Determinants of pre-hospital care non-usage for patients with emergency care needs [including commentary by Snooks H.]

Objective-To establish the demographic, health status and insurance determinants of pre-hospital ambulance non-usage for patients with emergency medical needs. Methods-Triage category, date of birth, sex, marital status, country of origin, method and time of arrival, ambulance insurance status, diagnosis, and disposal were collected for all patients who presented over a four month period (n=10 229) to the emergency department of a major provincial hospital. Data for patients with urgent (n=678) or critical care needs (n=332) who did not use pre-hospital care were analysed using Poisson regression. Results-Only a small percentage (6.6%) of the total sample were triaged as having urgent medical needs or critical care needs (3.2%). Predictors of usage for those with urgent care needs included age greater than 65 years (prevalence ratio (PR)=0.54; 95% confidence interval (CI)= 0.35 to 0.83), being admitted to intensive care or transferred to another hospital (PR=0.62; 95% CI=0.44 to 0.89) or ward (PR=0.72; 95% CI=0.56 to 0.93) and ambulance insurance status (PR=0.67; 95% CI=052 to 0.86). Sex, marital status, time of day and country of origin were not predictive of usage and non-usage. Predictors of usage for those with critical care needs included age 65 years or greater (PR=0.45; 95% CI=0.25 to 0.81) and a diagnosis of trauma (PR=0.49; 95% CI=0.26 to 0.92). A non-English speaking background was predictive of non-usage (PR=1.98; 95% CI=1.06 to 3.70). Sex, marital status, time of day, triage and ambulance insurance status were not predictive of non-usage. Conclusions-Socioeconomic and medical factors variously influence ambulance usage depending on the severity or urgency of the medical condition. Ambulance insurance status was less of an influence as severity of condition increased suggesting that, at a critical level of urgency, patients without insurance are willing to pay for a pre-hospital ambulance service.

Bwembya Chikolwa interviewed by Nicole Lindsay for Herald Sun 20th August 2009, Property trusts hit hard by US crash,

Listed Australian property companies wrote off more than $8.5 billlion from their ill-fated US investment adventures during this reporting season.

Bwembya Chikolwa quoted by Mike Taylor for Money Management 7th September 2009, Thaw for listed property

Australian property bond markets are starting to improve, but don’t expect a return to the buoyant days of the past any time soon.

What will the next buyer pay? the key to investing in property

Most investors look at the initial return (or yield) that they will receive from an investment property, but this is only part of the picture. The more important issue is what capital appreciation will be achieved. Unless an investment property will deliver substantial capital appreciation, it is unlikely to be a good investment in financial terms.

Determinants of listed property trust bond ratings : Australian evidence

Using artificial neural networks (ANN) and ordinal regression (OR) as alternative methods to predict LPT bond ratings, we examine the role that various financial and industry variables have on Listed Property Trust (LPT) bond ratings issued by Standard and Poor’s from 1999-2006. Our study shows that both OR and ANN provide robust alternatives to rating LPT bonds and that there are no significant differences in results between the two full models. OR results show that of the financial variables used in our models, debt coverage and financial leverage ratios have the most profound effect on LPT bond ratings. Further, ANN results show that 73.0% of LPT bond rating is attributable to financial variables and 23.0% to industry-based variables with office LPT sector accounting for 2.6%, retail LPT 10.9% and stapled management structure 13.5%.

The relationship between personality characteristics and postconcussion symptoms in a non-clinical sample

Postconcussion symptoms are relatively common in the acute recovery period following mild traumatic brain injury (MTBI). However, for a small subset of patients, self reported postconcussion symptoms continue long after injury. Many factors have been proposed to account for the presence of persistent postconcussion symptoms. The influence of personality traits has been proposed as one explanation. The purpose of this study was to examine the relation between postconcussion-like symptom reporting and personality traits in a sample of 96 healthy participants. Participants completed the British Columbia Postconcussion Symptom Inventory (BC-PSI) and the Millon Clinical Multiaxial Inventory III (MCMI-III). There was a strong positive relation between the majority of MCMI-III scales and postconcussion-like symptom reporting. Approximately half of the sample met the International Classification of Diseases-10 Criterion C symptoms for Postconcussional Syndrome (PCS). Compared with those participants who did not meet this criterion, the PCS group had significant elevations on the negativistic, depression, major depression, dysthymia, anxiety, dependent, sadistic, somatic, and borderline scales of the MCMI-III. These findings support the hypothesis that personality traits can play a contributing role in self reported postconcussion-like symptoms.

At work or play : a comparison of private property vehicle crashes with those occurring on public roads in north Queensland.

Objective: To define characteristics of vehicle crashes occurring on rural private property in north Queensland with an exploration of associated risk factors. Design: Descriptive analysis of private property crash data collected by the Rural and Remote Road Safety Study. Setting: Rural and remote north Queensland. Participants: A total of 305 vehicle controllers aged 16 years or over hospitalised at Atherton, Cairns, Mount Isa or Townsville for at least 24 hours as a result of a vehicle crash. Main outcome measure: A structured questionnaire completed by participants covering crash details, lifestyle and demographic characteristics, driving history, medical history, alcohol and drug use and attitudes to road use. Results: Overall, 27.9% of interviewees crashed on private property, with the highest proportion of private road crashes occurring in the North West Statistical Division (45%). Risk factors shown to be associated with private property crashes included male sex, riding off-road motorcycle or all-terrain vehicle, first-time driving at that site, lack of licence for vehicle type, recreational use and not wearing a helmet or seatbelt. Conclusions: Considerable trauma results from vehicle crashes on rural private property. These crashes are not included in most crash data sets, which are limited to public road crashes. Legislation and regulations applicable to private property vehicle use are largely focused on workplace health and safety, yet work-related crashes represent a minority of private property crashes in north Queensland.

Sentencing Indigenous and Non-Indigenous Women in Western Australia’s Higher Courts

This article presents results from an exploratory study seeking to examine the role of sentencing in the continuing overrepresentation of Indigenous women in Western Australia’s prisons. Sentencing data from Western Australia’s higher courts indicate that Indigenous women were less likely than non-Indigenous women to be sentenced to a term of imprisonment when appearing before the court for comparable offending behaviour and histories.

A comparison of farmland returns in Australia, Canada, New Zealand and United States

Rural land is still a major property asset class and rural commodity production is an important domestic and export market in all economies. This paper carries out a comprehensive analysis of both rural production and land prices in four major rural production countries. The study compares rural property values in Unites States, Canada, Australia and New Zealand over a period 1990 to 2005 and analyzes and compares the capital return and total return performance for rural land in these four countries. The analysis allows a comparison of farm land returns for both a subsidised and non-subsidised farming policy to determine if levels of farm support result in variations in farm profitability and therefore farm land values.

Non-motorized public transport development : present scenario and future approach in developing cities

Over the last few decades, most large cities in the developing world have been experiencing rapid and imbalanced transport sector development resulting in severe congestion and poor levels of service. The most common response at a policy level under this circumstance has been to focus on private and public motorized transport modes, and especially on traffic control measures and mass transit systems. Despite their major role in the overall transport system in many developing cities in Asia & Latin America, relatively little attention is given to non-motorized transport (NMT) modes (walk, bicycle and cycle-rickshaw). In particular, this ideology is applicable to the paid category of non-motorized public transport (NMPT), notably three-wheeler cycle rickshaws that still have an important socio-economic, environmental and trip-making role in many developing cities. Despite, they are often seen as inefficient and backward; an impediment to progress; and inconsistent with modern urban image. Policy measures therefore, to restrict or eliminate non-motorized transport from urban arterials and other feeder networks have been implemented in cities as diverse as Dhaka, Delhi, Karachi, Bangkok, Jakarta, Manila, Surabaya and Beijing . This paper will primarily investigate the key contribution of NMPT in the sustainable transport system and urban fabric of developing cities, with Dhaka as case study. The paper will also highlight in detail the impediments towards NMPT development and provide introductory concept on possible role this mode is expected to play into the future of these cities

Mutation frequency of non-ESBL phenotype SENTRY (Asia-Pacific) isolates of Klebsiella pneumoniae conversion to an ESBL positive phenotype

Extended spectrum β-lactamases or ESBLs, which are derived from non-ESBL precursors by point mutation of β-lactamase genes (bla), are spreading rapidly all over the world and have caused considerable problems in the treatment of infections caused by bacteria which harbour them. The mechanism of this resistance is not fully understood and a better understanding of these mechanisms might significantly impact on choosing proper diagnostic and treatment strategies. Previous work on SHV β-lactamase gene, blaSHV, has shown that only Klebsiella pneumoniae strains which contain plasmid-borne blaSHV are able to mutate to phenotypically ESBL-positive strains and there was also evidence of an increase in blaSHV copy number. Therefore, it was hypothesised that although specific point mutation is essential for acquisition of ESBL activity, it is not yet enough, and blaSHV copy number amplification is also essential for an ESBL-positive phenotype, with homologous recombination being the likely mechanism of blaSHV copy number expansion. In this study, we investigated the mutation rate of non-ESBL expressing K. pneumoniae isolates to an ESBL-positive status by using the MSS-maximum likelihood method. Our data showed that blaSHV mutation rate of a non-ESBL expressing isolate is lower than the mutation rate of the other single base changes on the chromosome, even with a plasmid-borne blaSHV gene. On the other hand, mutation rate from a low MIC ESBL-positive (≤ 8 µg/mL for cefotaxime) to high MIC ESBL-positive (≥16 µg/mL for cefotaxime) is very high. This is because only gene copy number increase is needed which is probably mediated by homologous recombination that typically takes place at a much higher frequencies than point mutations. Using a subinhibitory concentration of novobiocin, as a homologous recombination inhibitor, revealed that this is the case.

Property Education : an evaluation of how well undergraduate property students are prepared for commencing their careers

The evolution of property education to adapt to the changing business environment requires changes to course content, method of delivery and assessment. Many universities have a special interest in understanding how the students transition in and transition out of the property programs. The impact of the first year student experience is often easier to assess through students’ progression in the course and performance in their intermediate and advanced units. However, the students’ success in transitioning from university student to property professional is often more difficult to determine. In an environment where many property students commence their professional careers while still completing their undergraduate property qualification, a survey of current final year students was undertaken to identify the students’ perception of their level of preparedness for entry into the professional world. This study has also been informed by feedback received from and informal discussions held with industry representative bodies, alumni and senior members of professional organisations. The QUT UD40 Bachelor of Urban Development, Property Economics course has been designed to achieve graduate capabilities in core technical skills and generic professional skills which are required by property professionals. The results of this study were that some units in the program were perceived to provide direct preparation for students commencing their professional careers whilst the impact of other units was less tangible. Valuable feedback received during the study included an assessment of the relevance of many multi-disciplinary units, the appropriateness of the programming of units within the course and the appropriateness of repetition of content during the course. The further research question arises as to how universities can better assist students in the transition to the professional environment when frequently this occurs prior to completion of the property course.

Use of Property Rights Registers for sustainability : a Queensland Case Study

Sustainable natural resource management has been a concern of governments and legislators for the last 20 years. A key aspect of an effective management framework is easy access to information about rights and obligations in land and the natural resources in, on or below the land. Information about legal interests in land is managed through a Torrens register in each Australian State. These registers are primarily focused on the registration of a narrow group of legal interests in the land, and rights or obligations that fall outside of these recognised interests are not capable of registration. Practices have developed however for the recording of property rights in natural resources either on separate registers, with no link to the Torrens register or on a separate register managed by the Registrar of Titles but having no legal effect on the title to the land. This paper will discuss and analyse the various ways in which registers have been used in Queensland to provide access to information about rights in natural resources, and provide examples as to how this approach has impacted on the desire for sustainable management. It will also provide a critique of the Queensland model, and call for reform of the present system.