The growing demand for emergency healthcare

Emergency health is a critical component of health systems; one increasingly congested from growing demand and blocked access to care. The Emergency Health Services Queensland (EHSQ) study aimed to identify the factors driving increased demand for emergency healthcare. This study examined data on patients treated by the ambulance service and Emergency Departments across Queensland. Data was derived from the Queensland Ambulance Service’s (QAS) Ambulance Information Management System and electronic Ambulance Report Form and from the Emergency Department Information System (EDIS). Data was obtained for the period 2001-02 through to 2009-10. A snapshot of users for the 2009-10 year was used to describe the characteristics of users and comparisons made with the year 2003-04 to identify trends. Per capita demand for EDs has increased by 2% per annum over the decade and for ambulance by 3.7% per annum. The growth in ED demand is most significant in more urgent triage categories with decline in less urgent patients. The growth is most prominent amongst patients suffering injuries and poisoning, amongst both men and women and across all age groups. Patients from lower socioeconomic areas appear to have higher utilisation rates and the utilisation rate for indigenous people exceeds those of other backgrounds. The utilisation rates for immigrant people is less than Australian born however it has not been possible to eliminate the confounding impact of age and socioeconomic profiles. These findings contribute to an understanding of the growth in demand for emergency health. It is evident that the growth is amongst patients in genuine need of emergency healthcare and public rhetoric that congested emergency health services is due to inappropriate attendees is unsustainable. The growth in demand over the last decade reflects not only on changing demographics of the Australian population but also changes in health status, standards of acute health care and other social factors.

A Design Theory for Context-Aware Information Systems

This research studies information systems that adapt to the context in which they are used and provides recommendations on how the design of such systems can be improved. This thesis covers the problem of context-awareness via two case studies in the insurance and transportation industries. The study highlights shortcomings in the understanding of the relationship between information systems and context. Furthermore, it presents a new, theory-informed approach to design, and provides guidance for system developers seeking to implement context-aware information systems.

Patient Safety Law: From Silos to Systems

Patient safety has become a significant and pressing policy issue. Around the world, governments, the health care sector and the public are increasingly cognizant of the need to improve the safety of care delivered by their health systems. Pressure for change has been created by highly publicized incidents in a number of countries involving unsafe acts that were significant both in scale and consequence and a number of empirical studies that revealed the high rates of unsafe acts and their consequences. The costs of unsafe health care – both personal and fiscal – to individuals, their families and their communities and to the state are massive. In this research project we explored one particular avenue for change – that is, the use of legal instruments by governments to improve patient safety. We did this through a comparative review of the use of legal instruments or frameworks in other countries (specifically Australia, Denmark, New Zealand, the United Kingdom, and the United States) as well as two non-health care related sectors in Canada (transportation and occupational health and safety). We began this research by reviewing the legal instruments and undertaking extensive literature reviews. Further information was gathered through in-person interviews with policy-makers and academics in the countries studied, and from policy-makers and academics expert in the health, occupational health and safety, and transportation sectors in Canada. Once descriptions of the various countries and sectors were drafted, we held small-group meetings with local experts on particular aspects of patient safety. We then hosted a national consultation meeting. We subsequently drafted this final report and the appendices, which fully describe the results of the background research. Finally, we prepared a summary version of the report as well as posters and papers to be published and delivered at conferences and meetings with relevant groups.

Older people's mobility within the community : the impact of built environment and transportation on active aging

Population ageing is one of the major challenges of the 21st century and societies need to optimize opportunities for active ageing. This thesis explored how the built environment impacts the mobility and participation within the community. A combination of person-based GPS tracking and in-depth interviews was used to collect data on transportation use and engagement in activities of older people living within Brisbane. It showed that the built environment has a strong impact on mobility. To enable healthy and active ageing modern communities need to overcome car dependency and provide mobility options that are tailored towards older people’s needs.

Spreading peak demand for urban rail transit through differential fare policy : a review of empirical evidence

More evenly spread demand for public transport throughout a day can reduce transit service provider‟s total asset and labour costs. A plausible peak spreading strategy is to increase peak fare and/or to reduce off-peak fare. This paper reviews relevant empirical studies for urban rail systems, as rail transit plays a key role in Australian urban passenger transport and experiences severe peak loading variability. The literature is categorised into four groups: a) passenger opinions on willingness to change time for travel, b) valuations of displacement time using stated preference technique, c) simulations of peak spreading based on trip scheduling models, and: d) real-world cases of peak spreading using differential fare. Policy prescription is advised to take into account impacts of traveller‟s time flexibility and joint effects of mode shifting and peak spreading. Although focusing on urban rail, arguments in this paper are relevant to public transport in general with values to researchers and practitioners.

Channel tracking in SDMA-based multi-user MIMO-OFDM communications systems

Capacity of current and future high data rate wireless communications depend significantly on how well changes in the wireless channel are predicted and tracked. Generally, this can be estimated by transmitting known symbols. However, this increases overheads if the channel varies over time. Given today’s bandwidth demand and the increased necessity for mobile wireless devices, the contributions of this research are very significant. This study has developed a novel and efficient channel tracking algorithm that can recursively update the channel estimation for wireless broadband communications reducing overheads, therefore increasing the speed of wireless communication systems.

A critical analysis of business process management education and alignment with industry demand : an Australian perspective

Business Process Management (BPM) is accepted globally as an organizational approach to enhance productivity and drive cost efficiencies. Studies confirm a shortage of BPM skilled professionals with limited opportunities to develop the required BPM expertise. This study investigates this gap starting from a critical analysis of BPM courses offered by Australian universities and training institutions. These courses were analyzed and mapped against a leading BPM capability framework to determine how well current BPM education and training offerings in Australia address the core capabilities required by BPM professionals globally. To determine the BPM skill-sets sought by industry, online recruitment advertisements were collated, analyzed, and mapped against this BPM capability framework. The outcomes provide a detailed overview on the alignment of available BPM education/training and industry demand. These insights are useful for BPM professionals and their employers to build awareness of the BPM capabilities required for a BPM mature organization. Universities and other training institutions will benefit from these results by understanding where demand is, where the gaps are, and what other BPM education providers are supplying. This structured comparison method could continue to provide a common ground for future discussion across university-industry boundaries and continuous alignment of their respective practices.

Demand response for residential appliances via Customer Reward Scheme

This paper proposes a reward based demand response algorithm for residential customers to shave network peaks. Customer survey information is used to calculate various criteria indices reflecting their priority and flexibility. Criteria indices and sensitivity based house ranking is used for appropriate load selection in the feeder for demand response. Customer Rewards (CR) are paid based on load shift and voltage improvement due to load adjustment. The proposed algorithm can be deployed in residential distribution networks using a two-level hierarchical control scheme. Realistic residential load model consisting of non-controllable and controllable appliances is considered in this study. The effectiveness of the proposed demand response scheme on the annual load growth of the feeder is also investigated. Simulation results show that reduced peak demand, improved network voltage performance, and customer satisfaction can be achieved.

Coordinated control of grid connected photovoltaic reactive power and battery energy storage systems to improve the voltage profile of a residential distribution feeder

Increasing penetration of photovoltaic (PV) as well as increasing peak load demand has resulted in poor voltage profile for some residential distribution networks. This paper proposes coordinated use of PV and Battery Energy Storage (BES) to address voltage rise and/or dip problems. The reactive capability of PV inverter combined with droop based BES system is evaluated for rural and urban scenarios (having different R/X ratios). Results show that reactive compensation from PV inverters alone is sufficient to maintain acceptable voltage profile in an urban scenario (low resistance feeder), whereas, coordinated PV and BES support is required for the rural scenario (high resistance feeder). Constant as well as variable droop based BES schemes are analyzed. The required BES sizing and associated cost to maintain the acceptable voltage profile under both schemes is presented. Uncertainties in PV generation and load are considered, with probabilistic estimation of PV generation and randomness in load modeled to characterize the effective utilization of BES. Actual PV generation data and distribution system network data is used to verify the efficacy of the proposed method.

Specification & design of safety technologies for complex socio-technical systems : low-cost level crossings case study

The introduction of safety technologies into complex socio-technical systems requires an integrated and holistic approach to HF and engineering, considering the effects of failures not only within system boundaries, but also at the interfaces with other systems and humans. Level crossing warning devices are examples of such systems where technically safe states within the system boundary can influence road user performance, giving rise to other hazards that degrade safety of the system. Chris will discuss the challenges that have been encountered to date in developing a safety argument in support of low-cost level crossing warning devices. The design and failure modes of level crossing warning devices are known to have a significant influence on road user performance; however, quantifying this effect is one of the ongoing challenges in determining appropriate reliability and availability targets for low-cost level crossing warning devices.

On-line Demand Management of Low Voltage Residential Distribution Networks in Smart Grids

A novel intelligent online demand management system is discussed in this chapter for peak load management in low voltage residential distribution networks based on the smart grid concept. The discussed system also regulates the network voltage, balances the power in three phases and coordinates the energy storage within the network. This method uses low cost controllers, with two-way communication interfaces, installed in costumers’ premises and at distribution transformers to manage the peak load while maximizing customer satisfaction. A multi-objective decision making process is proposed to select the load(s) to be delayed or controlled. The efficacy of the proposed control system is verified by a MATLAB-based simulation which includes detailed modeling of residential loads and the network.

Crowdsourcing interactions : using crowdsourcing for evaluating interactive information retrieval systems

In the field of information retrieval (IR), researchers and practitioners are often faced with a demand for valid approaches to evaluate the performance of retrieval systems. The Cranfield experiment paradigm has been dominant for the in-vitro evaluation of IR systems. Alternative to this paradigm, laboratory-based user studies have been widely used to evaluate interactive information retrieval (IIR) systems, and at the same time investigate users’ information searching behaviours. Major drawbacks of laboratory-based user studies for evaluating IIR systems include the high monetary and temporal costs involved in setting up and running those experiments, the lack of heterogeneity amongst the user population and the limited scale of the experiments, which usually involve a relatively restricted set of users. In this paper, we propose an alternative experimental methodology to laboratory-based user studies. Our novel experimental methodology uses a crowdsourcing platform as a means of engaging study participants. Through crowdsourcing, our experimental methodology can capture user interactions and searching behaviours at a lower cost, with more data, and within a shorter period than traditional laboratory-based user studies, and therefore can be used to assess the performances of IIR systems. In this article, we show the characteristic differences of our approach with respect to traditional IIR experimental and evaluation procedures. We also perform a use case study comparing crowdsourcing-based evaluation with laboratory-based evaluation of IIR systems, which can serve as a tutorial for setting up crowdsourcing-based IIR evaluations.

The impact of a congestion charging exemption on the demand for new low‐emission vehicles

Numerous initiatives have been employed around the world in order to address rising greenhouse gas (GHG) emissions originating from the transport sector. These measures include: travel demand management (congestion‐charging), increased fuel taxes, alternative fuel subsidies and low‐emission vehicle (LEV) rebates. Incentivizing the purchase of LEVs has been one of the more prevalent approaches in attempting to tackle this global issue. LEVs, whilst having the advantage of lower emissions and, in some cases, more efficient fuel consumption, also bring the downsides of increased purchase cost, reduced convenience of vehicle fuelling, and operational uncertainty. To stimulate demand in the face of these challenges, various incentive‐based policies, such as toll exemptions, have been used by national and local governments to encourage the purchase of these types of vehicles. In order to address rising GHG emissions in Stockholm, and in line with the Swedish Government’s ambition to operate a fossil free fleet by 2030, a number of policies were implemented targeting the transport sector. Foremost amongst these was the combination of a congestion charge – initiated to discourage emissions‐intensive travel – and an exemption from this charge for some LEVs, established to encourage a transition towards a ‘green’ vehicle fleet. Although both policies shared the aim of reducing GHG emissions, the exemption for LEVs carried the risk of diminishing the effectiveness of the congestion charging scheme. As the number of vehicle owners choosing to transition to an eligible LEV increased, the congestion‐reduction effectiveness of the charging scheme weakened. In fact, policy makers quickly recognized this potential issue and consequently phased out the LEV exemption less than 18 months after its introduction (1). Several studies have investigated the demand for LEVs through stated‐preference (SP) surveys across multiple countries, including: Denmark (2), Germany (3, 4), UK (5), Canada (6), USA (7, 8) and Australia (9). Although each of these studies differed in approach, all involved SP surveys where differing characteristics between various types of vehicles, including LEVs, were presented to respondents and these respondents in turn made hypothetical decisions about which vehicle they would be most likely to purchase. Although these studies revealed a number of interesting findings in regards to the potential demand for LEVs, they relied on SP data. In contrast, this paper employs an approach where LEV choice is modelled by taking a retrospective view and by using revealed preference (RP) data. By examining the revealed preferences of vehicle owners in Stockholm, this study overcomes one of the principal limitations of SP data, namely that stated preferences may not in fact reflect individuals’ actual choices, such as when cost, time, and inconvenience factors are real rather than hypothetical. This paper’s RP approach involves modelling the characteristics of individuals who purchased new LEVs, whilst estimating the effect of the congestion charging exemption upon choice probabilities and subsequent aggregate demand. The paper contributes to the current literature by examining the effectiveness of a toll exemption under revealed preference conditions, and by assessing the total effect of the policy based on key indicators for policy makers, including: vehicle owner home location, commuting patterns, number of children, age, gender and income. Extended Abstract Submission for Kuhmo Nectar Conference 2014 2 The two main research questions motivating this study were:  Which individuals chose to purchase a new LEV in Stockholm in 2008?; and,  How did the congestion charging exemption affect the aggregate demand for new LEVs in Stockholm in 2008? In order to answer these research questions the analysis was split into two stages. Firstly, a multinomial logit (MNL) model was used to identify which demographic characteristics were most significantly related to the purchase of an LEV over a conventional vehicle. The three most significant variables were found to be: intra‐cordon residency (positive); commuting across the cordon (positive); and distance of residence from the cordon (negative). In order to estimate the effect of the exemption policy on vehicle purchase choice, the model included variables to control for geographic differences in preferences, based on the location of the vehicle owners’ homes and workplaces in relation to the congestion‐charging cordon boundary. These variables included one indicator representing commutes across the cordon and another indicator representing intra‐cordon residency. The effect of the exemption policy on the probability of purchasing LEVs was estimated in the second stage of the analysis by focusing on the groups of vehicle owners that were most likely to have been affected by the policy i.e. those commuting across the cordon boundary (in both directions). Given the inclusion of the indicator variable representing commutes across the cordon, it is assumed that the estimated coefficient of this variable captures the effect of the exemption policy on the utility of choosing to purchase an exempt LEV for these two groups of vehicle owners. The intra‐cordon residency indicator variable also controls for differences between the two groups, based upon direction of travel across the cordon boundary. A counter‐hypothesis to this assumption is that the coefficient of the variable representing commuting across the cordon boundary instead only captures geo‐demographic differences that lead to variations in LEV ownership across the different groups of vehicle owners in relation to the cordon boundary. In order to address this counter‐hypothesis, an additional analysis was performed on data from a city with a similar geodemographic pattern to Stockholm, Gothenburg ‐ Sweden’s second largest city. The results of this analysis provided evidence to support the argument that the coefficient of the variable representing commutes across the cordon was capturing the effect of the exemption policy. Based upon this framework, the predicted vehicle type shares were calculated using the estimated coefficients of the MNL model and compared with predicted vehicle type shares from a simulated scenario where the exemption policy was inactive. This simulated scenario was constructed by setting the coefficient for the variable representing commutes across the cordon boundary to zero for all observations to remove the utility benefit of the exemption policy. Overall, the procedure of this second stage of the analysis led to results showing that the exemption had a substantial effect upon the probability of purchasing and aggregate demand for exempt LEVs in Stockholm during 2008. By making use of unique evidence of revealed preferences of LEV owners, this study identifies the common characteristics of new LEV owners and estimates the effect of Stockholm's congestion charging exemption upon the demand for new LEVs during 2008. It was found that the variables that had the greatest effect upon the choice of purchasing an exempt LEV included intra‐cordon residency (positive), distance of home from the cordon (negative), and commuting across the cordon (positive). It was also determined that owners under the age of 30 years preferred non‐exempt LEVs (low CO2 LEVs), whilst those over the age of 30 years preferred electric vehicles. In terms of electric vehicles, it was apparent that those individuals living within the city had the highest propensity towards purchasing this vehicle type. A negative relationship between choosing an electric vehicle and the distance of an individuals’ residency from the cordon was also evident. Overall, the congestion charging exemption was found to have increased the share of exempt LEVs in Stockholm by 1.9%, with, as expected, a much stronger effect on those commuting across the boundary, with those living inside the cordon having a 13.1% increase, and those owners living outside the cordon having a 5.0% increase. This increase in demand corresponded to an additional 538 (+/‐ 93; 95% C.I.) new exempt LEVs purchased in Stockholm during 2008 (out of a total of 5 427; 9.9%). Policy makers can take note that an incentive‐based policy can increase the demand for LEVs and appears to be an appropriate approach to adopt when attempting to reduce transport emissions through encouraging a transition towards a ‘green’ vehicle fleet.

When supply does not meet demand-ER stress and plant programmed cell death

The endoplasmic reticulum (ER) is the central organelle in the eukaryotic secretory pathway. The ER functions in protein synthesis and maturation and is crucial for proper maintenance of cellular homeostasis and adaptation to adverse environments. Acting as a cellular sentinel, the ER is exquisitely sensitive to changing environments principally via the ER quality control machinery. When perturbed, ER-stress triggers a tightly regulated and highly conserved, signal transduction pathway known as the unfolded protein response (UPR) that prevents the dangerous accumulation of unfolded/misfolded proteins. In situations where excessive UPR activity surpasses threshold levels, cells deteriorate and eventually trigger programmed cell death (PCD) as a way for the organism to cope with dysfunctional or toxic signals. The programmed cell death that results from excessive ER stress in mammalian systems contributes to several important diseases including hypoxia, neurodegeneration, and diabetes. Importantly, hallmark features and markers of cell death that are associated with ER stress in mammals are also found in plants. In particular, there is a common, conserved set of chaperones that modulate ER cell death signaling. Here we review the elements of plant cell death responses to ER stress and note that an increasing number of plant-pathogen interactions are being identified in which the host ER is targeted by plant pathogens to establish compatibility.

Automatic inference of driving task demand from visual cues of emotion and attention

Sensing the mental, physical and emotional demand of a driving task is of primary importance in road safety research and for effectively designing in-vehicle information systems (IVIS). Particularly, the need of cars capable of sensing and reacting to the emotional state of the driver has been repeatedly advocated in the literature. Algorithms and sensors to identify patterns of human behavior, such as gestures, speech, eye gaze and facial expression, are becoming available by using low cost hardware: This paper presents a new system which uses surrogate measures such as facial expression (emotion) and head pose and movements (intention) to infer task difficulty in a driving situation. 11 drivers were recruited and observed in a simulated driving task that involved several pre-programmed events aimed at eliciting emotive reactions, such as being stuck behind slower vehicles, intersections and roundabouts, and potentially dangerous situations. The resulting system, combining face expressions and head pose classification, is capable of recognizing dangerous events (such as crashes and near misses) and stressful situations (e.g. intersections and way giving) that occur during the simulated drive.