Superannuation retirement balances: A surprising outcome

Aim: Although the guaranteed superannuation system is believed by many to provide a safe and adequate source of funds in retirement, some will be unpleasantly surprised. The aim of this paper is to demonstrate the significant effect of the economic cycle on the final accumulated balance in superannuation retirement accounts. Method: A Monte Carlo simulation is used to illustrate the variance in outcomes that can be expected for a hypothetical individual. Results: The expected accumulated superannuation balances for two hypothetical individuals are estimated. The spread of outcomes is used to illustrate the problem of using only the mean of the distribution as a predictor of wealth in the retirement years. Conclusions: Many retirees rely on superannuation to fund their retirement. However regular contributions to superannuation does not ensure a predictable outcome, and active management of contributions is required if retirement goals are to be met.

The shadow economy as an equilibrium outcome

We construct a dynamic general equilibrium model of tax evasion where agents choose to report some of their income. Unreported income requires using a payment method that avoids recordkeeping in some markets-cash. Trade using cash to avoid taxes is the 'shadow economy' in our model. We then calibrate our model using money, interest rate and GDP data to back out the size of the shadow economy for a sample of countries and compare our measures to traditional reduced form estimates. © 2014 Elsevier B.V.

The impact of past direct-personal traumatic events on 12-month outcome in first episode psychotic mania: trauma and early psychotic mania

Past traumatic events have been associated with poorer clinical outcomes in people with bipolar disorder. However, the impact of these events in the early stages of the illness remains unclear. The aim of this study was to investigate whether prior traumatic events were related to poorer outcomes 12 months following a first episode of psychotic mania.

Assessing outcomes for cost-utility analysis in depression : comparison of five multi-attribute utility instruments with two depression-specific outcome measures

Many mental health surveys and clinical studies do not include a multi-attribute utility instrument (MAUI) that produces quality-adjusted life-years (QALYs). There is also some question about the sensitivity of the existing utility instruments to mental health.

What makes a difference? Building a foundation for nationally consistent outcome measures

This project sought a solid, credible basis for measuring the effectiveness of homelessness services. It assumed that an effective service creates successful results for people experiencing homelessness, results which make a difference. To identify which results, which 'client outcomes', make a difference, the project used the international research evidence base and input from experienced practitioners and policy-makers.

Australian Enterococcal Sepsis Outcome Programme, 2011

From 1 January to 31 December 2011, 29 institutions around Australia participated in the Australian Enterococcal Sepsis Outcome Programme (AESOP). The aim of AESOP 2011 was to determine the proportion of enterococcal bacteraemia isolates in Australia that are antimicrobial resistant, with particular emphasis on susceptibility to ampicillin and the glycopeptides, and to characterise the molecular epidemiology of the Enterococcus faecalis and E. faecium isolates. Of the 1,079 unique episodes of bacteraemia investigated, 95.8% were caused by either E. faecalis (61.0%) or E. faecium (34.8%). Ampicillin resistance was detected in 90.4% of E. faecium but not detected in E. faecalis. Using Clinical and Laboratory Standards Institute breakpoints (CLSI), vancomycin non-susceptibility was reported in 0.6% and 31.4% of E. faecalis and E. faecium respectively and was predominately due to the acquisition of the vanB operon. Approximately 1 in 6 vanB E. faecium isolates however, had an minimum inhibitory concentration at or below the CLSI vancomycin susceptible breakpoint of ≤ 4 mg/L. Overall, 37% of E. faecium harboured vanA or vanB genes. Although molecular typing identified 126 E. faecalis pulsed-field gel electrophoresis (PFGE) pulsotypes, more than 50% belonged to 2 pulsotypes that were isolated across Australia. E. faecium consisted of 73 PFGE pulsotypes from which 43 multilocus sequence types were identified. Almost 90% of the E. faecium were identified as clonal complex 17 clones, of which approximately half were characterised as sequence type 203, which was isolated Australia-wide. In conclusion, the AESOP 2011 has shown that although polyclonal, enterococcal bacteraemias in Australia are frequently caused by ampicillin-resistant vanB E. faecium.

Association between surgical indications, operative risk, and clinical outcome in infective endocarditis: a prospective study from the International Collaboration on Endocarditis.

Use of surgery for the treatment of infective endocarditis (IE) as related to surgical indications and operative risk for mortality has not been well defined.

The characteristics and outcome of infective endocarditis involving implantable cardiac devices

Infection of implantable cardiac electronic devices in particular lead endocarditis (cardiac device infective endocarditis (CDIE)) is an emerging problem with significant morbidity, mortality and health care costs. The epidemiology is characterised with advanced age and health care association in cases presenting within 6 months of implantation. Risk factors include those of the patient, the procedure and the device. Staphylococcal species predominate as the causative organisms. Diagnosis is reliably made by blood cultures and transesophageal echocardiography. Complications include pulmonary and systemic emboli, persistent bacteremia and concomitant valvular involvement. Management includes complete device removal and prolonged antimicrobial therapy. With long-term follow-up to 1 year, the mortality of CDIE is as high as 23 %. It is associated with patient co-morbidities and concomitant valvular involvement and may be prevented by device removal during index admission.

Australian Enterococcal Sepsis Outcome Programme annual report, 2013.

From 1 January to 31 December 2013, 26 institutions around Australia participated in the Australian Enterococcal Sepsis Outcome Programme (AESOP). The aim of AESOP 2013 was to determine the proportion of enterococcal bacteraemia isolates in Australia that are antimicrobial resistant, and to characterise the molecular epidemiology of the Enterococcus faecium isolates. Of the 826 unique episodes of bacteraemia investigated, 94.6% were caused by either E. faecalis (56.1%) or E. faecium (38.5%). Ampicillin resistance was not detected in E. faecalis but was detected in over 90% of E. faecium. Vancomycin non-susceptibility was reported in 0.2% and 40.9% of E. faecalis and E. faecium respectively and was predominately due to the acquisition of the vanB operon. Overall, 41.6% of E. faecium harboured vanA or vanB genes. The percentage of E. faecium bacteraemia isolates resistant to vancomycin in Australia is significantly higher than that seen in most European countries. E. faecium isolates consisted of 81 pulsed-field gel electrophoresis pulsotypes of which 72.3% were classified into 14 major pulsotypes containing five or more isolates. Multilocus sequence typing grouped the 14 major pulsotypes into clonal cluster 17, a major hospital-adapted polyclonal E. faecium cluster. Of the 2 predominant sequence types, ST203 (80 isolates) was identified across Australia and ST555 (40 isolates) was isolated primarily in the western and central regions (Northern Territory, South Australia and Western Australia) respectively. In conclusion, the AESOP 2013 has shown enterococcal bacteraemias in Australia are frequently caused by polyclonal ampicillin-resistant high-level gentamicin resistant vanB E. faecium, which have limited treatment options.

Understanding gestational weight gain: the role of weight-related expectations and knowledge

BACKGROUND: Health behaviour theories acknowledge that beliefs, attitudes and knowledge contribute to health behaviours, yet the role of these cognitions in predicting weight gain during pregnancy has not been widely researched. AIMS: To explore and compare the predictive nature of gestational weight gain (GWG) expectations and knowledge on weight gain during pregnancy. MATERIALS AND METHODS: One hundred and sixty-six women were tracked during pregnancy. Participants provided information on prepregnancy weight, height, GWG expectations and knowledge at 16-18 weeks' gestation (Time 1). To calculate gestational weight gain, prepregnancy weight was subtracted from weight at 36 weeks' gestation (collected at Time 2). Gestational weight gain above the Institute of Medicine's GWG recommendations was classified as excessive. A hierarchical regression examined the predictive nature of GWG expectations for actual GWG. Chi-square significance tests determined whether the accuracy of GWG knowledge differed depending on GWG status and prepregnancy BMI category. RESULTS: GWG expectations were a significant predictor of weight gain during pregnancy. Women who experienced excessive GWG were more likely to overestimate the minimum amount of weight that they needed to gain to have a healthy baby. CONCLUSIONS: GWG expectations are predictive of actual GWG, and GWG knowledge among women is generally poor. In particular, overestimating of the minimum amount of weight to gain during pregnancy is associated with excessive GWG. As such, it may be beneficial to design interventions to prevent excessive GWG that targets these cognitions.

Patient expectations and preferences for follow-up after treatment for lung cancer: a pilot study

Introduction

There is no robust evidence to indicate the most appropriate models of follow-up care for patients who have completed treatment for lung cancer. This pilot study aimed to assess expectations and preferences for follow-up care in a sample of patients who had completed treatment for lung cancer.

Method

Thirty-one patients who had completed treatment for primary lung cancer were recruited. A 13 item self-report survey was developed to elicit patient's preferences and expectations for follow-up. Participants completed the developed survey and clinical and demographic variables were collected.

Results

Factors scored as extremely important by over 80% of respondents focused on care coordination: Being able to see the same doctor or health care professional at each visit (24/83%); Knowing which doctor or nurse to contact if queries arise between follow-up appointments (23/82%); and Knowing the patient can book an appointment or contact a health care professional involved in their care regarding health concerns between visits (25/89%). Patients were supportive of nurse-led follow-up when offered in the context of a model of shared care (21/78%).

Conclusion

This study offers new insight into the expectations and preferences for follow-up of patients with lung cancer, with participants indicated preference for intensive follow-up after the completion of treatment.