Risk classification of low-lying coral reef islands and their exposure to climate threats.

The bio-physical responses of low-lying coral islands to climate change are of concern. These islands exist across a broad range of bio-physical conditions, and vulnerabilities to rising and warming seas, ocean acidification and increased storminess. We propose a risk-based classification that scores 6 island eco-morphometric attributes and 6 bio-physical ocean/climate conditions from recent open-access data, to assign islands with respect to 5 risk classes (Very Low, Low, Moderate, High and Very High). The potential responses of 56 coral islands in Australia's jurisdiction (Coral Sea, NW Shelf and NE Indian Ocean) to climate change is considered with respect to their bio-physical attributes and eco-morphometrics. None of the islands were classed as Very Low risk, while 8 were classed as Low (14.3 %), 34 were Moderate (60.7 %), 11 were High (19.6 %), and 3 were Very High (5.4 %). Islands in the Very High risk class (located on the NW Shelf) are most vulnerable due to their small size (mean 10 Ha), low elevation (mean 2.6 m MSL), angular/elongated shape, unvegetated state, below average pH (mean 8.05), above average rates of sea-level rise (SLR; mean 4.6 mm/yr), isolation from other islands, and frequent tropical storms and marine heatwaves. In contrast, islands in the Low (and Very Low) risk class are less vulnerable due to their large size (mean 127 Ha), high elevation (mean 8.5 m MSL), sub-angular/round shape, vegetated state, near average pH (mean 8.06), near average SLR rates (mean 3.9 mm/yr), proximity to adjacent islands, and infrequent cyclones and marine heatwaves. Our method provides a risk matrix to assess coral island vulnerability to current climate change related risks and supports future research on the impacts of projected climate change scenarios. Findings have implications for communities living on coral islands, associated ecosystem services and coastal States that base their legal maritime zones on these islands.

Characterising resting patterns of mother-calf humpback whale groups in a semi-enclosed embayment along the Australian east coast migration pathway.

On migration from low latitude breeding grounds to high latitude feeding grounds, humpback whale mothers and calves spend time resting in coastal embayments. Unlike other areas where resting has been documented, Jervis Bay, on Australia's east coast, is remote from both breeding and feeding grounds, and provides a unique opportunity to compare resting behaviour observed within a semi-enclosed embayment to observations offshore. Land-based, and UAV surveys were conducted in Jervis Bay in 2018, 2019, and 2021. We show that (i) a disproportionately high percentage of groups with a calf enter Jervis Bay during the southbound migration, (ii) travelling speeds are significantly slower in the Bay compared to offshore, indicating resting behaviour, and (iii) aerial observations highlight resting and nurturing behaviour. Subsequently, we conclude that Jervis Bay is an important area for resting mother-calf humpback whale groups. Comparison with reports of resting behaviour during migration in areas nearer the breeding grounds shows commonalities that characterise resting behaviour in mothers and calves. This characterisation will allow improved monitoring and management of humpback whales in nearshore embayments during a critical stage of calf development, particularly those with increased anthropogenic activities.

Spatial analysis of pediatric burns shows geographical clustering of burns and 'hotspots' of risk factors in New South Wales, Australia.

OBJECTIVE: Pediatric burns are a significant cause of morbidity and mortality, and it is estimated that more than 80% are preventable. Studies among adults have shown that burns risk are geographically clustered, and higher in socioeconomically-disadvantaged areas. Few studies among children have examined whether burns are geographically clustered, and if burn prevention programs are best targeted to high-risk areas. METHOD: Retrospective analyses examined the 2005-to-2014 NSW Severe Burns Injury Service data. Geospatial imaging software was used to map the relative-risk and clustering of burns by postcodes in Greater Sydney Area (GSA). Cluster analyses were conducted using Getis-Ord and Global Moran's I statistics. High- and low-risk populations and areas were examined to ascertain differences by sociodemographic characteristics, etiology and the extent of the burn. RESULTS: Scalds were the most common types of burns and boys were at greater risk than girls. There was significant clustering of burns by postcode area, with a higher relative risk of burns in western and north-western areas of Sydney. The high-risk clusters were associated with socioeconomic disadvantage, and areas of low burns risk were associated with socioeconomic advantage. In both high- and low-risk areas burns occurred more frequently in the 12-24 months and the 24-36 months age groups. The implication of this study is that pediatric burns risk clustering occurs in specific geographic regions that are associated with socioeconomic disadvantage. The results of this study provide greater insight into how pediatric populations can be targeted when devising intervention strategies, and suggest that an area-targeted approach in socioeconomically-disadvantaged areas may reduce burns risk.

Too hot to handle? Hot water bottle injuries in Sydney, Australia.

OBJECTIVE: Hot water bottles are frequently used in the community as a source of warmth, and to alleviate a number of medical symptoms. In Australia it is believed that over 500,000 water bottles are sold annually (Whittam et al., 2010). This simple treatment is known to result in significant burns and has led to mandatory labeling requirements on hot water bottles in Australia. Despite this, few published studies have documented the incidence and nature of burns sustained through their use. This study aimed to assess the incidence, causation and outcome of hot water bottle burns presenting to a major burn trauma unit in Sydney (Australia). METHODS: The New South Wales Agency for Clinical Innovation Statewide Burn Injury database and admission data to the Concord Hospital Burns Injury Unit (major treatment unit) provided information on hot water bottle burns occurring between 2005 and 2013. Demographic details, cause of burn, burn depth, total burn surface area (%TBSA), and outcome of burn were ascertained. In order to assess the burn potential of hot water bottles, a separate study examined the thermic properties of hot water bottles in 'real life' scenarios. FINDINGS: There were 155 hot water bottle burn presentations resulting in 41 admissions and 24 grafts. The majority of patients were female, and most burns resulted from appliance rupture when used for local pain relief. Patients had an average TBSA of 2.4%. Burns patients were slightly more likely to reside in areas with greater socio-economic disadvantage. In real life scenarios, hot water bottles were shown to retain heat over 50°C for at least 3 hours (h). CONCLUSIONS: Hot water bottles are a source of common and preventable burns in the community, with women being more at risk than men. Hot water bottles may retain harmful levels of heat over an extended period of time. Additional labeling requirements pertaining to the longevity of hot water bottles and their use among people especially at risk of burns (i.e. children, the elderly, patients who have undergone recent surgery and/or those with conditions associated with sensory impairment) may further reduce the incidence and severity of hot water bottle burns in the community.

Geospatial and epidemiological analysis of severe burns in New South Wales by residential postcodes.

BACKGROUND: Burns are a common trauma, affecting 1% of the Australian population annually and are associated with significant physical, psychological, social and economic burdens for victims and their families. There has been a recent paradigm shift from the treatment of burns to a more preventative approach. OBJECTIVES: To examine the risk of severe burns by geographic region in New South Wales (NSW), Australia, using geospatial analytic techniques. METHOD: Retrospective analyses were carried out to examine the 2006-2010 NSW burns data collected by the NSW Severe Burns Injury Service. Spatial analysis software was used to map the relative risk of burns by postcode areas. Spatial cluster analyses were then undertaken for the Greater Sydney Area (GSA) using Global Moran's I statistics and Getis-Ord analyses. High- and low-risk populations and areas were examined to ascertain differences by sociodemographic characteristics, etiology and the extent of burn. RESULTS: Scalds were the most common types of burns and men were at greater risk of burns than women. There was significant clustering of burns by postcode area, with a higher relative risk of severe burns seen in Western Sydney area and lower risk observed in Eastern and Southern Sydney. In high-risk areas burns occurred more frequently in the 13-24 months and the 20-29 years age groups, while in low-risk areas burns mostly affect the 20-29 and 30-39 years age groups. High-risk areas were characterized by socioeconomic disadvantage. IMPLICATIONS: Mapping the risk of burns is a valuable tool for policy makers to plan and deliver targeted intervention strategies for burns prevention.

Primary scene responses by Helicopter Emergency Medical Services in New South Wales Australia 2008-2009.

BACKGROUND: Despite numerous studies evaluating the benefits of Helicopter Emergency Medical Services (HEMS) in primary scene responses, little information exists on the scope of HEMS activities in Australia. We describe HEMS primary scene responses with respect to the time taken, the distances travelled relative to the closest designated trauma hospital and the receiving hospital; as well as the clinical characteristics of patients attended. METHODS: Clinical service data were retrospectively obtained from three HEMS in New South Wales between July 2008 and June 2009. All available primary scene response data were extracted and examined. Geographic Information System (GIS) based network analysis was used to estimate hypothetical ground transport distances from the locality of each primary scene response to firstly the closest designated trauma hospital and secondly the receiving hospital. Predictors of bypassing the closest designated trauma hospital were analysed using logistic regression. RESULTS: Analyses included 596 primary missions. Overall the HEMS had a median return trip time of 94min including a median of 9min for activation, 34min travelling to the scene, 30min on-scene and 25min transporting patients to the receiving hospital. 72% of missions were within 100km of the receiving hospital and 87% of missions were in areas classified as 'major cities' or 'inner regional'. The majority of incidents attended by HEMS were trauma-related, with road trauma the predominant cause (44%). The majority of trauma patients (81%) had normal physiology at HEMS arrival (RTS = 7.84). We found 62% of missions bypassed the closest designated trauma hospital. Multivariate predictors of bypass included: age; presence of spinal or burns trauma; the level of the closest designated trauma hospital; the transporting HEMS. CONCLUSION: Our results document the large distances travelled by HEMS in NSW, especially in rural areas. The high proportion of HEMS missions that bypass the closest designated trauma hospital is a seldom mentioned benefit of HEMS transport. These results along with the characteristics of patients attended and the time HEMS take to complete primary scene responses are useful in understanding the benefit HEMS provides and the services it replaces.