The impact of a suicide prevention strategy on reducing the economic cost of suicide in the New South Wales construction industry

BACKGROUND: Little research has been conducted into the cost and prevention of self-harm in the workplace. AIMS: To quantify the economic cost of self-harm and suicide among New South Wales (NSW) construction industry (CI) workers and to examine the potential economic impact of implementing Mates in Construction (MIC). METHOD: Direct and indirect costs were estimated. Effectiveness was measured using the relative risk ratio (RRR). In Queensland (QLD), relative suicide risks were estimated for 5-year periods before and after the commencement of MIC. For NSW, the difference between the expected (i.e., using NSW pre-MIC [2008-2012] suicide risk) and counterfactual suicide cases (i.e., applying QLD RRR) provided an estimate of potential suicide cases averted in the post-MIC period (2013-2017). Results were adjusted using the average uptake (i.e., 9.4%) of MIC activities in QLD. Economic savings from averted cases were compared with the cost of implementing MIC. RESULTS: The cost of self-harm and suicide in the NSW CI was AU $527 million in 2010. MIC could potentially avert 0.4 suicides, 1.01 full incapacity cases, and 4.92 short absences, generating annual savings of AU $3.66 million. For every AU $1 invested, the economic return is approximately AU $4.6. CONCLUSION: MIC represents a positive economic investment in workplace safety.

Dynamic risk and sexual offending: the conundrum of assessment

The potential to reduce sexual victimisation, promote community safety, and decrease incarceration costs has resulted in considerable progress in terms of how we understand and predict sexual recidivism. And yet, the past decade has seen a degree of fragmentation emerge as research attention has shifted away from relative risk prediction (with its focus on static risk factors) to the identification of factors capable of reducing risk through intervention (i.e. dynamic risk). Although static and dynamic risk are often treated as orthogonal constructs [Beech, A. R., & Craig, L. A. (2012). The current status of static and dynamic factors in sexual offender risk assessment. Journal of Aggression, Conflict and Peace Research, 4(4), 169–185. doi:10.1108/17596591211270671], there are arguments to support a claim that the two are in fact functionally related [see Ward, T. (2015). Dynamic risk factors: Scientific kinds or predictive constructs. Psychology, Crime & Law (in this issue); Ward, T., & Beech, A. R. (2015). Dynamic risk factors: A theoretical dead-end? Psychology, Crime & Law, 21(2), 100–113. doi:10.1080/1068316X.2014.917854]. This discussion clearly affects how we assess dynamic risk. This review considered several commonly used methods of assessment and the evidence offered for their predictive accuracy. Of note were differences in the predictive accuracy of single psychometric measures versus composite scores of dynamic risk domains and the conventions used for establishing effect sizes for risk assessment tools.

How do the Australian guidelines for lipid-lowering drugs perform in practice? Cardiovascular disease risk in the AusDiab Study, 1999-2000

OBJECTIVE: To determine how well the current Pharmaceutical Benefits Scheme (PBS) eligibility criteria for subsidy of lipid-lowering drugs compare with current national guidelines for determining the population at high risk of developing cardiovascular disease (CVD). DESIGN AND PARTICIPANTS: Analyses of the population-based, cross-sectional Australian Diabetes, Obesity and Lifestyle (AusDiab) study, conducted in 1999-2000. The 1991 Framingham risk prediction equation was used to compute 5-year risk of developing first-time CVD in 8286 participants aged 30-74 years with neither CVD nor diabetes. Based on the National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand guidelines, people with either 5-year CVD risk > or = 15% or with 5-year CVD risk of 10%-< 15% and the metabolic syndrome were defined as having estimated high absolute CVD risk. MAIN OUTCOME MEASURES: 5-year CVD risk; estimated population with high CVD risk. RESULTS: Among participants without prevalent CVD or diabetes, 7.9% of men and 1.5% of women had a 5-year CVD risk > or = 15%. Of the estimated residential Australian population in 2000 aged 30-74 years without CVD or diabetes, 717 000 people were considered to be at high absolute CVD risk. Among the high-risk AusDiab participants without CVD or diabetes, only 16.9% of men and 15.4% of women were being treated with lipid-lowering drugs. Of the 9.6% of participants free of CVD and diabetes who were untreated but eligible for subsidy under PBS criteria, only 27.4% had an estimated high absolute CVD risk. CONCLUSION: Strategies for CVD prevention using lipid-lowering medications can be improved by adoption of the absolute-risk approach.

Predicting driving direction with weighted markov model

Driving direction prediction can be useful in different applications such as driver warning and route recommendation. In this paper, a framework is proposed to predict the driving direction based on weighted Markov model. First the city POI (Point of Interesting) map is generated from trajectory data using weighted PageRank algorithm. Then, a weighted Markov model is trained for the near term driving direction prediction based on the POI map and historical trajectories. The experimental results on real-world data set indicate that the proposed method can improve the original Markov prediction model by 10% at some circumstances and 5% overall.

iPrevent®: a tailored, web-based, decision support tool for breast cancer risk assessment and management

We aimed to develop a user-centered, web-based, decision support tool for breast cancer risk assessment and personalized risk management. Using a novel model choice algorithm, iPrevent(®) selects one of two validated breast cancer risk estimation models (IBIS or BOADICEA), based on risk factor data entered by the user. Resulting risk estimates are presented in simple language and graphic formats for easy comprehension. iPrevent(®) then presents risk-adapted, evidence-based, guideline-endorsed management options. Development was an iterative process with regular feedback from multidisciplinary experts and consumers. To verify iPrevent(®), risk factor data for 127 cases derived from the Australian Breast Cancer Family Study were entered into iPrevent(®), IBIS (v7.02), and BOADICEA (v3.0). Consistency of the model chosen by iPrevent(®) (i.e., IBIS or BOADICEA) with the programmed iPrevent(®) model choice algorithm was assessed. Estimated breast cancer risks from iPrevent(®) were compared with those attained directly from the chosen risk assessment model (IBIS or BOADICEA). Risk management interventions displayed by iPrevent(®) were assessed for appropriateness. Risk estimation model choice was 100 % consistent with the programmed iPrevent(®) logic. Discrepant 10-year and residual lifetime risk estimates of >1 % were found for 1 and 4 cases, respectively, none was clinically significant (maximal variation 1.4 %). Risk management interventions suggested by iPrevent(®) were 100 % appropriate. iPrevent(®) successfully integrates the IBIS and BOADICEA risk assessment models into a decision support tool that provides evidence-based, risk-adapted risk management advice. This may help to facilitate precision breast cancer prevention discussions between women and their healthcare providers.

Discrimination of origin of farmed trout by means of biometrical parameters, fillet chemical composition and flavour volatile compounds

To date it is well known that the quality of farmed trout is affected by diet composition, by feeding regime, by husbandry practices and by rearing conditions and environment. The trout processing industry and the large-scale retail trade, in consideration of the wide variability of trout quality and characteristics, have imposed, or will soon impose, quality criteria for the end product. Moreover, recent food scares and the malpractices of some food producers have increased public requests
for traceability. The aim of the present study was to evaluate the main chemical quality and the biometrical characteristics of rainbow trout produced in three different farms in Italy (two intensive farms, located one on mountain and one on plain, and an extensive farm in which fish fed only on naturally available nutrients) and to establish whether farmed trout
origins could be differentiated by these parameters. Trout farmed in the intensive mountain farm (IMF) showed the highest crude lipid content in the fillets and the fatty acids of their fillets were characterized by the highest percentage of MUFA. Trout farmed in the intensive plain farm (IPF) were characterized by low dressing percentage, and the lipid of their fillets
was rich in n-6 fatty acids. Trout stocked for the last year of their life in the extensive farm (EF) were leaner both in the carcass and in the fillets. The analysis of flavor volatile compounds showed some differences in the bouquet design, particularly differences in the amounts of n-3 and n-6 derivates volatile aldehydes and alcohols. All data significantly different
(P<0.05) were subjected to Linear Discriminant Analysis (LDA) and 8 variables were chosen to create two discriminant equations generating a strong prediction model for classification of farmed trout respective to their origins.

Exploring turnover intention of construction managers in China

Employee turnover has been identified as one of the principal causes of poor performance, low competitiveness and high technology loss in the construction industry. Construction managers normally acquire knowledge and skills in construction methods and management techniques on the basis of long-term practice, and their turnover can significantly impact on a construction organisation's survival and development. Therefore, there has been an increasing need to understand the major critical variables affecting the turnover of construction managers. The aims of this research were to determine these variables and use them to develop a quantitative turnover prediction model. A system framework was first developed to categorise all turnover variables into job satisfaction, organisation commitment and demographic variables and the turnover intention was measured in diverse directions. Based on an empirical study in Hubei province in China, the statistical results indicate that seven job satisfaction and organisational commitment variables dominate the turnover intentions of construction managers.

An empirical evaluation of sampling controversies in ratio-based modelling of corporate collapse

Empirical investigations regarding ratio-based modelling of corporate collapse have been on going for decades. With any study of an empirical nature, a data sample is a necessary prerequisite. It allows testing the performance of the prediction model, thereby establishing its practical relevance. However, it is necessary to first ensure that the data sample used satisfies certain conditions, and these have lead to some choice controversies. This paper considers the controversial issues that arise in data sampling, provides a critical evaluation of these issues, and makes choice recommendations on the controversial aspects, by empirically examining the literature.

Offender rehabilitation : a normative framework for forensic psychologists

Community protection from offenders is addressed through punishment, deterrence, incapacitation, and/or rehabilitation. The current public policy debate about community protection refers to community rights as opposed to offender rights as if the two are mutually exclusive. However, in this article it will be argued that offender rehabilitation can enhance community protection if it addresses community rights and offender rights. The author proposes a normative framework to guide forensic psychologists in offender rehabilitation. The normative framework considers psychological theory—the risk-need model to address community rights and the good lives model to address offender rights. However, forensic psychologists operate within the context of the criminal justice system and so legal theory will also be considered. Therapeutic jurisprudence can balance community rights and offender rights within a human rights perspective. The proposed normative framework guides forensic psychologists in the assessment of risk, the treatment of need, and the management of readiness in balancing community rights and offender rights. Within a human rights perspective, forensic psychologists have a duty to provide offenders with the opportunity to make autonomous decisions about whether to accept or reject rehabilitation.

The metabolic syndrome: in need of a global mission statement

Aims The value of clinical definitions of the metabolic syndrome has been questioned, with confusion surrounding their intended use and purpose. Our aim was to construct a mission statement that outlines the value of the metabolic syndrome in clinical and public health settings.

Methods Case studies have been used to demonstrate three key points.

Results We argue here for recognition of obesity as being a crucial element within the metabolic syndrome but perhaps even more important before its development. We also contend that the concept does indeed have a role as a risk prediction tool, and that it could provide a useful metric for the scale and progress of the looming global epidemic of diabetes and cardiovascular disease.

Conclusions Through appreciation of its purpose, and recognition of both its limitations and those attributes that make it unique and valuable, we believe we have demonstrated here that the metabolic syndrome deserves its place in the global toolbox of diabetes and CVD prevention.

Analysis of employee turnover amongst construction managers in Hubei Province

This study determined the most important factors affecting turnover intention and developed a prediction model of construction manager turnover in Hubei Province, China. This prediction model can help human resource managers take appropriate actions to reduce the rate of construction manager turnover and keep good construction managers.

Waist circumference has heterogeneous impact on development of diabetes in different populations : Longitudinal comparative study between Australia and Iran

Aims : Comparing waist circumference (WC) role in diabetes risk prediction and diagnosis of metabolic syndrome (MS) in different populations.

Methods : Population-based samples from Australia (n = 9026) and Iran (n = 8259) were studied in 2000 and followed for 4 years. Follow-up attendance was 58% and mean age was 51 vs. 47. Pearson correlations calculated between WC and other MS components. ROC for the role of WC in the prediction of incident diabetes was used.

Results : Prevalences of MS (48% vs. 28%), an increased WC (58.5% vs. 54.5%), low HDL-C (35% vs. 11.2%), high triglyceride (52.2% vs. 29.6%) were significantly higher in Iran. Fasting glucose ≥5.6 mmol/L was higher in Australia (26% vs. 23%). Hypertension was no different (38%). Pearson correlations between WC and other MS components were stronger in Australians: FPG (0.32 vs. 0.2), HDL (0.47 vs. 0.16), TG (0.38 vs. 0.30) and SBP (0.38 vs. 0.36). Among women, area under ROC curve for WC as a predictor for diabetes was significantly higher for Australians (0.76 vs. 0.68, p < 0.001) with no difference among men (0.69 vs. 0.71, p = 0.4).

Conclusion : WC was more strongly related to other components of MS in Australia. Association between WC and MS or incident diabetes varies between ethnicities.

Offender reintegration : an RNR-GLM framework

According to the Good Lives Model, the inability to meet human needs in an adaptive manner - through lack of suitable circumstances, abilities, or opportunity - compels the individual to address this deficiency through other (maladaptive) means available to them. Thus the GLM contends that offending behavior serves a specific function and that different behaviors (crimes) are used to meet different needs. This presentation will discuss how the Good Lives Model can be used, in conjunction with that of the Risk-Needs Model, in a prison service. The combined model develops and implements programming for offenders prior to release into the community by mapping the offender's offence, social and psychological history against the secondary goods described in the Good Lives Model (i.e., the concrete means by which primary goods or human needs can be achieved), with identified deficits in secondary goods being the focus of intervention.

Motivating offenders to change in therapy: an organizing framework

Objectives. Motivating offenders to change in therapy is an important aspect of effective offender treatment, yet despite this, offenders' motivation to change has received little close attention in the academic and professional literature. This situation is a result of an over-emphasis on the risk management model of rehabilitation, and a consequent failure to construe motivation within an overarching theory of offender rehabilitation.

Method. We present a social cognitive model of offender motivation — the Good Lives Model (GLM) — that provides a framework for incorporating factors that have been shown to be of importance in enhancing offender motivation. This is based upon the notion that all humans strive to achieve primary goods that are intrinsically rewarding and essential to well-being. Where offenders are concerned, criminogenic problems relate, not to the goods offenders seek, but to the way they seek them. Any treatment approach should take this into account and focus positively on equipping people with the skills required to achieve goals rather than simply look to manage risk. The motivational construct that we use here is that of goals. In the GLM, goals are the less abstract depictions of primary human goods and it is with these that people are typically engaged in their day-to-day activities and lives. Looking at therapeutic goal-setting, methods and styles of therapy, and therapist approaches, we derive theoretically-based key issues in motivating offenders to change in therapy.

Conclusion. In conclusion, we present a summary of 12 strategies and techniques that will not only help practitioners enhance their therapeutic effectiveness, but hopefully also act as a catalyst in the development of research on offenders' motivation to change.

Antidepressants and suicidal thought

The association of antidepressants with suicidal thought in people aged up to 25 year is a thorny issue. Balancing risk with benefit must always be at the core of any decision to treat and when the risk is an increased risk of suicide then a balanced decision can be difficult to make. Some clinicians who have been successfully treating patients using antidepressants have felt skepticism with these studies, finding them to be not reflective of their personal clinical experience. It may be wondered by some whether highlighting the link between suicidal thoughts and antidepressants may paradoxically lead to an increase in suicide by reducing the number of cases treated, however there is no evidence that this has occurred.

The association between antidepressants and suicidal thought may be unpalatable, but as with all new research the only way it can be judged is by the evidence to support it. The weight of evidence to demonstrate the association between antidepressants and suicidal thought in young people is convincing although the risk is low, estimated at one case of emerging suicidal ideation or suicide attempt for every 143 pediatric patients treated [1]. This risk is too low to displace antidepressants as the first line of treatment for depression but is too high a risk to be ignored. The risk is also too low to be recognized based on clinical experience alone as it is low enough to be imperceptible amongst suicides which occur due to depressive illness independent of antidepressant treatment. Only large studies are sufficiently powered to detect suicidal thought associated with antidepressant treatment. Clearly further studies would be helpful, especially if they can help characterize those at greatest risk. This is why the study by Lucy Goldsmith and Joanna Moncrieff in this issue of Current Drug Safety is an important step towards improving our understanding of antidepressant safety. These researchers find a link between increased suicidal impulses and emotional blunting and emotional instability.

Treating clinicians are urged to monitor for risk of suicide after initiation of antidepressant treatment, typically more frequently for the first four weeks of treatment and as indicated thereafter. However, if there is no history of suicidal thought or attempt and the patient does not admit to suicidal thought, suicidality may be missed by the treating clinician, ending in tragedy. Studies that provide new insights into this serious problem may lead to improvements in the effectiveness of monitoring patients for suicide risk, ultimately leading to better outcomes for patients.