A configural model of expert judgement as a preliminary epidemiological study of injury problems: an application to drowning

Robust epidemiological studies identifying determinants of negative health outcomes require significant research effort. Expert judgement is proposed as an efficient alternative or preliminary research design for risk factor identification associated with unintentional injury. This proposition was tested in a multi-factorial balanced experimental design using specialist judges (N = 18), lifeguards and surfers, to assess the risk contribution to drowning for swimming ability, surf bathing experience, and wave height. All factors provided unique contributions to drowning risk (p < .001). An interaction (p = .02) indicated that occasional surf bathers face a proportionally increased risk of drowning at increased wave heights relative to experienced surf bathers. Although findings were limited by strict criteria, and no gold standard comparison data were available, the study provides new evidence on causal risk factors for a drowning scenario. Countermeasures based on these factors are proposed. Further application of the method may assist in developing new interventions to reduce unintentional injury

Surf Bather Drowning Risk and Exposure-Related Factors Identified by an Expert Panel

In the absence of an established literature, identifying and quantifying surf bather drowning risk factors requires a clearly defined problem-focused research strategy. To initiate this strategy, nominal group technique (NGT) was used to identify and rank risk and water exposure-related factors based on consensus of an expert panel. The results identified, in order, level of experience (encompassing swimming ability in surf conditions), lack of local knowledge (encompassing awareness of surf hazards, including rip currents), and surf conditions (encompassing prevailing wave height and rip currents) as the three most influential surf bather drowning risk factors. Factors most influential on exposure to water were identified and ranked as prevailing weather, geographic location (encompassing bather accessibility to the beach), and infrastructure (encompassing the presence of artificial beach amenities). This study provides direction for future analytic epidemiological research and complementary studies on drowning at surf beaches and other locations

Drowning risk analysis comparing surf bather subgroups

The study assessed the utility of risk analysis for advancing knowledge on drowning risk factors. The setting was unintentional drowning of surf bathers in Australia. Bathers reported earlier exposure to selected risk factors (swimming ability, wave height associated with rip currents and surf bathing experience) and were observed for water exposure (in minutes). These data were then assembled in mathematical models. The analysis forecast relative drowning risk pertaining to risk markers representing selected surf bather subgroups (gender, age and water activity). Contextualized through previous study findings, comparison of results with a gold standard obtained from mortality data generated new surf bather drowning hypotheses suitable for future testing by rigorous analytical epidemiologic designs. The hypotheses were: (1) The male to female comparative surf bather drowning rate is explained primarily by differences in crude water exposure; (2) the association of cardio-vascular medical conditions with surf bather drowning is stronger for older surf bathers compared to younger surf bathers; and (3) other risk contributors to surf bather drowning are: Poorly calibrated perception of bathing ability (overconfidence) and use of alcohol. Nonetheless, drowning rates appear generally consistent with time exposure to water. The study findings may also support drowning prevention strategies targeting risk marker subgroups

Key issues of health and safety for workers in residential aged care: An expert study

Introduction: Residential aged care (RAC) represents a fast-growing sector within Australia's health care system and is characterized by high levels of workplace injury. To better understand this injury problem, this study investigated key informant perspectives concerning sector occupational health and safety (OHS) focused on key issues associated with the risk of worker injury. Method: Semi-structured interviews were undertaken with nine key informants representing (OHS) specialists, healthcare employers, regulators, worker association representatives, and academic researchers in OHS or healthcare. Interviews were transcribed verbatim and analyzed using thematic analysis. Results: This study identified six themes on OHS within RAC including (i) the physical and emotional nature of the work, (ii) casualization of employment, (iii) prioritization, (iv) workforce profile, (v) OHS role construction, and (vi) clinical standards. The study highlighted differences in OHS roles between RAC and other safety-critical sectors regarding governance and management of OHS. The key informants identified a propensity within RAC to downplay or disregard worker OHS issues justified through prioritizing resident safety. Further, neither OHS professional nor institutional logics are prominent in RAC leadership and decision-making where the emphasis is placed on mandatory standards to maintain funding purposes. Several recommendations are made to address identified issues

Rock fisher behaviours and perceptions regarding drowning risk assessed by direct observation and self-report: a public awareness campaign evaluation

Issue addressed: Participants engaged in rock fishing are at risk of drowning. Following coronial investigation of fatalities, a 3-year safety campaign targeting rock fishers was developed in Victoria, Australia. Key campaign messages were wearing lifejackets, not fishing alone, and checking sea and weather conditions. The reported study provides results from a campaign evaluation. Methods: Evaluation by self-report and direct observation of safety attitudes and behaviours was undertaken pre-and during campaign. Data collections were as follows: (a) online survey of rock fishers recruited from panels, social media and rock fishing networks (n = 350) and (b) rock fisher direct observation and self-report at selected Victorian rock fishing platforms (n = 282; n = 58, respectively). Results: Safety message recall was reported by 51.7% of rock fishers surveyed online though far fewer recalled campaign key messages. No effect on key safety behaviours or attitudes were detected for fishers on platforms during campaign. Never wearing a lifejacket was reported by 31.8% online, 60.3% at platforms and observed for 97.4%. From direct observation, most participants did not fish alone and checked conditions on arrival. Conclusion: Campaign evaluation measures showed mixed outcomes. Irrespective, most rock fishers carry high drowning risk through failure to wear lifejackets. Legal mandating of lifejackets for identified high-risk platform is being introduced for Victoria, although careful evaluation is required to detect unanticipated outcomes. Informing future campaign evaluation, complementary methods highlight likely bias in self-reporting through faulty recall or social desirability. So what?: Future campaigns require innovative or novel design, over longer duration,to capture attention and change rock fisher behaviours

The social justice issues of smoke im/mobilities

In 2014, the Hazelwood mine fire burned for 45 days. Local communities were impacted by smoke and ash, and there were reports of raised carbon monoxide levels. Local news and social media reported residents experiencing numerous physical symptoms of smoke inhalation, including bleeding noses, coughing, wheezing and chest tightness. Paper masks to filter particulate matter were made available to residents to wear outside. The dust and ash constantly seeped into homes and offices, which required cleaning daily and sometimes multiple times during the day. Smoke was free to move across physical and bodily boundaries while those most vulnerable were hampered by lack of movement: pregnant women, the elderly and children were advised to leave the area. However, this suggestion to ‘simply’ move ignored the context of a community disproportionately impacted through years of economic decline and societal change. This paper explores the unequal mobilities of smoke and people that arose as a result of this event and draws on concepts of mobility justice (Sheller 2018) and emergency mobilities (Adey 2016) to reflect on the political dimensions of uneven mobility in times of crisi

Implementing automated external defibrillators into community sports clubs/facilities: A cross-sectional survey of community club member preparedness for medical emergencies

Objective There is a growing focus on ensuring the availability of automated external defibrillators (AED) in sport settings to assist in preventing sudden cardiac death. For the AED to be most effective, understanding how best to integrate it with wider risk management and emergency action plans (EAP) is needed. The aim of this survey was to identify sports club/facility member knowledge of AED use and club EAPs, 6 months following participation in a government-funded AED provision and cardiopulmonary resuscitation training programme. Methods Cross-sectional survey of community sports clubs and facilities in Victoria, Australia. Included participants were members of sports club/facilities that had been provided with an AED and basic first aid training as part of a government programme to increase access to, and awareness of, AEDs. A descriptive analysis of availability of EAPs and AEDs, together with practical scenarios on AED use and maintenance, is presented. Results From 191 respondents, more than half (56%) had no previous training in AED use. Knowledge on availability of an EAP at the club/facility was varied: 53% said yes and knew where it was located, while 41% did not have, or did not know if they had, an EAP. Responses to clinical scenarios for use of AED were mostly accurate, with the exception of being unsure how to respond when ‘a participant falls to the ground and is making shaking movements.’ Conclusions While there were positive outcomes from this programme, such as half of the respondents being newly trained in emergency first aid response, further improvements are required to assist members with embedding their AED into their club/facility EAP and practices

Development and trial of a water exposure measure of estimated drowning risk for surf bathers

To better address drowning issues, risk assessment at the group and sample levels would be enhanced by precise measures of exposure to water. The aim of the study was to develop and pilot test a method of measuring exposure to water based on estimating immersions for surf bathers. Validated direct observation counts provided peak-bathing period point estimates and a daily bather immersion profile for an identified sampling frame comprising 20 beaches over 39 summer days. An estimated 10,089 water immersions occurred at the peak-bathing period in the sampling frame. Swimmers comprised 86.0% and surfers with equipment 14.0% of the observed bathing sample, respectively. For swimmers only on patrolled beaches, 77.1% bathed in the lifesaver supervised (flag) zones. The study has implications for the provision of organized bather supervision and provides a foundation for generation of hypotheses on the nature of drowning risk for selected surf bather groups

Framing headship:A demand-side analysis of how the headteacher role is articulated in job descriptions

The majority of studies into recruitment to the headship role have focused on supply-side dynamics and teachers’ own accounts of the factors that (dis)incentivize them from aspiring or progressing to headship. Significantly less work has been done in analyzing demand-side factors. This paper addresses the gap by presenting findings from a mixed-methods analysis of headteacher job descriptions (n = 67) published in a complete school year within Wales – one of the UK’s devolved education systems. A discourse analysis was conducted, based on organizational and occupational conceptions of professional work, which informed a subsequent content analysis of the job descriptions. Our findings identified a dominance of articulations that privileged organizationally-orientated understandings of headship and evidence of a lack of contextualization and agency by stakeholders responsible for recruitment. Such ‘demand-side’ analysis offers scope for examining and understanding the way in which headship is framed and aligns with policy within a variety of international educational contexts and jurisdictions