Can social dancing prevent falls in older adults? a protocol of the Dance, Aging, Cognition,Economics (DAnCE) fall prevention randomised controlled trial

Background:  Falls are one of the most common health problems among older people and pose a major economic burden on health care systems. Exercise is an accepted stand-alone fall prevention strategy particularly if it is balance training or regular participation in Tai chi. Dance shares the ‘holistic’ approach of practices such as Tai chi. It is a complex sensorimotor rhythmic activity integrating multiple physical, cognitive and social elements. Small-scale randomised controlled trials have indicated that diverse dance styles can improve measures of balance and mobility in older people, but none of these studies has examined the effect of dance on falls or cognition. This study aims to determine whether participation in social dancing: i) reduces the number of falls; and ii) improves cognitive functions associated with fall risk in older people.

Methods/design: A single-blind, cluster randomised controlled trial of 12 months duration will be conducted. Approximately 450 participants will be recruited from 24 self-care retirement villages that house at least 60 residents each in Sydney, Australia. Village residents without cognitive impairment and obtain medical clearance will be eligible. After comprehensive baseline measurements including physiological and cognitive tests and self-completed questionnaires, villages will be randomised to intervention sites (ballroom or folk dance) or to a wait-listed control using a computer randomisation method that minimises imbalances between villages based on two baseline fall risk measures. Main outcome measures are falls, prospectively measured, and the Trail Making cognitive function test. Cost-effectiveness and cost-utility analyses will be performed.

Discussion: This study offers a novel approach to balance training for older people. As a community-based approach to fall prevention, dance offers older people an opportunity for greater social engagement, thereby making a major contribution to healthy ageing. Providing diversity in exercise programs targeting seniors recognises the heterogeneity of multicultural populations and may further increase the number of taking part in exercise.

Decision-Making in Economics: Critical Lessons from Neurobiology

In this chapter, the authors consider some of the issues regarding the rational choice decision framework in neoclassical economics and how it can particularly be found wanting in the absence of due consideration for some of the underlying critical neurobiological factors which govern decision making. They develop a critical decision problem and explore the scenario where the solution predicted by formal economic theory may be in conflict with the decision that actually occurs. Such conflict is especially relevant in the context of economic decision making in emerging markets where there can be a lack of trust in the system by the agents operating within it. Based on logically consistent arguments derived from the extant literature, the authors argue that non-consideration of underlying neurobiological factors is a direct cause of this conflict.

Cost planning and control : case study of design economics for constructability and prefabrication construction

Cost management includes planning and control, and constructability1 and prefabrication construction are two main design economics factors for early cost planning decision. Despite the fact that constructability and prefabrication have been considered in design and cost planning, there is no guarantee if the intention meets the expectation. This requires on-going control during construction stage. In fact, prefabrication construction has been encouraged for some years, application is not always positive. One of the reasons is its constructability. This paper investigates the appropriate research methodology to determine how design for prefabrication and constructability will contribute to cost planning through control and review during construction stage. Through a study of an Australian residential project using prefabrication in structural concrete, internal partitioning and internal fit-out, this research concludes that case study is a viable choice. Prefabrication construction does provide a positive impact on the major project objectives: time, cost and quality. Cost reduction is due to saving in time related preliminaries as a direct result of time reduction of onsite activities whilst quality is ensured due to better control of prefabricated components inside the factories. However, it can only be achieved after considering constructability: suitable materials choice, design for available skills, use of available plant, and clear communication. The keys are through plan at design phase and control in construction stage.

Essays on the economics of natural disasters and political institutions

This thesis examines how natural disasters—earthquakes, floods and storms—affect democracy by altering economic outcomes. The results indicate that earthquakes and floods improve the level of democracy, while storms lead to non-democratic transitions, particularly in island countries.

Essays in political and development economics

 This research analyses the role of terrain ruggedness and elite domination as obstacles undermining the cooperation and cohesiveness of groups in societies. Specifically, terrain ruggedness hinders state capacity development and fiscal decentralisation could mitigate this negative effect. Additionally, it proves the role of elites in the selection of economic policies.

Applied econometrics and implications for energy economics research

Developments in applied econometrics, particularly with regard to unit root tests and cointegration tests, have motivated a rich empirical literature on energy economics over the last decade. This study reviews recent developments in time series econometrics applications in the energy economics literature. We first consider the literature on the integration properties of energy variables. We begin with a discussion of the implications of whether energy variables contain a unit root and proceed to examine how results differ according to the specific unit root or stationarity test employed. We then proceed to examine recent developments in the literature on cointegration, Granger causality and long-run estimates between (disaggregated) energy consumption and economic growth. We review both single country and panel studies and pay particular attention to studies which have expanded the literature through adding variables such as financial development and trade, in addition to energy consumption to the augmented production function, as well as studies which have extended the literature through examining disaggregated energy consumption by type. In each case we highlight best practice in the literature, point to limitations in the literature, including econometric modeling challenges, and suggest recommendations for future research. A key message of our survey is that the profession needs to guard against 'overload' of research in these areas as most applied studies are no longer adding anything more to what is already known. © 2014 Elsevier B.V. All rights reserved.

Mental health care system optimization from a health-economics perspective: where to sow and where to reap?

Health care expenditure (as % of GDP) has been rising in all OECD countries over the last decades. Now, in the context of the economic downturn, there is an even more pressing need to better guarantee the sustainability of health care systems. This requires that policy makers are informed about optimal allocation of budgets. We take the Dutch mental health system in the primary care setting as an example of new ways to approach optimal allocation.