Impact of ICARDA Research on Australian Agriculture

Research and Development/Tech Change/Emerging Technologies,

Estimating the cost-effectiveness of brief interventions for heavy drinking in primary health care across Europe

Background Screening and Brief Interventions for alcohol are an effective public health measure to tackle alcohol-related harm, however relatively few countries across the European Union (EU) have implemented them widely. This may be due to a lack of understanding of the specific financial implications of such policies within each country. Methods A novel ‘meta-modelling’ approach was developed based on previous SBI cost-effectiveness models for four EU countries. Data was collected on the key factors which drive cost-effectiveness for all 28 EU countries (mean per capita alcohol consumption, proportion of the population to be screened over a 10-year SBI programme; per capita alcohol-attributable mortality; per capita alcoholattributable morbidity; mean cost of an alcohol-related hospitalisation and mean SBI-delivery staff cost). Regression analysis was used to fit two meta-models estimating net programme costs and quality-adjusted life-years (QALYs) gained, to calculate cost-effectiveness estimates specific to each EU country. Results Costs are dependent upon the proportion of the population covered by the screening programme, the country-specific per capita mortality and morbidity rate and the country-specific costs of GP care and hospitalisation. QALYs depend on the proportion of the population screened and per capita alcohol consumption. Despite large inter-country variability in factor values, SBI programmes are likely to be cost-effective in 24 out of 28 EU countries and cost-saving in about 50% of countries. Conclusion Implementing national programmes of SBI in primary health care would be a cost-effective means of reducing alcohol-attributable morbidity and deaths in almost all countries of the EU

Can the United States Afford a “No-Fault” System of Compensation for Medical Injury?

One of the key issues separating US critics of a no-fault alternative to the tort system for compensating victims of medical injury from supporters is its anticipated cost. Results from a study are presented that estimate the costs of a no-fault system, one that is similar to the system now in operation in Sweden, within the context of the US health care system

The cost-effectiveness of an updated theory-based online health behavior intervention for new university students: U@Uni2

Background: The transition to university marks a point where young people may be open to changing health behaviours such as smoking, exercise, diet and alcohol intake. This study aimed to estimate the cost-effectiveness of an updated online health behaviour intervention for new university students in the UK – “U@Uni2”, compared with both a control (measurement only) scenario and with the original intervention (“U@Uni1”). Methods: The economic analysis, based on a randomised controlled trial, comprised a detailed costing analysis, a within-trial cost-effectiveness analysis and long-term economic modelling. Cost-effectiveness of the U@Uni2 trial was estimated using 6-month data on costs and health-related quality of life. An individual patient simulation model was adapted for long-term economic analysis of U@Uni2. Probabilistic sensitivity analysis and value of information analysis accounted for uncertainty in model inputs and identified key parameters. Results: The U@Uni2 intervention costs £45.97 per person for full implementation, £10.43 per person for roll-out in a different institution and £3.03 per person for roll-out over five years. The U@Uni2 trial was not cost-effective because marginally fewer quality-adjusted life years (QALYs) were obtained in the intervention arm than control. However, modelled over a lifetime, U@Uni2 is estimated to produce more QALYs than control but fewer than U@Uni1, primarily due to the effect of the interventions on smoking. Roll-out of U@Uni2 is highly likely to be more cost-effective than doing nothing (ICER = £536 per QALY, 86% probability cost-effective). Decision uncertainty occurs primarily around the effectiveness of the U@Uni2 intervention and is worth up to £3.24m. Conclusions: The U@Uni2 intervention is highly likely to be cost-effective to roll-out compared with doing nothing. The results suggest that preventing uptake of smoking is the key driver of QALY gain and should be the primary target of such interventions. Trial Registration: Current Controlled Trials ISRCTN6768418

Assessing the Potential Return on Investment of the Proposed UK NHS Diabetes Prevention Programme in Different Population Subgroups: An Economic Evaluation

Objectives: To evaluate potential return on investment of the NHS Diabetes Prevention Programme (DPP) in England, and estimate which population subgroups are likely to benefit most in terms of cost-effectiveness, cost-savings and health benefits. Design: Economic Analysis using the School for Public Health Research Diabetes Prevention Model Setting: England 2015-16 Population: Adults aged 16 or over with high risk of type 2 diabetes (HbA1c 6-6.4%). Population subgroups defined by age, sex, ethnicity, socioeconomic deprivation, baseline BMI, baseline HbA1c and working status. Interventions: The proposed NHS DPP: An intensive lifestyle intervention focussing on dietary advice, physical activity and weight loss. Comparator: No diabetes prevention intervention. Main outcome measures: Incremental costs, savings and return on investment, quality adjusted life years (QALYs), diabetes cases, cardiovascular cases and net monetary benefit from an NHS perspective. Results: Intervention costs will be recouped through NHS savings within 12 years, with net NHS saving of £1.28 over 20 years for each £1 invested. Per 100,000 DPP interventions given, 3,552 QALYs are gained. The DPP is most cost-effective and cost-saving in obese individuals, those with baseline HbA1c 6.2-6.4% and those aged 40-74. QALY gains are lower in minority ethnic and low socioeconomic status subgroups. Probabilistic sensitivity analysis suggests that there is 97% probability that the DPP will be cost-effective within 20 years. NHS savings are highly sensitive to intervention cost, effectiveness and duration of effect. Conclusions: The DPP is likely to be cost-effective and cost-saving under current assumptions. Prioritising obese individuals could create the most value for money and obtain the greatest health benefits per individual targeted. Low socioeconomic status or ethnic minority groups may gain fewer QALYs per intervention, so targeting strategies should ensure the DPP does not contribute to widening health inequalities. Further evidence is needed around the differential responsiveness of population subgroups to the DPP.

Forensic Social Work: Practice and Vision

Forensic social work can bridge the gap between the criminal justice and mental health systems and serve clients who “fall between the cracks.” The authors describe theoretical and clinical issues, utilizing case examples and the literature to develop a conceptual paradigm for the role of social workers in this area

An Acoustic Charge Transport Imager for High Definition Television Applications: Low-Voltage SAW Amplifiers on Multilayer GaAs/ZnO Substrates

This thesis addresses the acoustoelectric issues concerning the amplification of surface acoustic waves (SAWs) and the reflection of SAWs from slanted reflector gratings on GaAs, with application to a novel acoustic charge transport (ACT) device architecture. First a simple model of the SAWAMP was developed, which was subsequently used to define the epitaxially grown material structure necessary to provide simultaneously high resistance and high electron mobility. In addition, a segmented SAWAMP structure was explored with line widths on the order of an acoustic wavelength. This resulted in the demonstration of SAWAMPS with an order of magnitude less voltage and power requirements than previously reported devices. A two-dimensional model was developed to explain the performance of devices with charge confinement layers less then 0.5 mm, which was experimentally verified. This model was extended to predict a greatly increased gain from the addition of a ZnO overlay. These overlays were experimentally attempted, but no working devices were reported due to process incompatibilities. In addition to the SAWAMP research, the reflection of SAWs from slanted gratings on GaAs was also studied and experimentally determined reflection coefficients for both 45 deg grooves and Al stripes on GaAs have been reported for the first time. The SAWAMp and reflector gratings were combined to investigate the integrated ring oscillator for application to the proposed ACT device and design parameters for this device have been provided

The potential for linking cohort participants to official criminal records: a pilot study using the Avon Longitudinal Study of Parents and Children (ALSPAC)

Introduction: Linking longitudinal cohort resources with police-recorded records of criminal activity has the potential to inform public health style approaches to policing, and may reduce potential sources of bias from self-reported criminal data collected by cohort studies. A pilot linkage of police records to the Avon Longitudinal Study of Parents and Children (ALSPAC) allows us to consider the acceptability of this linkage, its utility as a data resource, differences in self-reported crime according to consent status for data linkage, and the appropriate governance mechanism to support such a linkage.Methods: We carried out a pilot study linking data from the ALSPAC birth cohort to Ministry of Justice (MoJ) records on criminal cautions and convictions. This pilot was conducted on a fully anonymous basis, meaning we cannot link the identified records to any participant or the wider information within the dataset. Using ALSPAC data, we used summary statistics to investigate differences in socio-economic background and self-reported criminal activity by consent status for crime linkage. We used MoJ records to identify the geographic and temporal concentration of criminality in the ALSPAC cohort.Results: We found that the linkage appears acceptable to participants (4% of the sample opted out), levels of criminal caution and conviction are high enough to support research, and that the majority of crimes occurred in Avon & Somerset (the policing area local to ALSPAC). Those who did not respond to consent requests had higher levels of self-reported criminal behaviour compared to participants who provided explicit consent.Conclusions: These findings suggest that data linkage in ALSPAC provides opportunities to study criminal behaviour and that linked individual-level records could provide robust research in the area. Our findings also suggest the potential for bias when only including participants who have explicitly consented to data linkage, highlighting the limitations of opt-in consent strategies

Neutrino signals from electroweak bremsstrahlung in solar WIMP annihilation

Bremsstrahlung of $W$ and $Z$ gauge bosons, or photons, can be an important dark matter annihilation channel. In many popular models in which the annihilation to a pair of light fermions is helicity suppressed, these bremsstrahlung processes can lift the suppression and thus become the dominant annihilation channels. The resulting dark matter annihilation products contain a large, energetic, neutrino component. We consider solar WIMP annihilation in the case where electroweak bremsstrahlung dominates, and calculate the resulting neutrino spectra. The flux consists of primary neutrinos produced in processes such as $\chi\chi\rightarrow \bar{\nu}\nu Z$ and $\chi\chi\rightarrow \bar{\nu}\ell W$, and secondary neutrinos produced via the decays of gauge bosons and charged leptons. After dealing with the neutrino propagation and flavour evolution in the Sun, we consider the prospects for detection in neutrino experiments on Earth. By comparing our signal with that for annihilation to $W^+W^-$, we show that the detection prospects for the bremsstrahlung annihilation channel are favourable.Comment: 18 pages, 5 figures. Discussion expanded; matches published versio