Background There is an increasing rate of cesarean section globally. Both low and high cesarean section rates are associated with maternal and neonatal mortality and morbidities. In Nicaragua, the rate of cesarean section is beyond the WHO recommendation of 10% to 15%. Aim The aim of this study was to evaluate the costs-effectiveness of elective caesarean section when compared with vaginal delivery in hospital in Nicaragua, a lower-middle income setting. Methods A 3 months prospective cohort study was conducted in a hospital in León, Nicaragua, from 1st May 2010 to 31st July 2010. Two questionnaires were used to obtain data, one on costs and maternal complications after delivery, and the other on postpartum complications. A descriptive analysis regarding maternal and neonatal outcomes, and a cost-effectiveness analysis were conducted comparing elective cesarean section with vaginal delivery, followed by a sensitivity analysis regarding change on rates of elective cesarean section. Results The cesarean section rate was 37.9%, and the elective cesarean section rate was 21%. The percentage of live births was 99.6% in elective cesarean section group and 98.9% in vaginal delivery group. Cesarean section had both positive and negative influences on maternal complications and postpartum complications. The costs of elective cesarean section was higher than vaginal delivery ($66 compared to $39.36). For one more live birth, 3805.71 US dollars were needed. Conclusion The maternal outcomes of cesarean section need to be improved. With the increasing cesarean section rates, more medical resources are needed in the future.

This paper takes a dive into understanding if funding extra diversity initiatives at Claremont McKenna College currently spurred on by students are worth the cost to the institution. Resources like that of Claremont McKenna’s C.A.R.E. Center (Civility, Access, Resources, and Expression) and funding for representative student organizations place large pressures on the institution’s available budget and there is not much proof that they will pay off in the long-run. In this paper, financial costs for supporting diverse students on campus are aggregated and compared to the possible financial benefits that may come of their consequential use. Results show that there is a largely positive societal benefit to the use of these resources at a fraction of the cost to the institution. These findings derive from CMC cost data; however, results imply similar conclusions across secondary education institutions nationwide.

The kinetic energy in river streams, tidal currents, or other artificial water channels has been used as a feasible source of renewable power through different conversion systems. Thus, hydrokinetic energy conversion systems are attracting worldwide interest as another form of distributed alternative energy. Because these systems are still in early stages of development, the basic approaches need significant research. The main challenges are not only to have efficient systems, but also to convert energy more economically so that the cost-benefit analysis drives the growth of this alternative energy form. One way to view this analysis is in terms of the energy conversion efficiency per unit cost. This study presents a detailed assessment of a prototype hydrokinetic energy system along with power output costs. This experimental study was performed using commercial low-cost blades of 20 in diameter inside a tank with water flow speed up to 1.3 m/s. The work was divided into two stages: (a) a fixed-pitch blade configuration, using a radial permanent magnet generator (PMG), and (b) the same hydrokinetic turbine, with a variable-pitch blade and an axial-flux PMG. The results indicate that even though the efficiency of a simple blade configuration is not high, the power coefficient is in the range of other, more complicated designs/prototypes. Additionally, the low manufacturing and operation costs of this system offer an option for low-cost distributed power applications.

The main concern of a construction client is to procure a facility that is able to meet its functional requirements, of the required quality, and delivered within an acceptable budget and timeframe. The cost aspect of these key performance indicators usually ranks highest. In spite of the importance of cost estimation, it is undeniably neither simple nor straightforward because of the lack of information in the early stages of the project. Construction projects therefore have routinely overrun their estimates. Cost overrun has been attributed to a number of sources including technical error in design, managerial incompetence, risk and uncertainty, suspicions of foul play and even corruption. Furthermore, even though it is accepted that factors such as tendering method, location of project, procurement method or size of project have an effect on likely final cost of a project, it is difficult to establish their measured financial impact. Estimators thus have to rely largely on experience and intuition when preparing initial estimates, often neglecting most of these factors in the final cost build-up. The decision-to-build for most projects is therefore largely based on unrealistic estimates that would inevitably be exceeded. The main aim of this research is to re-examine the sources of cost overrun on construction projects and to develop final cost estimation models that could help in reaching more reliable final cost estimates at the tendering stage of the project. The research identified two predominant schools of thought on the sources of overruns – referred to here as the PsychoStrategists and Evolution Theorists. Another finding was that there is no unanimity on the reference point from which cost performance could be assessed, leading to a large disparity in the size of overruns reported. Another misunderstanding relates to the term “cost overrun” itself. The experimental part of the research, conducted in collaboration with two industry partners, used a combination of non-parametric bootstrapping and ensemble modelling with artificial neural networks to develop final project cost models based on about 1,600 water infrastructure projects. 92% of the validation predictions were within ±10% of the actual final cost of the project. The models will be particularly useful at the pre-contract stage as they will provide a benchmark for evaluating submitted tenders and also allow the quick generation of various alternative solutions for a construction project using what-if scenarios. The original contribution of the study is a fresh thinking of construction “cost overruns”, now proposed to be more appropriately known as “cost growth” based on a synthesises of the two schools of thought into a conceptual model. The second contribution is the development of novel models of construction cost estimation utilising artificial neural networks coupled with bootstrapping and ensemble modelling.

Online learning in K-12 education is becoming a familiar option for students. By the end of 2011, all 50 states and the District of Columbia offered some form of online learning as an option for some students (Watson, Murin, Vashaw, Gemin, & Rapp, 2011). Online courses are appealing to students for a variety of reasons. The five most common reasons schools are currently offering online courses are for: meeting the needs of specific groups of students; offering courses not otherwise available; offering AP or college level courses; permitting students who failed a course to take it again; and reducing scheduling conflicts for students (Picciano & Seaman, 2010). (P. 9) Schools often implement online programs, choosing from a variety of options, without the research necessary to guide these decisions. The purpose of this research was to conduct a cost-effectiveness analysis of two online learning programs, commercially acquired and teacher-developed, used in a school division. The goal was to establish which program was a better choice with consideration to both cost and effectiveness. I used Levin and McEwan’s (2001) cost-effectiveness analysis to find (1) the cost per class taken, (2) the effectiveness, measured by courses passed and Virginia Standards of Learning tests passed, and (3) the cost-effectiveness ratio for both of the online programs. The ingredients method, suggested by Levin and McEwan (2001) was implemented with the use of cost worksheets to gather and itemize the costs associated with the each program. Only three courses were offered in both programs and used for comparison. Effectiveness data was based on students’ grade at the end of the online course and the end of course SOL test if applicable. Each effectiveness measure was used together with the cost total to calculate a cost-effectiveness ratio (CER) for each of the online learning programs. The cost-effectiveness analysis for passing the class revealed no difference between the two programs. The stalemate highlights the important findings of the research as the details in spending and methods of implementation of each program. The school system of interest benefits from the detailed itemization of costs, which identified areas for modification to the programs. The implication for schools looking to initiate an online program is the well-informed leader having detailed information on the costs involved and options for design. The difference in the cost-effectiveness ratio for the measurement of passing the SOL test was dramatically different. The commercially available program’s cost-effectiveness ratio was double that for the teacher-developed program. The implications for the school division in the research were to evaluate the alignment of a commercial program to state standards and to examine the ability of the online program to meet the goals of the school.

Research report to the SBL, Unisa, Midrand. / The research project aimed to establish whether corporate governance is important to investors from a value perspective. The implications and recommendations for further research were provided.

Class of 2007 Abstract / Objectives: The purpose of this study is to determine the direct costs of scorpion envenomation events in the acute care setting for patients treated in a southern Arizona hospital. Methods: A chart review analysis of documented treatment of scorpion envenomations at a university hospital was conducted to compile demographic, drug use, and resource utilization information. Patients were selected based on an ICD-9 code diagnosis of scorpion envenomation within the years 1993 to 2001. Results: 103 patient charts were reviewed. The average length of stay was 1.21 days (range 0.5-6.5 days), the average age was 4.7 years (range 0.2-53 years old). Males comprised 54% of the patients, 51.9% Caucasian, 41.6% Hispanic, and 60.2% were from an urban setting. The average drug cost was $51.82 (SD=53.22). The total average cost in the entire population was $6,764.54, (SD= $3,866.55). The average cost of rural versus urban was $7,535.74 and $6,254.55, respectively (p=0.100). The average cost for male versus female was $6,949.64 and $6,520.90 (p= 0.581), and the average cost for the 0-3 years group was $6,721.10, the >3 years to 14 years group’s average cost was $6,643.33, and the >14 years of age group’s average cost was $8,578.42. None of the comparisons between age groups were statistically significant, with p values ranging from 0.274 to 0.922. Conclusions: Although scorpion envenomations were costly, there were no statistically significant differences noted between any of the comparison groups. Transportation, including air transport in the rural setting, did not account for a significant change in cost. Many of the patients that were envenomated in the rural setting were seen at a regional hospital and then transported as necessary.

This paper studies determinants of FDI in Turkey using panel data analyses. The results of the study show that political stability, education level, rule of law, and trade cost have significant impact on FDI inflow in Turkey while similarity in economy size of home and host country (Turkey) has not. The effect of the trade cost and rule of law was surprising but it gave a clue to new research area. It was concluded that next studies of FDI determinants in Turkey must be conducted at firms' level to better understand the behaviour of foreign direct investments in the country.

Currently, nationwide efforts are being made to help policymakers, construction professionals and consumers become more aware of the benefits of incorporating sustainable energy principles in residential building design and construction (Miller 1996). Any success in applying these principles is the result of effective communication by design professionals to builders and homeowners in understanding cost benefit tradeoffs for using sustainable energies in homes. The Gordon and Janice Plumblee Residence, located on 1742 Routh Road in Burlington, NC, is an example of how passive solar-heating design elements, along with simple conventional construction techniques, have created a comfortable, affordable, and low-energy consumption home. This report evaluates the passive solar and energy conservative elements incorporated in the Plumblee Home and quantifies the significance of each element energy contribution. A model of the thermal performance of the home is compared to the actual performance. The accuracy of the model is verified. The modeling software is used to perform a sensitivity study of the thermal performance. An analysis of the construction methods and materials used is presented.

Master of Science / Department of Agricultural Economics / Vincent Amanor-Boadu / Transaction costs, one of the most significant barriers to market participation, may vary by buyer type. Depending on who a farmer sells their produce to, they may alter their potential transaction costs consequently influencing their market participation. This study examines the effect of buyer type on smallholder market participation in Northern Ghana where poverty is still endemic and often exacerbated by fewer opportunities for commercialization such as limited access to markets. The analysis is based on data from the agriculture production survey conducted in 2013 and 2014 and the Population based Survey conducted in 2012 in northern Ghana. Analysis is performed using the Double Hurdle approach to control for self-selection bias, ensure more flexibility on the variables affecting the decision to sell and how much to sell as well as to provide unconditional effects of the variables on market participation. The results reveal greater market participation of cash crop producing farmers than those producing a lower value food crop - Maize. The results also show that farmers selling to aggregator-type middlemen and other buyers have a propensity to sell more. The aggregators and ‘other buyers’ buy in bulky, offer lower prices and are associated with lower transport, loading and offloading costs than consumers. Farm output, access to information and price also have a significant positive impact on intensity of market participation. These findings support policy initiatives such as supporting aggregator-type middlemen, increasing the provision of information, promotion of cash crops as well as supporting more interventions focusing on increasing production and yields.