The use of economic evaluation in CAM : an introductory framework

Background For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities. In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Methods Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Conclusions Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM.

Potential of St John's Wort for the treatment of depression : the economic perspective

The burden of rising health care expenditures has created a demand for information regarding the clinical and economic outcomes associated with complementary and alternative medicines. Meta-analyses of randomized controlled trials have found Hypericum perforatum preparations to be superior to placebo and similarly effective as standard antidepressants in the acute treatment of mild to moderate depression. A clear advantage over antidepressants has been demonstrated in terms of the reduced frequency of adverse effects and lower treatment withdrawal rates, low rates of side effects and good compliance, key variables affecting the cost-effectiveness of a given form of therapy. The most important risk associated with use is potential interactions with other drugs, but this may be mitigated by using extracts with low hyperforin content. As the indirect costs of depression are greater than five times direct treatment costs, given the rising cost of pharmaceutical antidepressants, the comparatively low cost of Hypericum perforatum extract makes it worthy of consideration in the economic evaluation of mild to moderate depression treatments.

The organisation : risk, resilience and governance

Tarrant argues that a solid risk management strategy is critical to building effective, transformational and adaptive organisations. Organisations are a fundamental part of our society and economic system whether they are private, public or not-for-profits. There are very few aspects of our society and economy that don’t rely wholly or in part on the performance of organisations. Disasters and crises are complex and very challenging environments for organisations. How can effective transformational and adaptive capacity become institutionalised and a core part of good governance of organisations? Effective risk management is a critical element in meeting organisational objectives in a turbulent and uncertain environment.

Changing perceptions of preservice teachers : innovations in middle schooling teacher education

For the past twenty years, the disengagement of early adolescents has been the focus of much of the literature related to middle schooling. In response, some universities in Australia have introduced teacher education programs that focus upon graduating specialised middle schooling teachers. The aim of this study was to explore and describe the 38 first-year preservice teachers’ perceptions of their first middle schooling elective unit and ascertain whether the combination of university classes and school-based experiences assisted their development of middle schooling concepts and approaches. Data were gathered using pre-test and post-test questionnaires combined with guided written reflections to record their views before, after and during the unit delivery. Results indicated that initially the preservice teachers had little understanding of middle schooling concepts and pedagogical practices, however, 11 participants recognised that bullying and peer pressure were issues experienced by early adolescents. The reflections, which were presented after their field experiences, focused on teaching, learning, behaviour management, and resources and infrastructure. More school-based experiences linked to theoretical underpinnings can help to facilitate understandings about students in the middle phase.

Changing perceptions of preservice teachers : innovations in middle schooling teacher education

For the past twenty years, the disengagement of early adolescents has been the focus of much of the literature related to middle schooling. In response, some universities in Australia have introduced teacher education programs that focus upon graduating specialised middle schooling teachers. Constructing such programs is at the centre of much debate and discussion, however, it is advocated that positive futures for early adolescents can be enhanced through quality middle schooling teacher education programs (Education Queensland, 2004). At a Queensland university campus, middle schooling elective units were introduced as part of the Bachelor of Education (primary) degree. The design of the units was to support preservice teachers to gain the theoretical and pedagogical knowledge to engage and promote early adolescent learning. An innovative approach to the delivery of the units was promoted by a partnership agreement between local schools and the campus. The partnership allowed preservice teachers to combine university classes with opportunities to visit exemplary classrooms to observe, participate and reflect upon middle school teaching practices. The aim of this study was to explore and describe the 38 first-year preservice teachers’ perceptions of their first middle schooling elective unit and to ascertain whether the combination of university classes and school-based experiences assisted their development of middle schooling concepts and approaches. Data were gathered using pre-test and post-test questionnaires combined with guided written reflections to record their views before, after and during the unit delivery. Results indicated that initially 34 preservice teachers had little understanding of middle schooling concepts and pedagogical practices, however, 11 participants recognised that bullying and peer pressure were issues experienced by early adolescents. The collation of the written reflections supported the combined delivery of the middle years unit further supporting the inclusion of school experiences with university delivered units.

Cultural economic geography and global media studies : the rise of asian media capitals?

This paper considers the scope to develop an approach to the spatial dimensions of media and culture that is informed by cultural-economic geography. I refer to cultural-economic geography as that strand of research in the field of geography that has been informed on the one hand by the ‘cultural turn’ in both geographical and economic thought, and which focuses on the relationship between, space, knowledge and identity in the spheres of production and consumption, and on the other to work by geographers that has sought to map the scale and significance of the cultural or creative industries as new drivers of the global economy. The paper considers the extent to which this work enables those engaged with urban cultural policy to get beyond some of the impasses that have arisen with the development of “creative cities” policies derived from the work of authors such as Richard Florida as well as the business management literature on clusters. It will frame these debates in the context of recent work by Michael Curtin on media capitals, and the question of whether cities in East Asia can emerge as media capitals from outside of the US-Europe-dominated transnational cultural axis.

Toward a cultural economic geography of creative industries and urban development : introduction to the special issue on creative industries and urban development

The connections between the development of creative industries and the growth of cities was noted by several sources over the 2000s, but explanations relating to the nature of the link have thus far provide to be insufficient. The two dominant ‘scripts’ were those of ‘creative clusters’ and ‘creative/cities/creative class’ theories, but both have proved to be insufficient, not least because they privilege amenities-led, supply-drive accounts of urban development that fail to adequately situate cities in wider global circuits of culture and economic production. It is proposed that the emergent field of cultural economic geography provides some insights into redressing these lacunae, particularly in the possibilities for an original synthesis of cultural and economic geography, cultural studies and new strands of economic theory.

Mapping the territory of economic risk

It is widely contended that we live in a „world risk society‟, where risk plays a central and ubiquitous role in contemporary social life. A seminal contributor to this view is Ulrich Beck, who claims that our world is governed by dangers that cannot be calculated or insured against. For Beck, risk is an inherently unrestrained phenomenon, emerging from a core and pouring out from and under national borders, unaffected by state power. Beck‟s focus on risk's ubiquity and uncontrollability at an infra-global level means that there is a necessary evenness to the expanse of risk: a "universalization of hazards‟, which possess an inbuilt tendency towards globalisation. While sociological scholarship has examined the reach and impact of globalisation processes on the role and power of states, Beck‟s argument that economic risk is without territory and resistant to domestic policy has come under less appraisal. This is contestable: what are often described as global economic processes, on closer inspection, reveal degrees of territorial embeddedness. This not only suggests that "global‟ flows could sometimes be more appropriately explained as international, regional or even local processes, formed from and responsive to state strategies – but also demonstrates what can be missed if we overinflate the global. This paper briefly introduces two key principles of Beck's theory of risk society and positions them within a review of literature debating the novelty and degree of global economic integration and its impact on states pursuing domestic economic policies. In doing so, this paper highlights the value for future research to engage with questions such as "is economic risk really without territory‟ and "does risk produce convergence‟, not so much as a means of reducing Beck's thesis to a purely empirical analysis, but rather to avoid limiting our scope in understanding the complex relationship between risk and state.

Aligning communication, cultural and media studies research and scholarship with industry and policy : Australian instances

This article reflects on aspects of what is claimed to be the distinctiveness of Australian communication, cultural and media studies, focusing on two cases – the cultural policy debate in the 1990s, and the concept of creative industries in the 2000s – and the relations between them, which highlight the alignment of research and scholarship with industry and policy and with which the author has been directly involved. Both ‘moments’ have been controversial; the three main lines of critique of such alignment of research and scholarship with industry and policy (its untoward proximity to tenets of the dominant neo-liberal ideology; the evacuation of cultural value by the economic; and the possible loss of critical vocation of the humanities scholar) are debated.

Using economic data to reduce healthcare-acquired infection

In this issue Burns et al. report an estimate of the economic loss to Auckland City Hospital from cases of healthcare-associated bloodstream infection. They show that patients with infection stay longer in hospital and this must impose an opportunity cost because beds are blocked. Harder to measure costs fall on patients, their families and non-acute health services. Patients face some risk of dying from the infection.

Research-led educational renewal and economic-cultural convergence

The 'Queensland Model' grew out of three convergent agendas: educational renewal, urban redevelopment, and the Queensland state government's 'Smart State' strategy.

Attack of the creationist reverberators! Or: the end of the world (as we know it)

This special issue of Popular Communication examines the impact of the global financial crisis and recession on differnt aspects of global and regional media and the cultural industries, changing practices of media production, as well as media consumption, and the interplay of economic challenges and technological change.

Australian consumers' attitudes about sports sponsorship during an economic downturn

This paper provides an overview of the prevailing attitudes held by Australian residents as they relate to sports sponsorship during a global financial downturn. A survey of 1,158 Australians assessed changes in attitudes from 2008 to 2009; then it addressed issues specific to the economic conditions of 2009. In general, Australians view sports sponsorship favourably.

Is the association between temperature and mortality modified by age, gender and socio-economic status?

Background: A number of studies have examined the relationship between high ambient temperature and mortality. Recently, concern has arisen about whether this relationship is modified by socio-demographic factors. However, data for this type of study is relatively scarce in subtropical/tropical regions where people are well accustomed to warm temperatures. Objective: To investigate whether the relationship between daily mean temperature and daily all-cause mortality is modified by age, gender and socio-economic status (SES) in Brisbane, Australia. Methods: We obtained daily mean temperature and all-cause mortality data for Brisbane, Australia during 1996–2004. A generalised additive model was fitted to assess the percentage increase in all deaths with every one degree increment above the threshold temperature. Different age, gender and SES groups were included in the model as categorical variables and their modification effects were estimated separately. Results: A total of 53,316 non-external deaths were included during the study period. There was a clear increasing trend in the harmful effect of high temperature on mortality with age. The effect estimate among women was more than 20 times that among men. We did not find an SES effect on the percent increase associated with temperature. Conclusions: The effects of high temperature on all deaths were modified by age and gender but not by SES in Brisbane, Australia.

Developing a motorcycle and scooter safety compendium for the Asia-Pacific Economic Cooperation (APEC)

Motorcycle and scooter crashes are significant contributors to road trauma in many low, medium and high income countries. The APEC Transportation Working Group has commissioned CARRS-Q to develop a compendium of best practice measures that can be used to reduce crashes, post-crash trauma and associated socio-economic costs. The compendium will be informed by findings from a literature review and an expert survey. The literature review examined motorcycle and scooter safety usage and fatalities along with socio-cultural factors which might influence safety in each economy. A discussion is provided regarding the processes involved in the expert survey and how this might be integrated with the findings from the literature review. The implications for developing the compendium are discussed as is the next step of a workshop to further disseminate findings. This will enable the identification of important motorcycle safety issues in APEC economies and implications for implementation of countermeasures.