The use of economic evaluation in CAM : an introductory framework

Background For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities. In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Methods Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Conclusions Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM.

Health risk from the use of roof-harvested rainwater in Southeast Queensland, Australia, as potable or nonpotable water, determined using quantitative microbial risk assessment

A total of 214 rainwater samples from 82 tanks were collected in urban Southeast Queensland (SEQ) in Australia and analysed for the zoonotic bacterial and protozoan pathogen using real-time binary PCR and quantitative PCR (qPCR). Quantitative Microbial Risk Assessment (QMRA) analysis was used to quantify the risk of infection associated with the exposure to potential pathogens from potable and non-potable uses of roof-harvested rainwater. Of the 214 samples tested, 10.7%, 9.8%, and 5.6%, and 0.4% samples were positive for Salmonella invA, Giardia lamblia β-giardin , Legionella pneumophila mip, and Campylobacter jejuni mapA genes. Cryptosporidium parvum could not be detected. The estimated numbers of viable Salmonella spp., G. lamblia β-giradin, and L. pneumophila genes ranged from 1.6 × 101 to 9.5 × 101 cells, 1.4 × 10-1 to 9.0 × 10-1 cysts, and 1.5 × 101 to 4.3 × 101 per 1000 ml of water, respectively. Six risk scenarios were considered from exposure to Salmonella spp., G. lamblia and L. pneumophila. For Salmonella spp., and G. lamblia, these scenarios were: (1) liquid ingestion due to drinking of rainwater on a daily basis (2) accidental liquid ingestion due to garden hosing twice a week (3) aerosol ingestion due to showering on a daily basis, and (4) aerosol ingestion due to hosing twice a week. For L. pneumophila, these scenarios were: (5) aerosol inhalation due to showering on a daily basis, and (6) aerosol inhalation due to hosing twice a week. The risk of infection from Salmonella spp., G. lamblia, and L. pneumophila associated with the use of rainwater for showering and garden hosing was calculated to be well below the threshold value of one extra infection per 10,000 persons per year in urban SEQ. However, the risk of infection from ingesting Salmonella spp. and G. lamblia via drinking exceeds this threshold value, and indicates that if undisinfected rainwater were ingested by drinking, then the gastrointestinal diseases of Salmonellosis and Giardiasis is expected to range from 5.0 × 100 to 2.8 × 101 (Salmonellosis) and 1.0 × 101 to 6.4 × 101 (Giardiasis) cases per 10,000 persons per year, respectively. Since this health risk seems higher than that expected from the reported incidences of gastroenteritis, the assumptions used to estimate these infection risks are critically examined. Nonetheless, it would seem prudent to disinfect rainwater for potable use.

The impact of managers' characteristics on the use of public relations strategy : an exploratory study in Queensland schools

While previous positive and normative studies have focused on the role public relations should play in organisations and the need for management in all organisations to attend to public relations (Cutlip et al., 2006), there has been little discussion in the public relations literature on why or how managers choose to enact public relations strategies for their organisations. If the discipline of public relations is to cement itself as a management function, then researchers must gain a better understanding of managers themselves given that they are the ones who decide if and how public relations strategies should be employed in the organisation. This study has sought to explore evidence of a relationship between management characteristics and their impact on decisions managers make when choosing which public relations strategies to adopt in response to changes in the organisation’s operating environment. This exploratory research study has been conducted within a specific context of schools in Queensland, Australia. Queensland schools have been facing a number of changes within their operating environment due to changes in Federal funding models in Australia’s education system. This study used an exploratory, qualitative approach to understand the management characteristics demonstrated by managers in schools and how these have impacted on the selection of public relations strategies for responding to their changing and increasingly competitive environment. The unit of analysis for this research study was principals in State (government) schools and in non-government schools. Ten principals were interviewed from four different types of schools in Queensland – the more traditional, elite, private schools (GPS Schools); other Independent Schools; Catholic Schools; and State (or public) schools. These interviews were analysed for quantitative comparisons of the managers’ characteristics across the different schools (in terms of the number of principals in each age bracket, those holding postgraduate qualifications, years of experience etc.); and for qualitative data to provide a greater sense of their understanding of public relations. The 10 schools were selected within a geographic area from Brisbane’s inner city to its outer western suburbs to include an element of competition amongst those managers being interviewed. A detailed review of government, school and other public documents was also conducted to gain an insight into the environment in which principals made decisions about public relations strategy to respond to increasing competition. This study found support for the literature on the relationship between management characteristics and strategy. However, there was also variation in findings warranting further investigation of the literature on the relationship between management characteristics and strategy in a school setting. Key relationships found in this study were between: management characteristics themselves; age and the use of public relations strategies; and gender and the use of public relations strategies. There was also evidence of support for the literature linking the impact that the combination of managers’ age, education and experience had on the use of public relations strategies. While this study was exploratory in nature, it did reveal a number of areas that require further investigation to gain a deeper understanding of how and why managers choose public relations strategies as a response to changes in their operating environment. It also provided a different framework to gain a better understanding of managers’ understanding and support of public relations in schools, which, in conjunction with an analysis of their management characteristics, will hopefully allow public relations scholars and practitioners alike gain an understanding of how and why managers use public relations strategies.

The effects of cognitive ageing on the use of complex interfaces

This paper discusses an experiment investigating the effects of cognitive ageing and prior-experience with technology on using complex interfaces intuitively. Overall 37 participants, between the ages of 18 to 83, participated in this study. All participants were assessed for their cognitive abilities and prior-experience with technology. It was anticipated that the Central Executive function (a component of Working Memory) would emerge as one of the important cognitive functions in using complex interfaces. This was found to be the case with the strongest negative correlation occurring between sustained attention (one of the functions of the Central Executive), the time to complete the task and number of errors made by the participants.

Enhancing the use of Internet and Web services for quality learning : an action research

Internet and Web services have been used in both teaching and learning and are gaining popularity in today’s world. E-Learning is becoming popular and considered the latest advance in technology based learning. Despite the potential advantages for learning in a small country like Bhutan, there is lack of eServices at the Paro College of Education. This study investigated students’ attitudes towards online communities and frequency of access to the Internet, and how students locate and use different sources of information in their project tasks. Since improvement was at the heart of this research, an action research approach was used. Based on the idea of purposeful sampling, a semi-structured interview and observations were used as data collection instruments. 10 randomly selected students (5 girls and 5 boys) participated in this research as the controlled group. The study findings indicated that there is a lack of educational information technology services, such as e-learning at the college. Internet connection being very slow was the main barrier to learning using e-learning or accessing Internet resources. There is a strong relationship between the quality of written task and the source of the information, and between Web searching and learning. The source of information used in assignments and project work is limited to books in the library which are often outdated and of poor quality. Project tasks submitted by most of the students were of poor quality.

Towards improvement of autonomous glider navigation accuracy through the use of regional ocean models

Autonomous underwater gliders are robust and widely-used ocean sampling platforms that are characterized by their endurance, and are one of the best approaches to gather subsurface data at the appropriate spatial resolution to advance our knowledge of the ocean environment. Gliders generally do not employ sophisticated sensors for underwater localization, but instead dead-reckon between set waypoints. Thus, these vehicles are subject to large positional errors between prescribed and actual surfacing locations. Here, we investigate the implementation of a large-scale, regional ocean model into the trajectory design for autonomous gliders to improve their navigational accuracy. We compute the dead-reckoning error for our Slocum gliders, and compare this to the average positional error recorded from multiple deployments conducted over the past year. We then compare trajectory plans computed on-board the vehicle during recent deployments to our prediction-based trajectory plans for 140 surfacing occurrences.

Processing load and the use of concrete representations and strategies for solving linear equations

This paper is a report of students' responses to instruction which was based on the use of concrete representations to solve linear equations. The sample consisted of 21 Grade 8 students from a middle-class suburban state secondary school with a reputation for high academic standards and innovative mathematics teaching. The students were interviewed before and after instruction. Interviews and classroom interactions were observed and videotaped. A qualitative analysis of the responses revealed that students did not use the materials in solving problems. The increased processing load caused by concrete representations is hypothesised as a reason.

Bayesian network for risk of diarrhea associated with the use of recycled water

Estimating potential health risks associated with recycled (reused) water is highly complex given the multiple factors affecting water quality. We take a conceptual model, which represents the factors and pathways by which recycled water may pose a risk of contracting gastroenteritis, convert the conceptual model to a Bayesian net, and quantify the model using one expert’s opinion. This allows us to make various predictions as to the risks posed under various scenarios. Bayesian nets provide an additional way of modeling the determinants of recycled water quality and elucidating their relative influence on a given disease outcome. The important contribution to Bayesian net methodology is that all model predictions, whether risk or relative risk estimates, are expressed as credible intervals.

The use of supply chain management to reduce delays : Malaysian public sector construction projects

Construction delays are a critical problem for Malaysian public sector projects. These delays have been blamed mainly on inefficient traditional construction practices that continue to dominate the current industry. This paper reports the progress to date of a Ph.D. research project aimed at developing a framework to utilize Supply Chain Management (SCM) tools to improve the time performance of Malaysian Government projects. The potential of SCM has been identified for public sector governance and its use in Malaysia is now being considered within the strategy of the Malaysian Construction Industry Master Plan (2006-2015). Encouraged by success in the UK, there is a cautious optimism concerning the successful application of SCM in Malaysia. This paper considers delay as a problem in Malaysian public sector projects, establishes the need to embrace SCM and then elucidates the need and strategies for the development of a delay reduction framework. A literature review, survey mechanism and structured interview schedule will be undertaken to achieve the research objectives. The final research outcome will be a framework that addresses root delay contributors (“pathogens”) and applies SCM tools for their mitigation.

Preparing students for international study : the use of technology

About 1.6 million students currently study outside their home country. Despite this, and the fact that Australia, the United States, the United Kingdom and many of the other host countries of international students are themselves extremely culturally diverse communities, business education remains essentially mono-cultural in form and Anglo American in content. Whilst it is true that these international students may want to understand the "Western" way of doing things, they may not be familiar or comfortable with the processes used to facilitate learning. This paper explores a project undertaken to create a tool that provides essential pre-orientation information and advice to students before they leave home. Where cultural adjustment is required, catching students before departure is a very effective time to introduce key information about lifestyle, culture and approaches to teaching and learning that would assist students with the complex and difficult adjustment to studying abroad, so that they could make a smoother transition to their new place of learning. Welcome to Studying Business at QUT is a Data DVD with 19 short videos capturing a student perspective on life and study. Forty percent of the content is related to living and studying and includes sections on accommodation, lifestyle, food and transport etc., and 60% takes an in-depth look at studying business, featuring students and academics talking about issues such as assessment, academic writing and working in groups. This paper outlines the process of developing the DVD and the range of issues addressed.