Can the Cardiac ARIA Index Improve Cardiac Care for Australia's Indigenous Population?

Background: Timely access to appropriate cardiac care is critical for optimising outcomes. Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services for Australia's 20,387 population locations. Methods: An expert panel defined a single patient care pathway. Using geographic information systems (GIS) the numeric/alpha index was modelled in two phases. The acute phase index (numeric) ranged from 1 (access to tertiary centre with PCI ≤1 h) to 8 (no ambulance service, >3 h to medical facility, air transport required). The aftercare index was modelled into 5 alphabetic categories; A (Access to general practitioner, pharmacy, cardiac rehabilitation, pathology ≤1 h) to E (no services available within 1 h). Results: Approximately 70% or 13.9 million people lived within a CardiacARIAindex category 1A location. Disparity continues in access to category 1A cardiac services for 5.8 million (30%) of all Australians, 60% of Aboriginal and Torres Strait Islander people and 32% of people over 65 years of age. In a cardiac emergency only 40% of the Indigenous population reside within one hour of category 1 hospital. Approximately 30% (81,491 Indigenous persons) are more than one to three hours from basic cardiac services. Conclusion: Geographically, the majority of Australian's have timely access for survival of a cardiac event. The CardiacARIAindex objectively demonstrates that the healthcare system may not be providing for the needs of 60% of Indigenous people residing outside the 1A geographic radius. Innovative clinical practice maybe required to address these disparities.

Mapping Services to Support a Patient's Journey through Evidence-Based Care Pathways After a Cardiac Event

Background: There are inequalities in geographical access and delivery of health care services in Australia, particularly for cardiovascular disease (CVD), Australia's major cause of death. Analyses and models that can inform and positively influence strategies to augment services and preventative measures are needed. The Cardiac-ARIA project is using geographical spatial technology (GIS) to develop a national index for each of Australia's 13,000 population centres. The index will describe the spatial distribution of CVD health care services available to support populations at risk, in a timely manner, after a major cardiac event. Methods: In the initial phase of the project, an expert panel of cardiologists and an emergency physician have identified key elements of national and international guidelines for management of acute coronary syndromes, cardiac arrest, life-threatening arrhythmias and acute heart failure, from the time of onset (potentially dial 000) to return from the hospital to the community (cardiac rehabilitation). Results: A systematic search has been undertaken to identify the geographical location of, and type of, cardiac services currently available. This has enabled derivation of a master dataset of necessary services, e.g. telephone networks, ambulance, RFDS, helicopter retrieval services, road networks, hospitals, general practitioners, medical community centres, pathology services, CCUs, catheterisation laboratories, cardio-thoracic surgery units and cardiac rehabilitation services. Conclusion: This unique and innovative project has the potential to deliver a powerful tool to both highlight and combat the burden of disease of CVD in urban and regional Australia.

Measuring urban form : a comparative analysis of South East Queensland and South Florida

At first glance the built environments of South Florida and South East Queensland appear very similar, particularly along the highly urbanized coast. However this apparent similarity belies some fundamental differences between the two regions in terms of context and the approach to regulating development. This paper describes some of these key differences, but focuses on two research questions: 1) do these differences affect the built environment; and 2) if so, how does the built form differ? There has been considerable research on how to best measure urban form, particularly as it relates to measuring urban sprawl (Schwarz 2010; Clifton et al. 2008). Some of the key questions identified by this research include: what are the best variables to use?; what scale should be used?; and what time period to use? We will assimilate this research in order to develop a methodology for measuring urban form and apply it to both case study regions. There are several potential outcomes from this research -- one is that the built form between the two regions is quite different; and the second is that it is similar. The first outcome is what might be expected given the differences in context and development regulation. However how might the second outcome be explained – major differences in context and development regulation resulting in minor differences in key measures of urban form? One explanation is that differences in the way development is regulated are not as important in determining the built form as are private market forces.

Prediction of the wash-off of traffic related semi- and non-volatile organic compounds from urban roads under climate change influenced rainfall characteristics

Traffic generated semi and non volatile organic compounds (SVOCs and NVOCs) pose a serious threat to human and ecosystem health when washed off into receiving water bodies by stormwater. Climate change influenced rainfall characteristics makes the estimation of these pollutants in stormwater quite complex. The research study discussed in the paper developed a prediction framework for such pollutants under the dynamic influence of climate change on rainfall characteristics. It was established through principal component analysis (PCA) that the intensity and durations of low to moderate rain events induced by climate change mainly affect the wash-off of SVOCs and NVOCs from urban roads. The study outcomes were able to overcome the limitations of stringent laboratory preparation of calibration matrices by extracting uncorrelated underlying factors in the data matrices through systematic application of PCA and factor analysis (FA). Based on the initial findings from PCA and FA, the framework incorporated orthogonal rotatable central composite experimental design to set up calibration matrices and partial least square regression to identify significant variables in predicting the target SVOCs and NVOCs in four particulate fractions ranging from >300-1 μm and one dissolved fraction of <1 μm. For the particulate fractions range >300-1 μm, similar distributions of predicted and observed concentrations of the target compounds from minimum to 75th percentile were achieved. The inter-event coefficient of variations for particulate fractions of >300-1 μm were 5% to 25%. The limited solubility of the target compounds in stormwater restricted the predictive capacity of the proposed method for the dissolved fraction of <1 μm.

H. pylori-infection and antibody immune response in a rural Tanzanian population

Abstract Background: Helicobacter pylori (H. pylori) infection is ubiquitous in sub-Saharan Africa, but paradoxically gastric cancer is rare. Methods: Sera collected during a household-based survey in rural Tanzania in 1985 were tested for anti-H. pylori IgG and IgG subclass antibodies by enzyme immunoassay. Odds ratios (OR) and confidence intervals (CI) of association of seropositivity with demographic variables were computed by logistic regression models. Results: Of 788 participants, 513 were aged ≤17 years. H. pylori seropositivity increased from 76% at 0–4 years to 99% by ≥18 years of age. Seropositivity was associated with age (OR 11.5, 95% CI 4.2–31.4 for 10–17 vs. 0–4 years), higher birth-order (11.1; 3.6–34.1 for ≥3rd vs. 1st born), and having a seropositive next-older sibling (2.7; 0.9–8.3). Median values of IgG subclass were 7.2 for IgG1 and 2.0 for IgG2. The median IgG1/IgG2 ratio was 3.1 (IQR: 1.7–5.6), consistent with a Th2- dominant immune profile. Th2-dominant response was more frequent in children than adults (OR 2.4, 95% CI 1.3–4.4). Conclusion: H. pylori seropositivity was highly prevalent in Tanzania and the immunological response was Th2-dominant. Th2-dominant immune response, possibly caused by concurrent bacterial or parasitic infections, could explain, in part, the lower risk of H. pylori-associated gastric cancer in Africa.

Driver response time of queuing vehicles at urban signalized intersections

Driver response (reaction) time (tr) of the second queuing vehicle is generally longer than other vehicles at signalized intersections. Though this phenomenon was revealed in 1972, the above factor is still ignored in conventional departure models. This paper highlights the need for quantitative measurements and analysis of queuing vehicle performance in spontaneous discharge pattern because it can improve microsimulation. Video recording from major cities in Australia plus twenty two sets of vehicle trajectories extracted from the Next Generation Simulation (NGSIM) Peachtree Street Dataset have been analyzed to better understand queuing vehicle performance in the discharge process. Findings from this research will alleviate driver response time and also can be used for the calibration of the microscopic traffic simulation model.

Role of solids in heavy metals build-up on urban road surfaces

Solids are widely identified as a carrier of harmful pollutants in stormwater runoff exerting a significant risk to receiving waters. This paper outlines the findings of an in-depth investigation on heavy metal adsorption to solids surfaces. Pollutant build-up samples collected from sixteen road sites in residential, industrial and commercial land uses were separated into four particle size ranges and analysed for a range of physico-chemical parameters and nine heavy metals including Iron (Fe), Aluminum (Al), Lead (Pb), Zinc (Zn), Cadmium (Cd), Chromium (Cr), Manganese (Mn), Nickel (Ni) and Copper (Cu). High specific surface area (SSA) and total organic carbon (TOC) content in finer particle size ranges was noted, thus confirming strong correlations with heavy metals. Based on their physico-chemical characteristics, two different types of solids originating from traffic and soil sources were identified. Solids generated by traffic were associated with high loads of heavy metals such as Cd and Cr with strong correlation with SSA. This suggested the existence of surface dependent bonds such as cation exchange between heavy metals and solids. In contrast, Fe, Al and Mn which can be attributed to soil inputs showed strong correlation with TOC suggesting strong bonds such as chemsorption. Zn was found to be primarily attached to solids by bonding with the oxides of Fe, Al and Mn. The data analysis also confirmed the predominance of the finer fraction, with 70% of the solids being finer than 150 µm and containing 60% of the heavy metal pollutant load.

Benefits and issues of urban network travel time prediction

This paper presents the benefits and issues related to travel time prediction on urban network. Travel time information quantifies congestion and is perhaps the most important network performance measure. Travel time prediction has been an active area of research for the last five decades. The activities related to ITS have increased the attention of researchers for better and accurate real-time prediction of travel time. Majority of the literature on travel time prediction is applicable to freeways where, under non-incident conditions, traffic flow is not affected by external factors such as traffic control signals and opposing traffic flows. On urban environment the problem is more complicated due to conflicting areas (intersections), mid-link sources and sinks etc. and needs to be addressed.

Imagining the city : using fiction to explore urban environments

The paper will describe the ongoing project, Imagining the City: Brisbane Short Story Competition. In 2010, as part of a study investigating urban planning and the gentrification of inner city landmarks, QUT researchers developed six personas to help inform the design of city apartments. Rather than view these personas as static, the authors solicited creative responses to promote further development. Submissions of short stories based on one of the persons, and set in Brisbane, were invited from the general public. Successful stories will be published in an online anthology and as an iPhone application. The paper draws on ethnographic fiction theory to answer the question, how can research, specifically persona and use scenario, be transformed into fiction? The authors suggest that such creative responses in the form of fiction may be useful for urban designers.

People, content, location : sweet spotting urban screens for situated engagement

A growing body of research is looking at ways to bring the processes and benefits of online deliberation to the places they are about and in turn allow a larger, targeted proportion of the urban public to have a voice, be heard, and engage in questions of city planning and design. Seeking to take advantage of the civic opportunities of situated engagement through public screens and mobile devices, our research informed a public urban screen content application DIS that we deployed and evaluated in a wide range of real world public and urban environments. For example, it is currently running on the renowned urban screen at Federation Square in Melbourne. We analysed the data from these user studies within a conceptual framework that positions situated engagement across three key parameters: people, content, and location. We propose a way to identify the sweet spot within the nexus of these parameters to help deploy and run interactive systems to maximise the quality of the situated engagement for civic and related deliberation purposes.

Living with strangers: Urban space and the ethics of civility

Urban regeneration is occuring in cities across the world, as cities increase in scale and complexity. This chapter argues that in planning public spaces, greater consideration should be paid to sociability through consideration of the affective dimension of urban life.

Globalization and suburbanization : can creative industries develop in outer urban zones? the Australian case

The creative cities literature gives an emphasis to developing cultural amenity and creative clusters in inner city areas, in order to attract both international visitors and what Richard Florida termed the “creative class”. But many creative workers live in outer urban zones (suburbs). How do creative industries policies meet their needs? This paper reports on a three-year study supported by the Australian Research Council into creative workforce in Australian suburbs in the cities of Melbourne and Brisbane.

Inadequacy of land use and impervious area fraction for determining urban stormwater quality

Urban stormwater quality is multifaceted and the use of a limited number of factors to represent catchment characteristics may not be adequate to explain the complexity of water quality response to a rainfall event or site-to-site differences in stormwater quality modelling. This paper presents the outcomes of a research study which investigated the adequacy of using land use and impervious area fraction only, to represent catchment characteristics in urban stormwater quality modelling. The research outcomes confirmed the inadequacy of the use of these two parameters alone to represent urban catchment characteristics in stormwater quality prediction. Urban form also needs to be taken into consideration as it was found have an important impact on stormwater quality by influencing pollutant generation, build-up and wash-off. Urban form refers to characteristics related to an urban development such as road layout, spatial distribution of urban areas and urban design features.

Making connections : creative industries networks in outer urban locations

The role of networks and their contribution to sustaining and developing creative industries is well documented (Wittel 2001, Kong 2005, Pratt, 2007). This article argues that although networks operate across geographical boundaries, particularly through the use of communication technologies, the majority of studies have focussed on the ways in which networks operate among creative industry workers located in a) specific inner-urban metropolitan regions or b) specific industries. Such studies are informed by the geographical mindset of creative city proponents such as Florida (2002) and Landry (2000) in which inner-urban precincts are seen as the prime location or ‘hub’ for creative industries activity, business development and opportunity. But what of those creative industries situated beyond the inner city? Evidence in Australia suggests that there is increasing creative industries activity beyond the inner city, in outer-suburban and ex-urban areas (Gibson and Brennan-Horley 2006). This article identifies features of networks operating two outer-suburban locations.

Sustainable urban transport : smart technology initiatives in Singapore

Achieving sustainability is one of the major goals of many urban transportation systems. Over the years, many innovative policies have been attempted to achieve an efficient, safe, and sustainable transport system. Those policies often require smart technologies to assist implementation process and enhance effectiveness. This paper discusses how sustainability can be promoted by embedding smart technologies in a modern transportation system. In particular, this paper studies the transport system of Singapore to address how this system is addressing sustainability through the use of smart technologies. Various technological initiatives in managing traffic flow, monitoring and enforcement, sharing real-time information, and managing revenues are discussed in light of their potentiality in addressing sustainability issues. The Singapore experience provides a useful reference for the cities intending to develop and promote a sustainable transport system.