How costs change with infection prevention efforts

Purpose of review: To describe articles since January 2013 that include information on how costs change with infection prevention efforts. Recent findings: Three articles described only the costs imposed by nosocomial infection and so provided limited information about whether or not infection prevention efforts should be changed. One article was found that described the costs of supplying alcohol-based hand run in low-income countries. Eight articles showed the extra costs and cost savings from changing infection prevention programmes and discussed the health benefits. All concluded that the changes are economically worthwhile. There was a systematic review of the costs of methicillin-resistant Staphylococcus aureus control programmes and a methods article for how to make cost estimates for infection prevention programmes. Summary: The balance has shifted away from studies that report the high cost of nosocomial infections toward articles that address the value for money of infection prevention. This is good as simply showing a disease is high cost does not inform decisions to reduce it. More research, done well, on the costs of implementation, cost savings and change to health benefits in this area needs to be done as many gaps exist in our knowledge.

Applying design-led innovation in a not-for-profit aged care provider to create shared value

This study examines the role of Design-Led Innovation in creating shared value; sustainable competitive advantage for an organisation and social value for the communities in which it operates. A case study analysed an undertaking by a not-for-profit aged care organisation to create a sustainable competitive advantage in the market by reinventing the experience of ageing and defining an innovative future business model. This paper reflects on the role of Design-Led Innovation in facilitating this change agenda and explores the particular relevance of the associated techniques in a not-for-profit, human services context. It was found that the Design-Led Innovation approach was effective in achieving the goal of defining a way for the organisation to create shared value.

Making robust decisions for conservation with restricted money and knowledge

1. In conservation decision-making, we operate within the confines of limited funding. Furthermore, we often assume particular relationships between management impact and our investment in management. The structure of these relationships, however, is rarely known with certainty - there is model uncertainty. We investigate how these two fundamentally limiting factors in conservation management, money and knowledge, impact optimal decision-making. 2. We use information-gap decision theory to find strategies for maximizing the number of extant subpopulations of a threatened species that are most immune to failure due to model uncertainty. We thus find a robust framework for exploring optimal decision-making. 3. The performance of every strategy decreases as model uncertainty increases. 4. The strategy most robust to model uncertainty depends not only on what performance is perceived to be acceptable but also on available funding and the time horizon over which extinction is considered. 5. Synthesis and applications. We investigate the impact of model uncertainty on robust decision-making in conservation and how this is affected by available conservation funding. We show that subpopulation triage can be a natural consequence of robust decision-making. We highlight the need for managers to consider triage not as merely giving up, but as a tool for ensuring species persistence in light of the urgency of most conservation requirements, uncertainty and the poor state of conservation funding. We illustrate this theory by a specific application to allocation of funding to reduce poaching impact on the Sumatran tiger Panthera tigris sumatrae in Kerinci Seblat National Park. © 2008 The Authors.

Conceptual beliefs about human values and their implications: Human nature beliefs predict value importance, value trade-offs, and responses to value-laden rhetoric

Beliefs that may underlie the importance of human values were investigated in 4 studies, drawing on research that distinguishes natural-kind (natural), nominal-kind (conventional), and artifact (functional) beliefs. Values were best characterized by artifact and nominal-kind beliefs, as well as a natural-kind belief specific to the social domain, “human nature” (Studies 1 and 2). The extent to which values were considered central to human nature was associated with value importance in both Australia and Japan (Study 2), and experimentally manipulating human nature beliefs influenced value importance (Study 3). Beyond their association with importance, human nature beliefs predicted participants’ reactions to value trade-offs (Study 1) and to value-laden rhetorical statements (Study 4). Human nature beliefs therefore play a central role in the psychology of values.

Working as one: A road map to disaster resilience for Australia

Natural disasters cause widespread disruption, costing the Australian economy $6.3 billion per year, and those costs are projected to rise incrementally to $23 billion by 2050. With more frequent natural disasters with greater consequences, Australian communities need the ability to prepare and plan for them, absorb and recover from them, and adapt more successfully to their effects. Enhancing Australian resilience will allow us to better anticipate disasters and assist in planning to reduce losses, rather than just waiting for the next king hit and paying for it afterwards. Given the scale of devastation, governments have been quick to pick up the pieces when major natural disasters hit. But this approach (‘The government will give you taxpayers’ money regardless of what you did to help yourself, and we’ll help you rebuild in the same risky area.’) has created a culture of dependence. This is unsustainable and costly. In 2008, ASPI published Taking a punch: building a more resilient Australia. That report emphasised the importance of strong leadership and coordination in disaster resilience policymaking, as well as the value of volunteers and family and individual preparation, in managing the effects of major disasters. This report offers a roadmap for enhancing Australia’s disaster resilience, building on the 2011 National Strategy for Disaster Resilience. It includes a snapshot of relevant issues and current resilience efforts in Australia, outlining key challenges and opportunities. The report sets out 11 recommendations to help guide Australia towards increasing national resilience, from individuals and local communities through to state and federal agencies.

Product stability and sequestration mechanisms in Solanum tuberosum engineered to biosynthesize high value ketocarotenoids

To produce commercially valuable ketocarotenoids in Solanum tuberosum, the 4, 4′ β-oxygenase (crtW) and 3, 3′ β-hydroxylase (crtZ) genes from Brevundimonas spp. have been expressed in the plant host under constitutive transcriptional control. The CRTW and CRTZ enzymes are capable of modifying endogenous plant carotenoids to form a range of hydroxylated and ketolated derivatives. The host (cv. Désirée) produced significant levels of nonendogenous carotenoid products in all tissues, but at the apparent expense of the economically critical metabolite, starch. Carotenoid levels increased in both wild-type and transgenic tubers following cold storage; however, stability during heat processing varied between compounds. Subcellular fractionation of leaf tissues revealed the presence of ketocarotenoids in thylakoid membranes, but not predominantly in the photosynthetic complexes. A dramatic increase in the carotenoid content of plastoglobuli was determined. These findings were corroborated by microscopic analysis of chloroplasts. In tuber tissues, esterified carotenoids, representing 13% of the total pigment found in wild-type extracts, were sequestered in plastoglobuli. In the transgenic tubers, this proportion increased to 45%, with esterified nonendogenous carotenoids in place of endogenous compounds. Conversely, nonesterified carotenoids in both wild-type and transgenic tuber tissues were associated with amyloplast membranes and starch granules.

Corporate-cooperative management of fisheries: A potential alternative governance structure for low value small fisheries?

While the economic and environmental benefits of fisheries management are well accepted, the costs of effective management in low value fisheries, including the research necessary to underpin such management, may be considerable relative to the total economic benefits they may generate. Co-management is often seen as a panacea in low value fisheries. Increasing fisher participation increases legitimacy of management decision in the absence of detailed scientific input. However, where only a small number of operators exist, the potential benefits of co-management are negated by the high transaction cost to the individual fishers engaging in the management process. From an economic perspective, sole ownership has been identified as the management structure which can best achieve biological and economic sustainability. Moving low value fisheries with a small number of participants to a corporate-cooperative management model may come close to achieving these sole ownership benefits, with lower transaction costs. In this paper we look at the applicability of different management models with industry involvement to low value fisheries with a small number of participants. We provide an illustration as to how a fishery could be transitioned to a corporate-cooperative management model that captures the key benefits of sole management at a low cost and is consistent with societal objectives.

Public private partnership infrastructure delivery: Benefits and costs for society

This research provides additional knowledge on the benefits and costs to society, in particular of road transport procured through Public-Private Partnership (PPP) arrangements. Currently, the public sector comparator (PSC) and cost-benefit analysis (CBA) used to evaluate and measure the benefits and costs of PPP are limited in their capacity to predict and forecast long-term events. PPP is attractive to governments due to the non-upfront payment, perceived value for money, and risk allocation and transfer to the private investor. However, public sector remains the guarantor, and under-writer of the private investor's loan from financial institutions and other voluntary risks which are unlimited to future compensatory claims. The new knowledge from this research is the introduction of a framework capable of evaluating, and measuring the associated PPP benefits, as well as the costs, effects, and impacts to society which are protracted and sporadic by nature.

Can counseling add value to an exercise intervention for improving quality of life in breast cancer survivors? A feasibility study

Background: Improved survivorship has led to increased recognition of the need to manage the side effects of cancer and its treatment. Exercise and psychological interventions benefit survivors; however, it is unknown if additional benefits can be gained by combining these two modalities. Objective: Our purpose was to examine the feasibility of delivering an exercise and counseling intervention to 43 breast cancer survivors, to determine if counseling can add value to an exercise intervention for improving quality of life (QOL) in terms of physical and psychological function. Methods: We compared exercise only (Ex), counseling only (C), exercise and counseling (ExC), and usual care (UsC) over an 8 week intervention. Results: In all, 93% of participants completed the interventions, with no adverse effects documented. There were significant improvements in VO2max as well as upper body and lower body strength in the ExC and Ex groups compared to the C and UsC groups (P < .05). Significant improvements on the Beck Depression Inventory were observed in the ExC and Ex groups, compared with UsC (P < .04), with significant reduction in fatigue for the ExC group, compared with UsC, and no significant differences in QOL change between groups, although the ExC group had significant clinical improvement. Limitations: Limitations included small subject number and study of only breast cancer survivors. Conclusions: These preliminary results suggest that a combined exercise and psychological counseling program is both feasible and acceptable for breast cancer survivors and may improve QOL more than would a single-entity intervention.

What do most Americans think of cost-effectiveness research in health care?

My impression is that explicit data on the cost-effectiveness of different health care services are not valued highly by US policy makers. An example is a recent decision to approve ipilimumab for the treatment of metastatic melanoma. The extra health benefit over standard treatment is 2.1 months in previously untreated patients and the cost is $120,000 for 4 doses. This is poor value for money. Had $120,000 been allocated to an intensive lifestyle modification programme for diabetes risk (Diabet Med. 2004 Nov;21(11):1229-36) then 67 years of life or 800 months could have been returned. A massive increase in health benefits for the same costs.

Wide-area damping control for inter-area oscillations using inverse filtering technique

In this study, a non-linear excitation controller using inverse filtering is proposed to damp inter-area oscillations. The proposed controller is based on determining generator flux value for the next sampling time which is obtained by maximising reduction rate of kinetic energy of the system after the fault. The desired flux for the next time interval is obtained using wide-area measurements and the equivalent area rotor angles and velocities are predicted using a non-linear Kalman filter. A supplementary control input for the excitation system, using inverse filtering approach, to track the desired flux is implemented. The inverse filtering approach ensures that the non-linearity introduced because of saturation is well compensated. The efficacy of the proposed controller with and without communication time delay is evaluated on different IEEE benchmark systems including Kundur's two area, Western System Coordinating Council three-area and 16-machine, 68-bus test systems.

A hierarchical model of social marketing

Purpose This paper aims to set out a new hierarchical and differentiated model of social marketing principles, concepts and techniques that builds on, but supersedes, the existing lists of non-equivalent and undifferentiated benchmark criteria. Design/methodology/approach This is a conceptual paper that proposes a hierarchical model of social marketing principles, concepts and techniques. Findings This new delineation of the social marketing principle, its four core concepts and five techniques, represents a new way to conceptualize and recognize the different elements that constitute social marketing. This new model will help add to and further the development of the theoretical basis of social marketing, building on the definitional work led by the International Social Marketing Association (iSMA), Australian Association of Social Marketing (AASM) and European Social Marketing Association (ESMA). Research limitations/implications This proposed model offers a foundation for future research to expand upon. Further research is recommended to empirically test the proposed model. Originality/value This paper seeks to advance the theoretical base of social marketing by making a reasoned case for the need to differentiate between principles, concepts and techniques when seeking to describe social marketing.

Rediscovering law students as citizens: Critical thinking and the public value of legal education

In a series of publications over the last decade, Australian National University Professor Margaret Thornton has documented a disturbing change in the nature of legal education. This body of work culminates in a recently published book based on interviews with 145 legal academics in Australia, the United Kingdom, New Zealand and Canada. In it, Thornton describes a feeling of widespread unease among legal academics that society, government, university administrators and students themselves are moving away from viewing legal education as a public good which benefits both students and society. Instead, legal education is increasingly being viewed as a purely private good, for consumption by the student in the quest for individual career enhancement.

Leveraging the repository infrastructure to curate institutional heritage materials, learning objects and data assets

Developing and maintaining a successful institutional repository for research publications requires a considerable investment by the institution. Most of the money is spent on developing the skill-sets of existing staff or hiring new staff with the necessary skills. The return on this investment can be magnified by using this valuable infrastructure to curate collections of other materials such as learning objects, student work, conference proceedings and institutional or local community heritage materials. When Queensland University of Technology (QUT) implemented its repository for research publications (QUT ePrints) over 11 years ago, it was one of the first institutional repositories to be established in Australia. Currently, the repository holds over 29,000 open access research publications and the cumulative total number of full-text downloads for these document now exceeds 16 million. The full-text deposit rate for recently-published peer reviewed papers (currently over 74%) shows how well the repository has been embraced by QUT researchers. The success of QUT ePrints has resulted in requests to accommodate a plethora of materials which are ‘out of scope’ for this repository. QUT Library saw this as an opportunity to use its repository infrastructure (software, technical know-how and policies) to develop and implement a metadata repository for its research datasets (QUT Research Data Finder), a repository for research-related software (QUT Software Finder) and to curate a number of digital collections of institutional and local community heritage materials (QUT Digital Collections). This poster describes the repositories and digital collections curated by QUT Library and outlines the value delivered to the institution, and the wider community, by these initiatives.

Financial institutions using social media – do consumers perceive value?

Purpose The purpose of this paper is to examine consumer perceptions of value of financial institutions using social media to interact with consumers; if overall perceived value predicts a consumer’s intention to adopt, and if intention predicts self-reported adoption of social media to interact with a financial institution; and if perceptions of value in using social media to interact with a financial institution changes over time. Design/methodology/approach Self-administered surveys were run at two time points; 2010 and 2014. Data were analyzed using multiple and mediated regressions, and t-tests. Comparisons are made between the two time points. Findings Perceived usefulness, economic value, and social value predicted overall perceived value, which in turn predicted a consumer’s intention to adopt social media to interact with a financial institution. At Time 2, adoption intention predicted self-reported usage behavior. Finally, there were significant differences between perceptions across Time 1 and 2. Research limitations/implications The implications of the research highlight the importance of overall perceived value in the role of adoption intention, and that at Time 2, adoption intention predicted self-reported adoption to read and share content. A reduction in perceptions of value and intentions from Time 1 to Time 2 could be explained by perceptions of technology insecurity. In future studies, the authors recommend examining inhibitors to adoption including hedonic value. Practical implications The findings suggest that consumers will use social media if the sector creates and clearly articulates consumer value from using social media. The sector also needs to address technology security perceptions to increase usage of social media. Originality/value This paper is one of the first to investigate the consumer’s perspective in social media adoption by financial institutions, by exploring the role of value in consumer adoption and usage of social media.