When death is not a crime : challenges for police and policing

The over-representation of vulnerable populations within the criminal justice system, and the role of police in perpetuating this, has long been a topic of discussion in criminology. What is less discussed is the way in which non -criminal investigations by police, in areas like a death investigation, may perpetuate similar types of engagement with vulnerable populations. In Australia, as elsewhere, it is the police who are responsible for investigating both suspicious and violent deaths like homicide as well as non - suspicious, violent deaths like accidents and suicides. Police are also the agents tasked with investigating deaths which are neither violent nor suspicious but occur outside hospitals and other care facilities. This paper reports on how the police describe - or are described by others - their role in a non - suspicious death investigation, and the challenges that such investigations raise for police and policing.

An updated analysis of death data during the Morwell mine fire

An updated analysis of the previous analysis available here: http://eprints.qut.edu.au/76230/

The safety of bicycles being overtaken by cars : what do we know and what do we need to know?

Many cyclist deaths and serious injuries result from rear-end or sideswipe collisions involving a car or heavy vehicle. As a consequence, minimum passing distance laws (often referred to as ‘one metre rules’) have been introduced in a number of U.S. states along with European countries such as France, Belgium and Spain. A two-year trial of a minimum passing distance rule is underway in Queensland. The international studies show that while the average passing distance is more than one metre, significant proportions of passes occur at less than this distance. Average passing distances are greater with wider lanes, when bicycle lanes are present, for cars rather than vans or trucks, and (possibly) at higher speed limits. Perceived characteristics of the cyclist (other than gender) appear to have little effect on passing distances. The research questions the ability to judge lateral distance and whether nominated distances predict on-road behaviour. Cyclists have strong concerns about drivers passing too close but the extent to which this behaviour reflects deliberate intimidation versus an inability to judge what is a safe passing distance is not clear. There has been no systematic evaluation of the road safety benefits of minimum passing distance laws. These laws have received little police enforcement but it is unclear whether enforcement is necessary for them to be effective.

Relocating a flood-affected community : good planning or good politics?

Problem, research strategy and findings: On January 10, 2011, the town of Grantham, Queensland (Australia), was inundated with a flash flood in which 12 of the town's 370 residents drowned. The overall damage bill in Queensland was AUD∃2.38 billion (USD∃2.4 billion) with 35 deaths, and more than three-quarters of the state was declared a flood disaster zone. In this study, we focus on the unusual and even rare decision to relocate Grantham in March 2011. The Lockyer Valley Regional Council (LVRC) acquired a 377-hectare (932-acre) site to enable a voluntary swap of equivalent-sized lots. In addition, planning regulations were set aside to streamline the relocation of a portion of the town. We review the natural hazard literature as it relates to community relocation, state and local government documents related to Grantham, and reports and newspaper articles related to the flood. We also analyze data from interviews with key stakeholders. We document the process of community relocation, assess the relocation process in Grantham against best practice, examine whether the process of community relocation can be upscaled and if the Grantham relocation is an example of good planning or good politics. Takeaway for practice: Our study reveals two key messages for practice. Community relocation (albeit a small one) is possible, and the process can be done quickly; some Grantham residents moved into their new, relocated homes in December 2012, just 11 months after the flood. Moreover, the role of existing planning regulations can be a hindrance to quick action; political leadership, particularly at the local level, is key to implementing the relocation.

Are we there yet? Australian road safety targets and road traffic crash fatalities

Background Road safety targets are widely used and provide a basis for evaluating progress in road safety outcomes against a quantified goal. In Australia, a reduction in fatalities from road traffic crashes (RTCs) is a public policy objective: a national target of no more than 5.6 fatalities per 100,000 population by 2010 was set in 2001. The purpose of this paper is to examine the progress Australia and its states and territories have made in reducing RTC fatalities, and to estimate when the 2010 target may be reached by the jurisdictions. Methods Following a descriptive analysis, univariate time-series models estimate past trends in fatality rates over recent decades. Data for differing time periods are analysed and different trend specifications estimated. Preferred models were selected on the basis of statistical criteria and the period covered by the data. The results of preferred regressions are used to determine out-of-sample forecasts of when the national target may be attained by the jurisdictions. Though there are limitations with the time series approach used, inadequate data precluded the estimation of a full causal/structural model. Results Statistically significant reductions in fatality rates since 1971 were found for all jurisdictions with the national rate decreasing on average, 3% per year since 1992. However the gains have varied across time and space, with percent changes in fatality rates ranging from an 8% increase in New South Wales 1972-1981 to a 46% decrease in Queensland 1982-1991. Based on an estimate of past trends, it is possible that the target set for 2010 may not be reached nationally, until 2016. Unsurprisingly, the analysis indicated a range of outcomes for the respective state/territory jurisdictions though these results should be interpreted with caution due to different assumptions and length of data. Conclusions Results indicate that while Australia has been successful over recent decades in reducing RTC mortality, an important gap between aspirations and achievements remains. Moreover, unless there are fairly radical ("trend-breaking") changes in the factors that affect the incidence of RTC fatalities, deaths from RTCs are likely to remain above the national target in some areas of Australia, for years to come.

Scrutinising the other : incapacity, suspicion and manipulation in a death investigation

In common law countries like England, Australia, the USA and Canada, certain deaths come to be investigated through the coronial system. These include sudden, unnatural or suspicious deaths as well as those which appear to be the result of naturally occurring disease but the precise cause is unknown. When a reportable death occurs in Australia, a number of professional groups become involved in its investigation – police, coroners, pathologists and counsellors. While research has demonstrated the importance of training and education for staff in the context of criminal investigations – with its over-representation of vulnerable and marginalised populations – this is less likely to occur in the context of death investigations, despite such investigations also involving the over-representation of vulnerable populations. This paper, part of larger funded research on the decision-making of coronial professionals in the context of cultural and religious difference, explores the ways in which cultural and religious minority groups – in this case Islam, Judaism and Indigeneity – become differently positioned during the death investigation based upon how they are perceived as ‘other’. Our research raises three issues. First, positioning as ‘the other’ is dependent on the professional training of the staff member, with police and pathologists far more likely than coroners to be suspicious or ignorant of difference. Second, specific historical and contemporary events effect the Othering of religious and cultural difference. Third, the grieving practices associated with religious and cultural difference can be collectively Othered through their perceived opposition to modernity.

Investigating death: the emotional and cultural challenges for police

The over-representation of vulnerable populations within the criminal justice system, and the role of police in perpetuating this, has long been a topic of discussion in criminology. What is less discussed is the way in which non-criminal investigations by police, in areas like a death investigation, may similarly disadvantage and discriminate against vulnerable populations. In Australia, as elsewhere, it is police who are responsible for investigating both suspicious and violent deaths like homicide as well as non-suspicious, violent deaths like accidents and suicides. Police are also the agents tasked with investigating deaths which are neither violent nor suspicious but occur outside hospitals and other care facilities. This paper, part of a larger funded Australian research project focusing on the ways in which cultural and religious differences are dealt with during the death investigation process, reports on how police describe – or are described by others – during their role in a non-suspicious death investigation, and the challenges that such investigations raise for police and policing. The employment of police liaison officers is discussed as one response to the difficulty of policing cultural and religious difference with variable results.

Current pre-hospital traumatic brain injury management in China

BACKGROUND Traumatic brain injury (TBI) is associated with mo st trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, pre- hospital service can signifi cantly reduce case-fata lity rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in China. DATA SOURCES A literature search was conducted in January 2014 using the China National Knowledge Infrastructure (CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain hern iation was extracted from the identifi ed articles. RESULTS Of the 471 articles identified, 65 met the selecti on criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different regions. CONCLUSION Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China.

When coroners care too much: Therapeutic jurisprudence and suicide findings

In common law countries such as England and Australia, violent and otherwise unnatural deaths are investigated by coroners who make findings as to the “manner of death”. This includes determining whether the deceased person intentionally caused their own death. Previous research (Tait and Carpenter 2013a, 2013b, 2014) has suggested that coroners are reluctant to reach such determinations, citing the stigma of suicide and a need for sensitivity to grieving and traumatized families. Based on interviews with both English and Australian coroners, this paper explores whether an ‘ethic of care’ evident in English and Australian coronial suicide determinations, can be understood as an application of the ‘practices and techniques’ of therapeutic jurisprudence. Based on the ways in which coroners position the law as a potential therapeutic agent, we investigate how they understand their role and position as legal actors, and the effects of their decision making in the context of suspected suicides.

Estimating the burden of disease attributable to childhood and maternal undernutrition in South Africa in 2000

OBJECTIVES To estimate the disease burden attributable to being underweight as an indicator of undernutrition in children under 5 years of age and in pregnant women for the year 2000. DESIGN World Health Organization comparative risk assessment (CRA) methodology was followed. The 1999 National Food Consumption Survey prevalence of underweight classified in three low weight-for-age categories was compared with standard growth charts to estimate population-attributable fractions for mortality and morbidity outcomes, based on increased risk for each category and applied to revised burden of disease estimates for South Africa in 2000. Maternal underweight, leading to an increased risk of intra-uterine growth retardation and further risk of low birth weight (LBW), was also assessed using the approach adopted by the global assessment. Monte Carlo simulation-modeling techniques were used for the uncertainty analysis. SETTING South Africa. SUBJECTS Children under 5 years of age and pregnant women. OUTCOME MEASURES Mortality and disability-adjusted life years (DALYs) from protein- energy malnutrition and a fraction of those from diarrhoeal disease, pneumonia, malaria, other non- HIV/AIDS infectious and parasitic conditions in children aged 0 - 4 years, and LBW. RESULTS Among children under 5 years, 11.8% were underweight. In the same age group, 11,808 deaths (95% uncertainty interval 11,100 - 12,642) or 12.3% (95% uncertainty interval 11.5 - 13.1%) were attributable to being underweight. Protein-energy malnutrition contributed 44.7% and diarrhoeal disease 29.6% of the total attributable burden. Childhood and maternal underweight accounted for 2.7% (95% uncertainty interval 2.6 - 2.9%) of all DALYs in South Africa in 2000 and 10.8% (95% uncertainty interval 10.2 - 11.5%) of DALYs in children under 5. CONCLUSIONS The study shows that reduction of the occurrence of underweight would have a substantial impact on child mortality, and also highlights the need to monitor this important indicator of child health.

Estimating the burden of disease attributable to diabetes in South Africa in 2000

OBJECTIVES To estimate the burden of disease attributable to diabetes by sex and age group in South Africa in 2000. DESIGN The framework adopted for the most recent World Health Organization comparative risk assessment (CRA) methodology was followed. Small community studies used to derive the prevalence of diabetes by population group were weighted proportionately for a national estimate. Population-attributable fractions were calculated and applied to revised burden of disease estimates. Monte Carlo simulation-modelling techniques were used for uncertainty analysis. SETTING South Africa. SUBJECTS Adults 30 years and older. OUTCOME MEASURES Mortality and disability-adjusted life years (DALYs) for ischaemic heart disease (IHD), stroke, hypertensive disease and renal failure. RESULTS Of South Africans aged >or= 30 years, 5.5% had diabetes which increased with age. Overall, about 14% of IHD, 10% of stroke, 12% of hypertensive disease and 12% of renal disease burden in adult males and females (30+ years) were attributable to diabetes. Diabetes was estimated to have caused 22,412 (95% uncertainty interval 20,755 - 24,872) or 4.3% (95% uncertainty interval 4.0 - 4.8%) of all deaths in South Africa in 2000. Since most of these occurred in middle or old age, the loss of healthy life years comprises a smaller proportion of the total 258,028 DALYs (95% uncertainty interval 236,856 - 290,849) in South Africa in 2000, accounting for 1.6% (95% uncertainty interval 1.5 - 1.8%) of the total burden. CONCLUSIONS Diabetes is an important direct and indirect cause of burden in South Africa. Primary prevention of the disease through multi-level interventions and improved management at primary health care level are needed.

Estimating the burden of disease attributable to iron deficiency anaemia in South Africa in 2000

OBJECTIVES To estimate the extent of iron deficiency anaemia (IDA) among children aged 0 - 4 years and pregnant women aged 15 - 49 years, and the burden of disease attributed to IDA in South Africa in 2000. DESIGN The comparative risk assessment (CRA) methodology of the World Health Organization (WHO) was followed using local prevalence and burden estimates. IDA prevalence came from re-analysis of the South African Vitamin A Consultative Group study in the case of the children, and from a pooled estimate from several studies in the case of the pregnant women (haemoglobin level < 11 g/dl and ferritin level < 12 microg/l). Monte Carlo simulation-modelling was used for the uncertainty analysis. SETTING South Africa. SUBJECTS Children under 5 years and pregnant women 15 - 49 years. OUTCOME MEASURES Direct sequelae of IDA, maternal and perinatal deaths and disability-adjusted life years (DALYs) from mild mental disability related to IDA. Results. It is estimated that 5.1% of children and 9 - 12% of pregnant women had IDA and that about 7.3% of perinatal deaths and 4.9% of maternal deaths were attributed to IDA in 2000. Overall, about 174,976 (95% uncertainty interval 150,344 - 203,961) healthy years of life lost (YLLs), or between 0.9% and 1.3% of all DALYs in South Africa in 2000, were attributable to IDA. CONCLUSIONS This first study in South Africa to quantify the burden from IDA suggests that it is a less serious public health problem in South Africa than in many other developing countries. Nevertheless, this burden is preventable, and the study highlights the need to disseminate the food-based dietary guidelines formulated by the National Department of Health to people who need them and to monitor the impact of the food fortification programme.

Empirical reference points for Bernstein’s model of pedagogic rights: Recontextualising the reconciliation agenda to Australian schooling

In this chapter we use Bernstein’s (2000) model of pedagogic rights to examine the learning experiences for non-Indigenous teachers in two reconciliation projects. In the context within which we write, reconciliation is the process of establishing a culture of mutual respect between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. In 1991, the Royal Commission into Aboriginal Deaths in Custody linked the continuation of racism in Australian society to the weak coverage of Aboriginal and Torres Strait Islander content in the school curriculum (Reconciliation Australia 2010). Nearly two decades later, the Melbourne Declaration on Educational Goals for Young Australians issued by the council of Federal, State and Territory Ministers of Education proclaimed that curriculum should enable all students to ‘understand and acknowledge the value of Indigenous cultures and possess the knowledge, skills and understanding to contribute to, and benefit from reconciliation between Indigenous and non-Indigenous Australians’ (MCEETYA 2008, 9). Education holds out promise not only of better life chances for Indigenous young people, but also of replacing myths with understanding and tackling prejudice and racism within the non-Indigenous population. Bernstein’s (2000) model of pedagogic rights promises some purchase on this pedagogic work by providing concepts for looking systematically at the participation of non-Indigenous teachers in education. As observed by Frandji and Vitale (Chapter 2, this volume), the model is not sufficient to achieve a democratic reality, ‘but simply provides a basis for problematizing reality and considering possibilities’.

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010

BACKGROUND Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. METHODS We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. FINDINGS In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2-7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5-7·0]), and alcohol use (5·5% [5·0-5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8-9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6-8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4-6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2-10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0·9% (0·4-1·6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania. INTERPRETATION Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children.

Fatal consequences: An analysis of the failed employee voice system at the Bundaberg Hospital

In this paper we discuss the failure of the employee voice system at the Bundaberg Base Hospital (BBH) in Australia. Surgeon Jayant Patel was arrested over the deaths of patients on whom he operated when he was the director of surgery at the hospital. Our interest is in the reasons the established employee voice mechanisms failed when employees attempted to bring serious issues to the attention of managers. Our data is based on an analysis of the sworn testimonies of participants who participated in two inquiries concerning these events. An analysis of the events with a particular focus on the failings of the voice system is presented. We ask the following: how and why did the voice systems in the case of the BBH fail?