Growing demand for emergency health services in Queensland, Australia

Introduction: The demand for emergency health services (EHS), both in the prehospital (ambulance) and hospital (emergency departments) settings, is growing rapidly in Australia. Broader health system changes have reduced available health infrastructure, particularly hospital beds, resulting in reduced access to and congestion of the EHS as demonstrated by longer waiting times and ambulance “ramping”. Ambulance ramping occurring when patients have a prolonged wait on the emergency vehicle due to the unavailability of hospital beds. This presentation will outline the trends in EHS demand in Queensland compared with the rest of Australia and factors that appear to be contributing to the growth in demand. Methods: Secondary analysis was conducted using data from publicly available sources. Data from the Queensland Ambulance Service and Queensland Health Emergency Department Information System (EDIS) also were analyzed. Results: The demand for ambulance services and emergency departments has been increasing at 8% and 4% per year over the last decade, respectively; while accessible hospital beds have reduced by almost 10% contributing to the emergency department congestion and possibly contributing to the prehospital demand. While the increase in the proportion of the elderly population seems to explain a great deal of the demand for EHS, other factors also influence this growth including patient characteristics, institutional and societal factors, economic, EHS arrangements, and clinical factors. Conclusions: Overcrowding of facilities that provide EHS are causing considerable community concern. This overcrowding is caused by the growing demand and reduced access. The causes of this growing demand are complex, and require further detailed analysis in order to quantify and qualify these causes in order to provide a resilient foundation of evidence for future policy direction.

Mechanobiology of Bone Development and Computational Simulations

Bone is important because it provides the skeleton structural integrity and enables movement and locomotion. Its development and morphology follow its function. It adapts to changes of mechanical loading and has the ability to repair itself after damage or fracture. The processes of bone development, bone adaptation, and bone regeneration in fracture healing are regulated, in part, by mechanical stimuli that result when the bone is loaded.

Establishment of a preclinical ovine model for tibial segmental bone defect repair by applying bone tissue engineering strategies

Currently, well-established clinical therapeutic approaches for bone reconstruction are restricted to the transplantation of autografts and allografts, and the implantation of metal devices or ceramic-based implants to assist bone regeneration. Bone grafts possess osteoconductive and osteoinductive properties, however they are limited in access and availability and associated with donor site morbidity, haemorrhage, risk of infection, insufficient transplant integration, graft devitalisation, and subsequent resorption resulting in decreased mechanical stability. As a result, recent research focuses on the development of alternative therapeutic concepts. The field of tissue engineering has emerged as an important approach to bone regeneration. However, bench to bedside translations are still infrequent as the process towards approval by regulatory bodies is protracted and costly, requiring both comprehensive in vitro and in vivo studies. The subsequent gap between research and clinical translation, hence commercialization, is referred to as the ‘Valley of Death’ and describes a large number of projects and/or ventures that are ceased due to a lack of funding during the transition from product/technology development to regulatory approval and subsequently commercialization. One of the greatest difficulties in bridging the Valley of Death is to develop good manufacturing processes (GMP) and scalable designs and to apply these in pre-clinical studies. In this article, we describe part of the rationale and road map of how our multidisciplinary research team has approached the first steps to translate orthopaedic bone engineering from bench to bedside byestablishing a pre-clinical ovine critical-sized tibial segmental bone defect model and discuss our preliminary data relating to this decisive step.

Correspondence : lymphedema following breast cancer

Lymphedema—a chronic, disabling sequela of breast cancer treatment—is finally receiving the research attention it deserves. The work published by Norman et al1 in the January issue of Journal of Clinical Oncology supports the findings of this emerging literature, which demonstrates that lymphedema is common following breast cancer treatment, but that higher estimates are observed when self-report is used to assess lymphedema status compared with other measures such as circumferences, perometry, or bio-impedance spectroscopy. While Norman et al reported that the majority of cases occur within 2 years of diagnosis, work by us2 and others3 have demonstrated that the majority of cases (70% to 80%) occur within the first 12 months after diagnosis. Collectively, this work advocates for the measurement of lymphedema being included within routine presurgical and postsurgical care. However, until we know more about the effectiveness of lymphedema treatment, clinicians may remain skeptical about active screening for lymphedema.

Introducing Engineering Education in the Middle School

This paper first describes a new three-year, longitudinal project that is implementing engineering education in three middle schools in Australia (grade levels 7-9). This important domain is untapped in Australia. Hence, as a starting point, we conducted a context analysis to help situate engineering education in a school system. We report on this analysis with respect to findings from one of two literature-based surveys that gathered middle-school student responses in mathematics (n=172) and science (n=166) towards understanding their dispositions for engineering education. ANOVA indicated gender differences for 3 out of 23 items in both mathematics and science. In addition, the majority of students agreed or strongly agreed with 17 of the 23 survey items, however, there were some differences between mathematics and science. We conclude the paper with some recommendations for establishing engineering education in schools, including the development of partnerships among engineering and education faculties, school systems, and industry to develop contemporary engineering resources to support school-level mathematics, science, and technology.

Is Doctor Who Australian?

As part of an ARC Discovery project to write a history of Australian television from the point of view of audiences, I looked for Australian television fan communities. It transpired that the most productive communities exist around imported programming like the BBC’s Doctor Who. This program is an Australian television institution – and I was thus interested in finding out whether it should be included in an audience-centred history of Australian television. Research in archives of fan materials showed that the program has been made distinctively Australian through censorship and scheduling practices. There are uniquely Australian social practices built around it. Also, its very Britishness has become part of its being – in a sense - Australian. Through all of this, there is a clear awareness that this Australian institution originates somewhere else – that for these fans Australia is always secondary, relying on other countries to produce its myths for it, no matter how much it might reshape them.

Contemporary behavioural influences in an organisational setting and implications for intervention development

Professional drivers and safety Within the industrialised world, work-related crashes are the most common cause of work-related death, injury and reduced productivity (Charbotel et al., 2001; Toscano and Windau, 1994). Likewise in Australia, road crashes are the most common cause of work-related fatalities, injuries and absence from work (Haworth et al., 2000), with the average time lost being greater than any other workplace claim (Stewart-Bogle, 1999). There are obvious costs related to work crashes such as vehicle and property repair costs. There are also many hidden expenses including third party costs, workers compensation, medical costs, rehabilitation, customer-related costs, increased insurance premiums, administrative costs, legal fees and loss of productivity (Collingwood, 1997; Haworth et al, 2000).

When 'listeners can't talk' : comparing active listening in opening sequences of telephone and online counselling

While there is growing use of online counselling, little is known about its interactional organisation and how it compares to telephone counselling. This is despite past research suggesting that both counsellors and clients report the impact of the different modalities on the presentation and management of the counselling interaction. This paper compares the interactional affordances of telephone and online web counselling in opening sequences on Kids Help Line, a 24-hour Australian counselling service for children and young people up to the age of 25. We examine two ways that counsellors show active listening through response tokens and formulations. The analysis describes how counsellors’ use of minimal response tokens facilitate the clients’ problem presentation and are used in the management of turn taking and sequence organisation. For example, counsellors use the response token Mm hm to show that they understand that the client’s unit of talk to is not yet complete, and to affirm or invite the client to continue speaking. Formulations in phone and web counselling are another way that counsellors display active listening to re-present stretches of the clients’ preceding talk. In phone and web counselling, however, the respective modalities can complicate matters of turn transition and sequence organisation. By examining actual phone and online counselling sessions, this paper offers empirical demonstrations of the interactional affordances of phone and online counselling, and shows how the institutional practice of active listening is accomplished across different counselling modalities

Analysing preservice teachers' potential for implementing engineering education in the middle school

Engineering is pivotal to any country's development. Yet there are insufficient engineers to take up available positions in many countries, including Australia (Engineers Australia, 2008). Engineering education is limited in Australia at the primary, middle and high school levels. One of the starting points for addressing this shortfall lies in preservice teacher education. This study explores second-year preservice teachers' potential to teach engineering in middle school, following their engagement with engineering concepts in their science curriculum unit and their teaching of engineering activities to Year 7 students. Using a literature-based pretest-posttest survey, items were categorised into four constructs (ie. personal professional attributes, student motivation, pedagogical knowledge and fused curricula). Results indicated that the preservice teachers' responses had not changed for instilling positive attitudes (88%) and accepting advice from colleagues (94%). However, there was statistical significance with 9 of the 25 survey items (p<0.05) after the preservice teachers' involvement in engineering activities. Fusing engineering education with other subjects, such as mathematics and science, is an essential first step in promoting preservice teachers' potential to implement engineering education in the middle school.

Mining Negative Relevance Feedback for Information Filtering

It is a big challenge to clearly identify the boundary between positive and negative streams. Several attempts have used negative feedback to solve this challenge; however, there are two issues for using negative relevance feedback to improve the effectiveness of information filtering. The first one is how to select constructive negative samples in order to reduce the space of negative documents. The second issue is how to decide noisy extracted features that should be updated based on the selected negative samples. This paper proposes a pattern mining based approach to select some offenders from the negative documents, where an offender can be used to reduce the side effects of noisy features. It also classifies extracted features (i.e., terms) into three categories: positive specific terms, general terms, and negative specific terms. In this way, multiple revising strategies can be used to update extracted features. An iterative learning algorithm is also proposed to implement this approach on RCV1, and substantial experiments show that the proposed approach achieves encouraging performance.

An effective model of using negative relevance feedback for information filtering

Over the years, people have often held the hypothesis that negative feedback should be very useful for largely improving the performance of information filtering systems; however, we have not obtained very effective models to support this hypothesis. This paper, proposes an effective model that use negative relevance feedback based on a pattern mining approach to improve extracted features. This study focuses on two main issues of using negative relevance feedback: the selection of constructive negative examples to reduce the space of negative examples; and the revision of existing features based on the selected negative examples. The former selects some offender documents, where offender documents are negative documents that are most likely to be classified in the positive group. The later groups the extracted features into three groups: the positive specific category, general category and negative specific category to easily update the weight. An iterative algorithm is also proposed to implement this approach on RCV1 data collections, and substantial experiments show that the proposed approach achieves encouraging performance.

State-of-the-Art Review on Opinion Mining from Online Customers’ Feedback

Dealing with the ever-growing information overload in the Internet, Recommender Systems are widely used online to suggest potential customers item they may like or find useful. Collaborative Filtering is the most popular techniques for Recommender Systems which collects opinions from customers in the form of ratings on items, services or service providers. In addition to the customer rating about a service provider, there is also a good number of online customer feedback information available over the Internet as customer reviews, comments, newsgroups post, discussion forums or blogs which is collectively called user generated contents. This information can be used to generate the public reputation of the service providers’. To do this, data mining techniques, specially recently emerged opinion mining could be a useful tool. In this paper we present a state of the art review of Opinion Mining from online customer feedback. We critically evaluate the existing work and expose cutting edge area of interest in opinion mining. We also classify the approaches taken by different researchers into several categories and sub-categories. Each of those steps is analyzed with their strength and limitations in this paper.

Mixing colours: An ICT tool based on a semiotic framework for mathematical meaning-makng about ratio and fractions

This paper reports on the research and development of an ICT tool to facilitate the learning of ratio and fractions by adult prisoners. The design of the ICT tool was informed by a semiotic framework for mathematical meaning-making. The ICT tool thus employed multiple semiotic resources including topological, typological, and social-actional resources. The results showed that individual semiotic resource could only represent part of the mathematical concept, while at the same time it might signify something else to create a misconception. When multiple semiotic resources were utilised the mathematical ideas could be better learnt.

Air Gondwana : Using ICT to create an authentic learning environment to teach basic negotiation skills

In recent years greater emphasis has been placed by many Law Schools on teaching not only the substantive content of the law but also the skills needed for the practice of the law. Negotiation is one such skill. However, effective teaching of negotiation may be problematic in the context of large numbers of students studying in a variety of modes and often juggling other time commitments. This paper examines the Air Gondwana program, a blended learning environment designed to address these challenges. The program demonstrates that ICT can be used to create an authentic learning experience which engages and stimulates students.

How does ambulance service utilisation impact demand for Emergency Departments in Queensland, Australia?

Background: There are indications that pre-hospital emergency care and management of patients can help reduce the demand for hospital emergency departments (EDs). Ambulance services play a significant role at this stage of care. In 2003, the Queensland Government introduced a Community Ambulance Cover (CAC) levy in return for a free ambulance service at the point of access to all Queenslanders. This may have led to the impression in consumers of an entitlement to free ambulance services under any circumstances regardless of the urgency of the matter which may have in turn contributed to the crowding of EDs in Queensland. Objectives: This paper aims to answer the following questions: - How many patients arrive at hospital EDs by ambulance in Queensland, compared to other modes of arrival? - How has this changed over time, particularly after the CAC introduction in 2003? What percentage of ambulance arrivals are urgent ED patients? - Has the perceived free ambulance services created extra demand for EDs in Queensland, compared with other Australian jurisdictions that charge patients for ambulance services? Methods: We will secondary analyse the data from sources such as Queensland Ambulance Services, Department of Health and Australian Bureau of Statistics to answer the research questions. Findings and Conclusions Queensland has the highest utilization rate of ambulance services (about 18% in 2007-08) and the highest annual growth rate in demand for these services (7.7% on average since 2000-01), well above the population growth. On the other hand, the proportion of ED patients arriving by ambulance in Queensland has increased by about 4% annually. However, when compared with other states and territories with charge at the point of access, it seems that the growth in demand for EDs cannot be explained solely or mainly by CAC or ambulance utilisation in Queensland.