Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals

Background/objectives This study estimates the economic outcomes of a nutrition intervention to at-risk patients compared with standard care in the prevention of pressure ulcer. Subjects/methods Statistical models were developed to predict ‘cases of pressure ulcer avoided’, ‘number of bed days gained’ and ‘change to economic costs’ in public hospitals in 2002–2003 in Queensland, Australia. Input parameters were specified and appropriate probability distributions fitted for: number of discharges per annum; incidence rate for pressure ulcer; independent effect of pressure ulcer on length of stay; cost of a bed day; change in risk in developing a pressure ulcer associated with nutrition support; annual cost of the provision of a nutrition support intervention for at-risk patients. A total of 1000 random re-samples were made and the results expressed as output probability distributions. Results The model predicts a mean 2896 (s.d. 632) cases of pressure ulcer avoided; 12 397 (s.d. 4491) bed days released and corresponding mean economic cost saving of euros 2 869 526 (s.d. 2 078 715) with a nutrition support intervention, compared with standard care. Conclusion Nutrition intervention is predicted to be a cost-effective approach in the prevention of pressure ulcer in at-risk patients.

Cost-effectiveness analysis of a kidney and cardiovascular disease treatment program in an Australian Aboriginal population

The objective of the study was to assess, from a health service perspective, whether a systematic program to modify kidney and cardiovascular disease reduced the costs of treating end-stage kidney failure. The participants in the study were 1,800 aboriginal adults with hypertension, diabetes with microalbuminuria or overt albuminuria, and overt albuminuria, living on two islands in the Northern Territory of Australia during 1995 to 2000. Perindopril was the primary treatment agent, and other medications were also used to control blood pressure. Control of glucose and lipid levels were attempted, and health education was offered. Evaluation of program resource use and costs for follow-up periods was done at 3 and 4.7 years. On an intention-to-treat basis, the number of dialysis starts and dialysis-years avoided were estimated by comparing the fate of the treatment group with that of historical control subjects, matched for disease severity, who were followed in the before the treatment program began. For the first three years, an estimated 11.6 person-years of dialysis were avoided, and over 4.7 years, 27.7 person-years of dialysis were avoided. The net cost of the program was 1,210 dollars more per person per year than status quo care, and dialyses avoided gave net savings of 1.0 million dollars at 3 years and 3.4 million dollars at 4.6 years. The treatment program provided significant health benefit and impressive cost savings in dialysis avoided.

Managing the production of a Cochrane systematic review

Undertaking a Cochrane systematic review can be an incredibly rewarding experience. It is however a challenging and time-consuming task. The Cochrane Handbook for Systematic Reviews of Interventions1 provides an essential resource to help reviewers navigate the often complex methodological issues of systematic review research. Additional guidelines have been developed for those undertaking reviews of public health topics,2 and Cochrane Centres throughout the world offer invaluable training opportunities. This emphasis on training and methodological rigour has helped Cochrane reviews become one of the most respected sources of synthesized research available. Even with the assistance available, however, many authors with good intentions register titles and prepare protocols but fail to publish the completed review. Data extracted from Cochrane’s Information Management System (Archie) in June 2010 showed that there were 1,301 titles registered more than two years ago that have not been published as a full review.3 Of these registered titles, 697 have had protocols published (25 are no longer active) while 604 have not even progressed to this stage (154 are no longer active). There are also 146 protocols that have been published for more than two years without being converted into completed reviews. These registered titles and protocols that have not yet progressed to a completed review represent a significant amount of time and energy invested by review authors, Cochrane editorial staff and, in some cases, external referees...

A cost-outcome description of the septic work-up for bacterial infection in neonates in a tertiary care hospital

Analysis of the septic work-up of 194 neonates at Women's College Hospital, Toronto, showed that the only antepartum condition predicting neonatal sepsis was the mother being on antibiotics. The only postnatal condition predicting sepsis was a maternal postpartum white blood cell count over 11,000. The average cost for tests for a septic work-up in these 194 mother-neonate pairs was $71.48 (Canadian dollars), and the average cost of tests to find a septic case was $1,066.77.

Exploring the Pro-Am interface between production and produsage

This conference celebrates the passing of 40 years since the establishment of the Internet (dating this, presumably, to the first connection between two nodes on ARPANET in October 1969). For a gathering of media scholars such as this, however, it may be just as important not only to mark the first testing of the core technologies upon which much of our present-day Net continues to build, but also to reflect on another recent milestone: the 20th anniversary of what is today arguably the chief interface through which billions around the world access and experience the Internet – the World Wide Web, launched by Tim Berners-Lee in 1989.

Impact fees and new housing cost: A comparative analysis of the empirical models

Developers and policy makers are consistently at odds over the debate as to whether impact fees increase house prices. This debate continues despite the extensive body of theoretical and empirical international literature that discusses the passing on to home buyers of impact fees, and the corresponding increase to housing prices. In attempting to quantify this impact, over a dozen empirical studies have been carried out in the US and Canada since the 1980’s. However the methodologies used vary greatly, as do the results. Despite similar infrastructure funding policies in numerous developed countries, no such empirical works exist outside of the US/Canada. The purpose of this research is to analyse the existing econometric models in order to identify, compare and contrast the theoretical bases, methodologies, key assumptions and findings of each. This research will assist in identifying if further model development is required and/or whether any of these models have external validity and are readily transferable outside of the US. The findings conclude that there is very little explicit rationale behind the various model selections and that significant model deficiencies appear still to exist.

The potential for ethanol production from sugarcane in Australia

The Australian sugar industry processes approximately 35 million tonnes of sugarcane per year from 400 000 hectares of land. Sugar remains the principal revenue stream from sugarcane in Australia with less than 60 ML/y of fuel ethanol produced from final molasses at present. Modelling has been undertaken to estimate the potential ethanol production from the Australian sugar industry for integrated facilities producing both sugar and ethanol from the entire sugarcane resource. Although research aimed at developing commercial processes is ongoing, the use of a proportion of the bagasse and trash for ethanol production, in addition to juice and molasses fermentation, would allow significant increases in the scale of ethanol production from sugarcane in Australia, increasing total industry revenues while maintaining energy self sufficiency.

Benefit cost analysis applied to behavioral and engineering safety countermeasures in San Francisco, California

The state of the practice in safety has advanced rapidly in recent years with the emergence of new tools and processes for improving selection of the most cost-effective safety countermeasures. However, many challenges prevent fair and objective comparisons of countermeasures applied across safety disciplines (e.g. engineering, emergency services, and behavioral measures). These countermeasures operate at different spatial scales, are funded often by different financial sources and agencies, and have associated costs and benefits that are difficult to estimate. This research proposes a methodology by which both behavioral and engineering safety investments are considered and compared in a specific local context. The methodology involves a multi-stage process that enables the analyst to select countermeasures that yield high benefits to costs, are targeted for a particular project, and that may involve costs and benefits that accrue over varying spatial and temporal scales. The methodology is illustrated using a case study from the Geary Boulevard Corridor in San Francisco, California. The case study illustrates that: 1) The methodology enables the identification and assessment of a wide range of safety investment types at the project level; 2) The nature of crash histories lend themselves to the selection of both behavioral and engineering investments, requiring cooperation across agencies; and 3) The results of the cost-benefit analysis are highly sensitive to cost and benefit assumptions, and thus listing and justification of all assumptions is required. It is recommended that a sensitivity analyses be conducted when there is large uncertainty surrounding cost and benefit assumptions.

High rise residential building quality : residents satisfaction survey

It is widely recognized that the quality of design is crucial to the success of the construction or production process and fairly minor changes in design can often result in giving major effects on the cost and efficiency of production and construction as well as on the usefulness, constructability and marketability of the product especially in developing high rise residential property development. The purpose of this study is to suggest a framework model for property manager, considering the sustainable and building quality of property development in high rise residential complex. This paper evaluates and ranks the importance, and frequency of the building quality factors that affect the sustainability and comfort of living for the resident in the selected high rise residential complex in Malaysia. A total of 500 respondents consisting of 20 property managers participated in this study. The respondents were asked to indicate how important each of building equipments in giving them the comfort of living in the selected high rise residential complex. The data were then subjected to the calculation of important indices which enabled the factors to be ranked. After that, a framework model will be developed to make sure all property managers will be guided to prepare their property for the resident to stay in the complex. Accordingly, the living satisfaction by the framework model plays a meaningful role in preparing and developing sustainable and good building quality in Malaysia high rise residential complex.

An assessment for cost effective maintenance and operation of the Callide Power Station electrical system, using reliability evaluation

The reliable operation of the electrical system at Callide Power Station is of extreme importance to the normal everyday running of the Station. This study applied the principles of reliability to do an analysis on the electrical system at Callide Power Station. It was found that the level of expected outage cost increased exponentially with a declining level of maintenance. Concluding that even in a harsh economic electricity market where CS Energy tries and push their plants to the limit, maintenance must not be neglected. A number of system configurations were found to increase the reliability of the system and reduce the expected outage costs. A number of other advantages were identified as a result of using reliability principles to do this study on the Callide electrical system configuration.

"Who Are You" by DeepBlue Orchestra - Production of Recordings

The development and recording of 10 songs for a CD to accompany DeepBlue's new live orchestra production "Who Are You" which began touring Australia and Asia in 2012.

MAVwork : a framework for unified interfacing between micro aerial vehicles and visual controllers

Debugging control software for Micro Aerial Vehicles (MAV) can be risky out of the simulator, especially with professional drones that might harm people around or result in a high bill after a crash. We have designed a framework that enables a software application to communicate with multiple MAVs from a single unified interface. In this way, visual controllers can be first tested on a low-cost harmless MAV and, after safety is guaranteed, they can be moved to the production MAV at no additional cost. The framework is based on a distributed architecture over a network. This allows multiple configurations, like drone swarms or parallel processing of drones' video streams. Live tests have been performed and the results show comparatively low additional communication delays, while adding new functionalities and flexibility. This implementation is open-source and can be downloaded from github.com/uavster/mavwork

From ABCs to ADHD : the role of schooling the construction of behaviour disorder and the production of disorderly objects

Discussion of Attention-Deficit/Hyperactivity Disorder (ADHD) in the media, and thus much popular discourse, typically revolves around the possible causes of disruptive behaviour and the “behaviourally disordered” child. The usual suspects - too much television and video games, food additives, bad parenting, lack of discipline and single mothers – feature prominently as potential contributors to the spiralling rate of ADHD diagnosis in Western industrialised nations, especially the United States and Australia. Conspicuously absent from the field of investigation, however, is the scene of schooling and the influence that the discourses and practices of schooling might bring to bear upon the constitution of “disorderly behaviour” and subsequent recognition of particular children as a particular kind of “disorderly”. This paper reviews a sample of the literature surrounding ADHD, in order to question the function of this absence and, ultimately, make an argument for an interrogation of the school as a site for the production of disorderly objects.