Why do Queenslanders seek care in emergency departments? A population study

Objective This study aims to identify the main reasons for which first time and multiple users seek medical care through Queensland emergency departments (ED). Methods A cross-sectional survey was conducted at eight public EDs among presenting patients (n = 911). The questions measured the socio-demographic characteristics of patients, their beliefs and attitudes towards EDs services, and perceptions of health status. Bivariate and binary logistic regression analyses were performed to examine the differences between first time and multiple users of EDs. Results First time and multiple users accounted for 55.5% and 44.5%, respectively. Multiple users themselves believed to be sicker, have poorer health status, and additional and/or chronic health conditions. Multiple users more strongly believed that their condition required treatment at an ED and perceived their condition as being very serious. Multiple users reported weekly household incomes below $600, and half of the multiple users were not working as compared to 35% first time users. Multivariate analysis showed that multiple use was significantly associated with the existence of additional health problems, having chronic condition, lower self-efficacy, and need for ED treatment. Conclusions Patients who sought care for multiple times at EDs more often than first time users suffered from additional and chronic conditions. Their opinion of an ED as the most suitable place to address their current health problem was stronger than first time users. Any proposed demand management strategies need to address these beliefs together with the reasoning of patients to provide effective and appropriate care outside or within ED services.

Organisational belongingness mediates the relationship between sources of stress and post-trauma outcomes in fire-fighters

Previous research with emergency service workers has examined the relationship between operational and organisational stress and negative indicators of mental health, and generally found that organisational stress is more strongly related to pathology than operational stress. The current study aimed to create and test a model predicting both posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) simultaneously in a sample of fire-fighters (N = 250). The results found that the model demonstrated good fit for the data. In contrast to previous research operational stress was directly related to PTSD symptoms, while organisational stress was not. Organisational stress was indirectly related to PTG, through the mediating role of organisational belongingness. This research identified organisational belongingness as a good target for psychosocial interventions aimed at promoting positive adaptation following the experience of trauma in emergency services.

Using environmental criminology theories to compare ‘youth misuse of fire’ across age groups in New South Wales

Youth misuse of fire is a substantive community concern. Despite evidence which indicates youths account for a significant proportion of all deliberately lit fires within Australia, an absence of up-to-date, contextually specific research means the exact scope and magnitude of youth misuse of fire within Australia remains unknown. Despite research suggesting com- monalities exist between youth misuse of fire and juvenile offending more broadly, misuse of fire is rarely explained using criminological theory. In light of this gap, a descriptive analysis of youth misuse of fire within New South Wales was performed. Routine Activity Theory and Crime Pattern Theory were tested to explain differences in misuse of fire across age groups. Results suggest these environmental theories offer useful frameworks for explaining youth misuse of fire in New South Wales. It is argued that the Routine Activity Theory and Crime Pattern Theory can be employed to better inform youth misuse of fire policy and prevention efforts.

Numerical study of LSF floors made of hollow flange channels in fire

Light gauge steel frame (LSF) floor systems are generally made of lipped channel section joists and lined with gypsum plasterboards to provide adequate fire resistance rating under fire conditions. Recently a new LSF floor system made of welded hollow flange channel (HFC) section was developed and its fire performance was investigated using full scale fire tests. The new floor systems gave higher fire resistance ratings in comparison to conventional LSF floor systems. To avoid expensive and time consuming full scale fire tests, finite element analyses were also performed to simulate the fire performance of LSF floors made of HFC joists using both steady and transient state methods. This paper presents the details of the developed finite element models of HFC joists to simulate the structural fire performance of the LSF floor systems under standard fire conditions. Finite element analyses were performed using the measured time–temperature profiles of the failed joists from the fire tests, and their failure times, temperatures and modes, and deflection versus time curves were obtained. The developed finite element models successfully predicted the structural performance of LSF floors made of HFC joists under fire conditions. They were able to simulate the complex behaviour of thin cold-formed steel joists subjected to non-uniform temperature distributions, and local buckling and yielding effects. This study also confirmed the superior fire performance of the newly developed LSF floors made of HFC joists.

Experimental study of cold-formed steel floors made of hollow flange channel section joists under fire conditions

Fire safety plays a vital role in building design because appropriate level of fire safety is important to safeguard lives and property. Cold-formed steel channel sections along with fire-resistive plasterboards are used to construct light-gauge steel frame (LSF) floor systems to provide adequate fire resistance ratings (FRR). It is common practice to use lipped channel sections (LCS) as joists in LSF floor systems, and past research has only considered such systems. This research focuses on adopting improved joist sections such as hollow flange channel (HFC) sections to improve the structural performance and FRR of cold-formed LSF floor systems under standard fire conditions. The structural and thermal performances of LSF floor systems made of a welded HFC, LiteSteel Beams (LSB), with different plasterboard and insulation configurations, were investigated using four full-scale fire tests under standard fires. These fire tests showed that the new LSF floor system with LSB joists improved the FRR in comparison to that of conventional LCS joists. Fire tests have provided valuable structural and thermal performance data of tested floor systems that included time-temperature profiles and failure times, temperatures, and modes. This paper presents the details of the fire tests conducted in this study and their results along with some important findings.

Predicting the performance of LSF walls made of hollow flange channel sections in fire

Fire resistance of load bearing Light Gauge Steel Frame (LSF) wall systems is important to protect lives and properties in fire accidents. Recent fire tests of LSF walls made of the new cold-formed and welded hollow flange channel (HFC) section studs and the commonly used lipped channel section (LCS) studs have shown the influence of stud sections on the fire resistance rating (FRR) of LSF walls. To advance the use of HFC section studs and to verify the outcomes from the fire tests, finite element models were developed to predict the structural fire performance of LSF walls made of welded HFC section studs. The developed models incorporated the measured non-uniform temperature distributions in LSF wall studs due to the exposure of standard fire on one side, and accurate elevated temperature mechanical properties of steel used in the stud sections. These models simulated the various complexities involved such as thermal bowing and neutral axis shift caused by the non-uniform temperature distribution in the studs. The finite element analysis (FEA) results agreed well with the full scale fire test results including the FRR, outer hot and cold flange temperatures at failure and axial deformation and lateral displacement profiles. They also confirmed the superior fire performance of LSF walls made of HFC section studs. The applicability of both transient and steady state FEA of LSF walls under fire conditions was verified in this study, which also investigated the effects of using various temperature distribution patterns across the cross-section of HFC section studs on the FRR of LSF walls. This paper presents the details of this numerical study and the results.

Examining the profile and experiences of older sub-acute patients who present to public hospital emergency departments in South East Queensland: A mixed methods approach

There is a scarcity of research that informs Interface Health Service (IHS) development. This research applied a mixed methods approach to profile older emergency department patients and patterns of health service use and to explore their ED experiences in public hospital EDs in South-East Queensland. IHS was under-utilised by older people with complex co-morbidities. Lack of communication and need identification were factors that undermined the effectiveness of IHS in reaching this cohort which highlighted a need for change.

Impact of Grazing, Fire and Extraction on the Bamboo (Dendrocalamus-Strictus and Bambusa-Arundinacea) Populations of Karnataka

Dendrocalamus strictus and Bambusa arundinacea are monocarpic, gregariously flowering species of bamboo, common in the deciduous forests of the State of Karnataka in India. Their populations have significantly declined, especially since the last flowering. This decline parelleis increasing incidence of grazing, fire and extraction in recent decades. Results of an experiment in which the intensities of grazing and fire were varied, indicate that while grazing significantly depresses the survival of seedlings and the recruitment of new eulms of bamboo clumps, fire appeared to enhance seedling survival, presumably by reducing competition of lass fire-resistant species. New shoots of bamboo are destroyed by insects and a variety of herbivorous mammals. In areas of intense herbivore pressure, a bamboo clump initiates the production of a much larger number of new culrm, but results in many fewer and shorter intact culms. Extraction renders the new shoots more susceptible to herbivore pressure by removal of the protective covering of branches at the base of a bamboo clump. Hence, regular and extensive extraction by the paper mills in conjuction with intense grazing pressure strongly depresses the addition of new culms to bamboo clumps. Regulation of grazing in the forest by domestic livestock along with maintenance of the cover at the base of the clumps by extracting the culms at a higher level should reduce the rate of decline of the bamboo stocks.

Modelling the potential spread of Solenopsis invicta Buren (Hymenoptera: Formicidae) (red imported fire ant) in Australia

Quantifying the potential spread and density of an invading organism enables decision-makers to determine the most appropriate response to incursions. We present two linked models that estimate the spread of Solenopsis invicta Buren (red imported fire ant) in Australia based on limited data gathered after its discovery in Brisbane in 2001. A stochastic cellular automaton determines spread within a location (100 km by 100 km) and this is coupled with a model that simulates human-mediated movement of S. invicta to new locations. In the absence of any control measures, the models predict that S. invicta could cover 763 000–4 066 000 km2 by the year 2035 and be found at 200 separate locations around Australia by 2017–2027, depending on the rate of spread. These estimated rates of expansion (assuming no control efforts were in place) are higher than those experienced in the USA in the 1940s during the early invasion phases in that country. Active control efforts and quarantine controls in the USA (including a concerted eradication attempt in the 1960s) may have slowed spread. Further, milder winters, the presence of the polygynous social form, increased trade and human mobility in Australia in 2000s compared with the USA in 1940s could contribute to faster range expansion.

Revised benefits and costs of eradicating the red imported fire ant

The paper revisits estimates of cost/benefit for eradication in Australia provided in 2001 which were based largely on information about a US ecosystem. The study had two major components; spread modelling using a cellular automation model provided by Joe Scanlan and an impact analysis undertaken by the remaining authors. The revised figures provided in this study increased the damage estimate from $2.8 billion to $45 billion and the benefit-cost ratio of eradication efforts improved from 25:1 to 390:1.

Fire resistance of light gauge steel frame wall systems lined with gypsum plasterboards

Light gauge steel frame (LSF) wall systems are increasingly used in residential and commercial buildings as load bearing and non-load bearing elements. Conventionally, the fire resistance ratings of such building elements are determined using approximate prescriptive methods based on limited standard fire tests. However, recent studies have shown that in some instances real building fire time-temperature curves could be more severe than the standard fire curve, in terms of maximum temperature and rate of temperature rise. This has caused problems for safe evacuation and rescue activities, and in some instances has also lead to the collapse of buildings earlier than the prescribed fire resistance. Therefore a detailed research study into the performance of LSF wall systems under both standard fire and realistic fire conditions was undertaken using full scale fire tests to understand the fire performance of different LSF wall configurations. Both load bearing and non-load bearing full scale fire tests were performed on LSF walls configurations which included single layer, double layer, externally insulated wall panels made up of different steel sections and thicknesses of gypsum plasterboards. The non-load bearing fire test results were utilized to understand the factors affecting the fire resistance of LSF walls, while loading bearing fire test results led to development of simplified methods to predict the fire resistance ratings of load bearing LSF walls exposed to both standard and realistic design fires. This paper presents the results of full scale experimental study and highlights the effects of standard and realistic fire conditions on fire performance of LSF walls.

Numerical studies of gypsum plasterboard and MGO board lined LSF walls exposed to fire

Fire resistance of cold-formed light gauge steel frame (LSF) wall systems is enhanced by lining them with single or multiple layers of wall boards with varying thermal properties. These wall boards are gypsum plasterboards or Magnesium Oxide (MgO) boards produced by different manufacturers. Thermal properties of these boards appear to show considerable variations and this can lead to varying fire resistance levels (FRL) for their wall systems. Currently FRLs of wall systems are determined using full scale fire tests, but they are time consuming and expensive. Recent research studies on the fire performance of LSF wall systems have used finite element studies to overcome this problem, but they were developed based on 1-D and 2-D finite element platform capable of performing either heat transfer or structural analysis separately. Hence in this research a 3-D finite element model was developed first for LSF walls lined with gypsum plasterboard and cavity insulation materials. Accurate thermal properties of these boards are essential for finite element modelling, and thus they were measured at both ambient and elevated temperatures. This experimental study included specific heat, relative density and thermal conductivity of boards. The developed 3-D finite element model was then validated using the available fire tests results of LSF walls lined with gypsum plasterboard, and is being used to investigate the fire performance of different LSF wall configurations. The tested MgO board exhibited significant variations in their thermal properties in comparison to gypsum plasterboards with about 50% loss of its initial mass at about 500 ºC compared to 16% for gypsum plasterboards. Hence the FRL of MgO board lined LSF wall systems is likely to be significantly reduced. This paper presents the details of this research study on the fire performance of LSF wall systems lined with gypsum plasterboard and MgO board including the developed 3-D finite element models, thermal property tests and the results.

Qualitative study of patients' choice between public and private hospital emergency departments

Objective The aim of this study was to gather patients' perceptions regarding their choice between public and private hospital EDs for those who hold private health insurance. The findings of this study will contribute to knowledge regarding patients' decision-making processes and therefore may contribute to the development of evidence based public policies. Methods An in-depth semi-structured guide was used to interview participants at public and private hospital EDs. Questions sought to identify the issues that were considered by the participants to decide to attend that hospital ED, previous ED experience, expectations of ED services and perceived benefits and barriers to accessing services. Interviews were audio recorded, transcribed verbatim and analysed using content and thematic approaches. Results Four core themes emerged: prior good experience with the hospital, perceived quality of care, perceived waiting times and perceived costs that may explain patients' choice. Patients' choice between public and private EDs can be explained by the interaction of these core themes. The principal issues appear to be concern for gap payments at private hospital ED and waiting times at public hospital ED. Conclusions Patients who choose to attend public EDs appear to value financial concern over waiting time; those who choose to attend private EDs appear to value waiting time ahead of financial concerns.

Women Heat Up Soup Over Fire in a Hamburger Barrack Artworks

Digital Image

Women Heat Up Soup Over Fire in a Hamburger Barrack Artworks

postwar version of F 38362