Which interventions offer best value for money in primary prevention of cardiovascular disease?

Background
Despite many decades of declining mortality rates in the Western world, cardiovascular disease remains the leading cause of death worldwide. In this research we evaluate the optimal mix of lifestyle, pharmaceutical and population-wide interventions for primary prevention of cardiovascular disease.

Methods and Findings
In a discrete time Markov model we simulate the ischaemic heart disease and stroke outcomes and cost impacts of intervention over the lifetime of all Australian men and women, aged 35 to 84 years, who have never experienced a heart disease or stroke event. Best value for money is achieved by mandating moderate limits on salt in the manufacture of bread, margarine and cereal. A combination of diuretic, calcium channel blocker, ACE inhibitor and low-cost statin, for everyone with at least 5% five-year risk of cardiovascular disease, is also cost-effective, but lifestyle interventions aiming to change risky dietary and exercise behaviours are extremely poor value for money and have little population health benefit.

Conclusions
There is huge potential for improving efficiency in cardiovascular disease prevention in Australia. A tougher approach from Government to mandating limits on salt in processed foods and reducing excessive statin prices, and a shift away from lifestyle counselling to more efficient absolute risk-based prescription of preventive drugs, could cut health care costs while improving population health.

Framing the socialisation process of the DBA candidate: what can universities offer and what should candidates bring?

In Australia, the Doctorate of Business Administration (DBA) remains a popular program but considerable anguish persists within the university sector over just what it is offering students. In this article, we use the process of postgraduate socialisation to understand how candidates, supervisors and administrators navigate pathways to successful completion and offering of a DBA program. We identify four modes of knowledge applicable to the DBA and suggest that universities and candidates may draw on one another’s cultural capital to determine which mode(s) can be offered. We also illustrate how candidates exercise agency through their cultural and social capital as they move through the program. We present a conceptual framework to help guide future research, and resource allocation on the DBA.

Framing the socialisation process of the DBA candidate : what can universities offer and what should candidates bring?

In Australia, the Doctorate of Business Administration (DBA) remainsa popular program but considerable anguish persists within theuniversity sector over just what it is offering students. In thisarticle, we use the process of postgraduate socialisation tounderstand how candidates, supervisors and administratorsnavigate pathways to successful completion and offering of a DBAprogram. We identify four modes of knowledge applicable to theDBA and suggest that universities and candidates may draw onone another’s cultural capital to determine which mode(s) can beoffered. We also illustrate how candidates exercise agencythrough their cultural and social capital as they move through theprogram. We present a conceptual framework to help guidefuture research, and resource allocation on the DBA.