The Economics of NASA Mission Cost Reserves

Increases in NASA mission costs are well-noted but not well-understood, and there is little evidence that they are decreasing in frequency or amount over time. The need to control spending has led to analysis of the causes and magnitude of historical mission overruns, and many program control efforts are being implemented to attempt to prevent or mitigate the problem (NPR 7120). However, cost overruns have not abated, and while some direct causes of increased spending may be obvious (requirements creep, launch delays, directed changes, etc.), the underlying impetus to spend past the original budget may be more subtle. Gaining better insight into the causes of cost overruns will help NASA and its contracting organizations to avoid .them. This paper hypothesizes that one cause of NASA mission cost overruns is that the availability of reserves gives project team members an incentive to make decisions and behave in ways that increase costs. We theorize that the presence of reserves is a contributing factor to cost overruns because it causes organizations to use their funds less efficiently or to control spending less effectively. We draw a comparison to the insurance industry concept of moral hazard, the phenomenon that the presence of insurance causes insureds to have more frequent and higher insurance losses, and we attempt to apply actuarial techniques to quantifY the increase in the expected cost of a mission due to the availability of reserves. We create a theoretical model of reserve spending motivation by defining a variable ReserveSpending as a function of total reserves. This function has a positive slope; for every dollar of reserves available, there is a positive probability of spending it. Finally, the function should be concave down; the probability of spending each incremental dollar of reserves decreases progressively. We test the model against available NASA CADRe data by examining missions with reserve dollars initially available and testing whether they are more likely to spend those dollars, and whether larger levels of reserves lead to higher cost overruns. Finally, we address the question of how to prevent reserves from increasing mission spending without increasing cost risk to projects budgeted without any reserves. Is there a "sweet spot"? How can we derive the maximum benefit associated with risk reduction from reserves while minimizing the effects of reserve spending motivation

Group coaching as support for changing lifestyle for those diagnosed with a long-term condition

It is estimated that the treatment and care of those with a long term condition (LTC) accounts for 69% of the primary and acute healthcare budget in England (Department of Health 2008). This research took an action research approach to explore how group coaching can be a support mechanism for people with LTC to make changes to their lifestyle. Data was collected through five group-coaching sessions with six participants. Three themes emerged: practice; participants’ change and growth; self, emotions and awareness. Drawing on the findings a ‘group coaching health and wellbeing framework’ has been developed. The findings indicate that group coaching can be a support mechanism to support people with a LTC to make lifestyle changes

Data and Safety Monitoring of COVID-19 Vaccine Clinical Trials

To speed the development of vaccines against SARS-CoV-2, the United States Federal Government has funded multiple phase 3 trials of candidate vaccines. A single 11-member data and safety monitoring board (DSMB) monitors all government-funded trials to ensure coordinated oversight, promote harmonized designs, and allow shared insights related to safety across trials. DSMB reviews encompass 3 domains: (1) the conduct of trials, including overall and subgroup accrual and data quality and completeness; (2) safety, including individual events of concern and comparisons by randomized group; and (3) interim analyses of efficacy when event-driven milestones are met. Challenges have included the scale and pace of the trials, the frequency of safety events related to the combined enrollment of over 100 000 participants, many of whom are older adults or have comorbid conditions that place them at independent risk of serious health events, and the politicized environment in which the trials have taken place

The Incremental Cost of One or More Copies – Quantifying Efficiencies from Building Spacecraft and Instrument Constellations

Organizations struggle to estimate costs associated with generating small lots of instruments and spacecraft built as part of constellations. APL has experience building spacecraft constellations and instrument series, with a meticulous record of the associated historical costs available for research. To answer the question, “How much do the copies cost?” we explore the cost histories of STEREO, The Van Allen Probes, JEDI, and RBSPICE from APL experience. We generate a formula for estimating the cost of spacecraft and instrument copies from the historical record. We test the factor’s predictive value and provide associated statistics. Finally, we explore how other organizations can adjust and adapt the APL formula for instrument/spacecraft copy costs to reflect their own experience for estimating the cost of producing small constellations of identical instruments or spacecraft

HABIT efficacy and sustainability trial, a multi-center randomized controlled trial to improve hydroxyurea adherence in youth with sickle cell disease: a study protocol

Background Hydroxyurea (HU) is recommended as standard practice for youth with sickle cell disease (SCD). Yet, despite its efficacy, HU adherence in adolescents and young adults is often poor. Poor medication adherence increases disease burden, healthcare cost and widens health disparities. Adolescence is a critical time to improve adherence through improved chronic disease self-management. This study aims to test the efficacy of an intervention delivered to youth/parent dyads by community health workers (CHWs), augmented by tailored text messages on HU adherence (primary outcome). Secondary outcomes are intervention sustainability, youth health-related quality of life, self-management responsibility concordance, acute hospital use and self-reported disease symptoms. Methods Hydroxyurea Adherence for Personal Best in Sickle Cell Disease, “HABIT,” is a 12 month multi-center randomized controlled trial. One hundred four youth, 10 to 18 years of age prescribed HU who meet eligibility criteria, enrolled with their parent as dyads, will be randomized 1:1 to either the HABIT intervention or to usual clinical care plus education handouts. All subjects will complete clinic visits at months 0, 2, 4, 6 (efficacy component), 9 and 12 (sustainability component) for assessment of HbF biomarker, other hematologic parameters, and to complete questionnaires. In addition, dyads assigned to the HABIT intervention will work with CHWs to identify a daily habit (e.g., brushing teeth) on which to build a HU adherence habit. Tailored daily text message reminders to support the habit will be developed by the dyad in collaboration with the CHWs and sent to parent and youth. At the 6 month visit, the intervention will end and the sustainability portion of the trial will begin. All data analyses will be based on intention to treat with all randomized subjects included in the analyses. Discussion Prior retrospective studies demonstrate that a majority of adolescents are poorly adherent to HU. If efficacious, the HABIT intervention has the potential to improve the lives of youth with SCD. Trial registration Clinicaltrials.gov NCT03462511 . Registered March 6, 2018, last updated July 26, 2019

Taking responsibility for border security: commercial interests in the face of e-Borders

Security is an important feature of the macro environment for tourism that affects the consumption of travel products. Following high-profile terrorist attacks, UK border security measures have been increased through the implementation of the e-Borders programme. This initiative requires passenger carriers to collect and electronically transmit travel document information and service information for any individual entering or leaving the UK. The commercial impact of e-Borders on travel firms is investigated by examining the relationships between the affected stakeholders, considering the power and decision making at play, and exploring the outcomes. The e-Borders programme is described, and a framework for the in-depth, qualitative study is presented. The findings show that passenger carriers and travel firms manage the negative consequences of compliance and restore their commercial interests by engaging in a process we describe as recognizing, rationalizing and refashioning. The implications for research and practice are explored

Reverse Diffusion in US Multinationals: Barriers from the American Business System

This paper addresses the issue of 'reverse diffusion' of employment practices in multinational companies, which is defined as the transfer of practices from foreign subsidiaries to operations in the country of origin. It adds to the literature by examining the influence of the parent business system in multinationals. Specifically, it addresses how the dominant institutions and established organizational structures and practices in the home country affect the extent and impact of reverse diffusion of employment practices. Drawing on fresh evidence from American-owned multinationals in the UK we argue that there is considerable potential for reverse diffusion to occur among this group of firms. However, we highlight a number of barriers to reverse diffusion that the American business system presents, demonstrating that these constrain both the prevalence and the impact of it in practice. Copyright Blackwell Publishing Ltd 2005.