Prevalence and cost of musculoskeletal disorders: a population-based, public hospital system healthcare consumption approach.

Objective: To use a population-level, public-hospital approach to compare the prevalence and cost of musculoskeletal diseases (MSD) with other clinical specialties.

Methods: A healthcare utilization survey of 4 million individual records over 4 years, from all major public hospitals in the state of Victoria (estimated population 4.8 million residents in 2000/01) from 1997/98 to 2000/01. Main outcome measures were inpatient episodes of care, bed-days, and outpatient clinic encounters. MSD was defined as the combination of orthopedics and rheumatology.

Results: After obstetrics, MSD was the most frequent outpatient service, with orthopedics accounting for 9.9% of all visits in 2000/01. The proportion of MSD outpatient encounters (on average 11.6% of the total) was constant over the study period. Among 26 medical specialties, MSD had the sixth highest number of inpatient episodes (6.2% in 2000/01), following renal dialysis (14.6%), general surgery (8.2%), obstetrics (7.6%), gastroenterology (7.1%), and general medicine (6.7%). MSD was the fifth highest consumer of bed-days, occupying on average 7.7% of all beds per annum in the period 1997/98 to 2000/01, behind psychiatry (10.1%), respiratory medicine (8.5%), rehabilitation (8.3%), and general medicine (7.8%). MSD was the third most-costly discipline in 2000/01, with total costs of over A dollars 169 million (9.7% of total inpatient costs that year), behind respiratory medicine (11.6%) and general surgery (11.5%).

Conclusion: Compared to other diseases, MSD consumes a substantial proportion of healthcare resources in Victorian public hospitals. These data have important implications for allocation of healthcare resources, clinical care pathways, and prevention strategies.

The use of public transport in coastal Australia : modes of travel to work and greenhouse emissions

Commuting to work is one of the most important and regular routines of transportation in towns and cities. From a geographic perspective, the length of people’s commute is influenced, to some degree, by the spatial separation of their home and workplace and the transport infrastructure. The rise of car ownership in Australia from the 1950s to the present was accompanied by a considerable decrease of public transport use. Currently there is an average of 1.4 persons per car in Australia, and private cars are involved in approximately 90% of the trips, and public transportation in only 10%. Increased personal mobility has fuelled the trend of decentralised housing development, mostly without a clear planning for local employment, or alternative means of transportation. Transport sector accounts for 14% of Australia’s net greenhouse gas emissions. Without further policy action, Australia’s emissions are projected to continue to increase. The Australian Federal Government and the new Department of Climate Change have recently published a set of maps showing that rising seas would submerge large parts of Victoria coastal region. Such event would lead to major disruption in planned urban growth areas in the next 50 years with broad scale inundation of dwellings, facilities and road networks. The Greater Geelong Region has well established infrastructure as a major urban centre and tourist destination and hence attracted the attention of federal and state governments in their quest for further development and population growth. As a result of its natural beauty and ecological sensitivity, scenarios for growth in the region are currently under scrutiny from local government as well as development agencies, scientists, and planners. This paper is part of a broad research in the relationship between transportation system, urban form, trip demand, and emissions, as a paramount in addressing the challenges presented by urban growth. Progressing from previous work focused on private cars, this present paper investigates the use of public transport as a mode for commuting in the Greater Geelong Region. Using a GIS based interaction model, it characterises the current use of the existing public transportation system, and also builds a scenario of increased use of the existing public transportation system, estimating potencial reductions in CO2 emissions. This study provides an improved understanding of the extent to which choices of transport mode and travel activity patterns, affect emissions in the context of regional networks. The results indicate that emissions from commuting by public transportation are significantly lower than those from commuting by private car, and emphasise that there are opportunities for large abatment in the greenhouse emissions from the transportation sector related to efforts in increasing the use of existing public transportation system.

Associations of public transport accessibility with walking, obesity, metabolic syndrome and diabetes

Objective: To examine associations of public transport system accessibility with walking, obesity, metabolic syndrome and diabetes/impaired glucose regulation. Methods: Associations of public transport accessibility with self-reported walking for transport or recreation and measured biomarkers of chronic disease risk were estimated in 5241 adult residents of 42 randomly selected areas in Australia in 2004/05, drawn from the second wave of a population-based cohort study (AusDiab). Public transport accessibility was objectively measured using an adaptation of the Public Transport Accessibility Levels (PTAL) methodology, comprising both GIS derived spatial and temporal accessibility measures. Logistic regression models were adjusted for individual and environmental level covariates and clustering within areas. Results: Above median public transport accessibility was positively associated with a walking time of more than the median 90 min per week (OR=1.28, 95%CI 1.03, 1.60) and walking above the recommended 150 min per week (OR=1.35, 95%CI 1.11, 1.63). There were no associations of public transport accessibility with obesity (OR=1.05, 95%CI 0.85, 1.30), the metabolic syndrome (OR=1.09, 95%CI 0.91, 1.31) nor diabetes/impaired glucose regulation (OR=1.11, 95%CI 0.94, 1.30). Findings were similar for a subgroup reporting no vigorous recreational physical activity. Conclusions: In this Australian sample, public transport accessibility was positively associated with walking at recommended levels, including for people who are not otherwise vigorously active. Significance: Walking is crucial for increasing physical activity levels and population health, as well as maximising public transport system efficiency. Building evidence on public transport accessibility and walking will enable governments to exploit this important synergy.

Classroom teacher effectiveness research and inquiry, and its relevance to the development of public education policy: an Australian context

This paper has as its focus an analysis of the question and problem of classroom teacher effectiveness research and inquiry. It presents an examination of what counts as valid and worthwhile research in classroom teacher effectiveness studies for the development of education policy within an Australian context, the State of Victoria. The Government’s Blueprint, the major education policy document of the Victorian State Labour Government, outlines its educational approach. Important and core features of government direction for education policy include a focus on social and economic disadvantage. A priority for the Victorian State Labour Government is tangible and measurable improvement in the performance of the public education system. A particular concern is the problem of academic underperformance within public schools, particularly those designated as low-performing and situated in socially and economically disadvantaged communities. Building the capacity of the State’s teacher workforce forms a key component of the Blueprint, and State Government direction in public education. The paper utilises a qualitative theoretical framework. Eight education policy actor/participants were interviewed and their responses analysed using a critical discourse approach. The main findings indicate that education policy actors advocate a strong belief in particular forms of evidence-based research for the development of education policy in the area of classroom teacher effectiveness.

Accessibility impact of proposed Australian high speed rail

High speed rail (also commonly known as HSR) is highly regarded as one of the most significant innovation for mass passenger transportation to travellers willing to pay for reduced travel impediments (shorter travel time, convenience, safety, security, comfort, reliability, flexibility, uniqueness and attractiveness). The transport policy in Australia has until now focused primarily on private passenger car transport and air transportation to the degree that State and Federal Governments’ commitments and actions of rail-oriented mass transportation system still remains sketchy in spite of occasional political and public attentions into it. This has resulted in a limited use of passenger rail as a regional transport system. Using one of the several alternative HSR alignments proposed for the South-Eastern Coast of Australia connecting Melbourne, Canberra, Sydney and Brisbane, this study assesses the regional accessibility impacts of Australian HSR system by means of four indicators: location accessibility, economic potential accessibility, daily accessibility and commuting accessibility. These indicators are commonly used in transport geography literature and they offer different concepts of changes in regional accessibility conditions due to a long distance transport system. The results provide an understanding of differential effects on regional accessibility based on the geographical location and size of urban areas along HSR corridor.

Complex network theoretical analysis on information dissemination over vehicular networks

How to enhance the communication efficiency and quality on vehicular networks is one critical important issue. While with the larger and larger scale of vehicular networks in dense cities, the real-world datasets show that the vehicular networks essentially belong to the complex network model. Meanwhile, the extensive research on complex networks has shown that the complex network theory can both provide an accurate network illustration model and further make great contributions to the network design, optimization and management. In this paper, we start with analyzing characteristics of a taxi GPS dataset and then establishing the vehicular-to-infrastructure, vehicle-to-vehicle and the hybrid communication model, respectively. Moreover, we propose a clustering algorithm for station selection, a traffic allocation optimization model and an information source selection model based on the communication performances and complex network theory.

Pharmaceutical benefits in Australia and Sweden: welfare policy and the cost of prescription drugs

Pharmaceutical benefits provide a stable framework within which consumers, prescribers, suppliers, pharmacists and other actors undertake transactions. The state in effect delivers a good that enhances individual autonomy. A major reason for the legitimacy enjoyed by pharmaceutical benefits in both Australia and Sweden is that these programs have strong attributes of universalism (rather than targeting). Sweden's predominantly public health system allows greater scope for pharmaceutical policy innovation. Australia's Pharmaceutical Benefits Scheme (PBS), while historically resilient and effective, is now wedged precariously between traditional considerations of equity and public health on the one hand, and constant pressure for increased marketisation on the other.

Leading as emotional management work in high risk times: the counterintuitive impulses of performativity and passion

This paper explores, through a case study of educational restructuring in Victoria, Australia, how school leaders in a public education system in Australia mediate reform discourses emphasizing managerial and market accountability and the emotional and messy work of teaching and leading. These accountability exercises were often seen by teachers and principals to be distractions; more about reporting and recording, rather than addressing substantive educational issues. They simultaneously distanced teachers and leaders from the 'real' and 'passionate' work of education while appropriating and commodifying teachers' and leaders' emotions and desires to do well. School leaders were expected to manage the emotional performances of their students, parents and colleagues as well as themselves. They also managed the emotions arising from the dissonance between teachers' professional and personal commitment to making a difference for all students based on principles of equity and the performativity requirements based on efficiency and narrowly defined and predetermined criteria of effectiveness and success that often undermined improvement for many students. In that sense performativity ('being seen to be good') and passion (for 'doing good') often produced counterintuitive impulses.

Training general practitioners in flexible sigmoidoscopy to screen for colorectal cancer

Background: A screening programme to detect polyps or early carcinoma would significantly reduce the mortality and morbidity of colorectal cancer (CRC). The aims of the present study were to evaluate: (i) the feasibility of training general practitioners in flexible sigmoidoscopy (FS) for CRC screening; (ii) the acceptability of screening by faecal occult blood testing (FOBT) and FS in asymptomatic standard risk Australians aged over 50 years; and (iii) the yield of such screening. Methods: Subjects were recruited by general practitioner (GP) referral, newspaper advertisement or by a direct approach to retirement villages. Participants were mailed a FOBT kit and a prescreening questionnaire. Flexible sigmoidoscopy was performed by a GP supervised by an experienced endoscopist. Subjects then completed a second questionnaire. General practitioners were assessed after 50 unassisted procedures. Results: A total of 264 individuals contacted the study coordinator; 169 were screened. Screening was accepted well by the participants. Fifteen per cent of subjects had polyps and 4% had a positive FOBT. Training in FS was adversely affected by the availability of resources. Three GPs completed 50 unassisted procedures over a 15-month period, but none were able to reliably assess the distal bowel. Conclusions: Although the three trainees and their supervisors did not consider that the GPs were adequately trained after 50 unassisted procedures, training was adversely affected by limited resources within the Victorian public hospital system. Screening by FOBT and FS was considered to be acceptable by the patients undergoing these procedures. Existing facilities are not adequate if GPs are to be trained in FS as part of a national CRC screening program.

A study of train group operation multi-agent model oriented RITS

In this paper, aiming at describing interrelationships and communication mechanisms among agents based on a multi-agent framework of Railway Intelligent Transportation System (RITS), we construct the model about stations and trains in the system, which is called Agent-Oriented G-Net Train Group Operation Model (AGNTOM). The framework degrades the complexity of computation and makes the distribution of simulation system easy in design. The simulated experiments prove that the model provides an effective approach for dealing with communication problems in the system.

Scale development of individual and organisation infrastructure for heart health promotion in regional health authorities

Objective : The purpose of this study was to validate measures of individual and organisational infrastructure for health promotion within Alberta's (Canada) 17 Regional Health Authorities (RHAs).

Design : A series of phases were conducted to develop individual and organisational scales to measure health promotion infrastructure. Instruments were designed with focus groups and then pre-tested prior to the validation study.

Setting : In 1993 all hospitals and Public Health Units in the province of Alberta were regionalised into 17 RHAs, with responsibility for public health, community health, and acute and long-term care. While regionalisation may offer more opportunity for community participation, reorganisation of the public health system may have fragmented and diluted resources and skills for heart health promotion in some RHAs. Infrastructure (for example, human and financial resources), amongst other items, is believed to contribute to the capacity to promote health.

Method : All 17 RHAs participated in the study, yielding a total of 144 individuals (that is board members, senior/middle management, and front line staff). These representative employees completed a self- administered questionnaire on individual- and organisational-level infrastructure measures.

Results : Psychometric analyses of survey data provided empirical evidence for the robustness of the measures. Principal component analyses verified the construct validity of the scales, with alpha coefficients ranging from 0.75 to 0.95.

Conclusion : The scales can be used by health professionals and researchers to assess individual- and organisational-level infrastructure, and tailor interventions to increase infrastructure for health promotion in health organisations.

Marketing strategy for small application service providers in a new market

Small to medium-sized enterprises (SMEs) including small application service providers (ASPs) are playing an increasingly important role in the development of global economies particularly in developing countries like China. This paper studies marketing strategies of small application service providers (ASP) with a focus on what the important factors are to establish a new ASP business in China. An analytical hierarchy process (AHP) method is used to analyse critical factors of the ASP industry. The research surveyed CEOs or senior managers who are working in ASP firms, to identify how a marketing strategy can be developed for an ASP firm to start business in China. It is found that the localisation of middle level managers, the localisation of products and services, the protection of intellectual property (IP), and infrastructure and transportation system are the most important factors for small ASP firms to do business in China.

Simulation of Mg sheet press cell materials

Major characteristics of Magnesium alloy are low density (= 1.8 g/cm³) and excellent recyclability; therefore Mg is considered as one of low environmental loading materials. The low-density materials, such as Mg, are suitable for the transportation system to reduce the emission of Co2, save energy resource and increase the safety for accidents like corrosions. In the place, cellular materials like aluminum foams are also low-density materials and can be controlled the stress-strain relation. Combination of Mg alloy and cellular materials, that is Mg cell, is one of the most excellent materials for transportation system, because of its ultra low density. safeties, and recycle ability. To make the Mg cellular materials. there are some problems to solve. One is how to make them uniformly to supply them as same perfonnance materials. One is how to make them inexpensively. Most of cellular materials are very expensive because of there are many processes or special fabrication system to make them. To solve these problems. we investigated the press cell materials. The press cell material consists sheets pressed as cell shape and wall. Therefore, it is very easy to make cellular materials and control validation of the performance of each foam materials. In this paper, we simulated compression tests of this new type of Mg alloy cellular materials under dynamic loading to investigate the relation between the compression speed and the compression behavior to show the shock absorbing capability of this new foam material. It is very important to understand their mechanical properties relatcd with cell shapes and wall to be applied widely.

Challenging the dominant discourses of the state aid debate

The state aid debate is one of the longest running and most intractable issues in the public policy sphere in Australia. Recent decisions by the Commonwealth government to increase funding to private schools has reignited the debate. But the traditional defences of public education have proved inadequate to the task of hanging the course of current neo-liberal education policy trajectories. As the percentage of students attending private schools continues to grow, and as the spectre of a residualised public education system looms larger, so the need to rethink Australian public education becomes a more urgent project. In this paper we analyse what is happening and why; identify a range of concerns from the standpoint of a social democratic educational agenda; and theorise some possible strategies which might be pursued by those committed to a vibrant public schooling
system in Australia.