Academic literature on the topic 'Database management Australia'

Background: Sarcomas comprise a heterogenous group of malignant tumours of mesenchymal origin and can arise in the skin. Definitive management of skin sarcoma usually entails surgical resection with wide margins, often requiring reconstruction. The incidence and demographics of these neoplasms in Australia are poorly understood. Method: Incidence, gender and age distribution data for skin sarcomas for the period 1982–2009 were obtained from the Australian Cancer Database (ACD). Morphology and topographical region coding via the International Classification of Diseases for Oncology third edition (ICD-O-3)1 were used to identify the data.Results: A total of 5453 cases of skin sarcoma in the Australian population were identified over the 28-year period. Anatomically, 1610 cases (29%) occurred on the limbs, 1416 (26%) on the head and neck area, 957 (18%) on the trunk and 1470 (27%) had an unspecified skin origin. Overall incidence was 2.09 per 100,000 population. Males were more commonly affected (70%), most commonly in the 30–49 years and 70+ years age groups. The most common pathological subtypes were fibromatous sarcoma (including dermatofibrosarcoma protuberans), Kaposi’s sarcoma and pleomorphic dermal sarcoma.Conclusion: The Australian Cancer Database data used to describe the pattern and epidemiological trends for skin sarcoma in Australia demonstrated variation from international trends and highlight the need for further research into the aetiology of these tumours.

This study investigates the short-run performance of initial public offerings in Australia. Based on sources from the Morningstar DatAnalysis database, we analyzed 211 Australian publicly traded initial public offerings (IPO) listed on the Australian stock exchange between January 2011 and December 2015 using multiple regression analysis with dummies to represent industry and listing year. According to our analysis, total market return indicates an IPO underpricing phenomenon whereas secondary market shows an overpricing scenario. Moreover, this analysis supports the contention that short-run performance fluctuations were based on the listing year and industry settings. This study contributes to the literature by analysing the short-run performance of both the primary and secondary markets

Abstract. Nationally framed assessment and planning assists coordination of resource management activities across jurisdictional boundaries and provides context for assessing the cumulative effects of impacts that can be underestimated by local or regional studies. However, there were significant shortcomings in the existing spatial frameworks supporting national assessment and planning for Australia's rivers and streams. We describe the development of a new national stream and nested catchment framework for Australia that includes a fully connected and directed stream network and a nested catchment hierarchy derived using a modified Pfafstetter scheme. The directed stream network with associated catchment boundaries and Pfafstetter coding respect all distributary junctions and topographically driven surface flow pathways including across the areas of low relief and internal drainage that make up over half of the Australian continent. The Pfafstetter coding facilitates multi-scale analyses and easy tracing and query of upstream/downstream attributes and tributary/main stem relationships. Accompanying the spatial layers are 13 lookup tables containing nearly 400 attributes describing the natural and anthropogenic environment of each of the 1.4M stream segments across the Australian continent at multiple spatial scales (segment, sub-catchment and catchment). The database supplies key spatial layers to support national water information and accounting needs and assists a wide range of research, planning and assessment tasks at regional and continental scales. These include the delineation of reporting units for the Australian Water Resources Assessment, the development of an ecohydrological environment classification for Australian streams and the identification of high conservation value aquatic ecosystems for northern Australia.

Abstract. Nationally framed assessment and planning assists coordination of resource management activities across jurisdictional boundaries and provides context for assessing the cumulative effects of impacts that can be underestimated by local or regional studies. However, there have been significant shortcomings in the existing spatial frameworks supporting national assessment and planning for Australia's rivers and streams. We describe the development of a new national stream and nested catchment framework for Australia that includes a fully connected and directed stream network and a nested catchment hierarchy derived using a modified Pfafstetter scheme. The directed stream network with associated catchment boundaries and Pfafstetter coding respect all distributary junctions and topographically driven surface flow pathways, including those in the areas of low relief and internal drainage that make up over half of the Australian continent. The Pfafstetter coding facilitates multi-scale analyses and easy tracing and query of upstream/downstream attributes and tributary/main stem relationships. Accompanying the spatial layers are 13 lookup tables containing nearly 400 attributes describing the natural and anthropogenic environment of each of the 1.4 M stream segments at multiple spatial scales (segment, sub-catchment and catchment). The database supplies key spatial layers to support national water information and accounting needs and assists a wide range of research, planning and assessment tasks at regional and continental scales. These include the delineation of reporting units for the Australian Water Resources Assessment, the development of an ecohydrological environment classification for Australian streams and the identification of high conservation value aquatic ecosystems for northern Australia.

From its small beginnings in 1981 of six pilot users and the National Library of Australia (NLA), the Australian Bibliographic Network (ABN) has grown to be a truly national system, with 1,315 users at May 1995. The National Bibliographic Database has expanded to over 11 million records and 22 million holdings statements. It includes records from the USA, the UK, Canada, New Zealand, Singapore and Vietnam. It has come to be the single union list of holdings of Australian libraries, and the first point of reference for the majority of interlibrary loan transactions. The ABN is seen as both an NLA business and a cooperative undertaking of Australian libraries. Management consists of a Network Committee, which advises the Director General of NLA on all aspects of operation, and a Standards Committee, whose role is to make recommendations to NLA on cataloguing standards for the network. Annual Users' Meetings are held. Since 1987 NLA has been developing a database host for Australian libraries called OZLINE, in parallel with ABN. In 1990 it was decided to go for complete redevelopment using a text retrieval product and an industry standard Relational Database Management System. Following discussions with the National Library of New Zealand, which had indicated broadly similar requirements, it was agreed that the two libraries would jointly seek a system. The Australian service is to be known in future as WORLD 1.

The Australian petroleum exploration research program is customer-driven and reflects the balance between the need for the petroleum industry to reduce exploration risk in the short term and the government need to improve the perception of prospectivity in the longer term. Higher prospectivity will lead to greater exploration investment and competition, whereas risk-reduction will increase the efficiency and effectiveness of the exploration industry. Thus the objectives of the primary customers may be significantly different, with government intent on increasing the amount of investment and competition between explorers, whereas industry is intent on keeping expenditure to a minimum and maintaining competitive advantage. Despite the differences, collaboration between all groups involved in exploration and exploration-related research in Australia is essential to solve the range of exploration problems and generate new paradigms. Collaborative research ventures are most successful when new ideas stimulate explorer and researcher alike to focus resources on the key questions despite factors such as competitive advantage. Government geoscience researchers must play a significant role in generating and marketing new concepts to help maintain Australia's supply of domestic petroleum products.The scale of the petroleum research undertaken, and the degree of collaboration between industry and research groups in Australia, is remarkable. There is a productive balance between groups developing and applying new technology and those undertaking regional geological and petroleum systems research. This balance has been reached because of the long-term commitment by the Australian Government, via legislation and funding, to ensure the preservation of exploration data in national geoscience database systems, and that basic and applied research at all scales, from basins to wells, is undertaken in support of petroleum exploration and development.Despite the success of a number of collaborative research projects, research and development resources are still under-utilised by the Australian petroleum industry. Government research agencies must develop a higher marketing profile to ensure that the utilisation of the resources is at a maximum.

This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper OTC 30219, “SEAR JIP: A Success Story of Collaboration and How To Improve Equipment Reliability on Subsea Production Systems,” by Adriana Botto, Wood; Manish Tomar, Chevron; and Stuart Ferrier, ConocoPhillips, et al. The paper has not been peer reviewed. Copyright 2020 Offshore Technology Conference. Reproduced by permission. The Subsea Equipment Australia Reliability (SEAR) joint industry project (JIP) is a partnership led by Wood with participation from a group of operators including Chevron Australia, ConocoPhillips, Inpex, Santos, Shell Australia, and Woodside. Now delivering Phase 6, the JIP is focused on collaboration and knowledge-sharing to improve the competitiveness of Australia’s oil and gas industry by addressing critical challenges associated with premature subsea-equipment failure. The complete paper provides an overview of the JIP and outlines lessons learned and value created. Background The SEAR JIP was initiated in 2014 with an aim of generating significant cost savings by improving subsea-equipment reliability and design for Australian operations, a goal best achieved through collaboration and knowledge-sharing. A reliability database was developed to collect offshore-operations failure information from SEAR members. The database provides a low-cost/high-value method of capturing lessons learned for subsea-equipment performance in Australia. A complementary test program, Transforming Australian Subsea Equipment Reliability (TASER), is under way to model innovative technologies under variable environments to validate equipment advancements. Phase 6 of the JIP aims to continue populating the reliability database while addressing two major industry challenges: the effect of marine fouling affecting equipment operability, and unwanted gas in subsea controls umbilicals. The outcome of this phase should provide opportunities for standardization, life extension, and development of new technologies. The JIP plans to issue an industry recommended practice in 2022 harnessing the lessons learned. This recommended practice will identify root causes of equipment failure and recommend material selection and mechanical design requirements for different environmental conditions. This will enable an improvement in equipment availability and a reduction in operating expenditures by minimizing offshore intervention to address failed equipment.

Lentil (Lens culinaris ssp. culinaris) is consumed in many countries as a rich source of protein in largely vegetarian diets. Australia grows lentil as a cash crop in rotation with cereal and produces predominantly red lentils that are exported throughout the world, particularly to countries in South Asia and the Middle East. Differentiation of varieties is important when exporting products to such markets, maintaining variety purity during seed production and in the collection of end-point royalties. Lentil-specific and fluorescent sequenced tagged microsatellite markers (STMS) markers were used to construct a DNA fingerprint database for 10 Lens culinaris ssp. culinaris genotypes (Northfield, Digger, ILL7537, Nugget, Indianhead, ILL2024, ILL6788, Palouse, Nipper and Boomer) that represent major new cultivars and key breeding lines within the Australian breeding program. All 10 lentil genotypes were distinguished using the assessed STMS loci. Unique alleles were observed for several lines, including Boomer and Nipper, varieties recently released in Australia. This database will play an important role in seed typing for commercial export certification and the commercial management of cultivars.

Introduction: The Australian healthcare system, including its management of cutaneous malignancies, has faced unprecedented challenges due to the COVID-19 pandemic. This study aimed to quantify the impact of the first wave of the pandemic on the diagnosis and management of cutaneous malignancies in Australia. Methods: Monthly service data was extracted from the Australian Medicare Benefits Schedule database for all cutaneous biopsies, non-melanotic skin cancer (NMSC) excisions and melanoma excisions performed between January 2017 and December 2019. Holt-Winters exponential smoothing forecasting models were developed for total biopsies, NMSC excisions and melanoma excisions. These models were used to predict monthly data between January 2020 and June 2020 with a 95 per cent confidence interval (p < 0.05). Absolute and percentage residual differences (RDs) between actual and predicted excisions for this time period were calculated. Results: There were statistically significant reductions in total NMSC excisions in March 2020 (RD: −6,943, −13.0%), April 2020 (RD: −8,954, −12.2%), May 2020 (RD: −17,667, −20.9%) and June 2020 (RD: −5,152, −6.9%). There were statistically significant reductions in melanoma excisions in April 2020 (RD: –695, –11.1%), May 2020 (RD: −1,982, –28.7%) and June 2020 (RD: –973, –16.0%). Conclusions: There was a significant reduction in skin cancer excisions in Australia during the COVID-19 pandemic. This observed reduction in skin cancer surgery has significant public health implications, highlighting the need for improved surveillance, diagnosis and treatment capacity of cutaneous malignancies during the recovery phase of the pandemic.

Health literacy is fundamental if people are to successfully manage their own health. This requires a range of skills and knowledge about health and health care, including finding, understanding, interpreting and communicating health information, seeking of appropriate care and making critical health decisions. A primary health system that is appropriate and universally accessible requires an active agenda based on research of approaches to address low health literacy, while health care providers should be alert to the widespread problems of health literacy which span all age levels. This article reviews the progress made in Australia on health literacy in primary health care since health literacy was included in Australia's health goals and targets in the mid-1990s. A database search of published literature was conducted to identify existing examples of health literacy programs in Australia. Considerable work has been done on mental health literacy, and research into chronic disease self-management with CALD communities, which includes health literacy, is under way. However, the lack of breadth in research has led to a knowledge base that is patchy. The few Australian studies located on health literacy research together with the data about general literacy in Australia suggests the need for much more work to be done to increase our knowledge base about health literacy, in order to develop appropriate resources and tools to manage low health literacy in primary health settings.

Information Technology plays a significant role in the administration and operation of most organisations today. This is certainly the case with each of the Australian Ambulance Services. With the rapid increase in the use of Information Technology and the expectation about its use by both staff and the general public, the Ambulance Service managements' are faced with the dilemma of trying to ensure that their organisations are able to get the full advantage of advances in Information Technology and at the same time ensure that investments in IT are maintained at appropriate levels that will ensure the maximum return on the investment in terms of the Ambulance Service achieving its mission and objectives. The research considers three questions: How are IT investment decisions determined? How are levels of IT investments determined? Do IT investments contribute to the organisation's overall effectiveness? The general feeling by the ambulance service CEOs is that the investment in IT has been worthwhile in terms of contributing to the organisation being more effective. These findings are contrary to a study by United Research/Business Week and described by LaPlante (1988) where less than half of CEOs surveyed felt that their organisation did an excellent job of linking computer strategy to corporate goals.

The aim of the research was to investigate the formation of the information management discipline, propose a framework by which it is presently understood, and test that framework within a particular area of application, namely the provision of scientific and technological information (STI) services. The work is presented as a PhD by Publication which comprises a narrative that encompasses the series of published papers, and includes excerpts from the book written to illustrate the province of the discipline. In thee book the disciplinary context is detailed and exemplified based upon information management domains. The book consolidates information management principles within a framework defined by these operational, analytical and administrative domains. It was created by a redaction of prior epistemological proposals; an analysis of the understanding of practice that has been shaped by professional, institutional and information science influences; and demonstration of practice within the domain framework. The disciplinary framework was then used in a series of STI case studies where it was found to provide an effective description of information management. Together, the book and subsequent case studies provided illustration of the principles utilised in information management and the way that they are practiced within different domains, along with an explanation of the manner in which the information management discipline has been formed. These should assist with direction of future research and scholarship particularly with respect to factors relevant to information services and indicators for their successful application in future. It is anticipated that this generalised description of the practices across the range of interpretations of information management should enable practicing information professionals to appreciate the relationship of their own work to disciplines that are converging towards similar purpose, such as through a clearer indication of the extent to which technical and management standards may be applied, and performance analysis undertaken. Complementary outcomes that were achieved during the course of the work were: a comparative analysis of thesauri in the information field which shows that in this field, the ways that information professionals represent themselves remains unreconciled; an historical examination of Australian STI services that provides pointers to their effective continuation; and a reconsideration of the relationship between librarianship and information management. The work is presented as a compilation of papers that comprise firstly extracts from the book to exemplify its consolidation of information management principles, then a number of published and submitted papers that examine how principles have been applied in practice. This is in the context of six case studies of Australian STI services including interviews with creators and developers, and analysis of historical information.

The aim of the research was to investigate the formation of the information management discipline, propose a framework by which it is presently understood, and test that framework within a particular area of application, namely the provision of scientific and technological information (STI) services. The work is presented as a PhD by Publication which comprises a narrative that encompasses the series of published papers, and includes excerpts from the book written to illustrate the province of the discipline. In thee book the disciplinary context is detailed and exemplified based upon information management domains. The book consolidates information management principles within a framework defined by these operational, analytical and administrative domains. It was created by a redaction of prior epistemological proposals; an analysis of the understanding of practice that has been shaped by professional, institutional and information science influences; and demonstration of practice within the domain framework. The disciplinary framework was then used in a series of STI case studies where it was found to provide an effective description of information management. Together, the book and subsequent case studies provided illustration of the principles utilised in information management and the way that they are practiced within different domains, along with an explanation of the manner in which the information management discipline has been formed. These should assist with direction of future research and scholarship particularly with respect to factors relevant to information services and indicators for their successful application in future. It is anticipated that this generalised description of the practices across the range of interpretations of information management should enable practicing information professionals to appreciate the relationship of their own work to disciplines that are converging towards similar purpose, such as through a clearer indication of the extent to which technical and management standards may be applied, and performance analysis undertaken. Complementary outcomes that were achieved during the course of the work were: a comparative analysis of thesauri in the information field which shows that in this field, the ways that information professionals represent themselves remains unreconciled; an historical examination of Australian STI services that provides pointers to their effective continuation; and a reconsideration of the relationship between librarianship and information management. The work is presented as a compilation of papers that comprise firstly extracts from the book to exemplify its consolidation of information management principles, then a number of published and submitted papers that examine how principles have been applied in practice. This is in the context of six case studies of Australian STI services including interviews with creators and developers, and analysis of historical information.

Information can be found in government departments in many forms. It exists, for example, as performance indicators, statistics, economic analysis, policy advice, political know-how or opinions. Using information is a daily and oft repeated activity in government departments. Information is central to the achievement of outcomes and the delivery of services. It is critical to the government’s success in the information economy. It is central to the development of products and services. It supports policy making and it underpins accountability. Government departments are built on the generation and use of information that is relevant to the largest of all customer groups, the citizens. Even though information is all-pervasive in government departments, how government departments relate to information, what value they ascribe to it, and how their attitudes about information influence their behaviours towards information, is not well understood. The focus of this study was the values, attitudes, beliefs and behaviours which government departments in the Western Australian Public Sector exhibited towards information. That is, it investigated information culture. While there has been considerable research in the area of organisational culture, there is limited evidence of the study of information culture, particularly in the public sector. The abstract nature of information culture and the limited research mean that the concept is not widely acknowledged or appreciated. What constitutes information culture, its influence on an organisation, and the potential benefit of a high performing information culture are unresolved issues in the study of information culture. In the context of the Western Australian Public Sector, this study revealed information culture as complex, systemic and reflexive. Intricate and influential relationships with organisational culture, information management and information use were identified. The key findings of this study led to the development of a model for information culture in the public sector, and a definition which reflects the systemic, complex and multidimensional nature of information culture. This was a qualitative study within an interpretivist paradigm. Case study method was employed with the Western Australian Public Sector, in particular those departments which delivered services directly to the citizens, being the single case. The key participants were drawn from the public sector and academe. Interviews with best practice organisations and those who had undertaken research previously into information culture added to the richness of the data collection.

On-shore outsourcing has been common in Australia for a number of decades across a range of business services in both the public and private sectors. Given this, there is less literature examining Australian on-shore outsourcing than one would reasonably expect. Whilst the literature examines the general motives for organisations to outsource and the economic effects of outsourcing for those organisations, it generally does not examine whether there are any differences in the motives, management strategies and techniques, and economic outcomes associated with the outsourcing of high skill functions compared to the outsourcing of low skill functions. The literature also devotes less attention than may be expected to the role of managerial strategy in determining the economic outcomes and relative successes of outsourcing projects. This study aims to contribute a bounded examination of these issues to the academic literature, by presenting an in-depth comparative investigation of the on-shore outsourcing of (high skill) IT services and (low skill) cleaning services by large Australian Government Business Entities (GBEs) and private sector companies, from each organisation’s decision to outsource to the end of their outsourcing lifecycle (relationship). The study will; identify and explain any differences (or lack of differences) in the cited motives for Australian GBEs and companies to outsource IT and cleaning services; discuss the economic impact of outsourcing decisions upon these GBEs and companies; examine the strategies used by those organisations in outsourcing cleaning and IT services, and the effects of these chosen strategies upon the economic outcomes of outsourcing for each organisation; and explain any differences (or the lack of difference) between the economic outcomes of outsourcing cleaning and IT services. The study was conducted over a number of years, using a triangulated mixed methods design involving thirteen case study organisations (with in-depth semi structured interviews with a large number of primary interview subjects at each case study organisation site) and data triangulation using corroborative interviews, company and public records, service provider records, service provider (corroborative) interviews, and focus group data.

This study has three main aims: 1. to develop software for an indigenous kinship database and genealogy using a crossplatform Java engine; 2. to contribute to a kinship study, which will serve as a fieldwork support tool for anthropologists; and 3. to assess the importance and potential of the kinship database and genealogy in IT-based indigenous knowledge management. Regarding the third aim, we would like to emphasize the importance of kinship data in the post-colonial era, and the need for kinship data in land rights issues and the recognition of indigenous identity, as well as the possibility of the autonomous use of this visualized kinship database by indigenous peoples in the future. The Alliance Project, which is named after the alliance theory by C. Levi-Strauss (1969), started as the management of a kinship study for the Yolngu people of Eastern Arnhem Land, Northern Territory, Australia, and was later extended to the study of kinship in general.

The authors in this chapter show the essence, dignity, current state, and development prospects of avatar-based management using blockchain technology for improving implementation of economic solutions in the digital economy of Russia. The purpose of this chapter is not to review the existing published work on avatar-based models for policy advice, but to try an assessment of the merits and problems of avatar-based models as a solid basis for economic policy advice that is mainly based on the work and experience within the recently finished projects Triple H Avatar, an avatar-based software platform for HHH University, Sydney, Australia. The agenda of this project was to develop an avatar-based closed model with strong empirical grounding and micro-foundations that provides a uniform platform to address issues in different areas of digital economic and creating new tools to improve blockchain technology using the intelligent visualization techniques for big data analytic.

This chapter examines the literature of healthcare in the United States during the transitioning to electronic records. Key government legislation, such as the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH), which were part of the American Recovery and Reinvestment Act (ARRA) and the Affordable Health Care Act, are reviewed. The review concentrates on patient privacy issues, how they have been addressed in these acts, and what recommendations for improvement have been found in the literature. A comparison of the adoption of electronic health records on a nationwide scale in three countries is included. England, Australia, and the United States are all embarking in and are at different stages of implementing nationwide electronic health database systems. The resources used in locating relevant literature were PubMed, Medline, Highwire Press, State Library of Pennsylvania, and Google Scholar databases.

Enabling customers to influence the way they are represented in the bank’s databases, is one of the major personalization, responsiveness, and privacy issues of banking. In this chapter we draw on the results from a qualitative study of the ways in which Australians think of privacy, security, and money. We find that changes in life stages, residence, and relationships motivate people to share additional personal information with their bank, in order to receive personalized services. The chapter proposes ways in which privacy rights management can help customers better represent themselves in a flexible manner, reflecting the changes in their lives.

Building Information Modeling (BIM) is a modern approach to the design, documentation, delivery, and life cycle management of buildings through the use of project information databases coupled with object-based parametric modeling. BIM has the potential to revolutionize the Architecture, Engineering and Construction (AEC) industry in terms of the positive impact it may have on information flows, working relationships between project participants from different disciplines and the resulting benefits it may achieve through improvements to conventional methods. This chapter reviews the development of BIM, the extent to which BIM has been implemented in Australia, and the factors which have affected the up-take of BIM. More specifically, the objectives of this chapter are to investigate the adoption of BIM in the Australian AEC industry and factors that contribute towards the uptake (or non uptake) of BIM. These objectives are met by a review of the related literature in the first instance, followed by the presentation of the results of a 2007 postal questionnaire survey and telephone interviews of a random sample of professionals in the Australian AEC industry. The responses suggest that less than 25 percent of the sample had been involved in BIM – rather less than might be expected from reading the literature. Also, of those who have been involved with BIM, there has been very little interdisciplinary collaboration. The main barriers impeding the implementation of BIM widely across the Australian AEC industry are also identified. These were found to be primarily a lack of BIM expertise, lack of awareness and resistance to change. The benefits experienced as a result of using BIM are also discussed. These include improved design consistency, better coordination, cost savings, higher quality work, greater productivity and increased speed of delivery. In terms of conclusion, some suggestions are made concerning the underlying practical reasons for the slow up-take of BIM and the successes for those early adopters. Prospects for future improvement are discussed and proposals are also made for a large scale worldwide comparative study covering industry-wide participants.

Discipline formation in information management is investigated through a case study of the origination and development of information services for scientific and technical information in Australia. Particular reference is made to a case of AESIS, a national geoscience, minerals and petroleum reference database coordinated by the Australian Mineral Foundation. This study provided a model for consideration of similar services and their contribution to the discipline. The perspective adopted is to consider information management at operational, analytical and strategic levels. Political and financial influences are considered along with analysis of scope, performance and quality control. Factors that influenced the creation, transitions, and abeyance of the service are examined, and some conclusions are drawn about an information management discipline being exemplified by such services.

Purpose – Paper points out the importance of introducing and attending various educational programs, courses and workshops that are crucial in times of crisis. Knowledge resources need to be more integrated within management organizations, to ensure efficiency and effectiveness in overcoming challenging conditions. Managers must learn and devise new ways of managing in times of crisis. Methodology – Secondary data sources, relevant studies closely related to this area of research, indexed in the databases WoS, Scopus, Hrčak, and others where used. Countries Australia, Croatia and China were selected and analyzed, with the intention of indicating the degree of representation of educational programs in the field of crisis management, or whether they exist in university education, business activities, are they publicly available and is their theme exclusively based on the still present COVID-19 pandemic? Findings – Based on the research of educational programs in the field of crisis management in three selected countries (China, Australia, Croatia) from three different continents, it was noticed regardless of the difference in their size and education systems, that there are no significant deviations in the modalities of educational programs in crisis management. Contribution – The contribution is manifested in the representation and the literature review of contribution of educational programs in the field of crisis management. Given the occurrence of crisis situations in tourism, which are increasingly common and come from different sources, the need to strengthen educational programs in this area has undoubtedly been identified.

Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.