Provider cost analysis supports results-based contracting out of maternal and newborn health services: an evidence-based policy perspective

Background There is dearth of evidence on provider cost of contracted out services particularly for Maternal and Newborn Health (MNH). The evidence base is weak for policy makers to estimate resources required for scaling up contracting. This paper ascertains provider unit costs and expenditure distribution at contracted out government primary health centers to inform the development of optimal resource envelopes for contracting out MNH services. Methods This is a case study of provider costs of MNH services at two government Rural Health Centers (RHCs) contracted out to a non-governmental organization in Pakistan. It reports on four selected Basic Emergency Obstetrical and Newborn Care (BEmONC) services provided in one RHC and six Comprehensive Emergency Obstetrical and Newborn Care (CEmONC) services in the other. Data were collected using staff interviews and record review to compile resource inputs and service volumes, and analyzed using the CORE Plus tool. Unit costs are based on actual costs of MNH services and are calculated for actual volumes in 2011 and for volumes projected to meet need with optimal resource inputs. Results The unit costs per service for actual 2011 volumes at the BEmONC RHC were antenatal care (ANC) visit USD$18.78, normal delivery US$ 84.61, newborn care US$16.86 and a postnatal care (PNC) visit US$ 13.86; and at the CEmONC RHC were ANC visit US$45.50, Normal Delivery US$ 148.43, assisted delivery US$167.43, C-section US$ 183.34, Newborn Care US$41.07, and PNC visit US$ 27.34. The unit costs for the projected volumes needed were lower due to optimal utilization of resources. The percentage distribution of expenditures at both RHCs was largest for salaries of technical staff, followed by salaries of administrative staff, and then operating costs, medicines, medical and diagnostic supplies. Conclusions The unit costs of MNH services at the two contracted out government rural facilities remain higher than is optimal, primarily due to underutilization. Provider cost analysis using standard treatment guideline (STG) based service costing frameworks should be applied across a number of health facilities to calculate the cost of services and guide development of evidence based resource envelopes and performance based contracting

Pathology of the Model of Wind Turbine Manufacturing Technology Transfer Iran

http://dx.doi.org/10.5902/2179460X19446Attention to Renewable energy resources, first, because of the increasing environmental pollution and climate change, and the second due to reduce supplies of fossil fuels, is one of the policy priorities in many countries, especially developed countries has become because of a broad range of environmental damage and international commitments, developing countries have been obliged to enter into this field. attention to the gap between developed and developing countries in the field of renewable energy technologies, technology's transfer the first and most effective way for developing countries in this field. Iran also is no exception and takes a step in this direction. given the obstacles and challenges that there are in developing countries for technology's transfer, this paper a review of a project comes in technology's transfer in the field of wind turbines. the main reasons for the success of the project are indentified and improved model is proposed for future project.Attention to Renewable energy resources, first, because of the increasing environmental pollution and climate change, and the second due to reduce supplies of fossil fuels, is one of the policy priorities in many countries, especially developed countries has become. because of a broad range of environmental damage and international commitments, developing countries have been obliged to enter into this field. attention to the gap between developed and developing countries in the field of renewable energy technologies, technology's transfer the first and most effective way for developing countries in this field. Iran also is no exception and takes a step in this direction. given the obstacles and challenges that there are in developing countries for technology's transfer, this paper a review of a project comes in technology's transfer in the field of wind turbines. the main reasons for the success of the project are indentified and improved model is proposed for future project

Triangular Cubic Hesitant Fuzzy Einstein Hybrid Weighted Averaging Operator and Its Application to Decision Making

In this paper, triangular cubic hesitant fuzzy Einstein weighted averaging (TCHFEWA) operator, triangular cubic hesitant fuzzy Einstein ordered weighted averaging (TCHFEOWA) operator and triangular cubic hesitant fuzzy Einstein hybrid weighted averaging (TCHFEHWA) operator are proposed. An approach to multiple attribute group decision making with linguistic information is developed based on the TCHFEWA and the TCHFEHWA operators. Furthermore, we establish various properties of these operators and derive the relationship between the proposed operators and the existing aggregation operators. Finally, a numerical example is provided to demonstrate the application of the established approach

An interaction between congestion-control based transport protocols and MANET routing protocols

Problem statement: Although many efforts have been done on studying the behaviour of TCP in MANET, but the behaviour of TFRC remain unclear in MANET. The purpose of this research is two folds.First, we studied the behaviour of TFRC and TCP over AODV and DSR as the underlying routing protocols in terms of throughput, delay and jitter.The second objective was to identify whether MANET routing protocols have an impact on transport protocols or not.Approach: Network Simulator 2 (NS-2) was used to conduct all of the experiments, i.e., TFRC over AODV, TFRC over DSR, TCP over AODV and TCP over DSR.We created 30 nodes on a 1000×1000 m location area and each node was assigned CBR traffic, transport protocol and routing protocol.In order to simulate the nodes mobility, we implemented a Random Waypoint mobility model with varying speeds of 5, 10, 15 and 20 m sec−1 (m/sec) with a 10 sec pause time.Results: We observed that TFRC throughput increases almost 55% when using DSR as its routing protocol, but TCP throughput has no significant difference with different underlying protocols.However, in terms of jitter and delay, both routing protocols, i.e., AODV and DSR have the impact of more than 50% on TFRC and TCP. Conclusion/Recommendations: The results obtained also show us that TFRC or TCP should choose AODV as its routing protocol because it has less jitter which is one of the critical performance metrics for multimedia applications

Stock assessment of the Caspian Sea bony fishes

The project was carried out in the southern coastal areas of the Caspian Sea measuring length, weight and age of more than 30,000 fishes together with recording of relevant fishing information. Also age-weight, length-weight and age-length relationships was calculated for the separate species and total and natural mortality rates was determined. Furthermore biomass assays. Cohort analysis, and stock assessment of different fish species was conducted and maximum sustainable yield determined. The results showed that nearly 90% of the catch is composed of Rutilus frisii kutum, Mugil saliens and Mugil auratus. Total biomass of the mentioned fishes was estimated to be. 24000, 7000 and 2400 tones with the, maximum sustainable yield being 7000, 2900 and 960 ton respectively

NiO/CNTs Nanocomposite Modified Ionic Liquid Carbon Paste Electrode as a Voltammetric Sensor for Determination of Quercetin

A high sensitive carbon paste electrode modified with NiO/CNTs and ionic liquid (ILs/NiO/CNT/CPE) was describe for voltammetric determination of quercetin. Compared to unmodified carbon paste electrode, the electrochemical response was greatly improved for quercetin electrooxidation. Result shows, the oxidation peak current was increased to about 6.5 times at the surface of ILs/NiO/CNT/CPE compared to CPE. The linear response range and detection limit were found to be 0.08–400 µM and 0.03 µM, respectively. ILs/NiO/CNT/CPE was successfully applied for the determination of quercetin in real samples such as onions, apple and capsule. The results showed that the proposed method is highly selective, sensitive with a fast response for quercetin analysis

Server-based open system implementation for ICOSYS (ICOSYS2)

Information and communication services are developed to enhance the utilization of the ICT infrastructure.These services can be implemented either using proprietary or open source software platforms.This work focuses on the implementation of the open source services at the Faculty of Information Technology (FTM), Universiti Utara Malaysia. The study is part of the ICOSYS research intitiative.The underlying vision of ICOSYS2 is to create a conducive and efficient working environment using open source technologies.ICOSYS2 consists of four basic services that comprises file storage, application, printing and backup services.Firstly, ICOSYS2 files and storage services provide users with the ability of centrally storing and sharing data.Secondly, the ICOSYS2 application services provide access to the world of Linux-based open source applications.Thirdly, ICOSYS2 printing services allow users to send their print jobs to respective printers across the FTM network and pave the way for centralized printing administration.Finally, the ICOSYS2 backup services outlines a tertiary mean to backup the users' data.It is hoped the implementation of this ICOSYS2 project can facilitate academic and administrative tasks at FTM

Length-weight relationship, condition factor and relative condition factor of Alosa braschnikowi and A. caspia in the southeast of the Caspian Sea (Goharbaran)

The main objectives of the present study were to determine the species composition of Caspian shad, genus Alosa and to estimate the LWR, CF, and Kn of A. braschnikowi and A. caspia during different months in the southeastern coast of the Caspian Sea. Two fishing methods, small mesh size beach seine and gillnet were used from December 2013 through July 2014. A. braschnikowi and A. caspia, were distinguished in the southeastern part of the Caspian Sea (Goharbaran), consisting of 57.1% and 42.9% of the Alosa catch, respectively. The slopes (b values) of the length-weight regression were 3.241 and 2.844 which were significantly different from 3 (P<0.05), indicating positive and negative allometric growth, respectively. The average CF of A. braschnikowi and A. caspia were calculated as 0.72 ± 0.12 and 0.83 ± 0.13, respectively. The average CF for both species were significantly different among months (P<0.001). There was a significantly negative correlation between size classes and CF of A. caspia. The Kn was greater than 1 for A. braschnikowi and lower than 1 for A. caspia indicating good well-being of A. braschnikowi as opposed to A. caspia in the southeastern Caspian Sea

Five years of a single burn center experience with toxic epidermal necrolysis: retrospective study of causative drugs and the clinical outcome

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, but potentially life-threatening reactions to medications. Both conditions have significant morbidity and mortality. This study aimed to document the epidemiological features, aetiologies, treatment and clinical outcomes of such patients.Method: In this retrospective cross-sectional study the records of all patients with TEN treated for5 years in central Hospital, Mashhad, Iran were reviewed. Results: Thirty-four patients were studied with a mean age of 26.5 years. Mean age in the mortality and survivors groups was 33.6 and 25.3 years, respectively. Drugs accounted for all 34 cases were including Anti-convulsants (52.9%) other the most common implicated drug followed by antibiotics (26.5%), allopurinol (5.9%) and multiple drugs (anticonvulsants plus antibiotics) (14.7%). Antibiotics had the shortest interval between ingestion time and onset of symptoms. The mean ICU length of stay was 12.7 days, with a range of 1 to 30 days. The mean of SCORTEN was 2.3; it was 3.3 and 2.1 in the mortality and survivors group, respectively (P=0.001).All 34 TEN cases were given intravenous immunoglobulins (IVIG). Six patients with TEN died (17.6%). The highest mortality was found in the allopurinol group with 50%, whereas anticonvulsants and antibiotics had a mortality rate of 16.6% and 15.3%, respectively.Conclusion: Anti-convulsants especially Lamotrigine were the most frequently implicated drug, followed by antibiotics and allopurinol. IVIG was shown beneficial effects in TEN syndrome