Principals and legal risks: contrasting perspectives

There has been an increasing awareness across many jurisdictions of potential legal issues that might arise in schools. These issues range from bullying to sexual misconduct, from injury to negligence. In a recent study in Singapore, despite the increased attention to such issues, school principals displayed a range of attitudes toward legal risk and a diverse range of strategies to minimise it. The findings were compared to those from a small scale study of senior educators in Australia in order to ascertain commonalities and differences of view. This paper summarises those views and suggests some basic principles to help those in positions of leadership to avert unwanted legal attention.

Characterization and prediction of issue-related risks in software projects

Identifying risks relevant to a software project and planning measures to deal with them are critical to the success of the project. Current practices in risk assessment mostly rely on high-level, generic guidance or the subjective judgements of experts. In this paper, we propose a novel approach to risk assessment using historical data associated with a software project. Specifically, our approach identifies patterns of past events that caused project delays, and uses this knowledge to identify risks in the current state of the project. A set of risk factors characterizing “risky” software tasks (in the form of issues) were extracted from five open source projects: Apache, Duraspace, JBoss, Moodle, and Spring. In addition, we performed feature selection using a sparse logistic regression model to select risk factors with good discriminative power. Based on these risk factors, we built predictive models to predict if an issue will cause a project delay. Our predictive models are able to predict both the risk impact (i.e. the extend of the delay) and the likelihood of a risk occurring. The evaluation results demonstrate the effectiveness of our predictive models, achieving on average 48%-81% precision, 23%-90% recall, 29%-71% F-measure, and 70%-92% Area Under the ROC Curve. Our predictive models also have low error rates: 0.39-0.75 for Macro-averaged Mean Cost-Error and 0.7-1.2 for Macro-averaged Mean Absolute Error.

Higher dietary calcium intakes are associated with reduced risks of fractures, cardiovascular events, and mortality: a prospective cohort study of older men and women

The aim of this population-based, prospective cohort study was to investigate long-term associations between dietary calcium intake and fractures, non-fatal cardiovascular disease (CVD), and death from all causes. Participants were from the Melbourne Collaborative Cohort Study, which was established in 1990 to 1994. A total of 41,514 men and women (∼99% aged 40 to 69 years at baseline) were followed up for a mean (SD) of 12 (1.5) years. Primary outcome measures were time to death from all causes (n = 2855), CVD-related deaths (n = 557), cerebrovascular disease-related deaths (n = 139), incident non-fatal CVD (n = 1827), incident stroke events (n = 537), and incident fractures (n = 788). A total of 12,097 participants (aged ≥50 years) were eligible for fracture analysis and 34,468 for non-fatal CVD and mortality analyses. Mortality was ascertained by record linkage to registries. Fractures and CVD were ascertained from interview ∼13 years after baseline. Quartiles of baseline energy-adjusted calcium intake from food were estimated using a food-frequency questionnaire. Hazard ratios (HR) and odds ratios (OR) were calculated for quartiles of dietary calcium intake. Highest and lowest quartiles of energy-adjusted dietary calcium intakes represented unadjusted means (SD) of 1348 (316) mg/d and 473 (91) mg/d, respectively. Overall, there were 788 (10.3%) incident fractures, 1827 (9.0%) incident CVD, and 2855 people (8.6%) died. Comparing the highest with the lowest quartile of calcium intake, for all-cause mortality, the HR was 0.86 (95% confidence interval [CI] 0.76-0.98, ptrend  = 0.01); for non-fatal CVD and stroke, the OR was 0.84 (95% CI 0.70-0.99, ptrend  = 0.04) and 0.69 (95% CI 0.51-0.93, ptrend  = 0.02), respectively; and the OR for fracture was 0.70 (95% CI 0.54-0.92, ptrend  = 0.004). In summary, for older men and women, calcium intakes of up to 1348 (316) mg/d from food were associated with decreased risks for fracture, non-fatal CVD, stroke, and all-cause mortality.

Multiple states of financially distressed companies: Tests using a competing-risks model

This study examines the determinants of multiple states of financial distress by applying a competing-risks model. It investigates the effect of financial ratios, market-based variables and company-specific variables, including company age, size and squared size on three different states of corporate financial distress: active companies; distressed external administration companies; and distressed takeover, merger or acquisition companies. A sample of 1,081 publicly listed Australian non-financial companies over the period 1989 to 2005 using a competing-risks model is used to determine the possible differences in the factors of entering various states of financial distress. It is found that specifically, distressed external administration companies have a higher leverage, lower past excess returns and a larger size; while distressed takeover, merger or acquisition companies have a lower leverage, a higher capital utilisation efficiency and a larger size compared to active companies. Comparing the results from both the single-risk model and the competing-risks model reveals the need to distinguish between financial distress states.

Young people's perceptions of the risks of methamphetamine use in Adelaide nightclubs: a quantitative study

Understanding young people’s perceptions of the risks associated with the use of methamphetamines is an important but under-researched area. Precisely how these young people use the space of Adelaide nightclubs, perceive such drug risks, employ risk management strategies and how these factors interact to influence their experience of methamphetamines in the nightclub is largely unknown. This article presents self-report data drawn from a sample of 457 young people who completed the Perception of Risk survey questionnaire while waiting to enter one of five key Adelaide nightclubs in 2010. Participants were examined in terms of gender, age, drug use history, motivations for nightclub attendance and frequency of nightclub attendance. Approximately one-fifth of the sample reported using methamphetamines (21.0 percent).Participants demonstrated a pattern of attendance at Adelaide nightclubs that reflects a broader understanding of the important role of the nightclub in their social lives, which for some also involves the use of methamphetamines. Specifically, participants’ motivations for ‘nightclubbing’ concern the consumption of leisure and are guided by social group membership, in which methamphetamine use is not prioritised, as evident in the development of knowledge and risk management strategies to ensure safe consumption in the club. Perceptions of risk reflect concern surrounding unregulated methamphetamine use, as well as gendered concerns linked to safety and the prevalence of alcohol misuse, violence, drink spiking, physical injury and sexual assault. These findings were consistent across the sample, suggesting a shift in youth nightclub culture that has numerous implications for understanding and reducing the use of methamphetamines and regulation of the night-time economy generally, which are discussed herein.

Nursing handover from ICU to cardiac ward: standardised tools to reduce safety risks

BACKGROUND: Standardising handover processes and content, and using context-specific checklists are proposed as solutions to mitigate risks for preventable errors and patient harm associated with clinical handovers. OBJECTIVES: Adapt existing tools to standardise nursing handover from the intensive care unit (ICU) to the cardiac ward and assess patient safety risks before and after pilot implementation. METHODS: A three-stage, pre-post interrupted time-series design was used. Data were collected using naturalistic observations and audio-recording of 40 handovers and focus groups with 11 nurses. In Stage 1, examination of existing practice using observation of 20 handovers and a focus group interview provided baseline data. In Stage 2, existing tools for high-risk handovers were adapted to create tools specific to ICU-to-ward handovers. The adapted tools were introduced to staff using principles from evidence-based frameworks for practice change. In Stage 3, observation of 20 handovers and a focus group with five nurses were used to verify the design of tools to standardise handover by ICU nurses transferring care of cardiac surgical patients to ward nurses. RESULTS: Stage 1 data revealed variable and unsafe ICU-to-ward handover practices: incomplete ward preparation; failure to check patient identity; handover located away from patients; and information gaps. Analyses informed adaptation of process, content and checklist tools to standardise handover in Stage 2. Compared with baseline data, Stage 3 observations revealed nurses used the tools consistently, ward readiness to receive patients (10% vs 95%), checking patient identity (0% vs 100%), delivery of handover at the bedside (25% vs 100%) and communication of complete information (40% vs 100%) improved. CONCLUSION: Clinician adoption of tools to standardise ICU-to-ward handover of cardiac surgical patients reduced handover variability and patient safety risks. The study outcomes provide context-specific tools to guide handover processes and delivery of verbal content, a safety checklist, and a risk recognition matrix.

Sound the alarm: health and safety risks associated with alarm response for salaried and retained metropolitan firefighters

Responding to an emergency alarm poses a significant risk to firefighters' health and safety, particularly to cardiovascular health, physical and psychological stress, and fatigue. These risks have been largely categorised for salaried firefighters working 'on station'. Less is known about the factors that contribute to these risks for the vast number of non-salaried personnel who serve in retained roles, often deploying from home. The present study investigated the alarm response procedure for Australian metropolitan fire fighters, identifying common and divergent sources of risk for salaried and retained staff. There were significant differences in procedure between the two workgroups and this resulted in differences in risk profile between groups. Sleep and fatigue, actual response to the alarm stimulus, work-life balance and trauma emerged as sources of risk experienced differently by salaried and retained firefighters. Key findings included reports of fatigue in both groups, but particularly in the case of retained firefighters who manage primary employment as well as their retained position. This also translated into a poor sense of work-life balance. Both groups reported light sleep, insufficient sleep or fragmented sleep as a result of alarm response. In the case of salaried firefighters, this was associated with being woken on station when other appliances are called. There were risks from physical and psychological responses to the alarm stimulus, and reports of sleep inertia when driving soon after waking. The findings of this study highlight the common and divergent risks for these workgroups, and could be used in the ongoing management of firefighters' health and safety.

A review of vulnerability and risks for schizophrenia: beyond the two hit hypothesis

Schizophrenia risk has often been conceptualized using a model which requires two hits in order to generate the clinical phenotype-the first as an early priming in a genetically predisposed individual and the second a likely environmental insult. The aim of this paper was to review the literature and reformulate this binary risk-vulnerability model. We sourced the data for this narrative review from the electronic database PUBMED. Our search terms were not limited by language or date of publication. The development of schizophrenia may be driven by genetic vulnerability interacting with multiple vulnerability factors including lowered prenatal vitamin D exposure, viral infections, smoking intelligence quotient, social cognition cannabis use, social defeat, nutrition and childhood trauma. It is likely that these genetic risks, environmental risks and vulnerability factors are cumulative and interactive with each other and with critical periods of neurodevelopmental vulnerability. The development of schizophrenia is likely to be more complex and nuanced than the binary two hit model originally proposed nearly thirty years ago. Risk appears influenced by a more complex process involving genetic risk interfacing with multiple potentially interacting hits and vulnerability factors occurring at key periods of neurodevelopmental activity, which culminate in the expression of disease state. These risks are common across a number of neuropsychiatric and medical disorders, which might inform common preventive and intervention strategies across non-communicable disorders.

The microbiome: a biological mechanism underpinning the social gradient of musculoskeletal conditions?

We read with interest the article by Steves et al, published in J Bone Miner Res, 2016; 31(2):261-269 (1). The authors review available evidence and suggest that the modifiable nature of the gut microbiome (GM) provides a potential therapeutic target to intervene in musculoskeletal conditions of aging.

Why do hospitalized older adults take risks that may lead to falls?

Background: The behaviour of hospitalized older adults can contribute to falls, a common adverse event during and after hospitalization. Objective: To understand why older adults take risks that may lead to falls in the hospital setting and in the transition period following discharge home. Design: Qualitative research. Setting and participants: Hospital patients from inpatient medical and rehabilitation wards (n = 16), their informal caregivers (n = 8), and health professionals (n = 33) recruited from Southern Health hospital facilities, Victoria, Australia. Main variables studied: Perceived motivations for, and factors contributing to risk taking that may lead to falls. Main outcome measures: Semi-structured, in depth interviews and focus groups were used to generate qualitative data. Interviews were conducted both 2 weeks post-hospitalization and 3 months post-hospitalization. Results: Risk taking was classified as; (i) enforced (ii) voluntary and informed and (iii) voluntary and mal informed. Five key factors that influence risk taking behaviour were (i) risk compensation ability of the older adult, (ii) willingness to ask for help, (iii) older adult desire to test their physical boundaries, (iv) communication failure between and within older adults, informal care givers and health professionals and (v) delayed provision of help. Discussion and Conclusion: Tension exists between taking risks as a part of rehabilitation and the effect it has on likelihood of falling. Health professionals and caregivers played a central role in mitigating unnecessary risk taking, though some older adults appear more likely to take risks than others by virtue of their attitudes.

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Methods: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian metaregression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. Findings: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. Interpretation: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.

An investigation into health and safety risks associated with deconstruction

As a response to calls for making construction activities environmentally conscious, alternatives to mechanical demolition such as deconstruction, recycling and reuse for re-entering building materials and components back in to the supply chain have emerged. However, deconstruction has remained unexploited within the construction industry due to the adverse effects of barriers and challenges that make demolishing contractors shy away from implementing deconstruction in projects. On assessment of the barriers/challenges facing deconstruction it was revealed that deconstruction, like all construction activities, is fraught with various health and safety hazards. This study attempts to identify the role of health and safety risks in impeding the widespread implementation of deconstruction practices in construction projects. Afterwards, major health and safety risks associated with deconstruction activities are identified. Findings of the present study are based on the results acquired through conducting unstructured interviews with 6 demolition contractors in South Australia. The study contributes to the body of knowledge by further establishing the deconstruction field and providing a basis for future investigations into barriers of deconstruction. Further, presented discussions would provide professional implications by offering guidelines for managing deconstruction projects in a safer and more efficient environment.