Burden of epilepsy: a prevalence-based cost of illness study of direct, indirect and intangible costs for epilepsy

OBJECTIVES: We aimed to gauge the burden of epilepsy in China from a societal perspective by estimating the direct, indirect and intangible costs. METHODS: Patients with epilepsy and controls were enrolled from two tertiary hospitals in China. Patients were asked to complete a Cost-of-Illness (COI), Willingness-to-Pay (WTP) questionnaires, two utility elicitation instruments and Mini Mental State Examination (MMSE). Healthy controls only completed WTP questionnaire, and utility instruments. Univariate analyses were performed to investigate the differences in cost on the basis of different variables, while multivariate analysis was undertaken to explore the predictors of cost/cost component. RESULTS: In total, 141 epilepsy patients and 323 healthy controls were recruited. The median total cost, direct cost and indirect cost due to epilepsy were US$949.29, 501.34 and 276.72, respectively. Particularly, cost of anti-epileptic drugs (AEDs) (US$394.53) followed by cost of investigations (US$59.34), cost of inpatient and outpatient care (US$9.62) accounted for the majority of the direct medical costs. While patients' (US$103.77) and caregivers' productivity costs (US$103.77) constituted the major component of indirect cost. The intangible costs in terms of WTP value (US$266.07 vs. 88.22) and utility (EQ-5D, 0.828 vs. 0.923; QWB-SA, 0.657 vs. 0.802) were both substantially higher compared to the healthy subjects. CONCLUSIONS: Epilepsy is a cost intensive disease in China. According to the prognostic groups, drug-resistant epilepsy generated the highest total cost whereas patients in seizure remission had the lowest cost. AED is the most costly component of direct medical cost probably due to 83% of patients being treated by new generation of AEDs.

CmyView: Walking together apart

Networked learning practices are impacting the field of cultural heritage, both tangible and intangible, with implications for the way in which places of cultural significance are understood, managed, documented, engaged with and studied. Our research explores the intersection between walking, photography, technology and learning, investigating how mobile devices can be used to foster community participation and assess social value within a networked framework for digital heritage. The paper introduces CmyView, a mobile phone application and social media platform in development, with a design concept grounded on both digital heritage and networked learning perspectives. CmyView encourages people to collect and share their views by making images and audio recordings of personally meaningful sites they see, while walking outdoors. Each person’s walking trajectory (along with their associated images and audio files) then becomes a trace-able artefact, something potentially shareable with a community of fellow walkers. The aim of CmyView is to encourage networked heritage practices and community participation, as people learn to assess their own and experience others social values of the built environment. Drawing on a framework for the analysis and design of productive learning networks, we explore the educational design of CmyView arguing that the platform offers a space for democratic heritage education and interpretation, where participatory urban curatorship practices are nurtured. CmyView reframes social value as dynamic, fluid and located within communities, rather than fixed in a place. The paper presents preliminary findings of the activity of a group of four undergraduate students at an Australian university, who used CmyView to explore the immediate surroundings of their campus. Participants interacted with the platform, mapping, capturing, audio recording their impressions and sites of interest in their walks. In so doing, they created shareable trajectories, which were subsequently experienced by the same group of participants on a second walk. The paper concludes with a discussion about the impact of our research for the design of mobile technologies that embrace participation and sharing, through a networked learning perspective. The paper brings together concepts that sit at the intersection of previously separate fields, namely digital heritage and networked learning, to find their synergies.

Locating the intangible: integrating a sense of place into cost estimations of natural disasters

The field of disaster loss assessment attempts to provide comprehensive estimates of the cost of disasters. Assessment of intangibles remains a major weakness. Existing costing frameworks have acknowledged losses to cultural – as distinct from economic, social, human or environmental – capital. However, theinclusion of cultural line items has usually been conducted in an ad hoc and under-theorised way, withlittle empirical evidence. This paper presents the possibility of using cultural capital itself as an overarchingcategory for specifically cultural losses. It further focuses on the specific concept of sense of place asone area that has been neglected even in frameworks that consider other kinds of intangibles, and argues,on both theoretical and pragmatic grounds, that a collective or shared sense of place can be subsumedwithin cultural capital loss estimates. Christchurch provides an illustration of the idea as relevant andcomparable empirical material is available from before and since the 2011 earthquake.

Computer-aided design decision support: interfacing knowledge and information

Computer-aided design decision support has proved to be an elusive and intangible project for many researchers as they seek to encapsulate information and knowledge-based systems as useful multifunctional data structures. Definitions of ‘knowledge', ‘information', ‘facts', and ‘data' become semantic footballs in the struggle to identify what designers actually do, and what level of support would suit them best, and how that support might be offered. The Construction Primer is a database-drivable interactive multimedia environment that provides readily updated access to many levels of information aimed to suit students and practitioners alike. This is hardly a novelty in itself. The innovative interface and metadata structures, however, combine with the willingness of national building control legislators, standards authorities, materials producers, building research organisations, and specification services to make the Construction Primer a versatile design decision support vehicle. It is both compatible with most working methodologies while remaining reasonably future-proof. This paper describes the structure of the project and highlights the importance of sound planning and strict adhesion to library-standard metadata protocols as a means to avoid the support becoming too specific or too paradigmatic.

`This was a great project!`: reflections on a `successful` mental health promotion project in a remote Indigenous school

Issue addressed: The complexities encountered in an Indigenous community when a white project support team assisted a school (Bwgcolman on Palm Island, Queensland) to implement MindMatters, a centralised, national project aiming to promote the psychosocial health of young Australians through the development of a comprehensive, school- based mental health promotion program. Approach: The MindMatters consortium offered pilot schools curriculum materials, professional development for staff, funding and ongoing support at a local level in return for their participation in the project. The support team flew to the island on two occasions to provide support. Conclusion: Whether or not MindMatters constituted a community project at Bwgcolman is debatable. Nevertheless, the project at Bwgcolman was considered a 'success' by key players since initial aims identified by the school were tangible (eg, professional development, curriculum development) and met in a way that the school could take ownership of. Additionally, behavioural management policy was implemented in a manner that was cognisant of a history of coercive relations with Indigenous communities. So what?: It is important in the telling of the success story at Bwgcolman that even though MindMatters endeavoured to be culturally sensitive, it was nevertheless a centralist mental health promotion program. Future mental health promotion initiatives need to be aware that the approach of the support team in attempting to hand back some community control at the local level may have played a role in the school succeeding.

Codes of ethics: what are they really and what should they be?

Codes of ethics are prevalent in major corporations around the world. They are seen as the first tangible commitment to being ethical. This paper examines codes of ethics and tries to establish what they are, how they are developed and their net utility. We then proffer the idea of codes as the first part of a five-stage process that leads to an overall corporate commitment to being ethical in one's business dealings.

Floating lives : cultural citizenship and the limits of diaspora

Cultural citizenship may, in the simplest terms, be taken to mean a certain 'fit' or compatibility between the cultural attributes of an individual or group and those of the society in which they live. It is a complex concept, taking in rights, responsibilities and competencies as well as the more intangible issues of identity and belonging which have been the subject of intense debates within cultural studies in the last decade. In the case of diasporic or transnational peoples, it is further complicated by the fact of their multiple and unstable cultural and/or civic allegiances (to home and host nations in the first instance, but frequently also to the cultural space of diaspora itself).

This essay examines recent life stories by Chinese Australians: Clara Law's film Floating Life (1996) and two novellas by Liu Guande and Huangfu Jun, published together in English under the title Bitter Peaches and Plums (1995). Focusing on the diversity of experience evoked by notions of cultural belonging, it argues against the prevalent tendency within diaspora studies to engage in a rhetoric of cultural essentialism. The literatures of diaspora deserve to be read as documents of unique and complex cultural experiences rather than mere illustrations of archetypes

Surviving financial distress : the case of too many herbs and spices

Over 120 years ago Sir James Burns founded an organisation that is today, the international business group of Burns Philp and Company Ltd. The Group is widely known as a leading producer of yeast products and manufacturer of other bakery ingredients. Its ability to adapt to the ever-changing demands of business is widely recognised. During the late 1980’s however, after the group expanded into the herbs and spices industry its financial state deteriorated. Yet, arguably the Group had entered a market that complimented its then existing core-activities. This paper examines circumstances surrounding that venture into herbs and spices. It argues that the Group’s financial predicament, at that time, was exacerbated by the use of conventional accounting procedures. It illustrates that up-to-date market related financial details, in lieu of accounting book constructs, more aptly assist directors, managers, all stakeholders to conduct business and make informed economic decisions. This paper suggests that it is an entity’s current financial state of affairs, with regard to tangible market referents, that enables a firm’s strategic progress and facilitates proactive management; and in turn, assists in the sustainable development of business throughout the world.

Scientific proof that humans enjoy punishing wrongdoers: The implications for punishment and sentencing

Recent developments in brain science confirm that as a race we are in fact a punitive lot. Human beings actually derive pleasure from inflicting punishment on wrongdoers. We are wired in such a way that the part of our brain that reports pleasure is activated when we punish norm violators. This is even when punishment has no tangible or demonstrable benefits. However, we are not slaves lo our emotions. Another region of our brain 'kicks-in' if punishment becomes self-defeating, in that it conflicts with our other interests. The implications of this research for punishment theory and the practice of sentencing are discussed in this paper. The findings give qualified support to the theory known as intrinsic retributivism, but do not suggest it is the soundest theory of punishment. This is because we stop punishing when it comes at a cost to us. The good feeling that punishment invokes in punishers is another consequential consideration in favour of the utilitarian theory of punishment. However, it is not clear that the utilitarian calculus is necessarily affected by the findings. The main implication of the research findings relates to the relevance of public opinion to sentencing practice. The findings support the view that public sentiment, which seems to support increasingly tougher sanctions, can be curtailed of the public are informed that punishment comes of a cost to community.

Crafting organization

The recent shift in attention away from organization studies as science has allowed for consideration of new ways of thinking about both organization and organizing and has led to several recent attempts to 'bring down' organizational theorizing. In this paper, we extend calls for organization to be represented as a creative process by considering organization as craft. Organizational craft, we argue, is attractive, accessible, malleable, reproducible, and marketable. It is also a tangible way of considering organization studies with irreverence. We draw on the hierarchy of distinctions among fine art, decorative art, and craft to suggest that understanding the organization of craft assists in complicating our understanding of marginality. We illustrate our argument by drawing on the case of a contemporary Australian craftworks and marketplace known initially as the Meat Market Craft Centre ('MMCC') and then, until its recent closure, as Metro! ‡ Stella Minahan was a board member and then the Chief Executive Officer of the Metro! Craft Centre.

QuickTime multi-track theatricks

Digital media, corporate database applications and intranets provide efficient ways to create, store and deliver information and educational services. However some academics perceive new workload and other constraints eroding the potency of these technologies. Proposed corporate level information management systems for digital objects and their metadata are new complexities entering academicsÕ thoughts about using online multimedia.

Few staff understand digital multimedia concepts and fewer still, the systems designed to deal with IP management, copyright law compliance and the tracking of digital resource creation processes. Faltering staff enthusiasm warns of their need to experience working models and tangible benefits from these new directions. A project in Deakin's Faculty of Education provides a case study showing how QuickTime is helping academics understand, and increase their use of, multimedia in e-learning environments with an integrated library of digital resources with metadata.

We also report our experience of QuickTime in creating interactive learning objects using multi-tracks. We discuss our idea of theatricks as a performance drawcard - people will come! There is orchestration of multimedia and QuickTime conducts the events, its flexible functionalities providing a safer development environment for solving problems and grasping opportunities.

While difficult for some academics to comprehend, scripting automation and database connectivity through intelligent interfaces might facilitate QuickTime's use in building integrated learning environments with academics. These ideas are considered in relation to staff development, central to the case study project.

Electronic markets and service delivery: requisite competencies for virtual environments

Electronic markets have a short but dynamic history. How an electronic market can be successfully developed remains in dispute. There is a clear need to better understand the nature of electronic markets themselves and, in particular, to review important developments in their conceptualisation. To enable a deeper understanding of these issues, we decided to restrict our investigation to electronic markets in the agricultural export sector. Agribusiness is a natural early adopter of digital marketplaces because of the industry’s traditional reliance on markets and current take-up of global supply chain management (Wilkins, Swatman and Castleman, 2002). We review two portals from this sector that aimed to simplify access to regulatory documentation. The earlier implementation had its funding withdrawn after one year, whilst the more recently established portal is rapidly becoming a showcase project for the stakeholders. We use a composite theory based on Bijker (1995) and Nowotny et al (2001) to establish a framework for analysing our data. We also refer to a body of literature characterising intangible services and their design and its implications for emarket implementations. Our findings indicate that governance style is in fact closely related to the success or failure of specific sites. We also found support for earlier research indicating that expectations and understanding of electronic markets are still evolving.

A defection analysis of lapsed members of five sporting clubs : examining motivations and behaviours

The issue of defection has been examined primarily in a transactional context as opposed to subscription markets where the infrequent nature of the purchase or renewal means that retention of subscribers is often both more difficult and more crucial. This paper reports on a survey that aimed to uncover more information about the motivations and future intentions of recently lapsed subscribers. 1,011 lapsed members across four Australian Football League (AFL) clubs and one Australian National Rugby League (NRL) club were surveyed. Analysis of the responses returned suggests that although these lapsed members report that they joined to financially support and feel more involved with the club, they let their membership lapse primarily due to an inability to attend games. Despite joining for intangible, altruistic reasons, it seems that if these members could not get to games, they believed that the membership was not worth maintaining. These members were satisfied with the membership; however measures of overall level of satisfaction had only a weak positive relationship with the likelihood of members rejoining in the future. The inconsistencies in the findings challenge some conventional approaches to both the methods of researching lapsed members and the theories that are frequently used to explain behaviours. We find that simplistic entry or exit surveys are likely to be of limited value in subscription defection research and that satisfaction is unlikely to be a strong predictor of defection behaviour.

A defection analysis of lapsed season ticket holders : a consumer and organizational study

This paper reports on a four-stage study that investigated the motivations and future intentions of recently lapsed members (season-ticket holders) of professional sports organizations, and the marketing responses of those organizations to the issue of customer retention. Survey responses from over 1,000 recently lapsed members across five large sporting clubs were collected. A further study on one club was then conducted to compare attitudes and demographics of lapsed members to those who renewed. The responses suggests that although these lapsed members report that they joined to financially support and feel more involved with the club, they let their membership lapse primarily due to an inability to attend games. Despite joining for intangible, altruistic reasons, it seems that if these members could not get to games, they believed that the membership was not worth maintaining. These members were satisfied with the membership; however, measures of overall level of satisfaction had only a weak positive relationship with the likelihood of members rejoining in the future. These sport organizations were greatly concerned by lapsed members but have only ad hoc relationship marketing strategies in place to either prevent members lapsing or renew lapsed members.