Cost-effectiveness of a national initiative to improve hand hygiene compliance using the outcome of healthcare associated staphylococcus aureus bacteraemia

Background The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included. Methods The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011–2012. Findings No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER) of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits. Conclusions The Australian National Hand Hygiene Initiative was cost-effective against an Australian threshold of $42,000 per life year gained. The return on investment varied among the states and territories of Australia.

Global Media and National Policies : The Return of the State

Conventional wisdom views globalization as a process that heralds the diminishing role or even 'death' of the state and the rise of transnational media and transnational consumption, that defy state control or regulation. This book questions these assumptions and shows that the nation-state never left and is still a force to be reckoned with.

National media regulations in an age of convergent media: Beyond globalisation, neo-liberalism and internet freedom theories

There is a widely held view that the nation-state has become less central to media and communications policy over the last two decades. As Jan van Cuilenberg and Denis McQuail (2003, p. 181) observed in their overview of trends in communications policy-making, 'the old normative media policies have been challenged and policy-makers are searching for a new communications policy paradigm'. There are characteristically five factors put forward as to why the nation-state has become less central to media in the twenty-first century

Electronic Building Passport - Final Report: Project 2 National Energy Efficient Building Project Phase 2

The National Energy Efficient Building Project (NEEBP) Phase One report, published in December 2014, investigated “process issues and systemic failures” in the administration of the energy performance requirements in the National Construction Code. It found that most stakeholders believed that under-compliance with these requirements is widespread across Australia, with similar issues being reported in all states and territories. The report found that many different factors were contributing to this outcome and, as a result, many recommendations were offered that together would be expected to remedy the systemic issues reported. To follow up on this Phase 1 report, three additional projects were commissioned as part of Phase 2 of the overall NEEBP project. This Report deals with the development and piloting of an Electronic Building Passport (EBP) tool – a project undertaken jointly by pitt&sherry and a team at the Queensland University of Technology (QUT) led by Dr Wendy Miller. The other Phase 2 projects cover audits of Class 1 buildings and issues relating to building alterations and additions. The passport concept aims to provide all stakeholders with (controlled) access to the key documentation and information that they need to verify the energy performance of buildings. This trial project deals with residential buildings but in principle could apply to any building type. Nine councils were recruited to help develop and test a pilot electronic building passport tool. The participation of these councils – across all states – enabled an assessment of the extent to which these councils are currently utilising documentation; to track the compliance of residential buildings with the energy performance requirements in the National Construction Code (NCC). Overall we found that none of the participating councils are currently compiling all of the energy performance-related documentation that would demonstrate code compliance. The key reasons for this include: a major lack of clarity on precisely what documentation should be collected; cost and budget pressures; low public/stakeholder demand for the documentation; and a pragmatic judgement that non-compliance with any regulated documentation requirements represents a relatively low risk for them. Some councils reported producing documentation, such as certificates of final completion, only on demand, for example. Only three of the nine council participants reported regularly conducting compliance assessments or audits utilising this documentation and/or inspections. Overall we formed the view that documentation and information tracking processes operating within the building standards and compliance system are not working to assure compliance with the Code’s energy performance requirements. In other words the Code, and its implementation under state and territory regulatory processes, is falling short as a ‘quality assurance’ system for consumers. As a result it is likely that the new housing stock is under-performing relative to policy expectations, consuming unnecessary amounts of energy, imposing unnecessarily high energy bills on occupants, and generating unnecessary greenhouse gas emissions. At the same time, Councils noted that the demand for documentation relating to building energy performance was low. All the participant councils in the EBP pilot agreed that documentation and information processes need to work more effectively if the potential regulatory and market drivers towards energy efficient homes are to be harnessed. These findings are fully consistent with the Phase 1 NEEBP report. It was also agreed that an EBP system could potentially play an important role in improving documentation and information processes. However, only one of the participant councils indicated that they might adopt such a system on a voluntary basis. The majority felt that such a system would only be taken up if it were: - A nationally agreed system, imposed as a mandatory requirement under state or national regulation; - Capable of being used by multiple parties including councils, private certifiers, building regulators, builders and energy assessors in particular; and - Fully integrated into their existing document management systems, or at least seamlessly compatible rather than a separate, unlinked tool. Further, we note that the value of an EBP in capturing statistical information relating to the energy performance of buildings would be much greater if an EBP were adopted on a nationally consistent basis. Councils were clear that a key impediment to the take up of an EBP system is that they are facing very considerable budget and staffing challenges. They report that they are often unable to meet all community demands from the resources available to them. Therefore they are unlikely to provide resources to support the roll out of an EBP system on a voluntary basis. Overall, we conclude from this pilot that the public good would be well served if the Australian, state and territory governments continued to develop and implement an Electronic Building Passport system in a cost-efficient and effective manner. This development should occur with detailed input from building regulators, the Australian Building Codes Board (ABCB), councils and private certifiers in the first instance. This report provides a suite of recommendations (Section 7.2) designed to advance the development and guide the implementation of a national EBP system.

Posted Workers and Free Movement of Services in the European Union – the Impact on National Employment and Immigration Law

This thesis examines posting of workers within the free movement of services in the European Union. The emphasis is on the case law of the European Court of Justice and in the role it has played in the liberalisation of the service sector in respect of posting of workers. The case law is examined from two different viewpoints: firstly, that of employment law and secondly, immigration law. The aim is to find out how active a role the Court has taken with regard these two fields of law and what are the implications of the Court’s judgments for the regulation on a national level. The first part of the thesis provides a general review of the Community law principles governing the freedom to provide services in the EU. The second part presents the Posted Workers’ Directive and the case law of the European Court of Justice before and after the enactment of the Directive from the viewpoint of employment law. Special attention is paid to a recent judgment in which the Court has taken a restrictive position with regard to a trade union’s right to take collective action against a service provider established in another Member State. The third part of the thesis concentrates, firstly, on the legal status of non-EU nationals lawfully resident in the EU. Secondly, it looks into the question of how the Court’s case law has affected the possibilities to use non-EU nationals as posted workers within the freedom to provide services. The final chapter includes a critical analysis of the Court’s case law on posted workers. The judgments of the European Court of Justice are the principal source of law for this thesis. In the primary legislation the focus is on Articles 49 EC and 50 EC that lay down the rules concerning the free movement of services. Within the secondary legislation, the present work principally concentrates on the Posted Workers’ Directive. It also examines proposals of the European Commission and directives that have been adopted in the field of immigration. The conclusions of the case study are twofold: while in the field of employment law, the European Court of Justice has based its judgments on a very literal interpretation of the Posted Workers’ Directive, in the field of immigration its conclusions have been much more innovative. In both fields of regulation the Court’s judgments have far-reaching implications for the rules concerning posting of workers leaving very little discretion for the Member States’ authorities.

The Mediated Immediacy : João Batista Libanio and the Question of Latin American Liberation Theology

This study is a systematic analysis of mediated immediacy in the production of the Brazilian professor of theology João Batista Libanio. He stresses both ethical mediation and the immediate character of the faith. Libanio has sought an answer to the problem of science and faith. He makes use of the neo-scholastic distinction between matter and form. According to St. Thomas Aquinas, God cannot be known as a scientific object, but it is possible to predicate a formal theological content of other subject matter with the help of revelation. This viewpoint was emphasized in neo-Thomism and supported by the liberation theologians. For them, the material starting point was social science. It becomes a theologizable or revealable (revelabile) reality. This social science has its roots in Latin American Marxism which was influenced by the school of Louis Althusser and considered Marxism a science of history . The synthesis of Thomism and Marxism is a challenge Libanio faced, especially in his Teologia da libertação from 1987. He emphasized the need for a genuinely spiritual and ethical discernment, and was particularly critical of the ethical implications of class struggle. Libanio s thinking has a strong hermeneutic flavor. It is more important to understand than to explain. He does not deny the need for social scientific data, but that they cannot be the exclusive starting point of theology. There are different readings of the world, both scientific and theological. A holistic understanding of the nature of religious experience is needed. Libanio follows the interpretation given by H. C. de Lima Vaz, according to whom the Hegelian dialectic is a rational circulation between the totality and its parts. He also recalls Oscar Cullmann s idea of God s Kingdom that is already and not yet . In other words, there is a continuous mediation of grace into the natural world. This dialectic is reflected in ethics. Faith must be verified in good works. Libanio uses the Thomist fides caritate formata principle and the modern orthopraxis thinking represented by Edward Schillebeeckx. One needs both the ortho of good faith and the praxis of the right action. The mediation of praxis is the mediation of human and divine love. Libanio s theology has strong roots in the Jesuit spirituality that places the emphasis on contemplation in action.

Scoping study to inform the development of the new national nutrition policy for Australia

This comprehensive report (748 pages) scopes a new nutrition policy for Australia (RFT 028/1213) Australian Department of Health and Ageing. Optimum nutrition is fundamental to good health. It is essential for the normal growth and physical and cognitive development of infants and children, contributes significantly to quality of life, wellbeing and workforce productivity, enhances resistance to infection and reduces the risk of obesity, chronic disease and premature death (AIHW 2012; NHMRC 2013). This scoping study reviews the current literature to identify: - key population health issues related to diet and nutrition within the Australian population; and - where gaps in current policy are evident. The scoping study reviews the literature on past and present national and international nutrition policies, strategies (policy actions), interventions and evaluations. The study analyses the evidence from the literature review and formulates recommendations regarding the key elements of effective nutrition policies including scope, guiding principles, format, key inclusions (content), development processes, governance, implementation, timelines, monitoring and surveillance, evaluation and review to guide the development of a new comprehensive National Nutrition Policy for Australia.

Educating to secure the national interest

In this paper I examine how one political actor–former Prime Minister Kevin Rudd–proposes to use education for the purpose of securing national productivity and foreign policy. I work with Foucault’s suggestion that the apparatus of security is the essential technical instrument of governmentality and that the production of milieu, made up of human, spatial, temporal and cultural objects, and the government of risk are key strategies in the bio-politicisation of security. The discourse analysis also draws on Bacchi to problematise statements that (a) represent both the nation and regional neighbours as governable milieu within the ambit of a whole of government approach, and (b) locate literacy and education as both risk and solution in a security apparatus. My examination of the emergence of literacy and education as security technologies, takes account of the discursive effects of Rudd’s representation of the spaces and scale of national, geopolitical and global policy problems. I argue that in these examples of policy texts, education is used as a discursive tool to secure education workers and youth as subjects of economic interest and sovereign rule.

Transcending disciplinary, cultural and national boundaries: Emergent technologies, new education landscape and the cloud workshop project

As technology continues to become more accessible, miniaturised and diffused into the environment, the potential of wearable technology to impact our lives in significant ways becomes increasingly viable. Wearables afford unique interaction, communication and functional capabilities between users, their environment as well as access to information and digital data. Wearables also demand an inter-disciplinary approach and, depending on the purpose, can be fashioned to transcend cultural, national and spatial boundaries. This paper presents the Cloud Workshop project based on the theme of ‘Wearables and Wellbeing; Enriching connections between citizens in the Asia-Pacific region’, initiated through a cooperative partnership between Queensland University of Technology (QUT), Hong Kong Baptist University (HKBU) and Griffith University (GU). The project was unique due to its inter-disciplinary, inter-cultural and inter-national scope that occurred simultaneously between Australia and Hong Kong.

Itsenäisen Suomen puolesta : Sotilaskomitea 1915-1918

For Independent Finland. The Military Committee 1915–1918 In the course of the First World War, several organizations were founded with the purpose of making Finland independent or, at least, restoring her autonomous status. The Military Committee was the most significant active independence organization in Finland in the First World War, in addition to the activist student movement, i.e., the Jaeger Movement. The Military Committee was an organization founded in 1915 by officers who had attended the Hamina Cadet School, with the goal of creating a national army for a liberation war against the Russian troops. It was believed that the liberation war should succeed only with the help of the German Army. With the situation in society continually tensing up in the autumn 1917, the Military Committee also had to figure on the possibility of a Civil War. The activities of the Military Committee started in the early part of 1915 when they were still small-scale, but they gained significant momentum after the Russian Revolution in March 1917. In January 1918, the Military Committee formed the general staff for the White Army, the Senate’s troops. The independence-related activities of the Hamina cadets in the years of the First World War were more extensive and multifaceted than has been believed heretofore. The work of the Military Committee was divided into preparations for a liberation war in Finland, on one hand, and in Stockholm and Berlin, on the other hand. In Finland, the Military Committee took part in intelligence gathering for Germany and in supporting the recruiting Jaegers, and later in founding the civil guard organization, in solving the law and order authorities issue, and finally in selecting the Commander-in-Chief for the Senate’s troops. The member of the Military Committee, especially Captain Hannes Ignatius of the Cavalry contributed greatly to the drafting of the independence activists’ national action plan in Stockholm in May 1917. This plan preceded the formation of the civil guard organization. The Military Committee’s role in founding the civil guards was initially minor, but in the fall of 1917, the Military Committee started to finance the activities of the civil guards, named several former officers as commanders of the civil guards and finally overtook the entire civil guard movement. In Stockholm and Berlin, the representatives of the Military Committee were in active contact with both the high command of the German Army and with the representatives of the Swedish Army. Colonel Nikolai Mexmontan, who was a representative of the Military Committee, collaborated with Swedish officers and Jaeger officers in Stockholm in coming up with comprehensive and detailed plans for starting the Liberation War. Under Mexmontan’s leadership, there were serious negotiations to enter into a confederation with Germany. Lieutenant Colonel Wilhelm Thesleff, on the other hand, became the commander of the Jaeger Battalion 27. The influence and importance of the Military Committee came to the forefront in independent and conflict-torn Finland. The Military Committee became a Senate committee on the 7th of January 1918, with its chairman, for all practical purposes, as the Commander-in-Chief in an eventual war. Lieutenant General Claes Charpentier was the chairman of the Military Committee from mid-December 1917 onwards, but on the 15th of January 1918 he had to resign in favour of Lieutenant General Gustaf Mannerheim. Soon after that, Mannerheim got an order from the chairman of the Senate P. E. Svinhufvud to organize and assume the leadership of the law and order authorities. The chairman of the Military Committee became the Commander-in-Chief of the Senate troops in January 1918, and the Military Committee became the Commander-in-Chief’s general staff. The Military Committee had turned from a clandestine organization into the first general staff of the independent Finnish Army.

How terrorist campaigns end : The Rode Jeugd in the Netherlands and the Symbionese Liberation Army in the United States

This study explores the decline of terrorism by conducting source-based case studies on two left-wing terrorist campaigns in the 1970s, those of the Rode Jeugd in the Netherlands and the Symbionese Liberation Army in the United States. The purpose of the case studies is to bring more light into the interplay of different external and internal factors in the development of terrorist campaigns. This is done by presenting the history of the two chosen campaigns as narratives from the participants’ points of view, based on interviews with participants and extensive archival material. Organizational resources and dynamics clearly influenced the course of the two campaigns, but in different ways. This divergence derives at least partly from dissimilarities in organizational design and the incentive structure. Comparison of even these two cases shows that organizations using terrorism as a strategy can differ significantly, even when they share ideological orientation, are of the same size and operate in the same time period. Theories on the dynamics of terrorist campaigns would benefit from being more sensitive to this. The study also highlights that the demise of a terrorist organization does not necessarily lead to the decline of the terrorist campaign. Therefore, research should look at the development of terrorist activity beyond the lifespan of a single organization. The collective ideological beliefs and goals functioned primarily as a sustaining force, a lens through which the participants interpreted all developments. On the other hand, it appears that the role of ideology should not be overstated. Namely, not all participants in the campaigns under study fully internalized the radical ideology. Rather, their participation was mainly based on their friendship with other participants. Instead of ideology per se, it is more instructive to look at how those involved described their organization, themselves and their role in the revolutionary struggle. In both cases under study, the choice of the terrorist strategy was not merely a result of a cost-benefit calculation, but an important part of the participants’ self-image. Indeed, the way the groups portrayed themselves corresponded closely with the forms of action that they got involved in. Countermeasures and the lack of support were major reasons for the decline of the campaigns. However, what is noteworthy is that the countermeasures would not have had the same kind of impact had it not been for certain weaknesses of the groups themselves. Moreover, besides the direct impact the countermeasures had on the campaign, equally important was how they affected the attitudes of the larger left-wing community and the public in general. In this context, both the attitudes towards the terrorist campaign and the authorities were relevant to the outcome of the campaigns.

Scoping study for a national survey of the prevalence of child abuse and neglect

This is a report produced as a result of a study commissioned by the Australian Government Royal Commission into Institutional Responses to Child Sexual Abuse.

Carabid beetles (Coleoptera, Carabidae) as indicators of environmental change in Ranomafana National Park, Madagascar

Growing human populations and increasing exploitation of natural resources threaten nature all over the world. Tropical countries are especially vulnerable to human impact because of the high number of species, most of these endemic and still unknown. Madagascar is one of the centers of high biodiversity and renowned for its unique species. However, during the last centuries many endemic species have gone extinct and more are endangered. Because of high natural values, Madagascar is one of the global conservation priorities. The establishment of Ranomafana National Park (RNP) was intended to preserve the unique nature of Madagascar. Containing several endemic and threatened species, Ranomafana has been selected as one of UNESCO’s World Natural Heritage sites. However, due to strong human pressures the region immediately surroundings the protected area has severely degraded. Aims of this thesis were to inventory carabid fauna in RNP and evaluate their use as indicators of the environmental change. Carabid beetles were collected from protected area (secondary and primary forests) and from its degraded surrounding area. Collecting was mostly conducted by hand during years 2000-2005. Species compositions between the protected area and its surroundings were compared, and species habitat preferences and seasonal variations were studied. In total, 4498 individuals representing 127 carabid species (of which 38 are new species) were collected. Species compositions within and outside of the protected area were markedly different. Most of the species preferred forest as their primary habitat and were mainly collected from trees and bushes. Their value as indicators is based on their different habitat requirements and sensitivity to environmental variables. Some of the species were found only in the protected forest, some occupied also the degraded forests and some preferred open areas. Carabid fauna is very species rich in Ranomafana and there are still many species to be found. Most of the species are arboreal and probably cannot survive in the deforested areas outside the park. This is very likely also the case for other species. Establishment and continued protection of RNP is probably the only way to conserve this globally important area. However, new occupations and land use methods are urgently needed by the local people for improving their own lives while maintaining the forest intact.