Cardiac ARIA Index: Measuring Accessibility to Cardiovascular Services in Rural and Remote Australia via Applied Geographic Spatial Technology

Cardiovascular disease (CVD) continues to impose a heavy burden in terms of cost, disability and death in Australia. Evidence suggests that increasing remoteness, where cardiac services are scarce, is linked to an increased risk of dying from CVD. Fatal CVD events are reported to be between 20% and 50% higher in rural areas compared to major cities. The Cardiac ARIA project, with its extensive use of geographic Information Systems (GIS), ranks each of Australia’s 20,387 urban, rural and remote population centres by accessibility to essential services or resources for the management of a cardiac event. This unique, innovative and highly collaborative project delivers a powerful tool to highlight and combat the burden imposed by cardiovascular disease (CVD) in Australia. Cardiac ARIA is innovative. It is a model that could be applied internationally and to other acute and chronic conditions such as mental health, midwifery, cancer, respiratory, diabetes and burns services. Cardiac ARIA was designed to: 1. Determine by expert panel, what were the minimal services and resources required for the management of a cardiac event in any urban, rural or remote population locations in Australia using a single patient pathway to access care. 2. Derive a classification using GIS accessibility modelling for each of Australia’s 20,387 urban, rural and remote population locations. 3. Compare the Cardiac ARIA categories and population locations with census derived population characteristics. Key findings are as follows: • In the event of a cardiac emergency, the majority of Australians had very good access to cardiac services. Approximately 71% or 13.9 million people lived within one hour of a category one hospital. • 68% of older Australians lived within one hour of a category one hospital (Principal Referral Hospital with access to Cardiac Catheterisation). • Only 40% of indigenous people lived within one hour of the category one hospital. • 16% (74000) of indigenous people lived more than one hour from a hospital. • 3% (91,000) of people 65 years of age or older lived more than one hour from any hospital or clinic. • Approximately 96%, or 19 million, of people lived within one hour of the four key services to support cardiac rehabilitation and secondary prevention. • 75% of indigenous people lived within one hour of the four cardiac rehabilitation services to support cardiac rehabilitation and secondary prevention. Fourteen percent (64,000 persons) indigenous people had poor access to the four key services to support cardiac rehabilitation and secondary prevention. • 12% (56,000) of indigenous people were more than one hour from a hospital and only had access one the four key services (usually a medical service) to support cardiac rehabilitation and secondary prevention.

Perceptions of visibility and conspicuity of biomotion clothing configurations for road workers at road work sites

Aims: This study determined whether the visibility benefits of positioning retroreflective strips in biological motion configurations were evident at real world road worker sites. Methods: 20 visually normal drivers (M=40.3 years) participated in this study that was conducted at two road work sites (one suburban and one freeway) on two separate nights. At each site, four road workers walked in place wearing one of four different clothing options: a) standard road worker night vest, b) standard night vest plus retroreflective strips on thighs, c) standard night vest plus retroreflective strips on ankles and knees, d) standard night vest plus retroreflective strips on eight moveable joints (full biomotion). Participants seated in stationary vehicles at three different distances (80m, 160m, 240m) rated the relative conspicuity of the four road workers using a series of a standardized visibility and ranking scales. Results: Adding retroreflective strips in the full biomotion configuration to the standard night vest significantly (p<0.001) enhanced perceptions of road worker visibility compared to the standard vest alone, or in combination with thigh retroreflective markings. These visibility benefits were evident at all distances and at both sites. Retroreflective markings at the ankles and knees also provided visibility benefits compared to the standard vest, however, the full biomotion configuration was significantly better than all of the other configurations. Conclusions: These data provide the first evidence that the benefits of biomotion retroreflective markings that have been previously demonstrated under laboratory and closed- and open-road conditions are also evident at real work sites.

An object oriented road asset information model

Preservation and enhancement of transportation infrastructure is critical to continuous economic development in Australia. Of particular importance are the road assets infrastructure, due to their high costs of setting up and their social and economic impact on the national economy. Continuous availability of road assets, however, is contingent upon their effective design, condition monitoring, maintenance, and renovation and upgrading. However, in order to achieve this data exchange, integration, and interoperability is required across municipal boundaries. On the other hand, there are no agreed reference frameworks that consistently describe road infrastructure assets. As a consequence, specifications and technical solutions being chosen to manage road assets do not provide adequate detail and quality of information to support asset lifecycle management processes and decisions taken are based on perception not reality. This paper presents a road asset information model, which works as reference framework to, link other kinds of information with asset information; integrate different data suppliers; and provide a foundation for service driven integrated information framework for community infrastructure and asset management.

CARDIAC-ARIA: Measuring the Accessibility to Cardiovascular Services in Rural and Remote Australia Via Applied Geographical Spatial Technology (GIS)

Background/aims: Cardiovascular disease (CVD) continues to impose a heavy burden in terms of cost, disability and death in Australia. Recent evidence suggests that increasing remoteness, where cardiac services are scarce, is linked to an increased risk of dying from CVD. Fatal CVD events are reported to be between 20% and 50% higher in rural areas compared to major cities. Method: This project, with its extensive use of Geographic Information Systems (GIS) technology, will rank 11,338 rural and remote population centres to identify geographical ‘hotspots’ where there is likely to be a mismatch between the demand for and actual provision of cardiovascular services. It will, therefore, guide more equitable provision of services to rural and remote communities. Outcomes: The CARDIAC-ARIA project is designed to; map the type and location of cardiovascular services currently available in Australia, relative to the distribution of individuals who currently have symptomatic CVD; determine, by expert panel, what are the minimal requirements for comprehensive cardiovascular health support in metropolitan and rural communities and derive a rating classification based on the Accessibility and Remoteness Index of Australia (ARIA) for each of Australia's 11,338 rural and remote population centres. Conclusion: This unique, innovative and highly collaborative project has the potential to deliver a powerful tool to highlight and combat the burden imposed by cardiovascular disease (CVD) in Australia.

Evolution of traffic management measures on road traffic noise

Road traffic noise affects the quality of life in the areas adjoining the road. The effect of traffic noise on people is wide ranging and may include sleep disturbance and negative impact on work efficiency. To address the problem of traffic noise, it is necessary to estimate the noise level. For this, a number of noise estimation models have been developed which can estimate noise at the receptor points, based on simple configuration of buildings. However, for a real world situation we have multiple buildings forming built-up area. In such a situation, it is almost impossible to consider multiple diffractions and reflections in sound propagation from the source to the receptor point. An engineering solution to such a real world problem is needed to estimate noise levels in built-up area.

Project 2.7 Leveraging R&D Investment for the Australian built environment : Phase 2 Case Study Report Part 2 - Road Construction Safety

This report discusses findings of a case study into "Road Construction Safety" undertaken as a part of the retrospective analysis component of Sustainable Built Environment National Research Centre (SBEnrc) Project 2.7 Leveraging R&D investment for the Australian Built Environment. The Queensland Department of Transport and Main Roads (QTMR) has taken a leadership role in developing a safer working environment for road construction workers. In the past decades, a range of initiatives have been introduced to contribute to improved performance in this area. Several initiatives have been undertaken by QTMR as part of their overarching commitment to safety. Three such initiatives form the basis for this case study investigation, in order to better illustrate the nature of R&D investment and its impact on day-to-day operations and the supply chain. These are the development and implementation of: (i) the Mechanical Traffic Aid: (ii) the Thermal Imaging Camera; and (iii) the Trailer-based CCTV (camera). This case study should be read in conjunction with Part 1 of this suite of reports.

Vulnerable road user groups : a review of younger drivers, motorcyclists and older drivers

Scientific efforts to understand and reduce the occurrence of road crashes continue to expand, particularly in the areas of vulnerable road user groups. Three groups that are receiving increasing attention within the literature are younger drivers, motorcyclists and older drivers. These three groups are at an elevated risk of being in a crash or seriously injured, and research continues to focus on the origins of this risk as well as the development of appropriate countermeasures to improve driving outcomes for these cohorts. However, it currently remains unclear what factors produce the largest contribution to crash risk or what countermeasures are likely to produce the greatest long term positive effects on road safety. This paper reviews research that has focused on the personal and environmental factors that increase crash risk for these groups as well as considers direction for future research in the respective areas. A major theme to emerge from this review is that while there is a plethora of individual and situational factors that influence the likelihood of crashes, these factors often combine in an additive manner to exacerbate the risk of both injury and fatality. Additionally, there are a number of risk factors that are pertinent for all three road user groups, particularly age and the level of driving experience. As a result, targeted interventions that address these factors are likely to maximise the flow-on benefits to a wider range of road users. Finally, there is a need for further research that aims to bridge the research-to-practice gap, in order to develop appropriate pathways to ensure that evidenced-based research is directly transferred to effective policies that improve safety outcomes.

H. pylori-infection and antibody immune response in a rural Tanzanian population

Abstract Background: Helicobacter pylori (H. pylori) infection is ubiquitous in sub-Saharan Africa, but paradoxically gastric cancer is rare. Methods: Sera collected during a household-based survey in rural Tanzania in 1985 were tested for anti-H. pylori IgG and IgG subclass antibodies by enzyme immunoassay. Odds ratios (OR) and confidence intervals (CI) of association of seropositivity with demographic variables were computed by logistic regression models. Results: Of 788 participants, 513 were aged ≤17 years. H. pylori seropositivity increased from 76% at 0–4 years to 99% by ≥18 years of age. Seropositivity was associated with age (OR 11.5, 95% CI 4.2–31.4 for 10–17 vs. 0–4 years), higher birth-order (11.1; 3.6–34.1 for ≥3rd vs. 1st born), and having a seropositive next-older sibling (2.7; 0.9–8.3). Median values of IgG subclass were 7.2 for IgG1 and 2.0 for IgG2. The median IgG1/IgG2 ratio was 3.1 (IQR: 1.7–5.6), consistent with a Th2- dominant immune profile. Th2-dominant response was more frequent in children than adults (OR 2.4, 95% CI 1.3–4.4). Conclusion: H. pylori seropositivity was highly prevalent in Tanzania and the immunological response was Th2-dominant. Th2-dominant immune response, possibly caused by concurrent bacterial or parasitic infections, could explain, in part, the lower risk of H. pylori-associated gastric cancer in Africa.

Analysis of rural MUSA-MIMO-OFDM uplink channel capacity

Multi-user single antenna multiple-input multiple-output orthogonal frequency division multiplexing (MUSA-MIMO-OFDM) is a promising technology to improve the spectrum efficiency of fixed wireless broadband access systems in rural areas. This letter investigates the capacity of MUSA-MIMO-OFDM uplink channel by theoretical, simulation, and empirical approaches considering up to six users. We propose an empirical capacity formula suitable for rural areas. Characteristics of channel capacity temporal variations and their relationship with the wind speed, observed in a rural area, are also presented in this letter.

Role of solids in heavy metals build-up on urban road surfaces

Solids are widely identified as a carrier of harmful pollutants in stormwater runoff exerting a significant risk to receiving waters. This paper outlines the findings of an in-depth investigation on heavy metal adsorption to solids surfaces. Pollutant build-up samples collected from sixteen road sites in residential, industrial and commercial land uses were separated into four particle size ranges and analysed for a range of physico-chemical parameters and nine heavy metals including Iron (Fe), Aluminum (Al), Lead (Pb), Zinc (Zn), Cadmium (Cd), Chromium (Cr), Manganese (Mn), Nickel (Ni) and Copper (Cu). High specific surface area (SSA) and total organic carbon (TOC) content in finer particle size ranges was noted, thus confirming strong correlations with heavy metals. Based on their physico-chemical characteristics, two different types of solids originating from traffic and soil sources were identified. Solids generated by traffic were associated with high loads of heavy metals such as Cd and Cr with strong correlation with SSA. This suggested the existence of surface dependent bonds such as cation exchange between heavy metals and solids. In contrast, Fe, Al and Mn which can be attributed to soil inputs showed strong correlation with TOC suggesting strong bonds such as chemsorption. Zn was found to be primarily attached to solids by bonding with the oxides of Fe, Al and Mn. The data analysis also confirmed the predominance of the finer fraction, with 70% of the solids being finer than 150 µm and containing 60% of the heavy metal pollutant load.

Study on road traffic noise prediction model taking into account the citywide network

For the further noise reduction in the future, the traffic management which controls traffic flow and physical distribution is important. To conduct the measure by the traffic management effectively, it is necessary to apply the model for predicting the traffic flow in the citywide road network. For this purpose, the existing model named AVENUE was used as a macro-traffic flow prediction model. The traffic flow model was integrated with the road vehicles' sound power model, and the new road traffic noise prediction model was established. By using this prediction model, the noise map of entire city can be made. In this study, first, the change of traffic flow on the road network after the establishment of new roads was estimated, and the change of the road traffic noise caused by the new roads was predicted. As a result, it has been found that this prediction model has the ability to estimate the change of noise map by the traffic management. In addition, the macro-traffic flow model and our conventional micro-traffic flow model were combined, and the coverage of the noise prediction model was expanded.

Individual differences in drivers’ cognitive processing of road safety messages

Using Gray and McNaughton’s (2000) revised Reinforcement Sensitivity Theory (r-RST), we examined the influence of personality on processing of words presented in gain-framed and loss-framed anti-speeding messages and how the processing biases associated with personality influenced message acceptance. The r-RST predicts that the nervous system regulates personality and that behaviour is dependent upon the activation of the Behavioural Activation System (BAS), activated by reward cues and the Fight-Flight-Freeze System (FFFS), activated by punishment cues. According to r-RST, individuals differ in the sensitivities of their BAS and FFFS (i.e., weak to strong), which in turn leads to stable patterns of behaviour in the presence of rewards and punishments, respectively. It was hypothesised that individual differences in personality (i.e., strength of the BAS and the FFFS) would influence the degree of both message processing (as measured by reaction time to previously viewed message words) and message acceptance (measured three ways by perceived message effectiveness, behavioural intentions, and attitudes). Specifically, it was anticipated that, individuals with a stronger BAS would process the words presented in the gain-frame messages faster than those with a weaker BAS and individuals with a stronger FFFS would process the words presented in the loss-frame messages faster than those with a weaker FFFS. Further, it was expected that greater processing (faster reaction times) would be associated with greater acceptance for that message. Driver licence holding students (N = 108) were recruited to view one of four anti-speeding messages (i.e., social gain-frame, social loss-frame, physical gain-frame, and physical loss-frame). A computerised lexical decision task assessed participants’ subsequent reaction times to message words, as an indicator of the extent of processing of the previously viewed message. Self-report measures assessed personality and the three message acceptance measures. As predicted, the degree of initial processing of the content of the social gain-framed message mediated the relationship between the reward sensitive trait and message effectiveness. Initial processing of the physical loss-framed message partially mediated the relationship between the punishment sensitive trait and both message effectiveness and behavioural intention ratings. These results show that reward sensitivity and punishment sensitivity traits influence cognitive processing of gain-framed and loss-framed message content, respectively, and subsequently, message effectiveness and behavioural intention ratings. Specifically, a range of road safety messages (i.e., gain-frame and loss-frame messages) could be designed which align with the processing biases associated with personality and which would target those individuals who are sensitive to rewards and those who are sensitive to punishments.

Factors contributing to design-build (DB) project delivery system implementation in road infrastructure projects in Indonesia

Design-build (DB) project delivery systems have increasingly been adopted by many private and public sector organizations worldwide due to the many advantages offered on projects by such systems. However, many Indonesian road infrastructure projects are still delivered using the traditional design-bid-build (DBB) project delivery system. In order to provide evidence of the benefits of DB, it is essential to identify the factors that can contribute to successful DB implementation and this paper aims to provide evidence of such factors that can promote the successful implementation of DB project delivery systems on Indonesian road infrastructure projects. Four main factors and 28 indicators were identified from an extensive literature review, and a Delphi questionnaire survey was conducted amongst 20 experts drawn from the Indonesian road infrastructure construction sector. The first round Delphi study found that regulation, competency of clients, ability to manage DB projects and external conditions were the major factors that can promote successful DB implementation.

Adoption of innovative products on Australian road infrastructure projects

Product innovation is an important contributor to the performance of infrastructure projects in the construction industry. Maximizing the potential for innovative product adoption is a challenging task due to the complexities of the construction innovation system. A qualitative methodology involving interviews with major construction project stakeholders is employed to address the research question: ‘What are the main obstacles to the adoption of innovative products in the road industry?’ The characteristics of six key product innovation obstacles in Australian road projects are described. The six key obstacles are: project goal misalignment, client pressures, weak contractual relations, lack of product trialling, inflexible product specifications and product liability concerns. A snapshot of the dynamics underlying these obstacles is provided. There are few such assessments in the literature, despite the imperative to improve construction innovation rates globally in order to deliver road infrastructure projects of increasing size and complexity. Key obstacles are interpreted through an open innovation construct, providing direction for policy to enhance the uptake of innovation across the construction product supply network. Early evidence suggests the usefulness of an open innovation construct that integrates three conceptual lenses: network governance, absorptive capacity and knowledge intermediation, in order to interpret product adoption obstacles in the context of Australian road infrastructure projects. The paper also provides practical advice and direction for government and industry organizations that wish to promote the flow of innovative product knowledge across the construction supply network.

Prediction and measurement of multiuser MIMO-OFDM channel in rural Australia

Commonwealth Scientific and Industrial Research Organization (CSIRO) has recently conducted a technology demonstration of a novel fixed wireless broadband access system in rural Australia. The system is based on multi user multiple-input multiple-output orthogonal frequency division multiplexing (MU-MIMO-OFDM). It demonstrated an uplink of six simultaneous users with distances ranging from 10 m to 8.5 km from a central tower, achieving 20 bits s/Hz spectrum efficiency. This paper reports on the analysis of channel capacity and bit error probability simulation based on the measured MUMIMO-OFDM channels obtained during the demonstration, and their comparison with the results based on channels simulated by a novel geometric optics based channel model suitable for MU-MIMO OFDM in rural areas. Despite its simplicity, the model was found to predict channel capacity and bit error rate probability accurately for a typical MU-MIMO-OFDM deployment scenario.