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.

Evaluation of "Eat Well Queensland"

Eat Well Queensland 2002-2012: Smart Eating for a Healthier State (EWQ) was developed by the Queensland Public Health Forum in 2002 as a 10-year strategy to improve the health of Queenslanders through better food and nutrition. This study aimed to evaluate the implementation of EWQ and identify future strategic action required. Queensland Health funded a mid-point review of EWQ in 2008, to identify achievements, gaps, barriers and emerging issues associated with EWQ. 31 key stakeholders were interviewed, 83 stakeholders responded to an online survey, 150 stakeholders attended a state-wide practitioner workshop and 209 EWQ-related project reports were assessed.

Emergency Health Services (EHS) : demand and service delivery models. [Monograph 2 : Queensland EHS users’ profile]

Emergency health is a critical component of Australia’s health system and one which is increasingly congested from growing demand and blocked access to inpatient beds. The Emergency Health Services Queensland (EHSQ) study aims to identify the factors driving increased demand for emergency health and to evaluate strategies which may safely reduce the future demand growth. This monograph addresses the characteristics of users of emergency health services with an aim to identify those that appear to contribute to demand growth. This study utilises data on patients treated by Emergency Departments (ED) and Queensland Ambulance Service (QAS) across Queensland. ED data was derived from the Emergency Department Information System (EDIS) for the period 2001-02 through to 2010-11. Ambulance data was extracted from the QAS’ Ambulance Information Management System (AIMS) and electronic Ambulance Report Form (eARF) for the period 2001-02 through to 2009-10. Due to discrepancies and comparability issues for ED data, this monograph compares data from the 2003-04 time period with 2010-11 data for 21 of the reporting EDs. Also a snapshot of users for the 2010-11 financial year for 31 reporting EDs is used to describe the characteristics of users and to compare those characteristics with population demographics. For QAS data, the 2002-03 and 2009-10 time periods were selected for detailed analyses to identify trends. • Demand for emergency health care services is increasing, representing both increased population and increased relative utilisation. Per capita demand for ED attention has increased by 2% per annum over the last decade and for ambulance attention by 3.7% per annum. • The growth in ED demand is prominent in more urgent triage categories with actual decline in less urgent patients. An estimated 55% of patients attend hospital EDs outside of normal working hours. There is no evidence that patients presenting out of hours are significantly different to those presenting within working hours; they have similar triage assessments and outcomes. • Patients suffering from injuries and poisoning comprise 28% of the ED workload (an increase of 65% in the study period), whilst declines of 32% in cardiovascular and circulatory conditions, and musculoskeletal problems have been observed. • 25.6% of patients attending EDs are admitted to hospital. 19% of admitted patients and 7% of patients who die in the ED are triage category 4 or 5 on arrival. • The average age of ED patients is 35.6 years. Demand has grown in all age groups and amongst both men and women. Men have higher utilisation rates for ED in all age groups. The only group where the growth rate in women has exceeded men is in the 20-29 age group; this growth is particularly in the injury and poisoning categories. • Considerable attention has been paid publicly to ED performance criteria. It is worth noting that 50% of all patients were treated within 33 minutes of arrival. • Patients from lower socioeconomic areas appear to have higher utilisation rates and the utilisation rate for indigenous people appears to exceed those of European and other backgrounds. The utilisation rates for immigrant people is generally less than that of Australian born however it has not been possible to eliminate the confounding impact of different age and socioeconomic profiles. • Demand for ambulance service is also increasing at a rate that exceeds population growth. Utilisation rates have increased by an average of 5% per annum in Queensland compared to 3.6% nationally, and the utilisation rate in Queensland is 27% higher than the national average. • The growth in ambulance utilisation has also been amongst the more urgent categories of dispatch and utilisation rates are higher in rural and regional areas than in the metropolitan area. The demand for ambulance increases with age but the growth in demand for ambulance service has been more prominent in younger age groups. These findings contribute significantly to an understanding of the growth in demand for emergency health. It shows that the growth is amongst patients in genuine need of emergency healthcare and public rhetoric that the congestion of emergency health services is due to inappropriate attendees is unable to be substantiated. The consistency of the growth in demand over the last decade reflects not only the changing demographics of the Australian population but also the changes in health status, standards of acute health care and other social factors. The growth is also amongst patients with acute injury and poisoning which is inconsistent with rates of chronic disease as a fundamental driver. We have also interviewed patients in regard to their decision making choices for acute health care and the factors that influence these decisions and this will be the subject of a third Monograph and publications.

Making a case for social impact assessment in urban development : social impacts and legal disputes in Queensland, Australia

Urban land use planning and policy decisions are often contested, with the multiple stakeholders (business, developers, residents, policymakers and the wider community) frequently holding opposing viewpoints about the issues and best solution. In recent years, however, the participatory process of social impact assessment (SIA) has received significant attention as a way to mitigate conflict, facilitating negotiation and conflict resolution. This paper examines how social impacts have informed development appeals in Australia, focussing on ten cases from the Queensland Planning and Environment Court (QPEC). Half are appeals from community members (typically neighbours) wanting to oppose approvals and half from organisations appealing against City Councils’ decisions to deny their development applications. While legal challenges do not necessarily reflect attitudes and practices, they provide a means to begin to assess how social impacts (although not often explicitly defined as such) inform development related disputes. Based on the nature and outcomes of 10 QPEC cases, we argue that many legal cases could have been avoided if SIA had been undertaken appropriately. First, the issues in each case are clearly social, incorporating impacts on amenity, the character of an area, the needs of different social groups, perceptions of risk and a range of other social issues. Second, the outcomes and recommendations from each case, such as negotiating agreements, modifying plans and accommodating community concerns would have been equally served thorough SIA. Our argument is that engagement at an early stage, utilising SIA, could have likely achieved the same result in a less adversarial and much less expensive and time-consuming environment than a legal case.

Towards distributed citizen participation : lessons from WikiLeaks and the Queensland floods

This paper examines the rapid and ad hoc development and interactions of participative citizen communities during acute events, using the examples of the 2011 floods in Queensland, Australia, and the global controversy surrounding Wikileaks and its spokesman, Julian Assange. The self-organising community responses to such events which can be observed in these cases bypass or leapfrog, at least temporarily, most organisational or administrative hurdles which may otherwise frustrate the establishment of online communities; they fast-track the processes of community development and structuration. By understanding them as a form of rapid prototyping, e-democracy initiatives can draw important lessons from observing the community activities around such acute events.

Child car restraints : mandating type and seating row according to age with positive effect in regional city in Queensland, Australia

Road trauma is a leading cause of child injury worldwide. In highly motorised countries, injury as a passenger represents a major proportion of all child road deaths and hospitalisations. Australia is no exception, particularly since there are high levels of private motor vehicle travel to school in most Australian states. Recently the legislation governing the type of car restraints required for children aged under 7 years has changed in Australia, aligning requirements better with accepted best practice. However, it is unclear what effect these changes have had on children’s seating positions or the types of restraints used. A mixed methods evaluation of the impact of the new legislation on compliance was conducted at three times: baseline (Time 1); after announcement that changes were going to be implemented but before enforcement began (Time 2); and after enforcement commenced (Time 3). Measures of compliance were obtained using two methods: road-side observations of vehicles with child passengers; and parental self-report (intercept interviews conducted at Time 2 and Time 3 only). Results from the observations suggested an overall positive effect. Proportions of children occupying front seats decreased overall and use of dedicated child seats increased to almost 40% of the observed children by Time 3. However, almost a quarter of the children observed still occupied front seats. These results differed from those of the interview study where almost no children were reported as usually travelling in the front seat, and reported use of dedicated restraints with children was almost 90%, over twice that of the observations.

Physical activity in three regional communities in Queensland

Objective. To describe physical activity participation in three Queensland regional communities. Design. Cross-sectional mail survey of randomly selected residents, stratified by age and sex. Setting. Esk, Mareeba and Mount Isa. Participants. 1219 (58% female) adults, with a mean age 46.7 (SD 14.7) years. Main outcome measures. Proportion of people inactive, meeting Australian activity guidelines (a minimum of 150 minutes/week and 5 sessions/week), and walking a dog daily; time spent walking and cycling for transport; location and type of recreational physical activities. Results. Overall, 18% of respondents were inactive, with the highest proportions among women (22.3%) and older adults in Mount Isa (24.3%). The proportion meeting activity guidelines was 47% with the lowest proportions among women in Mount Isa (40.4%). Although 63% reported owning a dog, only 22% reported walking a dog daily. Few people reported walking or cycling for transport. The most common types of activities were walking, home-based exercise, running/jogging, and swimming, and the most common location was at or near home. Conclusions. Physical activity levels were lower in these regional communities than the state average. The findings indicate a need for physical activity policy and intervention strategies targeting regional and rural areas. This could focus on women and older adults, dog walking, and physical activity opportunities in or near the home.

The impact of penalty increases on speeding behaviour in Queensland and a characterisation of speeding offenders

This project examined the effects of speeding penalty changes that occurred in Queensland in 2003 on the behaviour of speeding offenders. These penalty changes included increasing the number of offence categories, and in turn narrowing the range of speeds associated with the offence categories; increasing the monetary fines for all offences, with the largest increases observed for high-range offences; and introducing automatic licence suspension and an eight demerit point penalty for the highest offence category. To explore the impact of the penalty changes, offence data collected for two cohorts of motorists in Queensland who were caught speeding prior to and subsequent to the penalty changes (N = 84,456) were compared. The first cohort consisted of individuals (operators of all vehicles including motorcycles) who committed a speeding offence in May 2001 (two years prior to the speeding penalty change); and individuals who committed a speeding offence in May 2003 (one month after the introduction of the penalty change). Four measures of recidivism were devised and used to assess the effects of the new penalties with regard to deterring the speeding behaviour of offenders. Additionally, the project investigated the relationship between speeding offences, other risky driving behaviours, crash involvement, and criminal behaviour.

Blogging the 2009 Queensland State Election

The internet has become important in political communication in Australia. Using Habermas' ideal types, it is argued that political blogs can be viewed as public spheres that might provide scope for the expansion of deliberative democratic discussion. This hypothesis is explored through analysis of the group political blog Pineapple Party Time. It is evident that the bloggers and those who commented on their posts were highly knowledgeable about and interested in politics. Form an examination of these posts and the comments on them, Pineapple Party Time did act as a public sphere to some degree, and did provide for the deliberative discussion essential for a democracy, but it was largely restricted to Crikey readers. For a deliberative public sphere and democratic discussion to function to any extent, the public sphere must be open to all citizens, who need to have the access and knowledge to engage in deliberative discussion.

The potential for ethanol production from sugarcane in Australia

The Australian sugar industry processes approximately 35 million tonnes of sugarcane per year from 400 000 hectares of land. Sugar remains the principal revenue stream from sugarcane in Australia with less than 60 ML/y of fuel ethanol produced from final molasses at present. Modelling has been undertaken to estimate the potential ethanol production from the Australian sugar industry for integrated facilities producing both sugar and ethanol from the entire sugarcane resource. Although research aimed at developing commercial processes is ongoing, the use of a proportion of the bagasse and trash for ethanol production, in addition to juice and molasses fermentation, would allow significant increases in the scale of ethanol production from sugarcane in Australia, increasing total industry revenues while maintaining energy self sufficiency.

Towards a commercial lignocellulosic ethanol industry in Australia : the Mackay Renewable Biocommodities Pilot Plant

In 2007, the Queensland University of Technology (QUT) received funding from the Australian Government through the NCRIS program and from the then Queensland Government Department of State Development to construct a pilot research and development facility for the production of bioethanol and other renewable biocommodities from biomass including sugar cane bagasse. This facility is being constructed adjacent to the Racecourse Sugar Mill in Mackay and is known as the Mackay Renewable Biocommodities Pilot Plant (MRBPP). The MRBPP will be capable of processing biomass through a pressurised pretreatment reactor and includes equipment for enzymatic saccharification, fermentation and distillation to produce ethanol. Lignin and fermentation co-products will also be produced at a pilot scale for product development and testing.

An update on the Mackay Renewable Biocommodities Pilot Plant : preliminary trial results

THE Mackay Renewable Biocommodities Pilot Plant is a pilot scale facility owned and operated by QUT for research and demonstration of the conversion of lignocellulosic biomass such as sugarcane bagasse into biofuels. The pilot plant accommodates unique state-of-the-art equipment to process a wide range of feedstocks and is strategically located on the site of the Mackay Sugar Ltd Racecourse Mill. Major facilities include a biomass handling system, pre-treatment reactor, saccharification reactor, fermentors, distillation column and bioseparations equipment. This paper provides an update on the design, construction, commissioning and start-up of the facility. In addition, the paper provides results from preliminary facility trials on the pre-treatment of sugarcane bagasse for cellulosic ethanol production.