A multi-layered risk estimation routine for strategic planning and operations for the maritime industry

Maritime regulators and port authorities require the ability to predict risk exposure for strategic planning aspects to optimize asset allocation, mitigate and prevent incidents. This article builds on previous work to develop the strategic planning component and introduces the concept of a multilayered risk estimation framework (MLREF) for strategic planning and operations. The framework accounts for most of the risk factors such as ship specific risk, vessel traffic densities and met ocean conditions and allows the integration of the effect of risk control option and a location specific spatial rate ratio to allow for micro level risk assessments. Both, the macro (eg. covering larger geographic areas or EEZ) and micro level application (eg. passage way, particular route of interest) of MLREF was tested via a pilot study for the Australian region using a comprehensive and unique combination of dataset. The underlying routine towards the development of a strategic planning tool was developed and tested in R. Applications of the layers for the operational part such as an automated alert system and sources of uncertainties for risk assessments in general are described and discussed along with future developments and improvements

A multi-layered risk exposure assessment approach for the shipping industry

__Abstract__ Shipping activity has increased worldwide and maritime administrations are trying to enhance risk mitigation strategies by using proactive approaches. We present and discuss a conceptual framework to minimize potential harm based on a multi-layered approach which can be implemented in either real time for operational purposes or in prediction mode for medium or longer term strategic planning purposes. We introduce the concept of total risk exposure which integrates risk at the individual ship level with vessel traffic densities and location specific parameters such as weather and oceanographic conditions, geographical features or environmental sensitivities. A comprehensive and robust method to estimate and predict risk exposure can be beneficial to maritime administrations to enhance mitigation strategies and understand uncertainties. We further provide a proof of concept based on 53 million observations of vessel positions and individual risk profiles of 8,900 individual ships. We present examples on how endpoints can be visualized for two integrated risk layers – ship specific risk and vessel traffic densities. We further identify and discuss uncertainties and present our ideas on how other risk layers could be integrated in the future

Predicting traffic and risk exposure in the maritime industry

Maritime regulators, port authorities, and industry require the ability to predict risk exposure of shipping activities at a micro and macro level to optimize asset allocation and to mitigate and prevent incidents. This article introduces the concept of a strategic planning tool by making use of the multi-layered risk estimation framework (MLREF), which accounts for ship specific risk, vessel traffic densities, and meets ocean conditions at the macro level. This article’s main contribution is to provide a traffic and risk exposure prediction routine that allows the traffic forecast to be distributed across the shipping route network to allow for predicting scenarios at the macro level (e.g., covering larger geographic areas) and micro level (e.g., passage way, particular route of interest). In addition, the micro level is introduced by providing a theoretical idea to integrate location specific spatial rate ratios along with the effect of the risk control option to perform sensitivity analysis of risk exposure prediction scenarios. Aspects of the risk exposure estimation routine were tested via a pilot study for the Australian region using a comprehensive and unique combination of datasets. Sources of uncertainties for risk assessments are described in general and discussed along with the potential for future developments and improvements

Emulation of a chemical transport model to assess air quality under future emission scenarios for the southwest of Western Australia

Simulation outputs from chemical transport models (CTMs) are essential to plan effective air quality policies. A key strength of these models is their ability to separate out source-specific components which facilitate the simulation of the potential impact of policy on future air quality. However, configuring and running these models is complex and computationally intensive, making the evaluation of multiple scenarios less accessible to many researchers and policy experts. The aim of this work is to present how Gaussian process emulation can provide a top-down approach to interrogating and interpreting the outputs from CTMs at minimal computational cost. A case study is presented (based on fine particle sources in the southwest of Western Australia) to illustrate how an emulator can be constructed to simultaneously evaluate changes in emissions from on-road transport and electricity sectors. This study demonstrates how emulation provides a flexible way of exploring local impacts of electric vehicles and wider regional effects of emissions from electricity generation. The potential for emulators to be applied to other settings involving air quality research is discussed

An international randomised placebo-controlled trial of a four-component combination pill ("polypill") in people with raised cardiovascular risk.

BACKGROUND:There has been widespread interest in the potential of combination cardiovascular medications containing aspirin and agents to lower blood pressure and cholesterol ('polypills') to reduce cardiovascular disease. However, no reliable placebo-controlled data are available on both efficacy and tolerability. METHODS:We conducted a randomised, double-blind placebo-controlled trial of a polypill (containing aspirin 75 mg, lisinopril 10 mg, hydrochlorothiazide 12.5 mg and simvastatin 20 mg) in 378 individuals without an indication for any component of the polypill, but who had an estimated 5-year cardiovascular disease risk over 7.5%. The primary outcomes were systolic blood pressure (SBP), LDL-cholesterol and tolerability (proportion discontinued randomised therapy) at 12 weeks follow-up. FINDINGS:At baseline, mean BP was 134/81 mmHg and mean LDL-cholesterol was 3.7 mmol/L. Over 12 weeks, polypill treatment reduced SBP by 9.9 (95% CI: 7.7 to 12.1) mmHg and LDL-cholesterol by 0.8 (95% CI 0.6 to 0.9) mmol/L. The discontinuation rates in the polypill group compared to placebo were 23% vs 18% (RR 1.33, 95% CI 0.89 to 2.00, p = 0.2). There was an excess of side effects known to the component medicines (58% vs 42%, p = 0.001), which was mostly apparent within a few weeks, and usually did not warrant cessation of trial treatment. CONCLUSIONS:This polypill achieved sizeable reductions in SBP and LDL-cholesterol but caused side effects in about 1 in 6 people. The halving in predicted cardiovascular risk is moderately lower than previous estimates and the side effect rate is moderately higher. Nonetheless, substantial net benefits would be expected among patients at high risk. TRIAL REGISTRATION:Australian New Zealand Clinical Trials Registry ACTRN12607000099426

Study protocol for a randomised trial of nicotine-free cigarettes as an adjunct to usual NRT-based cessation practice, in people who wish to stop smoking

This trial is funded by a programme grant from the Health Research Council of New Zealand.

The study protocol for a randomized controlled trial of a family-centred tobacco control program about environmental tobacco smoke (ETS) to reduce respiratory illness in Indigenous infants

Background: Acute respiratory illness (ARI) is the most common cause of acute presentations and hospitalisations of young Indigenous children in Australia and New Zealand (NZ). Environmental tobacco smoke (ETS) from household smoking is a significant and preventable contributor to childhood ARI. This paper describes the protocol for a study which aims to test the efficacy of a family-centred tobacco control program about ETS to improve the respiratory health of Indigenous infants in Australia and New Zealand. For the purpose of this paper 'Indigenous' refers to Australia's Aboriginal and Torres Strait Islander peoples when referring to Australian Indigenous populations. In New Zealand, the term 'Indigenous' refers to Maori

Distribution of Major Health Risks: Findings from the Global Burden of Disease Study

BACKGROUND: Most analyses of risks to health focus on the total burden of their aggregate effects. The distribution of risk-factor-attributable disease burden, for example by age or exposure level, can inform the selection and targeting of specific interventions and programs, and increase cost-effectiveness. METHODS AND FINDINGS: For 26 selected risk factors, expert working groups conducted comprehensive reviews of data on risk-factor exposure and hazard for 14 epidemiological subregions of the world, by age and sex. Age-sex-subregion-population attributable fractions were estimated and applied to the mortality and burden of disease estimates from the World Health Organization Global Burden of Disease database. Where possible, exposure levels were assessed as continuous measures, or as multiple categories. The proportion of risk-factor-attributable burden in different population subgroups, defined by age, sex, and exposure level, was estimated. For major cardiovascular risk factors (blood pressure, cholesterol, tobacco use, fruit and vegetable intake, body mass index, and physical inactivity) 43%–61% of attributable disease burden occurred between the ages of 15 and 59 y, and 87% of alcohol-attributable burden occurred in this age group. Most of the disease burden for continuous risks occurred in those with only moderately raised levels, not among those with levels above commonly used cut-points, such as those with hypertension or obesity. Of all disease burden attributable to being underweight during childhood, 55% occurred among children 1–3 standard deviations below the reference population median, and the remainder occurred among severely malnourished children, who were three or more standard deviations below median. CONCLUSIONS: Many major global risks are widely spread in a population, rather than restricted to a minority. Population-based strategies that seek to shift the whole distribution of risk factors often have the potential to produce substantial reductions in disease burden

Feasibility, design and conduct of a pragmatic randomized controlled trial to reduce overweight and obesity in children: The electronic games to aid motivation to exercise (eGAME) study

<p>Abstract</p> <p>Background</p> <p>Childhood obesity has reached epidemic proportions in developed countries. Sedentary screen-based activities such as video gaming are thought to displace active behaviors and are independently associated with obesity. Active video games, where players physically interact with images onscreen, may have utility as a novel intervention to increase physical activity and improve body composition in children. The aim of the Electronic Games to Aid Motivation to Exercise (eGAME) study is to determine the effects of an active video game intervention over 6 months on: body mass index (BMI), percent body fat, waist circumference, cardio-respiratory fitness, and physical activity levels in overweight children.</p> <p>Methods/Design</p> <p>Three hundred and thirty participants aged 10–14 years will be randomized to receive either an active video game upgrade package or to a control group (no intervention).</p> <p>Discussion</p> <p>An overview of the eGAME study is presented, providing an example of a large, pragmatic randomized controlled trial in a community setting. Reflection is offered on key issues encountered during the course of the study. In particular, investigation into the feasibility of the proposed intervention, as well as robust testing of proposed study procedures is a critical step prior to implementation of a large-scale trial.</p> <p>Trial registration</p> <p>Australian New Zealand Clinical Trials Registry ACTRN12607000632493</p

Comparative quantification of health risks: Conceptual framework and methodological issues

Reliable and comparable analysis of risks to health is key for preventing disease and injury. Causal attribution of morbidity and mortality to risk factors has traditionally been conducted in the context of methodological traditions of individual risk factors, often in a limited number of settings, restricting comparability. In this paper, we discuss the conceptual and methodological issues for quantifying the population health effects of individual or groups of risk factors in various levels of causality using knowledge from different scientific disciplines. The issues include: comparing the burden of disease due to the observed exposure distribution in a population with the burden from a hypothetical distribution or series of distributions, rather than a single reference level such as non-exposed; considering the multiple stages in the causal network of interactions among risk factor(s) and disease outcome to allow making inferences about some combinations of risk factors for which epidemiological studies have not been conducted, including the joint effects of multiple risk factors; calculating the health loss due to risk factor(s) as a time-indexed "stream" of disease burden due to a time-indexed "stream" of exposure, including consideration of discounting; and the sources of uncertainty