In an attempt to manage scarce health care resources and keep drug expenditure low, health care administrators worldwide have to make careful considerations regarding the choice of drugs to be provided to patients within their systems. One of the key strategies that is being employed to achieve this goal is the use of formularies. A major challenge in the formulary development process is to use pharmacoeconomics and outcomes research effectively to arrive at formularies that simultaneously provide patients with effective pharmacotherapy whilst maintaining financial stability. The extent to which this can be successfully achieved depends to a large extent on the availability of appropriate pharmacoeconomic data. The primary objectives of this study were to describe the availability and quality of literature pertaining to South African based pharmacoeconomic research, and to establish the manner in and extent to which pharmacoeconomic data is used in drug formulary decision-making processes, in both the private and public health care sectors in South Africa. A structured bibliographic search for South African pharmacoeconomic studies was conducted and a qualitative assessment of the identified studies which met the predetermined inclusion criteria was completed, using a pre-validated quality evaluation tool. In order to determine the use of pharmacoeconomic data in the formulary decisionmaking processes, by various stake holders in both the public and private of health care sectors in South Africa, a cross-sectional, descriptive study using a self-administered questionnaire was conducted. The results suggest that there is a limited availability of pharmacoeconomic research data in South Africa. Only 16 full pharmacoeconomic studies could be identified as having been published between 01 January 1995 and 30 June 2007. The quality of 3 of these studies was considered to be ‘dubious’, one study was found to be of high standard whilst the other 12 (74.95%) were of acceptable quality and thus could be considered as suitable to be used in formulary decision-making. The results of the national survey indicated that pharmacoeconomics is considered to be of importance and is used in formulary decision-making processes in both the public and private sectors. The primary source of pharmacoeconomic data used in formulary decisions appears to be international peer-reviewed publications. Of concern however, is the finding that this data, mostly from studies conducted outside of South Africa, is applied directly without sensitivity analysis or modelling. The results of the literature search and the subsequent quality appraisal suggest that pharmacoeconomic research and the use of pharmacoeconomic data in formulary decisions is at its infancy in South Africa. Thus efforts are needed to develop and grow the discipline of pharmacoeconomics in South Africa.

Bridge Information Modeling (BrIM), as a concept, has been introduced to enhance the procedures of the whole phases of a bridge life-cycle starting with concept and design, through construction and operation, and ending with maintenance and rehabilitation. Integrating BrIM and design tools will help improve the methods used in designing and constructing bridge projects at early stages taking into considerations their cost and time constraints. The main objective of this research is to develop an integrated model that helps owners, designers and construction managers visualize bridge projects in a 3D mode and accordingly automate the process of generating preliminary cost estimates during the conceptual design stage. To achieve the above mentioned objective, a proposed methodology will be applied where all the aspects needed to develop an efficiently integrated model are realized. Thus, this research describes the proposed methodology that incorporates three modules, which are the core of the integrated model. These modules are: a knowledge based system module, which is used to generate conceptual dimensions and parameters depending on algorithmic and heuristic knowledge gathered from codes, guidelines and design experts; a conceptual cost estimation module, which is used to generate conceptual cost estimate based on the results of the first module; and a 3DCAD module, which is integrated with the previous modules where users will visualize the proposed bridge in 3D based on the results of the knowledge based module. The successful development of the model would help owners and investors identify the cost and visualize the proposed projects at the early stages of the project life, so they have an idea of the budget required and the aesthetics of the proposed projects. The integrated model is validated through an actual case project to test its workability and output.

This dissertation consists of three separate essays, each dealing with a different aspect of the sunk cost phenomenon. The first essay proposes a multiattribute utility model of the sunk cost phenomenon. We argue that this phenomenon, the tendency toward over-investment in losing courses of action, is the result of tensions between economic and psychological factors such as cognitive dissonance. We formalize this tension by decomposing the investor's total utility into its economic and psychological components, and develop a two-attribute utility model which describes sunk cost behavior. We establish the interaction between the economic and psychological factors, which determines the form of the resulting model, both for decisions under certainty and under uncertainty. The model helps reconcile past explanations of sunk cost behavior, and also generates new predictions. We explore the behavioral ramifications of the model, and introduce formal concepts that are useful in characterizing the presence and intensity of a sunk cost effect. The model is then extended beyond the sunk cost problem, to more general allocation situations involving multiple projects or mental accounts. The second essay examines some of the strategic implications of the sunk cost phenomenon in sequential allocation decisions. Drawing from psychology and behavioral decision theory, we first present a typology of possible causes for this tendency. We then present a generic two-period allocation model of the phenomenon within a utility-maximization framework, and derive some comparative statics results - thus showing that the sunk cost phenomenon can be accommodated within formal micro-economic models. The model is used to formalize many of the possible causes of the phenomenon. We then move on to the analysis of some implications of this behavior in strategic situations. A strategic game analysis is used to derive the optimal allocations as a function of sunk cost behavior. We establish when this behavior can be used as a successful precommitment strategy by the sunk cost player, and when it is exploitable by an opponent. Numerous strategic applications of our game-theoretic approach are discussed. The third essay addresses key questions surrounding the financial implications of sunk cost behavior by using data on actual decisions made by firms, and the stock market reaction to these decisions. Specifically, using field evidence we test for the presence of a systematic sunk cost phenomenon in allocation decisions made by publicly traded firms, as recognized by the stock market and reflected in the prices of these firms' shares. We use a financial event study methodology to determine whether share prices reflect the stock market's belief that managers display a sunk cost effect, and use these results to infer the magnitude of the financial implications or "cost" of managers' sunk cost behavior to these firms. / Business, Sauder School of / Graduate

Control of groundwater plays an important part in operations at many open pit mines. Selection of an efficient and cost effective dewatering program that will improve slope stability of the pit walls is frequently complicated by the complex and somewhat uncertain hydrogeologic environment found at most mine sites. This dissertation describes a risk-cost-benefit (RCB) framework that can be used to identify the most effective dewatering strategy under such conditions, because the stochastic framework explicitly accounts for uncertainty in hydrogeologic and shear strength parameters in the groundwater flow, slope stability and economic analyses. In the framework, the monetary worth of each design alternative is measured in terms of an economic objective function. This function is defined in terms of a discounted stream of benefits, costs and risks over the operational life of the mine. Benefits consist of revenue generated from the sale of mineral concentrate. Costs include normal operating and dewatering expenses. Monetary risks are defined as the economic consequences associated with slope failure of the pit wall, multiplied by the probability of such a failure occurring. Selection of the best design strategy from a specified set of alternatives is achieved by determining the economic objective function for each design and then selecting the alternative that yields the highest value of the objective function. Estimation of the probability of slope failure requires an accurate assessment of the level of uncertainty associated with each input parameter, a forecast of how dewatering efforts are expected to affect pore pressures in the pit wall in light of the uncertain hydrogeologic environment, and an evaluation of the effect that the pore pressure reductions will have on improving stability of the pit wall. Prediction of the pore pressure response to dewatering efforts is achieved with SG-FLOW, a steady state, saturated-unsaturated finite element model of groundwater flow. Slope stability is evaluated with SG-SLOPE, a two dimensional, limit equilibrium stability model based on the versatile Sarma method of stability analysis. To account for input parameter uncertainty, both the groundwater flow stability models are invoked in a conditional Monte-Carlo simulation that is based on a geostatistical description of the level of uncertainty inherent in the available hydrogeological and geotechnical data. Besides documenting the methodology implemented in the framework to conduct the geostatistical groundwater flow and economic analyses of the objective function, this dissertation also presents a sensitivity analysis and a case history study that demonstrate the application of the RCB framework to design problems typically encountered in operating mines. The sensitivity study explores how each set of input parameters, including hydrologic data, shear strength parameters, slope angles of the pit wall and dewatering system specifications impact on the profitability of the mining operation. The study utilized a base case scenario that is based on overburden conditions at Highland Valley Copper; therefore, the conclusions cannot be applied blindly at other sites. However, the framework can be used to formulate site specific conclusions for other large base-metal open pit mines. After the objective function was calculated for the base case, the aforementioned input parameters were systematically perturbed in turn to study how each parameter impacts on profitability of the mine. The sensitivity study showed that in the particular case analyzed changes in the slope angle and dewatering efforts can improve profitability by many millions of dollars. In particular, steep slope angles can be utilized in the early stages of mine development while the pit walls are relatively low, and then flattened as the pit wall height increases and the monetary consequences of slope failure become more pronounced. Furthermore, the sensitivity results indicated that pit dewatering is likely to be effective over a range of hydraulic conductivities from lxlO"8 m/s to lxlO'5 m/s and that accurate estimation of the mean hydraulic conductivity is much more important than estimating other statistics that describe the hydraulic conductivity field, including the variance and the range of correlation. Results of the sensitivity study clearly demonstrate that the RCB framework can be used effectively to identify the most effective dewatering strategy given a limited amount of geologic and hydrologic information. Also, it is shown that the framework can be used to identify the most important input parameters for each specific dewatering problem and to establish the approximate monetary worth of data collection. The case history study documents how the RCB framework was applied at Highland Valley Copper (HVC). Groundwater control is recognized as an important component of mining operations at this mine site; dewatering measures utilized on the property involve both high capacity dewatering wells and horizontal drains. The benefits of pit dewatering include improved slope stability, drier operating conditions in the pit, and a convenient production water supply. These benefits do not come cheaply, HVC is expecting to spend in excess of six million dollars on groundwater control in the next ten years. Before investing such large sums in groundwater control, mine management should be confident that the capital investment is justified, i.e. that the resulting economic benefits will significantly exceed the costs of the dewatering effort. Using historical data provided by HVC, the case history study documented in this dissertation shows how the RCB framework is used to identify the most profitable combination of slope geometry and groundwater control in design sector R3 of HVC's Valley Pit. By considering three possible slope angle and groundwater control options it is shown that by continuing to implement an aggressive dewatering program, HVC can expect to reduce operating costs by as much as nine million dollars in this design sector. / Science, Faculty of / Earth, Ocean and Atmospheric Sciences, Department of / Graduate

The purpose of the master theses is to estimate gross direct financial cost brought about by support schemes for electricity generation in photovoltaic power plants in France, Italy and Belgium. In order to understand support schemes, I deal with legislation of each particular country and with its development. Based on development of subsidies for photovoltaics and production of electricity of new instalations I determine the final amount of costs. Individual outputs are subsequently compared with data regarding the Czech Republic, Spain, Germany, UK, Greece and Slovakia.

Incidence and prevalence of obesity is increasing worldwide. According to current trends, there is a high risk of pandemy of obesity in 21. century. WHO announced 1 bilion of obese people worldwide. In the majority of countries in Europe the prevalence of obesity is about 10-25%. Obesity has very negative impact on the public health, quality of life but also very high economic burden. The economic cost on obesity achieve 5% of teh whole healthcare cost in EU and 12% in the USA. Assumption of the direct and indirect cost was 32,8 bilion Euros in EU. It comes up to 0,3% of HDP. The aim of my analysis is to estimate direct cost on the healthcare in the direct connection with obesity in Czech Republic.

Class of 2008 Abstract / Objectives: This investigation was to assess the patient, hospital, or payer characteristics of inpatient cases of agranulocytosis from 1997 and 2005 with descriptive statistics. Methods: The retrospective database investigation used the U. S. Department of Health & Human Services, Agency for Healthcare Research and Quality, Healthcare Cost & Utilization Project public use database Nationwide Inpatient Sample (H-CUP NIS) for a principal diagnosis of agranulocytosis. Significance of difference between variables, including standard error (SE), was assessed with a z-test and an alpha level of 0.05. Results: alpha level of 0.05. RESULTS: The mean charges increased from 1997 at $19,670(SE $366) per patient vs. 2005 at $26,866 (SE $813) per patient (p<0.001) while inpatient mortality was not different in 1997 at 718(SE 72) vs. 2005 at 759(SE 69) (p=0.63) and the percentage of patients discharged to home declined from 84.32% [0.85%] in 1997 to 80.12% [1.29%] in 2005 (p=0.007). In 2005, inpatient mortality was lower in teaching hospitals at 1.13%( standard error 0.15%) vs. non teaching hospitals at 2.38%(SE 0.25%) (p<0.001) and for metropolitan areas hospitals at 1.42%(SE 0.14%) vs. non-metropolitan area hospitals at 3.60%(SE 0.68%) (p=0.002). Conclusions: Data from H-CUP NIS indicates higher costs per patient for the primary diagnosis of agranulocytosis in 2005 vs. 1997 while overall inpatient survival is not different and the percentage of patients discharged to home decreased. In 2005 rates of inpatient survival were higher in teaching hospitals than in non-teaching hospitals and hospitals in metropolitan areas than in non-metropolitan areas. These differences were not found in 1997.

This thesis investigates the revenue management (RM) problem encountered in an airport carpark of finite capacity, where the available parking spaces should be sold optimally in advance in order to maximise the revenues on a given day. Customer demand is stochastic, where random pre-booking times and stay lengths overlap with each other, a setting that generates strong inter-dependence among consecutive days and hence leads to a complex network optimisation problem. Several mathematical models are introduced to approximate the problem; a model based on a discrete-time formulation which is solved using Monte Carlo (MC) simulations and two single-resource models, the first based on a stochastic process and the other on a deterministic one, both developed in continuous-time that lead to a partial differential equation (PDE). The optimisation for the spaces is based on the expected displacement costs which are then used in a bid-price control mechanism to optimise the value of the carpark. Numerical tests are conducted to examine the methods’ performance under the network setting. Taking into account the methods’ efficiency, the computation times and the resulting expected revenues, the stochastic PDE approach is shown to be the preferable method. Since the pricing structure among operators varies, an adjusted model based on the stochastic PDE is derived in order to facilitate the solution applicable in all settings. Further, for large carparks facing high demand levels, an alternative second-order PDE model is proposed. Finally, an attempt to incorporate more information about the network structure and the inter-dependence between consecutive days leads to a weighted PDE scheme. Given a customer staying on day T, a weighting kernel is introduced to evaluate the conditional probability of stay on a neighbouring day. Then a weighted average is applied on the expected marginal values over all neighbouring days. The weighted PDE scheme shows significant improvement in revenue for small-size carparks. The use of the weighted PDE opens the possibility for new ways to approximate network RM problems and thus motivates further research in this direction.

M.Phil. / To achieve growth, most corporations invest a large portion of their turnover in new business ventures or in expanding current operations. These initiatives imply capital and thus a return is essential in order to ensure survival. Research indicates that capital projects seldom realize their full potential. The value that is released by a project is often unacceptably lower than the value that was initially forecast and for which the board granted approval. Furthermore, a number of projects achieved radical improvement within a relatively short period of time, when they embarked on an initiative focusing on improving the project. This indicates that, due to the relatively low cost and the rather large prize at stake, it is imperative to investigate and actively seek improvement potential. Value Engineering proves to be a methodology capable of unleashing these otherwise hidden opportunities. Three basic steps describe the value engineering process: analysis to understand the project; design to find the optimum or a better solution; and the implementation thereof. Before a team can embark on an improvement initiative an initiation study will determine the target, required focus of the exercise and set up an enabled team. This study also describes the integration of value engineering with the existing processes using a case study. In order for value engineering to work, skilled members are required, the initiative has to be timed and complement the existing processes.

Rotavirus diarrhea causes a disproportionate amount of the world's childhood mortality. Approximately 611,000 children die each year due to complications of rotavirus infections. In this study we evaluate rotavirus vaccination using four different methods. We look at the epidemiological history of the disease and vaccination against the disease, then we evaluate the effectiveness of vaccination first using a cost-benefit analysis, then using an ordinary differential equations based model, and last through computer simulations in Matlab. We do a traditional cost-benefit analysis as suggested by the Public Health Service of the United States to evaluate the costs and benefits of implementing a rotavirus vaccination program in Egypt with the RotaRix vaccine. Our results show that given the current standards of care in Egypt, it would be more cost-beneficial for Egypt not to use the rotavirus vaccine. We formulate a model of the spread of rotavirus diarrhea based on a continuous time ordinary differential equations model of two viral strains of influenza. We expand this influenza model to include the case of co-infection. We further expand the original model to explore the effects of vaccination. We used computer simulations to further analyze the effect of vaccination as a control method. These simulations show that the spread of the disease is highly sensitive to the levels of cross-immunity between the strains, and the level of vaccination in the population. We found that the dynamics observed in the new model are similar to the dynamics observed in the original model. We found the minimum levels of vaccination necessary in this model to eradicate severe rotavirus disease and minimum levels of cross-immunity between the strains