D. Turner

An introduction to patterns of fire in arid and semi-arid Australia, 1998–2004

Fire is a crucial element in shaping our world, whether of natural or anthropogenic origin. These fires can have both positive and negative consequences and impacts on our natural environment, society and its economics, not to mention global climate. Previous analyses of fire regimes in arid and semi-arid Australia have been of limited spatial or temporal extent. This lack of knowledge has hampered attempts at effective fire management. Satellite imagery allows the continuous detection, monitoring and mapping of fires. Active fires can be detected as fire hotspots, and burned areas mapped as patches from the change of surface reflectance properties in successive images. Data from NOAA’s advanced very high resolution radiometer (AVHRR) were used to assess the distribution, seasonality, frequency, number and extent of fire hotspots (FHS) and fire affected areas (FAA) across the entire arid and semi-arid country of Australia from 1998 to 2004. Utilising both of these fire datasets is important, as they complement each other and provide a more robust analysis of fire patterns. Between 1998 and 2004 almost 27% of arid and semi-arid Australia burnt at least once. The main trends in fire distribution follow latitudinal rainfall gradients. Regression analysis also shows a strong relationship with the pattern of antecedent rainfall. The seasonality of fire events varies between climate zones in accordance with the varying distribution of precipitation and temperature, which influence fuel accumulation and curing. For the first time we have a picture of fire patterns across the entire arid and semi-arid regions of the country. This includes several high fire years in certain areas following above-average rainfall. This analysis highlights similarities and differences between regions, giving policy makers and managers a basis from which to make more informed decisions in the present, and with which to compare future regimes.

Application of Geographic Modeling Techniques to Quantify Spatial Access to Health Services Before and After an Acute Cardiac Event The Cardiac Accessibility and Remoteness Index for Australia (ARIA) Project

Background Access to cardiac services is essential for appropriate implementation of evidence-based therapies to improve outcomes. The Cardiac Accessibility and Remoteness Index for Australia (Cardiac ARIA) aimed to derive an objective, geographic measure reflecting access to cardiac services. Methods and Results An expert panel defined an evidence-based clinical pathway. Using Geographic Information Systems (GIS), the team developed a numeric/alphabetic index at 2 points along the continuum of care. The acute category (numeric) measured the time from the emergency call to arrival at an appropriate medical facility via road ambulance. The aftercare category (alphabetic) measured access to 4 basic services (family doctor, pharmacy, cardiac rehabilitation, and pathology services) when a patient returned to his or her community. The numeric index ranged from 1 (access to principal referral center with cardiac catheterization service ≤1 hour) to 8 (no ambulance service, >3 hours to medical facility, air transport required). The alphabetic index ranged from A (all 4 services available within a 1-hour drive-time) to E (no services available within 1 hour). The panel found that 13.9 million Australians (71%) resided within Cardiac ARIA 1A locations (hospital with cardiac catheterization laboratory and all aftercare within 1 hour). Those outside Cardiac 1A were overrepresented by people >65 years of age (32%) and indigenous people (60%). Conclusions The Cardiac ARIA index demonstrated substantial inequity in access to cardiac services in Australia. This methodology can be used to inform cardiology health service planning and could be applied to other common disease states within other regions of the world. # Clinical Perspective {#article-title-42}Background Access to cardiac services is essential for appropriate implementation of evidence-based therapies to improve outcomes. The Cardiac Accessibility and Remoteness Index for Australia (Cardiac ARIA) aimed to derive an objective, geographic measure reflecting access to cardiac services. Methods and Results An expert panel defined an evidence-based clinical pathway. Using Geographic Information Systems (GIS), the team developed a numeric/alphabetic index at 2 points along the continuum of care. The acute category (numeric) measured the time from the emergency call to arrival at an appropriate medical facility via road ambulance. The aftercare category (alphabetic) measured access to 4 basic services (family doctor, pharmacy, cardiac rehabilitation, and pathology services) when a patient returned to his or her community. The numeric index ranged from 1 (access to principal referral center with cardiac catheterization service ⩽1 hour) to 8 (no ambulance service, >3 hours to medical facility, air transport required). The alphabetic index ranged from A (all 4 services available within a 1-hour drive-time) to E (no services available within 1 hour). The panel found that 13.9 million Australians (71%) resided within Cardiac ARIA 1A locations (hospital with cardiac catheterization laboratory and all aftercare within 1 hour). Those outside Cardiac 1A were overrepresented by people >65 years of age (32%) and indigenous people (60%). Conclusions The Cardiac ARIA index demonstrated substantial inequity in access to cardiac services in Australia. This methodology can be used to inform cardiology health service planning and could be applied to other common disease states within other regions of the world.

Access to cardiac rehabilitation does not equate to attendance

Background/Aims: Timely access to appropriate cardiac care is critical for optimizing positive outcomes after a cardiac event. Attendance at cardiac rehabilitation (CR) remains less than optimal (10%–30%). Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services after a cardiac event in Australia. Methods: An expert panel defined a single patient care pathway and a hierarchy of the minimum health services for CR and secondary prevention. Using geographic information systems a numeric/alpha index was modelled to describe access before and after a cardiac event. The aftercare phase was modelled into five alphabetical categories: from category A (access to medical service, pharmacy, CR, pathology within 1 h) to category E (no services available within 1 h). Results: Approximately 96% or 19 million people lived within 1 h of the four basic services to support CR and secondary prevention, including 96% of older Australians and 75% of the indigenous population. Conversely, 14% (64,000) indigenous people resided in population locations that had poor access to health services that support CR after a cardiac event. Conclusion: Results demonstrated that the majority of Australians had excellent ‘geographic’ access to services to support CR and secondary prevention. Therefore, it appears that it is not the distance to services that affects attendance. Our ‘geographic’ lens has identified that more research on socioeconomic, sociological or psychological aspects to attendance is needed.

A comparison of NOAA–AVHRR fire data with three Landsat data sets in arid and semi-arid Australia

Burnt area data, derived from the National Oceanic and Atmospheric Administration (NOAA) Advanced Very High Resolution Radiometer (AVHRR) imagery, are validated in 11 regions of arid and semi-arid Australia, using three separate Landsat-derived burnt area data sets. Mapping accuracy of burnt extent is highly variable between areas and from year to year within the same area. Where there are corresponding patches in the AVHRR and Landsat data sets, the fit is good. However, the AVHRR data set misses some large patches. Overall, 63% of the Landsat burnt area is also mapped in the AVHRR data set, but this varies from 0% to 89% at different sites. In total, 81% of the AVHRR burnt area data are matched in the Landsat data set, but range from 0% to 94%. The lower match rates (<50%) are generally when little area has burnt (0–500 km2), with figures generally better in the more northerly sites. Results of regressions analysis based on 10 km × 10 km cells are also variable, with R 2 values ranging from 0.37 (n = 116) to 0.94 (n = 85). For the Tanami Desert scene, R 2 varies from 0.41 to 0.61 (n = 368) over three separate years. Combining the data results in an R 2 of 0.60 (n = 1315) (or 0.56 with the intercept set to 0). The slopes of the regressions indicate that mapping the burnt area from AVHRR imagery underestimates the ‘true’ extent of burning for all scenes and years. Differences in mapping accuracy between low and high fire years are examined, as well as the influence of soil, vegetation, land use and tenure on mapping accuracy. Issues which are relevant to mapping fire in arid and semi-arid environments and discontinuous fuels are highlighted.

Application of Geographic Modeling Techniques to Quantify Spatial Access to Health Services Before and After an Acute Cardiac EventClinical Perspective

Background Access to cardiac services is essential for appropriate implementation of evidence-based therapies to improve outcomes. The Cardiac Accessibility and Remoteness Index for Australia (Cardiac ARIA) aimed to derive an objective, geographic measure reflecting access to cardiac services. Methods and Results An expert panel defined an evidence-based clinical pathway. Using Geographic Information Systems (GIS), the team developed a numeric/alphabetic index at 2 points along the continuum of care. The acute category (numeric) measured the time from the emergency call to arrival at an appropriate medical facility via road ambulance. The aftercare category (alphabetic) measured access to 4 basic services (family doctor, pharmacy, cardiac rehabilitation, and pathology services) when a patient returned to his or her community. The numeric index ranged from 1 (access to principal referral center with cardiac catheterization service ≤1 hour) to 8 (no ambulance service, >3 hours to medical facility, air transport required). The alphabetic index ranged from A (all 4 services available within a 1-hour drive-time) to E (no services available within 1 hour). The panel found that 13.9 million Australians (71%) resided within Cardiac ARIA 1A locations (hospital with cardiac catheterization laboratory and all aftercare within 1 hour). Those outside Cardiac 1A were overrepresented by people >65 years of age (32%) and indigenous people (60%). Conclusions The Cardiac ARIA index demonstrated substantial inequity in access to cardiac services in Australia. This methodology can be used to inform cardiology health service planning and could be applied to other common disease states within other regions of the world. # Clinical Perspective {#article-title-42}Background Access to cardiac services is essential for appropriate implementation of evidence-based therapies to improve outcomes. The Cardiac Accessibility and Remoteness Index for Australia (Cardiac ARIA) aimed to derive an objective, geographic measure reflecting access to cardiac services. Methods and Results An expert panel defined an evidence-based clinical pathway. Using Geographic Information Systems (GIS), the team developed a numeric/alphabetic index at 2 points along the continuum of care. The acute category (numeric) measured the time from the emergency call to arrival at an appropriate medical facility via road ambulance. The aftercare category (alphabetic) measured access to 4 basic services (family doctor, pharmacy, cardiac rehabilitation, and pathology services) when a patient returned to his or her community. The numeric index ranged from 1 (access to principal referral center with cardiac catheterization service ⩽1 hour) to 8 (no ambulance service, >3 hours to medical facility, air transport required). The alphabetic index ranged from A (all 4 services available within a 1-hour drive-time) to E (no services available within 1 hour). The panel found that 13.9 million Australians (71%) resided within Cardiac ARIA 1A locations (hospital with cardiac catheterization laboratory and all aftercare within 1 hour). Those outside Cardiac 1A were overrepresented by people >65 years of age (32%) and indigenous people (60%). Conclusions The Cardiac ARIA index demonstrated substantial inequity in access to cardiac services in Australia. This methodology can be used to inform cardiology health service planning and could be applied to other common disease states within other regions of the world.