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Taiwan is an island surrounded by vast open sea. The impacts of typhoon on fish farms located near shore are usually tremendously severe and cause a variety of difficulty in developing a profitable cage aquaculture industry. Thus it is often regarded as one of highly risky ventures for fishermen. While Tai Ping Island is located at the tropic zone, the south most territory of the Republic of China, rendering a superior farming site for cage culture due to its clean water quality and nonexistence of typhoon. This study evaluates the possibility of establishing a series of cage culture in Tai Ping Island and estimates its economic feasibility according to the information obtained from Penghu cage farmers. Since Tai Ping Island is a military base, it is still prohibited for public visit at the present moment. Once the operation of offshore cage aquaculture at the Tai Ping Island is established, it may inspire other cooperates associated with the fishery industry to cluster on the Island. The researcher has served at the coastal guard office in Tai Ping Island for a year and thus quite familiar with land-based facilities, surrounding marina, and ecosystem etc. Through past experience in protecting cage farmers knowing that good farming site is relatively important for cage culture to success, this study intend to offer a good farming site to fish farmers in Taiwan. It is anticipated that a prosperous fish farming industry will develop in the near future.

<p>Our aim in this thesis has been to look at the foreign citizens’ share of costs and benefits associated to the society in Sweden. We have compared Sweden on the national level to Jönköping County on the regional level to see if there are any deviations. We have conducted a new calculation approach in order to present the contributions given by immigrants and the associated costs. Figures are to a large extent viewed in relative terms in the thesis, and specified in concrete terms in the appendix. We have selected a series of four costs and one benefit in order to show how an estimation of the costs or benefits could be made. We have found that immigrants tend to work harder than the natives, but at a lower wage level. Even so they do not compensate for the costs to the society applied to immigrants.</p> / <p>Syftet med den här uppsatsen är att ta reda på hur stor del av kostnaderna för samhället som går att förknippa till invandrarna i Sverige. Sverige har jämförts med Jönköpings Län för att hitta eventuella avvikelser. Vi har försökt skapa ett beräkningssätt för att kunna visa hur mycket som går ut till invandrarna och hur mycket de ger tillbaka. Vi utrycker oss till största del i relativa termer i uppsatsen, för absoluta tal hänvisas till appendix. För att visa hur vårat beräkningssätt kan användas har vi gjort beräkningar på fyra kostnadsgrupper och en inkomstgrupp. Vi har kommit fram till att invandrare tenderar att arbeta mer än den inhemska befolkningen, men till en lägre lön. Trots detta så kompenseras inte kostnaderna för samhället av dess intäkter när man jämför de som är direkt kopplade till invandrarna.</p>

The Limited English Proficiency (LEP) population in the United States requires interpreters in order to receive appropriate medical care. However, interpreters are not used consistently in clinical encounters. This study aims to identify the barriers that interfere with providing this service, as well as to propose some possible ways of overcoming these barriers. A systematic review of the literature was conducted using Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO. Twenty articles that presented barriers to interpreter use were identified. These barriers referred to either professional interpreters or ad hoc interpreters, or were general barriers. The barriers to professional interpreter use most frequently identified related to cost. Most of the cost-related barrier citations were found in studies conducted in the U.S. The barriers to ad hoc interpreter use most frequently identified related to concern about the interpreters ability to interpret. I determined that appropriate provision of interpreters to the LEP community would require four elements: 1) The consistent use of professional interpreters, and the elimination of ad hoc interpreter use. 2) Research into the possible financial benefits that may arise from increased interpreter use, and how the cost of providing interpreters may be offset by the widespread benefits of using them. 3) Professionalization of interpreter services, with quality assurance and standardized training and evaluation of interpreters. 4) Increased education and training for patients and providers about the language services that are available and how to access them, and about how to work with an interpreter efficiently and effectively. One possible solution that would allow the implementation of all of the above elements is a national interpretation service.

The purpose of this thesis was to explore the use of cost effectiveness for interventions in orthopaedics. This was done through three cost effectiveness articles that have been published by the author. In each of these articles, similar methodologies were used. Decision models were constructed for cost-effectiveness analyses of competing orthopaedic interventions. Outcome probabilities and effectiveness values were derived from the literature. Effectiveness was expressed in quality adjusted life years gained. Cost data were compiled and verified from either hospital cost data or from Medicare data. Costs and utilities were discounted in accord with the United States Panel on Cost Effectiveness in Health and Medicine. Principal outcome measures were average incremental costs, incremental effectiveness, incremental quality-adjusted life years, and, in the case of one article, net health benefits. In particular the articles compared the following: 1. Core decompression versus conservative management for osteonecrosis of the hip as a way to delay hip replacement; 2. Total knee arthroplasty versus unicompartmental knee arthroplasty; and 3. Periacetabular osteotomy versus total hip arthroplasty for a young adult with developmental dysplasia of the hip. The more cost effective intervention was identified in each case, along with implications of the results for clinical and operative decision-making. Cost effectiveness was found to be a useful tool in orthopaedic surgery under limited circumstances of either scarce data on new interventions or the need to use more resources to achieve greater effectiveness. It also can provide excellent insight into ways to direct future clinical research.

The purpose of this study was to perform a cost-benefit analysis of an intervention to treat all the children in Bolivia (under 15 years of age) who are infected with Chagas disease. This research was carried out in La Paz, Bolivia where the author lived for a year collecting data in collaboration with the National Chagas Control Program, Bolivian Ministry of Health. Operational costs were based on current prices for laboratory testing and pharmaceuticals, average hourly wages for health care workers, and the number of children who would be treated. The benefit of the program was estimated as the sum of direct and indirect costs associated with chronic cardiac disease caused by Chagas infection. Direct costs were calculated as the minimum amount needed for adequate medical treatment summed over the patients life span. Indirect costs were measured in Disability-Adjusted Life Years (DALYs) multiplied by average yearly salary to more fully account for the true burden of disease. Implementation cost was estimated to be approximately $35 million. This intervention would prevent over 279,000 DALYs and alleviate $123 million in direct and $632 million in indirect costs. Clearly, such a program would be extremely cost-effective. Thus, with an initial investment of less than $135 per infected child, approximately $2,900 worth of future costs would be prevented, in addition to improvements in quality of life not captured by DALYs. A sensitivity analysis showed that even while assuming a high variability of the data, the cost and benefit of this intervention were significantly different (p-value < 0.001).

Transportation planners, engineers, and administrators face the difficult tasks of prioritizing and justifying proposed investments in transportation infrastructure, particularly as government budgets tighten and alternative investments compete for public funding. One means by which professionals can prioritize and justify large transportation investments is by describing how a proposed project will impact an area’s economy in terms of creating new jobs, raising aggregate income, and increasing business revenues. The report begins by examining the general impact of transportation investments on economic development. Then it surveys various methods and tools that have been proposed for estimating economic impacts. Among these, the TREDIS economic impact model is selected and used to estimate the economic impacts of a current interstate highway project in Texas. / text

Due to the interdisciplinary nature of eco-labelling, the sense of the phenomenon itself is lost when studied in isolation. With this consideration, a balance of research between practical and theoretical approaches, between environmental sociology, environmental economics, international trade relations, consumer society, sustainability and marketing theory was explored. Eco-labelling has far-reaching ramifications in society, not just in the commercial relationship between producer and consumer, but in socio-cultural norms and values. It combines economic and social forces via the marketplace. The research of this paper focuses on 1) the socio-cultural aspects of eco-labelling, 2) the economic incentive which drives eco-labelling and 3) the global institutional structures which influence the eco-labelling dimension. Chapter 1 provides an overview of eco-labelling and introduces ecological modernization, the theoretical foundation of this paper. Chapter 2 is a summary of interviews which were conducted with eco-labelling managers around the world. Chapter 3 analyses the economic impact of eco-labelling, the effects on international trade and the environment, and how eco-labelling affects consumers and producers. Chapter 4 deals with the social context of eco-labelling, and the social paradigms of consumer society and sustainability, merging in the case of ecological modernization. Chapter 5 looks at opportunities and challenges to eco-labelling, and concrete recommendations with respect to the design of eco-labelling programmes are made. Eco-labelling is the only tool which functions within the conflicting social forces of consumer society and sustainability. As a market-based instrument for environmental management that functions within the producer - consumer relationship, eco-labelling can be seen as the ecological marketisation of consumer society. Best practices in eco-labelling rely on accepting the fundamental market principles combined with social trends. (author´s abstract)

The study evaluated the cost-effectiveness of community based Nurse Case Management (NCM) utilizing existing hospital information systems data. Program outcomes of intensive NCM were compared with those of existing hospital programs for a group at high risk for readmission. Thirty-one elderly patients were assigned to one of three groups. A retrospective pretest-posttest design was used and multivariate analyses were performed. Outcomes were measured at six month intervals before and after NCM. The intensive NCM group had a higher length of stay and inpatient costs than the other two groups. Direct costs of NCM were estimated at $1.55 per active case per day. The study found that cost-effectiveness of NCM cannot be determined accurately unless health risk assessments are quantified, NCM is clearly translated into categories of intervention, and direct costs of NCM are measured consistently. These factors must be integrated into routine hospital information system reports.

ACE inhibitors have been widely used in the treatment of certain diseases of the cardiovascular system, the major use being hypertension, since all ACE inhibitors are prescribed for its treatment. ACE inhibitors is also used in the treatment of congestive heart failure. The angiotensin-converting enzyme (ACE) converts angiotensin 1 into angiotensin I1 and also stimulates the production of aldosterone (a hormone produced in the adrenal glands that influences salt and water retention by the kidneys, increasing blood volume and blood pressure). The cost benefit, cost-effectiveness and cost utility of ACE inhibitors have not been established. The objective of the study was to review and analyse the cost of ACE inhibitors by using a medical aid claims database. Data for the study population consisted of all prescriptions containing one or more ACE inhibitor combinations and were extracted from the central database of Interpharm datasystems for a period of one year, from 1 January 2001 to 31 December 2001. A total of 1 475 532 prescriptions containing a total of 2 953 244 ACE inhibitor items represented the study population. Through the analysis of the general medicine utilisation patterns that were obtained from the medicine claims database, it became evident that ACE inhibitor utilisation contributes considerably to the total prevalence and cost of all the medicine items available on the database. It constituted a total prevalence of 4,62% (n =1 475 532) of all the prescriptions and a total prevalence of 2,31% (n =2 953 244) for all the medicine items in the prescriptions with a cost of 3,65% (n =R379 91 1 472,OO). It was concluded that in the analysis of ACE inhibitors according to the innovator/generic classification, the majority of ACE inhibitors prescribed during the twelve-month period were for the innovator product, with a prevalence of 82,56% (n =68 162) and a cost of 89,11% (n =R13 863 080, 90). The utilisation of the generic ACE inhibitors, with a prevalence of 17,44% (n =68 162) and at a cost of 10,89% (n =R13 863 080, 90), was under-utilised. If the total number of prescriptions containing innovator ACE inhibitors could be generically substituted, (37,54%) R5 204 392,68 in cost expenditure could be saved over a twelve-month period. However, the fact that not all the innovator ACE inhibitors have generic equivalents available must be taken into account. If only the prescriptions containing ACE inhibitor items that have generic equivalents were to be substituted with their generic equivalents, R899 751.29(6.5%) would be saved. This was found by adding all the costs saved by substituting innovator drugs with their generics. Consequently, it can be concluded that the extensive use of the innovator ACE inhibitors could mean an exceptional increase in the cost expenditure associated with ACE inhibitor therapy. In completion of the study, recommendations were formulated as an aim to optimise the utilisation of ACE inhibitor generic equivalents. / Thesis (M. Pharm.)--North-West University, Potchefstroom Campus, 2004.