Can SNOMED CT as implemented in New South Wales, Australia be used for road trauma injury surveillance in emergency departments?

The introduction of Systematized Nomenclature of Medicine - Clinical Terms (Snomed CT) for diagnosis coding in emergency departments (EDs) in New South Wales (NSW) has implications for injury surveillance abilities. This study aimed to assess the consequences of its introduction, as implemented as part of the ED information system in NSW, for identifying road trauma-related injuries in EDs. It involved a retrospective analysis of road trauma-related injuries identified in linked police, ED and mortality records during March 2007 to December 2009. Between 53.7% to 78.4% of all Snomed CT classifications in the principal provisional diagnosis field referred to the type of injury or symptom experienced by the individual. Of the road users identified by police, 3.2% of vehicle occupants, 6% of motorcyclists, 10.0% of pedal cyclists and 5.2% of pedestrians were identified using Snomed CT classifications in the principal provisional diagnosis field. The introduction of Snomed CT may provide flexible terminologies for clinicians. However, unless carefully implemented in information systems, its flexibility can lead to mismatches between the intention and actual use of defined data fields. Choices available in Snomed CT to indicate either symptoms, diagnoses, or injury mechanisms need to be controlled and these three concepts need to be retained in separate data fields to ensure a clear distinction between their classification in the ED.

Road crash risk after whiplash associated disorder

The future on-road safety of drivers affected by Whiplash Associated Disorder (WAD), the most common soft-tissue injury suffered in a traffic crash, has not been extensively explored. We obtained an anonymised file of 4280 insurance claimants with WAD and, as controls, 1116 claimants with comparably severe soft-tissue injuries who are considered to be at no increased risk than the general population. Their demographic information, road user type and traffic crash records both prior and subsequent to the traffic incident in which the injury occurred, the index crash, were obtained. Rates of subsequent crash involvement in these two groups were then compared, adjusting for age, sex, road user type and prior crash experience. The risk of a subsequent crash in the WAD group relative to controls was 1.14 (95% confidence interval, 0.87–1.48). To allow for differentially altered driving exposure after index crash we distributed a brief survey asking about changes in driving habits after a traffic crash involving injury via physiotherapy clinics and online through the electronic newsletter of a local motoring organisation. The survey yielded responses from 113 drivers who had experienced WAD in a traffic crash and 53 with other soft tissue injuries. There were no differences on average between the groups in their prior driving levels or their percentage change therein at one, three or six months after injury. There was thus no evidence that drivers with WAD are at any higher safety risk than drivers with other types of relatively minor post-crash soft tissue injury.

A Guide to Applying Road Safety within a Workplace : A Bilateral Approach to Organisational Road Safety in Australia and New Zealand

Corporate and organisational fleet and road safety is of strong interest to government and government agencies in Australia and New Zealand. It has been identified that there is great opportunity to engage and assist organisations and corporations in the delivery of road safety and road safety measures to achieve nationally significant road related trauma reductions. This guide has therefore been developed through public sector funding for use by any workplace within Australia and New Zealand. Significant road safety benefits can be achieved by road safety government agencies (Australia and New Zealand) that engage with private and public sectors at their workplaces to address work related road safety issues. It has also been noted that organisational road safety advancement creates effective and sustainable outcomes, safer places of employment, and safer communities. This can be achieved without totally relying upon traditional and often lengthy processes such as further public legislation and/ or community attitudinal and behavioural change programs. Currently, there is little in the way of robust guides or support for those organisations that are wishing to adopt road safety within their places of employment, supply chain and/ or community. Due to this identified gap in available resource and support, it has been recommended that a practical organisational road safety guide be produced; hence the development of this guide. A guide, or supporting documentation, that bridges the gap between government and road safety research knowledge, internationally endorsed road safety methodology, and assists industry as the end user. To achieve this, the guide is designed to be non-specific to any industry sector and usable for small or large organisations, public or private, and engaging for senior executives and the personnel on the ground responsible for its implementation. Therefore, this guide is based on methodology and principles so that it can be applicable in a scalable way to the greatest number of public and private organisations while providing enough detail and ‘how to’ advice to enable organisations to generate their own solutions to road safety issues.

A multiscale road map of cancer spheroids : incorporating experimental and mathematical modelling to understand cancer progression

Computational models represent a highly suitable framework, not only for testing biological hypotheses and generating new ones but also for optimising experimental strategies. As one surveys the literature devoted to cancer modelling, it is obvious that immense progress has been made in applying simulation techniques to the study of cancer biology, although the full impact has yet to be realised. For example, there are excellent models to describe cancer incidence rates or factors for early disease detection, but these predictions are unable to explain the functional and molecular changes that are associated with tumour progression. In addition, it is crucial that interactions between mechanical effects, and intracellular and intercellular signalling are incorporated in order to understand cancer growth, its interaction with the extracellular microenvironment and invasion of secondary sites. There is a compelling need to tailor new, physiologically relevant in silico models that are specialised for particular types of cancer, such as ovarian cancer owing to its unique route of metastasis, which are capable of investigating anti-cancer therapies, and generating both qualitative and quantitative predictions. This Commentary will focus on how computational simulation approaches can advance our understanding of ovarian cancer progression and treatment, in particular, with the help of multicellular cancer spheroids, and thus, can inform biological hypothesis and experimental design.

Mathematical relationships for metal build-up on urban road surfaces based on traffic and land use characteristics

The study investigated the influence of traffic and land use parameters on metal build-up on urban road surfaces. Mathematical relationships were developed to predict metals originating from fuel combustion and vehicle wear. The analysis undertaken found that nickel and chromium originate from exhaust emissions, lead, copper and zinc from vehicle wear, cadmium from both exhaust and wear and manganese from geogenic sources. Land use does not demonstrate a clear pattern in relation to the metal build-up process, though its inherent characteristics such as traffic activities exert influence. The equation derived for fuel related metal load has high cross-validated coefficient of determination (Q2) and low Standard Error of Cross-Validation (SECV) values indicates that the model is reliable, while the equation derived for wear-related metal load has low Q2 and high SECV values suggesting its use only in preliminary investigations. Relative Prediction Error values for both equations are considered to be well within the error limits for a complex system such as an urban road surface. These equations will be beneficial for developing reliable stormwater treatment strategies in urban areas which specifically focus on mitigation of metal pollution.

Variability of metal composition and concentrations in road dust in the urban environment

Urban road dust comprises of a range of potentially toxic metal elements and plays a critical role in degrading urban receiving water quality. Hence, assessing the metal composition and concentration in urban road dust is a high priority. This study investigated the variability of metal composition and concentrations in road dust in 4 different urban land uses in Gold Coast, Australia. Samples from 16 road sites were collected and tested for selected 12 metal species. The data set was analyzed using both univariate and multivariate techniques. Outcomes of the data analysis revealed that the metal concentrations in road dust differ considerably within and between different land uses. Iron, aluminum, magnesium and zinc are the most abundant in urban land uses. It was also noted that metal species such as titanium, nickel, copper and zinc have the highest concentrations in industrial land use. The study outcomes revealed that soil and traffic related sources as key sources of metals deposited on road surfaces.

Behavioural Inhibition System response to conflicting advertisement cues: Road safety messages vs. motor vehicle promotional advertisements

This study assessed the revised Behavioural Inhibition System (BIS), as conceptualised by Gray and McNaughton’s (2000) revised RST, by exposing participants to a loss-framed road safety message (emphasising the negative consequences of speeding behaviour) and a high performance motor vehicle promotional advertisement. Licensed young drivers (N = 40, aged 17–25 years) were randomly allocated to view either the message or both the message and advertisement. Participants then completed a computerised lexical decision task prior to completing three personality measures: Corr-Cooper RST-PQ, CARROT and Q-Task. It was predicted that those with a stronger BIS would demonstrate greater processing of these mixed message cues compared to weaker BIS individuals, and that this BIS effect would only be observed in the mixed cues condition (due to simultaneous activation of the incentive and punishment systems). Preliminary findings will be discussed in the context of the influence of personality traits on health message processing.

Towards robotic visual and acoustic stealth for outdoor dynamic target tracking

Covertly tracking mobile targets, either animal or human, in previously unmapped outdoor natural environments using off-road robotic platforms requires both visual and acoustic stealth. Whilst the use of robots for stealthy surveillance is not new, the majority only consider navigation for visual covertness. However, most fielded robotic systems have a non-negligible acoustic footprint arising from the onboard sensors, motors, computers and cooling systems, and also from the wheels interacting with the terrain during motion. This time-varying acoustic signature can jeopardise any visual covertness and needs to be addressed in any stealthy navigation strategy. In previous work, we addressed the initial concepts for acoustically masking a tracking robot’s movements as it travels between observation locations selected to minimise its detectability by a dynamic natural target and ensuring con- tinuous visual tracking of the target. This work extends the overall concept by examining the utility of real-time acoustic signature self-assessment and exploiting shadows as hiding locations for use in a combined visual and acoustic stealth framework.

Acoustic Masking of a Stealthy Outdoor Robot Tracking a Dynamic Target

This work is motivated by the desire to covertly track mobile targets, either animal or human, in previously unmapped outdoor natural environments using off-road robotic platforms with a non-negligible acoustic signature. The use of robots for stealthy surveillance is not new. Many studies exist but only consider the navigation problem to maintain visual covertness. However, robotic systems also have a significant acoustic footprint from the onboard sensors, motors, computers and cooling systems, and also from the wheels interacting with the terrain during motion. All these can jepordise any visual covertness. In this work, we experimentally explore the concepts of opportunistically utilizing naturally occurring sounds within outdoor environments to mask the motion of a robot, and being visually covert whilst maintaining constant observation of the target. Our experiments in a constrained outdoor built environment demonstrate the effectiveness of the concept by showing a reduced acoustic signature as perceived by a mobile target allowing the robot to covertly navigate to opportunistic vantage points for observation.

Navigating the future of roads – considering potential impacts of environmental and social trends on road infrastructure

Providing mobility corridors for communities, enabling freight networks to transport goods and services, and a pathway for emergency services and disaster relief operations, roads are a vital component of our societal system. In the coming decades, a number of modern issues will face road agencies as a result of climate change, resource scarcity and energy related challenges that will have implications for society. To date, these issues have been discussed on a case by case basis, leading to a fragmented approach by state and federal agencies in considering the future of roads – with potentially significant cost and risk implications. Within this context, this paper summarises part of a research project undertaken within the ‘Greening the Built Environment’ program of the Sustainable Built Environment National Research Centre (SBEnrc, Australia), which identified key factors or ‘trends’ affecting the future of roads and key strategies to ensure that road agencies can continue to deliver road infrastructure that meets societal needs in an environmentally appropriate manner. The research was conducted over two years, including a review of academic and state agency literature, four stakeholder workshops in Western Australia and Queensland, and industry consultation. The project was supported financially and through peer review and contribution, by Main Roads Western Australia, QLD Department of Transport and Main Roads, Parsons Brinckerhoff, John Holland Group, and the Australian Green Infrastructure Council (AGIC). The project highlighted several potential trends that are expected to affect road agencies in the future, including predicted resource and materials shortages, increases in energy and natural resources prices, increased costs related to greenhouse gas emissions, changing use and expectations of roads, and changes in the frequency and intensity of weather events. Exploring the implications of these potential futures, the study then developed a number of strategies in order to prepare transport agencies for the associated risks that such trends may present. An unintended outcome of the project was the development of a process for enquiring into future scenarios, which will be explored further in Stage 2 of the project (2013-2014). The study concluded that regardless of the type and scale of response by the agency, strategies must be holistic in approach, and remain dynamic and flexible.

Sustainability in post disaster road infrastructure recovery projects and asset management

Civil infrastructure and especially roads are being impacted with increasing frequency by flood, Tsunami, cyclone related natural and manmade disasters in the world. Responding to such events and in preparing for more regular and intense climate-change induced events in future, the road governing agencies are reviewing how postdisaster road infrastructure recovery projects are best planned and delivered. In particular, there is awareness that rebuilding such infrastructure require sustainable asset management strategies across economic, environmental and social dimensions. A comprehensive asset management framework for pre and post disaster situations can minimize negative impacts on our communities, economy and environment. This research paper is focused on post disaster management in road infrastructures and road infrastructure asset management strategies used by road authorities. Analyzing the implications of disruption to transport network and associated services is an important part of preparing local and regional responses to the impacts of disasters. This research paper will contribute to strategic infrastructure asset planning, management leading to safe, efficient and integrated transport system that supports sustainable economic, social and environmental outcomes. This paper also focuses on proper asset management, governance and engineering principles which should be followed and adopted in post disaster recovery projects to maximize sustainability in environmental, social and economic dimensions.

Residential balconies with road traffic noise : a combined source image and radiosity model

Several significant studies have been made in recent decades toward understanding road traffic noise and its effects on residential balconies. These previous studies have used a variety of techniques such as theoretical models, scale models and measurements on real balconies. The studies have considered either road traffic noise levels within the balcony space or inside an adjacent habitable room or both. Previous theoretical models have used, for example, simplified specular reflection calculations, boundary element methods (BEM), adaptations of CoRTN or the use of Sabine Theory. This paper presents an alternative theoretical model to predict the effects of road traffic noise spatially within the balcony space. The model includes a specular reflection component by calculating up to 10 orders of source images. To account for diffusion effects, a two compartment radiosity component is utilised. The first radiosity compartment is the urban street, represented as a street with building facades on either side. The second radiosity compartment is the balcony space. The model is designed to calculate the predicted road traffic noise levels within the balcony space and is capable of establishing the effect of changing street and balcony geometries. Screening attenuation algorithms are included to determine the effects of solid balcony parapets and balcony ceiling shields.

Environmental indicators for sustainable road development and operation

Road construction, maintenance and operation are activities that impact the environment by way of energy use, resource consumption and emission. Components such as construction material, transportation, street lighting, rolling resistance, traffic congestion during works, albedo and end-of-life processing impact the environment at different phases of the life of a road. With a view to promote sustainable development, a few sustainability rating schemes, e.g. Infrastructure Sustainability and Invest (Australia), Envision and Greenroads (USA), and CEEQUAL (UK) have been developed, that can assess road projects. These schemes address environmental areas such as: energy and emission, land, water, materials, discharges into surroundings, waste and ecology as factors for sustainable development. This paper assesses different rating schemes based on a defined comprehensive life cycle assessment (LCA) system boundary for road projects to identify different environmental indicators that address sustainable road development and operation. The findings indicate that new indicators are required to address different environmental components during the operation phase of roads.

Beyond BIM: It’s not the end of the road!

Over several decades, academics around the world have investigated the necessary tools, techniques, and conditions which would allow BIM (building information modeling) to become a positive force in the world of construction. As the research results matured, BIM started to become commercially available. Researchers and many in industry soon realized that BIM, as a technological innovation, was, in and of itself, not the end point in the journey. The technical adoption of BIM has to be supported by process and culture change within organizations to make a real impact on a project (for example, see AECbytes Viewpoint #35 by Chuck Eastman, Paul Teicholz, Rafael Sacks and Kathleen Liston). Current academic research aims to understand the steps beyond BIM, which will help chart the future of our industry over the coming decades. This article describes an international research effort in this area, coordinated by the Integrated Design and Delivery Solutions (IDDS) initiative of the CIB (International Council for Research and Innovation in Building and Construction). We hope that it responds to and extends the discussion initiated by Brian Lighthart in AECbytes Viewpoint #56, which asked about who is charting future BIM directions.

Life cycle analysis for sustainability assessment of road projects

Road infrastructure has been considered as one of the most expensive and extensive infrastructure assets of the built environment globally. This asset also impacts the natural environment significantly during different phases of life e.g. construction, use, maintenance and end-of-life. The growing emphasis for sustainable development to meet the needs of future generations requires mitigation of the environmental impacts of road infrastructure during all phases of life e.g. construction, operation and end-of-life disposal (as required). Life-cycle analysis (LCA), a method of quantification of all stages of life, has recently been studied to explore all the environmental components of road projects due to limitations of generic environmental assessments. The LCA ensures collection and assessment of the inputs and outputs relating to any potential environmental factor of any system throughout its life. However, absence of a defined system boundary covering all potential environmental components restricts the findings of the current LCA studies. A review of the relevant published LCA studies has identified that environmental components such as rolling resistance of pavement, effect of solar radiation on pavement(albedo), traffic congestion during construction, and roadway lighting & signals are not considered by most of the studies. These components have potentially higher weightings for environment damage than several commonly considered components such as materials, transportation and equipment. This paper presents the findings of literature review, and suggests a system boundary model for LCA study of road infrastructure projects covering potential environmental components.