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Do, Cameron, Georgia Elizabeth Saunders, and Yuriy Kuleshov. "Assessment of Tropical Cyclone Risk to Coral Reefs: Case Study for Australia." Remote Sensing 14, no. 23 (December 4, 2022): 6150. http://dx.doi.org/10.3390/rs14236150.
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In this study, we attempt to expand tropical cyclone (TC) risk assessment methodology and build an understanding of TC risk to Australia’s natural environment by focusing on coral reefs. TCs are natural hazards known to have the potential to bring destruction due to associated gale-force winds, torrential rain, and storm surge. The focus of TC risk assessment studies has commonly centred around impacts on human livelihoods and infrastructure exposed to TC events. In our earlier study, we created a framework for assessing multi-hazard TC risk to the Australian population and infrastructure at the Local Government Area level. This methodology is used in this study with coral reefs as the focus. TC hazard, exposure, and vulnerability indices were created from selected coral-related datasets to calculate an overall TC risk index for the Ningaloo Reef (NR) and the Great Barrier Reef (GBR) regions. The obtained results demonstrate that the northern NR and the southern GBR had the highest risk values within the study area; however, limitations in data quality have meant that results are estimates at best. The study has shown the potential benefits of such a TC risk assessment framework that can be improved upon, as coral data collection becomes more readily available.
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Werner, Tim, Peter Bach, Mohan Yellishetty, Fatemeh Amirpoorsaeed, Stuart Walsh, Alec Miller, Matthew Roach, et al. "A Geospatial Database for Effective Mine Rehabilitation in Australia." Minerals 10, no. 9 (August 22, 2020): 745. http://dx.doi.org/10.3390/min10090745.
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The Australian landscape is affected by abandoned mines that pose environmental, public health and safety risks. To promote the beneficial reuse, rehabilitation and/or remediation of these sites and understand their spatial arrangement, we compiled, classified and analysed a country-wide geospatial database of all known inactive hard rock mine sites. Following extensive review and classification of disparate records of such sites that have been terminated, neglected or classified as heritage, plus those under care and maintenance in Australia, we assessed state-by-state reporting and cross-border rehabilitation requirements. This was enabled by the development of the Mining Incidence Documentation & Assessment Scheme (MIDAS) that can be used to catalogue and compare active or inactive mine data regardless of reporting conventions. At a national level, and with four case studies, we performed GIS-based spatial analyses and environmental risk assessments to demonstrate potential uses of our database. Analyses considered the proximity of sites to factors such as infrastructure and sensitive environmental receptors. As Australia struggles to manage the ongoing technical, socioeconomic and environmental challenges of effective mine rehabilitation, the insights enabled by this national-level spatial database may be key to developing coordinated responses that extend beyond state boundaries. Our classification and methodology are easily transferable, thereby encouraging more formalized, systematic and widespread documentation of abandoned mines worldwide.
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Kelly, Matthew, and Yuriy Kuleshov. "Flood Hazard Assessment and Mapping: A Case Study from Australia’s Hawkesbury-Nepean Catchment." Sensors 22, no. 16 (August 19, 2022): 6251. http://dx.doi.org/10.3390/s22166251.
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Floods are among the costliest natural hazards, in Australia and globally. In this study, we used an indicator-based method to assess flood hazard risk in Australia’s Hawkesbury-Nepean catchment (HNC). Australian flood risk assessments are typically spatially constrained through the common use of resource-intensive flood modelling. The large spatial scale of this study area is the primary element of novelty in this research. The indicators of maximum 3-day precipitation (M3DP), distance to river—elevation weighted (DREW), and soil moisture (SM) were used to create the final Flood Hazard Index (FHI). The 17–26 March 2021 flood event in the HNC was used as a case study. It was found that almost 85% of the HNC was classified by the FHI at ‘severe’ or ‘extreme’ level, illustrating the extremity of the studied event. The urbanised floodplain area in the central-east of the HNC had the highest FHI values. Conversely, regions along the western border of the catchment had the lowest flood hazard risk. The DREW indicator strongly correlated with the FHI. The M3DP indicator displayed strong trends of extreme rainfall totals increasing towards the eastern catchment border. The SM indicator was highly variable, but featured extreme values in conservation areas of the HNC. This study introduces a method of large-scale proxy flood hazard assessment that is novel in an Australian context. A proof-of-concept methodology of flood hazard assessment developed for the HNC is replicable and could be applied to other flood-prone areas elsewhere.
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Tan, Samson, Darryl Weinert, Paul Joseph, and Khalid Moinuddin. "Impact of Technical, Human, and Organizational Risks on Reliability of Fire Safety Systems in High-Rise Residential Buildings—Applications of an Integrated Probabilistic Risk Assessment Model." Applied Sciences 10, no. 24 (December 14, 2020): 8918. http://dx.doi.org/10.3390/app10248918.
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The current paper presents an application of an alternative probabilistic risk assessment methodology that incorporates technical, human, and organizational risks (T-H-O-Risk) using Bayesian network (BN) and system dynamics (SD) modelling. Seven case studies demonstrate the application of this holistic approach to the designs of high-rise residential buildings. An incremental risk approach allows for quantification of the impact of human and organizational errors (HOEs) on different fire safety systems. The active systems considered are sprinklers, building occupant warning systems, smoke detectors, and smoke control systems. The paper presents detailed results from T-H-O-Risk modelling for HOEs and risk variations over time utilizing the SD modelling to compare risk acceptance in the seven case studies located in Australia, New Zealand, Hong Kong, Singapore, and UK. Results indicate that HOEs impact risks in active systems up to ~33%. Large variations are observed in the reliability of active systems due to HOEs over time. SD results indicate that a small behavioral change in ’risk perception’ of a building management team can lead to a very large risk to life variations over time through the self-reinforcing feedback loops. The quantification of difference in expected risk to life due to technical, human, and organizational risks for seven buildings for each of 16 trial designs is a novel aspect of this study. The research is an important contribution to the development of the next generation building codes and risk assessment methods.
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Roser, D. J., C. M. Davies, N. J. Ashbolt, and P. Morison. "Microbial exposure assessment of an urban recreational lake: a case study of the application of new risk-based guidelines." Water Science and Technology 54, no. 3 (August 1, 2006): 245–52. http://dx.doi.org/10.2166/wst.2006.476.
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New WHO and Australian guidelines promote a risk-management approach for minimising exposure to pathogens in recreational waters. Between 2003 and 2005, they were applied to Lake Parramatta (10 ha, 450 ML), a potential recreation site in Sydney, Australia. A three stage approach was developed involving (1) initial suitability assessment using historic data, (2) revised suitability assessment based on new data and (3) characterisation of hazardous (especially wet weather) events. Contrary to the stage 1 suitability classification, stage 2 baseline data indicated that during dry weather the lake had water quality sufficient for primary contact recreation (95th percentiles for enterococci=19 MPN/100, n=50) and the major pathogen source was wildfowl. Guideline principles provided a rationale for collecting microbiological and geographic data needed to understand local cycles of lake contamination/recovery. The concept of hazardous events was particularly useful. Studies of stormwater events led us to identify a transition point (>10 mm rainfall in 24 h) where human-faecal pathogen risks increased and access needed to be controlled. Together baseline and event data yielded operational tools (i.e. event detection methods, action triggers, auditing criteria, remediation priorities) for minimising bather exposure.
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Shafapourtehrany, Mahyat. "Geospatial Wildfire Risk Assessment from Social, Infrastructural and Environmental Perspectives: A Case Study in Queensland Australia." Fire 6, no. 1 (January 9, 2023): 22. http://dx.doi.org/10.3390/fire6010022.
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Although it is hard to predict wildfires, risky areas can be systematically assessed and managed. Some of the factors for decision-making are hazard, vulnerability, and risk maps, which are the end product of wildfire mapping. This study deals with wildfire risk analysis in Queensland, Australia. A review of the previous studies focusing on each aspect has been done and used with wildfire records from 2011 to 2019 in Queensland, Australia, to compile the required input models to detect risky wildfire regions. Machine learning (ML) methods of Decision Tree (DT) and Support Vector Machine (SVM) were used to perform hazard assessment. The reason was to select the most accurate outcomes for the rest of the analysis. Among accuracy assessment techniques, the Area Under Curvature (AUC) method was used to evaluate the hazard maps. Prediction rates of 89.21% and 83.78% were obtained for DT and SVM, respectively. The DT prediction value showed that the DT-hazard map was more accurate than the SVM-hazard map. Vulnerability analysis was implemented by assigning weights to each factor according to the literature. Lastly, in order to create the wildfire risk map, the hazard and vulnerability indices were combined. The risk map showed that particularly dense urbanization regions are under future wildfire risk. To perform preliminary land use planning, this output can be used by local governmental authorities.
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de Silva, Andrea M., Jacqueline M. Martin-Kerry, Katherine McKee, and Deborah Cole. "Caries and periodontal disease in Indigenous adults in Australia: a case of limited and non-contemporary data." Australian Health Review 41, no. 4 (2017): 469. http://dx.doi.org/10.1071/ah15229.
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Objective The aim of the present study was to identify all evidence about the prevalence and severity of clinically measured caries and periodontal disease in Indigenous adults in Australia published in peer-reviewed journals and to summarise trends over time. In addition, we examined whether the studies investigated associations between putative risk factors and levels of caries and periodontal disease. Methods PubMed was searched in September 2014, with no date limitations, for published peer-reviewed articles reporting the prevalence rates and/or severity of caries and periodontal disease in Indigenous adults living in Australia. Articles were excluded if measurement was not based on clinical assessment and if oral disease was reported only in a specific or targeted sample, and not the general population. Results The search identified 18 papers (reporting on 10 primary studies) that met the inclusion criteria. The studies published clinical data about dental caries and/or periodontal disease in Australian Indigenous adults. The studies reported on oral health for Indigenous adults living in rural (40%), urban (10%) and both urban and rural (50%) locations. Included studies showed that virtually all Indigenous adults living in rural locations had periodontal disease. The data also showed caries prevalence ranged from 46% to 93%. Although 10 studies were identified, the peer-reviewed literature was extremely limited and no published studies were identified that provided statistics for a significant proportion of Australia (Victoria, Tasmania, Queensland or the Australian Capital Territory). There were also inconsistencies in how the data were reported between studies, making comparisons difficult. Conclusions This review highlights a lack of robust and contemporary data to inform the development of policies and programs to address the disparities in oral health in Indigenous populations living in many parts of Australia. What is known about the topic? Many studies report that Indigenous people in Australia have poorer general health compared with non-Indigenous people. What does this paper add? This paper documents the available caries and periodontal disease prevalence and experience for Indigenous adults in Australia published in peer-reviewed journals. It demonstrates significant limitations in the data, including no data in several large Australian jurisdictions, inconsistency with reporting methods and most data available being for Indigenous adults living in rural locations. Therefore, the oral health data available in the peer-reviewed literature do not reflect the situation of all Indigenous people living in Australia. What are the implications for practitioners? It is important for oral health practitioners to have access to current and relevant statistics on the oral health of Indigenous Australians. However, we have highlighted significant evidence gaps for this population group within the peer-reviewed literature and identified the limitations of the available data upon which decisions are currently being made. This paper also identifies ways to capture and report oral health data in the future to enable more meaningful comparisons and relevance for use in policy development.
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Parker, Amy L., Pascal Castellazzi, Thomas Fuhrmann, Matthew C. Garthwaite, and Will E. Featherstone. "Applications of Satellite Radar Imagery for Hazard Monitoring: Insights from Australia." Remote Sensing 13, no. 8 (April 7, 2021): 1422. http://dx.doi.org/10.3390/rs13081422.
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Earth observation (EO) satellites facilitate hazard monitoring and mapping over large-scale and remote areas. Despite Synthetic Aperture Radar (SAR) satellites being well-documented as a hazard monitoring tool, the uptake of these data is geographically variable, with the Australian continent being one example where the use of SAR data is limited. Consequently, less is known about how these data apply in the Australian context, how they could aid national hazard monitoring and assessment, and what new insights could be gleaned for the benefit of the international disaster risk reduction community. The European Space Agency Sentinel-1 satellite mission now provides the first spatially and temporally complete global SAR dataset and the first opportunity to use these data to systematically assess hazards in new locations. Using the example of Australia, where floods and uncontrolled bushfires, earthquakes, resource extraction (groundwater, mining, hydrocarbons) and geomorphological changes each pose potential risks to communities, we review past usage of EO for hazard monitoring and present a suite of new case studies that demonstrate the potential added benefits of SAR. The outcomes provide a baseline understanding of the potential role of SAR in national hazard monitoring and assessment in an Australian context. Future opportunities to improve national hazard identification will arise from: new SAR sensing capabilities, which for Australia includes a first-ever civilian EO capability, NovaSAR-1; the integration of Sentinel-1 SAR with other EO datasets; and the provision of standardised SAR products via Analysis Ready Data and Open Data Cubes to support operational applications.
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Britton, Neil R., and John Lindsay. "Demonstrating the Need to Integrate City Planning and Emergency Preparedness: Two Case Studies." International Journal of Mass Emergencies & Disasters 13, no. 2 (August 1995): 161–78. http://dx.doi.org/10.1177/028072709501300203.
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City planners need to consider aspects of emergency management, risk assessment and hazard vulnerability in their planning and development deliberations. Planners need to recognise that urban hazards, especially from technological sources, are more prevalent than may at first be apparent. An emergency management focus is particularly necessary when urban renewal and redevelopment is being considered Of special importance is the need for planners to understand that projects like this can exacerbate the plight of existing “at-risk” groups, and may even create a more hazardous social environment. Planners also need to be made aware that their professional actions have a direct impact on both the task-set and performance capabilities of disaster managers and emergency services operatives. In this paper two case studies are presented to demonstrate how these issues translate into practice. The first explores the consequences of a “classic” medium-scale technological emergency in Australia. The second study, from Canada, illustrates the ubiquity of small-scale industrial hazards in the modern city, and epitomises the extent to which city-dwellers are vulnerable.
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Moshi, Magdalena, Jacqueline Parsons, Rebecca Tooher, and Tracy Merlin. "OP143 Assessment Of mHealth Apps: Is Current Regulation Policy Adequate?" International Journal of Technology Assessment in Health Care 35, S1 (2019): 33. http://dx.doi.org/10.1017/s0266462319001697.
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IntroductionAustralians are adjusting to mobile health (mHealth) applications (apps) being used in clinical care. The nature of apps presents unique challenges (e.g. rapid lifecycle) to mHealth regulation. The risks they pose are mainly through the information they provide and how it is used in clinical decision-making. This study explores the international regulation of mHealth apps. It assesses whether the approach used in Australia to regulate apps is consistent with international standards and suitable to address the unique challenges presented by the technology.MethodsA policy analysis was conducted of all nine member jurisdictions of the International Medical Device Regulator's Forum (IMDRF), to determine if their regulatory agencies addressed the IMDRF recommendations relevant to the clinical evaluation of mHealth apps. Case-studies (submission to regulatory agencies) were also selected on varying types of regulated apps (standalone, active implantable, etc.) and assessed relative to the principles in the IMDRF's software as a medical device (SaMD): Clinical evaluation (2017) guidance document.ResultsAll included jurisdictions evaluated the effectiveness of mHealth apps, assessing the majority of the key sub-categories recommended by SaMD: Clinical evaluation. The submissions and jurisdictional regulatory bodies did not address the IMDRF safety principles in terms of the apps’ information security (cybersecurity). Furthermore, by failing to use the method recommended by the IMDRF (risk-classification), none of the submissions or jurisdictions recognized the potential dangers of misinformation on patient safety.ConclusionsNone of the approaches used by global regulatory bodies adequately address the unique challenges posed by apps. Australia's approach is consistent with app regulatory procedures used internationally. We recommend that mHealth apps are evaluated for cybersecurity and are also classified using the IMDRF risk-categories so as to fully protect the public.
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Bonini, Jim, Lucy Muir, and Steven Blackmore. "How an integrated multi-discipline approach to ALARP assessments can yield production increases while minimising HSE risk." APPEA Journal 56, no. 2 (2016): 543. http://dx.doi.org/10.1071/aj15049.
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Demonstration that risks are reduced to as low as reasonably practicable (ALARP) is a fundamental element of safety and environment regulation in the Australian oil and gas industry. The principle is well established, and offers operators relative flexibility in designing and managing their operations when compared to the more prescriptive regime adopted in other countries, such as the US. The approach, however, to building the ALARP case invariably differs between safety, environmental, and technical disciplines within oil and gas operators, leading to conflicting outcomes and sub-optimal solutions, which in turn can hamper production output and efficiency. A recent change in offshore regulations requires operators to focus on reducing overall environmental impacts from produced water through the ALARP principle, rather than by a prescribed limit. Through options screening, detailed technical studies, and consideration of environment and health and safety trade-offs, a robust ALARP position can be achieved, which yields increased production and efficiency, and reduced environmental impact, health and safety risk and associated cost. Drawing on recent project case studies with offshore oil and gas operators in Australia, the authors present best practices in the development of integrated ALARP cases for activities including produced water treatment and decommissioning.
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Chee, Amanda Hwa Ling, Edelina Melisa, and Xin Dong. "Case Studies: Application of Oil Spill Response Good Practice Guides for Inland and Near-shore Operations." International Oil Spill Conference Proceedings 2017, no. 1 (May 1, 2017): 2017254. http://dx.doi.org/10.7901/2169-3358-2017.1.000254.
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Following key oil spill incidents in the Gulf of Mexico and Australia, the industry initiated a three-year Joint Industry Project to develop guidelines for oil spill preparedness and response management. These documents are commonly known as the Oil Spill Response JIP (OSR-JIP) Good Practice Guides. As the OSR-JIP originated from lessons learnt from offshore incidents, it is only natural that the industry would apply it with the same type of operation, hence the tendency to limit the practical application for inland or near-shore facilities. This paper presents two examples where the OSR-JIP guides are applied at downstream operations located inland and near-shore. The first study is on a refinery located near-shore with an operational jetty and a single buoy mooring. We started with a comprehensive review of their operations and updated their oil spill risk assessment profile in line with the framework described in the OSR-JIP Tiered Preparedness and Response. This process provided a reflection of their current capability and identified the gaps for further improvement. Following this, we proceeded to update the contingency plan using the OSR-JIP Contingency Planning to ensure that the risks identified are adequately mitigated with training of personnel and equipment selection. This exercise supported in improving the readiness of the facility to respond to oil spill incidents in future. The second study involves a terminal located inland that supplies refined products through a pipeline that leads towards a jetty on the coast. We developed several area specific tactical response plans that cover risks from their above-ground pipelines and at the jetty where loading and offloading of the products to tankers are conducted. To accurately define the suitable response technique, we started the planning process with an oil spill risk assessment following OSR-JIP Risk Assessment. The tactical response plans were then developed with reference to several other OSR-JIP guides such as OSR-JIP Inland Response and NEBA. The resulting plans describe health and safety concerns, identification of sensitive receptors, response techniques, location and quantity of resources, logistical requirements and timings and waste management. Based on these case studies, we demonstrated that the OSR-JIP guides can certainly be applied for inland and near-shore facilities and have a more far wider application for the whole oil and gas industry rather than be limited to offshore operations.
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van Wilgen, Nicola J., Micaela S. Gillespie, David M. Richardson, and John Measey. "A taxonomically and geographically constrained information base limits non-native reptile and amphibian risk assessment: a systematic review." PeerJ 6 (November 8, 2018): e5850. http://dx.doi.org/10.7717/peerj.5850.
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For many taxa, new records of non-native introductions globally occur at a near exponential rate. We undertook a systematic review of peer-reviewed publications on non-native herpetofauna, to assess the information base available for assessing risks of future invasions, resulting in 836 relevant papers. The taxonomic and geographic scope of the literature was also compared to a published database of all known invasions globally. We found 1,116 species of herpetofauna, 95% of which were present in fewer than 12 studies. Nearly all literature on the invasion ecology of herpetofauna has appeared since 2000, with a strong focus on frogs (58%), particularly cane toads (Rhinella marina) and their impacts in Australia. While fewer papers have been published on turtles and snakes, proportionately more species from both these groups have been studied than for frogs. Within each herpetofaunal group, there are a handful of well-studied species:R. marina,Lithobates catesbeianus, Xenopus laevis,Trachemys scripta,Boiga irregularisandAnolis sagrei. Most research (416 papers; 50%) has addressed impacts, with far fewer studies on aspects like trade (2%). Besides Australia (213 studies), most countries have little location-specific peer-reviewed literature on non-native herpetofauna (on average 1.1 papers per established species). Other exceptions were Guam, the UK, China, California and France, but even their publication coverage across established species was not even. New methods for assessing and prioritizing invasive species such as the Environmental Impact Classification for Alien Taxa provide useful frameworks for risk assessment, but require robust species-level studies. Global initiatives, similar to the Global Amphibian Assessment, using the species and taxonomic groups identified here, are needed to derive the level of information across broad geographic ranges required to apply these frameworks. Expansive studies on model species can be used to indicate productive research foci for understudied taxa.
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Lüthi, Samuel, Gabriela Aznar-Siguan, Christopher Fairless, and David N. Bresch. "Globally consistent assessment of economic impacts of wildfires in CLIMADA v2.2." Geoscientific Model Development 14, no. 11 (November 25, 2021): 7175–87. http://dx.doi.org/10.5194/gmd-14-7175-2021.
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Abstract. In light of the dramatic increase in economic impacts due to wildfires over recent years, the need for globally consistent impact modelling of wildfire damages is ever increasing. Insurance companies, individual households, humanitarian organizations, governmental authorities, and investors and portfolio owners are increasingly required to account for climate-related physical risks. In response to these societal challenges, we present an extension to the open-source and open-access risk modelling platform CLIMADA (CLImate ADAptation) for modelling economic impacts of wildfires in a globally consistent and spatially explicit approach. All input data are free, public and globally available, ensuring applicability in data-scarce regions of the Global South. The model was calibrated at resolutions of 1, 4 and 10 km using information on past wildfire damage reported by the disaster database EM-DAT. Despite the large remaining uncertainties, the model yields sound damage estimates with a model performance well in line with the results of other natural catastrophe impact models, such as for tropical cyclones. To complement the global perspective of this study, we conducted two case studies on the recent megafires in Chile (2017) and Australia (2020). The model is made available online as part of a Python package, ready for application in practical contexts such as disaster risk assessment, near-real-time impact estimates or physical climate risk disclosure.
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Sathye, Milind, and Jesmin Islam. "Adopting a risk‐based approach to AMLCTF compliance: the Australian case." Journal of Financial Crime 18, no. 2 (May 10, 2011): 169–82. http://dx.doi.org/10.1108/13590791111127741.
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PurposeThe purpose of this paper is to develop a possible method of money laundering and terrorism financing (MLTF) risk assessment in non‐bank entities that are the subject matter of anti‐money laundering and counter terrorism financing (AMLCTF) Tranche II in Australia.Design/methodology/approachThe objectives are achieved by proposing a scorecard of risk assessment under its various dimensions drawing from the literature on credit‐scoring models. The method of analogy has been used and appropriate changes made to the elements of typical credit‐scoring model to arrive at a risk assessment model under AMLCTF II. The theory in which the paper is grounded is theories of money laundering regulation. Theory suggests an inverse relationship between money laundering regulation and the amount of money laundering. The more effective the regulatory mechanism the more costly it is for money launderers to launder funds and the lesser the amount of money laundering.FindingsIt was found that the AMLCTF Tranche II will impose several obligations the AMLCTF Tranche II legislation will impose several obligations on the entities such as accounting firms. These obligations require the identification, mitigation and management of MLTF risk arising out of provision of product/service. Two types of risks need to be managed by entities: regulatory risk and business risk. This paper, therefore, proposed a possible method for approaching the issue of risk assessment drawing from the literature on credit‐scoring models.Research limitations/implicationsFuture studies can undertake such surveys and gather more empirical evidence regarding the application of the model suggested and its utility in real world scenarios.Practical implicationsThe approach developed in this paper has value to the policy makers in the government in addressing risk assessment policy issues in the MLTF area in the context of non‐bank entities such as professional services, e.g. that of accountants. The relevant bodies will also find value in this paper because currently there is no guidance as to how to address the issue. Also, future academics/researchers can take this first approach as a guide and go on do further research in this area and to refine policy issues in this area. No established practice exists in this area at the moment. This paper attempts to provide a guideline.Originality/valueThis paper addresses a major unanswered question in the subject of anti‐money laundering. The question addressed in this paper, which has not been researched before is how MLTF risk can be assessed in the context of non‐bank entities such as professional services, e.g. that of accountants. The model will be useful to user groups such as organizations dealing with bullions, precious stones and precious jewellery, real estate, professional and business services such accounting, auditing and financial services for implementing the AMLCTF Tranche II. The relevant bodies will also find value in this paper because currently there is no guidance as to how to address the issue. Also future academics/researchers can take this first approach as a guide and go on do further research in this area and to refine policy issues in this area.
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Bellairs-Walsh, India, Sadhbh J. Byrne, Sarah Bendall, Yael Perry, Karolina Krysinska, Ashleigh Lin, Maria Michail, et al. "Working with Young People at Risk of Suicidal Behaviour and Self-Harm: A Qualitative Study of Australian General Practitioners’ Perspectives." International Journal of Environmental Research and Public Health 18, no. 24 (December 8, 2021): 12926. http://dx.doi.org/10.3390/ijerph182412926.
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General Practitioners (GPs) play a crucial role in the identification and support of young people at risk of suicidal behaviour and self-harm; however, no studies have explored GPs’ perspectives, approaches, challenges, and resource needs when working with this cohort in an Australian setting. This was a qualitative study where fifteen GPs (Mage = 45.25 years) from multiple clinics in Western Australia took part in semi-structured interviews, and data were analysed thematically. Seven main themes were identified: (1) working with young people has its unique challenges; (2) screening and assessment tools can help to manage uncertainty and discomfort; (3) going beyond tools–the dialogue and relationship are most important; (4) there are limits to what we can offer in the time available; (5) the service access and referral pathways lack clarity and coordination; (6) the provision of mental health support should not fall on GPs alone; and (7) more comprehensive training in suicide and self-harm is needed. The findings highlight a number of opportunities to enhance care and better assist GPs working with young people who present with suicidal behaviour and self-harm, including considerations for conducting assessments, targeted resources such as training, and system and service improvements.
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Scott, Gavin. "Sword or a shield? The changing dynamic of the regulatory landscape for Australian gas projects." APPEA Journal 54, no. 2 (2014): 509. http://dx.doi.org/10.1071/aj13082.
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From increased domestic opposition to CSG, to international legal challenges about the project financing of gas projects, the Australian gas industry is under siege from numerous stakeholders—communities, domestic governments and non-government organisations both in Australia and internationally. What this has meant for the industry is a significantly increased risk of in doing business in Australia. A key reason for this elevated risk is that stakeholders are becoming increasingly savvy in the legal and quasi-legal avenues for challenging a project—and regulators are increasingly providing stakeholders the tools to do this. During the past two years, we have seen a number of regulatory regimes used, not simply to protect stakeholders’ rights under these regimes, but as part of a strategy to undermine the legal, financial, and reputational foundations of project as a whole. These regimes include: the domestic and international social and environmental impact standards for the financing and assessment of projects; land access and compensation regimes; and, the native title and cultural heritage protection regimes. As a response to stakeholder action, regulators are also becoming more reactive and regulations more proscriptive. This extended abstract examines the financial and operational impacts of using regulatory regimes as a sword, rather than a shield, against gas proponents, using case studies including the challenge to US Ex-Im’s funding of the APLNG project and the James Price Point project. This extended abstract highlights how, in this new legal environment, proponents must balance compliance with relationships, domestic pressures with international standards and cost with exposure to risk.
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Barash, Jed A., Blair T. Johnson, and David I. Gregorio. "Is Surgery a Risk Factor for Creutzfeldt-Jakob Disease? Outcome Variation by Control Choice and Exposure Assessments." Infection Control & Hospital Epidemiology 29, no. 3 (March 2008): 212–18. http://dx.doi.org/10.1086/527514.
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Objective.To determine whether methodological differences explain divergent results in case-control studies examining surgery as a risk factor for Creutzfeldt-Jakob disease (CJD).Methods.After case-control studies were systematically identified using PubMed, we performed a homogeneity analysis and applied models to effect sizes (odds ratio [OR] with 95% confidence interval [CI]) using 2 parameters: type of control subject used and consistency of data ascertainment. The hospitals and communities were located in Europe, Japan, and Australia. Patients were CJD case subjects and age- and sex-matched control subjects in the hospital or community. Because of the natural history of the disease, CJD subjects are not considered reliable sources of information for these studies. Therefore, individuals who are considered close to the subjects and who have knowledge of their medical history, including spouses and relatives, are necessarily identified as proxy informants for the surgical record of the case subjects.Results.Overall, the effect sizes lacked homogeneity (P<.0001). Three studies that used control subjects from the community revealed a significantly elevated risk of CJD for patients who underwent surgery (OR, 1.82; 95% CI, 1.41-2.35 [P<.0001 ]), whereas 3 investigations that used control subjects from the hospital revealed a significantly reduced risk (OR, 0.69; 95% CI, 0.52-0.90 [P = .0069]). Two studies that used proxy informants to acquire information about case subjects and control subjects (consistent ascertainment) found that the risk of CJD was significantly lower in those subjects who underwent surgery (OR, 0.65; 95% CI, 0.48-0.87 [P = .0043]). Conversely, 4 studies in which proxy informants acted only on behalf of case subjects (inconsistent data ascertainment) found a significant positive association between surgery and CJD (OR, 1.67; 95% CI, 1.32-2.12 [P<.0001 ]). Both models fit the data very well, leaving no remaining variance in effect sizes to explain.Conclusion.Variation in the type of control subjects used and in exposure assessment in case-control studies may partially explain conflicting data regarding the association between surgery and CJD. However, there was almost complete confounding of these 2 parameters, making interpretation more difficult. Planning of future investigations must carefully consider these design elements.
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Ogale, Yasmin, Ping Teresa Yeh, Caitlin E. Kennedy, Igor Toskin, and Manjulaa Narasimhan. "Self-collection of samples as an additional approach to deliver testing services for sexually transmitted infections: a systematic review and meta-analysis." BMJ Global Health 4, no. 2 (April 2019): e001349. http://dx.doi.org/10.1136/bmjgh-2018-001349.
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BackgroundSelf-collection of samples for diagnostic testing offers the advantages of patient autonomy, confidentiality and convenience. Despite data showing their feasibility and accuracy, there is a need to better understand how to implement such interventions for sexually transmitted infections (STIs). To support WHO guidelines on self-care interventions, we conducted a systematic review to investigate whether self-collection of samples should be made available as an additional approach to deliver STI testing services.MethodsPeer-reviewed studies were included if they compared individuals who self-collected samples for chlamydia, gonorrhoea, syphilis and/or trichomonas testing to individuals who had samples collected by clinicians on the following outcomes: uptake/frequency of STI testing, social harms/adverse events, positive yield (case finding), linkage to clinical assessment/treatment and reported sexual risk behaviour. We searched PubMed, CINAHL, LILACS and EMBASE for articles published through July 2018. Risk of bias was assessed using the Cochrane tool for randomised controlled trials (RCTs) and the Evidence Project tool for non-RCTs. Meta-analysis was conducted using random effects models to generate pooled estimates of relative risk (RR).ResultsEleven studies, including five RCTs and six observational studies with a total of 202 745 participants, met inclusion criteria. Studies were conducted in Australia, Denmark and the USA. Meta-analysis found that programmes offering self-collection of samples increased overall uptake of STI testing services (RR: 2.941, 95% CI 1.188 to 7.281) and case finding (RR: 2.166, 95% CI 1.043 to 4.498). No studies reported measuring STI testing frequency, social harms/adverse events, linkage to care or sexual risk behaviour.DiscussionWhile greater diversity in study designs, outcomes and settings would strengthen the evidence base, findings from this review suggest that self-collection of STI samples could be an effective additional strategy to increase STI testing uptake.Prospero registration numberPROSPERO CRD42018114866.
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Morley, Christine, Joanne Clarke, Chez Leggatt-Cook, and Donna Shkalla. "Can a Paradigm Shift from Risk Management to Critical Reflection Improve Child-Inclusive Practice?" Societies 12, no. 1 (December 22, 2021): 1. http://dx.doi.org/10.3390/soc12010001.
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Child protection systems within Anglophone countries have been increasingly dominated by neoliberal managerial, risk-dominant paradigms over the past three decades. Assumed to deliver a cost-effective strategy to increase the safety of children, there are many ways this paradigmatic combination systematically undermines child welfare, participation, and well-being. This paper specifically focuses on the ways that risk assessment, neoliberal, and managerial discourses have infiltrated practice and operate to silence and exclude children’s voices. It draws on two case studies to showcase key findings of a comprehensive, state-wide research project called Empowering Children’s Voices, which was initiated by UnitingCare, a non-government organisation within Queensland, Australia, and conducted in partnership with researchers from Queensland University of Technology. It will be argued that a paradigm shift towards a critically reflective reinterpretation of risk can be far more effective at promoting child-inclusive practice and establishing children’s empowered voices as a protective factor against harm.
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Brook, Barry W., H. Resit Akçakaya, David A. Keith, Georgina M. Mace, Richard G. Pearson, and Miguel B. Araújo. "Integrating bioclimate with population models to improve forecasts of species extinctions under climate change." Biology Letters 5, no. 6 (July 22, 2009): 723–25. http://dx.doi.org/10.1098/rsbl.2009.0480.
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Climate change is already affecting species worldwide, yet existing methods of risk assessment have not considered interactions between demography and climate and their simultaneous effect on habitat distribution and population viability. To address this issue, an international workshop was held at the University of Adelaide in Australia, 25–29 May 2009, bringing leading species distribution and population modellers together with plant ecologists. Building on two previous workshops in the UK and Spain, the participants aimed to develop methodological standards and case studies for integrating bioclimatic and metapopulation models, to provide more realistic forecasts of population change, habitat fragmentation and extinction risk under climate change. The discussions and case studies focused on several challenges, including spatial and temporal scale contingencies, choice of predictive climate, land use, soil type and topographic variables, procedures for ensemble forecasting of both global climate and bioclimate models and developing demographic structures that are realistic and species-specific and yet allow generalizations of traits that make species vulnerable to climate change. The goal is to provide general guidelines for assessing the Red-List status of large numbers of species potentially at risk, owing to the interactions of climate change with other threats such as habitat destruction, overexploitation and invasive species.
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Keating, Barry, and Maryann Keating. "Private firms, public entities, and microeconomic incentives." International Journal of Organizational Analysis 21, no. 2 (May 16, 2013): 176–97. http://dx.doi.org/10.1108/ijoa-08-2011-0499.
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PurposePublic private partnerships (PPPs) centralize decision making into a hybrid type of firm, consisting of a government entity with a private firm, that is either a profit‐seeking or non‐profit entity, that initiates, constructs, maintains, or provides a service. The PPP model recognizes that both the public and the private sectors have certain comparative advantages in the performance of specific tasks. PPPs, grounded in cost/benefit analysis, have been used in Australia for decades and are presently being introduced in the USA as a form of innovate contracting. This paper aims to evaluate PPPs as a potentially transferable model for the delivery of public services. PPP firms are evaluated in terms of capital asset management, productive and allocative efficiency, transfer of risk between the public and private sectors, rights to the residual, and the public interest. A case study comparison of Fremantle Ports (Australia) and the Indiana Toll Road (USA) is employed to demonstrate PPP design and function.Design/methodology/approachA description and evaluation of public private partnerships (PPP) is presented and two original and primary case studies are reviewed.FindingsA PPP functioning as a monopoly provider of a common pool public asset approximates economic efficiency when user fees cover virtually full cost. Identifying optimal output and quality assessment is more challenging in the case of social goods in which the public goal is subsidy minimization and clients cannot assess quality. Best practices are helpful; they guarantee the PPP process, but not the outcome. All PPPs, in whatever country or industry, are vulnerable to bureaucratic expansion whenever they are given access to subsidized loans underwritten by taxpayers.Originality/valueThe two case studies in this paper are 100 percent original; they were examined in person by the authors, and the managers of the two entities were interviewed in Indiana (USA) and Fremantle, Western Australia.
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Sun, Qian, Grace Yun, and Ting Ling. "Identifying Heat Health Risks in the Urban Areas of Western Australia (WA) – An Enhanced Heat Vulnerability Assessment." Abstracts of the ICA 1 (July 15, 2019): 1. http://dx.doi.org/10.5194/ica-abs-1-356-2019.
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<p><strong>Abstract.</strong> The impact of heat on health can be more significant in urban areas with more population and where the microclimate is often unintentionally modified to create the Urban Heat Island (UHI) effect. Extreme heat and UHI pose a risk to the health of vulnerable individuals, such as the elderly, the very young, and those need care. Vulnerability has become a central concept in climate change research and policy. To assess it, many studies have used equal weighted cumulative indices to aggregate multiple factors into a composite HVI (Heat Vulnerability Index) and analyse the differences and intensity across local areas and regions. However, the aggregation and equal weighting rationality, and the disregard of spatial correlation can result in inaccurate explanation on local vulnerabilities.</p><p>This study develops an enhanced index of population heat vulnerability (HVI) in Perth metropolitan area, Western Australia (WA), using environmental, demographic, and health-related risk factors for heat exposure, sensitivity and adaptive capability. Satellite derived urban heat island data and community profiles were integrated by a spatial risk assessment methodology to highlight potential heat health risk areas and build the foundations for mitigation and adaptation plans. Principal component analysis (PCA) was used to identify the key risk factors for heat vulnerability. Geographically weighted regression (GWR) were used to model the spatial relationships between temperature and other contributing factors to produce weights for calculating HVI. The index was finally mapped to produce a spatial representation of risk. The maps of spatial heat health vulnerability provide information to target heat-related health risks by aiding policy advisors, healthcare professionals, and ancillary services to develop heatwave preparedness plans at a local scale.</p>
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Davidson, Peter. "Optimise your Indigenous training and employment outcomes through valid, reliable, culture-fair assessment." APPEA Journal 49, no. 2 (2009): 596. http://dx.doi.org/10.1071/aj08069.
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The initial assessment process to establish appropriate training and employment pathways is critical to the recruitment of workplace candidates. Where language and cultural barriers exist—as experienced by many Indigenous candidates—the application of a suitable assessment process optimises the potential validity and reliability of the outcomes. Recently a number of organisations with Indigenous employment needs have introduced the Q Test, a language-free culture-fair instrument designed for Indigenous candidates. The Q Test provides an insight into a candidate’s training potential, enabling companies to establish pathways based on their capacity to cope with available training programs and employment opportunities. The Q Test can reduce the potentially negative issues which may be encountered with language-based tests or un-structured interviews such as: the perceived cultural-bias leading to resistence to recruitment processes that include any form of assessment; the poor retention of recruits due to dissatisfaction of those who are inappropriately placed in unsuitable positions; the resistance of line managers to embrace Indigenous employees in their crews due to previously unsuccessful placements; and, the inherent dangers of having unsuitable employees in high risk environments. Since 2004, ValueEdge have completed over 4,000 Q Test assessments throughout Australia and Asia. Through these assessments it has become increasingly clear that the Q Test can assist organisations to optimise their training and employment outcomes of Indigenous candidates. Within this presentation, case studies will be presented illustrating how the Q Test has positively impacted on Indigenous training and employment programs.
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Yazlık, Ayşe, and Didem Ambarlı. "Do non-native and dominant native species carry a similar risk of invasiveness? A case study for plants in Turkey." NeoBiota 76 (October 3, 2022): 53–72. http://dx.doi.org/10.3897/neobiota.76.85973.
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Most risk analysis studies in invasion biology have focused on the invasiveness of non-native species, even though some native species also can pose a high risk to the environment and human well-being. This is especially true under current global change, which may cause dominant native species to expand their range of distribution and have substantial effects on the ecosystem. In this study, the risk of invasiveness of five non-native and five native plant species in Turkey was evaluated using a standard risk screening protocol. All ten species selected for screening are known to be invasive in several parts of the world, i.e. non-native Ailanthus altissima, Cuscuta campestris, Phytolacca americana, Robinia pseudoacacia and Sicyos angulatus, and native Cirsium arvense, Hedera helix, Onopordum acanthium, Phragmites australis and Sorghum halepense. The Australian Weed Risk Assessment decision-support tool adapted to Turkey’s geographical and climatic conditions was used for screening the study species based on their biological traits, ecology and management approaches. All species were classified as high-risk, with R. pseudoacacia among non-natives and P. australis among natives achieving the highest scores followed by S. halepense, C. campestris, C. arvense, O. acanthium, P. americana, S. angulatus, A. altissima and H. helix. Based on their risk scores, all non-native species were classified as invasive and all native species as ‘expanding’ for Turkey. An ordination based on the risk scores showed similarities between invasive and expanding species. The outcomes of this study indicate that species can have several risk-related traits resulting in high risk scores irrespective of their origin. Such species can modify their environment and interact with other species with severe consequences for biodiversity. It is argued that dominant species with highly negative environmental and socioeconomic impacts in their habitats should be included in priority lists for management measures irrespective of their origin (i.e. native or non-native). More studies are needed to evaluate the magnitude and prevalence of the present findings for other regions worldwide.
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Fennessy, Paul, Vanessa Clements, and Olivia Hibbitt. "OP44 Robot-Assisted Surgery: Joint HTA To Inform Australian Policy And Funding." International Journal of Technology Assessment in Health Care 35, S1 (2019): 10. http://dx.doi.org/10.1017/s0266462319001107.
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IntroductionRobot-Assisted Surgery (RAS) has been available in Australia since 2003. There are 50 da Vinci RAS systems in Australia (18 in NSW and 12 in Victoria) with most in the private hospital sector. In Australia the capital cost of a da Vinci RAS system is up to AUD 4 million (USD 2.8 million), which excludes annual maintenance fees of AUD 250,000 (USD 175,000) and consumable costs of AUD 3,500 (USD 2,450) for each procedure.MethodsThe NSW Ministry of Health and Victorian Department of Health and Human Services commissioned a health technology assessment (HTA) to explore the benefits, risks and economic implications of surgical robotics, which involved a review of the peer reviewed literature, a cost benefit analysis of public sector patients who received RAS and broad stakeholder consultation to document current perspectives on RAS applications.ResultsRAS is as safe and effective as other surgical modalities when performed by sufficiently skilled surgeons, although evidence generally comes from small studies with limited follow-up time and few studies report long term mortality, morbidity or patient-reported outcomes. Comparative benefits of RAS are uncertain as most studies conclude little or no difference in procedure related or functional outcomes. While RAS reduces length of stay, which offers patient and health system benefits, this is insufficient to fully offset high capital and consumable costs currently charged to Australian providers. Government and clinical stakeholders identified that establishing an RAS service requires consideration of important factors, including: i) Governance is critical; ii) Higher case volumes may improve financial viability; and iii) a need for state-wide/national standards for surgeon training and credentialing.ConclusionsRAS is as safe and effective as other modalities when performed by skilled surgeons. However, uncertainty remains around long-term outcomes and clinical and cost effectiveness. An accredited training program, monitoring and evaluation will be critical to ensure outcomes data inform ongoing evidence assessment and government policy and investment.
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Kumbier, Kristian, Rafael C. Carvalho, Athanasios T. Vafeidis, and Colin D. Woodroffe. "Investigating compound flooding in an estuary using hydrodynamic modelling: a case study from the Shoalhaven River, Australia." Natural Hazards and Earth System Sciences 18, no. 2 (February 12, 2018): 463–77. http://dx.doi.org/10.5194/nhess-18-463-2018.
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Abstract. Many previous modelling studies have considered storm-tide and riverine flooding independently, even though joint-probability analysis highlighted significant dependence between extreme rainfall and extreme storm surges in estuarine environments. This study investigates compound flooding by quantifying horizontal and vertical differences in coastal flood risk estimates resulting from a separation of storm-tide and riverine flooding processes. We used an open-source version of the Delft3D model to simulate flood extent and inundation depth due to a storm event that occurred in June 2016 in the Shoalhaven Estuary, south-eastern Australia. Time series of observed water levels and discharge measurements are used to force model boundaries, whereas observational data such as satellite imagery, aerial photographs, tidal gauges and water level logger measurements are used to validate modelling results. The comparison of simulation results including and excluding riverine discharge demonstrated large differences in modelled flood extents and inundation depths. A flood risk assessment accounting only for storm-tide flooding would have underestimated the flood extent of the June 2016 storm event by 30 % (20.5 km2). Furthermore, inundation depths would have been underestimated on average by 0.34 m and by up to 1.5 m locally. We recommend considering storm-tide and riverine flooding processes jointly in estuaries with large catchment areas, which are known to have a quick response time to extreme rainfall. In addition, comparison of different boundary set-ups at the intermittent entrance in Shoalhaven Heads indicated that a permanent opening, in order to reduce exposure to riverine flooding, would increase tidal range and exposure to both storm-tide flooding and wave action.
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Lau, Stuart, Natalie Czuczman, Liz Dennett, Matthew Hicks, and Maria Ospina. "72 Prevalence of Neurodevelopmental Disorder among Indigenous Children: A Systematic Review." Paediatrics & Child Health 27, Supplement_3 (October 1, 2022): e34-e34. http://dx.doi.org/10.1093/pch/pxac100.071.
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Abstract Background Neurodevelopment involves sensory-motor, cognitive, and social-emotional domains, which can be influenced by biological and psychosocial factors. Poor neurodevelopment can result in missing developmental milestones and neurodevelopmental disorders (NDs) that translate into negative consequences for long-term health and well-being. Indigenous children in countries with similar colonial histories face a disproportionate burden of infant mortality, chronic diseases, injuries, and disability compared to non-Indigenous children. However, there is no consensus on the prevalence of NDs among Indigenous children around the world. Objectives This systematic review (PROSPERO 2021 CRD42021238669) synthesized current evidence on the prevalence of NDs among Indigenous children in Australia, Canada, New Zealand, and the USA. Design/Methods Comprehensive searches of five databases from 2005 to Feb 15, 2021 were conducted to identify cohort and cross-sectional studies that assessed the objective. Two independent reviewers conducted study selection, data extraction/analysis, and risk of bias assessment. Risk of bias was assessed using the Newcastle-Ottawa scale for cohort and ecological studies (adapted), and the Quality Assessment Tool for Prevalence Studies by Hoy et al. for cross-sectional studies. Prevalence odds ratios (pOR) with 95% confidence intervals (CI) were calculated in random-effects meta-analyses for each ND outcome if there were two or more studies of the same study design. Results Of the 864 studies identified, 25 studies met the inclusion criteria. Twelve studies were conducted in Australia, one in Canada, four in New Zealand, and eight in the USA. Four studies evaluated attention-deficit/hyperactivity disorder (ADHD) prevalence, 13 for autism spectrum disorder (ASD), 10 for intellectual disability (ID), and five for motor disorders (MD). Most cohort studies (10/17) had high risk of bias. All cross-sectional studies (n=8) had low risk of bias. The prevalence of ADHD, ASD, ID, and MD for Indigenous children ranged from 2.7-3.9%, 0.07-3.0%, 1.1-3.9%, and 0.18-0.47%, respectively. Prevalence in non-Indigenous children ranged from 1.6-5.6%, 0.31-3.3%, 0.87-2.3%, and 0.22-0.37%. In cross-sectional studies, Indigenous children had decreased odds of ASD (three studies; pOR=0.80; 95% CI: 0.71-0.89) compared to non-Indigenous children. In cohort studies, higher odds of MD (two studies; pOR=1.57; 95%CI: 1.35-1.84) and lower odds of ASD (four studies; pOR=0.46; 95% CI: 0.28-0.76) were found in Indigenous children compared to non-Indigenous children. Conclusion Prevalence rates are greater in Indigenous children for MD and lower for ASD compared to their non-Indigenous counterparts. Differences in NDs prevalence between Indigenous and non-Indigenous children may be due to differences in access to health care services/assessment.
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Peterson, David, Tracey Clark, Richard Sprod, Trudi Verrall, Louise English, and Amanda Thomson. "Bloody Good! The Impact of eLearning on Medical and Nursing Practice." International Journal of Advanced Corporate Learning (iJAC) 10, no. 2 (November 9, 2017): 75. http://dx.doi.org/10.3991/ijac.v10i2.7349.
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<p class="Abstract">Blood transfusion is a commonly-performed medical procedure that improves and saves the lives of patients. However, this procedure also has significant risks, is sometimes used inappropriately and has substantial costs associated with the collection, testing, processing and distribution of blood and blood products.</p><p class="Abstract">BloodSafe eLearning Australia (BEA) (<a href="/index.php/i-jac/author/saveSubmit/www.bloodsafelearning.org.au">www.bloodsafelearning.org.au</a>) is an education program for Australian doctors, nurses and midwives, designed to improve the safety and quality of clinical transfusion practice. Courses are interactive and include case studies, videos, and best-practice tips. Successful completion of a multiple-choice assessment provides learners with a certificate of completion. To date there are more than 400,000 registered learners, from more than 1500 organisations, who have completed more than 765,000 courses.</p><p class="Abstract">Stakeholder feedback shows that the program: provides credible, consistent education across Australia; is cost effective; reduces duplication; is ‘best-practice’ elearning that is readily accessible; allows institutions to focus on practical aspects of transfusion education; results in change to clinical practice; and supports the broader implementation of a blood management strategy in Australia.</p><p class="Abstract">User evaluation shows that the courses have a positive impact, with 89% of respondents stating they had gained additional knowledge of transfusion practice, processes and/or policy and more than 87% reporting they will make, or have made, changes to their work practices which will improve patient safety and outcomes.</p>The BloodSafe eLearning Australia program provides education to a large number of health professionals across Australia. Evaluation demonstrates that these courses provide users with a consistent and reliable knowledge base that translates into changes to practice and improved patient outcomes.
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James, Carole L., Anna Giacomini, Frances Kay-Lambkin, Mark Rubin, and Brian Kelly. "Mental health and the resources sector: findings from a research program to promote effective mental health solutions." APPEA Journal 62, no. 2 (May 13, 2022): S282—S286. http://dx.doi.org/10.1071/aj21142.
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This paper outlines a multifaceted national workplace mental health research program that incorporated assessment of individual level, work characteristics and organisational factors on mental health among workers in the resources sector within Australia and internationally. This multistep program included: identification of level of mental health and substance use problems in an Australian national study; examination of risk and protective factors (work roles, social networks and location); attitudes to seeking mental health assistance; organisational policies regarding mental health within a workplace health and safety framework; piloting a resources-specific workplace mental health program for team leaders and supervisors and a workplace suicide prevention program; and application of digital mental health interventions to this sector. Additional linked studies in New South Wales and Queensland in the resources sector assessed personal factors influencing perception of workplace physical risks and hazards, risk behaviours and opportunities for risk mitigation; and links between mental and physical health factors. A summary of the key findings are presented within the context of a program of research addressing mental health within remote settings in the resources sector. Mental health-related problems are highly prevalent among workers in remote resource settings, which has significant implications for workplace health and safety. Strategies to address prevention and effective intervention need to be tailored to the industry and employee characteristics, and address models of mental health care that are feasible and accessible in often remote and challenging environments.
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Hamdan, Sara Z., Hamdan Zaki Hamdan, Mustafa Nimieri, and Ishag Adam. "The Association between Helicobacter Pylori Infection and Iron Deficiency Anemia in Children: A Systematic Review and Meta-Analysis." Journal of Pediatric Infectious Diseases 17, no. 02 (March 2022): 059–70. http://dx.doi.org/10.1055/s-0042-1743502.
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Abstract Objectives This study, comprising a systematic review and meta-analysis, was conducted to assess the association between Helicobacter pylori infection and the risk of iron deficiency anemia (IDA) in children. Methods We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant published studies were searched in the databases. Retrieved studies were assessed for quality using the Modified Newcastle-Ottawa Scale for quality assessment. The “meta” package of statistical software “R 4.0.3 was used for statistical analysis. Results Overall, 22 eligible studies (eight cross-sectional, six randomized control trials, five case-control, two surveys, and one cohort), including nine (40.9%) from Asia, four (18.1%) from America, four (18.1%) from Africa, four (18.1%) from Europe, and one (4.5%) from Australia with a total of 3,434 cases and 4,455 controls were included in this systematic review and meta-analysis. We found that H. pylori infection was associated with a high risk of IDA (odds ratio 1.70, 95% confidence interval 1.21 − 2.38) in a random-effects model. Meta-regression analysis showed that none of the investigated factors that may affect the prevalence of IDA reached statistical significance. There was statistically significant difference between results when studies were categorized according to the methods used to diagnose H. pylori and level of incomes based on World Bank classification. The GRADEpro Guideline Development Tool evidence for the risk of IDA was of a “moderate certainty.” Conclusions This meta-analysis with a “moderate certainty” of evidence showed an association between H. pylori infection and a high risk of developing IDA in children.
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Abeyaratne, Carmen, Samanta Lalic, J. Simon Bell, and Jenni Ilomäki. "Spontaneously reported adverse drug events related to tapentadol and oxycodone/naloxone in Australia." Therapeutic Advances in Drug Safety 9, no. 4 (March 25, 2018): 197–205. http://dx.doi.org/10.1177/2042098618760939.
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Background: The rapid increase in prescribing and use of opioids for noncancer pain has coincided with an increase in opioid-related adverse drug events (ADEs). The objective of our study was to describe ADEs related to tapentadol and oxycodone/naloxone spontaneously reported to the Australian Therapeutic Goods Administration (TGA). Methods: Public case detail reports for tapentadol (September 2013–March 2017) and oxycodone/naloxone (April 2011–March 2017) were sourced from the TGA. The total number of public case detail reports for tapentadol were 104 and 249 for oxycodone/naloxone. Demographic characteristics of patients, concomitant medications, causality assessment and outcome were described for each opioid according to the Medical Dictionary for Regulatory Activities (MedDRA) system organ class. Results: The most prevalent ADEs for tapentadol were nervous system disorders ( n = 52, 50%), psychiatric ( n = 34, 32.7%), gastrointestinal ( n = 18, 17.3%), and general disorders and administration site conditions ( n = 21, 20.2%). Sixteen (23.2%) of 69 nervous system disorders reaction terms were consistent with serotonin syndrome of which 14 (87.5%) involved documented coadministration with another serotonergic medication. The most prevalent ADEs for oxycodone/naloxone were psychiatric disorders ( n = 78, 31.3%), gastrointestinal ( n = 73, 29.3%), general disorders and administration site conditions ( n = 87, 35%), and nervous system disorders ( n = 62, 24.9%). There were 40 (16%) public case detail reports for oxycodone/naloxone with the MedDRA reaction terms ‘drug withdrawal syndrome’ and ‘withdrawal syndrome’. Conclusion: The profiles of spontaneous ADE reports for tapentadol and oxycodone/naloxone are largely consistent with their premarketing randomized controlled studies and profiles of opioids in general. Further research into the risk of serotonin syndrome with tapentadol use is warranted. The ADEs suggest clinicians should be cautious when switching patients to oxycodone/naloxone from other opioids.
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Mindel, A., E. Christie, C. Chung, T. Berger, and the Australian Herpes Management Forum (AHMF). "14. GENITAL HERPES ONLINE RISK SURVEY." Sexual Health 4, no. 4 (2007): 289. http://dx.doi.org/10.1071/shv4n4ab14.
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Background: Genital herpes is one of the most common sexually transmitted infections (STIs) worldwide. In Australia, a population-based survey revealed that 16% of women and 8% of men over 25 had antibodies to HSV-2. The majority of people infected with HSV-2 are asymptomatic. With increasing availability of web-based technology for use as an information and education tool, we established a web-based survey to determine risk for genital herpes and encourage people who maybe at risk to attend a health care professional for HSV testing. Methods: A web-based genital herpes risk assessment quiz was established on the AHMF web page. The quiz was based on epidemiological data derived from a national population-based survey and other epidemiological studies and consisted of 16 questions, each with a numerical weighting. Factors were weighted according to age, country of origin, gender, sexual history, condom use, symptoms suggestive of herpes and whether the individual was of Aboriginal or Torres Strait Islander (ATSI) origin. Scores were added up and individuals allocated a risk score of low, medium or high. Results: By the 24th May 2007, 2639 questionnaires had been completed, 52% were male and 48% female and 87% from Australia. 18% were classified as low risk for genital herpes, 46% as medium risk and 36% as high risk. Women had a higher mean risk score than men (p�<�0.001) and were less likely to report condom use than men (p�<�0.001), however, men were more likely than women to have had sex with someone they knew had herpes (p�=�0.018). ATSI participants had a higher mean risk score than non-ATSI participants. Detailed analyses of risk scores and comparisons between groups will be presented. Conclusions: On-line risk surveys are a useful way for individuals to determine their risk of genital herpes. Similar tools should be developed for other STIs.
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Carpenter, Chris. "Life-Extension Project Applies Assessment of Reinforced Concrete to Nonjacket Structures." Journal of Petroleum Technology 73, no. 09 (September 1, 2021): 53–54. http://dx.doi.org/10.2118/0921-0053-jpt.
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This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper OTC 31250, “Wandoo B: Application of Advanced Reinforced Concrete Assessment for Life Extension for Non-Jacket Structures,” by Robert Sheppard, Spire Engineering; Colin O’Brien, Vermilion Oil and Gas; and Yashar Moslehy, Spire Engineering, et al., prepared for the 2021 Offshore Technology Conference, originally scheduled to be held in Houston, 4–7 May. The paper has not been peer reviewed. Copyright 2021 Offshore Technology Conference. Reproduced by permission. Wandoo B is a concrete gravity-based structure (GBS) and is the main production facility for the Wandoo field offshore northwest Australia. It was installed in 1997 with a design life of 20 years. The structural assessments discussed in this paper are part of a comprehensive life-extension project encompassing wells, subsea systems, marine and safety systems, and topsides facilities and structures to demonstrate fitness for service through the end of field life. Background The GBS serves as the support structure for the Wandoo B facility and provides oil storage for the Wandoo field. The structure has four shafts approximately 11 m in diameter that support the top-sides facilities and a base structure with permanent ballast and oil storage cells (Fig. 1). It was originally developed as an ExxonMobil-led project and now is owned and operated wholly by Vermilion Oil and Gas Australia. The reinforced concrete (RC) shafts and the base top slab are pretensioned. In the shafts, tendons are enclosed in 20 ducts distributed around the circumference. The top of the shafts provides a mating point with the steel topsides structure with the connection formed by embedded anchor bolts in a bulge in the shaft cross section. The topsides structure is a three-level braced steel frame system supporting production operations for 12 well conductors contained within the northeast shaft and three outboard well conductors. Life-Extension Project The facility was designed with a target life of 20 years. The life-extension project was intended not only to satisfy the operator’s responsibility to continue safe operations and adhere to their safety case but also to meet the expectations of the regulator. The structural aspects of the project included four phases, the first two of which are detailed in this synopsis: - Design assessments per latest standards and modifications where required - Ultimate capacity assessments with retrofit modifications where required - Risk studies and workshops to demonstrate that risk is as low as reasonably practicable (ALARP) - Integrity-management manual and inspection plan The first two phases were addressed using the latest condition-assessment, weight, and environmental data available. The phased approach allowed the assessment team to use basic linear approaches to demonstrate code compliance and only use the more-advanced analysis techniques to evaluate the critical components that did not satisfy code or were needed to provide input to the ALARP assessment and establish target reliability for the facility.
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Garrick, Dustin, Lucia De Stefano, Fai Fung, Jamie Pittock, Edella Schlager, Mark New, and Daniel Connell. "Managing hydroclimatic risks in federal rivers: a diagnostic assessment." Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 371, no. 2002 (November 13, 2013): 20120415. http://dx.doi.org/10.1098/rsta.2012.0415.
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Hydroclimatic risks and adaptive capacity are not distributed evenly in large river basins of federal countries, where authority is divided across national and territorial governments. Transboundary river basins are a major test of federal systems of governance because key management roles exist at all levels. This paper examines the evolution and design of interstate water allocation institutions in semi-arid federal rivers prone to drought extremes, climatic variability and intensified competition for scarce water. We conceptualize, categorize and compare federal rivers as social–ecological systems to analyse the relationship between governance arrangements and hydroclimatic risks. A diagnostic approach is used to map over 300 federal rivers and classify the hydroclimatic risks of three semi-arid federal rivers with a long history of interstate allocation tensions: the Colorado River (USA/Mexico), Ebro River (Spain) and Murray–Darling River (Australia). Case studies review the evolution and design of water allocation institutions. Three institutional design trends have emerged: adoption of proportional interstate allocation rules; emergence of multi-layered river basin governance arrangements for planning, conflict resolution and joint monitoring; and new flexibility to adjust historic allocation patterns. Proportional allocation rules apportion water between states based on a share of available water, not a fixed volume or priority. Interstate allocation reform efforts in the Colorado and Murray–Darling rivers indicate that proportional allocation rules are prevalent for upstream states, while downstream states seek reliable deliveries of fixed volumes to increase water security. River basin governance arrangements establish new venues for multilayered planning, monitoring and conflict resolution to balance self governance by users and states with basin-wide coordination. Flexibility to adjust historic allocation agreements, without risk of defection or costly court action, also provides adaptive capacity to manage climatic variability and shifting values. Future research should develop evidence about pathways to adaptive capacity in different classes of federal rivers, while acknowledging limits to transferability and the need for context-sensitive design.
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Lepore, Michael, David Edvardsson, Ayumi Igarashi, and Julienne Meyer. "How Long-Term Care Quality Assurance Measures Address Dementia in Australia, England, Japan, and the United States." Innovation in Aging 5, Supplement_1 (December 1, 2021): 500–501. http://dx.doi.org/10.1093/geroni/igab046.1933.
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Abstract The prevalence of people with dementia living in long-term care (LTC) is high and rising internationally, and the need to improve LTC for people with dementia is widely recognized. In some countries, LTC quality assurance programs use quantitative measures of LTC quality, and international bodies emphasize the importance of person-centered care and healthy ageing outcomes. To better understand how LTC quality assurance programs address dementia, programs were reviewed in four countries—Australia, England, Japan, and the United States. Quality measures from each program were identified (n = 38) and examined to determine how they address dementia. Most measures did not address dementia, but four risk-adjusted for dementia (antipsychotic use, fractures, falls, mobility), one was dementia-specific (dementia/delirium hospitalizations), and one excluded people with dementia (losing bowel/bladder control). The other 32 measures were calculated equally regardless of the prevalence of dementia among LTC residents. Overall, LTC quality measurement differs internationally, but few measures address dementia. When dementia is addressed in quality measure calculations, it is most often as a risk-adjustor. Risk adjustment can help with attributing performance on these measures to the LTC setting rather than to the types of residents that the setting serves, but risk adjustment factors also are highly amenable to fraud, and thus require ongoing monitoring. Although LTC quality assessment programs and measures can help ensure people with dementia have access to quality LTC, adoption of measures that are meaningful to people with dementia—including measures of person-centered care and healthy ageing outcomes—remains needed.
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Ward, Michael P., and Victoria J. Brookes. "Rabies in Our Neighbourhood: Preparedness for an Emerging Infectious Disease." Pathogens 10, no. 3 (March 20, 2021): 375. http://dx.doi.org/10.3390/pathogens10030375.
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Emerging infectious disease (EID) events have the potential to cause devastating impacts on human, animal and environmental health. A range of tools exist which can be applied to address EID event detection, preparedness and response. Here we use a case study of rabies in Southeast Asia and Oceania to illustrate, via nearly a decade of research activities, how such tools can be systematically integrated into a framework for EID preparedness. During the past three decades, canine rabies has spread to previously free areas of Southeast Asia, threatening the rabies-free status of countries such as Timor Leste, Papua New Guinea and Australia. The program of research to address rabies preparedness in the Oceanic region has included scanning and surveillance to define the emerging nature of canine rabies within the Southeast Asia region; field studies to collect information on potential reservoir species, their distribution and behaviour; participatory and sociological studies to identify priorities for disease response; and targeted risk assessment and disease modelling studies. Lessons learnt include the need to develop methods to collect data in remote regions, and the need to continuously evaluate and update requirements for preparedness in response to evolving drivers of emerging infectious disease.
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Pilotto, Alberto, Nicola Veronese, Julia Daragjati, Alfonso J. Cruz-Jentoft, Maria Cristina Polidori, Francesco Mattace-Raso, Marc Paccalin, et al. "Using the Multidimensional Prognostic Index to Predict Clinical Outcomes of Hospitalized Older Persons: A Prospective, Multicenter, International Study." Journals of Gerontology: Series A 74, no. 10 (October 17, 2018): 1643–49. http://dx.doi.org/10.1093/gerona/gly239.
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Abstract Background Multidimensional Prognostic Index (MPI) is useful as a prognostic tool in hospitalized older patients, but our knowledge is derived from retrospective studies. We therefore aimed to evaluate in a multicenter, longitudinal, cohort study whether the MPI at hospital admission is useful to identify groups with different mortality risk and whether MPI at discharge may predict institutionalization, rehospitalization, and use of home care services during 12 months. Methods This longitudinal study, carried out between February 2015 and August 2017, included nine public hospitals in Europe and Australia. A standardized comprehensive geriatric assessment including information on functional, nutritional, cognitive status, risk of pressure sores, comorbidities, medications, and cohabitation status was used to calculate the MPI and to categorize participants in low, moderate, and severe risk of mortality. Data regarding mortality, institutionalization, rehospitalization, and use of home care services were recorded through administrative information. Results Altogether, 1,140 hospitalized patients (mean age 84.1 years, women = 60.8%) were included. In the multivariable analysis, compared to patients with low risk group at admission, patients in moderate (odds ratio [OR] = 3.32; 95% CI: 1.79–6.17; p < .001) and severe risk (OR = 10.72, 95% CI: 5.70–20.18, p < .0001) groups were at higher risk of overall mortality. Among the 984 older patients with follow-up data available, those in the severe-risk group experienced a higher risk of overall mortality, institutionalization, rehospitalization, and access to home care services. Conclusions In this cohort of hospitalized older adults, higher MPI values are associated with higher mortality and other negative outcomes. Multidimensional assessment of older people admitted to hospital may facilitate appropriate clinical and postdischarge management.
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Mitchell, Tim, and Janine Barrow. "The evolution of strategic environmental assessments for oil and gas developments—an approvals practitioner's perspective." APPEA Journal 52, no. 2 (2012): 680. http://dx.doi.org/10.1071/aj11094.
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Recent impact assessments for large-scale developments in Australia have brought a new focus and evolution in thinking in the application of strategic environmental assessments (SEA). The opportunity to provide a robust strategic-planning framework to facilitate certainty in approvals outcomes and timeframes is balanced by the risks of mis-aligned regulatory and external stakeholder expectations for data, engineering definition, process and condition-setting that may set onerous precedents. The need to consider the commercial reality of longer-term strategic assets and the associated confidentiality considerations is particularly important. While the concept of SEA is facing renewed interest in Australia with regulatory signals that it will continue to be made more standard in approach, it is certainly not a new science. Indeed, it is well established in international approvals circles, with some jurisdictions (e.g. the SEA Directive in the European Union) providing valuable insights. If planned well, SEA can deliver positive approvals outcomes with up-front definition of development zones and forward environmental protection objectives. This extended abstract provides a practitioner’s perspective on the merits of SEA for the oil and gas industry, referencing lessons learnt at domestic and international levels. Selected case studies and practices from other jurisdictions are outlined, with emphasis on providing a practical solution. The present approach to identify best practice objectives for SEA application for achieving optimal benefits for industry, government and community stakeholders are reviewed. The role of strategic assessment in the context of regional offsets planning is also considered.
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TILSE, CHERYL, JILL WILSON, LINDA ROSENMAN, DAVID MORRISON, and ANNE-LOUISE MCCAWLEY. "Managing older people's money: assisted and substitute decision making in residential aged-care." Ageing and Society 31, no. 1 (September 17, 2010): 93–109. http://dx.doi.org/10.1017/s0144686x10000747.
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ABSTRACTCurrent approaches to the assessment of cognitive capacity in many jurisdictions seek to balance older people's empowerment with their protection. These approaches incorporate a presumption of capacity, a decision-specific rather than global assessment of that capacity, and an obligation to provide the support needed for adults to make or communicate their own decisions. The implication is that older people are assisted to make decisions where possible, rather than using substitute decision makers. For older people, decision making about financial matters is a contentious domain because of competing interests in their assets and concerns about risk, misuse and abuse. In residential-care settings, older people risk being characterised as dependent and vulnerable, especially in relation to decisions about financial assets. This paper reports an Australian study of the factors that facilitate and constrain residents' involvement in financial decision making in residential settings. Case studies of four aged-care facilities explored how staff interpreted the legislative and policy requirements for assisted and substitute decision making, and the factors that facilitated and constrained residents' inclusion in decisions about their finances. The observed practices reveal considerable variation in the ways that current legislation is understood and implemented, that there are limited resources for this area of practice, and that policies and practices prioritise managing risk and protecting assets rather than promoting assisted decision making.
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Mughal, Faraz, M. Isabela Troya, Lisa Dikomitis, Carolyn A. Chew-Graham, Nadia Corp, and Opeyemi O. Babatunde. "Role of the GP in the management of patients with self-harm behaviour: a systematic review." British Journal of General Practice 70, no. 694 (February 10, 2020): e364-e373. http://dx.doi.org/10.3399/bjgp20x708257.
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BackgroundSelf-harm is a serious risk factor for suicide, a major public health concern, and a significant burden on the NHS. Rates of self-harm presentation in primary care are rising and GPs interact with patients both before and after they have self-harmed. There is significant public and political interest in reducing rates of self-harm, but there has been no robust synthesis of the existing literature on the role of GPs in the management of patients who self-harm.AimThis study aimed to explore the role of the GP in the management of patients with self-harm behaviour.Design and settingA systematic review and narrative synthesis of primary care literature.MethodThis systematic review was conducted and is reported in line with PRISMA guidance. Electronic databases systematically searched were MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, and AMED. Two independent reviewers conducted study screening and selection, data extraction, and quality appraisal of all included studies. Thematic analysis was conducted.ResultsFrom 6976 unique citations, 12 studies met eligibility criteria and were included. These 12 studies, published from 1997–2016, of 789 GPs/family medicine physicians from Europe, the US, and Australia were of good methodological quality. Five themes were identified for facilitating GP management of self-harm: GP training, improved communication, service provision, clinical guidelines, and young people. Four barriers for GP management of self-harm were identified: assessment, service provision, local, and systemic factors.ConclusionGPs recognise self-harm as a serious risk factor for suicide, but some feel unprepared for managing self-harm. The role of the GP is multidimensional and includes frontline assessment and treatment, referral to specialist care, and the provision of ongoing support.
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Martin, Danielle. "Oil and gas development and social responsibility—aligning project and community goals for mutually beneficial outcomes." APPEA Journal 50, no. 2 (2010): 699. http://dx.doi.org/10.1071/aj09063.
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Even on the most high-risk projects in the some of the most challenging locations, it is possible and advantageous to progress the social and environmental aspirations of host communities and contribute to improving the lives of those communities. This paper case studies a number of complex projects that have prompted and contributed to long-term, sustainable development. In particular, the paper presents the case study of an Indigenous Australian community’s efforts to pro-actively prepare for, and promote, oil and gas development on Indigenous-owned land, progressed with joint development goals and aspirations. This experience essentially establishes a new approach to company-community interactions for land access and petroleum development and provides a new model that many communities and developers will undoubtedly be keen to emulate. The case study considers: the importance of establishing the broader social aspirations of communities in relation to the petroleum development at the outset; the criticality of establishing a mutual understanding the commercial, non-negotiable parameters of the developer; the cumulative impacts and opportunities for both developer and community of multiple, large scale projects; the role of government and donors; and, the limitations of developers in contributing to broader social development. Through the analysis of case studies, the paper examines environmental and social impact assessment and performance techniques used to understand and manage the risks and opportunities of oil and gas development.The paper expands the boundaries of leading practice in respect to environmental and social impact assessment, community engagement and social responsibility in the oil and gas industry.
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Burrell, Anita, Vlad Zah, Zsombor Zrubka, and Carl Asche. "PD45 Paying For Digital Health: What Evidence Is Needed?" International Journal of Technology Assessment in Health Care 38, S1 (December 2022): S106—S107. http://dx.doi.org/10.1017/s026646232200304x.
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IntroductionDigital transformation has been promoted by the World Health Organization (WHO), Food and Drug Administration (FDA) and the European Commission (EC) to help improve health outcomes. To ensure sustainability, digital health interventions (DHI) require funding by payers. Evidence-informed decision and policy making requires an assessment of the impact on relevant outcomes vs current healthcare practice. Various national and international organizations are involved in creating or guiding the development of standards for the evidence required for digital technologies.MethodsWe undertook an intensive individual investigation of the websites of leading payer and health technology assessment (HTA) bodies in France, UK, Germany, Belgium, Austria, Finland, Canada, Australia, and the USA to identify new frameworks and any updated information. As the objective focused on evaluation frameworks which were used across DHIs by a particular payer to support pricing and reimbursement decisions, we excluded individual case studies where DHIs had been assessed, regulatory frameworks for approval of DHIs and frameworks which assessed feasibility or applicability of a DHI since these were not directly influencing the decision for funding.ResultsWe found six frameworks which directly address digital health interventions for the purposes of pricing and reimbursement: NICE Evidence Standards, FinCCHTA, MSAC, Germany BfArM, Belgium RIZIV and France HAS. The context for the framework and the requirements were compared on parameters including those normally found in HTA and for criteria related to digital technologies. The parameters included varied considerably across the frameworks as did the level of evidence expected to be available for the assessment. In some cases, these related to the level of risk or impact of the intended DHI.ConclusionsWhile DHIs are increasingly used in health, HTA is struggling to adapt to assess these technologies. Due to the multidisciplinary nature of digital health (combination of health care and technology), and the speed and rate of change of innovations in this area, an approach based upon the risk assessment posed by the technology seems reasonable. In this way the level of effort can be tailored to those interventions which seek to influence care or predict outcomes rather than those which are tailored to increased awareness of the patient about their condition.
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Ho, K. M. "Combining Sequential Organ Failure Assessment (SOFA) Score with Acute Physiology and Chronic Health Evaluation (APACHE) II Score to Predict Hospital Mortality of Critically Ill Patients." Anaesthesia and Intensive Care 35, no. 4 (August 2007): 515–21. http://dx.doi.org/10.1177/0310057x0703500409.
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The ability to accurately adjust for the severity of illness in outcome studies of critically ill patients is essential. Previous studies have showed that Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation (APACHE) II score can predict hospital mortality of critically ill patients. The effects of combining these two scores to predict hospital mortality of critically ill patients has not been evaluated. This cohort study evaluated the performance of combining the APACHE II score with SOFA score in predicting hospital mortality of critically ill patients. A total of 1,311 consecutive adult patients admitted to a tertiary 22-bed multidisciplinary intensive care unit (ICU) in Western Australia were considered. The APACHE II, Admission SOFA, Delta SOFA and maximum SOFA score were all related to hospital survival in the univariate analyses. Combining Max SOFA (area under receiver operating characteristic curve 0.875 vs. 0.858, P=0.014; Nagelkerke R2: 0.411 vs. 0.371; Brier Score: 0.086 vs. 0.090) or Delta SOFA score (area under receiver operating characteristic curve 0.874 vs. 0.858, P=0.003; Nagelkerke R2: 0.412 vs. 0.371; Brier Score: 0.086 vs. 0.090) with the APACHE II score improved the discrimination and overall performance of the predictions when compared with using the APACHE II score alone, especially in the emergency ICU admissions. Combining Max SOFA or Delta SOFA score with the APACHE II score may improve the accuracy of risk adjustment in outcome studies of critically ill patients.
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Rahman, Khalil, Abbas Khaksar, and Toby Kayes. "A geomechanical approach for sanding risk assessment applied to three field cases for completion optimisation." APPEA Journal 50, no. 1 (2010): 623. http://dx.doi.org/10.1071/aj09040.
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Mitigation of sand production is increasingly becoming an important and challenging issue in the petroleum industry. This is because the increasing demand for oil and gas resources is forcing the industry to expand its production operations in more challenging unconsolidated reservoir rocks and depleted sandstones with more complex well completion architecture. A sand production prediction study is now often an integral part of an overall field development planning study to see if and when sand production will be an issue over the life of the field. The appropriate type of sand control measures and a cost-effective sand management strategy are adopted for the field depending on timing and the severity of predicted sand production. This paper presents a geomechanical modelling approach that integrates production or flow tests history with information from drilling data, well logs and rock mechanics tests. The approach has been applied to three fields in the Australasia region, all with different geological settings. The studies resulted in recommendations for three different well completion and sand control approaches. This highlights that there is no unique solution for sand production problems, and that a robust geomechanical model is capable of finding a field-specific solution considering in-situ stresses, rock strength, well trajectory, reservoir depletion, drawdown and perforation strategy. The approach results in cost-effective decision making for appropriate well/perforation trajectory, completion type (e.g. cased hole, openhole or liner completion), drawdown control or delayed sand control installation. This type of timely decision making often turns what may be perceived as an economically marginal field development scenario into a profitable project. This paper presents three case studies to provide well engineers with guidelines to understanding the principles and overall workflow involved in sand production prediction and minimisation of sand production risk by optimising completion type.
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Anderson, C. "Rationale and Design of the Cardiac Magnetic Resonance Imaging Substudy of the ONTARGET Trial Programme." Journal of International Medical Research 33, no. 1_suppl (February 2005): 50A—57A. http://dx.doi.org/10.1177/14732300050330s107.
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Angiotensin-converting enzyme (ACE) inhibitors have been shown to improve cardiovascular disease outcomes in high-risk patients, but evidence for the cardioprotective effects of angiotensin II receptor blockers (ARBs) is less extensive. The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) and the parallel Telmisartan Randomized AssessmeNt Study in aCE iNtolerant subjects with cardiovascular Disease (TRANSCEND) - which together form The ONTARGET Trial Programme – are long-term, large-scale, double-blind, multinational outcome studies with the primary objectives of determining if the combination of the ARB telmisartan 80 mg and the ACE inhibitor ramipril 10 mg is more effective than ramipril 10 mg alone, and if telmisartan is at least as effective as ramipril (in the case of ONTARGET), and if telmisartan is superior to placebo (in the case of TRANSCEND), in providing cardiovascular protection for high-risk patients. A pre-defined substudy is being conducted within The ONTARGET Trial Programme to compare the effects of these agents, alone and in combination, on cardiac structure and function. The substudy overcomes criticisms of many previous studies, which have been performed in small numbers of patients using suboptimal methodology, by evaluating changes in left ventricular structure and function using sophisticated technology provided by magnetic resonance imaging (MRI). Some 300 randomized patients within ONTARGET, recruited from selected centres in Australia, Canada, Germany, Hong Kong, New Zealand and Thailand, will have MRI undertaken at baseline and at 2-year follow-up. As this method of assessing left ventricular dysfunction is somewhat time-consuming, expensive and complex, and in the light of current interest in the role of B-type natriuretic peptide (BNP) as a simple, inexpensive diagnostic and prognostic tool, the substudy will also examine whether changes in BNP during follow-up correlated with changes in left ventricular dysfunction.
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Harvey, Mark S., Michael G. Rix, Volker W. Framenau, Zoë R. Hamilton, Michael S. Johnson, Roy J. Teale, Garth Humphreys, and William F. Humphreys. "Protecting the innocent: studying short-range endemic taxa enhances conservation outcomes." Invertebrate Systematics 25, no. 1 (2011): 1. http://dx.doi.org/10.1071/is11011.
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A major challenge confronting many contemporary systematists is how to integrate standard taxonomic research with conservation outcomes. With a biodiversity crisis looming and ongoing impediments to taxonomy, how can systematic research continue to document species and infer the ‘Tree of Life’, and still maintain its significance to conservation science and to protecting the very species it strives to understand? Here we advocate a systematic research program dedicated to documenting short-range endemic taxa, which are species with naturally small distributions and, by their very nature, most likely to be threatened by habitat loss, habitat degradation and climate change. This research can dovetail with the needs of industry and government to obtain high-quality data to inform the assessment of impacts of major development projects that affect landscapes and their biological heritage. We highlight how these projects are assessed using criteria mandated by Western Australian legislation and informed by guidance statements issued by the Environmental Protection Authority (Western Australia). To illustrate slightly different biological scenarios, we also provide three case studies from the Pilbara region of Western Australia, which include examples demonstrating a rapid rise in the collection and documentation of diverse and previously unknown subterranean and surface faunas, as well as how biological surveys can clarify the status of species thought to be rare or potentially threatened. We argue that ‘whole of biota’ surveys (that include all invertebrates) are rarely fundable and are logistically impossible, and that concentrated research on some of the most vulnerable elements in the landscape – short-range endemics, including troglofauna and stygofauna – can help to enhance conservation and research outcomes.
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Jordan, Glenn. "SAFETY IN THE OFFSHORE PETROLEUM INDUSTRY: THE NEW REGIME." APPEA Journal 34, no. 2 (1994): 72. http://dx.doi.org/10.1071/aj93085.
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Following the recommendations of the UK Cullen and COSOP reports, a new regulatory and operational safety regime is being introduced across Australian territorial waters for the offshore petroleum industry. This paper details the concepts behind the new regime including the development and implementation strategies employed to introduce it and the implications to industry and government instrumentalities. The recognition that safety in the work place is an outcome of managerial commitment and a function of work system control is resulting in legislative reforms that will reduce the focus on physical compliance, in favour of a goal-setting legislative approach that places emphasis on systems of managing safety at the work place. By focussing upon ends rather than means, objective based regulation requires organisations to manage the design, construction and operation of facilities to reduce risk to a 'reasonably practicable level*. The details of the management arrangements and risk assessment studies once submitted in a 'safety case' and acknowledged by the regulator, form a co-regulatory guidance document that sets both the standards to be achieved and the mechanism for achieving them. Auditing of the operator against an accepted safety case will occur on a regular basis. Driven by measurement of an operator's safety performance, selected systems will be targeted and audited against the safety case by a team of auditors composed of both government inspectors and operator personnel. Performance measures will be both proactive and reactive in nature and include among other measures, results obtained through the newly created national data base for incidents and accidents. Preparation and assessment of safety cases provides regulators and operators alike with difficulties. Consistency of assessment and objective determination that acceptable minimum standards have been met provide a challenge to government agencies and to the petroleum industry. Recognition of the nature of this challenge has led to the adoption of Quality Management principles among government utilities. A key feature of the Quality Management System will be the introduction of systems that drive change through cyclic updates of the safety case assessment procedures.The safety case concept institutionalises a dialogue between regulator and operator that will facilitate the preparation, submission and assessment of the safety case. This initiative provides for a staged submission process to correspond to the development phase of the facility. It is considered that this methodology will ensure minimal delays in assessment and provide certainty in the business planning process. The new safety case regime provides for a greater level of employee participation both in the preparation of safety cases and the maintenance of safety at the work place. Transparency of approach by both operators and regulators will be needed if public and workforce confidence are to be maintained. Co-operation and continual improvement will hopefully be the hall mark of the Australian safety case regime.
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Polglaze, John. "Cetaceans and the petroleum industry—coexistence or mutual exclusion?" APPEA Journal 50, no. 2 (2010): 685. http://dx.doi.org/10.1071/aj09049.
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Legends, myths and plain old misinformation abound of whale migrations interrupted by international shipping, dolphin populations displaced by dredging activities, and of seismic survey campaigns resulting in disoriented, beached whales. While risks exist, in truth the Australian petroleum industry continues to demonstrate that it can successfully coexist productively alongside populations of cetacean. These whales and dolphins are seemingly able to at least tolerate, if not actually be undisturbed by, underwater noise. Other risks to cetaceans from oil and gas activities, whether actual or perceived, encompass vessel strike, turbidity plumes from dredging, port developments, underwater blasting, spills, the laying and operation of pipelines, and similar. URS Australia’s John Polglaze is a specialist in the environmental impact evaluation of underwater noise, and has over 15 years experience in marine environmental management and impact assessment following nearly 20 years service in the Royal Australian Navy. John presents on the range of environmental impact assessment challenges for the oil and gas industry in Australian coastal and offshore regions, and effective, pragmatic solutions for demonstrating low risks to cetaceans and other sensitive marine fauna. These include the application and limitations of computer-based models to predict underwater noise and blast propagation, the development of a risk assessment framework that has proven effective with state and Commonwealth regulators, and case studies of real-life interactions between the petroleum industry and cetacean populations. In particular, he will discuss how misunderstanding and misapprehension of these complex issues unnecessarily complicates the challenges of environmental compliance. This topic is timely, given that Australia’s rapidly increasing whale populations, coupled with the continued expansion of offshore petroleum activities, will lead to more frequent interaction between and overlap of cetaceans and oil and gas activities.
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Saha, Sumanta, and Sujata Saha. "Underreporting of treatment outcomes in hospitalized COVID-19 infected diabetes patients: a systematic review, meta-analysis, and meta-regression." Journal of Ideas in Health 4, no. 4 (November 23, 2021): 573–80. http://dx.doi.org/10.47108/jidhealth.vol4.iss4.168.
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Background: Prolonged inpatient care requirements and time constraints of research and researchers lead to the non-reporting of the treatment outcome of certain COVID-19 infected diabetes patients in published manuscripts. This study aims to quantify its global burden.
Methods: A search for citations addressing the above outcome ensued chiefly in the PubMed, Embase, and Scopus databases, irrespective of the publication date and geographical region. Recruited studies were critically appraised with the National Heart, Lung, and Blood Institute's tool. Using the random-effects meta-analysis with an exact binomial method and Freeman-Tukey double arcsine transformation, the overall and subgroup-wise weighted pooled prevalence of the missing treatment outcome data was determined. The heterogeneity and publication bias assessment utilized I2 and Chi2 statistics, and funnel plot, and Egger's test, respectively.
Results: Ten publications (primarily case series; 70.0%) included in this review sourced data from 6687 COVID-19 infected inpatient diabetes patients from Asia, Australia, Europe, and North America. The global pooled prevalence of missing treatment outcome data among these patients was 33.0% (95% CI: 15.0-53.0%; I2: 99.53%; P of Chi2: <0.001). It was highest in Europe (63%; 95% CI: 61.0-66.0%). Publication bias assessment was not suggestive of any small study effect.
Conclusion: A considerable proportion of crucial prognosis information of hospitalized COVID-19 patients with diabetes goes underreported. It increases the risk of biasing the contemporary COVID-19-diabetes literature. The reporting of these data in the post-publication era or postponing the primary publication until the availability of all patients' treatment outcome data, when feasible, is recommended to address this enigma.