Hospital infection control units: Staffing, costs, and priorities

Background: This article describes infection prevention and control professionals’ (ICPs’) staffing levels, patient outcomes, and costs associated with the provision of infection prevention and control services in Australian hospitals. A secondary objective was to determine the priorities for infection control units. Methods: A cross-sectional study design was used. Infection control units in Australian public and private hospitals completed a Web-based anonymous survey. Data collected included details about the respondent; hospital demographics; details and services of the infection control unit; and a description of infection prevention and control-related outputs, patient outcomes, and infection control priorities. Results: Forty-nine surveys were undertaken, accounting for 152 Australian hospitals. The mean number of ICPs was 0.66 per 100 overnight beds (95% confidence interval, 0.55-0.77). Privately funded hospitals have significantly fewer ICPs per 100 overnight beds compared with publicly funded hospitals (P < .01). Staffing costs for nursing staff in infection control units in this study totaled $16,364,392 (mean, $380,566). Infection control units managing smaller hospitals (<270 beds) identified the need for increased access to infectious diseases or microbiology support. Conclusion: This study provides valuable information to support future decisions by funders, hospital administrators, and ICPs on service delivery models for infection prevention and control. Further, it is the first to provide estimates of the resourcing and cost of staffing infection control in hospitals at a national level. Copyright

A theoretical framework for reducing tendering costs in the procurement of infrastructure projects

Purpose of this paper One way in which the tendering process can be further improved is by reviewing and clarifying the high costs that participants face during the course of the tendering phase. The study aims to provide project teams working in construction tender preparation a clear picture of what to expect when tendering for infrastructure projects. Design/methodology/approach Firstly, a review of current literature on tendering in infrastructure projects is conducted to identify the associated costs affecting traditional and PPP procurements as well as the potential measures contributing to tendering cost-reduction. A theoretical framework and its corresponding research hypotheses, which are based on the literature reviewed, are then proposed. An industry-wide questionnaire survey is currently under design to solicit industry practitioners’ views on tendering costs and the associated tendering cost-reduction measures. The data collected in the survey will subject to statistical analysis to test the proposed research hypotheses, which will be reported in a forthcoming paper. Findings and value The direct and indirect costs in public-private procurement have been identified and have been categorised into internal and external costs arising from working on tender submissions. A theoretical framework, mainly composed of five mechanisms of cost reduction, has been proposed and will be tested in a forthcoming industry-wide questionnaire survey. Originality/value of paper The findings are expected to lead to a transparent tendering process in infrastructure procurement, in which there is increased engagement from the private sector as well as an increase in competitive tendering.

Smart Cities, Social Capital, and Citizens at Play: A Critique and a Way Forward

Digital transformations are not contained within the digital domain but are increasingly spilling over into the physical world. In this chapter, we analyse some of the transformations undergoing in cities today towards becoming smart cities. We offer a critique of smart cities and a way forward, divided into three parts: First, we explore the concept of Smart Citizens in terms of both localities, the move towards a hyperlocal network and also the citizen’s role in the creation and use of data. We use the ‘Smart London’ plan drawn up by the Mayor of London, as a way to illustrate our discussion. Second, we turn to the civic innovations enabled by digital transformations and their potential impact on citizens and citizenship. Specifically, we are interested in the notion of social capital as an alternative form of in-kind currency and its function as an indicator of value, in order to ask, can digital transformations give rise to ‘civic capital,’ and how can such a concept help, for instance, a local government invite more representative residents and community champions to participate in community engagement for better urban planning. Third, we introduce a hybrid, location-based game under development by design agency Preliminal Games in London, UK. This illustrative case critiques and highlights the current challenges to establishing a new economic model that bridges the digital / physical divide. The game provides a vehicle for us to explore how established principles and strategies in game design such as immersive storytelling and goal setting, can be employed to encourage players to think of the interconnections of their hybrid digital / physical environments in new ways.

Receivers' future liability for costs

In Juniper Property Holdings No.15 Pty Ltd v Caltabiano [2015] QSC 95, Jackson J considered what he described as a 'novel point' as to whether the court had jurisdiction to make a determination of the liability of receivers and managers appointed to the plaintiff to pay any costs orders that may be made in favour of the defendant.

Costs assessor selection: A question of timing, or cost?

In Lessbrook Pty Ltd (in liq) v Whap; Stephen; Bowie; Kepa & Kepa [2014] QCA 63 the Queensland Court of Appeal dealt with significant questions of general application relating to the appointment of assessors to conduct an assessment of costs under the Uniform Civil Procedure Rules 1999 (Qld) (UCPR).

The solar capital: Canberra, clean tech, and climate change

There has been an increasing focus upon the role of cities and local government in respect of action upon climate change...

Projecting excess emergency department visits and associated costs in Brisbane, Australia, under population growth and climate change scenarios

The direct and indirect health effects of increasingly warmer temperatures are likely to further burden the already overcrowded hospital emergency departments (EDs). Using current trends and estimates in conjunction with future population growth and climate change scenarios, we show that the increased number of hot days in the future can have a considerable impact on EDs, adding to their workload and costs. The excess number of visits in 2030 is projected to range between 98–336 and 42–127 for younger and older groups, respectively. The excess costs in 2012–13 prices are estimated to range between AU$51,000–184,000 (0–64) and AU$27,000–84,000 (65+). By 2060, these estimates will increase to 229–2300 and 145–1188 at a cost of between AU$120,000–1,200,000 and AU$96,000–786,000 for the respective age groups. Improvements in climate change mitigation and adaptation measures are likely to generate synergistic health co-benefits and reduce the impact on frontline health services.

Sport across cultures: Applications of the human capital model in refugee communities

When working with the world’s most vulnerable populations there are questions surrounding the salience of physical activity promotion programs given the multitude of basic needs that must first be met. Indeed, physical activity may be a low priority for individuals seeking safety, reunification with loved ones, and food for their families, as a subsistence lifestyle makes excess weight gain, diabetes, and cardiovascular disease irrelevant. Yet, when working with people from a refugee background for whom these challenges all too frequently apply, opportunities for sport and activity have repeatedly surfaced as desirable and needed, yet are utterly deficient. If we conceptualize physical activity purely as a chronic disease prevention tool, its significance within under-resourced communities is most assuredly lost; however, if we harness the power of physical activity to serve as an agent of positive social change, then it instantly becomes more meaningful and necessary.

Social capital or ethnic enclave location? A multilevel explanation of immigrant business growth

The rapid increase in migration into host countries and the growth of immigrant-owned business enterprises has revitalized research on ethnic business. Does micro (individual)-level social capital, or meso (group)-level location within the ethnic enclave lead to immigrant business growth? Or do you need both? We analyze quantitative data collected from 110 Chinese restaurants in Australia, a major host country. At the micro level we find that coethnic (same ethnic group) networks are critical to the growth of an immigrant entrepreneur's business, particularly in the early years. But non-coethnic (different ethnic group) social capital only has a positive impact on business growth for immigrant businesses outside the ethnic enclave. Our findings are relevant, not only to host-country policymakers, but also for future immigrant business owners and ethnic community leaders trying to better understand how to promote healthy communities and sustainable economic growth.

A CCG virtual system for big data application communication costs analysis

Network topology and routing are two important factors in determining the communication costs of big data applications at large scale. As for a given Cluster, Cloud, or Grid system, the network topology is fixed and static or dynamic routing protocols are preinstalled to direct the network traffic. Users cannot change them once the system is deployed. Hence, it is hard for application developers to identify the optimal network topology and routing algorithm for their applications with distinct communication patterns. In this study, we design a CCG virtual system (CCGVS), which first uses container-based virtualization to allow users to create a farm of lightweight virtual machines on a single host. Then, it uses software-defined networking (SDN) technique to control the network traffic among these virtual machines. Users can change the network topology and control the network traffic programmingly, thereby enabling application developers to evaluate their applications on the same system with different network topologies and routing algorithms. The preliminary experimental results through both synthetic big data programs and NPB benchmarks have shown that CCGVS can represent application performance variations caused by network topology and routing algorithm.

Communicating consequences with costs: A commentary on Corso et al's cost of injury

Estimating the economic burden of injuries is important for setting priorities, allocating scarce health resources and planning cost-effective prevention activities. As a metric of burden, costs account for multiple injury consequences—death, severity, disability, body region, nature of injury—in a single unit of measurement. In a 1989 landmark report to the US Congress, Rice et al1 estimated the lifetime costs of injuries in the USA in 1985. By 2000, the epidemiology and burden of injuries had changed enough that the US Congress mandated an update, resulting in a book on the incidence and economic burden of injury in the USA.2 To make these findings more accessible to the larger realm of scientists and practitioners and to provide a template for conducting the same economic burden analyses in other countries and settings, a summary3 was published in Injury Prevention. Corso et al reported that, between 1985 and 2000, injury rates declined roughly 15%. The estimated lifetime cost of these injuries declined 20%, totalling US$406 billion, including US$80 billion in medical costs and US$326 billion in lost productivity. While incidence reflects problem size, the relative burden of injury is better expressed using costs.

Director independence or decision bias? An investigation of alternative sources of agency costs in board decision making

Research into boards traditionally focuses on independent monitoring of management, with studies focused on the effect of board independence on firm performance. This thesis aims to broaden the research tradition by consolidating prior research and investigating how agents may circumvent independent monitoring. Meta-analysis of previous board independence-firm performance studies indicated no systematic relationship between board independence and firm performance. Next, a series of experiments demonstrated that the presentation of recommendations to directors may bias decision making irrespective of other information presented and the independence of the decision maker. Together, results suggest that independence may be less important than the agent's motivation to misdirect the monitoring process.

The dilemma of international capital tax competition in the presence of public capital and endogenous growth

Using an OLG-model with endogenous growth and public capital we show, that an international capital tax competition leads to inefficiently low tax rates, and as a consequence to lower welfare levels and growth rates. Each national government has an incentive to reduce the capital income tax rates in its effort to ensure that this policy measure increases the domestic private capital stock, domestic income and domestic economic growth. This effort is justified as long as only one country applies this policy. However, if all countries follow this path then all of them will be made worse off in the long run.

Making apartments affordable: Moving from speculative to deliberative development

Urban planning policies in Australia presuppose apartments as the new dominant housing type, but much of what the market has delivered is criticised as over-development, and as being generic, poorly-designed, environmentally unsustainable and unaffordable. Policy responses to this problem typically focus on planning regulation and construction costs as the primary issues needing to be addressed in order to increase the supply of quality, affordable apartment housing. In contrast, this paper uses Ball’s (1983) ‘structures of provision’ approach to outline the key processes informing apartment development and identifies a substantial gap in critical understanding of how apartments are developed in Australia. This reveals economic problems not typically considered by policymakers. Using mainstream economic analysis to review the market itself, the authors found high search costs, demand risk, problems with exchange, and lack of competition present key barriers to achieving greater affordability and limit the extent to which ‘speculative’ developers can respond to the preferences of would be owner-occupiers of apartments. The existing development model, which is reliant on capturing uplift in site value, suits investors seeking rental yields in the first instance and capital gains in the second instance, and actively encourages housing price inflation. This is exacerbated by lack of density restrictions, such as have existed in inner Melbourne for many years, which permits greater yields on redevelopment sites. The price of land in the vicinity of such redevelopment sites is pushed up as landholders' expectation of future yield is raised. All too frequently existing redevelopment sites go back onto the market as vendors seek to capture the uplift in site value and exit the project in a risk free manner...

Bayesian and Decision Tree Approaches for Pattern Recognition Including Feature Measurement Costs

The minimum cost classifier when general cost functionsare associated with the tasks of feature measurement and classification is formulated as a decision graph which does not reject class labels at intermediate stages. Noting its complexities, a heuristic procedure to simplify this scheme to a binary decision tree is presented. The optimizationof the binary tree in this context is carried out using ynamicprogramming. This technique is applied to the voiced-unvoiced-silence classification in speech processing.