Cost-effectiveness of a central venous catheter care bundle

Background: A bundled approach to central venous catheter care is currently being promoted as an effective way of preventing catheter-related bloodstream infection (CR-BSI). Consumables used in the bundled approach are relatively inexpensive which may lead to the conclusion that the bundle is cost-effective. However, this fails to consider the nontrivial costs of the monitoring and education activities required to implement the bundle, or that alternative strategies are available to prevent CR-BSI. We evaluated the cost-effectiveness of a bundle to prevent CR-BSI in Australian intensive care patients. ---------- Methods and Findings: A Markov decision model was used to evaluate the cost-effectiveness of the bundle relative to remaining with current practice (a non-bundled approach to catheter care and uncoated catheters), or use of antimicrobial catheters. We assumed the bundle reduced relative risk of CR-BSI to 0.34. Given uncertainty about the cost of the bundle, threshold analyses were used to determine the maximum cost at which the bundle remained cost-effective relative to the other approaches to infection control. Sensitivity analyses explored how this threshold alters under different assumptions about the economic value placed on bed-days and health benefits gained by preventing infection. If clinicians are prepared to use antimicrobial catheters, the bundle is cost-effective if national 18-month implementation costs are below $1.1 million. If antimicrobial catheters are not an option the bundle must cost less than $4.3 million. If decision makers are only interested in obtaining cash-savings for the unit, and place no economic value on either the bed-days or the health benefits gained through preventing infection, these cost thresholds are reduced by two-thirds.---------- Conclusions: A catheter care bundle has the potential to be cost-effective in the Australian intensive care setting. Rather than anticipating cash-savings from this intervention, decision makers must be prepared to invest resources in infection control to see efficiency improvements.

Web searching interaction model based on user cognitive styles

As more and more information is available on the Web finding quality and reliable information is becoming harder. To help solve this problem, Web search models need to incorporate users’ cognitive styles. This paper reports the preliminary results from a user study exploring the relationships between Web users’ searching behavior and their cognitive style. The data was collected using a questionnaire, Web search logs and think-aloud strategy. The preliminary findings reveal a number of cognitive factors, such as information searching processes, results evaluations and cognitive style, having an influence on users’ Web searching behavior. Among these factors, the cognitive style of the user was observed to have a greater impact. Based on the key findings, a conceptual model of Web searching and cognitive styles is presented.

User-web interactions : how wholistic/analytic web users search the web?

User-Web interactions have emerged as an important research in the field of information science. In this study, we examine extensively the Web searching performed by general users. Our goal is to investigate the effects of users’ cognitive styles on their Web search behavior in relation to two broad components: Information Searching and Information Processing Approaches. We use questionnaires, a measure of cognitive style, Web session logs and think-aloud as the data collection instruments. Our study findings show wholistic Web users tend to adopt a top-down approach to Web searching, where the users searched for a generic topic, and then reformulate their queries to search for specific information. They tend to prefer reading to process information. Analytic users tend to prefer a bottom-up approach to information searching and they process information by scanning search result pages.

The Australian response to climate change : business as usual or legal innovation?

Through international agreement to the United Nations Framework Convention on Climate Change and the Kyoto Protocol the global community has acknowledged that climate change is a global problem and sought to achieve reductions in global emissions, within a sufficient timeframe, to avoid dangerous anthropogenic interference with the climate system. The sheer magnitude of emissions reductions required within such an urgent timeframe presents a challenge to conventional regulatory approaches both internationally and within Australia. The phenomenon of climate change is temporally and geographically challenging and it is scientifically complex and uncertain. The purpose of this paper is to analyse the current Australian legal response to climate change and to examine the legal measures which have been proposed to promote carbon trading, energy efficiency, renewable energy, and carbon sequestration initiatives across Australia. As this paper illustrates, the current Australian approach is clearly ineffective and the law as it stands overwhelmingly inadequate to address Australia’s emissions and meet the enormity of the challenges posed by climate change. Consequently, the government should look towards a more effective legal framework to achieve rapid and urgent transformations in the selection of energy sources, energy use and sequestration initiatives across the Australian community.

Impact of zooming and enhancing Region of Interests for optimizing user experience on mobile sports video

In mobile videos, small viewing size and bitrate limitation often cause unpleasant viewing experiences, which is particularly important for fast-moving sports videos. For optimizing the overall user experience of viewing sports videos on mobile phones, this paper explores the benefits of emphasizing Region of Interest (ROI) by 1) zooming in and 2) enhancing the quality. The main goal is to measure the effectiveness of these two approaches and determine which one is more effective. To obtain a more comprehensive understanding of the overall user experience, the study considers user’s interest in video content and user’s acceptance of the perceived video quality, and compares the user experience in sports videos with other content types such as talk shows. The results from a user study with 40 subjects demonstrate that zooming and ROI-enhancement are both effective in improving the overall user experience with talk show and mid-shot soccer videos. However, for the full-shot scenes in soccer videos, only zooming is effective while ROI-enhancement has a negative effect. Moreover, user’s interest in video content directly affects not only the user experience and the acceptance of video quality, but also the effect of content type on the user experience. Finally, the overall user experience is closely related to the degree of the acceptance of video quality and the degree of the interest in video content. This study is valuable in exploiting effective approaches to improve user experience, especially in mobile sports video streaming contexts, whereby the available bandwidth is usually low or limited. It also provides further understanding of the influencing factors of user experience.

External collaboration for innovation can alleviate the effect between the past innovation abandonment and future innovation introduction among SMEs

This study investigates the links between product innovation and external collaboration and between future product innovation and past abandonment in small and medium sized firms. Our findings from 449 manufacturing firms indicated firms that sought ideas or solutions from an external network such as suppliers, or business partners reported higher levels of new product introduction than firms without any external collaboration. Further, firms with past abandonment experiences reported higher levels of new product introduction than firms without such experience. Additionally, the findings indicated that firms with external collaboration were more likely to introduce new products even if they had previously experienced abandonment of a product innovation than firms without external collaboration. Implications, limitations and future research are outlined.

Powered two wheelers in a changing world : challenges and opportunities

Powered two wheelers (PTWs) come in diverse forms and are used for a range of purposes in very different parts of the world. In many parts of the world, the forms and uses of PTWs are changing, influenced by social, economic and demographic changes. Most of the challenges associated with PTWs relate to safety, while the majority of the opportunities relate to mobility. The challenges for improving safety relate to the PTW user, other road users, the road environment, the vehicle, data and research, and socio-political dimensions. The relative importance of particular challenges varies between developed and developing countries, and among developing countries according to whether PTWs are largely used for recreation or for transport. PTWs present a range of psychological, transport, economic and environmental opportunities to individuals and societies. The fun and excitement of riding PTWs is a major motivator for their purchase and use for recreational purposes, both off-road and on-road. The transport and economic advantages to the individual also need to be considered. At a societal level, research has examined the potential for increasing PTW volumes to reduce fossil fuel use and traffic congestion in busy cities. The future of PTWs may differ greatly between countries and environmental and technological changes are leading to an evolution in the form of PTWs to encompass new modes of personal transportation.

A model for integrating clinical care and basic science research, and pitfalls of performing complex research projects for addressing a clinical challenge

The collaboration of clinicians with basic science researchers is crucial for addressing clinically relevant research questions. In order to initiate such mutually beneficial relationships, we propose a model where early career clinicians spend a designated time embedded in established basic science research groups, in order to pursue a postgraduate qualification. During this time, clinicians become integral members of the research team, fostering long term relationships and opening up opportunities for continuing collaboration. However, for these collaborations to be successful there are pitfalls to be avoided. Limited time and funding can lead to attempts to answer clinical challenges with highly complex research projects characterised by a large number of "clinical" factors being introduced in the hope that the research outcomes will be more clinically relevant. As a result, the complexity of such studies and variability of its outcomes may lead to difficulties in drawing scientifically justified and clinically useful conclusions. Consequently, we stress that it is the basic science researcher and the clinician's obligation to be mindful of the limitations and challenges of such multi-factorial research projects. A systematic step-by-step approach to address clinical research questions with limited, but highly targeted and well defined research projects provides the solid foundation which may lead to the development of a longer term research program for addressing more challenging clinical problems. Ultimately, we believe that it is such models, encouraging the vital collaboration between clinicians and researchers for the work on targeted, well defined research projects, which will result in answers to the important clinical challenges of today.

Research adventures in Web 2.0 : encouraging collaborative local content creation through edgeX

The intersection of current arguments about the role of creative industries in economic development, online user-generated content, and the uptake of broadband in economically disadvantaged communities provides the content for this article. From 2006 to 2008 the authors carried out a research project in Ipswich, Queensland involving local creative practitioners and community groups in their development of edgeX, a Web-based platform for content uploads and social networking. The project aimed to explore issues of local identity and community building through online networking, as well as the possibilities for creating pathways from amateur to professional practice in the creative industries through the auspices of the Website. Set against the backdrop of a rapidly changing technological environment that has problematic implications for research projects aiming to build new online platforms, we present several case studies from the project to illustrate the challenges to participation experienced by people with limited access to, and literacy with, the Internet.

Building an Australian user community for VIVO

The Australian National Data Service (ANDS) was established in 2008 and aims to: influence national policy in the area of data management in the Australian research community; inform best practice for the curation of data, and, transform the disparate collections of research data around Australia into a cohesive collection of research resources One high profile ANDS activity is to establish the population of Research Data Australia, a set of web pages describing data collections produced by or relevant to Australian researchers. It is designed to promote visibility of research data collections in search engines, in order to encourage their re-use. As part of activities associated with the Australian National Data Service, an increasing number of Australian Universities are choosing to implement VIVO, not as a platform to profile information about researchers, but as a 'metadata store' platform to profile information about institutional research data sets, both locally and as part of a national data commons. To date, the University of Melbourne, Griffith University, the Queensland University of Technology, and the University of Western Australia have all chosen to implement VIVO, with interest from other Universities growing.

The citizen's voice : Albert Hirschman's Exit, Voice and Loyalty and its contribution to media citizenship debates

This paper analyses Albert Hirschman's Exit, Voice and Loyalty (Hirschman 1970) as a basis for understanding the relationship between media and citizenship. It considers the significance of Hirschman's concept of voice in relation to media policy, media participation through user-created content, and the rise of 'citizen media' and 'citizen journalism'. It associates these developments with a 'de-centering' of both media practice and media studies, as considered by Couldry (2006a, 2006b). It concludes by suggesting that voice and participation, rather than citizenship, may constitute a more suitable foundation for understanding new digital media initiatives.

What will the Apple iPad deliver for newspapers?

The launch of the Apple iPad in January 2010 was one of the most anticipated and publicised launched of a new technological device in recent history. Positioning itself as between a smart phone and a PC, but with the attributes of both, Apple have sought to develop a new market niche with the iPad for tablet PC devices, and early signs are that market expectations are being met.. The iPad’s launch was potentially fortuitous for the newspaper industry worldwide, as it offered the potential to address its two recurring problems: the slow but inexorable decline of print media circulation, and the inability to satisfactorily monetise online readerships. As a result, the Apple iPad has benefited from an enormous amount of free publicity in newspapers, as they develop their own applications (apps) for the device. This paper reports on findings from work undertaken through Smart Services CRC into potential take-up and likely uses of the iPad, and their implications for the news media industry. It reports on focus group analysis undertaken in the mid-2010 using “customer job mapping” methodologies, that draw attention to current gaps in user behaviour in terms of available devices, in order to anticipate possibilities beyond the current “three screens” of PC, mobile phone and television.

Journalism as social networking : the Australian youdecide project and the 2007 federal election

The increasing prevalence of new media technologies and the rise of citizen journalism has coincided with a crisis in industrial journalism –as the figure of the "journalist as hero" is fading, new media forms have facilitated the production of news content "from below" by citizens and "pro-am" journalists. Participation in an action-research project run during the 2007 Australian Federal Election, youdecide 2007, allowed the authors to gain first-hand insights into the progress of citizen-led news media in Australia, but also allowed us to develop an account of what the work of facilitating citizen journalism involves. These insights are important to understanding the future of professional journalism and journalism education, as more mainstream media organizations move to accommodate and harness user-created content. The paper considers the relevance of citizen journalism projects as forms of R&D for understanding news production and distribution in participatory media cultures, and the importance of grounded case studies for moving beyond normative debates about new media and the future of journalism.

The new middle class meets the creative class : the Master of Business Administration (MBA) and creative innovation in 21st-century China

‘MBA fever’ in China needs to be understood in the wider context of forces driving structural change in China’s relation to the global knowledge economy. The rise of a ‘new middle class’ in China is connected to the new claims for cultural leadership of an emergent ‘creative class’, which generates new issues about the relevance of the MBA in China, in terms of its relevance to Chinese economic circumstances, and its flexibility and capacity to respond to accumulation strategies that emphasise innovation, creativity and entrepreneurship.