In 1996, Duke Children's Hospital was in serious trouble. Its $11 million annual operating loss had forced administrators to make cutbacks. As a result, some caregivers felt that the quality of care had deteriorated. Parents' complaints were on the rise. Frustrated staff members were quitting. In this article, Jon Meliones, DCH's chief medical director, candidly describes how his debt-ridden ho...

There appears to be a renewed emphasis in Washington on reducing the federal budget deficit. Although the US economy is improving, it appears that the only way to make real progress in reducing the deficit is to reduce government expenditures. The desire to reduce the deficit, coupled with the President’s agenda that includes several controversial and potentially costly items, has many in Washi...

The Dynamic Energy Budget (DEB) theory has become a fundamental tool in modeling the metabolic behaviour of organisms. Its capacity to describe the biological aspect of life alone justifies its applicability in Artificial Life. Aware of this potential, the DEB research group in Instituto Superior Técnico (IST) in Lisbon has joined the videogame company Biodroid Entertainment in the Life Engine ...

OBJECTIVES The aim of this study was to determine budget impact of conversion from cyclosporine (CsA) to sirolimus (SRL) in renal transplant therapy (RTT) from the perspective of insurance organizations in Iran. METHODS An Excel-based model was developed to determine cost of RTT, comparing current CsA based therapy to an mTOR inhibitor-based therapy regimen. Total cost included both cost of i...

monthly and annual water and phosphorus mass budgets were set up over the year 2010 for thelake rio verde, brazil. limited data for the water budget was compensated using an interpolation methodwith data water budget data of a nearby reservoir. thus, errors of ca. 1.5% were estimated for the waterbudgets. dominant p mass input terms were inflows from the rivers and direct run off into the reser...

Aiming to introduce 7-valent pneumococcal conjugate vaccine (PVC-7) into routine vaccination schedule, the government of Japan gives a temporary budget to encourage municipalities in launching public vaccination programme which started on November 26, 2010 and ends on March 31, 2012. This study aims to appraise the 'value for money' of PCV-7 vaccination programme from the societal perspective a...

Tri-axial accelerometry has proved to be a useful technique to study animal behavior with little direct observation, and also an effective way to measure energy expenditure, allowing a refreshing revisit to optimal foraging theory. This theory predicts that individuals should gain the most energy for the lowest cost in terms of time and energy when foraging, in order to maximize their fitness. ...

In this paper, the sustainability of public debt is interpreted as the result of the interaction of fiscal policy with the economic environment, and not as a statistical concept as in most of the recent literature. If debt must not explode over time, policy makers have to respond to the changing conditions in the macroeconomic environment. This paper defines the conditions which will ensure com...