Sample records for key cost drivers

  1. Key cost drivers of pharmaceutical clinical trials in the United States.

    PubMed

    Sertkaya, Aylin; Wong, Hui-Hsing; Jessup, Amber; Beleche, Trinidad

    2016-04-01

    The increasing cost of clinical research has significant implications for public health, as it affects drug companies' willingness to undertake clinical trials, which in turn limits patient access to novel treatments. Thus, gaining a better understanding of the key cost drivers of clinical research in the United States is important. The study which is based on a report prepared by Eastern Research Group, Inc., for the US Department of Health and Human Services, examined different factors, such as therapeutic area, patient recruitment, administrative staff, and clinical procedure expenditures, and their contribution to pharmaceutical clinical trial costs in the United States by clinical trial phase. The study used aggregate data from three proprietary databases on clinical trial costs provided by Medidata Solutions. We evaluated per-study costs across therapeutic areas by aggregating detailed (per patient and per site) cost information. We also compared average expenditures on cost drivers with the use of weighted mean and standard deviation statistics. Therapeutic area was an important determinant of clinical trial costs by phase. The average cost of a Phase 1 study conducted at a US site ranged from US$1.4 million (pain and anesthesia) to US$6.6 million (immunomodulation), including estimated site overhead and monitoring costs of the sponsoring organization. A Phase 2 study cost from US$7.0 million (cardiovascular) to US$19.6 million (hematology), whereas a Phase 3 study cost ranged from US$11.5 million (dermatology) to US$52.9 (pain and anesthesia) on average. Across all study phases and excluding estimated site overhead costs and costs for sponsors to monitor the study, the top three cost drivers of clinical trial expenditures were clinical procedure costs (15%-22% of total), administrative staff costs (11%-29% of total), and site monitoring costs (9%-14% of total). The data were from 2004 through 2012 and were not adjusted for inflation. Additionally

  2. Assessing key cost drivers associated with caring for chronic kidney disease patients.

    PubMed

    Damien, Paul; Lanham, Holly J; Parthasarathy, Murali; Shah, Nikhil L

    2016-12-28

    To examine key factors influencing chronic kidney disease (CKD) patients' total expenditure and offer recommendations on how to reduce total cost of CKD care without compromising quality. Using the 2002-2011 Medical Expenditure Panel Survey (MEPS) data, our cross-sectional study analyzed 197 patient records-79 patients with one record and 59 with two entries per patient (138 unique patients). We used three patient groups, based on international statistical classification of diseases version 9 code for condition (ICD9CODX) classification, to focus inference from the analysis: (a) non-dialysis dependent CKD, (b) dialysis and (c) transplant. Covariate information included region, demographic, co-morbid conditions and types of services. We used descriptive methods and multivariate generalized linear models to understand the impact of cost drivers. We compared actual and predicted CKD cost of care data using a hold-out sample of nine, randomly selected patients to validate the models. Total costs were significantly affected by treatment type, with dialysis being significantly higher than non-dialysis and transplant groups. Costs were highest in the West region of the U.S. Average costs for patients with public insurance were significantly higher than patients with private insurance (p < .0743), and likewise, for patients with co-morbid conditions over those without co-morbid conditions (p < .001). Managing CKD patients both before and after the onset of dialysis treatment and managing co-morbid conditions in individuals with CKD are potential sources of substantial cost savings in the care of CKD patients. Comparing total costs pre and post the United States Affordable Care Act could provide invaluable insights into managing the cost-quality tradeoff in CKD care.

  3. Design and cost drivers in 2-D braiding

    NASA Technical Reports Server (NTRS)

    Morales, Alberto

    1993-01-01

    Fundamentally, the braiding process is a highly efficient, low cost method for combining single yarns into circumferential shapes, as evidenced by the number of applications for continuous sleeving. However, this braiding approach cannot fully demonstrate that it can drastically reduce the cost of complex shape structural preforms. Factors such as part geometry, machine design and configuration, materials used, and operating parameters are described as key cost drivers and what is needed to minimize their effect on elevating the cost of structural braided preforms.

  4. Key drivers of airline loyalty.

    PubMed

    Dolnicar, Sara; Grabler, Klaus; Grün, Bettina; Kulnig, Anna

    2011-10-01

    This study investigates drivers of airline loyalty. It contributes to the body of knowledge in the area by investigating loyalty for a number of a priori market segments identified by airline management and by using a method which accounts for the multi-step nature of the airline choice process. The study is based on responses from 687 passengers. Results indicate that, at aggregate level, frequent flyer membership, price, the status of being a national carrier and the reputation of the airline as perceived by friends are the variables which best discriminate between travellers loyal to the airline and those who are not. Differences in drivers of airline loyalty for a number of segments were identified. For example, loyalty programs play a key role for business travellers whereas airline loyalty of leisure travellers is difficult to trace back to single factors. For none of the calculated models satisfaction emerged as a key driver of airline loyalty.

  5. Key drivers of airline loyalty

    PubMed Central

    Dolnicar, Sara; Grabler, Klaus; Grün, Bettina; Kulnig, Anna

    2011-01-01

    This study investigates drivers of airline loyalty. It contributes to the body of knowledge in the area by investigating loyalty for a number of a priori market segments identified by airline management and by using a method which accounts for the multi-step nature of the airline choice process. The study is based on responses from 687 passengers. Results indicate that, at aggregate level, frequent flyer membership, price, the status of being a national carrier and the reputation of the airline as perceived by friends are the variables which best discriminate between travellers loyal to the airline and those who are not. Differences in drivers of airline loyalty for a number of segments were identified. For example, loyalty programs play a key role for business travellers whereas airline loyalty of leisure travellers is difficult to trace back to single factors. For none of the calculated models satisfaction emerged as a key driver of airline loyalty. PMID:27064618

  6. Understanding the underlying drivers of inpatient cost growth: a literature review.

    PubMed

    Goetghebeur, Mireille M; Forrest, Sharon; Hay, Joel W

    2003-06-01

    After the declining growth in inpatient hospital spending that occurred from 1994 through 1998, the recent trend in increased spending has been of concern to many. Understanding the underlying reasons for this new growth will aid decision makers in finding best means to manage inpatient costs. To identify potential contributors to recent growth in inpatient spending. Literature review. Healthcare and economic databases, prominent Web sites, and key journals were searched to identify potential drivers for the 1999-2001 rise in inpatient spending. Initial literature review and state-level regression analyses published in a companion paper were used to identify key explanatory factors, which were further explored. Although many of the contributors to the rise in inpatient costs overlap and are interrelated, the major cost drivers were identified as (1) workforce shortage; (2) new technology; (3) less tightly managed care; and (4) shifting hospital business directions. Underlying factors such as legislation, quality of care, limited access to noninpatient care, pressures on the safety net, population aging, and increasing chronic illness prevalence were found to influence the contributors and healthcare spending in general. Future trends in inpatient spending will depend on the response of the healthcare system to these cost drivers and underlying factors. Potential avenues to control inpatient spending include expanding access to primary care, encouraging cost-effective technology and more efficient hospital market structures, and developing incentives for the healthcare workforce.

  7. Higher Education Cost Drivers, Including Two Hidden Ones with Cost Containment Possibilities.

    ERIC Educational Resources Information Center

    Micceri, Ted

    Identifying higher education cost drivers and working to limit their effects appears to be a necessity if higher education is to retain the support historically allocated by society. Costs occur for three groups: students, institutions, and society. This paper summarizes information about cost drivers in higher education and identifies two that…

  8. Lunar Exploration Architecture Level Key Drivers and Sensitivities

    NASA Technical Reports Server (NTRS)

    Goodliff, Kandyce; Cirillo, William; Earle, Kevin; Reeves, J. D.; Shyface, Hilary; Andraschko, Mark; Merrill, R. Gabe; Stromgren, Chel; Cirillo, Christopher

    2009-01-01

    Strategic level analysis of the integrated behavior of lunar transportation and lunar surface systems architecture options is performed to assess the benefit, viability, affordability, and robustness of system design choices. This analysis employs both deterministic and probabilistic modeling techniques so that the extent of potential future uncertainties associated with each option are properly characterized. The results of these analyses are summarized in a predefined set of high-level Figures of Merit (FOMs) so as to provide senior NASA Constellation Program (CxP) and Exploration Systems Mission Directorate (ESMD) management with pertinent information to better inform strategic level decision making. The strategic level exploration architecture model is designed to perform analysis at as high a level as possible but still capture those details that have major impacts on system performance. The strategic analysis methodology focuses on integrated performance, affordability, and risk analysis, and captures the linkages and feedbacks between these three areas. Each of these results leads into the determination of the high-level FOMs. This strategic level analysis methodology has been previously applied to Space Shuttle and International Space Station assessments and is now being applied to the development of the Constellation Program point-of-departure lunar architecture. This paper provides an overview of the strategic analysis methodology and the lunar exploration architecture analyses to date. In studying these analysis results, the strategic analysis team has identified and characterized key drivers affecting the integrated architecture behavior. These key drivers include inclusion of a cargo lander, mission rate, mission location, fixed-versus- variable costs/return on investment, and the requirement for probabilistic analysis. Results of sensitivity analysis performed on lunar exploration architecture scenarios are also presented.

  9. Medical technology as a key driver of rising health expenditure: disentangling the relationship

    PubMed Central

    Sorenson, Corinna; Drummond, Michael; Bhuiyan Khan, Beena

    2013-01-01

    Health care spending has risen steadily in most countries, becoming a concern for decision-makers worldwide. Commentators often point to new medical technology as the key driver for burgeoning expenditures. This paper critically appraises this conjecture, based on an analysis of the existing literature, with the aim of offering a more detailed and considered analysis of this relationship. Several databases were searched to identify relevant literature. Various categories of studies (eg, multivariate and cost-effectiveness analyses) were included to cover different perspectives, methodological approaches, and issues regarding the link between medical technology and costs. Selected articles were reviewed and relevant information was extracted into a standardized template and analyzed for key cross-cutting themes, ie, impact of technology on costs, factors influencing this relationship, and methodological challenges in measuring such linkages. A total of 86 studies were reviewed. The analysis suggests that the relationship between medical technology and spending is complex and often conflicting. Findings were frequently contingent on varying factors, such as the availability of other interventions, patient population, and the methodological approach employed. Moreover, the impact of technology on costs differed across technologies, in that some (eg, cancer drugs, invasive medical devices) had significant financial implications, while others were cost-neutral or cost-saving. In light of these issues, we argue that decision-makers and other commentators should extend their focus beyond costs solely to include consideration of whether medical technology results in better value in health care and broader socioeconomic benefits. PMID:23807855

  10. The QUELCE Method: Using Change Drivers to Estimate Program Costs

    DTIC Science & Technology

    2016-08-01

    QUELCE computes a distribution of program costs based on Monte Carlo analysis of program cost drivers—assessed via analyses of dependency structure...possible scenarios. These include  a dependency structure matrix to understand the interaction of change drivers for a specific project  a...performed by the SEI or by company analysts. From the workshop results, analysts create a dependency structure matrix (DSM) of the change drivers

  11. Determining the effect of key climate drivers on global hydropower production

    NASA Astrophysics Data System (ADS)

    Galelli, S.; Ng, J. Y.; Lee, D.; Block, P. J.

    2017-12-01

    Accounting for about 17% of total global electrical power production, hydropower is arguably the world's main renewable energy source and a key asset to meet Paris climate agreements. A key component of hydropower production is water availability, which depends on both precipitation and multiple drivers of climate variability acting at different spatial and temporal scales. To understand how these drivers impact global hydropower production, we study the relation between four patterns of ocean-atmosphere climate variability (i.e., El Niño Southern Oscillation, Pacific Decadal Oscillation, North Atlantic Oscillation, and Atlantic Multidecadal Oscillation) and monthly time series of electrical power production for over 1,500 hydropower reservoirs—obtained via simulation with a high-fidelity dam model forced with 20th century climate conditions. Notably significant relationships between electrical power productions and climate variability are found in many climate sensitive regions globally, including North and South America, East Asia, West Africa, and Europe. Coupled interactions from multiple, simultaneous climate drivers are also evaluated. Finally, we highlight the importance of using these climate drivers as an additional source of information within reservoir operating rules where the skillful predictability of inflow exists.

  12. Impacts of the driver's bounded rationality on the traffic running cost under the car-following model

    NASA Astrophysics Data System (ADS)

    Tang, Tie-Qiao; Luo, Xiao-Feng; Liu, Kai

    2016-09-01

    The driver's bounded rationality has significant influences on the micro driving behavior and researchers proposed some traffic flow models with the driver's bounded rationality. However, little effort has been made to explore the effects of the driver's bounded rationality on the trip cost. In this paper, we use our recently proposed car-following model to study the effects of the driver's bounded rationality on his running cost and the system's total cost under three traffic running costs. The numerical results show that considering the driver's bounded rationality will enhance his each running cost and the system's total cost under the three traffic running costs.

  13. An Analysis of Young Driver Crash Types and the Associated Lifetime Care Cost in Victoria, Australia.

    PubMed

    Buckis, Samantha; Lenné, Mike G; Fitzharris, Michael

    2015-01-01

    The elevated crash involvement rate of young drivers is well documented. Given the higher crash risk of young drivers and the need for innovative policy and programs, it remains important to fully understand the type of crashes young drivers are involved in, and knowledge of the lifetime care cost of crashes can support effective policy development. The aim of this article is to document the number and type of young driver crashes, as well as the associated lifetime care cost over a 9-year period (2005-2013) in Victoria, Australia. In Victoria, Australia, the Transport Accident Commission (TAC) has legislated responsibility for road safety and the care of persons injured in road crashes, irrespective of fault. TAC claims data for the period 2005-2013 were used to document the number and type of young driver crashes. Lifetime care costs (past and future payment liabilities) were calculated by Taylor Fry actuarial consultancy. License and population data were used to define the crash involvement rate of young drivers. Over the 9-year period, 16,817 claims were lodged to the TAC by drivers 18-25 years of age following a crash. There were 646 fewer drivers aged 18-25 killed and injured in 2013, compared to 2005, representing an unadjusted change of -28.7% (-29.8% males; -28.4% females). The total lifetime care cost of young drivers killed and injured in Victoria for the period 2005-2013 was estimated to be AU$634 million (US$493 million). Differences between males and females, single- and multivehicle crashes, and fatalities and injuries were found to be statistically significant. Run-off-road crashes and crashes from opposing direction were overrepresented in the lifetime care costs for young driver claimants. Twenty-eight injured drivers were classified as high-severity claims. These 28 claimants require additional long-term care, which was estimated to be AU$219 million; of these 28, 24 were male (85.7%). The long-term care costs for these 28 drivers (0

  14. Estimated Cost of Crashes in Commercial Drivers Supports Screening and Treatment of Obstructive Sleep Apnea

    PubMed Central

    Gurubhagavatula, Indira; Nkwuo, Jonathan E.; Maislin, Greg; Pack, Allan I.

    2009-01-01

    Sleep apnea among commercial drivers may increase the risk of fall-asleep crashes, which incur large expenses. Drivers of passenger cars whose apnea is treated experience lower crash risk. Among community-based holders of commercial driver’s licenses, we considered three methods for identifying sleep apnea syndrome: 1) in-lab polysomnography; 2) selective in-lab polysomnography for high-risk drivers, where high risk is first identified by body mass index, age and gender, followed by oximetry in a subset of drivers; and 3) not screening. The costs for each of these three programs equaled the sum of the costs of testing, treatment of identified cases, and crashes. Assuming that treatment prevents apnea-related crashes, polysomnography is not cost-effective, because it was more expensive than the cost of crashes when no screening is done. Screening with BMI, age and gender, however, with confirmatory in-lab polysomnography only on high-risk drivers was cost-effective, as long as a high proportion (73.8%) of screened drivers accepts treatment. These findings indicate that strategies that reduce reliance on in-laboratory polysomnography may be more cost-effective than not screening, and that treatment acceptance may need to be a condition of employment for affected drivers. PMID:18215538

  15. Identifying Key Drivers of Return Reversal with Dynamical Bayesian Factor Graph

    PubMed Central

    Zhao, Shuai; Tong, Yunhai; Wang, Zitian; Tan, Shaohua

    2016-01-01

    In the stock market, return reversal occurs when investors sell overbought stocks and buy oversold stocks, reversing the stocks’ price trends. In this paper, we develop a new method to identify key drivers of return reversal by incorporating a comprehensive set of factors derived from different economic theories into one unified dynamical Bayesian factor graph. We then use the model to depict factor relationships and their dynamics, from which we make some interesting discoveries about the mechanism behind return reversals. Through extensive experiments on the US stock market, we conclude that among the various factors, the liquidity factors consistently emerge as key drivers of return reversal, which is in support of the theory of liquidity effect. Specifically, we find that stocks with high turnover rates or high Amihud illiquidity measures have a greater probability of experiencing return reversals. Apart from the consistent drivers, we find other drivers of return reversal that generally change from year to year, and they serve as important characteristics for evaluating the trends of stock returns. Besides, we also identify some seldom discussed yet enlightening inter-factor relationships, one of which shows that stocks in Finance and Insurance industry are more likely to have high Amihud illiquidity measures in comparison with those in other industries. These conclusions are robust for return reversals under different thresholds. PMID:27893780

  16. Identifying Key Drivers of Return Reversal with Dynamical Bayesian Factor Graph.

    PubMed

    Zhao, Shuai; Tong, Yunhai; Wang, Zitian; Tan, Shaohua

    2016-01-01

    In the stock market, return reversal occurs when investors sell overbought stocks and buy oversold stocks, reversing the stocks' price trends. In this paper, we develop a new method to identify key drivers of return reversal by incorporating a comprehensive set of factors derived from different economic theories into one unified dynamical Bayesian factor graph. We then use the model to depict factor relationships and their dynamics, from which we make some interesting discoveries about the mechanism behind return reversals. Through extensive experiments on the US stock market, we conclude that among the various factors, the liquidity factors consistently emerge as key drivers of return reversal, which is in support of the theory of liquidity effect. Specifically, we find that stocks with high turnover rates or high Amihud illiquidity measures have a greater probability of experiencing return reversals. Apart from the consistent drivers, we find other drivers of return reversal that generally change from year to year, and they serve as important characteristics for evaluating the trends of stock returns. Besides, we also identify some seldom discussed yet enlightening inter-factor relationships, one of which shows that stocks in Finance and Insurance industry are more likely to have high Amihud illiquidity measures in comparison with those in other industries. These conclusions are robust for return reversals under different thresholds.

  17. Long-term care cost drivers and expenditure projection to 2036 in Hong Kong

    PubMed Central

    Chung, Roger Y; Tin, Keith YK; Cowling, Benjamin J; Chan, King Pan; Chan, Wai Man; Lo, Su Vui; Leung, Gabriel M

    2009-01-01

    Background Hong Kong's rapidly ageing population, characterised by one of the longest life expectancies and the lowest fertility rate in the world, is likely to drive long-term care (LTC) expenditure higher. This study aims to identify key cost drivers and derive quantitative estimates of Hong Kong's LTC expenditure to 2036. Methods We parameterised a macro actuarial simulation with data from official demographic projections, Thematic Household Survey 2004, Hong Kong's Domestic Health Accounts and other routine data from relevant government departments, Hospital Authority and other LTC service providers. Base case results were tested against a wide range of sensitivity assumptions. Results Total projected LTC expenditure as a proportion of GDP reflected secular trends in the elderly dependency ratio, showing a shallow dip between 2004 and 2011, but thereafter yielding a monotonic rise to reach 3.0% by 2036. Demographic changes would have a larger impact than changes in unit costs on overall spending. Different sensitivity scenarios resulted in a wide range of spending estimates from 2.2% to 4.9% of GDP. The availability of informal care and the setting of formal care as well as associated unit costs were important drivers of expenditure. Conclusion The "demographic window" between the present and 2011 is critical in developing policies to cope with the anticipated burgeoning LTC burden, in concert with the related issues of health care financing and retirement planning. PMID:19775476

  18. Long-term care cost drivers and expenditure projection to 2036 in Hong Kong.

    PubMed

    Chung, Roger Y; Tin, Keith Yk; Cowling, Benjamin J; Chan, King Pan; Chan, Wai Man; Lo, Su Vui; Leung, Gabriel M

    2009-09-24

    Hong Kong's rapidly ageing population, characterised by one of the longest life expectancies and the lowest fertility rate in the world, is likely to drive long-term care (LTC) expenditure higher. This study aims to identify key cost drivers and derive quantitative estimates of Hong Kong's LTC expenditure to 2036. We parameterised a macro actuarial simulation with data from official demographic projections, Thematic Household Survey 2004, Hong Kong's Domestic Health Accounts and other routine data from relevant government departments, Hospital Authority and other LTC service providers. Base case results were tested against a wide range of sensitivity assumptions. Total projected LTC expenditure as a proportion of GDP reflected secular trends in the elderly dependency ratio, showing a shallow dip between 2004 and 2011, but thereafter yielding a monotonic rise to reach 3.0% by 2036. Demographic changes would have a larger impact than changes in unit costs on overall spending. Different sensitivity scenarios resulted in a wide range of spending estimates from 2.2% to 4.9% of GDP. The availability of informal care and the setting of formal care as well as associated unit costs were important drivers of expenditure. The "demographic window" between the present and 2011 is critical in developing policies to cope with the anticipated burgeoning LTC burden, in concert with the related issues of health care financing and retirement planning.

  19. A scenario elicitation methodology to identify the drivers of electricity infrastructure cost in South America

    NASA Astrophysics Data System (ADS)

    Moksnes, Nandi; Taliotis, Constantinos; Broad, Oliver; de Moura, Gustavo; Howells, Mark

    2017-04-01

    Developing a set of scenarios to assess a proposed policy or future development pathways requires a certain level of information, as well as establishing the socio-economic context. As the future is difficult to predict, great care in defining the selected scenarios is needed. Even so it can be difficult to assess if the selected scenario is covering the possible solution space. Instead, this paper's methodology develops a large set of scenarios (324) in OSeMOSYS using the SAMBA 2.0 (South America Model Base) model to assess long-term electricity supply scenarios and applies a scenario-discovery statistical data mining algorithm, Patient Rule Induction Method (PRIM). By creating a multidimensional space, regions related to high and low cost can be identified as well as their key driver. The six key drivers are defined a priori in three (high, medium, low) or two levers (high, low): 1) Demand projected from GDP, population, urbanization and transport, 2) Fossil fuel price, 3) Climate change impact on hydropower, 4) Renewable technology learning rate, 5) Discount rate, 6) CO2 emission targets.

  20. A Practical Methodology for Disaggregating the Drivers of Drug Costs Using Administrative Data.

    PubMed

    Lungu, Elena R; Manti, Orlando J; Levine, Mitchell A H; Clark, Douglas A; Potashnik, Tanya M; McKinley, Carol I

    2017-09-01

    Prescription drug expenditures represent a significant component of health care costs in Canada, with estimates of $28.8 billion spent in 2014. Identifying the major cost drivers and the effect they have on prescription drug expenditures allows policy makers and researchers to interpret current cost pressures and anticipate future expenditure levels. To identify the major drivers of prescription drug costs and to develop a methodology to disaggregate the impact of each of the individual drivers. The methodology proposed in this study uses the Laspeyres approach for cost decomposition. This approach isolates the effect of the change in a specific factor (e.g., price) by holding the other factor(s) (e.g., quantity) constant at the base-period value. The Laspeyres approach is expanded to a multi-factorial framework to isolate and quantify several factors that drive prescription drug cost. Three broad categories of effects are considered: volume, price and drug-mix effects. For each category, important sub-effects are quantified. This study presents a new and comprehensive methodology for decomposing the change in prescription drug costs over time including step-by-step demonstrations of how the formulas were derived. This methodology has practical applications for health policy decision makers and can aid researchers in conducting cost driver analyses. The methodology can be adjusted depending on the purpose and analytical depth of the research and data availability. © 2017 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.

  1. Cost drivers for breast, lung, and colorectal cancer care in a commercially insured population over a 6-month episode: an economic analysis from a health plan perspective.

    PubMed

    Sagar, Bhuvana; Lin, Yu Shen; Castel, Liana D

    2017-10-01

    In the absence of clinical data, accurate identification of cost drivers is needed for economic comparison in an alternate payment model. From a health plan perspective using claims data in a commercial population, the objective was to identify and quantify the effects of cost drivers in economic models of breast, lung, and colorectal cancer costs over a 6-month episode following initial chemotherapy. This study analyzed claims data from 9,748 Cigna beneficiaries with diagnosis of breast, lung, and colorectal cancer following initial chemotherapy from January 1, 2014 to December 31, 2015. We used multivariable regression models to quantify the impact of key factors on cost during the initial 6-month cancer care episode. Metastasis, facility provider affiliation, episode risk group (ERG) risk score, and radiation were cost drivers for all three types of cancer (breast, lung, and colorectal). In addition, younger age (p < .0001) and human epidermal growth factor receptor-2 oncogene overexpression (HER2+)-directed therapy (p < .0001) were associated with higher costs in breast cancer. Younger age (p < .0001) and female gender (p < .0001) were also associated with higher costs in colorectal cancer. Metastasis was also associated with 50% more hospital admissions and increased hospital length of stay (p < .001) in all three cancers over the 6-month episode duration. Chemotherapy and supportive drug therapies accounted for the highest proportion (48%) of total medical costs among beneficiaries observed. Value-based reimbursement models in oncology should appropriately account for key cost drivers. Although claims-based methodologies may be further augmented with clinical data, this study recommends adjusting for the factors identified in these models to predict costs in breast, lung, and colorectal cancers.

  2. Sensitivities of projected 1980 photovoltaic system costs to major system cost drivers

    NASA Technical Reports Server (NTRS)

    Zimmerman, L. W.; Smith, J. L.

    1984-01-01

    The sensitivity of projected 1990 photovoltaic (PV) system costs to major system cost drivers was examined. It includes: (1) module costs and module efficiencies; (2) area related balance of system (BOS) costs; (3) inverter costs and efficiencies; and (4) module marketing and distribution markups and system integration fees. Recent PV system cost experiences and the high costs of electricity from the systems are reviewed. The 1990 system costs are projected for five classes of PV systems, including four ground mounted 5-MWp systems and one residential 5-kWp system. System cost projections are derived by first projecting costs and efficiencies for all subsystems and components. Sensitivity analyses reveal that reductions in module cost and engineering and system integration fees seem to have the greatest potential for contributing to system cost reduction. Although module cost is clearly the prime candidate for fruitful PV research and development activities, engineering and system integration fees seem to be more amenable to reduction through appropriate choice of system size and market strategy. Increases in inverter and module efficiency yield significant benefits, especially for systems with high area related costs.

  3. Key drivers for market penetration of biosimilars in Europe

    PubMed Central

    Rémuzat, Cécile; Dorey, Julie; Cristeau, Olivier; Ionescu, Dan; Radière, Guerric; Toumi, Mondher

    2017-01-01

    ABSTRACT Background & Objectives: Potential drivers and barriers of biosimilar uptake were mainly analysed through qualitative approaches. The study objective was to conduct a quantitative analysis and identify drivers of biosimilar uptake of all available biosimilars in the European Union (EU). Methods: A three-step process was established to identify key drivers for the uptake of biosimilars in the top 10 EU member states (MS) pharmaceutical markets (Belgium, France, Germany, Greece, Hungary, Italy, Poland, Spain, Sweden, and the UK): (1) literature review to identify incentive policies in place to enhance biosimilars adoption; (2) assessment of biosimilar market dynamics based on database analysis; (3) regression model analysis on price using the following explicative variables: incentive policies; price difference between the biosimilar and the originator product; distribution channel; generic uptake and generic price cut; pharmaceutical expenditure per capita; and market competition. Results: At the study cut-off date, 20 biosimilars were available on the market. Incentive policies applied to biosimilars were found to be heterogeneous across countries, and uptakes of biosimilars were also very heterogeneous between different therapeutic classes and countries. Results from the model demonstrated that incentive policies and the date of first biosimilar market entry were correlated to biosimilar uptake. Pharmaceutical expenditure per capita and the highest generic uptake were inversely correlated with biosimilar uptake. Average generic price discount over originator and the number of biosimilars showed a trend toward statistical significance for correlation with biosimilar uptake, but did not reach the significance threshold. Biosimilar price discount over original biologic price, the number of analogues, and the distribution channel were not correlated with the biosimilar uptake. Conclusions: Understanding drivers of biosimilar uptake becomes a critical issue to

  4. Key drivers for market penetration of biosimilars in Europe.

    PubMed

    Rémuzat, Cécile; Dorey, Julie; Cristeau, Olivier; Ionescu, Dan; Radière, Guerric; Toumi, Mondher

    2017-01-01

    Background & Objectives : Potential drivers and barriers of biosimilar uptake were mainly analysed through qualitative approaches. The study objective was to conduct a quantitative analysis and identify drivers of biosimilar uptake of all available biosimilars in the European Union (EU). Methods : A three-step process was established to identify key drivers for the uptake of biosimilars in the top 10 EU member states (MS) pharmaceutical markets (Belgium, France, Germany, Greece, Hungary, Italy, Poland, Spain, Sweden, and the UK): (1) literature review to identify incentive policies in place to enhance biosimilars adoption; (2) assessment of biosimilar market dynamics based on database analysis; (3) regression model analysis on price using the following explicative variables: incentive policies; price difference between the biosimilar and the originator product; distribution channel; generic uptake and generic price cut; pharmaceutical expenditure per capita; and market competition. Results : At the study cut-off date, 20 biosimilars were available on the market. Incentive policies applied to biosimilars were found to be heterogeneous across countries, and uptakes of biosimilars were also very heterogeneous between different therapeutic classes and countries. Results from the model demonstrated that incentive policies and the date of first biosimilar market entry were correlated to biosimilar uptake. Pharmaceutical expenditure per capita and the highest generic uptake were inversely correlated with biosimilar uptake. Average generic price discount over originator and the number of biosimilars showed a trend toward statistical significance for correlation with biosimilar uptake, but did not reach the significance threshold. Biosimilar price discount over original biologic price, the number of analogues, and the distribution channel were not correlated with the biosimilar uptake. Conclusions : Understanding drivers of biosimilar uptake becomes a critical issue to

  5. Targeting key proximal drivers of type 2 inflammation in disease.

    PubMed

    Gandhi, Namita A; Bennett, Brandy L; Graham, Neil M H; Pirozzi, Gianluca; Stahl, Neil; Yancopoulos, George D

    2016-01-01

    Systemic type 2 inflammation encompassing T helper 2 (TH2)-type responses is emerging as a unifying feature of both classically defined allergic diseases, such as asthma, and a range of other inflammatory diseases. Rather than reducing inflammation with broad-acting immunosuppressants or narrowly targeting downstream products of the TH2 pathway, such as immunoglobulin E (IgE), efforts to target the key proximal type 2 cytokines - interleukin-4 (IL-4), IL-5 and IL-13 - represent a promising strategy to achieve therapeutic benefit across multiple diseases. After several initial disappointing clinical results with therapies targeting IL-4, IL-5 or IL-13 in asthma, applying a personalized approach achieved therapeutic benefit in an asthma subtype exhibiting an 'allergic' phenotype. More recently, efficacy was extended into a broad population of people with asthma. This argues that the Type 2 inflammation is broadly relevant across the severe asthma population if the key upstream drivers are properly blocked. Moreover, the simultaneous inhibition of IL-4 and IL-13 has shown significant clinical activity in diseases that are often co-morbid with asthma - atopic dermatitis and chronic sinusitis with nasal polyps - supporting the hypothesis that targeting a central 'driver pathway' could benefit multiple allergic diseases.

  6. Cost Modeling for low-cost planetary missions

    NASA Technical Reports Server (NTRS)

    Kwan, Eric; Habib-Agahi, Hamid; Rosenberg, Leigh

    2005-01-01

    This presentation will provide an overview of the JPL parametric cost models used to estimate flight science spacecrafts and instruments. This material will emphasize the cost model approaches to estimate low-cost flight hardware, sensors, and instrumentation, and to perform cost-risk assessments. This presentation will also discuss JPL approaches to perform cost modeling and the methodologies and analyses used to capture low-cost vs. key cost drivers.

  7. How to identify the key factors that affect driver perception of accident risk. A comparison between Italian and Spanish driver behavior.

    PubMed

    de Oña, Juan; de Oña, Rocio; Eboli, Laura; Forciniti, Carmen; Mazzulla, Gabriella

    2014-12-01

    Road crashes can be caused by different factors, including infrastructure, vehicles, and human variables. Many research studies have focused solely on identifying the key factors that cause road crashes. From these studies, it emerged that human factors have the most relevant impact on accident severity. More specifically, accident severity depends on several factors related directly to the driver, i.e., driving experience, driver's socio-economic characteristics, and driving behavior and attitudes. In this paper, we investigate driver behaviors and attitudes while driving and specifically focus on different methods for identifying the factors that most affect the driver's perception of accident risk. To this end, we designed and conducted a survey in two different European contexts: the city of Cosenza, which is located in the south of Italy, and the city of Granada, which is located in the south of Spain. Samples of drivers were contacted for their opinions on certain aspects of driving rules and attitudes while driving, and different types of questions were addressed to the drivers to assess their judgments of these aspects. Consequently, different methods of data analysis were applied to determine the aspects that heavily influence driver perception of accident risk. An experiment based on the stated preferences (SP) was carried out with the drivers, and the SP data were analyzed using an ordered probit (OP) model. Interesting findings emerged from different analyses of the data and from the comparisons among the data collected in the two different territorial contexts. We found that both Italian and Spanish drivers consider driving in an altered psychophysical state and violating the overtaking rules to be the most risky behaviors. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Estimating the Deep Space Network modification costs to prepare for future space missions by using major cost drivers

    NASA Technical Reports Server (NTRS)

    Remer, Donald S.; Sherif, Josef; Buchanan, Harry R.

    1993-01-01

    This paper develops a cost model to do long range planning cost estimates for Deep Space Network (DSN) support of future space missions. The paper focuses on the costs required to modify and/or enhance the DSN to prepare for future space missions. The model is a function of eight major mission cost drivers and estimates both the total cost and the annual costs of a similar future space mission. The model is derived from actual cost data from three space missions: Voyager (Uranus), Voyager (Neptune), and Magellan. Estimates derived from the model are tested against actual cost data for two independent missions, Viking and Mariner Jupiter/Saturn (MJS).

  9. Pan-cancer transcriptomic analysis associates long non-coding RNAs with key mutational driver events

    PubMed Central

    Ashouri, Arghavan; Sayin, Volkan I.; Van den Eynden, Jimmy; Singh, Simranjit X.; Papagiannakopoulos, Thales; Larsson, Erik

    2016-01-01

    Thousands of long non-coding RNAs (lncRNAs) lie interspersed with coding genes across the genome, and a small subset has been implicated as downstream effectors in oncogenic pathways. Here we make use of transcriptome and exome sequencing data from thousands of tumours across 19 cancer types, to identify lncRNAs that are induced or repressed in relation to somatic mutations in key oncogenic driver genes. Our screen confirms known coding and non-coding effectors and also associates many new lncRNAs to relevant pathways. The associations are often highly reproducible across cancer types, and while many lncRNAs are co-expressed with their protein-coding hosts or neighbours, some are intergenic and independent. We highlight lncRNAs with possible functions downstream of the tumour suppressor TP53 and the master antioxidant transcription factor NFE2L2. Our study provides a comprehensive overview of lncRNA transcriptional alterations in relation to key driver mutational events in human cancers. PMID:28959951

  10. Cost analysis of open radical cystectomy versus robot-assisted radical cystectomy.

    PubMed

    Bansal, Sukhchain S; Dogra, Tara; Smith, Peter W; Amran, Maisarah; Auluck, Ishna; Bhambra, Maninder; Sura, Manraj S; Rowe, Edward; Koupparis, Anthony

    2018-03-01

    To perform a cost analysis comparing the cost of robot-assisted radical cystectomy (RARC) with open RC (ORC) in a UK tertiary referral centre and to identify the key cost drivers. Data on hospital length of stay (LOS), operative time (OT), transfusion rate, and volume and complication rate were obtained from a prospectively updated institutional database for patients undergoing RARC or ORC. A cost decision tree model was created. Sensitivity analysis was performed to find key drivers of overall cost and to find breakeven points with ORC. Monte Carlo analysis was performed to quantify the variability in the dataset. One RARC procedure costs £12 449.87, or £12 106.12 if the robot was donated via charitable funds. In comparison, one ORC procedure costs £10 474.54. RARC is 18.9% more expensive than ORC. The key cost drivers were OT, LOS, and the number of cases performed per annum. High ongoing equipment costs remain a large barrier to the cost of RARC falling. However, minimal improvements in patient quality of life would be required to offset this difference. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  11. Cost drivers and resource allocation in military health care systems.

    PubMed

    Fulton, Larry; Lasdon, Leon S; McDaniel, Reuben R

    2007-03-01

    This study illustrates the feasibility of incorporating technical efficiency considerations in the funding of military hospitals and identifies the primary drivers for hospital costs. Secondary data collected for 24 U.S.-based Army hospitals and medical centers for the years 2001 to 2003 are the basis for this analysis. Technical efficiency was measured by using data envelopment analysis; subsequently, efficiency estimates were included in logarithmic-linear cost models that specified cost as a function of volume, complexity, efficiency, time, and facility type. These logarithmic-linear models were compared against stochastic frontier analysis models. A parsimonious, three-variable, logarithmic-linear model composed of volume, complexity, and efficiency variables exhibited a strong linear relationship with observed costs (R(2) = 0.98). This model also proved reliable in forecasting (R(2) = 0.96). Based on our analysis, as much as $120 million might be reallocated to improve the United States-based Army hospital performance evaluated in this study.

  12. Distribution and drivers of costs in type 2 diabetes mellitus treated with oral hypoglycemic agents: a retrospective claims data analysis.

    PubMed

    Bron, Morgan; Guerin, Annie; Latremouille-Viau, Dominick; Ionescu-Ittu, Raluca; Viswanathan, Prabhakar; Lopez, Claudia; Wu, Eric Q

    2014-09-01

    To describe the distribution of costs and to identify the drivers of high costs among adult patients with type 2 diabetes mellitus (T2DM) receiving oral hypoglycemic agents. T2DM patients using oral hypoglycemic agents and having HbA1c test data were identified from the Truven MarketScan databases of Commercial and Medicare Supplemental insurance claims (2004-2010). All-cause and diabetes-related annual direct healthcare costs were measured and reported by cost components. The 25% most costly patients in the study sample were defined as high-cost patients. Drivers of high costs were identified in multivariate logistic regressions. Total 1-year all-cause costs for the 4104 study patients were $55,599,311 (mean cost per patient = $13,548). Diabetes-related costs accounted for 33.8% of all-cause costs (mean cost per patient = $4583). Medical service costs accounted for the majority of all-cause and diabetes-related total costs (63.7% and 59.5%, respectively), with a minority of patients incurring >80% of these costs (23.5% and 14.7%, respectively). Within the medical claims, inpatient admission for diabetes-complications was the strongest cost driver for both all-cause (OR = 13.5, 95% CI = 8.1-23.6) and diabetes-related costs (OR = 9.7, 95% CI = 6.3-15.1), with macrovascular complications accounting for most inpatient admissions. Other cost drivers included heavier hypoglycemic agent use, diabetes complications, and chronic diseases. The study reports a conservative estimate for the relative share of diabetes-related costs relative to total cost. The findings of this study apply mainly to T2DM patients under 65 years of age. Among the T2DM patients receiving oral hypoglycemic agents, 23.5% of patients incurred 80% of the all-cause healthcare costs, with these costs being driven by inpatient admissions, complications of diabetes, and chronic diseases. Interventions targeting inpatient admissions and/or complications of diabetes may contribute to the decrease of the

  13. Key Reliability Drivers of Liquid Propulsion Engines and A Reliability Model for Sensitivity Analysis

    NASA Technical Reports Server (NTRS)

    Huang, Zhao-Feng; Fint, Jeffry A.; Kuck, Frederick M.

    2005-01-01

    This paper is to address the in-flight reliability of a liquid propulsion engine system for a launch vehicle. We first establish a comprehensive list of system and sub-system reliability drivers for any liquid propulsion engine system. We then build a reliability model to parametrically analyze the impact of some reliability parameters. We present sensitivity analysis results for a selected subset of the key reliability drivers using the model. Reliability drivers identified include: number of engines for the liquid propulsion stage, single engine total reliability, engine operation duration, engine thrust size, reusability, engine de-rating or up-rating, engine-out design (including engine-out switching reliability, catastrophic fraction, preventable failure fraction, unnecessary shutdown fraction), propellant specific hazards, engine start and cutoff transient hazards, engine combustion cycles, vehicle and engine interface and interaction hazards, engine health management system, engine modification, engine ground start hold down with launch commit criteria, engine altitude start (1 in. start), Multiple altitude restart (less than 1 restart), component, subsystem and system design, manufacturing/ground operation support/pre and post flight check outs and inspection, extensiveness of the development program. We present some sensitivity analysis results for the following subset of the drivers: number of engines for the propulsion stage, single engine total reliability, engine operation duration, engine de-rating or up-rating requirements, engine-out design, catastrophic fraction, preventable failure fraction, unnecessary shutdown fraction, and engine health management system implementation (basic redlines and more advanced health management systems).

  14. Key drivers of precipitation isotopes in Windhoek, Namibia (2012-2016)

    NASA Astrophysics Data System (ADS)

    Kaseke, K. F.; Wang, L.; Wanke, H.

    2017-12-01

    Southern African climate is characterized by large variability with precipitation model estimates varying by as much as 70% during summer. This difference between model estimates is partly because most models associate precipitation over Southern Africa with moisture inputs from the Indian Ocean while excluding inputs from the Atlantic Ocean. However, growing evidence suggests that the Atlantic Ocean may also contribute significant amounts of moisture to the region. This four-year (2012-2016) study investigates the isotopic composition (δ18O, δ2H and δ17O) of event-scale precipitation events, the key drivers of isotope variations and the origins of precipitation experienced in Windhoek, Namibia. Results indicate large storm-to-storm isotopic variability δ18O (25‰), δ2H (180‰) and δ17O (13‰) over the study period. Univariate analysis showed significant correlations between event precipitation isotopes and local meteorological parameters; lifted condensation level, relative humidity (RH), precipitation amount, average wind speed, surface and air temperature (p < 0.05). The number of significant correlations between local meteorological parameters and monthly isotopes was much lower suggesting loss of information through data aggregation. Nonetheless, the most significant isotope driver at both event and monthly scales was RH, consistent with the semi-arid classification of the site. Multiple linear regression analysis suggested RH, precipitation amount and air temperature were the most significant local drivers of precipitation isotopes accounting for about 50% of the variation implying that about 50% could be attributed to source origins. HYSLPIT trajectories indicated that 78% of precipitation originated from the Indian Ocean while 21% originated from the Atlantic Ocean. Given that three of the four study years were droughts while two of the three drought years were El Niño related, our data also suggests that δ'17O-δ'18O could be a useful tool to

  15. Exploring the effects of spatial autocorrelation when identifying key drivers of wildlife crop-raiding.

    PubMed

    Songhurst, Anna; Coulson, Tim

    2014-03-01

    Few universal trends in spatial patterns of wildlife crop-raiding have been found. Variations in wildlife ecology and movements, and human spatial use have been identified as causes of this apparent unpredictability. However, varying spatial patterns of spatial autocorrelation (SA) in human-wildlife conflict (HWC) data could also contribute. We explicitly explore the effects of SA on wildlife crop-raiding data in order to facilitate the design of future HWC studies. We conducted a comparative survey of raided and nonraided fields to determine key drivers of crop-raiding. Data were subsampled at different spatial scales to select independent raiding data points. The model derived from all data was fitted to subsample data sets. Model parameters from these models were compared to determine the effect of SA. Most methods used to account for SA in data attempt to correct for the change in P-values; yet, by subsampling data at broader spatial scales, we identified changes in regression estimates. We consequently advocate reporting both model parameters across a range of spatial scales to help biological interpretation. Patterns of SA vary spatially in our crop-raiding data. Spatial distribution of fields should therefore be considered when choosing the spatial scale for analyses of HWC studies. Robust key drivers of elephant crop-raiding included raiding history of a field and distance of field to a main elephant pathway. Understanding spatial patterns and determining reliable socio-ecological drivers of wildlife crop-raiding is paramount for designing mitigation and land-use planning strategies to reduce HWC. Spatial patterns of HWC are complex, determined by multiple factors acting at more than one scale; therefore, studies need to be designed with an understanding of the effects of SA. Our methods are accessible to a variety of practitioners to assess the effects of SA, thereby improving the reliability of conservation management actions.

  16. The direct and indirect costs of managing chronic obstructive pulmonary disease in Greece.

    PubMed

    Souliotis, Kyriakos; Kousoulakou, Hara; Hillas, Georgios; Tzanakis, Nikos; Toumbis, Michalis; Vassilakopoulos, Theodoros

    2017-01-01

    COPD is associated with significant economic burden. The objective of this study was to explore the direct and indirect costs associated with COPD and identify the key cost drivers of disease management in Greece. A Delphi panel of Greek pulmonologists was conducted, which aimed at eliciting local COPD treatment patterns and resource use. Resource use was translated into costs using official health insurance tariffs and Diagnosis-Related Groups (DRGs). In addition, absenteeism and caregiver's costs were recorded in order to quantify indirect COPD costs. The total costs of managing COPD per patient per year were estimated at €4,730, with direct (medical and nonmedical) and indirect costs accounting for 62.5% and 37.5%, respectively. COPD exacerbations were responsible for 32% of total costs (€1,512). Key exacerbation-related cost drivers were hospitalization (€830) and intensive care unit (ICU) admission costs (€454), jointly accounting for 85% of total exacerbation costs. Annual maintenance phase costs were estimated at €835, with pharmaceutical treatment accounting for 77% (€639.9). Patient time costs were estimated at €146 per year. The average number of sick days per year was estimated at 16.9, resulting in productivity losses of €968. Caregiver's costs were estimated at €806 per year. The management of COPD in Greece is associated with intensive resource use and significant economic burden. Exacerbations and productivity losses are the key cost drivers. Cost containment policies should focus on prioritizing treatments that increase patient compliance as these can lead to reduction of exacerbations, longer maintenance phases, and thus lower costs.

  17. Acoustic Levitation With One Driver

    NASA Technical Reports Server (NTRS)

    Wang, T. G.; Rudnick, I.; Elleman, D. D.; Stoneburner, J. D.

    1985-01-01

    Report discusses acoustic levitation in rectangular chamber using one driver mounted at corner. Placement of driver at corner enables it to couple effectively to acoustic modes along all three axes. Use of single driver reduces cost, complexity and weight of levitation system below those of three driver system.

  18. Determining the key drivers and mitigating factors that influence the role of the Nurse and/or Midwife Consultant: a cross-sectional survey.

    PubMed

    Fernandez, Ritin S; Sheppard-Law, Suzanne; Manning, Vicki

    2017-06-01

    Globally, many nurses and midwives are working at an advanced practice level. The role of a Nurse and/or Midwife Consultant encompasses a diverse and complex interaction between five specified domains namely Clinical Service and Consultancy, Clinical Leadership, Research, Education, and Clinical Services Planning and Management. The objective of this replication study was to identify the key drivers and mitigating factors that impact the role of Australian Nurse and/or Midwife Consultants. Cross-sectional survey. The study was conducted in a large metropolitan health district in Sydney, Australia. Participants for this study consisted of all Nurse and/or Midwife Consultants working within a health district in New South Wales (NSW). Data were collected by an anonymous online survey. Key drivers and mitigating factors perceived to influence their role were identified using previously implemented instruments. Data were analysed using SPSS version 21. Responses were obtained from 122 Nurse and/or Midwife Consultants. The number of years of experience as a Nurse and/or Midwife Consultant ranged from 6 months to 25.5 years. Personal attributes which included personal motivation and own communication skills were identified as key drivers to role performance with a mean score of 7.7±0.6. Other key drivers included peer support, organisational culture, personal attributes, professional learning, Nurse and/or Midwife Consultant experience, and collaborative relationships. Of the 14 mitigating factors to the role, the most common factors were lack of resources to set up and develop the role (2.6 ± 0.9), lack of secretarial support (2.6 ± 1.1), lack of managerial support (2.45 ± 1.1), and lack of understanding of the role by other health professionals (2.40 ± 0.8). Understanding the key drivers and mitigating factors that influence the role of the Nurse and/or Midwife Consultant is important for healthcare managers. Given the changing landscape of nursing

  19. Cost Drivers of a Hospital-Acquired Bacterial Pneumonia and Ventilator-Associated Bacterial Pneumonia Phase 3 Clinical Trial

    PubMed Central

    Stergiopoulos, Stella; Calvert, Sara B; Brown, Carrie A; Awatin, Josephine; Tenaerts, Pamela; Holland, Thomas L; DiMasi, Joseph A; Getz, Kenneth A

    2018-01-01

    Abstract Background Studies indicate that the prevalence of multidrug-resistant infections, including hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP), has been rising. There are many challenges associated with these disease conditions and the ability to develop new treatments. Additionally, HABP/VABP clinical trials are very costly to conduct given their complex protocol designs and the difficulty in recruiting and retaining patients. Methods With input from clinicians, representatives from industry, and the US Food and Drug Administration, we conducted a study to (1) evaluate the drivers of HABP/VABP phase 3 direct and indirect clinical trial costs; (2) to identify opportunities to lower these costs; and (3) to compare (1) and (2) to endocrine and oncology clinical trials. Benchmark data were gathered from proprietary and commercial databases and used to create a model that calculates the fully loaded (direct and indirect) cost of typical phase 3 HABP/VABP endocrine and oncology clinical trials. Results Results indicate that the cost per patient for a 200-site, 1000-patient phase 3 HABP/VABP study is $89600 per patient. The cost of screen failures and screen failure rates are the main cost drivers. Conclusions Results indicate that biopharmaceutical companies and regulatory agencies should consider strategies to improve screening and recruitment to decrease HABP/VABP clinical trial costs. PMID:29020279

  20. Key node selection in minimum-cost control of complex networks

    NASA Astrophysics Data System (ADS)

    Ding, Jie; Wen, Changyun; Li, Guoqi

    2017-11-01

    Finding the key node set that is connected with a given number of external control sources for driving complex networks from initial state to any predefined state with minimum cost, known as minimum-cost control problem, is critically important but remains largely open. By defining an importance index for each node, we propose revisited projected gradient method extension (R-PGME) in Monte-Carlo scenario to determine key node set. It is found that the importance index of a node is strongly correlated to occurrence rate of that node to be selected as a key node in Monte-Carlo realizations for three elementary topologies, Erdős-Rényi and scale-free networks. We also discover the distribution patterns of key nodes when the control cost reaches its minimum. Specifically, the importance indices of all nodes in an elementary stem show a quasi-periodic distribution with high peak values in the beginning and end of a quasi-period while they approach to a uniform distribution in an elementary cycle. We further point out that an elementary dilation can be regarded as two elementary stems whose lengths are the closest, and the importance indices in each stem present similar distribution as in an elementary stem. Our results provide a better understanding and deep insight of locating the key nodes in different topologies with minimum control cost.

  1. The long-term health plan and disability cost benefit of obstructive sleep apnea treatment in a commercial motor vehicle driver population.

    PubMed

    Hoffman, Benjamin; Wingenbach, Dustin D; Kagey, Amy N; Schaneman, Justin L; Kasper, David

    2010-05-01

    To assess the impact on health plan and disability costs associated with continuous positive airway pressure or bi-level positive airway pressure treatment of obstructive sleep apnea in a commercial motor vehicle driver population. A retrospective, pre/post claims-based comparison analysis was performed. Health plan and disability costs, in addition to disability claimant rates and missed workdays were compared for the 12 months before treatment to the 24 months after treatment. Health plan costs were significantly lower in both the first and second years after treatment. Short-term disability metrics also exhibited favorable results, with approximately half as many using the benefit, lower costs, and fewer missed workdays in the postperiod. Effective treatment of obstructive sleep apnea in drivers is associated with lower health care and disability costs and fewer missed workdays.

  2. Flood risk (d)evolution: Disentangling key drivers of flood risk change with a retro-model experiment.

    PubMed

    Zischg, Andreas Paul; Hofer, Patrick; Mosimann, Markus; Röthlisberger, Veronika; Ramirez, Jorge A; Keiler, Margreth; Weingartner, Rolf

    2018-05-19

    Flood risks are dynamically changing over time. Over decades and centuries, the main drivers for flood risk change are influenced either by perturbations or slow alterations in the natural environment or, more importantly, by socio-economic development and human interventions. However, changes in the natural and human environment are intertwined. Thus, the analysis of the main drivers for flood risk changes requires a disentangling of the individual risk components. Here, we present a method for isolating the individual effects of selected drivers of change and selected flood risk management options based on a model experiment. In contrast to purely synthetic model experiments, we built our analyses upon a retro-model consisting of several spatio-temporal stages of river morphology and settlement structure. The main advantage of this approach is that the overall long-term dynamics are known and do not have to be assumed. We used this model setup to analyse the temporal evolution of the flood risk, for an ex-post evaluation of the key drivers of change, and for analysing possible alternative pathways for flood risk evolution under different governance settings. We showed that in the study region the construction of lateral levees and the consecutive river incision are the main drivers for decreasing flood risks over the last century. A rebound effect in flood risk can be observed following an increase in settlements since the 1960s. This effect is not as relevant as the river engineering measures, but it will become increasingly relevant in the future with continued socio-economic growth. The presented approach could provide a methodological framework for studying pathways for future flood risk evolvement and for the formulation of narratives for adapting governmental flood risk strategies to the spatio-temporal dynamics in the built environment. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. The effect of three low-cost engineering treatments on driver fatigue: A driving simulator study.

    PubMed

    Merat, Natasha; Jamson, A Hamish

    2013-01-01

    Three engineering treatments were implemented in a driving simulator study to assess the effect of road-based measures on alleviating the symptoms of fatigue. Using results from previous research on the effect of circadian rhythms on fatigue-related crashes, two groups of male drivers were recruited for this study: young shift workers under the age of 35, who attended immediately after their night shift, and older drivers over the age of 45, who completed the study during the 'post lunch dip' period, after consuming lunch. Eye tracking (PERCLOS) and lateral driver performance measures were used to assess whether baseline measures of fatigue changed after drivers experienced each of the three treatments, which included variable message signs, chevrons and rumble strips. Results showed a marked difference in these measures between drivers' baseline (not fatigued) and experimental (fatigued) visits. There were also some reductions in lateral deviation and eye closure (as measured by PERCLOS) when the treatments were encountered, but no marked difference between the three treatments. These results suggest that in addition to driver- and vehicle-based methods currently employed to mitigate the effects of fatigue, the inclusion of such engineering measures may help alleviate fatigue-related impairments in driving, particularly if such treatments are implemented during long stretches of straight monotonous roads which are known to be associated with fatigue-related crashes. However, positive effects of the treatments were short lived, prompting the need for further investigations on their optimal frequency of presentation and combination to achieve maximum impact from these low-cost, road-based treatments. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  4. Resolving key drivers of variability through an important circulation choke point in the western Mediterranean Sea; using gliders, models & satellite remote sensing

    NASA Astrophysics Data System (ADS)

    Heslop, Emma; Aguiar, Eva; Mourre, Baptiste; Juza, Mélanie; Escudier, Romain; Tintoré, Joaquín

    2017-04-01

    The Ibiza Channel plays an important role in the circulation of the Western Mediterranean Sea, it governs the north/south exchange of different water masses that are known to affect regional ecosystems and is influenced by variability in the different drivers that affect sub-basins to the north (N) and south (S). A complex system. In this study we use a multi-platform approach to resolve the key drivers of this variability, and gain insight into the inter-connection between the N and S of the Western Mediterranean Sea through this choke point. The 6-year glider time series from the quasi-continuous glider endurance line monitoring of the Ibiza Channel, undertaken by SOCIB (Balearic Coastal Ocean observing and Forecasting System), is used as the base from which to identify key sub-seasonal to inter-annual patterns and shifts in water mass properties and transport volumes. The glider data indicates the following key components in the variability of the N/S flow of different water mass through the channel; regional winter mode water production, change in intermediate water mass properties, northward flows of a fresher water mass and the basin-scale circulation. To resolve the drivers of these components of variability, the strength of combining datasets from different sources, glider, modeling, altimetry and moorings, is harnessed. To the north atmospheric forcing in the Gulf of Lions is a dominant driver, while to the south the mesoscale circulation patterns of the Atlantic Jet and Alboran gyres dominate the variability but do not appear to influence the fresher inflows. Evidence of a connection between the northern and southern sub-basins is however indicated. The study highlights importance of sub-seasonal variability and the scale of rapid change possible in the Mediterranean, as well as the benefits of leveraging high resolution glider datasets within a multi-platform and modelling study.

  5. SPIDER: A Framework for Understanding Driver Distraction.

    PubMed

    Strayer, David L; Fisher, Donald L

    2016-02-01

    The objective was to identify key cognitive processes that are impaired when drivers divert attention from driving. Driver distraction is increasingly recognized as a significant source of injuries and fatalities on the roadway. A "SPIDER" model is developed that identifies key cognitive processes that are impaired when drivers divert attention from driving. SPIDER is an acronym standing for scanning, predicting, identifying, decision making, and executing a response. When drivers engage in secondary activities unrelated to the task of driving, SPIDER-related processes are impaired, situation awareness is degraded, and the ability to safely operate a motor vehicle may be compromised. The pattern of interference helps to illuminate the sources of driver distraction and may help guide the integration of new technology into the automobile. © 2015, Human Factors and Ergonomics Society.

  6. Cost, capability, and risk for planetary operations

    NASA Technical Reports Server (NTRS)

    Mclaughlin, William I.; Deutsch, Marie J.; Miller, Lanny J.; Wolff, Donna M.; Zawacki, Steven J.

    1992-01-01

    The three key factors for flight projects - cost, capability, and risk - are examined with respect to their interplay, the uplink process, cost drivers, and risk factors. Scientific objectives are translated into a computer program during the uplink process, and examples are given relating to the Voyager Interstellar Mission, Galileo, and the Comet Rendezvous Asteroid Flyby. The development of a multimission sequence system based on these uplinks is described with reference to specific subsystems such as the pointer and the sequence generator. Operational cost drivers include mission, flight-system, and ground-system complexity, uplink traffic, and work force. Operational risks are listed in terms of the mission operations, the environment, and the mission facilities. The uplink process can be analyzed in terms of software development, and spacecraft operability is shown to be an important factor from the initial stages of spacecraft development.

  7. A population-based analysis of the drivers of short-term costs after bariatric surgery within a publicly funded regionalized center of excellence system.

    PubMed

    Doumouras, Aristithes G; Saleh, Fady; Tarride, Jean-Eric; Hong, Dennis

    2016-06-01

    The most significant driver of healthcare utilization for bariatric surgery is the index admission and readmissions within the first 30 days after a procedure. Identifying areas to create efficiencies during this period is essential to decreasing overall healthcare costs. The objective of the study was to characterize the short-term costs of bariatric surgery within a regionalized center of excellence bariatric care system. The Ontario Bariatric Network is a regionalized bariatric care system with 4 high-volume Bariatric Centers of Excellence. We performed a population-based retrospective analysis including all adult patients who received a bariatric surgical procedure in Ontario from April 2009 until March 2012. Total hospital cost and number of days in hospital was calculated for all index admissions and all readmissions within 30 days of a bariatric surgical procedure. An inverse Gaussian generalized linear model was utilized to model the effect of covariates on costs. A Poisson regression was used to determine the effect on covariates on total days in hospital. After multivariable adjustment, the sleeve gastrectomy procedure decreased costs by $1447 over gastric bypass (95% confidence interval [CI] $1578 to-$1315]); P<.001). This effect increased when adjusting only for preoperative factors with a cost savings of nearly $2000 ($1953) (95% CI-$3250 to-$533; P = .003). Conversely, complications were the major drivers of increased cost as anastomotic leaks added $24,397 (95% CI $20,688-$28,106; P<.001) to healthcare costs. In addition, medical complications, such as respiratory failure/infection ($19,465) (95% CI $11,007-$27,924; P<.001), were also significant cost drivers. Major drivers of increased resource utilization included major surgical and medical complications, such as anastomotic leaks and respiratory failure/infection. Days in hospital were affected more by medical complications than surgical complications. Sleeve gastrectomy resulted in a clear short

  8. First direct landscape-scale measurement of tropical rain forest Leaf Area Index, a key driver of global primary productivity

    Treesearch

    David B. Clark; Paulo C. Olivas; Steven F. Oberbauer; Deborah A. Clark; Michael G. Ryan

    2008-01-01

    Leaf Area Index (leaf area per unit ground area, LAI) is a key driver of forest productivity but has never previously been measured directly at the landscape scale in tropical rain forest (TRF). We used a modular tower and stratified random sampling to harvest all foliage from forest floor to canopy top in 55 vertical transects (4.6 m2) across 500 ha of old growth in...

  9. Terroir is a key driver of seed-associated microbial assemblages.

    PubMed

    Klaedtke, Stephanie; Jacques, Marie-Agnès; Raggi, Lorenzo; Préveaux, Anne; Bonneau, Sophie; Negri, Valeria; Chable, Véronique; Barret, Matthieu

    2016-06-01

    Seeds have evolved in association with diverse microbial assemblages that may influence plant growth and health. However, little is known about the composition of seed-associated microbial assemblages and the ecological processes shaping their structures. In this work, we monitored the relative influence of the host genotypes and terroir on the structure of the seed microbiota through metabarcoding analysis of different microbial assemblages associated to five different bean cultivars harvested in two distinct farms. Overall, few bacterial and fungal operational taxonomic units (OTUs) were conserved across all seed samples. The lack of shared OTUs between samples is explained by a significant effect of the farm site on the structure of microbial assemblage, which explained 12.2% and 39.7% of variance in bacterial and fungal diversity across samples. This site-specific effect is reflected by the significant enrichment of 70 OTUs in Brittany and 88 OTUs in Luxembourg that lead to differences in co-occurrence patterns. In contrast, variance in microbial assemblage structure was not explained by host genotype. Altogether, these results suggest that seed-associated microbial assemblage is determined by niche-based processes and that the terroir is a key driver of these selective forces. © 2015 Society for Applied Microbiology and John Wiley & Sons Ltd.

  10. Design and Qualification of a SmallSat Stepper Motor Driver, Flight Results On-Board the Yes2 Satellite

    NASA Astrophysics Data System (ADS)

    Graczyk, R.; Kruijff, M.; Spiliotopoulos, I.

    2008-08-01

    Drivers for stepper motors are a commonly required critical technology for small satellites. This paper highlights the stepper driver design, test, and mission performance for the second Young Engineers' Satellite (YES2). The unit integrates the required digital and power parts and was developed with generic low-cost satellite applications in mind. One of the key mechanisms in YES2 is a friction brake containing a stepper motor which is in turn controlled by a stepper driver. The friction brake was used to control the deployment speed such that the tether deployed according to a pre-described two-stage trajectory. The stepper driver was itself commanded by an on-board computer that used tether deployment data as input and provided the new required position of the brake as output. The stepper driver design was driven by the requirements of a low cost yet reliable redundant design, use of a micro-controller and software commonly known to students, very small dimension, good thermal behavior and capable of delivering high torque at high efficiency. The work followed as much as possible ESA's design standards and was qualified by electromagnetic compatibility, thermal vacuum and shaker tests. It was functionally tested in real-time ground tether deployments. Mission data shows the stepper driver performed well in flight.

  11. The drivers of facility-based immunization performance and costs. An application to Moldova.

    PubMed

    Maceira, Daniel; Goguadze, Ketevan; Gotsadze, George

    2015-05-07

    This paper identifies factors that affect the cost and performance of the routine immunization program in Moldova through an analysis of facility-based data collected as part of a multi-country costing and financing study of routine immunization (EPIC). A nationally representative sample of health care facilities (50) was selected through multi-stage, stratified random sampling. Data on inputs, unit prices and facility outputs were collected during October 3rd 2012-January 14th 2013 using a pre-tested structured questionnaire. Ordinary least square (OLS) regression analysis was performed to determine factors affecting facility outputs (number of doses administered and fully immunized children) and explaining variation in total facility costs. The study found that the number of working hours, vaccine wastage rates, and whether or not a doctor worked at a facility (among other factors) were positively and significantly associated with output levels. In addition, the level of output, price of inputs and share of the population with university education were significantly associated with higher facility costs. A 1% increase in fully immunized child would increase total cost by 0.7%. Few costing studies of primary health care services in developing countries evaluate the drivers of performance and cost. This exercise attempted to fill this knowledge gap and helped to identify organizational and managerial factors at a primary care district and national level that could be addressed by improved program management aimed at improved performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Smart truck driver assistant : a cost effective solution for real time management of container delivery to trucks: [research brief].

    DOT National Transportation Integrated Search

    2015-12-01

    In this project, we developed a mobile application (app) that utilizes the rich environment and features of smartphones. Our app uses the widely available resources of smartphones (at no additional cost to drivers or terminals) to collect data from p...

  13. Process-based Cost Estimation for Ramjet/Scramjet Engines

    NASA Technical Reports Server (NTRS)

    Singh, Brijendra; Torres, Felix; Nesman, Miles; Reynolds, John

    2003-01-01

    Process-based cost estimation plays a key role in effecting cultural change that integrates distributed science, technology and engineering teams to rapidly create innovative and affordable products. Working together, NASA Glenn Research Center and Boeing Canoga Park have developed a methodology of process-based cost estimation bridging the methodologies of high-level parametric models and detailed bottoms-up estimation. The NASA GRC/Boeing CP process-based cost model provides a probabilistic structure of layered cost drivers. High-level inputs characterize mission requirements, system performance, and relevant economic factors. Design alternatives are extracted from a standard, product-specific work breakdown structure to pre-load lower-level cost driver inputs and generate the cost-risk analysis. As product design progresses and matures the lower level more detailed cost drivers can be re-accessed and the projected variation of input values narrowed, thereby generating a progressively more accurate estimate of cost-risk. Incorporated into the process-based cost model are techniques for decision analysis, specifically, the analytic hierarchy process (AHP) and functional utility analysis. Design alternatives may then be evaluated not just on cost-risk, but also user defined performance and schedule criteria. This implementation of full-trade study support contributes significantly to the realization of the integrated development environment. The process-based cost estimation model generates development and manufacturing cost estimates. The development team plans to expand the manufacturing process base from approximately 80 manufacturing processes to over 250 processes. Operation and support cost modeling is also envisioned. Process-based estimation considers the materials, resources, and processes in establishing cost-risk and rather depending on weight as an input, actually estimates weight along with cost and schedule.

  14. ROV's: The key is cost effectiveness

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

    Saunders, E.

    1986-10-01

    Although diver-support activities will continue to be required in terms of monitoring and assistance, low-cost, remotely operated vehicles (ROV's) will have an increasing presence in the oil industry and other fields provided there is ongoing improvement in management, preparation, and execution of work. Beyond the safety aspect, the key is cost effectiveness. It is the company's intention wherever possible, and within realistic constraints, to take the man out of the water either by direct ROV replacement of the diver or by assisting him. Shell's exploration and production operations are based in three main areas: the southern, central, and northern Northmore » Sea. These developed fields, which consist of 26 various structures (interconnected), are connected to the mainland by over 1,100 km of submarine pipeline. Maintenance and underwater engineering costs in northern operations alone exceed pounds40 million/year (about $60 million/year) where typical support is an estimated 700 ROV days/year. The utilization analysis indicates a major use in ''eyeball'' vehicles for diver monitoring, and a large percentage for pipeline survey with only a limited amount on structural work and other special applications. The ''Bondi initiative'' in the late 1970s was intended to remove the diver from the water by ROV replacement, but due to lack of development, the capability in many areas has not evolved.« less

  15. Key aspects of cost effective collector and solar field design

    NASA Astrophysics Data System (ADS)

    von Reeken, Finn; Nicodemo, Dario; Keck, Thomas; Weinrebe, Gerhard; Balz, Markus

    2016-05-01

    A study has been performed where different key parameters influencing solar field cost are varied. By using levelised cost of energy as figure of merit it is shown that parameters like GoToStow wind speed, heliostat stiffness or tower height should be adapted to respective site conditions from an economical point of view. The benchmark site Redstone (Northern Cape Province, South Africa) has been compared to an alternate site close to Phoenix (AZ, USA) regarding site conditions and their effect on cost-effective collector and solar field design.

  16. Economic viability of Stratified Medicine concepts: An investor perspective on drivers and conditions that favour using Stratified Medicine approaches in a cost-contained healthcare environment.

    PubMed

    Fugel, Hans-Joerg; Nuijten, Mark; Postma, Maarten

    2016-12-25

    Stratified Medicine (SM) is becoming a natural result of advances in biomedical science and a promising path for the innovation-based biopharmaceutical industry to create new investment opportunities. While the use of biomarkers to improve R&D efficiency and productivity is very much acknowledged by industry, much work remains to be done to understand the drivers and conditions that favour using a stratified approach to create economically viable products and to justify the investment in SM interventions as a stratification option. In this paper we apply a decision analytical methodology to address the economic attractiveness of different SM development options in a cost-contained healthcare environment. For this purpose, a hypothetical business case in the oncology market has been developed considering four feasible development scenarios. The article outlines the effects of development time and time to peak sales as key economic value drivers influencing profitability of SM interventions under specific conditions. If regulatory and reimbursement challenges can be solved, decreasing development time and enhancing early market penetration would most directly improve the economic attractiveness of SM interventions. Appropriate tailoring of highly differentiated patient subgroups is the prerequisite to leverage potential efficiency gains in the R&D process. Also, offering a better targeted and hence ultimately more cost-effective therapy at reimbursable prices will facilitate time to market access and allow increasing market share gains within the targeted populations. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Costs of a work-family intervention: evidence from the work, family, and health network.

    PubMed

    Barbosa, Carolina; Bray, Jeremy W; Brockwood, Krista; Reeves, Daniel

    2014-01-01

    To estimate the cost to the workplace of implementing initiatives to reduce work-family conflict. Prospective cost analysis conducted alongside a group-randomized multisite controlled experimental study, using a microcosting approach. An information technology firm. Employees (n = 1004) and managers (n = 141) randomized to the intervention arm. STAR (Start. Transform. Achieve. Results.) to enhance employees' control over their work time, increase supervisor support for employees to manage work and family responsibilities, and reorient the culture toward results. A taxonomy of activities related to customization, start-up, and implementation was developed. Resource use and unit costs were estimated for each activity, excluding research-related activities. Economic costing approach (accounting and opportunity costs). Sensitivity analyses on intervention costs. The total cost of STAR was $709,654, of which $389,717 was labor costs and $319,937 nonlabor costs (including $313,877 for intervention contract). The cost per employee participation in the intervention was $340 (95% confidence interval: $330-$351); $597 ($561-$634) for managers and $300 ($292-$308) for other employees (2011 prices). A detailed activity costing approach allows for more accurate cost estimates and identifies key drivers of cost. The key cost driver was employees' time spent on receiving the intervention. Ignoring this cost, which is usual in studies that cost workplace interventions, would seriously underestimate the cost of a workplace initiative.

  18. Driver development of IFE power plant in Japan Collaborative process with industry and industrial applications

    NASA Astrophysics Data System (ADS)

    Nakai, S.; Yamanaka, M.; Kitagawa, Y.; Fujita, K.; Heya, M.; Mima, K.; Izawa, Y.; Nakatsuka, M.; Murakami, M.; Ueda, K.; Sasaki, T.; Mori, Y.; Kanabe, T.; Hiruma, T.; Kan, H.; Kawashima, T.

    2006-06-01

    The typical specifications of the laser driver for a commercial IFE power plant are (1) total energy (MJ/pulse) with a tailored 20-40 ns pulse, (2) repetition operation (˜ 10 Hz), (3) efficiency (˜ 10%) with enough robustness and low cost. The key elements of the DPSSL driver technology are under development with HALNA. The HALNA 10 (High Average-power Laser for Nuclear-fusion Application) demonstrated 10 J × 10 Hz operation and the HALNA 100 (100 J × 10 Hz) is now under construction. By using the high average power and high intensity lasers, new industrial applications are being proceeded. The collaborative process for the development of high power laser with industry and for the industrial applications is effective and essential in the development of the laser driver for IFE power plant.

  19. Evaluation of a Stratified National Breast Screening Program in the United Kingdom: An Early Model-Based Cost-Effectiveness Analysis.

    PubMed

    Gray, Ewan; Donten, Anna; Karssemeijer, Nico; van Gils, Carla; Evans, D Gareth; Astley, Sue; Payne, Katherine

    2017-09-01

    To identify the incremental costs and consequences of stratified national breast screening programs (stratified NBSPs) and drivers of relative cost-effectiveness. A decision-analytic model (discrete event simulation) was conceptualized to represent four stratified NBSPs (risk 1, risk 2, masking [supplemental screening for women with higher breast density], and masking and risk 1) compared with the current UK NBSP and no screening. The model assumed a lifetime horizon, the health service perspective to identify costs (£, 2015), and measured consequences in quality-adjusted life-years (QALYs). Multiple data sources were used: systematic reviews of effectiveness and utility, published studies reporting costs, and cohort studies embedded in existing NBSPs. Model parameter uncertainty was assessed using probabilistic sensitivity analysis and one-way sensitivity analysis. The base-case analysis, supported by probabilistic sensitivity analysis, suggested that the risk stratified NBSPs (risk 1 and risk-2) were relatively cost-effective when compared with the current UK NBSP, with incremental cost-effectiveness ratios of £16,689 per QALY and £23,924 per QALY, respectively. Stratified NBSP including masking approaches (supplemental screening for women with higher breast density) was not a cost-effective alternative, with incremental cost-effectiveness ratios of £212,947 per QALY (masking) and £75,254 per QALY (risk 1 and masking). When compared with no screening, all stratified NBSPs could be considered cost-effective. Key drivers of cost-effectiveness were discount rate, natural history model parameters, mammographic sensitivity, and biopsy rates for recalled cases. A key assumption was that the risk model used in the stratification process was perfectly calibrated to the population. This early model-based cost-effectiveness analysis provides indicative evidence for decision makers to understand the key drivers of costs and QALYs for exemplar stratified NBSP. Copyright

  20. Knowledge, Risk Perception and Practice Regarding Tuberculosis Transmission among Long Distance Bus Drivers in Addis Ababa, Ethiopia: A Cross Sectional Study.

    PubMed

    Gebrehiwot, Tsegaye Tewelde; Tesfamichael, Fessahaye Alemseged

    2017-11-01

    Window opening during bus transportation is recommended as a tuberculosis prevention strategy.Yet, drivers are affected by lack knowledge and risk perception of passengers and assistants. Boosting knowledge of and notifying the high risk of tuberculosis transmission for every passenger could be too costly. However, strategies targeting bus drivers as key agents unlike targeting all passengers might be less costly for window opening. Data were collected from November 18/2014 to December 21/2014 in inter-region bus stations of Addis Ababa using cross sectional study design. Samples of 306 participants were selected using simple random sampling, and data were collected through face-to-face interview. Data were entered into Epi-data version 3.1 andanalyzed using IBM SPSS version 21. From a sample of 306 bus drivers, 303 were interviewed. Nine in ten and nearly half of participants believed in the need for opening all windows and avoiding overcrowding of passengers as TB preventive measures respectively. Few bus drivers (7.3%) believed that bus drivers and their assistants could be at risk of tuberculosis. The majority (85.7%) of bus drivers opened side window the whole day without precondition. Hearing tuberculosis related information from radio was a promoting factor for tuberculosis preventive measures among bus drivers. Tuberculosis preventive practices and knowledge of bus drivers seempositive (opportunities), despite their low risk perception (challenge). Using the opportunity, further empowering bus drivers to persuade passengers and assistants to open all the rest of the windows is needed.

  1. Battery Electric Vehicles: Range Optimization and Diversification for the U.S. Drivers

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

    Lin, Zhenhong

    2012-01-01

    Properly selecting the driving range is critical for accurately predicting the market acceptance and the resulting social benefits of BEVs. Analysis of transportation technology transition could be biased against battery electric vehicles (BEV) and mislead policy making, if BEVs are not represented with optimal ranges. This study proposes a coherent method to optimize the BEV driving range by minimizing the range-related cost, which is formulated as a function of range, battery cost, energy prices, charging frequency, access to backup vehicles, and the cost and refueling hassle of operating the backup vehicle. This method is implemented with a sample of 36,664more » drivers, representing U.S. new car drivers, based on the 2009 National Household Travel Survey data. Key findings are: 1) Assuming the near term (2015) battery cost at $405/kWh, about 98% of the sampled drivers are predicted to prefer a range below 200 miles, and about 70% below 100 miles. The most popular 20-mile band of range is 57 to77 miles, unsurprisingly encompassing the Leaf s EPA-certified 73-mile range. With range limited to 4 or 7 discrete options, the majority are predicted to choose a range below 100 miles. 2) Found as a statistically robust rule of thumb, the BEV optimal range is approximately 0.6% of one s annual driving distance. 3) Reducing battery costs could motivate demand for larger range, but improving public charging may cause the opposite. 4) Using a single range to represent BEVs in analysis could significantly underestimate their competitiveness e.g. by $3226/vehicle if BEVs are represented with 73-mile range only or by $7404/BEV if with 150-mile range only. Range optimization and diversification into 4 or 7 range options reduce such analytical bias by 78% or 90%, respectively.« less

  2. Innovations in cost management.

    PubMed

    Daly, Rich

    2014-03-01

    To better understand true costs and use this knowledge to drive savings, health systems are: finding ways to combine clinical and financial data to identify clinical care savings, including equipment not just care variation when researching clinical cost drivers, benchmarking to identify both relatively high-cost areas and lower-cost approaches, including nonclinical support areas when looking for systemwide cost drivers.

  3. Manufacturing cost/design trade-studies for flywheel

    NASA Astrophysics Data System (ADS)

    Noton, B. R.

    1982-12-01

    A procedure is described for enabling comparison of different flywheel designs based on both performance ratings, and manufacturing and inspection cost. Development of the methodology requires identification of all the steps in the manufacture and inspection of each design, the cost drivers, and the ground rules. A man-hour summary must also be provided. The approach to determine the recurring and nonrecurring manufacturing man-hours is presented. Cost drivers in composite manufacture are discussed as well as the approach to address cost driver data from industry. Some indications for cost driver data from industry. Some indications for cost reduction are included.

  4. A novel methodology for estimating upper limits of major cost drivers for profitable conceptual launch system architectures

    NASA Astrophysics Data System (ADS)

    Rhodes, Russel E.; Byrd, Raymond J.

    1998-01-01

    This paper presents a ``back of the envelope'' technique for fast, timely, on-the-spot, assessment of affordability (profitability) of commercial space transportation architectural concepts. The tool presented here is not intended to replace conventional, detailed costing methodology. The process described enables ``quick look'' estimations and assumptions to effectively determine whether an initial concept (with its attendant cost estimating line items) provides focus for major leapfrog improvement. The Cost Charts Users Guide provides a generic sample tutorial, building an approximate understanding of the basic launch system cost factors and their representative magnitudes. This process will enable the user to develop a net ``cost (and price) per payload-mass unit to orbit'' incorporating a variety of significant cost drivers, supplemental to basic vehicle cost estimates. If acquisition cost and recurring cost factors (as a function of cost per payload-mass unit to orbit) do not meet the predetermined system-profitability goal, the concept in question will be clearly seen as non-competitive. Multiple analytical approaches, and applications of a variety of interrelated assumptions, can be examined in a quick, (on-the-spot) cost approximation analysis as this tool has inherent flexibility. The technique will allow determination of concept conformance to system objectives.

  5. Compliance with driver's license laws and illegal licensing among commercial bus drivers in Lagos, Nigeria: policy implications and evidence for action.

    PubMed

    Okafor, I P; Odeyemi, K A; Dolapo, D C; Adegbola, A A

    2014-09-01

    To determine the level of compliance with driver's license laws among commercial bus drivers in Lagos, Nigeria. Two intercity motor parks were selected by simple random sampling and all consenting minibus drivers participated in the study. Key Informant Interviews (KIIs) were also conducted with selected officials in the driver training and licensing authorities. Compliance with the minimum age for driving was high (93.6%), so also was having driving test prior to driver's license procurement (83.3%). Formal driver training and VA testing were very low, (26.1% and 32.9% respectively) Overall, only 9.3% of them were found to have fulfilled all the pre-license obligations before obtaining their first driver's license. The odds of a driver with a secondary education having formal driver training is 3.33 times higher than those with no education (OR 3.33, 95% CI 1.01-11.35). Drivers who were 60 years or older were 3.62 times more likely to be compliant than those who were between 20-29 years (OR 3.62, 95% CI 0.56-29.19). For the 98.3% of them who possessed valid licenses, 52.3% of them obtained them illegally. All the key officials saw RTIs as a serious public health problem but faced several challenges in the course of their work. Overall compliance with pre-license regulations was very poor. There is need for a review and strict enforcement of driver's license laws to improve compliance. Also vital are fostering inter-sectoral collaboration and improvement in the operations of all establishments involved in driver training and license procurement in Nigeria.

  6. Drivers and challenges for implementing ISO 14001 environmental management systems in an emerging Gulf Arab country.

    PubMed

    Waxin, Marie-France; Knuteson, Sandra L; Bartholomew, Aaron

    2017-11-13

    Worldwide, ISO 14001 certification for organizations has become the norm, but the Arab world accounts for an insignificant portion of all the certified organizations. There is a dearth of research on environmental management systems (EMS) in Arab and emerging countries and in public organizations. The objectives of this research are to: (1) examine the key drivers and challenges related to implementation of ISO 14001 certified EMS in the United Arab Emirates, an emerging Arab country and (2) compare and contrast these drivers and challenges between private and public organizations. We adopt an explorative, qualitative methodology, using semi-structured interviews with environmental managers in 11 organizations (6 private and 5 public) from different industrial sectors. Drivers of EMS certification were mostly similar between private and public organizations, with some differences. Compliance with regulations and standards, and increasing environmental performance were the main drivers for ISO 14001 certification in both private and public organizations. Commitment to sustainability was more important for public organizations. Cost reduction, competitors, leadership commitment and customers' demands were shared drivers, but more stressed by private organizations. Local community and employees' pressures were reported by private organizations only. The challenges to ISO 14001 implementation were similar for private and public organizations. They were: a lack of qualified human resources, practical challenges associated with implementation, a lack of regulations, a lack of support from management, and high costs. Our findings have implications for managers, academics, consultants, and policy makers in the UAE and other emerging markets.

  7. Development of a practical costing method for hospitals.

    PubMed

    Cao, Pengyu; Toyabe, Shin-Ichi; Akazawa, Kouhei

    2006-03-01

    To realize an effective cost control, a practical and accurate cost accounting system is indispensable in hospitals. In traditional cost accounting systems, the volume-based costing (VBC) is the most popular cost accounting method. In this method, the indirect costs are allocated to each cost object (services or units of a hospital) using a single indicator named a cost driver (e.g., Labor hours, revenues or the number of patients). However, this method often results in rough and inaccurate results. The activity based costing (ABC) method introduced in the mid 1990s can prove more accurate results. With the ABC method, all events or transactions that cause costs are recognized as "activities", and a specific cost driver is prepared for each activity. Finally, the costs of activities are allocated to cost objects by the corresponding cost driver. However, it is much more complex and costly than other traditional cost accounting methods because the data collection for cost drivers is not always easy. In this study, we developed a simplified ABC (S-ABC) costing method to reduce the workload of ABC costing by reducing the number of cost drivers used in the ABC method. Using the S-ABC method, we estimated the cost of the laboratory tests, and as a result, similarly accurate results were obtained with the ABC method (largest difference was 2.64%). Simultaneously, this new method reduces the seven cost drivers used in the ABC method to four. Moreover, we performed an evaluation using other sample data from physiological laboratory department to certify the effectiveness of this new method. In conclusion, the S-ABC method provides two advantages in comparison to the VBC and ABC methods: (1) it can obtain accurate results, and (2) it is simpler to perform. Once we reduce the number of cost drivers by applying the proposed S-ABC method to the data for the ABC method, we can easily perform the cost accounting using few cost drivers after the second round of costing.

  8. Spying or steering? Views of parents of young novice drivers on the use and ethics of driver-monitoring technologies.

    PubMed

    Guttman, Nurit; Lotan, Tsippy

    2011-01-01

    In-vehicle technologies that document driving practices have the potential to enhance the driving safety of young drivers, but their installation depends largely on their parents' willingness and raises ethical dilemmas. This study investigated, using closed and open-ended questions, the views of 906 parents of young drivers in Israel regarding their willingness to install such a technology, and their conceptions of social norms and ethical issues associated with the technology and of factors that would encourage or discourage parents to adopt it. Most believed parents should feel morally obligated to install it. When cost was not a consideration, most said they would, and believed other parents would be willing to install the technology. Fewer (about half) expressed willingness to install it after being told about its estimated cost. Monetary cost was rated as a barrier to install it by about half. Environmental considerations were viewed as an incentive. Parents who supported the installation believed it would serve as a trigger for parent-young driver communication but those who did not thought it would erode trust in the parent-young driver relationship. Most said parents should have access to the monitoring data. Policy implications regarding issues of privacy and resources for parents are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

  9. Habitat degradation and loss as key drivers of regional population extinction

    EPA Science Inventory

    Habitat quality is a fundamental driver of species distributions and population outcomes but is often difficult to measure. Further, habitat quality can be abstract, multi-faceted and challenging to compare alongside measures of habitat amount and fragmentation. Consequently, hab...

  10. Novice drivers' individual trajectories of driver behavior over the first three years of driving.

    PubMed

    Roman, Gabriela D; Poulter, Damian; Barker, Edward; McKenna, Frank P; Rowe, Richard

    2015-09-01

    Identifying the changes in driving behavior that underlie the decrease in crash risk over the first few months of driving is key to efforts to reduce injury and fatality risk in novice drivers. This study represented a secondary data analysis of 1148 drivers who participated in the UK Cohort II study. The Driver Behavior Questionnaire was completed at 6 months and 1, 2 and 3 years after licensure. Linear latent growth models indicated significant increases across development in all four dimensions of aberrant driving behavior under scrutiny: aggressive violations, ordinary violations, errors and slips. Unconditional and conditional latent growth class analyses showed that the observed heterogeneity in individual trajectories was explained by the presence of multiple homogeneous groups of drivers, each exhibiting specific trajectories of aberrant driver behavior. Initial levels of aberrant driver behavior were important in identifying sub-groups of drivers. All classes showed positive slopes; there was no evidence of a group of drivers whose aberrant behavior decreased over time that might explain the decrease in crash involvement observed over this period. Male gender and younger age predicted membership of trajectories with higher levels of aberrant behavior. These findings highlight the importance of early intervention for improving road safety. We discuss the implications of our findings for understanding the behavioral underpinnings of the decrease in crash involvement observed in the early months of driving. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Investing in innovation: trade-offs in the costs and cost-efficiency of school feeding using community-based kitchens in Bangladesh.

    PubMed

    Gelli, Aulo; Suwa, Yuko

    2014-09-01

    School feeding programs have been a key response to the recent food and economic crises and function to some degree in nearly every country in the world. However, school feeding programs are complex and exhibit different, context-specific models or configurations. To examine the trade-offs, including the costs and cost-efficiency, of an innovative cluster kitchen implementation model in Bangladesh using a standardized framework. A supply chain framework based on international standards was used to provide benchmarks for meaningful comparisons across models. Implementation processes specific to the program in Bangladesh were mapped against this reference to provide a basis for standardized performance measures. Qualitative and quantitative data on key metrics were collected retrospectively using semistructured questionnaires following an ingredients approach, including both financial and economic costs. Costs were standardized to a 200-feeding-day year and 700 kcal daily. The cluster kitchen model had similarities with the semidecentralized model and outsourced models in the literature, the main differences involving implementation scale, scale of purchasing volumes, and frequency of purchasing. Two important features stand out in terms of implementation: the nutritional quality of meals and the level of community involvement. The standardized full cost per child per year was US$110. Despite the nutritious content of the meals, the overall cost-efficiency in cost per nutrient output was lower than the benchmark for centralized programs, due mainly to support and start-up costs. Cluster kitchens provide an example of an innovative implementation model, combining an emphasis on quality meal delivery with strong community engagement. However, the standardized costs-per child were above the average benchmarks for both low-and middle-income countries. In contrast to the existing benchmark data from mature, centralized models, the main cost drivers of the program were

  12. The high intensity solar cell: Key to low cost photovoltaic power

    NASA Technical Reports Server (NTRS)

    Sater, B. L.; Goradia, C.

    1975-01-01

    The design considerations and performance characteristics of the 'high intensity' (HI) solar cell are presented. A high intensity solar system was analyzed to determine its cost effectiveness and to assess the benefits of further improving HI cell efficiency. It is shown that residential sized systems can be produced at less than $1000/kW peak electric power. Due to their superior high intensity performance characteristics compared to the conventional and VMJ cells, HI cells and light concentrators may be the key to low cost photovoltaic power.

  13. Value Narratives: A Novel Method for Understanding High-Cost Pediatric Hospital Patients.

    PubMed

    Smith, Andrew; Andrews, Seth; Wilkins, Victoria; De Beritto, Theodore; Jenkins, Stephen; Maloney, Christopher G

    2016-10-01

    To delineate the drivers of cost associated with the most-costly inpatients in a tertiary pediatric hospital. We identified the 10% most-costly inpatients treated at a large regional children's hospital in 2010. From this group we randomly selected, within representative specialties, 2 groups of 50 inpatients for detailed chart review. By using daily cost data and clinical records, 2 independent reviewers examined the clinical course of each patient to identify events that drove cost beyond that expected for standard of care. By using an iterative process, these events were grouped into themes or "cost drivers." Linear regression was used to measure the association of number of cost drivers and total 2010 inpatient cost. We identified 7 cost drivers: medical complications (49%), futile treatment (6%), failure to identify family care preferences (9%), system errors (65%), preventable admissions (21%), complex family dynamics (11%), and expensive diagnosis with no other cost driver (15%). Cost drivers were associated with increased total costs. We developed a novel method for understanding high-cost inpatients. This method allowed a more detailed understanding of cost drivers than could be achieved with administrative data alone. Many of these cost drivers were related to problems with communication. Copyright © 2016 by the American Academy of Pediatrics.

  14. The Cost-Effectiveness of High-Risk Lung Cancer Screening and Drivers of Program Efficiency.

    PubMed

    Cressman, Sonya; Peacock, Stuart J; Tammemägi, Martin C; Evans, William K; Leighl, Natasha B; Goffin, John R; Tremblay, Alain; Liu, Geoffrey; Manos, Daria; MacEachern, Paul; Bhatia, Rick; Puksa, Serge; Nicholas, Garth; McWilliams, Annette; Mayo, John R; Yee, John; English, John C; Pataky, Reka; McPherson, Emily; Atkar-Khattra, Sukhinder; Johnston, Michael R; Schmidt, Heidi; Shepherd, Frances A; Soghrati, Kam; Amjadi, Kayvan; Burrowes, Paul; Couture, Christian; Sekhon, Harmanjatinder S; Yasufuku, Kazuhiro; Goss, Glenwood; Ionescu, Diana N; Hwang, David M; Martel, Simon; Sin, Don D; Tan, Wan C; Urbanski, Stefan; Xu, Zhaolin; Tsao, Ming-Sound; Lam, Stephen

    2017-08-01

    Lung cancer risk prediction models have the potential to make programs more affordable; however, the economic evidence is limited. Participants in the National Lung Cancer Screening Trial (NLST) were retrospectively identified with the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. The high-risk subgroup was assessed for lung cancer incidence and demographic characteristics compared with those in the low-risk subgroup and the Pan-Canadian Early Detection of Lung Cancer Study (PanCan), which is an observational study that was high-risk-selected in Canada. A comparison of high-risk screening versus standard care was made with a decision-analytic model using data from the NLST with Canadian cost data from screening and treatment in the PanCan study. Probabilistic and deterministic sensitivity analyses were undertaken to assess uncertainty and identify drivers of program efficiency. Use of the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial with a threshold set at 2% over 6 years would have reduced the number of individuals who needed to be screened in the NLST by 81%. High-risk screening participants in the NLST had more adverse demographic characteristics than their counterparts in the PanCan study. High-risk screening would cost $20,724 (in 2015 Canadian dollars) per quality-adjusted life-year gained and would be considered cost-effective at a willingness-to-pay threshold of $100,000 in Canadian dollars per quality-adjusted life-year gained with a probability of 0.62. Cost-effectiveness was driven primarily by non-lung cancer outcomes. Higher noncurative drug costs or current costs for immunotherapy and targeted therapies in the United States would render lung cancer screening a cost-saving intervention. Non-lung cancer outcomes drive screening efficiency in diverse, tobacco-exposed populations. Use of risk selection can reduce the budget impact, and

  15. Exploratory multinomial logit model-based driver injury severity analyses for teenage and adult drivers in intersection-related crashes.

    PubMed

    Wu, Qiong; Zhang, Guohui; Ci, Yusheng; Wu, Lina; Tarefder, Rafiqul A; Alcántara, Adélamar Dely

    2016-05-18

    Teenage drivers are more likely to be involved in severely incapacitating and fatal crashes compared to adult drivers. Moreover, because two thirds of urban vehicle miles traveled are on signal-controlled roadways, significant research efforts are needed to investigate intersection-related teenage driver injury severities and their contributing factors in terms of driver behavior, vehicle-infrastructure interactions, environmental characteristics, roadway geometric features, and traffic compositions. Therefore, this study aims to explore the characteristic differences between teenage and adult drivers in intersection-related crashes, identify the significant contributing attributes, and analyze their impacts on driver injury severities. Using crash data collected in New Mexico from 2010 to 2011, 2 multinomial logit regression models were developed to analyze injury severities for teenage and adult drivers, respectively. Elasticity analyses and transferability tests were conducted to better understand the quantitative impacts of these factors and the teenage driver injury severity model's generality. The results showed that although many of the same contributing factors were found to be significant in the both teenage and adult driver models, certain different attributes must be distinguished to specifically develop effective safety solutions for the 2 driver groups. The research findings are helpful to better understand teenage crash uniqueness and develop cost-effective solutions to reduce intersection-related teenage injury severities and facilitate driver injury mitigation research.

  16. Low-Cost, Light Weight, Thin Film Solar Concentrator

    NASA Technical Reports Server (NTRS)

    Ganapathi, G.; Palisoc, A.; Nesmith, B.; Greschik, G.; Gidanian, K.; Kindler, A.

    2013-01-01

    This research addresses a cost barrier towards achieving a solar thermal collector system with an installed cost of $75/sq m and meet the Department of Energy's (DOE's) performance targets for optical errors, operations during windy conditions and lifetime. Current concentrators can cost as much as 40-50% of the total installed costs for a CSP plant. In order to reduce the costs from current $200-$250/sq m, it is important to focus on the overall system. The reflector surface is a key cost driver, and our film-based polymer reflector will help significantly in achieving DOE's cost target of $75/sq m. The ease of manufacturability, installation and replacement make this technology a compelling one to develop. This technology can be easily modified for a variety of CSP options including heliostats, parabolic dishes and parabolic troughs.

  17. Survey data on key climate and environmental drivers of farmers' migration in Burkina Faso, West Africa.

    PubMed

    Sanfo, Safiétou; Fonta, M William; Boubacar, Ibrahim; Lamers, P A John

    2016-12-01

    This article describes two datasets generated from various sources in south western Burkina Faso to identify the key climate and environmental drivers that cause farmers to migrate. The survey sampling is random but reasoned and rational. The first dataset from 367 farm households contains data on farmers' perception of climate change risks or hazards, their impacts on farmland productivity and farm households' risk management strategies. The second dataset from 58 farm households contains data on agricultural practices, environmental changes, and environmental migration. Three supplemental Excel sheets show the results of the surveys. Details on the sample as well as further interpretation and discussion of the surveys are available in the associated research article ('Field Facts for Crop Insurance Design: Empirical Evidence from South Western Burkina Faso' (W. M. Fonta, S. Sanfo, B. Ibrahim, B. Barry, 2015) [1]).

  18. Delay and cost performance analysis of the diffie-hellman key exchange protocol in opportunistic mobile networks

    NASA Astrophysics Data System (ADS)

    Soelistijanto, B.; Muliadi, V.

    2018-03-01

    Diffie-Hellman (DH) provides an efficient key exchange system by reducing the number of cryptographic keys distributed in the network. In this method, a node broadcasts a single public key to all nodes in the network, and in turn each peer uses this key to establish a shared secret key which then can be utilized to encrypt and decrypt traffic between the peer and the given node. In this paper, we evaluate the key transfer delay and cost performance of DH in opportunistic mobile networks, a specific scenario of MANETs where complete end-to-end paths rarely exist between sources and destinations; consequently, the end-to-end delays in these networks are much greater than typical MANETs. Simulation results, driven by a random node movement model and real human mobility traces, showed that DH outperforms a typical key distribution scheme based on the RSA algorithm in terms of key transfer delay, measured by average key convergence time; however, DH performs as well as the benchmark in terms of key transfer cost, evaluated by total key (copies) forwards.

  19. Traffic Operations Control For Older Drivers And Pedestrians: Summary Report

    DOT National Transportation Integrated Search

    1996-07-01

    The purpose of this investigation was to determine which intersection operational characteristics could be altered to accommodate age-related changes. Two key drivers issues were examined in order to identify the specific older driver problems and th...

  20. Recognition method of construction conflict based on driver's eye movement.

    PubMed

    Xu, Yi; Li, Shiwu; Gao, Song; Tan, Derong; Guo, Dong; Wang, Yuqiong

    2018-04-01

    Drivers eye movement data in simulated construction conflicts at different speeds were collected and analyzed to find the relationship between the drivers' eye movement and the construction conflict. On the basis of the relationship between the drivers' eye movement and the construction conflict, the peak point of wavelet processed pupil diameter, the first point on the left side of the peak point and the first blink point after the peak point are selected as key points for locating construction conflict periods. On the basis of the key points and the GSA, a construction conflict recognition method so called the CCFRM is proposed. And the construction conflict recognition speed and location accuracy of the CCFRM are verified. The good performance of the CCFRM verified the feasibility of proposed key points in construction conflict recognition. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Evaluation of key driver categories influencing sustainable waste management development with the analytic hierarchy process (AHP): Serbia example.

    PubMed

    Tot, Bojana; Srđević, Bojan; Vujić, Bogdana; Russo, Mário Augusto Tavares; Vujić, Goran

    2016-08-01

    The problems of waste management have become increasingly complex in recent decades. The increasing amount of generated waste, adopted legislation in the field of waste management, administrative issues, economic impacts and social awareness are important drivers in achieving a sustainable waste management system. However, in practice, there are many other drivers that are often mutually in conflict. The purpose of this research is to define the precise driver and their corresponding sub-drivers, which are relevant for developing a waste management system and, on the basis of their importance, to determine which has the predominant influence on the slow development of a waste management system at the national and regional level, within the Republic of Serbia and similar countries of southeast Europe. This research presents two levels of decision making: the first is a pair-wise comparison of the drivers in relation to the goal and the second is a pair-wise comparison of the sub-drivers in relation to the driver and in relation to the goal. Results of performed analyses on the waste management drivers were integrated via the decision-making process supported by an analytic hierarchy process (AHP). The final results of this research shows that the Institutional-Administrative driver is the most important for developing a sustainable waste management system. © The Author(s) 2016.

  2. Vision-based method for detecting driver drowsiness and distraction in driver monitoring system

    NASA Astrophysics Data System (ADS)

    Jo, Jaeik; Lee, Sung Joo; Jung, Ho Gi; Park, Kang Ryoung; Kim, Jaihie

    2011-12-01

    Most driver-monitoring systems have attempted to detect either driver drowsiness or distraction, although both factors should be considered for accident prevention. Therefore, we propose a new driver-monitoring method considering both factors. We make the following contributions. First, if the driver is looking ahead, drowsiness detection is performed; otherwise, distraction detection is performed. Thus, the computational cost and eye-detection error can be reduced. Second, we propose a new eye-detection algorithm that combines adaptive boosting, adaptive template matching, and blob detection with eye validation, thereby reducing the eye-detection error and processing time significantly, which is hardly achievable using a single method. Third, to enhance eye-detection accuracy, eye validation is applied after initial eye detection, using a support vector machine based on appearance features obtained by principal component analysis (PCA) and linear discriminant analysis (LDA). Fourth, we propose a novel eye state-detection algorithm that combines appearance features obtained using PCA and LDA, with statistical features such as the sparseness and kurtosis of the histogram from the horizontal edge image of the eye. Experimental results showed that the detection accuracies of the eye region and eye states were 99 and 97%, respectively. Both driver drowsiness and distraction were detected with a success rate of 98%.

  3. Vehicle choices for teenage drivers: A national survey of U.S. parents.

    PubMed

    Eichelberger, Angela H; Teoh, Eric R; McCartt, Anne T

    2015-12-01

    Previous research has shown that many newly licensed teenagers in the United States are driving vehicles with inferior crash protection. The objective of this study was to update and extend previous research on U.S. parents' choices of vehicles for their teenagers. Telephone surveys were conducted with parents in May 2014 using a random sample of U.S. households likely to include teenagers. Participation was restricted to parents or guardians of teenagers who lived in the household and held either an intermediate or full driver's license. Parents were interviewed about the vehicle their teenager drives, the reason they chose the vehicle for their teenager, and the cost of purchased vehicles. Teenagers most often were driving 2000-06 model year vehicles (41%), with 30% driving a more recent model year and 19% driving an older model year. Teenagers most often were driving midsize or large cars (27%), followed by SUVs (22%), mini or small cars (20%), and pickups (14%). Far fewer were driving minivans (6%) or sports cars (1%). Forty-three percent of the vehicles driven by teenagers were purchased when the teenager started driving or later. A large majority (83%) were used vehicles. The median cost of the vehicles purchased was $5300, and the mean purchase price was $9751. Although parents report that the majority of teenagers are driving midsize or larger vehicles, many of these vehicles likely do not have key safety features, such as electronic stability control, which would be especially beneficial for teenage drivers. Many teenagers were driving older model year vehicles or vehicle types or sizes that are not ideal for novice drivers. Parents, and their teenage drivers, may benefit from consumer information about optimal vehicle choices for teenagers. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

  4. Drivers license display system

    NASA Astrophysics Data System (ADS)

    Prokoski, Francine J.

    1997-01-01

    Carjackings are only one of a growing class of law enforcement problems associated with increasingly violent crimes and accidents involving automobiles plays weapons, drugs and alcohol. Police traffic stops have become increasingly dangerous, with an officer having no information about a vehicle's potentially armed driver until approaching him. There are 15 million alcoholics in the US and 90 percent of them have drivers licenses. Many of them continue driving even after their licenses have ben revoked or suspended. There are thousands of unlicensed truck drivers in the country, and also thousands who routinely exceed safe operating periods without rest; often using drugs in an attempt to stay alert. MIKOS has developed the Drivers License Display Systems to reduce these and other related risks. Although every state requires the continuous display of vehicle registration information on every vehicle using public roads, no state yet requires the display of driver license information. The technology exists to provide that feature as an add-on to current vehicles for nominal cost. An initial voluntary market is expected to include: municipal, rental, and high value vehicles which are most likely to be mis-appropriated. It is anticipated that state regulations will eventually require such systems in the future, beginning with commercial vehicles, and then extending to high risk drivers and eventually all vehicles. The MIKOS system offers a dual-display approach which can be deployed now, and which will utilize all existing state licenses without requiring standardization.

  5. Countermeasures to Improve the Driving Performance of Older Drivers.

    ERIC Educational Resources Information Center

    Ashman, Richard D.; And Others

    1994-01-01

    In a 2-year project, 105 older drivers were given physical therapy (flexibility exercises), perceptual therapy (to improve visual discrimination), and driver education; traffic engineering modifications were also made. All four interventions improved performance an average of 7.9%. Engineering was most cost effective on high-volume roads, the…

  6. Cost/Effort Drivers and Decision Analysis

    NASA Technical Reports Server (NTRS)

    Seidel, Jonathan

    2010-01-01

    Engineering trade study analyses demand consideration of performance, cost and schedule impacts across the spectrum of alternative concepts and in direct reference to product requirements. Prior to detailed design, requirements are too often ill-defined (only goals ) and prone to creep, extending well beyond the Systems Requirements Review. Though lack of engineering design and definitive requirements inhibit the ability to perform detailed cost analyses, affordability trades still comprise the foundation of these future product decisions and must evolve in concert. This presentation excerpts results of the recent NASA subsonic Engine Concept Study for an Advanced Single Aisle Transport to demonstrate an affordability evaluation of performance characteristics and the subsequent impacts on engine architecture decisions. Applying the Process Based Economic Analysis Tool (PBEAT), development cost, production cost, as well as operation and support costs were considered in a traditional weighted ranking of the following system-level figures of merit: mission fuel burn, take-off noise, NOx emissions, and cruise speed. Weighting factors were varied to ascertain the architecture ranking sensitivities to these performance figures of merit with companion cost considerations. A more detailed examination of supersonic variable cycle engine cost is also briefly presented, with observations and recommendations for further refinements.

  7. Driver Distraction Using Visual-Based Sensors and Algorithms.

    PubMed

    Fernández, Alberto; Usamentiaga, Rubén; Carús, Juan Luis; Casado, Rubén

    2016-10-28

    Driver distraction, defined as the diversion of attention away from activities critical for safe driving toward a competing activity, is increasingly recognized as a significant source of injuries and fatalities on the roadway. Additionally, the trend towards increasing the use of in-vehicle information systems is critical because they induce visual, biomechanical and cognitive distraction and may affect driving performance in qualitatively different ways. Non-intrusive methods are strongly preferred for monitoring distraction, and vision-based systems have appeared to be attractive for both drivers and researchers. Biomechanical, visual and cognitive distractions are the most commonly detected types in video-based algorithms. Many distraction detection systems only use a single visual cue and therefore, they may be easily disturbed when occlusion or illumination changes appear. Moreover, the combination of these visual cues is a key and challenging aspect in the development of robust distraction detection systems. These visual cues can be extracted mainly by using face monitoring systems but they should be completed with more visual cues (e.g., hands or body information) or even, distraction detection from specific actions (e.g., phone usage). Additionally, these algorithms should be included in an embedded device or system inside a car. This is not a trivial task and several requirements must be taken into account: reliability, real-time performance, low cost, small size, low power consumption, flexibility and short time-to-market. The key points for the development and implementation of sensors to carry out the detection of distraction will also be reviewed. This paper shows a review of the role of computer vision technology applied to the development of monitoring systems to detect distraction. Some key points considered as both future work and challenges ahead yet to be solved will also be addressed.

  8. Driver Distraction Using Visual-Based Sensors and Algorithms

    PubMed Central

    Fernández, Alberto; Usamentiaga, Rubén; Carús, Juan Luis; Casado, Rubén

    2016-01-01

    Driver distraction, defined as the diversion of attention away from activities critical for safe driving toward a competing activity, is increasingly recognized as a significant source of injuries and fatalities on the roadway. Additionally, the trend towards increasing the use of in-vehicle information systems is critical because they induce visual, biomechanical and cognitive distraction and may affect driving performance in qualitatively different ways. Non-intrusive methods are strongly preferred for monitoring distraction, and vision-based systems have appeared to be attractive for both drivers and researchers. Biomechanical, visual and cognitive distractions are the most commonly detected types in video-based algorithms. Many distraction detection systems only use a single visual cue and therefore, they may be easily disturbed when occlusion or illumination changes appear. Moreover, the combination of these visual cues is a key and challenging aspect in the development of robust distraction detection systems. These visual cues can be extracted mainly by using face monitoring systems but they should be completed with more visual cues (e.g., hands or body information) or even, distraction detection from specific actions (e.g., phone usage). Additionally, these algorithms should be included in an embedded device or system inside a car. This is not a trivial task and several requirements must be taken into account: reliability, real-time performance, low cost, small size, low power consumption, flexibility and short time-to-market. The key points for the development and implementation of sensors to carry out the detection of distraction will also be reviewed. This paper shows a review of the role of computer vision technology applied to the development of monitoring systems to detect distraction. Some key points considered as both future work and challenges ahead yet to be solved will also be addressed. PMID:27801822

  9. California Charter Oversight: Key Elements and Actual Costs. CRB 12-001

    ERIC Educational Resources Information Center

    Blanton, Rebecca E.

    2012-01-01

    This study was mandated by SB537 (Simitian, Chapter 650, Stats. of 2007, codified at Ed. Code Section 47613), which requires the California Research Bureau (CRB) to prepare and submit to the Legislature a report on the key elements and actual costs of charter school oversight. Charter schools are public schools that are operated by entities other…

  10. [Cost analysis of home care with activity-based costing (ABC)].

    PubMed

    Lee, Su-Jeong

    2004-10-01

    This study was carried out to substantiate the application process of activity-based costing on the current cost of hospital home care (HHC) service. The study materials were documents, 120 client charts, health insurance demand bills, salary of 215 HHC nurses, operating expense, 6 HHC agencies, and 31 HHC nurses. The research was carried out by analyzing the HHC activities and then collecting labor and operating expenses. For resource drivers, HHC activity performance time and workload were studied. For activity drivers, the number of HHC activity performances and the activity number of visits were studied. The HHC activities were classified into 70 activities. In resource, the labor cost was 245 won per minute, operating cost was 9,570 won per visit and traffic expense was an average of 12,750 won. In resource drivers, education and training had the longest time of 67 minutes. Average length of performance for activities was 13.7 minutes. The workload was applied as a relative value. The average cost of HHC was 62,741 won and the cost ranged from 55,560 won to 74,016 won. The fixed base rate for a visit in the current HHC medical fee should be increased. Exclusion from the current fee structure or flexible operation of traveling expenses should be reviewed.

  11. Designing ecological climate change impact assessments to reflect key climatic drivers

    USGS Publications Warehouse

    Sofaer, Helen R.; Barsugli, Joseph J.; Jarnevich, Catherine S.; Abatzoglou, John T.; Talbert, Marian; Miller, Brian W.; Morisette, Jeffrey T.

    2017-01-01

    Identifying the climatic drivers of an ecological system is a key step in assessing its vulnerability to climate change. The climatic dimensions to which a species or system is most sensitive – such as means or extremes – can guide methodological decisions for projections of ecological impacts and vulnerabilities. However, scientific workflows for combining climate projections with ecological models have received little explicit attention. We review Global Climate Model (GCM) performance along different dimensions of change and compare frameworks for integrating GCM output into ecological models. In systems sensitive to climatological means, it is straightforward to base ecological impact assessments on mean projected changes from several GCMs. Ecological systems sensitive to climatic extremes may benefit from what we term the ‘model space’ approach: a comparison of ecological projections based on simulated climate from historical and future time periods. This approach leverages the experimental framework used in climate modeling, in which historical climate simulations serve as controls for future projections. Moreover, it can capture projected changes in the intensity and frequency of climatic extremes, rather than assuming that future means will determine future extremes. Given the recent emphasis on the ecological impacts of climatic extremes, the strategies we describe will be applicable across species and systems. We also highlight practical considerations for the selection of climate models and data products, emphasizing that the spatial resolution of the climate change signal is generally coarser than the grid cell size of downscaled climate model output. Our review illustrates how an understanding of how climate model outputs are derived and downscaled can improve the selection and application of climatic data used in ecological modeling.

  12. Designing ecological climate change impact assessments to reflect key climatic drivers.

    PubMed

    Sofaer, Helen R; Barsugli, Joseph J; Jarnevich, Catherine S; Abatzoglou, John T; Talbert, Marian K; Miller, Brian W; Morisette, Jeffrey T

    2017-07-01

    Identifying the climatic drivers of an ecological system is a key step in assessing its vulnerability to climate change. The climatic dimensions to which a species or system is most sensitive - such as means or extremes - can guide methodological decisions for projections of ecological impacts and vulnerabilities. However, scientific workflows for combining climate projections with ecological models have received little explicit attention. We review Global Climate Model (GCM) performance along different dimensions of change and compare frameworks for integrating GCM output into ecological models. In systems sensitive to climatological means, it is straightforward to base ecological impact assessments on mean projected changes from several GCMs. Ecological systems sensitive to climatic extremes may benefit from what we term the 'model space' approach: a comparison of ecological projections based on simulated climate from historical and future time periods. This approach leverages the experimental framework used in climate modeling, in which historical climate simulations serve as controls for future projections. Moreover, it can capture projected changes in the intensity and frequency of climatic extremes, rather than assuming that future means will determine future extremes. Given the recent emphasis on the ecological impacts of climatic extremes, the strategies we describe will be applicable across species and systems. We also highlight practical considerations for the selection of climate models and data products, emphasizing that the spatial resolution of the climate change signal is generally coarser than the grid cell size of downscaled climate model output. Our review illustrates how an understanding of how climate model outputs are derived and downscaled can improve the selection and application of climatic data used in ecological modeling. © 2017 John Wiley & Sons Ltd.

  13. Effort Drivers Estimation for Brazilian Geographically Distributed Software Development

    NASA Astrophysics Data System (ADS)

    Almeida, Ana Carina M.; Souza, Renata; Aquino, Gibeon; Meira, Silvio

    To meet the requirements of today’s fast paced markets, it is important to develop projects on time and with the minimum use of resources. A good estimate is the key to achieve this goal. Several companies have started to work with geographically distributed teams due to cost reduction and time-to-market. Some researchers indicate that this approach introduces new challenges, because the teams work in different time zones and have possible differences in culture and language. It is already known that the multisite development increases the software cycle time. Data from 15 DSD projects from 10 distinct companies were collected. The analysis shows drivers that impact significantly the total effort planned to develop systems using DSD approach in Brazil.

  14. A learning-based autonomous driver: emulate human driver's intelligence in low-speed car following

    NASA Astrophysics Data System (ADS)

    Wei, Junqing; Dolan, John M.; Litkouhi, Bakhtiar

    2010-04-01

    In this paper, an offline learning mechanism based on the genetic algorithm is proposed for autonomous vehicles to emulate human driver behaviors. The autonomous driving ability is implemented based on a Prediction- and Cost function-Based algorithm (PCB). PCB is designed to emulate a human driver's decision process, which is modeled as traffic scenario prediction and evaluation. This paper focuses on using a learning algorithm to optimize PCB with very limited training data, so that PCB can have the ability to predict and evaluate traffic scenarios similarly to human drivers. 80 seconds of human driving data was collected in low-speed (< 30miles/h) car-following scenarios. In the low-speed car-following tests, PCB was able to perform more human-like carfollowing after learning. A more general 120 kilometer-long simulation showed that PCB performs robustly even in scenarios that are not part of the training set.

  15. Determinants and Drivers of Infectious Disease Threat Events in Europe.

    PubMed

    Semenza, Jan C; Lindgren, Elisabet; Balkanyi, Laszlo; Espinosa, Laura; Almqvist, My S; Penttinen, Pasi; Rocklöv, Joacim

    2016-04-01

    Infectious disease threat events (IDTEs) are increasing in frequency worldwide. We analyzed underlying drivers of 116 IDTEs detected in Europe during 2008-2013 by epidemic intelligence at the European Centre of Disease Prevention and Control. Seventeen drivers were identified and categorized into 3 groups: globalization and environment, sociodemographic, and public health systems. A combination of >2 drivers was responsible for most IDTEs. The driver category globalization and environment contributed to 61% of individual IDTEs, and the top 5 individual drivers of all IDTEs were travel and tourism, food and water quality, natural environment, global trade, and climate. Hierarchical cluster analysis of all drivers identified travel and tourism as a distinctly separate driver. Monitoring and modeling such disease drivers can help anticipate future IDTEs and strengthen control measures. More important, intervening directly on these underlying drivers can diminish the likelihood of the occurrence of an IDTE and reduce the associated human and economic costs.

  16. Determinants and Drivers of Infectious Disease Threat Events in Europe

    PubMed Central

    Lindgren, Elisabet; Balkanyi, Laszlo; Espinosa, Laura; Almqvist, My S.; Penttinen, Pasi; Rocklöv, Joacim

    2016-01-01

    Infectious disease threat events (IDTEs) are increasing in frequency worldwide. We analyzed underlying drivers of 116 IDTEs detected in Europe during 2008–2013 by epidemic intelligence at the European Centre of Disease Prevention and Control. Seventeen drivers were identified and categorized into 3 groups: globalization and environment, sociodemographic, and public health systems. A combination of >2 drivers was responsible for most IDTEs. The driver category globalization and environment contributed to 61% of individual IDTEs, and the top 5 individual drivers of all IDTEs were travel and tourism, food and water quality, natural environment, global trade, and climate. Hierarchical cluster analysis of all drivers identified travel and tourism as a distinctly separate driver. Monitoring and modeling such disease drivers can help anticipate future IDTEs and strengthen control measures. More important, intervening directly on these underlying drivers can diminish the likelihood of the occurrence of an IDTE and reduce the associated human and economic costs. PMID:26982104

  17. Driver fatigue detection based on eye state.

    PubMed

    Lin, Lizong; Huang, Chao; Ni, Xiaopeng; Wang, Jiawen; Zhang, Hao; Li, Xiao; Qian, Zhiqin

    2015-01-01

    Nowadays, more and more traffic accidents occur because of driver fatigue. In order to reduce and prevent it, in this study, a calculation method using PERCLOS (percentage of eye closure time) parameter characteristics based on machine vision was developed. It determined whether a driver's eyes were in a fatigue state according to the PERCLOS value. The overall workflow solutions included face detection and tracking, detection and location of the human eye, human eye tracking, eye state recognition, and driver fatigue testing. The key aspects of the detection system incorporated the detection and location of human eyes and driver fatigue testing. The simplified method of measuring the PERCLOS value of the driver was to calculate the ratio of the eyes being open and closed with the total number of frames for a given period. If the eyes were closed more than the set threshold in the total number of frames, the system would alert the driver. Through many experiments, it was shown that besides the simple detection algorithm, the rapid computing speed, and the high detection and recognition accuracies of the system, the system was demonstrated to be in accord with the real-time requirements of a driver fatigue detection system.

  18. Driver Training Simulator for Backing Up Commercial Vehicles with Trailers

    NASA Astrophysics Data System (ADS)

    Berg, Uwe; Wojke, Philipp; Zöbel, Dieter

    Backing up tractors with trailers is a difficult task since the kinematic behavior of articulated vehicles is complex and hard to control. Especially unskilled drivers are overstrained with the complicated steering process. To learn and practice the steering behavior of articulated vehicles, we developed a 3D driving simulator. The simulator can handle different types of articulated vehicles like semi-trailers, one- and two-axle trailers, or gigaliners. The use of a driving simulator offers many advantages over the use of real vehicles. One of the main advantages is the possibility to learn the steering behavior of all vehicle types. Drivers can be given more and better driving instructions like collision warnings or steering hints. Furthermore, the driver training costs can be reduced. Moreover, mistakes of the student do not lead to real damages and costly repairs. The hardware of the simulator consists of a low cost commercial driving stand with original truck parts, a projection of the windshield and two flat panel monitors for the left and right exterior mirrors. Standard PC hardware is used for controlling the driving stand and for generating the realtime 3D environment. Each aspect of the simulation like realistic vehicle movements or generation of different views, is handled by a specific software module. This flexible system can be easily extended which offers the opportunity for other uses than just driver training. Therefore, we use the simulator for the development and test of driver assistance systems.

  19. Parametric Cost Analysis: A Design Function

    NASA Technical Reports Server (NTRS)

    Dean, Edwin B.

    1989-01-01

    Parametric cost analysis uses equations to map measurable system attributes into cost. The measures of the system attributes are called metrics. The equations are called cost estimating relationships (CER's), and are obtained by the analysis of cost and technical metric data of products analogous to those to be estimated. Examples of system metrics include mass, power, failure_rate, mean_time_to_repair, energy _consumed, payload_to_orbit, pointing_accuracy, manufacturing_complexity, number_of_fasteners, and percent_of_electronics_weight. The basic assumption is that a measurable relationship exists between system attributes and the cost of the system. If a function exists, the attributes are cost drivers. Candidates for metrics include system requirement metrics and engineering process metrics. Requirements are constraints on the engineering process. From optimization theory we know that any active constraint generates cost by not permitting full optimization of the objective. Thus, requirements are cost drivers. Engineering processes reflect a projection of the requirements onto the corporate culture, engineering technology, and system technology. Engineering processes are an indirect measure of the requirements and, hence, are cost drivers.

  20. Behind the wheel: community consultation informs adaptation of safe-transport program for older drivers.

    PubMed

    Coxon, Kristy; Keay, Lisa

    2015-12-09

    Safe-transport is important to well-being in later life but balancing safety and independence for older drivers can be challenging. While self-regulation is a promising tool to promote road safety, more research is required to optimise programs. Qualitative research was used to inform the choice and adaptation of a safe-transport education program for older drivers. Three focus groups were conducted with older drivers living in northwest Sydney to explore four key areas related to driving in later life including aged-based licensing, stopping or limiting driving, barriers to driving cessation and alternative modes of transportation. Data were analysed using content analysis. Four categories emerged from the data; bad press for older drivers, COMPETENCE not age, call for fairness in licensing regulations, and hanging up the keys: It's complicated! Two key issues being (1) older drivers wanted to drive for as long as possible but (2) were not prepared for driving cessation; guided the choice and adaption of the Knowledge Enhances Your Safety (KEYS) program. This program was adapted for the Australian context and focus group findings raised the need for practical solutions, including transport alternatives, to be added. Targeted messages were developed from the data using the Precaution Adoption Process Model (PAPM), allowing the education to be tailored to the individual's stage of behaviour change. Adapting our program based on insights gained from community consultation should ensure the program is sensitive to the needs, skills and preferences of older drivers.

  1. Collaborative testing for key-term definitions under representative conditions: Efficiency costs and no learning benefits.

    PubMed

    Wissman, Kathryn T; Rawson, Katherine A

    2018-01-01

    Students are expected to learn key-term definitions across many different grade levels and academic disciplines. Thus, investigating ways to promote understanding of key-term definitions is of critical importance for applied purposes. A recent survey showed that learners report engaging in collaborative practice testing when learning key-term definitions, with outcomes also shedding light on the way in which learners report engaging in collaborative testing in real-world contexts (Wissman & Rawson, 2016, Memory, 24, 223-239). However, no research has directly explored the effectiveness of engaging in collaborative testing under representative conditions. Accordingly, the current research evaluates the costs (with respect to efficiency) and the benefits (with respect to learning) of collaborative testing for key-term definitions under representative conditions. In three experiments (ns = 94, 74, 95), learners individually studied key-term definitions and then completed retrieval practice, which occurred either individually or collaboratively (in dyads). Two days later, all learners completed a final individual test. Results from Experiments 1-2 showed a cost (with respect to efficiency) and no benefit (with respect to learning) of engaging in collaborative testing for key-term definitions. Experiment 3 evaluated a theoretical explanation for why collaborative benefits do not emerge under representative conditions. Collectively, outcomes indicate that collaborative testing versus individual testing is less effective and less efficient when learning key-term definitions under representative conditions.

  2. Cooperative Driver Education and Safety Training. Coordinator's Guide.

    ERIC Educational Resources Information Center

    Seyfarth, John T.; And Others

    Characteristics of the cooperative approach which give this program advantages of low-cost, high-quality, flexible driver-training accessible to more students are: (1) use of technological teaching aids, permitting large class enrollment; (2) shared operating costs and capital investment among cooperating schools or systems; (3) reduced capital…

  3. Views of US drivers about driving safety.

    PubMed

    Williams, Allan F

    2003-01-01

    To assess how drivers view dangers on the highway, what motivates them to drive safely, how they say they reduce their crash and injury risk, and how they rate their own driving skills. Most drivers rated their skills as better than average. The biggest motivating factor for safe driving was concern for safety of others in their vehicle, followed by negative outcomes such as being in a crash, increased insurance costs, and fines. The greatest threats to their safety were thought to be other drivers' actions that increase crash risk such as alcohol impairment or running red lights. In terms of reducing crashes and injuries, drivers tended to focus on actions they could take such as driving defensively or using seat belts. There was less recognition of the role of vehicles and vehicle features in crash or injury prevention. Knowing how drivers view themselves and others, their concerns, and their motivations and techniques for staying out of trouble on the roads provides insight into the difficulty of changing driving practices.

  4. Fighting against a shortage of truck drivers in logistics: Measures that employers can take to promote drivers' work ability and health.

    PubMed

    Staats, Ulrike; Lohaus, Daniela; Christmann, Alina; Woitschek, Michèle

    2017-01-01

    For several years, the transportation industry has been concerned about a severe shortage of professional truck drivers. Studies investigating the reasons found that poor working conditions and stresses and strains resulting from physiological and psychological job demands have had a negative impact on drivers' health and ability to work. Nevertheless, until now, most employers have refrained from offering measures to support the work ability and well-being of drivers, mainly due to financial pressures in the industry. The present study was aimed at designing adequate and affordable measures to support drivers' health. With reference to the Work Ability Index and the house of work ability (Ilmarinen & Tuomi, 2004), 56 truck drivers participated in guided interviews about their working conditions and health-related problems as well as their attitudes, experiences, and desires with respect to being offered supportive measures by their employers. The measures derived are specific and realizable and expected to be widely accepted by professional drivers. They are designed to elicit a positive attitude in the drivers toward exercising and to help them overcome related psychological barriers. The implementation of the recommended measures can be expected to support drivers' work ability and help reduce the frictional costs of their employers.

  5. Unraveling Higher Education's Costs.

    ERIC Educational Resources Information Center

    Gordon, Gus; Charles, Maria

    1998-01-01

    The activity-based costing (ABC) method of analyzing institutional costs in higher education involves four procedures: determining the various discrete activities of the organization; calculating the cost of each; determining the cost drivers; tracing cost to the cost objective or consumer of each activity. Few American institutions have used the…

  6. Costs of care in a mild-to-moderate Alzheimer clinical trial sample: key resources and their determinants.

    PubMed

    Gustavsson, Anders; Cattelin, Francoise; Jönsson, Linus

    2011-07-01

    Costs of care are frequently included as secondary endpoint in Alzheimer clinical trials because payers demand evidence of the budgetary effects of novel therapies. Future clinical trial protocols can be optimized on the basis of the currently available data, including what are the key resources and how are they correlated to disease severity measures. Primary patient-level data from two 18 months clinical trials of a putative disease modifier in mild-to-moderate Alzheimer's disease (n = 2,744) were analyzed to identify key components of costs of care and their determinants in a clinical trial setting. Costs of care were assessed with the resource utilization in dementia Lite (RUD) instrument, which includes patient accommodation, informal care, community care, and hospitalizations. The contribution of each component to total costs of care and their correlation with one another and key disease severity measures (Alzheimer's Disease Assessment Scale--Cognitive Subscale, Mini-Mental State Examination, Clinical Dementia Rating-Sum of Boxes, Alzheimer's Disease Cooperative Study--Activities of Daily Living Inventory, and Neuropsychiatric Inventory Questionnaire) was explored. Informal care constituted 82% to 86% of the total costs of care over the 18-months trial and community care services and patient accommodation contributed 6% to 8% each. Informal care was positively correlated with hospitalizations but negatively to patient accommodation, indicating that these services are supplements. Informal care also had the strongest pair-wise correlation with key disease severity measures, suggesting a higher chance of identifying a treatment effect on this component. ADL-ability (Alzheimer's Disease Cooperative Study--Activities of Daily Living Inventory) was the strongest predictor of costs of care of all disease severity measures. Informal care is the most important component of costs of care in a mild-to-moderate Alzheimer clinical trial sample, and it is primarily

  7. Combining molecular and immunohistochemical analyses of key drivers in primary melanomas: interplay between germline and somatic variations.

    PubMed

    Bruno, William; Martinuzzi, Claudia; Dalmasso, Bruna; Andreotti, Virginia; Pastorino, Lorenza; Cabiddu, Francesco; Gualco, Marina; Spagnolo, Francesco; Ballestrero, Alberto; Queirolo, Paola; Grillo, Federica; Mastracci, Luca; Ghiorzo, Paola

    2018-01-19

    Due to the high mutational somatic burden of Cutaneous Malignant Melanoma (CMM) a thorough profiling of the driver mutations and their interplay is necessary to explain the timing of tumorigenesis or for the identification of actionable genetic events. The aim of this study was to establish the mutation rate of some of the key drivers in melanoma tumorigenesis combining molecular analyses and/or immunohistochemistry in 93 primary CMMs from an Italian cohort also characterized for germline status, and to investigate an interplay between germline and somatic variants. BRAF mutations were present in 68% of cases, while CDKN2A germline mutations were found in 16 % and p16 loss in tissue was found in 63%. TERT promoter somatic mutations were detected in 38% of cases while the TERT -245T>C polymorphism was found in 51% of cases. NRAS mutations were found in 39% of BRAF negative or undetermined cases. NF1 was expressed in all cases analysed. MC1R variations were both considered as a dichotomous variable or scored. While a positive, although not significant association between CDKN2A germline mutations, but not MC1R variants, and BRAF somatic mutation was found, we did not observe other associations between germline and somatic events. A yet undescribed inverse correlation between TERT -245T>C polymorphism and the presence of BRAF mutation was found. It is possible to hypothesize that -245T>C polymorphism could be included in those genotypes which may influence the occurrence of BRAF mutations. Further studies are needed to investigate the role of -245T>C polymorphism as a germline predictor of BRAF somatic mutation status.

  8. Surveying Cost Growth

    DTIC Science & Technology

    2004-01-01

    understand and account for potential cost drivers. Several cost studies, some of which specifically focus on the aircraft industry, have been performed...display a currently valid OMB control number. 1. REPORT DATE 2004 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Surveying Cost ...

  9. Toward lowering the cost of mission operations

    NASA Technical Reports Server (NTRS)

    Wall, S. D.; Ledbetter, K. W.

    1993-01-01

    The mission operations system is one of the more significant drivers of the cost of the mission operations and data analysis segment of missions. In large or long-lived projects, the MOS can also be a driver in total mission cost. Larger numbers of missions, together with an increasingly cost-conscious environment, dictate that future missions must more strictly control costs as they perform to their requirements. It is therefore prudent to examine the conduct of past missions for ways to conserve resources. In this paper we review inputs made to past projects' 'lessons-learned' activities, in which personnel from past projects (among other things) identified major cost drivers of MOS's and considered how economies were or might have been realized in both design and performance of their MOS. Common themes among four such reviews are summarized in an attempt to provide suggestions for cost reduction in future missions.

  10. Improving patient-level costing in the English and the German 'DRG' system.

    PubMed

    Vogl, Matthias

    2013-03-01

    The purpose of this paper is to develop ways to improve patient-level cost apportioning (PLCA) in the English and German inpatient 'DRG' cost accounting systems, to support regulators in improving costing schemes, and to give clinicians and hospital management sophisticated tools to measure and link their management. The paper analyzes and evaluates the PLCA step in the cost accounting schemes of both countries according to the impact on the key aspects of DRG introduction: transparency and efficiency. The goal is to generate a best available PLCA standard with enhanced accuracy and managerial relevance, the main requirements of cost accounting. A best available PLCA standard in 'DRG' cost accounting uses: (1) the cost-matrix from the German system; (2) a third axis in this matrix, representing service-lines or clinical pathways; (3) a scoring system for key cost drivers with the long-term objective of time-driven activity-based costing and (4) a point of delivery separation. Both systems have elements that the other system can learn from. By combining their strengths, regulators are supported in enhancing PLCA systems, improving the accuracy of national reimbursement and the managerial relevance of inpatient cost accounting systems, in order to reduce costs in health care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. Cost, drivers and action against land degradation through land use and cover change in Russia

    NASA Astrophysics Data System (ADS)

    Sorokin, Alexey; Strokov, Anton; Johnson, Timothy; Mirzabaev, Alisher

    2016-04-01

    The natural conditions and socio-economic factors determine the structure and the principles of land use in Russia. The increasing degradation of land resources in many parts of Russia manifested in numerous forms such as desertification, soil erosion, secondary salinization, water-logging and overgrazing. The major drivers of degradation include: climatic change, unsustainable agricultural practices, industrial and mining activities, expansion of crop production to fragile and marginal areas, inadequate maintenance of irrigation and drainage networks. Several methods for estimating Total Economic Value of land-use and land-cover change were used: 1) the cost of production per hectare (only provisional services were included); 2) the value of ecosystem services provided by Costanza et al, 1997; 3) coefficients of basic transfer and contingent approaches based on Tianhong et al, 2008 and Xie et al, 2003, who interviewed 200 ecologists to give a value of ecosystem services of different land types in China; 4) coefficients on a basic transfer and contingent approaches based on author's interview of 20 experts in Lomonosov Moscow State University. In general, the estimation of the prices for action and inaction in addressing the degradation and improvement of the land resources on a national scale (the Federal districts) with an emphasis on the period of economic reforms from 1990-2009 in Russia, where the area of arable lands decreased by 25% showed that the total land use/cover dynamic changes are about 130 mln ha, and the total annual costs of land degradation due to land-use change only, are about 189 bln USD in 2009 as compared with 2001, e.g. about 23.6 bln USD annually, or about 2% of Russia's Gross Domestic Product in 2010. The costs of action against land degradation are lower than the costs of inaction in Russia by 5-6 times over the 30 year horizon. Almost 92% of the costs of action are made up of the opportunity costs of action. The study was performed with

  12. Cost of Large Truck-and Bus-Involved Crashes

    DOT National Transportation Integrated Search

    2001-03-01

    Crashes involving trucks and buses with gross weight ratings over 10,000 pounds impose a variety of costs on the drivers of those vehicles; other drivers, involved either directly or indirectly in the crashes; and society as a whole. Such costs inclu...

  13. Activity-based costing: a practical model for cost calculation in radiotherapy.

    PubMed

    Lievens, Yolande; van den Bogaert, Walter; Kesteloot, Katrien

    2003-10-01

    The activity-based costing method was used to compute radiotherapy costs. This report describes the model developed, the calculated costs, and possible applications for the Leuven radiotherapy department. Activity-based costing is an advanced cost calculation technique that allocates resource costs to products based on activity consumption. In the Leuven model, a complex allocation principle with a large diversity of cost drivers was avoided by introducing an extra allocation step between activity groups and activities. A straightforward principle of time consumption, weighed by some factors of treatment complexity, was used. The model was developed in an iterative way, progressively defining the constituting components (costs, activities, products, and cost drivers). Radiotherapy costs are predominantly determined by personnel and equipment cost. Treatment-related activities consume the greatest proportion of the resource costs, with treatment delivery the most important component. This translates into products that have a prolonged total or daily treatment time being the most costly. The model was also used to illustrate the impact of changes in resource costs and in practice patterns. The presented activity-based costing model is a practical tool to evaluate the actual cost structure of a radiotherapy department and to evaluate possible resource or practice changes.

  14. Low energy stage study. Volume 4: Cost benefits analysis and recommendations. [orbital launching of space shuttle payloads

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The costs and benefits of existing/planned systems, new propulsion concepts, and adaptations of existing/planned systems (as supported by Orbiter interface requirements and operations requirements) were quantified. Scenarios of these propulsion approaches were established which accommodate the low energy regime as defined by the new low energy payload mission model. These scenarios were screened on a cost and then a benefits basis. A propulsion approach comprising existing/planned systems and a new propulsion concept were selected as the most cost effective approach to accommodate the model payloads and the low energy regime they represent. Key cost drivers and sensitivity trends were identified. All costs were derived in 1977 dollars.

  15. The costs and consequences of assisted reproductive technology: an economic perspective.

    PubMed

    Connolly, Mark P; Hoorens, Stijn; Chambers, Georgina M

    2010-01-01

    Despite the growing use of assisted reproductive technologies (ART) worldwide, there is only a limited understanding of the economics of ART to inform policy about effective, safe and equitable financing of ART treatment. A review was undertaken of key studies regarding the costs and consequences of ART treatment, specifically examining the direct and indirect costs of treatment, economic drivers of utilization and clinical practice and broader economic consequences of ART-conceived children. The direct costs of ART treatment vary substantially between countries, with the USA standing out as the most expensive. The direct costs generally reflect the costliness of the underlying healthcare system. If unsubsidized, direct costs represent a significant economic burden to patients. The level of affordability of ART treatment is an important driver of utilization, treatment choices, embryo transfer practices and ultimately multiple birth rates. The costs associated with caring for multiple-birth ART infants and their mothers are substantial, reflecting the underlying morbidity associated with such pregnancies. Investment analysis of ART treatment and ART-conceived children indicates that appropriate funding of ART services appears to represent sound fiscal policy. The complex interaction between the cost of ART treatment and how treatments are subsidized in different healthcare settings and for different patient groups has far-reaching consequences for ART utilization, clinical practice and infant outcomes. A greater understanding of the economics of ART is needed to inform policy decisions and to ensure the best possible outcomes from ART treatment.

  16. Effects of automobile steering characteristics on driver/vehicle system performance in discrete maneuvers

    NASA Technical Reports Server (NTRS)

    Klein, R. H.; Mcruer, D. T.

    1975-01-01

    A series of discrete maneuver tasks were used to evaluate the effects of steering gain and directional mode dynamic parameters on driver/vehicle responses. The importance and ranking of these parameters were evaluated through changes in subjective driver ratings and performance measures obtained from transient maneuvers such as a double lane change, an emergency lane change, and an unexpected obstacle. The unexpected obstacle maneuver proved more sensitive to individual driver differences than to vehicle differences. Results were based on full scale tests with an experienced test driver evaluating many different dynamic configurations plus seventeen ordinary drivers evaluating six key configurations.

  17. Fatigue factors affecting metropolitan bus drivers: a qualitative investigation.

    PubMed

    Biggs, Herbert; Dingsdag, Donald; Stenson, Nick

    2009-01-01

    Metropolitan bus drivers daily face work in a stressful and draining work environment, exposing them to the serious risk of driver fatigue. However, there has been a dearth of information exploring the unique antecedents and effects of such fatigue. To date, much of the research into metropolitan bus drivers has been under the umbrella of large heavy vehicle driving studies, which include a disproportionally large population of long-haul drivers, who are likely to face a significantly different set of fatigue factors [1]. The present study aimed to investigate which work and environmental factors may cause fatigue in metropolitan bus drivers by seeking drivers' own perspectives on the issues. To this end, focus groups were held at five bus depots in Sydney and Newcastle, with an effort made to include a stratified sample of drivers at each. Each of the groups were invited to nominate what factors they felt were most salient, with a number of common factors emerging across the depots. Key themes identified were: support from management; ticketing and related issues; interaction with passengers; cabin ergonomics; tight route schedules; turn-around and shift irregularity; extended shift cycles; interactions with other road users; and extended commute times.

  18. Responding to Recession: IT Funding and Cost Management in Higher Education. Key Findings

    ERIC Educational Resources Information Center

    Goldstein, Philip J.

    2010-01-01

    This document presents the key findings from "Responding to Recession: IT Funding and Cost Management in Higher Education", the 2010 ECAR (EDUCAUSE Center for Applied Research) study of how the economic recession is impacting information technology (IT) organizations and operations in higher education. The study was designed to address the…

  19. Estimating the Cost of Early Infant Male Circumcision in Zimbabwe: Results From a Randomized Noninferiority Trial of AccuCirc Device Versus Mogen Clamp.

    PubMed

    Mangenah, Collin; Mavhu, Webster; Hatzold, Karin; Biddle, Andrea K; Madidi, Ngonidzashe; Ncube, Getrude; Mugurungi, Owen; Ticklay, Ismail; Cowan, Frances M; Thirumurthy, Harsha

    2015-08-15

    Safe and cost-effective programs for implementing early infant male circumcision (EIMC) in Africa need to be piloted. We present results on a relative cost analysis within a randomized noninferiority trial of EIMC comparing the AccuCirc device with Mogen clamp in Zimbabwe. Between January and June 2013, male infants who met inclusion criteria were randomized to EIMC through either AccuCirc or Mogen clamp conducted by a doctor, using a 2:1 allocation ratio. We evaluated the overall unit cost plus the key cost drivers of EIMC using both AccuCirc and Mogen clamp. Direct costs included consumable and nonconsumable supplies, device, personnel, associated staff training, and environmental costs. Indirect costs comprised capital and support personnel costs. In 1-way sensitivity analyses, we assessed potential changes in unit costs due to variations in main parameters, one at a time, holding all other values constant. The unit costs of EIMC using AccuCirc and Mogen clamp were $49.53 and $55.93, respectively. Key cost drivers were consumable supplies, capacity utilization, personnel costs, and device price. Unit prices are likely to be lowest at full capacity utilization and increase as capacity utilization decreases. Unit prices also fall with lower personnel salaries and increase with higher device prices. EIMC has a lower unit cost when using AccuCirc compared with Mogen clamp. To minimize unit costs, countries planning to scale-up EIMC using AccuCirc need to control costs of consumables and personnel. There is also need to negotiate a reasonable device price and maximize capacity utilization.

  20. Estimating the Cost of Early Infant Male Circumcision in Zimbabwe: Results From a Randomized Noninferiority Trial of AccuCirc Device Versus Mogen Clamp

    PubMed Central

    Mavhu, Webster; Hatzold, Karin; Biddle, Andrea K.; Madidi, Ngonidzashe; Ncube, Getrude; Mugurungi, Owen; Ticklay, Ismail; Cowan, Frances M.; Thirumurthy, Harsha

    2015-01-01

    Background: Safe and cost-effective programs for implementing early infant male circumcision (EIMC) in Africa need to be piloted. We present results on a relative cost analysis within a randomized noninferiority trial of EIMC comparing the AccuCirc device with Mogen clamp in Zimbabwe. Methods: Between January and June 2013, male infants who met inclusion criteria were randomized to EIMC through either AccuCirc or Mogen clamp conducted by a doctor, using a 2:1 allocation ratio. We evaluated the overall unit cost plus the key cost drivers of EIMC using both AccuCirc and Mogen clamp. Direct costs included consumable and nonconsumable supplies, device, personnel, associated staff training, and environmental costs. Indirect costs comprised capital and support personnel costs. In 1-way sensitivity analyses, we assessed potential changes in unit costs due to variations in main parameters, one at a time, holding all other values constant. Results: The unit costs of EIMC using AccuCirc and Mogen clamp were $49.53 and $55.93, respectively. Key cost drivers were consumable supplies, capacity utilization, personnel costs, and device price. Unit prices are likely to be lowest at full capacity utilization and increase as capacity utilization decreases. Unit prices also fall with lower personnel salaries and increase with higher device prices. Conclusions: EIMC has a lower unit cost when using AccuCirc compared with Mogen clamp. To minimize unit costs, countries planning to scale-up EIMC using AccuCirc need to control costs of consumables and personnel. There is also need to negotiate a reasonable device price and maximize capacity utilization. PMID:26017658

  1. Resource utilization and outcomes of intoxicated drivers.

    PubMed

    Cherry, Robert A; Nichols, Pamela A; Snavely, Theresa M; Camera, Lindsay J; Mauger, David T

    2010-08-05

    The high risk behavior of intoxicated drivers, impaired reaction time, lack of seat belt use, and increased incidence of head injury raises questions of whether pre-hospital use of alcohol leads to a higher injury severity score and worse clinical outcomes. We therefore compared intoxicated and non-intoxicated drivers of motor vehicle crashes with respect to outcome measurements and also describe the resources utilized to achieve those outcomes at our Level 1 trauma center. Retrospective descriptive study (Jan 2002-June 2007) of our trauma registry and financial database comparing intoxicated drivers with blood alcohol levels (BAC) > 80 mg/dl (ETOH > 80) with drivers who had a BAC of 0 mg/dl (ETOH = 0). Drivers without a BAC drawn or who had levels ranging from 1 mg/dL to 80 mg/dL were excluded. Data was collected on demographic information (age, gender, injury severity score or ISS), outcome variables (mortality, complications, ICU and hospital LOS, ventilator days) and resource utilization (ED LOS, insurance, charges, costs, payments). p < 0.05 vs. ETOH > 80; stratified chi square. Out of 1732 drivers, the combined study group (n = 987) of 623 ETOH = 0 and 364 ETOH > 80 had a mean age of 38.8 +/- 17.9, ISS of 18.0 +/- 12.1, and 69.8%% male. There was no difference in ISS (p = 0.67) or complications (p = 0.38). There was a trend towards decreased mortality (p = 0.06). The ETOH = 0 group had more patients with a prolonged ICU LOS (>/= 5 days), ventilator days (>/= 8 days), and hospital LOS (> 14 days) when compared to the ETOH > 80 group (p < 0.05). The ETOH > 80 group tended to be self pay (4.9% vs. 0.7%, p < 0.5) and less likely to generate payment for hospital charges (p < 0.5). Hospital charges and costs were higher in the ETOH = 0 group (p < 0.5). The data suggests that intoxicated drivers may have better outcomes and a trend towards reduced mortality. They appeared to be less likely to have prolonged hospital LOS, ICU LOS, and ventilator days. We also

  2. Drivers of Hospital Costs in the Self-Pay Facelift (Rhytidectomy) Patient: Analysis of Hospital Resource Utilization in 1890 Patients.

    PubMed

    Chattha, Anmol; Bucknor, Alexandra; Chi, David; Ultee, Klaas; Chen, Austin D; Lin, Samuel J

    2018-04-01

    Rhytidectomy is one of the most commonly performed cosmetic procedures by plastic surgeons. Increasing attention to the development of a high-value, low-cost healthcare system is a priority in the USA. This study aims to analyze specific patient and hospital factors affecting the cost of this procedure. We conducted a retrospective cohort study of self-pay patients over the age of 18 who underwent rhytidectomy using the Healthcare Utilization Cost Project National Inpatient Sample database between 2013 and 2014. Mean marginal cost increases patient characteristics, and outcomes were studied. Generalized linear modeling with gamma regression and a log-link function were performed along with estimated marginal means to provide cost estimates. A total of 1890 self-pay patients underwent rhytidectomy. Median cost was $11,767 with an interquartile range of $8907 [$6976-$15,883]. The largest marginal cost increases were associated with postoperative hematoma ($12,651; CI $8181-$17,120), West coast region ($7539; 95% CI $6412-$8666), and combined rhinoplasty ($7824; 95% CI $3808-$11,840). The two risk factors associated with the generation of highest marginal inpatient costs were smoking ($4147; 95% CI $2804-$5490) and diabetes mellitus ($5622; 95% CI $3233-8011). High-volume hospitals had a decreased cost of - $1331 (95% CI - $2032 to - $631). Cost variation for inpatient rhytidectomy procedures is dependent on preoperative risk factors (diabetes and smoking), postoperative complications (hematoma), and regional trends (West region). Rhytidectomy surgery is highly centralized and increasing hospital volume significantly decreases costs. Clinicians and hospitals can use this information to discuss the drivers of cost in patients undergoing rhytidectomy. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors

  3. Association of Graduated Driver Licensing With Driver, Non-Driver, and Total Fatalities Among Adolescents.

    PubMed

    Zhu, Motao; Zhao, Songzhu; Long, D Leann; Curry, Allison E

    2016-07-01

    Graduated driver licensing systems typically require an extended learner permit phase, and create night-time driving or passenger restrictions for adolescent drivers. Restricted driving might increase the use of alternative transportation to replace driving and consequently increase crashes and injuries for passengers, bus riders, pedestrians, and bicyclists. This study examined whether graduated driver licensing increases non-driver fatalities among adolescents, and whether it reduces total traffic fatalities combining drivers and non-drivers. Longitudinal analyses were conducted using data from the 1995-2012 U.S. Fatality Analysis Reporting System. Adjusted rate ratios were estimated for being fatally injured in a crash according to: (1) presence/absence of a graduated driver licensing system; and (2) four levels of graduated driver licensing systems (absent, weak, medium, strong). Analyses were conducted in 2015. Among adolescents aged 16 years, graduated driver licensing was not associated with increased passenger fatalities (adjusted rate ratio, 0.96; 95% CI=0.90, 1.03) or pedestrian and bicyclist fatalities (adjusted rate ratio, 1.09; 95% CI=0.85, 1.39), but was associated with an 11% reduction in total traffic fatalities. Among those aged 17 years, graduated driver licensing was not associated with increased fatalities as passengers, pedestrians, or bicyclists, and was not associated with reduced total traffic fatalities. In general, graduated driver licensing systems were not associated with increased fatalities as passengers, pedestrians, bicyclists, and bus riders. Graduated driver licensing systems were associated with reduced total fatalities of adolescents aged 16 years. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  4. A roadside study of observable driver distractions.

    PubMed

    Sullman, Mark J M; Prat, Francesc; Tasci, Duygu Kuzu

    2015-01-01

    This study investigated the prevalence of observable distractions while driving and the effect of drivers' characteristics and time-related variables on their prevalence. Using roadside observation, 2 independent observers collected data at 4 randomly selected locations in St. Albans, UK. Of the 10,984 drivers observed, 16.8% were engaged in a secondary task, with talking to passengers being the most common distraction (8.8%), followed by smoking (1.9%) and talking on a hands-free mobile phone (1.7%). An additional 1.0% were observed talking on a handheld phone, and the rest of the distractions (e.g., texting, drinking) were recorded in less than 1% of the drivers observed. Gender-related differences were found for a number of different distractions (i.e., talking to passengers, drinking, and handheld mobile phone conversations), but age emerged as a significant predictor for most secondary tasks, including talking to passengers, smoking, hands-free mobile phone use, handheld mobile phone use, texting/keying numbers, drinking, and engagement in any type of distraction (all distractions combined). The overall pattern for age was that middle-aged and older drivers were less likely to be distracted than younger drivers. This work provides further evidence of the relatively high rate of distracted driving in the UK. The findings clearly indicate that younger drivers are more likely to drive distracted, which probably contributes to their higher crash rates.

  5. Vision and commercial motor vehicle driver safety : vol. 2 : appendix G

    DOT National Transportation Integrated Search

    2007-12-14

    The purpose of this evidence report is to address several key questions posed by the Federal Motor Carrier Safety Administration (FMCSA) that pertain to vision and commercial motor vehicle (CMV) driver safety. Each of these key questions was develope...

  6. Vision and commercial motor vehicle driver safety : vol. 1 : evidence report

    DOT National Transportation Integrated Search

    2008-06-06

    The purpose of this evidence report is to address several key questions posed by the Federal Motor Carrier Safety Administration (FMCSA) that pertain to vision and commercial motor vehicle (CMV) driver safety. Each of these key questions was develope...

  7. Getting the Price Right: Costing and Charging Commercial Provision in Centres of Vocational Excellence (CoVEs). Research Report

    ERIC Educational Resources Information Center

    Aitken, Liz; Chadwick, Arthur; Hughes, Maria

    2006-01-01

    Centres of Vocational Excellence (CoVEs) were established in 2001, intended to be a key driver in enhancing the contribution of the further education (FE) sector to meeting skills needs. Current government policy expects employers and individuals to pay a greater share of the costs of training, particularly at Level 3, which is the CoVE priority…

  8. Circuits of cancer drivers revealed by convergent misregulation of transcription factor targets across tumor types.

    PubMed

    Gonzalez-Perez, Abel

    2016-01-20

    Large tumor genome sequencing projects have now uncovered a few hundred genes involved in the onset of tumorigenesis, or drivers, in some two dozen malignancies. One of the main challenges emerging from this catalog of drivers is how to make sense of their heterogeneity in most cancer types. This is key not only to understand how carcinogenesis appears and develops in these malignancies to be able to early diagnose them, but also to open up the possibility to employ therapeutic strategies targeting a driver protein to counteract the alteration of another connected driver. Here, I focus on driver transcription factors and their connection to tumorigensis in several tumor types through the alteration of the expression of their targets. First, I explore their involvement in tumorigenesis as mutational drivers in 28 different tumor types. Then, I collect a list of downstream targets of the all driver transcription factors (TFs), and identify which of them exhibit a differential expression upon alterations of driver transcription factors. I identify the subset of targets of each TF most likely mediating the tumorigenic effect of their driver alterations in each tumor type, and explore their overlap. Furthermore, I am able to identify other driver genes that cause tumorigenesis through the alteration of very similar sets of targets. I thus uncover these circuits of connected drivers which cause tumorigenesis through the perturbation of overlapping cellular pathways in a pan-cancer manner across 15 malignancies. The systematic detection of these circuits may be key to propose novel therapeutic strategies indirectly targeting driver alterations in tumors.

  9. Cost-effectiveness analysis of stent type in endoscopic treatment of gastric leak after laparoscopic sleeve gastrectomy.

    PubMed

    Cosse, C; Rebibo, L; Brazier, F; Hakim, S; Delcenserie, R; Regimbeau, J M

    2018-04-01

    Gastric leak is the most feared surgical postoperative complication after sleeve gastrectomy. An endoscopic procedure is usually required to treat the leak. No data are available on the cost-effectiveness of different stent types in this procedure. Between April 2005 and July 2016, patients with a confirmed gastric leak undergoing endoscopic treatment using a covered stent (CS) or double-pigtail stent (DPS) were included. The primary objective of the study was to assess overall costs of the stent types after primary sleeve gastrectomy. Secondary objectives were the cost-effectiveness of each stent type expressed as an incremental cost-effectiveness ratio (ICER); the incremental net benefit; the probability of efficiency, defined as the probability of being cost-effective at a threshold of €30 000, and identification of the key drivers of ICER derived from a multivariable analysis. One hundred and twelve patients were enrolled. The overall mean costs of gastric leak were €22 470; the mean(s.d.) cost was €24 916(12 212) in the CS arm and €20 024(3352) in the DPS arm (P = 0·018). DPS was more cost-effective than CS (ICER €4743 per endoscopic procedure avoided), with an incremental net benefit of €25 257 and a 27 per cent probability of efficiency. Key drivers of the ICER were the inpatient ward after diagnosis of gastric leak (surgery versus internal medicine), type of institution (private versus public) and duration of hospital stay per endoscopic procedure. DPS for the treatment of gastric leak is more cost-effective than CS and should be proposed as the standard regimen whenever possible. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

  10. The cost of independence : socio-economic profiles of independent truck drivers

    DOT National Transportation Integrated Search

    2000-01-01

    Nearly 50,000 or one in five (22%) Canadian truck drivers on the road in 1998 were independent truckers or "owner-operators". However, similar to other forms of self-employment, the net-earnings and socio-economic characteristics of owner-operators h...

  11. Driver behavior profiling: An investigation with different smartphone sensors and machine learning

    PubMed Central

    Ferreira, Jair; Carvalho, Eduardo; Ferreira, Bruno V.; de Souza, Cleidson; Suhara, Yoshihiko; Pentland, Alex

    2017-01-01

    Driver behavior impacts traffic safety, fuel/energy consumption and gas emissions. Driver behavior profiling tries to understand and positively impact driver behavior. Usually driver behavior profiling tasks involve automated collection of driving data and application of computer models to generate a classification that characterizes the driver aggressiveness profile. Different sensors and classification methods have been employed in this task, however, low-cost solutions and high performance are still research targets. This paper presents an investigation with different Android smartphone sensors, and classification algorithms in order to assess which sensor/method assembly enables classification with higher performance. The results show that specific combinations of sensors and intelligent methods allow classification performance improvement. PMID:28394925

  12. Design and development of compact pulsed power driver for electron beam experiments

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

    Deb, Pankaj; Sharma, S.K.; Adhikary, B.

    2014-07-01

    Pulsed electron beam generation requires high power pulses of fast rise, short duration pulse with flat top. With this objective we have designed a low cost compact pulsed power driver based on water dielectric transmission line. The paper describes the design aspects and construction of the pulse power driver and its experimental results. The pulsed power driver consist of a capacitor bank and its charging power supply, high voltage generator, high voltage switch and pulse compression system. (author)

  13. Safety in numbers? Investigating Australian driver behaviour, knowledge and attitudes towards cyclists.

    PubMed

    Johnson, Marilyn; Oxley, Jennie; Newstead, Stuart; Charlton, Judith

    2014-09-01

    A key tenet of the safety in numbers theory is that as the number of people cycling increases, more drivers will also be cyclists and therefore will give greater consideration to cyclists when driving. We tested this theory in relation to self-reported behaviour, attitudes and knowledge in relation to cycling. An online survey was conducted of Australian drivers (n=1984) who were also cyclists (cyclist-drivers) and drivers who did not cycle (drivers). Cyclist-drivers were 1.5 times more likely than drivers to report safe driving behaviours related to sharing the roads with cyclists (95% CI: 1.1-1.9, p<0.01). Cyclist-drivers had better knowledge of the road rules related to cycling infrastructure than drivers; however knowledge of road rules related to bike lanes was low for both groups. Drivers were more likely than cyclist-drivers to have negative attitudes (e.g. cyclists are unpredictable and repeatedly overtaking cyclists is frustrating). Findings from this study highlight the need for increased education and awareness in relation to safe driving behaviour, road rules and attitudes towards cyclists. Specific recommendations are made for approaches to improve safety for cyclists. Copyright © 2014. Published by Elsevier Ltd.

  14. Energetic costs of performance in trained and untrained Anolis carolinensis lizards.

    PubMed

    Lailvaux, Simon P; Wang, Andrew Z; Husak, Jerry F

    2018-04-23

    The energetic costs of performance constitute a non-trivial component of animals' daily energetic budgets. However, we currently lack an understanding of how those costs are partitioned among the various stages of performance development, maintenance and production. We manipulated individual investment in performance by training Anolis carolinensis lizards for endurance or sprinting ability. We then measured energetic expenditure both at rest and immediately following exercise to test whether such training alters the maintenance and production costs of performance. Trained lizards had lower resting metabolic rates than controls, suggestive of a maintenance saving associated with enhanced performance as opposed to a cost. Production costs also differed, with sprint-trained lizards incurring a larger energetic performance cost and experiencing longer recovery times compared with endurance trained and control animals. Although performance training modifies metabolism, production costs are probably the key drivers of trade-offs between performance and other life-history traits in this species. © 2018. Published by The Company of Biologists Ltd.

  15. State of offsite construction in India-Drivers and barriers

    NASA Astrophysics Data System (ADS)

    Arif, M.; Bendi, D.; Sawhney, A.; Iyer, K. C.

    2012-05-01

    The rapid growth of the construction industry in India has influenced key players in the industry to adopt alternative technologies addressing time, cost and quality. The rising demand in housing, infrastructure and other facilities have further highlighted the need for the construction industry to look at adopting alternate building technologies. Offsite construction has evolved as a panacea to dealing with the under-supply and poor quality in the current age construction industry. Several offsite techniques have been adopted by the construction sector. Although, different forms of offsite techniques have been around for a while but their uptake has been low in the Indian context. This paper presents the perceptions about offsite construction in India and highlights some of the barriers and drivers facing the Indian construction industry. The data was gathered through a survey of 17 high level managers from some of the largest stakeholder organizations of the construction sector in India. The influence of time and cost has been highlighted as a major factor fuelling the adoption of offsite construction. However, the influence of current planning systems and the need for a paradigm shift are some of the prominent barriers towards the adoption of offsite techniques.

  16. Mass driver retrievals of earth-approaching asteroids. [earth orbit capture for mining purposes

    NASA Technical Reports Server (NTRS)

    Oleary, B.

    1977-01-01

    Mass driver tugs can be designed to move Apollo and Amor asteroids at opportunities of low velocity increment to the vicinity of the earth. The cost of transferring asteroids through a velocity interval of 3 km/sec by mass driver is about 16 cents per kilogram amortized over 10 years, about ten times less than that required to retrieve lunar resources during the early phases of a program of space manufacturing. About 22 per cent of a 200-meter diameter asteroid could be transferred to high earth orbit by an automated 100 megawatt solar-powered mass driver in a period of five years for a cost of approximately $1 billion. Estimates of the total investment of a space manufacturing program could be reduced twofold by using asteroidal instead of lunar resources; such a program could begin several years sooner with minimal concurrent development if asteroidal search programs and mass driver development are immediately accelerated.

  17. Understanding local-scale drivers of biodiversity outcomes in terrestrial protected areas.

    PubMed

    Barnes, Megan D; Craigie, Ian D; Dudley, Nigel; Hockings, Marc

    2017-07-01

    Conservation relies heavily on protected areas (PAs) maintaining their key biodiversity features to meet global biodiversity conservation goals. However, PAs have had variable success, with many failing to fully maintain their biodiversity features. The current literature concerning what drives variability in PA performance is rapidly expanding but unclear, sometimes contradictory, and spread across multiple disciplines. A clear understanding of the drivers of successful biodiversity conservation in PAs is necessary to make them fully effective. Here, we conduct a comprehensive assessment of the current state of knowledge concerning the drivers of biological outcomes within PAs, focusing on those that can be addressed at local scales. We evaluate evidence in support of potential drivers to identify those that enable more successful outcomes and those that impede success and provide a synthetic review. Interactions are discussed where they are known, and we highlight gaps in understanding. We find that elements of PA design, management, and local and national governance challenges, species and system ecology, and sociopolitical context can all influence outcomes. Adjusting PA management to focus on actions and policies that influence the key drivers identified here could improve global biodiversity outcomes. © 2016 New York Academy of Sciences.

  18. Simple wave drivers: electric toothbrush, shaver and razor

    NASA Astrophysics Data System (ADS)

    Kağan Temiz, Burak; Yavuz, Ahmet

    2018-05-01

    This study was conducted to develop simple and low-cost wave drivers that can be used in experiments on string waves. These wave drivers were made using a toothbrush (Oral-B Vitality), an electric shaver (Braun 7505) and a razor (Gillette Fusion Proglide Power). A common feature of all of these product is that they have vibration motors. In the experiments, string waves were generated by transferring these vibrations to a stretched string. By changing the tightness and length of the string, standing waves were generated, and various harmonics were observed.

  19. Resource utilization and outcomes of intoxicated drivers

    PubMed Central

    2010-01-01

    Background The high risk behavior of intoxicated drivers, impaired reaction time, lack of seat belt use, and increased incidence of head injury raises questions of whether pre-hospital use of alcohol leads to a higher injury severity score and worse clinical outcomes. We therefore compared intoxicated and non-intoxicated drivers of motor vehicle crashes with respect to outcome measurements and also describe the resources utilized to achieve those outcomes at our Level 1 trauma center. Methods Retrospective descriptive study (Jan 2002-June 2007) of our trauma registry and financial database comparing intoxicated drivers with blood alcohol levels (BAC) > 80 mg/dl (ETOH > 80) with drivers who had a BAC of 0 mg/dl (ETOH = 0). Drivers without a BAC drawn or who had levels ranging from 1 mg/dL to 80 mg/dL were excluded. Data was collected on demographic information (age, gender, injury severity score or ISS), outcome variables (mortality, complications, ICU and hospital LOS, ventilator days) and resource utilization (ED LOS, insurance, charges, costs, payments). Statistical analysis: p < 0.05 vs. ETOH > 80; stratified chi square. Results Out of 1732 drivers, the combined study group (n = 987) of 623 ETOH = 0 and 364 ETOH > 80 had a mean age of 38.8 ± 17.9, ISS of 18.0 ± 12.1, and 69.8%% male. There was no difference in ISS (p = 0.67) or complications (p = 0.38). There was a trend towards decreased mortality (p = 0.06). The ETOH = 0 group had more patients with a prolonged ICU LOS (≥ 5 days), ventilator days (≥ 8 days), and hospital LOS (> 14 days) when compared to the ETOH > 80 group (p < 0.05). The ETOH > 80 group tended to be self pay (4.9% vs. 0.7%, p < 0.5) and less likely to generate payment for hospital charges (p < 0.5). Hospital charges and costs were higher in the ETOH = 0 group (p < 0.5). Conclusions The data suggests that intoxicated drivers may have better outcomes and a trend towards reduced mortality. They appeared to be less likely to have prolonged

  20. Driver distraction and driver inattention: definition, relationship and taxonomy.

    PubMed

    Regan, Michael A; Hallett, Charlene; Gordon, Craig P

    2011-09-01

    There is accumulating evidence that driver distraction and driver inattention are leading causes of vehicle crashes and incidents. However, as applied psychological constructs, they have been inconsistently defined and the relationship between them remains unclear. In this paper, driver distraction and driver inattention are defined and a taxonomy is presented in which driver distraction is distinguished from other forms of driver inattention. The taxonomy and the definitions provided are intended (a) to provide a common framework for coding different forms of driver inattention as contributing factors in crashes and incidents, so that comparable estimates of their role as contributing factors can be made across different studies, and (b) to make it possible to more accurately interpret and compare, across studies, the research findings for a given form of driver inattention. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Understanding cost drivers and economic potential of two variants of ionic liquid pretreatment for cellulosic biofuel production

    PubMed Central

    2014-01-01

    Background Ionic liquid (IL) pretreatment could enable an economically viable route to produce biofuels by providing efficient means to extract sugars and lignin from lignocellulosic biomass. However, to realize this, novel IL-based processes need to be developed in order to minimize the overall production costs and accelerate commercial viability. In this study, two variants of IL-based processes are considered: one based on complete removal of the IL prior to hydrolysis using a water-wash (WW) step and the other based on a “one-pot” (OP) process that does not require IL removal prior to saccharification. Detailed techno-economic analysis (TEA) of these two routes was carried out to understand the cost drivers, economic potential (minimum ethanol selling price, MESP), and relative merits and challenges of each route. Results At high biomass loading (50%), both routes exhibited comparable economic performance with an MESP of $6.3/gal. With the possible advances identified (reduced water or acid/base consumption, improved conversion in pretreatment, and lignin valorization), the MESP could be reduced to around $3/gal ($3.2 in the WW route and $2.8 in the OP route). Conclusions It was found that, to be competitive at industrial scale, lowered cost of ILs used and higher biomass loadings (50%) are essential for both routes, and in particular for the OP route. Overall, while the economic potential of both routes appears to be comparable at higher biomass loadings, the OP route showed the benefit of lower water consumption at the plant level, an important cost and sustainability consideration for biorefineries. PMID:24932217

  2. Using Linked Electronic Health Records to Estimate Healthcare Costs: Key Challenges and Opportunities.

    PubMed

    Asaria, Miqdad; Grasic, Katja; Walker, Simon

    2016-02-01

    This paper discusses key challenges and opportunities that arise when using linked electronic health records (EHR) in health economics and outcomes research (HEOR), with a particular focus on estimating healthcare costs. These challenges and opportunities are framed in the context of a case study modelling the costs of stable coronary artery disease in England. The challenges and opportunities discussed fall broadly into the categories of (1) handling and organising data of this size and sensitivity; (2) extracting clinical endpoints from datasets that have not been designed and collected with such endpoints in mind; and (3) the principles and practice of costing resource use from routinely collected data. We find that there are a number of new challenges and opportunities that arise when working with EHR compared with more traditional sources of data for HEOR. These call for greater clinician involvement and intelligent use of sensitivity analysis.

  3. Simultaneous Identification of Multiple Driver Pathways in Cancer

    PubMed Central

    Leiserson, Mark D. M.; Blokh, Dima

    2013-01-01

    Distinguishing the somatic mutations responsible for cancer (driver mutations) from random, passenger mutations is a key challenge in cancer genomics. Driver mutations generally target cellular signaling and regulatory pathways consisting of multiple genes. This heterogeneity complicates the identification of driver mutations by their recurrence across samples, as different combinations of mutations in driver pathways are observed in different samples. We introduce the Multi-Dendrix algorithm for the simultaneous identification of multiple driver pathways de novo in somatic mutation data from a cohort of cancer samples. The algorithm relies on two combinatorial properties of mutations in a driver pathway: high coverage and mutual exclusivity. We derive an integer linear program that finds set of mutations exhibiting these properties. We apply Multi-Dendrix to somatic mutations from glioblastoma, breast cancer, and lung cancer samples. Multi-Dendrix identifies sets of mutations in genes that overlap with known pathways – including Rb, p53, PI(3)K, and cell cycle pathways – and also novel sets of mutually exclusive mutations, including mutations in several transcription factors or other genes involved in transcriptional regulation. These sets are discovered directly from mutation data with no prior knowledge of pathways or gene interactions. We show that Multi-Dendrix outperforms other algorithms for identifying combinations of mutations and is also orders of magnitude faster on genome-scale data. Software available at: http://compbio.cs.brown.edu/software. PMID:23717195

  4. An economic cost analysis of emergency department key performance indicators in Ireland.

    PubMed

    Gannon, Brenda; Jones, Cheryl; McCabe, Aileen; O'Sullivan, Ronan; Wakai, Abel

    2017-06-01

    High quality data is fundamental to using key performance indicators (KPIs) for performance monitoring. However, the resources required to collect high quality data are often significant and should usually be targeted at high priority areas. As part of a study of 11 emergency department (ED) KPIs in Ireland, the primary objective of this study was to estimate the relative cost of collecting the additional minimum data set (MDS) elements for those 11 KPIs. An economic cost analysis focused on 12 EDs in the Republic of Ireland. The resource use data were obtained using two separate focus group interviews. The number of available MDS elements was obtained from a sample of 100 patient records per KPI per participating ED. Unit costs for all resource use were taken at the midpoint of the relevant staff salary scales. An ED would need to spend an estimated additional &OV0556;3561 per month on average to capture all the MDS elements relevant to the 11 KPIs investigated. The additional cost ranges from 14.8 to 39.2%; this range is 13.9-32.3% for small EDs, whereas the range for medium EDs is 11.7-40%. Regional EDs have a higher additional estimated cost to capture all the relevant MDS elements (&OV0556;3907), compared with urban EDs (&OV0556;3353). The additional cost of data collection, contingent on that already collected, required to capture all the relevant MDS elements for the KPIs examined, ranges from 14.8 to 39.2% per KPI, with variation identified between regional and urban hospitals.

  5. Effects of driver cell-phone use on driver aggression.

    PubMed

    McGarva, Andrew R; Ramsey, Matthew; Shear, Suzannah A

    2006-04-01

    Using 2 field procedures, the authors assessed impacts of cell-phone use on mild forms of driver aggression. Participants were 135 drivers traveling within a city of approximately 17,000 people in an otherwise little-populated region of western North Dakota. The authors videotaped the participants while a confederate driver in a low-status vehicle frustrated them. In Experiment 1, the confederate was traveling well under the posted speed limit. In Experiment 2, the confederate remained motionless at a stoplight that had turned green. When the confederate visibly talked on a hand-held cell phone (n = 67), male drivers exhibited their frustration by honking their horn more quickly and frequently than did drivers in no-cell-phone trials, and female drivers were more angry according to blind judgments of videotaped facial expressions that were compared with those of drivers in no-cell-phone trials (n = 68). The present results suggested that driver cell-phone use contributes to the growing crisis of roadway aggression.

  6. Dirt and disgust as key drivers in nurses' infection control behaviours: an interpretative, qualitative study.

    PubMed

    Jackson, C; Griffiths, P

    2014-06-01

    Infection prevention remains a significant challenge for healthcare systems. Yet despite considerable work to provide clear policies and scientifically proven techniques to reduce infection transmission, beliefs and practices of healthcare workers do not always concur with scientific rationale. To provide explanations for nurses' infection prevention behaviours. An interpretative, qualitative approach was taken using semi-structured interviews. Twenty interviews with registered nurses working in an acute hospital setting were conducted. Analysis was conducted using the Framework method. This paper focuses on the theme 'protection from dirt'. Within the findings clear distinction was made between infection and dirt. Fear of contact with dirt, particularly dirt belonging to those who were unknown, was a key driver in behaviour carried out to reduce threat. Familiarity with the patient resulted in a reduction of the protective behaviours required. These behaviours, which initially appeared as part of an infection prevention strategy, were primarily a form of self-protection from patients, who at first encounter were considered as dirty. Behaviours do not always fit with a rational response to infection, but instead may be responses to dirt. Any programme that simply attempts to address scientific knowledge and behaviour deficits is unlikely to have the desired goals if it does not take into account existing social constructions of dirt and the response it evokes. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. Issuance of driver licenses and identification cards to prisoners : appendix C, travel cost assumptions and details.

    DOT National Transportation Integrated Search

    2010-06-01

    In 2009, the Oregon Legislature passed House Bill 2489, requiring the Oregon Driver and Motor Vehicle (DMV) Services Division and the Department of Corrections (DOC) to enter into agreements and adopt rules to assist offenders in obtaining a driver l...

  8. Teaching Driver Education Technology to Novice Drivers.

    ERIC Educational Resources Information Center

    Young, Anthony

    A cybernetic unit in driver education was developed to help grade 10 students develop the skills needed to acquire and process driver education information and prepare for the driving phase of driver education in grade 11. Students used a simulator to engage in a series of scenarios designed to promote development of social, behavioral, and mental…

  9. Occupational therapists lead a national injury prevention strategy to help older drivers.

    PubMed

    Craik, Janet M

    2011-04-01

    As older adults are the fastest growing segment of the driving population, the Canadian Association of Occupational Therapists (CAOT) has taken older driver safety as a key priority. The purpose of this paper is to present the National Blueprint for Injury Prevention in Older Drivers (Blueprint) and its related activities. Since 2006, CAOT has been working on initiatives relating to the National Blueprint for Injury Prevention in Older Drivers. The most recent activities include the launch of informational brochures and a website. The Blueprint and its related activities were developed with the intent to prolong safe driving among older adults in Canada, and to propose future actions to be addressed by all stakeholders interested in older driver safety.

  10. Predictors of micro-costing components in liver transplantation

    PubMed Central

    de Paiva Haddad, Luciana Bertocco; Ducatti, Liliana; Mendes, Luana Regina Baratelli Carelli; Andraus, Wellington; D’Albuquerque, Luiz Augusto Carneiro

    2017-01-01

    OBJECTIVES: Although liver transplantation procedures are common and highly expensive, their cost structure is still poorly understood. This study aimed to develop models of micro-costs among patients undergoing liver transplantation procedures while comparing the role of individual clinical predictors using tree regression models. METHODS: We prospectively collected micro-cost data from patients undergoing liver transplantation in a tertiary academic center. Data collection was conducted using an Intranet registry integrated into the institution’s database for the storing of financial and clinical data for transplantation cases. RESULTS: A total of 278 patients were included and accounted for 300 procedures. When evaluating specific costs for the operating room, intensive care unit and ward, we found that in all of the sectors but the ward, human resources were responsible for the highest costs. High cost supplies were important drivers for the operating room, whereas drugs were among the top four drivers for all sectors. When evaluating the predictors of total cost, a MELD score greater than 30 was the most important predictor of high cost, followed by a Donor Risk Index greater than 1.8. CONCLUSION: By focusing on the highest cost drivers and predictors, hospitals can initiate programs to reduce cost while maintaining high quality care standards. PMID:28658432

  11. Virtual instrument: remote control and monitoring of an artificial heart driver

    NASA Astrophysics Data System (ADS)

    Nguyen, An H.; Farrar, David

    1993-07-01

    A development of a virtual instrument based on the top-down model approach for an artificial heart driver is presented. Driver parameters and status were being dynamically updated on the virtual system at the remote station. The virtual system allowed the remote operator to interact with the physical heart driver as if he/she were at the local station. Besides use as an effective training tool, the system permits an expert operator to monitor and also control the Thoratec heart driver from a distant location. We believe that the virtual instrument for biomedical devices in general and for the Thoratec heart driver in particular, not only improves system reliability but also opens up a real possibility in reducing medical cost. Utilizing the top-down scheme developed recently for telerobotics, realtime operation in both instrument display and remote communication were possible via a low bandwidth telephone medium.

  12. Low-Cost Servomotor Driver for PFM Control

    PubMed Central

    Aragon-Jurado, David

    2017-01-01

    Servomotors have already been around for some decades and they are extremely popular among roboticists due to their simple control technique, reliability and low-cost. They are usually controlled by using Pulse Width Modulation (PWM) and this paper aims to keep the idea of simplicity and low-cost, while introducing a new control technique: Pulse Frequency Modulation (PFM). The objective of this paper is to focus on our development of a low-cost servomotor controller which will allow the research community to use them with PFM. A low-cost commercial servomotor is used as the base system for the development: a small PCB that fits inside the case and allocates all the electronic components to control the motor has been designed to replace the original. The potentiometer is retained as the feedback sensor and a microcontroller is responsible for controlling the position of the motor. The paper compares the performance of a PWM and a PFM controlled servomotor. The comparison shows that the servomotor with our controller achieves a faster mechanism for switching targets and a lower latency. This controller can be used with neuromorphic systems to remove the conversion from events to PWM. PMID:29301221

  13. Low-Cost Servomotor Driver for PFM Control.

    PubMed

    Aragon-Jurado, David; Morgado-Estevez, Arturo; Perez-Peña, Fernando

    2017-12-31

    Servomotors have already been around for some decades and they are extremely popular among roboticists due to their simple control technique, reliability and low-cost. They are usually controlled by using Pulse Width Modulation (PWM) and this paper aims to keep the idea of simplicity and low-cost, while introducing a new control technique: Pulse Frequency Modulation (PFM). The objective of this paper is to focus on our development of a low-cost servomotor controller which will allow the research community to use them with PFM. A low-cost commercial servomotor is used as the base system for the development: a small PCB that fits inside the case and allocates all the electronic components to control the motor has been designed to replace the original. The potentiometer is retained as the feedback sensor and a microcontroller is responsible for controlling the position of the motor. The paper compares the performance of a PWM and a PFM controlled servomotor. The comparison shows that the servomotor with our controller achieves a faster mechanism for switching targets and a lower latency. This controller can be used with neuromorphic systems to remove the conversion from events to PWM.

  14. Examination of Supplemental Driver Training and Online Basic Driver Education

    DOT National Transportation Integrated Search

    2012-06-01

    This report describes supplemental driver training programs and online basic driver education. It coves supplemental driver training that : focused on knowledge and skills beyond those normally found in traditional driver education delivered in the U...

  15. Parametric Cost Models for Space Telescopes

    NASA Technical Reports Server (NTRS)

    Stahl, H. Philip; Henrichs, Todd; Dollinger, Courtney

    2010-01-01

    Multivariable parametric cost models for space telescopes provide several benefits to designers and space system project managers. They identify major architectural cost drivers and allow high-level design trades. They enable cost-benefit analysis for technology development investment. And, they provide a basis for estimating total project cost. A survey of historical models found that there is no definitive space telescope cost model. In fact, published models vary greatly [1]. Thus, there is a need for parametric space telescopes cost models. An effort is underway to develop single variable [2] and multi-variable [3] parametric space telescope cost models based on the latest available data and applying rigorous analytical techniques. Specific cost estimating relationships (CERs) have been developed which show that aperture diameter is the primary cost driver for large space telescopes; technology development as a function of time reduces cost at the rate of 50% per 17 years; it costs less per square meter of collecting aperture to build a large telescope than a small telescope; and increasing mass reduces cost.

  16. A Low Cost Key Agreement Protocol Based on Binary Tree for EPCglobal Class 1 Generation 2 RFID Protocol

    NASA Astrophysics Data System (ADS)

    Jeng, Albert; Chang, Li-Chung; Chen, Sheng-Hui

    There are many protocols proposed for protecting Radio Frequency Identification (RFID) system privacy and security. A number of these protocols are designed for protecting long-term security of RFID system using symmetric key or public key cryptosystem. Others are designed for protecting user anonymity and privacy. In practice, the use of RFID technology often has a short lifespan, such as commodity check out, supply chain management and so on. Furthermore, we know that designing a long-term security architecture to protect the security and privacy of RFID tags information requires a thorough consideration from many different aspects. However, any security enhancement on RFID technology will jack up its cost which may be detrimental to its widespread deployment. Due to the severe constraints of RFID tag resources (e. g., power source, computing power, communication bandwidth) and open air communication nature of RFID usage, it is a great challenge to secure a typical RFID system. For example, computational heavy public key and symmetric key cryptography algorithms (e. g., RSA and AES) may not be suitable or over-killed to protect RFID security or privacy. These factors motivate us to research an efficient and cost effective solution for RFID security and privacy protection. In this paper, we propose a new effective generic binary tree based key agreement protocol (called BKAP) and its variations, and show how it can be applied to secure the low cost and resource constraint RFID system. This BKAP is not a general purpose key agreement protocol rather it is a special purpose protocol to protect privacy, un-traceability and anonymity in a single RFID closed system domain.

  17. Elevational Gradients in Fish Diversity in the Himalaya: Water Discharge Is the Key Driver of Distribution Patterns

    PubMed Central

    Bhatt, Jay P.; Manish, Kumar; Pandit, Maharaj K.

    2012-01-01

    Background Studying diversity and distribution patterns of species along elevational gradients and understanding drivers behind these patterns is central to macroecology and conservation biology. A number of studies on biogeographic gradients are available for terrestrial ecosystems, but freshwater ecosystems remain largely neglected. In particular, we know very little about the species richness gradients and their drivers in the Himalaya, a global biodiversity hotspot. Methodology/Principal Findings We collated taxonomic and distribution data of fish species from 16 freshwater Himalayan rivers and carried out empirical studies on environmental drivers and fish diversity and distribution in the Teesta river (Eastern Himalaya). We examined patterns of fish species richness along the Himalayan elevational gradients (50–3800 m) and sought to understand the drivers behind the emerging patterns. We used generalized linear models (GLM) and generalized additive models (GAM) to examine the richness patterns; GLM was used to investigate relationship between fish species richness and various environmental variables. Regression modelling involved stepwise procedures, including elimination of collinear variables, best model selection, based on the least Akaike’s information criterion (AIC) and the highest percentage of deviance explained (D2). This maiden study on the Himalayan fishes revealed that total and non-endemic fish species richness monotonously decrease with increasing elevation, while endemics peaked around mid elevations (700–1500 m). The best explanatory model (synthetic model) indicated that water discharge is the best predictor of fish species richness patterns in the Himalayan rivers. Conclusions/Significance This study, carried out along one of the longest bioclimatic elevation gradients of the world, lends support to Rapoport’s elevational rule as opposed to mid domain effect hypothesis. We propose a species-discharge model and contradict species

  18. Buy now, saved later? The critical impact of time-to-pandemic uncertainty on pandemic cost-effectiveness analyses.

    PubMed

    Drake, Tom; Chalabi, Zaid; Coker, Richard

    2015-02-01

    Investment in pandemic preparedness is a long-term gamble, with the return on investment coming at an unknown point in the future. Many countries have chosen to stockpile key resources, and the number of pandemic economic evaluations has risen sharply since 2009. We assess the importance of uncertainty in time-to-pandemic (and associated discounting) in pandemic economic evaluation, a factor frequently neglected in the literature to-date. We use a probability tree model and Monte Carlo parameter sampling to consider the cost effectiveness of antiviral stockpiling in Cambodia under parameter uncertainty. Mean elasticity and mutual information (MI) are used to assess the importance of time-to-pandemic compared with other parameters. We also consider the sensitivity to choice of sampling distribution used to model time-to-pandemic uncertainty. Time-to-pandemic and discount rate are the primary drivers of sensitivity and uncertainty in pandemic cost effectiveness models. Base case cost effectiveness of antiviral stockpiling ranged between is US$112 and US$3599 per DALY averted using historical pandemic intervals for time-to-pandemic. The mean elasticities for time-to-pandemic and discount rate were greater than all other parameters. Similarly, the MI scores for time to pandemic and discount rate were greater than other parameters. Time-to-pandemic and discount rate were key drivers of uncertainty in cost-effectiveness results regardless of time-to-pandemic sampling distribution choice. Time-to-pandemic assumptions can "substantially" affect cost-effectiveness results and, in our model, is a greater contributor to uncertainty in cost-effectiveness results than any other parameter. We strongly recommend that cost-effectiveness models include probabilistic analysis of time-to-pandemic uncertainty. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  19. Drivers Are More Physically Active Than Non-Drivers in Older Adults.

    PubMed

    Amagasa, Shiho; Fukushima, Noritoshi; Kikuchi, Hiroyuki; Takamiya, Tomoko; Odagiri, Yuko; Oka, Koichiro; Inoue, Shigeru

    2018-05-28

    Car use has been identified as sedentary behavior, although it may enhance mobility, particularly in the older population. This cross-sectional study aimed to compare the time spent in objectively determined sedentary behavior (SB) and physical activity (PA) between older drivers and non-drivers. Four hundred and fifty Japanese older adults (74.3 ± 2.9 years) who had valid accelerometer data were included. They were asked to respond to a questionnaire and wear an accelerometer (HJA-350IT, Omron Healthcare) on their waist for 7 consecutive days in 2015. To compare activity time between drivers and non-drivers, we calculated estimated means using analysis of covariance, adjusting for sociodemographic, physical, and psychological factors and accelerometer wear time. Compared to non-drivers, drivers engaged in more light-intensity PA (LPA) (drivers: 325.0 vs. non-drivers: 289.0 min/day) and moderate-to-vigorous PA (drivers: 37.5 vs. non-drivers: 30.0 min/day) and less SB (drivers: 493.4 vs. non-drivers: 535.9 min/day) (all p < 0.05). After stratification by age, sex, and residential area, larger effect of driving on PA time was found in older-older adults, in men, and in rural residents. Older drivers were found to be more physically active than non-drivers, suggesting more access to outdoor activities or expanding social network.

  20. Decomposition of the drivers of the U.S. hospital spending growth, 2001–2009

    PubMed Central

    2014-01-01

    Background United States health care spending rose rapidly in the 2000s, after a period of temporary slowdown in the 1990s. However, the description of the overall trend and the understanding of the underlying drivers of this trend are very limited. This study investigates how well historical hospital cost/revenue drivers explain the recent hospital spending trend in the 2000s, and how important each of these drivers is. Methods We used aggregated time series data to describe the trend in total hospital spending, price, and quantity between 2001 and 2009. We used the Oaxaca-Blinder method to investigate the relative importance of major hospital cost/spending drivers (derived from the literature) in explaining the change in hospital spending patterns between 2001 and 2007. We assembled data from Medicare Cost Reports, American Hospital Association annual surveys, Prospective Payment System (PPS) Impact Files, Medicare Provider Analysis and Review (MedPAR) Medicare claims data, InterStudy reports, National Health Expenditure data, and Area Resource Files. Results Aggregated time series trends show that high hospital spending between 2001 and 2009 appears to be driven by higher payment per unit of hospital output, not by increased utilization. Results using the Oaxaca-Blinder regression decomposition method indicate that changes in historically important spending drivers explain a limited 30% of unit-payment growth, but a higher 60% of utilization growth. Hospital staffing and labor-related costs, casemix, and demographics are the most important drivers of higher hospital revenue, utilization, and unit-payment. Technology is associated with lower utilization, higher unit payment, and limited increases in total revenue. Market competition, primarily because of increased managed care concentration, moderates total revenue growth by driving lower unit payment. Conclusions Much of the rapidly rising hospital spending growth in the 2000s in the United States is driven by

  1. Modular space station phase B extension program cost and schedules. Volume 1: Cost and schedule estimating process and results

    NASA Technical Reports Server (NTRS)

    Frassinelli, G. J.

    1972-01-01

    Cost estimates and funding schedules are presented for a given configuration and costing ground rules. Cost methodology is described and the cost evolution from a baseline configuration to a selected configuration is given, emphasizing cases in which cost was a design driver. Programmatic cost avoidance techniques are discussed.

  2. Improving Driver Performance. A Curriculum for Licensed Drivers.

    ERIC Educational Resources Information Center

    Highway Users Federation for Safety and Mobility, Washington, DC.

    Curriculum material presented in this manual is for use in the development of an instructional program for drivers who either want or need to improve their driving performance. Three principal units are included: man and highway transportation, driver performance, and factors influencing driver behavior. Each unit is further divided into episodes…

  3. Low cost, small form factor, and integration as the key features for the optical component industry takeoff

    NASA Astrophysics Data System (ADS)

    Schiattone, Francesco; Bonino, Stefano; Gobbi, Luigi; Groppi, Angelamaria; Marazzi, Marco; Musio, Maurizio

    2003-04-01

    In the past the optical component market has been mainly driven by performances. Today, as the number of competitors has drastically increased, the system integrators have a wide range of possible suppliers and solutions giving them the possibility to be more focused on cost and also on footprint reduction. So, if performances are still essential, low cost and Small Form Factor issues are becoming more and more crucial in selecting components. Another evolution in the market is the current request of the optical system companies to simplify the supply chain in order to reduce the assembling and testing steps at system level. This corresponds to a growing demand in providing subassemblies, modules or hybrid integrated components: that means also Integration will be an issue in which all the optical component companies will compete to gain market shares. As we can see looking several examples offered by electronic market, to combine low cost and SFF is a very challenging task but Integration can help in achieving both features. In this work we present how these issues could be approached giving examples of some advanced solutions applied to LiNbO3 modulators. In particular we describe the progress made on automation, new materials and low cost fabrication methods for the parts. We also introduce an approach in integrating optical and electrical functionality on LiNbO3 modulators including RF driver, bias control loop, attenuator and photodiode integrated in a single device.

  4. Automated secured cost effective key refreshing technique to enhance WiMAX privacy key management

    NASA Astrophysics Data System (ADS)

    Sridevi, B.; Sivaranjani, S.; Rajaram, S.

    2013-01-01

    In all walks of life the way of communication is transformed by the rapid growth of wireless communication and its pervasive use. A wireless network which is fixed and richer in bandwidth is specified as IEEE 802.16, promoted and launched by an industrial forum is termed as Worldwide Interoperability for Microwave Access (WiMAX). This technology enables seamless delivery of wireless broadband service for fixed and/or mobile users. The obscurity is the long delay which occurs during the handoff management in every network. Mobile WiMAX employs an authenticated key management protocol as a part of handoff management in which the Base Station (BS) controls the distribution of keying material to the Mobile Station (MS). The protocol employed is Privacy Key Management Version 2- Extensible Authentication Protocol (PKMV2-EAP) which is responsible for the normal and periodical authorization of MSs, reauthorization as well as key refreshing. Authorization key (AK) and Traffic Encryption key (TEK) plays a vital role in key exchange. When the lifetime of key expires, MS has to request for a new key to BS which in turn leads to repetition of authorization, authentication as well as key exchange. To avoid service interruption during reauthorization , two active keys are transmitted at the same time by BS to MS. The consequences of existing work are hefty amount of bandwidth utilization, time consumption and large storage. It is also endured by Man in the Middle attack and Impersonation due to lack of security in key exchange. This paper designs an automatic mutual refreshing of keys to minimize bandwidth utilization, key storage and time consumption by proposing Previous key and Iteration based Key Refreshing Function (PKIBKRF). By integrating PKIBKRF in key generation, the simulation results indicate that 21.8% of the bandwidth and storage of keys are reduced and PKMV2 mutual authentication time is reduced by 66.67%. The proposed work is simulated with Qualnet model and

  5. Cost of illness in rheumatoid arthritis in Germany in 1997-98 and 2002: cost drivers and cost savings.

    PubMed

    Kirchhoff, Timm; Ruof, Jörg; Mittendorf, Thomas; Rihl, Markus; Bernateck, Michael; Mau, Wilfried; Zeidler, Henning; Schmidt, Reinhold E; Merkesdal, Sonja

    2011-04-01

    Comparison of overall RA-related costs and of relative contribution of single-cost domains before and after the introduction of TNF-blocking agents in Germany. Two cohorts of RA outpatients (ACR '87 criteria) with long-standing disease are assessed in terms of disease-related costs and cost composition (n = 106 patients in 1997-98 and n = 180 patients in 2002 with similar patient characteristics). Full-cost analyses are performed including direct disease-related costs (medical and non-medical) and productivity costs as collected by patient questionnaires. Absolute costs (€/patient/year) are compared and the impact of single-cost domains on overall costing in RA is estimated (relative proportions of cost components within samples). Overall costs are comparable (1997-98: €4280; 2002: €3830; not significant). Differences can be observed in medication (1997-98: €550; 2002: €1580; P < 0.001) and hospitalization costs (1997-98: €1240; 2002: €500; P < 0.001). Productivity costs are significantly lower (€1480 vs €850; P < 0.05) in 2002. The impact of medication costs is outstanding in the 2002 sample (42 vs 12%), the proportion of hospitalization costs is substantially lower (29 vs 13%). Costs for DMARDs in 2002 are mostly driven by TNF blockers (37%). The number of DMARDs per patient is higher in 2002 as are costs for osteoporosis medication and gastroprotective treatment. Although overall costs before and after the introduction of TNF blockers are comparable, the decrease in hospitalization and productivity costs is promising in terms of future long-term cost savings. The development of these aspects and of the increasing medication costs will have to be evaluated with longer time frames.

  6. Prevalence and characteristics of road traffic injuries among young drivers in Oman, 2009-2011.

    PubMed

    Al Reesi, Hamed; Al Maniri, Abdullah; Adawi, Samir Al; Davey, Jeremy; Armstrong, Kerry; Edwards, Jason

    2016-07-03

    Studies from different parts of the world have indicated that the impact of road traffic incidents disproportionally affects young adults. Few known studies have been forthcoming from Arabian Gulf countries. Within Oman, a high proportion of the population is under the age of 20. Coupled with the drastic increase in motorization in recent years, there is a need to understand the state of road safety among young people in Oman. The current research aimed to explore the prevalence and characteristics of road traffic injuries among young drivers aged 17-25 years. Crash data from 2009 to 2011 were extracted from the Directorate General of Traffic, Royal Oman Police (ROP) database in Oman. The data were analyzed to explore the impact of road crashes on young people (17-25 years), the characteristics of young driver crashes, and how these differ from older drivers and to identify key predictors of fatalities in young driver crashes. Overall, young people were overrepresented in injuries and fatalities within the sample time period. Though it is true that many young people in crashes were driving at the time, it was also evident that young people were often victims in a crash caused by someone else. Thus, to reduce the impact of road crashes on young people, there is a need to generally address road safety within Oman. When young drivers were involved in crashes they were predominantly male. The types of crashes these drivers have can be broadly attributed to risk taking and inexperience. Speeding and nighttime driving were the key risk factors for fatalities. The results highlight the need to address young driver safety in Oman. From these findings, the introduction of a graduated driver licensing system with nighttime driving restrictions could significantly improve young driver safety.

  7. Driving fatigue in professional drivers: a survey of truck and taxi drivers.

    PubMed

    Meng, Fanxing; Li, Shuling; Cao, Lingzhi; Li, Musen; Peng, Qijia; Wang, Chunhui; Zhang, Wei

    2015-01-01

    Fatigue among truck drivers has been studied extensively; however, less is known regarding the fatigue experience of taxi drivers in heavily populated metropolitan areas. This study aimed to compare the differences and similarities between truck and taxi driver fatigue to provide implications for the fatigue management and education of professional drivers. A sample of 274 truck drivers and 286 taxi drivers in Beijing was surveyed via a questionnaire, which included items regarding work characteristics, fatigue experience, accident information, attitude toward fatigue, and methods of counteracting fatigue. Driver fatigue was prevalent among professional drivers, and it was even more serious for taxi drivers. Taxi drivers reported more frequent fatigue experiences and were involved in more accidents. Among the contributing factors to fatigue, prolonged driving time was the most important factor identified by both driver groups. Importantly, the reason for the engagement in prolonged driving was neither due to the lack of awareness concerning the serious outcome of fatigue driving nor because of their poor detection of fatigue. The most probable reason was the optimism bias, as a result of which these professional drivers thought that fatigue was more serious for other drivers than for themselves, and they thought that they were effective in counteracting the effect of fatigue on their driving performance. Moreover, truck drivers tended to employ methods that require stopping to counteract fatigue, whereas taxi drivers preferred methods that were simultaneous with driving. Although both driver groups considered taking a nap as one of the most effective means to address fatigue, this method was not commonly used. Interestingly, these drivers were aware that the methods they frequently used were not the most effective means to counteract fatigue. This study provides knowledge on truck and taxi drivers' characteristics in fatigue experience, fatigue attitude, and

  8. The cost of mapping trachoma: Data from the Global Trachoma Mapping Project

    PubMed Central

    Schmidt, Elena; McFarland, Deborah A.; Macleod, Colin K.; Amer, Khaled; Bio, Amadou A.; Bakhtiari, Ana; Bovill, Sarah; Doherty, Amy H.; Khan, Asad Aslam; Mbofana, Mariamo; McCullagh, Siobhain; Millar, Tom; Mwale, Consity; Rotondo, Lisa A.; Weaver, Angela; Willis, Rebecca; Solomon, Anthony W.

    2017-01-01

    Background The Global Trachoma Mapping Project (GTMP) was implemented with the aim of completing the baseline map of trachoma globally. Over 2.6 million people were examined in 1,546 districts across 29 countries between December 2012 and January 2016. The aim of the analysis was to estimate the unit cost and to identify the key cost drivers of trachoma prevalence surveys conducted as part of GTMP. Methodology and principal findings In-country and global support costs were obtained using GTMP financial records. In-country expenditure was analysed for 1,164 districts across 17 countries. The mean survey cost was $13,113 per district [median: $11,675; IQR = $8,365-$14,618], $17,566 per evaluation unit [median: $15,839; IQR = $10,773-$19,915], $692 per cluster [median: $625; IQR = $452-$847] and $6.0 per person screened [median: $4.9; IQR = $3.7-$7.9]. Survey unit costs varied substantially across settings, and were driven by parameters such as geographic location, demographic characteristics, seasonal effects, and local operational constraints. Analysis by activities showed that fieldwork constituted the largest share of in-country survey costs (74%), followed by training of survey teams (11%). The main drivers of in-country survey costs were personnel (49%) and transportation (44%). Global support expenditure for all surveyed districts amounted to $5.1m, which included grant management, epidemiological support, and data stewardship. Conclusion This study provides the most extensive analysis of the cost of conducting trachoma prevalence surveys to date. The findings can aid planning and budgeting for future trachoma surveys required to measure the impact of trachoma elimination activities. Furthermore, the results of this study can also be used as a cost basis for other disease mapping programmes, where disease or context-specific survey cost data are not available. PMID:29045419

  9. The cost of mapping trachoma: Data from the Global Trachoma Mapping Project.

    PubMed

    Trotignon, Guillaume; Jones, Ellen; Engels, Thomas; Schmidt, Elena; McFarland, Deborah A; Macleod, Colin K; Amer, Khaled; Bio, Amadou A; Bakhtiari, Ana; Bovill, Sarah; Doherty, Amy H; Khan, Asad Aslam; Mbofana, Mariamo; McCullagh, Siobhain; Millar, Tom; Mwale, Consity; Rotondo, Lisa A; Weaver, Angela; Willis, Rebecca; Solomon, Anthony W

    2017-10-01

    The Global Trachoma Mapping Project (GTMP) was implemented with the aim of completing the baseline map of trachoma globally. Over 2.6 million people were examined in 1,546 districts across 29 countries between December 2012 and January 2016. The aim of the analysis was to estimate the unit cost and to identify the key cost drivers of trachoma prevalence surveys conducted as part of GTMP. In-country and global support costs were obtained using GTMP financial records. In-country expenditure was analysed for 1,164 districts across 17 countries. The mean survey cost was $13,113 per district [median: $11,675; IQR = $8,365-$14,618], $17,566 per evaluation unit [median: $15,839; IQR = $10,773-$19,915], $692 per cluster [median: $625; IQR = $452-$847] and $6.0 per person screened [median: $4.9; IQR = $3.7-$7.9]. Survey unit costs varied substantially across settings, and were driven by parameters such as geographic location, demographic characteristics, seasonal effects, and local operational constraints. Analysis by activities showed that fieldwork constituted the largest share of in-country survey costs (74%), followed by training of survey teams (11%). The main drivers of in-country survey costs were personnel (49%) and transportation (44%). Global support expenditure for all surveyed districts amounted to $5.1m, which included grant management, epidemiological support, and data stewardship. This study provides the most extensive analysis of the cost of conducting trachoma prevalence surveys to date. The findings can aid planning and budgeting for future trachoma surveys required to measure the impact of trachoma elimination activities. Furthermore, the results of this study can also be used as a cost basis for other disease mapping programmes, where disease or context-specific survey cost data are not available.

  10. Object-based selection in the Baylis and Driver (1993) paradigm is subject to space-based attentional modulation.

    PubMed

    Müller, Hermann J; O'Grady, Rebecca; Krummenacher, Joseph; Heller, Dieter

    2008-11-01

    Three experiments re-examined Baylis and Driver's (1993) strong evidence for object-based selection, that making relative apex location judgments is harder between two objects than within a single object, with object (figure-ground) segmentation determined solely by color-based perceptual set. Using variations of the Baylis and Driver paradigm, the experiments replicated a two-object cost. However, they also showed a large part of the two-object cost to be attributable to space-based factors, though there remained an irreducible cost consistent with 'true' object-based selection.

  11. Drivers of surface moisture flux variations in northern terrestrial regions

    NASA Astrophysics Data System (ADS)

    Fischer, R.; Walsh, J. E.

    2017-12-01

    The wetness of the high-latitude land surface is strongly dependent on the difference between precipitation (P) and evapotranspiration (ET). Variations of ET over daily, seasonal and interannual timescales are poorly documented, as are their relationships to key drivers. A combination of regional climate model output and eddy covariance measurements from five flux tower sites in Alaska are used to test the hypothesis that temperature is the key driver of ET in tundra regions underlain by permafrost, while precipitation plays a greater role in boreal forest areas. At the tundra sites, both the flux tower data and the model simulations show that daily and warm-season totals of ET are largely temperature driven, although daily ET also shows a negative correlation with P. At the boreal forest sites, P is the main driver of year-to-year variations of the seasonally integrated net moisture flux, although ET does not correlate strongly with either P or T. A short period of negative P-ET typically occurs during the warm season in the flux tower data. The model depicts a stronger hydrologic cycle (larger P, larger ET) relative to the measurements at all the sites.

  12. United States comparative costs and absenteeism of diabetic ophthalmic conditions.

    PubMed

    Brook, Richard A; Kleinman, Nathan L; Patel, Sunil; Smeeding, Jim E; Beren, Ian A; Turpcu, Adam

    2015-06-01

    This retrospective cohort study examined the impact of diabetic macular edema (DME), diabetic retinopathy (DR), or diabetes on annual health benefit costs and absenteeism in US employees. Claims data from 2001 to 2012 was extracted from the Human Capital Management Services Group Research Reference Database on annual direct/indirect health benefit costs and absences for employees aged ≥ 18 years. Employees with DME, DR, or diabetes were identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes. Employees were divided into two groups, drivers or nondrivers, and examined in separate analyses. For drivers and nondrivers, the DME, DR, and diabetes cohorts were compared with their respective control groups (without diabetes). Two-part regression models controlled for demographics and job-related characteristics. A total of 39,702 driver and 426,549 nondriver employees were identified as having ≥ 1 year's continuous health plan enrollment. Direct medical costs for drivers with DME, DR, or diabetes were $6470, $8021, and $5102, respectively (>2.8 times higher and statistically significant compared with driver controls). Nondrivers with DME and DR incurred significantly higher sick leave and short-term disability costs compared with the nondrivers with diabetes and nondriver controls. In drivers with DME, the majority of days of absence were for short- and long-term disability (12.41 and 11.43 days, respectively). In drivers with DR, the majority of days of absence were for short-term disability (10.70 days). In nondrivers with DME and nondrivers with DR, the majority of days of absence were for sick leave (5.74 and 4.93 days, respectively) and short-term disability (5.08 and 4.93 days, respectively). DME and DR are associated with substantial direct medical cost and absenteeism in this real-world sample of medically insured employees. This research highlights the negative impact of DME and DR on annual costs and absenteeism

  13. The short-term effectiveness of written driver knowledge tests.

    DOT National Transportation Integrated Search

    1978-01-01

    Highway Safety Program Standard 5, Driver Licensing, issued by the U. S. Department of Transportation requires the states to test applicants for a renewal of their operator's license on rules of the road at least once every four years. The cost of ad...

  14. Drivers for OSH interventions in small and medium-sized enterprises.

    PubMed

    Cagno, Enrico; Masi, Donato; Leão, Celina Pinto

    2016-01-01

    The debate concerning occupational safety and health (OSH) interventions has recently focused on the need of improving the evaluation of interventions, and in particular on the need for providing information about why the intervention worked or not, under what circumstances and in which context. Key concepts in the analysis of the context are the drivers, i.e., those factors enabling, fostering or facilitating OSH interventions. However, the concept of driver for an OSH intervention is both confused and contested. Although the term is widely used, there is little consensus on how drivers should be understood, how important they are in different contexts and how they can facilitate interventions. This exploratory study based on interviews with the owner-managers and the safety officers of small and medium-sized enterprises (SMEs) gives an overview of the most characteristic drivers for OSH interventions. The results will be used to make an initial evaluation of SMEs' needs, and will help orient interventions and future research.

  15. Present status and future prospects of heavy ion beams as drivers for ICF

    NASA Astrophysics Data System (ADS)

    Godlove, Terry F.

    1986-01-01

    A candidate driver for a practical inertial fusion reactor system must, among other characteristics, be cost effective and reliable for the parameters required by the fusion target and the remainder of the system. Although the history of large particle accelerators provides abundant evidence of their reliability at high repetition rates, their capital cost for the fusion application has been open to question. Attempts to design cost effective systems began with accelerators based on currently available technology such as RF linacs and storage rings. The West German HIBALL and the Japanese HIBLIC are examples of this initial effort. These designs are sufficiently credible that a strong argument can be made for the heavy ion method in general, but to reduce the cost per unit power it was found necessary to design for large scale, hence high capital cost. Emphasis in the U.S. shifted to newer technologies which offer hope of significant improvement in cost. In this paper the status of various heavy ion driver designs are compared with currently perceived requirements in order to illustrate their potential and assess their development needs.

  16. Therapeutic modulation of epigenetic drivers of drug resistance in ovarian cancer

    PubMed Central

    Zeller, Constanze; Brown, Robert

    2010-01-01

    Epigenetic changes in tumours are associated not only with cancer development and progression, but also with resistance to chemotherapy. Aberrant DNA methylation at CpG islands and associated epigenetic silencing are observed during the acquisition of drug resistance. However, it remains unclear whether all of the observed changes are drivers of drug resistance, causally associated with response of tumours to chemotherapy, or are passenger events representing chance DNA methylation changes. Systematic approaches that link DNA methylation and expression with chemosensitivity will be required to identify key drivers. Such drivers will be important prognostic or predicitive biomarkers, both to existing chemotherapies, but also to epigenetic therapies used to modulate drug resistance. PMID:21789144

  17. Aging baby boomers--a blessing or challenge for driver licensing authorities.

    PubMed

    Dobbs, Bonnie M

    2008-08-01

    the need for cost-effective, accurate, and efficient methods for identifying and assessing the subgroup of older drivers whose driving has declined to an unsafe level. That subgroup consists of individuals with medical conditions (and treatments) affecting driving performance. The demographic shift has been a blessing for licensing authorities in that it has created awareness of the need for a reexamination of licensing policies and procedures designed to identify those older drivers who may no longer be safe to drive. If that awareness becomes translated into effective policies and procedures that appropriately target the medically at-risk/impaired older driver rather than the older driver per se, the result will be an increase in the safety and mobility of the older driving population and increased public safety overall. However, a continued focus on older drivers rather than medically at-risk drivers will result in a costly, ineffective, and overburdened system.

  18. Directions of management for the development of fuel-and-energy complex as the key driver of the social-and-economic development of regions

    NASA Astrophysics Data System (ADS)

    Mottaeva, Asiiat

    2017-10-01

    The article is dedicated to the problems of the participation of the energy enterprises in the social-and-economic development of the regions and municipalities. The complex of mechanisms of the implementation of the Energy strategy in the form of strategic initiatives of the development of the energy industry representing the complex inter-industry state-private long-term projects is presented in the article. The author considers the development of the energy industry to be the key driver of the social-and-economic development of regions. The author proves, that the increase in competitiveness of Russian energy, geographical and grocery diversification of export and improvement of quality of export products might allow to solve some problems of the development of national economy.

  19. SynCardia Portable Freedom Driver: A Single-Center Experience With 11 Patients.

    PubMed

    Shah, Nilay R; Jaroszewski, Dawn E; Ashfaq, Awais; Schroedl, Lucas A; Staley, Linda L; Pajaro, Octavio E; Kasirajan, Vigneshwar; Arabia, Francisco A

    2015-01-01

    The portable Freedom Drive (SynCardia Inc, Tucson, AZ USA) for total artificial heart (TAH-t) support was approved for an investigational device exemption study in March 2010. We review our center's experience with the portable driver. A retrospective review was conducted of patients who underwent TAH-t implantation and transfer to portable driver from September 2008 to June 2012, with follow-up through December 2012. A total of 30 patients underwent TAH-t implantation during this time period, with 11 patients successfully transferred to the Freedom Driver. Transfer to Freedom Driver after TAH-t implant was a median of 46 days (range, 225-86 days). Ninety-one percent (10) of 11 patients transferred to Freedom Driver were bridged to transplantation. One patient died on support. Five (45.5%) of 11 patients were discharged home and 5 (45.5%) remained in-patient on the portable driver before transplantation. Four patients (80%) successfully discharged home required at least 1 hospital readmission (range, 1-5 admissions per patient). Six patients (55%) transferred to the portable driver required a return to a main driver console. Two patients were temporarily maintained on the main driver then returned to the Freedom Driver for bridge to transplantation. Patients with TAH-t can be considered for transfer to the portable Freedom Driver while awaiting transplantation. Issues that complicated this patient population included inadequate social support, hemodynamic instability, and concurrent morbidities. The potential benefits of the portable driver are currently undergoing assessment. These may include increased mobility and improved quality of life, opportunity for discharge home, and decreased overall medical costs.

  20. Obstacles to engaging in young driver licensing: Perspectives of parents.

    PubMed

    Naz, Sehana; Scott-Parker, Bridie

    2017-02-01

    Young novice drivers remain at greater risk of injury and death despite a wealth of interventions including graduated driver licensing (GDL) programs. The key to implementing safer practices inherent in GDL appears to lie with optimising the role of parents. This qualitative research explored the parent's perspectives of obstacles to engaging in the driver licensing process within a GDL program. Parents also shared advice on what they found helpful, and where relevant, recommended changes in the process to enable safer practices for young drivers. Twenty-three parents (aged 35-60 years, M=49.52, SD=8.01, 11 males) participated in semi-structured interviews regarding licensing experiences with their young driver children. The young drivers included learner (n=11), provisional (restricted/intermediate) (n=9) and open (unrestricted/full) licence drivers (n=3), ranging from 16 to 24 years (M=18.04, SD=2.21, 13 males). Content analysis revealed that most obstacles were encountered at the learner licensing phase, with the parent-reported difficult temperament of the learner driver the most prominent. Unsurprisingly, advice to other parents to be patient and remain calm featured heavily during the same phase. Anxiety from not having control of the vehicle was another obstacle at the learner phase, translating to anxieties for child safety in the early stages of provisional driving. Recommendations for the current GDL included more rigorous road rule testing, with general support for the program, professional driver training at learner and provisional stages facilitated parental engagement through the licensing phases. The findings overwhelmingly suggest a need for parents to be educated regarding their importance in, and of, the driver licensing process, and the efficacy of their instruction, content and practices. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Child passengers and driver culpability in fatal crashes by driver gender.

    PubMed

    Maasalo, Ida; Lehtonen, Esko; Pekkanen, Jami; Summala, Heikki

    2016-07-03

    Studies based on accident statistics generally suggest that the presence of a passenger reduces adult drivers' accident risk. However, passengers have been reported to be a source of distraction in a remarkable portion of distraction-related crashes. Although the effect of passengers on driving performance has been studied extensively, few studies have focused on how a child passenger affects the driver.  A child in a car is a potential distractor for parents, especially for mothers of small children, who often suffer from sleep deficit. The aim of this study was to examine how the presence of child passengers of different ages is associated with a higher driver culpability, which was expected due to child-related distraction and fatigue. The analysis was based on the comprehensive data of fatal crashes studied in-depth by multidisciplinary road accident investigation teams in Finland during 1988-2012. Teams determine the primary party who had the most crucial effect on the origin of the event. We define the primary party as culpable and the others involved as nonculpable drivers. The culpability rate was defined as the percentage of culpable drivers and rates were compared for drivers with a child/teen passenger aged 0-17 years (N = 348), with an adult passenger without children (N = 324), and when driving alone (N = 579), grouped by child age and driver gender.  Drivers with specific risk-related behavior (substantial speeding, driving when intoxicated, unbelted, or without a license) were excluded from the analyses, in order to make the drivers with and without children comparable. Only drivers 26-47 years old were included, representing parents with children 0-9 years of age. Male drivers were less often culpable with 0- to 17-year-old passengers in the car than alone or with adults. This was not the case with female drivers. The gender difference in culpability was most marked with small children age 0-4 years. Female drivers' culpability rate with a 0

  2. Characterization of potential driver mutations involved in human breast cancer by computational approaches

    PubMed Central

    Rajendran, Barani Kumar; Deng, Chu-Xia

    2017-01-01

    Breast cancer is the second most frequently occurring form of cancer and is also the second most lethal cancer in women worldwide. A genetic mutation is one of the key factors that alter multiple cellular regulatory pathways and drive breast cancer initiation and progression yet nature of these cancer drivers remains elusive. In this article, we have reviewed various computational perspectives and algorithms for exploring breast cancer driver mutation genes. Using both frequency based and mutational exclusivity based approaches, we identified 195 driver genes and shortlisted 63 of them as candidate drivers for breast cancer using various computational approaches. Finally, we conducted network and pathway analysis to explore their functions in breast tumorigenesis including tumor initiation, progression, and metastasis. PMID:28477017

  3. The cost of molecular-guided therapy in oncology: a prospective cost study alongside the MOSCATO trial.

    PubMed

    Pagès, Arnaud; Foulon, Stéphanie; Zou, Zhaomin; Lacroix, Ludovic; Lemare, François; de Baère, Thierry; Massard, Christophe; Soria, Jean-Charles; Bonastre, Julia

    2017-06-01

    There is increasing use of molecular technologies to guide cancer treatments, but few cost data are available. Our objective was to assess the costs of molecular-guided therapy for patients with advanced solid tumors alongside the Molecular Screening for Cancer Treatment and Optimization (MOSCATO) trial. The study population consisted of 529 patients. The molecular diagnosis included seven steps from tumor biopsy to the multidisciplinary molecular tumor board. The cost of a complete molecular diagnosis was assessed by micro-costing. Direct costs incurred from enrollment until progression were assessed from the French National Health Insurance perspective. The patients' mean age was 54 years (range: 3-82) and the mean follow-up period was 145 days (range: 1-707 days). A complete molecular diagnosis cost [euro ]2,396. There were 220 patients with an actionable target (42%), among whom 105 (20%) actually received a targeted therapy. The cost of molecular-guided therapy per patient was [euro ]31,269. The main cost drivers were anticancer drugs (54%) and hospitalizations (35%). This prospective cost analysis showed that molecular diagnosis accounts for only 6% of the cost of molecular-guided therapy per patient. The costs of drugs and hospitalizations are the main cost drivers.Genet Med advance online publication 01 December 2016.

  4. Modeling multidecadal surface water inundation dynamics and key drivers on large river basin scale using multiple time series of Earth-observation and river flow data

    NASA Astrophysics Data System (ADS)

    Heimhuber, V.; Tulbure, M. G.; Broich, M.

    2017-02-01

    Periodically inundated floodplain areas are hot spots of biodiversity and provide a broad range of ecosystem services but have suffered alarming declines in recent history. Despite their importance, their long-term surface water (SW) dynamics and hydroclimatic drivers remain poorly quantified on continental scales. In this study, we used a 26 year time series of Landsat-derived SW maps in combination with river flow data from 68 gauges and spatial time series of rainfall, evapotranspiration and soil moisture to statistically model SW dynamics as a function of key drivers across Australia's Murray-Darling Basin (˜1 million km2). We fitted generalized additive models for 18,521 individual modeling units made up of 10 × 10 km grid cells, each split into floodplain, floodplain-lake, and nonfloodplain area. Average goodness of fit of models was high across floodplains and floodplain-lakes (r2 > 0.65), which were primarily driven by river flow, and was lower for nonfloodplain areas (r2 > 0.24), which were primarily driven by rainfall. Local climate conditions were more relevant for SW dynamics in the northern compared to the southern basin and had the highest influence in the least regulated and most extended floodplains. We further applied the models of two contrasting floodplain areas to predict SW extents of cloud-affected time steps in the Landsat series during the large 2010 floods with high validated accuracy (r2 > 0.97). Our framework is applicable to other complex river basins across the world and enables a more detailed quantification of large floods and drivers of SW dynamics compared to existing methods.

  5. The cost-effectiveness of air bags by seating position.

    PubMed

    Graham, J D; Thompson, K M; Goldie, S J; Segui-Gomez, M; Weinstein, M C

    1997-11-05

    Motor vehicle crashes continue to cause significant mortality and morbidity in the United States. Installation of air bags in new passenger vehicles is a major initiative in the field of injury prevention. To assess the net health consequences and cost-effectiveness of driver's side and front passenger air bags from a societal perspective, taking into account the increased risk to children who occupy the front passenger seat and the diminished effectiveness for older adults. A deterministic state transition model tracked a hypothetical cohort of new vehicles over a 20-year period for 3 strategies: (1) installation of safety belts, (2) installation of driver's side air bags in addition to safety belts, and (3) installation of front passenger air bags in addition to safety belts and driver's side air bags. Changes in health outcomes, valued in terms of quality-adjusted life-years (QALYs) and costs (in 1993 dollars), were projected following the recommendations of the Panel on Cost-effectiveness in Health and Medicine. US population-based and convenience sample data were used. Incremental cost-effectiveness ratios. Safety belts are cost saving, even at 50% use. The addition of driver's side air bags to safety belts results in net health benefits at an incremental cost of $24000 per QALY saved. The further addition of front passenger air bags results in an incremental net benefit at a higher incremental cost of $61000 per QALY saved. Results were sensitive to the unit cost of air bag systems, their effectiveness, baseline fatality rates, the ratio of injuries to fatalities, and the real discount rate. Both air bag systems save life-years at costs that are comparable to many medical and public health practices. Immediate steps can be taken to enhance the cost-effectiveness of front passenger air bags, such as moving children to the rear seat.

  6. Shuttle's 160 hour ground turnaround - A design driver

    NASA Technical Reports Server (NTRS)

    Widick, F.

    1977-01-01

    Turnaround analysis added a new dimension to the Space Program with the advent of the Space Shuttle. The requirement to turn the flight hardware around in 160 working hours from landing to launch was a significant design driver and a useful tool in forcing the integration of flight and ground systems design to permit an efficient ground operation. Although there was concern that time constraints might increase program costs, the result of the analysis was to minimize facility requirements and simplify operations with resultant cost savings.

  7. Yb:YAG ceramic-based laser driver for Inertial Fusion Energy (IFE)

    NASA Astrophysics Data System (ADS)

    Vetrovec, John; Copeland, Drew A.; Litt, Amardeep S.

    2016-03-01

    We report on a new class of laser amplifiers for inertial confinement fusion (ICF) drivers based on a Yb:YAG ceramic disk in an edge-pumped configuration and cooled by a high-velocity gas flow. The Yb lasant offers very high efficiency and low waste heat. The ceramic host material has a thermal conductivity nearly 15-times higher than the traditionally used glass and it is producible in sizes suitable for a typical 10- to 20-kJ driver beam line. The combination of high lasant efficiency, low waste heat, edge-pumping, and excellent thermal conductivity of the host, enable operation at 10 to 20 Hz at over 20% wall plug efficiency while being comparably smaller and less costly than recently considered face-pumped alternative drivers using Nd:glass, Yb:S-FAP, and cryogenic Yb:YAG. Scalability of the laser driver over a broad range of sizes is presented.

  8. The effects of mutational processes and selection on driver mutations across cancer types.

    PubMed

    Temko, Daniel; Tomlinson, Ian P M; Severini, Simone; Schuster-Böckler, Benjamin; Graham, Trevor A

    2018-05-10

    Epidemiological evidence has long associated environmental mutagens with increased cancer risk. However, links between specific mutation-causing processes and the acquisition of individual driver mutations have remained obscure. Here we have used public cancer sequencing data from 11,336 cancers of various types to infer the independent effects of mutation and selection on the set of driver mutations in a cancer type. First, we detect associations between a range of mutational processes, including those linked to smoking, ageing, APOBEC and DNA mismatch repair (MMR) and the presence of key driver mutations across cancer types. Second, we quantify differential selection between well-known alternative driver mutations, including differences in selection between distinct mutant residues in the same gene. These results show that while mutational processes have a large role in determining which driver mutations are present in a cancer, the role of selection frequently dominates.

  9. Association of driver air bags with driver fatality: a matched cohort study.

    PubMed

    Cummings, Peter; McKnight, Barbara; Rivara, Frederick P; Grossman, David C

    2002-05-11

    To estimate the association of driver air bag presence with driver fatality in road traffic crashes. Matched pair cohort study. All passenger vehicle crashes in the United States during 1990-2000 inclusive. 51 031 driver-passenger pairs in the same vehicle. Relative risk of death within 30 days of a crash. Drivers with an air bag were less likely to die than drivers without an air bag (adjusted relative risk 0.92 (95% confidence interval 0.88 to 0.96)). This estimate was nearly the same whether drivers wore a seat belt (adjusted relative risk 0.93) or not (0.91). Air bags were associated with more protection for women (0.88 (0.82 to 0.93)), than for men (0.94 (0.90 to 0.99)). Drivers wearing a seat belt were less likely to die than unbelted drivers (0.35 (0.33 to 0.36)). Belted drivers with an air bag were less likely to die than unbelted drivers without an air bag (0.32 (0.30 to 0.34)). If the associations are causal the average risk of driver death was reduced 8% (95% confidence interval 4% to 12%) by an air bag. Benefit was similar for belted and unbelted drivers and was slightly greater for women. However, seat belts offered much more protection than air bags.

  10. Association of driver air bags with driver fatality: a matched cohort study

    PubMed Central

    Cummings, Peter; McKnight, Barbara; Rivara, Frederick P; Grossman, David C

    2002-01-01

    Objective To estimate the association of driver air bag presence with driver fatality in road traffic crashes. Design Matched pair cohort study. Setting All passenger vehicle crashes in the United States during 1990-2000 inclusive. Subjects 51 031 driver-passenger pairs in the same vehicle. Main outcome measures Relative risk of death within 30 days of a crash. Results Drivers with an air bag were less likely to die than drivers without an air bag (adjusted relative risk 0.92 (95% confidence interval 0.88 to 0.96)). This estimate was nearly the same whether drivers wore a seat belt (adjusted relative risk 0.93) or not (0.91). Air bags were associated with more protection for women (0.88 (0.82 to 0.93)), than for men (0.94 (0.90 to 0.99)). Drivers wearing a seat belt were less likely to die than unbelted drivers (0.35 (0.33 to 0.36)). Belted drivers with an air bag were less likely to die than unbelted drivers without an air bag (0.32 (0.30 to 0.34)). Conclusions If the associations are causal the average risk of driver death was reduced 8% (95% confidence interval 4% to 12%) by an air bag. Benefit was similar for belted and unbelted drivers and was slightly greater for women. However, seat belts offered much more protection than air bags. What is already known on this topicStudies have estimated that driver air bags reduce the risk of death in a road vehicle crash by 10-14%These studies disagree as to whether benefit is greater for drivers wearing a seat belt or for unbelted driversWhat this study addsHaving an air bag was associated with an 8% reduction in the risk of death, whether the driver was belted or notThe reduction in risk was greater for women (12%) than for men (6%)Seat belts provided much greater protection, with seat belt use reducing the risk of death by 65% (or by 68% in combination with an air bag) PMID:12003882

  11. Comparison of a Virtual Older Driver Assessment with an On-Road Driving Test.

    PubMed

    Eramudugolla, Ranmalee; Price, Jasmine; Chopra, Sidhant; Li, Xiaolan; Anstey, Kaarin J

    2016-12-01

    To design a low-cost simulator-based driving assessment for older adults and to compare its validity with that of an on-road driving assessment and other measures of older driver risk. Cross-sectional observational study. Canberra, Australia. Older adult drivers (N = 47; aged 65-88, mean age 75.2). Error rate on a simulated drive with environment and scoring procedure matched to those of an on-road test. Other measures included participant age, simulator sickness severity, neuropsychological measures, and driver screening measures. Outcome variables included occupational therapist (OT)-rated on-road errors, on-road safety rating, and safety category. Participants' error rate on the simulated drive was significantly correlated with their OT-rated driving safety (correlation coefficient (r) = -0.398, P = .006), even after adjustment for age and simulator sickness (P = .009). The simulator error rate was a significant predictor of categorization as unsafe on the road (P = .02, sensitivity 69.2%, specificity 100%), with 13 (27%) drivers assessed as unsafe. Simulator error was also associated with other older driver safety screening measures such as useful field of view (r = 0.341, P = .02), DriveSafe (r = -0.455, P < .01), and visual motion sensitivity (r = 0.368, P = .01) but was not associated with memory (delayed word recall) or global cognition (Mini-Mental State Examination). Drivers made twice as many errors on the simulated assessment as during the on-road assessment (P < .001), with significant differences in the rate and type of errors between the two mediums. A low-cost simulator-based assessment is valid as a screening instrument for identifying at-risk older drivers but not as an alternative to on-road evaluation when accurate data on competence or pattern of impairment is required for licensing decisions and training programs. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  12. Availability of driver's license master lists for use in government-sponsored public health research.

    PubMed

    Walsh, Matthew C; Trentham-Dietz, Amy; Palta, Mari

    2011-06-15

    Although the percentage of US drivers with valid driver's licenses varies from state to state, it has historically been high enough to constitute a useful sampling frame for many public health purposes. Over the past decade, states have had to restrict access to this information to comply with the Driver's Privacy Protection Act (18 U.S.C. 2721-2725). In 2009 and 2010, the authors conducted a survey of all 50 states on the availability of master lists of licensed drivers to be used to contact citizens of each state for research purposes. A hypothetical situation requiring driver's license data was sent to each state's responsible government agency for review. In addition, the authors collected data on opt-out mechanisms available to drivers, costs to researchers, and additional state privacy policies pertaining to driver's license files. A total of 42 states (84%) responded; 16 (32%) states allowed access to data, 4 (8%) states were unable to respond to the hypothetical situation, and 22 (44%) states denied access to data. A total of 74,697,574 records were available from the 16 states providing driver's license data. Although the Driver's Privacy Protection Act has restricted access to data on licensed drivers, these data are still an available resource in many states.

  13. Availability of Driver's License Master Lists for Use in Government-Sponsored Public Health Research

    PubMed Central

    Walsh, Matthew C.; Trentham-Dietz, Amy; Palta, Mari

    2011-01-01

    Although the percentage of US drivers with valid driver's licenses varies from state to state, it has historically been high enough to constitute a useful sampling frame for many public health purposes. Over the past decade, states have had to restrict access to this information to comply with the Driver's Privacy Protection Act (18 U.S.C. 2721–2725). In 2009 and 2010, the authors conducted a survey of all 50 states on the availability of master lists of licensed drivers to be used to contact citizens of each state for research purposes. A hypothetical situation requiring driver's license data was sent to each state's responsible government agency for review. In addition, the authors collected data on opt-out mechanisms available to drivers, costs to researchers, and additional state privacy policies pertaining to driver's license files. A total of 42 states (84%) responded; 16 (32%) states allowed access to data, 4 (8%) states were unable to respond to the hypothetical situation, and 22 (44%) states denied access to data. A total of 74,697,574 records were available from the 16 states providing driver's license data. Although the Driver's Privacy Protection Act has restricted access to data on licensed drivers, these data are still an available resource in many states. PMID:21571870

  14. The costs of heparin-induced thrombocytopenia: a patient-based cost of illness analysis.

    PubMed

    Wilke, T; Tesch, S; Scholz, A; Kohlmann, T; Greinacher, A

    2009-05-01

    SUMMARY BACKGROUND AND OBJECTIVES: Due to the complexity of heparin-induced thrombocytopenia (HIT), currently available cost analyses are rough estimates. The objectives of this study were quantification of costs involved in HIT and identification of main cost drivers based on a patient-oriented approach. Patients diagnosed with HIT (1995-2004, University-hospital Greifswald, Germany) based on a positive functional assay (HIPA test) were retrieved from the laboratory records and scored (4T-score) by two medical experts using the patient file. For cost of illness analysis, predefined HIT-relevant cost parameters (medication costs, prolonged in-hospital stay, diagnostic and therapeutic interventions, laboratory tests, blood transfusions) were retrieved from the patient files. The data were analysed by linear regression estimates with the log of costs and a gamma regression model. Mean length of stay data of non-HIT patients were obtained from the German Federal Statistical Office, adjusted for patient characteristics, comorbidities and year of treatment. Hospital costs were provided by the controlling department. One hundred and thirty HIT cases with a 4T-score >or=4 and a positive HIPA test were analyzed. Mean additional costs of a HIT case were 9008 euro. The main cost drivers were prolonged in-hospital stay (70.3%) and costs of alternative anticoagulants (19.7%). HIT was more costly in surgical patients compared with medical patients and in patients with thrombosis. Early start of alternative anticoagulation did not increase HIT costs despite the high medication costs indicating prevention of costly complications. An HIT cost calculator is provided, allowing online calculation of HIT costs based on local cost structures and different currencies.

  15. Changing drivers' minds: the evaluation of an advanced driver coaching system.

    PubMed

    Stanton, N A; Walker, G H; Young, M S; Kazi, T; Salmon, P M

    2007-08-01

    This paper reports on the study of an advanced driver coaching system. The study distinguishes between different types of post-licensure programmes in order to explore a system based on a model of identifying and responding to hazards, called 'information, position, speed, gear and acceleration' (IPSGA). Previous literature has been sceptical about the benefits of advanced driver education; thus, the current study was designed to control for the effects of coaching drivers in the 'IPSGA' system (the treatment group) against the effects of being accompanied (control group 1), as well as the mere effects of time (control group 2). Measures were taken before the driver coaching began (as a baseline measure) and again after 8 weeks (to see if any changes had occurred). These measures included driver knowledge via a post-drive interview, observations of driving skill and driver attitude using a locus of control scale. The results suggest that advanced driver coaching using the IPSGA system had a beneficial effect on all of these measures. Drivers in the coaching condition improved their situation awareness, driving skills and reduced attributions of external locus of control. The study lends support to the case for one-to-one individualized driver coaching using a systematic model of driving.

  16. Drivers of sustained hygiene behaviour change: A case study from mid-western Nepal.

    PubMed

    McMichael, Celia; Robinson, Priscilla

    2016-08-01

    Behaviour change is central to the prevention of many population health problems, yet it is typically difficult to initiate and sustain. This paper reports on an evaluation of a water, sanitation and hygiene (WASH) intervention in mid-western Nepal, with particular focus on the drivers and barriers for handwashing with soap/ash and elimination of open defecation. The research was conducted during October-November 2014, two and half years following the intervention's end-point. Qualitative data were collected from the target community (n = 112) via group discussions, interviews and drawings/stories of 'most significant change'. Households' handwashing/water facilities and toilets were observed. Analysis was informed by a model that highlights environmental, psychosocial and technological factors that shape hygiene behaviours across multiple levels, from the habitual to the structural (Dreibelbis et al. 2013). Findings indicate the intervention has supported development of new norms around hygiene behaviours. Key drivers of sustained hygiene behaviour were habit formation, emotional drivers (e.g. disgust, affiliation), and collective action and civic pride; key constraints included water scarcity and socio-economic disadvantage. Identifying and responding to the drivers and constraints of hygiene behaviour change in specific contexts is critical to sustained behaviour change and population health impact. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Key issues for low-cost FGD installations

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

    DePriest, W.; Mazurek, J.M.

    1995-12-01

    This paper will discuss various methods for installing low-cost FGD systems. The paper will include a discussion of various types of FGD systems available, both wet and dry, and will compare the relative cost of each type. Important design issues, such as use of spare equipment, materials of construction, etc. will be presented. An overview of various low-cost construction techniques (i.e., modularization) will be included. This paper will draw heavily from Sargent & Lundy`s database of past and current FGD projects together with information we gathered for several Electric Power Research Institute (EPRI) studies on the subject.

  18. U.S. Balance-of-Station Cost Drivers and Sensitivities (Presentation)

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

    Maples, B.

    2012-10-01

    With balance-of-system (BOS) costs contributing up to 70% of the installed capital cost, it is fundamental to understanding the BOS costs for offshore wind projects as well as potential cost trends for larger offshore turbines. NREL developed a BOS model using project cost estimates developed by GL Garrad Hassan. Aspects of BOS covered include engineering and permitting, ports and staging, transportation and installation, vessels, foundations, and electrical. The data introduce new scaling relationships for each BOS component to estimate cost as a function of turbine parameters and size, project parameters and size, and soil type. Based on the new BOSmore » model, an analysis to understand the non‐turbine costs has been conducted. This analysis establishes a more robust baseline cost estimate, identifies the largest cost components of offshore wind project BOS, and explores the sensitivity of the levelized cost of energy to permutations in each BOS cost element. This presentation shows results from the model that illustrates the potential impact of turbine size and project size on the cost of energy from U.S. offshore wind plants.« less

  19. Drinking driver and traffic safety project. Volume 2, Probabilities for drinking drivers

    DOT National Transportation Integrated Search

    1973-10-01

    This is the second volume of a final report of a four-year study of drinking drivers. It includes a brief description of a prediction model developed from over 4000 cases, including drinking drivers, recidivist drinking drivers and drivers license ap...

  20. 77 FR 75491 - Entry-Level Driver Training; Public Listening Session

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-20

    ... identified are supported by research and data analyses, including cost/benefit considerations. The session...-27748] Entry-Level Driver Training; Public Listening Session AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of public listening session. SUMMARY: FMCSA announces that it will...

  1. Google glass: a driver distraction cause or cure?

    PubMed

    Sawyer, Ben D; Finomore, Victor S; Calvo, Andres A; Hancock, P A

    2014-11-01

    We assess the driving distraction potential of texting with Google Glass (Glass), a mobile wearable platform capable of receiving and sending short-message-service and other messaging formats. A known roadway danger, texting while driving has been targeted by legislation and widely banned. Supporters of Glass claim the head-mounted wearable computer is designed to deliver information without concurrent distraction. Existing literature supports the supposition that design decisions incorporated in Glass might facilitate messaging for drivers. We asked drivers in a simulator to drive and use either Glass or a smartphone-based messaging interface, then interrupted them with an emergency brake event. Both the response event and subsequent recovery were analyzed. Glass-delivered messages served to moderate but did not eliminate distracting cognitive demands. A potential passive cost to drivers merely wearing Glass was also observed. Messaging using either device impaired driving as compared to driving without multitasking. Glass in not a panacea as some supporters claim, but it does point the way to design interventions that effect reduced load in multitasking. Discussions of these identified benefits are framed within the potential of new in-vehicle systems that bring both novel forms of distraction and tools for mitigation into the driver's seat.

  2. Cost analysis of prenatal care using the activity-based costing model: a pilot study.

    PubMed

    Gesse, T; Golembeski, S; Potter, J

    1999-01-01

    The cost of prenatal care in a private nurse-midwifery practice was examined using the activity-based costing system. Findings suggest that the activities of the nurse-midwife (the health care provider) constitute the major cost driver of this practice and that the model of care and associated, time-related activities influence the cost. This pilot study information will be used in the development of a comparative study of prenatal care, client education, and self care.

  3. Cost Analysis of Prenatal Care Using the Activity-Based Costing Model: A Pilot Study

    PubMed Central

    Gesse, Theresa; Golembeski, Susan; Potter, Jonell

    1999-01-01

    The cost of prenatal care in a private nurse-midwifery practice was examined using the activity-based costing system. Findings suggest that the activities of the nurse-midwife (the health care provider) constitute the major cost driver of this practice and that the model of care and associated, time-related activities influence the cost. This pilot study information will be used in the development of a comparative study of prenatal care, client education, and self care. PMID:22945985

  4. A Vehicle Steering Recognition System Based on Low-Cost Smartphone Sensors.

    PubMed

    Liu, Xinhua; Mei, Huafeng; Lu, Huachang; Kuang, Hailan; Ma, Xiaolin

    2017-03-20

    Recognizing how a vehicle is steered and then alerting drivers in real time is of utmost importance to the vehicle and driver's safety, since fatal accidents are often caused by dangerous vehicle maneuvers, such as rapid turns, fast lane-changes, etc. Existing solutions using video or in-vehicle sensors have been employed to identify dangerous vehicle maneuvers, but these methods are subject to the effects of the environmental elements or the hardware is very costly. In the mobile computing era, smartphones have become key tools to develop innovative mobile context-aware systems. In this paper, we present a recognition system for dangerous vehicle steering based on the low-cost sensors found in a smartphone: i.e., the gyroscope and the accelerometer. To identify vehicle steering maneuvers, we focus on the vehicle's angular velocity, which is characterized by gyroscope data from a smartphone mounted in the vehicle. Three steering maneuvers including turns, lane-changes and U-turns are defined, and a vehicle angular velocity matching algorithm based on Fast Dynamic Time Warping (FastDTW) is adopted to recognize the vehicle steering. The results of extensive experiments show that the average accuracy rate of the presented recognition reaches 95%, which implies that the proposed smartphone-based method is suitable for recognizing dangerous vehicle steering maneuvers.

  5. The ScanTrainer obstetrics and gynaecology ultrasound virtual reality training simulator: A cost model to determine the cost viability of replacing clinical training with simulation training.

    PubMed

    Carolan-Rees, G; Ray, A F

    2015-05-01

    The aim of this study was to produce an economic cost model comparing the use of the Medaphor ScanTrainer virtual reality training simulator for obstetrics and gynaecology ultrasound to achieve basic competence, with the traditional training method. A literature search and survey of expert opinion were used to identify resources used in training. An executable model was produced in Excel. The model showed a cost saving for a clinic using the ScanTrainer of £7114 per annum. The uncertainties of the model were explored and it was found to be robust. Threshold values for the key drivers of the model were identified. Using the ScanTrainer is cost saving for clinics with at least two trainees per year to train, if it would take at least six lists to train them using the traditional training method and if a traditional training list has at least two fewer patients than a standard list.

  6. Economics of human performance and systems total ownership cost.

    PubMed

    Onkham, Wilawan; Karwowski, Waldemar; Ahram, Tareq Z

    2012-01-01

    Financial costs of investing in people is associated with training, acquisition, recruiting, and resolving human errors have a significant impact on increased total ownership costs. These costs can also affect the exaggerate budgets and delayed schedules. The study of human performance economical assessment in the system acquisition process enhances the visibility of hidden cost drivers which support program management informed decisions. This paper presents the literature review of human total ownership cost (HTOC) and cost impacts on overall system performance. Economic value assessment models such as cost benefit analysis, risk-cost tradeoff analysis, expected value of utility function analysis (EV), growth readiness matrix, multi-attribute utility technique, and multi-regressions model were introduced to reflect the HTOC and human performance-technology tradeoffs in terms of the dollar value. The human total ownership regression model introduces to address the influencing human performance cost component measurement. Results from this study will increase understanding of relevant cost drivers in the system acquisition process over the long term.

  7. Approaches of truck drivers and non-truck drivers toward reckless on-road behavior.

    PubMed

    Rosenbloom, Tova; Eldror, Ehud; Shahar, Amit

    2009-07-01

    The purpose of the study was to compare the reported approaches of truck drivers to those of non-truck drivers toward reckless on-road behaviors. One hundred and sixty-seven adult males, including 70 non-truck drivers, completed the questionnaires voluntarily. The truck drivers were employees of a concrete manufacturing company working at various company plants throughout Israel. Seventy were professional mixer truckers and 27 were tip-truckers. The participants completed the Reckless Driving Self-Report Scale based on Taubman Ben-Ari et al. [Taubman Ben-Ari, O., Florian, V., Mikulincer, M., 1999. The impact of mortality salience on reckless driving: a test of terror management mechanisms. Journal of Personality and Social Psychology 76, 35-45], adapted for truck drivers for this study. It was expected that non-professional, as compared to professional (truck) drivers, would be more permissive regarding reckless driving, since driving risks are less prominent in their daily driving experience. An ANOVA performed on mean reckless-driving scores yielded significant results. The post hoc Schéffe test indicated significantly higher reckless-driving scores for automobile drivers as compared to both mixer-truck driver scores and tip-truck driver scores. In addition, the reckless-driving scores for mixer-truck drivers were significantly higher than the tip-truck driver scores. We discuss various explanations for the findings and consider possible implications for training strategies in organizations as well as for media campaigns focused on mutual safe road use of truck drivers and private vehicle drivers.

  8. Hospital cost structure in the USA: what's behind the costs? A business case.

    PubMed

    Chandra, Charu; Kumar, Sameer; Ghildayal, Neha S

    2011-01-01

    Hospital costs in the USA are a large part of the national GDP. Medical billing and supplies processes are significant and growing contributors to hospital operations costs in the USA. This article aims to identify cost drivers associated with these processes and to suggest improvements to reduce hospital costs. A Monte Carlo simulation model that uses @Risk software facilitates cost analysis and captures variability associated with the medical billing process (administrative) and medical supplies process (variable). The model produces estimated savings for implementing new processes. Significant waste exists across the entire medical supply process that needs to be eliminated. Annual savings, by implementing the improved process, have the potential to save several billion dollars annually in US hospitals. The other analysis in this study is related to hospital billing processes. Increased spending on hospital billing processes is not entirely due to hospital inefficiency. The study lacks concrete data for accurately measuring cost savings, but there is obviously room for improvement in the two US healthcare processes. This article only looks at two specific costs associated with medical supply and medical billing processes, respectively. This study facilitates awareness of escalating US hospital expenditures. Cost categories, namely, fixed, variable and administrative, are presented to identify the greatest areas for improvement. The study will be valuable to US Congress policy makers and US healthcare industry decision makers. Medical billing process, part of a hospital's administrative costs, and hospital supplies management processes are part of variable costs. These are the two major cost drivers of US hospitals' expenditures that were examined and analyzed.

  9. Parametric Cost Modeling of Space Missions Using the Develop New Projects (DMP) Implementation Process

    NASA Technical Reports Server (NTRS)

    Rosenberg, Leigh; Hihn, Jairus; Roust, Kevin; Warfield, Keith

    2000-01-01

    This paper presents an overview of a parametric cost model that has been built at JPL to estimate costs of future, deep space, robotic science missions. Due to the recent dramatic changes in JPL business practices brought about by an internal reengineering effort known as develop new products (DNP), high-level historic cost data is no longer considered analogous to future missions. Therefore, the historic data is of little value in forecasting costs for projects developed using the DNP process. This has lead to the development of an approach for obtaining expert opinion and also for combining actual data with expert opinion to provide a cost database for future missions. In addition, the DNP cost model has a maximum of objective cost drivers which reduces the likelihood of model input error. Version 2 is now under development which expands the model capabilities, links it more tightly with key design technical parameters, and is grounded in more rigorous statistical techniques. The challenges faced in building this model will be discussed, as well as it's background, development approach, status, validation, and future plans.

  10. Elderly driver retraining

    DOT National Transportation Integrated Search

    1982-09-01

    This report documents a study of the traffic safety problems associated with elderly drivers. For the purposes of this study, "elderly drivers" are defined as drivers aged 55 years or older. The study involved five major activities. First, research w...

  11. Kin-Driver: a database of driver mutations in protein kinases.

    PubMed

    Simonetti, Franco L; Tornador, Cristian; Nabau-Moretó, Nuria; Molina-Vila, Miguel A; Marino-Buslje, Cristina

    2014-01-01

    Somatic mutations in protein kinases (PKs) are frequent driver events in many human tumors, while germ-line mutations are associated with hereditary diseases. Here we present Kin-driver, the first database that compiles driver mutations in PKs with experimental evidence demonstrating their functional role. Kin-driver is a manual expert-curated database that pays special attention to activating mutations (AMs) and can serve as a validation set to develop new generation tools focused on the prediction of gain-of-function driver mutations. It also offers an easy and intuitive environment to facilitate the visualization and analysis of mutations in PKs. Because all mutations are mapped onto a multiple sequence alignment, analogue positions between kinases can be identified and tentative new mutations can be proposed for studying by transferring annotation. Finally, our database can also be of use to clinical and translational laboratories, helping them to identify uncommon AMs that can correlate with response to new antitumor drugs. The website was developed using PHP and JavaScript, which are supported by all major browsers; the database was built using MySQL server. Kin-driver is available at: http://kin-driver.leloir.org.ar/ © The Author(s) 2014. Published by Oxford University Press.

  12. Value drivers: an approach for estimating health and disease management program savings.

    PubMed

    Phillips, V L; Becker, Edmund R; Howard, David H

    2013-12-01

    Health and disease management (HDM) programs have faced challenges in documenting savings related to their implementation. The objective of this eliminate study was to describe OptumHealth's (Optum) methods for estimating anticipated savings from HDM programs using Value Drivers. Optum's general methodology was reviewed, along with details of 5 high-use Value Drivers. The results showed that the Value Driver approach offers an innovative method for estimating savings associated with HDM programs. The authors demonstrated how real-time savings can be estimated for 5 Value Drivers commonly used in HDM programs: (1) use of beta-blockers in treatment of heart disease, (2) discharge planning for high-risk patients, (3) decision support related to chronic low back pain, (4) obesity management, and (5) securing transportation for primary care. The validity of savings estimates is dependent on the type of evidence used to gauge the intervention effect, generating changes in utilization and, ultimately, costs. The savings estimates derived from the Value Driver method are generally reasonable to conservative and provide a valuable framework for estimating financial impacts from evidence-based interventions.

  13. Technology and teen drivers.

    PubMed

    Lee, John D

    2007-01-01

    The rapid evolution of computing, communication, and sensor technology is likely to affect young drivers more than others. The distraction potential of infotainment technology stresses the same vulnerabilities that already lead young drivers to crash more frequently than other drivers. Cell phones, text messaging, MP3 players, and other nomadic devices all present a threat because young drivers may lack the spare attentional capacity for vehicle control and the ability to anticipate and manage hazards. Moreover, young drivers are likely to be the first and most aggressive users of new technology. Fortunately, emerging technology can also support safe driving. Electronic stability control, collision avoidance systems, intelligent speed adaptation, and vehicle tracking systems can all help mitigate the threats to young drivers. However, technology alone is unlikely to make young drivers safer. One promising approach to tailoring technology to teen drivers is to extend proven methods for enhancing young driver safety. The success of graduated drivers license programs (GDL) and the impressive safety benefit of supervised driving suggest ways of tailoring technology to the needs of young drivers. To anticipate the effects of technology on teen driving it may be useful to draw an analogy between the effects of passengers and the effects of technology. Technology can act as a teen passenger and undermine safety or it can act as an adult passenger and enhance safety. Rapidly developing technology may have particularly large effects on teen drivers. To maximize the positive effects and minimize the negative effects will require a broad range of industries to work together. Ideally, vehicle manufacturers would work with infotainment providers, insurance companies, and policy makers to craft new technologies so that they accommodate the needs of young drivers. Without such collaboration young drivers will face even greater challenges to their safety as new technologies emerge.

  14. Multivariable Parametric Cost Model for Ground Optical Telescope Assembly

    NASA Technical Reports Server (NTRS)

    Stahl, H. Philip; Rowell, Ginger Holmes; Reese, Gayle; Byberg, Alicia

    2005-01-01

    A parametric cost model for ground-based telescopes is developed using multivariable statistical analysis of both engineering and performance parameters. While diameter continues to be the dominant cost driver, diffraction-limited wavelength is found to be a secondary driver. Other parameters such as radius of curvature are examined. The model includes an explicit factor for primary mirror segmentation and/or duplication (i.e., multi-telescope phased-array systems). Additionally, single variable models Based on aperture diameter are derived.

  15. Multivariable Parametric Cost Model for Ground Optical: Telescope Assembly

    NASA Technical Reports Server (NTRS)

    Stahl, H. Philip; Rowell, Ginger Holmes; Reese, Gayle; Byberg, Alicia

    2004-01-01

    A parametric cost model for ground-based telescopes is developed using multi-variable statistical analysis of both engineering and performance parameters. While diameter continues to be the dominant cost driver, diffraction limited wavelength is found to be a secondary driver. Other parameters such as radius of curvature were examined. The model includes an explicit factor for primary mirror segmentation and/or duplication (i.e. multi-telescope phased-array systems). Additionally, single variable models based on aperture diameter were derived.

  16. Finding cancer driver mutations in the era of big data research.

    PubMed

    Poulos, Rebecca C; Wong, Jason W H

    2018-04-02

    In the last decade, the costs of genome sequencing have decreased considerably. The commencement of large-scale cancer sequencing projects has enabled cancer genomics to join the big data revolution. One of the challenges still facing cancer genomics research is determining which are the driver mutations in an individual cancer, as these contribute only a small subset of the overall mutation profile of a tumour. Focusing primarily on somatic single nucleotide mutations in this review, we consider both coding and non-coding driver mutations, and discuss how such mutations might be identified from cancer sequencing datasets. We describe some of the tools and database that are available for the annotation of somatic variants and the identification of cancer driver genes. We also address the use of genome-wide variation in mutation load to establish background mutation rates from which to identify driver mutations under positive selection. Finally, we describe the ways in which mutational signatures can act as clues for the identification of cancer drivers, as these mutations may cause, or arise from, certain mutational processes. By defining the molecular changes responsible for driving cancer development, new cancer treatment strategies may be developed or novel preventative measures proposed.

  17. Exploring lower-cost pathways to economical fusion power

    DOE PAGES

    Hsu, Scott C.

    2017-08-04

    This project, the Plasma Liner Experiment–ALPHA (PLX-α)5,is one of nine projects supported by the ALPHA Program6 of the Advanced Research Projects Agency–Energy (ARPA-E) of the U.S. Department of Energy (DOE). We use innovative, low-cost coaxial plasma guns (Fig. 1), developed and built by partner HyperV Technologies Corp.7, to launch a spherically converging array of supersonic plasma jets toward the middle of a large, spherical vacuum chamber (Fig. 2). A key near-term goal of PLX-α is to merge up to 60 plasma jets to form a spherically imploding plasma liner, as a low-cost, high-shot-rate driver for compressing magnetised target plasmas tomore » fusion conditions. Our approach is known as plasma-jet-driven MIF (or PJMIF)8. A new startup company HyperJet Fusion Corporation (which recently received seed funding from Strong Atomics, LLC, a new fusion venture fund) aims to develop PJMIF under continued public and private sponsorship.« less

  18. Exploring lower-cost pathways to economical fusion power

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

    Hsu, Scott C.

    This project, the Plasma Liner Experiment–ALPHA (PLX-α)5,is one of nine projects supported by the ALPHA Program6 of the Advanced Research Projects Agency–Energy (ARPA-E) of the U.S. Department of Energy (DOE). We use innovative, low-cost coaxial plasma guns (Fig. 1), developed and built by partner HyperV Technologies Corp.7, to launch a spherically converging array of supersonic plasma jets toward the middle of a large, spherical vacuum chamber (Fig. 2). A key near-term goal of PLX-α is to merge up to 60 plasma jets to form a spherically imploding plasma liner, as a low-cost, high-shot-rate driver for compressing magnetised target plasmas tomore » fusion conditions. Our approach is known as plasma-jet-driven MIF (or PJMIF)8. A new startup company HyperJet Fusion Corporation (which recently received seed funding from Strong Atomics, LLC, a new fusion venture fund) aims to develop PJMIF under continued public and private sponsorship.« less

  19. Understanding road safety in Kenya: views of matatu drivers.

    PubMed

    Raynor, Nicolas J; Mirzoev, Tolib

    2014-09-01

    Road traffic accidents (RTAs) are estimated to cause 1.3 million deaths and 20-50 million injuries worldwide. Road safety is a challenge in Kenya with causes being multi-factorial. Matatus (minibuses) are involved in a large proportion of accidents. A literature review was completed to identify key issues and refine the scope of the study. The fieldwork included 20 semi-structured interviews with matatu drivers. All participants were male, with driving experience of 1-20 years. Thematic framework was used for analysis. Some unstructured observations on different road users and their behaviours were also recorded. Literature showed that the causes of RTAs in Kenya are multi-factorial, but that human factors play a large part. There is also an evidence gap concerning matatu drivers, who are key stakeholders in road safety. Fieldwork showed that the matatu industry creates financial pressures on drivers and an excessive level of competition, leading to dangerous driving. Corruption of traffic police appears to be a major barrier to improving road safety, as road safety legislation is not enforced, and bribery has become the cultural norm. The general public, including passengers and private vehicles owners, also cause problems by failing to understand their role in road safety and placing the blame on others. The key policy implication for improving road safety in Kenya is seeking measures to ensure responsibility by all road users through awareness raising in the short-term and reforming the matatu industry and addressing the root causes of corruption in the longer term. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Motivating signage prompts safety belt use among drivers exiting senior communities.

    PubMed

    Cox, B S; Cox, A B; Cox, D J

    2000-01-01

    Senior drivers are vulnerable to automobile crashes and subsequent injury and death. Safety belts reduce health risks associated with auto crashes. Therefore, it is important to encourage senior drivers to wear safety belts while driving. Using an AB design, replicated five times, we evaluated the short- and long-term effects of a sign with the message "BUCKLE UP, STAY SAFE" attached to a stop sign at the exits of five different senior communities. Safety belt use was stable during two pretreatment assessments averaged across the five sites and 250 drivers (72% and 68% usage), but significantly increased following installation of these signs (94% usage). Six months after installation of the signs, the effect persisted (88% usage). Use of such signs may be a cost-effective way of promoting safety belt use.

  1. Machine learning methods for locating re-entrant drivers from electrograms in a model of atrial fibrillation

    NASA Astrophysics Data System (ADS)

    McGillivray, Max Falkenberg; Cheng, William; Peters, Nicholas S.; Christensen, Kim

    2018-04-01

    Mapping resolution has recently been identified as a key limitation in successfully locating the drivers of atrial fibrillation (AF). Using a simple cellular automata model of AF, we demonstrate a method by which re-entrant drivers can be located quickly and accurately using a collection of indirect electrogram measurements. The method proposed employs simple, out-of-the-box machine learning algorithms to correlate characteristic electrogram gradients with the displacement of an electrogram recording from a re-entrant driver. Such a method is less sensitive to local fluctuations in electrical activity. As a result, the method successfully locates 95.4% of drivers in tissues containing a single driver, and 95.1% (92.6%) for the first (second) driver in tissues containing two drivers of AF. Additionally, we demonstrate how the technique can be applied to tissues with an arbitrary number of drivers. In its current form, the techniques presented are not refined enough for a clinical setting. However, the methods proposed offer a promising path for future investigations aimed at improving targeted ablation for AF.

  2. Automatic Recognition and Understanding of the Driving Environment for Driver Feedback

    DOT National Transportation Integrated Search

    2018-01-01

    A smart driving system must consider two key elements to be able to generate recommendations and make driving decisions that are effective and accurate: The environment of the car and the behavior of the driver. Our long-term goal is to develop techn...

  3. Integrated Surveys of Neglected Tropical Diseases in Southern Sudan: How Much Do They Cost and Can They Be Refined?

    PubMed Central

    Kolaczinski, Jan H.; Hanson, Kara; Robinson, Emily; Picon, Diana; Sabasio, Anthony; Mpakateni, Martin; Lado, Mounir; Moore, Stephen; Petty, Nora; Brooker, Simon

    2010-01-01

    Background Increasing emphasis on integrated control of neglected tropical diseases (NTDs) requires identification of co-endemic areas. Integrated surveys for lymphatic filariasis (LF), schistosomiasis and soil-transmitted helminth (STH) infection have been recommended for this purpose. Integrated survey designs inevitably involve balancing the costs of surveys against accuracy of classifying areas for treatment, so-called implementation units (IUs). This requires an understanding of the main cost drivers and of how operating procedures may affect both cost and accuracy of surveys. Here we report a detailed cost analysis of the first round of integrated NTD surveys in Southern Sudan. Methods and Findings Financial and economic costs were estimated from financial expenditure records and interviews with survey staff using an ingredients approach. The main outcome was cost per IU surveyed. Uncertain variables were subjected to univariate sensitivity analysis and the effects of modifying standard operating procedures were explored. The average economic cost per IU surveyed was USD 40,206 or USD 9,573, depending on the size of the IU. The major cost drivers were two key categories of recurrent costs: i) survey consumables, and ii) personnel. Conclusion The cost of integrated surveys in Southern Sudan could be reduced by surveying larger administrative areas for LF. If this approach was taken, the estimated economic cost of completing LF, schistosomiasis and STH mapping in Southern Sudan would amount to USD 1.6 million. The methodological detail and costing template provided here could be used to generate cost estimates in other settings and readily compare these to the present study, and may help budget for integrated and single NTDs surveys elsewhere. PMID:20644619

  4. Software Development Cost Estimation Executive Summary

    NASA Technical Reports Server (NTRS)

    Hihn, Jairus M.; Menzies, Tim

    2006-01-01

    Identify simple fully validated cost models that provide estimation uncertainty with cost estimate. Based on COCOMO variable set. Use machine learning techniques to determine: a) Minimum number of cost drivers required for NASA domain based cost models; b) Minimum number of data records required and c) Estimation Uncertainty. Build a repository of software cost estimation information. Coordinating tool development and data collection with: a) Tasks funded by PA&E Cost Analysis; b) IV&V Effort Estimation Task and c) NASA SEPG activities.

  5. A Vehicle Active Safety Model: Vehicle Speed Control Based on Driver Vigilance Detection Using Wearable EEG and Sparse Representation.

    PubMed

    Zhang, Zutao; Luo, Dianyuan; Rasim, Yagubov; Li, Yanjun; Meng, Guanjun; Xu, Jian; Wang, Chunbai

    2016-02-19

    In this paper, we present a vehicle active safety model for vehicle speed control based on driver vigilance detection using low-cost, comfortable, wearable electroencephalographic (EEG) sensors and sparse representation. The proposed system consists of three main steps, namely wireless wearable EEG collection, driver vigilance detection, and vehicle speed control strategy. First of all, a homemade low-cost comfortable wearable brain-computer interface (BCI) system with eight channels is designed for collecting the driver's EEG signal. Second, wavelet de-noising and down-sample algorithms are utilized to enhance the quality of EEG data, and Fast Fourier Transformation (FFT) is adopted to extract the EEG power spectrum density (PSD). In this step, sparse representation classification combined with k-singular value decomposition (KSVD) is firstly introduced in PSD to estimate the driver's vigilance level. Finally, a novel safety strategy of vehicle speed control, which controls the electronic throttle opening and automatic braking after driver fatigue detection using the above method, is presented to avoid serious collisions and traffic accidents. The simulation and practical testing results demonstrate the feasibility of the vehicle active safety model.

  6. Ebola in the Netherlands, 2014-2015: costs of preparedness and response.

    PubMed

    Suijkerbuijk, Anita W M; Swaan, Corien M; Mangen, Marie-Josee J; Polder, Johan J; Timen, Aura; Ruijs, Wilhelmina L M

    2017-11-17

    The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the cost of staff time spent in preparedness and response activities was calculated based on a time-recording system and interviews with key professionals at the healthcare organizations involved. In addition, the organizations provided cost information on patient days of hospitalization, laboratory tests, personal protective equipment (PPE), as well as the additional cleaning and disinfection required. The estimated total costs averaged €12.6 million, ranging from €6.7 to €22.5 million. The main cost drivers were PPE expenditures and preparedness activities of personnel, especially those associated with ambulance services and hospitals. There were 13 possible cases clinically evaluated and one confirmed case admitted to hospital. The estimated total cost of EVD preparedness and response in the Netherlands was substantial. Future costs might be reduced and efficiency increased by designating one ambulance service for transportation and fewer hospitals for the assessment of possible patients with a highly infectious disease of high consequences.

  7. A cost-effective measurement-device-independent quantum key distribution system for quantum networks

    NASA Astrophysics Data System (ADS)

    Valivarthi, Raju; Zhou, Qiang; John, Caleb; Marsili, Francesco; Verma, Varun B.; Shaw, Matthew D.; Nam, Sae Woo; Oblak, Daniel; Tittel, Wolfgang

    2017-12-01

    We experimentally realize a measurement-device-independent quantum key distribution (MDI-QKD) system. It is based on cost-effective and commercially available hardware such as distributed feedback lasers and field-programmable gate arrays that enable time-bin qubit preparation and time-tagging, and active feedback systems that allow for compensation of time-varying properties of photons after transmission through deployed fiber. We examine the performance of our system, and conclude that its design does not compromise performance. Our demonstration paves the way for MDI-QKD-based quantum networks in star-type topology that extend over more than 100 km distance.

  8. Optimizing and Diversifying Electric Vehicle Driving Range for U.S. Drivers

    DOE PAGES

    Lin, Zhenhong

    2014-08-11

    Properly determining the driving range is critical for accurately predicting the sales and social benefits of battery electric vehicles (BEVs). This study proposes a framework for optimizing the driving range by minimizing the sum of battery price, electricity cost, and range limitation cost referred to as the "range-related cost" as a measurement of range anxiety. The objective function is linked to policy-relevant parameters, including battery cost and price markup, battery utilization, charging infrastructure availability, vehicle efficiency, electricity and gasoline prices, household vehicle ownership, daily driving patterns, discount rate, and perceived vehicle lifetime. Qualitative discussion of the framework and its empiricalmore » application to a sample (N=36664) representing new car drivers in the United States is included. The quantitative results strongly suggest that ranges of less than 100 miles are likely to be more popular in the BEV market for a long period of time. The average optimal range among U.S. drivers is found to be largely inelastic. Still, battery cost reduction significantly drives BEV demand toward longer ranges, whereas improvement in the charging infrastructure is found to significantly drive BEV demand toward shorter ranges. In conclusion, the bias of a single-range assumption and the effects of range optimization and diversification in reducing such biases are both found to be significant.« less

  9. Optimizing and Diversifying Electric Vehicle Driving Range for U.S. Drivers

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

    Lin, Zhenhong

    Properly determining the driving range is critical for accurately predicting the sales and social benefits of battery electric vehicles (BEVs). This study proposes a framework for optimizing the driving range by minimizing the sum of battery price, electricity cost, and range limitation cost referred to as the "range-related cost" as a measurement of range anxiety. The objective function is linked to policy-relevant parameters, including battery cost and price markup, battery utilization, charging infrastructure availability, vehicle efficiency, electricity and gasoline prices, household vehicle ownership, daily driving patterns, discount rate, and perceived vehicle lifetime. Qualitative discussion of the framework and its empiricalmore » application to a sample (N=36664) representing new car drivers in the United States is included. The quantitative results strongly suggest that ranges of less than 100 miles are likely to be more popular in the BEV market for a long period of time. The average optimal range among U.S. drivers is found to be largely inelastic. Still, battery cost reduction significantly drives BEV demand toward longer ranges, whereas improvement in the charging infrastructure is found to significantly drive BEV demand toward shorter ranges. In conclusion, the bias of a single-range assumption and the effects of range optimization and diversification in reducing such biases are both found to be significant.« less

  10. A Qualitative Study of Migrant-related Stressors, Psychosocial Outcomes and HIV Risk Behavior among Truck Drivers in Zambia

    PubMed Central

    Ncube, Nomagugu; Simona, Simona J.; Kansankala, Brian; Sinkala, Emmanuel; Raidoo, Jasmin

    2017-01-01

    Truck drivers are part of mobile populations which have been noted as a key population at risk of HIV in Zambia. This study was aimed at 1) determining Potentially Traumatic Events (PTEs), labor migrant-related stressors, psychosocial problems and HIV risk behaviors among truck drivers in Zambia and 2) examining the relationship between PTEs, migrant-related stressors, psychosocial outcomes and HIV sexual risk behavior among truck drivers in Zambia. We conducted fifteen semi-structured interviews with purposively sampled male truck drivers at trucking companies in Lusaka, Zambia. Findings indicate that truck drivers experience multiple stressors and potentially traumatic incidences, including delays and long waiting hours at borders, exposure to crime and violence, poverty, stress related to resisting temptation of sexual interactions with sex workers or migrant women, and job-related safety concerns. Multiple psychosocial problems such as intimate partner violence, loneliness, anxiety and depression-like symptoms were noted. Transactional sex, coupled with inconsistent condom use were identified as HIV sexual risk behaviors. Findings suggest the critical need to develop HIV prevention interventions which account for mobility, potentially traumatic events, psychosocial problems, and the extreme fear of HIV testing among this key population. PMID:27681145

  11. Research misconduct oversight: defining case costs.

    PubMed

    Gammon, Elizabeth; Franzini, Luisa

    2013-01-01

    This study uses a sequential mixed method study design to define cost elements of research misconduct among faculty at academic medical centers. Using time driven activity based costing, the model estimates a per case cost for 17 cases of research misconduct reported by the Office of Research Integrity for the period of 2000-2005. Per case cost of research misconduct was found to range from $116,160 to $2,192,620. Research misconduct cost drivers are identified.

  12. Chinese carless young drivers' self-reported driving behavior and simulated driving performance.

    PubMed

    Zhang, Qian; Jiang, Zuhua; Zheng, Dongpeng; Man, Dong; Xu, Xunnan

    2013-01-01

    Carless young drivers refers to those drivers aged between 18 and 25 years who have a driver's license but seldom have opportunities to practice their driving skills because they do not have their own cars. Due to China's lower private car ownership, many young drivers become carless young drivers after licensure, and the safety issue associated with them has raised great concern in China. This study aims to provide initial insight into the self-reported driving behaviors and simulated driving performance of Chinese carless young drivers. Thirty-three carless young drivers and 32 young drivers with their own cars (as a comparison group) participated in this study. A modified Driver Behavior Questionnaire (DBQ) with a 4-factor structure (errors, violations, attention lapses, and memory lapses) was used to study carless young drivers' self-reported driving behaviors. A simulated driving experiment using a low-cost, fixed-base driving simulator was conducted to measure their simulated driving performance (errors, violations, attention lapses, driving maintenance, reaction time, and accidents). Self-reported DBQ outcomes showed that carless young drivers reported similar errors, more attention lapses, fewer memory lapses, and significantly fewer violation behaviors relative to young drivers with their own cars, whereas simulated driving results revealed that they committed significantly more errors, attention lapses, and violation behaviors than the comparison group. Carless young drivers had a lower ability to maintain the stability of speed and lane position, drove more cautiously approaching and passing through red traffic lights, and committed more accidents during simulated driving. A tendency to speed was not found among carless young drivers; their average speed and speeding frequency were all much lower than that of the comparison group. Lifetime mileage was the only significant predictor of carless young drivers' self-reported violations, simulated violations

  13. Dying to get out: young drivers, safety and social inequity.

    PubMed

    Audrey, S; Langford, R

    2014-02-01

    Deaths and serious injuries among young drivers are an important public health concern. Road safety researchers and policy makers tend to focus on strategies to restrict the driving activities of young people. Other social research suggests the disadvantages experienced by young people in socially deprived groups are exacerbated by not having a driving licence or owning a car. In this qualitative study, we consider the views of young people from less affluent backgrounds in the south-west of England who took part in a brief intervention to encourage them to delay gaining a driving licence and car ownership. Between September 2011 and January 2012, a researcher observed four training sessions involving 173 young people. Postintervention, digitally recorded focus groups were conducted at three venues involving 23 randomly selected young people. Data from the focus group transcripts were sorted into charts in relation to key research questions and scrutinised using constant comparison. These young people believed the ability to drive, and car ownership, could increase their independence, improve access to further education, widen their employment opportunities, and enable them to contribute to family or household responsibilities. We argue there is a potential conflict between some strategies seeking to promote young driver safety and the impact this may have on equity and social disadvantage. Interdisciplinary work is required between professionals and researchers in transport, road safety, public health and social equity. Government policies should include low-cost, safe, reliable and attractive transport alternatives for young people in more deprived communities.

  14. Implementing managerial innovations in primary care: can we rank change drivers in complex adaptive organizations?

    PubMed

    Longo, Francesco

    2007-01-01

    There has been much innovation in primary care in the past few decades. Although external and systemic constraints for health care organizations are relevant for their managerial evolution, there is also evidence that organizations operating under the same external pressures reach different levels of maturity. Which of the internal drivers available explain and foster change? Is it possible to rank change drivers by looking at their rate of efficacy in order to define a general change management path in the relationship between managers and physicians? The study is a hypothesis-generating work, designed to discuss a framework, consistent with the complex adaptive systems literature, for more effective internal change management approaches. We employed a qualitative approach to conduct a multiple case study in order to directly observe the evidence and to ask "key change players" for their perceptions. We studied different organizations all subject to the same external constraints in order to focus on the effects of internal change drivers. According to key players' opinions, the main drivers for managerial development are characteristics of the actors involved: their motivation, leadership, and commitment; the quality of relationships among the main actors; and how the resources dedicated to manage change are used. Given these criteria, any organizational strategy and goal seems to be achievable. This is consistent with the suggestions coming from the complex adaptive system literature. MANAGERIAL IMPLICATIONS: Managers have to consider the management of the relationship with professionals as the key success factor for implementing change. Managerial leadership has to be diffused in the organization both in the vertical and horizontal dimensions. Innovations need a medium or long-term perspective to become widely applied, and this requires a strong commitment which is related to managerial stability. Resources for innovation are to be considered a critical driver

  15. Preliminary Multivariable Cost Model for Space Telescopes

    NASA Technical Reports Server (NTRS)

    Stahl, H. Philip

    2010-01-01

    Parametric cost models are routinely used to plan missions, compare concepts and justify technology investments. Previously, the authors published two single variable cost models based on 19 flight missions. The current paper presents the development of a multi-variable space telescopes cost model. The validity of previously published models are tested. Cost estimating relationships which are and are not significant cost drivers are identified. And, interrelationships between variables are explored

  16. Bus driver sues.

    PubMed

    1996-09-06

    A bus driver, known as John Doe, sued his employer, alleging that he was fired when he voluntarily disclosed that he was HIV-positive and needed a rest from the long hours of driving. The driver sued for back wages, benefits, and compensatory and punitive damages under the New Jersey Law Against Discrimination. Academy Bus tours told the driver he could not return to work without a doctor's examination. Doe has an excellent driving record and was certified as physically fit to work as a bus driver 14 months prior to his termination.

  17. The differential impact of low-carbon technologies on climate change mitigation cost under a range of socioeconomic and climate policy scenarios.

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

    Barron, Robert W.; McJeon, Haewon C.

    2015-05-01

    This paper considers the effect of several key parameters of low carbon energy technologies on the cost of abatement. A methodology for determining the minimum level of performance required for a parameter to have a statistically significant impact on CO2 abatement cost is developed and used to evaluate the impact of eight key parameters of low carbon energy supply technologies on the cost of CO2 abatement. The capital cost of nuclear technology is found to have the greatest impact of the parameters studied. The cost of biomass and CCS technologies also have impacts, while their efficiencies have little, if any.more » Sensitivity analysis of the results with respect to population, GDP, and CO2 emission constraint show that the minimum performance level and impact of nuclear technologies is consistent across the socioeconomic scenarios studied, while the other technology parameters show different performance under higher population, lower GDP scenarios. Solar technology was found to have a small impact, and then only at very low costs. These results indicate that the cost of nuclear is the single most important driver of abatement cost, and that trading efficiency for cost may make biomass and CCS technologies more competitive.« less

  18. Cost as a technology driver. [in aerospace R and D

    NASA Technical Reports Server (NTRS)

    Fitzgerald, P. E., Jr.; Savage, M.

    1976-01-01

    Cost managment as a guiding factor in optimum development of technology, and proper timing of cost-saving programs in the development of a system or technology with payoffs in development and operational advances are discussed and illustrated. Advances enhancing the performance of hardware or software advances raising productivity or reducing cost, are outlined, with examples drawn from: thermochemical thrust maximization, development of cryogenic storage tanks, improvements in fuel cells for Space Shuttle, design of a spacecraft pyrotechnic initiator, cost cutting by reduction in the number of parts to be joined, and cost cutting by dramatic reductions in circuit component number with small-scale double-diffused integrated circuitry. Program-focused supporting research and technology models are devised to aid judicious timing of cost-conscious research programs.

  19. Combined truck routing and driver scheduling problems under hours of service regulations.

    DOT National Transportation Integrated Search

    2009-08-20

    Regardless of changing variants, hours-of-service (HOS) regulations are intended to help truck drivers ensure get adequate rest and perform safe operations. The new HOS regulations, however, may lead to substantial cost increases for regional common ...

  20. Remarks to SBS PCM based self-navigation of laser drivers

    NASA Astrophysics Data System (ADS)

    Kalal, M.; Matena, L.; Kong, HJ; Martinkova, M.; Cha, S.

    2016-03-01

    A novel technology of self-navigation of laser drivers on injected inertial fusion energy pellets employing phase conjugating mirrors based on stimulating Brillouin scattering was recently proposed. Its feasibility as well as various implications were gradually studied and working solutions to potential problems were always suggested. As this technology could help to overcome several burning key issues of inertial fusion (e.g., a sufficiently precise navigation of laser drivers on injected pellets in the case of a direct drive scheme and decreased requirements on high-repetition high-power lasers) it gradually started to attract a carefully measured tentative interest among the major inertial fusion oriented laboratories and projects. In this paper the next step in this research path will be reported. It concerns the resulting phase and amplitude structures created by multiple low energy drivers (glints) illuminating the pellet during the first stage of the process after their reflection and a subsequent superposition on the collecting/focusing final optics. It was demonstrated that with a large number of such drivers acting simultaneously from many angles the situation gets somewhat complicated and requires more detailed studies/suggestions of suitable configurations.

  1. Driver Education Saves Gas.

    ERIC Educational Resources Information Center

    American Automobile Association, Falls Church, VA. Traffic Engineering and Safety Dept.

    The argument that driver education should be dropped because driver education cars use gas is shortsighted. High school driver education is an excellent vehicle for teaching concepts of energy conservation. A small investment in fuel now can result in major savings of gasoline over a student's lifetime. In addition good driver education courses…

  2. The relationship of alcohol safety laws to drinking drivers in fatal crashes

    DOT National Transportation Integrated Search

    1999-08-01

    This paper presents an analysis of the relationships between the passage of key alcohol safety laws and the number of drinking drivers in fatal crashes. The study evaluated the impact of three major alcohol safety laws (administrative license revocat...

  3. Reducing the burden of suffering from eating disorders: Unmet treatment needs, cost of illness, and the quest for cost-effectiveness.

    PubMed

    Striegel Weissman, Ruth; Rosselli, Francine

    2017-01-01

    Eating disorders are serious mental disorders as reflected in significant impairments in health and psychosocial functioning and excess mortality. Despite the clear evidence of clinical significance and despite availability of evidence-based, effective treatments, research has shown a paradox of elevated health services use and, yet, infrequent treatment specifically targeting the eating disorder (i.e., high unmet treatment need). This review paper summarizes key studies conducted in collaboration with G. Terence Wilson and offers an update of the research literature published since 2011 in three research areas that undergirded our collaborative research project: unmet treatment needs, cost of illness, and cost-effectiveness of treatments. In regards to unmet treatment needs, epidemiological studies find that the number of individuals with an eating disorder who do not receive disorder-specific treatment continues to remain high. Cost-of-illness show that eating disorders are associated with substantial financial burdens for individuals, their family, and society, yet comprehensive examination of costs across public sectors is lacking. Cost measures vary widely, making it difficult to draw firm conclusions. Hospitalization is a major driver of medical costs incurred by individuals with an eating disorder. Only a handful of cost-effectiveness studies have been conducted, leaving policy makers with little information on which to base decisions about allocation of resources to help reduce the burden of suffering attributable to eating disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Development of the physics driver in NOAA Environmental Modeling System (NEMS)

    NASA Astrophysics Data System (ADS)

    Lei, H.; Iredell, M.; Tripp, P.

    2016-12-01

    As a key component of the Next Generation Global Prediction System (NGGPS), a physics driver is developed in the NOAA Environmental Modeling System (NEMS) in order to facilitate the research, development, and transition to operations of innovations in atmospheric physical parameterizations. The physics driver connects the atmospheric dynamic core, the Common Community Physics Package and the other NEMS-based forecast components (land, ocean, sea ice, wave, and space weather). In current global forecasting system, the physics driver has incorporated major existing physics packages including radiation, surface physics, cloud and microphysics, ozone, and stochastic physics. The physics driver is also applicable to external physics packages. The structure adjustment in NEMS by separating the PHYS trunk is to create an open physics package pool. This open platform is beneficial to the enhancement of U.S. weather forecast ability. In addition, with the universal physics driver, the NEMS can also be used for specific functions by connecting external target physics packages through physics driver. The test of its function is to connect a physics dust-radiation model in the system. Then the modified system can be used for dust storm prediction and forecast. The physics driver is also developed into a standalone form. This is to facilitate the development works on physics packages. The developers can save instant fields of meteorology data and snapshots from the running system , and then used them as offline driving data fields to test the new individual physics modules or small modifications to current modules. This prevents the run of whole system for every test.

  5. Graduated Driver Licensing

    PubMed Central

    Bates, Lyndel J.; Allen, Siobhan; Armstrong, Kerry; Watson, Barry; King, Mark J.; Davey, Jeremy

    2014-01-01

    Graduated driver licensing (GDL) aims to gradually increase the exposure of new drivers to more complex driving situations and typically consists of learner, provisional and open licence phases. The first phase, the learner licence, is designed to allow novice drivers to obtain practical driving experience in lower risk situations. The learner licence can delay licensure, encourage novice drivers to learn under supervision, mandate the number of hours of practice required to progress to the next phase and encourage parental involvement. The second phase, the provisional licence, establishes various driving restrictions and thereby reduces exposure to situations of higher risk, such as driving at night, with passengers or after drinking alcohol. Parental involvement with a GDL system appears essential in helping novices obtain sufficient practice and in enforcing compliance with restrictions once the new driver obtains a provisional licence. Given the significant number of young drivers involved in crashes within Oman, GDL is one countermeasure that may be beneficial in reducing crash risk and involvement for this group. PMID:25364543

  6. Distractions N' Driving: video game simulation educates young drivers on the dangers of texting while driving.

    PubMed

    Saqer, Haneen; de Visser, Ewart; Strohl, Jonathan; Parasuraman, Raja

    2012-01-01

    The proliferation of portable communication and entertainment devices has introduced new dangers to the driving environment, particularly for young and inexperienced drivers. Graduate students from George Mason University illustrate a powerful, practical, and cost-effective program that has been successful in educating these drivers on the dangers of texting while driving, which can easily be adapted and implemented in other communities.

  7. Negativity Bias in Dangerous Drivers.

    PubMed

    Chai, Jing; Qu, Weina; Sun, Xianghong; Zhang, Kan; Ge, Yan

    2016-01-01

    The behavioral and cognitive characteristics of dangerous drivers differ significantly from those of safe drivers. However, differences in emotional information processing have seldom been investigated. Previous studies have revealed that drivers with higher anger/anxiety trait scores are more likely to be involved in crashes and that individuals with higher anger traits exhibit stronger negativity biases when processing emotions compared with control groups. However, researchers have not explored the relationship between emotional information processing and driving behavior. In this study, we examined the emotional information processing differences between dangerous drivers and safe drivers. Thirty-eight non-professional drivers were divided into two groups according to the penalty points that they had accrued for traffic violations: 15 drivers with 6 or more points were included in the dangerous driver group, and 23 drivers with 3 or fewer points were included in the safe driver group. The emotional Stroop task was used to measure negativity biases, and both behavioral and electroencephalograph data were recorded. The behavioral results revealed stronger negativity biases in the dangerous drivers than in the safe drivers. The bias score was correlated with self-reported dangerous driving behavior. Drivers with strong negativity biases reported having been involved in mores crashes compared with the less-biased drivers. The event-related potentials (ERPs) revealed that the dangerous drivers exhibited reduced P3 components when responding to negative stimuli, suggesting decreased inhibitory control of information that is task-irrelevant but emotionally salient. The influence of negativity bias provides one possible explanation of the effects of individual differences on dangerous driving behavior and traffic crashes.

  8. An extended continuum model accounting for the driver's timid and aggressive attributions

    NASA Astrophysics Data System (ADS)

    Cheng, Rongjun; Ge, Hongxia; Wang, Jufeng

    2017-04-01

    Considering the driver's timid and aggressive behaviors simultaneously, a new continuum model is put forwarded in this paper. By applying the linear stability theory, we presented the analysis of new model's linear stability. Through nonlinear analysis, the KdV-Burgers equation is derived to describe density wave near the neutral stability line. Numerical results verify that aggressive driving is better than timid act because the aggressive driver will adjust his speed timely according to the leading car's speed. The key improvement of this new model is that the timid driving deteriorates traffic stability while the aggressive driving will enhance traffic stability. The relationship of energy consumption between the aggressive and timid driving is also studied. Numerical results show that aggressive driver behavior can not only suppress the traffic congestion but also reduce the energy consumption.

  9. Cost-effectiveness analysis and efficient use of the pharmaceutical budget: the key role of clinical pharmacologists

    PubMed Central

    Edlin, Richard; Round, Jeff; Hulme, Claire; McCabe, Christopher

    2010-01-01

    The purpose of this paper is to provide information about cost-effectiveness analysis and the roles of clinical pharmacologists generally in providing efficient health care. The paper highlights the potential consequences of ‘off-label prescribing’ and ‘indication creep’ behaviour given slower growth (or potential cuts) in the NHS budget. This paper highlights the key roles of clinical pharmacologists in delivering an efficient health care system when resources are allocated using cost-effectiveness analyses. It describes what cost-effectiveness analysis (CEA) is and how incremental cost-effectiveness ratios (ICERs) are used to identify efficient options. After outlining the theoretical framework within which using CEA can promote the efficient allocation of the health care budget, it considers the place of disinvestment within achieving efficient resource allocation. Clinical pharmacologists are argued to be critical to providing improved population health under CEA-based resource allocation processes because of their roles in implementation and disinvestment. Given that the challenges facing the United Kingdom National Health Service (NHS) are likely to increase, this paper sets out the stark choices facing clinical pharmacologists. PMID:20716234

  10. Cost-effectiveness analysis and efficient use of the pharmaceutical budget: the key role of clinical pharmacologists.

    PubMed

    Edlin, Richard; Round, Jeff; Hulme, Claire; McCabe, Christopher

    2010-09-01

    The purpose of this paper is to provide information about cost-effectiveness analysis and the roles of clinical pharmacologists generally in providing efficient health care. The paper highlights the potential consequences of 'off-label prescribing' and 'indication creep' behaviour given slower growth (or potential cuts) in the NHS budget. This paper highlights the key roles of clinical pharmacologists in delivering an efficient health care system when resources are allocated using cost-effectiveness analyses. It describes what cost-effectiveness analysis (CEA) is and how incremental cost-effectiveness ratios (ICERs) are used to identify efficient options. After outlining the theoretical framework within which using CEA can promote the efficient allocation of the health care budget, it considers the place of disinvestment within achieving efficient resource allocation. Clinical pharmacologists are argued to be critical to providing improved population health under CEA-based resource allocation processes because of their roles in implementation and disinvestment. Given that the challenges facing the United Kingdom National Health Service (NHS) are likely to increase, this paper sets out the stark choices facing clinical pharmacologists.

  11. Mandatory Physician Reporting of At-Risk Drivers: The Older Driver Example.

    PubMed

    Agimi, Yll; Albert, Steven M; Youk, Ada O; Documet, Patricia I; Steiner, Claudia A

    2018-05-08

    In a number of states, physicians are mandated by state law to report at-risk drivers to licensing authorities. Often these patients are older adult drivers who may exhibit unsafe driving behaviors, have functional/cognitive impairments, or are diagnosed with conditions such as Alzheimer's disease and/or seizure disorders. The hypothesis that mandatory physician reporting laws reduce the rate of crash-related hospitalizations among older adult drivers was tested. Using retrospective data (2004-2009), this study identified 176,066 older driver crash-related hospitalizations, from the State Inpatient Databases. Three age-specific negative binomial generalized estimating equation models were used to estimate the effect of physician reporting laws on state's incidence rate of crash-related hospitalizations among older drivers. No evidence was found for an independent association between mandatory physician reporting laws and a lower crash hospitalization rate among any of the age groups examined. The main predictor of interest, mandatory physician reporting, failed to explain any significant variation in crash hospitalization rates, when adjusting for other state-specific laws and characteristics. Vision testing at in-person license renewal was a significant predictor of lower crash hospitalization rate, ranging from incidence rate ratio of 0.77 (95% confidence interval 0.62-0.94) among 60- to 64-year olds to 0.83 (95% confidence interval 0.67-0.97) among 80- to 84-year olds. Physician reporting laws and age-based licensing requirements are often at odds with older driver's need to maintain independence. This study examines this balance and finds no evidence of the benefits of mandatory physician reporting requirements on driver crash hospitalizations, suggesting that physician mandates do not yet yield significant older driver safety benefits, possibly to the detriment of older driver's well-being and independence.

  12. Understanding key drivers controlling daily stable isotope variations in precipitation of Costa Rica, Central America

    NASA Astrophysics Data System (ADS)

    Sanchez-Murillo, Ricardo; Welsh, Kristin; Birkel, Christian; Esquivel-Hernández, Germain; Corrales-Salazar, Jose; Boll, Jan; Brooks, Erin; Roupsard, Olivier; Katchan, Irina; Arce-Mesén, Rafael; Soulsby, Chris; Araguás-Araguás, Luis

    2015-04-01

    Costa Rica is located on the Central American Isthmus, which receives direct moisture inputs from the Caribbean Sea and the Pacific Ocean. The relatively narrow, but high relief Central American land bridge is characterized by unique mountainous and lowland microclimates. However, only limited knowledge exists about the impact of relief and regional atmospheric circulation patterns on precipitation origin, transport, and isotopic composition in this tropical region. Therefore, the main scope of this study is to identify the key drivers controlling variations in meteoric waters of Costa Rica using stable isotopes based on daily sample collection for the year 2013. The monitoring sites comprise three strategic locations across Costa Rica: Heredia (Central Valley), Turrialba (Caribbean slope), and Caño Seco (South Pacific slope). Sporadic dry season rain is mostly related to isolated enriched events ranging from -5.8‰ d18O up to -0.9‰ d18O. By mid-May, the Intertropical Convergence Zone reaches Costa Rica resulting in a notable depletion in isotope ratios (up to -18.5‰ d18O). HYSPLIT back air mass trajectories indicate the strong influence on the origin and transport of precipitation of two main moisture transport mechanisms, the Caribbean Low Level Jet and the Colombian Low Level Jet as well as localized convection events. Multiple linear regression models constructed based on Random Forests of surface meteorological information and atmospheric sounding profiles suggest that Lifted Condensation Level and surface relative humidity are the main factors controlling isotopic variations. These findings diverge from the recognized 'amount effect' in monthly composite samples across the tropics. Understanding of stable isotope dynamics in tropical precipitation can be used to enhance catchment and groundwater modeling efforts in ungauged basins where scarcity of long-term monitoring data drastically limit current and future water resources management.

  13. Ion propulsion cost effectivity

    NASA Technical Reports Server (NTRS)

    Zafran, S.; Biess, J. J.

    1978-01-01

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

  14. Negativity Bias in Dangerous Drivers

    PubMed Central

    Chai, Jing; Qu, Weina; Sun, Xianghong; Zhang, Kan; Ge, Yan

    2016-01-01

    The behavioral and cognitive characteristics of dangerous drivers differ significantly from those of safe drivers. However, differences in emotional information processing have seldom been investigated. Previous studies have revealed that drivers with higher anger/anxiety trait scores are more likely to be involved in crashes and that individuals with higher anger traits exhibit stronger negativity biases when processing emotions compared with control groups. However, researchers have not explored the relationship between emotional information processing and driving behavior. In this study, we examined the emotional information processing differences between dangerous drivers and safe drivers. Thirty-eight non-professional drivers were divided into two groups according to the penalty points that they had accrued for traffic violations: 15 drivers with 6 or more points were included in the dangerous driver group, and 23 drivers with 3 or fewer points were included in the safe driver group. The emotional Stroop task was used to measure negativity biases, and both behavioral and electroencephalograph data were recorded. The behavioral results revealed stronger negativity biases in the dangerous drivers than in the safe drivers. The bias score was correlated with self-reported dangerous driving behavior. Drivers with strong negativity biases reported having been involved in mores crashes compared with the less-biased drivers. The event-related potentials (ERPs) revealed that the dangerous drivers exhibited reduced P3 components when responding to negative stimuli, suggesting decreased inhibitory control of information that is task-irrelevant but emotionally salient. The influence of negativity bias provides one possible explanation of the effects of individual differences on dangerous driving behavior and traffic crashes. PMID:26765225

  15. Predicting performance and safety based on driver fatigue.

    PubMed

    Mollicone, Daniel; Kan, Kevin; Mott, Chris; Bartels, Rachel; Bruneau, Steve; van Wollen, Matthew; Sparrow, Amy R; Van Dongen, Hans P A

    2018-04-02

    Fatigue causes decrements in vigilant attention and reaction time and is a major safety hazard in the trucking industry. There is a need to quantify the relationship between driver fatigue and safety in terms of operationally relevant measures. Hard-braking events are a suitable measure for this purpose as they are relatively easily observed and are correlated with collisions and near-crashes. We developed an analytic approach that predicts driver fatigue based on a biomathematical model and then estimates hard-braking events as a function of predicted fatigue, controlling for time of day to account for systematic variations in exposure (traffic density). The analysis used de-identified data from a previously published, naturalistic field study of 106 U.S. commercial motor vehicle (CMV) drivers. Data analyzed included drivers' official duty logs, sleep patterns measured around the clock using wrist actigraphy, and continuous recording of vehicle data to capture hard-braking events. The curve relating predicted fatigue to hard-braking events showed that the frequency of hard-braking events increased as predicted fatigue levels worsened. For each increment on the fatigue scale, the frequency of hard-braking events increased by 7.8%. The results provide proof of concept for a novel approach that predicts fatigue based on drivers' sleep patterns and estimates driving performance in terms of an operational metric related to safety. The approach can be translated to practice by CMV operators to achieve a fatigue risk profile specific to their own settings, in order to support data-driven decisions about fatigue countermeasures that cost-effectively deliver quantifiable operational benefits. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Breast and prostate cancer productivity costs: a comparison of the human capital approach and the friction cost approach.

    PubMed

    Hanly, Paul; Timmons, Aileen; Walsh, Paul M; Sharp, Linda

    2012-05-01

    Productivity costs constitute a substantial proportion of the total societal costs associated with cancer. We compared the results of applying two different analytical methods--the traditional human capital approach (HCA) and the emerging friction cost approach (FCA)--to estimate breast and prostate cancer productivity costs in Ireland in 2008. Data from a survey of breast and prostate cancer patients were combined with population-level survival estimates and a national wage data set to calculate costs of temporary disability (cancer-related work absence), permanent disability (workforce departure, reduced working hours), and premature mortality. For breast cancer, productivity costs per person using the HCA were € 193,425 and those per person using the FCA were € 8,103; for prostate cancer, the comparable estimates were € 109,154 and € 8,205, respectively. The HCA generated higher costs for younger patients (breast cancer) because of greater lifetime earning potential. In contrast, the FCA resulted in higher productivity costs for older male patients (prostate cancer) commensurate with higher earning capacity over a shorter time period. Reduced working hours postcancer was a key driver of total HCA productivity costs. HCA costs were sensitive to assumptions about discount and growth rates. FCA costs were sensitive to assumptions about the friction period. The magnitude of the estimates obtained in this study illustrates the importance of including productivity costs when considering the economic impact of illness. Vastly different results emerge from the application of the HCA and the FCA, and this finding emphasizes the importance of choosing the study perspective carefully and being explicit about assumptions that underpin the methods. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. Assessing drivers' response during automated driver support system failures with non-driving tasks.

    PubMed

    Shen, Sijun; Neyens, David M

    2017-06-01

    With the increase in automated driver support systems, drivers are shifting from operating their vehicles to supervising their automation. As a result, it is important to understand how drivers interact with these automated systems and evaluate their effect on driver responses to safety critical events. This study aimed to identify how drivers responded when experiencing a safety critical event in automated vehicles while also engaged in non-driving tasks. In total 48 participants were included in this driving simulator study with two levels of automated driving: (a) driving with no automation and (b) driving with adaptive cruise control (ACC) and lane keeping (LK) systems engaged; and also two levels of a non-driving task (a) watching a movie or (b) no non-driving task. In addition to driving performance measures, non-driving task performance and the mean glance duration for the non-driving task were compared between the two levels of automated driving. Drivers using the automated systems responded worse than those manually driving in terms of reaction time, lane departure duration, and maximum steering wheel angle to an induced lane departure event. These results also found that non-driving tasks further impaired driver responses to a safety critical event in the automated system condition. In the automated driving condition, driver responses to the safety critical events were slower, especially when engaged in a non-driving task. Traditional driver performance variables may not necessarily effectively and accurately evaluate driver responses to events when supervising autonomous vehicle systems. Thus, it is important to develop and use appropriate variables to quantify drivers' performance under these conditions. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

  18. Microfabricated Ion Beam Drivers for Magnetized Target Fusion

    NASA Astrophysics Data System (ADS)

    Persaud, Arun; Seidl, Peter; Ji, Qing; Ardanuc, Serhan; Miller, Joseph; Lal, Amit; Schenkel, Thomas

    2015-11-01

    Efficient, low-cost drivers are important for Magnetized Target Fusion (MTF). Ion beams offer a high degree of control to deliver the required mega joules of driver energy for MTF and they can be matched to several types of magnetized fuel targets, including compact toroids and solid targets. We describe an ion beam driver approach based on the MEQALAC concept (Multiple Electrostatic Quadrupole Array Linear Accelerator) with many beamlets in an array of micro-fabricated channels. The channels consist of a lattice of electrostatic quadrupoles (ESQ) for focusing and of radio-frequency (RF) electrodes for ion acceleration. Simulations with particle-in-cell and beam envelope codes predict >10x higher current densities compared to state-of-the-art ion accelerators. This increase results from dividing the total ion beam current up into many beamlets to control space charge forces. Focusing elements can be biased taking advantage of high breakdown electric fields in sub-mm structures formed using MEMS techniques (Micro-Electro-Mechanical Systems). We will present results on ion beam transport and acceleration in MEMS based beamlets. Acknowledgments: This work is supported by the U.S. DOE under Contract No. DE-AC02-05CH11231.

  19. A National Evaluation of the Nighttime and Passenger Restriction Components of Graduated Driver Licensing

    PubMed Central

    Fell, James C.; Todd, Michael; Voas, Robert B.

    2011-01-01

    Introduction The high crash rate of youthful novice drivers has been recognized for half a century. Over the last decade, graduated driver licensing (GDL) systems, which extend the period of supervised driving and limit the novice’s exposure to higher-risk conditions (such as nighttime driving) has effectively reduced crash involvements of novice drivers. Method This study used data from the Fatality Analysis Reporting System (FARS) and the implementation dates of GDL laws in a state-by-year panel study to evaluate the effectiveness of two key elements of GDL laws: nighttime restrictions and passenger limitations. Results Nighttime restrictions were found to reduce 16- and 17-year-old driver involvements in nighttime fatal crashes by an estimated 10% and 16- and 17-year-old drinking drivers in nighttime fatal crashes by 13%. Passenger restrictions were found to reduce 16- and 17-year-old driver involvements in fatal crashes with teen passengers by an estimated 9%. Conclusions These results confirm the effectiveness of these provisions in GDL systems. Impact on Public Health The results of this study indicate that nighttime restrictions and passenger limitations are very important components of any GDL law. PMID:22017831

  20. On the feasibility of a fiber-based inertial fusion laser driver

    NASA Astrophysics Data System (ADS)

    Labaune, C.; Hulin, D.; Galvanauskas, A.; Mourou, G. A.

    2008-08-01

    One critical issue for the realization of Inertial Fusion Energy (IFE) power plants is the driver efficiency. High driver efficiency will greatly relax the driver energy requested to produce a fusion gain, resulting in more compact and less costly facilities. Among lasers, systems based on guided wave such as diode pumped Yb:glass fiber-amplifiers with a demonstrated overall efficiency close to 70% as opposed to few percents for systems based on free propagation, offer some intriguing opportunities. Guided optics provides the enormous advantage to directly benefit from the telecommunication industry where components are made cheap, rugged, well tested, environmentally stable, with lifetimes measured in tens of years and compatible with massive manufacturing. In this paper, we are studying the possibility to design a laser driver solely based on guided wave optics. We call this concept FAN for Fiber Amplification Network. It represents a profound departure from already proposed laser drivers all based on free propagation optics. The system will use a large number of identical fibers to combines long (ns) and short (ps) pulses that are needed for the fast ignition scheme. Technical details are discussed relative to fiber type, pump, phasing, pulse shaping and timing as well as fiber distribution around the chamber. The proposed fiber driver provides maximum and independent control on the wavefront, pulse duration, pulse shape, timing, making possible reaching the highest gain. The massive manufacturing will be amenable to a cheaper facility with an easy upkeep.

  1. Compact Torus plasma ring accelerator: a new type driver for inertial confinement fusion

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

    Hartman, C.W.; Eddleman, J.L.; Hammer, J.H.

    1986-08-22

    We discuss the acceleration of magnetically-confined plasma rings to provide a driver for ICF. The acceleration of plasma rings is predicted to be efficient and following focusing, to generate ion-bombardment power in the range 10/sup 15/ to 10/sup 16/ W/cm/sup 2/ at a total deposition energy of multimegajoules. The simplicity of plasma ring accelerator suggests that a 5 MJ (on target) driver would cost in the range 1 to 5 $/joule. First experimental tests of the accelerator are described.

  2. Thermally Activated Driver

    NASA Technical Reports Server (NTRS)

    Kinard, William H.; Murray, Robert C.; Walsh, Robert F.

    1987-01-01

    Space-qualified, precise, large-force, thermally activated driver (TAD) developed for use in space on astro-physics experiment to measure abundance of rare actinide-group elements in cosmic rays. Actinide cosmic rays detected using thermally activated driver as heart of event-thermometer (ET) system. Thermal expansion and contraction of silicone oil activates driver. Potential applications in fluid-control systems where precise valve controls are needed.

  3. Modeling of Driver Steering Operations in Lateral Wind Disturbances toward Driver Assistance System

    NASA Astrophysics Data System (ADS)

    Kurata, Yoshinori; Wada, Takahiro; Kamiji, Norimasa; Doi, Shun'ichi

    Disturbances decrease vehicle stability and increase driver's mental and physical workload. Especially unexpected disturbances such as lateral winds have severe effect on vehicle stability and driver's workload. This study aims at building a driver model of steering operations in lateral wind toward developing effective driver assistance system. First, the relationship between the driver's lateral motion and its reactive quick steering behavior is investigated using driving simulator with lateral 1dof motion. In the experiments, four different wind patterns are displayed by the simulator. As the results, strong correlation was found between the driver's head lateral jerk by the lateral disturbance and the angular acceleration of the steering wheel. Then, we build a mathematical model of driver's steering model from lateral disturbance input to steering torque of the reactive quick feed-forward steering based on the experimental results. Finally, validity of the proposed model is shown by comparing the steering torque of experimental results and that of simulation results.

  4. The Balsa bullet: A high speed, low-cost general aviation aircraft for Aeroworld

    NASA Technical Reports Server (NTRS)

    Eastland, Kevin; Greenwood, Sean; Kelly, Dan; Leonard, Chuck; Rooff, John; Scherock, Jeff

    1994-01-01

    The Balsa Bullet is a high speed, low cost six passenger general aviation aircraft. It will cruise at a speed of 55 ft/s with a maximum speed of 75 ft/s for distances in excess of 27000 feet. This range and speed combination provide The Balsa Bullet with the capability to service any two existing airports in Aeroworld in an efficient and timely manner. Overall, three major design drivers have been identified by the design team. The first is to provide a low cost airplane to the Aeroworld market. Maintaining the low cost objective will not simply meet the mission objective, but will also make the Bullet an economically viable option for a wide number of consumers. The Balsa Bullet has a total manufacturing cost of $1000 with a price to the consumer of only $2562. The second major driver is high speed performance. Once again this driver exists not only to meet the mission objective given Long Shot Aeronautics but it provides a desirable feature to the consumer, pride in owning the fastest aircraft in Aeroworld. The third design driver identified is the capability to service any runway in Aeroworld necessitating the ability to takeoff within 28 ft, the length of the shortest runways in Aeroworld. These design drivers provide three great reasons for the general public to purchase a Bullet.

  5. Encryption key distribution via chaos synchronization

    NASA Astrophysics Data System (ADS)

    Keuninckx, Lars; Soriano, Miguel C.; Fischer, Ingo; Mirasso, Claudio R.; Nguimdo, Romain M.; van der Sande, Guy

    2017-02-01

    We present a novel encryption scheme, wherein an encryption key is generated by two distant complex nonlinear units, forced into synchronization by a chaotic driver. The concept is sufficiently generic to be implemented on either photonic, optoelectronic or electronic platforms. The method for generating the key bitstream from the chaotic signals is reconfigurable. Although derived from a deterministic process, the obtained bit series fulfill the randomness conditions as defined by the National Institute of Standards test suite. We demonstrate the feasibility of our concept on an electronic delay oscillator circuit and test the robustness against attacks using a state-of-the-art system identification method.

  6. Encryption key distribution via chaos synchronization

    PubMed Central

    Keuninckx, Lars; Soriano, Miguel C.; Fischer, Ingo; Mirasso, Claudio R.; Nguimdo, Romain M.; Van der Sande, Guy

    2017-01-01

    We present a novel encryption scheme, wherein an encryption key is generated by two distant complex nonlinear units, forced into synchronization by a chaotic driver. The concept is sufficiently generic to be implemented on either photonic, optoelectronic or electronic platforms. The method for generating the key bitstream from the chaotic signals is reconfigurable. Although derived from a deterministic process, the obtained bit series fulfill the randomness conditions as defined by the National Institute of Standards test suite. We demonstrate the feasibility of our concept on an electronic delay oscillator circuit and test the robustness against attacks using a state-of-the-art system identification method. PMID:28233876

  7. Factors associated with self-reported driver sleepiness and incidents in city bus drivers

    PubMed Central

    ANUND, Anna; IHLSTRÖM, Jonas; FORS, Carina; KECKLUND, Göran; FILTNESS, Ashleigh

    2016-01-01

    Driver fatigue has received increased attention during recent years and is now considered to be a major contributor to approximately 15–30% of all crashes. However, little is known about fatigue in city bus drivers. It is hypothesized that city bus drivers suffer from sleepiness, which is due to a combination of working conditions, lack of health and reduced sleep quantity and quality. The overall aim with the current study is to investigate if severe driver sleepiness, as indicated by subjective reports of having to fight sleep while driving, is a problem for city based bus drivers in Sweden and if so, to identify the determinants related to working conditions, health and sleep which contribute towards this. The results indicate that driver sleepiness is a problem for city bus drivers, with 19% having to fight to stay awake while driving the bus 2–3 times each week or more and nearly half experiencing this at least 2–4 times per month. In conclusion, severe sleepiness, as indicated by having to fight sleep during driving, was common among the city bus drivers. Severe sleepiness correlated with fatigue related safety risks, such as near crashes. PMID:27098307

  8. Factors associated with self-reported driver sleepiness and incidents in city bus drivers.

    PubMed

    Anund, Anna; Ihlström, Jonas; Fors, Carina; Kecklund, Göran; Filtness, Ashleigh

    2016-08-05

    Driver fatigue has received increased attention during recent years and is now considered to be a major contributor to approximately 15-30% of all crashes. However, little is known about fatigue in city bus drivers. It is hypothesized that city bus drivers suffer from sleepiness, which is due to a combination of working conditions, lack of health and reduced sleep quantity and quality. The overall aim with the current study is to investigate if severe driver sleepiness, as indicated by subjective reports of having to fight sleep while driving, is a problem for city based bus drivers in Sweden and if so, to identify the determinants related to working conditions, health and sleep which contribute towards this. The results indicate that driver sleepiness is a problem for city bus drivers, with 19% having to fight to stay awake while driving the bus 2-3 times each week or more and nearly half experiencing this at least 2-4 times per month. In conclusion, severe sleepiness, as indicated by having to fight sleep during driving, was common among the city bus drivers. Severe sleepiness correlated with fatigue related safety risks, such as near crashes.

  9. Drivers of cost system development in hospitals: results of a survey.

    PubMed

    Cardinaels, Eddy; Roodhooft, Filip; van Herck, Gustaaf

    2004-08-01

    While many hospitals are under pressure to become more cost efficient, new costing systems such as activity-based costing (ABC) may form a solution. However, the factors that may facilitate (or inhibit) cost system changes towards ABC have not yet been disentangled in a specific hospital context. Via a survey study of hospitals, we discovered that cost system development in hospitals could largely be explained by hospital specific factors. Issues such as the support of the medical parties towards cost system use, the awareness of problems with the existing legal cost system, the type of contract for the physician's internal financial agreement, should be considered if hospitals refine their cost system. Conversely, ABC-adoption issues that were found to be crucial in other industries are less important. Apparently, installing a cost system requires a different approach in hospital settings. Especially, results suggest that hospital management should not underestimate the interest of the physician in the process of redesigning cost systems.

  10. Nurse Family Partnership: Comparing Costs per Family in Randomized Trials Versus Scale-Up.

    PubMed

    Miller, Ted R; Hendrie, Delia

    2015-12-01

    The literature that addresses cost differences between randomized trials and full-scale replications is quite sparse. This paper examines how costs differed among three randomized trials and six statewide scale-ups of nurse family partnership (NFP) intensive home visitation to low income first-time mothers. A literature review provided data on pertinent trials. At our request, six well-established programs reported their total expenditures. We adjusted the costs to national prices based on mean hourly wages for registered nurses and then inflated them to 2010 dollars. A centralized data system provided utilization. Replications had fewer home visits per family than trials (25 vs. 31, p = .05), lower costs per client ($8860 vs. $12,398, p = .01), and lower costs per visit ($354 vs. $400, p = .30). Sample size limited the significance of these differences. In this type of labor intensive program, costs probably were lower in scale-up than in randomized trials. Key cost drivers were attrition and the stable caseload size possible in an ongoing program. Our estimates reveal a wide variation in cost per visit across six state programs, which suggests that those planning replications should not expect a simple rule to guide cost estimations for scale-ups. Nevertheless, NFP replications probably achieved some economies of scale.

  11. Traffic Safety Facts, 2001: Young Drivers.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This document provides statistical information on U.S. traffic accidents involving young drivers. Data tables include: (1) driver fatalities and drivers involved in fatal crashes among drivers 15 to 20 years old, 1991-2001; (2) drivers involved in fatal crashes and driver involvement rates by age group, 2001; (3) drivers 15 to 20 years old…

  12. Young Drivers. Traffic Safety Facts, 2000.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This document provides statistical information on U.S. traffic accidents involving young drivers. Data tables include: (1) driver fatalities and drivers involved in fatal crashes among drivers 15 to 20 years old, 1990-2000; (2) drivers involved in fatal crashes and driver involvement rates by age group, 2000; (3) drivers 15 to 20 years old…

  13. MESA - A new approach to low cost scientific spacecraft

    NASA Astrophysics Data System (ADS)

    Keyes, G. W.; Case, C. M.

    1982-09-01

    Today, the greatest obstacle to science and exploration in space is its cost. The present investigation is concerned with approaches for reducing this cost. Trends in the scientific spacecraft market are examined, and a description is presented for the MESA space platform concept. The cost drivers are considered, taking into account planning, technical aspects, and business factors. It is pointed out that the primary function of the MESA concept is to provide a satellite system at the lowest possible price. In order to reach this goal an attempt is made to benefit from all of the considered cost drivers. It is to be tried to work with the customer early in the mission analysis stage in order to assist in finding the right compromise between mission cost and return. A three phase contractual arrangement is recommended for MESA platforms. The phases are related to mission feasibility, specification definition, and design and development. Modular kit design promotes flexibility at low cost.

  14. Offshore Wind Plant Balance-of-Station Cost Drivers and Sensitivities (Poster)

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

    Saur, G.; Maples, B.; Meadows, B.

    2012-09-01

    With Balance of System (BOS) costs contributing up to 70% of the installed capital cost, it is fundamental to understanding the BOS costs for offshore wind projects as well as potential cost trends for larger offshore turbines. NREL developed a BOS model using project cost estimates developed by GL Garrad Hassan. Aspects of BOS covered include engineering and permitting, ports and staging, transportation and installation, vessels, foundations, and electrical. The data introduce new scaling relationships for each BOS component to estimate cost as a function of turbine parameters and size, project parameters and size, and soil type. Based on themore » new BOS model, an analysis to understand the non-turbine costs associated with offshore turbine sizes ranging from 3 MW to 6 MW and offshore wind plant sizes ranging from 100 MW to 1000 MW has been conducted. This analysis establishes a more robust baseline cost estimate, identifies the largest cost components of offshore wind project BOS, and explores the sensitivity of the levelized cost of energy to permutations in each BOS cost element. This presentation shows results from the model that illustrates the potential impact of turbine size and project size on the cost of energy from US offshore wind plants.« less

  15. Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012.

    PubMed

    Hennessee, Ian; Chinkhumba, Jobiba; Briggs-Hagen, Melissa; Bauleni, Andy; Shah, Monica P; Chalira, Alfred; Moyo, Dubulao; Dodoli, Wilfred; Luhanga, Misheck; Sande, John; Ali, Doreen; Gutman, Julie; Lindblade, Kim A; Njau, Joseph; Mathanga, Don P

    2017-10-02

    With 71% of Malawians living on < $1.90 a day, high household costs associated with severe malaria are likely a major economic burden for low income families and may constitute an important barrier to care seeking. Nevertheless, few efforts have been made to examine these costs. This paper describes household costs associated with seeking and receiving inpatient care for malaria in health facilities in Malawi. A cross-sectional survey was conducted in a representative nationwide sample of 36 health facilities providing inpatient treatment for malaria from June-August, 2012. Patients admitted at least 12 h before study team visits who had been prescribed an antimalarial after admission were eligible to provide cost information for their malaria episode, including care seeking at previous health facilities. An ingredients-based approach was used to estimate direct costs. Indirect costs were estimated using a human capital approach. Key drivers of total household costs for illness episodes resulting in malaria admission were assessed by fitting a generalized linear model, accounting for clustering at the health facility level. Out of 100 patients who met the eligibility criteria, 80 (80%) provided cost information for their entire illness episode to date and were included: 39% of patients were under 5 years old and 75% had sought care for the malaria episode at other facilities prior to coming to the current facility. Total household costs averaged $17.48 per patient; direct and indirect household costs averaged $7.59 and $9.90, respectively. Facility management type, household distance from the health facility, patient age, high household wealth, and duration of hospital stay were all significant drivers of overall costs. Although malaria treatment is supposed to be free in public health facilities, households in Malawi still incur high direct and indirect costs for malaria illness episodes that result in hospital admission. Finding ways to minimize the economic

  16. Influence of pharmacogenomic profiling prior to pharmaceutical treatment in metastatic colorectal cancer on cost effectiveness : a systematic review.

    PubMed

    Frank, Martin; Mittendorf, Thomas

    2013-03-01

    Metastatic colorectal cancer (mCRC) imposes a substantial health burden on individual patients and society. Furthermore, rising costs in oncology cause a growing concern about reimbursement for innovations in this sector. The promise of pharmacogenomic profiling and related stratified therapies in mCRC is to improve treatment efficacy and potentially save costs. Among other examples, the commonly used epidermal growth factor receptor (EGFR) antibodies cetuximab and panitumumab are only effective in patients with kirsten rat sarcoma viral oncogene homolog (KRAS) wild-type cancers. Hence, the adaptation of predictive biomarker testing might be a valid strategy for healthcare systems worldwide. This study aims to review the clinical and economic evidence supporting pharmacogenomic profiling prior to the administration of pharmaceutical treatment in mCRC. Moreover, key drivers and areas of uncertainty in cost-effectiveness evaluations are analysed. A systematic literature review was conducted to identify studies evaluating the cost effectiveness of predictive biomarkers and the result dependent usage of pharmaceutical agents in mCRC. The application of predictive biomarkers to detect KRAS mutations prior to the administration of EGFR antibodies saved treatment costs and was cost effective in all identified evaluations. However, because of the lack of data regarding cost-effectiveness analyses for predictive biomarker testing, e.g. for first-line treatment, definitive conclusions cannot be stated. Key drivers and areas of uncertainty in current cost-effectiveness analyses are, among others, the consideration of predictive biomarker costs, the characteristics of single predictive biomarkers and the availability of clinical data for the respective pharmaceutical intervention. Especially the cost effectiveness of uridine diphosphate-glucuronyl transferase 1A1 (UGT1A1) mutation analysis prior to irinotecan-based chemotherapy remains unclear. Pharmacogenomic profiling has

  17. Occupational Fatalities Among Driver/Sales Workers and Truck Drivers in the United States, 2003–2008

    PubMed Central

    Chen, Guang X.; Amandus, Harlan E.; Wu, Nan

    2015-01-01

    Background This study provides a national profile of occupational fatalities among truck drivers and driver-sales workers. Methods Data from the 2003–2008 Census of Fatal Occupational Injuries were used. Cases were extracted specifically for occupational subcategories included in the Driver/Sales Workers and Truck Drivers occupational category: Driver/Sales Workers, Heavy and Tractor-Trailer Truck Drivers, and Light Truck or Delivery Services Drivers. Results In 2003–2008, the group Driver/Sales Workers and Truck Drivers had 5,568 occupational fatalities, representing 17% of all occupational fatalities in the United States. The majority of these fatalities were in the subgroup Heavy and Tractor-Trailer Truck Drivers (85%) and due to transportation incidents (80%). Older and male drivers had higher fatality rates than their counterparts. Conclusions Findings suggest a need for targeted interventions to reduce highway fatalities among heavy truck drivers. Better employment data are needed to separate the three occupational subcategories by worker characteristic and employment history for use in research and prevention efforts. PMID:24811905

  18. Unmanned Aerial Vehicles unique cost estimating requirements

    NASA Astrophysics Data System (ADS)

    Malone, P.; Apgar, H.; Stukes, S.; Sterk, S.

    Unmanned Aerial Vehicles (UAVs), also referred to as drones, are aerial platforms that fly without a human pilot onboard. UAVs are controlled autonomously by a computer in the vehicle or under the remote control of a pilot stationed at a fixed ground location. There are a wide variety of drone shapes, sizes, configurations, complexities, and characteristics. Use of these devices by the Department of Defense (DoD), NASA, civil and commercial organizations continues to grow. UAVs are commonly used for intelligence, surveillance, reconnaissance (ISR). They are also use for combat operations, and civil applications, such as firefighting, non-military security work, surveillance of infrastructure (e.g. pipelines, power lines and country borders). UAVs are often preferred for missions that require sustained persistence (over 4 hours in duration), or are “ too dangerous, dull or dirty” for manned aircraft. Moreover, they can offer significant acquisition and operations cost savings over traditional manned aircraft. Because of these unique characteristics and missions, UAV estimates require some unique estimating methods. This paper describes a framework for estimating UAV systems total ownership cost including hardware components, software design, and operations. The challenge of collecting data, testing the sensitivities of cost drivers, and creating cost estimating relationships (CERs) for each key work breakdown structure (WBS) element is discussed. The autonomous operation of UAVs is especially challenging from a software perspective.

  19. The strength of graduated drivers license programs and fatalities among teen drivers and passengers.

    PubMed

    Morrisey, Michael A; Grabowski, David C; Dee, Thomas S; Campbell, Christine

    2006-01-01

    The purpose of this study is to investigate the effects of differentially stringent graduated drivers license programs on teen driver fatalities, day-time and night-time teen driver fatalities, fatalities of teen drivers with passengers present, and fatalities among teen passengers. The study uses 1992-2002 data on motor vehicle fatalities among 15-17-year-old drivers from the Fatality Analysis Reporting System to identify the effects of "good", "fair", and "marginal" GDL programs based upon designations by the Insurance Institute for Highway Safety. Analysis is conducted using conditional negative binomial regressions with fixed effects. "Good" programs reduce total fatalities among young drivers by 19.4% (c.i. -33.0%, -5.9%). "Fair" programs reduce night-time young driver fatalities by 12.6% (c.i. -23.9%, -1.2%), but have no effect on day-time fatalities. "Marginal" programs had no statistically meaningful effect on driver fatalities. All three types of programs reduced teen passenger fatalities, but the effects of limitations on the number of passengers appear to have had only minimal effects in reducing fatalities among young drivers themselves. Stronger GDL programs are more effective than weaker programs in reducing teenage motor vehicle fatalities.

  20. Noise induced hearing loss risk assessment in truck drivers.

    PubMed

    Karimi, Ali; Nasiri, Saleh; Kazerooni, Farshid Khodaparast; Oliaei, Mohammad

    2010-01-01

    Hearing sense is one of the key elements which may have impact on the driver's task quality. This cross-sectional study investigates the hearing status of 500 truck drivers by pure tone audiometry (AC) in one of the cities in Fars province, Iran. Hearing threshold levels of the subjects were measured in frequencies of 500Hz-8000Hz. Screening and determination of permanent threshold shift (PTS) was the first aim of this study. Hence tests were done at least 16 hours after any exposure to noticeable sound. The effect of age as a confounding factor was considered using ISO equation and subtracted from whole hearing threshold. The threshold of 25 dB HL and above was considered abnormal but the calculation of hearing was also carried out using 0 dB HL as reference. Subjects were categorized into two groups on the basis of working experience and the hearing threshold of 25 dB was considered a boundary of normal hearing sense. The results of Pearson Chi-Square test showed that working experience as an independent variable has significant contributing effect on hearing thresholds of truck drivers in frequencies of 500, 1000, 2000 and 4000 Hz (p greater than 0.05). Also, it was shown that currently nine and 12.6 % of truck drivers suffer from impaired hearing sense in left and right respectively (hearing threshold level greater than 25 dB) in mid frequencies (500, 1000, 2000 Hz) and 45% in high frequencies of both ears (4000 and 8000 Hz). The results indicated that hearing damage of professional drivers was expected to occur sooner at 4000 and 8000 Hz than lower frequencies. Finally it was deduced that the occupational conditions of truck drivers may have bilateral, symmetrical harmful effect on hearing threshold sense in all frequencies mainly in frequency of 4000 Hz, so health surveillance programs such as education and periodic medical examinations are emphasized for pre-diagnosing and prevention of any possible impairment and an urgent need to take up some interventions

  1. Key beliefs influencing young drivers' engagement with social interactive technology on their smartphones: A qualitative study.

    PubMed

    Gauld, Cassandra S; Lewis, Ioni M; White, Katherine M; Watson, Barry

    2016-01-01

    The main aim of this study was to identify young drivers' underlying beliefs (i.e., behavioral, normative, and control) regarding initiating, monitoring/reading, and responding to social interactive technology (i.e., functions on a Smartphone that allow the user to communicate with other people). This qualitative study was a beliefs elicitation study in accordance with the theory of planned behavior and sought to elicit young drivers' behavioral (i.e., advantages, disadvantages), normative (i.e., who approves, who disapproves), and control beliefs (i.e., barriers, facilitators) that underpin social interactive technology use while driving. Young drivers (N = 26) aged 17 to 25 years took part in an interview or focus group discussion. Though differences emerged between the 3 behaviors of initiating, monitoring/reading, and responding for each of the behavioral, normative, and control belief categories, the strongest distinction was within the behavioral beliefs category (e.g., communicating with the person that they were on the way to meet was an advantage of initiating; being able to determine whether to respond was an advantage of monitoring/reading; and communicating with important people was an advantage of responding). Normative beliefs were similar for initiating and responding behaviors (e.g., friends and peers more likely to approve than other groups) and differences emerged for monitoring/reading (e.g., parents were more likely to approve of this behavior than initiating and responding). For control beliefs, there were differences between the beliefs regarding facilitators of these behaviors (e.g., familiar roads and conditions facilitated initiating; having audible notifications of an incoming communication facilitated monitoring/reading; and receiving a communication of immediate importance facilitated responding); however, the control beliefs that presented barriers were consistent across the 3 behaviors (e.g., difficult traffic/road conditions). The

  2. Efficacy of side airbags in reducing driver deaths in driver-side car and SUV collisions.

    PubMed

    McCartt, Anne T; Kyrychenko, Sergey Y

    2007-06-01

    To estimate the efficacy of side airbags in preventing driver deaths in passenger vehicles struck on the driver side. Risk ratios for driver deaths per driver-side collision were computed for side airbag-equipped cars and SUVs, relative to vehicles without side airbags. Driver fatality ratios also were calculated for the same vehicles in front and rear impacts, and these were used to adjust the side crash risk ratios for differences in fatality risk unrelated to side airbags. Risk ratios were calculated separately for side airbags providing torso-only protection and side airbags with head protection; almost all head protecting airbags also had airbags protecting the torso. Car driver death risk in driver-side crashes was reduced by 37 percent for head protecting airbags and 26 percent for torso-only side airbags. Car driver death risk was reduced for older and younger drivers, males and females, and drivers of small and midsize cars, and when the striking vehicle was an SUV/pickup or a car/minivan. Death risk for drivers of SUVs was reduced by 52 percent with head protecting side airbags and by 30 percent with torso-only airbags. The effectiveness of side airbags could not be assessed for pickups and minivans due to the small number of these vehicles with airbags involved in crashes. Side airbags substantially reduce the risk of car and SUV driver death in driver-side collisions. Making side airbags with head protection available to drivers and right front passengers in all passenger vehicles could reduce the number of fatalities in motor vehicle crashes in the United States by about 2,000 each year.

  3. Examination of supplemental driver training and online basic driver education courses : traffic tech.

    DOT National Transportation Integrated Search

    2012-08-01

    The first six months of unsupervised driving are the most : hazardous in a novice drivers driving experience. Most : States adopted graduated driver licensing (GDL) systems : to give novice drivers experience in a protective environment, : gradual...

  4. An application of the driver behavior questionnaire to Chinese carless young drivers.

    PubMed

    Zhang, Qian; Jiang, Zuhua; Zheng, Dongpeng; Wang, Yifan; Man, Dong

    2013-01-01

    Carless young drivers refers to those drivers aged between 18 and 25 years who have a driver's license but seldom have opportunities to practice their driving skills because they do not have their own cars. Due to China's lower private car ownership, many young drivers turn into carless young drivers after licensure, and the safety issue associated with them has become a matter of great concern in China. Because few studies have examined the driving behaviors of these drivers, this study aims to utilize the Driver Behavior Questionnaire (DBQ) to investigate the self-reported driving behaviors of Chinese carless young drivers. A total of 523 Chinese carless young drivers (214 females, 309 males) with an average age of 21.91 years completed a questionnaire including the 27-item DBQ and demographics. The data were first randomized into 2 subsamples for factor analysis and then combined together for the following analyses. Both an exploratory factor analysis (EFA, n = 174) and a confirmatory factor analysis (CFA, n = 349) were performed to investigate the factor structure of the DBQ. Correlation analysis was conducted to examine the relationships between the demographics and the DBQ scales' variables. Multivariate linear regression and logistic regression were performed to investigate the prediction of the DBQ scales and crash involvement in the previous year. The EFA produced a 4-factor structure identified as errors, violations, attention lapses, and memory lapses, and the CFA revealed a good model fit after the removal of one item with a low factor loading and the permission of the error covariance between some items. The Chinese carless young drivers reported a comparatively low level of aberrant driving behaviors. The 3 most frequently reported behaviors were all lapses and the 3 least were all violations. Gender was the only significant predictor of the 2 lapses scales and lifetime mileage was the only significant predictor of the violations scale. Only the

  5. A Systematic Review of the Cost-Effectiveness of Biologics for Ulcerative Colitis.

    PubMed

    Stawowczyk, Ewa; Kawalec, Paweł

    2018-04-01

    Ulcerative colitis (UC) is a chronic autoimmune inflammation of the colon. The condition significantly decreases quality of life and generates a substantial economic burden for healthcare payers, patients and the society in which they live. Some patients require chronic pharmacotherapy, and access to novel biologic drugs might be crucial for long-term remission. The analyses of cost-effectiveness for biologic drugs are necessary to assess their efficiency and provide the best available drugs to patients. Our aim was to collect and assess the quality of economic analyses carried out for biologic agents used in the treatment of UC, as well as to summarize evidence on the drivers of cost-effectiveness and evaluate the transferability and generalizability of conclusions. A systematic database review was conducted using MEDLINE (via PubMed), EMBASE, Cost-Effectiveness Analysis Registry and CRD0. Both authors independently reviewed the identified articles to determine their eligibility for final review. Hand searching of references in collected papers was also performed to find any relevant articles. The reporting quality of economic analyses included was evaluated by two reviewers using the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement checklist. We reviewed the sensitivity analyses in cost-effectiveness analyses to identify the variables that may have changed the conclusions of the study. Key drivers of cost-effectiveness were selected by identifying uncertain parameters that caused the highest change of the results of the analyses compared with base-case results. Of the 576 identified records, 87 were excluded as duplicates and 16 studies were included in the final review; evaluations for Canada, the UK and Poland were mostly performed. The majority of the evaluations revealed were performed for infliximab (approximately 75% of total volume); however, some

  6. The Potential Cost-Effectiveness of Pre-Exposure Prophylaxis Combined with HIV Vaccines in the United States.

    PubMed

    Adamson, Blythe J S; Carlson, Josh J; Kublin, James G; Garrison, Louis P

    2017-05-24

    This economic evaluation aims to support policy-making on the combined use of pre-exposure prophylaxis (PrEP) with HIV vaccines in development by evaluating the potential cost-effectiveness of implementation that would support the design of clinical trials for the assessment of combined product safety and efficacy. The target study population is a cohort of men who have sex with men (MSM) in the United States. Policy strategies considered include standard HIV prevention, daily oral PrEP, HIV vaccine, and their combination. We constructed a Markov model based on clinical trial data and the published literature. We used a payer perspective, monthly cycle length, a lifetime horizon, and a 3% discount rate. We assumed a price of $500 per HIV vaccine series in the base case. HIV vaccines dominated standard care and PrEP. At current prices, PrEP was not cost-effective alone or in combination. A combination strategy had the greatest health benefit but was not cost-effective (ICER = $463,448/QALY) as compared to vaccination alone. Sensitivity analyses suggest a combination may be valuable for higher-risk men with good adherence. Vaccine durability and PrEP drug prices were key drivers of cost-effectiveness. The results suggest that boosting potential may be key to HIV vaccine value.

  7. The Potential Cost-Effectiveness of Pre-Exposure Prophylaxis Combined with HIV Vaccines in the United States

    PubMed Central

    Adamson, Blythe J. S.; Carlson, Josh J.; Kublin, James G.; Garrison, Louis P.

    2017-01-01

    This economic evaluation aims to support policy-making on the combined use of pre-exposure prophylaxis (PrEP) with HIV vaccines in development by evaluating the potential cost-effectiveness of implementation that would support the design of clinical trials for the assessment of combined product safety and efficacy. The target study population is a cohort of men who have sex with men (MSM) in the United States. Policy strategies considered include standard HIV prevention, daily oral PrEP, HIV vaccine, and their combination. We constructed a Markov model based on clinical trial data and the published literature. We used a payer perspective, monthly cycle length, a lifetime horizon, and a 3% discount rate. We assumed a price of $500 per HIV vaccine series in the base case. HIV vaccines dominated standard care and PrEP. At current prices, PrEP was not cost-effective alone or in combination. A combination strategy had the greatest health benefit but was not cost-effective (ICER = $463,448/QALY) as compared to vaccination alone. Sensitivity analyses suggest a combination may be valuable for higher-risk men with good adherence. Vaccine durability and PrEP drug prices were key drivers of cost-effectiveness. The results suggest that boosting potential may be key to HIV vaccine value. PMID:28538691

  8. Licensing procedures for older drivers.

    DOT National Transportation Integrated Search

    2013-09-01

    This study examined the driver licensing procedures in all 50 States as they apply to the older (65+) driver. A literature review examined reports of possible declines in older driver capabilities and the ability of a driver licensing agency to scree...

  9. Is law enforcement of drug-impaired driving cost-efficient? An explorative study of a methodology for cost-benefit analysis.

    PubMed

    Veisten, Knut; Houwing, Sjoerd; Mathijssen, M P M René; Akhtar, Juned

    2013-03-01

    Road users driving under the influence of psychoactive substances may be at much higher relative risk (RR) in road traffic than the average driver. Legislation banning blood alcohol concentrations above certain threshold levels combined with roadside breath-testing of alcohol have been in lieu for decades in many countries, but new legislation and testing of drivers for drug use have recently been implemented in some countries. In this article we present a methodology for cost-benefit analysis (CBA) of increased law enforcement of roadside drug screening. This is an analysis of the profitability for society, where costs of control are weighed against the reduction in injuries expected from fewer drugged drivers on the roads. We specify assumptions regarding costs and the effect of the specificity of the drug screening device, and quantify a deterrence effect related to sensitivity of the device yielding the benefit estimates. Three European countries with different current enforcement levels were studied, yielding benefit-cost ratios in the approximate range of 0.5-5 for a tripling of current levels of enforcement, with costs of about 4000 EUR per convicted and in the range of 1.5 and 13 million EUR per prevented fatality. The applied methodology for CBA has involved a simplistic behavioural response to enforcement increase and control efficiency. Although this methodology should be developed further, it is clearly indicated that the cost-efficiency of increased law enforcement of drug driving offences is dependent on the baseline situation of drug-use in traffic and on the current level of enforcement, as well as the RR and prevalence of drugs in road traffic. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Simulator training with a forward collision warning system: effects on driver-system interactions and driver trust.

    PubMed

    Koustanaï, Arnaud; Cavallo, Viola; Delhomme, Patricia; Mas, Arnaud

    2012-10-01

    The study addressed the role of familiarization on a driving simulator with a forward collision warning (FCW) and investigated its impact on driver behavior. Drivers need a good understanding of how an FCW system functions to trust it and use it properly. Theoretical and empirical data suggest that exploring the capacities and limitations of the FCW during the learning period improves operating knowledge and leads to increased driver trust in the system and better driver-system interactions.The authors tested this hypothesis by comparing groups of drivers differing in FCW familiarity. During the familiarization phase, familiarized drivers were trained on the simulator using the FCW, unfamiliarized drivers simply read an FCW manual, and control drivers had no contact with the FCW. During the test, drivers drove the simulator and had to interact with traffic; both familiarized and unfamiliarized drivers used the FCW, whereas controls did not. Simulator familiarization improved driver understanding of FCW operation. Driver-system interactions were more effective: Familiarized drivers had no collisions, longer time headways, and better reactions in most situations. Familiarization increased trust in the FCW but did not raise system acceptance. Familiarization on the simulator had a positive effect on driver-system interactions and on trust in the system. The limitations of the familiarization method are discussed in relation to the driving simulator methodology. Practicing on a driving simulator with driving-assistance systems could facilitate their use during real driving.

  11. Cost of Illness of Multiple Sclerosis - A Systematic Review

    PubMed Central

    Ernstsson, Olivia; Gyllensten, Hanna; Alexanderson, Kristina; Tinghög, Petter; Friberg, Emilie; Norlund, Anders

    2016-01-01

    Background Cost-of-illness (COI) studies of Multiple Sclerosis (MS) are vital components for describing the economic burden of MS, and are frequently used in model studies of interventions of MS. We conducted a systematic review of studies estimating the COI of MS, to compare costs between studies and examine cost drivers, emphasizing generalizability and methodological choices. Material and method A literature search on studies published in English on COI of MS was performed in PubMed for the period January 1969 to January 2014, resulting in 1,326 publications. A mapping of studies using a bottom-up approach or top-down approach, respectively, was conducted for the 48 studies assessed as relevant. In a second analysis, the cost estimates were compared between the 29 studies that used a societal perspective on costs, human capital approach for indirect costs, presenting number of patients included, time-period studied, and year of price level used. Results The mapping showed that bottom-up studies and prevalence approaches were most common. The cost ratios between different severity levels within studies were relatively stable, to the ratio of 1 to 2 to 3 for disability level categories. Drugs were the main cost drivers for MS-patients with low disease severity, representing 29% to 82% of all costs in this patient group, while the main cost components for groups with more advanced MS symptoms were production losses due to MS and informal care, together representing 17% to 67% of costs in those groups. Conclusion The bottom-up method and prevalence approach dominated in studies of COI of MS. Our findings show that there are difficulties in comparing absolute costs across studies, nevertheless, the relative costs expressed as cost ratios, comparing different severity levels, showed higher resemblance. Costs of drugs were main cost drivers for less severe MS and informal care and production losses for the most severe MS. PMID:27411042

  12. Cost and energy demand of producing nickel manganese cobalt cathode material for lithium ion batteries

    DOE PAGES

    Ahmed, Shabbir; Nelson, Paul A.; Gallagher, Kevin G.; ...

    2017-01-05

    The price of the cathode active materials in lithium ion batteries is a key cost driver and thus significantly impacts consumer adoption of devices that utilize large energy storage contents (e.g. electric vehicles). A process model has been developed and used to study the production process of a common lithium-ion cathode material, lithiated nickel manganese cobalt oxide, using the co-precipitation method. The process was simulated for a plant producing 6500 kg day –1. The results indicate that the process will consume approximately 4 kWh kg NMC –1 of energy, 15 L kg NMC –1 of process water, and cost $23more » to produce a kg of Li-NMC333. The calculations were extended to compare the production cost using two co-precipitation reactions (with Na 2CO 3 and NaOH), and similar cathode active materials such as lithium manganese oxide and lithium nickel cobalt aluminum oxide. Finally, a combination of cost saving opportunities show the possibility to reduce the cost of the cathode material by 19%.« less

  13. Graduated driver licensing programs and fatal crashes of 16-year-old drivers: a national evaluation.

    PubMed

    Chen, Li-Hui; Baker, Susan P; Li, Guohua

    2006-07-01

    Implementation of graduated driver licensing programs is associated with reductions in crash rates of young drivers, but graduated driver licensing programs vary in their components. The impact of programs with different components is unknown. The purpose of this work was to determine which graduated driver licensing programs are associated with the greatest reductions in fatal motor vehicle crashes involving 16-year-old drivers. We conducted a retrospective study of all 16-year-old drivers involved in fatal crashes in the United States from 1994 through 2004 using data from the Fatality Analysis Reporting System and the US Census Bureau. We measured incidence rate ratios of fatal motor vehicle crashes involving 16-year-old drivers according to graduated driver licensing programs, adjusted for state and year. Compared with state quarters with no graduated driver licensing program components, reductions of 16% to 21% in fatal crash involvement rates of 16-year-old drivers occurred with programs that included > or = 3-month mandatory waiting period, nighttime driving restriction, and either > or = 30 hours of supervised driving or passenger restriction. Reductions of 18% to 21% occurred in state quarters with programs that included > or = 5 of the 7 components examined. Drivers aged 20 to 24 or 25 to 29 years did not experience significant reductions. Comprehensive graduated driver licensing programs are associated with reductions of approximately 20% in 16-year-old drivers' fatal crash involvement rates. The greatest benefit seems to be associated with programs that include age requirements and > or = 3 months of waiting before the intermediate stage, nighttime driving restriction, and either > or = 30 hours of supervised driving or passenger restriction.

  14. Threshold wind velocity dynamics as a driver of aeolian sediment mas flux

    USDA-ARS?s Scientific Manuscript database

    Horizontal (saltation) mass flux is a key driver of aeolian dust emission. Estimates of the horizontal mass flux underpin assessments of the global dust budget and influence our understanding of the dust cycle and its interactions. Current equations for predicting horizontal mass flux are based on l...

  15. How to Cut Costs by Saving School Bus Fuel.

    ERIC Educational Resources Information Center

    Seiff, Hank

    A program started in Washington County, Maryland in 1980 has been successful in saving school bus fuel and bringing down transportation costs incurred by its fleet of 200 buses. Driver training and motivation, as well as a partial transfer to diesel buses, are at the heart of the program. The drivers are taught five fuel saving techniques: cut…

  16. Part-time Labor, Work Rules, and Transit Costs

    DOT National Transportation Integrated Search

    1981-01-01

    This report examines two major issues: (1)the impact of labor union work rules : on bus transit operating costs and (2)the magnitude of cost savings that can be : expected from the use of part-time drivers. These issues are examined within : the cont...

  17. Estimated Costs of Sporadic Gastrointestinal Illness ...

    EPA Pesticide Factsheets

    BACKGROUND: The ·burden of illness can be described by addressing both incidence and illness severity attributable to water recreation. Monetized as cost. attributable disease burden estimates can be useful for environmental management decisions. OBJECTIVES: We characterize the disease burden attributable to water recreation using data from two cohort studies using a cost of illness (COI) approach and estimate the largest drivers of the disease burden of water recreation. METHODS: Data from the NEEAR study, which evaluated swimming and wading in marine and freshwater beaches in six U.S. states, and CHEERS, which evaluated illness after incidental-contact recreation (boating, canoeing, fishing, kayaking, and rowing) on waterways in the Chicago area, were used to estimate the cost per case of gastrointestinal illness and costs attributable to water recreation. Data on health care and medication utilization and missed days of work or leisure were collected and combined with cost data to construct measures of COI. RESULTS: Depending on different assumptions, the cost of gastrointestinal symptoms attributable to water recreation are estimated to be $1,220 for incidental-contact recreation (range $338-$1,681) and $1,676 for swimming/wading (range $425-2,743) per 1,000 recreators. Lost productivity is a major driver of the estimated COI, accounting for up to 90% of total costs. CONCLUSIONS: Our estimates suggest gastrointestinal illness attributed to surface water rec

  18. Economic burden of smoking: a systematic review of direct and indirect costs.

    PubMed

    Rezaei, Satar; Akbari Sari, Ali; Arab, Mohammad; Majdzadeh, Reza; Mohammad Poorasl, Asghar

    2016-01-01

    Smoking imposes considerably high economic costs both on the healthcare system as well as on a country as a whole. This study was aimed at systematically reviewing the currently published literature on the direct and indirect costs associated with smoking globally. A systematic review was performed on systematically searched articles from PubMed and Scopus databases published during the period 1990 to 2014. A combination of key terms such as "economic burden", "direct cost", "indirect cost", and smoking, tobacco or cigarette" and "productivity lost was used for the search. Original research article published in English with the age of study population greater than 35 years, at least three smoking-related diseases and reported direct or indirect cost of smoking were the inclusion criteria. Fourteen original articles were included in the review. The cost of outpatient care and premature deaths were found to be the most important cost driver of direct and indirect costs respectively. The study showed that smoking-related diseases were responsible for 1.5 - 6.8 % of the national health system expenditures and 0.22-0.88% of GDP of a country. Our review indicated that the costs of smoking are substantial, and smoking have a significant impact on the economy of a country. Policies such as increasing the taxation on a cigarette are required and should be implemented to reduce the economic burden of smoking.

  19. Driving Behavior among Different Groups of Iranian Drivers Based on Driver Coping Styles

    PubMed Central

    Lotfi, Saeid; Yazdanirad, Saeid; Pourabdiyan, Siyamak; Hassanzadeh, Akbar; Lotfi, Aliakbar

    2017-01-01

    Background: This study aimed to assess driving behavior of Iranian drivers based on their coping styles (problem-oriented, emotion-oriented, and avoiding). Methods: This study was conducted on 610 drivers divided into four different groups. The drivers’ behaviors and coping styles were evaluated using driver behavior questionnaire (DBQ) and coping inventory for stressful situations. Results: The results showed a significant difference among the three coping styles regarding the mean scores of DBQ dimensions (P < 0.001). In addition, the emotion-oriented drivers obtained higher mean scores compared to those with other coping styles. Conclusions: It can be concluded that emotion-oriented drivers were more susceptible to crashes compared to those with problem-solving and avoidance coping styles. PMID:28757929

  20. Land crabs as key drivers in tropical coastal forest recruitment

    USGS Publications Warehouse

    Lindquist, E.S.; Krauss, K.W.; Green, P.T.; O'Dowd, D. J.; Sherman, P.M.; Smith, T. J.

    2009-01-01

    Plant populations are regulated by a diverse assortment of abiotic and biotic factors that influence seed dispersal and viability, and seedling establishment and growth at the microsite. Rarely does one animal guild exert as significant an influence on different plant assemblages as land crabs. We review three tropical coastal ecosystems-mangroves, island maritime forests, and mainland coastal terrestrial forests-where land crabs directly influence forest composition by limiting tree establishment and recruitment. Land crabs differentially prey on seeds, propagules and seedlings along nutrient, chemical and physical environmental gradients. In all of these ecosystems, but especially mangroves, abiotic gradients are well studied, strong and influence plant species distributions. However, we suggest that crab predation has primacy over many of these environmental factors by acting as the first limiting factor of tropical tree recruitment to drive the potential structural and compositional organisation of coastal forests. We show that the influence of crabs varies relative to tidal gradient, shoreline distance, canopy position, time, season, tree species and fruiting periodicity. Crabs also facilitate forest growth and development through such activities as excavation of burrows, creation of soil mounds, aeration of soils, removal of leaf litter into burrows and creation of carbon-rich soil microhabitats. For all three systems, land crabs influence the distribution, density and size-class structure of tree populations. Indeed, crabs are among the major drivers of tree recruitment in tropical coastal forest ecosystems, and their conservation should be included in management plans of these forests. ?? 2009 Cambridge Philosophical Society.

  1. Detector Dewar cooler assemblies trade-off with equipment needs: a key issue for cost reduction

    NASA Astrophysics Data System (ADS)

    Chatard, Jean-Pierre

    1996-06-01

    Low cost equipment is the universal motto with the decrease in military budgets. A large panoply exists to solve partially this problem, such as simplification of the process, industrialization and the use of a collective manufacturing concept; but this is not enough. In the field of IRFPA using Mercury Cadmium Telluride (MCT), Sofradir has spent a lot of time in order to develop a very simple process to ensure producibility which has been totally demonstrated today. The production of more than 25 complex IRFPA per month has also allowed us to industrialize the process. A key factor is quantities. Today the only solution to increase quantities is to standardize detectors but in the field of IRFPA it is not so easy because each imaging system is specific. One solution to decrease the cost is to obtain the best trade-off between the application and the technology. As an example, people focus on indium antimonide staring array detectors today as they consider them as less expensive than other cooled infrared detector technologies. This is just because people focus on the FPA only, not on the global cost of the equipment. It will be demonstrated in this paper that MCT is a material so flexible that it is possible to obtain InSb detector performance at a higher temperature which allows decreased cost, volume and weight of the infrared equipment.

  2. Nonmarket economic user values of the Florida Keys/Key West

    Treesearch

    Vernon R. Leeworthy; J. Michael Bowker

    1997-01-01

    This report provides estimates of the nonmarket economic user values for recreating visitors to the Florida Keys/Key West that participated in natural resource-based activities. Results from estimated travel cost models are presented, including visitor’s responses to prices and estimated per person-trip user values. Annual user values are also calculated and presented...

  3. The co-occurrence of driver mutations in chronic myeloproliferative neoplasms.

    PubMed

    Boddu, Prajwal; Chihara, Dai; Masarova, Lucia; Pemmaraju, Naveen; Patel, Keyur P; Verstovsek, Srdan

    2018-06-27

    Myeloproliferative neoplasms (MPNs) are clonal disorders characterized by proliferation of one or more elements of the myeloid lineage. Key genetic aberrations include the BCR-ABL1 gene rearrangement in Philadelphia chromosome-positive chronic myelogenous leukemia (CML) and JAK2/MPL/CALR aberrations in Philadelphia chromosome-negative MPNs. While thought to be mutually exclusive, occasional isolated reports of coexistence of BCR-ABL1 and JAK2, and JAK2 with MPL or CALR aberrations have been described. Given the paucity of data, clinical characteristics and outcome of patients harboring concurrent Philadelphia-positive and Philadelphia-negative mutations or dual Philadelphia-negative driver mutations have not been systematically evaluated, and their clinical relevance is largely unknown. It is difficult to determine the true relevance of co-existing driver mutations on outcomes given the rarity of its occurrence. In this case series, we describe those patients who had dual driver mutations detected at any point during the course of their disease and characterized their clinical and laboratory features, bone marrow pathology, and overall disease course.

  4. Implementing quality initiatives in healthcare organizations: drivers and challenges.

    PubMed

    Abdallah, Abdallah

    2014-01-01

    Various quality initiatives seem to have successful implementation in some healthcare organizations yet fail in others. This paper sets out to study the literature trying to understand drivers and challenges facing quality initiatives implementation in healthcare organizations then compare findings from literature with those of a structured questionnaire answered by 60 representatives from 18 hospitals. Finally it proposes a framework that mitigates challenges and utilizes drivers to ensure best implementation results. Literature regarding implementing various quality initiatives in the healthcare sector was reviewed. Representatives from several healthcare organizations were surveyed. Results from both approaches are compared to highlight the key challenges and drivers facing implementers. This research reveals that internal factors related to leadership and employees greatly affect quality initiative success or failure. Design and relevance play a major role in successful implementation. PRACTICAL IMPLICATIONs: This research offers healthcare professionals greater success when implementing certain quality initiatives by taking success/failure factors into consideration. A general framework for successful implementation in the healthcare sector is provided. This article uncovers reasons behind success or failure in a comprehensive and practical way. It also explores how most popular quality initiatives are applied in hospitals.

  5. Cost analysis of chronic obstructive pulmonary disease in a tertiary care setting in Taiwan.

    PubMed

    Chiang, Chi-Huei

    2008-09-01

    The prevalence of COPD in the Western Pacific is increasing. The present study determined the total direct health-care costs for the management of COPD patients with differing degrees of disease severity. The study also aimed to find the key cost drivers in the management of COPD. COPD patients were recruited from a tertiary care hospital during April 2002 and March 2003. One-year costs were identified by applying cost data to medical information obtained by review of medical records. Costs included those for medications, oxygen therapy, laboratory and diagnostic tests, clinic visits, emergency room visits and hospital stays. There were 160 patients recruited. Patients were categorized by COPD severity: moderate A COPD (50 costs were New Taiwan dollars 288 825, 149 031 and 38 203 for severe COPD, moderate B COPD and moderate A COPD, respectively. The total annual cost was correlated with the disease severity. Hospitalization contributed the major portion of cost and also correlated with disease severity. There is a correlation between the cost of COPD and disease severity with hospitalization owing to disease exacerbation being a major contributor to cost. The keys to reducing health-care costs lie with reducing the frequency of exacerbations and the disease severity.

  6. Consistency between subjectively and objectively measured hazard perception skills among young male drivers.

    PubMed

    Ābele, Līva; Haustein, Sonja; Møller, Mette; Martinussen, Laila M

    2018-03-01

    Young male drivers have lower hazard perception skills (HPS) than older and more experienced drivers and a tendency to overestimate their skills in hazardous situations. Both factors contribute to an over-representation in traffic accidents. Based on a sample of 63 drivers aged 18-24, this study compares the consistency of HPS measured by objective and subjective measures and the link between these measures is the key contribution of the study. Both visible and hidden hazards are included. Objective measures of HPS include responsiveness and eye movements while driving in a driving simulator. Subjective measures of HPS include self-reports derived based on the Hazard Perception Questionnaire (HPQ), Driving Skill Questionnaire (DSQ), and Brief Sensation Seeking Scale (BSSS). Results show that drivers who respond to the hazards on time, as compared to drivers who do not respond, have higher scores on subjective measures of HPS and higher driving skills in the visible but not in the hidden condition. Eye movement analysis confirms the difference and shows that response in time to hazards indicate higher HPS and young drivers are poor at detecting hidden hazards. Drivers with a response in time locate the hazard faster, have more fixations, but dwell less on the hazard. At the same time, those who do not respond have a later first fixation and fewer but longer fixations on the hazard. High sensation seeking drivers respond to visible hazards on time, suggesting that sensation seeking does not affect HPS negatively when the hazard is visible. To enhance the HPS among young drivers, the results of this study suggest that specific hazard perception training is relevant, especially for hazards that require more advanced HPS. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Entry Descent and Landing Workshop Proceedings. Volume 1; Cost Drivers

    NASA Technical Reports Server (NTRS)

    Wright, Henry

    2015-01-01

    Provide some perspective on characteristics or features which drive the cost of the EDL Instrumentation. Using MEDLI, MEDLI2, EFT1, and Ares I-X as case studies. Need to consider what program is funding the effort and how that program likes to manage projects. Need to define the limits of the measurement subsystem - what is being provided and implemented - and by whom. The yearly end of fiscal year drama will always introduce uncertainty which will impact the cost - and cost phasing.

  8. Idaho Driver Education Instructional Guide. Revised.

    ERIC Educational Resources Information Center

    Idaho State Dept. of Education, Boise.

    This driver education instructional safety guide is organized in three sections: Driver Education; Motorcycle Education; and Driver Education for the Handicapped. The driver education section contains 10 units dealing with the following topics: parent orientation; student orientation; basic control skills; driver performance; driving regulations;…

  9. Effectiveness of graduated driver licensing in reducing motor vehicle crashes.

    PubMed

    Foss, R D; Evenson, K R

    1999-01-01

    To determine whether graduated driver licensing (GDL) systems and nighttime curfews reduce motor vehicle crashes, fatalities, or injuries among young drivers. We used Cochrane Collaboration search strategies to locate studies of graduated licensing or night driving restrictions. Studies were selected if they examined the effects of either (1) a comprehensive graduated driver licensing system including well-integrated components, or (2) nighttime driving restrictions/curfews that could affect young persons' nighttime driving, on a clearly defined crash or injury outcome. Seven studies met inclusion criteria. Two independent studies of the New Zealand graduated licensing program found a sustained 7%-8% reduction in teen driver crash injuries attributable to the program. No other full graduated licensing system has been evaluated to date. Four studies of either a general curfew or a nighttime driving restriction for teens, a key element of graduated licensing, found substantial crash reductions during restricted hours, with 23%-25% lower crash injury and fatality rates for curfews beginning prior to midnight. One study found no change in late night crashes before and after a 1 a.m.-6 a.m. night driving restriction took effect. The logic and empirical bases for graduated licensing are sound. Moreover, there is evidence that one central element, a restriction on nighttime driving by novices, reduces young driver crashes. However, a definitive conclusion about the effectiveness of GDL systems for reducing motor vehicle crashes or crash-related injuries must await examination of other GDL systems. This should be possible within the next few years, as several states and Canadian provinces have recently enacted GDL programs.

  10. Analysis of Anterior Cervical Discectomy and Fusion Healthcare Costs via the Value-Driven Outcomes Tool.

    PubMed

    Reese, Jared C; Karsy, Michael; Twitchell, Spencer; Bisson, Erica F

    2018-04-11

    Examining the costs of single- and multilevel anterior cervical discectomy and fusion (ACDF) is important for the identification of cost drivers and potentially reducing patient costs. A novel tool at our institution provides direct costs for the identification of potential drivers. To assess perioperative healthcare costs for patients undergoing an ACDF. Patients who underwent an elective ACDF between July 2011 and January 2017 were identified retrospectively. Factors adding to total cost were placed into subcategories to identify the most significant contributors, and potential drivers of total cost were evaluated using a multivariable linear regression model. A total of 465 patients (mean, age 53 ± 12 yr, 54% male) met the inclusion criteria for this study. The distribution of total cost was broken down into supplies/implants (39%), facility utilization (37%), physician fees (14%), pharmacy (7%), imaging (2%), and laboratory studies (1%). A multivariable linear regression analysis showed that total cost was significantly affected by the number of levels operated on, operating room time, and length of stay. Costs also showed a narrow distribution with few outliers and did not vary significantly over time. These results suggest that facility utilization and supplies/implants are the predominant cost contributors, accounting for 76% of the total cost of ACDF procedures. Efforts at lowering costs within these categories should make the most impact on providing more cost-effective care.

  11. Do Preferences of Drinker-Drivers Differ?

    PubMed Central

    Sloan, Frank A.

    2016-01-01

    Why people engage in illegal activities is not well understood. Using data collected for this research from eight cities in four states, this study investigates alternative explanations as to why people drive while intoxicated (DWI). We find that preferences and subjective beliefs about arrest/incarceration of persons who drink and drive do differ systematically from others in terms of benefits and costs of drink and driving, and in their risk tolerance. While most findings imply that DWI is a deliberate choice, we do find that drinker drivers tend to be more impulsive and lack self-control in their drinking. PMID:27878705

  12. Time-driven activity-based costing: a driver for provider engagement in costing activities and redesign initiatives.

    PubMed

    McLaughlin, Nancy; Burke, Michael A; Setlur, Nisheeta P; Niedzwiecki, Douglas R; Kaplan, Alan L; Saigal, Christopher; Mahajan, Aman; Martin, Neil A; Kaplan, Robert S

    2014-11-01

    To date, health care providers have devoted significant efforts to improve performance regarding patient safety and quality of care. To address the lagging involvement of health care providers in the cost component of the value equation, UCLA Health piloted the implementation of time-driven activity-based costing (TDABC). Here, the authors describe the implementation experiment, share lessons learned across the care continuum, and report how TDABC has actively engaged health care providers in costing activities and care redesign. After the selection of pilots in neurosurgery and urology and the creation of the TDABC team, multidisciplinary process mapping sessions, capacity-cost calculations, and model integration were coordinated and offered to engage care providers at each phase. Reviewing the maps for the entire episode of care, varying types of personnel involved in the delivery of care were noted: 63 for the neurosurgery pilot and 61 for the urology pilot. The average cost capacities for care coordinators, nurses, residents, and faculty were $0.70 (range $0.63-$0.75), $1.55 (range $1.28-$2.04), $0.58 (range $0.56-$0.62), and $3.54 (range $2.29-$4.52), across both pilots. After calculating the costs for material, equipment, and space, the TDABC model enabled the linking of a specific step of the care cycle (who performed the step and its duration) and its associated costs. Both pilots identified important opportunities to redesign care delivery in a costconscious fashion. The experimentation and implementation phases of the TDABC model have succeeded in engaging health care providers in process assessment and costing activities. The TDABC model proved to be a catalyzing agent for cost-conscious care redesign.

  13. Commercial Driver Medical Examinations

    PubMed Central

    Moffitt, Gary; Hanowski, Richard J.; Kales, Stefanos N.; Porter, Richard J.; Hegmann, Kurt T.

    2015-01-01

    Objective: The objective of this study was to assess relationships between body mass index (BMI) and comorbid conditions within a large sample of truck drivers. Methods: Commercial driver medical examination data from 88,246 commercial drivers between 2005 and 2012 were analyzed for associations between BMI, medical disorders, and driver certification. Results: Most drivers were obese (53.3%, BMI >30.0 kg/m2) and morbidly obese (26.6%, BMI >35.0 kg/m2), higher than prior reports. Obese drivers were less likely to be certified for 2 years and more likely to report heart disease, hypertension, diabetes mellitus, nervous disorders, sleep disorders, and chronic low back pain (all P < 0.0001). There are relationships between multiple potentially disqualifying conditions and increasing obesity (P < 0.0001). Morbid obesity prevalence increased 8.9% and prevalence of three or more multiple conditions increased fourfold between 2005 and 2012. Conclusions: Obesity is related to multiple medical factors as well as increasing numbers of conditions that limit driving certification. PMID:25710607

  14. Identification of druggable cancer driver genes amplified across TCGA datasets.

    PubMed

    Chen, Ying; McGee, Jeremy; Chen, Xianming; Doman, Thompson N; Gong, Xueqian; Zhang, Youyan; Hamm, Nicole; Ma, Xiwen; Higgs, Richard E; Bhagwat, Shripad V; Buchanan, Sean; Peng, Sheng-Bin; Staschke, Kirk A; Yadav, Vipin; Yue, Yong; Kouros-Mehr, Hosein

    2014-01-01

    The Cancer Genome Atlas (TCGA) projects have advanced our understanding of the driver mutations, genetic backgrounds, and key pathways activated across cancer types. Analysis of TCGA datasets have mostly focused on somatic mutations and translocations, with less emphasis placed on gene amplifications. Here we describe a bioinformatics screening strategy to identify putative cancer driver genes amplified across TCGA datasets. We carried out GISTIC2 analysis of TCGA datasets spanning 16 cancer subtypes and identified 486 genes that were amplified in two or more datasets. The list was narrowed to 75 cancer-associated genes with potential "druggable" properties. The majority of the genes were localized to 14 amplicons spread across the genome. To identify potential cancer driver genes, we analyzed gene copy number and mRNA expression data from individual patient samples and identified 42 putative cancer driver genes linked to diverse oncogenic processes. Oncogenic activity was further validated by siRNA/shRNA knockdown and by referencing the Project Achilles datasets. The amplified genes represented a number of gene families, including epigenetic regulators, cell cycle-associated genes, DNA damage response/repair genes, metabolic regulators, and genes linked to the Wnt, Notch, Hedgehog, JAK/STAT, NF-KB and MAPK signaling pathways. Among the 42 putative driver genes were known driver genes, such as EGFR, ERBB2 and PIK3CA. Wild-type KRAS was amplified in several cancer types, and KRAS-amplified cancer cell lines were most sensitive to KRAS shRNA, suggesting that KRAS amplification was an independent oncogenic event. A number of MAP kinase adapters were co-amplified with their receptor tyrosine kinases, such as the FGFR adapter FRS2 and the EGFR family adapters GRB2 and GRB7. The ubiquitin-like ligase DCUN1D1 and the histone methyltransferase NSD3 were also identified as novel putative cancer driver genes. We discuss the patient tailoring implications for existing cancer

  15. Identification of Druggable Cancer Driver Genes Amplified across TCGA Datasets

    PubMed Central

    Chen, Ying; McGee, Jeremy; Chen, Xianming; Doman, Thompson N.; Gong, Xueqian; Zhang, Youyan; Hamm, Nicole; Ma, Xiwen; Higgs, Richard E.; Bhagwat, Shripad V.; Buchanan, Sean; Peng, Sheng-Bin; Staschke, Kirk A.; Yadav, Vipin; Yue, Yong; Kouros-Mehr, Hosein

    2014-01-01

    The Cancer Genome Atlas (TCGA) projects have advanced our understanding of the driver mutations, genetic backgrounds, and key pathways activated across cancer types. Analysis of TCGA datasets have mostly focused on somatic mutations and translocations, with less emphasis placed on gene amplifications. Here we describe a bioinformatics screening strategy to identify putative cancer driver genes amplified across TCGA datasets. We carried out GISTIC2 analysis of TCGA datasets spanning 14 cancer subtypes and identified 461 genes that were amplified in two or more datasets. The list was narrowed to 73 cancer-associated genes with potential “druggable” properties. The majority of the genes were localized to 14 amplicons spread across the genome. To identify potential cancer driver genes, we analyzed gene copy number and mRNA expression data from individual patient samples and identified 40 putative cancer driver genes linked to diverse oncogenic processes. Oncogenic activity was further validated by siRNA/shRNA knockdown and by referencing the Project Achilles datasets. The amplified genes represented a number of gene families, including epigenetic regulators, cell cycle-associated genes, DNA damage response/repair genes, metabolic regulators, and genes linked to the Wnt, Notch, Hedgehog, JAK/STAT, NF-KB and MAPK signaling pathways. Among the 40 putative driver genes were known driver genes, such as EGFR, ERBB2 and PIK3CA. Wild-type KRAS was amplified in several cancer types, and KRAS-amplified cancer cell lines were most sensitive to KRAS shRNA, suggesting that KRAS amplification was an independent oncogenic event. A number of MAP kinase adapters were co-amplified with their receptor tyrosine kinases, such as the FGFR adapter FRS2 and the EGFR family adapter GRB7. The ubiquitin-like ligase DCUN1D1 and the histone methyltransferase NSD3 were also identified as novel putative cancer driver genes. We discuss the patient tailoring implications for existing cancer drug

  16. How accurately do drivers evaluate their own driving behavior? An on-road observational study.

    PubMed

    Amado, Sonia; Arıkan, Elvan; Kaça, Gülin; Koyuncu, Mehmet; Turkan, B Nilay

    2014-02-01

    Self-assessment of driving skills became a noteworthy research subject in traffic psychology, since by knowing one's strenghts and weaknesses, drivers can take an efficient compensatory action to moderate risk and to ensure safety in hazardous environments. The current study aims to investigate drivers' self-conception of their own driving skills and behavior in relation to expert evaluations of their actual driving, by using naturalistic and systematic observation method during actual on-road driving session and to assess the different aspects of driving via comprehensive scales sensitive to different specific aspects of driving. 19-63 years old male participants (N=158) attended an on-road driving session lasting approximately 80min (45km). During the driving session, drivers' errors and violations were recorded by an expert observer. At the end of the driving session, observers completed the driver evaluation questionnaire, while drivers completed the driving self-evaluation questionnaire and Driver Behavior Questionnaire (DBQ). Low to moderate correlations between driver and observer evaluations of driving skills and behavior, mainly on errors and violations of speed and traffic lights was found. Furthermore, the robust finding that drivers evaluate their driving performance as better than the expert was replicated. Over-positive appraisal was higher among drivers with higher error/violation score and with the ones that were evaluated by the expert as "unsafe". We suggest that the traffic environment might be regulated by increasing feedback indicators of errors and violations, which in turn might increase the insight into driving performance. Improving self-awareness by training and feedback sessions might play a key role for reducing the probability of risk in their driving activity. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. 2013 Cost of Wind Energy Review

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

    Mone, C.; Smith, A.; Maples, B.

    2015-02-01

    This report uses representative project types to estimate the levelized cost of wind energy (LCOE) in the United States for 2013. Scheduled to be published on an annual basis, it relies on both market and modeled data to maintain a current understanding of wind generation cost trends and drivers. It is intended to provide insight into current component-level costs and a basis for understanding current component-level costs and a basis for understanding variability in the LCOE across the industry. Data and tools developed from this analysis are used to inform wind technology cost projections, goals, and improvement opportunities.

  18. Graduated driver licensing decal law: effect on young probationary drivers.

    PubMed

    Curry, Allison E; Pfeiffer, Melissa R; Localio, Russell; Durbin, Dennis R

    2013-01-01

    Decal laws have been implemented internationally to facilitate police enforcement of graduated driver licensing (GDL) restrictions (e.g., passenger limit, nighttime curfew) but have not been evaluated. New Jersey implemented the first decal law in the U.S. on May 1, 2010. The aim of this study was to evaluate the effect of New Jersey's law on the rate of citations issued for violation of GDL restrictions and police-reported crashes among probationary drivers aged <21 years and to estimate the number of probationary drivers whose crashes were prevented by the law. New Jersey's licensing and crash databases were linked from January 1, 2008 to May 31, 2011, and each driver's license status, age, and outcome status were ascertained for each month. Monthly rates were calculated as the proportion of probationary drivers who experienced the outcome in that month. The pre-law period was defined as January 2008-January 2010 and the post-law period as May 2010-May 2011. Negative binomial regression models with robust SEs were used to determine the law's effect on crash and citation rates (adjusted for gender, seasonal trends, and overall trends) and estimate prevented crashes. Analyses were conducted in 2012. In the first year post-law, there was a 14% increase in the GDL citation rate (adjusted rate ratio 1.14 [95% CI=1.05, 1.24]); a 9% reduction in the police-reported crash rate (adjusted rate ratio 0.91 [95% CI=0.86, 0.97]), and an estimated 1624 young probationary drivers for whom a crash was prevented. Findings suggest that the law is positively affecting probationary drivers' safety. Results contribute to building the evidence base for the effectiveness of decal laws and provide valuable information to U.S. and international policymakers who are considering adding decal laws to enhance existing GDL laws. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders in Singapore.

    PubMed

    Teng, Monica; Zhou, Hui Jun; Lin, Liang; Lim, Pang Hung; Yeo, Doreen; Goh, Suzanne; Tjan, Soon Yin; Lim, Boon Peng

    2018-03-09

    The study evaluated the cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders (MSDs) in Singapore. A decision-analytic model was constructed to compare the cost-effectiveness of hydrotherapy to land-based therapy over 3 months from societal perspective. Target population comprised patients with low back pain (LBP), osteoarthritis (OA), rheumatoid arthritis (RA), total hip replacement (THR) and total knee replacement (TKR). Subgroup analyses were carried out to determine the cost-effectiveness of hydrotherapy in individual MSDs. Relative treatment effects were obtained through a systematic review of published data. Compared to land-based therapy, hydrotherapy was associated with an incremental cost-effectiveness ratio (ICER) of SGD 27 471 per quality-adjusted life-year (QALY) gained, which was below the willingness-to-pay threshold of SGD 70 000 per QALY (one gross domestic product per capita in Singapore in 2015). For the respective MSDs, hydrotherapy were dominant (more effective and less costly) in THR and TKR, cost-effective for LBP and RA, and not cost-effective for OA. Treatment adherence and cost of hydrotherapy were key drivers to the ICER values. Hydrotherapy was a cost-effective rehabilitation compared to land-based therapy for a population with MSDs in Singapore. However, the benefit of hydrotherapy was not observed in patients with OA.

  20. Malaria community health workers in Myanmar: a cost analysis.

    PubMed

    Kyaw, Shwe Sin; Drake, Tom; Thi, Aung; Kyaw, Myat Phone; Hlaing, Thaung; Smithuis, Frank M; White, Lisa J; Lubell, Yoel

    2016-01-25

    Myanmar has the highest malaria incidence and attributed mortality in South East Asia with limited healthcare infrastructure to manage this burden. Establishing malaria Community Health Worker (CHW) programmes is one possible strategy to improve access to malaria diagnosis and treatment, particularly in remote areas. Despite considerable donor support for implementing CHW programmes in Myanmar, the cost implications are not well understood. An ingredients based micro-costing approach was used to develop a model of the annual implementation cost of malaria CHWs in Myanmar. A cost model was constructed based on activity centres comprising of training, patient malaria services, monitoring and supervision, programme management, overheads and incentives. The model takes a provider perspective. Financial data on CHWs programmes were obtained from the 2013 financial reports of the Three Millennium Development Goal fund implementing partners that have been working on malaria control and elimination in Myanmar. Sensitivity and scenario analyses were undertaken to outline parameter uncertainty and explore changes to programme cost for key assumptions. The range of total annual costs for the support of one CHW was US$ 966-2486. The largest driver of CHW cost was monitoring and supervision (31-60% of annual CHW cost). Other important determinants of cost included programme management (15-28% of annual CHW cost) and patient services (6-12% of annual CHW cost). Within patient services, malaria rapid diagnostic tests are the major contributor to cost (64% of patient service costs). The annual cost of a malaria CHW in Myanmar varies considerably depending on the context and the design of the programme, in particular remoteness and the approach to monitoring and evaluation. The estimates provide information to policy makers and CHW programme planners in Myanmar as well as supporting economic evaluations of their cost-effectiveness.

  1. LNDriver: identifying driver genes by integrating mutation and expression data based on gene-gene interaction network.

    PubMed

    Wei, Pi-Jing; Zhang, Di; Xia, Junfeng; Zheng, Chun-Hou

    2016-12-23

    Cancer is a complex disease which is characterized by the accumulation of genetic alterations during the patient's lifetime. With the development of the next-generation sequencing technology, multiple omics data, such as cancer genomic, epigenomic and transcriptomic data etc., can be measured from each individual. Correspondingly, one of the key challenges is to pinpoint functional driver mutations or pathways, which contributes to tumorigenesis, from millions of functional neutral passenger mutations. In this paper, in order to identify driver genes effectively, we applied a generalized additive model to mutation profiles to filter genes with long length and constructed a new gene-gene interaction network. Then we integrated the mutation data and expression data into the gene-gene interaction network. Lastly, greedy algorithm was used to prioritize candidate driver genes from the integrated data. We named the proposed method Length-Net-Driver (LNDriver). Experiments on three TCGA datasets, i.e., head and neck squamous cell carcinoma, kidney renal clear cell carcinoma and thyroid carcinoma, demonstrated that the proposed method was effective. Also, it can identify not only frequently mutated drivers, but also rare candidate driver genes.

  2. Lung transplantation in the spotlight: Reasons for high-cost procedures.

    PubMed

    Vogl, Matthias; Warnecke, Gregor; Haverich, Axel; Gottlieb, Jens; Welte, Tobias; Hatz, Rudolf; Hunger, Matthias; Leidl, Reiner; Lingner, Heidrun; Behr, Juergen; Winter, Hauke; Schramm, Rene; Zwissler, Bernhard; Hagl, Christian; Strobl, Nicole; Jaeger, Cornelius; Preissler, Gerhard

    2016-10-01

    Hospital treatment costs of lung transplantation are insufficiently analyzed. Accordingly, it remains unknown, whether current Diagnosis Related Groups, merely accounting for 3 ventilation time intervals and length of hospital stay, reproduce costs properly, even when an increasing number of complex recipients are treated. Therefore, in this cost determination study, actual costs were calculated and cost drivers identified. A standardized microcosting approach allowed for individual cost calculations in 780 lung transplant patients taken care of at Hannover Medical School and University of Munich from 2009 to 2013. A generalized linear model facilitated the determination of characteristics predictive for inpatient costs. Lung transplantation costs varied substantially by major diagnosis, with a mean of €85,946 (median €52,938 ± 3,081). Length of stay and ventilation time properly reproduced costs in many cases. However, complications requiring prolonged ventilation or reinterventions were identified as additional significant cost drivers, responsible for high costs. Diagnosis Related Groups properly reproduce actual lung transplantation costs in straightforward cases, but costs in complex cases may remain underestimated. Improved grouping should consider major diagnosis, a higher gradation of ventilation time, and the number of reinterventions to allow for more reasonable reimbursement. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  3. Identifying driver characteristics influencing overtaking crashes.

    PubMed

    Mohaymany, Afshin Shariat; Kashani, Ali Tavakoli; Ranjbari, Andishe

    2010-08-01

    To identify the most important driver characteristics influencing crash-causing overtaking maneuvers on 2-lane, 2-way rural roads of Iran. Based on the crash data for rural roads of Iran over 3 years from 2006 to 2008, the classification and regression tree (CART) method combined with the quasi-induced exposure concept was applied for 4 independent variables and one target variable of "driver status" with 2 classes of at fault and not at fault. The independent variables were vehicle type, driver's age, driving license, and driving experience of the driver-the latter 2 driver characteristics are relatively new in traffic safety studies. According to the data set, 16,809 drivers were involved in 2-lane, 2-way rural roads overtaking crashes. The analysis revealed that drivers who are younger than 28 years old, whose driving license is type 2--a common driving license that is for driving with passenger car and light vehicles--and whose driving experience is less than 2 years are most probably responsible for overtaking crashes. It was indicated that vehicle type is the most important factor associated with drivers being responsible for the crashes. The results also revealed that younger drivers (18-28 years) are most likely to be at fault in overtaking crashes. Therefore, enforcement and education should be more concentrated on this age group. Due to the incompliant nature of this group, changing the type and amount of traffic fines is essential for more preventing objectives. The research also found 2 relatively new factors of driving license and driving experience to have considerable effects on drivers being at fault, such that type 2 licensed drivers are more responsible compared to type 1 (a driving license for driving with all motor vehicles, which has some age and experience requirements) licensed drivers or drivers with a special license (a driving license with special vehicle types). Moreover, drivers with less than 2 years' driving experience are more

  4. Affordability Engineering: Bridging the Gap Between Design and Cost

    NASA Technical Reports Server (NTRS)

    Reeves, J. D.; DePasquale, Dominic; Lim, Evan

    2010-01-01

    Affordability is a commonly used term that takes on numerous meanings depending on the context used. Within conceptual design of complex systems, the term generally implies comparisons between expected costs and expected resources. This characterization is largely correct, but does not convey the many nuances and considerations that are frequently misunderstood and underappreciated. In the most fundamental sense, affordability and cost directly relate to engineering and programmatic decisions made throughout development programs. Systems engineering texts point out that there is a temporal aspect to this relationship, for decisions made earlier in a program dictate design implications much more so than those made during latter phases. This paper explores affordability engineering and its many sub-disciplines by discussing how it can be considered an additional engineering discipline to be balanced throughout the systems engineering and systems analysis processes. Example methods of multidisciplinary design analysis with affordability as a key driver will be discussed, as will example methods of data visualization, probabilistic analysis, and other ways of relating design decisions to affordability results.

  5. Key data elements for use in cost-utility modeling of biological treatments for rheumatoid arthritis.

    PubMed

    Ganz, Michael L; Hansen, Brian Bekker; Valencia, Xavier; Strandberg-Larsen, Martin

    2015-05-01

    Economic evaluation is becoming more common and important as new biologic therapies for rheumatoid arthritis (RA) are developed. While much has been published about how to design cost-utility models for RA to conduct these evaluations, less has been written about the sources of data populating those models. The goal is to review the literature and to provide recommendations for future data collection efforts. This study reviewed RA cost-utility models published between January 2006 and February 2014 focusing on five key sources of data (health-related quality-of-life and utility, clinical outcomes, disease progression, course of treatment, and healthcare resource use and costs). It provided recommendations for collecting the appropriate data during clinical and other studies to support modeling of biologic treatments for RA. Twenty-four publications met the selection criteria. Almost all used two steps to convert clinical outcomes data to utilities rather than more direct methods; most did not use clinical outcomes measures that captured absolute levels of disease activity and physical functioning; one-third of them, in contrast with clinical reality, assumed zero disease progression for biologic-treated patients; little more than half evaluated courses of treatment reflecting guideline-based or actual clinical care; and healthcare resource use and cost data were often incomplete. Based on these findings, it is recommended that future studies collect clinical outcomes and health-related quality-of-life data using appropriate instruments that can convert directly to utilities; collect data on actual disease progression; be designed to capture real-world courses of treatment; and collect detailed data on a wide range of healthcare resources and costs.

  6. Speech-based E-mail and driver behavior: effects of an in-vehicle message system interface.

    PubMed

    Jamson, A Hamish; Westerman, Stephen J; Hockey, G Robert J; Carsten, Oliver M J

    2004-01-01

    As mobile office technology becomes more advanced, drivers have increased opportunity to process information "on the move." Although speech-based interfaces can minimize direct interference with driving, the cognitive demands associated with such systems may still cause distraction. We studied the effects on driving performance of an in-vehicle simulated "E-mail" message system; E-mails were either system controlled or driver controlled. A high-fidelity, fixed-base driving simulator was used to test 19 participants on a car-following task. Virtual traffic scenarios varying in driving demand. Drivers compensated for the secondary task by adopting longer headways but showed reduced anticipation of braking requirements and shorter time to collision. Drivers were also less reactive when processing E-mails, demonstrated by a reduction in steering wheel inputs. In most circumstances, there were advantages in providing drivers with control over when E-mails were opened. However, during periods without E-mail interaction in demanding traffic scenarios, drivers showed reduced braking anticipation. This may be a result of increased cognitive costs associated with the decision making process when using a driver-controlled interface when the task of scheduling E-mail acceptance is added to those of driving and E-mail response. Actual or potential applications of this research include the design of speech-based in-vehicle messaging systems.

  7. Social cost of heavy drinking and alcohol dependence in high-income countries.

    PubMed

    Mohapatra, Satya; Patra, Jayadeep; Popova, Svetlana; Duhig, Amy; Rehm, Jürgen

    2010-06-01

    A comprehensive review of cost drivers associated with alcohol abuse, heavy drinking, and alcohol dependence for high-income countries was conducted. The data from 14 identified cost studies were tabulated according to the potential direct and indirect cost drivers. The costs associated with alcohol abuse, alcohol dependence, and heavy drinking were calculated. The weighted average of the total societal cost due to alcohol abuse as percent gross domestic product (GDP)--purchasing power parity (PPP)--was 1.58%. The cost due to heavy drinking and/or alcohol dependence as percent GDP (PPP) was estimated to be 0.96%. On average, the alcohol-attributable indirect cost due to loss of productivity is more than the alcohol-attributable direct cost. Most of the countries seem to incur 1% or more of their GDP (PPP) as alcohol-attributable costs, which is a high toll for a single factor and an enormous burden on public health. The majority of alcohol-attributable costs incurred as a consequence of heavy drinking and/or alcohol dependence. Effective prevention and treatment measures should be implemented to reduce these costs.

  8. Cognitive characteristics of older Japanese drivers.

    PubMed

    Susilowati, Indri H; Yasukouchi, Akira

    2012-02-29

    Some causes of accidents among older drivers are: not paying attention to traffic signals; missing stop lines; and having to deal with and misjudging emergency situations. These causes of accidents reveal problems with attention and cognition. Such incidents are also related to driver perception and stress-coping mechanisms. It is important to examine the relation of stress reactions to attention and cognition as a factor influencing the causes of accidents commonly involving older drivers. Subjects were 10 young drivers (23.3 ± 3.33 years) and 25 older drivers divided into two groups (older1 [60 to 65 years] and older2 [> 65 years]). This study revealed the correlation within driver stress inventory and driver coping questionnaires parameters was observed only in older drivers. They also needed a longer response time for Trail Making Test A and B. The factors affected the attention and cognition of older drivers by age but not driving experience itself, and coping parameters such as emotion focus, reappraisal, and avoidance were not included as stress inventory parameters. Being prone to fatigue was less for younger drivers than older drivers. Because they have shorter distances, shorter drive times, and no need for expressways, older drivers also had a significantly lower risk of thrill-seeking behaviour and more patience. The intervention addressing their attention skills, aggressive feelings, and emotion focus should be considered. The technological improvements in cars will make older drivers feel safer and make driving easier which might lower the attention paid to the road, and regular driving training might be needed to assess and enhance their safety.

  9. Efficacy of side air bags in reducing driver deaths in driver-side collisions.

    PubMed

    Braver, Elisa R; Kyrychenko, Sergey Y

    2004-03-15

    Side air bags, a relatively new technology designed to protect the head and/or torso in side-impact collisions, are becoming increasingly common in automobiles. Their efficacy in preventing US driver deaths among cars struck on the near (driver's) side was examined using data from the Fatality Analysis Reporting System and the General Estimates System. Risk ratios for driver death per nearside collision during 1999-2001 were computed for head/torso and torso-only side air bags in cars from model years 1997-2002, relative to cars without side air bags. Confounding was addressed by adjusting nearside risk ratios for front- and rear-impact mortality, which is unaffected by side air bags. Risk ratios were 0.55 (95% confidence interval: 0.43, 0.71) for head/torso air bags and 0.89 (95% confidence interval: 0.79, 1.01) for torso-only air bags. Risk was reduced when cars with head/torso air bags were struck by cars/minivans (significant) or pickup trucks/sport utility vehicles (nonsignificant). Risk was reduced in two-vehicle collisions and among male drivers and drivers aged 16-64 years. Protective effects associated with torso-only air bags were observed in single-vehicle crashes and among male and 16- to 64-year-old drivers. Head/torso side air bags appear to be very effective in reducing nearside driver deaths, whereas torso-only air bags appear less protective.

  10. High-Throughput Functional Validation of Progression Drivers in Lung Adenocarcinoma

    DTIC Science & Technology

    2013-09-01

    2) a novel molecular barcoding approach that facilitates cost- effective detection of driver events following in vitro and in vivo functional screens...aberration construction pipeline, which we named High-Throughput 3 Mutagenesis and Molecular Barcoding (HiTMMoB; Fig.1). We have therefore been able...lentiviral vector specially constructed for this project. This vector is compatible with our flexible molecular barcoding technology (Fig. 1), thus each

  11. Economic analysis of electronic waste recycling: modeling the cost and revenue of a materials recovery facility in California.

    PubMed

    Kang, Hai-Yong; Schoenung, Julie M

    2006-03-01

    The objectives of this study are to identify the various techniques used for treating electronic waste (e-waste) at material recovery facilities (MRFs) in the state of California and to investigate the costs and revenue drivers for these techniques. The economics of a representative e-waste MRF are evaluated by using technical cost modeling (TCM). MRFs are a critical element in the infrastructure being developed within the e-waste recycling industry. At an MRF, collected e-waste can become marketable output products including resalable systems/components and recyclable materials such as plastics, metals, and glass. TCM has two main constituents, inputs and outputs. Inputs are process-related and economic variables, which are directly specified in each model. Inputs can be divided into two parts: inputs for cost estimation and for revenue estimation. Outputs are the results of modeling and consist of costs and revenues, distributed by unit operation, cost element, and revenue source. The results of the present analysis indicate that the largest cost driver for the operation of the defined California e-waste MRF is the materials cost (37% of total cost), which includes the cost to outsource the recycling of the cathode ray tubes (CRTs) (dollar 0.33/kg); the second largest cost driver is labor cost (28% of total cost without accounting for overhead). The other cost drivers are transportation, building, and equipment costs. The most costly unit operation is cathode ray tube glass recycling, and the next are sorting, collecting, and dismantling. The largest revenue source is the fee charged to the customer; metal recovery is the second largest revenue source.

  12. Balancing the cost of leaving with the cost of living: drivers of long-term retention of health workers: an explorative study in three rural districts in Eastern Uganda

    PubMed Central

    Namusoke Kiwanuka, Suzanne; Akulume, Martha; Tetui, Moses; Muhumuza Kananura, Rornald; Bua, John; Ekirapa-Kiracho, Elizabeth

    2017-01-01

    ABSTRACT Background: Health worker retention in rural and underserved areas remains a persisting problem in many low and middle income countries, and this directly affects the quality of health services offered. Objective: This paper explores the drivers of long-term retention and describes health worker coping mechanisms in rural Uganda. Methods: A descriptive qualitative study explored the factors that motivated health workers to stay, in three rural districts of Uganda: Kamuli, Pallisa, and Kibuku. In-depth interviews conducted among health workers who have been retained for at least 10 years explored factors motivating the health workers to stay within the district, opportunities, and the benefits of staying. Results: Twenty-one health workers participated. Ten of them male and 11 female with the age range of 33–51 years. The mean duration of stay among the participants was 13, 15, and 26 years for Kamuli, Kibuku, and Pallisa respectively. Long-term retention was related to personal factors, such as having family ties, community ties, and opportunities to invest. The decentralization policy and pension benefits also kept workers in place. Opportunities for promotion or leadership motivated long stay only if they came with financial benefits. Workload reportedly increased over the years, but staffing and emoluments had not increased. Multiple job, family support, and community support helped health workers cope with the costs of living, and holding a secure pensionable government job was valued more highly than seeking uncertain job opportunities elsewhere. Conclusion: The interplay between the costs of leaving and the benefit of staying is demonstrated. Family proximity, community ties, job security, and pension enhance staying, while higher costs of living and an unpredictable employment market make leaving risky. Health workers should be able to access investment opportunities in order to cope with inadequate remuneration. Promotions and leadership

  13. Geographic location and indirect costs as a barrier to dental treatment: a patient perspective.

    PubMed

    Curtis, B; Evans, R W; Sbaraini, A; Schwarz, E

    2007-12-01

    The recently published National Survey of Adult Oral Health 2004-06 indicated that tooth loss, mean decayed and number of DMF teeth were all higher outside capital city locations. In addition, dental attendance patterns were worse in terms of frequency, reason for visit, and continuity in rural and remote locations, but there was no difference by geographical location in terms of financial barriers to dental care. The objective of this research was to identify, quantify and analyse some of the non-treatment costs associated with dental treatment from the perspective of the patient and to determine whether the perceived impact of those costs may limit access to dental care. This cohort study was nested within a clinical trial. Patients had been allocated to treatment arms within clusters dependent on the randomization status of the dental practice they usually attended, classified as major city, regional or remote. A questionnaire was developed from a series of focus groups in which patients were asked to identify the domains of non-treatment costs associated with a dental visit that were important to them and to quantify those costs. Factor analysis was used to reduce these items to four core scales. These scales were assessed for reliability and validity. Regression and ANCOVA was used to explore differences in DMFS scores between the three groups and a predictive model developed to adjust for potential confounders. Two core scales were identified as key drivers on the perceived impact of indirect costs associated with dental visits; travel impact and family impact. Patients living in remote locations incurred significantly higher indirect costs associated with dental treatment and higher mean DMFS scores. Patient perception of the impact of travel costs and impact on family life are major drivers restricting access to dental services for people living in remote locations in New South Wales. Further research using outcomes directly related to access is required to

  14. Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe

    PubMed Central

    Mwenge, Lawrence; Sande, Linda; Mangenah, Collin; Ahmed, Nurilign; Kanema, Sarah; d’Elbée, Marc; Sibanda, Euphemia; Kalua, Thokozani; Ncube, Gertrude; Johnson, Cheryl C.; Hatzold, Karin; Cowan, Frances M.; Corbett, Elizabeth L.; Ayles, Helen; Maheswaran, Hendramoorthy

    2017-01-01

    Background Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. We sought to explore the costs of providing these services across three southern African countries with high HIV burden. Methods Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. Routinely collected monitoring and evaluation data for the health facilities were extracted to estimate the costs per individual tested and costs per HIV-positive individual identified. Costs are presented in 2016 US dollars. Sensitivity analysis explored key drivers of costs. Results Health facilities were testing on average 2290 individuals annually, albeit with wide variations. The mean cost per individual tested was US$5.03.9 in Malawi, US$4.24 in Zambia and US$8.79 in Zimbabwe. The mean cost per HIV-positive individual identified was US$79.58, US$73.63 and US$178.92 in Malawi, Zambia and Zimbabwe respectively. Both cost estimates were sensitive to scale of testing, facility staffing levels and the costs of HIV test kits. Conclusions Health facility based HIV testing remains an essential service to meet HIV universal access goals. The low costs and potential for economies of scale suggests an opportunity for further scale-up. However low uptake in many settings suggests that demand creation or alternative testing models may be needed to achieve economies of scale and reach populations less willing to attend facility based services. PMID:29036171

  15. Overweight and obesity on the island of Ireland: an estimation of costs

    PubMed Central

    Dee, Anne; Callinan, Aoife; Doherty, Edel; O'Neill, Ciaran; McVeigh, Treasa; Sweeney, Mary Rose; Staines, Anthony; Kearns, Karen; Fitzgerald, Sarah; Sharp, Linda; Kee, Frank; Hughes, John; Balanda, Kevin; Perry, Ivan J

    2015-01-01

    Objectives The increasing prevalence of overweight and obesity worldwide continues to compromise population health and creates a wider societal cost in terms of productivity loss and premature mortality. Despite extensive international literature on the cost of overweight and obesity, findings are inconsistent between Europe and the USA, and particularly within Europe. Studies vary on issues of focus, specific costs and methods. This study aims to estimate the healthcare and productivity costs of overweight and obesity for the island of Ireland in 2009, using both top-down and bottom-up approaches. Methods Costs were estimated across four categories: healthcare utilisation, drug costs, work absenteeism and premature mortality. Healthcare costs were estimated using Population Attributable Fractions (PAFs). PAFs were applied to national cost data for hospital care and drug prescribing. PAFs were also applied to social welfare and national mortality data to estimate productivity costs due to absenteeism and premature mortality. Results The healthcare costs of overweight and obesity in 2009 were estimated at €437 million for the Republic of Ireland (ROI) and €127.41 million for NI. Productivity loss due to overweight and obesity was up to €865 million for ROI and €362 million for NI. The main drivers of healthcare costs are cardiovascular disease, type II diabetes, colon cancer, stroke and gallbladder disease. In terms of absenteeism, low back pain is the main driver in both jurisdictions, and for productivity loss due to premature mortality the primary driver of cost is coronary heart disease. Conclusions The costs are substantial, and urgent public health action is required in Ireland to address the problem of increasing prevalence of overweight and obesity, which if left unchecked will lead to unsustainable cost escalation within the health service and unacceptable societal costs. PMID:25776042

  16. A systematic review of cost-effectiveness modeling of pharmaceutical therapies in neuropathic pain: variation in practice, key challenges, and recommendations for the future.

    PubMed

    Critchlow, Simone; Hirst, Matthew; Akehurst, Ron; Phillips, Ceri; Philips, Zoe; Sullivan, Will; Dunlop, Will C N

    2017-02-01

    Complexities in the neuropathic-pain care pathway make the condition difficult to manage and difficult to capture in cost-effectiveness models. The aim of this study is to understand, through a systematic review of previous cost-effectiveness studies, some of the key strengths and limitations in data and modeling practices in neuropathic pain. Thus, the aim is to guide future research and practice to improve resource allocation decisions and encourage continued investment to find novel and effective treatments for patients with neuropathic pain. The search strategy was designed to identify peer-reviewed cost-effectiveness evaluations of non-surgical, pharmaceutical therapies for neuropathic pain published since January 2000, accessing five key databases. All identified publications were reviewed and screened according to pre-defined eligibility criteria. Data extraction was designed to reflect key data challenges and approaches to modeling in neuropathic pain and based on published guidelines. The search strategy identified 20 cost-effectiveness analyses meeting the inclusion criteria, of which 14 had original model structures. Cost-effectiveness modeling in neuropathic pain is established and increasing across multiple jurisdictions; however, amongst these studies, there is substantial variation in modeling approach, and there are common limitations. Capturing the effect of treatments upon health outcomes, particularly health-related quality-of-life, is challenging, and the health effects of multiple lines of ineffective treatment, common for patients with neuropathic pain, have not been consistently or robustly modeled. To improve future economic modeling in neuropathic pain, further research is suggested into the effect of multiple lines of treatment and treatment failure upon patient outcomes and subsequent treatment effectiveness; the impact of treatment-emergent adverse events upon patient outcomes; and consistent and appropriate pain measures to inform

  17. netPICOMAG: a low-cost turn-key magnetometer for aurora detection

    NASA Astrophysics Data System (ADS)

    Schofield, I.; Connors, M.

    2008-12-01

    Previous work on development of a compact, low-cost, fluxgate magnetometer, dubbed PICOMAG, yielded a 1-nanotesla resolution, 1-second cadence instrument, suitable for research or teaching solar/terrestrial physics. With a low-cost magnetic instrument and the wider availability of Internet connectivity in the auroral zone (of Canada for example), the potential exists to fill gaps in spatial coverage that still plague auroral geomagnetic research. Thus, the ability to widely distribute accurate, low cost magnetometers was the motivating factor to develop PICOMAG. NetPICOMAG was developed in the effort to refine PICOMAG into a turn-key magnetometer data collection system that is self contained, simple to install and requires zero-maintenance. Once the unit is placed in the ground and connected to the Internet, it locks onto a GPS time signal and begins to transmit magnetic field measurements back to a central data repository, where it is archived, processed and plotted for public viewing via the World Wide Web. It is envisaged (among many other uses) that science teachers can use real scientific data provided by netPICOMAG in teaching the interactions between the sun and the Earth's magnetic field, manifesting itself in the phenomenon known as the northern lights. As such, netPICOMAG can be aptly described and is being promoted as an aurora detector. The netPICOMAG unit is based around three spatially oriented Speake and Company FGM-3/3h series magnetic field sensors that each emit a pulse stream whose frequency is related to the magnetic field along these three axes, and is nearly linearly related to magnetic field perturbations relevant to auroral studies. The individual pulse frequencies are measured by two PIC18F252 programmable microcontrollers. The measurements are combined with a GPS timestamp from a Garmin GPS 18 LVC GPS receiver, and transmitted as plain text as UDP datagrams by a Rabbit Semiconductor RCM4010 8-bit, networked microcontroller module. The self

  18. Cognitive characteristics of older Japanese drivers

    PubMed Central

    2012-01-01

    Background Some causes of accidents among older drivers are: not paying attention to traffic signals; missing stop lines; and having to deal with and misjudging emergency situations. These causes of accidents reveal problems with attention and cognition. Such incidents are also related to driver perception and stress-coping mechanisms. It is important to examine the relation of stress reactions to attention and cognition as a factor influencing the causes of accidents commonly involving older drivers. Finding Subjects were 10 young drivers (23.3 ± 3.33 years) and 25 older drivers divided into two groups (older1 [60 to 65 years] and older2 [> 65 years]). This study revealed the correlation within driver stress inventory and driver coping questionnaires parameters was observed only in older drivers. They also needed a longer response time for Trail Making Test A and B. The factors affected the attention and cognition of older drivers by age but not driving experience itself, and coping parameters such as emotion focus, reappraisal, and avoidance were not included as stress inventory parameters. Being prone to fatigue was less for younger drivers than older drivers. Because they have shorter distances, shorter drive times, and no need for expressways, older drivers also had a significantly lower risk of thrill-seeking behaviour and more patience. Conclusion The intervention addressing their attention skills, aggressive feelings, and emotion focus should be considered. The technological improvements in cars will make older drivers feel safer and make driving easier which might lower the attention paid to the road, and regular driving training might be needed to assess and enhance their safety. PMID:22738158

  19. Consistent Condom Use during Casual Sex among Long-Truck Drivers in Togo.

    PubMed

    Yaya, Issifou; Landoh, Dadja Essoya; Saka, Bayaki; Vignikin, Kokou; Aboubakari, Abdoul-Samadou; N'dri, Kouamé Mathias; Gbetoglo, Kodjo Dodji; Edorh, Atavi-Mensah; Ahlegnan, Komla; Yenkey, Holali Comlan; Toudeka, Ayawavi Sitsopé; Pitché, Palokinam

    2016-01-01

    In 2008, the proportion of truck drivers who were not systematically protected during sex was 63% with casual partners and 60% with sex workers. Despite the high level of knowledge on HIV/AIDS and the growing awareness of the existence of the risk of HIV infection, condom use always encounters resistance among truck drivers in Togo. We sought to document the factors associated with condom use during casual sex among trucks' drivers in Togo. This was an analytical cross-sectional study conducted in 2010 and targeted truckers at truck station on the two main roads of Togo, Lomé-Cinkassé and Kodjoviakopé-Sanvee Condji. In this study, 1,782 trucks' drivers and their helpers were interviewed. All were men, and their mean age was 28.8 ± 8.8 years. Trucks' drivers were doing an average of 3 stops on their journeys and 1,229 (69%) of them had at least two years of experience in the work. Of the 1,782 trucks' drivers, only 620 (34.8%) had consistently used condoms during casual sex in the last three months. In multivariate analysis, predictors were: education level (primary schooling: OR = 1.54; p = 0.002; Secondary schooling and higher OR = 1.38; p = 0.036), good knowledge of ways of HIV transmission (OR = 1.53; p = 0.000), tested for HIV (OR = 1.67, p = 0.000), duration in the profession (2-5 years: OR = 1.43, p = 0.008; more than 5 years: OR = 1.38, p = 0.027), and HIV risk's perception (OR = 1.44, p = 0.000). These results highlight factors associated with consistent condom use during casual sex by truck drivers in Togo. This is a key population group at high risk of HIV transmission toward which the national HIV/AIDS control program should strengthen the HIV prevention strategies.

  20. Student drivers: a study of fatal motor vehicle crashes involving 16-year-old drivers.

    PubMed

    Gonzales, Michael M; Dickinson, L Miriam; DiGuiseppi, Carolyn; Lowenstein, Steven R

    2005-02-01

    Motor vehicle crashes are the leading cause of death for US teenagers, accounting for 40% of fatalities. The purpose of this study was to compare novice (aged 16 years) and experienced (aged 25 to 49 years) drivers involved in fatal motor vehicle crashes with respect to crash characteristics and driver behaviors. This cross-sectional study of fatal motor vehicle crashes in Colorado used data from the Fatality Analysis Reporting System (1995 to 2001). Driver and crash variables were compared in the 2 age groups using separate logistic regression models, adjusted for sex, geographic locale, and year. Two thousand four hundred twenty fatal motor vehicle crashes were included; 158 fatalities (6.5%) were novice drivers. Novice drivers were more likely to have been speeding (odds ratio [OR] 1.87, 95% confidence interval [CI] 1.34 to 3.08); driving recklessly (OR 4.78, 95% CI 3.31 to 6.92); charged with a traffic violation (OR 3.08, 95% CI 2.20 to 4.31); in a single-vehicle (OR 1.84, 95% CI 1.32 to 2.57), rollover (OR 1.36, 95% CI 0.97 to 1.91) or run-off-the-road (OR 1.54, 95% CI 1.03 to 2.30) crash; and carrying 2 (OR 4.52, 95% CI 2.75 to 7.41) or more (OR 4.07, 95% CI 2.49 to 6.55) passengers. Safety belt nonuse was high for novice (48%) and experienced (42%) drivers (OR 1.19, 95% CI 0.86 to 1.67). Novice drivers had older cars (mean difference 1.5 years, 95% CI 0.37 to 2.57 years). Novice drivers were less likely to be involved in crashes caused by alcohol (OR 0.24, 95% CI 0.14 to 0.41) or adverse weather (OR 0.37, 95% CI 0.19 to 0.75) and to be driving a sport utility vehicle (OR 0.62, 95% CI 0.39 to 0.97). Fatal motor vehicle crashes involving novice drivers are characterized by speeding, recklessness, single-vehicle and rollover crashes, and traffic law violations, suggesting that novice drivers bear considerable responsibility for their fatal crashes. Moreover, almost half of 16-year-old drivers involved in fatal motor vehicle crashes were not wearing their safety

  1. Graduated driver licensing for reducing motor vehicle crashes among young drivers.

    PubMed

    Russell, Kelly F; Vandermeer, Ben; Hartling, Lisa

    2011-10-05

    Graduated driver licensing (GDL) has been proposed as a means of reducing crash rates among novice drivers by gradually introducing them to higher risk driving situations. To examine the effectiveness of GDL in reducing crash rates among young drivers. Studies were identified through searching MEDLINE, EMBASE, CINAHL, Healthstar, Web of Science, NTIS Bibliographic Database, TRIS Online, SIGLE, the World Wide Web, conference proceedings, consultation with experts and reference lists in relevant published literature. The searches were conducted from the time of inception to May 2009, and the Cochrane Injuries Group conducted an updated search of the TRANSPORT database in September 2009. Studies were included if: 1) they compared outcomes pre- and post-implementation of a GDL program within the same jurisdiction, 2) comparisons were made between jurisdictions with and without GDL, or 3) both. Studies had to report at least one objective, quantified outcome. Results were not pooled due to substantial heterogeneity. Percentage change was calculated for each year after the intervention, using one year prior to the intervention as baseline. Results were adjusted by internal controls. Analyses were stratified by denominators (population, licensed drivers). Results were calculated for the different crash types and presented for 16 year-olds alone as well as all teenage drivers. We included 34 studies evaluating 21 GDL programs and 2 analyses of >40 US states. GDL programs were implemented in the US (n=16), Canada (n=3), New Zealand (n=1), and Australia (n=1) and varied in their restrictions during the intermediate stage. Based on the Insurance Institute for Highway Safety (IIHS) classification, eleven programs were good, four were fair, five were marginal, one was poor and two could not be assessed. Reductions in crash rates were seen in all jurisdictions and for all crash types. Among 16 year-old drivers, the median decrease in per population adjusted overall crash rates

  2. Associating crash avoidance maneuvers with driver attributes and accident characteristics: a mixed logit model approach.

    PubMed

    Kaplan, Sigal; Prato, Carlo Giacomo

    2012-01-01

    The current study focuses on the propensity of drivers to engage in crash avoidance maneuvers in relation to driver attributes, critical events, crash characteristics, vehicles involved, road characteristics, and environmental conditions. The importance of avoidance maneuvers derives from the key role of proactive and state-aware road users within the concept of sustainable safety systems, as well as from the key role of effective corrective maneuvers in the success of automated in-vehicle warning and driver assistance systems. The analysis is conducted by means of a mixed logit model that represents the selection among 5 emergency lateral and speed control maneuvers (i.e., "no avoidance maneuvers," "braking," "steering," "braking and steering," and "other maneuvers) while accommodating correlations across maneuvers and heteroscedasticity. Data for the analysis were retrieved from the General Estimates System (GES) crash database for the year 2009 by considering drivers for which crash avoidance maneuvers are known. The results show that (1) the nature of the critical event that made the crash imminent greatly influences the choice of crash avoidance maneuvers, (2) women and elderly have a relatively lower propensity to conduct crash avoidance maneuvers, (3) drowsiness and fatigue have a greater negative marginal effect on the tendency to engage in crash avoidance maneuvers than alcohol and drug consumption, (4) difficult road conditions increase the propensity to perform crash avoidance maneuvers, and (5) visual obstruction and artificial illumination decrease the probability to carry out crash avoidance maneuvers. The results emphasize the need for public awareness campaigns to promote safe driving style for senior drivers and warning about the risks of driving under fatigue and distraction being comparable to the risks of driving under the influence of alcohol and drugs. Moreover, the results suggest the need to educate drivers about hazard perception, designing

  3. The impact of manufacturing complexity drivers on performance-a preliminary study

    NASA Astrophysics Data System (ADS)

    Huah Leang, Suh; Mahmood, Wan Hasrulnizzam Wan; Rahman, Muhamad Arfauz A.

    2018-03-01

    Manufacturing systems, in pursuit of cost, time and flexibility optimisation are becoming more and more complex, exhibiting a dynamic and nonlinear behaviour. Unpredictability is a distinct characteristic of such behaviour and effects production planning significantly. Therefore, this study was undertaken to investigate the priority level and current achievement of manufacturing performance in Malaysia’s manufacturing industry and the complexity drivers on manufacturing productivity performance. The results showed that Malaysia’s manufacturing industry prioritised product quality and they managed to achieve a good on time delivery performance. However, for other manufacturing performance, there was a difference where the current achievement of manufacturing performances in Malaysia’s manufacturing industry is slightly lower than the priority given to them. The strong correlation of significant value for priority status was observed between efficient production levelling (finished goods) and finish product management while the strong correlation of significant value for current achievement was minimised the number of workstation and factory transportation system. This indicates that complexity drivers have an impact towards manufacturing performance. Consequently, it is necessary to identify complexity drivers to achieve well manufacturing performance.

  4. Engineering and fabrication cost considerations for cryogenic wind tunnel models

    NASA Technical Reports Server (NTRS)

    Boykin, R. M., Jr.; Davenport, J. B., Jr.

    1983-01-01

    Design and fabrication cost drivers for cryogenic transonic wind tunnel models are defined. The major cost factors for wind tunnel models are model complexity, tolerances, surface finishes, materials, material validation, and model inspection. The cryogenic temperatures require the use of materials with relatively high fracture toughness but at the same time high strength. Some of these materials are very difficult to machine, requiring extensive machine hours which can add significantly to the manufacturing costs. Some additional engineering costs are incurred to certify the materials through mechanical tests and nondestructive evaluation techniques, which are not normally required with conventional models. When instrumentation such as accelerometers and electronically scanned pressure modules is required, temperature control of these devices needs to be incorporated into the design, which requires added effort. Additional thermal analyses and subsystem tests may be necessary, which also adds to the design costs. The largest driver to the design costs is potentially the additional static and dynamic analyses required to insure structural integrity of the model and support system.

  5. Common Low-cost IM Explosive Program. Development of Next Generation Insensitive Munitions: A Success Story

    DTIC Science & Technology

    2011-11-30

    fuze separating from the shell body preventing high order detonations thus saving the lives of the Soldiers. Unit’s SPC Alan Ng  with his father Peter...Sensitive If not fully compliant, must show improvement over Baseline explosive Affordable Artillery Cost Drivers = Steel Body Material & Explosive Fill...Mortar Cost Drivers = Steel Body Material, Fuze & Propelling Charges Producible within the National Technology and Industrial Base Infrastructure

  6. Comparison of older and younger novice driver crash rates: Informing the need for extended Graduated Driver Licensing restrictions.

    PubMed

    Curry, Allison E; Metzger, Kristina B; Williams, Allan F; Tefft, Brian C

    2017-11-01

    Few previous studies have directly compared crash rates of older and younger novice drivers. To inform discussion about whether Graduated Driver Licensing (GDL) policies that are applied in the US for younger novice drivers should be applied to older novice drivers, we conducted a longitudinal study to examine overall, nighttime, and multiple passenger crash rates over the initial four years of licensure differ for novice drivers licensed at different ages. Using data from the New Jersey Traffic Safety Outcomes (NJ-TSO) data warehouse, we selected all NJ drivers who obtained their initial intermediate driver's license from 2006 through 2014 and had at least one month of follow-up from the date of licensure to study end or death (n=1,034,835). Novice drivers were grouped based on age at licensure: age 17; 18-20; 21-24; and 25 or older. We estimated monthly rates for overall crashes (per 10,000 licensed drivers) as well as: late night crashes (11:01 p.m.-4:59 a.m.); early night crashes (9:00 p.m.-11:00 p.m.); and multiple passenger crashes (two or more passengers). Average monthly rates were calculated for specific relevant time periods and Poisson regression models were used to compare rates: (1) between novice driver groups with the same time since licensure; (2) over the first 48 months of licensure within each novice driver group; and (3) between same-aged 21-year-old drivers with varying lengths of licensure. Although initial (three months post-licensure) overall crash rates of novice NJ drivers age 21 and older were higher than rates of same-aged experienced drivers, they were substantially lower than initial rates for 17- to 20-year-old novice drivers, who are licensed under GDL policies. Moreover, older novice drivers experience much less steep crash reductions over the first year of licensure than younger novice drivers. Nighttime crash rates among the 21- to 24-year old and aged 25 and older novice driver groups were stable over the first year of licensure

  7. Key Design Considerations When Calculating Cost Savings for Population Health Management Programs in an Observational Setting.

    PubMed

    Murphy, Shannon M E; Hough, Douglas E; Sylvia, Martha L; Dunbar, Linda J; Frick, Kevin D

    2018-02-08

    To illustrate the impact of key quasi-experimental design elements on cost savings measurement for population health management (PHM) programs. Population health management program records and Medicaid claims and enrollment data from December 2011 through March 2016. The study uses a difference-in-difference design to compare changes in cost and utilization outcomes between program participants and propensity score-matched nonparticipants. Comparisons of measured savings are made based on (1) stable versus dynamic population enrollment and (2) all eligible versus enrolled-only participant definitions. Options for the operationalization of time are also discussed. Individual-level Medicaid administrative and claims data and PHM program records are used to match study groups on baseline risk factors and assess changes in costs and utilization. Savings estimates are statistically similar but smaller in magnitude when eliminating variability based on duration of population enrollment and when evaluating program impact on the entire target population. Measurement in calendar time, when possible, simplifies interpretability. Program evaluation design elements, including population stability and participant definitions, can influence the estimated magnitude of program savings for the payer and should be considered carefully. Time specifications can also affect interpretability and usefulness. © Health Research and Educational Trust.

  8. Preliminary evaluation of the North Carolina graduated driver licensing system : effects on young driver crashes

    DOT National Transportation Integrated Search

    2000-07-01

    In December 1997, North Carolina became the second state to enact a comprehensive Graduated Driver Licensing (GDL) system. The purpose of the GSL is to reduce young driver crashes by introducing beginning drivers to the full range of driving experien...

  9. Motor vehicle driver injury and socioeconomic status: a cohort study with prospective and retrospective driver injuries.

    PubMed

    Whitlock, G; Norton, R; Clark, T; Pledger, M; Jackson, R; MacMahon, S

    2003-07-01

    To investigate the association between motor vehicle driver injury and socioeconomic status. Cohort study with prospective and retrospective outcomes. New Zealand. 10 525 adults (volunteer sample of a multi-industry workforce, n=8008; and a random sample of urban electoral rolls, n=2517). Motor vehicle driver injury resulting in admission of the driver to hospital or the driver's death, or both, during the period 1988-98; hospitalisation and mortality data were obtained by record linkage to national health databases. After adjustment for age and sex, driver injury risk was inversely associated with both occupational status (p for linear trend <0.0001) and educational level (p for linear trend =0.007). Participants in the lowest approximate quartile of occupational status were four times as likely (HR 4.17, 95% CI 2.31 to 7.55) to have experienced a driver injury during follow up as participants in the highest approximate quartile. Participants who had been to secondary school for less than two years were twice as likely (HR 2.26, 95% CI 1.34 to 3.81) to have experienced a driver injury as those who had been to university or polytechnic. There was little evidence that driver injury risk was associated with neighbourhood income (p for linear trend =0.12) CONCLUSIONS: Occupational status and educational level seem to be important determinants of driver injury risk. Driver injury countermeasures should be targeted to people in low status occupations, as well as to people with comparatively little formal education.

  10. An analysis of UK waste minimization clubs: key requirements for future cost effective developments.

    PubMed

    Phillips, P S; Pratt, R M; Pike, K

    2001-01-01

    The UK waste strategy is based upon use of the best practicable environmental option (BPEO), by those making waste management decisions. BPEO is supported by the use of the waste hierarchy, with its range of preferable options for dealing with waste, and the proximity principle, where waste is treated/disposed of as close to its point of origin as possible. The national waste strategy emphasizes the key role of waste minimization and encourages industry, commerce and the public to move towards sustainable waste management practice for economic and environmental reasons. Waste minimization clubs have been used, since the early 1990s, to demonstrate to industry/commerce that reducing waste production can lead to significant financial savings. There have been around 75 such clubs in the UK and they receive support from a wide range of agencies, including the Environmental Technology Best Practice Program. The early Demonstration Clubs had significant savings to cost ratios, e.g. Aire and Calder at 8.4, but had very high costs, e.g. Aire and Calder at 400,000 pounds. It is acknowledged that the number of clubs will have to be approximately doubled in the next few years so as to have an adequate coverage of the UK. There are at present, marked regional variations in club development and cognizance needs to be taken, by facilitators, of the need for extensive coverage of the UK. Future clubs will probably have to operate in a financially constrained climate and they need to be designed to deliver significant savings and waste reduction at low cost. To aid future club design, final reports of all projects should report in a standard manner so that cost benefit analysis can be used to inform facilitators about the most effective club type. rights reserved.

  11. Implications of comorbidity on costs for patients with Alzheimer disease.

    PubMed

    Kuo, Tzu-Chun; Zhao, Yang; Weir, Sharada; Kramer, Marilyn Schlein; Ash, Arlene S

    2008-08-01

    No prior studies have used a comprehensive clinical classification system to examine the effect of differences in overall illness burden and the presence of other diseases on costs for patients with Alzheimer disease (AD) when compared with demographically matched nondemented controls. Of a total of 627,775 enrollees who were eligible for medical and pharmacy benefits for 2003 and 2004 in the MarketScan Medicare Supplemental and Coordination of Benefits Database, we found 25,109 AD patients. For each case, 3 demographically matched nondemented controls were selected using propensity scores. Applying the diagnostic cost groups (DCGs) model to all enrollees, 2003 diagnoses were used to estimate prospective relative risk scores (RRSs) that predict 2004 costs from all illness other than AD. RRSs were then used to control for illness burden to estimate AD's independent effect on costs. Compared with the control group, the AD cohort has more comorbid conditions (8.1 vs. 6.5) and higher illness burden (1.23 vs. 1.04). Individuals with AD are more likely to have mental health conditions, neurologic conditions, cognitive disorders, cerebrovascular disease, diabetes with acute complications, and injuries. Annual costs for AD patients are $3567 (34%) higher than for controls. Excess costs attributable to AD, after controlling for non-AD illness burden, are estimated at $2307 per year with outpatient pharmacy being the key driver ($1711 in excess costs). AD patients are sicker and more expensive than demographically matched controls. Even after adjusting for differences in illness burden, costs remain higher for AD patients.

  12. Estimating the over-involvement of suspended, revoked, and unlicensed drivers as at-fault drivers in California fatal crashes.

    PubMed

    Brar, Sukhvir S

    2014-09-01

    Quasi-induced exposure analysis was used to estimate annual fatal crash involvement rates for validly licensed, suspended or revoked (S/R), and unlicensed drivers in California from 1987 through 2009 using fatal crash data obtained from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System and crash culpability determinations from the California Highway Patrol's Statewide Integrated Traffic Records System. Although there was some year-to-year fluctuation in the annual estimates, S/R and unlicensed drivers were over-involved as at-fault drivers in fatal crashes during every year of the 23-year time period relative to validly licensed drivers. The fatal crash involvement ratios combined across all years were 0.86 for validly licensed drivers, 2.23 for S/R drivers, and 2.34 for unlicensed drivers. Hence, compared to validly licensed drivers, the odds of being at-fault for a fatal crash were 160% higher for S/R drivers (involvement ratio=2.60) and 173% higher for unlicensed drivers (involvement ratio=2.73). The excess risks of S/R and unlicensed drivers are somewhat lower than estimates found in a prior study using the same technique, but the results nonetheless provide evidence that S/R and unlicensed drivers are much more hazardous on the road than are validly licensed drivers and emphasize the importance of using strong countermeasures-including vehicle impoundment-to reduce their high crash risk. These findings support interventions to help reduce driving among S/R and unlicensed drivers. Published by Elsevier Ltd.

  13. Migration towards fibre to the home: key cost factors

    NASA Astrophysics Data System (ADS)

    Zhou, L. W.; Mas Machuca, C.; Zhao, R.; Grunert, K.

    2010-12-01

    This paper presents a comprehensive cost model for migration towards FTTH, some case study results from different network area scenarios, as well as the identification of the most important cost factors to be considered by operators aiming at increasing the profitability of their networks.

  14. Outer planet probe cost estimates: First impressions

    NASA Technical Reports Server (NTRS)

    Niehoff, J.

    1974-01-01

    An examination was made of early estimates of outer planetary atmospheric probe cost by comparing the estimates with past planetary projects. Of particular interest is identification of project elements which are likely cost drivers for future probe missions. Data are divided into two parts: first, the description of a cost model developed by SAI for the Planetary Programs Office of NASA, and second, use of this model and its data base to evaluate estimates of probe costs. Several observations are offered in conclusion regarding the credibility of current estimates and specific areas of the outer planet probe concept most vulnerable to cost escalation.

  15. Age-Related Differences in Vehicle Control and Eye Movement Patterns at Intersections: Older and Middle-Aged Drivers

    PubMed Central

    Yamani, Yusuke; Horrey, William J.; Liang, Yulan; Fisher, Donald L.

    2016-01-01

    Older drivers are at increased risk of intersection crashes. Previous work found that older drivers execute less frequent glances for detecting potential threats at intersections than middle-aged drivers. Yet, earlier work has also shown that an active training program doubled the frequency of these glances among older drivers, suggesting that these effects are not necessarily due to age-related functional declines. In light of findings, the current study sought to explore the ability of older drivers to coordinate their head and eye movements while simultaneously steering the vehicle as well as their glance behavior at intersections. In a driving simulator, older (M = 76 yrs) and middle-aged (M = 58 yrs) drivers completed different driving tasks: (1) travelling straight on a highway while scanning for peripheral information (a visual search task) and (2) navigating intersections with areas potential hazard. The results replicate that the older drivers did not execute glances for potential threats to the sides when turning at intersections as frequently as the middle-aged drivers. Furthermore, the results demonstrate costs of performing two concurrent tasks, highway driving and visual search task on the side displays: the older drivers performed more poorly on the visual search task and needed to correct their steering positions more compared to the middle-aged counterparts. The findings are consistent with the predictions and discussed in terms of a decoupling hypothesis, providing an account for the effects of the active training program. PMID:27736887

  16. A telegeriatric service in a small rural hospital: A case study and cost analysis.

    PubMed

    Versleijen, Marloes; Martin-Khan, Melinda G; Whitty, Jennifer A; Smith, Anthony C; Gray, Leonard C

    2015-12-01

    Small hospitals in rural areas usually have an insufficient caseload of frail old people to justify the regular presence of a geriatrician. This study examined the costs of providing a telegeriatric service by videoconference in a rural hospital, compared to the costs of a visiting geriatrician that travels to undertake in-person consultations. A cost analysis was undertaken to compare the costs of the telegeriatric service model with the costs of a visiting geriatrician service model. A recently established telegeriatric service at Warwick Hospital was used as a case study. In the base case model (assuming four patients per round and a round-trip travel distance of 312 kilometres), an estimated AUD$131 per patient consultation can be saved in favour of the telegeriatric service model. Key drivers of costs are the number of patients per round and the travel distance and time in the visiting geriatrician model. At a workload of four patients per round, it is less expensive to conduct a telegeriatric service than a visiting geriatrician service when the round-trip travel time exceeds 76 minutes. Even under quite conservative assumptions, a telegeriatric service offers an economically feasible approach to the delivery of specialist geriatric assessment in rural and remote settings. © The Author(s) 2015.

  17. "The little squealer" or "the virtual guardian angel"? Young drivers' and their parents' perspective on using a driver monitoring technology and its implications for parent-young driver communication.

    PubMed

    Guttman, Nurit; Gesser-Edelsburg, Anat

    2011-02-01

    In-vehicle driving monitoring technologies have the potential to enable young drivers to learn from self-assessment. However, their use is largely dependent on parental involvement. A total of 79 interviews were conducted with young drivers and parents regarding this technology and its use. Most had the experience of having an in-vehicle data recorder installed in the vehicle driven by the young drivers. Parents and the young drivers expressed both appreciation as well as reservations about its potential as a means to enhance the driving safety of young drivers. A surprising finding was that some parents did not check the feedback and said they relied on the young driver to do so. Main concerns related to privacy, parent-young driver relationship, self-esteem and confidence, constructive use of the feedback data, and the limitations of the documentation that can be done by the technology. Providing parents and young drivers with a support system and tools to discuss and utilize the feedback are underscored. Challenges include addressing the invasion of young drivers' privacy and gender differences, and using the monitoring-capacity of the technology to enhance safe driving practices. Implications for programs to enhance communication and a dialogical approach between parents and young drivers are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. Cost-Effective and Ecofriendly Plug-In Hybrid Electric Vehicle Charging Management

    DOE PAGES

    Kontou, Eleftheria; Yin, Yafeng; Ge, Ying-en

    2017-01-01

    In this study we explore two charging management schemes for plug-in hybrid electric vehicles (PHEVs). The PHEV drivers and the government were stakeholders who might have preferred different charging control strategies. For the former, a proposed controlled charging scheme minimized the operational cost during PHEV charge-depleting and sustaining modes. For the latter, the research minimized monetized carbon dioxide emissions from electricity generation for the PHEVs charging, as well as tailpipe emissions for the portion of PHEV trips fueled by gasoline. Hourly driving patterns and electricity data were leveraged. Both were representative of each of the eight North American Electric Reliabilitymore » Corporation regions to examine the results of the proposed schemes. The model accounted for drivers' activity patterns and charging availability spatial and temporal heterogeneity. The optimal charging profiles confirmed the differing nature of the objectives of PHEV drivers and the government; cost-effective charge should occur early in the morning, while ecofriendly charge should be late in the afternoon. Each control's trade-offs between operation cost and emission savings are discussed for each North American Electric Reliability Corporation region. The availability of workplace and public charging was found to affect the optimal charging profiles greatly. Charging control is more efficient for drivers and government when PHEVs have greater electric range.« less

  19. Cost-Effective and Ecofriendly Plug-In Hybrid Electric Vehicle Charging Management

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

    Kontou, Eleftheria; Yin, Yafeng; Ge, Ying-en

    In this study we explore two charging management schemes for plug-in hybrid electric vehicles (PHEVs). The PHEV drivers and the government were stakeholders who might have preferred different charging control strategies. For the former, a proposed controlled charging scheme minimized the operational cost during PHEV charge-depleting and sustaining modes. For the latter, the research minimized monetized carbon dioxide emissions from electricity generation for the PHEVs charging, as well as tailpipe emissions for the portion of PHEV trips fueled by gasoline. Hourly driving patterns and electricity data were leveraged. Both were representative of each of the eight North American Electric Reliabilitymore » Corporation regions to examine the results of the proposed schemes. The model accounted for drivers' activity patterns and charging availability spatial and temporal heterogeneity. The optimal charging profiles confirmed the differing nature of the objectives of PHEV drivers and the government; cost-effective charge should occur early in the morning, while ecofriendly charge should be late in the afternoon. Each control's trade-offs between operation cost and emission savings are discussed for each North American Electric Reliability Corporation region. The availability of workplace and public charging was found to affect the optimal charging profiles greatly. Charging control is more efficient for drivers and government when PHEVs have greater electric range.« less

  20. Main drivers of health expenditure growth in China: a decomposition analysis.

    PubMed

    Zhai, Tiemin; Goss, John; Li, Jinjing

    2017-03-09

    In past two decades, health expenditure in China grew at a rate of 11.6% per year, which is much faster than the growth of the country's economy (9.9% per year). As cost containment is a key aspect of China's new health system reform agenda, this study aims to identify the main drivers of past growth so that cost containment policies are focussed in the right areas. The analysis covered the period 1993-2012. To understand the drivers of past growth during this period, Das Gupta's decomposition method was used to decompose the changes in health expenditure by disease into five main components that include population growth, population ageing, disease prevalence rate, expenditure per case of disease, and excess health price inflation. Demographic data on population size and age-composition were obtained from the Department of Economic and Social Affairs of the United Nations. Age- and disease- specific expenditure and prevalence rates by age and disease were extracted from China's National Health Accounts studies and Global Burden of Disease 2013 studies of the Institute for Health Metrics and Evaluation, respectively. Growth in health expenditure in China was mainly driven by a rapid increase in real expenditure per prevalent case, which contributed 8.4 percentage points of the 11.6% annual average growth. Excess health price inflation and population growth contributed 1.3 and 1.3% respectively. The effect of population ageing was relatively small, contributing 0.8% per year. However, reductions in disease prevalence rates reduced the growth rate by 0.3 percentage points. Future policy in optimising growth in health expenditure in China should address growth in expenditure per prevalent case. This is especially so for neoplasms, and for circulatory and respiratory disease. And a focus on effective interventions to reduce the prevalence of disease in the country will ensure that changing disease rates do not lead to a higher growth in future health expenditure

  1. A comparison of drug use in driver fatalities and similarly exposed drivers

    DOT National Transportation Integrated Search

    1977-07-01

    Author's abstract: Crash information, urine, blood and bile samples from 900 fatally injured drivers were collected by medical examiners in 22 areas of the country. Randomly selected living drivers were interviewed at times and places of recent fatal...

  2. Motor vehicle driver injury and socioeconomic status: a cohort study with prospective and retrospective driver injuries

    PubMed Central

    Whitlock, G; Norton, R; Clark, T; Pledger, M; Jackson, R; MacMahon, S

    2003-01-01

    Study objective: To investigate the association between motor vehicle driver injury and socioeconomic status. Design: Cohort study with prospective and retrospective outcomes. Setting: New Zealand. Participants: 10 525 adults (volunteer sample of a multi-industry workforce, n=8008; and a random sample of urban electoral rolls, n=2517). Outcome measure: Motor vehicle driver injury resulting in admission of the driver to hospital or the driver's death, or both, during the period 1988–98; hospitalisation and mortality data were obtained by record linkage to national health databases. Main results: After adjustment for age and sex, driver injury risk was inversely associated with both occupational status (p for linear trend <0.0001) and educational level (p for linear trend =0.007). Participants in the lowest approximate quartile of occupational status were four times as likely (HR 4.17, 95% CI 2.31 to 7.55) to have experienced a driver injury during follow up as participants in the highest approximate quartile. Participants who had been to secondary school for less than two years were twice as likely (HR 2.26, 95% CI 1.34 to 3.81) to have experienced a driver injury as those who had been to university or polytechnic. There was little evidence that driver injury risk was associated with neighbourhood income (p for linear trend =0.12) Conclusions: Occupational status and educational level seem to be important determinants of driver injury risk. Driver injury countermeasures should be targeted to people in low status occupations, as well as to people with comparatively little formal education. PMID:12821697

  3. Space transfer vehicle concepts and requirements study. Volume 3, book 1: Program cost estimates

    NASA Technical Reports Server (NTRS)

    Peffley, Al F.

    1991-01-01

    The Space Transfer Vehicle (STV) Concepts and Requirements Study cost estimate and program planning analysis is presented. The cost estimating technique used to support STV system, subsystem, and component cost analysis is a mixture of parametric cost estimating and selective cost analogy approaches. The parametric cost analysis is aimed at developing cost-effective aerobrake, crew module, tank module, and lander designs with the parametric cost estimates data. This is accomplished using cost as a design parameter in an iterative process with conceptual design input information. The parametric estimating approach segregates costs by major program life cycle phase (development, production, integration, and launch support). These phases are further broken out into major hardware subsystems, software functions, and tasks according to the STV preliminary program work breakdown structure (WBS). The WBS is defined to a low enough level of detail by the study team to highlight STV system cost drivers. This level of cost visibility provided the basis for cost sensitivity analysis against various design approaches aimed at achieving a cost-effective design. The cost approach, methodology, and rationale are described. A chronological record of the interim review material relating to cost analysis is included along with a brief summary of the study contract tasks accomplished during that period of review and the key conclusions or observations identified that relate to STV program cost estimates. The STV life cycle costs are estimated on the proprietary parametric cost model (PCM) with inputs organized by a project WBS. Preliminary life cycle schedules are also included.

  4. Ground-Based Telescope Parametric Cost Model

    NASA Technical Reports Server (NTRS)

    Stahl, H. Philip; Rowell, Ginger Holmes

    2004-01-01

    A parametric cost model for ground-based telescopes is developed using multi-variable statistical analysis, The model includes both engineering and performance parameters. While diameter continues to be the dominant cost driver, other significant factors include primary mirror radius of curvature and diffraction limited wavelength. The model includes an explicit factor for primary mirror segmentation and/or duplication (i.e.. multi-telescope phased-array systems). Additionally, single variable models based on aperture diameter are derived. This analysis indicates that recent mirror technology advances have indeed reduced the historical telescope cost curve.

  5. Cost-benefit analysis of administrative license suspensions

    DOT National Transportation Integrated Search

    1991-01-01

    This report summarizes a study of the costs and benefits associated with the implementation of laws calling for the administrative suspension of driver licenses for driving while intoxicated (DWI). Such laws generally call for speedy license suspensi...

  6. Motor vehicle accident or driver suicide? Identifying cases of failed driver suicide in the trauma setting.

    PubMed

    Henderson, Antony F; Joseph, Anthony P

    2012-01-01

    Many authors have suggested that some road traffic crashes are disguised suicide attempts. A case report and literature review is used to explore this claim and to examine the frequency and risk factors associated with driver suicide. The author concludes the methodological difficulty of establishing the driver's intent of suicide accounts for an under-estimation of the frequency of this event and that many cases of driver suicide go unrecognised. Familiarity with the risk factors associated with driver suicide may assist in the identification of cases of failed driver suicide and referral to psychiatric services. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Injury severity analysis of commercially-licensed drivers in single-vehicle crashes: Accounting for unobserved heterogeneity and age group differences.

    PubMed

    Osman, Mohamed; Mishra, Sabyasachee; Paleti, Rajesh

    2018-05-18

    This study analyzes the injury severity of commercially-licensed drivers involved in single-vehicle crashes. Considering the discrete ordinal nature of injury severity data, the ordered response modeling framework was adopted. The moderating effect of driver's age on all other factors was examined by segmenting the parameters by driver's age group. Additional effects of the different drivers' age groups are taken into consideration through interaction terms. Unobserved heterogeneity of the different covariates was investigated using the Mixed Generalized Ordered Response Probit (MGORP) model. The empirical analysis was conducted using four years of the Highway Safety Information System (HSIS) data that included 6247 commercially-licensed drivers involved in single-vehicle crashes in the state of Minnesota. The MGORP model elasticity effects indicate that key factors that increase the likelihood of severe crashes for commercially-licensed drivers across all age groups include: lack of seatbelt usage, collision with a fixed object, speeding, vehicle age of 11 years or more, wind, night time, weekday, and female drivers. Also, the effects of several covariates were found to vary across different age groups. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Canadian drivers' attitudes regarding preventative responses to driving while impaired by alcohol.

    PubMed

    Vanlaar, Ward; Nadeau, Louise; McKiernan, Anna; Hing, Marisela M; Ouimet, Marie Claude; Brown, Thomas G

    2017-09-01

    In many jurisdictions, a risk assessment following a first driving while impaired (DWI) offence is used to guide administrative decision making regarding driver relicensing. Decision error in this process has important consequences for public security on one hand, and the social and economic well being of drivers on the other. Decision theory posits that consideration of the costs and benefits of decision error is needed, and in the public health context, this should include community attitudes. The objective of the present study was to clarify whether Canadians prefer decision error that: i) better protects the public (i.e., false positives); or ii) better protects the offender (i.e., false negatives). A random sample of male and female adult drivers (N=1213) from the five most populated regions of Canada was surveyed on drivers' preference for a protection of the public approach versus a protection of DWI drivers approach in resolving assessment decision error, and the relative value (i.e., value ratio) they imparted to both approaches. The role of region, sex and age on drivers' value ratio were also appraised. Seventy percent of Canadian drivers preferred a protection of the public from DWI approach, with the overall relative ratio given to this preference, compared to the alternative protection of the driver approach, being 3:1. Females expressed a significantly higher value ratio (M=3.4, SD=3.5) than males (M=3.0, SD=3.4), p<0.05. Regression analysis showed that both days of alcohol use in the past 30days (CI for B: -0.07, -0.02) and frequency of driving over legal BAC limits in the past year (CI for B=-0.19, -0.01) were significantly but modestly related to lower value ratios, R 2 (adj.)=0.014, p<0.001. Regional differences were also detected. Canadian drivers strongly favour a protection of the public approach to dealing with uncertainty in assessment, even at the risk of false positives. Accounting for community attitudes concerning DWI prevention and the

  9. Driver behavior analysis for right-turn drivers at signalized intersections using SHRP 2 naturalistic driving study data.

    PubMed

    Wu, Jianqing; Xu, Hao

    2017-12-01

    Understanding driver behavior is important for traffic safety and operation, especially at intersections where different traffic movements conflict. While most driver-behavior studies are based on simulation, this paper documents the analysis of driver-behavior at signalized intersections with the SHRP 2 Naturalistic Driving Study (NDS) data. This study analyzes the different influencing factors on the operation (speed control) and observation of right-turn drivers. A total of 300 NDS trips at six signalized intersections were used, including the NDS time-series sensor data, the forward videos and driver face videos. Different factors of drivers, vehicles, roads and environments were studied for their influence on driver behavior. An influencing index function was developed and the index was calculated for each influencing factor to quantitatively describe its influencing level. The influencing index was applied to prioritize the factors, which facilitates development and selection of safety countermeasures to improve intersection safety. Drivers' speed control was analyzed under different conditions with consideration of the prioritized influencing factors. Vehicle type, traffic signal status, conflicting traffic, conflicting pedestrian and driver age group were identified as the five major influencing factors on driver observation. This research revealed that drivers have high acceleration and low observation frequency under Right-Turn-On-Red (RTOR), which constituted potential danger for other roadway users, especially for pedestrians. As speed has a direct influence on crash rates and severities, the revealed speed patterns of the different situations also benefit selection of safety countermeasures at signalized intersections. Published by Elsevier Ltd.

  10. Experimental Research in Boost Driver with EDLCs

    NASA Astrophysics Data System (ADS)

    Matsumoto, Hirokazu

    The supply used in servo systems tends to have a high voltage in order to reduce loss and improve the response of motor drives. We propose a new boost motor driver that comprises EDLCs. The proposed driver has a simple structure, wherein the EDLCs are connected in series to the supply, and comprises a charge circuit to charge the EDLCs. The proposed driver has three advantages over conventional boost drivers. The first advantage is that the driver can easily attain the stable boost voltage. The second advantage is that the driver can reduce input power peaks. In a servo system, the input power peaks become greater than the rated power in order to accelerate the motor rapidly. This implies that the equipments that supply power to servo systems must have sufficient power capacity to satisfy the power peaks. The proposed driver can suppress the increase of the power capacity of supply facilities. The third advantage is that the driver can store almost all of the regenerative energy. Conventional drivers have a braking resistor to suppress the increase in the DC link voltage. This causes a considerable reduction in the efficiency. The proposed driver is more efficient than conventional drivers. In this study, the experimental results confirmed the effectiveness of the proposed driver and showed that the drive performance of the proposed driver is the same as that of a conventional driver. Furthermore, it was confirmed that the results of the simulation of a model of the EDLC module, whose capacitance is dependent on the frequency, correspond well with the experimental results.

  11. Applications drivers for data parking on the Information Superhighway

    NASA Technical Reports Server (NTRS)

    Johnson, Clark E., Jr.; Foeller, Thomas

    1994-01-01

    As the cost of data storage continues to decline (currently about one-millionth of its cost four decades ago) entirely new applications areas become economically feasible. Many of these new areas involved the extraordinarily high data rates and universal connectivity soon to be provided by the National Information Infrastructure (NII). The commonly held belief is that the main driver for the NII will be entertainment applications. We believe that entertainment applications as currently touted (multi-media, 500 video channels, video-on-demand, etc.) will play an important but far from dominant role in the development of the NII and its data storage components. The most pervasively effective drivers will be medical applications such as telemedicine and remote diagnosis, education and environmental monitoring. These applications have a significant funding base and offer a clearly perceived opportunity to improve the nation's standard of living. The NII's wideband connectivity both nationwide and worldwide requires a broad spectrum of data storage devices with a wide-range of performance capabilities. These storage centers will be dispersed throughout the system. Magnetic recording devices will fill the majority of these new data storage requirements for at least the rest of this century. The storage needs of various application areas and their respective market sizes will be explored. The comparative performance of various magnetic technologies and competitive alternative storage systems will be discussed.

  12. A decision-making framework for total ownership cost management of complex systems: A Delphi study

    NASA Astrophysics Data System (ADS)

    King, Russel J.

    This qualitative study, using a modified Delphi method, was conducted to develop a decision-making framework for the total ownership cost management of complex systems in the aerospace industry. The primary focus of total ownership cost is to look beyond the purchase price when evaluating complex system life cycle alternatives. A thorough literature review and the opinions of a group of qualified experts resulted in a compilation of total ownership cost best practices, cost drivers, key performance factors, applicable assessment methods, practitioner credentials and potential barriers to effective implementation. The expert panel provided responses to the study questions using a 5-point Likert-type scale. Data were analyzed and provided to the panel members for review and discussion with the intent to achieve group consensus. As a result of the study, the experts agreed that a total ownership cost analysis should (a) be as simple as possible using historical data; (b) establish cost targets, metrics, and penalties early in the program; (c) monitor the targets throughout the product lifecycle and revise them as applicable historical data becomes available; and (d) directly link total ownership cost elements with other success factors during program development. The resultant study framework provides the business leader with incentives and methods to develop and implement strategies for controlling and reducing total ownership cost over the entire product life cycle when balancing cost, schedule, and performance decisions.

  13. Online driver's license renewal.

    DOT National Transportation Integrated Search

    2015-09-01

    The Kentucky Department of Vehicle Regulation is exploring the possibility of developing and implementing online : drivers license renewal. The objective of this project was to: 1) evaluate online drivers license and REAL ID renewal : programs ...

  14. Taxi 'sugar daddies' and taxi queens: male taxi driver attitudes regarding transactional relationships in the Western Cape, South Africa.

    PubMed

    Potgieter, Cheryl; Strebel, Anna; Shefer, Tamara; Wagner, Claire

    2012-11-01

    Media reports are emerging on the phenomenon of young girls who travel with older mini-bus taxi drivers, and who are thought to have sex with the drivers in exchange for gifts and money. The extent to which such relationships might facilitate unsafe sexual practices and increased risks for both the men and the young women, often referred to as taxi queens, remains an important question in the light of the current challenges of HIV/AIDS in sub-Saharan Africa. However, very little research has been undertaken on this issue, especially regarding the perceptions and experiences of taxi drivers. Thus this paper aims to provide some preliminary findings on taxi drivers' attitudes and beliefs about taxi queens and their relationships with taxi drivers. A 22-item questionnaire was administered to 223 male taxi drivers in two regions in the Western Cape Province, South Africa. Taxi drivers in this study largely saw the relationship between taxi drivers and the young girls who ride with them as providing status for both the girls and drivers, and there seemed to be recognition of the transactional nature of the relationship between taxi drivers and taxi queens. The stigmatisation of young girls who ride with taxi drivers was evident. Drivers had knowledge and awareness of the risks of unsafe sex and supported condom use, although there appeared to be some uncertainty and confusion about the likelihood of HIV infection between drivers and girls. While taxi drivers recognised the role of alcohol in relationships with young girls, they seemed to deny that the abuse of drugs was common. The study highlights a number of key areas that need to be explored with men in the taxi industry, in order to address risk behaviours for both taxi drivers and the girls who ride with them.

  15. Research requirements to reduce civil helicopter life cycle cost

    NASA Technical Reports Server (NTRS)

    Blewitt, S. J.

    1978-01-01

    The problem of the high cost of helicopter development, production, operation, and maintenance is defined and the cost drivers are identified. Helicopter life cycle costs would decrease by about 17 percent if currently available technology were applied. With advanced technology, a reduction of about 30 percent in helicopter life cycle costs is projected. Technological and managerial deficiencies which contribute to high costs are examined, basic research and development projects which can reduce costs include methods for reduced fuel consumption; improved turbine engines; airframe and engine production methods; safety; rotor systems; and advanced transmission systems.

  16. The effect of the learner license Graduated Driver Licensing components on teen drivers' crashes.

    PubMed

    Ehsani, Johnathon Pouya; Bingham, C Raymond; Shope, Jean T

    2013-10-01

    Most studies evaluating the effectiveness of Graduated Driver Licensing (GDL) have focused on the overall system. Studies examining individual components have rarely accounted for the confounding of multiple, simultaneously implemented components. The purpose of this paper is to quantify the effects of a required learner license duration and required hours of supervised driving on teen driver fatal crashes. States that introduced a single GDL component independent of any other during the period 1990-2009 were identified. Monthly and quarterly fatal crash rates per 100,000 population of 16- and 17-year-old drivers were analyzed using single-state time series analysis, adjusting for adult crash rates and gasoline prices. Using the parameter estimates from each state's time series model, the pooled effect of each GDL component on 16- and 17-year-old drivers' fatal crashes was estimated using a random effects meta-analytic model to combine findings across states. In three states, a six-month minimum learner license duration was associated with a significant decline in combined 16- and 17-year-old drivers' fatal crash rates. The pooled effect of the minimum learner license duration across all states in the sample was associated with a significant change in combined 16- and 17-year-old driver fatal crash rates of -.07 (95% Confidence Interval [CI] -.11, -.03). Following the introduction of 30 h of required supervised driving in one state, novice drivers' fatal crash rates increased 35%. The pooled effect across all states in the study sample of having a supervised driving hour requirement was not significantly different from zero (.04, 95% CI -.15, .22). These findings suggest that a learner license duration of at least six-months may be necessary to achieve a significant decline in teen drivers' fatal crash rates. Evidence of the effect of required hours of supervised driving on teen drivers' fatal crash rates was mixed. Copyright © 2013 Elsevier Ltd. All rights

  17. Flexibility: The Key to Cutting Energy Costs.

    ERIC Educational Resources Information Center

    Stern, Joanne

    This speech provides concrete ways for school districts to save on energy costs, based on the general concept of flexibility in energy systems. These methods have been successfully implemented in the Salem (Oregon) school district. The first idea is to set up a weekly, rather than annual, bidding system to increase fuel price options. This…

  18. Evaluating Older Drivers' Skills

    DOT National Transportation Integrated Search

    2013-05-01

    Research has demonstrated that older drivers pose a higher risk of involvement in fatal crashes at intersections than : younger drivers. Age-triggered restrictions are problematic as research shows that the majority of older people : have unimpaired ...

  19. Model driver screening and evaluation program. Volume 2, Maryland pilot older driver study

    DOT National Transportation Integrated Search

    2003-05-01

    This research project studied the feasibility as well as the scientific validity and utility of performing functional capacity screening with older drivers. A Model Program was described encompassing procedures to detect functionally impaired drivers...

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

    PubMed

    Jericó, Marli de Carvalho; Castilho, Valéria

    2010-09-01

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

  1. Lowest cost due to highest productivity and highest quality

    NASA Astrophysics Data System (ADS)

    Wenk, Daniel

    2003-03-01

    Since global purchasing in the automotive industry has been taken up all around the world there is one main key factor that makes a TB-supplier today successful: Producing highest quality at lowest cost. The fact that Tailored Blanks, which today may reach up to 1/3 of a car body weight, are purchased on the free market but from different steel suppliers, especially in Europe and NAFTA, the philosophy on OEM side has been changing gradually towards tough evaluation criteria. "No risk at the stamping side" calls for top quality Tailored- or Tubular Blank products. Outsourcing Tailored Blanks has been starting in Japan but up to now without any quality request from the OEM side like ISO 13919-1B (welding quality standard in Europe and USA). Increased competition will automatically push the quality level and the ongoing approach to combine high strength steel with Tailored- and Tubular Blanks will ask for even more reliable system concepts which enables to weld narrow seams at highest speed. Beside producing quality, which is the key to reduce one of the most important cost driver "material scrap," in-line quality systems with true and reliable evaluation is going to be a "must" on all weld systems. Traceability of all process related data submitted to interfaces according to customer request in combination with ghost-shift-operation of TB systems are tomorrow's state-of-the-art solutions of Tailored Blank-facilities.

  2. Stakeholder perspectives on managing the occupational health of UK business drivers: a qualitative approach.

    PubMed

    Sang, Katherine J C; Gyi, Diane E; Haslam, Cheryl O

    2011-03-01

    Musculoskeletal disorders are one of the leading causes of work related ill health and sickness absence. Those who drive as part of their job may be at particular risk, with evidence suggesting that prolonged exposure to driving is associated with increased absence from work due to low back pain. Business drivers often work away from a traditional office environment. Such mobile working may pose greater risks to occupational health due to increased ergonomic risks, for example working from the car, longer working hours and a lack of concern amongst drivers about health and safety. It has been suggested that occupational health practices have not adapted to meet the needs of peripatetic workers. The current study explored how occupational health services are delivered to business drivers. Semi-structured interviews were carried out with a sample of 31 stakeholders in 4 organisations. Respondents included, health and safety professionals, occupational health nurses, fleet managers and high mileage business drivers. The interviews were transcribed and analysed using 'Template Analysis'. The data revealed that, within these organisations, the provision of occupational health services was often fragmented and drivers and other key stakeholders were often unaware of the existing systems within their organisations. The peripatetic nature of business drivers meant that they were difficult for occupational health teams to reach. The paper concludes by presenting recommendations for occupational health professionals and researchers engaged with improving the health of peripatetic workers, namely that occupational health policies should be integrated in company strategy and widely disseminated to drivers and those with responsibility for managing their occupational health provision. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  3. The Effects of Vehicle Redesign on the Risk of Driver Death.

    PubMed

    Farmer, Charles M; Lund, Adrian K

    2015-01-01

    fatality risk had declined 61% from its high in 1988, and SUV risk had declined 79% from its high in 1988. The risk of driver death in 2009 model passenger vehicles was 8% lower than that in 2008 models and about half that in 1984 models. Changes in vehicles, whether from government regulations and consumer testing that led to advanced safety designs or from other factors such as consumer demand for different sizes and types of vehicles, have been key contributors to the decline in U.S. motor vehicle occupant crash death rates since the mid-1990s. Since the early 1990s, environmental and behavioral risk factors have not shown similar improvement, until the recession of 2007, even though there are many empirically proven countermeasures that have been inadequately applied.

  4. Toward best practice in Human Machine Interface design for older drivers: A review of current design guidelines.

    PubMed

    Young, K L; Koppel, S; Charlton, J L

    2017-09-01

    Older adults are the fastest growing segment of the driving population. While there is a strong emphasis for older people to maintain their mobility, the safety of older drivers is a serious community concern. Frailty and declines in a range of age-related sensory, cognitive, and physical impairments can place older drivers at an increased risk of crash-related injuries and death. A number of studies have indicated that in-vehicle technologies such as Advanced Driver Assistance Systems (ADAS) and In-Vehicle Information Systems (IVIS) may provide assistance to older drivers. However, these technologies will only benefit older drivers if their design is congruent with the complex needs and diverse abilities of this driving cohort. The design of ADAS and IVIS is largely informed by automotive Human Machine Interface (HMI) guidelines. However, it is unclear to what extent the declining sensory, cognitive and physical capabilities of older drivers are addressed in the current guidelines. This paper provides a review of key current design guidelines for IVIS and ADAS with respect to the extent they address age-related changes in functional capacities. The review revealed that most of the HMI guidelines do not address design issues related to older driver impairments. In fact, in many guidelines driver age and sensory cognitive and physical impairments are not mentioned at all and where reference is made, it is typically very broad. Prescriptive advice on how to actually design a system so that it addresses the needs and limitations of older drivers is not provided. In order for older drivers to reap the full benefits that in-vehicle technology can afford, it is critical that further work establish how older driver limitations and capabilities can be supported by the system design process, including their inclusion into HMI design guidelines. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Mass driver reaction engine characteristics and performance in earth orbital transfer missions

    NASA Technical Reports Server (NTRS)

    Snow, W. R.; Dunbar, R. S.

    1982-01-01

    Configurations of a typical mass driver reaction engine (MDRE) are presented and its use for delivery of payloads to geosynchronous orbit (GEO) from low earth orbit (LEO) is discussed. Basic rocket equations are developed for LEO to GEO round-trip missions using a single exhaust velocity. It is shown that exhaust velocities in the 5-10 km/sec range (specific impulse of 500-1000 sec) are well suited for mass drivers, minimizing the overall cost of missions. Payload delivery rate fractions show that there is little to be gained by stretching out LEO to GEO transfer times from 90 to 180 days. It therefore pays to use the shorter trip time, approximately doubling the amount of delivered payload during any fixed time of use of the MDRE.

  6. Development of high precision digital driver of acoustic-optical frequency shifter for ROG

    NASA Astrophysics Data System (ADS)

    Zhang, Rong; Kong, Mei; Xu, Yameng

    2016-10-01

    We develop a high precision digital driver of the acoustic-optical frequency shifter (AOFS) based on the parallel direct digital synthesizer (DDS) technology. We use an atomic clock as the phase-locked loop (PLL) reference clock, and the PLL is realized by a dual digital phase-locked loop. A DDS sampling clock up to 320 MHz with a frequency stability as low as 10-12 Hz is obtained. By constructing the RF signal measurement system, it is measured that the frequency output range of the AOFS-driver is 52-58 MHz, the center frequency of the band-pass filter is 55 MHz, the ripple in the band is less than 1 dB@3MHz, the single channel output power is up to 0.3 W, the frequency stability is 1 ppb (1 hour duration), and the frequency-shift precision is 0.1 Hz. The obtained frequency stability has two orders of improvement compared to that of the analog AOFS-drivers. For the designed binary frequency shift keying (2-FSK) and binary phase shift keying (2-PSK) modulation system, the demodulating frequency of the input TTL synchronous level signal is up to 10 kHz. The designed digital-bus coding/decoding system is compatible with many conventional digital bus protocols. It can interface with the ROG signal detecting software through the integrated drive electronics (IDE) and exchange data with the two DDS frequency-shift channels through the signal detecting software.

  7. Peer influence predicts speeding prevalence among teenage drivers.

    PubMed

    Simons-Morton, Bruce G; Ouimet, Marie Claude; Chen, Rusan; Klauer, Sheila G; Lee, Suzanne E; Wang, Jing; Dingus, Thomas A

    2012-12-01

    Preventing speed-related crashes could reduce costs and improve efficiency in the transportation industry. This research examined the psychosocial and personality predictors of observed speeding among young drivers. Survey and driving data were collected from 42 newly-licensed teenage drivers during the first 18months of licensure. Speeding (i.e., driving 10mph over the speed limit; about 16km/h) was assessed by comparing speed data collected with recording systems installed in participants' vehicles with posted speed limits. Speeding was correlated with elevated g-force event rates (r=0.335, pb0.05), increased over time, and predicted by day vs. night trips, higher sensation seeking, substance use, tolerance of deviance, susceptibility to peer pressure, and number of risky friends. Perceived risk was a significant mediator of the association between speeding and risky friends. The findings support the contention that social norms may influence teenage speeding behavior and this relationship may operate through perceived risk. Copyright © 2012 National Safety Council and Elsevier Ltd. All rights reserved.

  8. Mass drivers. 3: Engineering

    NASA Technical Reports Server (NTRS)

    Arnold, W.; Bowen, S.; Cohen, S.; Fine, K.; Kaplan, D.; Kolm, M.; Kolm, H.; Newman, J.; Oneill, G. K.; Snow, W.

    1979-01-01

    The last of a series of three papers by the Mass-Driver Group of the 1977 Ames Summer Study is presented. It develops the engineering principles required to implement the basic mass-driver. Optimum component mass trade-offs are derived from a set of four input parameters, and the program used to design a lunar launcher. The mass optimization procedures is then incorporated into a more comprehensive mission optimization program called OPT-4, which evaluates an optimized mass-driver reaction engine and its performance in a range of specified missions. Finally, this paper discusses, to the extent that time permitted, certain peripheral problems: heating effects in buckets due to magnetic field ripple; an approximate derivation of guide force profiles; the mechanics of inserting and releasing payloads; the reaction mass orbits; and a proposed research and development plan for implementing mass drivers.

  9. Seniors' prescription drug cost inflation and cost containment: evidence from British Columbia.

    PubMed

    Morgan, Steven G; Agnew, Jonathan D; Barer, Morris L

    2004-06-01

    We develop an analytic framework to map out the nature and relative importance of different cost-driving trends in the prescription drug market. This is used to measure prescription drug cost-drivers for the population of seniors in British Columbia during a period when they received comprehensive public drug coverage. Between 1991 and 2001, expenditures on prescription drugs for BC seniors increased from dollar 149 to 320 million. Increases in the population of seniors, and the rate at which they utilized therapies contributed under half of the total cost increase over the period. Changes in the mix of therapies and the type of product selected explained over half of the observed drug expenditure inflation. Increased generic substitution significantly reduced the price of products selected over the period.

  10. Trends and drivers of fire activity vary across California aridland ecosystems

    USGS Publications Warehouse

    Syphard, Alexandra D.; Keeley, Jon E.; Abatzoglou, John T.

    2017-01-01

    Fire activity has increased in western US aridland ecosystems due to increased human-caused ignitions and the expansion of flammable exotic grasses. Because many desert plants are not adapted to fire, increased fire activity may have long-lasting ecological impacts on native vegetation and the wildlife that depend on it. Given the heterogeneity across aridland ecosystems, it is important to understand how trends and drivers of fire vary, so management can be customized accordingly. We examined historical trends and quantified the relative importance of and interactions among multiple drivers of fire patterns across five aridland ecoregions in southeastern California from 1970 to 2010. Fire frequency increased across all ecoregions for the first couple decades, and declined or plateaued since the 1990s; but area burned continued to increase in some regions. The relative importance of anthropogenic and biophysical drivers varied across ecoregions, with both direct and indirect influences on fire. Anthropogenic variables were equally important as biophysical variables, but some contributed indirectly, presumably via their influence on annual grass distribution and abundance. Grass burned disproportionately more than other cover types, suggesting that addressing exotics may be the key to fire management and conservation in much of the area.

  11. Graduated driver licensing for reducing motor vehicle crashes among young drivers.

    PubMed

    Hartling, L; Wiebe, N; Russell, K; Petruk, J; Spinola, C; Klassen, T P

    2004-01-01

    Graduated driver licensing (GDL) has been proposed as a means of reducing crash rates among novice drivers by gradually introducing them to higher risk driving situations. To examine the effectiveness of GDL systems in reducing crash rates of young drivers. Studies were identified through searches of MEDLINE, EMBASE, CINAHL, Healthstar, Web of Science, NTIS Bibliographic Database, TRIS Online, SIGLE, the World Wide Web, relevant conference proceedings, consultation with experts and authors, and reference lists. The search was not restricted by language or publication status. Studies were included if: 1) they compared outcomes pre- and post-implementation of a GDL program within the same jurisdiction, 2) comparisons were made between jurisdictions with and without GDL, or 3) both. Studies had to report at least one objective, quantified outcome. Two reviewers independently screened searches and assessed the full text of potentially relevant studies for inclusion using a standard form. Data were extracted by one reviewer and checked by a second. Additional data were requested from authors. Results were not pooled due to substantial heterogeneity between studies. Percentage change was calculated for each year after the intervention, using one year prior to the intervention as the baseline rate. Results were adjusted by internal controls. Analyses were stratified by different denominators (population, licensed drivers). Results were calculated for the different crash types (overall, injury, fatal, night-time, alcohol, and those resulting in hospitalization). Results were presented for 16 year-olds alone and all teenage drivers combined. We included 13 studies evaluating 12 GDL programs that were implemented between 1979 and 1998 in the US (n=7), Canada (3), New Zealand (1), and Australia (1). Programs varied in their restrictions during the intermediate stage: e.g. night curfews (8); limitations of extra passengers (2); roadway restrictions (1). Based on the Insurance

  12. Transcending as a driver of development.

    PubMed

    Travis, Frederick

    2016-06-01

    This paper draws from three different bodies of research to discuss the hypothesis that age-appropriate experiences enhance brain and cognitive development throughout the life span. These age-appropriate experiences could be considered as the drivers of development at each age, including drivers to foster development beyond adult abstract thinking, as described in Piaget's formal operational stage. We explore how a nurturing caregiver is the driver in the first 2 years of life, how language learning is the driver from 3 to 10 years, and how problem solving is the driver in the teenage years. To develop beyond adult rational thinking, we suggest that the driver is transcending thought, which can result when practicing meditations in the automatic self-transcending category, such as Transcendental Meditation. © 2016 New York Academy of Sciences.

  13. Bevel gear driver and method having torque limit selection

    NASA Technical Reports Server (NTRS)

    Cook, Joseph S., Jr. (Inventor)

    1994-01-01

    This invention comprises a torque drive mechanism utilizing axially translatable, mutually engageable transmission members having mating crown gears, driven and driving members with a three-element drive train being biased together by resilient means or by a fluid actuator system, the apparatus being operable to transmit a precisely controlled degree of torque to a driven member. The apparatus is applicable for use in hand tools and as a replacement for impact torque drivers, torque wrenches, motorized screw drivers, or the like, wherein the applied torque must be precisely controlled or limited. The bevel torque drive includes a drive gear which is axially displaceable and rotatable within cylindrical driver housing, a rotatable intermediate gear, and an output gear. Key rotationally secures displaceable gear with respect to input shaft but permits axial movement therebetween. A thrust bearing is preferably connected to the lower end of shaft for support to reduce play and friction between shaft and a transmission joint disc during rotation of the gear train. Coaxially mounted coiled spring is footed against displaceable gear for biasing the displaceable gear toward and into engagement with the intermediate gear for driving intermediate gear and output gear. Torque control is achieved by the use of straight or spiral beveled gears which are of configurations adapted to withdraw from mutual engagement upon the torque exceeding a predetermined limit. The novel, advantageous features of the invention include the configuration of the mating, crown gear sets and the axially translatable, slidable drive gear. The mechanism is capable of transmitting a high degree of torque within a narrow, compact transmission housing. The compact size and narrow, elongated configuration of the housing is particularly applicable for use in hand tools and in multiple torque driver mechanisms in which it is necessary to drive multiple fasteners which are located in close proximity. Prior

  14. The impact of specialty pharmaceuticals as drivers of health care costs.

    PubMed

    Hirsch, Bradford R; Balu, Suresh; Schulman, Kevin A

    2014-10-01

    The pharmaceutical industry is shifting its focus from blockbuster small molecules to specialty pharmaceuticals. Specialty pharmaceuticals are novel drugs and biologic agents that require special handling and ongoing monitoring, are administered by injection or infusion, and are sold in the marketplace by a small number of distributors. They are frequently identified by having a cost to payers and patients of $600 or more per treatment. The total costs of the new agents are likely to have a substantial impact on overall health care costs and on patients during the next decade, unless steps are taken to align competing interests. We examine the economic and policy issues related to specialty pharmaceuticals, taking care to consider the impact on patients. We assess the role of cost-sharing provisions, legislation that is promoting realignment within the market, the role of biosimilars in price competition, and the potential for novel drug development paradigms to help bend the cost curve. The economic aspects of this analysis highlight the need for a far-reaching discussion of potential novel approaches to innovation pathways in our quest for both affordability and new technology. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Overweight and obesity on the island of Ireland: an estimation of costs.

    PubMed

    Dee, Anne; Callinan, Aoife; Doherty, Edel; O'Neill, Ciaran; McVeigh, Treasa; Sweeney, Mary Rose; Staines, Anthony; Kearns, Karen; Fitzgerald, Sarah; Sharp, Linda; Kee, Frank; Hughes, John; Balanda, Kevin; Perry, Ivan J

    2015-03-16

    The increasing prevalence of overweight and obesity worldwide continues to compromise population health and creates a wider societal cost in terms of productivity loss and premature mortality. Despite extensive international literature on the cost of overweight and obesity, findings are inconsistent between Europe and the USA, and particularly within Europe. Studies vary on issues of focus, specific costs and methods. This study aims to estimate the healthcare and productivity costs of overweight and obesity for the island of Ireland in 2009, using both top-down and bottom-up approaches. Costs were estimated across four categories: healthcare utilisation, drug costs, work absenteeism and premature mortality. Healthcare costs were estimated using Population Attributable Fractions (PAFs). PAFs were applied to national cost data for hospital care and drug prescribing. PAFs were also applied to social welfare and national mortality data to estimate productivity costs due to absenteeism and premature mortality. The healthcare costs of overweight and obesity in 2009 were estimated at €437 million for the Republic of Ireland (ROI) and €127.41 million for NI. Productivity loss due to overweight and obesity was up to €865 million for ROI and €362 million for NI. The main drivers of healthcare costs are cardiovascular disease, type II diabetes, colon cancer, stroke and gallbladder disease. In terms of absenteeism, low back pain is the main driver in both jurisdictions, and for productivity loss due to premature mortality the primary driver of cost is coronary heart disease. The costs are substantial, and urgent public health action is required in Ireland to address the problem of increasing prevalence of overweight and obesity, which if left unchecked will lead to unsustainable cost escalation within the health service and unacceptable societal costs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

  16. Impact of graduated driver licensing restrictions on crashes involving young drivers in New Zealand

    PubMed Central

    Begg, D; Stephenson, S; Alsop, J; Langley, J

    2001-01-01

    Objective—To determine the impact on young driver crashes of the three main driving restrictions in the New Zealand graduated driver licensing (GDL) system: night-time curfew, no carrying of young passengers, and a blood alcohol limit of 30 mg/100 ml. Method—The database for this study was created by linking police crash reports to hospital inpatient records (1980–95). Multivariate logistic regression was used to compare car crashes involving a young driver licensed before GDL (n=2252) with those who held a restricted graduated licence (n=980) and with those who held a full graduated licence (n=1273), for each of the main driving restrictions. Results—Compared with the pre-GDL group, the restricted licence drivers had fewer crashes at night (p=0.003), fewer involving passengers of all ages (p=0.018), and fewer where alcohol was suspected (p=0.034), but not fewer involving young casualties (p=0.980). Compared with the pre-GDL drivers, those with the full graduated licence had fewer night crashes (p=0.042) but did not differ significantly for any of the other factors examined. Conclusion—These results suggest that some of the GDL restrictions, especially the night-time curfew, have contributed to a reduction in serious crashes involving young drivers. PMID:11770654

  17. Impact of graduated driver licensing restrictions on crashes involving young drivers in New Zealand.

    PubMed

    Begg, D J; Stephenson, S; Alsop, J; Langley, J

    2001-12-01

    To determine the impact on young driver crashes of the three main driving restrictions in the New Zealand graduated driver licensing (GDL) system: night-time curfew, no carrying of young passengers, and a blood alcohol limit of 30 mg/100 ml. The database for this study was created by linking police crash reports to hospital inpatient records (1980-95). Multivariate logistic regression was used to compare car crashes involving a young driver licensed before GDL (n=2,252) with those who held a restricted graduated licence (n=980) and with those who held a full graduated licence (n=1,273), for each of the main driving restrictions. Compared with the pre-GDL group, the restricted licence drivers had fewer crashes at night (p=0.003), fewer involving passengers of all ages (p=0.018), and fewer where alcohol was suspected (p=0.034), but not fewer involving young casualties (p=0.980). Compared with the pre-GDL drivers, those with the full graduated licence had fewer night crashes (p=0.042) but did not differ significantly for any of the other factors examined. These results suggest that some of the GDL restrictions, especially the night-time curfew, have contributed to a reduction in serious crashes involving young drivers.

  18. The relationship of alcohol safety laws to drinking drivers in fatal crashes.

    PubMed

    Voas, R B; Tippetts, A S; Fell, J

    2000-07-01

    This paper presents an analysis of the relationships between the passage of key alcohol safety laws and the number of drinking drivers in fatal crashes. The study evaluated three major alcohol safety laws--administrative license revocation laws, 0.10 illegal per se, and 0.08 illegal per se laws--on the proportion of drinking drivers in fatal crashes. Drivers aged 21 and older in fatal crashes at two BAC levels--0.01-0.09 and 0.10 or greater--were considered separately. Drivers under age 21 were not included because they are affected by the Minimum Legal Drinking Age (MLDA) law. This study used data on drinking drivers in fatal crashes from the Fatality Analysis Reporting System (FARS) covering 16 years (1982-1997) for all 50 states and the District of Columbia. Also included in the study were such variables as per capita alcohol consumption and annual vehicle miles traveled (VMT), which could affect the number of alcohol-related crashes. The results indicate that each of the three laws had a significant relationship to the downward trend in alcohol-related fatal crashes in the United States over that period. This paper points out that this long-term trend is not the product of a single law. Instead, it is the result of the growing impact of several laws over time plus the affect of some factors not included in the model tested (such as the increasing use of sobriety checkpoints and the media's attention to the drinking-and-driving problem).

  19. Drunk Driver Testing

    NASA Technical Reports Server (NTRS)

    1984-01-01

    Systems Technology, Inc. developed a technique to study/measure behavioral changes brought on by long term isolation is now being used in a system for determining whether a driver is too drunk to drive. Device is intended to discourage intoxicated drivers from taking to the road by advising them they are in no condition to operate a vehicle. System is being tested experimentally in California.

  20. Scoping the parameter space for demo and the engineering test facility (ETF)

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

    Meier, Wayne R.

    1999-01-19

    In our IFE development plan, we have set a goal of building an Engineering Test Facility (ETF) for a total cost of $2B and a Demo for $3B. In Mike Campbell' s presentation at Madison, we included a viewgraph with an example Demo that had 80 to 250 MWe of net power and showed a plausible argument that it could cost less than $3B. In this memo, I examine the design space for the Demo and then briefly for the ETF. Instead of attempting to estimate the costs of the drivers, I pose the question in a way to definemore » R&D goals: As a function of key design and performance parameters, how much can the driver cost if the total facility cost is limited to the specified goal? The design parameters examined for the Demo included target gain, driver energy, driver efficiency, and net power output. For the ETF; the design parameters are target gain, driver energy, and target yield. The resulting graphs of allowable driver cost determine the goals that the driver R&D programs must seek to meet.« less

  1. Consistent Condom Use during Casual Sex among Long-Truck Drivers in Togo

    PubMed Central

    Yaya, Issifou; Landoh, Dadja Essoya; Saka, Bayaki; Vignikin, Kokou; Aboubakari, Abdoul-Samadou; N’dri, Kouamé Mathias; Gbetoglo, Kodjo Dodji; Edorh, Atavi-Mensah; Ahlegnan, Komla; Yenkey, Holali Comlan; Toudeka, Ayawavi Sitsopé; Pitché, Palokinam

    2016-01-01

    Background In 2008, the proportion of truck drivers who were not systematically protected during sex was 63% with casual partners and 60% with sex workers. Despite the high level of knowledge on HIV/AIDS and the growing awareness of the existence of the risk of HIV infection, condom use always encounters resistance among truck drivers in Togo. We sought to document the factors associated with condom use during casual sex among trucks’ drivers in Togo. Methods This was an analytical cross-sectional study conducted in 2010 and targeted truckers at truck station on the two main roads of Togo, Lomé-Cinkassé and Kodjoviakopé-Sanvee Condji. Results In this study, 1,782 trucks’ drivers and their helpers were interviewed. All were men, and their mean age was 28.8 ± 8.8 years. Trucks’ drivers were doing an average of 3 stops on their journeys and 1,229 (69%) of them had at least two years of experience in the work. Of the 1,782 trucks’ drivers, only 620 (34.8%) had consistently used condoms during casual sex in the last three months. In multivariate analysis, predictors were: education level (primary schooling: OR = 1.54; p = 0.002; Secondary schooling and higher OR = 1.38; p = 0.036), good knowledge of ways of HIV transmission (OR = 1.53; p = 0.000), tested for HIV (OR = 1.67, p = 0.000), duration in the profession (2–5 years: OR = 1.43, p = 0.008; more than 5 years: OR = 1.38, p = 0.027), and HIV risk’s perception (OR = 1.44, p = 0.000). Conclusion These results highlight factors associated with consistent condom use during casual sex by truck drivers in Togo. This is a key population group at high risk of HIV transmission toward which the national HIV/AIDS control program should strengthen the HIV prevention strategies. PMID:27071059

  2. From cheetahs to chimpanzees: a comparative review of the drivers of human-carnivore conflict and human-primate conflict.

    PubMed

    Dickman, Amy J

    2012-01-01

    Human-wildlife conflict is a growing conservation threat, and is increasingly of importance to primate conservationists. Despite this, relatively little work has been done to date on the drivers of human-primate conflict, especially compared to other conflict-causing taxa such as large carnivores. However, the drivers of conflict are often very similar across species, so conflict researchers can learn important lessons from work conducted on other taxa. This paper discusses 8 key factors which are likely to affect how hostile people are towards wildlife and any damage they cause--6 of these are common to both carnivores and primates, while one is much more applicable to carnivores and the other is specific to primates. These conflict drivers involve numerous social and cultural factors, and highlight the importance of truly understanding the local drivers of conflict in order to develop effective mitigation strategies. Copyright © 2013 S. Karger AG, Basel.

  3. Real-time eye tracking for the assessment of driver fatigue.

    PubMed

    Xu, Junli; Min, Jianliang; Hu, Jianfeng

    2018-04-01

    Eye-tracking is an important approach to collect evidence regarding some participants' driving fatigue. In this contribution, the authors present a non-intrusive system for evaluating driver fatigue by tracking eye movement behaviours. A real-time eye-tracker was used to monitor participants' eye state for collecting eye-movement data. These data are useful to get insights into assessing participants' fatigue state during monotonous driving. Ten healthy subjects performed continuous simulated driving for 1-2 h with eye state monitoring on a driving simulator in this study, and these measured features of the fixation time and the pupil area were recorded via using eye movement tracking device. For achieving a good cost-performance ratio and fast computation time, the fuzzy K -nearest neighbour was employed to evaluate and analyse the influence of different participants on the variations in the fixation duration and pupil area of drivers. The findings of this study indicated that there are significant differences in domain value distribution of the pupil area under the condition with normal and fatigue driving state. Result also suggests that the recognition accuracy by jackknife validation reaches to about 89% in average, implying that show a significant potential of real-time applicability of the proposed approach and is capable of detecting driver fatigue.

  4. Real-time eye tracking for the assessment of driver fatigue

    PubMed Central

    Xu, Junli; Min, Jianliang

    2018-01-01

    Eye-tracking is an important approach to collect evidence regarding some participants’ driving fatigue. In this contribution, the authors present a non-intrusive system for evaluating driver fatigue by tracking eye movement behaviours. A real-time eye-tracker was used to monitor participants’ eye state for collecting eye-movement data. These data are useful to get insights into assessing participants’ fatigue state during monotonous driving. Ten healthy subjects performed continuous simulated driving for 1–2 h with eye state monitoring on a driving simulator in this study, and these measured features of the fixation time and the pupil area were recorded via using eye movement tracking device. For achieving a good cost-performance ratio and fast computation time, the fuzzy K-nearest neighbour was employed to evaluate and analyse the influence of different participants on the variations in the fixation duration and pupil area of drivers. The findings of this study indicated that there are significant differences in domain value distribution of the pupil area under the condition with normal and fatigue driving state. Result also suggests that the recognition accuracy by jackknife validation reaches to about 89% in average, implying that show a significant potential of real-time applicability of the proposed approach and is capable of detecting driver fatigue. PMID:29750113

  5. 2015 Cost of Wind Energy Review

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

    Moné, Christopher; Hand, Maureen; Bolinger, Mark

    This report uses representative utility-scale projects to estimate the levelized cost of energy (LCOE) for land-based and offshore wind plants in the United States. Data and results detailed here are derived from 2015 commissioned plants. More specifically, analysis detailed here relies on recent market data and state-of-the-art modeling capabilities to maintain an up-to-date understanding of wind energy cost trends and drivers. It is intended to provide insight into current component-level costs as well as a basis for understanding variability in LCOE across the industry. This publication reflects the fifth installment of this annual report.

  6. Low-cost safety measures at signalized intersections.

    DOT National Transportation Integrated Search

    2008-05-01

    The objectives of this study were to: a) identify intersections with a high number of crashes involving a driver disregarding the traffic signal, b) identify types of low-cost safety measures which may be used as a countermeasure for red light runnin...

  7. Variable cost of ICU care, a micro-costing analysis.

    PubMed

    Karabatsou, Dimitra; Tsironi, Maria; Tsigou, Evdoxia; Boutzouka, Eleni; Katsoulas, Theodoros; Baltopoulos, George

    2016-08-01

    Intensive care unit (ICU) costs account for a great part of a hospital's expenses. The objective of the present study was to measure the patient-specific cost of ICU treatment, to identify the most important cost drivers in ICU and to examine the role of various contributing factors in cost configuration. A retrospective cost analysis of all ICU patients who were admitted during 2011 in a Greek General, seven-bed ICU and stayed for at least 24hours was performed, by applying bottom-up analysis. Data collected included demographics and the exact cost of every single material used for patients' care. Prices were yielded from the hospital's purchasing costs and from the national price list of the imaging and laboratory tests, which was provided by the Ministry of Health. A total of 138 patients were included. Variable cost per ICU day was €573.18. A substantial cost variation was found in the total costs obtained for individual patients (median: €3443, range: €243.70-€116,355). Medicines were responsible for more than half of the cost and antibiotics accounted for the largest part of it, followed by blood products and cardiovascular drugs. Medical cause of admission, severe illness and increased length of stay, mechanical ventilation and dialysis were the factors associated with cost escalation. ICU variable cost is patient-specific, varies according to each patient's needs and is influenced by several factors. The exact estimation of variable cost is a pre-requisite in order to control ICU expenses. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Drivers within natural drinking groups: an exploration of role selection, motivation, and group influence on driver sobriety.

    PubMed

    Lange, James E; Johnson, Mark B; Reed, Mark B

    2006-01-01

    Young people consume alcohol almost exclusively in social contexts, but natural drinking group dynamics are poorly understood. Our research focuses on the drivers' role within natural drinking groups. We conducted breath-test surveys of existing groups of young people at the US/Mexico border crossing before they headed to Tijuana bars, and surveyed them again upon their return. Results indicated an individual's perception of other group member's drinking plans predicts drinking intentions to a greater degree for passengers than drivers. Additionally, drivers who anticipated heavy drinking among other group members returned to the United States with BACs nearly identical to drivers who reported that other group members would not drink at all. This suggests drivers were resistant to normative pressures to drink. Evidence that group-dynamic variables may impact drinking behavior underscores the importance of systematic exploration of natural drinking groups. Furthermore, the knowledge gleaned from studying the dynamics and decision making processes of natural drinking groups could be used to design intervention designed to increase designated driver use and to reduce drinking among designated drivers.

  9. The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia.

    PubMed

    Terris-Prestholt, Fern; Vickerman, Peter; Torres-Rueda, Sergio; Santesso, Nancy; Sweeney, Sedona; Mallma, Patricia; Shelley, Katharine D; Garcia, Patricia J; Bronzan, Rachel; Gill, Michelle M; Broutet, Nathalie; Wi, Teodora; Watts, Charlotte; Mabey, David; Peeling, Rosanna W; Newman, Lori

    2015-06-01

    Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. Although this analysis found screening using RPR to be relatively cheap, most (>70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. Copyright © 2015 International Federation of Gynecology and Obstetrics. All rights reserved.

  10. The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia

    PubMed Central

    Terris-Prestholt, Fern; Vickerman, Peter; Torres-Rueda, Sergio; Santesso, Nancy; Sweeney, Sedona; Mallma, Patricia; Shelley, Katharine D.; Garcia, Patricia J.; Bronzan, Rachel; Gill, Michelle M.; Broutet, Nathalie; Wi, Teodora; Watts, Charlotte; Mabey, David; Peeling, Rosanna W.; Newman, Lori

    2015-01-01

    Objective Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. Methods Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. Results Although this analysis found screening using RPR to be relatively cheap, most (> 70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. Conclusion This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. PMID:25963907

  11. Soil fauna: key to new carbon models

    NASA Astrophysics Data System (ADS)

    Filser, Juliane; Faber, Jack H.; Tiunov, Alexei V.; Brussaard, Lijbert; Frouz, Jan; De Deyn, Gerlinde; Uvarov, Alexei V.; Berg, Matty P.; Lavelle, Patrick; Loreau, Michel; Wall, Diana H.; Querner, Pascal; Eijsackers, Herman; José Jiménez, Juan

    2016-11-01

    Soil organic matter (SOM) is key to maintaining soil fertility, mitigating climate change, combatting land degradation, and conserving above- and below-ground biodiversity and associated soil processes and ecosystem services. In order to derive management options for maintaining these essential services provided by soils, policy makers depend on robust, predictive models identifying key drivers of SOM dynamics. Existing SOM models and suggested guidelines for future SOM modelling are defined mostly in terms of plant residue quality and input and microbial decomposition, overlooking the significant regulation provided by soil fauna. The fauna controls almost any aspect of organic matter turnover, foremost by regulating the activity and functional composition of soil microorganisms and their physical-chemical connectivity with soil organic matter. We demonstrate a very strong impact of soil animals on carbon turnover, increasing or decreasing it by several dozen percent, sometimes even turning C sinks into C sources or vice versa. This is demonstrated not only for earthworms and other larger invertebrates but also for smaller fauna such as Collembola. We suggest that inclusion of soil animal activities (plant residue consumption and bioturbation altering the formation, depth, hydraulic properties and physical heterogeneity of soils) can fundamentally affect the predictive outcome of SOM models. Understanding direct and indirect impacts of soil fauna on nutrient availability, carbon sequestration, greenhouse gas emissions and plant growth is key to the understanding of SOM dynamics in the context of global carbon cycling models. We argue that explicit consideration of soil fauna is essential to make realistic modelling predictions on SOM dynamics and to detect expected non-linear responses of SOM dynamics to global change. We present a decision framework, to be further developed through the activities of KEYSOM, a European COST Action, for when mechanistic SOM models

  12. Prospects for the U.S. energy and refining industries: Markets, profitability and key drivers for change

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

    Burke, B.F.

    The US refining industry has experienced an extended period of change covering the past 20 years. Growing regulatory requirements, combined with shifting market characteristics, have resulted in massive investments and significant and ongoing structural change. Despite excellent capacity utilization, recent profitability has been poor. Industry psychology can be described as depressed, with honest concern about the long-term attractiveness of domestic refining as an area for continued participation and investment. This paper provides an overview of how the industry arrived at these levels of poor profitability, examines the current situation and future drivers, and presents Chem Systems` views on the outlookmore » for domestic refining.« less

  13. 49 CFR 383.23 - Commercial driver's license.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... STANDARDS; REQUIREMENTS AND PENALTIES Single License Requirement § 383.23 Commercial driver's license. (a... the single license provision of § 383.21, a driver holding a commercial driver's license issued under... be considered valid commercial drivers' licenses for purposes of behind-the-wheel training on public...

  14. Modelling the Cost Effectiveness of Disease-Modifying Treatments for Multiple Sclerosis

    PubMed Central

    Thompson, Joel P.; Abdolahi, Amir; Noyes, Katia

    2013-01-01

    Several cost-effectiveness models of disease-modifying treatments (DMTs) for multiple sclerosis (MS) have been developed for different populations and different countries. Vast differences in the approaches and discrepancies in the results give rise to heated discussions and limit the use of these models. Our main objective is to discuss the methodological challenges in modelling the cost effectiveness of treatments for MS. We conducted a review of published models to describe the approaches taken to date, to identify the key parameters that influence the cost effectiveness of DMTs, and to point out major areas of weakness and uncertainty. Thirty-six published models and analyses were identified. The greatest source of uncertainty is the absence of head-to-head randomized clinical trials. Modellers have used various techniques to compensate, including utilizing extension trials. The use of large observational cohorts in recent studies aids in identifying population-based, ‘real-world’ treatment effects. Major drivers of results include the time horizon modelled and DMT acquisition costs. Model endpoints must target either policy makers (using cost-utility analysis) or clinicians (conducting cost-effectiveness analyses). Lastly, the cost effectiveness of DMTs outside North America and Europe is currently unknown, with the lack of country-specific data as the major limiting factor. We suggest that limited data should not preclude analyses, as models may be built and updated in the future as data become available. Disclosure of modelling methods and assumptions could improve the transferability and applicability of models designed to reflect different healthcare systems. PMID:23640103

  15. Economic drivers of mineral supply

    USGS Publications Warehouse

    Wagner, Lorie A.; Sullivan, Daniel E.; Sznopek, John L.

    2003-01-01

    The debate over the adequacy of future supplies of mineral resources continues in light of the growing use of mineral-based materials in the United States. According to the U.S. Geological Survey, the quantity of new materials utilized each year has dramatically increased from 161 million tons2 in 1900 to 3.2 billion tons in 2000. Of all the materials used during the 20th century in the United States, more than half were used in the last 25 years. With the Earth?s endowment of natural resources remaining constant, and increased demand for resources, economic theory states that as depletion approaches, prices rise. This study shows that many economic drivers (conditions that create an economic incentive for producers to act in a particular way) such as the impact of globalization, technological improvements, productivity increases, and efficient materials usage are at work simultaneously to impact minerals markets and supply. As a result of these economic drivers, the historical price trend of mineral prices3 in constant dollars has declined as demand has risen. When price is measured by the cost in human effort, the price trend also has been almost steadily downward. Although the United States economy continues its increasing mineral consumption trend, the supply of minerals has been able to keep pace. This study shows that in general supply has grown faster than demand, causing a declining trend in mineral prices.

  16. Driver anger on the information superhighway: A content analysis of online complaints of offensive driver behaviour.

    PubMed

    Wickens, Christine M; Wiesenthal, David L; Hall, Ashley; Roseborough, James E W

    2013-03-01

    In recent years, several websites have been developed allowing drivers to post their complaints about other motorists online. These websites allow drivers to describe the nature of the offensive behaviour and to identify the offending motorist by vehicle type, colour, and license plate number. Some websites also ask drivers to list the location where the event took place and the exact date and time of the offence. The current study was a content analysis of complaints posted to RoadRagers.com between 1999 and 2007 (N=5624). The purpose of the study was to: (1) assess the research value of this novel data source; (2) demonstrate the value of content analysis to the study of driver behaviour; (3) further validate an existing coding scheme; (4) determine whether this new data source would replicate previous research findings regarding the most frequent types of driver complaints and temporal distribution of these reports; (5) provide recommendations for improved driver training and public safety initiatives based on these data. A coding scheme that was originally developed for an assessment of complaints submitted to the Ontario Provincial Police (OPP) (Wickens et al., 2005) was revised to accommodate the new dataset. The inter-rater reliability of the revised coding scheme as applied to the website complaints was very good (kappa=.85). The most frequently reported improper driver behaviours were cutting/weaving, speeding, perceived displays of hostility, and tailgating. Reports were most frequent on weekdays and during the morning and afternoon rush hour. The current study replicated several findings from the analysis of reports to the OPP, but possible differences in the sample and data collection method also produced some differences in findings. The value of content analysis to driver behaviour research and of driver complaint websites as a data source was demonstrated. Implications for driver safety initiatives and future research will be discussed. Copyright

  17. Cost of Purchased Versus Produced Plasma from Donor Recruitment Through Transfusion.

    PubMed

    Prioli, Katherine M; Pizzi, Laura T; Karp, Julie Katz; Galanis, Taki; Herman, Jay H

    2016-10-01

    Plasma is used to treat acquired coagulopathy or thrombotic thrombocytopenic purpura, or to reverse warfarin effect. Scant data are available, however, about its costs. To estimate total costs of plasma from production through administration, from the perspective of a US hospital blood donor center (BDC). Six sequential decision analytic models were constructed and informed by primary and secondary data on time, tasks, personnel, and supplies for donation, processing, and administration. Expected values of the models were summed to yield the BDC's total cost of producing, preparing, and transfusing plasma. Costs ($US 2015) are reported for a typical patient using three units of plasma. Models assume plasma was obtained from whole blood donation and transfused in an inpatient setting. Univariate sensitivity analyses were performed to test the impact of changing inputs for personnel costs and adverse event (AE) rates and costs. BDC production cost of plasma was $91.24/patient ($30.41/unit), a $30.16/patient savings versus purchased plasma. Administration and monitoring costs totaled $194.64/patient. Sensitivity analyses indicated that modifying BDC personnel costs during donation and processing has little impact on total plasma costs. However, the probability and cost of transfusion-associated circulatory overload (TACO) have a significant impact on costs. Plasma produced by our BDC may be less costly than purchased plasma. Though plasma processes have multiple tasks involving staff time, these are not the largest cost driver. Major plasma-related AEs are uncommon, but are the biggest driver of total plasma costs.

  18. Psychological reactions of drivers to railway suicide.

    PubMed

    Tranah, T; Farmer, R D

    1994-02-01

    Around 90 London Underground train drivers experience a person jumping or falling in front of their train each year. The majority of these incidents are suicides or attempted suicides. 76 drivers were interviewed in order to assess the range of responses to these incidents. The following psychometric instruments were used: Present State Examination (PSE9); Post-Traumatic Stress Disorder (PTSD) Interview; General Health Questionnaire (GHQ-28); Impact of Events Scale (IES); Post-Traumatic Symptom Scale; Recent Difficulties/Events scale; Perceived Stress Scale and Eysenck Personality Questionnaire (EPQ). When interviewed 1 month after the incident 13 (17.11%) drivers presented with PTSD. Diagnoses other than PTSD e.g. neurotic depression and phobic state were present in 24 (31.58%) drivers (including 12 of the 13 PTSD cases who had one additional diagnosis). On the basis of diagnoses three groups were identified: Group 1 drivers had PTSD and in most cases an additional PSE9 diagnosis; Group 2 drivers had a PSE9 diagnosis only; Group 3 drivers were not cases. 56 drivers were again interviewed 6 months after the incident to assess duration of caseness and/or symptoms and to identify any cases of delayed onset. Two drivers were still cases at 6 months (neurotic depression and phobic state), no driver presented with PTSD at 6 months. At 6 months there was a significant drop in symptom scores compared with measures taken at 1 month. These results suggest that although approximately one-third of drivers suffered a severe psychological reaction following a railway suicide, when interviewed again 6 months after the incident most drivers reported a marked reduction in symptoms.

  19. Driver behaviour profiles for road safety analysis.

    PubMed

    Ellison, Adrian B; Greaves, Stephen P; Bliemer, Michiel C J

    2015-03-01

    Driver behaviour is a contributing factor in over 90 percent of road crashes. As a consequence, there is significant benefit in identifying drivers who engage in unsafe driving practices. Driver behaviour profiles (DBPs) are introduced here as an approach for evaluating driver behaviour as a function of the risk of a casualty crash. They employ data collected using global positioning system (GPS) devices, supplemented with spatiotemporal information. These profiles are comprised of common risk scores that can be used to compare drivers between each other and across time and space. The paper details the development of these DBPs and demonstrates their use as an input into modelling the factors that influence driver behaviour. The results show that even having controlled for the influence of the road environment, these factors remain the strongest predictors of driver behaviour suggesting different spatiotemporal environments elicit a variety of psychological responses in drivers. The approach and outcomes will be of interest to insurance companies in enhancing the risk-profiling of drivers with on-road driving and government through assessing the impacts of behaviour-change interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. 2015 Cost of Wind Energy Review

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

    Mone, Christopher; Hand, Maureen; Bolinger, Mark

    This report uses representative commercial projects to estimate the levelized cost of energy (LCOE) for both land-based and offshore wind plants in the United States for 2015. Scheduled to be published on an annual basis, the analysis relies on both market and modeled data to maintain an up-to-date understanding of wind generation cost trends and drivers. It is intended to provide insight into current component-level costs and a basis for understanding variability in the LCOE across the industry. Data and tools developed by the National Renewable Energy Laboratory (NREL) are used in this analysis to inform wind technology cost projections,more » goals, and improvement opportunities.« less

  1. 2014 Cost of Wind Energy Review

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

    Mone, Christopher; Stehly, Tyler; Maples, Ben

    2015-10-01

    This report uses representative commercial projects to estimate the levelized cost of energy (LCOE) for both land-based and offshore wind plants in the United States for 2014. Scheduled to be published on an annual basis, the analysis relies on both market and modeled data to maintain an up-to-date understanding of wind generation cost trends and drivers. It is intended to provide insight into current component-level costs and a basis for understanding variability in the LCOE across the industry. Data and tools developed by the National Renewable Energy Laboratory (NREL) are used in this analysis to inform wind technology cost projections,more » goals, and improvement opportunities.« less

  2. Characteristics of Two Groups of Angry Drivers

    ERIC Educational Resources Information Center

    Deffenbacher, Jerry L.; Filetti, Linda B.; Richards, Tracy L.; Lynch, Rebekah S.; Oetting, Eugene R.

    2003-01-01

    High anger drivers acknowledging problems with driving anger and interest in counseling (high anger/problem [HP] drivers) were compared with high and low anger drivers not acknowledging problems with driving anger and seeking counseling (high and low/nonproblem [HNP and LNP, respectively] drivers). High anger groups reported more anger while…

  3. Data and methods for studying commercial motor vehicle driver fatigue, highway safety and long-term driver health.

    PubMed

    Stern, Hal S; Blower, Daniel; Cohen, Michael L; Czeisler, Charles A; Dinges, David F; Greenhouse, Joel B; Guo, Feng; Hanowski, Richard J; Hartenbaum, Natalie P; Krueger, Gerald P; Mallis, Melissa M; Pain, Richard F; Rizzo, Matthew; Sinha, Esha; Small, Dylan S; Stuart, Elizabeth A; Wegman, David H

    2018-03-09

    This article summarizes the recommendations on data and methodology issues for studying commercial motor vehicle driver fatigue of a National Academies of Sciences, Engineering, and Medicine study. A framework is provided that identifies the various factors affecting driver fatigue and relating driver fatigue to crash risk and long-term driver health. The relevant factors include characteristics of the driver, vehicle, carrier and environment. Limitations of existing data are considered and potential sources of additional data described. Statistical methods that can be used to improve understanding of the relevant relationships from observational data are also described. The recommendations for enhanced data collection and the use of modern statistical methods for causal inference have the potential to enhance our understanding of the relationship of fatigue to highway safety and to long-term driver health. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. COMPARING THE IMPAIRMENT PROFILES OF OLDER DRIVERS AND NON-DRIVERS: TOWARD THE DEVELOPMENT OF A FITNESS-TO-DRIVE MODEL

    PubMed Central

    Antin, Jonathan F.; Stanley, Laura M.; Guo, Feng

    2011-01-01

    The purpose of this research effort was to compare older driver and non-driver functional impairment profiles across some 60 assessment metrics in an initial effort to contribute to the development of fitness-to-drive assessment models. Of the metrics evaluated, 21 showed statistically significant differences, almost all favoring the drivers. Also, it was shown that a logistic regression model comprised of five of the assessment scores could completely and accurately separate the two groups. The results of this study imply that older drivers are far less functionally impaired than non-drivers of similar ages, and that a parsimonious model can accurately assign individuals to either group. With such models, any driver classified or diagnosed as a non-driver would be a strong candidate for further investigation and intervention. PMID:22058607

  5. Comparison of the Ministry of Health's tariffs with the cost of radiology services using the activity-based costing method.

    PubMed

    Kalhor, Rohollah; Amini, Saeed; Emami, Majid; Kakasoltani, Keivan; Rhamani, Nasim; Kalhor, Leila

    2016-02-01

    Efficient use of resources in organizations is one of the most important duties of managers. Appropriate allocation of resources can help managers to do this well. The aim of this study was to determine the cost of radiology services and to compare it with governmental tariffs (introduced by the Ministry of Health in Iran). This was a descriptive and applied study that was conducted using the retrospective approach. First, activity centers were identified on the basis of five main groups of hospital activities. Then, resources and resource drivers, activities, and hospital activity drivers were identified. At the next step, the activities related to the delivery of radiology process were identified. Last, through allocation of activities cost to the cost objects, the cost price of 66 services that were delivered in the radiology department were calculated. The data were collected by making checklists, using the hospital's information system, observations, and interviews. Finally, the data were analyzed using the non-parametric Wilcoxon test, Microsoft Excel, and SPSS software, version 18. The findings showed that from the total cost of wages, materials, and overhead obtained, the unit cost of the 66 cost objects (delivered services) in the Radiology Department were calculated using the ABC method (Price of each unit of Nephrostogram obtained $15.8 and Cystogram obtained $18.4). The Kolmogorov-Smirnov test indicated that the distribution of data of cost price using the ABC method was not normal (p = 0.000). The Wilcoxon test showed that there was a significant difference between the cost of services and the tariff of radiology services (p = 0.000). The cost of delivered services in radiology departments was significantly higher than approved tariffs of the Ministry of Health, which can have a negative impact on the quality of services.

  6. Identifying Key Drivers of the Impact of an HIV Cure Intervention in Sub-Saharan Africa.

    PubMed

    Phillips, Andrew N; Cambiano, Valentina; Revill, Paul; Nakagawa, Fumiyo; Lundgren, Jens D; Bansi-Matharu, Loveleen; Mabugu, Travor; Sculpher, Mark; Garnett, Geoff; Staprans, Silvija; Becker, Stephen; Murungu, Joseph; Lewin, Sharon R; Deeks, Steven G; Hallett, Timothy B

    2016-07-01

    It is unknown what properties would be required to make an intervention in low income countries that can eradicate or control human immunodeficiency virus (HIV) without antiretroviral therapy (ART) cost-effective. We used a model of HIV and ART to investigate the effect of introducing an ART-free viral suppression intervention in 2022 using Zimbabwe as an example country. We assumed that the intervention (cost: $500) would be accessible for 90% of the population, be given to those receiving effective ART, have sufficient efficacy to allow ART interruption in 95%, with a rate of viral rebound of 5% per year in the first 3 months, and a 50% decline in rate with each successive year. An ART-free viral suppression intervention with these properties would result in >0.53 million disability-adjusted-life-years averted over 2022-2042, with a reduction in HIV program costs of $300 million (8.7% saving). An intervention of this efficacy costing anything up to $1400 is likely to be cost-effective in this setting. Interventions aimed at curing HIV infection have the potential to improve overall disease burden and to reduce costs. Given the effectiveness and cost of ART, such interventions would have to be inexpensive and highly effective. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

  7. Motor vehicle driver injury and marital status: a cohort study with prospective and retrospective driver injuries

    PubMed Central

    Whitlock, G; Norton, R; Clark, T; Jackson, R; MacMahon, S

    2004-01-01

    Objective: To investigate the association of marital status with risk of motor vehicle driver injury. Design: A cohort study with prospective and retrospective outcomes. Setting: New Zealand. Participants: A total of 10 525 adults (a volunteer sample of a multi-industry workforce, n = 8008; and a random sample of urban electoral rolls, n = 2517). Exposure variable: Self reported marital status, assessed from a questionnaire administered in 1992–93 (baseline). Main outcome measure: Motor vehicle driver injury resulting in admission of the driver to hospital and/or the driver's death, during the period 1988–98; hospitalisation and mortality data were obtained by record linkage to national health databases. Results: During 108 741 person-years of follow up, 139 driver injury cases occurred (85 before baseline, 54 after). After adjustment for age, sex, and study cohort, never married participants had twice the risk of driver injury (hazard ratio [HR] 2.06, 95% confidence interval [CI] 1.35 to 3.16) as married participants (HR 1.00). The relative risk for never married participants was slightly higher (HR 2.29), though less precise (95% CI 1.39 to 3.76), after further adjustment for alcohol intake, driving exposure, area of residence, body mass index, and occupational status. Conclusions: After taking age, sex, and other variables into account, never married people had a substantially higher risk of driver injury than married people. While requiring corroboration, these findings imply that it may be appropriate for driver injury countermeasures to be targeted to never married people. PMID:14760024

  8. Driver sleepiness on YouTube: A content analysis.

    PubMed

    Hawkins, A N; Filtness, A J

    2017-02-01

    Driver sleepiness is a major contributor to severe crashes and fatalities on our roads. Many people continue to drive despite being aware of feeling tired. Prevention relies heavily on education campaigns as it is difficult to police driver sleepiness. The video sharing social media site YouTube is extremely popular, particularly with at risk driver demographics. Content and popularity of uploaded videos can provide insight into the quality of publicly accessible driver sleepiness information. The purpose of this research was to answer two questions; firstly, how prevalent are driver sleepiness videos on YouTube? And secondly, what are the general characteristics of driver sleepiness videos in terms of (a) outlook on driver sleepiness, (b) tone, (c) countermeasures to driver sleepiness, and, (d) driver demographics. Using a keywords search, 442 relevant videos were found from a five year period (2nd December 2009-2nd December 2014). Tone, outlook, and countermeasure use were thematically coded. Driver demographic and video popularity data also were recorded. The majority of videos portrayed driver sleepiness as dangerous. However, videos that had an outlook towards driver sleepiness being amusing were viewed more often and had more mean per video comments and likes. Humorous videos regardless of outlook, were most popular. Most information regarding countermeasures to deal with driver sleepiness was accurate. Worryingly, 39.8% of videos with countermeasure information contained some kind of ineffective countermeasure. The use of humour to convey messages about the dangers of driver sleepiness may be a useful approach in educational interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Fusion of Optimized Indicators from Advanced Driver Assistance Systems (ADAS) for Driver Drowsiness Detection

    PubMed Central

    Daza, Iván G.; Bergasa, Luis M.; Bronte, Sebastián; Yebes, J. Javier; Almazán, Javier; Arroyo, Roberto

    2014-01-01

    This paper presents a non-intrusive approach for monitoring driver drowsiness using the fusion of several optimized indicators based on driver physical and driving performance measures, obtained from ADAS (Advanced Driver Assistant Systems) in simulated conditions. The paper is focused on real-time drowsiness detection technology rather than on long-term sleep/awake regulation prediction technology. We have developed our own vision system in order to obtain robust and optimized driver indicators able to be used in simulators and future real environments. These indicators are principally based on driver physical and driving performance skills. The fusion of several indicators, proposed in the literature, is evaluated using a neural network and a stochastic optimization method to obtain the best combination. We propose a new method for ground-truth generation based on a supervised Karolinska Sleepiness Scale (KSS). An extensive evaluation of indicators, derived from trials over a third generation simulator with several test subjects during different driving sessions, was performed. The main conclusions about the performance of single indicators and the best combinations of them are included, as well as the future works derived from this study. PMID:24412904

  10. Traffic safety facts 1999 : young drivers

    DOT National Transportation Integrated Search

    2000-01-01

    There were 187.2 million licensed drivers in the United States in 1999. Young drivers, between 15 and 20 years old, accounted for 6.8% (12.7 million) of the total, a 1.2% decrease from the 12.8 million young drivers in 1989. In 1999, 8,175 15- to 20-...

  11. Advanced driver assistance systems for teen drivers: Teen and parent impressions, perceived need, and intervention preferences.

    PubMed

    Weiss, Eve; Fisher Thiel, Megan; Sultana, Nahida; Hannan, Chloe; Seacrist, Thomas

    2018-02-28

    From the advent of airbags to electronic stability control, technological advances introduced into automobile design have significantly reduced injury and death from motor vehicle crashes. These advances are especially pertinent among teen drivers, a population whose leading cause of death is motor vehicle crashes. Recently developed advanced driver assistance systems (ADAS) have the potential to compensate for skill deficits and reduce overall crash risk. Yet, ADAS is only effective if drivers are willing to use it. Limited research has been conducted on the suitability of ADAS for teen drivers. The goal of this study is to identify teen drivers' perceived need for ADAS, receptiveness to in-vehicle technology, and intervention preferences. The long-term goal is to understand public perceptions and barriers to ADAS use and to help determine how these systems must evolve to meet the needs of the riskiest driving populations. Three focus groups (N = 24) were conducted with licensed teen drivers aged 16-19 years and 2 focus groups with parents of teen drivers (N = 12). Discussion topics included views on how ADAS might influence driving skills and behaviors; trust in technology; and data privacy. Discussions were transcribed; the team used conventional content analysis and open coding methods to identify 12 coding domains and code transcripts with NVivo 10. Interrater reliability testing showed moderate to high kappa scores. Overall, participants recognized potential benefits of ADAS, including improved safety and crash reduction. Teens suggested that ADAS is still developing and therefore has potential to malfunction. Many teens reported a greater trust in their own driving ability over vehicle technology. They expressed that novice drivers should learn to drive on non-ADAS-equipped cars and that ADAS should be considered a supplemental aid. Many teens felt that overreliance on ADAS may increase distracted driving or risky behaviors among teens. Parents also

  12. Identifying multiple coral reef regimes and their drivers across the Hawaiian archipelago

    PubMed Central

    Jouffray, Jean-Baptiste; Nyström, Magnus; Norström, Albert V.; Williams, Ivor D.; Wedding, Lisa M.; Kittinger, John N.; Williams, Gareth J.

    2015-01-01

    Loss of coral reef resilience can lead to dramatic changes in benthic structure, often called regime shifts, which significantly alter ecosystem processes and functioning. In the face of global change and increasing direct human impacts, there is an urgent need to anticipate and prevent undesirable regime shifts and, conversely, to reverse shifts in already degraded reef systems. Such challenges require a better understanding of the human and natural drivers that support or undermine different reef regimes. The Hawaiian archipelago extends across a wide gradient of natural and anthropogenic conditions and provides us a unique opportunity to investigate the relationships between multiple reef regimes, their dynamics and potential drivers. We applied a combination of exploratory ordination methods and inferential statistics to one of the most comprehensive coral reef datasets available in order to detect, visualize and define potential multiple ecosystem regimes. This study demonstrates the existence of three distinct reef regimes dominated by hard corals, turf algae or macroalgae. Results from boosted regression trees show nonlinear patterns among predictors that help to explain the occurrence of these regimes, and highlight herbivore biomass as the key driver in addition to effluent, latitude and depth.

  13. Measurement of signal use and vehicle turns as indication of driver cognition.

    PubMed

    Wallace, Bruce; Goubran, Rafik; Knoefel, Frank

    2014-01-01

    This paper uses data analytics to provide a method for the measurement of a key driving task, turn signal usage as a measure of an automatic over-learned cognitive function drivers. The paper augments previously reported more complex executive function cognition measures by proposing an algorithm that analyzes dashboard video to detect turn indicator use with 100% accuracy without any false positives. The paper proposes two algorithms that determine the actual turns made on a trip. The first through analysis of GPS location traces for the vehicle, locating 73% of the turns made with a very low false positive rate of 3%. A second algorithm uses GIS tools to retroactively create turn by turn directions. Fusion of GIS and GPS information raises performance to 77%. The paper presents the algorithm required to measure signal use for actual turns by realigning the 0.2Hz GPS data, 30fps video and GIS turn events. The result is a measure that can be tracked over time and changes in the driver's performance can result in alerts to the driver, caregivers or clinicians as indication of cognitive change. A lack of decline can also be shared as reassurance.

  14. Young drivers' optimism bias for accident risk and driving skill: Accountability and insight experience manipulations.

    PubMed

    White, Melanie J; Cunningham, Lauren C; Titchener, Kirsteen

    2011-07-01

    This study aimed to determine whether two brief, low cost interventions would reduce young drivers' optimism bias for their driving skills and accident risk perceptions. This tendency for such drivers to perceive themselves as more skillful and less prone to driving accidents than their peers may lead to less engagement in precautionary driving behaviours and a greater engagement in more dangerous driving behaviour. 243 young drivers (aged 17-25 years) were randomly allocated to one of three groups: accountability, insight or control. All participants provided both overall and specific situation ratings of their driving skills and accident risk relative to a typical young driver. Prior to completing the questionnaire, those in the accountability condition were first advised that their driving skills and accident risk would be later assessed via a driving simulator. Those in the insight condition first underwent a difficult computer-based hazard perception task designed to provide participants with insight into their potential limitations when responding to hazards in difficult and unpredictable driving situations. Participants in the control condition completed only the questionnaire. Results showed that the accountability manipulation was effective in reducing optimism bias in terms of participants' comparative ratings of their accident risk in specific situations, though only for less experienced drivers. In contrast, among more experienced males, participants in the insight condition showed greater optimism bias for overall accident risk than their counterparts in the accountability or control groups. There were no effects of the manipulations on drivers' skills ratings. The differential effects of the two types of manipulations on optimism bias relating to one's accident risk in different subgroups of the young driver sample highlight the importance of targeting interventions for different levels of experience. Accountability interventions may be beneficial for

  15. Age and gender differences in conviction and crash occurrence subsequent to being directed to Iowa's driver improvement program.

    PubMed

    Zhang, Wei; Gkritza, Konstantina; Keren, Nir; Nambisan, Shashi

    2011-10-01

    This paper investigates potential gender and age differences in conviction and crash occurrence subsequent to being directed to attend Iowa's Driver Improvement Program (DIP). Binary logit models were developed to investigate the factors that influence conviction occurrence after DIP by gender and age. Because of the low crash occurrence subsequent to DIP, association rules were applied to investigate the factors that influence crash occurrence subsequent to DIP, in lieu of econometric models. There were statistical significant differences by driver gender, age, and conviction history in the likelihood of subsequent convictions. However, this paper found no association between DIP outcome, crash history, and crash occurrence. Evaluating the differences in conviction and crash occurrence subsequent to DIP between female and male drivers, and among different age groups can lead to improvements of the effectiveness of DIPs and help to identify low-cost intervention measures, customized based on drivers' gender and age, for improving driving behaviors. Copyright © 2011 National Safety Council and Elsevier Ltd. All rights reserved.

  16. Costs and quality of life associated with acute upper gastrointestinal bleeding in the UK: cohort analysis of patients in a cluster randomised trial.

    PubMed

    Campbell, H E; Stokes, E A; Bargo, D; Logan, R F; Mora, A; Hodge, R; Gray, A; James, M W; Stanley, A J; Everett, S M; Bailey, A A; Dallal, H; Greenaway, J; Dyer, C; Llewelyn, C; Walsh, T S; Travis, S P L; Murphy, M F; Jairath, V

    2015-04-29

    Data on costs associated with acute upper gastrointestinal bleeding (AUGIB) are scarce. We provide estimates of UK healthcare costs, indirect costs and health-related quality of life (HRQoL) for patients presenting to hospital with AUGIB. Six UK university hospitals with >20 AUGIB admissions per month, >400 adult beds, 24 h endoscopy, and on-site access to intensive care and surgery. 936 patients aged ≥18 years, admitted with AUGIB, and enrolled between August 2012 and March 2013 in the TRIGGER trial of AUGIB comparing restrictive versus liberal red blood cell (RBC) transfusion thresholds. Healthcare resource use during hospitalisation and postdischarge up to 28  days, unpaid informal care, time away from paid employment and HRQoL using the EuroQol EQ-5D at 28  days were measured prospectively. National unit costs were used to value resource use. Initial in-hospital treatment costs were upscaled to a UK level. Mean initial in-hospital costs were £2458 (SE=£216) per patient. Inpatient bed days, endoscopy and RBC transfusions were key cost drivers. Postdischarge healthcare costs were £391 (£44) per patient. One-third of patients received unpaid informal care and the quarter in paid employment required time away from work. Mean HRQoL for survivors was 0.74. Annual initial inhospital treatment cost for all AUGIB cases in the UK was estimated to be £155.5 million, with exploratory analyses of the incremental costs of treating hospitalised patients developing AUGIB generating figures of between £143 million and £168 million. AUGIB is a large burden for UK hospitals with inpatient stay, endoscopy and RBC transfusions as the main cost drivers. It is anticipated that this work will enable quantification of the impact of cost reduction strategies in AUGIB and will inform economic analyses of novel or existing interventions for AUGIB. ISRCTN85757829 and NCT02105532. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  17. Automotive Radar and Lidar Systems for Next Generation Driver Assistance Functions

    NASA Astrophysics Data System (ADS)

    Rasshofer, R. H.; Gresser, K.

    2005-05-01

    Automotive radar and lidar sensors represent key components for next generation driver assistance functions (Jones, 2001). Today, their use is limited to comfort applications in premium segment vehicles although an evolution process towards more safety-oriented functions is taking place. Radar sensors available on the market today suffer from low angular resolution and poor target detection in medium ranges (30 to 60m) over azimuth angles larger than ±30°. In contrast, Lidar sensors show large sensitivity towards environmental influences (e.g. snow, fog, dirt). Both sensor technologies today have a rather high cost level, forbidding their wide-spread usage on mass markets. A common approach to overcome individual sensor drawbacks is the employment of data fusion techniques (Bar-Shalom, 2001). Raw data fusion requires a common, standardized data interface to easily integrate a variety of asynchronous sensor data into a fusion network. Moreover, next generation sensors should be able to dynamically adopt to new situations and should have the ability to work in cooperative sensor environments. As vehicular function development today is being shifted more and more towards virtual prototyping, mathematical sensor models should be available. These models should take into account the sensor's functional principle as well as all typical measurement errors generated by the sensor.

  18. Child Passenger Deaths Involving Alcohol-Impaired Drivers

    PubMed Central

    Quinlan, Kyran; Shults, Ruth A.; Rudd, Rose A.

    2017-01-01

    BACKGROUND AND OBJECTIVE Approximately 1 in 5 child passenger deaths in the United States involves an alcohol-impaired driver, most commonly the child’s own driver. The objective of this study was to document recent trends and state-specific rates of these deaths. METHODS A descriptive analysis of 2001–2010 Fatality Analysis Reporting System data for child passengers aged <15 years killed in alcohol-impaired driving crashes. Driver impairment was defined as a blood alcohol concentration of ≥0.08 g/dL. RESULTS During 2001–2010, 2344 children <15 years were killed in crashes involving at least 1 alcohol-impaired driver. Of these children, 1515 (65%) were riding with an impaired driver. Annual deaths among children riding with an alcohol-impaired driver decreased by 41% over the decade. Among the 37 states included in the state-level analysis, Texas (272) and California (135) had the most children killed while riding with an impaired driver and South Dakota (0.98) and New Mexico (0.86) had the highest annualized child passenger death rates (per 100 000 children). Most (61%) child passengers of impaired drivers were unrestrained at the time of the crash. One-third of the impaired drivers did not have a valid driver’s license. CONCLUSIONS Alcohol-impaired driving remains a substantial threat to the safety of child passengers in the United States, and typically involves children being driven by impaired drivers. This risk varies meaningfully among states. To make further progress, states and communities could consider increased use of effective interventions and efforts aimed specifically at protecting child passengers from impaired drivers. PMID:24799550

  19. Profiles in driver distraction : effects of cell phone conversations on younger and older drivers

    DOT National Transportation Integrated Search

    2004-01-01

    Synopsis Younger and older drivers conversing on a hands-free cell phone were found to have slower responses to random braking by the vehicle ahead. Cell phone use slowed the younger drivers responses to an extent that they were equivalent t...

  20. Children in fatal crashes: driver blood alcohol concentration and demographics of child passengers and their drivers.

    PubMed

    Voas, Robert B; Fisher, Deborah A; Tippetts, A Scott

    2002-11-01

    This study examines whether differences in two risk factors for crash-related injury for children-riding with a drinking driver and failure to use restraints-are related to various driver characteristics such as age, gender, ethnicity and drinking. Data on driver blood alcohol concentration (BAC), use of restraints and certain demographics were drawn from the Fatality Analysis Reporting System. Ethnicity data came from the Multiple Cause of Death File and socioeconomic information from the US Census. The use of restraints by child passengers and the drinking of alcohol by adult drivers are examined as a function of age, gender and membership of five racial/ethnic groups: White American, Black American, Native American, Asian/Pacific Islander American and Hispanic American. This study covers 160,770 drivers and 12,266 children younger than 16 years killed in motor vehicle crashes from January 1,1990 to December 31,1996. As might be expected, analyses of fatally injured drivers showed that, compared with men, women were more likely to be accompanied by children at the time of their crash, but those children were more likely to be restrained than if travelling with men. Drivers who had been drinking at the time of their crash were less likely to be transporting children and those children were less likely to be restrained. Analyses of killed children indicated that some ethnic groups, compared with White drivers, were more likely to be BAC-positive and children were less likely to be restrained. These findings underscore the continuing need to understand cultural factors in traffic safety and develop and disseminate culturally appropriate education programs.

  1. The direct and indirect costs of Dravet Syndrome.

    PubMed

    Whittington, Melanie D; Knupp, Kelly G; Vanderveen, Gina; Kim, Chong; Gammaitoni, Arnold; Campbell, Jonathan D

    2018-03-01

    The objective of this study was to estimate the annual direct and indirect costs associated with Dravet Syndrome (DS). A survey was electronically administered to the caregivers of patients with DS treated at Children's Hospital Colorado. Survey domains included healthcare utilization of the patient with DS and DS caregiver work productivity and activity impairment. Patient healthcare utilization was measured using modified questions from the National Health Interview Survey; caregiver work productivity and activity impairment were measured using modified questions from the Work Productivity and Activity Impairment questionnaire. Direct costs were calculated by multiplying the caregiver-reported healthcare utilization rates by the mean unit cost for each healthcare utilization category. Indirect costs included lost productivity, income loss, and lost leisure time. The indirect costs were a function of caregiver-reported hours spent caregiving and an hourly unit cost. The survey was emailed to 60 DS caregivers, of which 34 (57% response rate) responded. Direct costs on average were $27,276 (95% interval: $15,757, $41,904) per patient with DS. Hospitalizations ($11,565 a year) and in-home medical care visits ($9894 a year) were substantial cost drivers. Additionally, caregivers reported extensive time spent providing care to an individual with DS. This caregiver time resulted in average annual indirect costs of $81,582 (95% interval: $57,253, $110,151), resulting in an average total annual financial burden of $106,378 (95% interval: $78,894, $137,906). Dravet Syndrome results in substantial healthcare utilization, financial burden, and time commitment. Establishing evidence on the financial burden of DS is essential to understanding the overall impact of DS, identifying potential areas for support needs, and assessing the impact of novel treatments as they become available. Based on the study findings, in-home visits, hospitalizations, and lost productivity and

  2. Association of climate drivers with rainfall in New South Wales, Australia, using Bayesian Model Averaging

    NASA Astrophysics Data System (ADS)

    Duc, Hiep Nguyen; Rivett, Kelly; MacSween, Katrina; Le-Anh, Linh

    2017-01-01

    Rainfall in New South Wales (NSW), located in the southeast of the Australian continent, is known to be influenced by four major climate drivers: the El Niño/Southern Oscillation (ENSO), the Interdecadal Pacific Oscillation (IPO), the Southern Annular Mode (SAM) and the Indian Ocean Dipole (IOD). Many studies have shown the influences of ENSO, IPO modulation, SAM and IOD on rainfall in Australia and on southeast Australia in particular. However, only limited work has been undertaken using a multiple regression framework to examine the extent of the combined effect of these climate drivers on rainfall. This paper analysed the role of these combined climate drivers and their interaction on the rainfall in NSW using Bayesian Model Averaging (BMA) to account for model uncertainty by considering each of the linear models across the whole model space which is equal to the set of all possible combinations of predictors to find the model posterior probabilities and their expected predictor coefficients. Using BMA for linear regression models, we are able to corroborate and confirm the results from many previous studies. In addition, the method gives the ranking order of importance and the probability of the association of each of the climate drivers and their interaction on the rainfall at a site. The ability to quantify the relative contribution of the climate drivers offers the key to understand the complex interaction of drivers on rainfall, or lack of rainfall in a region, such as the three big droughts in southeastern Australia which have been the subject of discussion and debate recently on their causes.

  3. 2016 Cost of Wind Energy Review

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

    Stehly, Tyler J.; Heimiller, Donna M.; Scott, George N.

    This report uses representative utility-scale projects to estimate the levelized cost of energy (LCOE) for land-based and offshore wind power plants in the United States. Data and results detailed here are derived from 2016 commissioned plants. More specifically, analysis detailed here relies on recent market data and state-of-the-art modeling capabilities to maintain an up-to-date understanding of wind energy cost trends and drivers. This report is intended to provide insight into current component-level costs as well as a basis for understanding variability in LCOE across the country. This publication represents the sixth installment of this annual report.

  4. Addressing the Multiple Drivers of Wetland Ecosystems Degradation in Lagos, Nigeria

    NASA Astrophysics Data System (ADS)

    Agboola, J.; Ndimele, P. E.; Odunuga, S.; Akanni, A.; Kosemani, B.; Ahove, M.

    2015-12-01

    Several body of knowledge have noted the importance of wetland ecosystems in climate moderation, resource supply and flood risk reduction amongst others. Relevant as it may, rapidly increasing population and uncontrolled urban development poses a challenge in some regions and require understanding of the ecosystem components and drivers of change over a long period of time. Thus, the main thrust of this paper is to analyse multiple drivers of wetland ecosystems degradation in the last 30 years in the Lagos megacity using field study, desktop review, satellite data and laboratory analysis. Key drivers identified includes: conversion of wetlands to settlements and waste sink, land use planning that neglects wetland conservation and restoration, ineffective legal status for wetlands, over exploitation leading to degradation and fragmentation of wetland ecosystems governance. In stemming further loss of this vital ecosystem, this study adopted and proposed respectively, the Drivers, Pressure, State, Impact and Response (DPSIR) and Integrated Planning Approach (IPA) frameworks in analysing policy and governance issues in wetland development. These analyses figured out amongst others, strict conservation and sustainable use of wetland resources, habitat restoration, climate adaptation measures, legal protection and wetland management institution as major responses to current multiple pressures facing wetland ecosystems in Lagos. For these frameworks to be made meaningful, weak coordination among government agencies and institutional capacity in implementation and law enforcement, unsustainable resource extraction by private/business organization and issues on alternative sources of income on the part of the local communities amongst others needs to be addressed.

  5. Comparison of the Ministry of Health’s tariffs with the cost of radiology services using the activity-based costing method

    PubMed Central

    Kalhor, Rohollah; Amini, Saeed; Emami, Majid; Kakasoltani, Keivan; Rhamani, Nasim; Kalhor, Leila

    2016-01-01

    Introduction Efficient use of resources in organizations is one of the most important duties of managers. Appropriate allocation of resources can help managers to do this well. The aim of this study was to determine the cost of radiology services and to compare it with governmental tariffs (introduced by the Ministry of Health in Iran). Methods This was a descriptive and applied study that was conducted using the retrospective approach. First, activity centers were identified on the basis of five main groups of hospital activities. Then, resources and resource drivers, activities, and hospital activity drivers were identified. At the next step, the activities related to the delivery of radiology process were identified. Last, through allocation of activities cost to the cost objects, the cost price of 66 services that were delivered in the radiology department were calculated. The data were collected by making checklists, using the hospital’s information system, observations, and interviews. Finally, the data were analyzed using the non-parametric Wilcoxon test, Microsoft Excel, and SPSS software, version 18. Results The findings showed that from the total cost of wages, materials, and overhead obtained, the unit cost of the 66 cost objects (delivered services) in the Radiology Department were calculated using the ABC method (Price of each unit of Nephrostogram obtained $15.8 and Cystogram obtained $18.4). The Kolmogorov-Smirnov test indicated that the distribution of data of cost price using the ABC method was not normal (p = 0.000). The Wilcoxon test showed that there was a significant difference between the cost of services and the tariff of radiology services (p = 0.000). Conclusions The cost of delivered services in radiology departments was significantly higher than approved tariffs of the Ministry of Health, which can have a negative impact on the quality of services. PMID:27054013

  6. Rare discrepancies in a driver gene alteration within histologically heterogeneous primary lung cancers.

    PubMed

    Zhong, Wen-zhao; Su, Jian; Xu, Fang-ping; Zhai, Hao-ran; Zhang, Xu-chao; Yang, Xue-ning; Chen, Zhi-yong; Chen, Zhi-hong; Li, Wei; Dong, Song; Zhou, Qing; Yang, Jin-ji; Liu, Yan-hui; Wu, Yi-long

    2015-11-01

    Most lung adenocarcinomas consist of mixtures of histological subtypes harboring different frequencies of driver gene mutations. However, little is known about intratumoral heterogeneity(ITH) within histologically heterogeneous primary lung cancers. Investigating key driver genes in respective morphological pattern is crucial to personalized treatment. Morphologically different areas within the same surgically resected adenocarcinomas were extracted from tissues to analyze gene status in each growth pattern. Driver genes, epidermal growth factor receptor (EGFR), KRAS and EML4-ALK, were assessed by assays with different sensitivities. Seventy-nine consecutive eligible patients harboring a driver gene (EGFR=65; KRAS=10; EML4-ALK=4) were enrolled. For EGFR mutations, ITH occurred in 13.3% (8/60) by direct sequencing (DS) and 1.7% (1/60) by amplification refractory mutation system (ARMS) (P=0.016) among adenocarcinomas, but consistent within five adeno-squamous cell carcinomas by both methods. ITH among KRAS mutations were detected in 20% (2/10) by DS, whereas consistent (10/10) by high resolution melting. No discrepancies in EML4-ALK rearrangements existed according to fluorescence in situ hybridization. Rare ITHs of EGFR/KRAS/EML4-ALK alterations within histologically heterogeneous primary lung adenocarcinomas existed by methods with higher sensitivity. Discrepancies might be due to abundance of mutant tumor cells and detection assays. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Practical challenges in quantum key distribution

    DOE PAGES

    Diamanti, Eleni; Lo, Hoi -Kwong; Qi, Bing; ...

    2016-11-08

    Here, quantum key distribution (QKD) promises unconditional security in data communication and is currently being deployed in commercial applications. Nonetheless, before QKD can be widely adopted, it faces a number of important challenges such as secret key rate, distance, size, cost and practical security. Here, we survey those key challenges and the approaches that are currently being taken to address them.

  8. Practical challenges in quantum key distribution

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

    Diamanti, Eleni; Lo, Hoi -Kwong; Qi, Bing

    Here, quantum key distribution (QKD) promises unconditional security in data communication and is currently being deployed in commercial applications. Nonetheless, before QKD can be widely adopted, it faces a number of important challenges such as secret key rate, distance, size, cost and practical security. Here, we survey those key challenges and the approaches that are currently being taken to address them.

  9. An Evaluation of Graduated Driver Licensing Effects on Fatal Crash Involvements of Young Drivers in the United States

    PubMed Central

    Fell, James C.; Jones, Kristina; Romano, Eduardo; Voas, Robert

    2013-01-01

    Objective Graduated driver licensing (GDL) systems are designed to reduce the high crash risk of young novice drivers. Almost all states in the United States have some form of a three-phased GDL system with various restrictions in the intermediate phase. Studies of the effects of GDL in various states show significant reductions in fatal crash involvements of 16- and 17-year-old drivers; however, only a few national studies of GDL effects have been published. The objective of this national panel study was to evaluate the effect of GDL laws on the fatal crash involvements of novice drivers while controlling for possible confounding factors not accounted for in prior studies. Methods The Fatality Analysis Reporting System (FARS) was used to examine 16- and 17-year-old driver involvement in fatal crashes (where GDL laws are applied) relative to two young driver age groups (19-20, 21-25) where GDL would not be expected to have an effect. Dates when various GDL laws were adopted in the states between 1990 and 2007 were coded from a variety of sources. Covariates in the longitudinal panel regression analyses conducted included four laws that could have an effect on 16- and 17-year-old drivers: primary enforcement seat belt laws, zero-tolerance (ZT) alcohol laws for drivers younger than age 21, lowering the blood alcohol concentration limit for driving to .08, and so-called “use and lose” laws where drivers aged 20 and younger lose their licenses for underage drinking violations. Results The adoption of a GDL law of average strength was associated with a significant decrease in fatal crash involvements of 16- and 17-year-old drivers relative to fatal crash involvements of one of the two comparison groups. GDL laws rated as “good” showed stronger relationships to fatal crash reductions, and laws rated as “less than good” showed no reductions in crash involvements relative to the older driver comparison groups. Conclusions States that adopt a basic GDL law can

  10. School Bus Accidents and Driver Age.

    ERIC Educational Resources Information Center

    McMichael, Judith

    The study examines the rates and types of school bus accidents according to the age of the school bus driver. Accident rates in North Carolina for the school year 1971-72 were analyzed using three sources of data: accident reports, driver and mileage data, and questionnaires administered to a sample of school bus drivers. Data were obtained on…

  11. Analysis of risk factors affecting driver injury and crash injury with drivers under the influence of alcohol (DUI) and non-DUI.

    PubMed

    Chen, Huiqin; Chen, Qiang; Chen, Lei; Zhang, Guanjun

    2016-11-16

    The objective of this research was to study risk factors that significantly influence the severity of crashes for drivers both under and not under the influence of alcohol. Ordinal logistic regression was applied to analyze a crash data set involving drivers under and not under the influence of alcohol in China from January 2011 to December 2014. Four risk factors were found to be significantly associated with the severity of driver injury, including crash partner and intersection type. Age group was found to be significantly associated with the severity of crashes involving drivers under the influence of alcohol. Crash partner, intersection type, lighting conditions, gender, and time of day were found to be significantly associated with severe driver injuries, the last of which was also significantly associated with severe crashes involving drivers not under the influence of alcohol. This study found that pedestrian involvement decreases the odds of severe driver injury when a driver is under the influence of alcohol, with a relative risk of 0.05 compared to the vehicle-to-vehicle group. The odds of severe driver injury at T-intersections were higher than those for traveling along straight roads. Age was shown to be an important factor, with drivers 50-60 years of age having higher odds of being involved in severe crashes compared to 20- to 30-year-olds when the driver was under the influence of alcohol. When the driver was not under the influence of alcohol, drivers suffered more severe injuries between midnight and early morning compared to early nighttime. The vehicle-to-motorcycle and vehicle-to-pedestrian groups experienced less severe driver injuries, and vehicle collisions with fixed objects exhibited higher odds of severe driver injury than did vehicle-to-vehicle impacts. The odds of severe driver injury at cross intersections were 0.29 compared to travel along straight roads. The odds of severe driver injury when street lighting was not available at

  12. Presence of psychoactive substances in injured Belgian drivers.

    PubMed

    Legrand, Sara-Ann; Silverans, Peter; de Paepe, Peter; Buylaert, Walter; Verstraete, Alain G

    2013-01-01

    To estimate the percentage of drivers involved in a traffic crash in Belgium who have alcohol and drugs in their blood. Blood samples of the drivers injured in a traffic crash and admitted to the emergency departments of 5 hospitals in Belgium between January 2008 and May 2010 were analyzed for ethanol (with an enzymatic method) and 22 other psychoactive substances (with ultra-performance liquid chromatography with tandem mass spectrometry or gas chromatography-mass spectrometry). One thousand seventy-eight drivers were included in the study. Alcohol (≥0.1 g/L) was the most common substance (26.2%). A large majority of the drivers (64%) who were positive for alcohol had a blood alcohol concentration (BAC) ≥1.3 g/L (legal limit in Belgium: 0.5 g/L). These high BACs were most frequent among male injured drivers. Cannabis was the most prevalent illicit drug (5.3%) and benzodiazepines (5.3%) were the most prevalent medicinal drugs. Approximately 1 percent of the drivers were positive for cocaine and amphetamines. No drivers tested positive for illicit opioids. Medicinal drugs were more likely to be found among female drivers and drivers older than 35 years, and alcohol and illicit drugs were more likely to be found among male drivers and drivers younger than 35 years. A high percentage of the injured drivers were positive for a psychoactive substance at the time of injury. Alcohol was the most common substance, with 80 percent of the positive drivers having a BAC ≥0.5 g/L. Compared to a roadside survey in the same area, drivers/riders with high BACs and combinations of drugs were overrepresented. Efforts should be made to increase alcohol and drug enforcement. The introduction of a categorization and labeling system might reduce driving under the influence of medicinal drugs by informing health care professionals and patients.

  13. [Artefacts of questionnaire-based psychological testing of drivers].

    PubMed

    Łuczak, Anna; Tarnowski, Adam

    2014-01-01

    The purpose of this article is to draw attention to a significant role of social approval variable in the qustionnaire-based diagnosis of drivers' psychological aptitude. Three questionnaires were used: Formal Characteristics of Behavior - Temperament Inventory (FCB-TI), Eysenck Personality Questionnaire (EPQ-R(S) and Impulsiveness Questionnaire (Impulsiveness, Venturesomeness, Empathy - IVE). Three groups of drivers were analyzed: professional "without crashes" (N = 46), nonprofessional "without crashes" (N = 75), and nonprofessional "with crashes" (N = 75). Nonprofessional drivers "without crashes" significantly stood up against other drivers. Their personality profile, indicating a significantly utmost perseveration, emotional reactivity, neuroticism, impulsiveness and the lowest endurance did not fit in to the requirements to be met by drivers. The driver safety profile was characteristic of professional drivers (the lowest level of perseveration, impulsiveness and neuroticism and the highest level of endurance). Similar profile occurred among nonprofessional drivers--the offenders of road crashes. Compared to the nonprofessional "without crashes" group, professional drivers and offenders of road crashes were also characterized by a significantly higher score on the Lie scale, determining the need for social approval. This is likely to result from the study procedure according to which the result of professional drivers testing had an impact on a possible continuity of their job and that of nonprofessional drivers "with crashes" decided about possible recovery of the driving license. The variable of social approval can be a significant artifact in the study of psychological drivers' testing and reduce the reliability of the results of questionnaire methods.

  14. 78 FR 76757 - Regulatory Guidance on Hours of Service of Drivers Rest Break Requirement; Drivers Who Become...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-19

    ... days as ``short haul'' drivers exempt from the break rule, but who occasionally exceed the short haul distance or time limits. Such drivers are then subject to the break requirement and must prepare a record-of-duty-status (RODS) for the day. The intent of the break rule would be satisfied if drivers in...

  15. Direct and Indirect Costs of Asthma Management in Greece: An Expert Panel Approach.

    PubMed

    Souliotis, Kyriakos; Kousoulakou, Hara; Hillas, Georgios; Bakakos, Petros; Toumbis, Michalis; Loukides, Stelios; Vassilakopoulos, Theodoros

    2017-01-01

    Asthma is a major cause of morbidity and mortality and is associated with significant economic burden worldwide. The objectives of this study were to map current resource use associated with the disease management and to estimate the annual direct and indirect costs per adult patient with asthma. A Delphi panel with seven leading pulmonologists was conducted. A semistructured questionnaire was developed to elicit data on resource use and treatment patterns. Unit costs from official, published sources were subsequently assigned to resource use to estimate direct medical costs. Indirect costs were estimated as number of work loss days. Cost base year was 2015, and the perspective adopted was that of the National Organization of Health Care Services Provision, as well as the societal. Patients with asthma are mainly managed by pulmonologists (71.4%) and secondarily by general practitioners and internists (28.6%). The annual cost of managing exacerbations was estimated at €273.1, while maintenance costs were estimated at €1,100.2 per year. Total costs of managing asthma per patient per year were estimated at €2,281.8, 64.4% of which represented direct medical costs. Of the direct costs, pharmaceutical treatment was the key driver, accounting for 63.9 and 41.2% of direct and total costs, respectively. Direct non-medical costs (patient travel and waiting time) were estimated at €152.3. Indirect costs accounted for 28.9% of total costs. Asthma is a chronic condition, the management of which constrains the already limited Greek health care resources. The increasing prevalence of the disease raises concerns as it could translate per patient costs into a significant burden for the Greek health care system. Thus, the prevention, self-management, and improved quality of care for asthma should find a place in the health policy agenda in Greece.

  16. Driver-centred vehicle automation: using network analysis for agent-based modelling of the driver in highly automated driving systems.

    PubMed

    Banks, Victoria A; Stanton, Neville A

    2016-11-01

    To the average driver, the concept of automation in driving infers that they can become completely 'hands and feet free'. This is a common misconception, however, one that has been shown through the application of Network Analysis to new Cruise Assist technologies that may feature on our roads by 2020. Through the adoption of a Systems Theoretic approach, this paper introduces the concept of driver-initiated automation which reflects the role of the driver in highly automated driving systems. Using a combination of traditional task analysis and the application of quantitative network metrics, this agent-based modelling paper shows how the role of the driver remains an integral part of the driving system implicating the need for designers to ensure they are provided with the tools necessary to remain actively in-the-loop despite giving increasing opportunities to delegate their control to the automated subsystems. Practitioner Summary: This paper describes and analyses a driver-initiated command and control system of automation using representations afforded by task and social networks to understand how drivers remain actively involved in the task. A network analysis of different driver commands suggests that such a strategy does maintain the driver in the control loop.

  17. Bus driver fatigue and stress issues study

    DOT National Transportation Integrated Search

    2001-02-01

    Fatigue-related issues associated with motorcoach drivers differ from the issues faced by truck drivers because of the distinct nature of their jobs. For example, truck and motorcoach drivers deal with different vehicular operating characteristics, n...

  18. Expanding Access to a New, More Affordable Levonorgestrel Intrauterine System in Kenya: Service Delivery Costs Compared With Other Contraceptive Methods and Perspectives of Key Opinion Leaders.

    PubMed

    Rademacher, Kate H; Solomon, Marsden; Brett, Tracey; Bratt, John H; Pascual, Claire; Njunguru, Jesse; Steiner, Markus J

    2016-08-11

    The levonorgestrel intrauterine system (LNG IUS) is one of the most effective forms of contraception and offers important non-contraceptive health benefits. However, it is not widely available in developing countries, largely due to the high price of existing products. Medicines360 plans to introduce its new, more affordable LNG IUS in Kenya. The public-sector transfer price will vary by volume between US$12 to US$16 per unit; for an order of 100,000 units, the public-sector transfer price will be approximately US$15 per unit. We calculated the direct service delivery cost per couple-years of protection (CYP) of various family planning methods. The model includes the costs of contraceptive commodities, consumable supplies, instruments per client visit, and direct labor for counseling, insertion, removal, and resupply, if required. The model does not include costs of demand creation or training. We conducted interviews with key opinion leaders in Kenya to identify considerations for scale-up of a new LNG IUS, including strategies to overcome barriers that have contributed to low uptake of the copper intrauterine device. The direct service delivery cost of Medicines360's LNG IUS per CYP compares favorably with other contraceptive methods commonly procured for public-sector distribution in Kenya. The cost is slightly lower than that of the 3-month contraceptive injectable, which is currently the most popular method in Kenya. Almost all key opinion leaders agreed that introducing a more affordable LNG IUS could increase demand and uptake of the method. They thought that women seeking the product's non-contraceptive health benefits would be a key market segment, and most agreed that the reduced menstrual bleeding associated with the method would likely be viewed as an advantage. The key opinion leaders indicated that myths and misconceptions among providers and clients about IUDs must be addressed, and that demand creation and provider training should be prioritized

  19. Expanding Access to a New, More Affordable Levonorgestrel Intrauterine System in Kenya: Service Delivery Costs Compared With Other Contraceptive Methods and Perspectives of Key Opinion Leaders

    PubMed Central

    Rademacher, Kate H; Solomon, Marsden; Brett, Tracey; Bratt, John H; Pascual, Claire; Njunguru, Jesse; Steiner, Markus J

    2016-01-01

    ABSTRACT Background: The levonorgestrel intrauterine system (LNG IUS) is one of the most effective forms of contraception and offers important non-contraceptive health benefits. However, it is not widely available in developing countries, largely due to the high price of existing products. Medicines360 plans to introduce its new, more affordable LNG IUS in Kenya. The public‐sector transfer price will vary by volume between US$12 to US$16 per unit; for an order of 100,000 units, the public-sector transfer price will be approximately US$15 per unit. Methods: We calculated the direct service delivery cost per couple-years of protection (CYP) of various family planning methods. The model includes the costs of contraceptive commodities, consumable supplies, instruments per client visit, and direct labor for counseling, insertion, removal, and resupply, if required. The model does not include costs of demand creation or training. We conducted interviews with key opinion leaders in Kenya to identify considerations for scale-up of a new LNG IUS, including strategies to overcome barriers that have contributed to low uptake of the copper intrauterine device. Results: The direct service delivery cost of Medicines360’s LNG IUS per CYP compares favorably with other contraceptive methods commonly procured for public-sector distribution in Kenya. The cost is slightly lower than that of the 3-month contraceptive injectable, which is currently the most popular method in Kenya. Almost all key opinion leaders agreed that introducing a more affordable LNG IUS could increase demand and uptake of the method. They thought that women seeking the product’s non-contraceptive health benefits would be a key market segment, and most agreed that the reduced menstrual bleeding associated with the method would likely be viewed as an advantage. The key opinion leaders indicated that myths and misconceptions among providers and clients about IUDs must be addressed, and that demand creation

  20. The cost of chronic pain: an analysis of a regional pain management service in Ireland.

    PubMed

    Gannon, Brenda; Finn, David P; O'Gorman, David; Ruane, Nancy; McGuire, Brian E

    2013-10-01

    The objective of the study was to collect data on the direct and indirect economic cost of chronic pain among patients attending a pain management clinic in Ireland. A tertiary pain management clinic serving a mixed urban and rural area in the West of Ireland. Data were collected from 100 patients using the Client Services Receipt Inventory and focused on direct and indirect costs of chronic pain. Patients were questioned about health service utilization, payment methods, and relevant sociodemographics. Unit costs were multiplied by resource use data to obtain full costs. Cost drivers were then estimated. Our study showed a cost per patient of US$24,043 over a 12-month period. Over half of this was attributable to wage replacement costs and lost productivity in those unable to work because of pain. Hospital stays and outpatient hospital services were the main drivers for health care utilization costs, together accounting for 63% of the direct medical costs per study participant attending the pain clinic. The cost of chronic pain among intensive service users is significant, and when extrapolated to a population level, these costs represent a very substantial economic burden. Wiley Periodicals, Inc.

  1. A Vehicle Active Safety Model: Vehicle Speed Control Based on Driver Vigilance Detection Using Wearable EEG and Sparse Representation

    PubMed Central

    Zhang, Zutao; Luo, Dianyuan; Rasim, Yagubov; Li, Yanjun; Meng, Guanjun; Xu, Jian; Wang, Chunbai

    2016-01-01

    In this paper, we present a vehicle active safety model for vehicle speed control based on driver vigilance detection using low-cost, comfortable, wearable electroencephalographic (EEG) sensors and sparse representation. The proposed system consists of three main steps, namely wireless wearable EEG collection, driver vigilance detection, and vehicle speed control strategy. First of all, a homemade low-cost comfortable wearable brain-computer interface (BCI) system with eight channels is designed for collecting the driver’s EEG signal. Second, wavelet de-noising and down-sample algorithms are utilized to enhance the quality of EEG data, and Fast Fourier Transformation (FFT) is adopted to extract the EEG power spectrum density (PSD). In this step, sparse representation classification combined with k-singular value decomposition (KSVD) is firstly introduced in PSD to estimate the driver’s vigilance level . Finally, a novel safety strategy of vehicle speed control, which controls the electronic throttle opening and automatic braking after driver fatigue detection using the above method, is presented to avoid serious collisions and traffic accidents. The simulation and practical testing results demonstrate the feasibility of the vehicle active safety model. PMID:26907278

  2. Contributors to young drivers' driving styles - A comparison between Israel and Queensland.

    PubMed

    Skvirsky, Vera; Ben-Ari, Orit Taubman; Greenbury, Timothy J; Prato, Carlo G

    2017-12-01

    Among the numerous factors that contribute to young novice drivers' driving styles, personality characteristics, sociodemographic variables, family atmosphere, and friends' norms are known to have an important impact. However, cross-cultural comparisons are relatively rare in the safety literature concerning young drivers. This study aimed at comparing young drivers from Israel and Queensland (Australia) and examining the contribution of personality, sociodemographic, family and friends' aspects to their driving styles (reckless and careless; hostile and angry; anxious; patient and careful). More specifically, this study examined the associations between young drivers' driving style and their perceptions of separation-individuation, the family climate for road safety, and the safe driving climate among friends. We also examined sociodemographic and driving history variables such as gender, the marital status of parents, and personal exposure to traffic crashes. The study consisted of two samples of male and female young drivers (age 17-22) from Israel (n=160) and Queensland (n=160), who completed a set of valid and reliable self-report questionnaires. Findings indicate that in general, maladaptive driving styles are associated with lower family tendency to engage in promoting road safety, higher pressure and costs of driving with peers, and unhealthier separation-individuation aspects. The opposite is observed for the patient and careful driving style that relates to higher engagement of the family in road safety, lower pressure from friends, and healthier separation-individuation. Some differences were found regarding specific styles between the two samples. In addition, women scored lower than men in the reckless and careless style, and higher (in the Israeli sample) in the anxious as well as the patient and careful styles. Overall, similarities in the associations between the study variables in the samples exceed the differences, and the importance of examining

  3. Association between New Jersey's Graduated Driver Licensing decal provision and crash rates of young drivers with learners' permits.

    PubMed

    Curry, Allison E; Pfeiffer, Melissa R; Elliott, Michael R; Durbin, Dennis R

    2015-12-01

    New Jersey (NJ) implemented the first-in-the-US Graduated Driver Licensing (GDL) decal provision in May 2010 for young drivers with learner's permits or intermediate licenses. Previous analyses found an association between the provision and crash reduction among intermediate drivers. The aim of this study is to examine the association between NJ's provision and GDL citation and crash rates among drivers aged <21 years with learner's permits. We estimated monthly per-driver rates from January 2006 through June 2012. Negative binomial modeling compared pre and post decal crash rates adjusted for gender, age, calendar month, and gas price. The monthly GDL citation rate was two per 10,000 drivers in the predecal and postdecal periods. Crashes were rare and rates declined similarly pre and post decal (adjusted rate ratio of postdecal vs predecal slope: 1.04 (0.97 to 1.12)). NJ's GDL decal provision was not associated with a change in citation or crash rates among young NJ drivers with learner's permits. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Research on driver fatigue detection

    NASA Astrophysics Data System (ADS)

    Zhang, Ting; Chen, Zhong; Ouyang, Chao

    2018-03-01

    Driver fatigue is one of the main causes of frequent traffic accidents. In this case, driver fatigue detection system has very important significance in avoiding traffic accidents. This paper presents a real-time method based on fusion of multiple facial features, including eye closure, yawn and head movement. The eye state is classified as being open or closed by a linear SVM classifier trained using HOG features of the detected eye. The mouth state is determined according to the width-height ratio of the mouth. The head movement is detected by head pitch angle calculated by facial landmark. The driver's fatigue state can be reasoned by the model trained by above features. According to experimental results, drive fatigue detection obtains an excellent performance. It indicates that the developed method is valuable for the application of avoiding traffic accidents caused by driver's fatigue.

  5. Effect of freeway level of service and driver education on truck driver stress : phase 1.

    DOT National Transportation Integrated Search

    2012-08-01

    This research primarily deals with truck driver stress and its nature, stressors, and their mutual relationship. During the : study, the different demands of driving that are related to roads, vehicle, traffic conditions, driver predisposition to : s...

  6. Density as a Cost Driver in Naval Submarine Design and Procurement

    DTIC Science & Technology

    2008-06-01

    RADM Steve Johnson, thank you for this opportunity to contribute to the continued preeminence of the United States Submarine Force. Mr. Chris Deegan ...craft and is used to respond to questions from higher echelon Navy/DoD on cost of historical ships ( Deegan , 2005). NAVSEA 05U provided SCN end-cost...Arlington, VA 6. Chris Deegan Director, NAVSEA 05C Washington Navy Yard, Washington, DC 7. RDML William Hilardes Program Executive Officer

  7. A Simple Wave Driver

    ERIC Educational Resources Information Center

    Temiz, Burak Kagan; Yavuz, Ahmet

    2015-01-01

    This study was done to develop a simple and inexpensive wave driver that can be used in experiments on string waves. The wave driver was made using a battery-operated toy car, and the apparatus can be used to produce string waves at a fixed frequency. The working principle of the apparatus is as follows: shortly after the car is turned on, the…

  8. Clinical process cost analysis.

    PubMed

    Marrin, C A; Johnson, L C; Beggs, V L; Batalden, P B

    1997-09-01

    New systems of reimbursement are exerting enormous pressure on clinicians and hospitals to reduce costs. Using cheaper supplies or reducing the length of stay may be a satisfactory short-term solution, but the best strategy for long-term success is radical reduction of costs by reengineering the processes of care. However, few clinicians or institutions know the actual costs of medical care; nor do they understand, in detail, the activities involved in the delivery of care. Finally, there is no accepted method for linking the two. Clinical process cost analysis begins with the construction of a detailed flow diagram incorporating each activity in the process of care. The cost of each activity is then calculated, and the two are linked. This technique was applied to Diagnosis Related Group 75 to analyze the real costs of the operative treatment of lung cancer at one institution. Total costs varied between $6,400 and $7,700. The major driver of costs was personnel time, which accounted for 55% of the total. Forty percent of the total cost was incurred in the operating room. The cost of care decreased progressively during hospitalization. Clinical process cost analysis provides detailed information about the costs and processes of care. The insights thus obtained may be used to reduce costs by reengineering the process.

  9. Cost Comparison of B-1B Non-Mission-Capable Drivers Using Finite Source Queueing with Spares

    DTIC Science & Technology

    2012-09-06

    COMPARISON OF B-1B NON-MISSION-CAPABLE DRIVERS USING FINITE SOURCE QUEUEING WITH SPARES GRADUATE RESEARCH PAPER Presented to the Faculty...step into the lineup making large-number approximations unusable. Instead, a finite source queueing model including spares is incorporated...were reported as flying time accrued since last occurrence. Service time was given in both start-stop format and MX man-hours utilized. Service time was

  10. Reliability of drivers in urban intersections.

    PubMed

    Gstalter, Herbert; Fastenmeier, Wolfgang

    2010-01-01

    The concept of human reliability has been widely used in industrial settings by human factors experts to optimise the person-task fit. Reliability is estimated by the probability that a task will successfully be completed by personnel in a given stage of system operation. Human Reliability Analysis (HRA) is a technique used to calculate human error probabilities as the ratio of errors committed to the number of opportunities for that error. To transfer this notion to the measurement of car driver reliability the following components are necessary: a taxonomy of driving tasks, a definition of correct behaviour in each of these tasks, a list of errors as deviations from the correct actions and an adequate observation method to register errors and opportunities for these errors. Use of the SAFE-task analysis procedure recently made it possible to derive driver errors directly from the normative analysis of behavioural requirements. Driver reliability estimates could be used to compare groups of tasks (e.g. different types of intersections with their respective regulations) as well as groups of drivers' or individual drivers' aptitudes. This approach was tested in a field study with 62 drivers of different age groups. The subjects drove an instrumented car and had to complete an urban test route, the main features of which were 18 intersections representing six different driving tasks. The subjects were accompanied by two trained observers who recorded driver errors using standardized observation sheets. Results indicate that error indices often vary between both the age group of drivers and the type of driving task. The highest error indices occurred in the non-signalised intersection tasks and the roundabout, which exactly equals the corresponding ratings of task complexity from the SAFE analysis. A comparison of age groups clearly shows the disadvantage of older drivers, whose error indices in nearly all tasks are significantly higher than those of the other groups

  11. The Safety Performance of Passenger Carrier Drivers

    DOT National Transportation Integrated Search

    2012-12-01

    This paper examines the safety performance of passenger carrier drivers. Special emphasis is given to the motorcoach segment. A model that investigates the contribution of driver factors on the number of State-reportable crashes in which the driver w...

  12. Motorcoach Driver Fatigue Study, 2011

    DOT National Transportation Integrated Search

    2012-12-01

    Eighty-four commercial motorcoach drivers participated in a month-long study of duty start time, total duty time, total sleep time per 24 hours, with sleepiness, fatigue, and performance measured as they were going on and off duty. Drivers worked the...

  13. Mature Drivers: Traffic Safety Tips

    DOT National Transportation Integrated Search

    1996-01-01

    This fact sheet, NHTSA Facts: Summer 1996, discusses safety tips for drivers aged 70 and older. It notes that mature drivers: rank lower in aggressive actions; tend to make necessary safety adjustments in their driving, based on their own experience;...

  14. 20 CFR 404.1008 - Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. (a) General... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. 404.1008 Section 404.1008...

  15. 20 CFR 404.1008 - Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. (a) General... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. 404.1008 Section 404.1008...

  16. 20 CFR 404.1008 - Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. (a) General... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. 404.1008 Section 404.1008...

  17. 20 CFR 404.1008 - Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. (a) General... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. 404.1008 Section 404.1008...

  18. 20 CFR 404.1008 - Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. (a) General... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. 404.1008 Section 404.1008...

  19. The ACA’s Cost-Sharing Reduction Plans: A Key to Affordable Health Coverage for Millions of U.S. Workers.

    PubMed

    Gabel, Jon; Whitmore, Heidi; Green, Matthew; Call, Adrienne; Stromberg, Sam; Oran, Rebecca

    2016-10-01

    Issue: Without the cost-sharing reductions (CSRs) made available by the Affordable Care Act, health plans sold in the marketplaces may be unaffordable for many low-income people. CSRs are available to households earning between 100 percent and 250 percent of the federal poverty level that choose a silver-level marketplace plan. In 2016, about 7 million people received cost-sharing reductions that substantially lowered their deductibles, copayments, coinsurance, and out-of-pocket limits. Goal: To examine variations in consumer cost-sharing reductions between silver-level plans with CSRs to traditional marketplace plans and to employer-based insurance. Methods: Data analysis of 1,209 CSR-eligible plans sold in individual marketplaces in all 50 states and Washington, D.C. Key findings and conclusions: Cost-sharing amounts in silver plans with CSRs are much less than those in non-CSR base silver plans; silver plans with CSRs generally offer far better financial protection than those without. General annual deductibles range from $246 for CSR silver plans with a platinum-level actuarial value (94%) to as much as $3,063 for non-CSR silver plans. Out-of-pocket limits vary from $6,223 in base silver plans to $1,102 in silver plans with CSRs and a platinum-level actuarial level.

  20. Periodic Heterogeneous Vehicle Routing Problem With Driver Scheduling

    NASA Astrophysics Data System (ADS)

    Mardiana Panggabean, Ellis; Mawengkang, Herman; Azis, Zainal; Filia Sari, Rina

    2018-01-01

    The paper develops a model for the optimal management of logistic delivery of a given commodity. The company has different type of vehicles with different capacity to deliver the commodity for customers. The problem is then called Periodic Heterogeneous Vehicle Routing Problem (PHVRP). The goal is to schedule the deliveries according to feasible combinations of delivery days and to determine the scheduling of fleet and driver and routing policies of the vehicles. The objective is to minimize the sum of the costs of all routes over the planning horizon. We propose a combined approach of heuristic algorithm and exact method to solve the problem.

  1. Reducing young driver road trauma: guidance and optimism for the future

    PubMed Central

    Senserrick, T M

    2006-01-01

    This paper highlights lessons from each of the Expert Panel papers in the present supplement that provide guidance for future research and initiatives. Although some shortfalls still remain in our understanding, it is argued that much has been learned and we are ready for more translation, implementation, and evaluation of multilevel interventions to help reduce young driver road trauma. Non‐use of restraints, speeding, driving at night and with passengers, and fatigue are highlighted as key risk factors to address. “Best practice” intervention is proposed as implementing and strengthening graduated driver licensing systems and complementary candidate programs and research, such as hazard perception training programs. A schematic cognitive‐perceptual model to explain the crash sequence process is explored. There is optimism that meaningful impacts can be made, especially coupled with the advances in vehicle technologies, but caution is necessary in the absence of targeted “real world” evaluations and broader implementation and diffusion strategies. PMID:16788114

  2. Hand-movement-based in-vehicle driver/front-seat passenger discrimination for centre console controls

    NASA Astrophysics Data System (ADS)

    Herrmann, Enrico; Makrushin, Andrey; Dittmann, Jana; Vielhauer, Claus; Langnickel, Mirko; Kraetzer, Christian

    2010-01-01

    Successful user discrimination in a vehicle environment may yield a reduction of the number of switches, thus significantly reducing costs while increasing user convenience. The personalization of individual controls permits conditional passenger enable/driver disable and vice versa options which may yield safety improvement. The authors propose a prototypic optical sensing system based on hand movement segmentation in near-infrared image sequences implemented in an Audi A6 Avant. Analyzing the number of movements in special regions, the system recognizes the direction of the forearm and hand motion and decides whether driver or front-seat passenger touch a control. The experimental evaluation is performed independently for uniformly and non-uniformly illuminated video data as well as for the complete video data set which includes both subsets. The general test results in error rates of up to 14.41% FPR / 16.82% FNR and 17.61% FPR / 14.77% FNR for driver and passenger respectively. Finally, the authors discuss the causes of the most frequently occurring errors as well as the prospects and limitations of optical sensing for user discrimination in passenger compartments.

  3. Naturalistic distraction and driving safety in older drivers

    PubMed Central

    Aksan, Nazan; Dawson, Jeffrey D.; Emerson, Jamie L.; Yu, Lixi; Uc, Ergun Y.; Anderson, Steven W.; Rizzo, Matthew

    2013-01-01

    Objective This study aimed to quantify and compare performance of middle-aged and older drivers during a naturalistic distraction paradigm (visual search for roadside targets) and predict older driver performance given functioning in visual, motor, and cognitive domains. Background Distracted driving can imperil healthy adults and may disproportionally affect the safety of older drivers with visual, motor, and cognitive decline. Methods Two hundred and three drivers, 120 healthy older (61 men and 59 women, ages 65 years or greater) and 83 middle-aged drivers (38 men and 45 women, ages 40–64 years), participated in an on-road test in an instrumented vehicle. Outcome measures included performance in roadside target identification (traffic signs and restaurants) and concurrent driver safety. Differences in visual, motor, and cognitive functioning served as predictors. Results Older drivers identified fewer landmarks and drove slower but committed more safety errors than middle-aged drivers. Greater familiarity with local roads benefited performance of middle-aged but not older drivers. Visual cognition predicted both traffic sign identification and safety errors while executive function predicted traffic sign identification over and above vision. Conclusion Older adults are susceptible to driving safety errors while distracted by common secondary visual search tasks that are inherent to driving. The findings underscore that age-related cognitive decline affects older driver management of driving tasks at multiple levels, and can help inform the design of on-road tests and interventions for older drivers. PMID:23964422

  4. Naturalistic distraction and driving safety in older drivers.

    PubMed

    Aksan, Nazan; Dawson, Jeffrey D; Emerson, Jamie L; Yu, Lixi; Uc, Ergun Y; Anderson, Steven W; Rizzo, Matthew

    2013-08-01

    In this study, we aimed to quantify and compare performance of middle-aged and older drivers during a naturalistic distraction paradigm (visual search for roadside targets) and to predict older drivers performance given functioning in visual, motor, and cognitive domains. Distracted driving can imperil healthy adults and may disproportionally affect the safety of older drivers with visual, motor, and cognitive decline. A total of 203 drivers, 120 healthy older (61 men and 59 women, ages 65 years and older) and 83 middle-aged drivers (38 men and 45 women, ages 40 to 64 years), participated in an on-road test in an instrumented vehicle. Outcome measures included performance in roadside target identification (traffic signs and restaurants) and concurrent driver safety. Differences in visual, motor, and cognitive functioning served as predictors. Older drivers identified fewer landmarks and drove slower but committed more safety errors than did middle-aged drivers. Greater familiarity with local roads benefited performance of middle-aged but not older drivers.Visual cognition predicted both traffic sign identification and safety errors, and executive function predicted traffic sign identification over and above vision. Older adults are susceptible to driving safety errors while distracted by common secondary visual search tasks that are inherent to driving. The findings underscore that age-related cognitive decline affects older drivers' management of driving tasks at multiple levels and can help inform the design of on-road tests and interventions for older drivers.

  5. [Occupational stress situation analysis of different types of train drivers].

    PubMed

    Zhou, Wenhui; Gu, Guizhen; Wu, Hui; Yu, Shanfa

    2014-11-01

    To analyze the status of occupational stress in different types of train drivers. By using cluster sampling method, a cross-sectional study was conducted in 1 339 train drivers (including 289 passenger train drivers, 637 freight trains drivers, 339 passenger shunting train drivers, and 74 high speed rail drivers) from a Railway Bureau depot. The survey included individual factors, occupational stress factors, stress response factors and stress mitigating factors. The occupational stress factors, stress response factors and mitigating factors were measured by the revised effort-reward imbalance (ERI) model questionnaires and occupational stress measurement scale. By using the method of covariance analysized the difference of occupational stress factors of all types train drivers, the method of Stepwise regression was used to analyze the effection (R(2)) of occupational stress factors and stress mitigating factors on stress response factors. Covariance analysis as covariates in age, education level, length of service and marital status showed that the scores of ERI (1.58 ± 0.05), extrinsic effort (19.88 ± 0.44), rewards (23.43 ± 0.43), intrinsic effort (17.86 ± 0.36), physical environment (5.70 ± 0.22), social support (30.51 ± 0.88) and daily tension (10.27 ± 0.38 ) of high speed rail drivers were higher than other drivers (F values were 6.06, 11.32, 7.05, 13.25, 5.20, 9.48 and 6.14 respectively, P < 0.01), but the scores of emotional balance (4.15 ± 0.31) and positive emotion (2.06 ± 0.20) were lower than other drives (P < 0.01);the scores of psychological needs (10.48 ± 0.18), emotional balance (4.88 ± 0.16) and positive emotion (2.63 ± 0.10) of passenger train drivers were higher than other drivers (F values were 4.33 and 5.50 respectively, P < 0.01). The descending rank of the effect value on occupational stress factors and mitigating factors to depressive symptoms of train drivers was high speed rail drivers (R(2) = 0.64), passenger train drivers (R

  6. A probabilistic analysis of silicon cost

    NASA Technical Reports Server (NTRS)

    Reiter, L. J.

    1983-01-01

    Silicon materials costs represent both a cost driver and an area where improvement can be made in the manufacture of photovoltaic modules. The cost from three processes for the production of low-cost silicon being developed under the U.S. Department of Energy's (DOE) National Photovoltaic Program is analyzed. The approach is based on probabilistic inputs and makes use of two models developed at the Jet Propulsion Laboratory: SIMRAND (SIMulation of Research ANd Development) and IPEG (Improved Price Estimating Guidelines). The approach, assumptions, and limitations are detailed along with a verification of the cost analyses methodology. Results, presented in the form of cumulative probability distributions for silicon cost, indicate that there is a 55% chance of reaching the DOE target of $16/kg for silicon material. This is a technically achievable cost based on expert forecasts of the results of ongoing research and development and do not imply any market prices for a given year.

  7. Cost of obesity in the workplace.

    PubMed

    Schmier, Jordana K; Jones, Mechelle L; Halpern, Michael T

    2006-02-01

    As the prevalence of obesity increases, its economic consequences must be understood. This review summarizes published literature on the costs and resource use associated with obesity in the workplace. A Medline literature search was conducted for English-language publications. References from identified articles were also reviewed for relevance. The identified studies evaluated several cost components, including absenteeism, sick leave, disability, injuries, and claims data. Overall, overweight or obese employees had higher sick leave or disability use. Workplace injuries were higher among overweight or obese employees. Health care costs, based on claims data analyses, were also consistently higher for employees with higher body mass indices. Obesity is an important driver of costs in the workplace. These findings quantify the costs and can help employers consider whether to introduce workplace interventions or provide coverage for weight loss programs.

  8. Research data management and libraries: relationships, activities, drivers and influences.

    PubMed

    Pinfield, Stephen; Cox, Andrew M; Smith, Jen

    2014-01-01

    The management of research data is now a major challenge for research organisations. Vast quantities of born-digital data are being produced in a wide variety of forms at a rapid rate in universities. This paper analyses the contribution of academic libraries to research data management (RDM) in the wider institutional context. In particular it: examines the roles and relationships involved in RDM, identifies the main components of an RDM programme, evaluates the major drivers for RDM activities, and analyses the key factors influencing the shape of RDM developments. The study is written from the perspective of library professionals, analysing data from 26 semi-structured interviews of library staff from different UK institutions. This is an early qualitative contribution to the topic complementing existing quantitative and case study approaches. Results show that although libraries are playing a significant role in RDM, there is uncertainty and variation in the relationship with other stakeholders such as IT services and research support offices. Current emphases in RDM programmes are on developments of policies and guidelines, with some early work on technology infrastructures and support services. Drivers for developments include storage, security, quality, compliance, preservation, and sharing with libraries associated most closely with the last three. The paper also highlights a 'jurisdictional' driver in which libraries are claiming a role in this space. A wide range of factors, including governance, resourcing and skills, are identified as influencing ongoing developments. From the analysis, a model is constructed designed to capture the main aspects of an institutional RDM programme. This model helps to clarify the different issues involved in RDM, identifying layers of activity, multiple stakeholders and drivers, and a large number of factors influencing the implementation of any initiative. Institutions may usefully benchmark their activities against the

  9. Research Data Management and Libraries: Relationships, Activities, Drivers and Influences

    PubMed Central

    Pinfield, Stephen; Cox, Andrew M.; Smith, Jen

    2014-01-01

    The management of research data is now a major challenge for research organisations. Vast quantities of born-digital data are being produced in a wide variety of forms at a rapid rate in universities. This paper analyses the contribution of academic libraries to research data management (RDM) in the wider institutional context. In particular it: examines the roles and relationships involved in RDM, identifies the main components of an RDM programme, evaluates the major drivers for RDM activities, and analyses the key factors influencing the shape of RDM developments. The study is written from the perspective of library professionals, analysing data from 26 semi-structured interviews of library staff from different UK institutions. This is an early qualitative contribution to the topic complementing existing quantitative and case study approaches. Results show that although libraries are playing a significant role in RDM, there is uncertainty and variation in the relationship with other stakeholders such as IT services and research support offices. Current emphases in RDM programmes are on developments of policies and guidelines, with some early work on technology infrastructures and support services. Drivers for developments include storage, security, quality, compliance, preservation, and sharing with libraries associated most closely with the last three. The paper also highlights a ‘jurisdictional’ driver in which libraries are claiming a role in this space. A wide range of factors, including governance, resourcing and skills, are identified as influencing ongoing developments. From the analysis, a model is constructed designed to capture the main aspects of an institutional RDM programme. This model helps to clarify the different issues involved in RDM, identifying layers of activity, multiple stakeholders and drivers, and a large number of factors influencing the implementation of any initiative. Institutions may usefully benchmark their activities against

  10. 49 CFR 391.41 - Physical qualifications for drivers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 5 2012-10-01 2012-10-01 false Physical qualifications for drivers. 391.41... QUALIFICATIONS OF DRIVERS AND LONGER COMBINATION VEHICLE (LCV) DRIVER INSTRUCTORS Physical Qualifications and Examinations § 391.41 Physical qualifications for drivers. (a)(1)(i) A person subject to this part must not...

  11. 49 CFR 391.41 - Physical qualifications for drivers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 5 2011-10-01 2011-10-01 false Physical qualifications for drivers. 391.41... QUALIFICATIONS OF DRIVERS AND LONGER COMBINATION VEHICLE (LCV) DRIVER INSTRUCTORS Physical Qualifications and Examinations § 391.41 Physical qualifications for drivers. (a)(1)(i) A person subject to this part must not...

  12. 49 CFR 391.41 - Physical qualifications for drivers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 5 2013-10-01 2013-10-01 false Physical qualifications for drivers. 391.41... QUALIFICATIONS OF DRIVERS AND LONGER COMBINATION VEHICLE (LCV) DRIVER INSTRUCTORS Physical Qualifications and Examinations § 391.41 Physical qualifications for drivers. (a)(1)(i) A person subject to this part must not...

  13. 49 CFR 391.41 - Physical qualifications for drivers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 5 2014-10-01 2014-10-01 false Physical qualifications for drivers. 391.41... QUALIFICATIONS OF DRIVERS AND LONGER COMBINATION VEHICLE (LCV) DRIVER INSTRUCTORS Physical Qualifications and Examinations § 391.41 Physical qualifications for drivers. (a)(1)(i) A person subject to this part must not...

  14. Determination of characteristics of fatally injured drivers

    DOT National Transportation Integrated Search

    2001-12-01

    The objective of this study was to identify driver characteristics that can be used to predict driver risk of fatal crashes. The study had 3 components: (1) Comparisons were made among drivers who were killed in single-vehicle crashes or were at faul...

  15. Cost Effectiveness Trade-Offs in Software Support Environment Standardization.

    DTIC Science & Technology

    1986-09-30

    IIIIIEEEIIIIIE MiII I U..2 2 ma MICROCOPY RESOLUTION TEST CHART 911C FILE C y, o FINAL REPORT - September 30, 1986 G- TECHNION INTERNATIONAL, INC. Cost...Summary description of econometric model B-I C. Causal chain used as basis for model C-I D. Excerpts from [Wer185) D-1 LIST OF FIGURES S-1 USAF MCCR...Productivity cost drivers D-4 LIST OF TASL3$ I-1 Summary of Tangible Benefits in Econometric Equations 1-9 1-2 Summary of Tangible Costs in Econometric

  16. Driver drowsiness detection using multimodal sensor fusion

    NASA Astrophysics Data System (ADS)

    Andreeva, Elena O.; Aarabi, Parham; Philiastides, Marios G.; Mohajer, Keyvan; Emami, Majid

    2004-04-01

    This paper proposes a multi-modal sensor fusion algorithm for the estimation of driver drowsiness. Driver sleepiness is believed to be responsible for more than 30% of passenger car accidents and for 4% of all accident fatalities. In commercial vehicles, drowsiness is blamed for 58% of single truck accidents and 31% of commercial truck driver fatalities. This work proposes an innovative automatic sleep-onset detection system. Using multiple sensors, the driver"s body is studied as a mechanical structure of springs and dampeners. The sleep-detection system consists of highly sensitive triple-axial accelerometers to monitor the driver"s upper body in 3-D. The subject is modeled as a linear time-variant (LTV) system. An LMS adaptive filter estimation algorithm generates the transfer function (i.e. weight coefficients) for this LTV system. Separate coefficients are generated for the awake and asleep states of the subject. These coefficients are then used to train a neural network. Once trained, the neural network classifies the condition of the driver as either awake or asleep. The system has been tested on a total of 8 subjects. The tests were conducted on sleep-deprived individuals for the sleep state and on fully awake individuals for the awake state. When trained and tested on the same subject, the system detected sleep and awake states of the driver with a success rate of 95%. When the system was trained on three subjects and then retested on a fourth "unseen" subject, the classification rate dropped to 90%. Furthermore, it was attempted to correlate driver posture and sleepiness by observing how car vibrations propagate through a person"s body. Eight additional subjects were studied for this purpose. The results obtained in this experiment proved inconclusive which was attributed to significant differences in the individual habitual postures.

  17. Length of stay after reaching clinical stability drives hospital costs associated with adult community-acquired pneumonia.

    PubMed

    Cortoos, Pieter-Jan; Gilissen, Christa; Laekeman, Gert; Peetermans, Willy E; Leenaers, Hilde; Vandorpe, Luc; Simoens, Steven

    2013-03-01

    Community-acquired pneumonia (CAP) has a considerable clinical and economic impact. The aim of this study was to identify drivers of hospital costs associated with CAP in 2 Belgian hospitals. Specifically, the influence of patient characteristics, quality indicators, and other treatment aspects on hospital costs was explored. The following were registered for patients admitted with a confirmed diagnosis of CAP in a large university hospital (Universitaire Ziekenhuizen Leuven, UZL) and a medium-sized secondary care hospital (Ziekenhuis Oost-Limburg, ZOL) in Belgium: the pneumonia severity index (PSI), time to clinical stability, length of stay, antibiotic therapy, outcomes, compliance with validated quality indicators, and the different costs (pharmacy, laboratory, and radiology, and total). Regression analysis was used to identify influential variables. Between October 2007 and June 2010, 803 patients were included, with a median total cost of €4794.57. The length of stay after clinical stability and time to clinical stability had the highest influence on the total cost (+6.3% and +4.9% per additional day, respectively; p < 0.0001). Other important drivers of higher costs were total therapy duration, PSI score, age, and admission to intensive care. Patients treated with moxifloxacin had significantly, but limited, lower costs. Quality indicator compliance, including guideline-compliant antibiotic treatment and therapy streamlining, had little influence. The most important driver of hospital costs associated with CAP was the time between clinical stability and actual hospital discharge. In order to substantially decrease the costs of CAP treatment, this period should be rigorously evaluated for possible intervention targets that would allow costs in CAP treatment to be decreased in a substantial manner.

  18. A systematic review of cost-effectiveness analyses of drugs for postmenopausal osteoporosis.

    PubMed

    Hiligsmann, Mickaël; Evers, Silvia M; Ben Sedrine, Wafa; Kanis, John A; Ramaekers, Bram; Reginster, Jean-Yves; Silverman, Stuart; Wyers, Caroline E; Boonen, Annelies

    2015-03-01

    Given the limited availability of healthcare resources and the recent introduction of new anti-osteoporosis drugs, the interest in the cost effectiveness of drugs in postmenopausal osteoporosis remains and even increases. This study aims to identify all recent economic evaluations on drugs for postmenopausal osteoporosis, to critically appraise the reporting quality, and to summarize the results. A literature search using Medline, the National Health Service Economic Evaluation database and the Cost-Effectiveness Analysis Registry was undertaken to identify original articles published between January 1, 2008 and December 31, 2013. Studies that assessed cost effectiveness of drugs in postmenopausal osteoporosis were included. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement was used to assess the quality of reporting of these articles. Of 1,794 articles identified, 39 studies fulfilled the inclusion criteria. They were conducted in 14 different countries and nine active interventions were assessed. When compared with no treatment, active osteoporotic drugs were generally cost effective in postmenopausal women aged over 60-65 years with low bone mass, especially those with prior vertebral fractures. Key drivers of cost effectiveness included individual fracture risk, medication adherence, selected comparators and country-specific analyses. Quality of reporting varied between studies with an average score of 17.9 out of 24 (range 7-21.5). This review found a substantial number of published cost-effectiveness analyses of drugs in osteoporosis in the last 6 years. Results and critical appraisal of these articles can help decision makers when prioritizing health interventions and can inform the development of future economic evaluations.

  19. Medical education, cost and policy: what are the drivers for change? Commentary.

    PubMed

    Walsh, Kieran

    2014-01-01

    Medical education is expensive. Its expense has led many stakeholders to speculate on how costs could be reduced. In an ideal world such decisions would be made on sound evidence; however this is impossible in the absence of evidence. Sometimes practice will be informed by policy, but policy will not always be evidence based. So how is policy in the field of cost and value in medical education actually developed? The foremost influence on policy in cost and value should be evidence-based knowledge. Unfortunately policy is sometimes influenced by what might at best be termed tradition and at worst inertia. Another influence on policy will be people--but some individuals may have more influence than others. A further influence on policy in this field is events, and mainly events that have gone wrong. One final influence on emerging policy in medical education cost analysis is that of the media.

  20. North-South Corridor Demonstration Project: Ethical and Logistical Challenges in the Design of a Demonstration Study of Early Antiretroviral Treatment for Long Distance Truck Drivers along a Transport Corridor through South Africa, Zimbabwe, and Zambia

    PubMed Central

    Gomez, G. B.; Venter, W. D. F.; Lange, J. M. A.; Rees, H.; Hankins, C.

    2013-01-01

    Background. Long-distance truck drivers are at risk of acquiring and transmitting HIV and have suboptimal access to care. New HIV prevention strategies using antiretroviral drugs to reduce transmission risk (early antiretroviral therapy (ART) at CD4 count >350 cells/μL) have shown efficacy in clinical trials. Demonstration projects are needed to evaluate “real world” programme effectiveness. We present the protocol for a demonstration study to evaluate the feasibility, acceptability, and cost of an early ART intervention for HIV-positive truck drivers along a transport corridor across South Africa, Zimbabwe, and Zambia, as part of an enhanced strategy to improve treatment adherence and retention in care. Methods and Analysis. This demonstration study would follow an observational cohort of truck drivers receiving early treatment. Our mixed methods approach includes quantitative, qualitative, and economic analyses. Key ethical and logistical issues are discussed (i.e., choice of drug regimen, recruitment of participants, and monitoring of adherence, behavioural changes, and adverse events). Conclusion. Questions specific to the design of tailored early ART programmes are amenable to operational research approaches but present substantial ethical and logistical challenges. Addressing these in demonstration projects can inform policy decisions regarding strategies to reduce health inequalities in access to HIV prevention and treatment programmes. PMID:23606977