The feasibility, delivery and cost effectiveness of drink driving interventions : a qualitative analysis of professional stakeholders

Many intervention programs have been designed to decrease the rate of drink driving by altering the behavioural characteristics that may lead a person to drink and drive. However, most programs target high risk and repeat offenders. There is very little research on the feasibility and effectiveness of first offender programs. This project is part of a larger program of research that focuses on first time offenders, in order to reduce the rate of subsequent drink driving which may result in a repeat offence. A number of professional stakeholders were approached and interviewed with a view to capturing and reflecting current drink driving related concerns while developing an intervention in the context of Australian drink driving related legislation. The qualitative interviews involved open ended questioning which led to the themes discussed in the analysis. Included in the interviews were senior representatives from the Magistrates Court, Queensland Transport, Probation & Parole, Queensland Corrective Services, Royal Automobile Club Queensland (RACQ), Intraface Consulting (drug & alcohol EAP), Brisbane Police Prosecution Corps, Queensland Police Service and private practice psychology. Issues such as delivery of interventions, feasibility and cost-effectiveness were discussed, as were potential content and design. It was generally agreed that a tailored online intervention imposed as a sentencing option would be the most effective for first time offenders in terms of cost, ease of delivery and feasibility. The development of an online intervention program for first offenders is widely supported by professional stakeholders.

Exploring the internal dimensions of work stress : evidence from construction cost estimators in China

A recurring feature of modern practice is the stress placed on project professionals, with both debilitating effects on the people concerned and indirectly affecting project success. Cost estimation, for example, is an essential task for successful project management involving a high level of uncertainty. It is not surprising, therefore, that young cost estimators especially can become stressful at work due to a lack of experience and the heavy responsibilities involved. However, the concept of work stress and the associated underlying dimensions has not been clearly defined in extant studies in the construction management field. To redress this situation, an updated psychology perceived stress questionnaire (PSQ) , first developed by Levenstein et al (1993) and revised by Fliege et al (2005), is used to explore the dimensions of work stress with empirical evidence from the construction industry in China. With 145 reliable responses from young (less than 5 years’ experience) Chinese cost estimators, this study explores the internal dimensions of work stress, identifying four dimensions of tension, demands, lack of joy and worries. It is suggested that this four-dimensional structure may also be applicable in a more general context.

Minimizing the effects of overfitting and collinearity in construction cost estimation : a new hybird approach

Research problem: Overfitting and collinearity problems commonly exist in current construction cost estimation applications and obstruct researchers and practitioners in achieving better modelling results. Research objective and method: A hybrid approach of Akaike information criterion (AIC) stepwise regression and principal component regression (PCR) is proposed to help solve overfitting and collinearity problems. Utilization of this approach in linear regression is validated by comparing it with other commonly used approaches. The mean square error obtained by leave-one-out cross validation (MSELOOCV) is used in model selection in deciding predictive variables.

Near-miss event detection at railway level crossings

Recent modelling of socio-economic costs by the Australian railway industry in 2010 has estimated the cost of level crossing accidents to exceed AU$116 million annually. To better understand the causal factors of these accidents, a video analytics application is being developed to automatically detect near-miss incidents using forward facing videos from trains. As near-miss events occur more frequently than collisions, by detecting these occurrences there will be more safety data available for analysis. The application that is being developed will improve the objectivity of near-miss reporting by providing quantitative data about the position of vehicles at level crossings through the automatic analysis of video footage. In this paper we present a novel method for detecting near-miss occurrences at railway level crossings from video data of trains. Our system detects and localizes vehicles at railway level crossings. It also detects the position of railways to calculate the distance of the detected vehicles to the railway centerline. The system logs the information about the position of the vehicles and railway centerline into a database for further analysis by the safety data recording and analysis system, to determine whether or not the event is a near-miss. We present preliminary results of our system on a dataset of videos taken from a train that passed through 14 railway level crossings. We demonstrate the robustness of our system by showing the results of our system on day and night videos.

A cost-effectiveness analysis of a telephone-linked care intervention for individuals with Type 2 diabetes

AIM: To assess the cost-effectiveness of an automated telephone-linked care intervention, Australian TLC Diabetes, delivered over 6 months to patients with established Type 2 diabetes mellitus and high glycated haemoglobin level, compared to usual care. METHODS: A Markov model was designed to synthesize data from a randomized controlled trial of TLC Diabetes (n=120) and other published evidence. The 5-year model consisted of three health states related to glycaemic control: 'sub-optimal' HbA1c ≥58mmol/mol (7.5%); 'average' ≥48-57mmol/mol (6.5-7.4%) and 'optimal' <48mmol/mol (6.5%) and a fourth state 'all-cause death'. Key outcomes of the model include discounted health system costs and quality-adjusted life years (QALYS) using SF-6D utility weights. Univariate and probabilistic sensitivity analyses were undertaken. RESULTS: Annual medication costs for the intervention group were lower than usual care [Intervention: £1076 (95%CI: £947, £1206) versus usual care £1271 (95%CI: £1115, £1428) p=0.052]. The estimated mean cost for intervention group participants over five years, including the intervention cost, was £17,152 versus £17,835 for the usual care group. The corresponding mean QALYs were 3.381 (SD 0.40) for the intervention group and 3.377 (SD 0.41) for the usual care group. Results were sensitive to the model duration, utility values and medication costs. CONCLUSION: The Australian TLC Diabetes intervention was a low-cost investment for individuals with established diabetes and may result in medication cost-savings to the health system. Although QALYs were similar between groups, other benefits arising from the intervention should also be considered when determining the overall value of this strategy.

Sex workers can be screened too often : a cost-effectiveness analysis in Victoria, Australia

Objectives Commercial sex is licensed in Victoria, Australia such that sex workers are required to have regular tests for sexually transmitted infections (STIs). However, the incidence and prevalence of STIs in sex workers are very low, especially since there is almost universal condom use at work. We aimed to conduct a cost-effectiveness analysis of the financial cost of the testing policy versus the health benefits of averting the transmission of HIV, syphilis, chlamydia and gonorrhoea to clients. Methods We developed a simple mathematical transmission model, informed by conservative parameter estimates from all available data, linked to a cost-effectiveness analysis. Results We estimated that under current testing rates, it costs over $A90 000 in screening costs for every chlamydia infection averted (and $A600 000 in screening costs for each quality-adjusted life year (QALY) saved) and over $A4 000 000 for every HIV infection averted ($A10 000 000 in screening costs for each QALY saved). At an assumed willingness to pay of $A50 000 per QALY gained, HIV testing should not be conducted less than approximately every 40 weeks and chlamydia testing approximately once per year; in comparison, current requirements are testing every 12 weeks for HIV and every 4 weeks for chlamydia. Conclusions Mandatory screening of female sex workers at current testing frequencies is not cost-effective for the prevention of disease in their male clients. The current testing rate required of sex workers in Victoria is excessive. Screening intervals for sex workers should be based on local STI epidemiology and not locked by legislation.

A rapid and cost-effective method of producing recombinant proBNP and NT-proBNP variants in Escherichia coli for immunoassay of heart failure

The measurements of plasma natriuretic peptides (NT-proBNP, proBNP and BNP) are used to diagnose heart failure but these are expensive to produce. We describe a rapid, cheap and facile production of proteins for immunoassays of heart failure. DNA encoding N-terminally His-tagged NT-proBNP and proBNP were cloned into the pJexpress404 vector. ProBNP and NT-proBNP peptides were expressed in Escherichia coli, purified and refolded in vitro. The analytical performance of these peptides were comparable with commercial analytes (NT-proBNP EC50 for the recombinant is 2.6 ng/ml and for the commercial material is 5.3 ng/ml) and the EC50 for recombinant and commercial proBNP, are 3.6 and 5.7 ng/ml respectively). Total yield of purified refolded NT-proBNP peptide was 1.75 mg/l and proBNP was 0.088 mg/l. This approach may also be useful in expressing other protein analytes for immunoassay applications. To develop a cost effective protein expression method in E. coli to obtain high yields of NT-proBNP (1.75 mg/l) and proBNP (0.088 mg/l) peptides for immunoassay use.

Thrust allocation with linear constrained quadratic cost function

In this paper, a method of thrust allocation based on a linearly constrained quadratic cost function capable of handling rotating azimuths is presented. The problem formulation accounts for magnitude and rate constraints on both thruster forces and azimuth angles. The advantage of this formulation is that the solution can be found with a finite number of iterations for each time step. Experiments with a model ship are used to validate the thrust allocation system.

Profiling : an application assignment approach for green data centers

In the past few years, there has been a steady increase in the attention, importance and focus of green initiatives related to data centers. While various energy aware measures have been developed for data centers, the requirement of improving the performance efficiency of application assignment at the same time has yet to be fulfilled. For instance, many energy aware measures applied to data centers maintain a trade-off between energy consumption and Quality of Service (QoS). To address this problem, this paper presents a novel concept of profiling to facilitate offline optimization for a deterministic application assignment to virtual machines. Then, a profile-based model is established for obtaining near-optimal allocations of applications to virtual machines with consideration of three major objectives: energy cost, CPU utilization efficiency and application completion time. From this model, a profile-based and scalable matching algorithm is developed to solve the profile-based model. The assignment efficiency of our algorithm is then compared with that of the Hungarian algorithm, which does not scale well though giving the optimal solution.

The effect of knee flexion contracture following total knee arthroplasty on the energy cost of walking.

This study evaluated the energy cost of walking (Cw) with knee flexion contractures (FC) simulated with a knee brace, in total knee arthroplasty (TKA) recipients (n=16) and normal controls (n=15), and compared it to baseline (no brace). There was no significant difference in Cw between the groups at baseline but TKA recipients walked slower (P=0.048) and with greater knee flexion in this condition (P=0.003). Simulated FC significantly increased Cw in both groups (TKA P=0.020, control P=0.002) and this occurred when FC exceeded 20° in the TKA group and 15° in the controls. Reported perceived exertion was only significantly increased by FC in the control group (control P<0.001, TKA P=0.058). Simulated knee FCs less than 20° do not increase Cw or perceived exertion in TKA recipients.

A distributed computing framework for all-to-all comparison problems

Distributed computation and storage have been widely used for processing of big data sets. For many big data problems, with the size of data growing rapidly, the distribution of computing tasks and related data can affect the performance of the computing system greatly. In this paper, a distributed computing framework is presented for high performance computing of All-to-All Comparison Problems. A data distribution strategy is embedded in the framework for reduced storage space and balanced computing load. Experiments are conducted to demonstrate the effectiveness of the developed approach. They have shown that about 88% of the ideal performance capacity have be achieved in multiple machines through using the approach presented in this paper.

Prognostic validity of 3-Minute Nutrition Screening (3-MinNS) in predicting length of hospital stay, readmission, cost of hospitalisation and mortality : a cohort study

Background: It is important to identify patients who are at risk of malnutrition upon hospital admission as malnutrition results in poor outcomes such as longer length of hospital stay, readmission, hospitalisation cost and mortality. The aim of this study was to determine the prognostic validity of 3-Minute Nutrition Screening (3-MinNS) in predicting hospital outcomes in patients admitted to an acute tertiary hospital through a list of diagnosis-related groups (DRG). Methods: In this study, 818 adult patients were screened for risk of malnutrition using 3-MinNS within 24 hours of admission. Mortality data was collected from the National Registry with other hospitalisation outcomes retrieved from electronic hospital records. The results were adjusted for age, gender and ethnicity, and matched for DRG. Results: Patients identified to be at risk of malnutrition (37%) using 3-MinNS had significant positive association with longer length of hospital stay (6.6 ± 7.1 days vs. 4.5 ± 5.5 days, p<0.001), higher hospitalisation cost (S$4540 ± 7190 vs. S$3630 ± 4961, p<0.001) and increased mortality rate at 1 year (27.8% vs. 3.9%), 2 years (33.8% vs. 7.2%) and 3 years (39.1% vs. 10.5%); p<0.001 for all. Conclusions: The 3-MinNS is able to predict clinical outcomes and can be used to screen newly admitted patients for nutrition risk so that appropriate nutrition assessment and early nutritional intervention can be initiated.