Evaluation of the skills for preventing injury in youth program : impact on health risk behaviors, injury and school connectedness

Injury is the leading cause of death among young people, and involvement in health risk behaviors, such as alcohol use and transport-related risks, is related to increased risk for injury. Effective health promotion programs for adolescents focus on multiple levels, including relationships with peers and parents, student knowledge, behavior and attitudes, and school-level factors such as school connectedness. This study describes the pilot evaluation of a comprehensive, multi-level injury prevention program for 13-14 year old adolescents, targeting change in injury associated with transport and alcohol risks. The program, called Skills for Preventing Injury in Youth (SPIY), incorporates two primary elements: an 8-week, teacher delivered attitude and behavior change curriculum with peer protection and first aid messages; and professional development for program teachers focusing on strategies to increase students’ connectedness to school. Five Australian high schools were recruited for the pilot evaluation research, with three being assigned to receive intervention components and two assigned as curriculum-as-usual controls. In the intervention schools, 118 Year 8 students participated in surveys at baseline, with 105 completing surveys at follow up, six months following the intervention. In the control schools, 196 Year 8 students completed surveys at baseline and 207 at follow up. Survey measures included self-reported injury, risk taking behavior and school connectedness. Results showed that students in the control schools were significantly more likely to report riding bikes without helmets, riding with dangerous drivers, having driven cars on the road, and using alcohol six months after the program, while the intervention group showed no such increase in these behaviors. Additionally, students in the control schools were significantly more likely to report having had pedestrian-related injuries at follow up than they were at the baseline measurement, while intervention school students showed no change. There was also a trend observed in terms of a decrease in bicycle related injuries among intervention school students, compared with a slight increasing trend in bicycle injuries among control students. Overall, scores on the school connectedness scale decreased significantly from baseline to follow up for both intervention and control students, however measurement limitations may have impacted on results relating to students’ connectedness. Overall, the SPIY program has shown promising results in regards to prevention of students’ health risk behavior and injuries. Evidence suggests that the curriculum component was important; however there was limited evidence to suggest that teacher training in school connectedness strategies contributed to these promising results. While school connectedness may be an important factor to target in risk and injury prevention programs, programs may need to incorporate whole-of-school strategies or target a broader range of teachers than were selected for the current research.

Current research in risk-aware business process management : overview, comparison, and gap analysis

The management of risks in business processes has been a subject of active research in the past few years. Many benefits can potentially be obtained by integrating the two traditionally-separated fields of risk management and business process management, including the ability to minimize risks in business processes (by design) and to mitigate risks at run time. In the past few years, an increasing amount of research aimed at delivering such an integrated system has been proposed. However, these research efforts vary in terms of their scope, goals, and functionality. Through systematic collection and evaluation of relevant literature, this paper compares and classifies current approaches in the area of risk-aware business process management in order to identify and explain relevant research gaps. The process through which relevant literature is collected, filtered, and evaluated is also detailed.

Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality

Background & aims: The confounding effect of disease on the outcomes of malnutrition using diagnosis-related groups (DRG) has never been studied in a multidisciplinary setting. This study aims to determine the prevalence of malnutrition in a tertiary hospital in Singapore and its impact on hospitalization outcomes and costs, controlling for DRG. Methods: This prospective cohort study included a matched case control study. Subjective Global Assessment was used to assess the nutritional status on admission of 818 adults. Hospitalization outcomes over 3 years were adjusted for gender, age, ethnicity, and matched for DRG. Results: Malnourished patients (29%) had longer hospital stays (6.9 ± 7.3 days vs. 4.6 ± 5.6 days, p < 0.001) and were more likely to be readmitted within 15 days (adjusted relative risk = 1.9, 95%CI 1.1–3.2, p = 0.025). Within a DRG, the mean difference between actual cost of hospitalization and the average cost for malnourished patients was greater than well-nourished patients (p = 0.014). Mortality was higher in malnourished patients at 1 year (34% vs. 4.1 %), 2 years (42.6% vs. 6.7%) and 3 years (48.5% vs. 9.9%); p < 0.001 for all. Overall, malnutrition was a significant predictor of mortality (adjusted hazard ratio = 4.4, 95% CI 3.3-6.0, p < 0.001). Conclusions: Malnutrition was evident in up to one third of the inpatients and led to poor hospitalization outcomes and survival as well as increased costs of care, even after matching for DRG. Strategies to prevent and treat malnutrition in the hospital and post-discharge are needed.

Modeling perceived collision risk in port water navigation

An increase in the likelihood of navigational collisions in port waters has put focus on the collision avoidance process in port traffic safety. The most widely used on-board collision avoidance system is the automatic radar plotting aid which is a passive warning system that triggers an alert based on the pilot’s pre-defined indicators of distance and time proximities at the closest point of approaches in encounters with nearby vessels. To better help pilot in decision making in close quarter situations, collision risk should be considered as a continuous monotonic function of the proximities and risk perception should be considered probabilistically. This paper derives an ordered probit regression model to study perceived collision risks. To illustrate the procedure, the risks perceived by Singapore port pilots were obtained to calibrate the regression model. The results demonstrate that a framework based on the probabilistic risk assessment model can be used to give a better understanding of collision risk and to define a more appropriate level of evasive actions.

Modelling port water collision risk using traffic conflicts

Navigational collisions are one of the major safety concerns for many seaports. Despite the extent of work recently done on collision risk analysis in port waters, little is known about the influencing factors of the risk. This paper develops a technique for modeling collision risks in port waterways in order to examine the associations between the risks and the geometric, traffic, and regulatory control characteristics of waterways. A binomial logistic model, which accounts for the correlations in the risks of a particular fairway at different time periods, is derived from traffic conflicts and calibrated for the Singapore port fairways. Estimation results show that the fairways attached to shoreline, traffic intersection and international fairway attribute higher risks, whereas those attached to confined water and local fairway possess lower risks. Higher risks are also found in the fairways featuring higher degree of bend, lower depth of water, higher numbers of cardinal and isolated danger marks, higher density of moving ships and lower operating speed. The risks are also found to be higher for night-time conditions.

Adolescent involvement in anti-social and delinquent behaviours : predicting future injury risk

The purpose of this study was to challenge the broadly based focus of injury prevention strategies towards concern with the needs of young adolescents who engage in multiple anti-social and delinquent behaviours. Five hundred and forty 13-14 year olds reported on injuries and truancy, violence, illegal road behaviours, drug, and alcohol use. Engagement in these behaviours was found to contribute to the likelihood of an injury. Those engaging in the most anti-social and delinquent behaviours were around five times more likely to report medically-treated injuries in the past three months. Their likelihood of future injury was 1.8 times more likely when they were followed up three months later. The engagement in multiple delinquent and illegal behaviours thus significantly increased the likelihood of injury and identifies a particularly vulnerable group. The findings also suggest that reaching these young people represents a key target for change strategies in injury prevention programs.

Students as advisors in an intervention program for at-risk students : The QUT experience

A managed team of discipline-experienced and trained later year students are used as Student Success Advisors (SSAs) in the Student Success Program, an intervention program that manages student engagement by identifying and supporting first year students at-risk of disengaging from learning. This report focuses on the recruitment and training of SSAs and the day-to-day challenges they and their managers face. The Nuts & Bolts session provides participants with opportunities to discuss the applicability to their institutional contexts of the recruitment and training processes and the “solutions” to the challenges used at QUT.

A risk simulation framework for information infrastructure protection

Information communication and technology (ICT) systems are almost ubiquitous in the modern world. It is hard to identify any industry, or for that matter any part of society, that is not in some way dependent on these systems and their continued secure operation. Therefore the security of information infrastructures, both on an organisational and societal level, is of critical importance. Information security risk assessment is an essential part of ensuring that these systems are appropriately protected and positioned to deal with a rapidly changing threat environment. The complexity of these systems and their inter-dependencies however, introduces a similar complexity to the information security risk assessment task. This complexity suggests that information security risk assessment cannot, optimally, be undertaken manually. Information security risk assessment for individual components of the information infrastructure can be aided by the use of a software tool, a type of simulation, which concentrates on modelling failure rather than normal operational simulation. Avoiding the modelling of the operational system will once again reduce the level of complexity of the assessment task. The use of such a tool provides the opportunity to reuse information in many different ways by developing a repository of relevant information to aid in both risk assessment and management and governance and compliance activities. Widespread use of such a tool allows the opportunity for the risk models developed for individual information infrastructure components to be connected in order to develop a model of information security exposures across the entire information infrastructure. In this thesis conceptual and practical aspects of risk and its underlying epistemology are analysed to produce a model suitable for application to information security risk assessment. Based on this work prototype software has been developed to explore these concepts for information security risk assessment. Initial work has been carried out to investigate the use of this software for information security compliance and governance activities. Finally, an initial concept for extending the use of this approach across an information infrastructure is presented.

Decision support for the safe design and operation of unmanned aircraft systems

Unmanned Aircraft Systems (UAS) describe a diverse range of aircraft that are operated without a human pilot on-board. Unmanned aircraft range from small rotorcraft, which can fit in the palm of your hand, through to fixed wing aircraft comparable in size to that of a commercial passenger jet. The absence of a pilot on-board allows these aircraft to be developed with unique performance capabilities facilitating a wide range of applications in surveillance, environmental management, agriculture, defence, and search and rescue. However, regulations relating to the safe design and operation of UAS first need to be developed before the many potential benefits from these applications can be realised. According to the International Civil Aviation Organization (ICAO), a Risk Management Process (RMP) should support all civil aviation policy and rulemaking activities (ICAO 2009). The RMP is described in International standard, ISO 31000:2009 (ISO, 2009a). This standard is intentionally generic and high-level, providing limited guidance on how it can be effectively applied to complex socio-technical decision problems such as the development of regulations for UAS. Through the application of principles and tools drawn from systems philosophy and systems engineering, this thesis explores how the RMP can be effectively applied to support the development of safety regulations for UAS. A sound systems-theoretic foundation for the RMP is presented in this thesis. Using the case-study scenario of a UAS operation over an inhabited area and through the novel application of principles drawn from general systems modelling philosophy, a consolidated framework of the definitions of the concepts of: safe, risk and hazard is made. The framework is novel in that it facilitates the representation of broader subjective factors in an assessment of the safety of a system; describes the issues associated with the specification of a system-boundary; makes explicit the hierarchical nature of the relationship between the concepts and the subsequent constraints that exist between them; and can be evaluated using a range of analytic or deliberative modelling techniques. Following the general sequence of the RMP, the thesis explores the issues associated with the quantified specification of safety criteria for UAS. A novel risk analysis tool is presented. In contrast to existing risk tools, the analysis tool presented in this thesis quantifiably characterises both the societal and individual risk of UAS operations as a function of the flight path of the aircraft. A novel structuring of the risk evaluation and risk treatment decision processes is then proposed. The structuring is achieved through the application of the Decision Support Problem Technique; a modelling approach that has been previously used to effectively model complex engineering design processes and to support decision-making in relation to airspace design. The final contribution made by this thesis is in the development of an airworthiness regulatory framework for civil UAS. A novel "airworthiness certification matrix" is proposed as a basis for the definition of UAS "Part 21" regulations. The outcome airworthiness certification matrix provides a flexible, systematic and justifiable method for promulgating airworthiness regulations for UAS. In addition, an approach for deriving "Part 1309" regulations for UAS is presented. In contrast to existing approaches, the approach presented in this thesis facilitates a traceable and objective tailoring of system-level reliability requirements across the diverse range of UAS operations. The significance of the research contained in this thesis is clearly demonstrated by its practical real world outcomes. Industry regulatory development groups and the Civil Aviation Safety Authority have endorsed the proposed airworthiness certification matrix. The risk models have also been used to support research undertaken by the Australian Department of Defence. Ultimately, it is hoped that the outcomes from this research will play a significant part in the shaping of regulations for civil UAS, here in Australia and around the world.

Theoretical perspectives on motorcycle training: reducing risk taking

Little past empirical support has been found for the efficacy of motorcycle rider training as a road safety countermeasure. However, it has been argued that rider training should focus more particularly on the psychosocial factors that influence risk taking behaviour in addition to the traditional practice of developing vehicle-handling skills. This paper examines how rider training to reduce risk taking could be guided by appropriate theories. Two fundamental perspectives are examined: firstly training can be considered in terms of behaviour change, and secondly in terms of adult learning. Whilst behaviour change theories assume some pre-existing level of dysfunctional behaviour, an adult learning perspective does not necessarily carry this assumption. This distinction in perspectives conceptually aligns with the notions of intervention and prevention (respectively), with possible implications for specific target groups for pre-licence and post-licence training. The application of the Theory of Reasoned Action (Ajzen & Fishbein, 1975, 1980) and Transformative Learning Theory (Mezirow, 1997) to a pre-licence rider training program in Queensland, Australia is discussed.

Measuring the effect of motorcycle rider training on psychosocial influences for risk taking

Aim: Whilst motorcycle rider training is commonly incorporated into licensing programs in many developed nations, little empirical support has been found in previous research to prescribe it as an effective road safety countermeasure. It has been posited that the lack of effect of motorcycle rider training on crash reduction may, in part, be due to the predominant focus on skills-based training with little attention devoted to addressing attitudes and motives that influence subsequent risky riding. However, little past research has actually endeavoured to measure attitudinal and motivational factors as a function of rider training. Accordingly, this study was undertaken to assess the effect of a commercial motorcycle rider training program on psychosocial factors that have been shown to influence risk taking by motorcyclists. Method: Four hundred and thirty-eight motorcycle riders attending a competency-based licence training course in Brisbane, Australia, voluntarily participated in the study. A self-report questionnaire adapted from the Rider Risk Assessment Measure (RRAM) was administered to participants at the commencement of training, then again at the conclusion of training. Participants were informed of the independent nature of the research and that their responses would in no way effect their chance of obtaining a licence. To minimise potential demand characteristics, participants were instructed to seal completed questionnaires in envelopes and place them in a sealed box accessible only by the research team (i.e. not able to be viewed by instructors). Results: Significant reductions in the propensity for thrill seeking and intentions to engage in risky riding in the next 12 months were found at the end of training. In addition, a significant increase in attitudes to safety was found. Conclusions: These findings indicate that rider training may have a positive short-term influence on riders’ propensity for risk taking. However, such findings must be interpreted with caution in regard to the subsequent safety of riders as these factors may be subject to further influence once riders are licensed and actively engage with peers during on-road riding. This highlights a challenge for road safety education / training programs in regard to the adoption of safety practices and the need for behavioural follow-up over time to ascertain long-term effects. This study was the initial phase of an ongoing program of research into rider training and risk taking framed around Theory of Planned Behaviour concepts. A subsequent 12 month follow-up of the study participants has been undertaken with data analysis pending.

Effects of impulsive sensation seeking, aggression and risk-taking behavior on the vulnerability of motorcyclists

While extensive research efforts have been devoted to improve the motorcycle safety, the relationship between the rider behavior and the crash risk is still not well understood.The objective of this study is to evaluate how behavioral factors influence crash risk and to identify the most vulnerable group of motorcyclists. To explore the rider behavior, a questionnaire containing 61-items of impulsive sensation seeking, aggression, and risk-taking behavior was developed. By clustering the crash risk using the medoid portioning algorithm, the log-linear model relating the rider behavior to crash risk has been developed. Results show that crash-involved motorcyclists score higher in all three behavioral traits. Aggressive and high risk-taking motorcyclists are more likely to fall under the high vulnerable group while impulsive sensation seeking is not found to be significant. Defining personality types from aggression and risk-taking behavior, “Extrovert” and “Follower” personality type of motorcyclists are more prone to crashes. The findings of this study will be useful for road safety campaign planners to be more focused in the target group as well as those who employ motorcyclists for their delivery business