A cost-effectiveness analysis of two rehabilitation support services for women with breast cancer

The purpose of this research was to estimate the cost-effectiveness of two rehabilitation interventions for breast cancer survivors, each compared to a population-based, non-intervention group (n = 208). The two services included an early home-based physiotherapy intervention (DAART, n = 36) and a group-based exercise and psychosocial intervention (STRETCH, n = 31). A societal perspective was taken and costs were included as those incurred by the health care system, the survivors and community. Health outcomes included: (a) 'rehabilitated cases' based on changes in health-related quality of life between 6 and 12 months post-diagnosis, using the Functional Assessment of Cancer Therapy - Breast Cancer plus Arm Morbidity (FACT-B+4) questionnaire, and (b) quality-adjusted life years (QALYs) using utility scores from the Subjective Health Estimation (SHE) scale. Data were collected using self-reported questionnaires, medical records and program budgets. A Monte-Carlo modelling approach was used to test for uncertainty in cost and outcome estimates. The proportion of rehabilitated cases was similar across the three groups. From a societal perspective compared with the non-intervention group, the DAART intervention appeared to be the most efficient option with an incremental cost of $1344 per QALY gained, whereas the incremental cost per QALY gained from the STRETCH program was $14,478. Both DAART and STRETCH are low-cost, low-technological health promoting programs representing excellent public health investments.

Modelling, nitrogen dynamics in sugarcane systems: Recent advances and applications

Substantial amounts of nitrogen (N) fertiliser are necessary for commercial sugarcane production because of the large biomass produced by sugarcane crops. Since this fertiliser is a substantial input cost and has implications if N is lost to the environment, there are pressing needs to optimise the supply of N to the crops' requirements. The complexity of the N cycle and the strong influence of climate, through its moderation of N transformation processes in the soil and its impact on N uptake by crops, make simulation-based approaches to this N management problem attractive. In this paper we describe the processes to be captured in modelling soil and plant N dynamics in sugarcane systems, and review the capability for modelling these processes. We then illustrate insights gained into improved management of N through simulation-based studies for the issues of crop residue management, irrigation management and greenhouse gas emissions. We conclude by identifying processes not currently represented in the models used for simulating N cycling in sugarcane production systems, and illustrate ways in which these can be partially overcome in the short term. (c) 2005 Elsevier B.V. All rights reserved.

Promoter-, cell-, and ligand-specific transactivation responses of the VDRB1 isoform

The vitamin D receptor (VDR) mediates the effects of 1,25(OH)(2)D-3, the active form of vitamin D. The human VDRB1 isoform differs from the originally described VDR by an N-terminal extension of 50 amino acids. Here we investigate cell-, promoter-, and ligand-specific transactivation by the VDRB1 isoform. Transactivation by these isoforms of the cytochrome P450 CYP24 promoter was compared in kidney (HEK293 and COS1), tumor-derived colon (Caco-2, LS174T, and HCT15), and mammary (HS578T and MCF7) cell lines. VDRB1 transactivation in response to 1,25(OH)(2)D-3 was greater in Cost and HCT15 cells (145%), lower in HEK293 and Caco-2 cells (70-85%) and similar in other cell lines tested. By contrast, on the cytochrome P450 CYP3A4 promoter, 1,25(OH)(2)D-3-induced VDRB1 transactivation was significantly lower than VDRA in Caco-2 (68%), but comparable to VDRA in HEK293 and COS1 cells. Ligand-dependence of VDRB1 differential transactivation was investigated using the secondary bile acid lithocholic acid (LCA). On the CYP24 promoter LCA-induced transactivation was similar for both isoforms in COS1, whereas in Caco-2 and HEK293 cells VDRB1 was less active. On the CYP3A4 promoter, LCA activation of VDRB1 was comparable to VDRA in all the cell lines tested. Mutational analysis indicated that both the 1,25(OH)(2)D-3 and LCA-regulated activities of both VDR isoforms required a functional ligand-dependent activation function (AF-2) domain. In gel shift assays VDR:DNA complex formation was stronger in the presence of 1,25(OH)(2)D-3 than with LCA. These results indicate that regulation of VDRB1 transactivation activity is dependent on cellular context, promoter, and the nature of the ligand. (c) 2005 Elsevier Inc. All rights reserved.

Power flow based monetary flow method for electricity transmission and wheeling pricing

This paper proposes a transmission and wheeling pricing method based on the monetary flow tracing along power flow paths: the monetary flow-monetary path method. Active and reactive power flows are converted into monetary flows by using nodal prices. The method introduces a uniform measurement for transmission service usages by active and reactive powers. Because monetary flows are related to the nodal prices, the impacts of generators and loads on operation constraints and the interactive impacts between active and reactive powers can be considered. Total transmission service cost is separated into more practical line-related costs and system-wide cost, and can be flexibly distributed between generators and loads. The method is able to reconcile transmission service cost fairly and to optimize transmission system operation and development. The case study on the IEEE 30 bus test system shows that the proposed pricing method is effective in creating economic signals towards the efficient use and operation of the transmission system. (c) 2005 Elsevier B.V. All rights reserved.

Co-opting conservation: Migrant resource control and access to national park management in the Philippine uplands

The history of political and economic inequality in forest villages can shape how and why resource use conflicts arise during the evolution of national parks management. In the Philippine uplands, indigenous peoples and migrant settlers co-exist, compete over land and forest resources, and shape how managers preserve forests through national parks. This article examines how migrants have claimed lands and changed production and exchange relations among the indigenous Tagbanua to build on and benefit from otherwise coercive park management on Palawan Island, the Philippines. Migrant control over productive resources has influenced who, within each group, could sustain agriculture in the face of the state's dominant conservation narrative - valorizing migrant paddy rice and criminalizing Tagbanua swiddens. Upon settling, migrant farmers used new political and economic strengths to tap into provincial political networks in order to be hired at a national park. As a result, they were able to steer management to support paddy rice at the expense of swidden cultivation. While state conservation policy shapes how national parks impact upon local resource access and use, older political economic inequalities in forest villages build on such policies to influence how management affects the livelihoods of poor households.

Matching commercial clips from TV streams using a unique, robust and compact signature

One of critical challenges in automatic recognition of TV commercials is to generate a unique, robust and compact signature. Uniqueness indicates the ability to identify the similarity among the commercial video clips which may have slight content variation. Robustness means the ability to match commercial video clips containing the same content but probably with different digitalization/encoding, some noise data, and/or transmission and recording distortion. Efficiency is about the capability of effectively matching commercial video sequences with a low computation cost and storage overhead. In this paper, we present a binary signature based method, which meets all the three criteria above, by combining the techniques of ordinal and color measurements. Experimental results on a real large commercial video database show that our novel approach delivers a significantly better performance comparing to the existing methods.

The effect of business strategies and HRM policies on organizational performance:the Greek experience

This article investigates the relationship between simultaneity in decisions regarding business strategies and human resource management (HRM) policies and their impact on organizational performance. The research is based on a sample of 178 organizations operating in the Greek manufacturing sector. The results of this study support the hypothesis that when business strategies and HRM policies are developed simultaneously, they positively affect organizational performance. This is more valid for decisions taken simultaneously with respect to quality and employee development, innovation and employee rewards and relations, and cost and employee resourcing. © 2008 Wiley Periodicals, Inc.

Decision support system for inspection and maintenance:a case of oil pipelines

The existing method of pipeline health monitoring, which requires an entire pipeline to be inspected periodically, is unproductive. A risk-based decision support system (DSS) that reduces the amount of time spent on inspection has been presented. The risk-based DSS uses the analytic hierarchy process (AHP), a multiple attribute decision-making technique, to identify the factors that influence failure on specific segments and analyzes their effects by determining probability of occurrence of these risk factors. The severity of failure is determined through consequence analysis. From this, the effect of a failure caused by each risk factor can be established in terms of cost and the cumulative effect of failure is determined through probability analysis. The model optimizes the cost of pipeline operations by reducing subjectivity in selecting a specific inspection method, identifying and prioritizing the right pipeline segment for inspection and maintenance, deriving budget allocation, providing guidance to deploy the right mix labor for inspection and maintenance, planning emergency preparation, and deriving logical insurance plan. The proposed methodology also helps derive inspection and maintenance policy for the entire pipeline system, suggest design, operational philosophy, and construction methodology for new pipelines.

Project risk management:a combined analytic hierarchy process and decision tree approach

Time, cost and quality achievements on large-scale construction projects are uncertain because of technological constraints, involvement of many stakeholders, long durations, large capital requirements and improper scope definitions. Projects that are exposed to such an uncertain environment can effectively be managed with the application of risk management throughout the project life cycle. Risk is by nature subjective. However, managing risk subjectively poses the danger of non-achievement of project goals. Moreover, risk analysis of the overall project also poses the danger of developing inappropriate responses. This article demonstrates a quantitative approach to construction risk management through an analytic hierarchy process (AHP) and decision tree analysis. The entire project is classified to form a few work packages. With the involvement of project stakeholders, risky work packages are identified. As all the risk factors are identified, their effects are quantified by determining probability (using AHP) and severity (guess estimate). Various alternative responses are generated, listing the cost implications of mitigating the quantified risks. The expected monetary values are derived for each alternative in a decision tree framework and subsequent probability analysis helps to make the right decision in managing risks. In this article, the entire methodology is explained by using a case application of a cross-country petroleum pipeline project in India. The case study demonstrates the project management effectiveness of using AHP and DTA.

A risk-based model for inspection and maintenance of cross-country petroleum pipeline

The existing method of pipeline health monitoring, which requires an entire pipeline to be inspected periodically, is both time-wasting and expensive. A risk-based model that reduces the amount of time spent on inspection has been presented. This model not only reduces the cost of maintaining petroleum pipelines, but also suggests efficient design and operation philosophy, construction methodology and logical insurance plans. The risk-based model uses Analytic Hierarchy Process (AHP), a multiple attribute decision-making technique, to identify the factors that influence failure on specific segments and analyzes their effects by determining probability of risk factors. The severity of failure is determined through consequence analysis. From this, the effect of a failure caused by each risk factor can be established in terms of cost, and the cumulative effect of failure is determined through probability analysis. The technique does not totally eliminate subjectivity, but it is an improvement over the existing inspection method.

Advances in femtosecond micromachining and inscription of micro and nano photonic devices

This thesis has focused on three key areas of interest for femtosecond micromachining and inscription. The first area is micromachining where the work has focused on the ability to process highly repeatable, high precision machining with often extremely complex geometrical structures with little or no damage. High aspect ratio features have been demonstrated in transparent materials, metals and ceramics. Etch depth control was demonstrated especially in the work on phase mask fabrication. Practical chemical sensing and microfluidic devices were also fabricated to demonstrate the capability of the techniques developed during this work. The second area is femtosecond inscription. Here, the work has utilised the non-linear absorption mechanisms associated with femtosecond pulse-material interactions to create highly localised refractive index changes in transparent materials to create complex 3D structures. The techniques employed were then utilised in the fabrication of Phase masks and Optical Coherence Tomography (OCT) phantom calibration artefacts both of which show the potential to fill voids in the development of the fields. This especially the case for the OCT phantoms where there exists no previous artefacts of known shape, allowing for the initial specification of parameters associated with the quality of OCT machines that are being taken up across the world in industry and research. Finally the third area of focus was the combination of all of the techniques developed through work in planar samples to create a range of artefacts in optical fibres. The development of techniques and methods for compensating for the geometrical complexities associated with working with the cylindrical samples with varying refractive indices allowed for fundamental inscription parameters to be examined, structures for use as power monitors and polarisers with the optical fibres and finally the combination of femtosecond inscription and ablation techniques to create a magnetic field sensor with an optical fibre coated in Terfenol-D with directional capability. Through the development of understanding, practical techniques and equipment the work presented here demonstrates several novel pieces of research in the field of femtosecond micromachining and inscription that has provided a broad range of related fields with practical devices that were previously unavailable or that would take great cost and time to facilitate.

Stakeholder performance measurement:general approaches and methods of economic evaluation

This paper begins by suggesting that when considering Corporate Social Responsibility (CSR), even CSR as justified in terms of the business case, stakeholders are of great importance to corporations. In the UK the Company Law Review (DTI, 2002) has suggested that it is appropriate for UK companies to be managed upon the basis of an enlightened shareholder approach. Within this approach the importance of stakeholders, other than shareholders, is recognised as being instrumental in succeeding in providing shareholder value. Given the importance of these other stakeholders it is then important that corporate management measure and manage stakeholder performance. In order to do this there are two general approaches that could be adopted and these are the use of monetary values to reflect stakeholder value or cost and non-monetary values. In order to consider these approaches further this paper considered the possible use of these approaches for two stakeholder groups: namely employees and the environment. It concludes that there are ethical and practical difficulties with calculating economic values for stakeholder resources and so prefers a multi-dimensional approach to stakeholder performance measurement that does not use economic valuation.

Recent patents and trends in orally disintegrating tablets

Orally disintegrating tablets (ODTs) offer many advantages over the conventional oral dosage forms in terms of convenience and ease of use. Over the last decade, substantial advances in the formulation of ODTs have been achieved in academia and industry that resulted in the emerging of a large number of patents. The aim of this review is to summarise the most recent patents in ODT formulations and highlight their motivations, inventive steps and significances in the development of ODT formulations. Five major techniques have been applied in manufacturing of ODTs, namely conventional tablet press, moulding, freeze drying, tablet loading and pulverization, with majority of the patents dedicated to the use of conventional tablet pressing. The patents have addressed various issues concerning the manufacturing of robust and practical ODT formulations by disclosing new manufacturing techniques, advantageous materials, and innovative formulation steps. However, future developments are required to reduce the cost and widening the application of the new manufacturing techniques, while simplifying and shortening the formulation steps will be crucial in the well established ones.

Statnote 8: statistical power and sample size

Statistical software is now commonly available to calculate Power (P') and sample size (N) for most experimental designs. In many circumstances, however, sample size is constrained by lack of time, cost, and in research involving human subjects, the problems of recruiting suitable individuals. In addition, the calculation of N is often based on erroneous assumptions about variability and therefore such estimates are often inaccurate. At best, we would suggest that such calculations provide only a very rough guide of how to proceed in an experiment. Nevertheless, calculation of P' is very useful especially in experiments that have failed to detect a difference which the experimenter thought was present. We would recommend that P' should always be calculated in these circumstances to determine whether the experiment was actually too small to test null hypotheses adequately.

Outlook and application status of the Rolls-Royce Fuel Cell Systems SOFC

Rolls-Royce fuel cell systems is developing megawatt scale power systems based on solid oxide fuel cell technology. The hybrid design promises to meet challenging energy efficiency, cost and performance targets in a grid friendly fashion. Analysis and testing to date indicate that those targets can be met and enable a wealth of fuel cell applications to meet customer and existing grid and modern grid requirements. Working with a global development team, a series of laboratory tests and evaluations are completed and future field test and evaluation and demonstration planned.