Achieving zero accidents—A strategic framework for continuous safety improvement in the construction industry

In the U.S., construction accidents remain a significant economic and social problem. Despite recent improvement, the Construction industry, generally, has lagged behind other industries in implementing safety as a total management process for achieving zero accidents and developing a high-performance safety culture. One aspect of this total approach to safety that has frustrated the construction industry the most has been “measurement”, which involves identifying and quantifying the factors that critically influence safe work behaviors. The basic problem attributed is the difficulty in assessing what to measure and how to measure it—particularly the intangible aspects of safety. Without measurement, the notion of continuous improvement is hard to follow. This research was undertaken to develop a strategic framework for the measurement and continuous improvement of total safety in order to achieve and sustain the goal of zero accidents, while improving the quality, productivity and the competitiveness of the construction industry as it moves forward. The research based itself on an integral model of total safety that allowed decomposition of safety into interior and exterior characteristics using a multiattribute analysis technique. Statistical relationships between total safety dimensions and safety performance (measured by safe work behavior) were revealed through a series of latent variables (factors) that describe the total safety environment of a construction organization. A structural equation model (SEM) was estimated for the latent variables to quantify relationships among them and between these total safety determinants and safety performance of a construction organization. The developed SEM constituted a strategic framework for identifying, measuring, and continuously improving safety as a total concern for achieving and sustaining the goal of zero accidents.

The epidemiology of prostate cancer among multiethnic men

The research goal was to document differences in the epidemiology of prostate cancer among multicultural men [non-Hispanic White (NHW), Hispanic (H), non-Hispanic Black (NHB)], and Black subgroups, particularly among NHB subgroups [US-born (USB) and Caribbean-born (CBB)]. Study findings will be useful in supporting further research into Black subgroups. Aim 1 explored changes over time in reported prostate cancer prevalence, by race/ethnicity and by birthplace (within the Black subgroups). Aim 2 investigated relationships between observed and latent variables. The analytical approaches included confirmatory factor analysis (CFA for measurement models) and structural equation modeling (SEM for regression models). National Center for Health Statistics, National Health Interview Survey (NHIS) data from 1999–2008 were used. The study sample included men aged 18 and older, grouped by race/ethnicity. Among the CBB group, survey respondents were limited to the English-speaking Caribbean. Prostate cancer prevalence, by race showed a higher trend among NHB men than NHW men overall, however differences over time were not significant. CBB men reported a higher proportion of prostate cancer among cancers diagnosed than USB men overall. Due to small sample sizes, stable prostate cancer prevalence trends could not be assessed over time nor could trends in the receipt of a PSA exam among NHB men when stratified by birthplace. USB and CBB men differ significantly in their screening behavior. The effect of SES on PSA screening adjusted for risk factors was statistically significant while latent variable lifestyle was not. Among risk factors, family history of cancer exhibited a consistent positive effect on PSA screening for both USB and CBB men. Among the CBB men, the number of years lived in the US did not significantly affect PSA screening behavior. When NHB men are stratified by birthplace, CBB men had a higher overall prevalence of prostate cancer diagnoses than USB men although not statistically significant. USB men were 2 to 3 times more likely to have had a PSA exam compared to CBB men, but among CBB men birthplace did not make a significant difference in screening behavior. Latent variable SES, but not lifestyle, significantly affected the likelihood of a PSA exam.