Community sports safety

This research developed a valid and reliable instrument to assess the sports safety policies and practices of community sports clubs. The instrument was used to describe the safety policies and practices of a sample of community clubs and a training package was developed and trialled to address the gaps identified.

Associations between neighbourhood safety and physical activity among youth

This thesis examined how perceptions of neighbourhood safety and objective measures of the local road environment were related to physical activity among youth. Results demonstrated that neighbourhoods with walking tracks and traffic-calming measures promote active transport (walking/cycling) and may help stem age-related declines in physical activity among children and adolescents.

Australian patient safety survey

The national telephone survey found that 6.5% of respondents reported experiencing a medical adverse event during the preceding 12 months. Most reported were medication incidents, with misdiagnosis or wrong treatment second most common. Predictors of adverse event reporting included health status, hospital admission, and length of time seeing regular doctor.

The development and validation of a psychological contract of safety scale

Introduction
This paper builds on previous research by the author and describes the development and validation of a new measure of the psychological contract of safety. The psychological contract of safety is defined as the beliefs of individuals about reciprocal safety obligations inferred from implicit and explicit promises.

Method
A psychological contract is established when an individual believes that perceived employer and employee safety obligations are contingent on each other. A pilot test of the measure is first undertaken with participants from three different occupations: nurses, construction workers, and meat processing workers (N = 99). Item analysis is used to refine the measure and provide initial validation of the scale. A larger validation study is then conducted with a participant sample of health care workers (N = 424) to further refine the measure and to determine the psychometric properties of the scale.

Results
Item and correlational analyses produced the final employer and employee obligations scales, consisting of 21 and 17 items, respectively. Factor analyses identified two underlying dimensions in each scale comparable to that previously established in the organizational literature. These transactional and relational-type obligations provided construct validity of the scale. Internal consistency ratings using Cronbach's alpha found the components of the psychological contract of safety measure to be reliable.

Impact on Industry
The refined and validated psychological contract of safety measure will allow investigation of the positive and negative outcomes associated with fulfilment and breach of the psychological contract of safety in future research.

Are safety-related features of the road environment associated with smaller declines in physical activity among youth?

This study examined how objective measures of the local road environment related to safety were associated with change in physical activity (including active transport) among youth. Few longitudinal studies have examined the impact of the road environment on physical activity among children/adolescents in their neighborhoods. Participants were children aged 8–9 years (n=170) and adolescents aged 13–15 years (n=276) in 2004. Data were collected in 2004 and 2006 during followup of participants recruited initially in 2001 from 19 primary schools in Melbourne, Australia. Walking/cycling to local destinations was parent-reported for children and self-reported by adolescents. Moderate-to-vigorous physical activity (MVPA) during nonschool hours was recorded using accelerometers. Road environment features in each participant’s neighborhood (area within 800 m radius of their home) were measured objectively using a Geographical Information System. Linear regression analyses examined associations between road features and changes in active transport (AT) and MVPA over 2 years. Children’s AT increased but MVPA levels decreased in both age groups; on average, younger girls recorded the greatest declines. The number of traffic/pedestrian lights was associated with ΔAT among younger girls (B=0.45, p=0.004). The total length of walking tracks (in meters) was associated with ΔAT among younger girls (B=0.0016, p=0.015) and adolescent girls (B=0.0016, p=0.002). For adolescent boys, intersection density was associated with ΔAT (B=0.03, p=0.030). Slow points were associated with ΔMVPA among younger boys before school (B=1.55, p=0.021), while speed humps were associated with ΔMVPA among adolescent boys after school (B=0.23, p=0.015). There were many associations for adolescent girls: for example, the total length of local roads (B=0.49, p=0.005), intersection density (B=0.05, p=0.036), and number of speed humps (B=0.33, p=0.020) were associated with ΔMVPA during nonschool hours. Safety-related aspects of the built environment are conducive to physical activity among youth and may help stem age-related declines in physical activity. Passive road safety interventions may promote AT and physical activity among less active girls, in particular.

Nurses' role in medication safety

Aim To explore the nurses role in the process of medication management and identify the challenges associated with safe medication management in contemporary clinical practice.
Background Medication errors have been a long-standing factor affecting consumer safety. The nursing profession has been identified as essential to the promotion of patient safety.
Evaluation A review of literature on medication errors and the use of electronic prescribing in medication errors.
Key issues Medication management requires a multidisciplinary approach and interdisciplinary communication is essential to reduce medication errors. Information technologies can help to reduce some medication errors through eradication of transcription and dosing errors. Nurses must play a major role in the design of computerized medication systems to ensure a smooth transition to such as system.
Conclusion The nurses roles in medication management cannot be over-emphasized. This is particularly true when designing a computerized medication system.
Implication for nursing management The adoption of safety measures during decision making that parallel those of the aviation industry safety procedures can provide some strategies to prevent medication error. Innovations in information technology offer potential mechanisms to avert adverse events in medication management for nurses.

Extended supervision or civil commitment for managing the risk of sexual offenders : public safety and individual rights

Since the early 1990’s, there has been a proliferation of legislative initiatives in North America, the United Kingdom, and Australasia that are intended to improve public protection from high risk sexual offenders. These laws include extended supervision of sexual offenders once released from prison and indefinite involuntary civil commitment to secure treatment facilities following the expiration of a prison sentence. The enactment of these laws has sparked intense debate and numerous legal challenges on a variety of issues, including the need to strike a proper balance between public safety and the rights of individual offenders. Recent challenges to Extended Supervision Orders in New Zealand have included the assertion that this approach is inconsistent with the Bill of Rights Act. This article compares the use of Extended Supervision Orders in New Zealand to the use of civil commitment of Sexually Violent Predators in the United States, and particularly in California, which currently confines the largest number of offenders under this type of commitment. It is argued that Extended Supervision is more flexible, less intrusive, less punitive, and less costly than civil commitment. The degree to which it is effective in improving public safety remains an empirical question.

The safety of medications for the treatment of bipolar disorder during pregnancy and the peurperium

Risks associated with pharmacological treatment of bipolar disorder are heightened during reproductive events. Treatments need to be planned with the mutual agreement of both the treating physician and the patient and tailored to the needs of the individual so as to minimise risk while providing adequate treatment. Conventional treatments have all been associated with teratogeny in first trimester exposure, lithium with cardiac malformation and valproate and carbamazepine with neural tube malformations. There have been an insufficient number of first trimester exposures to the newer anticonvulsant mood stabilisers, lamotrigine and oxcarbazepine, to determine whether there is a safety advantage in switching to these agents. Increasingly, atypical antipsychotics are being suggested as useful agents for the treatment of bipolar disorder. While not known to be teratogenic, there are other reproductive safety concerns associated with these agents. Bipolar disorder patients may be prescribed antidepressants, and many of these agents are associated with a low safety risk during reproductive events, however data regarding use of these agents are currently equivocal. Adverse outcomes from inadequate pharmacological prophylaxis have been documented for both the mother and the baby. Risks and benefits need to be carefully balanced based on an accurate review of the evidence.

A review of clozapine safety

Clozapine is a distinctive antipsychotic agent, having a unique clinical profile and an idiosyncratic safety profile. More so than with other agents, the weighting of its adverse event profile is critical, in order to counterbalance its clear clinical advantages. The safety issues with clozapine are in a number of areas, some of which are considered medical emergencies and potentially life-threatening. These include haematological (neutropenia and agranulocytosis), CNS (seizures), cardiovascular (myocarditis and cardiomyopathy), metabolic (diabetes), gastrointestinal and neuromuscular. Understanding the safety profile of clozapine allows an informed use of the agent that can maximise its clear clinical benefit and minimise the known risks.