Comparative effectiveness of population interventions to improve access to reperfusion for ST-segment–elevation myocardial infarction in Australia

Background Improving timely access to reperfusion is a major goal of ST-segment–elevation myocardial infarction care. We sought to compare the population impact of interventions proposed to improve timely access to reperfusion therapy in Australia. Methods and Results Australian hospitals, population, and road network data were integrated using Geographical Information Systems. Hospitals were classified into those that provided primary percutaneous coronary intervention (PPCI) or fibrinolysis. Population impact of interventions proposed to improve timely access to reperfusion (PPCI, fibrinolysis, or both) were modeled and compared. Timely access to reperfusion was defined as the proportion of the population capable of reaching a fibrinolysis facility ≤60 minutes or a PPCI facility ≤120 minutes from emergency medical services activation. The majority (93.2%) of the Australian population has timely access to reperfusion, mainly (53%) through fibrinolysis. Only 40.2% of the population had timely access to PPCI, and access to PPCI services is particularly limited in regional and nonexistent in remote areas. Optimizing the emergency medical services’ response or increasing PPCI services resulted in marginal improvement in timely access (1.8% and 3.7%, respectively). Direct transport to PPCI facilities and interhospital transfer for PPCI improves timely access to PPCI for 19.4% and 23.5% of the population, respectively. Prehospital fibrinolysis markedly improved access to timely reperfusion in regional and remote Australia. Conclusions Significant gaps in timely provision of reperfusion remain in Australia. Systematic implementation of changes in service delivery has potential to improve timely access to PPCI for a majority of the population and improve access to fibrinolysis to those living in regional and remote areas.

Practical physical activity measurement in youth : a review of contemporary approaches

Background: The accurate evaluation of physical activity levels amongst youth is critical for quantifying physical activity behaviors and evaluating the effect of physical activity interventions. The purpose of this review is to evaluate contemporary approaches to physical activity evaluation amongst youth. Data sources: The literature from a range of sources was reviewed and synthesized to provide an overview of contemporary approaches for measuring youth physical activity. Results: Five broad categories are described: self-report, instrumental movement detection, biological approaches, direct observation, and combined methods. Emerging technologies and priorities for future research are also identified. Conclusions: There will always be a trade-off between accuracy and available resources when choosing the best approach for measuring physical activity amongst youth. Unfortunately, cost and logistical challenges may prohibit the use of "gold standard" physical activity measurement approaches such as doubly labelled water. Other objective methods such as heart rate monitoring, accelerometry, pedometry, indirect calorimetry, or a combination of measures have the potential to better capture the duration and intensity of physical activity, while self-reported measures are useful for capturing the type and context of activity.

Approaches to learning information literacy : a phenomenographic study

This paper reports on an empirical study that explores the ways students approach learning to find and use information. Based on interviews with 15 education students in an Australian university, this study uses phenomenography as its methodological and theoretical basis. The study reveals that students use three main strategies for learning information literacy: 1) learning by doing; 2) learning by trial and error; and 3) learning by interacting with other people. Understanding the different ways that students approach learning information literacy will assist librarians and faculty to design and provide more effective information literacy education.

Empirical evaluation of alternative approaches in identifying crash hot spots

This study proposes a framework of a model-based hot spot identification method by applying full Bayes (FB) technique. In comparison with the state-of-the-art approach [i.e., empirical Bayes method (EB)], the advantage of the FB method is the capability to seamlessly integrate prior information and all available data into posterior distributions on which various ranking criteria could be based. With intersection crash data collected in Singapore, an empirical analysis was conducted to evaluate the following six approaches for hot spot identification: (a) naive ranking using raw crash data, (b) standard EB ranking, (c) FB ranking using a Poisson-gamma model, (d) FB ranking using a Poisson-lognormal model, (e) FB ranking using a hierarchical Poisson model, and (f) FB ranking using a hierarchical Poisson (AR-1) model. The results show that (a) when using the expected crash rate-related decision parameters, all model-based approaches perform significantly better in safety ranking than does the naive ranking method, and (b) the FB approach using hierarchical models significantly outperforms the standard EB approach in correctly identifying hazardous sites.

Responsibilisation and Rights: Explorations in Comparative Youth Criminology

Studies of international youth justice, punishment and control are in their infancy but the issues of globalisation, transnationalisation, policy transfer and localisation are gradually being addressed. There also appears a growing demand in policy and pressure group circles in the UK to learn more about other jurisdictions in order to emulate ‘best practice’ and avoid the worst excesses of punitive populism. However, existing comparative work in this area rarely ventures much beyond country specific descriptions of historical development, powers and procedures. Statistical comparisons – predominantly of custody rates – are becoming more sophisticated but remain beset with problems of partial and inaccurate data collection. The extent to which different countries do things differently, and how and why such difference is maintained, remains a relatively unexcavated territory. This article suggests a conceptually comparative framework in which degrees of international, national and local convergence and divergence can begin to be revealed and assessed.

Illusions of Difference: Comparative Youth Justice in the Devolved UK

Surprisingly, there has been little or no systematic research to date that has explored the significance of UK devolution for youth justice policy and practice. This article explores the extent of differential justice in the United Kingdom, particularly as it is expressed in the myriad action plans, criminal justice reviews, frameworks for action, delivery plans and offending strategies that have surfaced since 1998. In particular, the article considers how far policy convergence and divergence are reflected through the discourses of risk, welfare, restoration and children's rights in the four administrations of England, Scotland, Wales and Northern Ireland. For comparative criminology, the United Kingdom offers a unique opportunity to explore how international and national pressures towards convergence and/or divergence can be challenged, rebranded, versioned, adapted or resisted at sub-national and local levels.

Teaching and assessing critical thinking : the interaction of student approaches to learning and teaching approaches

This study explored the relationship among student approaches to learning and teaching methods on critical thinking in two business units. Key findings included differences in critical thinking scores between student approaches to learning and some evidence of an interaction between student approaches to learning and critical thinking teach method (immersion vs. infusion). Possible explanations for the results are examined and implications for developing critical thinking skills across a degree discussed. What is apparent is that as Universities move towards program-wide level assessment of critical thinking, further work is required in terms of the design of critical thinking teaching interventions and assessment at the unit, school, and degree level. The session will discuss the challenges in developing critical thinking programs in individual units and at the Faculty level.

Health status and use of health services among recently arrived men with refugee backgrounds: A comparative analysis of urban and regional settlement in South-east Queensland

Approximately one-third of refugee and humanitarian entrants to Australia are adult men. Many of these men and their families settle in regional areas. Little is known about the health status of refugee men and the use of health services, and whether or not there are differences between those living in urban and regional areas. This paper reports on the cross-sectional differences in health status and use of health services among a group of 233 recently arrived refugee men living in urban and regional areas of South-east Queensland. Overall, participants reported good levels of subjective health status, moderate to good levels of well-being, and low prevalence of mental illness. Men living in urban areas were more likely to have a longstanding illness and report poorer health status than those settled in regional areas. In contrast, men living in regional areas reported poorer levels of well-being in the environment domain and were more likely to visit hospital emergency departments. Targeted health promotion programs will ensure that refugee men remain healthy and develop their full potential as members of the Australian community. Programs that facilitate refugees’ access to primary health care in regional areas may promote more appropriate use of hospital emergency departments by these communities.