The cost effectiveness of Naltrexone added to cognitive-behavioral therapy in the treatment of alcohol dependence

he purpose of this study was to evaluate the comparative cost of treating alcohol dependence with either cognitive behavioral therapy (CBT) alone or CBT combined with naltrexone (CBT+naltrexone). Two hundred ninety-eight outpatients dependent on alcohol who were consecutively treated for alcohol dependence participated in this study. One hundred seven (36%) patients received adjunctive pharmacotherapy (CBT+naltrexone). The Drug Abuse Treatment Cost Analysis Program was used to estimate treatment costs. Adjunctive pharmacotherapy (CBT+naltrexone) introduced an additional treatment cost and was 54% more expensive than CBT alone. When treatment abstinence rates (36.1% CBT; 62.6% CBT+naltrexone) were applied to cost effectiveness ratios, CBT+naltrexone demonstrated an advantage over CBT alone. There were no differences between groups on a preference-based health measure (SF-6D). In this treatment center, to achieve 100 abstainers over a 12-week program, 280 patients require CBT compared with 160 CBT+naltrexone. The dominant choice was CBT+naltrexone based on modest economic advantages and significant efficiencies in the numbers needed to treat.

Discharge planning in the emergency department : a comprehensive approach

Discharge planning has become increasingly important, with current trends toward shorter hospital stays, increased health care costs, and more community-based health services. Effective discharge planning ensures the safety and ongoing care for patients,1 and it also benefits health care providers and organizations. It results in shorter hospital stays, fewer readmissions, higher access rates to post-hospitalization services, greater patient satisfaction with the discharge, and improved quality of life and continuity of care.[2] and [3] All acute care patients and their caregivers require some degree of preparation for discharge home—education about their health status, risks, and treatment; help setting health goals and maintaining a good level of self-care; information about community resources; and follow-up appointments and referrals to appropriate community health providers. Inadequate preparation exposes the patient to unnecessary risks of recurrence or complications of the acute complaint, neglect of nonacute comorbidities, mismanagement and side effects of medication, disruption of family and social life, emotional distress, and financial loss.[2], [3] and [4] The result may be re-presentation to the emergency department. It is noteworthy that up to 18% of ED presentations are revisits within 72 hours of the original visit5; many of these are considered preventable.6 It is a primary responsibility of nurses to ensure that patients return to the community adequately prepared and with appropriate support in place. Up to 65% of ED patients are discharged home from the emergency department,7 and the characteristics of the emergency department and its patient population make the provision of a high standard of discharge planning uniquely difficult. In addition, discharge planning is neglected in contemporary emergency nursing—there are no monographs devoted to the subject, and there is little published research. In this article 3 issues are explored: the importance of emergency nurses’ participation in the discharge-planning process, impediments to their participation; and strategies to improve discharge planning in the emergency department.

Who is a journalist? : journalism in the age of blogging

As part of the first-ever World Journalism Education Congress (WJEC), attracting 440 journalism and mass communication educators and professionals from 44 countries, and held in Singapore on June 26-28, 2007, panelists Alan Knight, Cherian George, and Alex Gerlis presented a lively debate on “Who Is a Journalist.” Knight argued that Journalism paradigms are in transition. Bloggers are providing competition through their often eye-witness reports. Quality blogs are influencing journalism practices. Knight argued that journalists must adapt to and embrace the Internet. Gerlis proposed that when we now ask “Who Is a Journalist”, the answer is no longer anyone who is employed as journalist. The answer is that potentially, anyone and everyone can be a journalist. George warns again uncritically invoking professional standards as the dividing line that separates journalists from non-journalists

Regulating corporate governance in China and Hong Kong : do Chinese values and ethics have a place in the age of globalization?

Much has been said about the convergence of corporate governance and regulations. The underlying assumptions of this phenomenon are driven by globalisation and the dominance of the Anglo-US model of corporate governance. Since the Asian crisis in 1997, Hong Kong and perhaps to a less extend Mainland China, had amended both Company laws and Stock Exchange Listing Rules obligations, arguably, mirroring provisions and rules in the UK and US. However, there has been a small amount of literature in law drawing from cross cultural management asking the question - is Western governance and regulation appropriate for the East? This paper will approach this issue from a different mindset, instead of drawing distinctions about East and West, a meta-regulatory framework will attempt to incorporate Western ‗hard‘ and ‗soft‘ laws with Asian ethical values. The aim is to combine laws and ethics thereby enhancing corporate governance and, improve compliance of those rules by adapting Chinese ethical values like Confucianism into the regulatory system. The overarching goal of this exercise is to adapt the wisdom of Chinese ethics into regulatory guidelines to suit the modern global market.

The 2008 declaration of independence by the Hong Kong Court and anomalies in the Hong Kong Company Law

Discusses two aspects of Hong Kong law: 1) the judgment of the Hong Kong Court of Final Appeal in A Solicitor v The Law Society of Hong Kong on whether Hong Kong courts were bound, post-1997, by pre-1997 House of Lords or Privy Council decisions, by pre-1997 decisions of their own, or by post-1997 overseas decisions from any jurisdiction; and 2) the need for clarification in the Hong Kong Companies Ordinance of whether a company can have a single legal representative, the ultra vires rule and the duties of company directors

Research training and national innovation systems in Australia, Finland and the United States : a policy and systems study supported by 30 case studies of research students in the fields of geospatial science, wireless communication, biosciences, and materials science and engineering

Reforms to the national research and research training system by the Commonwealth Government of Australia sought to effectively connect research conducted in universities to Australia's national innovation system. Research training has a key role in ensuring an adequate supply of highly skilled people for the national innovation system. During their studies, research students produce and disseminate a massive amount of new knowledge. Prior to this study, there was no research that examined the contribution of research training to Australia's national innovation system despite the existence of policy initiatives aiming to enhance this contribution. Given Australia's below average (but improving) innovation performance compared to other OECD countries, the inclusion of Finland and the United States provided further insights into the key research question. This study examined three obvious ways that research training contributes to the national innovation systems in the three countries: the international mobility and migration of research students and graduates, knowledge production and distribution by research students, and the impact of research training as advanced human capital formation on economic growth. Findings have informed the concept of a research training culture of innovation that aims to enhance the contribution of research training to Australia's national innovation system. Key features include internationally competitive research and research training environments; research training programs that equip students with economically-relevant knowledge and the capabilities required by employers operating in knowledge-based economies; attractive research careers in different sectors; a national commitment to R&D as indicated by high levels of gross and business R&D expenditure; high private and social rates of return from research training; and the horizontal coordination of key organisations that create policy for, and/or invest in research training.

The silk road project : dance and embodiment in the age of motion capture

The Silk Road Project was a practice-based research project investigating the potential of motion capture technology to inform perceptions of embodiment in dance performance. The project created a multi-disciplinary collaborative performance event using dance performance and real-time motion capture at Deakin University’s Deakin Motion Lab. Several new technological advances in producing real-time motion capture performance were produced, along with a performance event that examined the aesthetic interplay between a dancer’s movement and the precise mappings of its trajectories created by motion capture and real-time motion graphic visualisations.

Hydrate stabilization in the three-dimensional hydrogen-bonded structure of the brucinium compound, bis(2,3-dimethoxy-10-oxostrychnidinium) biphenyl-4,4'-disulfonate hexahydrate

The crystal structure of the 2:1 proton-transfer compound of brucine with biphenyl-4,4’-disulfonate, bis(2,3-dimethoxy-10-oxostrychnidinium) biphenyl-4,4'-disulfonate hexahydrate (1) has been determined at 173 K. Crystals are monoclinic, space group P21 with Z = 2 in a cell with a = 8.0314(2), b = 29.3062(9), c = 12.2625(3) Å, β = 101.331(2)o. The crystallographic asymmetric unit comprises two brucinium cations, a biphenyl-4,4'-disulfonate dianion and six water molecules of solvation. The brucinium cations form a variant of the common undulating and overlapping head-to-tail sheet sub-structure. The sulfonate dianions are also linked head-to-tail by hydrogen bonds into parallel zig-zag chains through clusters of six water molecules of which five are inter-associated, featuring conjoint cyclic eight-membered hydrogen-bonded rings [graph sets R33(8) and R34(8)], comprising four of the water molecules and closed by sulfonate O-acceptors. These chain structures occupy the cavities between the brucinium cation sheets and are linked to them peripherally through both brucine N+-H...Osulfonate and Ocarbonyl…H-Owater to sulfonate O bridging hydrogen bonds, forming an overall three-dimensional framework structure. This structure determination confirms the importance of water in the stabilization of certain brucine compounds which have inherent crystal instability.

The return of a forgotten polymer : Polycaprolactone in the 21st century

During the resorbable-polymer-boom of the 1970s and 1980s, polycaprolactone (PCL) was used in the biomaterials field and a number of drug-delivery devices. Its popularity was soon superseded by faster resorbable polymers which had fewer perceived disadvantages associated with long term degradation (up to 3-4 years) and intracellular resorption pathways; consequently, PCL was almost forgotten for most of two decades. Recently, a resurgence of interest has propelled PCL back into the biomaterials-arena. The superior rheological and viscoelastic properties over many of its aliphatic polyester counterparts renders PCL easy to manufacture and manipulate into a large range of implants and devices. Coupled with relatively inexpensive production routes and FDA approval, this provides a promising platform for the production of longer-term degradable implants which may be manipulated physically, chemically and biologically to possess tailorable degradation kinetics to suit a specific anatomical site. This review will discuss the application of PCL as a biomaterial over the last two decades focusing on the advantages which have propagated its return into the spotlight with a particular focus on medical devices, drug delivery and tissue engineering.

Sounds from the empty city : a practice-led case study in the confluence of music, narrative and emotion

The creative practice: the adaptation of picture book The Empty City (Megarrity/Oxlade, Hachette 2007) into an innovative, interdisciplinary performance for children which combines live performance, music, projected animation and performing objects. The researcher, in the combined roles of writer/composer proposes deliberate experiments in music, narrative and emotion in the various drafts of the adaptation, and tests them in process and performance product. A particular method of composing music for live performance is tested in against the emergent needs of a collaborative, intermedial process. The unpredictable site of research means that this project is both looking to address both pre-determined and emerging points of inquiry. This analysis (directed by audience reception) finds that critical incidents of intermediality between music, narrative, action and emotion translate directly into highlights of the performance.

Dating and intimacy in the 21st century : the use of online dating sites in Australia

This article examines the growing phenomenon of online dating and intimacy in the 21st century. The exponential rise of communications technologies, which is both reflective and constitutive of an increasingly networked and globalized society, has the potential to significantly influence the nature of intimacy in everyday life. Yet, to date, there has been a minimal response by sociologists to seek, describe and understand this influence. In this article, we present some of the key findings of our research on online dating in Australia, in order to foster a debate about the sociological impacts on intimacy in the postmodern world. Based on a web audit of more than 60 online dating sites and in-depth interviews with 23 users of online dating services, we argue that recent global trends are influencing the uptake of online technologies for the purposes of forming intimate relations. Further, some of the mediating effects of these technologies – in particular, the hypercommunication – may have specific implications for the nature of intimacy in the global era.

Southern theory : the global dynamics of knowledge in the social sciences

Up front I am impelled to acknowledge an intellectual debt to Raewyn Connell as one of my PhD supervisors about 20 years ago and as having a lasting influence on my own sociological approach to research. One of key themes of this book is that southern theorists are rarely read in the northern hemisphere. This is not the case for Connell, however, one of Australia’s most internationally renowned scholars. The tome reads as the creative outpouring of her lifelong thirst for social science. Its main claim is that southern theory ‘has as much intellectual power as metropolitan social thought, and more political relevance’ (p. xii). A big but compelling claim, as I will explain.

Truth, obligation and ethics in the propagation of democracy

In this paper I present an analysis of the language used by the National Endowment for Democracy (NED) on its website (NED, 2008). The specific focus of the analysis is on the NED's high usage of the word “should” revealed in computer assisted corpus analysis using Leximancer. Typically we use the word “should” as a term to propose specific courses of action for ourselves and others. It is a marker of obligation and “oughtness”. In other words, its systematic institutional use can be read as a statement of ethics, of how the NED thinks the world ought to behave. As an ostensibly democracy-promoting institution, and one with a clear agenda of implementing American foreign policy, the ethics of NED are worth understanding. Analysis reveals a pattern of grammatical metaphor in which “should” is often deployed counter intuitively, and sometimes ambiguously, as a truth-making tool rather than one for proposing action. The effect is to present NED's imperatives for action as matters of fact rather than ethical or obligatory claims.