The impact of heatwaves on emergency department visits in Brisbane, Australia : a time series study

Introduction The acute health effects of heatwaves in a subtropical climate and their impact on emergency departments (ED) are not well known. The purpose of this study is to examine overt heat-related presentations to EDs associated with heatwaves in Brisbane. Methods Data were obtained for the summer seasons (December to February) from 2000-2012. Heatwave events were defined as two or more successive days with daily maximum temperature >=34[degree sign]C (HWD1) or >=37[degree sign]C (HWD2). Poisson generalised additive model was used to assess the effect of heatwaves on heat-related visits (International Classification of Diseases (ICD) 10 codes T67 and X30; ICD 9 codes 992 and E900.0). Results Overall, 628 cases presented for heat-related illnesses. The presentations significantly increased on heatwave days based on HWD1 (relative risk (RR) = 4.9, 95% confidence interval (CI): 3.8, 6.3) and HWD2 (RR = 18.5, 95% CI: 12.0, 28.4). The RRs in different age groups ranged between 3-9.2 (HWD1) and 7.5-37.5 (HWD2). High acuity visits significantly increased based on HWD1 (RR = 4.7, 95% CI: 2.3, 9.6) and HWD2 (RR = 81.7, 95% CI: 21.5, 310.0). Average length of stay in ED significantly increased by >1 hour (HWD1) and >2 hours (HWD2). Conclusions Heatwaves significantly increase ED visits and workload even in a subtropical climate. The degree of impact is directly related to the extent of temperature increases and varies by socio-demographic characteristics of the patients. Heatwave action plans should be tailored according to the population needs and level of vulnerability. EDs should have plans to increase their surge capacity during heatwaves.

The mining boom and Western Australia's changing landscape : towards sustainability or business as usual?

The practices and public reputation of mining have been changing over time. In the past, mining operations frequently stood accused of being socially and environmentally disruptive, whereas mining today invests heavily in ‘socially responsible’ and ‘sustainable’ business practices. Changes such as these can be witnessed internationally as well as in places like Western Australia (WA), where the mining sector has matured into an economic pillar of the state, and indeed the nation in the context of the recent resources boom. This paper explores the role of mining in WA, presenting a multi-disciplinary perspective on the sector's contribution to sustainable development in the state. The perspectives offered here are drawn from community-based research and the associated academic literature as well as data derived from government sources and the not-for-profit sector. Findings suggest that despite noteworthy attitudinal and operational improvements in the industry, social, economic and environmental problem areas remain. As mining in WA is expected to grow in the years to come, these problem areas require the attention of business and government alike to ensure the long-term sustainability of development as well as people and place.

Viewpoint : social and economic dimensions of involving savanna communities in carbon management systems

In this paper we discuss the social, economic and institutional aspects of the development of carbon management systems within Australia's tropical savannas. Land-use values in savanna landscapes are changing as a result of changing economic markets, greater recognition of native title, and growing social demands and expectations for tourism, recreation and conservation. In addition, there is increasing interest in developing markets and policy arrangements for greenhouse gas abatement, carbon sequestration and carbon trade in savannas. We argue that for carbon management to lead to national greenhouse outcomes, attention must be paid to social, economic and institutional issues in environmental planning and policy arrangements. From an economic perspective, the financial impact of carbon management on savanna enterprises will depend on appropriate and available policy mechanisms, unit price for carbon, landscape condition, existing management strategies and abatement measurements used. Local social and cultural features of communities and regions may enhance or constrain the implementation of carbon abatement strategies, depending on how they are perceived. In terms of institutional arrangements, policies and plans must support and enable carbon management. We identify three areas that require priority investigation and adjustment: regional planning arrangements, property rights, and rules for accounting at enterprise and regional scales. We conclude that the best potential for managing for carbon will be achieved while managing for range of other natural resource management outcomes, especially where managing for carbon delivers collateral benefits to enterprises.

Feral pig populations are structured at fine spatial scales in tropical Queensland, Australia

Feral pigs occur throughout tropical far north Queensland, Australia and are a significant threat to biodiversity and World Heritage values, agriculture and are a vector of infectious diseases. One of the constraints on long-lasting, local eradication of feral pigs is the process of reinvasion into recently controlled areas. This study examined the population genetic structure of feral pigs in far north Queensland to identify the extent of movement and the scale at which demographically independent management units exist. Genetic analysis of 328 feral pigs from the Innisfail to Tully region of tropical Queensland was undertaken. Seven microsatellite loci were screened and Bayesian clustering methods used to infer population clusters. Sequence variation at the mitochondrial DNA control region was examined to identify pig breed. Significant population structure was identified in the study area at a scale of 25 to 35 km, corresponding to three demographically independent management units (MUs). Distinct natural or anthropogenic barriers were not found, but environmental features such as topography and land use appear to influence patterns of gene flow. Despite the strong, overall pattern of structure, some feral pigs clearly exhibited ancestry from a MU outside of that from which they were sampled indicating isolated long distance dispersal or translocation events. Furthermore, our results suggest that gene flow is restricted among pigs of domestic Asian and European origin and non-random mating influences management unit boundaries. We conclude that the three MUs identified in this study should be considered as operational units for feral pig control in far north Queensland. Within a MU, coordinated and simultaneous control is required across farms, rainforest areas and National Park Estates to prevent recolonisation from adjacent localities.

Estimating present day extreme water level exceedance probabilities around the coastline of Australia : tides, extra-tropical storm surges and mean sea level

The occurrence of extreme water levels along low-lying, highly populated and/or developed coastlines can lead to considerable loss of life and billions of dollars of damage to coastal infrastructure. Therefore it is vitally important that the exceedance probabilities of extreme water levels are accurately evaluated to inform risk-based flood management, engineering and future land-use planning. This ensures the risk of catastrophic structural failures due to under-design or expensive wastes due to over-design are minimised. This paper estimates for the first time present day extreme water level exceedence probabilities around the whole coastline of Australia. A high-resolution depth averaged hydrodynamic model has been configured for the Australian continental shelf region and has been forced with tidal levels from a global tidal model and meteorological fields from a global reanalysis to generate a 61-year hindcast of water levels. Output from this model has been successfully validated against measurements from 30 tide gauge sites. At each numeric coastal grid point, extreme value distributions have been fitted to the derived time series of annual maxima and the several largest water levels each year to estimate exceedence probabilities. This provides a reliable estimate of water level probabilities around southern Australia; a region mainly impacted by extra-tropical cyclones. However, as the meteorological forcing used only weakly includes the effects of tropical cyclones, extreme water level probabilities are underestimated around the western, northern and north-eastern Australian coastline. In a companion paper we build on the work presented here and more accurately include tropical cyclone-induced surges in the estimation of extreme water level. The multi-decadal hindcast generated here has been used primarily to estimate extreme water level exceedance probabilities but could be used more widely in the future for a variety of other research and practical applications.

Estimating present day extreme water level exceedance probabilities around the coastline of Australia : tropical cyclone-induced storm surges

The incidence of major storm surges in the last decade have dramatically emphasized the immense destructive capabilities of extreme water level events, particularly when driven by severe tropical cyclones. Given this risk, it is vitally important that the exceedance probabilities of extreme water levels are accurately evaluated to inform risk-based flood and erosion management, engineering and for future land-use planning and to ensure the risk of catastrophic structural failures due to under-design or expensive wastes due to over-design are minimised. Australia has a long history of coastal flooding from tropical cyclones. Using a novel integration of two modeling techniques, this paper provides the first estimates of present day extreme water level exceedance probabilities around the whole coastline of Australia, and the first estimates that combine the influence of astronomical tides, storm surges generated by both extra-tropical and tropical cyclones, and seasonal and inter-annual variations in mean sea level. Initially, an analysis of tide gauge records has been used to assess the characteristics of tropical cyclone-induced surges around Australia. However, given the dearth (temporal and spatial) of information around much of the coastline, and therefore the inability of these gauge records to adequately describe the regional climatology, an observationally based stochastic tropical cyclone model has been developed to synthetically extend the tropical cyclone record to 10,000 years. Wind and pressure fields derived for these synthetically generated events have then been used to drive a hydrodynamic model of the Australian continental shelf region with annual maximum water levels extracted to estimate exceedance probabilities around the coastline. To validate this methodology, selected historic storm surge events have been simulated and resultant storm surges compared with gauge records. Tropical cyclone induced exceedance probabilities have been combined with estimates derived from a 61-year water level hindcast described in a companion paper to give a single estimate of present day extreme water level probabilities around the whole coastline of Australia. Results of this work are freely available to coastal engineers, managers and researchers via a web-based tool (www.sealevelrise.info). The described methodology could be applied to other regions of the world, like the US east coast, that are subject to both extra-tropical and tropical cyclones.

Innovations in dietetic training in foodservice management : can early exposure to practice enhance final year competency development?

Student engagement in the delivery of theoretical course materials is a current challenge in the tertiary sector including for dietetic training. In 2011 with the creation of a new nutritionist position for Queensland Meals on Wheels (QMOW), a service learning approach to support this organisation was used with third year dietetic students undertaking two days of structured activities at various QMOW sites in South East Queensland, aligned with coursework in Foodservice Management (FSM). This cohort of students was then followed in their final year post successful completion of five weeks professional practice in FSM to see if this experience supported readiness for placement and competency development. Evaluation was undertaken of eligible students (n = 50) via paper based survey (response rate 94%) with all participating in targeted focus groups. Findings showed that students acknowledged the QMOW experience (on reflection 14 months later) providing opportunity for participation and/or observation in 5 of 12 FSM areas taught in third year, including food safety, meal production, assembly, delivery and dishwashing. Over half the students identified good exposure to FSM competency areas during the QMOW experience, with 83% satisfied with their competency exposure and subsequent practice during final year placements. A consistent theme emerged from focus groups supporting inclusion of practical opportunities with the theoretical component of the FSM subject to highlight relevance to learning. These findings highlight the importance of such teaching initiatives to met student learning preferences, linking theory with practice and supporting competency development in the final year of training programs.

Creating regional resilience in Australia

This paper explores the impact that extreme weather events can have on communities. Using the Brisbane floods of 2011 to examine the recovery operations, the paper highlights the effectiveness of recovery and rebuilding in already strong and resilient communities. Our research has shown that communities which have a strong sense of identity, as well as organized places to meet, develop resilient networks that come into play in times of crisis. The increasing trend of the fly-in/fly-out (FIFO) or drive-in/drive-out (DIDO) workforce to service regional areas has undermined the resilience of existing communities. The first hint of this occurs with community groups not knowing who their neighbours are. The paper is based on research examining the needs of groups in regional communities with the goal to better equip regional communities with the capacity to respond positively to change (and crisis) through in-novative, evidence-based policies, resilience strategies and tools. Part of this process was to build an evidence-base to address a range of challenges associated with the place-based environments and the sharing of information systems within communities and decision makers. The first part of the paper explores the context in which communities have been required to mobilize in response to crises; the issues that have galvanized a common purpose; and the methods by which these communities shared their knowledge. The second part of the paper examines how communities could plan for and mitigate natural disasters in the future by developing better decision making tools. The paper defines the requirements for information systems that will link data models of built infrastruc-ture with data from the disaster and response plans. These will then form the basis for the use of social media to coordinate activities between official crews and the public to improve response coordination and provide the technology that could reduce the time required to allow communities to resume some semblance of normality.

Risk-management of UAS robust autonomy for its integration into civil aviation safety frameworks

This paper discusses a model of the civil aviation reg- ulation framework and shows how the current assess- ment of reliability and risk for piloted aircraft has limited applicability for Unmanned Aircraft Systems (UAS) with high levels of autonomous decision mak- ing. Then, a new framework for risk management of robust autonomy is proposed, which arises from combining quantified measures of risk with normative decision making. The term Robust Autonomy de- scribes the ability of an autonomous system to either continue or abort its operation whilst not breaching a minimum level of acceptable safety in the presence of anomalous conditions. The decision making associ- ated with risk management requires quantifying prob- abilities associated with the measures of risk and also consequences of outcomes related to the behaviour of autonomy. The probabilities are computed from an assessment under both nominal and anomalous sce- narios described by faults, which can be associated with the aircraft’s actuators, sensors, communication link, changes in dynamics, and the presence of other aircraft in the operational space. The consequences of outcomes are characterised by a loss function which rewards the certification decision

The moderating role of entrepreneurial management in the relationship between absorptive capacity and corporate entrepreneurship : an attention-based view

Building on the attention-based view, we argue that companies need a challenging mechanism to focus their absorptive capacity attention on corporate entrepreneurship versus mainstream activities or other purposes. We suggest entrepreneurial management as the attential driver for deploying absorptive capacity towards corporate entrepreneurship. From our analysis of a sample of 331 supplier companies providing products and services to the mining industry of Australia and Iran, we observe that absorptive capacity positively affects corporate entrepreneurship. The data also demonstrate that the effect of absorptive on corporate entrepreneurship increases when firms adopt the entrepreneurial culture and reward systems. However, the entrepreneurial growth and resource orientations negatively moderate the relationship between absorptive capacity and corporate entrepreneurship.

Quality management in service ecosystems

Service-oriented architectures and Web services mature and have become more widely accepted and used by industry. This growing adoption increased the demands for new ways of using Web service technology. Users start re-combining and mediating other providers’ services in ways that have not been anticipated by their original provider. Within organisations and cross-organisational communities, discoverable services are organised in repositories providing convenient access to adaptable end-to-end business processes. This idea is captured in the term Service Ecosystem. This paper addresses the question of how quality management can be performed in such service ecosystems. Service quality management is a key challenge when services are composed of a dynamic set of heterogeneous sub-services from different service providers. This paper contributes to this important area by developing a reference model of quality management in service ecosystems. We illustrate the application of the reference model in an exploratory case study. With this case study, we show how the reference model helps to derive requirements for the implementation and support of quality management in an exemplary service ecosystem in public administration.

Australia lawyer well-being : workplace demands, resources and the impact of time-billing targets

The purpose of the present study was to examine the types of workplace demands and resources experienced by full-time Australian lawyers, and the prevalence of a range of psychological outcomes. The study further focussed on the impact of time-billing targets on lawyers’ experience of these variables. Participants were 384 full-time Australian lawyers who completed an online questionnaire distributed by their Australian State or Territory Law Society. Analysis revealed that emphasis on profits within the workplace was the highest perceived demand, and the perception of social value in their work was the highest available resource. The results indicated that 37% of participants displayed Moderate to Extremely Severe depressive symptoms, and 35% were a positive screen for hazardous or harmful drinking. A series of three multivariate analyses of variance revealed significant differences between non-billers, low-to-moderate billers and high billers, with high billers experiencing greater demands, fewer resources and poorer psychological outcomes. The practical applications of these results for the legal profession are discussed.

The once-and-for-all withdrawal of the Liverpool Care Pathway in the UK : what are the implications for Australia?

This Perspective reflects on the withdrawal of the Liverpool Care Pathway in the UK, and its implications for Australia. Integrated care pathways are documents which outline the essential steps of multidisciplinary care in addressing a specific clinical problem. They can be used to introduce best clinical practice, to ensure that the most appropriate management occurs at the most appropriate time and that it is provided by the most appropriate health professional. By providing clear instructions, decision support and a framework for clinician-patient interactions, care pathways guide the systematic provision of best evidence-based care. The Liverpool Care Pathway (LCP) is an example of an integrated care pathway, designed in the 1990s to guide care for people with cancer who are in their last days of life and are expected to die in hospital. This pathway evolved out of a recognised local need to better support non-specialist palliative care providers’ care for patients dying of cancer within their inpatient units. Historically, despite the large number of people in acute care settings whose treatment intent is palliative, dying patients receiving general hospital acute care tended to lack sufficient attention from senior medical staff and nursing staff. The quality of end-of-life care was considered inadequate, therefore much could be learned from the way patients were cared for by palliative care services. The LCP was a strategy developed to improve end-of-life care in cancer patients and was based on the care received by those dying in the palliative care setting.

Catchment-specific element signatures in estuarine crocodiles (Crocodylus porosus) from the Alligator Rivers Region, northern Australia

The concentrations of Na, K, Ca, Mg, Ba, Sr, Fe, Al, Mn, Zn, Pb, Cu, Ni, Cr, Co, Se, U and Ti were determined in the osteoderms and/or flesh of estuarine crocodiles (Crocodylus porosus) captured in three adjacent catchments within the Alligator Rivers Region (ARR) of northern Australia. Results from multivariate analysis of variance showed that when all metals were considered simultaneously, catchment effects were significant (P≤0.05). Despite considerable within-catchment variability, linear discriminant analysis (LDA) showed that differences in elemental signatures in the osteoderms and/or flesh of C. porosus amongst the catchments were sufficient to classify individuals accurately to their catchment of occurrence. Using cross-validation, the accuracy of classifying a crocodile to its catchment of occurrence was 76% for osteoderms and 60% for flesh. These data suggest that osteoderms provide better predictive accuracy than flesh for discriminating crocodiles amongst catchments. There was no advantage in combining the osteoderm and flesh results to increase the accuracy of classification (i.e. 67%). Based on the discriminant function coefficients for the osteoderm data, Ca, Co, Mg and U were the most important elements for discriminating amongst the three catchments. For flesh data, Ca, K, Mg, Na, Ni and Pb were the most important metals for discriminating amongst the catchments. Reasons for differences in the elemental signatures of crocodiles between catchments are generally not interpretable, due to limited data on surface water and sediment chemistry of the catchments or chemical composition of dietary items of C. porosus. From a wildlife management perspective, the provenance or source catchment(s) of 'problem' crocodiles captured at settlements or recreational areas along the ARR coastline may be established using catchment-specific elemental signatures. If the incidence of problem crocodiles can be reduced in settled or recreational areas by effective management at their source, then public safety concerns about these predators may be moderated, as well as the cost of their capture and removal. Copyright © 2002 Elsevier Science B.V.