BackgroundImpairments of memory are commonly reported by people with traumatic brain injuries (TBI). Such deficits are persistent, debilitating, and can severely impact quality of life. Currently, many do not routinely receive follow-up appointments for residual memory problems following discharge.Methods/DesignThis is a multi-centre, randomised controlled trial investigating the clinical and cost-effectiveness of a group-based memory rehabilitation programme. Three hundred and twelve people with a traumatic brain injury will be randomised from four centres. Participants will be eligible if they had a traumatic brain injury more than 3 months prior to recruitment, have memory problems, are 18 to 69 years of age, are able to travel to one of our centres and attend group sessions, and are able to give informed consent. Participants will be randomised in clusters of 4 to 6 to the group rehabilitation intervention or to usual care. Intervention groups will receive 10 weekly sessions of a manualised memory rehabilitation programme, which has been developed in previous pilot studies. The intervention will include restitution strategies to retrain impaired memory functions and compensation strategies to enable participants to cope with their memory problems. All participants will receive a follow-up postal questionnaire and an assessment by a research assistant at 6 and 12 months post-randomisation. The primary outcome is the Everyday Memory Questionnaire at 6 months. Secondary outcomes include the Rivermead Behavioural Memory Test-3, General Health Questionnaire-30, health related quality of life, cost-effectiveness analysis determined by the EQ-5D and a service use questionnaire, individual goal attainment, European Brain Injury Questionnaire (patient and relative versions), and the Everyday Memory Questionnaire-relative version. The primary analysis will be based on intention to treat. A mixed-model regression analysis of the Everyday Memory Questionnaire at 6 months will be used to estimate the effect of the group memory rehabilitation programme.DiscussionThe study will hopefully provide robust evidence regarding the clinical and cost-effectiveness of a group-based memory rehabilitation intervention for civilians and military personnel following TBI. We discuss our decision-making regarding choice of outcome measures and control group, and the unique challenges to recruiting people with memory problems to trials.Trial registrationISRCTN65792154; Date: 18 October 2012

Throughout the 1990s, government reports such as the Competitive Tendering and Contracting Report (Industry Commission1996) and the Report of the Independent Commission to Review Public Sector Finances (McCarrey 1993), suggested that the contracting-out of government services would improve the delivery of public goods in Australia. This article reports on the findings of a case study of contracting-out of building maintenance services in the state of Western Australia in Australia. The study focuses on evaluating the impact of the contracting-out of these services on the wages and conditions of employees affected by moving from public sector to private sector employment. The study found differences in the employment conditions of white collar and blue collar workers. In general, the conditions of white collar workers improved but there was a marginal decline in the conditions of blue collar workers. The article concludes that while contracting-out created budgetary savings for government, these resulted partly from a reduction in wages and benefits of former blue collar staff, despite the best efforts of the Western Australian government to protect staff wages and benefits. The research makes an important theoretical contribution by arguing that the impact of contracting-out on staff wages, benefits and conditions is conditional upon the level of competition in the labor market for worker's expertise. In "thick markets", wages, benefits and conditions are likely to reduce, due to strong competition for expertise. However in "thin markets", wages, benefits and conditions are likely to increase, due to weak competition for expertise (Borland, 1994).

Objective Scope Geothermal energy is gaining attention worldwide as an attractive and vastly underutilized renewable energy source due to its abundance, baseload capability, resiliency, and reliability. While there are many types of geothermal energy concepts, the holy grail of geothermal – that would enable geothermal drilling and production in most places in the world – is hard rock or superhot rock concepts. Developing these systems requires drilling into granitic basement formations, often at temperatures exceeding 300º C. There are two main technological challenges associated with hard, hot rock concepts. Firstly, very hard rock, such as granite or basalt, limits the rate of penetration (ROP). Secondly, the temperature of the drilling system exceeds the operational limits of electronic tools like measurement while drilling (MWD) and Rotary Steerable. This paper discusses the modeling, design, and testing of a drilling system that solves both challenges. Methods Our approach to the ROP problem was to optimize the drilling system for drilling cold hard rock from 0º to 175º C and optimize the system for drilling hot hard rock where temperatures exceed 175º C. We will discuss the design and performance of both PDC drill bits and Hybrid Particle Impact/PDC bits in hard rock formations and the best application of the two methodologies moving forward. Our approach to the temperature problem was to model the entire wellbore and drillstring and investigate the effects of, but not limited to, the starting temperature of the fluid, flow rate of the fluid, type of fluid, impact of the thickness, type of insulation on the inside of the drillpipe, the diameter of the pipe, and continuous circulation. The objective of the modeling was to understand the relative impact of changes to the system on the temperature of the drilling fluid and the most cost-effective way to deliver a 150º C fluid to the bottom of the hole. Results, Observations and Conclusions This paper will discuss the results, observations, and conclusions of testing and running PDC drill bits and Particle Impact Drilling/PDC hybrids in hard formations. The results will derive from lab testing and geothermal drilling projects. The paper will also discuss the field testing and running of components of a drilling system optimized to deliver as cool a fluid as possible to the bottom of the wellbore. Novel/Additive Information The results shown in this paper suggest that we have solved, or are very close to solving, two of the major challenges which prevent geothermal energy from being economically viable worldwide and not just restricted to the small geographic areas where you have very high temperature gradients associated with volcanic activity. The results would also have significant benefits for oil and gas wells where the bottom hole temperatures exceed 175º C.

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