Richard C Franklin | James Cook University (original) (raw)

Papers by Richard C Franklin

Medical Journal of Australia, Feb 1, 2010

To explore 5 years of drowning deaths in Australia compared with a previous Australian study a de... more To explore 5 years of drowning deaths in Australia compared with a previous Australian study a decade earlier, and to assess the feasibility of achieving a 50% reduction in unintentional drowning deaths by 2020. An audit of all unintentional drowning deaths in Australia using data from the National Coroners Information System for 1 July 2002 to 30 June 2007. Number and rate of drowning deaths, by age, sex, location, activity, place of birth, visitor status, and involvement of alcohol or drugs. There were 1452 drowning deaths during the study period (76.4% male). The age-adjusted rate per 100 000 people ranged from 1.61 in 2002-03 to 1.23 in 2006-07. Children aged 0-4 years had the highest rate (2.63 per 100 000 people), and 29% of deaths were of people aged 55 years or older. Over half of all deaths occurred in rivers (20.3%), at beaches (18.3%), or in swimming pools (13.3%). Alcohol was involved in 21.6% of all drowning deaths, although this varied by age. This audit suggests that ...

Journal of Aging and Health

Objectives: To explore trends in unintentional fatal drowning among older adults (65 years and ol... more Objectives: To explore trends in unintentional fatal drowning among older adults (65 years and older). Methods: Total population retrospective analysis of unintentional fatal drowning among people aged 65 years and older in Australia, Canada and New Zealand (2005–2014) was conducted. Results: 1459 older adults died. Rates ranged from 1.69 (Canada) to 2.20 (New Zealand) per 100,000. Trends in crude drowning rates were variable from year to year. A downward trend was observed in New Zealand (y = −.507ln(x) + 2.9918), with upward trends in Australia (y = .1056ln(x) + 1.5948) and Canada (y = .1489ln(x) + 1.4571). Population projections suggest high annual drowning deaths by 2050 in Australia (range: 120–190; 1.69–2.76/100,000) and Canada (range: 209–430; 1.78–3.66/100,000). Significant locations and activities associated with older adult drowning differed by country and age band. Conclusions: Drowning among older adults is a hidden epidemic claiming increasing lives as the population ag...

Australian Journal of Rural Health

OBJECTIVE To examine unintentional drowning by remoteness in Australia. DESIGN A systematic revie... more OBJECTIVE To examine unintentional drowning by remoteness in Australia. DESIGN A systematic review of both peer-reviewed and grey literature published between January 1990 and December 2019 (inclusive). METHOD Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, MEDLINE (Ovid), PubMed, EMBASE, Scopus, PsycINFO (ProQuest), SPORTDiscus and Google Scholar were searched for studies exploring fatal and non-fatal unintentional drowning by remoteness. Epidemiological data, common factors and prevention strategies were extracted and mapped to Australian standard geographical classifications (major cities, inner regional, outer regional, remote and very remote). Level of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation and prevention strategies aligned to the hierarchy of control. RESULT Thirty-two studies satisfied inclusion criteria (66% reporting epidemiology; 59% risk factors; and 44% prevention strategies). All (100%) included studies were assessed very low against Grading of Recommendations Assessment, Development and Evaluation. Findings indicate rural populations (ie, excluding major cities) have higher rates of drowning positively correlated with increasing remoteness. Common factors included age (child), natural water bodies, undertaking boating and watercraft activities and alcohol consumption. While a range of prevention strategies has been proposed, only one study outlined a rural drowning prevention strategy which had been implemented and evaluated. Strategies were generally low on the hierarchy of control. CONCLUSION Rural populations are proportionately overrepresented in drowning statistics. Proposed prevention strategies have unknown efficacy. Greater research into rural drowning of Australians is needed especially exploring behavioural motivations, program delivery, cost-effectiveness and evaluation. Development and use of a standard definition for remoteness are recommended. Rural populations use water extensively; therefore, there is an urgent need to keep them safe.

Journal of Agromedicine

ABSTRACT Australia and with that Queensland have been extremely fortunate with the impact of COVI... more ABSTRACT Australia and with that Queensland have been extremely fortunate with the impact of COVID-19. Queensland has only had 1,067 cases as of June 30, 2020, of which 78% have been overseas acquired. Australia and Queensland acted early to address COVID-19 by putting in place a range of strategies including travel bans (international and domestic), isolation measures, testing regimes, advice to business, economic support, and research funding. Agriculture was designated an essential business and as such has continued operating throughout the pandemic. They have however had to develop and implement COVID plans to keep workers safe. To help agricultural business establish plans information was developed by Safe Work Australia, National Farmers Federation and the Queensland Department of Workplace Health and Safety. Workforce issues were identified early, particularly seasonal workers (those who travel from their usual place of residence to another place to work). The Queensland Government enacted a directive about how seasonal workers were to be managed and also developed a guide specifically for horticulture to help manage their COVID-19 response. We provide two case studies demonstrating how agriculture has responded to COVID-19. Agriculture has successfully, in Queensland, adapted quickly to the changing work conditions due to COVID-19. This is due to all levels of government coming together with industry to find solutions. Some changes have had wider benefits such as improved sanitation, better communication and a greater recognition of seasonal worker needs. Being prepared and resilient has enabled agriculture to alleviate the impact on their businesses ensuring the health of all.

Australian Journal of Rural Health

OBJECTIVE To contrast unintentional fatal drowning in rivers with lakes to determine appropriaten... more OBJECTIVE To contrast unintentional fatal drowning in rivers with lakes to determine appropriateness for application of existing river drowning prevention strategies. DESIGN A total population retrospective cross-sectional analysis using coronial data. SETTING Australia, 1 July 2013 to 30 June 2018. PARTICIPANTS Children and adults (n = 342) who died from unintentional drowning in a river or lake. MAIN OUTCOME MEASURES Incidence, crude fatality rates, relative risk (95% confidence interval) and chi-square tests of independence for risk factors for unintentional fatal drowning. Subset analysis of land management for lake drowning locations. RESULTS Four-fifths (82%) occurred in rivers. Lake drowning was more likely among 0- to 17-year-olds, Aboriginal and Torres Strait Islander people and when swimming or using watercraft. River drowning most commonly occurred following a fall into water and with alcohol involvement. Drowning risk in very remote areas was elevated for both lakes (relative risk = 18.34; 95% confidence interval: 1.61-209.44) and rivers (relative risk = 15.89; 95% confidence interval: 5.56-45.37) compared to major cities. Those responsible for land and water management at lakes were primarily local government (59%), water authorities (32%) and parks and wildlife authorities (7%). CONCLUSIONS In contrast to a focus on adults and alcohol in existing river drowning prevention strategies, lake interventions must target children, Aboriginal and Torres Strait Islander peoples and recreational lake users. Fatal drowning rates are high for remote rivers and lakes, necessitating focused effort. There are opportunities to embed drowning prevention strategies within land and water management plans. Lake drowning prevention requires broader engagement with land and water managers and Aboriginal and Torres Strait Islander peoples.

Safety

Injuries sustained while performing electrical work are a significant threat to the health and sa... more Injuries sustained while performing electrical work are a significant threat to the health and safety of workers and occur frequently. In some jurisdictions, non-fatal serious incidents have increased in recent years. Although significant work has been carried out on electrical safety from a human factor perspective, reviews of this literature are sparse. Thus, the purpose of this review is to collate and summarize human factors implicated in electrical safety events. Articles were collected from three databases (Scopus, Web of Science, and Google Scholar), using the search terms: safety, electri*, human factors, and arc flash. Titles and abstracts were screened, full-text reviews were conducted, and 18 articles were included in the final review. Quality checks were undertaken using the Mixed Methods Appraisal Tool and the Critical Appraisal Skills Program. Environmental, individual, team, organizational, and macro factors were identified in the literature as factors which shape fro...

Children

Injuries are a leading cause of harm for children. This study explores the impact of determinants... more Injuries are a leading cause of harm for children. This study explores the impact of determinants of health on children (0–19 years) injury-related mortality (namely remoteness and socio-economic disadvantage, calculated using the index of relative socio-economic advantage and disadvantage (IRSAD)). Cause of death data from the Australian Bureau of Statistics were sourced for children in Australia between 1 July 2007 to 30 June 2017. Fifteen injury categories (ICD-10-AM external cause codes) were used. Burden and trends by injury mechanism were explored. A total of 5153 children died; with road traffic incidents (3.39 per 100,000 population), intentional self-harm (2.46) and drowning (0.72) being the leading mechanisms. Female fatality rates in very remote areas (8.73) were nine times higher than in major cities (Relative Risk [RR] = 8.73; 95% Confidence Interval [95% CI]: 4.23–18.00). Fatality rates increased with remoteness; very remote areas recording an injury-related fatality r...

Safety

Aquatic competencies have been proposed as a prevention strategy for children aged 2–4 years who ... more Aquatic competencies have been proposed as a prevention strategy for children aged 2–4 years who are over-represented in drowning statistics. For this recommendation to be made, exploration of the connection between aquatic competencies and drowning is required. This review critically analyzed studies exploring aquatic competencies and their effect on drowning and/or injury severity in children 2–4 years. English language peer-reviewed literature up to 31 July 2019 was searched and the PRISMA process utilized. Data were extracted from twelve studies that fulfilled the inclusion criteria. Findings from this study included that aquatic competencies were not found to increase risk of drowning and demonstrated children aged 2–4 years are capable of developing age-appropriate aquatic competencies. Age-appropriate aquatic competencies extracted were propulsion/locomotion, flotation/buoyancy, water familiarization, submersion and water exits. The acquisition of these competencies holds ben...

Australasian Emergency Care

INTRODUCTION Measuring the performance of air ambulance services are complex and dynamic due to t... more INTRODUCTION Measuring the performance of air ambulance services are complex and dynamic due to the variability and interconnectedness of emergency systems. The aim of this study is to review the range and nature of air ambulance outcome measures published in peer review articles and construct a quality framework based on the results. A scoping review of the literature was conducted to identify outcome measures that evaluate the quality of air ambulance services. Combined frameworks from the Institutes of Medicine (IOM) and Dr. Avedia Donabedian were used to create a dashboard structure for a framework of air ambulance outcome measures. METHODS A literature search strategy was undertaken, following PRISMA-ScR guidelines and included eight databases over the period 2001-2019. Qualitative content analysis was conducted in 4-phases: 1) table summary of selected article outcome measures, 2) content analysis themes, codes of outcome measures and independent variables 3) narrative description of main themes 4) visual dashboard diagram of service priorities and quality strategies, based on the findings. RESULTS Thirty-four articles were screened by full text and eighteen met the selection criteria. Twenty codes emerged and were grouped to form eight consistent outcome themes; asset/ team type, access to definitive interventions, prehospital factors, mortality, morbidity, responsiveness of service, accessibility of service and patient disposition. CONCLUSIONS A quality framework consisting of eight outcome measures was created, it also identified seven gaps which ordinarily require performance evaluation; patient comfort and satisfaction reporting, cultural awareness training, safety alarms in place to identify volume stress, optimal coordination of resources, cost of service analysis, comprehensive patient journey time and an adaptive referral system analysis. The measures in the framework provide a broad perspective of air ambulance performance we believe will help decision-making and planning to improve patients experience and outcomes.

Acta Paediatrica

To explore temporal trends in fatal child drowning and benchmark progress across three high‐incom... more To explore temporal trends in fatal child drowning and benchmark progress across three high‐income countries to provide prevention and future investment recommendations.

Emergency Medicine Australasia

Aeromedical services are an essential part of the healthcare system. Centralised coordination of ... more Aeromedical services are an essential part of the healthcare system. Centralised coordination of aeromedical retrieval tasking offers benefits for safety, timeliness and efficiency in service delivery. The aim of the present study is to review aeromedical retrievals in Queensland exploring patient demographics, temporal patterns and usage characteristics.

Air Medical Journal

OBJECTIVE The purpose of this study was to investigate the epidemiology of air medical patients a... more OBJECTIVE The purpose of this study was to investigate the epidemiology of air medical patients and referral patterns in Central Queensland Hospital and Health Service (CQHHS). METHODS Analysis of air medical transport from January 2010 to December 2014. Air medical tasks within the local health service boundary were included. All patients transported on rotor or fixed wing aircraft for medical purposes were included. Patterns of air medical tasks in and out of the region by referring and receiving location, aircraft type, flight priority, time of day, month, sex, age, illness, and referral indexes were analyzed. RESULTS There were 11,456 air ambulance tasks in CQHHS region during the study period, an average of 2,291 retrievals per annum or 191 per month. Frequent referrals were to a tertiary facility, located 800 km across economic and political boundaries. Referral pattern indexes highlight a net patient flow of 1.2 to 1. Cardiology was the largest illness category (24%). Males represented 59% overall as well as patients 66 years and older (33%). Fixed wing aircraft carried out 87% of the tasks with a frequent response time of 6 to 24 hours. CONCLUSION Air medical transports are an integral part of the health system in Central Queensland communities with vast geographic distances. Identifying regional referral pattern rates and ratios aid in the planning of resource allocation.

Safety

Rivers are a leading location for drowning, yet little is known about people’s usage of these wat... more Rivers are a leading location for drowning, yet little is known about people’s usage of these waterways. This pilot study aimed to test the use of direct observations to calculate river usage. Direct observations were conducted at regular intervals within defined zones at four river drowning locations in Australia (including weekends and the Australia Day national public holiday). Data recorded were date and time of observation; total people (including males, females, children, and adults); and number of people on, in, and beside the water. Univariate analysis with mean (SD) and range was conducted. Interrater reliability for observations was determined using the intraclass correlation coefficient (ICC) (one-way random-effects, average measures model), with a 95% confidence interval (CI). Across 149 time points, 309 observations resulted in 13,326 river interactions observed by multiple observers. There was an average of 39 people (M = 39.4, SD = 29.4, range = 0–137) per observation...

International Journal of Aquatic Research and Education

Journal of Sociology

Gender is constructed from social and cultural meanings that dynamically shift and vary. Previous... more Gender is constructed from social and cultural meanings that dynamically shift and vary. Previous work has assumed that the constructions of masculinity in Australia are like those in other Western societies, and typically focus on qualities such as physical strength, courage and sometimes military engagement. This study explores whether these assumptions hold, by conducting telephone interviews among 617 Queensland men, aged 18 years and above, across all geographical parts of Queensland. This survey was administered in 2013, as part of the Queensland Social Survey series. The study explores the diverse meanings associated with being a ‘real man’ given by the survey participants. Three main dimensions emerged from the thematic analysis: physicality; personality and character; social roles and relationships. The study confirmed that masculinities are dynamic and complex. Responses revealed a surprising emphasis on character and morality 44.5% (n = 684) as defining manhood, as agains...

International Journal of Aquatic Research and Education

Safety

Unintentional fatal drowning among older people is an issue as lifespans lengthen and older peopl... more Unintentional fatal drowning among older people is an issue as lifespans lengthen and older people embrace active retirement. While pre-existing medical conditions are a known risk factor for drowning among this age group, less is known about the role of alcohol and drugs. This 15-year (1 July 2002 to 30 June 2017) Australian study used coronial data to investigate the impact on older people (aged 65 years and older) of the obtundent effects of prescribed drugs which had been ingested by those with a positive blood alcohol concentration (BAC). Of the closed coronial cases with toxicological information (N = 471), one quarter (24.6%; N = 116) had consumed alcohol prior to drowning (one in seven BAC ≥ 0.05%), of which a third also had obtundent drugs present (33.6%; N = 39). Rivers/creeks/streams and swimming pools were the locations with the highest number of drowning deaths. Bathtubs (36.8%) and rivers/creeks/streams (17.9%) recorded the highest proportion of cases with victims havi...

Australian occupational therapy journal, Jan 24, 2018

The transition from work to retirement is a complex process and unique experience with a relation... more The transition from work to retirement is a complex process and unique experience with a relationship existing between work and retirement with implications for health in later life. This review explored the relationship between pre-retirement job and participation in the work-to-retirement transition process in Australia by exploring: (i) factors influencing retirement in relation to pre-retirement job; (ii) how jobs are classified; (iii) the effect of pre-retirement job (based on categories) on this occupational transition; and (iv) the potential role for occupational therapy in this occupational transition. An integrative literature review was completed. PRISMA guidelines were used. Study designs were analysed for methodological quality using the National Health and Medical Research Council levels of evidence. Thematic analysis determined retirement factors which were used to compare differences between jobs. This review included 15 papers. There were two Level III-2, one Level I...

Medical Journal of Australia, Feb 1, 2010

To explore 5 years of drowning deaths in Australia compared with a previous Australian study a de... more To explore 5 years of drowning deaths in Australia compared with a previous Australian study a decade earlier, and to assess the feasibility of achieving a 50% reduction in unintentional drowning deaths by 2020. An audit of all unintentional drowning deaths in Australia using data from the National Coroners Information System for 1 July 2002 to 30 June 2007. Number and rate of drowning deaths, by age, sex, location, activity, place of birth, visitor status, and involvement of alcohol or drugs. There were 1452 drowning deaths during the study period (76.4% male). The age-adjusted rate per 100 000 people ranged from 1.61 in 2002-03 to 1.23 in 2006-07. Children aged 0-4 years had the highest rate (2.63 per 100 000 people), and 29% of deaths were of people aged 55 years or older. Over half of all deaths occurred in rivers (20.3%), at beaches (18.3%), or in swimming pools (13.3%). Alcohol was involved in 21.6% of all drowning deaths, although this varied by age. This audit suggests that ...

Journal of Aging and Health

Objectives: To explore trends in unintentional fatal drowning among older adults (65 years and ol... more Objectives: To explore trends in unintentional fatal drowning among older adults (65 years and older). Methods: Total population retrospective analysis of unintentional fatal drowning among people aged 65 years and older in Australia, Canada and New Zealand (2005–2014) was conducted. Results: 1459 older adults died. Rates ranged from 1.69 (Canada) to 2.20 (New Zealand) per 100,000. Trends in crude drowning rates were variable from year to year. A downward trend was observed in New Zealand (y = −.507ln(x) + 2.9918), with upward trends in Australia (y = .1056ln(x) + 1.5948) and Canada (y = .1489ln(x) + 1.4571). Population projections suggest high annual drowning deaths by 2050 in Australia (range: 120–190; 1.69–2.76/100,000) and Canada (range: 209–430; 1.78–3.66/100,000). Significant locations and activities associated with older adult drowning differed by country and age band. Conclusions: Drowning among older adults is a hidden epidemic claiming increasing lives as the population ag...

Australian Journal of Rural Health

OBJECTIVE To examine unintentional drowning by remoteness in Australia. DESIGN A systematic revie... more OBJECTIVE To examine unintentional drowning by remoteness in Australia. DESIGN A systematic review of both peer-reviewed and grey literature published between January 1990 and December 2019 (inclusive). METHOD Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, MEDLINE (Ovid), PubMed, EMBASE, Scopus, PsycINFO (ProQuest), SPORTDiscus and Google Scholar were searched for studies exploring fatal and non-fatal unintentional drowning by remoteness. Epidemiological data, common factors and prevention strategies were extracted and mapped to Australian standard geographical classifications (major cities, inner regional, outer regional, remote and very remote). Level of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation and prevention strategies aligned to the hierarchy of control. RESULT Thirty-two studies satisfied inclusion criteria (66% reporting epidemiology; 59% risk factors; and 44% prevention strategies). All (100%) included studies were assessed very low against Grading of Recommendations Assessment, Development and Evaluation. Findings indicate rural populations (ie, excluding major cities) have higher rates of drowning positively correlated with increasing remoteness. Common factors included age (child), natural water bodies, undertaking boating and watercraft activities and alcohol consumption. While a range of prevention strategies has been proposed, only one study outlined a rural drowning prevention strategy which had been implemented and evaluated. Strategies were generally low on the hierarchy of control. CONCLUSION Rural populations are proportionately overrepresented in drowning statistics. Proposed prevention strategies have unknown efficacy. Greater research into rural drowning of Australians is needed especially exploring behavioural motivations, program delivery, cost-effectiveness and evaluation. Development and use of a standard definition for remoteness are recommended. Rural populations use water extensively; therefore, there is an urgent need to keep them safe.

Journal of Agromedicine

ABSTRACT Australia and with that Queensland have been extremely fortunate with the impact of COVI... more ABSTRACT Australia and with that Queensland have been extremely fortunate with the impact of COVID-19. Queensland has only had 1,067 cases as of June 30, 2020, of which 78% have been overseas acquired. Australia and Queensland acted early to address COVID-19 by putting in place a range of strategies including travel bans (international and domestic), isolation measures, testing regimes, advice to business, economic support, and research funding. Agriculture was designated an essential business and as such has continued operating throughout the pandemic. They have however had to develop and implement COVID plans to keep workers safe. To help agricultural business establish plans information was developed by Safe Work Australia, National Farmers Federation and the Queensland Department of Workplace Health and Safety. Workforce issues were identified early, particularly seasonal workers (those who travel from their usual place of residence to another place to work). The Queensland Government enacted a directive about how seasonal workers were to be managed and also developed a guide specifically for horticulture to help manage their COVID-19 response. We provide two case studies demonstrating how agriculture has responded to COVID-19. Agriculture has successfully, in Queensland, adapted quickly to the changing work conditions due to COVID-19. This is due to all levels of government coming together with industry to find solutions. Some changes have had wider benefits such as improved sanitation, better communication and a greater recognition of seasonal worker needs. Being prepared and resilient has enabled agriculture to alleviate the impact on their businesses ensuring the health of all.

Australian Journal of Rural Health

OBJECTIVE To contrast unintentional fatal drowning in rivers with lakes to determine appropriaten... more OBJECTIVE To contrast unintentional fatal drowning in rivers with lakes to determine appropriateness for application of existing river drowning prevention strategies. DESIGN A total population retrospective cross-sectional analysis using coronial data. SETTING Australia, 1 July 2013 to 30 June 2018. PARTICIPANTS Children and adults (n = 342) who died from unintentional drowning in a river or lake. MAIN OUTCOME MEASURES Incidence, crude fatality rates, relative risk (95% confidence interval) and chi-square tests of independence for risk factors for unintentional fatal drowning. Subset analysis of land management for lake drowning locations. RESULTS Four-fifths (82%) occurred in rivers. Lake drowning was more likely among 0- to 17-year-olds, Aboriginal and Torres Strait Islander people and when swimming or using watercraft. River drowning most commonly occurred following a fall into water and with alcohol involvement. Drowning risk in very remote areas was elevated for both lakes (relative risk = 18.34; 95% confidence interval: 1.61-209.44) and rivers (relative risk = 15.89; 95% confidence interval: 5.56-45.37) compared to major cities. Those responsible for land and water management at lakes were primarily local government (59%), water authorities (32%) and parks and wildlife authorities (7%). CONCLUSIONS In contrast to a focus on adults and alcohol in existing river drowning prevention strategies, lake interventions must target children, Aboriginal and Torres Strait Islander peoples and recreational lake users. Fatal drowning rates are high for remote rivers and lakes, necessitating focused effort. There are opportunities to embed drowning prevention strategies within land and water management plans. Lake drowning prevention requires broader engagement with land and water managers and Aboriginal and Torres Strait Islander peoples.

Safety

Injuries sustained while performing electrical work are a significant threat to the health and sa... more Injuries sustained while performing electrical work are a significant threat to the health and safety of workers and occur frequently. In some jurisdictions, non-fatal serious incidents have increased in recent years. Although significant work has been carried out on electrical safety from a human factor perspective, reviews of this literature are sparse. Thus, the purpose of this review is to collate and summarize human factors implicated in electrical safety events. Articles were collected from three databases (Scopus, Web of Science, and Google Scholar), using the search terms: safety, electri*, human factors, and arc flash. Titles and abstracts were screened, full-text reviews were conducted, and 18 articles were included in the final review. Quality checks were undertaken using the Mixed Methods Appraisal Tool and the Critical Appraisal Skills Program. Environmental, individual, team, organizational, and macro factors were identified in the literature as factors which shape fro...

Children

Injuries are a leading cause of harm for children. This study explores the impact of determinants... more Injuries are a leading cause of harm for children. This study explores the impact of determinants of health on children (0–19 years) injury-related mortality (namely remoteness and socio-economic disadvantage, calculated using the index of relative socio-economic advantage and disadvantage (IRSAD)). Cause of death data from the Australian Bureau of Statistics were sourced for children in Australia between 1 July 2007 to 30 June 2017. Fifteen injury categories (ICD-10-AM external cause codes) were used. Burden and trends by injury mechanism were explored. A total of 5153 children died; with road traffic incidents (3.39 per 100,000 population), intentional self-harm (2.46) and drowning (0.72) being the leading mechanisms. Female fatality rates in very remote areas (8.73) were nine times higher than in major cities (Relative Risk [RR] = 8.73; 95% Confidence Interval [95% CI]: 4.23–18.00). Fatality rates increased with remoteness; very remote areas recording an injury-related fatality r...

Safety

Aquatic competencies have been proposed as a prevention strategy for children aged 2–4 years who ... more Aquatic competencies have been proposed as a prevention strategy for children aged 2–4 years who are over-represented in drowning statistics. For this recommendation to be made, exploration of the connection between aquatic competencies and drowning is required. This review critically analyzed studies exploring aquatic competencies and their effect on drowning and/or injury severity in children 2–4 years. English language peer-reviewed literature up to 31 July 2019 was searched and the PRISMA process utilized. Data were extracted from twelve studies that fulfilled the inclusion criteria. Findings from this study included that aquatic competencies were not found to increase risk of drowning and demonstrated children aged 2–4 years are capable of developing age-appropriate aquatic competencies. Age-appropriate aquatic competencies extracted were propulsion/locomotion, flotation/buoyancy, water familiarization, submersion and water exits. The acquisition of these competencies holds ben...

Australasian Emergency Care

INTRODUCTION Measuring the performance of air ambulance services are complex and dynamic due to t... more INTRODUCTION Measuring the performance of air ambulance services are complex and dynamic due to the variability and interconnectedness of emergency systems. The aim of this study is to review the range and nature of air ambulance outcome measures published in peer review articles and construct a quality framework based on the results. A scoping review of the literature was conducted to identify outcome measures that evaluate the quality of air ambulance services. Combined frameworks from the Institutes of Medicine (IOM) and Dr. Avedia Donabedian were used to create a dashboard structure for a framework of air ambulance outcome measures. METHODS A literature search strategy was undertaken, following PRISMA-ScR guidelines and included eight databases over the period 2001-2019. Qualitative content analysis was conducted in 4-phases: 1) table summary of selected article outcome measures, 2) content analysis themes, codes of outcome measures and independent variables 3) narrative description of main themes 4) visual dashboard diagram of service priorities and quality strategies, based on the findings. RESULTS Thirty-four articles were screened by full text and eighteen met the selection criteria. Twenty codes emerged and were grouped to form eight consistent outcome themes; asset/ team type, access to definitive interventions, prehospital factors, mortality, morbidity, responsiveness of service, accessibility of service and patient disposition. CONCLUSIONS A quality framework consisting of eight outcome measures was created, it also identified seven gaps which ordinarily require performance evaluation; patient comfort and satisfaction reporting, cultural awareness training, safety alarms in place to identify volume stress, optimal coordination of resources, cost of service analysis, comprehensive patient journey time and an adaptive referral system analysis. The measures in the framework provide a broad perspective of air ambulance performance we believe will help decision-making and planning to improve patients experience and outcomes.

Acta Paediatrica

To explore temporal trends in fatal child drowning and benchmark progress across three high‐incom... more To explore temporal trends in fatal child drowning and benchmark progress across three high‐income countries to provide prevention and future investment recommendations.

Emergency Medicine Australasia

Aeromedical services are an essential part of the healthcare system. Centralised coordination of ... more Aeromedical services are an essential part of the healthcare system. Centralised coordination of aeromedical retrieval tasking offers benefits for safety, timeliness and efficiency in service delivery. The aim of the present study is to review aeromedical retrievals in Queensland exploring patient demographics, temporal patterns and usage characteristics.

Air Medical Journal

OBJECTIVE The purpose of this study was to investigate the epidemiology of air medical patients a... more OBJECTIVE The purpose of this study was to investigate the epidemiology of air medical patients and referral patterns in Central Queensland Hospital and Health Service (CQHHS). METHODS Analysis of air medical transport from January 2010 to December 2014. Air medical tasks within the local health service boundary were included. All patients transported on rotor or fixed wing aircraft for medical purposes were included. Patterns of air medical tasks in and out of the region by referring and receiving location, aircraft type, flight priority, time of day, month, sex, age, illness, and referral indexes were analyzed. RESULTS There were 11,456 air ambulance tasks in CQHHS region during the study period, an average of 2,291 retrievals per annum or 191 per month. Frequent referrals were to a tertiary facility, located 800 km across economic and political boundaries. Referral pattern indexes highlight a net patient flow of 1.2 to 1. Cardiology was the largest illness category (24%). Males represented 59% overall as well as patients 66 years and older (33%). Fixed wing aircraft carried out 87% of the tasks with a frequent response time of 6 to 24 hours. CONCLUSION Air medical transports are an integral part of the health system in Central Queensland communities with vast geographic distances. Identifying regional referral pattern rates and ratios aid in the planning of resource allocation.

Safety

Rivers are a leading location for drowning, yet little is known about people’s usage of these wat... more Rivers are a leading location for drowning, yet little is known about people’s usage of these waterways. This pilot study aimed to test the use of direct observations to calculate river usage. Direct observations were conducted at regular intervals within defined zones at four river drowning locations in Australia (including weekends and the Australia Day national public holiday). Data recorded were date and time of observation; total people (including males, females, children, and adults); and number of people on, in, and beside the water. Univariate analysis with mean (SD) and range was conducted. Interrater reliability for observations was determined using the intraclass correlation coefficient (ICC) (one-way random-effects, average measures model), with a 95% confidence interval (CI). Across 149 time points, 309 observations resulted in 13,326 river interactions observed by multiple observers. There was an average of 39 people (M = 39.4, SD = 29.4, range = 0–137) per observation...

International Journal of Aquatic Research and Education

Journal of Sociology

Gender is constructed from social and cultural meanings that dynamically shift and vary. Previous... more Gender is constructed from social and cultural meanings that dynamically shift and vary. Previous work has assumed that the constructions of masculinity in Australia are like those in other Western societies, and typically focus on qualities such as physical strength, courage and sometimes military engagement. This study explores whether these assumptions hold, by conducting telephone interviews among 617 Queensland men, aged 18 years and above, across all geographical parts of Queensland. This survey was administered in 2013, as part of the Queensland Social Survey series. The study explores the diverse meanings associated with being a ‘real man’ given by the survey participants. Three main dimensions emerged from the thematic analysis: physicality; personality and character; social roles and relationships. The study confirmed that masculinities are dynamic and complex. Responses revealed a surprising emphasis on character and morality 44.5% (n = 684) as defining manhood, as agains...

International Journal of Aquatic Research and Education

Safety

Unintentional fatal drowning among older people is an issue as lifespans lengthen and older peopl... more Unintentional fatal drowning among older people is an issue as lifespans lengthen and older people embrace active retirement. While pre-existing medical conditions are a known risk factor for drowning among this age group, less is known about the role of alcohol and drugs. This 15-year (1 July 2002 to 30 June 2017) Australian study used coronial data to investigate the impact on older people (aged 65 years and older) of the obtundent effects of prescribed drugs which had been ingested by those with a positive blood alcohol concentration (BAC). Of the closed coronial cases with toxicological information (N = 471), one quarter (24.6%; N = 116) had consumed alcohol prior to drowning (one in seven BAC ≥ 0.05%), of which a third also had obtundent drugs present (33.6%; N = 39). Rivers/creeks/streams and swimming pools were the locations with the highest number of drowning deaths. Bathtubs (36.8%) and rivers/creeks/streams (17.9%) recorded the highest proportion of cases with victims havi...

Australian occupational therapy journal, Jan 24, 2018

The transition from work to retirement is a complex process and unique experience with a relation... more The transition from work to retirement is a complex process and unique experience with a relationship existing between work and retirement with implications for health in later life. This review explored the relationship between pre-retirement job and participation in the work-to-retirement transition process in Australia by exploring: (i) factors influencing retirement in relation to pre-retirement job; (ii) how jobs are classified; (iii) the effect of pre-retirement job (based on categories) on this occupational transition; and (iv) the potential role for occupational therapy in this occupational transition. An integrative literature review was completed. PRISMA guidelines were used. Study designs were analysed for methodological quality using the National Health and Medical Research Council levels of evidence. Thematic analysis determined retirement factors which were used to compare differences between jobs. This review included 15 papers. There were two Level III-2, one Level I...