A lesson in business: cost-effectiveness analysis of a novel financial incentive intervention for increasing physical activity in the workplace

Background: Recently both the UK and US governments have advocated the use of financial incentives to encourage healthier lifestyle choices but evidence for the cost-effectiveness of such interventions is lacking. Our aim was to perform a cost-effectiveness analysis (CEA) of a quasi-experimental trial, exploring the use of financial incentives to increase employee physical activity levels, from a healthcare and employer’s perspective.

Methods: Employees used a ‘loyalty card’ to objectively monitor their physical activity at work over 12 weeks. The Incentive Group (n=199) collected points and received rewards for minutes of physical activity completed. The No Incentive Group (n=207) self-monitored their physical activity only. Quality of life (QOL) and absenteeism were assessed at baseline and 6 months follow-up. QOL scores were also converted into productivity estimates using a validated algorithm. The additional costs of the Incentive Group were divided by the additional quality adjusted life years (QALYs) or productivity gained to calculate incremental cost effectiveness ratios (ICERs). Cost-effectiveness acceptability curves (CEACs) and population expected value of perfect information (EVPI) was used to characterize and value the uncertainty in our estimates.

Results: The Incentive Group performed more physical activity over 12 weeks and by 6 months had achieved greater gains in QOL and productivity, although these mean differences were not statistically significant. The ICERs were £2,900/QALY and £2,700 per percentage increase in overall employee productivity. Whilst the confidence intervals surrounding these ICERs were wide, CEACs showed a high chance of the intervention being cost-effective at low willingness-to-pay (WTP) thresholds.

Conclusions: The Physical Activity Loyalty card (PAL) scheme is potentially cost-effective from both a healthcare and employer’s perspective but further research is warranted to reduce uncertainty in our results. It is based on a sustainable “business model” which should become more cost-effective as it is delivered to more participants and can be adapted to suit other health behaviors and settings. This comes at a time when both UK and US governments are encouraging business involvement in tackling public health challenges.

The prospective effects of workplace violence on physicians' job satisfaction and turnover intentions: the buffering effect of job control

Background: Health care professionals, including physicians, are at high risk of encountering workplace violence. At the same time physician turnover is an increasing problem that threatens the functioning of the health care sector worldwide. The present study examined the prospective associations of work-related physical violence and bullying with physicians’ turnover intentions and job satisfaction. In addition, we tested whether job control would modify these associations.

Methods: The present study was a 4-year longitudinal survey study, with data gathered in 2006 and 2010.The present sample included 1515 (61% women) Finnish physicians aged 25–63 years at baseline. Analyses of covariance (ANCOVA) were conducted while adjusting for gender, age, baseline levels, specialisation status, and employment sector.

Results: The results of covariance analyses showed that physical violence led to increased physician turnover intentions and that both bullying and physical violence led to reduced physician job satisfaction even after adjustments. We also found that opportunities for job control were able to alleviate the increase in turnover intentions resulting from bullying.

Conclusions: Our results suggest that workplace violence is an extensive problem in the health care sector and may lead to increased turnover and job dissatisfaction. Thus, health care organisations should approach this problem through different means, for example, by giving health care employees more opportunities to control their own work.

Further refinement of the nature of the communication impairment in Cornelia de Lange syndrome

Purpose – Research into the communication skills of individuals with Cornelia de Lange syndrome (CdLS) is extremely limited. This paper aims to evaluate the nature of these skills and impairments in CdLS using a detailed informant assessment of pre-verbal communication skills.
Design/methodology/approach – The study used the Pre-verbal Communication Schedule to evaluate communication skills in individuals with CdLS (n ¼ 14), aged five to14 years. The group was compared with a contrast group of individuals with Cri du Chat syndrome (CdCS; n ¼ 14) who were matched for age and intellectual ability.
Findings – A significant difference was identified in understanding non-vocal communication (p , 0.005), with the CdLS group showing a greater deficit. These findings indicate the presence of a syndrome-specific deficit in understanding non-verbal communication in individuals with CdLS and suggest that there may be a dissociation between the processing of verbal and non-verbal communication.
Originality/value – The findings indicate that, in many ways, these two syndrome groups are not dissimilar in terms of their communication skills. However, individuals with CdLS show a syndrome-specific deficit in understanding non-vocal communication relative to the CdCS group.

BER Driven Synthesis for Directional Modulation Secured Wireless Communication

Directional modulation (DM) is a recently introduced technique for secure wireless transmission using direct physical layer wave-front manipulation. This paper provides a bit error rate (BER)-based DM array synthesis method. It is shown for the first time that the standard constellation mappings in In-phase and Quadrature (IQ) space to a pre-specified BER can be exactly achieved along a given specified spatial direction. Different receiver capabilities are investigated and different assessment metrics for each case are discussed. The approach is validated for a 1 × 4 element dipole array operating at 1 GHz.

Secure Communication in Cellular Networks: The Benefits of Millimeter Wave Mobile Broadband

This paper proposes millimeter wave (mmWave) mobile broadband for achieving secure communication in downlink cellular network. Analog beamforming with phase shifters is adopted for the mmWave transmission. The secrecy throughput is analyzed based on two different transmission modes, namely delay-tolerant transmission and delay-limited transmission. The impact of large antenna arrays at the mmWave frequencies on the secrecy throughput is examined. Numerical results corroborate our analysis and show that mmWave systems can enable significant secrecy improvement. Moreover, it is indicated that with large antenna arrays, multi-gigabit per second secure link at the mmWave frequencies can be reached in the delay-tolerant transmission mode and the adverse effect of secrecy outage vanishes in the delay-limited transmission mode.

Successful but Unappealing: Fifteen Years of Workplace Partnership in Ireland:Special Issue: Partnership, Collaboration and Mutual Gains

This paper presents the first comprehensive review and assessment of Ireland's influential 15-year experiment with workplace partnership. The paper reviews the outcomes of workplace partnership and explains the limited adoption of partnership in the private and public sectors, drawing on the authors' experiences as participants in policy initiatives concerned with promoting partnership in the workplace. Although the promotion of partnership was to the fore in public policy between the late 1990s to the onset of the recession and successful outcomes were reported for the main stakeholders where partnerships were established, the paper explains why the concept nevertheless remained largely unappealing across the private and public sectors.

Secured Communication in Cognitive MIMO Schemes under Hardware Impairments

In this paper, the impact of hardware impairments on secrecy performance of cognitive MIMO schemes is investigated. In addition, the relay which helps the source forward the source signal to the destination can operate either half-duplex mode or full-duplex mode. For performance evaluation, we give the expressions of average secrecy rate over Rayleigh fading channel. Monte-Carlo simulations are presented to compare and optimize the performance of the proposed schemes.