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.

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.

Equitable sharing of benefits from tiger conservation: Beneficiaries' willingness to pay to offset the costs of tiger conservation.

Costs of large predator conservation may not be equitably distributed among stakeholders; these include farming communities, tourism business owners and visitors. Financial redistribution mechanisms based on accrued benefits and costs of conservation require relevant data unavailable in many locations. To address this, a contingent valuation method identified willingness to pay (WTP) among national park visitors and connected tourism business owners. Both groups derive benefit from government-funded conservation policies. The study was conducted in Bardia and Chitwan National Parks, Nepal 2017-2018; two locations world-renowned for tiger conservation. Local and international park visitors (N = 387) provided WTP for ongoing conservation via additional park entry fees. Tourism business owners (TBOs; N = 74) proximate to the parks stated their WTP for compensation funding provided directly to farmers. The majority (65%) of park visitors were willing to pay extra to support conservation (sample mean US$ 20) while 85 percent of TBOs supported their payment of funds for compensating farming communities (sample mean annual contribution being US$ 156). Valid WTP regression modelling found that visitor WTP was predicted by international travel costsand environmental organization affiliation. For TBOs indicating WTP, the amount to pay was predicted by annual net income from the tourism business. Application of study data indicates US$ 25 average increase to visitor park fees would maximise revenue and contribute a further US$ 495,000 available for conservation activities. Similarly, a flat-rate tariff on TBOs at the mean WTP amount would contribute more than double the annual budget available for farmer compensation (providing approximately US$ 43,000). More generally, the study findings are informative for policy-makers seeking equitable conservation outcomes while maintaining viable populations of critically endangered wild tigers. They should however be interpreted with caution given limitations of the sampling frame and method of data elicitation. Regardless, any policy decision effects require careful scrutiny to ensure desired outcomes are realized.

Prospective reporting of injury in community-level cricket: A systematic review to identify research priorities.

OBJECTIVES: Cricket is a popular sport enjoyed worldwide. Injuries in cricket are not well understood at community level but are important to understand for prevention to ensure the game continues to be enjoyed safely. This systematic review was designed to assess the quality of data collection and reporting, and to summarise the injury data, in studies of community cricket players. DESIGN: Systematic review. METHODS: Nine databases were searched to November 2018 using the terms "cricket*" and "injur*". A nine-item critical appraisal and three-item likelihood-of-bias evaluation was conducted on included studies. Data completeness was evaluated against recommendations in the international cricket consensus statement for recording/reporting injury and the Australian Sports Injury Data Dictionary (ASIDD). Descriptive injury data (n,%) are presented in tabular format for different subgroups (activity, position, population). RESULTS: Thirteen studies were included, of which eight were rated as unclear, one as high and three having a low likelihood-of-bias. The mean score for completeness of data against the consensus statement was 3.5/10 (95%C.I. 2.8-4.2). The mean score for completeness of data against the ASIDD was 4.4/6 (95%C.I. 3.9-5.0). Bruising and inflammation was the most common injury in junior cricket. Stress fractures were most common in studies of bowlers. Where studies included all activities, batting accounted for most injuries (7-49%). CONCLUSIONS: The included studies inconsistently addressed recommended items for injury surveillance in community sport and cricket. Most studies focused on junior levels or adolescent bowlers, with bruising/inflammation and stress fractures being most common, respectively.

Medical-attention injuries in community cricket: a systematic review.

OBJECTIVES: The aim was to identify and describe outcomes from original published studies that present the number, nature, mechanism and severity of medically treated injuries sustained in community-level cricket. DESIGN: Systematic review. METHODS: Nine databases were systematically searched to December 2019 using terms "cricket*" and "injur*". Original, peer-reviewed studies reporting injury for at least one injury descriptor (body region, nature of injury and/or mechanism of injury) in community-level cricketers of all ages were included. Qualitative synthesis, critical appraisal and descriptive summary results are reported within the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS: Six studies were included: five reported hospital-treated data and one reported insurance claims data. Two had a low risk of bias. In hospital-based studies, fractures were the most frequent injury type. Upper and lower limb injuries (age ≥15 years) and injuries to the head (age <15 years) were the most common body region injured. Being struck by the ball was the most common mechanism for injury presenting to hospitals. Children were also commonly struck by equipment. One study using insurance claims data reported soft tissue injuries as the main of injury type. CONCLUSION: Hospital treatment data were most prominent, which emphasised injuries of a more serious nature or requiring acute care. These injuries were primarily fractures, dislocation/sprain and strains, bruising and open wounds with the majority resulting from players being struck by the ball. Research into whether properly fitted protective equipment, at an approved standard, is worn and is effective, is recommended.

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.

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.

"It Doesn't Make Sense for Us Not to Have One"-Understanding Reasons Why Community Sports Organizations Chose to Participate in a Funded Automated External Defibrillator Program.

OBJECTIVE: Implementation of automated external defibrillators (AEDs) in community sports settings is an important component of emergency medical planning. This study aimed to understand motivations for why sports organizations participated in a government-funded program that provided AEDs and associated first-aid training. DESIGN: Face-to-face interviews. SETTING: Community sports organizations in Victoria, Australia. PARTICIPANTS: Representatives from 14 organizations who participated in a government-funded AED program. MAIN OUTCOME MEASURES: Motivations to participate in the AED program were explored using a qualitative descriptive approach. RESULTS: Two overarching themes emerged: awareness of the program and decision to apply. Awareness was gained indirectly through grant advertising in newsletters/emails/web sites and directly through their sporting associations. For most organizations, there was no decision process per se, rather, the opportunity to apply was the key determinant for participating in the program. A duty of care also emerged as a key driving factor, with recognition of AEDs as a valuable asset to communities broadly, not just the participants' immediate sports setting. Reflecting on participation in the program, these participants identified that it was important to increase awareness about AED ownership and use. The program benefits were clearly summed up as being best prepared for a worst-case scenario. DISCUSSION: This study provides new understanding of why community sports organizations apply for an AED and training. The strongest reason was simply the opportunity to acquire this at no cost. Therefore, for wider implementation of AEDs, additional funding opportunities, targeted awareness of these opportunities, and continued promotion of AED importance are recommended.

Measurement of a drowning incidence rate combining direct observation of an exposed population with mortality statistics.

Drowning risk factors may be identified by comparing drowning incidence rates for comparable at-risk populations but precise methods are lacking. To address this knowledge gap, an ecological study extrapolated crude time-duration exposure to water for a specified at-risk sample of surf bathers to estimate the bather population for all wave-dominated beaches in Victoria, Australia, over a four-year summer season period. An incidence rate was calculated using surf bather drowning deaths frequencies matched for time and location. For the sample, 47,341 hours of surf bathing were estimated from 177,528 bathing episodes. Generalising these results to Victoria, the crude drowning deaths incidence rate in the summer season was 0.41 per 1,000,000 person-hours of surf bathing (95% CI 0.37-0.45). Further application of the method, particularly in open water settings, may be used to identify candidate drowning risk factors to advance drowning prevention strategies.

Surf lifeguard rescues.

OBJECTIVE: This study assessed the utility of lifeguard rescue data for providing information on person and situation factors to inform surf bather drowning prevention research. METHODS: The dataset comprised 872 beach-days (daily lifeguard reports) obtained from 26 beaches over a 95-day period in Victoria, Australia. RESULTS: The rescue rate was 128 per 100,000 in-water bathers. One or more rescues were required on 125 beach-days (14%). Rescue on a beach-day was more likely for offshore wind conditions, relatively high daily air temperatures, and high bather numbers (P < .05). Compared to female bathers, males were more frequently rescued (65%) and more likely (P < .05) to be from a younger age group (30 years or less), although being older was associated with a relatively poorer condition on rescue. CONCLUSIONS: Although rescues are proportional to water exposure, frequencies are also influenced by situation and person factors. Bathers at relatively high risk of rescue are hypothesized to be overrepresented in amenable sea and weather conditions, and poor patient condition on rescue may be associated with exposure to a preexisting health condition.

Self-reported water and drowning risk exposure at surf beaches.

OBJECTIVE: To document patterns of water exposure at surf beaches by gender and identify factors that predict bather confidence to return to shore if caught in a rip current. METHOD: Recreational surf beach bathers (N=406) provided self-completed data on water exposure patterns, surf activity behaviours and potential drowning risk and protective factors. RESULTS: Relative to females, males visited surf beaches more frequently, expected to spend longer in the water and in deeper water, and more often bathed after using alcohol (p<0.05). Confidence to return to shore if caught in a rip current was predicted by confidence to identify a rip current, self-rated swimming ability, gender, times visited any beach, and age in a standard linear regression model (adjusted R(2)=0.68). CONCLUSION: The study supports explanations that high male drowning rates result from more frequent exposure to water than females at high situational risk levels. IMPLICATIONS: Controlled studies are required to determine the role in drowning of overconfidence, swimming ability, surf experience, floatation devices and response to sea conditions.

Direct observation measurement of drowning risk exposure for surf beach bathers.

Because not all persons bathe at surf beaches, drowning rates based on resident population are likely to be underreported. To facilitate more precise drowning risk exposure data, this study aimed to develop a reliable direct observation measure of frequency and duration for surf beach bather exposure to water, by gender and age group. Bathers were defined as persons entering the water to wade, swim or surf with equipment. Observed bathers were systematically selected entering the water in daylight hours at six patrolled or unpatrolled beaches over 10 days. Variables measured were: weather and water conditions, water entries, duration of water exposure, water exposure location and person factors. The dataset comprised 204 (69.6%) males and 89 (30.4%) females, with males more likely to be in an older age group (p<0.05). Compared to females, males spent longer in the water, were more likely to use surfing equipment, and mainly used a surf zone located farther from the shore in deeper water (p<0.05). Two factors were significant predictors of bathing duration (adjusted R(2)=0.45): main surf zone occupied (based on water depth and distance from shore); and surf equipment used. The study provides new information about water exposure for bathers at surf beaches and new methods for measuring exposure to drowning risk. The findings suggest that overrepresentation of adolescent and adult males in surf beach drowning statistics is in part a product of greater total exposure to the water plus more frequent exposure to deeper water and bathing farther from shore.