The cost effectiveness of pharmacological smoking cessation therapies in developing countries: a case study in the Seychelles

OBJECTIVE: To examine the incremental cost effectiveness of the five first line pharmacological smoking cessation therapies in the Seychelles and other developing countries. DESIGN: A Markov chain cohort simulation. SUBJECTS: Two simulated cohorts of smokers: (1) a reference cohort given physician counselling only; (2) a treatment cohort given counselling plus cessation therapy. INTERVENTION: Addition of each of the five pharmacological cessation therapies to physician provided smoking cessation counselling. MAIN OUTCOME MEASURES: Cost per life-year saved (LYS) associated with the five pharmacotherapies. Effectiveness expressed as odds ratios for quitting associated with pharmacotherapies. Costs based on the additional physician time required and retail prices of the medications. RESULTS: Based on prices for currently available generic medications on the global market, the incremental cost per LYS for a 45 year old in the Seychelles was 599 US dollars for gum and 227 dollars for bupropion. Assuming US treatment prices as a conservative estimate, the incremental cost per LYS was significantly higher, though still favourable in comparison to other common medical interventions: 3712 dollars for nicotine gum, 1982 dollars for nicotine patch, 4597 dollars for nicotine spray, 4291 dollars for nicotine inhaler, and 1324 dollars for bupropion. Cost per LYS increased significantly upon application of higher discount rates, which may be used to reflect relatively high opportunity costs for health expenditures in developing countries with highly constrained resources and high overall mortality. CONCLUSION: Pharmacological cessation therapy can be highly cost effective as compared to other common medical interventions in low mortality, middle income countries, particularly if medications can be procured at low prices.

A Computer Based Information System for County Equipment Cost Records, Interim Report, HR-173, 1975

This report describes the work accomplished to date on research project HR-173, A Computer Based Information System for County Equipment Cost Records, and presents the initial design for this system. The specific topics discussed here are findings from the analysis of information needs, the system specifications developed from these findings, and the proposed system design based upon the system specifications. The initial system design will include tentative input designs for capturing input data, output designs to show the output formats and the items to be output for use in decision making, file design showing the organization of information to be kept on each piece of equipment in the computer data file, and general system design explaining how the entire system will operate. The Steering Committee appointed by Iowa Highway Research Board is asked to study this report, make appropriate suggestions, and give approval to the proposed design subject to any suggestions made. This approval will permit the designer to proceed promptly with the development of the computer program implementation phase of the design.

A Computer Based Information System for County Equipment Cost Records, Final Report, HR-173, 1975

This appendix is divided into three sections. The first section contains abstracts of each of the eight computer programs in the system, instructions for keypunching the three input documents, and computer operating instructions pertaining to each program. The second section contains system flowcharts for the entire system as well as program flowcharts for each program. The last section contains PL/l program listings of each program.

Cost-benefit analysis of multifunctional agriculture in Finland

Selostus: Kustannus-hyötyanalyysi monivaikutteisesta maataloudesta

Cost-effective measures for diffuse load abatement in forestry

Abstract

Optimizing Pavement Base, Subbase, and Subgrade Layers for Cost and Performance of Local Roads, TR-640

This report is one of two products for this project with the other being a design guide. This report describes test results and comparative analysis from 16 different portland cement concrete (PCC) pavement sites on local city and county roads in Iowa. At each site the surface conditions of the pavement (i.e., crack survey) and foundation layer strength, stiffness, and hydraulic conductivity properties were documented. The field test results were used to calculate in situ parameters used in pavement design per SUDAS and AASHTO (1993) design methodologies. Overall, the results of this study demonstrate how in situ and lab testing can be used to assess the support conditions and design values for pavement foundation layers and how the measurements compare to the assumed design values. The measurements show that in Iowa, a wide range of pavement conditions and foundation layer support values exist. The calculated design input values for the test sites (modulus of subgrade reaction, coefficient of drainage, and loss of support) were found to be different than typically assumed. This finding was true for the full range of materials tested. The findings of this study support the recommendation to incorporate field testing as part of the process to field verify pavement design values and to consider the foundation as a design element in the pavement system. Recommendations are provided in the form of a simple matrix for alternative foundation treatment options if the existing foundation materials do not meet the design intent. The PCI prediction model developed from multi-variate analysis in this study demonstrated a link between pavement foundation conditions and PCI. The model analysis shows that by measuring properties of the pavement foundation, the engineer will be able to predict long term performance with higher reliability than by considering age alone. This prediction can be used as motivation to then control the engineering properties of the pavement foundation for new or re-constructed PCC pavements to achieve some desired level of performance (i.e., PCI) with time.

Aplicació per a la gestió d'una empresa de transport

La finalitat d'aquest projecte és la creació d'una aplicació web per gestionar una empresa d'autobusos. El resultat que s'obtingui anirà dirigit a Agobe Tours SL. Permetrà reservar places als usuaris i l'administrador podrà gestionar tots els esdeveniments relacionats amb el negoci. Es desenvoluparà de zero per crear una aplicació a mida amb el propòsit de complir els objectius de l'empresa.

Independent Central Banks: Low inflation at no cost?: A model with fiscal policy

In this article we extend the rational partisan model of Alesina and Gatti (1995) to include a second policy, fiscal policy, besides monetary policy. It is shown that, with this extension, the politically induced variance of output is not always eliminated nor reduced by delegating monetary policy to an independent and conservative central bank. Further, in flation and output stabilisation will be affected by the degree of conservativeness of the central bank and by the probability of the less in flation averse party gaining power. Keywords: rational partisan theory; fiscal policy; independent central bank JEL Classi fication: E58, E63.

Silicon quantum dots embedded in a SiO2 matrix: From structural study to carrier transport properties

We study the details of electronic transport related to the atomistic structure of silicon quantum dots embedded in a silicon dioxide matrix using ab initio calculations of the density of states. Several structural and composition features of quantum dots (QDs), such as diameter and amorphization level, are studied and correlated with transport under transfer Hamiltonian formalism. The current is strongly dependent on the QD density of states and on the conduction gap, both dependent on the dot diameter. In particular, as size increases, the available states inside the QD increase, while the QD band gap decreases due to relaxation of quantum confinement. Both effects contribute to increasing the current with the dot size. Besides, valence band offset between the band edges of the QD and the silica, and conduction band offset in a minor grade, increases with the QD diameter up to the theoretical value corresponding to planar heterostructures, thus decreasing the tunneling transmission probability and hence the total current. We discuss the influence of these parameters on electron and hole transport, evidencing a correlation between the electron (hole) barrier value and the electron (hole) current, and obtaining a general enhancement of the electron (hole) transport for larger (smaller) QD. Finally, we show that crystalline and amorphous structures exhibit enhanced probability of hole and electron current, respectively.

Issue review : Department of Administrative Services cost savings.

This issue review is an examination of cost-saving actions by the Department of Administrative Services, DAS, by outsourcing services. The Department has outsourced janitorial services for three buildings on the Capitol Complex and have restructured the way construction projects are managed, with the goal of producing cost savings.

Cost-effectiveness of surgery in low- and middle-income countries: a systematic review.

BACKGROUND: There is increasing interest in provision of essential surgical care as part of public health policy in low- and middle-income countries (LMIC). Relatively simple interventions have been shown to prevent death and disability. We reviewed the published literature to examine the cost-effectiveness of simple surgical interventions which could be made available at any district hospital, and compared these to standard public health interventions. METHODS: PubMed and EMBASE were searched using single and combinations of the search terms "disability adjusted life year" (DALY), "quality adjusted life year," "cost-effectiveness," and "surgery." Articles were included if they detailed the cost-effectiveness of a surgical intervention of relevance to a LMIC, which could be made available at any district hospital. Suitable articles with both cost and effectiveness data were identified and, where possible, data were extrapolated to enable comparison across studies. RESULTS: Twenty-seven articles met our inclusion criteria, representing 64 LMIC over 16 years of study. Interventions that were found to be cost-effective included cataract surgery (cost/DALY averted range US$5.06-$106.00), elective inguinal hernia repair (cost/DALY averted range US$12.88-$78.18), male circumcision (cost/DALY averted range US$7.38-$319.29), emergency cesarean section (cost/DALY averted range US$18-$3,462.00), and cleft lip and palate repair (cost/DALY averted range US$15.44-$96.04). A small district hospital with basic surgical services was also found to be highly cost-effective (cost/DALY averted 1 US$0.93), as were larger hospitals offering emergency and trauma surgery (cost/DALY averted US$32.78-$223.00). This compares favorably with other standard public health interventions, such as oral rehydration therapy (US$1,062.00), vitamin A supplementation (US$6.00-$12.00), breast feeding promotion (US$930.00), and highly active anti-retroviral therapy for HIV (US$922.00). CONCLUSIONS: Simple surgical interventions that are life-saving and disability-preventing should be considered as part of public health policy in LMIC. We recommend an investment in surgical care and its integration with other public health measures at the district hospital level, rather than investment in single disease strategies.

A comparative study of difficulties in accounting preparation and judgement in agriculture using fair value and historical cost for biological assets valuation

Este estudio realiza un investigación empírica comparando las dificultades que se derivan de la utilización del valor razonable (VR) y del coste histórico (CH) en el sector agrícola. Se analiza también la fiabilidad de ambos métodos de valoración para la interpretación de la información y la toma de decisiones por parte de los agentes que actúan en el sector. Mediante un experimento realizado con estudiantes, agricultores y contables que operan en el sector agrícola, se halla que estos tienen más dificultades, cometen mayores errores e interpretan peor la información contable realizada a CH que la realizada a VR. Entrevistas en profundidad con agricultores y contables agrícolas desvelan prácticas contables defectuosas derivadas de la necesidad de aplicar el CH en el sector en España. Dadas las complejidades del cálculo del coste de los activos biológicos y el predominio de pequeñas explotaciones en el sector en los países occidentales avanzados, el estudio concluye que la contabilidad a VR constituye una mejoría de utilización y desarrollo de la contabilidad en el sector que la confeccionada a CH. Asimismo, el CH transmite una peor representación de la situación real de las explotaciones agrícolas.

Best Practices for Low-Cost Safety Improvements on Iowa’s Local Roads, 2008

Many good maintenance practices are done routinely to ensure safe travel on low-volume local roads. In addition, there are many specific treatments that may go beyond the point of routine maintenance and in fact provide additional safety benefits with a relatively low price tag. The purpose of this publication is to try to assemble many of these treatments that are currently practiced in Iowa by local agencies into one, easy-to-reference handbook that not only provides some clarity to each treatment with photos and narrative, but also features references to agencies currently using that technique. Some strategies that are utilized by Iowa, other states, and are topics of research have also been included to allow the user more information about possible options. Even though some areas overlap, the strategies presented have been grouped together in the following areas: Signing and Delineation, Traffic "Calming," Pavement Marking and Rumble Strips/Stripes, Roadside and Clear Zone, Guardrail and Barriers, Lighting, Pavements and Shoulders, Intersections, Railroad Crossings, Bridges and Culverts, and Miscellaneous. The intention is to make this a “living” document, which will continue to be updated and expanded periodically as other existing practices are recognized or new practices come into being.