The reliability of information on work-related injuries available from hospitalisation data in Australia

Objective: To examine the reliability of work-related activity coding for injury-related hospitalisations in Australia. Method: A random sample of 4373 injury-related hospital separations from 1 July 2002 to 30 June 2004 were obtained from a stratified random sample of 50 hospitals across 4 states in Australia. From this sample, cases were identified as work-related if they contained an ICD-10-AM work-related activity code (U73) allocated by either: (i) the original coder; (ii) an independent auditor, blinded to the original code; or (iii) a research assistant, blinded to both the original and auditor codes, who reviewed narrative text extracted from the medical record. The concordance of activity coding and number of cases identified as work-related using each method were compared. Results: Of the 4373 cases sampled, 318 cases were identified as being work-related using any of the three methods for identification. The original coder identified 217 and the auditor identified 266 work-related cases (68.2% and 83.6% of the total cases identified, respectively). Around 10% of cases were only identified through the text description review. The original coder and auditor agreed on the assignment of work-relatedness for 68.9% of cases. Conclusions and Implications: The current best estimates of the frequency of hospital admissions for occupational injury underestimate the burden by around 32%. This is a substantial underestimate that has major implications for public policy, and highlights the need for further work on improving the quality and completeness of routine, administrative data sources for a more complete identification of work-related injuries.

Development of a colorimetric assay for heparanase activity suitable for kinetic analysis and inhibitor screening

The role that heparanase plays during metastasis and angiogenesis in tumors makes it an attractive target for cancer therapeutics. Despite this enzyme’s significance, most of the assays developed to measure its activity are complex. Moreover, they usually rely on labeling variable preparations of the natural substrate heparan sulfate, making comparisons across studies precarious. To overcome these problems, we have developed a convenient assay based on the cleavage of the synthetic heparin oligosaccharide fondaparinux. The assay measures the appearance of the disaccharide product of heparanase-catalyzed fondaparinux cleavage colorimetrically using the tetrazolium salt WST-1. Because this assay has a homogeneous substrate with a single point of cleavage, the kinetics of the enzyme can be reliably characterized, giving a Km of 46 μM and a kcat of 3.5 s−1 with fondaparinux as substrate. The inhibition of heparanase by the published inhibitor, PI-88, was also studied, and a Ki of 7.9 nM was determined. The simplicity and robustness of this method, should, not only greatly assist routine assay of heparanase activity but also could be adapted for high-throughput screening of compound libraries, with the data generated being directly comparable across studies.

A lava park in Spain

The lava park is surrounded by the volcanic mountains of Les Preses, revealed as the edges of a vast caldera and repeated at a human scale with low walls made up of small volcanic boulders. These walls are evidence of how successive communities have gradually worked amongst this lava flow to create arable land, supported by rich soils. The people saw the land prosper and learned how to maximise its productivity. Boulders that had come to the surface during agricultural cultivation were moved with human labour to create "artigas“, the characteristic pilings of volcanic stone. They have been used to raise and lower areas, to create shelter and exposure for their crops and to make caves for storage. Amongst all this, paths weave and cross. The whole place is made up of grey and black rocks with a constant cover of green crops or grass.

Beyond the sound barrier

Freeway barriers used to be just great slabs of concrete that lined the road to tr and protect nearby residents from the constant rumble of the traffic. But in recent years, their visual appeal has become as important as their practical purpose with architects and designers clamouring to show off their ideas to the vast traveling public. Melbourne's Craigieburn Bypass is the latest to be recognised for its dual appeal winning the Urban Design Award at the recent Victorian Architecture Awards.

Health outcomes of adults 3 months after injury

Background: Injury is a leading cause of preventable mortality and morbidity in Australia and the world. Despite this there is little research examining the health related quality of life of adults following general trauma. Methods: A prospective cohort design was used to study adults who presented to hospital following injury. Data regarding injury and demographic details was collected through the routine operation of the Queensland Trauma Registry (QTR). In addition, the short form 36 (SF-36) was mailed to patients approximately 3 months following injury. Results: Participants included 339 injured patients who were hospitalised for ≥24 h in March-June 2003. A secondary group of 145 patients completed the SF-36, but did not have QTR data collected due to hospitalisation being <24 h. Both groups of participants reported significantly lower scores on all subscales of the SF-36 when compared to Australian norms. Conclusions: Health related quality of life of injured survivors is markedly reduced 3 months after injury. Ongoing treatment and support is necessary to improve these health outcomes.

Assessment in tertiary mathematics

There is a growing consensus among many educators that the goals of teaching and learning mathematics are to help students solve real-life problems, participate intelligently in daily affairs, and prepare them for jobs (Gardiner, 1994; Roeber, 1995). These goals suggest that the role of routine procedural skills should be diminished while more emphasis ought to be placed on learners gaining conceptual insights and analytical skills that appear essential in real-life mathematical problem solving (Schoenfeld, 1993; Stenmark, 1989).

Using a longitudinal model to estimate the effect of methicillin-resistant staphylococcus aureus infection on length of stay in an intensive care unit

Healthcare-associated methicillin-resistant Staphylococcus aureus(MRSA) infection may cause increased hospital stay or, sometimes, death. Quantifying this effect is complicated because it is a time-dependent exposure: infection may prolong hospital stay, while longer stays increase the risk of infection. We overcome these problems by using a multinomial longitudinal model for estimating the daily probability of death and discharge. We then extend the basic model to estimate how the effect of MRSA infection varies over time, and to quantify the number of excess ICU days due to infection. We find that infection decreases the relative risk of discharge (relative risk ratio = 0.68, 95% credible interval: 0.54, 0.82), but is only indirectly associated with increased mortality. An infection on the first day of admission resulted in a mean extra stay of 0.3 days (95% CI: 0.1, 0.5) for a patient with an APACHE II score of 10, and 1.2 days (95% CI: 0.5, 2.0) for a patient with an APACHE II score of 30. The decrease in the relative risk of discharge remained fairly constant with day of MRSA infection, but was slightly stronger closer to the start of infection. These results confirm the importance of MRSA infection in increasing ICU stay, but suggest that previous work may have systematically overestimated the effect size.

Towards a framework for business process standardization

Organizations increasingly seek to achieve operational excellence by standardizing business processes. Standardization initiatives may have different purposes, such as process streamlining, process automation, or even process outsourcing. However, standardization of processes is easier said than done. Standardization success depends on various factors, such as existent IT capabilities, available standard frameworks, market situation, and the processes’ nature, such as their level of routine or structuredness. This paper uncovers the complex nature and relative influence of process-internal and -environmental factors relevant to process standardization, by discussing three case studies from different industries. The findings are summarized in a set of initial conjectures about successful process standardization. This exploratory research is a first step towards uncovering the characteristics of successful process standardization efforts.

Controlled rate thermal analysis of sepiolite

CRTA technology offers better resolution and a more detailed interpretation of the decomposition processes of a clay mineral such as sepiolite via approaching equilibrium conditions of decomposition through the elimination of the slow transfer of heat to the sample as a controlling parameter on the process of decomposition. Constant-rate decomposition processes of non-isothermal nature reveal changes in the sepiolite as the sepiolite is converted to an anhydride. In the dynamic experiment two dehydration steps are observed over the ~20-170 and 170-350°C temperature range. In the dynamic experiment three dehydroxylation steps are observed over the temperature ranges 201-337, 337-638 and 638-982°C. The CRTA technology enables the separation of the thermal decomposition steps.