Occupational safety in China: safety climate and its influence on safety-related behavior

The improvement of health and safety standards within the organizational context is an important issue of global concern. China’s occupational health and safety (OHS) has increasingly drawn national and international attention as it has not kept pace with its globalization of production and trade. The traditional approach to managing workplace safety in China has focused on the technical aspects of engineering systems and processes, and it has attributed the majority of workplace accidents and injuries to unsafe working conditions instead of the unsafe work practices of employees. However, there has been a fundamental shift in the safety management research carried out in many countries and across diverse industries, which aims to measure the impact of attitudinal, organizational, cultural, and social dimensions on occupational safety. This article examines the relationship between safety climate and safety-related behavior in the Chinese context and draws implications for the management of occupational safety in China.

Association between attributions of responsibility for motor vehicle crashes, depressive symptoms, and return to work.

Perceptions surrounding the underlying causes of accidents and injuries may be a key mechanism influencing postaccident health and functional outcomes among people injured in road crashes. In particular, attributions of responsibility may influence rates of postcrash depressive symptomatology and return-to-work.

Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Background: Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65·3 years (UI 65·0-65·6) in 1990, to 71·5 years (UI 71·0-71·9) in 2013, while the number of deaths increased from 47·5 million (UI 46·8-48·2) to 54·9 million (UI 53·6-56·3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased.For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10·7%, from 4·3 million deaths in 1990 to 4·8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.

Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development.

Remarkable gains have been made in global health in the past 25 years, but progress has not been uniform. Mortality and morbidity from common conditions needing surgery have grown in the world’s poorest regions, both in real terms and relative to other health gains. At the same time, development of safe, essential, life-saving surgical and anaesthesia care in low-income and middle-income countries (LMICs) has stagnated or regressed. In the absence of surgical care, case-fatality rates are high for common, easily treatable conditions including appendicitis, hernia, fractures, obstructed labour, congenital anomalies, and breast and cervical cancer. In 2015, many LMICs are facing a multifaceted burden of infectious disease, maternal disease, neonatal disease, non-communicable diseases, and injuries. Surgical and anaesthesia care are essential for the treatment of many of these conditions and represent an integral component of a functional, responsive, and resilient health system. In view of the large projected increase in the incidence of cancer, road traffic injuries, and cardiovascular and metabolic diseases in LMICs, the need for surgical services in these regions will continue to rise substantially from now until 2030. Reduction of death and disability hinges on access to surgical and anaesthesia care, which should be available, affordable, timely, and safe to ensure good coverage, uptake, and outcomes. Despite growing need, the development and delivery of surgical and anaesthesia care in LMICs has been nearly absent from the global health discourse. Little has been written about the human and economic effect of surgical conditions, the state of surgical care, or the potential strategies for scale-up of surgical services in LMICs. To begin to address these crucial gaps in knowledge, policy, and action, the Lancet Commission on Global Surgery was launched in January, 2014. The Commission brought together an international, multi- disciplinary team of 25 commissioners, supported by advisors and collaborators in more than 110 countries and six continents. We formed four working groups that focused on thedomains of health-care delivery and management; work-force, training, and education; economics and finance; and information management. Our Commission has five key messages, a set of indicators and recommendations to improve access to safe, affordable surgical and anaesthesia care in LMICs, and a template for a national surgical plan.

Rigid removable cover for dorsal wound protection and tube fixation in pigs

Objective To report the design and benefits of a rigid polyethylenecover ‘shell’ for the protection of dorsal torso wounds andtube fixation in pigs.

Methods Open C-shaped polyethylene shells were designed toprotect wounds and dressings on the dorsum of pigs used inresearch into negative pressure dressing-assisted wound healing.The shells were designed to resist trauma and contamination, tobe comfortable and expansible, and to facilitate tube fixation andmanagement. Strap fixation was optimised during experimentation. Efficacy was assessed by direct observation of dressing andwound protection, tube integrity and by macroscopic and microscopicassessments of wound healing.

Results The shells effectively protected the wounds againstblunt and sharp trauma, were simple to remove and reapply, were well tolerated and allowed for growth of the pigs. Circumferentia lneck straps attached by lateral straps to the shells provedcritical. There was no wound infection or inflammation underlyingthe shells. Porting tubing via mid-dorsal holes in the shells andaffixing the tubing just cranial to these holes prevented tubedamage and traction, permitted tube management from outsidethe cages and allowed the pigs to move freely without becomingentangled.

Conclusion These shells effectively protected dorsal skinwounds and dressings, prevented tube damage and facilitatedtube management in pigs. Similar systems may be useful forother production animals for wound management and for tubemanagement with negative pressure wound healing, drain tubesor the delivery of nutrition, fluids or medications.

Ageing, chronic disease and injury: a study in western Victoria (Australia)

Background : An increasing burden of chronic disease and associated health service delivery is expected due to the ageing Australian population. Injuries also affect health and wellbeing and have a long-term impact on health service utilisation. There is a lack of comprehensive data on disease and injury in rural and regional areas of Australia. The aim of the Ageing, Chronic Disease and Injury study is to compile data from various sources to better describe the patterns of chronic disease and injury across western Victoria.

Design : Ecological study.

Methods : Information on demographics, socioeconomic indicators and lifestyle factors are obtained from health surveys and government departments. Data concerning chronic diseases and injuries will be sourced from various registers, health and emergency services, local community health centres and administrative databases and compiled to generate profiles for the study region and for sub-populations within the region.

Expected impact for public health: This information is vital to establish current and projected population needs to inform policy and improve targeted health services delivery, care transition needs and infrastructure development. This study provides a model that can be replicated in other geographical settings.

Effectiveness of targeted falls prevention programme in subacute hospital setting : randomised controlled trial

Objective : To assess the effectiveness of a targeted, multiple intervention falls prevention programme in reducing falls and injuries related to falls in a subacute hospital.

Design : Randomised controlled trial of a targeted multiple intervention programme implemented in addition to usual carecompared with usual care alone.

Setting :Three subacute wards in a metropolitan hospital specialising in rehabilitation and care of elderly patients.

Participants : 626 men and women aged 38 to 99 years (average 80 years) were recruited from consecutive admissions to subacute hospital wards.

Intervention : Falls risk alert card with information brochure, exercise programme, education programme, and hip protectors.

Main outcome measures : Incidence rate of falls, injuries related to falls, and proportion of participants who experienced one or more falls during their stay in hospital.

Results : Participants in the intervention group (n = 310) experienced 30% fewer falls than participants in the control group (n = 316). This difference was significant (Peto log rank test P = 0.045) and was most obvious after 45 days of observation. In the intervention group there was a trend for a reduction in the proportion of participants who experienced falls (relative risk 0.78, 95% confidence interval 0.56 to 1.06) and 28% fewer falls resulted in injury (log rank test P = 0.20).

Conclusions : A targeted multiple intervention falls prevention programme reduces the incidence of falls in the subacute hospital setting.

Electrospun nanofibres

This book deals with an emerging nanofibre-making technology, electrospinning, the functionalities of electrospun nanofibres and their wound healing application. An important fundamental issue, fibre morphological evolution during electrospinning, is clarified. Effective techniques to improve the fibre toughness and control the surface wettability of nanofibre membrane have been developed. These functional nanofibre membranes have been used as dressing materials for healing skin wounds, and shown promising results. This work makes electrospun nanofibre membrane an ideal candidate for wound healing application.

Alt.film.au(2) : Blogging at the margins in Australian retrospective 2012

In 1972 Albie Thoms wrote: ‘In Australia it has been impossible to elicit much sympathetic appraisal from critics who seem distressed by the relation of personal film to amateur movies. Even those proselytizing for the New cinema have underrated the personal film as a worthy antidote to the market assumptions of Hollywood.’ (Thoms 1978, p. 146) The question now is, of course, is anything different in 2012? The answer is of course yes and no. Although the politics remains frustratingly familiar the digital has progressed further to the point that where in the 60s every one picked up a guitar, now we pick up a video camera. A postscript relates those films in the program not available for inclusion in the original 90s rant- (i.e. they did not exist) I have further annotated this re-play of old wounds and victories with commentary on some of the films in the screening program.

The irrelevance to sentencing of (most) incidental hardships suffered by offenders

Criminal offenders often experience hardships beyond the imposition of a court-imposed sanction. These hardships typically take a variety of forms, but can be grouped into a number of relatively well-established categories, including loss of employment, public opprobrium and injuries sustained during or around the time of the commission of the crime. Other examples are deportation from Australia and the imposition of traditional forms of punishment.1 Collectively, these harms are termed incidental hardships or extra-curial punishment.2 Formally, extra-curial punishment is defined as a ‘loss or detriment imposed on an offender by persons other than the sentencing court, for the purpose of punishing the offender for his [or her] offence or at least by reason of the offender having committed the offence’.

The injury profile of an Australian specialist policing unit

This study investigated the injuries sustained by an Australian specialist police division. Injury records spanning four-years were analyzed. The role being performed when the injury occurred, injury cause, body part injured, and injury-related costs were quantified. The percentage of personnel injured multiple times was documented. One hundred and thirty eight personnel reported injuries, 58 of these on multiple occasions. This resulted in 229 injuries and 76 claims being raised. Half of the injuries occurred during operational policing tasks, however training activities accounted for >30% of injuries. The most common injury was strain/sprain, and upper body injuries were 2.5-times more common than lower-body or torso injuries. 1107 shifts were lost, and injuries cost the organization $487,159 (Australian Dollars) over the four-year period. The injury costs (both financial and in manpower) may prompt policy makers to review the current training and post-injury rehabilitation protocols.

Effect of three wound dressings on infection, healing comfort, and cost in patients with sternotomy wounds - a randomized trial

Study objective: To compare three dressing types in terms of their ability to protect against infection and promote healing, patient comfort, and cost-effectiveness.

Design: Prospective, randomized controlled trial.

Setting: Major metropolitan, academically affiliated, tertiary referral center.

Patients: Seven hundred thirty-seven patients were randomized to receive a dry absorbent dressing (n = 243) [Primapore; Smith & Nephew; Sydney, NSW, Australia], a hydrocolloid dressing (n = 267) [Duoderm Thin ConvaTec; Mulgrave, VIC, Australia], or a hydroactive dressing (n = 227) [Opsite; Smith & Nephew] in the operating theater on skin closure.

Results: There was no difference in the rate of wound infection or wound healing between treatment groups. The Primapore dressing was the most comfortable and cost-effective dressing option for the sternotomy wound. Duoderm Thin dressings were associated with increased wound exudate (p < 0.001), poor dressing integrity (p < 0.001), more frequent dressing changes (p < 0.001), more discomfort with removal (p < 0.05), and increased cost (p < 0.001).

Conclusions: In the context of no additional benefit for the prevention of wound infection or the rate of wound healing for any of the three dressing products examined, dry absorbent dressings are the most comfortable and cost-effective products for sternotomy wounds following cardiac surgery.

Critical injuries ; collaborative Indigenous life writing and the ethics of criticism

The publication of collaborative Indigenous life writing places both the text and its production under public scrutiny. The same is true for the criticism of life writing. For each, publication has consequences. Taking as its starting point the recent critical concern for harm occasioned in life writing, this
article argues that in the reading of collaborative Indigenous life writing, injury may eventuate from critical commentary itself. The critical work of G Thomas Couser and his concern for vulnerable subjects, whose life narratives reach published form through the efforts or with the assistance of another, has its
parallel in the critical attention given to collaboratively produced Indigenous life writing in Australia and Canada. In some cases, however, such analysis is generated without consultation with the Indigenous producers of collaborative texts. Criticism directing its arguments toward the conditions
of editorial constraint by which the Indigenous subject is enclosed or silenced has the ironic and surely unintended consequence of removing the Indigenous participants of collaboration from the field of critical engagement. With particular regard to the collaborative texts Ingelba and the Five Black Matriarchs and Stolen Life: the journey of a Cree woman, this article argues that literary criticism can benefit from the practice of consultation with the Indigenous subjects whose representations it comments upon.

Temporary agency workers and the contribution of workplace unfamiliarity to workplace injuries

International and Australian research agrees that temporary agency workers have a higher incidence of workplace injury, and those injuries are more severe. Much less research has been undertaken upon the cause of those injuries. This paper explores one factor contributing to their poorer occupational health and safety through an examination of the role of unfamiliarity with the hosts’ tasks and workplace. The paper commences with a review of the temporary agency employment literature relevant to placing workers in unfamiliar workplaces, and the OHS literature related to timing of injuries. Archival research on investigated workers’ compensation claims for a sample of agency workers and direct hire workers in Victoria is then analysed to assess the importance of unfamiliarity, and training undertaken to overcome that unfamiliarity, for these injured workers. The analysis includes an examination of the timing of the injury in relation to the workers’ placement with the host, and regression analysis on a range of characteristics related to newness at a host’s workplace. The findings confirm that agency workers are especially vulnerable to injury early in their placement, and insufficient attention is given to accommodating unfamiliarity to counter workers’ vulnerability in new workplaces.

Rural sports and recreational injuries in Australia: what do we know?

Objective: It is widely recognised that individuals residing in regional or rural areas have poorer health outcomes than those from metropolitan areas. Factors associated with these poorer health outcomes include geographical isolation, population declines, limited health care provision and higher levels of inactivity compared to urban areas. The mental, social and physical health of individuals and communities in rural areas can be improved through active participation in sport and recreation activities. Unfortunately, participation in such activities can potentially lead to injury. There is a suggestion that there is an increased risk of sports injuries in rural areas due to the lack of health professionals and coaching personnel, fewer available volunteers to organise and deliver sport, and the general attitude towards injuries in rural settings.

Results: There is very limited information about the number and types of injuries sustained during participation in sports activities in rural and regional settings. This is largely related to a lack of formal sporting structures and support mechanisms including research funding and trained personnel.

Conclusion: A range of factors need to be implemented to improve safety for sporting and recreational participants in these areas. These include improved monitoring of injury occurrence, stronger promotion of safety initiatives and wider implementation of education strategies.