Abstract Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been gaining importance in the treatment of advanced Parkinson's disease. This study was undertaken to evaluate the beneficial effects of bilateral STN stimulation on patient's clinical symptoms and quality of life related to the potential risks and side effects of the treatment. A consecutive series of 42 patients operated on for Parkinson's disease with STN DBS in Oulu University Hospital were included. A subgroup of these patients was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS), neuropsychological tests, and Health Related Quality of Life (HRQoL) instruments i.e. the Parkinson's Disease Questionnaire (PDQ-39) and the Finnish version of the Nottingham Health Profile (NHP). The costs of the treatment were calculated from the perspective of the health care provider. The possible effects of bilateral STN-operation on cardiovascular autonomic function were analyzed by measuring various time- and frequency domain indexes as well as non-linear indexes of heart rate variability (HRV) from 24-hour EKG recording before and 12 months after the operation. This study showed that STN DBS significantly improves the clinical symptoms and HRQoL of parkinsonian patients. The dyskinesia and clinical fluctuation scores were reduced very significantly in the UPDRS IV subscale. The clinical fluctuations were reduced by 53 %. After DBS best motor response (UPDRS III) scores also improved significantly. The HRQoL measured with both instruments improved significantly. Improvement was seen in the PDQ-39 summary index and the subscales of activities of daily living, emotional well-being, stigma and bodily discomfort. Only communication became worse during the follow-up. There was a statistically significant improvement in the score of the subscales of NHP measuring problems with energy, sleep, emotional reactions and social isolation. One patient died from pulmonary embolism and another contracted a late postoperative intracerebral hemorrhage leading to a permanent deterioration of her neurological condition to the bedridden stage. Other complications were much milder. Clinical improvement and improvement in HRQoL were positively correlated. STN DBS does not influence tonic autonomic cardiovascular regulation. The incremental costs of performing bilateral STN DBS in Finland compared to preoperative medical treatment amounted to an average of 25 591 EUR per patient during the first postoperative year. The majority of parkinsonian patients experienced significant and long lasting relief in their motor symptoms and an improvement in HRQoL following STN stimulation.

Thesis is focused on effectivity assessment of the reporting system of the selected company and the comparison of the former and current reporting solution. This is achieved by the appropriate literature research, creation of the individual assessment model based on the methodology of the analogy from the information systems assessment and based on the experience of the selected company's employees and the experience of the experts in the field of corporate financial management with the focus on the reporting systems. Model is defined by the set of criteria structured into the groups and by the weights assigned to criteria along with the value for each of them. The last phase consists of stepping out of the individual assessment and defines the generally applicable model, usable on the wide range of different reporting systems.

The erection of tollgates along the N1 freeway has triggered a great deal of interest. As a result of the toll fees, traffic has been diverted to alternative roads. This study investigates how traffic diverted from the toll road affect the welfare of users of the alternative road. The literature review provides a theoretical framework of economic impact assessment and road pricing. Furthermore, the literature study reviews previous studies of a similar nature and compare them with the findings of this study. There is no conclusive evidence that diversion of traffic from the N1 causes congestion on the R101 and has a negative impact on the economy of the region. On the contrary, evidence suggests that there was an initial diversion of traffic when the toll came into operation but that is slowly filtered back after six months. In the application of the RED model, economic benefits are derived from user benefits, which is a function of savings in VOC’s and time of normal and generated traffic on a road or saving due to an improvement in road safety, resulting from improved roads. A decrease in traffic has a measurable effect on vehicle travel speeds and travel time only when the roads are significantly congested. In the case of scenario 1 (including diversion), frequent maintenance needs to be performed under increased traffic. Increased traffic due to “diverted traffic” causes congestion in accidents and travelling time, which is a cost to the economy. Under scenario 2 (excluding diversion), it is assumed that ADT will return to normal. Due to lower levels of congestion and travelling times would be faster, while maintenance costs and accident rates would decrease. Scenario 2 is selected as being economically the most feasible option. It is clear that the R101 cannot cope with the current levels of traffic and congestion. One can speculate about the causes of the congestion but in order to derive at a solution to the problem more research needs to be done on the cause of the congestion in order to resolve the problem. / Dissertation (Magister Commercii)--University of Pretoria, 2007. / Economics / unrestricted

The aim of the final thesis Methods for IT investment evaluation and decision making is to verify relationship between strategy of the company its Enterprise Architecture and IT investments evaluation. To achieve the aim of the thesis is necessary to define the term of Enterprise Architecture and its relationship with IT Project Portfolio Management. The literature retrieval which follows after is focused on calculation of IT investment profitability and return. The calculation is very difficult due to intangible benefits which are one of the common goals of IT investments. The customer satisfaction, improve of the current business process or employees satisfaction are one of the examples of the intangible benefits. Cost/Benefit analysis is one of the methods depicted for calculation of the intangible benefits. Methods for decision support as Analytic Hierarchy Process are highlighted as the significant instrument. The risk analysis and simulation of the risk in IT investments decision making are also mentioned but according to the scope of thesis just very briefly. Major methods are used on the model example of the evaluation and decision making process to demonstrate the whole theoretical part of the thesis. The biggest added value of the final thesis is the deep analysis of the relationship between strategy of the company its Enterprise Architecture and IT investment evaluation. Entire final thesis should be used as the fundament for IT investment evaluation and decision making framework.

This thesis covers the implementation of ex post cost-benefit analysis (CBA) applied to specific sport event in the Czech Republic, specifically Biathlon World Championships, which was held in Nové Město na Moravě in 2013. The results of determinative criterion indicators reliably exceeded the required values, investment project can be considered as economically feasible. Concurrently the event has generated positive cash flow therefore we can talk about the feasibility of the project. Overall, the project can be recommended for realization, because brings more benefits than costs to interested parties.

The thesis focuses on impacts of shortage of places in kindergarten in the Czech Republic's tax revenues due to reduced participation of women in labor market. Within the work is described the situation on imaginary kindergarten market. The supply side is made of kindergartens and the demand side is made of children between age 3 and 6 and their parents. Comparasion of cost expended on establishing new positions in kinderkarten with tax revenue is illustrated by cost benefit analysis. The goal of cost benefit analysis in this work is to prove or disprove expediency hypothesis of establishing new positions in kindergartens in comparison with total lost tax revenue.

Många infrastrukturprojekt involverar byggnation i berg där det alltid finns osäkerheter att hantera, dessa kan minskas genom att utföra fler undersökningar. Eftersom förundersökningar i berg är relativt dyra gäller det att hitta en balans där fältprogrammet är ekonomiskt försvarbart. Ett området som studerats det senaste åren är att utreda kostnadsnyttan som förundersökningarna tillför. Metoden som har utvecklats kallas datavärdesanalys och används för att kunna bedöma kostnadsnyttan av att utföra ytterligare förundersökningar innan de är utförda. Syfte med studien är att utvärdera kostnadsnyttan av ytterligare förundersökningar för en injekterings- och bergförstärkningsdesign i ett riktigt bergbyggnadsprojekt. Detta kommer att göras med en utvecklad statistisk metod av datavärdesanalysen.  Förväntade resultat från studien var: Undersöka hur insamlad data från tidigare förundersökningar i projektet kan användas för att bedöma sannolikheterna i datavärdesanalysen. Utveckla datavärdesanalysen för att vara tillämpbar i ett bergbyggnadsprojekt. Testa metoden i ett byggprojekt med riktig data och kostnader. Utvärdera om den framtagna metoden är tillämpbar i ett bergbyggnadsprojekt. I studien upprättades först två olika typdesigner för injekteringen och bergförstärkningen, baserat på en begränsad mängd data som fanns tillgänglig för en utvald sektion (fall 1). Mängden data som var tillgänglig i fall 1 är liknande som i en förstudie. Sedan upprättades två nya typdesigner för vardera område där kompletterande information från högkvalitativ data från kärnborrhål, hammarborrhål och vattenförlustmätning adderades (fall 2). Sannolikheterna i datavärdesanalysen bedömdes genom att använda en statistik metod. Den statistiska metoden baserades på en monte carlo simulering där stupningen på brottet antogs variera för bergförstärkningen och konduktiviteten antogs variera för injekteringen.  Studien påvisade goda resultat för att datavärdesanalyser skulle kunna implementeras i projekt som ett beslutsunderlag. Problematiken som kan uppstå i projekt där man har olika åsikter om hur mycket förundersökningar som behövs skulle kunna elimineras genom att använda datavärdesanalyser på den tillgängliga informationen samt nyttan av mer information. Detta är viktigt ur ett samhällsekonomiskt perspektiv. Det är dock viktigt att personen som använder verktyget förstår hur metoden är uppbyggd och dess antaganden. Gör man inte det finns det stor risk att beslut fattas på grund av felaktigheter som kan finnas i både indata och misstolkad utdata. Vidare rekommenderas att metoden utvecklas innan den används i ett riktigt projekt. Exempel på detta kan vara att göra mindre antaganden. Det kan också vara att försöka koppla datavärdesanalysen till var man har utfört undersökningen på sträckan man studerar. Man skulle även kunna inkludera fler parametrar i sin monte carlo simulering. Slutligen kan man, för att göra metoden mer användarvänlig, skapa en bättre plattform som den kan användas på. / Many infrastructure projects involve construction in rock, where there are a lot of uncertainties to deal with. These uncertainties can be reduced by performing preliminary investigations. Since preliminary investigations are expensive, it is necessary to find a balance where the field program is financially justifiable. In recent years cost-benefit analysis has been studied to investigate the benefits that preliminary investigations add. The method that has been developed is called value of information analysis and it assesses the cost-benefit of doing more investigations before they are performed.  The purpose of this report is to evaluate the benefits of additional preliminary investigations in a real project that could improve the grouting and rock support designs. The studied method is VOIA (Value of Information Analysis) based on statistical probabilities. The expected result of the study was: Investigate how collected data from preliminary investigations can be used to determine the probabilities used in the VOIA concept based on statistics. Develop a VOIA concept that is based on statistics and can be applied in a real project. Test the concept in a real project with real data and costs. Evaluate however the statistical approach was suitable to be applied in a real project. First part of the study consists of establishing two basic designs for grouting and rock support, that is based on a limited amount of information for a certain section of the project (case 1). The data available in case 1 is similar to a desk study. For the second part of the study the previous designs were updated and adjusted according to the additional information, from high quality investigations such as core drilling and water pressure test (case 2). The probabilities in the value of information analysis were evaluated using a statistical approach. The method was based on a monte carlo simulation where the dip of the plane was assumed to vary for the reinforcement design. For the grouting design the conductivity was assumed to vary.   Conclusions from this report proves that a statistical approach for the VOIA concept has great possibilities of being applied in projects as a tool before making decisions regarding preliminary investigations. The problem that often occur in projects today concerning different opinions about the amount of investigations needed, could be eliminated if a well constructed statistical model can be used that has the possibility of adjusting to the amount of available data. This would be beneficial from a socioeconomic perspective. However it's important that the user of this approach understand the purpose of every assumption and understands how to interpret the output data. Otherwise, decisions can be based on errors made by assumptions or bad input data.   Furthermore, recommendations is presented in this report regarding some areas that need to be developed before it is suitable to apply the method in a real project. One is to construct the VOIA concept based on fewer assumptions. Another is to connect the VOIA method to the geographical point of where the investigations have been made. There is also a possibility to include more parameters in the monte carlo simulation. Finally, to construct a more applicable tool in a project, a user friendly platform to conduct the analysis from is a great area to develop.

<p>Municipal wastewater treatment plants treat wastewater such as domestic and industrial sewage and recirculates the clean water back into nature’s waterways. However, the wastewater treatment process is costly and complex. The cost of running a municipal wastewater treatment plant is funded via ratepayer fee dollars from customers and therefore receives a fixed budget for which to run the plant according to environmental standards. A local initiative was established to upgrade a Midwestern municipal wastewater facility to utilize biomass renewable energy to a greater extent than what is used by the wastewater facility. The first phase of the initiative tested the suitability of utilizing organic substrates from local industrial plants with the potential to produce larger amounts of biogas via anaerobic digestion. The analysis evaluated the technical and financial viability of utilizing biomass technologies to help power the facility efficiently and economically. The financial and technical analysis will include a cost-benefit analysis by comparing current and forecasted natural gas demand and costs for running heating the WWTP to biogas produced by the anerobic digesters. The results of the research study found that the industrial waste substrates are suitable for anaerobic digestion and yield a higher biogas potential than what is currently used for anaerobic digestion by the WWTP. The initial financial analysis found it is feasible and economical, for at least certain months of the year, for the WWTP to refrain from purchasing natural gas and instead utilize the produced biogas.</p>

This dissertation addresses the problem of how to manage environmental resources to improve the prospects that resource allocation activities will make the greatest possible contribution to social well-being. The study had two major aims. One aim was to provide a rational philosophical framework for guiding resource evaluation and decisionmaking processes. The second - and principal - aim was to develop a reliable and practical method for evaluating those resource allocation proposals which are particularly controversial. As part of the philosophical framework, a modification of the social welfare function is specified which explicitly addresses the well-being of future generations. This form of the social welfare function is based on certain a priori premises, which are used to define the goal and objectives of resource allocation, and to identify appropriate evaluation criteria. These evaluation criteria are then used to devise a resource management strategy and to develop an environmental evaluation methodology to serve that strategy. The methodology consists of both formal and informal methods of evaluation, but special attention is given to developing a formal method of evaluation that is simple and inexpensive to apply, and therefore particularly suited for Third World conditions. The principal research objective was to develop a useful method for evaluating those resource allocation proposals which are especially controversial. The method that has been developed - the Panel Evaluation Method - utilizes a cost-benefit framework and employs procedures modeled on the Delphi Method. The Panel Evaluation Method features three techniques for accomplishing a formal evaluation of competing proposals: the Impact Identification Technique is used to identify and define all the impacts of concern; the Significance Measurement Technique is used to judge the relative significance of the impacts; and the Criteria Trade-off Technique is used to determine which proposal best satisfies specified evaluation criteria. The Panel Evaluation Method was applied to several case studies with positive results. For example, the central feature of the method - the Significance Measurement Technique - was found to be capable of producing reasonably replicable results, and so is considered to provide an acceptable way to determine whether the costs of a proposal would exceed its benefits. The method thus serves to extend the capabilities of both Environmental Impact Assessment and Cost-benefit Analysis, and to link these two widely-used tools for guiding resource allocation decisions into a more powerful and versatile decisionmaking tool.

Interactions between the transport market and other distorted markets, such as the labor market, can have a large impact on the overall welfare effect of a road pricing policy or a congestion charge. Many road pricing studies therefore try to incorporate effects from other distorted markets in the analysis. A difficulty when assessing the welfare effect of a future transport policy is also that many factors and parameters needed for the analysis is uncertain. This thesis contains three papers all studying different methodological approaches to analyzing the welfare effects of transport policies. The first two papers analyze the welfare effect of congestion pricing in distorted economies. The main contribution of the first paper is to analyze how the welfare effect of a congestion charge in a distorted economy depends on what assumptions we make regarding the tax system in the initial no-toll situation. A critical assumption in many cost-benefit analyses of congestion charges is that the whole population has a single value of time. The second paper studies the effect of a congestion charge in a population of commuters with a continuously distributed value of time. The main contribution of the paper, compared to previous literature, is that it studies the welfare effect and distributional impact of a congestion charge in a population with endogenous labor supply and heterogeneous value of time where mode-choice self-selection plays an important role. The third paper studies the climate benefit of an investment in high speed rail by calculating the magnitude of annual traffic emission reduction required to compensate for the annualized embedded emissions from the construction of the line. To account for uncertainties in underlying assumptions, a Monte Carlo simulation framework is used in the analysis. The paper finds that to be able to balance the annualized emissions from the construction, traffic volumes of more than 10 million annual one-way trips are usually required, and most of the traffic diverted from other transport modes must come from aviation. / QC 20110812