What do most Americans think of cost-effectiveness research in health care?

My impression is that explicit data on the cost-effectiveness of different health care services are not valued highly by US policy makers. An example is a recent decision to approve ipilimumab for the treatment of metastatic melanoma. The extra health benefit over standard treatment is 2.1 months in previously untreated patients and the cost is $120,000 for 4 doses. This is poor value for money. Had $120,000 been allocated to an intensive lifestyle modification programme for diabetes risk (Diabet Med. 2004 Nov;21(11):1229-36) then 67 years of life or 800 months could have been returned. A massive increase in health benefits for the same costs.

Ants, apples and the ABCs: The use of commercial phonics programmes in prior-to-school children's services

Commercial phonics programmes (e.g. Jolly Phonics and Letterland) are becoming widely used in the early years of school. These programmes claim to use a systematic explicit approach, considered as the preferred method of phonics instruction for teaching alphabetic code-breaking skills in Australia and the UK in the first years of school (Department of Education, Science and Training, 2005; Rose, 2006). However, little is known about the extent to which they are being used in prior-to-school settings, and the reasons behind decisions to use them. This study surveyed 283 early childhood staff in Sydney, Australia and found that commercial phonics programmes were being used in 36% of the early childhood settings surveyed. Staff with early childhood univer- sity qualifications and staff working in not-for-profit service types were less likely to use a commercial phonics programme than staff without university qualifications and staff working in for-profit services. Staff with less than 10 years’ experience were also more likely to use a commercial phonics programme. The rationale behind decisions deter- mining whether or not staff used the programmes ranged from pragmatic reasons, such as parent pressure or higher management decisions, to pedagogical reasons, such as teacher beliefs about how children learn to read and write. The practices staff engage in to teach phonics are explored.

Pre-packaging preschool literacy: What drives early childhood teachers to use commercially produced phonics programs in prior to school settings

Language-rich environments are key to overall quality in early childhood settings, including frequent child–staff interactions around picture books and dramatic play. In a language-rich environment, explicit teaching of literacy concepts, such as phonics, is embedded in authentic and meaningful situations where alphabet letters and sounds are taught in a context meaningful to the child. Recent research, however, suggests that the use of commercial pre-packaged phonics programs (such as Letterland and Jolly Phonics) is widespread in prior to school settings in Sydney, Australia. Little is known about why early childhood teachers choose to use such programs with children aged five and under. In the present study, thematic analysis of data from interviews with five early childhood teachers using commercial phonics programs found that their reasons were pragmatic rather than pedagogical. Motivations included the idea that the programs reduced their workload, provided tangible evidence to parents of their child’s ‘school readiness’, and served as a marketing tool to attract parents. Further analysis found that the teachers were unable to articulate what phonics and phonological awareness are and how they are learnt in early childhood.

It's complicated: Romancing the [male] modernist canon

This research project proposes a model of dialogue between the [predominantly male] modernist canon and models of feminist resistance. Employing a practice based methodology that utilises humour as a method for ironic deconstruction as well as a feminist methodology of revision, critique, and dialogic exchange; the resulting body of work disrupts and augments the modernist canon. Making intimate relationships explicit, the artworks explor collaborative and faux-llaborative processes to form a series of tentative gestures that refute notions of mastery and control. The accompanying exegesis contextualises this work by placing the research and the outputs amongst the field.

Revisiting the Australian code of banking practice: Is self-regulation still relevant for improving consumer protection standards?

The Code of Banking Practice is one of the oldest examples of consumer protection provided through self-regulation in the Australian financial services sector. However, since the Banking Code was first released in 1993, the volume of consumer protection legislation applying to banks has increased exponentially and parts of the Banking Code that once provided new consumer rights have now been largely superseded by legislation. In light of the increasingly complex set of laws and regulations that govern the relationship between banks and their consumer and small business customers it could be argued that the Banking Code has a limited future role. However, an analysis of the Banking Code shows that it adds to the consumer protection standards provided by legislation and can continue to facilitate improvements in the standards of subscribing banks and of other institutions in the financial services sector. Self-regulation and industry codes should continue to be part of the regulatory mix. Any regulatory changes that flow from the recent Financial System Inquiry should also facilitate and support the self-regulation role, but the government should also consider further changes to encourage improvements in industry codes and ensure that the implicit regulatory benefits that are provided, in part, because of the existence of industry codes, are made explicit and made available only to code subscribers.

Playing Monopoly™ with real estate students

This paper outlines the results from a study into the educational use of the board game Monopoly City™ in a first year real estate unit. This game play was introduced as a fun and interactive way of achieving a number of desired outcomes including: introduction of foundational threshold concepts in real estate education; introduction of problem solving and critical analysis skills; early acculturation of real estate students to enhance student retention; early team building within the student cohort; and enhanced engagement of first year students and, all in an engaging and entertaining way. Results from this two-stage research project are encouraging. The students participating in this project have demonstrated explicit linkages between their Monopoly City™ experiences and foundation urban economic and valuation theories. Students are also recognising the role strategy and chance play in the real estate sector. Findings from this project and key success factors are presented.

Mobile app rating scale: A new tool for assessing the quality of health mobile apps

Background The use of mobile apps for health and well being promotion has grown exponentially in recent years. Yet, there is currently no app-quality assessment tool beyond “star”-ratings. Objective The objective of this study was to develop a reliable, multidimensional measure for trialling, classifying, and rating the quality of mobile health apps. Methods A literature search was conducted to identify articles containing explicit Web or app quality rating criteria published between January 2000 and January 2013. Existing criteria for the assessment of app quality were categorized by an expert panel to develop the new Mobile App Rating Scale (MARS) subscales, items, descriptors, and anchors. There were sixty well being apps that were randomly selected using an iTunes search for MARS rating. There were ten that were used to pilot the rating procedure, and the remaining 50 provided data on interrater reliability. Results There were 372 explicit criteria for assessing Web or app quality that were extracted from 25 published papers, conference proceedings, and Internet resources. There were five broad categories of criteria that were identified including four objective quality scales: engagement, functionality, aesthetics, and information quality; and one subjective quality scale; which were refined into the 23-item MARS. The MARS demonstrated excellent internal consistency (alpha = .90) and interrater reliability intraclass correlation coefficient (ICC = .79). Conclusions The MARS is a simple, objective, and reliable tool for classifying and assessing the quality of mobile health apps. It can also be used to provide a checklist for the design and development of new high quality health apps.

A finite element modelling method for thin layer mortared masonry systems

This paper deals with a finite element modelling method for thin layer mortared masonry systems. In this method, the mortar layers including the interfaces are represented using a zero thickness interface element and the masonry units are modelled using an elasto-plastic, damaging solid element. The interface element is formulated using two regimes; i) shear-tension and ii) shearcompression. In the shear-tension regime, the failure of joint is consiedered through an eliptical failure criteria and in shear-compression it is considered through Mohr Coulomb type failure criterion. An explicit integration scheme is used in an implicit finite element framework for the formulation of the interface element. The model is calibrated with an experimental dataset from thin layer mortared masonry prism subjected to uniaxial compression, a triplet subjected to shear loads a beam subjected to flexural loads and used to predict the response of thin layer mortared masonry wallettes under orthotropic loading. The model is found to simulate the behaviour of a thin layer mortated masonry shear wall tested under pre-compression and inplane shear quite adequately. The model is shown to reproduce the failure of masonry panels under uniform biaxial state of stresses.

Submission to Senate Standing Committee on Legal and Constitutional Affairs on the Copyright Amendment (Online Infringement) Bill 2015

We argue that safeguards are necessary to ensure human rights are adequately protected. All systems of blocking access to online content necessarily raise difficult and problematic issues of infringement of freedom of speech and access to information. Given the importance of access to information across the breadth of modern life, great care must be taken to ensure that any measures designed to protect copyright by blocking access to online locations are proportionate. Any measures to block access to online content must be carefully tailored to avoid serious and disproportionate impact on human rights. This means first that the measures must be effective and adapted to achieve a legitimate purpose. The experience of foreign jurisdictions suggests that this legislation is unlikely to be effective. Unless and until there is clear evidence that the proposed scheme is likely to increase effective returns to Australian creators, this legislation should not be introduced. Second, the principle of proportionality requires ensuring that the proposed legislation does not unnecessarily burden legitimate speech or access to information. As currently worded, the draft legislation may result in online locations being blocked even though they would, if operated in Australia, not contravene Australian law. This is unacceptable, and if introduced, the law should be drafted so that it is clearly limited only to foreign locations where there is clear and compelling evidence that the location would authorise copyright infringement if it were in Australia. Third, proportionality requires that measures are reasonable and strike an appropriate balance between competing interests. This draft legislation provides few safeguards for the public interest or the interests of private actors who would access legitimate information. New safeguards should be introduced to ensure that the public interest is well represented at both the stage of the primary application and at any applications to rescind or vary injunctions. We recommend that: The legislation not be introduced unless and until there is compelling evidence that it will have a real and significant positive impact on the effective incomes of Australian creators. The ‘facilitates an infringement’ test in s 115A(1)(b) should be replaced with ‘authorises infringement’. The ‘primary purpose’ test in s 115A(1)(c) should be replaced with: “the online location has no substantial non-infringing uses”. An explicit role for public interest groups as amici curiae should be introduced. Costs of successful applications should be borne by applicants. Injunctions should be valid only for renewable two year terms. Section 115A(5) should be clarified, and cl (b) and (c) be removed. The effectiveness of the scheme should be evaluated in two years.

Investigating a disciplinary approach to literacy learning in a secondary school

This paper presents findings from a Design-Based Research (DBR) project undertaken in a large regional high school in Queensland. The study focused on an intervention involving explicit teaching using systemic functional grammar in assessed writing across two Year 8 subjects: English and History. The study’s findings demonstrate that, despite efforts at the whole school and classroom level to support a disciplinary literacy approach to subject learning, there are considerable constraints that need to be considered and overcome in order for students to develop appropriate writing capabilities for particular discipline areas.

Computer analysis of impact behavior of concrete filled steel tube columns

This paper presents a numerical study of the response of axially loaded concrete filled steel tube (CFST) columns under lateral impact loading using explicit non-linear finite element techniques. The aims of this paper are to evaluate the vulnerability of existing columns to credible impact events as well as to contribute new information towards the safe design of such vulnerable columns. The model incorporates concrete confinement, strain rate effects of steel and concrete, contact between the steel tube and concrete and dynamic relaxation for pre-loading, which is a relatively recent method for applying a pre-loading in the explicit solver. The finite element model was first verified by comparing results with existing experimental results and then employed to conduct a parametric sensitivity analysis. The effects of various structural and load parameters on the impact response of the CFST column were evaluated to identify the key controlling factors. Overall, the major parameters which influence the impact response of the column are the steel tube thickness to diameter ratio, the slenderness ratio and the impact velocity. The findings of this study will enhance the current state of knowledge in this area and can serve as a benchmark reference for future analysis and design of CFST columns under lateral impact.

Managing mental health co-morbidities in hepatitis C: A systematic review of clinical guidelines

BACKGROUND Mental health co-morbidities are prevalent in hepatitis C (HCV), and in practice often considered a contraindication for initiation of treatment. A systematic review was conducted to explore whether and how current HCV clinical practice guidelines address pre-existing mental health co-morbidities. METHODS A review of the literature was undertaken to identify guidelines for the management of HCV, published in English, between 2002 and January 2015. Characteristics of the guidelines were recorded and key themes on mental health were summarized across predefined stages in the patient journey (diagnosis, pre-HCV drug therapy, on HCV drug therapy, post-HCV drug therapy, advanced disease or palliative care). RESULTS Twenty-five HCV clinical guidelines were included. Referral to psychiatrist is generally recommended as pre- and in-treatment assessment of mental health co-morbidities but HCV guidelines do not offer explicit instructions on how to manage mental health co-morbidities. Post-treatment assessment of mental health co-morbidities were lacking. Conclusions Current chronic HCV clinical guidelines are limited in their advice to clinicians regarding the management of mental health co-morbidities.

Sports anti-siphoning laws and the controversy of sports broadcasting: A case study of Pakistan

Controversies between private and public broadcasters over the broadcasting of live sports, especially cricket, during important sports events have emerged as a serious legal issue in Pakistan. Controversy between Geo Super and Pakistan Television over live telecast of the ICC Cricket World Cup is a typical example of such controversies. An aggressive legal battle, during a most important cricketing event, not only hampered the enjoyment of cricket viewers across the country but also gave Pakistan a bad name across the globe. This article discusses in detail this controversy and highlights lacunas in the existing sports broadcasting regime of Pakistan. There are no clear and well defined sports broadcasting laws in Pakistan. The Pakistan Electronic Media Regulatory Authority (PEMRA) rules are of general nature. Secondly, PEMRA rules are not comprehensive and explicit enough to provide clear guidelines about sports broadcasting. This may be a possible reason why sports broadcasting controversies reach the highest court in Pakistan, the Supreme Court of Pakistan. Despite these ugly battles between broadcasters, the government of Pakistan has never given due importance to this issue and no efforts have been made at any level to come up with legislation on sports broadcasting to avoid such controversies or to resolve them amicably in the light of well-defined laws on this subject. The purpose of this article is to draw the attention of the concerned authorities towards this important issue because in future more such controversies may be expected in the absence of a sports broadcasting regime in the country.

Geographical and morphological variation within and between colour phases in Coris julis (L. 1758), a protogynous marine fish

The possible differences between sexes in patterns of morphological variation in geographical space have been explored only in gonochorist freshwater species. We explored patterns of body shape variation in geographical space in a marine sequential hermaphrodite species, Coris julis (L. 1758), analyzing variation both within and between colour phases, through the use of geometric morphometrics and spatially-explicit statistical analyses. We also tested for the association of body shape with two environmental variables: temperature and chlorophyll a concentration, as obtained from time-series of satellite-derived data. Both colour phases showed a significant morphological variation in geographical space and patterns of variation divergent between phases. Although the morphological variation was qualitatively similar, individuals in the initial colour phase showed a more marked variation than individuals in the terminal phase. Body shape showed a weak but significant correlation with environmental variables, which was more pronounced in primary specimens.

Expectation and variation with a virtual die

By the time students reach the middle years they have experienced many chance activities based on dice. Common among these are rolling one die to explore the relationship of frequency and theoretical probability, and rolling two dice and summing the outcomes to consider their probabilities. Although dice may be considered overused by some, the advantage they offer is a familiar context within which to explore much more complex concepts. If the basic chance mechanism of the device is understood, it is possible to enter quickly into an arena of more complex concepts. This is what happened with a two hour activity engaged in by four classes of Grade 6 students in the same school. The activity targeted the concepts of variation and expectation. The teachers held extended discussions with their classes on variation and expectation at the beginning of the activity, with students contributing examples of the two concepts from their own experience. These notions are quite sophisticated for Grade 6, but the underlying concepts describe phenomena that students encounter every day. For example, time varies continuously; sporting results vary from game to game; the maximum temperature varies from day to day. However, there is an expectation about tomorrow’s maximum temperature based on the expert advice from the weather bureau. There may also be an expectation about a sporting result based on the participants’ previous results. It is this juxtaposition that makes life interesting. Variation hence describes the differences we see in phenomena around us. In a scenario displaying variation, expectation describes the effort to characterise or summarise the variation and perhaps make a prediction about the message arising from the scenario. The explicit purpose of the activity described here was to use the familiar scenario of rolling a die to expose these two concepts. Because the students had previously experienced rolling physical dice they knew instinctively about the variation that occurs across many rolls and about the theoretical expectation that each side should “come up” one-sixth of the time. They had observed the instances of the concepts in action, but had not consolidated the underlying terminology to describe it. As the two concepts are so fundamental to understanding statistics, we felt it would be useful to begin building in the familiar environment of rolling a die. Because hand-held dice limit the explorations students can undertake, the classes used the soft-ware TinkerPlots (Konold & Miller, 2011) to simulate rolling a die multiple times.