Economic evaluation and catheter-related bloodstream infections

Catheter-related bloodstream infections are a serious problem. Many interventions reduce risk, and some have been evaluated in cost-effectiveness studies. We review the usefulness and quality of these economic studies. Evidence is incomplete, and data required to inform a coherent policy are missing. The cost-effectiveness studies are characterized by a lack of transparency, short time-horizons, and narrow economic perspectives. Data quality is low for some important model parameters. Authors of future economic evaluations should aim to model the complete policy and not just single interventions. They should be rigorous in developing the structure of the economic model, include all relevant economic outcomes, use a systematic approach for selecting data sources for model parameters, and propagate the effect of uncertainty in model parameters on conclusions. This will inform future data collection and improve our understanding of the economics of preventing these infections.

Beyond Bryan: Builders' liability and pure economic loss

In Bryan v Maloney, the High Court extended a builder’s duty of care to encompass a liability in negligence for the pure economic loss sustained by a subsequent purchaser of a residential dwelling as a result of latent defects in the building’s construction. Recently, in Woolcock Street Investments Pty Ltd v CDG Pty Ltd, the Court refused to extend this liability to defects in commercial premises. The decision therefore provides an opportunity to re-examine the rationale and policy behind current jurisprudence governing builders’ liability for pure economic loss. In doing so, this article considers the principles relevant to the determination of a duty of care generally and whether the differences between purchasers of residential and commercial properties are as great as the case law suggests

Sustainability and the building code of Australia

This report is the culmination of a two-stage research project to inform the Australian property and construction industry generally, in addition to providing the Australian Building Codes Board (ABCB) with information to allow it to determine whether or not sustainability requirements are necessary in the Future Building Code of Australia (BCA21). The Australian Building Codes Board is a joint initiative of all levels of government in Australia. The Board’s mission is to provide for efficiency and cost effectiveness in meeting community expectations for health, safety and amenity in the design, construction and use of buildings through the creation of nationally consistent building codes, standards, regulatory requirements and regulatory systems. The Stage 1 (literature review) and Stage 2 (workshops) reports are intended to be read in conjunction with one another. These reports and the Database are provided as appendices. The Conclusions of this, the final report, are the result of the overall program of work.

Literature review

This research aims to improve the economic and environmental sustainability of the construction & demolition waste and precast concrete supply chains through the development, trial and evaluation of an innovative public sector supply chain management strategy. The long-term goals are to improve competitive behaviour and market sector performance and improve business process efficiency and effectiveness of public sector program delivery by influencing policy development, changing organisational behaviour and implementation development to achieve more economic and environmental sustainable markets.

Final report: stage 1 : results

This research project aims to improve economic, social and environmental sustainability of the pre-cast concrete and construction and demolition waste supply chains through the development, trial and evaluation of an innovative supply chain management strategy. The long-term goals are to improve competitive behaviour and market sector performance and improve business process efficiency and effectiveness of public sector program delivery by influencing policy development, changing organisational behaviour and implementation development to achieve more economic, social and environmental sustainable markets.

A sustainable model for supporting entrepreneurship in developing countries

Principal Topic Small and micro-enterprises are believed to play a significant part in economic growth and poverty allevition in developing countries. However, there are a range of issues that arise when looking at the support required for local enterprise development, the role of micro finance and sustainability. This paper explores the issues associated with the establishment and resourcing of micro-enterprise develoment and proposes a model of sustainable support of enterprise development in very poor developing economies, particularly in Africa. The purpose of this paper is to identify and address the range of issues raised by the literature and empirical research in Africa, regarding micro-finance and small business support, and to develop a model for sustainable support for enterprise development within a particular cultural and economic context. Micro-finance has become big business with a range of models - from those that operate on a strictly business basis to those that come from a philanthropic base. The models used grow from a range of philosophical and cultural perspectives. Entrepreneurship training is provided around the world. Success is often measured by the number involved and the repayment rates - which are very high, largely because of the lending models used. This paper will explore the range of options available and propose a model that can be implemented and evaluated in rapidly changing developing economies. Methodology/Key Propositions The research draws on entrepreneurial and micro-finance literature and empirical research undertaken in Mozambique, which lies along the Indian ocean sea border of Southern Africa. As a result of war and natural disasters over a prolonged period, there is little industry, primary industries are primitive and there is virtually no infrastructure. Mozambique is ranked as one of the poorest countries in the world. The conditions in Mozambique, though not identical, reflect conditions in many other parts of Africa. A numebr of key elements in the development of enterprises in poor countries are explored including: Impact of micro-finance Sustainable models of micro-finance Education and training Capacity building Support mechanisms Impact on poverty, families and the local economy Survival entrepreneurship versus growth entrepreneurship Transitions to the formal sector. Results and Implications The result of this study is the development of a model for providing intellectual and financial resources to micro-entrepreneurs in poor developing countries in a sustainable way. The model provides a base for ongoing research into the process of entrepreneurial growth in African developing economies. The research raises a numeber of issues regarding sustainability including the nature of the donor/recipient relationship, access to affordable resources, the impact of individual entrepreneurial activity on the local economny and the need for ongoing research to understand the whole process and its impact, intended and unintended.

Sustainable built environmen : barriers to establishing a sustainability charter and commissioner

In August 2005, House of Representatives Standing Committee on Environment and Heritage released the Sustainable Cities report. The Australian Sustainable Built Environment Council (ASBEC) wrote to the Committee endorsing Recommendations 1 to 3, and Recommendation 31. In particular Recommendation 31 states: The committee recommends that, with reference to the Swedish model of environmental objectives, the Australian Government:

Achieving better stewardship of major infrastructure assets through configuration of governance arrangements utilising Stewardship Theory

Major infrastructure assets are often governed by a mix of public and private organizations, each fulfilling a specific and separate role i.e. policy, ownership, operation or maintenance. This mix of entities is a legacy of Public Choice Theory influenced NPM reforms of the late 20th century. The privatization of the public sector has resulted in agency theory based ‘self-interest’ relationships and governance arrangements for major infrastructure assets which emphasize economic efficiency but which do not do not advance non-economic public values and the collective Public Interest. The community is now requiring that governments fulfill their stewardship role of also satisfying non-economic public values such as sustainability and intergenerational responsibility. In the 21st century governance arrangements which minimize individual self-interest alone and look to also pursue the interests of other stakeholders have emerged. Relational contracts, Public-Private Partnerships (PPP’s) and hybrid mixes of organizations from the state, market and network modes (Keast et al 2006) provide options for governance which better meet the interests of contractors, government and the community there is emerging a body of research which extends the consideration of the immediate governance configuration to the metagovernance environment constituted by hierarchy, regulation, industry standards, trust, culture and values. Stewardship theory has reemerged as a valuable aid in the understanding of the features of governance configurations which establish relationships between principal and agent which maximize the agent acting in the interests of the principal, even to the detriment of the agent. This body of literature suggests that an improved stewardship outcome from infrastructure governance configurations can be achieved by the application of the emerging options as to the immediate governance configuration, and the surrounding metagovernance environment. Stewardship theory provides a framework for the design of the relationships within that total governance environment, focusing on the achievement of a better, complete stewardship outcome. This paper explores the directions future research might take in seeking to improve the understanding of the design of the governance of major, critical infrastructure assets.

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.

Sustainable construction for the future - the role of government in energy efficiency and sustainability in buildings

This paper will summarise the findings from a study that explored the link between dwelling design, or type, and energy efficiencies in sub-tropical climates. An increasing number of government and private sector development companies are initiating projects that aim to deliver enhanced environmental outcomes at both sub-divisional and dwelling levels. The study used AccuRate, a new thermal modelling tool developed by CSIRO that responds to the need to improve ventilation modelling. The study found that dwellings developed in conjunction with the Departments of Housing and Public Works have set the benchmark. It provides a snapshot of the energy efficiency of a range of dwelling types found in recent subdivisions. However, the trend toward increasing urban densities may reduce the likelihood that cooling breezes will be available to cool dwellings. The findings are relevant to regulators, designers and industry in all states interested in reducing the energy used to cool dwellings in summer.

How to achieve sustainability : regulatory challenges

The importance of designing sustainable buildings is gaining greater acceptance worldwide. Evidence of this is how regulators are incorporating sustainable design principles into building regulations and requirements. The aim being to increase the number of sustainable buildings and move from a traditional voluntary compliance to one that is mandatory. However, developing regulations that actually achieve these aims can be a difficult exercise. Several countries in South East Asia, such as Singapore and Malaysia, have performance based building regulations that are supplemented by prescriptive measures for achieving the desired performance. Australia too has similar building regulations and has had energy efficiency regulations within the Building Code of Australia for over a decade. This paper explores some of the difficulties and problems that Australian regulators have experienced with the performance-based method and the prescriptive or “deemed-to-comply” method and measures that have been taken to try and overcome these problems. These experiences act as a useful guide to all regulators considering the incorporation of sustainable design measures into their countries building regulations. The paper also speculates on future environmental requirements being incorporated into regulations, including the possibility of non-residential buildings being required to meet minimum energy efficiency requirements, and the possible systems that would need to be in place before such requirements were included. Finally, the paper looks at a possible way forward using direct assessment from electronic designs and introduces several software tools that are currently being developed that move towards achieving this goal. Keywords: Sustainable buildings, Performance-based, Regulations, Energy efficiency, Assessment tools.

Keeping giving going : charitable bequests and Australians

The potential of bequests to contribute to the sustainability of charities1 is immense, with social and economic trends opening up the bequest landscape. Yet so much is unknown about how Australians think about charitable bequests – particularly about the motivations, barriers and triggers surrounding this behaviour. Do bequestors differ from other donors? What prevents good intentions from becoming good actions? Where do charities figure in this process? This study aims at a better understanding of those Australians who make a charitable bequest and those who might. It offers individual charities, and the sector as a whole, empirical evidence to support and extend the anecdotal knowledge of those working with donors around this sensitive, but vital, area. This research has been supported by the Perpetual Foundation, the EF and SL Gluyas Trust and the Edward Corbould Charitable Trust under the management of Perpetual Trustee Company Ltd.

Sustainability and the Building Code of Australia

This was a two-stage project to inform the Australian property and construction industry generally, and to provide the Australian Building Codes Board (ABCB) with information to allow it to determine whether or not sustainability requirements are necessary in the Future Building Code of Australia (BCA21). Research objectives included: examine overseas sustainability requirements for buildings and outline the reason why it is controlled and regulated in the particular country, state, principality etc. examine studies focusing on sustainability developments in buildings in Australia and overseas identify potential issues and implications associated with sustainable building requirements provide advice on whether provisions are necessary in the BCA21 to make buildings sustainable if the study determines there is a need for sustainability requirements in the BCA21, the study was to demonstrate the need to control and regulate along with the method to control and regulate. This research was broken down into two stages. Stage 1 was a literature review of international requirements as well as current thinking and practice for sustainable building developments. Stage 2 identified issues and implications of sustainability requirements for buildings and advice on whether provisions are necessary in the BCA21. This stage included workshops in all capital cities and involved key stakeholders, such as regulators, local government and representatives from key associations. This final report brings together the work of both stages, along with a searchable internet database of references and a series of nine key recommendations.

Towards a building sustainability assessment framework

This paper provides an overview of a new framework for a design stage Building Environmental Assessment (BEA) tool and a discussion of strategic responses to existing tool issues and relative stakeholder requirements that lead to the development of this tool founded on new information and communication technology (ICT) related to developments in 3D CAD technology. After introducing the context of the BEA and some of their team’s new work the authors • Critique current BEA tool theory; • Review previous assessments of stakeholder needs; • Introduce a new framework applied to analyse such tools • Highlight and key results considering illustrative ICT capabilities and • Discuss their potential significance upon BEA tool stakeholders.