 1 month (lunar spawning cycle) and 2 weeks (semi-lunar spawning cycle) or daily according to tidal changes (tidal spawning cycle). In species showing lunar-related spawning cycles, oocytes in the ovary develop towards and mature around a specific moon phase for lunar spawners, around spring tides for semi-lunar spawners and at daytime high tides for tidal spawners. The production of sex steroid hormones also changes in accordance with synchronous oocyte development. Since the production of the steroid hormones with lunar-related reproductive periodicity is regulated by gonadotropins, it is considered that the higher parts of the hypothalamus-pituitary-gonad axis play important roles in the perception and regulation of lunar-related periodicity. It is likely that fishes perceive cues from the moon by sensory organs; however, it is still unknown how lunar cues are transduced as an endogenous rhythm exerting lunar-related spawning rhythmicity. Recent research has revealed that melatonin fluctuated according to the brightness at night, magnetic fields and the tidal cycle. In addition, cyclic changes in hydrostatic pressure had an effect on monoamine contents in the brain. These factors may be indirectly related to the exertion of lunar-related periodicity. Molecular approaches have revealed that mRNA expressions of light-sensitive clock genes change with moonlight, suggesting that brightness at night plays a role in phase-shifting or resetting of biological clocks. Some species may have evolved biological clocks in relation to lunar cycles, although it is still not known how lunar periodicities are endogenously regulated in fishes. This review demonstrates that lunar-related periodicity is utilized and incorporated by ecological and physiological mechanisms governing the reproductive success

  18. The effects of age, gender, and crash types on drivers' injury-related health care costs.

    PubMed

    Shen, Sijun; Neyens, David M

    2015-04-01

    There are many studies that evaluate the effects of age, gender, and crash types on crash related injury severity. However, few studies investigate the effects of those crash factors on the crash related health care costs for drivers that are transported to hospital. The purpose of this study is to examine the relationships between drivers' age, gender, and the crash types, as well as other crash characteristics (e.g., not wearing a seatbelt, weather condition, and fatigued driving), on the crash related health care costs. The South Carolina Crash Outcome Data Evaluation System (SC CODES) from 2005 to 2007 was used to construct six separate hierarchical linear regression models based on drivers' age and gender. The results suggest that older drivers have higher health care costs than younger drivers and male drivers tend to have higher health care costs than female drivers in the same age group. Overall, single vehicle crashes had the highest health care costs for all drivers. For males older than 64-years old sideswipe crashes are as costly as single vehicle crashes. In general, not wearing a seatbelt, airbag deployment, and speeding were found to be associated with higher health care costs. Distraction-related crashes are more likely to be associated with lower health care costs in most cases. Furthermore this study highlights the value of considering drivers in subgroups, as some factors have different effects on health care costs in different driver groups. Developing an understanding of longer term outcomes of crashes and their characteristics can lead to improvements in vehicle technology, educational materials, and interventions to reduce crash-related health care costs.

  19. Perceived parental control of food intake is related to external, restrained and emotional eating in 7-12-year-old boys and girls.

    PubMed

    van Strien, Tatjana; Bazelier, Francien G

    2007-11-01

    This study examined the prevalence of external, restrained and emotional eating and the relationship of these disturbed types of eating behaviours with perceived parental control of food intake (pressure to eat and restriction) in a group of 7- to 12-year-old boys and girls (n = 596). External eating turned out to be the most prevalent disturbed eating behaviour for boys and girls, followed by restrained eating and emotional eating. Sex differences were found in external and restrained eating. For the boys, perceived pressure to eat was positively related to emotional and external eating. For both sexes, perceived restriction to eat was negatively related to emotional and external eating and positively related to restrained eating. This led to the conclusion that perceived pressure to eat has a disruptive effect on a child's self-regulating mechanism of food intake, particularly so for boys, whereas perceived restriction can also have a positive effect.

  20. Beam related response of in vivo diode detectors for external radiotherapy

    NASA Astrophysics Data System (ADS)

    Baci, Syrja; Telhaj, Ervis; Malkaj, Partizan

    2016-03-01

    In Vivo Dosimetry (IVD) is a set of methods used in cancer treatment clinics to determine the real dose of radiation absorbed by target volume in a patient's body. IVD has been widely implemented in radiotherapy treatment centers and is now recommended part of Quality Assurance program by many International health and radiation organizations. Because of cost and lack of specialized personnel, IVD has not been practiced as yet, in Albanian radiotherapy clinics. At Hygeia Hospital Tirana, patients are irradiated with high energy photons generated by Elekta Synergy Accelerators. We have recently started experimenting with the purpose of establishing an IVD practice at this hospital. The first set of experiments was aimed at calibration of diodes that are going to be used for IVD. PMMA, phantoms by PTW were used to calibrate p - type Si, semiconductor diode dosimeters, made by PTW Freiburg for entrance dose. Response of the detectors is affected by energy of the beam, accumulated radiation dose, dose rate, temperature, angle against the beam axis, etc. Here we present the work done for calculating calibration factor and correction factors of source to surface distance, field size, and beam incidence for the entrance dose for both 6 MV photon beam and 18 MV photon beam. Dependence of dosimeter response was found to be more pronounced with source to surface distance as compared to other variables investigated.

  1. The Relation of Attachment Security to Adolescents' Paternal and Peer Relationships, Depression, and Externalizing Behavior

    ERIC Educational Resources Information Center

    Allen, Joseph P.; Porter, Maryfrances; McFarland, Christy; McElhaney, Kathleen Boykin; Marsh, Penny

    2007-01-01

    The relation of attachment security to multiple domains of psychosocial functioning was examined in a community sample of 167 early adolescents. Security of attachment organization, assessed using the Adult Attachment Interview, was linked to success in establishing autonomy while maintaining a sense of relatedness both with fathers and with…

  2. Remission of Maternal Depression: Relations to Family Functioning and Youth Internalizing and Externalizing Symptoms

    ERIC Educational Resources Information Center

    Foster, Cynthia Ewell; Webster, Melissa C.; Weissman, Myrna M.; Pilowsky, Daniel J.; Wickramaratne, Priya J.; Talati, Ardesheer; Rush, A. John; Hughes, Carroll W.; Garber, Judy; Malloy, Erin; Cerda, Gabrielle; Kornstein, Susan G.; Alpert, Jonathan E.; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Fava, Maurizio; King, Cheryl A.

    2008-01-01

    Family functioning and parenting were hypothesized to mediate the relation between remission of maternal depression and children's psychosocial adjustment. Participants were 114 mother-child dyads participating in the Sequenced Treatment Alternatives to Relieve Depression Child 3-month follow-up. All mothers had been diagnosed with major…

  3. Health care cost containment in Denmark and Norway: a question of relative professional status?

    PubMed

    Andersen, Lotte B

    2014-04-01

    The demand for publicly subsidized health care services is insatiable, but the costs can be contained in different ways: formal rules can limit access to and the number of subsidized services, demand and supply can be regulated through the price mechanism, the relevant profession can contain the costs through state-sanctioned self-regulation, and other professions can contain the costs (e.g. through referrals). The use of these cost containment measures varies between countries, depending on demand and supply factors, but the relative professional status of the health professions may help explain why different countries use cost containment measures differently for different services. This article compares cost containment measures in Denmark and Norway because these countries vary with regard to the professional status of the medical profession relative to other health care providers, while other relevant variables are approximately similar. The investigation is based on formal agreements and rules, historical documents, existing analyses and an analysis of 360 newspaper articles. It shows that high relative professional status seems to help professions to avoid user fees, steer clear of regulation from other professions and regulate the services produced by others. This implies that relative professional status should be taken into consideration in analyses of health care cost containment.

  4. External Actors and National Preference Formation: European Energy Security Policy & Relations with Russia

    NASA Astrophysics Data System (ADS)

    Le Renard, Callie

    This dissertation examines how Russia has impacted the development of a common European energy security policy through case studies of six member states which represent a variety of perspectives on integration and relations with Russia. These case studies focus on how national preferences on energy security policy are formed and the role, if any, Russia has played. The cases, which include Germany, Poland, UK, Bulgaria, Lithuania and France, rely on open source data and interviews with member states' Permanent Representations and subject matter experts from a variety of institutions both in Brussels and in the member states. The cases were selected based on factors such as size, wealth, energy dependence, historic relations with Russia, and membership in the former Eastern Bloc.

  5. Age-related shapes of the cost of reproduction in vertebrates.

    PubMed

    Proaktor, G; Milner-Gulland, E J; Coulson, T

    2007-12-22

    The shape of the association between age and the cost of reproduction varies across species. However, it is unclear whether there are any general patterns in the way the cost of reproduction varies with life history, taxon or ecological function. Using a simple theoretical method, we identified three characteristic patterns to describe the age-related survival cost of reproduction. The most frequent pattern is an approximately exponential decay (ED) with increasing age. Two additional u-shaped patterns were identified, where the cost of reproduction was higher for young and old individuals compared with intermediate-aged individuals. The majority of these u-shaped curves suggested higher costs of reproduction at older ages (RQ), with the rest suggesting a higher cost at young ages (LQ). While predators were most likely to exhibit ED-shaped cost curves, herbivores were equally likely to exhibit ED and RQ curves; birds were likely to exhibit ED-shaped curves and mammals were split equally between ED and RQ curves. These findings suggest that there may be predictable differences in the age-related shape of the cost of reproduction between species, but further research is required to identify the mechanisms generating such differences.

  6. The Cost of Work-Related Stress to Society: A Systematic Review.

    PubMed

    Hassard, Juliet; Teoh, Kevin R H; Visockaite, Gintare; Dewe, Philip; Cox, Tom

    2017-03-30

    A systematic review of the available evidence examining the cost of work-related stress (WRS) would yield important insights into the magnitude of this social phenomenon. The objective of this review was to collate, extract, and synthesize economic evaluations of the cost of WRS to society. A research protocol was developed. Included cost-of-illness (COI) studies estimated the cost of WRS at a societal level, and were published in English, French or German. Searches were carried out in ingentaconnect, EBSCO, JSTOR, Science Direct, Web of Knowledge, Google, and Google scholar. Included studies were assessed against 10 COI quality assessment criteria. Fifteen studies met the inclusion criteria and were reviewed. These originated from Australia, Canada, Denmark, France, Sweden, Switzerland, the United Kingdom, and the EU-15. The total estimated cost of WRS was observed to be considerable and ranged substantially from US$221.13 million to $187 billion. Productivity related losses were observed to proportionally contribute the majority of the total cost of WRS (between 70 to 90%), with health care and medical costs constituting the remaining 10 to 30%. The evidence reviewed here suggests a sizable financial burden imposed by WRS on society. The observed range of cost estimates was understood to be attributable to variations in definitions of WRS; the number and type of costs estimated; and, in how production loss was estimated. It is postulated that the cost estimates identified by this review are likely conservative because of narrow definitions of WRS and the exclusion of diverse range of cost components. (PsycINFO Database Record

  7. Is relational aggression part of the externalizing spectrum? a bifactor model of youth antisocial behavior.

    PubMed

    Tackett, Jennifer L; Daoud, Stephanie L S B; De Bolle, Marleen; Burt, Sybil Alexandra

    2013-01-01

    The primary purpose of the present study was to examine support for the inclusion of relational aggression (RAgg) alongside physical aggression (Agg) and rule-breaking behaviors (RB) as a subfactor of antisocial behavior (ASB). Caregiver reports were collected for 1,087 youth (48.9% male) ages 6-18. Results indicated that all three subfactors of ASB demonstrated substantial loadings on a general ASB factor. Using a bifactor model approach, specific factors representing each ASB subfactor were simultaneously modeled, allowing for examination of common and specific correlates. At the scale level, results demonstrated consistently strong connections with high Neuroticism and low Agreeableness across all 3 ASB subfactors, a pattern which was replicated for the general ASB factor in the bifactor approach. Specific factors in the bifactor model demonstrated connections with personality and psychopathology correlates, primarily for Agg. These findings provide some support for an overall grouping of RAgg with other ASB subfactors in youth, and further distinguish Agg as potentially representing a more potent variant of youth ASB relative to both RB and RAgg.

  8. Cost-of-illness and disease burden of food-related pathogens in the Netherlands, 2011.

    PubMed

    Mangen, Marie-Josée J; Bouwknegt, Martijn; Friesema, Ingrid H M; Haagsma, Juanita A; Kortbeek, Laetitia M; Tariq, Luqman; Wilson, Margaret; van Pelt, Wilfrid; Havelaar, Arie H

    2015-03-02

    To inform risk management decisions on control and prevention of food-related disease, both the disease burden expressed in Disability Adjusted Life Years (DALY) and the cost-of-illness of food-related pathogens are estimated and presented. Disease burden of fourteen pathogens that can be transmitted by food, the environment, animals and humans was previously estimated by Havelaar et al. (2012). In this paper we complement these by cost-of-illness estimates. Together, these present a complete picture of the societal burden of food-related diseases. Using incidence estimates for 2011, community-acquired non-consulting cases, patients consulting their general practitioner, hospitalized patients and the incidence of sequelae and fatal cases, estimates were obtained for DALYs, direct healthcare costs (e.g. costs for doctor's fees, hospitalizations and medicines), direct non-healthcare costs (e.g. travel costs to and from the doctor), indirect non-healthcare costs (e.g. productivity loss, special education) and total costs. The updated disease burden for 2011 was equal to 13,940 DALY/year (undiscounted) or 12,650 DALY/year (discounted at 1.5%), and was of the same magnitude as previous estimates. At the population-level thermophilic Campylobacter spp., Toxoplasma gondii and rotavirus were associated with the highest disease burden. Perinatal listeriosis infection was associated with the highest DALY per symptomatic case. The total cost-of-illness in 2011 of fourteen food-related pathogens and associated sequelae was estimated at € 468 million/year, if undiscounted, and at € 416 million/year if discounted by 4%. Direct healthcare costs accounted for 24% of total costs, direct non-healthcare costs for 2% and indirect non-healthcare costs for 74% of total costs. At the population-level, norovirus had the highest total cost-of-illness in 2011 with € 106 million/year, followed by thermophilic Campylobacter spp. (€ 76 million/year) and rotavirus (€ 73 million

  9. Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research

    PubMed Central

    Oyana, Tonny J.; Matthews-Juarez, Patricia; Cormier, Stephania A.; Xu, Xiaoran; Juarez, Paul D.

    2015-01-01

    Objective: We have conducted a study to assess the role of environment on the burden of maternal morbidities and mortalities among women using an external exposome approach for the purpose of developing targeted public health interventions to decrease disparities. Methods: We identified counties in the 48 contiguous USA where observed low birthweight (LBW) rates were higher than expected during a five-year study period. The identification was conducted using a retrospective space-time analysis scan for statistically significant clusters with high or low rates by a Discrete Poisson Model. Results: We observed statistically significant associations of LBW rate with a set of predictive variables. However, in one of the two spatiotemporal models we discovered LBW to be associated with five predictive variables (teen birth rate, adult obesity, uninsured adults, physically unhealthy days, and percent of adults who smoke) in two counties situated in Alabama after adjusting for location changes. Counties with higher than expected LBW rates were similarly associated with two environmental variables (ozone and fine particulate matter). Conclusions: The county-level predictive measures of LBW offer new insights into spatiotemporal patterns relative to key contributory factors. An external framework provides a promising place-based approach for identifying “hotspots” with implications for designing targeted interventions and control measures to reduce and eliminate health disparities. PMID:26703702

  10. Relating the Stored Magnetic Energy of a Parallel-Plate Inductor to the Work of External Forces

    NASA Astrophysics Data System (ADS)

    Gauthier, N.

    2007-11-01

    Idealized models are often used in introductory physics courses. For one, such models involve simple mathematics, which is a definite plus since complex mathematical manipulations quickly become an obstacle rather than a tool for a beginner. Idealized models facilitate a student's understanding and grasp of a given physical phenomenon, yet they convey the essential elements of a sometimes intricate and abstract physical concept. It is thus worthwhile to use available models, or to develop new ones, for use in the introductory classroom. Early discussions of electric energy storage within the framework of the infinite parallel-plate capacitor model are an excellent case in point. In this case one can show, through relatively simple mathematical manipulations, that the work done by an external agent in order to increase the separation between the plates is equal to the corresponding change in the electrical energy of the system. The purpose of this paper is to show that a similar model can also be used to discuss magnetic energy storage based on a calculation of the work done by the external forces that act on the system, a subject that is greatly neglected at the introductory level. We examine this system next.

  11. Resting-state EEG power predicts conflict-related brain activity in internally guided but not in externally guided decision-making.

    PubMed

    Nakao, Takashi; Bai, Yu; Nashiwa, Hitomi; Northoff, Georg

    2013-02-01

    Most experimental studies of decision-making have specifically examined situations in which a single correct answer exists (externally guided decision-making). Along with such externally guided decision-making, there are instances of decision-making in which no correct answer based on external circumstances is available for the subject (internally guided decision-making, e.g. preference judgment). We compared these two different types of decision-making in terms of conflict-monitoring and their relation with resting-state brain activity. Current electroencephalography (EEG) data demonstrated that conflict-related N2 amplitudes (i.e., difference between large-conflict and small-conflict conditions) in externally guided decision-making were modulated by the type of external stimulus (i.e., large-conflict stimulus pair or small-conflict stimulus pair) but were not found to be correlated with resting-state brain activity (i.e. resting-state EEG power). In contrast, conflict-related N2 amplitudes in internally guided decision-making were found to be correlated with resting-state brain activity, but were not found to be modulated by the type of stimulus itself: the degree to which the type of external stimulus modulates the conflict during stimulus encoding varies according to individual differences in intrinsic brain activity. Considering those results comprehensively, we demonstrate for the first time resting-state and stimulus-related differences between externally and internally guided decision-making.

  12. Allocation to Reproduction and Relative Reproductive Costs in Two Species of Dioecious Anacardiaceae with Contrasting Phenology

    PubMed Central

    Matsuyama, Shuhei; Sakimoto, Michinori

    2008-01-01

    Background and Aims The cost of reproduction in dioecious plants is often female-biased. However, several studies have reported no difference in costs of reproduction between the sexes. In this study, the relative reproductive allocation and costs at the shoot and whole-plant levels were examined in woody dioecious Rhus javanica and R. trichocarpa, in order to examine differences between types of phenophase (i.e. physiological stage of development). Methods Male and female Rhus javanica and R. trichocarpa were sampled and the reproductive and vegetative allocation of the shoot were estimated by harvesting reproductive current-year shoots during flowering and fruiting. Measurements were made of the number of reproductive and total current-year shoots per whole plant, and of the basal area increment (BAI). The numbers of reproductive and total current-year shoots per 1-year-old shoot were counted in order to examine the costs in the following year at the shoot level. Key Results A female-biased annual reproductive allocation was found; however, the ratio of reproductive current-year shoots per tree and the BAI did not differ between sexes in Rhus javanica and R. trichocarpa. The percentage of 1-year-old shoots with at least one reproductive current-year shoot was significantly male-biased in R. trichocarpa, but not in R. javanica, indicating that there was a relative cost at the shoot level only in R. trichocarpa. The female-biased leaf mass per shoot, an indicator of compensation for costs, was only found in R. javanica. Conclusions Relative reproductive costs at the shoot level were detected in Rhus trichocarpa, which has simultaneous leafing and flowering, but not in R. javanica, which has leafing followed by flowering. However, the costs for the whole-plant level were diminished in both species. The results suggest that the phenophase type may produce the different costs for R. javanica and R. trichocarpa through the development of a compensation mechanism. PMID

  13. City-scale analysis of water-related energy identifies more cost-effective solutions.

    PubMed

    Lam, Ka Leung; Kenway, Steven J; Lant, Paul A

    2017-02-01

    Energy and greenhouse gas management in urban water systems typically focus on optimising within the direct system boundary of water utilities that covers the centralised water supply and wastewater treatment systems, despite a greater energy influence by the water end use. This work develops a cost curve of water-related energy management options from a city perspective for a hypothetical Australian city. It is compared with that from the water utility perspective. The curves are based on 18 water-related energy management options that have been implemented or evaluated in Australia. In the studied scenario, the cost-effective energy saving potential from a city perspective (292 GWh/year) is far more significant than that from a utility perspective (65 GWh/year). In some cases, for similar capital cost, if regional water planners invested in end use options instead of utility options, a greater energy saving potential at a greater cost-effectiveness could be achieved in urban water systems. For example, upgrading a wastewater treatment plant for biogas recovery at a capital cost of $27.2 million would save 31 GWh/year with a marginal cost saving of $63/MWh, while solar hot water system rebates at a cost of $28.6 million would save 67 GWh/year with a marginal cost saving of $111/MWh. Options related to hot water use such as water-efficient shower heads, water-efficient clothes washers and solar hot water system rebates are among the most cost-effective city-scale opportunities. This study demonstrates the use of cost curves to compare both utility and end use options in a consistent framework. It also illustrates that focusing solely on managing the energy use within the utility would miss substantial non-utility water-related energy saving opportunities. There is a need to broaden the conventional scope of cost curve analysis to include water-related energy and greenhouse gas at the water end use, and to value their management from a city perspective. This

  14. Costs for integrating wind into the future ERCOT system with related costs for savings in CO2 emissions.

    PubMed

    Lu, Xi; McElroy, Michael B; Sluzas, Nora A

    2011-04-01

    Wind power can make an important contribution to the goal of reducing emissions of CO2. The major problem relates to the intrinsic variability of the source and the difficulty of reconciling the supply of electricity with demand particularly at high levels of wind penetration. This challenge is explored for the case of the ERCOT system in Texas. Demand for electricity in Texas is projected to increase by approximately 60% by 2030. Considering hourly load data reported for 2006, assuming that the pattern of demand in 2030 should be similar to 2006, and adopting as a business as usual (BAU) reference an assumption that the anticipated additional electricity should be supplied by a combination of coal and gas with prices, discounted to 2007 dollars of $2 and $6 per MMBTU respectively, we conclude that the bus-bar price for electricity would increase by about 1.1 ¢/kWh at a wind penetration level of 30%, by about 3.4 ¢/kWh at a penetration level of 80%. Corresponding costs for reductions in CO2 range from $20/ton to $60/ton. A number of possibilities are discussed that could contribute to a reduction in these costs including the impact of an expanded future fleet of electrically driven vehicles.

  15. The relation of potassium and sodium intakes to diet cost among US adults

    PubMed Central

    Drewnowski, Adam; Rehm, Colin D; Maillot, Matthieu; Monsivais, Pablo

    2014-01-01

    The 2010 Dietary Guidelines recommended that Americans increase potassium and decrease sodium intakes to reduce the burden of hypertension. One reason why so few Americans meet the recommended potassium or sodium goals may be perceived or actual food costs. This study explored the monetary costs associated with potassium and sodium intakes using national food prices and a representative sample of US adults. Dietary intake data from the 2001-2002 National Health and Nutrition Examination Survey were merged with a national food prices database. In a population of 4,744 adults, the association between the energy-adjusted sodium and potassium intakes and the sodium-to-potassium ratio (Na:K), and energy-adjusted diet cost was evaluated. Diets that were more potassium-rich or had lower sodium-potassium ratios were associated with higher diet costs, while sodium intakes were not related to cost. The difference in diet cost among participants with highest and lowest potassium intakes was $1.49 (95% CI 1.29, 1.69). A food-level analysis showed that beans, potatoes, coffee, milk, bananas, citrus juices and carrots are frequently consumed and low-cost sources of potassium. Based on existing dietary data and current American eating habits, a potassium-dense diet was associated with higher diet costs, while sodium was not. Price interventions may be an effective approach to improve potassium intakes and reduce the Na:K ratio of the diet. The present methods helped identify some alternative low-cost foods that were effective in increasing potassium intakes. The identification and promotion of lower-cost foods to help individuals meet targeted dietary recommendations could accompany future dietary guidelines. PMID:24871907

  16. The relation of potassium and sodium intakes to diet cost among U.S. adults.

    PubMed

    Drewnowski, A; Rehm, C D; Maillot, M; Monsivais, P

    2015-01-01

    The 2010 Dietary Guidelines recommended that Americans increase potassium and decrease sodium intakes to reduce the burden of hypertension. One reason why so few Americans meet the recommended potassium or sodium goals may be perceived or actual food costs. This study explored the monetary costs associated with potassium and sodium intakes using national food prices and a representative sample of US adults. Dietary intake data from the 2001-2002 National Health and Nutrition Examination Survey were merged with a national food prices database. In a population of 4744 adults, the association between the energy-adjusted sodium and potassium intakes, and the sodium-to-potassium ratio (Na:K) and energy-adjusted diet cost was evaluated. Diets that were more potassium-rich or had lower Na:K ratios were associated with higher diet costs, while sodium intakes were not related to cost. The difference in diet cost between extreme quintiles of potassium intakes was $1.49 (95% confidence interval: 1.29, 1.69). A food-level analysis showed that beans, potatoes, coffee, milk, bananas, citrus juices and carrots are frequently consumed and low-cost sources of potassium. Based on existing dietary data and current American eating habits, a potassium-dense diet was associated with higher diet costs, while sodium was not. Price interventions may be an effective approach to improve potassium intakes and reduce the Na:K ratio of the diet. The present methods helped identify some alternative low-cost foods that were effective in increasing potassium intakes. The identification and promotion of lower-cost foods to help individuals meet targeted dietary recommendations could accompany future dietary guidelines.

  17. Cost effectiveness of treatments for wet age-related macular degeneration.

    PubMed

    Mitchell, Paul; Annemans, Lieven; White, Richard; Gallagher, Meghan; Thomas, Simu

    2011-02-01

    Age-related macular degeneration (AMD) is a leading cause of blindness in people aged ≥50 years. Wet AMD in particular has a major impact on patient quality of life and imposes substantial burdens on healthcare systems. This systematic review examined the cost-effectiveness data for current therapeutic options for wet AMD. PubMed and EMBASE databases were searched for all articles reporting original cost-effectiveness analyses of wet AMD treatments. The Centre for Reviews and Dissemination and Cochrane Library databases were searched for all wet AMD health technology assessments (HTAs). Overall, 44 publications were evaluated in full and included in this review. A broad range of cost-effectiveness analyses were identified for the most commonly used therapies for wet AMD (pegaptanib, ranibizumab and photodynamic therapy [PDT] with verteporfin). Three studies evaluated the cost effectiveness of bevacizumab in wet AMD. A small number of analyses of other treatments, such as laser photocoagulation and antioxidant vitamins, were also found. Ranibizumab was consistently shown to be cost effective for wet AMD in comparison with all the approved wet AMD therapies (four of the five studies identified showed ranibizumab was cost effective vs usual care, PDT or pegaptanib); however, there was considerable variation in the methodology for cost-effectiveness modelling between studies. Findings from the HTAs supported those from the PubMed and EMBASE searches; of the seven HTAs that included ranibizumab, six (including HTAs for Australia, Canada and the UK) concluded that ranibizumab was cost effective for the treatment of wet AMD; most compared ranibizumab with PDT and/or pegaptanib. By contrast, HTAs at best generally recommended pegaptanib or PDT for restricted use in subsets of patients with wet AMD. In the literature analyses, pegaptanib was found to be cost effective versus usual/best supportive care (including PDT) or no treatment in one of five studies; the other four

  18. Incidence and costs of bicycle-related traumatic brain injuries in the Netherlands.

    PubMed

    Scholten, Annemieke C; Polinder, Suzanne; Panneman, Martien J M; van Beeck, Ed F; Haagsma, Juanita A

    2015-08-01

    The main cause of death and serious disability in bicycle accidents is traumatic brain injury (TBI). The aim of this population-based study was to assess the incidence and costs of bicycle-related TBI across various age groups, and in comparison to all bicycle-related injuries, to identify main risk groups for the development of preventive strategies. Data from the National Injury Surveillance System and National Medical Registration were used for all patients with bicycle-related injuries and TBI who visited a Dutch emergency department (ED) between 1998 and 2012. Demographics and national, weighted estimates of injury mechanism, injury severity and costs were analysed per age group. Direct healthcare costs and indirect costs were determined using the incidence-based Dutch Burden of Injury Model. Between 1998 and 2012, the incidence of ED treatments due to bicycle-related TBI strongly increased with 54%, to 43 per 100,000 persons in 2012. However, the incidence of all bicycle-related injuries remained stable, from 444 in 1998 to 456/100,000 in 2012. Incidence of hospital admission increased in both TBI (92%) and all injuries from cycling (71%). Highest increase in incidence of both ED treatments and hospital admissions was seen in adults aged 55+. The injury rate of TBI per kilometre travelled increased (44%) except in children, but decreased (-4%) for all injuries, showing a strong decrease in children (-36%) but an increase in men aged 25+, and women aged 15+. Total costs of bicycle-related TBI were €74.5 million annually. Although bicycle-related TBI accounted for 9% of the incidence of all ED treatments due to cycling, it accounted for 18% of the total costs due to all bicycle-related injuries (€410.7 million). Children and adolescents (aged 0-24) had highest incidence of ED treatments due to bicycle-related injuries. Men in the working population (aged 15-64) had highest indirect costs following injuries from cycling, including TBI. Older cyclists (aged

  19. Health-related economic costs of the Three-Mile Island accident.

    PubMed

    Hu, T W; Slaysman, K S

    1984-01-01

    On March 1979, a nuclear power station at Three-Mile Island (TMI) near Harrisburg, Pennsylvania, had a major breakdown. During the two-week period of the accident, about 150,000 residents were evacuated for reasons associated with safety and health. Many residents during and after the accident, regardless of whether they left or stayed, made mental and physical adjustments due to this accident. This paper is to estimate the economic costs incurred by individuals or communities as a result of a change in physical or mental health status and/or a change in health care services due to the TMI accident. The findings indicate that stress symptoms caused by the accident did affect the health-related behaviors of area residents. Of the costs examined, the economic costs of work days lost and physician visits are the largest cost items. There were some increases in consumption of alcohol, cigarettes, and tranquilizers immediately following the accident.

  20. A study of the relative effectiveness and cost of computerized information retrieval in the interactive mode

    NASA Technical Reports Server (NTRS)

    Smetana, F. O.; Furniss, M. A.; Potter, T. R.

    1974-01-01

    Results of a number of experiments to illuminate the relative effectiveness and costs of computerized information retrieval in the interactive mode are reported. It was found that for equal time spent in preparing the search strategy, the batch and interactive modes gave approximately equal recall and relevance. The interactive mode however encourages the searcher to devote more time to the task and therefore usually yields improved output. Engineering costs as a result are higher in this mode. Estimates of associated hardware costs also indicate that operation in this mode is more expensive. Skilled RECON users like the rapid feedback and additional features offered by this mode if they are not constrained by considerations of cost.

  1. Predictors of longitudinal outcome and recovery of pragmatic language and its relation to externalizing behaviour after pediatric traumatic brain injury.

    PubMed

    Ryan, Nicholas P; Catroppa, Cathy; Beare, Richard; Coleman, Lee; Ditchfield, Michael; Crossley, Louise; Beauchamp, Miriam H; Anderson, Vicki A

    2015-03-01

    The purpose of the present investigation was to evaluate the contribution of age-at-insult and brain pathology on longitudinal outcome and recovery of pragmatic language in a sample of children and adolescents with traumatic brain injury (TBI). Children and adolescents with mild to severe TBI (n=112) were categorized according to timing of brain insult: (i) Middle Childhood (5-9 years; n=41); (ii) Late Childhood (10-11 years; n=39); and (iii) Adolescence (12-15 years; n=32) and group-matched for age, gender and socio-economic status (SES) to a typically developing (TD) control group (n=43). Participants underwent magnetic resonance imaging (MRI) including a susceptibility weighted imaging (SWI) sequence 2-8 weeks after injury and were assessed on measures of pragmatic language and behavioural functioning at 6- and 24-months after injury. Children and adolescents with TBI of all severity levels demonstrated impairments in these domains at 6-months injury before returning to age-expected levels at 2-years post-TBI. However, while adolescent TBI was associated with post-acute disruption to skills that preceded recovery to age-expected levels by 2-years post injury, the middle childhood TBI group demonstrated impairments at 6-months post-injury that were maintained at 2-year follow up. Reduced pragmatic communication was associated with frontal, temporal and corpus callosum lesions, as well as more frequent externalizing behaviour at 24-months post injury. Findings show that persisting pragmatic language impairment after pediatric TBI is related to younger age at brain insult, as well as microhemorrhagic pathology in brain regions that contribute to the anatomically distributed social brain network. Relationships between reduced pragmatic communication and more frequent externalizing behavior underscore the need for context-sensitive rehabilitation programs that aim to increase interpersonal effectiveness and reduce risk for maladaptive behavior trajectories into the

  2. Prospects for cost reductions from relaxing additional cross-border measures related to livestock trade.

    PubMed

    Hop, G E; Mourits, M C M; Slager, R; Oude Lansink, A G J M; Saatkamp, H W

    2013-05-01

    Compared with the domestic trade in livestock, intra-communal trade across the European Union (EU) is subject to costly, additional veterinary measures. Short-distance transportation just across a border requires more measures than long-distance domestic transportation, while the need for such additional cross-border measures can be questioned. This study examined the prospects for cost reductions from relaxing additional cross-border measures related to trade within the cross-border region of the Netherlands (NL) and Germany (GER); that is, North Rhine Westphalia and Lower Saxony. The study constructed a deterministic spread-sheet cost model to calculate the costs of both routine veterinary measures (standard measures that apply to both domestic and cross-border transport) and additional cross-border measures (extra measures that only apply to cross-border transport) as applied in 2010. This model determined costs by stakeholder, region and livestock sector, and studied the prospects for cost reduction by calculating the costs after the relaxation of additional cross-border measures. The selection criteria for relaxing these measures were (1) a low expected added value on preventing contagious livestock diseases, (2) no expected additional veterinary risks in case of relaxation of measures and (3) reasonable cost-saving possibilities. The total cost of routine veterinary measures and additional cross-border measures for the cross-border region was €22.1 million, 58% (€12.7 million) of which came from additional cross-border measures. Two-thirds of this €12.7 million resulted from the trade in slaughter animals. The main cost items were veterinary checks on animals (twice in the case of slaughter animals), export certification and control of export documentation. Four additional cross-border measures met the selection criteria for relaxation. The relaxation of these measures could save €8.2 million (€5.0 million for NL and €3.2 million for GER) annually

  3. Dual task cost of walking is related to fall risk in persons with multiple sclerosis.

    PubMed

    Wajda, Douglas A; Motl, Robert W; Sosnoff, Jacob J

    2013-12-15

    Persons with multiple sclerosis (MS) commonly have walking and cognitive impairments. While walking with a simultaneous cognitive task, persons with MS experience a greater decline in walking performance than healthy controls. This change in performance is termed dual task cost or dual task interference and has been associated with fall risk in older adults. We examined whether dual task cost during walking was related to fall risk in persons with MS. Thirty-three ambulatory persons with MS performed walking tasks with and without a concurrent cognitive task (dual task condition) as well as underwent a fall risk assessment. Dual task cost was operationalized as the percent change in velocity from normal walking conditions to dual task walking conditions. Fall risk was quantified using the Physiological Profile Assessment. A Spearman correlation analysis revealed a significant positive correlation between dual task cost of walking velocity and fall risk as well as dual task cost of stride length and fall risk. Overall, the findings indicate that dual task cost is associated with fall risk and may be an important target for falls prevention strategies.

  4. 48 CFR 1631.205-70 - FEHBP public relations and advertising costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false FEHBP public relations and advertising costs. 1631.205-70 Section 1631.205-70 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS...

  5. 48 CFR 1631.205-70 - FEHBP public relations and advertising costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false FEHBP public relations and advertising costs. 1631.205-70 Section 1631.205-70 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS...

  6. The Deductibility of Work-Related Higher Education Costs: The Saga Continues

    ERIC Educational Resources Information Center

    Segal, Mark A.; Bird, Bruce M.

    2011-01-01

    Whether a taxpayer's work-related higher education costs are deductible under IRC (Internal Revenue Code) Section 162 is an issue highly dependent upon facts and circumstances. The regulations pursuant to IRC Section 162 and the emergence of case law on this topic constitute important elements to consider in making this determination.

  7. Epidemiology of workplace-related fall from height and cost of trauma care in Qatar

    PubMed Central

    Tuma, Mazin A.; Acerra, John R.; El-Menyar, Ayman; Al-Thani, Hassan; Al-Hassani, Ammar; Recicar, John F.; Al Yazeedi, Wafaa; Maull, Kimball I.

    2013-01-01

    Background: This study was designed to identify the incidence, injury patterns, and actual medical costs of occupational-related falls in Qatar, in order to provide a reference for establishing fall prevention guidelines and recommendations. Settings and Design: Retrospective database registry review in Level 1 Trauma Center at Tertiary Hospital in Qatar. Materials and Methods: During a 12-month period between November 1st 2007 and October 31st 2008, construction workers who fell from height were enrolled. A database was designed to characterize demographics, injury severity score (ISS), total hospital length of stay, resource utilization, and cost of care. Statistical Analysis: Data were presented as proportions, mean ± standard deviation or median and range as appropriate. In addition, case fatality rate and cost analysis were obtained from the Biostatistics and finance departments of the same hospital. Results: There were 315 fall-related injuries, of which 298 were workplace related. The majority (97%) were male immigrants with mean age of 33 ± 11 years. The most common injuries were to the spine, head, and chest. Mean ISS was 16.4 ± 10. There was total of 29 deaths (17 pre-hospital and 12 in-hospital deaths) for a case fatality rate of 8.6%. Mean cost of care (rounded figures) included pre-hospital services Emergency Medical Services (EMS), trauma resuscitation room, radiology and imaging, operating room, intensive care unit care, hospital ward care, rehabilitation services, and total cost (123, 82, 105, 130, 496, 3048,434, and 4418 thousand United States Dollars (USD), respectively). Mean cost of care per admitted patient was approximately 16,000 USD. Conclusions: Falling from height at a construction site is a common cause of trauma that poses a significant financial burden on the health care system. Injury prevention efforts are warranted along with strict regulation and enforcement of occupational laws. PMID:23724377

  8. Specific count model for investing the related factors of cost of GERD and functional dyspepsia

    PubMed Central

    Abadi, Alireza; Chaibakhsh, Samira; Safaee, Azadeh; Moghimi-Dehkordi, Bijan

    2013-01-01

    Aim The purpose of this study is to analyze the cost of GERD and functional dyspepsia for investing its related factors. Background Gastro-oesophageal reflux disease GERD and dyspepsia are the most common symptoms of gastrointestinal disorders. Recent studies showed high prevalence and variety of clinical presentation of these two symptoms imposed enormous economic burden to the society. Cost data that related to economics burden have specific characteristics. So this kind of data needs to specific models. Poisson regression (PR) and negative binomial regression (NB) are the models that were used for analyzing cost data in this paper. Patients and methods This study designed as a cross-sectional household survey from May 2006 to December 2007 on a random sample of individual in the Tehran province, Iran to find the prevalence of gastrointestinal symptoms and disorders and its related factors. The Cost in each item was counted. PR and NB were carried out to the data respectively. Likelihood ratio test was performed for comparison between models. Also Log likelihood, Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used to compare performance of the models. Results According to Likelihood ratio test and all three criterions that we used to compare performance of the models, NB was the best model for analyzing this cost data. Sex, age and insurance statues were being significant. Conclusion PR and NB models were carried out for this data and according the results improved fit of the NB model over PR, it clearly indicates that over-dispersion is involved due to unobserved heterogeneity and/or clustering. NB model in cost data more appropriate fit than PR. PMID:24834282

  9. Work-related stress in Australia: The effects of legislative interventions and the cost of treatment.

    PubMed

    Guthrie, Robert; Ciccarelli, Marina; Babic, Angela

    2010-01-01

    The Australian Institute of Health and Welfare data published in 2002 shows a continued rise in health care costs to the Australian community due to the growing number of people diagnosed with mental health disorders. Those mental health disorders may originate from a number of sources, including work and non-work-related factors. The so called work-related stress claims in all Australian jurisdictions are the most expensive form of workers compensation claim. In the most part this is due to the lengthy period of absence (duration) and complicated medical care which are characteristic of these claims. In Australia, in the last decade, attempts have been made to reduce the costs of compensable stress-related claims by imposing special legislative thresholds on such claims. This 'back end' approach to cost reduction has resulted in an array of legislative formula designed to exclude work-related stress claims. This article surveys the various legislative provisions dealing with work-related stress claims in Australia and provides an analysis of their effectiveness. A range of options are presented as alternatives to the exclusion of particular forms of work-related stress claims. The use of a corporate citizenship approach to the prevention and management of stress claims is also discussed as a proactive alternative to occupational safety and health legislative provisions and the workers compensation legislative exclusions.

  10. High cost factors for leukaemia and lymphoma patients: a new analysis of costs within these diagnosis related groups

    PubMed Central

    Quantin, C.; Entezam, F.; Brunet-Lecomte, P.; Lepage, E.; Guy, H.; Dusserre, L.

    1999-01-01

    STUDY OBJECTIVE: To determine high cost factors to help managers and clinicians to analyse the reasons of adverse costs and provide indications for financial negotiation. DESIGN: To locate high cost or long stay patients, the analysis was designed on the basis of a mixture of Weibull distributions. In this new model, the proportion of high cost patients was expressed according to the multinomial logistic regression, permitting the determination of high cost factors. SETTING: The 1993 French reference database, constituted in the framework of the national study of DRG costs, conducted by the French Ministry of Health. The database of discharge abstracts recorded in 1993 in the Dijon public teaching hospital. PARTICIPANTS: The analyses were based on 1352 abstracts from the French reference database and 368 from the Dijon database concerning patients, aged 18 and over, suffering from leukaemia and lymphoma. MAIN RESULTS: High cost and long stay factors were the same: number of stays, death, transfer, acute leukaemia, neutropenia, septicaemia, high dose aplastic chemotherapy, central venous catheterisation, parenteral nutrition, protected or laminar airflow room, blood transfusion, and intravenous antibiotherapy. CONCLUSIONS: Taking into account high cost predictive factors, as shown in the case of leukaemia and lymphoma patients, would help to reduce the adverse effects of a prospective payment system.   PMID:10326049

  11. Robust, low-cost data loggers for stream temperature, flow intermittency, and relative conductivity monitoring

    USGS Publications Warehouse

    Chapin, Thomas; Todd, Andrew S.; Zeigler, Matthew P.

    2014-01-01

    Water temperature and streamflow intermittency are critical parameters influencing aquatic ecosystem health. Low-cost temperature loggers have made continuous water temperature monitoring relatively simple but determining streamflow timing and intermittency using temperature data alone requires significant and subjective data interpretation. Electrical resistance (ER) sensors have recently been developed to overcome the major limitations of temperature-based methods for the assessment of streamflow intermittency. This technical note introduces the STIC (Stream Temperature, Intermittency, and Conductivity logger); a robust, low-cost, simple to build instrument that provides long-duration, high-resolution monitoring of both relative conductivity (RC) and temperature. Simultaneously collected temperature and RC data provide unambiguous water temperature and streamflow intermittency information that is crucial for monitoring aquatic ecosystem health and assessing regulatory compliance. With proper calibration, the STIC relative conductivity data can be used to monitor specific conductivity.

  12. Relation between quality and production cost for pure biodiesel bases on the mixes of raw materials

    NASA Astrophysics Data System (ADS)

    Tsanaktsidis, C. G.; Spinthiropoulos, K. G.; Guliyev, Fariz; Dimitriou, D.; Euthaltsidou, K.; Tzilantonis, G. T.

    2016-08-01

    Nowadays biodiesel has become more attractive because it is made from renewable resources. The main ingredients of industrial biodiesel are rap oil, sun oil, fat acid, olive oil cooked. In this study we verify that, the proportion of these components sets the qualitative composition and energy efficiency of the final product. Essential we link the raw materials (rap oil, sun oil, fat acid, olive oil cooked) used in the manufacture of industrial biodiesel the proportion of mixes, with the variation of physicochemical properties of biodiesel produced. According to the quantitative analysis we notice that the physiochemical properties which alter the value for example humidity, acidity, while a large number of physicochemical properties do not change their value depending on the ratio of raw materials in each mixture. The analysis of these changes seems that the presence of fat acids is negative for the quality of the mixture. From the analysis of the cost of the final mixtures that lower cost is achieved in the mixture was 10 and the highest cost was in the mixture 3. Based on a study of the cost of the mixtures can determine a basic relation between the quality and the cost of the final product.

  13. Relative costs of offspring sex and offspring survival in a polygynous mammal

    PubMed Central

    Clutton-Brock, Tim H.

    2016-01-01

    Costs of reproduction are expected to be ubiquitous in wild animal populations and understanding the drivers of variation in these costs is an important aspect of life-history evolution theory. We use a 43 year dataset from a wild population of red deer to examine the relative importance of two factors that influence the costs of reproduction to mothers, and to test whether these costs vary with changing ecological conditions. Like previous studies, our analyses indicate fitness costs of lactation: mothers whose calves survived the summer subsequently showed lower survival and fecundity than those whose calves died soon after birth, accounting for 5% and 14% of the variation in mothers' survival and fecundity, respectively. The production of a male calf depressed maternal survival and fecundity more than production of a female, but accounted for less than 1% of the variation in either fitness component. There was no evidence for any change in the effect of calf survival or sex with increasing population density. PMID:27601725

  14. Relation between postural sway magnitude and metabolic energy cost during upright standing on a compliant surface.

    PubMed

    Houdijk, Han; Brown, Starr E; van Dieën, Jaap H

    2015-09-15

    Postural control performance is often described in terms of postural sway magnitude, assuming that lower sway magnitude reflects better performance. However, people do not typically minimize sway magnitude when performing a postural control task. Possibly, other criteria are satisfied when people select the amount of sway they do. Minimal metabolic cost has been suggested as such a criterion. The aim of this study was to experimentally test the relation between sway magnitude and metabolic cost to establish whether metabolic cost could be a potential optimization criterion in postural control. Nineteen healthy subjects engaged in two experiments in which different magnitudes of sway were evoked during upright standing on a foam surface while metabolic energy expenditure, center of pressure (CoP) excursion, and muscle activation were recorded. In one experiment, sway was manipulated by visual feedback of CoP excursion. The other experiment involved verbal instructions of standing still, natural or relaxed. In both experiments, metabolic cost changed with sway magnitude in an asymmetric parabolic fashion, with a minimum around self-selected sway magnitudes and a larger increase at small compared with large sway magnitudes. This metabolic response was paralleled by a change in tonic and phasic EMG activity in the major leg muscles. It is concluded that these results are in line with the notion that metabolic cost can be an optimization criterion used to set postural control and as such could account for the magnitude of naturally occurring postural sway in healthy individuals, although the pathway remains to be elucidated.

  15. Cost of diseases related to alcohol consumption in the Brazilian Unified Health System

    PubMed Central

    Coutinho, Evandro Silva Freire; Bahia, Luciana; Barufaldi, Laura Augusta; Abreu, Gabriela de Azevedo; Malhão, Thainá Alves; Pepe, Camila Ribeiro; Araujo, Denizar Vianna

    2016-01-01

    ABSTRACT OBJECTIVE To estimate the direct costs associated to outpatient and hospital care of diseases related to alcohol consumption in the Brazilian Unified Health System. METHODS Attributable populational risks were estimated for the selected diseases related to the use of 25 g/day or more of ethanol (risk consumption), considering a relative risk (RR) ≥ 1.20. The RR estimates were obtained from three meta-analysis. The risk consumption rates of the Brazilian population ≥ 18 years old were obtained by a national survey. Data from the Hospital Information System of SUS (HIS-SUS) were used to estimate the annual costs of the health system with the diseases included in the analysis. RESULTS The total estimated costs for a year regarding diseases related to risk consumption were U$8,262,762 (US$4,413,670 and US$3,849,092, for outpatient and hospital care, respectively). CONCLUSIONS Risk consumption of alcohol is an important economic and health problem, impacting significantly the health system and society. PMID:27305403

  16. 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

  17. Cost-Utility Analyses of Cataract Surgery in Advanced Age-Related Macular Degeneration

    PubMed Central

    Ma, Yingyan; Huang, Jiannan; Zhu, Bijun; Sun, Qian; Miao, Yuyu; Zou, Haidong

    2016-01-01

    ABSTRACT Purpose To explore the cost-utility of cataract surgery in patients with advanced age-related macular degeneration (AMD). Methods Patients who were diagnosed as having and treated for age-related cataract and with a history of advanced AMD at the Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, were included in the study. All of the participants underwent successful phacoemulsification with foldable posterior chamber intraocular lens implantation under retrobulbar anesthesia. Best-corrected visual acuity (BCVA) and utility value elicited by time trade-off method from patients at 3-month postoperative time were compared with those before surgery. Quality-adjusted life years (QALYs) gained in a lifetime were calculated at a 3% annual discounted rate. Costs per QALY gained were calculated using the bootstrap method, and probabilities of being cost-effective were presented using a cost-effectiveness acceptability curve. Sensitivity analyses were performed to test the robustness of the results. Results Mean logarithm of the minimum angle of resolution BCVA in the operated eye increased from 1.37 ± 0.5 (Snellen, 20/469) to 0.98 ± 0.25 (Snellen, 20/191) (p < 0.001); BCVA in the weighted average from both eyes (=75% better eye + 25% worse eye) was changed from 1.13 ± 0.22 (Snellen, 20/270) to 0.96 ± 0.17 (Snellen, 20/182) (p < 0.001). Utility values from both patients and doctors increased significantly after surgery (p < 0.001 and p = 0.007). Patients gained 1.17 QALYs by cataract surgery in their lifetime. The cost per QALY was 8835 Chinese yuan (CNY) (1400 U.S. dollars [USD]). It is cost-effective at the threshold of 115,062 CNY (18,235 USD) per QALY in China recommended by the World Health Organization. The cost per QALY varied from 7045 CNY (1116 USD) to 94,178 CNY (14,925 USD) in sensitivity analyses. Conclusions Visual acuity and quality of life assessed by utility value improved significantly after surgery

  18. A noticeable difference? Productivity costs related to paid and unpaid work in economic evaluations on expensive drugs.

    PubMed

    Krol, Marieke; Papenburg, Jocé; Tan, Siok Swan; Brouwer, Werner; Hakkaart, Leona

    2016-05-01

    Productivity costs can strongly impact cost-effectiveness outcomes. This study investigated the impact in the context of expensive hospital drugs. This study aimed to: (1) investigate the effect of productivity costs on cost-effectiveness outcomes, (2) determine whether economic evaluations of expensive drugs commonly include productivity costs related to paid and unpaid work, and (3) explore potential reasons for excluding productivity costs from the economic evaluation. We conducted a systematic literature review to identify economic evaluations of 33 expensive drugs. We analysed whether evaluations included productivity costs and whether inclusion or exclusion was related to the study population's age, health and national health economic guidelines. The impact on cost-effectiveness outcomes was assessed in studies that included productivity costs. Of 249 identified economic evaluations of expensive drugs, 22 (9 %) included productivity costs related to paid work. One study included unpaid productivity. Mostly, productivity cost exclusion could not be explained by the study population's age and health status, but national guidelines appeared influential. Productivity costs proved often highly influential. This study indicates that productivity costs in economic evaluations of expensive hospital drugs are commonly and inconsistently ignored in economic evaluations. This warrants caution in interpreting and comparing the results of these evaluations.

  19. Relation between physical time-energy cost of a quantum process and its information fidelity

    NASA Astrophysics Data System (ADS)

    Fung, Chi-Hang Fred; Chau, H. F.

    2014-08-01

    A quantum system can be described and characterized by at least two different concepts, namely, its physical and informational properties. Here, we explicitly connect these two concepts, by equating the time-energy cost which is the product of the largest energy of a Hamiltonian of quantum dynamics and the evolution time, and the entanglement fidelity which is the informational difference between an input state and the corresponding output state produced by a quantum channel characterized by the Hamiltonian. Specifically, the worst-case entanglement fidelity between the input and output states is exactly the cosine of the channel's time-energy cost (except when the fidelity is zero). The exactness of our relation makes a strong statement about the intimate connection between information and physics. Our exact result may also be regarded as a time-energy uncertainty relation for the fastest state that achieves a certain fidelity.

  20. Physics and Slavery: The Relative Cost of Calories for Slave Infants and Their Mothers,

    DTIC Science & Technology

    1979-11-01

    THE RELATIVE COST OF CALORIES FOR SLAVE INFANTS AND THEIR MOTHERSI In Time On The Cross Robert Fogel and Stanley Engerman use as the rate of slave...was supported by National Science Foundation Grants GS-3262 and GS-27262 to Harvard University. 2Robert William Fogel and Stanley L. Engerman, Time On...is an exemplary practice in this regard. Since the methods employed by Fogel and Engerman give more weight to children than to adults, their value

  1. Potential escalation of heat-related working costs with climate and socioeconomic changes in China

    PubMed Central

    Zhao, Yan; Sultan, Benjamin; Vautard, Robert; Braconnot, Pascale; Wang, Huijun J.; Ducharne, Agnes

    2016-01-01

    Global climate change will increase the frequency of hot temperatures, impairing health and productivity for millions of working people and raising labor costs. In mainland China, high-temperature subsidies (HTSs) are allocated to employees for each working day in extremely hot environments, but the potential heat-related increase in labor cost has not been evaluated so far. Here, we estimate the potential HTS cost in current and future climates under different scenarios of socioeconomic development and radiative forcing (Representative Concentration Pathway), taking uncertainties from the climate model structure and bias correction into account. On average, the total HTS in China is estimated at 38.6 billion yuan/y (US $6.22 billion/y) over the 1979–2005 period, which is equivalent to 0.2% of the gross domestic product (GDP). Assuming that the HTS standards (per employee per hot day) remain unchanged throughout the 21st century, the total HTS may reach 250 billion yuan/y in the 2030s and 1,000 billion yuan/y in 2100. We further show that, without specific adaptation, the increased HTS cost is mainly determined by population growth until the 2030s and climate change after the mid-21st century because of increasingly frequent hot weather. Accounting for the likely possibility that HTS standards follow the wages, the share of GDP devoted to HTS could become as high as 3% at the end of 21st century. PMID:27044089

  2. Potential escalation of heat-related working costs with climate and socioeconomic changes in China.

    PubMed

    Zhao, Yan; Sultan, Benjamin; Vautard, Robert; Braconnot, Pascale; Wang, Huijun J; Ducharne, Agnes

    2016-04-26

    Global climate change will increase the frequency of hot temperatures, impairing health and productivity for millions of working people and raising labor costs. In mainland China, high-temperature subsidies (HTSs) are allocated to employees for each working day in extremely hot environments, but the potential heat-related increase in labor cost has not been evaluated so far. Here, we estimate the potential HTS cost in current and future climates under different scenarios of socioeconomic development and radiative forcing (Representative Concentration Pathway), taking uncertainties from the climate model structure and bias correction into account. On average, the total HTS in China is estimated at 38.6 billion yuan/y (US $6.22 billion/y) over the 1979-2005 period, which is equivalent to 0.2% of the gross domestic product (GDP). Assuming that the HTS standards (per employee per hot day) remain unchanged throughout the 21st century, the total HTS may reach 250 billion yuan/y in the 2030s and 1,000 billion yuan/y in 2100. We further show that, without specific adaptation, the increased HTS cost is mainly determined by population growth until the 2030s and climate change after the mid-21st century because of increasingly frequent hot weather. Accounting for the likely possibility that HTS standards follow the wages, the share of GDP devoted to HTS could become as high as 3% at the end of 21st century.

  3. Thyroid cancer in the Marshallese: relative risk of short-lived internal emitters and external radiation exposure

    SciTech Connect

    Lessard, E.T.; Brill, A.B.; Adams, W.H.

    1985-01-01

    In a study of the comparative effects of internal versus external irradiation of the thyroid in young people, we determined that the dose from internal irradiation of the thyroid with short-lived internal emitters produced several times less thyroid cancer than did the same dose of radiation given externally. We determined this finding for a group of 85 Marshall Islands children, who were less than 10 years of age at the time of exposure and who were accidentially exposed to internal and external thyroid radiation at an average level of 1400 rad. The external risk coefficient ranged between 2.5 and 4.9 cancers per million person-rad-years at risk, and thus, from our computations, the internal risk coefficient for the Marshallese children was estimated to range between 1.0 and 1.4 cancers per million person-rad-years at risk. In contrast, for individual more than 10 years of age at the time of exposure, the dose from internal irradiation of the thyroid with short-lived internal emitters produced several times more thyroid cancer than did the same dose of radiation given externally. The external risk coefficients for the older age groups were reported in the literature to be in the range of 1.0 to 3.3 cancers per million person-rad-years-at risk. We computed internal risk coefficients of 3.3 to 8.1 cancers per million person-rad-years at risk for adolescent and adult groups. This higher sensitivity to cancer induction in the exposed adolescents and adults, is different from that seen in other exposed groups. 14 refs., 8 tabs.

  4. Control of Rhagoletis indifferents using Thiamethoxam and Spinosad baits under external fly pressure and its relation to rapidity of kill and residual bait activity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Control of western cherry fruit fly (Rhagoletis indifferens Curran) using thiamethoxam in sucrose bait and spinosad bait in cherry orchards under external fly pressure and its relation to rapidity of kill and residual bait activity were studied in Washington and Utah in 2010 and 2011. Thiamethoxam ...

  5. The Internal/External Frame of Reference Model of Self-Concept and Achievement Relations: Age-Cohort and Cross-Cultural Differences

    ERIC Educational Resources Information Center

    Marsh, Herbert W.; Abduljabbar, Adel Salah; Parker, Philip D.; Morin, Alexandre J. S.; Abdelfattah, Faisal; Nagengast, Benjamin; Möller, Jens; Abu-Hilal, Maher M.

    2015-01-01

    The internal/external frame of reference (I/E) model and dimensional comparison theory posit paradoxical relations between achievement (ACH) and self-concept (SC) in mathematics (M) and verbal (V) domains; ACH in each domain positively affects SC in the matching domain (e.g., MACH to MSC) but negatively in the nonmatching domain (e.g., MACH to…

  6. Impact of Measurement Invariance on Construct Correlations, Mean Differences, and Relations with External Correlates: An Illustrative Example Using Big Five and RIASEC Measures

    ERIC Educational Resources Information Center

    Schmitt, Neal; Golubovich, Juliya; Leong, Frederick T. L.

    2011-01-01

    The impact of measurement invariance and the provision for partial invariance in confirmatory factor analytic models on factor intercorrelations, latent mean differences, and estimates of relations with external variables is investigated for measures of two sets of widely assessed constructs: Big Five personality and the six Holland interests…

  7. A Longitudinal Examination of the Relation between Parental Expressed Emotion and Externalizing Behaviors in Children and Adolescents with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Bader, Stephanie H.; Barry, Tammy D.

    2014-01-01

    The current study explored the longitudinal relation between parental expressed emotion, a well-established predictor of symptom relapse in various other disorders (e.g., schizophrenia) with externalizing behaviors in 84 children, ages 8-18 (at Time 2), with autism spectrum disorder (ASD). It was found that parental expressed emotion, specifically…

  8. Multimethod Assessment of Psychopathy in Relation to Factors of Internalizing and Externalizing from the Personality Assessment Inventory: The Impact of Method Variance and Suppressor Effects

    ERIC Educational Resources Information Center

    Blonigen, Daniel M.; Patrick, Christopher J.; Douglas, Kevin S.; Poythress, Norman G.; Skeem, Jennifer L.; Lilienfeld, Scott O.; Edens, John F.; Krueger, Robert F.

    2010-01-01

    Research to date has revealed divergent relations across factors of psychopathy measures with criteria of "internalizing" (INT; anxiety, depression) and "externalizing" (EXT; antisocial behavior, substance use). However, failure to account for method variance and suppressor effects has obscured the consistency of these findings…

  9. Daily Energy Expenditure and Its Relation to Health Care Costs in Patients Undergoing Ambulatory Electrocardiographic Monitoring.

    PubMed

    George, Jason; Abdulla, Rami Khoury; Yeow, Raymond; Aggarwal, Anshul; Boura, Judith; Wegner, James; Franklin, Barry A

    2017-02-15

    Our increasingly sedentary lifestyle is associated with a heightened risk of obesity, diabetes, heart disease, and cardiovascular mortality. Using the recently developed heart rate index formula in 843 patients (mean ± SD age 62.3 ± 15.7 years) who underwent 24-hour ambulatory electrocardiographic (ECG) monitoring, we estimated average and peak daily energy expenditure, expressed as metabolic equivalents (METs), and related these data to subsequent hospital encounters and health care costs. In this cohort, estimated daily average and peak METs were 1.7 ± 0.7 and 5.5 ± 2.1, respectively. Patients who achieved daily bouts of peak energy expenditure ≥5 METs had fewer hospital encounters (p = 0.006) and median health care costs that were nearly 50% lower (p <0.001) than their counterparts who attained <5 METs. In patients whose body mass index was ≥30 kg/m(2), there were significant differences in health care costs depending on whether they achieved <5 or ≥5 METs estimated by ambulatory ECG monitoring (p = 0.005). Interestingly, patients who achieved ≥5 METs had lower and no significant difference in their health care costs, regardless of their body mass index (p = 0.46). Patients with previous percutaneous coronary intervention who achieved ≥5 METs had lower health care costs (p = 0.044) and fewer hospital encounters (p = 0.004) than those who achieved <5 METs. In conclusion, average and peak daily energy expenditures estimated from ambulatory ECG monitoring may provide useful information regarding health care utilization in patients with and without previous percutaneous coronary intervention, irrespective of body habitus. Our findings are the first to link lower intensities of peak daily energy expenditure, estimated from ambulatory ECG monitoring, with increased health care utilization.

  10. Frequency, types, and direct related costs of medication errors in an academic nephrology ward in Iran.

    PubMed

    Gharekhani, Afshin; Kanani, Negin; Khalili, Hossein; Dashti-Khavidaki, Simin

    2014-09-01

    Medication errors are ongoing problems among hospitalized patients especially those with multiple co-morbidities and polypharmacy such as patients with renal diseases. This study evaluated the frequency, types and direct related cost of medication errors in nephrology ward and the role played by clinical pharmacists. During this study, clinical pharmacists detected, managed, and recorded the medication errors. Prescribing errors including inappropriate drug, dose, or treatment durations were gathered. To assess transcription errors, the equivalence of nursery charts and physician's orders were evaluated. Administration errors were assessed by observing drugs' preparation, storage, and administration by nurses. The changes in medications costs after implementing clinical pharmacists' interventions were compared with the calculated medications costs if the medication errors were continued up to patients' discharge time. More than 85% of patients experienced medication error. The rate of medication errors was 3.5 errors per patient and 0.18 errors per ordered medication. More than 95% of medication errors occurred at prescription nodes. Most common prescribing errors were omission (26.9%) or unauthorized drugs (18.3%) and low drug dosage or frequency (17.3%). Most of the medication errors happened on cardiovascular drugs (24%) followed by vitamins and electrolytes (22.1%) and antimicrobials (18.5%). The number of medication errors was correlated with the number of ordered medications and length of hospital stay. Clinical pharmacists' interventions decreased patients' direct medication costs by 4.3%. About 22% of medication errors led to patients' harm. In conclusion, clinical pharmacists' contributions in nephrology wards were of value to prevent medication errors and to reduce medications cost.

  11. High Antenatal Maternal Anxiety Is Related to ADHD Symptoms, Externalizing Problems, and Anxiety in 8- and 9-Year-Olds

    ERIC Educational Resources Information Center

    Van den Bergh, Bea R.H.; Marcoen, Alfons

    2004-01-01

    Associations between antenatal maternal anxiety, measured with the State Trait Anxiety Inventory, and disorders in 8- and 9-year-olds were studied prospectively in 71 normal mothers and their 72 firstborns. Clinical scales were completed by the mother, the child, the teacher, and an external observer. Hierarchical multiple regression analyses…

  12. Defensive Dysregulation in Preschool Children's Attachment Story Narratives and Its Relation to Attachment Classification and Externalizing Behaviour

    ERIC Educational Resources Information Center

    Stacks, Ann M.

    2007-01-01

    This study examines the relationship between disorganized attachment representations, defensive dysregulation in preschool children's doll play story narratives and child externalizing behaviour. Preschool children (n = 53) participated in the George and Solomon (1990, 1996, 2000) "Six-Year Attachment Doll Play Procedure" and their mothers…

  13. Guide to resource conservation and cost savings opportunities in the soap, detergents and related products sector

    SciTech Connect

    1998-10-01

    This guide was prepared to help those involved in the manufacturing of soap, detergent, and related products to identify potential process improvements that will reduce production costs and conserve resources. The guide offers a series of generic process descriptions and checklists of improvement opportunities specific to each of five major processes used in the industry: Soap production, surfactant production, solid cake product formulation, liquid product formulation, and granulated powdered product formulation. The checklists identify thermal, electrical, environmental, water use, and low- or no-cost measures that can be implemented, as well as retrofit technology options. A variety of new technologies that may exhibit future potential are also described. Appendices include a glossary, background information on the Ontario soap/detergent industry, and description of the four major categories of ingredients used in the industry.

  14. Temporal data mining for the assessment of the costs related to diabetes mellitus pharmacological treatment.

    PubMed

    Concaro, Stefano; Sacchi, Lucia; Cerra, Carlo; Stefanelli, Mario; Fratino, Pietro; Bellazzi, Riccardo

    2009-11-14

    Diabetes care and chronic disease management represent data-intensive contexts which allow Local Healthcare Agencies (ASL) to collect a huge amount of information. Time is often an essential component of such information, given the strong importance of the temporal evolution of the considered disease and of its treatment. In this paper we show the application of a temporal data mining technique to extract temporal association rules over an integrated repository including both administrative and clinical data related to a sample of diabetic patients. We will show how the method can be used to highlight cases and conditions which lead to the highest pharmaceutical costs. Considering the perspective of a Regional Healthcare Agency, this method could be properly exploited to assess the overall standards and quality of care, while lowering costs.

  15. Environmental impacts and costs of energy.

    PubMed

    Rabl, Ari; Spadaro, Joseph V

    2006-09-01

    Environmental damage is one of the main justifications for continued efforts to reduce energy consumption and to shift to cleaner sources such as solar energy. In recent years there has been much progress in the analysis of environmental damages, in particular thanks to the ExternE (External Costs of Energy) Project of the European Commission. This article presents a summary of the methodology and key results for the external costs of the major energy technologies. Even though the uncertainties are large, the results provide substantial evidence that the classical air pollutants (particles, No(x), and SO(2)) from fossil fuels impose significant public health costs, comparable to the cost of global warming from CO(2) emissions. The total external costs are relatively low for natural gas (in the range of about 0.5-1 eurocents/kWh for most EU countries), but much higher for coal and lignite (in the range of about 2-6 eurocents/kWh for most EU countries). By contrast, the external costs of nuclear, wind, and photovoltaics are very low. The external costs of hydro are extremely variable from site to site, and the ones of biomass depend strongly on the specific technologies used and can be quite large for combustion.

  16. 25 CFR 39.160 - Does ISEF provide supplemental funding for extraordinary costs related to a school's geographic...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... costs related to a school's geographic isolation? Yes. Havasupai Elementary School, for as long as it... costs related to a school's geographic isolation? 39.160 Section 39.160 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Indian School...

  17. 25 CFR 39.160 - Does ISEF provide supplemental funding for extraordinary costs related to a school's geographic...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... costs related to a school's geographic isolation? Yes. Havasupai Elementary School, for as long as it... costs related to a school's geographic isolation? 39.160 Section 39.160 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Indian School...

  18. 25 CFR 39.160 - Does ISEF provide supplemental funding for extraordinary costs related to a school's geographic...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... costs related to a school's geographic isolation? Yes. Havasupai Elementary School, for as long as it... costs related to a school's geographic isolation? 39.160 Section 39.160 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Indian School...

  19. 25 CFR 39.160 - Does ISEF provide supplemental funding for extraordinary costs related to a school's geographic...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... costs related to a school's geographic isolation? Yes. Havasupai Elementary School, for as long as it... costs related to a school's geographic isolation? 39.160 Section 39.160 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Indian School...

  20. 25 CFR 39.160 - Does ISEF provide supplemental funding for extraordinary costs related to a school's geographic...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... costs related to a school's geographic isolation? Yes. Havasupai Elementary School, for as long as it... costs related to a school's geographic isolation? 39.160 Section 39.160 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Indian School...

  1. Externalities of oil imports revisited

    SciTech Connect

    Lemon, R.

    1980-09-01

    A re-analysis of the externalities associated with oil imports reaffirms the major findings of an earlier study: (1) The current externalities of oil imports are large even after several favorable assumptions are made, including the existence of a large buffer stock and enlightened monetary and fiscal policy. (2) The large externalities of oil imports call for increased domestic supplies, including conservation, if they are cost-effective and based on marginal social costs. (3) A corrective public policy could involve oil-import taxes and the subsidization of new domestic energy sources without large government externalities. 20 references.

  2. Older adults and substance-related disorders: trends and associated costs.

    PubMed

    Rosen, Daniel; Heberlein, Emily; Engel, Rafael J

    2013-01-01

    Purpose. The aim of this study is to examine the changing service profile of older adults receiving substance abuse services over the past decade and the increased costs of treating this population. Design and Methods. Medicaid claims for mental health and substance abuse services data from a medium sized county in an eastern state were analyzed for individuals aged 50 years and older in calendar year 2000 or 2009. Univariate statistics are presented to describe the substance abuse and mental health services used by older adults in these two years. Results. The number of low-income older adults who accessed services for treatment and who had a substance-related diagnosis grew from 545 individuals in 2000 to 1,653 individuals in 2009. Costs for services utilized by older adults with a substance-related diagnosis rose by 358% from $2.1 million in 2000 to $9.5 million in 2009. Implications. The increase in the number of low-income older adults with a substance-related disorder and the concomitant rise in total spending for Medicaid reimbursed services indicate that local and state social service providers need to prepare for an older adult population who will need appropriate substance abuse prevention and treatment programs.

  3. The role of external pressure and support on teacher choices related to evolution curriculum in the secondary biology classroom

    NASA Astrophysics Data System (ADS)

    Oschman, Scot

    The scientific community strongly and virtually universally supports the teaching of biological evolution in our public schools. However, there are many in the general public who object to the teaching of biological evolution in our nation's science classrooms. Groups such as Answers in Genesis and the Discovery Institute, along with parents, students, school boards, and school administrators are alleged by many in the scientific and science education communities to be pressuring teachers in a variety of ways regarding the teaching of evolution. The purpose of this study was to examine the sources of, extent of, and ways in which science teachers deal with external influences that attempt to alter their science curriculum related to the teaching of the theory of biological evolution in order to support it, deemphasize it or remove it from their classrooms. It also attempted to determine the impact these outside influences have on evolution education in the classroom. Internal influences were examined in order to ascertain other possible reasons why teachers might or might not de-emphasize, omit, or teach evidence contrary to evolution. Two thousand cover letters were sent out to high school biology teachers selected at random from three states in the U.S. Registry of Teachers, directing them to a web site where they could complete the questionnaire online. One hundred seventy eight teachers responded to the survey. The statistical analyses used in this study to examine the results included analysis of variance (ANOVA), independent samples t tests for means comparisons, as well as a variety of descriptive statistics. This study found that 59% of the teachers who responded had experienced some form of pressure related to their evolution curriculum, and that the majority of this pressure came from students, groups or individuals not affiliated with their school district, and parents. The most common manifestations of pressure were to teach that evolution was "only" a

  4. 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

    2017-01-24

    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.

  5. Air Defense Options for Taiwan: An Assessment of Relative Costs and Operational Benefits

    DTIC Science & Technology

    2016-01-01

    C O R P O R A T I O N AIR DEFENSE OPTIONS FOR TAIWAN An Assessment of Relative Costs and Operational Benefits AIR D EFEN SE OPTION S FOR TAIW AN...confusion about its special and privileged relationship with the U.S. Department of Defense, RAND does not undertake work on behalf of, or act as a sub...materiel, or services to the Department of Defense. Similarly, any relationship of a RAND Associate with a defense contractor must be closely screened

  6. Solar System constraints on renormalization group extended general relativity: The PPN and Laplace-Runge-Lenz analyses with the external potential effect

    NASA Astrophysics Data System (ADS)

    Rodrigues, Davi C.; Mauro, Sebastião; de Almeida, Álefe O. F.

    2016-10-01

    General relativity extensions based on renormalization group effects are motivated by a known physical principle and constitute a class of extended gravity theories that have some unexplored unique aspects. In this work we develop in detail the Newtonian and post-Newtonian limits of a realization called renormalization group extended general relativity (RGGR). Special attention is given to the external potential effect, which constitutes a type of screening mechanism typical of RGGR. In the Solar System, RGGR depends on a single dimensionless parameter ν¯⊙, and this parameter is such that for ν¯⊙=0 one fully recovers GR in the Solar System. Previously this parameter was constrained to be |ν¯ ⊙|≲10-21 , without considering the external potential effect. Here we show that under a certain approximation RGGR can be cast in a form compatible with the parametrized post-Newtonian (PPN) formalism, and we use both the PPN formalism and the Laplace-Runge-Lenz technique to put new bounds on ν¯⊙, either considering or not the external potential effect. With the external potential effect the new bound reads |ν¯ ⊙|≲10-16 . We discuss the possible consequences of this bound on the dark matter abundance in galaxies.

  7. Extending OPNET Modeler with External Pseudo Random Number Generators and Statistical Evaluation by the Limited Relative Error Algorithm

    NASA Astrophysics Data System (ADS)

    Becker, Markus; Weerawardane, Thushara Lanka; Li, Xi; Görg, Carmelita

    Pseudo Random Number Generators (PRNG) are the base for stochastic simulations. The usage of good generators is essential for valid simulation results. OPNET Modeler a well-known tool for simulation of communication networks provides a Pseudo Random Number Generator. The extension of OPNET Modeler with external generators and additional statistical evaluation methods that has been performed for this paper increases the flexibility and options in the simulation studies performed.

  8. Colistin and tigecycline for management of external ventricular device-related ventriculitis due to multidrug-resistant Acinetobacter baumannii

    PubMed Central

    Shrestha, Gentle Sunder; Tamang, Sushil; Paneru, Hem Raj; Shrestha, Pramesh Sunder; Keyal, Niraj; Acharya, Subhash Prasad; Marhatta, Moda Nath; Shilpakar, Sushil

    2016-01-01

    Acinetobacter baumannii is an important cause of nosocomial ventriculitis associated with external ventricular device (EVD). It is frequently multidrug resistant (MDR), carries a poor outcome, and is difficult to treat. We report a case of MDR Acinetobacter ventriculitis treated with intravenous and intraventricular colistin together with intravenous tigecycline. The patient developed nephrotoxicity and poor neurological outcome despite microbiological cure. Careful implementation of bundle of measures to minimize EVD-associated ventriculitis is valuable. PMID:27365967

  9. 15 CFR 717.4 - Report of inspection-related costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS...), costs of producing records, and costs associated with shutting down chemical production or...

  10. 15 CFR 717.4 - Report of inspection-related costs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS...), costs of producing records, and costs associated with shutting down chemical production or...

  11. 78 FR 17300 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-21

    ... Cooperative Agreements; Cost Principles and Administrative Requirements (Including Single Audit Act) AGENCY...; Cost Principles and Administrative Requirements (Including Single Audit Act) published February 1,...

  12. 15 CFR 717.4 - Report of inspection-related costs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS...), costs of producing records, and costs associated with shutting down chemical production or...

  13. 15 CFR 717.4 - Report of inspection-related costs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS...), costs of producing records, and costs associated with shutting down chemical production or...

  14. 15 CFR 717.4 - Report of inspection-related costs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS...), costs of producing records, and costs associated with shutting down chemical production or...

  15. An economic evaluation: Simulation of the cost-effectiveness and cost-utility of universal prevention strategies against osteoporosis-related fractures

    PubMed Central

    Nshimyumukiza, Léon; Durand, Audrey; Gagnon, Mathieu; Douville, Xavier; Morin, Suzanne; Lindsay, Carmen; Duplantie, Julie; Gagné, Christian; Jean, Sonia; Giguère, Yves; Dodin, Sylvie; Rousseau, François; Reinharz, Daniel

    2013-01-01

    A patient-level Markov decision model was used to simulate a virtual cohort of 500,000 women 40 years old and over, in relation to osteoporosis-related hip, clinical vertebral, and wrist bone fractures events. Sixteen different screening options of three main scenario groups were compared: (1) the status quo (no specific national prevention program); (2) a universal primary prevention program; and (3) a universal screening and treatment program based on the 10-year absolute risk of fracture. The outcomes measured were total directs costs from the perspective of the public health care system, number of fractures, and quality-adjusted life-years (QALYs). Results show that an option consisting of a program promoting physical activity and treatment if a fracture occurs is the most cost-effective (CE) (cost/fracture averted) alternative and also the only cost saving one, especially for women 40 to 64 years old. In women who are 65 years and over, bone mineral density (BMD)-based screening and treatment based on the 10-year absolute fracture risk calculated using a Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tool is the best next alternative. In terms of cost-utility (CU), results were similar. For women less than 65 years old, a program promoting physical activity emerged as cost-saving but BMD-based screening with pharmacological treatment also emerged as an interesting alternative. In conclusion, a program promoting physical activity is the most CE and CU option for women 40 to 64 years old. BMD screening and pharmacological treatment might be considered a reasonable alternative for women 65 years old and over because at a healthcare capacity of $50,000 Canadian dollars ($CAD) for each additional fracture averted or for one QALY gained its probabilities of cost-effectiveness compared to the program promoting physical activity are 63% and 75%, respectively, which could be considered socially acceptable. Consideration of the indirect costs could

  16. An overview of the patterns of prescription opioid use, costs and related harms in Australia

    PubMed Central

    Blanch, Bianca; Pearson, Sallie-Anne; Haber, Paul S

    2014-01-01

    Aims To report Australian population trends in subsidized prescribed opioid use, total costs to the Australian government to subsidize these medicines and opioid-related harms based on hospitalizations and accidental poisoning deaths. Methods We utilized three national aggregated data sources including dispensing claims from the Pharmaceutical Benefits Scheme, opioid-related hospitalizations from the National Hospital Morbidity Database and accidental poisoning deaths from the Australian Bureau of Statistics. Results Between 1992 and 2012, opioid dispensing episodes increased 15-fold (500 000 to 7.5 million) and the corresponding cost to the Australian government increased 32-fold ($8.5 million to $271 million). Opioid-related harms also increased. Opioid-related hospitalizations increased from 605 to 1464 cases (1998–2009), outnumbering hospitalizations due to heroin poisonings since 2001. Deaths due to accidental poisoning (pharmaceutical opioids and illicit substances combined) increased from 151 to 266 (2002–2011), resulting in a rise in the death rate of 0.78 to 1.19 deaths/100 000 population over 10 years. Death rates increased 1.8 fold in males and 1.4 fold in females. Conclusions The striking increase in opioid use and related harms in Australia is consistent with trends observed in other jurisdictions. Further, there is no evidence to suggest these increases are plateauing. There is currently limited evidence in Australia about individual patterns of opioid use and the associated risk of adverse events. Further research should focus on these important issues so as to provide important evidence supporting effective change in policy and practice. PMID:24962372

  17. Metabolic costs of heat solicitation calls in relation to thermal need in embryos of American white pelicans.

    PubMed

    Abraham; Evans

    1999-04-01

    Chilled embryos of pelicans, Pelecanus erythrorhynchos, begin to vocally solicit parental heat at the pipped-egg stage. Honest signalling models predict that if vocal heat solicitation is a true reflection of need, then solicitation should be costly and costs should increase with the embryo's need for warmth. Using open-flow respirometry, we measured the metabolic costs associated with vocal heat solicitation by exposing embryos to either a decreasing or increasing series of body temperatures, ranging from 25 to 37.8 degrees C. We measured baseline costs (stable temperature, embryo silent) and costs associated with cold-induced calling at each temperature. At natural incubation temperature (37.8 degrees C), call rates and costs associated with calling were negligible, as was thermal need. Metabolic costs relative to baseline costs and costs per call increased with thermal need as body temperature declined. Absolute metabolic costs increased between 37.8 and 35 degrees C, then remained stable down to 25 degrees C. Call rates increased as embryos were chilled within the range of temperatures most frequently experienced in nature (35-37.8 degrees C), then decreased significantly for all lower temperatures, probably owing to reduced overall metabolic rate at lower temperatures (25-37.8 degrees C). The results generally support the honest signalling prediction that vocal heat solicitation is metabolically costly, and that costs increase with need. Copyright 1999 The Association for the Study of Animal Behaviour.

  18. Parkinson's disease: health-related quality of life, economic cost, and implications of early treatment.

    PubMed

    Chen, Jack J

    2010-03-01

    Parkinson's disease (PD) is the second most common neurodegenerative disorder, marked by progressive increases in movement-related disability, impaired balance, and nonmotor symptoms. Its prevalence in the United States is expected to double within the next 20 years as the percentage of the elderly in the population grows. Patients with PD have twice the direct medical costs of those without PD, the majority of which occur later in the disease as disability and therapy-related complications increase. Greater awareness of a prodromal/premotor stage of the disease, efforts toward early and accurate diagnosis, and the continuous refinement of treatment paradigms provide an opportunity for discussion on the use of potential disease-modifying agents to slow or halt the progression of motor and nonmotor disability. Such compounds could not only significantly improve patient and caregiver quality of life, but substantially reduce direct and indirect costs. To date, numerous compounds have been evaluated in clinical trials, including coenzyme Q10, creatine, levodopa, pramipexole, rasagiline, ropinirole, and selegiline. None has demonstrated irrefutable and enduring disease-modifying qualities, although the best available clinical evidence appears most promising for rasagiline.

  19. How much is it going to cost me? Bidirectional relations between adolescents' moral personality and prosocial behavior.

    PubMed

    Padilla-Walker, Laura M; Fraser, Ashley M

    2014-10-01

    The current study examined bidirectional relations between adolescents' moral personality (prosocial values, self-regulation, and sympathy) and low- and high-cost prosocial behavior toward strangers. Participants included 682 adolescents (M age of child = 14.31, SD = 1.07, 50% female) who participated at two time points, approximately one year apart. Cross-lag analyses suggested that adolescents' values were associated with both low- and high-cost prosocial behavior one year later, self-regulation was associated with high-cost prosocial behavior, and sympathy was associated with low-cost prosocial behavior. Findings also suggested that low-cost prosocial behavior was associated with sympathy one year later, and high-cost prosocial behavior was associated with values. Discussion focuses on reciprocal relations between moral personality and prosocial behavior, and the need to consider a more multidimensional approach to prosocial development during adolescence.

  20. Examining the economic costs related to lifestyle and pharmacological interventions in youth with Type 2 diabetes

    PubMed Central

    Songer, Thomas; Glazner, Judith; Coombs, Laura P; Cuttler, Leona; Daniel, Mary; Estrada, Silvia; Klingensmith, Georgeanna; Kriska, Andrea; Laffel, Lori; Zhang, Ping

    2009-01-01

    The best treatment option for children with Type 2 diabetes has not yet been established. The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study is currently testing the efficacy of three therapies: metformin, metformin plus rosiglitazone and metformin plus an intensive lifestyle intervention. The relative cost–effectiveness of these therapies is also being examined. This review discusses the rationale for the design and methods applied in the economic analysis. The design of the economic analysis in the TODAY study was influenced by the existing literature and two primary study parameters: the nature of the interventions and the participants' age. The lifestyle intervention is an intensive behavioral intervention comprising diet and physical activity. Since economic factors influence both diet and physical activity, the analytical plan includes measurement of food and exercise-related purchases. Due to the young age of the participants, the impact of the intervention on adult caregivers is also included in the analysis. This analysis focuses on the time spent by the caregivers in both medical treatment and nutrition- and activity-related activities, and the value of this time relative to usual activities. Important methodological questions include how and when to collect information, not only on medical costs, but also on the impact of caregiver time, travel, food and equipment purchases. In the TODAY study, these latter resources are being measured by regularly administered surveys completed by the caregivers. The approach to the cost–effectiveness assessment undertaken by the TODAY study is one of the first in diabetes research to focus on youth and to include a societal perspective, regular and prospective assessment of clinician and caregiver time, and a comprehensive assessment of the costs associated with lifestyle behaviors. It can serve as a model for future studies of diabetes treatments. PMID:19774104

  1. Measuring the societal burden of cancer: the cost of lost productivity due to premature cancer-related mortality in Europe.

    PubMed

    Hanly, Paul; Soerjomataram, Isabelle; Sharp, Linda

    2015-02-15

    Every cancer-related death in someone of working age represents an economic loss to society. To inform priorities for cancer control, we estimated costs of lost productivity due to premature cancer-related mortality across Europe, for all cancers and by site, gender, region and country. Cancer deaths in 2008 were obtained from GLOBOCAN for 30 European countries across four regions. Costs were valued using the human capital approach. Years of productive life lost (YPLL) were computed by multiplying deaths between 15 and 64 years by working-life expectancy, then by country-, age- and gender-specific annual wages, corrected for workforce participation and unemployment. Lost productivity costs due to premature cancer-related mortality in Europe in 2008 were €75 billion. Male costs (€49 billion) were almost twice female costs (€26 billion). The most costly sites were lung (€17 billion; 23% of total costs), breast (€7 billion; 9%) and colorectum (€6 billion; 8%). Stomach cancer (in Southern and Central-Eastern Europe) and pancreatic cancer (in Northern and Western Europe) were also among the most costly sites. The average lost productivity cost per cancer death was €219,241. Melanoma had the highest cost per death (€312,798), followed by Hodgkin disease (€306,628) and brain and CNS cancer (€288,850). Premature mortality costs were 0.58% of 2008 European gross domestic product, highest in Central-Eastern Europe (0.81%) and lowest in Northern Europe (0.51%). Premature cancer-related mortality costs in Europe are significant. These results provide a novel perspective on the societal cancer burden and may be used to inform priority setting for cancer control.

  2. Relative costs of prebasic and prealternate molts for male blue-winged teal

    USGS Publications Warehouse

    Hohman, W.L.; Manley, S.W.; Richard, D.

    1997-01-01

    We compared masses of definitive basic and alternate plumages of male Blue-winged Teal (Anas discors) to evaluate the hypothesis that nutritional investments in basic and alternate plumages are related to the duration that plumages are worn and to assess the relative costs of prebasic and prealternate molts. Because these plumages are worn by males for approximately equal durations, we predicted that masses of the basic and alternate body plumages would be similar. To assess nutritional stress (demands greater than available resources) associated with molt, we examined the relation between remigial length and structural size and compared predicted and observed plum-age masses of Blue-winged Teal and other ducks. If birds were nutritionally challenged during remigial molt, then we predicted remigial length would be influenced by nutrition rather than size, and remigial length and size would be unrelated. Alternate body plumage of male Blue-winged Teal weighed about 10% more than the basic body plumage; however, masses of both plumages were less than that predicted on the basis of lean body mass. We argue that deviations between observed and predicted plumage masses were related to factors other than nutrition. Further, remigial lengths were significantly, albeit weakly, related to structural size. We therefore concluded that, although the potential for molt-induced stress may be greatest in small-bodied waterfowl species, there was no clear evidence that molting male Blue-winged Teal were nutritionally stressed. ?? The Cooper Ornithological Society 1997.

  3. The internal/external issue what is an outer object? Another person as object and as separate other in object relations models.

    PubMed

    Zachrisson, Anders

    2013-01-01

    The question of what we mean by the term outer object has its roots in the epistemological foundation of psychoanalysis. From the very beginning, Freud's view was Kantian, and psychoanalysis has kept that stance, as it seems. The author reviews the internal/external issue in Freud's thinking and in the central object relations theories (Klein, Winnicott, and Bion). On this background he proposes a simple model to differentiate the concept of object along one central dimension: internal object, external object, and actual person. The main arguments are: (1) there is no direct, unmediated perception of the actual person--the experience of the other is always affected by the perceiver's subjectivity; (2) in intense transference reactions and projections, the perception of the person is dominated by the qualities of an inner object--and the other person "becomes" an external object for the perceiver; (3) when this distortion is less dominating, the other person to a higher degree remains a separate other--a person in his or her own right. Clinical material illustrates these phenomena, and a graphical picture of the model is presented. Finally with the model as background, the author comments on a selection of phenomena and concepts such as unobjectionable transference, "the third position," mourning and loneliness. The way that the internal colours and distorts the external is of course a central preoccupation of psychoanalysis generally. (Spillius et al., 2011, p. 326)

  4. Feature-Based Attention and Conflict Monitoring in Criminal Offenders: Interactive Relations of Psychopathy with Anxiety and Externalizing

    PubMed Central

    Zeier, Joshua D.; Newman, Joseph P.

    2013-01-01

    As predicted by the response modulation model, psychopathic offenders are insensitive to potentially important inhibitory information when it is peripheral to their primary focus of attention. To date, the clearest tests of this hypothesis have manipulated spatial attention to cue the location of goal-relevant versus inhibitory information. However, the theory predicts a more general abnormality in selective attention. In the current study male prisoners performed a conflict-monitoring task, which included a feature-based manipulation (i.e., color) that biased selective attention toward goal-relevant stimuli and away from inhibitory distracters on some trials but not others. Paralleling results for spatial cuing, feature-based cuing resulted in less distracter interference, particularly for participants with primary psychopathy (i.e., low anxiety). This study also investigated the moderating effect of externalizing on psychopathy. Participants high in psychopathy but low in externalizing performed similarly to primary psychopathic individuals. These results demonstrate that the abnormal selective attention associated with primary psychopathy is not limited to spatial attention but, instead, applies to diverse methods for establishing attentional focus. Furthermore, they demonstrate a novel method of investigating psychopathic subtypes using continuous analyses. PMID:24016017

  5. Feature-based attention and conflict monitoring in criminal offenders: interactive relations of psychopathy with anxiety and externalizing.

    PubMed

    Zeier, Joshua D; Newman, Joseph P

    2013-08-01

    As predicted by the response modulation model, psychopathic offenders are insensitive to potentially important inhibitory information when it is peripheral to their primary focus of attention. To date, the clearest tests of this hypothesis have manipulated spatial attention to cue the location of goal-relevant versus inhibitory information. However, the theory predicts a more general abnormality in selective attention. In the current study, male prisoners performed a conflict-monitoring task, which included a feature-based manipulation (i.e., color) that biased selective attention toward goal-relevant stimuli and away from inhibitory distracters on some trials but not others. Paralleling results for spatial cuing, feature-based cuing resulted in less distracter interference, particularly for participants with primary psychopathy (i.e., low anxiety). This study also investigated the moderating effect of externalizing on psychopathy. Participants high in psychopathy but low in externalizing performed similarly to primary psychopathic individuals. These results demonstrate that the abnormal selective attention associated with primary psychopathy is not limited to spatial attention but, instead, applies to diverse methods for establishing attentional focus. Furthermore, they demonstrate a novel method of investigating psychopathic subtypes using continuous analyses.

  6. Health care utilization, costs, and the burden of disease related to eosinophilic esophagitis in the United States

    PubMed Central

    Jensen, Elizabeth T.; Kappelman, Michael D.; Martin, Christopher F.; Dellon, Evan S.

    2015-01-01

    Objectives Eosinophilic esophagitis (EoE) has rapidly become a major cause of upper GI morbidity, but health care costs related to EoE have not been described. This study aimed to estimate EoE-related health care costs and utilization in the United States. Methods We performed a study of health care utilization of EoE cases compared to age- and sex-matched controls using administrative claims data, representative of the commercially insured population in the U.S. Cases of EoE were identified using a previously validated definition. We assessed inpatient, outpatient, emergency department, outpatient prescription, and endoscopy-related costs for patients with EoE, and estimated total costs related to EoE extrapolated to the U.S. population. Results We identified 8,135 cases of EoE and 32,540 controls. The median total annual cost per EoE case was $3,304 compared to $1,001 for controls (p<0.001). For EoE, median costs included $2,508/year for outpatient visits, $157 for endoscopies, and $325 for pharmacy claims, compared to $699, $0, and $76 for controls (p<0.001 for all). The overall median costs associated with EoE were $2,302/year/patient. Total costs in the U.S. ranged from $503 million to $1.36 billion/year, depending on the prevalence estimate, with costs attributable to EoE ranging from $350-$947 million/year. Conclusions Patients with EoE have an estimated annual health care cost of as much as $1.4 billion in the U.S. This represents a remarkable burden of disease for an entity that was essentially unknown two decades ago. These cost data can be used by policy makers to guide resource allocation. PMID:25267327

  7. Differences in metabolic costs of terrestrial mobility in two closely related species of albatross.

    PubMed

    Kabat, Alexander P; Phillips, Richard A; Croxall, John P; Butler, Patrick J

    2007-08-01

    Black-browed albatrosses Thalassarche melanophrys typically colonise steeper habitats than grey-headed albatrosses T. chrysostoma. The present study investigated the effect of colony philopatry on terrestrial locomotory ability in these two species, to determine: (1) if there is a difference in terrestrial locomotory ability between these two closely related species, and (2) what physiological or behavioural adaptations may account for any differences identified. We examined the metabolic cost, mechanical efficiency on an incline, and gait characteristics of terrestrial locomotion of these two species on both level and inclined planes. T. chrysostoma were able to perform at a significantly greater speed than T. melanophrys without reaching a significantly different maximal rate of oxygen consumption (V(O(2))). Conversely, T. melanophrys were able to move up a significantly steeper incline than T. chrysostoma while maintaining a similar maximal V(O(2)). Each species demonstrates stride length, force production (behavioural) and leg length (morphological) adaptations that minimise the cost of traversing their chosen colonies, indicating a clear relationship between terrestrial performance and local topography. However, it is not possible to determine if the difference in locomotory ability results from differences in colony topography, or if choice of colony site is dictated by the ability of the species to traverse different terrain.

  8. Accommodation: The role of the external muscles of the eye: A consideration of refractive errors in relation to extraocular malfunction.

    PubMed

    Hargrave, B K

    2014-11-01

    Speculation as to optical malfunction has led to dissatisfaction with the theory that the lens is the sole agent in accommodation and to the suggestion that other parts of the eye are also conjointly involved. Around half-a-century ago, Robert Brooks Simpkins suggested that the mechanical features of the human eye were precisely such as to allow for a lengthening of the globe when the eye accommodated. Simpkins was not an optical man but his theory is both imaginative and comprehensive and deserves consideration. It is submitted here that accommodation is in fact a twofold process, and that although involving the lens, is achieved primarily by means of a give - and - take interplay between adducting and abducting external muscles, whereby an elongation of the eyeball is brought about by a stretching of the delicate elastic fibres immediately behind the cornea. The three muscles responsible for convergence (superior, internal and inferior recti) all pull from in front backwards, while of the three abductors (external rectus and the two obliques) the obliques pull from behind forwards, allowing for an easy elongation as the eye turns inwards and a return to its original length as the abducting muscles regain their former tension, returning the eye to distance vision. In refractive errors, the altered length of the eyeball disturbs the harmonious give - and - take relationship between adductors and abductors. Such stresses are likely to be perpetuated and the error exacerbated. Speculation is not directed towards a search for a possible cause of the muscular imbalance, since none is suspected. Muscles not used rapidly lose tone, as evidenced after removal of a limb from plaster. Early attention to the need for restorative exercise is essential and results usually impressive. If flexibility of the external muscles of the eyes is essential for continuing good sight, presbyopia can be avoided and with it the supposed necessity of glasses in middle life. Early attention

  9. 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

    SciTech Connect

    Kim, Hayeon; Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful; Smith, Kenneth J.

    2015-03-01

    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) 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

  10. Molecular Genetics External Quality Assessment Pilot Scheme for Irinotecan-Related UGT1A1 Genotyping in China

    PubMed Central

    Zhang, Kuo; Wang, Lunan; Zhang, Rui; Xie, Jiehong; Li, Jinming

    2016-01-01

    Irinotecan is widely used in the treatment of solid tumors, especially in colorectal cancer and lung cancer. Molecular testing for UGT1A1 genotyping is increasingly required in China for optimum irinotecan administration. In order to determine the performance of laboratories with regard to the whole testing process for UGT1A1 to ensure the consistency and accuracy of the test results, the National Center for Clinical Laboratories conducted an external quality assessment program for UGT1A1*28 genotyping in 2015. The panel, which comprised of four known mutational samples and six wild-type samples, was distributed to 45 laboratories that test for the presence of UGT1A1*28 polymorphisms. Participating laboratories were allowed to perform polymorphism analysis by using their routine methods. The accuracy of the genotyping and reporting of results was analyzed. Other information from the individual laboratories, including the number of samples tested each month, accreditation/certification status, and test methodology, was reviewed. Forty-four of the 45 participants reported the correct results for all samples. There was only one genotyping error, with a corresponding analytical sensitivity of 99.44% (179/180 challenges; 95% confidence interval: 96.94−99.99%) and an analytical specificity of 100% (270/270 challenges; 95% confidence interval: 98.64−100%). Both commercial kits and laboratory development tests were commonly used by the laboratories, and pyrosequencing was the main methodology used (n = 26, 57.8%). The style of the written reports showed large variation, and many reports showed a shortage of information. In summary, the first UGT1A1 genotyping external quality assessment result demonstrated that UGT1A1 genotype analysis of good quality was performed in the majority of pharmacogenetic testing centers that were investigated. However, greater education on the reporting of UGT1A1 genetic testing results is needed. PMID:26820647

  11. Observational study on external social and lifestyle related factors and their role in pathogenesis of premature ageing and stress.

    PubMed

    Deole, Yogesh S; Thakar, Anup B; Chandola, Harimohan; Ravishankar, B

    2012-07-01

    In the present era of stress, when lifestyle disorders are high on rise, premature ageing is also one of the most prevalent disorders. It is needed to study the external environmental psychological causative factors in premature ageing and stress. An observational study was carried out to evaluate the relationship of lifestyle, occupational and social factors and mental makeup in individuals diagnosed with premature ageing. A total of 108 patients of premature ageing and stress fulfilling the criteria of inclusion as per ageing scale were selected from outpatient Department of Panchakarma and Manasa Roga, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar. The diagnosed patients of premature ageing were subjected to specialized proforma enlisting all the factors as well as ageing scale, Manasa Bhava Pariksha, and Manasa Vibhrama Pariksha. The method of survey was by a questionnaire about the points regarding the lifestyle causative factors. Maximum patients had shown signs of premature ageing with Mana-Buddhi-Smriti-Bhakti Vibhrama (100% each) and involvement of negative Manasa Bhava. The 78.70% patients in this study felt of having excess responsibility on them in family. The 52.77% patients had average good relationship with their family members, while remaining 47.22% narrated history of disturbed relationship. The center of stress was found to be at personal level in all patients; at family level in 73.14%; at professional or work level in 64.81%. Various external, occupational, social and familial factors play significant role in the pathology of premature ageing by disturbing the overall psychological status. This proves the link of Manasa affecting Sharira and vice versa with reference to modern contemporary concept of psycho-neuro endocrinology.

  12. Observational study on external social and lifestyle related factors and their role in pathogenesis of premature ageing and stress

    PubMed Central

    Deole, Yogesh S.; Thakar, Anup B.; Chandola, Harimohan; Ravishankar, B.

    2012-01-01

    In the present era of stress, when lifestyle disorders are high on rise, premature ageing is also one of the most prevalent disorders. It is needed to study the external environmental psychological causative factors in premature ageing and stress. An observational study was carried out to evaluate the relationship of lifestyle, occupational and social factors and mental makeup in individuals diagnosed with premature ageing. A total of 108 patients of premature ageing and stress fulfilling the criteria of inclusion as per ageing scale were selected from outpatient Department of Panchakarma and Manasa Roga, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar. The diagnosed patients of premature ageing were subjected to specialized proforma enlisting all the factors as well as ageing scale, Manasa Bhava Pariksha, and Manasa Vibhrama Pariksha. The method of survey was by a questionnaire about the points regarding the lifestyle causative factors. Maximum patients had shown signs of premature ageing with Mana-Buddhi-Smriti-Bhakti Vibhrama (100% each) and involvement of negative Manasa Bhava. The 78.70% patients in this study felt of having excess responsibility on them in family. The 52.77% patients had average good relationship with their family members, while remaining 47.22% narrated history of disturbed relationship. The center of stress was found to be at personal level in all patients; at family level in 73.14%; at professional or work level in 64.81%. Various external, occupational, social and familial factors play significant role in the pathology of premature ageing by disturbing the overall psychological status. This proves the link of Manasa affecting Sharira and vice versa with reference to modern contemporary concept of psycho-neuro endocrinology. PMID:23723645

  13. An Educational Intervention to Decrease Drug Costs Related to Terminal Secretions in a Hospice Organization.

    PubMed

    Brock, Cara; Cooper, Sarah; Herndon, Christopher M

    2017-03-01

    Terminal secretions is a common symptom seen in hospice patients. Antimuscarinic drugs are commonly used to treat this symptom despite a lack of supporting data. Wide variability in cost exists among these treatments. Hospice program data were assessed to identify high-use and high-cost medications. An educational intervention (EI) was developed to target one such medication, transdermal scopolamine. The EI focused on efficacy, safety, and actual cost (by unit and total expenditure) for each possible treatment of terminal secretions. Following the EI, drug utilization data was re-evaluated. Prior to the deployment of the EI, total monthly hospice drug costs averaged $91,405 (SD 1,444) with an average drug cost per patient per day of $11.42 (SD 0.54). Monthly costs of drugs frequently employed to treat terminal secretions averaged $7,187.67 (SD 2,253) pre-intervention. Following the EI, monthly drug costs decreased 22.5%, average daily patient drug costs decreased 11.1%, and total anti-secretion costs decreased 28.5% after adjusting for difference in census. Education regarding the use and cost of medications to treat symptoms at end-of-life in hospice patients can be an intervention used to lead to significant cost savings to hospice organizations while maintaining appropriate symptom management for patients. Future interventions to target additional high-cost medications are warranted.

  14. What Drives Spacecraft Cost: A Look Into How Material Characteristics Relate to the Material Complexity Multipliers

    NASA Technical Reports Server (NTRS)

    Rosmait, Russell L.

    1996-01-01

    Today a variety of engineered materials are used to build the space vehicles and satellites that NASA, DOD and the aerospace community will use in future projects. These materials can be a significant part of the cost when designing and building these systems. Current cost models such as NASCOM, SEER-H and PRICE allow the cost analysis to select materials requirements during the development of the cost model. It should be noted however that some of these models do not always give the most detailed information with respect to material specifications for the given cost model. Instead the materials are defined within broad classification, giving questionable data with regard to specific material cost. It is the objective of this paper to present a summary of basic information on materials to assist the cost analyst in the development of their models. Specifically, this paper will compare materials and their complexity multipliers to some specific material properties.

  15. Costs of Foraging Predispose Animals to Obesity-Related Mortality when Food Is Constantly Abundant

    PubMed Central

    McNamara, John M.; Houston, Alasdair I.; Higginson, Andrew D.

    2015-01-01

    Obesity is an important medical problem affecting humans and animals in the developed world, but the evolutionary origins of the behaviours that cause obesity are poorly understood. The potential role of occasional gluts of food in determining fat-storage strategies for avoiding mortality have been overlooked, even though animals experienced such conditions in the recent evolutionary past and may follow the same strategies in the modern environment. Humans, domestic, and captive animals in the developed world are exposed to a surplus of calorie-rich food, conditions characterised as ‘constant-glut’. Here, we use a mathematical model to demonstrate that obesity-related mortality from poor health in a constant-glut environment should equal the average mortality rate in the ‘pre-modern’ environment when predation risk was more closely linked with foraging. It should therefore not be surprising that animals exposed to abundant food often over-eat to the point of ill-health. Our work suggests that individuals tend to defend a given excessive level of reserves because this level was adaptive when gluts were short-lived. The model predicts that mortality rate in constant-glut conditions can increase as the assumed health cost of being overweight decreases, meaning that any adaptation that reduced such health costs would have counter-intuitively led to an increase in mortality in the modern environment. Taken together, these results imply that efforts to reduce the incidence of obesity that are focussed on altering individual behaviour are likely to be ineffective because modern, constant-glut conditions trigger previously adaptive behavioural responses. PMID:26545121

  16. Cost-Effectiveness Models in Age-Related Macular Degeneration: Issues and Challenges.

    PubMed

    Schmier, Jordana K; Hulme-Lowe, Carolyn K

    2016-03-01

    Age-related macular degeneration (AMD) is a common ophthalmic condition that can have few symptoms in its early stage but can progress to major visual impairment. While there are no treatments for early-stage AMD, there are multiple modalities of treatment for advanced disease. Given the increasing prevalence of the disease, there are dozens of analyses of cost effectiveness of AMD treatments, but methods and approaches vary broadly. The goal of this review was to identify, characterize, and critique published models in AMD and provide guidance for their interpretation. After a literature review was performed to identify studies, and exclusion criteria applied to limit the review to studies comparing treatments for AMD, we compared methods across the 36 studies meeting the review criteria. To some extent, variation was related to targeting different audiences or acknowledging the most appropriate population for a given treatment. However, the review identified potential areas of uncertainty and difficulty in interpretation, particularly regarding duration of observation periods and the importance of visual acuity as an endpoint or a proxy for patient-reported utilities. We urge thoughtful consideration of these study characteristics when comparing results.

  17. Mitigation potential and cost in tropical forestry - relative role for agroforestry

    SciTech Connect

    Makundi, Willy R.; Sathaye, Jayant A.

    2004-01-01

    This paper summarizes studies of carbon mitigation potential (MP) and costs of forestry options in seven developing countries with a focus on the role of agroforestry. A common methodological approach known as comprehensive mitigation assessment process (COMAP) was used in each study to estimate the potential and costs between 2000 and 2030. The approach requires the projection of baseline and mitigation land-use scenarios derived from the demand for forest products and forestland for other uses such as agriculture and pasture. By using data on estimated carbon sequestration, emission avoidance, costs and benefits, the model enables one to estimate cost effectiveness indicators based on monetary benefit per t C, as well as estimates of total mitigation costs and potential when the activities are implemented at equilibrium level. The results show that about half the MP of 6.9 Gt C (an average of 223 Mt C per year) between 2000 and 2030 in the seven countries could be achieved at a negative cost, and the other half at costs not exceeding $100 per t C. Negative cost indicates that non-carbon revenue is sufficient to offset direct costs of about half of the options. The agroforestry options analyzed bear a significant proportion of the potential at medium to low cost per t C when compared to other options. The role of agroforestry in these countries varied between 6% and 21% of the MP, though the options are much more cost effective than most due to the low wage or opportunity cost of rural labor. Agroforestry options are attractive due to the large number of people and potential area currently engaged in agriculture, but they pose unique challenges for carbon and cost accounting due to the dispersed nature of agricultural activities in the tropics, as well as specific difficulties arising from requirements for monitoring, verification, leakage assessment and the establishment of credible baselines.

  18. GHG Mitigation potential and cost in tropical forestry - Relative role for agroforestry

    SciTech Connect

    Makundi, Willy R.; Sathaye, Jayant A.

    2004-01-01

    This paper summarizes studies of carbon mitigation potential (MP) and costs of forestry options in seven developing countries with a focus on the role of agroforestry. A common methodological approach known as comprehensive mitigation assessment process (COMAP) was used in each study to estimate the potential and costs between 2000 and 2030. The approach requires the projection of baseline and mitigation land-use scenarios derived from the demand for forest products and forestland for other uses such as agriculture and pasture. By using data on estimated carbon sequestration, emission avoidance, costs and benefits, the model enables one to estimate cost effectiveness indicators based on monetary benefit per t C, as well as estimates of total mitigation costs and potential when the activities are implemented at equilibrium level. The results show that about half the MP of 6.9 Gt C (an average of 223 Mt C per year) between 2000 and 2030 in the seven countries could be achieved at a negative cost, and the other half at costs not exceeding $100 per t C. Negative cost indicates that non-carbon revenue is sufficient to offset direct costs of about half of the options. The agroforestry options analyzed bear a significant proportion of the potential at medium to low cost per t C when compared to other options. The role of agroforestry in these countries varied between 6% and 21% of the MP, though the options are much more cost effective than most due to the low wage or opportunity cost of rural labor. Agroforestry options are attractive due to the large number of people and potential area currently engaged in agriculture, but they pose unique challenges for carbon and cost accounting due to the dispersed nature of agricultural activities in the tropics, as well as specific difficulties arising from requirements for monitoring, verification, leakage assessment and the establishment of credible baselines.

  19. 15 CFR 716.9 - Report of inspection-related costs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS... records, and costs associated with shutting down chemical production or processing during inspections,...

  20. 15 CFR 716.9 - Report of inspection-related costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS... records, and costs associated with shutting down chemical production or processing during inspections,...

  1. 15 CFR 716.9 - Report of inspection-related costs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS... records, and costs associated with shutting down chemical production or processing during inspections,...

  2. 15 CFR 716.9 - Report of inspection-related costs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS... records, and costs associated with shutting down chemical production or processing during inspections,...

  3. 15 CFR 716.9 - Report of inspection-related costs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS... records, and costs associated with shutting down chemical production or processing during inspections,...

  4. Medical costs of asbestos-related diseases in Spain between 2004 and 2011

    PubMed Central

    GARCÍA-GÓMEZ, Montserrat; GARRIDO, Rosa URBANOS; LÓPEZ, Rosario CASTAÑEDA; MENÉNDEZ-NAVARRO, Alfredo

    2016-01-01

    The objective of this article was to estimate the medical costs derived from malignant ARD treatment in the Spanish National Health System (NHS) between 2004 and 2011. Estimation of direct healthcare costs was based on national primary data on the cost of specialized care for inpatients and outpatients treated at NHS hospitals and on national and regional secondary data on costs of primary healthcare and pharmaceutical prescriptions. A prevalence approach was used to estimate the overall burden of ARDs. Direct medical costs of 37,557 ARDs attended in Spanish NHS facilities in 2004–2011 were estimated at 464 million euros; specialist care accounted for 50.9% of total costs, primary healthcare 10.15%, and drug prescription 38.9%. The cost was 27.8-fold higher in males than in females. Bronchopulmonary cancers represented the greatest healthcare cost, 281 million euros. The cost of delivering healthcare to ARDs victims in Spain has a negative economic impact on the NHS due to the gross under-recognition of occupational victims under the Spanish National Insurance System. PMID:27334423

  5. 48 CFR 931.205-47 - Costs related to legal and other proceedings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ENERGY GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial..., coercion, restraint, threat, intimidation or other similar negative action taken against an employee by...

  6. Age in Relation to Worker Compensation Costs in the Construction Industry

    PubMed Central

    Schwatka, Natalie V.; Butler, Lesley M.; Rosecrance, John C.

    2015-01-01

    Background A better understanding of how workers’ compensation (WC) costs are affected by an aging US workforce is needed, especially for physically demanding industries, such as construction. Methods The relationship between age and injury type on claim costs was evaluated using a database of 107,064 Colorado WC claims filed between 1998 and 2008 among construction workers. Results Mean WC costs increased with increasing age for total cost (P < 0.0001), medical costs (P < 0.0001), and indemnity costs (P < 0.0001). For each one-year increase in age, indemnity, and medical costs increased by 3.5% and 1.1%, respectively. For specific injury types, such as strains and contusions, the association between age and indemnity costs was higher among claimants aged ≥65 compared to claimants aged 18–24. Conclusions Our findings suggest that specific injury types may be partially responsible for the higher indemnity costs among older construction workers, compared with their younger coworkers. PMID:22782837

  7. Switch Costs Occur at Lemma Stage When Bilinguals Name Digits: Evidence from Language-Switching and Event-Related Potentials.

    PubMed

    Chang, Song; Xie, Jiushu; Li, Li; Wang, Ruiming; Liu, Ming

    2016-01-01

    Switch costs are generally found in language switching tasks. However, the locus where switch costs occur during bilingual language production remains unclear. Several studies that used a cued language-switching paradigm have attempted to investigate this question in bilingual language production, but researchers have not reached a consensus. Moreover, we are interested in where switch costs occur when language selection occurs after lemma activation. Previous studies have not investigated this question because most previous studies presented language cues before or along with the stimuli. Therefore, we used a modified cued language-switching paradigm with a combined event-related potentials (ERPs) technique to explore the locus of switch costs during bilingual language production. The cue and stimulus were separated and presented in two different presentation sequences in which Indonesian-Chinese bilingual speakers were instructed to name digits in their L1 or L2 according to the color of the cue. The ERPs related to the cue and stimulus for two presentation sequences were measured. In the stimulus-cue sequence, the analysis that was time-locked to cues revealed a reversed switch cost as early as 220 ms after the cue onset; furthermore, a switch cost was shown in L1 with a late stage post-cue onset. The results suggested that when language selection occurred after lemma activation, the switch costs mainly occurred at the lemma selection stage. In the cue-stimulus sequence, the analysis that was time-locked to cues did not reveal significant main effects of switching, whereas the analysis that was time-locked to digits yielded a switch cost, again indicating that switch costs mainly occurred at the lemma selection stage rather than at the language task schema competition stage. Overall, our results indicated that when bilinguals spoke digits aloud in the language switching task, switch costs mainly occurred at the lemma selection stage.

  8. Extent, nature and hospital costs of fireworks-related injuries during the Wednesday Eve Festival in Iran

    PubMed Central

    Alinia, Siros; Rezaei, Satar; Daroudi, Rajabali; Hadadi, Mashyaneh; Akbari Sari, Ali

    2013-01-01

    Abstract: Background: Fireworks are commonly used in local and national celebrations. The aim of this study is to explore the extent, nature and hospital costs of injuries related to the Persian Wednesday Eve festival in Iran. Methods: Data for injuries caused by fireworks during the 2009 Persian Wednesday Eve festival were collected from the national Ministry of Health database. Injuries were divided into nine groups and the average and total hospital costs were estimated for each group. The cost of care for patients with burns was estimated by reviewing a sample of 100 patients randomly selected from a large burn center in Tehran. Other costs were estimated by conducting semi structured interviews with expert managers at two large government hospitals. Results: 1817 people were injured by fireworks during the 2009 Wednesday Eve festival. The most frequently injured sites were the hand (43.3%), eye (24.5%) and face (13.2%), and the most common types of injury were burns (39.9%), contusions/abrasions (24.6%) and lacerations (12.7%). The mean length of hospital stay was 8.15 days for patients with burns, 10.7 days for those with amputations, and 3 days for those with other types of injury. The total hospital cost of injuries was US$ 284 000 and the average cost per injury was US$ 156. The total hospital cost of patients with amputations was US$ 48 598. Most of the costs were related to burns (56.6%) followed by amputations (12.2%). Conclusions: Injuries related to the Persian Wednesday Eve festival are common and lead to extensive morbidity and medical costs. PMID:21964162

  9. Effects of Cuts in Medicaid on Dental-Related Visits and Costs at a Safety-Net Hospital

    PubMed Central

    Neely, Martha; Rich, Sharron; Gutierrez, Lillelenny Santana; Mehra, Pushkar

    2014-01-01

    We used data from Boston Medical Center, Massachusetts, to determine whether dental-related emergency department (ED) visits and costs increased when Medicaid coverage for adult dental care was reduced in July 2010. In this retrospective study of existing data, we examined the safety-net hospital’s dental-related ED visits and costs for 3 years before and 2 years after Massachusetts Health Care Reform. Dental-related ED visits increased 2% the first and 14% the second year after Medicaid cuts. Percentage increases were highest among older adults, minorities, and persons receiving charity care, Medicaid, and Medicare. PMID:24825223

  10. Low cost sensors for PM and related air pollutants in the US and India

    EPA Science Inventory

    Emerging air quality sensors have a variety of possible applications. If accurate and reliable, they have a number of benefits over conventional monitors. They are low-cost, lightweight, and have low power consumption. Because of their low cost, a dense array of sensors instal...

  11. 42 CFR 413.130 - Introduction to capital-related costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... depreciable assets under § 413.134(f). (2) Taxes on land or depreciable assets used for patient care. (3) Leases and rentals, including license and royalty fees, for the use of depreciable assets or land, as... costs, debt discounts, and debt redemption costs, if the associated debt was incurred to acquire land...

  12. [The extra cost of care-related adverse events in hospitals].

    PubMed

    Nestrigue, Clément; Or, Zeynep

    2016-04-01

    Adverse events bring into question the safety and quality of care for patients, but also represent a significant cost for society. For example, the annual cost of nine adverse events assessed in a study by the French Institute for Research and Documentation in Health Economics (IRDES) was estimated at €682 million in 2007.

  13. Effects on Children of Reinforcement and Response Cost: A Relation of Learning to Motivation.

    ERIC Educational Resources Information Center

    Sattler, Howard E.; And Others

    1979-01-01

    Children in the response-cost condition required more trials to reach a performance criterion and exhibited longer response times than children receiving reinforcement only. Response cost appeared to produce a negative effect that interfered with problem solving ability. (Author/RL)

  14. COSTS AND ISSUES RELATED TO REMEDIATION OF PETROLEUM-CONTAMINATED SITES

    EPA Science Inventory

    The remediation costs required at sites contaminated with petroleum-derived compounds remains a relevant issue because of the large number of existing underground storage tanks the United States and the presence of benzene, MTBE, and TBA in some drinking water supplies. Cost inf...

  15. COSTS AND ISSUES RELATED TO REMEDIATION OF PETROLEUM-CONTAMINATED SITES (NEW ORLEANS, LA)

    EPA Science Inventory

    The remediation costs required at sites contaminated with petroleum-derived compounds remains a relevant issue because of the large number of existing underground storage tanks the United States and the presence of benzene, MTBE, and TBA in some drinking water supplies. Cost inf...

  16. A Method for Record-Keeping and Analysis of Equipment and Related Costs by Educational Program.

    ERIC Educational Resources Information Center

    Thomas, Ruth G.

    A system employing a micro-level approach to the ongoing recording of educational equipment costs by educational program was developed. The system was designed to depreciate equipment and to allow determination of annual costs by educational program; consumption; maintenance and repair; interest on the capital investment; and insurance for…

  17. Relative controls of external and internal variability on time-variable transit time distributions, and the importance of StorAge Selection function approaches

    NASA Astrophysics Data System (ADS)

    Kim, M.; Pangle, L. A.; Cardoso, C.; Lora, M.; Meira, A.; Volkmann, T. H. M.; Wang, Y.; Harman, C. J.; Troch, P. A. A.

    2015-12-01

    Transit time distributions (TTDs) are an efficient way of characterizing complex transport dynamics of a hydrologic system. Time-invariant TTD has been studied extensively, but TTDs are time-varying under unsteady hydrologic systems due to both external variability (e.g., time-variability in fluxes), and internal variability (e.g., time-varying flow pathways). The use of "flow-weighted time" has been suggested to account for the effect of external variability on TTDs, but neglects the role of internal variability. Recently, to account both types of variability, StorAge Selection (SAS) function approaches were developed. One of these approaches enables the transport characteristics of a system - how the different aged water in the storage is sampled by the outflow - to be parameterized by time-variable probability distribution called the rank SAS (rSAS) function, and uses it directly to determine the time-variable TTDs resulting from a given timeseries of fluxes in and out of a system. Unlike TTDs, the form of the rSAS function varies only due to changes in flow pathways, but is not affected by the timing of fluxes alone. However, the relation between physical mechanisms and the time-varying rSAS functions are not well understood. In this study, relative effects of internal and external variability on the TTDs are examined using observations from a homogeneously packed 1 m3 sloping soil lysimeter. The observations suggest the importance of internal variability on TTDs, and reinforce the need to account for this variability using time-variable rSAS functions. Furthermore, the relative usefulness of two other formulations of SAS functions and the mortality rate (which plays a similar role to SAS functions in the McKendrick-von Foerster model of age-structured population dynamics) are also discussed. Finally, numerical modeling is used to explore the role of internal and external variability for hydrologic systems with diverse geomorphic and climate characteristics

  18. Is gender policy related to the gender gap in external cause and circulatory disease mortality? A mixed effects model of 22 OECD countries 1973–2008

    PubMed Central

    2012-01-01

    Background Gender differences in mortality vary widely between countries and over time, but few studies have examined predictors of these variations, apart from smoking. The aim of this study is to investigate the link between gender policy and the gender gap in cause-specific mortality, adjusted for economic factors and health behaviours. Methods 22 OECD countries were followed 1973–2008 and the outcomes were gender gaps in external cause and circulatory disease mortality. A previously found country cluster solution was used, which includes indicators on taxes, parental leave, pensions, social insurances and social services in kind. Male breadwinner countries were made reference group and compared to earner-carer, compensatory breadwinner, and universal citizen countries. Specific policies were also analysed. Mixed effect models were used, where years were the level 1-units, and countries were the level 2-units. Results Both the earner-carer cluster (ns after adjustment for GDP) and policies characteristic of that cluster are associated with smaller gender differences in external causes, particularly due to an association with increased female mortality. Cluster differences in the gender gap in circulatory disease mortality are the result of a larger relative decrease of male mortality in the compensatory breadwinner cluster and the earner-carer cluster. Policies characteristic of those clusters were however generally related to increased mortality. Conclusion Results for external cause mortality are in concordance with the hypothesis that women become more exposed to risks of accident and violence when they are economically more active. For circulatory disease mortality, results differ depending on approach – cluster or indicator. Whether cluster differences not explained by specific policies reflect other welfare policies or unrelated societal trends is an open question. Recommendations for further studies are made. PMID:23145477

  19. Examining the Relations Among the DSM-5 Alternative Model of Personality, the Five-Factor Model, and Externalizing and Internalizing Behavior.

    PubMed

    Sleep, Chelsea E; Hyatt, Courtland S; Lamkin, Joanna; Maples-Keller, Jessica L; Miller, Joshua D

    2017-01-26

    Given long-standing criticisms of the DSM's reliance on categorical models of psychopathology, including the poor reliability and validity of personality-disorder diagnoses, the American Psychiatric Association (APA) published an alternative model (AM) of personality disorders in Section III of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; APA, 2013), which, in part, comprises 5 pathological trait domains based on the 5-factor model (FFM). However, the empirical profiles and discriminant validity of the AM traits remain in question. We recruited a sample of undergraduates (N = 340) for the current study to compare the relations found between a measure of the DSM-5 AM traits (i.e., the Personality Inventory for DSM-5; PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012) and a measure of the FFM (i.e., the International Personality Item Pool; IPIP; Goldberg, 1999) in relation to externalizing and internalizing symptoms. In general, the domains from the 2 measures were significantly related and demonstrated similar patterns of relations with these criteria, such that Antagonism/low Agreeableness and Disinhibition/low Conscientiousness were related to externalizing behaviors, whereas Negative Affectivity/Neuroticism was most significantly related to internalizing symptoms. However, the PID-5 demonstrated large interrelations among its domains and poorer discriminant validity than the IPIP. These results provide additional support that the conception of the trait model included in the DSM-5 AM is an extension of the FFM, but highlight some of the issues that arise due to the PID-5's more limited discriminant validity. (PsycINFO Database Record

  20. Correcting for compensating mechanisms related to productivity costs in economic evaluations of health care programmes.

    PubMed

    Jacob-Tacken, Karin H M; Koopmanschap, Marc A; Meerding, Willem Jan; Severens, Johan L

    2005-05-01

    In the economic evaluation of health care programmes, productivity costs are often estimated using patients' wages for the period of absence. However, the use of such methods for short periods of absence is controversial. A previous study found that short-term absence is often compensated for during normal working hours and therefore does not lead to productivity losses. As such, the application of any approach almost certainly overestimates productivity costs. In this study, we examined the productivity costs for five different patient populations and one employee population, using the classical method and by identifying when extra effort was needed. In general, the results showed that productivity costs based on identifying extra effort were 25-30% of the classical estimates. For absences of just one day, productivity costs were relevant in only 17-19% of cases. For absences of two weeks or longer, productivity costs were relevant in 35-39% of cases. Measurement of the compensating mechanisms seemed to be valid, since there is considerable agreement between the opinion of supervisors and their employees about whether compensation covers productivity costs. There was much less agreement between supervisors and their employees on specific compensating mechanisms, however. The measurement of compensating mechanisms also seemed to be valid, because--as expected--different compensating mechanisms were reported for different occupations. In our study populations, compensating mechanisms appeared to differ with occupational characteristics, like part-time work, managerial work and shift work.

  1. TOTAL COST OF HOSPITALIZATION OF PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY RELATED TO NUTRITIONAL STATUS

    PubMed Central

    de MENEZES, Francisco Julimar Correia; de MENEZES, Lara Gadelha Luna; da SILVA, Guilherme Pinheiro Ferreira; MELO-FILHO, Antônio Aldo; MELO, Daniel Hardy; da SILVA, Carlos Antonio Bruno

    2016-01-01

    ABSTRACT Background: In the Western world, the population developed an overweight profile. The morbidly obese generate higher cost to the health system. However, there is a gap in this approach with regard to individuals above the eutrofic pattern, who are not considered as morbidly obese. Aim: To correlate nutritional status according to BMI with the costs of laparoscopic cholecystectomy in a public hospital. Method: Data were collected from medical records about: nutritional risk assessment, nutricional state and hospital cost in patients undergoing elective laparoscopic cholecystectomy. Results: Were enrolled 814 procedures. Average age was 39.15 (±12.16) years; 47 subjects (78.3%) were women. The cost was on average R$ 6,167.32 (±1830.85) to 4.06 (±2.76) days of hospitalization; 41 (68.4%) presented some degree of overweight; mean BMI was 28.07 (±5.41) kg/m²; six (10%) individuals presented nutritional risk ≥3. There was a weak correlation (r=0.2) and not significant (p <0.08) between the cost of hospitalization of the sample and length of stay; however, in individuals with normal BMI, the correlation was strong (r=0,57) and significant (p<0.01). Conclusion: Overweight showed no correlation between cost and length of stay. However, overweight individuals had higher cost of hospitalization than those who had no complications, but with no correlation with nutritional status. Compared to those with normal BMI, there was a strong and statistically significant correlation with the cost of hospital stay, stressing that there is normal distribution involving adequate nutritional status and success of the surgical procedure with the consequent impact on the cost of hospitalization. PMID:27438031

  2. The Relative Effectiveness of Signaling Systems: Relying on External Items Reduces Signaling Accuracy while Leks Increase Accuracy

    PubMed Central

    Leighton, Gavin M.

    2014-01-01

    Multiple evolutionary phenomena require individual animals to assess conspecifics based on behaviors, morphology, or both. Both behavior and morphology can provide information about individuals and are often used as signals to convey information about quality, motivation, or energetic output. In certain cases, conspecific receivers of this information must rank these signaling individuals based on specific traits. The efficacy of information transfer associated within a signal is likely related to the type of trait used to signal, though few studies have investigated the relative effectiveness of contrasting signaling systems. I present a set of models that represent a large portion of signaling systems and compare them in terms of the ability of receivers to rank signalers accurately. Receivers more accurately assess signalers if the signalers use traits that do not require non-food resources; similarly, receivers more accurately ranked signalers if all the signalers could be observed simultaneously, similar to leks. Surprisingly, I also found that receivers are only slightly better at ranking signaler effort if the effort results in a cumulative structure. This series of findings suggests that receivers may attend to specific traits because the traits provide more information relative to others; and similarly, these results may explain the preponderance of morphological and behavioral display signals. PMID:24626221

  3. Cost of presumptive source term Remedial Actions Laboratory for energy-related health research, University of California, Davis

    SciTech Connect

    Last, G.V.; Bagaasen, L.M.; Josephson, G.B.; Lanigan, D.C.; Liikala, T.L.; Newcomer, D.R.; Pearson, A.W.; Teel, S.S.

    1995-12-01

    A Remedial Investigation/Feasibility Study (RI/FS) is in progress at the Laboratory for Energy Related Health Research (LEHR) at the University of California, Davis. The purpose of the RI/FS is to gather sufficient information to support an informed risk management decision regarding the most appropriate remedial actions for impacted areas of the facility. In an effort to expedite remediation of the LEHR facility, the remedial project managers requested a more detailed evaluation of a selected set of remedial actions. In particular, they requested information on both characterization and remedial action costs. The US Department of Energy -- Oakland Office requested the assistance of the Pacific Northwest National Laboratory to prepare order-of-magnitude cost estimates for presumptive remedial actions being considered for the five source term operable units. The cost estimates presented in this report include characterization costs, capital costs, and annual operation and maintenance (O&M) costs. These cost estimates are intended to aid planning and direction of future environmental remediation efforts.

  4. The costs of overweight and obesity-related diseases in the Brazilian public health system: cross-sectional study

    PubMed Central

    2012-01-01

    Background Obesity is a major global epidemic and a burden to society and health systems. It is well known risk factor for a number of chronic medical conditions with high morbidity and mortality. This study aimed to provide an estimate of the direct costs associated to outpatient and inpatient care of overweight and obesity related diseases in the perspective of the Brazilian Health System (SUS). Methods Population attributable risk (PAR) was calculated for selected diseases related to overweight and obesity and with the following parameters: Relative risk (RR) ≥ 1.20 or RR ≥1.10 and < 1.20, but important problem of public health due its high prevalence. After a broad search in the literature, two meta-analysis were selected to provide RR for PAR calculation. The prevalence rates of overweight and obesity in Brazilians with ≥18 years were obtained from large national survey. The national health database (DATASUS) was used to estimate the annual cost of the Brazilian Unified Health System (SUS) with the diseases included in the analysis. The extracted values were stratified by sex, type of service (inpatient or outpatient care) and year. Data were collected from 2008 to 2010 and the results reflect the average of 3 years. Brazilian costs were converted into US dollars during the analysis using a purchasing power parity basis (2010). Results The estimated total costs in one year with all diseases related to overweight and obesity are US$ 2,1 billion; US$ 1,4 billion (68.4% of total costs) due to hospitalizations and US$ 679 million due to ambulatory procedures. Approximately 10% of these cost is attributable to overweight and obesity. Conclusion The results confirm that overweight and obesity carry a great economic burden for Brazilian health system and for the society. The knowledge of these costs will be useful for future economic analysis of preventive and treatment interventions. PMID:22713624

  5. 48 CFR 31.205-47 - Costs related to legal and other proceedings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... could have led to any of the outcomes listed in subparagraphs (b) (1) through (3) of this subsection... that which led to a different proceeding whose costs are unallowable by reason of subparagraphs (b)...

  6. 48 CFR 2131.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... general health and fitness or encouraging healthful lifestyles; (2) The costs of the contractor's messages... which have the primary effect of, calling favorable attention to the contractor or subcontractor for...

  7. 48 CFR 2131.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... general health and fitness or encouraging healthful lifestyles; (2) The costs of the contractor's messages... which have the primary effect of, calling favorable attention to the contractor or subcontractor for...

  8. 48 CFR 2131.205-1 - Public relations and advertising costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... general health and fitness or encouraging healthful lifestyles; (2) The costs of the contractor's messages... which have the primary effect of, calling favorable attention to the contractor or subcontractor for...

  9. The costs of target prioritization and the external requirements for using a recall-to-reject strategy in memory exclusion tasks: a meta-analysis.

    PubMed

    Rosburg, Timm; Mecklinger, Axel

    2017-03-15

    In event-related potential (ERP) studies, the left-parietal old/new effect is commonly considered as a neural correlate of recollection. In memory exclusion tasks, the effect is usually observed when the targeted information is identified, but it is not necessarily present when studied items are rejected as nontargets. Interestingly, both the presence and the absence of such old/new effects to nontargets have been regarded as indicator for strategic retrieval. We reviewed previous ERP studies using memory exclusion tasks to analyze the reaction time (RT) pattern in such studies, as well as the influence of task difficulty on the occurrence of nontarget retrieval. We identified 44 test conditions, reported in 24 studies, and subjected the behavioral data to a meta-analysis. The RTs to correctly rejected new items were shorter than the RTs to hits, in particular in studies that required differentiating conceptual or perceptual information at test. When the retrieval of target information was prioritized, RTs to nontargets were delayed relative to targets. Without such prioritization, no such RT differences were observed. For test conditions with nontarget retrieval, the retrieval accuracy was poorer compared with test conditions without such retrieval. The findings support previous studies that claimed that nontarget retrieval becomes more likely when target retrieval is difficult, but the strong overlap in task difficulty between conditions with and without nontarget retrieval indicates that other, partly yet to-be-identified factors contribute to the occurrence of nontarget retrieval as well.

  10. Cost-Effectiveness of Management Activities Related to the Interaction between the California Sea Lion and the Southern California Shark Gill-Net Fishery.

    DTIC Science & Technology

    1983-03-01

    AD-A128 126 COST-EFFECTIVENESS OF MANAGEMENT ACTIVITIES RELATED TO /1 THE INTERACTION BE..(U) NAVAL POSTGRADUATE SCHOOL MONTEREY CA T D JACKSON MAR...SIANDARDS )Qb% A im NAVAL POSTGRADUATE SCHOOL Monterey Caliornia DTIC ELECTE S MAY 171993DTHESIS D COST-EFFECTIVENESS OF MANAGEMENT ACTIVITIES RELATED ...various costs concerning State management have to be studied, This thesis addresses the cost and effectiveness of five activities relating 00 I, UnM 1473 s

  11. Relative Cost and Performance Comparison of GEO Space Situational Awareness Architectures

    NASA Astrophysics Data System (ADS)

    Morris, K.; Rice, C.; Little, E.

    2014-09-01

    With declining government budgets, new architecture approaches are being studied to determine the most cost effective GEO Space Situational Awareness architectures. Looking at four different architecture concepts utilizing CubeSats, Microsats, Hosted Payload Sensors, and larger satellites, highlights the benefits and regrets of each class of spacecraft that helps support upgrades to the current space surveillance network. CubeSats have been shown in previous studies to provide GEO SSA mission value while maintaining affordability. However, there are limitations such as mission assurance that will increase the costs over time. Microsats provide higher quality SSA with less restrictions, but the rideshare options to GEO become fewer. Hosted Payload sensors on future GEO spacecraft can provide affordable access to space but are constrained by the host orbit. Larger satellites can provide exquisite SSA information but are more expensive individually and require dedicated launches. To credibly compare costs, the analysis is based on launch, spacecraft, ground and operations, spacecraft replenishment based on expected mission life, and integration costs over the life of the architecture. Performance is based on observations of all GEO objects with evaluation on percentage of time with access to each object, and the revisit times to each object. The results show the CubeSat architecture can provide good performance for access and percentages with a low initial investment but require increased costs over time to cover the lower mission assurance. Hosted payloads suffer performance due to limited GEO locations but at an affordable cost. Microsats provide a balance between performance and cost but have lower revisit rates due to fewer spacecraft in orbit. The larger satellites provide high performance but require higher costs mostly due to the dedicated launches. All of these architectures have benefits and regrets that help to highlight where future investments are needed

  12. Oxygen cost of dynamic or isometric exercise relative to recruited muscle mass

    PubMed Central

    Elder, Christopher P; Mahoney, Edward T; Black, Christopher D; Slade, Jill M; Dudley, Gary A

    2006-01-01

    Background Oxygen cost of different muscle actions may be influenced by different recruitment and rate coding strategies. The purpose of this study was to account for these strategies by comparing the oxygen cost of dynamic and isometric muscle actions relative to the muscle mass recruited via surface electrical stimulation of the knee extensors. Methods Comparisons of whole body pulmonary Δ V˙ MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaqabeGadaaakeaacuWGwbGvgaGaaaaa@2DEA@O2 were made in seven young healthy adults (1 female) during 3 minutes of dynamic or isometric knee extensions, both induced by surface electrical stimulation. Recruited mass was quantified in T2 weighted spin echo magnetic resonance images. Results The Δ V˙ MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaqabeGadaaakeaacuWGwbGvgaGaaaaa@2DEA@O2 for dynamic muscle actions, 242 ± 128 ml • min-1 (mean ± SD) was greater (p = 0.003) than that for isometric actions, 143 ± 99 ml • min-1. Recruited muscle mass was also greater (p = 0.004) for dynamic exercise, 0.716 ± 282 versus 0.483 ± 0.139 kg. The rate of oxygen consumption per unit of recruited muscle (V˙O2RM MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaqabeGadaaakeaacuqGwbGvgaGaaiabb+eapnaaBaaaleaacqaIYaGmdaahaaadbeqaaiabbkfasjabb2eanbaaaSqabaaaaa@32B0@) was similar in dynamic and isometric exercise (346 ± 162 versus 307 ± 198 ml • kg-1 • min-1; p = 0.352), but the V˙O2RM MathType@MTEF@5

  13. Altered diurnal pattern of steroid hormones in relation to various behaviors, external factors and pathologies: A review.

    PubMed

    Collomp, K; Baillot, A; Forget, H; Coquerel, A; Rieth, N; Vibarel-Rebot, N

    2016-10-01

    The adrenal and gonadal stress steroids [i.e., cortisol, testosterone and dehydroepiandrosterone (DHEA)] have gathered considerable attention in the last few decades due to their very broad physiological and psychological actions. Their diurnal patterns have become a particular focus following new data implicating altered diurnal hormone patterns in various endocrine, behavioral and cardiovascular risk profiles. In this review of the current literature, we present a brief overview of the altered diurnal patterns of these hormones that may occur in relation to chronic stress, nutritional behaviors, physical exercise, drugs and sleep deprivation/shift. We also present data on the altered diurnal hormone patterns implicated in cardiometabolic and psychiatric/neurologic diseases, cancer and other complex pathologies. We consider the occasionally discrepant results of the studies, and summarize the current knowledge in this new field of interest, underlining the potential effects on both biological and psychological functioning, and assess the implications of these effects. Last, we conclude with some practical considerations and perspectives.

  14. [Practical and theoretical aspects of cost-benefit relations in viscerosynthesis].

    PubMed

    Fuchs, K H; Heimbucher, J; Geiger, D; Thiede, A

    1997-01-01

    The necessity of limiting health care costs requires adequate service recording and quality control even in visceral surgery. In this field, the safety of the anastomoses is of greatest importance. Anastomoses at risk are esophageal connections to jejunum or colon and deep rectal anastomoses. At these locations expensive suture devices, such as stapling instruments, can be used in a cost saving aspect, if they help to increase anastomotic safety, time saving and expansion of surgical indication. Manual sutures thus represent the cheapest anastomotic technique as continuous sutures would cost between DM 10.- to 20.- and single stitch sutures between DM 60.- and 100.-. A surgical school should prevalently aim at training manual anastomoses, while special anastomotic techniques should only complete the skill for selected indications. The overall staff expenditure for extended operations amounts around DM 600.- per hour respectively DM 10.- per minute. Time for surgery might be shortened by auxiliary tools as much as to perform an additional operation. However, a circular stapler anastomosis that costs between DM 650.- to 850.- is twice as expensive as manual sutures notwithstanding the double time needed. In the past years, the necessity for a rational use of different anastomotic techniques has shown to be mandatory since, increasingly, financial aspects of health economy require cost benefit calculations in visceral surgery.

  15. Relative contribution of set cathode potential and external mass transport on TCE dechlorination in a continuous-flow bioelectrochemical reactor.

    PubMed

    Verdini, Roberta; Aulenta, Federico; de Tora, Francesca; Lai, Agnese; Majone, Mauro

    2015-10-01

    Microbial bioelectrochemical systems, which use solid-state cathodes to drive the reductive degradation of contaminants such as the chlorinated hydrocarbons, are recently attracting considerable attention for bioremediation applications. So far, most of the published research has focused on analyzing the influence of key (bio)electrochemical factors influencing contaminant degradation, such as the cathode potential, whereas only few studies have examined the potential impact of mass transport phenomena on process performance. Here we analyzed the performance of a flow-through bioelectrochemical reactor, continuously fed with a synthetic groundwater containing trichloroethene at three different linear fluid velocities (from 0.3 m d(-1) to 1.7 m d(-1)) and three different set cathode potentials (from -250 mV to -450 mV vs. the standard hydrogen electrode). The obtained results demonstrated that, in the range of fluid velocities which are characteristics for natural groundwater systems, mass transport phenomena may strongly influence the rate and extent of reductive dechlorination. Nonetheless, the relative importance of mass transport largely depends on the applied cathode potential which, in turn, controls the intrinsic kinetics of biological reactions and the underlying electron transfer mechanisms.

  16. Paired Synchronous Rhythmic Finger Tapping without an External Timing Cue Shows Greater Speed Increases Relative to Those for Solo Tapping

    PubMed Central

    Okano, Masahiro; Shinya, Masahiro; Kudo, Kazutoshi

    2017-01-01

    In solo synchronization-continuation (SC) tasks, intertap intervals (ITI) are known to drift from the initial tempo. It has been demonstrated that people in paired and group contexts modulate their action timing unconsciously in various situations such as choice reaction tasks, rhythmic body sway, and hand clapping in concerts, which suggests the possibility that ITI drift is also affected by paired context. We conducted solo and paired SC tapping experiments with three tempos (75, 120, and 200 bpm) and examined whether tempo-keeping performance changed according to tempo and/or the number of players. Results indicated that those tapping in the paired conditions were faster, relative to those observed in the solo conditions, for all tempos. For the faster participants, the degree of ITI drift in the solo conditions was strongly correlated with that in the paired conditions. Regression analyses suggested that both faster and slower participants adapted their tap timing to that of their partners. A possible explanation for these results is that the participants reset the phase of their internal clocks according to the faster beat between their own tap and the partners’ tap. Our results indicated that paired context could bias the direction of ITI drift toward decreasing. PMID:28276461

  17. Natural gas and CO2 price variation: impact on the relative cost-efficiency of LNG and pipelines

    PubMed Central

    Ulvestad, Marte; Overland, Indra

    2012-01-01

    This article develops a formal model for comparing the cost structure of the two main transport options for natural gas: liquefied natural gas (LNG) and pipelines. In particular, it evaluates how variations in the prices of natural gas and greenhouse gas emissions affect the relative cost-efficiency of these two options. Natural gas is often promoted as the most environmentally friendly of all fossil fuels, and LNG as a modern and efficient way of transporting it. Some research has been carried out into the local environmental impact of LNG facilities, but almost none into aspects related to climate change. This paper concludes that at current price levels for natural gas and CO2 emissions the distance from field to consumer and the volume of natural gas transported are the main determinants of transport costs. The pricing of natural gas and greenhouse emissions influence the relative cost-efficiency of LNG and pipeline transport, but only to a limited degree at current price levels. Because more energy is required for the LNG process (especially for fuelling the liquefaction process) than for pipelines at distances below 9100 km, LNG is more exposed to variability in the price of natural gas and greenhouse gas emissions up to this distance. If the prices of natural gas and/or greenhouse gas emission rise dramatically in the future, this will affect the choice between pipelines and LNG. Such a price increase will be favourable for pipelines relative to LNG. PMID:24683269

  18. 47 CFR 52.33 - Recovery of carrier-specific costs directly related to providing long-term number portability.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... network elements under section 251. (iv) The incumbent local exchange carrier shall levelize the monthly... statistical areas or with an adjacent number portability-capable local exchange carrier may assess each end...) Incumbent local exchange carriers may recover their carrier-specific costs directly related to...

  19. Natural gas and CO2 price variation: impact on the relative cost-efficiency of LNG and pipelines.

    PubMed

    Ulvestad, Marte; Overland, Indra

    2012-06-01

    THIS ARTICLE DEVELOPS A FORMAL MODEL FOR COMPARING THE COST STRUCTURE OF THE TWO MAIN TRANSPORT OPTIONS FOR NATURAL GAS: liquefied natural gas (LNG) and pipelines. In particular, it evaluates how variations in the prices of natural gas and greenhouse gas emissions affect the relative cost-efficiency of these two options. Natural gas is often promoted as the most environmentally friendly of all fossil fuels, and LNG as a modern and efficient way of transporting it. Some research has been carried out into the local environmental impact of LNG facilities, but almost none into aspects related to climate change. This paper concludes that at current price levels for natural gas and CO2 emissions the distance from field to consumer and the volume of natural gas transported are the main determinants of transport costs. The pricing of natural gas and greenhouse emissions influence the relative cost-efficiency of LNG and pipeline transport, but only to a limited degree at current price levels. Because more energy is required for the LNG process (especially for fuelling the liquefaction process) than for pipelines at distances below 9100 km, LNG is more exposed to variability in the price of natural gas and greenhouse gas emissions up to this distance. If the prices of natural gas and/or greenhouse gas emission rise dramatically in the future, this will affect the choice between pipelines and LNG. Such a price increase will be favourable for pipelines relative to LNG.

  20. 32 CFR 37.535 - How do I value cost sharing related to real property or equipment?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false How do I value cost sharing related to real property or equipment? 37.535 Section 37.535 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award...

  1. 32 CFR 37.535 - How do I value cost sharing related to real property or equipment?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 1 2012-07-01 2012-07-01 false How do I value cost sharing related to real property or equipment? 37.535 Section 37.535 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award...

  2. 32 CFR 37.535 - How do I value cost sharing related to real property or equipment?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false How do I value cost sharing related to real property or equipment? 37.535 Section 37.535 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award...

  3. Impact of mobility impairment on indirect costs and health-related quality of life in multiple sclerosis.

    PubMed

    Coleman, Craig I; Sidovar, Matthew F; Roberts, Matthew S; Kohn, Christine

    2013-01-01

    This study was conducted to estimate the indirect costs and health-related quality of life (HRQoL) (utilities) of multiple sclerosis (MS) patients in the United States (US), and to determine the impact of worsening mobility on these parameters. In collaboration with the North American Research Committee on Multiple Sclerosis (NARCOMS) registry we conducted a cross-sectional study of participants who completed the biannual update and supplemental spring 2010 survey. Demographic, employment status, income, mobility impairment, and health utility data were collected from a sample of registry participants who met the study criteria and agreed to participate in the supplemental Mobility Study. Mean annual indirect costs per participant in 2011US$ and mean utilities for the population and for cohorts reporting different levels of mobility impairment were estimated. Analyses included 3,484 to 3,611 participants, based on survey completeness. Thirty-seven percent of registrants were not working or attending school and 46.7% of these reported retiring early. Indirect costs per participant per year, not including informal caregiver cost, were estimated at $30,601±31,184. The largest relative increase in indirect costs occurred at earlier mobility impairment stages, regardless of the measure used. Participants' mean utility score (0.73±0.18) was lower than that of a similarly aged sample from the general US population (0.87). As with indirect costs, larger decrements in utility were seen at earlier mobility impairment stages. These results suggest that mobility impairment may contribute to increases in indirect costs and declines in HRQoL in MS patients.

  4. Association between P3 event-related potential amplitude and externalizing disorders: a time-domain and time-frequency investigation of 29-year-old adults.

    PubMed

    Yoon, Henry H; Malone, Stephen M; Burwell, Scott J; Bernat, Edward M; Iacono, William G

    2013-07-01

    This study determined whether time-domain P3 amplitude and time-frequency principal component (TF-PC) reductions are present in adulthood (age 29) when participants have largely passed through the age of heaviest substance misuse. Participants were assessed from age 17 through 29 for lifetime externalizing (EXT) disorders. EEG comparisons from three topographic regions were examined for P3 amplitude and TF-PCs at delta and theta frequency ranges. Significant P3 amplitude reductions were found in those with EXT for both regional and site-Pz analyses, with stronger effects observed the greater the EXT comorbidity. Reductions were also observed in all eight TF-PCs extracted, with a delta component yielding frontal effects not apparent in the time domain. Overall, results suggest that these brain measures continue, at age 29, to provide effective indices of EXT that potentially tap a neural substrate related to behavioral disinhibition.

  5. Has Clinton made externalities extraneous

    SciTech Connect

    Haites, E.

    1993-08-01

    Over the past several years state utility regulators have become increasingly concerned with the environmental externalities associated with electricity generation. Currently, 26 states have requirements in place, although these vary considerably in scope and complexity. The vast majority apply only to the selection of new resources; the most detailed specify a monetary value for each discharge to the environment. Regulatory concern with environmental externalities stems from the desire to minimize the cost of electricity service to society. Externalities requirements focus on the residual discharges after environmental regulations are complied with. Ignoring externalities leads to inefficient use of resources and environmental damage beyond with may be called a [open quotes]socially optimal[close quotes] level of pollution. Adjusting to the cost options for environmental externalities should lead utilities to select a combination of resources that is closer to the socially optimal mix. President Bill Clinton's recent announcement that the United States will limit its emissions of carbon dioxide (CO[sub 2]) to 1990 levels by 2000 may make externalities regulation superfluous. National limits on sulfur dioxide (SO[sub 2]), nitrogen oxide (NO[sub x]), and CO[sub 2] emissions by utilities will likely be in effect by 2000. It will not be possible to comply with emissions limits solely through changes to the mix of resource additions, even though consideration of environmental externalities in resource addition decisions can reduce incremental emissions. Other strategies to reduce the emissions of existing generating stations, as well as new sources, will be needed.

  6. Measuring PM and related air pollutants using low-cost sensors

    EPA Science Inventory

    Emerging air quality sensors may play a key role in better characterizing levels of air pollution in a variety of settings There are a wide range of low-cost (< $500 US) sensors on the market, but few have been characterized. If accurate, this new generation of inexpensive sens...

  7. Inactive Lifestyles and Obesity in Chilean Youth: Individual Costs in Health-Related Choices

    ERIC Educational Resources Information Center

    Correa-Burrows, Paulina; Burrows, Raquel A.

    2014-01-01

    Objective: A recent economic approach suggests that people do not account for the long-term implications of unhealthy behaviours, preventing them from performing a fully rational trade-off between current benefits and future costs, leading to negative health outcomes. We examined whether the current allocation of time to physical activity among…

  8. Fall-Related Hospitalization and Facility Costs among Residents of Institutions Providing Long-Term Care

    ERIC Educational Resources Information Center

    Carroll, Norman V.; Delafuente, Jeffrey C.; Cox, Fred M.; Narayanan, Siva

    2008-01-01

    Purpose: The purpose of this study was to estimate hospital and long-term-care costs resulting from falls in long-term-care facilities (LTCFs). Design and Methods: The study used a retrospective, pre/post with comparison group design. We used matching, based on propensity scores, to control for baseline differences between fallers and non-fallers.…

  9. An Annotated Bibliography of Literature Relating to the Costs and Benefits of Graduate Education.

    ERIC Educational Resources Information Center

    Powel, John H., Jr.; Lamson, Robert D.

    This study and analysis of the literature on the costs and benefits of graduate education (the GRADCOST study) is organized into 4 parts: (1) The Economics of Higher Education (Behavioral Models, Planning and Budgeting, the Financing of Higher Education); (2) Outputs and Benefits of Higher Education (Conceptual Literature, Measurements of Outputs…

  10. Community College Finance: A Cost Analysis of Community College Expenditures Related to Maintenance and Operations

    ERIC Educational Resources Information Center

    Collins, Michael T.

    2011-01-01

    The purpose of this study is to develop a costing model for maintenance and operations expenditures among 16 single-campus California community college districts and assess the impact of a variety of variables including size of student enrollment, physical plant age, acreage, gross square footage, and general obligation facility bonds on district…

  11. Cost Effectiveness of Free Access to Smoking Cessation Treatment in France Considering the Economic Burden of Smoking-Related Diseases

    PubMed Central

    Cadier, Benjamin; Durand-Zaleski, Isabelle; Thomas, Daniel; Chevreul, Karine

    2016-01-01

    Context In France more than 70,000 deaths from diseases related to smoking are recorded each year, and since 2005 prevalence of tobacco has increased. Providing free access to smoking cessation treatment would reduce this burden. The aim of our study was to estimate the incremental cost-effectiveness ratios (ICER) of providing free access to cessation treatment taking into account the cost offsets associated with the reduction of the three main diseases related to smoking: lung cancer, chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). To measure the financial impact of such a measure we also conducted a probabilistic budget impact analysis. Methods and Findings We performed a cost-effectiveness analysis using a Markov state-transition model that compared free access to cessation treatment to the existing coverage of €50 provided by the French statutory health insurance, taking into account the cost offsets among current French smokers aged 15–75 years. Our results were expressed by the incremental cost-effectiveness ratio in 2009 Euros per life year gained (LYG) at the lifetime horizon. We estimated a base case scenario and carried out a Monte Carlo sensitivity analysis to account for uncertainty. Assuming a participation rate of 7.3%, the ICER value for free access to cessation treatment was €3,868 per LYG in the base case. The variation of parameters provided a range of ICER values from -€736 to €15,715 per LYG. In 99% of cases, the ICER for full coverage was lower than €11,187 per LYG. The probabilistic budget impact analysis showed that the potential cost saving for lung cancer, COPD and CVD ranges from €15 million to €215 million at the five-year horizon for an initial cessation treatment cost of €125 million to €421 million. Conclusion The results suggest that providing medical support to smokers in their attempts to quit is very cost-effective and may even result in cost savings. PMID:26909802

  12. Suppression sours sacrifice: emotional and relational costs of suppressing emotions in romantic relationships.

    PubMed

    Impett, Emily A; Kogan, Aleksandr; English, Tammy; John, Oliver; Oveis, Christopher; Gordon, Amie M; Keltner, Dacher

    2012-06-01

    What happens when people suppress their emotions when they sacrifice for a romantic partner? This multimethod study investigates how suppressing emotions during sacrifice shapes affective and relationship outcomes. In Part 1, dating couples came into the laboratory to discuss important romantic relationship sacrifices. Suppressing emotions was associated with emotional costs for the partner discussing his or her sacrifice. In Part 2, couples participated in a 14-day daily experience study. Within-person increases in emotional suppression during daily sacrifice were associated with decreases in emotional well-being and relationship quality as reported by both members of romantic dyads. In Part 3, suppression predicted decreases in relationship satisfaction and increases in thoughts about breaking up with a romantic partner 3 months later. In the first two parts of the study, authenticity mediated the costly effects of suppression. Implications for research on close relationships and emotion regulation are discussed.

  13. Cost justification of clinical pharmacy services on a general surgery team: focus on diagnosis-related group cases.

    PubMed

    Bertch, K E; Hatoum, H T; Willett, M S; Witte, K W

    1988-11-01

    We used a novel approach to cost-justify clinical pharmacy services on a general surgery team in nine diagnosis-related group cases. The clinical pharmacist monitored nine patients longitudinally on a general surgery team from admission to discharge and intervened in their therapeutic management. Each recommendation was analyzed for rationale, acceptance, perceived impact on quality and/or cost of patient care, whether self-initiated or solicited, and impact on patient outcome. Types of recommendations and outcomes were categorized by process and outcome measurement criteria. Total cost avoidance per patient was calculated using costs of drug therapy, laboratory tests, and length of stay. Accounting for cost of clinical pharmacy services, net cost avoidance per patient was calculated. The clinical pharmacist made 101 recommendations on nine patients. Physicians accepted 82 percent of the recommendations; 77 percent of the recommendations were self-initiated and 23 percent were solicited. Recommendations had a perceived impact on cost, quality, or both at 13, 31, and 56 percent, respectively. Most recommendations (79 percent) brought patient therapy to a level of conformance with current standards of practice as documented in the medical literature. Recommendations that potentially preserved a major organ function by preventing drug-induced toxicity or the exacerbation of existing problems constituted 16 percent of the total. None of the accepted recommendations adversely affected patient outcome and 23 percent directly resulted in a measurable positive outcome in patient care. A total of four hospital days was potentially saved for two cases. Based on objective outcome criteria, a 1.9-day increase in therapeutic control was documented per patient.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. The cost of cancer care is not related to its outcomes

    PubMed Central

    Storme, Guy; Dhaese, S; Corens, D; De Ridder, Mark

    2016-01-01

    Solid tumours make up 90% of all proliferative diseases and the main action for cure remains surgery, removing the visible tumour as well as the surrounding tissue. Radiotherapy is an added value for eliminating local microscopic as well as regional disease. Systemic treatment has a small impact on the outcome but has a cost, which is as much as all the other actions such as diagnostic tools and treatments. PMID:27994643

  15. Bullying perpetration and victimization as externalizing and internalizing pathways: A retrospective study linking parenting styles and self-esteem to depression, alcohol use, and alcohol-related problems

    PubMed Central

    Patock-Peckham, Julie A; Medina, Mia; Terrell, Nathan; Belton, Daniel; King, Kevin M

    2016-01-01

    Emerging research suggests significant positive associations between bullying and substance use behaviors. However, these studies typically focused either on the link between substance use and bullying perpetration or victimization, and few have conceptualized bullying perpetration and/or victimization as mediators. In this study, we simultaneously tested past bullying perpetration and victimization as mediational pathways from retrospective report of parenting styles and global self-esteem to current depressive symptoms, alcohol use and alcohol-related problems. Data were collected from a college sample of 419 drinkers. Mediation effects were conducted using a bias-corrected bootstrap technique in structural equation modeling. Two-path mediation analyses indicated that mother and father authoritativeness were protective against bully victimization and depression through higher self-esteem. Conversely, having a permissive or authoritarian mother was positively linked to bullying perpetration, which in turn was associated with increased alcohol use, and to a lesser degree, more alcohol-related problems. Mother authoritarianism was associated with alcohol-related problems through depressive symptoms. Three-path mediation analyses suggested a trend in which individuals with higher self-esteem were less likely to report alcohol-related problems through lower levels of bullying victimization and depression. Results suggested that bullying perpetration and victimization may respectively serve as externalizing and internalizing pathways through which parenting styles and self-esteem are linked to depression and alcohol-related outcomes. The present study identified multiple modifiable precursors of, and mediational pathways to, alcohol-related problems which could guide the development and implementation of prevention programs targeting problematic alcohol use. PMID:26757486

  16. Public Relations: The Cost-Effective Way to Build Your Business.

    ERIC Educational Resources Information Center

    Ochman, B. L.

    1989-01-01

    Differences between advertising and public relations are described, and basic elements of public relations are outlined: community relations, special events, and publicity. Examples of successful community relations and special events conducted by corporations are noted. Techniques for acquiring publicity are described using the acronym NEWS (new,…

  17. Multimethod assessment of psychopathy in relation to factors of internalizing and externalizing from the Personality Assessment Inventory: the impact of method variance and suppressor effects.

    PubMed

    Blonigen, Daniel M; Patrick, Christopher J; Douglas, Kevin S; Poythress, Norman G; Skeem, Jennifer L; Lilienfeld, Scott O; Edens, John F; Krueger, Robert F

    2010-03-01

    Research to date has revealed divergent relations across factors of psychopathy measures with criteria of internalizing (INT; anxiety, depression) and externalizing (EXT; antisocial behavior, substance use). However, failure to account for method variance and suppressor effects has obscured the consistency of these findings across distinct measures of psychopathy. Using a large correctional sample, the current study employed a multimethod approach to psychopathy assessment (self-report, interview and file review) to explore convergent and discriminant relations between factors of psychopathy measures and latent criteria of INT and EXT derived from the Personality Assessment Inventory (Morey, 2007). Consistent with prediction, scores on the affective-interpersonal factor of psychopathy were negatively associated with INT and negligibly related to EXT, whereas scores on the social deviance factor exhibited positive associations (moderate and large, respectively) with both INT and EXT. Notably, associations were highly comparable across the psychopathy measures when accounting for method variance (in the case of EXT) and when assessing for suppressor effects (in the case of INT). Findings are discussed in terms of implications for clinical assessment and evaluation of the validity of interpretations drawn from scores on psychopathy measures.

  18. Alternating between pro- and antisaccades: switch-costs manifest via decoupling the spatial relations between stimulus and response.

    PubMed

    Heath, Matthew; Gillen, Caitlin; Samani, Ashna

    2016-03-01

    Antisaccades are a nonstandard task requiring a response mirror-symmetrical to the location of a target. The completion of an antisaccade has been shown to delay the reaction time (RT) of a subsequent prosaccade, whereas the converse switch elicits a null RT cost (i.e., the unidirectional prosaccade switch-cost). The present study sought to determine whether the prosaccade switch-cost arises from low-level interference specific to the sensory features of a target (i.e., modality-dependent) or manifests via the high-level demands of dissociating the spatial relations between stimulus and response (i.e., modality-independent). Participants alternated between pro- and antisaccades wherein the target associated with the response alternated between visual and auditory modalities. Thus, the present design involved task-switch (i.e., switching from a pro- to antisaccade and vice versa) and modality-switch (i.e., switching from a visual to auditory target and vice versa) trials as well as their task- and modality-repetition counterparts. RTs were longer for modality-switch than modality-repetition trials. Notably, however, modality-switch trials did not nullify or lessen the unidirectional prosaccade switch-cost; that is, the magnitude of the RT cost for task-switch prosaccades was equivalent across modality-switch and modality-repetition trials. Thus, competitive interference within a sensory modality does not contribute to the unidirectional prosaccade switch-cost. Instead, the modality-independent findings evince that dissociating the spatial relations between stimulus and response instantiates a high-level and inertially persistent nonstandard task-set that impedes the planning of a subsequent prosaccade.

  19. Cost of care and social consequences of very low birth weight infants without premature- related morbidities in Italy.

    PubMed

    Cavallo, Maria Caterina; Gugiatti, Attilio; Fattore, Giovanni; Gerzeli, Simone; Barbieri, Dario; Zanini, Rinaldo

    2015-08-19

    Aim of this study was to estimate the cost that is borne by the Italian National Health Service, families, and social security due to very low birth weight infants (VLBWIs) without prematurity-related morbidities up to the age of 18 months. We followed up on 150 VLBWIs and 145 comparable full-term infants (FTIs) who were born in one of 25 different neonatal intensive care units upon discharge from the hospital and at six and 18 months of age. The average length of the primary hospitalisation of the VLBWIs was 59.7 days (SD 21.6 days), with a total cost of €20,502 (SD €8409), compared with three days (SD 0.4 days) with a total cost of €907 (SD €304) for the FTIs. The total societal cost of the VLBWIs for the first 18 months of life was €58,098 (SD €21,625), while the corresponding figure for FTIs was €24,209 (SD €15,557). Among VLBWIs, both low birth weight and gestational age were correlated with the length of hospitalisation after birth (r(2) = 0.61 and r(2) = 0.57, respectively; p values < 0.0005). Our findings highlight that the existing DRGs and tariffs inadequately reflect the actual costs for Italian National Health Service.

  20. Hospital treatment, mortality and healthcare costs in relation to socioeconomic status among people with bipolar affective disorder

    PubMed Central

    Yeh, Ling-Ling; Chen, Yu-Chun; Kuo, Kuei-Hong; Chang, Chin-Kuo

    2016-01-01

    Background Evidence regarding the relationships between the socioeconomic status and long-term outcomes of individuals with bipolar affective disorder (BPD) is lacking. Aims We aimed to estimate the effects of baseline socioeconomic status on longitudinal outcomes. Method A national cohort of adult participants with newly diagnosed BPD was identified in 2008. The effects of personal and household socioeconomic status were explored on outcomes of hospital treatment, mortality and healthcare costs, over a 3-year follow-up period (2008–2011). Results A total of 7987 participants were recruited. The relative risks of hospital treatment and mortality were found elevated for the ones from low-income households who also had higher healthcare costs. Low premium levels did not correlate with future healthcare costs. Conclusions Socioeconomic deprivation is associated with poorer outcome and higher healthcare costs in BPD patients. Special care should be given to those with lower socioeconomic status to improve outcomes with potential benefits of cost savings in the following years. Declaration of interest None. Copyright and usage © 2016 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703748

  1. The direct, indirect and intangible costs of visual impairment caused by neovascular age-related macular degeneration.

    PubMed

    Ke, Kathleen Melissa

    2010-12-01

    Neovascular age-related macular degeneration (nvAMD) is a chronic, progressive disease of the central retina, and its prevalence is expected to rise with the ageing population. Using a bottom-up approach based on retrospective data, this cross-sectional study estimated average annual direct costs of nvAMD to be £4,047, and average annual indirect costs to be £449. An attempt to measure intangible costs through willingness-to-pay yielded a lower response rate and estimated intangible costs to be 11.5% of monthly income. Direct costs were significantly higher for male participants, for those who have mild or moderate visual impairment in both eyes, and for those who have been diagnosed for a shorter time. The findings of this study suggest that the availability of early diagnosis, effective treatment, support services, and sustained research into the management of nvAMD may reduce the burden of visual impairment caused by nvAMD to affected individuals and the state.

  2. Health-Related Quality of Life After Single-Fraction High-Dose-Rate Brachytherapy and Hypofractionated External Beam Radiotherapy for Prostate Cancer

    SciTech Connect

    Morton, Gerard C.; Loblaw, D. Andrew; Chung, Hans; Tsang, Gail; Sankreacha, Raxa; Deabreu, Andrea; Zhang Liying; Mamedov, Alexandre; Cheung, Patrick; Batchelar, Deidre; Danjoux, Cyril; Szumacher, Ewa

    2011-08-01

    Purpose: To investigate the change in health-related quality of life for men after high-dose-rate brachytherapy and external beam radiotherapy for prostate cancer and the factors associated with this change. Methods and Materials: Eligible patients had clinically localized intermediate-risk prostate cancer. The patients received high-dose-rate brachytherapy as a single 15-Gy implant, followed by external beam radiotherapy to 37.5 Gy in 15 fractions. The patients were monitored prospectively for toxicity (Common Terminology Criteria for Adverse Events, version 3.0) and health-related quality of life (Expanded Prostate Cancer Index Composite [EPIC]). The proportion of patients developing a clinically significant difference in the EPIC domain score (minimally important difference of >0.5 standard deviation) was determined and correlated with the baseline clinical and dosimetric factors. The study accrued 125 patients, with a median follow-up of 24 months. Results: By 24 months, 23% had Grade 2 urinary toxicity and only 5% had Grade 2 bowel toxicity, with no Grade 3 toxicity. The proportion of patients reporting a significant decrease in EPIC urinary, bowel, sexual, and hormonal domain scores was 53%, 51%, 45%, and 40% at 12 months and 57%, 65%, 51%, and 30% at 24 months, respectively. The proportion with a >1 standard deviation decrease in the EPIC urinary, bowel, sexual, and hormonal domain scores was 38%, 36%, 24%, and 20% at 12 months and 46%, 48%, 19%, and 8% at 24 months, respectively. On multivariate analysis, the dose to 10% of the urethra was associated with a decreasing EPIC urinary domain score (p = .0089) and, less strongly (p = .0312) with a decreasing hormonal domain score. No association was found between the prostate volume, bladder dose, or high-dose volume and urinary health-related quality of life. A high baseline International Index of Erectile Function score was associated (p = .0019) with a decreasing sexual domain score. The optimal maximal dose

  3. Health-Related Quality of Life 2 Years After Treatment With Radical Prostatectomy, Prostate Brachytherapy, or External Beam Radiotherapy in Patients With Clinically Localized Prostate Cancer

    SciTech Connect

    Ferrer, Montserrat Suarez, Jose Francisco; Guedea, Ferran; Fernandez, Pablo; Macias, Victor; Marino, Alfonso; Hervas, Asuncion; Herruzo, Ismael; Ortiz, Maria Jose; Villavicencio, Humberto; Craven-Bratle, Jordi; Garin, Olatz; Aguilo, Ferran

    2008-10-01

    Purpose: To compare treatment impact on health-related quality of life (HRQL) in patients with localized prostate cancer, from before treatment to 2 years after the intervention. Methods and Materials: This was a longitudinal, prospective study of 614 patients with localized prostate cancer treated with radical prostatectomy (134), three-dimensional external conformal radiotherapy (205), and brachytherapy (275). The HRQL questionnaires administered before and after treatment (months 1, 3, 6, 12, and 24) were the Medical Outcomes Study 36-Item Short Form, the Functional Assessment of Cancer Therapy (General and Prostate Specific), the Expanded Prostate Cancer Index Composite (EPIC), and the American Urological Association Symptom Index. Differences between groups were tested by analysis of variance and within-group changes by univariate repeated-measures analysis of variance. Generalized estimating equations (GEE) models were constructed to assess between-group differences in HRQL at 2 years of follow-up after adjusting for clinical variables. Results: In each treatment group, HRQL initially deteriorated after treatment with subsequent partial recovery. However, some dimension scores were still significantly lower after 2 years of treatment. The GEE models showed that, compared with the brachytherapy group, radical prostatectomy patients had worse EPIC sexual summary and urinary incontinence scores (-20.4 and -14.1; p < 0.001), and external radiotherapy patients had worse EPIC bowel, sexual, and hormonal summary scores (-3.55, -5.24, and -1.94; p < 0.05). Prostatectomy patients had significantly better EPIC urinary irritation scores than brachytherapy patients (+4.16; p < 0.001). Conclusions: Relevant differences between treatment groups persisted after 2 years of follow-up. Radical prostatectomy had a considerable negative effect on sexual functioning and urinary continence. Three-dimensional conformal radiotherapy had a moderate negative impact on bowel

  4. Reduced oxygen cost of running is related to alignment of the resultant GRF and leg axis vector: A pilot study.

    PubMed

    Moore, I S; Jones, A M; Dixon, S J

    2016-07-01

    This pilot study investigated whether a 10-week running program (10wkRP), which reduced the oxygen cost of running, affected resultant ground reaction force (GRF), leg axis alignment, joint moment characteristics, and gear ratios. Ten novice, female runners completed a 10wkRP. Running kinematics and kinetics, in addition to oxygen consumption ( V ˙ O 2 ) during steady-state running, were recorded pre- and post-10wkRP. V ˙ O 2 decreased (8%) from pre-10wkRP to post-10wkRP. There was a better alignment of the resultant GRF and leg axis at peak propulsion post-10wkRP compared with pre-10wkRP (10.8 ± 4.9 vs 1.6 ± 1.2°), as the resultant GRF vector was applied 7 ± 0.6° (P = 0.008) more horizontally. There were shorter external ankle moment arms (24%) and smaller knee extensor moments (23%) at peak braking post-10wkRP. The change in V ˙ O 2 was associated with the change in alignment of the resultant GRF and leg axis (rs  = 0.88, P = 0.003). As runners became more economical, they exhibited a more aligned resultant GRF vector and leg axis at peak propulsion. This appears to be a self-optimization strategy that may improve performance. Additionally, changes to external ankle moment arms indicated beneficial low gear ratios were achieved at the time of peak braking force.

  5. The case for stratified cost-effectiveness analysis by baseline health-related QOL: theory and sensitivity analysis.

    PubMed

    Schaafsma, Joseph

    2005-01-01

    The purpose of this paper is to argue that systematic data heterogeneity exists when the objective of pharmacotherapy is improved health-related quality of life (HR-QOL), and that the pharmacotherapy's cost effectiveness will vary inversely with the patient's baseline HR-QOL (BHR-QOL), the patient's HR-QOL just prior to treatment. It is argued that when improved HR-QOL is the primary objective of a pharmacotherapy, the magnitude of the HR-QOL response to treatment may be negatively correlated with BHR-QOL and that the net cost of the pharmacotherapy may be positively correlated with BHR-QOL. It is also argued that the value placed on a given increment in HR-QOL declines as BHR-QOL rises. The case for sample stratification by BHR-QOL, and for conducting cost-effectiveness analysis (CEA) at the stratum level, is illustrated with numerical examples using hypothetical data and the incremental net monetary benefit (INMB) criterion. Sensitivity analysis is used to explore the response of the INMB at the stratum level to different degrees of data heterogeneity across the BHR-QOL strata. This paper demonstrates that because of cumulative effects, even relatively minor data heterogeneity related to BHR-QOL results in substantial differences in the cost effectiveness of treatments across BHR-QOL strata. CEA stratified by BHR-QOL enables a more efficient and equitable allocation of public healthcare funding than standard cost-effectiveness screening of pharmaceutical drugs based on full-sample averages.

  6. Investigating the chemical profile of regenerated scorpion (Parabuthus transvaalicus) venom in relation to metabolic cost and toxicity.

    PubMed

    Nisani, Zia; Boskovic, Danilo S; Dunbar, Stephen G; Kelln, Wayne; Hayes, William K

    2012-09-01

    We investigated the biochemical profile of regenerated venom of the scorpion Parabuthus transvaalicus in relation to its metabolic cost and toxicity. Using a closed-system respirometer, we compared oxygen consumption between milked and unmilked scorpions to determine the metabolic costs associated with the first 192 h of subsequent venom synthesis. Milked scorpions had a substantially (21%) higher mean metabolic rate than unmilked scorpions, with the largest increases in oxygen consumption occurring at approximately 120 h, 162 h, and 186 h post-milking. Lethality tests in crickets indicated that toxicity of the regenerated venom returned to normal levels within 4 d after milking. However, the chemical profile of the regenerated venom, as evaluated by FPLC and MALDI-TOF mass spectrometry, suggested that regeneration of different venom components was asynchronous. Some peptides regenerated quickly, particularly those associated with the scorpion's "prevenom," whereas others required much or all of this time period for regeneration. This asynchrony could explain the different spikes detected in oxygen consumption of milked scorpions as various peptides and other venom components were resynthesized. These observations confirm the relatively high metabolic cost of venom regeneration and suggest that greater venom complexity can be associated with higher costs of venom production.

  7. Estimate of Flood-Related Human Costs in the 1983 Flood at Jackson, Mississippi.

    DTIC Science & Technology

    1984-05-01

    in the three studies. TABLE 2 COMPARISON OF PERCENTAGE OF INDIVIDUALS IN EACH TRAUMA EFFECT CLASS TUG FORK, LAKE ELSINORE , AND JACKSON I II III TUG...FORK, WEST VIRGINIA & KENTUCKY 30.0 41.0 29.0 LAKE ELSINORE , CALIFORNIA 24.6 56.4 19.0 JACKSON, MISSISSIPPI (1979 Flood) 15.8 65.3 18.9 JACKSON...request of the Los Angeles District, in support of its Lake - Elinore study. In both the Tug Fork and Lake Elsinore cases the human costs were considerable

  8. Estimating reduction of nitrogen leaching from arable land and the related costs.

    PubMed

    Larsson, Martin H; Kyllmar, Katarina; Jonasson, Lars; Johnsson, Holger

    2005-11-01

    The EU Water Framework Directive will require river-basin management plans in order to achieve good ecological status and find the most cost-efficient nitrogen (N) leaching abatement measures. Detailed scenario calculations based on modeling methods will be valuable in this regard. This paper describes the approach and an application with a coefficient method based on the simulation model SOILNDB for quantification of N leaching from arable land and for prediction of the effect of abatement scenarios for the Rönneå catchment (1900 km2) in southern Sweden. Cost calculations for the different measures were also performed. The results indicate that the individual measures-cover crop and spring plowing, late termination of ley and fallow, and spring application of manure-would only reduce N leaching by between 5% and 8%. If all measures were combined and winter crops replaced by their corresponding spring variants, a 21% reduction in N leaching would be possible. However, this would require total fulfillment of the suggested measures.

  9. The Reciprocal Internal/External Frame of Reference Model: An Integration of Models of Relations between Academic Achievement and Self-Concept

    ERIC Educational Resources Information Center

    Moller, Jens; Retelsdorf, Jan; Koller, Olaf; Marsh, Herb W.

    2011-01-01

    The reciprocal internal/external frame of reference model (RI/EM) combines the internal/external frame of reference model and the reciprocal effects model. The RI/EM predicts positive effects of mathematics and verbal achievement and academic self-concepts (ASC) on subsequent mathematics and verbal achievements and ASCs within domains and negative…

  10. Costs associated with functional gastrointestinal disorders and related signs and symptoms in infants: a systematic review protocol

    PubMed Central

    Glanville, Julie; Ludwig, Thomas; Lifschitz, Carlos; Mahon, James; Miqdady, Mohamad; Saps, Miguel; Hock Quak, Seng; Lenoir-Wijnkoop, Irene; Wood, Hannah; Szajewska, Hania

    2016-01-01

    Introduction Functional gastrointestinal disorders (FGIDs) and FGID-related signs and symptoms have a fundamental impact on the psychosocial, physical and mental well-being of infants and their parents alike. Recent reviews and studies have indicated that FGIDs and related signs and symptoms may also have a substantial impact on the budgets of third-party payers and/or parents. The objective of this systematic review is to investigate these costs. Methods and analysis The population of interest is healthy term infants (under 12 months of age) with colic, regurgitation and/or functional constipation. Outcomes of interest will include the frequency and volume of reported treatments, the cost to third-party payers and/or parents for prescribed or over the counter treatments, visits to health professionals and changes in infant formula purchases, and the loss of income through time taken off work and out of pocket costs. Relevant studies will be identified by searching databases from 2005 onwards (including MEDLINE, EMBASE, PsycINFO, NEXIS, DARE, Health Technology Assessment database, National Health Service Economic Evaluation Database and others), conferences from the previous 3 years and scanning reference lists of eligible studies. Study selection, data extraction and quality assessment will be conducted by two independent reviewers and disagreements resolved in discussion with a third reviewer. Quality assessment will involve study design-specific checklists. Relevant studies will be summarised narratively and presented in tables. An overview of treatments and costs will be provided, with any geographical or other differences highlighted. An assessment of how the totals for cost differ across countries and elements that contribute to the differences will be generated. Ethics and dissemination This is a systematic review of published studies that will be submitted for publication to a peer-reviewed journal. Ethical committee approval is not required. Trial

  11. Biomass reduction of juvenile birch is more strongly related to stomatal uptake of ozone than to indices based on external exposure

    NASA Astrophysics Data System (ADS)

    Uddling, J.; Günthardt-Goerg, M. S.; Matyssek, R.; Oksanen, E.; Pleijel, H.; Selldén, G.; Karlsson, P. E.

    In order to test the hypothesis that ozone-induced limitation of biomass production in juvenile silver birch ( Betula pendula Roth) is driven by stomatal uptake of ozone (O 3) rather than external exposure, biomass reduction was related to the cumulative uptake of O 3 through stomata over an uptake cut-off threshold of x nmol O 3 m -2 s -1 (CUO> x), to the accumulated exposure to O 3 over a threshold of y nmol mol -1 during daylight hours (daylight AOT y) or during 24 h (24 h AOT y), and to the sum of daytime concentrations exceeding 60 nmol mol -1 (SUM06). The analysis included data from nine different experiments conducted in Sweden, Finland and Switzerland. Stomatal uptake of O 3 was estimated using a stomatal conductance ( gs) model including gs response functions for photosynthetic photon flux density, water vapour pressure deficit of the air and air temperature. Experiment-specific maximum gs ( gmax) as well as gs in darkness ( gdark) were assessed through local measurements. Biomass reduction was more strongly related to CUO> x than to SUM06 and daylight or 24 h AOT y, but the difference between CUO> x and 24 h AOT y was small. The better performance of CUO> x was dependent on the use of site- and experiment-specific gmax and gdark values, and there was a positive relationship between gmax and biomass reduction per unit AOT40. Daylight AOT y and SUM06 could not account for the growth limiting impact of nocturnal O 3 uptake in the Swiss experiments. A sensitivity analysis revealed that the CUO> x estimates were largely insensitive to the estimate of the conductance for non-stomatal leaf surface deposition of O 3, as a result of turbulent conditions at the experimental plots. In summary, we conclude that CUO> x was more successful in accounting for the variation in biomass reduction in juvenile birch as compared to indices based on external exposure, if gmax and gdark were locally parameterised.

  12. Social and economic costs and health-related quality of life in stroke survivors in the Canary Islands, Spain

    PubMed Central

    2012-01-01

    Background Cost-of-illness analysis is the main method of providing an overall vision of the economic impact of a disease. Such studies have been used to set priorities for healthcare policies and inform resource allocation. The aim of this study was to determine the economic burden and health-related quality of life (HRQOL) in the first, second and third years after surviving a stroke in the Canary Islands, Spain. Methods Cross-sectional, retrospective study of 448 patients with stroke based on ICD 9 discharge codes, who received outpatient care at five hospitals. The study was approved by the Research Ethics Committee of Nuestra Señora de la Candelaria University Hospital. Data on demographic characteristics, health resource utilization, informal care, labor productivity losses and HRQOL were collected from the hospital admissions databases and questionnaires completed by stroke patients or their caregivers. Labor productivity losses were calculated from physical units and converted into monetary units with a human capital-based method. HRQOL was measured with the EuroQol EQ-5D questionnaire. Healthcare costs, productivity losses and informal care costs were analyzed with log-normal, probit and ordered probit multivariate models. Results The average cost for each stroke survivor was €17 618 in the first, €14 453 in the second and €12 924 in the third year after the stroke; the reference year for unit prices was 2004. The largest expenditures in the first year were informal care and hospitalizations; in the second and third years the main costs were for informal care, productivity losses and medication. Mean EQ-5D index scores for stroke survivors were 0.50 for the first, 0.47 for the second and 0.46 for the third year, and mean EQ-5D visual analog scale scores were 56, 52 and 55, respectively. Conclusions The main strengths of this study lie in our bottom-up-approach to costing, and in the evaluation of stroke survivors from a broad perspective (societal

  13. The role of the workplace in the production and containment of health costs: the case of stress-related disorders.

    PubMed

    Shain, M

    1999-01-01

    Workplaces vary enormously in the amount of harmful stress they produce, even within specific economic sectors. Stress of certain kinds and at certain levels tend to produce health harms and costs that are borne not only by individual employees and employers but also by families and society at large. Variations in stress levels within economic sectors can be traced to variations in management practices that govern key conditions of work involving demand, effort, control and reward. The costs of stress-related disorders produced by adverse governance practices are transferred outside the workplace in varying degrees. The actual extent of this cost transfer depends on policies and programs within the workplace. We can characterize workplaces according to a typology in which the key dimensions are commitment to abate harm through participatory management practices and the effectiveness and efficiency of harm containment through programs such as employee assistance and health promotion. The most health-promoting and cost-avoiding workplaces foster high control, high reward conditions and support employees with employee assistance and health promotion programs. The policy implications of this observation are drawn out.

  14. Partition of aerobic and anaerobic swimming costs related to gait transitions in a labriform swimmer.

    PubMed

    Svendsen, Jon C; Tudorache, Christian; Jordan, Anders D; Steffensen, John F; Aarestrup, Kim; Domenici, Paolo

    2010-07-01

    Members of the family Embiotocidae exhibit a distinct gait transition from exclusively pectoral fin oscillation to combined pectoral and caudal fin propulsion with increasing swimming speed. The pectoral-caudal gait transition occurs at a threshold speed termed U(p-c). The objective of this study was to partition aerobic and anaerobic swimming costs at speeds below and above the U(p-c) in the striped surfperch Embiotoca lateralis using swimming respirometry and video analysis to test the hypothesis that the gait transition marks the switch from aerobic to anaerobic power output. Exercise oxygen consumption rate was measured at 1.4, 1.9 and 2.3 L s(-1). The presence and magnitude of excess post-exercise oxygen consumption (EPOC) were evaluated after each swimming speed. The data demonstrated that 1.4 L s(-1) was below the U(p-c), whereas 1.9 and 2.3 L s(-1) were above the U(p-c). These last two swimming speeds included caudal fin propulsion in a mostly steady and unsteady (burst-assisted) mode, respectively. There was no evidence of EPOC after swimming at 1.4 and 1.9 L s(-1), indicating that the pectoral-caudal gait transition was not a threshold for anaerobic metabolism. At 2.3 L s(-1), E. lateralis switched to an unsteady burst and flap gait. This swimming speed resulted in EPOC, suggesting that anaerobic metabolism constituted 25% of the total costs. Burst activity correlated positively with the magnitude of the EPOC. Collectively, these data indicate that steady axial propulsion does not lead to EPOC whereas transition to burst-assisted swimming above U(p-c) is associated with anaerobic metabolism in this labriform swimmer.

  15. Relative effects of submersion and increased pressure on respiratory mechanics, work, and energy cost of breathing.

    PubMed

    Held, Heather E; Pendergast, David R

    2013-03-01

    Submersion and increased pressure (depth) characterize the diving environment and may independently increase demand on the respiratory system. To quantify changes in respiratory mechanics, this study employed a unique protocol and techniques to measure, in a hyperbaric chamber, inspiratory and expiratory alveolar pressures (interrupter technique), inspiratory and expiratory resistance in the airways (RawI and RawE, esophageal balloon technique), nitric oxide elimination (thought to correlate with Raw), inspiratory and expiratory mechanical power of breathing, and the total energy cost of ventilation. Eight healthy adult men underwent experiments at 1, 2.7, and 4.6 atmospheres absolute (ATA) in dry and fully submersed conditions. Subjects rested, cycled on an ergometer at 100 W, and rested while voluntarily matching their ventilation to their own exercise hyperpnea (isocapnic simulated exercise ventilation). During isocapnic simulated exercise ventilation, increased O2 uptake (above rest values) resulted from increased expired ventilation. RawI decreased with submersion (mean 43% during rest and 20% during exercise) but increased from 1 to 4.6 ATA (19% during rest and 75% during exercise), as did RawE (53% decrease with submersion during rest and 10% during exercise; 9% increase from 1 to 4.6 ATA during rest and 66% during exercise). Nitric oxide elimination did not correlate with Raw. Depth increased inspiratory mechanical power of breathing during rest (40%) and exercise (20%). Expiratory mechanical power of breathing was largely unchanged. These results suggest that the diving environment affects ventilatory mechanics primarily by increasing Raw, secondary to increased gas density. This necessitates increased alveolar pressure and increases the work and energy cost of breathing as the diver descends. These findings can inform physician assessment of diver fitness and the pulmonary risks of hyperbaric O2 therapy.

  16. The Indirect Effect of Age Group on Switch Costs via Gray Matter Volume and Task-Related Brain Activity

    PubMed Central

    Steffener, Jason; Gazes, Yunglin; Habeck, Christian; Stern, Yaakov

    2016-01-01

    Healthy aging simultaneously affects brain structure, brain function, and cognition. These effects are often investigated in isolation ignoring any relationships between them. It is plausible that age related declines in cognitive performance are the result of age-related structural and functional changes. This straightforward idea is tested in within a conceptual research model of cognitive aging. The current study tested whether age-related declines in task-performance were explained by age-related differences in brain structure and brain function using a task-switching paradigm in 175 participants. Sixty-three young and 112 old participants underwent MRI scanning of brain structure and brain activation. The experimental task was an executive context dual task with switch costs in response time as the behavioral measure. A serial mediation model was applied voxel-wise throughout the brain testing all pathways between age group, gray matter volume, brain activation and increased switch costs, worsening performance. There were widespread age group differences in gray matter volume and brain activation. Switch costs also significantly differed by age group. There were brain regions demonstrating significant indirect effects of age group on switch costs via the pathway through gray matter volume and brain activation. These were in the bilateral precuneus, bilateral parietal cortex, the left precentral gyrus, cerebellum, fusiform, and occipital cortices. There were also significant indirect effects via the brain activation pathway after controlling for gray matter volume. These effects were in the cerebellum, occipital cortex, left precentral gyrus, bilateral supramarginal, bilateral parietal, precuneus, middle cingulate extending to medial superior frontal gyri and the left middle frontal gyri. There were no significant effects through the gray matter volume alone pathway. These results demonstrate that a large proportion of the age group effect on switch costs can

  17. The Indirect Effect of Age Group on Switch Costs via Gray Matter Volume and Task-Related Brain Activity.

    PubMed

    Steffener, Jason; Gazes, Yunglin; Habeck, Christian; Stern, Yaakov

    2016-01-01

    Healthy aging simultaneously affects brain structure, brain function, and cognition. These effects are often investigated in isolation ignoring any relationships between them. It is plausible that age related declines in cognitive performance are the result of age-related structural and functional changes. This straightforward idea is tested in within a conceptual research model of cognitive aging. The current study tested whether age-related declines in task-performance were explained by age-related differences in brain structure and brain function using a task-switching paradigm in 175 participants. Sixty-three young and 112 old participants underwent MRI scanning of brain structure and brain activation. The experimental task was an executive context dual task with switch costs in response time as the behavioral measure. A serial mediation model was applied voxel-wise throughout the brain testing all pathways between age group, gray matter volume, brain activation and increased switch costs, worsening performance. There were widespread age group differences in gray matter volume and brain activation. Switch costs also significantly differed by age group. There were brain regions demonstrating significant indirect effects of age group on switch costs via the pathway through gray matter volume and brain activation. These were in the bilateral precuneus, bilateral parietal cortex, the left precentral gyrus, cerebellum, fusiform, and occipital cortices. There were also significant indirect effects via the brain activation pathway after controlling for gray matter volume. These effects were in the cerebellum, occipital cortex, left precentral gyrus, bilateral supramarginal, bilateral parietal, precuneus, middle cingulate extending to medial superior frontal gyri and the left middle frontal gyri. There were no significant effects through the gray matter volume alone pathway. These results demonstrate that a large proportion of the age group effect on switch costs can

  18. Intangible costs of alcohol dependence from the perspective of patients and their relatives: A contingent valuation study.

    PubMed

    Mosquera Nogueira, Jacinto; Rodríguez-Míguez, Eva

    2016-09-29

    Alcohol dependence causes multiple problems not only for the person suffering dependence but also for others. In this study, the contingent valuation method is proposed to measure the intangible effects of alcohol dependence from the perspective of the persons directly involved: the patients and their relatives. Interviews were conducted with 145 patients and 61 relatives. Intangible effects of alcohol dependence were determined based on willingness to pay for a hypothetical treatment for dependence, with different success scenarios (100% and 50%). The mean monthly willingness to pay among the alcohol-dependent population was €129 and €168, respectively, for the treatments with 100% and 50% success. The willingness to pay of relatives was greater in both scenarios (€307 and €420, respectively), which could be explained by their greater perception of the family, labour, and health problems resulting from alcohol dependence. Regression analysis showed that patients' willingness to pay is positively related to treatment efficacy, personal income and moderate health deterioration, and negatively related to feeling discouraged and depressed. The results from this study can be applied to economic valuation studies that aim to measure the benefits of programs intended to reduce the prevalence of alcohol dependence. The intangible costs estimated can be added to the direct and indirect costs commonly used.

  19. Enhanced External Counterpulsation (EECP)

    PubMed Central

    2006-01-01

    Executive Summary Objective To assess the effectiveness, and cost effectiveness of EECP in patients with severe anginal symptoms, secondary to chronic coronary disease, who are unresponsive to exhaustive pharmacotherapy and not candidates for surgical/percutaneous revascularization procedures (e.g., angioplasty, coronary bypass surgery). To assess the effectiveness, and cost effectiveness of EECP in patients with heart failure. Clinical Need Angina Angina is a clinical syndrome characterized by discomfort in the chest, jaw, shoulder, back or arm. Angina usually occurs in patients with coronary artery disease (CAD) involving ≥1 large epicardial artery. However it can also occur in people with valvular heart disease, hypertrophic cardiomyopathy, and uncontrolled hypertension. Conventional approaches to restoring the balance between oxygen supply and demand focus on the disruption of the underlying disease through: drug therapy (β blockers, calcium channel blockers, nitrates, antiplatelet agents, ACE inhibitors, statins); life-style modifications (smoking cessation, weight loss); or revascularization techniques such as coronary artery bypass graft surgery (CABG) or percutaneous coronary interventions (PCI). (1) Limitations of each of these approaches include: adverse drug effects, procedure-related mortality and morbidity, restenosis after PCI, and time dependent graft attrition after CABG. Furthermore, an increasing number of patients are not appropriate candidates for standard revascularization options, due to co-morbid conditions (HF, peripheral vascular disease), poor distal coronary artery targets, and patient preference. The morbidity and mortality associated with repeat surgical revascularization procedures are significantly higher, and often excludes these patients from consideration for further revascularizations. (2) Patients with CAD who have chronic ischemic symptoms that are unresponsive to both conventional medical therapy and revascularization

  20. The reliable assurance of detecting somatic mutations in cancer-related genes by next-generation sequencing: the results of external quality assessment in China.

    PubMed

    Zhang, Rui; Ding, Jiansheng; Han, Yanxi; Yi, Lang; Xie, Jiehong; Yang, Xin; Fan, Gaowei; Wang, Guojing; Hao, Mingju; Zhang, Dong; Zhang, Kuo; Lin, Guigao; Li, Jinming

    2016-09-06

    To evaluate the proficiencies of laboratories utilizing next-generation sequencing (NGS) to detect somatic mutations in cancer-related genes, an external quality assessment (EQA) was implemented by the National Center for Clinical Laboratories of China in 2015. We prepared a panel of samples that comprised eight samples made by mixing synthetic mutated DNA fragments with normal human genomic DNA and one reference sample containing only genomic DNA. We validated our sample panel, and then distributed it to laboratories across China. We received complete results from 64 laboratories. The performances of 51.6 % (33/64) respondent labs were acceptable and 26.6 % (17/64) of the labs returned perfect results. In total, 449 mistakes were reported, including 201 false-negatives (201/449, 44.8 %) and 222 false-positives (222/449, 49.4 %) and 26 slightly discordant results (26/449, 5.8 %). We believe these unsatisfactory results and varied performances are mainly due to the enrichment methods used, the diverse sequencing chemistries of the different NGS platforms, and other errors within the sequencing process. The results indicate that our sample panel is suitable for use in EQA studies, and that further laboratory training in targeted NGS testing is urgently required. To address this, we propose a targeted NGS workflow with details on quality assurance procedures according to the current guidelines.

  1. The reliable assurance of detecting somatic mutations in cancer-related genes by next-generation sequencing: the results of external quality assessment in China

    PubMed Central

    Han, Yanxi; Yi, Lang; Xie, Jiehong; Yang, Xin; Fan, Gaowei; Wang, Guojing; Hao, Mingju; Zhang, Dong; Zhang, Kuo; Lin, Guigao; Li, Jinming

    2016-01-01

    To evaluate the proficiencies of laboratories utilizing next-generation sequencing (NGS) to detect somatic mutations in cancer-related genes, an external quality assessment (EQA) was implemented by the National Center for Clinical Laboratories of China in 2015. We prepared a panel of samples that comprised eight samples made by mixing synthetic mutated DNA fragments with normal human genomic DNA and one reference sample containing only genomic DNA. We validated our sample panel, and then distributed it to laboratories across China. We received complete results from 64 laboratories. The performances of 51.6 % (33/64) respondent labs were acceptable and 26.6 % (17/64) of the labs returned perfect results. In total, 449 mistakes were reported, including 201 false-negatives (201/449, 44.8 %) and 222 false-positives (222/449, 49.4 %) and 26 slightly discordant results (26/449, 5.8 %). We believe these unsatisfactory results and varied performances are mainly due to the enrichment methods used, the diverse sequencing chemistries of the different NGS platforms, and other errors within the sequencing process. The results indicate that our sample panel is suitable for use in EQA studies, and that further laboratory training in targeted NGS testing is urgently required. To address this, we propose a targeted NGS workflow with details on quality assurance procedures according to the current guidelines. PMID:27542269

  2. Cost-Effectiveness Evaluation of Quadrivalent Human Papilloma Virus Vaccine for HPV-Related Disease in Iran

    PubMed Central

    Khatibi, Mohsen; Rasekh, Hamid Reza; Shahverdi, Zohreh; jamshidi, Hamid Reza

    2014-01-01

    Human Papilloma Virus (HPV) vaccine has been added recently to the Iran Drug List. So, decision makers need information beyond that available from RCTs to recommend funding for this vaccination program to add it to the National Immunization program in Iran. Modeling and economic studies have addressed some of those information needs in foreign countries. In order to determine the long term benefit of this vaccine and impact of vaccine program on the future rate of cervical cancer in Iran, we described a model, based on the available economic and health effects of human papilloma virus (HPV), to estimate the cost-effectiveness of HPV vaccination of 15-year-old girls in Iran. Our objective is to estimate the cost-effectiveness of HPV vaccination in Iran against cervical cancer based on available data; incremental cost-effectiveness ratio (ICER) calculations were based on a model comparing a cohort of 15-year-old girls with and without vaccination. We developed a static model based on available data in Iran on the epidemiology of HPV related health outcome. The model compared the cohort of all 15-year old girls alive in the year 2013 with and without vaccination. The cost per QALY, which was found based on our assumption for the vaccination of 15-years old girl to current situation was 439,000,000 Iranian Rial rate (IRR). By considering the key parameters in our sensitivity analysis, value varied from 251,000,000 IRR to 842,000,000 IRR. In conclusion, quadrivalent HPV vaccine (Gardasil) is not cost-effective in Iran based on the base-case parameters value. PMID:24711850

  3. Singing-related neural activity distinguishes two putative pallidal cell types in the songbird basal ganglia: comparison to the primate internal and external pallidal segments

    PubMed Central

    Goldberg, Jesse H.; Adler, Avital; Bergman, Hagai; Fee, Michale S.

    2010-01-01

    The songbird area X is a basal ganglia homologue that contains two pallidal cell types—local neurons that project within the basal ganglia and output neurons that project to the thalamus. Based on these projections, it has been proposed that these classes are structurally homologous to the primate external (GPe) and internal (GPi) pallidal segments. To test the hypothesis that the two area X pallidal types are functionally homologous to GPe and GPi neurons, we recorded from neurons in area X of singing juvenile male zebra finches, and directly compare their firing patterns to neurons recorded in the primate pallidus. In area X, we find two cell classes that exhibited high firing (HF) rates (>60Hz) characteristic of pallidal neurons. HF-1 neurons, like most GPe neurons we examined, exhibited large firing rate modulations, including bursts and long pauses. In contrast, HF-2 neurons, like GPi neurons, discharged continuously without bursts or long pauses. To test if HF-2 neurons were the output neurons that project to the thalamus, we next recorded directly from pallidal axon terminals in thalamic nucleus DLM, and found that all terminals exhibited singing-related firing patterns indistinguishable from HF-2 neurons. Our data show that singing-related neural activity distinguishes two putative pallidal cell types in area X: thalamus-projecting neurons that exhibit activity similar to the primate GPi, and non-thalamus-projecting neurons that exhibit activity similar to the primate GPe. These results suggest that song learning in birds and motor learning in mammals employ conserved basal ganglia signaling strategies. PMID:20484651

  4. Morbidity, mortality and cost from HPV-related oropharyngeal cancer: Impact of 2-, 4- and 9-valent vaccines

    PubMed Central

    Ward, Greg; Mehta, Vikas; Moore, Michael

    2016-01-01

    ABSTRACT Objective: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) related to human papillomavirus (HPV) is increasing at a dramatic rate, with men affected more commonly than women. Individuals who develop this disease suffer significant morbidity and potential mortality from their cancer and its associated treatment. We aim to evaluate the possible impact that the currently available HPV vaccines will have on this group of cancers. Data sources: Available peer-reviewed literature, practice guidelines, and statistics published by the Center for Disease Control and Prevention. Review methods: Contemporary peer-reviewed medical literature was selected based on its scientific validity and relevance to the impact HPV vaccination may have on the morbidity, mortality and cost resulting from HPV-related OPSCC in the United States. Conclusions: The incidence of HPV-related OPSCC is increasing at a near epidemic rate in the United States. The cost of treatment of HPV-related OPSCC is high, and the disease and its therapy result in significant morbidity and potential mortality to individuals. Using a cut-off of $50,000/Quality-Adjusted Life Year, expansion of current HPV vaccine indications to include prevention of OPSCC in both men and women should be recommended. PMID:26566988

  5. Annual carbon cost of autotrophic respiration in boreal forest ecosystems in relation to species and climate

    NASA Astrophysics Data System (ADS)

    Ryan, Michael G.; Lavigne, Michael B.; Gower, Stith T.

    1997-12-01

    Autotrophic respiration (Ra) in forest ecosystems can be >50% of the carbon fixed in photosynthesis and may regulate productivity and carbon storage in forest ecosystems, because Ra increases with temperature. We estimated annual Ra from chamber measurements in aspen, black spruce, and jack pine forests in Canada for 1994. Mean foliage respiration at 10°C for expanded leaves was 0.21-0.95 μmol m-2 (leaf surface) s-1 for all species and differed little from May to September. Wood respiration at 15°C (0.2-1 μmol m-2 (stem surface) s-1 for all species) was strongly seasonal, with high rates in midsummer that coincided with wood growth. Fine root respiration at 10°C was 2.5-7.7 μmol kg-1 s-1 for all species and declined throughout the growing season for the conifers. Annual costs of Ra for foliage, wood, and roots (overstory and understory) were 490, 610, and 450 g C m-2 (ground) yr-1 for aspen, black spruce, and jack pine (old) in northern Manitoba and 600, 480, and 310 g C m-2 yr-1 for aspen, black spruce, and jack pine (old) in central Saskatchewan. Carbon use efficiency (CUE), the ratio of net production to production plus Ra, averaged 0.44, 0.34, and 0.39 for aspen, black spruce, and jack pine (old) for all tissues and 0.61, 0.36, and 0.44 for aboveground tissues. Differences in CUE between the northern and the southern sites were small for all species, and CUE did not vary with stand biomass. Species differences in CUE suggest that models assuming a constant CUE across species may poorly estimate production and carbon balance for any given site.

  6. 77 FR 17360 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles And...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-26

    ... OF MANAGEMENT AND BUDGET 2 CFR Chapters I and II Reform of Federal Policies Relating to Grants and...: Executive Office of the President, Office of Management and Budget (OMB). ACTION: Advance notice of proposed guidance; extension of comment period. SUMMARY: The Office of Management and Budget (OMB) is extending...

  7. INTERDISCIPLINARY PHYSICS AND RELATED AREAS OF SCIENCE AND TECHNOLOGY: Oscillating Propagation of Kink in Nondissipative Frenkel-Kontorova Chain Due to External DC Force

    NASA Astrophysics Data System (ADS)

    Zeng, Shang-You; Tang, Yi; Ren, Xi-Mei; Zhao, De-Jiang

    2009-04-01

    We report the oscillating propagation of kink in a nondissipative Frenkel-Kontorova (FK) chain driven by external DC force, which is different from the usual propagation of localized modes with equal speed. When the kink moves in the opposite direction of the external DC force, the kink will be accelerated and the potential of the FK chain in the external force field is transformed to be the kinetic energy of the kink. If the kink reaches the boundary of the FK chain, the kink will be bounced back and moves in the opposite direction, then the kink will be decelerated gradually and the kinetic energy of the kink is transformed to be the potential of the FK chain in the external force field. If the speed of the kink reaches zero, the kink will move in the opposite direction again driven by the external DC force, and a new oscillating cycle begins. Simulation result demonstrates exactly the transformation between the kinetic energy of the kink and the potential of the FK chain in the external force field. The interesting energy exchange is induced by the special topology of kinks, and other localized modes, such as breathers and envelope solitons, have no the interesting phenomenon.

  8. Impact of External Beam Adjuvant Radiotherapy on Health-Related Quality of Life for Long-Term Survivors of Endometrial Adenocarcinoma: A Population-Based Study

    SciTech Connect

    Poll-Franse, Lonneke V. van de; Essink-Bot, Marie-Louise; Vingerhoets, Ad J.J.M.; Lybeert, Marnix L.M.; Berg, Hetty A. van den; Coebergh, Jan Willem W.

    2007-09-01

    Purpose: To compare the health-related quality of life (HRQOL) among 5-10-year survivors of Stage I-II endometrial (adeno-)carcinoma (EC) treated with surgery alone or surgery with external beam adjuvant radiotherapy (EBRT) and an age-matched norm population. Methods and Materials: A population-based, cross-sectional survey was conducted by the Eindhoven Cancer Registry. All patients were included who had been diagnosed with EC between 1994 and 1998 (n = 462). Information from the questionnaires returned was linked to data from the Eindhoven Cancer Registry on patient, tumor, and treatment characteristics. Results: Responses were received from 75% of the patients. The analyses were restricted to women with Stage I-II disease at diagnosis, treated with either surgery alone or surgery with adjuvant EBRT, and without recurrent disease or new primary malignancies (n = 264). The patients who had received adjuvant EBRT (n = 80) had had a significantly higher tumor stage and grade at diagnosis (p < 0.0001) and a longer mean time since diagnosis (p = 0.04). Age, number of comorbid diseases, current marital status, nulliparity, education, and occupation were similar for both treatment groups. On multivariate analyses, adjuvant EBRT was independently and negatively associated with the vitality and physical and social well-being scale scores. The HRQOL scores of both treatment groups, however, were similar to those of an age-matched norm population. Conclusion: In general, the HRQOL of EC survivors is good. EC survivors treated with surgery alone had a better HRQOL than women treated with surgery and adjuvant EBRT, although for both groups, the HRQOL was in the range of the norm population.

  9. Predation-related costs and benefits of conspecific attraction in songbirds--an agent-based approach.

    PubMed

    Szymkowiak, Jakub; Kuczyński, Lechosław

    2015-01-01

    Songbirds that follow a conspecific attraction strategy in the habitat selection process prefer to settle in habitat patches already occupied by other individuals. This largely affects the patterns of their spatio-temporal distribution and leads to clustered breeding. Although making informed settlement decisions is expected to be beneficial for individuals, such territory clusters may potentially provide additional fitness benefits (e.g., through the dilution effect) or costs (e.g., possibly facilitating nest localization if predators respond functionally to prey distribution). Thus, we hypothesized that the fitness consequences of following a conspecific attraction strategy may largely depend on the composition of the predator community. We developed an agent-based model in which we simulated the settling behavior of birds that use a conspecific attraction strategy and breed in a multi-predator landscape with predators that exhibited different foraging strategies. Moreover, we investigated whether Bayesian updating of prior settlement decisions according to the perceived predation risk may improve the fitness of birds that rely on conspecific cues. Our results provide evidence that the fitness consequences of conspecific attraction are predation-related. We found that in landscapes dominated by predators able to respond functionally to prey distribution, clustered breeding led to fitness costs. However, this cost could be reduced if birds performed Bayesian updating of prior settlement decisions and perceived nesting with too many neighbors as a threat. Our results did not support the hypothesis that in landscapes dominated by incidental predators, clustered breeding as a byproduct of conspecific attraction provides fitness benefits through the dilution effect. We suggest that this may be due to the spatial scale of songbirds' aggregative behavior. In general, we provide evidence that when considering the fitness consequences of conspecific attraction for

  10. Increased strength and decreased flexibility are related to reduced oxygen cost of walking

    PubMed Central

    McCarthy, John P.; Bryan, David R.; Zuckerman, Paul A.; Bamman, Marcas M.; Byrne, Nuala M.

    2009-01-01

    Purpose was determine effects resistance training/weight loss induced changes in muscular strength and flexibility have on net walking oxygen uptake (netVO2). Sixty-seven premenopausal women lost 12 kg. Before weight loss subjects were assigned to diet (WL) or diet/3 days per week resistance training (WLRT). Resting energy expenditure, oxygen uptake while walking at 4.84 km h−1 on the flat and up 2.5% grade, isometric knee extension strength, and flexibility of the knee extensors and plantar flexors were measured. Strength increased in WLRT (+36 N) but not in WL (−24 N). NetVO2 decreased significantly while flat walking (7.3%) and 2.5% grade walking (5.7%) in WLRT, but not in WL. Delta strength was negatively while delta knee extensor and plantar flexor flexibility were positively related to delta netVO2. Decreases in walking and grade netVO2 were independently and positively related to increased knee extension strength and decreased knee extensor and plantar flexor flexibility. PMID:18758805

  11. Does non-adherence to DMARDs influence hospital-related healthcare costs for early arthritis in the first year of treatment?

    PubMed Central

    Pasma, Annelieke; Schenk, Charlotte; Timman, Reinier; van ‘t Spijker, Adriaan; Appels, Cathelijne; van der Laan, Willemijn H.; van den Bemt, Bart; Goekoop, Robert; Hazes, Johanna M. W.; Busschbach, Jan J. V.

    2017-01-01

    Introduction Non-adherence to disease-modifying antirheumatic drugs (DMARDs) is suspected to relate to health care costs. In this study we investigated this relation in the first year of treatment. Methods In a multi-center cohort study with a one year follow up, non-adherence was continuously measured using electronic monitored medication jars. Non-adherence was defined as the number of days with a negative difference between expected and observed opening of the container. Cost measurement focused on hospital costs in the first year: consultations, emergency room visits, hospitalization, medical procedures, imaging modalities, medication costs, and laboratory tests. Cost volumes were registered from patient medical files. We applied multivariate regression analyses for the association between non-adherence and costs, and other variables (age, sex, center, baseline disease activity, diagnosis, socioeconomic status, anxiety and depression) and costs. Results Of the 275 invited patients, 206 were willing to participate. 74.2% had rheumatoid arthritis, 20.9% had psoriatic arthritis and 4.9% undifferentiated arthritis. 23.7% of the patients were more than 20% non-adherent over the follow-up period. Mean costs are € 2117.25 (SD € 3020.32). Non-adherence was positively related to costs in addition to baseline anxiety. Conclusion Non-adherence is associated with health care costs in the first year of treatment for arthritis. This suggests that improving adherence is not only associated with better outcome, but also with savings. PMID:28152001

  12. Six climate change-related events in the United States accounted for about $14 billion in lost lives and health costs.

    PubMed

    Knowlton, Kim; Rotkin-Ellman, Miriam; Geballe, Linda; Max, Wendy; Solomon, Gina M

    2011-11-01

    The future health costs associated with predicted climate change-related events such as hurricanes, heat waves, and floods are projected to be enormous. This article estimates the health costs associated with six climate change-related events that struck the United States between 2000 and 2009. The six case studies came from categories of climate change-related events projected to worsen with continued global warming-ozone pollution, heat waves, hurricanes, infectious disease outbreaks, river flooding, and wildfires. We estimate that the health costs exceeded $14 billion, with 95 percent due to the value of lives lost prematurely. Actual health care costs were an estimated $740 million. This reflects more than 760,000 encounters with the health care system. Our analysis provides scientists and policy makers with a methodology to use in estimating future health costs related to climate change and highlights the growing need for public health preparedness.

  13. Financial, performance, and organizational outcomes of a nurse extern program.

    PubMed

    Oja, Kenneth John

    2013-01-01

    Nurse externships help prepare nursing students for practice, but the organizational costs are high. To decrease costs, nurse educators collaborated to revise their existing nurse extern program. Nursing professional development educators who want to implement a nurse extern program within an organization will benefit by learning about the planning, implementation, and evaluation of a nurse extern program designed to decrease costs while producing well-prepared new graduate nurses.

  14. [Work-related disability among postal employees: incidence, duration, and social security costs in 2008].

    PubMed

    Mascarenhas, Flávia Alves Neves; Barbosa-Branco, Anadergh

    2014-06-01

    This study analyzed the characteristics of Brazilian postal workers that received sick leave benefits in 2008. The databases were from the Unified Benefits System (SUB) and the National Registry of Social Information (CNIS). The incidence rate was 556.5 benefits per 10,000 employees, and the leading causes of work-related sick leave were injuries, musculoskeletal disorders, and mental disorders. Areas most frequently reported in injuries were knees and legs, wrists and hands, ankles and feet, and shoulders and arms, with higher incidence rates in men. Women were more affected by musculoskeletal disorders and mental disorders. Average sick leave lasted longer in men, and the incidence of benefits increased with age. The States with the highest incidence rates were Mato Grosso do Sul, Goiás, and Santa Catarina, and security benefits averaged BRL 1,847.00. Postal work may involve additional risk of injuries to the limbs, due to the long distances carrying heavy weight, assault, and dog bites.

  15. Quantifying the demographic cost of human-related mortality to a raptor population

    USGS Publications Warehouse

    Hunt, W. Grainger; Wiens, David; Law, Peter R.; Fuller, Mark R.; Hunt, Teresa L.; Driscoll, Daniel E.; Jackman, Ronald E.

    2017-01-01

    Raptors are exposed to a wide variety of human-related mortality agents, and yet population-level effects are rarely quantified. Doing so requires modeling vital rates in the context of species life-history, behavior, and population dynamics theory. In this paper, we explore the details of such an analysis by focusing on the demography of a resident, tree-nesting population of golden eagles (Aquila chrysaetos) in the vicinity of an extensive (142 km2) windfarm in California. During 1994–2000, we tracked the fates of >250 radio-marked individuals of four life-stages and conducted five annual surveys of territory occupancy and reproduction. Collisions with wind turbines accounted for 41% of 88 uncensored fatalities, most of which were subadults and nonbreeding adults (floaters). A consistent overall male preponderance in the population meant that females were the limiting sex in this territorial, monogamous species. Estimates of potential population growth rate and associated variance indicated a stable breeding population, but one for which any further decrease in vital rates would require immigrant floaters to fill territory vacancies. Occupancy surveys 5 and 13 years later (2005 and 2013) showed that the nesting population remained intact, and no upward trend was apparent in the proportion of subadult eagles as pair members, a condition that would have suggested a deficit of adult replacements. However, the number of golden eagle pairs required to support windfarm mortality was large. We estimated that the entire annual reproductive output of 216–255 breeding pairs would have been necessary to support published estimates of 55–65 turbine blade-strike fatalities per year. Although the vital rates forming the basis for these calculations may have changed since the data were collected, our approach should be useful for gaining a clearer understanding of how anthropogenic mortality affects the health of raptor populations, particularly those species with delayed

  16. Quantifying the demographic cost of human-related mortality to a raptor population.

    PubMed

    Grainger Hunt, W; David Wiens, J; Law, Peter R; Fuller, Mark R; Hunt, Teresa L; Driscoll, Daniel E; Jackman, Ronald E

    2017-01-01

    Raptors are exposed to a wide variety of human-related mortality agents, and yet population-level effects are rarely quantified. Doing so requires modeling vital rates in the context of species life-history, behavior, and population dynamics theory. In this paper, we explore the details of such an analysis by focusing on the demography of a resident, tree-nesting population of golden eagles (Aquila chrysaetos) in the vicinity of an extensive (142 km2) windfarm in California. During 1994-2000, we tracked the fates of >250 radio-marked individuals of four life-stages and conducted five annual surveys of territory occupancy and reproduction. Collisions with wind turbines accounted for 41% of 88 uncensored fatalities, most of which were subadults and nonbreeding adults (floaters). A consistent overall male preponderance in the population meant that females were the limiting sex in this territorial, monogamous species. Estimates of potential population growth rate and associated variance indicated a stable breeding population, but one for which any further decrease in vital rates would require immigrant floaters to fill territory vacancies. Occupancy surveys 5 and 13 years later (2005 and 2013) showed that the nesting population remained intact, and no upward trend was apparent in the proportion of subadult eagles as pair members, a condition that would have suggested a deficit of adult replacements. However, the number of golden eagle pairs required to support windfarm mortality was large. We estimated that the entire annual reproductive output of 216-255 breeding pairs would have been necessary to support published estimates of 55-65 turbine blade-strike fatalities per year. Although the vital rates forming the basis for these calculations may have changed since the data were collected, our approach should be useful for gaining a clearer understanding of how anthropogenic mortality affects the health of raptor populations, particularly those species with delayed

  17. Quantifying the demographic cost of human-related mortality to a raptor population

    PubMed Central

    Grainger Hunt, W.; David Wiens, J.; Law, Peter R.; Fuller, Mark R.; Hunt, Teresa L.; Driscoll, Daniel E.; Jackman, Ronald E.

    2017-01-01

    Raptors are exposed to a wide variety of human-related mortality agents, and yet population-level effects are rarely quantified. Doing so requires modeling vital rates in the context of species life-history, behavior, and population dynamics theory. In this paper, we explore the details of such an analysis by focusing on the demography of a resident, tree-nesting population of golden eagles (Aquila chrysaetos) in the vicinity of an extensive (142 km2) windfarm in California. During 1994–2000, we tracked the fates of >250 radio-marked individuals of four life-stages and conducted five annual surveys of territory occupancy and reproduction. Collisions with wind turbines accounted for 41% of 88 uncensored fatalities, most of which were subadults and nonbreeding adults (floaters). A consistent overall male preponderance in the population meant that females were the limiting sex in this territorial, monogamous species. Estimates of potential population growth rate and associated variance indicated a stable breeding population, but one for which any further decrease in vital rates would require immigrant floaters to fill territory vacancies. Occupancy surveys 5 and 13 years later (2005 and 2013) showed that the nesting population remained intact, and no upward trend was apparent in the proportion of subadult eagles as pair members, a condition that would have suggested a deficit of adult replacements. However, the number of golden eagle pairs required to support windfarm mortality was large. We estimated that the entire annual reproductive output of 216–255 breeding pairs would have been necessary to support published estimates of 55–65 turbine blade-strike fatalities per year. Although the vital rates forming the basis for these calculations may have changed since the data were collected, our approach should be useful for gaining a clearer understanding of how anthropogenic mortality affects the health of raptor populations, particularly those species with delayed

  18. Impact of work-related cancers in Taiwan-Estimation with QALY (quality-adjusted life year) and healthcare costs.

    PubMed

    Lee, Lukas Jyuhn-Hsiarn; Lin, Cheng-Kuan; Hung, Mei-Chuan; Wang, Jung-Der

    2016-12-01

    This study estimates the annual numbers of eight work-related cancers, total losses of quality-adjusted life years (QALYs), and lifetime healthcare expenditures that possibly could be saved by improving occupational health in Taiwan. Three databases were interlinked: the Taiwan Cancer Registry, the National Mortality Registry, and the National Health Insurance Research Database. Annual numbers of work-related cancers were estimated based on attributable fractions (AFs) abstracted from a literature review. The survival functions for eight cancers were estimated and extrapolated to lifetime using a semi-parametric method. A convenience sample of 8846 measurements of patients' quality of life with EQ-5D was collected for utility values and multiplied by survival functions to estimate quality-adjusted life expectancies (QALEs). The loss-of-QALE was obtained by subtracting the QALE of cancer from age- and sex-matched referents simulated from national vital statistics. The lifetime healthcare expenditures were estimated by multiplying the survival probability with mean monthly costs paid by the National Health Insurance for cancer diagnosis and treatment and summing this for the expected lifetime. A total of 3010 males and 726 females with eight work-related cancers were estimated in 2010. Among them, lung cancer ranked first in terms of QALY loss, with an annual total loss-of-QALE of 28,463 QALYs and total lifetime healthcare expenditures of US$36.6 million. Successful prevention of eight work-related cancers would not only avoid the occurrence of 3736 cases of cancer, but would also save more than US$70 million in healthcare costs and 46,750 QALYs for the Taiwan society in 2010.

  19. 49 CFR 195.108 - External pressure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false External pressure. 195.108 Section 195.108 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Design Requirements § 195.108 External pressure. Any external pressure that will be exerted on...

  20. 49 CFR 195.108 - External pressure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false External pressure. 195.108 Section 195.108 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Design Requirements § 195.108 External pressure. Any external pressure that will be exerted on...

  1. 49 CFR 195.108 - External pressure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false External pressure. 195.108 Section 195.108 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Design Requirements § 195.108 External pressure. Any external pressure that will be exerted on...

  2. 49 CFR 195.108 - External pressure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false External pressure. 195.108 Section 195.108 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Design Requirements § 195.108 External pressure. Any external pressure that will be exerted on...

  3. 49 CFR 195.108 - External pressure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false External pressure. 195.108 Section 195.108 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Design Requirements § 195.108 External pressure. Any external pressure that will be exerted on...

  4. Cost-related nonadherence to prescribed medicines among older Canadians in 2014: a cross-sectional analysis of a telephone survey

    PubMed Central

    Lee, Augustine; Morgan, Steve

    2017-01-01

    Background: Canadians receive universal coverage for medically necessary hospital and physician services, but pharmaceutical coverage is incomplete. We sought to assess the effects of cost on access to medicines among older Canadians using data from a large survey conducted in 2014. Methods: This is a cross-sectional analysis of data from the Commonwealth Fund's 2014 International Health Policy Survey of Older Adults. Our primary outcome variable was self-reported cost-related nonadherence in the form of either not filling a prescription or skipping doses within the last 12 months because of out-of-pocket costs. We computed sample-weighted estimates of the population prevalence of cost-related nonadherence and conducted logistic regression analyses to determine associated factors. Results: We estimate that the prevalence of cost-related nonadherence in 2014 among Canadians aged 55 years and older was 8.3% (about 1 in 12). The population prevalence and adjusted odds of cost-related nonadherence was significantly higher among Canadians who were younger, in worse health, poorer or without private health insurance. Regional differences in population prevalence of cost-related nonadherence were not significant. The only provincial or regional difference in the adjusted odds of cost-related nonadherence was that residents of Quebec aged 55-64 years were about half as likely to report nonadherence as similarly aged residents of Ontario, our reference province (adjusted odds ratio 0.49, 95% confidence interval 0.29-0.82). Interpretation: The financial accessibility of prescription medicines still is a substantial public health issue in Canada that affects 1 in 12 Canadians older than 55 years of age. Older Canadians at greatest risk of cost-related nonadherence to prescribed treatments are those with low incomes and those without private insurance to cover costs not covered by public programs.

  5. Energy metabolism of rabbit retina as related to function: high cost of Na+ transport.

    PubMed

    Ames, A; Li, Y Y; Heher, E C; Kimble, C R

    1992-03-01

    . Changes in temperature caused changes in the amplitude of light-evoked electrical responses of 6.5% per degree and caused changes in both O2 consumption and glycolysis of 6.8% per degree (Q10 = 1.9). A surprisingly large fraction of oxidative energy, corresponding to about 40% of the total energy generated, could not be assigned to phototransduction, to neurotransmission, to Na+ transport for other purposes, or to vegetative metabolism. We cannot account for its usage, but it may be related to the (previously reported) rapid turnover of the gamma-phosphate of retinal GTP, the function of which also remains unknown.(ABSTRACT TRUNCATED AT 400 WORDS)

  6. Relating Child Care during Infancy to Externalizing and Internalizing Behaviors in Toddlerhood: How Specific Features of Child Care Quality Matter Depending on a Child's Gender and Temperament

    ERIC Educational Resources Information Center

    Lemay, Lise; Bigras, Nathalie; Bouchard, Caroline

    2014-01-01

    This study explored whether the relationships between specific features of child care quality and externalizing and internalizing behaviors in 24-month-old children are moderated by gender and temperament. Questionnaires were used to record children's gender and measure their temperament. Child care quality was observed with the "Échelles…

  7. External Ballistics. Part 1

    DTIC Science & Technology

    1978-07-11

    clcsely related with aezodyzasics, ky gzavtaetry and the thecry cf the figure of Earth , by metecrology. Ballistic calculatica Sives all the bamic data...external tallistics. %he conteaFcrary state of the sciemce of the action cf rcckets and artillery ste]l cf different t)pes is such, that many of the e...height. L- 14near distance ovX tOf surface of thq Earth . ol - crbital velocity. V-1 - escape velocity. 2v_ - range angle. S- eaight of projqctile. Q

  8. 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.

  9. Measuring Use and Cost of Health Sector and Related Care in a Population of Girls and Young Women with Rett Syndrome

    ERIC Educational Resources Information Center

    Hendrie, Delia; Bebbington, Ami; Bower, Carol; Leonard, Helen

    2011-01-01

    This study measured use and cost of health sector and related services in Rett syndrome and effects of socio-demographic, clinical severity and genetic factors on costs. The study population consisted of individuals with Rett syndrome registered with the Australian Rett Syndrome Database in 2004. Descriptive analysis was used to examine patterns…

  10. External referencing and pharmaceutical price negotiation.

    PubMed

    Garcia Mariñoso, Begoña; Jelovac, Izabela; Olivella, Pau

    2011-06-01

    External referencing (ER) imposes a price cap for pharmaceuticals, based on prices of identical or comparable products in foreign countries. Suppose a foreign country (F) negotiates prices with a pharmaceutical firm, whereas a home country (H) can either negotiate prices independently or implement ER, based on the foreign price. We show that country H prefers ER if copayments in H are relatively high. This preference is reinforced when H's population is small. Irrespective of relative country sizes, ER by country H harms country F. Our model is inspired by the wide European experience with this cost-containment policy. Namely, in Europe, drug authorization and price negotiations are carried out by separate agencies. We confirm our main results in two extensions. The first one allows for therapeutic competition between drugs. In the second one, drug authorization and price negotiation take place in a single agency.

  11. Donor impurity states and related terahertz range nonlinear optical response in GaN cylindrical quantum wires: Effects of external electric and magnetic fields

    SciTech Connect

    Correa, J. D.; Mora-Ramos, M. E.; Duque, C. A.

    2014-06-07

    We report a study on the optical absorption coefficient associated to hydrogenic impurity interstate transitions in zinc-blende GaN quantum wires of cylindrical shape taking into account the effects of externally applied static electric and magnetic fields. The electron states emerge within the effective mass approximation, via the exact diagonalization of the donor-impurity Hamiltonian with parabolic confinement and external field effects. The nonlinear optical absorption is calculated using a recently derived expression for the dielectric susceptibility, obtained via a nonperturbative solution of the density-matrix Bloch equation. Our results show that this treatment eliminates not only the intensity-dependent bleaching effect but also the change in sign of the nonlinear contribution due to the combined effect of asymmetric impurity location and the applied electric field.

  12. Donor impurity states and related terahertz range nonlinear optical response in GaN cylindrical quantum wires: Effects of external electric and magnetic fields

    NASA Astrophysics Data System (ADS)

    Correa, J. D.; Mora-Ramos, M. E.; Duque, C. A.

    2014-06-01

    We report a study on the optical absorption coefficient associated to hydrogenic impurity interstate transitions in zinc-blende GaN quantum wires of cylindrical shape taking into account the effects of externally applied static electric and magnetic fields. The electron states emerge within the effective mass approximation, via the exact diagonalization of the donor-impurity Hamiltonian with parabolic confinement and external field effects. The nonlinear optical absorption is calculated using a recently derived expression for the dielectric susceptibility, obtained via a nonperturbative solution of the density-matrix Bloch equation. Our results show that this treatment eliminates not only the intensity-dependent bleaching effect but also the change in sign of the nonlinear contribution due to the combined effect of asymmetric impurity location and the applied electric field.

  13. 40 CFR 35.3520 - Systems, projects, and project-related costs eligible for assistance from the Fund.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... Capacity to serve future population growth cannot be a substantial portion of a project. (c) Eligible... costs are eligible for assistance from the Fund: (1) Costs for planning and design and associated pre-project costs. A State that makes a loan for only planning and design is not required to...

  14. Does increasing community and liquor licensees' awareness, police activity, and feedback reduce alcohol-related violent crime? A benefit-cost analysis.

    PubMed

    Navarro, Héctor José; Shakeshaft, Anthony; Doran, Christopher M; Petrie, Dennis J

    2013-10-28

    Approximately half of all alcohol-related crime is violent crime associated with heavy episodic drinking. Multi-component interventions are highly acceptable to communities and may be effective in reducing alcohol-related crime generally, but their impact on alcohol-related violent crime has not been examined. This study evaluated the impact and benefit-cost of a multi-component intervention (increasing community and liquor licensees' awareness, police activity, and feedback) on crimes typically associated with alcohol-related violence. The intervention was tailored to weekends identified as historically problematic in 10 experimental communities in NSW, Australia, relative to 10 control ones. There was no effect on alcohol-related assaults and a small, but statistically significant and cost-beneficial, effect on alcohol-related sexual assaults: a 64% reduction in in the experimental relative to control communities, equivalent to five fewer alcohol-related sexual assaults, with a net social benefit estimated as AUD$3,938,218. The positive benefit-cost ratio was primarily a function of the value that communities placed on reducing alcohol-related harm: the intervention would need to be more than twice as effective for its economic benefits to be comparable to its costs. It is most likely that greater reductions in crimes associated with alcohol-related violence would be achieved by a combination of complementary legislative and community-based interventions.

  15. Non-Traumatic Dental Condition-Related Emergency Department Visits and Associated Costs for Children and Adults with Autism Spectrum Disorders

    PubMed Central

    Nakao, Sy; Scott, JoAnna M.; Masterson, Erin E.; Chi, Donald L.

    2014-01-01

    We analyzed 2010 U.S. National Emergency Department Sample data and ran regression models to test the hypotheses that individuals with ASD are more likely to have non-traumatic dental condition (NTDC)-related emergency department (ED) visits and to incur greater costs for these visits than those without ASD. There were nearly 2.3 million NTDC-related ED visits in 2010. Less than 1.0% (children) and 2.1% (adults) of all ED visits were for NTDC. There was no significant difference in NTDC-related ED visits or costs for children by ASD status. Adults with ASD had significantly lower odds of NTDC-related ED visits (OR=0.39; 95% CI: 0.29, 0.52; P<0.001) but incurred significantly greater mean costs for NTDC-related ED visits (P<0.006) than did adults without ASD. PMID:25374135

  16. External artery heat pipe

    NASA Technical Reports Server (NTRS)

    Gernert, Nelson J. (Inventor); Ernst, Donald M. (Inventor); Shaubach, Robert M. (Inventor)

    1989-01-01

    An improved heat pipe with an external artery. The longitudinal slot in the heat pipe wall which interconnects the heat pipe vapor space with the external artery is completely filled with sintered wick material and the wall of the external artery is also covered with sintered wick material. This added wick structure assures that the external artery will continue to feed liquid to the heat pipe evaporator even if a vapor bubble forms within and would otherwise block the liquid transport function of the external artery.

  17. Cost analysis of a hospital-wide selective screening programme for methicillin-resistant Staphylococcus aureus (MRSA) carriers in the context of diagnosis related groups (DRG) payment.

    PubMed

    Wernitz, M H; Keck, S; Swidsinski, S; Schulz, S; Veit, S K

    2005-06-01

    The costs of a hospital-wide selective screening programme were analysed for a period of 19 months. During this time, 539 inpatients were screened, of whom 111 were MRSA-positive. Based on microbiological costs (staff and materials) and the costs of preventive contact isolation for 2 days until microbiological results were available (including material costs for medical consumable goods and the costs of additional nursing time), a total of 26,241.51 Euro was spent for the 539 patients screened. Based on cost units, the costs were 39.96 Euro for a patient found to be MRSA-negative and 82.33 Euro for a patient found to be MRSA-positive. Under the prospective diagnosis related groups (DRG) payment system in Germany, the costs of a prolonged hospital stay resulting from a hospital-acquired MRSA infection (HA-MRSA-I) are not reimbursed adequately by revenues, with a calculated average cost-revenue loss/patient with HA-MRSA-I of 5705.75 Euro. The screening programme was able to prevent 48% of predicted HA-MRSA-Is (35.2 patients with infection), thereby saving a predicted 200,782.73 Euro. After subtracting the screening costs, there was a net saving of 110,236.56 Euro annually. A sensitivity analysis of the break-even points for different screening frequencies and different MRSA incidence rates indicated that the screening programme became cost-effective at a low MRSA incidence rate, meaning that it can be recommended for most hospitals with an MRSA problem.

  18. External Measures of Cognition

    PubMed Central

    Cairό, Osvaldo

    2011-01-01

    The human brain is undoubtedly the most impressive, complex, and intricate organ that has evolved over time. It is also probably the least understood, and for that reason, the one that is currently attracting the most attention. In fact, the number of comparative analyses that focus on the evolution of brain size in Homo sapiens and other species has increased dramatically in recent years. In neuroscience, no other issue has generated so much interest and been the topic of so many heated debates as the difference in brain size between socially defined population groups, both its connotations and implications. For over a century, external measures of cognition have been related to intelligence. However, it is still unclear whether these measures actually correspond to cognitive abilities. In summary, this paper must be reviewed with this premise in mind. PMID:22065955

  19. Hanford External Dosimetry Program

    SciTech Connect

    Fix, J.J.

    1990-10-01

    This document describes the Hanford External Dosimetry Program as it is administered by Pacific Northwest Laboratory (PNL) in support of the US Department of Energy (DOE) and its Hanford contractors. Program services include administrating the Hanford personnel dosimeter processing program and ensuring that the related dosimeter data accurately reflect occupational dose received by Hanford personnel or visitors. Specific chapters of this report deal with the following subjects: personnel dosimetry organizations at Hanford and the associated DOE and contractor exposure guidelines; types, characteristics, and procurement of personnel dosimeters used at Hanford; personnel dosimeter identification, acceptance testing, accountability, and exchange; dosimeter processing and data recording practices; standard sources, calibration factors, and calibration processes (including algorithms) used for calibrating Hanford personnel dosimeters; system operating parameters required for assurance of dosimeter processing quality control; special dose evaluation methods applied for individuals under abnormal circumstances (i.e., lost results, etc.); and methods for evaluating personnel doses from nuclear accidents. 1 ref., 14 figs., 5 tabs.

  20. Relative Cost-Effectiveness of Treatments for Adolescent Depression: 36-Week Results from the TADS Randomized Trial

    ERIC Educational Resources Information Center

    Domino, Marisa Elena; Foster, E. Michael; Vitiello, Benedetto; Kratochvil, Christopher J.; Burns, Barbara J.; Silva, Susan G.; Reinecke, Mark A.; March, John S.

    2009-01-01

    Randomized controlled trials that involve 327 participants aged 12 to 18 who were diagnosed with major depression were given either fluoxetine alone, cognitive-behavioral therapy, or a combination of both. Cost-effectiveness acceptability curves suggest that combination treatment is highly likely to be the most cost-effective treatment than…

  1. The social costs of nitrogen.

    PubMed

    Keeler, Bonnie L; Gourevitch, Jesse D; Polasky, Stephen; Isbell, Forest; Tessum, Chris W; Hill, Jason D; Marshall, Julian D

    2016-10-01

    Despite growing recognition of the negative externalities associated with reactive nitrogen (N), the damage costs of N to air, water, and climate remain largely unquantified. We propose a comprehensive approach for estimating the social cost of nitrogen (SCN), defined as the present value of the monetary damages caused by an incremental increase in N. This framework advances N accounting by considering how each form of N causes damages at specific locations as it cascades through the environment. We apply the approach to an empirical example that estimates the SCN for N applied as fertilizer. We track impacts of N through its transformation into atmospheric and aquatic pools and estimate the distribution of associated costs to affected populations. Our results confirm that there is no uniform SCN. Instead, changes in N management will result in different N-related costs depending on where N moves and the location, vulnerability, and preferences of populations affected by N. For example, we found that the SCN per kilogram of N fertilizer applied in Minnesota ranges over several orders of magnitude, from less than $0.001/kg N to greater than $10/kg N, illustrating the importance of considering the site, the form of N, and end points of interest rather than assuming a uniform cost for damages. Our approach for estimating the SCN demonstrates the potential of integrated biophysical and economic models to illuminate the costs and benefits of N and inform more strategic and efficient N management.

  2. The social costs of nitrogen

    PubMed Central

    Keeler, Bonnie L.; Gourevitch, Jesse D.; Polasky, Stephen; Isbell, Forest; Tessum, Chris W.; Hill, Jason D.; Marshall, Julian D.

    2016-01-01

    Despite growing recognition of the negative externalities associated with reactive nitrogen (N), the damage costs of N to air, water, and climate remain largely unquantified. We propose a comprehensive approach for estimating the social cost of nitrogen (SCN), defined as the present value of the monetary damages caused by an incremental increase in N. This framework advances N accounting by considering how each form of N causes damages at specific locations as it cascades through the environment. We apply the approach to an empirical example that estimates the SCN for N applied as fertilizer. We track impacts of N through its transformation into atmospheric and aquatic pools and estimate the distribution of associated costs to affected populations. Our results confirm that there is no uniform SCN. Instead, changes in N management will result in different N-related costs depending on where N moves and the location, vulnerability, and preferences of populations affected by N. For example, we found that the SCN per kilogram of N fertilizer applied in Minnesota ranges over several orders of magnitude, from less than $0.001/kg N to greater than $10/kg N, illustrating the importance of considering the site, the form of N, and end points of interest rather than assuming a uniform cost for damages. Our approach for estimating the SCN demonstrates the potential of integrated biophysical and economic models to illuminate the costs and benefits of N and inform more strategic and efficient N management. PMID:27713926

  3. Cost-effectiveness of anti-oxidant vitamins plus zinc treatment to prevent the progression of intermediate age-related macular degeneration. A Singapore perspective

    PubMed Central

    Saxena, Nakul; George, Pradeep Paul; Heng, Bee Hoon; Lim, Tock Han; Yong, Shao Onn

    2015-01-01

    Purpose: To determine if providing high dose anti-oxidant vitamins and zinc treatment age-related eye disease study (AREDS formulation) to patients with intermediate age-related macular degeneration (AMD) aged 40–79 years from Singapore is cost-effective in preventing progression to wet AMD. Methods: A hypothetical cohort of category 3 and 4 AMD patients from Singapore was followed for 5 calendar years to determine the number of patients who would progress to wet AMD given the following treatment scenarios: (a) AREDS formulation or placebo followed by ranibizumab (as needed) for wet AMD. (b) AREDS formulation or placebo followed by bevacizumab (monthly) for wet AMD. (c) AREDS formulation or placebo followed by aflibercept (VIEW I and II trial treatment regimen). Costs were estimated for the above scenarios from the providers’ perspective, and cost-effectiveness was measured by cost per disability-adjusted life year (DALY) averted with a disability weight of 0.22 for wet AMD. The costs were discounted at an annual rate of 3%. Results: Over 5400 patients could be prevented from progressing to wet AMD cumulatively if AREDS formulation were prescribed. AREDS formulation followed by ranibizumab was cost-effective compared to placebo-ranibizumab or placebo-aflibercept combinations (cost per DALY averted: SGD$23,662.3 and SGD$21,138.8, respectively). However, bevacizumab (monthly injections) alone was more cost-effective compared to AREDS formulation followed by bevacizumab. Conclusion: Prophylactic treatment with AREDS formulation for intermediate AMD patients followed by ranibizumab or for patients who progressed to wet AMD was found to be cost-effective. These findings have implications for intermediate AMD screening, treatment and healthcare planning in Singapore. PMID:26265643

  4. Moderation of the Relation of County-Level Cost of Living to Nutrition by the Supplemental Nutrition Assistance Program

    PubMed Central

    Wimer, Christopher; Seligman, Hilary

    2016-01-01

    Objectives. To examine the association of county-level cost of living with nutrition among low-income Americans. Methods. We used the National Household Food Acquisition and Purchase Survey (2012–2013; n = 14 313; including 5414 persons in households participating in the Supplemental Nutrition Assistance Program [SNAP]) to examine associations between county-level cost-of-living metrics and both food acquisitions and the Healthy Eating Index, with control for individual-, household-, and county-level covariates and accounting for unmeasured confounders influencing both area of living and food acquisition. Results. Living in a higher-cost county—particularly one with high rent costs—was associated with significantly lower volume of acquired vegetables, fruits, and whole grains; greater volume of acquired refined grains, fats and oils, and added sugars; and an 11% lower Healthy Eating Index score. Participation in SNAP was associated with nutritional improvements among persons living in higher-cost counties. Conclusions. Living in a higher-cost county (particularly with high rent costs) is associated with poorer nutrition among low-income Americans, and SNAP may mitigate the negative nutritional impact of high cost of living. PMID:27631742

  5. External tank aft cargo carrier

    NASA Technical Reports Server (NTRS)

    Mobley, T. B.

    1984-01-01

    The External Tank (ET) Aft Cargo Carrier (ACC) is a low cost, low risk augmentation of the Space Transportation System (STS). It almost doubles the cargo volume of the STS while minimally impacting other STS elements (orbiter, ET and solid rocket boosters SRBs, launch facilities and STS operations. In addition to increasing the potential volume of cargo carried on a Shuttle launch, the ACC provides the following additional benefits: (1) Increased STS competitiveness for payloads; (2) Increased cargo manifest flexibility; (3) Increased spacecraft design options; (4) Alternate manifesting for special payloads; and (5) Future space platform/station design options.

  6. External radiation surveillance

    SciTech Connect

    Antonio, E.J.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site.

  7. Accounting for Heterogeneity in Relative Treatment Effects for Use in Cost-Effectiveness Models and Value-of-Information Analyses

    PubMed Central

    Soares, Marta O.; Palmer, Stephen; Ades, Anthony E.; Harrison, David; Shankar-Hari, Manu; Rowan, Kathy M.

    2015-01-01

    Cost-effectiveness analysis (CEA) models are routinely used to inform health care policy. Key model inputs include relative effectiveness of competing treatments, typically informed by meta-analysis. Heterogeneity is ubiquitous in meta-analysis, and random effects models are usually used when there is variability in effects across studies. In the absence of observed treatment effect modifiers, various summaries from the random effects distribution (random effects mean, predictive distribution, random effects distribution, or study-specific estimate [shrunken or independent of other studies]) can be used depending on the relationship between the setting for the decision (population characteristics, treatment definitions, and other contextual factors) and the included studies. If covariates have been measured that could potentially explain the heterogeneity, then these can be included in a meta-regression model. We describe how covariates can be included in a network meta-analysis model and how the output from such an analysis can be used in a CEA model. We outline a model selection procedure to help choose between competing models and stress the importance of clinical input. We illustrate the approach with a health technology assessment of intravenous immunoglobulin for the management of adult patients with severe sepsis in an intensive care setting, which exemplifies how risk of bias information can be incorporated into CEA models. We show that the results of the CEA and value-of-information analyses are sensitive to the model and highlight the importance of sensitivity analyses when conducting CEA in the presence of heterogeneity. The methods presented extend naturally to heterogeneity in other model inputs, such as baseline risk. PMID:25712447

  8. The efficiency of life insurance and family Takaful in Malaysia: Relative efficiency using the stochastic cost frontier analysis

    NASA Astrophysics Data System (ADS)

    Baharin, Roziana; Isa, Zaidi

    2013-04-01

    This paper focuses on the Stochastic cost Frontier Analysis (SFA) approach, in an attempt to measure the relationship between efficiency and organizational structure for Takaful and insurance operators in Malaysia's dual financial system. This study applied a flexible cost functional form i.e., Fourier Flexible Functional Form, for a sample consisting of 19 firms, chosen between 2002 and 2010, by employing the Battese and Coelli invariant efficiency model. The findings show that on average, there is a significant difference in cost efficiency between the Takaful industry and the insurance industry. It was found that Takaful has lower cost efficiency than conventional insurance, which shows that the organization form has an influence on efficiency. Overall, it was observed that the level of efficiency scores for both life insurance and family Takaful do not vary across time.

  9. 75 FR 9142 - Regulations Under I.R.C. Section 7430 Relating to Awards of Administrative Costs and Attorneys...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... Awards of Administrative Costs and Attorneys Fees; Hearing Cancellation AGENCY: Internal Revenue Service... attorneys fees under section 7430 to conform to amendments made in the Taxpayer Relief Act of 1997 and...

  10. Parkinson Symptoms and Health Related Quality of Life as Predictors of Costs: A Longitudinal Observational Study with Linear Mixed Model Analysis

    PubMed Central

    Martinez-Martín, Pablo; Rodriguez-Blazquez, Carmen; Paz, Silvia; Forjaz, Maria João; Frades-Payo, Belén; Cubo, Esther; de Pedro-Cuesta, Jesús; Lizán, Luis

    2015-01-01

    Objective To estimate the magnitude in which Parkinson’s disease (PD) symptoms and health- related quality of life (HRQoL) determined PD costs over a 4-year period. Materials and Methods Data collected during 3-month, each year, for 4 years, from the ELEP study, included sociodemographic, clinical and use of resources information. Costs were calculated yearly, as mean 3-month costs/patient and updated to Spanish €, 2012. Mixed linear models were performed to analyze total, direct and indirect costs based on symptoms and HRQoL. Results One-hundred and seventy four patients were included. Mean (SD) age: 63 (11) years, mean (SD) disease duration: 8 (6) years. Ninety-three percent were HY I, II or III (mild or moderate disease). Forty-nine percent remained in the same stage during the study period. Clinical evaluation and HRQoL scales showed relatively slight changes over time, demonstrating a stable group overall. Mean (SD) PD total costs augmented 92.5%, from €2,082.17 (€2,889.86) in year 1 to €4,008.6 (€7,757.35) in year 4. Total, direct and indirect cost incremented 45.96%, 35.63%, and 69.69% for mild disease, respectively, whereas increased 166.52% for total, 55.68% for direct and 347.85% for indirect cost in patients with moderate PD. For severe patients, cost remained almost the same throughout the study. For each additional point in the SCOPA-Motor scale total costs increased €75.72 (p = 0.0174); for each additional point on SCOPA-Motor and the SCOPA-COG, direct costs incremented €49.21 (p = 0.0094) and €44.81 (p = 0.0404), respectively; and for each extra point on the pain scale, indirect costs increased €16.31 (p = 0.0228). Conclusions PD is an expensive disease in Spain. Disease progression and severity as well as motor and cognitive dysfunctions are major drivers of costs increments. Therapeutic measures aimed at controlling progression and symptoms could help contain disease expenses. PMID:26698860

  11. Costs and cost containment in nursing homes.

    PubMed Central

    Smith, H L; Fottler, M D

    1981-01-01

    The study examines the impact of structural and process variables on the cost of nursing home care and the utilization of various cost containment methods in 43 california nursing homes. Several predictors were statistically significant in their relation to cost per patient day. A diverse range of cost containment techniques was discovered along with strong predictors of the utilization of these techniques by nursing home administrators. The trade-off between quality of care and cost of care is discussed. PMID:7228713

  12. Cost-effectiveness of health-related lifestyle advice delivered by peer or lay advisors: synthesis of evidence from a systematic review

    PubMed Central

    2013-01-01

    Background Development of new peer or lay health-related lifestyle advisor (HRLA) roles is one response to the need to enhance public engagement in, and improve cost-effectiveness of, health improvement interventions. This article synthesises evidence on the cost-effectiveness of HRLA interventions aimed at adults in developed countries, derived from the first systematic review of the effectiveness, cost-effectiveness, equity and acceptability of different types of HRLA role. Methods The best available evidence on the cost-effectiveness of HRLA interventions was obtained using systematic searches of 20 electronic databases and key journals, as well as searches of the grey literature and the internet. Interventions were classified according to the primary health behaviour targeted and intervention costs were estimated where necessary. Lifetime health gains were estimated (in quality-adjusted life years, where possible), based on evidence of effectiveness of HRLAs in combination with published estimates of the lifetime health gains resulting from lifestyle changes, and assumptions over relapse. Incremental cost-effectiveness ratios are reported. Results Evidence of the cost-effectiveness of HRLAs was identified from 24 trials included in the systematic review. The interventions were grouped into eight areas. We found little evidence of effectiveness of HRLAs for promotion of exercise/improved diets. Where HRLAs were effective cost-effectiveness varied considerably: Incremental Cost effectiveness Ratios were estimated at £6,000 for smoking cessation; £14,000 for a telephone based type 2 diabetes management; and £250,000 or greater for promotion of mammography attendance and for HIV prevention amongst drug users. We lacked sufficient evidence to estimate ICERs for breastfeeding promotion and mental health promotion, or to assess the impact of HRLAs on health inequalities. Conclusions Overall, there is limited evidence suggesting that HRLAs are cost-effective in

  13. ASSESSMENTOF BETA PARTICLE FLUX FROM SURFACE CONTAMINATION AS A RELATIVE INDICATOR FOR RADIONUCLIDE DISTRIBUTION ON EXTERNAL SURFACES OF A MULTI-STORY BUILDING IN PRIPYAT

    SciTech Connect

    Farfan, E.

    2009-11-17

    How would we recover if a Radiological Dispersion Device (e.g., dirty bomb) or Improvised Nuclear Device were to detonate in a large city? In order to assess the feasibility of remediation following such an event, several issues would have to be considered, including the levels and characteristics of the radioactive contamination, the availability of the required resources to accomplish decontamination, and the planned future use of the city's structures and buildings. Presently little is known about the distribution, redistribution, and migration of radionuclides in an urban environment. However, Pripyat, a city substantially contaminated by the Chernobyl Nuclear Power Plant accident, may provide some answers. The main objective of this study was to determine the radionuclide distribution on a Pripyat multi-story building, which had not been previously decontaminated and therefore could reflect the initial fallout and its further natural redistribution on external surfaces. The 7-story building selected was surveyed from the ground floor to the roof on horizontal and vertical surfaces along seven ground-to-roof transections. Some of the results from this study indicate that the upper floors of the building had higher contamination levels than the lower floors. The authors consequently recommend that existing decontamination procedures for tall structures be re-examined and modified accordingly.

  14. Cost-effectiveness of ranibizumab and bevacizumab for age-related macular degeneration: 2-year findings from the IVAN randomised trial

    PubMed Central

    Dakin, Helen A; Wordsworth, Sarah; Rogers, Chris A; Abangma, Giselle; Raftery, James; Harding, Simon P; Lotery, Andrew J; Downes, Susan M; Chakravarthy, Usha; Reeves, Barnaby C

    2014-01-01

    Objective To assess the incremental cost and cost-effectiveness of continuous and discontinuous regimens of bevacizumab (Avastin) and ranibizumab (Lucentis) for neovascular age-related macular degeneration (nAMD) from a UK National Health Service (NHS) perspective. Design A within-trial cost-utility analysis with a 2-year time horizon, based on a multicentre factorial, non-inferiority randomised controlled trial. Setting 23 hospital ophthalmology clinics. Participants 610 patients aged ≥50 years with untreated nAMD in the study eye. Interventions 0.5 mg ranibizumab or 1.25 mg bevacizumab given continuously (monthly) or discontinuously (as-needed) for 2 years. Main outcome measures Quality-adjusted life-years (QALYs). Results Total 2-year costs ranged from £3002/patient ($4700; 95% CI £2601 to £3403) for discontinuous bevacizumab to £18 590/patient ($29 106; 95% CI £18 258 to £18 922) for continuous ranibizumab. Ranibizumab was significantly more costly than bevacizumab for both continuous (+£14 989/patient ($23 468); 95% CI £14 522 to £15 456; p<0.001) and discontinuous treatment (+£8498 ($13 305); 95% CI £7700 to £9295; p<0.001), with negligible difference in QALYs. Continuous ranibizumab would only be cost-effective compared with continuous bevacizumab if the NHS were willing to pay £3.5 million ($5.5 million) per additional QALY gained. Patients receiving continuous bevacizumab accrued higher total costs (+£599 ($938); 95% CI £91 to £1107; p=0.021) than those receiving discontinuous bevacizumab, but also accrued non-significantly more QALYs (+0.020; 95% CI −0.032 to 0.071; p=0.452). Continuous bevacizumab therefore cost £30 220 ($47 316) per QALY gained versus discontinuous bevacizumab. However, bootstrapping demonstrated that if the NHS is willing to pay £20 000/QALY gained, there is a 37% chance that continuous bevacizumab is cost-effective versus discontinuous bevacizumab. Conclusions Ranibizumab is not

  15. How Well Do All Patient Refined–Diagnosis-Related Groups Explain Costs of Pediatric Cancer Chemotherapy Admissions in the United States?

    PubMed Central

    Street, Andrew; Ho, Vivian

    2016-01-01

    Purpose: State-based Medicaid programs have begun using All Patient Refined–Diagnosis-Related Groups (APR-DRGs) to determine hospital reimbursement rates. Medicaid provides coverage for 45% of childhood cancer admissions. This study aimed to examine how well APR-DRGs reflect admission costs for childhood cancer chemotherapy to inform clinicians, hospitals, and policymakers in the wake of policy changes. Methods: We identified 25,613 chemotherapy admissions in the 2009 Kids’ Inpatient Database. To determine how well APR-DRGs explain costs, we applied a hierarchic linear regression model of hospital costs, allowing for a variety of patient, hospital, and geographic confounders. Results: APR-DRGs proved to be the most important predictors of admission costs (P < .001), with costs increasing by DRG severity code. Diagnosis, age, and hospital characteristics also predicted costs above and beyond those explained by APR-DRGs. Compared with admissions for patients with acute lymphoblastic leukemia, costs of admissions for patients with acute myelomonocytic leukemia were 82% higher; non-Hodgkin lymphoma, 20% higher; Hodgkin lymphoma, 25% lower; and CNS tumors, 27% lower. Admissions for children who were 10 years of age or older cost 26% to 35% more than admissions for infants. Admissions to children’s hospitals cost 46% more than admissions to other hospital types. Conclusion: APR-DRGs developed for adults are applicable to childhood cancer chemotherapy but should be refined to account for cancer diagnosis and patient age. Possible policy and clinical management changes merit further study to address factors not captured by APR-DRGs. PMID:27118158

  16. Mind the Gap! A Multilevel Analysis of Factors Related to Variation in Published Cost-Effectiveness Estimates within and between Countries

    PubMed Central

    Boehler, Christian E. H.; Lord, Joanne

    2016-01-01

    Background. Published cost-effectiveness estimates can vary considerably, both within and between countries. Despite extensive discussion, little is known empirically about factors relating to these variations. Objectives. To use multilevel statistical modeling to integrate cost-effectiveness estimates from published economic evaluations to investigate potential causes of variation. Methods. Cost-effectiveness studies of statins for cardiovascular disease prevention were identified by systematic review. Estimates of incremental costs and effects were extracted from reported base case, sensitivity, and subgroup analyses, with estimates grouped in studies and in countries. Three bivariate models were developed: a cross-classified model to accommodate data from multinational studies, a hierarchical model with multinational data allocated to a single category at country level, and a hierarchical model excluding multinational data. Covariates at different levels were drawn from a long list of factors suggested in the literature. Results. We found 67 studies reporting 2094 cost-effectiveness estimates relating to 23 countries (6 studies reporting for more than 1 country). Data and study-level covariates included patient characteristics, intervention and comparator cost, and some study methods (e.g., discount rates and time horizon). After adjusting for these factors, the proportion of variation attributable to countries was negligible in the cross-classified model but moderate in the hierarchical models (14%−19% of total variance). Country-level variables that improved the fit of the hierarchical models included measures of income and health care finance, health care resources, and population risks. Conclusions. Our analysis suggested that variability in published cost-effectiveness estimates is related more to differences in study methods than to differences in national context. Multinational studies were associated with much lower country-level variation than single

  17. External approach to rhinoplasty.

    PubMed

    Goodman, Wilfred S; Charbonneau, Paul A

    2015-07-01

    The technique of external rhinoplasty is outlined. Having reviewed 74 cases, its advantages and disadvantages are discussed. Reluctance to use this external approach seems to be based on emotional rather than radical grounds, for its seems to be the procedure of choice for many problems.

  18. Relative weight-related costs of healthcare use by children--results from the two German birth cohorts, GINI-plus and LISA-plus.

    PubMed

    Breitfelder, Ariane; Wenig, Christina M; Wolfenstetter, Silke B; Rzehak, Peter; Menn, Petra; John, Jürgen; Leidl, Reiner; Bauer, Carl Peter; Koletzko, Sibylle; Röder, Stefan; Herbarth, Olf; von Berg, Andrea; Berdel, Dietrich; Krämer, Ursula; Schaaf, Beate; Wichmann, H-Erich; Heinrich, Joachim

    2011-07-01

    Obesity among children and adolescents is a growing public health burden. According to a national reference among German children and adolescents aged 3-17 years, 15% are overweight (including obese) and 6.3% are obese. This study aims to assess the economic burden associated with overweight and obesity in children based on a cross-sectional survey from two birth cohort studies: the GINI-plus - German Infant Nutritional Intervention plus Non-Intervention study (3287 respondents aged 9 to <12 years) and the LISA-plus study - Influence of life-style factors on the development of the immune system and allergies in East and West Germany (1762 respondents aged 9 to <12 years). Using a bottom-up approach, we analyse direct costs induced by the utilisation of healthcare services and indirect costs emerging from parents' productivity losses. To investigate the impact of Body Mass Index (BMI) on costs, we perform various descriptive analyses and estimate a two-part regression model. Average annual total direct medical costs of healthcare use are estimated to be €418 (95% CI [346-511]) per child, split between physician (22%), therapist (29%), hospital (41%) and inpatient rehabilitation costs (8%). Bivariate analysis shows considerable differences between BMI groups: €469 (severely underweight), €468 (underweight), €402 (normal weight), €468 (overweight) and €680 (obese). Indirect costs make up €101 per year on average and tend to be higher for obese children, although this was not statistically significant. Drawing on these results, differences in healthcare costs between BMI groups are already apparent in children.

  19. Restricted access molecularly imprinted polymers obtained by bovine serum albumin and/or hydrophilic monomers' external layers: a comparison related to physical and chemical properties.

    PubMed

    Santos, Mariane Gonçalves; Moraes, Gabriel de Oliveira Isac; Nakamura, Maurício Gustavo; dos Santos-Neto, Álvaro José; Figueiredo, Eduardo Costa

    2015-11-21

    Molecularly imprinting polymers (MIPs) can be modified with external layers in order to obtain restricted access molecularly imprinted polymers (RAMIPs) able to exclude macromolecules and retain low weight compounds. These modifications have been frequently achieved using hydrophilic monomers, chemically bound on the MIP surface. Recently, our group proposed a new biocompatible RAMIP based on the formation of a bovine serum albumin coating on the surface of MIP particles. This material has been used to extract drugs directly from untreated human plasma samples, but its physicochemical evaluation has not been carried out yet, mainly in comparison with RAMIPs obtained by hydrophilic monomers. Thus, we proposed in this paper a comparative study involving the surface composition, microscopic aspect, selectivity, binding kinetics, adsorption and macromolecule elimination ability of these different materials. We concluded that the synthesis procedure influences the size and shape of particles and that hydrophilic co-monomer addition as well as coating with BSA do not alter the chemical recognition ability of the material. The difference between imprinted and non-imprinted polymers' adsorption was evident (suggesting that imprinted polymers have a better capacity to bind the template than the non-imprinted ones). The Langmuir model presents the best fit to describe the materials' adsorption profile. The polymer covered with hydrophilic monomers presented the best adsorption for the template in an aqueous medium, probably due to a hydrophilic layer on its surface. We also concluded that an association of the hydrophilic monomers with the bovine serum albumin coating is important to obtain materials with higher capacity of macromolecule exclusion.

  20. Shared networks of interpreter services, at relatively low cost, can help providers serve patients with limited english skills.

    PubMed

    Jacobs, Elizabeth A; Leos, Ginelle Sanchez; Rathouz, Paul J; Fu, Paul

    2011-10-01

    Language barriers in health care-a large and growing problem in the United States-contribute to disparities in health care quality and outcomes in populations with limited English proficiency. Providing access to adequate interpreter services has been shown to reduce health disparities in these populations. However, many health care organizations do not provide such services because of the perceived high cost. In this observational study we calculated the costs incurred by a group of California public hospitals that formed a network to make trained interpreters available via videoconference and telephone. We found that encounters in this network where interpreters helped patients and providers communicate lasted an average of 10.6 minutes and cost an average of $24.86 per encounter. Such costs should be weighed against the likely alternatives, such as the opportunity costs of having other hospital staff act as ad hoc interpreters; medical errors that could result from inadequate interpretation; and the fact that not providing such services may leave providers out of compliance with federal law. We also discuss ways in which providers could be compensated for providing interpreter services.

  1. On the externalization of auditory images

    NASA Technical Reports Server (NTRS)

    Durlach, N. I.; Rigopulos, A.; Pang, X. D.; Woods, W. S.; Kulkarni, A.; Colburn, H. S.; Wenzel, E. M.

    1992-01-01

    An acoustic image is said to be 'externalized' if the sound source appears to the listener to lie outside the head. The purpose of the note is to put the phenomenon of externalization of auditory images in proper perspective. It points out that the listener's pinnae (the so-called 'pinna factor') is only one of many factors that determine the extent to which a sound image is externalized and that the relative importance of these factors is not yet clear. The note begins with some general comments on externalization. It then considers the effect of reverberation. It examines head movements, visual effects, and other factors. It concludes with remarks on externalization's relation to head-related transfer functions (HRTFs), the pinna factor, and improved experimental instrumentation.

  2. Transmission rates, screening methods and costs of MRSA--a systematic literature review related to the prevalence in Germany.

    PubMed

    Tübbicke, A; Hübner, C; Kramer, A; Hübner, N-O; Fleßa, S

    2012-10-01

    Methicillin-resistant Staphylococcus aureus (MRSA) infections represent a serious challenge for health care institutions, which is inherent in the combination of prevalence, transmission rates and costs. Furthermore, performing an MRSA screening requires information on the complex system of effectiveness, accuracy and costs of different screening methods. The purpose of this study was to give an overview of parameters with decisive significance for the burden of MRSA and the selection of a specific MRSA screening strategy. A systematic literature search for peer-reviewed health economic studies associated with MRSA was performed (from 1995 to the present). Eighty-seven different studies met all inclusion and exclusion criteria. Primary outcomes included the prevalence of MRSA, MRSA transmission rates, performance characteristics of MRSA screening methods, costs for pre-emptive isolation precautions and costs per MRSA case. The prevalence rates reported for all inpatients (1.2-5.3 %) as well as for inpatients with risk factors or patients in risk areas (3.85-20.6 %) vary greatly. The range of cross-transmission rates per day reported for patients with MRSA in isolation is 0.00081-0.009 and for carriers not in isolation is 0.00137-0.140, respectively. For polymerase chain reaction (PCR) methods, the mean sensitivity and specificity were 91.09 and 95.79 %, respectively. Culture methods show an average sensitivity of 89.01 % and an average specificity of 93.21 %. The turn-around time for PCR methods averages 15 h, while for the culture method, it can only be estimated as 48-72 h. This review filtered important parameters and cost drivers, and covered them with literature-based averages. These findings serve as an ideal evidence base for further health economic considerations of the cost-effectiveness of different MRSA screening methods.

  3. Forms of Spanking and Children's Externalizing Behaviors

    ERIC Educational Resources Information Center

    Lansford, Jennifer E.; Wager, Laura B.; Bates, John E.; Pettit, Gregory S.; Dodge, Kenneth A.

    2012-01-01

    Research suggests that corporal punishment is related to higher levels of child externalizing behavior, but there has been controversy regarding whether infrequent, mild spanking predicts child externalizing or whether more severe and frequent forms of corporal punishment account for the link. Mothers rated the frequency with which they spanked…

  4. An Investigation of the Cost-Benefits and Consumer Outcomes Related to Competency Based Education In a Community College Nursing Program. Final Report, 1973-74.

    ERIC Educational Resources Information Center

    Mount Hood Community Coll., Gresham, OR.

    Three final reports on a competency-based computer-assisted nursing education program at Mt. Hood Community College include the following: (1) the examination and refinement of curricular outcomes; (2) cost analysis of the program relative to nursing education, learner benefits, and effectiveness; and (3) an examination of the relationship between…

  5. Non-Traumatic Dental Condition-Related Emergency Department Visits and Associated Costs for Children and Adults with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Nakao, Sy; Scott, JoAnna M.; Masterson, Erin E.; Chi, Donald L.

    2015-01-01

    We analyzed 2010 US National Emergency Department Sample data and ran regression models to test the hypotheses that individuals with ASD are more likely to have non-traumatic dental condition (NTDC)-related emergency department (ED) visits and to incur greater costs for these visits than those without ASD. There were nearly 2.3 million…

  6. Evaluation of cost of treatment of drug-related events in a tertiary care public sector hospital in Northern India: a prospective study

    PubMed Central

    Pattanaik, Smita; Dhamija, Punit; Malhotra, Samir; Sharma, Navneet; Pandhi, Promila

    2009-01-01

    AIMS Drug related events (DREs) contribute significantly to hospital admissions. These are largely preventable events and require optimum use of the therapeutic agents. The study was conducted to analyze the cost of treatment of DREs. PATIENTS & METHODS All visits to medical emergency department of a tertiary care public sector hospital in northern India were recorded in a prospective, non-interventional manner over a period of 4 months. DREs were recognized and were followed up till their stay in the hospital. Data about the cost generating components of direct and indirect costs of treatment of DREs were collected. The projected cost of treatment of the same DREs in a private sector hospital was estimated and compared. RESULTS Out of 1833 admissions, 92(5.01%) were due to DREs. Maximum cases were due to non compliance (66%) followed by ADR (28%) and drug overdose(6%). The common DREs leading to ED visits were cerebrovascular accident(19.44%), followed by accelerated hypertension(18.36%) and diabetic ketoacidosis(14.04%). Total cost of management of all the 92 DREs in our hospital was calculated to be INR17,37,339(€30,215). The direct cost was INR1,72,961(€3008) and the approximate indirect cost was INR15,64, 378(€27, 206). The projected cost of management of all the 92 DREs was estimated to be INR63,63,872(€1,01, 676) in a private sector hospital. CONCLUSION The study shows that ADEs leading to emergency department visits and hospitalizations constitute a significant economic burden. Training of the patients and the prescribers may lessen the economic burden on the patient as well as the health care system. PMID:19523017

  7. When is Genomic Testing Cost-Effective? Testing for Lynch Syndrome in Patients with Newly-Diagnosed Colorectal Cancer and Their Relatives

    PubMed Central

    Grosse, Scott D.

    2015-01-01

    Varying estimates of the cost-effectiveness of genomic testing applications can reflect differences in study questions, settings, methods and assumptions. This review compares recently published cost-effectiveness analyses of testing strategies for Lynch Syndrome (LS) in tumors from patients newly diagnosed with colorectal cancer (CRC) for either all adult patients or patients up to age 70 along with cascade testing of relatives of probands. Seven studies published from 2010 through 2015 were identified and summarized. Five studies analyzed the universal offer of testing to adult patients with CRC and two others analyzed testing patients up to age 70; all except one reported incremental cost-effectiveness ratios (ICERs) < $ 100,000 per life-year or quality-adjusted life-year gained. Three studies found lower ICERs for selective testing strategies using family history-based predictive models compared with universal testing. However, those calculations were based on estimates of sensitivity of predictive models derived from research studies, and it is unclear how sensitive such models are in routine clinical practice. Key model parameters that are influential in ICER estimates included 1) the number of first-degree relatives tested per proband identified with LS and 2) the cost of gene sequencing. Others include the frequency of intensive colonoscopic surveillance, the cost of colonoscopy, and the inclusion of extracolonic surveillance and prevention options. PMID:26473097

  8. Cost related sensitivity analysis for optimal operation of a grid-parallel PEM fuel cell power plant

    NASA Astrophysics Data System (ADS)

    El-Sharkh, M. Y.; Tanrioven, M.; Rahman, A.; Alam, M. S.

    Fuel cell power plants (FCPP) as a combined source of heat, power and hydrogen (CHP&H) can be considered as a potential option to supply both thermal and electrical loads. Hydrogen produced from the FCPP can be stored for future use of the FCPP or can be sold for profit. In such a system, tariff rates for purchasing or selling electricity, the fuel cost for the FCPP/thermal load, and hydrogen selling price are the main factors that affect the operational strategy. This paper presents a hybrid evolutionary programming and Hill-Climbing based approach to evaluate the impact of change of the above mentioned cost parameters on the optimal operational strategy of the FCPP. The optimal operational strategy of the FCPP for different tariffs is achieved through the estimation of the following: hourly generated power, the amount of thermal power recovered, power trade with the local grid, and the quantity of hydrogen that can be produced. Results show the importance of optimizing system cost parameters in order to minimize overall operating cost.

  9. An actuarial analysis shows that offering lung cancer screening as an insurance benefit would save lives at relatively low cost.

    PubMed

    Pyenson, Bruce S; Sander, Marcia S; Jiang, Yiding; Kahn, Howard; Mulshine, James L

    2012-04-01

    Lung cancer screening is not established as a public health practice, yet the results of a recent large randomized controlled trial showed that screening with low-dose spiral computed tomography reduces lung cancer mortality. Using actuarial models, this study estimated the costs and benefits of annual lung cancer screening offered as a commercial insurance benefit in the high-risk US population ages 50-64. Assuming current commercial reimbursement rates for treatment, we found that screening would cost about $1 per insured member per month in 2012 dollars. The cost per life-year saved would be below $19,000, an amount that compares favorably with screening for cervical, breast, and colorectal cancers. Our results suggest that commercial insurers should consider lung cancer screening of high-risk individuals to be high-value coverage and provide it as a benefit to people who are at least fifty years old and have a smoking history of thirty pack-years or more. We also believe that payers and patients should demand screening from high-quality, low-cost providers, thus helping set an example of efficient system innovation.

  10. 26 CFR 1.1059A-1 - Limitation on taxpayer's basis or inventory cost in property imported from related persons.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... any way the authority of the Commissioner to increase or decrease the claimed basis or inventory cost... liquidated upon importation, the section 1059A limitation on the undervalued article may be increased up to... increased by the amount of the duty over-paid on Article B, $.20, times 1/.10, up to the amount of...

  11. Proceedings: National conference on environmental externalities

    SciTech Connect

    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 are given in these proceedings. Individual papers are processed separately for databases. (MB)

  12. Results of calculations of external gamma radiation exposure rates from local fallout and the related radionuclide compositions of two hypothetical 1-MT nuclear bursts. Final report

    SciTech Connect

    Hicks, H.

    1984-12-01

    This report presents data on calculated gamma radiation exposure rates and local surface deposition of related radionuclides resulting from two hypothetical 1-Mt nuclear bursts. Calculations are made of the debris from two types of bombs: one containing /sup 235/U as a fissionable material (designated oralloy), the other containing /sup 238/U (designated tuballoy). 4 references.

  13. Forms of Spanking and Children's Externalizing Behaviors.

    PubMed

    Lansford, Jennifer E; Wager, Laura B; Bates, John E; Pettit, Gregory S; Dodge, Kenneth A

    2012-04-01

    Research suggests that corporal punishment is related to higher levels of child externalizing behavior, but there has been controversy regarding whether infrequent, mild spanking predicts child externalizing or whether more severe and frequent forms of corporal punishment account for the link. Mothers rated the frequency with which they spanked and whether they spanked with a hand or object when their child was 6, 7, and 8 years old. Mothers and teachers rated children's externalizing behaviors at each age. Analyses of covariance revealed higher levels of mother-reported externalizing behavior for children who experienced harsh spanking. Structural equation models for children who experienced no spanking or mild spanking only revealed that spanking was related to concurrent and prior, but not subsequent, externalizing. Mild spanking in one year was a risk factor for harsh spanking in the next year. Findings are discussed in the context of efforts to promote children's rights to protection.

  14. Future of External Reporting

    ERIC Educational Resources Information Center

    Powers, Kristina

    2015-01-01

    This chapter builds on prior chapters and focuses on higher education trends on the horizon and the resulting impact on external reporting for institutional researchers. Three practical recommendations and examples for institutional researchers are also presented.

  15. Relative EBV antibody concentrations and cost of standard IVIG and CMV-IVIG for PTLD prophylaxis in solid organ transplant patients.

    PubMed

    Ramirez-Avila, L; Garner, O B; Cherry, J D

    2014-09-01

    Some centers prefer CMV-IVIG over IVIG for the prophylaxis of EBV-related PTLD in solid organ transplant patients. Our objective was to compare the relative dose-related EBV ELISA antibody concentrations and cost of standard IVIG and CMV-IVIG. The concentration of EBV IgG to VCA was analyzed via ELISA in four lots of IVIG and four lots of CMV-IVIG. Relative EBV ELISA antibody concentrations and cost were compared assuming an IVIG dose of 0.5 gm/kg and CMV-IVIG dose of 0.15 gm/kg in a 50-kg patient. The price of IVIG was $70/gm and CMV-IVIG $430/gm. IVIG contains the same EBV antibody concentrations (20 790 ELISA antibody units/mL) than CMV-IVIG (17 430 ELISA antibody units/mL, p > 0.2) in the four lots of each product sampled. When factoring in the dosing scheme for a 50-kg patient, IVIG contains two times more EBV antibody than CMV-IVIG. Yet, CMV-IVIG is 1.8 times more expensive than IVIG ($3225 vs. $1750). In the four lots of each product sampled, IVIG contains more EBV antibodies and costs less than CMV-IVIG when factoring in the dosing scheme. Studies are needed to determine whether there is clinical efficacy of immunoglobulin products for EBV-related PTLD prophylaxis.

  16. 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.

  17. Effectiveness of a Nurse-Led Initiative, Peer-to-Peer Teaching, on Organizational CAUTI Rates and Related Costs.

    PubMed

    Pashnik, Barbara; Creta, Angela; Alberti, Lynette

    2017-02-16

    A nurse-led initiative of peer-to-peer teaching positively impacted organizational incidence of catheter-associated urinary tract infections (CAUTIs). The initiative included validating the competency of the nursing staff, highlighting the importance of CAUTI prevention, identifying CAUTI costs, quantifying the value of nursing care, and supporting nurses as teachers. The project demonstrated that peer-to-peer teaching and competency validation can be effective methods to engage nurses in quality improvement.

  18. Externally modulated theranostic nanoparticles.

    PubMed

    Urban, Cordula; Urban, Alexander S; Charron, Heather; Joshi, Amit

    2013-08-01

    Externally modulated nanoparticles comprise a rapidly advancing class of cancer nanotherapeutics, which combine the favorable tumor accumulation of nanoparticles, with external spatio-temporal control on therapy delivery via optical, magnetic, or ultrasound modalities. The local control on therapy enables higher tumor treatment efficacy, while simultaneously reducing off-target effects. The nanoparticle interactions with external fields have an additional advantage of frequently generating an imaging signal, and thus such agents provide theranostic (both diagnostic and therapeutic) capabilities. In this review, we classify the emerging externally modulated theranostic nanoparticles according to the mode of external control and describe the physiochemical mechanisms underlying the external control of therapy, and illustrate the major embodiments of nanoparticles in each class with proven biological efficacy: (I) electromagnetic radiation in visible and near-infrared range is being exploited for gold based and carbon nanostructures with tunable surface plasmon resonance (SPR) for imaging and photothermal therapy (PTT) of cancer, photochemistry based manipulations are employed for light sensitive liposomes and porphyrin based nanoparticles; (II) Magnetic field based manipulations are being developed for iron-oxide based nanostructures for magnetic resonance imaging (MRI) and magnetothermal therapy; (III) ultrasound based methods are primarily being employed to increase delivery of conventional drugs and nanotherapeutics to tumor sites.

  19. Externally modulated theranostic nanoparticles

    PubMed Central

    Urban, Cordula; Urban, Alexander S.; Charron, Heather; Joshi, Amit

    2013-01-01

    Externally modulated nanoparticles comprise a rapidly advancing class of cancer nanotherapeutics, which combine the favorable tumor accumulation of nanoparticles, with external spatio-temporal control on therapy delivery via optical, magnetic, or ultrasound modalities. The local control on therapy enables higher tumor treatment efficacy, while simultaneously reducing off-target effects. The nanoparticle interactions with external fields have an additional advantage of frequently generating an imaging signal, and thus such agents provide theranostic (both diagnostic and therapeutic) capabilities. In this review, we classify the emerging externally modulated theranostic nanoparticles according to the mode of external control and describe the physiochemical mechanisms underlying the external control of therapy, and illustrate the major embodiments of nanoparticles in each class with proven biological efficacy: (I) electromagnetic radiation in visible and near-infrared range is being exploited for gold based and carbon nanostructures with tunable surface plasmon resonance (SPR) for imaging and photothermal therapy (PTT) of cancer, photochemistry based manipulations are employed for light sensitive liposomes and porphyrin based nanoparticles; (II) Magnetic field based manipulations are being developed for iron-oxide based nanostructures for magnetic resonance imaging (MRI) and magnetothermal therapy; (III) ultrasound based methods are primarily being employed to increase delivery of conventional drugs and nanotherapeutics to tumor sites. PMID:24834381

  20. The Clinical Effectiveness and Cost-Effectiveness of Screening for Age-Related Macular Degeneration in Japan: A Markov Modeling Study

    PubMed Central

    Tamura, Hiroshi; Goto, Rei; Akune, Yoko; Hiratsuka, Yoshimune; Hiragi, Shusuke; Yamada, Masakazu

    2015-01-01

    Objective To investigate the cost-effectiveness of screening and subsequent intervention for age-related macular degeneration (AMD) in Japan. Methods The clinical effectiveness and cost-effectiveness of screening and subsequent intervention for AMD were assessed using a Markov model. The Markov model simulation began at the age of 40 years and concluded at the age of 90 years. The first-eye and second-eye combined model assumed an annual state-transition probability, development of prodromal symptoms, choroidal neovascularization (CNV), and reduction in visual acuity. Anti–vascular-endothelial-growth-factor (anti-VEGF) intravitreal injection therapy and photodynamic therapy (PDT) were performed to treat CNV. Intake of supplements was recommended to patients who had prodromal symptoms and unilateral AMD. Data on prevalence, morbidity, transition probability, utility value of each AMD patient, and treatment costs were obtained from published clinical reports. Results In the base-case analysis, screening for AMD every 5 years, beginning at the age of 50 years, showed a decrease of 41% in the total number of blind patients. The screening program reduced the incidence of blindness more than did the additional intake of supplements. However, the incremental cost-effectiveness ratio (ICER) of screening versus no screening was 27,486,352 Japanese yen (JPY), or 259,942 US dollars (USD) per quality-adjusted life year (QALY). In the sensitivity analysis, prodromal symptom-related factors for AMD had great impacts on the cost-effectiveness of screening. The lowest ICER obtained from the best scenario was 4,913,717 JPY (46,470 USD) per QALY, which was approximately equal to the willingness to pay in Japan. Conclusions Ophthalmologic screening for AMD in adults is highly effective in reducing the number of patients with blindness but not cost-effective as demonstrated by a Markov model based on clinical data from Japan. PMID:26214804

  1. Costs of reproduction as related to the timing of phenological phases in the dioecious Shrub Pistacia lentiscus L.

    PubMed

    Milla, R; Castro-Díez, P; Maestro-Martínez, M; Montserrat-Martí, G

    2006-01-01

    Females of woody dioecious species usually devote more resources to reproduction than males. This may lead to a decrease in female survival and growth. The costs of reproduction, however, can be lightened through a number of mechanisms, as for example avoiding the temporal coincidence of reproduction and vegetative growth. The aim of this study was to evaluate whether males and females of P. lentiscus differ in the timing of their vegetative growth, and to assess whether the sequencing of vegetative growth and reproduction reduces reproductive costs. We monitored phenology in males and females. We also compared male and female allocation of nutrients and biomass in the branch, and the developmental stability of the growing shoots. We did this both prior to and at the end of the fruiting period. Males and females showed similar vegetative and flowering phenologies. Males invested more biomass in flowering, but the sexes showed equal vegetative biomass and nutrient content prior to the fruiting period. In female branches, no trade-off was found between fruit load and current-year vegetative growth. In P. lentiscus, avoiding the overlap of flowering, vegetative growth and fruiting probably contributes to reduce the immediate costs of reproductive efforts, both in males and females.

  2. Evidence summary: what 'cost of illness' evidence is there about cross-infection related infections in dental practice?

    PubMed

    Fox, Chris

    2010-07-24

    Since August 2009, members of the Primary Care Dentistry Research Forum (http://www.dentistryresearch.org) have taken part in an online vote to identify questions in day-to-day practice that they felt most needed to be answered with conclusive research. The question which receives the most votes each month forms the subject of a critical appraisal of the relevant literature. Each month a new round of voting takes place to decide which further questions will be reviewed. Dental practitioners and dental care professionals are encouraged to take part in the voting and submit their own questions to be included in the vote by joining the website.The paper below details a summary of the findings of the seventh critical appraisal. In conclusion, the critical appraisal identified no evidence on the epidemiological scale of cross-infection caused in dental practices and therefore also of the cost impact of cross-infection caused in primary dental practices. As a result, no 'cost of illness', or cost-benefit assessment, exists or is feasible at this time.

  3. The Role of Advocacy Organizations in Reducing Negative Externalities.

    PubMed

    Biglan, Anthony

    2009-07-01

    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 unsustainability of manufacturing processes, and marketing of products contributing to environmental damage, and economic policies that maintain high levels of poverty due to effective lobbying by the business community. This paper examines the problem of externalities in terms of metacontingencies. Externalities continue precisely because there is no cost to the organizations for practices that impose these costs on third parties. The paper describes the cultural practices needed to influence governments are motivated to make corporations bear the true costs of their practices-costs that are currently imposed on others.

  4. Implications of environmental externalities assessments for solar thermal powerplants

    NASA Astrophysics Data System (ADS)

    Lee, A. D.; Baechler, M. C.

    1991-03-01

    Externalities are those impacts of one activity on other activities that are not priced in the marketplace. An externality is said to exist when two conditions hold: (1) the utility or operations of one economic agent, A, include nonmonetary variables whose values are chosen by another economic agent, B, without regard to the effects on A, and (2) B does not pay A compensation equal to the incremental costs inflicted on A. Electricity generation involves a wide range of potential and actual environmental impacts. Legislative, permitting, and regulatory requirements directly or indirectly control certain environmental impacts, implicitly causing them to become internalized in the cost of electricity generation. Electricity generation, however, often produces residual environmental impacts that meet the definition of an externality. Mechanisms have been developed by several states to include the costs associated with externalities in the cost-effectiveness analyses of new powerplants. This paper examines these costs for solar thermal plants and applies two states' scoring methodologies to estimate how including externalities would affect the levelized costs of power from a solar plant in the Pacific Northwest. It concludes that including externalities in the economics can reduce the difference between the levelized cost of a coal and solar plant by between 0.74 and 2.42 cents/kWh.

  5. Bidirectional relations between parenting practices and child externalizing behavior: a cross-lagged panel analysis in the context of a psychosocial treatment and 3-year follow-up.

    PubMed

    Shaffer, Anne; Lindhiem, Oliver; Kolko, David J; Trentacosta, Christopher J

    2013-02-01

    In the current study, we examined longitudinal changes in, and bidirectional effects between, parenting practices and child behavior problems in the context of a psychosocial treatment and 3-year follow-up period. The sample comprised 139 parent-child dyads (child ages 6-11) who participated in a modular treatment protocol for early-onset ODD or CD. Parenting practices and child behavior problems were assessed at six time-points using multiple measures and multiple reporters. The data were analyzed using cross-lagged panel analyses. Results indicated robust temporal stabilities of parenting practices and child behavior problems, in the context of treatment-related improvements, but bidirectional effects between parenting practices and child behavior were less frequently detected. Our findings suggest that bidirectional effects are relatively smaller than the temporal stability of each construct for school-age children with ODD/CD and their parents, following a multi-modal clinical intervention that is directed at both parents and children. Implications for treatment and intervention are discussed.

  6. What Does it Really Cost? Allocating Indirect Costs.

    ERIC Educational Resources Information Center

    Snyder, Herbert; Davenport, Elisabeth

    1997-01-01

    Better managerial control in terms of decision making and understanding the costs of a system/service result from allocating indirect costs. Allocation requires a three-step process: selecting cost objectives, pooling related overhead costs, and selecting costs bases to connect the objectives to the pooled costs. Argues that activity-based costing…

  7. Compliant flooring to prevent fall-related injuries in older adults: A scoping review of biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety

    PubMed Central

    Jurkowski, Michal P.; Dymarz, Ania C.; Robinovitch, Stephen N.; Feldman, Fabio; Laing, Andrew C.; Mackey, Dawn C.

    2017-01-01

    Background Compliant flooring, broadly defined as flooring systems or floor coverings with some level of shock absorbency, may reduce the incidence and severity of fall-related injuries in older adults; however, a lack of synthesized evidence may be limiting widespread uptake. Methods Informed by the Arksey and O’Malley framework and guided by a Research Advisory Panel of knowledge users, we conducted a scoping review to answer: what is presented about the biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety associated with compliant flooring systems that aim to prevent fall-related injuries in healthcare settings? We searched academic and grey literature databases. Any record that discussed a compliant flooring system and at least one of biomechanical efficacy, clinical effectiveness, cost-effectiveness, or workplace safety was eligible for inclusion. Two independent reviewers screened and abstracted records, charted data, and summarized results. Results After screening 3611 titles and abstracts and 166 full-text articles, we included 84 records plus 56 companion (supplementary) reports. Biomechanical efficacy records (n = 50) demonstrate compliant flooring can reduce fall-related impact forces with minimal effects on standing and walking balance. Clinical effectiveness records (n = 20) suggest that compliant flooring may reduce injuries, but may increase risk for falls. Preliminary evidence suggests that compliant flooring may be a cost-effective strategy (n = 12), but may also result in increased physical demands for healthcare workers (n = 17). Conclusions In summary, compliant flooring is a promising strategy for preventing fall-related injuries from a biomechanical perspective. Additional research is warranted to confirm whether compliant flooring (i) prevents fall-related injuries in real-world settings, (ii) is a cost-effective intervention strategy, and (iii) can be installed without negatively impacting workplace

  8. Relative cost-effectiveness of using an extensively hydrolyzed casein formula containing the probiotic Lactobacillus rhamnosus GG in managing infants with cow’s milk allergy in Poland

    PubMed Central

    Guest, Julian F; Weidlich, Diana; Kaczmarski, Maciej; Jarocka-Cyrta, Elzbieta; Kobelska-Dubiel, Natalia; Krauze, Agnieszka; Sakowska-Maliszewska, Iwona; Zawadzka-Krajewska, Anna

    2016-01-01

    Objective To estimate the cost-effectiveness of using an extensively hydrolyzed casein formula (eHCF) containing the probiotic Lactobacillus rhamnosus GG (eHCF + LGG; Nutramigen LGG) as an initial treatment for cow’s milk allergy compared with eHCF alone and amino acid formulas (AAF) in Poland from the perspective of the Polish National Health Fund (Narodowy Fundusz Zdrowia [NFZ]) and parents. Methods Decision modeling was used to estimate the probability of cow’s milk allergic infants developing tolerance to cow’s milk by 18 months. The model also estimated the cost to the NFZ and parents (Polish Zloty [PLN] at 2013–2014 prices) for managing infants over 18 months after starting one of the formulas as well as the relative cost-effectiveness of each of the formulas. Results The probability of developing tolerance to cow’s milk by 18 months was higher among infants who were fed eHCF + LGG (0.82) compared with those fed eHCF alone (0.53) or an AAF (0.22). An infant who is initially managed with eHCF + LGG is expected to consume fewer health care resources than infants managed with the other formulas. Hence, the estimated total health care cost incurred by the NFZ for initially feeding infants with eHCF + LGG (PLN 5,693) was less than that of feeding infants with eHCF alone (PLN 7,749) or an AAF (PLN 24,333). However, the total cost incurred by parents for initially feeding infants with an AAF (PLN 815) was marginally less than that of feeding with eHCF + LGG (PLN 993), which was less than that of feeding with eHCF alone (PLN 1,226). Conclusion Using eHCF + LGG instead of eHCF alone or an AAF for first-line management of newly diagnosed infants with cow’s milk allergy affords a cost-effective use of NFZ-funded resources, since it improves outcome for less cost. Whether eHCF + LGG would be viewed as being cost-effective by parents is dependent on their willingness to pay an additional cost for additional tolerance acquisition to cow’s milk. PMID:27418845

  9. Are floods in part a form of land use externality?

    NASA Astrophysics Data System (ADS)

    Dorner, W.; Porter, M.; Metzka, R.

    2008-05-01

    Peak and volume of river flows are functions of the catchment surface characteristics. This means that any impacts to the run-off regime (for example surface sealing and river training) could affect people and land users in the lower system. The costs of flood defence or compensation of damages are usually not included in the economic calculation of the upstream land owner or land user. In economic terms these effects are referred to as unidirectional externalities. This paper presents a methodology to identify externalities related to land use and run-off and describes the relevant cause-effect relations and how they can be modelled. The Herzogbach is a small tributary of the Danube River in Lower Bavaria. It is located in a rural area, dominated by intensive farming practices. A combination of hydrological and hydraulic modelling provided the core of the project methodology to allow the interpretation of economic data. Comparisons of damage estimates resulting from different hydrological scenarios based on different land uses, and flood mitigation costs were used to show the economic significance of human impacts.

  10. Estimating Airline Operating Costs

    NASA Technical Reports Server (NTRS)

    Maddalon, D. V.

    1978-01-01

    The factors affecting commercial aircraft operating and delay costs were used to develop an airline operating cost model which includes a method for estimating the labor and material costs of individual airframe maintenance systems. The model permits estimates of aircraft related costs, i.e., aircraft service, landing fees, flight attendants, and control fees. A method for estimating the costs of certain types of airline delay is also described.

  11. Relative cost-effectiveness of using an extensively hydrolyzed casein formula containing the probiotic Lactobacillus rhamnosus GG in managing infants with cow’s milk allergy in Spain

    PubMed Central

    Guest, Julian F; Weidlich, Diana; Mascuñan Díaz, J Ignacio; Díaz, Juan J; Ojeda, Pedro Manuel; Ferrer-González, J Pablo; Gil, David; Onrubia, Isabel; Rincón Victor, Pedro

    2015-01-01

    Objective To estimate the cost-effectiveness of using an extensively hydrolyzed casein formula containing the probiotic Lactobacillus rhamnosus GG (eHCF + LGG; Nutramigen LGG) as a first-line management for cow’s milk allergy compared with eHCF alone, and amino acid formulae in Spain, from the perspective of the Spanish National Health Service (SNS). Methods Decision modeling was used to estimate the probability of immunoglobulin E (IgE)-mediated and non–IgE-mediated allergic infants developing tolerance to cow’s milk by 18 months. The models also estimated the SNS cost (at 2012/2013 prices) of managing infants over 18 months after starting a formula as well as the relative cost-effectiveness of each of the formulae. Results The probability of developing tolerance to cow’s milk by 18 months was higher among infants with either IgE-mediated or non–IgE-mediated allergy who were fed eHCF + LGG compared with those fed one of the other formulae. The total health care cost of initially feeding infants with eHCF + LGG was less than that of feeding infants with one of the other formulae. Hence, eHCF + LGG affords the greatest value for money to the SNS for managing both IgE-mediated and non–IgE-mediated cow’s milk allergy. Conclusion Using eHCF + LGG instead of eHCF alone or amino acid formulae for first-line management of newly-diagnosed infants with cow’s milk allergy affords a cost-effective use of publicly funded resources because it improves outcome for less cost. A randomized controlled study showing faster tolerance development in children receiving a probiotic-containing formula is required before this conclusion can be confirmed. PMID:26648744

  12. Multisystemic Therapy for Externalizing Youth

    PubMed Central

    Zajac, Kristyn; Randall, Jeff; Swenson, Cynthia Cupit

    2015-01-01

    Synopsis Externalizing problems are multi-determined and related to individual, family, peer, school, and community risk factors. Multisystemic therapy (MST) was originally developed to address these risk factors among youth with serious conduct problems who were at-risk for out-of-home placement. Several decades of research has established MST as an evidence-based intervention for adolescents with serious clinical problems, including serious offending, delinquency, substance abuse, and parental physical abuse and neglect. Further, research points to the importance of maintaining high treatment fidelity through systematic quality assurance procedures to replicate positive clinical outcomes. This paper presents an overview of the clinical procedures and evidence base of MST for externalizing problems as well as two adaptations: MST for Substance Abuse and MST for Child Abuse and Neglect. PMID:26092742

  13. A safe, efficient and cost effective process for removing petroleum hydrocarbons from a highly heterogeneous and relatively inaccessible shoreline.

    PubMed

    Guerin, Turlough F

    2015-10-01

    A rocky, intractable and highly heterogeneous, intertidal zone, was contaminated from a diesel fuel spill that occurred during refuelling of a grader used in road construction, on an operational mine's shiploading facility. A practical, cost-effective, and safer (to personnel by avoiding drilling and earthworks), and non-invasive sampling and remediation strategy was designed and implemented since the location and nature of the impacted geology (rock fill) and sediment, precluded conventional ex-situ and any in-situ treatment where drilling would be required. Enhanced biostimulation with surfactant, available N & P (which were highly constrained), and increased aeration, increased the degradation rate from no discernable change for 2 years post-spill, to 170 mg/kg/day; the maximum degradation rate after intervention. While natural attenuation was ineffective in this application, the low-cost, biostimulation intervention proved successful, allowing the site owner to meet their regulatory obligations. Petroleum hydrocarbons (aliphatic fraction) decreased from ∼20,000 mg/kg to <200 mg/kg at the completion of 180 weeks of treatment.

  14. Mini external fixation in the hand.

    PubMed

    Ugwonali, Obinwanne Fidelis C; Jupiter, Jesse B

    2006-09-01

    External fixation is an effective means of addressing several pathologies of the hand. The advantages of its use include the ability to achieve stable fixation, minimize soft tissue trauma at the site of injury, and allow wound care and mobilization of adjacent joints. External fixators can be constructed from material readily available in the operating room or obtained from a commercial source. Sufficient rigidity can be achieved by any of these means. Improper placement, although achieving rigid fixation, may compromise motion and overall function if basic principles of external fixation are not followed or if the anatomy of the hand is not taken into consideration. The objective of this article is to describe the technique of application of mini external fixation, emphasizing the basic principles of external fixation as they relate to the specific anatomy of the hand. In addition to fracture fixation, various other uses are described including distraction lengthening, arthrodesis, treatment of nonunion, and infection.

  15. Effects of tocainide and lidocaine on the transmembrane action potentials as related to external potassium and calcium concentrations in guinea-pig papillary muscles.

    PubMed

    Oshita, S; Sada, H; Kojima, M; Ban, T

    1980-10-01

    Effects of lidocaine and tocainide on transmembrane potentials were studied in isolated guinea-pig papillary muscles, superfused with modified Tyrode's solution containing either 5.4, 2.7, 10.0 or 8.1 mmol/l potassium concentration, [K]0. The last solution applied contained either 1.8 (normal [Ca]0) or 7.2 mmol/l [Ca]0 (high [Ca]0. The concentrations of lidocaine and tocainide used were 18.5, 36.9 and 73.9 mumol/l and 43.7, 87.5 and 174.9 mumol/l in 5.4 mmol/l [K]0 solution and 36.9 and 87.5 mumol/l in the other solutions, respectively. At the driving rate of 1 Hz in 5.4 mmol/l "K]0 solution, both drugs produced dose-dependently a reduction of maximum rate of rise of action potential (Vmax), together with a prolongation of the relative refractory period. Vmax decreased progressively as the driving rate was increased from 1 Hz (for lidocaine) and from 0.25 Hz (for tocainide) to 5 Hz. This action was accentuated dose-dependently. A slow component (time constant tau = 232 ms for lidocaine, 281--303 ms for tocainide) and slower component (tau = 2.1--3.8 s for tocainide) of the recovery (reactivation) of Vmax were observed in premature responses at 0.25 Hz and in the first response after interruption of the basic driving rate at 1 Hz. All these effects were accentuated with rising [K]0 and attenuated in the high [Ca]0 solution. Both drugs abbreviated the action potential duration at 50% (APD50) and 90% (APD90) levels at 5.4, 8.1 and 10.0 mmol/l [K]0 but not at 2.7 mmol/l [K]0 nor a high [Ca]0 at 1 Hz. These [K]0-dependent effects of lidocaine on Vmax were successfully simulated by the model proposed by Hondeghem and Katzung (1977), with a slight change in parameter values. The mode of interaction of lidocaine with sodium channels in the open, closed and rested states was deduced from these results.

  16. 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.

  17. Metasurface external cavity laser

    SciTech Connect

    Xu, Luyao Curwen, Christopher A.; Williams, Benjamin S.; Hon, Philip W. C.; Itoh, Tatsuo; Chen, Qi-Sheng

    2015-11-30

    A vertical-external-cavity surface-emitting-laser is demonstrated in the terahertz range, which is based upon an amplifying metasurface reflector composed of a sub-wavelength array of antenna-coupled quantum-cascade sub-cavities. Lasing is possible when the metasurface reflector is placed into a low-loss external cavity such that the external cavity—not the sub-cavities—determines the beam properties. A near-Gaussian beam of 4.3° × 5.1° divergence is observed and an output power level >5 mW is achieved. The polarized response of the metasurface allows the use of a wire-grid polarizer as an output coupler that is continuously tunable.

  18. Estimating airline operating costs

    NASA Technical Reports Server (NTRS)

    Maddalon, D. V.

    1978-01-01

    A review was made of the factors affecting commercial aircraft operating and delay costs. From this work, an airline operating cost model was developed which includes a method for estimating the labor and material costs of individual airframe maintenance systems. The model, similar in some respects to the standard Air Transport Association of America (ATA) Direct Operating Cost Model, permits estimates of aircraft-related costs not now included in the standard ATA model (e.g., aircraft service, landing fees, flight attendants, and control fees). A study of the cost of aircraft delay was also made and a method for estimating the cost of certain types of airline delay is described.

  19. 32 CFR 536.80 - Payment of costs, settlements, and judgments related to certain medical malpractice claims.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., paramedic, or other supporting personnel (including medical and dental technicians, nurse assistants... wrongful actions or omissions occurred during the performance of medical, dental, or related health...

  20. 32 CFR 536.80 - Payment of costs, settlements, and judgments related to certain medical malpractice claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., paramedic, or other supporting personnel (including medical and dental technicians, nurse assistants... wrongful actions or omissions occurred during the performance of medical, dental, or related health...

  1. 32 CFR 536.80 - Payment of costs, settlements, and judgments related to certain medical malpractice claims.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., paramedic, or other supporting personnel (including medical and dental technicians, nurse assistants... wrongful actions or omissions occurred during the performance of medical, dental, or related health...

  2. 32 CFR 536.80 - Payment of costs, settlements, and judgments related to certain medical malpractice claims.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., paramedic, or other supporting personnel (including medical and dental technicians, nurse assistants... wrongful actions or omissions occurred during the performance of medical, dental, or related health...

  3. 32 CFR 536.80 - Payment of costs, settlements, and judgments related to certain medical malpractice claims.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., paramedic, or other supporting personnel (including medical and dental technicians, nurse assistants... wrongful actions or omissions occurred during the performance of medical, dental, or related health...

  4. A system dynamic modeling approach for evaluating municipal solid waste generation, landfill capacity and related cost management issues.

    PubMed

    Kollikkathara, Naushad; Feng, Huan; Yu, Danlin

    2010-11-01

    As planning for sustainable municipal solid waste management has to address several inter-connected issues such as landfill capacity, environmental impacts and financial expenditure, it becomes increasingly necessary to understand the dynamic nature of their interactions. A system dynamics approach designed here attempts to address some of these issues by fitting a model framework for Newark urban region in the US, and running a forecast simulation. The dynamic system developed in this study incorporates the complexity of the waste generation and management process to some extent which is achieved through a combination of simpler sub-processes that are linked together to form a whole. The impact of decision options on the generation of waste in the city, on the remaining landfill capacity of the state, and on the economic cost or benefit actualized by different waste processing options are explored through this approach, providing valuable insights into the urban waste-management process.

  5. A system dynamic modeling approach for evaluating municipal solid waste generation, landfill capacity and related cost management issues

    SciTech Connect

    Kollikkathara, Naushad; Feng Huan; Yu Danlin

    2010-11-15

    As planning for sustainable municipal solid waste management has to address several inter-connected issues such as landfill capacity, environmental impacts and financial expenditure, it becomes increasingly necessary to understand the dynamic nature of their interactions. A system dynamics approach designed here attempts to address some of these issues by fitting a model framework for Newark urban region in the US, and running a forecast simulation. The dynamic system developed in this study incorporates the complexity of the waste generation and management process to some extent which is achieved through a combination of simpler sub-processes that are linked together to form a whole. The impact of decision options on the generation of waste in the city, on the remaining landfill capacity of the state, and on the economic cost or benefit actualized by different waste processing options are explored through this approach, providing valuable insights into the urban waste-management process.

  6. Relative cost-effectiveness of using a liquid human milk fortifier in preterm infants in the US

    PubMed Central

    Guest, Julian F; Moya, Fernando; Sisk, Paula M; Hudak, Mark L; Kuehn, Devon

    2017-01-01

    Objective To human milk fortifier (LHMF) compared to a powdered human milk fortifier (PHMF) in preterm infants in the US from the perspective of third-party payers and parents. Methods This was a decision modelling study using patient data obtained from a randomized controlled trial comparing a LHMF with a PHMF in preterm infants, supplemented with additional data obtained by performing a chart review among 79% of the trial patients. The model estimated the cost-effectiveness of LHMF versus PHMF in US$ at 2014/2015 prices. Results More infants in the LHMF group were discharged home (92% versus 89%) and more infants in the PHMF group were transferred to another unit (9% versus 5%). Gestational age was an independent predictor for being discharged home (odds ratio of 2.18; p=0.006 for each week of gestational age). Mean length of neonatal intensive care unit (NICU) stay was 1 day less in the LHMF than the PHMF group (62.3 versus 63.4 days), but mean length of NICU stay among infants who developed NEC or sepsis was 79.3 days and 61.2 days in the PHMF and LHMF groups, respectively. Total management cost up to discharge was $10,497 per infant less in the LHMF group than the PHMF group ($240,928 versus $251,425). Conclusion Using LHMF instead of PHMF in preterm infants enabled resources to be freed-up for alternative use within the system. There is no health economic reason why LHMF should not be used in preference to PHMF in the NICU. PMID:28115859

  7. Negotiators who give too much: unmitigated communion, relational anxieties, and economic costs in distributive and integrative bargaining.

    PubMed

    Amanatullah, Emily T; Morris, Michael W; Curhan, Jared R

    2008-09-01

    A series of studies found that the personality dimension of unmitigated communion (H. L. Fritz & V. S. Helgeson, 1998) leads negotiators to make concessions to avoid straining relationships. Results indicate that even within the population of successful business executives, this dimension of relational anxiety can be identified distinctly from more general relational orientations, such as agreeableness, and that it distinctly predicts accommodating tendencies in everyday conflicts. In economic games, unmitigated communion predicts giving in contexts in which the relational norm of reciprocity applies, but not in contexts tapping instrumental or altruistic motives for cooperation. In distributive negotiations, the effect of unmitigated communion in lowering a negotiator's outcome is mediated by prenegotiation anxieties about relational strain and plans to make large concessions if needed to avoid impasse (lower reservation points). In integrative negotiations, high unmitigated communion on both sides of the negotiation dyad results in relational accommodation, evidenced by decreased success in maximizing economic joint gain but increased subjective satisfaction with the relationship.

  8. Quantifying relationships between selected work-related risk factors and back pain: a systematic review of objective biomechanical measures and cost-related health outcomes.

    PubMed

    Nelson, Nancy A; Hughes, Richard E

    2009-01-01

    The objective of this investigation was to use published literature to demonstrate that specific changes in workplace biomechanical exposure levels can predict reductions in back injuries. A systematic literature review was conducted to identify epidemiologic studies which could be used to quantify relationships between several well-recognized biomechanical measures of back stress and economically relevant outcome measures. Eighteen publications, describing 15 research studies, which fulfilled search criteria were found. Quantitative associations were observed between back injuries and measures of spinal compression, lifting, lifting ratios, postures, and combinations thereof. Results were intended to provide safety practitioners with information that could be applied to their own work situations to estimate costs and benefits of ergonomic intervention strategies before they are implemented.

  9. Quantifying relationships between selected work-related risk factors and back pain: a systematic review of objective biomechanical measures and cost-related health outcomes

    PubMed Central

    Hughes, Richard E.

    2009-01-01

    The objective of this investigation was to use published literature to demonstrate that specific changes in workplace biomechanical exposure levels can predict reductions in back injuries. A systematic literature review was conducted to identify epidemiologic studies which could be used to quantify relationships between several well-recognized biomechanical measures of back stress and economically relevant outcome measures. Eighteen publications, describing 15 research studies, which fulfilled search criteria were found. Quantitative associations were observed between back injuries and measures of spinal compression, lifting, lifting ratios, postures, and combinations thereof. Results were intended to provide safety practitioners with information that could be applied to their own work situations to estimate costs and benefits of ergonomic intervention strategies before they are implemented. PMID:20047008

  10. The Trends of Atrial Fibrillation-Related Hospital Visit and Cost, Treatment Pattern and Mortality in Korea: 10-Year Nationwide Sample Cohort Data

    PubMed Central

    Lee, Hancheol; Kim, Tae-Hoon; Baek, Yong-Soo; Uhm, Jae-Sun; Pak, Hui-Nam; Lee, Moon-Hyoung

    2017-01-01

    Background and Objectives The change of in-hospital and out-hospital treatments, and hospital costs for atrial fibrillation (AF) were not well known in rapidly aging Asian countries. This study is to examine the trends of AF management and outcomes in Korea. Subjects and Methods In the sample cohort from Korean National Health Insurance Data Sample Cohort (K-NHID-Sample Cohort) from 2004 through 2013, we identified patients with AF and hospital visit records using Korean Classification of Diseases, 6th Revision (KCD-6). Hospital cost, prescribed medications, radiofrequency catheter ablation (RFCA), morbidity and mortality were identified. Results AF-related hospitalization and outpatient clinic visits increased by 2.19 and 3.06-fold, respectively. While the total cost increased from 3.6 to 11.3 billion won (p<0.001), the mean cost per patient increased from 0.68 to 0.83 million won (p<0.001). Although the mean CHA2DS2-VASc score increased from 3.5 to 4.4 in the total AF population, the proportion of patients who receive anticoagulation therapy with warfarin showed no significant change for the decade. The proportion of hospitalization for RFCA was increased (0.4% to 1.1%, p<0.001). All-cause mortality (6.7% to 5.0%), cardiovascular mortality (1.4% to 1.1%) and stroke-related death (1.3% to 0.8%) showed a modest decrease from 2004 to 2013. Conclusion During the last decade, AF-related hospitalization and outpatient clinic visits have increased with the increase of many other comorbidities, whereas the rate of anticoagulation did not improved. Although mortality in patients with AF showed a modest decrease from 2004 to 2013, proper anticoagulation therapy is warranted for the improvement of public health. PMID:28154592

  11. Discrete Wavelength-Locked External Cavity Laser

    NASA Technical Reports Server (NTRS)

    Pilgrim, Jeffrey S.; Silver, Joel A.

    2004-01-01

    A prototype improved external cavity laser (ECL) was demonstrated in the second phase of a continuing effort to develop wavelength-agile lasers for fiber-optic communications and trace-gas-sensing applications. This laser is designed to offer next-generation performance for incorporation into fiber-optic networks. By eliminating several optical components and simplifying others used in prior designs, the design of this laser reduces costs, making lasers of this type very competitive in a price-sensitive market. Diode lasers have become enabling devices for fiber optic networks because of their cost, compactness, and spectral properties. ECLs built around diode laser gain elements further enhance capabilities by virtue of their excellent spectral properties with significantly increased (relative to prior lasers) wavelength tuning ranges. It is essential to exploit the increased spectral coverage of ECLs while simultaneously insuring that they operate only at precisely defined communication channels (wavelengths). Heretofore, this requirement has typically been satisfied through incorporation of add-in optical components that lock the ECL output wavelengths to these specific channels. Such add-in components contribute substantially to the costs of ECL lasers to be used as sources for optical communication networks. Furthermore, the optical alignment of these components, needed to attain the required wavelength precision, is a non-trivial task and can contribute substantially to production costs. The design of the present improved ECL differs significantly from the designs of prior ECLs. The present design relies on inherent features of components already included within an ECL, with slight modifications so that these components perform their normal functions while simultaneously effecting locking to the required discrete wavelengths. Hence, add-in optical components and the associated cost of alignment can be eliminated. The figure shows the locking feedback signal

  12. Working with External Evaluators

    ERIC Educational Resources Information Center

    Silver, Lauren; Burg, Scott

    2015-01-01

    Hiring an external evaluator is not right for every museum or every project. Evaluations are highly situational, grounded in specific times and places; each one is unique. The museum and the evaluator share equal responsibility in an evaluation's success, so it is worth investing time and effort to ensure that both are clear about the goals,…

  13. [Internal and external haemorrhoids].

    PubMed

    Schuurman, J P; Go, P M N Y H

    2011-01-01

    In this article, we present 3 cases of patients with different types of haemorrhoidal disease. The first patient is a 27-year-old woman who had been experiencing incidental rectal blood loss without pain during defecation for 3 months. The second patient is a 76-year-old woman who had been bothered by varying degrees of pain from a swelling nearby the anus for 1 year. The third case involves a 31-year-old man who had had continuous severe pain in the anal area for 3 consecutive days. The first patient appeared to have internal hemorrhoids, whereas different forms of external hemorrhoids affected the patients in the other 2 cases. Internal haemorrhoids develop from the intraluminal corpus cavernosum recti; external haemorrhoids from the perianal marginal veins. Patients with internal haemorrhoids present with symptoms that include blood loss and prolaps feeling during defecation. In patients with external haemorrhoids pain is the prominent symptom. Internal haemorrhoids are treated either conservatively or surgically, depending upon their severity. Considering external haemorrhoidal disease surgical treatment provides the most rapid and persistent relief of symptoms.

  14. External College Survey.

    ERIC Educational Resources Information Center

    Gold, Ben K.

    This report presents the results of a community survey which attempted to determine the demand for another college in the Los Angeles Community College District. The function of this "community campus" or "external college" would be to serve members of the community who are not already served by the eight existing colleges. Questionnaires received…

  15. External Interest Group Impingements.

    ERIC Educational Resources Information Center

    Millard, Richard M.

    The history of the interrelation among state approval, accreditation, and institutional eligibility is considered. It is suggested that faculty and college administrators can be either an internal or external group in relationship to the planning process. The federal government, or the state government, passes legislation that may have both…

  16. Orangutans (Pongo abelii) "play the odds": information-seeking strategies in relation to cost, risk, and benefit.

    PubMed

    Marsh, Heidi L; MacDonald, Suzanne E

    2012-08-01

    Recent research has examined whether animals possess metacognition, or the ability to monitor their knowledge states. However, the extent to which animals actively control their knowledge states is still not well delineated. Although organisms might be capable of seeking information when it is lacking, it does not mean that it is always adaptive to do so. In the present set of experiments, we examined the flexibility of this behavior in captive orangutans (Pongo abelii; two adults and one juvenile) in a foraging task, by varying the necessity of information-seeking, the cost associated with it, the likelihood of error, and the value of the reward. In Experiment 1, subjects searched for information most often when it was "cheapest" energetically. In Experiment 2, subjects searched for information most often when the odds of making an error were the greatest. In Experiment 3, subjects searched for information more when the reward was doubled in value. In Experiment 4, adult subjects adapted to risk/benefit trade-offs in their searching behavior. In every experiment, subjects sought information more often when they needed it than when they already knew the solution to the problem. Therefore, the current research suggests that information-seeking behavior in orangutans shows a sophisticated level of flexibility, comparable to that seen in human children, as they appear to "play the odds" when making the decision to seek information or not.

  17. Design and Fabrication of Low-Cost 1536-Chamber Microfluidic Microarrays for Mood-Disorders-Related Serological Studies

    PubMed Central

    Zhao, Xinyan; Dong, Tao

    2013-01-01

    Mood disorders are common mental diseases, but physiological diagnostic methods are still lacking. Since much evidence has implied a relationship between mood disorders and the protein composition of blood sera, it is conceivable to develop a serological criterion for assisting diagnosis of mood disorders, based on a correlative database with enough capacity and high quality. In this pilot study, a low-cost microfluidic microarray device for quantifying at most 384 serological biomarkers at the same time was designed for the data acquisition of the serological study. The 1,536-chamber microfluidic device was modeled on a 1,536-well microtiter plate in order to employ a common microplate reader as the detection module for measuring the chemiluminescent immunoassay tests on the chips. The microfluidic microarrays were rapidly fabricated on polymethylmethacrylate slides using carbon dioxide laser ablation, followed by effective surface treatment processing. Sixteen types of different capture antibodies were immobilized on the chips to test the corresponding hormones and cytokines. The preliminary tests indicated that the signal-to-noise ratio and the limit of detection of microfluidic microarrays have reached the level of standard ELISA tests, whereas the operation time of microfluidic microarrays was sharply reduced. PMID:24169541

  18. Computer Vision Tools for Low-Cost and Noninvasive Measurement of Autism-Related Behaviors in Infants

    PubMed Central

    Vallin Spina, Thiago; Papanikolopoulos, Nikolaos; Egger, Helen

    2014-01-01

    The early detection of developmental disorders is key to child outcome, allowing interventions to be initiated which promote development and improve prognosis. Research on autism spectrum disorder (ASD) suggests that behavioral signs can be observed late in the first year of life. Many of these studies involve extensive frame-by-frame video observation and analysis of a child's natural behavior. Although nonintrusive, these methods are extremely time-intensive and require a high level of observer training; thus, they are burdensome for clinical and large population research purposes. This work is a first milestone in a long-term project on non-invasive early observation of children in order to aid in risk detection and research of neurodevelopmental disorders. We focus on providing low-cost computer vision tools to measure and identify ASD behavioral signs based on components of the Autism Observation Scale for Infants (AOSI). In particular, we develop algorithms to measure responses to general ASD risk assessment tasks and activities outlined by the AOSI which assess visual attention by tracking facial features. We show results, including comparisons with expert and nonexpert clinicians, which demonstrate that the proposed computer vision tools can capture critical behavioral observations and potentially augment the clinician's behavioral observations obtained from real in-clinic assessments. PMID:25045536

  19. Autism and Externalizing Behaviors: Buffering Effects of Parental Emotion Coaching

    ERIC Educational Resources Information Center

    Wilson, Beverly J.; Berg, Jessica L.; Zurawski, Megan E.; King, Kathleen A.

    2013-01-01

    The purpose of this study was to examine the relation between parental emotion coaching and externalizing behaviors in children with autism spectrum disorders (ASD). Children with ASD often exhibit externalizing behaviors, particularly emotionally driven externalizing behaviors, at a higher rate than their typically developing peers. An…

  20. Teradata University Network: A No Cost Web-Portal for Teaching Database, Data Warehousing, and Data-Related Subjects

    ERIC Educational Resources Information Center

    Jukic, Nenad; Gray, Paul

    2008-01-01

    This paper describes the value that information systems faculty and students in classes dealing with database management, data warehousing, decision support systems, and related topics, could derive from the use of the Teradata University Network (TUN), a free comprehensive web-portal. A detailed overview of TUN functionalities and content is…

  1. Externally heated thermal battery

    NASA Astrophysics Data System (ADS)

    Pracchia, Louis; Vetter, Ronald F.; Rosenlof, Darwin

    1991-04-01

    A thermal battery activated by external heat comprising an anode (e.g., composed of a lithium-aluminum alloy), a cathode (e.g., composed of iron disulfide), and an electrolyte (e.g., a lithium chloride-potassium chloride eutectic) with the electrolyte inactive at ambient temperature but activated by melting at a predetermined temperature when exposed to external heating is presented. The battery can be used as a sensor or to ignite pyrotechnic and power electronic devices in a system for reducing the hazard of ordnance exposed to detrimental heating. A particular application is the use of the battery to activate a squib to function in conjunction with one or more other components to vent an ordnance case in order to prevent its explosion in a fire.

  2. Externally triggered microcapsules

    NASA Technical Reports Server (NTRS)

    Morrison, Dennis R. (Inventor); Mosier, Benjamin (Inventor)

    2011-01-01

    Disclosed are microcapsules comprising a polymer shell enclosing one or more immiscible liquid phases in which a drug or drug precursor are contained in a liquid phase. The microparticles also contain magnetic particles that can be heated by application of an external magnetic field and thus heated to a predetermined Curie temperature. Heating of the particles melts the polymer shell and releases the drug without causing heating of surrounding tissues.

  3. Cost Planning System

    ERIC Educational Resources Information Center

    Bowen, Brian

    1974-01-01

    The third installment of a Building Cost File points out the necessity of providing a framework for overall cost control during design. A cost analysis (see EA 504 571) illustrates how the use of construction elements or subsystems provide a suitable means. Other related articles are EA 503 949, 950, 951, and EA 504 578-579. (MF)

  4. 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…

  5. Australian governments' spending on preventing and responding to drug abuse should target the main sources of drug-related harm and the most cost-effective interventions.

    PubMed

    McDonald, David

    2011-01-01

    A notable feature of Australian drug policy is the limited public and professional attention given to the financial costs of drug abuse and to the levels and patterns of government expenditures incurred in preventing and responding to this. Since 1991, Collins and Lapsley have published scholarly reports documenting the social costs of drug abuse in Australia and their reports also contain estimates of governments' drug budgets: revenue and expenditures. They show that, in 2004-2005, Australian governments expended at least $5288 million on drug abuse, with 50% of the expenditure directed to preventing and dealing with alcohol-related problems, 45% to illicit drugs and just 5% to tobacco. Some 60% of the expenditure was directed at drug crime and 37% at health interventions. This pattern of resource allocation does not adequately reflect an evidence-informed policy orientation in that it largely fails to focus on the drug types that are the sources of the most harm (tobacco and alcohol rather than illicit drugs), and the sectors for which we have the strongest evidence of the cost-effectiveness of the available interventions (treatment and harm reduction rather than legislation and law enforcement). The 2010-2014 phase of Australia's National Drug Strategy should include incremental changes to the resource allocation mix, and not simply maintain the historical resource allocation formulae.

  6. [Direct cost related to management and care provision for HIV-infected children in the asymptomatic stage in Abidjan, Cote d'Ivoire].

    PubMed

    Djohan, G; Kouakoussui, A; Msellati, P

    2005-12-01

    The objective of this study was to estimate the direct cost of medical and psychological care provided to asymptomatic HIV-infected children in Abidjan, Cote d'Ivoire. For this purpose, a retrospective study was carried out among a group of asymptomatic HIV-infected children in Abidjan who were part of the "projet enfant Yopougon" (ANRS 1244/1278). The study reviewed these childrens' hospital records and files dating between October 2000 and March 2003. The follow up period for a total of 46 children represented a cumulative of 83.4 children years and showed that 8 potentially death-threatening medical events were recorded on average per child per year. The mean annual cost for the management and delivery of medical and psychological care per asymptomatic HIV-infected child was 132, 730 FCFA per year, or rather 11,000 FCFA (16.63 Euros) per month. This relatively low cost should be used to advocate for more financial support from governments and the international community to contribute to more effective management of care and services for HIV-infected children.

  7. Relative cost-effectiveness of using an extensively hydrolyzed casein formula in managing infants with cow’s milk allergy in Brazil

    PubMed Central

    Guest, Julian F; Yang, Ariana C; Oba, Jane; Rodrigues, Maraci; Caetano, Rosane; Polster, Lilian

    2016-01-01

    Objective To estimate the cost-effectiveness of three alternative dietetic strategies for cow’s milk allergy in Brazil: 1) using an extensively hydrolyzed casein formula (eHCF; Nutramigen) as a first-line formula, but switching to an amino acid formula (AAF) if infants remain symptomatic; 2) using an AAF as a first-line formula and then switching to an eHCF after 4 weeks once infants are symptom-free, but switching back to an AAF if infants become symptomatic; and 3) using an AAF as a first-line formula and keeping all infants on that formula. The analysis was conducted from the perspective of the Brazilian public health care system, Sistema Único de Saude. Methods Decision modeling was used to estimate the probability of immunoglobulin E (IgE)-mediated and non-IgE-mediated allergic infants developing tolerance to cow’s milk by 12 months from starting a formula. The models also estimated the Sistema Único de Saude cost (at 2013/2014 prices) of managing infants over 12 months after starting a formula, as well as the relative cost-effectiveness of each of the dietetic strategies. Results The probability of developing tolerance to cow’s milk by 12 months from starting a formula was higher among infants with either IgE-mediated or non-IgE-mediated allergy who were initially fed with an eHCF, compared with those who were initially fed with an AAF. The total health care cost of initially feeding an eHCF to cow’s milk allergic infants was less than that of initially feeding both IgE-mediated and non-IgE-mediated infants with an AAF. Conclusion Within the study’s limitations, using an eHCF instead of an AAF for the first-line management of newly-diagnosed infants with cow’s milk allergy affords a cost-effective use of publicly funded resources, since it improves the outcome for less cost. PMID:27799804

  8. On the Cost of Big Events: Are Weather-Related Disasters as Bad as Economic Recessions for Health Disparities Related to Drug Use?

    PubMed

    Caiaffa, Waleska Teixeira; Andrade, Roseli Gomes

    2015-01-01

    This commentary reviews two manuscripts about big event empirical data exploring concepts and pathways of drug use and health-related events. Using basic concepts and tools, it proposes a focused framework in order to help comprehension of the multifactorial and multilevel components between macrosocial determinants of health, contextual pathways of drug use and drug-use harm and individual levels in the episode of a big event occurrence. The text also discusses implications of preexisting conditions that may be contributing factors for socially and economically segregated subsets of the population, groups possibly "at risk of risks," meaning unequally exposed to risks that generate exposure to other risks, amplifying preexistent inequities.

  9. Externalities and electric power: an integrated assessment approach

    SciTech Connect

    Lee, R.

    1995-12-31

    This paper describes an integrated assessment approach for considering the options that electric utilities have to meet the anticipated demand for their power. The objective that this paper considers is one of meeting the demand for power, with an acceptable degree of reliability, at minimum cost. The total cost is the sum of the private cost of producing the electric power plus the external costs that result from its production. These external costs, or externalities, are effects on the well-being of third parties that producers and consumers of electric power do not take into account in their decisions. The external costs include many different types of effects such as illness, ecosystem damage, and road damage. The solution to the problem of minimizing total cost is addressed in two steps. The first step uses damage function methods to establish a common metric for the weights of the different objectives (i.e., external costs). The damage function analysis also reduces the dimensionality of the analysis in the second step, and identifies criteria to include in that analysis. The second step uses multi-criteria decision methods. This analysis includes the most important externalities that the damage function analysis identifies and, in addition, potentially important factors that can not be quantified reliably using damage function methods. An example of the latter are the damages from global climate change. The two-step method that this paper describes addresses many of the limitations of the damage function method and multi-criteria methods, that arise when they are used separately. This linked method can be used by electric utilities for their integrated resource planning. It can also be adapted to other applications.

  10. External split field generator

    DOEpatents

    Thundat, Thomas George [Knoxville, TN; Van Neste, Charles W [Kingston, TN; Vass, Arpad Alexander [Oak Ridge, TN

    2012-02-21

    A generator includes a coil disposed about a core. A first stationary magnetic field source may be disposed on a first end portion of the core and a second stationary magnetic field source may be disposed on a second end portion of core. The first and second stationary magnetic field sources apply a stationary magnetic field to the coil. An external magnetic field source may be disposed outside the coil to apply a moving magnetic field to the coil. Electrical energy is generated in response to an interaction between the coil, the moving magnetic field, and the stationary magnetic field.

  11. DIRBE External Calibrator (DEC)

    NASA Technical Reports Server (NTRS)

    Wyatt, Clair L.; Thurgood, V. Alan; Allred, Glenn D.

    1987-01-01

    Under NASA Contract No. NAS5-28185, the Center for Space Engineering at Utah State University has produced a calibration instrument for the Diffuse Infrared Background Experiment (DIRBE). DIRBE is one of the instruments aboard the Cosmic Background Experiment Observatory (COBE). The calibration instrument is referred to as the DEC (Dirbe External Calibrator). DEC produces a steerable, infrared beam of controlled spectral content and intensity and with selectable point source or diffuse source characteristics, that can be directed into the DIRBE to map fields and determine response characteristics. This report discusses the design of the DEC instrument, its operation and characteristics, and provides an analysis of the systems capabilities and performance.

  12. 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…

  13. 48 CFR 231.205-70 - External restructuring costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... incurred (e.g., planning and analysis, contract administration and oversight, or recurring financial and... companies not previously under common ownership or control are combined, whether by merger, acquisition, or... after a business combination that affect the operations of companies not previously under...

  14. Swimming in external fields

    NASA Astrophysics Data System (ADS)

    Stark, Holger

    2016-11-01

    Microswimmers move autonomously but are subject to external fields, which influence their swimming path and their collective dynamics. With three concrete examples we illustrate swimming in external fields and explain the methodology to treat it. First, an active Brownian particle shows a conventional sedimentation profile in a gravitational field but with increased sedimentation length and some polar order along the vertical. Bottom-heavy swimmers are able to invert the sedimentation profile. Second, active Brownian particles interacting by hydrodynamic flow fields in a three-dimensional harmonic trap can spontaneously break the isotropic symmetry. They develop polar order, which one can describe by mean-field theory reminiscent to Weiss theory of ferromagnetism, and thereby pump fluid. Third, a single microswimmer shows interesting non-linear dynamics in Poiseuille flow including swinging and tumbling trajectories. For pushers, hydrodynamic interactions with bounding surfaces stabilize either straight swimming against the flow or tumbling close to the channel wall, while pushers always move on a swinging trajectory with a specific amplitude as limit cycle.

  15. [External pancreatic fistulas management].

    PubMed

    Stepan, E V; Ermolov, A S; Rogal', M L; Teterin, Yu S

    2017-01-01

    The main principles of treatment of external postoperative pancreatic fistulas are viewed in the article. Pancreatic trauma was the reason of pancreatic fistula in 38.7% of the cases, operations because of acute pancreatitis - in 25.8%, and pancreatic pseudocyst drainage - in 35.5%. 93 patients recovered after the treatment. Complex conservative treatment of EPF allowed to close fistulas in 74.2% of the patients with normal patency of the main pancreatic duct (MPD). The usage of octreotide 600-900 mcg daily for at least 5 days to decrease pancreatic secretion was an important part of the conservative treatment. Endoscopic papillotomy was performed in patients with major duodenal papilla obstruction and interruption of transporting of pancreatic secretion to duodenum. Stent of the main pancreatic duct was indicated in patients with extended pancreatic duct stenosis to normalize transport of pancreatic secretion to duodenum. Surgical formation of anastomosis between distal part of the main pancreatic duct and gastro-intestinal tract was carried out when it was impossible to fulfill endoscopic stenting of pancreatic duct either because of its interruption and diastasis between its ends, or in the cases of unsuccessful conservative treatment of external pancreatic fistula caused by drainage of pseudocyst.

  16. 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.

  17. Managing Information On Costs

    NASA Technical Reports Server (NTRS)

    Taulbee, Zoe A.

    1990-01-01

    Cost Management Model, CMM, software tool for planning, tracking, and reporting costs and information related to costs. Capable of estimating costs, comparing estimated to actual costs, performing "what-if" analyses on estimates of costs, and providing mechanism to maintain data on costs in format oriented to management. Number of supportive cost methods built in: escalation rates, production-learning curves, activity/event schedules, unit production schedules, set of spread distributions, tables of rates and factors defined by user, and full arithmetic capability. Import/export capability possible with 20/20 Spreadsheet available on Data General equipment. Program requires AOS/VS operating system available on Data General MV series computers. Written mainly in FORTRAN 77 but uses SGU (Screen Generation Utility).

  18. Neural correlates of sound externalization.

    PubMed

    Callan, Akiko; Callan, Daniel E; Ando, Hiroshi

    2013-02-01

    When we listen to sounds through headphones without utilizing special transforms, sound sources seem to be located inside our heads. The sound sources are said to be lateralized to one side or the other to varying degree. This internal lateralization is different than sound source localization in the natural environment in which the sound is localized distal to the head. We used fMRI to investigate difference in neural responses between lateralization and localization. Individualized binaural recordings were used as externalized auditory stimuli and stereo recordings were used as internalized auditory stimuli. Brain activity was measured while 14 participants performed an active auditory localization task and while 12 participants performed a stimulus type identification task. Irrespective of the task condition, we observed enhanced activity in the bilateral posterior temporal gyri (pSTG) for the externalized stimuli relative to the internalized stimuli. Region of interest analysis indicated that both left and right pSTG were more sensitive to sound sources in contra- than ipsilateral hemifields. Moreover, greater back than front activity was also found in the left pSTG. Compared to impoverished spatial auditory stimuli, realistic spatial auditory stimuli enhance neural responses in the pSTG. This may be why we could observe contralateral hemifield preference in bilateral pSTG that many previous studies have failed to observe. Overall, the results indicate the importance of using ecologically valid stimuli for investigating neural processes in human cortex.

  19. Relative Biologic Effects of Low-Dose-Rate {alpha}-Emitting {sup 227}Th-Rituximab and {beta}-Emitting {sup 90}Y-Tiuexetan-Ibritumomab Versus External Beam X-Radiation

    SciTech Connect

    Dahle, Jostein Bruland, Oyvind S.; Larsen, Roy H.

    2008-09-01

    Purpose: To determine the relative biologic effects (RBE) of {alpha}-particle radiation from {sup 227}Th-rituximab and of {beta}-radiation from {sup 90}Y-tiuexetan-ibritumomab (Zevalin) compared with external beam X-radiation in the Raji lymphoma xenograft model. Methods and Materials: Radioimmunoconjugates were administered intravenously in nude mice with Raji lymphoma xenografts at different levels of activity. Absorbed dose to tumor was estimated by separate biodistribution experiments for {sup 227}Th-rituximab and Zevalin. Tumor growth was measured two to three times per week after injection or X-radiation. Treatment-induced increase in growth delay to reach tumor volumes of 500 and 1,000 mm{sup 3}, respectively, was used as an end point. Results: The absorbed radiation dose-rate in tumor was slightly more than 0.1 Gy/d for the first week following injection of {sup 227}Th-rituximab, and thereafter gradually decreased to 0.03 Gy/d at 21 days after injection. For treatment with Zevalin the maximum dose-rate in tumor was achieved already 6 h after injection (0.2 Gy/d), and thereafter decreased to 0.01 Gy/d after 7 days. The relative biologic effect was between 2.5 and 7.2 for {sup 227}Th-rituximab and between 1 and 1.3 for Zevalin. Conclusions: Both at low doses and low-dose-rates, the {sup 227}Th-rituximab treatment was more effective per absorbed radiation dose unit than the two other treatments. The considerable effect at low doses suggests that the best way to administer low-dose-rates, {alpha}-emitting radioimmunoconjugates is via multiple injections.

  20. Cost-related non-adherence to prescribed medicines among older adults: a cross-sectional analysis of a survey in 11 developed countries

    PubMed Central

    Lee, Augustine

    2017-01-01

    Objectives To assess the effects of costs on access to medicines in 11 developed countries offering different levels of prescription drug coverage for their populations. Design Cross-sectional study of data from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults. Setting Telephone survey conducted in 11 high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK and the USA. Participants 22 532 adults aged 55 and older and living in the community in studied countries. Primary outcome measure Self-reported cost-related non-adherence (CRNA) in the form of either not filling a prescription or skipping doses within the last 12 months because of out-of-pocket costs. Results Estimated prevalence of CRNA among all older adults varied from <3% in the France, Norway, Sweden, Switzerland and the UK to 16.8% in the USA. Canada had the second highest national prevalence of CRNA (8.3%), followed by Australia (6.8%). Older adults in the USA were approximately six times more likely to report CRNA than older adults in the UK (adjusted OR=6.09; 95% CI 3.60 to 10.20). Older adults in Australia and Canada were also statistically significantly more likely to report CRNA than older adults in the UK. Across most countries, the prevalence of CRNA was higher among lower income residents and lower among residents over age 65. Conclusions Observed differences in national prevalence of CRNA appear to follow lines of availability of prescription drug coverage and the extent of direct patient charges for prescriptions under available drug plans. PMID:28143838

  1. 48 CFR 9903.201-8 - Compliant accounting changes due to external restructuring activities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... changes due to external restructuring activities. 9903.201-8 Section 9903.201-8 Federal Acquisition... Requirements 9903.201-8 Compliant accounting changes due to external restructuring activities. The contract price and cost adjustment requirements of this part 9903 are not applicable to compliant cost...

  2. Efficiency of Emission Control Measures on Particulate Matter-Related Health Impacts and Economic Cost during the 2014 Asia-Pacific Economic Cooperation Meeting in Beijing

    PubMed Central

    Liu, Qichen; Huang, Jing; Guo, Bin; Guo, Xinbiao

    2016-01-01

    Background: The Asia-Pacific Economic Cooperation (APEC) meeting was held from 5 November to 11 November 2014 in Beijing, and comprehensive emission control measures were implemented. The efficiency of these measures on particulate matter-related health impacts and economic cost need to be evaluated. Methods: The influences of emission control measures during APEC on particulate matter were evaluated, and health economic effects were assessed. Results: Average concentrations of PM2.5 and PM10 during APEC were reduced by 57.0%, and 50.6% respectively, compared with pre-APEC period. However, the concentrations of particulate matter rebounded after APEC. Compared with the pre-APEC and post-APEC periods, the estimated number of deaths caused by non-accidental, cardiovascular and respiratory diseases that could be attributed to PM2.5 and PM10 during the APEC were the lowest. The economic cost associated with mortality caused by PM2.5 and PM10 during the APEC were reduced by (61.3% and 66.6%) and (50.3% and 60.8%) respectively, compared with pre-APEC and post-APEC. Conclusions: The emission control measures were effective in improving short term air quality and reducing health risks and medical expenses during 2014 APEC, but more efforts is needed for long term and continuous air quality improvement and health protection. PMID:28036006

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

    SciTech Connect

    Martinez-Sanchez, Veronica; Kromann, Mikkel A.

    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, 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

  4. Bevalac external beamline optics

    SciTech Connect

    Kalnins, J.G.; Krebs, G.F.; Tekawa, M.M.; Alonso, J.R.

    1987-04-01

    This handbook is intended as an aid for tuning the external particle beam (EPB) lines at the Lawrence Berkeley Laboratory's Bevalac. The information contained within will be useful to the Bevalac's Main Control Room and experimenters alike. First, some general information is given concerning the EPB lines and beam optics. Next, each beam line is described in detail: schematics of the beam line components are shown, all the variables required to run a beam transport program are presented, beam envelopes are given with wire chamber pictures and magnet currents, focal points and magnifications. Some preliminary scaling factors are then presented which should aid in choosing a given EPB magnet's current for a given central Bevalac field. Finally, some tuning hints are suggested.

  5. Evaluation of primary HPV-DNA testing in relation to visual inspection methods for cervical cancer screening in rural China: an epidemiologic and cost-effectiveness modelling study

    PubMed Central

    2011-01-01

    Background A new lower-cost rapid-throughput human papillomavirus (HPV) test (careHPV, Qiagen, Gaithersburg, USA) has been shown to have high sensitivity for the detection of high grade cervical intraepithelial neoplasia. Methods We assessed the outcomes and cost-effectiveness of careHPV screening in rural China, compared to visual inspection with acetic acid, when used alone (VIA) or in combination with Lugol's iodine (VIA/VILI). Using data on sexual behaviour, test accuracy, diagnostic practices and costs from studies performed in rural China, we estimated the cost-effectiveness ratio (CER) and associated lifetime outcomes for once-lifetime and twice-lifetime screening strategies, and for routine screening at 5-yearly, 10-yearly and IARC-recommended intervals. The optimal age range for once-lifetime screening was also assessed. Results For all strategies, the relative ordering of test technologies in reducing cervical cancer incidence and mortality was VIA (least effective); VIA/VILI; careHPV@1.0 pg/ml and careHPV@0.5 pg/ml (most effective). For once-lifetime strategies, maximum effectiveness was achieved if screening occurred between 35-50 years. Assuming a participation rate of ~70%, once-lifetime screening at age 35 years would reduce cancer mortality by 8% (for VIA) to 12% (for careHPV@0.5) over the long term, with a CER of US$557 (for VIA) to $959 (for careHPV@1.0) per life year saved (LYS) compared to no intervention; referenced to a 2008 GDP per capita in Shanxi Province of $2,975. Correspondingly, regular screening with an age-standardised participation rate of 62% (which has been shown to be achievable in this setting) would reduce cervical cancer mortality by 19-28% (for 10-yearly screening) to 43-54% (using IARC-recommended intervals), with corresponding CERs ranging from $665 (for 10-yearly VIA) to $2,269 (for IARC-recommended intervals using careHPV@1.0) per LYS. Conclusions This modelled analysis suggests that primary careHPV screening compares

  6. External Community Review Committee:

    PubMed Central

    Smith, Maureen A.; Kaufman, Nancy J.; Dearlove, Andrea J.

    2013-01-01

    Background: Major gaps exist between what we know and what we do in clinical practice and community health programs and narrowing this gap will require substantive partnerships between academic researchers and the communities they serve. Objectives: We describe a research pilot award program that makes a unique commitment to community engagement through the addition of an External Community Review Committee to the typical research review process that gives external stakeholders decision-making power over research funding. Methods: Whereas engaging community reviewers in discussion and rating of research proposals is not novel, the ICTR ECRC review process is distinct in that it is subsequent to peer review and uses different criteria and methodology. This method of engagement allows for the community review panel to re-rank scientifically meritorious proposals—such that proposals funded do not necessarily follow the rank order from scientific peer review. The approach taken by UW ICTR differs from those discussed in the literature that present a model of community-academic co-review. Results: This article provides guidance for others interested in this model of community engagement and reviews insights gained during the evolution of this strategy; including how we addressed conflict, how the committee was able to change the pilot award program over time, and individual roles that were crucial to the success of this approach. Conclusions: The advantages of this approach include success through traditional academic metrics while achieving an innovative shared-power mechanism for community engagement which we believe is critical for narrowing the gap between knowledge and practice. PMID:24056512

  7. [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.

  8. Tax incidence and net benefits in the market for employment-related health insurance: sensitivity of estimates to the incidence of employer costs.

    PubMed

    Selden, Thomas M; Bernard, Didem M

    2004-06-01

    The market for employment-related coverage contains public transfers through the tax system and private transfers across workers with predictably different risks. We examine both transfers across a wide range of employee characteristics, including age, race, ethnicity, family size, poverty level, and health risk. To resolve longstanding questions regarding the incidence of employer contributions, we simulate a range of alternative incidence scenarios in which (i) all employees offered coverage in a firm share equally in the employer's costs, (ii) burdens are narrowly targeted according to employee-specific health risks, and (iii) intermediate cases with burdens targeted by job characteristics, age, sex, race, ethnicity, and family size. Our results provide evidence regarding the distribution of tax subsidies and net benefits under a range of scenarios that we believe bound the true incidence of employer premium contributions.

  9. Screening for osteoporosis using easily obtainable biometrical data: diagnostic accuracy of measured, self-reported and recalled BMI, and related costs of bone mineral density measurements.

    PubMed

    van der Voort, D J; Brandon, S; Dinant, G J; van Wersch, J W

    2000-01-01

    The aims of the present study were: to determine the diagnostic accuracy of objectively measured, self-reported and recalled body mass index (BMI) for osteoporosis and osteopenia; to determine the diagnostic costs, in terms of bone mineral density (BMD) measurements, per osteoporotic or osteopenic patient detected, using different BMI tests; and to determine the extent to which the results can be used within the framework of the current screening program for breast cancer in The Netherlands. Within the framework of a cross-sectional study on the prevalence of osteoporosis in the south of The Netherlands, 1155 postmenopausal women aged 50-80 years were asked for their present height and their weight at age 20-30 years. Subsequently their actual weight, height and BMD of the lumbar spine (DXA) were measured. The BMD cutoff was 0.800 g/cm2 for osteoporosis and 0.970 g/cm2 for low BMD (osteoporosis + osteopenia). After receiver operating characteristic analysis, age was cut off at 60 years and BMI at 27 kg/m2. Diagnostic accuracies of objectively measured, self-reported and recalled BMI were evaluated using predictive values (PV) and odds ratios. The resulting 'true positive' and 'false positive' rates were used to calculate diagnostic costs (i.e., DXA) for each osteoporotic patient or low-BMD patient detected. The prevalence of osteoporosis in the study population was 25%, that of low BMD 65%. Only the age-BMI tests 'age > or = 60, BMI < or = 27' showed PVs for osteoporosis (31-41%) and for low BMD (71-81%) that were higher than the prior probabilities for these conditions. Related odds ratios were 2.14-3.18 (osteoporosis) and 1.87-3.04 (low BMD). The objective BMI test detected 50% of the osteoporotic patients. Using the self-reported BMI test and the recalled BMI test, detection rates increased to 55% and 69%, respectively. Concomitant costs per osteoporotic patient detected rose by 24%. Detection of patients with a low BMD increased from 38% for objective BMI and

  10. Cost goals

    NASA Technical Reports Server (NTRS)

    Hoag, J.

    1981-01-01

    Cost goal activities for the point focusing parabolic dish program are reported. Cost goals involve three tasks: (1) determination of the value of the dish systems to potential users; (2) the cost targets of the dish system are set out; (3) the value side and cost side are integrated to provide information concerning the potential size of the market for parabolic dishes. The latter two activities are emphasized.

  11. Tracking Costs

    ERIC Educational Resources Information Center

    Erickson, Paul W.

    2010-01-01

    Even though there's been a slight reprieve in energy costs, the reality is that the cost of non-renewable energy is increasing, and state education budgets are shrinking. One way to keep energy and operations costs from overshadowing education budgets is to develop a 10-year energy audit plan to eliminate waste. First, facility managers should…

  12. Estimating Externalities of Natural Gas Fuel Cycles, Report 4

    SciTech Connect

    Barnthouse, L.W.; Cada, G.F.; Cheng, M.-D.; Easterly, C.E.; Kroodsma, R.L.; Lee, R.; Shriner, D.S.; Tolbert, V.R.; Turner, R.S.

    1998-01-01

    This report describes methods for estimating the external costs (and possibly benefits) to human health and the environment that result from natural gas fuel cycles. Although the concept of externalities is far from simple or precise, it generally refers to effects on individuals' well being, that result from a production or market activity in which the individuals do not participate, or are not fully compensated. In the past two years, the methodological approach that this report describes has quickly become a worldwide standard for estimating externalities of fuel cycles. The approach is generally applicable to any fuel cycle in which a resource, such as coal, hydro, or biomass, is used to generate electric power. This particular report focuses on the production activities, pollution, and impacts when natural gas is used to generate electric power. In the 1990s, natural gas technologies have become, in many countries, the least expensive to build and operate. The scope of this report is on how to estimate the value of externalities--where value is defined as individuals' willingness to pay for beneficial effects, or to avoid undesirable ones. This report is about the methodologies to estimate these externalities, not about how to internalize them through regulations or other public policies. Notwithstanding this limit in scope, consideration of externalities can not be done without considering regulatory, insurance, and other considerations because these institutional factors affect whether costs (and benefits) are in fact external, or whether they are already somehow internalized within the electric power market. Although this report considers such factors to some extent, much analysis yet remains to assess the extent to which estimated costs are indeed external. This report is one of a series of reports on estimating the externalities of fuel cycles. The other reports are on the coal, oil, biomass, hydro, and nuclear fuel cycles, and on general methodology.

  13. Oncological results, functional outcomes and health-related quality-of-life in men who received a radical prostatectomy or external beam radiation therapy for localized prostate cancer: a study on long-term patient outcome with risk stratification.

    PubMed

    Takizawa, Itsuhiro; Hara, Noboru; Nishiyama, Tsutomu; Kaneko, Masaaki; Hoshii, Tatsuhiko; Tsuchida, Emiko; Takahashi, Kota

    2009-05-01

    Health-related quality-of-life (HRQOL) after a radical prostatectomy (RP) or external beam radiation therapy (EBRT) has not been studied in conjunction with oncological outcomes in relation to disease risk stratification. Moreover, the long-term outcomes of these treatment approaches have not been studied. We retrospectively analyzed oncological outcomes between consecutive patients receiving RP (n=86) and EBRT (n=76) for localized prostate cancer. HRQOL and functional outcomes could be assessed in 62 RP (79%) and 54 EBRT (79%) patients over a 3-year follow-up period (median: 41 months) using the Medical Outcomes Study Short Form-36 (SF-36) and the University of California Los Angeles Prostate Cancer Index (UCLA PCI). The 5-year biochemical progression-free survival did not differ between the RP and EBRT groups for low-risk (74.6% vs. 75.0%, P=0.931) and intermediate-risk (61.3% vs. 71.1%, P=0.691) patients. For high-risk patients, progression-free survival was lower in the RP group (45.1%) than in the EBRT group (79.7%) (P=0.002). The general HRQOL was comparable between the two groups. Regarding functional outcomes, the RP group reported lower scores on urinary function and less urinary bother and sexual bother than the EBRT group (P<0.001, P<0.05 and P<0.001, respectively). With risk stratification, the low- and intermediate-risk patients in the RP group reported poorer urinary function than patients in the EBRT group (P<0.001 for each). The sexual function of the high-risk patients in the EBRT group was better than that of the same risk RP patients (P<0.001). Biochemical recurrence was not associated with the UCLA PCI score in either group. In conclusion, low- to intermediate-risk patients treated with an RP may report relatively decreased urinary function during long-term follow-up. The patient's HRQOL after treatment did not depend on biochemical recurrence.

  14. Functional Coherence of Insula Networks is Associated with Externalizing Behavior

    PubMed Central

    Abram, Samantha V.; Wisner, Krista M.; Grazioplene, Rachael G.; Krueger, Robert F.; MacDonald, Angus W.; DeYoung, Colin G.

    2015-01-01

    The externalizing spectrum encompasses a range of maladaptive behaviors, including substance use problems, impulsivity, and aggression. While previous literature has linked externalizing behaviors with prefrontal and amygdala abnormalities, recent studies suggest insula functionality is implicated. The present study investigated the relation between insula functional coherence and externalizing in a large community sample (N=244). Participants underwent a resting functional magnetic resonance imaging scan. Three non-artifactual intrinsic connectivity networks (ICNs) substantially involving the insula were identified after completing independent components analysis. Three externalizing domains—general disinhibition, substance abuse, and callous aggression—were measured with the Externalizing Spectrum Inventory. Regression models tested whether within-network coherence for the three insula ICNs was related to each externalizing domain. Posterior insula coherence was positively associated with general disinhibition and substance abuse. Anterior insula/ventral striatum/anterior cingulate network coherence was negatively associated with general disinhibition. Insula coherence did not relate to the callous aggression domain. Follow-up analyses indicated specificity for insula ICNs in their relation to general disinhibition and substance abuse as compared to other frontal and limbic ICNs. This study found insula network coherence was significantly associated with externalizing behaviors in community participants. Frontal and limbic ICNs containing less insular cortex were not related to externalizing. Thus, the neural synchrony of insula networks may be central for understanding externalizing psychopathology. PMID:26301974

  15. 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

  16. A Study to Develop a Methodology to Enable Direct Cost UCA (Uniform Chart of Accounts) Data to Be Expressed in Terms of Cost per Admission for Specific Diagnosis Related Groups

    DTIC Science & Technology

    1985-07-01

    revision has a dramatic effect on the calculation of the costs for the remaining DRGs, which were artificially depressed in the first sets of...itself are charged to the ICU. Thus, costs are artificially depressed in the affected clinical services, and incompletely described for the ICU. It would...Neurology EA AAJF Neurology Family Practice AK AAKA Oncology AL AALA Pulmonary/Upper Respiratory Disease FA AALF Pulmon /Upper Resp Dis Family Practice

  17. Data of high performance precast external walls for warm climate.

    PubMed

    Baglivo, Cristina; Maria Congedo, Paolo

    2015-09-01

    The data given in the following paper are related to input and output information of the paper entitled Design method of high performance precast external walls for warm climate by multi-objective optimization analysis by Baglivo et al. [1]. Previous studies demonstrate that the superficial mass and the internal areal heat capacity are necessary to reach the best performances for the envelope of the Zero Energy Buildings located in a warm climate [2-4]. The results show that it is possible to achieve high performance precast walls also with light and ultra-thin solutions. A multi-criteria optimization has been performed in terms of steady and dynamic thermal behavior, eco sustainability score and costs. The modeFRONTIER optimization tool, with the use of computational procedures developed in Matlab, has been used to assess the thermal dynamics of building components. A large set of the best configurations of precast external walls for warm climate with their physical and thermal properties have been reported in the data article.

  18. External Diagnostic Ultrasound Capabilities, Limitations, And Future Trends

    NASA Astrophysics Data System (ADS)

    Von Behren, Patrick L.; Lee, Richard M.; Milburn, Donald T.

    1989-08-01

    External ultrasound has achieved an important niche in the spectrum of diagnostic imaging modalities. Its real-time capability, ease of use, and relative low cost have brought it to prominence as an important diagnostic tool. Medical ultrasound imaging, driven by advances in technology and by clinical needs, continues to improve its diagnostic capabilities. Key technologies for ultrasound development are new transducers, advances in signal processing algorithms, and increased computer power. Although external ultrasound image quality continues to steadily improve, certain clinical limitations such as organ access and tissue attenuation have spurred the development of more invasive scanning techniques. Endorectal, endovaginal, and transesophageal probes provide better access to--and provide superior images for--the prostate, uterus and heart. Intraluminal ultrasound is an emerging field of imaging, employing miniature, high-frequency probes which can be inserted into arteries to monitor interventional procedures. To put these developments into perspective, this manuscript reviews the capabilities and limitations of existing ultrasound technology and discusses the impetus for future developments.

  19. Ship emissions and their externalities for Greece

    NASA Astrophysics Data System (ADS)

    Tzannatos, Ernestos

    2010-06-01

    The existing and emerging international and European policy framework for the reduction of ship exhaust emissions dictates the need to produce reliable national, regional and global inventories in order to monitor emission trends and consequently provide the necessary support for future policy making. Furthermore, the inventories of ship exhaust emissions constitute the basis upon which their external costs are estimated in an attempt to highlight the economic burden they impose upon the society and facilitate the cost-benefit analysis of the proposed emission abatement technologies, operational measures and market-based instruments prior to their implementation. The case of Greece is of particular interest mainly because the dense ship traffic within the Greek seas directly imposes the impact of its exhaust emission pollutants (NO x, SO 2 and PM) upon the highly populated, physically sensitive and culturally precious Greek coastline, as well as upon the land and seas of Greece in general, whereas the contribution of Greece in the global CO 2 inventory at a time of climatic change awareness cannot be ignored. In this context, this paper presents the contribution of Greece in ship exhaust emissions of CO 2, NO x, SO 2 and PM from domestic and international shipping over the last 25 years (1984-2008), utilizing the fuel-based (fuel sales) emission methodology. Furthermore, the ship exhaust emissions generated within the Greek seas and their externalities are estimated for the year 2008, through utilizing the fuel-based (fuel sales) approach for domestic shipping and the activity-based (ship traffic) approach for international shipping. On this basis, it was found that during the 1984 to 2008 period the fuel-based (fuel sales) ship emission inventory for Greece increased at an average annual rate of 2.85%. In 2008, the CO 2, NO x, SO 2 and PM emissions reached 12.9 million tons (of which 12.4 million tons of CO 2) and their externalities were found to be around 3

  20. 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