Perceptions of clinical safety climate of the multicultural nursing workforce in Saudi Arabia : a cross-sectional survey

Purpose The purpose of this study is to explore the safety climate perceptions of the multicultural nursing workforce, and to investigate the influence of diversity of the multicultural nursing workforce on clinical safety in a large tertiary hospital in Saudi Arabia. Background Working in a multicultural environment is challenging. Each culture has its own unique characteristics and dimensions that shape the language, lifestyle, beliefs, values, customs, traditions, and patterns of behaviour, which expatriate nurses must come to terms with. However, cultural diversity in the health care environment can potentially affect the quality of care and patient safety. Method A mixed-method case study (survey, interview and document analysis) was employed. A primary study phase entailed the administration of the Safety Climate Survey (SCS). A population sampling strategy was used and 319 nurses participated, yielding a 76.8% response rate. Descriptive and inferential statistics (Kruskal–Wallis test) were used to analyse survey data. Results The data revealed the nurses’ perceptions of the clinical safety climate in this multicultural environment was unsafe, with a mean score of 3.9 out of 5. No significant difference was found between the age groups, years of nursing experience and their perceptions of the safety climate in this context. A significant difference was observed between the national background categories of nurses and perceptions of safety climate. Conclusion Cultural diversity within the nursing workforce could have a significant influence on perceptions of clinical safety. These findings have the potential to inform policy and practice related to cultural diversity in Saudi Arabia.

Traffic-related fine and ultrafine particle exposures of professional drivers and illness : An opportunity to better link exposure science and epidemiology to address an occupational hazard?

Exposures to traffic-related air pollution (TRAP) can be particularly high in transport microenvironments (i.e. in and around vehicles) despite the short durations typically spent there. There is a mounting body of evidence that suggests that this is especially true for fine (b2.5 μm) and ultrafine (b100 nm, UF) particles. Professional drivers, who spend extended periods of time in transport microenvironments due to their job, may incur exposures markedly higher than already elevated non-occupational exposures. Numerous epidemiological studies have shown a raised incidence of adverse health outcomes among professional drivers, and exposure to TRAP has been suggested as one of the possible causal factors. Despite this, data describing the range and determinants of occupational exposures to fine and UF particles are largely conspicuous in their absence. Such information could strengthen attempts to define the aetiology of professional drivers' illnesses as it relates to traffic combustion-derived particles. In this article, we suggest that the drivers' occupational fine and UF particle exposures are an exemplar case where opportunities exist to better link exposure science and epidemiology in addressing questions of causality. The nature of the hazard is first introduced, followed by an overview of the health effects attributable to exposures typical of transport microenvironments. Basic determinants of exposure and reduction strategies are also described, and finally the state of knowledge is briefly summarised along with an outline of the main unanswered questions in the topic area.

Evaluation of the GHR car following model for traffic safety studies

Traffic safety studies mandate more than what existing micro-simulation models can offer as they postulate that every driver exhibits a safe behaviour. All the microscopic traffic simulation models are consisting of a car-following model and the Gazis–Herman–Rothery (GHR) car-following model is a widely used model. This paper highlights the limitations of the GHR car-following model capability to model longitudinal driving behaviour for safety study purposes. This study reviews and compares different version of the GHR model. To empower the GHR model on precise metrics reproduction a new set of car-following model parameters is offered to simulate unsafe vehicle conflicts. NGSIM vehicle trajectory data is used to evaluate the new model and short following headways and Time to Collision are employed to assess critical safety events within traffic flow. Risky events are extracted from available NGSIM data to evaluate the modified model against the generic versions of the GHR model. The results from simulation tests illustrate that the proposed model does predict the safety metrics better than the generic GHR model. Additionally it can potentially facilitate assessing and predicting traffic facilities’ safety using microscopic simulation. The new model can predict Near-miss rear-end crashes.

Multiuser virtual safety training system for tower crane dismantlement

Tower crane dismantling is one of the most dangerous activities in the construction industry. Tower crane erection and dismantlement causes 10–12% of the fatalities of all crane accidents. The nature of the task is such that off-the-job training is not practicable, and the knowledge and expertise needed has to be gained on the job. However, virtual trainers such as Microsoft Flight Simulator for airplane pilots and mission rehearsal exercise (MRE) for army personnel have been developed and are known to provide a highly successful means of overcoming the risks involved in such on-the-job learning and clearly have potential in construction situations. This paper describes the newly developed multiuser virtual safety training system (MVSTS) aimed at providing a similar learning environment for those involved in tower crane dismantlement. The proposed training system is developed by modifying an existing game engine. Within the close-to-reality virtual environment, trainees can participate in a virtual dismantling process. During the process, they learn the correct dismantling procedure and working location and to cooperate with other trainees by virtually dismantling the crane. The system allows the trainees to experience the complete procedure in a risk-free environment. A case study is provided to demonstrate how the system works and its practical application. The proposed system was evaluated by interviews with 30 construction experts with different backgrounds, divided into three groups according to their experience and trained by the traditional and virtual methods, respectively. The results indicate that the trainees of the proposed system generally learned better than those using the traditional method. The ratings also indicate that the system generally has great potential as a training platform.

The impacts of power outages on the residents of contemporary multistorey apartment buildings in subtropical environments

With significant population growth experienced in South East Queensland over the past two decades and a high rate of growth expected to continue in coming decades, the Queensland Government is promoting urban consolidation planning policies to manage growth sustainably. Multi-residential buildings will play an important role in facilitating the increased densities which urban consolidation policies imply. However, a major flood event in January 2011 has brought to light the vulnerability of certain types of multi-residential typologies to power outages. The crisis conditions exposed how contemporary building design and construction practices, coupled with regulatory and planning issues, appear to have compromised the resilience and habitability of multi-storey residential buildings. In the greater urban area of Brisbane, Queensland, the debilitating dependence that certain types of apartment buildings have on mains electricity was highlighted by residents’ experiences of the Brisbane River flood disaster, before, during and after the event. This research examined high density residential buildings in West End, Brisbane, an inner city suburb which was severely affected by the flood and is earmarked for significant urban densification under the Brisbane City Plan. Medium-to-high-density residential buildings in the suburb were mapped in flooded and non-flooded locations and a database containing information about the buildings was created. Parameters included date of construction, number of storeys, systems of access and circulation, and potential for access to natural light and ventilation for habitable areas. A series of semi-structured interviews were conducted with residents involved in the owners’ management committees of several buildings to verify information the mapping could not provide. The interviews identified a number of critical systems failures due to power outage which had a significant impact on residents’ wellbeing, comfort and safety. Building services such as lifts, running water, fire alarms, security systems and air-conditioning ceased to operate when power was disconnected to neighbourhoods and buildings in anticipation of rising flood waters. Lack of access to buildings and dwellings, lack of safety, lack of building security, and lack of thermal comfort affected many residents whether or not their buildings were actually subjected to inundation, with some buildings rendered uninhabitable for a prolonged period. The extent of the impact on residents was dramatically influenced by the scale and type of building inhabited, with those dwelling in buildings under a 25m height limit, with a single lift, found to be most affected. The energy-dependency and strong trend of increasing power demands of high-rise buildings is well-documented. Extended electricity outages such as the one brought about by the 2011 flood in Queensland are likely to happen more frequently than the 50-year average of the flood event itself. Electricity blackouts can result from a number of man-made or natural causes, including shortages caused by demand exceeding supply. This paper highlights the vulnerability of energy-dependent buildings to power outages and investigates options for energy security for occupants of multi-storey buildings and makes recommendations to increase resilience and general liveability in multi-residential buildings in the subtropics through design modifications.

Impact of prescribed burning on urban air quality : a case study

For fuel management and/or ecological reasons prescribed burnings are conducted each year across Australia. Smoke from prescribed burnings could be the major source of air pollution in urban environment during the period of intensive prescribed burning. To investigate the impact of prescribed burning on air quality and the characteristics of prescribed burning particles, field measurements were conducted during the end period of a prescribed burning event in September 2011, Brisbane, Australia.

Monitoring charged particles in indoor air using a neutral cluster and air ion spectrometer

While there are sources of ions both outdoors and indoors, ventilation systems can introduce as well as remove ions from the air. As a result, indoor ion concentrations are not directly related to air exchange rates in buildings. In this study, we attempt to relate these quantities with the view of understanding how charged particles may be introduced into indoor spaces.

Positive impacts of environmental characteristics on health and wellbeing in health-care facilities : a review

Well-designed indoor environments can support people’s health and welfare. In this literature review, we identify the environmental features that affect human health and wellbeing. Environmental characteristics found to influence health outcomes and/or wellbeing included: environmental safety; indoor air quality (e.g. odour and temperature); sound and noise; premises and interior design (e.g. construction materials, viewing nature and experiencing nature, windows versus no windows, light, colours, unit layout and placement of the furniture, the type of room, possibilities to control environmental elements, environmental complexity and sensory simulations, cleanliness, ergonomics and accessibility, ‛‛wayfinding’’); art, and music, among others. Indoor environments that incorporate healing elements can, for instance, reduce anxiety, lower blood pressure, lessen pain and shorten hospital stays.

Preliminary results on the chemical composition of outdoor airborne particles at urban schools and possible implications for the air quality in classrooms

Vehicle emissions are a significant source of fine particles (Dp < 2.5 µm) in an urban environment. These fine particles have been shown to have detrimental health effects, with children thought to be more susceptible. Vehicle emissions are mainly carbonaceous in nature, and carbonaceous aerosols can be defined as either elemental carbon (EC) or organic carbon (OC). EC is a soot-like material emitted from primary sources while OC fraction is a complex mixture of hundreds of organic compounds from either primary or secondary sources (Cao et al., 2006). Therefore the ratio of OC/EC can aid in the identification of source. The purpose of this paper is to use the concentration of OC and EC in fine particles to determine the levels of vehicle emissions in schools. It is expected that this will improve the understanding of the potential exposure of children in a school environment to vehicle emissions.

A qualitative investigation of older pedestrian views of influences on their road crossing safety

With Australia’s population rapidly ageing, older pedestrian safety has begun to receive greater attention from road safety researchers. However, reliance on simulator studies and observational techniques has limited current understanding of why older pedestrians adopt particular crossing behaviours, and how they perceive crossing the road. The current study aimed to investigate the psychological factors that may contribute to older pedestrians’ crash risk by examining their perceptions of the issues they encounter on the road. Qualitative semi-structured interviews with 18 pedestrians aged 55 years and older were conducted, and the interview transcripts underwent thematic analysis. From this analysis, four key themes emerged. Firstly, the physical design of the road was perceived as posing a significant threat for older pedestrians, particularly sloped, semi-mountable kerbs and designated crossings. Secondly, declines in older pedestrians’ confidence in their ability to cross the road were evident through fewer reported risks being taken. Additionally, older pedestrians sensed an increased threat from other road users when crossing the road, particularly from drivers and cyclists. Finally, older pedestrians referred to the informal rules and strategies used to guide their road crossing. The results suggest that the road environment is perceived as increasingly dangerous and hazardous environment for older pedestrians. Implications regarding the physical road design in areas with an existing high proportion of elderly people are discussed.

Submission to the Joint Select Committee on Cyber Safety. Inquiry into the Cybersafety of Seniors.

This submission addresses the following terms of reference: 1) the nature, prevalence and level of cybersafety risks and threats experienced by senior Australians; 2) the impact and implications of those risks and threats on access and use of information and communication technologies by senior Australians; 3) the adequacy and effectiveness of current government and industry initiatives to respond to those threats, including education initiatives aimed at senior Australians; 4) best practice safeguards, and any possible changes to Australian law, policy or practice that will strengthen the cybersafety of senior Australians.

Evaluation of screening tests for predicting older driver performance and safety assessed by an on-road test

A number of tests and test batteries are available for the prediction of older driver safety, but many of these have not been validated against standardized driving outcome measures. The aim of this study was to evaluate a series of previously described screening tests in terms of their ability to predict the potential for safe and unsafe driving. Participants included 79 community-dwelling older drivers (M=72.16 years, SD=5.46; range 65-88 years; 57 males and 22 females) who completed a previously validated multi-disciplinary driving assessment, a hazard perception test, a hazard change detection test and a battery of vision and cognitive tests. Participants also completed a standardized on-road driving assessment. The multi-disciplinary test battery had the highest predictive ability with a sensitivity of 80% and a specificity of 73%, followed by the hazard perception test which demonstrated a sensitivity of 75% and a specificity of 61%. These findings suggest that a relatively simple and practical battery of tests from a range of domains has the capacity to predict safe and unsafe driving in older adults.

Submission to the Legal Affairs and Community Safety Committee - Youth Justice (Boot Camp Orders) and Other Legislation Amendment Bill 2012

This submission addresses the Youth Justice (Boot Camp Orders) and Other Legislation Amendment Bill 2012 which has as its objectives (1) the introduction of a Boot Camp Order as an option instead of detention for young offenders and (2) the removal of the option of court referred youth justice conferencing for young offenders. As members of the QUT Faculty of Law Centre for Crime and Justice we welcome the invitation to participate in the discussion of these issues which are critically important to the Queensland community at large but especially to our young people.

Improved surgical safety after laparoscopic compared to open surgery for apparent early stage endometrial cancer : results from a randomised controlled trial

AIM: To compare Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH) with regard to surgical safety. METHODS: Between October 2005 and June 2010, 760 patients with apparent early stage endometrial cancer were enroled in a multicentre, randomised clinical trial (LACE) comparing outcomes following TLH or TAH. The main study end points for this analysis were surgical adverse events (AE), hospital length of stay, conversion from laparoscopy to laparotomy, including 753 patients who completed at least 6 weeks of follow-up. Postoperative AEs were graded according to Common Toxicity Criteria (V3), and those immediately life-threatening, requiring inpatient hospitalisation or prolonged hospitalisation, or resulting in persistent or significant disability/incapacity were regarded as serious AEs. RESULTS: The incidence of intra-operative AEs was comparable in either group. The incidence of post-operative AE CTC grade 3+ (18.6% in TAH, 12.9% in TLH, p 0.03) and serious AE (14.3% in TAH, 8.2% in TLH, p 0.007) was significantly higher in the TAH group compared to the TLH group. Mean operating time was 132 and 107 min, and median length of hospital stay was 2 and 5 days in the TLH and TAH group, respectively (p<0.0001). The decline of haemoglobin from baseline to day 1 postoperatively was 2g/L less in the TLH group (p 0.006). CONCLUSIONS: Compared to TAH, TLH is associated with a significantly decreased risk of major surgical AEs. A laparoscopic surgical approach to early stage endometrial cancer is safe.