Total Economic Cost Research Articles

A new multi-timescale optimal scheduling model considering wind power uncertainty and demand response

When wind power is connected to a power grid, intermittency and uncertainty increase the difficulty of power system dispatching and operation. A multi-timescale optimal scheduling model based on wind power uncertainty and demand response are proposed to address the uncertainty of wind power integration. The demand response program is first implemented on the customer side to adjust the electricity consumption pattern and reduce the peak-valley load difference. Then, the robust optimization based on extreme scenarios is used in the day-ahead scheduling stage according to the characteristic that the wind power prediction accuracy gradually improves step by step with the refinement of timescales so that the decision variable meets requirements in all scenarios. In the intraday scheduling stage, the method based on stochastic chance-constrained programming is used, and the out-of-bounds phenomenon is allowed in extreme cases. During real-time scheduling, the deviation remaining after intraday scheduling is corrected. Finally, a 10-unit system is used as an example to demonstrate the feasibility and effectiveness of the proposed scheduling model. The simulation results show that the total economic cost, reserve cost and wind power curtailments of the real-time scheduling model are reduced by 18.21%, 66.06% and 66.57%, respectively, compared with the day-ahead scheduling model. In addition, compared with the intraday scheduling model, the wind power curtailments of the real-time scheduling model are reduced by 20.00%, which proves the necessity of multi-timescale coordinated scheduling.

Aligning sustainability and regional earthquake hazard mitigation planning: integrating greenhouse gas emissions and vertical equity

Concerns about the potential economic consequences of earthquakes have increased in recent years as scientifically based probabilities of future earthquakes in many large urban areas have risen. These hazards disproportionately impact low-income communities as wealth disparities limit their capacity to prepare and recover from potentially disastrous events. In addition to major economic losses, the activities related to building recovery result in significant greenhouse gas emissions contributing to climate change. This article develops a framework that quantifies the complex relationships between pre-earthquake retrofit activities and their economic, environmental and equity implications to promote informed decision-making, using the city of San Francisco, California as a case study. This research consists of two sections. In the first section, a bi-objective optimization model is proposed to identify optimal earthquake risk mitigation policies to minimize total earthquake-related economic and environmental costs, simultaneously. Decisions entail the seismic retrofit, combined seismic and energy retrofit or complete reconstruction of building-type groups. The benefits of increased energy efficiency of the upgraded buildings are incorporated to evaluate decisions from a holistic perspective. In the second section, the model is extended to address the issue of inequitable budget allocation from a public-sector perspective. Vertical equity considerations are incorporated as an optimization constraint to distribute available resources aiming to limit the discrepancy of expected losses as a fraction of income between households across income groups. The tradeoff between equity and economic efficiency is explored. Results show that life-cycle environmental impacts constitute an informative performance metric to regional risk mitigation decision-makers, in addition to the more customarily used monetary losses. Although construction costs primarily dictate optimal decisions from an economic perspective, energy considerations largely impact optimal decisions from an environmental perspective.

Socio-technical modelling of UK energy transition under three global SSPs, with implications for IAM scenarios

The potential for using findings from socio-technical energy transition (STET) models in integrated assessment models (IAMs) has been proposed by several authors. A STET simulation model called TEMPEST, which includes the influence of societal and political factors in the UK’s energy transition, is used to model three of the global shared socioeconomic pathways (SSPs) at the national level. The SSP narratives are interpreted as inputs to TEMPEST, which drive scenario simulations to reflect varying societal preferences for mitigation measures, the level of political support for energy transition, and future economic and population trends. SSP1 and SSP2 come close to meeting UK net zero targets in 2050 but SSP5 does not reach net zero before 2080. An estimate of the total societal, political, and economic cost of scenarios indicates that while SSP1 achieves the best emissions reductions it also has the highest total cost, and SSP2 achieves the best ratio between rate of emissions reductions and total cost. Feasibility appears to be highest for SSP2 since it is the least different to historical precedent. Current UK government energy strategy is closer to the narrative in SSP5, however, which has the highest total cost and exceeds an estimated carbon budget by 32%. Three key TEMPEST findings are recommended for use in IAMs: (i) the uncertainty in emissions savings due to variability in political and societal support for energy transition, (ii) the influence of negative societal pushback to policies in achievement of expected policy outcomes, and (iii) the combined influence on energy service demand of disposable income, public willingness to participate, and user impacts from measures.

Economic costs of protecting islands from invasive alien species.

Biological invasions represent a key threat to insular systems and have pronounced impacts across environments and economies. The ecological impacts have received substantial focus, but the socioeconomic impacts are poorly synthesized across spatial and temporal scales. We used the InvaCost database, the most comprehensive assessment of published economic costs of invasive species, to assess economic impacts on islands worldwide. We analyzed socioeconomic costs across differing expenditure types and examined temporal trends across islands that differ in their political geography-island nation states, overseas territories, and islands of continental countries. Over US$36 billion in total costs (including damages and management) has occurred on islands from 1965 to 2020 due to invasive species' impacts. Nation states incurred the greatest total and management costs, and islands of continental countries incurred costs of similar magnitude, both far higher than those in overseas territories. Damage-loss costs were significantly lower, but with qualitatively similar patterns across differing political geographies. The predominance of management spending differs from the pattern found for most countries examined and suggests important knowledge gaps in the extent of many damage-related socioeconomic impacts. Nation states spent the greatest proportion of their gross domestic products countering these costs, at least 1 order of magnitude higher than other locations.Most costs were borne by authorities and stakeholders, demonstrating the key role of governmental and nongovernmental bodies in addressing island invasions. Temporal trends revealed cost increases across all island types, potentially reflecting efforts to tackle invasive species at larger, more socially complex scales. Nevertheless, the already high total economic costs of island invasions substantiate the role of biosecurity in reducing and preventing invasive species arrivals to reduce strains on limited financial resources and avoid threats to sustainable development goals.

On the problem of optimizing emissions of industrial enterprises

The problem of optimization of emissions of industrial enterprises is solved, taking into account the minimum dose of pollution of environmentally significant zones. Economic costs for reorganization of technology of the considered industrial objects are taken as the main criterion so that the total economic costs for the given reduction of pollution would be minimal for the enterprises for the whole region. As a result, the problem is reduced to a linear programming problem using solution of basic and conjugate equations of transport and diffusion of polluting aerosols.

How much does effective health facility inspection cost? An analysis of the economic costs of Kenya’s Joint Health Inspection innovations

BackgroundIn most low- and middle-income countries, health facility regulation is fragmented, ineffective and under-resourced. The Kenyan Government piloted an innovative regulatory regime involving Joint Health Inspections (JHI) which synthesized requirements across multiple regulatory agencies; increased inspection frequency; digitized inspection tools; and introduced public display of regulatory results. The pilot significantly improved regulatory compliance. We calculated the costs of the development and implementation of the JHI pilot and modelled the costs of national scale-up in Kenya.MethodsWe calculated the economic costs of three phases: JHI checklist development, start-up activities, and first year of implementation, from the providers’ perspective in three pilot counties. Data collection involved extraction from expenditure records and key informant interviews. The annualized costs of JHI were calculated by adding annualized development and start-up costs to annual implementation costs. National level scale-up costs were also modelled and compared to those of current standard inspections.ResultsThe total economic cost of the JHI pilot was USD 1,125,600 (2017 USD), with the development phase accounting for 19%, start-up 43% and the first year of implementation 38%. The annualized economic cost was USD 519,287, equivalent to USD 206 per health facility visit and USD 311 per inspection completed. Scale up to the national level, while replacing international advisors with local staff, was estimated to cost approximately USD 4,823,728, equivalent to USD 103 per health facility visit and USD 155 per inspection completed. This compares to an estimated USD 86,997 per year (USD 113 per inspection completed) spent on a limited number of inspections prior to JHI.ConclusionInformation on costs is essential to consider affordability and value for money of regulatory interventions. This is the first study we are aware of costing health facility inspections in sub-Saharan Africa. It has informed debates on appropriate inspection design and potential efficiency gains. It will also serve as an important benchmark for future studies, and a key input into cost-effectiveness analyses.

An Optimization of New Energy Hybrid Configuration Parameters Based on GA Method

Configuration parameters of vehicular hybrid power systems (HPSs) are critical to their economy, weight, and fuel consumption. Many marine vehicles have parameters often set based on engineering experience when designing them, which often leads to excess power from power sources, increased costs, and increased emissions. In this paper, a multi-objective optimization model, which includes the economic cost, weight, and fuel consumption, is proposed to evaluate the performance of configuration parameters. To optimize the objective optimization model, this paper adopts a genetic algorithm (GA) method to iteratively calculate the globally optimal configuration parameter results. Finally, three sets of different weight coefficients are used to verify the configuration optimization results when considering different optimization objectives. To verify the advantage of the multi-objective optimization method, the three sets of optimized results are compared to a specific configuration parameter of a marine vehicle. From the simulation results, compared with the original configuration scheme, the total economic cost of Scheme 1 is reduced by 37.25 × 104 $, the total weight is reduced by 213.55 kg, and the total fuel consumption is reduced by 163.64 t; the total economic cost of Scheme 2 is reduced by 12.2 × 104 $, the total weight is increased by 393.36 kg, and the total fuel consumption is reduced by 271.89 t; the total economic cost of Scheme 3 is reduced by 36.89 × 104 $, the total weight is reduced by 209.2 kg, and the total fuel consumption is reduced by 162.35 t.

Comprehensive approach to costing cervical cancer prevention and control: a case study in the United Republic of Tanzania using the Cervical Cancer Prevention and Control Costing (C4P) tool

BackgroundThe World Health Organization (WHO) has developed a costing tool, the Cervical Cancer Prevention and Control Costing (C4P) tool, to estimate the comprehensive cost of cervical cancer primary, secondary and tertiary prevention in low- and middle-income countries. The tool was piloted in the United Republic of Tanzania, a country with a high incidence of cervical cancer with 62.5 cases per 100,000 women in 2020. This paper presents the costing tool methods as well as the results from the pilot in Tanzania.MethodsThe C4P tool estimates the incremental costs of cervical cancer prevention and control programmes. It estimates the financial (monetary costs to the government) and economic costs (opportunity costs). For the pilot, the study team collected data on costs and programme assumptions for human papillomavirus (HPV) vaccination of 14-year-old girls and scaling up of cervical cancer screening (visual inspection with acetic acid and HPV-DNA testing) and treatment for women for 2020–2024. Assumptions were made on how vaccination coverage would increase over the 5 years as well as developing additional screening and treatment capacity through health personnel training and infrastructure strengthening.ResultsThe total financial and economic costs of the comprehensive programme during 2020–2024 are projected to be US$68 million and US$124 million, respectively. The financial and economic costs of a fully immunized girl with HPV vaccine are estimated to be US$6.68 and US$17.31, respectively, while the costs per woman screened for cervical cancer are, on average, US$4.02 and US$5.83, respectively; US$6.44 and US$9.37 for pre-cancer treatment, respectively; and US$101 and US$107 for diagnosis of invasive cancer, respectively. The cost of treating and managing invasive cancer range from US$7.05 and US$7.83 for outpatient palliative care to US$800.21 and US$893.80 for radiotherapy, respectively.ConclusionsThe C4P costing tool can assist national cervical cancer programmes to estimate monetary resources needed as well as opportunity costs of reducing national cervical cancer incidence through primary, secondary and tertiary prevention.

Managing water-energy-carbon nexus in integrated regional water network planning through graph theory-based bi-level programming

The water-energy-carbon nexus (WECN) has raised the attentions in the past years due to the shortages of water and energy resources, climate change and their close connection. It is critical to study WECN in water network systems due to their energy- and carbon-intensive characteristics. In optimization of WECN in water network planning, decision makers with conflictive objectives may have different decision-making power levels. In this study, an integrated Graph Theory-Based Bi-Level Water Network Planning Model, named GraBiL is developed, which represents a methodological contribution to the challenge of quantitative interrelationships of WECN and hierarchical decision-making problem in regional-scale water network planning. The GraBiL model has improved upon the existing bi-level programming and graph theory-based method for solving spatial layout optimization in two-level decision-making problem. Two-level conflictive objectives including minimizing total system cost and maximizing energy saving are considered. Fuzzy uncertainties associated with water loads are quantified. The impacts of carbon emission control on total system economic costs, energy consumption and the optimal water network planning are effectively addressed. The results from a hypothetical case study indicate that enhanced overall satisfaction for meeting the two-level objectives can be achieved with the proposed GraBiL model. Optimal water network planning schemes including spatial layout under four representative carbon emission control scenarios are compared. The proposed model has provided insight into quantitative interrelationships of WECN, hierarchical decision-making, optimization of water network spatial layout and quantification of fuzzy uncertainty associated with water loads in regional-scale water network planning.

Costs of delivering human papillomavirus vaccination in Tanzania

Abstract Background Cervical cancer caused by human papillomavirus (HPV) is the most frequent cancer in women in many low-income countries.Tanzania implemented a national HPV vaccination program in 2018 using a two-dose quadrivalent HPV vaccine. This study aimed to (1) estimate financial and economic costs of a two-dose vaccination program based on experiences with the national vaccination program, (2) estimate costs of a one-dose vaccination schedule to enable future cost-effectiveness analyses, and (3) assess the effect of alternative assumptions for future vaccination coverage rates on estimated costs of vaccination. Methods The WHO Cervical Cancer Prevention and Control Costing (C4P) tool was used to estimate the incremental costs of the national vaccination programme from the perspective of the Tanzanian government using data collected via surveys, workshops, and interviews with local stakeholders. Deterministic sensitivity analyses were performed to estimate the effect of alternative assumptions for coverage rates and delivery strategies and to assess the impact of a potential one-dose vaccination schedule. Results The total financial and economic costs were US$10,117,455 and US$45,683,204, respectively, at a financial cost of $5.17 per two-dose fully immunized girl (FIG), and an economic cost of $23.34 per FIG. Under the assumption of a one-dose vaccination schedule, costs per FIG would reduce to financial costs of $2.51 and economic costs of $12.18. Conclusions The overall cost of Tanzania’s HPV vaccination program was lower per vaccinee than previous demonstration projects in the region suggest. These data provide important baseline data for Tanzania’s HPV vaccination program to date and may serve as a guide for improving coverage going forward. The findings may also aid in the prioritization of funding for countries that have not yet added HPV vaccines to their routine immunizations. Key messages • If a single dose regimen were found to be as effective as a two-dose series, it would result in significant cost savings as well as an increase in the number of girls that could be reached. • School-based vaccinations resulted in the lowest price per fully immunized girl, but other settings are needed to achieve equitable high coverage of HPV vaccination in Tanzania.

Global economic costs of mammal invasions

Invasive alien mammals cause huge adverse ecological impact on human society and natural ecosystems. Although studies have estimated economic costs of mammal invasions at regional scales, there is lacking the large-scale comprehensive assessment of currency costs for this taxon. Here, we estimated the economic cost of invasive alien mammals on a global scale using the most comprehensive global database compiling economic costs of invasive species (InvaCost). From 1960 to 2021, mammal invasions caused costs (summing damage costs and management costs) of US$ 462.49 billion to the global economy, while the total amount of robust costs reached US$ 52.49 billion. The majority of the total economic costs corresponded to damage costs (90.27 %), while only 7.43 % were related to management cost. Economic costs showed an increasing trend over time. The distribution of costs was uneven among taxonomic groups and regions, with the global total cost highly biasing toward to 5 species (European rabbit, Domestic cat, Black rat, Wild boar and Coypu), and North America reporting much higher costs (60.78 % of total economic costs) than other regions. The total costs were borne by agriculture, environment, authorities stakeholders and other sectors. Geographic and taxonomic biases suggested that total economic costs caused by invasive alien mammals were underestimated. Integrated research efforts are needed to fill in knowledge gaps in the economic costs generated by mammal invasions and to identify the drivers of the economic costs.

Modeling the Economic Cost of Obesity Risk and Its Relation to the Health Insurance Premium in the United States: A State Level Analysis

We propose a new approach for estimating the state-level direct and indirect economic cost of obesity in the United States for the time period 1996 to 2018. Our unique top-down methodology integrates a prevalence-based method with various medical-level costs, economic, demographic, and socio-economic factors. Using this approach, we investigate the relationship between the estimates of the total obesity-related costs and the health insurance premium by state in order to evaluate the state burden of obesity. Our estimate of the total national economic cost attributed to obesity is approximately $422 billion in 2018, representing about 2% of the national GDP for the same year. Using exponential smoothing models, we forecast that the total cost would reach $475 billion in 2021 without accounting for the impact of COVID-19 on obesity. The top states driving the cost estimates are California, Texas, New York, and Florida. A bootstrapping technique is employed to the state-level estimated cost in order to determine the average cost per person. We hope that our study will promote interest in this topic and open discussion for further research in this area.

Analysis of medical and economic efficiency of vaccine prevention of respiratory diseases among builders of the Amur Gas Processing Plant using expert assessments and methods of predictive modeling

Introduction. Acute respiratory viral and pneumococcal infections, the incidence of which is associated with high economic costs, are one of the most important problems in epidemiology and pulmonology. Preventive vaccination is a tool for managing the incidence of acute respiratory viral infection (ARVI) and pneumococcal infections. The issues of medical and economic efficiency of preventive vaccination are constantly in the field of epidemiological surveillance, and the estimates obtained in this case are a necessary condition for making decisions on the viability of investing in its organization.Aim. Expert assessment and predictive modeling of the potential cost-effectiveness of vaccination with pneumococcal and influenza vaccines in immunocompetent adult patients with different levels of risk of acute and chronic respiratory diseases among the builders of the Amur Gas Processing Plant (GPP).Materials and methods. A complex of studies was carried out using the methods of statistics, epidemiological analysis and monitoring, comparative and economic analysis. Determination of the economic profitability of vaccination was carried out on the basis of methods of comparing “costs” and “benefits”. The surveyed cohort is represented by adults working on the construction of the Amur GPP (Svobodny, Amur Region). The main risk factors and inclusion criteria were the conditions of adverse effects of occupational, social and biological factors on human respiratory health. A set of preventive measures was carried out using methods and means of specific prevention of acute and chronic respiratory diseases: anti-influenza (Ultrix Quadri) and pneumococcal (Prevenar-13) vaccines. Efficacy analysis was carried out for 20-, 40- and 60-year-old patients with 1, 2 and 3 risk factors in accordance with the methods of its medical, social and economic evaluation. A retrospective determination of the cases of diseases (deaths) and economic damage prevented as a result of vaccination was carried out on the basis of the difference in morbidity (mortality) rates for the period preceding vaccination and for the period following vaccination. When constructing a predictive model for evaluating the effectiveness of vaccine prevention of respiratory infections, expert assessments, legal documents and the methodology of individual researchers were used.Results. The predicted incidence of pneumonia among the builders of the Amur GPP, taking into account all risk factors, can be 32.3‰. At the same time, the total volume of prevented predictive incidence of pneumonia in the post-vaccination period only with the use of pneumococcal vaccine can be 26.5‰, reducing the initial incidence rate by 5.5 times. As a result of the calculations and economic assessment, it was found that the total (direct and indirect) economic costs of the state and the plant (economic damage) with the incidence of community-acquired pneumonia in the working-age population (20-60 years) on the territory of this construction site is 112,811 rubles. per person per year. Consequently, the prevented economic damage among the employees and builders of the Amur GPP only as a result of the use of the pneumococcal vaccine “Prevenar-13” is 13,537,411 rubles. In addition, immunoprophylaxis with the use of influenza vaccines can reduce the incidence of influenza, ARVI, pneumonia and chronic forms of respiratory diseases, which corresponds to additional prevented economic damage to the plant in the amount of 103,786,764 rubles. Thus, the predicted total prevented economic damage for this plant as a result of vaccination may amount to 117,324,175 rubles.Conclusion. The results of the studies indicate that the implementation of the Program for the Prevention of Acute Respiratory Diseases by means of influenza and pneumococcal vaccines among the builders of the Amur GPP has a high level of medical and socio-economic efficiency, identified on the basis of its predictive modeling and expert assessments.

Economic impacts of overweight and obesity: current and future estimates for 161 countries

IntroductionThe scope of the challenge of overweight and obesity (OAO) has not been fully realised globally, in part because much of what is known about the economic impacts of OAO...

Comparative Analysis of Environmental and Economic Performance of Agricultural Cooperatives and Smallholder Farmers for Apple Production in China

China is the world’s largest apple producer, and agricultural cooperatives play an important role in promoting sustainable production in its whole life cycle system. However, few studies on cooperatives have evaluated the environmental and economic performance from the life cycle thinking perspective. In this study, the combined methods of life cycle assessment (LCA) and life cycle cost (LCC) were used to comparatively analyze the environmental and economic performance of apple production between cooperatives and smallholder farmers. The results showed that, compared to the smallholder farmers, cooperatives significantly reduced resource depletion and environmental impacts by 12.50–22.16% in each category. The total environmental index for the cooperatives was 7.44% and 22.09% lower than smallholder farmers; meanwhile, the total LCC was 2659.71 Chinese Yuan (CNY), 19.27% lower than smallholder farmers. However, the net profit was 2990.29 CNY for the cooperatives, 21.23% higher than smallholder farmers. The results indicated that cooperatives exhibited a higher net profit while having lower resource input, environmental impact, and LCC than smallholder farmers. Moreover, pesticides and fertilizers were identified as the most critical environmental hotspots. Moreover, human labor cost was the most significant contributor to the total economic cost of the apple production system. These findings provide insights into optimizing farm inputs for apple production and active participation in agricultural cooperatives to alleviate multiple environmental impacts while maintaining apple yield and improving economic benefits, intending to make a marginal contribution to promoting sustainable development of the apple industry in China.

How rainfalls influence urban traffic congestion and its associated economic losses at present and in future: taking cities in the Beijing-Tianjin-Hebei region, China for example?

Traffic congestion is one of serious problems in cities; rainfalls would exacerbate traffic congestion, and thus result in huge economic losses. However, limited studies focused on how rainfalls influenced traffic congestion and its associated economic losses. Based on detailed hourly data, we estimated how traffic congestion index (TCI) changed with different rainfall intensities in the Beijing-Tianjin-Hebei (BTH) region, and we also explored their economic losses. The results illustrated that all cities presented the similar trend of daily traffic congestion, and morning peak occurred 2 h later on holidays than workdays. Rainfall had significant impacts on traffic congestion for most time windows, except midnight. Traffic congestion increased with rainfall intensities, but smaller cities were more vulnerable to rainfall intensity than megacities. Rainfalls led to 0.95 billion yuan of extra economic losses in 2019, 38% of which occurred under heavy rainfalls. Traffic congestion in 2019 caused a total economic cost of 30.08 billion yuan in the BTH region (0.4% of its GDP), including the recurrent cost and economic losses due to rainfalls; besides, the social cost and direct cost contributed the same share of 49.5%, with 1% from the environmental costs. Considering future urban development and climate change, it is beneficial to establish the climate-resilient transportation system for avoiding future serious traffic congestion as well as huge economic losses in future.

Discrepancies in ozone levels and temporal variations between urban and rural North China Plain

Effective emission reductions of some primary pollutants have brought down aerosol loadings but led to increasing relative importance of secondary pollutants, as was indicated by the rising O3 levels during warm seasons within urban and suburban areas of China, which has received much attention in recent years, especially in the North China Plain (NCP). This has raised serious concerns on its agricultural impacts, which were mainly evaluated based upon O3 model simulations or urban/suburban measurements due to a lack in long-term rural observations. In this study, we present highly valuable continuous O3 observations at a rural NCP site during 2013–2019. Compared to nearby urban/suburban sites, which experienced increased O3 levels, rural observations exhibited decreasing O3 mole fractions. While O3 mole fractions and AOT40 widely increased at urban/suburban NCP sites from 2013 to 2019, O3 observations in the rural NCP site (GC) revealed decreases, especially during summer and autumn with greater rates for AOT40. A reassessment of O3 agricultural impacts in the NCP region was performed using rural observations, resulting in wheat, maize and soybean averaged relative yield losses of 37 ± 14, 8 ± 4 and 30 ± 13% yr–1, respectively. O3 impacts on crop yields and resulting economic losses did not increase as was suggested by previous estimations based on urban/suburban O3 data. Our analyses indicated high overestimations (i.e., average relative differences in estimated crop production loss reaching 53%, 112% and 75%, respectively, for wheat, maize, and soybean). Despite alleviated O3 agricultural impacts, the total economic cost loss in Hebei province still took up 0.89% of the gross domestic production (3.47 × 1012 USD) in Hebei province. Since the China National Environmental Monitoring Center mainly aims at monitoring O3 levels in populated areas, observation sites representative of agricultural regions are lacking across China. The current study highlights the urgent necessity for the establishment of rural O3 observation networks and encourages extensive field experiments on exposure–response relationships of different crops varieties to O3 for more accurate agricultural impact evaluations. Additionally, explorations into the underlying mechanisms behind the reversed O3 temporal variation between rural and urban areas should be conducted for future development of pollution control strategies.

Estimating the Economic Burden of Diabetes Mellitus in Kenya: a Cost of Illness Study

Diabetes mellitus is one of the non-communicable diseases that depletes the wealth of any individual directly and indirectly due to the cost associated with treating the illness and its complications. The study aims to estimate the economic burden of Diabetes mellitus in Kenya from a societal perspective using a cost-of-illness approach. The study’s results and findings for the economic burden of diabetes mellitus in Kenya relied on the cost of illness approach. The approach identifies and measures all the costs of Diabetes mellitus, including direct and indirect costs. The 552,400 adult cases reported in 2019 resulted in a total economic cost of USD 372,184,585, equivalent to USD 674 per diabetes mellitus patient. The total direct costs accounted for the highest proportion of the overall costs at 61% (USD 227,980,126), whereas indirect costs accounted for 39% of the total economic costs (USD 144,204,459). Costs of medicines accounted for the highest costs over the total economic costs at about 29%, followed by the income lost while seeking care at 19.7%. Other costs that accounted for more than 10% of the total costs include productivity losses (19%), diagnostic tests (13%), and travel (12%). The rest of the cost categories accounted for less than 5%. Efforts should be made to reduce the costs of these medicines to enhance care. The high indirect costs reported, majorly in income lost by patients while seeking medical care, are 19%. Access to affordable health services such as diabetes mellitus education, regular blood glucose screening initiatives, and increasing local manufacturing of medicines can reduce the economic burden of diabetes mellitus and increase the health outcomes of the population and their contributions to society.

Costs and Cost-Effectiveness of mCME Version 2.0: An SMS-Based Continuing Medical Education Program for HIV Clinicians in Vietnam

The Mobile Continuing Medical Education (mCME) 2.0 project was a randomized controlled trial that found that a 6-month text message-based CME intervention improved both the use of online medical training resources and medical knowledge among a cadre of HIV clinicians in Vietnam. This companion study analyzed intervention costs and cost-effectiveness. We conducted (1) a financial analysis based on costs incurred during the trial's planning and implementation; (2) an economic analysis to consider resource utilization; and (3) cost-effectiveness analyses to estimate cost inputs relative to impact: increase in self-study (measured by visits to online courses) and increase in knowledge (measured by exam score improvement) (in 2016 US$). Finally, we estimated the economic cost of a 9-month national program and a 10-year scaled-up model (in 2021 US$). The total financial cost of the intervention was US$49,552; the main cost drivers were personnel time (71.4%) and technology inputs (14.9%). The total economic cost was estimated at US$92,212, with the same key cost inputs (representing 77.7% and 8.0%, respectively, of total costs). The financial cost per 10% increase in accessing online courses was US$923, while the cost of improving knowledge, measured by a 10% improvement in mean exam score across the study population, was US$32,057 (US$605 per intervention clinician). The comparable total economic cost of each improvement, respectively, was US$1,770 and US$61,452 (US$1,159 per intervention clinician). A future 9-month national program was estimated to cost US$37,403, while the full 10-year scaled-up program was estimated at US$196,446. This analysis indicates that leveraging mobile technology could be a feasible way to provide distance learning to health professions across Vietnam at a relatively low cost. Given the need for practical ways to expand CME in resource-constrained regions of the world, this approach warrants further study and possible adoption.

Development of a treated cardboard wastes injection machine into the sandy soils

This study aimed to evaluate a new prototype for an injection machine that works in sandy soils using treated cardboard waste. The tests were divided into three major categories: The first one was a performance evaluation of the new injection prototype. Secondly, study the effect of adding the treated cardboard to the sandy subsoil on reducing the irrigation levels and increasing the moisture content in the root zone of cultivated plants. As well, investigate sandy soil water storage efficiency and its impact on improving the soil’s properties. Thirdly, measurements on water-sensitive crop yields, like potatoes. The new prototype technique was designed based on using an automatic control system that is integrated to precisely control the injection discharge rate. So, the injection operation is proportionally synchronized with the tractor's forward speed. The field experiments were carried out at 0.24, 0.40, 0.57 and 0.74 m sec-1 of tractor forward speeds with 250, 350 and 450 mm of furrow openers' subsoil depths at 140 and 200 mm of injection widths and 5 and 10% concentrations of cardboard solution. The main results indicated that the maximal consumed energy was 196.08 kWh ha-1 with a field efficiency of 89.05% and an optimal field capacity of 0.281 ha h-1 using the highest variable levels. In addition, the water saving percentage was 35.80%, while the water storage efficiency was 85.85%. Furthermore, the total economic costs were reduced by 13.88% compared to the traditional silt injection method for the tested control plots.