Demand for public hospital emergency department services in Australia : 2000–2001 to 2009–2010

Objective: Hospital EDs are a significant and high-profile component of Australia’s health-care system, which in recent years have experienced considerable crowding. This crowding is caused by the combination of increasing demand, throughput and output factors. The aim of the present article is to clarify trends in the use of public ED services across Australia with a view to providing an evidence basis for future policy analysis and discussion. Methods: The data for the present article have been extracted, compiled and analysed from publicly available sources for a 10 year period between 2000–2001 and 2009–2010. Results: Demand for public ED care increased by 37% over the decade, an average annual increase of 1.8% in the utilization rate per 1000 persons. There were significant differences in utilization rates and in trends in growth among states and territories that do not easily relate to general population trends alone. Conclusions: This growth in demand exceeds general population growth, and the variability between states both in utilization rates and overall trends defies immediate explanation. The growth in demand for ED services is a partial contributor to the crowding being experienced in EDs across Australia. There is a need for more detailed study, including qualitative analysis of patient motivations in order to identify the factors driving this growth in demand.

Pre-clinical evaluation of amphiphilic silicone oligomers for scar remediation

The formation of hypertrophic scars is a frequent outcome of wound repair and often requires further therapy with treatments such as silicone gel sheets (SGS; Perkins et al., 1983). Although widely used, knowledge regarding SGS and their mechanism of action on hypertrophic scars is limited. Furthermore, SGS require consistent application for at least twelve hours a day for up to twelve consecutive months, beginning as soon as wound reepithelialisation has occurred. Preliminary research at QUT has shown that some species of silicone present in SGS have the ability to permeate into collagen gel skin mimetics upon exposure. An analogue of these species, GP226, was found to decrease both collagen synthesis and the total amount of collagen present following exposure to cultures of cells derived from hypertrophic scars. This silicone of interest was a crude mixture of silicone species, which resolved into five fractions of different molecular weight. These five fractions were found to have differing effects on collagen synthesis and cell viability following exposure to fibroblasts derived from hypertrophic scars (HSF), keloid scars (KF) and normal skin (nHSF and nKF). The research performed herein continues to further assess the potential of GP226 and its fractions for scar remediation by determining in more detail its effects on HSF, KF, nHSF, nKF and human keratinocytes (HK) in terms of cell viability and proliferation at various time points. Through these studies it was revealed that Fraction IV was the most active fraction as it induced a reduction in cell viability and proliferation most similar to that observed with GP226. Cells undergoing apoptosis were also detected in HSF cultures exposed to GP226 and Fraction IV using the Tunel assay (Roche). These investigations were difficult to pursue further as the fractionation process used for GP226 was labour-intensive and time inefficient. Therefore a number of silicones with similar structure to Fraction IV were synthesised and screened for their effect following application to HSF and nHSF. PDMS7-g-PEG7, a silicone-PEG copolymer of low molecular weight and low hydrophilic-lipophilic balance factor, was found to be the most effective at reducing cell proliferation and inducing apoptosis in cultures of HSF, nHSF and HK. Further studies investigated gene expression through microarray and superarray techniques and demonstrated that many genes are differentially expressed in HSF following treatment with GP226, Fraction IV and PDMS7-g-PEG7. In brief, it was demonstrated that genes for TGFβ1 and TNF are not differentially regulated while genes for AIFM2, IL8, NSMAF, SMAD7, TRAF3 and IGF2R show increased expression (>1.8 fold change) following treatment with PDMS7-g-PEG7. In addition, genes for αSMA, TRAF2, COL1A1 and COL3A1 have decreased expression (>-1.8 fold change) following treatment with GP226, Fraction IV and PDMS7-g-PEG7. The data obtained suggest that many different pathways related to apoptosis and collagen synthesis are affected in HSF following exposure to PDMS7-g-PEG7. The significance is that silicone-PEG copolymers, such as GP226, Fraction IV and PDMS7-g-PEG7, could potentially be a non-invasive substitute to apoptosis-inducing chemical agents that are currently used as scar treatments. It is anticipated that these findings will ultimately contribute to the development of a novel scar therapy with faster action and improved outcomes for patients suffering from hypertrophic scars.

Communications and learning structures that facilitate transfer of knowledge at innovation transition points

Innovation processes are rarely smooth and disruptions often occur at transition points were one knowledge domain passes the technology on to another domain. At these transition points communication is a key component in assisting the smooth hand over of technologies. However for smooth transitions to occur we argue that appropriate structures have to be in place and boundary spanning activities need to be facilitated. This paper presents three case studies of innovation processes and the findings support the view that structures and boundary spanning are essential for smooth transitions. We have explained the need to pass primary responsibility between agents to successfully bring an innovation to market. We have also shown the need to combine knowledge through effective communication so that absorptive capacity is built in process throughout the organisation rather than in one or two key individuals.

Feature-based visual odometry and featureless place recognition for SLAM in 2.5D environments

In this paper we present a novel algorithm for localization during navigation that performs matching over local image sequences. Instead of calculating the single location most likely to correspond to a current visual scene, the approach finds candidate matching locations within every section (subroute) of all learned routes. Through this approach, we reduce the demands upon the image processing front-end, requiring it to only be able to correctly pick the best matching image from within a short local image sequence, rather than globally. We applied this algorithm to a challenging downhill mountain biking visual dataset where there was significant perceptual or environment change between repeated traverses of the environment, and compared performance to applying the feature-based algorithm FAB-MAP. The results demonstrate the potential for localization using visual sequences, even when there are no visual features that can be reliably detected.

Designerly analysis of a socio-physical design activity

The Making Design and Analysing Interaction track at the Participatory Innovation Conference calls for submissions from ‘Makers’ who will contribute examples of participatory innovation activities documented in video and ‘Analysts’ who will analyse those examples of participatory innovation activity. The aim of this paper is to open up for a discussion within the format of the track of the roles that designers could play in analysing the participatory innovation activities of others and to provide a starting point for this discussion through a concrete example of such ‘designerly analysis’. Designerly analysis opens new analytic frames for understanding participatory innovation and contributes to our understanding of design activities.

Modeling player-like behaviour for game Al design

The design of artificial intelligence in computer games is an important component of a player's game play experience. As games are becoming more life-like and interactive, the need for more realistic game AI will increase. This is particularly the case with respect to AI that simulates how human players act, behave and make decisions. The purpose of this research is to establish a model of player-like behavior that may be effectively used to inform the design of artificial intelligence to more accurately mimic a player's decision making process. The research uses a qualitative analysis of player opinions and reactions while playing a first person shooter video game, with recordings of their in game actions, speech and facial characteristics. The initial studies provide player data that has been used to design a model of how a player behaves.

Stomp : an interactive platform for people with intellectual disabilities

For people with intellectual disabilities there are significant barriers to inclusion in socially cooperative endeavours. This paper investigates the effectiveness of Stomp, a tangible user interface (TUI) designed to provide new participatory experiences for people with intellectual disability. Results from an observational study reveal the extent to which the Stomp system supports social and physical interaction. The tangible, spatial and embodied qualities of Stomp result in an experience that does not rely on the acquisition of specific competencies before interaction and engagement can occur.

Pathways to employment for migrants and refugees? The case of social enterprise

This paper examines the use of social enterprise – that is, not for personal profit businesses that have a strong social purpose- to support training and employment pathways for migrants and refugees facing multiple forms of exclusion. Drawing on an evaluation of a program that supports seven social enterprises in the Australian state of Victoria, the study finds that social enterprise affords unique local opportunities for economic and social participation for the program’s participants. Nevertheless, there are limits to the impacts of programs that mediate transitions within an increasingly flexible labour market without redressing the broader social determinants of labour market segmentation.

A framework for analysing system intelligence of the building control system: a study of the integrated building management system

The lack of satisfactory consensus for characterizing the system intelligence and structured analytical decision models has inhibited the developers and practitioners to understand and configure optimum intelligent building systems in a fully informed manner. So far, little research has been conducted in this aspect. This research is designed to identify the key intelligent indicators, and develop analytical models for computing the system intelligence score of smart building system in the intelligent building. The integrated building management system (IBMS) was used as an illustrative example to present a framework. The models presented in this study applied the system intelligence theory, and the conceptual analytical framework. A total of 16 key intelligent indicators were first identified from a general survey. Then, two multi-criteria decision making (MCDM) approaches, the analytic hierarchy process (AHP) and analytic network process (ANP), were employed to develop the system intelligence analytical models. Top intelligence indicators of IBMS include: self-diagnostic of operation deviations; adaptive limiting control algorithm; and, year-round time schedule performance. The developed conceptual framework was then transformed to the practical model. The effectiveness of the practical model was evaluated by means of expert validation. The main contribution of this research is to promote understanding of the intelligent indicators, and to set the foundation for a systemic framework that provide developers and building stakeholders a consolidated inclusive tool for the system intelligence evaluation of the proposed components design configurations.

The philosophy and practice of water sensitive urban design : is it consistent with a whole system approach

This paper provides a critique of the Water Sensitive Urban Design (WSUD) paradigm by discussing its congruence with an established sustainable design principle called 'whole system design'. It was found that WSUD is congruent with the whole system design approach as a philosophy, but not in practice. Future improvement of WSUD practice may depend on the adoption of a front-loaded, teamwork-based design and planning process that is embedded in the principle of whole system design.

The effectiveness of cross-lingual link discovery

This paper describes the evaluation in benchmarking the effectiveness of cross-lingual link discovery (CLLD). Cross lingual link discovery is a way of automatically finding prospective links between documents in different languages, which is particularly helpful for knowledge discovery of different language domains. A CLLD evaluation framework is proposed for system performance benchmarking. The framework includes standard document collections, evaluation metrics, and link assessment and evaluation tools. The evaluation methods described in this paper have been utilised to quantify the system performance at NTCIR-9 Crosslink task. It is shown that using the manual assessment for generating gold standard can deliver a more reliable evaluation result.

Overlapping medical alarms are almost indiscriminable

Objective: We explore how accurately and quickly nurses can identify melodic medical equipment alarms when no mnemonics are used, when alarms may overlap, and when concurrent tasks are performed. Background: The international standard IEC 60601-1-8 (International Electrotechnical Commission, 2005) has proposed simple melodies to distinguish seven alarm sources. Previous studies with nonmedical participants reveal poor learning of melodic alarms and persistent confusions between some of them. The effects of domain expertise, concurrent tasks, and alarm overlaps are unknown. Method: Fourteen intensive care and general medical unit nurses learned the melodic alarms without mnemonics in two sessions on separate days. In the second half of Day 2 the nurses identified single alarms or pairs of alarms played in sequential, partially overlapping, or nearly completely overlapping configurations. For half the experimental blocks nurses performed a concurrent mental arithmetic task. Results: Nurses' learning was poor and was no better than the learning of nonnurses in a previous study. Nurses showed the previously noted confusions between alarms. Overlapping alarms were exceptionally difficult to identify. The concurrent task affected response time but not accuracy. Conclusion: Because of a failure of auditory stream segregation, the melodic alarms cannot be discriminated when they overlap. Directives to sequence the sounding of alarms in medical electrical equipment must be strictly adhered to, or the alarms must redesigned to support better auditory streaming. Application: Actual or potential uses of this research include the implementation of IEC 60601-1-8 alarms in medical electrical equipment.

Learnability and discriminability of melodic medical equipment alarms

Melodic alarms proposed in the IEC 60601-1-8 standard for medical electrical equipment were tested for learnability and discriminability. Thirty-three non-anaesthetist participants learned the alarms over two sessions of practice, with or without mnemonics suggested in the standard. Fewer than 30% of participants could identify the alarms with 100% accuracy at the end of practice. Confusions persisted between pairs of alarms, especially if mnemonics were used during learning (p = 0.011). Participants responded faster (p < 0.00001) and more accurately (p = 0.002) to medium priority alarms than to high priority alarms, even though they rated the high priority alarms as sounding more urgent (p < 0.00001). Participants with at least 1 year of formal musical training identified the alarms more accurately (p = 0.0002) than musically untrained participants, and found the task easier overall (p < 0.00001). More intensive studies of the IEC 60601-1-8 alarms are needed for their effectiveness to be determined.

Online retailing versus traditional stores in the purchasing decision making process

Due to proliferation of online stores prior expectations that retailing would move completely online were not fulfilled. Previous research about consumers’ preference of retailing channels suggested that online sales are driven by the convenience of online shopping, or as a natural extension of online searches. This paradigm has changed over the years. Changes in consumer behaviour are indicating that while consumers are searching online using various information sources to learn about products, ultimately when purchasing, consumers are shifting between online and offline retailing channels depending on various factors. Online shopping is still considered to be a convenient way to purchase goods, but the convenience is not the key factor. This qualitative research is based on 22 in-depth interviews with shoppers in Australia.

Tools and methods for capturing Twitter data during natural disasters

During the course of several natural disasters in recent years, Twitter has been found to play an important role as an additional medium for many–to–many crisis communication. Emergency services are successfully using Twitter to inform the public about current developments, and are increasingly also attempting to source first–hand situational information from Twitter feeds (such as relevant hashtags). The further study of the uses of Twitter during natural disasters relies on the development of flexible and reliable research infrastructure for tracking and analysing Twitter feeds at scale and in close to real time, however. This article outlines two approaches to the development of such infrastructure: one which builds on the readily available open source platform yourTwapperkeeper to provide a low–cost, simple, and basic solution; and, one which establishes a more powerful and flexible framework by drawing on highly scaleable, state–of–the–art technology.