scholarly journals Land-Based Impact of Nutrient Loads and Eutrophication on an Ancient Mediterranean Natural Lake

Hydrology ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 7
Author(s):  
Bachisio Mario Padedda ◽  
Antonella Lugliè ◽  
Giuseppina Grazia Lai ◽  
Filippo Giadrossich ◽  
Cecilia Teodora Satta ◽  
...  

In water management plans, all human impacts on the aquatic environment are quantified and evaluated. For this purpose, lake-related assessment methods of watersheds are needed. The aim of this study is to present the environmental condition along the watershed–lake continuum of Lake Baratz, located in the northeastern part of Sardinia. We provide a method to evaluate the impact of a small watershed area on the trophic state of this ancient Mediterranean natural lake. This study demonstrates the potentialities of coupling simple land structure-based models with empirical ones, allowing one to hierarchize, interpret, and predict the relationships among the watershed ecological unity and lake trophic conditions at multiple spatial and temporal scales. It also demonstrates how the impact of single and interacting nutrient stressors can have a different impact on the trophic status which, in particular, applies to autotrophs, constituting a key response in the ecosystem. We suggest that the stressor hierarchy should be considered as a way of prioritizing actions in the cost-effective implementation of conservation and management plans.

2011 ◽  
Vol 14 (2) ◽  
Author(s):  
Thomas G Koch

Current estimates of obesity costs ignore the impact of future weight loss and gain, and may either over or underestimate economic consequences of weight loss. In light of this, I construct static and dynamic measures of medical costs associated with body mass index (BMI), to be balanced against the cost of one-time interventions. This study finds that ignoring the implications of weight loss and gain over time overstates the medical-cost savings of such interventions by an order of magnitude. When the relationship between spending and age is allowed to vary, weight-loss attempts appear to be cost-effective starting and ending with middle age. Some interventions recently proven to decrease weight may also be cost-effective.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Obinna Ikechukwu Ekwunife ◽  
Chinelo Janefrances Ofomata ◽  
Charles Ebuka Okafor ◽  
Maureen Ugonwa Anetoh ◽  
Stephen Okorafor Kalu ◽  
...  

Abstract Background In sub-Saharan Africa, there is increasing mortality and morbidity of adolescents due to poor linkage, retention in HIV care and adherence to antiretroviral therapy (ART). This is a result of limited adolescent-centred service delivery interventions. This cost-effectiveness and feasibility study were piggybacked on a cluster-randomized trial that assessed the impact of an adolescent-centred service delivery intervention. The service delivery intervention examined the impact of an incentive scheme consisting of conditional economic incentives and motivational interviewing on the health outcomes of adolescents living with HIV in Nigeria. Method A cost-effectiveness analysis from the healthcare provider’s perspective was performed to assess the cost per additional patient achieving undetected viral load through the proposed intervention. The cost-effectiveness of the incentive scheme over routine care was estimated using the incremental cost-effectiveness ratio (ICER), expressed as cost/patient who achieved an undetectable viral load. We performed a univariate sensitivity analysis to examine the effect of key parameters on the ICER. An in-depth interview was conducted on the healthcare personnel in the intervention arm to explore the feasibility of implementing the service delivery intervention in HIV treatment hospitals in Nigeria. Result The ICER of the Incentive Scheme intervention compared to routine care was US$1419 per additional patient with undetectable viral load. Going by the cost-effectiveness threshold of US$1137 per quality-adjusted life-years suggested by Woods et al., 2016, the intervention was not cost-effective. The sensitivity test showed that the intervention will be cost-effective if the frequency of CD4 count and viral load tests are reduced from quarterly to triannually. Healthcare professionals reported that patients’ acceptance of the intervention was very high. Conclusion The conditional economic incentives and motivational interviewing was not cost-effective, but can become cost-effective if the frequency of HIV quality of life indicator tests are performed 1–3 times per annum. Patients’ acceptance of the intervention was very high. However, healthcare professionals believed that sustaining the intervention may be difficult unless factors such as government commitment and healthcare provider diligence are duly addressed. Trial registration This trial is registered in the WHO International Clinical Trials Registry through the WHO International Registry Network (PACTR201806003040425).


2020 ◽  
Vol 13 (1) ◽  
pp. 309
Author(s):  
George N. Zaimes ◽  
Valasia Iakovoglou

Riparian areas, especially in the Mediterranean, offer many ecosystem services for the welfare of society benefits from their sustainable management. This study presents different tools used to assess riparian areas of Greece and their results. Riparian areas with different land-uses/vegetation covers along streams or torrents were assessed. The assessment tools were visual protocols, bioindicators, geographic information systems (GIS), vegetation indices, and a model. These tools differ in scale, accuracy, and difficulty of implementation. The riparian areas had Low and Moderate quality in Greece because of agricultural activities and hydrologic alterations. Vegetation appeared more important for the integrity of riparian areas than stream flow (perennial or intermittent). In addition, territorial variables (distance from dam and sea) were more influential compared to climatic variables. Visual protocols and GIS were effective for preliminary assessments. GIS can be applied at a greater scale but was less accurate than the protocols. Bioindicators can provide more cost-effective monitoring than physicochemical water variables. Finally, vegetation indices and models can be used for larger spatial and temporal scales, but require specialized personnel. Overall, riparian areas of Greece seem to be degraded, and monitoring would contribute to the development of a database on riparian areas that should form the basis for sustainable management plans in Greece.


2019 ◽  
Vol 70 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Tinevimbo Shiri ◽  
Angela Loyse ◽  
Lawrence Mwenge ◽  
Tao Chen ◽  
Shabir Lakhi ◽  
...  

Abstract Background Mortality from cryptococcal meningitis remains very high in Africa. In the Advancing Cryptococcal Meningitis Treatment for Africa (ACTA) trial, 2 weeks of fluconazole (FLU) plus flucytosine (5FC) was as effective and less costly than 2 weeks of amphotericin-based regimens. However, many African settings treat with FLU monotherapy, and the cost-effectiveness of adding 5FC to FLU is uncertain. Methods The effectiveness and costs of FLU+5FC were taken from ACTA, which included a costing analysis at the Zambian site. The effectiveness of FLU was derived from cohorts of consecutively enrolled patients, managed in respects other than drug therapy, as were participants in ACTA. FLU costs were derived from costs of FLU+5FC in ACTA, by subtracting 5FC drug and monitoring costs. The cost-effectiveness of FLU+5FC vs FLU alone was measured as the incremental cost-effectiveness ratio (ICER). A probabilistic sensitivity analysis assessed uncertainties and a bivariate deterministic sensitivity analysis examined the impact of varying mortality and 5FC drug costs on the ICER. Results The mean costs per patient were US $847 (95% confidence interval [CI] $776–927) for FLU+5FC, and US $628 (95% CI $557–709) for FLU. The 10-week mortality rate was 35.1% (95% CI 28.9–41.7%) with FLU+5FC and 53.8% (95% CI 43.1–64.1%) with FLU. At the current 5FC price of US $1.30 per 500 mg tablet, the ICER of 5FC+FLU versus FLU alone was US $65 (95% CI $28–208) per life-year saved. Reducing the 5FC cost to between US $0.80 and US $0.40 per 500 mg resulted in an ICER between US $44 and US $28 per life-year saved. Conclusions The addition of 5FC to FLU is cost-effective for cryptococcal meningitis treatment in Africa and, if made available widely, could substantially reduce mortality rates among human immunodeficiency virus–infected persons in Africa.


2021 ◽  
Vol 11 (3) ◽  
pp. 55-57
Author(s):  
Rani C ◽  
Harshavardhan V ◽  
Harshith G

In the 21st century online marketing is the most effective wayof advertising any product or service.Online marketing helps the smallbusinesses and also startup’sin a significant manner.online marketing happens in a virtual and interactive space where the promotion of products and services takes place. The advancement in technology has drastically changed the way of marketing. In online marketing the cost-effective compared to the traditional marketing. Most of the startup’s fail due to a lack of proper strategy.Onlinemarketing is innovativelycreating a platform for start-ups in innovative manner to reach the customers the main motto of this presentation is to show the positive side of the online marketing on start-ups and small businesses.


2019 ◽  
Vol 5 (3) ◽  
pp. 28 ◽  
Author(s):  
Alice Bessey ◽  
James Chilcott ◽  
Joanna Leaviss ◽  
Carmen de la Cruz ◽  
Ruth Wong

Severe combined immunodeficiency (SCID) can be detected through newborn bloodspot screening. In the UK, the National Screening Committee (NSC) requires screening programmes to be cost-effective at standard UK thresholds. To assess the cost-effectiveness of SCID screening for the NSC, a decision-tree model with lifetable estimates of outcomes was built. Model structure and parameterisation were informed by systematic review and expert clinical judgment. A public service perspective was used and lifetime costs and quality-adjusted life years (QALYs) were discounted at 3.5%. Probabilistic, one-way sensitivity analyses and an exploratory disbenefit analysis for the identification of non-SCID patients were conducted. Screening for SCID was estimated to result in an incremental cost-effectiveness ratio (ICER) of £18,222 with a reduction in SCID mortality from 8.1 (5–12) to 1.7 (0.6–4.0) cases per year of screening. Results were sensitive to a number of parameters, including the cost of the screening test, the incidence of SCID and the disbenefit to the healthy at birth and false-positive cases. Screening for SCID is likely to be cost-effective at £20,000 per QALY, key uncertainties relate to the impact on false positives and the impact on the identification of children with non-SCID T Cell lymphopenia.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e035224
Author(s):  
Haoya Yun ◽  
Guoqiang Zhao ◽  
Xiaojie Sun ◽  
Lizheng Shi

ObjectiveThis study aimed to estimate the cost–utility of sofosbuvir/velpatasvir (SOF/VEL) compared with other direct-acting antivirals (DAAs) in Chinese patients with hepatitis C virus (HCV).DesignA Markov model was developed to estimate the disease progression of patients with HCV over a lifetime horizon from the healthcare system perspective. Efficacy, clinical inputs and utilities were derived from the published literature. Drug costs were from the market price survey, and health costs for Markov health states were sourced from a Chinese study. Costs and utilities were discounted at an annual rate of 5%. One-way and probabilistic sensitivity analyses were conducted to test the impact of input parameters on the results.InterventionsSOF/VEL was compared with sofosbuvir+ribavirin (SR), sofosbuvir+dasabuvir (SD), daclatasvir+asunaprevir (DCV/ASV), ombitasvir/paritaprevir/ritonavir+dasabuvir (3D) and elbasvir/grazoprevir (EBR/GZR).Primary and secondary outcomesCosts, quality-adjusted life years (QALYs) and incremental cost–utility ratios (ICURs).ResultsSOF/VEL was economically dominant over SR and SD. However, 3D was economically dominant compared with SOF/VEL. Compared with DCV/ASV, SOF/VEL was cost-effective with the ICUR of US$1522 per QALY. Compared with EBR/GZR, it was not cost-effective with the ICUR of US$369 627 per QALY. One-way sensitivity analysis demonstrated that reducing the cost of SOF/VEL to the lower value of CI resulted in dominance over EBR/GZR and 3D. Probabilistic sensitivity analysis demonstrated that 3D was cost-effective in 100% of iterations in patients with genotype (GT) 1b and SOF/VEL was not cost-effective.ConclusionsCompared with other oral DAA agents, SOF/VEL treatment was not the most cost-effectiveness option for patients with chronic HCV GT1b in China. Lower the price of SOF/VEL will make it cost-effective while simplifying treatment and achieving the goal of HCV elimination.


Author(s):  
Charles Gray ◽  
G. D. Kittredge

The Environmental Protection Agency has completed a study of the impact of aircraft emissions on air quality and a study of the technological feasibility of controlling aircraft emissions including an analysis of the cost and time requirements of the various control approaches. The air quality study has determined the need for aircraft emission standards, and the control technology study has determined that control is feasible and cost effective given adequate development time.


Climate ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 19 ◽  
Author(s):  
Abdullah A. Alsumaiei

Efficient water management plans should rely on quantitative metrics for assessing water resource shortage scenarios. This study develops a simplified precipitation index (PI) requiring precipitation data only in order to assess hydrometeorological droughts affecting various hydrological systems. The PI index is inspired by the famous Standardized Precipitation Index (SPI), and it aims to provide the same indication for drought severity and duration while overcoming the disadvantage of needing hydrological data normalization. Avoiding hydrological data normalization overcomes the non-satisfactory results of this procedure that were reported in previous studies. Analysis of groundwater drought drivers in the arid region of Kuwait is presented to test the index applicability at timescales 12 and 24 months using available historical precipitation data from 1958 to 2017. A bivariate joint probability analysis was conducted by Clayton copula to assess the occurrence of certain drought severities and durations. The results showed that PI is comparable to the original SPI and provides drought severity linearly propagating with respect to time. This index constitutes a simple means to help water managers assess and describe the impact of droughts in precipitation-controlled systems and establish appropriate water management plans.


2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Iakovos Toumazis ◽  
Emily B Tsai ◽  
S Ayca Erdogan ◽  
Summer S Han ◽  
Wenshuai Wan ◽  
...  

Abstract Background Numerous health policy organizations recommend lung cancer screening, but no consensus exists on the optimal policy. Moreover, the impact of the Lung CT screening reporting and data system guidelines to manage small pulmonary nodules of unknown significance (a.k.a. indeterminate nodules) on the cost-effectiveness of lung cancer screening is not well established. Methods We assess the cost-effectiveness of 199 screening strategies that vary in terms of age and smoking eligibility criteria, using a microsimulation model. We simulate lung cancer-related events throughout the lifetime of US-representative current and former smokers. We conduct sensitivity analyses to test key model inputs and assumptions. Results The cost-effectiveness efficiency frontier consists of both annual and biennial screening strategies. Current guidelines are not on the frontier. Assuming 4% disutility associated with indeterminate findings, biennial screening for smokers aged 50–70 years with at least 40 pack-years and less than 10 years since smoking cessation is the cost-effective strategy using $100 000 willingness-to-pay threshold yielding the highest health benefit. Among all health utilities, the cost-effectiveness of screening is most sensitive to changes in the disutility of indeterminate findings. As the disutility of indeterminate findings decreases, screening eligibility criteria become less stringent and eventually annual screening for smokers aged 50–70 years with at least 30 pack-years and less than 10 years since smoking cessation is the cost-effective strategy yielding the highest health benefit. Conclusions The disutility associated with indeterminate findings impacts the cost-effectiveness of lung cancer screening. Efforts to quantify and better understand the impact of indeterminate findings on the effectiveness and cost-effectiveness of lung cancer screening are warranted.


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