Design and Development of an In-Vehicle Human Machine Interface to Improve Fuel Efficiency & 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 behaviour 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, this research seeks to use human factors related theories and practices to inform the design and evaluation of an in-vehicle Human Machine Interface (HMI) providing real-time driver feedback with the aim of improving both fuel efficiency and safety.

The development of a component to improve the loading safety of bone-anchored prostheses

Use of socket prostheses Currently, for individuals with limb loss, the conventional method of attaching a prosthetic limb relies on a socket that fits over the residual limb. However, there are a number of issues concerning the use of a socket (e.g., blisters, irritation, and discomfort) that result in dissatisfaction with socket prostheses, and these lead ultimately a significant decrease in quality of life. Bone-anchored prosthesis Alternatively, the concept of attaching artificial limbs directly to the skeletal system has been developed (bone anchored prostheses), as it alleviates many of the issues surrounding the conventional socket interface.Bone anchored prostheses rely on two critical components: the implant, and the percutaneous abutment or adapter, which forms the connection for the external prosthetic system (Figure 1). To date, an implant that screws into the long bone of the residual limb has been the most common intervention. However, more recently, press-fit implants have been introduced and their use is increasing. Several other devices are currently at various stages of development, particularly in Europe and the United States. Benefits of bone-anchored prostheses Several key studies have demonstrated that bone-anchored prostheses have major clinical benefits when compared to socket prostheses (e.g., quality of life, prosthetic use, body image, hip range of motion, sitting comfort, ease of donning and doffing, osseoperception (proprioception), walking ability) and acceptable safety, in terms of implant stability and infection. Additionally, this method of attachment allows amputees to participate in a wide range of daily activities for a substantially longer duration. Overall, the system has demonstrated a significant enhancement to quality of life. Challenges of direct skeletal attachment However, due to the direct skeletal attachment, serious injury and damage can occur through excessive loading events such as during a fall (e.g., component damage, peri-prosthetic fracture, hip dislocation, and femoral head fracture). These incidents are costly (e.g., replacement of components) and could require further surgical interventions. Currently, these risks are limiting the acceptance of bone-anchored technology and the substantial improvement to quality of life that this treatment offers. An in-depth investigation into these risks highlighted a clear need to re-design and improve the componentry in the system (Figure 2), to improve the overall safety during excessive loading events. Aim and purposes The ultimate aim of this doctoral research is to improve the loading safety of bone-anchored prostheses, to reduce the incidence of injury and damage through the design of load restricting components, enabling individuals fitted with the system to partake in everyday activities, with increased security and self-assurance. The safety component will be designed to release or ‘fail’ external to the limb, in a way that protects the internal bone-implant interface, thus removing the need for restorative surgery and potential damage to the bone. This requires detailed knowledge of the loads typically experienced by the limb and an understanding of potential overload situations that might occur. Hence, a comprehensive review of the loading literature surrounding bone anchored prostheses will be conducted as part of this project, with the potential for additional experimental studies of the loads during normal activities to fill in gaps in the literature. This information will be pivotal in determining the specifications for the properties of the safety component, and the bone-implant system. The project will follow the Stanford Biodesign process for the development of the safety component.

Identifying safety beliefs among Australian electrical workers

The current study explored underlying beliefs regarding work safety among a sample of experienced Australian electrical workers. A qualitative research methodology using the theory of planned behavior as a framework was employed. A series of interviews and focus groups with licensed electrical workers (N = 46) were analyzed using thematic content analysis. Beliefs were classified as advantages (e.g. personal safety of self and co-workers), disadvantages (e.g., inconvenience to customer/clients and workload), referents (e.g., supervisors, work colleagues, customers), barriers (e.g., time and cost), and facilitators (e.g., training and knowledge, equipment availability) of safety adherence. The belief basis of the theory of planned behavior was a useful framework for exploring workers’ safety beliefs. The identified beliefs can inform future research about the important factors influencing safe work decisions and inform strategies to promote safer workplace decision making within the electrical safety context.

Traffic safety at road–rail level crossings using a driving simulator and traffic simulation

Several intelligent transportation systems (ITS) were used with an advanced driving simulator to assess its influence on driving behavior. Three types of ITS interventions were tested: video in vehicle, audio in vehicle, and on-road flashing marker. The results from the driving simulator were inputs for a developed model that used traffic microsimulation (VISSIM 5.4) to assess the safety interventions. Using a driving simulator, 58 participants were required to drive through active and passive crossings with and without an ITS device and in the presence or absence of an approaching train. The effect of changes in driver speed and compliance rate was greater at passive crossings than at active crossings. The slight difference in speed of drivers approaching ITS devices indicated that ITS helped drivers encounter crossings in a safer way. Since the traffic simulation was not able to replicate a dynamic speed change or a probability of stopping that varied depending on ITS safety devices, some modifications were made to the traffic simulation. The results showed that exposure to ITS devices at active crossings did not influence drivers’ behavior significantly according to the traffic performance indicator, such as delay time, number of stops, speed, and stopped delay. However, the results of traffic simulation for passive crossings, where low traffic volumes and low train headway normally occur, showed that ITS devices improved overall traffic performance.

Nursing physical assessment for patient safety in general wards: Reaching consensus on core skills

Aims and objectives To determine consensus across acute care specialty areas on core physical assessment skills necessary for early recognition of changes in patient status in general wards. Background Current approaches to physical assessment are inconsistent and have not evolved to meet increased patient and system demands. New models of nursing assessment are needed in general wards that ensure a proactive and patient safety approach. Design A modified Delphi study. Methods Focus group interviews with 150 acute care registered nurses (RNs) at a large tertiary referral hospital generated a framework of core skills that were developed into a web-based survey. We then sought consensus with a panel of 35 senior acute care RNs following a classical Delphi approach over three rounds. Consensus was predefined as at least 80% agreement for each skill across specialty areas. Results Content analysis of focus group transcripts identified 40 discrete core physical assessment skills. In the Delphi rounds, 16 of these were consensus validated as core skills and were conceptually aligned with the primary survey: (Airway) Assess airway patency; (Breathing) Measure respiratory rate, Evaluate work of breathing, Measure oxygen saturation; (Circulation) Palpate pulse rate and rhythm, Measure blood pressure by auscultation, Assess urine output; (Disability) Assess level of consciousness, Evaluate speech, Assess for pain; (Exposure) Measure body temperature, Inspect skin integrity, Inspect and palpate skin for signs of pressure injury, Observe any wounds, dressings, drains and invasive lines, Observe ability to transfer and mobilise, Assess bowel movements. Conclusions Among a large and diverse group of experienced acute care RNs consensus was achieved on a structured core physical assessment to detect early changes in patient status. Relevance to clinical practice Although further research is needed to refine the model, clinical application should promote systematic assessment and clinical reasoning at the bedside.

Getting older drivers off the road won't solve safety problems

When an older driver has a crash with tragic consequences, there are calls for stricter licensing controls to detect “unfit” drivers and take their licences away, typically focusing on those aged 75 or over. When the crash records for older drivers are compared across jurisdictions, however, there is no observable impact of any restrictions. This includes compulsory re-testing, which is strongly advocated by the public but is not supported by the research.

Regulating supply chains to protect road transport workers: An early assessment of the road safety remuneration tribunal

The Road Safety Remuneration Act 2012 (Cth) (the Act) explicitly enables the Road Safety Remuneration Tribunal to make orders that can impose binding requirements on all the participants in the road transport supply chain, including consignors and consignees at the apex the chain, for the pay and safety of both employee and independent contractor drivers. The tribunal is also specifically empowered to make enforceable orders to reduce or remove remuneration related incentives and pressures that contribute to unsafe work practices in the road transport industry. Recently the tribunal handed down its first order. The article considers whether, and the degree to which, the tribunal has been willing to exercise its explicit power to impose enforceable obligations on consignors and consignees — such as large supermarket chains — at the apex of road transport supply chains. It examines the substance and extent of the obligations imposed by the tribunal, including whether the tribunal has exercised the full range of powers vested in it by the Act. We contend that the tribunal’s first order primarily imposes obligations on direct work providers and drivers without making large, powerful consignors and consignees substantively responsible for driver pay and safety. We argue that the tribunal’s first order could have more comprehensively fulfilled the objectives of the Act by more directly addressing the root causes of low pay and poor safety in the road transport industry.

Challenges in developing a new regional road safety strategy for ASEAN

In 2011, more than 75,000 people died in road crashes in the ten member countries of the Association of South East Asian Nations (ASEAN) and many times this number sustained long term injuries. Improving road safety outcomes in ASEAN is not only important for the welfare and economic benefit of these countries, but given that a significant proportion of the world's population lives in ASEAN, it will strongly influence whether the aims of the United Nations Decade of Action for Road Safety and the Sustainable Development Goals are reached. Following the ASEAN Senior Transport Officials Meeting in May 2011, the Secretariat requested the Asian Development Bank (ADB) to provide assistance to improve road safety in ASEAN. In response, ADB, funded by the Japan Fund for Poverty Reduction, has funded a package of action to improve road safety in ASEAN, including the development of a new regional road safety strategy. The diversity of the member nations of ASEAN poses significant challenges for the development of the strategy. For example, the road fatality rates per 100,000 population in Malaysia and Thailand are about 5 times greater than in Singapore. In addition, the importance of particular road safety issues varies across the ASEAN countries and for countries which are undergoing rapid motorization, the order of importance may change over the life of the strategy. The development of the ASEAN Regional Road Safety Strategy has adopted the five pillars of road safety of the UN Decade of Action but focused on those aspects which are most relevant at the regional level and where a regional approach will support and facilitate actions taken by individual countries. A draft ASEAN Regional Road Safety Strategy document has been prepared and consultation will further refine its directions and contents. The paper will describe the processes undertaken to identify issues and solutions, the measurement of road safety maturity and behavioural risk factors, and the overall structure and themes of the strategy.

Cultural safety and diversity: Refocusing our energies in mental health nursing practice, education and research

INTRODUCTION AND BACKGROUND: This presentation draws on a body of work assessing cultural safety's potential to generate change in mental health nursing research (Cox and Simpson 2015), in education and in clinical practice (Cox and Taua 2013, 2016; Happell, Cowin, Roper, Lakeman & Cox 2013). It presents evidence to suggest that cultural safety could resolve the conceptual confusion surrounding culture and diversity in nursing curricular, in clinical and in research practice. The history and nature of mental health work recommend cultural safety to focus attention on diversity, power imbalance, racism, cultural dominance, and structural inequality, identified as barriers and tensions in clinical practice and in service user participation. Cultural safety gives mental health nursing a well theorized and articulated model, which is evolving to improve practice into the future. DESCRIPTION: This work involved an immersion in the literature on cultural safety and the Service User Research movement. It draws on 5 months' work with a service users' research group in the UK and reflections on 9 years of cultural safety teaching. POLICY/PRACTICE CHANGE: This work provokes a crucial change of emphasis from locating the source of issues in the diversity of people to locating it in how society responds to diversity: a change from individualistic to systemic concerns. IMPLICATIONS FOR MENTAL HEALTH NURSING: Cultural safety in clinical practice, education, and research is specifically concerned with awareness of the impact of systemic workplace cultures and with staff cultural self-awareness to bring about cultural change and person-centred care of individuals' unique needs and aspirations within their life context.

The experience of Indigenous students in a Bachelor of Nursing Program in Australia: cultural safety and decolonising nurse education

Background In Australia significant health inequalities, such as an 11year life expectancy gap, impact on the continent’s traditional owners, the Aboriginal peoples and Torres Strait Islanders. Evidence suggests links between improved Indigenous health and a greater proportion of Indigenous people employed in all sectors. Achieving a greater proportion of Indigenous people in health services and in the health education workforce, requires improved higher education completion rates. Currently Indigenous people are under-represented in higher education and attrition rates amongst those who do participate are high. We argue these circumstances make health and education matters of social justice, largely related to unexamined relations of power within universities where the pedagogical and social environment revolve around the norms and common-sense of the dominant culture. Project Research at Queensland University of Technology in 2010-2012, aimed to gain insights into attrition/retention in the Bachelor of Nursing. A literature review on Indigenous participation in higher education in nursing contextualised a mixed methods study. The project examined enrolment, attrition and success by an analysis of enrolment data from 1984-2012. Using Indigenous Research Assistants we then conducted 20 in-depth interviews with Indigenous students followed by a thematic analysis seeking to gain insights into the impact of students’ university experience on retention. Our findings indicate that cultural safety, mentorship, acceptance and support are crucial in student academic success. They also indicate that inflexible systems based on ethnocentric assumptions exacerbate the structural issues that impact on the students’ everyday life and are also part of the story of attrition. The findings reinforced the assumption that educational environments and processes are inherently cultural and political. This perspective calls into question the role of the students’ cultural experience at university in attrition rates. A partnership between the School of Nursing and the Indigenous Education Unit is working to better support Indigenous students.

An incident database for improving metro safety: The case of shanghai

Large cities depend heavily on their metro systems to reduce traffic congestion, which is particularly the case with Shanghai, the largest and most developed city in China. For the purposes of enhancing the possibility in quantitative risk assessment and promoting the safety management level in Shanghai metro, an adaptable metro operation incident database (MOID) is therefore presented for containing details of all incidents that have occurred in metro operation. Taking compatibility and simplicity into consideration, Microsoft Access 2010 software is used for the comprehensive and thorough design of the MOID. Based on MOID, statistical characteristics of incident, such as types, causes, time, and severity, are discovered and 24 accident precursors are identified in Shanghai metro. The processes are demonstrated to show how the MOID can be used to identify trends in the incidents that have occurred and to anticipate and prevent future accidents. In order to promote the application of MOID, an organizational structure is proposed from the four aspects of supervision, research, implementation, and manufacturer. This research would be conducive to safety risk analysis in identifying relevant precursors in safety management and assessing safety level as a qualitative tool.

A Bayesian latent class safety performance function for identifying motor vehicle crash blackspots

The current state of the practice in Blackspot Identification (BSI) utilizes safety performance functions based on total crash counts to identify transport system sites with potentially high crash risk. This paper postulates that total crash count variation over a transport network is a result of multiple distinct crash generating processes including geometric characteristics of the road, spatial features of the surrounding environment, and driver behaviour factors. However, these multiple sources are ignored in current modelling methodologies in both trying to explain or predict crash frequencies across sites. Instead, current practice employs models that imply that a single underlying crash generating process exists. The model mis-specification may lead to correlating crashes with the incorrect sources of contributing factors (e.g. concluding a crash is predominately caused by a geometric feature when it is a behavioural issue), which may ultimately lead to inefficient use of public funds and misidentification of true blackspots. This study aims to propose a latent class model consistent with a multiple crash process theory, and to investigate the influence this model has on correctly identifying crash blackspots. We first present the theoretical and corresponding methodological approach in which a Bayesian Latent Class (BLC) model is estimated assuming that crashes arise from two distinct risk generating processes including engineering and unobserved spatial factors. The Bayesian model is used to incorporate prior information about the contribution of each underlying process to the total crash count. The methodology is applied to the state-controlled roads in Queensland, Australia and the results are compared to an Empirical Bayesian Negative Binomial (EB-NB) model. A comparison of goodness of fit measures illustrates significantly improved performance of the proposed model compared to the NB model. The detection of blackspots was also improved when compared to the EB-NB model. In addition, modelling crashes as the result of two fundamentally separate underlying processes reveals more detailed information about unobserved crash causes.

Patient Safety - A Psychological Perspective

This comprehensive book takes a psychological perspective on patient safety. It is based on the most recent theoretical and empirical research evidence from psychology (including clinical, work, and organizational psychology) and adjacent social and behavioral sciences such as human factors. Factors that influence safety-related experiences, behaviors, and outcomes of patients and professionals working in clinical settings such as medical practices and hospitals are reviewed, structured, and critically evaluated. Consistent with the complexity of the topic, the author takes a multi-level approach to patient safety, which includes a review of individual, team, and organizational factors and outcomes. The book describes how these factors, by themselves and in combination, can facilitate or impede patient safety. Individual factors include safety-relevant knowledge, skills, abilities, and personality traits such as conscientiousness and emotional stability. Team factors include group communication, training, and leadership. Finally, organizational factors include the safety culture and climate. Throughout the book, different evidence-based intervention programs are described that can help practitioners promote patient safety and prevent accidents. The book is a valuable resource for both researchers and practitioners interested in understanding, maintaining, and improving patient safety in a variety of applied settings. It is based on the most up-to-date research evidence from psychology and neighboring disciplines, and it is written in a clear and non-technical language understandable for a wide audience.

Medication incident reporting in residential aged care facilities: Limitations and risks to residents' safety

Background Medication incident reporting (MIR) is a key safety critical care process in residential aged care facilities (RACFs). Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation) in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a) design MIR artefacts that facilitate identification of the root causes of medication incidents, b) integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c) support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes.