Medication warnings about driving : risk perceptions among French and Australian Communities

Increased crash risk is associated with sedative medications and researchers and health-professionals have called for improvements to medication warnings about driving. The tiered warning system in France since 2005 indicates risk level, uses a color-coded pictogram, and advises the user to seek the advice of a doctor before driving. In Queensland, Australia, the mandatory warning on medications that may cause drowsiness advises the user not to drive or operate machinery if they self-assess that they are affected, and calls attention to possible increased impairment when combined with alcohol. Objectives The reported aims of the study were to establish and compare risk perceptions associated with the Queensland and French warnings among medication users. It was conducted to complement the work of DRUID in reviewing the effectiveness of existing campaigns and practice guidelines. Methods Medication users in France and Queensland were surveyed using warnings about driving from both contexts to compare risk perceptions associated with each label. Both samples were assessed for perceptions of the warning that carried the strongest message of risk. The Queensland study also included perceptions of the likelihood of crash and level of impairment associated with the warning. Results Findings from the French study (N = 75) indicate that when all labels were compared, the majority of respondents perceived the French Level-3 label as the strongest warning about risk concerning driving. Respondents in Queensland had significantly stronger perceptions of potential impairment to driving ability, z = -13.26, p <.000 (n = 325), and potential chance of having a crash, z = -11.87, p < .000 (n = 322), after taking a medication that displayed the strongest French warning, compared with the strongest Queensland warning. Conclusions Evidence suggests that warnings about driving displayed on medications can influence risk perceptions associated with use of medication. Further analyses will determine whether risk perceptions influence compliance with the warnings.

Psychiatric and substance abuse comorbidity among a large sample of DUI Texas offenders

Research is indicating that individuals who present for DUI treatment may have competing substance abuse and mental health needs. This study aimed to examine the extent of such comorbidity issues among a sample of Texas DUI offenders. Method: Records of 36,372 DUI clients and 308,695 non-DUI clients admitted to Texas treatment programs between 2005 and 2008 were obtained from the State's administrative dataset. The data were analysed to identify the relationship between substance use, psychiatric problems, program completion and recidivism rates. Results: Analysis indicated that while non-DUI clients were more likely to present with more severe illicit substance use problems, DUI clients were more likely to have a primary problem with alcohol. Additionally, a cannabis use problem was also found to be significantly associated with DUI recidivism in the last year. In regards to mental health needs, a major finding was that depression was the most common psychiatric condition reported by DUI clients, including those with more than one DUI offence in the past year. This group were also more at risk of being diagnosed with Bipolar Disorder compared to the general population, and such a diagnosis was also associated with an increased likelihood of not completing treatment. Interestingly, female DUI and non-DUI clients were also more likely to be diagnosed with mental health problems compared to males, as well as more likely to be placed on medications at admission and have problems with methamphetamine, cocaine, and opiates. Conclusion: The findings highlight the complex competing needs of some DUI offenders who enter treatment. The results also suggest that there is a need to utilise mental health and substance abuse screening methods to ensure DUI offenders are directed towards appropriate treatment pathways as well as ensure that such interventions adequately cater for complex substance abuse and psychiatric needs.

A criminological analysis : using real-time monitoring to gather data on online predators

The Internet presents a constantly evolving frontier for criminology and policing, especially in relation to online predators – paedophiles operating within the Internet for safer access to children, child pornography and networking opportunities with other online predators. The goals of this qualitative study are to undertake behavioural research – identify personality types and archetypes of online predators and compare and contrast them with behavioural profiles and other psychological research on offline paedophiles and sex offenders. It is also an endeavour to gather intelligence on the technological utilisation of online predators and conduct observational research on the social structures of online predator communities. These goals were achieved through the covert monitoring and logging of public activity within four Internet Relay Chat(rooms) (IRC) themed around child sexual abuse and which were located on the Undernet network. Five days of monitoring was conducted on these four chatrooms between Wednesday 1 to Sunday 5 April 2009; this raw data was collated and analysed. The analysis identified four personality types – the gentleman predator, the sadist, the businessman and the pretender – and eight archetypes consisting of the groomers, dealers, negotiators, roleplayers, networkers, chat requestors, posters and travellers. The characteristics and traits of these personality types and archetypes, which were extracted from the literature dealing with offline paedophiles and sex offenders, are detailed and contrasted against the online sexual predators identified within the chatrooms, revealing many similarities and interesting differences particularly with the businessman and pretender personality types. These personality types and archetypes were illustrated by selecting users who displayed the appropriate characteristics and tracking them through the four chatrooms, revealing intelligence data on the use of proxies servers – especially via the Tor software – and other security strategies such as Undernet’s host masking service. Name and age changes, which is used as a potential sexual grooming tactic was also revealed through the use of Analyst’s Notebook software and information on ISP information revealed the likelihood that many online predators were not using any safety mechanism and relying on the anonymity of the Internet. The activities of these online predators were analysed, especially in regards to child sexual grooming and the ‘posting’ of child pornography, which revealed a few of the methods in which online predators utilised new Internet technologies to sexually groom and abuse children – using technologies such as instant messengers, webcams and microphones – as well as store and disseminate illegal materials on image sharing websites and peer-to-peer software such as Gigatribe. Analysis of the social structures of the chatrooms was also carried out and the community functions and characteristics of each chatroom explored. The findings of this research have indicated several opportunities for further research. As a result of this research, recommendations are given on policy, prevention and response strategies with regards to online predators.

Slum free India program. Report on the findings and recommendations of QUT BEE workshop to investigate strategies to deliver better outcomes

As a result of a broad invitation extended by Professor Martin Betts, Executive Dean of the Faculty of Built Environment and Engineering, to the community of interest at QUT, a cross-disciplinary collaborative workshop was conducted to contribute ideas about responding to the Government of India’s urgent requirement to implement a program to re-house slum dwellers. This is a complex problem facing the Indian Ministry of Housing. Not only does the government aspire to eradicate existing slum conditions and to achieve tangible results within five years, but it must also ensure that slums do not form in the future. The workshop focused on technological innovation in construction to deliver transformation from the current unsanitary and overcrowded informal urban settlements to places that provide the economically weaker sections of Indian society with healthy, environmentally sustainable, economically viable mass housing that supports successful urban living. The workshop was conducted in two part process as follows: Initially, QUT academics from diverse fields shared current research and provided technical background to contextualise the challenge at a pre-workshop briefing session. This was followed by a one-day workshop during which participants worked intensively in multi-disciplinary groups through a series of exercises to develop innovative approaches to the complex problem of slum redevelopment. Dynamic, compressed work sessions, interspersed with cross-functional review and feedback by the whole group took place throughout the day. Reviews emphasised testing the concepts for their level of complexity, and likelihood of success. The two-stage workshop process achieved several objectives:  Inspired a sense of shared purpose amongst a diverse group of academics  Built participants’ knowledge of each other’s capacity  Engaged multi disciplinary team in an innovative design research process  Built participants’ confidence in the collaborative process  Demonstrated that collaborative problem solving can create solutions that represent transformative change.  Developed a framework of how workable solutions might be developed for the program through follow up workshops and charrettes of a similar nature involving stakeholders drawn from the context of the slum housing program management.

Bayesian filtering over compressed appearance states

This paper presents a framework for performing real-time recursive estimation of landmarks’ visual appearance. Imaging data in its original high dimensional space is probabilistically mapped to a compressed low dimensional space through the definition of likelihood functions. The likelihoods are subsequently fused with prior information using a Bayesian update. This process produces a probabilistic estimate of the low dimensional representation of the landmark visual appearance. The overall filtering provides information complementary to the conventional position estimates which is used to enhance data association. In addition to robotics observations, the filter integrates human observations in the appearance estimates. The appearance tracks as computed by the filter allow landmark classification. The set of labels involved in the classification task is thought of as an observation space where human observations are made by selecting a label. The low dimensional appearance estimates returned by the filter allow for low cost communication in low bandwidth sensor networks. Deployment of the filter in such a network is demonstrated in an outdoor mapping application involving a human operator, a ground and an air vehicle.

A statistical framework for natural feature representation

This paper presents a robust stochastic framework for the incorporation of visual observations into conventional estimation, data fusion, navigation and control algorithms. The representation combines Isomap, a non-linear dimensionality reduction algorithm, with expectation maximization, a statistical learning scheme. The joint probability distribution of this representation is computed offline based on existing training data. The training phase of the algorithm results in a nonlinear and non-Gaussian likelihood model of natural features conditioned on the underlying visual states. This generative model can be used online to instantiate likelihoods corresponding to observed visual features in real-time. The instantiated likelihoods are expressed as a Gaussian mixture model and are conveniently integrated within existing non-linear filtering algorithms. Example applications based on real visual data from heterogenous, unstructured environments demonstrate the versatility of the generative models.

A stochastic model for natural feature representation

This paper presents a robust stochastic model for the incorporation of natural features within data fusion algorithms. The representation combines Isomap, a non-linear manifold learning algorithm, with Expectation Maximization, a statistical learning scheme. The representation is computed offline and results in a non-linear, non-Gaussian likelihood model relating visual observations such as color and texture to the underlying visual states. The likelihood model can be used online to instantiate likelihoods corresponding to observed visual features in real-time. The likelihoods are expressed as a Gaussian Mixture Model so as to permit convenient integration within existing nonlinear filtering algorithms. The resulting compactness of the representation is especially suitable to decentralized sensor networks. Real visual data consisting of natural imagery acquired from an Unmanned Aerial Vehicle is used to demonstrate the versatility of the feature representation.

Multivariate Markov Process Models for the transmission of methicillin-resistant Staphylococcus Aureus in a hospital ward

Methicillin-resistant Staphylococcus Aureus (MRSA) is a pathogen that continues to be of major concern in hospitals. We develop models and computational schemes based on observed weekly incidence data to estimate MRSA transmission parameters. We extend the deterministic model of McBryde, Pettitt, and McElwain (2007, Journal of Theoretical Biology 245, 470–481) involving an underlying population of MRSA colonized patients and health-care workers that describes, among other processes, transmission between uncolonized patients and colonized health-care workers and vice versa. We develop new bivariate and trivariate Markov models to include incidence so that estimated transmission rates can be based directly on new colonizations rather than indirectly on prevalence. Imperfect sensitivity of pathogen detection is modeled using a hidden Markov process. The advantages of our approach include (i) a discrete valued assumption for the number of colonized health-care workers, (ii) two transmission parameters can be incorporated into the likelihood, (iii) the likelihood depends on the number of new cases to improve precision of inference, (iv) individual patient records are not required, and (v) the possibility of imperfect detection of colonization is incorporated. We compare our approach with that used by McBryde et al. (2007) based on an approximation that eliminates the health-care workers from the model, uses Markov chain Monte Carlo and individual patient data. We apply these models to MRSA colonization data collected in a small intensive care unit at the Princess Alexandra Hospital, Brisbane, Australia.

Empirical Bayes method in the study of traffic safety via heterogeneous negative multinomial model

In the study of traffic safety, expected crash frequencies across sites are generally estimated via the negative binomial model, assuming time invariant safety. Since the time invariant safety assumption may be invalid, Hauer (1997) proposed a modified empirical Bayes (EB) method. Despite the modification, no attempts have been made to examine the generalisable form of the marginal distribution resulting from the modified EB framework. Because the hyper-parameters needed to apply the modified EB method are not readily available, an assessment is lacking on how accurately the modified EB method estimates safety in the presence of the time variant safety and regression-to-the-mean (RTM) effects. This study derives the closed form marginal distribution, and reveals that the marginal distribution in the modified EB method is equivalent to the negative multinomial (NM) distribution, which is essentially the same as the likelihood function used in the random effects Poisson model. As a result, this study shows that the gamma posterior distribution from the multivariate Poisson-gamma mixture can be estimated using the NM model or the random effects Poisson model. This study also shows that the estimation errors from the modified EB method are systematically smaller than those from the comparison group method by simultaneously accounting for the RTM and time variant safety effects. Hence, the modified EB method via the NM model is a generalisable method for estimating safety in the presence of the time variant safety and the RTM effects.

Continuous appearance-based trajectory SLAM

This paper describes a novel probabilistic approach to incorporating odometric information into appearance-based SLAM systems, without performing metric map construction or calculating relative feature geometry. The proposed system, dubbed Continuous Appearance-based Trajectory SLAM (CAT-SLAM), represents location as a probability distribution along a trajectory, and represents appearance continuously over the trajectory rather than at discrete locations. The distribution is evaluated using a Rao-Blackwellised particle filter, which weights particles based on local appearance and odometric similarity and explicitly models both the likelihood of revisiting previous locations and visiting new locations. A modified resampling scheme counters particle deprivation and allows loop closure updates to be performed in constant time regardless of map size. We compare the performance of CAT-SLAM to FAB-MAP (an appearance-only SLAM algorithm) in an outdoor environment, demonstrating a threefold increase in the number of correct loop closures detected by CAT-SLAM.

Bayes Factor based speaker segmentation for speaker diarization

This paper proposes the use of the Bayes Factor as a distance metric for speaker segmentation within a speaker diarization system. The proposed approach uses a pair of constant sized, sliding windows to compute the value of the Bayes Factor between the adjacent windows over the entire audio. Results obtained on the 2002 Rich Transcription Evaluation dataset show an improved segmentation performance compared to previous approaches reported in literature using the Generalized Likelihood Ratio. When applied in a speaker diarization system, this approach results in a 5.1% relative improvement in the overall Diarization Error Rate compared to the baseline.

The effects of ambulance ramping on Emergency Department length of stay and mortality

Background: Ambulance ramping within the Emergency Department (ED) is a common problem both internationally and in Australia. Previous research has focused on various issues associated with ambulance ramping such as access block, ED overcrowding and ambulance bypass. However, limited research has been conducted on ambulance ramping and its effects on patient outcomes. ----- ----- Methods: A case-control design was used to describe, compare and predict patient outcomes of 619 ramped (cases) vs. 1238 non-ramped (control) patients arriving to one ED via ambulance from 1 June 2007 to 31 August 2007. Cases and controls were matched (on a 1:2 basis) on age, gender and presenting problem. Outcome measures included ED length of stay and in-hospital mortality. ----- ----- Results: The median ramp time for all 1857 patients was 11 (IQR 6—21) min. Compared to nonramped patients, ramped patients had significantly longer wait time to be triaged (10 min vs. 4 min). Ramped patients also comprised significantly higher proportions of those access blocked (43% vs. 34%). No significant difference in the proportion of in-hospital deaths was identified (2%vs. 3%). Multivariate analysis revealed that the likelihood of having an ED length of stay greater than eight hours was 34% higher among patients who were ramped (OR 1.34, 95% CI 1.06—1.70, p = 0.014). In relation to in-hospital mortality age was the only significant independent predictor of mortality (p < 0.0001). ----- ----- Conclusion: Ambulance ramping is one factor that contributes to prolonged ED length of stay and adds additional strain on ED service provision. The potential for adverse patient outcomes that may occur as a result of ramping warrants close attention by health care service providers.

Anticipated behaviours of emergency prehospital medical care providers during an influenza pandemic

Introduction: Emergency prehospital medical care providers are frontline health workers during emergencies. However, little is known about their attitudes, perceptions, and likely behaviors during emergency conditions. Understanding these attitudes and behaviors is crucial to mitigating the psychological and operational effects of biohazard events such as pandemic influenza, and will support the business continuity of essential prehospital services. ----- ----- Problem: This study was designed to investigate the association between knowledge and attitudes regarding avian influenza on likely behavioral responses of Australian emergency prehospital medical care providers in pandemic conditions. ----- ----- Methods: Using a reply-paid postal questionnaire, the knowledge and attitudes of a national, stratified, random sample of the Australian emergency prehospital medical care workforce in relation to pandemic influenza were investigated. In addition to knowledge and attitudes, there were five measures of anticipated behavior during pandemic conditions: (1) preparedness to wear personal protective equipment (PPE); (2) preparedness to change role; (3) willingness to work; and likely refusal to work with colleagues who were exposed to (4) known and (5) suspected influenza. Multiple logistic regression models were constructed to determine the independent predictors of each of the anticipated behaviors, while controlling for other relevant variables. ----- ----- Results: Almost half (43%) of the 725 emergency prehospital medical care personnel who responded to the survey indicated that they would be unwilling to work during pandemic conditions; one-quarter indicated that they would not be prepared to work in PPE; and one-third would refuse to work with a colleague exposed to a known case of pandemic human influenza. Willingness to work during a pandemic (OR = 1.41; 95% CI = 1.0–1.9), and willingness to change roles (OR = 1.44; 95% CI = 1.04–2.0) significantly increased with adequate knowledge about infectious agents generally. Generally, refusal to work with exposed (OR = 0.48; 95% CI = 0.3–0.7) or potentially exposed (OR = 0.43; 95% CI = 0.3–0.6) colleagues significantly decreased with adequate knowledge about infectious agents. Confidence in the employer’s capacity to respond appropriately to a pandemic significantly increased employee willingness to work (OR = 2.83; 95% CI = 1.9–4.1); willingness to change roles during a pandemic (OR = 1.52; 95% CI = 1.1–2.1); preparedness to wear PPE (OR = 1.68; 95% CI = 1.1–2.5); and significantly decreased the likelihood of refusing to work with colleagues exposed to (suspected) influenza (OR = 0.59; 95% CI = 0.4–0.9). ----- ----- Conclusions:These findings indicate that education and training alone will not adequately prepare the emergency prehospital medical workforce for a pandemic. It is crucial to address the concerns of ambulance personnel and the perceived concerns of their relationship with partners in order to maintain an effective prehospital emergency medical care service during pandemic conditions.

Access control : allocating resources to selfish agents

The ultimate goal of an authorisation system is to allocate each user the level of access they need to complete their job - no more and no less. This proves to be challenging in an organisational setting because on one hand employees need enough access to perform their tasks, while on the other hand more access will bring about an increasing risk of misuse - either intentionally, where an employee uses the access for personal benefit, or unintentionally through carelessness, losing the information or being socially engineered to give access to an adversary. With the goal of developing a more dynamic authorisation model, we have adopted a game theoretic framework to reason about the factors that may affect users’ likelihood to misuse a permission at the time of an access decision. Game theory provides a useful but previously ignored perspective in authorisation theory: the notion of the user as a self-interested player who selects among a range of possible actions depending on their pay-offs.

Improved salinity management for the Nebine / Mungallala / Wallam catchment

The low stream salinity naturally in the Nebine-Mungallala Catchment, extent of vegetation retention, relatively low rainfall and high evaporation indicates that there is a relatively low risk of rising shallow groundwater tables in the catchment. Scalding caused by wind and water erosion exposing highly saline sub-soils is a more important regional issue, such as in the Homeboin area. Local salinisation associated with evaporation of bore water from free flowing bore drains and bores is also an important land degradation issue particularly in the lower Nebine, Wallam and Mungallala Creeks. The replacement of free flowing artesian bores and bore drains with capped bores and piped water systems under the Great Artesian Basin bore rehabilitation program is addressing local salinisation and scalding in the vicinity of bore drains and preventing the discharge of saline bore water to streams. Three principles for the prevention and control of salinity in the Nebine Mungallala catchment have been identified in this review: • Avoid salinity through avoiding scalds – i.e. not exposing the near-surface salt in landscape through land degradation; • Riparian zone management: Scalding often occurs within 200m or so of watering lines. Natural drainage lines are most likely to be overstocked, and thus have potential for scalding. Scalding begins when vegetation is removed, and without that binding cover, wind and water erosion exposes the subsoil; and • Monitoring of exposed or grazed soil areas. Based on the findings of the study, we make the following recommendations: 1. Undertake a geotechnical study of existing maps and other data to help identify and target areas most at risk of rising water tables causing salinity. Selected monitoring should then be established using piezometers as an early warning system. 2. SW NRM should financially support scald reclamation activity through its various funding programs. However, for this to have any validity in the overall management of salinity risk, it is critical that such funding require the landholder to undertake a salinity hazard/risk assessment of his/her holding. 3. A staged approach to funding may be appropriate. In the first instance, it would be reasonable to commence funding some pilot scald reclamation work with a view to further developing and piloting the farm hazard/risk assessment tools, and exploring how subsequent grazing management strategies could be incorporated within other extension and management activities. Once the details of the necessary farm level activities have been more clearly defined, and following the outcomes of the geotechnical review recommended above, a more comprehensive funding package could be rolled out to priority areas. 4. We recommend that best-practice grazing management training currently on offer should be enhanced with information about salinity risk in scald-prone areas, and ways of minimising the likelihood of scald formation. 5. We recommend that course material be developed for local students in Years 6 and 7, and that arrangements be made with local schools to present this information. Given the constraints of existing syllabi, we envisage that negotiations may have to be undertaken with the Department of Education in order for this material to be permitted to be used. We have contact with key people who could help in this if required. 6. We recommend that SW NRM continue to support existing extension activities such as Grazing Land Management and the Monitoring Made Easy tools. These aids should be able to be easily expanding to incorporate techniques for monitoring, addressing and preventing salinity and scalding. At the time of writing staff of SW NRM were actively involved in this process. It is important that these activities are adequately resourced to facilitate the uptake by landholders of the perception that salinity is an issue that needs to be addressed as part of everyday management. 7. We recommend that SW NRM consider investing in the development and deployment of a scenario-modelling learning support tool as part of the awareness raising and education activities. Secondary salinity is a dynamic process that results from ongoing human activity which mobilises and/or exposes salt occurring naturally in the landscape. Time scales can be short to very long, and the benefits of management actions can similarly have immediate or very long time frames. One way to help explain the dynamics of these processes is through scenario modelling.