A cost-outcome description of the septic work-up for bacterial infection in neonates in a tertiary care hospital

Analysis of the septic work-up of 194 neonates at Women's College Hospital, Toronto, showed that the only antepartum condition predicting neonatal sepsis was the mother being on antibiotics. The only postnatal condition predicting sepsis was a maternal postpartum white blood cell count over 11,000. The average cost for tests for a septic work-up in these 194 mother-neonate pairs was $71.48 (Canadian dollars), and the average cost of tests to find a septic case was $1,066.77.

Impact fees and new housing cost: A comparative analysis of the empirical models

Developers and policy makers are consistently at odds over the debate as to whether impact fees increase house prices. This debate continues despite the extensive body of theoretical and empirical international literature that discusses the passing on to home buyers of impact fees, and the corresponding increase to housing prices. In attempting to quantify this impact, over a dozen empirical studies have been carried out in the US and Canada since the 1980’s. However the methodologies used vary greatly, as do the results. Despite similar infrastructure funding policies in numerous developed countries, no such empirical works exist outside of the US/Canada. The purpose of this research is to analyse the existing econometric models in order to identify, compare and contrast the theoretical bases, methodologies, key assumptions and findings of each. This research will assist in identifying if further model development is required and/or whether any of these models have external validity and are readily transferable outside of the US. The findings conclude that there is very little explicit rationale behind the various model selections and that significant model deficiencies appear still to exist.

Getting beyond 'heroic agency' in conceptualising social workers as policy actors in the Twenty-First Century

The professional project of social work assumes a particular orientation to human agency on the part of social workers. Specifically, the social work educational literature focusing on the nature of the profession suggests that social workers exert considerable control over the means and ends of their practice. In this paper we ask whether this assumption is warranted. While we conceptualise this issue as relevant to the entire spectrum of professional social work practice, here we discuss our claim in relation to social workers adopting policy activist roles. We suggest that the actual engagement of social workers in policy practice and political change in liberal democracies is muted and we canvas a number of reasons that help explain why this is the case. We canvas the impact of naive conceptualisations of what we call the ‘heroic agency’ of social work identity as employed in texts used in pre-service social work education. Specifically we pose the thesis that new social work graduates, when immersed into the organisational rationalities of reconfigured ‘welfare states’, may experience a considerable mismatch between the promise of being a social change agent and their experience as a beginning practitioner, making it difficult for them to confidently articulate their political identity and purpose.

Benefit cost analysis applied to behavioral and engineering safety countermeasures in San Francisco, California

The state of the practice in safety has advanced rapidly in recent years with the emergence of new tools and processes for improving selection of the most cost-effective safety countermeasures. However, many challenges prevent fair and objective comparisons of countermeasures applied across safety disciplines (e.g. engineering, emergency services, and behavioral measures). These countermeasures operate at different spatial scales, are funded often by different financial sources and agencies, and have associated costs and benefits that are difficult to estimate. This research proposes a methodology by which both behavioral and engineering safety investments are considered and compared in a specific local context. The methodology involves a multi-stage process that enables the analyst to select countermeasures that yield high benefits to costs, are targeted for a particular project, and that may involve costs and benefits that accrue over varying spatial and temporal scales. The methodology is illustrated using a case study from the Geary Boulevard Corridor in San Francisco, California. The case study illustrates that: 1) The methodology enables the identification and assessment of a wide range of safety investment types at the project level; 2) The nature of crash histories lend themselves to the selection of both behavioral and engineering investments, requiring cooperation across agencies; and 3) The results of the cost-benefit analysis are highly sensitive to cost and benefit assumptions, and thus listing and justification of all assumptions is required. It is recommended that a sensitivity analyses be conducted when there is large uncertainty surrounding cost and benefit assumptions.

An assessment for cost effective maintenance and operation of the Callide Power Station electrical system, using reliability evaluation

The reliable operation of the electrical system at Callide Power Station is of extreme importance to the normal everyday running of the Station. This study applied the principles of reliability to do an analysis on the electrical system at Callide Power Station. It was found that the level of expected outage cost increased exponentially with a declining level of maintenance. Concluding that even in a harsh economic electricity market where CS Energy tries and push their plants to the limit, maintenance must not be neglected. A number of system configurations were found to increase the reliability of the system and reduce the expected outage costs. A number of other advantages were identified as a result of using reliability principles to do this study on the Callide electrical system configuration.

How safe is safe enough? : a socio-technical view of low-cost level crossing safety

Low-cost level crossings are often criticized as being unsafe. Does a SIL (safety integrity level) rating make the railway crossing any safer? This paper discusses how a supporting argument might be made for low-cost level crossing warning devices with lower levels of safety integrity and issues such as risk tolerability and derivation of tolerable hazard rates for system-level hazards. As part of the design of such systems according to fail-safe principles, the paper considers the assumptions around the pre-defined safe states of existing warning devices and how human factors issues around such states can give rise to additional hazards.

Approaches to access control under uncertainty

The ultimate goal of an access control system is to allocate each user the precise level of access they need to complete their job - no more and no less. This proves to be challenging in an organisational setting. On one hand employees need enough access to the organisation’s resources in order to perform their jobs and on the other hand more access will bring about an increasing risk of misuse - either intentionally, where an employee uses the access for personal benefit, or unintentionally, through carelessness or being socially engineered to give access to an adversary. This thesis investigates issues of existing approaches to access control in allocating optimal level of access to users and proposes solutions in the form of new access control models. These issues are most evident when uncertainty surrounding users’ access needs, incentive to misuse and accountability are considered, hence the title of the thesis. We first analyse access control in environments where the administrator is unable to identify the users who may need access to resources. To resolve this uncertainty an administrative model with delegation support is proposed. Further, a detailed technical enforcement mechanism is introduced to ensure delegated resources cannot be misused. Then we explicitly consider that users are self-interested and capable of misusing resources if they choose to. We propose a novel game theoretic access control model to reason about and influence the factors that may affect users’ incentive to misuse. Next we study access control in environments where neither users’ access needs can be predicted nor they can be held accountable for misuse. It is shown that by allocating budget to users, a virtual currency through which they can pay for the resources they deem necessary, the need for a precise pre-allocation of permissions can be relaxed. The budget also imposes an upper-bound on users’ ability to misuse. A generalised budget allocation function is proposed and it is shown that given the context information the optimal level of budget for users can always be numerically determined. Finally, Role Based Access Control (RBAC) model is analysed under the explicit assumption of administrators’ uncertainty about self-interested users’ access needs and their incentives to misuse. A novel Budget-oriented Role Based Access Control (B-RBAC) model is proposed. The new model introduces the notion of users’ behaviour into RBAC and provides means to influence users’ incentives. It is shown how RBAC policy can be used to individualise the cost of access to resources and also to determine users’ budget. The implementation overheads of B-RBAC is examined and several low-cost sub-models are proposed.

The cost of being perfect : perfectionism and suicide ideation in university students

Objective: The aim of the study was to assess the relationship between dimensions of perfectionism and suicide ideation in a tertiary student population in Australia. Method: The methodology involved 405 students completing the General Health Questionnaire (GHQ-28) which includes a subset of questions which can be used to assess suicide ideation, and the Multidimensional Perfectionism Scale. Results: The presence of suicide ideation was associated with higher scores on total perfectionism and two perfectionism dimensions, and total GHQ scores. There were significant differences between participants with high levels of perfectionism and participants with moderate to low levels of perfectionism on a measure of suicide ideation. Neither gender nor age were associated with differences in the scores, with results indicating high levels of perfectionism may indicate a vulnerability to suicide ideation. Conclusions: Perfectionism is a valued attribute in high-achieving populations. The question needs to be asked, however, at what cost? The findings indicate that high levels of perfectionism may be associated with an increased vulnerability to suicide ideation. Future research is needed to gain a better understanding of the complex interrelationship between personality and temperament, environmental factors and self-destructive behaviour.

The cost of being ethical : evidence from Islamic equity funds

This paper examines the relationship between financial performance and ethical screening intensity of a special class of ethical funds that is rooted in Islamic values – Islamic equity funds (IEFs). These faith-based ethical funds screen investments on compliance with Islamic values where conventional interest expense (riba), gambling (maysir), excessive uncertainty (gharar), and non-ethical (non-halal) products are prohibited. We test whether these extra screens affect the financial performance of IEFs relative to non-Islamic funds. Based on a large survivorship-free international sample of 387 Islamic funds, our results show that IEFs on average underperform conventional funds by 40 basis points per month, or 4.8% per year (supporting the underperformance hypothesis). While Islamic funds do not generally perform better during crisis periods, they outperformed conventional funds during the recent sub-prime crisis (supporting the outperformance hypothesis). Using holdings-based measures for ethical screening intensity, results show IEFs that apply more intensive screening perform worse, suggesting that there is a cost to being ethical.

The cost of carbon : capital market effects of the proposed emission trading scheme (ETS)

In March 2008, the Australian Government announced its intention to introduce a national Emissions Trading Scheme (ETS), now expected to start in 2015. This impending development provides an ideal setting to investigate the impact an ETS in Australia will have on the market valuation of Australian Securities Exchange (ASX) firms. This is the first empirical study into the pricing effects of the ETS in Australia. Primarily, we hypothesize that firm value will be negatively related to a firm's carbon intensity profile. That is, there will be a greater impact on firm value for high carbon emitters in the period prior (2007) to the introduction of the ETS, whether for reasons relating to the existence of unbooked liabilities associated with future compliance and/or abatement costs, or for reasons relating to reduced future earnings. Using a sample of 58 Australian listed firms (constrained by the current availability of emissions data) which comprise larger, more profitable and less risky listed Australian firms, we first undertake an event study focusing on five distinct information events argued to impact the probability of the proposed ETS being enacted. Here, we find direct evidence that the capital market is indeed pricing the proposed ETS. Second, using a modified version of the Ohlson (1995) valuation model, we undertake a valuation analysis designed not only to complement the event study results, but more importantly to provide insights into the capital market's assessment of the magnitude of the economic impact of the proposed ETS as reflected in market capitalization. Here, our results show that the market assesses the most carbon intensive sample firms a market value decrement relative to other sample firms of between 7% and 10% of market capitalization. Further, based on the carbon emission profile of the sample firms we imply a ‘future carbon permit price’ of between AUD$17 per tonne and AUD$26 per tonne of carbon dioxide emitted. This study is more precise than industry reports, which set a carbon price of between AUD$15 to AUD$74 per tonne.

Mobile cost estimating

Martin Skitmore introduces a most "remarkable couple", Rod and Annie Stewart of Huntsville, Alabama (and elsewhere), and their post retirement business, Mobile Data Services. Contrary to popular expectations, Rod and Annie are not only computer-friendly, but are almost entirely dependent on the new technology for their survival.

Surgical site infection prevention following total hip arthroplasty in Australia : a cost-effectiveness analysis

Background: Surgical site infection (SSI) is associated with substantial costs for health services, reduced quality of life, and functional outcomes. The aim of this study was to evaluate the cost-effectiveness of strategies claiming to reduce the risk of SSI in hip arthroplasty in Australia. Methods: Baseline use of antibiotic prophylaxis (AP) was compared with no antibiotic prophylaxis (no AP), antibiotic-impregnated cement (AP þ ABC), and laminar air operating rooms (AP þ LOR). A Markov model was used to simulate long-term health and cost outcomes of a hypothetical cohort of 30,000 total hip arthroplasty patients from a health services perspective. Model parameters were informed by the best available evidence. Uncertainty was explored in probabilistic sensitivity and scenario analyses. Results: Stopping the routine use of AP resulted in over Australian dollars (AUD) $1.5 million extra costs and a loss of 163 quality-adjusted life years (QALYs). Using antibiotic cement in addition to AP (AP þ ABC)generated an extra 32 QALYs while saving over AUD $123,000. The use of laminar air operating rooms combined with routine AP (AP þ LOR) resulted in an AUD $4.59 million cost increase and 127 QALYs lost compared with the baseline comparator. Conclusion: Preventing deep SSI with antibiotic prophylaxis and antibiotic-impregnated cement has shown to improve health outcomes among hospitalized patients, save lives, and enhance resource allocation. Based on this evidence, the use of laminar air operating rooms is not recommended.