The determination of long-term goals for climate policy, or of near-term mitigation effort, requires a shared conception among nations of what is at stake. Unfortunately, because of different attitudes to risk, problems of valuing non-market effects, and disagreements about aggregation across rich and poor nations, no single benefit measure is possible that can provide commonly accepted basis for judgment. In response to this circumstance, a portfolio of estimates is recommended, including global variables that can be represented in probabilistic terms, regional impacts expressed in natural units, and integrated monetary valuation. Development of such a portfolio is a research task, and the needed program of work suggested. / Abstract in HTML and technical report in PDF available on the Massachusetts Institute of Technology Joint Program on the Science and Policy of Global Change website (http://mit.edu/globalchange/www/). / Results cited from the MIT Joint Program on the Science and Policy of Global Change were developed with the support of the US Department of Energy, Office of Biological and Environmental Research [BER] (DE-FG02-94ER61937) the US Environmental Protection Agency (X-827703-01-0), the Electric Power Research Institute, and by a consortium of industry and foundation sponsors.

An increasing emphasis on chemical process safety over the last two decades has led to the development and application of powerful risk assessment tools. Hazard analysis and risk evaluation techniques have developed to the point where quantitatively meaningful risks can be calculated for processes and plants. However, the results are typically presented in semi-quantitative “ranked list” or “categorical matrix” formats, which are certainly useful but not optimal for making business decisions. A relatively new technique for performing valuation under uncertainty, Value at Risk (VaR), has been developed in the financial world. VaR is a method of evaluating the probability of a gain or loss by a complex venture, by examining the stochastic behavior of its components. We believe that combining quantitative risk assessment techniques with VaR concepts will bridge the gap between engineers and scientists who determine process risk and business leaders and policy makers who evaluate, manage, or regulate risk. We present a few basic examples of the application of VaR to hazard analysis in the chemical process industry. We discover that by using the VaR tool we are able to present data that allows management to make better informed decisions.

Seen from the viewpoints of politics and administration, the retirement system of civil servant is related to the overall planning and flexible utilization of human resource, the improvement of national competitiveness and the collocation of financial resource of a country; seen from the viewpoint of economy, the prosperity or depression of national economy closely affects the planning of retirement payment system; in the aspect of society, as the aged society comes earlier than expected and the social structure changes, the retirement system of civil servant is related to whether the living security and social welfare system for the aged people is sound enough. Through the proper and reasonable retirement payment, the retirement system of civil servant is intended, firstly, to motivate the civil servants to be satisfied with the job and work hard for the public; secondly, to provide a reasonable income for the civil servants and guarantee their life in the years after retirement; and thirdly, with the reasonable retirement payment mechanism and the social security mechanism of the country, to construct a complete social security system network and build a safe and peaceful society in which all people can make their own livings. The implementation of the new pension system has really improved the problems faced in the old public finance-based pension system, and has laid a solid foundation in stabilizing the source of pension fund and establishing the civil servants' concept of being prepared to burden their post-retirement life when they are on the job. However, the current retirement system was designed more than 20 years ago and some tradeoff or progressive measures were taken for the purpose of reducing the resistance in the beginning of implementation. As the age and the environment both have changed, some provisions of the pension system have been behind the time. Therefore, it is really necessary to research how to manage and operate the retirement system, think over the problems in the current retirement system of civil servant, and research how to build a better retirement fund system and balance the retirement benefits of the civil servants of different generations. In this thesis, the legal system of retirement of civil servant is the subject of research and the other related administrative legal provisions are used for explanation, and the basic theories of administrative law ¡V administrative principles, administrative organization, administrative authority, administrative remedy, and administrative supervision, are used as the research methods to review the retirement system of civil servant in Taiwan. Through the research it is found that, the average age of Taiwanese people has been higher and a lot of civil servants choose to retire earlier for they can receive monthly pension for a long time; this is likely to deteriorate the governmental finance. How to solve this problem efficiently and reasonably, relieve the accumulation of retirement cost and avoid it from being transferred to the later generations as a heavy burden, maintain the existing rights and benefits, provide a reasonable guarantee for the original expectation of civil servants and distribute the national resources reasonably? It is necessary for us to think about for planning a reasonable legal system of retirement.

Objectives:<br>1. Describe patient-related and hospice-related characteristics such as gender, average length of hospice stay, primary diagnoses, average daily census, number of admissions per year, net operating revenues, inpatient unit (IPU) operating costs, and medication expenditures of hospices in Ohio and compare it with NHPCO data.<br>2. Identify and analyze therapeutic drug classes and medications with the most frequent utilization rates and largest percentage of expenditures in hospice care.<br><br>Method:<br>Hospice Pharmacy Benefit Managers (PBM) employ pharmacists to provide comprehensive pharmaceutical care services for patients under hospice care and one component of pharmacist provided services include comprehensive medication review. To study the impact of pharmacist-led medication review on hospice costs and medication utilization, PBM claims data for year 2007 were obtained from five hospices in Ohio. The data included information on utilization and costs of medications, patient-related (gender, average length of hospice service, and primary diagnoses) and hospice-related (number of admissions per year, average daily census, net operating revenues, inpatient unit [IPU] operating costs and pharmacy costs) characteristics. Claims data were analyzed to identify the most frequently used therapeutic drug classes and those classes which contributed to the largest percentage of pharmacy expenditures. Prescription drug count and total cost for medications under the identified therapeutic drug classes were also obtained. For benchmarking purposes, analysis was conducted to compare patient and hospice-related data obtained from the five hospices to the 2007 NHPCO data.<br><br>Results:<br>The average number of admissions per hospice for the year 2007 was 627 patients. Average daily census (136 patients) and total patient days (51,350 days) in these five hospices were 1.5 times higher as compared to that of NHPCO data (90 patients and 31,300 days, respectively.). Annual drug expenditures per hospice ranged from $67,580 to $763,413 while average hospice medication cost per patient per day (PPPD) was $11.12 ($12.43 PPPD for home care and $8.5 PPPD for nursing care). Average PPPD excluding outliers such as enoxaparin was $10.72 ($12.05 PPPD for home care and $8.25 PPPD for nursing care).<br>Approximately 1,020 different drugs under 246 therapeutic classes were utilized in the five hospices. The most frequently utilized therapeutic class of drugs, based on prescription drug volume included analgesic-narcotics (15.6%) followed by laxatives-cathartics (7.5%), and anti-anxiety drugs (7%). Therapeutic classes contributing to the majority of drug expenditures, included analgesics-narcotics (16.5%), SSRIs (4.7%), and anti-anxiety drugs (4.5%). Medications whose frequency of use accounted for high expense included morphine sulfate (5.3% - utilization, 4.4% - expenditure), lorazepam (4.4%, 3.1%), furosemide (4%, 0.6%), methadone (3%, 0.9%), and prednisone (3.1%, 0.5%). Medications such as enoxaparin injections whose frequency of utilization was low (0.01%), contributed to 3.1% of total medication expenditure. Likewise, fentanyl and oxycodone contributed to 3.5% and 3.7%, respectively to the total medication expenditure, but their frequency of utilization was only 0.9% and 1.9%, respectively.<br><br>Conclusion:<br>The five hospices in Ohio utilized preferred drugs recommended by pharmacists following a medication review to identify potential drug related problems (DRPs) and encourage cost-effective drug utilization. As a result of these interventions, the utilization of expensive medications is low. Pharmacists specializing in hospice and palliative care are able to recommend preferred medications in end-of-life care thus producing cost-savings. More importantly, hospice pharmacists frequently identify DRP's which can improve patient outcomes. Hospices should consider interventions made by pharmacists and place emphasis on the utilization of cost effective drugs that can be used among terminally ill patients to provide a high level of quality care with fiscal responsibility. / Mylan School of Pharmacy and the Graduate School of Pharmaceutical Sciences; / Pharmacy Administration; / MS; / Thesis;

The demand for energy is forever growing. The technology of extracting power from uranium through nuclear facilities is rather old. Core melting, nuclear bombs, uranium extraction costs and the question what to do with the wastes has hindered countries from exploiting this resource. The technology of extraction, containment and refinement has however come a far way since the beginning. There is a need of revaluing this method of generating power. What better way of doing this than making a cost and benefit analysis upon Nuclear Power. If the costs of overweight the benefits, the governments should dismount the reactors in the involved country. If it’s the other way around; benefits surpassing costs, there should be a development within this sector. In this thesis we will analyze a cost-benefit-analysis of new nuclear power generation in the UK. We will explain how a CBA is constructed, give some examples of cost and benefits of nuclear power and with this knowledge we will then critically look at the 2006 CBA of new nuclear power in UK (Kennedy) which compares costs and benefits of nuclear new build with conventional gas-fired generation and low carbon technologies.

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Taiwan Coastal-Offshore Fisheries, for lack of effective fisheries conservation, which are in face of random competition and excessive exploitation of resources under vicious circle, have made resources exhausted in the sea area near Taiwan and have diminished catch of fish. CPUE (Catch per Unit of Effort) was decreased year after year because of excessive competition, so that it caused income of the fishing population to get in a crisis. The fact that we know, in order to solve effectively the operating difficult position in Coastal-Offshore Fisheries, is that the government adopt an phase-in on elimination and construction system in connection with the fishing boat and some measures of vessels reduction, for reducing amount of fishing boat and fishing effort, to promote the vitality and the competitive ability of production in Coastal-Offshore Fisheries. The basic theory of vessels reduction comes from the following backgrounds: 1. A viewpoint of economy in bio-ecology: when experts decide the whole policy according to this mode, the goal to determine fishing effort can be selected among divers fishing effort which was made by laissez-faire economy of completely free competition, Maximum Sustainable Yield (MSY), and Maximum Economic Yield (MEY) . 2. A viewpoint of welfare economics: to achieve the goal of welfare economics with the thoughts of whole people, the intersection of marginal cost and average income is the most proper that we can obtain from the maximum sum of producers surplus and consumers surplus as fishing effort. 3. A viewpoint of external diseconomies: when marginal value of people is equal to marginal cost of fishing population, this point will be the most proper for fishing effort. The purpose of study in this thesis is to use a method of analysis exploring the correctness of vessels reduction program that the fishery authorities in our government execute, and to look over its effect to find out whether it has achieved the goal we expected. We have discovered the result through cost-benefit analysis of actual examples, of which the vessels reduction program to purchase the old fishing boats for lack of a complete set of other measures which based on fishing effort and fishery management in the theory of vessels reduction , will cause the measures to fail to improve remarkably these two important goals¢wto decrease the fishing pressure, and to promote the fishing gains¢win an expectable time. This study propose that the vessels reduction program could consider cutting down fishing effort with other methods for pursuing the eternal development in Coastal-Offshore Fisheries, such as to rest fishing and to carry out the measures of a complete set in a ration system, and that the effect, except the proper fishing effort made by the consideration in basic theory of vessels reduction , will be better. Furthermore, an object of vessels reduction should not only be limited to the old fishing boats over 15 years of age, but also take the ones as object which remain working at sea and have reached over 2 years of age in case of uneasy or bad operation. As before, it will be able to attain the aim of decreasing competition in fishing circles.

An increasing emphasis on chemical process safety over the last two decades has led to the development and application of powerful risk assessment tools. Hazard analysis and risk evaluation techniques have developed to the point where quantitatively meaningful risks can be calculated for processes and plants. However, the results are typically presented in semi-quantitative “ranked list” or “categorical matrix” formats, which are certainly useful but not optimal for making business decisions. A relatively new technique for performing valuation under uncertainty, Value at Risk (VaR), has been developed in the financial world. VaR is a method of evaluating the probability of a gain or loss by a complex venture, by examining the stochastic behavior of its components. We believe that combining quantitative risk assessment techniques with VaR concepts will bridge the gap between engineers and scientists who determine process risk and business leaders and policy makers who evaluate, manage, or regulate risk. We present a few basic examples of the application of VaR to hazard analysis in the chemical process industry. We discover that by using the VaR tool we are able to present data that allows management to make better informed decisions.

Due to under intense competitions and uneven resource allotments, many medical institutes are not only being pushed ahead with their medical technology but also constantly improving their medical management and efficiency for achieving higher medical quality. In Taiwan, it takes ten years to train a doctor; however, it is possible to have a NP (Nursing Practitioner) to substitute partial capacity of a resident; as long as the NP has equivalent working experiences, a short-term training and also to pass exams as well. Therefore, using a qualified NP in medical institutes is a more economical and practical way of utilizing human resource benefits; as far as for the medial caring services it also has a substantive significance. This study is a research that is based on a certain southern teaching medical hospital¡¦s doctors, nurses, patients, medical services and other medical related people.It is divided into two parts to proceed: first, collect information from quality based researching interviews of targeting people in order to study their perspectives toward to the system of NP. Then, a quantifiable survey is being designed according to the result of the interviews and some other verified literature content; therefore, the merit of NP can be proven by the medical hospital¡¦s human resource efficiency trend.Further discussion on whether medical professional personnel attributes can affect theperception of NP; to anticipate an establishment of independent NP system in the future medical system. According to the research results: (1) 51.8% participants of the interviews think that the establishment of independent NP system is not only a demand from hospitals, doctors as well as the patients. It may even promote overall hospitals management efficiency. The demand 28.4% accounts come from doctors; to a certain extent that many participants believe to establish an independent NP system can possible to share an appropriate amount of doctors¡¦ workloads. 47.2% participants believed that the act of NPs in medical system is ¡§Physician Assistant¡¨. In addition, about 50% participant thought that the NPs can substitute residents and they can cut down cost,be economized the use of manpower training time, improve efficiency, promote medical service quality and so on. (2) A remarkable difference in ¡§Expanding System Construction Interface¡¨¡]F=3.495¡Ap=.018¡^is found because the participants come from different age groups. The younger participants are, the lower they score. Thus, it is possibly to say when come to develop nursing care network and community medical caring Expanding System Construction Interface that the younger medical professionals are, the lower understanding and less recognizing they are. (3) According to different seniority of every single interface variance analysis; the differences of seniority medical professionals in ¡§Expanding System Construction Interface¡¨¡]F=4.153¡Ap=.008¡^, after comparing with Scheffe¡¦s method,has scored above an average: above five years > 3-5. In comparison, one who has more seniority has obtained a higher score. (4) Monthly income in the SubstitutionConstruction Interface (F=3.174, p=.046) has a remarkable difference. According to the description of personnel attributes; doctors who have the average monthly income above 120,000NTD have occupied the majority (38.2%). However, in comparing with other categories; to provide resident's immediate supports, as well as others¡¦ understanding and recognizing of the NPs have obtained a lower score. The purpose of this research is to believe that there should be more explicit direction and further related implementation in all the future hospital policy, in order to enable the NPs to make full use of their ability. At the moment, there is a rather vague definition of NPs¡¦ job in Taiwan; in fact, the establishment of NPs¡¦ system has not much explication either. Therefore, while evaluating overseas¡¦ system, method and training, it may not be approved by the present medical professionals without envisaging a thoughtful systematic construction first. However, according to the findings of this research; it is necessary to have a further discussion. It is to suggesting a future specific and comprehensive plan: expanding case acceptance throughout all level of hospitals in Taiwan to promote the result of inference; designing a further discussion survey of focusing on NPs¡¦ beneficial results as for the future research foundation.

Thesis (M.B.A.)--Naval Postgraduate School, June 2004. / Thesis advisor(s): Richard Doyle, Ira Lewis. Includes bibliographical references (p. 77-82). Also available online.