Sir Neville Howse (VC), Private John Simpson Kirkpatrick and Private Martin O’Meara (VC) and their contributions to Australian military medicine

Medical personnel serving with the Defence Forces have contributed to the evolution of trauma treatment and the advancement of prehospital care within the military environment. This paper investigates the stories of an Australian Medical Officer, Sir Neville Howse, and two stretcher bearers, Private John Simpson (Kirkpatrick) and Private Martin O’Meara, In particular it describes the gruelling conditions under which they performed their roles, and reflects on the legacy that they have left behind in Australian society. While it is widely acknowledged that conflicts such as World War One should never have happened, as civilian and defence force paramedics, we should never forget the service and sacrifice of defence force medical personnel and their contribution to the body of knowledge on the treatment of trauma. These men and women bravely provided emergency care in the most harrowing conditions possible. However, men like Martin O’Meara may not have been given the same status in society today as Sir Neville Howse or Simpson and his donkey, due to the public’s lack of awareness and acceptance of war neurosis and conditions such as post traumatic stress disorder, reactive psychosis and somatoform disorders which were suffered by many soldiers during their wartime service and on their return home after fighting in war.

Driving performance on monotonous roads

Driving on motorways has largely been reduced to a lane-keeping task with cruise control. Rapidly, drivers are likely to get bored with such a task and take their attention away from the road. This is of concern in terms of road safety – particularly for professional drivers - since inattention has been identified as one of the main contributing factors to road crashes and is estimated to be involved in 20 to 30% of these crashes. Furthermore, drivers are not aware that their vigilance level has decreased and that their driving performance is impaired. Intelligent Transportation System (ITS) intervention can be used as a countermeasure against vigilance decrement. This paper aims to identify a variety of metrics impacted during monotonous driving - ranging from vehicle data to physiological variables - and relate them to two monotonous factors namely the monotony of the road design (straightness) and the monotony of the environment (landscape, signage, traffic). Data are collected in a driving simulator instrumented with an eye tracking system, a heart rate monitor and an electrodermal activity device (N=25 participants). The two monotonous factors are varied (high and low) leading to the use of four different driving scenarios (40 minutes each). We show with Generalised Linear Mixed Models that driver performance decreases faster when the road is monotonous. We also highlight that road monotony impairs a variety of driving performance and vigilance measures, ranging from speed, lateral position of the vehicle to physiological measurements such as heart rate variability, blink frequency and electrodermal activity. This study informs road designers of the importance of having a varied road environment. It also provides a range of metrics that can be used to detect in real-time the impairment of driving performance on monotonous roads. Such knowledge could result in the development of an in-vehicle device warning drivers at early signs of driving performance impairment on monotonous roads.

Parental beliefs about supervising children when crossing roads and cycling

Pedestrian and cyclist injuries are significant public health issues together accounting for 11-30% of road deaths in highly motorised countries. Children are particularly at risk. In Australia in 2009 children 0-16 years comprised 11.4% of pedestrian deaths and 6.4% of cyclist deaths. Parental attitudes and level of supervision are important to children’s road safety. Results from a telephone survey with parents of children 5-9 years (N=147) are reported. Questions addressed beliefs about preventability of injury, appropriate ages for children to cross the road or cycle independently, and the frequency of holding 5-9 year old children’s hands while crossing the road. Results suggest that parents believe most injuries are preventable and that they personally can act to improve their own safety in the home, on the road, at work, as well as in or on the water. Most parents (68%) indicated children should be 10 years or older before crossing the road or cycling independently. Parents were more likely to report holding younger children’s hands (5-6 years) when crossing the road and less likely to do so for 7-9 year olds. There was a small effect of child gender, with parents more likely to hold boy’s hand than a girl’s.

Effect of physical activity and other stressors on appetite: Overcoming underconsumption of military operational rations revisited.

Recognizing the importance of good nutrition for physical and mental status, the Department of Defense asked the Institute of Medicine to guide the design of the nutritional composition of a ration for soldiers on short-term, high-stress missions. Nutrient Composition of Rations for Short-Term, High-Intensity Combat Operations considers military performance, health concerns, food intake, energy expenditure, physical exercise, and food technology issues. The success of military operations depends to a large extent on the physical and mental status of the individuals involved.

From Civil Strife to Civil Society: civil and military responsibilities in disrupted states

"The 1990s saw the United Nations, the militaries of key member states, and NGOs increasingly entangled in the complex affairs of disrupted states. Whether as deliverers of humanitarian assistance or as agents of political, social, and civic reconstruction, whether in Somalia, Bosnia, Kosovo, or East Timor, these actors have had to learn ways of interacting with each other in order to optimize the benefits for the populations they seek to assist. Yet the challenges have proved daunting. Civil and military actors have different organizational cultures and standard operating procedures and are confronted with the need to work together to perform tasks to which different actors may attach quite different priorities."--BOOK JACKET.

Property damage crash equivalency factors to solve crash frequency-severity dilemma: Case study on South Korean rural roads

Safety interventions (e.g., median barriers, photo enforcement) and road features (e.g., median type and width) can influence crash severity, crash frequency, or both. Both dimensions—crash frequency and crash severity—are needed to obtain a full accounting of road safety. Extensive literature and common sense both dictate that crashes are not created equal, with fatalities costing society more than 1,000 times the cost of property damage crashes on average. Despite this glaring disparity, the profession has not unanimously embraced or successfully defended a nonarbitrary severity weighting approach for analyzing safety data and conducting safety analyses. It is argued here that the two dimensions (frequency and severity) are made available by intelligently and reliably weighting crash frequencies and converting all crashes to property-damage-only crash equivalents (PDOEs) by using comprehensive societal unit crash costs. This approach is analogous to calculating axle load equivalents in the prediction of pavement damage: for instance, a 40,000-lb truck causes 4,025 times more stress than does a 4,000-lb car and so simply counting axles is not sufficient. Calculating PDOEs using unit crash costs is the most defensible and nonarbitrary weighting scheme, allows for the simple incorporation of severity and frequency, and leads to crash models that are sensitive to factors that affect crash severity. Moreover, using PDOEs diminishes the errors introduced by underreporting of less severe crashes—an added benefit of the PDOE analysis approach. The method is illustrated with rural road segment data from South Korea (which in practice would develop PDOEs with Korean crash cost data).

Ions in motor vehicle exhaust and their dispersion near busy roads

Measurements in the exhaust plume of a petrol-driven motor car showed that molecular cluster ions of both signs were present in approximately equal amounts. The emission rate increased sharply with engine speed while the charge symmetry remained unchanged. Measurements at the kerbside of nine motorways and five city roads showed that the mean total cluster ion concentration near city roads (603 cm-3) was about one-half of that near motorways (1211 cm-3) and about twice as high as that in the urban background (269 cm-3). Both positive and negative ion concentrations near a motorway showed a significant linear increase with traffic density (R2=0.3 at p<0.05) and correlated well with each other in real time (R2=0.87 at p<0.01). Heavy duty diesel vehicles comprised the main source of ions near busy roads. Measurements were conducted as a function of downwind distance from two motorways carrying around 120-150 vehicles per minute. Total traffic-related cluster ion concentrations decreased rapidly with distance, falling by one-half from the closest approach of 2m to 5m of the kerb. Measured concentrations decreased to background at about 15m from the kerb when the wind speed was 1.3 m s-1, this distance being greater at higher wind speed. The number and net charge concentrations of aerosol particles were also measured. Unlike particles that were carried downwind to distances of a few hundred metres, cluster ions emitted by motor vehicles were not present at more than a few tens of metres from the road.

The impacts of traffic and rainfall characteristics on heavy metals build-up and wash-off from urban roads

An investigation into the effects of changes in urban traffic characteristics due to rapid urbanisation and the predicted changes in rainfall characteristics due to climate change on the build-up and wash-off of heavy metals was carried out in Gold Coast, Australia. The study sites encompassed three different urban land uses. Nine heavy metals commonly associated with traffic emissions were selected. The results were interpreted using multivariate data analysis and decision making tools, such as principal component analysis (PCA), fuzzy clustering (FC), PROMETHEE and GAIA. Initial analyses established high, low and moderate traffic scenarios as well as low, low to moderate, moderate, high and extreme rainfall scenarios for build-up and wash-off investigations. GAIA analyses established that moderate to high traffic scenarios could affect the build-up while moderate to high rainfall scenarios could affect the wash-off of heavy metals under changed conditions. However, in wash-off, metal concentrations in 1-75µm fraction were found to be independent of the changes to rainfall characteristics. In build-up, high traffic activities in commercial and industrial areas influenced the accumulation of heavy metal concentrations in particulate size range from 75 - >300 µm, whereas metal concentrations in finer size range of <1-75 µm were not affected. As practical implications, solids <1 µm and organic matter from 1 - >300 µm can be targeted for removal of Ni, Cu, Pb, Cd, Cr and Zn from build-up whilst organic matter from <1 - >300 µm can be targeted for removal of Cd, Cr, Pb and Ni from wash-off. Cu and Zn need to be removed as free ions from most fractions in wash-off.

Analysis of the build-up of semi and non volatile organic compounds on urban roads

Vehicular traffic in urban areas may adversely affect urban water quality through the build-up of traffic generated semi and non volatile organic compounds (SVOCs and NVOCs) on road surfaces. The characterisation of the build-up processes is the key to developing mitigation measures for the removal of such pollutants from urban stormwater. An in-depth analysis of the build-up of SVOCs and NVOCs was undertaken in the Gold Coast region in Australia. Principal Component Analysis (PCA) and Multicriteria Decision tools such as PROMETHEE and GAIA were employed to understand the SVOC and NVOC build-up under combined traffic scenarios of low, moderate, and high traffic in different land uses. It was found that congestion in the commercial areas and use of lubricants and motor oils in the industrial areas were the main sources of SVOCs and NVOCs on urban roads, respectively. The contribution from residential areas to the build-up of such pollutants was hardly noticeable. It was also revealed through this investigation that the target SVOCs and NVOCs were mainly attached to particulate fractions of 75 to 300 µm whilst the redistribution of coarse fractions due to vehicle activity mainly occurred in the >300 µm size range. Lastly, under combined traffic scenario, moderate traffic with average daily traffic ranging from 2300 to 5900 and average congestion of 0.47 was found to dominate SVOC and NVOC build-up on roads.

Analysis of build-up of heavy metals and volatile organics on urban roads in Gold Coast, Australia

Urban water quality can be significantly impaired by the build-up of pollutants such as heavy metals and volatile organics on urban road surfaces due to vehicular traffic. Any control strategy for the mitigation of traffic related build-up of heavy metals and volatile organic pollutants should be based on the knowledge of their build-up processes. In the study discussed in this paper, the outcomes of a detailed experiment investigation into build-up processes of heavy metals and volatile organics are presented. It was found that traffic parameters such as average daily traffic, volume over capacity ratio and surface texture depth had similar strong correlations with the build-up of heavy metals and volatile organics. Multicriteria decision analyses revealed that the 1 - 74 um particulate fraction of total suspended solids (TSS) could be regarded as a surrogate indicator for particulate heavy metals in build-up and this same fraction of total organic carbon could be regarded as a surrogate indicator for particulate volatile organics build-up. In terms of pollutants affinity, TSS was found to be the predominant parameter for particulate heavy metals build-up and total dissolved solids was found to be the predominant parameter for he potential dissolved particulate fraction in heavy metals build-up. It was also found that land use did not play a significant role in the build-up of traffic generated heavy metals and volatile organics.