Risk factor analysis and spatiotemporal CART model of cryptosporidiosis in Queensland, Australia

Background: It remains unclear whether it is possible to develop a spatiotemporal epidemic prediction model for cryptosporidiosis disease. This paper examined the impact of social economic and weather factors on cryptosporidiosis and explored the possibility of developing such a model using social economic and weather data in Queensland, Australia. ----- ----- Methods: Data on weather variables, notified cryptosporidiosis cases and social economic factors in Queensland were supplied by the Australian Bureau of Meteorology, Queensland Department of Health, and Australian Bureau of Statistics, respectively. Three-stage spatiotemporal classification and regression tree (CART) models were developed to examine the association between social economic and weather factors and monthly incidence of cryptosporidiosis in Queensland, Australia. The spatiotemporal CART model was used for predicting the outbreak of cryptosporidiosis in Queensland, Australia. ----- ----- Results: The results of the classification tree model (with incidence rates defined as binary presence/absence) showed that there was an 87% chance of an occurrence of cryptosporidiosis in a local government area (LGA) if the socio-economic index for the area (SEIFA) exceeded 1021, while the results of regression tree model (based on non-zero incidence rates) show when SEIFA was between 892 and 945, and temperature exceeded 32°C, the relative risk (RR) of cryptosporidiosis was 3.9 (mean morbidity: 390.6/100,000, standard deviation (SD): 310.5), compared to monthly average incidence of cryptosporidiosis. When SEIFA was less than 892 the RR of cryptosporidiosis was 4.3 (mean morbidity: 426.8/100,000, SD: 319.2). A prediction map for the cryptosporidiosis outbreak was made according to the outputs of spatiotemporal CART models. ----- ----- Conclusions: The results of this study suggest that spatiotemporal CART models based on social economic and weather variables can be used for predicting the outbreak of cryptosporidiosis in Queensland, Australia.

Risk factors for fatal crashes in rural Australia

This paper presents findings from the rural and remote road safety study, conducted in Queensland, Australia, from March 2004 till June 2007, and compares fatal crashes and non-fatal but serious crashes in respect of their environmental, vehicle and operator factors. During the study period there were 613 non-fatal crashes resulting in 684 hospitalised casualties and 119 fatal crashes resulting in 130 fatalities. Additional information from police sources was available on 103 fatal and 309 non-fatal serious crashes. Over three quarters of both fatal and hospitalised casualties were male and the median age in both groups was 34 years. Fatal crashes were more likely to involve speed, alcohol and violations of road rules and fatal crash victims were 2 and a 1/2 times more likely to be unrestrained inside the vehicle than non-fatal casualties, consistent with current international evidence. After controlling for human factors, vehicle and road conditions made a minimal contribution to the seriousness of the crash outcome. Targeted interventions to prevent fatalities on rural and remote roads should focus on reducing speed and drink driving and promoting seatbelt wearing.

Bayesian network for risk of diarrhea associated with the use of recycled water

Estimating potential health risks associated with recycled (reused) water is highly complex given the multiple factors affecting water quality. We take a conceptual model, which represents the factors and pathways by which recycled water may pose a risk of contracting gastroenteritis, convert the conceptual model to a Bayesian net, and quantify the model using one expert’s opinion. This allows us to make various predictions as to the risks posed under various scenarios. Bayesian nets provide an additional way of modeling the determinants of recycled water quality and elucidating their relative influence on a given disease outcome. The important contribution to Bayesian net methodology is that all model predictions, whether risk or relative risk estimates, are expressed as credible intervals.

Incorporating parameter uncertainty into quantitative microbial risk assessment (QMRA)

Modern statistical models and computational methods can now incorporate uncertainty of the parameters used in Quantitative Microbial Risk Assessments (QMRA). Many QMRAs use Monte Carlo methods, but work from fixed estimates for means, variances and other parameters. We illustrate the ease of estimating all parameters contemporaneously with the risk assessment, incorporating all the parameter uncertainty arising from the experiments from which these parameters are estimated. A Bayesian approach is adopted, using Markov Chain Monte Carlo Gibbs sampling (MCMC) via the freely available software, WinBUGS. The method and its ease of implementation are illustrated by a case study that involves incorporating three disparate datasets into an MCMC framework. The probabilities of infection when the uncertainty associated with parameter estimation is incorporated into a QMRA are shown to be considerably more variable over various dose ranges than the analogous probabilities obtained when constants from the literature are simply ‘plugged’ in as is done in most QMRAs. Neglecting these sources of uncertainty may lead to erroneous decisions for public health and risk management.

HapMap tag-SNP analysis confirms a role for COMT in schizophrenia risk and reveals a novel association

Catechol-O-methyl transferase (COMT) encodes an enzyme involved in the metabolism of dopamine and maps to a commonly deleted region that increases schizophrenia risk. A non-synonymous polymorphism (rs4680) in COMT has been previously found to be associated with schizophrenia and results in altered activity levels of COMT. Using a haplotype block-based gene-tagging approach we conducted an association study of seven COMT single nucleotide polymorphisms (SNPs) in 160 patients with a DSM-IV diagnosis of schizophrenia and 250 controls in an Australian population. Two polymorphisms including rs4680 and rs165774 were found to be significantly associated with schizophrenia. The rs4680 results in a Val/Met substitution but the strongest association was shown by the novel SNP, rs165774, which may still be functional even though it is located in intron five. Individuals with schizophrenia were more than twice as likely to carry the GG genotype compared to the AA genotype for both the rs165774 and rs4680 SNPs. This association was slightly improved when males were analysed separately possibly indicating a degree of sexual dimorphism. Our results confirm that COMT is a good candidate for schizophrenia risk, by replicating the association with rs4680 and identifying a novel SNP association.

Risk taking in Extreme Sports: A phenomenological perspective

Participation in extreme sports is enjoying incredible growth while more traditional recreational activities such as golf are struggling to maintain numbers. Theoretical perspectives on extreme sports and extreme sport participants have assumed that participation is about risk-taking. However, these theory-driven methodologies may reflect judgments that do not necessarily relate to participants' lived experience. In this paper I review current risk-oriented perspectives on extreme sports and present research findings that question this assumed relationship between extreme sports and risk and thus reposition the experience in a hitherto unexplored manner. Risk taking is not the focus. Participants acknowledge that the potential outcome of a mismanaged mistake or accident could be death. However, accepting this potential outcome does not mean that they search for risk. Participants argue that many everyday life events (e.g., driving) are high-risk events. Participants undertake detailed preparation in order to minimise the possibility of negative outcomes because extreme sports trigger a range of positive experiential outcomes. The study is significant as it followed a hermeneutic phenomenological process which did not presuppose a risk-taking orientation. Hermeneutic phenomenology allows for a multitude of data sources including interviews (10 male and 5 female extreme sports participants, ages 30 to 72 years), auto-biographies, videos and other firsthand accounts. This process allowed this unexpected perspective to emerge more clearly.

Assigning metabolic equivalent (MET) values to the 2002 Census Occupational Classification System

Background: The Current Population Survey (CPS) and the American Time Use Survey (ATUS) use the 2002 census occupation system to classify workers into 509 separate occupations arranged into 22 major occupational categories. Methods: We describe the methods and rationale for assigning detailed MET estimates to occupations and present population estimates (comparing outputs generated by analysis of previously published summary MET estimates to the detailed MET estimates) of intensities of occupational activity using the 2003 ATUS data comprised of 20,720 respondents, 5,323 (2,917 males and 2,406 females) of whom reported working 6+ hours at their primary occupation on their assigned reporting day. Results: Analysis using the summary MET estimates resulted in 4% more workers in sedentary occupations, 6% more in light, 7% less in moderate, and 3% less in vigorous compared to using the detailed MET estimates. The detailed estimates are more sensitive to identifying individuals who do any occupational activity that is moderate or vigorous in intensity resulting in fewer workers in sedentary and light intensity occupations. Conclusions: Since CPS/ATUS regularly captures occupation data it will be possible to track prevalence of the different intensity levels of occupations. Updates will be required with inevitable adjustments to future occupational classification systems.

Identifying relationship between skid resistance, road characteristics and crashes using probability-based risk approach

Road accidents are of great concerns for road and transport departments around world, which cause tremendous loss and dangers for public. Reducing accident rates and crash severity are imperative goals that governments, road and transport authorities, and researchers are aimed to achieve. In Australia, road crash trauma costs the nation A$ 15 billion annually. Five people are killed, and 550 are injured every day. Each fatality costs the taxpayer A$1.7 million. Serious injury cases can cost the taxpayer many times the cost of a fatality. Crashes are in general uncontrolled events and are dependent on a number of interrelated factors such as driver behaviour, traffic conditions, travel speed, road geometry and condition, and vehicle characteristics (e.g. tyre type pressure and condition, and suspension type and condition). Skid resistance is considered one of the most important surface characteristics as it has a direct impact on traffic safety. Attempts have been made worldwide to study the relationship between skid resistance and road crashes. Most of these studies used the statistical regression and correlation methods in analysing the relationships between skid resistance and road crashes. The outcomes from these studies provided mix results and not conclusive. The objective of this paper is to present a probability-based method of an ongoing study in identifying the relationship between skid resistance and road crashes. Historical skid resistance and crash data of a road network located in the tropical east coast of Queensland were analysed using the probability-based method. Analysis methodology and results of the relationships between skid resistance, road characteristics and crashes are presented.

Waist circumference cut-off values for the prediction of cardiovascular risk factors clustering in Chinese school-aged children : a cross-sectional study

Background: Waist circumference has been identified as a valuable predictor of cardiovascular risk in children. The development of waist circumference percentiles and cut-offs for various ethnic groups are necessary because of differences in body composition. The purpose of this study was to develop waist circumference percentiles for Chinese children and to explore optimal waist circumference cut-off values for predicting cardiovascular risk factors clustering in this population.----- ----- Methods: Height, weight, and waist circumference were measured in 5529 children (2830 boys and 2699 girls) aged 6-12 years randomly selected from southern and northern China. Blood pressure, fasting triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and glucose were obtained in a subsample (n = 1845). Smoothed percentile curves were produced using the LMS method. Receiver-operating characteristic analysis was used to derive the optimal age- and gender-specific waist circumference thresholds for predicting the clustering of cardiovascular risk factors.----- ----- Results: Gender-specific waist circumference percentiles were constructed. The waist circumference thresholds were at the 90th and 84th percentiles for Chinese boys and girls respectively, with sensitivity and specificity ranging from 67% to 83%. The odds ratio of a clustering of cardiovascular risk factors among boys and girls with a higher value than cut-off points was 10.349 (95% confidence interval 4.466 to 23.979) and 8.084 (95% confidence interval 3.147 to 20.767) compared with their counterparts.----- ----- Conclusions: Percentile curves for waist circumference of Chinese children are provided. The cut-off point for waist circumference to predict cardiovascular risk factors clustering is at the 90th and 84th percentiles for Chinese boys and girls, respectively.

The impact of school connectedness on violent behavior, transport risk taking behavior and associated injuries in adolescence

Adolescents engage in many risk-taking behaviors that have the potential to lead to injury. The school environment has a significant role in shaping adolescent behavior, and this study aimed to provide additional information about the benefits associated with connectedness to school. Early adolescents aged 13 to 15 years (N = 509, 49% boys) were surveyed about school connectedness, engagement in transport and violence risk-taking, and injury experiences. Significant relations were found between school connectedness and reduced engagement in both transport and violence risk-taking, as well as fewer associated injuries. This study has implications for the area of risk-taking and injury prevention, as it suggests the potential for reducing adolescents' injury through school based interventions targeting school connectedness.

Image-based safety assessment : automated spatial safety risk identification of earthmoving and surface mining activities

This paper presents an automated image‐based safety assessment method for earthmoving and surface mining activities. The literature review revealed the possible causes of accidents on earthmoving operations, investigated the spatial risk factors of these types of accident, and identified spatial data needs for automated safety assessment based on current safety regulations. Image‐based data collection devices and algorithms for safety assessment were then evaluated. Analysis methods and rules for monitoring safety violations were also discussed. The experimental results showed that the safety assessment method collected spatial data using stereo vision cameras, applied object identification and tracking algorithms, and finally utilized identified and tracked object information for safety decision making.

History-aware, real-time risk detection in business processes (Extended Version)

This paper proposes a novel approach for identifying risks in executable business processes and detecting them at run time. The approach considers risks in all phases of the business process management lifecycle, and is realized via a distributed, sensor-based architecture. At design-time, sensors are defined to specify risk conditions which when fulfilled, are a likely indicator of faults to occur. Both historical and current execution data can be used to compose such conditions. At run-time, each sensor independently notifies a sensor manager when a risk is detected. In turn, the sensor manager interacts with the monitoring component of a process automation suite to prompt the results to the user who may take remedial actions. The proposed architecture has been implemented in the YAWL system and its performance has been evaluated in practice.

Maternal exposure to ambient temperature and the risk of preterm birth and stillbirth in Brisbane, Australia

Almost 10% of all births are preterm and 2.2% are stillbirths globally. Recent research has suggested that environmental factors may be a contributory cause to these adverse birth outcomes. The authors examined the relationship between ambient temperature and preterm birth and stillbirth in Brisbane, Australia between 2005 and 2009 (n = 101,870). They used a Cox proportional hazard model with live birth and stillbirth as competing risks. They also examined if there were periods of the pregnancy where exposure to high temperatures had a greater effect. Exposure to higher ambient temperatures during pregnancy increased the risk of stillbirth. The hazard ratio for stillbirth was 0.3 at 12 °C relative to the reference temperature at 21 °C. The temperature effect was greatest for fetuses of less than 36 weeks of gestation. There was an association between higher temperature and shorter gestation, as the hazard ratio for live birth was 0.96 at 15 °C and 1.02 at 25 °C. This effect was greatest at later gestational ages. The results provide strong evidence of an association between increased temperature and increased risk of stillbirth and shorter gestations.

Fleet safety : risk reduction for work related vehicle use

Research has demonstrated that driving a vehicle for work is potentially one of the most dangerous workplace activities. Although organisations are required to meet legislative obligations under workplace health and safety in relation to work related vehicle use, organisations are often reluctant to acknowledge and address the risks associated with the vehicle as a workplace. Recent research undertaken investigating the challenges associated with driver and organisational aspects of fleet safety are discussed. This paper provides a risk management framework to assist organisations to meet legislative requirements and reduce the risk associated with vehicle use in the workplace. In addition the paper argues that organisations need to develop and maintain a positive fleet safety culture to proactively mitigate risk in an effort to reduce the frequency and severity of vehicle related incidents within the workplace.