Marginal costs of hospital-acquired conditions : information for priority-setting for patient safety programmes and research

Objective: To estimate the relative inpatient costs of hospital-acquired conditions. Methods: Patient level costs were estimated using computerized costing systems that log individual utilization of inpatient services and apply sophisticated cost estimates from the hospital's general ledger. Occurrence of hospital-acquired conditions was identified using an Australian ‘condition-onset' flag for diagnoses not present on admission. These were grouped to yield a comprehensive set of 144 categories of hospital-acquired conditions to summarize data coded with ICD-10. Standard linear regression techniques were used to identify the independent contribution of hospital-acquired conditions to costs, taking into account the case-mix of a sample of acute inpatients (n = 1,699,997) treated in Australian public hospitals in Victoria (2005/06) and Queensland (2006/07). Results: The most costly types of complications were post-procedure endocrine/metabolic disorders, adding AU$21,827 to the cost of an episode, followed by MRSA (AU$19,881) and enterocolitis due to Clostridium difficile (AU$19,743). Aggregate costs to the system, however, were highest for septicaemia (AU$41.4 million), complications of cardiac and vascular implants other than septicaemia (AU$28.7 million), acute lower respiratory infections, including influenza and pneumonia (AU$27.8 million) and UTI (AU$24.7 million). Hospital-acquired complications are estimated to add 17.3% to treatment costs in this sample. Conclusions: Patient safety efforts frequently focus on dramatic but rare complications with very serious patient harm. Previous studies of the costs of adverse events have provided information on ‘indicators’ of safety problems rather than the full range of hospital-acquired conditions. Adding a cost dimension to priority-setting could result in changes to the focus of patient safety programmes and research. Financial information should be combined with information on patient outcomes to allow for cost-utility evaluation of future interventions.

Rules and mechanics

So far in this book, we have seen a large number of methods for generating content for existing games. So, if you have a game already, you could now generate many things for it: maps, levels, terrain, vegetation, weapons, dungeons, racing tracks. But what if you don’t already have a game, and want to generate the game itself? What would you generate, and how? At the heart of any game are its rules. This chapter will discuss representations for game rules of different kinds, along with methods to generate them, and evaluation functions and constraints that help us judge complete games rather than just isolated content artefacts. Our main focus here will be on methods for generating interesting, fun, and/or balanced game rules. However, an important perspective that will permeate the chapter is that game rule encodings and evaluation functions can encode game design expertise and style, and thus help us understand game design. By formalising aspects of the game rules, we define a space of possible rules more precisely than could be done through writing about rules in qualitative terms; and by choosing which aspects of the rules to formalise, we define what aspects of the game are interesting to explore and introduce variation in. In this way, each game generator can be thought of an executable micro-theory of game design, though often a simplified, and sometimes even a caricatured one

Book Review: "Metal Rules the Globe: Heavy Metal Music around the World". Durham, NC: Duke University Press.

It is rare to find an anthology that realizes the possibilities of the form. We tend to regard our edited collections as lesser siblings, and forget their special value. But at times, a subject seems to require an edited collection much more than it does a classic monograph. So it is with the subject showcased here, which concerns the global circulation, performance and consumption of heavy metal. This is a relatively new and emerging body of work, hitherto scattered disparately in the broader popular music studies, but quickly gaining status as a “studies” with the establishment of a global conference, a journal, and publication of this anthology, all in recent years. Metal Rules the Globe took the editors’ a decade to compile. That they have thought deeply about how they want the collection to speak shows through in the book’s thoughtful arrangement and design, and in the way in which they draw on the contributions herein to develop for the field a research agenda that will take it forward...

In search of good probability assessors: An experimental comparison of elicitation rules for confidence judgments

In this paper, we use an experimental design to compare the performance of elicitation rules for subjective beliefs. Contrary to previous works in which elicited beliefs are compared to an objective benchmark, we consider a purely subjective belief framework (confidence in one’s own performance in a cognitive task and a perceptual task). The performance of different elicitation rules is assessed according to the accuracy of stated beliefs in predicting success. We measure this accuracy using two main factors: calibration and discrimination. For each of them, we propose two statistical indexes and we compare the rules’ performances for each measurement. The matching probability method provides more accurate beliefs in terms of discrimination, while the quadratic scoring rule reduces overconfidence and the free rule, a simple rule with no incentives, which succeeds in eliciting accurate beliefs. Nevertheless, the matching probability appears to be the best mechanism for eliciting beliefs due to its performances in terms of calibration and discrimination, but also its ability to elicit consistent beliefs across measures and across tasks, as well as its empirical and theoretical properties.

Scoring rules and abnormally low bids criteria in construction tenders: A taxonomic review

In the global construction context, the Best Value or Most Economically Advantageous Tender is becoming a widespread approach for contractor selection, as an alternative to other traditional awarding criteria such as the Lowest Price. In these multi-attribute tenders, the owner or auctioneer solicits proposals containing both a price bid and additional technical features. Once the proposals are received, each bidder's price bid is given an economic score according to a scoring rule, generally called an Economic Scoring Formula (ESF) and a technical score according to pre-specified criteria. Eventually, the contract is awarded to the bidder with the highest weighted overall score (economic + technical). However, Economic Scoring Formula selection by auctioneers is invariably and paradoxically a highly intuitive process in practice, involving few theoretical or empirical considerations, despite having being considered traditionally and mistakenly as objective, due to its mathematical nature. This paper provides a taxonomic classification of a wide variety of ESF and Abnormally Low Bid Criteria (ALBC) gathered in several countries with different tendering approaches. Practical implications concern the optimal design of price scoring rules in construction contract tenders, as well as future analyses of the effects of ESF and ALBC on competitive bidding behaviour.

Fire design rules for load bearing cold-formed steel frame walls exposed to realistic design fire curves

Light gauge Steel Frame (LSF) walls are extensively used in the building industry due to the many advantages they provide over other wall systems. Although LSF walls have been used widely, fire design of LSF walls is based on approximate prescriptive methods based on limited fire tests. Also these fire tests were conducted using the standard fire curve [1] and the applicability of available design rules to realistic design fire curves has not been verified. This paper investigates the accuracy of existing fire design rules in the current cold-formed steel standards and the modifications proposed by previous researchers. Of these the recently developed design rules by Gunalan and Mahendran [2] based on Eurocode 3 Part 1.3 [3] and AS/NZS 4600 [4] for standard fire exposure [1] were investigated in detail to determine their applicability to predict the axial compression strengths and fire resistance ratings of LSF walls exposed to realistic design fire curves. This paper also presents the fire performance results of LSF walls exposed to a range of realistic fire curves obtained using a finite element analysis based parametric study. The results from the parametric study were used to develop a simplified design method based on the critical hot flange temperature to predict the fire resistance ratings of LSF walls exposed to realistic fire curves. Finally, the stud failure times (fire resistance rating) obtained from the fire design rules and the simplified design method were compared with parametric study results for LSF walls lined with single and double plasterboards, and externally insulated with rock fibres under realistic fire curves.

Priority threat management of non-native plants to maintain ecosystem integrity across heterogeneous landscapes

Invasive non-native plants have negatively impacted on biodiversity and ecosystem functions world-wide. Because of the large number of species, their wide distributions and varying degrees of impact, we need a more effective method for prioritizing control strategies for cost-effective investment across heterogeneous landscapes. Here, we develop a prioritization framework that synthesizes scientific data, elicits knowledge from experts and stakeholders to identify control strategies, and appraises the cost-effectiveness of strategies. Our objective was to identify the most cost-effective strategies for reducing the total area dominated by high-impact non-native plants in the Lake Eyre Basin (LEB). We use a case study of the ˜120 million ha Lake Eyre Basin that comprises some of the most distinctive Australian landscapes, including Uluru-Kata Tjuta National Park. More than 240 non-native plant species are recorded in the Lake Eyre Basin, with many predicted to spread, but there are insufficient resources to control all species. Lake Eyre Basin experts identified 12 strategies to control, contain or eradicate non-native species over the next 50 years. The total cost of the proposed Lake Eyre Basin strategies was estimated at AU$1·7 billion, an average of AU$34 million annually. Implementation of these strategies is estimated to reduce non-native plant dominance by 17 million ha – there would be a 32% reduction in the likely area dominated by non-native plants within 50 years if these strategies were implemented. The three most cost-effective strategies were controlling Parkinsonia aculeata, Ziziphus mauritiana and Prosopis spp. These three strategies combined were estimated to cost only 0·01% of total cost of all the strategies, but would provide 20% of the total benefits. Over 50 years, cost-effective spending of AU$2·3 million could eradicate all non-native plant species from the only threatened ecological community within the Lake Eyre Basin, the Great Artesian Basin discharge springs. Synthesis and applications. Our framework, based on a case study of the ˜120 million ha Lake Eyre Basin in Australia, provides a rationale for financially efficient investment in non-native plant management and reveals combinations of strategies that are optimal for different budgets. It also highlights knowledge gaps and incidental findings that could improve effective management of non-native plants, for example addressing the reliability of species distribution data and prevalence of information sharing across states and regions.

Priority threat management of invasive animals to protect biodiversity under climate change

Climate change is a major threat to global biodiversity, and its impacts can act synergistically to heighten the severity of other threats. Most research on projecting species range shifts under climate change has not been translated to informing priority management strategies on the ground. We develop a prioritization framework to assess strategies for managing threats to biodiversity under climate change and apply it to the management of invasive animal species across one-sixth of the Australian continent, the Lake Eyre Basin. We collected information from key stakeholders and experts on the impacts of invasive animals on 148 of the region's most threatened species and 11 potential strategies. Assisted by models of current distributions of threatened species and their projected distributions, experts estimated the cost, feasibility, and potential benefits of each strategy for improving the persistence of threatened species with and without climate change. We discover that the relative cost-effectiveness of invasive animal control strategies is robust to climate change, with the management of feral pigs being the highest priority for conserving threatened species overall. Complementary sets of strategies to protect as many threatened species as possible under limited budgets change when climate change is considered, with additional strategies required to avoid impending extinctions from the region. Overall, we find that the ranking of strategies by cost-effectiveness was relatively unaffected by including climate change into decision-making, even though the benefits of the strategies were lower. Future climate conditions and impacts on range shifts become most important to consider when designing comprehensive management plans for the control of invasive animals under limited budgets to maximize the number of threatened species that can be protected.

Global rules on conflict-of-laws matters in international insolvency law cases: An Australian perspective

The 2012 Report “Transnational Insolvency: Global Principles for Co-operation in International Insolvency Cases” – commissioned by The American Law Institute in conjunction with The International Insolvency Institute – annexed 23 “Global Rules on Conflict-of-Laws Matters in International Insolvency Cases”. These proposed “Global Rules” are intended to “serve as legislative recommendations” to (inter alia) promote uniformity and greater certainty in the unpredictable area of conflict of laws. This article provides a brief commentary upon the 23 proposed Global Rules from an Australian perspective (comparing the effect and intent of each rule with the current Australian conflict-of-laws position) and offers some conclusions as to the merits of the “Global Rules” initiative.

Improved shear design rules of cold-formed steel beams

Light gauge cold-formed steel sections have been developed as more economical building solutions to the alternative heavier hot-rolled sections in the commercial and residential markets. Cold-formed lipped channel beams (LCB), LiteSteel beams (LSB) and triangular hollow flange beams (THFB) are commonly used as flexural members such as floor joists and bearers while rectangular hollow flange beams (RHFB) are used in small scale housing developments through to large building structures. However, their shear capacities are determined based on conservative design rules. For the shear design of cold-formed steel beams, their elastic shear buckling strength and the potential post-buckling strength must be determined accurately. Hence experimental and numerical studies were conducted to investigate the shear behaviour and strength of LCBs, LSBs, THFBs and RHFBs. Improved shear design rules including the direct strength method (DSM) based design equations were developed to determine the ultimate shear capacities of these open and hollow flange steel beams. An improved equation for the higher elastic shear buckling coefficient of cold-formed steel beams was proposed based on finite element analysis results and included in the design equations. A new post-buckling coefficient was also introduced in the design equations to include the available post-buckling strength of cold-formed steel beams. This paper presents the details of this study on cold-formed steel beams subject to shear, and the results. It proposes generalised and improved shear design rules that can be used for any type of cold-formed steel beam.

Who Rules Japan? Popular Participation in the Japanese Legal Process

"The dramatic growth of the Japanese economy in the postwar period, and its meltdown in the 1990s, has attracted sustained interest in the power dynamics underlying the management of Japan’s administrative state. Scholars and commentators have long debated over who wields power in Japan, asking the fundamental question: who really governs Japan? This important volume revisits this question by turning its attention to the regulation and design of the Japanese legal system. With essays covering the new lay-judge system in Japanese criminal trials, labour dispute resolution panels, prison policy, gendered justice, government lawyers, welfare administration and administrative transparency, this comprehensive book explores the players and processes in Japan’s administration of justice."--publisher website

Introduction: Who rules Japan?

This chapter reviews the debate about who governs Japan and considers the implications of legal system reforms initiated by the Justice System Reform Council report of 2001.

Towards simple rules heuristics for IT business value

The business value of IT (BVIT) has been a prominent and central research topic in the IS discipline. Due to continuous and unpredictable technology and business changes, a more dynamic perspective on IT business value that includes organizational learning is required. We suggest that simple rules heuristics can address this challenge. The simple rules heuristics approach has been introduced by Eisenhardt and co-authors (Bingham & Eisenhardt, 2011; Bingham, Eisenhardt, & Furr, 2007; Eisenhardt & Sull, 2001) to better understand strategic decision making for capturing superabundant, heterogeneous, fastmoving opportunities. They argue that explicit organizational learning can translate accumulated experience into increasingly effective heuristics for strategic processes in highvelocity environments. We make three main contributions by exploring the suitability of a simple rules heuristics approach for the creation of IT business value: (1) we propose six types of simple rules heuristics for capturing IT-based opportunities in dynamic environments, including synergy heuristics as specifically relevant in an IT context, (2) we show how a simple rules heuristics approach can advance our understanding of dynamics and organizational learning for BVIT, and; (3) we introduce the strategic logic of opportunity to BVIT.