Growing demand for emergency health services in Queensland, Australia

Introduction: The demand for emergency health services (EHS), both in the prehospital (ambulance) and hospital (emergency departments) settings, is growing rapidly in Australia. Broader health system changes have reduced available health infrastructure, particularly hospital beds, resulting in reduced access to and congestion of the EHS as demonstrated by longer waiting times and ambulance “ramping”. Ambulance ramping occurring when patients have a prolonged wait on the emergency vehicle due to the unavailability of hospital beds. This presentation will outline the trends in EHS demand in Queensland compared with the rest of Australia and factors that appear to be contributing to the growth in demand. Methods: Secondary analysis was conducted using data from publicly available sources. Data from the Queensland Ambulance Service and Queensland Health Emergency Department Information System (EDIS) also were analyzed. Results: The demand for ambulance services and emergency departments has been increasing at 8% and 4% per year over the last decade, respectively; while accessible hospital beds have reduced by almost 10% contributing to the emergency department congestion and possibly contributing to the prehospital demand. While the increase in the proportion of the elderly population seems to explain a great deal of the demand for EHS, other factors also influence this growth including patient characteristics, institutional and societal factors, economic, EHS arrangements, and clinical factors. Conclusions: Overcrowding of facilities that provide EHS are causing considerable community concern. This overcrowding is caused by the growing demand and reduced access. The causes of this growing demand are complex, and require further detailed analysis in order to quantify and qualify these causes in order to provide a resilient foundation of evidence for future policy direction.

Humanistic science education : moves from within and challenges from without

For a number of years now it has been evident that the major issue facing science educators in the more developed countries of the world is the quantitative decline in enrolments in the senior secondary sciences, particularly the physical sciences, and in the number of higher achieving students applying for places in universities to undertake further studies in science. The deep malaise in school science to which these quantitative measures point has been elucidated by more qualitative studies of the students’ experience of studying science in secondary school in several of these countries (Sweden, Lindahl (2003); England, Simon and Osborne (2002); and Australia, Lyons (2005)). Remarkably concordant descriptions of these experiences can be summarized as: School science is: • transmission of knowledge from the teacher or the textbook to the students. • about content that is irrelevant and boring to our lives. • difficult to learn in comparison with other subjects Incidentally, the Australian study only involved consistently high achieving students; but even so, most of them found science more difficult than other more interesting subjects, and concluded that further science studies should be avoided unless they were needed for some career purpose. Other more representative confirmations of negative evaluations of the science curricula across Australia (and in particular states) are now available in Australia, from the large scale reviews of Goodrum, Hackling and Rennie (2001) and from the TIMSS (2002). The former reported that well under half of secondary students find the science at school relevant to my future, useful ion everyday life, deals with things I am concerned with and helps me make decisions about my health.. TIMSS found that 62 and 65 % of females and males in Year 4 agree with I like learning science, but by Year 8 only 26 and 33 % still agree. Students in Japan have been doubly notably because of (a) their high performance in international measures of science achievement like TIMSS and PISA and (b) their very low response to items in these studies which relate to interest in science. Ogura (2003) reported an intra-national study of students across Years 6-9 (upper primary through Junior High); interest in a range of their subjects (including science) that make up that country’s national curriculum. There was a steady decline in interest in all these subjects which might have indicated an adolescent reaction against schooling generally. However, this study went on to ask the students a further question that is very meaningful in the Japanese context, If you discount the importance of this subject for university entrance, is it worth studying? Science and mathematics remained in decline while all the other subjects were seen more positively. It is thus ironic, at a time when some innovations in curriculum and other research-based findings are suggesting ways that these failures of school science might be corrected, to find school science under a new demands that come from quite outside science education, and which certainly do not have the correction of this malaise as a priority. The positive curricular and research findings can be characterized as moves from within science education, whereas the new demands are moves that come from without science education. In this paper I set out these two rather contrary challenges to the teaching of science as it is currently practised, and go on to suggest a way forward that could fruitfully combine the two.

The Queensland study of melanoma : Environmental and genetic associations (Q-MEGA); Study design, baseline characteristics, and repeatability of phenotype and sun exposure measures

Cutaneous malignant melanoma (CMM) is a major health issue in Queensland, Australia, which has the world’s highest incidence. Recent molecular and epidemiologic studies suggest that CMM arises through multiple etiological pathways involving gene-environment interactions. Understanding the potential mechanisms leading to CMM requires larger studies than those previously conducted. This article describes the design and baseline characteristics of Q-MEGA, the Queensland Study of Melanoma: Environmental and Genetic Associations, which followed up 4 population-based samples of CMM patients in Queensland, including children, adolescents, men aged over 50, and a large sample of adult cases and their families, including twins. Q-MEGA aims to investigate the roles of genetic and environmental factors, and their interaction, in the etiology of melanoma. Three thousand, four hundred and seventy-one participants took part in the follow-up study and were administered a computer-assisted telephone interview in 2002-2005. Updated data on environmental and phenotypic risk factors, and 2777 blood samples were collected from interviewed participants as well as a subset of relatives. This study provides a large and well-described population-based sample of CMM cases with follow-up data. Characteristics of the cases and repeatability of sun exposure and phenotype measures between the baseline and the follow-up surveys, from 6 to 17 years later, are also described.

Measuring cognitive and dispositional characteristics of creativity in elementary students

This article describes the theoretical underpinning and development of a measurement instrument that provides teachers with a tool to observe the personal creativity characteristics of individual students. The instrument was developed by compiling a list of characteristics derived from the literature to be indicative of the personal characteristics of creative people. The list was then reduced by grouping like characteristics to 9 cognitive and dispositional traits that were considered appropriate for elementary students. The 9-item instrument was then administered in 24 classrooms to 520 Year 6 and Year 7 students. Factor analysis using maximum likelihood extraction with an oblimin rotation revealed a single factor with an eigenvalue greater than 1 and accounting for 63% of the variance. All 9 items on this factor loaded at .72 or greater. The results indicated that the Creativity Checklist has very high internal consistency and is a reliable measurement instrument (a = .93).

An investigation of differences in crash characteristics between males and females involved in a fatigue-related crash or close call event

There is consensus among community and road safety agencies that driver fatigue is a major road safety issue and it is well known that excessive fatigue is linked with an increased risk of a motor vehicle crash. Previous research has implicated a wide variety of factors involved in fatigue-related crashes and the effects of these various factors in regard to crash risk can be interpreted as causal (i.e. alcohol and/or drugs may induce fatigue states) or additive (e.g. where a lack of sleep is combined with alcohol). As such, the purpose of this investigation was to examine self-report data to determine whether there are any differences in the prevalence, crash characteristics, and travel patterns of males and females involved in a fatigue-related crash or close call event. Such research is important to understand how fatigue related incidents occur within the typical driving patterns of men and women and it provides a starting point in order to explore if males and females experience and understand the risk of diving when tired in the same way. A representative sample of (N = 1,600) residents living in the Australian Capital Territory (ACT) and New South Wales (NSW), Australia, were surveyed regarding their experience of fatigue and their involvement in fatigue-related crashes and close call incidents. Results revealed that over 35% of participants reported having had a close call or crash due to driving when tired in the five years prior to the study being conducted. In addition, the results obtained revealed a number of interesting characteristics that provide preliminary evidence that gender differences do exist when examining the prevalence, crash characteristics, and travel patterns of males and females involved in a fatigue-related crash or close call event. It is argued that the results obtained can provide particularly useful information for the refinement and further development of appropriate countermeasures that better target this complex issue.

Breastfeeding experiences of Japanese women living in Perth, Australia

The aim of this study was to document the breastfeeding practices of Japanese-Australian mothers living in Perth. A cross-sectional survey of mothers who had delivered babies in Japan or Australia or both was carried out on a sample of 163 mothers recruited through Japanese social and cultural groups in Perth and by a 'snowball' technique. Factors involved in the decision to breastfeed were analysed using multivariate regression analysis. The main outcome measures were the initiation and duration of breastfeeding and cultural beliefs about breastfeeding. Breastfeeding initiation rates of the Japanese- Australian mothers in Japan and in Australia were higher than for other Australians and are consistent with breastfeeding rates in Japan. In Australia, 65% of Japanese-Australian mothers were still breastfeeding at six months. The most common reason for the decision to cease breastfeeding was 'insufficient breastmilk'. The significant factors in breastfeeding duration were 'the time the infant was introduced to infant formula', 'the time when the feeding decision was made', 'doctors support breastfeeding' and 'the mother received enough help from hospital staff'; these were positively associated with the duration of breastfeeding. Japanese mothers take a lot of notice of advice given by health professionals about infant feeding practices.

Ethnic differences in the BMI-%BF relationships between young Japanese and Australian-Caucasian males living in Australia using dual-energy X-ray absorptiometry

The Body Mass Index (BMI) has been used worldwide as an indicator of fatness. However, the universal cut-off points by the World Health Organisation (WHO) classification may not be appropriate for every ethnic group when consider the relationship with their actual total body fatness(%BF). The application of population-specific classifications to assess BMI may be more relevant to public health. Ethnic differences in the BMI%BF relationship between 45 Japanese and 42 Australian-Caucasian males were assessed using whole body dual-energy X-ray absorptiometry (DXA) scan and anthropometry using a standard protocol. Japanese males had significantly (p<0.05) greater %BF at given BMI values than Australian males. When this is taken into account the newly proposed Asia-Pacific BMI classification of BMI 23 as overweight and 25 as obese may better assess the level of obesity that is associated increased health risks for this population. To clarify the current findings, further studies that compare the relationships across other Japanese populations are recommended.

Ethnic differences in body composition and anthropometric characteristics in Australian Caucasian and urban Indigenous children

The objective was to compare ethnic differences in anthropometry, including size, proportions and fat distribution, and body composition in a cohort of seventy Caucasian (forty-four boys, twenty-six girls) and seventy-four urban Indigenous (thirty-six boys, thirty-eight girls) children (aged 9–15 years). Anthropometric measures (stature, body mass, eight skinfolds, thirteen girths, six bone lengths and five bone breadths) and body composition assessment using dual-energy X-ray absorptiometry were conducted. Body composition variables including total body fat percentage and percentage abdominal fat were determined and together with anthropometric indices, including BMI (kg/m2), abdominal:height ratio (AHtR) and sum of skinfolds, ethnic differences were compared for each sex. After adjustment for age, Indigenous girls showed significantly (P < 0·05) greater trunk circumferences and proportion of overweight and obesity than their Caucasian counterparts. In addition, Indigenous children had a significantly greater proportion (P < 0·05) of trunk fat. The best model for total and android fat prediction included sum of skinfolds and age in both sexes (>93 % of variation). Ethnicity was only important in girls where abdominal circumference and AHtR were included and Indigenous girls showed significantly (P < 0·05) smaller total/android fat deposition than Caucasian girls at the given abdominal circumference or AHtR values. Differences in anthropometric and fat distribution patterns in Caucasian and Indigenous children may justify the need for more appropriate screening criteria for obesity in Australian children relevant to ethnic origin.

Library technician course recognition : meeting the challenge of a distributed national education program

This paper looks at the challenges presented for the Australian Library and Information Association by its role as the professional association responsible for ensuring the quality of Australian library technician graduates. There is a particular focus on the issue of course recognition, where the Association's role is complicated by the need to work alongside the national quality assurance processes that have been established by the relevant technical education authorities. The paper describes the history of course recognition in Australia; examines the relationship between course recognition and other quality measures; and describes the process the Association has undertaken recently to ensure appropriate professional scrutiny in a changing environment of accountability.

Increase in Body Mass Index decreases body satisfaction of their abdominal, arm and thigh regions in young Japanese women [in Japanese]

The aim of the present study was to examine body concern and satisfactions in 191 female university students and their relationships with measured body composition and circumferences of selected body parts. Body composition and circumference measurements of participants were conducted after obtaining their consent. Body concern and satisfaction were determined using the Body Shape Questionnaire (BSQ) and the Body parts and General subscales from the Body Satisfaction Scales (BSS). Increase in body composition and circumferences were associated with decrease in body concern and satisfaction. Increase in body size, including circumferences did not decrease whole body satisfaction but increased dissatisfaction at the abdominal, arm and thigh regions.

National consumer credit laws, financial exclusion and interest rate caps : The case for diversity within a centralised framework

Australia is going through a major reform of consumer credit regulation, with the implementation of a proposal to transfer regulatory responsibility from the State and Territory Governments to the Commonwealth Government. While the broad policy approach is supported, the reform process has missed a significant opportunity to engage directly with issues of financial exclusion and with the potential role of regulation to reduce financial exclusion. The imposition of an interest rate cap can limit the impact of financial exclusion. However, the future of the existing interest rate caps is uncertain, given the diversity of approaches, and the heated debate that surrounds this issue. In the absence of support for regulatory initiatives to increase the availability of low cost, small loans, permitting regulatory diversity on this issue of interest rate caps, within an otherwise centralised regulatory framework., can minimise the impact of financial exclusion on consumers.

The status of Australian nurse practitioners : the first national census

A five-section questionnaire was mailed to all 234 authorised Australian nurse practitioners in late 2007. An 85% response rate was achieved (202 responses). Respondents had a mean age of 47.0 years and 84.2% were women. Only 145 nurse practitioners (72% of respondents) reported being employed in Australia at the time of the census. Emergency nurse practitioners were the most commonly employed nationally (26.9%). Nearly one third of employed nurse practitioners reported that they were still awaiting approval to prescribe medications despite this being a core legislated skill. Over 70% stated that lack of Medicare provider numbers and lack of authority to prescribe through the Pharmaceut ical Benef its Scheme was extremely limiting to their practice. These findings are consistent with the international literature describing establishment of reformative

In-vehicle driver distractions : characteristics underlying drivers' risk perceptions

Driver distraction continues to receive considerable research interest but the drivers‟ perspective is less well documented. The current research focussed on identifying features that are salient to drivers in their risk perception judgements for 19 in-vehicle distractions. Both technological (e.g. mobile phones) and non technological (e.g. eating) distractions were considered. Analysis identified that males and females were rating 7 of the 19 distractions differently. The current paper presents the data for the female participants (n = 84). Multidimensional scaling analysis identified three main dimensions contributing to female drivers‟ risk perception judgements. Qualitative characteristics such as the level of exposure to a distraction were identified as significant contributors to drivers‟ risk perception as well as features inherent in the distractions such as distractions being related to communication. This exploratory work contributes to better understanding female drivers‟ perceptions of risk associated with in-vehicle distractions. Understanding the drivers‟ perspective can help guide the development of road safety messages and ultimately improve the impact of such messages.

Supervision practices in allied mental health : relationships of supervision characteristics to perceived impact and job satisfaction

This study examined whether supervision characteristics impacted on mental health practice and morale, and developed a new Supervision Attitude Scale (SAS). Telephone surveys were conducted with a representative sample of 272 staff from public mental health services across Queensland. Although supervision was widely received and positively rated, it had low average intensity, and assessment and training of skills was rarely incorporated. Perceived impact on practice was associated with acquisition of skills and positive attitudes to supervisors, but extent of supervision was related to impact only if it was from within the profession. Intention to resign was unrelated to extent of supervision, but was associated with positive attitudes to supervisors, accessibility, high impact, and empathy or praise in supervision sessions. The SAS had high internal consistency, and its intercorrelations were consistent with it being a measure of relationship positivity. The study supported the role of supervision in retention and in improving practice. It also highlighted supervision characteristics that might be targeted in training, and provided preliminary data on a new measure.