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.

CAD/CAm-assisted breast reconstruction

The application of computer-aided design and manufacturing (CAD/CAM) techniques in the clinic is growing slowly but steadily. The ability to build patient-specific models based on medical imaging data offers major potential. In this work we report on the feasibility of employing laser scanning with CAD/CAM techniques to aid in breast reconstruction. A patient was imaged with laser scanning, an economical and facile method for creating an accurate digital representation of the breasts and surrounding tissues. The obtained model was used to fabricate a customized mould that was employed as an intra-operative aid for the surgeon performing autologous tissue reconstruction of the breast removed due to cancer. Furthermore, a solid breast model was derived from the imaged data and digitally processed for the fabrication of customized scaffolds for breast tissue engineering. To this end, a novel generic algorithm for creating porosity within a solid model was developed, using a finite element model as intermediate.

Developmental lessons from the Capricornia Arts Mob (CAM)

The Capricornia Arts Mob (CAM) is a collective of Aboriginal and Torres Strait Islander visual artists, sculptors, photographers, carvers and writers based in the Rockhampton region of Central Queensland. This paper explores the early development of CAM, identifies some of the lessons its members have learned about working together, and considers its role as a regional artists’ collective. The authors identify that traditional Indigenous practices, such as yarning and the sharing of food, have helped to facilitate the emergence of CAM as a vibrant, challenging, eclectic artistic family. They recognise the cultural challenges faced by the collective – including finding a culturally appropriate place to meet and work, and the cross-cultural issues that can emerge within Aboriginal and Torres Strait Islander groups. In just 18 months, CAM has held successful exhibitions and developed public artworks. It is a strong part of regional Queensland’s arts scene, which supports emerging artists and provides a space to celebrate and support Indigenous art.

CAM : a collaborative object memory system

Physical design objects such as sketches, drawings, collages, storyboards and models play an important role in supporting communication and coordination in design studios. CAM (Cooperative Artefact Memory) is a mobile-tagging based messaging system that allows designers to collaboratively store relevant information onto their design objects in the form of messages, annotations and external web links. We studied the use of CAM in a Product Design studio over three weeks, involving three different design teams. In this paper, we briefly describe CAM and show how it serves as 'object memory'.

Additive tissue manufacturing for breast reconstruction: Combining CAD/CAM with adipose tissue engineering

The primary aim of this multidisciplinary project was to develop a new generation of breast implants. Disrupting the currently prevailing paradigm of silicone implants which permanently introduce a foreign body into mastectomy patients, highly porous implants developed as part of this PhD project are biodegradable by the body and augment the growth of natural tissue. Our technology platform leverages computer-assisted-design which allows us to manufacture fully patient-specific implants based on a personalised medicine approach. Multiple animal studies conducted in this project have shown that the polymeric implant slowly degrades within the body harmlessly while the body's own tissue forms concurrently.

The con-stitutional re-cognition (s)cam-pain: The campaign for the hidden recognition of first nations peoples' racial inferiority

The constitutional recognition campaign has received party-wide support and its efforts have been promoted by Prime Minister Tony Abbott as being something that would ‘complete our Constitution.’ The broader rhetoric surrounding this campaign suggests that it will result in a just, albeit delayed, recognition of indigenous peoples in the Australian legal system. However, beneath the surface of this seemingly benevolent gesture, is a reaffirmation of the colonial subordination and erasure of the several hundred original nations’ peoples and ways of being.

Revised Cam-Clay Model

The Cam-clay models, or any other plasticity-based models, do not make distinction between the mode of stress transfer in coarse- and fine-grained soils. An examination of behavior at micro level in fine-grained soils, from the consideration of load transfer through physico-chemical interactions, suggests that the plastic compressions result from the grouping of particles into larger clusters and that elastic compressions result from the decrease in the spacing between particles. During shearing, these clusters gradually get dismembered, releasing the locked-in energy. The effect of such dismembering of clusters can be easily incorporated into the original Cam-clay model, and better predictions can be obtained with the associated flow rule, itself, for both normally and over consolidated states. The method essentially defines the hardening of yield surfaces with internal changes in the spacing between particles, instead of changes in externally observed plastic strains. The approach describes the behavior of over consolidated soils as yielding along successfively hardening Roscoe surfaces with gradually varying plastic properties.

Design of fully rotatable, roller-crank-driven, cam mechanisms for arbitrary motion specifications

The design of a non-traditional cam and roller-follower mechanism is described here. In this mechanism, the roller-crank rather than the cam is used as the continuous input member, while both complete a full rotation in each revolution and remain in contact throughout. It is noted that in order to have the cam fully rotate for every full rotation of the roller-crank, the cam cannot be a closed profile, rather the roller traverses the open cam profile twice in each cycle. Using kinematic analysis, the angular velocity of the cam when the roller traverses the cam profile in one direction, is related to the angular velocity of the cam when the roller retraces its path on the cam in the other direction. Thus, one can specify any arbitrary function relating the motion of the cam to the motion of the roller-crank for only 180 degrees of rotation in the angular velocity space. The motion of the cam in the remaining portion is then automatically determined. In specifying the arbitrary motion, many desirable characteristics such as multiple dwells, low acceleration and jerk, etc., can be obtained. Useful design equations are derived for this purpose. Using the kinematic inversion technique, the cam profile is readily obtained once the motion is specified in the angular velocity space. The only limitation to the arbitrary motion specification is making sure that the transmission angle never gets too low, so that the force will be transmitted efficiently from roller to cam. This is addressed by incorporating a transmission index into the motion specification in the synthesis process. Consequently, in this method we can specify any arbitrary motion within a permissible rone, such that the transmission index is higher than the specified minimum value. Single-dwell, double-dwell and a long hesitation motion are used as examples to demonstrate the ffectiveness of the design method. Force closure using an optimally located spring and quasi-kinetostatic analysis are also discussed. (C) 2001 Elsevier Science Ltd. All rights reserved.

Disko-balaztaren fabrikazio prozesuaren deskribapena eta mekanizaziorako CAM bidezko programazioa

[EU]Lan honetan auto baten disko-balaztaren fabrikazio prozesua deskribatzen da, mekanizazio prozesuaren CAM bidezko programazioan sakonduz. Disko-balaztaren fabrikazioarekin hasi aurretik, informazio osagarri bezala, honek historian zehar izan duen garapena eta piezaren deskribapen zein funtzionamenduaren azalpena ematen dira. Jarraian, disko-balaztaren fabrikazioaren alderdi ezberdinak azaltzen dira, prozesu honek aurkezten dituen aukera desberdinak adieraziz. Azkenik, CAM bidezko programazioaren funtzionamendua erakusten da disko-balaztaren mekanizazio prozesurako aplikatuta.