The increasing criminalization of economic law : a competition law perspective

Purpose – The purpose of this paper is to examine the trend towards the criminalization of hard core cartel conduct and to consider the appropriateness and effectiveness of extending the criminal law to this conduct. In addition, it will consider some of the legal implications, including the exposure of directors of companies to potential racketeering charges.
Design/methodology/approach – The paper first examines cartel theory and the justification for prohibition. The paper then identifies the emerging trend toward criminalization of hard core cartel conduct, followed by an assessment of potential justifications for criminalization. Implications of criminalization, including the potential impact of organized crime legislation on offenders and regulators, will then be considered.
Findings – There is a clear trend towards the criminalization of hard core cartels. The paper argues that this trend is appropriate, both because of the moral culpability it attracts and because of its potential to enhance general deterrence. The paper also argues that cartel conduct, in jurisdictions in which it is criminalized, will constitute “organized crime” as defined in the Palermo Convention and, as such, expose participants to potential money laundering and asset forfeiture consequences.
Originality/value – This paper is of value to governments and regulators considering adoption or implementation of a criminal cartel regime and to practitioners in advising clients about potential consequences of cartel conduct within a criminal regime.

The role of capital-labour substitution in economic growth

Purpose – Although the importance of the elasticity of substitution between capital and labour (s) has been recognized in many areas in economics, this parameter has not received enough attention in economic growth. The purpose of this paper is to review the recent development in the importance of s in economic growth.

Design/methodology/approach – This paper specifically reviews the possibility of perpetual growth and slowdown, and the asymptotic behaviour of the balanced growth path for different values of s. It also reviews the determinants of the aggregate s.

Findings – Based on the empirical evidence that the value of s significantly departs from the Cobb-Douglas value of unity, the paper recommends employing the constant elasticity of substitution (CES) production function in both theoretical and empirical growth research.

Originality/value – This paper offers a new perspective on the elasticity of substitution between capital and labour due to its evaluation of various factors, methods and approaches.

Clinical and economic burden of emergency department presentations for neutropenia following outpatient chemotherapy for cancer in Victoria, Australia

Objective. To examine the clinical characteristics and financial charges associated with treating adult cancer patients receiving chemotherapy in outpatient clinics who presented to the emergency department (ED) with neutropenia.
Design and Setting. A retrospective audit was conducted across two health services involving ED episodes and subsequent hospital admissions of patients who received chemotherapy through day oncology from January 1 to December 31, 2007 and presented to the ED with neutropenia. ED data were collected from the Victorian Emergency Minimum Dataset and charges were collected from Health Information Services. Descriptive and bivariate statistics were used to describe the patient and clinical characteristics and financial outcomes, and to explore associations between these factors.
Results. In total, 200 neutropenic episodes in 159 outpatients were seen in the ED over the survey period. The mean patient age was 56.6 years (standard deviation, 13.2 years) and 47.2% were male. Overall, 70.0% of ED episodes were triaged as Australasian Triage Scale 2 (emergency). The median ED wait time was 10 minutes and the median ED length of stay was 6.8 hours. The median charge for each ED episode was $764.08 Australian dollars. The total combined ED and inpatient charge per episode was in the range of $144.27-$174,732.68, with a median charge of $5,640.87.
Conclusions. This study provides important insights into the clinical and economic burden of neutropenia from both the ED and inpatient perspectives. Alternative treatment models, such as outpatient treatment, early discharge programs or prophylactic interventions to reduce the clinical and economic burden of neutropenia on our health system, must be explored.

Optimising errors in signaling corporate collapse using MCCCRA

Purpose – The purpose of this paper is to put forward an innovative approach for reducing the variation between Type I and Type II errors in the context of ratio-based modeling of corporate collapse, without compromising the accuracy of the predictive model. Its contribution to the literature lies in resolving the problematic trade-off between predictive accuracy and variations between the two types of errors.

Design/methodology/approach – The methodological approach in this paper – called MCCCRA – utilizes a novel multi-classification matrix based on a combination of correlation and regression analysis, with the former being subject to optimisation criteria. In order to ascertain its accuracy in signaling collapse, MCCCRA is empirically tested against multiple discriminant analysis (MDA).

Findings – Based on a data sample of 899 US publicly listed companies, the empirical results indicate that in addition to a high level of accuracy in signaling collapse, MCCCRA generates lower variability between Type I and Type II errors when compared to MDA.

Originality/value – Although correlation and regression analysis are long-standing statistical tools, the optimisation constraints that are applied to the correlations are unique. Moreover, the multi-classification matrix is a first in signaling collapse. By providing economic insight into more stable financial modeling, these innovations make an original contribution to the literature.

Utilisation of primary total knee joint replacements across socioeconomic status in the Barwon Statistical Division, Australia 2006-7 : a cross-sectional study

Objectives There are few Australian data that examine the association between total knee joint replacement (TKR) utilisation and socioeconomic status (SES). This study examined TKR surgeries with a diagnosis of osteoarthritis (OA) performed for residents of Barwon Statistical Division (BSD) for 2006–2007.

Design Cross-sectional.

Setting BSD, South-eastern Victoria, Australia

Participants All patients who underwent a TKR for OA, 2006–2007, and whose residential postcode was identified as within the BSD of Australia, and for whom SES data were available, were eligible for inclusion.

Primary outcome measure Primary TKR data ascertained from the Australian Orthopaedic Association National Joint Replacement Registry. Residential addresses were matched with the Australian Bureau of Statistics census data, and the Index of Relative Socioeconomic Disadvantage was used to determine SES, categorised into quintiles whereby quintile 1 indicated the most disadvantaged and quintile 5 the least disadvantaged. Age-specific and sex-specific rates of TKR utilisation per 1000 person-years were reported for 10-year age bands.

Results Females accounted for 62.7% of the 691 primary TKR surgeries performed during 2006–2007. The greatest utilisation rates of TKR in males was 7.6 observed in those aged >79 years, and in 10.2 in females observed in those aged 70–79 years. An increase in TKR was observed for males in SES quintile four compared to quintile 1 in which the lowest utilisation which was observed (p=0.04). No differences were observed in females across SES quintiles.

Conclusions Further investigation is warranted on a larger scale to examine the role that SES may play in TKR utilisation, and to determine whether any social disparities in TKR utilisation reflect health system biases or geographic differences.

Cultural regionalism and environmental planning and design : charting regionalism in deference to globalism

The last 400 years has witnessed Western colonialism spread across the Asian communities and landscape transforming and re-defining their identity, culture, landscape patterns and meanings, as well as their land ethic. Whilst independence has brought forth robust attempts at nationalism it has been at the deference of regionalism and cultural identity. Instead, modernism, economic regeneration and growth, and attempts to define a nationalist image out of the newly created nations that are often a patchwork quilt of pre-colonial empires, are signalling the demise of critical regionalism and Indigenous knowledge systems. This paper considers the changes and cultural transformations over the last 400 years pointing to key dilemmas in regionalist growth, deterioration and stabilisation that are causing a loss of environmental and cultural values, morals and codes. These are the cultural and planning ‘rules’ that originally structured and guided the sustainable life and spirit of community, land and culture as an integrated whole. Particular attention will be drawn to the Indigenous communities of Malaysia, Indonesia and Australia that are struggling to maintain identity and environmental ethic in the shadow of major disjointed and multi-objectival national and international economic growth and digital transformation advances. Several possible answers or mediated strategies are offered, through a cultural heritage and planning lens, that could afford a respect and creative integration of these Indigenous knowledge systems to better inform regional growth and land management strategies so that it was regionally relevant.

Composite indices: rank robustness, statistical association, and redundancy

This article evaluates the robustness of rankings obtained from composite indices that combine information from two or more components via a weighted sum. It examines the empirical prevalence of robust comparisons using the method proposed by Foster et al. (2010). Indices examined are the Human Development Index (HDI), the Index of Economic Freedom (IEF), and the Environmental Performance Index (EPI). Key theoretical results demonstrate links between the prevalence of robust comparisons, Kendall’s tau rank correlation coefficient, and statistical association across components. Implications for redundancy among index components are also examined.

The 6-PACK programme to decrease falls and fall-related injuries in acute hospitals : protocol for an economic evaluation alongside a cluster randomised controlled trial

Background Falls are a common hospital occurrence complicating the care of patients. From an economic perspective, the impact of in-hospital falls and related injuries is substantial. However, few studies have examined the economic implications of falls prevention interventions in an acute care setting. The 6-PACK programme is a targeted nurse delivered falls prevention programme designed specifically for acute hospital wards. It includes a risk assessment tool and six simple strategies that nurses apply to patients classified as high-risk by the tool.
Objective To examine the incremental cost-effectiveness of the 6-PACK programme for the prevention of falls and fall-related injuries, compared with usual care practice, from an acute hospital perspective.
Methods and design The 6-PACK project is a multicentre cluster randomised controlled trial (RCT) that includes 24 acute medical and surgical wards from six hospitals in Australia to investigate the efficacy of the 6-PACK programme. This economic evaluation will be conducted alongside the 6-PACK cluster RCT. Outcome and hospitalisation cost data will be prospectively collected on approximately 16 000 patients admitted to the participating wards during the 12-month trial period. The results of the economic evaluation will be expressed as ‘cost or saving per fall prevented’ and ‘cost or saving per fall-related injury prevented’ calculated from differences in mean costs and effects in the intervention and control groups, to generate an incremental cost-effectiveness ratio (ICER).
Discussion This economic evaluation will provide an opportunity to explore the cost-effectiveness of a targeted nurse delivered falls prevention programme for reducing in-hospital falls and fall-related injuries. This protocol provides a detailed statement of a planned economic evaluation conducted alongside a cluster RCT to investigate the efficacy of the 6-PACK programme to prevent falls and fall-related injuries.

Breaking up is hard to do : the economic impact of provisional funding contingent upon evidence development

Funding contingent upon evidence development (FED) has recently been the subject of some considerable debate in the literature but relatively little has been made of its economic impact. We argue that FED has the potential to shorten the lag between innovation and access but may also (i) crowd-out more valuable interventions in situations in which there is a fixed dedicated budget; or (ii) lead to a de facto increase in the funding threshold and increased expenditure growth in situations in which the programme budget is open-ended. Although FED would typically entail periodic review of provisional or interim listings, it may prove difficult to withdraw funding even at cost/QALY ratios well in excess of current listing thresholds. Further consideration of the design and implementation of FED processes is therefore required to ensure that its introduction yields net benefits over existing processes.

A study protocol of a randomised controlled trial incorporating a health economic analysis to investigate if additional allied health services for rehabilitation reduce length of stay without compromising patient outcomes

Background
Reducing patient length of stay is a high priority for health service providers. Preliminary information suggests additional Saturday rehabilitation services could reduce the time a patient stays in hospital by three days. This large trial will examine if providing additional physiotherapy and occupational therapy services on a Saturday reduces health care costs, and improves the health of hospital inpatients receiving rehabilitation compared to the usual Monday to Friday service. We will also investigate the cost effectiveness and patient outcomes of such a service.
Methods/Design A randomised controlled trial will evaluate the effect of providing additional physiotherapy and occupational therapy for rehabilitation. Seven hundred and twelve patients receiving inpatient rehabilitation at two metropolitan sites will be randomly allocated to the intervention group or control group. The control group will receive usual care physiotherapy and occupational therapy from Monday to Friday while the intervention group will receive the same amount of rehabilitation as the control group Monday to Friday plus a full physiotherapy and occupational therapy service on Saturday. The primary outcomes will be patient length of stay, quality of life (EuroQol questionnaire), the Functional Independence Measure (FIM), and health utilization and cost data. Secondary outcomes will assess clinical outcomes relevant to the goals of therapy: the 10 metre walk test, the timed up and go test, the Personal Care Participation Assessment and Resource Tool (PC PART), and the modified motor assessment scale. Blinded assessors will assess outcomes at admission and discharge, and follow up data on quality of life, function and health care costs will be collected at 6 and 12 months after discharge. Between group differences will be analysed with analysis of covariance using baseline measures as the covariate. A health economic analysis will be carried out alongside the randomised controlled trial.
Discussion This paper outlines the study protocol for the first fully powered randomised controlled trial incorporating a health economic analysis to establish if additional Saturday allied health services for rehabilitation inpatients reduces length of stay without compromising discharge outcomes. If successful, this trial will have substantial health benefits for the patients and for organizations delivering rehabilitation services.

Statistical approaches to testing the relationships of the built environment with resident-level physical activity behavior and health outcomes in cross-sectional studies with cluster sampling

To achieve valid conclusions, studies exploring associations of the built environment with residents' physical activity and health-related outcomes need to employ statistical approaches accounting for clustered data. This article discusses the following main statistical approaches: analysis of covariance, regression models with robust standard errors, generalized estimating equations, and multilevel generalized linear models. The choice of a statistical method depends on the characteristics of the study and research questions. While the first three approaches are employed to account for clustering in the data, multilevel models can also help unravel more substantive issues within a social ecological theoretical framework of health behavior.

Sitting time and socio-economic differences in overweight and obesity

Objectives: To examine (1) the inter-relationships between socio-economic status (SES), physical activity, three different domains of sitting time (weekday, weekend day and leisure-time sitting), and being overweight or obese (body mass index25 kg/m2); and (2) the potential mediation effects of sitting time in the relationship between socio-economic factors and being overweight or obese in working Australian adults.

Design: Observational epidemiological study.

Subjects: One thousand forty eight working adults. Using a multistage sampling design on neighbourhood SES, participants were from high and low SES neighbourhoods of an Australian capital city.

Measurements: Neighbourhood SES was assessed using census data; individual SES was based on self-reported educational attainment and household income. There were three sitting time variables: sitting time on weekdays, weekend days and in leisure time. Overweight and obesity were determined using self-reported body weight and height.

Results: Gender, age, neighbourhood SES, education, working hours and physical activity were independently associated with weekday, weekend day and leisure-related sitting time. With the exception of education and working hours, these variables were also independently associated with being overweight or obese. Leisure-time sitting was found to be a mediator in the relationships between gender, education and being overweight or obese.

Conclusion: Strategies to promote less sitting in leisure time are required to combat overweight and obesity in Australian adults, especially among those from low SES neighbourhoods, and among those with high levels of education and income who work long hours.

Sustainable planning and design of large-scale metropolitan development projects

Actors in the built environment are increasingly considering environmental issues alongside functional and economic aspects of development projects. However, to date in Australia and internationally, there have been few practical examples of integrated applications of sustainability principles in the built environment across all lifecycle phases. In response to this gap, this paper proposes a conceptual framework based on the principal that early intervention is the most cost-effective and efficient means of implementing effective strategies for sustainability. A strategic environmental assessment (SEA) approach is forwarded as an umbrella analytical framework, assembled from analytical methods which are strategically 'tiered' to inform stages of the project decision-making process. Practically applied and timed accordingly, the framework can allow assessments to be targeted towards appropriate decision making levels and enable better decision-making and more efficient resource allocation for major infrastructure development projects.

Socio-economic disparities in Australian adolescents' eating behaviours

Objective: To assess the association between socio-economic position (SEP) and poor eating behaviours in a large representative sample of Australian secondary school students.
Design: Cross-sectional survey of students’ vegetable, fruit, sugar-sweetened beverage and fast-food consumption assessed using validated instruments and collected via a web-based self-report format.
Setting: Secondary schools across all Australian states and territories.
Subjects: Secondary-school students (n 12 188; response rate: 54 %) aged 12–17 years participating in the 2009–10 National Secondary Students’ Diet and Activity (NaSSDA) survey.
Results: Overall, 25% of students reported consuming <1 serving of vegetables/d and 29% reported eating <1 serving of fruit/d. Fourteen per cent of students reported drinking at least 1–2 cups of sugar-sweetened beverages/d while 9% reported eating fast food <3 times/week. After adjusting for other demographic factors, students of lower-SEP areas were more likely to report low intake of vegetables (F (4, 231) = 3.61, P = 0.007) and high frequency of consumption of sugar-sweetened beverages (F (4, 231) =8.41, P < 0.001) and fast food (F (4, 231) = 4.59, P =0.001) compared with students of high-SEP neighbourhoods. A positive SEP association was found for fruit consumption among female students only (F (4, 231) = 4.20, P = 0.003). Those from lower-SEP areas were also more likely to engage in multiple poor eating behaviours (F (4, 231) = 5.80, P, < 0.001).
Conclusions: Results suggest that socio-economic disparities in Australian adolescents’ eating behaviours do exist, with students residing in lower-SEP neighbourhoods faring less well than those from high-SEP neighbourhoods. Reducing social inequalities in eating behaviours among young people should be a key consideration of future preventive strategies.

Graduating Students' Perceptions of Learning Design in an Undergraduate Engineering Course

BACKGROUNDUndergraduate Civil Engineering Course at Deakin University, Australia is relatively a new course. It graduated its second main cohort in 2013. Since its beginning in 2012, this study has been running an internal annual Course Experience Surveys targeted at uncovering the graduating students’ perceptions on three components of contemporary learning system provided by Deakin University learning design, learning environment and the human factor. Learning design covers the learning curriculum, learning resources, learning activities and learning supports; learning environment includes physical environment, virtual environment and psychosocial environment; and human factor includes learners, facilitators/teachers and help/support staff and their culture. There is a common agreement among educators in higher education that these three components of learning system should interact and complement each other in order to maximise student learning. This paper coversonly learning design aspect of the overall surveys from 2012 and 2013.PURPOSEThe aim of this study is to analyse the students’ perceptions of learning design provided by Deakin University to its undergraduate civil engineering students in 2012 and 2013. This will help track down the progresses in different aspects of learning design and to understand whether the learning design provided by the institution have actually helped students in their learning and met their learning expectations.DESIGN/METHODThis study adopts questionnaire approach to collect original data by asking students about their perceptions of learning design provided by the institution. 5-point Likert-scale questionnaire survey (strongly disagree, disagree, neutral, agree, strongly agree) is developed and responses are collected. The responses are then statistically analysed in order to uncover the students’ perceptions of learning design provided by the university.RESULTSThe statistical analysis shows that the graduating students in both 2012 and 2013 did not perceive some important aspects of the learning design of the undergraduate civil engineering program/course as good as they expected. Moreover, in line with the shift in the learning design paradigm from content-centric to more inclusive learning design where soft skills, self-directed learning skills and research skills are incorporated, graduating students clearly perceived these changes. However, respondents’ perceptions on some components of learning design got slightly down in 2013 compared with 2012 particularly the ‘learning resources’, ‘learning activities’ and ‘learning supports’.CONCLUSIONSThe shift in the learning design paradigm of the undergraduate civil engineering program/course at Deakin University from teacher-centric to student-centric between 2012 and 2013 has not been perceived by students positively as expected. Students have clearly indicated that they prefer improved curriculum, quality learning resources, customised learning activities and additional learning supports in order to successfully implement student-centric learning design.