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Cost Reduction (cost + reduction)
Selected AbstractsMinimizing the cost of placing and sizing wavelength division multiplexing and optical crossconnect equipment in a telecommunications networkNETWORKS: AN INTERNATIONAL JOURNAL, Issue 4 2005Belén Melián Abstract Cost reduction is a major concern when designing optical fiber networks. Multiwavelength optical devices are new technology for increasing the capacity of fiber networks while reducing costs, when compared to installing traditional (e.g., SONET) equipment and new fiber. In this article we discuss the development of a metaheuristic method that seeks to optimize the location of Wavelength Division Multiplexing (WDM) and Optical Crossconnect (OXC) equipment in fiber networks. The procedure combines ideas from the scatter search, tabu search, and multistart methodologies. Computational experiments with both real-world and artificial data show the effectiveness of the proposed procedure. The experiments include a comparison with a permutation-based approach and with lower bounds generated with CPLEX. © 2005 Wiley Periodicals, Inc. NETWORKS, Vol. 45(4), 199,209 2005 [source] A direct circuit experiment system in non-immersive virtual environments for education and entertainmentCOMPUTER APPLICATIONS IN ENGINEERING EDUCATION, Issue 2 2005Quang-Cherng Hsu Abstract This article proposes to contribute to the goal of "The Popular Science Teaching Research Project" as well as to enhance the programming abilities of mechanical engineering students. Topics being included as example are in physical science, which include battery, lamp, and electric circuit. These materials are designed, based on virtual-reality technology that is suitable for students as early as fourth-grade students of primary school. It will help the students become familiar with new computer technology and provide an opportunity to study while playing virtual reality computer games. The benefits of the developed application software system of virtual reality are virtualization of teaching equipment, cost reduction of teaching materials, unlimited teaching style, and optimization of learning procedures. © 2005 Wiley Periodicals, Inc. Comput Appl Eng Educ 13: 146,152, 2005; Published online in Wiley InterScience (www.interscience.wiley.com); DOI 10.1002/cae.20044 [source] Cytologic diagnosis of osseous lesions: A review with emphasis on the diagnosis of primary neoplasms of boneDIAGNOSTIC CYTOPATHOLOGY, Issue 4 2009Lester J. Layfield M.D. Abstract Fine-needle aspiration has been utilized as the initial diagnostic technique at a large number of body sites for over three quarters of a century. As early as the 1930s, fine-needle aspiration (FNA) was used to investigate lesions of the musculoskeletal system. In many early reports, FNA was most frequently and successfully used for the diagnosis of metastatic disease to bone. Less emphasis was placed on its utility for the investigation of primary neoplasms of bone and soft tissue. Current utilization of FNA continues to de-emphasize its application to the diagnosis of primary lesions of the musculoskeletal system. Recent advances in imaging techniques, immunohistochemistry, and molecular diagnostics along with an increasing familiarity among pathologists with the cytologic appearance of primary osseous tumors has led to reevaluation of the technique for investigation of these tumors. The diagnostic accuracy of FNA along with its relatively low cost and high degree of safety makes it a desirable technique for the investigation of primary lesions of the musculoskeletal system. This article reviews issues of diagnostic accuracy, optimal practice procedures, and benefits of the technique including cost reduction. The article will review criteria for selection of appropriate tissue targets for FNA to reduce the number of unsatisfactory specimens. Cytomorphologic features of the more common primary neoplasms of bone will be summarized along with recommendations for the utilization of immunohistochemistry and molecular diagnostics in the work-up of primary neoplasms of bone. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] A simple method for output voltage control of a three-phase multilevel inverter considering DC voltage fluctuationELECTRICAL ENGINEERING IN JAPAN, Issue 3 2010Kenji Amei Abstract Multilevel inverter circuit generates the stair-like voltage without using transformer and interphase reactor, and it is the circuit which realizes reduction in the harmonics and enlargement of the capacity. In addition, the application of PWM control improves the waveform, and reduces the switching component to the conventional half, and the filter capacity is reduced. In this paper, improvement on the voltage utilization factor and feedback control of output voltage are applied to multilevel inverter circuit. For the DC power supply with the intense fluctuation, it is necessary to construct inverter circuit which can supply stabilized AC voltage. One-chip microcomputer with various functions is used for the control equipment of this circuit, and miniaturization and cost reduction of the control equipment are realized. Here, the control principle and experimental results of this equipment are mainly reported. © 2009 Wiley Periodicals, Inc. Electr Eng Jpn, 170(3): 40,47, 2010; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.20906 [source] Positive health-care effects of an alcohol ignition interlock programme among driving while impaired (DWI) offendersADDICTION, Issue 11 2007Bo Bjerre ABSTRACT Aims To compare the costs of hospital care and sick leave/disability pensions between two groups of driving while impaired (DWI) offenders: participants in an alcohol ignition interlock programme (AIIP) and controls with revoked licences, but with no comparable opportunity to participate in an AIIP. Setting As an alternative to licence revocation DWI offenders can participate in a voluntary 2-year AIIP permitting the offender to drive under strict regulations entailing regular medical check-ups. The participants are forced to alter their alcohol habits and those who cannot demonstrate sobriety are dismissed from the programme. Participants are liable for all costs themselves. Design Quasi-experimental, with a non-equivalent control group used for comparison; intent-to-treat design. Based on the number of occasions/days in hospital and on sick leave/disability pension, the health-care costs for public insurance have been calculated. Finding Average total health-care costs were 25% lower among AIIP participants (1156 individuals) than among controls (815 individuals) during the 2-year treatment period. This corresponds to over ,1000 (SEK9610) less annual costs per average participant. For those who complete the 2-year programme the cost reduction was more pronounced; 37% during the treatment and 20% during the post-treatment period. Conclusions The positive health-care effects were due apparently to reduced alcohol consumption. The social benefit of being allowed to drive while in the AIIP may also have contributed. The reduction in health-care costs was significant only during the 2-year treatment period, but among those who completed the entire AIIP sustained effects were also observed in the post-treatment period. The effects were comparable to those of regular alcoholism treatment programmes. [source] Review: Durability and Degradation Issues of PEM Fuel Cell ComponentsFUEL CELLS, Issue 1 2008F. A. de Bruijn Abstract Besides cost reduction, durability is the most important issue to be solved before commercialisation of PEM Fuel Cells can be successful. For a fuel cell operating under constant load conditions, at a relative humidity close to 100% and at a temperature of maximum 75,°C, using optimal stack and flow design, the voltage degradation can be as low as 1,2,,V·h. However, the degradation rates can increase by orders of magnitude when conditions include some of the following, i.e. load cycling, start,stop cycles, low humidification or humidification cycling, temperatures of 90,°C or higher and fuel starvation. This review paper aims at assessing the degradation mechanisms of membranes, electrodes, bipolar plates and seals. By collecting long-term experiments as well, the relative importance of these degradation mechanisms and the operating conditions become apparent. [source] Isolation of Solid Solution Phases in Size-Controlled LixFePO4 at Room TemperatureADVANCED FUNCTIONAL MATERIALS, Issue 3 2009Genki Kobayashi Abstract State-of-the-art LiFePO4 technology has now opened the door for lithium ion batteries to take their place in large-scale applications such as plug-in hybrid vehicles. A high level of safety, significant cost reduction, and huge power generation are on the verge of being guaranteed for the most advanced energy storage system. The room-temperature phase diagram is essential to understand the facile electrode reaction of LixFePO4 (0,<,x,<,1), but it has not been fully understood. Here, intermediate solid solution phases close to x,=,0 and x,=,1 have been isolated at room temperature. Size-dependent modification of the phase diagram, as well as the systematic variation of lattice parameters inside the solid-solution compositional domain closely related to the electrochemical redox potential, are demonstrated. These experimental results reveal that the excess capacity that has been observed above and below the two-phase equilibrium potential is largely due to the bulk solid solution, and thus support the size-dependent miscibility gap model. [source] Application of Six Sigma Methods for Improving the Analytical Data Management Process in the Environmental IndustryGROUND WATER MONITORING & REMEDIATION, Issue 2 2006Christopher M. French Honeywell applied the rigorous and well-documented Six Sigma quality-improvement approach to the complex, highly heterogeneous, and mission-critical process of remedial site environmental data management to achieve a sea change in terms of data quality, environmental risk reduction, and overall process cost reduction. The primary focus was to apply both qualitative and quantitative Six Sigma methods to improve electronic management of analytical laboratory data generated for environmental remediation and long-term monitoring programs. The process includes electronic data delivery, data QA/QC checking, data verification, data validation, database administration, regulatory agency reporting and linkage to spatial information, and real-time geographical information systems. Results of the analysis identified that automated, centralized web-based software tools delivered through Software as a Service (SaaS) model are optimal to improve the process resulting in cost reductions, while simultaneously improving data quality and long-term data usability and perseverance. A pilot project was completed that quantified cycle time and cost improvements of 50% and 65%, respectively. [source] Proposal of a standard approach to dental extraction in haemophilia patients.HAEMOPHILIA, Issue 5 2000A case-control study with good results We found no case,control studies on dental extraction in haemophilia patients in the literature even though the use of antifibrinolytic agents following a single infusion of factor VIII or IX has been accompanied by a lower number of bleeding complications in dental extractions. In this study we verified the incidence of bleeding complications after dental extraction in a group of 77 haemophilia patients. One hundred and eighty-four male patients requiring dental extraction represented the control group. All haemophilia patients received 20 mg kg,1 of tranexamic acid and a single infusion of factor VIII or IX to achieve a peak level about 30% of factor VIII or IX in vivo prior to dental extraction. Forty-five of 98 (45.9%) dental extractions in haemophilia patients and 110 of 239 (46%) dental extractions in the control group were surgical ones. We registered two bleeding complications in the group of haemophilia patients (one late bleeding and one haematoma in the site of the anaesthetic injection) and one (a late bleeding) in the control group. The difference of bleeding complications in the two groups of patients were not statistically significant (P=0.2; OR 0.2; CI 0.01,2.22). The protocol proposed in this study, characterized by the feasibility and the number of haemorrhagic complications not different from normal population, make dental extractions in haemophilia patients possible on an out-patient basis with a cost reduction for the community and minor discomfort for the patients. [source] Does Prospective Payment Really Contain Nursing Home Costs?HEALTH SERVICES RESEARCH, Issue 2 2002Li-Wu Chen Objective. To examine whether nursing homes would behave more efficiently, without compromising their quality of care, under prospective payment. Data Sources. Four data sets for 1994: the Skilled Nursing Facility Minimum Data Set, the Online Survey Certification and Reporting System file, the Area Resource File, and the Hospital Wage Indices File. A national sample of 4,635 nursing homes is included in the analysis. Study Design. Using a modified hybrid functional form to estimate nursing home costs, we distinguish our study from previous research by controlling for quality differences (related to both care and life) and addressing the issues of output and quality endogeneity, as well as using more recent national data. Factor analysis was used to operationalize quality variables. To address the endogeneity problems, instrumental measures were created for nursing home output and quality variables. Principal Findings. Nursing homes in states using prospective payment systems do not have lower costs than their counterpart facilities under retrospective cost-based payment systems, after quality differences among facilities are controlled for and the endogeneity problem of quality variables is addressed. Conclusions. The effects of prospective payment on nursing home cost reduction may be through quality cuts, rather than cost efficiency. If nursing home payments under prospective payment systems are not adjusted for quality, nursing homes may respond by cutting their quality levels, rather than controlling costs. Future outcomes research may provide useful insights into the adjustment of quality in the design of prospective payment for nursing home care. [source] A new image sharpening approach for single-sensor digital cameras,INTERNATIONAL JOURNAL OF IMAGING SYSTEMS AND TECHNOLOGY, Issue 3 2007Rastislav Lukac Abstract This article introduces a new image sharpening approach suitable for single-sensor digital cameras equipped with a Bayer color filter array (CFA). The proposed solution firstly enhances the structural content of the captured CFA image data. Subsequent demosaicking of the enhanced CFA image data produces a visually pleasing full-color image which is noticeably sharper compared to the output of the traditional imaging pipeline. Results reported in this work suggest a three-fold processing cost reduction when the new approach is followed. © 2007 Wiley Periodicals, Inc. Int J Imaging Syst Technol, 17, 123,131, 2007 [source] Closed suctioning system: Critical analysis for its useJAPAN JOURNAL OF NURSING SCIENCE, Issue 1 2010Nahoko HARADA Abstract Aim:, To determine the efficacy and effectiveness of the closed suctioning system. Method:, Literature review articles were accessed from the following databases: PubMed, EMBASE, CINAHL, and Cochrane Library. The literature review criteria included: all publication styles except meta-analysis, participants that were ,18 years, written in English, and published between 1973 and 2008. Results:, This literature review revealed that the efficacy and effectiveness of the closed suctioning system remains to be demonstrated. The device manufacturers' studies focused on cost reduction, cross-contamination, and preservation of the oxygen saturation of patients during endotracheal suctioning; however, the clinical studies focused on the use of closed suctioning systems to prevent ventilator-associated pneumonia. The reviewed studies had small sample sizes with heterogeneous demographics and non-randomized controls. Recent studies suggest that closed suctioning systems are no better than open suctioning systems in terms of mortality, morbidity, or the cost-benefit ratio. A few studies did indicate that the closed suctioning system might reduce the loss of lung volume and oxygen desaturation. Conclusion:, The studies reviewed in this article suggest that the evidence on the efficacy and effectiveness of closed suctioning systems is inconclusive. Only limited populations will benefit clinically from the use of this device. There is a need for further studies with randomized controlled trials to explore the use of closed suction systems and to update current clinical practise guidelines. [source] Clinical indicators of ineffective airway clearance in children with congenital heart diseaseJOURNAL OF CLINICAL NURSING, Issue 5 2009Viviane Martins Da Silva Aims and objectives., To analyse the sensitivity and specificity of clinical indicators of ineffective airway clearance in children with congenital heart disease and to identify the indicators that have high predictive power. Background., The precise establishment of nursing diagnoses has been found to be one of the factors contributing to higher quality of care and cost reduction in healthcare institutions. The use of indicators to diagnose ineffective airway clearance could improve care of children with congenital heart disease. Design., Longitudinal study. Methods., Participants consisted of 45 children, ,1 year of age, with congenital heart disease, who had not had definitive or palliative surgical correction. Six assessments were made at 2-day intervals. Each clinical indicator was defined based on previously established operational criteria. Sensitivity, specificity and positive and negative predictive values of each indicator were calculated based on a model for the longitudinal data. Results., A nursing diagnosis of ineffective airway clearance was made in 31% of patients on the first assessment, rising to 71% on the last assessment, for a 40% increase. Sensitivity was highest for Changes in Respiratory Rates/Rhythms (0·99), followed by Adventitious Breath Sounds (0·97), Sputum Production (0·85) and Restlessness (0·53). Specificity was higher for Sputum Production (0·92), followed by Restlessness (0·73), Adventitious Breath Sounds (0·70) and Changes in Respiratory Rates/Rhythms (0·17). The best positive predictive values occurred for Sputum Production (0·93) and Adventitious Breath Sounds (0·80). Conclusions., Adventitious Breath Sounds followed by Sputum Production were the indicators that had the best overall sensitivity and specificity as well as the highest positive predictive values. Relevance to clinical practice., The use of simple indicators in nursing diagnoses can improve identification of ineffective airway clearance in children with congenital heart disease, thus leading to early treatment of the problem and better care for these children. [source] Impact of advanced exercise ECG analysis on cost of coronary artery disease managementJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2010Riccardo Bigi PhD Abstract Background, Conventional analysis of exercise electrocardiogram (EX-ECG) has limited accuracy. This study aims to evaluate the potential impact of improving EX-ECG accuracy on costs of diagnosis and number of misdiagnoses of coronary artery disease (CAD). Methods, A decision-tree model was simulated including sequential application of diagnostic procedures for suspected CAD. The model was structured in two main branches (presence or absence of CAD). A probabilistic sensitivity analysis was then performed for several combinations of improvement in test sensitivity and specificity. Results, A clear trend in cost reduction was observed at improving EX-ECG specificity (about 8,8.5 million dollars, corresponding to a 5.6,7.6% reduction according to the prevalence level). Wrong diagnoses counted for 9,13% of test. Improvements in test parameters lead to reductions in wrong diagnoses, especially when increasing specificity (8.8,12.5%). Conclusions, A proper improvement in EX-ECG sensitivity and specificity would have a relevant impact on the costs of CAD management, while reducing the number of misdiagnoses. [source] Case study: a maintenance practice used with real-time telecommunications softwareJOURNAL OF SOFTWARE MAINTENANCE AND EVOLUTION: RESEARCH AND PRACTICE, Issue 2 2001Miroslav Popovi Abstract In this paper we present a case study of the software maintenance practice that has been successfully applied to real-time distributed systems, which are installed and fully operational in Moscow, St. Petersburg, and other cities across Russia. In this paper we concentrate on the software maintenance process, including customer request servicing, in-field error logging, role of information system, software deployment, and software quality policy, and especially the software quality prediction process. In this case study, the prediction process is shown to be integral and one of the most important parts of the software maintenance process. We include a software quality prediction procedure overview and an example of the actual practice. The quality of the new software update is predicted on the basis of the current update's quantity metrics data and quality data, and new update's quantity metrics data. For management, this forecast aids software maintenance efficiency, and cost reduction. For practitioners, the most useful result presented is the process for determining the value for the break point. We end this case study with five lessons learned. Copyright © 2001 John Wiley & Sons, Ltd. [source] Partnership Sourcing: An Organization Change Management PerspectiveJOURNAL OF SUPPLY CHAIN MANAGEMENT, Issue 3 2000Ronan McIvor SUMMARY This article highlights the organization change implications for organizations that are attempting to develop collaborative relationships with their suppliers. The research focuses on four dimensions of collaborative relations including joint buyer-supplier cost reduction, supplier involvement in new product development, delivery and logistics management, and core business strategy. A case study is presented which outlines how an organization adopted a strategy that led to extensive outsourcing and the adoption of more collaborative relations with its key suppliers. The pursuit of this strategy has acted as a stimulus for change within the organization. The article identifies a number of issues that must be addressed, including the adoption of an integrated approach to the management of strategic change, the pivotal role of senior managers as facilitators of this change, and the involvement of those most affected by the movement toward more collaborative buyer-supplier relationships. [source] Microwave Dielectric Ceramics for Resonators and Filters in Mobile Phone NetworksJOURNAL OF THE AMERICAN CERAMIC SOCIETY, Issue 7 2006Ian M. Reaney Temperature-stable, medium-permittivity dielectric ceramics have been used as resonators in filters for microwave (MW) communications for several decades. The growth of the mobile phone market in the 1990s led to extensive research and development in this area. The main driving forces were the greater utilization of available bandwidth, that necessitates extremely low dielectric loss (high-quality factor), an increase in permittivity so that smaller components could be fabricated, and, as ever in the commercial world, cost reduction. Over the last decade, a clear picture has emerged of the principal factors, that influence MW properties. This article reviews these basic principles and gives examples of where they have been used to control microwave properties and ultimately develop new materials. [source] Managerial optimism and investment choiceMANAGERIAL AND DECISION ECONOMICS, Issue 4 2010Florian Englmaier This paper analyzes whether it might be desirable for a firm to hire an overoptimistic manager to commit to a certain R&D strategy. I consider a Cournot model with an ex-ante R&D stage where firms can invest in cost reduction before product market competition takes place. I show that firms want to hire overoptimistic managers and argue that a manager's type may serve as a substitute for strategic delegation via contracts. Copyright © 2010 John Wiley & Sons, Ltd. [source] On the first come,first served rule in multi-echelon inventory controlNAVAL RESEARCH LOGISTICS: AN INTERNATIONAL JOURNAL, Issue 5 2007Sven Axsäter Abstract A two-echelon distribution inventory system with a central warehouse and a number of retailers is considered. The retailers face stochastic demand and replenish from the warehouse, which, in turn, replenishes from an outside supplier. The system is reviewed continuously and demands that cannot be met directly are backordered. Standard holding and backorder costs are considered. In the literature on multi-echelon inventory control it is standard to assume that backorders at the warehouse are served according to a first come,first served policy (FCFS). This allocation rule simplifies the analysis but is normally not optimal. It is shown that the FCFS rule can, in the worst case, lead to an asymptotically unbounded relative cost increase as the number of retailers approaches infinity. We also provide a new heuristic that will always give a reduction of the expected costs. A numerical study indicates that the average cost reduction when using the heuristic is about two percent. The suggested heuristic is also compared with two existing heuristics. © 2007 Wiley Periodicals, Inc. Naval Research Logistics, 2007 [source] A logistics scheduling model: Inventory cost reduction by batchingNAVAL RESEARCH LOGISTICS: AN INTERNATIONAL JOURNAL, Issue 4 2005Xiangtong Qi Abstract Logistics scheduling refers to the problems where the decisions of job scheduling and transportation are integrated in a single framework. In this paper, we discuss a logistics scheduling model where the raw material is delivered to the shop in batches. By making the batching and scheduling decisions simultaneously, the total inventory and batch setup cost can be reduced. We study different models on this issue, present complexity analysis and optimal algorithms, and conduct computational experiments. Some managerial insights are observed. © 2005 Wiley Periodicals, Inc. Naval Research Logistics, 2005. [source] Review article: Low-molecular-weight heparin as an alternative anticoagulant to unfractionated heparin for routine outpatient haemodialysis treatmentsNEPHROLOGY, Issue 5 2009ANDREW DAVENPORT SUMMARY Unfractionated heparin is currently the most widely used anticoagulant for outpatient haemodialysis. However, unfractionated heparin is a series of molecules, and as such has variable pharmacodynamics. Low-molecular-weight heparins were developed to improve both drug pharmacokinetic and dynamics, so to provide a reliable predictable clinical effect. The low-molecular-weight heparins are potent agents, but have an increased half-life compared with unfractionated heparin, and also require specialist laboratory monitoring. Despite these apparent drawbacks, low-molecular-weight heparins have become the anticoagulants of choice in Western Europe for routine outpatient haemodialysis sessions, due to the reliability of their clinical effect, and ease of administration, coupled with cost reduction. In standard clinical practice laboratory monitoring is not routinely performed, with drug dosing assessed by clinical inspection of the extracorporeal circuit, and the time for fistula needle sites to stop bleeding. [source] The economic lot size of the integrated vendor-buyer inventory system derived without derivativesOPTIMAL CONTROL APPLICATIONS AND METHODS, Issue 3 2002P.C. Yang Abstract In previous modellings of the integrated vendor,buyer system, the buyer's economic order quantity and the vendor's optimal number of deliveries are derived by setting the first derivatives to zero and solving the simultaneous equations. The Hessian matrix of second derivatives is used to prove the convexity of the objective function. This procedure can be difficult for students who lack the background of differential calculus. This study develops algebraically the optimal policy of the integrated vendor,buyer inventory system without using differential calculus. A significant cost reduction is also achieved when Goyal's model is modified. Copyright © 2002 John Wiley & Sons, Ltd. [source] Introduction of flexible packaging systems for toiletry productsPACKAGING TECHNOLOGY AND SCIENCE, Issue 5 2001Yuji Ikeda Abstract Flexible manufacturing systems (FMS) are rapidly gaining in importance for manufacturers throughout the industrialized world. Lion Corporation is no exception in its need of FMS because of the great variety of toiletry and household products it produces. Toiletry products, such as toothpaste, detergent and shampoo, are our mainstay products, which account for 75% of our total sales. On our production lines, therefore, it is essential that they can be changed flexibly for the manufacture of ever-changing products. Introduced in this report are some of our flexible packaging systems, which use carriers, robots, standardized shampoo bottles, etc., without relying on special tools or new parts for line change. Innovation of our flexible packaging systems for greater flexibility and cost reduction will continue in the future. Copyright © 2001 John Wiley & Sons, Ltd. [source] Reduction in Medication Costs for Patients with Chronic Nonmalignant Pain Completing a Pain Rehabilitation Program: A Prospective Analysis of Admission, Discharge, and 6-Month Follow-Up Medication CostsPAIN MEDICINE, Issue 5 2009Julie L. Cunningham PharmD ABSTRACT Objective., Chronic nonmalignant pain (CNMP) is both a prevalent and a costly health problem in our society. Pain rehabilitation programs have been shown to provide cost-effective treatment. A treatment goal for some rehabilitation programs is reduction in the use of pain-related medication. Medication costs savings from pain rehabilitation programs have not been analyzed in previous studies. Design., This prospective cohort study of 186 patients with CNMP addresses the costs of medications at admission to a 3-week outpatient pain rehabilitation program, at discharge, and at 6-month follow-up. Medication use was determined through a detailed pharmacist interview with patients at admission and discharge. Patients were sent questionnaires 6 months after program completion, which obtained current medication information. Results., Statistically significant medication cost savings were seen for program completers at discharge and at 6-month follow-up (P < 0.05). The mean (standard deviation) daily prescription medication cost reduction from admission to discharge was $9.31 ($12.70) using the average wholesale price of medications. From the original study cohort, 121 patients completed the 6-month follow-up survey. The mean daily prescription medication cost savings from admission to 6-month follow-up was $6.68 ($14.40). Conclusion., Patients benefited from significant medication cost savings at the completion of the 3-week outpatient pain rehabilitation program and maintained significant savings after 6 months. This study adds to the current literature on the economic value of comprehensive pain rehabilitation programs. [source] From electronic grade to solar grade silicon: chances and challenges in photovoltaicsPHYSICA STATUS SOLIDI (A) APPLICATIONS AND MATERIALS SCIENCE, Issue 15 2005S. Pizzini Abstract Photovoltaics is a promising but challenging opportunity for the environmentally clean production of electric energy, as the cost of the produced energy is still too high to compete with conventional thermal and nuclear sources, in spite of the scientific and technological progress occurred in this field after the first oil crisis of 1973. Among the problems which should be solved to make photovoltaics fully competitive, a breakthrough concerning the cost reduction of the base material is compulsory. Aim of this paper is to discuss the scientific and technological problems encountered in the development of solar silicon for its use in high efficiency and low cost solar cells, and to give some firm experimental evidences about its potentialities. (© 2005 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] UPSTREAM VOLATILITY IN THE SUPPLY CHAIN: THE MACHINE TOOL INDUSTRY AS A CASE STUDYPRODUCTION AND OPERATIONS MANAGEMENT, Issue 3 2000EDWARD G. ANDERSON JR. Cyclicality is a well-known and accepted fact of life in market-driven economies. Less well known or understood, however, is the phenomenon of amplification as one looks "upstream" in the industrial supply chain. We examine the amplification phenomenon and its implications through the lens of one upstream industry that is notorious for the intensity of the business cycles it faces: the machine tool industry. Amplification of demand volatility in capital equipment supply chains, e. g., machine tools, is particularly large relative to that seen in distribution and component parts supply chains. We present a system dynamics simulation model to capture demand volatility amplification in capital supply chains. We explore the lead-time, inventory, production, productivity, and staffing implications of these dynamic forces. Several results stand out. First, volatility hurts productivity and lowers average worker experience. Second, even though machine tool builders can do little to reduce the volatility in their order streams through choice of forecast rule, a smoother forecasting policy will lead companies to retain more of their skilled work force. This retention of skilled employees is often cited as one of the advantages that European and Japanese companies have had relative to their U. S. competitors. Our results suggest some insights for supply chain design and management: downstream customers can do a great deal to reduce the volatility for upstream suppliers through their choice of order forecast rule. In particular, companies that use smoother forecasting policies tend to impose less of their own volatility upon their supply base and may consequently enjoy system-wide cost reduction. [source] 8% Efficient thin-film polycrystalline-silicon solar cells based on aluminum- induced crystallization and thermal CVDPROGRESS IN PHOTOVOLTAICS: RESEARCH & APPLICATIONS, Issue 7 2007I. Gordon Abstract A considerable cost reduction could be achieved in photovoltaics if efficient solar cells could be made from polycrystalline-silicon (pc-Si) thin films on inexpensive substrates. We recently showed promising solar cell results using pc-Si layers obtained by aluminum-induced crystallization (AIC) of amorphous silicon in combination with thermal chemical vapor deposition (CVD). To obtain highly efficient pc-Si solar cells, however, the material quality has to be optimized and cell processes different from those applied for standard bulk-Si solar cells have to be developed. In this work, we present the different process steps that we recently developed to enhance the efficiency of pc-Si solar cells on alumina substrates made by AIC in combination with thermal CVD. Our present pc-Si solar cell process yields cells in substrate configuration with efficiencies so far of up to 8·0%. Spin-on oxides are used to smoothen the alumina substrate surface to enhance the electronic quality of the absorber layers. The cells have heterojunction emitters consisting of thin a-Si layers that yield much higher Voc values than classical diffused emitters. Base and emitter contacts are on top of the cell in interdigitated finger patterns, leading to fill factors above 70%. The front surface of the cells is plasma textured to increase the current density. Our present pc-Si solar cell efficiency of 8% together with the fast progression that we have made over the last few years indicate the large potential of pc-Si solar cells based on the AIC seed layer approach. Copyright © 2007 John Wiley & Sons, Ltd. [source] Use of mixed technologies to remediate chlorinated DNAPL at a Brownfields siteREMEDIATION, Issue 3 2008David Robinson A former chlorofluorocarbon manufacturing facility in northern New Jersey was purchased for redevelopment as a warehousing/distribution center as part of the New Jersey Department of Environmental Protection's Brownfields redevelopment initiative. Soil and groundwater at the site were impacted with dense nonaqueous-phase liquids (chlorinated organic compounds) and light nonaqueous-phase liquids (petroleum hydrocarbons). The initial remedial strategy (excavation and offsite disposal) developed by prior site owners would have been cost-prohibitive to the new site owners and made redevelopment infeasible. Mixed remedial technologies were employed to reduce the cost of remediation while meeting regulatory contaminant levels that are protective of human health and the environment. The most heavily impacted soils (containing greater than 95 percent of the contaminant mass) were excavated and treated onsite by the addition of calcium oxide and lime kiln dust coupled with physical mixing. Treated soils were reused onsite as part of the redevelopment. Residual soil and groundwater contamination was treated via in situ injections of emulsified oil to enhance anaerobic biodegradation, and emulsified oil/zero-valent iron to chemically reduce residual contaminants. Engineering (cap) and administrative (deed restriction) controls were used as part of the final remedy. The remedial strategy presented in this article resulted in a cost reduction of 50 percent of the initial remedial cost estimate. © 2008 Wiley Periodicals, Inc. [source] DOES ELECTRICITY RESTRUCTURING WORK?THE JOURNAL OF INDUSTRIAL ECONOMICS, Issue 3 2007EVIDENCE FROM THE U.S. NUCLEAR ENERGY INDUSTRY This paper examines whether electricity restructuring improves the efficiency of U.S. nuclear power generation. Using a panel dataset consisting of the full sample of 73 investor-owned nuclear plants in the United States from 1992 to 1998, I estimate the plant-level cross-sectional and longitudinal efficiency changes associated with restructuring. Special attention is given to the potential policy endogeneity bias and different modeling strategies are presented to cope with the issue. Overall, I find a striking positive relationship between restructuring and cost reduction, and increased plant utilization. [source] Health Care Information Technology in Rural America: Electronic Medical Record Adoption Status in Meeting the National AgendaTHE JOURNAL OF RURAL HEALTH, Issue 2 2008James A. Bahensky MS ABSTRACT:,Continuing is a national political drive for investments in health care information technology (HIT) that will allow the transformation of health care for quality improvement and cost reduction. Despite several initiatives by the federal government to spur this development, HIT implementation has been limited, particularly in the rural market. The status of technology use in the transformation effort is reviewed by examining electronic medical records (EMRs), analyzing the existing rural environment, identifying barriers and factors affecting their development and implementation, and recommending needed steps to make this transformation occur, particularly in rural communities. A review of the literature for HIT in rural settings indicates that very little progress has been made in the adoption and use of HIT in rural America. Financial barriers and a large number of HIT vendors offering different solutions present significant risks to rural health care providers wanting to invest in HIT. Although evidence in the literature has demonstrated benefits of adopting HIT such as EMRs, important technical, policy, organizational, and financial barriers still exist that prevent the implementation of these systems in rural settings. To expedite the spread of HIT in rural America, federal and state governments along with private payers, who are important beneficiaries of HIT, must make difficult decisions as to who pays for the investment in this technology, along with driving standards, simplifying approaches for reductions in risk, and creating a workable operational plan. [source] | ||||||||||||||||||||||||||||||||||||||||