Valuing environmental services provided by local stormwater management

NASA Astrophysics Data System (ADS)

Brent, Daniel A.; Gangadharan, Lata; Lassiter, Allison; Leroux, Anke; Raschky, Paul A.

2017-06-01

The management of stormwater runoff via distributed green infrastructures delivers a number of environmental services that go beyond the reduction of flood risk, which has been the focus of conventional stormwater systems. Not all of these services may be equally valued by the public, however. This paper estimates households' willingness to pay (WTP) for improvements in water security, stream health, recreational and amenity values, as well as reduction in flood risk and urban heat island effect. We use data from nearly 1000 personal interviews with residential homeowners in Melbourne and Sydney, Australia. Our results suggest that the WTP for the highest levels of all environmental services is A799 per household per year. WTP is mainly driven by residents valuing improvements in local stream health, exemptions in water restrictions, the prevention of flash flooding, and decreased peak urban temperatures respectively at A297, A244, A104 and A$65 per year. We further conduct a benefit transfer analysis and find that the WTP and compensating surplus are not significantly different between the study areas. Our findings provide additional support that stormwater management via green infrastructures have large nonmarket benefits and that, under certain conditions, benefit values can be transferred to different locations.

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

Kot, Wing K.; Pegg, Ian L.; Brandys, Marek

One of the primary roles of waste pretreatment at the Hanford Tank Waste Treatment and Immobilization Plant (WTP) is to separate the majority of the radioactive components from the majority of the nonradioactive components in retrieved tank wastes, producing a high level waste (HLW) stream and a low activity waste (LAW) stream. This separation process is a key element in the overall strategy to reduce the volume of HLW that requires vitrification and subsequent disposal in a national deep geological repository for high level nuclear waste. After removal of the radioactive constituents, the LAW stream, which has a much largermore » volume but smaller fraction of radioactivity than the HLW stream, will be immobilized and disposed of in near surface facilities at the Hanford site.« less

An Approach to Understanding Cohesive Slurry Settling, Mobilization, and Hydrogen Gas Retention in Pulsed Jet Mixed Vessels

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

Gauglitz, Phillip A.; Wells, Beric E.; Fort, James A.

2009-05-22

The Hanford Waste Treatment and Immobilization Plant (WTP) is being designed and built to pretreat and vitrify a large portion of the waste in Hanford’s 177 underground waste storage tanks. Numerous process vessels will hold waste at various stages in the WTP. Some of these vessels have mixing-system requirements to maintain conditions where the accumulation of hydrogen gas stays below acceptable limits, and the mixing within the vessels is sufficient to release hydrogen gas under normal conditions and during off-normal events. Some of the WTP process streams are slurries of solid particles suspended in Newtonian fluids that behave as non-Newtonianmore » slurries, such as Bingham yield-stress fluids. When these slurries are contained in the process vessels, the particles can settle and become progressively more concentrated toward the bottom of the vessels, depending on the effectiveness of the mixing system. One limiting behavior is a settled layer beneath a particle-free liquid layer. The settled layer, or any region with sufficiently high solids concentration, will exhibit non-Newtonian rheology where it is possible for the settled slurry to behave as a soft solid with a yield stress. In this report, these slurries are described as settling cohesive slurries.« less

Evaporation Of Hanford Waste Treatment Plant Direct Feed Low Activity Waste Effluent Management Facility Core Simulant

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

Adamson, D.; Nash, C.; Mcclane, D.

The Hanford Waste Treatment and Immobilization Plant (WTP) Low Activity Waste (LAW) vitrification facility will generate an aqueous condensate recycle stream (LAW Melter Off-Gas Condensate, LMOGC) from the off-gas system. The baseline plan for disposition of this stream during full WTP operations is to send it to the WTP Pretreatment Facility, where it will be blended with LAW, concentrated by evaporation, and recycled to the LAW vitrification facility. However, during the Direct Feed LAW (DFLAW) scenario, planned disposition of this stream is to evaporate it in a new evaporator, in the Effluent Management Facility (EMF), and then return it tomore » the LAW melter. It is important to understand the composition of the effluents from the melter and new evaporator, so that the disposition of these streams can be accurately planned and accommodated. Furthermore, alternate disposition of the LMOGC stream would eliminate recycling of problematic components, and would reduce the need for closely integrated operation of the LAW melter and the Pretreatment Facilities. Long-term implementation of this option after WTP start-up would decrease the LAW vitrification mission duration and quantity of glass waste, amongst the other operational complexities such a recycle stream presents. In order to accurately plan for the disposition path, it is key to experimentally determine the fate of contaminants. To do this, testing is needed to accurately account for the buffering chemistry of the components, determine the achievable evaporation end point, identify insoluble solids that form, and determine the distribution of key regulatory-impacting constituents. The LAW Melter Off-Gas Condensate stream will contain components that are volatile at melter temperatures, have limited solubility in the glass waste form, and represent a materials corrosion concern, such as halides and sulfate. Because this stream will recycle within WTP, these components will accumulate in the Melter Condensate stream, exacerbating their impact on the number of LAW glass containers that must be produced. Diverting the stream reduces the halides and sulfates in the recycled Condensate and is a key outcome of this work. This overall program examines the potential treatment and immobilization of this stream to enable alternative disposal. The objective of this task was to demonstrate evaporation of a simulant of the LAW Melter Off-gas Condensate expected during DFLAW operations, in order to predict the composition of the effluents from the EMF evaporator to aid in planning for their disposition. This document describes the results of that test using the core simulant. This simulant formulation is designated as the “core simulant”; other additives will be included for specific testing, such as volatiles for evaporation or hazardous metals for measuring leaching properties of waste forms. The results indicate that the simulant can easily be concentrated via evaporation. During that the pH adjustment step in simulant preparation, ammonium is quickly converted to ammonia, and most of the ammonia was stripped from the simulated waste and partitioned to the condensate. Additionally, it was found that after concentrating (>12x) and cooling that a small amount of LiF and Na 3(SO 4)F precipitate out of solution. With the exception of ammonia, analysis of the condensate indicated very low to below detectable levels of many of the constituents in the simulant, yielding very high decontamination factors (DF).« less

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

Nichols, Ralph L.; Seitz, Roger R.; Dixon, Kenneth L.

The Waste Treatment and Immobilization Plant (WTP) at Hanford is being constructed to treat 56 million gallons of radioactive waste currently stored in underground tanks at the Hanford site. Operation of the WTP will generate several solid secondary waste (SSW) streams including used process equipment, contaminated tools and instruments, decontamination wastes, high-efficiency particulate air filters (HEPA), carbon adsorption beds, silver mordenite iodine sorbent beds, and spent ion exchange resins (IXr) all of which are to be disposed in the Integrated Disposal Facility (IDF). An applied research and development program was developed using a phased approach to incrementally develop the informationmore » necessary to support the IDF PA with each phase of the testing building on results from the previous set of tests and considering new information from the IDF PA calculations. This report contains the results from the exploratory phase, Phase 1 and preliminary results from Phase 2. Phase 3 is expected to begin in the fourth quarter of FY17.« less

Treatment of drinking water residuals: comparing sedimentation and dissolved air flotation performance with optimal cation ratios.

PubMed

Bourgeois, J C; Walsh, M E; Gagnon, G A

2004-03-01

Spent filter backwash water (SFBW) and clarifier sludge generally comprise the majority of the waste residual volume generated and in relative terms, these can be collectively referred to as combined filter backwash water (CFBW). CFBW is essentially a low-solids wastewater with metal hydroxide flocs that are typically light and slow to settle. This study evaluates the impact of adding calcium and magnesium carbonates to CFBW in terms of assessing the impacts on the sedimentation and DAF separation processes. Representative CFBW samples were collected from two surface water treatment plants (WTP): Lake Major WTP (Dartmouth, Nova Scotia, Canada) and Victoria Park WTP (Truro, Nova Scotia, Canada). Bench-scale results indicated that improvements in the CFBW settled water quality could be achieved through the addition of the divalent cations, thereby adjusting the monovalent to divalent (M:D) ratios of the wastewater. In general, the DAF process required slightly higher M:D ratios than the sedimentation process. The optimum M:D ratios for DAF and sedimentation were determined to be 1:1 and 0.33:1, respectively. It was concluded that the optimisation of the cation balance between monovalent cations (e.g., Na(+), K(+)) and added divalent cations (i.e., Ca(2+), Mg(2+)) aided in the settling mechanism through charge neutralisation-precipitation. The increase in divalent cation concentrations within the waste residual stream promoted destabilisation of the negatively charged colour molecules within the CFBW, thereby causing the colloidal content to become more hydrophobic.

Lifecycle assessment of microalgae to biofuel: Comparison of thermochemical processing pathways

DOE PAGES

Bennion, Edward P.; Ginosar, Daniel M.; Moses, John; ...

2015-01-16

Microalgae are currently being investigated as a renewable transportation fuel feedstock based on various advantages that include high annual yields, utilization of poor quality land, does not compete with food, and can be integrated with various waste streams. This study focuses on directly assessing the impact of two different thermochemical conversion technologies on the microalgae to biofuel process through life cycle assessment. A system boundary of a “well to pump” (WTP) is defined and includes sub-process models of the growth, dewatering, thermochemical bio-oil recovery, bio-oil stabilization, conversion to renewable diesel, and transport to the pump. Models were validated with experimentalmore » and literature data and are representative of an industrial-scale microalgae to biofuel process. Two different thermochemical bio-oil conversion systems are modeled and compared on a systems level, hydrothermal liquefaction (HTL) and pyrolysis. The environmental impact of the two pathways were quantified on the metrics of net energy ratio (NER), defined here as energy consumed over energy produced, and greenhouse gas (GHG) emissions. Results for WTP biofuel production through the HTL pathway were determined to be 1.23 for the NER and GHG emissions of -11.4 g CO 2-eq (MJ renewable diesel) -1. WTP biofuel production through the pyrolysis pathway results in a NER of 2.27 and GHG emissions of 210 g CO2 eq (MJ renewable diesel)-1. The large environmental impact associated with the pyrolysis pathway is attributed to feedstock drying requirements and combustion of co-products to improve system energetics. Discussion focuses on a detailed breakdown of the overall process energetics and GHGs, impact of modeling at laboratory- scale compared to industrial-scale, environmental impact sensitivity to engineering systems input parameters for future focused research and development and a comparison of results to literature.« less

Life cycle assessment of microalgae to biofuel: Thermochemical processing through hydrothermal liquefaction or pyrolysis

NASA Astrophysics Data System (ADS)

Bennion, Edward P.

Microalgae are currently being investigated as a renewable transportation fuel feedstock based on various advantages that include high annual yields, utilization of poor quality land, does not compete with food, and can be integrated with various waste streams. This study focuses on directly assessing the impact of two different thermochemical conversion technologies on the microalgae-to-biofuel process through life cycle assessment. A system boundary of a "well to pump" (WTP) is defined and includes sub-process models of the growth, dewatering, thermochemical bio-oil recovery, bio-oil stabilization, conversion to renewable diesel, and transport to the pump. Models were validated with experimental and literature data and are representative of an industrial-scale microalgae-to-biofuel process. Two different thermochemical bio-oil conversion systems are modeled and compared on a systems level, hydrothermal liquefaction (HTL) and pyrolysis. The environmental impact of the two pathways were quantified on the metrics of net energy ratio (NER), defined here as energy consumed over energy produced, and greenhouse gas (GHG) emissions. Results for WTP biofuel production through the HTL pathway were determined to be 1.23 for the NER and GHG emissions of -11.4 g CO2 eq (MJ renewable diesel)-1. WTP biofuel production through the pyrolysis pathway results in a NER of 2.27 and GHG emissions of 210 g CO2 eq (MJ renewable diesel)-1. The large environmental impact associated with the pyrolysis pathway is attributed to feedstock drying requirements and combustion of co-products to improve system energetics. Discussion focuses on a detailed breakdown of the overall process energetics and GHGs, impact of modeling at laboratory-scale compared to industrial-scale, environmental impact sensitivity to engineering systems input parameters for future focused research and development, and a comparison of results to literature.

Laboratory Evaporation Testing Of Hanford Waste Treatment Plant Low Activity Waste Off-Gas Condensate Simulant

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

Adamson, Duane J.; Nash, Charles A.; McCabe, Daniel J.

2014-01-01

The Hanford Waste Treatment and Immobilization Plant (WTP) Low Activity Waste (LAW) vitrification facility will generate an aqueous condensate recycle stream, LAW Off-Gas Condensate, from the off-gas system. The baseline plan for disposition of this stream is to send it to the WTP Pretreatment Facility, where it will be blended with LAW, concentrated by evaporation and recycled to the LAW vitrification facility again. Alternate disposition of this stream would eliminate recycling of problematic components, and would enable de-coupled operation of the LAW melter and the Pretreatment Facilities. Eliminating this stream from recycling within WTP would also decrease the LAW vitrificationmore » mission duration and quantity of canistered glass waste forms. This LAW Off-Gas Condensate stream contains components that are volatile at melter temperatures and are problematic for the glass waste form. Because this stream recycles within WTP, these components accumulate in the Condensate stream, exacerbating their impact on the number of LAW glass containers that must be produced. Approximately 32% of the sodium in Supplemental LAW comes from glass formers used to make the extra glass to dilute the halides to be within acceptable concentration ranges in the LAW glass. Diverting the stream reduces the halides in the recycled Condensate and is a key outcome of this work. Additionally, under possible scenarios where the LAW vitrification facility commences operation prior to the WTP Pretreatment facility, identifying a disposition path becomes vitally important. This task examines the impact of potential future disposition of this stream in the Hanford tank farms, and investigates auxiliary evaporation to enable another disposition path. Unless an auxiliary evaporator is used, returning the stream to the tank farms would require evaporation in the 242-A evaporator. This stream is expected to be unusual because it will be very high in corrosive species that are volatile in the melter (chloride, fluoride, sulfur), will have high ammonia, and will contain carryover particulates of glass-former chemicals. These species have potential to cause corrosion of tanks and equipment, precipitation of solids, release of ammonia gas vapors, and scale in the tank farm evaporator. Routing this stream to the tank farms does not permanently divert it from recycling into the WTP, only temporarily stores it prior to reprocessing. Testing is normally performed to demonstrate acceptable conditions and limits for these compounds in wastes sent to the tank farms. The primary parameter of this phase of the test program was measuring the formation of solids during evaporation in order to assess the compatibility of the stream with the evaporator and transfer and storage equipment. The origin of this LAW Off-Gas Condensate stream will be the liquids from the Submerged Bed Scrubber (SBS) and the Wet Electrostatic Precipitator (WESP) from the LAW facility melter offgas system. The stream is expected to be a dilute salt solution with near neutral pH, and will likely contain some insoluble solids from melter carryover. The soluble components are expected to be mostly sodium and ammonium salts of nitrate, chloride, and fluoride. This stream has not been generated yet, and, thus, the composition will not be available until the WTP begins operation, but a simulant has been produced based on models, calculations, and comparison with pilot-scale tests. This report discusses results of evaporation testing of the simulant. Two conditions were tested, one with the simulant at near neutral pH, and a second at alkaline pH. The neutral pH test is comparable to the conditions in the Hanford Effluent Treatment Facility (ETF) evaporator, although that evaporator operates at near atmospheric pressure and tests were done under vacuum. For the alkaline test, the target pH was based on the tank farm corrosion control program requirements, and the test protocol and equipment was comparable to that used for routine evaluation of feed compatibility studies for the 242-A evaporator. One of the radionuclides that is volatile in the melter and expected to be in high concentration in this LAW Off-Gas Condensate stream is Technetium-99 (99Tc). Technetium will not be removed from the aqueous waste in the Hanford WTP, and will primarily end up immobilized in the LAW glass by repeated recycle of the off-gas condensate into the LAW melter. Other radionuclides that are also expected to be in appreciable concentrations in the LAW Off-Gas Condensate are 129I, 90Sr, 137Cs, and 241Am. The concentrations of these radionuclides in this stream will be much lower than in the LAW, but they will still be higher than limits for some of the other disposition pathways currently available. At this time, these scoping tests did not evaluate the partitioning of the radionuclides to the evaporator condensate, since ample data are available separately from other experience in the DOE complex. Results from the evaporation testing show that the neutral SBS simulant first forms turbidity at ~7.5X concentration, while the alkaline-adjusted simulant became turbid at ~3X concentration. The major solid in both cases was Kogarkoite, Na3FSO4. Sodium and lithium fluorides were also detected. Minimal solids were formed in the evaporator bottoms until a substantial fraction of liquid was removed, indicating that evaporation could minimize storage volume issues. Achievable concentration factors without significant insoluble solids were 17X at alkaline pH, and 23X at neutral pH. In both runs, significant ammonia carried over and was captured in the condenser with the water condensate. Results also indicate that with low insoluble solids formation in the initial testing at neutral pH, the use of Reverse Osmosis is a potential alternate method for concentrating the solution, although an evaluation is needed to identify equipment that can tolerate insoluble solids. Most of the ammonia remains in the evaporator bottoms during the neutral pH evaporation, but partitions to the condensate during alkaline evaporation. Disposition of both streams needs to consider the management of ammonia vapor and its release. Since this is an initial phase of testing, additional tasks related to evaporation methods are expected to be identified for development. These tasks likely include evaluation and testing of composition variability testing and evaluations, corrosion and erosion testing, slurry storage and immobilization investigations, and evaporator condensate disposition.« less

Final Report - Melt Rate Enhancement for High Aluminum HLW Glass Formulation, VSL-08R1360-1, Rev. 0, dated 12/19/08

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

Kruger, Albert A.; Pegg, I. L.; Chaudhuri, M.

2013-11-13

The principal objective of the work reported here was to develop and identify HLW glass compositions that maximize waste processing rates for the aluminum limted waste composition specified by ORP while maintaining high waste loadings and acceptable glass properties. This was accomplished through a combination of crucible-scale tests, confirmation tests on the DM100 melter system, and demonstration at pilot scale (DM1200). The DM100-BL unit was selected for these tests since it was used previously with the HLW waste streams evaluated in this study, was used for tests on HLW glass compositions to support subsequent tests on the HLW Pilot Melter,more » conduct tests to determine the effect of various glass properties (viscosity and conductivity) and oxide concentrations on glass production rates with HLW feed streams, and to assess the volatility of cesium and technetium during the vitrification of an HLW AZ-102 composition. The same melter was selected for the present tests in order to maintain comparisons between the previously collected data. These tests provide information on melter processing characteristics and off-gas data, including formation of secondary phases and partitioning. Once DM100 tests were completed, one of the compositions was selected for further testing on the DM1200; the DM1200 system has been used for processing a variety of simulated Hanford waste streams. Tests on the larger melter provide processing data at one third of the scale of the actual WTP HLW melter and, therefore, provide a more accurate and reliable assessment of production rates and potential processing issues. The work focused on maximizing waste processing rates for high aluminum HLW compositions. In view of the diversity of forms of aluminum in the Hanford tanks, tests were also conducted on the DM100 to determine the effect of changes in the form of aluminum on feed properties and production rate. In addition, the work evaluated the effect on production rate of modest increases in melter operating temperature. Glass composition development was based on one of the HLW waste compositions specified by ORP that has a high concentration of aluminum. Small-scale tests were used to provide an initial screening of various glass formulations with respect to melt rates; more definitive screening was provided by the subsequent DM100 tests. Glass properties evaluated included: viscosity, electrical conductivity, crystallinity, gross glass phase separation and the 7- day Product Consistency Test (ASTM-1285). Glass property limits were based upon the reference properties for the WTP HLW melter. However, the WTP crystallinity limit (< 1 vol% at 950oC) was relaxed slightly as a waste loading constraint for the crucible melts.« less

Radionuclide Retention Mechanisms in Secondary Waste-Form Testing: Phase II

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

Um, Wooyong; Valenta, Michelle M.; Chung, Chul-Woo

2011-09-26

This report describes the results from laboratory tests performed at Pacific Northwest National Laboratory (PNNL) for Washington River Protection Solutions (WRPS) to evaluate candidate stabilization technologies that have the potential to successfully treat liquid secondary waste stream effluents produced by the Hanford Tank Waste Treatment and Immobilization Plant (WTP). WRPS is considering the design and construction of a Solidification Treatment Unit (STU) for the Effluent Treatment Facility (ETF) at Hanford. The ETF, a multi-waste, treatment-and-storage unit that has been permitted under the Resource Conservation and Recovery Act (RCRA), can accept dangerous, low-level, and mixed wastewaters for treatment. The STU needsmore » to be operational by 2018 to receive secondary liquid waste generated during operation of the WTP. The STU will provide the additional capacity needed for ETF to process the increased volume of secondary waste expected to be produced by WTP. This report on radionuclide retention mechanisms describes the testing and characterization results that improve understanding of radionuclide retention mechanisms, especially for pertechnetate, {sup 99}TcO{sub 4}{sup -} in four different waste forms: Cast Stone, DuraLith alkali aluminosilicate geopolymer, encapsulated fluidized bed steam reforming (FBSR) product, and Ceramicrete phosphate bonded ceramic. These data and results will be used to fill existing data gaps on the candidate technologies to support a decision-making process that will identify a subset of the candidate waste forms that are most promising and should undergo further performance testing.« less

Technology Readiness Assessment of a Large DOE Waste Processing Facility

DTIC Science & Technology

2007-09-12

Waste Generation at Hanford – Waste Treatment and Immobilization Plant ( WTP ) Project • Motivation to Conduct TRA • TRA Approach • Actions to ensure...Hanford’s WTP will be the world’s largest radioactive waste treatment plant to treat Hanford’s underground tank waste Waste Treatment Plant ( WTP ) Major...Mass Maximize Activity WTP Flow Sheet – Key Process Flows Hanford Tank Waste 10 How is the Vitrified Waste Dispositioned? High Level Waste Canisters

Analysis of a municipal wastewater treatment plant using a neural network-based pattern analysis

USGS Publications Warehouse

Hong, Y.-S.T.; Rosen, Michael R.; Bhamidimarri, R.

2003-01-01

This paper addresses the problem of how to capture the complex relationships that exist between process variables and to diagnose the dynamic behaviour of a municipal wastewater treatment plant (WTP). Due to the complex biological reaction mechanisms, the highly time-varying, and multivariable aspects of the real WTP, the diagnosis of the WTP are still difficult in practice. The application of intelligent techniques, which can analyse the multi-dimensional process data using a sophisticated visualisation technique, can be useful for analysing and diagnosing the activated-sludge WTP. In this paper, the Kohonen Self-Organising Feature Maps (KSOFM) neural network is applied to analyse the multi-dimensional process data, and to diagnose the inter-relationship of the process variables in a real activated-sludge WTP. By using component planes, some detailed local relationships between the process variables, e.g., responses of the process variables under different operating conditions, as well as the global information is discovered. The operating condition and the inter-relationship among the process variables in the WTP have been diagnosed and extracted by the information obtained from the clustering analysis of the maps. It is concluded that the KSOFM technique provides an effective analysing and diagnosing tool to understand the system behaviour and to extract knowledge contained in multi-dimensional data of a large-scale WTP. ?? 2003 Elsevier Science Ltd. All rights reserved.

Review of Potential Candidate Stabilization Technologies for Liquid and Solid Secondary Waste Streams

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

Pierce, Eric M.; Mattigod, Shas V.; Westsik, Joseph H.

2010-01-30

Pacific Northwest National Laboratory has initiated a waste form testing program to support the long-term durability evaluation of a waste form for secondary wastes generated from the treatment and immobilization of Hanford radioactive tank wastes. The purpose of the work discussed in this report is to identify candidate stabilization technologies and getters that have the potential to successfully treat the secondary waste stream liquid effluent, mainly from off-gas scrubbers and spent solids, produced by the Hanford Tank Waste Treatment and Immobilization Plant (WTP). Down-selection to the most promising stabilization processes/waste forms is needed to support the design of a solidificationmore » treatment unit (STU) to be added to the Effluent Treatment Facility (ETF). To support key decision processes, an initial screening of the secondary liquid waste forms must be completed by February 2010.« less

Advances in Glass Formulations for Hanford High-Aluminum, High-Iron and Enhanced Sulphate Management in HLW Streams - 13000

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

Kruger, Albert A.

2013-07-01

The current estimates and glass formulation efforts have been conservative in terms of achievable waste loadings. These formulations have been specified to ensure that the glasses are homogenous, contain essentially no crystalline phases, are processable in joule-heated, ceramic-lined melters and meet Hanford Tank Waste Treatment and Immobilization Plant (WTP) Contract terms. The WTP's overall mission will require the immobilization of tank waste compositions that are dominated by mixtures of aluminum (Al), chromium (Cr), bismuth (Bi), iron (Fe), phosphorous (P), zirconium (Zr), and sulphur (S) compounds as waste-limiting components. Glass compositions for these waste mixtures have been developed based upon previousmore » experience and current glass property models. Recently, DOE has initiated a testing program to develop and characterize HLW glasses with higher waste loadings and higher throughput efficiencies. Results of this work have demonstrated the feasibility of increases in waste loading from about 25 wt% to 33-50 wt% (based on oxide loading) in the glass depending on the waste stream. In view of the importance of aluminum limited waste streams at Hanford (and also Savannah River), the ability to achieve high waste loadings without adversely impacting melt rates has the potential for enormous cost savings from reductions in canister count and the potential for schedule acceleration. Consequently, the potential return on the investment made in the development of these enhancements is extremely favorable. Glass composition development for one of the latest Hanford HLW projected compositions with sulphate concentrations high enough to limit waste loading have been successfully tested and show tolerance for previously unreported tolerance for sulphate. Though a significant increase in waste loading for high-iron wastes has been achieved, the magnitude of the increase is not as substantial as those achieved for high-aluminum, high-chromium, high-bismuth or sulphur. Waste processing rate increases for high-iron streams as a combined effect of higher waste loadings and higher melt rates resulting from new formulations have been achieved. (author)« less

Advances in Glass Formulations for Hanford High-Alumimum, High-Iron and Enhanced Sulphate Management in HLW Streams - 13000

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

Kruger, Albert A.

2013-01-16

The current estimates and glass formulation efforts have been conservative in terms of achievable waste loadings. These formulations have been specified to ensure that the glasses are homogenous, contain essentially no crystalline phases, are processable in joule-heated, ceramic-lined melters and meet Hanford Tank Waste Treatment and Immobilization Plant (WTP) Contract terms. The WTP?s overall mission will require the immobilization of tank waste compositions that are dominated by mixtures of aluminum (Al), chromium (Cr), bismuth (Bi), iron (Fe), phosphorous (P), zirconium (Zr), and sulphur (S) compounds as waste-limiting components. Glass compositions for these waste mixtures have been developed based upon previousmore » experience and current glass property models. Recently, DOE has initiated a testing program to develop and characterize HLW glasses with higher waste loadings and higher throughput efficiencies. Results of this work have demonstrated the feasibility of increases in waste loading from about 25 wt% to 33-50 wt% (based on oxide loading) in the glass depending on the waste stream. In view of the importance of aluminum limited waste streams at Hanford (and also Savannah River), the ability to achieve high waste loadings without adversely impacting melt rates has the potential for enormous cost savings from reductions in canister count and the potential for schedule acceleration. Consequently, the potential return on the investment made in the development of these enhancements is extremely favorable. Glass composition development for one of the latest Hanford HLW projected compositions with sulphate concentrations high enough to limit waste loading have been successfully tested and show tolerance for previously unreported tolerance for sulphate. Though a significant increase in waste loading for high-iron wastes has been achieved, the magnitude of the increase is not as substantial as those achieved for high-aluminum, high-chromium, high-bismuth or sulphur. Waste processing rate increases for high-iron streams as a combined effect of higher waste loadings and higher melt rates resulting from new formulations have been achieved.« less

SOLIDIFICATION OF THE HANFORD LAW WASTE STREAM PRODUCED AS A RESULT OF NEAR-TANK CONTINUOUS SLUDGE LEACHING AND SODIUM HYDROXIDE RECOVERY

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

Reigel, M.; Johnson, F.; Crawford, C.

2011-09-20

The U.S. Department of Energy (DOE), Office of River Protection (ORP), is responsible for the remediation and stabilization of the Hanford Site tank farms, including 53 million gallons of highly radioactive mixed wasted waste contained in 177 underground tanks. The plan calls for all waste retrieved from the tanks to be transferred to the Waste Treatment Plant (WTP). The WTP will consist of three primary facilities including pretreatment facilities for Low Activity Waste (LAW) to remove aluminum, chromium and other solids and radioisotopes that are undesirable in the High Level Waste (HLW) stream. Removal of aluminum from HLW sludge canmore » be accomplished through continuous sludge leaching of the aluminum from the HLW sludge as sodium aluminate; however, this process will introduce a significant amount of sodium hydroxide into the waste stream and consequently will increase the volume of waste to be dispositioned. A sodium recovery process is needed to remove the sodium hydroxide and recycle it back to the aluminum dissolution process. The resulting LAW waste stream has a high concentration of aluminum and sodium and will require alternative immobilization methods. Five waste forms were evaluated for immobilization of LAW at Hanford after the sodium recovery process. The waste forms considered for these two waste streams include low temperature processes (Saltstone/Cast stone and geopolymers), intermediate temperature processes (steam reforming and phosphate glasses) and high temperature processes (vitrification). These immobilization methods and the waste forms produced were evaluated for (1) compliance with the Performance Assessment (PA) requirements for disposal at the IDF, (2) waste form volume (waste loading), and (3) compatibility with the tank farms and systems. The iron phosphate glasses tested using the product consistency test had normalized release rates lower than the waste form requirements although the CCC glasses had higher release rates than the quenched glasses. However, the waste form failed to meet the vapor hydration test criteria listed in the WTP contract. In addition, the waste loading in the phosphate glasses were not as high as other candidate waste forms. Vitrification of HLW waste as borosilicate glass is a proven process; however the HLW and LAW streams at Hanford can vary significantly from waste currently being immobilized. The ccc glasses show lower release rates for B and Na than the quenched glasses and all glasses meet the acceptance criterion of < 4 g/L. Glass samples spiked with Re{sub 2}O{sub 7} also passed the PCT test. However, further vapor hydration testing must be performed since all the samples cracked and the test could not be performed. The waste loading of the iron phosphate and borosilicate glasses are approximately 20 and 25% respectively. The steam reforming process produced the predicted waste form for both the high and low aluminate waste streams. The predicted waste loadings for the monolithic samples is approximately 39%, which is higher than the glass waste forms; however, at the time of this report, no monolithic samples were made and therefore compliance with the PA cannot be determined. The waste loading in the geopolymer is approximately 40% but can vary with the sodium hydroxide content in the waste stream. Initial geopolymer mixes revealed compressive strengths that are greater than 500 psi for the low aluminate mixes and less than 500 psi for the high aluminate mixes. Further work testing needs to be performed to formulate a geopolymer waste form made using a high aluminate salt solution. A cementitious waste form has the advantage that the process is performed at ambient conditions and is a proven process currently in use for LAW disposal. The Saltstone/Cast Stone formulated using low and high aluminate salt solutions retained at least 97% of the Re that was added to the mix as a dopant. While this data is promising, additional leaching testing must be performed to show compliance with the PA. Compressive strength tests must also be performed on the Cast Stone monoliths to verify PA compliance. Based on testing performed for this report, the borosilicate glass and Cast Stone are the recommended waste forms for further testing. Both are proven technologies for radioactive waste disposal and the initial testing using simulated Hanford LAW waste shows compliance with the PA. Both are resistant to leaching and have greater than 25% waste loading.« less

Department of Energy Technology Readiness Assessments - Process Guide and Training Plan

DTIC Science & Technology

2008-09-12

Hanford Waste Treatment and Immobilization Plant ( WTP ) Analytical Laboratory, Low Activity Waste (LAW) Facility and Balance of Facilities (3 TRAs... WTP High-Level Waste (HLW) Facility – WTP Pre-Treatment (PT) Facility – Hanford River Protection Project Low Activity Waste Treatment Alternatives

Laboratory Tests on Post-Filtration Precipitation in the WTP Pretreatment Process

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

Russell, Renee L.; Peterson, Reid A.; Rinehart, Donald E.

Pacific Northwest National Laboratory (PNNL) has been tasked by Bechtel National Inc. (BNI) on the River Protection Project-Hanford Tank Waste Treatment and Immobilization Plant (RPP-WTP) project to perform research and development activities to resolve technical issues identified for the Pretreatment Facility (PTF). The Pretreatment Engineering Platform (PEP) was designed, constructed, and operated as part of a plan to respond to issue M12, "Undemonstrated Leaching Processes," of the External Flowsheet Review Team (EFRT) issue response plan (Barnes et al. 2006). The PEP is a 1/4.5-scale test platform designed to simulate the WTP pretreatment caustic leaching, oxidative leaching, ultrafiltration solids concentration, andmore » slurry washing processes. The PEP replicates the WTP leaching processes using prototypic equipment and control strategies. A simplified flow diagram of the PEP system is shown in Figure 1.1. Two operating scenarios are currently being evaluated for the ultrafiltration process (UFP) and leaching operations. The first scenario has caustic leaching performed in the UFP-2 ultrafiltration feed vessels (i.e., vessel UFP-VSL-T02A in the PEP; and vessels UFP-VSL-00002A and B in the WTP PTF). The second scenario has caustic leaching conducted in the UFP-1 ultrafiltration feed preparation vessels (i.e., vessels UFP-VSL-T01A and B in the PEP; vessels UFP-VSL-00001A and B in the WTP PTF).« less

RADIOACTIVE DEMONSTRATION OF FINAL MINERALIZED WASTE FORMS FOR HANFORD WASTE TREATMENT PLANT SECONDARY WASTE BY FLUIDIZED BED STEAM REFORMING USING THE BENCH SCALE REFORMER PLATFORM

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

Crawford, C.; Burket, P.; Cozzi, A.

2012-02-02

The U.S. Department of Energy's Office of River Protection (ORP) is responsible for the retrieval, treatment, immobilization, and disposal of Hanford's tank waste. Currently there are approximately 56 million gallons of highly radioactive mixed wastes awaiting treatment. A key aspect of the River Protection Project (RPP) cleanup mission is to construct and operate the Waste Treatment and Immobilization Plant (WTP). The WTP will separate the tank waste into high-level and low-activity waste (LAW) fractions, both of which will subsequently be vitrified. The projected throughput capacity of the WTP LAW Vitrification Facility is insufficient to complete the RPP mission in themore » time frame required by the Hanford Federal Facility Agreement and Consent Order, also known as the Tri-Party Agreement (TPA), i.e. December 31, 2047. Therefore, Supplemental Treatment is required both to meet the TPA treatment requirements as well as to more cost effectively complete the tank waste treatment mission. In addition, the WTP LAW vitrification facility off-gas condensate known as WTP Secondary Waste (WTP-SW) will be generated and enriched in volatile components such as {sup 137}Cs, {sup 129}I, {sup 99}Tc, Cl, F, and SO{sub 4} that volatilize at the vitrification temperature of 1150 C in the absence of a continuous cold cap (that could minimize volatilization). The current waste disposal path for the WTP-SW is to process it through the Effluent Treatment Facility (ETF). Fluidized Bed Steam Reforming (FBSR) is being considered for immobilization of the ETF concentrate that would be generated by processing the WTP-SW. The focus of this current report is the WTP-SW. FBSR offers a moderate temperature (700-750 C) continuous method by which WTP-SW wastes can be processed irrespective of whether they contain organics, nitrates, sulfates/sulfides, chlorides, fluorides, volatile radionuclides or other aqueous components. The FBSR technology can process these wastes into a crystalline ceramic (mineral) waste form. The mineral waste form that is produced by co-processing waste with kaolin clay in an FBSR process has been shown to be as durable as LAW glass. Monolithing of the granular FBSR product is being investigated to prevent dispersion during transport or burial/storage, but is not necessary for performance. A Benchscale Steam Reformer (BSR) was designed and constructed at the SRNL to treat actual radioactive wastes to confirm the findings of the non-radioactive FBSR pilot scale tests and to qualify the waste form for applications at Hanford. BSR testing with WTP SW waste surrogates and associated analytical analyses and tests of granular products (GP) and monoliths began in the Fall of 2009, and then was continued from the Fall of 2010 through the Spring of 2011. Radioactive testing commenced in 2010 with a demonstration of Hanford's WTP-SW where Savannah River Site (SRS) High Level Waste (HLW) secondary waste from the Defense Waste Processing Facility (DWPF) was shimmed with a mixture of {sup 125/129}I and {sup 99}Tc to chemically resemble WTP-SW. Prior to these radioactive feed tests, non-radioactive simulants were also processed. Ninety six grams of radioactive granular product were made for testing and comparison to the non-radioactive pilot scale tests. The same mineral phases were found in the radioactive and non-radioactive testing.« less

Secondary Waste Cast Stone Waste Form Qualification Testing Plan

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

Westsik, Joseph H.; Serne, R. Jeffrey

2012-09-26

The Hanford Tank Waste Treatment and Immobilization Plant (WTP) is being constructed to treat the 56 million gallons of radioactive waste stored in 177 underground tanks at the Hanford Site. The WTP includes a pretreatment facility to separate the wastes into high-level waste (HLW) and low-activity waste (LAW) fractions for vitrification and disposal. The LAW will be converted to glass for final disposal at the Integrated Disposal Facility (IDF). Cast Stone – a cementitious waste form, has been selected for solidification of this secondary waste stream after treatment in the ETF. The secondary-waste Cast Stone waste form must be acceptablemore » for disposal in the IDF. This secondary waste Cast Stone waste form qualification testing plan outlines the testing of the waste form and immobilization process to demonstrate that the Cast Stone waste form can comply with the disposal requirements. Specifications for the secondary-waste Cast Stone waste form have not been established. For this testing plan, Cast Stone specifications are derived from specifications for the immobilized LAW glass in the WTP contract, the waste acceptance criteria for the IDF, and the waste acceptance criteria in the IDF Permit issued by the State of Washington. This testing plan outlines the testing needed to demonstrate that the waste form can comply with these waste form specifications and acceptance criteria. The testing program must also demonstrate that the immobilization process can be controlled to consistently provide an acceptable waste form product. This testing plan also outlines the testing needed to provide the technical basis for understanding the long-term performance of the waste form in the disposal environment. These waste form performance data are needed to support performance assessment analyses of the long-term environmental impact of the secondary-waste Cast Stone waste form in the IDF« less

Radioactive demonstration of final mineralized waste forms for Hanford waste treatment plant secondary waste (WTP-SW) by fluidized bed steam reforming (FBSR) using the bench scale reformer platform

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

Crawford, C.; Burket, P.; Cozzi, A.

2014-08-01

The U.S. Department of Energy’s Office of River Protection (ORP) is responsible for the retrieval, treatment, immobilization, and disposal of Hanford’s tank waste. Currently there are approximately 56 million gallons of highly radioactive mixed wastes awaiting treatment. A key aspect of the River Protection Project (RPP) cleanup mission is to construct and operate the Waste Treatment and Immobilization Plant (WTP). The WTP will separate the tank waste into high-level and low-activity waste (LAW) fractions, both of which will subsequently be vitrified. The projected throughput capacity of the WTP LAW Vitrification Facility is insufficient to complete the RPP mission in themore » time frame required by the Hanford Federal Facility Agreement and Consent Order, also known as the Tri-Party Agreement (TPA), i.e. December 31, 2047. Therefore, Supplemental Treatment is required both to meet the TPA treatment requirements as well as to more cost effectively complete the tank waste treatment mission. In addition, the WTP LAW vitrification facility off-gas condensate known as WTP Secondary Waste (WTP-SW) will be generated and enriched in volatile components such as 137Cs, 129I, 99Tc, Cl, F, and SO4 that volatilize at the vitrification temperature of 1150°C in the absence of a continuous cold cap (that could minimize volatilization). The current waste disposal path for the WTP-SW is to process it through the Effluent Treatment Facility (ETF). Fluidized Bed Steam Reforming (FBSR) is being considered for immobilization of the ETF concentrate that would be generated by processing the WTP-SW. The focus of this current report is the WTP-SW.« less

The United States Army Medical Department Journal. July - September 2011

DTIC Science & Technology

2011-09-01

compliance. Figure 1. Functional schematic of the flow path and treatment stages of the water treatment plant. Basin 5  Basin  4  Basin  3  Basin 2...that hindered optimal performance of the WTP. They were the flocculation treatment process and flow distribution through the WTP. Flocculation...designed to simulate the WTP at a flow of 1.5 MGD (the flow through the WTP at the time of jar testing). Jar test samples were collected after

Efficacy of two wastewater treatment plants in removing genotoxins.

PubMed

Jolibois, B; Guerbet, M

2005-04-01

The genotoxic potential of influents and effluents of two different wastewater treatment plants (WTP-A and WTP-B) located in the Rouen, France, area was evaluated by the SOS chromotest without metabolic activation (on Escherichia coli PQ37) and the Ames fluctuation test (on Salmonella typhimurium strains TA 98, 100, TA 102) with and without metabolic activation. The wastewater samples were taken during two 1-week periods in January and April 2003. The simultaneous use of the SOS chromotest and Ames fluctuation test allowed us to evaluate the efficacy of the wastewater treatment plants at removing genotoxins. Genotoxins were detected with the Ames test but not with the SOS chromotest. Out of a total of 24 influents tested (14 for WTP-A and 10 for WTP-B), almost all were genotoxic in at least one Ames test strain (71% for WTP-A and 100% for WTP-B). In contrast, all of the tested effluents were nongenotoxic. This work showed that the treatment process used in the 2 wastewater treatment plants studied (activated sludge) was able to remove the genotoxins detected in their influents. Nevertheless, studies could be undertaken to determine which step of the treatment process removes genotoxins and whether WTP sludge use could be a source of genotoxic contamination for humans and the environment.

Technology Readiness Assessment of Department of Energy Waste Processing Facilities

DTIC Science & Technology

2007-09-11

Must Be Reliable, Robust, Flexible, and Durable 6 EM Is Piloting the TRA/AD2 Process Hanford Waste Treatment Plant ( WTP ) – The Initial Pilot Project...Evaluation WTP can only treat ~ ½ of the LAW in the time it will take to treat all the HLW. • There is a need for tank space that will get more urgent with...Facility before the WTP Pretreatment and High-Level Waste (HLW) Vitrification Facilities are available (Requires tank farm pretreatment capability) TRAs

Estimation of CO2 emission from water treatment plant--model development and application.

PubMed

Kyung, Daeseung; Kim, Dongwook; Park, Nosuk; Lee, Woojin

2013-12-15

A comprehensive mathematical model developed for this study was used to compare estimates of on-site and off-site CO2 emissions, from conventional and advanced water treatment plants (WTPs). When 200,000 m(3) of raw water at 10 NTU (Nepthelometric Turbidity Unit) was treated by a conventional WTP to 0.1 NTU using aluminum sulfate as a coagulant, the total CO2 emissions were estimated to be 790 ± 228 (on-site) and 69,596 ± 3950 (off-site) kg CO2e/d. The emissions from an advanced WTP containing micro-filtration (MF) membrane and ozone disinfection processes; treating the same raw water to 0.005 NTU, were estimated to be 395 ± 115 (on-site) and 38,197 ± 2922 (off-site) kg CO2e/d. The on-site CO2 emissions from the advanced WTP were half that from the conventional WTP due to much lower use of coagulant. On the other hand, off-site CO2 emissions due to consumption of electricity were 2.14 times higher for the advanced WTP, due to the demands for operation of the MF membrane and ozone disinfection processes. However, the lower use of chemicals in the advanced WTP decreased off-site CO2 emissions related to chemical production and transportation. Overall, total CO2 emissions from the conventional WTP were 1.82 times higher than that from the advanced WTP. A sensitivity analysis was performed for the advanced WTP to suggest tactics for simultaneously reducing CO2 emissions further and enhancing water quality. Copyright © 2013 Elsevier Ltd. All rights reserved.

Full-scale effects of addition of sludge from water treatment stations into processes of sewage treatment by conventional activated sludge.

PubMed

Luiz, Marguti André; Sidney Seckler, Ferreira Filho; Passos, Piveli Roque

2018-06-01

An emerging practice for water treatment plant (WTP) sludge is its disposal in wastewater treatment plants (WWTP), an alternative that does not require the installation of sludge treatment facilities in the WTP. This practice can cause both positive and negative impacts in the WWTP processes since the WTP sludge does not have the same characteristics as domestic wastewater. This issue gives plenty of information in laboratory and pilot scales, but lacks data from full-scale studies. The main purpose of this paper is to study the impact of disposing sludge from the Rio Grande conventional WTP into the ABC WWTP, an activated sludge process facility. Both plants are located in São Paulo, Brazil, and are full-scale facilities. The WTP volumetric flow rate (4.5 m³/s) is almost three times that of WWTP (1.6 m³/s). The data used in this study came from monitoring the processes at both plants. The WWTP liquid phase treatment analysis included the variables BOD, COD, TSS, VSS, ammonia, total nitrogen, phosphorus and iron, measured at the inlet, primary effluent, mixed liquor, and effluent. For the WWTP solids treatment, the parameters tested were total and volatile solids. The performance of the WWTP process was analyzed with and without sludge addition: 'without sludge' in years 2005 and 2006 and 'with sludge' from January 2007 to March 2008. During the second period, the WTP sludge addition increased the WWTP removal efficiencies for solids (93%-96%), organic matter (92%-94% for BOD) and phosphorus (52%-88%), when compared to the period 'without sludge'. These improvements can be explained by higher feed concentrations combined to same or lower effluent concentrations in the 'with sludge' period. No critical negative impacts occurred in the sludge treatment facilities, since the treatment units absorbed the extra solids load from the WTP sludge. Copyright © 2018 Elsevier Ltd. All rights reserved.

Endotoxin contamination and control in surface water sources and a drinking water treatment plant in Beijing, China.

PubMed

Can, Zhang; Wenjun, Liu; Wen, Sun; Minglu, Zhang; Lingjia, Qian; Cuiping, Li; Fang, Tian

2013-07-01

In this paper, endotoxin contamination was determined in treated water following each unit of a drinking water treatment plant (WTP) in Beijing, China and its source water (SW) from a long water diversion channel (Shijiazhuang-Beijing) originating from four reservoirs in Hebei province, China. The total-endotoxin activities in SW ranged from 21 to 41 EU/ml at five selected cross sections of the diversion channel. The total-endotoxin in raw water of the WTP ranged from 11 to 16 EU/ml due to dilution and pretreatment during water transportation from Tuancheng Lake to the WTP, and finished water of the WTP ranged from 4 to 10 EU/ml, showing a 49% decrease following the full-scale treatment process at the WTP. Compared with the 31% removal of free-endotoxin, the WTP removed up to 71% of bound-endotoxin in raw water. The traditional treatment processes (coagulation, sedimentation and filtration) in the WTP removed substantial amounts of total-endotoxin (up to 63%), while endotoxin activities increased after granular activated carbon (GAC) adsorption and chlorination. The total-endotoxin in the actual water was composed of free-endotoxin and bound-endotoxin (endotoxin aggregates, bacteria-bound endotoxins and particle-attached endotoxins). The endotoxin aggregates, bacteria-bound endotoxins and particle-attached endotoxins co-exist as suspended particles in water, and only the bacteria-bound endotoxins were correlated with bacterial cells suspended in water. The particle distribution of endotoxin aggregates in ultrapure water was also tested and the results showed that the majority (64-89%) of endotoxin aggregates had diameters <2 μm. The endotoxin contamination and control in treated water following each unit of the WTP processes and its SW from reservoirs are discussed and compared with regard to bacterial cell counts and particle characteristics, which were dependent, to a certain extent, on different flow rates and turbulence of the water environments. Copyright © 2013 Elsevier Ltd. All rights reserved.

Phase 2 testing results of immobilization of WTP effluent management facility vaporator bottoms simulant

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

Reigel, M.; Cozzi, A.; McCabe, D.

2017-09-08

The Hanford Waste Treatment and Immobilization Plant (WTP) Low Activity Waste (LAW) vitrification facility will generate an aqueous condensate recycle stream (LAW Melter Off-Gas Condensate) from the primary off-gas system. This work examined three waste form formulations based on previous testing with related simulants: 8 wt% ordinary portland cement (OPC), 47 wt% blast furnace slag (BFS), 45 wt% fly ash (FA) known as Cast Stone formulation; 20 wt% Aquaset® II-GH and 80 wt% BFS; 20 wt% OPC and 80 wt% BFS. These tests successfully produced one waste form that set within five days (Cast Stone formulation); however the other twomore » formulations, Aquaset® II-GH/BFS and OPC/BFS, took approximately eight and fourteen days to set, respectively.« less

WTP Waste Feed Qualification: Glass Fabrication Unit Operation Testing Report

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

Stone, M. E.; Newell, J. D.; Johnson, F. C.

The waste feed qualification program is being developed to protect the Hanford Tank Waste Treatment and Immobilization Plant (WTP) design, safety basis, and technical basis by assuring waste acceptance requirements are met for each staged waste feed campaign prior to transfer from the Tank Operations Contractor to the feed receipt vessels inside the Pretreatment Facility. The Waste Feed Qualification Program Plan describes the three components of waste feed qualification: 1. Demonstrate compliance with the waste acceptance criteria 2. Determine waste processability 3. Test unit operations at laboratory scale. The glass fabrication unit operation is the final step in the processmore » demonstration portion of the waste feed qualification process. This unit operation generally consists of combining each of the waste feed streams (high-level waste (HLW) and low-activity waste (LAW)) with Glass Forming Chemicals (GFCs), fabricating glass coupons, performing chemical composition analysis before and after glass fabrication, measuring hydrogen generation rate either before or after glass former addition, measuring rheological properties before and after glass former addition, and visual observation of the resulting glass coupons. Critical aspects of this unit operation are mixing and sampling of the waste and melter feeds to ensure representative samples are obtained as well as ensuring the fabrication process for the glass coupon is adequate. Testing was performed using a range of simulants (LAW and HLW simulants), and these simulants were mixed with high and low bounding amounts of GFCs to evaluate the mixing, sampling, and glass preparation steps in shielded cells using laboratory techniques. The tests were performed with off-the-shelf equipment at the Savannah River National Laboratory (SRNL) that is similar to equipment used in the SRNL work during qualification of waste feed for the Defense Waste Processing Facility (DWPF) and other waste treatment facilities at the Savannah River Site. It is not expected that the exact equipment used during this testing will be used during the waste feed qualification testing for WTP, but functionally similar equipment will be used such that the techniques demonstrated would be applicable. For example, the mixing apparatus could use any suitable mixer capable of being remoted and achieving similar mixing speeds to those tested.« less

Liquid secondary waste: Waste form formulation and qualification

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

Cozzi, A. D.; Dixon, K. L.; Hill, K. A.

The Hanford Site Effluent Treatment Facility (ETF) currently treats aqueous waste streams generated during site cleanup activities. When the Hanford Tank Waste Treatment and Immobilization Plant (WTP) begins operations, including Direct Feed Low Activity Waste (DFLAW) vitrification, a liquid secondary waste (LSW) stream from the WTP will need to be treated. The volume of effluent for treatment at the ETF will increase significantly. The powdered salt waste form produced by the ETF will be replaced by a stabilized solidified waste form for disposal in Hanford’s Integrated Disposal Facility (IDF). Washington River Protection Solutions is implementing a Secondary Liquid Waste Immobilizationmore » Technology Development Plan to address the technology needs for a waste form and solidification process to treat the increased volume of waste planned for disposal at the IDF. Waste form testing to support this plan is composed of work in the near term to provide data as input to a performance assessment (PA) for Hanford’s IDF. In 2015, three Hanford Liquid Secondary Waste simulants were developed based on existing and projected waste streams. Using these waste simulants, fourteen mixes of Hanford Liquid Secondary Waste were prepared and tested varying the waste simulant, the water-to-dry materials ratio, and the dry materials blend composition.1 In FY16, testing was performed using a simulant of the EMF process condensate blended with the caustic scrubber—from the Low Activity Waste (LAW) melter—, processed through the ETF. The initial EMF-16 simulant will be based on modeling efforts performed to determine the mass balance of the ETF for the DFLAW.2 The compressive strength of all of the mixes exceeded the target of 3.4 MPa (500 psi) to meet the requirements identified as potential IDF Waste Acceptance Criteria in Table 1 of the Secondary Liquid Waste Immobilization Technology Development Plan.3 The hydraulic properties of the waste forms tested (hydraulic conductivity and water characteristic curves) were comparable to the properties measured on the Savannah River Site (SRS) Saltstone waste form. Future testing should include efforts to first; 1) determine the rate and amount of ammonia released during each unit operation of the treatment process to determine if additional ammonia management is required, then; 2) reduce the ammonia content of the ETF concentrated brine prior to solidification, making the waste more amenable to grouting, or 3) manage the release of ammonia during production and ongoing release during storage of the waste form, or 4) develop a lower pH process/waste form thereby precluding ammonia release.« less

Household response to environmental incentives for rain garden adoption

NASA Astrophysics Data System (ADS)

Newburn, David A.; Alberini, Anna

2016-02-01

A decentralized approach to encourage the voluntary adoption of household stormwater management practices is increasingly needed to mitigate urban runoff and to comply with more stringent water quality regulations. We analyze the household response to a hypothetical rebate program to incentivize rain garden adoption using household survey data from the Baltimore-Washington corridor. We asked respondents whether the household would adopt a rain garden without a rebate or when offered a randomly assigned rebate. An interval-data model is used to estimate household demand on the willingness to pay (WTP) for a rain garden as a function of demographic factors, gardening activities, environmental attitudes, and other household characteristics. Estimation results indicate that mean WTP for a rain garden in our sample population is approximately $6.72 per square foot, corresponding to almost three-fourths of the installation cost. The expected adoption rate more than tripled when comparing no rebate versus a government rebate set at one-third of the installation cost, indicating that economic incentives matter. There is substantial heterogeneity in the WTP among households. Higher levels of WTP are estimated for households with higher environmental concern for the Chesapeake Bay and local streams, garden experience, higher income, and non-senior citizen adults. We conclude that a cost-share rebate approach is likely to significantly affect household adoption decisions, and the partial contributions paid by households can assist with lowering the substantial compliance costs for local governments to meet water quality requirements.

Nitrate Sources and Transport in the Upper Illinois River Basin Evaluated with Stable Isotope Ratios and SWAT Modeling

NASA Astrophysics Data System (ADS)

Lin, J.; Demissie, Y.; Yan, E.; Bohlke, J. K.; Sturchio, N. C.

2014-12-01

Measurements of nitrate concentrations and δ15N and δ18O values in 450 surface-water samples from the Upper Illinois River Basin (UIRB) were combined with SWAT (Soil and Water Assessment Tool) modeling to study the influence of land use on nitrate sources, mixing, and transformation within the watershed. The samples were collected from the Illinois River and its tributaries, including effluent from Chicago's largest wastewater treatment plant (WTP), October 2004 through October 2008. The isotopic and concentration measurements indicated that WTP effluent and agricultural drainage waters were the two principal nitrate endmembers within the UIRB. Isotopic compositions indicated the source of nitrate during the annual spring flushing event was mostly derived from agriculture. An apparent denitrification trend was identified from spring through fall in tributaries draining agricultural subbasins and those having mixed urban-agricultural land use. Mass balance indicated that the fraction of nitrate from the WTP effluent was as low as 5 % or less during the spring flush (March-May) and much larger during late summer and fall. A SWAT model was constructed to evaluate effects of land use, fertilizer applications, and WTP point source discharge by coupling hydrologic processes with nutrient cycling and plant growth. The UIRB SWAT model was calibrated and validated with flow and nitrate measurements: the Nash-Sutcliffe efficiency (NSE) ranged from 0.60 to 0.83 and the determination coefficient (R2) ranged from 0.59 to 0.87. To explore the influence of fertilizer input on basin nitrate transport, the calibrated model was used to evaluate impacts of spring and fall fertilizer applications on stream nitrate loads. Simulations with a -50% change in the total fertilizer application rate (kg N/ha) resulted in as much as -42% change in basin nitrate export (kg N/month), while causing only -9% or less change in corn yield (kg N/ha). Decreased fertilizer application also led to reductions of annual basin N percolation rate below the root zone (kg N/ha) and nitrate loading to surface runoff (kg N/ha), causing changes as much as -32.2% and -15.6% respectively. Combined modeling and isotopic studies can be useful for understanding nutrient mixing and transformation processes and for optimizing nutrient export reduction strategies.

Crystallization In High Level Waste (HLW) Glass Melters: Operational Experience From The Savannah River Site

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

Fox, K. M.

2014-02-27

processing strategy for the Hanford Tank Waste Treatment and Immobilization Plant (WTP). The basis of this alternative approach is an empirical model predicting the crystal accumulation in the WTP glass discharge riser and melter bottom as a function of glass composition, time, and temperature. When coupled with an associated operating limit (e.g., the maximum tolerable thickness of an accumulated layer of crystals), this model could then be integrated into the process control algorithms to formulate crystal tolerant high level waste (HLW) glasses targeting higher waste loadings while still meeting process related limits and melter lifetime expectancies. This report provides amore » review of the scaled melter testing that was completed in support of the Defense Waste Processing Facility (DWPF) melter. Testing with scaled melters provided the data to define the DWPF operating limits to avoid bulk (volume) crystallization in the un-agitated DWPF melter and provided the data to distinguish between spinels generated by K-3 refractory corrosion versus spinels that precipitated from the HLW glass melt pool. This report includes a review of the crystallization observed with the scaled melters and the full scale DWPF melters (DWPF Melter 1 and DWPF Melter 2). Examples of actual DWPF melter attainment with Melter 2 are given. The intent is to provide an overview of lessons learned, including some example data, that can be used to advance the development and implementation of an empirical model and operating limit for crystal accumulation for WTP. Operation of the first and second (current) DWPF melters has demonstrated that the strategy of using a liquidus temperature predictive model combined with a 100 °C offset from the normal melter operating temperature of 1150 °C (i.e., the predicted liquidus temperature (TL) of the glass must be 1050 °C or less) has been successful in preventing any detrimental accumulation of spinel in the DWPF melt pool, and spinel has not been observed in any of the pour stream glass samples. Spinel was observed at the bottom of DWPF Melter 1 as a result of K-3 refractory corrosion. Issues have occurred with accumulation of spinel in the pour spout during periods of operation at higher waste loadings. Given that both DWPF melters were or have been in operation for greater than 8 years, the service life of the melters has far exceeded design expectations. It is possible that the DWPF liquidus temperature approach is conservative, in that it may be possible to successfully operate the melter with a small degree of allowable crystallization in the glass. This could be a viable approach to increasing waste loading in the glass assuming that the crystals are suspended in the melt and swept out through the riser and pour spout. Additional study is needed, and development work for WTP might be leveraged to support a different operating limit for the DWPF. Several recommendations are made regarding considerations that need to be included as part of the WTP crystal tolerant strategy based on the DWPF development work and operational data reviewed here. These include: Identify and consider the impacts of potential heat sinks in the WTP melter and glass pouring system; Consider the contributions of refractory corrosion products, which may serve to nucleate additional crystals leading to further accumulation; Consider volatilization of components from the melt (e.g., boron, alkali, halides, etc.) and determine their impacts on glass crystallization behavior; Evaluate the impacts of glass REDuction/OXidation (REDOX) conditions and the distribution of temperature within the WTP melt pool and melter pour chamber on crystal accumulation rate; Consider the impact of precipitated crystals on glass viscosity; Consider the impact of an accumulated crystalline layer on thermal convection currents and bubbler effectiveness within the melt pool; Evaluate the impact of spinel accumulation on Joule heating of the WTP melt pool; and Include noble metals in glass melt experiments because of their potential to act as nucleation sites for spinel crystallization.« less

RADIOACTIVE DEMONSTRATIONS OF FLUIDIZED BED STEAM REFORMING AS A SUPPLEMENTARY TREATMENT FOR HANFORD'S LOW ACTIVITY WASTE AND SECONDARY WASTES

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

Jantzen, C.; Crawford, C.; Cozzi, A.

The U.S. Department of Energy's Office of River Protection (ORP) is responsible for the retrieval, treatment, immobilization, and disposal of Hanford's tank waste. Currently there are approximately 56 million gallons of highly radioactive mixed wastes awaiting treatment. A key aspect of the River Protection Project (RPP) cleanup mission is to construct and operate the Waste Treatment and Immobilization Plant (WTP). The WTP will separate the tank waste into high-level and low-activity waste (LAW) fractions, both of which will subsequently be vitrified. The projected throughput capacity of the WTP LAW Vitrification Facility is insufficient to complete the RPP mission in themore » time frame required by the Hanford Federal Facility Agreement and Consent Order, also known as the Tri-Party Agreement (TPA), i.e. December 31, 2047. Therefore, Supplemental Treatment is required both to meet the TPA treatment requirements as well as to more cost effectively complete the tank waste treatment mission. The Supplemental Treatment chosen will immobilize that portion of the retrieved LAW that is not sent to the WTP's LAW Vitrification facility into a solidified waste form. The solidified waste will then be disposed on the Hanford site in the Integrated Disposal Facility (IDF). In addition, the WTP LAW vitrification facility off-gas condensate known as WTP Secondary Waste (WTP-SW) will be generated and enriched in volatile components such as Cs-137, I-129, Tc-99, Cl, F, and SO4 that volatilize at the vitrification temperature of 1150 C in the absence of a continuous cold cap. The current waste disposal path for the WTP-SW is to recycle it to the supplemental LAW treatment to avoid a large steady state accumulation in the pretreatment-vitrification loop. Fluidized Bed Steam Reforming (FBSR) offers a moderate temperature (700-750 C) continuous method by which LAW and/or WTP-SW wastes can be processed irrespective of whether they contain organics, nitrates, sulfates/sulfides, chlorides, fluorides, volatile radionuclides or other aqueous components. The FBSR technology can process these wastes into a crystalline ceramic (mineral) waste form. The mineral waste form that is produced by co-processing waste with kaolin clay in an FBSR process has been shown to be as durable as LAW glass. Monolithing of the granular FBSR product is being investigated to prevent dispersion during transport or burial/storage but is not necessary for performance. A Benchscale Steam Reformer (BSR) was designed and constructed at the Savannah River National Laboratory (SRNL) to treat actual radioactive wastes to confirm the findings of the non-radioactive FBSR pilot scale tests and to qualify the waste form for applications at Hanford. Radioactive testing commenced in 2010 with a demonstration of Hanford's WTP-SW where Savannah River Site (SRS) High Level Waste (HLW) secondary waste from the Defense Waste Processing Facility (DWPF) was shimmed with a mixture of I-125/129 and Tc-99 to chemically resemble WTP-SW. Ninety six grams of radioactive product were made for testing. The second campaign commenced using SRS LAW chemically trimmed to look like Hanford's LAW. Six hundred grams of radioactive product were made for extensive testing and comparison to the non-radioactive pilot scale tests. The same mineral phases were found in the radioactive and non-radioactive testing.« less

Greater preference consistency during the Willingness-to-Pay task is related to higher resting state connectivity between the ventromedial prefrontal cortex and the ventral striatum.

PubMed

Mackey, Scott; Olafsson, Valur; Aupperle, Robin L; Lu, Kun; Fonzo, Greg A; Parnass, Jason; Liu, Thomas; Paulus, Martin P

2016-09-01

The significance of why a similar set of brain regions are associated with the default mode network and value-related neural processes remains to be clarified. Here, we examined i) whether brain regions exhibiting willingness-to-pay (WTP) task-related activity are intrinsically connected when the brain is at rest, ii) whether these regions overlap spatially with the default mode network, and iii) whether individual differences in choice behavior during the WTP task are reflected in functional brain connectivity at rest. Blood-oxygen-level dependent (BOLD) signal was measured by functional magnetic resonance imaging while subjects performed the WTP task and at rest with eyes open. Brain regions that tracked the value of bids during the WTP task were used as seed regions in an analysis of functional connectivity in the resting state data. The seed in the ventromedial prefrontal cortex was functionally connected to core regions of the WTP task-related network. Brain regions within the WTP task-related network, namely the ventral precuneus, ventromedial prefrontal and posterior cingulate cortex overlapped spatially with publically available maps of the default mode network. Also, those individuals with higher functional connectivity during rest between the ventromedial prefrontal cortex and the ventral striatum showed greater preference consistency during the WTP task. Thus, WTP task-related regions are an intrinsic network of the brain that corresponds spatially with the default mode network, and individual differences in functional connectivity within the WTP network at rest may reveal a priori biases in choice behavior.

Greater preference consistency during the Willingness-to-Pay task is related to higher resting state connectivity between the ventromedial prefrontal cortex and the ventral striatum

PubMed Central

Mackey, Scott; Olafsson, Valur; Aupperle, Robin; Lu, Kun; Fonzo, Greg; Parnass, Jason; Liu, Thomas; Paulus, Martin P.

2015-01-01

The significance of why a similar set of brain regions are associated with the default mode network and value-related neural processes remains to be clarified. Here, we examined i) whether brain regions exhibiting willingness-to-pay (WTP) task-related activity are intrinsically connected when the brain is at rest, ii) whether these regions overlap spatially with the default mode network, and iii) whether individual differences in choice behavior during the WTP task are reflected in functional brain connectivity at rest. Blood-oxygen-level dependent (BOLD) signal was measured by functional magnetic resonance imaging while subjects performed the WTP task and at rest with eyes open. Brain regions that tracked the value of bids during the WTP task were used as seed regions in an analysis of functional connectivity in the resting state data. The seed in the ventromedial prefrontal cortex was functionally connected to core regions of the WTP task-related network. Brain regions within the WTP task-related network, namely the ventral precuneus, ventromedial prefrontal and posterior cingulate cortex overlapped spatially with publically available maps of the default mode network. Also, those individuals with higher functional connectivity during rest between the ventromedial prefrontal cortex and the ventral striatum showed greater preference consistency during the WTP task. Thus, WTP task-related regions are an intrinsic network of the brain that corresponds spatially with the default mode network, and individual differences in functional connectivity within the WTP network at rest may reveal a priori biases in choice behavior. PMID:26271206

Process value of care safety: women's willingness to pay for perinatal services.

PubMed

Anezaki, Hisataka; Hashimoto, Hideki

2017-08-01

To evaluate the process value of care safety from the patient's view in perinatal services. Cross-sectional survey. Fifty two sites of mandated public neonatal health checkup in 6 urban cities in West Japan. Mothers who attended neonatal health checkups for their babies in 2011 (n = 1316, response rate = 27.4%). Willingness to pay (WTP) for physician-attended care compared with midwife care as the process-related value of care safety. WTP was estimated using conjoint analysis based on the participants' choice over possible alternatives that were randomly assigned from among eight scenarios considering attributes such as professional attendance, amenities, painless delivery, caesarean section rate, travel time and price. The WTP for physician-attended care over midwife care was estimated 1283 USD. Women who had experienced complications in prior deliveries had a 1.5 times larger WTP. We empirically evaluated the process value for safety practice in perinatal care that was larger than a previously reported accounting-based value. Our results indicate that measurement of process value from the patient's view is informative for the evaluation of safety care, and that it is sensitive to individual risk perception for the care process. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care.

PEP Run Report for Integrated Test A, Caustic Leaching in UFP-VSL-T01A, Oxidative Leaching in UFP-VSL-T02A

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

Guzman-Leong, Consuelo E.; Bredt, Ofelia P.; Burns, Carolyn A.

2009-12-04

Pacific Northwest National Laboratory (PNNL) was tasked by Bechtel National Inc. (BNI) on the River Protection Project-Hanford Tank Waste Treatment and Immobilization Plant (RPP-WTP) project to perform research and development activities to resolve technical issues identified for the Pretreatment Facility (PTF). The Pretreatment Engineering Platform (PEP) was designed and constructed and operated as part of a plan to respond to issue M12, “Undemonstrated Leaching Processes.”(a) The PEP, located in the Process Engineering Laboratory-West (PDLW) located in Richland, Washington, is a 1/4.5-scale test platform designed to simulate the WTP pretreatment caustic leaching, oxidative leaching, ultrafiltration solids concentration, and slurry washing processes.more » The PEP replicates the WTP leaching processes using prototypic equipment and control strategies. The PEP also includes non-prototypic ancillary equipment to support the core processing.« less

Organic Separation Test Results

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

Russell, Renee L.; Rinehart, Donald E.; Peterson, Reid A.

2014-09-22

Separable organics have been defined as “those organic compounds of very limited solubility in the bulk waste and that can form a separate liquid phase or layer” (Smalley and Nguyen 2013), and result from three main solvent extraction processes: U Plant Uranium Recovery Process, B Plant Waste Fractionation Process, and Plutonium Uranium Extraction (PUREX) Process. The primary organic solvents associated with tank solids are TBP, D2EHPA, and NPH. There is concern that, while this organic material is bound to the sludge particles as it is stored in the tanks, waste feed delivery activities, specifically transfer pump and mixer pump operations,more » could cause the organics to form a separated layer in the tank farms feed tank. Therefore, Washington River Protection Solutions (WRPS) is experimentally evaluating the potential of organic solvents separating from the tank solids (sludge) during waste feed delivery activities, specifically the waste mixing and transfer processes. Given the Hanford Tank Waste Treatment and Immobilization Plant (WTP) waste acceptance criteria per the Waste Feed Acceptance Criteria document (24590-WTP-RPT-MGT-11-014) that there is to be “no visible layer” of separable organics in the waste feed, this would result in the batch being unacceptable to transfer to WTP. This study is of particular importance to WRPS because of these WTP requirements.« less

TECHNICAL ASSESSMENT OF BULK VITRIFICATION PROCESS & PRODUCT FOR TANK WASTE TREATMENT AT THE DEPARTMENT OF ENERGY HANFORD SITE

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

SCHAUS, P.S.

At the U.S. Department of Energy (DOE) Hanford Site, the Waste Treatment Plant (WTP) is being constructed to immobilize both high-level waste (IUW) for disposal in a national repository and low-activity waste (LAW) for onsite, near-surface disposal. The schedule-controlling step for the WTP Project is vitrification of the large volume of LAW, current capacity of the WTP (as planned) would require 50 years to treat the Hanford tank waste, if the entire LAW volume were to be processed through the WTP. To reduce the time and cost for treatment of Hanford Tank Waste, and as required by the Tank Wastemore » Remediation System Environmental Impact Statement Record of Decision and the Hanford Federal Facility Consent Agreement (Tn-Party Agreement), DOE plans to supplement the LAW treatment capacity of the WTP. Since 2002, DOE, in cooperation with the Environmental Protection Agency and State of Washington Department of Ecology has been evaluating technologies that could provide safe and effective supplemental treatment of LAW. Current efforts at Hanford are intended to provide additional information to aid a joint agency decision on which technology will be used to supplement the WTP. A Research, Development and Demonstration permit has been issued by the State of Washington to build and (for a limited time) operate a Demonstration Bulk Vitrification System (DBVS) facility to provide information for the decision on a supplemental treatment technology for up to 50% of the LAW. In the Bulk Vitrification (BV) process, LAW, soil, and glass-forming chemicals are mixed, dried, and placed in a refractory-lined box, Electric current, supplied through two graphite electrodes in the box, melts the waste feed, producing a durable glass waste-form. Although recent modifications to the process have resulted in significant improvements, there are continuing technical concerns.« less

76 FR 35861 - Safety Culture at the Waste Treatment and Immobilization Plant

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-20

... high. This unhealthy tension has rendered the WTP project's formal processes to resolve safety issues... Board's investigative record demonstrates that both DOE and contractor project management behaviors... allegations raised by Dr. Tamosaitis, a contractor employee removed from his position at WTP, a construction...

Implementation of Recommendations from the One System Comparative Evaluation of the Hanford Tank Farms and Waste Treatment Plant Safety Bases

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

Garrett, Richard L.; Niemi, Belinda J.; Paik, Ingle K.

2013-11-07

A Comparative Evaluation was conducted for One System Integrated Project Team to compare the safety bases for the Hanford Waste Treatment and Immobilization Plant Project (WTP) and Tank Operations Contract (TOC) (i.e., Tank Farms) by an Expert Review Team. The evaluation had an overarching purpose to facilitate effective integration between WTP and TOC safety bases. It was to provide One System management with an objective evaluation of identified differences in safety basis process requirements, guidance, direction, procedures, and products (including safety controls, key safety basis inputs and assumptions, and consequence calculation methodologies) between WTP and TOC. The evaluation identified 25more » recommendations (Opportunities for Integration). The resolution of these recommendations resulted in 16 implementation plans. The completion of these implementation plans will help ensure consistent safety bases for WTP and TOC along with consistent safety basis processes. procedures, and analyses. and should increase the likelihood of a successful startup of the WTP. This early integration will result in long-term cost savings and significant operational improvements. In addition, the implementation plans lead to the development of eight new safety analysis methodologies that can be used at other U.S. Department of Energy (US DOE) complex sites where URS Corporation is involved.« less

Simulant Basis for the Standard High Solids Vessel Design

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

Peterson, Reid A.; Fiskum, Sandra K.; Suffield, Sarah R.

The Waste Treatment and Immobilization Plant (WTP) is working to develop a Standard High Solids Vessel Design (SHSVD) process vessel. To support testing of this new design, WTP engineering staff requested that a Newtonian simulant and a non-Newtonian simulant be developed that would represent the Most Adverse Design Conditions (in development) with respect to mixing performance as specified by WTP. The majority of the simulant requirements are specified in 24590-PTF-RPT-PE-16-001, Rev. 0. The first step in this process is to develop the basis for these simulants. This document describes the basis for the properties of these two simulant types. Themore » simulant recipes that meet this basis will be provided in a subsequent document.« less

Low-Activity Waste Pretreatment System Additional Engineering-Scale Integrated Test Report

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

Landon, Matt R.; Wilson, Robert A.

Washington River Protections Solutions, LLC’s (WRPS) Low Activity Waste Pretreatment System (LAWPS) Project provides for the early production of immobilized low-activity waste (ILAW) by feeding LAW directly from Tank Farms to the Waste Treatment and Immobilization Plant (WTP) LAW Facility, bypassing the WTP Pretreatment Facility. Prior to the transfer of feed to the WTP LAW Vitrification Facility, tank supernatant waste will be pretreated in the LAWPS to meet the WTP LAW waste acceptance criteria (WAC). Full-scale and engineering-scale testing of critical technology elements, as part of the technology maturation process, are components of the overall LAWPS Project. WRPS awarded themore » engineering-scale integrated testing scope to AECOM via WRPS Subcontract 58349. This report is deliverable MSR-008 of the subcontract.« less

Technical Basis of Scaling Relationships for the Pretreatment Engineering Platform

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

Kuhn, William L.; Arm, Stuart T.; Huckaby, James L.

Pacific Northwest National Laboratory has been tasked by Bechtel National Inc. (BNI) on the River Protection Project-Waste Treatment Plant (RPP-WTP) project to perform research and development activities. The Pretreatment Engineering Platform (PEP) is being designed and constructed as part of a plan to respond to an issue raised by the WTP External Flowsheet Review Team (EFRT) entitled “Undemonstrated Leaching Processes” and numbered M12. The PEP replicates the WTP leaching process using prototypic equipment and control strategies. The approach for scaling PEP performance data to predict WTP performance is critical to the successful resolution of the EFRT issue. This report describesmore » the recommended PEP scaling approach, PEP data interpretation and provides recommendations on test conduct and data requirements.« less

Diversity of microbiota found in coffee processing wastewater treatment plant.

PubMed

Pires, Josiane Ferreira; Cardoso, Larissa de Souza; Schwan, Rosane Freitas; Silva, Cristina Ferreira

2017-11-13

Cultivable microbiota presents in a coffee semi-dry processing wastewater treatment plant (WTP) was identified. Thirty-two operational taxonomic units (OTUs) were detected, these being 16 bacteria, 11 yeasts and 4 filamentous fungi. Bacteria dominated the microbial population (11.61 log CFU mL - 1 ), and presented the highest total diversity index when observed in the WTP aerobic stage (Shannon = 1.94 and Simpson = 0.81). The most frequent bacterial species were Enterobacter asburiae, Sphingobacterium griseoflavum, Chryseobacterium bovis, Serratia marcescens, Corynebacterium flavescens, Acetobacter orientalis and Acetobacter indonesiensis; these showed the largest total bacteria populations in the WTP, with approximately 10 log CFU mL - 1 . Yeasts were present at 7 log CFU mL - 1 of viable cells, with Hanseniaspora uvarum, Wickerhamomyces anomalus, Torulaspora delbrueckii, Saturnispora gosingensis, and Kazachstania gamospora being the prevalent species. Filamentous fungi were found at 6 log CFU mL - 1 , with Fusarium oxysporum the most populous species. The identified species have the potential to act as a biological treatment in the WTP, and the application of them for this purpose must be better studied.

Properties important to mixing and simulant recommendations for WTP full-scale vessel testing

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

Poirier, M. R.; Martino, C. J.

2015-12-01

Full Scale Vessel Testing (FSVT) is being planned by Bechtel National, Inc., to demonstrate the ability of the standard high solids vessel design (SHSVD) to meet mixing requirements over the range of fluid properties planned for processing in the Pretreatment Facility (PTF) of the Hanford Waste Treatment and Immobilization Plant (WTP). Testing will use simulated waste rather than actual Hanford waste. Therefore, the use of suitable simulants is critical to achieving the goals of the test program. WTP personnel requested the Savannah River National Laboratory (SRNL) to assist with development of simulants for use in FSVT. Among the tasks assignedmore » to SRNL was to develop a list of waste properties that are important to pulse-jet mixer (PJM) performance in WTP vessels with elevated concentrations of solids.« less

Willingness to Pay for Hospice Care Using the Contingent Valuation Method

PubMed Central

Kim, Mee-Ok; Kim, Jung-Hoe; Joo, Ji-Soo

2011-01-01

Purpose It is necessary to develop a proper payment system for more health care facilities to provide hospice and palliative cares. In deciding the proper level of payment for hospice per diem fee, willingness to pay (WTP) may provide one of the critical information. This study was conducted to determine WTP for hospice care and to analyze those factors affecting WTP. Materials and Methods A contingent valuation method with a double-bounded dichotomous-choice model was used. Interview survey was organized and conducted by a survey company from April 4 to 18, 2008. The mean WTP was calculated through an infinite integration of survival functions. Results The average willingness to pay was found to be 42,240 Korean won (KRW) (USD 35), with the amount becoming higher as hospice services were deemed more necessary or where average monthly household income was higher. The amount was also higher among male respondents than females. Conclusion To compare this WTP with actual cost (32,500 KRW) (USD 27) for hospice care. To facilitate hospice service, hospice specific payment system should be developed. This study provides information regarding the general public's preference of hospice service and their WTP for hospice care, and it may be useful in the decision-making process. PMID:21488196

A One System Integrated Approach to Simulant Selection for Hanford High Level Waste Mixing and Sampling Tests - 13342

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

Thien, Mike G.; Barnes, Steve M.

2013-07-01

The Hanford Tank Operations Contractor (TOC) and the Hanford Waste Treatment and Immobilization Plant (WTP) contractor are both engaged in demonstrating mixing, sampling, and transfer system capabilities using simulated Hanford High-Level Waste (HLW) formulations. This represents one of the largest remaining technical issues with the high-level waste treatment mission at Hanford. Previous testing has focused on very specific TOC or WTP test objectives and consequently the simulants were narrowly focused on those test needs. A key attribute in the Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 2010-2 is to ensure testing is performed with a simulant that represents the broadmore » spectrum of Hanford waste. The One System Integrated Project Team is a new joint TOC and WTP organization intended to ensure technical integration of specific TOC and WTP systems and testing. A new approach to simulant definition has been mutually developed that will meet both TOC and WTP test objectives for the delivery and receipt of HLW. The process used to identify critical simulant characteristics, incorporate lessons learned from previous testing, and identify specific simulant targets that ensure TOC and WTP testing addresses the broad spectrum of Hanford waste characteristics that are important to mixing, sampling, and transfer performance are described. (authors)« less

Willingness to pay more for value-added pomegranate juice (Punica granatum L.): An open-ended contingent valuation.

PubMed

Romano, Karen Rodrigues; Dias Bartolomeu Abadio Finco, Fernanda; Rosenthal, Amauri; Vinicius Alves Finco, Marcus; Deliza, Rosires

2016-11-01

This study aimed at estimating the consumer's willingness to pay (WTP) more for value-added pomegranate juice using the contingent valuation method (CVM). The WTP was estimated applying the open-ended elicitation technique with 454 consumers in two supermarkets located in Rio de Janeiro, Brazil. The average consumer's WTP more for pomegranate juice was estimated in R$2.04 (Brazilian currency) and the income elasticity coefficient at the midpoint was 0.19, i.e., a 10% increase in consumer income will increase, on average, 1.9% the WTP of pomegranate juice (ceteris paribus). Therefore, the income elasticity coefficient was considered inelastic, once an increase in income would have low effect on the WTP for these consumers. The results indicated that the consumers were interested in acquiring a non-traditional juice processed using a technology that preserves vitamins and antioxidants, maintains the flavor of "fresh juice" without colorants and preservatives, despite the pomegranate is not part of the Brazilian diet. Copyright © 2016 Elsevier Ltd. All rights reserved.

WASTE TREATMENT PLANT (WTP) LIQUID EFFLUENT TREATABILITY EVALUATION

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

LUECK, K.J.

2004-10-18

A forecast of the radioactive, dangerous liquid effluents expected to be produced by the Waste Treatment Plant (WTP) was provided by Bechtel National, Inc. (BNI 2004). The forecast represents the liquid effluents generated from the processing of Tank Farm waste through the end-of-mission for the WTP. The WTP forecast is provided in the Appendices. The WTP liquid effluents will be stored, treated, and disposed of in the Liquid Effluent Retention Facility (LERF) and the Effluent Treatment Facility (ETF). Both facilities are located in the 200 East Area and are operated by Fluor Hanford, Inc. (FH) for the US. Department ofmore » Energy (DOE). The treatability of the WTP liquid effluents in the LERF/ETF was evaluated. The evaluation was conducted by comparing the forecast to the LERF/ETF treatability envelope (Aromi 1997), which provides information on the items which determine if a liquid effluent is acceptable for receipt and treatment at the LERF/ETF. The format of the evaluation corresponds directly to the outline of the treatability envelope document. Except where noted, the maximum annual average concentrations over the range of the 27 year forecast was evaluated against the treatability envelope. This is an acceptable approach because the volume capacity in the LERF Basin will equalize the minimum and maximum peaks. Background information on the LERF/ETF design basis is provided in the treatability envelope document.« less

Overview of Corrosion, Erosion, and Synergistic Effects of Erosion and Corrosion in the WTP Pre-treatment Facility

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

Imrich, K. J.

2015-03-27

Corrosion is an extremely complex process that is affected by numerous factors. Addition of a flowing multi-phase solution further complicates the analysis. The synergistic effects of the multiple corrosive species as well as the flow-induced synergistic effects from erosion and corrosion must be thoroughly evaluated in order to predict material degradation responses. Public domain data can help guide the analysis, but cannot reliably provide the design basis especially when the process is one-of-a-kind, designed for 40 plus years of service, and has no viable means for repair or replacement. Testing in representative simulants and environmental conditions with prototypic components willmore » provide a stronger technical basis for design. This philosophy was exemplified by the Defense Waste Processing Facility (DWPF) at the Savannah River Site and only after 15 plus years of successful operation has it been validated. There have been “hiccups”, some identified during the cold commissioning phase and some during radioactive operations, but they were minor and overcome. In addition, the system is robust enough to tolerate most flowsheet changes and the DWPF design allows minor modifications and replacements – approaches not available with the Hanford Waste Treatment Plant (WTP) “Black Cell” design methodology. Based on the available data, the synergistic effect between erosion and corrosion is a credible – virtually certain – degradation mechanism and must be considered for the design of the WTP process systems. Testing is recommended due to the number of variables (e.g., material properties, process parameters, and component design) that can affect synergy between erosion and corrosion and because the available literature is of limited applicability for the complex process chemistries anticipated in the WTP. Applicable testing will provide a reasonable and defensible path forward for design of the WTP Black Cell and Hard-to-Reach process equipment. These conclusions are consistent with findings from the various Bechtel National Inc., Independent Review Teams, and Department of Energy (DOE) reviews. A test methodology is outlined, which should provide a clear, logical road map for the testing that is necessary to provide applicable and defensible data essential to support design calculations.« less

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

KRUGER AA; MATLACK KS; KOT WK

This document provides the final report on data and results obtained from a series of nine tests performed on the one-third scale DuraMelter{trademark} 1200 (DM1200) HLW Pilot Melter system that has been installed at VSL with an integrated prototypical off-gas treatment system. That system has replaced the DM1000 system that was used for HLW throughput testing during Part B1 [1]. Both melters have similar melt surface areas (1.2 m{sup 2}) but the DM1200 is prototypical of the present RPP-WTP HLW melter design whereas the DM1000 was not. These tests were performed under a corresponding RPP-WTP Test Specification and associated Testmore » Plans. The nine tests reported here were preceded by an initial series of short-duration tests conducted to support the start-up and commissioning of this system. This report is a followup to the previously issued Preliminary Data Summary Reports. The DM1200 system was deployed for testing and confirmation of basic design, operability, flow sheet, and process control assumptions as well as for support of waste form qualification and permitting. These tests include data on processing rates, off-gas treatment system performance, recycle stream compositions, as well as process operability and reliability. Consequently, this system is a key component of the overall HLW vitrification development strategy. The primary objective of the present series of tests was to determine the effects of a variety of parameters on the glass production rate in comparison to the RPP-WTP HL W design basis of 400 kg/m{sup 2}/d. Previous testing on the DMIOOO system [1] concluded that achievement of that rate with simulants of projected WTP melter feeds (AZ-101 and C-106/AY-102) was unlikely without the use of bubblers. As part of those tests, the same feed that was used during the cold-commissioning of the West Valley Demonstration Project (WVDP) HLW vitrification system was run on the DM1000 system. The DM1000 tests reproduced the rates that were obtained at the larger WVDP facility, lending confidence to the tests results [1]. Since the inclusion or exclusion of a bubbler has significant design implications, the Project commissioned further tests to address this issue. In an effort to identify factors that might increase the glass production rate for projected WTP melter feeds, a subsequent series of tests was performed on the DM100 system. Several tests variables led to glass production rate increases to values significantly above the 400 kg/m2/d requirement. However, while small-scale melter tests are useful for screening relative effects, they tend to overestimate absolute glass production rates, particularly for un-bubbled tests. Consequently, when scale-up effects were taken into account, it was not clear that any of the variables investigated would conclusively meet the 400 kg/m{sup 2}/d requirement without bubbling. The present series of tests was therefore performed on the DM1200 one-third scale HLW pilot melter system to provide the required basis for a final decision on whether bubblers would be included in the HLW melter. The present tests employed the same AZ-101 waste simulant and glass composition that was used for previous testing for consistency and comparability with the results from the earlier tests.« less

RPP-PRT-58489, Revision 1, One Systems Consistent Safety Analysis Methodologies Report. 24590-WTP-RPT-MGT-15-014

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

Gupta, Mukesh; Niemi, Belinda; Paik, Ingle

2015-09-02

In 2012, One System Nuclear Safety performed a comparison of the safety bases for the Tank Farms Operations Contractor (TOC) and Hanford Tank Waste Treatment and Immobilization Plant (WTP) (RPP-RPT-53222 / 24590-WTP-RPT-MGT-12-018, “One System Report of Comparative Evaluation of Safety Bases for Hanford Waste Treatment and Immobilization Plant Project and Tank Operations Contract”), and identified 25 recommendations that required further evaluation for consensus disposition. This report documents ten NSSC approved consistent methodologies and guides and the results of the additional evaluation process using a new set of evaluation criteria developed for the evaluation of the new methodologies.

Resource allocation in NHS dentistry: recognition of societal preferences (RAINDROP): study protocol.

PubMed

Vernazza, Christopher R; Carr, Katherine; Wildman, John; Gray, Joanne; Holmes, Richard D; Exley, Catherine; Smith, Robert A; Donaldson, Cam

2018-06-22

Resources in any healthcare systems are scarce relative to need and therefore choices need to be made which often involve difficult decisions about the best allocation of these resources. One pragmatic and robust tool to aid resource allocation is Programme Budgeting and Marginal Analysis (PBMA), but there is mixed evidence on its uptake and effectiveness. Furthermore, there is also no evidence on the incorporation of the preferences of a large and representative sample of the general public into such a process. The study therefore aims to undertake, evaluate and refine a PBMA process within the exemplar of NHS dentistry in England whilst also using an established methodology (Willingness to Pay (WTP)) to systematically gather views from a representative sample of the public. Stakeholders including service buyers (commissioners), dentists, dental public health representatives and patient representatives will be recruited to participate in a PBMA process involving defining current spend, agreeing criteria to judge services/interventions, defining areas for investment and disinvestment, rating these areas against the criteria and making final recommendations. The process will be refined based on participatory action research principles and evaluated through semi-structured interviews, focus groups and observation of the process by the research team. In parallel a representative sample of English adults will be recruited to complete a series of four surveys including WTP valuations of programmes being considered by the PBMA panel. In addition a methodological experiment comparing two ways of eliciting WTP will be undertaken. The project will allow the PBMA process and particularly the use of WTP within it to be investigated and developed. There will be challenges around engagement with the task by the panel undertaking it and with the outputs by stakeholders but careful relationship building will help to mitigate this. The large volume of data will be managed through careful segmenting of the analysis and the use of the well-established Framework approach to qualitative data analysis. WTP has various potential biases but the elicitation will be carefully designed to minimise these and some methodological investigation will take place.

Validity of Willingness to Pay Measures under Preference Uncertainty.

PubMed

Braun, Carola; Rehdanz, Katrin; Schmidt, Ulrich

2016-01-01

Recent studies in the marketing literature developed a new method for eliciting willingness to pay (WTP) with an open-ended elicitation format: the Range-WTP method. In contrast to the traditional approach of eliciting WTP as a single value (Point-WTP), Range-WTP explicitly allows for preference uncertainty in responses. The aim of this paper is to apply Range-WTP to the domain of contingent valuation and to test for its theoretical validity and robustness in comparison to the Point-WTP. Using data from two novel large-scale surveys on the perception of solar radiation management (SRM), a little-known technique for counteracting climate change, we compare the performance of both methods in the field. In addition to the theoretical validity (i.e. the degree to which WTP values are consistent with theoretical expectations), we analyse the test-retest reliability and stability of our results over time. Our evidence suggests that the Range-WTP method clearly outperforms the Point-WTP method.

Validity of Willingness to Pay Measures under Preference Uncertainty

PubMed Central

Braun, Carola; Rehdanz, Katrin; Schmidt, Ulrich

2016-01-01

Recent studies in the marketing literature developed a new method for eliciting willingness to pay (WTP) with an open-ended elicitation format: the Range-WTP method. In contrast to the traditional approach of eliciting WTP as a single value (Point-WTP), Range-WTP explicitly allows for preference uncertainty in responses. The aim of this paper is to apply Range-WTP to the domain of contingent valuation and to test for its theoretical validity and robustness in comparison to the Point-WTP. Using data from two novel large-scale surveys on the perception of solar radiation management (SRM), a little-known technique for counteracting climate change, we compare the performance of both methods in the field. In addition to the theoretical validity (i.e. the degree to which WTP values are consistent with theoretical expectations), we analyse the test-retest reliability and stability of our results over time. Our evidence suggests that the Range-WTP method clearly outperforms the Point-WTP method. PMID:27096163

Parents' willingness to pay for the prevention of childhood overweight and obesity.

PubMed

Kesztyüs, Dorothea; Lauer, Romy; Schreiber, Anja C; Kesztyüs, Tibor; Kilian, Reinhold; Steinacker, Jürgen M

2014-12-01

To determine parental willingness-to-pay (WTP) for childhood obesity prevention. Cross-sectional data from the follow-up measurements (2011) of a health promotion programme in German primary schools. Data collection included anthropometric measurements of children and self-administered questionnaires for parents, including WTP assessment. Mann-Whitney U-Test was used for differences between groups, and regression analysis to identify factors associated with general WTP and amount of WTP. From 1 534 parents, 97.8% considered overweight/obesity to be serious public health problems. A general WTP to reduce the incidence of childhood overweight/obesity by half, was declared by 48.8%. Parents of overweight/obese children showed with 61.4%, significantly more frequently, their general WTP than the others with 47.2% (p = 0.001). Mean WTP was 23.04 (99% confidence interval (CI) [22.45; 23.75]) per month. Parents of centrally obese children showed significantly higher WTP than parents of the other children (p = 0.001). General WTP and the amount of WTP were associated with the central obesity of the child, migration status and household income. Additionally, general WTP was associated with maternal obesity. Nearly half of the parents were willing to invest in prevention of obesity. The general WTP significantly occurs more often and with higher amount in affected parents.

An Update on Modifications to Water Treatment Plant Model

EPA Science Inventory

Water treatment plant (WTP) model is an EPA tool for informing regulatory options. WTP has a few versions: 1). WTP2.2 can help in regulatory analysis. An updated version (WTP3.0) will allow plant-specific analysis (WTP-ccam) and thus help meet plant-specific treatment objectives...

Willingness to pay for rapid diagnostic tests for the diagnosis and treatment of malaria in southeast Nigeria: ex post and ex ante

PubMed Central

2010-01-01

Background The introduction of rapid diagnostic tests (RDTs) has improved the diagnosis and treatment of malaria. However, any successful control of malaria will depend on socio-economic factors that influence its management in the community. Willingness to pay (WTP) is important because consumer responses to prices will influence utilization of services and revenues collected. Also the consumer's attitude can influence monetary valuation with respect to different conditions ex post and ex ante. Methods WTP for RDT for Malaria was assessed by the contingent valuation method using a bidding game approach in rural and urban communities in southeast Nigeria. The ex post WTP was assessed at the health centers on 618 patients immediately following diagnosis of malaria with RDT and the ex ante WTP was assessed by household interviews on 1020 householders with a prior history of malaria. Results For the ex ante WTP, 51% of the respondents in urban and 24.7% in rural areas were willing to pay for RDT. The mean WTP (235.49 naira) in urban is higher than WTP (182.05 Naira) in rural areas. For the ex post WTP, 89 and 90.7% of the respondents in urban and rural areas respectively were WTP. The mean WTP (372.30 naira) in urban is also higher than (296.28 naira) in rural areas. For the ex post scenario, the lower two Social Economic Status (SES) quartiles were more willing to pay and the mean WTP is higher than the higher two SES while in the ex ante scenario, the higher two SES quartiles were more WTP and with a higher WTP than the lower two SES quartile. Ex ante and ex post WTP were directly dependent on costs. Conclusion The ex post WTP is higher than the ex ante WTP and both are greater than the current cost of RDTs. Urban dwellers were more willing to pay than the rural dwellers. The mean WTP should be considered when designing suitable financial strategies for making RDTs available to communities. PMID:20148118

A comparison of regional and national values for recovering threatened and endangered marine species in the United States.

PubMed

Wallmo, Kristy; Lew, Daniel K

2016-09-01

It is generally acknowledged that willingness-to-pay (WTP) estimates for environmental goods exhibit some degree of spatial variation. In a policy context, spatial variation in threatened and endangered species values is important to understand, as the benefit stream from policies affecting threatened and endangered species may vary locally, regionally, or among certain population segments. In this paper we present WTP estimates for eight different threatened and endangered marine species estimated from a stated preference choice experiment. WTP is estimated at two different spatial scales: (a) a random sample of over 5000 U.S. households and (b) geographically embedded samples (relative to the U.S. household sample) of nine U.S. Census regions. We conduct region-to-region and region-to-nation statistical comparisons to determine whether species values differ among regions and between each region and the entire U.S. Our results show limited spatial variation between national values and values estimated from regionally embedded samples, and differences are only found for three of the eight species. More variation exists between regions, and for all species there is a significant difference in at least one region-to-region comparison. Given that policy analyses involving threatened and endangered marine species can often be regional in scope (e.g., ecosystem management) or may disparately affect different regions, our results should be of high interest to the marine management community. Published by Elsevier Ltd.

Literature Review: Assessment of DWPF Melter and Melter Off-gas System Lifetime

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

Reigel, M.

2015-07-30

Testing to date for the MOC for the Hanford Waste Treatment and Immobilization Plant (WTP) melters is being reviewed with the lessons learned from DWPF in mind and with consideration to the changes in the flowsheet/feed compositions that have occurred since the original testing was performed. This information will be presented in a separate technical report that identifies any potential gaps for WTP processing.

Advanced High-Level Waste Glass Research and Development Plan

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

Peeler, David K.; Vienna, John D.; Schweiger, Michael J.

2015-07-01

The U.S. Department of Energy Office of River Protection (ORP) has implemented an integrated program to increase the loading of Hanford tank wastes in glass while meeting melter lifetime expectancies and process, regulatory, and product quality requirements. The integrated ORP program is focused on providing a technical, science-based foundation from which key decisions can be made regarding the successful operation of the Hanford Tank Waste Treatment and Immobilization Plant (WTP) facilities. The fundamental data stemming from this program will support development of advanced glass formulations, key process control models, and tactical processing strategies to ensure safe and successful operations formore » both the low-activity waste (LAW) and high-level waste (HLW) vitrification facilities with an appreciation toward reducing overall mission life. The purpose of this advanced HLW glass research and development plan is to identify the near-, mid-, and longer-term research and development activities required to develop and validate advanced HLW glasses and their associated models to support facility operations at WTP, including both direct feed and full pretreatment flowsheets. This plan also integrates technical support of facility operations and waste qualification activities to show the interdependence of these activities with the advanced waste glass (AWG) program to support the full WTP mission. Figure ES-1 shows these key ORP programmatic activities and their interfaces with both WTP facility operations and qualification needs. The plan is a living document that will be updated to reflect key advancements and mission strategy changes. The research outlined here is motivated by the potential for substantial economic benefits (e.g., significant increases in waste throughput and reductions in glass volumes) that will be realized when advancements in glass formulation continue and models supporting facility operations are implemented. Developing and applying advanced glass formulations will reduce the cost of Hanford tank waste management by reducing the schedule for tank waste treatment and reducing the amount of HLW glass for storage, transportation, and disposal. Additional benefits will be realized if advanced glasses are developed that demonstrate more tolerance for key components in the waste (such as Al 2O 3, Cr 2O 3, SO 3 and Na 2O) above the currently defined WTP constraints. Tolerating these higher concentrations of key waste loading limiters may reduce the burden on (or even eliminate the need for) leaching to remove Cr and Al and washing to remove excess S and Na from the HLW fraction. Advanced glass formulations may also make direct vitrification of the HLW fraction without significant pretreatment more cost effective. Finally, the advanced glass formulation efforts seek not only to increase waste loading in glass, but also to increase glass production rate. When coupled with higher waste loading, ensuring that all of the advanced glass formulations are processable at or above the current contract processing rate leads to significant improvements in waste throughput (the amount of waste being processed per unit time),which could significantly reduce the overall WTP mission life. The integration of increased waste loading, reduced leaching/washing requirements, and improved melting rates provides a system-wide approach to improve the effectiveness of the WTP process.« less

PEP Support Laboratory Leaching and Permeate Stability Tests

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

Russell, Renee L.; Peterson, Reid A.; Rinehart, Donald E.

2009-09-25

Pacific Northwest National Laboratory (PNNL) has been tasked by Bechtel National Inc. (BNI) on the River Protection Project-Hanford Tank Waste Treatment and Immobilization Plant (RPP-WTP) project to perform research and development activities to resolve technical issues identified for the Pretreatment Facility (PTF). The Pretreatment Engineering Platform (PEP) was designed, constructed, and operated as part of a plan to respond to issue M12, "Undemonstrated Leaching Processes," of the External Flowsheet Review Team (EFRT) issue response plan.( ) The PEP is a 1/4.5-scale test platform designed to simulate the WTP pretreatment caustic leaching, oxidative leaching, ultrafiltration solids concentration, and slurry washing processes.more » The PEP replicates the WTP leaching processes using prototypic equipment and control strategies. A simplified flow diagram of the PEP system is shown in Figure 1.1. Two operating scenarios are currently being evaluated for the ultrafiltration process (UFP) and leaching operations. The first scenario has caustic leaching performed in the UFP-2 ultrafiltration feed vessels (i.e., vessel UFP-VSL-T02A in the PEP and vessels UFP-VSL-00002A and B in the WTP PTF). The second scenario has caustic leaching conducted in the UFP-1 ultrafiltration feed preparation vessels (i.e., vessels UFP-VSL-T01A and B in the PEP and vessels UFP-VSL-00001A and B in the WTP PTF). In both scenarios, 19-M sodium hydroxide solution (NaOH, caustic) is added to the waste slurry in the vessels to leach solid aluminum compounds (e.g., gibbsite, boehmite). Caustic addition is followed by a heating step that uses direct injection of steam to accelerate the leach process. Following the caustic leach, the vessel contents are cooled using vessel cooling jackets and/or external heat exchangers. The main difference between the two scenarios is that for leaching in UFP-VSL-T01A and B, the 19-M NaOH is added to un-concentrated waste slurry (3 to 8 wt% solids), while for leaching in UFP-VSL-T02A, the slurry is concentrated to nominally 20 wt% solids using cross-flow ultrafiltration before adding caustic.« less

Women's willingness to pay out-of-pocket for drug treatment for osteoporosis before and after the enactment of regulations providing public funding: evidence from a natural experiment in Israel.

PubMed

Werner, P; Vered, I

2002-03-01

This study examines women's willingness to pay (WTP) for drug treatment for osteoporosis before and after the enactment of regulations approving public funding for the drugs and for a hypothetical more effective but not funded drug. One hundred and nine postmenopausal women recruited sequentially from a large bone metabolism outpatient clinic in central Israel were asked by telephone interview to report their maximum WTP out-of-pocket for a drug that would reduce the risk of hip fracture by 50% in four hypothetical cases varying by the level of risk described. Additionally, after the regulations, responses were elicited also for a hypothetical more effective drug. Information regarding participants' sociodemographic and health characteristics, as well as their knowledge of osteoporosis, was also collected. Women would pay considerable sums of money (between 85% to 124% of the price of the drugs) for osteoporosis treatment and these sums increase significantly as the risk of suffering a hip fracture increases. After the enactment of the regulations, women were still willing to pay 54% to 100% of the price of the drugs out-of-pocket. Increased WTP after the regulations was associated with increased ability to pay and to lower levels of knowledge of the disease. After the enactment, participants' WTP for a more effective drug was no different from their WTP for a less effective drug. WTP measures show relative stability over time. The dissemination of information regarding policy or regulatory changes should be encouraged in order to ensure rational decision-making processes.

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

Dahl, Suzanne; Biyani, Rabindra; Holmes, Erika

The United States Department of Energy's (US DOE's) Hanford Nuclear Site has 177 underground waste storage tanks located 19 to 24 km (12 to 15 miles) from the Columbia River in south-central Washington State. Hanford's tanks now hold about 212,000 cu m (56 million gallons) of highly radioactive and chemically hazardous waste. Sixty-seven tanks have leaked an estimated 3,785 cu m (1 million gallons) of this waste into the surrounding soil. Further releases to soil, groundwater, and the Columbia River are the inevitable result of the tanks continuing to age. The risk from this waste is recognized as a threatmore » to the Northwest by both State and Federal governments. US DOE and Bechtel National, Inc., are building the Waste Treatment and Immobilization Plant (WTP) to treat and vitrify (immobilize in glass) the waste from Hanford's tanks. As is usual for any groundbreaking project, problems have arisen that must be resolved as they occur if treatment is to take place as specified in the court-enforceable Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) and the Consent Decree, entered into by US DOE, the U.S. Environmental Protection Agency, and the Washington State Department of Ecology (Ecology). At times, US DOE's approach to solving these critical issues seems to have caused undue wastes of time, energy, and, ultimately, public funds. Upon reviewing the history of Hanford's tank waste treatment project, Ecology hopes that constructive criticism of past failures and praise of successes will inspire US DOE to consider changing practices, be more transparent with regulatory agencies and the public, and take a 'lean production' approach to successfully completing this project. All three Tri-Party Agreement agencies share the goal of completing WTP on time, ensuring it is operational and in compliance with safety standards. To do this, Ecology believes US DOE should: - Maintain focus on the primary goal of completing the five major facilities of WTP. - Construct a supplemental low-activity waste (LAW) vitrification facility for the two-thirds balance of LAW that will not be treated by the vitrification facility under construction. - Prepare infrastructure for waste feed from the tanks and facilities to handle the WTP waste streams. To support this project track, Ecology expedites dangerous waste permitting by using a design-build approach to integrate WTP into the Resource Conservation and Recovery Act permit for Hanford. (authors)« less

Silver-functionalized silica aerogels and their application in the removal of iodine from aqueous environments

DOE PAGES

Asmussen, R. Matthew; Matyas, Josef; Qafoku, Nikolla P.; ...

2018-05-01

Here, one of the key challenges for radioactive waste management is the efficient capture and immobilization of radioiodine, because of its radiotoxicity, high mobility in the environment, and long half-life (t 1/2 = 1.57 × 10 7 years). Silver-functionalized silica aerogel (AgAero) represents a strong candidate for safe sequestration of radioiodine from various nuclear waste streams and subsurface environments. Batch sorption experiments up to 10 days long were carried out in oxic and anoxic conditions in both deionized water (DIW) and various Hanford Site Waste Treatment Plant (WTP) off-gas condensate simulants containing from 5 to 10 ppm of iodide (Imore » –) or iodate (IO 3 –). Also tested was the selectivity of AgAero towards I – in the presence of other halide anions. AgAero exhibited fast and complete removal of I – from DIW, slower but complete removal of I – from WTP off-gas simulants, preferred removal of I – over Br – and Cl –, and it demonstrated ability to remove IO 3 – through reduction to I –.« less

Silver-functionalized silica aerogels and their application in the removal of iodine from aqueous environments

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

Asmussen, R. Matthew; Matyas, Josef; Qafoku, Nikolla P.

Here, one of the key challenges for radioactive waste management is the efficient capture and immobilization of radioiodine, because of its radiotoxicity, high mobility in the environment, and long half-life (t 1/2 = 1.57 × 10 7 years). Silver-functionalized silica aerogel (AgAero) represents a strong candidate for safe sequestration of radioiodine from various nuclear waste streams and subsurface environments. Batch sorption experiments up to 10 days long were carried out in oxic and anoxic conditions in both deionized water (DIW) and various Hanford Site Waste Treatment Plant (WTP) off-gas condensate simulants containing from 5 to 10 ppm of iodide (Imore » –) or iodate (IO 3 –). Also tested was the selectivity of AgAero towards I – in the presence of other halide anions. AgAero exhibited fast and complete removal of I – from DIW, slower but complete removal of I – from WTP off-gas simulants, preferred removal of I – over Br – and Cl –, and it demonstrated ability to remove IO 3 – through reduction to I –.« less

Silver-functionalized silica aerogels and their application in the removal of iodine from aqueous environments.

PubMed

Asmussen, R Matthew; Matyáš, Josef; Qafoku, Nikolla P; Kruger, Albert A

2018-05-01

One of the key challenges for radioactive waste management is the efficient capture and immobilization of radioiodine, because of its radiotoxicity, high mobility in the environment, and long half-life (t 1/2  = 1.57 × 10 7 years). Silver-functionalized silica aerogel (AgAero) represents a strong candidate for safe sequestration of radioiodine from various nuclear waste streams and subsurface environments. Batch sorption experiments up to 10 days long were carried out in oxic and anoxic conditions in both deionized water (DIW) and various Hanford Site Waste Treatment Plant (WTP) off-gas condensate simulants containing from 5 to 10 ppm of iodide (I - ) or iodate (IO 3 - ). Also tested was the selectivity of AgAero towards I - in the presence of other halide anions. AgAero exhibited fast and complete removal of I - from DIW, slower but complete removal of I - from WTP off-gas simulants, preferred removal of I - over Br - and Cl - , and it demonstrated ability to remove IO 3 - through reduction to I - . Copyright © 2018 Elsevier B.V. All rights reserved.

Evaluating Willingness-to-Pay Thresholds for Dementia Caregiving Interventions: Application to the Tailored Activity Program

PubMed Central

Jutkowitz, Eric; Gitlin, Laura N.; Pizzi, Laura T.

2017-01-01

Objectives The study aims to apply willingness-to-pay (WTP) values derived from the literature to inform decision-makers of the cost-effectiveness of the Tailored Activity Program (TAP), an intervention proven to reduce caregiver burden. Methods TAP and other caregiver interventions employ an individual perspective and non–quality-adjusted life-year (QALY) outcome measure where the primary objective is to determine caregiver burden from an individual perspective. Therefore, standard cost/QALY thresholds are not appropriate. To identify relevant WTP values, we searched for studies that: 1) were published in the past 5 years and used contingent valuation methodology to identify WTP; 2) assessed WTP for a dementia-related intervention requiring out-of-pocket expenditure; and 3) asked caregivers their WTP for an outcome related to reducing caregiver burden. Three studies were identified utilizing four WTP values. We also assessed potential financial savings that caregivers could achieve from purchasing TAP. To assess the probability of TAP being cost-effective, we built a Monte Carlo simulation to test the four WTP values applied to two TAP outcome measures: reduction in caregiver hours “on duty;” and “doing things.” Results For outcome measure “on duty,” WTP varied between $1.06/hour and $4.58/hour. For outcome measure “doing things,” WTP varied between $2.21/hour and $9.57/hour. Applying the four identified WTP values from the literature to TAP outcomes resulted in TAP cost-effectiveness varying between 50% and 80% for both outcome measures. Conclusions When WTP data are not collected prospectively or conventional metrics cannot be applied, retrospectively assessing literature-derived WTP may be acceptable for informing decision-makers of potential cost-effectiveness of a proven program. Application of WTP to TAP shows potential cost-effectiveness that can be expected under the tested WTP scenarios. PMID:20561331

Neural correlates of economic value and valuation context: an event-related potential study.

PubMed

Tyson-Carr, John; Kokmotou, Katerina; Soto, Vicente; Cook, Stephanie; Fallon, Nicholas; Giesbrecht, Timo; Stancak, Andrej

2018-05-01

The value of environmental cues and internal states is continuously evaluated by the human brain, and it is this subjective value that largely guides decision making. The present study aimed to investigate the initial value attribution process, specifically the spatiotemporal activation patterns associated with values and valuation context, using electroencephalographic event-related potentials (ERPs). Participants completed a stimulus rating task in which everyday household items marketed up to a price of £4 were evaluated with respect to their desirability or material properties. The subjective values of items were evaluated as willingness to pay (WTP) in a Becker-DeGroot-Marschak auction. On the basis of the individual's subjective WTP values, the stimuli were divided into high- and low-value items. Source dipole modeling was applied to estimate the cortical sources underlying ERP components modulated by subjective values (high vs. low WTP) and the evaluation condition (value-relevant vs. value-irrelevant judgments). Low-WTP items and value-relevant judgments both led to a more pronounced N2 visual evoked potential at right frontal scalp electrodes. Source activity in right anterior insula and left orbitofrontal cortex was larger for low vs. high WTP at ∼200 ms. At a similar latency, source activity in right anterior insula and right parahippocampal gyrus was larger for value-relevant vs. value-irrelevant judgments. A stronger response for low- than high-value items in anterior insula and orbitofrontal cortex appears to reflect aversion to low-valued item acquisition, which in an auction experiment would be perceived as a relative loss. This initial low-value bias occurs automatically irrespective of the valuation context. NEW & NOTEWORTHY We demonstrate the spatiotemporal characteristics of the brain valuation process using event-related potentials and willingness to pay as a measure of subjective value. The N2 component resolves values of objects with a bias toward low-value items. The value-related changes of the N2 component are part of an automatic valuation process.

Willingness-to-pay stated preferences for 8 health-related quality-of-life domains in psoriatic arthritis: a pilot study.

PubMed

Hu, Stephanie W; Holt, Elizabeth W; Husni, M Elaine; Qureshi, Abrar A

2010-04-01

Psoriatic arthritis (PsA) is a seronegative inflammatory arthritis found in up to 5 to 42% of patients with psoriasis. As current instruments do not fully capture health-related quality of life (HR-QOL) in PsA from the patient's perspective, we piloted a novel application of "willingness-to-pay" (WTP) as a Patient Reported Outcome to measure the relative impact of PsA in 8 domains of HR-QOL. Fifty-nine PsA patients were interviewed on 8 WTP HR-QOL domains (physical, emotional, sleep, work, social, self-care, intimacy, and concentration). Participants were asked to rank the 8 domains of health in order of HR-QOL impact. In each domain, participants were asked whether PsA affected that domain, whether they were willing to pay for a cure in that domain, and the amount they were willing to pay. Median WTP amounts were compared with the proportion of participants affected by and willing to pay in each domain. Responses in US dollars were interpreted as strength of preference rather than absolute monetary values. The majority of participants were white (98%), > or =45 years of age (70%), insured (98%), and earned >$65,000/yr (66%). The physical domain was most affected by PsA; intimacy and concentration were ranked lowest. Participants reported a wide range of WTP amounts ($0 to $1,000,000), and median WTP amounts were highest in the physical, work, sleep, and self-care domains. Related domains elicited median WTP amounts that were highly correlated. No significant differences in median WTP amounts were found across ages, genders, and income levels for the different domains. WTP is a novel quantitative patient-perspective measure that is comprehensible and feasible to administer in PsA patients. It represents a unique tool for capturing the complex manifestations of PsA and its impact on the individual, allowing the quantification of specific HR-QOL parameters and providing the potential for comparison across various disease processes in a given individual. Copyright 2010 Elsevier Inc. All rights reserved.

Genotoxicity biomonitoring of sewage in two municipal wastewater treatment plants using the Tradescantia pallida var. purpurea bioassay.

PubMed

Thewes, Márcia Regina; Junior, Delio Endres; Droste, Annette

2011-10-01

The genotoxicity of untreated and treated sewage from two municipal wastewater treatment plants (WTP BN and WTP SJN) in the municipality of Porto Alegre, in the southern Brazilian state of Rio Grande do Sul, was evaluated over a one-year period using the Tradescantia pallida var. purpurea (Trad-MCN) bioassay. Inflorescences of T. pallida var. purpurea were exposed to sewage samples in February (summer), April (autumn), July (winter) and October (spring) 2009, and the micronuclei (MCN) frequencies were estimated in each period. The high genotoxicity of untreated sewage from WTP BN in February and April was not observed in treated sewage, indicating the efficiency of treatment at this WTP. However, untreated and treated sewage samples from WTP SJN had high MCN frequencies, except in October, when rainfall may have been responsible for reducing these frequencies at both WTPs. Physicochemical analyses of sewage from both WTPs indicated elevated concentrations of organic matter that were higher at WTP SJN than at WTP BN. Chromium was detected in untreated and treated sewage from WTP SJN, but not in treated sewage from WTP BN. Lead was found in all untreated sewage samples from WTP SJN, but only in the summer and autumn at WTP BN. These results indicate that the short-term Trad-MCN genotoxicity assay may be useful for regular monitoring of municipal WTPs.

Genotoxicity biomonitoring of sewage in two municipal wastewater treatment plants using the Tradescantia pallida var. purpurea bioassay

PubMed Central

Thewes, Márcia Regina; Junior, Delio Endres; Droste, Annette

2011-01-01

The genotoxicity of untreated and treated sewage from two municipal wastewater treatment plants (WTP BN and WTP SJN) in the municipality of Porto Alegre, in the southern Brazilian state of Rio Grande do Sul, was evaluated over a one-year period using the Tradescantia pallida var. purpurea (Trad-MCN) bioassay. Inflorescences of T. pallida var. purpurea were exposed to sewage samples in February (summer), April (autumn), July (winter) and October (spring) 2009, and the micronuclei (MCN) frequencies were estimated in each period. The high genotoxicity of untreated sewage from WTP BN in February and April was not observed in treated sewage, indicating the efficiency of treatment at this WTP. However, untreated and treated sewage samples from WTP SJN had high MCN frequencies, except in October, when rainfall may have been responsible for reducing these frequencies at both WTPs. Physicochemical analyses of sewage from both WTPs indicated elevated concentrations of organic matter that were higher at WTP SJN than at WTP BN. Chromium was detected in untreated and treated sewage from WTP SJN, but not in treated sewage from WTP BN. Lead was found in all untreated sewage samples from WTP SJN, but only in the summer and autumn at WTP BN. These results indicate that the short-term Trad-MCN genotoxicity assay may be useful for regular monitoring of municipal WTPs. PMID:22215975

Office of River Protection Advanced Low-Activity Waste Glass Research and Development Plan

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

Peeler, David K.; Kim, Dong-Sang; Vienna, John D.

2015-11-01

The U.S. Department of Energy Office of River Protection (ORP) has initiated and leads an integrated Advanced Waste Glass (AWG) program to increase the loading of Hanford tank wastes in glass while meeting melter lifetime expectancies and process, regulatory, and product performance requirements. The integrated ORP program is focused on providing a technical, science-based foundation for making key decisions regarding the successful operation of the Hanford Tank Waste Treatment and Immobilization Plant (WTP) facilities in the context of an optimized River Protection Project (RPP) flowsheet. The fundamental data stemming from this program will support development of advanced glass formulations, keymore » product performance and process control models, and tactical processing strategies to ensure safe and successful operations for both the low-activity waste (LAW) and high-level waste vitrification facilities. These activities will be conducted with the objective of improving the overall RPP mission by enhancing flexibility and reducing cost and schedule. The purpose of this advanced LAW glass research and development plan is to identify the near-term, mid-term, and longer-term research and development activities required to develop and validate advanced LAW glasses, property-composition models and their uncertainties, and an advanced glass algorithm to support WTP facility operations, including both Direct Feed LAW and full pretreatment flowsheets. Data are needed to develop, validate, and implement 1) new glass property-composition models and 2) a new glass formulation algorithm. Hence, this plan integrates specific studies associated with increasing the Na2O and SO3/halide concentrations in glass, because these components will ultimately dictate waste loadings for LAW vitrification. Of equal importance is the development of an efficient and economic strategy for 99Tc management. Specific and detailed studies are being implemented to understand the fate of Tc throughout the WTP flowsheet and the underlying mechanisms that dictate its partitioning between streams within the LAW vitrification facility. These studies are aimed at increasing the single-pass Tc retention in glass and the potential use of high-temperature mineral phases to capture Tc. The Tc-bearing mineral phases would be thermally stable and resistant to Tc release during feed melting reactions or they could serve as alternative waste forms. The LAW glass research and development is focused on reducing the total volume of LAW glass produced and minimizing the impact of (or potentially eliminating) the need for recycle.« less

Nassriya Water Treatment Plant Nassriya, Iraq. Sustainment Assessment

DTIC Science & Technology

2008-04-28

Progress During Construction 8 Status of the WTP at Time of Turnover 11 Site Assessment 13 Continuing Problems for the Nassriya WTP 27...Future Plans for the Nassriya WTP 35 Conclusions 37 Recommendations 38 Management Comments 39 Evaluation of Management Comments 39...Appendices A. Scope and Methodology 40 B. FluorAmec’s Organizational Structure for the Nassriya WTP 41 C. FluorAmec’s Nassriya WTP Staffing Plan 42 D

A Comparison Between Caucasians and African Americans in Willingness to Participate in Cancer Clinical Trials: The Roles of Knowledge, Distrust, Information Sources, and Religiosity.

PubMed

Meng, Jingbo; McLaughlin, Margaret; Pariera, Katrina; Murphy, Sheila

2016-06-01

This study aims to (a) examine the roles of knowledge, distrust in medical professionals, information sources, and 2 dimensions of religiosity (i.e., religious activity and religious belief) in influencing willingness to participate (WTP) in cancer clinical trials and to (b) compare the results for Caucasians and African Americans in order to inform future recruitment. An online survey was fielded via a Knowledge Networks panel with a nationally representative sample including 478 Caucasians and 173 African Americans. The results showed that distrust in medical professionals was a strong barrier to WTP for both ethnic groups, whereas factual knowledge about trial procedures was not associated with WTP for either ethnic group. Seeking trial information from doctors was positively associated with WTP for Caucasians; seeking trial information from hospitals was positively associated with WTP for African Americans. More interestingly, levels of religious activity negatively predicted WTP for Caucasians but positively predicted WTP for African Americans. Self-reported religious belief was not associated with WTP for either ethnic group. In sum, although distrust is a common barrier to WTP, the influence of preferred information sources and religious activity on WTP varies as a function of ethnicity.

Identification determinant factors on willingness to pay for health services in Iran.

PubMed

Javan-Noughabi, Javad; Kavosi, Zahra; Faramarzi, Ahmad; Khammarnia, Mohammad

2017-11-21

A common method used to examine the relationship between internal preferences and caring externalities is willingness to pay (WTP) approach. We aimed to estimate WTP for health status with different severity level and identify determinant factors on WTP. For determining main factors in WTP, a cross-sectional study was conducted in Shiraz in the southeast of Iran, in March to April 2015. The open-ended method was used to estimate monthly WTP in private and altruistic section. Multivariate regression analyses using ordinary least squares were applied to examine the effect of Scio-demographic factors on WTP using SPSS software 21. Participants were willing to pay an average amount of $ 295 in health status 1 and an average amount of $ 596 in health status 6 (worst status) for internal preferences. Altruistic WTP for health status 1 was $ 294 and participants were willing to pay an average amount of $ 416 in health status 6. Multiple regression analysis identified monthly income as the key determinant of WTP for internal preferences and caring externalities (P < 0.01). With an increase of 1% in income, private WTP increase 1.38% in health status 1. The finding indicates that the mean of WTP increases at severe health status; therefore, health policy maker should allocate resources toward severe health status.

Donor insemination: Israel as a representative case of a competitive market examining the possibility of policy reform.

PubMed

Gonen, Limor D

2017-03-01

To measure the private and social benefits of donor insemination (DI). An empirical model investigates the general public and DI clients' willingness to pay (WTP) for DI, and the willingness of potential donors to become altruistic or paid sperm donors. The general public and DI clients value DI and have a positive WTP for it, whereas willingness to donate, altruistically or for payment, is either low or very low. The general public's and DI clients' WTP for DI is in average above actual cost, so the government should consider funding or subsidizing DI. The government should encourage altruistic gamete donation through information and education of all parties involved directly and indirectly in the process of donation whose ultimate goal is the birth of a child.

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

Josephson, Gary B.; Geeting, John GH; Bredt, Ofelia P.

Pacific Northwest National Laboratory (PNNL) has been tasked by Bechtel National Inc. (BNI) on the River Protection Project-Waste Treatment Plant (RPP-WTP) project to perform research and development activities to resolve technical issues identified for the Pretreatment Facility (PTF). The Pretreatment Engineering Platform (PEP) was designed, constructed, and operated as part of a plan to respond to issue M12, "Undemonstrated Leaching Processes." The PEP is a 1/4.5-scale test platform designed to simulate the WTP pretreatment caustic leaching, oxidative leaching, ultrafiltration solids concentration, and slurry washing processes. The PEP replicates the WTP leaching processes using prototypic equipment and control strategies. The PEPmore » also includes non-prototypic ancillary equipment to support the core processing. Two operating scenarios are currently being evaluated for the ultrafiltration process (UFP) and leaching operations. The first scenario has caustic leaching performed in the UFP-2 ultrafiltration feed vessels (i.e., vessel UFP-VSL-T02A in the PEP; and vessels UFP-VSL-00002A and B in the WTP PTF). The second scenario has caustic leaching conducted in the UFP-1 ultrafiltration feed preparation vessels (i.e., vessels UFP-VSL-T01A and B in the PEP; vessels UFP-VSL-00001A and B in the WTP PTF). In both scenarios, 19-M sodium hydroxide solution (NaOH, caustic) is added to the waste slurry in the vessels to leach solid aluminum compounds (e.g., gibbsite, boehmite). Caustic addition is followed by a heating step that uses direct injection of steam to accelerate the leach process. Following the caustic leach, the vessel contents are cooled using vessel cooling jackets and/or external heat exchangers. The main difference between the two scenarios is that for leaching in UFP-1, the 19-M NaOH is added to un-concentrated waste slurry (3-8 wt% solids), while for leaching in UFP-2, the slurry is concentrated to nominally 20 wt% solids using cross-flow ultrafiltration before the addition of caustic. In both scenarios, following the caustic leach, the slurry was then concentrated to 17 wt% and washed with inhibited water to remove NaOH and other soluble salts. Next, the slurry was oxidatively leached using sodium permanganate to solubilize chrome. The slurry was then washed to remove the dissolved chrome and concentrated.« less

Waterborne outbreak of cryptosporidiosis in the South East of Ireland: weighing up the evidence.

PubMed

Mahon, M; Doyle, S

2017-11-01

In late Spring 2012, 12 cases of cryptosporidiosis in a town in the South East of Ireland were notified to the regional Department of Public Health. The purpose of this paper is to describe the outbreak and the investigative process which led to the conclusion that the source was a public drinking water supply. Outbreak and incident control teams were convened to investigate and control the outbreak. Eleven cases were speciated as Cryptosporidium parvum. GP60 analysis demonstrated that 10 were C. parvum IIaA20G3R1, indicating that the cases were linked. The public water supply was the only common risk factor identified. Increased water sampling identified Cryptosporidium muris/andersoni in the treated water at one of two water treatment plants (Water Treatment Plant, WTP A) for the supply, and on the network. C. parvum was subsequently identified in raw water from WTP A. The Health Service Executive (HSE) concluded that this outbreak was "probably associated with water" produced at WTP A based on (1) descriptive epidemiological evidence suggesting water-related illness and excluding other obvious explanations; and (2) water treatment failure at WTP A. WTP A was closed to facilitate an upgrade. No boil water notice was required as a supplementary supply was available. The upgrade was completed and the incident closed in 2013.

TECHNETIUM RETENTION IN WTP LAW GLASS WITH RECYCLE FLOW-SHEET DM10 MELTER TESTING VSL-12R2640-1 REV 0

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

Abramowitz, Howard; Brandys, Marek; Cecil, Richard

2012-12-11

Melter tests were conducted to determine the retention of technetium and other volatiles in glass while processing simulated Low Activity Waste (LAW) streams through a DM10 melter equipped with a prototypical off-gas system that concentrates and recycles fluid effiuents back to the melter feed. To support these tests, an existing DM10 system installed at Vitreous State Laboratory (VSL) was modified to add the required recycle loop. Based on the Hanford Tank Waste Treatment and Immobilization Plant (WTP) LAW off-gas system design, suitably scaled versions of the Submerged Bed Scrubber (SBS), Wet Electrostatic Precipitator (WESP), and TLP vacuum evaporator were designed,more » built, and installed into the DM10 system. Process modeling was used to support this design effort and to ensure that issues associated with the short half life of the {sup 99m}Tc radioisotope that was used in this work were properly addressed and that the system would be capable of meeting the test objectives. In particular, this required that the overall time constant for the system was sufficiently short that a reasonable approach to steady state could be achieved before the {sup 99m}Tc activity dropped below the analytical limits of detection. The conceptual design, detailed design, flow sheet development, process model development, Piping and Instrumentation Diagram (P&ID) development, control system design, software design and development, system fabrication, installation, procedure development, operator training, and Test Plan development for the new system were all conducted during this project. The new system was commissioned and subjected to a series of shake-down tests before embarking on the planned test program. Various system performance issues that arose during testing were addressed through a series of modifications in order to improve the performance and reliability of the system. The resulting system provided a robust and reliable platform to address the test objectives.« less

Measuring the willingness to pay user fees for interpretive services at a national forest

NASA Astrophysics Data System (ADS)

Goldhor-Wilcock, Barbara Ashley

An understanding of willingness to pay (WTP) for nonmarket environmental goods is useful for planning and policy, but difficult to determine. WTP for interpretive services was investigated using interviews with 361 participants in guided nature tours. Immediately after the tour, participants were asked to state their WIT for the tour. Responses were predominantly 5 (42%), 2 (14%) and 10 (13%). A predetermined amount was added to the open-ended (OE) WTP offer and respondents were asked if they were willing to pay a larger amount. Acceptance of the larger amount depended strongly on the relative increase over the initial WTP. If the increase was smaller than the initial offer, most respondents agreed, whereas if the increment was larger, most did not agree, suggesting that the initial offer was approximately half of the true WTP. The two WTP questions were used to define lower and upper bounds for each respondent's true WTP. A censored interval regression was used to estimate a WTP distribution with mean 11.30 and median $10.00. The median is twice that of the OE WTP, further suggesting that the OE response understated value by 50 percent. The estimated true WTP distribution and the OE WTP distribution have a weak, but statistically significant, dependence on some demographic, travel, and benefit variables, although these relations have negligible practical significance over the observed range of the variables. To evaluate whether the WTP amounts were based on a true economic tradeoff, respondents were asked to explain their WTP responses. For the initial OE question, 38% gave explanations that could be interpreted as an economic tradeoff, whereas 33% gave reasons that were clearly irrelevant. For the second, dichotomous choice (DC), question, 59% gave reasons suggesting a relevant economic judgement. A DC question may provoke apparently relevant answers, regardless of the underlying reasoning (a majority simply said "it was (not) worth it"). The DC reasoning may also be influenced by the preceding OE question, which provides a comparative base. Combining OE and DC questions in a single survey may encourage relevant reasoning, while also helping to identify the true WTP and consumer surplus.

Assessing Medicare beneficiaries' willingness-to-pay for medication therapy management services.

PubMed

Woelfel, Joseph A; Carr-Lopez, Sian M; Delos Santos, Melanie; Bui, Ann; Patel, Rajul A; Walberg, Mark P; Galal, Suzanne M

2014-02-01

To assess Medicare beneficiaries' willingness-to-pay (WTP) for medication therapy management (MTM) services and determine sociodemographic and clinical characteristics influencing this payment amount. A cross-sectional, descriptive study design was adopted to elicit Medicare beneficiaries' WTP for MTM. Nine outreach events in cities across Central/Northern California during Medicare's 2011 open-enrollment period. A total of 277 Medicare beneficiaries participated in the study. Comprehensive MTM was offered to each beneficiary. Pharmacy students conducted the MTM session under the supervision of licensed pharmacists. At the end of each MTM session, beneficiaries were asked to indicate their WTP for the service. Medication, self-reported chronic conditions, and beneficiary demographic data were collected and recorded via a survey during the session. The mean WTP for MTM was $33.15 for the 277 beneficiaries receiving the service and answering the WTP question. WTP by low-income subsidy recipients (mean ± standard deviation; $12.80 ± $24.10) was significantly lower than for nonsubsidy recipients ($41.13 ± $88.79). WTP was significantly (positively) correlated with number of medications regularly taken and annual out-of-pocket drug costs. The mean WTP for MTM was $33.15. WTP for MTM significantly varied by race, subsidy status, and number of prescription medications taken. WTP was significantly higher for nonsubsidy recipients than subsidy recipients, and significantly positively correlated with the number of medications regularly taken and the beneficiary rating of the delivered services.

Willingness to pay for health care services in common cold, retinal detachment, and myocardiac infarction: an internet survey in Japan.

PubMed

Yasunaga, Hideo; Ide, Hiroo; Imamura, Tomoaki; Ohe, Kazuhiko

2006-02-20

The application of Willingness To Pay (WTP) measurement with Contingent Valuation Method (CVM) to medical services is gradually increasing. Knowing what influences WTP is an important matter because validity of CVM in medical services remains controversial. The objective of this survey is to measure WTP for the treatment of typical acute illnesses and to analyze the factors affecting WTP. A questionnaire survey was conducted over the Internet, in which 795 men and women between 40 and 59 years old responded to questions about WTP for medical expenses in three hypothetical scenarios: common cold (CC), retinal detachment (RD) and myocardiac infarction (MI). Mean WTP was $29.9 for CC, $2,233 for RD, and $8,976 for MI. WTP for RD and MI was lower in the low-income group. While WTP for CC did not vary with income, WTP was higher in groups whose current subjective fitness levels were low. Although WTP measurements are criticized frequently for their validity and reliability, they are still useful for determining the economic value of medical services. Based on the results of this study, it is deemed necessary to enhance safety nets for low-income earners in regards to serious illnesses that incur high medical expenses. Further, it is recommended that the rate of co-payments be set relatively high with respect to mild illnesses for which alternative services are available.

Ex post and ex ante willingness to pay (WTP) for the ICT Malaria Pf/Pv test kit in Myanmar.

PubMed

Cho-Min-Naing; Lertmaharit, S; Kamol-Ratanakul, P; Saul, A J

2000-03-01

Willingness to pay (WTP) for the ICT Malaria Pf/Pv test kit was assessed by the contingent valuation method using a bidding game approach in two villages in Myanmar. Kankone (KK) village has a rural health center (RHC) and Yae-Aye-Sann (YAS) is serviced by community health worker (CHW). The objectives were to assess WTP for the ICT Malaria Pf/Pv test kit and to determine factors affecting the WTP. In both villages WTP was assessed in two different conditions, ex post and ex ante. The ex post WTP was assessed at an RHC in the KK village and at the residence of a CHW in the YAS village on patients immediately following diagnosis of malaria. The ex ante WTP was assessed by household interviews in both villages on people with a prior history of malaria. Ordinary least squares (OLS) multiple regression analysis was used to analyze factors affecting WTP. The WTP was higher in ex post conditions than ex ante in both villages. WTP was significantly positively associated with the average monthly income of the respondents and severity of illness in both ex post and ex ante conditions (p < 0.001). Distance between the residence of the respondents and the health center was significantly positively associated (p < 0.05) in the ex ante condition in a household survey of YAS village. Traveling time to RHC had a negative relationship with WTP (p < 0.05) in the ex post condition in the RHC survey in KK village.

Standard High Solids Vessel Design De-inventory Simulant Qualification

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

Fiskum, Sandra K.; Burns, Carolyn A.M.; Gauglitz, Phillip A.

The Hanford Tank Waste Treatment and Immobilization Plant (WTP) is working to develop a Standard High Solids Vessel Design (SHSVD) process vessel. To support testing of this new design, WTP engineering staff requested that a Newtonian simulant be developed that would represent the de-inventory (residual high-density tank solids cleanout) process. Its basis and target characteristics are defined in 24590-WTP-ES-ENG-16-021 and implemented through PNNL Test Plan TP-WTPSP-132 Rev. 1.0. This document describes the de-inventory Newtonian carrier fluid (DNCF) simulant composition that will satisfy the basis requirement to mimic the density (1.18 g/mL ± 0.1 g/mL) and viscosity (2.8 cP ± 0.5more » cP) of 5 M NaOH at 25 °C.1 The simulant viscosity changes significantly with temperature. Therefore, various solution compositions may be required, dependent on the test stand process temperature range, to meet these requirements. Table ES.1 provides DNCF compositions at selected temperatures that will meet the density and viscosity specifications as well as the temperature range at which the solution will meet the acceptable viscosity tolerance.« less

A systematic review and meta-analysis of willingness-to-pay values: the case of malaria control interventions.

PubMed

Trapero-Bertran, M; Mistry, H; Shen, J; Fox-Rushby, J

2013-04-01

The increasing use of willingness to pay (WTP) to value the benefits of malaria control interventions offers a unique opportunity to explore the possibility of estimating a transferable indicator of mean WTP as well as studying differences across studies. As regression estimates from individual WTP studies are often assumed to transfer across populations it also provides an opportunity to question this practice. Using a qualitative review and meta analytic methods, this article determines what has been studied and how, provides a summary mean WTP by type of intervention, considers how and why WTP estimates vary and advises on future reporting of WTP studies. WTP has been elicited mostly for insecticide-treated nets, followed by drugs for treatment. Mean WTP, including zeros, is US$2.79 for insecticide-treated nets, US$6.65 for treatment and US$2.60 for other preventive services. Controlling for a limited number of sample and design effects, results can be transferred to different countries using the value function. The main concerns are the need to account for a broader range of explanators that are study specific and the ability to transfer results into malaria contexts beyond those represented by the data. Future studies need to improve the reporting of WTP. Copyright © 2012 John Wiley & Sons, Ltd.

Willingness to pay in dermatology: assessment of the burden of skin diseases.

PubMed

Seidler, Anne M; Bayoumi, Ahmed M; Goldstein, Mary K; Cruz, Ponciano D; Chen, Suephy C

2012-07-01

Willingness to pay (WTP) is a monetary, preference-based, burden-of-disease measure with a potential role in dermatology, where many conditions are temporary and/or mild, and many treatments are inexpensive and one might be able to imagine paying out of pocket. We assessed construct validity by interviewing 254 consecutive dermatology patients at Stanford Medical Center, Grady Hospital, and Parkland Hospital. Instruments asked about an individual's own health status and elicited WTP, time-trade-off (TTO) utilities, and health status quality of life (QOL). We measured WTP cure (short treatment course to eliminate disease) and WTP control (lifelong medication). Our data indicate greater construct validity in non-Medicaid (n=163) than Medicaid (n=91) patients. Non-Medicaid subjects had greater WTP as percent of income for cure (median: 2%) than control (median: 1.6%), P<0.01; Medicaid WTP amounts for control and cure did not differ. Non-Medicaid subjects with verrucae had little QOL impact, no measurable burden by TTO, and a correspondingly low WTP. Medicaid subjects with basal cell carcinoma had a strong, negative QOL impact and high burden by TTO, but had relatively moderate WTP. WTP appears promising in certain income categories. More studies are needed for conclusions about specific diagnoses.

Sensitivity to scale of willingness-to-pay within the context of menorrhagia.

PubMed

Sanghera, Sabina; Frew, Emma; Gupta, Janesh Kumar; Kai, Joe; Roberts, Tracy Elizabeth

2017-04-01

Willingness-to-pay (WTP) provides a broad assessment of well-being, capturing benefits beyond health. However, the validity of the approach has been questioned and the evidence relating to the sensitivity of WTP to changes in health status is mixed. Using menorrhagia (heavy menstrual bleeding) as a case study, this exploratory study assesses the sensitivity to scale of WTP to change in health status as measured by a condition-specific measure, MMAS, which includes both health and non-health benefits. The relationship between EQ-5D and change in health status is also assessed. Baseline EQ-5D and MMAS values were collected from women taking part in a randomized controlled trial for pharmaceutical treatment of menorrhagia. Following treatment, these measures were administered along with a WTP exercise. The relationship between the measures was assessed using Spearman's correlation analysis, and the sensitivity to scale of WTP was measured by identifying differences in WTP alongside differences in MMAS and EQ5D values. Our exploratory findings indicated that WTP, and not EQ-5D, was significantly positively correlated with change in MMAS, providing some evidence for convergent validity. These findings suggest that WTP is capturing the non-health benefits within the MMAS measure. Mean WTP also increased with percentage improvements in MMAS, suggesting sensitivity to scale. When compared to quality of life measured using the condition-specific MMAS measure, the convergent validity and sensitivity to scale of WTP is indicated. The findings suggest that WTP is more sensitive to change in MMAS, than with EQ-5D. © 2016 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Willingness to pay for public health services in rural Central Java, Indonesia: methodological considerations when using the contingent valuation method.

PubMed

Shono, Aiko; Kondo, Masahide; Ohmae, Hiroshi; Okubo, Ichiro

2014-06-01

In the health sectors of low- and middle-income countries, contingent valuation method (CVM) studies on willingness to pay (WTP) have been used to gather information on demand variation or financial perspectives alongside price setting, such as the introduction of user fees and valuation of quality improvements. However, WTP found in most CVM studies have only explored the preferences that consumers express through their WTP without exploring whether they are actually able to pay for it. Therefore, this study examines the issues pertaining to WTP estimation for health services using the conventional CVM. We conducted 202 household interviews in 2008, in which we asked respondents about three types of public health services in Indonesia and assessed WTP estimated by the conventional CVM as well as in the scenario of "resorting to debt" to recognize their budget constraints. We find that all the demand curves for both WTP scenarios show gaps. Furthermore, the gap for midwife services is negatively affected by household income and is larger for the poor. These results prove that CVM studies on WTP do not always reveal WTP in the latter scenario. Those findings suggest that WTP elicited by the conventional CVM is different to that from the maximum price that prevents respondents from resorting to debt as their WTP. In order to bridge this gap in the body of knowledge on this topic, studies should improve the scenarios that CVM analyses use to explore WTP. Furthermore, because valuing or pricing health services based on the results of CVM studies on WTP alone can exacerbate the inequity of access to these services, information provided by such studies requires careful interpretation when used for this purpose, especially for the poor and vulnerable sections of society. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effect of information about animal welfare on consumer willingness to pay for yogurt.

PubMed

Napolitano, F; Pacelli, C; Girolami, A; Braghieri, A

2008-03-01

This study aimed to verify whether consumers confirm their willingness to pay extra costs for higher animal welfare standards in a situation where a potential purchase performed by consumers, such as the Vickrey auction, is used. A 104-member consumer panel was asked to rate its willingness to pay (WTP) for plain and low-fat yogurts in 3 information conditions: tasting without information (blind WTP), information about animal welfare without tasting (expected WTP), tasting with information about animal welfare (actual WTP). Information was provided to the consumers under the form of labels indicating the level of animal cleanliness and freedom of movement (5-point scale, from poor to very good). Consumers were influenced by information about low standards of animal welfare (low cleanliness and low freedom of movement) and moved their willingness to pay in the direction of their expectations. However, the discrepancy between expectancy and actual WTP was not totally assimilated, indicating that WTP was also expressed in relation to other aspects (e.g., the sensory properties of the products). Conversely, the information concerning high standards of animal welfare (high cleanliness and high freedom of movement) was able to affect expectancy but had an effect on actual WTP only when the most acceptable yogurt was offered to the consumers. In the case of discordant information on animal welfare, partly indicating high levels of welfare (freedom of movements) and low levels of welfare (cleanliness), expected WTP was always lower than blind WTP. However, when the least acceptable product was presented, they completely assimilated their actual WTP to the expectations. Conversely, with the most acceptable yogurt, no assimilation occurred and sensory properties prevailed in orienting consumer WTP. Within each product, consumers expressed a higher WTP for products with labels indicating high welfare standards as compared with yogurts with labels reporting intermediate and low welfare standard. These results show that information about animal welfare, if given to the consumers, can be a major determinant of consumer WTP for animal-based food products. However, information about high standards of animal welfare should be paired with products presenting a good eating quality.

HLW Melter Control Strategy Without Visual Feedback VSL-12R2500-1 Rev 0

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

Kruger, A A.; Joseph, Innocent; Matlack, Keith S.

2012-11-13

Plans for the treatment of high level waste (HL W) at the Hanford Tank Waste Treatment and Immobilization Plant (WTP) are based upon the inventory of the tank wastes, the anticipated performance of the pretreatment processes, and current understanding of the capability of the borosilicate glass waste form [I]. The WTP HLW melter design, unlike earlier DOE melter designs, incorporates an active glass bubbler system. The bubblers create active glass pool convection and thereby improve heat and mass transfer and increase glass melting rates. The WTP HLW melter has a glass surface area of 3.75 m{sup 2} and depth ofmore » ~ 1.1 m. The two melters in the HLW facility together are designed to produce up to 7.5 MT of glass per day at 100% availability. Further increases in HL W waste processing rates can potentially be achieved by increasing the melter operating temperature above 1150°C and by increasing the waste loading in the glass product. Increasing the waste loading also has the added benefit of decreasing the number of canisters for storage.« less

Importance of calcium and magnesium in water - water hardening

NASA Astrophysics Data System (ADS)

Barloková, D.; Ilavský, J.; Kapusta, O.; Šimko, V.

2017-10-01

Basic information about importance of calcium and magnesium in water, about their properties, effect to human health, problems what can cause under the lower (< 1 mmol/L) and higher (> 5 mmol/L) concentrations in water supply distribution systems, the most commonly used methods of water hardening are presented. The article contains the water hardening results carried out during the pilot plant experiments in WTP Hriňová and WTP Turček. For water hardening, treated water at the end of the process line, i.e., after coagulation, sedimentation and filtration, saturated with CO2 and filtrated through half-burnt dolomite material (PVD) was used. The results show that the filtration rate is 17.1 m/h in the case of WTP Hriňová and 15.2 m/h in the case of WTP Turček to achieve the recommended concentration of Ca and Mg in the treated water after the addition of CO2 and filtration through PVD. The longer the water contact time with PVD (depending on the CO2 content), the more water is enriched with magnesium, but the calcium concentration has not so much increased.

Evaluation of the willingness-to-pay for cancer treatment in Korean metastatic breast cancer patients: a multicenter, cross-sectional study.

PubMed

Oh, Do-Youn; Crawford, Bruce; Kim, Sung-Bae; Chung, Hyun-Cheol; McDonald, Jeffrey; Lee, Sang Yoon; Ko, Su-Kyoung; Ro, Jungsil

2012-09-01

To evaluate the inherent value of breast cancer therapy a willingness-to-pay (WTP) study was conducted in Korean patients with metastatic breast cancer. Patients were prospectively enrolled from four study centers and completed quality of life questionnaires to reflect their status pre-cancer and their current health status. Clinical and socioeconomic data were collected to characterize the population and utilize during modeling. Patients' WTP for breast cancer treatment was assessed using an open-ended question following three rounds of bidding to better hone in on their maximal WTP, starting with one of three randomly assigned start bids. Predictors of patient WTP was evaluated using linear regression models. Associations between WTP and other parameters were evaluated with correlations. Korean metastatic breast cancer patients were WTP an average of KRW 8 696 329 (US$7555) per month to return to their pre-cancer health state, with those who were recently diagnosed as WTP the most (KRW 12 955 000 [$11 254]). WTP was closely associated with the patient's education level, income, personal financial difficulties, Eastern Cooperative Oncology Group performance status, and their experience of arm symptoms. The results suggest that patients are WTP significant amounts per month for treatment. Breast cancer patients are heavily burdened physically, mentally and financially, and the present study indicated this significant financial burden by disclosing its relationship with WTP. Providing a better understanding of the inherent value of treatment will allow Koreans to better evaluate treatment in the coming era of personalized medicine. © 2012 Wiley Publishing Asia Pty Ltd.

Economic analysis of the intangible impacts of informal care for people with Alzheimer's disease and other mental disorders.

PubMed

Gervès, Chloé; Bellanger, Martine Marie; Ankri, Joël

2013-01-01

Valuation of the intangible impacts of informal care remains a great challenge for economic evaluation, especially in the framework of care recipients with cognitive impairment. Our main objective was to explore the influence of intangible impacts of caring on both informal caregivers' ability to estimate their willingness to pay (WTP) to be replaced and their WTP value. We mapped characteristics that influence ability or inability to estimate WTP by using a multiple correspondence analysis. We ran a bivariate probit model with sample selection to further analyze the caregivers' WTP value conditional on their ability to estimate their WTP. A distinction exists between the opportunity costs of the caring dimension and those of the intangible costs and benefits of caring. Informal caregivers' ability to estimate WTP is negatively influenced by both intangible benefits from caring (P < 0.001) and negative intangible impacts of caring (P < 0.05). Caregivers' WTP value is negatively associated with positive intangible impacts of informal care (P < 0.01). Informal caregivers' WTP and their ability to estimate WTP are both influenced by intangible burden and benefit of caring. These results call into question the relevance of a hypothetical generalized financial compensation system as the optimal way to motivate caregivers to continue providing care. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Are children rational decision makers when they are asked to value their own health? A contingent valuation study conducted with children and their parents.

PubMed

Guerriero, Carla; Cairns, John; Bianchi, Fabrizio; Cori, Liliana

2018-02-01

Despite the importance of including children's preferences in the valuation of their own health benefits, no study has investigated the ability of children to understand willingness-to-pay (WTP) questions. Using a contingent valuation method, we elicit children's and parents' WTP to reduce children's risk of an asthma attack. Our results suggest that children are able to understand and value their own health risk reductions, and their ability to do so improves with age. Child age was found to be inversely related to parents' and children's WTP. The results also suggest that non-paternalistic altruism is predictive of children's WTP. For parents, care for their own health was found to be inversely related with their WTP for children's risk reductions. Comparison of parents' and children's WTP suggests that parents are willing to sacrifice for their child's health risk reduction an amount that is approximately twice that of their children. The analysis of matched pairs of parents and children suggest that there are within-household similarities as the child's WTP is positively related to parents' WTP. Copyright © 2017 John Wiley & Sons, Ltd.

Valuing a Lifestyle Intervention for Middle Eastern Immigrants at Risk of Diabetes.

PubMed

Saha, Sanjib; Gerdtham, Ulf-G; Siddiqui, Faiza; Bennet, Louise

2018-02-27

Willingness-to-pay (WTP) techniques are increasingly being used in the healthcare sector for assessing the value of interventions. The objective of this study was to estimate WTP and its predictors in a randomized controlled trial of a lifestyle intervention exclusively targeting Middle Eastern immigrants living in Malmö, Sweden, who are at high risk of type 2 diabetes. We used the contingent valuation method to evaluate WTP. The questionnaire was designed following the payment-scale approach, and administered at the end of the trial, giving an ex-post perspective. We performed logistic regression and linear regression techniques to identify the factors associated with zero WTP value and positive WTP values. The intervention group had significantly higher average WTP than the control group (216 SEK vs. 127 SEK; p = 0.035; 1 U.S.$ = 8.52 SEK, 2015 price year) per month. The regression models demonstrated that being in the intervention group, acculturation, and self-employment were significant factors associated with positive WTP values. Male participants and lower-educated participants had a significantly higher likelihood of zero WTP. In this era of increased migration, our findings can help policy makers to take informed decisions to implement lifestyle interventions for immigrant populations.

Valuing a Lifestyle Intervention for Middle Eastern Immigrants at Risk of Diabetes

PubMed Central

Siddiqui, Faiza

2018-01-01

Willingness-to-pay (WTP) techniques are increasingly being used in the healthcare sector for assessing the value of interventions. The objective of this study was to estimate WTP and its predictors in a randomized controlled trial of a lifestyle intervention exclusively targeting Middle Eastern immigrants living in Malmö, Sweden, who are at high risk of type 2 diabetes. We used the contingent valuation method to evaluate WTP. The questionnaire was designed following the payment-scale approach, and administered at the end of the trial, giving an ex-post perspective. We performed logistic regression and linear regression techniques to identify the factors associated with zero WTP value and positive WTP values. The intervention group had significantly higher average WTP than the control group (216 SEK vs. 127 SEK; p = 0.035; 1 U.S.$ = 8.52 SEK, 2015 price year) per month. The regression models demonstrated that being in the intervention group, acculturation, and self-employment were significant factors associated with positive WTP values. Male participants and lower-educated participants had a significantly higher likelihood of zero WTP. In this era of increased migration, our findings can help policy makers to take informed decisions to implement lifestyle interventions for immigrant populations. PMID:29495529

Testing the limits of temporal stability: Willingness to pay values among Grand Canyon whitewater boaters across decades

USGS Publications Warehouse

Neher, Chris J.; Duffield, John; Bair, Lucas S.; Patterson, David A.; Neher, Katherine

2017-01-01

We directly compare trip willingness to pay (WTP) values between 1985 and 2015 stated preference surveys of private party Grand Canyon boaters using identically designed valuation methods. The temporal gap of 30 years between these two studies is well beyond that of any tests of WTP temporal stability in the literature. Comparisons were made of mean WTP estimates for four hypothetical Colorado River flow level scenarios. WTP values from the 1985 survey were adjusted to 2015 levels using the consumer price index. Mean WTP precision was estimated through simulation. No statistically significant differences were detected between the adjusted Bishop et al. (1987) and the current study mean WTP estimates. Examination of pooled models of the data from the studies suggest that while the estimated WTP values are stable over time, the underlying valuation functions may not be, particularly when the data and models are corrected to account for differing bid structures and possible panel effects.

Testing the Limits of Temporal Stability: Willingness to Pay Values among Grand Canyon Whitewater Boaters Across Decades

NASA Astrophysics Data System (ADS)

Neher, Chris; Duffield, John; Bair, Lucas; Patterson, David; Neher, Katherine

2017-12-01

We directly compare trip willingness to pay (WTP) values between 1985 and 2015 stated preference surveys of private party Grand Canyon boaters using identically designed valuation methods. The temporal gap of 30 years between these two studies is well beyond that of any tests of WTP temporal stability in the literature. Comparisons were made of mean WTP estimates for four hypothetical Colorado River flow level scenarios. WTP values from the 1985 survey were adjusted to 2015 levels using the consumer price index. Mean WTP precision was estimated through simulation. No statistically significant differences were detected between the adjusted Bishop et al. (1987) and the current study mean WTP estimates. Examination of pooled models of the data from the studies suggest that while the estimated WTP values are stable over time, the underlying valuation functions may not be, particularly when the data and models are corrected to account for differing bid structures and possible panel effects.

Adapting water treatment design and operations to the impacts of global climate change

NASA Astrophysics Data System (ADS)

Clark, Robert M.; Li, Zhiwei; Buchberger, Steven G.

2011-12-01

It is anticipated that global climate change will adversely impact source water quality in many areas of the United States and will therefore, potentially, impact the design and operation of current and future water treatment systems. The USEPA has initiated an effort called the Water Resources Adaptation Program (WRAP) which is intended to develop tools and techniques that can assess the impact of global climate change on urban drinking water and wastewater infrastructure. A three step approach for assessing climate change impacts on water treatment operation and design is being persude in this effort. The first step is the stochastic characterization of source water quality, the second step is the application of the USEPA Water Treatment Plant model and the third step is the application of cost algorithms to provide a metric that can be used to assess the coat impact of climate change. A model has been validated using data collected from Cincinnati's Richard Miller Water Treatment Plant for the USEPA Information Collection Rule (ICR) database. An analysis of the water treatment processes in response to assumed perturbations in raw water quality identified TOC, pH, and bromide as the three most important parameters affecting performance of the Miller WTP. The Miller Plant was simulated using the EPA WTP model to examine the impact of these parameters on selected regulated water quality parameters. Uncertainty in influent water quality was analyzed to estimate the risk of violating drinking water maximum contaminant levels (MCLs).Water quality changes in the Ohio River were projected for 2050 using Monte Carlo simulation and the WTP model was used to evaluate the effects of water quality changes on design and operation. Results indicate that the existing Miller WTP might not meet Safe Drinking Water Act MCL requirements for certain extreme future conditions. However, it was found that the risk of MCL violations under future conditions could be controlled by enhancing existing WTP design and operation or by process retrofitting and modification.

SECONDARY WASTE MANAGEMENT FOR HANFORD EARLY LOW ACTIVITY WASTE VITRIFICATION

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

UNTERREINER BJ

2008-07-18

More than 200 million liters (53 million gallons) of highly radioactive and hazardous waste is stored at the U.S. Department of Energy's Hanford Site in southeastern Washington State. The DOE's Hanford Site River Protection Project (RPP) mission includes tank waste retrieval, waste treatment, waste disposal, and tank farms closure activities. This mission will largely be accomplished by the construction and operation of three large treatment facilities at the Waste Treatment and Immobilization Plant (WTP): (1) a Pretreatment (PT) facility intended to separate the tank waste into High Level Waste (HLW) and Low Activity Waste (LAW); (2) a HLW vitrification facilitymore » intended to immobilize the HLW for disposal at a geologic repository in Yucca Mountain; and (3) a LAW vitrification facility intended to immobilize the LAW for shallow land burial at Hanford's Integrated Disposal Facility (IDF). The LAW facility is on target to be completed in 2014, five years prior to the completion of the rest of the WTP. In order to gain experience in the operation of the LAW vitrification facility, accelerate retrieval from single-shell tank (SST) farms, and hasten the completion of the LAW immobilization, it has been proposed to begin treatment of the low-activity waste five years before the conclusion of the WTP's construction. A challenge with this strategy is that the stream containing the LAW vitrification facility off-gas treatment condensates will not have the option of recycling back to pretreatment, and will instead be treated by the Hanford Effluent Treatment Facility (ETF). Here the off-gas condensates will be immobilized into a secondary waste form; ETF solid waste.« less

Increased Levels of Multiresistant Bacteria and Resistance Genes after Wastewater Treatment and Their Dissemination into Lake Geneva, Switzerland

PubMed Central

Czekalski, Nadine; Berthold, Tom; Caucci, Serena; Egli, Andrea; Bürgmann, Helmut

2012-01-01

At present, very little is known about the fate and persistence of multiresistant bacteria (MRB) and their resistance genes in natural aquatic environments. Treated, but partly also untreated sewage of the city of Lausanne, Switzerland is discharged into Vidy Bay (Lake Geneva) resulting in high levels of contamination in this part of the lake. In the present work we have studied the prevalence of MRB and resistance genes in the wastewater stream of Lausanne. Samples from hospital and municipal raw sewage, treated effluent from Lausanne’s wastewater treatment plant (WTP) as well as lake water and sediment samples obtained close to the WTP outlet pipe and a remote site close to a drinking water pump were evaluated for the prevalence of MRB. Selected isolates were identified (16S rRNA gene fragment sequencing) and characterized with regards to further resistances, resistance genes, and plasmids. Mostly, studies investigating this issue have relied on cultivation-based approaches. However, the limitations of these tools are well known, in particular for environmental microbial communities, and cultivation-independent molecular tools should be applied in parallel in order to take non-culturable organisms into account. Here we directly quantified the sulfonamide resistance genes sul1 and sul2 from environmental DNA extracts using TaqMan real-time quantitative PCR. Hospital sewage contained the highest load of MRB and antibiotic resistance genes (ARGs). Wastewater treatment reduced the total bacterial load up to 78% but evidence for selection of extremely multiresistant strains and accumulation of resistance genes was observed. Our data clearly indicated pollution of sediments with ARGs in the vicinity of the WTP outlet. The potential of lakes as reservoirs of MRB and potential risks are discussed. PMID:22461783

What explains willingness to pay for smoking-cessation treatments - addiction level, quit-rate effectiveness or the opening bid?

PubMed

Olsen, Jan Abel; Røgeberg, Ole J; Stavem, Knut

2012-11-01

Several countries have now passed laws that place limitations on where smokers may smoke. A range of smoking-cessation treatments have become available, many of which have documented increased quit rates. Population surveys show that most smokers wish to quit, and most non-smokers would prefer to reduce the prevalence of smoking in society. The strengths of these preferences, however, as measured by their willingness to pay (WTP), have not yet been investigated. This study aims to identify variables that explain variations in people's answers to WTP questions on smoking-cessation treatments. A representative sample of the Norwegian population was asked their WTP in terms of an earmarked contribution to a public smoking-cessation programme. A sub-group of daily smokers was, in addition, asked about their WTP for a hypothetical treatment that would remove their urge to smoke. The impact of variation in the question format (different opening bids) on stated WTP was compared with that of factors suggested by economic theory, such as quit-rate effectiveness, degree of addiction as measured by the 12-item Cigarette Dependence Scale (CDS-12), and degree of peer group influence as measured by the proportion of one's friends who smoke. In both programmes, the most important determinant for explaining variations in WTP was the size of the opening bid. Differences in quit-rate effectiveness did not matter for people's WTP for the smoking-cessation programme. Addiction, and having a small proportion of friends who smoke, were positively associated with smokers' WTP to quit smoking. Variations in WTP were influenced more by how the question was framed in terms of differences in opening bids, than by variables reflecting the quality (effectiveness) and need (addiction level) for the good in question. While the WTP method is theoretically attractive, the findings that outcomes in terms of different quit rates did not affect WTP, and that WTP answers can be manipulated by the chosen opening bid, should raise further doubts on the ability of this method to provide valid and reliable answers that reflect true preferences for health and healthcare.

Differences in willingness to pay for an extraction, a filling, and cleaning teeth at various levels of oral health-related quality of life, as measured by oral impacts on daily performance, among older adults in Singapore.

PubMed

Nair, Rahul; Yee, Robert

2016-12-01

To examine the differences in Willingness to pay (WTP) for an extraction, a filling, and cleaning of teeth among older adults with varying levels of Oral Health-related Quality of Life (OHQoL). OHQoL has been used extensively to measure utilities as reported by individuals of interest. Currently there are no reports that examine the WTP of individuals at various levels of OHQoL. A convenience sample of adults 60 years or older were recruited. Besides other domains, questionnaires were used to assess WTP (extraction, filling, and cleaning of teeth), OHQoL (using Oral Impacts on Daily Performance-OIDP), McArthur scale, and access to care. Tamil ethnicity was related to higher WTP for an extraction (mean ratio, 1.63-3.98; 95% Confidence Interval [CI]), increase of age in years was related to lower WTP for extraction (mean ratio, 0.96-1.00 [95%CI]) and increasing OIDP score was related to lower WTP for extractions (mean ratio, 0.80-0.99 [95%CI]). Tamil ethnicity was associated with higher WTP for fillings (mean ratio, 2.69-6.44 [95%CI]); higher age in years was associated with lower WTP for fillings (mean ratio, 0.94-0.99 [95%CI]), and higher OIDP scores was trending to be associated to lower WTP for filling (mean ratio, 0.80-1.00 [95%CI]). Tamil Ethnicity was also associated with higher WTP for cleaning (mean ratio, 2.14-7.19 [95%CI]), higher age in years was also associated with cleaning (mean ratio, 0.94-0.99 [95%CI]). Individuals with higher OIDP scores tended to have lower WTP for extraction, filling and cleaning; with significant differences reported for extraction. Copyright © 2016. Published by Elsevier B.V.

Eliciting the Monetary Value of a Quality-Adjusted Life Year in a Greek Outpatient Department in Times of Economic Austerity.

PubMed

Mavrodi, A; Aletras, V; Spanou, A; Niakas, D

2017-12-01

Contingent valuation is widely used to determine individuals' willingness to pay (WTP) for a health gain. Our study aimed to elicit an empirical estimate of the monetary value of a quality-adjusted life year (QALY) in a Greek outpatient setting in times of economic austerity and assess the impact of patients' characteristics on their valuations. We used a questionnaire as a survey tool to determine the maximum WTP for a health gain of a hypothetical therapy and to evaluate patients' health-related quality of life (EuroQoL-5D-3L) and demographic and socioeconomic characteristics. EuroQoL tariffs were used to estimate health utilities. Mean WTP values were computed and ordinary least squares regressions performed on transformed Box-Cox and logarithmic dependent WTP per QALY variables to remedy observed skewness problems. Analyses were performed for 167 patients with utility values less than unity. Mean WTP per QALY reported was similar for both payment vehicles examined: payments made out-of-pocket (€2629) and payments made through new tax imposition (€2407). Regression results showed that higher net monthly family income was associated with higher WTP per QALY for both payment vehicles. Moreover, the presence of a chronic condition and higher level of education were associated with higher out-of-pocket WTP per QALY and WTP per QALY through taxes, respectively. The very low WTP per QALY estimates could be explained by the recent severe economic depression and austerity in Greece. In fact, family income was found to be a significant predictor of WTP per QALY. Since these estimates deviate significantly from the cost-effectiveness thresholds still employed in economic evaluations in this country, research should be undertaken promptly to further examine this important issue using a nationwide representative sample of the general population along with WTP and other methodologies.

Willingness to pay for diagnostic technologies: a review of the contingent valuation literature.

PubMed

Lin, Pei-Jung; Cangelosi, Michael J; Lee, David W; Neumann, Peter J

2013-01-01

To understand how people value information from diagnostic technologies, we reviewed and analyzed published willingness-to-pay (WTP) studies on the topic. We searched PubMed for English-language articles related to WTP for diagnostic laboratory tests published from 1985 through 2011. We characterized methodological differences across studies, examined individual- and technology-level factors associated with WTP, and summarized median WTP values across different diagnostic tests. We identified 66 relevant WTP studies. Half focused on oncology, while others analyzed infectious diseases (n = 11, 16.1%) and obstetric or gynecological conditions (n = 8, 11.7%), among others. Most laboratory tests included in studies were biological samples/genetic testing (n = 44, 61.1%) or imaging tests (n = 23, 31.9%). Approximately one third of the analyses (n = 20, 30.3%) used discrete-choice questions to elicit WTP values. Higher income, education, disease severity, perceived disease risk, family history, and more accurate tests were in general associated with higher WTP values for diagnostic information. Of the 44 studies with median WTP values available, most reported a median WTP value below $100. The median WTP value for colon or colorectal cancer screening ranged from below $100 to over $1000. The contingent valuation literature in diagnostics has grown rapidly, and suggests that many respondents place considerable value on diagnostic information. There exists, however, great variation in studies with respect to the type of technologies and diseases assessed, respondent characteristics, and study methodology. The perceived value of diagnostic technologies is also influenced by the study design and elicitation methods. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Estimating the willingness to pay for a quality-adjusted life year in Thailand: does the context of health gain matter?

PubMed Central

Thavorncharoensap, Montarat; Teerawattananon, Yot; Natanant, Sirin; Kulpeng, Wantanee; Yothasamut, Jomkwan; Werayingyong, Pitsaphun

2013-01-01

Background This study aims to elicit the value of the willingness to pay (WTP) for a quality-adjusted life year (QALY) and to examine the factors associated with the WTP for a QALY (WTP/QALY) value under the Thai health care setting. Methods A community-based survey was conducted among 1191 randomly selected respondents. Each respondent was interviewed face-to-face to elicit his/her health state preference in each of three pairs of health conditions: (1) unilateral and bilateral blindness, (2) paraplegia and quadriplegia, and (3) mild and moderate allergies. A visual analog scale (VAS) and time trade off (TTO) were used as the eliciting methods. Subsequently, the respondents were asked about their WTP for the treatment and prevention of each pair of health conditions by using a bidding-game technique. Results With regards to treatment, the mean WTP for a QALY value (WTP/QALYtreatment) estimated by the TTO method ranged from 59,000 to 285,000 baht (16.49 baht = US$1 purchasing power parity [PPP]). In contrast, the mean WTP for a QALY value in terms of prevention (WTP/QALYprevention) was significantly lower, ranging from 26,000 to 137,000 baht. Gender, household income, and hypothetical scenarios were also significant factors associated with the WTP/QALY values. Conclusion The WTP/QALY values elicited in this study were approximately 0.4 to 2 times Thailand’s 2008 GDP per capita. These values were in line with previous studies conducted in several different settings. This study’s findings clearly support the opinion that a single ceiling threshold should not be used for the resource allocation of all types of interventions. PMID:23345984

Estimating the willingness to pay for a quality-adjusted life year in Thailand: does the context of health gain matter?

PubMed

Thavorncharoensap, Montarat; Teerawattananon, Yot; Natanant, Sirin; Kulpeng, Wantanee; Yothasamut, Jomkwan; Werayingyong, Pitsaphun

2013-01-01

This study aims to elicit the value of the willingness to pay (WTP) for a quality-adjusted life year (QALY) and to examine the factors associated with the WTP for a QALY (WTP/QALY) value under the Thai health care setting. A community-based survey was conducted among 1191 randomly selected respondents. Each respondent was interviewed face-to-face to elicit his/her health state preference in each of three pairs of health conditions: (1) unilateral and bilateral blindness, (2) paraplegia and quadriplegia, and (3) mild and moderate allergies. A visual analog scale (VAS) and time trade off (TTO) were used as the eliciting methods. Subsequently, the respondents were asked about their WTP for the treatment and prevention of each pair of health conditions by using a bidding-game technique. With regards to treatment, the mean WTP for a QALY value (WTP/QALY(treatment)) estimated by the TTO method ranged from 59,000 to 285,000 baht (16.49 baht = US$1 purchasing power parity [PPP]). In contrast, the mean WTP for a QALY value in terms of prevention (WTP/QALY(prevention)) was significantly lower, ranging from 26,000 to 137,000 baht. Gender, household income, and hypothetical scenarios were also significant factors associated with the WTP/QALY values. The WTP/QALY values elicited in this study were approximately 0.4 to 2 times Thailand's 2008 GDP per capita. These values were in line with previous studies conducted in several different settings. This study's findings clearly support the opinion that a single ceiling threshold should not be used for the resource allocation of all types of interventions.

Willingness to pay and quality of life in patients with rosacea.

PubMed

Beikert, F C; Langenbruch, A K; Radtke, M A; Augustin, M

2013-06-01

Rosacea is a chronic inflammatory dermatosis affecting >2% of the population. Willingness to pay (WTP) is a well established method which reflects the individual burden of disease. Evaluation of WTP and quality of life (QoL) in patients with rosacea. Nationwide postal survey on adult patients with rosacea affiliated with the German rosacea patient advocacy group. WTP was evaluated by three standardized items and compared to historical data on vitiligo (n = 1023). QoL was assessed using the Dermatology Life Quality Index (DLQI). Data from n = 475 rosacea patients (79.9% women, mean age 56.3, range 26-90) were analysed. On average, patients were willing to pay € 2880 (median € 500) for complete healing compared with € 7360 (median € 3000) in vitiligo. Relative WTP was higher in women; the highest sums were registered for the age group 21-30 years. The extent of facial involvement predicted a higher relative WTP, whereas WTP decreased with the duration of symptoms and age. Mean DLQI total score was 4.3 compared to 7.0 in vitiligo. In rosacea, the highest values were observed in patients <30 years. Severe QoL reductions (DLQI>10) were less frequent (11%) than in vitiligo (24.6%). The correlation between WTP and DLQI was significant (e.g. r = 0.249, P = 0.000 for relative WTP). Rosacea patients show a moderate WTP and average QoL reduction is mild. WTP proved to be a valid tool to assess patients' burden of disease. Patient education and the development of effective treatment options might still improve patients' satisfaction. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

The willingness of patients to pay for intravenous patient-controlled analgesia in Korea.

PubMed

Lim, Hyungsun; Lee, Duck-Hyoung; Lee, Jeongwoo; Han, Young Jin; Choe, Huhn; Son, Ji-Seon

2012-06-01

The use of intravenous patient-controlled analgesia (IV-PCA) has been increasing because it has advantages such as improved pain relief, greater patient satisfaction, and fewer postoperative complications. However, current research has not considered the patients' thoughts about IV-PCA's cost-effectiveness. The purpose of this study was to investigate the willingness to pay (WTP) for IV-PCA and the relationship between patients' characteristics and WTP in Korea. We enrolled 400 adult patients who were scheduled for elective surgery. The patient was requested to indicate a series of predefined amounts of money (Korean won; 30,000/50,000/100,000/150,000/200,000/300,000/500,000). We also recorded patient characteristics, such as age, sex, type of surgery, IV-PCA history, education level, the person responsible for medical expenses, type of insurance, net annual income, and residential area. Three days after surgery, we asked about the degree of satisfaction and the WTP for IV-PCA. For IV-PCA, the median WTP was 100,000 won (25-75%; 50,000-200,000 won: US$1 = W1078.04; July 19, 2011) before surgery. All patients' characteristics were not related to preoperative WTP for IV-PCA, whereas the increase in WTP after surgery showed a tendency correlated to higher IV-PCA satisfaction. The median WTP was 100,000 won. The satisfaction of IV-PCA increased patients' WTP after surgery, but the WTP may be independent of patient characteristics in Korea.

Valuing avoided morbidity using meta-regression analysis: what can health status measures and QALYs tell us about WTP?

PubMed

Van Houtven, George; Powers, John; Jessup, Amber; Yang, Jui-Chen

2006-08-01

Many economists argue that willingness-to-pay (WTP) measures are most appropriate for assessing the welfare effects of health changes. Nevertheless, the health evaluation literature is still dominated by studies estimating nonmonetary health status measures (HSMs), which are often used to assess changes in quality-adjusted life years (QALYs). Using meta-regression analysis, this paper combines results from both WTP and HSM studies applied to acute morbidity, and it tests whether a systematic relationship exists between HSM and WTP estimates. We analyze over 230 WTP estimates from 17 different studies and find evidence that QALY-based estimates of illness severity--as measured by the Quality of Well-Being (QWB) Scale--are significant factors in explaining variation in WTP, as are changes in the duration of illness and the average income and age of the study populations. In addition, we test and reject the assumption of a constant WTP per QALY gain. We also demonstrate how the estimated meta-regression equations can serve as benefit transfer functions for policy analysis. By specifying the change in duration and severity of the acute illness and the characteristics of the affected population, we apply the regression functions to predict average WTP per case avoided. Copyright 2006 John Wiley & Sons, Ltd.

CURRENT CONDITIONS AND RESIDENCE PREFERENCES OR CITIZENS' PERCEPTIONS ON NONCONVENTIONAL WATER RESOURCES

NASA Astrophysics Data System (ADS)

Tsuzuki, Yoshiaki; Aramaki, Toshiya

Preferences or perceptions of ordinary citizens on three kinds of nonconventional water resources including rainwater, permissible groundwater exuding to underground railway stations and tunnels and reclaimed wastewater were investigated by use of the Internet survey method. The survey results were analysed with analytical hierar chal process (AHP) and willingness to pay (WTP). Weight vectors of natural environment and people's lives were found larger than other three first order evaluation conditions, society, economics and technology. The order of the weight vector values for the three water resources were rainwater, reclaimed wastewater and permissible groundwater. That for the five water usages were agricultural and horticulture water, water storage in preparation for disaster, toilet flushing water, environment water and sprinkler water for washing road and cooling atmosphere temperature. The difference between toilet flushing water and environment water was not significant by 5% significance. The analyzed data showed that differences between the weight vector values of the alternatives (water resources and their usages) became small by increasing the number of the evaluation conditions, which would be a topic to be resolved for AHP application to actual public projects. For water resources, WTP with public budgets was Japanese Yen (JY) 53,100-55,100 person-1 year-1, and WTP with private finances was JY 19,100-20,800 person-1 year-1. For water usages, public WTP was JY 20,400-47,200 person-1 year-1 and private WTP was JY 8,400-16,000 person-1 year-1. The orders of WTP values were similar to the orders of the weight vector values for both water resources and their usages obtained by the AHP analysis. Effective dissemination subjects and objects of the nonconventional water resources and their usages were extracted by the analysis for attributes including sex, age, living area, occupation and education.

Effects of social sustainability signaling on neural valuation signals and taste-experience of food products

PubMed Central

Enax, Laura; Krapp, Vanessa; Piehl, Alexandra; Weber, Bernd

2015-01-01

Value-based decision making occurs when individuals choose between different alternatives and place a value on each alternative and its attributes. Marketing actions frequently manipulate product attributes, by adding, e.g., health claims on the packaging. A previous imaging study found that an emblem for organic products increased willingness to pay (WTP) and activity in the ventral striatum (VS). The current study investigated neural and behavioral processes underlying the influence of Fair Trade (FT) labeling on food valuation and choice. Sustainability is an important product attribute for many consumers, with FT signals being one way to highlight ethically sustainable production. Forty participants valuated products in combination with an FT emblem or no emblem and stated their WTP in a bidding task while in an MRI scanner. After that, participants tasted—objectively identical—chocolates, presented either as “FT” or as “conventionally produced”. In the fMRI task, WTP was significantly higher for FT products. FT labeling increased activity in regions important for reward-processing and salience, that is, in the VS, anterior and posterior cingulate, as well as superior frontal gyrus. Subjective value, that is, WTP was correlated with activity in the ventromedial prefrontal cortex (vmPFC). We find that the anterior cingulate, VS and superior frontal gyrus exhibit task-related increases in functional connectivity to the vmPFC when an FT product was evaluated. Effective connectivity analyses revealed a highly probable directed modulation of the vmPFC by those three regions, suggesting a network which alters valuation processes. We also found a significant taste-placebo effect, with higher experienced taste pleasantness and intensity for FT labeled chocolates. Our results reveal a possible neural mechanism underlying valuation processes of certified food products. The results are important in light of understanding current marketing trends as well as designing future interventions that aim at positively influencing food choice. PMID:26441576

Adolescent and Parent Willingness to Participate in Microbicide Safety Studies

PubMed Central

Catallozzi, Marina; de Roche, Ariel M.; Hu, Mei-Chen; Breitkopf, Carmen Radecki; Chang, Jane; Ipp, Lisa S.; Francis, Jenny K. R.; Rosenthal, Susan L.

2018-01-01

Study Objective To understand adolescents’ and parents’ willingness to participate (WTP) in a hypothetical Phase I prevention study of sexually transmitted infections, discordance within adolescent-parent dyads, and expectations of each other during decision-making. Design Adolescent-parent dyads were recruited to participate in a longitudinal study about research participation attitudes. Participants Adolescents (14–17 years old) and their parents (n=301 dyads) participated. Interventions None Main outcome measures Individual interviews at baseline assessed WTP on a six-level Likert scale. WTP was dichotomized (willing/unwilling) to assess discordance. Results WTP was reported by 60% of adolescents and 52% of parents. In bivariate analyses, older adolescent age, sexual experience and less involvement of parents in research processes were associated with higher level of WTP for adolescents; only sexual experience remained in the multivariable analysis. For parents, older adolescent age, perceived adolescent sexual experience, and conversations about sexual health were significant; only conversations remained. Dyadic discordance (44%) was more likely in dyads where the parent reported previous research experience, and less likely when parents reported higher family expressiveness. Adolescents (83%) and parents (88%) thought that the other would have similar views, influence their decision (adolescents 66%, parents 75%), and listen (adolescents 90%, parents 96%). There were no relationships between these perceptions and discordance. Conclusions Inclusion of adolescents in Phase 1 clinical trials is necessary to ensure that new methods are safe, effective and acceptable for them. Given that these trials currently require parental consent, strategies that manage adolescent-parent discordance and support adolescent independence and parental guidance are critically needed. PMID:27381236

Support for HLW Direct Feed - Phase 2, VSL-15R3440-1

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

Matlack, K. S.; Pegg, I.; Joseph, I.

This report describes work performed to develop and test new glass and feed formulations originating from a potential flow-sheet for the direct vitrification of High Level Waste (HLW) with minimal or no pretreatment. In the HLW direct feed option that is under consideration for early operations at the Hanford Tank Waste Treatment and Immobilization Plant (WTP), the pretreatment facility would be bypassed in order to support an earlier start-up of the vitrification facility. For HLW, this would mean that the ultrafiltration and caustic leaching operations that would otherwise have been performed in the pretreatment facility would either not be performedmore » or would be replaced by an interim pretreatment function (in-tank leaching and settling, for example). These changes would likely affect glass formulations and waste loadings and have impacts on the downstream vitrification operations. Modification of the pretreatment process may result in: (i) Higher aluminum contents if caustic leaching is not performed; (ii) Higher chromium contents if oxidative leaching is not performed; (iii) A higher fraction of supernate in the HLW feed resulting from the lower efficiency of in-tank washing; and (iv) A higher water content due to the likely lower effectiveness of in-tank settling compared to ultrafiltration. The HLW direct feed option has also been proposed as a potential route for treating HLW streams that contain the highest concentrations of fast-settling plutoniumcontaining particles, thereby avoiding some of the potential issues associated with such particles in the WTP Pretreatment facility [1]. In response, the work presented herein focuses on the impacts of increased supernate and water content on wastes from one of the candidate source tanks for the direct feed option that is high in plutonium.« less

PEP Integrated Test D Run Report Caustic and Oxidative Leaching in UFP-VSL-T02A

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

Sevigny, Gary J.; Bredt, Ofelia P.; Burns, Carolyn A.

2009-12-11

Pacific Northwest National Laboratory (PNNL) has been tasked by Bechtel National Inc. (BNI) on the River Protection Project-Hanford Tank Waste Treatment and Immobilization Plant (RPP-WTP) project to perform research and development activities to resolve technical issues identified for the Pretreatment Facility (PTF). The Pretreatment Engineering Platform (PEP) was designed, constructed and operated as part of a plan to respond to issue M12, "Undemonstrated Leaching Processes" of the External Flowsheet Review Team (EFRT) issue response plan. The PEP is a 1/4.5-scale test platform designed to simulate the WTP pretreatment caustic leaching, oxidative leaching, ultrafiltration solids concentration, and slurry washing processes. Themore » PEP replicates the WTP leaching processes using prototypic equipment and control strategies. The PEP also includes non-prototypic ancillary equipment to support the core processing. Two operating scenarios are currently being evaluated for the ultrafiltration process (UFP) and leaching operations. The first scenario (Test B and D) has caustic leaching performed in the UFP-2 ultrafiltration feed vessels (i.e., vessel UFP-VSL-T02A in the PEP and vessels UFP-VSL-00002A and B in the WTP PTF). The second scenario (Test A) has caustic leaching conducted in the UFP-1 ultrafiltration feed preparation vessels (i.e., vessels UFP-VSL-T01A and B in the PEP and vessels UFP VSL-00001A and B in the WTP PTF). In Test D, 19M sodium hydroxide (NaOH, caustic) was added to the waste slurry in the UFP VSL T02 vessel after the solids were concentrated to ~20% undissolved solids. The NaOH was added to leach solid aluminum compounds (e.g., gibbsite, boehmite). Caustic addition is followed by heating to 85°C using direct injection of steam to accelerate the leach process. The main difference of Test D compared to Test B is that the leach temperature is 85°C for 24 hrs as compared to 100°C for 12 hours. The other difference is the Test D simulant had Cr in the simulant from the start of processing and Test B had Cr added to adjust the simulant composition after aluminum leaching. Following the caustic leach, the UFP-VSL-T02A vessel contents are cooled using the vessel cooling jacket. The slurry was then concentrated to 17 wt% undissolved solids and washed with inhibited water to remove NaOH and other soluble salts. Next, the slurry was oxidatively leached using sodium permanganate to solubilize chrome. The slurry was then washed to remove the dissolved chrome and concentrated.« less

Gender's effect on willingness-to-pay for community-based insurance in Burkina Faso.

PubMed

Dong, Hengjin; Kouyate, Bocar; Snow, Rachel; Mugisha, Frederick; Sauerborn, Rainer

2003-05-01

The purpose was to study gender's effect on willingness-to-pay (WTP) for community-based insurance (CBI) in order to provide information for deciding enrolment unit and setting premium in Burkina Faso. A two-stage cluster sampling was used in the household survey, with each household having the same probability of being selected. One thousand one hundred and seventy-eight men and 1236 women in the 800 households were interviewed. The bidding game approach was used to elicit WTP. We found that compared to male, female had less education, lower income and expenditure, less episodes of diseases and lower ratio of becoming household head, but higher marriage rate. These characteristics influenced the WTP difference between men and women. Men were willing to pay 3666 CFA ($4.89) to join CBI, 928 CFA higher than women were. Education and economic status positively influenced WTP, implying higher years of schooling and economic status and higher WTP. Age and distance to health facility negatively influenced WTP, thus higher age and longer distance and less WTP. Based on the results from this study, we suggest that CBI should be enrolled on the basis of households or villages in order to protect vulnerable persons, such as the aged, women and the poor. In setting premium a policy-maker needs to take into account costs of the CBI benefits package, possible subsidies from government and other agencies and WTP information. WTP should never be taken as a premium because it only provides some information for the respondents' financial acceptability for a certain benefits package.

Willingness to pay for a cure of low-risk melanoma patients in Germany.

PubMed

Augustin, Matthias; Blome, Christine; Forschner, Andrea; Gutzmer, Ralf; Hauschild, Axel; Heinzerling, Lucie; Livingstone, Elisabeth; Loquai, Carmen; Schadendorf, Dirk; Utikal, Jochen; Wagner, Tobias; Wilden, Sophia; Kähler, Katharina C

2018-01-01

Malignant melanoma is potentially life-threatening but in most cases curable if detected early. Willingness to pay (WTP) is a preference-based construct that reflects burden of disease by assessment of the monetary value for a hypothetical cure from disease. Since WTP (directly as total amount of money) has not been assessed so far in patients with low risk melanoma, it was interesting to gain insights in this patient population and then, in a second step, compare it directly with the WTP of their treating dermato-oncologists. WTP was assessed in 125 patients with low-risk melanoma and additionally in 105 treating physicians, asking for the one-time and continuous payments they would be willing to make for a sustainable cure, both as absolute sums and as percentages of monthly income. The median WTP based on one-time payment was €10,000 for patients and €100,000 for physicians; relative numbers were 100% versus 300% of monthly income. For continuous monthly payments, WTP was €500 for patients and €1000 for physicians, relative numbers 25% and 50% of income, respectively. Even after controlling for income differences, there was a significantly higher WTP in physicians for all four questions. Compared to patients with chronic skin diseases such as vitiligo, rosacea, atopic eczema and psoriasis, patients with low-risk melanoma showed a significantly higher WTP. Our data suggest that there is a relevant burden of disease even in patients with low-risk tumors. Higher WTP of physicians underlines the prevalence of differences in disease perception.

Willingness to pay for a cure of low-risk melanoma patients in Germany

PubMed Central

Augustin, Matthias; Blome, Christine; Forschner, Andrea; Gutzmer, Ralf; Hauschild, Axel; Heinzerling, Lucie; Livingstone, Elisabeth; Loquai, Carmen; Schadendorf, Dirk; Utikal, Jochen; Wagner, Tobias; Wilden, Sophia

2018-01-01

Malignant melanoma is potentially life-threatening but in most cases curable if detected early. Willingness to pay (WTP) is a preference-based construct that reflects burden of disease by assessment of the monetary value for a hypothetical cure from disease. Since WTP (directly as total amount of money) has not been assessed so far in patients with low risk melanoma, it was interesting to gain insights in this patient population and then, in a second step, compare it directly with the WTP of their treating dermato-oncologists. WTP was assessed in 125 patients with low-risk melanoma and additionally in 105 treating physicians, asking for the one-time and continuous payments they would be willing to make for a sustainable cure, both as absolute sums and as percentages of monthly income. The median WTP based on one-time payment was €10,000 for patients and €100,000 for physicians; relative numbers were 100% versus 300% of monthly income. For continuous monthly payments, WTP was €500 for patients and €1000 for physicians, relative numbers 25% and 50% of income, respectively. Even after controlling for income differences, there was a significantly higher WTP in physicians for all four questions. Compared to patients with chronic skin diseases such as vitiligo, rosacea, atopic eczema and psoriasis, patients with low-risk melanoma showed a significantly higher WTP. Our data suggest that there is a relevant burden of disease even in patients with low-risk tumors. Higher WTP of physicians underlines the prevalence of differences in disease perception. PMID:29795621

Seasonal and spatial evolution of trihalomethanes in a drinking water distribution system according to the treatment process.

PubMed

Domínguez-Tello, A; Arias-Borrego, A; García-Barrera, Tamara; Gómez-Ariza, J L

2015-11-01

This paper comparatively shows the influence of four water treatment processes on the formation of trihalomethanes (THMs) in a water distribution system. The study was performed from February 2005 to January 2012 with analytical data of 600 samples taken in Aljaraque water treatment plant (WTP) and 16 locations along the water distribution system (WDS) in the region of Andévalo and the coast of Huelva (southwest Spain), a region with significant seasonal and population changes. The comparison of results in the four different processes studied indicated a clear link of the treatment process with the formation of THM along the WDS. The most effective treatment process is preozonation and activated carbon filtration (P3), which is also the most stable under summer temperatures. Experiments also show low levels of THMs with the conventional process of preoxidation with potassium permanganate (P4), delaying the chlorination to the end of the WTP; however, this simple and economical treatment process is less effective and less stable than P3. In this study, strong seasonal variations were obtained (increase of THM from winter to summer of 1.17 to 1.85 times) and a strong spatial variation (1.1 to 1.7 times from WTP to end points of WDS) which largely depends on the treatment process applied. There was also a strong correlation between THM levels and water temperature, contact time and pH. On the other hand, it was found that THM formation is not proportional to the applied chlorine dose in the treatment process, but there is a direct relationship with the accumulated dose of chlorine. Finally, predictive models based on multiple linear regressions are proposed for each treatment process.

Willingness to Pay for Elderly Telecare Service Using the Internet and Digital Terrestrial Broadcasting

PubMed Central

Kaga, Satoshi; Suzuki, Teppei

2017-01-01

Background In Japan over the past few years, more attention has been focused on unnoticed solitary death in the context of an aging society and the trend toward nuclear family. A number of institutions and companies have implemented a prevention measure with digital terrestrial broadcasting telecare services for the elderly: Hokkaido University; TV-Asahi Corporation; Hitachi, Ltd; Iwamizawa City; Hokkaido Television Broadcasting Co, Ltd; and Hamanasu Information Co, Ltd. Although this system is provided free of charge as a demonstration test, determining the appropriate price for the service is required for its sustainable operation. Objective The aim of this study was to quantify individual willingness to pay (WTP) so as to test the tenability of digital terrestrial broadcasting service for elderly telecare. Methods We used the contingent valuation method (CVM) to estimate the WTP for this service among 305 citizens (valid response rate 76.0%) living in Japan. A questionnaire survey was conducted for people aged 18 to 100 years according to Japanese age distribution from September 2016. To elicit WTP, we adopted a double-bound dichotomous choice method to ask the respondents whether they agree or disagree with the price we offered. Results The median WTP for this service’s monthly fee is estimated to be 431 JPY (approximately US $3.7). The finding suggests that gender (0.66, P=.01), health consciousness (1.08, P=.01), willingness to use (2.38, P<.001), and seeing others less than once a week (1.00, P=.06) made a positive effect on WTP. Conclusions We conclude that reliable WTP was elicited by CVM based on an Internet survey. Calculated median WTP for digital terrestrial broadcasting service for elderly telecare was 431 JPY (approximately US $3.7). In the analysis of factors that affect WTP, constant factors, log-bid, health consciousness, gender, see others less than one time for week, and willingness to use made positive effect to probability of acceptance. In comparison of WTP in different groups, age groups showed that WTP of the elderly group was higher than WTP of the middle age group and younger age group. However, WTP surveys need to be carefully conducted to minimize the sampling bias and allocate accurate structure of gender distribution. PMID:29066428

Willingness to Pay for Elderly Telecare Service Using the Internet and Digital Terrestrial Broadcasting.

PubMed

Kaga, Satoshi; Suzuki, Teppei; Ogasawara, Katsuhiko

2017-10-24

In Japan over the past few years, more attention has been focused on unnoticed solitary death in the context of an aging society and the trend toward nuclear family. A number of institutions and companies have implemented a prevention measure with digital terrestrial broadcasting telecare services for the elderly: Hokkaido University; TV-Asahi Corporation; Hitachi, Ltd; Iwamizawa City; Hokkaido Television Broadcasting Co, Ltd; and Hamanasu Information Co, Ltd. Although this system is provided free of charge as a demonstration test, determining the appropriate price for the service is required for its sustainable operation. The aim of this study was to quantify individual willingness to pay (WTP) so as to test the tenability of digital terrestrial broadcasting service for elderly telecare. We used the contingent valuation method (CVM) to estimate the WTP for this service among 305 citizens (valid response rate 76.0%) living in Japan. A questionnaire survey was conducted for people aged 18 to 100 years according to Japanese age distribution from September 2016. To elicit WTP, we adopted a double-bound dichotomous choice method to ask the respondents whether they agree or disagree with the price we offered. The median WTP for this service's monthly fee is estimated to be 431 JPY (approximately US $3.7). The finding suggests that gender (0.66, P=.01), health consciousness (1.08, P=.01), willingness to use (2.38, P<.001), and seeing others less than once a week (1.00, P=.06) made a positive effect on WTP. We conclude that reliable WTP was elicited by CVM based on an Internet survey. Calculated median WTP for digital terrestrial broadcasting service for elderly telecare was 431 JPY (approximately US $3.7). In the analysis of factors that affect WTP, constant factors, log-bid, health consciousness, gender, see others less than one time for week, and willingness to use made positive effect to probability of acceptance. In comparison of WTP in different groups, age groups showed that WTP of the elderly group was higher than WTP of the middle age group and younger age group. However, WTP surveys need to be carefully conducted to minimize the sampling bias and allocate accurate structure of gender distribution. ©Satoshi Kaga, Teppei Suzuki, Katsuhiko Ogasawara. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 24.10.2017.

Willingness to pay for adverse drug event regulatory actions.

PubMed

Bouvy, Jacoline; Weemers, Just; Schellekens, Huub; Koopmanschap, Marc

2011-11-01

Regulatory requirements for the pharmaceutical industry have become increasingly demanding with respect to the safety and effectiveness of drugs. The objective of this study was to determine the willingness to pay (WTP), of both the Dutch general public and dialysis patients, for regulatory requirements related to reducing the risk of pure red cell aplasia (PRCA) associated with epoetin alpha use. A survey was carried out in April 2009. The Dutch general public (n = 422) was approached through a survey sampling agency. Patients (n = 112) were included through several Dutch dialysis clinics because they are often treated with epoetin alpha and therefore were expected to have a higher WTP than the general public. The survey aimed to determine the WTP for reducing the risk of PRCA in epoetin alpha users from 4.5 to 0 per 10 000 patients per year, based on regulatory actions that have been taken by the European Medicines Agency (EMA). WTP was determined via a payment scale and an open-ended follow-up question. Patients were asked how much extra per year they would be willing to pay for their basic healthcare insurance. We used two censored regression models to test the association between WTP and a set of independent variables: a Tobit model with the stated WTP as the dependent variable and an interval regression model with the interval between the lower and upper bounds of the payment scale as the dependent variable. The patients' mean WTP was significantly higher (€46.52) than that of the general public (€24.40). The Tobit model showed significant associations (α = 0.05) with WTP for dialysis patients, risk perception and respondents' opinions on costs of healthcare. The interval regression model showed significant associations with WTP for the same variables as the Tobit model and for one additional variable (risk aversion). Income did not significantly affect WTP. A scenario with a 10-fold larger risk reduction did not increase WTP significantly. This study is, as far as we know, one of the first attempts to analyse the WTP for drug regulation and should in future be used in studies of the societal costs of drug regulation for epoetin alpha use. Our results indicate that the Dutch general public, especially Dutch dialysis patients, are willing to pay limited amounts to reduce the risk of serious adverse events associated with drug use.

Analysis of the Military Medical Retirement System

DTIC Science & Technology

2009-03-01

Willingness-to-pay ( WTP ) studies examine how much an individual is willing to pay in order to decrease their risk of death. Contingent valuation...lacks a budgetary constraint, while the WTP approach is bound by the limits of one’s budget (EPA 1990: I-1). WTP is further distinguished into two...that reduction in the risk of death” (Lanoie et al 1995: 236). The summation of each person’s WTP is the overall value of statistical life. The

Factors affecting direction and strength of patient preferences for treatment of molar teeth with nonvital pulps.

PubMed

Vernazza, C R; Steele, J G; Whitworth, J M; Wildman, J R; Donaldson, C

2015-12-01

To elicit the factors affecting willingness to pay (WTP) values for the preferred options of participants for dealing with a molar tooth with a nonvital pulp, a common but difficult problem. A total of 503 patients were recruited from dental practices in the North East of England and interviewed. Their preferred treatment option for a molar tooth with a nonvital pulp (endodontics, extraction and various prosthetic restorative options) and WTP for this preferred option were elicited. Factors affecting preferred option and WTP were analysed using econometric modelling. Overall, 53% of the sample wished to save the tooth with a mean WTP of £373. The variance in WTP was high. Of those opting for extraction, the majority chose to leave a gap or have an implant. The preferred option was influenced by previous treatment experience. WTP was only influenced by having a low income. The high level of variance in WTP and its relatively unpredictable nature pose difficult questions for policy makers trying to ensure the delivery of an equitable service. For dentists, it is important not to make assumptions about patient preference and strength of preference when making decisions. Ideally, WTP values should be considered alongside effectiveness data, and those on costs, in policy making. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Pretreatment Engineering Platform Phase 1 Final Test Report

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

Kurath, Dean E.; Hanson, Brady D.; Minette, Michael J.

2009-12-23

Pacific Northwest National Laboratory (PNNL) was tasked by Bechtel National Inc. (BNI) on the River Protection Project, Hanford Tank Waste Treatment and Immobilization Plant (RPP-WTP) project to conduct testing to demonstrate the performance of the WTP Pretreatment Facility (PTF) leaching and ultrafiltration processes at an engineering-scale. In addition to the demonstration, the testing was to address specific technical issues identified in Issue Response Plan for Implementation of External Flowsheet Review Team (EFRT) Recommendations - M12, Undemonstrated Leaching Processes.( ) Testing was conducted in a 1/4.5-scale mock-up of the PTF ultrafiltration system, the Pretreatment Engineering Platform (PEP). Parallel laboratory testing wasmore » conducted in various PNNL laboratories to allow direct comparison of process performance at an engineering-scale and a laboratory-scale. This report presents and discusses the results of those tests.« less

Willingness to pay for a QALY based on community member and patient preferences for temporary health states associated with herpes zoster.

PubMed

Lieu, Tracy A; Ray, G Thomas; Ortega-Sanchez, Ismael R; Kleinman, Ken; Rusinak, Donna; Prosser, Lisa A

2009-01-01

A clear sense of what society is willing to pay for a QALY could enhance the usefulness of cost-effectiveness analysis as a field. Scant information exists on willingness to pay (WTP) for a QALY based on direct elicitation of preferences from community members or patients. We had the opportunity to evaluate WTP per QALY using data from a survey on temporary health outcomes related to herpes zoster. Our aims were to (i) describe how much community members are willing to pay to save a QALY based on scenarios describing temporary health states; (ii) evaluate how WTP per QALY varies based on experience with the disease being described and with demographic variables; and (iii) evaluate how the duration and intensity of pain in a scenario influences WTP per QALY. Community members drawn from a nationally representative survey research panel (n = 478) completed an Internet-based survey using time trade-off (TTO) and WTP questions to value a series of scenarios that described herpes zoster cases of varying pain intensity (on a scale of 0-10) and duration (30 days to 1 year). Patients with shingles (n = 354) or postherpetic neuralgia (PHN; n = 120) [defined as having symptoms for 90 days or more] from two large healthcare systems completed telephone interviews with similar questions. Mean and median WTP per QALY values were calculated by dividing the WTP amount by the discounted time traded for each scenario. Responses with a WTP value of more than zero and a TTO value of zero (which would have resulted in an undefined value) were excluded. TTO values were discounted by 3% per year. WTP per QALY means were calculated after trimming the top and bottom 2.5% of responses. Multivariate analyses were conducted using generalized linear mixed models that assumed a negative binomial distribution. Among all respondents, the WTP per QALY ranged from a median of $US7000 to $US11,000 and a trimmed mean of $US26 000 to $US45,000 (year 2005 values), depending on the scenario described. WTP per QALY values varied significantly with respondent characteristics, as well as among respondents with similar characteristics. In multivariate analyses, the mean WTP per QALY was higher among respondents who were younger, male or had higher educational or income levels. After adjusting for these demographic variables, patients who had experienced shingles gave responses with the highest WTP per QALY values. Patients who had experienced PHN gave the lowest values, and community members gave values intermediate to the shingles and PHN groups. In multivariate models that evaluated the effects of pain and duration of the hypothetical zoster scenario, lower duration was associated with higher WTP per QALY. This effect appeared to be due to people increasing the amounts of time they would be willing to trade as duration increased, without proportional increases in the amounts of money they would be willing to pay. Community members and patients gave mean WTP per QALY values that varied significantly based on age, sex, socioeconomic status, experience with shingles and duration of the health state evaluated. The variability in WTP per QALY suggests that it may be difficult to define a unitary threshold of dollars per QALY for policy making based on cost-effectiveness analyses.

Estimating Willingness-to-Pay for health insurance among rural poor in India by reference to Engel's law.

PubMed

Binnendijk, Erika; Dror, David M; Gerelle, Eric; Koren, Ruth

2013-01-01

Community-Based Health Insurance (CBHI) (a.k.a. micro health insurance) is a contributory health insurance among rural poor in developing countries. As CBHI schemes typically function with no subsidy income, the schemes' expenditures cannot exceed their premium income. A good estimate of Willingness-To-Pay (WTP) among the target population affiliating on a voluntary basis is therefore essential for package design. Previous estimates of WTP reported materially and significantly different WTP levels across locations (even within one state), making it necessity to base estimates on household surveys. This is time-consuming and expensive. This study seeks to identify a coherent anchor for local estimation of WTP without having to rely on household surveys in each CBHI implementation. Using data collected in 2008-2010 among rural poor households in six locations in India (total 7874 households), we found that in all locations WTP expressed as percentage of income decreases with household income. This reminds of Engel's law on food expenditures. We checked several possible anchors: overall income, discretionary income and food expenditures. We compared WTP expressed as percentage of these anchors, by calculating the Coefficient of Variation (for inter-community variation) and Concentration indices (for intra-community variation). The Coefficient of variation was 0.36, 0.43 and 0.50 for WTP as percent of food expenditures, overall income and discretionary income, respectively. In all locations the concentration index for WTP as percentage of food expenditures was the lowest. Thus, food expenditures had the most consistent relationship with WTP within each location and across the six locations. These findings indicate that like food, health insurance is considered a necessity good even by people with very low income and no prior experience with health insurance. We conclude that the level of WTP could be estimated based on each community's food expenditures, and that this information can be obtained everywhere without having to conduct household surveys. Copyright © 2012 Elsevier Ltd. All rights reserved.

Willingness to pay for mammography: item development and testing among five ethnic groups

PubMed Central

Hu, Teh-wei; Dueñas, Grace V.; Pasick, Rena J.

2010-01-01

The goal of this study was to develop a willingness to pay (WTP) question for mammography that is appropriate for low income, ethnically-diverse women. Through qualitative research with 50 low income women of five ethnic groups we developed both a WTP question and a willingness to travel question (WTT). After being refined through interviews with 41 women, these questions were pilot tested on a random sample of 52 low income, ethnically-diverse women in the San Francisco area. Results show that the concepts underlying WTP and WTT were culturally appropriate to the five ethnicities in this study. Analyses generally confirm the validity of the WTP and WTT questions. As expected, WTP was associated with household income, perceived risk of cancer, and knowledge that one needs a mammogram even after a clinical breast examination. Despite the small samples, WTP varied among the ethnic groups. Additionally, WTT was moderately correlated with the natural log of WTP (r = 0.58, P < 0.001). These questions are now in use in a larger clinical trial and future analyses will explore willingness to pay and willingness to travel within and across the ethnic groups. PMID:11014787

Secondary Waste Form Development and Optimization—Cast Stone

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

Sundaram, S. K.; Parker, Kent E.; Valenta, Michelle M.

2011-07-14

Washington River Protection Services is considering the design and construction of a Solidification Treatment Unit (STU) for the Effluent Treatment Facility (ETF) at Hanford. The ETF is a Resource Conservation and Recovery Act-permitted, multi-waste, treatment and storage unit and can accept dangerous, low-level, and mixed wastewaters for treatment. The STU needs to be operational by 2018 to receive secondary liquid wastes generated during operation of the Hanford Tank Waste Treatment and Immobilization Plant (WTP). The STU to ETF will provide the additional capacity needed for ETF to process the increased volume of secondary wastes expected to be produced by WTP.

EFRT M12 Issue Resolution: Comparison of PEP and Bench-Scale Oxidative Leaching Results

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

Rapko, Brian M.; Brown, Christopher F.; Eslinger, Paul W.

2009-08-14

Pacific Northwest National Laboratory (PNNL) has been tasked by Bechtel National Inc. (BNI) on the River Protection Project-Hanford Tank Waste Treatment and Immobilization Plant (RPP-WTP) project to perform research and development activities to resolve technical issues identified for the Pretreatment Facility (PTF). The Pretreatment Engineering Platform (PEP) was designed and constructed and is to be operated as part of a plan to respond to issue M12, “Undemonstrated Leaching Processes.” The PEP is a 1/4.5-scale test platform designed to simulate the WTP pretreatment caustic leaching, oxidative leaching, ultrafiltration solids concentration, and slurry washing processes. The PEP replicates the WTP leaching processesmore » using prototypic equipment and control strategies. The PEP also includes non-prototypic ancillary equipment to support the core processing. Two operating scenarios are currently being evaluated for the ultrafiltration process (UFP) and leaching operations. The first scenario has caustic leaching performed in the UFP-2 ultrafiltration feed vessels (i.e., vessel UFP-VSL-T02A in the PEP; and vessels UFP-VSL-00002A and B in the WTP PTF). The second scenario has caustic leaching conducted in the UFP-1 ultrafiltration feed preparation vessels (i.e., vessels UFP-VSL-T01A and B in the PEP; vessels UFP-VSL-00001A and B in the WTP PTF). In both scenarios, 19-M sodium hydroxide solution (NaOH, caustic) is added to the waste slurry in the vessels to dissolve solid aluminum compounds (e.g., gibbsite, boehmite). Caustic addition is followed by a heating step that uses direct steam injection to accelerate the leaching process. Following the caustic leach, the vessel contents are cooled using vessel cooling jackets and/or external heat exchangers. The main difference between the two scenarios is that for leaching in UFP1, the 19-M NaOH is added to un-concentrated waste slurry (3 to 8 wt% solids), while for leaching in UFP2, the slurry is concentrated to nominally 20 wt% solids using cross-flow ultrafiltration before the addition of caustic. For wastes that have significantly high chromium content, the caustic leaching and slurry dewatering is followed by adding sodium permanganate to UFP-VSL-T02A, and the slurry is subjected to oxidative leaching at nominally ambient temperature. The purpose of the oxidative leaching is to selectively oxidize the poorly alkaline-soluble Cr(III) believed to be the insoluble form in Hanford tank sludge to the much more alkaline-soluble Cr(VI), e.g., chromate. The work described in this report provides the test results that are related to the efficiency of the oxidative leaching process to support process modeling based on tests performed with a Hanford waste simulant. The tests were completed both at the lab-bench scale and in the PEP. The purpose of this report is to summarize the results from both scales that are related to oxidative leaching chemistry to support a scale factor for the submodels to be used in the G2 model, which predicts WTP operating performance. Owing to schedule constraints, the PEP test data to be included in this report are limited to those from Integrated Tests A (T01 A/B caustic leaching) and B (T02A caustic leaching).« less

Systematic Review of Willingness to Pay for Health Insurance in Low and Middle Income Countries.

PubMed

Nosratnejad, Shirin; Rashidian, Arash; Dror, David Mark

2016-01-01

Access to healthcare is mostly contingent on out-of-pocket spending (OOPS) by health seekers, particularly in low- and middle-income countries (LMICs). This would require many LMICs to raise enough funds to achieve universal health insurance coverage. But, are individuals or households willing to pay for health insurance, and how much? What factors positively affect WTP for health insurance? We wanted to examine the evidence for this, through a review of the literature. We systematically searched databases up to February 2016 and included studies of individual or household WTP for health insurance. Two authors appraised the identified studies. We estimated the WTP as a percentage of GDP per capita, and adjusted net national income per capita of each country. We used meta-analysis to calculate WTP means and confidence intervals, and vote-counting to identify the variables that more often affected WTP. 16 studies (21 articles) from ten countries met the inclusion criteria. The mean WTP of individuals was 1.18% of GDP per capita and 1.39% of adjusted net national income per capita. The corresponding figures for households were 1.82% and 2.16%, respectively. Increases in family size, education level and income were consistently correlated with higher WTP for insurance, and increases in age were correlated with reduced WTP. The WTP for healthcare insurance among rural households in LMICs was just below 2% of the GPD per capita. The findings demonstrate that in moving towards universal health coverage in LMICs, governments should not rely on households' premiums as a major financing source and should increase their fiscal capacity for an equitable health care system using other sources.

Exploring the Use of Cost-Benefit Analysis to Compare Pharmaceutical Treatments for Menorrhagia.

PubMed

Sanghera, Sabina; Frew, Emma; Gupta, Janesh Kumar; Kai, Joe; Roberts, Tracy Elizabeth

2015-09-01

The extra-welfarist theoretical framework tends to focus on health-related quality of life, whilst the welfarist framework captures a wider notion of well-being. EQ-5D and SF-6D are commonly used to value outcomes in chronic conditions with episodic symptoms, such as heavy menstrual bleeding (clinically termed menorrhagia). Because of their narrow-health focus and the condition's periodic nature these measures may be unsuitable. A viable alternative measure is willingness to pay (WTP) from the welfarist framework. We explore the use of WTP in a preliminary cost-benefit analysis comparing pharmaceutical treatments for menorrhagia. A cost-benefit analysis was carried out based on an outcome of WTP. The analysis is based in the UK primary care setting over a 24-month time period, with a partial societal perspective. Ninety-nine women completed a WTP exercise from the ex-ante (pre-treatment/condition) perspective. Maximum average WTP values were elicited for two pharmaceutical treatments, levonorgestrel-releasing intrauterine system (LNG-IUS) and oral treatment. Cost data were offset against WTP and the net present value derived for treatment. Qualitative information explaining the WTP values was also collected. Oral treatment was indicated to be the most cost-beneficial intervention costing £107 less than LNG-IUS and generating £7 more benefits. The mean incremental net present value for oral treatment compared with LNG-IUS was £113. The use of the WTP approach was acceptable as very few protests and non-responses were observed. The preliminary cost-benefit analysis results recommend oral treatment as the first-line treatment for menorrhagia. The WTP approach is a feasible alternative to the conventional EQ-5D/SF-6D approaches and offers advantages by capturing benefits beyond health, which is particularly relevant in menorrhagia.

Systematic Review of Willingness to Pay for Health Insurance in Low and Middle Income Countries

PubMed Central

Nosratnejad, Shirin; Rashidian, Arash; Dror, David Mark

2016-01-01

Objective Access to healthcare is mostly contingent on out-of-pocket spending (OOPS) by health seekers, particularly in low- and middle-income countries (LMICs). This would require many LMICs to raise enough funds to achieve universal health insurance coverage. But, are individuals or households willing to pay for health insurance, and how much? What factors positively affect WTP for health insurance? We wanted to examine the evidence for this, through a review of the literature. Methods We systematically searched databases up to February 2016 and included studies of individual or household WTP for health insurance. Two authors appraised the identified studies. We estimated the WTP as a percentage of GDP per capita, and adjusted net national income per capita of each country. We used meta-analysis to calculate WTP means and confidence intervals, and vote-counting to identify the variables that more often affected WTP. Result 16 studies (21 articles) from ten countries met the inclusion criteria. The mean WTP of individuals was 1.18% of GDP per capita and 1.39% of adjusted net national income per capita. The corresponding figures for households were 1.82% and 2.16%, respectively. Increases in family size, education level and income were consistently correlated with higher WTP for insurance, and increases in age were correlated with reduced WTP. Conclusions The WTP for healthcare insurance among rural households in LMICs was just below 2% of the GPD per capita. The findings demonstrate that in moving towards universal health coverage in LMICs, governments should not rely on households' premiums as a major financing source and should increase their fiscal capacity for an equitable health care system using other sources. PMID:27362356

Dataset on the cost estimation for spent filter backwash water (SFBW) treatment.

PubMed

Ebrahimi, Afshin; Mahdavi, Mokhtar; Pirsaheb, Meghdad; Alimohammadi, Fariborz; Mahvi, Amir Hossein

2017-12-01

The dataset presented in this article are related to the research article entitled "Hybrid coagulation-UF processes for spent filter backwash water treatment: a comparison studies for PAFCl and FeCl 3 as a pre-treatment" (Ebrahimi et al., 2017) [1]. This article reports the cost estimation for treating produced spent filter backwash water (SFBW) during water treatment in Isfahan- Iran by various methods including primary sedimentation, coagulation & flocculation, second clarification, ultra filtration (UF) and recirculation of settled SFBW to water treatment plant (WTP) entrance. Coagulation conducted by PAFCl and FeCl 3 as pre polymerized and traditional coagulants. Cost estimation showed that contrary to expectations, the recirculation of settled SFBW to WTP entrance is more expensive than other method and it costs about $ 37,814,817.6. Versus the cheapest option related to separate primary sedimentation, coagulation & flocculation in WTP. This option cost about $ 4,757,200 and $ 950,213 when FeCl3 and PAFCl used as coagulant, respectively.

A cost-effectiveness analysis of self-debriefing versus instructor debriefing for simulated crises in perioperative medicine in Canada.

PubMed

Isaranuwatchai, Wanrudee; Alam, Fahad; Hoch, Jeffrey; Boet, Sylvain

2017-01-01

High-fidelity simulation training is effective for learning crisis resource management (CRM) skills, but cost is a major barrier to implementing high-fidelity simulation training into the curriculum. The aim of this study was to examine the cost-effectiveness of self-debriefing and traditional instructor debriefing in CRM training programs and to calculate the minimum willingness-to-pay (WTP) value when one debriefing type becomes more cost-effective than the other. This study used previous data from a randomized controlled trial involving 50 anesthesiology residents in Canada. Each participant managed a pretest crisis scenario. Participants who were randomized to self-debrief used the video of their pretest scenario with no instructor present during their debriefing. Participants from the control group were debriefed by a trained instructor using the video of their pretest scenario. Participants individually managed a post-test simulated crisis scenario. We compared the cost and effectiveness of self-debriefing versus instructor debriefing using net benefit regression. The cost-effectiveness estimate was reported as the incremental net benefit and the uncertainty was presented using a cost-effectiveness acceptability curve. Self-debriefing costs less than instructor debriefing. As the WTP increased, the probability that self-debriefing would be cost-effective decreased. With a WTP ≤Can$200, the self-debriefing program was cost-effective. However, when effectiveness was priced higher than cost-savings and with a WTP >Can$300, instructor debriefing was the preferred alternative. With a lower WTP (≤Can$200), self-debriefing was cost-effective in CRM simulation training when compared to instructor debriefing. This study provides evidence regarding cost-effectiveness that will inform decision-makers and clinical educators in their decision-making process, and may help to optimize resource allocation in education.

[Comparing the value of ecological protection in Sanjiang Plain wetland, Northeast China based on the stated preference method.

PubMed

Fan, Zi Juan; Ao, Chang Lin; Mao, Bi Qi; Chen, Hong Guang; Wang, Xu Dong

2017-02-01

Stated preference method is usually used to evaluate the non-market value of environmental goods which includes contingent valuation method (CVM) and choice experiments (CE). In this paper, stated preference method was adopted to evaluate the non-market value of Sanjiang Plain wetland. A willingness to pay (WTP) evaluation model of stated preference method was constructed based on the random utility theory. The average WTP of CVM and CE was obtained, respectively. The average WTP elicited by CE was 379 yuan per year, and the marginal WTPs of different selection properties including water conservation, wetland area, natural landscape and biodiversity were114.00, 72.55, 59.55 and 37.09 yuan per year, respectively. Meanwhile, the average WTP elicited by CVM was 134 yuan per year. The influence of factors on WTP was analyzed and reasons for protest responses were discussed. Results showed that the respondents' WTP elicited by CE was signi-ficantly higher than that by CVM, and respondents' socio-economic attitudes such as level of education and personal annual income had a significant positive impact on respondents' WTP. There were no significant difference in the reasons of protest responses between CVM and CE. Besides, respondents' multiple attributes and multiple levels analysis could be carried out by CE and the WTP of wetland's selection attributes could be calculated. Therefore, CE had the better ability of revealing respondents' preference information than CVM and its assessment results were more close to the actual value.

Multi-objective Optimization for the Robust Performance of Drinking Water Treatment Plants under Climate Change and Climate Extremes

NASA Astrophysics Data System (ADS)

Raseman, W. J.; Kasprzyk, J. R.; Rosario-Ortiz, F.; Summers, R. S.; Stewart, J.; Livneh, B.

2016-12-01

To promote public health, the United States Environmental Protection Agency (US EPA), and similar entities around the world enact strict laws to regulate drinking water quality. These laws, such as the Stage 1 and 2 Disinfectants and Disinfection Byproducts (D/DBP) Rules, come at a cost to water treatment plants (WTPs) which must alter their operations and designs to meet more stringent standards and the regulation of new contaminants of concern. Moreover, external factors such as changing influent water quality due to climate extremes and climate change, may force WTPs to adapt their treatment methods. To grapple with these issues, decision support systems (DSSs) have been developed to aid WTP operation and planning. However, there is a critical need to better address long-term decision making for WTPs. In this poster, we propose a DSS framework for WTPs for long-term planning, which improves upon the current treatment of deep uncertainties within the overall potable water system including the impact of climate on influent water quality and uncertainties in treatment process efficiencies. We present preliminary results exploring how a multi-objective evolutionary algorithm (MOEA) search can be coupled with models of WTP processes to identify high-performing plans for their design and operation. This coupled simulation-optimization technique uses Borg MOEA, an auto-adaptive algorithm, and the Water Treatment Plant Model, a simulation model developed by the US EPA to assist in creating the D/DBP Rules. Additionally, Monte Carlo sampling methods were used to study the impact of uncertainty of influent water quality on WTP decision-making and generate plans for robust WTP performance.

Alternative Salary Auction Mechanisms for the Navy: An Experimental Program

DTIC Science & Technology

2007-12-01

33 2. Fidelity of WTP Information ............................................................33 3. Effects of Competition...70 3. WTA and WTP Control ....................................................................70 4. Bidding...jar of pennies would be $18, which is the maximum that buyer’s willingness to pay ( WTP ) for that object. 8 2. First-price and Second-price

Why the WTA - WTP disparity matters

Treesearch

Brown Thomas C.; Gregory R.

1999-01-01

The disparity between willingness to pay (WTP) and willingness to accept compensation (WTA) has been demonstrated repeatedly. Because using WTP estimates of value where a WTA estimate is appropriate tends to undervalue environmental assets, this issue is important to environmental managers. We summarize reasons for the disparity and then discuss some of the...

UAV Communication Management and Coordination for Multitarget Tracking

DTIC Science & Technology

2009-02-26

6.3 Weighted Trace Penalty 16 6.4 Results with WTP for ECTG 17 7 Multiple UAV Case 20 7.1 Extension of WTP 20 7.2 Coordinated sensor motion...growth by a weighted trace penalty ( WTP ) term, which is a product of the current covariancc trace and the minimum distance to observability (MDO) for a...Specifically, the terminal cost or ECTG term using the WTP has the form J(b) = JWTP(b) := iD(s, e) Tfc P\\ (6.1) where 7 is a positive constant, i is the

Exploring the willingness to pay for a quality-adjusted life-year in the state of Penang, Malaysia

PubMed Central

Shafie, Asrul Akmal; Lim, Yen Wei; Chua, Gin Nie; Hassali, Mohammed Azmi Ahmad

2014-01-01

Introduction The incremental cost-effectiveness ratio (ICER) is typically compared with a reference value to support the cost-effectiveness of a decision. One method for estimating this value is to estimate the willingness-to-pay (WTP) for a quality-adjusted life-year (QALY). This study was conducted to explore the WTP for a QALY in the Malaysian population. Methods A cross-sectional, contingent valuation study was conducted in Penang, Malaysia. Respondents were selected from randomly chosen geographical grids of Penang. Respondents’ sociodemographic information, qualities of life, and WTP for one additional QALY were collected using predesigned questionnaires in face-to-face interviews. WTP values were elicited using a double-bound dichotomous choice via a bidding game approach. The Heckman selection model was applied to the analysis of the mean WTP/QALY values, where the “protest zero” values, which may contribute to selection bias, were excluded. Results The mean value of WTP for an additional QALY gained was estimated to be MYR (Malaysian Ringgit) 29,080 (~USD 9,000). Key factors that affected the WTP include ethnicity and estimated monthly household income. Conclusion The study findings suggested that the cost-effectiveness threshold value as studied in Penang, Malaysia was estimated to be MYR 29,080. PMID:25364267

Can a Circular Payment Card Format Effectively Elicit Preferences? Evidence From a Survey on a Mandatory Health Insurance Scheme in Tunisia.

PubMed

Chanel, Olivier; Makhloufi, Khaled; Abu-Zaineh, Mohammad

2017-06-01

The choice of elicitation format is a crucial but tricky aspect of stated preferences surveys. It affects not only the quantity and quality of the information collected on respondents' willingness to pay (WTP) but also the potential errors/biases that prevent their true WTP from being observed. We propose a new elicitation mechanism, the circular payment card (CPC), and show that it helps overcome the drawbacks of the standard payment card (PC) format. It uses a visual pie chart representation without start or end points: respondents spin the circular card in any direction until they find the section that best matches their true WTP. We performed a contingent valuation survey regarding a mandatory health insurance scheme in Tunisia, a middle-income country. Respondents were randomly allocated into one of three subgroups and their WTP was elicited using one of three formats: open-ended (OE), standard PC and the new CPC. We compared the elicited WTP. We found significant differences in unconditional and conditional analyses. Our empirical results consistently indicated that the OE and standard PC formats led to significantly lower WTP than the CPC format. Overall, our results are encouraging and suggest CPC could be an effective alternative format to elicit 'true' WTP.

WTP and WTA: do people think differently?

PubMed

Whynes, David K; Sach, Tracey H

2007-09-01

Contingent valuation (CV) studies in health care have used the willingness to pay (WTP) approach, to the virtual exclusion of willingness to accept (WTA). Outside the health care field, disparities between WTP and WTA values have been observed. Were such disparities to be demonstrated for health care technologies, the conventional assumption of a linear cost-effectiveness plane would be invalidated. This paper employs data derived from interviews with users of the UK's paediatric cochlear implantation (PCI) programme based in Nottingham (i) to assess the feasibility of estimating WTA for the potential discontinuation of an existing technology, and (ii) to investigate any WTA-WTP disparity which might be revealed. Only one-third of subjects providing WTP values were willing and able to offer a corresponding WTA value. Our qualitative data revealed that modes of response differed between the two valuation approaches. In particular, the presumption of fungibility of the health care intervention was a far more serious obstacle to completing the WTA task than it was for WTP. Among those prepared to offer values under both approaches, mean WTA was approximately four times mean WTP. Until more health studies are conducted, it remains unclear whether or not the findings are specific both to the intervention and to the elicitation format.

Exploring the willingness to pay for a quality-adjusted life-year in the state of Penang, Malaysia.

PubMed

Shafie, Asrul Akmal; Lim, Yen Wei; Chua, Gin Nie; Hassali, Mohammed Azmi Ahmad

2014-01-01

The incremental cost-effectiveness ratio (ICER) is typically compared with a reference value to support the cost-effectiveness of a decision. One method for estimating this value is to estimate the willingness-to-pay (WTP) for a quality-adjusted life-year (QALY). This study was conducted to explore the WTP for a QALY in the Malaysian population. A cross-sectional, contingent valuation study was conducted in Penang, Malaysia. Respondents were selected from randomly chosen geographical grids of Penang. Respondents' sociodemographic information, qualities of life, and WTP for one additional QALY were collected using predesigned questionnaires in face-to-face interviews. WTP values were elicited using a double-bound dichotomous choice via a bidding game approach. The Heckman selection model was applied to the analysis of the mean WTP/QALY values, where the "protest zero" values, which may contribute to selection bias, were excluded. The mean value of WTP for an additional QALY gained was estimated to be MYR (Malaysian Ringgit) 29,080 (~USD 9,000). Key factors that affected the WTP include ethnicity and estimated monthly household income. The study findings suggested that the cost-effectiveness threshold value as studied in Penang, Malaysia was estimated to be MYR 29,080.

Valuing health risk in agriculture: a choice experiment approach to pesticide use in China.

PubMed

Jin, Jianjun; Wang, Wenyu; He, Rui; Gong, Haozhou

2017-07-01

This paper presents a choice experiment approach to investigate farmers' valuations for health risk changes associated with pesticide use in Anqiu County, China. An empirical comparison on the disparity between farmers' willingness to pay (WTP) for a health risk reduction and willingness to accept (WTA) for the same risk increase is also conducted. Respondents were randomly assigned into the WTP group or the WTA group. Four attributes (health consequence, baseline risk, risk change size, and price) were identified and included. The results show that cancer consequence due to pesticide use decreases the utility of the farmer. A higher baseline risk has a higher WTP to reduce the risk and a higher probability of receiving compensation. If the health risk change size is bigger, it will result in a higher WTP and higher compensation. Household income, education, and age have significant and positive impacts on farmers' WTP. Farmers who are more educated or female are more likely to accept the compensation scheme if health risks increase. The marginal WTA for the same risk change is about two times higher than the marginal WTP. The findings of this study can contribute to the literature comparing people's WTP and WTA in a discrete choice experiment on valuing health risk changes associated with pesticide use.

Valuation of National Park System Visitation: The Efficient Use of Count Data Models, Meta-Analysis, and Secondary Visitor Survey Data

NASA Astrophysics Data System (ADS)

Neher, Christopher; Duffield, John; Patterson, David

2013-09-01

The National Park Service (NPS) currently manages a large and diverse system of park units nationwide which received an estimated 279 million recreational visits in 2011. This article uses park visitor data collected by the NPS Visitor Services Project to estimate a consistent set of count data travel cost models of park visitor willingness to pay (WTP). Models were estimated using 58 different park unit survey datasets. WTP estimates for these 58 park surveys were used within a meta-regression analysis model to predict average and total WTP for NPS recreational visitation system-wide. Estimated WTP per NPS visit in 2011 averaged 102 system-wide, and ranged across park units from 67 to 288. Total 2011 visitor WTP for the NPS system is estimated at 28.5 billion with a 95% confidence interval of 19.7-43.1 billion. The estimation of a meta-regression model using consistently collected data and identical specification of visitor WTP models greatly reduces problems common to meta-regression models, including sample selection bias, primary data heterogeneity, and heteroskedasticity, as well as some aspects of panel effects. The article provides the first estimate of total annual NPS visitor WTP within the literature directly based on NPS visitor survey data.

A Longitudinal Investigation of Willingness to Pay for Health Insurance in Germany.

PubMed

Bock, Jens-Oliver; Hajek, André; Brenner, Hermann; Saum, Kai-Uwe; Matschinger, Herbert; Haefeli, Walter Emil; Schöttker, Ben; Quinzler, Renate; Heider, Dirk; König, Hans-Helmut

2017-06-01

To investigate factors affecting willingness to pay (WTP) for health insurance of older adults in a longitudinal setting in Germany. Survey data from a cohort study in Saarland, Germany, from 2008-2010 and 2011-2014 (n 1  = 3,124; n 2  = 2,761) were used. Panel data were taken at two points from an observational, prospective cohort study. WTP estimates were derived using a contingent valuation method with a payment card. Participants provided data on sociodemographics, lifestyle factors, morbidity, and health care utilization. Fixed effects regression models showed higher individual health care costs to increase WTP, which in particular could be found for members of private health insurance. Changes in income and morbidity did not affect WTP among members of social health insurance, whereas these predictors affected WTP among members of private health insurance. The fact that individual health care costs affected WTP positively might indicate that demanding (expensive) health care services raises the awareness of the benefits of health insurance. Thus, measures to increase WTP in old age should target at improving transparency of the value of health insurances at the moment when individual health care utilization and corresponding costs are still relatively low. © Health Research and Educational Trust.

Tooth replacement for partially dentate elders: A willingness-to-pay analysis.

PubMed

McKenna, G; Tada, S; Woods, N; Hayes, M; DaMata, C; Allen, P F

2016-10-01

The primary aim of this study was to investigate partially dentate elders' willingness-to-pay (WTP) for two different tooth replacement strategies: Removable Partial Dentures (RPDs) and, functionally orientated treatment according to the principles of the Shortened Dental Arch (SDA). The secondary aim was to measure the same patient groups' WTP for dental implant treatment. 55 patients who had completed a previous RCT comparing two tooth replacement strategies (RPDs (n=27) and SDA (n=28)) were recruited (Trial Registration no. ISRCTN26302774). Patients were asked to indicate their WTP for treatment to replace missing teeth in a number of hypothetical scenarios using the payment card method of contingency evaluation coupled to different costs. Data were collected on patients' social class, income levels and other social circumstances. A Mann-Whitney U Test was used to compare differences in WTP between the two treatment groups. To investigate predictive factors for WTP, multiple linear regression analyses were conducted. The median age for the patient sample was 72.0 years (IQR: 71-75 years). Patients who had been provided with RPDs indicated that their WTP for this treatment strategy was significantly higher (€550; IQR: 500-650) than those patients who had received SDA treatment (€500; IQR: 450-550) (p=0.003). However patients provided with RPDs indicated that their WTP for SDA treatment (€650; IQR: 600-650) was also significantly higher than those patients who had actually received functionally orientated treatment (€550; IQR: 500-600) (p<0.001). The results indicated that both current income levels and previous treatment allocation were significantly correlated to WTP for both the RPD and the SDA groups. Patients in both treatment groups exhibited little WTP for dental implant treatment with a median value recorded which was half the market value for this treatment (€1000; IQR: 500-1000). Amongst this patient cohort previous treatment experience had a strong influence on WTP as did current income levels. Both treatment groups indicated a very strong WTP for simpler, functionally orientated care using adhesive fixed prostheses (SDA) over conventional RPDs. Partially dentate older patients expressed a strong preference for functionally orientated tooth replacement as an alternative to conventional RPDs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Improved Management of the Technical Interfaces Between the Hanford Tank Farm Operator and the Hanford Waste Treatment Plant - 13383

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

Duncan, Garth M.; Saunders, Scott A.

2013-07-01

The Department of Energy (DOE) is constructing the Waste Treatment and Immobilization Plant (WTP) at the Hanford site in Washington to treat and immobilize approximately 114 million gallons of high level radioactive waste (after all retrievals are accomplished). In order for the WTP to be designed and operated successfully, close coordination between the WTP engineering, procurement, and construction contractor, Bechtel National, Inc. and the tank farms operating contractor (TOC), Washington River Protection Solutions, LLC, is necessary. To develop optimal solutions for DOE and for the treatment of the waste, it is important to deal with the fact that two differentmore » prime contractors, with somewhat differing contracts, are tasked with retrieving and delivering the waste and for treating and immobilizing that waste. The WTP and the TOC have over the years cooperated to manage the technical interface. To manage what is becoming a much more complicated interface as the WTP design progresses and new technical issues have been identified, an organizational change was made by WTP and TOC in November of 2011. This organizational change created a co-located integrated project team (IPT) to deal with mutual and interface issues. The Technical Organization within the One System IPT includes employees from both TOC and WTP. This team has worked on a variety of technical issues of mutual interest and concern. Technical issues currently being addressed include: - The waste acceptance criteria; - Waste feed delivery and the associated data quality objectives (DQO); - Evaluation of the effects of performing a riser cut on a single shell tank on WTP operations; - The disposition of secondary waste from both TOC and WTP; - The close coordination of the TOC double shell tank mixing and sampling program and the Large Scale Integrated Test (LSIT) program for pulse jet mixers at WTP along with the associated responses to the Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 2010-2; - Development of a set of alternatives to the current baseline that involve aspects of direct feed, feed conditioning, and design changes. The One System Technical Organization has served WTP, TOC, and DOE well in managing and resolving issues at the interface. This paper describes the organizational structure used to improve the interface and several examples of technical interface issues that have been successfully addressed by the new organization. (authors)« less

Bench-Scale Filtration Testing in Support of the Pretreatment Engineering Platform (PEP)

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

Billing, Justin M.; Daniel, Richard C.; Kurath, Dean E.

Pacific Northwest National Laboratory (PNNL) has been tasked by Bechtel National Inc. (BNI) on the River Protection Project-Hanford Tank Waste Treatment and Immobilization Plant (RPP-WTP) project to perform research and development activities to resolve technical issues identified for the Pretreatment Facility (PTF). The Pretreatment Engineering Platform (PEP) was designed, constructed and operated as part of a plan to respond to issue M12, “Undemonstrated Leaching Processes.” The PEP is a 1/4.5-scale test platform designed to simulate the WTP pretreatment caustic leaching, oxidative leaching, ultrafiltration solids concentration, and slurry washing processes. The PEP testing program specifies that bench-scale testing is to bemore » performed in support of specific operations, including filtration, caustic leaching, and oxidative leaching.« less

Water quality in the Little Sac River basin near Springfield, Missouri, 1999-2001

USGS Publications Warehouse

Smith, Brenda J.

2002-01-01

The Little Sac River, north of Springfield, Missouri, flows through mainly agricultural and forest land. However, the quality of the river water is a concern because the river flows into Stockton Lake, which is a supplemental drinking water source for Springfield. Large bacterial densities and nutrient concentrations are primary concerns to the water quality of the river.A 29-river mile reach of the Little Sac River is on the 1998 list of waters of Missouri designated under section 303(d) of the Federal Clean Water Act because of fecal coliform densities larger than the Missouri Department of Natural Resources standard (hereinafter referred to as Missouri standard) of 200 colonies per 100 milliliters for whole-body contact recreation. During an investigation of the water quality in the Little Sac River by the U.S. Geological Survey, in cooperation with the Watershed Committee of the Ozarks, fecal coliform bacteria densities exceeded the Missouri standard (the standard applies from April 1 through October 31) in one sample from a site near Walnut Grove. At other sites on the Little Sac River, the Missouri standard was exceeded in two samples and equalled in one sample upstream from the Northwest Wastewater Treatment Plant (NW WTP) and in one sample immediately downstream from the NW WTP.Effluent from the NW WTP flows into the Little Sac River. Annually from April 1 through October 31, the effluent is disinfected to meet the Missouri standard for whole-body contact recreation. Fecal coliform bacteria densities in samples collected during this period generally were less than 100 colonies per 100 milliliters. For the rest of the year when the effluent was not disinfected, the bacteria densities in samples ranged from 50 (sample collected on November 1, 2000) to 10,100 colonies per 100 milliliters (both counts were non-ideal). When the effluent was disinfected and the fecal coliform bacteria density was small, samples from sites upstream and downstream from the NW WTP had a bacteria density larger than the density in the effluent. Other sources of bacteria are likely to be present in the study area in addition to the NW WTP. These potential sources include effluent from domestic septic systems and animal wastes.Nutrient concentrations in the Little Sac River immediately downstream from the NW WTP were affected by effluent from the NW WTP and possibly other sources. At two sites upstream from the NW WTP, median nitrite plus nitrate concentrations were 1.1 and 1.4 milligrams per liter. The median nitrite plus nitrate concentration for the effluent from the NW WTP was 6.4 milligrams per liter, and the median concentration decreased downstream in the Little Sac River to 2.2, 1.2, and 0.56 milligrams per liter.The effects of the effluent from the NW WTP on the water quality of the Little Sac River downstream from the NW WTP were reflected in an increase in discharge (effluent from the NW WTP can be as much as 50 percent of the flow at the site about 1.5 river miles downstream from the NW WTP), an increase in specific conductance values, an increase in several inorganic constituent concentrations, including calcium, magnesium, and sulfate, and a large increase in sodium and chloride concentrations. The effluent from the NW WTP seemed to have no effect on the pH value, temperature, and dissolved oxygen concentrations in the Little Sac River.Results of repetitive element polymerase chain reaction (rep-PCR) pattern analysis indicated that most Escherichia coli (E. coli) bacteria in water samples probably were from nonhuman sources, such as horses and cattle. The rep-PCR pattern analysis indicated that horses were an important source of E. coli downstream from the NW WTP, which was consistent with horses pastured adjacent to the sampling site. Fecal coliform bacteria loads increased upstream from the NW WTP from the most upstream site to the site immediately upstream from the NW WTP. Loads in the effluent from the NW WTP and also tho

A systematic review of studies eliciting willingness-to-pay per quality-adjusted life year: does it justify CE threshold?

PubMed

Nimdet, Khachapon; Chaiyakunapruk, Nathorn; Vichansavakul, Kittaya; Ngorsuraches, Surachat

2015-01-01

A number of studies have been conducted to estimate willingness to pay (WTP) per quality-adjusted life years (QALY) in patients or general population for various diseases. However, there has not been any systematic review summarizing the relationship between WTP per QALY and cost-effectiveness (CE) threshold based on World Health Organization (WHO) recommendation. To systematically review willingness-to-pay per quality-adjusted-life-year (WTP per QALY) literature, to compare WTP per QALY with Cost-effectiveness (CE) threshold recommended by WHO, and to determine potential influencing factors. We searched MEDLINE, EMBASE, Psyinfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Center of Research Dissemination (CRD), and EconLit from inception through 15 July 2014. To be included, studies have to estimate WTP per QALY in health-related issues using stated preference method. Two investigators independently reviewed each abstract, completed full-text reviews, and extracted information for included studies. We compared WTP per QALY to GDP per capita, analyzed, and summarized potential influencing factors. Out of 3,914 articles founded, 14 studies were included. Most studies (92.85%) used contingent valuation method, while only one study used discrete choice experiments. Sample size varied from 104 to 21,896 persons. The ratio between WTP per QALY and GDP per capita varied widely from 0.05 to 5.40, depending on scenario outcomes (e.g., whether it extended/saved life or improved quality of life), severity of hypothetical scenarios, duration of scenario, and source of funding. The average ratio of WTP per QALY and GDP per capita for extending life or saving life (2.03) was significantly higher than the average for improving quality of life (0.59) with the mean difference of 1.43 (95% CI, 1.81 to 1.06). This systematic review provides an overview summary of all studies estimating WTP per QALY studies. The variation of ratio of WTP per QALY and GDP per capita depended on several factors may prompt discussions on the CE threshold policy. Our research work provides a foundation for defining future direction of decision criteria for an evidence-informed decision making system.

Willingness to pay for flexible working conditions of people with type 2 diabetes: discrete choice experiments.

PubMed

Nexo, M A; Cleal, B; Hagelund, Lise; Willaing, I; Olesen, K

2017-12-15

The increasing number of people with chronic diseases challenges workforce capacity. Type 2 diabetes (T2D) can have work-related consequences, such as early retirement. Laws of most high-income countries require workplaces to provide accommodations to enable people with chronic disabilities to manage their condition at work. A barrier to successful implementation of such accommodations can be lack of co-workers' willingness to support people with T2D. This study aimed to examine the willingness to pay (WTP) of people with and without T2D for five workplace initiatives that help individuals with type 2 diabetes manage their diabetes at work. Three samples with employed Danish participants were drawn from existing online panels: a general population sample (n = 600), a T2D sample (n = 693), and a matched sample of people without diabetes (n = 539). Participants completed discrete choice experiments eliciting their WTP (reduction in monthly salary, €/month) for five hypothetical workplace initiatives: part-time job, customized work, extra breaks with pay, and time off for medical consultations with and without pay. WTP was estimated by conditional logits models. Bootstrapping was used to estimate confidence intervals for WTP. There was an overall WTP for all initiatives. Average WTP for all attributes was 34 €/month (95% confidence interval [CI]: 27-43] in the general population sample, 32 €/month (95% CI: 26-38) in the T2D sample, and 55 €/month (95% CI: 43-71) in the matched sample. WTP for additional breaks with pay was considerably lower than for the other initiatives in all samples. People with T2D had significantly lower WTP than people without diabetes for part-time work, customized work, and time off without pay, but not for extra breaks or time off with pay. For people with and without T2D, WTP was present for initiatives that could improve management of diabetes at the workplace. WTP was lowest among people with T2D. Implementation of these initiatives seems feasible and may help unnecessary exclusion of people with T2D from work.

Willingness to pay for a quality-adjusted life year: an evaluation of attitudes towards risk and preferences.

PubMed

Martín-Fernández, Jesus; Polentinos-Castro, Elena; del Cura-González, Ma Isabel; Ariza-Cardiel, Gloria; Abraira, Victor; Gil-LaCruz, Ana Isabel; García-Pérez, Sonia

2014-07-03

This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response. Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic and socioeconomic characteristics, as well as usage of health services by the subjects were collected. The attitude towards risk was evaluated by collecting risky behaviors data, by the subject's self-evaluation, and through lottery games. Six hundred and sixty two subjects participated and 449 stated a utility inferior to 1. WTP/QALY ratios varied significantly when payments with personal money (mean €10,119; median €673) or through taxes (mean €28,187; median €915) were suggested. Family income, area income, higher education level, greater use of healthcare services, and the number of co-inhabitants were associated with greater WTP/QALY ratios. Age and female gender were associated with lower WTP/QALY ratios. Risk inclination was independently associated with a greater WTP/QALY when "out of pocket" payments were suggested. Clear discrepancies were demonstrated between linearity and neutrality towards risk assumptions and experimental results. WTP/QALY ratios vary noticeably based on demographic and socioeconomic characteristics of the subject, but also on their attitude towards risk. Knowing the expression of preferences by patients from this outcome measurement can be of interest for health service planning.

Critical Review of Willingness to Pay for Clinical Oral Health Interventions

PubMed Central

Tan, Sharon Hui Xuan; Vernazza, Christopher R; Nair, Rahul

2017-01-01

Objectives This critical review aimed to identify, consolidate and evaluate the quality of Willingness to Pay (WTP) studies applied to clinical contexts in the field of dentistry. Methods PubMed and Web of Science databases were systematically searched for relevant publications. Screening and data extraction was then performed. Primary literature in English-language were included to assess the WTP for oral health interventions, when the valuations were applied to a clinical measure. Twenty-six publications met the inclusion criteria. Results WTP was elicited mainly via face-to-face interviews (13 publications) and questionnaires (12 publications). The majority (24) of publications selected an out-of-pocket payment vehicle. Eleven publications adopted a bidding method, nine publications adopted an open-ended format, and the remaining six studies adopted a payment card or choice method. Pre-testing was reported in only nine publications, and few studies accounted for starting point bias. Eight of 11 publications found that higher incomes were associated with higher WTP values. The female gender, a younger age and higher education levels were associated with a higher WTP in select studies. Conclusions Only a small minority of the studies used strategies to avoid well documented biases related to WTP elicitation. Cost versus benefit of many clinical scenarios remain uninvestigated. Clinical significance WTP studies in dentistry may benefit from pre-testing and the inclusion of a script to minimise hypothetical bias. They may also be better conducted face-to-face and via a shuffled payment card method. Income levels, and potentially education levels, gender and age, should be assessed for their influence on WTP values. PMID:28662842

Predicting hypothetical willingness to participate (WTP) in a future phase III HIV vaccine trial among high-risk adolescents.

PubMed

Giocos, Georgina; Kagee, Ashraf; Swartz, Leslie

2008-11-01

The present study sought to determine whether the Theory of Planned Behaviour predicted stated hypothetical willingness to participate (WTP) in future Phase III HIV vaccine trials among South African adolescents. Hierarchical logistic regression analyses showed that The Theory of Planned Behaviour (TPB) significantly predicted WTP. Of all the predictors, Subjective norms significantly predicted WTP (OR = 1.19, 95% C.I. = 1.06-1.34). A stepwise logistic regression analysis revealed that Subjective Norms (OR = 1.19, 95% C.I. = 1.07-1.34) and Attitude towards participation in an HIV vaccine trial (OR = 1.32, 95% C.I. = 1.00-1.74) were significant predictors of WTP. The addition of Knowledge of HIV vaccines and HIV vaccine trials, Perceived self-risk of HIV infection, Health-promoting behaviours and Attitudes towards HIV/AIDS yielded non-significant results. These findings provide support for the Theory of Reasoned Action (TRA) and suggest that psychosocial factors may play an important role in WTP in Phase III HIV vaccine trials among adolescents.

Approach for Configuring a Standardized Vessel for Processing Radioactive Waste Slurries

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

Bamberger, Judith A.; Enderlin, Carl W.; Minette, Michael J.

2015-09-10

A standardized vessel design is being considered at the Waste Treatment and Immobilization Plant (WTP) that is under construction at Hanford, Washington. The standardized vessel design will be used for storing, blending, and chemical processing of slurries that exhibit a variable process feed including Newtonian to non-Newtonian rheologies over a range of solids loadings. Developing a standardized vessel is advantageous and reduces the testing required to evaluate the performance of the design. The objectives of this paper are to: 1) present a design strategy for developing a standard vessel mixing system design for the pretreatment portion of the waste treatmentmore » plant that must process rheologically and physically challenging process streams, 2) identify performance criteria that the design for the standard vessel must satisfy, 3) present parameters that are to be used for assessing the performance criteria, and 4) describe operation of the selected technology. Vessel design performance will be assessed for both Newtonian and non-Newtonian simulants which represent a range of waste types expected during operation. Desired conditions for the vessel operations are the ability to shear the slurry so that flammable gas does not accumulate within the vessel, that settled solids will be mobilized, that contents can be blended, and that contents can be transferred from the vessel. A strategy is presented for adjusting the vessel configuration to ensure that all these conditions are met.« less

Eliciting patients’ values by use of ‘willingness to pay’: letting the theory drive the method

PubMed Central

Donaldson, Cam

2001-01-01

Objective To describe the three different ways in which ‘willingness to pay’ (WTP) has been used to elicit patients’ values of alternative interventions. Design For each of the three approaches a survey of patients or the public was undertaken. Setting, participants and interventions studied For two surveys, the setting was Aberdeen Maternity Hospital, where pregnant women were asked about their WTP for different methods of prenatal screening for cystic fibrosis. In the third survey, parents of primary and secondary schoolchildren were asked about their WTP for different ways of providing child health services. Main outcome measures Ability of WTP to discriminate between options (i.e. to say whether one option is ‘better’ than another) and the consistency of WTP with stated preferences. Results Experience with some methods shows that, despite the apparent logic of the technique, it is difficult to elicit consistent responses whereby WTP values derived match the rankings of interventions compared. The most promising technique, the ‘marginal approach’, happens to conform more with economic theory than other approaches. Potential limitations of WTP, such as its association with ability to pay, are discussed, as are approaches to dealing with such problems. Finally, if patients prefer an intervention that is more costly than the status quo, logic dictates that those extra resources will have to be obtained from another health‐care programme. In such contexts, to aid decision‐making, values derived from members of the community for different programmes may be more relevant than values derived from patients. Initial studies in the use of WTP in this broader context of eliciting community values are also outlined. Conclusions WTP has potential, but its application, and interpretation, are not straightforward. More testing of the ‘marginal approach’ is required and greater use of qualitative research, to assess the validity of the approach, should be made in this area. PMID:11493324

“Gaining or losing”: The importance of the perspective in primary care health services valuation

PubMed Central

Ariza-Cardiel, Gloria; Peña-Longobardo, Luz Mª; Polentinos-Castro, Elena; Oliva-Moreno, Juan; Gil-Lacruz, Ana Isabel; Medina-Palomino, Héctor; del Cura-González, Isabel

2017-01-01

Rationale and objectives Economic theory classifies an intervention as socially beneficial if the total Willingness to Pay (WTP) of those who gain exceeds the total Willingness to accept (WTA) of those who are harmed. This paper examines the differences in health system users’ valuation of a health care service in primary care setting based on the WTP and WTA perspectives, discussing the impact of personal and service variables, including risk attitudes, on these disparities. Method Six hundred and sixty two subjects who asked for care in health centres in the Region of Madrid (Spain) were interviewed, using the contingent valuation method to estimate WTP and WTA. Patient sociodemographic characteristics, health needs, satisfaction with the service and risk attitude and behaviour under risk (measured by self-reported scales and lottery games respectively) were collected. Generalised Linear Models were used to estimate the association between the explanatory variables and the WTA/WTP ratio. Results We obtained the WTA/WTP ratio for 570 subjects (mean 1.66 CI 95%: 1.53–1.79; median 1, interquartile range 1–2). People with higher education or in high social groups expressed WTA values closest to WTP. The opposite occurred in patients with the greatest health needs or who were born abroad. Self-reported expression of risk aversion appeared also related to increases in the WTA/WTP ratio. Satisfaction with the service evaluated was the most influential factor in the WTA/WTP ratio. Conclusion Health need, difficulty in obtaining substitutes and satisfaction with the service could serve for profiling people averse to loss for health care services in primary care setting. Self-reported expression of risk aversion could also be related to increases in the WTA/WTP ratio. This would mean that these characteristics should be taken into account both in the design and implementation of new healthcare interventions, as in the making decision for disinvestment. PMID:29206847

"Gaining or losing": The importance of the perspective in primary care health services valuation.

PubMed

Martín-Fernández, Jesús; Ariza-Cardiel, Gloria; Peña-Longobardo, Luz Mª; Polentinos-Castro, Elena; Oliva-Moreno, Juan; Gil-Lacruz, Ana Isabel; Medina-Palomino, Héctor; Del Cura-González, Isabel

2017-01-01

Economic theory classifies an intervention as socially beneficial if the total Willingness to Pay (WTP) of those who gain exceeds the total Willingness to accept (WTA) of those who are harmed. This paper examines the differences in health system users' valuation of a health care service in primary care setting based on the WTP and WTA perspectives, discussing the impact of personal and service variables, including risk attitudes, on these disparities. Six hundred and sixty two subjects who asked for care in health centres in the Region of Madrid (Spain) were interviewed, using the contingent valuation method to estimate WTP and WTA. Patient sociodemographic characteristics, health needs, satisfaction with the service and risk attitude and behaviour under risk (measured by self-reported scales and lottery games respectively) were collected. Generalised Linear Models were used to estimate the association between the explanatory variables and the WTA/WTP ratio. We obtained the WTA/WTP ratio for 570 subjects (mean 1.66 CI 95%: 1.53-1.79; median 1, interquartile range 1-2). People with higher education or in high social groups expressed WTA values closest to WTP. The opposite occurred in patients with the greatest health needs or who were born abroad. Self-reported expression of risk aversion appeared also related to increases in the WTA/WTP ratio. Satisfaction with the service evaluated was the most influential factor in the WTA/WTP ratio. Health need, difficulty in obtaining substitutes and satisfaction with the service could serve for profiling people averse to loss for health care services in primary care setting. Self-reported expression of risk aversion could also be related to increases in the WTA/WTP ratio. This would mean that these characteristics should be taken into account both in the design and implementation of new healthcare interventions, as in the making decision for disinvestment.

Determinants of willingness to pay for self-paid vaccines in China.

PubMed

Hou, Zhiyuan; Jie Chang; Yue, Dahai; Fang, Hai; Meng, Qingyue; Zhang, Yuting

2014-07-31

While vaccines not covered by China's Expanded Program on Immunization can be received voluntarily with out-of-pocket payment, the uptake of self-paid vaccines in China is low. To investigate willingness to pay (WTP) for self-paid vaccines and its determinants in China. We interviewed 2160 randomly selected households with children 0-3 years old, in 108 communities from three provinces in 2013. A bidding game method was used to elicit WTP for two self-paid vaccines: 7-valent pneumococcal conjugate vaccine and influenza vaccine. We conducted multivariate linear regressions to determine factors affecting the WTP. Median WTP for pneumococcal conjugate vaccine and influenza vaccine were Chinese Yuan 200 and 60 (10 US Dollars). 92% and 55% of respondents, respectively were not willing to pay the market price for these two vaccines. Lower price barrier and higher ability to pay were associated with higher WTP. Those with better vaccine or disease-related knowledge, higher perceived vulnerability and severity of diseases were willing to pay more. However, perceived effectiveness and safety barriers to vaccination had no significant effects on the WTP. Recommendations from peers and healthcare providers increased the WTP. Fathers and grand parents of children had a higher WTP than their mothers. The WTP decreased with age, but was not affected by education and occupation. The majority of individuals, in our study, were not willing to pay the market price for self-paid vaccines against high-burden diseases in China. The economic barriers to vaccination should therefore be removed to increase the demand. Region-specific information about disease burden, fiscal capacity and cost-effectiveness is important for the development of local financing policy in order to cover vaccination costs. Interventions targeting psychosocial factors, such as health education and communication with providers and peers, could also be effective in increasing the uptake of these vaccinations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Implications of a valuation study for ecological and social indicators associated with Everglades restoration.

PubMed

Seeteram, Nadia A; Engel, Victor; Mozumder, Pallab

2018-06-15

The Everglades of south Florida, although degraded, imparts vital ecosystem benefits, including contributions to high quality drinking water supplies and habitat for a number of threatened and endangered species. Restoration of the Everglades can improve the provision of these benefits but also may impose tradeoffs with competing societal demands. This study focuses on understanding public preferences for Everglades restoration and estimating the willingness to pay (WTP) values for restored ecosystem services (ES) through the implementation of a discrete choice experiment (DCE). We collected data from 2302 respondents from the general public from an online survey designed to elicit WTP values for selected ecological and social attributes associated with Everglades restoration scenarios. We compare the findings to results from earlier studies (Milon et al., 1999; Milon and Scrogin, 2005), which also estimated WTP values among Floridians for Everglades restoration. For some attributes, WTP for Everglades restoration appears to have slightly increased while for others WTP appears to have decreased. We estimated statewide aggregate WTP values for components of species population restoration up to $2B over 10 years. Several factors impeded a direct comparison of current and historical WTP values, including time elapsed, different samples and sampling methods- which may have implications for integrating ecosystem service valuation studies into water management decisions. Copyright © 2018 Elsevier B.V. All rights reserved.

Critical review of willingness to pay for clinical oral health interventions.

PubMed

Tan, Sharon Hui Xuan; Vernazza, Christopher R; Nair, Rahul

2017-09-01

This critical review aimed to identify, consolidate and evaluate the quality of Willingness to Pay (WTP) studies applied to clinical contexts in the field of dentistry. PubMed and Web of Science databases were systematically searched for relevant publications. Screening and data extraction was then performed. Primary literature in English-language were included to assess the WTP for oral health interventions, when the valuations were applied to a clinical measure. Twenty-six publications met the inclusion criteria. WTP was elicited mainly via face-to-face interviews (13 publications) and questionnaires (12 publications). The majority (24) of publications selected an out-of-pocket payment vehicle. Eleven publications adopted a bidding method, nine publications adopted an open-ended format, and the remaining six studies adopted a payment card or choice method. Pre-testing was reported in only nine publications, and few studies accounted for starting point bias. Eight of 11 publications found that higher incomes were associated with higher WTP values. The female gender, a younger age and higher education levels were associated with a higher WTP in select studies. Only a small minority of the studies used strategies to avoid well documented biases related to WTP elicitation. Cost versus benefit of many clinical scenarios remain uninvestigated. WTP studies in dentistry may benefit from pre-testing and the inclusion of a script to minimise hypothetical bias. They may also be better conducted face-to-face and via a shuffled payment card method. Income levels, and potentially education levels, gender and age, should be assessed for their influence on WTP values. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Factors affecting patient valuations of caries prevention: Using and validating the willingness to pay method.

PubMed

Vernazza, Christopher R; Wildman, John R; Steele, Jimmy G; Whitworth, John M; Walls, Angus W G; Perry, Ross; Matthews, Roger; Hahn, Petra; Donaldson, Cam

2015-08-01

Determining the value of, or strength of preference for health care interventions is useful for policy makers in planning health care services. Willingness to pay (WTP) is an established economic technique to determine the strength of preferences for interventions by eliciting monetary valuations from individuals in hypothetical situations. The objective of this study was to elicit WTP values for a dental preventive intervention and to analyze the factors affecting these as well as investigating the validity of the WTP method. Patients aged 40 years plus attending dental practices in the UK and Germany were recruited on a consecutive basis over one month. Participants received information about a novel root caries prevention intervention. They then completed a questionnaire including a WTP task. Where the coating was indicated, patients were offered this for a payment and acceptance was recorded. Analysis included econometric modelling and comparison of expected (based on stated WTP) versus actual behaviour. The mean WTP for the coating was £96.41 (standard deviation 60.61). Econometric models showed that no demographic or dental history factors were significant predictors of WTP. 63% of the sample behaved as expected when using stated WTP to predict whether they would buy the coating. The remainder were split almost equally between those expected to pay but who did not and those who were expected to refuse but paid. Values for a caries preventive intervention had a large and unpredictable variance. In comparing hypothetical versus real preferences both under- and over-valuation occurs. Wide and unpredictable variation in valuations for prevention may mean that there are difficult policy questions around what resource should be allocated to dental prevention and how to target this resource. Copyright © 2015 Elsevier Ltd. All rights reserved.

Willingness to pay per quality-adjusted life year: is one threshold enough for decision-making?: results from a study in patients with chronic prostatitis.

PubMed

Zhao, Fei-Li; Yue, Ming; Yang, Hua; Wang, Tian; Wu, Jiu-Hong; Li, Shu-Chuen

2011-03-01

To estimate the willingness to pay (WTP) per quality-adjusted life year (QALY) ratio with the stated preference data and compare the results obtained between chronic prostatitis (CP) patients and general population (GP). WTP per QALY was calculated with the subjects' own health-related utility and the WTP value. Two widely used preference-based health-related quality of life instruments, EuroQol (EQ-5D) and Short Form 6D (SF-6D), were used to elicit utility for participants' own health. The monthly WTP values for moving from participants' current health to a perfect health were elicited using closed-ended iterative bidding contingent valuation method. A total of 268 CP patients and 364 participants from GP completed the questionnaire. We obtained 4 WTP/QALY ratios ranging from $4700 to $7400, which is close to the lower bound of local gross domestic product per capita, a threshold proposed by World Health Organization. Nevertheless, these values were lower than other proposed thresholds and published empirical researches on diseases with mortality risk. Furthermore, the WTP/QALY ratios from the GP were significantly lower than those from the CP patients, and different determinants were associated with the within group variation identified by multiple linear regression. Preference elicitation methods are acceptable and feasible in the socio-cultural context of an Asian environment and the calculation of WTP/QALY ratio produced meaningful answers. The necessity of considering the QALY type or disease-specific QALY in estimating WTP/QALY ratio was highlighted and 1 to 3 times of gross domestic product/capita recommended by World Health Organization could potentially serve as a benchmark for threshold in this Asian context.

Occurrence of waterborne pathogens and Escherichia coli at offshore drinking water intakes in lake Ontario.

PubMed

Edge, T A; Khan, I U H; Bouchard, R; Guo, J; Hill, S; Locas, A; Moore, L; Neumann, N; Nowak, E; Payment, P; Yang, R; Yerubandi, R; Watson, S

2013-10-01

The occurrence of waterborne pathogens was investigated at three drinking water intakes located about 2 km offshore in Lake Ontario. Water sampling was conducted over 3 years for Campylobacter spp., Cryptosporidium spp., Giardia spp., cultivable enteric viruses, and water quality parameters. All pathogens were detected in the offshore source water for each water treatment plant (WTP1 to WTP3), although at relatively low frequencies and concentrations. Giardia was the most common pathogen, occurring in 36% of water samples from the influent of WTP1 (n = 46), and with a maximum concentration of 0.70 cysts/liter in this influent. Cryptosporidium occurred as frequently as 15% in the WTP2 influent (n = 35), with a maximum concentration of 0.40 oocysts/liter in the WTP1 influent. The human Bacteroidales HF183 DNA marker was most common in the WTP1 influent (19%), and this was the only WTP where the Cryptosporidium hominis genotype was detected. No water quality parameter was predictive of pathogen occurrence across all three WTP influents. Escherichia coli was often below detection when pathogens were detected, and spikes in E. coli concentrations often did not coincide with pathogen occurrence. After summer rain events, river plumes had E. coli concentrations as high as 222 CFU/100 ml in surface waters 2 km offshore, without impacting drinking water intakes below the thermocline on the lake bottom. At times, prechlorination to control mussels at offshore intake cribs compromised the use of E. coli for "raw" water quality assessment, particularly for chlorine-resistant Cryptosporidium. E. coli measured by standard methods did not reliably predict pathogen occurrence at drinking water intakes in offshore ecosystems.

Occurrence of Waterborne Pathogens and Escherichia coli at Offshore Drinking Water Intakes in Lake Ontario

PubMed Central

Khan, I. U. H.; Bouchard, R.; Guo, J.; Hill, S.; Locas, A.; Moore, L.; Neumann, N.; Nowak, E.; Payment, P.; Yang, R.; Yerubandi, R.; Watson, S.

2013-01-01

The occurrence of waterborne pathogens was investigated at three drinking water intakes located about 2 km offshore in Lake Ontario. Water sampling was conducted over 3 years for Campylobacter spp., Cryptosporidium spp., Giardia spp., cultivable enteric viruses, and water quality parameters. All pathogens were detected in the offshore source water for each water treatment plant (WTP1 to WTP3), although at relatively low frequencies and concentrations. Giardia was the most common pathogen, occurring in 36% of water samples from the influent of WTP1 (n = 46), and with a maximum concentration of 0.70 cysts/liter in this influent. Cryptosporidium occurred as frequently as 15% in the WTP2 influent (n = 35), with a maximum concentration of 0.40 oocysts/liter in the WTP1 influent. The human Bacteroidales HF183 DNA marker was most common in the WTP1 influent (19%), and this was the only WTP where the Cryptosporidium hominis genotype was detected. No water quality parameter was predictive of pathogen occurrence across all three WTP influents. Escherichia coli was often below detection when pathogens were detected, and spikes in E. coli concentrations often did not coincide with pathogen occurrence. After summer rain events, river plumes had E. coli concentrations as high as 222 CFU/100 ml in surface waters 2 km offshore, without impacting drinking water intakes below the thermocline on the lake bottom. At times, prechlorination to control mussels at offshore intake cribs compromised the use of E. coli for “raw” water quality assessment, particularly for chlorine-resistant Cryptosporidium. E. coli measured by standard methods did not reliably predict pathogen occurrence at drinking water intakes in offshore ecosystems. PMID:23835181

Willingness to pay for a quality-adjusted life year: an evaluation of attitudes towards risk and preferences

PubMed Central

2014-01-01

Background This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response. Methods Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic and socioeconomic characteristics, as well as usage of health services by the subjects were collected. The attitude towards risk was evaluated by collecting risky behaviors data, by the subject’s self-evaluation, and through lottery games. Results Six hundred and sixty two subjects participated and 449 stated a utility inferior to 1. WTP/QALY ratios varied significantly when payments with personal money (mean €10,119; median €673) or through taxes (mean €28,187; median €915) were suggested. Family income, area income, higher education level, greater use of healthcare services, and the number of co-inhabitants were associated with greater WTP/QALY ratios. Age and female gender were associated with lower WTP/QALY ratios. Risk inclination was independently associated with a greater WTP/QALY when “out of pocket” payments were suggested. Clear discrepancies were demonstrated between linearity and neutrality towards risk assumptions and experimental results. Conclusions WTP/QALY ratios vary noticeably based on demographic and socioeconomic characteristics of the subject, but also on their attitude towards risk. Knowing the expression of preferences by patients from this outcome measurement can be of interest for health service planning. PMID:24989615

Differences between willingness to pay and willingness to accept for visits by a family physician: A contingent valuation study

PubMed Central

2010-01-01

Background The economic value attributed by users of health services in public health systems can be useful in planning and evaluation. This value can differ from the perspectives of Willingness to Pay (WTP) and Willingness to Accept [Compensation] (WTA). Our objective was to study the perceptions of the patient about the service provided by the family physician by means of the WTA/WTP ratio. Methods An economic evaluation study by the Contingent Valuation Method was designed. Interviews were conducted with 451 subjects at six health centres (four urban and two rural) in areas with different socioeconomic characteristics. A payment card was used to measure the WTP and WTA. Other characteristics of the subject or service that could influence these responses were collected. An explicative model was constructed to study the WTA/WTP relationship. Results Four hundred and four subjects (89.6%) expressed a WTP and WTA different from zero. The WTA/WTP quotient showed a median of 1.55 (interquartile range 1-3.08) and a mean of 3.30 (IC 95%: 2.84-3.75). The WTA/WTP ratio increases with age and in low-income areas. It decreases in professional groups with more specialized activities, with growing family income, and in the chronically ill. Other characteristics related to the perception of state of health, accessibility to the service, satisfaction, or perception of risk were not explicative. Conclusions Subjects who were older and had a less favourable socioeconomic situation expressed a higher WTA/WTP ratio when valuing the visit to the family physician. These characteristics could identify a profile of "aversion to loss" with respect to this service. PMID:20459714

LITERATURE REVIEWS TO SUPPORT ION EXCHANGE TECHNOLOGY SELECTION FOR MODULAR SALT PROCESSING

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

King, W

2007-11-30

This report summarizes the results of literature reviews conducted to support the selection of a cesium removal technology for application in a small column ion exchange (SCIX) unit supported within a high level waste tank. SCIX is being considered as a technology for the treatment of radioactive salt solutions in order to accelerate closure of waste tanks at the Savannah River Site (SRS) as part of the Modular Salt Processing (MSP) technology development program. Two ion exchange materials, spherical Resorcinol-Formaldehyde (RF) and engineered Crystalline Silicotitanate (CST), are being considered for use within the SCIX unit. Both ion exchange materials havemore » been studied extensively and are known to have high affinities for cesium ions in caustic tank waste supernates. RF is an elutable organic resin and CST is a non-elutable inorganic material. Waste treatment processes developed for the two technologies will differ with regard to solutions processed, secondary waste streams generated, optimum column size, and waste throughput. Pertinent references, anticipated processing sequences for utilization in waste treatment, gaps in the available data, and technical comparisons will be provided for the two ion exchange materials to assist in technology selection for SCIX. The engineered, granular form of CST (UOP IE-911) was the baseline ion exchange material used for the initial development and design of the SRS SCIX process (McCabe, 2005). To date, in-tank SCIX has not been implemented for treatment of radioactive waste solutions at SRS. Since initial development and consideration of SCIX for SRS waste treatment an alternative technology has been developed as part of the River Protection Project Waste Treatment Plant (RPP-WTP) Research and Technology program (Thorson, 2006). Spherical RF resin is the baseline media for cesium removal in the RPP-WTP, which was designed for the treatment of radioactive waste supernates and is currently under construction in Hanford, WA. Application of RF for cesium removal in the Hanford WTP does not involve in-riser columns but does utilize the resin in large scale column configurations in a waste treatment facility. The basic conceptual design for SCIX involves the dissolution of saltcake in SRS Tanks 1-3 to give approximately 6 M sodium solutions and the treatment of these solutions for cesium removal using one or two columns supported within a high level waste tank. Prior to ion exchange treatment, the solutions will be filtered for removal of entrained solids. In addition to Tanks 1-3, solutions in two other tanks (37 and 41) will require treatment for cesium removal in the SCIX unit. The previous SCIX design (McCabe, 2005) utilized CST for cesium removal with downflow supernate processing and included a CST grinder following cesium loading. Grinding of CST was necessary to make the cesium-loaded material suitable for vitrification in the SRS Defense Waste Processing Facility (DWPF). Because RF resin is elutable (and reusable) and processing requires conversion between sodium and hydrogen forms using caustic and acidic solutions more liquid processing steps are involved. The WTP baseline process involves a series of caustic and acidic solutions (downflow processing) with water washes between pH transitions across neutral. In addition, due to resin swelling during conversion from hydrogen to sodium form an upflow caustic regeneration step is required. Presumably, one of these basic processes (or some variation) will be utilized for MSP for the appropriate ion exchange technology selected. CST processing involves two primary waste products: loaded CST and decontaminated salt solution (DSS). RF processing involves three primary waste products: spent RF resin, DSS, and acidic cesium eluate, although the resin is reusable and typically does not require replacement until completion of multiple treatment cycles. CST processing requires grinding of the ion exchange media, handling of solids with high cesium loading, and handling of liquid wash and conditioning solutions. RF processing requires handling and evaporation of cesium eluates, disposal of spent organic resin, and handling of the various liquid wash and regenerate solutions used. In both cases, the DSS will be immobilized in a low activity waste form. It appears that both technologies are mature, well studied, and generally suitable for this application. Technology selection will likely be based on downstream impacts or preferences between the various processing options for the two materials rather than on some unacceptable performance property identified for one material. As a result, the following detailed technical review and summary of the two technologies should be useful to assist in technology selection for SCIX.« less

A comparison of cheap talk and alternative certainty calibration techniques in contingent valuation

Treesearch

Mihail Samnaliev; Thomas Stevens; Thomas More

2003-01-01

A field test of cheap talk and two types of certainty calibration in contingent valuation of public lands indicated that cheap talk does not reduce WTP estimates. Use of a ten point certainty calibration scale reduces WTP estimates by about half. However, adjusting for uncertainty using a 'Not Sure' option does not reduce WTP estimates but increases the...

A Systematic Review of Studies Eliciting Willingness-to-Pay per Quality-Adjusted Life Year: Does It Justify CE Threshold?

PubMed Central

Nimdet, Khachapon; Chaiyakunapruk, Nathorn; Vichansavakul, Kittaya; Ngorsuraches, Surachat

2015-01-01

Background A number of studies have been conducted to estimate willingness to pay (WTP) per quality-adjusted life years (QALY) in patients or general population for various diseases. However, there has not been any systematic review summarizing the relationship between WTP per QALY and cost-effectiveness (CE) threshold based on World Health Organization (WHO) recommendation. Objective To systematically review willingness-to-pay per quality-adjusted-life-year (WTP per QALY) literature, to compare WTP per QALY with Cost-effectiveness (CE) threshold recommended by WHO, and to determine potential influencing factors. Methods We searched MEDLINE, EMBASE, Psyinfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Center of Research Dissemination (CRD), and EconLit from inception through 15 July 2014. To be included, studies have to estimate WTP per QALY in health-related issues using stated preference method. Two investigators independently reviewed each abstract, completed full-text reviews, and extracted information for included studies. We compared WTP per QALY to GDP per capita, analyzed, and summarized potential influencing factors. Results Out of 3,914 articles founded, 14 studies were included. Most studies (92.85%) used contingent valuation method, while only one study used discrete choice experiments. Sample size varied from 104 to 21,896 persons. The ratio between WTP per QALY and GDP per capita varied widely from 0.05 to 5.40, depending on scenario outcomes (e.g., whether it extended/saved life or improved quality of life), severity of hypothetical scenarios, duration of scenario, and source of funding. The average ratio of WTP per QALY and GDP per capita for extending life or saving life (2.03) was significantly higher than the average for improving quality of life (0.59) with the mean difference of 1.43 (95% CI, 1.81 to 1.06). Conclusion This systematic review provides an overview summary of all studies estimating WTP per QALY studies. The variation of ratio of WTP per QALY and GDP per capita depended on several factors may prompt discussions on the CE threshold policy. Our research work provides a foundation for defining future direction of decision criteria for an evidence-informed decision making system. PMID:25855971

Cost benefit analysis of malaria rapid diagnostic test: the perspective of Nigerian community pharmacists.

PubMed

Ezennia, Ifeoma Jovita; Nduka, Sunday Odunke; Ekwunife, Obinna Ikechukwu

2017-01-03

In 2010, the World Health Organization issued a guideline that calls for a shift from presumptive to test-based treatment. However, test-based treatment is still unpopular in community pharmacies. This could be due to unwillingness of customers to spend extra finance on rapid diagnostic test (RDT). It could also result from lack of interest from community pharmacists since they may perceive no financial gain attached to this service. This study assessed the cost-benefit of test-based malaria treatment to community pharmacists. The study was a community pharmacy-based cross sectional survey. Potential benefit of RDT was determined using customers' willingness-to-pay (WTP) for service. Average WTP was estimated using contingent valuation. Binary logistic regression was used to assess correlates of WTP acceptance while multiple linear regression was used to model the relationship between the independent variables and WTP amount. Cost associated with provision of RDT was estimated from provider's perspective. Probabilistic sensitivity analysis was used to capture parameter uncertainty. Benefit-cost ratio (BCR) was calculated to determine study objective. A total of 135 out of 235 participants (57.4%) responded to the WTP question. Of this subset, 111 participants (82.2%) preferred RDT before malaria treatment. Average WTP [minimum-maximum] was US$1.23 [US$0.0-US$5.03]. Educated participants had 1.8 times higher odds of WTP for RDT. Participants that understood RDT as described in the questionnaire had 18.3 times higher odds of WTP for RDT compared to participants that did not understand RDT as described in the questionnaire. Additionally, a unit increase in level of education (e.g. from primary to secondary school) led to US$0.298 increase in WTP amount for RDT. Also, a unit increase in malaria frequency (e.g. from 'never' to 'rarely') led to US$0.293 decrease in WTP amount for RDT. Average cost [minimum-maximum] of RDT test kit and pharmacist time spent in administering the test were US$0.15 [US$0.13-US$0.17] and US$0.41 [US$0.18-US$0.52], respectively. BCR of test-based malaria treatment was 6.7 (95% CI 6.4-7.0). Test-based malaria treatment is cost-beneficial for pharmacy practitioners. This finding could be used as an advocacy tool to increase community pharmacists' interest and uptake of test-based malaria treatment.

Willingness to pay for the social health insurance in Iran.

PubMed

Nosratnejad, Shirin; Rashidian, Arash; Mehrara, Mohsen; Akbari Sari, Ali; Mahdavi, Ghadir; Moeini, Maryam

2014-05-30

The substantial level of out-of-pocket expenditure for health care by the population causes policy makers to draw particular attention to the proposal of a social health insurance for uninsured members of the community. Hence, it is essential to gather reliable information about the amount of Willingness To Pay (WTP) for health insurance. We assessed the WTP for health insurance in Iran in order to suggest an affordable social health insurance. The study sample included 300 household heads in all Iranian provinces. The double bounded dichotomous choice approach was used to elicit the WTP. The average WTP for social health insurance per person per month was 137 000 Rial (5.5 $US). Household heads with higher levels of education, income and those who worked had more WTP for the health insurance. Besides, the WTP increased in direct proportion to the number of insured members of each household and in inverse proportion to the family size. From a policy point of view, the WTP value can be used as a premium in a society. An important finding of this study is that although households' Willingness To Pay is not more than the total insurance premium, households are willing to pay more than the premium they ought to pay for health insurance coverage. That is, total insurance premium is 150 000 Rials and households ought to pay approximately half of this sum. This can afford policy makers the ideal opportunity to provide good insurance coverage for medical services according to the need of society.

Tungsten Transport Protein A (WtpA) in Pyrococcus furiosus: the First Member of a New Class of Tungstate and Molybdate Transporters

PubMed Central

Bevers, Loes E.; Hagedoorn, Peter-Leon; Krijger, Gerard C.; Hagen, Wilfred R.

2006-01-01

A novel tungstate and molybdate binding protein has been discovered from the hyperthermophilic archaeon Pyrococcus furiosus. This tungstate transport protein A (WtpA) is part of a new ABC transporter system selective for tungstate and molybdate. WtpA has very low sequence similarity with the earlier-characterized transport proteins ModA for molybdate and TupA for tungstate. Its structural gene is present in the genome of numerous archaea and some bacteria. The identification of this new tungstate and molybdate binding protein clarifies the mechanism of tungstate and molybdate transport in organisms that lack the known uptake systems associated with the ModA and TupA proteins, like many archaea. The periplasmic protein of this ABC transporter, WtpA (PF0080), was cloned and expressed in Escherichia coli. Using isothermal titration calorimetry, WtpA was observed to bind tungstate (dissociation constant [KD] of 17 ± 7 pM) and molybdate (KD of 11 ± 5 nM) with a stoichiometry of 1.0 mol oxoanion per mole of protein. These low KD values indicate that WtpA has a higher affinity for tungstate than do ModA and TupA and an affinity for molybdate similar to that of ModA. A displacement titration of molybdate-saturated WtpA with tungstate showed that the tungstate effectively replaced the molybdate in the binding site of the protein. PMID:16952940

Willingness to pay for health insurance among the elderly population in Germany.

PubMed

Bock, Jens-Oliver; Heider, Dirk; Matschinger, Herbert; Brenner, Hermann; Saum, Kai-Uwe; Haefeli, Walter E; König, Hans-Helmut

2016-03-01

All elderly Germans are legally obliged to have health insurance. About 90 % of this population are members of social health insurances (SHI) whose premiums are generally income-related and independent of health status. For most of these members, holding social health insurance is mandatory. As a consequence, genuine information about preferences for health insurance is not available. The aim of this study was therefore to determine and analyze the willingness to pay (WTP) for health insurance among elderly Germans. Data from a population-based 8-year follow-up of a large cohort study conducted in the Saarland, Germany was used. Participants aged 57-84 years passed a geriatric assessment and responded to a health economic questionnaire. Individuals' WTP was elicited based on a contingent valuation method with a payment card. Mean monthly WTP per capita for health insurance amounted to €260. This corresponded to about 20% of individual disposable income. Regression analyses showed that WTP increased significantly with higher income, male gender, higher educational level, and privately insured status. In contrast, neither increasing morbidity level nor higher individual health care costs influenced WTP significantly. The relatively large extent of average WTP for health insurance indicates that the elderly would probably accept higher contributions to SHI rather than policy efforts to reduce contributions. The identified determinants of WTP might indicate that elderly generally approve the principle of solidarity of the SHI with contributions depending on income rather than morbidity.

Value orientation and payment for ecosystem services: Perceived detrimental consequences lead to willingness-to-pay for ecosystem services.

PubMed

Obeng, Elizabeth Asantewaa; Aguilar, Francisco Xavier

2018-01-15

This research analyzed whether the three distinct value orientations posited under the Value-Belief-Norm (VBN) model determine willingness-to-pay (WTP) for a payment for ecosystem services (PES) program. A survey instrument gathered U.S. residents' knowledge and attitudes toward ecosystem services and PES, and elicited WTP for the restoration of a hypothetical degraded forest watershed for improved ecosystem services. Data from over 1000 respondents nationwide were analyzed using exploratory factor analysis (EFA) and ordered logistic regression. Urban respondents were more familiar with the concepts of ecosystem service and PES than rural respondents but familiarity did not yield statistically different WTP estimates. Based on results from the EFA, we posit that latent value orientations might be distinguished as 'detrimental', 'biospheric' and 'beneficial (egoistic)' - as compared to 'altruistic', 'biospheric' and 'egoistic' as suggested in the VBN's general awareness of consequences scale. Awareness of biospheric and detrimental consequences along with ascriptions to personal norms had positive and significant effects on stated WTP. Beneficial (egoistic) value orientation was negatively associated with WTP and carried a negative average WTP per household per year (US$ -30.48) for the proposed PES restoration program as compared with biospheric (US$ 15.53) and detrimental (US$ 3.96) orientations. Besides personal norms, awareness of detrimental consequences to human wellbeing from environmental degradation seems the stronger driver of WTP for the restoration and protection of forest watershed ecosystem services under a PES program. Copyright © 2017 Elsevier Ltd. All rights reserved.

Willingness to pay per quality-adjusted life year for life-saving treatments in Thailand

PubMed Central

Nimdet, Khachapon; Ngorsuraches, Surachat

2015-01-01

Objective To estimate the willingness to pay (WTP) per quality-adjusted life year (QALY) value for life-saving treatments and to determine factors affecting the WTP per QALY value. Design A cross-sectional survey with multistage sampling and face-to-face interviews. Setting General population in the southern part of Thailand. Participants A total of 600 individuals were included in the study. Only 554 (92.3%) responses were usable for data analyses. Outcome measure Participants were asked for the maximum amount of WTP value for life-saving treatments by an open-ended question. EQ-5D-3L and visual analogue scale (VAS) were used to estimate additional QALY. Results The amount of WTP values varied from 0 to 720 000 Baht/year (approximately 32 Baht=US$1). The averages of additional QALY obtained from VAS and EQ-5D-3L were only slightly different (0.872 and 0.853, respectively). The averages of WTP per QALY obtained from VAS and EQ-5D-3L were 244720 and 243120 Baht/QALY, respectively. As compared to male participants, female participants were more likely to pay less for an additional QALY (p=0.007). In addition, participants with higher household incomes tended to have higher WTP per QALY values (p<0.001). Conclusions Our study added another WTP per QALY value specifically for life-saving treatments, which would complement the current cost-effectiveness threshold used in Thailand and optimise patient access to innovative treatments or technologies. PMID:26438135

Willingness to Pay for Conservation of Transborder Migratory Species: A Case Study of the Mexican Free-Tailed Bat in the United States and Mexico.

PubMed

Haefele, Michelle A; Loomis, John B; Merideth, Robert; Lien, Aaron; Semmens, Darius J; Dubovsky, James; Wiederholt, Ruscena; Thogmartin, Wayne E; Huang, Ta-Ken; McCracken, Gary; Medellin, Rodrigo A; Diffendorfer, James E; López-Hoffman, Laura

2018-05-06

We estimated U.S. and Mexican citizens' willingness to pay (WTP) for protecting habitat for a transborder migratory species, the Mexican free-tailed bat (Tadarida brasiliensis mexicana), using the contingent valuation method. Few contingent valuation surveys have evaluated whether households in one country would pay to protect habitat in another country. This study addresses that gap. In our study, Mexican respondents were asked about their WTP for conservation of Mexican free-tailed bat habitat in Mexico and in the United States. Similarly, U.S. respondents were asked about their WTP for conservation in the United States and in Mexico. U.S. households would pay $30 annually to protect habitat in the United States and $24 annually to protect habitat in Mexico. Mexican households would pay $8 annually to protect habitat in Mexico and $5 annually to protect habitat in the United States. In both countries, these WTP amounts rose significantly for increasing the size of the bat population rather than simply stabilizing the current bat population. The ratio of Mexican household WTP relative to U.S. household WTP is nearly identical to that of Mexican household income relative to U.S. household income. This suggests that the perceived economic benefits received from the bats is similar in Mexico and the United States, and that scaling WTP by relative income in international benefit transfer may be plausible.

Sadr City R3 Water Treatment Plant Baghdad, Iraq

DTIC Science & Technology

2008-10-29

Agency for International Development 41 I. Assessment Team Members 47 1 Introduction Background A water treatment plant ( WTP ) is a vital...goals, the responsibility lies not only with the WTP , but also with the community. Community actions include: keeping the water source free of debris...in the distribution system, and most importantly, using this valuable produced resource responsibly. Prior to construction of the Sadr City WTP

Willingness to pay for private primary care services in Hong Kong: are elderly ready to move from the public sector?

PubMed

Liu, Su; Yam, Carrie H K; Huang, Olivia H Y; Griffiths, Sian M

2013-10-01

How to provide better primary care and achieve the right level of public-private balance in doing so is at the centre of many healthcare reforms around the world. In a healthcare system like Hong Kong, where inpatient services are largely funded through general taxation and ambulatory services out of pocket, the family doctor model of primary care is underdeveloped. Since 2008, the Government has taken forward various initiatives to promote primary care and encourage more use of private services. However, little is known in Hong Kong or elsewhere about consumers' willingness to pay (WTP) for private services when care is available in the public sector. This study assessed willingness of the Hong Kong elderly to pay for specific primary care and preventive services in the private sector, through a cross-sectional in-person questionnaire survey and focus group discussions among respondents. The survey revealed that the WTP for private services in general was low among the elderly; particularly, reported WTP for chronic conditions and preventive care both fell below the current market prices. Sub-group analysis showed higher WTP among healthier and more affluent elderly. Among other things, concerns over affordability and uncertainty (of price and quality) in the private sector were associated with this low level of WTP. These results suggest that most elderly, who are heavy users of public health services but with limited income, may not use more private services without seeing significant reduction in price. Financial incentives for consumers alone may not be enough to promote primary care or public-private partnership. Public education on the value of prevention and primary care, as well as supply-side interventions should both be considered. Hong Kong's policy-making process of the initiative studied here may also provide lessons for other countries with ongoing healthcare reforms.

Economic Valuation of Selected Illnesses in Environmental Public Health Tracking.

PubMed

Zhou, Ying; Nurmagambetov, Tursynbek; McCord, Matthew; Hsu, Wan-Hsiang

In benefit-cost analysis of public health programs, health outcomes need to be assigned monetary values so that different health endpoints can be compared and improvement in health can be compared with cost of the program. There are 2 major approaches for estimating economic value of illnesses: willingness to pay (WTP) and cost of illness (COI). In this study, we compared these 2 approaches and summarized valuation estimates for 3 health endpoints included in the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Network-asthma, carbon monoxide (CO) poisoning, and lead poisoning. First, we compared results of WTP and COI estimates reported in the peer-reviewed literature when these 2 methods were applied to the same study participants. Second, we reviewed the availability and summarized valuations using these 2 approaches for 3 health endpoints. For the same study participants, WTP estimates in the literature were higher than COI estimates for minor and moderate cases. For more severe cases, with substantial portion of the costs paid by the third party, COI could exceed WTP. Annual medical cost of asthma based on COI approach ranged from $800 to $3300 and indirect costs ranged from $90 to $1700. WTP to have no asthma symptoms ranged from $580 to $4200 annually. We found no studies estimating WTP to avoid CO or lead poisoning. Cost of a CO poisoning hospitalization ranged from $14 000 to $17 000. For patients who sustained long-term cognitive sequela, lifetime earnings and quality-of-life losses can significantly exceed hospitalization costs. For lead poisoning, most studies focused on lead exposure and cognitive ability, and its impact on lifetime earnings. For asthma, more WTP studies are needed, particularly studies designed for conditions that involve third-party payers. For CO poisoning and lead poisoning, WTP studies need to be conducted so that more comprehensive economic valuation estimates can be provided. When COI estimates are used alone, it should be clearly stated that COI does not fully capture the nonmarket cost of illness, such as pain and suffering, which highlights the need for WTP estimates.

Willingness-to-Pay for Community-Based Health Insurance among Informal Workers in Urban Bangladesh.

PubMed

Ahmed, Sayem; Hoque, Mohammad Enamul; Sarker, Abdur Razzaque; Sultana, Marufa; Islam, Ziaul; Gazi, Rukhsana; Khan, Jahangir A M

2016-01-01

Reliance on out-of-pocket payment for healthcare may lead poor households to undertake catastrophic health expenditure, and risk-pooling mechanisms have been recommended to mitigate such burdens for households in Bangladesh. About 88% of the population of Bangladesh depends on work in the informal sector. We aimed to estimate willingness-to-pay (WTP) for CBHI and identify its determinants among three categories of urban informal workers rickshaw-pullers, shopkeepers and restaurant workers. The bidding game version of contingent valuation method was used to estimate weekly WTP. In three urban locations 557 workers were interviewed using a structured questionnaire during 2010 and 2011. Multiple-regression analysis was used to predict WTP by demographic and household characteristics, occupation, education level and past illness. WTP for a CBHI scheme was expressed by 86.7% of informal workers. Weekly average WTP was 22.8 BDT [Bangladeshi Taka; 95% confidence interval (CI) 20.9-24.8] or 0.32 USD and varied significantly across occupational groups (p = 0.000) and locations (p = 0.003). WTP was highest among rickshaw-pullers (28.2 BDT or 0.40 USD; 95% CI: 24.7-31.7), followed by restaurant workers (20.4 BDT 0.29 USD; 95% CI: 17.0-23.8) and shopkeepers (19.2 BDT or 0.27 USD; 95% CI: 16.1-22.4). Multiple regression analysis identified monthly income, occupation, geographical location and educational level as the key determinants of WTP. WTP increased 0.196% with each 1% increase in monthly income, and was 26.9% lower among workers with up to a primary level of education versus those with higher than primary, but less than one year of education. Informal workers in urban areas thus are willing to pay for CBHI and socioeconomic differences explain the magnitude of WTP. The policy maker might think introducing community-based model including public-community partnership model for healthcare financing of informal workers. Decision making regarding the implementation of such schemes should consider worker location and occupation.

Willingness-to-Pay for Community-Based Health Insurance among Informal Workers in Urban Bangladesh

PubMed Central

Ahmed, Sayem; Hoque, Mohammad Enamul; Sarker, Abdur Razzaque; Sultana, Marufa; Islam, Ziaul; Gazi, Rukhsana; Khan, Jahangir A. M.

2016-01-01

Introduction Reliance on out-of-pocket payment for healthcare may lead poor households to undertake catastrophic health expenditure, and risk-pooling mechanisms have been recommended to mitigate such burdens for households in Bangladesh. About 88% of the population of Bangladesh depends on work in the informal sector. We aimed to estimate willingness-to-pay (WTP) for CBHI and identify its determinants among three categories of urban informal workers rickshaw-pullers, shopkeepers and restaurant workers. Methods The bidding game version of contingent valuation method was used to estimate weekly WTP. In three urban locations 557 workers were interviewed using a structured questionnaire during 2010 and 2011. Multiple-regression analysis was used to predict WTP by demographic and household characteristics, occupation, education level and past illness. Results WTP for a CBHI scheme was expressed by 86.7% of informal workers. Weekly average WTP was 22.8 BDT [Bangladeshi Taka; 95% confidence interval (CI) 20.9–24.8] or 0.32 USD and varied significantly across occupational groups (p = 0.000) and locations (p = 0.003). WTP was highest among rickshaw-pullers (28.2 BDT or 0.40 USD; 95% CI: 24.7–31.7), followed by restaurant workers (20.4 BDT 0.29 USD; 95% CI: 17.0–23.8) and shopkeepers (19.2 BDT or 0.27 USD; 95% CI: 16.1–22.4). Multiple regression analysis identified monthly income, occupation, geographical location and educational level as the key determinants of WTP. WTP increased 0.196% with each 1% increase in monthly income, and was 26.9% lower among workers with up to a primary level of education versus those with higher than primary, but less than one year of education. Conclusion Informal workers in urban areas thus are willing to pay for CBHI and socioeconomic differences explain the magnitude of WTP. The policy maker might think introducing community-based model including public-community partnership model for healthcare financing of informal workers. Decision making regarding the implementation of such schemes should consider worker location and occupation. PMID:26828935

Integrated Watershed Management to Rehabilitate the Distorded Hydrologic Cycle in a Korean Urban Region

NASA Astrophysics Data System (ADS)

Lee, K.; Chung, E.; Park, K.

2007-12-01

Many urbanized watersheds suffer from streamflow depletion and poor stream quality, which often negatively affects related factors such as in-stream and near-stream ecologic integrity and water supply. But any watershed management which does not consider all potential risks is not proper since all hydrological components are closely related. Therefore this study has developed and applied a ten-step integrated watershed management (IWM) procedure to sustainably rehabilitate distorted hydrologic cycles due to urbanization. Step 1 of this procedure is understanding the watershed component and processes. This study proposes not only water quantity/quality monitoring but also continuous water quantity/quality simulation and estimation of annual pollutant loads from unit loads of all landuses. Step 2 is quantifying the watershed problem as potential flood damage (PFD), potential streamflow depletion (PSD), potential water quality deterioration (PWQD) and watershed evaluation index (WEI). All indicators are selected from the sustainability concept, Pressure-State- Response (PSR) model. All weights are estimated by Analytic Hierarchy Process (AHP). Four indices are calculated using composite programming, a kind of multicritera decision making technque. In Step 3 residents' preference on management objectives which consists of flood damage mitigation, prevention of streamflow depletion, and water quality enhancement are quantified. WEI can be recalculated using these values. Step 4 requires one to set the specific goals and objectives based on the results from Step 2 and 3. Objectives can include spatial flood allocation, instreamflow requirement and total maximum daily load (TMDL). Step 5 and 6 are developing all possible alternatives and to eliminate the infeasible. Step 7 is analyzing the effectiveness of all remaining feasible alternatives. The criteria of water quantity are presented as changed lowflow(Q275) and drought flow(Q355) of flow duration curve and number of days to satisfy the instreamflow requirement. Also the criteria of water quality are proposed as changed average BOD concentration and total daily loads and number of days to satisfy the TMDL. Step 8 involves the calculation of AEI using various MCDM techniques. The indicators of AEI are obtained by the sustainability concept, Drivers-Pressure-State-Impact-Response (DPSIR), an improved PSR model. All previous results are used in this step. Step 9 is estimating the benefit and cost of alternatives. Discrete Willingness To Pay (WTP) for the specific improvement of some current watershed conditions are estimated by the choice experiment method which is an economic valuation with stated presence techniques. WTPs of specific alternatives are calculated by combining AEI and choice experiment results. Therefore, the benefit of alternatives can be obtained by multiplying WTP and total household value of the sub-watershed. Finally in Step 10 the final alternatives comparing the net benefit and BC ratio are determined. Final alternatives derived from the proposed IWM procedure should not be carried out immediately but be discussed by stakeholders and decision makers. However, since plans obtained from the elaborated analyses reflect even sustainability concept, these alternatives can be apt to be accepted comparatively. This ten-step procedure will be helpful in making decision support system for sustainable IWM.

Demand for health care in Denmark: results of a national sample survey using contingent valuation.

PubMed

Gyldmark, M; Morrison, G C

2001-10-01

In this paper we use willingness to pay (WTP) to elicit values for private insurance covering treatment for four different health problems. By way of obtaining these values, we test the viability of the contingent valuation method (CVM) and econometric techniques, respectively, as means of eliciting and analysing values from the general public. WTP responses from a Danish national sample survey, which was designed in accordance with existing guidelines, are analysed in terms of consistency and validity checks. Large numbers of zero responses are common in WTP studies, and are found here; therefore, the Heckman selectivity model and log-transformed OLS are employed. The selectivity model is rejected, but test results indicate that the lognormal model yields efficient and unbiased estimates. The results give confidence in the WTP estimates obtained and, more generally, in CVM as a means of valuing publicly provided goods and in econometrics as a tool for analysing WTP results containing many zero responses.

Assessing community values in health care: is the 'willingness to pay' method feasible?

PubMed

Donaldson, C; Farrar, S; Mapp, T; Walker, A; Macphee, S

1997-03-01

In this paper an economics approach to assessing community values in health care priority setting is examined. The approach is based on the concept of 'willingness to pay' (WTP). Eighty two parents were interviewed with regard to three aspects of provision of child health services. For each aspect a choice of two courses of action was presented. Parents were asked which course of action they preferred and what was the maximum amount of money they would be prepared to pay for this rather than their less preferred option. WTP responses are acceptable to the majority of respondents and appear to 'behave' in accordance with a priori expectations. A method of assessing the influence of ability to pay on preferences and WTP is outlined. Preferences and WTP do not appear to have been unduly distorted by ability to pay. Use of WTP data does have the potential to provide health care purchasers and providers with information on intensity as well as direction of the preferences of members of the community.

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

Russell, Renee L.; Fiskum, Sandra K.; Smoot, Margaret R.

Washington River Protection Solutions (WRPS) is developing a Low-Activity Waste Pretreatment System (LAWPS) to provide low-activity waste (LAW) directly to the Hanford Tank Waste Treatment and Immobilization Plant (WTP) Low-Activity Waste Facility for immobilization. The pretreatment that will be conducted on tank waste supernate at the LAWPS facility entails filtration to remove entrained solids and cesium (Cs) ion exchange to remove Cs from the product sent to the WTP. Currently, spherical resorcinol-formaldehyde (sRF) resin (Microbeads AS, Skedsmokorset, Norway) is the Cs ion exchange resin of choice. Most work on Cs ion exchange efficacy in Hanford tank waste has been conductedmore » at nominally 5 M sodium (Na). WRPS is examining the possibility of processing supernatant at high Na concentrations—up to 8 M Na—to maximize processing efficiency through the LAWPS. Minimal Cs ion exchange work has been conducted at 6 M and 8 M Na concentrations..« less

Willingness to pay for the maintenance of equity in a local ivermectin distribution scheme in Toro, Northern Nigeria.

PubMed

Onwujekwe, O E; Shu, E N; Okonkwo, P O

1999-07-01

The willingness to pay (WTP) for the maintenance of equity in a local ivermectin distribution scheme in the context of a community financing framework was determined in Toro, Northern Nigeria, using 214 randomly selected heads of households, or their representatives. Though WTP of the respondents for their own households was elicited, the focus of this paper is on WTP to maintain equity in a community financing scheme. Contingent valuation was used for the exercise, and WTP was elicited using an open-ended question. 97.2% of the respondents were in favour of allowing those that lack the ability to pay, to benefit from the scheme and the maximum WTP amounts they were willing to contribute annually so that those who lack the ability to pay could benefit from the scheme ranged from 5 Naira ($0. 06) to 100 Naira ($1.25). The mean WTP to maintain equity was 29.00 Naira ($0.36) while the median was 20.00 Naira ($0.25). This study shows that a community financing scheme for local ivermectin distribution will not be inequitable, since enough funds will be realised from well-to-do community members to cover the costs for those who are unable to pay.

Willingness to pay and benefit-cost analysis of modern contraceptives in Nigeria.

PubMed

Onwujekwe, Obinna; Ogbonna, Chinwe; Ibe, Ogochukwu; Uzochukwu, Benjamin

2013-08-01

To determine the willingness to pay (WTP) and the benefit-cost of modern contraceptives delivered through the public sector in Nigeria. Data were collected from 4517 randomly selected households. The WTP for the 6 major contraceptive methods available in the public sector was elicited. Logistic regression was used to determine whether the decision to state a positive WTP amount was valid; Tobit regression was used to test the validity of the elicited WTP amounts. For each contraceptive, 3 BCR values were computed, based on the official unit price, the unit cost per couple-year of protection (CYP), and the average actual expenditure for contraceptives in the month preceding the interview. The mean WTP for the different contraceptives varied by socioeconomic status and geographic (urban versus rural) location (P<0.01). The BCR analysis showed that the benefits of providing contraceptives through the public sector far outweighed the costs, except for female condoms, where the CYP-based BCR was 0.9. The benefits of providing contraceptives outweigh the costs, making public sector investment worthwhile. The median WTP amounts, which reflect the ideal upper thresholds for pricing, indicate that cost recovery is feasible for all contraceptives. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Mobile phone use and willingness to pay for SMS for diabetes in Bangladesh.

PubMed

Shariful Islam, Sheikh Mohammed; Lechner, Andreas; Ferrari, Uta; Seissler, Jochen; Holle, Rolf; Niessen, Louis W

2016-03-01

Mobile phone SMS is increasingly used as a means of communication between patients and their healthcare providers in many countries of the world. We investigated mobile phone use and factors associated with willingness-to-pay (WTP) for diabetes SMS among patients with type 2 diabetes in Bangladesh. As part of a randomized controlled study, in 515 patients with type 2 diabetes, socioeconomic status, mobile phone use, WTP for diabetes SMS, anthropometry and HbA1c were measured. Multivariate regression was used to identify factors associated with WTP. The median (interquartile range [IQR]) of WTP for diabetes SMS was 20 (45) Bangladesh Taka (BDT) (1 BDT = 0.013 US$). WTP was significantly higher for males [OR 2.4, 95% CI (1.0-5.7)], patients with household income >50 000 BDT [4.6 (1.1-20.4)] and those with primary education [5.6 (1.2-26.6)] and secondary and higher education [5.2 (1.4-19.6)]. The high proportion of mobile phone use and WTP for diabetes SMS are encouraging as possible strategy to use such technologies and deserve further evaluation. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

WTP for a QALY and health states: More money for severer health states?

PubMed Central

2013-01-01

Background In economic evaluation, cost per quality-adjusted life year (QALY) is generally used as an indicator for cost-effectiveness. Although JPY 5 million to 6 million (USD 60, 000 to 75,000) per QALY is frequently referred to as a threshold in Japan, do all QALYs have the same monetary value? Methods To examine the relationship between severity of health status and monetary value of a QALY, we obtained willingness to pay (WTP) values for one additional QALY in eight patterns of health states. We randomly sampled approximately 2,400 respondents from an online panel. To avoid misunderstanding, we randomly allocated respondents to one of 16 questionnaires, with 250 responses expected for each pattern. After respondents were asked whether they wanted to purchase the treatment, double-bounded dichotomous choice method was used to obtain WTP values. Results The results clearly show that the WTP per QALY is higher for worse health states than for better health states. The slope was about JPY −1 million per 0.1 utility score increase. The mean and median WTP values per QALY for 16 health states were JPY 5 million, consistent with our previous survey. For respondents who wanted to purchase the treatment, WTP values were significantly correlated with household income. Conclusion This survey shows that QALY based on the EQ-5D does not necessarily have the same monetary value. The WTP per QALY should range from JPY 2 million (USD 20,000) to JPY 8 million (USD 80,000), corresponding to the severity of health states. PMID:24128004

Implementation of Instrument Based on Eight Health Related Quality of Life Domains for Measuring of Willingness to Pay for Psoriasis Treatment.

PubMed

Dobrev, Hristo P; Atanasov, Nikolay G; Dimitrova, Donka D

2017-09-01

Psoriasis vulgaris (PsV) is a chronic skin condition that has a major impact on health-related quality of life (HRQOL). To determine the individual burden of PsV on HRQOL using willingness to pay (WTP) instrument. Fifty-one consecutive PsV patients were asked to evaluate their overall health and psoriasis affected health by visual analogue scale (VAS), and interviewed on 8 domains (physical, emotional, sleep, work, social, self-care, intimacy, and concentration) of HRQOL and WTP for a hypothetical cure in each domain. Two additional questions proposing 6 alternatives for therapy were also asked. The analysis is performed with descriptive and frequency statistics, Mann-Whitney and Kruskal-Wallis tests. The domains ranked highly were: physical comfort (90%), social comfort (77%), emotional health (75%) and work (53%). The following tendencies concerning WTP for top four impacted domains were found: the median WTP were the highest in the top impacted domains; the younger patients were willing to pay more than the older ones; the highest median WTP amounts appear in the lowest income group; the highest median WTP is associated with smaller psoriasis affected health VAS scores. The largest proportion and number of patients (37.3%, n=19) stated preferences for the systemic therapy. The second preferred choice was the thalassotherapy (29.4%, n=15). The utility and reliability of the instrument based on the assessment of WTP stated preferences for 8 domains of HRQOL for evaluation the individual burden of psoriasis were strongly supported.

WTP for a QALY and health states: More money for severer health states?

PubMed

Shiroiwa, Takeru; Igarashi, Ataru; Fukuda, Takashi; Ikeda, Shunya

2013-01-01

In economic evaluation, cost per quality-adjusted life year (QALY) is generally used as an indicator for cost-effectiveness. Although JPY 5 million to 6 million (USD 60, 000 to 75,000) per QALY is frequently referred to as a threshold in Japan, do all QALYs have the same monetary value? To examine the relationship between severity of health status and monetary value of a QALY, we obtained willingness to pay (WTP) values for one additional QALY in eight patterns of health states. We randomly sampled approximately 2,400 respondents from an online panel. To avoid misunderstanding, we randomly allocated respondents to one of 16 questionnaires, with 250 responses expected for each pattern. After respondents were asked whether they wanted to purchase the treatment, double-bounded dichotomous choice method was used to obtain WTP values. The results clearly show that the WTP per QALY is higher for worse health states than for better health states. The slope was about JPY -1 million per 0.1 utility score increase. The mean and median WTP values per QALY for 16 health states were JPY 5 million, consistent with our previous survey. For respondents who wanted to purchase the treatment, WTP values were significantly correlated with household income. This survey shows that QALY based on the EQ-5D does not necessarily have the same monetary value. The WTP per QALY should range from JPY 2 million (USD 20,000) to JPY 8 million (USD 80,000), corresponding to the severity of health states.

Willingness to pay for one-stop anesthesia in pediatric day surgery

PubMed Central

2011-01-01

Background This study assesses the parents' Willingness To Pay (WTP) for One Stop Anesthesia (OSA). OSA is part of a free screening procedure that determines the timing of the anesthesiological assessment. In OSA-positive patients, the preoperative assessment is carried out on the same day as the surgery. The OSA allows patients who have to undergo surgery in a pediatric day surgery to avoid accessing the pre-admission clinic. Method This is a descriptive cohort study. A sample of 106 parents were interviewed directly by means of a questionnaire. The questionnaire builds a hypothetical scenario where the interviewee has a chance to buy the OSA health service with the WTP. The WTP values are distributed in classes and are contingent to the market built in the questionnaire. The Chi Square and Cramer's V tests evaluate the WTP dependence on the parents' place of origin and occupation. Results The approximate average of the WTP classes is €87.21 per family. The Chi Square test relative to the WTP classes and the places of origin is statistically significant (p < 0.05). The Cramer's V test is 0.347 and points to a positive association between the two demographics. The Cramer's V test of the WTP classes and the types of job is 0.339 and indicates a positive association. Conclusion Nearly 90% of pediatric patients who were screened for timing the preoperative assessment are true positives to OSA. This allows doing away with the pre-hospitalization, with definite advantages for the families. This screening is a health service that families would be hypothetically willing to pay. PMID:21586162

Willingness To Pay for Social Health Insurance in Iran

PubMed Central

Nosratnejad, Shirin; Rashidian, Arash; Mehrara, Mohsen; Sari, Ali Akbari; Mahdavi, Ghadir; Moeini, Maryam

2014-01-01

Objective: The substantial level of out-of-pocket expenditure for health care by the population causes policy makers to draw particular attention to the proposal of a social health insurance for uninsured members of the community. Hence, it is essential to gather reliable information about the amount of Willingness To Pay (WTP) for health insurance. We assessed the WTP for health insurance in Iran in order to suggest an affordable social health insurance. Method: The study sample included 300 household heads in all Iranian provinces. The double bounded dichotomous choice approach was used to elicit the WTP. Result: The average WTP for social health insurance per person per month was 137 000 Rial (5.5 $US). Household heads with higher levels of education, income and those who worked had more WTP for the health insurance. Besides, the WTP increased in direct proportion to the number of insured members of each household and in inverse proportion to the family size. Conclusions: From a policy point of view, the WTP value can be used as a premium in a society. An important finding of this study is that although households’ Willingness To Pay is not more than the total insurance premium, households are willing to pay more than the premium they ought to pay for health insurance coverage. That is, total insurance premium is 150 000 Rials and households ought to pay approximately half of this sum. This can afford policy makers the ideal opportunity to provide good insurance coverage for medical services according to the need of society. PMID:25168979

Assessing willingness to pay for improved sanitation in rural Vietnam.

PubMed

Van Minh, Hoang; Nguyen-Viet, Hung; Thanh, Nguyen Hoang; Yang, Jui-Chen

2013-07-01

The willingness to pay (WTP) for the construction of bathrooms with a flush toilet was assessed in households in a rural community in northern Vietnam. We also examined the effects of socio-economic factors on the WTP. The contingent valuation method, an economic survey technique, was used. We used the iterative bidding game technique to elicit household WTP that involved a sequence of dichotomous choice questions followed by a final open-ended question. A total of 370 households that did not have toilets were selected for this study. Respondents to the questionnaire were the primary income earners and decision-makers of their respective household. Of those responding to the questionnaire, 62.1 % reported being willing to pay for the construction of bathrooms with a flush toilet. The mean and median of maximum WTP amounts were Viet Nam Dong (VND) 15.6 million and VND 13.0 million, respectively (minimum VND 2.0 million; maximum VND 45.0 million). Significant correlates of the WTP rate were: (1) gender of the head of household, (2) age of the head of household, (3) economic status of household, (4) type of current toilet, (5) satisfaction with existing toilet, and (6) knowledge of health effects of poor sanitation. The significant determinants of WTP amount were (1) geographic location and (2) economic status of household. About two-third of the households in the study area were willing to pay for an improvement in their current sanitation arrangements. Both WTP rate and WP amount were strongly influenced by the economic status of the households and health knowledge of the study respondents.

Reconstructing Historical VOC Concentrations in Drinking Water for Epidemiological Studies at a U.S. Military Base: Summary of Results

PubMed Central

Maslia, Morris L.; Aral, Mustafa M.; Ruckart, Perri Z.; Bove, Frank J.

2017-01-01

A U.S. government health agency conducted epidemiological studies to evaluate whether exposures to drinking water contaminated with volatile organic compounds (VOC) at U.S. Marine Corps Base Camp Lejeune, North Carolina, were associated with increased health risks to children and adults. These health studies required knowledge of contaminant concentrations in drinking water—at monthly intervals—delivered to family housing, barracks, and other facilities within the study area. Because concentration data were limited or unavailable during much of the period of contamination (1950s–1985), the historical reconstruction process was used to quantify estimates of monthly mean contaminant-specific concentrations. This paper integrates many efforts, reports, and papers into a synthesis of the overall approach to, and results from, a drinking-water historical reconstruction study. Results show that at the Tarawa Terrace water treatment plant (WTP) reconstructed (simulated) tetrachloroethylene (PCE) concentrations reached a maximum monthly average value of 183 micrograms per liter (μg/L) compared to a one-time maximum measured value of 215 μg/L and exceeded the U.S. Environmental Protection Agency’s current maximum contaminant level (MCL) of 5 μg/L during the period November 1957–February 1987. At the Hadnot Point WTP, reconstructed trichloroethylene (TCE) concentrations reached a maximum monthly average value of 783 μg/L compared to a one-time maximum measured value of 1400 μg/L during the period August 1953–December 1984. The Hadnot Point WTP also provided contaminated drinking water to the Holcomb Boulevard housing area continuously prior to June 1972, when the Holcomb Boulevard WTP came on line (maximum reconstructed TCE concentration of 32 μg/L) and intermittently during the period June 1972–February 1985 (maximum reconstructed TCE concentration of 66 μg/L). Applying the historical reconstruction process to quantify contaminant-specific monthly drinking-water concentrations is advantageous for epidemiological studies when compared to using the classical exposed versus unexposed approach. PMID:28868161

Determinants of willingness to pay for a new therapy in a sample of menopausal-aged women.

PubMed

Rasch, Andrej; Hodek, Jan-Marc; Runge, Claus; Greiner, Wolfgang

2009-01-01

Menopause is a natural physiological event that usually begins in women between the ages of 48 and 55 years. In many cases, this event is associated with unpleasant somatic-vegetative, urogenital or psychological symptoms. To test the health and social demographic factors (especially household income level) that influence willingness to pay (WTP) for a new hormone-free treatment in women of menopausal age. 1365 women between the ages of 45 and 73 years were surveyed about their health and WTP for the new treatment. WTP was evaluated with a closed-ended binary questionnaire (four groups with different levels of co-payment between euro15 and euro60), using the contingent valuation method. The average WTP was calculated according to the area under the demand function. Factors contributing to payment readiness were examined by means of binary logistic regression. WTP was significantly affected by women's opinion of the new medication, the level of co-payment required, net household income, whether currently in treatment for menopausal symptoms, and Menopause Rating Scale (MRS) values. Compared with other factors, the level of co-payment was predicted to have a negative impact on WTP. Income level is an important factor in WTP and correlates highly with several other health-related variables (WHO-5 index, MRS value, receipt of other menopause medicines and existing co-morbidity). The average co-payment that our group of women was willing to pay was between euro17 and euro35 per month, or euro24 to euro42 for women who were currently receiving treatment for symptoms of menopause. While interpreting the results, it should be considered that the hypothetical therapy was assumed to be a new non-reimbursable alternative to conventional therapy offered under the existing statutory framework for health insurance in Germany. Despite some methodological limitations, these results are useful for examining the factors affecting WTP and incremental utilities for future medicine dealing with menopause.

Willingness to Pay in Caregivers of Patients Affected by Schizophrenia.

PubMed

Daltio, Claudiane Salles; Attux, Cecilia; Ferraz, Marcos Bosi

2017-03-01

Schizophrenia is a debilitating disorder that often requires the affected individual to receive care from a caregiver. Willingness to Pay (WTP) technique allows a valuation of the health state preferences by assessing the impact of the disease and translating it into monetary terms. The objective was to determine the WTP of schizophrenic patients' caregivers on a hypothetical recovery scenario and correlate it to socio-demographic and clinical characteristics, Knowledge of Disease, Quality of life and Burden of Disease. A convenience sample consecutively assessed 189 outpatients' caregivers from Schizophrenia Program of Federal University of Sao Paulo. A single caregiver was considered for each patient, taking into consideration their close relationship and their direct involvement in the treatment. Open WTP questionnaire for a hypothetical schizophrenia recovery scenario, KAST (Knowledge of Disease), SF-6D (Quality of life) and ZBI-22 (Burden of Disease) scales were applied. A monthly WTP mean value (SD) of US\\USD 63.63 (111.88) was found. The average value (SD) found was 12.96 (2.45) on KAST, 0.78 (0.08) on SF6D and 29.91 (16.10) on ZARIT. Income, education, social class, knowledge of disease and burden of caregiver were positively correlated to the WTP value. By linear regression model, income and education remained significant. Willingness to Pay (WTP) is a method that can be used to determine the strength of preference of patients and caregivers for a recovery in schizophrenia. The higher the income and education, the higher the willingness to pay. No clinical characteristics of patients had a statistically significant relation to the value the caregiver would pay. WTP is a potentially useful tool to determine values and health care preferences, and can be used for the development of mental health policies. Future research should be used to enhance WTP tool in mental health studies on the impact of diseases, including schizophrenia.

Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey.

PubMed

Nguyen, Quyen Le Thi; Nguyen, Long Hoang; Tran, Bach Xuan; Phan, Huong Thi Thu; Le, Huong Thi; Nguyen, Hinh Duc; Tran, Tho Dinh; Do, Cuong Duy; Nguyen, Cuong Manh; Thuc, Vu Thi Minh; Latkin, Carl; Zhang, Melvyn W B; Ho, Roger C M

2017-01-01

Viral load testing is considered the gold standard for monitoring HIV treatment; however, given its high cost, some patients cannot afford viral load testing if this testing is not subsidized. Since foreign aid for HIV/AIDS in Vietnam is rapidly decreasing, we sought to assess willingness to pay (WTP) for viral load and CD4 cell count tests among HIV-positive patients, and identified factors that might inform future co-payment schemes. A multi-site cross-sectional survey was conducted with 1133 HIV-positive patients on antiretroviral therapy (ART) in Hanoi and Nam Dinh. Patients' health insurance coverage, quality of life, and history of illicit drug use were assessed. A contingent valuation approach was employed to measure patients' WTP for CD4 cell count and viral load testing. HIV-positive patients receiving ART at provincial sites reported more difficulty obtaining health insurance (HI) and had the overall the poorest quality of life. Most patients (90.9%) were willing to pay for CD4 cell count testing; here, the mean WTP was valued at US$8.2 (95%CI = 7.6-8.8 US$) per test. Most patients (87.3%) were also willing to pay for viral load testing; here, mean WTP was valued at US$18.6 (95%CI = 16.3-20.9 US$) per test. High income, high education level, and hospitalization were positively associated with WTP, while co-morbidity with psychiatric symptoms and trouble paying for health insurance were both negatively related to WTP. These findings raise concerns that HIV-positive patients in Vietnam might have low WTP for CD4 cell count and viral load testing. This means that without foreign financial subsidies, many of these patients would likely go without these important tests. Treating psychiatric co-morbidities, promoting healthcare services utilization, and removing barriers to accessing health insurance may increase WTP for monitoring of HIV/AIDS treatment among HIV+-positive Vietnamese patients.

Investigating the Willingness to Pay for a Contributory National Health Insurance Scheme in Saudi Arabia: A Cross-sectional Stated Preference Approach.

PubMed

Al-Hanawi, Mohammed Khaled; Vaidya, Kirit; Alsharqi, Omar; Onwujekwe, Obinna

2018-04-01

The Saudi Healthcare System is universal, financed entirely from government revenue principally derived from oil, and is 'free at the point of delivery' (non-contributory). However, this system is unlikely to be sustainable in the medium to long term. This study investigates the feasibility and acceptability of healthcare financing reform by examining households' willingness to pay (WTP) for a contributory national health insurance scheme. Using the contingent valuation method, a pre-tested interviewer-administered questionnaire was used to collect data from 1187 heads of household in Jeddah province over a 5-month period. Multi-stage sampling was employed to select the study sample. Using a double-bounded dichotomous choice with the follow-up elicitation method, respondents were asked to state their WTP for a hypothetical contributory national health insurance scheme. Tobit regression analysis was used to examine the factors associated with WTP and assess the construct validity of elicited WTP. Over two-thirds (69.6%) indicated that they were willing to participate in and pay for a contributory national health insurance scheme. The mean WTP was 50 Saudi Riyal (US$13.33) per household member per month. Tobit regression analysis showed that household size, satisfaction with the quality of public healthcare services, perceptions about financing healthcare, education and income were the main determinants of WTP. This study demonstrates a theoretically valid WTP for a contributory national health insurance scheme by Saudi people. The research shows that willingness to participate in and pay for a contributory national health insurance scheme depends on participant characteristics. Identifying and understanding the main influencing factors associated with WTP are important to help facilitate establishing and implementing the national health insurance scheme. The results could assist policy-makers to develop and set insurance premiums, thus providing an additional source of healthcare financing.

Radiological assessment of water treatment processes in a water treatment plant in Saudi Arabia: Water and sludge radium content, radon air concentrations and dose rates.

PubMed

Al-Jaseem, Q Kh; Almasoud, Fahad I; Ababneh, Anas M; Al-Hobaib, A S

2016-09-01

There is an increase demand for clean water sources in Saudi Arabia and, yet, renewable water resources are very limited. This has forced the authorities to explore deep groundwater which is known to contain large concentrations of radionuclides, mainly radium isotopes. Lately, there has been an increase in the number of water treatment plants (WTPs) around the country. In this study, a radiological assessment of a WTP in Saudi Arabia was performed. Raw water was found to have total radium activity of 0.23Bq/L, which exceeds the international limit of 0.185Bq/L (5pCi/L). The WTP investigated uses three stages of treatment: flocculation/sedimentation, sand filtration and reverse osmosis. The radium removal efficiency was evaluated for each stage and the respective values were 33%, 22% and 98%. Moreover, the activity of radium in the solid waste generated from the WTP in the sedimentation and sand filtrations stages were measured and found to be 4490 and 6750Bq/kg, respectively, which exceed the national limit of 1000Bq/kg for radioactive waste. A radiological assessment of the air inside the WTP was also performed by measuring the radon concentrations and dose rates and were found in the ranges of 2-18Bq/m(3) and 70-1000nSv/h, respectively. The annual effective dose was calculated and the average values was found to be 0.3mSv which is below the 1mSv limit. Copyright © 2016 Elsevier B.V. All rights reserved.

Experimental Plan for Crystal Accumulation Studies in the WTP Melter Riser

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

Miller, D.; Fowley, M.

2015-04-28

This experimental plan defines crystal settling experiments to be in support of the U.S. Department of Energy – Office of River Protection crystal tolerant glass program. The road map for development of crystal-tolerant high level waste glasses recommends that fluid dynamic modeling be used to better understand the accumulation of crystals in the melter riser and mechanisms of removal. A full-scale version of the Hanford Waste Treatment and Immobilization Plant (WTP) melter riser constructed with transparent material will be used to provide data in support of model development. The system will also provide a platform to demonstrate mitigation or recoverymore » strategies in off-normal events where crystal accumulation impedes melter operation. Test conditions and material properties will be chosen to provide results over a variety of parameters, which can be used to guide validation experiments with the Research Scale Melter at the Pacific Northwest National Laboratory, and that will ultimately lead to the development of a process control strategy for the full scale WTP melter. The experiments described in this plan are divided into two phases. Bench scale tests will be used in Phase 1 (using the appropriate solid and fluid simulants to represent molten glass and spinel crystals) to verify the detection methods and analytical measurements prior to their use in a larger scale system. In Phase 2, a full scale, room temperature mockup of the WTP melter riser will be fabricated. The mockup will provide dynamic measurements of flow conditions, including resistance to pouring, as well as allow visual observation of crystal accumulation behavior.« less

Contingent Valuation Analysis of an Otolaryngology and Ophthalmology Emergency Department: The Value of Acute Specialty Care.

PubMed

Naunheim, Matthew R; Kozin, Elliot D; Sethi, Rosh K; Ota, H G; Gray, Stacey T; Shrime, Mark G

2017-03-01

Specialty emergency departments (EDs) provide a unique mechanism of health care delivery, but the value that they add to the medical system is not known. Evaluation of patient preferences to determine value can have a direct impact on resource allocation and direct-to-specialist care. To assess the feasibility of contingent valuation (CV) methodology using a willingness-to-pay (WTP) survey to evaluate specialty emergency services, in the context of an ophthalmology- and otolaryngology-specific ED. Contingent valuation analysis of a standalone otolaryngology and ophthalmology ED. Participants were English-speaking adults presenting to a dedicated otolaryngology and ophthalmology ED. The WTP questions were assessed using a payment card format, with reference to an alternative modality of treatment (ie, general ED), and were analyzed with multivariate regression. Validated WTP survey administered from October 14, 2014, through October 1, 2015. Sociodemographic data, level of distress, referral data, income, and WTP. A total of 327 of 423 (77.3%) ED patients responded to the WTP survey, with 116 ophthalmology and 211 otolaryngology patients included (52.3% female; mean [range] age, 46 [18-90] years). The most common reason for seeking care at this facility was a reputation for specialty care for both ear, nose, and throat (80 [37.9%]) and ophthalmology (43 [37.1%]). Mean WTP for specialty-specific ED services was $377 for ophthalmology patients, and $321 for otolaryngology patients ($340 overall; 95% CI, $294 to $386), without significant difference between groups (absolute difference, $56; 95% CI, $-156 to $43). Self-reported level of distress was higher among ear, nose, and throat vs ophthalmology patients (absolute difference, 0.47 on a Likert scale of 1-7; 95% CI, 0.10 to 0.84). Neither level of distress, income, nor demographic characteristics influenced WTP, but patients with higher estimates of total visit cost were more likely to have higher WTP (β coefficient, 0.27; SE, 0.05; adjusted R2 = 0.17 for model). Patients with eye and ear, nose, and throat complaints place a mean explicit value on specialty emergency services of $340 per visit, relative to general emergency care. Ultimately, CV data using WTP methodology are useful in valuing patient preferences in monetary terms and can help inform state-wide resource allocation and the availability of direct-to-specialist care.

Prosthetic restoration in the single-tooth gap: patient preferences and analysis of the WTP index.

PubMed

Augusti, Davide; Augusti, Gabriele; Re, Dino

2014-11-01

The objective of this study was to evaluate the preference of a patients' population, according to the index of willingness to pay (WTP), against two treatments to restore a single-tooth gap: the implant-supported crown (ISC) and the 3-unit fixed partial denture prosthesis (FPDP) on natural teeth. Willingness to pay values were recorded on 107 subjects by asking the WTP from a starting bid of €2000 modifiable through monetary increases or decreases (€100). Data were collected through an individually delivered questionnaire. The characteristics of the population and choices made, the median values and WTP associations with socio-demographic parameters (Mann-Whitney and Kruskal-Wallis tests), correlations between variables (chi-square test in contingency tables) and significant parameters for predicting WTP values obtained in a multiple linear regression model were revealed. The 64% of patients expressed a preference for ISC, while the remaining 36% of the population chose the FPDP. The current therapeutic choice and those carried out in the past were generally in agreement (>70% of cases, P = 0.0001); a relationship was discovered between the anterior and posterior area to the same method of rehabilitation (101 of 107 cases, 94.4%). The WTP median values for ISC were of €3000 and of €2500 in the anterior and posterior areas, respectively. The smallest amount of money has been allocated for FPDP in posterior region (median of €1500). The "importance of oral care" for the patient was a significant predictor, in the regression model analysis, for the estimation of both anterior (P = 0.0003) and posterior (P < 0.0001) WTP values. The "previous therapy" variable reached and was just close to significance in anterior (P = 0.0367) and posterior (P = 0.0511) analyses, respectively. Within the limitations of this study, most of the population (64%) surveyed indicated the ISC as a therapeutic solution for the replacement of a single missing tooth, showing a higher WTP index in the anterior area. Among investigated socio-demographic variables, the importance assigned by the patient to oral care appeared to influence WTP values of the rehabilitation, regardless the location of the single gap in the mouth. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Willingness to pay for maternal health outcomes: are women willing to pay more than men?

PubMed

Ternent, Laura; McNamee, Paul; Newlands, David; Belemsaga, Danielle; Gbangou, Adjima; Cross, Suzanne

2010-01-01

Only a limited number of studies have specifically sought to analyse and try to understand sex differences in willingness to pay (WTP). To identify the role of sex in determining monetary values placed upon improvements in maternal health in Burkina Faso, West Africa. A contingent valuation survey using the bidding game method was conducted in the district of Nouna in 2005; a sample of 409 male heads of households and their spouses were asked their WTP for a reduction in the number of maternal deaths in the Nouna area. Ordinary least squares regression analysis was employed to examine the determinants of WTP. Men were willing to pay significantly more than women (3127 vs 2273 West African francs), although this represented a significantly smaller proportion of their annual income (4% vs 11%). In the multivariate analyses of all respondents there was a significant positive relationship between WTP values and both starting bid and whether there had been a previous maternal complication in the respondent's household. However, there was a significant negative relationship between WTP and female sex. Once interactions between sex and income were taken into account, income did affect valuations, with a positive relationship between higher-income women and WTP values. In absolute terms, men were willing to pay more than women, while women were willing to pay a greater proportion of their income. Differences between men and women in their WTP, both in absolute terms and in terms of proportion of income, can be explained by a household effect. Future studies should distinguish between individual income and command over decision making with respect to use of individual and household income, and gain further insight into the strategies used by respondents in answering bidding game questions.

The maximum willingness to pay for smoking cessation method among adult smokers in Mexico.

PubMed

Heredia-Pi, Ileana B; Servan-Mori, Edson; Reynales-Shigematsu, Luz Myriam; Bautista-Arredondo, Sergio

2012-01-01

To estimate the maximum willingness to pay (WTP) for an effective smoking cessation treatment among smokers in Mexico and to identify the environmental, demographic, and socioeconomic factors associated with the WTP. A cross-sectional study was conducted. The sample contained 777 smokers (willingness to quit using a WTP of >0) who had responded to the 2009 Global Adult Tobacco Survey conducted in Mexico. Statistical associations and descriptive analyses were conducted to describe smokers and their WTP by using tobacco-related environmental, socioeconomic, and demographic variables. Overall, 74.4% of the smokers were men and 51.4% were daily smokers. On average, the smokers had been consuming tobacco for more than 15 years, 58.6% had made cessation attempts in the past, and around 10.0% knew about the existence of centers to aid in smoking cessation. The average WTP for an effective cessation method was US $191. Among men, the WTP was US $152 lower than among women. In all the estimated models, the higher an individual's education and socioeconomic level, the higher his or her WTP. This study suggests that Mexican smokers interested in quitting smoking attribute a high monetary value to an effective cessation method. Male smokers demonstrated less altruistic behavior than did female smokers. Mexico requires the implementation of more policies designed to support smoking cessation and to limit tobacco addiction. Expanding the availability of cessation programs and access to pharmacological treatments may contribute to reaching universal coverage by integrating new pharmacological alternatives into the health sector's medicine formulary. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Does message framing predict willingness to participate in a hypothetical HIV vaccine trial: an application of Prospect Theory.

PubMed

Evangeli, Michael; Kafaar, Zuhayr; Kagee, Ashraf; Swartz, Leslie; Bullemor-Day, Philippa

2013-01-01

It is vital that enough participants are willing to participate in clinical trials to test HIV vaccines adequately. It is, therefore, necessary to explore what affects peoples' willingness to participate (WTP) in such trials. Studies have only examined individual factors associated with WTP and not the effect of messages about trial participation on potential participants (e.g., whether losses or gains are emphasized, or whether the outcome is certain or uncertain). This study explores whether the effects of message framing on WTP in a hypothetical HIV vaccine trial are consistent with Prospect Theory. This theory suggests that people are fundamentally risk averse and that (1) under conditions of low risk and high certainty, gain-framed messages will be influential (2) under conditions of high risk and low certainty, loss-framed messages will be influential. This cross-sectional study recruited 283 HIV-negative students from a South African university who were given a questionnaire that contained matched certain gain-framed, certain loss-framed, uncertain gain-framed, and uncertain loss-framed statements based on common barriers and facilitators of WTP. Participants were asked to rate how likely each statement was to result in their participation in a hypothetical preventative HIV vaccine trial. Consistent with Prospect Theory predictions, for certain outcomes, gain-framed messages were more likely to result in WTP than loss-framed messages. Inconsistent with predictions, loss-framed message were not more likely to be related to WTP for uncertain outcomes than gain-framed messages. Older students were less likely to express their WTP across the different message frames. Recruitment for HIV vaccine trials should pay attention to how messages about the trial are presented to potential participants.

Adolescent and Young Adult Cancer Survivors' Valuation of Post-Treatment Recommended Care.

PubMed

Kaul, Sapna; Smits-Seemann, Rochelle R; Zamora, Eduardo R; Spraker-Perlman, Holly; Boyle, Kevin J; Kirchhoff, Anne C

2017-03-01

Examine whether survivors of adolescent and young adult (AYA) cancer value recommended post-treatment care using focus groups and a willingness to pay (WTP) survey. WTP, a measure of value, indicates the dollar amount individuals are willing to pay to use a service. Participants were recruited through the Utah Cancer Registry. N = 28 survivors diagnosed with cancer at ages 15-39 and currently aged ≥18 participated in focus groups, and N = 4 in phone interviews (participation rate = 50%). All participants responded to a demographic survey and WTP questions based on one-time and monthly payments for annual visits. Focus group participants responded to an open-ended question on the value of follow-up care. Interval regressions identified factors associated with WTP. Qualitative analysis summarized themes for the open-ended question. Focus group participants reported valuing follow-up care as it brings peace of mind and helps them manage their health. Yet, 38% reported not having a cancer-related visit in the previous year. Only 27% and 43% of survivors agreed to pay any one-time and monthly payments, respectively. The monthly payment mean WTP was $41 (95% confidence interval [CI]: 31-84), equating to $494 annually, which is greater than the mean WTP for one-time payment ($362, 95% CI: 293-432, p < 0.001), suggesting that survivors may prefer monthly payments. Several factors, including being female and in better health, predicted higher WTP. Many AYA cancer survivors report not visiting their doctors annually for post-treatment care despite verbally valuing care. Models that demonstrate high quality and distribute costs over time should be evaluated to encourage survivors to receive recommended care.

Willingness to pay per quality-adjusted life year for life-saving treatments in Thailand.

PubMed

Nimdet, Khachapon; Ngorsuraches, Surachat

2015-10-05

To estimate the willingness to pay (WTP) per quality-adjusted life year (QALY) value for life-saving treatments and to determine factors affecting the WTP per QALY value. A cross-sectional survey with multistage sampling and face-to-face interviews. General population in the southern part of Thailand. A total of 600 individuals were included in the study. Only 554 (92.3%) responses were usable for data analyses. Participants were asked for the maximum amount of WTP value for life-saving treatments by an open-ended question. EQ-5D-3L and visual analogue scale (VAS) were used to estimate additional QALY. The amount of WTP values varied from 0 to 720,000 Baht/year (approximately 32 Baht=US$1). The averages of additional QALY obtained from VAS and EQ-5D-3L were only slightly different (0.872 and 0.853, respectively). The averages of WTP per QALY obtained from VAS and EQ-5D-3L were 244,720 and 243,120 Baht/QALY, respectively. As compared to male participants, female participants were more likely to pay less for an additional QALY (p=0.007). In addition, participants with higher household incomes tended to have higher WTP per QALY values (p<0.001). Our study added another WTP per QALY value specifically for life-saving treatments, which would complement the current cost-effectiveness threshold used in Thailand and optimise patient access to innovative treatments or technologies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Mothers' Preferences and Willingness to Pay for Human Papillomavirus Vaccination for Their Daughters: A Discrete Choice Experiment in Hong Kong.

PubMed

Wong, Carlos K H; Man, Kenneth K C; Ip, Patrick; Kwan, Mike; McGhee, Sarah M

2018-05-01

To determine the preference of mothers in Hong Kong and their willingness to pay (WTP) for human papillomavirus (HPV) vaccination for their daughters. A discrete choice experiment survey with a two-alternative study design was developed. Data were collected from pediatric specialist outpatient clinics from 482 mothers with daughters aged between 8 and 17 years. Preferences of the four attributes of HPV vaccines (protection against cervical cancer, protection duration, side effects, and out-of-pocket costs) were evaluated. The marginal and overall WTP were estimated using multinomial logistic regression. A subgroup analysis was conducted to explore the impact of socioeconomic factors on mothers' WTP. Side effects, protection against cervical cancer, protection duration, and out-of-pocket cost determined the decision to receive or not receive the vaccine. All attributes had a statistically significant effect on the preference of and the WTP for the vaccine. Maximum WTP for ideal vaccines (i.e., 100% protection, lifetime protection duration, and 0% side effects) was HK$8976 (US $1129). The estimated WTP for vaccines currently available was HK$1620 (US $208), lower than the current market price. Among those who had a monthly household income of more than HK$100,000 (US $12,821), the WTP for vaccines currently offered was higher than the market price. This study provides new data on how features of the HPV vaccine are viewed and valued by mothers by determining their perception of ideal or improved and current vaccine technologies. These findings could contribute to future policies on the improvement of HPV vaccine and be useful for the immunization service in Hong Kong. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Is there a kink in consumers' threshold value for cost-effectiveness in health care?

PubMed

O'Brien, Bernie J; Gertsen, Kirsten; Willan, Andrew R; Faulkner, Lisa A

2002-03-01

A reproducible observation is that consumers' willingness-to-accept (WTA) monetary compensation to forgo a program is greater than their stated willingness-to-pay (WTP) for the same benefit. Several explanations exist, including the psychological principle that the utility of losses weighs heavier than gains. We sought to quantify the WTP-WTA disparity from published literature and explore implications for cost-effectiveness analysis accept-reject thresholds in the south-west quadrant of the cost-effectiveness plane (less effect, less cost). We reviewed published studies (health and non-health) to estimate the ratio of WTA to WTP for the same program benefit for each study and to determine if WTA is consistently greater than WTP in the literature. WTA/WTP ratios were greater than unity for every study we reviewed. The ratios ranged from 3.2 to 89.4 for environmental studies (n=7), 1.9 to 6.4 for health care studies (n=2), 1.1 to 3.6 for safety studies (n=4) and 1.3 to 2.6 for experimental studies (n=7). Given that WTA is greater than WTP based on individual preferences, should not societal preferences used to determine cost-effectiveness thresholds reflect this disparity? Current convention in cost-effectiveness analysis is that any given accept-rejection criterion (e.g. $50 k/QALY gained) is symmetric - a straight line through the origin of the cost-effectiveness plane. The WTA-WTP evidence suggests a downward 'kink' through the origin for the south-west quadrant, such that the 'selling price' of a QALY is greater than the 'buying price'. The possibility of 'kinky cost-effectiveness' decision rules and the size of the kink merits further exploration. Copyright 2002 John Wiley & Sons, Ltd.

Potential for Cost Recovery: Women’s Willingness to Pay for Injectable Contraceptives in Tigray, Ethiopia

PubMed Central

Prata, Ndola; Bell, Suzanne; Weidert, Karen; Gessessew, Amanuel

2013-01-01

Objective To investigate factors associated with a woman’s willingness to pay (WTP) for injectable contraceptives in Tigray, Ethiopia. Methods We used a multistage random sampling design to generate a representative sample of reproductive age women from the Central Zone of Tigray, Ethiopia to participate in a survey (N = 1490). Respondents who had ever used injectable contraceptives or who were interested in using them were asked whether they would be willing to pay, and if so, how much. Logistic regression odds ratios (ORs) with 95% confidence intervals (CIs) and p-values were used to assess which factors were associated with WTP in our final model. Findings On average, respondents were willing to pay 11 birr ($0.65 USD) per injection. Being married, completing any amount of education, having given birth, and having visited a health facility in the last 12 months (whether received family planning information or not) were associated with statistically significantly increased odds of WTP. Having initiated sexual activity and having 1–2 children (compared to 0 children) were associated with statistically significantly decreased odds of WTP. We also detected two significant interactions. Among women who prefer injectable contraceptives, their odds of WTP for injectable contraceptives vary across length of time they have used them. And among women who work for pay, their odds of WTP for injectable contraceptives vary by whether they agree with their husband/partner about the ideal number of children. Conclusion In a sector that continually struggles with funding, cost recovery for contraceptive services may offer a means of improved financial sustainability while increasing rural access to injectable contraceptives. Results indicate there are opportunities for cost recovery in rural Tigray, Ethiopia and highlight factors that could be leveraged to increase WTP for injectable contraceptives. PMID:23700451

Maternal willingness to pay for infant and young child nutrition counseling services in Vietnam.

PubMed

Nguyen, Phuong H; Hoang, Minh V; Hajeebhoy, Nemat; Tran, Lan M; Le, Chung H; Menon, Purnima; Rawat, Rahul

2015-01-01

Alive & Thrive Vietnam, a 6-year initiative (2009-2014), has developed and incorporated elements of social franchising into government health services to provide high-quality nutrition counseling services to improve infant and young child feeding practices. One element of franchising that has not yet been implemented is fee for service, which is a potential financing mechanism for sustaining services in the long run. This research aims to estimate maternal willingness to pay (WTP) for nutrition counseling services and to examine potential factors associated with their WTP. Data were drawn from an impact evaluation survey of 2,511 women with a child <2 years old from four provinces in Vietnam. An iterative bidding technique was employed to explore individual WTP. The first bid was defined as VND 20,000 (~US$ 1), which was approximately the level of the actual service cost. Depending on the participant response, the bid increased or decreased. Finally, the respondents were asked about the highest price they would be willing to pay for the service. Overall, 92.6% of clients reported a need for nutrition counseling services for children <2 years. The WTP rates at bid levels of VND 5,000, 10,000, 20,000, 40,000, and 100,000 were 95.2, 94.4, 90.7, 68.9, and 33.4%, respectively. The mean and median of the maximum WTP were VND 58,500 and 50,000, respectively. In multiple regression models, WTP rates were higher among younger women, the Kinh majority group, and better educated and wealthier women. A high demand for nutrition counseling coupled with a WTP by almost all segments of society would potentially cover costs of delivery for nutrition counseling services in Vietnam.

Factors affecting the willingness to pay for implants: A study of patients in Riyadh, Saudi Arabia.

PubMed

Al Garni, Bishi; Pani, Sharat Chandra; Almaaz, Adel; Al Qeshtaini, Ehsan; Abu-Haimed, Hamad; Al Sharif, Khalid

2012-11-01

One of the factors that dissuade patients needing tooth replacement from choosing dental implants is the prohibitive cost. Willingness to pay (WTP) is a useful tool to determine the ideal cost of an expensive procedure. The aim of this study was to study the factors that influence the willingness to pay (WTP) among patients attending a private clinic and compare them to those attending a government setup. A total of 100 patients (38 male, 62 female) who had one or more missing teeth were presented with different cost-benefit scenarios and then asked if they were willing to pay the median cost of a single implant in Riyadh city. The mean WTP price was compared using the one way-ANOVA, factors which could possibly influence patients' WTP were grouped together in a Binomial logistic regression model. Of the 100 individuals surveyed 67% said they would be willing to pay the median price for the placement of an implant. A comparison of socio-demographic factors showed that significant differences were found between gender, income groups and setting of the clinic in the mean WTP price of the patients (P < 0.05). We also found that there was a significant difference in the mean WTP price between groups with regard to the area of the missing tooth, the patients' perception of their oral health and the their desire to want an implant (P < 0.05). The majority of the patients surveyed were willing to pay the median price for an implant. Willingness to pay (WTP) is a multifactorial variable which is significantly influenced by the income of the patient, the setting of the clinic and the gender; the most significant factor being the acceptability of the implant to the patient.

Maternal willingness to pay for infant and young child nutrition counseling services in Vietnam

PubMed Central

Nguyen, Phuong H.; Hoang, Minh V.; Hajeebhoy, Nemat; Tran, Lan M.; Le, Chung H.; Menon, Purnima; Rawat, Rahul

2015-01-01

Background Alive & Thrive Vietnam, a 6-year initiative (2009–2014), has developed and incorporated elements of social franchising into government health services to provide high-quality nutrition counseling services to improve infant and young child feeding practices. One element of franchising that has not yet been implemented is fee for service, which is a potential financing mechanism for sustaining services in the long run. Objective This research aims to estimate maternal willingness to pay (WTP) for nutrition counseling services and to examine potential factors associated with their WTP. Design and methods Data were drawn from an impact evaluation survey of 2,511 women with a child <2 years old from four provinces in Vietnam. An iterative bidding technique was employed to explore individual WTP. The first bid was defined as VND 20,000 (~US$ 1), which was approximately the level of the actual service cost. Depending on the participant response, the bid increased or decreased. Finally, the respondents were asked about the highest price they would be willing to pay for the service. Results Overall, 92.6% of clients reported a need for nutrition counseling services for children <2 years. The WTP rates at bid levels of VND 5,000, 10,000, 20,000, 40,000, and 100,000 were 95.2, 94.4, 90.7, 68.9, and 33.4%, respectively. The mean and median of the maximum WTP were VND 58,500 and 50,000, respectively. In multiple regression models, WTP rates were higher among younger women, the Kinh majority group, and better educated and wealthier women. Conclusion A high demand for nutrition counseling coupled with a WTP by almost all segments of society would potentially cover costs of delivery for nutrition counseling services in Vietnam. PMID:26328947

Willingness-to-pay for schistosomiasis-related health outcomes in Kenya.

PubMed

Kirigia, J M; Sambo, L G; Kainyu, L H

2000-01-01

Cost-benefit analysis (CBA) provides a framework for identifying, quantifying, and valuing in monetary terms all the important costs and consequences to society of competing disease interventions. Thus, CBA requires that impacts of schistosomiasis interventions on beneficiaries'health be valued in monetary terms Economic theory requires the use of the willingness to pay (WTP) approach in valuation of changes in health as a result of intervention. It is the only approach which is consistent with the potential Pareto improvement principle, and hence, consistent with CBA. The present study developed a health outcome measure and tested its operational feasibility. Contingent valuation for certain return to normal health from various health states, and for remaining in one's current health state were elicited through direct interview of randomly selected rice farmers, teachers, and health personnel in Kenya. The WTP to avoid risk of advancing to the next more severe state, seemed to be higher than WTP for a return to normal health. Generally, there was a significant difference between the average WTP values of farmers, teachers and health personnel populations. The gender and occupation variable coefficients were positive and highly significant in all regressions. The coefficients of the other explanatory variables were generally not statistically significant, indicating that medical expenses, anxiety cost, loss of earnings, and loss of work time, implied in various health states descriptions did not have significant effect on respondents expressed WTP values. The latter finding shows that there is need for more research to identify the other (besides gender and occupation) determinants of expressed WTP values in Africa. This study has demonstrated that it is possible to elicit coherent WTP values from economically under-developed countries. Further empirical work is clearly needed to at least address the validity and reliability of the contingent valuation approach and its measurements in Africa.

Sedimentation Effects on the Water Supply of APG

DTIC Science & Technology

2009-05-07

THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Background  The APG (South) Water Treatment Plant ( WTP ...low flow (15.6 cfs)  Typically during Maryland summers drought conditions prevent water uptake Background Cont’d  In 2007 the WTP was forced to shut...around the WTP intake  Will decrease particulate matter in the intake water  Will prevent sedimentation from completely blocking flow to the water

Willingness to pay for ovulation induction treatment in case of WHO II anovulation: a study using the contingent valuation method.

PubMed

Poder, Thomas G; He, Jie; Simard, Catherine; Pasquier, Jean-Charles

2014-01-01

To measure the willingness to pay (WTP) of women aged 18-45 years to receive drug treatment for ovulation induction (ie, the social value of normal cycles of ovulation for a woman of childbearing age) in order to feed the debate about the funding of fertility cares. An anonymous questionnaire was used over the general population of Quebec. A total of 136 subjects were recruited in three medical clinics, and 191 subjects through an online questionnaire. THE QUESTIONNAIRE CONSISTED OF THREE PARTS: introduction to the problematic, socioeconomic data collection to determine factors influencing the formation of WTP, and a WTP question using the simple bid price dichotomous choice elicitation technique. The econometric estimation method is based on the "random utility theory." Each subject responding to our questionnaire could express her uncertainty about the answer to our WTP question by choosing the answer "I do not know." The WTP in Canadian dollars of women aged 18-45 years to receive drug treatment for ovulation induction. Results are positive and indicate an average WTP exceeding 4,800 CAD, which is much more than the drug treatment cost. There is no evidence of sample frame bias or avidity bias across the two survey modes that cannot be controlled in econometric estimates. Medical treatment for ovulation induction is highly socially desirable in Quebec.

Wt-p53 action in human leukaemia cell lines corresponding to different stages of differentiation.

PubMed

Rizzo, M G; Zepparoni, A; Cristofanelli, B; Scardigli, R; Crescenzi, M; Blandino, G; Giuliacci, S; Ferrari, S; Soddu, S; Sacchi, A

1998-05-01

Recent studies support the potential application of the wt-p53 gene in cancer therapy. Expression of exogenous wt-p53 suppresses a variety of leukaemia phenotypes by acting on cell survival, proliferation and/or differentiation. As for tumour gene therapy, the final fate of the neoplastic cells is one of the most relevant points. We examined the effects of exogenous wt-p53 gene expression in several leukaemia cell lines to identify p53-responsive leukaemia. The temperature-sensitive p53Val135 mutant or the human wt-p53 cDNA was transduced in leukaemia cell lines representative of different acute leukaemia FAB subtypes, including M1 (KG1), M2 (HL-60), M3 (NB4), M5 (U937) and M6 (HEL 92.1.7), as well as blast crisis of chronic myelogenous leukaemia (BC-CML: K562, BV173) showing diverse differentiation features. By morphological, molecular and biochemical analyses, we have shown that exogenous wt-p53 gene expression induces apoptosis only in cells corresponding to M1, M2 and M3 of the FAB classification and in BC-CML showing morphological and cytochemical features of undifferentiated blast cells. In contrast, it promotes differentiation in the others. Interestingly, cell responsiveness was independent of the vector used and the status of the endogenous p53 gene.

A game-theoretic framework for estimating a health purchaser's willingness-to-pay for health and for expansion.

PubMed

Yaesoubi, Reza; Roberts, Stephen D

2010-12-01

A health purchaser's willingness-to-pay (WTP) for health is defined as the amount of money the health purchaser (e.g. a health maximizing public agency or a profit maximizing health insurer) is willing to spend for an additional unit of health. In this paper, we propose a game-theoretic framework for estimating a health purchaser's WTP for health in markets where the health purchaser offers a menu of medical interventions, and each individual in the population selects the intervention that maximizes her prospect. We discuss how the WTP for health can be employed to determine medical guidelines, and to price new medical technologies, such that the health purchaser is willing to implement them. The framework further introduces a measure for WTP for expansion, defined as the amount of money the health purchaser is willing to pay per person in the population served by the health provider to increase the consumption level of the intervention by one percent without changing the intervention price. This measure can be employed to find how much to invest in expanding a medical program through opening new facilities, advertising, etc. Applying the proposed framework to colorectal cancer screening tests, we estimate the WTP for health and the WTP for expansion of colorectal cancer screening tests for the 2005 US population.

Paying for Forest Ecosystem Services: Voluntary Versus Mandatory Payments.

PubMed

Roesch-McNally, Gabrielle E; Rabotyagov, Sergey S

2016-03-01

The emergence of new markets for forest ecosystem services can be a compelling opportunity for market diversification for private forest landowners, while increasing the provision of public goods from private lands. However, there is limited information available on the willingness-to-pay (WTP) for specific forest ecosystem services, particularly across different ecosystem market mechanisms. We utilize survey data from Oregon and Washington households to compare marginal WTP for forest ecosystem services and the total WTP for cost-effective bundles of forest ecosystem services obtained from a typical Pacific Northwest forest across two value elicitation formats representing two different ecosystem market mechanisms: an incentive-compatible choice experiment involving mandatory tax payments and a hypothetical private provision scenario modeled as eliciting contributions to the preferred forest management alternative via a provision point mechanism with a refund. A representative household's total WTP for the average forest management program was estimated at $217.59 per household/year under a mandatory tax mechanism and $160.44 per household/per year under a voluntary, crowdfunding-style, contribution mechanism; however, these estimates are not statistically different. Marginal WTP estimates were assessed for particular forest ecosystem service attributes including water quality, carbon storage, mature forest habitat, and public recreational access. This study finds that survey respondents place significant economic value on forest ecosystem services in both elicitation formats and that the distributions of the marginal WTP are not statistically significantly different.

Willingness to Pay for Complementary Health Care Insurance in Iran.

PubMed

Nosratnejad, Shirin; Rashidian, Arash; Akbari Sari, Ali; Moradi, Najme

2017-09-01

Complementary health insurance is increasingly used to remedy the limitations and shortcomings of the basic health insurance benefit packages. Hence, it is essential to gather reliable information about the amount of Willingness to Pay (WTP) for health insurance. We assessed the WTP for health insurance in Iran in order to suggest an affordable complementary health insurance. The study sample consisted of 300 household heads all over provinces of Iran in 2013. The method applied was double bounded dichotomous choice and open-ended question approach of contingent valuation. The average WTP for complementary health insurance per person per month by double bounded dichotomous choice and open-ended question method respectively was 199000 and 115300 Rials (8 and 4.6 USD, respectively). Household's heads with higher levels of income and those who worked had more WTP for the health insurance. Besides, the WTP increased in direct proportion to the number of insured members of each household and in inverse proportion to the family size. The WTP value can be used as a premium in a society. As an important finding, the study indicated that the households were willing to pay higher premiums than currently collected for the complementary health insurance coverage in Iran. This offers the policy makers the opportunity to increase the premium and provide good benefits package for insured people of country then better risk pooling.

Paying for Forest Ecosystem Services: Voluntary Versus Mandatory Payments

NASA Astrophysics Data System (ADS)

Roesch-McNally, Gabrielle E.; Rabotyagov, Sergey S.

2016-03-01

The emergence of new markets for forest ecosystem services can be a compelling opportunity for market diversification for private forest landowners, while increasing the provision of public goods from private lands. However, there is limited information available on the willingness-to-pay (WTP) for specific forest ecosystem services, particularly across different ecosystem market mechanisms. We utilize survey data from Oregon and Washington households to compare marginal WTP for forest ecosystem services and the total WTP for cost-effective bundles of forest ecosystem services obtained from a typical Pacific Northwest forest across two value elicitation formats representing two different ecosystem market mechanisms: an incentive-compatible choice experiment involving mandatory tax payments and a hypothetical private provision scenario modeled as eliciting contributions to the preferred forest management alternative via a provision point mechanism with a refund. A representative household's total WTP for the average forest management program was estimated at 217.59 per household/year under a mandatory tax mechanism and 160.44 per household/per year under a voluntary, crowdfunding-style, contribution mechanism; however, these estimates are not statistically different. Marginal WTP estimates were assessed for particular forest ecosystem service attributes including water quality, carbon storage, mature forest habitat, and public recreational access. This study finds that survey respondents place significant economic value on forest ecosystem services in both elicitation formats and that the distributions of the marginal WTP are not statistically significantly different.

WTP (willingness to pay) for tele-health consultation service in Hokkaido, Japan.

PubMed

Ogasawara, Katsuhiko; Abe, Tamotsu

2013-01-01

We developed a tele-health consultation system that combines a sphygmomanometer with a tele-conference system. These were placed in pharmacies and the University. We selected five pharmacies to set up a consultation room; one in a local area, two in a suburban area, and the remaining two in an urban area. Nurses with more than 5 years of clinical experience were assigned as consultants. These consultants offer health consultation but do not practice medicine. Some researchers have indicated the economic viability of at-home health management systems, but nothing has been researched on the economic viability of tele-health consultation. The objective of present study was estimated Willingness to Payment (WTP) of Tele-health consultation service. The WTP was estimated by Double-Bounded Dichotomous-Choice model. We performed logistic-regression analysis to confirm factors to affect WTP. The number of the respondent was 480. Mean WTP was calculated 495 yen and the median was 367 yen. There was significant difference for factor of "annual income", "have a willingness to use this system", and "have a child/children".

Frontal Brain Asymmetry and Willingness to Pay.

PubMed

Ramsøy, Thomas Z; Skov, Martin; Christensen, Maiken K; Stahlhut, Carsten

2018-01-01

Consumers frequently make decisions about how much they are willing to pay (WTP) for specific products and services, but little is known about the neural mechanisms underlying such calculations. In this study, we were interested in testing whether specific brain activation-the asymmetry in engagement of the prefrontal cortex-would be related to consumer choice. Subjects saw products and subsequently decided how much they were willing to pay for each product, while undergoing neuroimaging using electroencephalography. Our results demonstrate that prefrontal asymmetry in the gamma frequency band, and a trend in the beta frequency band that was recorded during product viewing was significantly related to subsequent WTP responses. Frontal asymmetry in the alpha band was not related to WTP decisions. Besides suggesting separate neuropsychological mechanisms of consumer choice, we find that one specific measure-the prefrontal gamma asymmetry-was most strongly related to WTP responses, and was most coupled to the actual decision phase. These findings are discussed in light of the psychology of WTP calculations, and in relation to the recent emergence of consumer neuroscience and neuromarketing.

Frontal Brain Asymmetry and Willingness to Pay

PubMed Central

Ramsøy, Thomas Z.; Skov, Martin; Christensen, Maiken K.; Stahlhut, Carsten

2018-01-01

Consumers frequently make decisions about how much they are willing to pay (WTP) for specific products and services, but little is known about the neural mechanisms underlying such calculations. In this study, we were interested in testing whether specific brain activation—the asymmetry in engagement of the prefrontal cortex—would be related to consumer choice. Subjects saw products and subsequently decided how much they were willing to pay for each product, while undergoing neuroimaging using electroencephalography. Our results demonstrate that prefrontal asymmetry in the gamma frequency band, and a trend in the beta frequency band that was recorded during product viewing was significantly related to subsequent WTP responses. Frontal asymmetry in the alpha band was not related to WTP decisions. Besides suggesting separate neuropsychological mechanisms of consumer choice, we find that one specific measure—the prefrontal gamma asymmetry—was most strongly related to WTP responses, and was most coupled to the actual decision phase. These findings are discussed in light of the psychology of WTP calculations, and in relation to the recent emergence of consumer neuroscience and neuromarketing. PMID:29662432

Minority Households' Willingness-to-Pay for Public and Private Wildfire Risk Reduction in Florida

NASA Astrophysics Data System (ADS)

Gonzalez-Caban, A.; Sanchez, J. J.

2017-12-01

The purpose of this work is to estimate willingness-to-pay (WTP) for minority (African-American and Hispanic) homeowners in Florida for private and public wildfire risk reduction programs and also to test for differences in response between the two groups. A random parameter logit and latent class models allowed us to determine if there is difference in wildfire mitigation program preferences, whether WTP is higher for public or private actions for wildfire risk reduction, and whether households with personal experience and who perceive that they live in higher-risk areas have significantly higher WTP. We also compare FL minority homeowners' WTP values with Florida original homeowners' estimates. Results suggest that FL minority homeowners are willing to invest in public programs, with African-Americans WTP values at a higher rate than Hispanics. In addition, the highest priority for cost sharing funds would go to low-income homeowners, especially to cost-share private actions on their own land. These results may help fire managers optimize allocation of scarce cost-sharing funds for public versus private actions.

Convergent validity between willingness to pay elicitation methods: an application to Grand Canyon whitewater boaters

USGS Publications Warehouse

Neher, Christopher; Bair, Lucas S.; Duffield, John; Patterson, David A.; Neher, Katherine

2018-01-01

We directly compare trip willingness to pay (WTP) values between dichotomous choice contingent valuation (DCCV) and discrete choice experiment (DCE) stated preference surveys of private party Grand Canyon whitewater boaters. The consistency of DCCV and DCE estimates is debated in the literature, and this study contributes to the body of work comparing the methods. Comparisons were made of mean WTP estimates for four hypothetical Colorado River flow-level scenarios. Boaters were found to most highly value mid-range flows, with very low and very high flows eliciting lower WTP estimates across both DCE and DCCV surveys. Mean WTP precision was estimated through simulation. No statistically significant differences were detected between the two methods at three of the four hypothetical flow levels.

Combining Trust and Behavioral Analysis to Detect Security Threats in Open Environments

DTIC Science & Technology

2010-11-01

behavioral feature values. This would provide a baseline notional object trust and is formally defined as follows: TO(1)[0, 1] = ∑ 0,n:νbt wtP (S) (8...TO(2)[0, 1] = ∑ wtP (S) · identity(O,P ) (9) 28- 12 RTO-MP-IST-091 Combining Trust and Behavioral Analysis to Detect Security Threats in Open...respectively. The wtP weight function determines the significance of a particular behavioral feature in the final trust calculation. Note that the weight

Evaluation on the cost-effective threshold of osteoporosis treatment on elderly women in China using discrete event simulation model.

PubMed

Ni, W; Jiang, Y

2017-02-01

This study used a simulation model to determine the cost-effective threshold of fracture risk to treat osteoporosis among elderly Chinese women. Osteoporosis treatment is cost-effective among average-risk women who are at least 75 years old and above-average-risk women who are younger than 75 years old. Aging of the Chinese population is imposing increasing economic burden of osteoporosis. This study evaluated the cost-effectiveness of osteoporosis treatment among the senior Chinese women population. A discrete event simulation model using age-specific probabilities of hip fracture, clinical vertebral fracture, wrist fracture, humerus fracture, and other fracture; costs (2015 US dollars); and quality-adjusted life years (QALYs) was used to assess the cost-effectiveness of osteoporosis treatment. Incremental cost-effectiveness ratio (ICER) was calculated. The willingness to pay (WTP) for a QALY in China was compared with the calculated ICER to decide the cost-effectiveness. To determine the absolute 10-year hip fracture probability at which the osteoporosis treatment became cost-effective, average age-specific probabilities for all fractures were multiplied by a relative risk (RR) that was systematically varied from 0 to 10 until the WTP threshold was observed for treatment relative to no intervention. Sensitivity analyses were also performed to evaluate the impacts from WTP and annual treatment costs. In baseline analysis, simulated ICERs were higher than the WTP threshold among Chinese women younger than 75, but much lower than the WTP among the older population. Sensitivity analyses indicated that cost-effectiveness could vary due to a higher WTP threshold or a lower annual treatment cost. A 30 % increase in WTP or a 30 % reduction in annual treatment costs will make osteoporosis treatment cost-effective for Chinese women population from 55 to 85. The current study provides evidence that osteoporosis treatment is cost-effective among a subpopulation of Chinese senior women. The results also indicate that the cost-effectiveness of using osteoporosis treatment is sensitive to the WTP threshold and annual treatment costs.

Willingness to participate in HIV vaccine trials among men who have sex with men in Chennai and Mumbai, India.

PubMed

Newman, Peter A; Chakrapani, Venkatesan; Weaver, James; Shunmugam, Murali; Rubincam, Clara

2014-10-07

Men who have sex with men (MSM) are at disproportionately high risk for HIV in India and would benefit greatly from a safe and effective HIV vaccine. We assessed willingness to participate (WTP) in HIV vaccine trials and the impact of various trial characteristics on WTP among MSM in Mumbai and Chennai. We used venue-based time-space sampling to recruit MSM at cruising sites and drop-in centers at community-based organizations. Structured survey interviews assessed sociodemographics, WTP and the impact of 10 trial characteristics on WTP. We tested for differences in WTP by sociodemographics and trial characteristics, and sociodemographic differences in the impact of trial characteristics on WTP. Among 400 participants (median age=25 years), 46.9% identified as kothi, 40.0% panthi/double-decker, 13.0% gay/bisexual; 29.0% had primary school education or less; and 40.0% had monthly income <=5000 INR (∼3USD/day). Overall, 48.1% reported being definitely willing to participate. Posttrial availability of an efficacious vaccine was the highest rated (90.98 on 100-point scale) trial characteristic, followed by availability of free medical treatment (90.79), life insurance (89.84) and side effects (79.81). Distance to the trial site, side effects, financial incentive, life insurance and free medical care had significant impacts on WTP, with differential importance of trial characteristics by sexual identity, education, income and living arrangement. The prioritization of trial-related financial and healthcare provisions, including access to an efficacious vaccine posttrial, among MSM in India indicates the importance of trials providing such services, as well as the value of formative research in identifying key concerns among participating communities in resource-limited settings. The significant impact of trial characteristics on WTP suggests that providing trial benefits deemed fair and important, addressing logistical concerns, and supporting educational interventions to mitigate vaccine fears may support recruitment of MSM in India in fairly and ethically conducted HIV vaccine trials. Copyright © 2014 Elsevier Ltd. All rights reserved.

What are colorectal cancer survivors' preferences for dietary advice? A best-worst discrete choice experiment.

PubMed

Wright, Stuart J; Gibson, Debbie; Eden, Martin; Lal, Simon; Todd, Chris; Ness, Andy; Burden, Sorrel

2017-12-01

Studies on healthy lifestyle interventions in survivors of colorectal cancer have been disappointing, demonstrating only modest changes. This study aims to quantify people's preferences for different aspects of dietary intervention. A best-worst discrete choice experiment was designed and incorporated into a questionnaire including participants' characteristics and a self-assessment of lifestyle. The response rate was 68% and 179 questionnaires were analysed. When analysing aggregate preferences, the modes of information provision selected as the most preferred were "face-to-face" (willingness to pay (WTP) £63.97, p ≤ 0.001) and "telephone" (WTP £62.36, p < 0.001) discussions whereas group discussions were preferred least (WTP -£118.96, p ≤ 0.001). Scenarios that included hospitals were most preferred (WTP £17.94, p = 0.031), and the favoured provider was bowel cancer nurses (WTP £75.11, p ≤ 0.001). When investigating preference heterogeneity, three sub-groups were identified: Firstly, "technophiles" preferring email (WTP £239.60, p ≤ 0.001) were male, were younger and had fewer risk factors. Secondly, a "one-to-one" group had strong preference for interventions over the telephone or at their local doctors and were older (WTP £642.13, p ≤ 0.001). Finally, a "person-centred" group preferred face-to-face individual or group sessions (WTP £358.79, p < 0.001) and had a high risk lifestyle. For survivors of colorectal cancer, there is not one approach that suits all when it comes to providing dietary advice. This is important information to consider when planning healthy lifestyle interventions which include dietary advice for survivors of colorectal cancer. Aligning services to individuals' preferences has the potential to improve patient experience and outcomes by increasing uptake of healthy lifestyle advice services and promoting a more tailored approach to dietary modifications, acknowledging sub-groups of people within the total population of colorectal cancer survivors.

Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey

PubMed Central

Tran, Bach Xuan; Phan, Huong Thi Thu; Le, Huong Thi; Nguyen, Hinh Duc; Tran, Tho Dinh; Do, Cuong Duy; Nguyen, Cuong Manh; Thuc, Vu Thi Minh; Latkin, Carl; Zhang, Melvyn W. B.; Ho, Roger C. M.

2017-01-01

Background Viral load testing is considered the gold standard for monitoring HIV treatment; however, given its high cost, some patients cannot afford viral load testing if this testing is not subsidized. Since foreign aid for HIV/AIDS in Vietnam is rapidly decreasing, we sought to assess willingness to pay (WTP) for viral load and CD4 cell count tests among HIV-positive patients, and identified factors that might inform future co-payment schemes. Methods A multi-site cross-sectional survey was conducted with 1133 HIV-positive patients on antiretroviral therapy (ART) in Hanoi and Nam Dinh. Patients’ health insurance coverage, quality of life, and history of illicit drug use were assessed. A contingent valuation approach was employed to measure patients’ WTP for CD4 cell count and viral load testing. Results HIV-positive patients receiving ART at provincial sites reported more difficulty obtaining health insurance (HI) and had the overall the poorest quality of life. Most patients (90.9%) were willing to pay for CD4 cell count testing; here, the mean WTP was valued at US$8.2 (95%CI = 7.6–8.8 US$) per test. Most patients (87.3%) were also willing to pay for viral load testing; here, mean WTP was valued at US$18.6 (95%CI = 16.3–20.9 US$) per test. High income, high education level, and hospitalization were positively associated with WTP, while co-morbidity with psychiatric symptoms and trouble paying for health insurance were both negatively related to WTP. Conclusions These findings raise concerns that HIV-positive patients in Vietnam might have low WTP for CD4 cell count and viral load testing. This means that without foreign financial subsidies, many of these patients would likely go without these important tests. Treating psychiatric co-morbidities, promoting healthcare services utilization, and removing barriers to accessing health insurance may increase WTP for monitoring of HIV/AIDS treatment among HIV+-positive Vietnamese patients. PMID:28199405

On what basis are medical cost-effectiveness thresholds set? Clashing opinions and an absence of data: a systematic review.

PubMed

Cameron, David; Ubels, Jasper; Norström, Fredrik

2018-01-01

The amount a government should be willing to invest in adopting new medical treatments has long been under debate. With many countries using formal cost-effectiveness (C/E) thresholds when examining potential new treatments and ever-growing medical costs, accurately setting the level of a C/E threshold can be essential for an efficient healthcare system. The aim of this systematic review is to describe the prominent approaches to setting a C/E threshold, compile available national-level C/E threshold data and willingness-to-pay (WTP) data, and to discern whether associations exist between these values, gross domestic product (GDP) and health-adjusted life expectancy (HALE). This review further examines current obstacles faced with the presently available data. A systematic review was performed to collect articles which have studied national C/E thresholds and willingness-to-pay (WTP) per quality-adjusted life year (QALY) in the general population. Associations between GDP, HALE, WTP, and C/E thresholds were analyzed with correlations. Seventeen countries were identified from nine unique sources to have formal C/E thresholds within our inclusion criteria. Thirteen countries from nine sources were identified to have WTP per QALY data within our inclusion criteria. Two possible associations were identified: C/E thresholds with HALE (quadratic correlation of 0.63), and C/E thresholds with GDP per capita (polynomial correlation of 0.84). However, these results are based on few observations and therefore firm conclusions cannot be made. Most national C/E thresholds identified in our review fall within the WHO's recommended range of one-to-three times GDP per capita. However, the quality and quantity of data available regarding national average WTP per QALY, opportunity costs, and C/E thresholds is poor in comparison to the importance of adequate investment in healthcare. There exists an obvious risk that countries might either over- or underinvest in healthcare if they base their decision-making process on erroneous presumptions or non-evidence-based methodologies. The commonly referred to value of 100,000$ USD per QALY may potentially have some basis.

On what basis are medical cost-effectiveness thresholds set? Clashing opinions and an absence of data: a systematic review

PubMed Central

Cameron, David; Ubels, Jasper; Norström, Fredrik

2018-01-01

ABSTRACT Background: The amount a government should be willing to invest in adopting new medical treatments has long been under debate. With many countries using formal cost-effectiveness (C/E) thresholds when examining potential new treatments and ever-growing medical costs, accurately setting the level of a C/E threshold can be essential for an efficient healthcare system. Objectives: The aim of this systematic review is to describe the prominent approaches to setting a C/E threshold, compile available national-level C/E threshold data and willingness-to-pay (WTP) data, and to discern whether associations exist between these values, gross domestic product (GDP) and health-adjusted life expectancy (HALE). This review further examines current obstacles faced with the presently available data. Methods: A systematic review was performed to collect articles which have studied national C/E thresholds and willingness-to-pay (WTP) per quality-adjusted life year (QALY) in the general population. Associations between GDP, HALE, WTP, and C/E thresholds were analyzed with correlations. Results: Seventeen countries were identified from nine unique sources to have formal C/E thresholds within our inclusion criteria. Thirteen countries from nine sources were identified to have WTP per QALY data within our inclusion criteria. Two possible associations were identified: C/E thresholds with HALE (quadratic correlation of 0.63), and C/E thresholds with GDP per capita (polynomial correlation of 0.84). However, these results are based on few observations and therefore firm conclusions cannot be made. Conclusions: Most national C/E thresholds identified in our review fall within the WHO’s recommended range of one-to-three times GDP per capita. However, the quality and quantity of data available regarding national average WTP per QALY, opportunity costs, and C/E thresholds is poor in comparison to the importance of adequate investment in healthcare. There exists an obvious risk that countries might either over- or underinvest in healthcare if they base their decision-making process on erroneous presumptions or non-evidence-based methodologies. The commonly referred to value of 100,000$ USD per QALY may potentially have some basis. PMID:29564962

Preventing land loss in coastal Louisiana: estimates of WTP and WTA.

PubMed

Petrolia, Daniel R; Kim, Tae-Goun

2011-03-01

A dichotomous-choice contingent-valuation survey was conducted in the State of Louisiana (USA) to estimate compensating surplus (CS) and equivalent surplus (ES) welfare measures for the prevention of future coastal wetland losses in Louisiana. Valuations were elicited using both willingness to pay (WTP) and willingness to accept compensation (WTA) payment vehicles. Mean CS (WTP) estimates based on a probit model using a Box-Cox specification on income was $825 per household annually, and mean ES (WTA) was estimated at $4444 per household annually. Regression results indicate that the major factors influencing support for land-loss prevention were income (positive, WTP model only), perceived hurricane protection benefits (positive), environmental and recreation protection (positive), distrust of government (negative), age (positive, WTA model only), and race (positive for whites). Copyright © 2010 Elsevier Ltd. All rights reserved.

Estimating a constant WTP for a QALY-a mission impossible?

PubMed

Sund, Björn; Svensson, Mikael

2017-09-21

Economic evaluations are an important input to decision-making and priority-setting in the health care sector. Measuring preferences for health improvements, as the demand-side value (willingness to pay) of gaining a quality-adjusted life year (QALY), is one relevant component in the interpretation of the results from health economic evaluations. Our article addresses whether willingness to pay for a QALY (WTP-Q) is sensitive to the size of the health differences and the probability for improvement. We use data from a contingent valuation survey based on 1400 respondents conducted in the spring of 2014. The results show that the expectation of sensitivity to scope, or higher WTP to the larger expected quality of life improvement, is not supported. We find WTP-Q values that conform reasonably well to previous studies in Sweden.

A Comparative Study on Willingness to Pay for Breast Cancer and Osteoporosis Screening in Kerman, Southeastern Iran.

PubMed

Sabermahani, Asma; Mohammad Taghizade, Sedighe; Goodarzi, Reza

2017-05-01

One of the economic evaluation techniques involves calculation of willingness to pay (WTP) for a service to find out the value of that service from the clients' perspective. This study estimated WTP for both breast cancer and osteoporosis screening and comparatively examined the contributing factors. In fact, the comparisons served to provide an exact analysis of individual attitudes and behaviors in relation to screening programs for cancers and other diseases. This study was first designed in six scenarios several questionnaires concerning individual breast cancer and osteoporosis screening cases, and determined the WTP median in each scenario between people in Kerman Province of Iran in 2016. Then, the demand function for breast cancer and osteoporosis screening was formulated. Moreover, the factors contributing to WTP were examined through various scenarios in Stata and econometric techniques. The median and mean values of WTP in all the above scenarios were greater for breast cancer screening than for osteoporosis screening. Theoretically, the price assumed a minus sign whereas risk assumed a plus sign within the demand function formulated for both screening programs. Regarding the evaluated factors, age in breast cancer screening and risk of disease in osteoporosis screening were the major factors contributing to WTP. Breast cancer screening was more valuable than osteoporosis screening program from the perspective of the subjects. The programs can be successfully designed by concentrating on patients' age groups in breast cancer screening and high-risk patients in osteoporosis screening.

Intensification of decadal and multi-decadal sea level variability in the western tropical Pacific during recent decades

NASA Astrophysics Data System (ADS)

Han, Weiqing; Meehl, Gerald A.; Hu, Aixue; Alexander, Michael A.; Yamagata, Toshio; Yuan, Dongliang; Ishii, Masayoshi; Pegion, Philip; Zheng, Jian; Hamlington, Benjamin D.; Quan, Xiao-Wei; Leben, Robert R.

2014-09-01

Previous studies have linked the rapid sea level rise (SLR) in the western tropical Pacific (WTP) since the early 1990s to the Pacific decadal climate modes, notably the Pacific Decadal Oscillation in the north Pacific or Interdecadal Pacific Oscillation (IPO) considering its basin wide signature. Here, the authors investigate the changing patterns of decadal (10-20 years) and multidecadal (>20 years) sea level variability (global mean SLR removed) in the Pacific associated with the IPO, by analyzing satellite and in situ observations, together with reconstructed and reanalysis products, and performing ocean and atmosphere model experiments. Robust intensification is detected for both decadal and multidecadal sea level variability in the WTP since the early 1990s. The IPO intensity, however, did not increase and thus cannot explain the faster SLR. The observed, accelerated WTP SLR results from the combined effects of Indian Ocean and WTP warming and central-eastern tropical Pacific cooling associated with the IPO cold transition. The warm Indian Ocean acts in concert with the warm WTP and cold central-eastern tropical Pacific to drive intensified easterlies and negative Ekman pumping velocity in western-central tropical Pacific, thereby enhancing the western tropical Pacific SLR. On decadal timescales, the intensified sea level variability since the late 1980s or early 1990s results from the "out of phase" relationship of sea surface temperature anomalies between the Indian and central-eastern tropical Pacific since 1985, which produces "in phase" effects on the WTP sea level variability.

Levers supporting tariff growth for water services: evidence from a contingent valuation analysis.

PubMed

Guerrini, Andrea; Vigolo, Vania; Romano, Giulia; Testa, Federico

2018-02-01

The backwardness of the water utilities sector necessitates urgent investment in infrastructure to improve water quality and efficiency in water supply networks. A policy of tariff growth represents the main source to sustain such investments. Therefore, customer engagement in the form of willingness to pay (WTP) is highly desirable by water utilities to obtain social legitimization and support. This study examines the determinants of consumers' WTP for improvement programs for three drinking water issues: quality of water sources, renewal of water mains, and building of new wastewater treatment plants. The study is based on a survey conducted among a sample of 587 customers of a water utility located in the province of Verona in the north of Italy. The contingence valuation method is used to measure WTP. Specifically, an ordinal logistic regression model yields the following significant determinants of WTP: quality of water and services provided, preference for privatization of the water utility, sustainable consumption of water, and some socio-demographic variables. The findings provide interesting insights into the drivers of WTP as well as managerial recommendations for water utilities. In particular, the findings show that water utilities need to improve service and water quality to increase customers' acceptance of tariff growth. In addition, utilities should invest in customer education and communication activities focusing on specific age groups (e.g., older customers) to enhance their WTP. Finally, communication strategies should reinforce the possible role of liberalization and privatization in supporting infrastructure investments. Copyright © 2017 Elsevier Ltd. All rights reserved.

Acceptability of willingness to pay techniques to consumers.

PubMed

Taylor, Susan J; Armour, Carol L

2002-12-01

The purpose of this study was to assess and compare the proportion of usable responses and protest votes obtained with two willingness to pay (WTP) techniques, contingent valuation (CV) and discrete choice experiment (DCE) and to assess the acceptability of the techniques to respondents. Pregnant women attending the public antenatal clinics of a Sydney teaching hospital were surveyed. Preference for either Treatment A (artificial rupture of the membranes followed by intravenous oxytocin) or Treatment B (prostaglandin E2 gel followed by oxytocin if necessary) was assessed. Then WTP for the preferred treatments was assessed using CV and WTP for specific attributes of the treatments in the DCE. In addition, the acceptability of the two techniques was compared in terms of responses deemed to be valid according to defined criteria, protest votes and comments recorded by consumers. With the CV, 74% of respondents chose gel and their maximum WTP was Aus$178 compared with $133 for the alternative. A total of 68% of responses were deemed to be valid including 5% who may have been expressing a protest vote. With the DCE, respondents were WTP $55 for every 1 h reduction in the length of time from induction to delivery. A total of 72% of responses were deemed valid and only two of these 258 women were considered to have expressed a protest vote. Only a small number of women expressed objections to the use of WTP questions in health-care and the majority of women completed both questions successfully.

Willingness to pay for ovulation induction treatment in case of WHO II anovulation: a study using the contingent valuation method

PubMed Central

Poder, Thomas G; He, Jie; Simard, Catherine; Pasquier, Jean-Charles

2014-01-01

Objective To measure the willingness to pay (WTP) of women aged 18–45 years to receive drug treatment for ovulation induction (ie, the social value of normal cycles of ovulation for a woman of childbearing age) in order to feed the debate about the funding of fertility cares. Setting An anonymous questionnaire was used over the general population of Quebec. Participants A total of 136 subjects were recruited in three medical clinics, and 191 subjects through an online questionnaire. Method The questionnaire consisted of three parts: introduction to the problematic, socioeconomic data collection to determine factors influencing the formation of WTP, and a WTP question using the simple bid price dichotomous choice elicitation technique. The econometric estimation method is based on the “random utility theory.” Each subject responding to our questionnaire could express her uncertainty about the answer to our WTP question by choosing the answer “I do not know.” Outcome measure The WTP in Canadian dollars of women aged 18–45 years to receive drug treatment for ovulation induction. Results Results are positive and indicate an average WTP exceeding 4,800 CAD, which is much more than the drug treatment cost. There is no evidence of sample frame bias or avidity bias across the two survey modes that cannot be controlled in econometric estimates. Conclusion Medical treatment for ovulation induction is highly socially desirable in Quebec. PMID:25328385

Willingness to pay for small-quantity lipid-based nutrient supplements for women and children: Evidence from Ghana and Malawi.

PubMed

Adams, Katherine P; Vosti, Stephen A; Ayifah, Emmanuel; Phiri, Thokozani E; Adu-Afarwuah, Seth; Maleta, Kenneth; Ashorn, Ulla; Arimond, Mary; Dewey, Kathryn G

2018-04-01

Small-quantity lipid-based nutrient supplements (SQ-LNS) are designed to enrich maternal and child diets with the objective of preventing undernutrition during the first 1,000 days. Scaling up the delivery of supplements such as SQ-LNS hinges on understanding private demand and creatively leveraging policy-relevant factors that might influence demand. We used longitudinal stated willingness-to-pay (WTP) data from contingent valuation studies that were integrated into randomized controlled nutrition trials in Ghana and Malawi to estimate private valuation of SQ-LNS during pregnancy, postpartum, and early childhood. We found that average stated WTP for a day's supply of SQ-LNS was more than twice as high in Ghana than Malawi, indicating that demand for SQ-LNS (and by extension, the options for effective delivery of SQ-LNS) may be very context specific. We also examined factors associated with WTP, including intervention group, household socioeconomic status, birth outcomes, child growth, and maternal and child morbidity. In both sites, WTP was consistently negatively associated with household food insecurity, indicating that subsidization might be needed to permit food insecure households to acquire SQ-LNS if it is made available for purchase. In Ghana, WTP was higher among heads of household than among mothers, which may be related to control over household resources. Personal experience using SQ-LNS was not associated with WTP in either site. © 2017 The Authors. Maternal and Child Nutrition published by John Wiley & Sons, Ltd.

Integrating self-determined needs into the relationship among product design, willingness-to-pay a premium, and word-of-mouth: a cross-cultural gender-specific study.

PubMed

Gilal, Faheem Gul; Zhang, Jian; Gilal, Naeem Gul; Gilal, Rukhsana Gul

2018-01-01

The present study integrates self-determined needs satisfaction into a relationship between product design (eg, aesthetic, functional, and symbolic design) and consumer behavior (eg, willingness-to-pay [WTP] a premium and negative word-of-mouth [WOM]) and to explore whether gender can differentiate the effects of aesthetic, functional, and symbolic product designs on self-determined needs satisfaction. To this end, participants from Pakistan and China were recruited, and the hypotheses for this study were tested using structural equation modeling and SPSS-PROCESS. The effects of three product designs on self-determined needs satisfaction were significantly positive across samples. The results further show that self-determined needs satisfaction had the strongest positive effect on WTP a premium and the strongest negative effect on vindictive WOM for Pakistanis. Self-determined needs frustration had the strongest negative effect on the WTP a premium for Chinese participants and an equivalent magnitude effect on vindictive WOM for Pakistani and Chinese participants. The cross-cultural gender-specific findings revealed that Pakistani men are more aesthetic and hedonic than women in Pakistan. Surprisingly, Chinese women resemble Pakistani men in the sense that they prefer aesthetically pleasing products. Chinese men resemble Pakistani women in terms of little interest in symbolic products, whereas Chinese women and Pakistani men respond similarly regarding their decisions to choose symbolic products. To the best of the authors' knowledge, the present study is one of the initial attempts to integrate self-determined needs into the relationship between product design and consumer WTP a premium and WOM, and further explore cross-cultural gender-specific differences across Pakistan and China. The findings of the present study may help international marketers in terms of segmenting, targeting, and positioning their markets.

Consumer preferences and willingness to pay for value-added chicken product attributes.

PubMed

Martínez Michel, Lorelei; Anders, Sven; Wismer, Wendy V

2011-10-01

A growing demand for convenient and ready-to-eat products has increased poultry processors' interest in developing consumer-oriented value-added chicken products. In this study, a conjoint analysis survey of 276 chicken consumers in Edmonton was conducted during the summer of 2009 to assess the importance of the chicken part, production method, processing method, storage method, the presence of added flavor, and cooking method on consumer preferences for different value-added chicken product attributes. Estimates of consumer willingness to pay (WTP) premium prices for different combinations of value-added chicken attributes were also determined. Participants'"ideal" chicken product was a refrigerated product made with free-range chicken breast, produced with no additives or preservatives and no added flavor, which could be oven heated or pan heated. Half of all participants on average were willing to pay 30% more for a value-added chicken product over the price of a conventional product. Overall, young consumers, individuals who shop at Farmers' Markets and those who prefer free-range or organic products were more likely to pay a premium for value-added chicken products. As expected, consumers' WTP was affected negatively by product price. Combined knowledge of consumer product attribute preferences and consumer WTP for value-added chicken products can help the poultry industry design innovative value-added chicken products. Practical Application:  An optimum combination of product attributes desired by consumers for the development of a new value-added chicken product, as well as the WTP for this product, have been identified in this study. This information is relevant to the poultry industry to enhance consumer satisfaction of future value-added chicken products and provide the tools for future profit growth. © 2011 Institute of Food Technologists®

Performance of small water treatment plants: The case study of Mutshedzi Water Treatment Plant

NASA Astrophysics Data System (ADS)

Makungo, R.; Odiyo, J. O.; Tshidzumba, N.

The performance of small water treatment plants (SWTPs) was evaluated using Mutshedzi WTP as a case study. The majority of SWTPs in South Africa (SA) that supply water to rural villages face problems of cost recovery, water wastages, limited size and semi-skilled labour. The raw and final water quality analyses and their compliance were used to assess the performance of the Mutshedzi WTP. Electrical conductivity (EC), pН and turbidity were measured in the field using a portable multimeter and a turbidity meter respectively. Atomic Absorption Spectrometry and Ion Chromatography were used to analyse metals and non-metals respectively. The results were compared with the Department of Water Affairs (DWA) guidelines for domestic use. The turbidity levels partially exceeded the recommended guidelines for domestic water use of 1 NTU. The concentrations of chemical parameters in final water were within the DWA guidelines for domestic water use except for fluoride, which exceeded the maximum allowable guideline of 1.5 mg/L in August 2009. Mutshedzi WTP had computed compliance for raw and final water analyses ranging from 79% to 93% and 86% to 93% throughout the sampling period, respectively. The results from earlier studies showed that the microbiological quality of final water in Mutshedzi WTP complied with the recommended guidelines, eliminating the slight chance of adverse aesthetic effects and infectious disease transmission associated with the turbidity values between 1 and 5 NTU. The study concluded that Mutshedzi WTP, though moving towards compliance, is still not producing adequate quality of water. Other studies also indicated that the quantity of water produced from Mutshedzi WTP was inadequate. The findings of the study indicate that lack of monitoring of quantity of water supplied to each village, dosage of treatment chemicals, the treatment capacity of the WTP and monitoring the quality of water treated are some of the factors that limit the performance of Mutshedzi WTP. These have been confirmed in literature to be widespread in similar WTPs in SA. It is recommended that water meters be provided and the community be advised to subsidise the cost of water supply. The study recommended that the treatments of turbidity and fluoride should form critical functions of the plant to ensure that final water for domestic use is always safe from any harmful substances or disease causing pathogens. The study concluded that the WTP only needs minor improvement to boost its efficiency with regard to the treatment of raw water. This will also ensure that the plant achieves 100% compliance for final water.

Measuring the Monetary Value of Dental Implants for Denture Retention: A Willingness to Pay Approach.

PubMed

Sendi, Pedram; Bertschinger, Nadine; Brand, Christina; Marinello, Carlo P; Bucher, Heiner C; Bornstein, Michael M

2017-01-01

Two interforaminal dental implants in is a common treatment option for denture retention in edentulous patients. Economic methods to assess the patient's quality of life include the willingness to pay (WTP) for implant treatment and willingness to accept (WTA) to forgo implant treatment. The purpose of this study was to assess the monetary value of implant retained complete dentures using WTP and WTA. We included a convenience sample of 16 patients from a previously published cohort study on the survival of immediately loaded implants in edentulous patients to assess WTP and WTA for this treatment option. The average maximum WTP for implant treatment was 4606 (95% CI: 2991-6222) Swiss Francs. Out of the 16 patients, only 5 were willing to trade their implants for money, with a mean WTA of CHF 33'500 (range: 3000-100'000).All patients would agree to undergo the implant surgery procedure again. The results of the present study show that most patients are not willing to trade the increase in quality of life after implant surgery against money, suggesting that WTA exceeds by large WTP for the same health condition.

Use of partial least squares path modelling to assess the willingness of Chinese female sex workers to participate in a microbicide trial.

PubMed

Yao, N; Zeng, Q; Zhong, N X; Li, D X; Huang, L A; Shao, M Y; Ruan, H Y

2015-09-01

To investigate the willingness of Chinese female sex workers (FSWs) to participate (WTP) in a clinical trial of microbicides; to explore the potential hindrances and facilitating factors; and to provide support for future microbicide clinical trials by tailoring their design to better meet the specific needs of FSWs. Cross-sectional study. In total, 404 FSWs were investigated using structured questionnaires. Exploratory factor analysis and partial least squares path modelling were used to explore the correlations between several influencing factors and WTP. The WTP of FSWs enrolled in this study was high (53.47%, 216/404). Possible benefits from enrolment in the trial were positively associated with WTP, while concern about a hypothetical microbicide, potential physical harm, economic loss from participation, and fear of family or social isolation were negatively associated with WTP. FSWs are appropriate participants in microbicide clinical trials, and are likely to benefit from effective microbicides. In a microbicide clinical trial, it is imperative to ensure protection of the rights, dignity, safety, confidentiality and welfare of FSW participants. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Hanford Low-Activity Waste Processing: Demonstration of the Off-Gas Recycle Flowsheet - 13443

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

Ramsey, William G.; Esparza, Brian P.

2013-07-01

Vitrification of Hanford Low-Activity Waste (LAW) is nominally the thermal conversion and incorporation of sodium salts and radionuclides into borosilicate glass. One key radionuclide present in LAW is technetium-99. Technetium-99 is a low energy, long-lived beta emitting radionuclide present in the waste feed in concentrations on the order of 1-10 ppm. The long half-life combined with a high solubility in groundwater results in technetium-99 having considerable impact on performance modeling (as potential release to the environment) of both the waste glass and associated secondary waste products. The current Hanford Tank Waste Treatment and Immobilization Plant (WTP) process flowsheet calls formore » the recycle of vitrification process off-gas condensates to maximize the portion of technetium ultimately immobilized in the waste glass. This is required as technetium acts as a semi-volatile specie, i.e. considerable loss of the radionuclide to the process off-gas stream can occur during the vitrification process. To test the process flowsheet assumptions, a prototypic off-gas system with recycle capability was added to a laboratory melter (on the order of 1/200 scale) and testing performed. Key test goals included determination of the process mass balance for technetium, a non-radioactive surrogate (rhenium), and other soluble species (sulfate, halides, etc.) which are concentrated by recycling off-gas condensates. The studies performed are the initial demonstrations of process recycle for this type of liquid-fed melter system. This paper describes the process recycle system, the waste feeds processed, and experimental results. Comparisons between data gathered using process recycle and previous single pass melter testing as well as mathematical modeling simulations are also provided. (authors)« less

Biological Treatment of Solvent-Based Paint

DTIC Science & Technology

2011-01-01

ESTCP Environmental Security Technology Certification Program FK-WTP Fort Kamehameha Wastewater Treatment Plant FTIR Fourier Transform Infrared...established by the Fort Kamehameha Wastewater Treatment Plant (FK-WTP) for the water; toxicity characteristic leaching procedure (TCLP) requirements for

Utilization of Drinking Water Treatment Slurry to Produce Aluminum Sulfate Coagulant.

PubMed

Fouad, Mahmoud M; Razek, Taha M A; Elgendy, Ahmed S

2017-02-01

  In Egypt, water treatment consumes about 365 000 tons of aluminum sulfate and produces more than 100 million tons of sludge per year. The common disposal system of sludge in Egypt is to discharge it into natural waterways. Toxicity of aluminum, environmental regulations and costs of chemicals used in water treatment and sludge treatment processes led to an evaluation of coagulant recovery and subsequent reuse. The present work aimed at aluminum recovery from sludge of El-Shiekh Zayd water treatment plant (WTP) to produce aluminum sulfate coagulant. Sludge was characterized and the effect of five variables was tested and the process efficiency was evaluated at different operating conditions. Maximum recovery is 94.2% at acid concentration 1.5 N, sludge weight 5 g, mixing speed 60 rpm, temperature 60 °C and leaching time 40 min. Then optimum conditions were applied to get maximum recovery for aluminum sulfate and compared to commercial coagulant on raw water of El-Shiekh Zayd (WTP).

Nucleation and crystal growth behavior of nepheline in simulated high-level waste glasses

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

Fox, K.; Amoroso, J.; Mcclane, D.

The Savannah River National Laboratory (SRNL) has been tasked with supporting glass formulation development and process control strategies in key technical areas, relevant to the Department of Energy’s Office of River Protection (DOE-ORP) and related to high-level waste (HLW) vitrification at the Waste Treatment and Immobilization Plant (WTP). Of specific interest is the development of predictive models for crystallization of nepheline (NaAlSiO4) in HLW glasses formulated at high alumina concentrations. This report summarizes recent progress by researchers at SRNL towards developing a predicative tool for quantifying nepheline crystallization in HLW glass canisters using laboratory experiments. In this work, differential scanningmore » calorimetry (DSC) was used to obtain the temperature regions over which nucleation and growth of nepheline occur in three simulated HLW glasses - two glasses representative of WTP projections and one glass representative of the Defense Waste Processing Facility (DWPF) product. The DWPF glass, which has been studied previously, was chosen as a reference composition and for comparison purposes. Complementary quantitative X-ray diffraction (XRD) and optical microscopy confirmed the validity of the methodology to determine nucleation and growth behavior as a function of temperature. The nepheline crystallization growth region was determined to generally extend from ~ 500 to >850 °C, with the maximum growth rates occurring between 600 and 700 °C. For select WTP glass compositions (high Al2O3 and B2O3), the nucleation range extended from ~ 450 to 600 °C, with the maximum nucleation rates occurring at ~ 530 °C. For the DWPF glass composition, the nucleation range extended from ~ 450 to 750 °C with the maximum nucleation rate occurring at ~ 640 °C. The nepheline growth at the peak temperature, as determined by XRD, was between 35 - 75 wt.% /hour. A maximum nepheline growth rate of ~ 0.1 mm/hour at 700 °C was measured for the DWPF composition using optical microscopy. This research establishes a viable alternative to more traditional techniques for evaluating nepheline crystallization in large numbers of glasses, which are prohibitively time consuming or otherwise impractical. The ultimate objective is to combine the nucleation and growth information obtained from DSC, like that presented in this report, with computer simulations of glass cooling within the canister to accurately predict nepheline crystallization in HLW during processing through WTP.« less

Comparing the validity of the payment card and structured haggling willingness to pay methods: The case of a diabetes prevention program in rural Kenya.

PubMed

Kangethe, Anne; Franic, Duska M; Corso, Phaedra S

2016-11-01

The objective of this study was to compare the theoretical validity of two willingness-to-pay (WTP) methods, the commonly used payment card (PC) and the recently developed structured haggling (SH), for estimating the potential benefits of a diabetes prevention program in rural Kenya. A convenience sample of adult residents from a rural county in Kenya (Kiambu), with no history of diabetes, was randomly assigned to one of two WTP methods, PC or SH, using structured face-to-face interviews from December 2011 to February 2012. A total of 376 respondents completed the interviews using PC (n = 185) or SH (n = 191). More than 95% of respondents were willing to pay something for program access. The study showed that both methods were feasible in rural Kenya. SH resulted in a higher annual mean WTP than PC, Ksh504.05 (US$7.25) versus Ksh619.95 (US$5.90), respectively (p < 0.01). Based on theory, it was hypothesized that certain predisposing factors would result in greater WTP. Greater socio-economic status (measured using income proxies) resulted in greater unconditional WTP for both the PC and SH groups (t-tests and bivariate correlations) and conditional WTP (GLM models). GLM for PC showed being male, employed and having distant relatives with diabetes were significant predictors for WTP, while for SH being educated, employed and owning a vehicle were significant predictors. Both PC and SH showed theoretical validity in rural Kenya. However, the use of SH over PC in rural Kenya may be the better choice given that SH more closely mirrors marketplace transactions in this setting and the use of SH resulted in more significant variables in the GLM models. Copyright © 2016 Elsevier Ltd. All rights reserved.

Factors and values of willingness to pay for improved construction waste management--a perspective of Malaysian contractors.

PubMed

Begum, Rawshan Ara; Siwar, Chamhuri; Pereira, Joy Jacqueline; Jaafar, Abdul Hamid

2007-01-01

Malaysia is facing an increase in the generation of waste and of accompanying problems with the disposal of this waste. In the last two decades, extensive building and infrastructure development projects have led to an increase in the generation of construction waste material. The construction industry has a substantial impact on the environment, and its environmental effects are in direct relation to the quality and quantity of the waste it generates. This paper discusses general characteristics of the construction contractors, the contractors' willingness to pay (WTP) for improved construction waste management, determining factors which affect the amount of their willingness to pay, and suggestions and policy implications in the perspective of construction waste management in Malaysia. The data in this study is based on contractors registered with the construction industry development board (CIDB) of Malaysia. Employing the open ended contingent valuation method, the study assessed the contractors' average maximum WTP for improved construction waste management to be RM69.88 (1US$=3.6 RM) per tonne of waste. The result shows that the average maximum WTP is higher for large contractors than for medium and small contractors. The highest average maximum WTP value is RM88.00 for Group A (large contractors) RM78.25 for Group B (medium-size contractors) and RM55.80 for Group C (small contractors). One of the contributions of this study is to highlight the difference of CIDB registration grade in the WTP for improved construction waste management. It is found that contractors' WTP for improved waste collection and disposal services increases with the increase in contractors' current paid up capital. The identified factors and determinants of the WTP will assist the formulation of appropriate policies in addressing the construction waste problem in Malaysia and indirectly improve the quality of construction in the country.

Factors influencing postpartum women's willingness to participate in a preventive pelvic floor muscle training program: a web-based survey.

PubMed

Moossdorff-Steinhauser, Heidi F A; Albers-Heitner, Pytha; Weemhoff, Mirjam; Spaanderman, Marc E A; Nieman, Fred H M; Berghmans, Bary

2015-12-01

Pregnancy and delivery are the most prominent risk factors for the onset of pelvic floor injuries and - later-on - urinary incontinence. Supervised pelvic floor muscle training during and after pregnancy is proven effective for the prevention of urinary incontinence on the short term. However, only a minority of women do participate in preventive pelvic floor muscle training programs. Our aim was to analyze willingness to participate (WTP) in an intensive preventive pelvic floor muscle training (PFMT) program and influencing factors, from the perspective of postpartum women, for participation. We included 169 three-month postpartum women in a web-based survey in the Netherlands. Demographic and clinical characteristics, knowledge and experience with PFMT and preconditions for actual WTP were assessed. Main outcome measures were frequencies and percentages for categorical data. Cross tabulations were used to explore the relationship between WTP and various independent categorical variables. A linear regression analysis was done to analyze which variables are associated with WTP. A response rate of 64% (n=169) was achieved. 31% of the women was WTP, 41% was hesitating, 12% already participated in PFMT and 15% was not interested (at all). No statistically significant association was found between WTP and risk or prognostic pelvic floor dysfunction factors. Women already having symptoms of pelvic floor dysfunction such as incontinence and pelvic organ prolapse symptoms were more WTP (p=0.010, p=0.001, respectively) as were women perceiving better general health (p<0.001). Preconditions for women to participate were program costs, and travel time not exceeding 15min. From the perspective of postpartum women, there is room for improvement of preventive pelvic floor management. Further research should focus on strategies to tackle major barriers and to introduce facilitators for postpartum women to participate in PFMT programs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A mechanism to derive more truthful willingness to accept values for renewable energy systems.

PubMed

Radmehr, Mehrshad; Willis, Ken; Metcalf, Hugh

2018-01-01

This paper examines and compares households' willingness to accept (WTA)/willingness to pay (WTP) ratio for solar power equipment on their premises through both a novel experimental approach and conventional techniques. The experimental approach was administered by using a Becker-DeGroot-Marschak method and cheap talk, with open-ended questions of WTA/WTP. The results were quite striking. The ratio for the incentivised approach was 1.08:1; whereas for the conventional approach it was 3.5:1. The findings suggest that the hypothesis that WTP equals WTA cannot be rejected for the incentivised mechanism, and it appears to control for the individual's strategic behaviour bias as a treatment against over-estimating WTA and under-estimating WTP. The findings also provide some policy implications for Northern Cyprus: the government can set lower financial incentives to increase the solar power installed capacity on the island.

Manufacturing ceramic bricks with polyaluminum chloride (PAC) sludge from a water treatment plant.

PubMed

da Silva, E M; Morita, D M; Lima, A C M; Teixeira, L Girard

2015-01-01

The objective of this research work is to assess the viability of manufacturing ceramic bricks with sludge from a water treatment plant (WTP) for use in real-world applications. Sludge was collected from settling tanks at the Bolonha WTP, which is located in Belém, capital of the state of Pará, Brazil. After dewatering in drainage beds, sludge was added to the clay at a local brickworks at different mass percentages (7.6, 9.0, 11.7, 13.9 and 23.5%). Laboratory tests were performed on the bricks to assess their resistance to compression, water absorption, dimensions and visual aspects. Percentages of 7.6, 9.0, 11.7 and 13.9% (w/w) of WTP sludge presented good results in terms of resistance, which indicates that technically, ceramic bricks can be produced by incorporating up to 13.9% of WTP sludge.

Coping with unreliable public water supplies: Averting expenditures by households in Kathmandu, Nepal

NASA Astrophysics Data System (ADS)

Pattanayak, Subhrendu K.; Yang, Jui-Chen; Whittington, Dale; Bal Kumar, K. C.

2005-02-01

This paper investigates two complementary pieces of data on households' demand for improved water services, coping costs and willingness to pay (WTP), from a survey of 1500 randomly sampled households in Kathmandu, Nepal. We evaluate how coping costs and WTP vary across types of water users and income. We find that households in Kathmandu Valley engage in five main types of coping behaviors: collecting, pumping, treating, storing, and purchasing. These activities impose coping costs on an average household of as much as 3 U.S. dollars per month or about 1% of current incomes, representing hidden but real costs of poor infrastructure service. We find that these coping costs are almost twice as much as the current monthly bills paid to the water utility but are significantly lower than estimates of WTP for improved services. We find that coping costs are statistically correlated with WTP and several household characteristics.

Willingness to Pay for Home-Based Rehabilitation Service Among Older Adults.

PubMed

Li, Xuemei; Wan, Xia; Pang, Yajuan; Zhou, Lanshu

2018-06-18

This study aims to investigate the willingness to pay (WTP) for a home-based rehabilitation service and explore the influencing factors of WTP among older adults in Shanghai, China. A cross-sectional design was used. A questionnaire survey based on the contingent valuation method was conducted by face-to-face survey over 3 months. Only 242 (44%) participants were willing to pay for a home-based rehabilitation service. The median amount they were willing to pay was RMB 8 (US$1.15) per visit. Older adults who had higher monthly income, had at least one partner who worked, and had medical insurance were willing to pay more for the service. Older adults showed low WTP for a home-based rehabilitation service. Economic status and health condition are the significant influencing factors of WTP. Studies on recipients' precise needs and ability to pay are required before home-based services are implemented.

Willingness to pay for a new drug delivery in Parkinson patients.

PubMed

Lökk, Johan; Olofsson, Sara; Persson, Ulf

2014-01-01

The Swedish reimbursement system operates a system where prices are set based on the expected value to the consumer. This value can be measured using willingness to pay (WTP). To assess Parkinson's disease (PD) patients' WTP for newly developed microtablets of levodopa in combination with a drug-delivering electronic device (M/E) compared to standard treatment with levodopa in combination with the COMT (catechol-O-methyl transferase)-inhibitor entacapone (L/e). A total of 2,000 randomly included PD patients had a postal questionnaire covering demographics, disease-specific issues, views on medication and WTP in different hypothetical scenarios. The first scenario was M/E with no change in effects or side effects; the second scenario was M/E with same effect and less side effects; and the third scenario was M/E with improved effect and less side effects. These scenarios were coupled to different costs to choose from. A total of 999 patients (50%) responded, mean age of 71 years and a mean PD duration of 9 years. Of all respondents, 50% preferred M/E before L/e in scenario one with increasing preference to scenario three. The average monthly WTP among all respondents in scenario one was SEK 230 and SEK 226 in L/e, both with an almost longitudinal doubling up to scenario three. Duration of PD-related symptoms, high education, and high medication intake implied a higher WTP in all scenarios in contrast to age, sex, and extra doses of levodopa. WTP for M/E increased gradually with high medication intake and education as well as with expected increased reduction of PD symptoms.

Monsoon rainfall over India in June and link with northwest tropical pacific - June ISMR and link with northwest tropical pacific

NASA Astrophysics Data System (ADS)

Surendran, Sajani; Gadgil, Sulochana; Rajendran, Kavirajan; Varghese, Stella Jes; Kitoh, Akio

2018-03-01

Recent years have witnessed large interannual variation of all-India rainfall (AIR) in June, with intermittent large deficits and excesses. Variability of June AIR is found to have the strongest link with variation of rainfall over northwest tropical Pacific (NWTP), with AIR deficit (excess) associated with enhancement (suppression) of NWTP rainfall. This association is investigated using high-resolution Meteorological Research Institute model which shows high skill in simulating important features of Asian summer monsoon, its variability and the inverse relationship between NWTP rainfall and AIR. Analysis of the variation of NWTP rainfall shows that it is associated with a change in the latitudinal position of subtropical westerly jet over the region stretching from West of Tibetan Plateau (WTP) to NWTP and the phase of Rossby wave steered in it with centres over NWTP and WTP. In years with large rainfall excess/deficit, the strong link between AIR and NWTP rainfall exists through differences in Rossby wave phase steered in the jet. The positive phase of the WTP-NWTP pattern, with troughs over WTP and west of NWTP, tends to be associated with increased rainfall over NWTP and decreased AIR. This scenario is reversed in the opposite phase. Thus, the teleconnection between NWTP rainfall and AIR is a manifestation of the difference in the phase of Rossby wave between excess and deficit years, with centres over WTP and NWTP. This brings out the importance of prediction of phase of Rossby waves over WTP and NWTP in advance, for prediction of June rainfall over India.

Acceptability of willingness to pay techniques to consumers

PubMed Central

Taylor, Susan J.; Armour, Carol L.

2002-01-01

Abstract Objective The purpose of this study was to assess and compare the proportion of usable responses and protest votes obtained with two willingness to pay (WTP) techniques, contingent valuation (CV) and discrete choice experiment (DCE) and to assess the acceptability of the techniques to respondents. Setting and participants Pregnant women attending the public antenatal clinics of a Sydney teaching hospital were surveyed. Main variables studied Preference for either Treatment A (artificial rupture of the membranes followed by intravenous oxytocin) or Treatment B (prostaglandin E2 gel followed by oxytocin if necessary) was assessed. Then WTP for the preferred treatments was assessed using CV and WTP for specific attributes of the treatments in the DCE. In addition, the acceptability of the two techniques was compared in terms of responses deemed to be valid according to defined criteria, protest votes and comments recorded by consumers. Results With the CV, 74% of respondents chose gel and their maximum WTP was Aus$178 compared with $133 for the alternative. A total of 68% of responses were deemed to be valid including 5% who may have been expressing a protest vote. With the DCE, respondents were WTP $55 for every 1 h reduction in the length of time from induction to delivery. A total of 72% of responses were deemed valid and only two of these 258 women were considered to have expressed a protest vote. Conclusions Only a small number of women expressed objections to the use of WTP questions in health‐care and the majority of women completed both questions successfully. PMID:12460223

Parents' willingness to pay for biologic treatments in juvenile idiopathic arthritis.

PubMed

Burnett, Heather F; Ungar, Wendy J; Regier, Dean A; Feldman, Brian M; Miller, Fiona A

2014-12-01

Biologic therapies are considered the standard of care for children with the most severe forms of juvenile idiopathic arthritis (JIA). Inconsistent and inadequate drug coverage, however, prevents many children from receiving timely and equitable access to the best treatment. The objective of this study was to evaluate parents' willingness to pay (WTP) for biologic and nonbiologic disease-modifying antirheumatic drugs (DMARDs) used to treat JIA. Utility weights from a discrete choice experiment were used to estimate the WTP for treatment characteristics including child-reported pain, participation in daily activities, side effects, days missed from school, drug treatment, and cost. Conditional logit regression was used to estimate utilities for each attribute level, and expected compensating variation was used to estimate the WTP. Bootstrapping was used to generate 95% confidence intervals for all WTP estimates. Parents had the highest marginal WTP for improved participation in daily activities and pain relief followed by the elimination of side effects of treatment. Parents were willing to pay $2080 (95% confidence interval $698-$4065) more for biologic DMARDs than for nonbiologic DMARDs if the biologic DMARD was more effective. Parents' WTP indicates their preference for treatments that reduce pain and improve daily functioning without side effects by estimating the monetary equivalent of utility for drug treatments in JIA. In addition to evidence of safety and efficacy, assessments of parents' preferences provide a broader perspective to decision makers by helping them understand the aspects of drug treatments in JIA that are most valued by families. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Socio-economic inequity in demand for insecticide-treated nets, in-door residual house spraying, larviciding and fogging in Sudan.

PubMed

Onwujekwe, Obinna; Malik, El-Fatih Mohamed; Mustafa, Sara Hassan; Mnzava, Abraham

2005-12-15

In order to optimally prioritize and use public and private budgets for equitable malaria vector control, there is a need to determine the level and determinants of consumer demand for different vector control tools. To determine the demand from people of different socio-economic groups for indoor residual house-spraying (IRHS), insecticide-treated nets (ITNs), larviciding with chemicals (LWC), and space spraying/fogging (SS) and the disease control implications of the result. Ratings and levels of willingness-to-pay (WTP) for the vector control tools were determined using a random cross-sectional sample of 720 householdes drawn from two states. WTP was elicited using the bidding game. An asset-based socio-economic status (SES) index was used to explore whether WTP was related to SES of the respondents. IRHS received the highest proportion of highest preferred rating (41.0%) followed by ITNs (23.1%). However, ITNs had the highest mean WTP followed by IRHS, while LWC had the least. The regression analysis showed that SES was positively and statistically significantly related to WTP across the four vector control tools and that the respondents' rating of IRHS and ITNs significantly explained their levels of WTP for the two tools. People were willing to pay for all the vector-control tools, but the demand for the vector control tools was related to the SES of the respondents. Hence, it is vital that there are public policies and financing mechanisms to ensure equitable provision and utilisation of vector control tools, as well as protecting the poor from cost-sharing arrangements.

Multi-country willingness to pay study on road-traffic environmental health effects: are people willing and able to provide a number?

PubMed Central

2014-01-01

Background The health impacts from traffic-related pollutants bring costs to society, which are often not reflected in market prices for transportation. We set out to simultaneously assess the willingness-to-pay (WTP) for traffic-related air pollution and noise effect on health, using a single measurement instrument and approach. We investigated the proportion and determinants of “protest vote/PV responses (people who were against valuing their health in terms of money)” and “don’t know”/DK answers, and explored the effect of DK on the WTP distributions. Methods Within the framework of the EU-funded project INTARESE, we asked over 5,200 respondents in five European countries to state their WTP to avoid health effects from road traffic-related air pollution and noise in an open-ended web-based questionnaire. Determinants of PV and DK were studied by logistic regression using variables concerning socio-demographics, income, health and environmental concern, and risk perception. Results About 10% of the respondents indicated a PV response and between 47-56% of respondents gave DK responses. About one-third of PV respondents thought that costs should be included in transportation prices, i.e. the polluter should pay. Logistic regression analyses showed associations of PV and DK with several factors. In addition to social-demographic, economic and health factors known to affect WTP, environmental concern, awareness of health effects, respondent’s ability to relax in polluted places, and their view on the government’s role to reduce pollution and on policy to improve wellbeing, also affected the PV and DK response. An exploratory weighting and imputation exercise did not show substantial effects of DK on the WTP distribution. Conclusions With a proportion of about 50%, DK answers may be a more relevant issue affecting WTP than PV’s. The likelihood to give PV and DK response were influenced by socio-demographic, economic and health factors, as well as environmental concerns and appreciation of environmental conditions and policies. In contested policy issues where actual policy may be based on WTP studies, PV and DK answers may indeed affect the outcome of the WTP study. PV and DK answers and their determinants therefore deserve further study in CV studies on environmental health effects. PMID:24885941

Multi-country willingness to pay study on road-traffic environmental health effects: are people willing and able to provide a number?

PubMed

Istamto, Tifanny; Houthuijs, Danny; Lebret, Erik

2014-05-09

The health impacts from traffic-related pollutants bring costs to society, which are often not reflected in market prices for transportation. We set out to simultaneously assess the willingness-to-pay (WTP) for traffic-related air pollution and noise effect on health, using a single measurement instrument and approach. We investigated the proportion and determinants of "protest vote/PV responses (people who were against valuing their health in terms of money)" and "don't know"/DK answers, and explored the effect of DK on the WTP distributions. Within the framework of the EU-funded project INTARESE, we asked over 5,200 respondents in five European countries to state their WTP to avoid health effects from road traffic-related air pollution and noise in an open-ended web-based questionnaire. Determinants of PV and DK were studied by logistic regression using variables concerning socio-demographics, income, health and environmental concern, and risk perception. About 10% of the respondents indicated a PV response and between 47-56% of respondents gave DK responses. About one-third of PV respondents thought that costs should be included in transportation prices, i.e. the polluter should pay. Logistic regression analyses showed associations of PV and DK with several factors. In addition to social-demographic, economic and health factors known to affect WTP, environmental concern, awareness of health effects, respondent's ability to relax in polluted places, and their view on the government's role to reduce pollution and on policy to improve wellbeing, also affected the PV and DK response. An exploratory weighting and imputation exercise did not show substantial effects of DK on the WTP distribution. With a proportion of about 50%, DK answers may be a more relevant issue affecting WTP than PV's. The likelihood to give PV and DK response were influenced by socio-demographic, economic and health factors, as well as environmental concerns and appreciation of environmental conditions and policies. In contested policy issues where actual policy may be based on WTP studies, PV and DK answers may indeed affect the outcome of the WTP study. PV and DK answers and their determinants therefore deserve further study in CV studies on environmental health effects.

A method to transfer speckle patterns for digital image correlation

NASA Astrophysics Data System (ADS)

Chen, Zhenning; Quan, Chenggen; Zhu, Feipeng; He, Xiaoyuan

2015-09-01

A simple and repeatable speckle creation method based on water transfer printing (WTP) is proposed to reduce artificial measurement error for digital image correlation (DIC). This technique requires water, brush, and a piece of transfer paper that is made of prefabricated decal paper, a protected sheet, and printed speckle patterns. The speckle patterns are generated and optimized via computer simulations, and then printed on the decal paper. During the experiments, operators can moisten the basement with water and the brush, so that digital patterns can be simply transferred to the carriers’ surfaces. Tensile experiments with an extended three-dimensional (3D) DIC system are performed to test and verify the validity of WTP patterns. It is shown that by comparing with a strain gage, the strain error is less than 50μɛ in a uniform tensile test. From five carbon steel tensile experiments, Lüders bands in both WTP patterns and spray paint patterns are demonstrated to propagate symmetrically. In the necking part where the strain is up to 66%, WTP patterns are proved to adhere to the specimens well. Hence, WTP patterns are capable of maintaining coherence and adherence to the specimen surface. The transfer paper, working as the role of strain gage in the electrometric method, will contribute to speckle creation.

Impact of East Asian Winter and Australian Summer Monsoons on the Enhanced Surface Westerlies over the Western Tropical Pacific Ocean Preceding the El Niño Onset

NASA Astrophysics Data System (ADS)

Zheng, Y.; Zhang, R.; Bourassa, M. A.

2014-12-01

Composite analysis from NCEP-NCAR reanalysis datasets over the period 1948-2007 indicates that stronger East Asian winter monsoons (EAWM) and stronger Australian summer monsoons (ASM) generally co-exist in boreal winters preceding the onset of El Niño, although the EAWM tend to be weak after 1990, probably because of the decadal shift of EAWM and the change in El Niño events from cold-tongue type to warm-pool type. The anomalous EAWM and ASM enhance surface westerlies over the western tropical Pacific Ocean (WTP). It is proposed that the enhanced surface westerlies over the WTP prior to El Niño onset are generally associated with the concurrent anomalous EAWM and ASM. A simple analytical atmospheric model is constructed to test the hypothesis that the emergence of enhanced surface westerlies over the WTP can be linked to concurrent EAWM and ASM anomalies. Model results indicate that when anomalous northerlies from the EAWM converge with anomalous southerlies from the ASM, westerly anomalies over the WTP are enhanced. This result provides a possible explanation of the co-impact of the EAWM and the ASM on the onset of El Niño through enhancing the surface westerly over the WTP.

Willingness of patients with ankylosing spondylitis to pay for inpatient treatment is influenced by the treatment environment and expectations of improvement.

PubMed

Boonen, A; Severens, J L; van Tubergen, A; Landewé, R; Bonsel, G; van der Heijde, D; van der Linden, Sj

2005-11-01

To assess the willingness to pay (WTP) for treatment in a spa resort of patients with ankylosing spondylitis (AS) and to assess if the experience of a spa influences the WTP. 120 patients participating in a randomised trial comparing 3 weeks' treatment in a spa resort in Austria or in the Netherlands with a control group completed a WTP questionnaire before and after spa treatment. Patients indicated on a payment card the maximal co-payment they wanted to contribute for three scenarios that included (a) two levels of improvement in pain and stiffness and (b) two treatment environments: a rehabilitation hospital and a spa resort. At baseline, patients wanted to contribute more for the same improvement after treatment in a spa resort compared with a rehabilitation hospital (p<0.003), and were prepared to pay more when expected effects were higher (p<0.001). No differences were found between men and women, pain, or income. After the trial none of the treatment groups showed a change in their WTP. The WTP of patients with AS for inpatient treatment is influenced by the treatment environment and the expected improvement. Experiencing treatment in a spa resort does not influence the co-payment.

Singapore’s willingness to pay for mitigation of transboundary forest-fire haze from Indonesia

NASA Astrophysics Data System (ADS)

Lin, Yuan; Wijedasa, Lahiru S.; Chisholm, Ryan A.

2017-02-01

Haze pollution over the past four decades in Southeast Asia is mainly a result of forest and peatland fires in Indonesia. The economic impacts of haze include adverse health effects and disruption to transport and tourism. Previous studies have used a variety of approaches to assess the economic impacts of haze and the forest fires more generally. But no study has used contingent valuation to assess non-market impacts of haze on individuals. Here we apply contingent valuation to estimate impacts of haze on Singapore, one of most severely affected countries. We used a double-bounded dichotomous-choice survey design and the Kaplan-Meier-Turnbull method to infer the distribution of Singaporeans’ willingness to pay (WTP) for haze mitigation. Our estimate of mean individual WTP was 0.97% of annual income (n = 390). To calculate total national WTP, we stratified by income, the demographic variable most strongly related to individual WTP. The total WTP estimate was 643.5 million per year (95% CI [527.7 million, 765.0 million]). This estimate is comparable in magnitude to previously estimated impacts of Indonesia’s fires and also to the estimated costs of peatland protection and restoration. We recommend that our results be incorporated into future cost-benefit analyses of the fires and mitigation strategies.

Willingness to pay for community-based ivermectin distribution: a study of three onchocerciasis-endemic communities in Nigeria.

PubMed

Onwujekwe, O E; Shu, E N; Nwagbo, D; Akpala, C O; Okonkwo, P O

1998-10-01

To determine the willingness to pay (WTP) for local ivermectin distribution in a community financing framework. Contingent valuation in three communities in Nigeria, using randomly selected household heads. WTP was elicited using a bidding game, and for collecting information on the households' socio-economic status, level of knowledge, priority ranking and perception of risk of contracting the disease, structured questionnaires were used. Ordinary least squares (OLS) multiple regression analysis was used to analyse factors associated with WTP. Between 92.1% and 93.3 % of respondents were willing to pay amounts ranging from 5 Naira (US$ 0.06) to 100 Naira (US$ 1.25) (median: 20 Naira, US$ 0.25) in the three communities, more than three times the modelled unit direct cost of distributing ivermectin by the communities themselves. Occupation of the respondent, marital status, average monthly expenditure on health care, manifestations of onchocerciasis, the type of savings scheme embarked on by the respondent, age-group, level of education and type of property were statistically significant (P < 0.05) variables affecting WTP. This study shows that there is WTP for local ivermectin distribution in the three study communities, and that it should be assessed before instituting community-directed treatment with ivermectin.

Willingness to pay for avoiding infection of climate change diseases, in particular tsutsugamushi disease.

PubMed

Rhee, Hae-Chun

2013-02-01

As the prevalence of tsutsugamushi disease has tripled over the past decade to affect 8307 people in October 2012, this study is conducted to estimate the willingness to pay (WTP) to avoid infection of tsutsugamushi disease in order to analyze the loss of value caused by climate change diseases. The double-bounded dichotomous choice of contingent valuation method was used to estimate the WTP to avoid infection of tsutsugamushi disease, through surveys conducted in the patient group (n = 120) and the control group (n = 240). More young people in the family, higher level of awareness of risks caused by climate change, more male members (as opposed to female), higher income, lower suggested bid, and greater WTP, is better positioned to avoid infection of disease. The mean of the amount of WTP has been estimated to be 3689 Kwon per month. As people have become increasingly aware of climate change diseases, WTP to avoid infection of tsutsugamushi disease has increased accordingly. The implicit loss of value due to climate change diseases is becoming increasingly higher. Therefore, there should be stronger and more aggressive promotional activities to prevent people from being infected with tsutsugamushi disease and to build a healthier society free from climate change diseases.

Development of an Integrated Leachate Treatment Solution for the Port Granby Waste Management Facility - 12429

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

Conroy, Kevin W.; Vandergaast, Gerald

2012-07-01

The Port Granby Project (the Project) is located near the north shore of Lake Ontario in the Municipality of Clarington, Ontario, Canada. The Project consists of relocating approximately 450,000 m{sup 3} of historic Low-Level Radioactive Waste (LLRW) and contaminated soil from the existing Port Granby Waste Management Facility (WMF) to a proposed Long-Term Waste Management Facility (LTWMF) located adjacent to the WMF. The LTWMF will include an engineered waste containment facility, a Wastewater Treatment Plant (WTP), and other ancillary facilities. A series of bench- and pilot-scale test programs have been conducted to identify preferred treatment processes to be incorporated intomore » the WTP to treat wastewater generated during the construction, closure and post-closure periods at the WMF/LTWMF. (authors)« less

Secondary Waste Simulant Development for Cast Stone Formulation Testing

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

Russell, Renee L.; Westsik, Joseph H.; Rinehart, Donald E.

Washington River Protection Solutions, LLC (WRPS) funded Pacific Northwest National Laboratory (PNNL) to conduct a waste form testing program to implement aspects of the Secondary Liquid Waste Treatment Cast Stone Technology Development Plan (Ashley 2012) and the Hanford Site Secondary Waste Roadmap (PNNL 2009) related to the development and qualification of Cast Stone as a potential waste form for the solidification of aqueous wastes from the Hanford Site after the aqueous wastes are treated at the Effluent Treatment Facility (ETF). The current baseline is that the resultant Cast Stone (or grout) solid waste forms would be disposed at the Integratedmore » Disposal Facility (IDF). Data and results of this testing program will be used in the upcoming performance assessment of the IDF and in the design and operation of a solidification treatment unit planned to be added to the ETF. The purpose of the work described in this report is to 1) develop simulants for the waste streams that are currently being fed and future WTP secondary waste streams also to be fed into the ETF and 2) prepare simulants to use for preparation of grout or Cast Stone solid waste forms for testing.« less

Willingness to pay for social health insurance among informal sector workers in Wuhan, China: a contingent valuation study.

PubMed

Bärnighausen, Till; Liu, Yuanli; Zhang, Xinping; Sauerborn, Rainer

2007-07-20

Most of the about 140 million informal sector workers in urban China do not have health insurance. A 1998 central government policy leaves it to the discretion of municipal governments to offer informal sector workers in cities voluntary participation in a social health insurance for formal sector workers, the so-called 'basic health insurance' (BHI). We used the contingent valuation method to assess the maximum willingness to pay (WTP) for BHI among informal sector workers, including unregistered rural-to-urban migrants, in Wuhan City, China. We selected respondents in a two-stage self-weighted cluster sampling scheme. On average, informal sector workers were willing to pay substantial amounts for BHI (30 Renminbi (RMB), 95% confidence interval (CI) 27-33) as well as substantial proportions of their incomes (4.6%, 95% CI 4.1-5.1%). Average WTP increased significantly when any one of the copayments of the BHI was removed in the valuation: to 51 RMB (95% CI 46-56) without reimbursement ceiling; to 43 RMB (95% CI 37-49) without deductible; and to 47 RMB (95% CI 40-54) without coinsurance. WTP was higher than estimates of the cost of BHI based on past health expenditure or on premium contributions of formal sector workers. Predicted coverage with BHI declined steeply with the premium contribution at low contribution levels. When we applied equity weighting in the aggregation of individual WTP values in order to adjust for inequity in the distribution of income, mean WTP for BHI increased with inequality aversion over a plausible range of the aversion parameter. Holding other factors constant in multiple regression analysis, for a 1% increase in income WTP for BHI with different copayments increased by 0.434-0.499% (all p < 0.0001), and for a 1% increase in past health care expenditure WTP increased by 0.076-0.148% (all p < 0.0004). Being male, a migrant, or without permanent employment significantly decreased WTP for BHI. Education was not a significant determinant of WTP for BHI. Our results suggest that Chinese municipal governments should allow informal sector workers to participate in the BHI. From a normative perspective, BHI for informal sector workers is likely to increase social welfare because average WTP for BHI is significantly higher than estimates of the average cost of BHI. We further find that informal sector workers do not value the BHI as a mechanism to recover the relatively frequent but small financial losses associated with common illnesses, but because it protects against the rare but large financial losses associated with catastrophic care. From a behavioural perspective, our results predict that at a price equal to the average premium contribution of formal sector workers 35% of informal sector workers will enroll in the BHI. Subsidies and changes in insurance attributes (e.g. including catastrophic care and portability) should be effective in increasing BHI coverage. In addition, coverage should expand with rising incomes among informal sector workers in China. Finally, adverse selection will be unlikely to be a large problem, if the BHI is offered to informal sector workers.

Willingness to pay for social health insurance among informal sector workers in Wuhan, China: a contingent valuation study

PubMed Central

Bärnighausen, Till; Liu, Yuanli; Zhang, Xinping; Sauerborn, Rainer

2007-01-01

Background Most of the about 140 million informal sector workers in urban China do not have health insurance. A 1998 central government policy leaves it to the discretion of municipal governments to offer informal sector workers in cities voluntary participation in a social health insurance for formal sector workers, the so-called 'basic health insurance' (BHI). Methods We used the contingent valuation method to assess the maximum willingness to pay (WTP) for BHI among informal sector workers, including unregistered rural-to-urban migrants, in Wuhan City, China. We selected respondents in a two-stage self-weighted cluster sampling scheme. Results On average, informal sector workers were willing to pay substantial amounts for BHI (30 Renminbi (RMB), 95% confidence interval (CI) 27-33) as well as substantial proportions of their incomes (4.6%, 95% CI 4.1-5.1%). Average WTP increased significantly when any one of the copayments of the BHI was removed in the valuation: to 51 RMB (95% CI 46-56) without reimbursement ceiling; to 43 RMB (95% CI 37-49) without deductible; and to 47 RMB (95% CI 40-54) without coinsurance. WTP was higher than estimates of the cost of BHI based on past health expenditure or on premium contributions of formal sector workers. Predicted coverage with BHI declined steeply with the premium contribution at low contribution levels. When we applied equity weighting in the aggregation of individual WTP values in order to adjust for inequity in the distribution of income, mean WTP for BHI increased with inequality aversion over a plausible range of the aversion parameter. Holding other factors constant in multiple regression analysis, for a 1% increase in income WTP for BHI with different copayments increased by 0.434-0.499% (all p < 0.0001), and for a 1% increase in past health care expenditure WTP increased by 0.076-0.148% (all p < 0.0004). Being male, a migrant, or without permanent employment significantly decreased WTP for BHI. Education was not a significant determinant of WTP for BHI. Conclusion Our results suggest that Chinese municipal governments should allow informal sector workers to participate in the BHI. From a normative perspective, BHI for informal sector workers is likely to increase social welfare because average WTP for BHI is significantly higher than estimates of the average cost of BHI. We further find that informal sector workers do not value the BHI as a mechanism to recover the relatively frequent but small financial losses associated with common illnesses, but because it protects against the rare but large financial losses associated with catastrophic care. From a behavioural perspective, our results predict that at a price equal to the average premium contribution of formal sector workers 35% of informal sector workers will enrol in the BHI. Subsidies and changes in insurance attributes (e.g. including catastrophic care and portability) should be effective in increasing BHI coverage. In addition, coverage should expand with rising incomes among informal sector workers in China. Finally, adverse selection will be unlikely to be a large problem, if the BHI is offered to informal sector workers. PMID:17659084

Winter ambient training conditions are associated with increased bronchial hyperreactivity and with shifts in serum innate immunity proteins in young competitive speed skaters.

PubMed

Kurowski, Marcin; Jurczyk, Janusz; Moskwa, Sylwia; Jarzębska, Marzanna; Krysztofiak, Hubert; Kowalski, Marek L

2018-01-01

Regular training modulates airway inflammation and modifies susceptibility to respiratory infections. The impact of exercise and ambient conditions on airway hyperreactivity and innate immunity has not been well studied. We aimed to assess exercise-related symptoms, lung function, airway hyperresponsiveness and innate immunity proteins in relation to meteorological conditions and exercise load in competitive athletes. Thirty-six speed skaters were assessed during winter (WTP) and summer (STP) periods. The control group comprised 22 non-exercising subjects. An allergy questionnaire for athletes (AQUA) and IPAQ (International Physical Activity Questionnaire) were used to assess symptoms and exercise. Meteorological parameters were acquired from World Meteorological Organization resources. Serum innate immunity proteins were measured by ELISA. Exercise-associated respiratory symptoms were reported by 79.4% of skaters. Despite similar exercise load and lung parameters during both periods, positive methacholine challenge was more frequent during winter ( p = 0.04). Heat shock protein HSPA1 and IL-1RA were significantly decreased during STP compared to WTP and controls. During WTP, IL-1RA was elevated in skaters reporting exercise-induced symptoms ( p = 0.007). sCD14 was elevated in athletes versus controls in both periods ( p < 0.05). HSPA1 was significantly higher in WTP compared to STP irrespective of presence of respiratory tract infections (RTIs). IL-1RA in WTP was elevated versus STP ( p = 0.004) only in RTI-negative athletes. Serum IL-1RA negatively correlated with most meteorological parameters during WTP. Ambient training conditions, but not training load, influence bronchial hyperreactivity and the innate immune response in competitive athletes assessed during winter. The protective effect of regular exercise against respiratory infections is associated with a shift in serum innate immunity proteins.

Cost-effectiveness acceptability curves and a reluctance to lose.

PubMed

Severens, Johan L; Brunenberg, Daniëlle E M; Fenwick, Elisabeth A L; O'Brien, Bernie; Joore, Manuela A

2005-01-01

Cost-effectiveness acceptability curves (CEACs) are a method used to present uncertainty surrounding incremental cost-effectiveness ratios (ICERs). Construction of the curves relies on the assumption that the willingness to pay (WTP) for health gain is identical to the willingness to accept (WTA) health loss. The objective of this paper is to explore the impact that differences between WTP and WTA health changes have on CEACs. Previous empirical evidence has shown that the relationship between WTP and WTA is not 1:1. The discrepancy between WTP and WTA for health changes can be expressed as a ratio: the accept/reject ratio (which can vary between 1 and infinity). Depending on this ratio, the area within the southwest quadrant of the cost-effectiveness plane in which any bootstrap cost-effect pairs will be considered to be cost effective will be smaller, resulting in a lower CEAC. We used data from two clinical trials to illustrate that relaxing the 1:1 WTP/WTA assumption has an impact on the CEACs. Given the difficulty in assessing the accept/reject ratio for every evaluation, we suggest presenting a series of CEACs for a range of values for the accept/reject ratio, including 1 and infinite. Although it is not possible to explain this phenomenon within the extra-welfarist framework, it has been shown empirically that individuals give a higher valuation to the removal of effective therapies than to the introduction of new therapies that are more costly and effective. In cost-effectiveness analyses where uncertainty of the ICER covers the southwest quadrant of the cost-effectiveness plane, the discrepancy between societies' WTP and WTA should be indicated by drawing multiple CEACs.

Estimating a WTP-based value of a QALY: the 'chained' approach.

PubMed

Robinson, Angela; Gyrd-Hansen, Dorte; Bacon, Philomena; Baker, Rachel; Pennington, Mark; Donaldson, Cam

2013-09-01

A major issue in health economic evaluation is that of the value to place on a quality adjusted life year (QALY), commonly used as a measure of health care effectiveness across Europe. This critical policy issue is reflected in the growing interest across Europe in development of more sound methods to elicit such a value. EuroVaQ was a collaboration of researchers from 9 European countries, the main aim being to develop more robust methods to determine the monetary value of a QALY based on surveys of the general public. The 'chained' approach of deriving a societal willingness-to-pay (WTP) based monetary value of a QALY used the following basic procedure. First, utility values were elicited for health states using the standard gamble (SG) and time trade off (TTO) methods. Second, a monetary value to avoid some risk/duration of that health state was elicited and the implied WTP per QALY estimated. We developed within EuroVaQ an adaptation to the 'chained approach' that attempts to overcome problems documented previously (in particular the tendency to arrive at exceedingly high WTP per QALY values). The survey was administered via Internet panels in each participating country and almost 22,000 responses achieved. Estimates of the value of a QALY varied across question and were, if anything, on the low side with the (trimmed) 'all country' mean WTP per QALY ranging from $18,247 to $34,097. Untrimmed means were considerably higher and medians considerably lower in each case. We conclude that the adaptation to the chained approach described here is a potentially useful technique for estimating WTP per QALY. A number of methodological challenges do still exist, however, and there is scope for further refinement. Copyright © 2013 Elsevier Ltd. All rights reserved.

Valuing the visual impact of wind farms: A calculus method for synthesizing choice experiments studies.

PubMed

Wen, Cheng; Dallimer, Martin; Carver, Steve; Ziv, Guy

2018-05-06

Despite the great potential of mitigating carbon emission, development of wind farms is often opposed by local communities due to the visual impact on landscape. A growing number of studies have applied nonmarket valuation methods like Choice Experiments (CE) to value the visual impact by eliciting respondents' willingness to pay (WTP) or willingness to accept (WTA) for hypothetical wind farms through survey questions. Several meta-analyses have been found in the literature to synthesize results from different valuation studies, but they have various limitations related to the use of the prevailing multivariate meta-regression analysis. In this paper, we propose a new meta-analysis method to establish general functions for the relationships between the estimated WTP or WTA and three wind farm attributes, namely the distance to residential/coastal areas, the number of turbines and turbine height. This method involves establishing WTA or WTP functions for individual studies, fitting the average derivative functions and deriving the general integral functions of WTP or WTA against wind farm attributes. Results indicate that respondents in different studies consistently showed increasing WTP for moving wind farms to greater distances, which can be fitted by non-linear (natural logarithm) functions. However, divergent preferences for the number of turbines and turbine height were found in different studies. We argue that the new analysis method proposed in this paper is an alternative to the mainstream multivariate meta-regression analysis for synthesizing CE studies and the general integral functions of WTP or WTA against wind farm attributes are useful for future spatial modelling and benefit transfer studies. We also suggest that future multivariate meta-analyses should include non-linear components in the regression functions. Copyright © 2018. Published by Elsevier B.V.

Acceptability and willingness to pay for telemedicine services in Enugu state, southeast Nigeria

PubMed Central

Arize, Ifeyinwa; Onwujekwe, Obinna

2017-01-01

Background This study examines the level of awareness, acceptability and consumers’ willingness to pay (WTP) for telemedicine services using the contingent valuation method (CVM). This work is important as it elicits the value that consumers attach to telemedicine given there is a gap in this knowledge in many sub-Saharan countries such as in Nigeria. Methods The study was based on primary data obtained through an interviewer-administered questionnaire of 370 individuals including both males and females from 25 years and over, to collect data on respondents’ awareness of, acceptability of, and WTP for telemedicine, using the bidding game question format. A socioeconomic status (SES) index was created, based on information on household assets, and was used to categorize respondents into SES quartiles. The data were analyzed using a combination of descriptive techniques, logistics and the Tobit regression model (Tobit Type 1) methods. Results The study found that majority of the people (58.9%) had no knowledge of telemedicine. However, 48.7% of the respondents were willing to pay for telemedicine. The mean WTP for a telemedicine was US$2.04 for each visit. Tobit regression analysis showed that respondents’ socioeconomic status (SES) was the main statistically significant variable that explained their WTP for telemedicine. Conclusion The study has shown that there is a low-level awareness of and WTP for telemedicine services in Enugu State, South East of Nigeria. The finding of a positive relationship between SES and WTP implies that the poor may not be able to pay for telemedicine and may need government subsidies to be able to benefit from such service. Also, government and their partners need to undertake wide scale campaign before the introduction of telemedicine. PMID:29942606

Selective sensitization to DNA-damaging agents in a human rhabdomyosarcoma cell line with inducible wild-type p53 overexpression.

PubMed

Gibson, A A; Harwood, F G; Tillman, D M; Houghton, J A

1998-01-01

Drug-induced cytotoxicity or apoptosis may be influenced by the expression of the p53 tumor suppressor gene and by the specific oncogene expressed, which may dictate the threshold at which a cytotoxic response may by induced. The objective of the study was to elucidate how DNA-damaging agents with different mechanisms of action were sensitized in the context of expression of the Pax3/FKHR fusion protein, a transformation event unique to alveolar rhabdomyosarcomas (ARMSs), and wild-type p53 (wtp53). A wtp53 cDNA was subcloned into the pGRE5-2/EBV vector with dexamethasone-inducible overexpression and transfected into Rh30 ARMS cells that express Pax3/FKHR and a mutant p53 phenotype. Following dexamethasone induction of wtp53 overexpression in a derived clone (Cl.#27), growth was slowed, and cells accumulated in G1. Functional wtp53 activity was demonstrated by selective transactivation of p50-2, a wtp53 chloramphenicol acetyltransferase reporter construct, and by up-regulated expression of endogenous p21Waf1. Data demonstrated p53-dependent sensitization (> or = 4-fold) to bleomycin, actinomycin D, and 5-fluorouracil and considerably less p53-dependence (< or = 2-fold) for doxorubicin, topotecan, etoposide, and cisplatin in Cl.#27 compared to an equivalent clone containing the pGRE5-EBV vector alone (VC#3). Data demonstrate that ARMS cells show a selective sensitization to DNA-damaging agents when wtp53 is overexpressed. The cytotoxic activity of agents that are not potentiated substantially must, therefore, depend upon p53-independent factors that relate to the mechanism of drug action.

Socio-economic inequity in demand for insecticide-treated nets, in-door residual house spraying, larviciding and fogging in Sudan

PubMed Central

Onwujekwe, Obinna; Malik, El-Fatih Mohamed; Mustafa, Sara Hassan; Mnzava, Abraham

2005-01-01

Background In order to optimally prioritize and use public and private budgets for equitable malaria vector control, there is a need to determine the level and determinants of consumer demand for different vector control tools. Objectives To determine the demand from people of different socio-economic groups for indoor residual house-spraying (IRHS), insecticide-treated nets (ITNs), larviciding with chemicals (LWC), and space spraying/fogging (SS) and the disease control implications of the result. Methods Ratings and levels of willingness-to-pay (WTP) for the vector control tools were determined using a random cross-sectional sample of 720 householdes drawn from two states. WTP was elicited using the bidding game. An asset-based socio-economic status (SES) index was used to explore whether WTP was related to SES of the respondents. Results IRHS received the highest proportion of highest preferred rating (41.0%) followed by ITNs (23.1%). However, ITNs had the highest mean WTP followed by IRHS, while LWC had the least. The regression analysis showed that SES was positively and statistically significantly related to WTP across the four vector control tools and that the respondents' rating of IRHS and ITNs significantly explained their levels of WTP for the two tools. Conclusion People were willing to pay for all the vector-control tools, but the demand for the vector control tools was related to the SES of the respondents. Hence, it is vital that there are public policies and financing mechanisms to ensure equitable provision and utilisation of vector control tools, as well as protecting the poor from cost-sharing arrangements. PMID:16356177

Western tropical Pacific multidecadal variability forced by the Atlantic multidecadal oscillation

NASA Astrophysics Data System (ADS)

Kucharski, F.; Sun, C.; Li, J.; Jin, F. F.; Kang, I. S.; Ding, R.

2017-12-01

Observational analysis suggests that the western tropical Pacific (WTP) sea surface temperature (SST) shows predominant variability over multidecadal time scales, which is unlikely to be explained by the Interdecadal Pacific Oscillation. Here we show that this variability is largely explained by the remote Atlantic multidecadal oscillation (AMO). A suite of Atlantic Pacemaker experiments successfully reproduces the WTP multidecadal variability and the AMO-WTP SST connection. The AMO warm SST anomaly generates an atmospheric teleconnection to the North Pacific, which weakens the Aleutian low and subtropical North Pacific westerlies. The wind changes induce a subtropical North Pacific SST warming through wind-evaporation-SST effect, and in response to this warming, the surface winds converge towards the subtropical North Pacific from the tropics, leading to anomalous cyclonic circulation and low pressure over the WTP region. The warm SST anomaly further develops due to the SST-sea level pressure-cloud-longwave radiation positive feedback. Our findings suggest that the Atlantic Ocean acts as a key pacemaker for the western Pacific decadal climate variability.

`Been There Done That': Disentangling Option Value Effects from User Heterogeneity When Valuing Natural Resources with a Use Component

NASA Astrophysics Data System (ADS)

Lyssenko, Nikita; Martínez-Espiñeira, Roberto

2012-11-01

Endogeneity bias arises in contingent valuation studies when the error term in the willingness to pay (WTP) equation is correlated with explanatory variables because observable and unobservable characteristics of the respondents affect both their WTP and the value of those variables. We correct for the endogeneity of variables that capture previous experience with the resource valued, humpback whales, and with the geographic area of study. We consider several endogenous behavioral variables. Therefore, we apply a multivariate Probit approach to jointly model them with WTP. In this case, correcting for endogeneity increases econometric efficiency and substantially corrects the bias affecting the estimated coefficients of the experience variables, by isolating the decreasing effect on option value caused by having already experienced the resource. Stark differences are unveiled between the marginal effects on WTP of previous experience of the resource in an alternative location versus experience in the location studied, Newfoundland and Labrador (Canada).

Western tropical Pacific multidecadal variability forced by the Atlantic multidecadal oscillation

PubMed Central

Sun, Cheng; Kucharski, Fred; Li, Jianping; Jin, Fei-Fei; Kang, In-Sik; Ding, Ruiqiang

2017-01-01

Observational analysis suggests that the western tropical Pacific (WTP) sea surface temperature (SST) shows predominant variability over multidecadal time scales, which is unlikely to be explained by the Interdecadal Pacific Oscillation. Here we show that this variability is largely explained by the remote Atlantic multidecadal oscillation (AMO). A suite of Atlantic Pacemaker experiments successfully reproduces the WTP multidecadal variability and the AMO–WTP SST connection. The AMO warm SST anomaly generates an atmospheric teleconnection to the North Pacific, which weakens the Aleutian low and subtropical North Pacific westerlies. The wind changes induce a subtropical North Pacific SST warming through wind–evaporation–SST effect, and in response to this warming, the surface winds converge towards the subtropical North Pacific from the tropics, leading to anomalous cyclonic circulation and low pressure over the WTP region. The warm SST anomaly further develops due to the SST–sea level pressure–cloud–longwave radiation positive feedback. Our findings suggest that the Atlantic Ocean acts as a key pacemaker for the western Pacific decadal climate variability. PMID:28685765

'Been there done that': disentangling option value effects from user heterogeneity when valuing natural resources with a use component.

PubMed

Lyssenko, Nikita; Martínez-Espiñeira, Roberto

2012-11-01

Endogeneity bias arises in contingent valuation studies when the error term in the willingness to pay (WTP) equation is correlated with explanatory variables because observable and unobservable characteristics of the respondents affect both their WTP and the value of those variables. We correct for the endogeneity of variables that capture previous experience with the resource valued, humpback whales, and with the geographic area of study. We consider several endogenous behavioral variables. Therefore, we apply a multivariate Probit approach to jointly model them with WTP. In this case, correcting for endogeneity increases econometric efficiency and substantially corrects the bias affecting the estimated coefficients of the experience variables, by isolating the decreasing effect on option value caused by having already experienced the resource. Stark differences are unveiled between the marginal effects on WTP of previous experience of the resource in an alternative location versus experience in the location studied, Newfoundland and Labrador (Canada).

The relationship between attitudes toward suicide and willingness to pay for suicide prevention: a cross-sectional study in Japan.

PubMed

Sueki, Hajime

2017-10-01

There are gaps in our knowledge of the role attitudes toward suicide play in determining people's willingness to participate (WTP) for suicide prevention. We conducted a large nationwide cross-sectional study with the aim of clarifying the relationship between WTP for reducing suicide risk and attitudes toward suicide. Ordinal logistic regression analyses (n = 1771) showed that there were significant associations of WTP for suicide prevention with 'Suicide as a right' (β = -.15, 95% CI: -.25 to -.04, p = .006), 'Preventability/readiness to help' (β = .81, 95% CI: .69-.94, p < .001) and 'Common occurrence' (β = .32, 95% CI: .19-.46, p < .001). 'Incomprehensibility/unpredictability' did not show an association with WTP. Taxpayer acceptance for suicide prevention is more likely to be achieved through provision of information that increases endorsement of 'preventability/readiness to help' and 'common occurrence' factors, and decreases 'suicide as a right' scores.

Western tropical Pacific multidecadal variability forced by the Atlantic multidecadal oscillation

NASA Astrophysics Data System (ADS)

Sun, Cheng; Kucharski, Fred; Li, Jianping; Jin, Fei-Fei; Kang, In-Sik; Ding, Ruiqiang

2017-07-01

Observational analysis suggests that the western tropical Pacific (WTP) sea surface temperature (SST) shows predominant variability over multidecadal time scales, which is unlikely to be explained by the Interdecadal Pacific Oscillation. Here we show that this variability is largely explained by the remote Atlantic multidecadal oscillation (AMO). A suite of Atlantic Pacemaker experiments successfully reproduces the WTP multidecadal variability and the AMO-WTP SST connection. The AMO warm SST anomaly generates an atmospheric teleconnection to the North Pacific, which weakens the Aleutian low and subtropical North Pacific westerlies. The wind changes induce a subtropical North Pacific SST warming through wind-evaporation-SST effect, and in response to this warming, the surface winds converge towards the subtropical North Pacific from the tropics, leading to anomalous cyclonic circulation and low pressure over the WTP region. The warm SST anomaly further develops due to the SST-sea level pressure-cloud-longwave radiation positive feedback. Our findings suggest that the Atlantic Ocean acts as a key pacemaker for the western Pacific decadal climate variability.

Microcredit and willingness to pay for environmental quality: Evidence from a randomized-controlled trial of finance for sanitation in rural Cambodia.

PubMed

Ben Yishay, Ariel; Fraker, Andrew; Guiteras, Raymond; Palloni, Giordano; Shah, Neil Buddy; Shirrell, Stuart; Wang, Paul

2017-11-01

Low willingness to pay (WTP) for environmental quality in developing countries is a key research question in environmental economics. One explanation is that missing credit markets may suppress WTP for environmental improvements that require large up-front investments. We test the impact of microloans on WTP for hygienic latrines via a randomized controlled trial in 30 villages in rural Cambodia. We find that microcredit dramatically raises WTP for improved latrines, with 60% of households in the Financing arm willing to purchase at an unsubsidized price, relative to 25% in the Non-financing arm. Effects on latrine installation are positive but muted by several factors, including a negative peer effect: randomly induced purchases by neighbors reduce a household's probability of installing its own latrine. On methodological grounds, this paper shows that a "decision-focused evaluation" can be integrated into academic analysis to provide insight into questions of general interest.

[Acceptance and understandability of various methods of health valuations for the chronically ill: willingness to pay, visual analogue scale and rating scale].

PubMed

Meder, M; Farin, E

2009-11-01

Health valuations are one way of measuring patient preferences with respect to the results of their treatment. The study examines three different methods of health valuations--willingness to pay (WTP), visual analogue scale (VAS), and a rating question for evaluating the subjective significance. The goal is to test the understandability and acceptance of these methods for implementation in questionnaires. In various rehabilitation centres, a total of six focus groups were conducted with 5-9 patients each with a mean age of 57.1 years. The illnesses considered were chronic-ischaemic heart disease, chronic back pain, and breast cancer. Patients filled out a questionnaire that was then discussed in the group. In addition to the quantitative evaluation of the data in the questionnaire, a qualitative analysis of the contents of the group discussion protocols was made. We have results from a total of 42 patients. 14.6% of the patients had "great difficulties" understanding the WTP or rated it as "completely incomprehensible"; this value was 7.3% for VAS and 0% for the rating scale. With respect to acceptance, 31.0% of the patients indicated that they were "not really" or "not at all" willing to answer such a WTP question in a questionnaire; this was 6.6% for the VAS, and again 0% for the rating scale. The qualitative analysis provided an indication as to why some patients view the WTP question in particular in a negative light. Many difficulties in understanding it were related to the formulation of the question and the structure of the questionnaire. However, the patients' statements also made it apparent that the hypothetical nature of the WTP questionnaire was not always recognised. The most frequent reason for the lack of acceptance of the WTP was the patients' fear of negative financial consequences of their responses. With respect to understandability and acceptance, VAS questions appear to be better suited for reflecting patient preferences than WTP questions. The rating scale for assessing the personally estimated importance was understandable, but had poor distribution properties and was considered by patients to be superfluous.

Willingness to pay to avoid health risks from road-traffic-related air pollution and noise across five countries.

PubMed

Istamto, Tifanny; Houthuijs, Danny; Lebret, Erik

2014-11-01

We conducted a multi-country study to estimate the perceived economic values of traffic-related air pollution and noise health risks within the framework of a large European project. We used contingent valuation as a method to assess the willingness-to-pay (WTP) for both types of pollutants simultaneously. We asked respondents how much they would be willing to pay annually to avoid certain health risks from specific pollutants. Three sets of vignettes with different levels of information were provided prior to the WTP questions. These vignettes described qualitative general health risks, a quantitative single health risk related to a pollutant, and a quantitative scenario of combined health risks related to a pollutant. The mean WTP estimates to avoid road-traffic air pollution effects for the three vignettes were: €130 per person per year (pp/y) for general health risks, €80 pp/y for a half year shorter in life expectancy, and €330 pp/y to a 50% decrease in road-traffic air pollution. Their medians were €40 pp/y, €10 pp/y and €50 pp/y, respectively. The mean WTP estimates to avoid road-traffic noise effects for the three vignettes were: €90 pp/y for general health risks, €100 pp/y for a 13% increase in severe annoyance, and €320 pp/y for a combined-risk scenario related to an increase of a noise level from 50 dB to 65 dB. Their medians were €20 pp/y, €20 pp/y and €50 pp/y, respectively. Risk perceptions and attitudes as well as environmental and pollutant concerns significantly affected WTP estimates. The observed differences in crude WTP estimates between countries changed considerably when perception-related variables were included in the WTP regression models. For this reason, great care should be taken when performing benefit transfer from studies in one country to another. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Willingness to Pay for Social Health Insurance in Central Vietnam.

PubMed

Nguyen, Lan Hoang; Hoang, Anh Thuan Duc

2017-01-01

A social health insurance (SHI) program was implemented in Vietnam in 1992. Participation is compulsory for some groups, such as formal-sector workers and voluntary for other groups. In 2013, 68% of the total population was covered by SHI, with most enrollees from compulsory groups. Enrollment has remained low among persons whose enrollment is voluntary. As a result, households face financial risk due to high out-of-pocket payments for health care. The goal of this study is to identify willingness to pay (WTP) for the SHI scheme among persons whose enrollment is voluntary and to examine factors that influence their choice. Three hundred thirty-one uninsured persons from three districts and one city of Thua Thien Hue province were interviewed face to face using a structured questionnaire. Contingent valuation technique was used to assess the WTP among the study participants. Each individual was asked to choose the maximum premium they were willing to pay for a health insurance card per year with three copayment levels of 0, 10, and 20%. Seven premium levels were offered ranging from 0 to 900,000 Vietnamese Dong (VND) (42.12 USD). The mean WTP of respondents for each scenario was estimated. Multiple linear regression analysis was used to identify factors influencing WTP for SHI. The survey found that 73.1, 72.2, and 71.6%, respectively, for each copayment level, of the respondents would agree to participate in the SHI scheme and are willing to pay an annual premium of 578,926 VND (27.1 USD); 473,222 VND (22.1 USD); and 401,266 VND (18.8 USD) at the copayment levels of 0, 10, and 20%, respectively. The WTP for SHI is influenced by knowledge of SHI at all copayment levels ( p value < 0.05). The more knowledge about SHI individuals have, the higher the WTP amount. Chronic disease was related to WTP only at a copayment level of 20% ( p  = 0.049). Enhanced awareness of the benefits of SHI among the population should contribute to expanding SHI coverage in Vietnam.

Assessment of respondent acceptability of preference measures: discriminatory power of graphic positioning scale versus traditional scaling measures.

PubMed

Franic, Duska M; Pathak, Dev S

2003-01-01

The objective of this study was to compare discriminatory power of two different measures-graphic positioning scale (GPS) versus traditional scale (TS)-in assessing respondent acceptability of three preference measures: visual analog scale (VAS), standard gamble (SG), and willingness to pay (WTP). Two face-to-face interviews were conducted at least 1 week apart in a convenience sample of women aged 22 to 50 years with no history of breast cancer or cancer requiring chemotherapy. Study participation required completion of two surveys: one evaluating health preferences for an acute condition (chemotherapy-induced nausea and vomiting) and one evaluating a chronic condition (breast cancer). Data were collected from March 2000 to June 2000 at Ohio State University. Respondents were randomized to either GPS or TS surveys. Data analysis was a two-step process. First, a four-way multivariate repeated-measures analysis of variance (MANOVA) was conducted to assess respondent acceptability of three-preference metrics-VAS, SG, and WTP-in health-care decision making. Each of the four dependent variables, difficulty, clarity, reasonableness, and comfort in use in decision making, was measured on 9-point Likert scale. Second, a mixed design univariate analysis of variance (ANOVA) was performed for each dependent variable to optimize MANOVA analysis. Univariate ANOVAs, 2 x (2 x 3), were composed of three independent variables: assessment (GPS/TS), condition (acute and chronic), and preferences (VAS, SG, WTP). Of 126 respondents, 119 were usable and complete. MANOVA results showed (P <.05) for two main effects, condition (F4,114 = 6.375) and preferences (F8,110 = 9.290), and two significant interactions, condition x assessment (F4,114 = 3.421) and condition x preferences (F8,110 = 2.087). GPS has higher discriminatory power than TS in assessing respondent attitudes toward health preference measures. Results showed that respondents had more difficulty and less comfort when making decisions for chronic than for acute conditions. Results also show that respondents regard WTP as a more reasonable decision-making tool when assessing acute interventions in preference to SG and vice versa for chronic conditions. Of VAS, SG, and WTP methods, VAS was perceived as being the easiest to understand. These results can be explained by direct versus indirect comparisons made with GPS and TS methods, respectively.

The demand for a dengue vaccine: a contingent valuation survey in Metro Manila.

PubMed

Palanca-Tan, Rosalina

2008-02-13

Using data gathered from a contingent valuation survey, this study estimated the willingness to pay (WTP) for a single dengue fever vaccine and the household demand function for dengue vaccines. Mean WTP for the vaccine ranged from US$27 to US$32 and household demand averaged 2 per household. Our findings indicate sufficiently high WTP for dengue vaccines and hence a significant potential for selling the vaccine in private markets. For the lower income groups with lower capacity to pay, a mass vaccination campaign program in which part of the financial costs are covered by vaccine user charges is viable.

Determinants of willingness to pay taxes for a community-based prevention programme.

PubMed

Lindholm, L A; Rosén, M E; Stenbeck, M E

1997-06-01

Prevention can reduce the risk of disease, but has other consequences as well. Willingness-to-pay (WTP) is one method to analyse these multi-dimensional consequences, if the stated WTP is assumed to be a function of all the expected positive and negative effects perceived. An interview study of a community-based cardiovascular disease prevention programme in northern Sweden shows that expectations regarding reduced mortality in the community and future savings in public health care spending increase the perceived value of the programme. Among personal benefits, decreased disease risk was not positively associated with WTP, while a low level of anxiety was.

Valuing morbidity from wildfire smoke exposure: a comparison of revealed and stated preference techniques

USGS Publications Warehouse

Richardson, Leslie; Loomis, John B.; Champ, Patricia A.

2013-01-01

Estimating the economic benefits of reduced health damages due to improvements in environmental quality continues to challenge economists. We review welfare measures associated with reduced wildfire smoke exposure, and a unique dataset from California’s Station Fire of 2009 allows for a comparison of cost of illness (COI) estimates with willingness to pay (WTP) measures. The WTP for one less symptom day is estimated to be $87 and $95, using the defensive behavior and contingent valuation methods, respectively. These WTP estimates are not statistically different but do differ from a $3 traditional daily COI estimate and $17 comprehensive daily COI estimate.

Societal Value of Surgery for Facial Reanimation.

PubMed

Su, Peiyi; Ishii, Lisa E; Joseph, Andrew; Nellis, Jason; Dey, Jacob; Bater, Kristin; Byrne, Patrick J; Boahene, Kofi D O; Ishii, Masaru

2017-03-01

Patients with facial paralysis are perceived negatively by society in a number of domains. Society's perception of the health utility of varying degrees of facial paralysis and the value society places on reconstructive surgery for facial reanimation need to be quantified. To measure health state utility of varying degrees of facial paralysis, willingness to pay (WTP) for a repair, and the subsequent value of facial reanimation surgery as perceived by society. This prospective observational study conducted in an academic tertiary referral center evaluated a group of 348 casual observers who viewed images of faces with unilateral facial paralysis of 3 severity levels (low, medium, and high) categorized by House-Brackmann grade. Structural equation modeling was performed to understand associations among health utility metrics, WTP, and facial perception domains. Data were collected from July 16 to September 26, 2015. Observer-rated (1) quality of life (QOL) using established health utility metrics (standard gamble, time trade-off, and a visual analog scale) and (2) their WTP for surgical repair. Among the 348 observers (248 women [71.3%]; 100 men [28.7%]; mean [SD] age, 29.3 [11.6] years), mixed-effects linear regression showed that WTP increased nonlinearly with increasing severity of paralysis. Participants were willing to pay $3487 (95% CI, $2362-$4961) to repair low-grade paralysis, $8571 (95% CI, $6401-$11 234) for medium-grade paralysis, and $20 431 (95% CI, $16 273-$25 317) for high-grade paralysis. The dominant factor affecting the participants' WTP was perceived QOL. Modeling showed that perceived QOL decreased with paralysis severity (regression coefficient, -0.004; 95% CI, -0.005 to -0.004; P < .001) and increased with attractiveness (regression coefficient, 0.002; 95% CI, 0.002 to 0.003; P < .001). Mean (SD) health utility scores calculated by the standard gamble metric for low- and high-grade paralysis were 0.98 (0.09) and 0.77 (0.25), respectively. Time trade-off and visual analog scale measures were highly correlated. We calculated mean (SD) WTP per quality-adjusted life-year, which ranged from $10 167 ($14 565) to $17 008 ($38 288) for low- to high-grade paralysis, respectively. Society perceives the repair of facial paralysis to be a high-value intervention. Societal WTP increases and perceived health state utility decreases with increasing House-Brackmann grade. This study demonstrates the usefulness of WTP as an objective measure to inform dimensions of disease severity and signal the value society places on proper facial function. NA.

Testing the convergent validity of the contingent valuation and travel cost methods in valuing the benefits of health care.

PubMed

Clarke, Philip M

2002-03-01

In this study, the convergent validity of the contingent valuation method (CVM) and travel cost method (TCM) is tested by comparing estimates of the willingness to pay (WTP) for improving access to mammographic screening in rural areas of Australia. It is based on a telephone survey of 458 women in 19 towns, in which they were asked about their recent screening behaviour and their WTP to have a mobile screening unit visit their nearest town. After eliminating missing data and other non-usable responses the contingent valuation experiment and travel cost model were based on information from 372 and 319 women, respectively. Estimates of the maximum WTP for the use of mobile screening units were derived using both methods and compared. The highest mean WTP estimated using the TCM was $83.10 (95% C.I. $99.06-$68.53), which is significantly less than the estimate of $148.09 ($131.13-$166.60) using the CVM. This could be due to the CVM estimates also reflecting non-use values such as altruism, or a range of potential biases that are known to affect both methods. Further tests of validity are required in order to gain a greater understanding of the relationship between these two methods of estimating WTP. Copyright 2001 John Wiley & Sons, Ltd.

Comparing WTP values of different types of QALY gain elicited from the general public.

PubMed

Pennington, Mark; Baker, Rachel; Brouwer, Werner; Mason, Helen; Hansen, Dorte Gyrd; Robinson, Angela; Donaldson, Cam

2015-03-01

The appropriate thresholds for decisions on the cost-effectiveness of medical interventions remain controversial, especially in 'end-of-life' situations. Evidence of the values placed on different types of health gain by the general public is limited. Across nine European countries, 17,657 people were presented with different hypothetical health scenarios each involving a gain of one quality adjusted life year (QALY) and asked about their willingness to pay (WTP) for that gain. The questions included quality of life (QoL) enhancing and life extending health gains, and a scenario where respondents faced imminent, premature death. The mean WTP values for a one-QALY gain composed of QoL improvements were modest (PPP$11,000). When comparing QALY gains obtained in the near future, the valuation of life extension exceeded the valuation of QoL enhancing gains (mean WTP PPP$19,000 for a scenario in which a coma is avoided). The mean WTP values were higher still when respondents faced imminent, premature death (PPP$29,000). Evidence from the largest survey on the value of health gains by the general public indicated a higher value for life extending gains compared with QoL enhancing gains. A further modest premium may be indicated for life extension when facing imminent, premature death. Copyright © 2013 John Wiley & Sons, Ltd.

Preference and willingness to pay for nutritional counseling services in urban Hanoi.

PubMed

Nguyen, Hai Viet; Trinh, Ngoc Bao; Le, Huong Thi; Nguyen, Cuong Tat; Mai, Hue Thi; Tran, Tho Dinh; Le, Huong Thi; Le, Quynh Ngoc Hoang; Tran, Bach Xuan; Vu, Thuc Thi Minh

2017-01-01

Background: Despite substantial achievement in reducing malnutrition rates in Vietnam, there has been an increasing rate of overweight individuals in urban areas, which may result in a high burden of non-communicable diseases. Nutritional counseling clinics have been introduced in several settings; however, little is known about the preference for this service among urban clients. This study aimed to assess the preference and willingness to pay (WTP) for nutritional counseling services among urban clients. Methods: We interviewed 429 clients who attended Hanoi Medical University Nutritional Counseling Clinic (Hanoi, Vietnam). WTP was determined using double-bounded dichotomous-choice questions and open-ended questions. Results: In total, 78.6% respondents were willing to use nutritional counseling services. The mean amount of WTP for one-time service and one-year package was 96,100VND (~$4.3) and 946,400VND (~$41.9), respectively. Clients' willingness to use the service was higher among females, those seeking counseling for elderly people and those who preferred face-to-face counseling services (p<0.05). WTP was higher among those who were over 35 years old, those seeking services for the elderly people, those having poor nutritional status, and those having under-6 year old children (p<0.05). Conclusions: The preference and WTP for nutritional counseling services in urban Hanoi were relatively high. Scaling up this service is necessary to actively prevent and control the spread of non-communicable diseases.

Effect of race/ethnicity on participation in HIV vaccine trials and comparison to other trials of biomedical prevention.

PubMed

Dhalla, Shayesta; Poole, Gary

2014-01-01

Racial/ethnic minorities are underrepresented in actual HIV vaccine trials in North America, and willingness to participate (WTP) and retention in an HIV vaccine trial may differ from that in Whites. In this review, the authors identified HIV vaccine preparedness studies (VPS) in North America in high-risk populations that examined the relationship between race/ethnicity and WTP in a preventive phase 3 HIV vaccine trial, and the relationship to retention. Studies were categorized by risk group, and comparison group (Whites vs. non-Whites). Other types of trials of biomedical prevention were also identified, and WTP and retention rates were compared and contrasted to actual HIV vaccine trials. In the studies identified, WTP in a hypothetical trial HIV vaccine trial did not differ by race/ethnicity. In contrast, actual HIV vaccine trials, an HIV acquisition trial, and a phase 2B preexposure prophylaxis (PrEP) trial have enrolled a large percentage of White men. Human papilloma virus (HPV) privately-funded trials have also enrolled a large number of Whites, due to convenience sampling. Retention in the HIV acquisition trial was lower in African-Americans compared with Whites. Strategies to increase WTP and enhanced retention (ER) strategies may help in recruiting and retaining minority participants in actual HIV vaccine trials and other trials of biomedical prevention.

Are people who still have their natural teeth willing to pay for mandibular two-implant overdentures?

PubMed

Srivastava, Akanksha; Feine, Jocelyne S; Esfandiari, Shahrokh

2014-05-01

Oral health in Canada and most developed and developing countries is funded by private payers, whose acceptance of treatment depends on their valuation of it. This study aims to determine how dentate individuals in Quebec, Canada, would value the benefits of mandibular two-implant overdentures based on their willingness to pay (WTP) for the treatment, either directly or with insurance/government coverage. A total of 39 individuals (23-54 years) completed a Web-based WTP survey that consisted of three cost scenarios: (a) out-of-pocket payment; (b) private dental insurance coverage; and (c) public funding through additional taxes. Variations in WTP amounts were measured using regression models. Among respondents who were dentate or missing some teeth, average WTP out of pocket for implant overdentures was CAD$5419 for a 90% success rate. They were willing to pay an average CAD$169 as one-time payment for private dental insurance, with a one in five chance of becoming edentate. WTP amounts increased substantially with the probability of success of implant overdenture therapy. The results of regression analyses were consistent with theoretical predictions for education level and income (P < 0.05). The results of this study, within its limitations, suggest that dentate individuals would be willing to pay a significant amount to receive mandibular two-implant overdentures if and when they become edentate. © 2013 Wiley Publishing Asia Pty Ltd.

The economic feasibility of producing sweet sorghum as an ethanol feedstock in Mississippi

NASA Astrophysics Data System (ADS)

Linton, Joseph Andrew

This study examines the feasibility of producing sweet sorghum as an ethanol feedstock in Mississippi. An enterprise budgeting system is used along with estimates of transportation costs to estimate farmers' breakeven costs for producing and delivering sweet sorghum biomass. This breakeven cost for the farmer, along with breakeven costs for the producer based on wholesale ethanol price, production costs, and transportation and marketing costs for the refined ethanol, is used to estimate the amounts that farmers and ethanol producers would be willing to accept (WTA) and willing to pay (WTP), respectively, for sweet sorghum biomass. These WTA and WTP estimates are analyzed by varying key factors in the biomass and ethanol production processes. Deterministic and stochastic models are used to estimate profits for sweet sorghum and competing crops in two representative counties in Mississippi, with sweet sorghum consistently yielding negative per-acre profits in both counties.

Dataset on the spent filter backwash water treatment by sedimentation, coagulation and ultra filtration.

PubMed

Mahdavi, Mokhtar; Ebrahimi, Afshin; Azarpira, Hossein; Tashauoei, Hamid Reza; Mahvi, Amir Hossein

2017-12-01

During operation of most water treatment plants, spent filter backwash water (SFBW) is generated, which accounts about 2-10% of the total plant production. By increasing world population and water shortage in many countries, SFBW can be used as a permanent water source until the water treatment plant is working. This data article reports the practical method being used for water reuse from SFBW through different method including pre-sedimentation, coagulation and flocculation, second clarification, ultra filtration (UF) and returned settled SFBW to the beginning of water treatment plant (WTP). Also, two coagulants of polyaluminum ferric chloride (PAFCl) and ferric chloride (FeCl 3 ) were investigated with respect to their performance on treated SFBW quality. Samples were collected from Isfahan's WTP in Iran during spring and summer season. The acquired data indicated that drinkable water can be produced form SFBW by applying hybrid coagulation-UF process (especially when PAFCl used as coagulant).

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

Poloski, Adam P.; Wells, Beric E.; Tingey, Joel M.

The U.S. Department of Energy (DOE) Office of River Protection’s Waste Treatment and Immobilization Plant (WTP) will process and treat radioactive waste that is stored in tanks at the Hanford Site. Piping, pumps, and mixing vessels have been selected to transport, store, and mix the high-level waste slurries in the WTP. This report addresses the analyses performed by the Rheology Working Group (RWG) and Risk Assessment Working Group composed of Pacific Northwest National Laboratory (PNNL), Bechtel National Inc. (BNI), CH2M HILL, DOE Office of River Protection (ORP) and Yasuo Onishi Consulting, LLC staff on data obtained from documented Hanford wastemore » analyses to determine a best-estimate of the rheology of the Hanford tank wastes and their settling behavior. The actual testing activities were performed and reported separately in referenced documentation. Because of this, many of the required topics below do not apply and are so noted.« less

Measuring consumers' interest in instant fortified pearl millet products: a field experiment in Touba, Senegal.

PubMed

De Groote, Hugo; Kariuki, Sarah W; Traore, Djibril; Taylor, John Rn; Ferruzzi, Mario G; Hamaker, Bruce R

2018-04-01

In Africa, food-processing industries are emerging fast, especially for cereals. New low-cost extrusion cookers give small enterprises an opportunity to enter the market for processed cereal products, in particular instant, fortified and flavoured mixes. Before engaging in the marketing of these products, consumers' interest needs to be assessed. This study used a combination of affective tests and experimental auctions with 200 consumers in Touba, Senegal, to evaluate four new products with conventional pearl millet flour as the control: instant pearl millet flour, instant pearl millet flour with added dry mango and carrot powder (naturally fortified), and the previous products with added conventional chemical micronutrient fortificants. During affective tests, consumers made little distinction between the five products in appearance, aroma, taste and overall appreciation. The experimental auctions showed that, without providing additional information on the products, there was no difference in 'willingness to pay' (WTP) between them. However, after that information is provided, consumers were willing to pay a modest premium for instant flour, and a large premium for added mango and carrot extract and for added micronutrients, but were not willing to pay a premium if those micronutrients came from natural sources. Income increased overall WTP, while education increased WTP for instant flour. There is a potential market in low-income African countries for instant and fortified cereal food products, but likely in the higher income and education groups. The increased cost needs to be compared to the premiums consumers are willing to pay. In the next step, the new and promising products could be tested in pilot markets, with target consumers. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Integrating self-determined needs into the relationship among product design, willingness-to-pay a premium, and word-of-mouth: a cross-cultural gender-specific study

PubMed Central

Gilal, Faheem Gul; Zhang, Jian; Gilal, Naeem Gul; Gilal, Rukhsana Gul

2018-01-01

Background The present study integrates self-determined needs satisfaction into a relationship between product design (eg, aesthetic, functional, and symbolic design) and consumer behavior (eg, willingness-to-pay [WTP] a premium and negative word-of-mouth [WOM]) and to explore whether gender can differentiate the effects of aesthetic, functional, and symbolic product designs on self-determined needs satisfaction. Methods To this end, participants from Pakistan and China were recruited, and the hypotheses for this study were tested using structural equation modeling and SPSS-PROCESS. Results The effects of three product designs on self-determined needs satisfaction were significantly positive across samples. The results further show that self-determined needs satisfaction had the strongest positive effect on WTP a premium and the strongest negative effect on vindictive WOM for Pakistanis. Self-determined needs frustration had the strongest negative effect on the WTP a premium for Chinese participants and an equivalent magnitude effect on vindictive WOM for Pakistani and Chinese participants. The cross-cultural gender-specific findings revealed that Pakistani men are more aesthetic and hedonic than women in Pakistan. Surprisingly, Chinese women resemble Pakistani men in the sense that they prefer aesthetically pleasing products. Chinese men resemble Pakistani women in terms of little interest in symbolic products, whereas Chinese women and Pakistani men respond similarly regarding their decisions to choose symbolic products. Conclusion To the best of the authors’ knowledge, the present study is one of the initial attempts to integrate self-determined needs into the relationship between product design and consumer WTP a premium and WOM, and further explore cross-cultural gender-specific differences across Pakistan and China. The findings of the present study may help international marketers in terms of segmenting, targeting, and positioning their markets. PMID:29922102

Equity in Pharmaceutical Pricing and Reimbursement: Crossing the Income Divide in Asia Pacific.

PubMed

Daems, Rutger; Maes, Edith; Glaetzer, Christoph

2013-05-01

The article takes a three-dimensional approach (triangulation) in defining international pricing policy for pharmaceuticals using cost-effectiveness analysis (CEA), willingness-to-pay (WTP) analysis, and ability-to-pay (ATP) analysis. It attempts to find a balance between the various economic methods of which some focus on effectiveness while others are geared toward incorporating equity in the equation. A critical review of the first two established economic methods and their ability to evaluate not only "efficacy" but also "fairness" in pricing decisions identifies a gap in the latter. Therefore, a third analytic method is presented that measures the ATP based on a country's score in the human development index of the United Nations Development Program for 120 countries. This approach allows practicing differential pricing among and within countries. To refine this equity-driven pricing concept, two additional parameters can be added to the model: the Oxford "Multidimensional Poverty Index" and the "Out-of-Pocket" or "Self Pay" health expenditure as reported by the World Bank. There is no hierarchy between the above three pricing methods. Because one method provides further insight into the other, however, it is recommended to start with CEA followed by WTP analysis. These types of analysis are closely linked in that the first provides the CE ratio for the compound investigated and the other sets the anticipated ceiling threshold of the payer's WTP (in a particular country). The ATP method provides a supplementary "equity" check and facilitates the process of equity-based differential pricing. A third method should be used in conjunction with the standard CEA and WTP analysis that measures the ATP with the human development index as yardstick to provide sustainable and equitable access to medicines. We recommend that ATP analysis becomes an additional practice in policy decision making and in defining international pricing strategies for pharmaceuticals. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

PROJECT W-551 INTERIM PRETREATMENT SYSTEM PRECONCEPTUAL CANDIDATE TECHNOLOGY DESCRIPTIONS

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

MAY TH

The Office of River Protection (ORP) has authorized a study to recommend and select options for interim pretreatment of tank waste and support Waste Treatment Plant (WTP) low activity waste (LAW) operations prior to startup of all the WTP facilities. The Interim Pretreatment System (IPS) is to be a moderately sized system which separates entrained solids and 137Cs from tank waste for an interim time period while WTP high level waste vitrification and pretreatment facilities are completed. This study's objective is to prepare pre-conceptual technology descriptions that expand the technical detail for selected solid and cesium separation technologies. This revisionmore » includes information on additional feed tanks.« less

FINAL REPORT REGULATORY OFF GAS EMISSIONS TESTING ON THE DM1200 MELTER SYSTEM USING HLW AND LAW SIMULANTS VSL-05R5830-1 REV 0 10/31/05

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

KRUGER AA; MATLACK KS; GONG W

2011-12-29

The operational requirements for the River Protection Project - Waste Treatment Plant (RPP-WTP) Low Activity Waste (LAW) and High Level Waste (HLW) melter systems, together with the feed constituents, impose a number of challenges to the off-gas treatment system. The system must be robust from the standpoints of operational reliability and minimization of maintenance. The system must effectively control and remove a wide range of solid particulate matter, acid mists and gases, and organic constituents (including those arising from products of incomplete combustion of sugar and organics in the feed) to concentration levels below those imposed by regulatory requirements. Themore » baseline design for the RPP-WTP LAW primary off-gas system includes a submerged bed scrubber (SBS), a wet electrostatic precipitator (WESP), and a high efficiency particulate air (HEPA) filter. The secondary off-gas system includes a sulfur-impregnated activated carbon bed (AC-S), a thermal catalytic oxidizer (TCO), a single-stage selective catalytic reduction NOx treatment system (SCR), and a packed-bed caustic scrubber (PBS). The baseline design for the RPP-WTP HLW primary off-gas system includes an SBS, a WESP, a high efficiency mist eliminator (HEME), and a HEPA filter. The HLW secondary off-gas system includes a sulfur-impregnated activated carbon bed, a silver mordenite bed, a TCO, and a single-stage SCR. The one-third scale HLW DM1200 Pilot Melter installed at the Vitreous State Laboratory (VSL) was equipped with a prototypical off-gas train to meet the needs for testing and confirmation of the performance of the baseline off-gas system design. Various modifications have been made to the DM1200 system as the details of the WTP design have evolved, including the installation of a silver mordenite column and an AC-S column for testing on a slipstream of the off-gas flow; the installation of a full-flow AC-S bed for the present tests was completed prior to initiation of testing. The DM1200 system was reconfigured to enable testing of the baseline HLW or LAW off-gas trains to perform off-gas emissions testing with both LAW and HLW simulants in the present work. During 2002 and 2003, many of these off-gas components were tested individually and in an integrated manner with the DM1200 Pilot Melter. Data from these tests are being used to support engineering design confirmation and to provide data to support air permitting activities. In fiscal year 2004, the WTP Project was directed by the Office of River Protection (ORP) to comply with Environmental Protection Agency (EPA) Maximum Achievable Control Technology (MACT) requirements for organics. This requires that the combined melter and off-gas system have destruction and removal efficiency (DRE) of >99.99% for principal organic dangerous constituents (PODCs). In order to provide confidence that the melter and off-gas system are able to achieve the required DRE, testing has been directed with both LAW and HLW feeds. The tests included both 'normal' and 'challenge' WTP melter conditions in order to obtain data for the potential range of operating conditions for the WTP melters and off-gas components. The WTP Project, Washington State Department of Ecology, and ORP have agreed that naphthalene will be used for testing to represent semi-volatile organics and allyl alcohol will be used to represent volatile organics. Testing was also performed to determine emissions of halides, metals, products of incomplete combustion (PICs), dioxins, furans, coplanar PCBs, total hydrocarbons, and COX and NOX, as well as the particle size distribution (PSD) of particulate matter discharged at the end of the off-gas train. A description of the melter test requirements and analytical methods used is provided in the Test Plan for this work. Test Exceptions were subsequently issued which changed the TCO catalyst, added total organic emissions (TOE) to exhaust sampling schedule, and allowing modification of the test conditions in response to attainable plenum temperatures as well as temperature increases in the sulfur impregnated activated carbon (AC-S) column. Data are provided in this final report for all the required emission samples as well as melter and off-gas conditions during all the sampling periods. Appended to this report are previously issued VSL Letter Reports on method development for monitoring allyl alcohol in melter exhaust streams, on the results of characterization of the selected AC-S carbon media (Donnau BAT37), and on DM1200 off-line tests on the AC-S bed; also appended are reports from Air Tech on emissions sampling, and reports from Keika Ventures on validation of analytical data provided by Severn Trent Laboratories of Knoxville, Tennessee.« less

ROAD MAP FOR DEVELOPMENT OF CRYSTAL-TOLERANT HIGH LEVEL WASTE GLASSES

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

Fox, K.; Peeler, D.; Herman, C.

The U.S. Department of Energy (DOE) is building a Tank Waste Treatment and Immobilization Plant (WTP) at the Hanford Site in Washington to remediate 55 million gallons of radioactive waste that is being temporarily stored in 177 underground tanks. Efforts are being made to increase the loading of Hanford tank wastes in glass while meeting melter lifetime expectancies and process, regulatory, and product quality requirements. This road map guides the research and development for formulation and processing of crystaltolerant glasses, identifying near- and long-term activities that need to be completed over the period from 2014 to 2019. The primary objectivemore » is to maximize waste loading for Hanford waste glasses without jeopardizing melter operation by crystal accumulation in the melter or melter discharge riser. The potential applicability to the Savannah River Site (SRS) Defense Waste Processing Facility (DWPF) will also be addressed in this road map. The planned research described in this road map is motivated by the potential for substantial economic benefits (significant reductions in glass volumes) that will be realized if the current constraints (T1% for WTP and TL for DWPF) are approached in an appropriate and technically defensible manner for defense waste and current melter designs. The basis of this alternative approach is an empirical model predicting the crystal accumulation in the WTP glass discharge riser and melter bottom as a function of glass composition, time, and temperature. When coupled with an associated operating limit (e.g., the maximum tolerable thickness of an accumulated layer of crystals), this model could then be integrated into the process control algorithms to formulate crystal-tolerant high-level waste (HLW) glasses targeting high waste loadings while still meeting process related limits and melter lifetime expectancies. The modeling effort will be an iterative process, where model form and a broader range of conditions, e.g., glass composition and temperature, will evolve as additional data on crystal accumulation are gathered. Model validation steps will be included to guide the development process and ensure the value of the effort (i.e., increased waste loading and waste throughput). A summary of the stages of the road map for developing the crystal-tolerant glass approach, their estimated durations, and deliverables is provided.« less

Sources of Influence on Students' Enrollment Decision in Post-Secondary Vocational-Technical Education.

ERIC Educational Resources Information Center

Sandford, Brian A.; Torres, Robert M.

Descriptive survey research methodology was used to explore and describe factors--demographic, influential, or informational--that influenced student enrollment decisions in entry-level Welding Technology Program (WTP) courses. The target population included 38 students enrolled in the first semester courses offered by the WTP at Dona Ana…

Using a contingent valuation approach for improved solid waste management facility: Evidence from Kuala Lumpur, Malaysia

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

Afroz, Rafia, E-mail: rafia_afroz@yahoo.com; Masud, Muhammad Mehedi

2011-04-15

This study employed contingent valuation method to estimate the willingness to pay (WTP) of the households to improve the waste collection system in Kuala Lumpur, Malaysia. The objective of this study is to evaluate how household WTP changes when recycling and waste separation at source is made mandatory. The methodology consisted of asking people directly about their WTP for an additional waste collection service charge to cover the costs of a new waste management project. The new waste management project consisted of two versions: version A (recycling and waste separation is mandatory) and version B (recycling and waste separation ismore » not mandatory). The households declined their WTP for version A when they were asked to separate the waste at source although all the facilities would be given to them for waste separation. The result of this study indicates that the households were not conscious about the benefits of recycling and waste separation. Concerted efforts should be taken to raise environmental consciousness of the households through education and more publicity regarding waste separation, reducing and recycling.« less

The effects of information on willingness to pay for animal welfare in dairy production: application of nonhypothetical valuation mechanisms.

PubMed

Elbakidze, L; Nayga, R M

2012-03-01

The objective of this study was to examine consumer willingness to pay (WTP) for animal welfare in dairy production using nonhypothetical Vickrey auctions and open-ended choice experiments. Two hundred fifteen subjects participated in experimental sessions with 4 types of dairy products (humane animal care-labeled cheese and ice cream and conventional cheese and ice cream) and 4 valuation mechanisms. Information treatment, which included information about humane animal care principles in dairy production, was used to examine the effects of information on WTP. The results showed that participants, on average, were willing to pay extra for a scoop of humane animal care-labeled ice cream above the price of conventional ice cream. However, no premium WTP for humane animal care-labeled cheese was detected. Furthermore, provision of information only about humane animal care principles in dairy production, without corresponding information about conventional production practices, did not increase WTP for humane animal care-labeled products. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Economic valuation of the Emas waterfall, Mogi-Guaçu River, SP, Brazil.

PubMed

Peixer, Janice; Giacomini, Henrique C; Petrere, Miguel

2011-12-01

The Emas waterfall in Mogi-Guaçu River is regionally recognized as an important fishing spot and touristic place. The first reports of the professional and sport fishing there date back from the 30's, which is the same period when the tourism took place. The present paper provides an environmental valuation of this place and an assessment of the differences among the major groups of people using the area. During 2006 we interviewed 33 professional fishers, 107 sport fishers, 45 tourists and 103 excursionists in order to estimate the Willingness to Pay (WTP) for each category and to analyze the influence of socioeconomic factors by means of logistic regressions and ANCOVAs. The WTP of professional fisher was significantly influenced by age and education, and the WTP for the sport fishers was influenced by the family income. The variables that influenced the tourists' and excursionists' WTP were sex and education. The total annual aggregated value to maintain the waterfall in the current conditions was estimated in US$ 11.432.128, and US$ 55.424.283 to restore it.

Estimating cost of road traffic injuries in Iran using willingness to pay (WTP) method.

PubMed

Ainy, Elaheh; Soori, Hamid; Ganjali, Mojtaba; Le, Henry; Baghfalaki, Taban

2014-01-01

We aimed to use the willingness to pay (WTP) method to calculate the cost of traffic injuries in Iran in 2013. We conducted a cross-sectional questionnaire-based study of 846 randomly selected road users. WTP data was collected for four scenarios for vehicle occupants, pedestrians, vehicle drivers, and motorcyclists. Final analysis was carried out using Weibull and maximum likelihood method. Mean WTP was 2,612,050 Iranian rials (IRR). Statistical value of life was estimated according to 20,408 fatalities 402,314,106,073,648 IRR (US$13,410,470,202 based on purchasing power parity at (February 27th, 2014). Injury cost was US$25,637,870,872 (based on 318,802 injured people in 2013, multiple daily traffic volume of 311, and multiple daily payment of 31,030 IRR for 250 working days). The total estimated cost of injury and death cases was 39,048,341,074$. Gross national income of Iran was, US$604,300,000,000 in 2013 and the costs of traffic injuries constituted 6·46% of gross national income. WTP was significantly associated with age, gender, monthly income, daily payment, more payment for time reduction, trip mileage, drivers and occupants from road users. The costs of traffic injuries in Iran in 2013 accounted for 6.64% of gross national income, much higher than the global average. Policymaking and resource allocation to reduce traffic-related death and injury rates have the potential to deliver a huge economic benefit.

Effect of Tourist Characteristic, Marine Tourism Demand, and Number of Visits to the Value Perceptions and Willingness to Pay to Environmental Marine Tourism in Ambon City

NASA Astrophysics Data System (ADS)

Papilaya, Renoldy L.

2018-02-01

Development of tourism in this era must balance between supply and demand aspects. The tendency of policy makers pay more attention to aspects of supply than demand aspect will lead to the development of tourist products and services do not get good results. This research examined the relationship between marine tourism demand, characteristics and number of visits to the level of perception and willingness to pay (WTP) for a tourists on a marine tourism destination in Ambon city. Respondents come from overseas tourists, domestic and local, amounting to 140 people. The analysis was performed descriptively and further using SEM analysis Amos 19.00 with path analysis. The analysis shows the close relationship between marine tourism demand variables, characteristics, and the number of tourist visits to the perception of value and WTP for tourists. Variable marine tourism demand when connected directly to the tourists perception and WTP tends to correlate negatively than when using a variable as a variable number of tourist visits as a intervening variables. Instead tourists characteristic variables are positively correlated directly or indirectly with the perception of value and WTP for tourists. It is hoped that with this study will motivate tourism policy makers and local communities to be concerned and studied aspects of perception, WTP, marine tourism demand, the number of tourist visits and the characteristics that turned out to be related to each other.

Willingness to pay for improved respiratory and cardiovascular health: a multiple-format, stated-preference approach.

PubMed

Johnson, F R; Banzhaf, M R; Desvousges, W H

2000-06-01

This study uses stated-preference (SP) analysis to measure willingness to pay (WTP) to reduce acute episodes of respiratory and cardiovascular ill health. The SP survey employs a modified version of the health state descriptions used in the Quality of Well Being (QWB) Index. The four health state attributes are symptom, episode duration, activity restrictions and cost. Preferences are elicited using two different SP formats: graded-pair and discrete-choice. The different formats cause subjects to focus on different evaluation strategies. Combining two elicitation formats yields more valid and robust estimates than using only one approach. Estimates of indirect utility function parameters are obtained using advanced panel econometrics for each format separately and jointly. Socio-economic differences in health preferences are modelled by allowing the marginal utility of money relative to health attributes to vary across respondents. Because the joint model captures the combined preference information provided by both elicitation formats, these model estimates are used to calculate WTP. The results demonstrate the feasibility of estimating meaningful WTP values for policy-relevant respiratory and cardiac symptoms, even from subjects who never have personally experienced these conditions. Furthermore, because WTP estimates are for individual components of health improvements, estimates can be aggregated in various ways depending upon policy needs. Thus, using generic health attributes facilitates transferring WTP estimates for benefit-cost analysis of a variety of potential health interventions. Copyright 2000 John Wiley & Sons, Ltd.

Surgical treatment of GERD. Comperative study of WTP vs. Toupet fundoplication - results of 151 consecutive cases.

PubMed

Wróblewski, Tadeusz; Kobryn, Konrad; Nowosad, Małgorzata; Krawczyk, Marek

2016-01-01

Gastroesophageal reflux disease (GERD) is recognized as one of the most common disorders of the upper gastrointestinal tract (GIT). The best choice of management for advanced GERD is laparoscopic surgery. To compare and evaluate the results of surgical treatment of GERD patients operated on using two different techniques. Between 2001 and 2012, 353 patients (211 female and 142 male), aged 17-76 years (mean 44), underwent laparoscopic antireflux surgery. The study included patients who underwent a Toupet fundoplication or Wroblewski Tadeusz procedure (WTP). The mean age of the group was 47.77 years (17-80 years). Forty-nine (32.45%) patients had severe symptoms, 93 (61.58%) had mild symptoms and 9 (5.96%) had a single mild but intolerable sign of GERD. Eighty-six (56.95%) patients had a Toupet fundoplication and 65 (43.04%) had a WTP. The follow-up period was 18-144 months. The average operating time for Toupet fundoplication and the WTP procedure was 164 min (90-300 min) and 147 min (90-210 min), respectively. The perioperative mortality rate was 0.66%. The average post-operative hospitalization period was 5.4 days (2-16 post-operative days (POD) = Toupet) vs. 4.7 days (2-9 POD = WTP). No reoperations were performed. No major surgical complications were identified. Wroblewski Tadeusz procedure due to a low percentage of post-operative complications, good quality of life of patients and a zero recurrence rate of hiatal hernia should be a method of choice.

Residents' behaviors, attitudes, and willingness to pay for recycling e-waste in Macau.

PubMed

Song, Qingbin; Wang, Zhishi; Li, Jinhui

2012-09-15

Large quantities of e-waste are presently being generated in Macau, but since recycling facilities and laws on e-waste still need to be developed, most e-waste cannot currently be properly treated. Moreover, little is known about residents' behaviors, attitudes, and their willingness to pay (WTP) for recycling e-waste. These issues are discussed in this study, based on a questionnaire survey on household electronic product usage. In 2010, "Life span completed" was the primary reason respondents abandoned their electronic products, accounting for about 37.97% of responses; the main disposal methods of e-waste in Macau were "Retailers retrieve from consumer" and "Sale to a recycling corporation." While having little understanding of e-waste disposal issues, most residents were still willing to hand their e-waste into the government for centralized collection. In addition, the respondents gave "telephone reservation" as their preferred collection method. Finally, the residents' WTP in Macau was estimated by the logistic regression method. It was found that education level, age and household income were the significant factors affecting residents' WTP. The monthly mean WTP was 20.03MOP (2.50 US dollar) per household, and the annual WTP was approximately 40,185,067 MOP (5,023,133 US dollar) for all of Macau. The results of our study can help managers develop more effective environmental management policies for e-waste disposal. Copyright © 2012 Elsevier Ltd. All rights reserved.

Preference and willingness to pay for nutritional counseling services in urban Hanoi

PubMed Central

Nguyen, Hai Viet; Trinh, Ngoc Bao; Le, Huong Thi; Nguyen, Cuong Tat; Mai, Hue Thi; Tran, Tho Dinh; Le, Huong Thi; Le, Quynh Ngoc Hoang; Tran, Bach Xuan; Vu, Thuc Thi Minh

2017-01-01

Background: Despite substantial achievement in reducing malnutrition rates in Vietnam, there has been an increasing rate of overweight individuals in urban areas, which may result in a high burden of non-communicable diseases. Nutritional counseling clinics have been introduced in several settings; however, little is known about the preference for this service among urban clients. This study aimed to assess the preference and willingness to pay (WTP) for nutritional counseling services among urban clients. Methods: We interviewed 429 clients who attended Hanoi Medical University Nutritional Counseling Clinic (Hanoi, Vietnam). WTP was determined using double-bounded dichotomous-choice questions and open-ended questions. Results: In total, 78.6% respondents were willing to use nutritional counseling services. The mean amount of WTP for one-time service and one-year package was 96,100VND (~$4.3) and 946,400VND (~$41.9), respectively. Clients’ willingness to use the service was higher among females, those seeking counseling for elderly people and those who preferred face-to-face counseling services (p<0.05). WTP was higher among those who were over 35 years old, those seeking services for the elderly people, those having poor nutritional status, and those having under-6 year old children (p<0.05). Conclusions: The preference and WTP for nutritional counseling services in urban Hanoi were relatively high. Scaling up this service is necessary to actively prevent and control the spread of non-communicable diseases. PMID:29152220

[WTP guidance technology: a comparison of payment card, single-bounded and double-bounded dichotomous formats for evaluating non-use values of Sanjiang Plain ecotourism water resources].

PubMed

Chen, Hong-Guang; Wang, Qiu-Dan; Li, Chen-Yang

2014-09-01

Contingent valuation method (CVM) is the most widespread method to assess resources and value of environmental goods and services. The guidance technology of willingness to pay (WTP) is an important means of CVM. Therefore, the study on the WTP guidance technology is an important approach to improve the reliability and validity of CVM. This article conducted comprehensive evaluation on non-use value of eco-tourism water resources in Sanjiang Plain by using payment card, single-bound dichotomous choice and double-bound dichotomous choice. Results showed that the socio-economic attributes were consistent with the willingness to pay in the three formats, and the tender value, age, educational level, annual income and the concern level had significant effect on the willingness to pay, while gender and job did not have significant influence. The WTP value was 112.46 yuan per capita with the payment card, 136.15 with the single-bound dichotomous choice, and 168.74 with the double-bound dichotomous choice. Comprehensive consideration of the nature of the investigation, investigation costs and statistical techniques, the result of double-bound dichotomous choice (47.86 x 10(8) yuan · a(-1)) was best in accordance with the reality, and could be used as non-use value of eco-tourism water resources in Sanjiang Plain. The format of questionnaire was very important to improve its validity, and made a great influence on the WTP.

The general public's willingness to pay for tax increases to support unrestricted access to an Alzheimer's disease medication.

PubMed

Oremus, Mark; Tarride, Jean-Eric; Raina, Parminder; Thabane, Lehana; Foster, Gary; Goldsmith, Charlie H; Clayton, Natasha

2012-11-01

Alzheimer's disease (AD) is a neurodegenerative disorder highlighted by progressive declines in cognitive and functional abilities. Our objective was to assess the general public's maximum willingness to pay ((M)WTP) for an increase in annual personal income taxes to fund unrestricted access to AD medications. We randomly recruited 500 Canadians nationally and used computer-assisted telephone interviewing to administer a questionnaire. The questionnaire contained four 'efficacy' scenarios describing an AD medication as capable of symptomatically treating cognitive decline or modifying disease progression. The scenarios also described the medication as having no adverse effects or a 30% chance of adverse effects. We randomized participants to order of scenarios and willingness-to-pay bid values; (M)WTP for each scenario was the highest accepted bid for that scenario. We conducted linear regression and bootstrap sensitivity analyses to investigate potential determinants of (M)WTP. Mean (M)WTP was highest for the 'disease modification/no adverse effects' scenario ($Can130.26) and lowest for the 'symptomatic treatment/30% chance of adverse effects' scenario ($Can99.16). Bootstrap analyses indicated none of our potential determinants (e.g. age, sex) were associated with participants' (M)WTP. The general public is willing to pay higher income taxes to fund unrestricted access to AD (especially disease-modifying) medications. Consequently, the public should favour placing new AD medications on public drug plans. As far as we are aware, no other study has elicited the general public's willingness to pay for AD medications.

Estimating Cost of Road Traffic Injuries in Iran Using Willingness to Pay (WTP) Method

PubMed Central

Ainy, Elaheh; Soori, Hamid; Ganjali, Mojtaba; Le, Henry; Baghfalaki, Taban

2014-01-01

We aimed to use the willingness to pay (WTP) method to calculate the cost of traffic injuries in Iran in 2013. We conducted a cross-sectional questionnaire-based study of 846 randomly selected road users. WTP data was collected for four scenarios for vehicle occupants, pedestrians, vehicle drivers, and motorcyclists. Final analysis was carried out using Weibull and maximum likelihood method. Mean WTP was 2,612,050 Iranian rials (IRR). Statistical value of life was estimated according to 20,408 fatalities 402,314,106,073,648 IRR (US$13,410,470,202 based on purchasing power parity at (February 27th, 2014). Injury cost was US$25,637,870,872 (based on 318,802 injured people in 2013, multiple daily traffic volume of 311, and multiple daily payment of 31,030 IRR for 250 working days). The total estimated cost of injury and death cases was 39,048,341,074$. Gross national income of Iran was, US$604,300,000,000 in 2013 and the costs of traffic injuries constituted 6·46% of gross national income. WTP was significantly associated with age, gender, monthly income, daily payment, more payment for time reduction, trip mileage, drivers and occupants from road users. The costs of traffic injuries in Iran in 2013 accounted for 6.64% of gross national income, much higher than the global average. Policymaking and resource allocation to reduce traffic-related death and injury rates have the potential to deliver a huge economic benefit. PMID:25438150

Combined RAF1 protein expression and p53 mutational status provides a strong predictor of cellular radiosensitivity

PubMed Central

Warenius, H M; Jones, M; Gorman, T; McLeish, R; Seabra, L; Barraclough, R; Rudland, P

2000-01-01

The tumour suppressor gene, p53, and genes coding for positive signal transduction factors can influence transit through cell-cycle checkpoints and modulate radiosensitivity. Here we examine the effects of RAF1 protein on the rate of exit from a G2/M block induced by γ-irradiation in relation to intrinsic cellular radiosensitivity in human cell lines expressing wild-type p53 (wtp53) protein as compared to mutant p53 (mutp53) protein. Cell lines which expressed mutp53 protein were all relatively radioresistant and exhibited no relationship between RAF1 protein and cellular radiosensitivity. Cell lines expressing wtp53 protein, however, showed a strong relationship between RAF1 protein levels and the radiosensitivity parameter SF2. In addition, when post-irradiation perturbation of G2/M transit was compared using the parameter T50 (time after the peak of G2/M delay at which 50% of the cells had exited from a block induced by 2 Gy of irradiation), RAF1 was related to T50 in wtp53, but not mutp53, cell lines. Cell lines which expressed wtp53 protein and high levels of RAF1 had shorter T50s and were also more radiosensitive. These results suggest a cooperative role for wtp53 and RAF1 protein in determining cellular radiosensitivity in human cells, which involves control of the G2/M checkpoint. © 2000 Cancer Research Campaign PMID:10993658

Willingness to pay for highlands' agro-tourism recreational facility: A case of Boh Tea plantation, Cameron Highlands, Malaysia

NASA Astrophysics Data System (ADS)

A, Syamsul Herman M.; M, Nur A'in C.; S, Ahmad; S, Ramachandran

2014-03-01

The increase in tourist demand for highland experience is inevitable. Cameron Highlands, established as a Tea Plantation Estate during the British Colonial era in 1929, has evolved into a major highland tourism destination providing a cool climatic experience coupled with scenic beauty in the midst of Tudor concept architecture which enhances the destinations historical value. Realising such tourism potential, the Boh Plantation management has provided a visitor centre as recreational facility for tourist utilisation. However, the absence in imposing an entrance fee has left a vacuum in determining the recreational economic value of this facility as the benefit of this agro-tourism product to tourists remains unknown. It would be important for the management to identify the benefit since the development and maintenance of the facility is costly. Hence, the purpose of this paper is to estimate the benefit of such establishment in highlands area by assessing visitor's Willingness to pay (WTP). The study examines, explores and debates the issues in a critical yet supportive environment especially highlands. The study obtained 179 usable questionnaires from visitors during weekends, weekdays and public holidays. The result showed that 59% of the visitors were willing to pay for the agro-tourism product. The WTP was estimated at RM 7.21 (1.81). Three factors were found to be influencing WTP which were monthly income, years of education and perception on scenery. Although the study was conducted post development, the finding indicated the WTP for current management practise. Should the management change its style, it would also affect WTP and also the total economic value. Since WTP is established concept, the finding of the study reflects on the opportunities, barriers and challenges inherent in embracing post-disciplinary approaches to research and suggest ways to further enhance the approach.

Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP) for nursing consultations.

PubMed

Martín-Fernández, Jesús; del Cura-González, Ma Isabel; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Zamora, Javier; Gómez-Gascón, Tomás; Polentinos-Castro, Elena; Pérez-Rivas, Francisco Javier; Domínguez-Bidagor, Julia; Beamud-Lagos, Milagros; Tello-Bernabé, Ma Eugenia; Conde-López, Juan Francisco; Aguado-Arroyo, Óscar; Sanz-Bayona, Ma Teresa; Gil-Lacruz, Ana Isabel

2013-01-01

Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2-15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6-22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4-6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of health services.

Nitrogen Isotopic Composition of Proteinaceous Coral Skeletal Amino Acids Records Change in Source Nitrate to the Euphotic Zone in the Western Tropical Pacific

NASA Astrophysics Data System (ADS)

Williams, B.; Thibodeau, B.; Chikaraishi, Y.; Ohkouchi, N.; Grottoli, A. G.

2014-12-01

Instrumental and proxy data and global climate model experiments indicate a multi-decadal shoaling of the western tropical Pacific (WTP) thermocline potentially related to a shift in ENSO frequency. In the WTP, the nutricline coincides with the thermocline, and a shoaling of the nutricline brings more nitrate-rich seawater higher in the water column and within the sunlit euphotic zone. In the nutrient-poor WTP, this incursion of nitrate-rich water at the bottom of the euphotic zone may stimulate productivity in the water column. However, there is a general paucity of measurements below the surface with which to investigate recent changes in seawater chemistry. Nitrogen isotope (δ15N) measurements of particulate organic matter (POM) can elucidate the source of nitrogen to the WTP and related trophic dynamics. This POM is the food source to the long-lived proteinaceous corals, and drives the nitrogen isotopic composition of their skeleton. Here, we report time series δ15N values from the banded skeletons of proteinaceous corals from offshore Palau in the WTP that provide proxy information about past changes in euphotic zone nitrogen dynamics. Bulk skeletal δ15N values declined between 1977 and 2010 suggesting a progressively increasing contribution of deep water with isotopically-light nitrate to the euphotic zone and/or a shortening of the planktonic food web. Since only some amino acids are enriched in δ15N with each trophic transfer in a food web, we measured the δ15N composition of seven individual amino acids in the same coral skeleton. The δ15N time series of the individual amino acids also declined over time, mirroring the bulk values. These new data indicate that the changes in the source nitrogen to the base of the euphotic zone drives a decline in coral skeletal δ15N values, consistent with the shoaling nutricline, with no coinciding alteration of the trophic structure in the WTP.

Economic Valuation of Health Care Services in Public Health Systems: A Study about Willingness to Pay (WTP) for Nursing Consultations

PubMed Central

Martín-Fernández, Jesús; del Cura-González, Mª Isabel; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Zamora, Javier; Gómez-Gascón, Tomás; Polentinos-Castro, Elena; Pérez-Rivas, Francisco Javier; Domínguez-Bidagor, Julia; Beamud-Lagos, Milagros; Tello-Bernabé, Mª Eugenia; Conde-López, Juan Francisco; Aguado-Arroyo, Óscar; Bayona, Mª Teresa Sanz-; Gil-Lacruz, Ana Isabel

2013-01-01

Background Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Methods and Results Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2–15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6–22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4–6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). Conclusions The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of health services. PMID:23626858

A study of the user's perception of economic value in nursing visits to primary care by the method of contingent valuation.

PubMed

Martín-Fernández, Jesús; Pérez-Rivas, Francisco Javier; Gómez-Gascón, Tomás; del Cura-González, Isabel; Tello Bernabé, Eugenia; Rodríguez-Martínez, Gemma; Polentinos-Castro, Elena; Domínguez-Bidagor, Julia; Ariza-Cardiel, Gloria; Conde-López, Juan Francisco; Beamud-Lagos, Milagros; Aguado-Arroyo, Oscar; Sanz-Bayona, Teresa; Gil-Lacruz, Ana Isabel

2011-10-03

The identification of the attribution of economic value that users of a health system assign to a health service could be useful in planning these services. The method of contingent valuation can provide information about the user's perception of value in monetary terms, and therefore comparable between services of a very different nature. This study attempts to extract the economic value that the subject, user of primary care nursing services in a public health system, attributes to this service by the method of contingent valuation, based on the perspectives of Willingness to Pay (WTP) and Willingness to Accept [Compensation] (WTA). This is an economic study with a transversal design. The contingent valuation method will be used to estimate the user's willingness to pay (WTP) for the care received from the primary care nurse and the willingness to accept [compensation] (WTA), were this service eliminated. A survey that meets the requisites of the contingent valuation method will be constructed and pilot-tested. Subsequently, 600 interviews will be performed with subjects chosen by systematic randomized sampling from among those who visit nursing at twenty health centers with different socioeconomic characteristics in the Community of Madrid. The characteristics of the subject and of the care received that can explain the variations in WTP, WTA and in the WTP/WTA ratio expressed will be studied. A theoretical validation of contingent valuation will be performed constructing two explanatory multivariate mixed models in which the dependent variable will be WTP, and the WTP/WTA relationship, respectively. The identification of the attribution of economic value to a health service that does not have a direct price at the time of use, such as a visit to primary care nursing, and the definition of a profile of "loss aversion" in reference to the service evaluated, can be relevant elements in planning, enabling incorporating patient preferences to health policy decision-making.

Impact of educational intervention on willingness-to-pay for health insurance: A study of informal sector workers in urban Bangladesh.

PubMed

Khan, Jahangir Am; Ahmed, Sayem

2013-04-29

The reliance on out-of-pocket payments for health services leads to a catastrophic burden for many households in Bangladesh. The World Health Organization suggests that risk-pooling mechanisms should be used for financing healthcare. Like many low-income countries (LIC), a large share of employment in Bangladesh is in the informal sector (88%). Inclusion of these workers in health insurance is a big challenge. Among other barriers, the "literacy gap" for health insurance" is a reason for the low insurance uptake in Bangladesh. The aim of this study is, therefore, to assess the impact of an educational intervention on willingness-to-pay (WTP) for health insurance among informal sector workers in urban Bangladesh. An educational intervention on occupational solidarity and health insurance is offered to groups of informal workers. Educational sessions take place once a week (3-4 hours) during three subsequent weeks for each occupational group. For assessing the impact of the educational intervention, WTP for joining health insurance using occupational solidarity between workers in "pre- and post-treatment" periods as well as between "control and treatment" groups were compared. Multiple-regression analysis is applied for predicting WTP by educational intervention, while controlling for demographic and socioeconomic characteristics. The coefficient of variation (CoV) of the WTP is estimated in control and treatment groups and expected to be lower in the latter. The WTP for health insurance is higher (33.8%) among workers who joined the educational intervention in comparison with those who did not (control group). CoV of WTP is found to be generally lower in post-treatment period and in treatment group compared to pre-treatment period and control group respectively. Educational interventions can be used for increasing demand for health insurance scheme using occupational solidarity among informal sector workers.

A study of the user's perception of economic value in nursing visits to primary care by the method of contingent valuation

PubMed Central

2011-01-01

Background The identification of the attribution of economic value that users of a health system assign to a health service could be useful in planning these services. The method of contingent valuation can provide information about the user's perception of value in monetary terms, and therefore comparable between services of a very different nature. This study attempts to extract the economic value that the subject, user of primary care nursing services in a public health system, attributes to this service by the method of contingent valuation, based on the perspectives of Willingness to Pay (WTP) and Willingness to Accept [Compensation] (WTA). Methods/Design This is an economic study with a transversal design. The contingent valuation method will be used to estimate the user's willingness to pay (WTP) for the care received from the primary care nurse and the willingness to accept [compensation] (WTA), were this service eliminated. A survey that meets the requisites of the contingent valuation method will be constructed and pilot-tested. Subsequently, 600 interviews will be performed with subjects chosen by systematic randomized sampling from among those who visit nursing at twenty health centers with different socioeconomic characteristics in the Community of Madrid. The characteristics of the subject and of the care received that can explain the variations in WTP, WTA and in the WTP/WTA ratio expressed will be studied. A theoretical validation of contingent valuation will be performed constructing two explanatory multivariate mixed models in which the dependent variable will be WTP, and the WTP/WTA relationship, respectively. Discussion The identification of the attribution of economic value to a health service that does not have a direct price at the time of use, such as a visit to primary care nursing, and the definition of a profile of "loss aversion" in reference to the service evaluated, can be relevant elements in planning, enabling incorporating patient preferences to health policy decision-making. PMID:21967306

Patients' willingness to pay for their drugs in primary care clinics in an urbanized setting in Malaysia: a guide on drug charges implementation.

PubMed

Puteh, Sharifa Ezat Wan; Ahmad, Siti Nurul Akma; Aizuddin, Azimatun Noor; Zainal, Ramli; Ismail, Ruhaini

2017-01-01

Malaysia is an upper middle income country that provides subsidized healthcare to ensure universal coverage to its citizens. The challenge of escalating health care cost occurs in most countries, including Malaysia due to increase in disease prevalence, which induced an escalation in drug expenditure. In 2009, the Ministry of Health has allocated up to Malaysian Ringgit (MYR) 1.402 billion (approximately USD 390 million) on subsidised drugs. This study was conducted to measure patients' willingness to pay (WTP) for treatment of chronic condition or acute illnesses, in an urbanized population. A cross-sectional study, through face-to-face interview was conducted in an urban state in 2012-2013. Systematic random sampling of 324 patients was selected from a list of patients attending ten public primary cares with Family Medicine Specialist service. Patients were asked using a bidding technique of maximum amount (in MYR) if they are WTP for chronic or acute illnesses. Patients are mostly young, female, of lower education and lower income. A total of 234 respondents (72.2%) were not willing to pay for drug charges. WTP for drugs either for chronic or acute illness were at low at median of MYR10 per visit (USD 3.8). Bivariate analysis showed that lower numbers of dependent children (≤3), higher personal and household income are associated with WTP. Multivariate analysis showed only number of dependent children (≤3) as significant ( p  = 0.009; 95% CI 1.27-5.44) predictor to drugs' WTP. The result indicates that primary care patients have low WTP for drugs, either for chronic condition or acute illness. Citizens are comfortable in the comfort zone whereby health services are highly subsidized through universal coverage. Hence, there is a resistance to pay for drugs.

Increasing access to modern contraceptives: the potential role of community solidarity through altruistic contributions.

PubMed

Onwujekwe, Obinna E; Ogbonna, Chinwe; Uguru, Nkoli; Uzochukwu, Benjamin S C; Lawson, Agathe; Ndyanabangi, Bannet

2012-07-06

There is an urgent need for universal access to modern contraceptives in Nigeria, to facilitate the achievement of the Millennium Development Goals and other national goals. This study provides information on the potential role of community solidarity in increasing access to contraceptives for the most-poor people through exploration of the role of altruism by determining level of altruistic willingness to pay (WTP) for modern contraceptives across different geographic contexts in Nigeria. It was a cross-sectional national survey which took place in six states spread across the six-geopolitical zones of the country. In each state, an urban and a rural area were selected for the study, giving a total of 6 urban and 6 rural sites. A pre-tested interviewer-administered questionnaire was used to collect information from at least 720 randomly selected householders from each state. The targeted respondent in a household was a female primary care giver of child bearing age (usually the wives), or in her absence, another female household member of child bearing age. A scenario on altruistic WTP was presented before the value was elicited using a binary with open-ended follow-up question format. Test of validity of elicited altruistic WTP was undertaken using Tobit regression. More than 50 % of the respondents across all the states were willing to contribute some money so that the very poor would be provided with modern contraceptives. The average amount of money that people were willing to contribute annually was 650 Naira (US$4.5). Mean altruistic WTP differed across SES quintiles and urban-rural divide (p < .01). Multiple regression analysis showed that age was negatively related to altruistic WTP (p < 0.05). However, years of schooling, being employed by government or being a big business person, prior experience of paying for contraceptives and socioeconomic status had statistically significant effects on altruistic WTP (p < 0.05). There is room for community solidarity to ensure that the very poor benefit from modern contraceptives and assure universal coverage with modern contraceptives. The factors that determine altruistic WTP should be harnessed to ensure that altruistic contributions are actually made. The challenge will be how to collect and pool the altruistic contributions for purchasing and delivering modern contraceptives to the most-poor, within the context of community financing.

Willingness to pay for contagious bovine pleuropneumonia vaccination in Narok South District of Kenya.

PubMed

Kairu-Wanyoike, Salome W; Kaitibie, Simeon; Heffernan, Claire; Taylor, Nick M; Gitau, George K; Kiara, Henry; McKeever, Declan

2014-08-01

Contagious bovine pleuropneumonia (CBPP) is an economically important trans-boundary cattle disease which affects food security and livelihoods. A conjoint analysis-contingent valuation was carried out on 190 households in Narok South District of Kenya to measure willingness to pay (WTP) and demand for CBPP vaccine and vaccination as well as factors affecting WTP. The mean WTP was calculated at Kenya Shillings (KSh) 212.48 (USD 3.03) for vaccination using a vaccine with the characteristics that were preferred by the farmers (preferred vaccine and vaccination) and KSh -71.45 (USD -1.02) for the currently used vaccine and vaccination. The proportion of farmers willing to pay an amount greater than zero was 66.7% and 34.4% for the preferred and current vaccine and vaccination respectively. About one third (33.3%) of farmers would need to be compensated an average amount of KSh 1162.62 (USD 13.68) per animal to allow their cattle to be vaccinated against CBPP using the preferred vaccine and vaccination. About two-thirds (65.6%) of farmers would need to be compensated an average amount of KSh 853.72 (USD 12.20) per animal to allow their cattle to be vaccinated against CBPP using the current vaccine and vaccination. The total amount of compensation would be KSh 61.39 million (USD 0.88 million) for the preferred vaccine and vaccination and KSh 90.15 million (USD 1.29 million) for the current vaccine and vaccination. Demand curves drawn from individual WTP demonstrated that only 59% and 27% of cattle owners with a WTP greater than zero were willing to pay a benchmark cost of KSh 34.60 for the preferred and current vaccine respectively. WTP was negatively influenced by the attitude about household economic situation (p=0.0078), presence of cross breeds in the herd (p<0.0001) and years since CBPP had been experienced in the herd (p=0.0375). It was positively influenced by education (p=0.0251) and the practice of treating against CBPP (p=0.0432). The benefit cost ratio (BCR) for CBPP vaccination was 2.9-6.1 depending on the vaccination programme. In conclusion, although a proportion of farmers was willing to pay, participation levels may be lower than those required to interrupt transmission of CBPP. Households with characteristics that influence WTP negatively need persuasion to participate in CBPP vaccination. It is economically worthwhile to vaccinate against CBPP. A benefit cost analysis (BCA) using aggregated WTP as benefits can be used as an alternative method to the traditional BCA which uses avoided production losses (new revenue) and costs saved as benefits. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Willingness to pay for contagious bovine pleuropneumonia vaccination in Narok South District of Kenya

PubMed Central

Kairu-Wanyoike, Salome W.; Kaitibie, Simeon; Heffernan, Claire; Taylor, Nick M.; Gitau, George K.; Kiara, Henry; McKeever, Declan

2014-01-01

Contagious bovine pleuropneumonia (CBPP) is an economically important trans-boundary cattle disease which affects food security and livelihoods. A conjoint analysis–contingent valuation was carried out on 190 households in Narok South District of Kenya to measure willingness to pay (WTP) and demand for CBPP vaccine and vaccination as well as factors affecting WTP. The mean WTP was calculated at Kenya Shillings (KSh) 212.48 (USD 3.03) for vaccination using a vaccine with the characteristics that were preferred by the farmers (preferred vaccine and vaccination) and KSh −71.45 (USD −1.02) for the currently used vaccine and vaccination. The proportion of farmers willing to pay an amount greater than zero was 66.7% and 34.4% for the preferred and current vaccine and vaccination respectively. About one third (33.3%) of farmers would need to be compensated an average amount of KSh 1162.62 (USD 13.68) per animal to allow their cattle to be vaccinated against CBPP using the preferred vaccine and vaccination. About two-thirds (65.6%) of farmers would need to be compensated an average amount of KSh 853.72 (USD 12.20) per animal to allow their cattle to be vaccinated against CBPP using the current vaccine and vaccination. The total amount of compensation would be KSh 61.39 million (USD 0.88 million) for the preferred vaccine and vaccination and KSh 90.15 million (USD 1.29 million) for the current vaccine and vaccination. Demand curves drawn from individual WTP demonstrated that only 59% and 27% of cattle owners with a WTP greater than zero were willing to pay a benchmark cost of KSh 34.60 for the preferred and current vaccine respectively. WTP was negatively influenced by the attitude about household economic situation (p = 0.0078), presence of cross breeds in the herd (p < 0.0001) and years since CBPP had been experienced in the herd (p = 0.0375). It was positively influenced by education (p = 0.0251) and the practice of treating against CBPP (p = 0.0432). The benefit cost ratio (BCR) for CBPP vaccination was 2.9–6.1 depending on the vaccination programme. In conclusion, although a proportion of farmers was willing to pay, participation levels may be lower than those required to interrupt transmission of CBPP. Households with characteristics that influence WTP negatively need persuasion to participate in CBPP vaccination. It is economically worthwhile to vaccinate against CBPP. A benefit cost analysis (BCA) using aggregated WTP as benefits can be used as an alternative method to the traditional BCA which uses avoided production losses (new revenue) and costs saved as benefits. PMID:24774477

Societal Value of Surgery for Facial Reanimation

PubMed Central

Su, Peiyi; Ishii, Lisa E.; Joseph, Andrew; Nellis, Jason; Dey, Jacob; Bater, Kristin; Byrne, Patrick J.; Boahene, Kofi D. O.; Ishii, Masaru

2017-01-01

IMPORTANCE Patients with facial paralysis are perceived negatively by society in a number of domains. Society’s perception of the health utility of varying degrees of facial paralysis and the value society places on reconstructive surgery for facial reanimation need to be quantified. OBJECTIVE To measure health state utility of varying degrees of facial paralysis, willingness to pay (WTP) for a repair, and the subsequent value of facial reanimation surgery as perceived by society. DESIGN, SETTING, AND PARTICIPANTS This prospective observational study conducted in an academic tertiary referral center evaluated a group of 348 casual observers who viewed images of faces with unilateral facial paralysis of 3 severity levels (low, medium, and high) categorized by House-Brackmann grade. Structural equation modeling was performed to understand associations among health utility metrics, WTP, and facial perception domains. Data were collected from July 16 to September 26, 2015. MAIN OUTCOMES AND MEASURES Observer-rated (1) quality of life (QOL) using established health utility metrics (standard gamble, time trade-off, and a visual analog scale) and (2) their WTP for surgical repair. RESULTS Among the 348 observers (248 women [71.3%]; 100 men [28.7%]; mean [SD] age, 29.3 [11.6] years), mixed-effects linear regression showed that WTP increased nonlinearly with increasing severity of paralysis. Participants were willing to pay $3487 (95% CI, $2362–$4961) to repair low-grade paralysis, $8571 (95% CI, $6401–$11 234) for medium-grade paralysis, and $20 431 (95% CI, $16 273–$25 317) for high-grade paralysis. The dominant factor affecting the participants’ WTP was perceived QOL. Modeling showed that perceived QOL decreased with paralysis severity (regression coefficient, −0.004; 95% CI, −0.005 to −0.004; P < .001) and increased with attractiveness (regression coefficient, 0.002; 95% CI, 0.002 to 0.003; P < .001). Mean (SD) health utility scores calculated by the standard gamble metric for low- and high-grade paralysis were 0.98 (0.09) and 0.77 (0.25), respectively. Time trade-off and visual analog scale measures were highly correlated. We calculated mean (SD) WTP per quality-adjusted life-year, which ranged from $10 167 ($14 565) to $17 008 ($38 288) for low- to high-grade paralysis, respectively. CONCLUSIONS AND RELEVANCE Society perceives the repair of facial paralysis to be a high-value intervention. Societal WTP increases and perceived health state utility decreases with increasing House-Brackmann grade. This study demonstrates the usefulness of WTP as an objective measure to inform dimensions of disease severity and signal the value society places on proper facial function. LEVEL OF EVIDENCE NA. PMID:27892977

The endowment effect and WTA: a quasi-experimental test

Treesearch

H.F. MacDonald; J. Michael Bowker

1993-01-01

This paper reports a test of the endowment effect in an economic analysis of localized air pollution. Regression techniques are used to test the significance of perceived property rights on household WTP for improved air quality versus WTA compensation to forgo an improvement in air quality. Our experimental contributes to the research into WTP/WTA divergence by...

75 FR 38500 - Notice of Availability of Draft Environmental Impact Statement for the Proposed Folsom South of U...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

... Water Facility Alternative--Raw Water Conveyance--Grant Line Road Alignment and On- site WTP; (3) Off-site Water Facility Alternative 1--Raw Water Conveyance--Grant Line Road Alignment and White Rock WTP; (4) Off-site Water Facility Alternative 1A--Raw Water Conveyance--Grant Line Road Route Variation...

An economic analysis of localized pollution: rendering emissions in a residential setting

Treesearch

J. Michael Bowker; H.F. MacDonald

1991-01-01

The contingent value method is employed to estimate economic damages to households resulting from rendering plant emissions in a small town. Household willingness to accept (WTA) and willingness to pay (WTP) are estimated individually and in aggregate. The influence of household characteristics on WTP and WTA is examined via regression models. The perception of health...

Accounting for respondent uncertainty to improve willingness-to-pay estimates

Treesearch

Rebecca Moore; Richard C. Bishop; Bill Provencher; Patricia A. Champ

2010-01-01

In this paper, we develop an econometric model of willingness to pay (WTP) that integrates data on respondent uncertainty regarding their own WTP. The integration is utility consistent, there is no recoding of variables, and no need to calibrate the contingent responses to actual payment data, so the approach can "stand alone." In an application to a...

The Role of Channel Distribution Information for Interference Management and Network Performance Enhancement

DTIC Science & Technology

2010-11-03

U,V wTp s.t. Γl ≥ γl,l = 1, . . . , L (2) For a fixed set of channel matrices Hli’s, this problem can be solved and will give a set of power...outage. The main optimization problem using CDI can then be formulated: min p≥0,U,V wTp s.t. Pr(Γl ≤ γl) ≤ αl, l = 1, . . . , L (3) In this formulation...can be written as min p≥0,U,V wTp s.t. 1− e− γl 2 σ2Nl cllpl ∏ i 6=l ( 1 + γl clipi cllpl )−1 ≤ αl, l = 1, . . . , L (11) To get the constraints in (11

Social and private benefits of assisted reproductive technology: a national survey-based evaluation in Israel.

PubMed

Gonen, Limor Dina

2016-01-01

The objective of this paper was to measure the private and social benefits resulting from technological advances in fertility treatment. An empirical model investigates the willingness-to-pay (WTP) for advances in the medical technology of in vitro fertilization (IVF) among the general public and among IVF patients in Israel. The empirical model's findings demonstrate that IVF patients and the general public value medical technology advances and have a positive WTP for it. The average WTP for IVF technology advances, among IVF patients, is US $3116.9 whereas for the general public it is US$2284.4. Available evidence suggests that advances in medical technology have delivered substantial benefits and appear to have contributed to improved wellbeing.

COMPUTATIONAL FLUID DYNAMICS MODELING OF SCALED HANFORD DOUBLE SHELL TANK MIXING - CFD MODELING SENSITIVITY STUDY RESULTS

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

JACKSON VL

2011-08-31

The primary purpose of the tank mixing and sampling demonstration program is to mitigate the technical risks associated with the ability of the Hanford tank farm delivery and celtification systems to measure and deliver a uniformly mixed high-level waste (HLW) feed to the Waste Treatment and Immobilization Plant (WTP) Uniform feed to the WTP is a requirement of 24590-WTP-ICD-MG-01-019, ICD-19 - Interface Control Document for Waste Feed, although the exact definition of uniform is evolving in this context. Computational Fluid Dynamics (CFD) modeling has been used to assist in evaluating scaleup issues, study operational parameters, and predict mixing performance atmore » full-scale.« less

Timing effects in health valuations.

PubMed

Leiter, Andrea M; Pruckner, Gerald J

2014-06-01

This paper analyzes the impact of external sources of information, conveyed by the frequency of risky events that vary across time, on the individual willingness to pay (WTP) for a reduction of mortality risk. We collected data from a contingent valuation (CV) exercise conducted in two waves (fall and winter) to examine whether individual WTP varied across periods that differed in the predominance of fatal accidents. Risk valuations were based on fatal snow avalanche accidents, that is, a type of risk with seasonal differences in occurrence. We found slightly lower but statistically significant mean WTP figures in the winter than in the fall sample because of time-varying individual risk attitudes and, therefore, recommend controlling for these factors in risk assessment CV surveys. Copyright © 2013 John Wiley & Sons, Ltd.

Occurrences and removal of pharmaceuticals and personal care products (PPCPs) in drinking water and water/sewage treatment plants: A review.

PubMed

Yang, Yi; Ok, Yong Sik; Kim, Ki-Hyun; Kwon, Eilhann E; Tsang, Yiu Fai

2017-10-15

In recent years, many of micropollutants have been widely detected because of continuous input of pharmaceuticals and personal care products (PPCPs) into the environment and newly developed state-of-the-art analytical methods. PPCP residues are frequently detected in drinking water sources, sewage treatment plants (STPs), and water treatment plants (WTPs) due to their universal consumption, low human metabolic capability, and improper disposal. When partially metabolized PPCPs are transferred into STPs, they elicit negative effects on biological treatment processes; therefore, conventional STPs are insufficient when it comes to PPCP removal. Furthermore, the excreted metabolites may become secondary pollutants and can be further modified in receiving water bodies. Several advanced treatment systems, including membrane filtration, granular activated carbon, and advanced oxidation processes, have been used for the effective removal of individual PPCPs. This review covers the occurrence patterns of PPCPs in water environments and the techniques adopted for their treatment in STP/WTP unit processes operating in various countries. The aim of this review is to provide a comprehensive summary of the removal and fate of PPCPs in different treatment facilities as well as the optimum methods for their elimination in STP and WTP systems. Copyright © 2017 Elsevier B.V. All rights reserved.

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

Deng, Yueying; Kruger, Albert A.

The Hanford Tank Waste Treatment and Immobilization Plant (WTP) Statement of Work (Department of Energy Contract DE-AC27-01RV14136, Section C) requires the contractor to develop and use process models for flowsheet analyses and pre-operational planning assessments. The Dynamic (G2) Flowsheet is a discrete-time process model that enables the project to evaluate impacts to throughput from eventdriven activities such as pumping, sampling, storage, recycle, separation, and chemical reactions. The model is developed by the Process Engineering (PE) department, and is based on the Flowsheet Bases, Assumptions, and Requirements Document (24590-WTP-RPT-PT-02-005), commonly called the BARD. The terminologies of Dynamic (G2) Flowsheet and Dynamicmore » (G2) Model are interchangeable in this document. The foundation of this model is a dynamic material balance governed by prescribed initial conditions, boundary conditions, and operating logic. The dynamic material balance is achieved by tracking the storage and material flows within the plant as time increments. The initial conditions include a feed vector that represents the waste compositions and delivery sequence of the Tank Farm batches, and volumes and concentrations of solutions in process equipment before startup. The boundary conditions are the physical limits of the flowsheet design, such as piping, volumes, flowrates, operation efficiencies, and physical and chemical environments that impact separations, phase equilibriums, and reaction extents. The operating logic represents the rules and strategies of running the plant.« less

Double shell tanks (DST) chemistry control data quality objectives

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

BANNING, D.L.

2001-10-09

One of the main functions of the River Protection Project is to store the Hanford Site tank waste until the Waste Treatment Plant (WTP) is ready to receive and process the waste. Waste from the older single-shell tanks is being transferred to the newer double-shell tanks (DSTs). Therefore, the integrity of the DSTs must be maintained until the waste from all tanks has been retrieved and transferred to the WTP. To help maintain the integrity of the DSTs over the life of the project, specific chemistry limits have been established to control corrosion of the DSTs. These waste chemistry limitsmore » are presented in the Technical Safety Requirements (TSR) document HNF-SD-WM-TSR-006, Sec. 5 . IS, Rev 2B (CHG 200 I). In order to control the chemistry in the DSTs, the Chemistry Control Program will require analyses of the tank waste. This document describes the Data Quality Objective (DUO) process undertaken to ensure appropriate data will be collected to control the waste chemistry in the DSTs. The DQO process was implemented in accordance with Data Quality Objectives for Sampling and Analyses, HNF-IP-0842, Rev. Ib, Vol. IV, Section 4.16, (Banning 2001) and the U.S. Environmental Protection Agency EPA QA/G4, Guidance for the Data Quality Objectives Process (EPA 1994), with some modifications to accommodate project or tank specific requirements and constraints.« less

Consumer reactions to risk information on bovine spongiform encephalopathy in Japan

PubMed Central

Yasunaga, Hideo; Obana, Naoya; Ogawa, Toshio; Imamura, Tomoaki

2010-01-01

Objectives To investigate the impact of information on foodborne disease on consumers, we quantified consumers’ anxiety, purchasing behaviors, and willingness-to-pay (WTP) in response to the reading of newspaper articles published in 2001 that documented the first cow in Japan to be infected with bovine spongiform encephalopathy (BSE). Methods An online questionnaire survey of 993 females aged 20–59 years was conducted in 2007. The participants were randomly selected from the general population via the Internet and were divided into three groups. Each group was assigned a different number of BSE-related articles to read, namely, two, four, and six articles, respectively. Each participant described her personal level of anxiety, underlying reasons for her anxiety, and changes in purchasing behavior after reading the articles. The respondents who wanted to buy guaranteed-safe beef were asked to state their maximal WTP. Results The level of anxiety was significantly lower and distrust of the relevant administration significantly greater in the group asked to read six articles than in the other groups. The WTP value for guaranteed beef was approximately 1.3-fold higher than the regular purchase price, with significant differences between groups. In the ‘six-article’ group, the ratio between WTP and the regular purchase price was significantly less than that in the ‘four-article’ group. Conclusions These findings suggest that the anxiety of consumers can be reduced if they receive an appropriate amount of published information. WTP may be linked to the contents of the articles. PMID:21432560

Exploring residents' attitudes and willingness to pay for solid waste management in Macau.

PubMed

Song, Qingbin; Wang, Zhishi; Li, Jinhui

2016-08-01

Increasing public attention has been brought to bear on the solid waste management in Macau, due to the continually increasing generation of amount and the limited space. In this study, we discussed residents' attitudes and willingness to pay (WTP) for solid waste management through a questionnaire survey. The results showed that Macau residents owned a relatively high environmental awareness. In regard to Macau environmental quality, most respondents (92.4 %) expressed their satisfactions on the current situation. About 50.2 % respondents thought that the solid waste pollution in Macau should be paid more attention than the other three environmental pollution ways (air pollution, water pollution, and soil pollution). The survey data revealed the positive attitudes toward source separation in Macau. About 95.7 % respondents were willing to sort the solid waste at home, if the government required them to do it. In addition, for the question on how to improve the solid waste issues in Macau, "Enhancing residents' environmental awareness" was considered as the most effective method, accounting for about 38.5 % respondents. In our study, most respondents (85.4 %) also provided positive answers to the questions about WTP. Using the logistic regression method, these survey results support the hypothesis that the probability of the respondents' saying "yes" to the WTP question increases with education level. The monthly mean WTP was 38.5 MOP per household, and the annual WTP was approximately 79.7 million MOP for all of Macau. The results of our study can help managers develop more effective environmental management policies for solid waste disposal.

WILLINGNESS TO PARTICIPATE IN HIV/STD PREVENTION ACTIVITIES AMONG CHINESE RURAL–TO–URBAN MIGRANTS

PubMed Central

Yang, Hongmei; Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi; Lin, Danhua; Mao, Rong; Chen, Xinguang; Liu, Hongjie

2007-01-01

Data from 4,208 migrants aged 18–30 years old in Beijing and Nanjing, China, were analyzed to examine the correlates of willingness to participate (WTP) in HIV/STD prevention intervention activities among Chinese rural–to–urban migrants. Overall, 83.3% of the respondents would be willing to participate. Increased WTP was associated with employment in the industrial sector (OR = 1.59, 95% CI: 1.11–2.29), migrating to cities to learn more about the outside world (OR = 1.31, 95% CI: 1.08–1.59), prior experience with health maintenance (OR = 1.36, 95% CI: 1.11–1.66), higher level of HIV/AIDS awareness (OR = 1.16, 95% CI: 1.02–1.31), and perceived severity of risk behaviors (OR = 1.32, 95% CI: 1.04–1.68). Decreased WTP was associated with increased involvement in health risk behaviors (OR = 0.50, 95% CI: 0.35–0.73), increased perceptions of peer risk involvement (OR = 0.81, 95% CI: 0.68–0.98), perceived intrinsic rewards for risk behaviors (OR = 0.81, 95% CI: 0.68–0.96) and perceptions of HIV–related stigma (OR = 0.68, 95% CI: 0.53–0.89). The high level of WTP suggests that HIV/STD prevention activities are acceptable among rural–to–urban migrants. Their awareness of HIV/AIDS should be increased and HIV–related stigma should be reduced to increase the level of WTP. Recruitment and retention of individuals with high-risk behavior in prevention activities will be critical and challenging. PMID:15585431

Surgical treatment of GERD. Comperative study of WTP vs. Toupet fundoplication – results of 151 consecutive cases

PubMed Central

Wróblewski, Tadeusz; Nowosad, Małgorzata; Krawczyk, Marek

2016-01-01

Introduction Gastroesophageal reflux disease (GERD) is recognized as one of the most common disorders of the upper gastrointestinal tract (GIT). The best choice of management for advanced GERD is laparoscopic surgery. Aim To compare and evaluate the results of surgical treatment of GERD patients operated on using two different techniques. Material and methods Between 2001 and 2012, 353 patients (211 female and 142 male), aged 17–76 years (mean 44), underwent laparoscopic antireflux surgery. The study included patients who underwent a Toupet fundoplication or Wroblewski Tadeusz procedure (WTP). Results The mean age of the group was 47.77 years (17–80 years). Forty-nine (32.45%) patients had severe symptoms, 93 (61.58%) had mild symptoms and 9 (5.96%) had a single mild but intolerable sign of GERD. Eighty-six (56.95%) patients had a Toupet fundoplication and 65 (43.04%) had a WTP. The follow-up period was 18–144 months. The average operating time for Toupet fundoplication and the WTP procedure was 164 min (90–300 min) and 147 min (90–210 min), respectively. The perioperative mortality rate was 0.66%. The average post-operative hospitalization period was 5.4 days (2–16 post-operative days (POD) = Toupet) vs. 4.7 days (2–9 POD = WTP). No reoperations were performed. No major surgical complications were identified. Conclusions Wroblewski Tadeusz procedure due to a low percentage of post-operative complications, good quality of life of patients and a zero recurrence rate of hiatal hernia should be a method of choice. PMID:27458484

Psychometric and demographic predictors of the perceived risk of terrorist threats and the willingness to pay for terrorism risk management programs.

PubMed

Mumpower, Jeryl L; Shi, Liu; Stoutenborough, James W; Vedlitz, Arnold

2013-10-01

A 2009 national telephone survey of 924 U.S. adults assessed perceptions of terrorism and homeland security issues. Respondents rated severity of effects, level of understanding, number affected, and likelihood of four terrorist threats: poisoned water supply; explosion of a small nuclear device in a major U.S. city; an airplane attack similar to 9/11; and explosion of a bomb in a building, train, subway, or highway. Respondents rated perceived risk and willingness to pay (WTP) for dealing with each threat. Demographic, attitudinal, and party affiliation data were collected. Respondents rated bomb as highest in perceived risk but gave the highest WTP ratings to nuclear device. For both perceived risk and WTP, psychometric variables were far stronger predictors than were demographic ones. OLS regression analyses using both types of variables to predict perceived risk found only two significant demographic predictors for any threat--Democrat (a negative predictor for bomb) and white male (a significant positive predictor for airline attack). In contrast, among psychometric variables, severity, number affected, and likelihood were predictors of all four threats and level of understanding was a predictor for one. For WTP, education was a negative predictor for three threats; no other demographic variables were significant predictors for any threat. Among psychometric variables, perceived risk and number affected were positive predictors of WTP for all four threats; severity and likelihood were predictors for three; level of understanding was a significant predictor for two. © 2013 Society for Risk Analysis.

How much does heat content of the western tropical Pacific Ocean modulate the South China Sea summer monsoon onset in the last four decades?

NASA Astrophysics Data System (ADS)

Feng, Junqiao; Hu, Dunxin

2014-07-01

The role of the western tropical Pacific Ocean heat content in the South China Sea summer monsoon (SCSSM) onset is investigated in the present paper, by using atmospheric data from NCEP and ocean subsurface temperature data from Japan Meteorology Agency. It is showed from the result that the heat content (HC) of the upper 400 m layer in the western tropical Pacific (WTP), especially in the region of (130°E-150°E, 0°N-14°N) in the last four decades, is a good predictive indicator for the SCSSM onset. Positive (negative) HC anomalies can induce a strong (weak) convection over the WTP, leading to stronger (weaker) Walker circulation and weaker (stronger) western North Pacific subtropical high (WNPSH) in the boreal spring. Consequently, the anomalous westerly (easterly) in the tropical Indian Ocean is favorable (unfavorable) for the airflow into the SCS and for an early (late) WNPSH retreat from the SCS and hence for an early (late) SCSSM onset. It is elucidated that the long-term trend of SCSSM onset changes its sign around 1993/94 from decline to rise, which is responding and attributed to the WTP HC trend. During the period of 1971-1993, the WTP HC shows a significant decrease trend. In particular, a significant decline trend is observed in the HC difference between the WTP and western tropical Indian Ocean, which causes an easterly trend in the SCS and strengthened WNPSH trend, leading to a late onset trend of SCSSM. The situation is reverse after 1993/94.

How Much Are Floridians Willing to Pay for Protecting Sea Turtles from Sea Level Rise?

NASA Astrophysics Data System (ADS)

Hamed, Ahmed; Madani, Kaveh; Von Holle, Betsy; Wright, James; Milon, J. Walter; Bossick, Matthew

2016-01-01

Sea level rise (SLR) is posing a great inundation risk to coastal areas. Some coastal nesting species, including sea turtle species, have experienced diminished habitat from SLR. Contingent valuation method (CVM) was used in an effort to assess the economic loss impacts of SLR on sea turtle nesting habitats for Florida coasts; and to elicit values of willingness to pay (WTP) of Central Florida residents to implement certain mitigation strategies, which would protect Florida's east coast sea turtle nesting areas. Using the open-ended and dichotomous choice CVM, we sampled residents of two Florida communities: Cocoa Beach and Oviedo. We estimated the WTP of households from these two cities to protect sea turtle habitat to be between 42 and 57 per year for 5 years. Additionally, we attempted to assess the impact of the both the respondents' demographics and their perception toward various situations on their WTP value. Findings include a negative correlation between the age of a respondent and the probability of an individual willing to pay the hypothetical WTP amount. We found that WTP of an individual was not dependent on prior knowledge of the effects of SLR on sea turtle habitat. The greatest indicators of whether or not an individual was willing to pay to protect sea turtle habitat were the respondents' perception regarding the trustworthiness and efficiency of the party which will implement the conservation measures and their confidence in the conservation methods used. Respondents who perceive sea turtles having an effect on their life were also more likely to pay.

Largely ignored: the impact of the threshold value for a QALY on the importance of a transferability factor.

PubMed

Vemer, Pepijn; Rutten-van Mölken, Maureen P M H

2011-10-01

Recently, several checklists systematically assessed factors that affect the transferability of cost-effectiveness (CE) studies between jurisdictions. The role of the threshold value for a QALY has been given little consideration in these checklists, even though the importance of a factor as a cause of between country differences in CE depends on this threshold. In this paper, we study the impact of the willingness-to-pay (WTP) per QALY on the importance of transferability factors in the case of smoking cessation support (SCS). We investigated, for several values of the WTP, how differences between six countries affect the incremental net monetary benefit (INMB) of SCS. The investigated factors were demography, smoking prevalence, mortality, epidemiology and costs of smoking-related diseases, resource use and unit costs of SCS, utility weights and discount rates. We found that when the WTP decreased, factors that mainly affect health outcomes became less important and factors that mainly effect costs became more important. With a WTP below 1,000, the factors most responsible for between country differences in INMB were resource use and unit costs of SCS and the costs of smoking-related diseases. Utility values had little impact. At a threshold above 10,000, between country differences were primarily due to different discount rates, utility weights and epidemiology of smoking-related diseases. Costs of smoking-related diseases had little impact. At all thresholds, demography had little impact. We concluded that, when judging the transferability of a CE study, we should consider the between country differences in WTP threshold values.

Cost-Benefit Analysis of an Otolaryngology Emergency Room Using a Contingent Valuation Approach.

PubMed

Naunheim, Matthew R; Kozin, Elliot D; Sethi, Rosh K; Ota, H Gregory; Gray, Stacey T; Shrime, Mark G

2015-10-01

Dedicated otolaryngology emergency rooms (ERs) provide a unique mechanism of health care delivery. Relative costs and willingness to pay (WTP) for these services have not been studied. This study aims to provide a cost-benefit analysis of otolaryngology-specific ER care. Cost-benefit analysis based on contingent valuation surveys. An otolaryngology-specific ER in a tertiary care academic medical center. Adult English-speaking patients presenting to an otolaryngology ER were included. WTP questions were used to assess patient valuations of specialty emergency care. Sociodemographic data, income, and self-reported levels of distress were assessed. State-level and institution-specific historical cost data were merged with WTP data within a cost-benefit analysis framework. The response rate was 75.6%, and 199 patients were included in the final analysis. Average WTP for otolaryngology ER services was $319 greater than for a general ER (95% CI: $261 to $377), with a median value of $200. The historical mean cost per visit at a general ER was $575, and mean cost at the specialty ER was $551 (95% CI: $529 to $574). Subtracting incremental cost from incremental WTP yielded a net benefit of $343. Dedicated otolaryngology ER services are valued by patients for acute otolaryngologic problems and have a net benefit of $343 per patient visit. They appear to be a cost-beneficial method for addressing acute otolaryngologic conditions. This study has implications for ER-based otolaryngologic care and direct-to-specialist services. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

How Much Are Floridians Willing to Pay for Protecting Sea Turtles from Sea Level Rise?

PubMed

Hamed, Ahmed; Madani, Kaveh; Von Holle, Betsy; Wright, James; Milon, J Walter; Bossick, Matthew

2016-01-01

Sea level rise (SLR) is posing a great inundation risk to coastal areas. Some coastal nesting species, including sea turtle species, have experienced diminished habitat from SLR. Contingent valuation method (CVM) was used in an effort to assess the economic loss impacts of SLR on sea turtle nesting habitats for Florida coasts; and to elicit values of willingness to pay (WTP) of Central Florida residents to implement certain mitigation strategies, which would protect Florida's east coast sea turtle nesting areas. Using the open-ended and dichotomous choice CVM, we sampled residents of two Florida communities: Cocoa Beach and Oviedo. We estimated the WTP of households from these two cities to protect sea turtle habitat to be between $42 and $57 per year for 5 years. Additionally, we attempted to assess the impact of the both the respondents' demographics and their perception toward various situations on their WTP value. Findings include a negative correlation between the age of a respondent and the probability of an individual willing to pay the hypothetical WTP amount. We found that WTP of an individual was not dependent on prior knowledge of the effects of SLR on sea turtle habitat. The greatest indicators of whether or not an individual was willing to pay to protect sea turtle habitat were the respondents' perception regarding the trustworthiness and efficiency of the party which will implement the conservation measures and their confidence in the conservation methods used. Respondents who perceive sea turtles having an effect on their life were also more likely to pay.

Feasibility of ultra-low-volume indoor space spraying for dengue control in Southern Thailand.

PubMed

Ditsuwan, Thanittha; Liabsuetrakul, Tippawan; Ditsuwan, Vallop; Thammapalo, Suwich

2013-02-01

To assess the feasibility of conducting standard indoor space spraying using ultra-low-volume (SID-ULV) in terms of willingness to pay (WTP) and ability to pay (ATP) and ability to conduct space spraying by local administrative organisations (LAO) in lower Southern Thailand. Cross-sectional study. The executive leaders of each LAO were asked to state their WTP and ATP for SID-ULV. Willingness to pay was measured by the payment card and open-ended question methods. Ability to pay was calculated using the budget allocation for space spraying and estimated expenditure for SID-ULV. Ability to conduct the SID-ULV was assessed by interviewing the spraymen. Average WTP and ATP were calculated and uncertainties were estimated using a bootstrapping technique. Ninty-three percent of executive leaders were willing to pay for SID-ULV. The average WTP per case was USD 259 (95% confidence interval [CI] 217-303). Thirty-eight percent of all LAO had actual ATP and 60% had ideal ATP. The average annual budget allocated for space spraying was USD 2327 (95% CI: 1654-3138). The amount of money LAO were willing to pay did not vary significantly between their different types, but ATP did. Thirty-two percent of spraymen could not complete all nine procedures of SID-ULV. Although WTP for SID-ULV space spraying was high, ATP was low, which revealed the flexibility of budget allocation for SID-ULV in each LAO. The spraymen require training in SID-ULV space spraying. © 2012 Blackwell Publishing Ltd.

Change in drinking water quality from source to point-of-use and storage: a case study from Guwahati, India.

PubMed

Khadse, Gajanan Kisan; Kalita, Moromi D; Labhsetwar, Pawan K

2012-09-01

To ascertain the quality of drinking water being supplied and maintained at Guwahati, the study was conducted on the status of water supply in city through surveillance of drinking water quality for consecutive 7 days at various treatment stages, distribution network and consumer ends. The performance of five water treatment plants (WTPs), viz. Panbazar WTP, Satpukhuri WTP, Kamakhya WTP, PHED WTP and Hegrabari WTP were assessed for summer, piost-post-monsoon and winter seasons. No significant change in raw water quality was observed on day-to-day basis. Residual chlorine was found in the range of nil to 0.2 mg/L in the treated water. During post-monsoon, winter, and summer seasons the thermotolerent TC and FC counts ranged between Nil to 168 CFU/100 ml and Nil to 84 CFU/100 ml; Nil to 3356 CFU/100 ml and Nil to 152 CFU/100 ml; and Nil to 960 CFU/100 ml and Nil to 108 CFU/100 ml respectively. There was variation in bacterial counts among the different service reservoirs and consumer ends, which may be attributed to the general management practices for maintenance of service reservoirs and the possibility of enroute contamination. Evaluation of the raw water quality indicate that the water is suitable for drinking after conventional treatment followed by disinfection. The finished water quality meets the level of standards described as per Bureau of Indian Standard specifications (BIS:10500 1991) for potability in terms of its physico-chemical characteristics.

Measuring melasma patients' quality of life using willingness to pay and time trade-off methods in thai population

PubMed Central

2011-01-01

Background Melasma is a common hyperpigmentation disorder that has a significant effect on an individual's quality of life. However, there is no preference-based measurement that reflects quality of life in patients with melasma. The objective of this study was to assess the impact of melasma on quality of life by using a health status measurement - the Dermatology Life Quality Index (DLQI) - and a preference-based measurement - Willingness to Pay (WTP) and Time Trade-Off (TTO). Methods A cross-sectional descriptive study was conducted. Seventy-eight patients with melasma who attended the melasma clinic at Siriraj Hospital from February to March 2009 were recruited in this study. The Thai version of the DLQI, questionnaires about WTP, standard TTO, and daily TTO were used to assess patients' quality of life. Results Seventy-seven (98.7%) patients were female with a mean age of 47.8 ± 7.9 years. The mean health utility based on standard TTO was 0.96. The utility obtained by the daily TTO method was 0.92 and was significantly correlated with an economically inactive occupation (p < 0.05). The mean monthly WTP for the most effective treatment was 1,157 baht (7.2% of monthly income), ranging from 100 to 5,000 baht (1 USD ~ 35.1 baht). The WTP was significantly correlated with monthly personal income and the total DLQI score. Conclusion The WTP method could be a useful tool with which to measure the quality of life of patients with melasma. PMID:22182399

75 FR 44976 - Notice of Availability of the West Tavaputs Plateau Natural Gas Full Field Development Plan Final...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-30

... availability of the Record of Decision (ROD) for this project, located in Carbon, Duchesne, and Uintah Counties... . SUPPLEMENTARY INFORMATION: The West Tavaputs Plateau (WTP) Project Area is located in Carbon, Duchesne, and... the project would be located in Carbon County. The WTP Project Area is bounded on the west by Sheep...

Measuring the difference in mean willingness to pay when dichotomous choice contingent valuation responses are not independent

Treesearch

Gregory L. Poe; Michael P. Welsh; Patricia A. Champ

1997-01-01

Dichotomous choice contingent valuation surveys frequently elicit multiple values in a single questionnaire. If individual responses are correlated across scenarios, the standard approach of estimating willingness to pay (WTP) functions independently for each scenario may result in biased estimates of the significance of the difference in mean WTP values. This paper...

Which response format reveals the truth about donations to a public good?

Treesearch

Thomas C. Brown; Patricia A. Champ; Richard C. Bishop; Daniel W. McCollum

1996-01-01

Seceral contingent valuation studies hace found that the open-ended format yields lower estimates of willingness to pay (WTP) than does the closed-ended, or dichotomous choice, format. In this study, WTP for a public encironmental good was estimated under four conditions: actual payment in response to open-ended and closed-ended requests, and hypothetical payment in...

Defense Health Board Review of the U.S. Army Center for Health Promotion and Preventive Medicine Assessment of Sodium Dichromate Exposure at Qarmat Ali Water Treatment Plant

DTIC Science & Technology

2008-12-19

Medicine (USACHPPM) occupational and environmental health assessment conducted in 2003 at the Qarmat Ali Water Treatment Plant ( WTP ) in Basra, Iraq...Information Briefing Occupational and Environmental Health (OEH) Assessment: Sodium Dichromate Exposures at the Qarmat Ali Water Treatment Plant ( WTP ) in

Non-use Economic Values for Little-Known Aquatic Species at Risk: Comparing Choice Experiment Results from Surveys Focused on Species, Guilds, and Ecosystems

NASA Astrophysics Data System (ADS)

Rudd, Murray A.; Andres, Sheri; Kilfoil, Mary

2016-09-01

Accounting for non-market economic values of biological diversity is important to fully assess the benefits of environmental policies and regulations. This study used three choice experiments (species-, guild-, and ecosystem-based surveys) in parallel to quantify non-use values for little-known aquatic species at risk in southern Ontario. Mean willingness-to-pay (WTP) ranged from 9.45 to 21.41 per listing status increment under Canada's Species at Risk Act for both named and unnamed little-known species. Given the broad range of valuable ecosystem services likely to accrue to residents from substantial increases in water quality and the rehabilitation of coastal wetlands, the difference in WTP between species- and ecosystem-based surveys seemed implausibly small. It appeared that naming species—the `iconization' of species in two of the three surveys—had an important effect on WTP. The results suggest that reasonable annual household-level WTP values for little-known aquatic species may be 10 to 25 per species or 10 to 20 per listing status increment. The results highlighted the utility of using parallel surveys to triangulate on non-use economic values for little-known species at risk.

Non-use Economic Values for Little-Known Aquatic Species at Risk: Comparing Choice Experiment Results from Surveys Focused on Species, Guilds, and Ecosystems.

PubMed

Rudd, Murray A; Andres, Sheri; Kilfoil, Mary

2016-09-01

Accounting for non-market economic values of biological diversity is important to fully assess the benefits of environmental policies and regulations. This study used three choice experiments (species-, guild-, and ecosystem-based surveys) in parallel to quantify non-use values for little-known aquatic species at risk in southern Ontario. Mean willingness-to-pay (WTP) ranged from $9.45 to $21.41 per listing status increment under Canada's Species at Risk Act for both named and unnamed little-known species. Given the broad range of valuable ecosystem services likely to accrue to residents from substantial increases in water quality and the rehabilitation of coastal wetlands, the difference in WTP between species- and ecosystem-based surveys seemed implausibly small. It appeared that naming species-the 'iconization' of species in two of the three surveys-had an important effect on WTP. The results suggest that reasonable annual household-level WTP values for little-known aquatic species may be $10 to $25 per species or $10 to $20 per listing status increment. The results highlighted the utility of using parallel surveys to triangulate on non-use economic values for little-known species at risk.

Identification of Trihalomethanes (THMs) Levels in Water Supply: A Case Study in Perlis, Malaysia

NASA Astrophysics Data System (ADS)

Jalil, Mohd Faizal Ab; Hamidin, Nasrul; Anas Nagoor Gunny, Ahmad; Nihla Kamarudzaman, Ain

2018-03-01

In Malaysia, chlorination is used for drinking water disinfection at water treatment plants due to its cost-effectiveness and efficiency. However, the use of chlorine poses potential health risks due to the formation of disinfection by-products such as trihalomethanes (THMs). THMs are formed due to the reaction between chlorine and some natural organic matter. The objective of the study is to analyze the level of THMs in the water supply in Perlis, Malaysia. The water samples were collected from end-user tap water near the water treatment plant (WTP) located in Perlis, including Timah Tasoh WTP, Kampung Sungai Baru WTP, Arau Phase I, II, III, and IV WTPs. The THMs were analyzed using a Gas Chromatography-Mass Spectrometry (GC/MS). The results showed that the water supply from Timah Tasoh WTP generates the most THMs, whereas Kuala Sungai Baru shows the fewest amounts of total THMs. In conclusion, the presence of THMs in tap water has caused great concern since these components can cause cancer in humans. Therefore, the identification of THM formation is crucial in order to make sure that the tap water quality remains at acceptable safety levels.

The willingness to pay of parties to traffic accidents for loss of productivity and consolation compensation.

PubMed

Jou, Rong-Chang; Chen, Tzu-Ying

2015-12-01

In this study, willingness to pay (WTP) for loss of productivity and consolation compensation by parties to traffic accidents is investigated using the Tobit model. In addition, WTP is compared to compensation determined by Taiwanese courts. The modelling results showed that variables such as education, average individual monthly income, traffic accident history, past experience of severe traffic accident injuries, the number of working days lost due to a traffic accident, past experience of accepting compensation for traffic accident-caused productivity loss and past experience of accepting consolation compensation caused by traffic accidents have a positive impact on WTP. In addition, average WTP for these two accident costs were obtained. We found that parties to traffic accidents were willing to pay more than 90% of the compensation determined by the court in the scenario of minor and moderate injuries. Parties were willing to pay approximately 80% of the compensation determined by the court for severe injuries, disability and fatality. Therefore, related agencies can use our study findings as the basis for determining the compensation that parties should pay for productivity losses caused by traffic accidents of different types. Copyright © 2015 Elsevier Ltd. All rights reserved.

The demand for health with uncertainty and insurance.

PubMed

Liljas, B

1998-04-01

This paper develops Michael Grossman's demand-for-health model by letting the depreciation rate depend upon the level of health, by letting the incidence and size of illness be uncertain and by investigating how the individual's demand for health would be affected by the introduction of insurance. Beside the more theoretical results, there are also some results with important policy implications. When formulating the hypothetical scenario in willingness to pay (WTP) studies it is important whether the individual believes that the level of health is uncertain or not. The existence of insurance could also affect the stated WTP amount. Taking this into account could therefore explain some of the differences in the WTP for seemingly identical health care programs in different countries or different areas in the same country.

Goethite Bench-scale and Large-scale Preparation Tests

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

Josephson, Gary B.; Westsik, Joseph H.

2011-10-23

The Hanford Waste Treatment and Immobilization Plant (WTP) is the keystone for cleanup of high-level radioactive waste from our nation's nuclear defense program. The WTP will process high-level waste from the Hanford tanks and produce immobilized high-level waste glass for disposal at a national repository, low activity waste (LAW) glass, and liquid effluent from the vitrification off-gas scrubbers. The liquid effluent will be stabilized into a secondary waste form (e.g. grout-like material) and disposed on the Hanford site in the Integrated Disposal Facility (IDF) along with the low-activity waste glass. The major long-term environmental impact at Hanford results from technetiummore » that volatilizes from the WTP melters and finally resides in the secondary waste. Laboratory studies have indicated that pertechnetate ({sup 99}TcO{sub 4}{sup -}) can be reduced and captured into a solid solution of {alpha}-FeOOH, goethite (Um 2010). Goethite is a stable mineral and can significantly retard the release of technetium to the environment from the IDF. The laboratory studies were conducted using reaction times of many days, which is typical of environmental subsurface reactions that were the genesis of this new process. This study was the first step in considering adaptation of the slow laboratory steps to a larger-scale and faster process that could be conducted either within the WTP or within the effluent treatment facility (ETF). Two levels of scale-up tests were conducted (25x and 400x). The largest scale-up produced slurries of Fe-rich precipitates that contained rhenium as a nonradioactive surrogate for {sup 99}Tc. The slurries were used in melter tests at Vitreous State Laboratory (VSL) to determine whether captured rhenium was less volatile in the vitrification process than rhenium in an unmodified feed. A critical step in the technetium immobilization process is to chemically reduce Tc(VII) in the pertechnetate (TcO{sub 4}{sup -}) to Tc(Iv)by reaction with the ferrous ion, Fe{sup 2+}-Fe{sup 2+} is oxidized to Fe{sup 3+} - in the presence of goethite seed particles. Rhenium does not mimic that process; it is not a strong enough reducing agent to duplicate the TcO{sub 4}{sup -}/Fe{sup 2+} redox reactions. Laboratory tests conducted in parallel with these scaled tests identified modifications to the liquid chemistry necessary to reduce ReO{sub 4}{sup -} and capture rhenium in the solids at levels similar to those achieved by Um (2010) for inclusion of Tc into goethite. By implementing these changes, Re was incorporated into Fe-rich solids for testing at VSL. The changes also changed the phase of iron that was in the slurry product: rather than forming goethite ({alpha}-FeOOH), the process produced magnetite (Fe{sub 3}O{sub 4}). Magnetite was considered by Pacific Northwest National Laboratory (PNNL) and VSL to probably be a better product to improve Re retention in the melter because it decomposes at a higher temperature than goethite (1538 C vs. 136 C). The feasibility tests at VSL were conducted using Re-rich magnetite. The tests did not indicate an improved retention of Re in the glass during vitrification, but they did indicate an improved melting rate (+60%), which could have significant impact on HLW processing. It is still to be shown whether the Re is a solid solution in the magnetite as {sup 99}Tc was determined to be in goethite.« less

Tests of a High Temperature Sample Conditioner for the Waste Treatment Plant LV-S2, LV-S3, HV-S3A and HV-S3B Exhaust Systems

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

Flaherty, Julia E.; Glissmeyer, John A.

2015-03-18

Tests were performed to evaluate a sample conditioning unit for stack monitoring at Hanford Tank Waste Treatment and Immobilization Plant (WTP) exhaust stacks with elevated air temperatures. The LV-S2, LV-S3, HV-S3A and HV-S3B exhaust stacks are expected to have elevated air temperature and dew point. At these emission points, exhaust temperatures are too high to deliver the air sample directly to the required stack monitoring equipment. As a result, a sample conditioning system is considered to cool and dry the air prior to its delivery to the stack monitoring system. The method proposed for the sample conditioning is a dilutionmore » system that will introduce cooler, dry air to the air sample stream. This method of sample conditioning is meant to reduce the sample temperature while avoiding condensation of moisture in the sample stream. An additional constraint is that the ANSI/HPS N13.1-1999 standard states that at least 50% of the 10 μm aerodynamic diameter (AD) particles present in the stack free stream must be delivered to the sample collector. In other words, depositional loss of particles should be limited to 50% in the sampling, transport, and conditioning systems. Based on estimates of particle penetration through the LV-S3 sampling system, the diluter should perform with about 80% penetration or better to ensure that the total sampling system passes the 50% or greater penetration criterion.« less

Decadal trends of the upper ocean salinity in the tropical Indo-Pacific since mid-1990s

NASA Astrophysics Data System (ADS)

DU, Y.; Zhang, Y.

2016-02-01

A contrasting trend pattern of sea surface salinity (SSS) between the western tropical Pacific (WTP) and the southeastern tropical Indian Ocean (SETIO) is observed during 2004-2013, with significant salinity increase in the WTP and freshening in the SETIO. In this study, we show that increased precipitation around the Maritime Continent (MC), decreased precipitation in the western-central tropical Pacific, and ocean advection processes contribute to the salinity trends in the region. From a longer historical record, these salinity trends started in the mid-1990s, a few years before the Global Warming Hiatus from 1998 to present. The salinity trends are associated a strengthening trend of the Walker Circulation over the tropical Indo-Pacific, which have reversed the long-term salinity changes in the tropical Indo-Pacific as a consequence of global warming. Understanding decadal variations of SSS in the tropical Indo-Pacific will better inform on how the tropical hydrological cycle will be affected by the natural variability and a warming climate.

Decadal trends of the upper ocean salinity in the tropical Indo-Pacific since mid-1990s

NASA Astrophysics Data System (ADS)

Du, Yan; Zhang, Yuhong; Feng, Ming; Wang, Tianyu; Zhang, Ningning; Wijffels, Susan

2015-11-01

A contrasting trend pattern of sea surface salinity (SSS) between the western tropical Pacific (WTP) and the southeastern tropical Indian Ocean (SETIO) is observed during 2004-2013, with significant salinity increase in the WTP and freshening in the SETIO. In this study, we show that increased precipitation around the Maritime Continent (MC), decreased precipitation in the western-central tropical Pacific, and ocean advection processes contribute to the salinity trends in the region. From a longer historical record, these salinity trends started in the mid-1990s, a few years before the Global Warming Hiatus from 1998 to present. The salinity trends are associated a strengthening trend of the Walker Circulation over the tropical Indo-Pacific, which have reversed the long-term salinity changes in the tropical Indo-Pacific as a consequence of global warming. Understanding decadal variations of SSS in the tropical Indo-Pacific will better inform on how the tropical hydrological cycle will be affected by the natural variability and a warming climate.

Decadal trends of the upper ocean salinity in the tropical Indo-Pacific since mid-1990s

PubMed Central

Du, Yan; Zhang, Yuhong; Feng, Ming; Wang, Tianyu; Zhang, Ningning; Wijffels, Susan

2015-01-01

A contrasting trend pattern of sea surface salinity (SSS) between the western tropical Pacific (WTP) and the southeastern tropical Indian Ocean (SETIO) is observed during 2004–2013, with significant salinity increase in the WTP and freshening in the SETIO. In this study, we show that increased precipitation around the Maritime Continent (MC), decreased precipitation in the western-central tropical Pacific, and ocean advection processes contribute to the salinity trends in the region. From a longer historical record, these salinity trends started in the mid-1990s, a few years before the Global Warming Hiatus from 1998 to present. The salinity trends are associated a strengthening trend of the Walker Circulation over the tropical Indo-Pacific, which have reversed the long-term salinity changes in the tropical Indo-Pacific as a consequence of global warming. Understanding decadal variations of SSS in the tropical Indo-Pacific will better inform on how the tropical hydrological cycle will be affected by the natural variability and a warming climate. PMID:26522168

Decadal trends of the upper ocean salinity in the tropical Indo-Pacific since mid-1990s.

PubMed

Du, Yan; Zhang, Yuhong; Feng, Ming; Wang, Tianyu; Zhang, Ningning; Wijffels, Susan

2015-11-02

A contrasting trend pattern of sea surface salinity (SSS) between the western tropical Pacific (WTP) and the southeastern tropical Indian Ocean (SETIO) is observed during 2004-2013, with significant salinity increase in the WTP and freshening in the SETIO. In this study, we show that increased precipitation around the Maritime Continent (MC), decreased precipitation in the western-central tropical Pacific, and ocean advection processes contribute to the salinity trends in the region. From a longer historical record, these salinity trends started in the mid-1990s, a few years before the Global Warming Hiatus from 1998 to present. The salinity trends are associated a strengthening trend of the Walker Circulation over the tropical Indo-Pacific, which have reversed the long-term salinity changes in the tropical Indo-Pacific as a consequence of global warming. Understanding decadal variations of SSS in the tropical Indo-Pacific will better inform on how the tropical hydrological cycle will be affected by the natural variability and a warming climate.

Air Sample Conditioner Helps the Waste Treatment Plant Meet Emissions Standards

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

Glissmeyer, John A.; Flaherty, Julia E.; Pekour, Mikhail S.

2014-12-02

The air in three of the Hanford Site Waste Treatment and Immobilization Plant (WTP) melter off-gas discharge stacks will be hot and humid after passing through the train of emission abatement equipment. The off-gas temperature and humidity levels will be incompatible with the airborne emissions monitoring equipment required for this type of stack. To facilitate sampling from these facilities, an air sample conditioner system will be installed to introduce cool, dry air into the sample stream to reduce the temperature and dew point. This will avoid thermal damage to the instrumentation and problematic condensation. The complete sample transport system mustmore » also deliver at least 50% of the particles in the sample airstream to the sample collection and on-line analysis equipment. The primary components of the sample conditioning system were tested in a laboratory setting. The sample conditioner itself is based on a commercially-available porous tube filter design. It consists of a porous sintered metal tube inside a coaxial metal jacket. The hot gas sample stream passes axially through the porous tube, and the dry, cool air is injected into the jacket and through the porous wall of the inner tube, creating an effective sample diluter. The dilution and sample air mix along the entire length of the porous tube, thereby simultaneously reducing the dew point and temperature of the mixed sample stream. Furthermore, because the dilution air enters through the porous tube wall, the sample stream does not come in contact with the porous wall and particle deposition is reduced in this part of the sampling system. Tests were performed with an environmental chamber to supply air with the temperature and humidity needed to simulate the off-gas conditions. Air from the chamber was passed through the conditioning system to test its ability to reduce the temperature and dew point of the sample stream. To measure particle deposition, oil droplets in the range of 9 to 11 micrometer aerodynamic diameter were injected into the environmental chamber and drawn through the conditioning system, which included a filter to capture droplets that passed through the conditioner. The droplets were tagged with a fluorescent dye which allowed quantification of droplet deposition on each component of the system. The tests demonstrated the required reductions in temperature and moisture, with no condensation forming when heat tracing was added on the upstream end of the sample conditioner. Additionally, tests indicated that the system, operating at several flow rates and in both vertical and horizontal orientations, delivers nearly all of the sampled particles for analysis. Typical aerosol penetration values were between 98 and 99%. PNNL, Bechtel National Inc., and the instrument vendor are working to implement the sample conditioner into the air monitoring systems used for the melter off-gas exhaust streams. Similar technology may be useful for processes in other facilities with air exhaust streams with elevated temperature and/or humidity.« less

Inputs and Fluvial Transport of Pharmaceutical Chemicals in An Urban Watershed

NASA Astrophysics Data System (ADS)

Foster, G. D.; Shala, L.

2006-05-01

Pharmaceuticals and personal care products (PPCPs) are classes of emerging chemical contaminants thought to enter the aquatic environment primarily through wastewater treatment plant (WTP) discharges. As the use of drugs is expected to rise with the aging demographics of the human population and with more river water being diverted to meet potable water demands, the presence of PPCPs in surface water is becoming an issue of public concern. The intent of our study was to quantify potential WTP inputs of PPCPs to rivers in the Wasington, DC (USA) region, and to investigate the fluvial transport of PPCPs in the Anacostia River (AR), the mainstem of a highly contaminated urban watershed in Washington, DC. The approach was to sample WTP water at various stages of treatment, and to measure seasonal concentrations of PPCPs in fluvial transport in the AR. Surface water from the AR was collected through the use of automated samplers during normal flow and storm flow regimes near the head of tide of the AR, just upstream from the confluence of the Northeast (NE) and Northwest (NW) Branches, the two prominent drainages in the watershed. The water samples were filtered to separate river particles from water, and the filtered water was extracted using solid phase extraction (SPE) cartridges. The filters were extracted by sonication in methanol. The SPE and filter extracts were analyzed for a group of widely distributed PPCPs as trimethylsilyl derivatives by using gas chromatography/mass spectrometry. The most frequently detected PPCPs at WTPs included ibuprofen, caffeine, naproxen and triclosan, which ranged from 45 μg/L (caffeine) to 5 μg/L (triclosan) in WTP influent and from 0.08 μg/L (triclosan) to 0.02 μg/L (ibuprofen) in effluent water. Similar PPCPs were detected in both the NE and NW Branches of the AR, but higher concentrations on average were observed in the NE Branch, which receives WTP effluent upstream from the sampling point. The incidence of PPCPs correlated with WTP discharge, but other sources appear to exist based on the occurrence of PPCPs in the NW Branch, which does not receive WTP discharge. Surface water concentrations of the PPCPs were only weakly dependent on the flow regime of the Anacosita River, ranging from 10 to 250 ng/L in AR water. PPCPs are transported in surface waters at parts per trillion concentrations throughout the year, but sources to the AR are not confined to WTPs.

Willingness to pay for opioid agonist treatment among opioid dependent people who inject drugs in Ukraine.

PubMed

Makarenko, Iuliia; Mazhnaya, Alyona; Marcus, Ruthanne; Bojko, Martha J; Madden, Lynn; Filippovich, Sergii; Dvoriak, Sergii; Altice, Frederick L

2017-07-01

In the context of decreasing external and limited Ukrainian governmental funding for opioid agonist treatments (OAT) for opioid dependent people who inject drugs in Ukraine, information on sustainable financial models is needed. Data on 855 opioid dependent people who inject drugs (PWID) were drawn from a cross-sectional nationwide survey of 1613 PWID. They comprised 434 participants who were receiving OAT and 421 who were on OAT in the past or have never been on OAT and were interested in receiving the treatment. Multivariate logistic regression was used to examine factors associated with willingness-to-pay (WTP) for OAT, stratified by OAT experience. Variation in the price which respondents were willing to pay for OAT and its effect on their monthly income among PWID with different OAT experience were assessed as a continuous variable using one-way ANOVA and Kruskal-Wallis test. Overall, 378 (44%) expressed WTP for OAT. Factors independently associated with WTP differed by OAT experience. Among those using OAT, independent predictors of WTP included: city (Dnipro - aOR=1.9; 95%CI=1.1-4.8 and Lviv - (aOR=2.2; 95%CI=1.1-4.8) compared to those elsewhere in Ukraine), higher income (aOR=1.8; 95%CI=1.2-2.7) and receiving psychosocial counseling (aOR=1.8; 95%CI=1.2-2.7). Among those who had previously been on OAT, positive attitude towards OAT (aOR=1.3; 95%CI=1.1-1.6) and family support of OAT (aOR=2.5; 95%CI=1.1-5.7) were independently associated with WTP. Among PWID who had never been on OAT, being male (aOR=2.2; 95%CI=1.1-4.2), younger age (aOR=1.9; 95%CI=1.2-3.2), higher income (aOR=2.0; 95%CI=1.2-3.4) and previous unsuccessful attempts to enter OAT (aOR=2.3; 95%CI=1.1-4.7) were independently associated with WTP. PWID were willing to commit a large percentage of their monthly income for OAT, which, however, varied significantly based on OAT experience: current OAT: 37% of monthly income, previous OAT: 53%, and never OAT: 60% (p-value=0.0009). WTP for OAT was substantial among PWID in Ukraine, supporting the implementation of self-pay or co-payment programs. Such strategies, however, must remain affordable, provide better access to OAT, and consider specific needs of PWID. Copyright © 2017 Elsevier B.V. All rights reserved.

FY2016 Update on ILAW Glass Testing for Disposal at IDF

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

Brown, E. E.; Swanberg, D. J.; Muller, Isabelle S.

2017-04-12

This status report provides a FY2016 update on work performed to collect information on the corrosion behavior of LAW glasses to support the IDF PA. In addition to the development of the baseline operating envelope for the WTP, since 2003, VSL has developed a wide range of LAW formulations that achieve considerably higher waste loadings than the WTP baseline formulations.

Estimating the robustness of contingenet valuation estimates of WTP to survey mode and treatment of protest responses.

Treesearch

John Loomis; Armando Gonzalez-Caban; Joseph Champ

2011-01-01

Over the past four decades teh contingent valuation method (CVM) has become a technique frequently used by economists to estimate willingness-to-pay (WTP) for improvements in environmental quality and prot3tion of natural resources. The CVM was originall applied to estmate recreation use values (Davis, 1963; Hammack and Brown, 1974)and air quality (Brookshire et al....

Willingness to pay and conjoint analysis to determine women's preferences for ovarian stimulating hormones in the treatment of infertility in Spain.

PubMed

Palumbo, A; De La Fuente, P; Rodríguez, M; Sánchez, F; Martínez-Salazar, J; Muñoz, M; Marqueta, J; Hernández, J; Espallardo, O; Polanco, C; Paz, S; Lizán, L

2011-07-01

Despite many advances in assisted reproductive techniques (ART), little is known about preferences for technological developments of women undergoing fertility treatments. The aims of this study were to investigate the preferences of infertile women undergoing ART for controlled ovarian stimulation (COS) treatments; to determine the utility values ascribed to different attributes of COS treatments; and to estimate women's willingness to pay (WTP) for COS. A representative sample of ambulatory patients ready to receive, or receiving, COS therapies for infertility were recruited from seven specialized private centres in six autonomous communities in Spain. Descriptive, inferential and conjoint analyses (CA) were used to elicit preferences and WTP. Attributes and levels of COS treatments were identified by literature review and two focus groups with experts and patients. WTP valuations were derived by a combination of double-bounded (closed-ended) and open questions and contingent ranking methods. In total, 160 patients [mean (standard deviation; SD) age: 35.8 (4.2) years] were interviewed. Over half of the participants (55.0%) had a high level of education (university degree), most (78.8%) were married and half (50.0%) had an estimated net income of >€1502 per month and had paid a mean (SD) €1194.17 (€778.29) for their most recent hormonal treatment. The most frequent causes of infertility were related to sperm abnormalities (50.3%). In 30.6% of cases, there were two causes of infertility. The maximum WTP for COS treatment was €800 (median) per cycle; 35.5% were willing to pay an additional €101-€300 for a 1-2% effectiveness gain in the treatment. Utility values (CA) showed that effectiveness was the most valued attribute (39.82), followed by costs (18.74), safety (17.75) and information sharing with physicians (14.93). WTP for COS therapies exceeds current cost. Additional WTP exists for 1-2% effectiveness improvement. Effectiveness and costs were the most important determinants of preferences, followed by safety and information sharing with physicians.

Willingness to pay for a reduction in mortality risk after a myocardial infarction: an application of the contingent valuation method to the case of eplerenone.

PubMed

Pinto-Prades, Jose-Luis; Farreras, Veronica; de Bobadilla, Jaime Fernandez

2008-02-01

In order to allocate health care resources more efficiently, it is necessary to relate health improvements provided by new medicines to their cost. It is necessary to ascertain when the additional cost of introducing a new health technology is justified by the additional health gain produced. Eplerenone is a new medicine that reduces the risk of death after myocardial infarction (MI) but produces additional cost to the health system. The contingent valuation approach can be used to measure the monetary value of this risk reduction and to estimate society's willingness to pay (WTP) for a new medicine that reduces the risk of death after MI by 2% points. We used a contingent valuation approach to evaluate WTP amongst members of the general population. We used the ex-ante and the ex-post approach. In the ex-ante approach, subjects are asked if they would accept an increase in their taxes in order to have access to eplerenone should they need it in the future. In the ex-post approach, subjects are asked if they would pay a certain amount of money as co-payment per month during 5 years if they suffered an MI. We used the dichotomous choice method, using five bids in each approach. The WTP was estimated using both single-bound and double-bound dichotomous choice (SBDC, DBDC). Extensive piloting (n = 187) preceded the final survey (n = 350). The WTP in the ex-ante case was euro 58 per year under both SBDC and DBDC. In the ex-post case, monthly WTP was euro 141 for the SBDC and euro 85 for the DBDC. Subjects with higher income and subjects with a higher perception of risk showed a higher WTP (P 0.05). Society is willing to pay an additional amount of money in order to give eplerenone to present and future patients. We estimate that euro 85 per month is a conservative estimate of the monetary value of a 2% risk reduction in mortality after MI and to spend this additional amount of money in Eplerenone can be considered an efficient policy.

Long-Term Bacterial Dynamics in a Full-Scale Drinking Water Distribution System

PubMed Central

Prest, E. I.; Weissbrodt, D. G.; Hammes, F.; van Loosdrecht, M. C. M.; Vrouwenvelder, J. S.

2016-01-01

Large seasonal variations in microbial drinking water quality can occur in distribution networks, but are often not taken into account when evaluating results from short-term water sampling campaigns. Temporal dynamics in bacterial community characteristics were investigated during a two-year drinking water monitoring campaign in a full-scale distribution system operating without detectable disinfectant residual. A total of 368 water samples were collected on a biweekly basis at the water treatment plant (WTP) effluent and at one fixed location in the drinking water distribution network (NET). The samples were analysed for heterotrophic plate counts (HPC), Aeromonas plate counts, adenosine-tri-phosphate (ATP) concentrations, and flow cytometric (FCM) total and intact cell counts (TCC, ICC), water temperature, pH, conductivity, total organic carbon (TOC) and assimilable organic carbon (AOC). Multivariate analysis of the large dataset was performed to explore correlative trends between microbial and environmental parameters. The WTP effluent displayed considerable seasonal variations in TCC (from 90 × 103 cells mL-1 in winter time up to 455 × 103 cells mL-1 in summer time) and in bacterial ATP concentrations (<1–3.6 ng L-1), which were congruent with water temperature variations. These fluctuations were not detected with HPC and Aeromonas counts. The water in the network was predominantly influenced by the characteristics of the WTP effluent. The increase in ICC between the WTP effluent and the network sampling location was small (34 × 103 cells mL-1 on average) compared to seasonal fluctuations in ICC in the WTP effluent. Interestingly, the extent of bacterial growth in the NET was inversely correlated to AOC concentrations in the WTP effluent (Pearson’s correlation factor r = -0.35), and positively correlated with water temperature (r = 0.49). Collecting a large dataset at high frequency over a two year period enabled the characterization of previously undocumented seasonal dynamics in the distribution network. Moreover, high-resolution FCM data enabled prediction of bacterial cell concentrations at specific water temperatures and time of year. The study highlights the need to systematically assess temporal fluctuations in parallel to spatial dynamics for individual drinking water distribution systems. PMID:27792739

Long-Term Bacterial Dynamics in a Full-Scale Drinking Water Distribution System.

PubMed

Prest, E I; Weissbrodt, D G; Hammes, F; van Loosdrecht, M C M; Vrouwenvelder, J S

2016-01-01

Large seasonal variations in microbial drinking water quality can occur in distribution networks, but are often not taken into account when evaluating results from short-term water sampling campaigns. Temporal dynamics in bacterial community characteristics were investigated during a two-year drinking water monitoring campaign in a full-scale distribution system operating without detectable disinfectant residual. A total of 368 water samples were collected on a biweekly basis at the water treatment plant (WTP) effluent and at one fixed location in the drinking water distribution network (NET). The samples were analysed for heterotrophic plate counts (HPC), Aeromonas plate counts, adenosine-tri-phosphate (ATP) concentrations, and flow cytometric (FCM) total and intact cell counts (TCC, ICC), water temperature, pH, conductivity, total organic carbon (TOC) and assimilable organic carbon (AOC). Multivariate analysis of the large dataset was performed to explore correlative trends between microbial and environmental parameters. The WTP effluent displayed considerable seasonal variations in TCC (from 90 × 103 cells mL-1 in winter time up to 455 × 103 cells mL-1 in summer time) and in bacterial ATP concentrations (<1-3.6 ng L-1), which were congruent with water temperature variations. These fluctuations were not detected with HPC and Aeromonas counts. The water in the network was predominantly influenced by the characteristics of the WTP effluent. The increase in ICC between the WTP effluent and the network sampling location was small (34 × 103 cells mL-1 on average) compared to seasonal fluctuations in ICC in the WTP effluent. Interestingly, the extent of bacterial growth in the NET was inversely correlated to AOC concentrations in the WTP effluent (Pearson's correlation factor r = -0.35), and positively correlated with water temperature (r = 0.49). Collecting a large dataset at high frequency over a two year period enabled the characterization of previously undocumented seasonal dynamics in the distribution network. Moreover, high-resolution FCM data enabled prediction of bacterial cell concentrations at specific water temperatures and time of year. The study highlights the need to systematically assess temporal fluctuations in parallel to spatial dynamics for individual drinking water distribution systems.

RITA can induce cell death in p53-defective cells independently of p53 function via activation of JNK/SAPK and p38

PubMed Central

Weilbacher, A; Gutekunst, M; Oren, M; Aulitzky, W E; van der Kuip, H

2014-01-01

Significant advances have been made in the development of small molecules blocking the p53/MDM2 interaction. The Mdm2 inhibitor Nutlin-3 is restricted to tumors carrying wtp53. In contrast, RITA, a compound that binds p53, has recently been shown also to restore transcriptional functions of mtp53. As more than 50% of solid tumors carry p53 mutations, RITA promises to be a more effective therapeutic strategy than Nutlin-3. We investigated effects of RITA on apoptosis, cell cycle and induction of 45 p53 target genes in a panel of 14 cell lines from different tumor entities with different p53 status as well as primary lymphocytes and fibroblasts. Nine cell strains expressed wtp53, four harbored mtp53, and three were characterized by the loss of p53 protein. A significant induction of cell death upon RITA was observed in 7 of 16 cell lines. The nonmalignant cells in our panel were substantially less sensitive. We found that in contrast to Nultin-3, RITA is capable to induce cell death not only in tumor cells harboring wtp53 and mtp53 but also in p53-null cells. Importantly, whereas p53 has a central role for RITA-mediated effects in wtp53 cells, neither p53 nor p63 or p73 were essential for the RITA response in mtp53 or p53-null cells in our panel demonstrating that besides the known p53-dependent action of RITA in wtp53 cells, RITA can induce cell death also independently of p53 in cells harboring defective p53. We identified an important role of both p38 and JNK/SAPK for sensitivity to RITA in these cells leading to a typical caspase- and BAX/BAK-dependent mitochondrial apoptosis. In conclusion, our data demonstrate that RITA can induce apoptosis through p38 and JNK/SAPK not only in tumor cells harboring wtp53 and mtp53 but also in p53-null cells, making RITA an interesting tumor-selective drug. PMID:25010984

RITA can induce cell death in p53-defective cells independently of p53 function via activation of JNK/SAPK and p38.

PubMed

Weilbacher, A; Gutekunst, M; Oren, M; Aulitzky, W E; van der Kuip, H

2014-07-10

Significant advances have been made in the development of small molecules blocking the p53/MDM2 interaction. The Mdm2 inhibitor Nutlin-3 is restricted to tumors carrying wtp53. In contrast, RITA, a compound that binds p53, has recently been shown also to restore transcriptional functions of mtp53. As more than 50% of solid tumors carry p53 mutations, RITA promises to be a more effective therapeutic strategy than Nutlin-3. We investigated effects of RITA on apoptosis, cell cycle and induction of 45 p53 target genes in a panel of 14 cell lines from different tumor entities with different p53 status as well as primary lymphocytes and fibroblasts. Nine cell strains expressed wtp53, four harbored mtp53, and three were characterized by the loss of p53 protein. A significant induction of cell death upon RITA was observed in 7 of 16 cell lines. The nonmalignant cells in our panel were substantially less sensitive. We found that in contrast to Nultin-3, RITA is capable to induce cell death not only in tumor cells harboring wtp53 and mtp53 but also in p53-null cells. Importantly, whereas p53 has a central role for RITA-mediated effects in wtp53 cells, neither p53 nor p63 or p73 were essential for the RITA response in mtp53 or p53-null cells in our panel demonstrating that besides the known p53-dependent action of RITA in wtp53 cells, RITA can induce cell death also independently of p53 in cells harboring defective p53. We identified an important role of both p38 and JNK/SAPK for sensitivity to RITA in these cells leading to a typical caspase- and BAX/BAK-dependent mitochondrial apoptosis. In conclusion, our data demonstrate that RITA can induce apoptosis through p38 and JNK/SAPK not only in tumor cells harboring wtp53 and mtp53 but also in p53-null cells, making RITA an interesting tumor-selective drug.

Willingness to pay for health insurance in the informal sector of Sierra Leone.

PubMed

Jofre-Bonet, Mireia; Kamara, Joseph

2018-01-01

The objective of this project is to study the willingness to pay (WTP) for health insurance (HI) of individuals working in the informal sector in Sierra Leone, using a purposely-designed survey of a representative sample of this sector. We elicit the WTP using the Double-Bounded Dichotomous Choice with Follow Up method. We also examine the factors that are positively and negatively associated with the likelihood of the respondents to answer affirmatively to joining a HI scheme and to paying three different possible premiums, to join the HI scheme. We additionally analyze the individual and household characteristics associated with the maximum amount the household is willing to pay to join the HI scheme. The results indicate that the average WTP for the HI is 20,237.16 SLL (3.6 USD) per adult but it ranges from about 14,000 SLL (2.5 USD) to about 35,000 SLL (6.2 USD) depending on region, occupation, household and respondent characteristics. The analysis of the maximum WTP indicates that living outside the Western region and working in farming instead of petty trade are associated with a decrease in the maximum premium respondents are WTP for the HI scheme. Instead, the maximum WTP is positively associated to being a driver or a biker; having secondary or tertiary education (as opposed to not having any); the number of pregnant women in the household; having a TV; and, having paid for the last medical requirement. In summary, the various analyses show that a premium for the HI package could be set at approximately 20,000 SLL (3.54 USD) but also that establishing a single premium for all individuals in the informal sector could be risky. The efficient functioning of a HI scheme relies on covering as much of the population as possible, in order to spread risks and make the scheme viable. The impact of the various population characteristics raises the issue of how to rate premiums. In other words, setting a premium that may be too high for a big proportion of the population could mean losing many potential enrollees and might have viability consequences for the operation of the scheme.

A pilot study to evaluate the feasibility of using willingness to pay as a measure of value in cancer supportive care: an assessment of amifostine cytoprotection.

PubMed

Dranitsaris, G

1997-11-01

The most commonly used method for pharmacoeconomic studies has been the cost-effectiveness analysis (CEA), where the outcome is expressed as an incremental cost per unit of effectiveness (e.g. quality-adjusted life years). Although CEA is a valuable tool for identifying therapies that are more effective and less expensive, deficiencies develop when a given treatment is both more expensive and more effective. An alternative that has not been investigated in the oncology setting is the willingness-to-pay (WTP) method. In this pilot study, a WTP strategy was utilized to estimate the value that the Canadian tax-paying public puts on amifostine, a new cytoprotective agent that reduces the risk of chemotherapy-induced toxicity. The method of WTP was used within the framework of a classical cost-benefit analysis to estimate the net cost or benefit of prophylactic amifostine in patients with ovarian cancer who were receiving chemotherapy. This included direct costs for amifostine administration and hospital savings secondary to the reduced incidence of antineoplastic toxicity. A random sample of 50 Canadian tax-payers were interviewed to ascertain their maximum WTP for the new drug. The WTP survey instrument was simple to administer and easily understood by participants. Respondents stated that they would be willing to pay an average of $Can3,476 (95% confidence interval = $Can2,275 to $Can4,676) as an income tax increase to be paid over their lifetime for the value offered by the product. The benefit was then subtracted from the overall cost of amifostine ($Can3,826). This produced a net cost of $Can350 per patient (95% confidence interval = -$Can850 to $Can1,551), suggesting a situation of cost neutrality. WTP as a measure of value for oncology products is feasible and should be considered for future economic evaluations. The strategy is currently being used at this institution to determine the net societal cost or benefit of other cancer supportive care therapies, such as epoetin-alfa.

Willingness to pay and conjoint analysis to determine women's preferences for ovarian stimulating hormones in the treatment of infertility in Spain

PubMed Central

Palumbo, A.; De La Fuente, P.; Rodríguez, M.; Sánchez, F.; Martínez-Salazar, J.; Muñoz, M.; Marqueta, J.; Hernández, J.; Espallardo, O.; Polanco, C.; Paz, S.; Lizán, L.

2011-01-01

BACKGROUND Despite many advances in assisted reproductive techniques (ART), little is known about preferences for technological developments of women undergoing fertility treatments. The aims of this study were to investigate the preferences of infertile women undergoing ART for controlled ovarian stimulation (COS) treatments; to determine the utility values ascribed to different attributes of COS treatments; and to estimate women's willingness to pay (WTP) for COS. METHODS A representative sample of ambulatory patients ready to receive, or receiving, COS therapies for infertility were recruited from seven specialized private centres in six autonomous communities in Spain. Descriptive, inferential and conjoint analyses (CA) were used to elicit preferences and WTP. Attributes and levels of COS treatments were identified by literature review and two focus groups with experts and patients. WTP valuations were derived by a combination of double-bounded (closed-ended) and open questions and contingent ranking methods. RESULTS In total, 160 patients [mean (standard deviation; SD) age: 35.8 (4.2) years] were interviewed. Over half of the participants (55.0%) had a high level of education (university degree), most (78.8%) were married and half (50.0%) had an estimated net income of >€1502 per month and had paid a mean (SD) €1194.17 (€778.29) for their most recent hormonal treatment. The most frequent causes of infertility were related to sperm abnormalities (50.3%). In 30.6% of cases, there were two causes of infertility. The maximum WTP for COS treatment was €800 (median) per cycle; 35.5% were willing to pay an additional €101–€300 for a 1–2% effectiveness gain in the treatment. Utility values (CA) showed that effectiveness was the most valued attribute (39.82), followed by costs (18.74), safety (17.75) and information sharing with physicians (14.93). CONCLUSIONS WTP for COS therapies exceeds current cost. Additional WTP exists for 1–2% effectiveness improvement. Effectiveness and costs were the most important determinants of preferences, followed by safety and information sharing with physicians. PMID:21558333

Podoconiosis patients’ willingness to pay for treatment services in Northwest Ethiopia: potential for cost recovery

PubMed Central

2014-01-01

Background Podoconiosis is non-filarial elephantiasis of the lower legs. It is more commonly found in tropical Africa, Central and South America, and northwest India. In Ethiopia, a few non-governmental organizations provide free treatment to podoconiosis patients, but sustainability of free treatment and scale-up of services to reach the huge unmet need is challenged by resource limitations. We aimed to determine podoconiosis patient’s willingness to pay (WTP) for a treatment package (composed of deep cleaning of limbs with diluted antiseptic solution, soap, and water, bandaging, application of emollient on the skin, and provision of shoes), and factors associated with WTP in northwestern Ethiopia. Methods A cross-sectional study was conducted among randomly selected untreated podoconiosis patients (n = 393) in Baso Liben woreda, northwestern Ethiopia. The contingent valuation method was used with a pre-tested interviewer-administered questionnaire. Results The majority of podoconiosis patients (72.8%) were willing to pay for treatment services. The median WTP amount was 64 Birr (US$ 3.28) per person per year. More than one-third of patients (36.7%) were willing to pay at least half of the full treatment cost and 76.2% were willing to pay at least half of the cost of shoes. A multivariate analysis showed that having a higher monthly income, being a woman, older age, being aware of the role of shoes to prevent podoconiosis, and possession of a functional radio were significantly associated with higher odds of WTP. Conclusions The considerable WTP estimates showed that podoconiosis treatment could improve sustainability and service utilization. A subsidized cost recovery scheme could reduce treatment costs and more feasibility integrate podoconiosis treatment service with other NTDs and the government’s primary health care system. PMID:24642085

The Monetary Valuation of Lifetime Health Improvement and Life Expectancy Gains in Turkey

PubMed Central

Tekeşin, Cem

2017-01-01

The main objective of this study is to estimate the monetary value of the gains of healthy days and life expectancy due to the ambient air quality standard that came into effect in 2014 by estimating the country-specific value of a life year (VOLY) and the value of the healthier and longer life (VHLL) for Turkey. Contingent valuation method is adopted to reveal individuals’ willingness to pay for an improvement of health condition and the extension of their life expectancy by avoiding respiratory and lung related illnesses. VHLL is composed of two parts, WTP for an extension of one’s life years (VOLY) and for an increase in the number of healthy days throughout one’s life time (VHLL-VOLY). We found that close to 80% of WTP is allocated to the latter component of VHLL and only 20% is for VOLY mainly due to Islamic beliefs of the respondents. A total of 1314 observations are collected by face-to-face interviews from Afsin-Elbistan, Kutahya-Tavsanli and Ankara. The estimated VHLL and VOLY are [41,750 TL, 10,258 TL] with all the observations, [30,185 TL, 7132 TL] for Afsin-Elbistan, [31,718 TL, 7081 TL] for Kutahya-Tavsanli and [52,334 TL, 14,813 TL] for Ankara. The Inverse-U shaped relationship between Age and WTP is confirmed. The income elasticities of WTP is found to be close to 0.5 for all study areas while an Inverse-U shaped relationship between the household income and Income Elasticity of WTP is observed in the income group based analysis. Age and household income are the two prominent determinants of VHLL. PMID:28961227

The Monetary Valuation of Lifetime Health Improvement and Life Expectancy Gains in Turkey.

PubMed

Ara, Shihomi; Tekeşin, Cem

2017-09-29

The main objective of this study is to estimate the monetary value of the gains of healthy days and life expectancy due to the ambient air quality standard that came into effect in 2014 by estimating the country-specific value of a life year (VOLY) and the value of the healthier and longer life (VHLL) for Turkey. Contingent valuation method is adopted to reveal individuals' willingness to pay for an improvement of health condition and the extension of their life expectancy by avoiding respiratory and lung related illnesses. VHLL is composed of two parts, WTP for an extension of one's life years (VOLY) and for an increase in the number of healthy days throughout one's life time (VHLL-VOLY). We found that close to 80% of WTP is allocated to the latter component of VHLL and only 20% is for VOLY mainly due to Islamic beliefs of the respondents. A total of 1314 observations are collected by face-to-face interviews from Afsin-Elbistan, Kutahya-Tavsanli and Ankara. The estimated VHLL and VOLY are [41,750 TL, 10,258 TL] with all the observations, [30,185 TL, 7132 TL] for Afsin-Elbistan, [31,718 TL, 7081 TL] for Kutahya-Tavsanli and [52,334 TL, 14,813 TL] for Ankara. The Inverse-U shaped relationship between Age and WTP is confirmed. The income elasticities of WTP is found to be close to 0.5 for all study areas while an Inverse-U shaped relationship between the household income and Income Elasticity of WTP is observed in the income group based analysis. Age and household income are the two prominent determinants of VHLL.

The Potential Cost-Effectiveness of Amblyopia Screening Programs

PubMed Central

Rein, David B.; Wittenborn, John S.; Zhang, Xinzhi; Song, Michael; Saaddine, Jinan B.

2013-01-01

Background To estimate the incremental cost-effectiveness of amblyopia screening at preschool and kindergarten, we compared the costs and benefits of 3 amblyopia screening scenarios to no screening and to each other: (1) acuity/stereopsis (A/S) screening at kindergarten, (2) A/S screening at preschool and kindergarten, and (3) photoscreening at preschool and A/S screening at kindergarten. Methods We programmed a probabilistic microsimulation model of amblyopia natural history and response to treatment with screening costs and outcomes estimated from 2 state programs. We calculated the probability that no screening and each of the 3 interventions were most cost-effective per incremental quality-adjusted life year (QALY) gained and case avoided. Results Assuming a minimal 0.01 utility loss from monocular vision loss, no screening was most cost-effective with a willingness to pay (WTP) of less than $16,000 per QALY gained. A/S screening at kindergarten alone was most cost-effective between a WTP of $17,000 and $21,000. A/S screening at preschool and kindergarten was most cost-effective between a WTP of $22,000 and $75,000, and photoscreening at preschool and A/S screening at kindergarten was most cost-effective at a WTP greater than $75,000. Cost-effectiveness substantially improved when assuming a greater utility loss. All scenarios were cost-effective when assuming a WTP of $10,500 per case of amblyopia cured. Conclusions All 3 screening interventions evaluated are likely to be considered cost-effective relative to many other potential public health programs. The choice of screening option depends on budgetary resources and the value placed on monocular vision loss prevention by funding agencies. PMID:21877675

Podoconiosis patients' willingness to pay for treatment services in Northwest Ethiopia: potential for cost recovery.

PubMed

Tamiru, Abreham; Tsegay, Girmay; Wubie, Moges; Gedefaw, Molla; Tomczyk, Sara; Tekola-Ayele, Fasil

2014-03-19

Podoconiosis is non-filarial elephantiasis of the lower legs. It is more commonly found in tropical Africa, Central and South America, and northwest India. In Ethiopia, a few non-governmental organizations provide free treatment to podoconiosis patients, but sustainability of free treatment and scale-up of services to reach the huge unmet need is challenged by resource limitations. We aimed to determine podoconiosis patient's willingness to pay (WTP) for a treatment package (composed of deep cleaning of limbs with diluted antiseptic solution, soap, and water, bandaging, application of emollient on the skin, and provision of shoes), and factors associated with WTP in northwestern Ethiopia. A cross-sectional study was conducted among randomly selected untreated podoconiosis patients (n=393) in Baso Liben woreda, northwestern Ethiopia. The contingent valuation method was used with a pre-tested interviewer-administered questionnaire. The majority of podoconiosis patients (72.8%) were willing to pay for treatment services. The median WTP amount was 64 Birr (US$ 3.28) per person per year. More than one-third of patients (36.7%) were willing to pay at least half of the full treatment cost and 76.2% were willing to pay at least half of the cost of shoes. A multivariate analysis showed that having a higher monthly income, being a woman, older age, being aware of the role of shoes to prevent podoconiosis, and possession of a functional radio were significantly associated with higher odds of WTP. The considerable WTP estimates showed that podoconiosis treatment could improve sustainability and service utilization. A subsidized cost recovery scheme could reduce treatment costs and more feasibility integrate podoconiosis treatment service with other NTDs and the government's primary health care system.

A national survey of HDR source knowledge among practicing radiation oncologists and residents: Establishing a willingness-to-pay threshold for cobalt-60 usage.

PubMed

Mailhot Vega, Raymond; Talcott, Wesley; Ishaq, Omar; Cohen, Patrice; Small, Christina J; Duckworth, Tamara; Sarria Bardales, Gustavo; Perez, Carmen A; Schiff, Peter B; Small, William; Harkenrider, Matthew M

Ir-192 is the predominant source for high-dose-rate (HDR) brachytherapy in United States markets. Co-60, with longer half-life and fewer source exchanges, has piloted abroad with comparable clinical dosimetry but increased shielding requirements. We sought to identify practitioner knowledge of Co-60 and establish acceptable willingness-to-pay (WTP) thresholds for additional shielding requirements for use in future cost-benefit analysis. A nationwide survey of U.S. radiation oncologists was conducted from June to July 2015, assessing knowledge of HDR sources, brachytherapy unit shielding, and factors that may influence source-selection decision-making. Self-identified decision makers in radiotherapy equipment purchase and acquisition were asked their WTP on shielding should a more cost-effective source become available. Four hundred forty surveys were completed and included. Forty-four percent were ABS members. Twenty percent of respondents identified Co-60 as an HDR source. Respondents who identified Co-60 were significantly more likely to be ABS members, have attended a national brachytherapy conference, and be involved in brachytherapy selection. Sixty-six percent of self-identified decision makers stated that their facility would switch to a more cost-effective source than Ir-192, if available. Cost and experience were the most common reasons provided for not switching. The most common WTP value selected by respondents was <$25,000. A majority of respondents were unaware of Co-60 as a commercially available HDR source. This investigation was novel in directly assessing decision makers to establish WTP for shielding costs that source change to Co-60 may require. These results will be used to establish WTP threshold for future cost-benefit analysis. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Willingness to pay for physician services at a primary contact in Ukraine: results of a contingent valuation study.

PubMed

Danyliv, Andriy; Pavlova, Milena; Gryga, Irena; Groot, Wim

2013-06-08

The existence of quasi-formal and informal payments in the Ukrainian health care system jeopardizes equity and creates barriers to access to proper care. Patient payment policies that better match patient preferences are necessary. We analyze the potential and feasibility of official patient charges for public health care services in Ukraine by studying the patterns of fee acceptability, ability and willingness to pay (WTP) for public health care among population groups. We use contingent valuation data collected from 303 respondents representative of the adult Ukrainian population. Three decision points were separated: objection to pay, inability to pay, and level of positive non-zero WTP. These decisions were studied for relations with quality profiles of the services, and socio-demographic characteristics of the respondents and their households. The likelihood to object to pay is mostly determined by the quality characteristics of the services. Objection to pay is not related to corresponding behavior in real life. The likelihood of being unable to pay is associated with older age, lower income, and a larger share of household members with no income. The level of positive WTP is positively related to income (+7% per 1000 UAH increase in income) and is lower for people who visited a doctor but did not pay (-22%). Rather substantial WTP levels (between 0.9% and 1.9% of household income) for one visit to physician indicate a potential for official patient charges in Ukraine. User fees may cover a substantial share of personnel cost in the out-patient sector. The patterns of inability to pay support well designed exemption criteria based on age, income, and other aspects of economic status. The WTP patterns highlight the necessity for payments that are proportional to income. Other methodological and policy implications are discussed.

Final Report - ILAW PCT, VHT, Viscosity, and Electrical Conductivity Model Development, VSL-07R1230-1

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

Kruger, Albert A.; Cooley, S. K.; Joseph, I.

This report describes the results of work and testing specified by the Test Specifications (24590-LAW-TSP-RT-01-013 Rev.1 and 24590-WTP-TSP-RT-02-001 Rev.0), Test Plans (VSL-02T4800-1 Rev.1 & TP-RPP-WTP-179 Rev.1), and Text Exception (24590-WTP-TEF-RT-03-040). The work and any associated testing followed established quality assurance requirements and conducted as authorized. The descriptions provided in this test report are an accurate account of both the conduct of the work and the data collected. Results required by the Test Plans are reported. Also reported are any unusual or anomalous occurrences that are different from the starting hypotheses. The test results and this report have been reviewed andmore » verified.« less

Estimating the economic benefits of maintaining residential lake levels at an irrigation reservoir: A contingent valuation study

NASA Astrophysics Data System (ADS)

Loomis, John; Smith, Adam; Huszar, Paul

2005-08-01

The contingent valuation method (CVM) was used to estimate homeowners' willingness to pay for water leasing to maintain stable lake levels at an irrigation reservoir in a residential neighborhood. A binary logit model was used to analyze households' voter referendum responses for maintaining the lake level. The median willingness to pay (WTP) was found to be $368 per year for lakefront residents and $59 per year for off-lake residents. The median WTP for lakefront residents was significantly different from off-lake residents at the 90% confidence level. Using the median WTP for lakefront and nonlakefront residents, we found that the increase in homeowner association fees would generate approximately $43,000, enough money to lease sufficient water to reach the target higher lake level in a normal water year.

Public willingness to pay for CO2 mitigation and the determinants under climate change: a case study of Suzhou, China.

PubMed

Yang, Jie; Zou, Liping; Lin, Tiansheng; Wu, Ying; Wang, Haikun

2014-12-15

This study explored the factors that influence respondents' willingness to pay (WTP) for CO2 mitigation under climate change. A questionnaire survey combined with contingent valuation and psychometric paradigm methods were conducted in the city of Suzhou, Jiangsu Province in China. Respondents' traditional demographic attributes, risk perception of greenhouse gas (GHG), and attitude toward the government's risk management practices were established using a Tobit model to analyze the determinants. The results showed that about 55% of the respondents refused to pay for CO2 mitigation, respondent's WTP increased with increasing CO2 mitigation percentage. Important factors influencing WTP include people's feeling of dread of GHGs, confidence in policy, the timeliness of governmental information disclosure, age, education and income level. Copyright © 2014 Elsevier Ltd. All rights reserved.

An Assessment of Farmers' Willingness to Pay for Extension Services Using the Contingent Valuation Method (CVM): The Case of Oyo State, Nigeria

ERIC Educational Resources Information Center

Ajayi, A. O.

2006-01-01

This study assessed farmers' willingness to pay (WTP) for extension services. The Contingent Valuation Method (CVM) was used to assess the amount which farmers are willing to pay. Primary data on the demographic, socio-economic variables of farmers and their WTP were collected from 228 farmers selected randomly in a stage-wise sampling procedure…

Are all-terrain vehicle riders willing to pay trail user fees to ride on public lands in the USA?

Treesearch

Stephanie A. Snyder; Robert A. Smail

2009-01-01

Some public lands in the USA offer opportunities for all-terrain vehicle (ATV) riding, but few charge trail use fees. In a case study in the US state of Wisconsin, the contingent valuation method was used to examine riders' willingness to pay (WTP) to ride on public lands. Information on riders' habits, preferences and responses to a dichotomous choice WTP...

International survey on willingness-to-pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?

PubMed

Shiroiwa, Takeru; Sung, Yoon-Kyoung; Fukuda, Takashi; Lang, Hui-Chu; Bae, Sang-Cheol; Tsutani, Kiichiro

2010-04-01

Although the threshold of cost effectiveness of medical interventions is thought to be 20 000- 30 000 UK pounds in the UK, and $50 000-$100 000 in the US, it is well known that these values are unjustified, due to lack of explicit scientific evidence. We measured willingness-to-pay (WTP) for one additional quality-adjusted life-year gained to determine the threshold of the incremental cost-effectiveness ratio. Our study used the Internet to compare WTP for the additional year of survival in a perfect status of health in Japan, the Republic of Korea (ROK), Taiwan, Australia, the UK, and the US. The research utilized a double-bound dichotomous choice, and analysis by the nonparametric Turnbull method. WTP values were JPY 5 million (Japan), KWN 68 million (ROK), NT$ 2.1 million (Taiwan), 23 000 UK pounds (UK), AU$ 64 000 (Australia), and US$ 62 000 (US). The discount rates of outcome were estimated at 6.8% (Japan), 3.7% (ROK), 1.6% (Taiwan), 2.8% (UK), 1.9% (Australia), and 3.2% (US). Based on the current study, we suggest new classification of cost-effectiveness plane and methodology for decision making. Copyright (c) 2009 John Wiley & Sons, Ltd.

Occurrence of betablockers in effluents of wastewater treatment plants from the Lyon area (France) and risk assessment for the downstream rivers.

PubMed

Miège, Cécile; Favier, Maxime; Brosse, Corinne; Canler, Jean-Pierre; Coquery, Marina

2006-11-15

Five betablockers (oxprenolol, metoprolol, propranolol, bisoprolol, betaxolol) were analysed in effluents collected over a 3-month period from wastewater treatment plants (WTP) from the Lyon area in France. The analytical protocol consisted of solid phase extraction of the dissolved aqueous phase on HLB cartridges and analysis by gas chromatography coupled with mass detection (GC-MS) after derivatization. Concentrations of metoprolol, propranolol and bisoprolol varied from 45 to 2838ng/L whereas oxprenolol and betaxolol were never detected in these effluent samples. A high variability of betablockers concentrations and fluxes was observed between WTP effluents and within each WTP over the time period studied. Considering a flux per person for a dry weather period, Fontaine plant was pointed out as the less efficient WTP, which might be explained by its type of treatment (biological aerated filters). But we need additional analysis of effluent and influent waters to confirm this hypothesis. A tentative approach of local environmental risk assessment of propranolol based on the calculation of PEC/PNEC (predicted environmental concentration/predicted non effect concentration) ratio approach lead us to conclude on a negligible risk for the downstream rivers (Rhône river at Ternay and Saône river at Couzon Mt d'Or).

Comparison of physicochemical characteristics and consumer perception of rice samples with different countries of origin and prices.

PubMed

Jang, Eun-Hee; Lim, Seung-Taik; Kim, Sang Sook

2012-06-01

Rice is the only food item which is not liberalized in Korea. To prepare for future liberalization of the rice market in Korea, the physicochemical characteristics and consumer perception of four domestic rice samples were compared with those of 11 foreign rice samples. Additionally, the influences of country of origin (CO) and price on purchase intent (PI) and willingness to pay (WTP) were investigated. Consumer acceptance of rice samples from Japan was generally higher than that of rice samples from other countries. In an informed test, PI was affected by price and CO, while WTP was affected mostly by price. The PI decreased with the price provided while the WTP increased. In a blind test, consumers evaluated PI and WTP according to sensory liking. The PI was higher in the informed test than in the blind test in all domestic samples. Generally, consumer acceptance was highly correlated with fat acidity (r = - 0.76), protein content (r = - 0.72), and b value (r = - 0.64) of the rice samples. Further efforts to increase the quality of rice are recommended for survival in the global market after liberalization of rice, even though consumers showed loyalty for PI of domestic samples. Copyright © 2011 Society of Chemical Industry.

Measurement of consumer preference for treatments used to induce labour: a willingness-to-pay approach.

PubMed

Taylor, Susan J.; Armour, Carol L.

2000-09-01

AIM: The purpose of the study was to assess the acceptability to consumers of two methods of induction of labour using a willingness-to-pay (WTP) approach. The methods compared were amniotomy plus oxytocin and prostaglandin E2 vaginal gel, followed by oxytocin if necessary. METHODS: A description of each method was presented, in questionnaire format, to pregnant women attending a public hospital ante-natal clinic. Women were asked to choose one of the two treatments, then give a valuation in dollar terms for both their preferred treatment and the alternative. RESULTS: It was found that 73.7% of patients preferred gel. The mean maximum WTP for amniotomy plus oxytocin was Aus$133 while that for gel was Aus$178 (P=0.0001). Those who chose amniotomy plus oxytocin were WTP 90% more for their preferred treatment compared with the alternative (Aus$180 vs. Aus$95). Similarly, those who preferred gel were WTP 90% more for their preferred treatment compared with the alternative (Aus$222 vs. Aus$119). CONCLUSION: Consumers were able to assess drug information provided on the two therapies, make an informed choice and to value that choice. Information obtained in this way, combined with information on costs, could be used in policy decision-making.

Measurement of consumer preference for treatments used to induce labour: a willingness‐to‐pay approach

PubMed Central

Taylor, Susan J.; Armour, Carol L.

2001-01-01

Aim The purpose of the study was to assess the acceptability to consumers of two methods of induction of labour using a willingness‐to‐pay (WTP) approach. The methods compared were amniotomy plus oxytocin and prostaglandin E2 vaginal gel, followed by oxytocin if necessary. Methods A description of each method was presented, in questionnaire format, to pregnant women attending a public hospital ante‐natal clinic. Women were asked to choose one of the two treatments, then give a valuation in dollar terms for both their preferred treatment and the alternative. Results It was found that 73.7% of patients preferred gel. The mean maximum WTP for amniotomy plus oxytocin was Aus$133 while that for gel was Aus$178 (P=0.0001). Those who chose amniotomy plus oxytocin were WTP 90% more for their preferred treatment compared with the alternative (Aus$180 vs. Aus$95). Similarly, those who preferred gel were WTP 90% more for their preferred treatment compared with the alternative (Aus$222 vs. Aus$119). Conclusion Consumers were able to assess drug information provided on the two therapies, make an informed choice and to value that choice. Information obtained in this way, combined with information on costs, could be used in policy decision‐making. PMID:11281930

Valuing the Economic Costs of Allergic Rhinitis, Acute Bronchitis, and Asthma from Exposure to Indoor Dampness and Mold in the US

PubMed Central

2016-01-01

Two foundational methods for estimating the total economic burden of disease are cost of illness (COI) and willingness to pay (WTP). WTP measures the full cost to society, but WTP estimates are difficult to compute and rarely available. COI methods are more often used but less likely to reflect full costs. This paper attempts to estimate the full economic cost (2014$) of illnesses resulting from exposure to dampness and mold using COI methods and WTP where the data is available. A limited sensitivity analysis of alternative methods and assumptions demonstrates a wide potential range of estimates. In the final estimates, the total annual cost to society attributable to dampness and mold is estimated to be $3.7 (2.3–4.7) billion for allergic rhinitis, $1.9 (1.1–2.3) billion for acute bronchitis, $15.1 (9.4–20.6) billion for asthma morbidity, and $1.7 (0.4–4.5) billion for asthma mortality. The corresponding costs from all causes, not limited to dampness and mold, using the same approach would be $24.8 billion for allergic rhinitis, $13.5 billion for acute bronchitis, $94.5 billion for asthma morbidity, and $10.8 billion for asthma mortality. PMID:27313630

Construct validity of the bidding game, binary with follow-up, and a novel structured haggling question format in determining willingness to pay for insecticide-treated mosquito nets.

PubMed

Onwujekwe, Obinna; Fox-Rushby, Julia; Hanson, Kara

2008-01-01

This study examines whether making question formats better fit the cultural context of markets would improve the construct validity of estimates of willingness to pay (WTP). WTP for insecticide-treated mosquito nets was elicited using the bidding game, binary with follow-up (BWFU), and a novel structured haggling technique (SH) that mimicked price taking in market places in the study area. The results show that different question formats generated different distributions of WTP. Following a comparison of alternative models for each question format, construct validity was compared using the most consistently appropriate model across question formats for the positive WTP values, in this case, ordinary least squares. Three criteria (the number of statistically significant explanatory variables that had the anticipated sign, the value of the adjusted R(2), and the proportion that were statistically significant With the anticipated sign) used to assess the relative performance of each question format indicated that SH performed best and BWFU worst. However, differences in the levels of income, education, and percentage of household heads responding to the different question formats across the samples complicate this conclusion. Hence, the results suggest that the SH technique is worthy of further investigation and use.

Acceptability and willingness to pay for primary care videoconferencing: a randomized controlled trial.

PubMed

Stahl, James E; Dixon, Ronald F

2010-01-01

We examined videoconferencing in comparison with face-to-face office visits in primary care. Four physicians took part in the study and 175 patients were recruited from a general medical practice. Patients were interviewed and examined in both face-to-face and virtual settings, the order being randomized. Patients and clinicians were surveyed by questionnaire after each visit. Physicians were very satisfied with videoconferencing but preferred face-to-face overall (P < 0.0001). For videoconferencing, the physical examination and the ability to order appropriate laboratory tests were the least satisfying elements of the encounter. Patients were also very satisfied with videoconferencing but overall preferred face-to-face (P < 0.0001). This difference was significant for gastrointestinal, musculoskeletal and respiratory complaints. However, in terms of willingness to pay (WTP) for videoconferencing access, patients with musculoskeletal and respiratory complaints were the most willing. Age and gender did not significantly predict WTP. The technical quality of the videoconference had a significant effect on satisfaction with the clinical encounter but did not correlate with the patients' WTP for videoconferencing. Travel costs up to $40 and travel times up to 4 hours did not influence the WTP of patients. For non-rural, relatively mobile patients, videoconferencing appears suitable for short visits for relatively simple complaints.

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

Mahoney, Lenna A.

Through radiolytic and thermolytic reactions, Hanford tank wastes generate and retain a variety of gases, including hydrogen, nitrous oxide, methane (and other hydrocarbons), ammonia, and nitrogen. This gas generation can be expected to continue during processing in the Hanford Tank Waste Treatment and Immobilization Plant (WTP). The generation rates in the WTP will change from those for the in-situ tank waste because of different process temperatures, different dose rates produced by in-process changes in the proportions of solid and liquid, and dilution of the waste liquid. The flammability of the generated gas that is continuously released, and of any retainedmore » gas that might be released into a vessel headspace in quantity due to a spontaneous release, depends on the concentrations not only of the fuel gases—primarily hydrogen (H2), methane, other hydrocarbons, and ammonia—but of the oxidizer nitrous oxide (N2O). As a result of high concentrations of N2O, some gas mixtures are “self-flammable” (i.e., ignition can occur when no air is present because N2O provides the only oxidizer needed). Self-flammability could potentially reduce the effectiveness of using a nitrogen (N2) purge in the headspace as a flammability control, if its effects are not accounted for. A given amount of inertant gas (N2) can accommodate only a certain amount of a generated self-flammable gas before the mixture with inertant gas becomes flammable.« less

Eliciting willingness to pay: comparing closed-ended with open-ended and payment scale formats.

PubMed

Frew, Emma J; Whynes, David K; Wolstenholme, Jane L

2003-01-01

Willingness to pay (WTP) is increasingly being used as a measure of valuation in health technology assessment. A variety of formats for eliciting values are available, although the relative virtues of each remain the subject of methodological controversy. This article compares valuation results obtained using a WTP survey instrument in a closed-ended format with those obtained from instruments using open-ended and payment scale formats. Samples of subjects were drawn from a general population, and all were asked to value the same intervention--alternative methods of screening for colorectal cancer. It was discovered that, whereas the open-ended and payment scale formats produced broadly similar valuations, the closed-ended format produced significantly higher WTP valuations and different justifications for those valuations. It is hypothesized that anchoring and yea-saying effects explain these differences and that the closed-ended format triggers a different response mode in subjects.

Public willingness to pay for a US carbon tax and preferences for spending the revenue

NASA Astrophysics Data System (ADS)

Kotchen, Matthew J.; Turk, Zachary M.; Leiserowitz, Anthony A.

2017-09-01

We provide evidence from a nationally representative survey on Americans’ willingness to pay (WTP) for a carbon tax, and public preferences for how potential carbon-tax revenue should be spent. The average WTP for a tax on fossil fuels that increases household energy bills is US177 per year. This translates into an average WTP of 14% more on average for households across the United States, where energy costs differ significantly across states. Regarding the tax revenues, Americans are most in support of using the money to invest in clean energy and infrastructure. There is relatively less support for reducing income or payroll taxes, returning dividends to households, and other expenditure categories. Finally, Americans support using the tax revenues to assist displaced workers in the coal industry enough to compensate each miner nearly US146 000 upon passage of a carbon tax.

Exploring factors influencing farmers' willingness to pay (WTP) for a planned adaptation programme to address climatic issues in agricultural sectors.

PubMed

Ahmed, Adeel; Masud, Muhammad Mehedi; Al-Amin, Abul Quasem; Yahaya, Siti Rohani Binti; Rahman, Mahfuzur; Akhtar, Rulia

2015-06-01

This study empirically estimates farmers' willingness to pay (WTP) for a planned adaptation programme for addressing climate issues in Pakistan's agricultural sectors. The contingent valuation method (CVM) was employed to determine a monetary valuation of farmers' preferences for a planned adaptation programme by ascertaining the value attached to address climatic issues. The survey was conducted by distributing structured questionnaires among Pakistani farmers. The study found that 67 % of respondents were willing to pay for a planned adaptation programme. However, several socioeconomic and motivational factors exert greater influence on their willingness to pay (WTP). This paper specifies the steps needed for all institutional bodies to better address issues in climate change. The outcomes of this paper will support attempts by policy makers to design an efficient adaptation framework for mitigating and adapting to the adverse impacts of climate change.

Influence of flood risk characteristics on flood insurance demand: a comparison between Germany and the Netherlands

NASA Astrophysics Data System (ADS)

Seifert, I.; Botzen, W. J. W.; Kreibich, H.; Aerts, J. C. J. H.

2013-07-01

The existence of sufficient demand for insurance coverage against infrequent losses is important for the adequate function of insurance markets for natural disaster risks. This study investigates how characteristics of flood risk influence household flood insurance demand based on household surveys undertaken in Germany and the Netherlands. Our analyses confirm the hypothesis that willingness to pay (WTP) for insurance against medium-probability medium-impact flood risk in Germany is higher than WTP for insurance against low-probability high-impact flood risk in the Netherlands. These differences in WTP can be related to differences in flood experience, individual risk perceptions, and the charity hazard. In both countries there is a need to stimulate flood insurance demand if a relevant role of private insurance in flood loss compensation is regarded as desirable, for example, by making flood insurance compulsory or by designing information campaigns.

Measuring the willingness to pay for drinking water quality improvements: results of a contingent valuation survey in Songzi, China.

PubMed

Jianjun, Jin; Wenyu, Wang; Ying, Fan; Xiaomin, Wang

2016-06-01

The aim of this study is to elicit local residents' willingness to pay (WTP), by applying the contingent valuation method as a surcharge on their water bill, for a given improvement in the drinking water quality and the supply reliability. The mean WTP for the drinking water quality improvement program was estimated to be 16.71 yuan (0.3% of total household income). The results note that more educated respondents and households with higher income and with fewer household members are, on average, willing to pay more. This study also demonstrates that respondents' concerns regarding drinking water quality and perceptions of the health risk of drinking water quality can have significant positive impacts on people's WTP. The research results can help decision-makers understand the local population's demand for improved drinking water quality and undertake an environmental cost-benefit analysis.

Effects of information on young consumers' willingness to pay for genetically modified food: experimental auction analysis.

PubMed

Kajale, Dilip B; Becker, T C

2014-01-01

This study examines the effects of information on consumers' willingness to pay (WTP) for genetically modified food (GMF). We used Vickrey second price experimental auction method for elicitation of consumer WTP for GM potato chips and GM soya-chocolate bar. The sample used in this study was university students from Delhi, India. Four information formats (positive, negative, no information, and combined information about GM technology) were used for the examination. The results show that, when students received the combine information they were willing to pay around 17%-20% premium for GMF and when received the negative information they demanded around 22% discount for GMF. While the positive- and the no-information formats alone have no considerable effect on consumers' WTP for GMF. Overall, our findings suggest that while doing marketing of GMF in India, the best strategy is to provide combined information about GM technology.

Inequalities in purchase of mosquito nets and willingness to pay for insecticide-treated nets in Nigeria: Challenges for malaria control interventions

PubMed Central

Onwujekwe, Obinna; Hanson, Kara; Fox-Rushby, Julia

2004-01-01

Objective To explore the equity implications of insecticide-treated nets (ITN) distribution programmes that are based on user charges. Methods A questionnaire was used to collect information on previous purchase of untreated nets and hypothetical willingness to pay (WTP) for ITNs from a random sample of householders. A second survey was conducted one month later to collect information on actual purchases of ITNs. An economic status index was used for characterizing inequity. Major findings The lower economic status quintiles were less likely to have previously purchased untreated nets and also had a lower hypothetical and actual WTP for ITNs. Conclusion ITN distribution programmes need to take account of the diversity in WTP for ITNs if they are to ensure equity in access to the nets. This could form part of the overall poverty reduction strategy. PMID:15023234

Ion Exchange Distribution Coefficient Tests and Computer Modeling at High Ionic Strength Supporting Technetium Removal Resin Maturation

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

Nash, Charles A.; Hamm, L. Larry; Smith, Frank G.

2014-12-19

The primary treatment of the tank waste at the DOE Hanford site will be done in the Waste Treatment and Immobilization Plant (WTP) that is currently under construction. The baseline plan for this facility is to treat the waste, splitting it into High Level Waste (HLW) and Low Activity Waste (LAW). Both waste streams are then separately vitrified as glass and poured into canisters for disposition. The LAW glass will be disposed onsite in the Integrated Disposal Facility (IDF). There are currently no plans to treat the waste to remove technetium, so its disposition path is the LAW glass. Duemore » to the water solubility properties of pertechnetate and long half-life of 99Tc, effective management of 99Tc is important to the overall success of the Hanford River Protection Project mission. To achieve the full target WTP throughput, additional LAW immobilization capacity is needed, and options are being explored to immobilize the supplemental LAW portion of the tank waste. Removal of 99Tc, followed by off-site disposal, would eliminate a key risk contributor for the IDF Performance Assessment (PA) for supplemental waste forms, and has potential to reduce treatment and disposal costs. Washington River Protection Solutions (WRPS) is developing some conceptual flow sheets for supplemental LAW treatment and disposal that could benefit from technetium removal. One of these flowsheets will specifically examine removing 99Tc from the LAW feed stream to supplemental immobilization. To enable an informed decision regarding the viability of technetium removal, further maturation of available technologies is being performed. This report contains results of experimental ion exchange distribution coefficient testing and computer modeling using the resin SuperLig ® 639 a to selectively remove perrhenate from high ionic strength simulated LAW. It is advantageous to operate at higher concentration in order to treat the waste stream without dilution and to minimize the volume of the final wasteform. This work examined the impact of high ionic strength, high density, and high viscosity if higher concentration LAW feed solution is used. Perrhenate (ReO 4 -) has been shown to be a good nonradioactive surrogate for pertechnetate in laboratory testing for this ion exchange resin, and the performance bias is well established. Equilibrium contact testing with 7.8 M [Na +] average simulant concentrations indicated that the SuperLig ® 639 resin average perrhenate distribution coefficient was 368 mL/g at a 100:1 phase ratio. Although this indicates good performance at high ionic strength, an equilibrium test cannot examine the impact of liquid viscosity, which impacts the diffusivity of ions and therefore the loading kinetics. To get an understanding of the effect of diffusivity, modeling was performed, which will be followed up with column tests in the future.« less

Research on two-port network of wavelet transform processor using surface acoustic wavelet devices and its application.

PubMed

Liu, Shoubing; Lu, Wenke; Zhu, Changchun

2017-11-01

The goal of this research is to study two-port network of wavelet transform processor (WTP) using surface acoustic wave (SAW) devices and its application. The motive was prompted by the inconvenience of the long research and design cycle and the huge research funding involved with traditional method in this field, which were caused by the lack of the simulation and emulation method of WTP using SAW devices. For this reason, we introduce the two-port network analysis tool, which has been widely used in the design and analysis of SAW devices with uniform interdigital transducers (IDTs). Because the admittance parameters calculation formula of the two-port network can only be used for the SAW devices with uniform IDTs, this analysis tool cannot be directly applied into the design and analysis of the processor using SAW devices, whose input interdigital transducer (IDT) is apodized weighting. Therefore, in this paper, we propose the channel segmentation method, which can convert the WTP using SAW devices into parallel channels, and also provide with the calculation formula of the number of channels, the number of finger pairs and the static capacitance of an interdigital period in each parallel channel firstly. From the parameters given above, we can calculate the admittance parameters of the two port network for each channel, so that we can obtain the admittance parameter of the two-port network of the WTP using SAW devices on the basis of the simplification rule of parallel two-port network. Through this analysis tool, not only can we get the impulse response function of the WTP using SAW devices but we can also get the matching circuit of it. Large numbers of studies show that the parameters of the two-port network obtained by this paper are consistent with those measured by network analyzer E5061A, and the impulse response function obtained by the two-port network analysis tool is also consistent with that measured by network analyzer E5061A, which can meet the accuracy requirements of the analysis of the WTP using SAW devices. Therefore the two-port network analysis tool discussed in this paper has comparatively higher theoretical and practical value. Copyright © 2017 Elsevier B.V. All rights reserved.

Managing Minor Ailments; The Public's Preferences for Attributes of Community Pharmacies. A Discrete Choice Experiment.

PubMed

Porteous, Terry; Ryan, Mandy; Bond, Christine; Watson, Margaret; Watson, Verity

2016-01-01

Demand for health services continues to rise. Greater use of community pharmacy services instead of medical services for minor ailments could help relieve pressure on healthcare providers in high-cost settings. Community pharmacies are recognised sources of treatment and advice for people wishing to manage these ailments. However, increasing the public's use of pharmacy services may depend on attributes of pharmacies and their staff. This study aimed to determine the general public's relative preferences for community pharmacy attributes using a discrete choice experiment (DCE). A UK-wide DCE survey of the general public was conducted using face-to-face computer-assisted personal interviews. Attributes and levels for the DCE were informed by a literature review and a cohort study of community pharmacy customers. The context for the experiment was a minor ailment scenario describing flu-like symptoms. The DCE choice sets described two hypothetical community pharmacy services; respondents were asked to choose which (if either) of the two pharmacies they would prefer to help them manage symptoms. Data from 1,049 interviews were analysed using an error components logit model. Willingness to pay (WTP), a monetary measure of benefit, was estimated for the different attribute levels. When seeking help or treatment for flu-like symptoms, respondents most valued a pharmacy service that would improve their understanding and management of symptoms (WTP = £6.28), provided by staff who are trained (WTP (pharmacist) = £2.63: WTP(trained assistant) = £3.22), friendly and approachable (WTP = £3.38). Waiting time, pharmacy location and availability of parking also contributed to respondents' preferences. WTP for a service comprising the best possible combination of attributes and levels was calculated as £55.43. Attributes of a community pharmacy and its staff may influence people's decisions about which pharmacy they would visit to access treatment and advice for minor ailments. In line with the public's preferences, offering community pharmacy services that help people to better understand and manage symptoms, are provided promptly by trained staff who are friendly and approachable, and in a local setting with easy access to parking, has the potential to increase uptake amongst those seeking help to manage minor ailments. In this way it may be possible to shift demand away from high-cost health services and make more efficient use of scarce public resources.

Willingness to pay for health insurance in the informal sector of Sierra Leone

PubMed Central

Jofre-Bonet, Mireia; Kamara, Joseph

2018-01-01

Purpose The objective of this project is to study the willingness to pay (WTP) for health insurance (HI) of individuals working in the informal sector in Sierra Leone, using a purposely-designed survey of a representative sample of this sector. Methods We elicit the WTP using the Double-Bounded Dichotomous Choice with Follow Up method. We also examine the factors that are positively and negatively associated with the likelihood of the respondents to answer affirmatively to joining a HI scheme and to paying three different possible premiums, to join the HI scheme. We additionally analyze the individual and household characteristics associated with the maximum amount the household is willing to pay to join the HI scheme. Results The results indicate that the average WTP for the HI is 20,237.16 SLL (3.6 USD) per adult but it ranges from about 14,000 SLL (2.5 USD) to about 35,000 SLL (6.2 USD) depending on region, occupation, household and respondent characteristics. The analysis of the maximum WTP indicates that living outside the Western region and working in farming instead of petty trade are associated with a decrease in the maximum premium respondents are WTP for the HI scheme. Instead, the maximum WTP is positively associated to being a driver or a biker; having secondary or tertiary education (as opposed to not having any); the number of pregnant women in the household; having a TV; and, having paid for the last medical requirement. Conclusions In summary, the various analyses show that a premium for the HI package could be set at approximately 20,000 SLL (3.54 USD) but also that establishing a single premium for all individuals in the informal sector could be risky. The efficient functioning of a HI scheme relies on covering as much of the population as possible, in order to spread risks and make the scheme viable. The impact of the various population characteristics raises the issue of how to rate premiums. In other words, setting a premium that may be too high for a big proportion of the population could mean losing many potential enrollees and might have viability consequences for the operation of the scheme. PMID:29768409

Willingness to pay for municipality hospital services in rural Japan: a contingent valuation study

PubMed Central

2011-01-01

Background The Japanese healthcare system has undergone reforms to address the struggles that municipality hospitals face. Reform guidelines clearly define criteria for administrative improvement. However, criteria to evaluate the demand for healthcare provisions in rural Japan, including the needs of rural residents for municipality hospitals in particular have not been specified. The purpose of this paper is to measure residents' willingness to pay (WTP) for municipality hospital services using the contingent valuation method, and to evaluate municipality hospital valuation on the basis of WTP. K town, located in the Hokkaido prefecture of Japan, was selected as the location for this study. Participants were recruited by a town hall healthcare administrator, hospital and clinic staff, and a local dentist. Participants were asked what amount they would be willing to pay as taxes to continue accessing the services of the municipality hospital for one year by using open-ended questions in face-to-face interviews. Findings Forty-eight residents were initially recruited, and 40 participants were selected for the study (response rate 83%). As compared to K town's population, this data slanted toward the elderly, although there was no significant difference in frequency among the characteristics. The median WTP was estimated at 39,484 yen ($438.71), with a 95% confidence interval 27,806-55,437 yen ($308.95-615.96). Logistic regression revealed no significant factors affecting WTP. Conclusions If the total amount of residents' WTP for the municipality hospital were to be estimated by this result, it would calculate with 129,586,000 yen ($1,439,844). This is approximately equal to the amount of money to be transferred from the general account of the government of K town, more than one-half of the town tax of K town, and about two-fold in comparison to Japan as a whole. This showed that K town's residents placed a high valuation on the municipality hospital, which nearly equalled the amount that the K town government provided to the municipality hospital to cover its annual deficit. K town residents had come to expect not only general clinical practice, but also emergency medical services and night practice provided by their own town's municipality hospital. WTP can be used as a measure of hospital evaluation because it reflects the importance of the hospital to the residents in its region. PMID:21645419

Patients' willingness to pay for the treatment of tuberculosis in Nigeria: exploring own use and altruism.

PubMed

Ochonma, Ogbonnia G; Onwujekwe, Obinna E

2017-05-10

Although, current treatment services for Tuberculosis (TB) in Nigeria are provided free of charge in public facilities, the benefits (value) that patients attach to such service is not known. In addition, the prices that could be charged for treatment in case government and its partners withdraw from the provision of free services or inclusion of the services in health insurance plans are not known. Hence, there is a need to elicit the maximum amounts that patients are willing to pay for TB treatment services, both for themselves and for the very poor patients that may not be able to pay if some user fees are introduced (altruistic willingness to pay). A pretested interviewer-administered questionnaire was used to elicit the maximum willingness to pay (WTP) for TB treatment services from TB patients in a tertiary hospital in southeast Nigeria. WTP was elicited using the bidding game question format after a scenario was presented to the respondents. Data was analysed using tabulations. Tobit regression models were used to examine the validity of the elicited WTP for own use and altruistic WTP. The results show that those aged 30 years and below constituted more than two-fifth (43.2%) of the respondents. More than half of the respondents (52.8%) were not employed. 100 (80.0%) of the respondents were willing to pay for their own use of TB treatment services while 78(62.4%) of the respondents were willing to make altruistic contributions so that the very poor could benefit from the TB services. A Tobit regression analysis of maximum WTP for TB for own use shows that respondents were willing to pay maximum amounts at different statistically significant levels. The results equally show that altruistic WTP was positively and statistically significantly related to the employment status, distance from UNTH and global seriousness of TB. Most patients positively valued the provision of free TB services and were willing to pay for TB treatment for own use. The better-off ones were also willing to make altruistic contributions. Free provision of TB treatment services is potentially worthwhile, but there is potential scope for continuation of universal provision of TB treatment services, even if the government and donors scale down their financing of the services.

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

Poloski, Adam P.; Adkins, Harold E.; Abrefah, John

The WTP pipe plugging issue, as stated by the External Flowsheet Review Team (EFRT) Executive Summary, is as follows: “Piping that transports slurries will plug unless it is properly designed to minimize this risk. This design approach has not been followed consistently, which will lead to frequent shutdowns due to line plugging.” A strategy was employed to perform critical-velocity tests on several physical simulants. Critical velocity is defined as the point where a stationary bed of particles deposits on the bottom of a straight horizontal pipe during slurry transport operations. Results from the critical velocity testing provide an indication ofmore » slurry stability as a function of fluid rheological properties and transport conditions. The experimental results are compared to the WTP design guide on slurry transport velocity in an effort to confirm minimum waste velocity and flushing velocity requirements as established by calculations and critical line velocity correlations in the design guide. The major findings of this testing is discussed below. Experimental results indicate that the use of the Oroskar and Turian (1980) correlation in the design guide is conservative—Slurry viscosity has a greater affect on particles with a large surface area to mass ratio. The increased viscous forces on these particles result in a decrease in predicted critical velocities from this traditional industry derived equations that focus on particles large than 100 μm in size. Since the Hanford slurry particles generally have large surface area to mass ratios, the reliance on such equations in the Hall (2006) design guide is conservative. Additionally, the use of the 95% percentile particle size as an input to this equation is conservative. However, test results indicate that the use of an average particle density as an input to the equation is not conservative. Particle density has a large influence on the overall result returned by the correlation. Lastly, the viscosity correlation used in the WTP design guide has been shown to be inaccurate for Hanford waste feed materials. The use of the Thomas (1979) correlation in the design guide is not conservative—In cases where 100% of the particles are smaller than 74 μm or particles are considered to be homogeneous due to yield stress forces suspending the particles the homogeneous fraction of the slurry can be set to 100%. In such cases, the predicted critical velocity based on the conservative Oroskar and Turian (1980) correlation is reduced to zero and the design guide returns a value from the Thomas (1979) correlation. The measured data in this report show that the Thomas (1979) correlation predictions often fall below that measured experimental values. A non-Newtonian deposition velocity design guide should be developed for the WTP— Since the WTP design guide is limited to Newtonian fluids and the WTP expects to process large quantities of such materials, the existing design guide should be modified address such systems. A central experimental finding of this testing is that the flow velocity required to reach turbulent flow increases with slurry rheological properties due to viscous forces dampening the formation of turbulent eddies. The flow becomes dominated by viscous forces rather than turbulent eddies. Since the turbulent eddies necessary for particle transport are not present, the particles will settle when crossing this boundary called the transitional deposition boundary. This deposition mechanism should be expected and designed for in the WTP.« less

Assessing Public Preferences for Forest Biomass Based Energy in the Southern United States

NASA Astrophysics Data System (ADS)

Susaeta, Andres; Alavalapati, Janaki; Lal, Pankaj; Matta, Jagannadha R.; Mercer, Evan

2010-04-01

This article investigated public preferences for forest biomass based liquid biofuels, particularly ethanol blends of 10% ( E10) and 85% ( E85). We conducted a choice experiment study in three southern states in the United States: Arkansas, Florida, and Virginia. Reducing atmospheric CO2, decreasing risk of wildfires and pest outbreaks, and enhancing biodiversity were presented to respondents as attributes of using biofuels. Results indicated that individuals had a positive extra willingness to pay (WTP) for both ethanol blends. The extra WTP was greater for higher blends that offered larger environment benefits. The WTPs for E10 were 0.56 gallon-1, 0.58 gallon-1, and 0.48 gallon-1, and for E85 they were 0.82 gallon-1, 1.17 gallon-1, and 1.06 gallon-1 in Arkansas, Florida, and Virginia, respectively. Although differences in WTP for E10 were statistically insignificant among the three states, significant differences were found in the WTP for E85 between AR and FL and between AR and VA. Preferences for the environmental attributes appeared to be heterogeneous, as respondents’ were willing to pay a premium for E10 in all three states to facilitate the reduction of CO2 and the improvement of biodiversity but were not willing to pay more for E85 in order to enhance biodiversity.

Logit and probit model in toll sensitivity analysis of Solo-Ngawi, Kartasura-Palang Joglo segment based on Willingness to Pay (WTP)

NASA Astrophysics Data System (ADS)

Handayani, Dewi; Cahyaning Putri, Hera; Mahmudah, AMH

2017-12-01

Solo-Ngawi toll road project is part of the mega project of the Trans Java toll road development initiated by the government and is still under construction until now. PT Solo Ngawi Jaya (SNJ) as the Solo-Ngawi toll management company needs to determine the toll fare that is in accordance with the business plan. The determination of appropriate toll rates will affect progress in regional economic sustainability and decrease the traffic congestion. These policy instruments is crucial for achieving environmentally sustainable transport. Therefore, the objective of this research is to find out how the toll fare sensitivity of Solo-Ngawi toll road based on Willingness To Pay (WTP). Primary data was obtained by distributing stated preference questionnaires to four wheeled vehicle users in Kartasura-Palang Joglo artery road segment. Further data obtained will be analysed with logit and probit model. Based on the analysis, it is found that the effect of fare change on the amount of WTP on the binomial logit model is more sensitive than the probit model on the same travel conditions. The range of tariff change against values of WTP on the binomial logit model is 20% greater than the range of values in the probit model . On the other hand, the probability results of the binomial logit model and the binary probit have no significant difference (less than 1%).

Epstein-Barr virus nuclear protein 3C binds to the N-terminal (NTD) and beta trefoil domains (BTD) of RBP/CSL; Only the NTD interaction is essential for lymphoblastoid cell growth

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

Calderwood, Michael A.; Lee, Sungwook; Holthaus, Amy M.

Association of EBV nuclear proteins EBNA2, EBNA3A and EBNA3C with RBP/CSL, is essential for lymphoblastoid cell line (LCL) proliferation. Conserved residues in the EBNA3 homology domain, required for RBP/CSL interaction, lack the W{Phi}P motif that mediates EBNA2 and Notch binding to the RBP/CSL beta-trefoil domain (BTD). We map RBP/CSL interacting residues within EBNA3A(aa128-204) and EBNA3C(aa211-233). The EBNA3A results are consistent with an earlier report (aa125-222), but the EBNA3C domain is unexpectedly small and includes a 'WTP' sequence. This EBNA3C WTP motif confers RBP/CSL binding in vitro, in yeast, and in mammalian cells. Further, an EBNA3C WTP {yields} STP(W227S) mutation impairedmore » BTD binding whereas EBNA3 homology domain mutations disrupted RBP/CSL N-terminal domain (NTD) binding. WTP was not essential for EBNA3C repression of EBNA2 in reporter assays or for maintenance of LCL growth. Our results indicate that EBNA3 proteins interact with multiple RBP/CSL domains, but only NTD interactions are required for LCL growth.« less

A Comparison of Willingness to Pay to Prevent Child Maltreatment Deaths in Ecuador and the United States

PubMed Central

Corso, Phaedra S.; Ingels, Justin B.; Roldos, M. Isabel

2013-01-01

Estimating the benefits of preventing child maltreatment (CM) is essential for policy makers to determine whether there are significant returns on investment from interventions to prevent CM. The aim of this study was to estimate the benefits of preventing CM deaths in an Ecuadorian population, and to compare the results to a similar study in a US population. The study used the contingent valuation method to elicit respondents’ willingness to pay (WTP) for a 1 in 100,000 reduction in the risk of CM mortality. After adjusting for differences in purchasing power, the WTP to prevent the CM mortality risk reduction in the Ecuador population was $237 and the WTP for the same risk reduction in the US population was $175. In the pooled analysis, WTP for a reduction in CM mortality was significantly impacted by country (p = 0.03), history of CM (p = 0.007), payment mechanism (p < 0.001), confidence in response (p = 0.014), and appropriateness of the payment mechanism (p < 0.001). These findings suggest that estimating benefits from one culture may not be transferable to another, and that low- and middle-income countries, such as Ecuador, may be better served by developing their own benefits estimates for use in future benefit-cost analyses of interventions designed to prevent CM. PMID:23538730

Will Australians pay for health care advice from a community pharmacist? A video vignette study.

PubMed

Sriram, Deepa; McManus, Alexandra; Emmerton, Lynne; Jiwa, Moyez

2015-01-01

Large proportion of Australians have access to pharmacists' health advice at no cost. The impact of a proposed co-payment levy for general practitioner (GP) consultation by Australian government is unclear. This raises an interesting question about consumers' perceived value of health-related consultations. This survey of representative sample of Western Australians explores the hypothesis that Australians are willing to pay for advanced model of pharmacy consultation. Two videos illustrating current-services and quality-enhanced-service (QES) incorporating systematic assessment of symptoms and referral to GP if necessary, were used. Participants viewed videos online and completed a willingness-to-pay (WTP) questionnaire about their perception and WTP for each service. Logistic regression and McNemar tests were used to identify WTP groups. Of the 175 respondents, one in nine (19/175, 11%) were willing to pay and (35/175) 20% might consider paying for advice at pharmacies as per current-practice. Almost one in four (49/175, 28%) were willing to pay and (47/175) 27% would consider paying for QES (McNemar Test P < 0.001). The majority of West Australians may be willing to pay for consultation at pharmacies that offers more private, time-intensive experience with documented GP referral where required. Further research is warranted to test WTP with actual customers to confirm these results. Copyright © 2015 Elsevier Inc. All rights reserved.

The income elasticity of Willingness-To-Pay (WTP) revisited: A meta-analysis of studies for restoring Good Ecological Status (GES) of water bodies under the Water Framework Directive (WFD).

PubMed

Tyllianakis, Emmanouil; Skuras, Dimitris

2016-11-01

The income elasticity of Willingness-To-Pay (WTP) is ambiguous and results from meta-analyses are disparate. This may be because the environmental good or service to be valued is very broadly defined or because the income measured in individual studies suffers from extensive non-reporting or miss reporting. The present study carries out a meta-analysis of WTP to restore Good Ecological Status (GES) under the Water Framework Directive (WFD). This environmental service is narrowly defined and its aims and objectives are commonly understood among the members of the scientific community. Besides income reported by the individual studies, wealth and income indicators collected by Eurostat for the geographic entities covered by the individual studies are used. Meta-regression analyses show that income is statistically significant, explains a substantial proportion of WTP variability and its elasticity is considerable in magnitude ranging from 0.6 to almost 1.7. Results are robust to variations in the sample of the individual studies participating in the meta-analysis, the econometric approach and the function form of the meta-regression. The choice of wealth or income measure is not that important as it is whether this measure is Purchasing Power Parity (PPP) adjusted among the individual studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Fluoride tracer test for the performance analysis of a basin used as a lagooning pre-treatment facility in a WTP.

PubMed

Ruffino, Barbara

2015-07-01

The water treatment plant (WTP) of the city of Torino (NW Italy), which treats about 40 · 10(6) m(3)/year of raw water from Po river, has a 15-ha basin used as a lagooning pre-treatment facility. Since the efficiency of the lagooning process in the removal of pollutants from raw water depends on the internal hydrodynamics of the basin, the hydraulic performance of the basin was studied by combining the results of a stimulus-response tracer test with the monitoring of the tracer (fluoride) concentration throughout the basin at different times. The outcomes of the test demonstrated that the system was efficiently mixed and could be assimilated to a continuous stirred reactor presenting no flow anomalies, with an actual mean residence time (RT) of 12.7 days, compared with a nominal RT of 18 days. This assured that dissolved contaminants (such as fluoride) coming from the river were efficiently diluted before entering the WTP. The axial dispersion coefficient calculated from the RT distribution was approximately 47,300 m(2)/day. Three of the most popular formulae developed for the calculation of the axial dispersion coefficient provided results spreading over three orders of magnitude, thus showing their limitations. Finally, because of the width extent of the basin and the characteristics of its inflow, the 1-D advection-dispersion model failed in predicting the tracer concentration values in time at the outlet channel. On the contrary, the analytical solution of the 2-D advection-dispersion model proved to be suitable to fit the tracer concentration data over time at the outlet channel but it failed in describing the tracer distribution throughout the basin on the monitoring dates.

Cost-Effectiveness Analysis of Universal Influenza Vaccination: Application of Susceptible-Infectious-Complication-Recovery Model.

PubMed

Yang, Kuen-Cheh; Hung, Hui-Fang; Chen, Meng-Kan; Chen, Li-Sheng; Fann, Jean Ching-Yuan; Chiu, Sherry Yueh-Hsia; Yen, Amy-Ming Fang; Huang, Kuo-Chin; Chen, Hsiu-Hsi; Wang, Sen-Te

2018-06-12

Despite the fact that vaccination is an effective primary prevention strategy for containing influenza outbreak, health policymakers show great concern over enormous costs involved in universal immunization particularly when resources are limited. We conducted a two-arm cost-effectiveness analysis (CEA) that takes into account the aspect of herd immunity, using a study cohort that was composed of 100,000 residents with the make-up of demographic characteristics identical to those of the underlying population in Taipei County, Taiwan, during the epidemic influenza season of 2001-2002. The parameters embedded in the dynamic process of infection were estimated by the application of the newly proposed susceptible-infection-complication-recovery model to the empirical data in order to compute the number of deaths and complications averted due to universal vaccination compared to non-vaccination. Incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curve (CEAC) given maximum amount of willingness-to-pay (WTP) were calculated to delineate the results of the two-arm CEA. Incremental costs involved in the vaccinated group as opposed to the unvaccinated group was $1,195 for reducing one additional complication and $805 for averting one additional death, allowing for herd immunity. The corresponding figures were higher for the results without considering herd immunity. Given the ceiling ratio of willingness-to-pay (WTP) equal to $10,000 (approximately two-thirds of the GDP), the probability of being cost-effective for vaccination was 100% and 96.7% for averting death and complications, respectively. Universal vaccination against seasonal influenza was very cost-effective particularly when herd immunity is considered. The probability of being cost-effective was almost certain given the maximum amount of WTP within two-thirds of the GDP. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

One System Integrated Project Team: Retrieval And Delivery Of The Hanford Tank Wastes For Vitrification In The Waste Treatment Plant

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

Harp, Benton J.; Kacich, Richard M.; Skwarek, Raymond J.

The One System Integrated Project Team (IPT) was formed in late 2011 as a way for improving the efficiency of delivery and treatment of highly radioactive waste stored in underground tanks at the U.S. Department of Energy's (DOE's) 586-square-mile Hanford Site in southeastern Washington State. The purpose of the One System IPT is to improve coordination and integration between the Hanford's Waste Treatment Plant (WTP) contractor and the Tank Operations Contractor (TOC). The vision statement is: One System is a WTP and TOC safety conscious team that, through integrated management and implementation of risk-informed decision and mission-based solutions, will enablemore » the earliest start of safe and efficient treatment of Hanford's tank waste, to protect the Columbia River, environment and public. The IPT is a formal collaboration between Bechtel National, Inc. (BNI), which manages design and construction of the WTP for the U.S. Department of Energy's Office of River Protection (DOEORP), and Washington River Protection Solutions (WRPS), which manages the TOC for ORP. More than fifty-six (56) million gallons of highly radioactive liquid waste are stored in one hundred seventy-seven (177) aging, underground tanks. Most of Hanford's waste tanks - one hundred forty-nine (149) of them - are of an old single-shell tank (SST) design built between 1944 and 1964. More than sixty (60) of these tanks have leaked in the past, releasing an estimated one million gallons of waste into the soil and threatening the nearby Columbia River. There are another twenty-eight (28) new double-shelled tanks (DSTs), built from 1968 to 1986, that provide greater protection to the environment. In 1989, DOE, the U.S. Environmental Protection Agency (EPA), and the Washington State Department of Ecology (Ecology) signed a landmark agreement that required Hanford to comply with federal and state environmental standards. It also paved the way for agreements that set deadlines for retrieving the tank wastes and for building and operating the WTP. The tank wastes are the result of Hanford's nearly fifty (50) years of plutonium production. In the intervening years, waste characteristics have been increasingly better understood. However, waste characteristics that are uncertain and will remain as such represent a significant technical challenge in terms of retrieval, transport, and treatment, as well as for design and construction ofWTP. What also is clear is that the longer the waste remains in the tanks, the greater the risk to the environment and the people of the Pacific Northwest. The goal of both projects - tank operations and waste treatment - is to diminish the risks posed by the waste in the tanks at the earliest possible date. About two hundred (200) WTP and TOC employees comprise the IPT. Individual work groups within One System include Technical, Project Integration & Controls, Front-End Design & Project Definition, Commissioning, Nuclear Safety & Engineering Systems Integration, and Environmental Safety and Health and Quality Assurance (ESH&QA). Additional functions and team members will be added as the WTP approaches the operational phase. The team has undertaken several initiatives since its formation to collaborate on issues: (1) alternate scenarios for delivery of wastes from the tank farms to WTP; (2) improvements in managing Interface Control Documents; (3) coordination on various technical issues, including the Defense Nuclear Facilities Nuclear Safety Board's Recommendation 2010-2; (4) deployment of the SmartPlant Foundation-configuration Management System; and (5) preparation of the joint contract deliverable of the Operational Readiness Support Plan.« less

Enhancement of seasonal prediction of East Asian summer rainfall related to western tropical Pacific convection

NASA Astrophysics Data System (ADS)

Lee, Doo Young; Ahn, Joong-Bae; Yoo, Jin-Ho

2015-08-01

The prediction skills of climate model simulations in the western tropical Pacific (WTP) and East Asian region are assessed using the retrospective forecasts of seven state-of-the-art coupled models and their multi-model ensemble (MME) for boreal summers (June-August) during the period 1983-2005, along with corresponding observed and reanalyzed data. The prediction of summer rainfall anomalies in East Asia is difficult, while the WTP has a strong correlation between model prediction and observation. We focus on developing a new approach to further enhance the seasonal prediction skill for summer rainfall in East Asia and investigate the influence of convective activity in the WTP on East Asian summer rainfall. By analyzing the characteristics of the WTP convection, two distinct patterns associated with El Niño-Southern Oscillation developing and decaying modes are identified. Based on the multiple linear regression method, the East Asia Rainfall Index (EARI) is developed by using the interannual variability of the normalized Maritime continent-WTP Indices (MPIs), as potentially useful predictors for rainfall prediction over East Asia, obtained from the above two main patterns. For East Asian summer rainfall, the EARI has superior performance to the East Asia summer monsoon index or each MPI. Therefore, the regressed rainfall from EARI also shows a strong relationship with the observed East Asian summer rainfall pattern. In addition, we evaluate the prediction skill of the East Asia reconstructed rainfall obtained by hybrid dynamical-statistical approach using the cross-validated EARI from the individual models and their MME. The results show that the rainfalls reconstructed from simulations capture the general features of observed precipitation in East Asia quite well. This study convincingly demonstrates that rainfall prediction skill is considerably improved by using a hybrid dynamical-statistical approach compared to the dynamical forecast alone.

Seasonal prediction of East Asian summer rainfall using a multi-model ensemble system

NASA Astrophysics Data System (ADS)

Ahn, Joong-Bae; Lee, Doo-Young; Yoo, Jin‑Ho

2015-04-01

Using the retrospective forecasts of seven state-of-the-art coupled models and their multi-model ensemble (MME) for boreal summers, the prediction skills of climate models in the western tropical Pacific (WTP) and East Asian region are assessed. The prediction of summer rainfall anomalies in East Asia is difficult, while the WTP has a strong correlation between model prediction and observation. We focus on developing a new approach to further enhance the seasonal prediction skill for summer rainfall in East Asia and investigate the influence of convective activity in the WTP on East Asian summer rainfall. By analyzing the characteristics of the WTP convection, two distinct patterns associated with El Niño-Southern Oscillation developing and decaying modes are identified. Based on the multiple linear regression method, the East Asia Rainfall Index (EARI) is developed by using the interannual variability of the normalized Maritime continent-WTP Indices (MPIs), as potentially useful predictors for rainfall prediction over East Asia, obtained from the above two main patterns. For East Asian summer rainfall, the EARI has superior performance to the East Asia summer monsoon index or each MPI. Therefore, the regressed rainfall from EARI also shows a strong relationship with the observed East Asian summer rainfall pattern. In addition, we evaluate the prediction skill of the East Asia reconstructed rainfall obtained by hybrid dynamical-statistical approach using the cross-validated EARI from the individual models and their MME. The results show that the rainfalls reconstructed from simulations capture the general features of observed precipitation in East Asia quite well. This study convincingly demonstrates that rainfall prediction skill is considerably improved by using a hybrid dynamical-statistical approach compared to the dynamical forecast alone. Acknowledgements This work was carried out with the support of Rural Development Administration Cooperative Research Program for Agriculture Science and Technology Development under grant project PJ009353 and Korea Meteorological Administration Research and Development Program under grant CATER 2012-3100, Republic of Korea.

The Onset of a Novel Environmental Offset: A case study for diverse pollutant scheme in Australia.

NASA Astrophysics Data System (ADS)

Sengupta, A.; Arora, M.; Delbridge, N.; Pettigrove, V.; Feldman, D.

2014-12-01

Environmental offset schemes employ a crediting system to mitigate the impacts of pollutants. In this talk, we present a novel trade-off concept comparing diverse groups of pollutants: environmental flows, micropollutants (heavy metals, pesticides, estrogen compounds) and nutrients in a test watershed (Jacksons Creek), in the vicinity of Melbourne. A reservoir in the upper watershed, and a wastewater treatment plant (WTP) are the main sources of flow into Jacksons Creek. The current land use is a mix of agriculture, and rural, though rapid urbanization is anticipated with a 40% increase in the population by 2040. The creek is impacted by: 1) low flow, especially during dry periods (contribution from the reservoir drops dramatically), 2) nutrient enrichment (WTP and agricultural runoff), and 3) micropollutants-heavy metals (urban runoff), estrogenic compounds (WTP), and pesticides (agricultural runoff). In this offset framework, we evaluated current and future scenarios to identify the main stressor in Jacksons Creek. We collected monitoring data at 15 sites for separate 3 events. Then we developed a watershed model to assess sources of pollutant loads to the creek, using two different tools, Model for Urban Stormwater Improvement Conceptualisation (MUSIC) for the preliminary flow and water quality modeling, and eWater Source for integrated water resource management (IWRM), and a decision support system for stakeholders. Scenario analysis includes urbanization and population growth, and anticipated discharges from WTP and the reservoir. Measured nutrient concentrations were high for all sampling events. Micropollutants were detected at a concentration higher than the trigger value at several locations. Preliminary analysis shows that low flow is one of the major stressors in the creek causing elevated micropollutant and nutrient concentrations (non-point), and that discharge from the WTP is essential to maintain the minimum environmental flows, though nutrient enrichment downstream could occur. This study demonstrates an innovative case for evaluating net environmental benefits, and might hold important lessons for the design of offset schemes in comparable environments elsewhere.

Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono district, Uganda

PubMed Central

Hansen, Kristian Schultz; Pedrazzoli, Debora; Mbonye, Anthony; Clarke, Sian; Cundill, Bonnie; Magnussen, Pascal; Yeung, Shunmay

2013-01-01

In Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures. PMID:22589226

Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono District, Uganda.

PubMed

Hansen, Kristian Schultz; Pedrazzoli, Debora; Mbonye, Anthony; Clarke, Sian; Cundill, Bonnie; Magnussen, Pascal; Yeung, Shunmay

2013-03-01

In Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures.

Down-regulation of MutS homolog 3 by hypoxia in human colorectal cancer

PubMed Central

Li, Jie; Koike, Junichi; Kugoh, Hiroyuki; Arita, Michitsune; Ohhira, Takahito; Kikuchi, Yoshinori; Funahashi, Kimihiko; Takamatsu, Ken; Boland, C. Richard; Koi, Minoru; Hemmi, Hiromichi

2013-01-01

Down-regulation of hMSH3 is associated with elevated microsatellite alterations at selected tetranucleotide repeats and low levels of microsatellite instability in colorectal cancer (CRC). However, the mechanism that down-regulates hMSH3 in CRC is not known. In this study, a significant association between over-expression of glucose transporter 1, a marker for hypoxia, and down-regulation of hMSH3 in CRC tissues was observed. Therefore, we examined the effect of hypoxia on the expression of hMSH3 in human cell lines. When cells with wild type p53 (wt-p53) were exposed to hypoxia, rapid down-regulation of both hMSH2 and hMSH3 occurred. In contrast, when null or mutated p53 (null/mut-p53) cells were exposed to hypoxia, only hMSH3 was down-regulated, and at slower rate than wt-p53 cells. Using a reporter assay, we found that disruption of the two putative hypoxia response elements (HREs) located within the promoter region of the hMSH3 abrogated the suppressive effect of hypoxia on reporter activity regardless of p53 status. In an EMSA, two different forms of HIF-1α complexes that specifically bind to these HREs were detected. A larger complex containing HIF-1α predominantly bound to the HREs in hypoxic null/mut-p53 cells whereas a smaller complex predominated in wt-p53 cells. Finally, HIF-1α knockdown by siRNA significantly inhibited down-regulation of hMSH3 by hypoxia in both wt-p53 and mut-p53 cells. Taken together, our results suggest that the binding of HIF-1α complexes to HRE sites is necessary for down-regulation of hMSH3 in both wt-p53 and mut-p53 cells. PMID:22343000

People's willingness to pay for health insurance in rural Vietnam.

PubMed

Lofgren, Curt; Thanh, Nguyen X; Chuc, Nguyen Tk; Emmelin, Anders; Lindholm, Lars

2008-08-11

The inequity caused by health financing in Vietnam, which mainly relies on out-of-pocket payments, has put pre-payment reform high on the political agenda. This paper reports on a study of the willingness to pay for health insurance among a rural population in northern Vietnam, exploring whether the Vietnamese are willing to pay enough to sufficiently finance a health insurance system. Using the Epidemiological Field Laboratory for Health Systems Research in the Bavi district (FilaBavi), 2070 households were randomly selected for the study. Existing FilaBavi interviewers were trained especially for this study. The interview questionnaire was developed through a pilot study followed by focus group discussions among interviewers. Determinants of households' willingness to pay were studied through interval regression by which problems such as zero answers, skewness, outliers and the heaping effect may be solved. Households' average willingness to pay (WTP) is higher than their costs for public health care and self-treatment. For 70-80% of the respondents, average WTP is also sufficient to pay the lower range of premiums in existing health insurance programmes. However, the average WTP would only be sufficient to finance about half of total household public, as well as private, health care costs. Variables that reflect income, health care need, age and educational level were significant determinants of households' willingness to pay. Contrary to expectations, age was negatively related to willingness to pay. Since WTP is sufficient to cover household costs for public health care, it depends to what extent households would substitute private for public care and increase utilization as to whether WTP would also be sufficient enough to finance health insurance. This study highlights potential for public information schemes that may change the negative attitude towards health insurance, which this study has uncovered. A key task for policy makers is to win the trust of the population in relation to a health insurance system, particularly among the old and those with relatively low education.

A systematic review assessing the economic impact of sildenafil citrate (Viagra) in the treatment of erectile dysfunction.

PubMed

Martin, Amber L; Huelin, Rachel; Wilson, David; Foster, Talia S; Mould, Joaquin F

2013-05-01

Sildenafil was the first oral phosphodiesterase type 5 (PDE5) inhibitor introduced as primary therapy for erectile dysfunction (ED). In the 7 years following its market launch, sildenafil was prescribed by more than 750,000 physicians to more than 23 million men worldwide. To date, few studies have evaluated the economic impact of sildenafil in treating ED. To evaluate the cost-effectiveness and impact of sildenafil on health care costs for patients with ED in multiple countries. Economic outcomes including cost, cost-effectiveness, cost of illness, cost consequence, resource use, productivity, work loss, and willingness to pay (WTP) were investigated. Using keywords related to economic outcomes and sildenafil, we systematically searched literature published between July 2001 and July 2011 using MEDLINE and EMBASE. Included articles pertained to costs, WTP, and economic evaluations. In the last 10 years, 12 studies assessed economic outcomes associated with sildenafil for ED. Most studies were conducted in the United States and the United Kingdom, with one study identified in Canada and one from Mexico. Six studies evaluated cost of illness, cost consequence, or cost of care, and four studies evaluated WTP or drug pricing by country in the United States and the United Kingdom. In the United States and the United Kingdom, costs to health care systems have increased with demand for treatment. Cost analyses suggested that sildenafil would lower direct costs compared with other PDE5 inhibitors. U.S. and U.K. studies found that patients exhibited WTP for sildenafil. The two cost-effectiveness models we identified examined ED sub-groups, those with spinal cord injury and those with diabetes or hypertension. These models indicated favorable cost-effectiveness profiles for sildenafil compared with other active-treatment options in both Mexico and Canada. The relative value of sildenafil vs. surgically implanted prosthetic devices and other PDE5 inhibitors, is underscored by patients' WTP, and cost-effectiveness in ED patients with comorbidities. © 2013 International Society for Sexual Medicine.

The value of informal care in the context of option B+ in Malawi: a contingent valuation approach.

PubMed

Chiwaula, Levison Stanely; Chirwa, Gowokani Chijere; Cataldo, Fabian; Kapito-Tembo, Atupele; Hosseinipour, Mina C; van Lettow, Monique; Tweya, Hannock; Kayoyo, Virginia; Khangamwa-Kaunda, Blessings; Kasende, Florence; Trapence, Clement; Gugsa, Salem; Rosenberg, Nora E; Eliya, Michael; Phiri, Sam

2016-04-19

Informal care, the health care provided by the patient's social network is important in low income settings although its monetary value is rarely estimated. The lack of estimates of the value of informal care has led to its omission in economic evaluations but this can result in incorrect decisions about cost effectiveness of an intervention. We explore the use of contingent valuation methods of willingness to pay (WTP) and willingness to accept (WTA) to estimate the value of informal care provided to HIV infected women that are accessing antiretroviral therapy (ART) under the Option B+ approach to prevention of mother-to-child transmission (PMTCT) of HIV in Malawi. We collected cross sectional data from 93 caregivers of women that received ART care from six health facilities in Malawi. Caregivers of women that reported for ART care on the survey day and consented to participate in the survey were included until the targeted sample size for the facility was reached. We estimated the value of informal care by using the willingness to accept (WTA) and willingness to pay (WTP) approaches. Medians were used to summarize the values and these were compared by the Wilcoxon signed-rank test. The median WTA to provide informal care in a month was US$30 and the median WTP for informal care was US$13 and the two were statistically different (p < 0.000). Median WTP was higher in the urban areas than in the rural areas (US$21 vs. US$13, p < 0.001) and for caregivers from households from higher wealth quintile than in the lower quintile (US$15 vs. US$13, p < 0.0462). Informal caregivers place substantial value on informal care giving. In low income settings where most caregivers are not formally employed, WTP and WTA approaches can be used to value informal care. NCT02005835.

Farmers' willingness to pay for less health risks by pesticide use: A case study from the cotton belt of Punjab, Pakistan.

PubMed

Khan, Muhammad; Damalas, Christos A

2015-10-15

The amount of pesticides used in crop production in Pakistan has increased rapidly in the last decades, whereas farmers in many areas of the country show little knowledge of safe and efficient use of pesticides. The level of willingness to pay (WTP) for avoiding health risks by pesticides was studied among 318 randomly selected cotton farmers from two districts of the area of Punjab (i.e., Vehari and Lodhran) in Pakistan, using the contingent valuation method. Most farmers felt that pesticide use is a prerequisite for successful cotton production, whereas at the same time they were well aware of pesticide health risks, which they considered minor. The majority of the farmers (77%) showed varying levels of WTP some fee up to 20% of the current pesticide expenditures for avoiding pesticide health risks, but few were willing to pay a fee over 20%. The mean WTP per farmer was low, reaching 5.8 $US on an annual basis. By contrast, a considerable proportion of the farmers (23%) were not willing to pay any fee for avoiding pesticide health risks. These individuals were mostly poor small-scale farmers with limited or no education. High levels of risk perception about pesticides, past experience of pesticide intoxication, high levels of education, and high income were associated with high farmers' WTP for less health risks by pesticides. Farmers who perceived major health risks by pesticides appeared to be highly willing to pay a premium for safe pesticides. Elderly farmers appeared more likely to pay some premium for safe pesticides as a result of higher farming experience and higher income than young farmers. Well-educated farmers were more likely to pay a high premium for safe pesticides. Large farm size was a significant predictor of positive WTP, which was interpreted as an indicator of farmers' wealth. Copyright © 2015 Elsevier B.V. All rights reserved.

Willingness to pay for physician services at a primary contact in Ukraine: results of a contingent valuation study

PubMed Central

2013-01-01

Background The existence of quasi-formal and informal payments in the Ukrainian health care system jeopardizes equity and creates barriers to access to proper care. Patient payment policies that better match patient preferences are necessary. We analyze the potential and feasibility of official patient charges for public health care services in Ukraine by studying the patterns of fee acceptability, ability and willingness to pay (WTP) for public health care among population groups. Methods We use contingent valuation data collected from 303 respondents representative of the adult Ukrainian population. Three decision points were separated: objection to pay, inability to pay, and level of positive non-zero WTP. These decisions were studied for relations with quality profiles of the services, and socio-demographic characteristics of the respondents and their households. Results The likelihood to object to pay is mostly determined by the quality characteristics of the services. Objection to pay is not related to corresponding behavior in real life. The likelihood of being unable to pay is associated with older age, lower income, and a larger share of household members with no income. The level of positive WTP is positively related to income (+7% per 1000 UAH increase in income) and is lower for people who visited a doctor but did not pay (−22%). Conclusions Rather substantial WTP levels (between 0.9% and 1.9% of household income) for one visit to physician indicate a potential for official patient charges in Ukraine. User fees may cover a substantial share of personnel cost in the out-patient sector. The patterns of inability to pay support well designed exemption criteria based on age, income, and other aspects of economic status. The WTP patterns highlight the necessity for payments that are proportional to income. Other methodological and policy implications are discussed. PMID:23758839

Protecting Lake Ontario - Treating Wastewater from the Remediated Low-Level Radioactive Waste Management Facility - 13227

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

Freihammer, Till; Chaput, Barb; Vandergaast, Gary

2013-07-01

The Port Granby Project is part of the larger Port Hope Area Initiative, a community-based program for the development and implementation of a safe, local, long-term management solution for historic low level radioactive waste (LLRW) and marginally contaminated soils (MCS). The Port Granby Project involves the relocation and remediation of up to 0.45 million cubic metres of such waste from the current Port Granby Waste Management Facility located in the Municipality of Clarington, Ontario, adjacent to the shoreline of Lake Ontario. The waste material will be transferred to a new suitably engineered Long-Term Waste Management Facility (LTWMF) to be locatedmore » inland approximately 700 m from the existing site. The development of the LTWMF will include construction and commissioning of a new Wastewater Treatment Plant (WWTP) designed to treat wastewater consisting of contaminated surface run off and leachate generated during the site remediation process at the Port Granby Waste Management Facility as well as long-term leachate generated at the new LTWMF. Numerous factors will influence the variable wastewater flow rates and influent loads to the new WWTP during remediation. The treatment processes will be comprised of equalization to minimize impacts from hydraulic peaks, fine screening, membrane bioreactor technology, and reverse osmosis. The residuals treatment will comprise of lime precipitation, thickening, dewatering, evaporation and drying. The distribution of the concentration of uranium and radium - 226 over the various process streams in the WWTP was estimated. This information was used to assess potential worker exposure to radioactivity in the various process areas. A mass balance approach was used to assess the distribution of uranium and radium - 226, by applying individual contaminant removal rates for each process element of the WTP, based on pilot scale results and experience-based assumptions. The mass balance calculations were repeated for various flow and load scenarios. (authors)« less

FINAL REPORT SUMMARY OF DM 1200 OPERATION AT VSL VSL-06R6710-2 REV 0 9/7/06

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

KRUGER AA; MATLACK KS; DIENER G

2011-12-29

The principal objective of this report was to summarize the testing experience on the DuraMelter 1200 (DMI200), which is the High Level Waste (HLW) Pilot Melter located at the Vitreous State Laboratory (VSL). Further objectives were to provide descriptions of the history of all modifications and maintenance, methods of operation, problems and unit failures, and melter emissions and performance while processing a variety of simulated HL W and low activity waste (LAW) feeds for the Hanford Waste Treatment and Immobilization Plant (WTP) and employing a variety of operating methods. All of these objectives were met. The River Protection Project -more » Hanford Waste Treatment and Immobilization Plant (RPP-WTP) Project has undertaken a 'tiered' approach to vitrification development testing involving computer-based glass formulation, glass property-composition models, crucible melts, and continuous melter tests of increasing, more realistic scales. Melter systems ranging from 0.02 to 1.2 m{sup 2} installed at the Vitreous State Laboratory (VSL) have been used for this purpose, which, in combination with the 3.3 m{sup 2} low activity waste (LAW) Pilot Melter at Duratek, Inc., span more than two orders of magnitude in melt surface area. In this way, less-costly small-scale tests can be used to define the most appropriate tests to be conducted at the larger scales in order to extract maximum benefit from the large-scale tests. For high level waste (HLW) vitrification development, a key component in this approach is the one-third scale DuraMelter 1200 (DM 1200), which is the HLW Pilot Melter that has been installed at VSL with an integrated prototypical off-gas treatment system. That system replaced the DM1000 system that was used for HLW throughput testing during Part B1. Both melters have similar melt surface areas (1.2 m{sup 2}) but the DM1200 is prototypical of the present RPP-WTP HLW melter design whereas the DM1000 was not. In particular, the DM1200 provides for testing on a vitrification system with the specific train of unit operations that has been selected for both HLW and LAW RPP-WTP off-gas treatment.« less

Willingness to Pay for Mosquito Control in Key West, Florida and Tucson, Arizona.

PubMed

Dickinson, Katherine L; Hayden, Mary H; Haenchen, Steven; Monaghan, Andrew J; Walker, Kathleen R; Ernst, Kacey C

2016-04-01

Mosquito-borne illnesses like West Nile virus (WNV) and dengue are growing threats to the United States. Proactive mosquito control is one strategy to reduce the risk of disease transmission. In 2012, we measured the public's willingness to pay (WTP) for increased mosquito control in two cities: Key West, FL, where there have been recent dengue outbreaks, and Tucson, AZ, where dengue vectors are established and WNV has been circulating for over a decade. Nearly three quarters of respondents in both cities (74% in Tucson and 73% in Key West) would be willing to pay $25 or more annually toward an increase in publicly funded mosquito control efforts. WTP was positively associated with income (both cities), education (Key West), and perceived mosquito abundance (Tucson). Concerns about environmental impacts of mosquito control were associated with lower WTP in Key West. Expanded mosquito control efforts should incorporate public opinion as they respond to evolving disease risks. © The American Society of Tropical Medicine and Hygiene.

Reimagining cost recovery in Pakistan's irrigation system through willingness-to-pay estimates for irrigation water from a discrete choice experiment

NASA Astrophysics Data System (ADS)

Bell, Andrew Reid; Shah, M. Azeem Ali; Ward, Patrick S.

2014-08-01

It is widely argued that farmers are unwilling to pay adequate fees for surface water irrigation to recover the costs associated with maintenance and improvement of delivery systems. In this paper, we use a discrete choice experiment to study farmer preferences for irrigation characteristics along two branch canals in Punjab Province in eastern Pakistan. We find that farmers are generally willing to pay well in excess of current surface water irrigation costs for increased surface water reliability and that the amount that farmers are willing to pay is an increasing function of their existing surface water supply as well as location along the main canal branch. This explicit translation of implicit willingness-to-pay (WTP) for water (via expenditure on groundwater pumping) to WTP for reliable surface water demonstrates the potential for greatly enhanced cost recovery in the Indus Basin Irrigation System via appropriate setting of water user fees, driven by the higher WTP of those currently receiving reliable supplies.

Reimagining cost recovery in Pakistan's irrigation system through willingness-to-pay estimates for irrigation water from a discrete choice experiment

PubMed Central

Bell, Andrew Reid; Shah, M Azeem Ali; Ward, Patrick S

2014-01-01

It is widely argued that farmers are unwilling to pay adequate fees for surface water irrigation to recover the costs associated with maintenance and improvement of delivery systems. In this paper, we use a discrete choice experiment to study farmer preferences for irrigation characteristics along two branch canals in Punjab Province in eastern Pakistan. We find that farmers are generally willing to pay well in excess of current surface water irrigation costs for increased surface water reliability and that the amount that farmers are willing to pay is an increasing function of their existing surface water supply as well as location along the main canal branch. This explicit translation of implicit willingness-to-pay (WTP) for water (via expenditure on groundwater pumping) to WTP for reliable surface water demonstrates the potential for greatly enhanced cost recovery in the Indus Basin Irrigation System via appropriate setting of water user fees, driven by the higher WTP of those currently receiving reliable supplies. PMID:25552779

An exploration of older Hong Kong residents' willingness to make copayments toward vouchers for community care.

PubMed

Fu, Yuan Yuan; Chui, Ernest Wing-Tak; Law, Chi Kin; Zhao, XinYi; Lou, Vivian W Q

2018-05-10

Because of its rapidly aging population, Hong Kong faces great challenges in the provision and financing of long-term care (LTC) and needs to explore sustainable funding mechanisms. However, there is a paucity of research on older people's willingness to pay (WTP) for LTC services in Hong Kong. This study utilizes data collected in Hong Kong in 2011 (N = 536) to investigate older people's receptivity to this financing mode by assessing their co-payments for a community care service voucher scheme and then testing how potential factors affect respondents' amount of co-payment. Results show that respondents' WTP was positively associated with family financial support, financial condition, and positive attitudes toward this novel policy and negatively associated with family caregiving support. Direct and moderating effects of family financial support on WTP were found. The policy-related implications of LTC financing to improve older people's acceptance of co-payment mechanisms, financial condition, and shared responsibility of care are discussed.

Recreational benefits of urban forests: explaining visitors' willingness to pay in the context of the theory of planned behavior.

PubMed

Bernath, Katrin; Roschewitz, Anna

2008-11-01

The extension of contingent valuation models with an attitude-behavior based framework has been proposed in order to improve the descriptive and predictive ability of the models. This study examines the potential of the theory of planned behavior to explain willingness to pay (WTP) in a contingent valuation survey of the recreational benefits of the Zurich city forests. Two aspects of WTP responses, protest votes and bid levels, were analyzed separately. In both steps, models with and without the psychological predictors proposed by the theory of planned behavior were compared. Whereas the inclusion of the psychological predictors significantly improved explanations of protest votes, their ability to improve the performance of the model explaining bid levels was limited. The results indicate that the interpretation of bid levels as behavioral intention may not be appropriate and that the potential of the theory of planned behavior to improve contingent valuation models depends on which aspect of WTP responses is examined.

Financing marine protected areas through visitor fees: insights from tourists willingness to pay in Chile.

PubMed

Gelcich, Stefan; Amar, Francisca; Valdebenito, Abel; Castilla, Juan Carlos; Fernandez, Miriam; Godoy, Cecilia; Biggs, Duan

2013-12-01

Tourism is a financing mechanism considered by many donor-funded marine conservation initiatives. Here we assess the potential role of visitor entry fees, in generating the necessary revenue to manage a marine protected area (MPA), established through a Global Environmental Facility Grant, in a temperate region of Chile. We assess tourists' willingness to pay (WTP) for an entry fee associated to management and protection of the MPA. Results show 97 % of respondents were willing to pay an entrance fee. WTP predictors included the type of tourist, tourists' sensitivity to crowding, education, and understanding of ecological benefits of the MPA. Nature-based tourists state median WTP values of US$ 4.38 and Sun-sea-sand tourists US$ 3.77. Overall, entry fees could account for 10-13 % of MPA running costs. In Chile, where funding for conservation runs among the weakest in the world, visitor entry fees are no panacea in the short term and other mechanisms, including direct state/government support, should be considered.

Patients' willingness to pay for electronic communication with their general practitioner.

PubMed

Bergmo, Trine Strand; Wangberg, Silje Camilla

2007-06-01

Despite the common use of electronic communication in other aspects of everyday life, its use between patients and health care providers has been slow to diffuse. Possible explanations are security issues and lack of payment mechanisms. This study investigated how patients value secure electronic access to their general practitioner (GP). One hundred and ninety-nine patients were asked an open-ended willingness-to-pay (WTP) question as part of a randomised controlled trial. We compared the WTP values between two groups of respondents; one group had had the opportunity to communicate electronically with their GP for a year and the other group had not. Fifty-two percent of the total sample was willing to pay for electronic GP contact. The group of patients with access revealed a significantly lower WTP than the group without such access. Possible explanations are that the system had fewer benefits than expected, a presence of hypothetical bias or simply a preference for face-to-face encounters.

[Smoking cessation interventions in Mexico: analysis of the willingness to pay for an effective method to quit].

PubMed

Serván-Mori, Edson E; Heredia-Pi, Ileana B; Reynales-Shigematsu, Luz Myriam; Bautista-Arredondo, Sergio

2012-06-01

To identify environmental, demographic and socioeconomic factors associated with the desire to quit, estimate the willingness to pay (WTP) for smoking cessation treatments (SCT) and to identify associated factors with this valuation. Using the Global Adult Tobacco Survey, Mexico 2009, we characterized 1 626 smokers. Logistic and multiple lineal regression models allowed to identify associated factors with the desire to quit and the WTP for SCT. 82.2 % of the current smokers who did not want to quit were men. Between those who wanted to quit, 49.8 % had been consuming tobacco every day, for more than 16 years, 57 % had made cessation attempts in the past, and around 10% knew about the existence of centers to help quit smoking. Average WTP was 2 708 Mexican pesos (MXP), with differences by educational and socioeconomic levels. This evidence supports policymakers in the design of smoking cessation interventions improving national health system interventions for quit smoking.

The neural correlates of endowment effect without economic transaction.

PubMed

Votinov, Mikhail; Mima, Tatsuya; Aso, Toshihiko; Abe, Mitsunari; Sawamoto, Nobukatsu; Shinozaki, Jun; Fukuyama, Hidenao

2010-09-01

People always concern about what they have and what they might lose even it is just imaginary property. According to Prospect Theory, the losses might be weighted by subjects higher than gain, which would cause the disparity between the willingness to accept (WTA) and willingness to pay (WTP) compensation in economic valuation. Using functional MRI, we investigated neural correlates of this inconsistent value estimation, known as the endowment effect, during a simple pricing task without economic transaction. Brain activation associated with this price discrepancy was observed in the right inferior frontal gyrus (IFG), where voxel-based morphometry of MRI revealed the positive correlation between gray matter concentration and WTA/WTP ratio. These findings suggest the functional relevance of IFG in WTA/WTP discrepancy for pricing without any actual gain and loss, where an integration of loss aversion-related signals from insula and expected value signals may occur. 2010 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

Resident Motivations and Willingness-to-Pay for Urban Biodiversity Conservation in Guangzhou (China)

NASA Astrophysics Data System (ADS)

Chen, Wendy Y.; Jim, C. Y.

2010-05-01

The monetary assessment of biodiversity measures the welfare damages brought by biodiversity losses and the cost-benefit analysis of conservation projects in a socio-economic context. The contingent valuation method could include motivational factors to strengthen economic analysis of nature conservation. This study analyzed Guangzhou residents’ motivations and willingness-to-pay (WTP) for an urban biodiversity conservation program in the National Baiyun Mountain Scenic Area (BMSA). The peri-urban natural site, offering refuge to some endemic species, is under increasing development pressures for recreational and residential use. A questionnaire survey was conducted in the Guangzhou metropolitan area during June to October 2007. We interviewed face-to-face 720 stratified sampled households to probe residents’ attitudes towards the city’s environmental issues, motivations for urban nature conservation, and WTP for biodiversity conservation. Principal component analysis identified five motivational factors, including environmental benefit, ecological diversity, nature-culture interaction, landscape-recreation function, and intergenerational sustainability, which illustrated the general economic values of urban nature. Logistic regression was applied to predict the probability of people being willing to pay for the urban biodiversity conservation in BMSA. The significant predictors of WTP included household income and the factor nature-culture interaction. The median WTP estimated RMB149/household (about US19.5/household) per year and an aggregate of RMB291 million (approximately US38.2 million) annually to support the urban conservation project. Including public motivations into contingent valuation presents a promising approach to conduct cost-benefit analysis of public projects in China.

Physician and patient willingness to pay for electronic cardiovascular disease management.

PubMed

Deal, Ken; Keshavjee, Karim; Troyan, Sue; Kyba, Robert; Holbrook, Anne Marie

2014-07-01

Cardiovascular disease (CVD) is an important target for electronic decision support. We examined the potential sustainability of an electronic CVD management program using a discrete choice experiment (DCE). Our objective was to estimate physician and patient willingness-to-pay (WTP) for the current and enhanced programs. Focus groups, expert input and literature searches decided the attributes to be evaluated for the physician and patient DCEs, which were carried out using a Web-based program. Hierarchical Bayes analysis estimated preference coefficients for each respondent and latent class analysis segmented each sample. Simulations were used to estimate WTP for each of the attributes individually and for an enhanced vascular management system. 144 participants (70 physicians, 74 patients) completed the DCE. Overall, access speed to updated records and monthly payments for a nurse coordinator were the main determinants of physician choices. Two distinctly different segments of physicians were identified - one very sensitive to monthly subscription fee and speed of updating the tracker with new patient data and the other very sensitive to the monthly cost of the nurse coordinator and government billing incentives. Patient choices were most significantly influenced by the yearly subscription cost. The estimated physician WTP was slightly above the estimated threshold for sustainability while the patient WTP was below. Current willingness to pay for electronic cardiovascular disease management should encourage innovation to provide economies of scale in program development, delivery and maintenance to meet sustainability thresholds. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Managing poorly performing clinicians: health care providers' willingness to pay for independent help.

PubMed

Watson, Verity; Sussex, Jon; Ryan, Mandy; Tetteh, Ebenezer

2012-03-01

To determine the willingness to pay (WTP) of senior managers in the UK National Health Service (NHS) for services to help manage performance concerns with doctors, dentists and pharmacists. A discrete choice experiment (DCE) was used to elicit senior managers' preferences for a support service to help manage clinical performance concerns. The DCE was based on: a literature review; interviews with support service providers and clinical professional bodies; and discussion groups with managers. From the DCE responses, we estimate marginal WTP for aspects of support services. 451 NHS managers completed the DCE questionnaire. NHS managers are willing to pay for: advice, 'facilitation', and behavioural, health, clinical and organisational assessments. Telephone advice with written confirmation was valued most highly. NHS managers were willing to pay £161.56 (CI: £160.81-£162.32) per year per whole time equivalent doctor, dentist or pharmacist, for support to help manage clinical performance concerns. Marginal WTP varied across respondent subgroups but was always positive. Health care managers valued help in managing the clinicians' performance, and were willing to pay for it from their organisations' limited funds. Their WTP exceeds the current cost of a UK body providing similar support. Establishing a central body to provide such services across a health care system, with the associated economies of scale including cumulative experience, is an option that policy makers should consider seriously. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Valuing the benefits of genetic testing for retinitis pigmentosa: a pilot application of the contingent valuation method.

PubMed

Eden, Martin; Payne, Katherine; Combs, Ryan M; Hall, Georgina; McAllister, Marion; Black, Graeme C M

2013-08-01

Technological advances present an opportunity for more people with, or at risk of, developing retinitis pigmentosa (RP) to be offered genetic testing. Valuation of these tests using current evaluative frameworks is problematic since benefits may be derived from diagnostic information rather than improvements in health. This pilot study aimed to explore if contingent valuation method (CVM) can be used to value the benefits of genetic testing for RP. CVM was used to elicit willingness-to-pay (WTP) values for (1) genetic counselling and (2) genetic counselling with genetic testing. Telephone and face-to-face interviews with a purposive sample of individuals with (n=25), and without (n=27), prior experience of RP were used to explore the feasibility and validity of CVM in this context. Faced with a hypothetical scenario, the majority of participants stated that they would seek genetic counselling and testing in the context of RP. Between participant groups, respondents offered similar justifications for stated WTP values. Overall stated WTP was higher for genetic counselling plus testing (median=£524.00) compared with counselling alone (median=£224.50). Between-group differences in stated WTP were statistically significant; participants with prior knowledge of the condition were willing to pay more for genetic ophthalmology services. Participants were able to attach a monetary value to the perceived potential benefit that genetic testing offered regardless of prior experience of the condition. This exploratory work represents an important step towards evaluating these services using formal cost-benefit analysis.

Estimating the cost of referral and willingness to pay for referral to higher-level health facilities: a case series study from an integrated community case management programme in Uganda.

PubMed

Nanyonjo, Agnes; Bagorogoza, Benson; Kasteng, Frida; Ayebale, Godfrey; Makumbi, Fredrick; Tomson, Göran; Källander, Karin

2015-08-28

Integrated community case management (iCCM) relies on community health workers (CHWs) managing children with malaria, pneumonia, diarrhoea, and referring children when management is not possible. This study sought to establish the cost per sick child referred to seek care from a higher-level health facility by a CHW and to estimate caregivers' willingness to pay (WTP) for referral. Caregivers of 203 randomly selected children referred to higher-level health facilities by CHWs were interviewed in four Midwestern Uganda districts. Questionnaires and document reviews were used to capture direct, indirect and opportunity costs incurred by caregivers, CHWs and health facilities managing referred children. WTP for referral was assessed through the 'bidding game' approach followed by an open-ended question on maximum WTP. Descriptive analysis was conducted for factors associated with referral completion and WTP using logistic and linear regression methods, respectively. The cost per case referred to higher-level health facilities was computed from a societal perspective. Reasons for referral included having fever with a negative malaria test (46.8%), danger signs (29.6%) and drug shortage (37.4%). Among the referred, less than half completed referral (45.8%). Referral completion was 2.8 times higher among children with danger signs (p = 0.004) relative to those without danger signs, and 0.27 times lower among children who received pre-referral treatment (p < 0.001). The average cost per case referred was US$ 4.89 and US$7.35 per case completing referral. For each unit cost per case referred, caregiver out of pocket expenditure contributed 33.7%, caregivers' and CHWs' opportunity costs contributed 29.2% and 5.1% respectively and health facility costs contributed 39.6%. The mean (SD) out of pocket expenditure was US$1.65 (3.25). The mean WTP for referral was US$8.25 (14.70) and was positively associated with having received pre-referral treatment, completing referral and increasing caregiver education level. The mean WTP for referral was higher than the average out of pocket expenditure. This, along with suboptimal referral completion, points to barriers in access to higher-level facilities as the primary cause of low referral. Community mobilisation for uptake of referral is necessary if the policy of referring children to the nearest health facility is to be effective.

Managing Minor Ailments; The Public’s Preferences for Attributes of Community Pharmacies. A Discrete Choice Experiment

PubMed Central

Ryan, Mandy; Bond, Christine; Watson, Margaret

2016-01-01

Background Demand for health services continues to rise. Greater use of community pharmacy services instead of medical services for minor ailments could help relieve pressure on healthcare providers in high-cost settings. Community pharmacies are recognised sources of treatment and advice for people wishing to manage these ailments. However, increasing the public’s use of pharmacy services may depend on attributes of pharmacies and their staff. This study aimed to determine the general public’s relative preferences for community pharmacy attributes using a discrete choice experiment (DCE). Method A UK-wide DCE survey of the general public was conducted using face-to-face computer-assisted personal interviews. Attributes and levels for the DCE were informed by a literature review and a cohort study of community pharmacy customers. The context for the experiment was a minor ailment scenario describing flu-like symptoms. The DCE choice sets described two hypothetical community pharmacy services; respondents were asked to choose which (if either) of the two pharmacies they would prefer to help them manage symptoms. Data from 1,049 interviews were analysed using an error components logit model. Willingness to pay (WTP), a monetary measure of benefit, was estimated for the different attribute levels. Results When seeking help or treatment for flu-like symptoms, respondents most valued a pharmacy service that would improve their understanding and management of symptoms (WTP = £6.28), provided by staff who are trained (WTP (pharmacist) = £2.63: WTP(trained assistant) = £3.22), friendly and approachable (WTP = £3.38). Waiting time, pharmacy location and availability of parking also contributed to respondents’ preferences. WTP for a service comprising the best possible combination of attributes and levels was calculated as £55.43. Conclusion Attributes of a community pharmacy and its staff may influence people’s decisions about which pharmacy they would visit to access treatment and advice for minor ailments. In line with the public’s preferences, offering community pharmacy services that help people to better understand and manage symptoms, are provided promptly by trained staff who are friendly and approachable, and in a local setting with easy access to parking, has the potential to increase uptake amongst those seeking help to manage minor ailments. In this way it may be possible to shift demand away from high-cost health services and make more efficient use of scarce public resources. PMID:27031588

Enhancement of seasonal prediction of East Asian summer rainfall related to the western tropical Pacific convection

NASA Astrophysics Data System (ADS)

Lee, D. Y.; Ahn, J. B.; Yoo, J. H.

2014-12-01

The prediction skills of climate model simulations in the western tropical Pacific (WTP) and East Asian region are assessed using the retrospective forecasts of seven state-of-the-art coupled models and their multi-model ensemble (MME) for boreal summers (June-August) during the period 1983-2005, along with corresponding observed and reanalyzed data. The prediction of summer rainfall anomalies in East Asia is difficult, while the WTP has a strong correlation between model prediction and observation. We focus on developing a new approach to further enhance the seasonal prediction skill for summer rainfall in East Asia and investigate the influence of convective activity in the WTP on East Asian summer rainfall. By analyzing the characteristics of the WTP convection, two distinct patterns associated with El Niño-Southern Oscillation (ENSO) developing and decaying modes are identified. Based on the multiple linear regression method, the East Asia Rainfall Index (EARI) is developed by using the interannual variability of the normalized Maritime continent-WTP indices (MPIs), as potentially useful predictors for rainfall prediction over East Asia, obtained from the above two main patterns. For East Asian summer rainfall, the EARI has superior performance to the East Asia summer monsoon index (EASMI) or each MP index (MPI). Therefore, the regressed rainfall from EARI also shows a strong relationship with the observed East Asian summer rainfall pattern. In addition, we evaluate the prediction skill of the East Asia reconstructed rainfall obtained by statistical-empirical approach using the cross-validated EARI from the individual models and their MME. The results show that the rainfalls reconstructed from simulations capture the general features of observed precipitation in East Asia quite well. This study convincingly demonstrates that rainfall prediction skill is considerably improved by using the statistical-empirical method compared to the dynamical models. Acknowledgements This work was carried out with the support of the Rural Development Administration Cooperative Research Program for Agriculture Science and Technology Development under Grant Project No. PJ009953, Republic of Korea.

Measuring consumer preference for models of diabetes care delivered by pharmacists

PubMed Central

Taylor, Susan; Hourihan, Fleur; Krass, Ines; Armour, Carol

2009-01-01

Evaluation of a community pharmacy disease management program for type 2 diabetes, ‘SugarCare’, was conducted. Compared with the standard care offered by pharmacists, this enhanced program offered patients closer monitoring of blood glucose levels, counselling about lifestyle, etc. The SugarCare study was funded by a grant but if the care is to continue some other method of financing must be found. Objectives: This study aimed to measure consumer preference for one of the two types of care offered in the SugarCare study, the control/standard and the intervention/enhanced service; the strength of that preference; and participants’ willingness to pay (WTP) for their preferred care. Methods: SugarCare was a parallel groups, control versus intervention, repeated measures design conducted in three areas of NSW, Australia. Patients in the Intervention group (enhanced care) had one initial visit to the pharmacy with six follow up visits over approximately 9 months. At these visits blood glucose was downloaded and patient care issues addressed. At the end of the service, a survey instrument was mailed to the intervention and control participants who were asked to read it and then expect a telephone call within 2 weeks of receipt. Responses were requested over the phone and the survey instrument completed by the researcher. WTP data were collected using a modified payment card method. Results: Overall, 44/75 (59%; 47%-70% 95%CI) respondents expressed a preference for Scenario B (the enhanced care) while 31/75 (41%; 31%-52% 95%CI) preferred Scenario A (standard care) however, the difference was not statistically significant. The median maximum WTP was AUD10 for the enhanced care and AUD3.50 for the standard care (p<0.03). Conclusions: While the WTP values expressed were significantly higher for the enhanced care they did not match with the cost providing that diabetes care. Discrete choice analysis has the potential to overcome some of the difficulties encountered with the contingent valuation technique used here. Further research is required before WTP values such as these could be used with confidence to determine funding policy. PMID:25136394

Measuring consumer preference for models of diabetes care delivered by pharmacists.

PubMed

Taylor, Susan; Hourihan, Fleur; Krass, Ines; Armour, Carol

2009-10-01

Evaluation of a community pharmacy disease management program for type 2 diabetes, 'SugarCare', was conducted. Compared with the standard care offered by pharmacists, this enhanced program offered patients closer monitoring of blood glucose levels, counselling about lifestyle, etc. The SugarCare study was funded by a grant but if the care is to continue some other method of financing must be found. This study aimed to measure consumer preference for one of the two types of care offered in the SugarCare study, the control/standard and the intervention/enhanced service; the strength of that preference; and participants' willingness to pay (WTP) for their preferred care. SugarCare was a parallel groups, control versus intervention, repeated measures design conducted in three areas of NSW, Australia. Patients in the Intervention group (enhanced care) had one initial visit to the pharmacy with six follow up visits over approximately 9 months. At these visits blood glucose was downloaded and patient care issues addressed. At the end of the service, a survey instrument was mailed to the intervention and control participants who were asked to read it and then expect a telephone call within 2 weeks of receipt. Responses were requested over the phone and the survey instrument completed by the researcher. WTP data were collected using a modified payment card method. Overall, 44/75 (59%; 47%-70% 95%CI) respondents expressed a preference for Scenario B (the enhanced care) while 31/75 (41%; 31%-52% 95%CI) preferred Scenario A (standard care) however, the difference was not statistically significant. The median maximum WTP was AUD10 for the enhanced care and AUD3.50 for the standard care (p<0.03). While the WTP values expressed were significantly higher for the enhanced care they did not match with the cost providing that diabetes care. Discrete choice analysis has the potential to overcome some of the difficulties encountered with the contingent valuation technique used here. Further research is required before WTP values such as these could be used with confidence to determine funding policy.

Health care contingent valuation studies: a review and classification of the literature.

PubMed

Diener, A; O'Brien, B; Gafni, A

1998-06-01

The contingent valuation method (CVM) is a survey-based approach for eliciting consumer's monetary valuations for programme benefits for use in cost-benefit analysis (CBA). We used the conceptual framework of O'Brien and Gafni (1996) to classify and critically appraise health care CVM studies. Search of computerized health care and economic citation databases (e.g. MEDLINE, ECONLIT) and manual search for papers published between 1984 1996 reporting primary data valuing health programme benefits in monetary units by CVM using willingness-to-pay (WTP) or accept (WTA). We classified studies using both empirical (i.e. who was surveyed and how) and conceptual criteria (i.e. which measure of consumer utility was measured and why). 48 CVM studies were retrieved; the majority (42) undertook money valuation in the context of cost benefit analysis (CBA), with the remainder being pricing/demand studies. Among the 42 CBA studies, the consumer utility being measured (i.e. compensating (CV) vs. equivalent variation (EV) was explicitly stated in only three (7%) studies). WTP was measured in 95% of studies and WTA in 5%. By cross-tabulation, 42 (91%) studies were designed as WTP/CV, two (4%) were WTP/EV, two (4%) were WTA/CV and no studies used WTA/EV. Most studies were administered by mail (52%) with 38% being in-person interviews. Value elicitation techniques included open-ended questions (38%), payment cards (19%) discrete choice questions (26%) or bidding games (29%). Some form of construct validation tests, particularly associations between WTP and income, were done in 21 studies (50%). (i) The number of health care CVM studies is growing rapidly and the majority are done in the context of CBA; (ii) there is wide variation among health care CVM studies in terms of the types of questions being posed and the elicitation formats being used; (iii) classification and appraisal of the literature is difficult because reporting of methods and their relationship with the conceptual framework of CBA is poor; (iii) the applicability to health care of the CVM guidelines issued by the National Oceanic and Atmospheric Administration (NOAA) panel for environmental economics is unclear.

Willingness to pay and willingness to accept in a patient-centered blood pressure control study.

PubMed

Gleason-Comstock, Julie; Streater, Alicia; Goodman, Allen; Janisse, James; Brody, Aaron; Mango, LynnMarie; Dawood, Rachelle; Levy, Phillip

2017-08-07

Elevated blood pressure is a major risk factor for cardiovascular disease and stroke but patients often discount recommended behavioral changes and prescribed medications. While effective interventions to promote adherence have been developed, cost-effectiveness from the patient's perspective, has not been well studied. The valuation of patient time and out of pocket expenses should be included while performing cost effectiveness evaluation. The Achieve BP study uses the contingent valuation method to assess willingness to accept (WTA) and willingness to pay (WTP) among patients with a history of uncontrolled blood pressure discharged from an urban emergency department and enrolled in a larger randomized controlled trial. WTA and WTP were assessed by asking patients a series of questions about time and travel costs and time value related to their study participation. A survey was conducted during the final study visit with patients to investigate the effectiveness of a kiosk-based educational intervention on blood pressure control. All study patients, regardless of study arm, received the same clinical protocol of commonly prescribed antihypertensive medication and met with research clinicians four times as part of the study procedures. Thirty-eight patients were offered the opportunity to participate in the cost-effectiveness study and all completed the survey. Statistical comparisons revealed these 38 patients were similar in representation to the entire RCT study population. All 38 (100.0%) were African-American, with an average age of 49.1 years; 55.3% were male, 21.1% were married, 78.9% had a high school or higher education, and 44.7% were working. 55.9% did not have a primary care provider and 50.0% did not have health insurance. Time price linear regression analysis was performed to estimate predictors of WTA and WTP. WTP and WTA may generate different results, and the elasticities were proportional to the estimated coefficients, with WTP about twice as responsive as WTA. An additional feature for health services research was successful piloting in a clinical setting of a brief patient-centered cost effectiveness survey. https://clinicaltrials.gov . Registration Number NCT02069015 . Registered February 19, 2014 (Retrospectively registered).

Willingness to Pay for Dog Rabies Vaccine and Registration in Ilocos Norte, Philippines (2012).

PubMed

Birhane, Meseret G; Miranda, Mary Elizabeth G; Dyer, Jessie L; Blanton, Jesse D; Recuenco, Sergio

2016-03-01

The Philippines is one of the developing countries highly affected by rabies. Dog vaccination campaigns implemented through collaborative effort between the government and NGOs have played an important role in successfully reducing the burden of disease within the country. Nevertheless, rabies vaccination of the domestic animal population requires continuous commitment not only from governments and NGOs, but also from local communities that are directly affected by such efforts. To create such long-term sustained programs, the introduction of affordable dog vaccination and registration fees is essential and has been shown to be an important strategy in Bohol, Philippines. The aim of this study, therefore, was to estimate the average amount of money that individuals were willing to pay for dog vaccination and registration in Ilocos Norte, Philippines. This study also investigated some of the determinants of individuals' willingness to pay (WTP). A cross-sectional questionnaire was administered to 300 households in 17 municipalities (out of a total of 21) selected through a multi-stage cluster survey technique. At the time of the survey, Ilocos Norte had a population of approximately 568,017 and was predominantly rural. The Contingent Valuation Method was used to elicit WTP for dog rabies vaccination and registration. A 'bidding game' elicitation strategy that aims to find the maximum amount of money individuals were willing to pay was also employed. Data were collected using paper-based questionnaires. Linear regression was used to examine factors influencing participants' WTP for dog rabies vaccination and registration. On average, Ilocos Norte residents were willing to pay 69.65 Philippine Pesos (PHP) (equivalent to 1.67 USD in 2012) for dog vaccination and 29.13PHP (0.70 USD) for dog registration. Eighty-six per cent of respondents were willing to pay the stated amount to vaccinate each of their dogs, annually. This study also found that WTP was influenced by demographic and knowledge factors. Among these, we found that age, income, participants' willingness to commit to pay each year, municipality of residency, knowledge of the signs of rabies in dogs, and number of dogs owed significantly predicted WTP.

Willingness to Pay for Dog Rabies Vaccine and Registration in Ilocos Norte, Philippines (2012)

PubMed Central

Birhane, Meseret G.; Miranda, Mary Elizabeth G.; Dyer, Jessie L.; Blanton, Jesse D.; Recuenco, Sergio

2016-01-01

Background The Philippines is one of the developing countries highly affected by rabies. Dog vaccination campaigns implemented through collaborative effort between the government and NGOs have played an important role in successfully reducing the burden of disease within the country. Nevertheless, rabies vaccination of the domestic animal population requires continuous commitment not only from governments and NGOs, but also from local communities that are directly affected by such efforts. To create such long-term sustained programs, the introduction of affordable dog vaccination and registration fees is essential and has been shown to be an important strategy in Bohol, Philippines. The aim of this study, therefore, was to estimate the average amount of money that individuals were willing to pay for dog vaccination and registration in Ilocos Norte, Philippines. This study also investigated some of the determinants of individuals’ willingness to pay (WTP). Methods A cross-sectional questionnaire was administered to 300 households in 17 municipalities (out of a total of 21) selected through a multi-stage cluster survey technique. At the time of the survey, Ilocos Norte had a population of approximately 568,017 and was predominantly rural. The Contingent Valuation Method was used to elicit WTP for dog rabies vaccination and registration. A ‘bidding game’ elicitation strategy that aims to find the maximum amount of money individuals were willing to pay was also employed. Data were collected using paper-based questionnaires. Linear regression was used to examine factors influencing participants’ WTP for dog rabies vaccination and registration. Key Results On average, Ilocos Norte residents were willing to pay 69.65 Philippine Pesos (PHP) (equivalent to 1.67 USD in 2012) for dog vaccination and 29.13PHP (0.70 USD) for dog registration. Eighty-six per cent of respondents were willing to pay the stated amount to vaccinate each of their dogs, annually. This study also found that WTP was influenced by demographic and knowledge factors. Among these, we found that age, income, participants’ willingness to commit to pay each year, municipality of residency, knowledge of the signs of rabies in dogs, and number of dogs owed significantly predicted WTP. PMID:26999021

Water Triple-Point Comparisons: Plateau Averaging or Peak Value?

NASA Astrophysics Data System (ADS)

Steur, P. P. M.; Dematteis, R.

2014-04-01

With a certain regularity, national metrology institutes conduct comparisons of water triple-point (WTP) cells. The WTP is the most important fixed point for the International Temperature Scale of 1990 (ITS-90). In such comparisons, it is common practice to simply average all the single measured temperature points obtained on a single ice mantle. This practice is quite reasonable whenever the measurements show no time dependence in the results. Ever since the first Supplementary Information for the International Temperature Scale of 1990, published by the Bureau International des Poids et Mesures in Sèvres, it was strongly suggested to wait at least 1 day before taking measurements (now up to 10 days), in order for a newly created ice mantle to stabilize. This stabilization is accompanied by a change in temperature with time. A recent improvement in the sensitivity of resistance measurement enabled the Istituto Nazionale di Ricerca Metrologica to detect more clearly the (possible) change in temperature with time of the WTP on a single ice mantle, as for old borosilicate cells. A limited investigation was performed where the temperature of two cells was monitored day-by-day, from the moment of mantle creation, where it was found that with (old) borosilicate cells it may be counterproductive to wait the usual week before starting measurements. The results are presented and discussed, and it is suggested to adapt the standard procedure for comparisons of WTP cells allowing for a different data treatment with (old) borosilicate cells, because taking the temperature dependence into account will surely reduce the reported differences between cells.

The analysis of cost-effectiveness of implant and conventional fixed dental prosthesis.

PubMed

Chun, June Sang; Har, Alix; Lim, Hyun-Pil; Lim, Hoi-Jeong

2016-02-01

This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective. The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate. When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at 10(th) year after the treatment, and more cost-effective regardless of the WTP from 20(th) year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the 10(th) year after the prosthodontic treatment, more than 35,000 won at the 20(th) year after prosthodontic treatment. The CFDP was more cost-effective unless the WTP was more than 75,000 won at the 10(th) year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed.

A Discrete Choice Experiment to Elicit Patient Willingness to Pay for Attributes of Treatment-Induced Symptom Relief in Comorbid. Insomnia.

PubMed

Roy, Anuja N; Madhavan, S Suresh; Lloyd, Andrew

2015-04-01

Insomnia is a burdensome, commonly comorbid condition. How patients value various aspects of the safety and efficacy of available drugs has not been studied. The aim of the present study was to quantify patient-rated utility by studying willingness to pay (WTP) for attributes of symptom relief via a discrete choice experiment (DCE). Adult primary care patients (West Virginia University Hospital) with comorbid insomnia were enrolled. The attributes and levels examined were sleep onset latency (SOL; 10, 20,30 minutes), awakenings (1, 2, 3), wake time after sleep onset (WASO; 15,45, 60 minutes), total sleep time (TST; 6, 7, 8 hours), hangover (none, mild, moderate), FDA-approved duration of use (short term, not restricted to short term, no restrictions), and out-of-pocket cost per month ($20, $35, $50). Willingness to pay (WTP) data were analyzed using a random effects binary logistic regression model. A total of 82 patients completed the DCE (74 analyzed). SOL, WASO, TST, and cost were all found to predict treatment choice. Higher values of SOL, WASO, and cost resulted in decreased preference for a particular treatment, while higher TST predicted increased preference. Modeling revealed an estimated marginal WTP of $66.69 for an example product that improved SOL by 10 minutes, reduced WASO by 15 minutes, and improved TST by 1 hour. Patient WTP for symptomatic relief in insomnia can help clinicians fine-tune interventions based on patient preferences, provide evidence for drug formulary and reimbursement decisions, and potentially guide the development of novel drugs.

Expanding co-payment for methadone maintenance services in Vietnam: the importance of addressing health and socioeconomic inequalities.

PubMed

Tran, Bach Xuan; Nguyen, Quyen Le; Nguyen, Long Hoang; Phan, Huong Thu Thi; Le, Huong Thi; Tran, Tho Dinh; Vu, Thuc Thi Minh; Latkin, Carl A

2017-07-12

Ensuring high enrollment while mobilizing resources through co-payment services is critical to the success of the methadone maintenance treatment (MMT) program in Vietnam. This study assessed the willingness of patients to pay (WTP) for different MMT services delivery models and determined its associated factors. A facility based survey was conducted among 1016 MMT patients (98.7% male, 42% aged 35 or less, and 67% living with spouse) in five MMT clinics in Hanoi and Nam Dinh province in 2013. Socioeconomic, HIV and health status, history of drug use and rehabilitation, and MMT experience were interviewed. WTP was assessed using contingent valuation method, including a set of double-bounded binary questions and a follow-up open-ended question. Point and interval data models were used to estimate maximum willingness to pay. 95.5% patients were willing to pay for MMT at the monthly mean price of US$ 32 (95%CI = 28-35). Higher WTP was associated with higher level of educational attainment, higher income, male sex, and had high expenses on opiates prior to MMT. Patients who reported having any problem in Pain/ Discomfort, and who did not have outpatient care last year were willing to pay less for MMT than others. High level of WTP supports the co-payment policies as a strategy to mobilize resources for the MMT program in Vietnam. However, it is necessary to ensure equalities across patient groups by acknowledging socioeconomic status of different settings and providing financial supports for disadvantaged patients with severe health status.