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Capacitated vehicle-routing problem model for scheduled solid waste collection and route optimization using PSO algorithm

Hannan MA, Akhtar M, Begum RA, Basri H, Hussain A, Scavino E

Waste Manag, 2018 Jan;71:31-41.
PMID: 29079284 DOI: 10.1016/j.wasman.2017.10.019

Waste collection widely depends on the route optimization problem that involves a large amount of expenditure in terms of capital, labor, and variable operational costs. Thus, the more waste collection route is optimized, the more reduction in different costs and environmental effect will be. This study proposes a modified particle swarm optimization (PSO) algorithm in a capacitated vehicle-routing problem (CVRP) model to determine the best waste collection and route optimization solutions. In this study, threshold waste level (TWL) and scheduling concepts are applied in the PSO-based CVRP model under different datasets. The obtained results from different datasets show that the proposed algorithmic CVRP model provides the best waste collection and route optimization in terms of travel distance, total waste, waste collection efficiency, and tightness at 70-75% of TWL. The obtained results for 1 week scheduling show that 70% of TWL performs better than all node consideration in terms of collected waste, distance, tightness, efficiency, fuel consumption, and cost. The proposed optimized model can serve as a valuable tool for waste collection and route optimization toward reducing socioeconomic and environmental impacts.

Matched MeSH terms: Costs and Cost Analysis
Fulltext Economic analysis of broiler production in Peninsular Malaysia

Abdurofi, I., Ismail, M.M., Kamal, H. A. W., Gabdo, B. H.

International Food Research Journal, 2017;24(4):1387-1392.
MyJurnal

The domestic demand for broiler meat is one of the highest in the Malaysian markets. The
industry requires continuous evaluation to identify the existing problems and improves its
competitive advantage. Thus, economic analysis of this sort will continue to update current
statistics on production cost, output and profitability. Following this, the study, therefore, aims
to assess the existing financial condition of farmers, marginal cost of production, total net
income and input-output ratio of broiler production in different regions in Peninsular Malaysia.
The study used multi-stage sampling in selecting 310 operators from Southern, Northern, East
Coast and Centeral regions. The analytical tools include descriptive statistics and farm budget.
The findings disclosed that the broiler farm incurs major cost from acquiring operating inputs
especially feed. The operations in the East Coast region was almost unprofitable for the reason
that feed conversion rate is more than 2 resulting in higher production cost. But the other three
regions indicate positive returns based on the estimated input-output ratios of 1:1.09, 1:1.17
and 1: 1.23 for Northern, Southern and Central regions, respectively.The study advocates for
both managerial and policy measures that will help cut the cost of production to attract more
investors and increase export.

Matched MeSH terms: Costs and Cost Analysis
Fulltext Validity of low-cost measures for global surveillance of physical activity in pre-school children: The SUNRISE validation study

Mwase-Vuma TW, Janssen X, Okely AD, Tremblay MS, Draper CE, Florindo AA, et al.

J Sci Med Sport, 2022 Dec;25(12):1002-1007.
PMID: 36270900 DOI: 10.1016/j.jsams.2022.10.003

OBJECTIVES: To validate parent-reported child habitual total physical activity against accelerometry and three existing step-count thresholds for classifying 3 h/day of total physical activity in pre-schoolers from 13 culturally and geographically diverse countries.
DESIGN: Cross-sectional validation study.
METHODS: We used data involving 3- and 4-year-olds from 13 middle- and high-income countries who participated in the SUNRISE study. We used Spearman's rank-order correlation, Bland-Altman plots, and Kappa statistics to validate parent-reported child habitual total physical activity against activPAL™-measured total physical activity over 3 days. Additionally, we used Receiver Operating Characteristic Area Under the Curve analysis to validate existing step-count thresholds (Gabel, Vale, and De Craemer) using step-counts derived from activPAL™.
RESULTS: Of the 352 pre-schoolers, 49.1 % were girls. There was a very weak but significant positive correlation and slight agreement between parent-reported total physical activity and accelerometer-measured total physical activity (r: 0.140; p = 0.009; Kappa: 0.030). Parents overestimated their child's total physical activity compared to accelerometry (mean bias: 69 min/day; standard deviation: 126; 95 % limits of agreement: -179, 316). Of the three step-count thresholds tested, the De Craemer threshold of 11,500 steps/day provided excellent classification of meeting the total physical activity guideline as measured by accelerometry (area under the ROC curve: 0.945; 95 % confidence interval: 0.928, 0.961; sensitivity: 100.0 %; specificity: 88.9 %).
CONCLUSIONS: Parent reports may have limited validity for assessing pre-schoolers' level of total physical activity. Step-counting is a promising alternative - low-cost global surveillance initiatives could potentially use pedometers for assessing compliance with the physical activity guideline in early childhood.

Matched MeSH terms: Costs and Cost Analysis
Fulltext Cost volume profit analysis for full paying patient services in Malaysia: A study protocol

Mohd Fadzil M, Wan Puteh SE, Aizuddin AN, Ahmed Z, Muhamad NA, Harith AA

PLoS One, 2023;18(11):e0294623.
PMID: 37988370 DOI: 10.1371/journal.pone.0294623

Dual practice within public hospitals, characterised by the concurrent provision of public and private healthcare services within public hospitals, has become a widespread phenomenon. With the participation of selected public hospitals, dual practice within public hospitals, also known as Full Paying Patient services, was an initiative the Ministry of Health Malaysia took in 2007 to retain senior specialist physicians in Malaysia. The revenue generated from the Full Paying Patient services aims to provide an avenue for public sector specialists to supplement their incomes while alleviating the Government's burden of subsidising healthcare for financially capable individuals. However, the effectiveness of Full Paying Patient services in recouping service delivery costs and yielding a profit is still uncertain after 16 years of implementation. This study is designed to evaluate the impact of Full Paying Patient inpatient services volume, revenue, and cost on profit versus loss at selected hospitals from 2017 to 2020. From the perspective of healthcare providers, we plan to perform a cost volume profit analysis. This analysis enables us to determine the break-even point, at which total revenues match total costs, along with no-loss and no-profit thresholds for Full Paying Patient services. This study has the potential to provide insights into how variations in service volume, cost, and pricing impact healthcare providers' profitability. It also offers critical financial information regarding the volume of services required to reach the break-even point. A comprehensive understanding of service volume, cost and pricing is imperative for making informed decisions to fulfil the objectives and ensure the sustainability of the FPP services.

Matched MeSH terms: Costs and Cost Analysis
Fulltext Comparing the cost, glycaemic control and medication adherence of utilizing patients' own medicines (POMs) versus usual dispensing among diabetic patients in an outpatient setting

Lim PC, Chung YY, Tan SJ, Wong TY, Permalu DD, Cheah TK, et al.

Daru, 2021 Jun;29(1):125-132.
PMID: 33538999 DOI: 10.1007/s40199-021-00389-6

BACKGROUND: Millions worth of unused drugs particularly those indicated for chronic diseases such as diabetes were returned and disposed leading to substantial wastage. Use of patients' own medications (POMs) in the inpatient setting has reduced wastage and saved cost. The impact of utilizing POMs in the outpatient setting has hitherto not been determined.
PURPOSE: This study aims to compare the cost, medication adherence and glycaemic control of utilizing POMs versus usual dispensing.
METHODS: Prospective randomized controlled study was conducted among diabetic patients that required monthly medication refill in the Outpatient Pharmacy in 2017. Patients who consented were equally divided into POMs and control groups. Both groups brought excess medications from home at week-0 and week-12. Patients in the POMs group brought excess medications monthly and sufficient amount of drugs were added until the next refill date. Drugs were dispensed as usual in the control group. Total cost consisting of the cost of drugs, staff and building was calculated. Glycosylated haemoglobin (HbA1c) was measured at baseline and week-12. Adherence was measured based on pill counting.
RESULTS: Thirty patients aged 56.77 ± 14.67 years with 13.37 ± 7.36 years of diabetes participated. Baseline characteristics were similar between the groups. POMs minimized the total cost by 38.96% which translated to a cost saving of USD 42.76 ± 6.98, significantly different versus USD 0.02 ± 0.52 in the control group, p = 0.025. Mean HbA1c reduced significantly (-0.79%, p = 0.016) in the POMs group but not significant in the control group (-0.11%, p = 0.740). Medication adherence improved significantly in both groups at week-12 (p cost saving, improved adherence and better glycaemic control. Use of POMs should be practiced in the outpatient pharmacy to reduce wastage and cost.

Matched MeSH terms: Costs and Cost Analysis
Cigarette price level and variation in five Southeast Asian countries

Liber AC, Ross H, Ratanachena S, Dorotheo EU, Foong K

Tob Control, 2015 Jun;24(e2):e137-41.
PMID: 24500266 DOI: 10.1136/tobaccocontrol-2013-051184

OBJECTIVES: To monitor and analyse impacts of the interaction between tobacco excise tax policy and industry price strategy, on the price level and variation of cigarettes sold in five Southeast Asian countries (Indonesia, Cambodia, Lao PDR, the Philippines and Vietnam).
METHODS: Prices of cigarette sold by sticks and packs were collected through an in-person survey of retailers during 2011. Mean cigarette prices and price variation were calculated in each study country for single cigarettes, whole packs and brand groups.
RESULTS: Price variation of whole packs was greater in countries with ad-valorem excise tax structures (Cambodia, Lao PDR and Vietnam) than in countries with multitiered specific excise taxes (Indonesia and the Philippines). The price variation for single sticks appeared to be driven by local currency denomination. Cigarettes sold individually cost more per stick than cigarettes sold in whole packs in every brand group except for Indonesia's domestic brands.
CONCLUSIONS: Tobacco industry strategy and excise tax structure drove the price level and variation of cigarettes sold in packs, while currency denominations influence the selling price of single sticks. To maximise the effectiveness of tobacco tax policies, countries should adopt specific excise tax structures to decrease cigarette price variation, which would minimise opportunities for smokers to 'trade down' to a cheaper brand to avoid a tax-driven price increase.
KEYWORDS: Low/Middle Income Country; Packaging and Labelling; Price; Surveillance and Monitoring; Taxation

Matched MeSH terms: Costs and Cost Analysis*
Fulltext An empirical study on asymmetric jump diffusion for option and annuity pricing

Lau KJ, Goh YK, Lai AC

PLoS One, 2019;14(5):e0216529.
PMID: 31063498 DOI: 10.1371/journal.pone.0216529

In this paper, we present a method to estimate the market parameters modelled by an asymmetric jump diffusion process. The method proposed is based on Kou's jump diffusion model while the market parameters refer to the market drift, the market volatility, the jump intensity on market price, and the rate of jump occurrence in a consistent manner throughout the entire paper. The model captures the asymmetric nature of the price fluctuation during up trend markets and down trend markets. The results are compared to conventional options to observe the impact of jump effects. The results from simulation show that the asymmetric jump diffusion model can estimate the fair prices of European call options and annuity better than the Black-Scholes model and the symmetric jump diffusion model proposed by Kou and Merton.

Matched MeSH terms: Costs and Cost Analysis*
Fulltext A malaria-control experiment in the interior of Borneo

De Zulueta J, Lachance F

Bull World Health Organ, 1956;15(3-5):673-93.
PMID: 13404443

A first experiment on malaria control in the interior of Borneo by spraying with residual insecticides is described. The work was carried out in the isolated, sparsely populated valleys of the Baram River and its tributary, the Tinjar, in northern Sarawak. The experimental area was divided into three parts: a DDT test area, where a 75% suspension of wettable powder was applied at the rate of 2 g of DDT per m(2) of surface; a BHC test area, where a 50% suspension of wettable powder was applied at the rate of 0.10 g of gamma isomer per m(2); and a check area.Entomological investigations made before the spraying operations were started showed that Anopheles leucosphyrus Dönitz, 1901 was the main malaria vector in both the test and the check areas. Out of a total of 7568 A. leucosphyrus dissected, 30 gland infections were detected-a sporozoite-rate of 0.40%. A. barbirostris was found to be a secondary vector throughout the experimental area.THE RESULTS OF INSECTICIDE SPRAYING WERE SATISFACTORY: in the DDT test area, the spleen-rate fell from 51.8% to 25.1%, and the parasite-rate from 35.6% to 1.6%, in 21 months, and a similar reduction in the rates was observed in the BHC test area. In the check area, the spleen- and parasite-rates rose during the period of observations. It is considered that if such a degree of control can be obtained in 21 months, complete eradication can be expected in the near future.Although BHC spraying proved effective, the fact that it has to be repeated every three months makes it impracticable in the interior of Sarawak, where communications are very poor and difficulties of transport very great. DDT spraying, which need only be done twice a year, is therefore to be preferred. The cost of the DDT operations-US$ 0.45 per person protected per year-is comparatively high, owing to the difficulty of communications and to the necessity for spraying not only the village "longhouses", but also the temporary shelters which the semi-nomadic people in the interior of Sarawak build each year in the rice-fields.

Matched MeSH terms: Costs and Cost Analysis*
Fulltext Cost analysis of private primary care services hn three urban centres in Malaysia

Syed Mohamed Aljunid, Nyunt-U, Soe, Cheah, Molly, Kwa, S.K., Rohaizat Yon, Ding, L.M.

Malaysian Journal of Public Health Medicine, 2001;1(1):8-15.
MyJurnal

A study was undertaken amongst private primary care providers in three urban centres of Malaysia to understand the organizational structure of the facilities and to assess the cost of running such services. A total of 150 clinics were involved in the study. Data was collected through interviews with owners of the clinics using semi-structured questionnaires. Solo-practitioners owned 64.7% of the clinics while 35.3% of them were owned by group practice. This study showed that the mean number of patients visited the clinics daily was 49.3 with the average operating hours of 79.4 hours/week (range 28.0 - 168.0 hours/week). Group practice clinics operates 23.9 hours longer than solo-practice clinics. Group practice clinics were more likely to offer 24 hours service than solo-practice clinics. Most of the clinics were manned by a single doctor (57.3%), 30.0 % had two doctors and only 12.7% were run by more than two doctors. On average, group practice employed greater number of supporting staff than solo-practice clinics (6.0 vs 4.3 people). The mean annual cost to run each facility was found to be RM 444,698. The mean cost per patient was found to be RM 32.09 for solo-practice clinics and RM 38.55 for group practice. Wages represented the highest proportion in the recurrent cost (61.1%) followed by drugs (29.2%) and consumables (2.7%). Building cost (67.9%) and equipment cost (25.9%) were the major capital costs for the clinics. This study could serve as a basis to reimburse private primary care providers in the future health financing scheme in Malaysia. To improve efficiency and contain cost in primary care settings, efforts should be targeted towards cost of wages and drugs utilised by the providers in their daily practice.
Key words: Private practice; primary care; costs; Malaysia.

Matched MeSH terms: Costs and Cost Analysis*
Fulltext Approaches to refining estimates of global burden and economics of dengue

Shepard DS, Undurraga EA, Betancourt-Cravioto M, Guzmán MG, Halstead SB, Harris E, et al.

PLoS Negl Trop Dis, 2014 Nov;8(11):e3306.
PMID: 25412506 DOI: 10.1371/journal.pntd.0003306

Dengue presents a formidable and growing global economic and disease burden, with around half the world's population estimated to be at risk of infection. There is wide variation and substantial uncertainty in current estimates of dengue disease burden and, consequently, on economic burden estimates. Dengue disease varies across time, geography and persons affected. Variations in the transmission of four different viruses and interactions among vector density and host's immune status, age, pre-existing medical conditions, all contribute to the disease's complexity. This systematic review aims to identify and examine estimates of dengue disease burden and costs, discuss major sources of uncertainty, and suggest next steps to improve estimates. Economic analysis of dengue is mainly concerned with costs of illness, particularly in estimating total episodes of symptomatic dengue. However, national dengue disease reporting systems show a great diversity in design and implementation, hindering accurate global estimates of dengue episodes and country comparisons. A combination of immediate, short-, and long-term strategies could substantially improve estimates of disease and, consequently, of economic burden of dengue. Suggestions for immediate implementation include refining analysis of currently available data to adjust reported episodes and expanding data collection in empirical studies, such as documenting the number of ambulatory visits before and after hospitalization and including breakdowns by age. Short-term recommendations include merging multiple data sources, such as cohort and surveillance data to evaluate the accuracy of reporting rates (by health sector, treatment, severity, etc.), and using covariates to extrapolate dengue incidence to locations with no or limited reporting. Long-term efforts aim at strengthening capacity to document dengue transmission using serological methods to systematically analyze and relate to epidemiologic data. As promising tools for diagnosis, vaccination, vector control, and treatment are being developed, these recommended steps should improve objective, systematic measures of dengue burden to strengthen health policy decisions.

Matched MeSH terms: Costs and Cost Analysis/methods
Fulltext Rapid Assessment of Price Instability and Paucity of Medicines and Protection for COVID-19 Across Asia: Findings and Public Health Implications for the Future

Godman B, Haque M, Islam S, Iqbal S, Urmi UL, Kamal ZM, et al.

Front Public Health, 2020;8:585832.
PMID: 33381485 DOI: 10.3389/fpubh.2020.585832

Background: Countries have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE), with some countries adopting preventative strategies earlier than others. However, there has been considerable controversy surrounding some treatments. This includes hydroxychloroquine where the initial hype and misinformation lead to shortages, price rises and suicides. Price rises and shortages have also been seen for PPE. Such activities can have catastrophic effects on patients where there are high co-payment levels and issues of affordability. Consequently, there is a need to investigate this further. Objective: Assess changes in the availability, utilization and prices of relevant medicines and PPE during the pandemic among a range of Asian countries. Our approach: Narrative literature review combined with interviews among community pharmacists to assess changes in consumption, prices and shortages of medicines and PPE from the beginning of March 2020 until end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: 308 pharmacists took part from five Asian countries. There was an appreciable increase in the utilization of antimicrobials in Pakistan (in over 88% of pharmacies), with lower increases or no change in Bangladesh, India, Malaysia and Vietnam. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries, as well as limited price rises for antimicrobials in India, Malaysia and Vietnam, although greater price rises seen for analgesics and vitamin C/immune boosters. Appreciable price increases were also seen for PPE across some countries. Conclusion: Encouraging to see increases in utilization of vitamins/immune boosters and PPE. However, increases in the utilization and prices of antimicrobials is a concern that needs addressing alongside misinformation and any unintended consequences from the pandemic. Community pharmacists can play a key role in providing evidence-based advice, helping to moderate prices, as well as helping address some of the unintended consequences of the pandemic.

Matched MeSH terms: Costs and Cost Analysis*
Fulltext Asthma guideline knowledge, adherence and cost of treating asthma at emergency department [Abstract]

Khan AH, Syed Sulaiman A, Hassali AA, Saleem F, Aftab RA, Ali I

Value Health, 2014 Nov;17(7):A725.
PMID: 27202576 DOI: 10.1016/j.jval.2014.08.050

Conference abstract:
Objectives: To evaluate physician’s knowledge and adherence to asthma guideline adherence (GINA 2011) at emergency department of Hospital Pulau Pinang, Malaysia and to calculate cost of adhered and non-adhered prescriptions
Methods: A cross-sectional survey was conducted to evaluate knowledge of GINA, 2011 asthma guideline at emergency department of Hospital Pulau Pinang, Malaysia. A total of 810 patient prescriptions of 27 doctors (30 prescriptions per doctor) were viewed to asses doctor’s guideline adherence. Patients’ prescriptions were categorised in terms of asthma severity as mild, moderate and severe. Prescriptions were labelled as adhered or non-adhered in terms of doctor treatment according to patient asthma severity as recommended by CPG (GINA 2011). Cost of adhered and non-adhered was calculated according to asthma severity.
Results: Twenty two (81.5%) doctor’s had adequate GINA, 2011 asthma guideline knowledge (Mean 16.7, SD ± 1.5). Six hundred and twenty eight (77.5%) patients received guideline (GINA 2011) adhered pharmacotherapy. Six hundred and seventy eight (83.7%) patients asthma were classified as mild asthma, 128 (15.8%) patients were classified as moderate asthma and 4 (0.5%) patients were classified as severe asthma. Pearson correlation indicated no statistical significant association between asthma guideline adherence and asthma guideline knowledge score (p=0.27). Univariate analysis indicate that patients with age group 25-35 years and with hypertension as co-morbidity received significantly better pharmacotherapy (p=0.04, p=0.03 respectively). Total cost of 628 adhered prescriptions was RM 5792.87 whereas cost of 182 non-adhered prescriptions was RM 1759.09. Cost of single mild asthma adhered prescription (RM 9.18) was less as compared to non adhered mild asthma prescription (RM 10.39).
Conclusions: Emergency doctor’s had adequate GINA, 2011 asthma guideline knowledge. Majority of patients received GINA, 2011 asthma guideline adhered pharmacotherapy. Cost effective medication can significantly reduce socioeconomic burden related to asthma.

Matched MeSH terms: Costs and Cost Analysis
Applicability of fluidized bed reactor in recalcitrant compound degradation through advanced oxidation processes: a review

Tisa F, Abdul Raman AA, Wan Daud WMA

J Environ Manage, 2014 Dec 15;146:260-275.
PMID: 25190594 DOI: 10.1016/j.jenvman.2014.07.032

Treatment of industrial waste water (e.g. textile waste water, phenol waste water, pharmaceutical etc) faces limitation in conventional treatment procedures. Advanced oxidation processes (AOPs) do not suffer from the limits of conventional treatment processes and consequently degrade toxic pollutants more efficiently. Complexity is faced in eradicating the restrictions of AOPs such as sludge formation, toxic intermediates formation and high requirement for oxidants. Increased mass-transfer in AOPs is an alternate solution to this problem. AOPs combined with Fluidized bed reactor (FBR) can be a potential choice compared to fixed bed or moving bed reactor, as AOP catalysts life-span last for only maximum of 5-10 cycles. Hence, FBR-AOPs require lesser operational and maintenance cost by reducing material resources. The time required for AOP can be minimized using FBR and also treatable working volume can be increased. FBR-AOP can process from 1 to 10 L of volume which is 10 times more than simple batch reaction. The mass transfer is higher thus the reaction time is lesser. For having increased mass transfer sludge production can be successfully avoided. The review study suggests that, optimum particle size, catalyst to reactor volume ratio, catalyst diameter and liquid or gas velocity is required for efficient FBR-AOP systems. However, FBR-AOPs are still under lab-scale investigation and for industrial application cost study is needed. Cost of FBR-AOPs highly depends on energy density needed and the mechanism of degradation of the pollutant. The cost of waste water treatment containing azo dyes was found to be US$ 50 to US$ 500 per 1000 gallons where, the cost for treating phenol water was US$ 50 to US$ 800 per 1000 gallons. The analysis for FBR-AOP costs has been found to depend on the targeted pollutant, degradation mechanism (zero order, 1st order and 2nd order) and energy consumptions by the AOPs.

Matched MeSH terms: Costs and Cost Analysis
Determination of chest x-ray cost using activity based costing approach at Penang General Hospital, Malaysia

Atif M, Sulaiman SA, Shafie AA, Saleem F, Ahmad N

Pan Afr Med J, 2012;12:40.
PMID: 22891098

Activity based costing (ABC) is an approach to get insight of true costs and to solve accounting problems. It provides more accurate information on product cost than conventional accounting system. The purpose of this study was to identify detailed resource consumption for chest x-ray procedure.

Matched MeSH terms: Costs and Cost Analysis
Fulltext Physician adherence to hypertension treatment guidelines and drug acquisition costs of antihypertensive drugs at the cardiac clinic: a pilot study

Abdulameer SA, Sahib MN, Aziz NA, Hassan Y, Alrazzaq HA, Ismail O

Patient Prefer Adherence, 2012;6:101-8.
PMID: 22346346 DOI: 10.2147/PPA.S27223

Prescribing pattern surveys are one of the pharmacoepidemiological techniques that provide an unbiased picture of prescribing habits. Prescription surveys permit the identification of suboptimal prescribing patterns for further evaluation. The aims of this study were to determine the prescribing trend, adherence of the prescribers to the guideline, and the impact of drug expenditure on drug utilization at the cardiac clinic of Penang Hospital, Malaysia. This was a cross-sectional study. Demographic data of the patients, diagnoses and the drugs prescribed were recorded. The average drug acquisition costs (ADAC) were calculated for each antihypertensive drug class on a daily and annual basis. Adherence to the guideline was calculated as a percentage of the total number of patients. A total of 313 individuals fulfilled the inclusion criteria. The average age of the study population was 59.30 ± 10.35 years. The mean number of drugs per prescription in the study was 2.09 ± 0.78. There were no significant differences in the demographic data. Antihypertensive drugs were used in monotherapy and polytherapy in 20.8% and 79.2% of the patients, respectively. Adherence to the guideline regarding prescription occurred in 85.30% of the patients. The lowest priced drug class was diuretics and the highest was angiotensin-receptor blockers. In conclusion, the total adherence to the guideline was good; the adherence percentage only slightly decreased with a co-existing comorbidity (such as diabetes mellitus). The use of thiazide diuretics was encouraged because they are well tolerated and inexpensive, and perindopril was still prescribed for diabetic patients since it is relatively cheap (generic drug) and its daily dosage is beneficial.

Study site: cardiac clinic of Penang Hospital, Malaysia

Matched MeSH terms: Costs and Cost Analysis
Evaluation of papaya seeds as a novel non-conventional low-cost adsorbent for removal of methylene blue

Hameed BH

J Hazard Mater, 2009 Mar 15;162(2-3):939-44.
PMID: 18606493 DOI: 10.1016/j.jhazmat.2008.05.120

The feasibility of using papaya seeds (PS), abundantly available waste in Malaysia, for the cationic dye (methylene blue) adsorption has been investigated. Batch adsorption studies were conducted to study the effects of contact time, initial concentration (50-360 mg/L), pH (3-10) and adsorbent dose (0.05-1.00 g) on the removal of methylene blue (MB) at temperature of 30 degrees C. The equilibrium data were analyzed by the Langmuir, the Freundlich and the Temkin isotherms. The data fitted well with the Langmuir model with a maximum adsorption capacity of 555.557 mg/g. The pseudo-second-order kinetics was the best for the adsorption of MB by PS with good correlation. The results demonstrated that the PS is very effective to remove methylene blue from aqueous solutions.

Matched MeSH terms: Costs and Cost Analysis
A coordinated research programme to develop methodologies for an integrated approach to improve small scale market oriented dairy systems in developing countries

Perera BM

Trop Anim Health Prod, 2007 Dec;39(8):543-8.
PMID: 18265863

A five-year Coordinated Research Project (CRP) entitled 'Integrated approach for improving small scale market oriented dairy systems' is currently being implemented by the Food and Agriculture Organization and the International Atomic Energy Agency, through their Joint Programme on 'Nuclear Techniques in Food and Agriculture'. The objectives are to (a) identify and prioritize the constraints and opportunities in the selected dairy farms; (b) determine the most important limiting factors; (c) develop intervention strategies; (c) assess the economic impact of the interventions; (d) develop methodologies for recording and demonstrating the economic impact; and (e) promote the adoption and dissemination of proven strategies and methodologies. Fifteen institutes in developing as well as developed countries are participating in the project, through ten research contracts (Bangladesh, Cameroon, Pakistan, Paraguay, Peru, South Africa, Sri Lanka, Tanzania, Tunisia and Venezuela), one technical contract (Peru) and four research agreements (Malaysia, U.K., U.S.A. and Uruguay). The initial phase of the project, which focused on the conduct of Participatory Rural Appraisals and Economic Opportunity Surveys in the countries of the research contract holders, has now been completed. This paper describes the background to the CRP approach and the procedures used for developing, initiating and implementing this project.

Matched MeSH terms: Costs and Cost Analysis
Implementation of the semi-aerobic landfill system (Fukuoka method) in developing countries: a Malaysia cost analysis

Chong TL, Matsufuji Y, Hassan MN

Waste Manag, 2005;25(7):702-11.
PMID: 16009304

Most of the existing solid waste landfill sites in developing countries are practicing either open dumping or controlled dumping. Proper sanitary landfill concepts are not fully implemented due to technological and financial constraints. Implementation of a fully engineered sanitary landfill is necessary and a more economically feasible landfill design is crucial, particularly for developing countries. This study was carried out by focusing on the economics from the development of a new landfill site within a natural clay area with no cost of synthetic liner up to 10 years after its closure by using the Fukuoka method semi-aerobic landfill system. The findings of the study show that for the development of a 15-ha landfill site in Malaysia with an estimated volume of 2,000,000 m(3), the capital investment required was about US 1,312,895 dollars, or about US 0.84 dollars/tonne of waste. Assuming that the lifespan of the landfill is 20 years, the total cost of operation was about US 11,132,536 dollars or US 7.15 dollars/tonne of waste. The closure cost of the landfill was estimated to be US 1,385,526 dollars or US 0.89 dollars/tonne of waste. Therefore, the total cost required to dispose of a tonne of waste at the semi-aerobic landfill was estimated to be US 8.89 dollars. By considering an average tipping fee of about US 7.89 dollars/tonne of waste in Malaysia in the first year, and an annual increase of 3% to about US 13.84 dollars in year-20, the overall system recorded a positive revenue of US 1,734,749 dollars. This is important information for the effort of privatisation of landfill sites in Malaysia, as well as in other developing countries, in order to secure efficient and effective landfill development and management.

Matched MeSH terms: Costs and Cost Analysis
Fulltext Under-recognized pertussis in adults from Asian countries: a cross-sectional seroprevalence study in Malaysia, Taiwan and Thailand

Koh MT, Liu CS, Chiu CH, Boonsawat W, Watanaveeradej V, Abdullah N, et al.

Epidemiol Infect, 2016 Apr;144(6):1192-200.
PMID: 26468043 DOI: 10.1017/S0950268815002393

Surveillance data on the burden of pertussis in Asian adults are limited. This cross-sectional study evaluated the prevalence of serologically confirmed pertussis in adults with prolonged cough in Malaysia, Taiwan and Thailand. Adults (⩾19 years) with cough lasting for ⩾14 days without other known underlying cause were enrolled from outpatient clinics of seven public and/or private hospitals. Single blood samples for anti-pertussis toxin antibodies (anti-PT IgG) were analysed and economic impact and health-related quality of life (EQ-5D) questionnaires assessed. Sixteen (5·13%) of the 312 chronically coughing adults had serological evidence of pertussis infection within the previous 12 months (anti-PT IgG titre ⩾62·5 IU/ml). Three of them were teachers. Longer duration of cough, paroxysms (75% seroconfirmed, 48% non-seroconfirmed) and breathlessness/chest pain (63% seroconfirmed, 36% non-seroconfirmed) were associated with pertussis (P < 0·04). Of the seroconfirmed patients, the median total direct medical cost per pertussis episode in public hospitals (including physician consultations and/or emergency room visits) was US$13 in Malaysia, US$83 in Taiwan (n = 1) and US$26 in Thailand. The overall median EQ-5D index score of cases was 0·72 (range 0·42-1·00). Pertussis should be considered in the aetiology of adults with a prolonged or paroxysmal cough, and vaccination programmes considered.
Study site in Malaysia: Klinik Kesihatan Seremban, Negeri Sembilan; Primary Care Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Costs and Cost Analysis
The Cost of Dengue Vector Control Activities in Malaysia by Different Service Providers

Packierisamy PR, Ng CW, Dahlui M, Venugopalan B, Halasa YA, Shepard DS

Asia Pac J Public Health, 2015 Nov;27(8 Suppl):73S-78S.
PMID: 26047628 DOI: 10.1177/1010539515589339

We examined variations in dengue vector control costs and resource consumption between the District Health Departments (DHDs) and Local Authorities (LAs) to assist informed decision making as to the future roles of these agencies in the delivery of dengue vector control services in Malaysia. Data were collected from the vector control units of DHDs and LAs in 8 selected districts. We captured costs and resource consumption in 2010 for premise inspection for mosquito breeding sites, fogging to destroy adult mosquitoes and larviciding of potential breeding sites. Overall, DHDs spent US$5.62 million or US$679 per case and LAs spent US$2.61 million or US$499 per case. The highest expenditure for both agencies was for fogging, 51.0% and 45.8% of costs for DHDs and LAs, respectively. The DHDs had higher resource costs for human personnel, vehicles, pesticides, and equipment. The findings provide some evidence to rationalize delivery of dengue vector control services in Malaysia.

Matched MeSH terms: Costs and Cost Analysis

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