Rural and remote road safety study : final report

• Introduction: Concern and action for rural road safety is relatively new in Australia in comparison to the field of traffic safety as a whole. In 2003, a program of research was begun by the Centre for Accident Research and Road Safety - Queensland (CARRS-Q) and the Rural Health Research Unit (RHRU) at James Cook University to investigate factors contributing to serious rural road crashes in the North Queensland region. This project was funded by the Premier’s Department, Main Roads Department, Queensland Transport, QFleet, Queensland Rail, Queensland Ambulance Service, Department of Natural Resources and Queensland Police Service. Additional funding was provided by NRMA Insurance for a PhD scholarship. In-kind support was provided through the four hospitals used for data collection, namely Cairns Base Hospital, The Townsville Hospital, Mount Isa Hospital and Atherton Hospital.----- The primary aim of the project was to: Identify human factors related to the occurrence of serious traffic incidents in rural and remote areas of Australia, and to the trauma suffered by persons as a result of these incidents, using a sample drawn from a rural and remote area in North Queensland.----- The data and analyses presented in this report are the core findings from two broad studies: a general examination of fatalities and casualties from rural and remote crashes for the period 1 March 2004 until 30 June 2007, and a further linked case-comparison study of hospitalised patients compared with a sample of non-crash-involved drivers.----- • Method: The study was undertaken in rural North Queensland, as defined by the Australian Bureau of Statistics (ABS) statistical divisions of North Queensland, Far North Queensland and North-West Queensland. Urban areas surrounding Townsville, Thuringowa and Cairns were not included. The study methodology was centred on serious crashes, as defined by a resulting hospitalisation for 24 hours or more and/or a fatality. Crashes meeting this criteria within the North Queensland region between 1 March 2004 and 30 June 2007 were identified through hospital records and interviewed where possible. Additional data was sourced from coroner’s reports, the Queensland Transport road crash database, the Queensland Ambulance Service and the study hospitals in the region.----- This report is divided into chapters corresponding to analyses conducted on the collected crash and casualty data.----- Chapter 3 presents an overview of all crashes and casualties identified during the study period. Details are presented in regard to the demographics and road user types of casualties; the locations, times, types, and circumstances of crashes; along with the contributing circumstances of crashes.----- Chapter 4 presents the results of summary statistics for all casualties for which an interview was able to be conducted. Statistics are presented separately for drivers and riders, passengers, pedestrians and cyclists. Details are also presented separately for drivers and riders crashing in off-road and on-road settings. Results from questionnaire data are presented in relation to demographics; the experience of the crash in narrative form; vehicle characteristics and maintenance; trip characteristics (e.g. purpose and length of journey; periods of fatigue and monotony; distractions from driving task); driving history; alcohol and drug use; medical history; driving attitudes, intentions and behaviour; attitudes to enforcement; and experience of road safety advertising.----- Chapter 5 compares the above-listed questionnaire results between on-road crash-involved casualties and interviews conducted in the region with non-crash-involved persons. Direct comparisons as well as age and sex adjusted comparisons are presented.----- Chapter 6 presents information on those casualties who were admitted to one of the study hospitals during the study period. Brief information is given regarding the demographic characteristics of these casualties. Emergency services’ data is used to highlight the characteristics of patient retrieval and transport to and between hospitals. The major injuries resulting from the crashes are presented for each region of the body and analysed by vehicle type, occupant type, seatbelt status, helmet status, alcohol involvement and nature of crash. Estimates are provided of the costs associated with in-hospital treatment and retrieval.----- Chapter 7 describes the characteristics of the fatal casualties and the nature and circumstances of the crashes. Demographics, road user types, licence status, crash type and contributing factors for crashes are presented. Coronial data is provided in regard to contributing circumstances (including alcohol, drugs and medical conditions), cause of death, resulting injuries, and restraint and helmet use.----- Chapter 8 presents the results of a comparison between casualties’ crash descriptions and police-attributed crash circumstances. The relative frequency of contributing circumstances are compared both broadly within the categories of behavioural, environmental, vehicle related, medical and other groupings and specifically for circumstances within these groups.----- Chapter 9 reports on the associated research projects which have been undertaken on specific topics related to rural road safety.----- Finally, Chapter 10 reports on the conclusions and recommendations made from the program of research.---- • Major Recommendations : From the findings of these analyses, a number of major recommendations were made: + Male drivers and riders - Male drivers and riders should continue to be the focus of interventions, given their very high representation among rural and remote road crash fatalities and serious injuries.----- - The group of males aged between 30 and 50 years comprised the largest number of casualties and must also be targeted for change if there is to be a meaningful improvement in rural and remote road safety.----- + Motorcyclists - Single vehicle motorcycle crashes constitute over 80% of serious, on-road rural motorcycle crashes and need particular attention in development of policy and infrastructure.----- - The motorcycle safety consultation process currently being undertaken by Queensland Transport (via the "Motorbike Safety in Queensland - Consultation Paper") is strongly endorsed. As part of this process, particular attention needs to be given to initiatives designed to reduce rural and single vehicle motorcycle crashes.----- - The safety of off-road riders is a serious problem that falls outside the direct responsibility of either Transport or Health departments. Responsibility for this issue needs to be attributed to develop appropriate policy, regulations and countermeasures.----- + Road safety for Indigenous people - Continued resourcing and expansion of The Queensland Aboriginal Peoples and Torres Strait Islander Peoples Driver Licensing Program to meet the needs of remote and Indigenous communities with significantly lower licence ownership levels.----- - Increased attention needs to focus on the contribution of geographic disadvantage (remoteness) factors to remote and Indigenous road trauma.----- + Road environment - Speed is the ‘final common pathway’ in determining the severity of rural and remote crashes and rural speed limits should be reduced to 90km/hr for sealed off-highway roads and 80km/hr for all unsealed roads as recommended in the Austroads review and in line with the current Tasmanian government trial.----- - The Department of Main Roads should monitor rural crash clusters and where appropriate work with local authorities to conduct relevant audits and take mitigating action. - The international experts at the workshop reviewed the data and identified the need to focus particular attention on road design management for dangerous curves. They also indicated the need to maximise the use of audio-tactile linemarking (audible lines) and rumble strips to alert drivers to dangerous conditions and behaviours.----- + Trauma costs - In accordance with Queensland Health priorities, recognition should be given to the substantial financial costs associated with acute management of trauma resulting from serious rural and remote crashes.----- - Efforts should be made to develop a comprehensive, regionally specific costing formula for road trauma that incorporates the pre-hospital, hospital and post-hospital phases of care. This would inform health resource allocation and facilitate the evaluation of interventions.----- - The commitment of funds to the development of preventive strategies to reduce rural and remote crashes should take into account the potential cost savings associated with trauma.----- - A dedicated study of the rehabilitation needs and associated personal and healthcare costs arising from rural and remote road crashes should be undertaken.----- + Emergency services - While the study has demonstrated considerable efficiency in the response and retrieval systems of rural and remote North Queensland, relevant Intelligent Transport Systems technologies (such as vehicle alarm systems) to improve crash notification should be both developed and evaluated.----- + Enforcement - Alcohol and speed enforcement programs should target the period between 2 and 6pm because of the high numbers of crashes in the afternoon period throughout the rural region.----- + Drink driving - Courtesy buses should be advocated and schemes such as the Skipper project promoted as local drink driving countermeasures in line with the very high levels of community support for these measures identified in the hospital study.------ - Programs should be developed to target the high levels of alcohol consumption identified in rural and remote areas and related involvement in crashes.----- - Referrals to drink driving rehabilitation programs should be mandated for recidivist offenders.----- + Data requirements - Rural and remote road crashes should receive the same quality of attention as urban crashes. As such, it is strongly recommended that increased resources be committed to enable dedicated Forensic Crash Units to investigate rural and remote fatal and serious injury crashes.----- - Transport department records of rural and remote crashes should record the crash location using the national ARIA area classifications used by health departments as a means to better identifying rural crashes.----- - Rural and remote crashes tend to be unnoticed except in relatively infrequent rural reviews. They should receive the same level of attention and this could be achieved if fatalities and fatal crashes were coded by the ARIA classification system and included in regular crash reporting.----- - Health, Transport and Police agencies should collect a common, minimal set of data relating to road crashes and injuries, including presentations to small rural and remote health facilities.----- + Media and community education programmes - Interventions seeking to highlight the human contribution to crashes should be prioritised. Driver distraction, alcohol and inappropriate speed for the road conditions are key examples of such behaviours.----- - Promotion of basic safety behaviours such as the use of seatbelts and helmets should be given a renewed focus.----- - Knowledge, attitude and behavioural factors that have been identified for the hospital Brief Intervention Trial should be considered in developing safety campaigns for rural and remote people. For example challenging the myth of the dangerous ‘other’ or ‘non-local’ driver.----- - Special educational initiatives on the issues involved in rural and remote driving should be undertaken. For example the material used by Main Roads, the Australian Defence Force and local initiatives.

Using videotelephony to support paediatric oncology-related palliative care in the home : from abandoned RCT to acceptability study

Videotelephony (real-time audio-visual communication) has been used successfully in adult palliative home care. This paper describes two attempts to complete an RCT (both of which were abandoned following difficulties with family recruitment), designed to investigate the use of videotelephony with families receiving palliative care from a tertiary paediatric oncology service in Brisbane, Australia. To investigate whether providing videotelephone-based support was acceptable to these families, a 12-month non-randomised acceptability trial was completed. Seventeen palliative care families were offered access to a videotelephone support service in addition to the 24 hours ‘on-call’ service already offered. A 92% participation rate in this study provided some reassurance that the use of videotelephones themselves was not a factor in poor RCT participation rates. The next phase of research is to investigate the integration of videotelephone-based support from the time of diagnosis, through outpatient care and support, and for palliative care rather than for palliative care in isolation

A framework for assessing social policy inclusion proposals

This document outlines a framework that could be used by government agencies in assessing policy interventions aimed at achieving social outcomes from government construction contracts. The framework represents a rational interpretation of the information gathered during the multi-outcomes construction policies project. The multi-outcomes project focused on the costs and benefits of using public construction contracts to promote the achievement of training and employment and public art objectives. The origin of the policy framework in a cost-benefit appraisal of current policy interventions is evidenced by its emphasis on sensitivity to policy commitment and project circumstances (especially project size and scope).The quantitative and qualitative analysis conducted in the multi-outcomes project highlighted, first, that in the absence of strong industry commitment to policy objectives, policy interventions typically result in high levels of avoidance activity, substantial administrative costs and very few benefits. Thus, for policy action on, for example, training or local employment to be successful compliance issues must be adequately addressed. Currently it appears that pre-qualification schemes (similar to the Priority Access Scheme) and schemes that rely on measuring, for example, the training investments of contractors within particular projects do not achieve high levels of compliance and involve significant administrative costs. Thus, an alternative is suggested in the policy framework developed here: a levy on each public construction project – set as a proportion of the total project costs. Although a full evaluation of this policy alternative was beyond the scope of the multi-outcomes construction policies project, it appears to offer the potential to minimize the transaction costs on contractors whilst enabling the creation of a training agency dedicated to improving the supply of skilled construction labour. A recommendation is thus made that this policy alternative be fully researched and evaluated. As noted above, the outcomes of the multi-outcomes research project also highlighted the need for sensitivity to project circumstances in the development and implementation of polices for public construction projects. Ideally a policy framework would have the flexibility to respond to circumstances where contractors share a commitment to the policy objectives and are able to identify measurable social outcomes from the particular government projects they are involved in. This would involve a project-by-project negotiation of goals and performance measures. It is likely to only be practical for large, longer term projects.

I-cobb - An innovative technique in spinal radiographic measurement

The measurement of Cobb angles on radiographs of patients with spinal deformities is routine practice in spinal clinics. The technique relies on the use and availability of specialist equipment such as a goniometer, cobbometer or protractor. The aim of this study was to validate the use of i-Phone (Apple Inc) combined with Tilt Meter Pro software as compared to a protractor in the measurement of Cobb angles. The i-Phone combined with Tilt Meter Pro software offers a faster alternative to the traditional method of Cobb angle measurement. The use of i-Phone offers a more convenient way of measuring Cobb angles in the outpatient setting. The intra-observer repeatability of the iPhone is equivalent to the protractor in the measurement of Cobb angles.

The efficacy of waste management plans in Australian commercial construction refurbishment projects

Renovation and refurbishment of the existing commercial building stock is a growing area of total construction activity and a significant generator of waste sent to landfill in Australia. A written waste management plan (WMP) is a widespread regulatory requirement for commercial office redevelopment projects. There is little evidence, however, that WMPs actually increase the quantity of waste that is ultimately diverted from landfill. Some reports indicate an absence of any formal verification or monitoring process by regulators to assess the efficacy of the plans. In order to gauge the extent of the problem a survey was conducted of twenty four consultants and practitioners involved in commercial office building refurbishment projects to determine the state of current practice with regard to WMPs and to elicit suggestions with regard to ways of making the process more effective. Considerable variation in commitment to recycling policies was encountered indicating a need to revisit waste minimisation practices if the environmental performance of refurbishment projects is to be improved.

Can governments use their construction contracts to improve training outcomes?

This paper explores the likely efficacy of government agencies using their contracting relationships with private firms to affect training outcomes in the construction industry. Specifically, it reports on the results of a study of two training policies of theWestern Australian government. Empirical data is drawn from the government’s Tender Registration System between 1997 and 2006. The main finding of the quantitative analysis is that in the absence of strong industry commitment to policy objectives, the contracting approach is likely to result in high levels of avoidance activity and generate very few benefits. The results of a qualitative investigation also support these findings.

Analysing the internationalisation readiness of firms

The internationalisation of firms has gained much research attention since the 1970s. However, the behavioural aspect of firms’ during their pre-internationalisation phase has not been sufficiently explored. This research proposes that a pre-internationalisation focus would not only offer an additional perspective to the study of firm internationalisation but would also address the significant research gap in studies that are theoretically based around the Uppsala Model. This study views the development of a firm from its pre-internationalisation phase into an international firm in accordance with the Uppsala Model’s ‘state’ to ‘change’ aspect transition, with ‘internationalisation readiness’ established as the missing link between these two aspects. During the pre-internationalisation phase, a firm is exposed to a wide variety of internal and external stimuli that triggers an impulse for foreign market expansion. The perception of these stimuli and the attitudinal commitment taken by the firm’s decision-makers, as well as the firm’s resource capabilities and the moderating effect of lateral rigidity, are influential towards an internationalisation decision. This paper argues the significance of adopting the pre-internationalisation phase as a research platform and the importance of analysing firms’ internationalisation readiness. A method is proposed for the development of an Internationalisation Readiness Index that could be used for measuring a firm’s propensity to commence its first export operation.

Constructing an Internationalisation Readiness Index

In this study we incorporate a pre-internationalisation phase into the traditional Uppsala model of firm internationalisation to address the question: Where does the process begin? We identify through the literature four concepts fundamental to the ability of a firm to begin internationalisation of its operations: stimuli, attitudinal/psychological commitment, resources and lateral rigidity. Through a survey of 274 Australian exporting and non-exporting firms we collect data relating to the four pre-internationalisation concepts. An internationalisation readiness index is constructed and applied to some representative cases to establish its validity as a diagnostic tool.

Before the first export decision : internationalisation readiness in the pre-export phase

Although the internationalisation process of the firm has been well researched since the 1970s, the behaviour of firms prior to internationalisation has not received commensurate research attention.This paper argues that a focus on firms’ pre-internationalisation activities will not only offer an additional important perspective to the study of firm internationalisation but it will also address a significant research gap in studies that are theoretically based on the so-called stages models. During the pre-internationalisation phase, a firm is exposed to stimuli factors that may trigger an impulse for foreign market expansion. Decision makers’ perceptions of stimuli, their attitudinal commitment towards internationalisation, the firms’ resources and capabilities, as well as the mediating effect of lateral rigidity comprise a learning process that leads a firm towards readiness to initiate an internationalisation decision. This paper advances the concept of internationalisation readiness and proposes a method for developing an Internationalisation Readiness Index.

Examining the antecedents and consequences of ritualized fan behavior [Abstract]

One of the features of the sporting industry is the ritualized way in which it is consumed across the world. Fans of every sport have rituals and superstitions to help them enjoy the spectacle, socialize with other like-minded fans, and reduce some of the anxiety of watching their team play. These rituals include dress, barracking styles and pre and post match behaviors. What is not known are the factors that lead fans to engage in ritual behaviors and what relationship rituals have with desirable outcomes such as increased attendance, attitudinal loyalty or satisfaction. Given that some ritual behaviors are clearly undesirable, (e.g., hooliganism), understanding these relationships is important to managers who may be questioning whether rituals should be encouraged. Although ritualized behavior amongst fans is clearly visible, the symbolic and emotional nature of ritual poses challenges to researchers. Most previous ritual research is exploratory and qualitative in nature. This study, however, uses a behavior-based scale to measure fan ritual and relates it to desirable outcomes such as commitment and attendance. Over 2,000 season ticket holders of a football (soccer) team in Australia’s professional A-League competition were surveyed to investigate the antecedents and consequences of fan ritual behavior. Cluster analysis was used to explore the characteristics of respondents, and it revealed that those fans that engage in ritual behavior also differed on many other demographic and attitudinal dimensions. The associations between ritual and psychological commitment, and ritual and attendance are positive and significant. When used in conjunction with other constructs, fan ritual also improves the explanation of attendance behavior. The findings support previous research that found a significant and positive relationship between team identification, involvement and attendance, and extend previous research by finding a significant and positive relationship between rituals and attendance. For sports marketing practitioners, the results indicate the importance of developing and managing consumption rituals tied to game day attendance, with a view to generating uncommon loyalty.

What’s in a handshake? Exploring business-to-business relational exchange

Despite its importance in the development of competitive advantage, attempts to unify diverse classifications of business-to-business relational exchange have been largely unsuccessful. We used 18 semi-structured, in-depth interviews with managers from a wide range of industries to explain the business-to-business relational exchange construct. Analysis of the data revealed that business-to-business relational exchange comprises five key dimensions. These are communication, compatibility, commitment, trust and power symmetry. The research highlights the importance of personal interaction in business relationships and provided additional insights into the importance of affective commitment. In addition we reveal a number of negative consequences of affective commitment, which have been previously unexplored. A new conceptual model of business-to-business relational exchange is presented, which synthesises these findings and directs future research.

The development of a clinical learning environment scale

Within nursing, there is a strong demand for high-quality, cost-effective clinical education experiences that facilitate student learning in the clinical setting The clinical learning environment (CLE) is the interactive network of forces within the clinical setting that influence the students'clinical learning outcomes The identification of factors that characterize CLE could lead to strategies that foster the factors most predictive of desirable student learning outcomes and ameliorate those which may have a negative impact on student outcomes The CLE scale is a 23-item instrument with five subscales staff–student relationships, nurse manager commitment, patient relationships, interpersonal relationships, and student satisfaction These factors have strong substantive face validity and construct validity, as determined by confirmatory factor analysis Reliability coefficients range from high (0 85) to marginal (0 63) The CLE scale provides the educator with a valid and reliable instrument to evaluate affectively relevant factors in the CLE, direct resources to areas where improvement may be required, and nurture those areas functioning well It will assist in the application of resources in a cost-effective, efficient, productive manner, and will ensure that the clinical learning experience offers the nursing student the best possible learning outcomes

Bike park in Groningen, The Netherlands

Groningen is a city that collects contemporary projects. A trip around town reveals something like a zoo, with examples of all design languages of the last twenty years, many of them now aging and distinctly past their prime. Even though some of these projects are outdated, this collection not only demonstrates a commitment to design (even occasionally lacking judgement) but also serves an archival function: we can consult the Groningen Zoo of Design to determine the design to determine the design preoccupations of the past and how those often theoretical interests (since most of the work by these designers was not built) manifested themselves in material form on the ground.

Marketing to change public opinion on climate change : a case study

Corporate advertisers spend far greater budgets than any social marketing campaign and have great potential to change public opinion on the urgent need for action on climate change. However “green-washing” has become a widespread practice by companies that wish to appear to be socially responsible without a genuine commitment and consumers can be very cynical about green marketing campaigns. Can companies be climate change advocates and still satisfy shareholders? This paper offers a case study on an Australian insurance company that argues it can make money from doing the right thing.

Institutional problems of the emerging scientific community in Iran

This article attempts to explore the concept of scientific community at the macro-national level in the context of Iran. Institutionalisation of science and its professional growth has been constrained by several factors. The article first conceptualises the notion of science community as found in the literature in the context of Iran, and attempts to map through some indicators. The main focus, however, lies in mapping some institutional problems through empirical research. This was undertaken in 2002–04 in order to analyse the structure of the scientific community in Iran in the ‘exact sciences’ (mathematics, physics, chemistry, biology and earth sciences). The empirical work was done in two complementary perspectives: through a questionnaire and statistical analysis of it, and through semistructured interviews with the researchers. There are number of problems confronting scientists in Iran. Facilities provided by institutions is one of the major problems of research. Another is the tenuous cooperation among scientists. This is reported by most of the researchers, who deplore the lack of cooperation among their group. Relationships are mostly with the Ph.D. students and only marginally with colleagues. Our research shows that the more brilliant the scientists, the more frustrated they are from scientific institutions in Iran. Medium-range researchers seem to be much happier about the scientific institution to which they belong than the brighter scholars. The scientific institutions in Iran seem to be built for the needs of the former rather than the latter. These institutions seem not to play a positive role in the case of the best scientists. On the whole, many ingredients of the scientific community, at least at its inception, are present among Iranian scientists: the strong desire for scientific achievement in spite of personal, institutional and economic problems.