Marginal costs of hospital-acquired conditions : information for priority-setting for patient safety programmes and research

Objective: To estimate the relative inpatient costs of hospital-acquired conditions. Methods: Patient level costs were estimated using computerized costing systems that log individual utilization of inpatient services and apply sophisticated cost estimates from the hospital's general ledger. Occurrence of hospital-acquired conditions was identified using an Australian ‘condition-onset' flag for diagnoses not present on admission. These were grouped to yield a comprehensive set of 144 categories of hospital-acquired conditions to summarize data coded with ICD-10. Standard linear regression techniques were used to identify the independent contribution of hospital-acquired conditions to costs, taking into account the case-mix of a sample of acute inpatients (n = 1,699,997) treated in Australian public hospitals in Victoria (2005/06) and Queensland (2006/07). Results: The most costly types of complications were post-procedure endocrine/metabolic disorders, adding AU$21,827 to the cost of an episode, followed by MRSA (AU$19,881) and enterocolitis due to Clostridium difficile (AU$19,743). Aggregate costs to the system, however, were highest for septicaemia (AU$41.4 million), complications of cardiac and vascular implants other than septicaemia (AU$28.7 million), acute lower respiratory infections, including influenza and pneumonia (AU$27.8 million) and UTI (AU$24.7 million). Hospital-acquired complications are estimated to add 17.3% to treatment costs in this sample. Conclusions: Patient safety efforts frequently focus on dramatic but rare complications with very serious patient harm. Previous studies of the costs of adverse events have provided information on ‘indicators’ of safety problems rather than the full range of hospital-acquired conditions. Adding a cost dimension to priority-setting could result in changes to the focus of patient safety programmes and research. Financial information should be combined with information on patient outcomes to allow for cost-utility evaluation of future interventions.

Stabilization of stormwater biofilters: Impacts of wetting and drying phases and the addition of organic matter to filter media

Ripening period refers to a phase of stabilization in sand filters in water treatment systems that follows a new installation or cleaning of the filter. Intermittent wetting and drying, a unique property of stormwater biofilters, would similarly be subjected to a phase of stabilization. Suspended solids, is an important parameter that is often used to monitor the stabilization of sand filters in water treatment systems. Stormwater biofilters however, contain organic material that is added to the filter layer to enhance nitrate removal, the dynamics of which is seldom analysed in stabilization of stormwater biofilters. Therefore, in this study of stormwater biofiltration in addition to suspended solids (Turbidity), organic matter (TOC, DOC, TN and TKN) was also monitored as a parameter for stabilization of the stormwater biofilter. One Perspex bioretention column (94 mm internal diameter) was fabricated with filter layer that contained 8% organic material and fed with tapwater with different antecedent dry days (0 – 40 day) at 100 mL/min. Samples were collected from the outflow at different time intervals between 2 – 150 minutes and were tested for Total Organic Carbon, Dissolved Organic Carbon, Total Nitrogen, Total Kjeldhal Nitrogen and Turbidity. The column was observed to experience two phases of stabilization, one at the beginning of each event that lasted for 30 minutes while the other phase was observed across subsequent events that related to the age of filter.

Hydraulic conductivity increases in a sodic clay soil in response to gypsum applications impacts of bulk density and cation exchange

Amelioration of sodic soils is commonly achieved by applying gypsum, which increases soil hydraulic conductivity by altering soil chemistry. The magnitude of hydraulic conductivity increases expected in response to gypsum applications depends on soil properties including clay content, clay mineralogy, and bulk density. The soil analyzed in this study was a kaolinite rich sodic clay soil from an irrigated area of the Lower Burdekin coastal floodplain in tropical North Queensland, Australia. The impact of gypsum amelioration was investigated by continuously leaching soil columns with a saturated gypsum solution, until the hydraulic conductivity and leachate chemistry stabilized. Extended leaching enabled the full impacts of electrolyte effects and cation exchange to be determined. For the columns packed to 1.4 g/cm3, exchangeable sodium concentrations were reduced from 5.0 ± 0.5 mEq/100 g to 0.41 ± 0.06 mEq/100 g, exchangeable magnesium concentrations were reduced from 13.9 ± 0.3 mEq/100 g to 4.3 ± 2.12 mEq/100 g, and hydraulic conductivity increased to 0.15 ± 0.04 cm/d. For the columns packed to 1.3 g/cm3, exchangeable sodium concentrations were reduced from 5.0 ± 0.5 mEq/100 g to 0.51 ± 0.03 mEq/100 g, exchangeable magnesium concentrations were reduced from 13.9 ± 0.3 mEq/100 g to 0.55 ± 0.36 mEq/100 g, and hydraulic conductivity increased to 0.96 ± 0.53 cm/d. The results of this study highlight that both sodium and magnesium need to be taken into account when determining the suitability of water quality for irrigation of sodic soils and that soil bulk density plays a major role in controlling the extent of reclamation that can be achieved using gypsum applications.

The impact of project announcements on property values: An empirical analysis

The study examines the property value impacts of an announcement of a project which has potential environmental impacts as distinct from other studies that address costs associated with under-construction and the operating impacts of developments. The hypothesis is that the announcement of a proposed project with potential environmental impact creates uncertainty in the property market of the affected area, and this impact is greater on properties closer to the project than those farther from it. The results of the study confirm the hypothesis and indicate that the marginal willingness to pay for properties within a 5 km distance declined by AU$17,020 per km proximity to the proposed heavy vehicle route, after the proposed route was announced. The results support the need for more holistic measurement of cost–benefit analysis of projects and provide a basis for improved consideration by policy makers of the rights of affected parties.

Local experiences, global similarities: Teacher perceptions of the impacts of national testing

Since 2008, Australian schoolchildren in Years 3, 5, 7 and 9 have sat a series of tests each May designed to assess their attainment of basic skills in literacy and numeracy. These tests are known as the National Assessment Program – Literacy and Numeracy (NAPLAN). In 2010, individual school NAPLAN data were first published on the MySchool website which enables comparisons to be made between individual schools and statistically like schools across Australia. NAPLAN represents the increased centrality of the federal government in education, particularly in regards to education policy. One effect of this has been a recast emphasis of education as an economic, rather than democratic, good. As Reid (2009) suggests, this recasting of education within national productivity agendas mobilises commonsense discourses of accountability and transparency. These are common articles of faith for many involved in education administration and bureaucracy; more and better data, and holding people to account for that data, must improve education...

A preliminary OSL chronology for coastal dunes on Moreton island, Queensland, Australia – Marginal deposits of A large-scale quaternary shelf sediment system

Moreton Island and several other large siliceous sand dune islands and mainland barrier deposits in SE Queensland represent the distal, onshore component of an extensive Quaternary continental shelf sediment system. This sediment has been transported up to 1000 km along the coast and shelf of SE Australia over multiple glacioeustatic sea-level cycles. Stratigraphic relationships and a preliminary Optically Stimulated Luminance (OSL) chronology for Moreton Island indicate a middle Pleistocene age for the large majority of the deposit. Dune units exposed in the centre of the island and on the east coast have OSL ages that indicate deposition occurred between approximately 540 ka and 350 ka BP, and at around 96±10 ka BP. Much of the southern half of the island has a veneer of much younger sediment, with OSL ages of 0.90±0.11 ka, 1.28±0.16 ka, 5.75±0.53 ka and <0.45 ka BP. The younger deposits were partially derived from the reworking of the upper leached zone of the much older dunes. A large parabolic dune at the northern end of the island, OSL age of 9.90±1.0 ka BP, and palaeosol exposures that extend below present sea level suggest the Pleistocene dunes were sourced from shorelines positioned several to tens of metres lower than, and up to few kilometres seaward of the present shoreline. Given the lower gradient of the inner shelf a few km seaward of the island, it seems likely that periods of intermediate sea level (e.g. ~20 m below present) produced strongly positive onshore sediment budgets and the mobilisation of dunes inland to form much of what now comprises Moreton Island. The new OSL ages and comprehensive OSL chronology for the Cooloola deposit, 100 km north of Moreton Island, indicate that the bulk of the coastal dune deposits in SE Queensland were emplaced between approximately 540 ka BP and prior to the Last Interglacial. This chronostratigraphic information improves our fundamental understanding of long-term sediment transport and accumulation on large-scale continental shelf sediment systems.

Tornado damage and impacts on nuclear facilities in the United States

This report provides an overview of the tornado impact on the safe operation and shutdown of nuclear power plants in the United States. The motivation for this review stems from the damage and failure of the Fukushima nuclear power plant on March 11, 2011. That disaster warrants comparison of the safety measures in place within the global nuclear power industry.

Solution chemistry impacts on the seawater neutralisation process: Benefits of nanofiltered seawater and reverse osmosis brine

It is well known that the neutralisation of Bayer liquor with seawater causes the precipitation of stable alkaline products and a reduction in pH and dissolved metal concentrations in the effluent. However, there is limited information available on solution chemistry effects on the stability and reaction kinetics of these precipitates. This investigation shows the influence of reactive species (magnesium and calcium) in seawater on precipitate stabilities and volumetric efficiencies during the neutralisation of bauxite refinery residues. Correlations between synthetic seawater solutions and real samples of seawater (filtered seawater, nanofiltered seawater and reverse osmosis brine) have been made. These investigations have been used to confirm that alternative seawater sources can be used to increase the productivity potential of the neutralisation process with minimal implications on the composition and stability of precipitates formed. The volume efficiency of the neutralisation process using synthetic analogues has been shown to be almost directly proportional with the concentration of magnesium. This was further confirmed in the nanofiltered seawater and reverse osmosis brine that showed increases in the efficiency of neutralisation by factors of 3 and 2 compared to seawater, which corresponds with relatively the same increase in the concentration of magnesium in these alternative seawater sources. An assessment of the chemical stability of the precipitates, volumetric efficiency, and discharge water quality have been determined using numerous techniques that include pH, conductivity, inductively coupled plasma optical emission spectroscopy, infrared spectroscopy, thermogravimetric analysis coupled to mass spectrometry and X-ray diffraction. Correlations between synthetic solution compositions and alternative seawater sources have been used to determine if alternative seawater sources are potential substitutes for seawater based on improvements in productivity, implementation costs, savings to operations and environmental benefits.

Impacts of sodic soil amelioration on hydraulic conductivity and deep drainage in the Lower Burdekin

An understanding of the influence of soil chemistry on soil hydraulic properties is of critical importance for the management of sodic soils under irrigation. The hydraulic conductivity of sodic soils has been shown to be affected by properties of the applied solution including pH (Suarez et al. 1984), sodicity and salt concentration (McNeal and Coleman 1966). The changes in soil hydraulic conductivity are the result of changes in the spacing between clay layers in response to changes in soil solution chemistry. While the importance o f soil chemistry in controlling hydraulic conductivity is known, the exact impacts of sodic soil amelioration on hydraulic conductivity and deep drainage at a given location are difficult to predict. This is because the relationships between soil chemical factors and hydraulic conductivity are soil specific and because local site specific factors also need to be considered to determine the actual impacts on deep drainage rates.

How professional development impacts on experienced teachers' perceptions of their ICT practices

Teachers are at the forefront of Information Communication Technology (ICT) use in schools. Teachers face many challenges and competing priorities such as literacy, numeracy and changing curriculum frameworks and are expected to adopt new ICT practices to improve students¿ outcomes. Effective professional development (PD) methods must be identified and implemented. This research examined two core issues: (1) experienced teachers' perceptions of their ICT practices and (2) how PD courses have affected these practices. This case study and its findings has important implications for the implementation of effective PD in schools.

Impacts of wind power integration on small signal stability and low frequency oscillation characteristics of interconnected power systems

为研究风电并网对互联系统低频振荡的影响,基于完整的双馈风电机组模型,定性分析了两区域互联系统在风电机组并网前后阻尼特性的变化情况.从双馈风电机组并网输送距离、并网容量、互联系统联络线传送功率、是否加装电力系统稳定器等多个方面,多角度分析了风电场并网对互联系统小干扰稳定及低频振荡特性的影响.之后,以两个包括两个区域的电力系统为例,进行了系统的计算分析和比较.结果表明,有双馈风电机组接入的互联电力系统,在不同运行模式下,双馈风电机组的并网输送距离、出力水平、联络线传送功率对低频振荡模式的影响在趋势和程度上均有显著差异,这样在对风电场进行入网规划、设计和运行时就需要综合考虑这些因素的影响.

Impacts of tillage and application methods on atrazine and alachlor losses from upland fields: Research paper

The effects of tillage practises and the methods of chemical application on atrazine and alachlor losses through run-off were evaluated for five treatments: conservation (untilled) and surface (US), disk and surface, plow and surface, disk and preplant-incorporated, and plow and preplant-incorporated treatments. A rainfall simulator was used to create 63.5 mm h^-1 of rainfall for 60 min and 127 mm h^-1 for 15 min. Rainfall simulation occurred 24-36 h after chemical application. There was no significant difference in the run-off volume among the treatments but the untilled treatment significantly reduced erosion loss. The untilled treatments had the highest herbicide concentration and the disk treatments were higher than the plow treatments. The surface treatments showed a higher concentration than the incorporated treatments. The concentration of herbicides in the water decreased with time. Among the experimental sites, the one with sandy loam soil produced the greatest losses, both in terms of the run-off volume and herbicide loss. The US treatments had the highest loss and the herbicide incorporation treatments had smaller losses through run-off as the residue cover was effective in preventing herbicide losses. Incorporation might be a favorable method of herbicide application to reduce the herbicide losses by run-off.

Theorising the impacts of digitally mediated social interaction on diasporic identity formation: A case of Chinese diaspora in Australia

With the scope of Chinese diaspora in Australia, this paper theorises the impacts of digitally mediated social interaction on diasporic identity formation in the new media landscape. People’s identity is the outcome of their social interactions with other individuals. In the new media landscape, digital media technologies are changing the way in which people communicate with others. On one hand, space and time are unprecedentedly compressed by media technologies so people can maintain more frequent and instant connections with others than before. On the other hand, the digital media technologies have constructed a virtual social space that might withdraw people from their physical social interactions. As we witness today, our social interactions are increasing digitally mediated, in the forms of posts and comments in social network sites, as well as the messages in social apps. As to the diasporic groups, this new media landscape is presenting a challenge to their identity formation. They physically live in the host countries but still keep close social and cultural connections with their homelands. Facilitated by digital media technologies, they are facing two platforms in which they can practice different identity performances: one is the digitally mediated social network; the other is the physical social network. In the case of Chinese diaspora, the situation is more complex due to the language factor and media censorship in Mainland China, which will be articulated in the main text. This paper aims to fill a gap between media studies and diaspora research. Most of existing research on the relationship between diasporic identity and media primarily focuses on the development of ethnic media institutions, and the production and consumption of ethnic media in the pre-digital media context. However, the process of globalisation and digital media technologies are increasing the homogeneity and hybridity of media content worldwide. In this new context, attributing the formation of different identities to the consumption of media content is arguable to some extent. Therefore, the overlapped area of new media studies and diaspora research still has space deserves further investigation.

Managing the impacts of sugarcane farming on the Great Barrier Reef: An evaluation of the implementation of the Polluter Pays Principle

This report provides an evaluation of the implementation of the Polluter Pays Principle (PPP) – a principle of international environmental law – in the context of pollution from sugarcane farming affecting Australia’s Great Barrier Reef (GBR). The research was part of an experiment to test methods for evaluating the effectiveness of environmental laws. Overall, we found that whilst the PPP is reflected to a limited extent in Australian law (more so in Queensland law, than at the national level), the behaviour one might expect in terms of implementing the principle was largely inadequate. Evidence of a longer term, explicit commitment to the PPP was particularly weak.

Predicting occupant risk indicators for frontal impacts with redirective crash cushions

Crash cushions are devices deployed on the road network in order to shield fixed roadside hazards and the non-crashworthy ends of road safety barriers. However crash cushions vary in terms of configuration and operation, meaning that different devices may also vary in terms of ability to mitigate occupant risk. In this study, data derived from crash testing of eleven redirective crash cushions is used as the base input to a numerical procedure for calculation of occupant risk indicators Occupant Impact Velocity (OIV), Occupant Ridedown Acceleration (ORA) and longitudinal Acceleration Severity Index (ASI) for a range of simulated impacting vehicles (mass 800 kg to 2,500 kg) impacting each crash cushion at a range of impact speeds (18 m/s to 32 m/s). The results may be interpreted as demonstrating firstly that enhanced knowledge of the performance of a device over a range of impact conditions, i.e., beyond the crash testing, may assist in determining the crash cushion most suited to a particular application; secondly that a more appropriate conformance test for occupant risk would be a frontal impact by a small (light) vehicle travelling parallel to and aligned with the centreline of the crash cushion; and thirdly that current documented numerical procedures for calculating occupant risk indicators may require review.