The health loss from ischemic stroke and intracerebral hemorrhage : evidence from the North East Melbourne Stroke Incidence Study (NEMESIS)

Background People suffering different types of stroke have differing demographic characteristics and survival. However, current estimates of disease burden are based on the same underlying assumptions irrespective of stroke type. We hypothesized that average Quality Adjusted Life Years (QALYs) lost from stroke would be different for ischemic stroke and intracerebral hemorrhage (ICH).

Methods We used 1 and 5-year data collected from patients with first-ever stroke participating in the North East Melbourne Stroke Incidence Study (NEMESIS). We calculated case fatality rates, health-adjusted life expectancy, and quality-of-life (QoL) weights specific to each age and gender category. Lifetime 'health loss' for first-ever ischemic stroke and ICH surviving 28-days for the 2004 Australian population cohort was then estimated. Multivariable uncertainty analyses and sensitivity analyses (SA) were used to assess the impact of varying input parameters e.g. case fatality and QoL weights.

Results Paired QoL data at 1 and 5 years were available for 237 NEMESIS participants. Extrapolating NEMESIS rates, 31,539 first-ever strokes were expected for Australia in 2004. Average discounted (3%) QALYs lost per first-ever stroke were estimated to be 5.09 (SD 0.20; SA 5.49) for ischemic stroke (n = 27,660) and 6.17 (SD 0.26; SA 6.45) for ICH (n = 4,291; p < 0.001). QALYs lost also differed according to gender for both subtypes (ischemic stroke: males 4.69 SD 0.38, females 5.51 SD 0.46; ICH: males 5.82 SD 0.67, females 6.50 SD 0.40).

Discussion People with ICH incurred greater loss of health over a lifetime than people with ischemic stroke. This is explained by greater stroke related case fatality at a younger age, but longer life expectancy with disability after the first 12 months for people with ICH. Thus, studies of disease burden in stroke should account for these differences between subtype and gender. Otherwise, in countries where ICH is more common, health loss for stroke may be underestimated. Similar to other studies of this type, the generalisability of the results may be limited. Sensitivity and uncertainty analyses were used to provide a plausible range of variation for Australia. In countries with demographic and life expectancy characteristics comparable to Australia, our QoL weights may be reasonably applicable.

Organized blood pressure control programs to prevent stroke in Australia : would they be cost-effective?

Background and Purpose—: High blood pressure (BP) is the most important modifiable stroke risk factor. Worldwide high BP in many people is uncontrolled or people are unaware of their BP status. We aimed to assess whether a program of organized multidisciplinary care and medication would be cost-effective for improving BP control for the prevention of stroke.

Methods—: A novel aspect was to simulate the intervention to match recent primary care initiatives (eg, new Medicare reimbursement items) to ensure policy relevance. Current practice and additional costs of each intervention were included using the best available evidence. The differences in the cost per quality-adjusted life year (QALY) gained for the interventions were compared against current practice. Cost-effectiveness was defined as cost per QALY gained was less than Australian dollars (AUD) 50 000 (societal perspective; reference year 2004). The robustness of estimates was assessed with probabilistic multivariable uncertainty analysis.

Results—: For primary prevention, the median cost per QALY gained was AUD11 068 (95% uncertainty interval AUD5201 to AUD18 696) in those aged 75 years or older and was AUD17 359 (95% uncertainty interval AUD10 516 to AUD26 036) in those aged 55 to 84 years with >=15% absolute risk of stroke. Primary prevention interventions were not cost-effective if aged younger than 50 years. The median cost per QALY gained for secondary prevention was AUD1811 and AUD4704, depending on which medications were modeled.

Conclusions—: Organized care for BP control targeted at specific populations offers excellent value over current practice. Organized care for secondary prevention provided the greatest benefits and strongest cost-effectiveness. Translation into clinical practice requires improved use of relevant Medicare policy in Australia.

Parallel bucket sorting on graphics processing units based on convex optimization

We found an interesting relation between convex optimization and sorting problem. We present a parallel algorithm to compute multiple order statistics of the data by minimizing a number of related convex functions. The computed order statistics serve as splitters that group the data into buckets suitable for parallel bitonic sorting. This led us to a parallel bucket sort algorithm, which we implemented for many-core architecture of graphics processing units (GPUs). The proposed sorting method is competitive to the state-of-the-art GPU sorting algorithms and is superior to most of them for long sorting keys.

How Twitter is being used by Australian engineering academic units

For organisations, social media provide new avenues for communication and collaboration with their stakeholders, however, any value created for an organisation through social media comes not from any particular platforms, but from how they are used. The potential value of social media tools to assist in the successful communication inside and outside of engineering organisations has been identified in the literature. While social media may be widely used by individuals and many organisations, their use in higher education is still relatively new. Applications of social media in engineering education can also be found in the literature, including in work integrated learning. One of the most widely-used social media tools employed by organisations is Twitter. Research on the use of social media by higher education institutions is still limited and evaluation of the impact of social media activities is not straightforward. One approach to evaluation is network analysis.

Characterizing Twitter communication - a case study of international engineering academic units

Engineering academic units might engage with social media for a range of purposes including for general communication with students, staff, alumni, other important stakeholders and the wider community at large; for student recruitment and for marketing and promotion more generally. This paper presents an investigation into the use of Twitter by six engineering academic units internationally, using publicly available Twitter data over an 18-month period for analysis and visualization, to characterize the engagement by engineering academic units with one popular social media tool. Widely varying levels of activity were observed, from essentially undirected 'Megaphone' Tweeting, through to sustained and complex interactions with multiple external accounts. This work provides insights into how engineering academic units are using Twitter and how they might more effectively use the platform to achieve their individual objectives for institutional social media communications and marketing, and offers a methodology for future research. © 2014 © 2014 Taylor & Francis.