The growing demand for emergency healthcare

Emergency health is a critical component of health systems; one increasingly congested from growing demand and blocked access to care. The Emergency Health Services Queensland (EHSQ) study aimed to identify the factors driving increased demand for emergency healthcare. This study examined data on patients treated by the ambulance service and Emergency Departments across Queensland. Data was derived from the Queensland Ambulance Service’s (QAS) Ambulance Information Management System and electronic Ambulance Report Form and from the Emergency Department Information System (EDIS). Data was obtained for the period 2001-02 through to 2009-10. A snapshot of users for the 2009-10 year was used to describe the characteristics of users and comparisons made with the year 2003-04 to identify trends. Per capita demand for EDs has increased by 2% per annum over the decade and for ambulance by 3.7% per annum. The growth in ED demand is most significant in more urgent triage categories with decline in less urgent patients. The growth is most prominent amongst patients suffering injuries and poisoning, amongst both men and women and across all age groups. Patients from lower socioeconomic areas appear to have higher utilisation rates and the utilisation rate for indigenous people exceeds those of other backgrounds. The utilisation rates for immigrant people is less than Australian born however it has not been possible to eliminate the confounding impact of age and socioeconomic profiles. These findings contribute to an understanding of the growth in demand for emergency health. It is evident that the growth is amongst patients in genuine need of emergency healthcare and public rhetoric that congested emergency health services is due to inappropriate attendees is unsustainable. The growth in demand over the last decade reflects not only on changing demographics of the Australian population but also changes in health status, standards of acute health care and other social factors.

Numerical solution of an optimal control model of dendritic cell treatment of a growing tumour

A new optimal control model of the interactions between a growing tumour and the host immune system along with an immunotherapy treatment strategy is presented. The model is based on an ordinary differential equation model of interactions between the growing tu- mour and the natural killer, cytotoxic T lymphocyte and dendritic cells of the host immune system, extended through the addition of a control function representing the application of a dendritic cell treat- ment to the system. The numerical solution of this model, obtained from a multi species Runge–Kutta forward-backward sweep scheme, is described. We investigate the effects of varying the maximum al- lowed amount of dendritic cell vaccine administered to the system and find that control of the tumour cell population is best effected via a high initial vaccine level, followed by reduced treatment and finally cessation of treatment. We also found that increasing the strength of the dendritic cell vaccine causes an increase in the number of natural killer cells and lymphocytes, which in turn reduces the growth of the tumour.

Urban agriculture : a growing field of research workshop at INTERACT 2013

Growing food presents diverse challenges and opportunities within the urban environment. As cities develop, population density rises, land prices rise, and the opportunity to use land for traditional farming and gardening diminishes. Counter to this trend there are a growing number of both community gardens, city farms, guerrilla gardening, rooftop and vertical gardens, pot plants, windowsill herbs, and other balcony or backyard gardens cropping up in different cities, all with a purpose to produce food. This workshop brings to-gether practitioners and researchers in the field of urban agriculture and Hu-man-Computer Interaction to explore and opportunities for technology design to support the different forms of growing practice and foster local food production in cities. This 1-day workshop will serve as an active forum for researchers and practi-tioners across various fields including, but not limited to, agriculture and gar-dening, education, urban planning, human-computer interaction, and communi-ty engagement. This workshop has three distinct points of focus: i) Individual and small-scale gardening and food production, and how to connect like minded people who are involved in these practices to share their knowledge ii) Com-munities involved in urban agriculture, either through community gardens, city farms, or grassroots movements, often dependant on volunteer participation, providing the challenge of managing limited resources iii) Environmental and sociocultural sustainability through urban agriculture. The participants will have an opportunity to present their own work. This will be followed by a visit to a nearby city farm, which will provide a local context for a group design exercise. Finally the workshop will conclude with panel dis-cussions to review opportunities for further research and collaborations beyond the conference. For more information, please visit the workshop website, at http://www.urbaninformatics.net/resources/interact2013cfp/

Stage-specific embryonic antigen-4 is not a marker for chondrogenic and osteogenic potential in cultured chondrocytes and mesenchymal progenitor cells

One important challenge for regenerative medicine is to produce a clinically relevant number of cells with consistent tissue-forming potential. Isolation and expansion of cells from skeletal tissues results in a heterogeneous population of cells with variable regenerative potential. A more consistent tissue formation could be achieved by identification and selection of potent progenitors based on cell surface molecules. In this study, we assessed the expression of stage-specific embryonic antigen-4 (SSEA-4), a classic marker of undifferentiated stem cells, and other surface markers in human articular chondrocytes (hACs), osteoblasts, and bone marrow-derived mesenchymal stromal cells (bmMSCs) and characterized their differentiation potential. Further, we sorted SSEA-4-expressing hACs and followed their potential to proliferate and to form cartilage in vitro. Cells isolated from cartilage and bone exhibited remarkably heterogeneous SSEA-4 expression profiles in expansion cultures. SSEA-4 expression levels increased up to approximately 5 population doublings, but decreased following further expansion and differentiation cultures; levels were not related to the proliferation state of the cells. Although SSEA-4-sorted chondrocytes showed a slightly better chondrogenic potential than their SSEA-4-negative counterparts, differences were insufficient to establish a link between SSEA-4 expression and chondrogenic potential. SSEA-4 levels in bmMSCs also did not correlate to the cells' chondrogenic and osteogenic potential in vitro. SSEA-4 is clearly expressed by subpopulations of proliferating somatic cells with a MSC-like phenotype. However, the predictive value of SSEA-4 as a specific marker of superior differentiation capacity in progenitor cell populations from adult human tissue and even its usefulness as a stem cell marker appears questionable.

Influence of drying conditions on the moisture diffusion during single stage and two stage fluidized bed drying of bovine intestine for pet food

Bovine intestine samples were heat pump fluidized bed dried at atmospheric pressure and at temperatures below and above the material freezing points equipped with a continuous monitoring system. The investigation of the drying characteristics has been conducted in the temperature range -10~25oC and the airflow in the range 1.5~2.5 m/s. Some experiments were conducted as a single temperature drying experiments and others as two stage drying experiments employing two temperatures. An Arrhenius-type equation was used to interpret the influence of the drying air parameters on the effective diffusivity, calculated with the method of slopes in terms of energy activation, and this was found to be sensitivity of the temperature. The effective diffusion coefficient of moisture transfer was determined by Fickian method using uni-dimensional moisture movement in both moisture, removal by evaporation and combined sublimation and evaporation. Correlations expressing the effective moisture diffusivity and drying temperature are reported.

Enduring powers of attorney : promoting attorneys' accountability as substitute decision makers

Aim The misuse and abuse of Enduring Powers of Attorney (EPAs) by attorneys, particularly in relation to financial decision-making, is a growing concern. This paper explores the opportunities to enhance accountability of attorneys at the time of the execution of the document in Queensland. Method A four stage multi-method design comprised a critical reference group; semi-structured interviews with 32 principals or potential principals, attorneys and witnesses; two focus groups with service providers and a state wide survey of 76 principals, attorneys and witnesses. Results Across all methods and user groups, understanding the role and obligations of the attorney in an EPA was consistently identified as problematic. Conclusions Promoting accountability and understanding can be addressed by greater attention to the role of the attorney in the forms/ guidelines and in the structure and witnessing of the forms, increased direction about record keeping and access to appropriate advice and support.

Differences in Epidural and Analgesic Use in Patients with Apparent Stage I Endometrial Cancer treated by open versus laparoscopic surgery: results from the randomised LACE trial

Objectives: We compared post-operative analgesic requirements between women with early stage endometrial cancer treated by total abdominal hysterectomy (TAH) or total laparoscopic hysterectomy (TLH). Methods: 760 patients with apparent stage I endometrial cancer were treated in the international, multicentre, prospective randomised trial (LACE) by TAH (n=353) or TLH (n=407) (2005-2010). Epidural, opioid and non-opioid analgesic requirements were collected until ten months after surgery. Results: Baseline demographics and analgesic use were comparable between treatment arms. TAH patients were more likely to receive epidural analgesia than TLH patients (33% vs 0.5%, p<0.001) during the early postoperative phase. Although opioid use was comparable in the TAH vs TLH groups during postoperative 0-2 days (99.7% vs 98.5%, p 0.09), a significantly higher proportion of TAH patients required opioids 3-5 days (70% vs 22%, p<0.0001), 6-14 days (35% vs 15%, p<0.0001), and 15-60 days (15% vs 9%, p 0.02) post-surgery. Mean pain scores were significantly higher in the TAH versus TLH group one (2.48 vs 1.62, p<0.0001) and four weeks (0.89 vs 0.63, p 0.01) following surgery. Conclusion: Treatment of early stage endometrial cancer with TLH is associated with less frequent use of epidural, lower post-operative opioid requirements and better pain scores than TAH.

Towards connoisseurship in educational leadership : following the data in a three stage line of inquiry

Following an epistemic frame advanced by Elliott Eisner (2002), it is argued that the tradition of the arts and perspectives from artists have the potential to yield refreshing and interesting insights for the field of educational leadership. Moreover, it is argued that Eisner’s work on tacit knowledge which he advanced as an example of connoisseurship has important implications and posits the possibility of developing a more discerning “eye” in describing the work of educational leaders. To assess these assertions, the paper reports on two stages of interviews with nine former and current artists from Australia in order to understand the processes in which they engaged when they create art and how they encountered and managed barriers. The implications of this preliminary investigation are explored in this paper as they related to how leadership is defined and the issues pertaining to claims that leadership studies must be “scientific” to have currency and credibility. The article begins by making an argument for the value of the arts to advanced a more nuanced view of leadership, considers the importance of connoisseurship as a frame for understanding it, and then explores the cognitive functions performed by the arts before turning to the study at hand.

A pattern based two-stage text classifier

In a classification problem typically we face two challenging issues, the diverse characteristic of negative documents and sometimes a lot of negative documents that are closed to positive documents. Therefore, it is hard for a single classifier to clearly classify incoming documents into classes. This paper proposes a novel gradual problem solving to create a two-stage classifier. The first stage identifies reliable negatives (negative documents with weak positive characteristics). It concentrates on minimizing the number of false negative documents (recall-oriented). We use Rocchio, an existing recall based classifier, for this stage. The second stage is a precision-oriented “fine tuning”, concentrates on minimizing the number of false positive documents by applying pattern (a statistical phrase) mining techniques. In this stage a pattern-based scoring is followed by threshold setting (thresholding). Experiment shows that our statistical phrase based two-stage classifier is promising.

Growing existing aboriginal designs to guide a cross-cultural design project

Designing across cultures requires considerable attention to inter-relational design methods that facilitate mutual exploration, learning and trust. Many Western design practices have been borne of a different model, utilizing approaches for the design team to rapidly gain insight into “users” in order to deliver concepts and prototypes, with little attention paid to different cultural understandings about being, knowledge, participation and life beyond the design project. This paper describes a project that intends to create and grow a sustainable set of technology assisted communication practices for the Warnindilyakwa people of Groote Eylandt in the form of digital noticeboards. Rather than academic practices of workshops, interviews, probes or theoretical discourses that emphasize an outside-in perspective, we emphasize building upon the local designs and practices. Our team combines bilingual members from the local Land Council in collaboration with academics from a remote urban university two thousand kilometers away. We contribute an approach of growing existing local practices and materials digitally in order to explore viable, innovative and sustainable technical solutions from this perspective.

Thermal stability and hot-stage Raman spectroscopic study of Ca-montmorillonite modified with different surfactants : a comparative study

Three long chain cationic surfactants were intercalated into Ca-montmorillonite through ion exchangeand the obtained organoclays were characterized by X-ray diffraction (XRD), high resolution thermo-gravimetric analysis (TG) and Raman spectroscopy. The intercalation of surfactants not only changes thesurface properties of clay from hydrophilic to hydrophobic but also greatly increases the basal spacing ofthe interlayers based on XRD analysis. The thermal stability of organoclays intercalated with three sur-factants (TTAB, DTAB and CTAB) and the different arrangements of the surfactant molecules intercalatedinto Ca-montmorillonite were determined by TG-DTG analysis. A Raman spectroscopic study on the Ca-montmorillonite modified by three surfactants prepared at different concentrations provided the detailedconformational ordering of different intercalated long-chain surfactants under different conditions. Thewavenumber of the antisymmetric stretching mode is more sensitive than that of the symmetric stretch-ing mode to the mobility of the tail of the amine chain. At room temperature, the conformational orderingis more easily affected by the packing density in the lateral model. With the increase of the temperature,the positions of both the antisymmetric and symmetric stretching bands shift to higher wavenumbers,which indicates a decrease of conformational ordering. This study offers new insights into the struc-ture and properties of Ca-montmorillonite modified with different long chain surfactants. Moreover, theexperimental results confirm the potential applications of organic Ca-montmorillonites for the removalof organic impurities from aqueous media.

What it means to be green : an examination of early stage environmental and sustainability focused firms

This paper examines ‘green’ entrepreneurial nascent and young firms in Australia. Findings of interest in this paper include: • Green entrepreneurs are more likely to be highly educated and have an extended depth of experience within their industry and are more likely to have started a business prior to their current venture. • Green entrepreneurs exhibit increased levels of innovation, with an increased focus on new & high technology, R&D and the development of proprietary technology. • Green entrepreneurs are most likely to be based upon a product rather than a service and have a higher emphasis upon growth when compared with non-green entrepreneurs. • Green entrepreneurial firms tend to have a longer venture creation process and draw financial resources from a larger number of sources and rely more upon equity as a means of financing their venture.

Two-stage power network reconfiguration strategy considering node importance and restored generation capacity

Network reconfiguration after complete blackout of a power system is an essential step for power system restoration. A new node importance evaluation method is presented based on the concept of regret, and maximisation of the average importance of a path is employed as the objective of finding the optimal restoration path. Then, a two-stage method is presented to optimise the network reconfiguration strategy. Specifically, the restoration sequence of generating units is first optimised so as to maximise the restored generation capacity, then the optimal restoration path is selected to restore the generating nodes concerned and the issues of selecting a serial or parallel restoration mode and the reconnecting failure of a transmission line are next considered. Both the restoration path selection and skeleton-network determination are implemented together in the proposed method, which overcomes the shortcoming of separate decision-making in the existing methods. Finally, the New England 10-unit 39-bus power system and the Guangzhou power system in South China are employed to demonstrate the basic features of the proposed method.

Variation in leaf morphology of the invasive cat's claw creeper Dolichandra unguis-cati (Bignoniaceae)

The invasive liana cat’s claw creeper Dolichandra unguis-cati (L.) L.G. Lohmann (syn. Macfadyena unguis-cati (L.) A.H. Gentry) exhibits intraspecific variation in leaf morphology, but this is rarely noted in the published literature. The present study documents variation in leaf morphology in two forms of the species that occur in Australia (long pod and short pod). Leaf morphology is compared between the two forms and the position of the shoots (trunk and ground) at the only two sites in which they co-occur. Leaves were categorised on the basis of leaflet number and the presence or absence of tendrils. Simple leaves were produced mainly on shoots growing along the ground and were more abundant in the short-pod form. Long-pod plants were dominated by bifoliate leaves with tendrils. Cat’s claw creeper exhibits considerably wider variation in leaf morphology than recorded previously. Variations in leaf morphology may be linked to differences in the genotype, developmental stage and plastic responses of the plants. Understanding these variations may have implications for taxonomic delimitation and improved management, particularly biological control involving leaf-feeding insects.