Determinants of pre-hospital care non-usage for patients with emergency care needs [including commentary by Snooks H.]

Objective-To establish the demographic, health status and insurance determinants of pre-hospital ambulance non-usage for patients with emergency medical needs. Methods-Triage category, date of birth, sex, marital status, country of origin, method and time of arrival, ambulance insurance status, diagnosis, and disposal were collected for all patients who presented over a four month period (n=10 229) to the emergency department of a major provincial hospital. Data for patients with urgent (n=678) or critical care needs (n=332) who did not use pre-hospital care were analysed using Poisson regression. Results-Only a small percentage (6.6%) of the total sample were triaged as having urgent medical needs or critical care needs (3.2%). Predictors of usage for those with urgent care needs included age greater than 65 years (prevalence ratio (PR)=0.54; 95% confidence interval (CI)= 0.35 to 0.83), being admitted to intensive care or transferred to another hospital (PR=0.62; 95% CI=0.44 to 0.89) or ward (PR=0.72; 95% CI=0.56 to 0.93) and ambulance insurance status (PR=0.67; 95% CI=052 to 0.86). Sex, marital status, time of day and country of origin were not predictive of usage and non-usage. Predictors of usage for those with critical care needs included age 65 years or greater (PR=0.45; 95% CI=0.25 to 0.81) and a diagnosis of trauma (PR=0.49; 95% CI=0.26 to 0.92). A non-English speaking background was predictive of non-usage (PR=1.98; 95% CI=1.06 to 3.70). Sex, marital status, time of day, triage and ambulance insurance status were not predictive of non-usage. Conclusions-Socioeconomic and medical factors variously influence ambulance usage depending on the severity or urgency of the medical condition. Ambulance insurance status was less of an influence as severity of condition increased suggesting that, at a critical level of urgency, patients without insurance are willing to pay for a pre-hospital ambulance service.

Taking a 'reality' check : expanding pre-service teachers' views on pedagogy and diversity

The outcomes of a two-pronged 'real-world' learning project, which aimed to expand the views of pre-service teachers about learning, pedagogy and diversity, will be discussed in this paper. Seventy-two fourth-year and 22 first-year students, enrolled in a Bachelor of Education degree in Queensland, Australia, were engaged in community sites outside of university lectures, and separate from their practicum. Using Butin's conceptual framework for service learning, we show evidence that this approach can enable pre-service teachers to see new realities about the dilemmas and ambiguities of performing as learners and as teachers. We contend that when such 'real-world' experiences have different foci at different times in their four-year degree, pre-service teachers have more opportunities to develop sophisticated understandings of pedagogy in diverse contexts for diverse learners.

Evaluation of valuation of noise amelioration treatments within and outside the road reserve

In urban environments road traffic volumes are increasing and the density of living is becoming higher. As a consequence the urban community is being exposed to increasing levels of road traffic noise. It is also evident that the noise reduction potential of within-the-road-reserve treatments such as noise barriers, mounding and pavement surfacing has been exhausted. This paper presents a strategy that involves the comparison of noise ameliorative treatments both within and outside the road reserve. The noise reduction resulting from the within-the-road-reserve component of treatments has been evaluated using a leading application of the CoRTN Model, developed by the UK Department of Transport 1988 [1], and the outside road reserve treatment has been evaluated in accordance with the Australian Standard 3671, Acoustics – Road traffic noise intrusion – Building sitting and construction [5]. The evaluation of noise treatments has been undertaken using a decision support tool (DST) currently being developed under the research program conducted at RMIT University and Department of Main Roads, Queensland. The case study has been based on data from a real project in Queensland, Australia. The research described here was carried out by the Australian Cooperative Research Centre for Construction Innovation [9], in collaboration with Department of Main Roads, Queensland, Department of Public Works, Queensland, Arup Pty. Ltd., Queensland University of technology and RMIT University.

Before the first export decision : internationalisation readiness in the pre-export phase

Although the internationalisation process of the firm has been well researched since the 1970s, the behaviour of firms prior to internationalisation has not received commensurate research attention.This paper argues that a focus on firms’ pre-internationalisation activities will not only offer an additional important perspective to the study of firm internationalisation but it will also address a significant research gap in studies that are theoretically based on the so-called stages models. During the pre-internationalisation phase, a firm is exposed to stimuli factors that may trigger an impulse for foreign market expansion. Decision makers’ perceptions of stimuli, their attitudinal commitment towards internationalisation, the firms’ resources and capabilities, as well as the mediating effect of lateral rigidity comprise a learning process that leads a firm towards readiness to initiate an internationalisation decision. This paper advances the concept of internationalisation readiness and proposes a method for developing an Internationalisation Readiness Index.

Teacher educators embrace philosophy: reflections on a new way of looking at preparing pre-service teachers

Over the last decade in Australia, the role of the teacher has changed. Teachers are now expected to model and foster in their students a wide range of skills such as critical thinking, self-regulated learning, knowledge of self and others and lifelong learning. These changes are having a significant impact on the design of pre-service teacher education programmes, with university educators re-evaluating the teacher training curriculum and embedded pedagogical processes in order to consider how they might develop these skills in pre-service teachers. One approach is to consider the processes and practices inherent in philosophical inquiry. This paper reports on three participants’ reflections of a 12-week philosophy programme that was conducted for teacher educators at Queensland’s University of Technology (QUT) in 2008. The programme was facilitated by teachers from Buranda State School who have been teaching philosophy in their P-7 school for more than ten years. This paper provides insight into teacher educators’ reflections on the philosophy programme and the associated changes and challenges of implementing such a programme in pre-service teacher education degrees.

“I am a secondary teacher and I teach history and SOSE” : negotiating pre-service teacher identities in times of curriculum change

Secondary social education in Australia is set to change with the new national history curriculum but integrated social education will continue in the middle years of schooling. Competing discourses of disciplinary and integrated social education approaches create new challenges for pre-service teachers as identification with a teaching area is an important aspect of developing a broader teacher identity. Feedback on a compulsory, final year curriculum studies unit revealed the majority of secondary pre-service teachers identified with at least one social science discipline. However, only a small number listed the integrated social education curriculum of Studies of Society and Environment (SOSE), even though SOSE was an essential part of their brief. More complex identities were revealed in post-teaching practice interviews. In times of curriculum change, attention to pre-service teachers’ disciplinary knowledge is critical in developing a stable subject identity.

A Malaysian tale : pre-service teacher education and ICT integration for a better world

The use of Information and Communication Technologies (ICT) in education is often a topic of much discussion within all sectors of education with educators and educational researchers continually looking for innovative ways of using these technologies to support and enhance student outcomes in education. Consequently, Malaysia is no exception to this and as the Ministry of Education (MOE), Malaysia strives to meet its government’s Vision 2020, educational reform across all educational sectors has become imperative. ICT will play an integral role in the educational reform process and teacher education programs are no exception to this. ICT and capacity building will play an important role in the re-conceptualisation of teacher education programs. This paper reports on how a collaborative capacity building project between two Malaysian teacher education Institutes and an Australian University has given lecturers and pre-service teachers an opportunity to redefine their use of ICT in their prospective teaching areas of science, mathematics and design and technology. It also highlights the positive capacity building programs that occurred between both Australian university lecturers and Malaysian Institute lecturers and how this contributed to the effective integration and use of ICT.

Major depressive disorder and nutritional medicine : a review of monotherapies and adjuvant treatments

A literature review was conducted to examine the evidence for nutritional interventions in depression. It revealed a number of significant conclusions. Interestingly, more positive clinical trials were found to support adjuvant, rather than monotherapeutic, use of nutrients to treat depression. Much evidence exists in the area of adjuvant application of folic acid, S-adenosyl-methionine, omega-3, and L-tryptophan with antidepressants. Current evidence does not support omega-3 as an effective monotherapy to treat depression. However, this may be due, at least in part, to olive oil being used as the control intervention, some studies using docosahexaenoic acid alone or a higher docosahexaenoic acid to eicosapentaenoic acid ratio, and significant heterogeneity regarding depressive populations. Nevertheless, adjunctive prescription of omega-3 with antidepressants, or in people with dietary deficiency, may be beneficial. Inositol lacks evidence as an effective antidepressant and cannot be currently recommended. Evidence on the use of L-trytophan for depression is inconclusive and additional studies utilizing a more robust methodology are required.

A thematic approach to integrating maths and science for pre-service primary teachers via sustainability

Efforts to improve mathematics and science content knowledge have in many institutions required redefining teacher education through new teaching and learning. See, for example, Peard & Pumadevi (2007) for an account of one such attempt involving the development of a Foundations Unit, Scientific and Quantitative Literacy. This unit is core for all first year pre-service primary teacher education students at Queensland University of Technology (QUT) and two Education Institutes in Malaysia, Institute Perguruan Raja Melewar (IPRM), and Institute Perguruan Teknik (IPT) Kuala Lumpur. Since then, QUT has modified the unit to adopt a thematic approach to the same content. An aim of the unit rewrite was the development of a positive attitude and disposition to the teaching and learning of mathematics and science, with a curiosity and willingness to speculate about and explore the world. Numeracy was specifically identified within the mathematics encountered and appropriately embedded in the science learning area. The importance of the ability to engage in communication of and about mathematics and science was considered crucial to the development of pre-service primary teachers. Cognisance was given to the appropriate selection and use of technology to enhance learning - digital technologies were embedded in the teaching, learning and assessment of the unit to avoid being considered as an optional extra. This was achieved around the theme of “the sustainable school”. This „sustainability‟ theme was selected due to its prominence in Australia‟s futures-oriented National Curriculum which will be implemented in 2011. This paper outlines the approach taken to the implementation of the unit and discusses early indicators of its effectiveness.

A thematic approach to integrating maths and science for pre-service primary teachers via sustainability

Efforts to improve mathematics and science content knowledge have in many institutions required redefining teacher education through new teaching and learning. See, for example, Peard & Pumadevi (2007) for an account of one such attempt involving the development of a Foundations Unit, Scientific and Quantitative Literacy. This unit is core for all first year pre-service primary teacher education students at Queensland University of Technology (QUT) and two Education Institutes in Malaysia, Institute Perguruan Raja Melewar (IPRM), and Institute Perguruan Teknik (IPT) Kuala Lumpur. Since then, QUT has modified the unit to adopt a thematic approach to the same content. An aim of the unit rewrite was the development of a positive attitude and disposition to the teaching and learning of mathematics and science, with a curiosity and willingness to speculate about and explore the world. Numeracy was specifically identified within the mathematics encountered and appropriately embedded in the science learning area. The importance of the ability to engage in communication of and about mathematics and science was considered crucial to the development of pre-service primary teachers. Cognisance was given to the appropriate selection and use of technology to enhance learning - digital technologies were embedded in the teaching, learning and assessment of the unit to avoid being considered as an optional extra. This was achieved around the theme of “the sustainable school”. This ‘sustainability’ theme was selected due to its prominence in Australia’s futures-oriented National Curriculum which will be implemented in 2011. This paper outlines the approach taken to the implementation of the unit and discusses early indicators of its effectiveness.

Transfer of learning across the globe : pre-service teachers taking the initiative

A continuing challenge for pre-service teacher education is the learning transfer between the university based components and the practical school based components of their training. It is not clear how easily pre-service teachers can transfer university learnings into ‘in school’ practice. Similarly, it is not clear how easily knowledge learned in the school context can be disembedded from this particular context and understood more generally by the pre-service teacher. This paper examines the effect of a community of practice formed specifically to explore learning transfer via collaboration and professional enquiry, in ‘real time’, across the globe. “Activity Theory” (Engestrom, 1999) provided the theoretical framework through which the cognitive, physical and social processes involved could be understood. For the study, three activity systems formed community of practice network. The first activity system involved pre-service teachers at a large university in Queensland, Australia. The second activity system was introduced by the pre-service teachers and involved Year 12 students and teachers at a private secondary school also in Queensland, Australia. The third activity system involved university staff engineers at a large university in Pennsylvania, USA. The common object among the three activity systems was to explore the principles and applications of nanotechnology. The participants in the two Queensland activity systems, controlled laboratory equipment (a high powered Atomic Force Microscope – CPII) in Pennsylvania, USA, with the aim of investigating surface topography and the properties of nano particles. The pre-service teachers were to develop their remote ‘real time’ experience into school classroom tasks, implement these tasks, and later report their findings to other pre-service teachers in the university activity system. As an extension to the project, the pre-service teachers were invited to co-author papers relating to the project. Data were collected from (a) reflective journals; (b) participant field notes – a pre-service teacher initiative; (c) surveys – a pre-service teacher initiative; (d) lesson reflections and digital recordings – a pre-service teacher initiative; and (e) interviews with participants. The findings are reported in terms of the major themes: boundary crossing, the philosophy of teaching, and professional relationships The findings have implications for teacher education. The researchers feel that deliberate planning for networking between activity systems may well be a solution to the apparent theory/practice gap. Proximity of activity systems need not be a hindering issue.

Mainstreaming sustainability into pre-service teacher edcuation in Australia

There is a growing interest in and support for education for sustainability in Australian schools. Australian Government schemes such as the Australian Sustainable Schools Initiative (AuSSI), along with strategies such as Educating for a Sustainable Future: A National Environmental Education Statement for Australian Schools(NEES(Australian Government and Curriculum Corporation (2005) and Living Sustainably: The Australian Government’s National Action Plan for Education for Sustainability (Australian Government 2009), recognise the need and offer support for education for sustainability in Australian schools. The number of schools that have engaged with AuSSI indicates that this interest also exists within Australian schools. Despite this, recent research indicates that pre-service teacher education institutions and programs are not doing all they can to prepare teachers for teaching education for sustainability or for working within sustainable schools. The education of school teachers plays a vital role in achieving changes in teaching and learning in schools. Indeed, the professional development of teachers in education for sustainability has been identified as ‘the priority of priorities’. Much has been written about the need to ‘reorient teacher education towards sustainability’. Teacher education is seen as a key strategy that is yet to be effectively utilised to embed education for sustainability in schools. Mainstreaming sustainability in Australian schools will not be achieved without the preparation of teachers for this task. The Mainstreaming Sustainability model piloted in this study seeks to engage a range of stakeholder organisations and key agents of change within a system to all work simultaneously to bring about a change, such as the mainstreaming of sustainability. The model is premised on the understanding that sustainability will be mainstreamed within teacher education if there is engagement with key agents of change across the wider teacher education system and if the key agents of change are ‘deeply’ involved in making the change. The model thus seeks to marry broad engagement across a system with the active participation of stakeholders within that system. Such a systemic approach is a way of bringing together diverse viewpoints to make sense of an issue and harness that shared interpretation to define boundaries, roles and relationships leading to a better defined problem that can be acted upon more effectively. Like action research, the systemic approach is also concerned with modelling change and seeking plausible solutions through collaboration between stakeholders. This is important in ensuring that outcomes are useful to the researchers/stakeholders and the system being researched as it creates partnerships and commitments to the outcomes by stakeholder participants. The study reported on here examines whether the ‘Mainstreaming Sustainability’ model might be effective as a means to mainstream sustainability in pre-service teacher education. This model, developed in an earlier study, was piloted in the Queensland teacher education system in order to examine its effectiveness in creating organisational and systemic change. The pilot project in Queensland achieved a number of outcomes. The project: • provided useful insights into the effectiveness of the Mainstreaming Sustainability model in bringing about change while also building research capacity within the system • developed capacities within the teacher education community: o developing competencies in education for sustainability o establishing more effective interactions between decision-makers and other stakeholders o establishing a community of inquiry • changed teaching and learning approaches used in participating teacher education institutions through: o curriculum and resource development o the adoption of education for sustainability teaching and learning processes o the development of institutional policies • improved networks within the teacher education system through: o identifying key agents of change within the system o developing new, and building on existing, partnerships between schools, teacher education institutions and government agencies • engaged relevant stakeholders such as government agencies and non-government organisations to understand and support the change Our findings indicate that the Mainstreaming Sustainability model is able to facilitate organisational and systemic change – over time – if: • the individuals involved have the conceptual and personal capacities needed to facilitate change, that is, to be a key agent of change • stakeholders are engaged as participants in the process of change, not simply as ‘interested parties’ • there is a good understanding of systemic change and the opportunities for leveraging change within systems. In particular, in seeking to mainstream sustainability in pre-service teacher education in Queensland it has become clear that one needs to build capacity for change within participants such as knowledge of education for sustainability, conceptual skills in systemic thinking, action research and organisational change, and leadership skills. It is also of vital importance that key agents of change – those individuals who are ‘hubs’ within a system and can leverage for change across a wide range of the system – are identified and engaged with as early as possible. Key agents of change can only be correctly identified, however, if the project leaders and known participants have clearly identified the boundary to their system as this enables the system, sub-system and environment of the system to be understood. Through mapping the system a range of key organisations and stakeholders will be identified, including government and nongovernment organisations, teacher education students, teacher education academics, and so on. On this basis, key agents of change within the system and sub-system can be identified and invited to assist in working for change. A final insight is that it is important to have time – and if necessary the funding to ‘buy time’ – in seeking to bring about system-wide change. Seeking to bring about system-wide change is an ambitious project, one that requires a great deal of effort and time. These insights provide some considerations for those seeking to utilise the Mainstreaming Sustainability model to bring about change within and across a pre-service teacher education system.

Connecting pre-service teachers to 'real world' teaching practices through microteaching

Action research proved a useful strategy for monitoring the evolution of microteaching task as an authentic assessment for post-graduate pre-service teachers. Through four iterations of continually reflecting on the structure, purpose and outcomes of utilising microteaching as assessment, unit coordinators implemented an authentic assessment task that simulated real world experience.

A fuzzy neural network approach for contractor pre-qualification

Nonlinearity, uncertainty and subjectivity are the three predominant characteristics of contractors prequalification which cause the process more of an art than a scientific evaluation. A fuzzy neural network (FNN) model, amalgamating both the fuzzy set and neural network theories, has been developed aiming to improve the objectiveness of contractor prequalification. Through the FNN theory, the fuzzy rules as used by the prequalifiers can be identified and the corresponding membership functions can be transformed. Eighty-five cases with detailed decision criteria and rules for prequalifying Hong Kong civil engineering contractors were collected. These cases were used for training (calibrating) and testing the FNN model. The performance of the FNN model was compared with the original results produced by the prequalifiers and those generated by the general feedforward neural network (GFNN, i.e. a crisp neural network) approach. Contractor’s ranking orders, the model efficiency (R2) and the mean absolute percentage error (MAPE) were examined during the testing phase. These results indicate the applicability of the neural network approach for contractor prequalification and the benefits of the FNN model over the GFNN model. The FNN is a practical approach for modelling contractor prequalification.

Decision support system for contractor pre-qualification : artificial neural network model

The selection criteria for contractor pre-qualification are characterized by the co-existence of both quantitative and qualitative data. The qualitative data is non-linear, uncertain and imprecise. An ideal decision support system for contractor pre-qualification should have the ability of handling both quantitative and qualitative data, and of mapping the complicated nonlinear relationship of the selection criteria, such that rational and consistent decisions can be made. In this research paper, an artificial neural network model was developed to assist public clients identifying suitable contractors for tendering. The pre-qualification criteria (variables) were identified for the model. One hundred and twelve real pre-qualification cases were collected from civil engineering projects in Hong Kong, and eighty-eight hypothetical pre-qualification cases were also generated according to the “If-then” rules used by professionals in the pre-qualification process. The results of the analysis totally comply with current practice (public developers in Hong Kong). Each pre-qualification case consisted of input ratings for candidate contractors’ attributes and their corresponding pre-qualification decisions. The training of the neural network model was accomplished by using the developed program, in which a conjugate gradient descent algorithm was incorporated for improving the learning performance of the network. Cross-validation was applied to estimate the generalization errors based on the “re-sampling” of training pairs. The case studies show that the artificial neural network model is suitable for mapping the complicated nonlinear relationship between contractors’ attributes and their corresponding pre-qualification (disqualification) decisions. The artificial neural network model can be concluded as an ideal alternative for performing the contractor pre-qualification task.