The risk of drought

This section of the report summarises the effect of different levels of climate change on risk of drought.

The management of adolescents at risk of suicide by Australian general practitioners: issues in practice and confidence

This study involved an anonymous survey of 41Victorian GPs regarding their diagnostic and treatment practices with adolescent patients with depression and/or suicide ideation. The results indicated that the majority of respondents correctly diagnosed the level of depression and the risk of suicide in a case scenario. Although they commonly asked some of the questions related to an assessment of suicide risk, they rarely conducted a comprehensive risk assessment and the level of referral to telephone and internet crisis services was poor. Most GPs indicated a lack of confidence in their ability to detect and manage depression and suicide in this population and strongly emphasized a need for more training.

Is the risk of illness through consuming vegetables irrigated with reclaimed wastewater different for different population groups?

The use of reclaimed wastewater for irrigation of horticultural crops is commonplace in many parts of the world and is likely to increase. Concerns about risks to human health arising from such practice, especially with respect to infection with microbial pathogens, are common. Several factors need to be considered when attempting to quantify the risk posed to a population, such as the concentration of pathogens in the source water, water treatment efficiency, the volume of water coming into contact with the crop, and the die-off rate of pathogens in the environment. Another factor, which has received relatively less attention, is the amount of food consumed. Plainly, higher consumption rates place one at greater risk of becoming infected. The amount of vegetables consumed is known to vary among ethic groups. We use Quantitative Microbial Risk Assessment Modelling (QMRA) to see if certain ethnic groups are exposed to higher risks by virtue of their consumption behaviour. The results suggest that despite the disparities in consumption rates by different ethnic groups they generally all faced comparable levels of risks. We conclude by suggesting that QMRA should be used to assess the relative levels of risk faced by groups based on divisions other than ethnicity, such as those with compromised immune systems.

Pressure injury: an exploration of the relationship between risk factors and interface pressure

Pressure injuries are a serious risk for patients admitted to hospital and are thought to result from a number of forces operating on skin tissue (pressure, shear and friction). Most research on interface pressure (IP) has taken place using healthy volunteers or mannequins. Little is currently known about the relationship between pressure injury risk and IP for hospital patients. This relationship was investigated with a sample of 121 adult hospital patients. Pressure injury risk was evaluated using the Waterlow Risk Assessment Tool (WRAT) and IP was measured at the sacrum using a Tekscan ClinSeatTM IP sensor mat. Other factors considered were body mass index (BMI), blood pressure, reason for hospital admission, comorbidities and admission route to hospital. Patients were classified according to WRAT categories (‘low risk’, ‘at risk’, ‘high risk’, ‘very high risk’) and then remained still on a standard hospital mattress for 10 minutes while IP was measured. Participants in the ‘low risk’ group were significantly younger than all other groups (p<0.001) and there were some group differences in BMI. IP readings were compared between the ‘low risk’ group and all of the participants at greater risk. The ‘low risk’ group had significantly lower IP at the sacrum on a standard hospital mattress than those at greater risk (p=0.002). Those at greater risk tended to have IP readings at the low end of the compromised IP range. This study is significant because it describes a new, clinically relevant methodology and presents findings that challenge clinician assumptions about the relationships between pressure injury risk assessment and IP.

Environmental design : incorporating a rating tool into the design of commercial buildings

Environmental performance assessment or green building rating tools for commercial buildings are one of the more recent responses to encourage green solutions for commercial buildings. This paper discusses the initial stages of a research project that looks at the impact of a rating tool, such as Green Star, on design. There are numerous ways in which an architect can design commercial buildings, but environmental design solutions have consistently failed to become accepted practice. Therefore, how will this tool be incorporated into the building design process? Developed to assist the designer can the inclusion of a rating tool such as Green Star provide an effective framework to encourage the inclusion of environmental design strategies in commercial buildings? A field study, recording the design process of a commercial building, anticipates that a whole building assessment approach towards design, as proposed through the Green Star Rating Tool, will provide an effective framework to set and monitor design targets in order to optimise the environmental design goals in commercial buildings.

Risk items associated with patient falls in oncology and medical settings

The aim of this study was to determine whether items on a falls risk-assessment tool, made up of brief cognitive and physical measures that nurses use in practice, differentiated fallers and nonfallers in oncology and medical settings. A measure of leg muscle strength clearly distinguished between fallers and nonfallers, with the latter having stronger leg muscles. For nursing practice, the assessment of patients' muscle strength seems to be the most useful scale for identifying potential fallers.

Fire fighters' assessments of fireground risk

Fire fighters are often required to work in dynamic and hazardous environments involving a high level of uncertainty. The present study investigated 110 volunteer fire fighters’ assessments of levels of risk associated with a photographic depiction of a typical grassland fire situation. The fire fighters used a standard fire agency risk-rating matrix procedure requiring them to specify the severity of the hazards depicted and the probability of a mishap in order to rate overall level of risk (1 = Low; 4 = Extreme). The risk ratings made by the fire fighters varied greatly. The overall rate of agreement with the risk level rating of the situation made by a panel of expert fire officers (=1, Low) was only 27%. It seems that use of a standard risk-rating matrix procedure by fire fighters at incidents, as recommended currently by many fire agencies, is likely to result in unreliable risk assessments, at least in the absence of effective training in the risk assessment procedure. The 110 volunteers were also asked to identify the total number of potential hazards apparent in five photographs depicting different kinds of emergency incidents. Identifying more hazards was found to be associated with (a) previous personal experience of a ‘near-miss’; and (b) higher levels of education. The findings imply that when faced with identical fire ground situations, individual fire fighters are likely to differ in their situational awareness of hazards and consequent risk assessments.

Sculpting fog: attempting to define "acceptable risk" in emergency services.

There is currently no consensus as to how “acceptable risk” should be defined in emergency service response. Attempts to address this have relied upon the assumption that a probabilistic model of risk can be calculated and that acceptable levels of risk can be determined. Examples of this process can be seen in a number of emergency services, e.g. dynamic risk assessment utilised by a number of fire services.

Safeguarding Australia from cyber-terrorism : a proposed cyber-terrorism SCADA risk framework for Australia

Terrorist groups are currently using information and communication technologies (ICTs) to orchestrate their conventional physical attacks. More recently, terrorists have been developing a new form of capability within the cyber-arena to coordinate cyber-based attacks. This paper identifies that cyber-terrorism capabilities are an integral, imperative, yet under-researched component in establishing, and enhancing cyber-terrorism risk assessment models for SCADA systems. This paper is an extension of work previously published by Beggs and
Warren 2008, it presents a high level overview of a cyber-terrorism SCADA risk framework that has been adopted and validated by SCADA industry practitioners. The paper proposes a managerial framework which is designed to measure and protect SCADA systems from the threat of cyber-terrorism within Australia. The findings and results of an industry focus group are presented in support of the developed framework for SCADA industry adoption and acceptance.

Design-related bias in hospital fall risk screening tool predictive accuracy evaluations: systematic review and meta-analysis.

Introduction: Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals. Design-related bias in evaluations of tool predictive accuracy could lead to overoptimistic results, which would then contribute to program failure in practice.

Methods: A systematic review was undertaken. Two blind reviewers assessed the methodology of relevant publications into a four-point classification system adapted from multiple sources. The association between study design classification and reported results was examined using linear regression with clustering based on screening tool and robust variance estimates with point estimates of Youden Index (= sensitivity + specificity - 1) as the dependent variable. Meta-analysis was then performed pooling data from prospective studies.

Results: Thirty-five publications met inclusion criteria, containing 51 evaluations of fall risk screening tools. Twenty evaluations were classified as retrospective validation evaluations, 11 as prospective (temporal) validation evaluations, and 20 as prospective (external) validation evaluations. Retrospective evaluations had significantly higher Youden Indices (point estimate [95% confidence interval]: 0.22 [0.11, 0.33]). Pooled Youden Indices from prospective evaluations demonstrated the STRATIFY, Morse Falls Scale, and nursing staff clinical judgment to have comparable accuracy.

Discussion: Practitioners should exercise caution in comparing validity of fall risk assessment tools where the evaluation has been limited to retrospective classifications of methodology. Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular settings, but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment.

Assessing risk for sexual offenders in New Zealand : development and validation of a computer-scored risk measure

A growing research base supports the predictive validity of actuarial methods of risk assessment with sexual offenders. These methods use clearly defined variables with demonstrated empirical association with re-offending. The advantages of actuarial measures for screening large numbers of offenders quickly and economically are further enhanced when the variables used can be extracted from existing electronic databases. This study reports the results of applying a computerized set of historical variables with a sample of 1,133 male sexual offenders released from prison by the New Zealand Department of Corrections. Area under the curve figures of 0.70-0.78 were obtained over periods of 5 to 15 years, reflecting a significant level of association with sexual recidivism. Detected rates of re-offending across risk levels were comparable to those previously reported for the Static-99. Rates of sexual re-offending by child molesters for all sexual offences and offences against child victims are reported separately.

Assessment and case conceptualization in sex offender treatment

The assessment of sexual offenders consists of the systematic collection of clinically relevant information in order to detect clinical phenomena or problems and to provide clear treatment targets. The result of this process is a conceptual model, or case formulation, representing the client’s various problems, the hypothesized underlying mechanisms, and their interrelationships. The focus of this article is on the importance of psychological assessment and case formulation in the rehabilitation and management of individuals convicted of sexual offences. First, we make a number of general points about the importance of evidence based assessment and clinical reasoning in case formulation. Second, we review key elements of contemporary sexual offender theory that highlights the heterogeneity evident among sex offenders and the implications for case formulation and treatment planning. Third, we discuss the role of case formulation for risk assessment and management. Finally, we illustrate our major points with a brief case study and conclude with a brief consideration of the value of case formulations.

Risk of sexual recidivism as a function of age and actuarial risk

The study of risk for sexual recidivism has undergone substantial development in recent years. The foundation for advances in this area has been the use of actuarial measures to identify subgroups of offenders with different observed rates of sexual re-offending over time. An unresolved issue within this research area has been the moderating function of age in the assessment of risk. The current study examined sexual re-offending as a function of age and actuarial risk in a large sample of sexual offenders released from prison between 1990 and 2004. There was an overall decrease in the rate of sexual re-offending over the age of 50. However, a small group of offenders from the higher actuarial risk categories of the older age groups continued to re-offend at higher rates than their lower-risk peers.

Identifying and managing low money laundering risk : perspectives on FATF's risk-based guidance

Purpose – The purpose of this paper is to investigate Financial Action Task Force (FATF)'s risk-based guidance to combat money laundering and terrorist financing to determine its approach to the identification and management of low-risk providers, products and transactions.

Design/methodology/approach – The paper analyses the relevant FATF recommendations and its guidance notes and reflects on key questions for regulators and financial institutions.

Findings – FATF has not defined “risk” for purposes of the risk-based approach. The absence of a clear definition complicates the identification of low-risk products. FATF do provide an example of a risk matrix that can be used to identify low-risk banks, but the example is based on assumptions and generalisations that are not sustainable. In addition, it identifies certain low-value transactions as “low risk” transactions. The paper reflects on the role of value as an indicator of risk and concludes with a number of suggestions to clarify the conceptual framework.

Originality/value – Low-risk products and transactions are often overlooked because the risk-based approach focuses attention on high-risk matters. Low-risk products are however crucial to the efforts to increase financial inclusion. The paper identifies gaps in the current conceptual framework and indicates ways in which they can be addressed.

Is jump risk in iTraxx Sector Indices diversifiable?

The article presents an analysis of jump risks in iTraxx Europe index in a multivariate structural time-series setting for the stochastic process, as well as in the credit default swap (CDS) market. It also examines the rapid development of the credit derivatives market, particularly the CDS market. This analysis found a significant Poisson-distributed jumps in the iTraxx Non-Financials index and its subindices. Based on a statistical analysis, nondiversifiable jump risk strongly exists in the CDS market.