Managing alcohol and drugs in event and venue settings: The australian case

© 2014 Cognizant Comm. Corp. One of the major challenges of operating events and venues is that of managing attendee/patron alcohol and drug use. In the Australian context, a rising number of alcohol and drug-related incidents in and around these settings have resulted in a renewed focus on how these negative outcomes can be more effectively controlled. In order to aid those charged with the task of addressing this matter- event and venue managers, police, security firms, alcohol and drug regulatory bodies, and governments at all levels-this article seeks to identify those variables with the potential to impact this management issue. Further, it aims to provide the previously identified stakeholders with a deeper appreciation of the raft of practices that are currently in use, and potentially available to them, as they build responses to this challenge at the individual state, precinct, venue, or event level. The research approach used involved an extensive literature review and a series of in-depth interviews with key stakeholders across three states-New South Wales, Victoria, and Western Australia

Atrial fibrillation after minimally invasive direct coronary artery bypass surgery

AbstractOBJECTIVESThe study compared the adjusted risk for developing atrial fibrillation (AF) after minimally invasive direct coronary artery bypass surgery (MIDCAB) and coronary artery bypass graft surgery (CABG).BACKGROUNDAtrial fibrillation results in increased morbidity and delays hospital discharge after CABG. Recently, MIDCAB has been explored as an alternative to CABG. Because of differences in surgical approach between the two procedures, the incidence of AF may differ.METHODSRandomly selected patients undergoing CABG and MIDCAB were examined. Baseline variables and postoperative course were recorded through review of medical record data.RESULTSThe MIDCAB patients were younger than CABG patients (64 ± 12 vs. 67 ± 10, p < 0.04) and had less extensive coronary artery disease (53% of MIDCAB vs. 3% of CABG had single-vessel disease, while 15% of MIDCAB vs. 69% of CABG had triple-vessel disease, p < 0.001 for overall group comparisons). No other differences in clinical or treatment data were noted. Postoperative AF occurred less often after MIDCAB (23% vs 39%, p = 0.02). Other significant factors associated with postoperative AF included age (p = 0.0024), prior AF (p = 0.0007), left main disease (p = 0.01), number of vessels bypassed (p = 0.009), absence of postoperative beta-blocker therapy (p = 0.0001), and a serious postoperative complication (p = 0.0018). Because of differences between CABG and MIDCAB patients, multivariate logistic analysis was performed to determine independent predictors of postoperative AF. The type of surgery (CABG vs. MIDCAB) was no longer a significant predictor of postoperative AF (estimated relative risk for AF in CABG vs. MIDCAB patients: 1.57, 95% confidence interval (0.82–2.52).CONCLUSIONSAlthough AF appears to be less common after MIDCAB than after CABG, the lower incidence is due to different clinical characteristics of patients undergoing these procedures

An exploratory randomised controlled trial of a premises-level intervention to reduce alcohol-related harm including violence in the United Kingdom

&lt;b&gt;Background&lt;/b&gt;&lt;p&gt;&lt;/p&gt; To assess the feasibility of a randomised controlled trial of a licensed premises intervention to reduce severe intoxication and disorder; to establish effect sizes and identify appropriate approaches to the development and maintenance of a rigorous research design and intervention implementation.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt;&lt;p&gt;&lt;/p&gt; An exploratory two-armed parallel randomised controlled trial with a nested process evaluation. An audit of risk factors and a tailored action plan for high risk premises, with three month follow up audit and feedback. Thirty-two premises that had experienced at least one assault in the year prior to the intervention were recruited, match paired and randomly allocated to control or intervention group. Police violence data and data from a street survey of study premises’ customers, including measures of breath alcohol concentration and surveyor rated customer intoxication, were used to assess effect sizes for a future definitive trial. A nested process evaluation explored implementation barriers and the fidelity of the intervention with key stakeholders and senior staff in intervention premises using semi-structured interviews.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt;&lt;p&gt;&lt;/p&gt; The process evaluation indicated implementation barriers and low fidelity, with a reluctance to implement the intervention and to submit to a formal risk audit. Power calculations suggest the intervention effect on violence and subjective intoxication would be raised to significance with a study size of 517 premises.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt;&lt;p&gt;&lt;/p&gt; It is methodologically feasible to conduct randomised controlled trials where licensed premises are the unit of allocation. However, lack of enthusiasm in senior premises staff indicates the need for intervention enforcement, rather than voluntary agreements, and on-going strategies to promote sustainability

Situational prevention and public transport crime in El Salvador

By any standard, there is a serious problem of crime on the public transport system in El Salvador. Guided by crime opportunity theory, this study undertook a rapid assessment of the problem consisting of a systematic observation of public transport in El Salvador and focus group discussions with passengers, bus operators, police and bus company owners/managers. The purposes were (1) to describe the main forms of crime and disorder afflicting the system, (2) to identify features of the system that contribute to the high levels of crime and disorder, and (3) to identify preventive measures, consistent with international experience. A program of situational crime prevention measures was identified which consisted of two main kinds: (1) measures relating to the operations of the bus system as a whole, intended to help to create a more orderly and secure transport environment and, (2) more specific measures designed to reduce opportunities for crimes occurring on buses or at bus stops, such as homicides, robberies, and sexual assaults on women. Future research and implementation of the preventive measures are discussed

Was an increase in cocaine use among injecting drug users in New South Wales, Australia, accompanied by an increase in violent crime?

BACKGROUND: A sharp reduction in heroin supply in Australia in 2001 was followed by a large but transient increase in cocaine use among injecting drug users (IDU) in Sydney. This paper assesses whether the increase in cocaine use among IDU was accompanied by increased rates of violent crime as occurred in the United States in the 1980s. Specifically, the paper aims to examine the impact of increased cocaine use among Sydney IDU upon police incidents of robbery with a weapon, assault and homicide. METHODS: Data on cocaine use among IDU was obtained from the Illicit Drug Reporting System (IDRS). Monthly NSW Police incident data on arrests for cocaine possession/use, robbery offences, homicides, and assaults, were obtained from the Bureau of Crime Statistics and Research. Time series analysis was conducted on the police data series where possible. Semi-structured interviews were conducted with representatives from law enforcement and health agencies about the impacts of cocaine use on crime and policing. RESULTS: There was a significant increase in cocaine use and cocaine possession offences in the months immediately following the reduction in heroin supply. There was also a significant increase in incidents of robbery where weapons were involved. There were no increases in offences involving firearms, homicides or reported assaults. CONCLUSION: The increased use of cocaine among injecting drug users following the heroin shortage led to increases in violent crime. Other States and territories that also experienced a heroin shortage but did not show any increases in cocaine use did not report any increase in violent crimes. The violent crimes committed did not involve guns, most likely because of its stringent gun laws, in contrast to the experience of American cities that have experienced high rates of cocaine use and violent crime

Preventing Violence in Seven Countries: Global Convergence in Policies

Do governments take the measures that are supported by the best scientific evidence available? We present a brief review of the situation in: Australia, Canada, Germany, the Netherlands, Spain, the United Kingdom, and the United States. Our findings show surprisingly similar developments across countries. While all seven countries are moving towards evidence-based decision making regarding policies and programs to prevent violence, there remain a number of difficulties before this end can be achieved. For example, there continue to be few randomized controlled trials or rigorous quasi-experimental studies on aggression and violence. Results from experimental research are essential to both policy makers and researchers to determine the effectiveness of programs as well as increase our knowledge of the problem. Additionally, all noted that media attention for violence is high in their country, often leading to management by crisis with the result that policies are not based on evidence, but instead seek to appease public outrage. And perhaps because of attendant organizational problems (i.e., in many countries violence prevention was not under the guise of one particular agency or ministry), most have not developed a coordinated policy focusing on the prevention of violence and physical aggression. It is hypothesized that leaders in democratic countries, who must run for election every 4 to 6 years, may feel a need to focus on short-term planning rather than long-term preventive policies since the costs, but not the benefits for the latter would be incurred while they still served in office. We also noted a general absence of expertise beyond those within scientific circles. The need for these ideas to be more widely accepted will be an essential ingredient to real and sustaining change. This means that there must be better communication and increased understanding between researchers and policy makers. Toward those ends, the recent establishment of the Campbell Collaboration, formed to provide international systematic reviews of program effectiveness, will make these results more available and accessible to politicians, administrators and those charged with making key policy decision

The reduction of intoxication and disorder in premises licensed to serve alcohol: An exploratory randomised controlled trial

Background: Licensed premises offer a valuable point of intervention to reduce alcohol-related harm. Objective: To describe the research design for an exploratory trial examining the feasibility and acceptability of a premises-level intervention designed to reduce severe intoxication and related disorder. The study also aims to assess the feasibility of a potential future large scale effectiveness trial and provide information on key trial design parameters including inclusion criteria, premises recruitment methods, strategies to implement the intervention and trial design, outcome measures, data collection methods and intra-cluster correlations. Design: A randomised controlled trial in licensed premises that had experienced at least one assault in the year preceding the intervention, documented in police or hospital Emergency Department (ED) records. Premises were recruited from four study areas by piloting four recruitment strategies of varying intensity. Thirty two licensed premises were grouped into matched pairs to reduce potential bias and randomly allocated to the control or intervention condition. The study included a nested process evaluation to provide information on intervention acceptability and implementation. Outcome measures included police-recorded violent incidents, assault-related attendances at each premises' local ED and patron Breath Alcohol Concentration assessed on exiting and entering study premises. Results: The most successful recruitment method involved local police licensing officers and yielded a 100% success rate. Police-records of violence provided the most appropriate source of data about disorder at the premises level. Conclusion: The methodology of an exploratory trial is presented and despite challenges presented by the study environment it is argued an exploratory trial is warranted. Initial investigations in recruitment methods suggest that study premises should be recruited with the assistance of police officers. Police data were of sufficient quality to identify disorder and street surveys are a feasible method for measuring intoxication at the individual level

In situ observations of phase changes in shock compressed forsterite

Shockwave data on mineral‐forming compounds such as Mg2SiO4 are essential for understanding the interiors of Earth and other planets, but correct interpretation of these data depend on knowing the phase assemblage being probed at high pressure. Hence direct observations of the phase or phases making up the measured states along the forsterite Hugoniot are essential to assess whether kinetic factors inhibit the achievement of the expected equilibrium, phase‐separated assemblage. Previous shock recovery experiments on forsterite, which has orthorhombic space group Pbnm, show discrepant results as to whether forsterite undergoes segregation into its equilibrium phase assemblage of compositionally distinct structures upon shock compression. Here, we present the results of plate impact experiments on polycrystalline forsterite conducted at the Dynamic Compression Sector of the Advanced Photon Source. In situ x‐ray diffraction measurements were used to probe the crystal structure(s) in the shock state and to investigate potential decomposition into periclase and bridgmanite. In contrast to previous interpretations of the forsterite shock Hugoniot, we find that forsterite does not decompose, but instead reaches the forsterite III structure, which is a metastable structure of Mg_2SiO_4 with orthorhombic space group Cmc2_1

In situ observations of phase changes in shock compressed forsterite

Shockwave data on mineral‐forming compounds such as Mg2SiO4 are essential for understanding the interiors of Earth and other planets, but correct interpretation of these data depend on knowing the phase assemblage being probed at high pressure. Hence direct observations of the phase or phases making up the measured states along the forsterite Hugoniot are essential to assess whether kinetic factors inhibit the achievement of the expected equilibrium, phase‐separated assemblage. Previous shock recovery experiments on forsterite, which has orthorhombic space group Pbnm, show discrepant results as to whether forsterite undergoes segregation into its equilibrium phase assemblage of compositionally distinct structures upon shock compression. Here, we present the results of plate impact experiments on polycrystalline forsterite conducted at the Dynamic Compression Sector of the Advanced Photon Source. In situ x‐ray diffraction measurements were used to probe the crystal structure(s) in the shock state and to investigate potential decomposition into periclase and bridgmanite. In contrast to previous interpretations of the forsterite shock Hugoniot, we find that forsterite does not decompose, but instead reaches the forsterite III structure, which is a metastable structure of Mg_2SiO_4 with orthorhombic space group Cmc2_1