Impact of a stroke unit on length of hospital stay and in-hospital case fatality

Background and Purpose Randomized trials have demonstrated reduced morbidity and mortality with stroke unit care; however, the effect on length of stay, and hence the economic benefit, is less well-defined. In 2001, a multidisciplinary stroke unit was opened at our institution. We observed whether a stroke unit reduces length of stay and in-hospital case fatality when compared to admission to a general neurology/medical ward. Methods A retrospective study of 2 cohorts in the Foothills Medical Center in Calgary was conducted using administrative databases. We compared a cohort of stroke patients managed on general neurology/medical wards before 2001, with a similar cohort of stroke patients managed on a stroke unit after 2003. The length of stay was dichotomized after being centered to 7 days and the Charlson Index was dichotomized for analysis. Multivariable logistic regression was used to compare the length of stay and case fatality in 2 cohorts, adjusted for age, gender, and patient comorbid conditions defined by the Charlson Index. Results Average length of stay for patients on a stroke unit (n=2461) was 15 days vs 19 days for patients managed on general neurology/medical wards (n=1567). The proportion of patients with length of stay >7 days on general neurology/medical wards was 53.8% vs 44.4% on the stroke unit (difference 9.4%; P<0.0001). The adjusted odds of a length of stay >7 days was reduced by 30% (P<0.0001) on a stroke unit compared to general neurology/medical wards. Overall in-hospital case fatality was reduced by 4.5% with stroke unit care. Conclusions We observed a reduced length of stay and reduced in-hospital case-fatality in a stroke unit compared to general neurology/medical wards.

Impact of adolescent peer aggression on later educational and employment outcomes in an Australian cohort

This study used prospective birth cohort data to analyse the relationship between peer aggression at 14 years of age and educational and employment outcomes at 17 years (N = 1091) and 20 years (N = 1003). Participants from the Western Australian Pregnancy Cohort (Raine) study were divided into mutually exclusive categories of peer aggression. Involvement in peer aggression was reported by 40.2% (10.1% victims; 21.4% perpetrators; 8.7% victim–perpetrators) of participants. Participants involved in any form of peer aggression were less likely to complete secondary school. Perpetrators and victim–perpetrators of peer aggression were more likely to be in the ‘No Education, Employment or Training’ group at 20 years of age. This association was explained by non-completion of secondary school. These findings demonstrate a robust association between involvement in peer aggression and non-completion of secondary school, which in turn was associated with an increased risk of poor educational and employment outcomes in early adulthood.

Effect of bond length on the behaviour of CFRP strengthened concrete-filled steel tubes under transverse impact

Concrete-filled steel tubular (CFST) columns have shown great potential as axial load carrying member and used widely in many mission critical infrastructures. However, attention is needed to strengthen these members where transverse impact force is expected to occur due to vehicle collisions. In this work, finite element (FE) model of carbon fibre reinforced polymer (CFRP) strengthened CFST columns are developed and the effect of CFRP bond length is investigated under transverse impact loading. Initially the numerical models have been validated by comparing impact test results from literature. The validated models are then used for detail parametric studies by varying the length of externally bonded CFRP composites. The parameters considered for this research are impact velocity, impact mass, CFRP modulus, adhesive type, and axial static loading. It has been observed that the effect of CFRP strengthening is consistent after an optimum effective bond length of CFRP wrapping. The effect of effective bond length has been studied for above parameters. The results show that, under combined axial static and transverse impact loads CFST columns can successfully prevent global buckling failure by strengthening only 34% of column length. Therefore, estimation of effective bond length is essential to utilise the CFRP composites cost effectively.

Reducing the environmental impact of road construction

The practice of road construction and maintenance is inherently lean and efficient; a result of the economic benefits that are gained by minimizing wasted resources. In this age of conservation and environmental management, the inbuilt sustainability of existing road construction practices is being developed and extended to produce variety of environmentally sustainable options. A new concept of a “sustainable road” has emerged through both academia and industry, and is defined to be a road that is: - constructed to reduce environmental impacts; - designed to optimise the alignment (vertical and horizontal including considerations of ecological constraints and operational use by vehicles); - resilient to future environmental and economic pressures (e.g. climate change and resource scarcity); - adaptable to changing uses including increased travel volumes, greater demand for public and active (cycling and walking) transport, and; - able to harvest the energy to power itself.

How religiosity influences consumption: The impact of consumer religiosity on perceptions of psychological and social risk

For some people, religion is an important influence in decision-making. This thesis investigates the relationship between the religiosity of consumers and their perceived risk in adopting new products. Two studies gathered data from religious consumers living in Saudi Arabia, Australia, Canada, New Zealand, the UK and the USA. The results confirm the significant impact of religion on perceived risk, and suggest why this may lead to delays in adoption. Theoretically, these studies provide a better explanation of how religion influences consumption decisions, and offer brand managers options to improve the adoption of new products in religious markets.

Impact of electric energy storage scheduling on reliability of distribution system

The development of Electric Energy Storage (EES) integrated with Renewable Energy Resources (RER) has increased use of optimum scheduling strategy in distribution systems. Optimum scheduling of EES can reduce cost of purchased energy by retailers while improve the reliability of customers in distribution system. This paper proposes an optimum scheduling strategy for EES and the evaluation of its impact on reliability of distribution system. Case study shows the impact of the proposed strategy on reliability indices of a distribution system.

The impact of project announcements on property values: An empirical analysis

The study examines the property value impacts of an announcement of a project which has potential environmental impacts as distinct from other studies that address costs associated with under-construction and the operating impacts of developments. The hypothesis is that the announcement of a proposed project with potential environmental impact creates uncertainty in the property market of the affected area, and this impact is greater on properties closer to the project than those farther from it. The results of the study confirm the hypothesis and indicate that the marginal willingness to pay for properties within a 5 km distance declined by AU$17,020 per km proximity to the proposed heavy vehicle route, after the proposed route was announced. The results support the need for more holistic measurement of cost–benefit analysis of projects and provide a basis for improved consideration by policy makers of the rights of affected parties.

The impact of the health insurance program on the near-poor in Vietnam

This thesis is a cross-sectional study of a health insurance scheme for a representative sample of the near-poor in Cao Lanh district, Dong Thap province, Vietnam. It examines insurance coverage, health service utilisation, out-of-pocket expenditures and their associated factors. The research findings contribute evidence for policy makers who seek to improve the health insurance scheme for socioeconomically disadvantaged people in Vietnam, which is an important component of national efforts to implement universal health insurance. This community-level research adds to the evidence-base needed to improve the insurance system and thereby influence the quality of health care services.

Keep It Tame: Promoting respect online Safe And Well Online Pilot Study: Evaluating the design, engagement and impact of a social marketing approach aimed at 12 to 18 year olds

This report describes the Year One Pilot Study processes, and articulates findings from the major project components designed to address these challenges noted above (See Figure 1). Specifically, the pilot study tested the campaign research and development process involving participatory design with young people and sector partners, and the efficacy and practicality of conducting a longitudinal, randomised control trial online with minors, including ways oflinking survey data to campaign data. Each sub-study comprehensively considered the ethical requirements of conducting online research with minors in school settings. The theoretical and methodological framework for measuring campaign engagement and efficacy (Sub-studies 3, 4 and 5) drew on the Model of Goal-Directed Behaviour (MGB) (Perugini & Bagozzi 2001) and Nudge Theory (Thaler & Sunstein, 2008).

The effects of NAPLAN: Teacher perceptions of the impact of NAPLAN on pedagogy and curriculum

This paper reports preliminary findings of a survey of in-service teachers in WA and SA conducted in 2012. Participants completed an online survey open to all teachers in WA and SA. The survey ran for three months from April to June 2012. One section of the survey asked teachers to report their perceptions of the impact that NAPLAN has had on the curriculum and pedagogy of their classroom and school. Two principal research questions were addressed in this preliminary analysis. First what are teacher perceptions of the effects on NAPLAN on curriculum and pedagogy? Second, are there any interaction effects between gender, socioeconomics status, location and school system on teachers perceptions? Statistical analyses examined one- and two-way MANOVA to assess main effects and interaction effects on teachers' global perceptions. These were followed by a series of exploratory one- and two-way ANOVA of specific survey items to suggest potential sources for differences among teachers from different socioeconomic regions, states and systems. Teachers report that they are either choosing or being instructed to teach to the test, that this results in less time being spent on other curriculum areas and that these effects contribute in a negative way on the engagement of students. This largely agrees with a body of international research that suggests that high-stakes literacy and numeracy tests often results in unintended consequences such as a narrow curriculum focus (Au, 2007), a return to teacher-centred instruction (Barret, 2009) and a decrease in motivation (Ryan & Wesinstein, 2009). Preliminary results from early survey respondents suggests there is a relationship between participant responses to the effect of NAPLAN on curriculum and pedagogy based on the characteristics of which State the teacher taught in, their perceptions of the socioeconomic status of the school and the school system in which they were employed (State, Catholic, and Independent).

The impact of snares on the continuity of adolescent-onset antisocial behaviour: A test of Moffitt's developmental taxonomy

Moffitt’s dual typology of ‘life-course persistent’ and ‘adolescence limited’ offending has received extensive empirical attention, but the extent to which the antisocial behaviour of adolescence limited offenders is constrained to adolescence is relatively under-examined.Using data from the Australian Mater University Study of Pregnancy and its Outcomes, we explore Moffitt’s concept of snares, or those factors that may lead to an adolescent persisting in antisocial behaviour such as drug addiction, educational failure, and contact with the justice system. The Mater University Study of Pregnancy and its Outcomes is a longitudinal study of mother–child dyads from the pre-natal stage to 21 years of age. Findings show that one-third of individuals identified as having an adolescent onset of antisocial behaviour persisted with this antisocial behaviour as young adults. This continuity can, in part, be explained by snares and the research suggests that reducing exposure to snares may lead to less antisocial behaviour in adulthood.

Computer analysis of impact behavior of concrete filled steel tube columns

This paper presents a numerical study of the response of axially loaded concrete filled steel tube (CFST) columns under lateral impact loading using explicit non-linear finite element techniques. The aims of this paper are to evaluate the vulnerability of existing columns to credible impact events as well as to contribute new information towards the safe design of such vulnerable columns. The model incorporates concrete confinement, strain rate effects of steel and concrete, contact between the steel tube and concrete and dynamic relaxation for pre-loading, which is a relatively recent method for applying a pre-loading in the explicit solver. The finite element model was first verified by comparing results with existing experimental results and then employed to conduct a parametric sensitivity analysis. The effects of various structural and load parameters on the impact response of the CFST column were evaluated to identify the key controlling factors. Overall, the major parameters which influence the impact response of the column are the steel tube thickness to diameter ratio, the slenderness ratio and the impact velocity. The findings of this study will enhance the current state of knowledge in this area and can serve as a benchmark reference for future analysis and design of CFST columns under lateral impact.

The differential impact of monetary policy announcements and explanatory minutes releases on the Australian interest rate futures market

Unlike US and Continental European jurisdictions, Australian monetary policy announcements are not followed promptly by projections materials or comprehensive summaries that explain the decision process. This information is disclosed 2 weeks later when the explanatory minutes of the Reserve Bank board meeting are released. This paper is the first study to exploit the features of the Australian monetary policy environment in order to examine the differential impact of monetary policy announcements and explanatory statements on the Australian interest rate futures market. We find that both monetary policy announcements and explanatory minutes releases have a significant impact on the implied yield and volatility of Australian interest rate futures contracts. When the differential impact of these announcements is examined using the full sample, no statistically significant difference is found. However, when the sample is partitioned based on stable periods and the Global Financial Crisis, a differential impact is evident. Further, contrary to the findings of Kim and Nguyen (2008), Lu et al. (2009), and Smales (2012a), the response along the yield curve, is found to be indifferent between the short and medium terms.

The impact of nonlinear pedagogy on physical education teacher education students’ intrinsic motivation

Background: Providing motivationally supportive physical education experiences for learners is crucial since empirical evidence in sport and physical education research has associated intrinsic motivation with positive educational outcomes. Self-determination theory (SDT) provides a valuable framework for examining motivationally supportive physical education experiences through satisfaction of three basic psychological needs: autonomy, competence and relatedness. However, the capacity of the prescriptive teaching philosophy of the dominant traditional physical education teaching approach to effectively satisfy the psychological needs of students to engage in physical education has been questioned. The constraints-led approach (CLA) has been proposed as a viable alternative teaching approach that can effectively support students’ self-motivated engagement in physical education. Purpose: We sought to investigate whether adopting the learning design and delivery of the CLA, guided by key pedagogical principles of nonlinear pedagogy (NLP), would address basic psychological needs of learners, resulting in higher self-reported levels of intrinsic motivation. The claim was investigated using action research. The teacher/researcher delivered two lessons aimed at developing hurdling skills: one taught using the CLA and the other using the traditional approach. Participants and Setting: The main participant for this study was the primary researcher and lead author who is a PETE educator, with extensive physical education teaching experience. A sample of 54 pre-service PETE students undertaking a compulsory second year practical unit at an Australian university was recruited for the study, consisting of an equal number of volunteers from each of two practical classes. A repeated measures experimental design was adopted, with both practical class groups experiencing both teaching approaches in a counterbalanced order. Data collection and analysis: Immediately after participation in each lesson, participants completed a questionnaire consisting of 22 items chosen from validated motivation measures of basic psychological needs and indices of intrinsic motivation, enjoyment and effort. All questionnaire responses were indicated on a 7-point Likert scale. A two-tailed, paired-samples t-test was used to compare the groups’ motivation subscale mean scores for each teaching approach. The size of the effect for each group was calculated using Cohen’s d. To determine whether any significant differences between the subscale mean scores of the two groups was due to an order effect, a two-tailed, independent samples t test was used. Findings: Participants’ reported substantially higher levels of self-determination and intrinsic motivation during the CLA hurdles lesson compared to during the traditional hurdles lesson. Both groups reported significantly higher motivation subscale mean scores for competence, relatedness, autonomy, enjoyment and effort after experiencing the CLA than mean scores reported after experiencing the traditional approach. This significant difference was evident regardless of the order that each teaching approach was experienced. Conclusion: The theoretically based pedagogical principles of NLP that inform learning design and delivery of the CLA may provide teachers and coaches with tools to develop more functional pedagogical climates, which result in students exhibiting more intrinsically motivated behaviours during learning.

Multilingualism and speech-language competence in early childhood: Impact on academic and social-emotional outcomes at school

This large-scale longitudinal population study provided a rare opportunity to consider the interface between multilingualism and speech-language competence on children’s academic and social-emotional outcomes and to determine whether differences between groups at 4 to 5 years persist, deepen, or disappear with time and schooling. Four distinct groups were identified from the Kindergarten cohort of the Longitudinal Study of Australian Children (LSAC) (1) English-only + typical speech and language (n = 2,012); (2) multilingual + typical speech and language (n = 476); (3) English-only + speech and language concern (n = 643); and (4) multilingual + speech and language concern (n = 109). Two analytic approaches were used to compare these groups. First, a matched case-control design was used to randomly match multilingual children with speech and language concern (group 4, n = 109) to children in groups 1, 2, and 3 on gender, age, and family socio-economic position in a cross-sectional comparison of vocabulary, school readiness, and behavioral adjustment. Next, analyses were applied to the whole sample to determine longitudinal effects of group membership on teachers’ ratings of literacy, numeracy, and behavioral adjustment at ages 6 to 7 and 8 to 9 years. At 4 to 5 years, multilingual children with speech and language concern did equally well or better than English-only children (with or without speech and language concern) on school readiness tests but performed more poorly on measures of English vocabulary and behavior. At ages 6 to 7 and 8 to 9, the early gap between English-only and multilingual children had closed. Multilingualism was not found to contribute to differences in literacy and numeracy outcomes at school; instead, outcomes were more related to concerns about children’s speech and language in early childhood. There were no group differences for socio-emotional outcomes. Early evidence for the combined risks of multilingualism plus speech and language concern was not upheld into the school years.