A randomised, feasibility trial of a tele-health intervention for Acute Coronary Syndrome patients with depression ('MoodCare')

Background Coronary heart disease (CHD) and depression are leading causes of disease burden globally and the two often co-exist. Depression is common after Myocardial Infarction (MI) and it has been estimated that 15-35% of patients experience depressive symptoms. Co-morbid depression can impair health related quality of life (HRQOL), decrease medication adherence and appropriate utilisation of health services, lead to increased morbidity and suicide risk, and is associated with poorer CHD risk factor profiles and reduced survival. We aim to determine the feasibility of conducting a randomised, multi-centre trial designed to compare a tele-health program (MoodCare) for depression and CHD secondary prevention, with Usual Care (UC). Methods Over 1600 patients admitted after index admission for Acute Coronary Syndrome (ACS) are being screened for depression at six metropolitan hospitals in the Australian states of Victoria and Queensland. Consenting participants are then contacted at two weeks post-discharge for baseline assessment. One hundred eligible participants are to be randomised to an intervention or a usual medical care control group (50 per group). The intervention consists of up to 10 × 30-40 minute structured telephone sessions, delivered by registered psychologists, commencing within two weeks of baseline screening. The intervention focuses on depression management, lifestyle factors (physical activity, healthy eating, smoking cessation, alcohol intake), medication adherence and managing co-morbidities. Data collection occurs at baseline (Time 1), 6 months (post-intervention) (Time 2), 12 months (Time 3) and 24 months follow-up for longer term effects (Time 4). We are comparing depression (Cardiac Depression Scale [CDS]) and HRQOL (Short Form-12 [SF-12]) scores between treatment and UC groups, assessing the feasibility of the program through patient acceptability and exploring long term maintenance effects. A cost-effectiveness analysis of the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the government. Discussion This manuscript presents the protocol for a randomised, multi-centre trial to evaluate the feasibility of a tele-based depression management and CHD secondary prevention program for ACS patients. The results of this trial will provide valuable new information about potential psychological and wellbeing benefits, cost-effectiveness and acceptability of an innovative tele-based depression management and secondary prevention program for CHD patients experiencing depression.

It’s about time : investing in transportation to keep Texas economically competitive : Appendices

APPENDIX A : PAVEMENT QUALITY (Zhanmin Zhang, Michael R. Murphy, Robert Harrison), 7 pages -- APPENDIX B : BRIDGE QUALITY (Jose Weissmann, Angela J. Weissmann), 6 pages -- APPENDIX C : URBAN TRAFFIC CONGESTION (Tim Lomax, David Schrank), 32 pages -- APPENDIX D: RURAL CORRIDORS (Tim Lomax, David Schrank), 6 pages -- APPENDIX E: ADDITIONAL REVENUE SOURCE OPTIONS FOR PAVEMENT AND BRIDGE MAINTENANCE (Mike Murphy, Seokho Chi, Randy Machemehl, Khali Persad, Robert Harrison, Zhanmin Zhang), 81 pages -- APPENDIX F: FUNDING TRANSPORTATION IMPROVEMENTS (David Ellis, Brianne Glover, Nick Norboge, Wally Crittenden), 19 pages -- APPENDIX G: ESTIMATING VEHICLE OPERATING COSTS AND PAVEMENT DETERIORATION (by Robert Harrison), 4 pages

Maintenance test section survey : data collection and analysis

A Maintenance Test Section Survey (MTSS) was conducted as part of a Peer State Review of the Texas Maintenance Program conducted October 5–7, 2010. The purpose of the MTSS was to conduct a field review of 34 highway test sections and obtain participants’ opinions about pavement, roadside, and maintenance conditions. The goal was to cross reference or benchmark TxDOT’s maintenance practices based on practices used by selected peer states. Representatives from six peer states (California, Georgia, Kansas, Missouri, North Carolina, and Washington) were invited to Austin to attend a 3-day Peer State Review of TxDOT Maintenance Practices Workshop and to participate in a field survey of a number of pre-selected one-mile roadway sections. It should be emphasized that the objective of the survey was not to evaluate and grade or score TxDOT’s road network but rather to determine whether the selected roadway sections met acceptable standards of service as perceived by Directors of Maintenance or senior maintenance managers from the peer states...

The health and cost implications of high body mass index in Australian Defence Force personnel.

BACKGROUND: Frequent illness and injury among workers with high body mass index (BMI) can raise the costs of employee healthcare and reduce workforce maintenance and productivity. These issues are particularly important in vocational settings such as the military, which require good physical health, regular attendance and teamwork to operate efficiently. The purpose of this study was to compare the incidence of injury and illness, absenteeism, productivity, healthcare usage and administrative outcomes among Australian Defence Force personnel with varying BMI. METHODS: Personnel were grouped into cohorts according to the following ranges for (BMI): normal (18.5-24.9 kg/m²; n = 197), overweight (25-29.9 kg/m²; n = 154) and obese (≥30 kg/m²) with restricted body fat (≤28 % for females, ≤24 % for males) (n = 148) and with no restriction on body fat (n = 180). Medical records for each individual were audited retrospectively to record the incidence of injury and illness, absenteeism, productivity, healthcare usage (i.e., consultation with medical specialists, hospital stays, medical investigations, prescriptions) and administrative outcomes (e.g., discharge from service) over one year. These data were then grouped and compared between the cohorts. RESULTS: The prevalence of injury and illness, cost of medical specialist consultations and cost of medical scans were all higher (p <0.05) in both obese cohorts compared with the normal cohort. The estimated productivity losses from restricted work days were also higher (p <0.05) in the obese cohort with no restriction on body fat compared with the normal cohort. Within the obese cohort, the prevalence of injury and illness, healthcare usage and productivity were not significantly greater in the obese cohort with no restriction on body fat compared with the cohort with restricted body fat. The number of restricted work days, the rate of re-classification of Medical Employment Classification and the rate of discharge from service were similar between all four cohorts. CONCLUSIONS: High BMI in the military increases healthcare usage, but does not disrupt workforce maintenance. The greater prevalence of injury and illness, greater healthcare usage and lower productivity in obese Australian Defence Force personnel is not related to higher levels of body fat.

Practice and Procedure: UCPR r 708 - costs order against several defendants and third party

Glenwood Homes Pty Ltd v Everhard [2008] QSC 192 involved the not uncommon situation where one costs order is made against several parties represented by a single firm of solicitors. Dutney J considered the implications when only some of the parties liable for the payment of the costs file a notice of objection to the costs statement served in respect of those costs.

Remote, rural, and regional airports in Australia

This paper provides an overview of the challenges faced by remote, rural and regional airports in Australia. The deregulation of airports over the past decades has resulted in local councils owning most of the rural and regional airports across Australia. The paper provides an overview of the international literature on regional airports and research directed at defining the issues faced by regional and rural airports in Australia. A survey of airport managers, regulators and local councils was undertaken across Australia to outline the challenges and stresses that regional airports are facing. Core findings indicate that the operation of rural and regional airports is under stress due to the interrelating factors of infrastructure costs, high cost of maintenance, and security infrastructure upgrades. Small airports often compete with one another to attract airlines and maintain their infrastructure advantage.

Maintenance optimisation of a multi-state series-parallel system considering economic dependence and state-dependent inspection intervals

This paper presents a maintenance optimisation method for a multi-state series-parallel system considering economic dependence and state-dependent inspection intervals. The objective function considered in the paper is the average revenue per unit time calculated based on the semi-regenerative theory and the universal generating function (UGF). A new algorithm using the stochastic ordering is also developed in this paper to reduce the search space of maintenance strategies and to enhance the efficiency of optimisation algorithms. A numerical simulation is presented in the study to evaluate the efficiency of the proposed maintenance strategy and optimisation algorithms. The simulation result reveals that maintenance strategies with opportunistic maintenance and state-dependent inspection intervals are more cost-effective when the influence of economic dependence and inspection cost is significant. The study further demonstrates that the optimisation algorithm proposed in this paper has higher computational efficiency than the commonly employed heuristic algorithms.

Determinants of health costs due to farmers’ exposure to pesticides: an empirical analysis

Pesticide spraying by farmers has an adverse impact on their health. However, in studies to date examining farmers’ exposure to pesticides, the costs of ill health and their determinants have been based on information provided by farmers themselves. Some doubt has therefore been cast on the reliability of these estimates. In this study, we address this by conducting surveys among two groups of farmers who use pesticides on a regular basis. The first group is made up of farmers who perceive that their ill health is due to exposure to pesticides and have obtained at least some form of treatment (described in this article as the ‘general farmer group’). The second group is composed of farmers whose ill health has been diagnosed by doctors and who have been treated in hospital for exposure to pesticides (described here as the ‘hospitalised farmer group’). Cost comparisons are made between the two groups of farmers. Regression analysis of the determinants of health costs show that the most important determinants of medical costs for both samples are the defensive expenditure, the quantity of pesticides used per acre per month, frequency of pesticide use and number of pesticides used per hour per day. The results have important policy implications.

Interactions and consequences of inertia and switching costs

Purpose: Service research typically relates switching costs to customer loyalty, and portrays them as effective switching deterrents that engender harmful word-of-mouth (WOM). Rather than to customer loyalty, this paper aims to relate switching costs to consumer inertia, and show that while switching costs may result in customer retention, they can engender positive and negative WOM. This depends on whether the inertia stems from satisfaction or indifference. Design/methodology/approach: A mall-intercept survey investigated 518 customers' perceptions of their mobile phone service providers. Structural equation modelling fitted the data to the conceptual model. Findings: Switching costs deterred switching and engendered negative WOM, but only with low-inertia customers. With high-inertia customers, retention and WOM behaviours depended on whether the inertia stemmed from satisfaction or indifference. Satisfied customers with high switching costs tended to stay, gave more positive and less negative WOM. With indifferent customers, switching costs were unrelated to retention or WOM behaviours. Research limitations/implications: While they may be perceived negatively, switching costs can engender PWOM. Hence, research should not consider switching costs alone without considering the context that produces them. Practical implications: Service providers should segment their customers into low-inertia, high-inertia/satisfied and high-inertia/indifferent, and target each segment differently. By converting customers into the high-inertia/satisfied segment, service providers can make the best use of switching costs – not only in the traditional sense as a barrier to defection, but also as a way of generating positive WOM. Originality/value: This study is the first to consider the role of inertia with switching costs, positive WOM, and negative WOM. The findings suggest that past studies portraying switching costs as negative impediments that evoke only negative WOM might be misleading.

A flexible asset maintenance decision-making process model

Optimal Asset Maintenance decisions are imperative for efficient asset management. Decision Support Systems are often used to help asset managers make maintenance decisions, but high quality decision support must be based on sound decision-making principles. For long-lived assets, a successful Asset Maintenance decision-making process must effectively handle multiple time scales. For example, high-level strategic plans are normally made for periods of years, while daily operational decisions may need to be made within a space of mere minutes. When making strategic decisions, one usually has the luxury of time to explore alternatives, whereas routine operational decisions must often be made with no time for contemplation. In this paper, we present an innovative, flexible decision-making process model which distinguishes meta-level decision making, i.e., deciding how to make decisions, from the information gathering and analysis steps required to make the decisions themselves. The new model can accommodate various decision types. Three industrial case studies are given to demonstrate its applicability.

Optimising preventive maintenance strategy for production Lines

Preventive Maintenance (PM) is often applied to improve the reliability of production lines. A Split System Approach (SSA) based methodology is presented to assist in making optimal PM decisions for serial production lines. The methodology treats a production line as a complex series system with multiple (imperfect) PM actions over multiple intervals. The conditional and overall reliability of the entire production line over these multiple PM intervals are hierarchically calculated using SSA, and provide a foundation for cost analysis. Both risk-related cost and maintenance-related cost are factored into the methodology as either deterministic or random variables. This SSA based methodology enables Asset Management (AM) decisions to be optimised considering a variety of factors including failure probability, failure cost, maintenance cost, PM performance, and the type of PM strategy. The application of this new methodology and an evaluation of the effects of these factors on PM decisions are demonstrated using an example. The results of this work show that the performance of a PM strategy can be measured by its Total Expected Cost Index (TECI). The optimal PM interval is dependent on TECI, PM performance and types of PM strategies. These factors are interrelated. Generally, it was found that a trade-off between reliability and the number of PM actions needs to be made so that one can minimise Total Expected Cost (TEC) for asset maintenance.

Federal Court Rules O23 r 11 - offers of compromise - offer for dismissal of claim and to forego recovery of costs.

In Uniline Australia Ltd ACN 010752057 v S Briggs Pty Ltd ACN 007415518 (No 2) [2009] FCA 920 Greenwood J considered a number of principles guiding the exercise of discretion in relation to costs, particularly when offers of compromise have been made under the formal process provided by the Federal Court Rules.

Efficient route update and maintenance processes for multipath routing in large-scale industrial wireless sensor networks

Reliable communications is one of the major concerns in wireless sensor networks (WSNs). Multipath routing is an effective way to improve communication reliability in WSNs. However, most of existing multipath routing protocols for sensor networks are reactive and require dynamic route discovery. If there are many sensor nodes from a source to a destination, the route discovery process will create a long end-to-end transmission delay, which causes difficulties in some time-critical applications. To overcome this difficulty, the efficient route update and maintenance processes are proposed in this paper. It aims to limit the amount of routing overhead with two-tier routing architecture and introduce the combination of piggyback and trigger update to replace the periodic update process, which is the main source of unnecessary routing overhead. Simulations are carried out to demonstrate the effectiveness of the proposed processes in improvement of total amount of routing overhead over existing popular routing protocols.

Full circle on costs

This article considers the implications of the decision in Paroz v Clifford Gouldson Lawyers [2012] QDC 151, which examined provisions of the Legal Profession Act 2007 (Qld) dealing with costs disclosure and assessment, and also considered associated provisions of the Uniform Civil Procedure Rules 1999 (Qld).