Journal articles

Purpose The study tests the relationships between continuous improvement (CI) and clinical practices (CP) with perceived operational performance in Australian and New Zealand (NZ) emergency departments.

Design/methodology/approach A survey instrument was designed to collect data from Australian and NZ Emergency Department physicians to test a model developed from the literature, the continuous improvement and clinical practice (CICP) model. Hypotheses were developed and tested using bivariate correlation analysis and multiple regression analysis.

Findings ED operational performance is positively impacted by CI culture, reinforced by an established CI governance structure built on employee education of CI tools and methods. The lack of nonclinical time allocation for CI activities has remained a major impediment for the implementation of a sustainable CI culture. The study found physicians experience tension between continuous improvement and clinical practice.

Practical implications Developing a CI mindset across all levels of emergency departments would encourage staff to embrace change to support the implementation of CI and to improve clinical practices. The study highlights potential implications for national bodies, academics, policymakers and ED physicians. Study insights suggest that continuous improvement and effective clinical practices are crucial for enhancing ED performance results in their day-to-day responsibilities.

Originality/value The paper is original by applying methodological rigour to identify the best predictors of performance in EDs and how a theoretical causal model can be tested to identify the best predictors of operational performance in EDs.

Zines have recently emerged as methodological tools in qualitative research seeking to deploy arts-based approaches that foreground agency, collaboration, creativity, affect and critique. This article reflects on the use of zine-making as method in a project focused on Kingston and Arthur's Vale Historic Area, Norfolk Island. The article analyses seven methods used in making zine content: sticky notes, memory prompts, story completion, letter writing, interpretive text, conversations and participatory mapping. The article positions the project's multi-method approach to zine-making as a form of critical cultural justice inquiry. We discuss zine-making in terms of its sociable qualities, as well as its capacity to support representational belonging and a sense of ownership among participants over project outputs. As part of critical cultural justice inquiry, zine-making can enable ‘doing research otherwise’ – resisting extractivism and instead emphasising building relationships, engaging in dialogue and co-creating resources for hope and action.

This study sought to investigate the nuances in predictive relationships existing among teaching presence, cognitive presence and social presence as well as learner presence in the Community of Inquiry (CoI) framework towards online course satisfaction. The study is necessitated by the deficiency of current literature in providing information on the nuances in interaction among the three original presences and learner presence, prior to the final determination of online course satisfaction. Thus, the study adopted a survey design and collected data via a questionnaire from 347 postgraduate students on an online database course. Partial Least Squares Structural Equation Modelling was used to validate a definite model on the predictive relationships existing among teaching presence, cognitive presence, social presence, learner presence and online course satisfaction. Results from the structural model analysis proved a statistically significant predictive relationship between learner presence and the three other presences (i.e. cognitive presence, social presence and teaching presence). Other relationships established include social presence and cognitive presence; social presence and teaching presence. Finally, online course satisfaction was predicted by social presence and teaching presence. Based on the findings it was recommended that institutions that offer online courses should device concrete strategies that promote social presence and teaching presence since these variables are precursors to online course satisfaction. Finally, the design of online courses should be effective and learner-centred to attract the learner since learner presence determines all the other three ‘presences’ in online learning environment.

Physical activity improves myocardial structure, function and resilience via complex, incompletely defined mechanisms. We explored effects of 1-2 wks swim training on cardiac and systemic phenotype in young male C57Bl/6 mice. Two wks forced swimming (90 min twice daily) resulted in cardiac hypertrophy (22% increase in heart:body weight, P<0.01), with improved inotropy (22% higher left ventricular +dP/dt, P<0.01) and functional tolerance to ischemia-reperfusion (I-R) (40-50% reductions in stunning and diastolic dysfunction, P<0.01; without changes in cell death assessed from enzyme loss) in Langendorff perfused hearts. Initial Western immunoblot analysis indicated no shifts in cardiac expression of determinants of autophagy (LC3A/B), mitochondrial biogenesis/dynamics (PGC-1α, MFN-1, OPA-1) or stress signaling (caveolin-3, GSK-3β). Furthermore, no changes in cardiac cytokines (Il-1b, Il-6, Il-10, Il-12, GM-CSF, TNF-α, IFN-γ) were detected in multiplex immunoassays. Exploratory profiling of RTK phosphorylation provided evidence for moderately increased activity of receptors involved in cardiac/coronary growth and protection (insulin, IGF-1, FGF R2, Tie-2, PDGFβ, EphB4), together with a fall in M-CSF R and ephrin sub-type receptor phosphorylation. Swimming increased growth factor while reducing inflammatory mediators across extra-cardiac tissues (brain, pancreas, thymus, lymph nodes, white adipose tissue - WAT). This included a pattern of increased LIF, VEGF and pentraxin-2 vs. reduced CXCL2/MIP-2a, chitinase 3-like 1, CCL6, MMP9, CD40/TNFRSF5 and IGFBP6 in multiple tissues; and a shift to a pro-browning profile in WAT. Summarizing: swimming produces integrated systemic benefits, improving cardiac growth, inotropy and resilience in association with increased growth factor and reduced inflammatory and lipogenic mediators in multiple tissues.

Background: ICU patients have multiple risk factors and are vulnerable to pressure injury. Previous studies have shown that pressure injury prevalence and incidence are high in ICU compared to non-ICU samples. However, few studies report mucosal injuries, and many exclude Stage 1 pressure injuries, making benchmarking difficult.

Aim: To analyse state-wide prevalence of hospital-acquired pressure injury (HAPI) in ICU versus non-ICU patients.

Method: Secondary data analysis of five state-wide annual point-prevalence studies between 2015 to 2019. Sample: N = 15678, ICU n = 611.

Results: ICU HAPI prevalence = 9.6% (non-ICU = 2.1%; p < .001); ≥ Stage II ICU HAPI prevalence = 8.6% (non-ICU = 1.2%; p < .001); ICU patients 5 times greater likelihood to have a HAPI than non-ICU patients; ICU patients 7 times greater likelihood to have a ≥ Stage 2 HAPI than non-ICU patients. The proportion of ‘severe’ HAPIs (Stages III-IV and SDTI) in ICU (27.9%) was greater than non-ICU participants (14.4%); p = .004. The largest proportions of ICU HAPIs were on the sacrum/coccyx (20.9%) or heel (16.3%) and there was a significantly greater proportion of hospital-acquired mucosal injuries in ICU patients (1.6% versus 0.1%).

Conclusions: The difference in HAPI prevalence between ICU and non-ICU patients was statistically and clinically significant. The relatively high prevalence of HAPI in ICU indicates that despite heightened awareness of prevention in ICU, they remain a significant clinical problem. Although prevalence was high in this Australian study, it compares favourably with other recent global studies. These results may be used for national and benchmarking.

Pharmaceutical contaminants have spread in natural environments across the globe, endangering biodiversity, ecosystem functioning, and public health. Research on the environmental impacts of pharmaceuticals is growing rapidly, although a majority of studies are still conducted under controlled laboratory conditions. As such, there is an urgent need to understand the impacts of pharmaceutical exposures on wildlife in complex, real-world scenarios. Here, we validate the performance of slow-release pharmaceutical implants─a recently developed tool in field-based ecotoxicology that allows for the controlled chemical dosing of free-roaming aquatic species─in terms of the accumulation and distribution of pharmaceuticals of interest in tissues. Across two years, we directly exposed 256 Atlantic salmon (Salmo salar) smolts to one of four pharmaceutical treatments: clobazam (50 μg g-1 of implant), tramadol (50 μg g-1), clobazam and tramadol (50 μg g-1 of each), and control (0 μg g-1). Fish dosed with slow-release implants containing clobazam or tramadol, or their mixture, accumulated these pharmaceuticals in all of the sampled tissues: brain, liver, and muscle. Concentrations of both pharmaceuticals peaked in all tissues at 1 day post-implantation, before reaching relatively stable, slowly declining concentrations for the remainder of the 30-day sampling period. Generally, the highest concentrations of clobazam and tramadol were detected in the liver, followed by the brain and then muscle, with observed concentrations of each pharmaceutical being higher in the single-exposure treatments relative to the mixture exposure. Taken together, our findings underscore the utility of slow-release implants as a tool in field-based ecotoxicology, which is an urgent research priority given the current lack of knowledge on the real-world impacts of pharmaceuticals on wildlife.

To move beyond an energy economy dominated by fossil fuel utilization, high-performance electrochemical cells must be designed for energy storage and conversion. Selective etching is a promising, cost-effective solution-processing method for the large-scale top-down production of nanomaterials for high-performance electrodes. This review outlines general methodologies and mechanisms by which selective etching can be applied to create nanomaterials, including various template-assisted, facet-selective, and electrochemical methods, as well as in-depth case studies of state-of-the-art research involving selectively etched nanomaterials for electrocatalytic and energy storage applications. In addition, the standard design strategies by which the electrochemical performance of selectively etched nanomaterials is enhanced, including increased surface area, morphology, diffusion channels, heterojunction interfaces, and facet reactivity, are discussed. This review provides a foundation of knowledge for researchers seeking the rational design of nanomaterials for electrode application through selective etching.

In fewshot image classification tasks, capturing remote semantic information in feature extraction modules based on convolutional neural network and single measure of edgefeature similarity are challenging. Therefore, in this study, we present a fewshot image classification method utilizing a graph neural network based on Swin Transformer. First, the Swin Transformer is used to extract image features, which are utilized as node features in the graph neural network. Next, the edgefeature similarity measurement module is improved by adding additional metrics, thus forming a dualmeasurement module to calculate the similarity between the node features. The obtained similarity is used as the edgefeature input of the graph neural network. Finally, the nodes and edges of the graph neural network are alternately updated to predict image class labels. The classification accuracy of our proposed method for a 5- way 1- shot task on Stanford Dogs, Stanford Cars, and CUB200- 2011 datasets is calculated as 85. 21%, 91. 10%, and 91. 08%, respectively, thereby achieving significant results in fewshot image classification.

Proteins derived from microorganisms that survive in the harshest environments on Earth have stable activity under extreme conditions, providing rich resources for industrial applications and enzyme engineering. Due to the time-consuming nature of experimental determinations, it is imperative to develop computational models for fast and accurate prediction of protein optimal conditions. Previous studies were limited by the scarcity of data and the neglect of protein structures. To solve these problems, we constructed an up-to-date dataset with 175,905 non-redundant proteins and proposed a new model GeoPoc based on geometric graph learning for the protein optimal temperature, pH, and salt concentration prediction. GeoPoc leverages protein structures and sequence embeddings extracted from pre-trained language model, and further employs a geometric graph transformer network to capture the sequence and spatial information. We first focused on in-house validation for optimal temperature prediction for robustness assessment, and achieved a PCC of 0.78. The algorithm is further confirmed in an independent test set, where GeoPoc surpasses the state-of-the-art method by 2.3% in AUC. Additionally, GeoPoc was extended to pH and salt concentration prediction, and obtained AUC scores of 0.78 and 0.77, respectively. Through further interpretable analysis, GeoPoc elucidates the critical physicochemical properties that contribute to enhancing protein thermostability.

Technological advancements in the transportation sector have enabled new mobility solutions. Mobility as a Service (MaaS) is one such example that represents the integration of information technology-enabled apps with transport modes to provide door-to-door and affordable transport options to substitute private cars. Research in transportation is growing in focus on MaaS, and so are commercial MaaS products in various developed countries across the world. This study employs the systematic quantitative literature review approach to select scientific research articles on MaaS published to date and proposes a nested ecosystem framework involving actors, infrastructure, value, and customers. The ecosystem framework presented in this review provides valuable guidance to both transport sector academics and practitioners, highlighting the challenges involved in the successful deployment of MaaS schemes. In the end, this review provides future research directions to expand knowledge on MaaS to answer questions in the wake of fast-growing transport technology and global mobility patterns.

INTRODUCTION: Improving the dietary behaviors of personnel can result in positive impact beyond the individual, creating benefits for their organization and wider society. Military personnel endure extended periods of physical and cognitive activity. Healthful dietary behaviors by military personnel support preparedness; yet poor diet behaviors remain common and persistent, and adversely impact health and physical and cognitive performance. Urgent and effective action is needed to improve diet behaviors, but this action has not been prioritized. This study aimed to estimate the value that could be realized from improved diet behaviors to support prioritization of investment in this area for policy and program change. MATERIALS AND METHODS: Value estimations (via Social Return on Investment methods) were performed to determine the potential financial benefit derived from improved diet behaviors for 2 military organizations: Australia and the UK. Estimations focused on benefits of reduced attrition and separation, improved productivity, mitigation of musculoskeletal injury (MSKI) risk, and reduced medical claims. RESULTS: The value of 5 outcomes was estimated for Australia and 3 for the UK. Conservative estimates were of the order of ∼£30 million in the UK (MSKI alone) and ∼$24 million in Australia. These are not insignificant sums of money and could deliver more when invested in health and performance compared with how far they would go toward alleviating attrition, productivity losses, and MSKI. CONCLUSION: These estimates were constructed using the best available data and transparency within the calculations, but they remain estimates. The collection of additional data would enable the calculation of further outcomes and increase the usefulness of Social Return on Investment estimation in this area. Militaries should invest greater effort and funding in achieving, maintaining, and optimizing personnel health and performance. Promoting healthy diet behaviors should be prioritized as a cost-effective preventive action that supports productivity and performance, in comparison with the costs of remediating treatment. Conceptualizing the value of improving diet behaviors in monetary terms may refocus efforts on prevention rather than treatment.

Despite the significant growth of heritage consultancies in many countries over the last few decades, there is little scholarship that engages empirically with the experiences of those consulted. This article examines community attitudes towards heritage consultancy undertaken in relation to Norfolk Island’s Kingston and Arthur’s Vale Historic Area (KAVHA, or simply Kingston). Underpinned by critical cultural justice inquiry, the article analyses consultation processes as experienced by Pitcairn Settler descendants and others with long and deep connections to Kingston. Key concerns raised by participants include: the number and frequency of heritage consultancies; feeling fatigued, hopeless and that their voices are not being heard; the sense that consultancies are perfunctory with predetermined outcomes; and the inappropriateness of recommendations. Such problems stem from structural issues with Australia’s heritage consultancy industry and result in significant cultural injustices, cultural harm and symbolic violence for Kingston’s core community. A more culturally just approach to heritage consultancy must recognise that the core community of a living heritage site is not simply one of the many groups of stakeholders, but rather the experts in and custodians of their own heritage. This recognition must also translate into action via agency and power in decision-making processes related to living heritage management.

Many important pro-environmental conservation practices do not only require money, but they also require time. This paper examines what role the shadow price of time plays in shaping green preferences across different behavioral domains. Using household production theory, we develop a simple model of “selfish” green consumer behavior that predicts how (i) rising wages and (ii) longer working hours influence how consumers trade-off between purchasing relatively expensive green goods and engaging in time-intensive conservation practices. The model predicts that rising wages will increase the consumer's Willingness To Pay (WTP) for green goods, but also reduce their propensity to adopt time-intensive conservation practices. A second prediction is that self-perceived financial stress and time stress will have asymmetric effects on inhibiting the adoption of green purchasing and conservation practices. Although time stress is predicted to have no significant influence on consumers' tendency to purchase green goods, it will inhibit the consumers' tendency to engage in time-intensive conservation practices. The reverse is true for financial stress. Empirical evidence sourced from a French household survey supports these hypotheses and policy implications are discussed.

Accounting for the cost of repairing the degradation of Earth’s biosphere is critical to guide conservation and sustainable development decisions. Yet the costs of repairing nature through the recovery of a continental suite of threatened species across their range have never been calculated. We estimated the cost of in situ recovery of nationally listed terrestrial and freshwater threatened species (n = 1,657) across the megadiverse continent of Australia by combining the spatially explicit costs of all strategies required to address species-specific threats. Individual species recovery required up to 12 strategies (mean 2.3), predominantly habitat retention and restoration, and the management of fire and invasive species. The estimated costs of maximizing threatened species recovery across Australia varied from AU$0–$12,626 per ha, depending on the species, threats and context of each location. The total cost of implementing all strategies to recover threatened species in their in situ habitat across Australia summed to an estimated AU$583 billion per year, with management of invasive weeds making up 81% of the total cost. This figure, at 25% of Australia’s GDP, does not represent a realistic biodiversity conservation budget, but needs to be accounted for when weighing up decisions that lead to further costly degradation of Australia’s natural heritage.

This article delves into the role of microalgae in advancing a green economy, thereby contributing to the attainment of Sustainable Development Goals (SDGs). Microalgae, as sustainable resources, offer multifaceted benefits across various sectors, including aquaculture, agriculture, food and feed, pharmaceuticals, cosmetics, wastewater treatment, and carbon sequestration. This review highlights the versatility of microalgae in producing biofuels, high-value bioactive compounds, and bioremediation processes. It examines the technical viability and environmental sustainability of microalgae cultivation, emphasizing its low carbon footprint and resource efficiency. This article also explores the integration of microalgae into existing industrial processes, illustrating their potential to mitigate climate change, promote biodiversity, and enhance resource circularity. Challenges such as scalability, cost-effectiveness, and regulatory frameworks are discussed alongside the prospects for technological innovations and policy support to bolster the microalgae industry. By harnessing the potential of microalgae, this article underscores a pathway towards a more sustainable and greener future, aligning with the global agenda for sustainable development.

Police resistance to research is a major barrier to the implementation of evidence-based policing. In this study, we explored how individual, educational and organisational factors affect receptivity to research evidence among both police officers and criminology students in Taiwan. We did this via a longitudinal quasi-experimental design tracking two cohorts of police officers (n = 540) and a comparison group of criminology undergraduates (n = 43). Our findings show that individual, educational and organisational factors are all significantly related to police officer receptivity to research evidence. Comparing police officers to criminology students, we find that time spent in police education significantly reduces receptivity to research evidence. Among criminology students the reverse was true. The implications of the findings for police education and evidence-based policing in Taiwan are discussed.

The term irony is here used in the sense pioneered in 1983 by Lisanne Bainbridge, to describe a solution which increases rather than reduces a problem. Bainbridge used the term in relation to automation, but it can be applied to other issues, particularly in how human factors engineering relies on training, procedures, design and automation as its main app­roaches to managing human variability. ‘Human factors’ tends to consider human agility or performance variability as a liability that should either be eliminated or brought under control. The paper encourages us to recognise that variability is an indispensable asset, without which few of the common human factors solutions would ever work.

Background: Asthma is a chronic inflammatory disease and a leading cause of disability, posing a huge economic and social burden. Plant-based antioxidants have the potential to block proinflammatory pathways and protect against oxidative damage, which could improve asthma management. Objective: This review examines the role of plant-based antioxidants as adjuvant therapy on inflammatory markers and clinical outcomes of adults with asthma. Methods: Digital databases, including Scopus, MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Airway Group's Specialized Register of Trials, were searched. Two independent authors performed initial and full-text screening of identified papers. The criteria for study inclusion and exclusion were predefined. Two authors independently performed data extraction and risk of bias as per the PRISMA checklist. Results: After full-text screening, nine randomized controlled trials were included in the final review. Seven of the included studies highlighted the efficacy of plant-based antioxidants in modulating the inflammatory cytokines in asthmatics. The benefits of antioxidants were also observed for improving oxidative status, lung functioning, and airway inflammatory markers. Furthermore, the overall quality of asthmatic patients’ lives was improved with fewer exacerbations such as night coughs and wheezing. Despite having some limitations, the overall risk of bias was low in this review. Conclusion: The review indicated that plant-based antioxidants could have adjuvant beneficial effects in the management of asthma inflammatory markers, which may help improve asthma-related clinical outcomes. However, due to the small number of study subjects, further research is required on the effect of plant-based antioxidants on asthma-inflammatory markers and clinical outcomes.

Dispersal behaviour of fish expanding their range is an important component of invasion success and can evolve along dispersal pathways. Understanding the movement biology of invasive species during the spread phase of a new invasion is important for developing targeted management strategies. This study determined the extent and movement patterns of two tilapia species, Oreochromis mossambicus and Pelmatolapia mariae, in the Mitchell River catchment, northern Australia, during the spread phase of the invasion. Tilapia were only found in three locations within one sub-catchment of the Mitchell River. Strontium isotopes of tilapia otoliths revealed different movement patterns among these three locations, with active dispersal to one of the locations from both other locations. Movements made by P. mariae mostly occurred within the first two years of life. These movement patterns demonstrate active habitat seeking behaviour, mostly by juveniles, that lead to the successful establishment of tilapia at new locations within a catchment following introduction. The movement patterns revealed in this study were used to recommend priority management actions to limit the risk of tilapia spreading to vulnerable floodplain habitats and other river systems in the Gulf of Carpentaria. These include monitoring within the sub-catchment containing established tilapia and control measures applied to the established local populations to limit population growth, limiting the risk of downstream spread by reducing dispersal probability.

A novel cell topology for a vertical 1200 V SiC planar double-implanted MOSFET (DMOSFET) is proposed in this work. Based on the conventional linear cell topology and the calibrated two-dimensional (2D) technology computer-aided design (TCAD) model parameters, a novel cell topology with the insertion of P+ body implanted regions over a fractional part of the channel and junction field effect transistor (JFET) regions was designed and optimized to achieve a low high-frequency figure of merit (HF-FOM, Ron × Cgd). Utilizing three-dimensional (3D) TCAD simulations, the new proposed cell topology with optimized selected structure parameters exhibits an HF-FOM of 328.748 mΩ·pF, which is 10.02% lower than the conventional linear topology. It also shows an improvement in the switching performance, with an 11.73% reduction in switching loss. Moreover, the impact of source ohmic contact resistivity on the performance of the proposed cell topology was highlighted, indicating the dependency of the source ohmic contact resistivity on the switching performance. This research provides a new perspective for enhancing the switching performance of SiC MOSFETs in high-frequency applications, considering practical factors such as contact resistivity.