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Abstract: This study examined decisions made by householders under wildfire threat. Data were obtained from interviews with survivors of severe wildfires in Victoria (Australia) on 7 February 2009 which killed 172 civilians and destroyed more than 2000 homes. Prior to this, Australian fire agency community wildfire safety policy was that residents should: ‘Prepare, stay and defend or leave early’. Most of the 223 interviewees who stayed and defended did so because this was their wildfire safety plan, and they believed that they would be successful despite the predicted extreme fire danger weather. In 79% of cases, defence was successful; for the remaining 21% the house was destroyed and several lives were imperilled. Of the 216 who left for a safer location only 39% said that this was their wildfire safety plan; for most, the action of leaving was triggered by realisation of the imminent threat posed by the fire; 36% self-evacuated under hazardous conditions. The findings suggest that community wildfire safety programs should emphasize: (a) the risks associated with staying to defend a property; and (b) how householders should prepare in order to leave safely if a fire threatens. [Copyright &y& Elsevier]

A survey of soil erosion was conducted in Australia using the fallout radioisotope caesium-137 as an indicator of topsoil redistribution. Two hundred and six sites were sampled, 100 within rotational cropping and horticultural use, 52 within uncultivated permanent pasture and forest, and 54 in rangelands. Average net soil losses were approximately equal for cultivated cropping lands and rangelands ( ca. 5.5 t ha−1 yr−1), and just over 1 t ha−1 yr−1 for pasture and forest. The Mann Whitney U Test revealed that losses under cropping and rangeland conditions were significantly higher (p < 0.05) than under uncultivated pasture and forest. Soil loss was negatively correlated with mean annual rainfall and slope gradient, and positively correlated with slope length (Spearman's rank correlation). There was no correlation between rates of soil loss and a rainfall erosi-vity index. An assessment of erosional events was provided by landholders for 104 sites, with their ranking being weakly but significantly correlated with soil loss estimates (r =+0.35). Sixty percent of sites had net soil losses greater than 1 t ha−1 yr−1, and 74% of sites had losses of more than 0.5 t ha−1 yr−1. This latter rate may be regarded as a limit for a tolerable level of soil loss. These high rates of soil loss have occurred since the mid-1950s despite there being significant landholder awareness of the soil erosion hazard. [ABSTRACT FROM AUTHOR]

Objective: To describe the characteristics of people attending mental health clinics at shelters for the homeless in inner city Sydney., Design: Retrospective review of medical records of homeless hostel clinic attenders., Setting: Mental health clinics located in three inner city homeless hostels., Participants: Consecutive series of clinic attenders, 21 July 2008 - 31 December 2016., Main Outcome Measures: Demographic characteristics; social, medical and mental health histories of homeless people., Results: 2388 individual patients were seen at the clinics during the 8.5-year study period. Their mean age was 42 years (standard deviation, 13 years), 93% were men, and 56% were receiving disability support pensions. 59% of attenders had been homeless for more than a year, and 34% of all attenders reported sleeping in the open. The most common diagnoses were substance use disorder (66%), psychotic illness (51%), acquired brain injury (14%), and intellectual disability (5%). Most patients had more than one diagnosis. Early life and recent trauma was reported by 42% of patients. Pathways to homelessness included release from prison (28% of the homeless), discharge from a psychiatric hospital (21%), loss of public housing tenancy (21%), and inability to pay rent because of problem gambling., Conclusions: The high rates of substance use and mental disorder among homeless people in inner Sydney confirms the need for increased access to treatment for these conditions in this setting. Homelessness among those with mental illness might be reduced by developing alternative housing models, and supporting people with multiple problems to retain tenancy.

Objective: The increasing prevalence and earlier onset of chronic health conditions amongst Aboriginal and Torres Strait Islander people has become a concerning and significant problem. Telehealth may be a useful application for the early detection, monitoring, and treatment of chronic diseases such as ear disease and vision impairment. This study evaluates whether it is feasible to integrate a mobile telemedicine-enabled ear and eye-screening service with existing community-based services for Australian indigenous children., Materials and Methods: A collaborative service was established with the local community and delivered from a van fitted with screening equipment and telemedicine capabilities. Indigenous children (0-16 years) were assessed at school by an aboriginal health worker for conditions impacting hearing and vision. Screening data and video-otoscopic images were uploaded to a database and made accessible to specialists via a secure Web site. Those children who failed an ear-screening assessment, tele-otology clinics were conducted remotely by an ear, nose, and throat specialist, who reviewed cases and provided a diagnosis and treatment plan. Similarly, children who failed vision assessments were referred to an optometrist for follow-up care., Results: During the first 6 months, the service visited 12 of the 16 schools in the region, screening 442 of the 760 consented children (58%). Of the 183 (41%) children who failed ear screening, 59 were reviewed remotely by an ear, nose, and throat surgeon, with 9 children booked for surgery. Three hundred and four or 41% of the consenting children completed an eye assessment, in which 46 (15%) failed and required referral to the optometrist., Conclusions: It is feasible to integrate a mobile telehealth screening service with existing community-based services to provide specialist review and treatment planning at a distance. Community consultation, engagement, and collaboration in all areas of the project have been important.

Objective: The criminal justice system relies on the opinions of expert witness to assist in decisions about fitness to stand trial (FST) and verdicts of not guilty by reason of mental illness (NGMI). The aim of the present study was to assess the level of agreement between experts about these legal issues using a consecutive series of serious criminal matters in New South Wales., Methods: Pairs of reports from 110 consecutive criminal matters completed by the New South Wales Office of the Director of Public Prosecutions between 2005 and 2007 were examined. The opinions of experts about FST and NGMI were recorded., Results: Agreement about FST was fair-moderate (experts engaged by opposite sides, kappa = 0.293; experts engaged by the same side, kappa = 0.471), although there was a higher level of agreement in homicide matters. Agreement about NGMI was moderate-good (experts engaged by opposite sides, kappa = 0.508; experts engaged by the same side, kappa = 0.644) and there was a higher level of agreement when the experts also agreed about the diagnosis of schizophrenia. Further analysis using generalized estimating equations did not find a higher level of agreement about FST or NGMI in pairs of reports containing the opinion of experts from the same side., Conclusions: Little evidence was found for bias in expert opinions about either FST or NGMI, but the comparatively low level of agreement about FST suggests the need for reform in the way that FST is assessed.

High incidences of skin damage and skin cancer amongst Australians have resulted in numerous campaigns to encourage people to protect themselves against solar ultraviolet radiation (UVR). The detrimental effects of UV-B radiation have been known for some time but recently there has been concern over the effects of UV-A radiation which had been thought of as relatively harmless. The proliferation of solaria, which incorporate UV-A sources, prompted the issuing of an Australian standard dealing with technical and non-technical aspects of the artificial suntanning industry. The purpose of this study was to measure the irradiance and spectral distribution of the emission from sunbeds and other UVR sources used for tanning, to evaluate the hazard potential and also the compliance with the standard. It was found that the majority of the UV-A lamps evaluated met the requirements of the standard. The UV-B lamps and portable sunlamps are potentially hazardous and their use should be discouraged. In general, the survey of solaria highlighted the need for further education of the public and especially the users and operators of solaria, on the hazards of UVR and of protective measures required for its safe use.