Disability due to road traffic crashes and the management of road safety in developing countries

Injury as a result of road traffic crashes is one of the most significant public health problems in developing countries. It intersects with disability as a development issue because a substantial proportion of people injured in road traffic crashes experience disability, both short term and long term. While there have been significant steps towards better management of road safety globally, especially in developing countries, the implications for road safety policy and practice of disability due road traffic crashes is not fully appreciated. In particular, qualitative information on the lived experience people with a long term disability as a result of a road traffic crash can inform better road safety policy and practice, as demonstrated in a case study from Thailand. The benefits of better policies and practices are likely to accrue to a wide range of road users, and to contribute to the achievement of sustainable development.

Perceived safety, quality and cultural competency of maternity care for culturally and linguistically diverse women in Queensland

Various policies, plans, and initiatives have been implemented to provide safe, quality, and culturally competent care to patients within Queensland’s healthcare system. A series of models of maternity care are available in Queensland that range from standard public care to private midwifery care. The current study aimed to determine whether identifying as Culturally or Linguistically Diverse (CALD) was associated with the perceived safety, quality, and cultural competency of maternity care from a consumer perspective, and to identify specific needs and preferences of CALD maternity care consumers. Secondary analysis of data collected in the Having a Baby in Queensland Survey 2012 was used to compare the experiences of 655 CALD women to those of 4049 non-CALD women in Queensland, Australia, across three stages of maternity care: pregnancy, labour and birth, and after birth. After adjustment for model of maternity care received and socio-demographic characteristics, CALD women were significantly more likely than non-CALD women to experience suboptimal staff technical competence in pregnancy, overall perceived safety in pregnancy and labour/birth, and interpersonal sensitivity in pregnancy and labour/birth. Approximately 50% of CALD women did not have the choice to use a translator or interpreter, or the gender of their care provider, during labour and birth. Thirteen themes of preferences and needs of CALD maternity care consumers based on ethnicity, cultural beliefs, or traditions were identified, however, these were rarely met. Findings imply that CALD women in Queensland experience disadvantageous maternity care with regards to perceived staff technical competence, safety, and interpersonal sensitivity, and receive care that lacks cultural competence. Improved access to support persons, continuity and choice of carer, and staff availability and training is recommended.

Road safety and pavement management: A case study of Tanzania

The implementation of pavement management seems to ignore road safety, with its focus being mainly on infrastructure condition. Safety management as part of pavement management should consider various means of reducing the frequency of vehicle crashes by allocating corrective measures to mitigate accident exposure, as well as reduce accident severity and likelihood. However, it is common that lack of accident records and crash contributing factors impedes incorporating safety into pavement management. This paper presents a case study for the initial development of pavement management systems considering data limitations for 3000 km of Tanzania’s national roads. A performance based optimization utilizes indices for safety and surface condition to allocate corrective measures. A modified Pareto analysis capable of accounting for annual performance and of balancing resources to achieve good surface condition and low levels of safety was applied. Tradeoff analysis for the case study found the need to assign 30% relevance to condition and 70% to road safety. Safety and condition deficiencies were corrected within 5 years with the majority of improvements dedicated to surface treatments and some geometric corrections. Large investments for correcting geometric issues were observed in years two and three if more money was made available.

[await full-text]Evaluation of QAS Workplace Health and Safety Action Plan

This report identifies the outcomes of a program evaluation of the five year Workplace Health and Safety Strategy (2012-2017), specifically, the engagement component within the Queensland Ambulance Service. As part of the former Department of Community Safety, their objective was to work towards harmonising the occupational health and safety policies and process to improve the workplace culture. The report examines and assess the process paths and resource inputs into the strategy, provides feedback on progress to achieving identified goals as well as identify opportunities for improvements and barriers to progress. Consultations were held with key stakeholders within QAS and focus groups were facilitated with managers and health and safety representatives of each Local Area Service Network.

The practical potential of self-advocacy for improving safety outcomes for school-aged workers

Young workers are over-represented in workplace injury statistics and there is growing interest in addressing their vulnerability and safety exposure. Such concerns have been raised within a broader discursive framework of responsibilisation which has seen a transfer of responsibility for workplace safety from employer to worker. This article examines the potential for self-advocacy as a strategy for improving the safety of young workers through the provision of resources to articulate and act on workplace rights. The study utilises data derived from 48 group interviews involving 216 high school students (13–16 years of age) at 19 high schools in Queensland, Australia, who were asked to discuss their knowledge and experience of workplace rights and responsibilities. The limitations of the safety self-advocacy approach are explored, including the social, developmental and organisational issues that might affect the ability or willingness of school-aged workers to self-advocate. The findings reveal that the notion of self-advocacy is internalised by young people before they even enter the formal labour market but that in practice, attempts by young people to enact rights to safety are often dismissed or undermined.

Reviewing in-vehicle systems to improve fuel efficiency and road safety

Road transport plays a significant role in various industries and mobility services around the globe and has a vital impact on our daily lives. However it also has serious impacts on both public health and the environment. In-vehicle feedback systems are a relatively new approach to encouraging driver behavior change for improving fuel efficiency and safety in automotive environments. While many studies claim that the adoption of eco-driving practices, such as eco-driving training programs and in-vehicle feedback to drivers, has the potential to improve fuel efficiency, limited research has integrated safety and eco-driving. Therefore, it is crucial to understand the human factors related theories and practices which will inform the design of an in-vehicle Human Machine Interface (HMI) that could provide real-time driver feedback and consequently improve both fuel efficiency and safety. This paper provides a comprehensive review of the current state of published literature on in-vehicle systems to identify and evaluate the impact of eco-driving and safety feedback systems. This paper also discusses how these factors may conflict with one another and have a negative effect on road safety, while also exploring possible eco-driving practices that could encourage more sustainable, environmentally-conscious and safe driving behavior. The review revealed a lack of comprehensive theoretical research integrating eco-driving and safe driving, and no current available HMI covering both aspects simultaneously. Furthermore, the review identified that some eco-driving in-vehicle systems may enhance fuel efficiency without compromising safety. The review has identified a range of concepts which can be developed to influence driver acceptance of safety and eco-driving systems within the area of HMI. This can promote new research aimed at enhancing our understanding of the relationship between eco-driving and safety from the human factors viewpoint. This provides a foundation for developing innovative, persuasive and acceptable in-vehicle HMI systems to improve fuel efficiency and road safety.

Cultural factors: Understanding culture to design organisation structures and systems to optimise safety

Safety culture is a term with numerous definitions in the literature. Many authors advocate a prescriptive approach to safety culture in which if an organisation has certain levels of externally prescribed systems and structures in place it has a “good safety culture”. Conversely, other researchers suggest an anthropological approach of exploring deep meanings and understandings present within an organisation’s workforce. In a recent published review, the authors presented an alternative view to safety culture, in which the anthropological aspects of safety culture interact with the structures and systems in place within an organisation to result in behavioural patterns. This can be viewed as a human factors approach to safety culture in which, through understanding the specific interactions between the culture of a workforce and external organisational elements, organisational structures and systems can be optimised in order to shape worker behaviour and improve safety. This paper presents findings from a recent investigation of safety culture in the Australian heavy vehicle (transport) industry. Selected results are discussed to explore how understanding culture can provide direction to the optimisation of organisational structures and systems to match worker culture and thus improve safety. Specifically the value placed on personal experience and stories, as well as on both time and money are discussed, and interventions that are suited to these aspects of the culture are discussed. These findings demonstrate the importance of shifting beyond mere prescriptive and interpretive approaches to safety culture and instead to focus on the interaction between cultural and contextual elements to optimise organisational structures and systems.

Left on the side of the road? A review of deterrence-based theoretical developments in road safety

Deterrence-based initiatives form a cornerstone of many road safety countermeasures. This approach is informed by Classical Deterrence Theory, which proposes that individuals will be deterred from committing offences if they fear the perceived consequences of the act, especially the perceived certainty, severity and swiftness of sanctions. While deterrence-based countermeasures have proven effective in reducing a range of illegal driving behaviours known to cause crashes such as speeding and drink driving, the exact level of exposure, and how the process works, remains unknown. As a result the current study involved a systematic review of the literature to identify theoretical advancements within deterrence theory that has informed evidence-based practice. Studies that reported on perceptual deterrence between 1950 and June 2015 were searched in electronic databases including PsychINFO and ScienceDirect, both within road safety and non-road safety fields. This review indicated that scientific efforts to understand deterrence processes for road safety were most intense during the 1970s and 1980s. This era produced competing theories that postulated both legal and non-legal factors can influence offending behaviours. Since this time, little theoretical progression has been made in the road safety arena, apart from Stafford and Warr's (1993) reconceptualisation of deterrence that illuminated the important issue of punishment avoidance. In contrast, the broader field of criminology has continued to advance theoretical knowledge by investigating a range of individual difference-based factors proposed to influence deterrent processes, including: moral inhibition, social bonding, self-control, tendencies to discount the future, etc. However, this scientific knowledge has not been directed towards identifying how to best utilise deterrence mechanisms to improve road safety. This paper will highlight the implications of this lack of progression and provide direction for future research.

Translating road safety research on night-time visibility to the context of mining

In recent years a significant amount of research has been undertaken in collision avoidance and personnel location technology in order to reduce the number of incidents involving pedestrians and mobile plant equipment which are a high risk in underground coal mines. Improving the visibility of pedestrians to drivers would potentially reduce the likelihood of these incidents. In the road safety context, a variety of approaches have been used to make pedestrians more conspicuous to drivers at night (including vehicle and roadway lighting technologies and night vision enhancement systems). However, emerging research from our group and others has demonstrated that clothing incorporating retroreflective markers on the movable joints as well as the torso can provide highly significant improvements in pedestrian visibility in reduced illumination. Importantly, retroreflective markers are most effective when positioned on the moveable joints creating a sensation of “biological motion”. Based only on the motion of points on the moveable joints of an otherwise invisible body, observers can quickly recognize a walking human form, and even correctly judge characteristics such as gender and weight. An important and as yet unexplored question is whether the benefits of these retroreflective clothing configurations translate to the context of mining where workers are operating under low light conditions. Given that the benefits of biomotion clothing are effective for both young and older drivers, as well as those with various eye conditions common in those >50 years reinforces their potential application in the mining industry which employs many workers in this age bracket. This paper will summarise the visibility benefits of retroreflective markers in a biomotion configuration for the mining industry, highlighting that this form of clothing has the potential to be an affordable and convenient way to provide a sizeable safety benefit. It does not involve modifications to vehicles, drivers, or infrastructure. Instead, adding biomotion markings to standard retroreflective vests can enhance the night-time conspicuity of mining workers by capitalising on perceptual capabilities that have already been well documented.

Inside the black box of food safety: A qualitative study of ‘non-compliance’ among food businesses

Issue addressed The paper examines the meanings of food safety among food businesses deemed non-compliant and considers the need for an ‘insider perspective’ to inform a more nuanced health promotion practice. Methods In-depth interviews were conducted with 29 food business operators who had been recently deemed ‘non-compliant’ through Council inspection. Result Paradoxically, these ‘non-compliers’ revealed a strong belief in the importance of food safety as well as a desire to comply with the regulations as communicated to them by Environmental Health Officers (EHOs). Conclusions The evidence base of food safety is largely informed by the science of food hazards, yet there is a very important need to illuminate the ‘insider’ experience of food businesses doing food safety on a daily basis. This requires a more socially nuanced appreciation of food businesses beyond the simple dichotomy of compliant/ non-compliant. So what? Armed with a deeper understanding of the social context surrounding food safety practice, it is anticipated that a more balanced, collaborative mode of food safety health promotion could develop which could add to the current signature model of regulation.

Barriers to good occupational health and safety (OHS) practices by small construction firms

The construction industry has long been considered to have unacceptably high injury and fatality rates. Previous research has shown that small construction companies sustain higher injury rates than large companies. However, despite the industry being dominated by a very large number of such small companies, little is known of their occupational health and safety (OHS) needs, practices and constraints. This paper takes a first step in aiming to identify the principal barriers that affect good OHS performance of small construction companies so that effective OHS practices can be developed to improve this in future. The contents of the literature are first summarised, in which three critical barriers to good OHS practice in small construction firms are proposed. They are : cost, time, lack of safety awareness and concern. The results of a questionnaire survey carried out with South East Queensland construction personnel are presented, which largely confirm what is suggested by the literature research and also succeed in providing an indication of their ranking in terms of importance and suggestions for overcoming these barriers. The research results provide a better understanding of the issues that restrict good OHS practice in small construction companies and potential measures for improvement.

The role of time pressure and different psychological safety climate referents in the prediction of nurses’ hand hygiene compliance

In this study of 638 Australian nurses, compliance to hand hygiene (HH), as defined by the “five moments” recommended by the World Health Organisation (2009), was examined. Hypotheses focused on the extent to which time pressure reduces compliance and safety climate (operationalised in relation to HH using colleagues, manager, and hospital as referents) increases compliance. It also was proposed that HH climate would interact with time pressure, such that the negative effects of time pressure would be less marked when HH climate is high. The extent to which the three HH climate variables would interact among each other, either in the form of boosting or compensatory effects, was tested in an exploratory manner. A prospective research design was used in which time pressure and the HH climate variables were assessed at Time 1 and compliance was assessed by self-report two weeks later. Compliance was high but varied significantly across the 5 HH Moments, suggesting that nurses make distinctions between inherent and elective HH and also seemed to engage in some implicit rationing of HH. Time pressure dominated the utility of HH climate to have its positive impact on compliance. The most conducive workplace for compliance was one low in time pressure and high in HH climate. Colleagues were very influential in determining compliance, more so than the manager and hospital. Manager and hospital support for HH enhanced the positive effects of colleagues on compliance. Providing training and enhancing knowledge was important, not just for compliance, but for safety climate.

Empirical investigation of factors contributing to the psychological safety climate on construction sites

Employees’ safety climate perceptions dictate their safety behavior because individuals act based on their perceptions of reality. Extensive empirical research in applied psychology has confirmed this relationship. However, rare efforts have been made to investigate the factors contributing to a favorable safety climate in construction research. As an initial effort to address the knowledge gap, this paper examines factors contributing to a psychological safety climate, an operationalization of a safety climate at the individual level, and, hence, the basic element of a safety climate at higher levels. A multiperspective framework of contributors to a psychological safety climate is estimated by a structural equation modeling technique using individual questionnaire responses from a random sample of construction project personnel. The results inform management of three routes to psychological safety climate: a client’s proactive involvement in safety management, a workforce-friendly workplace created by the project team, and transformational supervisors’ communication about safety matters with the workforce. This paper contributes to the field of construction engineering and management by highlighting a broader contextual influence in a systematic formation of psychological safety climate perceptions.

Efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis: Results of a randomised placebo-controlled trial (ABILITY-1)

Purpose: To evaluate the efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis (nr-axSpA). Methods: Patients fulfilled Assessment of Spondyloarthritis international Society (ASAS) criteria for axial spondyloarthritis, had a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of ≥ 4, total back pain score of ≥ 4 (10 cm visual analogue scale) and inadequate response, intolerance or contraindication to non-steroidal anti-inflammatory drugs (NSAIDs); patients fulfilling modified New York criteria for ankylosing spondylitis were excluded. Patients were randomised to adalimumab (N=91) or placebo (N=94). The primary endpoint was the percentage of patients achieving ASAS40 at week 12. Efficacy assessments included BASDAI and Ankylosing Spondylitis Disease Activity Score (ASDAS). MRI was performed at baseline and week 12 and scored using the Spondyloarthritis Research Consortium of Canada (SPARCC) index. Results: Significantly more patients in the adalimumab group achieved ASAS40 at week 12 compared with patients in the placebo group (36% vs 15%, p<0.001). Significant clinical improvements based on other ASAS responses, ASDAS and BASDAI were also detected at week 12 with adalimumab treatment, as were improvements in quality of life measures. Inflammation in the spine and sacroiliac joints on MRI significantly decreased after 12 weeks of adalimumab treatment. Shorter disease duration, younger age, elevated baseline C-reactive protein or higher SPARCC MRI sacroiliac joint scores were associated with better week 12 responses to adalimumab. The safety profile was consistent with what is known for adalimumab in ankylosing spondylitis and other diseases. Conclusions: In patients with nr-axSpA, adalimumab treatment resulted in effective control of disease activity, decreased inflammation and improved quality of life compared with placebo. Results from ABILITY-1 suggest that adalimumab has a positive benefit-risk profile in active nr-axSpA patients with inadequate response to NSAIDs.