A comparison of Australian rural and metropolitan cardiovascular risk and mortality: the Greater Green Triangle and North West Adelaide population surveys

Objectives:
Cardiovascular (CVD) mortality disparities between rural/regional and urban-dwelling residents of Australia are persistent. Unavailability of biomedical CVD risk factor data has, until now, limited efforts to understand the causes of the disparity. This study aimed to further investigate such disparities.

Modelling urban growth futures within inner metropolitan Melbourne

In the light of the Victorian State Government's move towards the development of 'Plan Melbourne' - a new metropolitan planning strategy currently being prepared to take Melbourne forward to 2050 - the following paper attempts to address the issue of how an inner city target of 90,000 new dwellings (Inner Metropolitan Action Plan - IMAP Strategy 5) will impact on existing inner Melbourne activity centres. Working with the prospect of establishing a more compact city within the inner Melbourne region, the paper will focus on key suburbs within the Port Phillip area. Working with a 'Housing Variance Model' based on household structure and dwelling type, the paper will attempt to assess the impact on urban morphology as capacity is progressively altered through a range of built form permutations.

Sustainable planning and design of large-scale metropolitan development projects

Actors in the built environment are increasingly considering environmental issues alongside functional and economic aspects of development projects. However, to date in Australia and internationally, there have been few practical examples of integrated applications of sustainability principles in the built environment across all lifecycle phases. In response to this gap, this paper proposes a conceptual framework based on the principal that early intervention is the most cost-effective and efficient means of implementing effective strategies for sustainability. A strategic environmental assessment (SEA) approach is forwarded as an umbrella analytical framework, assembled from analytical methods which are strategically 'tiered' to inform stages of the project decision-making process. Practically applied and timed accordingly, the framework can allow assessments to be targeted towards appropriate decision making levels and enable better decision-making and more efficient resource allocation for major infrastructure development projects.

Working with 'housing variance' to model urban growth futures with inner metropolitan Melbourne

Continued population growth in Melbourne over the past decade has led to the development of a range of strategies and policies by State and Local levels of government to set an agenda for a more sustainable form of urban development. As the Victorian State government moves towards the development of 'Plan Melbourne', a new metropolitan planning strategy currently being prepared to take Melbourne forward to 2050, the following paper addresses the issue of how new residential built form will impact on and be accommodated in existing Inner Melbourne activity centres. Working with the prospect of establishing a more compact city in order to meet an inner city target of 90,000 new dwellings (Inner Metropolitan Action Plan - IMAP Strategy 5), the paper presents a 'Housing Variance Model' based on household structure and dwelling type. As capacity is progressively altered through a range of built form permutations, the research attempts to assess the impact on the urban morphology of a case study of four Major Activity Centres in the municipality of Port Phillip.

A protocol for a discrete choice experiment: understanding preferences of patients with cancer towards their cancer care across metropolitan and rural regions in Australia.

Medical decision-making in oncology is a complicated process and to date there are few studies examining how patients with cancer make choices with respect to different features of their care. It is also unknown whether patient choices vary by geographical location and how location could account for observed rural and metropolitan cancer differences. This paper describes an ongoing study that aims to (1) examine patient and healthcare-related factors that influence choices of patients with cancer; (2) measure and quantify preferences of patients with cancer towards cancer care using a discrete choice experiment (DCE) and (3) explore preference heterogeneity between metropolitan and rural locations.

How active are people in metropolitan parks? An observational study of park visitation in Australia

BACKGROUND: Parks are generally an under-utilized resource in the community with great potential to enhance levels of physical activity. If parks are to attract more visitors across a broad cross-section of the population and facilitate increased physical activity, research is needed to better understand park visitor characteristics and how visitors spend their time in parks. The Recording and EValuating Activity in a Modified Park (REVAMP) study is a natural experiment monitoring a park upgrade in a low socioeconomic status (SES) neighborhood. This study described the observed baseline characteristics of park visitors (age, sex) and characteristics of visitation (weekday or weekend day, period of the day) and explored how these characteristics were associated with observed park-based physical activity in two metropolitan parks located Melbourne, Australia. METHODS: Direct observations of park visitors were conducted using a modified version of SOPARC (the System for Observing Play and Recreation in Communities) on four weekdays and four weekend days. During weekdays, observations were conducted every hour from 7:30 am-4:30 pm and on weekend days from 8:30 am-4:30 pm. This equated to a total of 1460 scans across the two parks. Chi-square tests examined bivariate associations between park-based physical activity, and socio-demographic and park visitation characteristics. Logistic regression models examined the odds of being observed engaging in moderate- to vigorous-intensity physical activity relative to lying/sitting/standing according to socio-demographic and park visitation characteristics. RESULTS: In total, 4756 park visitors were observed with the majority visiting on weekend days (87 %) and in the afternoon (41 %). Most visitors (62 %) were lying, sitting or standing, with only 29 % observed engaging in moderate-intensity and 9 % in vigorous-intensity physical activity. Park use differed by time of day, sex, age group, and neighborhood SES. Physical activity was lower for women than men (OR 0.76) and higher among visitors in the high SES area (OR 1.52). CONCLUSIONS: Parks offer substantial opportunities for people of all ages to engage in physical activity; however, this study showed that a large proportion of the park visitors observed were engaged in sedentary pursuits. Further research on how park design, amenities and programming can optimize park visitation and park-based physical activity is needed. TRIAL REGISTRATION: Current controlled trial ISRCTN50745547 , registration date 11.1.2014.

Exploring child dental service use among migrant families in metropolitan Melbourne, Australia

Abstract Background This study describes and explores factors related to dental service use among migrant children. Methods A cross-sectional analysis of baseline data from Teeth Tales, an exploratory trial implementing a community based child oral health promotion intervention. The sample size and target population was 600 families with 1-4 year old children from Iraqi, Lebanese and Pakistani backgrounds residing in metropolitan Melbourne. Participants were recruited into the study using purposive and snowball sampling techniques. Results Most (88%; 550/625) children had never visited the dentist (mean (SD) age 3.06 years (1.11)). In the fully adjusted model the variable most significantly associated with child dental visiting was parent reported 'no reason for child to visit the dentist' (OR = 0.07, p < 0.001). Of those children whose parents reported their child had no reason to visit the dentist, 22% (37/165) experienced dental caries with 8% (13/165) at the level of cavitation. Conclusions Dental service use by migrant preschool children was very low. The relationship between perceived dental need and dental service use is currently not aligned. One in 10 children of select migrant background had visited a dentist, which is in the context of 1 in 3 with dental caries. To improve utilization, health services should consider organizational cultural competence, outreach and increased engagement with the migrant community.

Inter-hospital 'patient expect' calls of clinical handovers for expected patients transferred from rural to metropolitan hospitals: a retrospective clinical audit

Patients requiring inter-hospital air transport across large geographical spaces are at significant risk of adverse outcomes. The aims of this study were to examine the characteristics of clinical handover conducted by telephone and subsequently transcribed in medical records during the inter-hospital transfer of rural patients, and to identify any deficits of this telephone clinical handover. A retrospective audit was conducted of transcribed telephone handovers ('patient expect' calls) occurring with inter-hospital transfers from two rural hospitals to a metropolitan tertiary hospital of all rural patients (n = 127) between January and June 2012. Patient transport between various sites occurred through the Royal Flying Doctor Service. For these hospitals, patient expect calls constituted the only handover record for clinicians during the time of patient transport. Information on patient identification stickers relating to patients' age or gender did not always correspond with details collected during patient expect calls. The name of a clinician at the receiving hospital authorising the transfer was provided in 14 calls (11.1%). It was difficult to determine who made and received calls, and who accepted responsibility for patients at the receiving site. Deterioration in a patient's condition was made in three calls. Actions to be taken after patients' arrival were included in 24 (19%) calls. Planning was restricted to identifying who to contact to review instructions. Inconsistent and overuse of abbreviations was likely to have affected the ability to accurately read back patient information. Crucial information was missing from calls, which may have contributed to delayed and inappropriate delivery of care.

Security and privacy concerns for Australian SMEs cloud adoption: empirical study of metropolitan vs regional SMEs

New national infrastructure initiatives such as the National Broadband Network (NBN) allow small and medium-sized enterprises (SMEs) in Australia to have greater access to cost effective Cloud computing. However, the ability of Cloud computing to store data remotely and share services in a dynamic environment brings with it security and privacy concerns. Evaluating these concerns is critical to address the Cloud computing underutilisation issue and leverage the benefits of costly NBN investment. This paper examines the influence of privacy and security factors on Cloud adoption by Australian SMEs in metropolitan and regional area. Data were collected from 150 Australian SMEs (specifically, 79 metropolitan SMEs and 71 regional SMEs) and structural equation modelling was used for the analysis. The findings reveal that privacy and security factors do not significantly influence the decision-making of Australian SMEs in the adoption of Cloud computing. Moreover, the results indicate that Cloud computing adoption is not influenced by the geographical location (i.e., metropolitan or regional location) of the SMEs. The findings extend the current understanding of Cloud computing adoption by Australian SMEs. The results will be useful to SMEs, Cloud service providers and policy makers devising Cloud security and privacy policies.

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.