Are we there yet? Australian road safety targets and road traffic crash fatalities

Background Road safety targets are widely used and provide a basis for evaluating progress in road safety outcomes against a quantified goal. In Australia, a reduction in fatalities from road traffic crashes (RTCs) is a public policy objective: a national target of no more than 5.6 fatalities per 100,000 population by 2010 was set in 2001. The purpose of this paper is to examine the progress Australia and its states and territories have made in reducing RTC fatalities, and to estimate when the 2010 target may be reached by the jurisdictions. Methods Following a descriptive analysis, univariate time-series models estimate past trends in fatality rates over recent decades. Data for differing time periods are analysed and different trend specifications estimated. Preferred models were selected on the basis of statistical criteria and the period covered by the data. The results of preferred regressions are used to determine out-of-sample forecasts of when the national target may be attained by the jurisdictions. Though there are limitations with the time series approach used, inadequate data precluded the estimation of a full causal/structural model. Results Statistically significant reductions in fatality rates since 1971 were found for all jurisdictions with the national rate decreasing on average, 3% per year since 1992. However the gains have varied across time and space, with percent changes in fatality rates ranging from an 8% increase in New South Wales 1972-1981 to a 46% decrease in Queensland 1982-1991. Based on an estimate of past trends, it is possible that the target set for 2010 may not be reached nationally, until 2016. Unsurprisingly, the analysis indicated a range of outcomes for the respective state/territory jurisdictions though these results should be interpreted with caution due to different assumptions and length of data. Conclusions Results indicate that while Australia has been successful over recent decades in reducing RTC mortality, an important gap between aspirations and achievements remains. Moreover, unless there are fairly radical ("trend-breaking") changes in the factors that affect the incidence of RTC fatalities, deaths from RTCs are likely to remain above the national target in some areas of Australia, for years to come.

What roles do contemporaneous and cumulative incomes play in the income–child health gradient for young children? Evidence from an Australian Panel

The literature to date shows that children from poorer households tend to have worse health than their peers, and the gap between them grows with age. We investigate whether and how health shocks (as measured by the onset of chronic conditions) contribute to the income–child health gradient and whether the contemporaneous or cumulative effects of income play important mitigating roles. We exploit a rich panel dataset with three panel waves called the Longitudinal Study of Australian children. Given the availability of three waves of data, we are able to apply a range of econometric techniques (e.g. fixed and random effects) to control for unobserved heterogeneity. The paper makes several contributions to the extant literature. First, it shows that an apparent income gradient becomes relatively attenuated in our dataset when the cumulative and contemporaneous effects of household income are distinguished econometrically. Second, it demonstrates that the income–child health gradient becomes statistically insignificant when controlling for parental health and health-related behaviours or unobserved heterogeneity.

Does school type affect cognitive and non-cognitive development in children? Evidence from Australian primary schools

This paper investigates the effects of primary school choices on cognitive and non-cognitive development in children using data from the Longitudinal Study of Australian Children (LSAC). We militate against the measurement problems that are associated with individual unobserved heterogeneity by exploiting the richness of LSAC data and applying contemporary econometric approaches. We find that sending children to Catholic or other independent primary schools has no significant effect on their cognitive and non-cognitive outcomes. The literature now has evidence from three different continents that the returns to attending Catholic primary schools are no different than public schools.

Psychological health and the risk of diabetes mellitus in Australian women: A 21-year prospective study

Background Symptoms of depression can be recurrent or limited to one episode. This study discusses the prospective association between psychological health, measured as change in depression symptoms, and the risk of diabetes mellitus in Australian women. Methods Data obtained from the Mater-University of Queensland Study of Pregnancy. Depression was measured using the Delusions-Symptoms: States Inventory. To examine possible transitions over time, depression was grouped into four categories and assessed at different phases over the 21-year period. Multiple logistic regression models and sensitivity analysis to assess the robustness of our analytical strategy were performed. Results Three hundred and one women reported diabetes 21 years after the index pregnancy. Almost one-third of the women who reported depression symptoms continued to report these at a subsequent follow-up (FU) phase. About 1 in 20 women who had not reported depression symptoms at the 5-year FU did so at the subsequent 14-year FU. In prospective analyses, we did not find a significant association between diabetes and negative change (not depressed to depressed, at subsequent phase); however, for women with positive history of symptoms of depression and women with persistent symptoms, there was a 1.97-fold (95% confidence interval [CI]: 1.14–3.40) to 2.23-fold (95% CI: 1.09–4.57) greater risk of diabetes. Conclusions Our study suggests that an increased risk of diabetes is significantly associated with persistent depression symptoms. It highlights the importance of recognizing depression symptoms in terms of women's psychological wellbeing and thus provides a basis for targeting those most at risk.

Summarising and reporting sugarcane locomotive run statistics from TOTools and GPS data

The majority of sugar mill locomotives are equipped with GPS devices from which locomotive position data is stored. Locomotive run information (e.g. start times, run destinations and activities) is electronically stored in software called TOTools. The latest software development allows TOTools to interpret historical GPS information by combining this data with run information recorded in TOTools and geographic information from a GIS application called MapInfo. As a result, TOTools is capable of summarising run activity details such as run start and finish times and shunt activities with great accuracy. This paper presents 15 reports developed to summarise run activities and speed information. The reports will be of use pre-season to assist in developing the next year's schedule and for determining priorities for investment in the track infrastructure. They will also be of benefit during the season to closely monitor locomotive run performance against the existing schedule.

Using a theory of planned behaviour framework to explore hand hygiene beliefs at the ‘5 critical moments’ among Australian hospital-based nurses

Background Improving hand hygiene among health care workers (HCWs) is the single most effective intervention to reduce health care associated infections in hospitals. Understanding the cognitive determinants of hand hygiene decisions for HCWs with the greatest patient contact (nurses) is essential to improve compliance. The aim of this study was to explore hospital-based nurses’ beliefs associated with performing hand hygiene guided by the World Health Organization’s (WHO) 5 critical moments. Using the belief-base framework of the Theory of Planned Behaviour, we examined attitudinal, normative, and control beliefs underpinning nurses’ decisions to perform hand hygiene according to the recently implemented national guidelines. Methods Thematic content analysis of qualitative data from focus group discussions with hospital-based registered nurses from 5 wards across 3 hospitals in Queensland, Australia. Results Important advantages (protection of patient and self), disadvantages (time, hand damage), referents (supportive: patients, colleagues; unsupportive: some doctors), barriers (being too busy, emergency situations), and facilitators (accessibility of sinks/products, training, reminders) were identified. There was some equivocation regarding the relative importance of hand washing following contact with patient surroundings. Conclusions The belief base of the theory of planned behaviour provided a useful framework to explore systematically the underlying beliefs of nurses’ hand hygiene decisions according to the 5 critical moments, allowing comparisons with previous belief studies. A commitment to improve nurses’ hand hygiene practice across the 5 moments should focus on individual strategies to combat distraction from other duties, peer-based initiatives to foster a sense of shared responsibility, and management-driven solutions to tackle staffing and resource issues. Hand hygiene following touching a patient’s surroundings continues to be reported as the most neglected opportunity for compliance.

Organochlorine pesticides (OCPs) and polybrominated diphenyl ethers (PBDEs) in the Australian population: Levels in human milk

This study arose out of the 2002 Review of the PCB Management Plan by the Scheduled Waste Management Network (SWMN) and the National Advisory Body (NAB). The Review indicated it would be beneficial to obtain some data on the levels of organochlorine pesticides (OCPs) in the Australian population. In 2002, the Environment Protection and Heritage Standing Committee (EPHSC) agreed and noted that the Australian Government Department of the Environment and Heritage (DEH) would commission a study using the same samples from the National Dioxins Program (NDP) breast milk study collected in 2002- 03. The study, however, was also broadened to include polybrominated diphenyl ethers (PBDEs).

Data replication and extension: A commentary

Honig and Samuelsson (2014) and Delmar (2015) recently had an exchange in this journal related to a replication-and-extension attempt of two papers which originally arrived at different conclusions based on the same data set. This commentary provides further clarification on the issues and links the debate to broader issues scholarly culture and practices in entrepreneurship research.

Sharing of clinical data in a maternity setting: How do paper hand-held records and electronic health records compare for completeness?

Background Historically, the paper hand-held record (PHR) has been used for sharing information between hospital clinicians, general practitioners and pregnant women in a maternity shared-care environment. Recently in alignment with a National e-health agenda, an electronic health record (EHR) was introduced at an Australian tertiary maternity service to replace the PHR for collection and transfer of data. The aim of this study was to examine and compare the completeness of clinical data collected in a PHR and an EHR. Methods We undertook a comparative cohort design study to determine differences in completeness between data collected from maternity records in two phases. Phase 1 data were collected from the PHR and Phase 2 data from the EHR. Records were compared for completeness of best practice variables collected The primary outcome was the presence of best practice variables and the secondary outcomes were the differences in individual variables between the records. Results Ninety-four percent of paper medical charts were available in Phase 1 and 100% of records from an obstetric database in Phase 2. No PHR or EHR had a complete dataset of best practice variables. The variables with significant improvement in completeness of data documented in the EHR, compared with the PHR, were urine culture, glucose tolerance test, nuchal screening, morphology scans, folic acid advice, tobacco smoking, illicit drug assessment and domestic violence assessment (p = 0.001). Additionally the documentation of immunisations (pertussis, hepatitis B, varicella, fluvax) were markedly improved in the EHR (p = 0.001). The variables of blood pressure, proteinuria, blood group, antibody, rubella and syphilis status, showed no significant differences in completeness of recording. Conclusion This is the first paper to report on the comparison of clinical data collected on a PHR and EHR in a maternity shared-care setting. The use of an EHR demonstrated significant improvements to the collection of best practice variables. Additionally, the data in an EHR were more available to relevant clinical staff with the appropriate log-in and more easily retrieved than from the PHR. This study contributes to an under-researched area of determining data quality collected in patient records.

Developing and evaluating approaches for utilising injury data to support product safety initiatives

With increasing concern about consumer product-related injuries in Australia, product safety regulators need evidence-based research to understand risks and patterns to inform their decision making. This study analysed paediatric injury data to identify and quantify product-related injuries in children to inform product safety prioritisation. This study provides information on novel techniques for interrogating health data to identify trends and patterns in product-related injuries to inform strategic directions in this growing area of concern.

Exploring the usefulness of structural-functional approaches to systematically assess the functionality of governance arrangements for natural resource management planning in two Australian case studies

This research developed and applied an evaluative framework to analyse multiple scales of decision-making for environmental management planning. It is the first exploration of the sociological theory of structural-functionalism and its usefulness to support evidence based decision-making in a planning context. The framework was applied to analyse decision-making in Queensland's Cape York Peninsula and Wet Tropics regions.

Non-Therapeutic Medication Omissions: Incidence and Predictors at an Australian Hospital

Background: The inconsistent definition of non-therapeutic medication omissions, under-reporting, and a poor understanding of their associated factors hamper efforts to improve medication administration practices. Aim: To examine the incidence of non-therapeutic medication omissions among acutely ill medical and surgical adult patients; and to identify the patient-, drug- and system-related predictors of these omissions. Method: A medication chart audit of 288 acutely ill adult medical and surgical patients admitted to 4 target wards (2 surgical and 2 medical) at an Australian hospital. Patients admitted to these wards from December 2008 to November 2009, with at least one regularly prescribed medication, were eligible. The sample was stratified according to gender, season and ward. A medication chart audit identified medication omissions, and data were collected on gender, age, length of stay, comorbidities, medication history and clinical pharmacy review. Results: Of the 288 medication charts audited, 220 (75%) had one or more medication omissions. Of the 15 020 medication administration episodes, there were 1687 omissions, resulting in an omission rate per medication administration episode of 11%. Analgesics and aperients were the most frequently omitted medications, with failure to sign the medication record and patient refusal, the main reasons for omission. Female gender (p < 0.001) and the number of medication administration episodes (p < 0.001) were statistically significant predictors of non-therapeutic medication omissions. Conclusion: The high incidence of medication omissions suggests there is need for an agreed definition of medication omission and its inclusion as a reportable incident. Increasing medication reconciliation via implementation of the Medication Management Plan may also reduce the opportunity for error. J Pharm Pract Res 2011; 41: 188-91.

Psychometric properties of an Australian supportive care needs assessment tool for Indigenous patients with cancer

BACKGROUND There are significant disparities in cancer outcomes between Indigenous and non-Indigenous Australians. Identifying the unmet supportive care needs of Indigenous Australians with cancer is imperative to improve their cancer care. The purpose of this study was to test the psychometric properties of a supportive care needs assessment tool for Indigenous Australian (SCNAT-IP) cancer patients. METHODS The SCNAT-IP was administered to 248 Indigenous Australians diagnosed with a range of cancer types and stages, and received treatment in one of four Queensland hospitals. All 39 items were assessed for ceiling and floor effects and analysed using exploratory factor analysis (EFA) to determine construct validity. Identified factors were assessed for internal consistency and convergent validity to validated psychosocial tools. RESULTS EFA revealed a four-factor structure (physical and psychological, hospital care, information and communication, and practical and cultural needs) explaining 51% of the variance. Internal consistency of four subscales was good, with Cronbach Alpha reliability coefficients ranging from 0.70-0.89. Convergent validity was supported by significant correlations between the SCNAT-IP with the Distress Thermometer (r=0.60, p<0.001), and The Cancer Worry Chart (r=0.58, p<0.001) and a moderately strong negative correlation with Assessment of Quality of Life questionnaire (r=-0.56, p<0.001). CONCLUSION These data provide initial support for the SCNAT-IP a measure of multiple supportive care needs domains specific to Indigenous Australian cancer patients undergoing treatment.

Improving the identification of fatigue-related crashes in the Australian Capital Territory

It has been well established nationally and internationally that fatigue-related driving is an important contributory factor in fatal and serious injury crashes. The purpose of this report was to survey a large, representative sample of residents living in both the NSW and ACT to ask about their experience of fatigue and their involvement in fatigue-related crashes and incidents. This will provide valuable data about the number and characteristics of fatigue-related crashes and incidents of ACT residents. Specifically this study assessed the prevalence of incidents of fatigue-related driving for residents of NSW and the ACT, the characteristics surrounding the incident, if the report would fit within the NSW, QLD, or ATSB proxy definition or if it would fall outside of the proxy definition...

Leaf and inflorescence structure and phylogenetics of Tripogon and affiliated genera (Poaceae: Chloridoideae)

This thesis provides new knowledge on an understudied group of grasses, some of which are resurrection grasses (i.e. able to withstand extreme drought). The sole Australian species (Tripogon loliiformis) is morphologically diverse and could be more than one species. This study sought to determine how many species of Tripogon occur in Australia, their relationships to other species in the genus and to two other genera of resurrection grasses (Eragrostiella and Oropetium). Results of the research indicate there is not enough evidence, from DNA sequence data, to warrant splitting up T. loliiformis into multiple species. The extensive morphological diversity seems to be influenced by environmental conditions. The three genera are so closely related that they could be grouped into a single genus. This new knowledge opens up pathways for future investigations, including studying genes responsible for desiccation tolerance and the conservation of native grasses that occur in rocky habitats.