Returning to the roots of culture : a review and re-conceptualisation of safety culture

Despite significant research, there is still little agreement over how to define safety culture or of what it is comprised. Due to this lack of agreement, much of the safety culture research has little more than safety management strategies in common. There is, however, a degree of acceptance of the close relationship between safety culture and organisational culture. Organisational culture can be described using traditional views of culture drawn from the anthropology and cultural psychology literature. However, the safety culture literature rarely ventures beyond organisational culture into discussions of these more traditional concepts of culture. There is a need to discuss how these concepts of culture can be applied to safety culture to provide greater understanding of safety culture and additional means by which to approach safety in the workplace. This review explores how three traditional conceptualisations of culture; the normative, anthropological and pragmatist conceptualisations, can and have been be applied to safety culture. Finally the review proposes a synthesised conceptualisation of safety culture which can be used to provide greater depth and practical applicability of safety culture, by increasing our understanding of the interactions between cultural and contextual variables in a given workplace and the effect they have on safety.

The emergence of critical health psychology : can it contribute to promoting public health?

The purpose of this article is twofold : first to provide an overview of the emergence of critical health psychology for those working in the related social and health sciences and as a review of its major developments for health psychology; and second to discuss critically the potential for critical health psychology to contribute to promoting public health with specific reference to the directives espoused by Prilleltensky (2003) and Murray and Campbell (2003). The identification of three philosophical phases of the emergence of critical health psychology is used to examine the directions of the field and the challenges facing critical health psychology in order to contribute to public and global health.

Decision-making about hormone replacement therapy by women in England and Scotland

OBJECTIVE: The aim of this study was to explore women's decision-making about the balance of risks and benefits of taking hormone replacement therapy (HRT) based on the latest evidence from the Women's Health Initiative (WHI) trial of combined HRT. METHODS: Women aged 50-69 years, who were eligible for the Women's International Study of long Duration Oestrogen after Menopause (WISDOM) trial, were invited to participate in one of eight focus groups. Participants were asked to discuss their views about taking HRT based on the latest international evidence. RESULTS AND CONCLUSIONS: Eighty-two women participated overall. Qualitative content analysis was applied to the discussion transcripts. Women regarded the decisions they make about taking HRT as highly personal, and, for women currently taking HRT, the overwhelming reason for continuation was perceived improvement in quality of life regardless of either the risks or the benefits in the longer term.

An FE investigation simulating intra-operative corrective forces applied to correct scoliosis deformity

Background: Adolescent idiopathic scoliosis (AIS) is a deformity of the spine, which may 34 require surgical correction by attaching a rod to the patient’s spine using screws 35 implanted in the vertebral bodies. Surgeons achieve an intra-operative reduction in the 36 deformity by applying compressive forces across the intervertebral disc spaces while 37 they secure the rod to the vertebra. We were interested to understand how the 38 deformity correction is influenced by increasing magnitudes of surgical corrective forces 39 and what tissue level stresses are predicted at the vertebral endplates due to the 40 surgical correction. 41 Methods: Patient-specific finite element models of the osseoligamentous spine and 42 ribcage of eight AIS patients who underwent single rod anterior scoliosis surgery were 43 created using pre-operative computed tomography (CT) scans. The surgically altered 44 spine, including titanium rod and vertebral screws, was simulated. The models were 45 analysed using data for intra-operatively measured compressive forces – three load 46 profiles representing the mean and upper and lower standard deviation of this data 47 were analysed. Data for the clinically observed deformity correction (Cobb angle) were 48 compared with the model-predicted correction and the model results investigated to 49 better understand the influence of increased compressive forces on the biomechanics of 50 the instrumented joints. 51 Results: The predicted corrected Cobb angle for seven of the eight FE models were 52 within the 5° clinical Cobb measurement variability for at least one of the force profiles. 53 The largest portion of overall correction was predicted at or near the apical 54 intervertebral disc for all load profiles. Model predictions for four of the eight patients 55 showed endplate-to-endplate contact was occurring on adjacent endplates of one or 56 more intervertebral disc spaces in the instrumented curve following the surgical loading 57 steps. 58 Conclusion: This study demonstrated there is a direct relationship between intra-59 operative joint compressive forces and the degree of deformity correction achieved. The 60 majority of the deformity correction will occur at or in adjacent spinal levels to the apex 61 of the deformity. This study highlighted the importance of the intervertebral disc space 62 anatomy in governing the coronal plane deformity correction and the limit of this 63 correction will be when bone-to-bone contact of the opposing vertebral endplates 64 occurs.

The implications of cross-regional differences for the design of In-vehicle Information Systems : a comparison of Australian and Chinese drivers

The increasing global distribution of automobiles necessitates that the design of In-vehicle Information Systems (IVIS) is appropriate for the regions to which they are being exported. Differences between regions such as culture, environment and traffic context can influence the needs, usability and acceptance of IVIS. This paper describes two studies aimed at identifying regional differences in IVIS design needs and preferences across drivers from Australia and China to determine the impact of any differences on IVIS design. Using a questionnaire and interaction clinics, the influence of cultural values and driving patterns on drivers' preferences for, and comprehension of, surface- and interaction-level aspects of IVIS interfaces was explored. Similarities and differences were found between the two regional groups in terms of preferences for IVIS input control types and labels and in the comprehension of IVIS functions. Specifically, Chinese drivers preferred symbols and Chinese characters over English words and were less successful (compared to Australians) at comprehending English abbreviations, particularly for complex IVIS functions. Implications in terms of the current trend to introduce Western-styled interfaces into other regions with little or no adaptation are discussed.

Towards a capabilities database to inform inclusive design : Experimental investigation of effective survey-based predictors of human-product interaction

A key issue in the field of inclusive design is the ability to provide designers with an understanding of people's range of capabilities. Since it is not feasible to assess product interactions with a large sample, this paper assesses a range of proxy measures of design-relevant capabilities. It describes a study that was conducted to identify which measures provide the best prediction of people's abilities to use a range of products. A detailed investigation with 100 respondents aged 50-80 years was undertaken to examine how they manage typical household products. Predictor variables included self-report and performance measures across a variety of capabilities (vision, hearing, dexterity and cognitive function), component activities used in product interactions (e.g. using a remote control, touch screen) and psychological characteristics (e.g. self-efficacy, confidence with using electronic devices). Results showed, as expected, a higher prevalence of visual, hearing, dexterity, cognitive and product interaction difficulties in the 65-80 age group. Regression analyses showed that, in addition to age, performance measures of vision (acuity, contrast sensitivity) and hearing (hearing threshold) and self-report and performance measures of component activities are strong predictors of successful product interactions. These findings will guide the choice of measures to be used in a subsequent national survey of design-relevant capabilities, which will lead to the creation of a capability database. This will be converted into a tool for designers to understand the implications of their design decisions, so that they can design products in a more inclusive way.

Characteristics of Chinese drivers attending a mandatory training course following license suspension

Penalties and sanctions to deter risky/illegal behaviours are important components of traffic law enforcement. Sanctions can be applied to the vehicle (e.g., impoundment), the person (e.g., remedial programs or jail), or the licence (e.g., disqualification). For licence sanctions, some offences attract automatic suspension while others attract demerit points which can indirectly lead to licence loss. In China, a licence is suspended when a driver accrues twelve demerit points within one year. When this occurs, the person must undertake a one-week retraining course at their own expense and successfully pass an examination to become relicensed. Little is known about the effectiveness of this program. A pilot study was conducted in Zhejiang Province to examine basic information about participants of a retraining course. The aim was to gather baseline data for future comparison. Participants were recruited at a driver retraining centre in a large city in Zhejiang Province. In total, 239 suspended drivers completed an anonymous questionnaire which included demographic information, driving history, and crash involvement. Overall, 87% were male with an overall mean age of 35.02 years (SD=8.77; range 21-60 years). A large proportion (83.3%) of participants owned a vehicle. Commuting to work was reported by 64% as their main reason for driving, while 16.3% reported driving for work. Only 6.4% reported holding a licence for 1 year or less (M=8.14 years, SD=6.5, range 1-31 years) and people reported driving an average of 18.06 hours/week (SD=14.4, range 1-86 hours). This represents a relatively experienced group, especially given the increase in new drivers in China. The number of infringements reportedly received in the previous year ranged from 2 to 18 (M=4.6, SD=3.18); one third of participants reported having received 5 or more infringements. Approximately one third also reported having received infringements in the previous year but not paid them. Various strategies for avoiding penalties were reported. The most commonly reported traffic violations were: drink driving (DUI; 0.02-0.08 mg/100ml) with 61.5% reporting 1 such violation; and speeding (47.7% reported 1-10 violations). Only 2.2% of participants reported the more serious drunk driving violation (DWI; above 0.08mg/100ml). Other violations included disobeying traffic rules, using inappropriate licence, and licence plate destroyed/not displayed. Two-thirds of participants reported no crash involvement in the previous year while 14.2% reported involvement in 2-5 crashes. The relationship between infringements and crashes was limited, however there was a small, positive significant correlation between crashes and speeding infringements (r=.2, p=.004). Overall, these results indicate the need for improved compliance with the law among this sample of traffic offenders. For example, lower level drink driving (DUI) and speeding were the most commonly reported violations with some drivers having committed a large number in the previous year. It is encouraging that the more serious offence of drunk driving (DWI) was rarely reported. The effectiveness of this driver retraining program and the demerit point penalty system in China is currently unclear. Future research including driver follow up via longitudinal study is recommended to determine program effectiveness to enhance road safety in China.

Alcohol and other drugs in the Australian construction industry : a pathway for safety focused cultural change

Background: Anecdotal evidence from the infrastructure and building sectors highlights issues of alcohol and other drugs (AODs) and its association with safety risk on construction sites. Currently, there is no clear evidence on the prevalence and risk of AOD use among Australian construction workers and there is limited evidential guidance regarding how to effectively address such an issue. Aims: The current research aims to scientifically evaluate the use of AODs within the Australian construction industry in order to reduce the potential resulting safety and performance impacts and engender a cultural change in the workforce. A nationally consistent and collaborative approach across the workforce will be adopted. Methods: A national assessment of the use of AODs was conducted in participating organisations across three states. The World Health Organisation’s Alcohol Use Disorders Identification Test (AUDIT) was used to measure alcohol use. Illicit drug use, ‘readiness to change’, impediments to reducing impairment, feasibility of proposed interventions, and employee attitudes and knowledge regarding AOD was also measured through a combination of survey items and interviews. Through an educative approach and consultation with employers, employees, union groups and leaders in applied AOD research, this assessment was used to inform and support cultural change management of AOD use in the industry. Results: Results (n=494) indicate that as in the general population, a proportion of those sampled in the construction sector may be at risk of hazardous alcohol consumption. A total of 286 respondents (58%) scored above the cut-off cumulative score for risky or hazardous alcohol use. Other drug use was also identified as a major issue. Interview responses and input from all project partners is presented within a guiding principle framework for cultural change. Conclusions: Results support the need for evidence-based, comprehensive and tailored responses in the workplace. This paper will discuss the final results in the context of facilitating cultural change in the construction industry.

Strengthening critical health psychology : a critical action orientation

The commentaries on my original article ‘The Emergence of Critical Health Psychology: Can it Contribute to Promoting Public Health?’ provided engaging views on what critical health psychology (CHP) actually is and does. Consideration of each commentary gave rise to numerous themes and generated my own further thoughts on CHP which I frame as five key areas of a continuing dialogue: (1) reflexivity and CHP; (2) health psychology: pluralist or not? (3) CHP as a moral project; (4) social action and change; and (5) strengthening critical approaches to health. Throughout I highlight concepts and issues that are integral to the capacity of CHP to create a shift towards a reinvigorated action-orientated agenda.

Public health psychology : a conceptual and practical framework

Increasingly, the development of public health infrastructures requires psychology to reevaluate its contribution to public health at local, national and global levels. Already familiar to some psychologists, particularly those in community psychology and health promotion, the expansion of public health has implications for psychology in terms of knowledge/practice and working differently in multidisciplinary settings. In this article, I provide a critical overview of the implications of the historical and international development of health psychology and the changing nature of public health to strengthen the establishment of public health psychology. A conceptual and practical framework is proposed in which public health psychology theory, methods and practice are considered as well as its relevance to the health social sciences more generally.

Book Review : "The Psychology of Eating : From Healthy to Disordered Behaviour"

WHEN JANE Ogden embarked on writing a book about the psychology of eating I wonder whether she realized the enormity of the task given the breadth of research literature in this field. Through a series of 12 closely related chapters on eating, health, food choice, dieting, obesity, body image, eating disorders and others, an extensive range of areas of the psychology of eating is covered. As well as these areas, included within each chapter is a discussion of the significance of historical, cultural, social and familial factors, theoretical approaches and empirical data in the understanding of the multifaceted problems related to eating. At the end of each chapter there is a box entitled ‘Towards an integrated model of diet’ that links the content with that of the following chapters...

Understanding body image disturbance in the promotion of mental health : a discourse analytic study

Health care interventions in the area of body image disturbance and eating disorders largely involve individual treatment approaches, while prevention and health promotion are relatively underexplored. A review of health promotion activities in the area of body image in Australia revealed three programmes, the most extensive and longest standing having been established in 1992. The aims of this programme are to reduce body image dissatisfaction and inappropriate eating behaviour, especially among women. Because health promotion is concerned with the social aspects of health, it was hypothesized by the authors that a social understanding of body image and eating disorders might be advanced in a health promotion setting and reflected in the approach to practice. In order to examine approaches to body image in health promotion, 10 health professionals responsible for the design and management of this programme participated in a series of semi-structured interviews between 1997 and 2000. Three discursive themes were evident in health workers' explanations of body image problems: (1) cognitive-behavioural themes; (2) gender themes; and (3) socio-cultural themes. While body image problems were constructed as psychological problems that are particularly experienced by women, their origins were largely conceived to be socio-cultural. The implications of these constructions are critically discussed in terms of the approach to health promotion used in this programme.

Book review: "Qualitative Health Psychology. Theories and Methods" Michael Murray and Kerry Chamberlain (Eds.)

Qualitative Health Psychology aims to contribute to the debate about the nature of psychology and of science through ‘an examination of the role of qualitative research within health psychology’ (p. 3). The editors, in bringing together contributors from the UK, Ireland, Canada, Brazil, New Zealand and Australia, have compiled a text that reflects different uses of qualitative health research in diverse social and cultural contexts. Structured into three parts, the book encompasses key theoretical and methodological issues in qualitative research in its attempt to encourage broad epistemological debate within health psychology.

Book review: Leaky Bodies and Boundaries. Feminism, Post-modernism and (Bio)ethics. Shildrick, M. (1997)

This thoughtful book is a much needed contribution to feminist ethics that is brimming with detailed and insightful analyses of the positioning of women in contemporary health care and particularly in relation to new reproductive technologies (NRTs). The clearly written and structured chapters provide accessible points to modern ethics, post-modernism, and feminist ethics. Margrit Shildrick takes on these areas with authority and vigour, building an argument for women to enter the relations of reproduction on terms more expressive of feminine desire...

Influencing the experience of people in urban public places through mobile mediated interactions

This study presents research findings to informthe design and development of innovativemobile services aiming to enable collocated people to interact with each other in public urban places. The main goal of this research is to provide applications and deliver guidelines to positively influence the user experience of different public urban places during everyday urban life. This study describes the design and evaluation of mobile content and services enabling mobile mediated interactions in an anonymous way. The research described in this thesis is threefold. First, this study investigates how Information and Communication Technology (ICT) can be utilised in particular urban public places to influence the experience of urban dwellers during everyday life. The research into urban residents and public places guides the design of three different technologies that form case studies to investigate and discover possibilities to digitally augment the public urban space and make the invisible data of our interactions in the urban environment visible. • Capital Music enables urban dwellers to listen to their music on their mobile devices as usual but also visualises the artworks of songs currently being played and listened to by other users in ones’ vicinity. • PlaceTagz uses QR codes printed on stickers that link to a digital message board enabling collocated users to interact with each other over time resulting in a place-based digital memory. • Sapporo World Window, Brisbane Hot Spots, and YourScreen are interactive content applications allowing people to share data with their mobile phones on public urban screens. The applications employ mobile phones to mediate interactions in form of location and video sharing. Second, this study sets out to explore the quality and nature of the experiences created through the developed and deployed case study applications. The development of a user experience framework for evaluating mobile mediated interactions in urban public places is described and applied within each case. Third, drawing on research from urban sociology, psychology, urban design, and the findings from this study, this thesis discusses how such interactions can have an impact on the urban experience.