Demand for hospital emergency departments : a conceptual understanding

BACKGROUND: Emergency departments (EDs) are critical to the management of acute illness and injury, and the provision of health system access. However, EDs have become increasingly congested due to increased demand, increased complexity of care and blocked access to ongoing care (access block). Congestion has clinical and organisational implications. This paper aims to describe the factors that appear to infl uence demand for ED services, and their interrelationships as the basis for further research into the role of private hospital EDs. DATA SOURCES: Multiple databases (PubMed, ProQuest, Academic Search Elite and Science Direct) and relevant journals were searched using terms related to EDs and emergency health needs. Literature pertaining to emergency department utilisation worldwide was identified, and articles selected for further examination on the basis of their relevance and significance to ED demand. RESULTS: Factors influencing ED demand can be categorized into those describing the health needs of the patients, those predisposing a patient to seeking help, and those relating to policy factors such as provision of services and insurance status. This paper describes the factors influencing ED presentations, and proposes a novel conceptual map of their interrelationship. CONCLUSION: This review has explored the factors contributing to the growing demand for ED care, the influence these factors have on ED demand, and their interrelationships depicted in the conceptual model.

From supply to demand-driven opportunities : unravelling the role of the customer in opportunity identification processes

Successful identification and exploitation of opportunities has been an area of interest to many entrepreneurship researchers. Since Shane and Venkataraman’s seminal work (e.g. Shane and Venkataraman, 2000; Shane, 2000), several scholars have theorised on how firms identify, nurture and develop opportunities. The majority of this literature has been devoted to understanding how entrepreneurs search for new applications of their technological base or discover opportunities based on prior knowledge (Zahra, 2008; Sarasvathy et al., 2003). In particular, knowledge about potential customer needs and problems that may present opportunities is vital (Webb et al., 2010). Whereas the role of prior knowledge of customer problems (Shane, 2003; Shepherd and DeTienne, 2005) and positioning oneself in a so-called knowledge corridor (Fiet, 1996) has been researched, the role of opportunity characteristics and their interaction with customer-related mechanisms that facilitate and hinder opportunity identification has received scant attention.

Transit line passenger transmission and productiveness under high load conditions

Deterministic transit capacity analysis applies to planning, design and operational management of urban transit systems. The Transit Capacity and Quality of Service Manual (1) and Vuchic (2, 3) enable transit performance to be quantified and assessed using transit capacity and productive capacity. This paper further defines important productive performance measures of an individual transit service and transit line. Transit work (p-km) captures the transit task performed over distance. Passenger transmission (p-km/h) captures the passenger task delivered by service at speed. Transit productiveness (p-km/h) captures transit work performed over time. These measures are useful to operators in understanding their services’ or systems’ capabilities and passenger quality of service. This paper accounts for variability in utilized demand by passengers along a line and high passenger load conditions where passenger pass-up delay occurs. A hypothetical case study of an individual bus service’s operation demonstrates the usefulness of passenger transmission in comparing existing and growth scenarios. A hypothetical case study of a bus line’s operation during a peak hour window demonstrates the theory’s usefulness in examining the contribution of individual services to line productive performance. Scenarios may be assessed using this theory to benchmark or compare lines and segments, conditions, or consider improvements.

Demand for, and Supply of, the Services of Primary Producer Representative Bodies in Queensland

In Queensland, at least 93 bodies exist to represent the interests of, and provide other services for, their farmer members, and their industries. The bodies vary greatly in focus, roles and activities, priorities, resources, size, and affiliations with other bodies. Results from a survey of 68 producer representative bodies (PRBs), and other data and information are used to examine the demand for, and supply of, farmer representational and other services in Queensland. The main results were: 1. member demand for services varies considerably between PRBs and is influenced by numerous factors; 2. members and non-members of one PRB vary significantly in the importance attached to some services; 3. the types of activities undertaken by PRBs varies between those for emerging and established industries; and 4. PRBs with paid staff/officers undertake more activities than others. The paper concludes that PRBs must continue to evolve and adapt their operations and structures to take account of changes in member and industry needs, external environments, cost pressures, resource availability, and sources of funding/assistance.

Sustainable, smart, safe : a 3'S' approach towards a modern transportation system

Sustainability, smartness and safety are three sole components of a modern transportation system. The objective of this study is to introduce a modern transportation system in the light of a 3‘S’ approach: sustainable, smart and safe. In particular this paper studies the transportation system of Singapore to address how this system is progressing in this three-pronged approach towards a modern transportation system. While sustainability targets environmental justice and social equity without compromising economical efficiency, smartness incorporates qualities like automated sensing, processing and decision making, and action-taking into the transportation system. Since a system cannot be viable without being safe, the safety of the modern transportation system aims minimizing crash risks of all users including motorists, motorcyclists, pedestrians, and bicyclists. Various policy implications and technology applications inside the transportation system of Singapore are discussed to illustrate a modern transportation system within the framework of the 3‘S’ model.

Corporations Act 2001 s 459G : application to set aside statutory demand

The application before the court in Millerview Constructions Pty Ltd v Palmer Plumbing Pty Ltd [2008] QSC 005 raised a significant question regarding the appropriate construction of s 459G of the Corporations Act 2001 (Cth) (the Act). The decision emphasises the importance of ensuring that any application to set aside a statutory demand must be served in a timely way on the creditor at the creditor’s address for service as stated in the statutory demand, or in strict compliance with another manner authorised by the Act.

It’s about time : investing in transportation to keep Texas economically competitive : Appendices

APPENDIX A : PAVEMENT QUALITY (Zhanmin Zhang, Michael R. Murphy, Robert Harrison), 7 pages -- APPENDIX B : BRIDGE QUALITY (Jose Weissmann, Angela J. Weissmann), 6 pages -- APPENDIX C : URBAN TRAFFIC CONGESTION (Tim Lomax, David Schrank), 32 pages -- APPENDIX D: RURAL CORRIDORS (Tim Lomax, David Schrank), 6 pages -- APPENDIX E: ADDITIONAL REVENUE SOURCE OPTIONS FOR PAVEMENT AND BRIDGE MAINTENANCE (Mike Murphy, Seokho Chi, Randy Machemehl, Khali Persad, Robert Harrison, Zhanmin Zhang), 81 pages -- APPENDIX F: FUNDING TRANSPORTATION IMPROVEMENTS (David Ellis, Brianne Glover, Nick Norboge, Wally Crittenden), 19 pages -- APPENDIX G: ESTIMATING VEHICLE OPERATING COSTS AND PAVEMENT DETERIORATION (by Robert Harrison), 4 pages

Critical Factors of Promoting Market Demand of Sustainable Housing in Australia

Strong regulatory pressure on environmental issues and the improved public awareness will continue to influence the market demand for sustainable housing in the coming years. Despite this potential, the voluntary up-take rate of sustainable practices is not as high as expected within the new built housing industry. This is in contrast to the influx of emerging building technologies, new materials and innovative designs as seen in office buildings and exemplar homes built worldwide. One possible reason for this is that key stakeholders such as developers, builders and consumers do not fully understand and appreciate the tangible and mutual benefits of sustainability in their professional and business activities. This situation warrants the study of a multifaceted strategy that integrates the needs of multiple stakeholders. This research investigates multiple factors that affect key stakeholder’s benefits in sustainable housing implementation. Drawing insights from a quantitative study on a questionnaire survey and a qualitative study of in-depth interviews with key stakeholders in the Australian housing industry, 11 critical factors of driving market demand for sustainable housing were unearthed. Their inter-relationships were identified with the aid of Interpretive Structural Modelling. The study concludes with a hierarchical model that amalgamates the strategies for the decision making of key stakeholders.

A safety adapted car following model for traffic safety studies

Traffic safety studies demand more than what current micro-simulation models can provide as they presume that all drivers exhibit safe behaviors. All the microscopic traffic simulation models include a car following model. This paper highlights the limitations of the Gipps car following model ability to emulate driver behavior for safety study purposes. A safety adapted car following model based on the Gipps car following model is proposed to simulate unsafe vehicle movements, with safety indicators below critical thresholds. The modifications are based on the observations of driver behavior in real data and also psychophysical notions. NGSIM vehicle trajectory data is used to evaluate the new model and short following headways and Time To Collision are employed to assess critical safety events within traffic flow. Risky events are extracted from available NGSIM data to evaluate the modified model against them. The results from simulation tests illustrate that the proposed model can predict the safety metrics better than the generic Gipps model. The outcome of this paper can potentially facilitate assessing and predicting traffic safety using microscopic simulation.

Innovative damage assessment of steel truss bridges using modal strain energy correlation

As a part of vital infrastructure and transportation network, bridge structures must function safely at all times. Bridges are designed to have a long life span. At any point in time, however, some bridges are aged. The ageing of bridge structures, given the rapidly growing demand of heavy and fast inter-city passages and continuous increase of freight transportation, would require diligence on bridge owners to ensure that the infrastructure is healthy at reasonable cost. In recent decades, a new technique, structural health monitoring (SHM), has emerged to meet this challenge. In this new engineering discipline, structural modal identification and damage detection have formed a vital component. Witnessed by an increasing number of publications is that the change in vibration characteristics is widely and deeply investigated to assess structural damage. Although a number of publications have addressed the feasibility of various methods through experimental verifications, few of them have focused on steel truss bridges. Finding a feasible vibration-based damage indicator for steel truss bridges and solving the difficulties in practical modal identification to support damage detection motivated this research project. This research was to derive an innovative method to assess structural damage in steel truss bridges. First, it proposed a new damage indicator that relies on optimising the correlation between theoretical and measured modal strain energy. The optimisation is powered by a newly proposed multilayer genetic algorithm. In addition, a selection criterion for damage-sensitive modes has been studied to achieve more efficient and accurate damage detection results. Second, in order to support the proposed damage indicator, the research studied the applications of two state-of-the-art modal identification techniques by considering some practical difficulties: the limited instrumentation, the influence of environmental noise, the difficulties in finite element model updating, and the data selection problem in the output-only modal identification methods. The numerical (by a planer truss model) and experimental (by a laboratory through truss bridge) verifications have proved the effectiveness and feasibility of the proposed damage detection scheme. The modal strain energy-based indicator was found to be sensitive to the damage in steel truss bridges with incomplete measurement. It has shown the damage indicator's potential in practical applications of steel truss bridges. Lastly, the achievement and limitation of this study, and lessons learnt from the modal analysis have been summarised.

Smart grid-demand side response model for optimization air conditioning

The growing demand of air-conditioning is one of the largest contributors to Australia’s overall electricity consumption. This has started to create peak load supply problems for some electricity utilities particularly in Queensland. This research aimed to develop consumer demand side response model to assist electricity consumers to mitigate peak demand on the electrical network. The model developed demand side response model to allow consumers to manage and control air conditioning for every period, it is called intelligent control. This research investigates optimal response of end-user toward electricity price for several cases in the near future, such as: no spike, spike and probability spike price cases. The results indicate the potential of the scheme to achieve energy savings, reducing electricity bills (costs) to the consumer and targeting best economic performance for electrical generation distribution and transmission.

Assessing efficiency of a transit oriented development (TOD) by comparative analysis

Transit oriented developments (TODs) are master planned communities constructed to reduce the dependence on the private car and promote the modes of transport such as public transport, walking and cycling, which are presumed by many transport professionals to be more sustainable. This paper tests this assumption that TOD is a more sustainable form of development than traditional development, with respect to travel demand, by conducting travel surveys for a case study TOD and comparing the travel characteristics of TOD residents with the travel characteristics of residents of Brisbane, Australia who live in non TOD suburbs. The results of a household comparison showed that the Kelvin Grove Urban Village (KGUV) households had slightly smaller household size, lower vehicle and bicycle ownership compared to Brisbane Statistical Division (BSD), Brisbane’s inner north and inner south suburbs. The comparison of average trip characteristics showed that on an average KGUV residents undertook fewer trips on the given travel day (2.6 trips/person) compared to BSD (3.1 trips/person), Brisbane Inner North Suburbs (BINS) (3.6 trips/person) and Brisbane Inner South Suburbs (BISS) (3.5 trips/person) residents. The mode share comparison indicated that KGUV residents used more public transport and made more walk-only trips in comparison to BSD, BINS and BISS residents. Overall, 72.4 percent of KGUV residents used a sustainable mode of transport for their travel on a typical weekday. On the other hand, only 17.4 percent, 22.2 percent and 24.4 percent residents of BSD, BINS and BISS used sustainable modes of transport for this travel. The results of trip length comparison showed that overall KGUV residents have smaller average trip lengths as compared to its counterparts. KGUV & BINS residents used car for travelling farther and used public transport for accessing destinations located closer to their homes. On the contrary, BSD and BISS residents exhibited an opposite trend. These results support the transportation claims of many transport professionals that TODs are more transport efficient and therefore more sustainable in this respect.

Beyond demand management : the value of sharing electricity information

Technologies such as smart meters and electricity feedback are becoming an increasingly compelling focus for HCI researchers in light of rising power prices and peak demand. We argue, however, that a pre-occupation with the goal of demand management has limited the scope of design for these technologies. In this paper we present our work-in-progress investigating the potential value of socially sharing electricity information as a means of broadening the scope of design for these devices. This paper outlines some preliminary findings gathered from a design workshop and a series of qualitative interviews with householders in Brisbane, Australia, regarding their attitudes towards electricity feedback and sharing consumption information. Preliminary findings suggest that; (1) the social sharing of electricity feedback information has the potential to be of value in better informing consumption decisions, however; (2) the potential for sharing may be constrained by attitudes towards privacy, trust and the possibility of misinformation being shared. We conclude by outlining ideas for our future research on this topic and invite comments on these ideas.

The integrated land use and transportation indexing model : assessing the sustainability of the Gold Coast, Australia

Urban sustainability and sustainable urban development concepts have been identified as the ultimate goal of many contemporary planning endeavours and have become central concepts on which the urban development policies are formulated. In the confinement of these concepts, land use and transport integration has been highlighted as one of the most important policy objectives considering the interrelationship between them and available intervention means of planning. While its interpretation varies, in Australia, it has been embraced as integration of land use and transport planning/policies and been an integral part of regional and local plans. Accordingly, a number of principles have been defined to guide its implementation, to name a few, planning for compact and connected urban development, encouraging active transport modes, creation of mixed-use activity centres and public transport precincts, provision of high quality public transport services, and enhancing character and amenity of urban areas. However, there is lack of an evaluation framework to measure the extent of achievement of implementation of these principles. In pursuit of filling this gap, this study aims to devise an evaluation framework to measure the performance of urban settings according to the integration principles in South East Queensland, Australia context and to demarcate problematic areas which can be intervened by planning tools...