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CIVINS / A decision analysis study was conducted on the process of materials selection for high-speed naval craft using the Modified Digital Logic (MDL) method. The purpose is to show how this method along with Ashby's material selection process can be integrated to provide a comprehensive tool designed specifically for light-weight material optimization. Using Ashby's Material Selection Charts and the MDL method, a step by step material selection process is outlined. Furthermore, a comparison of the materials based on equivalent plate uni-axial ideal elastic compressive stress was completed using the American Bureau of Shipbuilding (ABS) Guide for Building and Classing High-Speed Naval Craft and then an evaluation was done to optimize material selection depending on the designer's preference for weight and cost, The potential materials for evaluation were selected using Naval Sea Systems Command (NAVSEA) references for the most current materials in use, or being evaluated, for light weight naval construction. The results demonstrate the feasibility of using the MDL method to select one or more materials based on desired mechanical and structural characteristics. The study also introduces the potential use of non-traditional materials in Naval Architecture, such as Ultra High-Performance Concrete Composite (UHP2C) DUCTAL. / Contract number: N62271-97-G-0026. / CIVINS

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M.B.A. / Please refer to full text to view abstract

Faculty of health Sciences, School of Pharmacy, Msc (Med)Research Thesis. / Objective: To assess the relative cost effectiveness of moxifloxacin once-daily empirical monotherapy and ofloxacin/ metronidazole twice daily combination therapy for the treatment of uncomplicated pelvic inflammatory disease in adult female patients. Design: This is a retrospective cost analysis using data from a clinical trial in order to perform the economic anlysis from a funder perspective. The cost analysis is based on the clinical results of the MAIDEN study which is a prospective, randomized, double-blind, multicentre, multinational Phase III study comparing the efficacy and safety of moxifloxacin 400 mg po od for 14 days with ofloxacin 400mg po bid plus metronidazole 400mg po bid for 14 days in patients with uncomplicated pelvic inflammatory disease. Decision analysis is used to characterise the economic outcomes between groups and provide a structure upon which to base the sensitivity analyses. Published 2004 cost values are used throughout. Cost values for moxifloxacin are based on the retail price of Avelon tablets in South Africa as appears on the Orderwise Retail Pharmacy Ordering System (September 2004). Cost values for the comparator, ofloxacin and metronidazole, are based on the cheapest available generics on the South African market i.e. Zanocin 400 and Metazol 400mg respectively. Method: The cost analysis is based on the clinical results obtained from the MAIDEN study. Patients were enrolled in either the moxifloxacin treatment group (Group A) or the ofloxacin / metronidazole comparator group (Group B). Resource utilization included: - cost for study antimicrobials (total number of doses for the study period) - treatment for adverse events occurring up to 7 days after stopping the study medication - treatment for failures (includes patients continued on antimicrobial therapy after the 14 day course of therapy) - cost of additional physician visits to treat adverse events and treatment failures The primary end-point is the overall cost of treatment per patient as determined by: Clinical response 7 to 14 days after the last dose of study medication (Test-of-Cure visit) Since the clinical findings from the MAIDEN study showed that moxifloxacin treatment was at least as efficacious as ofloxacin/metronidazole treatment, a cost-minimization analysis was performed and the results were analysed according to decision analysis. Decision analysis was used to characterise the economic outcomes between the groups and provided a structure upon which to base the sensitivity analyses. The outcomes were depicted on a decision tree which proportionately determined the cost of treatment per patient in the two treatment groups. Results: No significant differences in clinical success rates were detected. Differences were mainly due to the cost of treating adverse events in the two groups. Costs per patient in the monotherapy vs combination therapy comparisons were R10 847.00 for moxifloxacin and R16 630.00 for ofloxacin/metronidazole treatment. Sensitivity analyses revealed that moxifloxacin monotherapy can be cost effective compared with ofloxacin/metronidazole combination therapy in different situations. Conclusion: Per patient, the cost of drug treatment and treatment of adverse events and clinical relapses was R10 847.00 for treatment with moxifloxacin therapy and R16 630.00 for ofloxacin/metronidazole therapy . In comparison to ofloxacin/metronidazole combination therapy, moxifloxacin monotherapy was therefore cost saving.

BACKGROUND: Until recently budget allocation for public hospitals in the Gauteng Province were based on the historical values and not on the costed activities. It is therefore unknown how much of the allocated budget is used per discipline in an institution. Because of recurrent over expenditure by institutions, Gauteng Department of Health and Social Development have decided to change policy for budget allocation of funding public health facilities from historical allocation to activity based costing. Although good financial management of hospitals is a priority for the government, data on real costs of providing health care services is scarce and unreliable. No formal study has been done to estimate the cost to provide inpatient services in the Helen Joseph Hospital, a regional hospital in the Gauteng Province. In view of that, it was decided to initiate this study at the Orthopaedic unit of the Hospital, which would then be extended to the other units. AIM: To estimate the caseload, profile of patients and operational cost of providing the inpatient orthopaedics services at a regional hospital in Gauteng. METHODOLOGY: A cross-sectional study design was used based on retrospective review of patients’ and hospital records of patients admitted during one month study period at the two Orthopaedic Ward in the Helen Joseph Hospital, situated in the Johannesburg Health District in the Gauteng Province. RESULTS: Total number of patients admitted in the Orthopaedic Unit of the Hospital in the year 2009/2010 was 2160 (The mean number of inpatients per month was 180 ± 28). Profile of patients One hundred and ninety seven patients were admitted during one month study period. There were more male than female patients. The median age was 41 years (IQR 31-53 years). More black patients were admitted during this period, even though the main catchment population for the Hospital is predominantly white and coloured. The majority of patients were from a low socio-economic class as reflected by their classification for user fee payment using the means test. The median inpatient day was 3. The most common cause of admissions is due to injury, poisoning and certain other consequences of external causes as expected in an Orthopaedic Ward. A low complication rate (4.5%) was found to be the lowest as compared to other units in the Hospital. The majority of patients were discharged. Cost drivers The major cost driver was human resource which accounted for 70% of the total expenditure. Other cost drivers were material resources used in the unit, which includes: laboratory, blood and blood products, radiology and pharmaceuticals. Expenditure on these items account for only 13.7% of total expenditure. Cost driver Amount Unit cost Laboratory R61,215.57 R412.26 Blood and blood products R53,164.41 R269.87 Radiology R52,085.50 R264.39 Pharmaceuticals R17,315.82 R87.90 The total expenditure during this period was R 1,481,363.30 or R 17,776,359.60 annually. The unit cost of laboratory services (Ward 4: R926.30 and Ward 5: R272.97), blood and blood products (Ward 4: R463.05 and Ward 5: R217.52), radiology (Ward 4: R659.97 and Ward 5: R157.20) and pharmaceuticals (Ward 4: R236.63 and Ward 5: R47.60) and varied significantly between Ward 4 and Ward 5 which might be due to difference in clinical practices between the two Wards. CONCLUSION: This study showed the operational costs needed to provide an inpatient orthopaedic service at a regional health facility. Further study based on more detailed costing at individual patient level is necessary to develop a better understanding of costing at these Wards. This study highlighted the significance of understanding the importance of determining the actual costs needed to provide an inpatient service in a health facility. Simple cost analysis method could easily be done at Unit/ Ward level to provide more insight to Hospital managers who are always criticized for overexpenditure.

In the engineering domain, customers traditionally purchase a product by paying a one-off price to the supplier. Currently, customers are increasingly demanding engineering services in different disciplines, such as in the aerospace, defence, manufacturing and construction sectors. This means that the customer may buy a product, which includes an integrated service or purchase the usage of a product/service (i.e. availability and capability) rather than the ownership of a product. To meet this demand for engineering services rather than stand-alone products, many companies have moved from providing a tangible product to offering such services. In both academia and industry, the majority of the activities have focused on estimating the cost for products with little in the area of estimating the cost of providing engineering services. There appears to be a clear knowledge gap in the field of costing models and rules for providing such services. It is this gap in knowledge, which is the focus of the research presented in this thesis. This research is focused on estimating the cost for engineering services using parametrics and the bathtub failure model. This is illustrated through the application to a Chinese manufacturing and service provider. Eight years of cost-related data such as historical bills, service charges, maintenance records, and costs for storage has been collected. Observations, questionnaires and structured meetings have been conducted within the company. A methodology and a cost model for estimating the cost for engineering services are provided. The major contribution of this research is the creation of an approach, which is to estimate the cost of engineering services using parametrics and the bathtub failure model.