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Tuberculosis (TB) infects over 9 million people annually and is responsible for approximately 1.5 million deaths each year. Despite high treatment success rates, declines in incidence have averaged only 1.5% per year over the past decade. The newly adopted End TB Strategy sets a progressive agenda that moves beyond the medical sphere and includes a focus on upstream social determinants aimed at prevention. The strategy specifically calls for stronger poverty alleviation and social protection programs and policies. This dissertation sets out to support the need for social protection programs to combat TB, as well as attempting to answer the questions of who should be the recipients of such programs and in what form should they take.Paper one uses country-level data to show that spending on social protection is associated with decreased TB prevalence, incidence, and mortality. This work has a global purview and predicts a drop of 18 per 100,000 persons in TB prevalence rate from 1% increase in social protection spending. This is true even after adjusting for factors associated with TB rates such as level of economic development, the strength of the health system, and HIV burden.The second paper examines the relationship between household poverty and TB disease. Using household asset and characteristic data, this work creates household socioeconomic quintiles and attempts to show the relationship between this measure and individual active TB disease. The work utilized eight national TB prevalence surveys; large household surveys with a rigorous diagnostic TB algorithm. Although this approach found lower risk of TB disease for individuals in the poorest quintiles in four countries, a dose-response relationship was not observed. This paper also created an absolute wealth estimate, a US dollar-based measure of household wealth, which allowed for comparability across settings and also pooled country models. This measure of household socio-economic level did not have a clear association with individual TB risk. This work suggests novel ways of assessing the relationship between poverty and TB at the individual level that have the potential to be more efficient and to further the field of the social determinants of TB. The final paper of this dissertation focuses on a TB patient cost survey in Myanmar. This nationally representative survey includes 966 TB patients across the country and gathers information about their income and costs while seeking care. This survey is the first step in measuring the percentage of TB-affected households experiencing catastrophic costs due to the disease, defined as costs exceeding 20% of annual household income. This metric is one of the high level indicators in the End TB Strategy and will be measured by the World Health Organization and its partners in the majority of high burden countries in the coming years. The Myanmar survey found 65% of households experiencing catastrophic costs due to TB, with major cost drivers being patient’s time and additional food and/or nutritional supplements required because of the disease. Together these three papers support the need for social protection, alongside appropriate and timely medical care, in order to reach the ambitious targets set forth by the End TB Strategy.

Background: Type 2 diabetes represents an increasingly critical challenge for health policy worldwide. It absorbs massive resources from both patients and national economies to sustain direct costs of the treatment of type 2 diabetes and its complications and indirect costs related to work loss and wages. More recently, there are innovations based on remote control and personalised programs that promise a more cost-effective diabetes management while reducing diabetes-related complications. In such a context, this work attempts to update cost analysis reviews on type 2 diabetes, focusing on France and Germany, in order to explore most significant cost drivers and cost-saving opportunities through innovations in diabetes care. Although both countries approach care delivery differently, France and Germany represent the primary European markets for diabetes technologies. Methods: A systematic review of the literature listed in MEDLINE, Embase and EconLit has been carried out. It covered interventional, observational and modelling studies on expenditures for type 2 diabetes management in France or Germany published since 2012. Included articles were analysed for annual direct, associated and indirect costs of type 2 diabetes patients. An appraisal of study quality was performed. Results were summarised narratively. Results: From 1260 records, the final sample was composed of 24 papers selected according to predefined inclusion/exclusion criteria. Both France and Germany revealed a predominant focus on direct costs. Comparability was limited due to different study populations and cost categories used. Indirect costs were only available in Germany. According to prior literature, reported cost drivers are hospitalisation, prescriptions, higher HbA1c and BMI, treatment with insulin and complications, all indicators of disease severity. The diversity of available data and included costs limits the results and may explain the differences found. Conclusions: Complication prevention and glycaemic control are widely recognized as the most effective ways to control diabetes treatment costs. The value propositions of self-based supports, such as hybrid closed-loop metabolic systems, already implemented in type 1 diabetes management, are the key points for further debates and policymaking, which should involve the perspectives of caregivers, patients and payers.

Background: Measurement with mixed-mode administration (i.e., paper-mode versus web-mode) of patient-reported outcome (PRO) health surveys may vary by psychometric measurement equivalence (ME), differential response rates, costs, and data quality. Purpose: Three data-based papers evaluated ME, cost, and data quality when a mixed-mode approach for self-administration was used. Methods: Data were derived from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) study, a multi-institutional United States based longitudinal prostate cancer registry. ME study used a randomized cross-over design of 209 participants. Cost and data quality analyses used a cross-sectional time frame of 5,008 participants. The Short Form-36 (SF-36) and the UCLA-Prostate Cancer Index (UCLA-PCI) were examined. Results: ME study, participants were White (97%), college educated (66%), reported an annual income > $75,000 (46%), and a median age of 69 years. Intraclass correlation coefficients were high (ICC = 0.66-0.97). Exact percent agreement was high (> 0.89). For the cost and data quality analyses, 90% opted for paper-mode and 10% for web-mode. Total cost to process 5,008 surveys was $75,216 or on average $15.02 per survey with web-mode costs significantly higher ($18.47/survey) than paper-mode ($14.66/survey). Web-mode surveys had lower error rate (9% versus 14%, NS). Overall response rate was 77%, paper-mode 76% versus 88% web-mode (p

There exists enormous variation in estimates of the lifetime cost of obesity by race. In order to justify policy measures to reduce obesity rates nationally, we must first discern the cost of doing nothing, so this question remains imperative and unresolved. Although several researchers have sought to quantify obesity’s true cost stratified by race, none have produced a race-specific age-related weight gain curve, a vital component in producing an accurate estimate. This paper employs a Markov model of BMI category state changes separately for black and white males and females from ages 18 to 75 applied to updated estimates of obesity’s costs and effect on mortality to quantify the median lifetime cost of obesity at age 18. It finds lower lifetime costs than previously, due largely to the staggering gain in weight among normal weight individuals, particularly among black males, that occurs in early adulthood.

In a country that thrives on commercialism and image, the motion picture industryis an engine of social commentary, celebrity, and enormous cash flows. From thedevelopment of the first kinetoscope to our current star-studded event-movie culture,the industry has evolved and grown to become one of the largest and most influentialcultural forces in the world today. Substantial critical analysis and literature exist discussing aesthetic qualities infilm production. This paper does not follow that particular line of inquiry. Instead,we examine film as an industry focused on profitability, in which all decisions arebased on the ultimate bottom-line. More specifically, the purpose of this paper is torelate temporal cost decisions and profitability by reconciling the contrasting qualitiesof high upfront costs with a high degree of uncertainty of reward at the outset of afilm project. Since the genesis of the industry, the structure of film financing and thenature of revenue accrual have undergone profound change, wrought both by externalforces and competition from within. In this paper we try to provide an overview ofhow the industry actually operates, and an understanding of the seemingly irrationalways in which decisions are often made.This paper is organized as follows. It will first explain the political, legal, andeconomic forces that led to a shift in contract and cost structure in the featurefilm industry. It will then present an economic model explaining how, based oneconomic intuition, we should expect costs of feature film production to be structuredonce equilibrium is attained. Next, it will give an overview of the current body ofacademic literature on forecasting box office receipts, revenues, and other measuresof profitability in the film industry. It will then present an econometric model that attempts to provide empirical evidence for the conclusions of the earlier economicmodel. Next will be a discussion of the data compiled, econometric analysis of saiddata, and an interpretation of the results. Finally, possible extensions and furtherresearch will be presented, followed by a conclusion.

As marketplace competition drives industrial innovation to increase product value and decrease production costs, emerging technologies foster a new era through Industry 4.0. One aspect of the movement, additive manufacturing, or 3D [three-dimensional] printing, contains potential to revolutionize traditional manufacturing techniques and approach to design. However, uncertainties within the processes and high investment costs deter corporations from implementing and developing the technology. While several industries are benefitting from additive manufacturing’s current state, as the technology continues to progress, more companies will need to evaluate it for industrial viability and adoption. As such, there exists a need for a framework to evaluate the business case for investment review. While many papers in the literature provide cost estimation models for additively manufactured parts, there does not exist a thorough guide for decision making. This master’s thesis report introduces a process to evaluate machine investment and part production between additive manufacturing and traditional manufacturing technologies using operational and financial key performance indicators. A case study application of the process yielded suspect part unit costs 3.71% higher than its literature basis, indicating a viable methodology. The present value total investment cost for an EOSINT M 270 machine tool, with a five-year lifespan, was determined to be $3,241,710 in the case context; breakeven point occurs beyond investment life at 2.28 years. Results were dependent on product valuation and assumptions made. Key output metrics indicated the suspect machine could generate 5,238 units annually at a 1.4 part per hour throughput rate. As part production was deemed feasible under the provided constraints, sensitivity analysis indicated material and equipment costs as cost drivers. Similarly, production drivers were found to be scan rate and machine utilization. Results were consistent with common belief that additive manufacturing is currently viable for small-to-mid series production, or parts of high complexity value. These findings indicate areas of improvement for the additive manufacturing industry for commercialization purposes, and demonstrate a useful methodology for assessing the business case of additive manufacturing.

Digital signal processing designs are getting larger. At the same time modern applications are demanding smaller and smaller form factors. This project is a design with a specific problem. The design is a massive Multiple-Input-Multiple-Output FIR filter array. Currently the design is supported using multiple FPGAs. The problem is getting the entire FIR filter array to fit into a single FPGA. To reduce the size of the array, this paper looked at methods of reducing the size of FIR filters. Multiple approaches were reviewed: linear-phase filters, sparse filters, multichannel filters, multirate filters and filter banks. Each approach was implemented in VHDL for simulation and synthesis results. Based on the results, each approach can be analyzed for costs and tradeoffs. Based on the analysis, two of the approaches show the most promise for massive FIR filter arrays. Those two approaches are the multichannel and the filter bank approaches. These two approaches have their limitations. However within those limitations either approach can support large FIR filter arrays within a single FPGA.

To improve corporate governance and audit work procedures, the Sarbanes-Oxley Act of 2002 was quickly passed. The legislation not only strengthens the internal control within the public companies, but also exerts the pressure on public accounting firms. Under strict regulations, public companies will pay higher audit fees for audit firms so that to meet new act’s requirements, thus increase the companies’ operating costs. Though companies’ internal control will be improved a lot in post-SOX environment, many managers and experts think Act’s costs may exceed its benefits. In this paper, reasons of increase of costs and benefits will be analyzed through exploration of SOX provisions.

This dissertation consists of three theoretical and empirical essays. In all essays strategic behavior is a key factor. The first essay tries to explain certain pricing behaviors in cellular communication markets using social interactions as a basis for modeling. The second essay estimates the demand in the Turkish dishwasher market. It utilizes the complaint call rate for a firm as a new explanatory variable in the estimation process. The last essay examines the effects of market share restrictions on the cost reduction efforts of firms in a market. The first essay develops a model of competition in cellular network markets. People's choices are investigated in their social environments with differing utilities for different calls, which creates the distinctive part of this article. People get higher utilities from talking to people who are closer to them in the social environment. In the constructed market, different tariff types, per unit pricing and two part tariffs are examined for the existence of non-monopoly equilibria. In the well-known papers of the literature, different prices for in-line and between-line calls are justified with different cost structures for in-line and between-line calls. This essay is different from the literature because it is able to explain price discrimination with customer necessities and without cost differences. For per unit charging, assuming each firm has different costs which are larger than zero, the smaller cost firm gets a higher share with lower prices in the equilibrium. For two part tariffs with costs higher than zero and different from each other, a two firm equilibrium is reached in which the higher cost firm charges higher prices and a lower fixed fee, whereas the lower cost firm charges lower prices and a higher fixed fee. The second chapter is the empirical essay of this dissertation. In demand estimations, unobserved characteristics like perceived quality or after-sale service quality of products have created omitted variable bias. In the essay, the complaint call rate for a product is offered as a proxy to solve the endogeneity problem that arises from unobserved heterogeneity. Using demand and supply estimations of the Turkish dishwasher market, the complaint call rate is shown to be a valid proxy to solve the problem. Use of this proxy is possible under less restrictive assumptions than the popular instrumental variable method, which is also offered for the solution of the same problem. In addition, the model constructed in the essay has strong testable implications and is demonstrated to be consistent with a stable market of a leader firm and followers. Demand and supply elasticities of dishwashers are estimated for Turkey, which can help durable goods firms to use their investment and marketing resources more efficiently in emerging countries. The third essay studies the effects of market share restrictions on research and development effects of firms in a market. Market share of firms are closely followed by regulatory authorities and restrictions are applied in many cases around the world. This essay investigates if these restrictions affect the cost reduction efforts of the firms in a market. The theoretical model constructed shows that under the no exit assumption, market share restrictions lower the level of competition and possible rewards from R&D efforts, therefore causing smaller levels of R&D efforts both for big and small firms in the market.

The objective of the research presented in this paper is the development of cost curves for small-scale biodiesel production and a comparison of relevant technologies. The three technologies considered are the biodiesel pilot plant at the Iowa Energy Center's Biomass Energy Conversion Center, the commercially-sold Fuelmeister, and the bicycle-powered machine currently under development by students at Oberlin College. The price of biodiesel at which production via these technologies becomes profitable and the relative profitability of each will be determined through the use of a linear program. The importance of resource recovery and energy efficiency and the use of recycled feedstocks will be considered.

The increased costs of health care demand innovative responses to heath care delivery. One solution has been the introduction of non-physician caregivers, or physician extenders, to the hospital setting. Has the addition of this role merely fostered a “perception” of change in the quality of care, access to care and cost of care for the patient? Or is there a relationship between the physician extender role, patient length of stay and cost reduction in the cardiac surgery population? This paper will explore a possible correlation by examining outcome measures in three consecutive fiscal years (i.e., 1997, 1998, and 1999).