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Additional Cost (additional + cost)
Selected AbstractsComparison of Additional Costs for Several Replacement Strategies of Randomly Ageing Reinforced Concrete PipesCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 7 2009Franck Schoefs Some of them carry seawater and can deteriorate with time because of internal corrosion. Because of the low O2 content of aggressive water, slow corrosion is expected for such applications. If the RCPs are not periodically replaced, they will eventually fail. Replacement strategies for these pipes depend on (1) the risks associated with the failure of the water distribution network, and (2) the costs associated with replacing the pipes, including the removal of existing pipes, installation of new pipes, and associated production losses. Because of the lack of statistical data regarding RCP failure, the development of a risk-based replacement strategy is not an easy task. This article demonstrates how predictive models for the evolution of the failure of RCPs and the associated consequences of failure can be used to develop risk-based replacement strategies for RCPs. An application for the replacement strategies of a network modeled as a system consisting of 228 RCPs is presented as a case study. We focus on the assessment of the number of replaced components that governs the costs. The main objective of this article is to provide a theoretical approach for comparing replacement strategies, based on (1) the results of a reliability study, (2) the representation of the distributions of failed components (binomial distribution), and (3) the decision tree representation for replacement of RCPs. A focus on the scatter of the induced costs themselves is suggested to emphasize the financial risk. [source] The public health problem of acute respiratory illness in childcareJOURNAL OF CLINICAL NURSING, Issue 3 2001AFCHSE, Helen McCutcheon BA, MRCNA ,,Acute respiratory illness continues to be a significant problem for children attending childcare. ,,The problems for the child are in terms of prevalence, incidence, and quality of life. ,,Additional costs relate to parental absence from work and loss of earnings. ,,This paper reports on the literature, and notes that little research has been undertaken to determine whether there are long-term risks or benefits to experiencing acute respiratory illness in early childhood. ,,Research to date is presented, and the role of public health nurses is discussed in relation to how they might assist in reducing the incidence/prevalence of acute respiratory illness in children attending childcare. [source] Cost-effectiveness of targeted and tailored interventions on colorectal cancer screening useCANCER, Issue 4 2008David R. Lairson PhD Abstract BACKGROUND. Colorectal cancer (CRC) screening is cost-effective but underused. The objective of this study was to determine the cost-effectiveness of targeted and tailored behavioral interventions to increase CRC screening use by conducting an economic analysis associated with a randomized trial among patients in a large, racially and ethnically diverse, urban family practice in Philadelphia. METHODS. The incremental costs per unit increase were measured in individuals who were screened during the 24 months after intervention. Percent increase in screening was adjusted for baseline differences in the study groups. Each intervention arm received a targeted screening invitation letter, stool blood test (SBT) cards, informational booklet, and reminder letter. Tailored interventions incrementally added tailored messages and reminder telephone calls. RESULTS. Program costs of the targeted intervention were $42 per participant. Additional costs of adding tailored print materials and of delivering a reminder telephone call were $150 and $200 per participant, respectively. The cost per additional individual screened was $319 when comparing the no intervention group with the targeted intervention group. CONCLUSIONS. The targeted intervention was more effective and less costly than the tailored intervention. Although tailoring plus reminder telephone call was the most effective strategy, it was very costly per additional individual screened. Mailed SBT cards significantly boosted CRC screening use. However, going beyond the targeted intervention to include tailoring or tailoring plus reminder calls in the manner used in this study did not appear to be an economically attractive strategy. Cancer 2008. © 2007 American Cancer Society. [source] A fast triangle to triangle intersection test for collision detectionCOMPUTER ANIMATION AND VIRTUAL WORLDS (PREV: JNL OF VISUALISATION & COMPUTER ANIMATION), Issue 5 2006Oren Tropp Abstract The triangle-to-triangle intersection test is a basic component of all collision detection data structures and algorithms. This paper presents a fast method for testing whether two triangles embedded in three dimensions intersect. Our technique solves the basic sets of linear equations associated with the problem and exploits the strong relations between these sets to speed up their solution. Moreover, unlike previous techniques, with very little additional cost, the exact intersection coordinates can be determined. Finally, our technique uses general principles that can be applied to similar problems such as rectangle-to-rectangle intersection tests, and generally to problems where several equation sets are strongly related. We show that our algorithm saves about 20% of the mathematical operations used by the best previous triangle-to-triangle intersection algorithm. Our experiments also show that it runs 18.9% faster than the fastest previous algorithm on average for typical scenarios of collision detection (on Pentium 4). Copyright © 2006 John Wiley & Sons, Ltd. [source] Issues Regarding the Composition of Capital FlowsDEVELOPMENT POLICY REVIEW, Issue 1 2001John Williamson This article considers the composition of capital flows to developing countries. After developing a taxonomy of the alternative possible forms, it presents a brief summary of the main facts and stylised facts of relevance to the topic. It argues that accessing FDI, portfolio equity, or long-term loans, as opposed to short-term loans (e.g. from banks), is well worth the additional cost, because of advantages in terms of risk-sharing, access to intellectual property, impact on investment, and lesser vulnerability to capital flow reversal. It proceeds to discuss the extent to which authorities control appropriate policy levers and concludes with a brief look at the composition of capital outflows from developing countries. [source] Hexavalent uranium supports growth of Anaeromyxobacter dehalogenans and Geobacter spp. with lower than predicted biomass yieldsENVIRONMENTAL MICROBIOLOGY, Issue 11 2007Robert A. Sanford Summary The stimulation of bacteria capable of reducing soluble U(VI) to sparingly soluble U(IV) is a promising approach for containing U(VI) plumes. Anaeromyxobacter dehalogenans is capable of mediating this activity; however, its ability to couple U(VI) reduction to growth has not been established. Monitoring the increase in 16S rRNA gene copy numbers using quantitative real-time PCR (qPCR) in cultures provided with U(VI) as an electron acceptor demonstrated growth, and 7.7,8.6 × 106 cells were produced per ,mole of U(VI) reduced. This biomass yield was lower than predicted based on the theoretical free energy changes associated with U(VI)-to-U(IV) reduction. Lower than predicted growth yields with U(VI) as electron acceptor were also determined in cultures of Geobacter lovleyi and Geobacter sulfurreducens suggesting that U(VI) reduction is inefficient or imposes an additional cost to growing cells. These findings have implications for U(VI) bioremediation because Anaeromyxobacter spp. and Geobacter spp. contribute to radionuclide immobilization in contaminated subsurface environments. [source] Stochastic Cost Optimization of Multistrategy DNAPL Site RemediationGROUND WATER MONITORING & REMEDIATION, Issue 3 2010Jack Parker This paper investigates numerical optimization of dense nonaqueous phase liquid (DNAPL) site remediation design considering effects of prediction and measurement uncertainty. Results are presented for a hypothetical problem involving remediation using thermal source reduction (TSR) and bioremediation with electron donor (ED) injection. Pump-and-treat is utilized as a backup measure if compliance criteria are not met. Remediation system design variables are optimized to minimize expected net present value (ENPV) cost. Adaptive criteria are assumed for real-time control of TSR and ED duration. Source zone dissolved concentration data enabled more reliable and lower cost operation of TSR than soil concentration data, but using both soil and dissolved data improved results sufficiently to more than offset the additional cost. Decisions to terminate remediation and monitoring or to initiate pump-and-treat are complicated by measurement noise. Simultaneous optimization of monitoring frequency, averaging period, and lookback periods to confirm decisions, in addition to remediation design variables, reduced ENPV cost. Results indicate that remediation design under conditions of uncertainty is affected by subtle interactions and tradeoffs between design variables, compliance rules, site characteristics, and uncertainty in model predictions and monitoring data. Optimized designs yielded cost savings of up to approximately 50% compared with a nonoptimized design based on common engineering practices. Significant improvements in accuracy and reductions in cost were achieved by recalibrating the model to data collected during remediation and re-optimizing design variables. Repeating this process periodically is advisable to minimize total costs and maximize reliability. [source] Evaluation of the cost-effectiveness of root canal treatment using conventional approaches versus replacement with an implantINTERNATIONAL ENDODONTIC JOURNAL, Issue 10 2009M. W. Pennington Abstract Aim, To evaluate the cost-effectiveness of root canal treatment for a maxillary incisor tooth with a pulp infection, in comparison with extraction and replacement with a bridge, denture or implant supported restoration. Methodology, A Markov model was built to simulate the lifetime path of restorations placed on the maxillary incisor following the initial treatment decision. It was assumed that the goal of treatment was the preservation of a fixed platform support for a crown without involving the adjacent teeth. Consequently, the model estimates the lifetime costs and the total longevity of tooth and implant supported crowns at the maxillary incisor site. The model considers the initial treatment decisions, and the various subsequent treatment decisions that might be taken if initial restorations fail. Results, Root canal treatment extended the life of the tooth at an additional cost of £5,8 per year of tooth life. Provision of orthograde re-treatment, if the root canal treatment fails returns further extension of the expected life of the tooth at a cost of £12,15 per year. Surgical re-treatment is not cost-effective; it is cheaper, per year, to extend the life of the crown by replacement with a single implant restoration if orthograde endodontic treatment fails. Conclusion, Modelling the available clinical and cost data indicates that, root canal treatment is highly cost-effective as a first line intervention. Orthograde re-treatment is also cost-effective, if a root treatment subsequently fails, but surgical re-treatment is not. Implants may have a role as a third line intervention if re-treatment fails. [source] Bias from Farmer Self-Selection in Genetically Modified Crop Productivity Estimates: Evidence from Indian DataJOURNAL OF AGRICULTURAL ECONOMICS, Issue 1 2007Benjamin Crost Q12; D81 Abstract In the continuing debate over the impact of genetically modified (GM) crops on farmers of developing countries, it is important to accurately measure magnitudes such as farm-level yield gains from GM crop adoption. Yet most farm-level studies in the literature do not control for farmer self-selection, a potentially important source of bias in such estimates. We use farm-level panel data from Indian cotton farmers to investigate the yield effect of GM insect-resistant cotton. We explicitly take into account the fact that the choice of crop variety is an endogenous variable which might lead to bias from self-selection. A production function is estimated using a fixed-effects model to control for selection bias. Our results show that efficient farmers adopt Bacillus thuringiensis (Bt) cotton at a higher rate than their less efficient peers. This suggests that cross-sectional estimates of the yield effect of Bt cotton, which do not control for self-selection effects, are likely to be biased upwards. However, after controlling for selection bias, we still find that there is a significant positive yield effect from adoption of Bt cotton that more than offsets the additional cost of Bt seed. [source] Relation between Holstein bulls' proofs for milk in USA and the survival and body weights up to 18 months of their F1 zebu progeny in VenezuelaJOURNAL OF ANIMAL BREEDING AND GENETICS, Issue 3 2003J. R. Pacheco Summary The purpose of the study was to determine the relation between Holstein bulls' proofs for milk in USA, and the survival and body weights of their F1 progeny under lowland grazing conditions in Venezuela. Semen was selected from sires with the highest proofs available locally (class H, n = 23) or with proofs close to the breed average (class A, n = 18). Mean proofs were 934 kg (H) and 237 kg (A), respectively, when semen was purchased (1989,93), falling to 204 and ,386 kg when updated in 2001. Dams were Brahman-type zebus on seven farms, raising the F1 progeny (n = 866) on native or cultivated pasture with only mineral supplements. Records of survival to 8 and 18 months and weights at birth, 8 and 18 months of age were analysed using linear models. Sire class had no effect on survival or weight at birth, but H progeny were slightly heavier than A progeny at 8 (4.0%, p = 0.06) and 18 months (2.6%, p < 0.05). The interaction class × farm was only significant for survival, with H progeny equal or superior to A groups on six farms. The effect of sire within class was highly significant for survival to 8 months and weight at 18 months. Rank correlations using sires' milk proofs and F1 progeny weights and survival were not significant. It was concluded that the use of Holstein bulls with high milk proofs may lead to slightly higher 18-month weights in their F1 progeny in tropical grazing systems, covering the additional cost of H semen, but that sire evaluation for weight gain and progeny survival rates may be justified under these conditions. Zusammenfassung Beziehungen zwischen den Zuchtwerten für Milch von Holstein-Bullen in den USA und dem Überleben und dem Körpergewicht bis zu 18 Monaten ihrer F1-Zebu-Nachkommen in Venezuela Der Zweck dieser Studie war die Ermittlung der Beziehungen zwischen den Milch-Zuchtwerten von Holstein-Bullen in den USA und dem Überleben und dem Körpergewicht von F1-Nachkommen unter den Weidebedingungen des Flachlandes in Venezuela. Ausgewählt wurde das Sperma von lokal verfügbaren Bullen mit den höchsten Zuchtwerten (Klasse H, n = 23) oder mit Zuchtwerten, die eng am Populationsdurchschnitt (Klasse A, n = 18) lagen. Beim Erwerb des Spermas (1989,1993) betrugen die mittleren Zuchtwerte 934 kg (H) beziehungsweise 237 kg (A), die bei der Neubewertung 2001 auf 204 kg und ,386 kg abfielen. Die Kühe waren Zebus im Brahman-Typ von sieben Farmen, die die F1-Nachkommen (n = 866) auf natürlichen oder kultivierten Weiden nur mit zusätzlichem Mineralfutter aufzogen. Das Überleben mit acht und 18 Monaten und das Gewicht bei der Geburt, mit acht und mit 18 Monaten wurde mittels linearer Modelle analysiert. Die Bullenklasse zeigte keinen Effekt auf das Überleben und das Geburtsgewicht, aber die H-Nachkommen waren mit acht (4%, p = 0,06) und 18 Monaten (2,6%, p < 0,05) etwas schwerer als die A-Nachkommen. Die Interaktion "Klasse × Farm" war nur für das Überleben signifikant, mit H-Nachkommen gleich oder besser als die A-Gruppen auf sechs Farmen. Der Effekt des Vaters innerhalb der Klasse war hochsignifikant für das Überleben der ersten acht Monate und das Gewicht mit 18 Monaten. Rang-Korrelationen mit den Milch-Zuchtwerten der Bullen und den Gewichten und dem Überleben der F1-Nachkommen waren nicht signifikant. Die Verwendung von Holstein-Bullen mit hohen Zuchtwerten für Milch kann zu einer leichten Erhöhung des Gewicht der F1-Nachkommen mit 18 Monaten in tropischen Weidesystemen führen, welche die zusätzlichen Kosten des H-Spermas abdeckt, aber die Bewertung der Bullen hinsichtlich Gewichtszunahme und Überlebensrate der Nachkommen müsste unter diesen Bedingungen berichtigt werden. [source] Abdominal Aortic Calcification Detected on Lateral Spine Images From a Bone Densitometer Predicts Incident Myocardial Infarction or Stroke in Older WomenJOURNAL OF BONE AND MINERAL RESEARCH, Issue 3 2008John T Schousboe MD Abstract Among a cohort of elderly women, abdominal aortic calcification scored on baseline lateral spine densitometric images intended for vertebral fracture assessment was associated with subsequent myocardial infarction or stroke over a median 4-yr period, independent of clinical cardiovascular disease risk factors. Introduction: Cardiovascular disease (CVD) risk among older women is not adequately captured by traditional CVD risk factors. Lateral spine images obtained on bone densitometers for vertebral fracture assessment (VFA) can detect abdominal aortic calcification (AAC), an important marker of subclinical CVD. Our objective was to estimate the association between AAC scored on VFA images and subsequent myocardial infarction (MI) or stroke in elderly women. Materials and Methods: Among participants in a randomized controlled trial (women; age >75 yr) of clodronate versus placebo, those who sustained an MI or stroke during the median 4-yr follow-up study period were selected as cases (n = 408), and 408 controls were randomly selected from the remainder of the parent study population. Baseline VFA images were scored for AAC with a previously validated 24-point scale and a newer, simpler 8-point scale. Results: The OR of incident MI or stroke for those in the middle and top tertiles, respectively, compared with the bottom tertile of AAC score were 1.14 (95% CI, 0.79,1.66) and 1.74 (95% CI, 1.19,2.56) for the 24-point scale and 1.42 (95% CI, 0.98,2.05) and 1.77 (95% CI, 1.22,2.55) for the 8-point scale, adjusted for age, high-density lipoprotein and low-density lipoprotein cholesterol, triglycerides, blood pressure, smoking, renal function, health status, and baseline diagnoses of diabetes mellitus, hypertension, angina, and prior stroke. Conclusions: AAC scored on VFA images is independently associated with incident MI or stroke. Because bone densitometry is indicated for all women ,65 yr of age, VFA imaging offers an opportunity to capture this CVD risk factor in postmenopausal women undergoing bone densitometry at very little additional cost. [source] Current Strategy of Repair of Tetralogy of Fallot in Children and Adults: Emphasis on a New Technique to Create a Monocusp-Patch for Reconstruction of the Right Ventricular Outflow TractJOURNAL OF CARDIAC SURGERY, Issue 6 2008D.Sc., Guo-Wei He M.D., Ph.D. Methods: From 2001 through 2005, 74 patients (50 male, 24 female; mean age of 13.6 ± 0.8 years, ranging from four to 34 years) with TOF (67) or double outlet RV (DORV)-type-TOF (seven) underwent complete repair. The resection of RVOT stenosis ± pulmonary valvotomy was principally through RA. A new two-patch technique to create a folded mono-cusp valve by using autologous pericardium was applied since August 2004. Results: The repair was through RA in 52 patients and through RA + RVOT/PA in 22 patients (18/4). TAPR was performed in 17 patients (23%, eight non-valved and nine valved). The aortic cross-clamp time was 130.1 ± 6.8 min in TAPR group and 85.8 ± 4.6 min in non-TAPR group (p < 0.0001). The operative mortality was 4.0% (3/74) in all and 2.9% (2/67) in TOF patients (due to low output, uncontrollable bleeding, and repeated bleeding from the pulmonary collateral vessels late) and was similar in TAPR or non-TAPR. The valved patch-repaired patients had mild PI and good RV function postoperatively up to eight to 12 months. Conclusions: Repair of TOF in older children/adults should include low rate of TAPR of RVOT. If indicated, the new folded monocusp-patch technique is recommended. It is an effective and simple way to markedly reduce postoperative PI with no additional cost. [source] Consumer Awareness and Willingness to Pay for High-Pressure Processing of Ready-to-Eat FoodJOURNAL OF FOOD SCIENCE EDUCATION, Issue 2 2009Doris T. Hicks ABSTRACT:, Commercial, nonthermal processing of food, such as high hydrostatic-pressure processing (HPP), has increased. The safety and quality of foods produced by HPP has not been well communicated to the public. An online, nationwide consumer survey was implemented to assess awareness of alternative food processing technologies, consumer food safety attitudes and knowledge, and willingness to pay (WTP) for HPP products. The consumer survey was administered by ZoomerangÔ, an online survey clearinghouse. The survey was completed by 1204 adults. Frequencies and crosstabs were calculated on Zoomerang and SPSS used for one-way ANOVA and chi-square analyses. The survey assessed knowledge of HPP, attitudes about new food processing techniques, WTP for HPP foods and demographics. Overall, many demographic characteristics reflected U.S. census population. While traditional methods, that is, canning, freezing, and microwaving were all well recognized by over 80% of respondents, only 8% recognized HPP. Trends indicated an increase in age, education, and income reflected greater food safety knowledge. Regardless of demographics, no survey respondent exhibited knowledge mastery (80%). Given an explanation of HPP and its benefits, 39% of respondents indicated they would be WTP an additional cost, with higher income and education having the most impact. Majority of respondents indicated a WTP of $0.25 to $0.50 regardless of the value of the food product. More respondents were WTP slightly more for a more expensive product. New technologies often encounter a stumbling block in consumer acceptance and processing costs. A consumer's WTP, once they were informed, could encourage industry to look favorably on this technology. [source] Enhancing high water content biomass gasification with impregnated Ca in fuel dryingAICHE JOURNAL, Issue 10 2006Guangwen Xu Abstract In view of energy conversion efficiency, the gas production from high water content (>60 wt.%) biomass via gasification is necessarily conducted with fuel drying in advance. In regard to this kind of processes, the present study was devised to impregnate Ca onto fuel during fuel drying and thereby to increase fuel's gasification reactivity to raise the gas production efficiency with minimal additional cost. By employing wet coffee grounds as a model biomass fuel and slurry dewatering in kerosene as the adopted drying technology, the Ca impregnation was implemented through dosing Ca(OH)2 into a fuel-kerosene slurry and in turn treating the slurry in the same way as for the case without Ca addition. The resulting Ca (4.0 wt.% load in CaO base) exhibited high dispersion through the fuel matrix in both SEM-EDX image and XRD spectrum. Gasification of the fuel in a pilot dual fluidized gasification setup further demonstrated that the fuel possessed distinctively high reaction reactivity. This led it to show C and H conversions of 91% and 138%, respectively, at a reaction temperature of about 1083 K, whereas these conversions were only 70% and 92% for the fuel with a similar amount of physically mixed CaO. The catalytic effect of the impregnated Ca manifested also on hydrocarbon reforming and water gas shift, making the resulting product gas evidently rich in H2 and lean in CO and hydrocarbons. © 2006 American Institute of Chemical Engineers AIChE J, 2006 [source] Optical and physicochemical properties of silica-supported TiO2 photocatalystsAICHE JOURNAL, Issue 8 2006Javier Marugán Abstract Commercial applications of photocatalysis in slurry reactors employing titanium dioxide particles present the disadvantage of the additional cost associated with the downstream catalyst separation. In past years a significant effort has been made to develop supported titania photocatalysts on particles of larger size in order to facilitate the sedimentation recovery process. In this work, two different silica materials have been used for preparing immobilized catalysts. Their physicochemical characteristics have been compared with those corresponding to two commercially available unsupported titanium dioxide catalysts. However, for reaction kinetics and reactor design purposes, three additional properties must be known: (i) the spectral specific radiation absorption coefficient, (ii) the spectral specific radiation scattering coefficient, and (iii) the asymmetry factor of a model for the angular distribution of the scattered photons (the phase function). They have been determined with specially designed spectrophotometer transmission, diffuse transmittance, and diffuse reflectance experiments and constitute the most significant addition to this contribution. © 2006 American Institute of Chemical Engineers AIChE J, 2006 [source] Assessing Cost-Effectiveness of Sealant Placement in ChildrenJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2 2005Rocio B. Quiñonez DMD Abstract Objective: The lack of cost-effectiveness information regarding sealant placement strategies is thought to have influenced reimbursement policies and subsequent sealant utilization in dental practice. This study compared three strategies for managing the occlusal surfaces of first permanent molars: seal all (SA), risk-based (RBS), and seal none (SN). Methods: A decision tree was developed for various possible outcomes following each of the above strategies. Due to the complexity of the decision tree, a Markov model was used to allow for the construction of a chain of events representing the natural history of sealant retention, caries formation, and their associated health states. The outcome measures were the incremental cost per month gained in a cavity-free state over a ten-year period. Results: Our theoretical model showed that RBS strategy improved clinical outcomes, in the form of cavity-free months, and saved money over SN. The strategy of sealing both high and low risk teeth (SA) further improved outcomes but at an additional cost compared to RBS. However, the cost was small, $08 for each additional cavity-free month gained per tooth. Further, minor changes in the baseline assumptions resulted in the SA strategy being the dominant strategy. Conclusion: This study provides evidence that sealing children's first permanent molars can improve outcomes and save money by delaying or avoiding invasive treatment and the destructive cycle of caries. In a time of limited funds for dental services, these results can assist payers in establishing more rational sealant reimbursement policies. [source] Public congestion network situations and related gamesNETWORKS: AN INTERNATIONAL JOURNAL, Issue 4 2010John Kleppe Abstract This article analyses congestion in network situations from a cooperative game theoretic perspective. In network situations, players have to connect themselves to a source. As we consider publicly available networks, any group of players is allowed to use the entire network to establish their connections. We deal with the problem of finding an optimal network and discuss the associated cost allocation problem. For the latter, we introduce two different transferable utility cost games. For concave cost functions, we use the direct cost game, in which coalition costs are based on what a coalition can do in the absence of other players. This article, however, mainly discusses network situations with convex cost functions, which are analyzed by the use of the marginal cost game. In this game, the cost of a coalition is defined as the additional cost it induces when it joins the complementary group of players. We prove that this game is concave. Furthermore, we define a cost allocation by means of three equal treatment principles and show that this allocation is an element of the core of the marginal cost game. These results are extended to a class of continuous network situations and associated games. © 2009 Wiley Periodicals, Inc. NETWORKS, 2010 [source] Partnership Between an Educational Institution and a Healthcare Agency,Lessons Learned: Part INURSING FORUM, Issue 3 2009Loucine M. Huckabay RN PURPOSE., The purpose of this paper is to provide a model of a partnership program between a major educational institution and a large community medical center that has become a win,win situation for both, which enabled the former to double its undergraduate nursing (BSN) program when it was on the verge of reducing enrollments by 33% because of repeated financial cuts, and a healthcare agency (HCA) to find a creative way of hiring BSN-educated registered nurses in perpetuity, thus reducing their $2 million a month recruitment expenses. PROCESS., This was a 5-year, $15 million partnership between California State University, Long Beach, School of Nursing and Long Beach Memorial Medical Center/Miller Children's Hospital. The HCA contributed the $10 million in funds and in in-kind contributions in the form of facilities and adjunct clinical professors, and the university contributed the $5 million, all in in-kind contribution by doubling the lecture classes without additional cost. The project started in the spring of 2004. CONCLUSION., To date, eight groups have graduated from this program for a total of 288 additional BSN graduates. Retention rate has been a minimum of 95%. Over 95% of the graduates have been hired by the participating HCA. Indeed, it has been a win,win situation for both. [source] Thick, cheap and easy: Fortifying texture-modified meals with infant cerealNUTRITION & DIETETICS, Issue 2 2007Suzanne KENNEWELL Abstract Patients requiring texture-modified meals, particularly those with dysphagia, were identified as being at high risk of malnutrition and aspiration. The innovative use of a common infant cereal as an iron-fortified thickening agent significantly improved food texture and increased iron content of pureed and minced meals by 57%, without any discernible change in flavour. These results are currently benefiting up to 33% of patients and can be directly applied to all areas where consumers require thickened, iron-rich texture-modified meals with minimal additional cost. [source] Evaluation of the performance of iron-based oxygen scavengers, with comments on their optimal applicationsPACKAGING TECHNOLOGY AND SCIENCE, Issue 1 2005Joseph Miltz Abstract Oxygen scavengers are commonly used in packaged foods in Japan and much less so in other developed countries, in spite of the advantages that they offer in maintaining quality and extending shelf-life. The reason stems from the additional cost involved, and even more so because of the lack of sufficient technical information on their performance and the lack of understanding of how to apply them effectively. In the present study the performance of iron-based oxygen-scavenging sachets was evaluated. It was found that the actual scavenging capacity is much higher than the ,nominal' capacity provided by the manufacturers. Also, a significant distribution in the oxygen absorption capacity exists, even in the same scavenger type. The rate of oxygen scavenging was found to depend on the scavenger type and capacity. It was also found that in an atmosphere containing CO2 (as in MAP applications) the iron-based oxygen scavengers also absorb CO2. Copyright © 2004 John Wiley & Sons, Ltd. [source] Flame retarding effects of nanoclay on wood,fiber compositesPOLYMER ENGINEERING & SCIENCE, Issue 3 2007G. Guo This research article focuses on investigating the effects of nanoclay particles on the flame retarding characteristics of wood,fiber/plastic composites (WPC) using ASTM D635. The processing aspects of nanocomposites with WPC are presented. The processing techniques for controlling the degree of exfoliation and the cost aspect are also described. It turns out that the coupling agent used for wood,fibers is also effective for the exfoliation of clay, and therefore, no additional cost is required. This research indicates that the structure of nanocomposites (i.e., the degree of exfoliation) and the clay content used have a large impact on the flame retardancy of WPC. The flame retardancy is investigated as a function of these parameters. Based on this, a cost-effective way to improve flame retardancy of WPC is presented. POLYM. ENG. SCI., 47:308,313, 2007. © 2007 Society of Plastics Engineers. [source] Down syndrome screening using first-trimester combined tests and contingent use of femur length at routine anomaly scanPRENATAL DIAGNOSIS, Issue 8 2010Laurent J. Salomon Abstract Objective The objective of this study was to evaluate the performance of the contingent use of femur length (FL) at routine mid-trimester scan in screening for Down syndrome (DS) in women having previously undergone first-trimester screening with disclosure of risk estimates. Methods Data from a prospective screening trial for DS in a population of 21 492 women with 80 observed DS were used. The performance of a contingent screening strategy based on adding short FL (FL < 5th percentile) as a soft marker in women at intermediate first-trimester risks was evaluated through simulated data. Results In our population, the median (25th,75th percentile) maternal age was 30.7 years (28.0,33.9; range: 18.0,46.3). The median (25th,75th percentile) gestational age at ultrasound examination was 12 weeks 3 days (12 weeks and 12 weeks 6 days; range: 11 weeks to 13 weeks 6 days). Contingent screening allowed an improvement in screening performance. For example, using a first-trimester risk cut-off of 1/100 and an intermediate-risk population within (1/1000, 1/100) for the search of FL, a sensitivity (Se) of 88.4% at a 3% false-positive rate (FPR) was reached. With a cut-off of 1/200 and an intermediate-risk population within (1/1000, 1/200), screening would allow an Se of 92.3% at a 4% FPR. Conclusions Contingent screening could be used following first-trimester combined screening followed by second-trimester ultrasound soft markers. This could identify indications for early invasive testing in the highest risk cases and would allow efficient and simple ultrasound-based screening in the second trimester. This would provide an 88.4% Se for a 3% FPR, at no additional cost as compared to first-trimester combined screening and routine mid-trimester scan. Copyright © 2010 John Wiley & Sons, Ltd. [source] Infant carrying: The role of increased locomotory costs in early tool developmentAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2007C.M. Wall-Scheffler Abstract Among the costs of reproduction, carrying one's infant incurs one of the greatest drains on maternal energy, simply because of the added mass alone. Because of the dearth of archaeological evidence, however, how early bipeds dealt with the additional cost of having to carry infants who were less able to support their body weight against gravity is not particularly well understood. This article presents evidence on the caloric drain of carrying an infant in one's arms versus having a tool with which to sling the infant and carry her passively. The burden of carrying an infant in one's arms is on average 16% greater than having a tool to support the baby's mass and seems to have the potential to be a greater energetic burden even than lactation. In addition, carrying a baby in one's arms shortens and quickens the stride. An anthropometric trait that seems to offset some of the increased cost of carrying a baby in the arms is a wider bi-trochanteric width. Am J Phys Anthropol, 2007. © 2007 Wiley-Liss, Inc. [source] Touch sensitivity with sterile standard surgical gloves and single-use protective glovesANAESTHESIA, Issue 10 2006W. Tiefenthaler The purpose of this study was to evaluate touch sensitivity and static two-point discrimination of the dominant index and middle finger in 20 anaesthetists wearing no gloves, single-use protective gloves or sterile standard surgical gloves. Semmes-Weinstein filaments were used to measure cutaneous pressure thresholds, and a Two-Point-Discriminator to estimate static two-point discrimination. Wearing gloves significantly reduced touch sensitivity (p < 0.01), but not two-point discrimination. No difference in touch sensitivity or two-point discrimination was found between different types of gloves. The results of our study suggest that the additional cost of sterile standard surgical gloves can not be justified in terms of touch sensitivity. [source] Paternity validation and estimation of genotyping error rate for the BovineSNP50 BeadChipANIMAL GENETICS, Issue 5 2010J. I. Weller Summary Incorrect paternity assignment in cattle can have a major effect on rates of genetic gain. Of the 576 Israeli Holstein bulls genotyped by the BovineSNP50 BeadChip, there were 204 bulls for which the father was also genotyped. The results of 38 828 valid single nucleotide polymorphisms (SNPs) were used to validate paternity, determine the genotyping error rates and determine criteria enabling deletion of defective SNPs from further analysis. Based on the criterion of >2% conflicts between the genotype of the putative sire and son, paternity was rejected for seven bulls (3.5%). The remaining bulls had fewer conflicts by one or two orders of magnitude. Excluding these seven bulls, all other discrepancies between sire and son genotypes are assumed to be caused by genotyping mistakes. The frequency of discrepancies was >0.07 for nine SNPs, and >0.025 for 81 SNPs. The overall frequency of discrepancies was reduced from 0.00017 to 0.00010 after deletion of these 81 SNPs, and the total expected fraction of genotyping errors was estimated to be 0.05%. Paternity of bulls that are genotyped for genomic selection may be verified or traced against candidate sires at virtually no additional cost. [source] Efficiency of quantitative trait loci-assisted selection in correlations between identified and residual genotypesANIMAL SCIENCE JOURNAL, Issue 1 2008Ching Y. LIN ABSTRACT This study quantified the efficiency of quantitative traits loci (QTL)-assisted selection in the presence of correlations (,qr) between identified (q) and residual (r) genotypes. Two levels of heritability (h2 = 0.1 or 0.3), two levels of correlation (,qr = ,0.3 or 0.3) and five proportions of genetic variance explained by QTL detected (= 0.1, 0.2, 0.4, 0.6 or 0.8) were combined to give 20 scenarios in all. QTL-assisted selection placed a larger index weight on the QTL genotype than on the phenotype in 17 of 20 scenarios, yielding a greater response in the QTL genotype than in residual genotype. Although QTL-assisted selection was superior to phenotypic selection in all 20 scenarios, QTL-assisted selection showed a greater advantage over phenotypic selection when ,qr was positive than when ,qr was negative. Doubling the proportion of detected QTL variance to genetic variance does not result in a twofold increase in the genetic response to QTL-assisted selection, suggesting that economic returns diminish for each additional cost of detecting extra QTL. The correlation between q and r would make the interpretation (or prediction) of QTL effects difficult and QTL-assisted selection strategy must consider the joint effect of q and r. When q and r are not independent, a failure to account for ,qr in QTL-assisted selection would underestimate the genetic responses when ,qr is positive, but overestimate the genetic responses when ,qr is negative. Estimation bias is more serious at high heritability than at low heritability. Accounting for ,qr would improve the efficiency of QTL-assisted selection and the accuracy of QTL detection. The generalized procedure developed in this study allows for quantifying the efficiency of QTL-assisted selection and assessing estimation bias for ignoring the correlation between q and r for all possible combinations of h2, ,qr, and . [source] Measurement error bias in pharmaceutical cost-effectiveness analysisAPPLIED STOCHASTIC MODELS IN BUSINESS AND INDUSTRY, Issue 5-6 2006*Article first published online: 20 DEC 200, Ian C. Marschner Abstract Drug development in the pharmaceutical industry is increasingly influenced by measures of cost-effectiveness, such as cost per life-year gained, and some governments make decisions about whether to pay for drugs based on cost-effectiveness considerations. While cost per life-year gained is a key measure of cost-effectiveness, costs associated with the intermediate outcome of improving a biomarker, such as cholesterol level or blood pressure, provide important supplementary information, particularly where mortality data may be limited. In this case, cost-effectiveness can be interpreted as the additional cost per unit time of achieving an additional beneficial biomarker response to treatment. A problem in this context is that biomarker assessment is typically subject to measurement error which leads to bias in assessing the benefit of a drug, and hence in the assessment of its cost-effectiveness. We discuss the adjustment of cost-effectiveness analyses for measurement error and consider the potential magnitude of bias that can arise. Using example calculations in the context of cholesterol-lowering therapy, it is demonstrated that such biases can be significant, leading to costs being overestimated by in excess of 25%. Ignoring measurement error in cost-effectiveness analyses can, therefore, have a substantial effect on the interpretation of such analyses. Copyright © 2006 John Wiley & Sons, Ltd. [source] Should liquid-based cytology be performed prior to colposcopy?AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2009A comparison of the accuracy, cost in a tertiary referral setting, unsatisfactory rates Objective:, To compare the use of liquid-based cytology (LBC) with conventional cytology (CC) in the assessment cervical intraepithelial neoplasia (CIN) prior to colposcopy. Design:, Retrospective Cohort Study. Methods:, Liquid-based cytology and CC findings were compared with colposcopic assessment and directed cervical biopsy in terms of sensitivity and specificity for high grade lesions only and for any abnormalities. The degree of correlation was sought. Secondary outcomes were unsatisfactory rate and cost. Results:, A total of 1961 women had colposcopy of whom 528 had cervical biopsy. LBC and CC have similar sensitivity and specificity for both high-grade lesions and any abnormalities. In comparison with cervical biopsy, LBC and CC sensitivity for high-grade disease was 89.1% and 88.6% respectively and for any abnormalities, the sensitivity was 86.6% and 87.0%. Specificity for high-grade disease was 83.1% and 84.7% and for any abnormalities, the specificity was 53.8% and 56.4%. The unsatisfactory rate was significantly lower in LBC 4.38% compared to 1.84% (P < 0.001). However, the use of LBC was associated with an additional cost of A$1496 for each unsatisfactory smear avoided. Conclusion:, In high prevalence setting, LBC showed no statistically significant difference in sensitivity and specificity from CC for the detection of CIN. A reduction in unsatisfactory smears was evident, but at significant additional cost. [source] A limited sampling strategy for tacrolimus in renal transplant patientsBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 4 2008Binu S. Mathew WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT , Tacrolimus trough concentration is being currently used for dose individualization. , Limited sampling strategies (LSS) have been developed and validated for renal transplant patients. , Earlier literature has suggested that measurement of tacrolimus AUC is more reliable than trough with respect to both rejection and nephrotoxicity. WHAT THIS STUDY ADDS , Four thousand renal transplants take place annually in India, with many patients prescribed tacrolimus in combination with mycophenolate and steroid. , In this study a LSS with two points, i.e. trough and 1.5 h postdose was developed and validated to estimate AUC0,12. , The added benefit of only a single additional sample with completion of blood collection in 1.5 h and minimum additional cost makes this a viable LSS algorithm in renal transplant patients. , In patients having tacrolimus trough concentrations outside the recommended range (<3 and >10 ng ml,1 in the treatment protocol in our institution) or having side-effects in spite of trough concentrations in the desired range, we can estimate AUC using this LSS for a better prediction of exposure. AIMS To develop and validate limited sampling strategy (LSS) equations to estimate area under the curve (AUC0,12) in renal transplant patients. METHODS Twenty-nine renal transplant patients (3,6 months post transplant) who were at steady state with respect to tacrolimus kinetics were included in this study. The blood samples starting with the predose (trough) and collected at fixed time points for 12 h were analysed by microparticle enzyme immunoassay. Linear regression analysis estimated the correlations of tacrolimus concentrations at different sampling time points with the total measured AUC0,12. By applying multiple stepwise linear regression analysis, LSS equations with acceptable correlation coefficients (R2), bias and precision were identified. The predictive performance of these models was validated by the jackknife technique. RESULTS Three models were identified, all with R2 , 0.907. Two point models included one with trough (C0) and 1.5 h postdose (C1.5), another with trough and 4 h postdose. Increasing the number of sampling time points to more than two increased R2 marginally (0.951 to 0.990). After jackknife validation, the two sampling time point (trough and 1.5 h postdose) model accurately predicted AUC0,12. Regression coefficient R2 = 0.951, intraclass correlation = 0.976, bias [95% confidence interval (CI)] 0.53% (,2.63, 3.69) and precision (95% CI) 6.35% (4.36, 8.35). CONCLUSION The two-point LSS equation [AUC0,12 = 19.16 + (6.75.C0) + (3.33.C1.5)] can be used as a predictable and accurate measure of AUC0,12 in stable renal transplant patients prescribed prednisolone and mycophenolate. [source] The Cost Efficiency of Wild Dog Conservation in South AfricaCONSERVATION BIOLOGY, Issue 4 2005P. A. LINDSEY crianza de especies cinegéticas; financiamiento de donantes; Lycaon pictus; metapoblación; reintroducción Abstract:,Aside from Kruger National Park, no other suitable reserves of sufficient size exist in South Africa that will hold a viable population of wild dogs (Lycaon pictus). Consequently, conservation efforts have been focused on creating a metapopulation through a series of wild dog reintroductions into isolated fenced reserves. Additional potential exists for conserving wild dogs on private ranch land. Establishing the metapopulation was an expensive process, accounting for approximately 75% of the US$380,000 spent on wild dog conservation in South Africa during 1997-2001. The principal goal of the metapopulation project was to reduce the risk of catastrophic population decline. Now that this has been achieved, we developed a uniform cost-efficiency index to estimate the cost efficiency of current and potential future conservation strategies in South Africa. Conserving wild dogs in large protected areas was predicted to be the most cost-efficient conservation strategy (449 packs/$100,000 expenditure). Establishing the metapopulation has been less cost efficient (23 packs/$100,000), and expansion of the metapopulation was predicted to be even less cost efficient if predation by wild dogs results in additional costs, as is to be expected if private reserves are used for reintroductions (3-13 packs/$100,000). Because of low logistical costs, conserving wild dogs in situ on private ranch land was potentially more cost efficient than reintroducing wild dogs (14-27 packs/$100,000). We recommend that donor funding be used to reintroduce wild dogs into transfrontier parks, when they are established, to maintain the existing metapopulation and to establish conservation programs involving wild dogs on private ranch land. Investing in the expansion of the metapopulation should be limited to state-owned nature reserves willing to carry predation costs without compensation. Resumen:,Además del Parque Nacional Kruger, en África del Sur no existen otras reservas de suficiente tamaño como para mantener una población viable de perros salvajes (Lycaon pictus). En consecuencia, los esfuerzos de conservación se han enfocado en la creación de una metapoblación por medio de una serie de reintroducciones en pequeñas reservas cercadas. Hay un potencial adicional para la conservación de perros salvajes en terrenos privados. El establecimiento de la metapoblación fue un proceso costoso, ,75% de US $380,000 que fueron gastados en la conservación de perros salvajes entre 1997 y 2001 en África del Sur. La meta principal del proyecto de metapoblación fue la reducción del riesgo de una declinación catastrófica de la población. Ya que esto se ha logrado, desarrollamos un índice de rentabilidad uniforme para estimar la rentabilidad de las actuales y potenciales estrategias de conservación en África del Sur. Se predijo que la estrategia de conservación de más rentable (449manadas/$100,000 de gasto) era la conservación de perros salvajes en áreas protegidas grandes. El establecimiento de la metapoblación ha sido menos rentable (23 manadas/$100,000), y se predijo que la expansión de la metapoblación sería aun menos rentable si la depredación por perros salvajes resulta en costos adicionales, como se esperaría si se utilizan reservas privadas para las reintroducciones (3-13 manadas/$100,000). Debido a los bajos costos de logística, la conservación de perros salvajes in situ en terrenos privados fue potencialmente más rentable que reintroducir a los perros salvajes (14-27 manadas/$100,000). Recomendamos que el financiamiento de donantes sea utilizado para reintroducir perros salvajes en parque transfronterizos, cuando sean establecidos, para mantener a la metapoblación existente y para establecer programas de conservación que involucren a perros salvajes en terrenos privados. La inversión en la expansión de la metapoblación deberá limitarse a reservas naturales propiedad del estado que estén dispuestas a absorber los costos de la depredación sin ser compensadas. [source] | ||||||||||||||||||||||||||||