In the blink of an eye : the circadian effects on ocular and subjective indices of driver sleepiness

Driver sleepiness contributes substantially to fatal and severe crashes and the contribution it makes to less serious crashes is likely to as great or greater. Currently, drivers’ awareness of sleepiness (subjective sleepiness) remains a critical component for the mitigation of sleep-related crashes. Nonetheless, numerous calls have been made for technological monitors of drivers’ physiological sleepiness levels so drivers can be ‘alerted’ when approaching high levels of sleepiness. Several physiological indices of sleepiness show potential as a reliable metric to monitor drivers’ sleepiness levels, with eye blink indices being a promising candidate. However, extensive evaluations of eye blink measures are lacking including the effects that the endogenous circadian rhythm can have on eye blinks. To examine the utility of ocular measures, 26 participants completed a simulated driving task while physiological measures of blink rate and duration were recorded after partial sleep restriction. To examine the circadian effects participants were randomly assigned to complete either a morning or an afternoon session of the driving task. The results show subjective sleepiness levels increased over the duration of the task. The blink duration index was sensitive to increases in sleepiness during morning testing, but was not sensitive during afternoon testing. This finding suggests that the utility of blink indices as a reliable metric for sleepiness are still far from specific. The subjective measures had the largest effect size when compared to the blink measures. Therefore, awareness of sleepiness still remains a critical factor for driver sleepiness and the mitigation of sleep-related crashes.

Trauma and survival in African humanitarian entrants to Australia

Former refugees have been resettled in Australia since the 1940’s through the Humanitarian Migration Stream. This chapter highlights the impact of forced migration and the refugee experience of trauma on survival. The journey from pre-migration crises, to the process of fleeing one’s country, through to the challenges associated with resettlement, can have a significant impact on the mental health of Humanitarian Entrants to Australia. Differences in culture can have an impact on the meaning constructed from these experiences, and on help-seeking behaviour and preferred methods of intervention. To date, Western mental health services have used an understanding of trauma based on pathology and largely individualist intervention techniques. In this chapter, however, we seek to understand the experience of trauma for former refugees from a salutogenic perspective, and acknowledge community based coping methods and the strengths and resilience of former refugees. Using the construct of posttraumatic growth, adaptive factors of strength, religion, compassion, and new possibilities are identified as relevant to African Humanitarian Entrants in Australia.

Predicting posttraumatic growth and posttraumatic stress in fire-fighters

Emergency service workers (e.g., fire-fighters, police and paramedics) are exposed to elevated levels of potentially traumatising events through the course of their work. Such exposure can have lasting negative consequences (e. g., Post Traumatic Stress Disorder; PTSD) and/or positive outcomes (e. g., Posttraumatic Growth; PTG). Research had implicated trauma, occupational and personal variables that account for variance in post-trauma outcomes yet at this stage no research has investigated these factors and their relative influence on both PTSD and PTG in a single study. Based in Calhoun and Tedeschi’s (2013) model of PTG and previous research, in this study regression models of PTG and PTSD symptoms among 218 fire-fighters were tested. Results indicated organisational factors predicted symptoms of PTSD, while there was partial support for the hypothesis that coping and social support would be predictors of PTG. Experiencing multiple sources of trauma, higher levels of organisational and operational stress, and utilising cognitive reappraisal coping, were all significant predictors of PTSD symptoms. Increases in PTG were predicted by experiencing trauma from multiple sources and the use of self-care coping. Results highlight the importance of organisational factors in the development of PTSD symptoms, and of individual factors for promoting PTG.

Sharing news, making sense, saying thanks : patterns of talk on twitter during the Queensland floods

This paper examines the discursive aspects of Twitter communication during the floods in the summer of 2010–2011 in Queensland, Australia. Using a representative sample of communication associated with the #qldfloods hashtag on Twitter, we coded and analysed the patterns of communication. We focus on key phenomena in the use of social media in crisis communication: communal sense- making practices, the negotiation of participant roles, and digital convergence around shared events. Social media is used both as a crisis communication and emergency management tool, as well as a space for participants to engage in emotional exchanges and communication of distress.

Critical factors for sustainable reconstruction of post natural disasters

While scientists are still debating the level of climate change impact to new weather patterns, there have been some devastating natural disasters worldwide in the last decade. From cyclones to earthquakes and from Tsunamis to landslides, these disasters occur with formidable forces and crushing effects. As one of the most important arrangements to erase the negative influence of natural disasters and help with the recovery and redevelopment of the hit area, reconstruction is of utmost importance in light of sustainable objectives. However, current reconstruction practice confronts quite a lot of criticisms for focusing on providing short-term necessities. How to conduct the post disaster reconstruction in a long-term perspective and achieve sustainable development is thereby a highlight for industry practice and research. This paper introduced an on-going research project which is aimed at establishing an operational framework for improving sustainability performance of post disaster reconstruction by identifying critical sustainable factors and exploring their internal relationships. The research reported in this paper is part of the project. After a comprehensive literature review, 17 potential critical sustainability factors for post disaster reconstruction were identified. Preliminary examination and discussion of the factors was conducted.

Lessons from the 4-hour standard in England for Australia

Australia is in the process of making the most important change to its health care system since the implementation of Medicare.1 We agree with Cameron and Cooke that there are important lessons for Australia from the implementation of the 4-hour rule in the United Kingdom. As in Robert Zemeckis’s 1985 movie classic, Back to the future, the old question of “If I had the opportunity to do something again, what would I have done differently?” applies. We challenge the assumption that Australia is embarking on something that the UK has recently abandoned. The UK has not actually abandoned the 4-hour rule but expanded it into a suite of eight indicators that include three time-based measures, including total time in the emergency department (ED).

Patients perceptions of emergency department services : better specialised staff, convenient and available services

Many factors are identified as contributing to the high demand for emergency department (ED) care. Similarly, there have been many initiatives taken to minimise the impact that is placed on EDs. Many of these, however, do not consider the patient's opinions and motivations. The aim of this cross-sectional study was to understand patients’ perspectives and reasons behind their decision to present to EDs. 911 surveys were collected from patients presenting to eight QLD EDs in 2011. Based on the Principal Component Analysis technique, a six-item scale entitled "Best services at emergency departments" was extracted (α = 0.729) measuring patients' opinions and perspectives. Further, the independent t-tests were conducted between various groups of ED users. The results suggest that multiple users more likely viewed EDs as the best place for their conditions than the first-time users (Median 10.73 v 11.56, p<0.001). Moreover, patients who made the decision to present by themselves had a more favourable perception of the ED services than those for whom the decision was made or others were involved (Median 11.38 v 10.80, p=0.003). Method of arrival did not affect the respondents’ perception of ED (11.13 v 11.00, p=0.65). The results of this research indicate that patients’ perception of ED as the best and most appropriate place for attention to their medical conditions plays an important role in their decision to present and keep returning to ED. Understanding patients’ reasons and decisions enhances the success of planning and implementing alternative services to manage the demand for ED services.

Emergency Health Services (EHS) : demand and service delivery models. monograph 3 : patients’ reasons and perceptions

Executive Summary Emergency health is a critical component of Australia’s health system and emergency departments (EDs) are increasingly congested from growing demand and blocked access to inpatient beds. The Emergency Health Services Queensland (EHSQ) study aims to identify the factors driving increased demand for emergency health and to evaluate strategies which may safely reduce the future demand growth. This monograph addresses the perspectives of users of both ambulance services and EDs. The research reported here aimed to identify the perspectives of users of emergency health services, both ambulance services and public hospital Emergency Departments and to identify the factors that they took into consideration when exercising their choice of location for acute health care. A cross-sectional survey design was used involving a survey of patients or their carers presenting to the EDs of a stratified sample of eight hospitals. A specific purpose questionnaire was developed based on a novel theoretical model which had been derived from analysis of the literature (Monograph 1). Two survey versions were developed: one for adult patients (self-complete); and one for children (to be completed by parents/guardians). The questionnaires measured perceptions of social support, health status, illness severity, self-efficacy; beliefs and attitudes towards ED and ambulance services; reasons for using these services, and actions taken prior to the service request. The survey was conducted at a stratified sample of eight hospitals representing major cities (four), inner regional (two) and outer regional and remote (two). Due to practical limitations, data were collected for ambulance and ED users within hospital EDs, while patients were waiting for or under treatment. A sample size quota was determined for each ED based on their 2009/10 presentation volumes. The data collection was conducted by four members of the research team and a group of eight interviewers between March and May 2011 (corresponding to autumn season). Of the total of 1608 patients in all eight emergency departments the interviewers were able to approach 1361 (85%) patients and seek their consent to participate in the study. In total, 911 valid surveys were available for analysis (response rate= 67%). These studies demonstrate that patients elected to attend hospital EDs in a considered fashion after weighing up alternatives and there is no evidence of deliberate or ill-informed misuse. • Patients attending ED have high levels of social support and self-efficacy that speak to the considered and purposeful nature of the exercise of choice. • About one third of patients have new conditions while two thirds have chronic illnesses • More than half the attendees (53.1%) had consulted a healthcare professional prior to making the decision. • The decision to seek urgent care at an ED was mostly constructed around the patient’s perception of the urgency and severity of their illness, reinforced by a strong perception that the hospital ED was the correct location for them (better specialised staff, better care for my condition, other options not as suitable). • 33% of the respondent held private hospital insurance but nevertheless attended a public hospital ED. Similarly patients exercised considered and rational judgements in their choice to seek help from the ambulance service. • The decision to call for ambulance assistance was based on a strong perception about the severity of the illness (too severe to use other means of transport) and that other options were not considered appropriate. • The decision also appeared influenced by a perception that the ambulance provided appropriate access to the ED which was considered most appropriate for their particular condition (too severe to go elsewhere, all facilities in one spot, better specialised and better care). • In 43.8% of cases a health care professional advised use of the ambulance. • Only a small number of people perceived that ambulance should be freely available regardless of severity or appropriateness. These findings confirm a growing understanding that the choice of professional emergency health care services is not made lightly but rather made by reasonable people exercising a judgement which is influenced by public awareness of the risks of acute health and which is most often informed by health professionals. It is also made on the basis of a rational weighing up of alternatives and a deliberate and considered choice to seek assistance from a service which the patient perceived was most appropriate to their needs at that time. These findings add weight to dispensing with public perceptions that ED and ambulance congestion is a result of inappropriate choice by patients. The challenge for health services is to better understand the patient’s needs and to design and validate services that meet those needs. The failure of our health system to do so should not be grounds for blaming the patient, claiming inappropriate patient choices.

Better prepared next time : considering nutrition in an emergency response

To the Editor: Cyclones, floods and bushfires are experienced in Australia every year, and Australia’s management of natural disasters centres on prevention, preparedness, response and recovery.1 Although access to safe food is a basic human need, during the 2010–2011 Queensland floods there was minimal information available to guide household food preparedness and food supply to communities...

Researching information experience : object and domain

Information experience has emerged as a new and dynamic field of information research in recent years. This chapter will discuss and explore information experience in two distinct ways: (a) as a research object, and; (b) as a research domain. Two recent studies will provide the context for this exploration. The first study investigated the information experiences of people using social media (e.g., Facebook, Twitter, YouTube) during natural disasters. Data was gathered by in-depth semi-structured interviews with 25 participants, from two areas affected by natural disasters (i.e., Brisbane and Townsville). The second study investigated the qualitatively different ways in which people experienced information literacy during a natural disaster. Using phenomenography, data was collected via semi-structured interviews with 7 participants. These studies represent two related yet different investigations. Taken together the studies provide a means to critically debate and reflect upon our evolving understandings of information experience, both as a research object and as a research domain. This chapter presents our preliminary reflections and concludes that further research is needed to develop and strengthen our conceptualisation of this emerging area.

Crisis Communication in Natural Disasters : The Queensland Floods and Christchurch Earthquakes

Over the past decade, social media have gone through a process of legitimation and official adoption, and they are now becoming embedded as part of the official communications apparatus of many commercial and public-sector organisations— in turn, providing platforms like Twitter with their own sources of legitimacy. Arguably, the demonstrated utility of social media platforms and tools in times of crisis—from civil unrest and violent crime through to natural disasters like bushfires, earthquakes, and floods—has been a crucial driver of this newfound legitimacy. In the mid-2000s, user-created content and ‘Web 2.0’ platforms were known to play a role in crisis communication; back then, the involvement of extra-institutional actors in providing and sharing information around such events involved distributed, ad hoc, or niche platforms (like Flickr), and was more likely to be framed as ‘citizen journalism’ or ‘crowdsourcing’ (see, for example, Liu, Palen, Sutton, Hughes, & Vieweg, 2008, on the then-emerging role of photo-sharing in disasters). Since then, the dramatically increased take-up of mainstream social media platforms like Facebook and Twitter means that the pool of potential participants in online crisis communication has broadened to include a much larger proportion of the general population, as well as traditional media and official emergency response organisations.

Recovering from the earthquake : early childhood teachers and children collaboratively telling stories about their experiences

Purpose – Traumatic events can cause post-traumatic stress disorder due to the severity of the often unexpected events. The purpose of this paper is to reveal how conversations around lived experiences of traumatic events, such as the Christchurch earthquake in February 2011, can work as a strategy for people to come to terms with their experiences collaboratively. By encouraging young children to recall and tell of their earthquake stories with their early childhood teachers they can begin to respond, renew, and recover (Brown, 2012), and prevent or minimise more stress being developed. Design/methodology/approach – The study involved collecting data of the participating children taking turns to wear a wireless microphone where their interactions with each other and with teachers were video recorded over one week in November 2011. A total of eight hours and 21 minutes of footage was collected; four minutes and 19 seconds of that footage are presented and analysed in this paper. The footage was watched repeatedly and transcribed using conversation analysis methods (Sacks, 1995). Findings – Through analysing the detailed turn-taking utterances between teachers and children, the orderliness of the co-production of remembering is revealed to demonstrate that each member orients to being in agreement about what actually happened. These episodes of story telling between the teachers and children demonstrate how the teachers encourage the children to tell about their experiences through actively engaging in conversations with them about the earthquake. Originality/value – The conversation analysis approach used in this research was found to be useful in investigating aspects of disasters that the participants themselves remember as important and real. This approach offers a unique insight into understanding how the earthquake event was experienced and reflected on by young children and their teachers, and so can inform future policy and provision in post-disaster situations.

Living in a broken world : how young children's well-being is supported through playing out their earthquake experiences

The therapeutic value of play can be shown in spontaneous play situations following children’s experiences of traumatic events. Following the events of the Christchurch earthquakes in New Zealand in 2010 and 2011, an investigation was conducted of how children used the earthquake event as a catalyst in pretend play with peers and in discussions with teachers. Supporting children’s well-being is a focus area in New Zealand early childhood education as it is a strand of the national curriculum, Te Whāriki (Ministry of Education [MoE], 1996). In this article, children are observed engaging in pretend play episodes and with Learning Story books to explore personal reflections of the earthquake, prompting the children to make reference to things being ‘broken’ and needing 'fixing.' Analysis shows how the content of the pretend play experiences helped the children to come to terms with their experiences. Affording children time and interactional opportunities to play out and discuss traumatic experiences contributes to the psychological well-being of participants following a traumatic event.

Social media and journalism during times of crisis

Around lunchtime on 22 February 2011, the New Zealand city of Christchurch – the country’s second largest city – was hit by a magnitude 6.3 earthquake. Built on a geological faultline, like Los Angeles and Tokyo, Christchurch is no stranger to tremors; indeed, it had experienced a magnitude 7.1 quake just months before, in September 2010, and technically, this new earthquake was no more than an aftershock of the earlier tremor. That earlier quake had caused significant structural damage, but no fatalities, but the February earthquake was different: with its epicentre located no more than ten kilometres from the Christchurch city centre, at a depth of only five kilometres, it proved considerably more destructive – and it affected buildings whose structural integrity had already been severely compromised by the September quake, in the middle of a weekday when schools and city offices would have been fully occupied. While the full death toll has yet to be determined, it is estimated at close to 200.

Crisis communication

While a substantial part of the discourse around social media continues to focus on concerns over cyberbullying or other undesirable practices, the important role which such media play in information dissemination, especially in the context of natural disasters and other acute events, is also being realised. A series of natural and human-made crisis events since 2011, including several major natural disasters in Australia, have highlighted this role.