scholarly journals A Cost-Benefit Analysis of the ENIGMA Trial

2011 ◽  
Vol 115 (2) ◽  
pp. 265-272 ◽  
Author(s):  
Alison M. Graham ◽  
Paul S. Myles ◽  
Kate Leslie ◽  
Matthew T.V. Chan ◽  
Michael J. Paech ◽  
...  
Keyword(s):  
Free Group ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Sensitivity Analyses ◽  
Major Surgery ◽  
Financial Benefit ◽  
Significant Difference ◽  
Inhalational Agent ◽  
Clinical Consequences ◽  
Additional Costs

Background The ENIGMA trial was a prospective, randomized, multicenter study that evaluated the clinical consequences of including N₂O in general anesthesia. Patients who were given a N₂O-free anesthetic when undergoing major surgery for which the expected hospital stay was at least 3 days had lower rates of some postoperative complications. This suggests that, despite a higher consumption of potent inhalational agent, there could be a financial benefit when N₂O is avoided in such settings. Methods A retrospective cost analysis of the 2,050 patients recruited to the ENIGMA trial was performed. We measured costs from the perspective of an implementing hospital. Direct health care costs include the costs for maintaining anesthesia, daily medications, hospitalization, and complications. The primary outcome was the net financial savings from avoiding N₂O in major noncardiac surgery. Comparisons between groups were analyzed using Student t test and bootstrap methods. Sensitivity analyses were also performed. Results Rates of some serious complications were higher in the N₂O group. Total costs in the N₂O group were $16,203 and in the N₂O-free group $13,837, mean difference of $2,366 (95% CI: 841-3,891); P = 0.002. All sensitivity analyses retained a significant difference in favor of the N₂O-free group (all P ≤ 0.005). Conclusions Despite N₂O reducing the consumption of more expensive potent inhalational agent, there were marked additional costs associated with its use in adult patients undergoing major surgery because of an increased rate of complications. There is no cogent argument to continue using N₂O on the basis that it is an inexpensive drug.

scholarly journals Effect of isoproteinous feed on growth and survival of tilapia (Oreochromis niloticus) fry

2012 ◽  
Vol 10 (1) ◽  
pp. 169-174
Author(s):  
I Siddika ◽  
M Das ◽  
K R Sumi
Keyword(s):  
Wheat Flour ◽  
Rice Bran ◽  
Oreochromis Niloticus ◽  
Fish Meal ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Meat And Bone Meal ◽  
Bone Meal ◽  
Growth And Survival ◽  
Significant Difference

A four week experiment was conducted to evaluate the effect of isoproteinous (35%) feed prepared named diet 1, 2, 3 and 4 respectively by substituting 0%, 50% , 75% and 100% fish meal with meat and bone meal in view of preparing a cost effective tilapia (Oreochromis niloticus) fry feed. The four experimental diets (diet 1 to 4) each were randomly assigned to twelve hapas with three replications. Tilapia fry (0.011g) were randomly stocked in 100 fry/9ft² hapa and fed five times a day up to their apparent satiation. The results of the study showed that the weight gain, specific growth rate (SGR), the apparent net protein utilization value and survival (%) of the fish were significantly  (P<0.05) higher and better feed utilization with lower FCR value was observed in fish fed on the diet 4 where meat and bone meal was used as sole source of protein base. There was no significant difference between the carcass moisture and lipid of fish fed with different experimental diets. The results of the study indicated that diet 1 containing fish meal (45.15% Fish meal, 27.43% Rice bran and 27.43% Wheat flour) can be replaced by meat and bone meal containing diet 4 (54.06% Meat and bone meal, 22.97% Rice bran and 22.97% Wheat flour) with no adverse effects on growth and survival of O. niloticus. Before recommendation several trials will be necessary in different farms to be  sure of the reproducibility of the result obtained in the present experiment. Cost- benefit analysis reveals that the   meat and bone meal containing diet certainly provides cheaper feed.   DOI: http://dx.doi.org/10.3329/jbau.v10i1.12110   J. Bangladesh Agril. Univ. 10(1): 169–174, 2012  

We Never Built Small Modular Reactors (SMRs), but What Do We Know About Modularization in Construction?

2018 ◽  
Author(s):  
Benito Mignacca ◽  
Giorgio Locatelli ◽  
Mahmoud Alaassar ◽  
Diletta Colette Invernizzi
Keyword(s):  
Nuclear Power ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Project Managers ◽  
Schedule Compression ◽  
Small Modular Reactors ◽  
Key Characteristics ◽  
Additional Costs ◽  
Structured Knowledge ◽  
The Cost

The key characteristics of small modular reactors (SMRs), as their name emphasized, are their size and modularity. Since SMRs are a family of novel reactor designs, there is a gap of empirical knowledge about the cost/benefit analysis of modularization. Conversely, in other sectors (e.g. Oil & Gas) the empirical experience on modularization is much greater. This paper provides a structured knowledge transfer from the general literature (i.e. other major infrastructure) and the Oil & Gas sector to the nuclear power plant construction world. Indeed, in the project management literature, a number of references discuss the costs and benefits determined by the transition from the stick-built construction to modularization, and the main benefits presented in the literature are the reduction of the construction cost and the schedule compression. Additional costs might arise from an increased management hurdle and higher transportation expenses. The paper firstly provides a structured literature review of the benefits and costs of modularization divided into qualitative and quantitative references. In the second part, the paper presents the results of series of interviews with Oil & Gas project managers about the value of modularization in this sector.

Cost benefit analysis of bovine mastitis in the UK

1992 ◽  
Vol 59 (4) ◽  
pp. 449-460 ◽  
Author(s):  
Harvey S. Beck ◽  
William S. Wise ◽  
Frank H. Dodd
Keyword(s):  
Cost Benefit Analysis ◽  
Bovine Mastitis ◽  
Cost Benefit ◽  
Clinical Mastitis ◽  
Control Measures ◽  
Annual Number ◽  
Financial Benefit ◽  
Precise Knowledge ◽  
Control Procedures ◽  
The Uk

SummaryBovine mastitis reduces the yield and quality of milk and increases the rate of culling and veterinary costs. This reduces the profitability of farm milk production but the calculation of the extent of this economic loss is complex because of the many factors involved and deficiencies in the evidence on the relationship between the disease and various production factors. This paper examines the available evidence for the UK and provides a consistent analytical framework within which the benefits arising from reduced mastitis in dairy herds constrained by quota can be considered. It is estimated that since 1970 the farms that have followed the recommended control procedures have reduced the average annual number of cases of clinical mastitis from 135 to 40 cases/100 cows each year, while the quarters remaining uninfected for a whole year has increased from 65 to 80% of the total quarters. The costs of the main control procedures (e.g. £8–60/cow for dry-cow therapy and teat dipping or spraying) are broadly covered by the reduction in clinical mastitis, leaving the benefits of reduced subclinical infection (e.g. £3810 for a 100 cow herd unconstrained by quota and achieving the average reduction in infection) as a substantial bonus. The imposition of quotas reduces the financial benefit of mastitis control but it still remains a worthwhile investment. The results of this analysis can be used to suggest maximum costs of additional new control measures produced by research. It also indicates that there is considerable value in production research which gives more precise knowledge of production Systems, thus allowing producers to respond optimally to quota cuts.

A Short-Run Cost-Benefit Analysis of Community-Based Interventions for Juvenile Offenders

2001 ◽  
Vol 47 (2) ◽  
pp. 265-284 ◽  
Author(s):  
Angela A. Robertson ◽  
Paul W. Grimes ◽  
Kevin E. Rogers
Keyword(s):  
Juvenile Offenders ◽  
Justice System ◽  
Cost Benefit Analysis ◽  
Behavioral Therapy ◽  
Cost Benefit ◽  
Community Based Interventions ◽  
Community Based ◽  
Positive Effects ◽  
Significant Difference ◽  
Short Run

Recent empirical research indicates that for juvenile offenders various community-based intervention techniques result in significantly greater positive effects when compared to more traditional approaches. This article presents a cost-benefit evaluation of two such techniques: intensive supervision and monitoring (ISM) and intensive outpatient counseling with cognitive behavioral therapy (CB). A two-equation regression model that controlled for differences in demographic characteristics, personality traits, behavior, and the home environment of the subjects was estimated. The results indicate that, relative to those on probation, participants in the CB program imposed significantly fewer costs on the justice system during the investigative period. No significant difference in justice system expenditures was demonstrated by the ISM group. Comparing the reduced costs of the CB program to the marginal cost of administering the program revealed a net saving of $1,435 in justice system expenditures per youth offender served for the sample period.

scholarly journals Improving Drinking Water Quality in South Korea: A Choice Experiment with Hypothetical Bias Treatments

Water ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2569
Author(s):  
Adelina Gschwandtner ◽  
Cheul Jang ◽  
Richard McManus
Keyword(s):  
South Korea ◽  
Choice Experiment ◽  
Latent Class ◽  
Cost Benefit Analysis ◽  
Stated Preference ◽  
Cost Benefit ◽  
Hypothetical Bias ◽  
Sensitivity Analyses ◽  
The Difference ◽  
Water Treatments

The objective of this present study is to use choice experiments and an extensive cost-benefit analysis (CBA) to investigate the feasibility of installing two advanced water treatments in Cheongju waterworks in South Korea. The study uses latent class attribute non-attendance models in a choice experiment setting in order to estimate the benefits of the two water treatments. Moreover, it explores strategies to mitigate potential hypothetical bias as this has been the strongest criticism brought to stated preference methods to date. Hypothetical bias is the difference between what people state in a survey they would be willing to pay and what they would actually pay in a real situation. The study employs cheap talk with a budget constraint reminder and honesty priming with the latter showing more evidence of reducing potential hypothetical bias. The lower bound of the median WTP (willingness to pay) for installing a new advanced water treatment system is approximately $2 US/month, similar to the average expenditures for bottled water per household in South Korea. These lower bounds were found using bootstrapping and simulations. The CBA shows that one of the two treatments, granular activated carbon is more robust to sensitivity analyses, making this the recommendation of the study.

scholarly journals Cost-benefit Analysis of Maintaining a Fully Stocked Malignant Hyperthermia Cart versus an Initial Dantrolene Treatment Dose for Maternity Units

2018 ◽  
Vol 129 (2) ◽  
pp. 249-259 ◽  
Author(s):  
Phi T. Ho ◽  
Brendan Carvalho ◽  
Eric C. Sun ◽  
Alex Macario ◽  
Edward T. Riley
Keyword(s):  
United States ◽  
Malignant Hyperthermia ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
The United States ◽  
Sensitivity Analyses ◽  
Maternity Unit ◽  
Benefit Analysis ◽  
General Anesthetic ◽  
Tree Model

Abstract What We Already Know about This Topic What This Article Tells Us That Is New Background The Malignant Hyperthermia Association of the United States recommends that dantrolene be available for administration within 10 min. One approach to dantrolene availability is a malignant hyperthermia cart, stocked with dantrolene, other drugs, and supplies. However, this may not be of cost benefit for maternity units, where triggering agents are rarely used. Methods The authors performed a cost-benefit analysis of maintaining a malignant hyperthermia cart versus a malignant hyperthermia cart readily available within the hospital versus an initial dantrolene dose of 250 mg, on every maternity unit in the United States. A decision-tree model was used to estimate the expected number of lives saved, and this benefit was compared against the expected costs of the policy. Results We found that maintaining a malignant hyperthermia cart in every maternity unit in the United States would reduce morbidity and mortality costs by $3,304,641 per year nationally but would cost $5,927,040 annually. Sensitivity analyses showed that our results were largely driven by the extremely low incidence of general anesthesia. If cesarean delivery rates in the United States remained at 32% of all births, the general anesthetic rate would have to be greater than 11% to achieve cost benefit. The only cost-effective strategy is to keep a 250-mg dose of dantrolene on the unit for starting therapy. Conclusions It is not of cost benefit to maintain a fully stocked malignant hyperthermia cart with a full supply of dantrolene within 10 min of maternity units. We recommend that hospitals institute alternative strategies (e.g., maintain a small supply of dantrolene on the maternity unit for starting treatment).

An economic analysis of bioethanol production from the marine macroalga Ulva (Chlorophyta)

TECHNOLOGY ◽  
2015 ◽  
Vol 03 (02n03) ◽  
pp. 114-118 ◽  
Author(s):  
Leor Korzen ◽  
Yoav Peled ◽  
Shiri Zemah Shamir ◽  
Mordechai Shechter ◽  
Aharon Gedanken ◽  
...  
Keyword(s):  
Animal Feed ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Sensitivity Analyses ◽  
Bioethanol Production ◽  
Daily Growth ◽  
Distillers Grains With Solubles ◽  
Dried Distillers Grains ◽  
Offshore Aquaculture ◽  
Marine Macroalga

We performed a cost-benefit analysis for bioethanol production using biomass of Ulva rigida, a marine macroalga (seaweed), co-cultured with fish in an intensive offshore aquaculture unit. This is the first report for such analysis that takes into consideration offshore seaweed cultivation and uses a recently developed, novel and simplified ethanol production technology that is devoid of costly pre-treatments imposed to the seaweed biomass. By simultaneously producing ethanol with valuable Dried Distillers Grains with Solubles (DDGS) by-products such as animal feed, the economic viability of this system is plausible over a production range of 77–240 dry tons of seaweed per day. As such, applying the model to suggested future scenarios for the Israeli Mediterranean shorelines, which limits aquaculture to ca. 600 ha, results in unprofitability. Further, sensitivity analyses place profitability as mainly dependent on DDGS prices and on the daily growth rate (biomass yield) of the macroalga. These two are key factors to achieve profitability at the 600-ha scenario.

A comprehensive appraisal of four kinds of forage under irrigation in Xilingol, Inner Mongolia, China

2018 ◽  
Vol 40 (2) ◽  
pp. 171 ◽  
Author(s):  
Yulong Yan ◽  
Zhiqiang Wan ◽  
Ran Chao ◽  
Yiqing Ge ◽  
Yali Chen ◽  
...  
Keyword(s):  
Inner Mongolia ◽  
Cost Benefit Analysis ◽  
Forage Quality ◽  
Cost Benefit ◽  
Field Capacity ◽  
Grazing Pressure ◽  
Natural Ecosystems ◽  
Crude Fibre ◽  
Natural Rainfall ◽  
Significant Difference

Planting of forage can alleviate grazing pressure on natural ecosystems. In the Inner Mongolian environment, higher forage yields can be expected under irrigation because water is a key factor that limits plant growth. Lower grass yield caused by land degradation and climatic change highlight the potential importance of irrigated forage for maintaining livestock production in this environment. The present study in the Xilingol area of Inner Mongolia aimed to identify forage varieties producing high-yielding, quality forage. Three lucerne (alfalfa) varieties (Medicago sativa L. cvv. Aohan and Zhaodong, Medicago varia Martyn) and a grass (Elymus nutans Griseb) were assessed. Irrigation commenced when soil moisture at 10 cm depth reached the wilting coefficient, and ceased when soil reached field capacity. After 4 months, irrigation had significantly increased specific leaf area, tiller numbers and yield under irrigation (P < 0.05) in all varieties. Yield of cv. Zhaodong was highest at 5111 kg ha–1. Forage quality was evaluated by using yield, leaf : stem ratio and crude fibre, crude protein and crude fat contents. Forage quality was significantly higher in the three lucerne varieties than in the grass, under both irrigation and natural rainfall, with no significant difference among the three lucerne varieties. Cost–benefit analysis showed that irrigation was much more profitable for the three lucerne varieties than for the grass because of the lower market value and yield of the grass.

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