The Private Sector and HIV/AIDS in Africa: Taking Stock of Six Years of Applied Research

Background: Until recently, little was known about the costs of the HIV/AIDS epidemic to businesses in Africa and business responses to the epidemic. This paper synthesizes the results of a set of studies conducted between 1999 and 2006 and draws conclusions about the role of the private sector in Africa’s response to AIDS. Methods: Detailed human resource, financial, and medical data were collected from 14 large private and parastatal companies in South Africa, Uganda, Kenya, Zambia, and Ethiopia. Surveys of small and medium-sized enterprises (SMEs) were conducted in South Africa, Kenya, and Zambia. Large companies’ responses or potential responses to the epidemic were investigated in South Africa, Uganda, Kenya, Zambia, and Rwanda. Results: Among the large companies, estimated workforce HIV prevalence ranged from 5%¬37%. The average cost per employee lost to AIDS varied from 0.5-5.6 times the average annual compensation of the employee affected. Labor cost increases as a result of AIDS were estimated at anywhere from 0.6%-10.8% but exceeded 3% at only 2 of 14 companies. Treatment of eligible employees with ART at a cost of $360/patient/year was shown to have positive financial returns for most but not all companies. Uptake of employer-provided testing and treatment services varied widely. Among SMEs, HIV prevalence in the workforce was estimated at 10%-26%. SME managers consistently reported low AIDS-related employee attrition, little concern about the impacts of AIDS on their companies, and relatively little interest in taking action, and fewer than half had ever discussed AIDS with their senior staff. AIDS was estimated to increase the average operating costs of small tourism companies in Zambia by less than 1%; labor cost increases in other sectors were probably smaller. Conclusions: Although there was wide variation among the firms studied, clear patterns emerged that will permit some prediction of impacts and responses in the future.

How Much Does It Cost to Provide Antiretroviral Therapy for HIV/AIDS in Africa?

Background: Many African countries are rapidly expanding HIV/AIDS treatment programs. Empirical information on the cost of delivering antiretroviral therapy (ART) for HIV/AIDS is needed for program planning and budgeting. Methods: We searched published and gray sources for estimates of the cost of providing ART in service delivery (non-research) settings in sub-Saharan Africa. Estimates were included if they were based on primary local data for input prices. Results: 17 eligible cost estimates were found. Of these, 10 were from South Africa. The cost per patient per year ranged from $396 to $2,761. It averaged approximately $850/patient/year in countries outside South Africa and $1,700/patient/year in South Africa. The most recent estimates for South Africa averaged $1,200/patient/year. Specific cost items included in the average cost per patient per year varied, making comparison across studies problematic. All estimates included the cost of antiretroviral drugs and laboratory tests, but many excluded the cost of inpatient care, treatment of opportunistic infections, and/or clinic infrastructure. Antiretroviral drugs comprised an average of one third of the cost of treatment in South Africa and one half to three quarters of the cost in other countries. Conclusions: There is very little empirical information available about the cost of providing antiretroviral therapy in non-research settings in Africa. Methods for estimating costs are inconsistent, and many estimates combine data drawn from disparate sources. Cost analysis should become a routine part of operational research on the treatment rollout in Africa.

On the Effectiveness of Genetic Search in Combinatorial Optimization

In this paper, we study the efficacy of genetic algorithms in the context of combinatorial optimization. In particular, we isolate the effects of cross-over, treated as the central component of genetic search. We show that for problems of nontrivial size and difficulty, the contribution of cross-over search is marginal, both synergistically when run in conjunction with mutation and selection, or when run with selection alone, the reference point being the search procedure consisting of just mutation and selection. The latter can be viewed as another manifestation of the Metropolis process. Considering the high computational cost of maintaining a population to facilitate cross-over search, its marginal benefit renders genetic search inferior to its singleton-population counterpart, the Metropolis process, and by extension, simulated annealing. This is further compounded by the fact that many problems arising in practice may inherently require a large number of state transitions for a near-optimal solution to be found, making genetic search infeasible given the high cost of computing a single iteration in the enlarged state-space.

Unicast Routing: Cost-Performance Tradeoffs

The objective of unicast routing is to find a path from a source to a destination. Conventional routing has been used mainly to provide connectivity. It lacks the ability to provide any kind of service guarantees and smart usage of network resources. Improving performance is possible by being aware of both traffic characteristics and current available resources. This paper surveys a range of routing solutions, which can be categorized depending on the degree of the awareness of the algorithm: (1) QoS/Constraint-based routing solutions are aware of traffic requirements of individual connection requests; (2) Traffic-aware routing solutions assume knowledge of the location of communicating ingress-egress pairs and possibly the traffic demands among them; (3) Routing solutions that are both QoS-aware as (1) and traffic-aware as (2); (4) Best-effort solutions are oblivious to both traffic and QoS requirements, but are adaptive only to current resource availability. The best performance can be achieved by having all possible knowledge so that while finding a path for an individual flow, one can make a smart choice among feasible paths to increase the chances of supporting future requests. However, this usually comes at the cost of increased complexity and decreased scalability. In this paper, we discuss such cost-performance tradeoffs by surveying proposed heuristic solutions and hybrid approaches.

A smart wireless inertial measurement unit system: simplifying & encouraging usage of WIMU technology

Wireless Inertial Measurement Units (WIMUs) combine motion sensing, processing & communications functionsin a single device. Data gathered using these sensors has the potential to be converted into high quality motion data. By outfitting a subject with multiple WIMUs full motion data can begathered. With a potential cost of ownership several orders of magnitude less than traditional camera based motion capture, WIMU systems have potential to be crucially important in supplementing or replacing traditional motion capture and opening up entirely new application areas and potential markets particularly in the rehabilitative, sports & at-home healthcarespaces. Currently WIMUs are underutilized in these areas. A major barrier to adoption is perceived complexity. Sample rates, sensor types & dynamic sensor ranges may need to be adjusted on multiple axes for each device depending on the scenario. As such we present an advanced WIMU in conjunction with a Smart WIMU system to simplify this aspect with 3 usage modes: Manual, Intelligent and Autonomous. Attendees will be able to compare the 3 different modes and see the effects of good andbad set-ups on the quality of data gathered in real time.

Development of miniaturized wireless sensor nodes suitable for building energy management and modelling

Buildings consume 40% of Ireland's total annual energy translating to 3.5 billion (2004). The EPBD directive (effective January 2003) places an onus on all member states to rate the energy performance of all buildings in excess of 50m2. Energy and environmental performance management systems for residential buildings do not exist and consist of an ad-hoc integration of wired building management systems and Monitoring & Targeting systems for non-residential buildings. These systems are unsophisticated and do not easily lend themselves to cost effective retrofit or integration with other enterprise management systems. It is commonly agreed that a 15-40% reduction of building energy consumption is achievable by efficiently operating buildings when compared with typical practice. Existing research has identified that the level of information available to Building Managers with existing Building Management Systems and Environmental Monitoring Systems (BMS/EMS) is insufficient to perform the required performance based building assessment. The cost of installing additional sensors and meters is extremely high, primarily due to the estimated cost of wiring and the needed labour. From this perspective wireless sensor technology provides the capability to provide reliable sensor data at the required temporal and spatial granularity associated with building energy management. In this paper, a wireless sensor network mote hardware design and implementation is presented for a building energy management application. Appropriate sensors were selected and interfaced with the developed system based on user requirements to meet both the building monitoring and metering requirements. Beside the sensing capability, actuation and interfacing to external meters/sensors are provided to perform different management control and data recording tasks associated with minimisation of energy consumption in the built environment and the development of appropriate Building information models(BIM)to enable the design and development of energy efficient spaces.

Investment incentives and valuation of power sector infrastructure assets with increasing interconnection, intermittency and decarbonisation

This dissertation applies a variety of quantitative methods to electricity and carbon market data, utility company accounts data, capital and operating costs to analyse some of the challenges associated with investment in energy assets. In particular, three distinct research topics are analysed within this general theme: the efficiency of interconnector trading, the optimal sizing of intermittent wind facilities and the impact of carbon pricing on the cost of capital for investors are researched in successive sections.

Development of a triple stage heat transformer for the recycling of low temperature heat energy

Absorption heat transformers are thermodynamic systems which are capable of recycling industrial waste heat energy by increasing its temperature. Triple stage heat transformers (TAHTs) can increase the temperature of this waste heat by up to approximately 145˚C. The principle factors influencing the thermodynamic performance of a TAHT and general points of operating optima were identified using a multivariate statistical analysis, prior to using heat exchange network modelling techniques to dissect the design of the TAHT and systematically reassemble it in order to minimise internal exergy destruction within the unit. This enabled first and second law efficiency improvements of up to 18.8% and 31.5% respectively to be achieved compared to conventional TAHT designs. The economic feasibility of such a thermodynamically optimised cycle was investigated by applying it to an oil refinery in Ireland, demonstrating that in general the capital cost of a TAHT makes it difficult to achieve acceptable rates of return. Decreasing the TAHT's capital cost may be achieved by redesigning its individual pieces of equipment and reducing their size. The potential benefits of using a bubble column absorber were therefore investigated in this thesis. An experimental bubble column was constructed and used to track the collapse of steam bubbles being absorbed into a hotter lithium bromide salt solution. Extremely high mass transfer coefficients of approximately 0.0012m/s were observed, showing significant improvements over previously investigated absorbers. Two separate models were developed, namely a combined heat and mass transfer model describing the rate of collapse of the bubbles, and a stochastic model describing the hydrodynamic motion of the collapsing vapour bubbles taking into consideration random fluctuations observed in the experimental data. Both models showed good agreement with the collected data, and demonstrated that the difference between the solution's temperature and its boiling temperature is the primary factor influencing the absorber's performance.

The ranking of alternative tariff and quota policies in the presence of domestic monopoly

Bhagwati demonstrated the nonequivalence between tariffs and quotas in the presence of monopoly. This paper also assumes domestic production to be monopolized and shows that giving import licenses or tariff revenues to the domestic producer may raise or lower the welfare cost of protection and the price paid by consumers from the price under other tariff and quota arrangements which maintain the same market share for the domestic producer. However, if the monopolist realizes that commercial policy is an instrument used to maximize the policymaker's welfare function, instead of being a goal in itself, the equivalence of tariffs and quotas re-emerges. © 1977.

Caregivers of people with neurodegenerative diseases: profile and unmet needs from a population-based survey in South Australia.

INTRODUCTION: Neurodegenerative diseases (NDD) are characterized by progressive decline and loss of function, requiring considerable third-party care. NDD carers report low quality of life and high caregiver burden. Despite this, little information is available about the unmet needs of NDD caregivers. METHODS: Data from a cross-sectional, whole of population study conducted in South Australia were analyzed to determine the profile and unmet care needs of people who identify as having provided care for a person who died an expected death from NDDs including motor neurone disease and multiple sclerosis. Bivariate analyses using chi(2) were complemented with a regression analysis. RESULTS: Two hundred and thirty respondents had a person close to them die from an NDD in the 5 years before responding. NDD caregivers were more likely to have provided care for more than 2 years and were more able to move on after the death than caregivers of people with other disorders such as cancer. The NDD caregivers accessed palliative care services at the same rate as other caregivers at the end of life, however people with an NDD were almost twice as likely to die in the community (odds ratio [OR] 1.97; 95% confidence interval [CI] 1.30 to 3.01) controlling for relevant caregiver factors. NDD caregivers reported significantly more unmet needs in emotional, spiritual, and bereavement support. CONCLUSION: This study is the first step in better understanding across the whole population the consequences of an expected death from an NDD. Assessments need to occur while in the role of caregiver and in the subsequent bereavement phase.