Language and utilisation of emergency care in Queensland

Objective: To compare access and utilisation of EDs in Queensland public hospitals between people who speak only English at home and those who speak another language at home. Methods: A retrospective analysis of a Queensland statewide hospital ED dataset (ED Information System) from 1 January 2008 to 31 December 2010 was conducted. Access to ED care was measured by the proportion of the state’s population attending EDs. Logistic regression analyses were performed to determine the relationships between ambulance use and language, and between hospital admission and language, both after adjusting for age, sex and triage category. Results: The ED utilisation rate was highest in English only speakers (290 per 1000 population), followed by Arabic speakers (105), and lowest among German speakers (30). Compared with English speakers, there were lower rates of ambulance use in Chinese (odds ratio 0.50, 95% confidence interval, 0.47–0.54), Vietnamese (0.87, 0.79–0.95), Arabic (0.87, 0.78–0.97), Spanish (0.56, 0.50–0.62), Italian (0.88, 0.80–0.96), Hindi (0.61, 0.53–0.70) and German (0.87, 0.79–0.90) speakers. Compared with English speakers, German speakers had higher admission rates (odds ratio 1.17, 95% confidence interval, 1.02–1.34), whereas there were lower admission rates in Chinese (0.90, 0.86–0.99), Arabic (0.76, 0.67–0.85) and Spanish (0.83, 0.75–0.93) speakers. Conclusion: This study showed that there was a significant association between lower utilisation of emergency care and speaking languages other than English at home. Further researches are needed using in-depth methodology to investigate if there are language barriers in accessing emergency care in Queensland.

Introduction to grounded theory

Grounded theory, first developed by Glaser and Strauss in the 1960s, was introduced into nursing education as a distinct research methodology in the 1970s. The theory is grounded in a critique of the dominant contemporary approach to social inquiry, which imposed "enduring" theoretical propositions onto study data. Rather than starting from a set theoretical framework, grounded theory relies on researchers distinguishing meaningful constructs from generated data and then identifying an appropriate theory. Grounded theory is thus particularly useful in investigating complex issues and behaviours not previously addressed and concepts and relationships in particular populations or places that are still undeveloped or weakly connected. Grounded theory data analysis processes include open, axial and selective coding levels. The purpose of this article was to explore the grounded theory research process and provide an initial understanding of this methodology.

A reliable real-time transport protocol for control systems over wireless networks

Deploying networked control systems (NCSs) over wireless networks is becoming more and more popular. However, the widely-used transport layer protocols, Transmission Control Protocol (TCP) and User Datagram Protocol (UDP), are not designed for real-time applications. Therefore, they may not be suitable for many NCS application scenarios because of their limitations on reliability and/or delay performance, which real-control systems concern. Considering a typical type of NCSs with periodic and sporadic real-time traffic, this paper proposes a highly reliable transport layer protocol featuring a packet loss-sensitive retransmission mechanism and a prioritized transmission mechanism. The packet loss-sensitive retransmission mechanism is designed to improve the reliability of all traffic flows. And the prioritized transmission mechanism offers differentiated services for periodic and sporadic flows. Simulation results show that the proposed protocol has better reliability than UDP and improved delay performance than TCP over wireless networks, particularly when channel errors and congestions occur.

Efficient route update and maintenance processes for multipath routing in large-scale industrial wireless sensor networks

Reliable communications is one of the major concerns in wireless sensor networks (WSNs). Multipath routing is an effective way to improve communication reliability in WSNs. However, most of existing multipath routing protocols for sensor networks are reactive and require dynamic route discovery. If there are many sensor nodes from a source to a destination, the route discovery process will create a long end-to-end transmission delay, which causes difficulties in some time-critical applications. To overcome this difficulty, the efficient route update and maintenance processes are proposed in this paper. It aims to limit the amount of routing overhead with two-tier routing architecture and introduce the combination of piggyback and trigger update to replace the periodic update process, which is the main source of unnecessary routing overhead. Simulations are carried out to demonstrate the effectiveness of the proposed processes in improvement of total amount of routing overhead over existing popular routing protocols.

STEM futures and practice, can we teach STEM in a more meaningful and integrated way?

Integrating Science, Technology, Engineering and Mathematics (STEM) subjects can be engaging for students, can promote problem-solving and critical thinking skills and can help build real-world connections. However, STEM has long been an area of some confusion for some educators. While they can see many of the conceptual links between the various domains of knowledge they often struggle to meaningfully integrate and simultaneously teach the content and methodologies of each these areas in a unified and effective way for their students. Essentially the question is;how can the content and processes of four disparate and yet integrated learning areas be taught at the same time? How can the integrity of each of the areas be maintained and yet be learnt in a way that is complementary? Often institutional barriers exitin schools and universities to the integration of STEM. Organizationally, at a departmental and administrative level, the teaching staff may be co-located, but when it comes to classroom practice or the teaching and learning of these areas they are usually taught very separately. They are usually taught in different kinds of spaces, in different ways (using different pedagogical approaches) and at different times. But is this the best way for students to engage with the STEM areas of learning? How can we make learning more integrated, meaningful and engaging for the students?

Systematics and biology of the iconic Australian scribbly gum moths Ogmograptis Meyrick (Lepidoptera: Bucculatricidae) and their unique insect-plant interaction

The larvae of particular Ogmograptis spp. produce distinctive scribbles on some smooth-barked Eucalyptus spp. which are a common feature on many ornamental and forest trees in Australia. However, although they are conspicuous in the environment the systematics and biology of the genus has been poorly studied. This has been addressed through detailed field and laboratory studies of their biology of three species (O. racemosa Horak sp. nov., O. fraxinoides Horak sp. nov., O. scribula Meyrick), in conjunction with a comprehensive taxonomic revision support by a molecular phylogeny utilising the mitochondrial Cox1 and nuclear 18S genes. In brief, eggs are laid in bark depressions and the first instar larvae bore into the bark to the level where the future cork cambium forms (the phellegen). Early instar larvae bore wide, arcing tracks in this layer before forming a tighter zig-zag shaped pattern. The second last instar turns and bores either closely parallel to the initial mine or doubles its width, along the zig-zag shaped mine. The final instar possesses legs and a spinneret (unlike the earlier instars) and feeds exclusively on callus tissue which forms within the zig-zag shaped mine formed by the previous instar, before emerging from the bark to pupate at the base of the tree. The scars of mines them become visible scribble following the shedding of bark. Sequence data confirm the placement of Ogmograptis within the Bucculatricidae, suggest that the larvae responsible for the ‘ghost scribbles’ (unpigmented, raised scars found on smooth-barked eucalypts) are members of the genus Tritymba, and support the morphology-based species groups proposed for Ogmograptis. The formerly monotypic genus Ogmograptis Meyrick is revised and divided into three species groups. Eleven new species are described: Ogmograptis fraxinoides Horak sp. nov., Ogmograptis racemosa Horak sp. nov. and Ogmograptis pilularis Horak sp. nov. forming the scribula group with Ogmograptis scribula Meyrick; Ogmograptis maxdayi Horak sp. nov., Ogmograptis barloworum Horak sp. nov., Ogmograptis paucidentatus Horak sp. nov., Ogmograptis rodens Horak sp. nov., Ogmograptis bignathifer Horak sp. nov. and Ogmograptis inornatus Horak sp. nov. as the maxdayi group; Ogmograptis bipunctatus Horak sp. nov., Ogmograptis pulcher Horak sp. nov., Ogmograptis triradiata (Turner) comb. nov. and Ogmograptis centrospila (Turner) comb. nov. as the triradiata group. Ogmograptis notosema (Meyrick) cannot be assigned to a species group as the holotype has not been located. Three unique synapomorphies, all derived from immatures, redefine the family Bucculatricidae, uniting Ogmograptis, Tritymba Meyrick (both Australian) and Leucoedemia Scoble & Scholtz (African) with Bucculatrix Zeller, which is the sister group of the southern hemisphere genera. The systematic history of Ogmograptis and the Bucculatricidae is discussed.

Exploring governance issues on collaborative contracts in the construction industry

This paper reports the findings of an in-depth literature review, which was designed as the first phase of a study that ultimately aims to rank the importance of key governance mechanisms on collaborative construction projects, in terms of impact on value-for-money. The absence of such information in the global knowledge base has prompted the current study. Seminal research completed recently concluded that deductive evidence with regard to the performance outcomes of collaborative procurement mechanisms is currently limited (Eriksson and Westerberg 2011). The authors aim to address this gap in current understanding. The literature review identifies key features of both formal and informal mechanisms which have been applied within collaborative contracting contexts. The literature review lays a solid foundation for designing a deductive research strategy to be implemented in the second phase of the study, which will employ a large-scale quantitative survey to shed light on the governance structures of collaborative contracts, and the ways in which they impact on realisation of VfM during project delivery in the Australian infrastructure industry. The current paper aims to identify the main categories of formal and informal governance mechanisms currently being employed globally. This will provide structure for the development of the survey in the second phase of the study.

Evidence supporting exercise interventions for persons in early-stage Alzheimer’s disease

The purpose of this article is to grade research evidence supporting exercise-based interventions for persons with early-stage dementias and to report the recommendations of a consensus panel. The search produced 11 data based articles testing the effects of exercise interventions on a variety of outcomes. The body of evidence to support exercise interventions in the prevention and treatment of Alzheimer’s disease is growing and has potential as a treatment modality following translational studies in recreation therapy and other fields.

An ensemble method for predicting subnuclear localizations from primary protein structures

Background Predicting protein subnuclear localization is a challenging problem. Some previous works based on non-sequence information including Gene Ontology annotations and kernel fusion have respective limitations. The aim of this work is twofold: one is to propose a novel individual feature extraction method; another is to develop an ensemble method to improve prediction performance using comprehensive information represented in the form of high dimensional feature vector obtained by 11 feature extraction methods. Methodology/Principal Findings A novel two-stage multiclass support vector machine is proposed to predict protein subnuclear localizations. It only considers those feature extraction methods based on amino acid classifications and physicochemical properties. In order to speed up our system, an automatic search method for the kernel parameter is used. The prediction performance of our method is evaluated on four datasets: Lei dataset, multi-localization dataset, SNL9 dataset and a new independent dataset. The overall accuracy of prediction for 6 localizations on Lei dataset is 75.2% and that for 9 localizations on SNL9 dataset is 72.1% in the leave-one-out cross validation, 71.7% for the multi-localization dataset and 69.8% for the new independent dataset, respectively. Comparisons with those existing methods show that our method performs better for both single-localization and multi-localization proteins and achieves more balanced sensitivities and specificities on large-size and small-size subcellular localizations. The overall accuracy improvements are 4.0% and 4.7% for single-localization proteins and 6.5% for multi-localization proteins. The reliability and stability of our classification model are further confirmed by permutation analysis. Conclusions It can be concluded that our method is effective and valuable for predicting protein subnuclear localizations. A web server has been designed to implement the proposed method. It is freely available at http://bioinformatics.awowshop.com/snlpr​ed_page.php.

Language affects length of stay in emergency departments in Queensland public hospitals

BACKGROUND: A long length of stay (LOS) in the emergency department (ED) associated with overcrowding has been found to adversely affect the quality of ED care. The objective of this study is to determine whether patients who speak a language other than English at home have a longer LOS in EDs compared to those whose speak only English at home. METHODS: A secondary data analysis of a Queensland state-wide hospital EDs dataset (Emergency Department Information System) was conducted for the period, 1 January 2008 to 31 December 2010. RESULTS: The interpreter requirement was the highest among Vietnamese speakers (23.1%) followed by Chinese (19.8%) and Arabic speakers (18.7%). There were significant differences in the distributions of the departure statuses among the language groups (Chi-squared=3236.88, P<0.001). Compared with English speakers, the Beta coeffi cient for the LOS in the EDs measured in minutes was among Vietnamese, 26.3 (95%CI: 22.1–30.5); Arabic, 10.3 (95%CI: 7.3–13.2); Spanish, 9.4 (95%CI: 7.1–11.7); Chinese, 8.6 (95%CI: 2.6–14.6); Hindi, 4.0 (95%CI: 2.2–5.7); Italian, 3.5 (95%CI: 1.6–5.4); and German, 2.7 (95%CI: 1.0–4.4). The fi nal regression model explained 17% of the variability in LOS. CONCLUSION: There is a close relationship between the language spoken at home and the LOS at EDs, indicating that language could be an important predictor of prolonged LOS in EDs and improving language services might reduce LOS and ease overcrowding in EDs in Queensland's public hospitals.

Assessing the overuse of antibiotics in children with URTIs in Saudi Arabia : development of the parental perception on antibiotics scale (PAPA scale)

Background: Antibiotic overuse is influenced by several factors that can only be measured using a valid and reliable psychosocial measurement instrument. This study aims to establish translation and early stage validation of an instrument recently developed by this research team to measure factors influencing the overuse of antibiotics in children with upper respiratory tract infections in Saudi Arabia. Method: The content evaluation panel was composed of area experts approached using the Delphi Technique. Experts were provided with the questionnaires iteratively, on a three-round basis until consensus on the relevance of items was reached independently. Translation was achieved by adapting Brislin’s model of translation. Results: After going through the iterative process with the experts, consensus was reached to 58 items (including demographics). Experts also pointed out some issues related to ambiguity and redundancy in some items. A final Arabic version was produced from the translation process. Conclusion: This study produced preliminary validation of the developed instrument from the experts’ contributions. Then, the instrument was translated from English to Arabic. The instrument will undergo further validation steps in the future, such as construct validity.

Improving the hydrogen gas sensing performance of Pt/MoO3 nanoplatelets using a nano thick layer of La2O3

In this paper, we present how a thin RF sputtered layer of lanthanum oxide (La2O3) can alter electrical and improve hydrogen gas sensing characteristics of Pt/molybdenum oxide (MoO3) nanostructures Schottky diodes. We derived the barrier height, ideality factor and dielectric constant from the measured I–V characteristics at operating temperatures in the range of 25–300 ◦C. The dynamic response, response and recovery times were obtained upon exposure to hydrogen gas at different concentrations. Analysis of the results indicated a substantial improvement to the voltage shift sensitivity of the sensors incorporating the La2O3 layer. We associate this enhancement to the formation of numerous trap states due to the presence of the La2O3 thin film on the MoO3 nanoplatelets. These trap states increase the intensity of the dipolar charges at the metal–semiconductor interface, which induce greater bending of the energy bands. However, results also indicate that the presence of La2O3 trap states also increases response and recover times as electrons trapping and de-trapping processes occur before they can pass through this thin dielectric layer.

Assessing the overuse of antibiotics in children in Saudi Arabia : validation of the parental perception on antibiotics scale (PAPA scale)

Background Antibiotics overuse is a global public health issue influenced by several factors, of which some are parent-related psychosocial factors that can only be measured using valid and reliable psychosocial measurement instruments. The PAPA scale was developed to measure these factors and the content validity of this instrument was assessed. Aim This study further validated the recently developed instrument in terms of (1) face validity and (2) construct validity including: deciding the number and nature of factors, and item selection. Methods Questionnaires were self-administered to parents of children between the ages of 0 and 12 years old. Parents were conveniently recruited from schools’ parental meetings in the Eastern Province, Saudi Arabia. Face validity was assessed with regards to questionnaire clarity and unambiguity. Construct validity and item selection processes were conducted using Exploratory factor analysis. Results Parallel analysis and Exploratory factor analysis using principal axis factoring produced six factors in the developed instrument: knowledge and beliefs, behaviours, sources of information, adherence, awareness about antibiotics resistance, and parents’ perception regarding doctors’ prescribing behaviours. Reliability was assessed (Cronbach’s alpha = 0.78) which demonstrates the instrument as being reliable. Conclusion The ‘factors’ produced in this study coincide with the constructs contextually identified in the development phase of other instruments used to study antibiotic use. However, no other study considering perceptions of antibiotic use had gone beyond content validation of such instruments. This study is the first to constructively validate the factors underlying perceptions regarding antibiotic use in any population and in parents in particular.