Beyond the hospital door : a retrospective, cohort study of associations between birthing in the public or private sector and women’s postpartum care

Background In Australia, maternity care is available through universal coverage and a parallel, competitive private health insurance system. Differences between sectors in antenatal and intrapartum care and associated outcomes are well documented but few studies have investigated differences in postpartum care following hospital discharge and their impact on maternal satisfaction and confidence. Methods Women who birthed in Queensland, Australia from February to May 2010 were mailed a self-report survey 4 months postpartum. Regression analysis was used to determine associations between sector of birth and postpartum care, and whether postpartum care experiences explained sector differences in postpartum well-being (satisfaction, parenting confidence and feeling depressed). Results Women who birthed in the public sector had higher odds of health professional contact in the first 10 days post-discharge and satisfaction with the amount of postpartum care. After adjusting for demographic and postpartum contact variables, sector of birth no longer had an impact on satisfaction (AOR 0.95, 99% CI 0.78-1.31), but any form of health professional contact did. Women who had a care provider’s 24 hour contact details had higher odds of being satisfied (AOR 3.64, 95% CI 3.00-4.42) and confident (AOR 1.34, 95% CI 1.08- 1.65). Conclusion Women who birthed in the public sector appeared more satisfied because they had higher odds of receiving contact from a health professional within 10 days post-discharge. All women should have an opportunity to speak to and/or see a doctor, midwife or nurse in the first 10 days at home, and the details of a person they can contact 24 hours a day.

Assessing driver acceptance of intelligent transport systems in the context of railway level crossings

Intelligent Transport Systems (ITS) have the potential to substantially reduce the number of crashes caused by human errors at railway levels crossings. Such systems, however, will only exert an influence on driving behaviour if they are accepted by the driver. This study aimed at assessing driver acceptance of different ITS interventions designed to enhance driver behaviour at railway crossings. Fifty eight participants, divided into three groups, took part in a driving simulator study in which three ITS devices were tested: an in-vehicle visual ITS, an in-vehicle audio ITS, and an on-road valet system. Driver acceptance of each ITS intervention was assessed in a questionnaire guided by the Technology Acceptance Model and the Theory of Planned Behaviour. Overall, results indicated that the strongest intentions to use the ITS devices belonged to participants exposed to the road-based valet system at passive crossings. The utility of both models in explaining drivers’ intention to use the systems is discussed, with results showing greater support for the Theory of Planned Behaviour. Directions for future studies, along with strategies that target attitudes and subjective norms to increase drivers’ behavioural intentions, are also discussed.

Synthetic rating system for railway bridge management

This thesis developed a condition assessment and rating method to identify those bridges in a network which are in most need of repair for an effective life cycle management. The method estimates the contribution of critical factors towards bridge deterioration and uses structural analysis to overcome the subjectivity of traditional current condition assessment methods. This research was a part of the CRC project titled 'Life Cycle Management of Railway Bridges'. Efficient usage of resources and enhancing the safety and serviceability of railway bridges are the significant outcomes of using the proposed method.

From the bush to the burbs : a comparison of driver situation awareness at rural and urban railway level crossings

The problem of collisions between road users and trains at rail level crossings (RLXs) remains resistant to current countermeasures. One factor underpinning these collisions is poor Situation Awareness (SA) on behalf of the road user involved (i.e. not being aware of an approaching train). Although this is a potential threat at any RLX, the factors influencing SA may differ depending on whether the RLX is located in a rural or urban road environment. Despite this, there has been no empirical investigation regarding how road user SA might differ across distinct RLX environments. This knowledge is needed to establish the extent to which a uniform approach to RLX design and safety is acceptable. The aim of this paper is to investigate the differences in driver SA at rural versus urban RLXs. We present analyses of driver SA in both rural and urban RLX environments based on two recent on-road studies undertaken in Victoria, Melbourne. The findings demonstrate that driver SA is markedly different at rural and urban RLXs, and also that poor SA regarding approaching trains may be caused by different factors. The implications for RLX design and safety are discussed.

Associations between early shared music activities in the home and later child outcomes : findings from the Longitudinal Study of Australian Children

The benefits of early shared book reading between parents and children have long been established,yet the same cannot be said for early shared music activities in the home. This study investigated the parent–child home music activities in a sample of 3031 Australian children participating in Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC) study. Frequency of shared home music activities was reported by parents when children were 2–3 years and a range of social, emotional,and cognitive outcomes were measured by parent and teacher report and direct testing two years later when children were 4–5 years old. A series of regression analyses (controlling for a set of important socio-demographic variables) found frequency of shared home music activities to have a small significant partial association with measures of children’s vocabulary, numeracy, attentional and emotional regulation, and prosocial skills. We then included both book reading and shared home music activities in the same models and found that frequency of shared home music activities maintained small partial associations with measures of prosocial skills, attentional regulation, and numeracy. Our findings suggest there may be a role for parent-child home music activities in supporting children’s development.

Multi-objective models and techniques for analysing the absolute capacity of railway networks

Railway capacity determination and expansion are very important topics. In prior research, the competition between different entities such as train services and train types, on different network corridors however have been ignored, poorly modelled, or else assumed to be static. In response, a comprehensive set of multi-objective models have been formulated in this article to perform a trade-off analysis. These models determine the total absolute capacity of railway networks as the most equitable solution according to a clearly defined set of competing objectives. The models also perform a sensitivity analysis of capacity with respect to those competing objectives. The models have been extensively tested on a case study and their significant worth is shown. The models were solved using a variety of techniques however an adaptive E constraint method was shown to be most superior. In order to identify only the best solution, a Simulated Annealing meta-heuristic was implemented and tested. However a linearization technique based upon separable programming was also developed and shown to be superior in terms of solution quality but far less in terms of computational time.

Associations between ghrelin and ghrelin receptor polymorphisms and cancer in Caucasian populations: A meta-analysis

Background There is growing evidence that the ghrelin axis, including ghrelin (GHRL) and its receptor, the growth hormone secretagogue receptor (GHSR), play a role in cancer progression. Ghrelin gene and ghrelin receptor gene polymorphisms have been reported to have a range of effects in cancer, from increased risk, to protection from cancer, or having no association. In this study we aimed to clarify the role of ghrelin and ghrelin receptor polymorphisms in cancer by performing a meta-analysis of published case–control studies. We conducted searches of the literature published up to January 2013 in MEDLINE using the PubMed search engine. Individual data on 8,430 cases and 14,008 controls from six case–control studies of an all Caucasian population were evaluated for three ghrelin gene (GHRL; rs696217, rs4684677, rs2075356) and one ghrelin receptor (GHSR; rs572169) polymorphism in breast cancer, esophageal cancer, colorectal cancer and non-Hodgkins lymphoma. Results In the overall analysis, homozygous and recessive associations indicated that the minor alleles of rs696217 and rs2075356 GHRL polymorphisms conferred reduced cancer risk (odds ratio [OR] 0.61-0.78). The risk was unchanged for breast cancer patients when analysed separately (OR 0.73-0.83). In contrast, the rs4684677 GHRL and the rs572169 GHSR polymorphisms conferred increased breast cancer risk (OR 1.97-1.98, p = 0.08 and OR 1.42-1.43, p = 0.08, respectively). All dominant and co-dominant effects showed null effects (OR 0.96-1.05), except for the rs572169 co-dominant effect, with borderline increased risk (OR 1.08, p = 0.05). Conclusions This study suggests that the rs696217 and rs2075356 ghrelin gene (GHRL) polymorphisms may protect carriers against breast cancer, and the rs4684677 GHRL and rs572169 GHSR polymorphisms may increase the risk among carriers. In addition, larger studies are required to confirm these findings.

Tracking locomotive position to evaluate sugarcane railway schedules and predict arrival time

This research utilised software developed for managing the Australian sugar industry's cane rail transport operations and GPS data used to track locomotives to ensure safe operation of the railway system to improve transport operations. As a result, time usage in the sugarcane railway can now be summarised and locomotive arrival time to sidings and mills can be predicted. This information will help the development of more efficient run schedules and enable mill staff and harvesters to better plan their shifts ahead, enabling cost reductions through better use of available time.

Numerical simulation of railway track supporting system using finite-infinite and thin layer elements under impulsive loads

The present study deals with two dimensional, numerical simulation of railway track supporting system subjected to dynamic excitation force. Under plane strain condition, the coupled finite-infinite elements to represent the near and far field stress distribution and thin layer interface element was employed to model the interfacial behavior between sleepers and ballast. To account for the relative debonding, slipping and crushing that could take place in the contact area between the sleepers and ballast, modified Mohr-Coulomb criterion was adopted. Furthermore an attempt has been made to consider the elasto-plastic material non-linearity of the railway track supporting media by employing different constitutive models to represent steel, concrete and supporting materials. Based on the proposed physical and constitutive modeling a code has been developed for dynamic loads. The applicability of the developed F.E code has been demonstrated by analyzing a real railway supporting structure.

Numerical modeling of railway track supporting system using finite–infinite and thin layer elements

The present contribution deals with the numerical modelling of railway track-supporting systems-using coupled finite-infinite elements-to represent the near and distant field stress distribution, and also employing a thin layer interface element to account for the interfacial behaviour between sleepers and ballast. To simulate the relative debonding, slipping and crushing at the contact area between sleepers and ballast, a modified Mohr-Coulomb criterion was adopted. Further more an attempt was made to consider the elasto plastic materials’ non-linearity of the railway track supporting media by employing different constitutive models to represent steel, concrete and other supporting materials. It is seen that during an incremental-iterative mode of load application, the yielding initially started from the edge of the sleepers and then flowed vertically downwards and spread towards the centre of the railway supporting system.

Driver’s behavioural changes with new Intelligent Transport System interventions at railway level crossings: A driving simulator study

Improving safety at railway level crossings is an important issue for the Australian transport system. Governments, the rail industry and road organisations have tried a variety of countermeasures for many years to improve railway level crossing safety. New types of Intelligent Transport System (ITS) interventions are now emerging due to the availability and the affordability of technology. These interventions target both actively and passively protected railway level crossings and attempt to address drivers’ errors at railway crossings, which are mainly a failure to detect the crossing or the train and misjudgement of the train approach speed and distance. This study aims to assess the effectiveness of three emerging ITS that the rail industry considers implementing in Australia: a visual in-vehicle ITS, an audio in-vehicle ITS, as well as an on-road flashing beacons intervention. The evaluation was conducted on an advanced driving simulator with 20 participants per trialled technology, each participant driving once without any technology and once with one of the ITS interventions. Every participant drove through a range of active and passive crossings with and without trains approaching. Their speed approach of the crossing, head movements and stopping compliance were measured. Results showed that driver behaviour was changed with the three ITS interventions at passive crossings, while limited effects were found at active crossings, even with reduced visibility. The on-road intervention trialled was unsuccessful in improving driver behaviour; the audio and visual ITS improved driver behaviour when a train was approaching. A trend toward worsening driver behaviour with the visual ITS was observed when no trains were approaching. This trend was not observed for the audio ITS intervention, which appears to be the ITS intervention with the highest potential for improving safety at passive crossings.

Driving simulator evaluation of the failure of an audio in-vehicle warning for railway level crossings

It is impracticable to upgrade the 18,900 Australian passive crossings as such crossings are often located in remote areas, where power is lacking and with low road and rail traffic. The rail industry is interested in developing innovative in-vehicle technology interventions to warn motorists of approaching trains directly in their vehicles. The objective of this study was therefore to evaluate the benefits of the introduction of such technology. We evaluated the changes in driver performance once the technology is enabled and functioning correctly, as well as the effects of an unsafe failure of the technology? We conducted a driving simulator study where participants (N=15) were familiarised with an in-vehicle audio warning for an extended period. After being familiarised with the system, the technology started failing, and we tested the reaction of drivers with a train approaching. This study has shown that with the traditional passive crossings with RX2 signage, the majority of drivers complied (70%) and looked for trains on both sides of the rail track. With the introduction of the in-vehicle audio message, drivers did not approach crossings faster, did not reduce their safety margins and did not reduce their gaze towards the rail tracks. However participants’ compliance at the stop sign decreased by 16.5% with the technology installed in the vehicle. The effect of the failure of the in-vehicle audio warning technology showed that most participants did not experience difficulties in detecting the approaching train even though they did not receive any warning message. This showed that participants were still actively looking for trains with the system in their vehicle. However, two participants did not stop and one decided to beat the train when they did not receive the audio message, suggesting potential human factors issues to be considered with such technology.

A simulator evaluation of effects of assistive technologies on driver cognitive load at railway level crossings

Intelligent Transport Systems (ITS) have the potential to substantially reduce the number of crashes caused by human errors at railway levels crossings. However, such systems could overwhelm drivers, generate different types of driver errors and have negative effects on safety at level crossing. The literature shows an increasing interest for new ITS for increasing driver situational awareness at level crossings, as well as evaluations of such new systems on compliance. To our knowledge, the potential negative effects of such technologies have not been comprehensively evaluated yet. This study aimed at assessing the effect of different ITS interventions, designed to enhance driver behaviour at railway crossings, on driver’s cognitive loads. Fifty eight participants took part in a driving simulator study in which three ITS devices were tested: an in-vehicle visual ITS, an in-vehicle audio ITS, and an on-road valet system. Driver cognitive load was objectively and subjectively assessed for each ITS intervention. Objective data were collected from a heart rate monitor and an eye tracker, while subjective data was collected with the NASA-TLX questionnaire. Overall, results indicated that the three trialled technologies did not result in significant changes in cognitive load while approaching crossings.