A centrifugação é o principal método utilizado para fracionar o Sangue Total (ST) nos componentes sanguíneos: Concentrados de Hemácias (CH), Concentrados Plaquetas (CP), Plasma e Crioprecipitado, (também chamados de Hemocomponentes). Com intuito de prevenir ou controlar hemorragias, os CP obtidos por centrifugação tornaram-se o padrão no atendimento inicial aos pacientes com baixas contagens de plaquetas. Porém, para obter uma unidade terapêutica (UT), no Hemocentro RP, é necessário agregar seis CP, formando o Pool de CPST (PCP), o que leva a exposição do receptor a vários doadores diferentes. O CP obtido por aférese (CPAF), advindo de equipamento que permite a seleção já na coleta, fornece a dose necessária em apenas uma doação. Baseado no levantamento de dados internos do Hemocentro de RP o presente estudo analisou, através da metodologia de Custeio Baseado em Atividade (ABC), os custos atribuídos às distintas metodologias para a produção dos CP, sabendo que no Hemocentro RP, os CP são dispensados como UT independente da forma de obtenção. Os resultados obtidos foram utilizados na Análise de Custo-Efetividade, evidenciando que a coleta por Centrifugação de ST com a produção de PCP foi mais custo efetiva em 2015 do que a coleta de aférese, porém, por uma diferença relativamente pequena, devido ao grande percentual de obtenção de dupla Unidade Terapêutica (CPAF2). / Centrifugation is the main method used for fractionating Total Blood (TB) to blood components: Red Cells Concentrate (CR), Platelet Concentrates (PC), Plasma and Cryoprecipitate (also called Hemocomponents). In order to prevent or control bleeding, CPs obtained by centrifugation became the standard treatment of patients with low platelet counts. However, to obtain a therapeutic unit (TU), at Hemocentro RP, it is necessary to get together six PCs, forming a Pool of TBPC (PCP), exposing the receptor to several different donors. PC obtained by apheresis (CPAF), which is provided by a equipment that allows selective collection, achieve the dose necessary for the selection in just one donation. Based on the collection of internal data from the Hemocentro RP, the present study analyzed, through the methodology of ActivityBased Costing (ABC), the costs attributed to the different methodologies for the production of PCs knowing that in the Hemocenter RP PCs are dispensed as TU independent of the way of obtaining. The results obtained were used in the CostEffectiveness Analysis, showing collecting by TB Centrifugation producing PC is more cost-effective, however CPAF was almost as effective as in 2015, a great achievement of Dual Therapeutic Unit in a single donation (CPAF2).

Abstract Fertility declines with advancing age and the number of couples seeking infertility treatment at an older age is constantly increasing. A top quality embryo is believed to have the highest potential for implantation and development into a child. A better understanding of the relative importance of patient and treatment characteristics and of embryo quality could help to optimise the existing therapeutic schemes and the safety of in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI). In this work, databases of five Finnish infertility clinics were studied retrospectively. Data on treatments performed in the years 1994–2005 were collected. A total of 19,000 treatment cycles were analysed. Special attention was paid to the relative significance of the transfer of top quality embryos with regards to pregnancy, miscarriage, live birth and cost of treatment in the general IVF/ICSI patient population and in groups with expected poor outcome. The results showed that the transfer of a top quality embryo is associated with a better chance of pregnancy and live birth. However, it does not diminish the probability of miscarriage. Both low and high BMI increase the miscarriage rate. Advancing age and a positive history of previous miscarriages are also associated with a higher probability of miscarriage. In addition, the need for hormonal substitution in cases of frozen-embryo transfer is a risk factor of miscarriage, probably because of suboptimal endometrial function. Since the transfer of several embryos leads to multiple pregnancies, which are associated with a high risk of maternal and fetal complications, elective single embryo transfer (eSET) of a top quality embryo allows all additional good quality embryos to be frozen and transferred later in frozen-thawed embryo transfer cycles. The present work demonstrates that eSET is a safe treatment strategy at least until the age of 40. However, it might not be performed in women with fewer than four collected oocytes, since the prognosis might remain poor even if the response is improved in a following cycle. When eSET is applied routinely and on a large scale, it diminishes treatment costs while increasing the number of deliveries occurring at term, making IVF/ICSI at the same time safer and more affordable even to patients without access to reimbursed IVF treatment.

From introduction: In this thesis some of the economic theory underlying the application of cost-benefit analysis to education is considered with the view to discussing its relevance to the field of educational provision for Black people in South Africa. The fact that educational facilities available to Blacks are so vastly inferior to those of the Whites has given rise to virtual consensus that more has to be provided for the Black population. The economic implications of education are frequently cited to support this viewpoint. Using (a ) the theoretical bases established in chapters 1 and 2, (b) the review of the rate of return to education studies in chapter 3 and (c) the broader socio-economic considerations introduced in chapter 4, it is concluded that this viewpoint is not necessarily well founded in South Africa and that the potential for greater use of the techniques described, is far from exhausted.

E-tolling was recently implemented on roads in Gauteng, South Africa. This gave rise to a great deal of protest by road users and a court battle between the South African National Roads Agency (SANRAL) and the Opposition to Urban Tolling Alliance, a body representing road users. The e-tolling system was criticised at various levels and on numerous grounds, some financial and others appearing to be emotional. This thesis attempted to analyse the various grounds for objection against the system, the main goal of the research being to analyse e-tolling in Gauteng to ascertain whether or not the introduction of e-tolling was justified or whether an alternative method of taxation to pay for the upgrading of Gauteng roads would have been more cost-effective. Secondary data in the form of documents from multiple sources was used in the analysis, including an Economic Impact Assessment that was one of the key inputs into the decision to introduce e-tolling. It was found that there are multiple problems plaguing the e-toll system and e-tolling is not the most cost-effective taxation method of paying for Gauteng roads. Using a fuel levy or general tax revenue available to the National Treasury were both found to be more cost-effective methods as they would have achieved the same result (repairing and upgrading specific Gauteng roads), at a cost of R20,0913 billion less than e-tolling. It was suggested that the best taxation method/s to pay for the roads would have been using a fuel levy and general tax revenue as the primary funding methods, with vehicle licensing fees and long distance toll roads as secondary methods to aid the primary methods.

In today’s dynamic technological landscape, wireless communication networks have become an important part of economic development. The emergence of wireless technologies raises hopes to extend communication to remote areas that have not seen any tangible deployment to date. As developing nations pin their hopes to wireless technologies, cost models for wireless communication networks are becoming vital to support the emerging technologies. However, varying cost changes raise critical challenges to the estimation of both capital expenditure and operational expenditure. The network deployment process has numerous events that may cause adjustments to initially estimated project costs. These adjustments are necessary for a cost management plan and this plan includes monitoring cost performance and ensuring that only appropriate changes are made to the network project. The incidents that may cause cost changes can not be entirely predicted as their distribution tend to change dynamically from time to time. Estimating network deployment costs in such a dynamic environment necessitates cost models that can adapt to random occurrence of cost changes. Widely used cost models are usually performed by experienced personnel whose engineering experience is derived from deploying similar networks. In this approach experienced personnel add a certain percentage to the cost estimate to cater for contingency costs. Certainly such an approach depends on individual opinion, making it subjective and void of mathematical estimating relationships which are of paramount importance in ensuring that estimated deployment costs are sufficient to deal with cost uncertainties. We observe that existing approaches can only explore a limited solution space and hence can lead to cost overruns if implemented in dynamically cost changing environments. This thesis presents a wireless communication network deployment cost model that incorporates uncertainties into the final cost estimate. The model is adaptive to unpredictable cost changes since it allows adjustments of confidence levels when calculating contingency costs. This allows dynamically updating the cost changes without the cost model being reconstructed from scratch. We make use of the Poisson process in modeling the occurrence of incidents that are responsible for causing cost changes during network deployment. We also show that the occurrence of the incidents causing cost change are random and tend to follow the Poisson distribution. Using different levels of confidence we model various cost contingencies and make sensitivity analyses to identify the probability of cost overrun when given different contingencies. The dynamic adaptive cost model can be used either at the strategic level to understand the cost of a particular technique or at the operational level, as a way to show how Poisson process in network deployment can compare with engineering experience and other estimating techniques. We believe that the model is useful for remote areas where deployment costs are volatile and the distribution of incidents causing cost change to original cost estimates are diverse and dynamically changing. Further we expect that our research improves the knowledge base of information about the costs for rural communities to connect to the Internet, consequently providing useful input to future policy debates. This work is further poised to be a utility function to help those planning internet infrastructure deployments in least developed regions.

This thesis presents two applications of the incompleteness and one application of the imperfection of the market economy. The first application, Chapter 2, studies the decision making problem of an individual seeking to accumulate an optimal amount of human capital realizing that the wage income derived from the accumulated human capital is subject to incompletely insured uncertainty. In other words, the financial market that insures against wage income risk is not fully functional. We find that the individual's inability to diversify wage income risk tends to increase the need to accumulate more human capital in order to elevate wage path and compensate for the burden of its associated risk. This is particularly true when (i) the wage income risk is positively correlated with the rate-of-return risk in the financial market, resulting in an even greater risk burden to the individual, and (ii) the individual is more risk averse. There are two possibilities that no human capital is needed. The first possibility occurs when it is optimal to work as an unskilled worker because both the burden from wage income risk and the rate of return from education are low. The second possibility is the case where the risk burden is so high that the optimal time spent in school to acquire sufficient human capital to cover the risk is so long that the discounted rate of return from education is negative. In this case, the best strategy is to invest in financial assets alone and forfeit the opportunity to earn wage income - either as an educated or as an unskilled worker - to avoid its associated risk. Chapter 3 applies equilibrium unemployment theory with a frictional labor market to study the impact of immigration on the local labor market. Markets are imperfect in the sense that job matching takes time and recruitment is costly. We find that labor market outcomes of both the natives and existing immigrants depend crucially on how the economic surplus from successful matching is divided between the firms and the workers or, in other words, on the bargaining power of the workers. An arrival of immigrants with low bargaining power tends to benefit both the natives and the existing immigrants. A disparity between the two worker types in the matching efficiency also plays a major role. An inferior matching technology among the immigrants, interpreted here as reflecting their less established social network, lowers their wage rate and increases their unemployment rate. The natives are more likely to benefit from additional immigration than the existing immigrants and, when they do, the overall benefit can be decomposed into "job creation spillover" effect resulting from the immigrants' low bargaining power, and "job stealing" effect resulting from the immigrants' less efficient matching. The implications on the pattern of international migration flows are also discussed. In Chapter 4, a simple macroeconomic model is constructed and applied quantitatively to OECD countries, to analyze the effect of incomplete insurance on saving, growth and welfare in a closed economy. In this economy, precautionary saving motivated by uninsured idiosyncratic shocks raises growth rates but lowers risk-free returns. Welfare is measured by the sum of growth rates and risk-free rates of return, not growth rates alone. This welfare measure takes the negative impact of precautionary saving into consideration. Applied to the OECD data, three major results emerge: (i) the heterogeneous performance of growth and saving across the countries reflects different degrees of insurance incompleteness, (ii) since the externality of growth on productivity was very strong in the 1960's, the heavily constrained insurance market itself improves productivity by promoting growth, thereby enhancing welfare, (iii) while the externality of growth became weaker in the 1980's, the development of insurance markets lowered growth, but still contributed to a raise in welfare. / Arts, Faculty of / Vancouver School of Economics / Graduate

M.Cur. / A staffing programme does not exist in a private hospital that compiles with the criteria cost effectiveness and quality nursing care. For this reason a study was undertaken to develop a staffing programme that would facilitate cost-effectiveness as well as quality nursing care. The nursing managers' role is not only to maintain cost-effectiveness but also to facilitate wholeness in patients and nursing staff. To achieve wholeness an exploratory. descriptive instrumental study was conducted and the Nursing Theory of Wholeness was used as a foundation for this study. Various research techniques were used such as scheduled observation, a structured questionnaire, nursing audit and a semi structured interviewing technique to quantify results. An analysis was conducted retrospectively to verify the statistical significance of a cost effective staffing programme. A staffing programme was designed consisting of seven steps to provide a basis for validity and reliability of the programme. The staffing programme proved to be cost-effective and proved to be statistically significant and shows a significant difference on a I% significance level (p = <0,003). The most important conclusion made is that valid, reliable staffing programme was designed for a nursing service in the private hospital. The staffing programme proved to be easily comprehended, useful, and relevant to its purpose. Cost-effectiveness was proved. A patient questionnaire was implemented to test the construct quality nursing. Partial validity of the construct quality nursing was confirmed.

Mesmo com o crescimento da dependência da vida humana em relação aos serviços ecossistêmicos, a taxa de perda de diversidade genética no planeta tem alcançado níveis semelhantes à de grandes eventos de extinção, evidenciando a necessidade de ações para a conservação dos recursos naturais. Em adição aos tradicionais instrumentos de comando e controle para a conservação, os instrumentos econômicos têm tido crescente atenção no mundo nos últimos anos, com especial destaque para os Pagamentos por Serviços Ambientais (PSA). A abordagem de pagamentos de incentivos tem crescido na última década e, apesar das potencialidades que o PSA apresenta, muitos programas falham em incorporar o conhecimento científico em sua execução, sendo esse um dos aspectos que podem acarretar baixo desempenho ambiental e econômico. Neste contexto, o presente projeto buscou avaliar a custo-eficácia do PSA em paisagens fragmentadas. A área de estudo é o estado de São Paulo, cuja fragmentação historicamente ocorre pela expansão agropecuária e pelos diversos impactos decorrentes do grande crescimento populacional em seu território. Foram distribuídos questionários para a obtenção das preferências dos proprietários rurais paulistas em relação aos programas de PSA para restauração de vegetação nativa. Os dados coletados foram relacionados a características socioeconômicas e ambientais e um modelo beta inflacionado de zero misto dentro da classe GAMLSS foi utilizado. Em seguida, o modelo foi utilizado para predizer os resultados para os proprietários não entrevistados e a curva de investimento para diferentes retornos para conservação foi construída. Os resultados apontaram que o PSA é uma alternativa muito custosa frente aos orçamentos ambientais paulistas e que traz poucos benefícios para a restauração no estado de São Paulo. A pesquisa possui uma vertente teórica, pois contribui para a compreensão da adequabilidade do PSA em paisagens fragmentadas, e uma vertente prática, pois explicita a quantidade de recursos necessária para a execução dos programas analisados. / Although the dependence of human activities on ecosystem services has risen in the past decades, the current rate of genetic diversity loss has substantially declined and reached alarming levels. In addition to the traditional command and control approach for the promotion of conservation, growing attention has been given to economic instruments, especially to Payments for Environmental Services (PES). Despite all potentialities of the PES instrument, many programs fail to introduce scientic knowledge in the execution. Such a lack of foundation may result in low environmental and economic performance. The present research aims at evaluating the cost-effectiveness of PES in fragmented landscapes. The study area is the state of São Paulo, which has been fragmented by the agricultural and pasture expansion, and the impacts linked to the large population growth. A survey with dierent PES programs was sent to rural landowners and responses were analyzed and linked to socioeconomic and environmental characteristics through a zero-inflated beta mixed model, within the GAMLSS framework. The model was used to predict enrollment of non-respondents in different PES programs. Finally, the relationship between total area for restoration and the amount of resources needed for each program was compared to the environmental budget of the state of São Paulo. Results show that PES is a very costly alternative that can provide only few results for restoration. The present work has a theoretical orientation, as it contributes to the comprehension of the feasibility of PES programs in fragmented landscapes, and a practical orientation, as it quantifies the amount of resources required by the programs analyzed.

El presente trabajo de investigación muestra la viabilidad financiera del proyecto inmobiliario propuesto por la empresa Qualis SAC en el estudio que concluye en mayo 2021, frente a la receción económica que ocasiona el fenómeno del niño. La viabilidad del proyecto no es sólo financiera, sino también se percibe por el sostenido desarrollo del sector inmobiliario en el Perú y por el apoyo de parte del Estado, que a través de programas sociales como Techo Propio y Mi Vivienda hace accesible el crédito al consumidor. El proyecto también tiene un enfoque social considerando a la población de Chaclacayo, la cual eventualmente es afectada por los estragos antes mencionados. El desarrollo del proyecto propone el uso del Recurso Humano de la zona, la creación de obras publicas, viviendas de calidad con servicios básicos y accesibles. El estudio de mercado realizado, muestra que los clientes tienen conocimientos básicos en programas sociales para la obtención de una vivienda, sin embargo, representan una demanda insatisfecha, la cual busca adquirir una casa propia ya construida a un precio accesible. El análisis de rentabilidad es favorable, obteniendo como resultados un VAN de S/8,208,420, una TIR 22.88% la cual es mayor a un WACC de 8.60% que incluye un nivel de riesgo país afectado por la pandemia del covid-19 (se excluye el riesgo político en el análisis). En conclusión, recomendamos la elaboración del proyecto financiero debido a que genera beneficios para los accionistas y cuenta con enfoque social. / The following research work seeks to demonstrate the financial viability of the real-estate project proposed by the company Qualis SAC in the study concluding May 2021, facing the economic recession created by the climate phenomenon known as El Niño. The viability of this project is not only financial in nature but also focuses on supporting the ongoing development of real-estate in Peru and with the help of the government, which through social equity initiatives such as Techo Propio and Mi Vivienda have made real-estate and loans accesible for consumers. The project also has a social impact lens focusing specifically on the community of Chaclacayo, which is directly affected by the natural phenomenon and social inequities previously mentioned. The developmental aspect of the project proposes the use of Human Resources in the area, the creation of more public works, and quality homes with basic necessities and accessibilities for the community. Market study research shows that consumers have basic knowledge of social programs for the purpose of homeownership, however, they represent a sector whose needs have not been met, which seeks to purchase finished homes at a price that is accessible. The profitability analysis is favorable, achieving, as a result, an NPV of S/8,208,420, and an IRR of 22.88%, which is higher than a WACC of 8.60% that includes the level of risk of a country affected by the COVID-19 pandemic (political risk excluded from analysis). In conclusion, we recommend the green light of the financial project due to the benefit it generates for the investors, and the social impact it generates for the community. / Trabajo de investigación

The diploma thesis focuses on the process of analysis of the current state of logistics of the purchasing process at Tourbus, a.s. Its main target is set to identificate the areas in the purchasing processes of the company, which can be rationalized and streamlined. The goal of this thesis is the improvement of the current state of logistics, in order for the company to be able to maintain its competitiveness in the market.