Hospital infection control units: Staffing, costs, and priorities

Background: This article describes infection prevention and control professionals’ (ICPs’) staffing levels, patient outcomes, and costs associated with the provision of infection prevention and control services in Australian hospitals. A secondary objective was to determine the priorities for infection control units. Methods: A cross-sectional study design was used. Infection control units in Australian public and private hospitals completed a Web-based anonymous survey. Data collected included details about the respondent; hospital demographics; details and services of the infection control unit; and a description of infection prevention and control-related outputs, patient outcomes, and infection control priorities. Results: Forty-nine surveys were undertaken, accounting for 152 Australian hospitals. The mean number of ICPs was 0.66 per 100 overnight beds (95% confidence interval, 0.55-0.77). Privately funded hospitals have significantly fewer ICPs per 100 overnight beds compared with publicly funded hospitals (P < .01). Staffing costs for nursing staff in infection control units in this study totaled $16,364,392 (mean, $380,566). Infection control units managing smaller hospitals (<270 beds) identified the need for increased access to infectious diseases or microbiology support. Conclusion: This study provides valuable information to support future decisions by funders, hospital administrators, and ICPs on service delivery models for infection prevention and control. Further, it is the first to provide estimates of the resourcing and cost of staffing infection control in hospitals at a national level. Copyright

Self-reported circumstances and consequences of driving while sleepy

Driver surveys are indispensable sources of information when estimating the role of sleepiness in crash causation. The purpose of the study was to (1) identify the prevalence of driving while sleepy among Finnish drivers, (2) determine the circumstances of such instances, and (3) identify risk factors and risk groups. Survey data were collected from a representative sample of active Finnish drivers (N = 1121). One-fifth of the drivers (19.5%) reported having fallen asleep at the wheel during their driving career, with 15.9% reporting having been close to falling asleep or having difficulty staying awake when driving during the previous twelve months. Epworth Sleepiness Scale scores were found to be associated with both types of sleepiness-related driving instances, while sleep quality was associated only with the latter. Compared to women, men more often reported falling asleep at the wheel; the differences were somewhat smaller with respect to fighting sleep while driving during the previous twelve months. The reported discrepancy in sleepiness-related instances (high prevalence of fighting sleep while driving during the previous twelve months and lower proportion of actually falling asleep) identifies young men (⩽25 years) as one of the main target groups for safety campaigns. Approximately three-quarters of drivers who had fallen asleep while driving reported taking action against falling asleep before it actually happened. Furthermore, almost all drivers who had fallen asleep while driving offered at least one logical reason that could have contributed to their falling asleep. These data indicate some degree of awareness about driving while sleepy and of the potential pre-trip factors that could lead to sleepiness while driving, and supports the notion that falling asleep at the wheel does not come as a (complete) surprise to the driver.

Commuting mode choice in transit oriented development: Disentangling the effects of competitive neighbourhoods, travel attitudes, and self-selection

This research identifies the commuting mode choice behaviour of 3537 adults living in different types of transit oriented development (TOD) in Brisbane by disentangling the effects of their “evil twin” transit adjacent developments (TADs), and by also controlling for residential self-selection, travel attitudes and preferences, and socio-demographic effects. A TwoStep cluster analysis was conducted to identify the natural groupings of respondents’ living environment based on six built environment indicators. The analysis resulted in five types of neighbourhoods: urban TODs, activity centre TODs, potential TODs, TADs, and traditional suburbs. HABITAT survey data were used to derive the commute mode choice behaviour of people living in these neighbourhoods. In addition, statements reflecting both respondents’ travel attitudes and living preferences were also collected as part of the survey. Factor analyses were conducted based on these statements and these derived factors were then used to control for residential self-selection. Four binary logistic regression models were estimated, one for each of the travel modes used (e.g. public transport, active transport, less sustainable transport such as the car/taxi, and other), to differentiate between the commuting behaviour of people living in the five types of neighbourhoods. The findings verify that urban TODs enhance the use of public transport and reduce car usage. No significant difference was found in the commuting behaviour between respondents living in traditional suburbs and TADs. The results confirm the hypothesis that TADs are the “evil twin” of TODs. The data indicates that TADs and the mode choices of residents in these neighbourhoods is a missed transport policy opportunity. Further policy efforts are required for a successive transition of TADs into TODs in order to realise the full benefits of these. TOD policy should also be integrated with context specific TOD design principles.

Cross-cultural adaptation and validation of the Foot Function Index to Spanish

Background The purpose of this study was to adapt and validate the Foot Function Index to the Spanish (FFI-Sp) following the guidelines of the American Academy of Orthopaedic Surgeons. Methods A cross-sectional study 80 participants with some foot pathology. A statistical analysis was made, including a correlation study with other questionnaires (the Foot Health Status Questionnaire, EuroQol 5-D, Visual Analogue Pain Scale, and the Short Form SF-12 Health Survey). Data analysis included reliability, construct and criterion-related validity and factor analyses. Results The principal components analysis with varimax rotation produced 3 principal factors that explained 80% of the variance. The confirmatory factor analysis showed an acceptable fit with a comparative fit index of 0.78. The FFI-Sp demonstrated excellent internal consistency on the three subscales: pain 0.95; disability 0.96; and activity limitation 0.69, the subscale that scored lowest. The correlation between the FFI-Sp and the other questionnaires was high to moderate. Conclusions The Spanish version of the Foot Function Index (FFI-Sp) is a tool that is a valid and reliable tool with a very good internal consistency for use in the assessment of pain, disability and limitation of the function of the foot, for use both in clinic and research.

Keep It Tame: Promoting respect online Safe And Well Online Pilot Study: Evaluating the design, engagement and impact of a social marketing approach aimed at 12 to 18 year olds

This report describes the Year One Pilot Study processes, and articulates findings from the major project components designed to address these challenges noted above (See Figure 1). Specifically, the pilot study tested the campaign research and development process involving participatory design with young people and sector partners, and the efficacy and practicality of conducting a longitudinal, randomised control trial online with minors, including ways oflinking survey data to campaign data. Each sub-study comprehensively considered the ethical requirements of conducting online research with minors in school settings. The theoretical and methodological framework for measuring campaign engagement and efficacy (Sub-studies 3, 4 and 5) drew on the Model of Goal-Directed Behaviour (MGB) (Perugini & Bagozzi 2001) and Nudge Theory (Thaler & Sunstein, 2008).

The return to work experiences of middle-aged Australian workers diagnosed with colorectal cancer: a matched cohort study

Background Few studies have been undertaken to understand the employment impact in patients with colorectal cancer and none in middle-aged individuals with cancer. This study described transitions in, and key factors influencing, work participation during the 12 months following a diagnosis of colorectal cancer. Methods We enrolled 239 adults during 2010 and 2011who were employed at the time of their colorectal cancer diagnosis and were prospectively followed over 12 months. They were compared to an age- and gender-matched general population group of 717 adults from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Data were collected using telephone and postal surveys. Primary outcomes included work participation at 12 months, changes in hours worked and time to work re-entry. Multivariable logistic and Cox proportional hazards models were undertaken. Results A significantly higher proportion of participants with colorectal cancer (27%) had stopped working at 12 months than participants from the comparison group (8%) (p < 0.001). Participants with cancer who returned to work took a median of 91 days off work (25–75 percentiles: 14–183 days). For participants with cancer, predictors of not working at 12 months included: being older, lower BMI and lower physical well-being. Factors related to delayed work re-entry included not being university-educated, working for an employer with more than 20 employees in a non-professional or managerial role, longer hospital stay, poorer perceived financial status and having or had chemotherapy. Conclusions In middle-adulthood, those working and diagnosed with colorectal cancer can expect to take around three months off work. Individuals treated with chemotherapy, without a university degree and from large employers could be targeted for specific assistance for a more timely work entry.

Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refi nements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2∙4 billion and 1∙6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537∙6 million in 1990 to 764∙8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114∙87 per 1000 people to 110∙31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. Interpretation Ageing of the world’s population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to nonfatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.

Acceptability of Bus Rapid Transit (BRT) to commuters in Dhaka

This research has made substantial and novel contributions to the body of knowledge by combining mixed, quantitative and qualitative analyses to understand the potential uptake of a proposed Bus Rapid Transit (BRT) system by commuters in a developing country's megacity, using Dhaka, Bangladesh as the case study. The quantitative analysis took a unique approach by dividing the analysis into an exploratory analysis of Revealed Preference (RP) survey data, modelling with RP data and modelling with Preferred Mode Selection (PMS) survey data. The qualitative analysis also made a novel contribution by taking a "lesson drawing" approach from model cities in analysing Dhaka's transport environment.

Workers’ attitude towards bus rapid transit: Considering Dhaka, Bangladesh

The Government of Bangladesh is planning to develop and implement Bus Rapid Transit (BRT) in Dhaka city. This paper presents a stated choice survey conducted to understand workers’ attitudes toward BRT in Dhaka. The survey data are analysed using a multinomial logit (MNL) model to scrutinize social and economic factors’ impact on participant’s mode choices. Analysis results reveal that males, workers of higher age, education qualification, and income have a greater tendency towards choosing BRT.

Travel behaviours of immigrants in Queensland, Australia

The aim of this research is to determine if there is a significant difference in public transport usage between Australian-born and overseas-born travellers in South East Queensland and identify if further investigation into this demographic factor is necessary. Using the household travel survey data of Southeast Queensland, Australia, this paper analyses the travel behaviours of immigrants and non-immigrants in the region. The immigrant population is divided into six sub-groups based on their continent of origin. The analysis results suggest that immigrants are more likely to use public transit in Brisbane over other regions in the study. Overall, this research strongly suggests that in Australia, a higher proportion of the immigrant population is more likely to use public transit compared to the proportion of the local population.

Public trust in Australian charities: Accounting for cause and effect

This paper reports on a study of the key determinants of public trust in charitable organisations, using survey data commissioned by the Australian Charities and Not-for-profits Commission. Data analysis used partial least squares structural equation modelling to examine both antecedents of trust and the influence of trust on charitable donative intentions. We found that people tend to trust charities with which they are familiar, and which are transparent in their reporting. Organisational size, importance, reputation and national significant were also antecedents of trust. People are more likely to volunteer or donate to charities they trust. The practical implications of this are that charities seeking to enhance their volunteer and donation base should pay attention to their marketing, reputation and disclosure activities, as well as to doing good work on an ongoing basis in the community. Theoretically, the implications are that transparency and reputation do not result directly in donations and volunteering, but they do create trust, and it is trust which then leads to donations and volunteering.

Multifaceted Modelling of Complex Business Enterprises

We formalise and present a new generic multifaceted complex system approach for modelling complex business enterprises. Our method has a strong focus on integrating the various data types available in an enterprise which represent the diverse perspectives of various stakeholders. We explain the challenges faced and define a novel approach to converting diverse data types into usable Bayesian probability forms. The data types that can be integrated include historic data, survey data, and management planning data, expert knowledge and incomplete data. The structural complexities of the complex system modelling process, based on various decision contexts, are also explained along with a solution. This new application of complex system models as a management tool for decision making is demonstrated using a railway transport case study. The case study demonstrates how the new approach can be utilised to develop a customised decision support model for a specific enterprise. Various decision scenarios are also provided to illustrate the versatility of the decision model at different phases of enterprise operations such as planning and control.

The relationship between the determinants of rental housing satisfaction and considering moving in Finland

Purpose The purpose of this paper is to discuss the relation between dissatisfaction with housing conditions and considering moving among residents of Finnish rental multifamily buildings. The paper examines physical attributes, socioeconomic factors, and subjective opinions related to housing conditions and satisfaction with housing. Design/methodology/approach Logistic regression analysis is used to examine survey data to analyse which factors contribute to dissatisfaction with the housing unit and the apartment building and whether dissatisfaction is related to consideration of moving. Findings The findings indicate that dissatisfaction with the building and individual housing unit are associated with greater probability of considering moving. Satisfaction with kitchen, living room, storage, and building age are the most important indicators of satisfaction with the housing unit, and satisfaction with living room, bathroom, storage, and building age are associated with satisfaction with the apartment building. These are the areas in which landlords could invest in renovations to increase satisfaction in an attempt to reduce turnover. Research limitations/implications The study is conducted with Finnish data only. The sample is not a representative sample of the Finnish population. A longitudinal study would be needed to determine whether dissatisfied residents indending to move actually change residence. Originality/value This study is the first of its kind in the Finnish housing market. It tests a general model that has been suggested to be customized to local conditions. In addition, much of the research on this topic is more than 20 years old. Examination of the model under current housing and socioeconomic conditions is necessary to determine if relationships have changed over time.

Choosing a model of maternity care: decision support needs of Australian women

- BACKGROUND Access to information on the features and outcomes associated with the various models of maternity care available in Australia is vital for women's informed decision-making. This study sought to identify women's preferences for information access and decision-making involvement, as well as their priority information needs, for model of care decision-making. - METHODS A convenience sample of adult women of childbearing age in Queensland, Australia were recruited to complete an online survey assessing their model of care decision support needs. Knowledge on models of care and socio-demographic characteristics were also assessed. - RESULTS Altogether, 641 women provided usable survey data. Of these women, 26.7 percent had heard of all available models of care before starting the survey. Most women wanted access to information on models of care (90.4%) and an active role in decision-making (99.0%). Nine priority information needs were identified: cost, access to choice of mode of birth and care provider, after hours provider contact, continuity of carer in labor/birth, mobility during labor, discussion of the pros/cons of medical procedures, rates of skin-to-skin contact after birth, and availability at a preferred birth location. This information encompassed the priority needs of women across age, birth history, and insurance status subgroups. - CONCLUSIONS This study demonstrates Australian women's unmet needs for information that supports them to effectively compare available options for model of maternity care. Findings provide clear direction on what information should be prioritized and ideal channels for information access to support quality decision-making in practice.

Why are students choosing STEM and when do they make their choice?

BACKGROUND OR CONTEXT The higher education sector plays an important role in encouraging students into the STEM pipeline through fostering partnerships with schools, building on universities long tradition in engagement and outreach to secondary schools. Numerous activities focus on integrated STEM learning experiences aimed at developing conceptual scientific and mathematical knowledge with opportunities for students to show and develop skills in working with each other and actively engaging in discussion, decision making and collaborative problem solving. (NAS, 2013; AIG, 2015; OCS, 2014). This highlights the importance of the development and delivery of engaging integrated STEM activities connected to the curriculum to inspire the next generation of scientists and engineers and generally preparing students for post-secondary success. The broad research objective is to gain insight into which engagement activities and to what level they influence secondary school students’ selection of STEM-related career choices at universities. PURPOSE OR GOAL To evaluate and determine the effectiveness of STEM engagement activities impacting student decision making in choosing a STEM-related degree choice at university. APPROACH A survey was conducted with first-year domestic students studying STEM-related fieldswithin the Science and Engineering Faculty at Queensland University of Technology. Of the domestic students commencing in 2015, 29% responded to the survey. The survey was conducted using Survey Monkey and included a variety of questions ranging from academic performance at school to inspiration for choosing a STEM degree. Responses were analysed on a range of factors to evaluate the influence on students’ decisions to study STEM and whether STEM high school engagement activities impacted these decisions. To achieve this the timing of decision making for students choice in study area, degree, and university is compared with the timing of STEM engagement activities. DISCUSSION Statistical analysis using SPSS was carried out on survey data looking at reasons for choosing STEM degrees in terms of gender, academic performance and major influencers in their decision making. It was found that students choose their university courses based on what subjects they enjoyed and exceled at in school. These results found a high correlation between enjoyment of a school subject and their interest in pursuing this subject at university and beyond. Survey results indicated students are heavily influenced by their subject teachers and parents in their choice of STEM-related disciplines. In terms of career choice and when students make their decision, 60% have decided on a broad area of study by year 10, whilst only 15% had decided on a specific course and 10% had decided on which university. The timing of secondary STEM engagement activities is seen as a critical influence on choosing STEM disciplines or selection of senior school subjects with 80% deciding on specific degree between year 11 and 12 and 73% making a decision on which university in year 12. RECOMMENDATIONS/IMPLICATIONS/CONCLUSION Although the data does not support that STEM engagement activities increase the likelihood of STEM-related degree choice, the evidence suggests the students who have participated in STEM activities associate their experiences with their choice to pursue a STEM-related course. It is important for universities to continue to provide quality engaging and inspirational learning experiences in STEM, to identify and build on students’ early interest and engagement, increase STEM knowledge and awareness, engage them in interdisciplinary project-based STEM practices, and provide them with real-world application experiences to sustain their interest.