Improving Traffic Safety Culture in Iowa, 2011

Vehicle crashes rank among the leading causes of death in the United States. In 2006, the AAA Foundation for Traffic Safety “made a long- term commitment to address the safety culture of the United States, as it relates to traffic safety, by launching a sustained research and educational outreach initiative.” An initiative to produce a culture of safety in Iowa includes the Iowa Comprehensive Highway Safety Plan (CHSP). The Iowa CHSP “engages diverse safety stakeholders and charts the course for the state, bringing to bear sound science and the power of shared community values to change the culture and achieve a standard of safer travel for our citizens.” Despite the state’s ongoing efforts toward highway safety, an average of 445 deaths and thousands of injuries occur on Iowa’s public roads each year. As such, a need exists to revisit the concept of safety culture from a diverse, multi-disciplinary perspective in an effort to improve traffic safety. This study summarizes the best practices and effective laws in improving safety culture in the United States and abroad. Additionally, this study solicited the opinions of experts in public health, education, law enforcement, public policy, social psychology, safety advocacy, and traffic safety engineering in a bid to assess the traffic safety culture initiatives in Iowa. Recommendations for improving traffic safety culture are offered in line with the top five Iowa CHSP safety policy strategies, which are young drivers, occupant protection, motorcycle safety, traffic safety enforcement and traffic safety improvement program, as well as the eight safety program strategies outlined in the CHSP. As a result of this study, eleven high-level goals were developed, each with specific actions to support its success. The goals are: improve emergency medical services response, toughen law enforcement and prosecution, increase safety belt use, reduce speeding-related crashes, reduce alcohol-related crashes, improve commercial vehicle safety, improve motorcycle safety, improve young driver education, improve older driver safety, strengthen teenage licensing process, and reduce distracted driving.

Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.

Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.

Efficacy and safety of tigecycline versus levofloxacin for community-acquired pneumonia.

Abstract Background: Tigecycline, an expanded broad-spectrum glycylcycline, exhibits in vitro activity against many common pathogens associated with community-acqui red pneumonia (CAP), as well as penetration into lung tissues that suggests effectiveness in ho spitalized CAP patients. The aim of the present study was to compare the efficacy and safety of intravenous (IV) tigecycline with IV levofloxacin in hospitalized adults with CAP. Methods: In this prospective, double-blin d, non-inferiority phase 3 trial, eligible patients with a clinical diagnosis of CAP supported by radiographic evidence were stratified by Fine Pneumonia Severity Index and randomized to tigecycline or levofloxacin for 7-14 days of therapy. Co-primary efficacy endpoints were clinical response in the clinically evaluable (CE) and clinical modified intent- to-treat (c-mITT) populations at te st-of-cure (Day 10-21 post-therapy). Results: Of the 428 patients who received at least on e dose of study drug, 79% had CAP of mild-moderate severity according to their Fine score. Clinical cure rates for the CE population were 88.9% for tigecycline and 85.3% for levofloxac in. Corresponding c-mITT population rates were 83.7% and 81.5%, respectively. Eradication rates for Streptococcus pneumoniae were 92% for tigecycline and 89% for levofloxac in. Nausea, vomiting, and diarrhoea were the most frequently reported adverse events. Rates of premature disc continuation of study drug or study withdrawal because of any adverse event were similar for both study drugs. Conclusion: These findings suggest that IV tigecycline is non-inferior to IV levofloxacin and is generally well-tolerated in the treatment of hospitalized adults with CAP.

Validation Studies of Thermal-hydraulic Code for Safety Analysis of Nuclear Power Plants

This thesis gives an overview of the validation process for thermal hydraulic system codes and it presents in more detail the assessment and validation of the French code CATHARE for VVER calculations. Three assessment cases are presented: loop seal clearing, core reflooding and flow in a horizontal steam generator. The experience gained during these assessment and validation calculations has been used to analyze the behavior of the horizontal steam generator and the natural circulation in the geometry of the Loviisa nuclear power plant. The cases presented are not exhaustive, but they give a good overview of the work performed by the personnel of Lappeenranta University of Technology (LUT). Large part of the work has been performed in co-operation with the CATHARE-team in Grenoble, France. The design of a Russian type pressurized water reactor, VVER, differs from that of a Western-type PWR. Most of thermal-hydraulic system codes are validated only for the Western-type PWRs. Thus, the codes should be assessed and validated also for VVER design in order to establish any weaknesses in the models. This information is needed before codes can be used for the safety analysis. Theresults of the assessment and validation calculations presented here show that the CATHARE code can be used also for the thermal-hydraulic safety studies for VVER type plants. However, some areas have been indicated which need to be reassessed after further experimental data become available. These areas are mostly connected to the horizontal stem generators, like condensation and phase separation in primary side tubes. The work presented in this thesis covers a large numberof the phenomena included in the CSNI code validation matrices for small and intermediate leaks and for transients. Also some of the phenomena included in the matrix for large break LOCAs are covered. The matrices for code validation for VVER applications should be used when future experimental programs are planned for code validation.

Translation as a Process and Translation as a Product in Teaching Translation

L'ensenyament de la traducció s'ha utilitzat tradicionalment en algunes titulacions de filologia com a eina d'aprenentatge d'habilitats de la llengua. Aquesta circumstància, però, no ha d'estar renyida amb la producció d'una traducció acceptable. En aquest article es pretén analitzar si pot aconseguir-se aquest objectiu mitjançant la incorporació d'informació extratextual en l'enunciat de l'exercici de traducció. Els resultats obtinguts amb un grup d'estudiants de filologia mostren que en les seves decisions lingüístiques va tenir un pes important el tipus d'informació extratextual adjunta als textes originals anglesos. Si bé caldria fer un esforç investigador més sistemàtic per poder afirmar-ho categòricament, aquest estudi intenta esbossar la qüestió tan discutida de fins on l'aprenentatge d'una llengua s'ha de realitzar junt amb l'aprenentatge de la traducció. Aquest estudi, també, planteja la necessitat d'incorporar informació extratextual en l'aprenentatge de la traducció, independentment de la titulació que en aquests estudis s'insereixen.

USER'S GUIDE FOR ADVANCED PROCESS SIMULATION SOFTWARE APROS 5

Tässä diplomityössä tehtiin käyttäjän opas kehittyneelle prosessisimulointiohjelmistolle APROS 5. Opas on osa VTT Energialle tehtävää APROS 5 käyttäjän koulutuspakettia, joka julkaistaan myöhemmin CD-ROM -muotoisena. Prosessisimulointiohjelmistoa AAPROS 5 voidaan käyttää termohydraulisten prosessien, automaatiopiirien ja sähköjärjestelmien mallinnuksessa. Ohjelma sisältää myös neutroniikkamallin ydinreaktorin käyttäytymisen mallintamiseksi. APROS:in aikaisemmilla UNIX-ympäristössä toimivilla versioilla on toteutettu useita ydinvoimalaitosten turvallisuustutkimukseen liittyviä analyysejä ja sekä ydinvoimalaitosten että konventionaalisten voimalaitosten koulutussimulaattoreita. APROS 5 toimii Windows NT -ympäristössä ja on oleellisesti erilainen käyttää kuin aikaisemmat versiot. Tämän myötä syntyi tarve uudelle käyttäjän oppaalle. Käyttäjän oppaassa esitetään APROS 5:n tärkeimmät toiminnot, mallinnuksen periaatteet ja termohydraulisten ja neutroniikan ratkaisumallit. Lisäksi oppaassa esitetään esimerkki, jossa mallinnetaan yksinkertaistettu VVER-440 -tyyppisen ydinvoimalaitoksen primääripiiri. Yksityiskohtaisempaa tietoa ohjelmistosta on saatavilla APROS 5 -dokumentaatiosta.

Operational Knowledge in Process Design

Työn tarkoituksena on selvittää, miten käyttötietämystä hyödynnetään prosessisuunnittelussa. Tavoitteena on löytää keinoja parantaa käyttötietämyksen hallintaa suunnitteluprosessin aikana ja selvittää, vaikuttaako tämä prosessisuunnittelun laatuun.Prosessisuunnittelun laatua arvioidaan seitsemällä kriteerillä, jotka ovat investointikustannukset, käyttökustannukset, turvallisuus, ympäristövaikutukset, käytettävyys, innovatiivisuus ja aikataulu. Suunnitteluprosessi jaetaan kolmeen vaiheeseen: esisuunnitteluun, perussuunnitteluun ja detaljisuunnitteluun. Prosessisuunnittelua, investointiprojektia, prosessisuunnittelun laatukriteerejä, suunnitteluprosessin eri vaiheita ja käyttötietämyksen luokittelua tarkastellaan yleisesti. Työssä selvitettiin käyttötietämyksen hyödyntämistä Kemiralla. Aluksi muotoiltiin yleisiä väittämiä käyttötietämyksen hyödyntämisestä Kemiran ulkopuolisten eri alojen asiantuntijoiden haastattelujen perusteella. Tämän jälkeen Kemiran prosessisuunnittelijat arvioivat väittämiä. Arvioiden perusteella tehtiin johtopäätöksiä yleisesti käyttötietämyksen hyödyntämisestä prosessisuunnittelussa. Seuraavaksi haastateltiin kahdessa erityyppisessä case-projektissa mukana olleita henkilöitä ja muotoiltiin yleiset väittämät näihin projekteihin sopiviksi. Projekteissa mukana olleet henkilöt arvioivat väittämiä, ja näiden arvioiden perusteella projekteja vertailtiin keskenään. Lopussa esitetään johtopäätökset kaikkien väittämien arvioiden perusteella. Johtopäätöksenä voidaan todeta, että käyttötietämystä voidaan hyödyntää kaikissa suunnittelun vaiheissa, mutta paras hyöty saadaan perus- ja detaljisuunnittelussa. Käyttötietämyksellä voidaan vaikuttaa joihinkin prosessisuunnittelun laatukriteereihin, kuten esimerkiksi käytettävyyteen ja turvallisuuteen enemmän kuin muihin. Kemiralle suositellaan nykyisten tiedonhallintamenetelmien kehittämistä, jotta käyttötietämyksen saatavuus ja sen siirtäminen paranisi. Pr

Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.

Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.

Fostering Collaborative Knowledge Building by the Effective Provision of Knowledge about the Discussion Process

Peer-reviewed

Transforming Maritime Safety Culture. Evaluation of the impacts of the ISM Code on maritime safety culture in Finland

The purpose of the METKU Project (Development of Maritime Safety Culture) is to study how the ISM Code has influenced the safety culture in the maritime industry. This literature review is written as a part of the Work Package 2 which is conducted by the University of Turku, Centre for Maritime Studies. The maritime traffic is rapidly growing in the Baltic Sea which leads to a growing risk of maritime accidents. Particularly in the Gulf of Finland, the high volume of traffic causes a high risk of maritime accidents. The growing risks give us good reasons for implementing the research project concerning maritime safety and the effectiveness of the safety measures, such as the safety management systems. In order to reduce maritime safety risks, the safety management systems should be further developed. The METKU Project has been launched to examine the improvements which can be done to the safety management systems. Human errors are considered as the most important reason for maritime accidents. The international safety management code (the ISM Code) has been established to cut down the occurrence of human errors by creating a safety-oriented organizational culture for the maritime industry. The ISM Code requires that a company should provide safe practices in ship operation and a safe working environment and establish safeguards against all identified risk. The fundamental idea of the ISM Code is that companies should continuously improve safety. The commitment of the top management is essential for implementing a safety-oriented culture in a company. The ISM Code has brought a significant contribution to the progress of maritime safety in recent years. Shipping companies and ships’ crews are more environmentally friendly and more safety-oriented than 12 years ago. This has been showed by several studies which have been analysed for this literature research. Nevertheless, the direct effect and influence of the ISM Code on maritime safety could not be isolated very well. No quantitative measurement (statistics/hard data) could be found in order to present the impacts of the ISM Code on maritime safety. In this study it has been discovered that safety culture has emerged and it is developing in the maritime industry. Even though the roots of the safety culture have been established there are still serious barriers to the breakthrough of the safety management. These barriers could be envisaged as cultural factors preventing the safety process. Even though the ISM Code has been effective over a decade, the old-established behaviour which is based on the old day’s maritime culture still occurs. In the next phase of this research project, these cultural factors shall be analysed in regard to the present safety culture of the maritime industry in Finland.

Food Safety Testing: Rapid Molecular Methods for Chemical and Biological Hazards

The central goal of food safety policy in the European Union (EU) is to protect consumer health by guaranteeing a high level of food safety throughout the food chain. This goal can in part be achieved by testing foodstuffs for the presence of various chemical and biological hazards. The aim of this study was to facilitate food safety testing by providing rapid and user-friendly methods for the detection of particular food-related hazards. Heterogeneous competitive time-resolved fluoroimmunoassays were developed for the detection of selected veterinary residues, that is coccidiostat residues, in eggs and chicken liver. After a simplified sample preparation procedure, the immunoassays were performed either in manual format with dissociation-enhanced measurement or in automated format with pre-dried assay reagents and surface measurement. Although the assays were primarily designed for screening purposes providing only qualitative results, they could also be used in a quantitative mode. All the developed assays had good performance characteristics enabling reliable screening of samples at concentration levels required by the authorities. A novel polymerase chain reaction (PCR)-based assay system was developed for the detection of Salmonella spp. in food. The sample preparation included a short non-selective pre-enrichment step, after which the target cells were collected with immunomagnetic beads and applied to PCR reaction vessels containing all the reagents required for the assay in dry form. The homogeneous PCR assay was performed with a novel instrument platform, GenomEra^™, and the qualitative assay results were automatically interpreted based on end-point time-resolved fluorescence measurements and cut-off values. The assay was validated using various food matrices spiked with sub-lethally injured Salmonella cells at levels of 1-10 colony forming units (CFU)/25 g of food. The main advantage of the system was the exceptionally short time to result; the entire process starting from the pre-enrichment and ending with the PCR result could be completed in eight hours. In conclusion, molecular methods using state-of-the-art assay techniques were developed for food safety testing. The combination of time-resolved fluorescence detection and ready-to-use reagents enabled sensitive assays easily amenable to automation. Consequently, together with the simplified sample preparation, these methods could prove to be applicable in routine testing.

The process of basic training, applied training, maintaining the performance of an observer

In the field of observational methodology the observer is obviously a central figure, and close attention should be paid to the process through which he or she acquires, applies, and maintains the skills required. Basic training in how to apply the operational definitions of categories and the rules for coding, coupled with the opportunity to use the observation instrument in real-life situations, can have a positive effect in terms of the degree of agreement achieved when one evaluates intra- and inter-observer reliability. Several authors, including Arias, Argudo, & Alonso (2009) and Medina and Delgado (1999), have put forward proposals for the process of basic and applied training in this context. Reid y De Master (1982) focuses on the observer's performance and how to maintain the acquired skills, it being argued that periodic checks are needed after initial training because an observer may, over time, become less reliable due to the inherent complexity of category systems. The purpose of this subsequent training is to maintain acceptable levels of observer reliability. Various strategies can be used to this end, including providing feedback about those categories associated with a good reliability index, or offering re-training in how to apply those that yield lower indices. The aim of this study is to develop a performance-based index that is capable of assessing an observer's ability to produce reliable observations in conjunction with other observers.