Environmental circumstances surrounding bushfire fatalities in Australia 1901-2011

This paper describes the development and analysis of a dataset covering bushfire related life loss in Australia over the past 110 years (1901-2011). Over this time period 260 bushfires have been associated with a total of 825 known civilian and firefighter fatalities. This database was developed to provide an evidence base from which an Australian national fire danger rating system can be developed and has benefits in formalising our understanding of community exposure to bushfire. The database includes detail of the spatial, temporal and localised context in which the fatalities occurred. This paper presents the analysis of 674 civilian fatalities. The analysis has focused on characterising the relationship between fatal exposure location, weather conditions (wind speed, temperature, relative humidity and drought indices), proximity to fuel, activities and decision making leading up to the death. The analysis demonstrates that civilian fatalities were dominated by several iconic bushfires that have occurred under very severe weather conditions. The fatalities from Australia's 10 worst bushfire days accounted for 64% of all civilian fatalities. Over 50% of all fatalities occurred on days where the McArthur Forest Fire Danger Index (FFDI) exceeded 100 (the current threshold for declaring a day as 'catastrophic') proximal to the fatality. The dominant location category was open air representing 58% of all fatalities followed by 28% in structures, and 8% in vehicles (6% are unknown). For bushfires occurring under weather conditions exceeding an FFDI value of 100, fatalities within structures represented over 60% of all fatalities. These were associated with people dying while attempting to shelter mainly in their place of residence. Of the fatalities that occurred inside a structure in a location that was specifically known, 41% occurred in rooms with reduced visibility to the outside conditions. Over 78% of all fatalities occurred within 30m of the forest.12 page(s

New functional biomaterials for medicine and healthcare, 1st edition [Woodhead Publishing Series in Biomaterials, 67]

The book begins with an overview of the use of biomaterials in contemporary healthcare and the process of developing novel biomaterials; the key issues and challenges associated with the design of complex implantable systems are also highlighted. The book then reviews the main materials used in functional biomaterials, particularly their properties and applications. Individual chapters focus on both natural and synthetic polymers, metallic biomaterials, and bio-inert and bioactive ceramics

Establishing a global quality of care benchmark report

Background: the Movember funded TrueNTH Global Registry (TNGR) aims to improve care by collecting and analysing a consistent dataset to identify variation in disease management, benchmark care delivery in accordance with best practice guidelines and provide this information to those in a position to enact change. We discuss considerations of designing and implementing a quality of care report for TNGR. Methods: eleven working group sessions were held prior to and as reports were being built with representation from clinicians, data managers and investigators contributing to TNGR. The aim of the meetings was to understand current data display approaches, share literature review findings and ideas for innovative approaches. Preferred displays were evaluated with two surveys (survey 1: 5 clinicians and 5 non-clinicians, 83% response rate; survey 2: 17 clinicians and 18 non-clinicians, 93% response rate). Results: consensus on dashboard design and three data-display preferences were achieved. The dashboard comprised two performance summary charts; one summarising site’s relative quality indicator (QI) performance and another to summarise data quality. Binary outcome QIs were presented as funnel plots. Patient-reported outcome measures of function score and the extent to which men were bothered by their symptoms were presented in bubble plots. Time series graphs were seen as providing important information to supplement funnel and bubble plots. R Markdown was selected as the software program principally because of its excellent analytic and graph display capacity, open source licensing model and the large global community sharing program code enhancements. Conclusions: international collaboration in creating and maintaining clinical quality registries has allowed benchmarking of process and outcome measures on a large scale. A registry report system was developed with stakeholder engagement to produce dynamic reports that provide user-specific feedback to 132 participating sites across 13 countries.</p

Association between glycated haemoglobin and the risk of congestive heart failure in diabetes mellitus:systematic review and meta-analysis

<p>Clinical trials to date have not provided definitive evidence regarding the effects of glucose lowering on the incidence of congestive heart failure (CHF). We synthesized available prospective epidemiological data on the association between glycaemia measured by haemoglobin A(1c) (HbA(1c)) and incident CHF in individuals with diabetes.</p><p>We searched electronic databases and reference lists of selected articles for relevant prospective epidemiological studies. We abstracted data from relevant studies using standardized forms and obtained additional data from investigators when required. We pooled study-specific relative risk estimates using random-effects model meta-analysis.</p><p>Of the 1044 citations identified, we included 10 studies comprising 178 929 participants with diabetes and 14 176 incident CHF cases. Five studies included only patients with type 2 diabetes, four studies had predominantly patients with type 2 diabetes, and one study included only patients with type 1 diabetes. All studies except one showed an increased risk of CHF with higher HbA(1c). The overall adjusted risk ratio (RR) for CHF was 1.15 [95 confidence interval (CI) 1.101.21] for each percentage point higher HbA(1c). There was substantial heterogeneity across the 10 studies (I-2: 83; 95 CI 6991; P 0.001) not explained by available study-level characteristics such as study design or average HbA(1c) level. In seven studies reporting RRs with more than one degree of adjustment, the association was minimally altered after adjustment for several cardiovascular risk factors.</p><p>In observational studies of individuals with diabetes, a higher HbA(1c) level was associated with a significantly increased incidence of CHF.</p>