Development and piloting of an exposure database and surveillance system for DOE cleanup operations

An industrial hygiene exposure database and surveillance system was developed in partnership between National Institute for Occupational Safety and Health (NIOSH)-funded independent investigators and practicing industrial hygienists at the Rocky Flats Environmental Technology Site (RFETS) in Golden, Colo. RFETS is a former U.S. Department of Energy nuclear weapons plant that is now in cleanup phase. This project is presented as a case study in the development of an exposure database and surveillance system in terms that are generalizable to most other industries and work contexts. Steps include gaining organizational support; defining system purpose and scope; defining database elements and coding; planning practical and efficient analysis strategies; incorporating reporting capabilities; and anticipating communication strategies that maximize the probability that surveillance findings will feed back to preventive applications. For each of these topics, the authors describe both general considerations as well as the specific choices made for this system. An important feature of the system is a two-tier task-coding scheme comprising 33 categories of task groups. Examples of grouped analyses of exposure data captured during the system pilot period demonstrate applications to exposure control, medical surveillance, and other preventive measures. Reprinted by permission of the publisher.

Integrating workplace exposure databases for occupational medicine services and epidemiologic studies at a former nuclear weapons facility

We outline methods for integrating epidemiologic and industrial hygiene data systems for the purpose of exposure estimation, exposure surveillance, worker notification, and occupational medicine practice. We present examples of these methods from our work at the Rocky Flats Plant?a former nuclear weapons facility that fabricated plutonium triggers for nuclear weapons and is now being decontaminated and decommissioned. The weapons production processes exposed workers to plutonium, gamma photons, neutrons, beryllium, asbestos, and several hazardous chemical agents, including chlorinated hydrocarbons and heavy metals. We developed a job exposure matrix (JEM) for estimating exposures to 10 chemical agents in 20 buildings for 120 different job categories over a production history spanning 34 years. With the JEM, we estimated lifetime chemical exposures for about 12,000 of the 16,000 former production workers. We show how the JEM database is used to estimate cumulative exposures over different time periods for epidemiological studies and to provide notification and determine eligibility for a medical screening program developed for former workers. We designed an industrial hygiene data system for maintaining exposure data for current cleanup workers. We describe how this system can be used for exposure surveillance and linked with the JEM and databases on radiation doses to develop lifetime exposure histories and to determine appropriate medical monitoring tests for current cleanup workers. We also present time-line-based graphical methods for reviewing and correcting exposure estimates and reporting them to individual workers.

Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods

 Background: Efficient and reliable surveillance and notification systems are vital for monitoring public health and disease outbreaks. However, most surveillance and notification systems are affected by a degree of underestimation (UE) and therefore uncertainty surrounds the 'true' incidence of disease affecting morbidity and mortality rates. Surveillance systems fail to capture cases at two distinct levels of the surveillance pyramid: from the community since not all cases seek healthcare (under-ascertainment), and at the healthcare-level, representing a failure to adequately report symptomatic cases that have sought medical advice (underreporting). There are several methods to estimate the extent of under-ascertainment and underreporting. Methods. Within the context of the ECDC-funded Burden of Communicable Diseases in Europe (BCoDE)-project, an extensive literature review was conducted to identify studies that estimate ascertainment or reporting rates for salmonellosis and campylobacteriosis in European Union Member States (MS) plus European Free Trade Area (EFTA) countries Iceland, Norway and Switzerland and four other OECD countries (USA, Canada, Australia and Japan). Multiplication factors (MFs), a measure of the magnitude of underestimation, were taken directly from the literature or derived (where the proportion of underestimated, under-ascertained, or underreported cases was known) and compared for the two pathogens. Results: MFs varied between and within diseases and countries, representing a need to carefully select the most appropriate MFs and methods for calculating them. The most appropriate MFs are often disease-, country-, age-, and sex-specific. Conclusions: When routine data are used to make decisions on resource allocation or to estimate epidemiological parameters in populations, it becomes important to understand when, where and to what extent these data represent the true picture of disease, and in some instances (such as priority setting) it is necessary to adjust for underestimation. MFs can be used to adjust notification and surveillance data to provide more realistic estimates of incidence. © 2014 Gibbons et al.; licensee BioMed Central Ltd.

Monitoring and analysis of respiratory patterns using microwave doppler radar

 Noncontact detection characteristic of Doppler radar provides an unobtrusive means of respiration detection and monitoring. This avoids additional preparations, such as physical sensor attachment or special clothing, which can be useful for certain healthcare applications. Furthermore, robustness of Doppler radar against environmental factors, such as light, ambient temperature, interference from other signals occupying the same bandwidth, fading effects, reduce environmental constraints and strengthens the possibility of employing Doppler radar in long-term respiration detection, and monitoring applications such as sleep studies. This paper presents an evaluation in the of use of microwave Doppler radar for capturing different dynamics of breathing patterns in addition to the respiration rate. Although finding the respiration rate is essential, identifying abnormal breathing patterns in real-time could be used to gain further insights into respiratory disorders and refine diagnostic procedures. Several known breathing disorders were professionally role played and captured in a real-time laboratory environment using a noncontact Doppler radar to evaluate the feasibility of this noncontact form of measurement in capturing breathing patterns under different conditions associated with certain breathing disorders. In addition to that, inhalation and exhalation flow patterns under different breathing scenarios were investigated to further support the feasibility of Doppler radar to accurately estimate the tidal volume. The results obtained for both experiments were compared with the gold standard measurement schemes, such as respiration belt and spirometry readings, yielding significant correlations with the Doppler radar-based information. In summary, Doppler radar is highlighted as an alternative approach not only for determining respiration rates, but also for identifying breathing patterns and tidal volumes as a preferred nonwearable alternative to the conventional - ontact sensing methods.

Responses and relationship dynamics of men and their spouses during active surveillance for prostate cancer: health literacy as an inquiry framework

BACKGROUND: Early stage prostate cancer patients may be allocated to active surveillance, where the condition is observed over time with no intervention. Living with a cancer diagnosis may impose stress on both the men and their spouses. In this study we explore whether the scores of and verbal responses to a Health Literacy Questionnaire can be used to identify individuals in need of information and support and to reveal differences in perception and understanding in health related situations within couples. METHODS: We used the nine-domain Health Literacy Questionnaire (HLQ) as a framework to explore health literacy in eight couples where the men were on active surveillance for prostate cancer progression. Scores were calculated for each domain for both individuals. For each couple differences in scores were also calculated and related to the informants' self-reported experiences and reflections in relation to participating in an active surveillance program. Also an inductive analysis was performed to identify themes in the responses and these themes were compared to those of HLQ. RESULTS: The men tended to score higher than their spouses. There was no consistent relation between scores and the reported experiences and reflections. However, some interesting patterns emerged, e.g. in two of the three couples with the largest within couple differences in HLQ scores, responses revealed discrepancies in how the men and their spouses perceived their situation. Also, three themes emerged which related to six of the HLQ domains, i.e. involvement of spouses and other people around the men; support from and interaction with healthcare professionals; and use of the Internet for information retrieval. CONCLUSIONS: Using the HLQ as an interview framework provided insight into the differences within couples and provided new perspectives on their experiences, including their contact with health professionals and the patient-spouse interaction when dealing with prostate cancer. The HLQ used as a dialogue tool may be an adjunct to assist healthcare providers to understand the need for support and information of men with prostate cancer on active surveillance and the dynamics within couples.

Surveillance, criminal law and sovereighty

Seeking better understanding of the relationship between criminal law and surveillance demands investigating the evolving nature of sovereignty in an era of transnational digital information flows. While territorial boundaries determine the limits of police investigative and surveillance powers under the criminal law, several recent United States (US) examples demonstrate how new forms of extraterritorial surveillance that enable police to access online communications by foreign citizens and digital information stored in offshore locations are authorized by US courts. This discussion outlines how the processes of mutual legal assistance that ordinarily govern the search, seizure and transfer of digital evidence from one jurisdiction to another are increasingly considered to undermine police efficiency, even though they protect the due process rights afforded to crime suspects under established principles of sovereignty (Palmer and Warren 2013).

The effect of low parental warmth and low monitoring on disordered eating in mid-adolescence: findings from the Australian Temperament Project

OBJECTIVE: To investigate the interactions between low parental warmth and monitoring at age 13-14 years and disordered eating attitudes and behaviours at age 15-16 years. METHOD: Data on 1300 (667 females) adolescents and their parents were drawn from The Australian Temperament Project (ATP), a 30 year (15 wave) population based longitudinal study of social-emotional development. Parent participants completed surveys on parenting practices in late childhood, and adolescent participants reported disordered eating using the drive for thinness and bulimia subscales of the Eating Disorder Inventory (EDI) and an additional body dissatisfaction scale. Interaction was examined on the additive scale by estimating super-additive risk; i.e., risk in excess of the sum of individual risks. RESULTS: For boys, neither parental warmth or monitoring, nor their interaction, was related to disordered eating. For girls, low parental warmth (alone) was associated with bulimic behaviours. In contrast, exposure to both low monitoring and warmth was associated with ∼3½-fold, ∼4-fold and ∼5-fold increases in the odds of reporting body dissatisfaction, drive for thinness and bulimia, respectively. For body dissatisfaction and drive for thinness, risk associated with joint exposure exceeded the sum of individual risks, suggesting an additive interaction between parenting styles. CONCLUSION: Further investment in family-level interventions that focus on promoting parental monitoring behaviour and a warm parent-child relationship remain important strategies for preventing a range of disordered eating behaviours in adolescents.

Characterising the extent of misreporting of high blood pressure, high cholesterol, and diabetes using the Australian Health Survey

BACKGROUND: Measuring and monitoring the true prevalence of risk factors for chronic conditions is essential for evidence-based policy and health service planning. Understanding the prevalence of risk factors for cardiovascular disease (CVD) in Australia relies heavily on self-report measures from surveys, such as the triennial National Health Survey. However, international evidence suggests that self-reported data may substantially underestimate actual risk factor prevalence. This study sought to characterise the extent of misreporting in a large, nationally-representative health survey that included objective measures of clinical risk factors for CVD.

METHODS: This study employed a cross-sectional analysis of 7269 adults aged 18 years and over who provided fasting blood samples as part of the 2011-12 Australian Health Survey. Self-reported prevalence of high blood pressure, high cholesterol and diabetes was compared to measured prevalence, and univariate and multivariate logistic regression analyses identified socio-demographic characteristics associated with underreporting for each risk factor.

RESULTS: Approximately 16 % of the total sample underreported high blood pressure (measured to be at high risk but didn't report a diagnosis), 33 % underreported high cholesterol, and 1.3 % underreported diabetes. Among those measured to be at high risk, 68 % did not report a diagnosis for high blood pressure, nor did 89 % of people with high cholesterol and 29 % of people with high fasting plasma glucose. Younger age was associated with underreporting high blood pressure and high cholesterol, while lower area-level disadvantage and higher income were associated with underreporting diabetes.

CONCLUSIONS: Underreporting has important implications for CVD risk factor surveillance, policy planning and decisions, and clinical best-practice guidelines. This analysis highlights concerns about the reach of primary prevention efforts in certain groups and implications for patients who may be unaware of their disease risk status.

On the race of worms and patches: modeling the spread of information in wireless sensor networks

Sensor networks are a branch of distributed ad hoc networks with a broad range of applications in surveillance and environment monitoring. In these networks, message exchanges are carried out in a multi-hop manner. Due to resource constraints, security professionals often use lightweight protocols, which do not provide adequate security. Even in the absence of constraints, designing a foolproof set of protocols and codes is almost impossible. This leaves the door open to the worms that take advantage of the vulnerabilities to propagate via exploiting the multi-hop message exchange mechanism. This issue has drawn the attention of security researchers recently. In this paper, we investigate the propagation pattern of information in wireless sensor networks based on an extended theory of epidemiology. We develop a geographical susceptible-infective model for this purpose and analytically derive the dynamics of information propagation. Compared with the previous models, ours is more realistic and is distinguished by two key factors that had been neglected before: 1) the proposed model does not purely rely on epidemic theory but rather binds it with geometrical and spatial constraints of real-world sensor networks and 2) it extends to also model the spread dynamics of conflicting information (e.g., a worm and its patch). We do extensive simulations to show the accuracy of our model and compare it with the previous ones. The findings show the common intuition that the infection source is the best location to start patching from, which is not necessarily right. We show that this depends on many factors, including the time it takes for the patch to be developed, worm/patch characteristics as well as the shape of the network.

Preventing tobacco use and harm: what is evidence based policy?

The majority of tobacco users commence in early to mid-adolescence. Tobacco smoking can be characterised as a chronic, relapsing disorder. While risk increases with amount smoked, there is no safe level of use (i.e., all use is risky). Duration of use is the most important predictor of premature death with the majority of excess morbidity and mortality avoidable if people quit before middle age. Investment in initiatives that reduce smoking among pregnant women and those at risk of cardiovascular disease provide quickest returns -in reduced health care episodes and expenditure.  Measures that successfully reduce smoking among parents probably reduce smoking uptake by children, and high levels of smoking among both children and parents appear to be associated with higher levels of illicit drug use.
The evidence base for pharmcotherapies in the treatment of tobacco dependence is very strong. Population-level initiatives such as tax increases, mass media-led campaigns and smoke-free policies are all highly cost-effective in reducing population-smoking levels, including among children and young people.
Australian tobacco control initiatives have been based on "social ecology" conceptualisations of the problem, which acknowledge the pivotal role of the media in shaping social values, and public and political opinion.
Broad social change, as well as more focused prevention and cessation initiatives, has drawn heavily on research findings from the behavioural sciences. Considerable effort (mainly, in Australian, in the NGO sector) has gone into documenting policy inputs and monitoring impact and outcome measures.
This chapter discusses why conceptualising tobacco-related harm from legal, economic and social policy perspectives should also help build support for tobacco control policy among academic and practising economists and lawyers, and in the business, welfare and government sectors.

Distribution and density of the hooded plover Thinornis rubricollis along a remote coastline in North West Tasmania

The Arthur-Pieman Conservation Area, on the north-west coast of Tasmania, provides many kilometres of ocean beach habitat for the vulnerable Hooded Plover Thinornis rubricollis. Hooded Plovers were surveyed along a 43.5 km section of coast which included both rocky shores and sandy beaches. They were absent from the rocky portion of the coastline (17.0 km), but 65 individuals were recorded along the sandy portion of coastline (26.5 km). The recorded population density of 2.45 birds/km compares favourably with reported mean densities for most parts of south-eastern Australia. Careful management and monitoring are required if the current numbers of the Hooded Plover in this area are to be maintained.

A comparison of Australian and Malaysian views on the use of biometric devices in everyday situations

Since the September 11, 2001 terrorist attacks in New York City, many countries including Australia and Malaysia have been able to justify the use biometric devices such as finger print scans, retina scans and facial recognition for identification and surveillance of its citizens and others in the name of national security. In addition, biometric devices are increasingly being used worldwide by organizations to keep track of their employees and their productivity, leading to concerns of privacy, the safety, reliability, abuse and misuse of the data collected and violations of civil liberties. Taking the critical theory perspective, this paper will analyse the data collected and report on the findings of a survey carried out in Australia and Malaysia, with respect to the responses provided and opinions expressed to the survey s open ended and other questions
by individuals as to their current use, experiences, preferences, concerns about the devices and the situations in which they think biometric devices should be used, including in their workplaces. This descriptive study uses both quantitative and qualitative data to examine what Australians and Malaysians think about the use of biometric devices in everyday situtions
and compare them as to their similarities and differences. The paper will then critically examine the ethical and civil liberties issues involved in the use of biometric devices in everyday life and argues that regulatory and legal measures should be taken to safeguard the rights of citizens while maintaining national security and productivity, in order to avoid the situation of Michel Foucaults Panopticon becoming an unpleasant everyday reality, which could negatively irifluence socialjustice and create social change due to its effects on individuals in two multicultural societies. The paper will argue about the need to educate the general public as to the issues of surveillance and privacy involved in the use of biometric devices in everyday situations.

Foucault goes to the footy: professionalism, performance, prudentialism and playstations in the life of AFL footballers

This paper will report on a research project funded by the Australian Football League (AFL) that is exploring the emergence and evolution of a ‘professional identity’ for AFL footballers – an identity that has many facets including the emerging ideas that a professional leads a balanced life, and has a prudent orientation to the future. The research is informed by Foucault’s later work on the care of the Self to focus on the ways in which player identities are governed by coaches, club officials, player agents and the AFL Commission/Executive; and the manner in which players conduct themselves in ways that can be characterised as professional - or not. The paper explores elements of these processes by analysing the forms of risk management that Clubs use in the processes of List and Player management that they engage in as a consequence of AFL rules. Psychological testing and profiling of players is becoming more important in identifying, recruiting and managing players. The paper discusses how this testing is used to identify character or personality traits prior to initial recruitment in the draft or trading processes – and suggests that a number of issues related to workplace surveillance and identity emerge as a result.

Interpersonal trust and control behaviour of Chinese managers

Interpersonal trust is believed to influence the management and control of organisations in China. China's importance as a host country for foreign direct investments (FDIs) through multinational company subsidiaries (MNCs) and international joint ventures (IJVs) is growing rapidly. MNCs and INs located in China often employ local Chinese managers to control their subsidiaries or ventures. This makes it essential for designers of management control systems to have an understanding of the interpersonal trust-sensitive control behaviour of Chinese managers. One of the important aspects of control behaviour is how managers control their subordinates.

This paper examines the relationship between Chinese managers' trust in subordinates and their (Chinese managers') control behaviour towards the subordinates. On the basis of a questionnaire survey of a cohort of managers from Beijing, the study explores the effects of trust on the use of social controls, formal controls, and monitoring.

The findings of this study indicate that a manager's high (low) trust in a subordinate is associated with a low (high) level of monitoring, a high (high) level of social control and a high (low) level of perceived performance. The hypothesis that a superior's high (low) level of trust is associated with a low (high) level of reliance on formal controls was not supported. These findings, while indicative of control behaviour of Chinese managers in particular, also add to the growing academic literature on trust and control in general. In a practical sense, an
understanding of the trust-sensitive control behaviour of Chinese managers is particularly useful in designing and implementing effective control systems for international organisations operating in China.

Professional identity and the contemporary university: a culture of control, accountability and virtuality?

In recent years many changes to the funding and management of universities have taken place. In the current climate of academia in Australia professional academics find themselves immersed in the culture of the managed university that uses the rhetoric of commitment to flexible delivery to put in place systems designed to increase accountability, surveillance and control. At the same time some argue that the focus on research, quality teaching and effective pedagogy has lessened. The empirical research base for this paper has enabled me to better understand some of the emerging trends my university. It looks at how changes to the experience of being academic impact on the work of academics as the power relations of the university continuously reposition them, and how academics in turn display resistance technologies. Changes to the technologies of management/administration of the university have resulted in what some academics have described as a loss of valuing of their knowledge and expertise and which may be seen by some as a threat to their opportunities to conduct productive educational inquiry.