Cost-effectiveness of a national initiative to improve hand hygiene compliance using the outcome of healthcare associated staphylococcus aureus bacteraemia

Background The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included. Methods The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011–2012. Findings No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER) of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits. Conclusions The Australian National Hand Hygiene Initiative was cost-effective against an Australian threshold of $42,000 per life year gained. The return on investment varied among the states and territories of Australia.

Development of foreign direct investment in Finland

During 1990 to 2009, Foreign Direct Investment (FDI henceforth) in Finland has fluctuated greatly. This paper focused on analyzing the overall development and basic characteristics of Foreign Direct Investment in Finland, covering the period from 1990 to present. By comparing FDI in Finland with FDI in other countries, the picture of Finland’s FDI position in the world market is clearer. A lot of statistical data, tables and figures are used to describe the trend of Foreign Direct Investment in Finland. All the data used in this study were obtained from Statistics Finland, UNCTAD, OECD, World Bank and International Labor Office, Investment map website and etc. It is also found that there is a big, long-lasting and increasing imbalance of the inward FDI and outward FDI in Finland, the performance of outward FDI is stronger than the inward FDI in Finland. Finland’s position of FDI in the world is rather modest. And based on existing theories, I tried to analyze the factors that might determine the size of the inflows of FDI in Finland. The econometric model of my thesis is based on time series data ranging from 1990 to 2007. A Log linear regression model is adopted to analyze the impact of each variable. The regression results showed that Labor Cost and Investment in Education have a negative influence on the FDI inflows into Finland. Too high labor cost is the main impediment of FDI in Finland, explaining the relative small size of FDI inflows into Finland. GDP and Economy openness have a significant positive impact on the inflows of FDI into Finland; other variables do not emerge as significant factor in affecting the size of FDI inflows in Finland as expected. Meanwhile, the impacts of the most recent financial and economic crisis on FDI in the world and in Finland are discussed as well. FDI inflows worldwide and in Finland have suffered from a big setback from the 2008 global crisis. The economic crisis has undoubtedly significant negative influence on the FDI flows in the world and in Finland. Nevertheless, apart from the negative impact, the crisis itself also brings in chances for policymakers to implement more efficient policies in order to create a pro-business and pro-investment climate for the recovery of FDI inflows. . The correspondent policies and measures aiming to accelerate the recovery of the falling FDI were discussed correspondently.

Groups constrain the use of risky habitat by individuals: a new cost to sociality?

Predation risk can strongly constrain how individuals use time and space. Grouping is known to reduce an individual's time investment in costly antipredator behaviours. Whether grouping might similarly provide a spatial release from antipredator behaviour and allow individuals to use risky habitat more and, thus, improve their access to resources is poorly known. We used mosquito larvae, Aedes aegypti, to test the hypothesis that grouping facilitates the use of high-risk habitat. We provided two habitats, one darker, low-risk and one lighter, high-risk, and measured the relative time spent in the latter by solitary larvae versus larvae in small groups. We tested larvae reared under different resource levels, and thus presumed to vary in body condition, because condition is known to influence risk taking. We also varied the degree of contrast in habitat structure. We predicted that individuals in groups should use high-risk habitat more than solitary individuals allowing for influences of body condition and contrast in habitat structure. Grouping strongly influenced the time spent in the high-risk habitat, but, contrary to our expectation, individuals in groups spent less time in the high-risk habitat than solitary individuals. Furthermore, solitary individuals considerably increased the proportion of time spent in the high-risk habitat over time, whereas individuals in groups did not. Both solitary individuals and those in groups showed a small increase over time in their use of riskier locations within each habitat. The differences between solitary individuals and those in groups held across all resource and contrast conditions. Grouping may, thus, carry a poorly understood cost of constraining habitat use. This cost may arise because movement traits important for maintaining group cohesion (a result of strong selection on grouping) can act to exaggerate an individual preference for low-risk habitat. Further research is needed to examine the interplay between grouping, individual movement and habitat use traits in environments heterogeneous in risk and resources. (C) 2015 The Association for the Study of Animal Behaviour. Published by Elsevier Ltd. All rights reserved.

Cost-Saving production technologies and strategic delegation

This work analyzes a managerial delegation model in which firms that produce a differentiated good can choose between two production technologies: a low marginal cost technology and a high marginal cost technology. For the former to be adopted more investment is needed than for the latter. By giving managers of firms an incentive scheme based on a linear combination of profit and sales revenue, we find that Bertrand competition provides a stronger incentive to adopt the cost-saving technology than the strict profit maximization case. However, the results may be reversed under Cournot competition. We show that if the degree of product substitutability is sufficiently low (high), the incentive to adopt the cost-saving technology is larger under strict profit maximization (strategic delegation).

Investment prospects in fish feed technology

The author endeavours to analyse the recent trend in the local production of fish by sector over a period of 5 years, 1980-1985 and the data available to the author on the Nigerian fish imports. The present and future deficit in fish production in Nigeria could only be met from the capture fishery and the fish farm industry but more likely from the latter. The production techniques involved in fish feed industry are illustrated in this paper with standard feed formulations to arrive at a suitable fish diet. Associated problems of fish feed industry and their possible solutions are highlighted. A case study of investment prospects in fish feed industry as well as the production of brine shrimps are suggested as possible areas of investments in the industry. The unit production cost of fish feed is about 700/ton, while in the case of artemia (brine shrimp), the estimated unit cost if about 400/ton

Investment prospects of fish farming in the Jos-Plateau, Nigeria

The investment prospects of fish farming in the Jos-Plateau, Nigeria, strategically located in about the centre of the country are discussed with special reference to its numerous abandoned mine lakes and the tripartite role of government, universities and individuals. In the Jos-Plateau, about 17.0 km super(2) is covered by these disused mine lakes, making up about 20-30% of the area covered. In such enterprise, problems commonly encountered, like population growth and government planning policies, fish demand and supply, manpower, feed and seed availability, preservation, processing and marketing are discussed. Inspite of these, prospects still abound with regards to land-use of these numerous disused mine lakes and feed availability based on the principles of using both industrial and farm by-products for fish culture, processing and marketing. These potentials, if properly harnessed, will help to supplement the protein insufficiency in the diet of the populace. In this regard, proposals on the economics of production and sales, strategies for achieving these development goals, cost-benefit analysis and their implications in further development of fish culture are discussed

Investment potentials in shellfish culture in Nigeria

Shellfish are a major but cheap protein source for human consumption as well as source of income for coastal towns and villages of the Niger Delta in Rivers State, Cross River, and Lagos States. A research into the nutritive value of some of these marine shellfish viz: bivalves (oyster - Crassostrea gasar and cockle - Anadara senilis); gastropods (periwinkle - Tympanotonus fuscatus, obtuse periwinkle - Semifusus morio and the giant whelk - Thais callifera) and mangrove crabs (green crab - Goniopsis pelli, ghost crab - Cardisoma ormatum, and common blue crab - Callinectes latimanus) was carried out to compare their quality and cost with beef, chicken meat, pork and egg in order to identify those most suitable for commercial culture. Results show that all shellfish had at least 16% crude protein except blue crab (13.38%). All shellfish had higher protein content than egg (13.36%). Cockle with protein content 25.47% compared favourably with beef, (29.60%). Beef, chicken meat and pork cost 11.50, 9.00 and 8.00 per kilo respectively while oyster, periwinkle and the common blue crab cost 3.50, 3.00, and 1.50 per kilo respectively. Oysters and Cockles are recommended for commercial culture based on the findings of this research

Utilization of treated wood, steel, fibreglass, ferrocement and aluminium in the construction of modern fishing boats and their comparative cost analysis

Modern fishing boats have to be built not only on perfect lines but also with sound and strong construction materials that will ensure a long lasting trouble free service commensurate with the heavy capital investment involved. Choice of construction materials for fishing boats need careful scrutiny as they have to perform too well under most aggressive environments-sea-water and marine atmosphere. A number of alternative boat-building materials are now available whose comparative merits and demerits as well as comparative costs are brought out in this paper.

Investment funds: What next?

Investment funds provide a low cost method of sharing in the rewards from capitalism. Recently “alternative investments” such as hedge funds have grown rapidly and the trading strategies open to hedge funds are now becoming available to mutual funds and even to ordinary retail investors. In this paper we analyze problems in assessing fund performance and the prospects for investment fund sectors. Choosing genuine outperformers among top funds requires a careful assessment of non-normality, order statistics and the possibility of false discoveries. The risk adjusted performance of the average hedge fund over the last 10-15 is actually not that impressive, although the “top” funds do appear to have statistically significant positive alphas.

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.

A study on the cost sharing model for supply lead time reduction with component commonality

This paper studies a two-level supply chain consisting of components supplier and product assembly manufacturer, while the manufacturer shares the investment on shortening supply lead time. The objective of this research is to investigate the benefits of cost sharing strategy and adopting component commonality. The result of numerical analysis demonstrates that using component commonality can help reduce the total cost, especially when the manufacture shares a higher fraction of the cost of investment in shortening supply lead time.

Parent-off spring associations in wintering brent geese: parental investment or mutual assistance?

The continued parent-offspring associations in the Eastern Canadian High Arctic light-bellied brent goose Branta bernicla hrota was examined to determine whether this is an example of continued parental investment or mutual assistance. Adults with juveniles spend more than twice as much time being vigilant and aggressive than do those without offspring. The loss of a partner, however, does not result in the remaining parent increasing parental care but does result in increased 'self-care' by the juveniles. Neither parents nor single-parent juveniles appear to pay an energetic cost relative to non-parental adults and two-parent juveniles, respectively. Differences in the feeding distribution of parents and non-parents and equivalent or better physical condition suggests that families are able to maintain access to a superior food supply over the winter. Passive 'assistance' by juveniles may assist in maintaining this position in favoured areas, and this is achieved with little overt aggression. The present study thus provides no data that show a net cost to parents by remaining with their juveniles over the winter period. Thus, mutual assistance might be a better explanation of the prolonged association rather than a period of parental investment with an overall cost.

Cost-effectiveness of internal limiting membrane peeling versus no peeling for patients with an idiopathic full-thickness macular hole:Results from a randomised controlled trial

Aim: To determine whether internal limiting membrane (ILM) peeling is cost-effective compared with no peeling for patients with an idiopathic stage 2 or 3 full-thickness macular hole. Methods: A cost-effectiveness analysis was performed alongside a randomised controlled trial. 141 participants were randomly allocated to receive macular-hole surgery, with either ILM peeling or no peeling. Health-service resource use, costs and quality of life were calculated for each participant. The incremental cost per quality-adjusted life year (QALY) gained was calculated at 6 months. Results: At 6 months, the total costs were on average higher (£424, 95% CI -182 to 1045) in the No Peel arm, primarily owing to the higher reoperation rate in the No Peel arm. The mean additional QALYs from ILM peel at 6 months were 0.002 (95% CI 0.01 to 0.013), adjusting for baseline EQ-5D and other minimisation factors. A mean incremental cost per QALY was not computed, as Peeling was on average less costly and slightly more effective. A stochastic analysis suggested that there was more than a 90% probability that Peeling would be cost-effective at a willingness-to-pay threshold of £20 000 per QALY. Conclusion: Although there is no evidence of a statistically significant difference in either costs or QALYs between macular hole surgery with or without ILM peeling, the balance of probabilities is that ILM Peeling is likely to be a cost-effective option for the treatment of macular holes. Further long-term follow-up data are needed to confirm these findings.

On international cost-sharing of pharmaceutical R&D

Ramsey pricing has been proposed in the pharmaceutical industry as a principle to price discriminate among markets while allowing to recover the (fixed) R&D cost. However, such analyses neglect the presence of insurance or the fund raising costs for most of drug reimbursement. By incorporating these new elements, we aim at providing some building blocks towards an economic theory incorporating Ramsey pricing and insurance coverage. We show how coinsurance affects the optimal prices to pay for the R&D investment. We also show that under certain conditions, there is no strategic incentive by governments to set coinsurance rates in order to shift the financial burden of R&D. This will have important implications to the application of Ramsey pricing principles to pharmaceutical products across countries.

The Portuguese contemporary art as an investment

In this paper we investigate what drives the prices of Portuguese contemporary art at auction and explore the potential of art as an asset. Based on a hedonic prices model we construct an Art Price Index as a proxy for the Portuguese contemporary art market over the period of 1994 to 2014. A performance analysis suggests that art underperforms the S&P500 but overperforms the Portuguese stock market and American Government bonds. However, It does it at the cost of higher risk. Results also show that art as low correlation with financial markets, evidencing some potential in risk mitigation when added to traditional equity portfolios.