The economic rationale for infection control in Australian hospitals

The objective of the present study was to predict the economic consequences of healthcare-acquired infections arising among admissions to Australian acute care hospitals. A quantitative algorithm informed by epidemiological and economic data was developed. All acute care hospitals in Australia were included in the study and the participants included all admissions to general medical and general surgical specialties. The main outcome measures were the numbers of cases of healthcare-acquired infection and bed days lost annually. It was estimated that there are 175 153 (95% credible interval 155 911 : 195 168) cases of healthcare-acquired infection among admissions to Australian hospitals annually, and the extra stay in hospital to treat symptoms accounts for 854 289 bed days (95% credible interval 645 091 : 1 096 244). If rates were reduced by 1%, then 150 158 bed days would be released for alternative uses. This would allow ~38 500 new admissions. Healthcare-acquired infections in patients cause bed blocks in Australian hospitals. The cost-effectiveness of hospital services might be improved by allocating more resources to infection control, releasing beds and allowing new admissions. There exists an opportunity to improve the efficiency of the Australian health care system.

High quality indoor environments for sustainable office buildings

The quality of office indoor environments is considered to consist of those factors that impact occupants according to their health and well-being and (by consequence) their productivity. Indoor Environment Quality (IEQ) can be characterized by four indicators: • Indoor air quality indicators • Thermal comfort indicators • Lighting indicators • Noise indicators. Within each indicator, there are specific metrics that can be utilized in determining an acceptable quality of an indoor environment based on existing knowledge and best practice. Examples of these metrics are: indoor air levels of pollutants or odorants; operative temperature and its control; radiant asymmetry; task lighting; glare; ambient noise. The way in which these metrics impact occupants is not fully understood, especially when multiple metrics may interact in their impacts. While the potential cost of lost productivity from poor IEQ has been estimated to exceed building operation costs, the level of impact and the relative significance of the above four indicators are largely unknown. However, they are key factors in the sustainable operation or refurbishment of office buildings. This paper presents a methodology for assessing indoor environment quality (IEQ) in office buildings, and indicators with related metrics for high performance and occupant comfort. These are intended for integration into the specification of sustainable office buildings as key factors to ensure a high degree of occupant habitability, without this being impaired by other sustainability factors. The assessment methodology was applied in a case study on IEQ in Australia’s first ‘six star’ sustainable office building, Council House 2 (CH2), located in the centre of Melbourne. The CH2 building was designed and built with specific focus on sustainability and the provision of a high quality indoor environment for occupants. Actual IEQ performance was assessed in this study by field assessment after construction and occupancy. For comparison, the methodology was applied to a 30 year old conventional building adjacent to CH2 which housed the same or similar occupants and activities. The impact of IEQ on occupant productivity will be reported in a separate future paper

Improved maritime target tracker using colour fusion

Searching for humans lost in vast stretches of ocean has always been a difficult task. This paper investigates a machine vision system that addresses this problem by exploiting the useful properties of alternate colour spaces. In particular, the paper investigates the fusion of colour information from the HSV, RGB, YCbCr and YIQ colour spaces within the emission matrix of a Hidden Markov Model tracker to enhance video based maritime target detection. The system has shown promising results. The paper also identifies challenges still needing to be met.

Learning Strategies for Digital Tools

Learning a digital tool is often a hidden process. We tend to learn new tools in a bewildering range of ways. Formal, informal, structured, random, conscious, unconscious, individual, group strategies, may all play a part, but are often lost to us in the complex and demanding processes of learning. But when we reflect carefully on the experience, some patterns and surprising techniques emerge. This monograph presents the thinking of seven students in MDN642, Digital Pedagogies, where they have deliberately reflected on the mental processes at work as they learnt a digital technology of their choice.

Strategies for zonal cartilage repair using hydrogels

Articular cartilage is a highly hydrated tissue with depth-dependent cellular and matrix properties that provide low-friction load bearing in joints. However, the structure and function are frequently lost and there is insufficient repair response to regenerate high-quality cartilage. Several hydrogel-based tissue-engineering strategies have recently been developed to form constructs with biomimetic zonal variations to improve cartilage repair. Modular hydrogel systems allow for systematic control over hydrogel properties, and advanced fabrication techniques allow for control over construct organization. These technologies have great potential to address many unanswered questions involved in prescribing zonal properties to tissue-engineered constructs for cartilage repair.

Performance Benchmarking of Australian Business Regulation : Submission to the Productivity Commission

The need to “reduce red tape” and regulatory inconsistencies is a desirable outcome (OECD 1997) for developed countries. The costs normally associated with regulatory regimes are compliance costs and direct charges. Geiger and Hoffman (1998) have noted that the extent of regulation in an industry tends to be negatively associated with firm performance. Typically, approaches to estimation of the cost of regulations examine direct costs, such as fees and charges, together with indirect costs, such as compliance costs. However, in a fragmented system, such as Australia, costs can also be incurred due to procedural delays, either by government, or by industry having to adapt documentation for different spheres of government; lack of predictable outcomes, with variations occurring between spheres of government and sometimes within the same government agency; and lost business opportunities, with delays and red tape preventing realisation of business opportunities (OECD 1997). In this submission these costs are termed adaptation costs. The adaptation costs of complying with variations in regulations between the states has been estimated by the Building Product Innovation Council (2003) as being up to $600 million per annum for building product manufacturers alone. Productivity gains from increased harmonisation of the regulatory system have been estimated in the hundreds of millions of dollars (ABCB 2003). This argument is supported by international research which found that increasing the harmonisation of legislation in a federal system of government reduces what we have termed adaptation costs (OECD 2001). Research reports into the construction industry in Australia have likewise argued that improved consistency in the regulatory environment could lead to improvements in innovation (PriceWaterhouseCoopers 2002), and that research into this area should be given high priority (Hampson & Brandon 2004). The opinion of industry in Australia has consistently held that the current regulatory environment inhibits innovation (Manley 2004). As a first step in advancing improvements to the current situation, a summary of the current costs experienced by industry needs to be articulated. This executive summary seeks to outline these costs in the hope that the Productivity Commission would be able to identify the best tools to quantify the actual costs to industry.

A longitudinal study comparing bereavement phenomena in recently bereaved spouses, adult children and parents

Objective: The study investigated previous research findings and clinical impressions which indicated that the intensity of grief for parents who had lost a child was likely to be higher than that for widows/widowers, who in turn were likely to have more intense reactions than adult children losing a parent. Method: In order to compare the intensities of the bereavement reactions among representative community samples of bereaved spouses (n = 44), adult children (n = 40) and parents (n = 36), and to follow the course of such phenomena, a detailed Bereavement Questionnaire was administered at four time points over a 13-month period following the loss. Results: Measures based on items central to the construct of bereavement showed significant time and group differences in accordance with the proposed hypothesis. More global items associated with the construct of resolution showed a significant time effect, but without significant group differences. Conclusions: Evidence from this study supports the hypothesis that in non-clinical, community-based populations the frequency with which core bereavement phenomena are experienced is in the order: bereaved parents bereaved spouses bereaved adult children.

Green a city grow a wall

As Brisbane grows, it is rapidly becoming akin to any other city in the world with its typical stark grey concrete buildings rather than being characterized by its subtropical element of abundant green vegetation. Living Walls can play a vital role in restoring the loss of this distinct local element of a subtropical city. This paper will start by giving an overview of the traditional methods of greening subtropical cities with the use of urban parks and street trees. Then, by examining a recent heat imaging map of Brisbane, the effect of green cover with the built environment will be shown. With this information from a macro level, this paper will proceed to examine a typical urban block within the Central Business District (CBD) to demonstrate urban densification in relation to greenery in the city. Then, this paper will introduce the new technology where Living Walls have the untapped potential of effectively greening a city where land is scarce and given over to high density development. Living Walls incorporated into building design does not only enhance the subtropical lifestyle that is being lost in modern cities but is also an effective means for addressing climate change. This paper will serve as a preliminary investigation into the effects of incorporating Living Walls into cities. By growing a Living Wall onto buildings, we can be part of an effective design solution for countering global warming and at the same time, Living Walls can return local character to subtropical cities, thereby greening the city as well.

Vocational psychological and organisational perspectives on career : towards a multidisciplinary dialogue

It has long been lamented that, although several disciplines contribute to career scholarship, they work in isolation from one another, thus denying career theory, research, and practice the benefits that multidisciplinary collaboration would bring. This constitutes a lost opportunity at a time when new understandings and approaches are needed in order to respond effectively to global changes in society and work. This book takes a major step towards remedying this situation by bringing together two key perspectives on career, the vocational psychological and the organisational (interpreted broadly to include organisation behaviour and human resource management). Written by international experts, the book opens by identifying some of the “tributaries” that flow into the “great delta of careers scholarship”, and noting the need to link what are at present separate “islands” of scholarship. It is structured to allow comparison between the ways in which the two perspectives address career development and career management theory, research and interventions. It concludes by pointing to the possibilities for dialogue, and even collaboration, between these perspectives, and suggesting ways in which these could be brought about. The book will be essential reading for career scholars because, with its potential to stimulate new thinking and developments in theory and research and also, importantly, in practice (with beneficial spin-offs for policy-makers), this dialogue could open a new phase in career scholarship. With its overviews of the history, theory, research and practice of both perspectives, the book will also be a valuable resource for students of both perspectives.

Contemporary behavioural influences in an organisational setting and implications for intervention development

Professional drivers and safety Within the industrialised world, work-related crashes are the most common cause of work-related death, injury and reduced productivity (Charbotel et al., 2001; Toscano and Windau, 1994). Likewise in Australia, road crashes are the most common cause of work-related fatalities, injuries and absence from work (Haworth et al., 2000), with the average time lost being greater than any other workplace claim (Stewart-Bogle, 1999). There are obvious costs related to work crashes such as vehicle and property repair costs. There are also many hidden expenses including third party costs, workers compensation, medical costs, rehabilitation, customer-related costs, increased insurance premiums, administrative costs, legal fees and loss of productivity (Collingwood, 1997; Haworth et al, 2000).

Australian horror movies

The Australian horror film is a fascinating specimen. While a tradition has antecedents in the silent era of cinema, and at times has produced popular and commercially successful titles, Australian horror films have existed among the shadows of Australian cinema. Within a national cinema funded by public subsidy to foster a sense of national identity, emphasizing ‘quality’ cultural films and refusing to recognize popular movie genres in attempt to differentiate itself from Hollywood, generic and low-culture horror films have been in opposition to these objectives. Consequently, horror movies have been heavily marginalized within public funding environments and mainstream film culture, and either ignored or despised by mainstream critics. The chapter provides a historical introduction to Australian horror cinema before reviewing a selection of recent Aussie horror titles, namely: Wolf Creek, Undead, Black Water, Dying Breed, Lost Things, Prey, Cut, Rogue and Storm Warning.

"And one fine morning" : Gatsby, Obama, and the resurection of hope

Hope is a word that has re-emerged in light of Obama's stunning win in the United States election. In this time of economic gloom and the reality of bleak recession and unprecedented job losses the United States has embraced the hopeful message of Barack Obama. For many years 'hope' has been a word that has been lost, forgotten , and banished to the margins of romantic longing and wishful thinking. Hope is also a word that has been much discussed in relation to the iconic The Great Gatsby but usually in a negative fashion to demonstrate the unattainability of the American dream. Marcella Taylor called Gatsby "the unfinished American Epic" which focused on the "passing of the last utopian frontier" and suggested the significance of this passing on American society as a whole. In the last months, however, hope has made a return and one gets the feeling that Fitzgerald's words "but that's no matter-to-morrow we will run faster, stretch out our arms farther . . . And one fine morning' are once again being heard.

The costs arising from pressure ulcers attributable to malnutrition

Aim To estimate the economic consequences of pressure ulcers attributable to malnutrition. Method Statistical models were developed to predict the number of cases of pressure ulcer, associated bed days lost and the dollar value of these losses in public hospitals in 2002/2003 in Queensland, Australia. The following input parameters were specified and appropriate probability distributions fitted • Number of at risk discharges per annum • Incidence rate for pressure ulcer • Attributable fraction of malnutrition in the development of pressure ulcer • Independent effect of pressure ulcer on length of hospital stay • Opportunity cost of hospital bed day One thousand random re-samples were made and the results expressed as (output) probabilistic distributions. Results The model predicts a mean 16060 (SD 5 671) bed days lost and corresponding mean economic cost of AU$12 968 668 (SD AU$4 924 148) (EUROS 6 925 268 SD 2 629 495; US$ 7 288 391 SD 2 767 371) of pressure ulcer attributable to malnutrition in 2002/2003 in public hospitals in Queensland, Australia. Conclusion The cost of pressure ulcer attributable to malnutrition in bed days and dollar terms are substantial. The model only considers costs of increased length of stay associated with pressure ulcer and not other factors associated with care.

International labour standards and Queensland

Queensland’s legal labour disputes history does not exhibit the current trend seen in Canada and Switzerland (Gravel & Delpech, 2008) where cases citing International Labour Standards (ILS) are often successful (which is not presently the case in Queensland either). The two Queensland cases (Kuhler v. Inghams Enterprises P/L & Anor, 1997 and Bale v. Seltsam Pty Ltd, 1996) that have used ILSs were lost. Australia is a member state of the International Labour Organization (ILO) and a signatory of many ILSs. Yet, ILSs are not used in their legal capacity when compared to other international standards in other areas of law. It is important to recognize that ILSs are uniquely underutilized in labour law. Australian environmental, criminal, and industrial disputes consistently draw on international standards. Why not for the plight of workers? ILSs draw their power from supranational influence in that when a case cites an ILS the barrister or solicitor is going beyond legal precedence and into international peer pressure. An ILS can be appropriately used to highlight that Australian or Queensland legislation does not conform to a Convention or Recommendation. However, should the case deal with a breach of existing law based or modified by an ILS, citing the ILS is a good way to remind the court of its origin. It’s a new legal paradigm critically lacking in Queensland’s labour law practice. The following discusses the research methodology used in this paper. It is followed by a comparative discussion of results between the prevalence of ILSs and other international standards in Queensland case history. Finally, evidence showing the international trend of labour disputes using ILSs for victory is discussed.

Mathematical modelling of muscle recruitment and function in the lumbar spine

Low back pain is an increasing problem in industrialised countries and although it is a major socio-economic problem in terms of medical costs and lost productivity, relatively little is known about the processes underlying the development of the condition. This is in part due to the complex interactions between bone, muscle, nerves and other soft tissues of the spine, and the fact that direct observation and/or measurement of the human spine is not possible using non-invasive techniques. Biomechanical models have been used extensively to estimate the forces and moments experienced by the spine. These models provide a means of estimating the internal parameters which can not be measured directly. However, application of most of the models currently available is restricted to tasks resembling those for which the model was designed due to the simplified representation of the anatomy. The aim of this research was to develop a biomechanical model to investigate the changes in forces and moments which are induced by muscle injury. In order to accurately simulate muscle injuries a detailed quasi-static three dimensional model representing the anatomy of the lumbar spine was developed. This model includes the nine major force generating muscles of the region (erector spinae, comprising the longissimus thoracis and iliocostalis lumborum; multifidus; quadratus lumborum; latissimus dorsi; transverse abdominis; internal oblique and external oblique), as well as the thoracolumbar fascia through which the transverse abdominis and parts of the internal oblique and latissimus dorsi muscles attach to the spine. The muscles included in the model have been represented using 170 muscle fascicles each having their own force generating characteristics and lines of action. Particular attention has been paid to ensuring the muscle lines of action are anatomically realistic, particularly for muscles which have broad attachments (e.g. internal and external obliques), muscles which attach to the spine via the thoracolumbar fascia (e.g. transverse abdominis), and muscles whose paths are altered by bony constraints such as the rib cage (e.g. iliocostalis lumborum pars thoracis and parts of the longissimus thoracis pars thoracis). In this endeavour, a separate sub-model which accounts for the shape of the torso by modelling it as a series of ellipses has been developed to model the lines of action of the oblique muscles. Likewise, a separate sub-model of the thoracolumbar fascia has also been developed which accounts for the middle and posterior layers of the fascia, and ensures that the line of action of the posterior layer is related to the size and shape of the erector spinae muscle. Published muscle activation data are used to enable the model to predict the maximum forces and moments that may be generated by the muscles. These predictions are validated against published experimental studies reporting maximum isometric moments for a variety of exertions. The model performs well for fiexion, extension and lateral bend exertions, but underpredicts the axial twist moments that may be developed. This discrepancy is most likely the result of differences between the experimental methodology and the modelled task. The application of the model is illustrated using examples of muscle injuries created by surgical procedures. The three examples used represent a posterior surgical approach to the spine, an anterior approach to the spine and uni-lateral total hip replacement surgery. Although the three examples simulate different muscle injuries, all demonstrate the production of significant asymmetrical moments and/or reduced joint compression following surgical intervention. This result has implications for patient rehabilitation and the potential for further injury to the spine. The development and application of the model has highlighted a number of areas where current knowledge is deficient. These include muscle activation levels for tasks in postures other than upright standing, changes in spinal kinematics following surgical procedures such as spinal fusion or fixation, and a general lack of understanding of how the body adjusts to muscle injuries with respect to muscle activation patterns and levels, rate of recovery from temporary injuries and compensatory actions by other muscles. Thus the comprehensive and innovative anatomical model which has been developed not only provides a tool to predict the forces and moments experienced by the intervertebral joints of the spine, but also highlights areas where further clinical research is required.