The effect of age, gender and driver status on pedestrians' intentions to cross the road in risky situations

The theory of planned behaviour (TPB) has been used successfully in the past to account for pedestrians' intentions to cross the road in risky situations. However, accident statistics show age and gender differences in the likelihood of adult pedestrian accidents. This study extends earlier work by examining the relative importance of the model components as predictors of intention to cross for four different adult age groups, men, women, drivers and nondrivers. The groups did not differ in the extent to which they differentiated between two situations of varying perceived risk. The model fit was good, but accounted for less of the variance in intention for the youngest group (17-24) than for other age groups. Differences between the age groups in intention to cross seemed to be due to differences in perceived value of crossing rather than differences in perceived risk. Women were less likely to intend to cross than men and perceived more risk, and there were important age, gender and driver status differences in the importance of the TPB variables as predictors of intention. A key implication of these findings is that road safety interventions need to be designed differently for different groups. © 2006 Elsevier Ltd. All rights reserved.

Gender differences in factors predicting unsafe crossing decisions in adult pedestrians across the lifespan: a simulation study

Adult pedestrian accident data has demonstrated that the risk of being killed or seriously injured varies with age and gender. A range of factors affecting road crossing choices of 218 adults aged 17-90+ were examined in a simulation study using filmed real traffic. With increasing age, women were shown to make more unsafe crossing decisions, to leave small safety margins and to become poorer at estimating their walking speed. However, the age effects on all of these were ameliorated by driving experience. Men differed from women in that age was not a major factor in predicting unsafe crossing decisions. Rather, reduced mobility was the key factor, leading them to make more unsafe crossings and delay longer in leaving the kerb. For men, driving experience did not predict unsafe road crossing decisions. Although male drivers were more likely to look both ways before crossing than male non-drivers, the impact of being a driver had a negative effect in terms of smaller safety margins and delay in leaving the kerb. The implications of the different predictor variables for men and women for unsafe road crossing are discussed and possible reasons for the differences explored.

The effect of age, gender and attitudes on self-regulation in driving

Self-regulation in driving has primarily been studied as a precursor to driving cessation in older people, who minimise driving risk and compensate for physical and cognitive decline by avoiding driving in challenging circumstances, e.g. poor weather conditions, in the dark and at busy times. This research explores whether other demographic groups of drivers adopt self-regulatory behaviours and examines the effects of affective and instrumental attitudes on self-regulation across the lifespan. Quantitative data were collected from 395 drivers. Women were significantly more likely than men to engage in self-regulation, and to be negatively influenced by their emotions (affective attitude). A quadratic effect of age on self-regulation was determined such that younger and older drivers reported higher scores for self-regulation than middle-years' drivers. However, this effect was affected by experience such that when experience was controlled for, self-regulation increased with age. Nevertheless, anxious driving style and negative affective attitude were independent predictors of self-regulation behaviours. Results suggest that self-regulation behaviours are present across the driving lifespan and may occur as a result of driving anxiety or low confidence rather than as an effect of ageing.

Influence of personal mobile phone ringing and usual intention to answer on driver error

Given evidence of effects of mobile phone use on driving, and also legislation, many careful drivers refrain from answering their phones when driving. However, the distracting influence of a call on driving, even in the context of not answering, has not been examined. Furthermore, given that not answering may be contrary to an individual’s normal habits, this study examined whether distraction caused by the ignored call varies according to normal intention to answer whilst driving. That is, determining whether the effect is more than a simple matter of noise distraction. Participants were 27 young drivers (18-29 years), all regular mobile users. A Theory of Planned Behaviour questionnaire examined predictors of intention to refrain from answering calls whilst driving. Participants provided their mobile phone number and were instructed not to answer their phone if it were to ring during a driving simulation. The simulation scenario had seven hazards (e.g. car pulling out, pedestrian crossing) with three being immediately preceded by a call. Infractions (e.g. pedestrian collisions, vehicle collisions, speed exceedances) were significantly greater when distracted by call tones than with no distraction. Lower intention to ignore calls whilst driving correlated with a larger effect of distraction, as was feeling unable to control whether one answered whilst driving (Perceived Behavioural Control). The study suggests that even an ignored call can cause significantly increased infractions in simulator driving, with pedestrian collisions and speed exceedances being striking examples. Results are discussed in relation to cognitive demands of inhibiting normal behaviour and to drivers being advised to switch phones off whilst driving.

Examining links between cognitive markers, movement initiation and change, and pedestrian safety in older adults

Objective: The purpose of this study was to determine the extent to which mobility indices (such as walking speed and postural sway), motor initiation, and cognitive function, specifically executive functions, including spatial planning, visual attention, and within participant variability, differentially predicted collisions in the near and far sides of the road with increasing age. Methods: Adults aged over 45 years participated in cognitive tests measuring executive function and visual attention (using Useful Field of View; UFoV®), mobility assessments (walking speed, sit-to-stand, self-reported mobility, and postural sway assessed using motion capture cameras), and gave road crossing choices in a two-way filmed real traffic pedestrian simulation. Results: A stepwise regression model of walking speed, start-up delay variability, and processing speed) explained 49.4% of the variance in near-side crossing errors. Walking speed, start-up delay measures (average & variability), and spatial planning explained 54.8% of the variance in far-side unsafe crossing errors. Start-up delay was predicted by walking speed only (explained 30.5%). Conclusion: Walking speed and start-up delay measures were consistent predictors of unsafe crossing behaviours. Cognitive measures, however, differentially predicted near-side errors (processing speed), and far-side errors (spatial planning). These findings offer potential contributions for identifying and rehabilitating at-risk older pedestrians.

A road safety performance indicator for vehicle fleet compatibility

This paper discusses the development and the application of a safety performance indicator which measures the intrinsic safety of a country's vehicle fleet related to fleet composition. The indicator takes into account both the ‘relative severity’ of individual collisions between different vehicle types, and the share of those vehicle types within a country's fleet. The relative severity is a measure for the personal damage that can be expected from a collision between two vehicles of any type, relative to that of a collision between passenger cars. It is shown how this number can be calculated using vehicle mass only. A sensitivity analysis is performed to study the dependence of the indicator on parameter values and basic assumptions made. The indicator is easy to apply and satisfies the requirements for appropriate safety performance indicators. It was developed in such a way that it specifically scores the intrinsic safety of a fleet due to its composition, without being influenced by other factors, like helmet wearing. For the sake of simplicity, and since the required data is available throughout Europe, the indicator was applied to the relative share of three of the main vehicle types: passenger cars, heavy goods vehicles and motorcycles. Using the vehicle fleet data from 13 EU Member States and Norway, the indicator was used to rank the countries’ safety performance. The UK was found to perform best in terms of its fleet composition (value is 1.07), while Greece has the worst performance with the highest indicator value (1.41).

Managing healthcare quality using logical framework analysis

Purpose - The purpose of this paper is to develop an integrated quality management model that identifies problems, suggests solutions, develops a framework for implementation and helps to evaluate dynamically healthcare service performance. Design/methodology/approach - This study used the logical framework analysis (LFA) to improve the performance of healthcare service processes. LFA has three major steps - problems identification, solution derivation, and formation of a planning matrix for implementation. LFA has been applied in a case-study environment to three acute healthcare services (Operating Room utilisation, Accident and Emergency, and Intensive Care) in order to demonstrate its effectiveness. Findings - The paper finds that LFA is an effective method of quality management of hospital-based healthcare services. Research limitations/implications - This study shows LFA application in three service processes in one hospital. This very limited population sample needs to be extended. Practical implications - The proposed model can be implemented in hospital-based healthcare services in order to improve performance. It may also be applied to other services. Originality/value - Quality improvement in healthcare services is a complex and multi-dimensional task. Although various quality management tools are routinely deployed for identifying quality issues in healthcare delivery, they are not without flaws. There is an absence of an integrated approach, which can identify and analyse issues, provide solutions to resolve those issues, develop a project management framework to implement those solutions. This study introduces an integrated and uniform quality management tool for healthcare services. © Emerald Group Publishing Limited.

A redesign of a road traffic accident reporting system using business process simulation

Business process simulation (BPS) is used to evaluate the effect of the redesign of a police road traffic accident (RTA) reporting system. The new system aims to provide timely statistical analysis of traffic behaviour to government bodies and to enable more effective utilisation of traffic police personnel. The simulation method is demonstrated in the context of assisting process change enabled by the use of information systems in an organisation in which there had been a historically mixed pattern of success in this activity.

Technology flows, outsourcing and productivity:an analysis of UK trade and FDI

By engaging in trade and foreign direct investment (FDI) with foreign partners, a country can access the R&D and related knowledge stocks of other countries (by accident or by design) and so benefit from those stocks of knowledge at a cost lower than that which would be incurred by developing the knowledge internally. This should lead to beneficial ‘spillover’ effects on the productivity of domestic firms. However, the literature on technology spillovers from trade and FDI is ambiguous in its findings. This may in part be because of the assumption in much of the work that trade and FDI flows are homogeneous in their determinants and thus in their effects. We develop a taxonomy of trade and FDI determinants based on R&D intensity and unit labour cost differentials, and test for the presence of spillovers from inward investment and imports on an extensive sample of UK manufacturing plants. We find that both trade and FDI have measurable spillover effects, but the size of these effects varies depending on the technological and labour cost differentials between the UK and its trading partners. There is therefore an identifiable link between the determinants and effects of trade and FDI which the previous literature has not explored. We also find that absorptive capacity matters for spillovers from FDI, but not from trade. Overall, these findings suggest that the productivity effects of FDI are largely restricted to plants with high absorptive capacity, while the productivity effects of imports occur largely among higher-technology plants regardless of their absorptive capacity.

An analysis of fatal accidents in agriculture in Great Britain

The number of fatal accidents in the agricultural, horticultural and forestry industry in Great Britain has declined from an annual rate of about 135 in the 1960's to its current level of about 50. Changes to the size and makeup of the population at risk mean that there has been no real improvement in fatal injury incidence rates for farmers. The Health and Safety Executives' (HSE) current system of accident investigation, recording, and analysis is directed primarily at identifying fault, allocating blame, and punishing wrongdoers. Relatively little information is recorded about the personal and organisational factors that contributed to, or failed to prevent accidents. To develop effective preventive strategies, it is important to establish whether errors by the victims and others, occur at the skills, rules, or knowledge level of functioning: are violations of some rule or procedure; or stem from failures to correctly appraise, or control a hazard. A modified version of the Hale and Glendon accident causation model was used to study 230 fatal accidents. Inspectors' original reports were examined and expert judgement applied to identify and categorise the errors committed by each of the parties involved. The highest proportion of errors that led directly to accidents occurred whilst the victims were operating at the knowledge level. The mix and proportion of errors varied considerably between different classes of victim and kind of accident. Different preventive strategies will be needed to address the problem areas identified.

Safety and health in mines: the rise of bureaucracy in the coal mining industry and its results as evidenced by the public enquiry into an accident at Houghton Main Colliery

This thesis is concerned with certain aspects of the Public Inquiry into the accident at Houghton Main Colliery in June 1975. It examines whether prior to the accident there existed at the Colliery a situation in which too much reliance was being placed upon state regulation and too Iittle upon personal responsibility. I study the phenomenon of state regulation. This is done (a) by analysis of selected writings on state regulation/intervention/interference/bureaucracy (the words are used synonymously) over the last two hundred years, specifically those of Marx on the 1866 Committee on Mines, and (b) by studying Chadwick and Tremenheere, leading and contrasting "bureaucrats" of the mid-nineteenth century. The bureaucratisation of the mining industry over the period 1835-1954 is described, and it is demonstrated that the industry obtained and now possesses those characteristics outlined by Max Weber in his model of bureaucracy. I analyse criticisms of the model and find them to be relevant, in that they facilitate understanding both of the circumstances of the accident and of the Inquiry . Further understanding of the circumstances and causes of the accident was gained by attendance at the lnquiry and by interviewing many of those involved in the Inquiry. I analyse many aspects of the Inquiry - its objectives. structure, procedure and conflicting interests - and find that, although the Inquiry had many of the symbols of bureaucracy, it suffered not from " too much" outside interference. but rather from the coal mining industry's shared belief in its ability to solve its own problems. I found nothing to suggest that, prior to the accident, colliery personnel relied. or were encouraged to rely, "too much" upon state regulation.

Rural road accident investigation and prevention in Iran

The objectives are to examine rural road accident data in order to develop a method by which high accident rate locations and accident causes can be identified, and also to develop proposals for improvements at such locations and to identify measures which will improve road safety throughout the country. The problem of road safety in Iran is an important issue, because of the tragic and unnecessary loss of life, and the enormous cost of accidents in the country. The resources available to deal with the problems are limited and must be allocated on priority basis. This study represents an initial effort to identify the extent of the problem in order to take remedial measures. A study was made of all the available road accident data collected by agencies related to road safety in Iran, and the major organisations responsible for road safety development were visited. The Vice Minister of Roads and Transportation selected for this study a 280 Km rural road in South West Iran. Mainly because of the lack of suitable maps and plans of the roads, it was not possible to accurately identify the location of accidents. Accident scene data was subsequently collected by the highway police and personally by the author. The data for the study road was then analysed to identify 'high accident rate' locations, and also to determine, as far as was possible, the reasons for the accidents. The study suggests specific improvements for each of the high accident rate locations examined (eg. the building of dual carriageways with central guard rails to reduce the risk of collision with oncoming vehicles, pedestrian facilities to allow pedestrians to cross dangerous roadsl]. In addition recommendations are made to guide and assist the major organisations responsible for road safety in Iran. These recommendations are: (al for improving accident data collection and storage (bl for subsequent analysis for taking remedial measures with a view to accident prevention

Rural road accidents in Iran: analysis, comparison and the cost

In the general introduction of the road-accident phenomenon inside and outside Iran, the results of previous research-works and international conferences and seminars on road-safety have been reviewed. Also a sample-road between Tehran and Mashad has been investigated as a case-study. Examining the road-accident data and iriformation,first: the information presented in road-accident report-forms in developed countries is discussed and, second: the procedures for road-accident data collection in Iran are investigated in detail. The data supplied by Iran Road-Police Central Statistics Office, is analysed, different rates are computed, due comparisons with other nations are made, and the results are discussed. Also such analysis and comparisons are presented for different provinces of Iran. It is concluded that each province with its own natural, geographical, social and economical characteristics possesses its own reasons for the quality and quantity of road-accidents and therefore must receive its own appropriate remedial solutions. The question~ of "what is the cost of road-accidents", "why and how evaluate the cost", "what is the appropriate way of approach to such evaluation" are all discussed and then "the cost of road-accidents in Iran" based on two different approaches: "Gross National Output"and "court award" is computed. It is concluded that this cost is about 1.5 per cent of the country's national product. In Appendix 3 an impressive example is given of the trend of costs and benefits that can be attributed to investment in road-safety measures.

Combined quality function deployment and logical framework analysis to improve quality of emergency care in Malta

Purpose – The purpose of this paper is to develop an integrated patient-focused analytical framework to improve quality of care in accident and emergency (A&E) unit of a Maltese hospital. Design/methodology/approach – The study adopts a case study approach. First, a thorough literature review has been undertaken to study the various methods of healthcare quality management. Second, a healthcare quality management framework is developed using combined quality function deployment (QFD) and logical framework approach (LFA). Third, the proposed framework is applied to a Maltese hospital to demonstrate its effectiveness. The proposed framework has six steps, commencing with identifying patients’ requirements and concluding with implementing improvement projects. All the steps have been undertaken with the involvement of the concerned stakeholders in the A&E unit of the hospital. Findings – The major and related problems being faced by the hospital under study were overcrowding at A&E and shortage of beds, respectively. The combined framework ensures better A&E services and patient flow. QFD identifies and analyses the issues and challenges of A&E and LFA helps develop project plans for healthcare quality improvement. The important outcomes of implementing the proposed quality improvement programme are fewer hospital admissions, faster patient flow, expert triage and shorter waiting times at the A&E unit. Increased emergency consultant cover and faster first significant medical encounter were required to start addressing the problems effectively. Overall, the combined QFD and LFA method is effective to address quality of care in A&E unit. Practical/implications – The proposed framework can be easily integrated within any healthcare unit, as well as within entire healthcare systems, due to its flexible and user-friendly approach. It could be part of Six Sigma and other quality initiatives. Originality/value – Although QFD has been extensively deployed in healthcare setup to improve quality of care, very little has been researched on combining QFD and LFA in order to identify issues, prioritise them, derive improvement measures and implement improvement projects. Additionally, there is no research on QFD application in A&E. This paper bridges these gaps. Moreover, very little has been written on the Maltese health care system. Therefore, this study contributes demonstration of quality of emergency care in Malta.