Which interventions offer best value for money in primary prevention of cardiovascular disease?

Background
Despite many decades of declining mortality rates in the Western world, cardiovascular disease remains the leading cause of death worldwide. In this research we evaluate the optimal mix of lifestyle, pharmaceutical and population-wide interventions for primary prevention of cardiovascular disease.

Methods and Findings
In a discrete time Markov model we simulate the ischaemic heart disease and stroke outcomes and cost impacts of intervention over the lifetime of all Australian men and women, aged 35 to 84 years, who have never experienced a heart disease or stroke event. Best value for money is achieved by mandating moderate limits on salt in the manufacture of bread, margarine and cereal. A combination of diuretic, calcium channel blocker, ACE inhibitor and low-cost statin, for everyone with at least 5% five-year risk of cardiovascular disease, is also cost-effective, but lifestyle interventions aiming to change risky dietary and exercise behaviours are extremely poor value for money and have little population health benefit.

Conclusions
There is huge potential for improving efficiency in cardiovascular disease prevention in Australia. A tougher approach from Government to mandating limits on salt in processed foods and reducing excessive statin prices, and a shift away from lifestyle counselling to more efficient absolute risk-based prescription of preventive drugs, could cut health care costs while improving population health.

A review of the cost estimation issues in the tender preparation process in construction industry

Cost estimation process is undertaken to predict the total cost of the project. Studies indicate that one of the construction company failures in contracting is because of the uncertain, incorrect, and unrealistic cost estimation. Cost estimation process are heavily influenced by the complexity of the project, scale and scope of construction, market conditions, method of construction, site constraints, client’s financial position, buildability and the location of the project. However, there are other combinations factors that have not been studied thus far. Hence, this paper focuses on the review of other researchers’ findings in relation to cost estimation issues in the construction industry. Among the findings, it has been revealed that the cost estimation issues are related to accuracy, human factors, practical knowledge and insufficient cost data/information. The aim of this paper is to investigate these factors and determining other potential factors that may influence cost estimation process in the construction industry.

The factors that affect the cost estimation activities in the tender preparation process in the Malaysian construction industry

The possibility of winning the tender is subject to the cost estimation proposed by the contractors compared to the cost estimation prepared by the client’s representative. Studies indicated that one of the construction company failures in the tendering process is due to the uncertain, incorrect, and unrealistic cost estimation. Failure to provide a competitive cost estimation on time is the main reason the contractor is not successful in winning the tender, and will not be considered for the tender evaluation stage. The aim of this paper is to validate the key factors that affect the cost estimation activities in the tender preparation process. This paper describes the results of a pilot study, from a questionnaire survey on the factors that affect the cost estimation activities in the tender preparation process. The study shows the importance of all the factors in the cost estimation activities in the tender preparation process in terms of human factors, working culture, and information technology.

Settling sexual harassment complaints - what benefits does ADR offer?

Sexual harassment complaints are predominantly resolved through confidential alternative dispute resolution (ADR) processes rather than a tribunal hearing, so very little is known about the type of complaints which are made or how they are being resolved. This secrecy has created problems for the law’s development and its effectiveness. This article compares settlement agreements negotiated through ADR with tribunal orders, so as to identify whether ADR offers any additional benefits to the process of addressing sexual harassment and to identify changes to the process which would increase the law’s effectiveness while maintaining the benefits of ADR. Very little is known about the type of settlements negotiated in this jurisdiction, so the secondary purpose of the study is to provide information about how sexual harassment is being addressed.

That tender discipline: spacing, structured nothingness & kumbhaka

In the discussion that follows here, I will attempt what I have decided to call an onto-poetic reading of the yogic practice of kumbhaka. I choose the double-barrelled nomination 'onto-poetic' since I would like to use my experience of kumbhaka both to think of certain current ontological paradigms and implications, and also to allow myself the flexibility and discipline that I associate with the poetic register. I will draw on three particular thinkers, namely Alain Badiou, Jacques Derrida and Luce Irigaray. Badiou makes very explicit metaontological claims that, I believe, have something to contribute to a reading of kumbhaka. Derrida, for his part, has written extensively about phonologocentrism and its inherent links with speech and breath in the history of phallocentric metaphysics. Irigaray, finally, demonstrates a way to think unity, breath and praxis so as to bring these conceptual strands together in a kind of elegant, but urgent, agency.
What can the very practice of kumbhaka help me to think? And how can such thinking impact on what happens when I practice pranayama that involves kumbhaka? Kumbhaka can be situated as a practice within the broader discipline of Yogic pranayama. Yoga, as it often encountered in this historical moment in the so-called West, can appear to emphasize physical posture (which are certainly as aspect of its breadth). Yoga, however, as a technology of existential and ontological inquiry, has often, throughout its long and meandering history, made use of the manipulation of, and abstinence from, breath. I will begin by cursorily outlining the place of pranayama itself within the yogic canon of practice. Then, I will go on to explain specifically the technology of kumbhaka, before embarking on my onto-poetic discussion.

Framing the socialisation process of the DBA candidate: what can universities offer and what should candidates bring?

In Australia, the Doctorate of Business Administration (DBA) remains a popular program but considerable anguish persists within the university sector over just what it is offering students. In this article, we use the process of postgraduate socialisation to understand how candidates, supervisors and administrators navigate pathways to successful completion and offering of a DBA program. We identify four modes of knowledge applicable to the DBA and suggest that universities and candidates may draw on one another’s cultural capital to determine which mode(s) can be offered. We also illustrate how candidates exercise agency through their cultural and social capital as they move through the program. We present a conceptual framework to help guide future research, and resource allocation on the DBA.

Evaluation of tender solutions for aviation training using discrete event simulation and best performance criteria

This paper describes a novel discrete event simulation (DES) methodology for the evaluation of aviation training tenders where performance is measured against “best performance” criteria. The objective was to assess and compare multiple aviation training schedules and their resource allocation plans against predetermined training objectives. This research originated from the need to evaluate tender proposals for the Australian Defence Aviation Training School that is currently undergoing aviation training consolidation and helicopter rationalization. We show how DES is an ideal platform for evaluating resource plans and schedules, and discuss metric selection to objectively encapsulate performance and permit an unbiased comparison. DES allows feasibility studies for each tender proposal to assure they satisfy system and policy constraints. Consequently, to create an objective and fair environment to compare tendered solutions, what-if scenarios have been strategically examined to consider improved implementations of the proposed solutions.

October 2002: Righting Writing; Web Sites Offer Help in Combating Digital Plagiarism

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Problemas elípticos com potencial que pode tender a zero no in?nito

Pós-graduação em Matemática - IBILCE