Planning volunteer responses to low-volume mass gatherings: do event characteristics predict patient workload?

INTRODUCTION: Workforce planning for first aid and medical coverage of mass gatherings is hampered by limited research. In particular, the characteristics and likely presentation patterns of low-volume mass gatherings of between several hundred to several thousand people are poorly described in the existing literature. OBJECTIVES: This study was conducted to: 1. Describe key patient and event characteristics of medical presentations at a series of mass gatherings, including events smaller than those previously described in the literature; 2. Determine whether event type and event size affect the mean number of patients presenting for treatment per event, and specifically, whether the 1:2,000 deployment rule used by St John Ambulance Australia is appropriate; and 3. Identify factors that are predictive of injury at mass gatherings. METHODS: A retrospective, observational, case-series design was used to examine all cases treated by two Divisions of St John Ambulance (Queensland) in the greater metropolitan Brisbane region over a three-year period (01 January 2002-31 December 2004). Data were obtained from routinely collected patient treatment forms completed by St John officers at the time of treatment. Event-related data (e.g., weather, event size) were obtained from event forms designed for this study. Outcome measures include: total and average number of patient presentations for each event; event type; and event size category. Descriptive analyses were conducted using chi-square tests, and mean presentations per event and event type were investigated using Kruskal-Wallis tests. Logistic regression analyses were used to identify variables independently associated with injury presentation (compared with non-injury presentations). RESULTS: Over the three-year study period, St John Ambulance officers treated 705 patients over 156 separate events. The mean number of patients who presented with any medical condition at small events (less than or equal to 2,000 attendees) did not differ significantly from that of large (>2,000 attendees) events (4.44 vs. 4.67, F = 0.72, df = 1, 154, p = 0.79). Logistic regression analyses indicated that presentation with an injury compared with non-injury was independently associated with male gender, winter season, and sporting events, even after adjusting for relevant variables. CONCLUSIONS: In this study of low-volume mass gatherings, a similar number of patients sought medical treatment at small (<2,000 patrons) and large (>2,000 patrons) events. This demonstrates that for low-volume mass gatherings, planning based solely on anticipated event size may be flawed, and could lead to inappropriate levels of first-aid coverage. This study also highlights the importance of considering other factors, such as event type and patient characteristics, when determining appropriate first-aid resourcing for low-volume events. Additionally, identification of factors predictive of injury presentations at mass gatherings has the potential to significantly enhance the ability of event coordinators to plan effective prevention strategies and response capability for these events.

High speed rail and regional competitiveness

The presence of High Speed Rail (HSR) systems influences market shares of road and air transport, and the development of cities and regions they serve. With the deployment of HSR infrastructure, changes in accessibility have occurred. These changes have lead researchers to investigate effects on the economic and spatial derived variables. Contention exists when managing the trade off between efficiency, and access points which are usually in the range of hundreds of kilometres apart. In short, it is argued that intermediate cities, bypassed by HSR services, suffer a decline in their accessibility and developmental opportunities. The present Chapter will analyse possible impacts derived from the presence of HSR infrastructure. In particular, it will consider small and medium agglomerations in the vicinity of HSR corridors, not always served by HSR stations. Thus, a methodology is developed to quantify accessibility benefits and their distribution. These benefits will be investigated in relation to different rail transit strategies integrating HSR infrastructure where a HSR station cannot be positioned. These strategies are selected principally for the type of service offered: (i) cadenced, (ii) express, (iii) frequent or (iv) non-stopping. Furthermore, to ground the theoretical approach linking accessibility and competitiveness, a case study in the North-Eastern Italian regions will be used for the application of the accessibility distributive patterns between the HSR infrastructure and the selected strategies. Results indicate that benefits derive from well informed decisions on HSR station positioning and the appropriate blend of complementary services in the whole region to interface HSR infrastructure. The results are significant for all countries in Europe and worldwide, not only for investing in HSR infrastructure, but mostly in terms of building territorial cohesion, while seeking international recognition for developing successful new technology and systems.

The effect of various temperature indicators on different mortality categories in a subtropical city of Brisbane, Australia.

BACKGROUND: The relationship between temperature and mortality has been explored for decades and many temperature indicators have been applied separately. However, few data are available to show how the effects of different temperature indicators on different mortality categories, particularly in a typical subtropical climate. OBJECTIVE: To assess the associations between various temperature indicators and different mortality categories in Brisbane, Australia during 1996-2004. METHODS: We applied two methods to assess the threshold and temperature indicator for each age and death groups: mean temperature and the threshold assessed from all cause mortality was used for all mortality categories; the specific temperature indicator and the threshold for each mortality category were identified separately according to the minimisation of AIC. We conducted polynomial distributed lag non-linear model to identify effect estimates in mortality with one degree of temperature increase (or decrease) above (or below) the threshold on current days and lagged effects using both methods. RESULTS: Akaike's Information Criterion was minimized when mean temperature was used for all non-external deaths and deaths from 75 to 84 years; when minimum temperature was used for deaths from 0 to 64 years, 65-74 years, ≥ 85 years, and from the respiratory diseases; when maximum temperature was used for deaths from cardiovascular diseases. The effect estimates using certain temperature indicators were similar as mean temperature both for current day and lag effects. CONCLUSION: Different age groups and death categories were sensitive to different temperature indicators. However, the effect estimates from certain temperature indicators did not significantly differ from those of mean temperature.

Planning of distribution networks for medium voltage and low voltage

Determination of the placement and rating of transformers and feeders are the main objective of the basic distribution network planning. The bus voltage and the feeder current are two constraints which should be maintained within their standard range. The distribution network planning is hardened when the planning area is located far from the sources of power generation and the infrastructure. This is mainly as a consequence of the voltage drop, line loss and system reliability. Long distance to supply loads causes a significant amount of voltage drop across the distribution lines. Capacitors and Voltage Regulators (VRs) can be installed to decrease the voltage drop. This long distance also increases the probability of occurrence of a failure. This high probability leads the network reliability to be low. Cross-Connections (CC) and Distributed Generators (DGs) are devices which can be employed for improving system reliability. Another main factor which should be considered in planning of distribution networks (in both rural and urban areas) is load growth. For supporting this factor, transformers and feeders are conventionally upgraded which applies a large cost. Installation of DGs and capacitors in a distribution network can alleviate this issue while the other benefits are gained. In this research, a comprehensive planning is presented for the distribution networks. Since the distribution network is composed of low and medium voltage networks, both are included in this procedure. However, the main focus of this research is on the medium voltage network planning. The main objective is to minimize the investment cost, the line loss, and the reliability indices for a study timeframe and to support load growth. The investment cost is related to the distribution network elements such as the transformers, feeders, capacitors, VRs, CCs, and DGs. The voltage drop and the feeder current as the constraints are maintained within their standard range. In addition to minimizing the reliability and line loss costs, the planned network should support a continual growth of loads, which is an essential concern in planning distribution networks. In this thesis, a novel segmentation-based strategy is proposed for including this factor. Using this strategy, the computation time is significantly reduced compared with the exhaustive search method as the accuracy is still acceptable. In addition to being applicable for considering the load growth, this strategy is appropriate for inclusion of practical load characteristic (dynamic), as demonstrated in this thesis. The allocation and sizing problem has a discrete nature with several local minima. This highlights the importance of selecting a proper optimization method. Modified discrete particle swarm optimization as a heuristic method is introduced in this research to solve this complex planning problem. Discrete nonlinear programming and genetic algorithm as an analytical and a heuristic method respectively are also applied to this problem to evaluate the proposed optimization method.

Sustainability and urban settlements: urban metabolism as a framework for achieving sustainable development

Urban settlements, with their role as economic and governance nerve centres, are rapidly expanding in size and in consumption of resources, and consequently have significant impacts on the environment. The transition to an ‘eco-city’ - an urban settlement that adopts the goals and principles in the urban metabolism model - needs to occur to meet the challenges posed by a multitude of pressures including population growth, climate change and resource depletion. Thus, the adoption and integration of ‘sustainable development’ into the management of urban growth is one of the most critical governance issues for urban settlements. A framework in which sustainable development can be achieved is through the lenses of the established theoretical concept of ‘urban metabolism’. The key facet of the proposed ‘Integrated Urban Metabolism Framework’ is the provision of a platform whereby different fields can appreciate, absorb and learn from other areas, to increase the understanding of where each and every one of the pieces fit together in order to create a larger, holistic approach to the currently stagnant problem of unsustainable development.

What determines real-world meal size? Evidence for pre-meal planning

The customary approach to the study of meal size suggests that ‘events’ occurring during a meal lead to its termination. Recent research, however, suggests that a number of decisions are made before eating commences that may affect meal size. The present study sought to address three key research questions around meal size: the extent to which plate cleaning occurs; prevalence of pre-meal planning and its influence on meal size; and the effect of within-meal experiences, notably the development of satiation. To address these, a large-cohort internet-based questionnaire was developed. Results showed that plate cleaning occurred at 91% of meals, and was planned from the outset in 92% of these cases. A significant relationship between plate cleaning and meal planning was observed. Pre meal plans were resistant to modification over the course of the meal: only 18% of participants reported consumption that deviated from expected. By contrast, 28% reported continuing eating beyond satiation, and 57% stated that they could have eaten more at the end of the meal. Logistic regression confirmed pre-meal planning as the most important predictor of consumption. Together, our findings demonstrate the importance of meal planning as a key determinant of meal size and energy intake.

Planning for SMEs’ Proactive Waste Management in Office Building Retrofit Projects

Office building retrofit projects face many challenges for on-site waste management. While the projects themselves have the potential for a significant level of reuse and recycling from decon-struction and demolition, their unique characteristics often prohibit direct application of existing waste management systems, which are typically based on managing waste generated through new material application in new build projects. Moreover, current waste management plans include no stimuli to involve Small and Medium Enterprises (SMEs) for on-site waste management. As SMEs carry out the majority of on-site work as subcontractors, their active involvements will result in more proactive approaches to waste management and enhance project delivery. This paper discusses the interim results of a continuing research aimed at engaging SMEs in the planning processes of waste management through the collaboration between subcontractors and main contractors of retrofitting projects. It introduces a conceptual model for SMEs to proactively plan and manage on-site waste generation for both deconstruction and construction stages, before traditional waste management plans by the main contractor come into place. The model also suggests a collaboration process between SMEs as subcontractors and large companies as the main contractor to improve the involvement and performance of SMEs in waste management of office building retrofit projects.

‘I could eat a horse’! : meal planning determines meal size

Evidence that our food environment can affect meal size is often taken to indicate a failure of ‘conscious control’. By contrast, our research suggests that ‘expected satiation’ (fullness that a food is expected to confer) predicts self-selected meal size. However, the role of meal planning as a determinant of actual meal size remains unresolved, as does the extent to which meal planning is commonplace outside the laboratory. Here, we quantified meal planning and its relation to meal size in a large-cohort study. Participants (N= 764; 25.6 yrs, 78% female) completed a questionnaire containing items relating to their last meal. The majority (91%) of meals were consumed in their entirety. Furthermore, in 92% of these cases the participants decided to consume the whole meal, even before it began. A second major objective was to explore the prospect that meal plans are revised based on within-meal experience (e.g., development of satiation). Only 8% of participants reported ‘unexpected’ satiation that caused them to consume less than anticipated. Moreover, at the end of the meal 57% indicated that they were not fully satiated, and 29% continued eating beyond comfortable satiation (often to avoid wasting food). This pattern was neither moderated by BMI nor dieting status, and was observed across meal types. Together, these data indicate that meals are often planned and that planning corresponds closely with amount consumed. By contrast, we find limited evidence for within-meal modification of these plans, suggesting that ‘pre-meal cognition’ is an important determinant of meal size in humans.

Re-thinking how we plan to address technically complex problems : drawing on planning theory to guide practice in revision of land use plans in coastal high hazard zones

Queensland's new State Planning Policy for Coastal Protection, released in March and approved in April 2011 as part of the Queensland Coastal Plan, stipulates that local governments prepare and implement adaptation strategies for built up areas projected to be subject to coastal hazards between present day and 2100. Urban localities within the delineated coastal high hazard zone (as determined by models incorporating a 0.8 meter rise in sea level and a 10% increase in the maximum cyclone activity) will be required to re-evaluate their plans to accommodate growth, revising land use plans to minimise impacts of anticipated erosion and flooding on developed areas and infrastructure. While implementation of such strategies would aid in avoidance or minimisation of risk exposure, communities are likely to face significant challenges in such implementation, especially as development in Queensland is so intensely focussed upon its coasts with these new policies directing development away from highly desirable waterfront land. This paper examines models of planning theory to understand how we plan when faced with technically complex problems towards formulation of a framework for evaluating and improving practice.

Residential satisfaction in inner urban higher-density Brisbane, Australia : role of dwelling, neighbours and neighbourhood

Increasing the population density of urban areas is a key policy strategy to sustainably manage growth, but many residents often view higher density living as an undesirable long-term housing option. Thus, this research explores the predictors of residential satisfaction in inner urban higher-density (IUHD) environments, surveying 636 IUHD residents in Brisbane, Australia about the importance of dwelling, neighbours and neighbourhood. Relationships with immediate neighbours did not predict residential satisfaction, but features of the neighbourhood and dwelling were critical, specifically satisfaction with dwelling position, design and facilities, and social contacts (family and friends) in the neighbourhood. Identifying the factors that influence residential satisfaction in IUHD will assist with both planning and design, helping ensure a lower resident turnover rate and greater uptake of high density living.

The role of universities in building prosperous knowledge cities : the Malaysian experience

This paper explores the role and importance of universities, particularly in the Malaysian context, for building prosperous knowledge cities of the rising knowledge economy. It aims to shed light on how universities contribute to the knowledge-based development of Malaysian cities by undertaking a case study investigation. In the case of Bandar Seri Iskandar, the paper scrutinises the creation – from scratch – of a knowledge city, including the establishment of new public and private universities and hence providing a unique opportunity to understand how the idea of the knowledge economy has permeated economic development policy within a developing country context. The research findings reveal that in Malaysia, much like many of the developed countries, universities are being positioned to play a major role in supporting knowledge city (trans)formation. While there has been a tangible success on the spatial development based on a rapid land use change towards accommodating knowledge-intensive land use and activities, the research reports that a more concerted and coordinated effort from academia, public and private sectors are needed to further foster the growth and development of economical, environmental, institutional and social aspects of Bandar Seri Iskandar to become a fully functioning prosperous knowledge city.

Knowledge-based urban development redefined : from theory to practice knowledge-based development of cities

The concept of knowledge-based urban development has first come to the urban planning and development agenda during the very last years of the 20th century as a promising paradigm to support the transformation process of cities into knowledge cities and their societies into knowledge societies. However, soon after the exponentially rapid advancements experienced, during the first decade of the 21st century, particularly, in the domains of economy, society, management and technology along with the severe impacts of climate change, have made the redefinition of the term a necessity. This paper, first, reports the findings of the review of the relatively short but dynamic history of urbanisation experiences of our cities around the globe. The paper, then, focuses on the 21st century urbanisation context and discusses the conceptual base of the knowledge-based development of cities and how this concept found application ground in many parts of the world. Following this, the paper speculates development of future cities by particularly highlighting potential challenges and opportunities that previously have not been fully considered. This paper, lastly, introduces and elaborates how relevant theories support the better conceptualisation of this relatively new, but rapidly emerging paradigm, and redefines it accordingly.

Choosing landmarks for risky planning

This work examines the effect of landmark placement on the efficiency and accuracy of risk-bounded searches over probabilistic costmaps for mobile robot path planning. In previous work, risk-bounded searches were shown to offer in excess of 70% efficiency increases over normal heuristic search methods. The technique relies on precomputing distance estimates to landmarks which are then used to produce probability distributions over exact heuristics for use in heuristic searches such as A* and D*. The location and number of these landmarks therefore influence greatly the efficiency of the search and the quality of the risk bounds. Here four new methods of selecting landmarks for risk based search are evaluated. Results are shown which demonstrate that landmark selection needs to take into account the centrality of the landmark, and that diminishing rewards are obtained from using large numbers of landmarks.

Path planning using surface shape and ground properties

This paper presents a path planning technique for ground vehicles that accounts for the dynamics of the vehicle, the topography of the terrain and the wheel/ground interaction properties such as friction. The first two properties can be estimated using well known sensors and techniques, but the third is not often estimated even though it has a significant effect on the motion of a high-speed vehicle. We introduce a technique which allows the estimation of wheel slip from which frictional parameters can be inferred. We present simulation results which show the importance of modelling topography and ground properties and experimental results which show how ground properties can be estimated along a 350m outdoor traverse.

Interactions between pedestrians and cyclists in the city centre

The city centre represents a complex environment for cycling with large volumes of pedestrians and motorised vehicles and frequent signalised intersections. Much of the previous literature has focused on cyclist-motor vehicle interactions because of the safety implications for cyclists, but there is increasing concern from pedestrians about the threats they perceive from cyclists. In the absence of objective data, this has the potential to lead to restrictions on cyclist access and behaviour. This presentation reports the development of a method to study the extent of cycling in the city centre and the frequency and nature of interactions between cyclists and pedestrians. Queensland is one of the few Australian jurisdictions that permits adults to cycle on the footpath and this was also of interest. 1992 cyclists were observed at six locations in the Brisbane city centre, during 7-9am, 9-11am, 2-4pm and 4-6pm on four weekdays in October 2010. The majority (85.5%) of cyclists were male, and 21.8% rode on the footpath. Females were more likely to travel on the footpath than males. One or more pedestrians were within 1m for 18.1% of observed cyclists, and one or more pedestrians were within 5m for 39.1% of observed cyclists. There were few conflicts, defined as an occasion where if no one took evasive action a collision would occur, between cyclists and pedestrians or vehicles (1.1% and 0.6% respectively) but they were more common for adolescents and riders not wearing (or not fastening) helmets.