Universal access to ambulance does not increase overall demand for ambulance services in Queensland, Australia

Objective. To determine the impact of the introduction of universal access to ambulance services via the implementation of the Community Ambulance Cover (CAC) program in Queensland in 2003–04. Method. The study involved a 10-year (2000–01 to 2009–10) retrospective analysis of routinely collected data reported by the Queensland Ambulance Service (QAS) and by the Council of Ambulance Authorities. The data were analysed for the impact of policy changes that resulted in universal access to ambulance services in Queensland. Results. QASis a statewide, publically funded ambulance service. In Queensland, ambulance utilisation rate (AUR)per 1000 persons grew by 41% over the decade or 3.9% per annum (10-year mean = 149.8, 95% CI: 137.3–162.3). The AUR mean after CAC was significantly higher for urgent incidents than for non-urgent ones. However projection modelling demonstrates that URs after the introduction of CAC were significantly lower than the projected utilisation for the same period. Conclusions. The introduction of universal access under the Community Ambulance Cover program in Queensland has not had any significant independent long-term impact on demand overall. There has been a reduction in the long-term growth rate, which may have been contributed to by an ‘appropriate use’ public awareness program.

A systematic review of psychological interventions for excessive alcohol consumption among people with psychotic disorders

Objective: Excessive alcohol consumption is common among people with psychotic disorders. While there is an extensive literature on the efficacy of psychological treatments for excessive drinking, few studies have examined interventions addressing this issue among people with psychotic disorders. Method: Systematic searches in PubMed and PsycINFO were conducted to identify randomized controlled trials comparing manual guided psychological interventions for excessive alcohol consumption among individuals with psychotic disorders. Of the 429 articles identified, 7 met inclusion criteria. Data were extracted from each study regarding study sample characteristics, design, results, clinical significance of alcohol consumption results, and methodological limitations. Results: Assessment interviews, brief motivational interventions and lengthier cognitive behavior therapy have been associated with reductions in alcohol consumption among people with psychosis. While brief interventions (i.e., 1-2 sessions) were generally as effective as longer duration psychological interventions (i.e., 10 session) for reducing alcohol consumption, longer interventions provided additional benefits for depression, functioning and other alcohol outcomes. Conclusion: Excessive alcohol consumption among people with psychotic disorders is responsive to psychological interventions. It is imperative that such approaches are integrated within standard care for people with psychosis.

Changing learning to improve practice : hand hygiene education in Queensland medical schools

The aim of Queensland Health’s ‘Clean hands are life savers’ program is to change the culture and behaviour of healthcare workers related to hand hygiene. Hand hygiene is considered to be the most effective means of preventing pathogen cross-transmission and healthcare-associated infections. Most hospitals throughout Queensland as well as Australia now manage a hand hygiene program to increase the hand hygiene compliance of all healthcare workers. Reports taken from routine hand hygiene observations reveal that doctors are usually less compliant in their hand-washing practices than other healthcare worker groups. The Centre for Healthcare Related Infection Surveillance and Prevention (CHRISP) has attempted to have an impact on this challenging group through their Medical Leadership Initiative. With education as a core component of the program, efforts were made to ensure our future doctors were receiving information that aligned with Queensland Health standards during their formative years at medical school. CHRISP met with university instructors to understand what infection prevention education was currently included in the curriculum and support the introduction of new learning activities that specifically focused on hand hygiene. This prompted change to the existing curriculum and a range of interventions were employed with mixed success. Although met with challenges, methods to integrate more infection prevention teaching were found.

Markers of cutaneous human papillomavirus infection in individuals with tumor-free skin, actinic keratoses, and squamous cell carcinoma

Separately, actinic keratosis (AK) and cutaneous squamous cell carcinoma (SCC) have been associated with cutaneous human papillomavirus (HPV) infections. To further explore the association between HPV infection and SCC development, we determined markers of cutaneous HPV infection within a single population in persons with precursor lesions (AK), cancerous lesions (SCC), and without. Serum and plucked eyebrow hairs were collected from 57 tumor-free controls, 126 AK, and 64 SCC cases. Presence of HPV L1 and E6 seroreactivity and viral DNA were determined for HPV types 5, 8, 15, 16, 20, 24, and 38. Significant positive associations with increasing severity of the lesions (controls, AK, and SCC, respectively) were observed for overall HPV L1 seropositivity (13%, 26%, and 37%) and for HPV8 (4%, 17%, and 30%). In parallel, the proportion of L1 seropositive individuals against multiple HPV types increased from 14% to 39% and 45%. The overall E6 seroreactivity, however, tended to decline with AK and SCC, especially for HPV8 (21%, 11%, and 2%). HPV DNA positivity was most prevalent in the AK cases (54%) compared with the SCC cases (44%) and the tumor-free controls (40%). Among all participants, there was a positive trend between overall HPV DNA positivity and L1 seropositivity, but not E6 seropositivity. Taken together, our data suggest that cutaneous HPV infections accompanied by detectable HPV DNA in eyebrow hairs and HPV L1 seropositivity, but not E6 seropositivity, are associated with an increased risk of AK and SCC.

Nurses’ willingness to report medication administration errors in Saudi Arabia

Reporting of medication administration errors (MAEs) is one means by which health care facilities monitor their practice in an attempt to maintain the safest patient environment. This study examined the likelihood of registered nurses (RNs) reporting MAEs when working in Saudi Arabia. It also attempted to identify potential barriers in the reporting of MAE. This study found that 63% of RNs raised concerns about reporting of MAEs in Saudi Arabia—nursing administration was the largest impediment affecting nurses' willingness to report MAEs. Changing attitude to a non-blame system and implementation of anonymous reporting systems may encourage a greater reporting of MAEs.

Factors that influence Chinese TEFL academics' research capacity building : an institutional case study

Research capacity building has become a prominent theme in higher education institutions across the world. To build research capacity, it is necessary to identify areas of challenges academics face within the academia. This case study focuses on Chinese teaching English as a foreign language (TEFL) academics with the purpose of identifying factors that influence their research capacity building. Six TEFL academics from a Chinese national university were interviewed and institutional research documents were analysed. Findings showed that obstacles and difficulties in conducting research were more related to departmental factors than individual characteristics. The institution was keen on developing a research culture, and encouraged research and publications. Departmental support for research was improving, but it seems that it was more generic than tailored to individual needs. The findings of this study provide implications for research administrators in further supporting TEFL academics’ research capacity building.

An infrared spectroscopic comparison of four Chinese palygorskites

Infrared spectroscopy has been used to characterize and compare four palygorskite mineral samples from China. The position of the main bands identified by infrared spectra is similar, but there are some differences in intensity, which are significant. In addition, several additional bands are observed in the spectra of palygorskite and their impurities. This variability is attributed to differences in the geological environment, such as the degree of weathering and the extent of transportation of the minerals during formation or deposition, and the impurity content in these palygorskites. The bands of water and hydroxyl groups in these spectra of palygorskite samples have been studied. The characteristic band of palygorskite is observed at 1195 cm�1. Another four bands observed at 3480, 3380, 3266 and 3190 cm�1 are attributed to the water molecules in the palygorskite structure. These results suggest that the infrared spectra of palygorskites mineral from different regions are decided not only by the main physicochemical properties of palygorskite, but also by the amount and kind of impurities.

Achieving at university and beyond : does it help to be good looking?

Purpose – The purpose of this study is to examine the associations between attitudes to academic achievement and post university success using perceptions of attractiveness, gender, ethnic identity, personality, and social acceptance as antecedents. Design/methodology/approach – An online questionnaire was completed by male (N=116) and female (N=126) university students from various cultural backgrounds. To evaluate the proposed relationships, multiple regression analysis was used. Findings – The findings suggest that attractiveness is related to attitudes to academic achievement and success through its association with social appeal and acceptance. Ethnic identity is also related to both academic achievement and post university success. Personality is not positively related to academic achievement. Finally, social acceptance is positively related to academic achievement for males and to success for females. Research limitations/implications – Whilst the survey targeted students from various cultural backgrounds studying in Australia, it did not look at university students from other countries. A cross-cultural perspective could reveal further differences in attitudes. Originality/value – This study links attractiveness and academic achievement theories. The findings have implications for tertiary institutions and suggest academics and policy-makers to vigorously promote core personality and values such as intelligence, communication skills, and sincerity, rather than allow superficial values such as attractiveness to be placed at the centre stage of students' endeavour.

Studying in Cuba, returning home to work : experiences of graduates from the English-speaking Caribbean

Cuba’s higher education scholarship program has received little attention in the literature on education and development. In this chapter, I discuss themes that emerge from my interviews with graduates from English-speaking Caribbean countries who studied in Cuba, as well as Cuban educators, on the nature of their academic programs and their subsequent careers. This facilitates exploration of a number of questions, including the following: 1. How, in the perceptions of scholarship students and graduates, have they experienced the philosophy of combing study, practical work, and research in the tertiary education curriculum in Cuban universities? 2. What impact does studying in Cuba appear to have on graduates after they return to their home countries? 3. How does the experience of the graduates throw light on the relationship between tertiary education and national development?

Low temperature response of nanostructured tungsten oxide thin films toward hydrogen and ethanol

Semiconducting metal oxide based gas sensors usually operate in the temperature range 200–500 °C. In this paper, we present a new WO3 thin film based gas sensor for H2 and C2H5OH, operating at 150 °C. Nanostructured WO3 thin films were synthesized by thermal evaporation method. The properties of the as-deposited films were modified by annealing in air at 300 °C and 400 °C. Various analytical techniques such as AFM, TEM, XPS, XRD and Raman spectroscopy have been employed to characterize their properties. A clear indication from TEM and XRD analysis is that the as-deposited WO3 films are highly amorphous and no improvement is observed in the crystallinity of the films after annealing at 300 °C. Annealing at 400 °C significantly improved the crystalline properties of the films with the formation of about 5 nm grains. The films annealed at 300 °C show no response to C2H5OH (ethanol) and a little response to H2, with maximum response obtained at 280 °C. The films annealed at 400 °C show a very good response to H2 and a moderate response to C2H5OH (ethanol) at 150 °C. XPS analysis revealed that annealing of the WO3 thin films at 400 °C produces a significant change in stoichiometry, increasing the number of oxygen vacancies in the film, which is highly beneficial for gas sensing. Our results demonstrate that gas sensors with significant performance at low operating temperatures can be obtained by annealing the WO3 films at 400 °C and optimizing the crystallinity and nanostructure of the as-deposited films.

Organisational obstacles to reducing carbon emissions in Hong Kong

An emerging theme for a nation transiting into a sustainable future is the provision of a low carbon (dioxide) environment. Carbon emission reduction is therefore important for the industry and community as a whole. Buildings contribute immensely to total greenhouse gas emissions, so pragmatic actions need to be taken to cut the amount of carbon emitted by the construction industry. These typically involve strategies such as energy-saving features in the design, construction and operation of building projects. However, a variety of characteristics of the markets and stakeholders involved are suppressing their development. This paper reports on a series of interviews with a variety of Hong Kong construction project participants aimed at identifying the drivers of, and obstacles to, the construction industry's attempts to reduce carbon emissions. The results confirm the main actions currently undertaken are energy efficiency enhancement, green procurement, research and development activities, waste/water management and other technical measures such as the provision of thermal insulation. The majority of the drivers are economical in nature, suggesting that financial aids, and particularly government incentives, are likely to be useful motivators. Also suggested is the increased promotion of the benefits of environmental sustainability to the wider community, in order to alert the general public to the need for reducing the amount of carbon originating from building usage.

A quasi-maximum likelihood method for estimating the parameters of multivariate diffusions

A quasi-maximum likelihood procedure for estimating the parameters of multi-dimensional diffusions is developed in which the transitional density is a multivariate Gaussian density with first and second moments approximating the true moments of the unknown density. For affine drift and diffusion functions, the moments are exactly those of the true transitional density and for nonlinear drift and diffusion functions the approximation is extremely good and is as effective as alternative methods based on likelihood approximations. The estimation procedure generalises to models with latent factors. A conditioning procedure is developed that allows parameter estimation in the absence of proxies.

Workplace information literacy : cultivation strategies for 'working smarter' in 21st century libraries

This paper presents a hybrid framework of Swedish cultural practices and Australian grounded theory for organizational development and suggests practical strategies for 'working smarter' in 21st Century libraries. Toward that end, reflective evidence-based practices are offered to incrementally build organizational capacity for asking good questions, selecting authoritative sources, evaluating multiple perspectives, organizing emerging insights, and communicating them to inform, educate, and influence. In addition, to ensure the robust information exchange necessary to collective workplace learning, leadership traits are proposed for ensuring inclusive communication, decision making, and planning processes. These findings emerge from action research projects conducted from 2003 to 2008 in two North American libraries.

Acute illness is a risk factor for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterization laboratory

Impaired respiratory function (IRF) during procedural sedation and analgesia (PSA) poses considerable risk to patient safety as it can lead to inadequate oxygenation and ventilation. Risk factors that can be screened prior to the procedure have not been identified for the cardiac catheterization laboratory (CCL).

Vision-based place recognition : how low can you go?

In this paper we use the algorithm SeqSLAM to address the question, how little and what quality of visual information is needed to localize along a familiar route? We conduct a comprehensive investigation of place recognition performance on seven datasets while varying image resolution (primarily 1 to 512 pixel images), pixel bit depth, field of view, motion blur, image compression and matching sequence length. Results confirm that place recognition using single images or short image sequences is poor, but improves to match or exceed current benchmarks as the matching sequence length increases. We then present place recognition results from two experiments where low-quality imagery is directly caused by sensor limitations; in one, place recognition is achieved along an unlit mountain road by using noisy, long-exposure blurred images, and in the other, two single pixel light sensors are used to localize in an indoor environment. We also show failure modes caused by pose variance and sequence aliasing, and discuss ways in which they may be overcome. By showing how place recognition along a route is feasible even with severely degraded image sequences, we hope to provoke a re-examination of how we develop and test future localization and mapping systems.