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.

Thermal-Hydraulic Studies on the Safety Of VVER-440 Type Nuclear Power Plants

This thesis includes several thermal hydraulic analyses related to the Loviisa WER 440 nuclear power plant units. The work consists of experimental studies, analysis of the experiments, analysis of some plant transits and development of a calculational model for calculation of boric acid concentrations in the reactor. In the first part of the thesis, in the case of won of boric acid solution behaviour during long term cooling period of LOCAs, experiments were performed in scaled down test facilities. The experimental data together with the results of RELAPS/MOD3 simulations were used to develop a model for calculations of boric acid concentrations in the reactor during LOCAs. The results of calculations showed that margins to critical concentrations that would lead to boric acid crystallization were large, both in the reactor core and in the lower plenum. This was mainly caused by the fact that water in the primary cooling circuit includes borax (Na)BsO,.IOHZO), which enters the reactor when ECC water is taken from the sump and greatly increases boric acid solubility in water. In the second part, in the case of simulation of horizontal steam generators, experiments were performed with PACTEL integral test loop to simulate loss of feedwater transients. The PACTEL experiments, as well as earlier REWET III natural circulation tests, were analyzed with RELAPS/MOD3 Version Sm5 code. The analysis showed that the code was capable of simulating the main events during the experiments. However, in the case of loss of secondary side feedwater the code was not completely capable to simulate steam superheating in the secondary side of the steam generators. The third part of the work consists of simulations of Loviisa VVER reactor pump trip transients with RELAPSlMODI Eur, RELAPS/MOD3 and CATHARE codes. All three codes were capable to simulate the two selected pump trip transients and no significant differences were found between the results of different codes. Comparison of the calculated results with the data measured in the Loviisa plant also showed good agreement.

Maritime Safety in the Gulf of Finland. Review on Policy Instruments

Suomenlahden lisääntynyt meriliikenne on herättänyt huolta meriliikenteen turvallisuuden tasosta, ja erityisesti Venäjän öljyviennin kasvu on lisännyt öljyonnettomuuden todennäköisyyttä Suomenlahdella. Erilaiset kansainväliset, alueelliset ja kansalliset ohjauskeinot pyrkivät vähentämään merionnettomuuden riskiä ja meriliikenteen muita haittavaikutuksia. Tämä raportti käsittelee meriturvallisuuden yhteiskunnallisia ohjauskeinoja: ohjauskeinoja yleisellä tasolla, meriturvallisuuden keskeisimpiä säätelijöitä, meriturvallisuuden ohjauskeinoja ja meriturvallisuuspolitiikan tulevaisuuden näkymiä, ohjauskeinojen tehokkuutta ja nykyisen meriturvallisuuden ohjausjärjestelmän heikkouksia. Raportti on kirjallisuuskatsaus meriturvallisuuden yhteiskunnalliseen sääntelyn rakenteeseen ja tilaan erityisesti Suomenlahden meriliikenteen näkökulmasta. Raportti on osa tutkimusprojektia ”SAFGOF - Suomenlahden meriliikenteen kasvunäkymät 2007 - 2015 ja kasvun vaikutukset ympäristölle ja kuljetusketjujen toimintaan” ja sen työpakettia 6 ”Keskeisimmät riskit ja yhteiskunnalliset vaikutuskeinot”. Yhteiskunnalliset ohjauskeinot voidaan ryhmitellä hallinnollisiin, taloudellisiin ja tietoohjaukseen perustuviin ohjauskeinoihin. Meriturvallisuuden edistämisessä käytetään kaikkia näitä, mutta hallinnolliset ohjauskeinot ovat tärkeimmässä asemassa. Merenkulun kansainvälisen luonteen vuoksi meriturvallisuuden sääntely tapahtuu pääosin kansainvälisellä tasolla YK:n ja erityisesti Kansainvälisen merenkulkujärjestön (IMO) toimesta. Lisäksi myös Euroopan Unionilla on omaa meriturvallisuuteen liittyvää sääntelyä ja on myös olemassa muita alueellisia meriturvallisuuden edistämiseen liittyviä elimiä kuten HELCOM. Joitakin meriturvallisuuden osa-alueita säädellään myös kansallisella tasolla. Hallinnolliset meriturvallisuuden ohjauskeinot sisältävät aluksen rakenteisiin ja varustukseen, alusten kunnon valvontaan, merimiehiin ja merityön tekemiseen sekä navigointiin liittyviä ohjauskeinoja. Taloudellisiin ohjauskeinoihin kuuluvat esimerkiksi väylä- ja satamamaksut, merivakuutukset, P&I klubit, vastuullisuus- ja korvauskysymykset sekä taloudelliset kannustimet. Taloudellisten ohjauskeinojen käyttö meriturvallisuuden edistämiseen on melko vähäistä verrattuna hallinnollisten ohjauskeinojen käyttöön, mutta niitä voitaisiin varmasti käyttää enemmänkin. Ongelmana taloudellisten ohjauskeinojen käytössä on se, että ne kuuluvat pitkälti kansallisen sääntelyn piiriin, joten alueellisten tai kansainvälisten intressien edistäminen taloudellisilla ohjauskeinoilla voi olla hankalaa. Tieto-ohjaus perustuu toimijoiden vapaaehtoisuuteen ja yleisen tiedotuksen lisäksi tieto-ohjaukseen sisältyy esimerkiksi vapaaehtoinen koulutus, sertifiointi tai meriturvallisuuden edistämiseen tähtäävät palkinnot. Poliittisella tasolla meriliikenteen aiheuttamat turvallisuusriskit Suomenlahdella on otettu vakavasti ja paljon työtä tehdään eri tahoilla riskien minimoimiseksi. Uutta sääntelyä on odotettavissa etenkin liittyen meriliikenteen ympäristövaikutuksiin ja meriliikenteen ohjaukseen kuten meriliikenteen sähköisiin seurantajärjestelmiin. Myös inhimilliseen tekijän merkitykseen meriturvallisuuden kehittämisessä on kiinnitetty lisääntyvissä määrin huomiota, mutta inhimilliseen tekijän osalta tehokkaiden ohjauskeinojen kehittäminen näyttää olevan haasteellista. Yleisimmin lääkkeeksi esitetään koulutuksen kehittämistä. Kirjallisuudessa esitettyjen kriteereiden mukaan tehokkaiden ohjauskeinojen tulisi täyttää seuraavat vaatimukset: 1) tarkoituksenmukaisuus – ohjauskeinojen täytyy olla sopivia asetetun tavoitteen saavuttamiseen, 2) taloudellinen tehokkuus – ohjauskeinon hyödyt vs. kustannukset tulisi olla tasapainossa, 3) hyväksyttävyys – ohjauskeinon täytyy olla hyväksyttävä asianosaisten ja myös laajemman yhteiskunnan näkökulmasta katsottuna, 4) toimeenpano – ohjauskeinon toimeenpanon pitää olla mahdollista ja sen noudattamista täytyy pystyä valvomaan, 5) lateraaliset vaikutukset – hyvällä ohjauskeinolla on positiivisia seurannaisvaikutuksia muutoinkin kuin vain ohjauskeinon ensisijaisten tavoitteiden saavuttaminen, 6) kannustin ja uuden luominen – hyvä ohjauskeino kannustaa kokeilemaan uusia ratkaisuja ja kehittämään toimintaa. Meriturvallisuutta koskevaa sääntelyä on paljon ja yleisesti ottaen merionnettomuuksien lukumäärä on ollut laskeva viime vuosikymmenien aikana. Suuri osa sääntelystä on ollut tehokasta ja parantanut turvallisuuden tasoa maailman merillä. Silti merionnettomuuksia ja muita vaarallisia tapahtumia sattuu edelleen. Nykyistä sääntelyjärjestelmää voidaan kritisoida monen asian suhteen. Kansainvälisen sääntelyn aikaansaaminen ei ole helppoa: prosessi on yleensä hidas ja tuloksena voi olla kompromissien kompromissi. Kansainvälinen sääntely on yleensä reaktiivista eli ongelmakohtiin puututaan vasta kun jokin onnettomuus tapahtuu sen sijaan että se olisi proaktiivista ja pyrkisi puuttumaan ongelmakohtiin jo ennen kuin jotain tapahtuu. IMO:n työskentely perustuu kansallisvaltioiden osallistumiseen ja sääntelyn toimeenpano tapahtuu lippuvaltioiden toimesta. Kansallisvaltiot ajavat IMO:ssa pääasiallisesti omia intressejään ja sääntelyn toimeenpanossa on suuria eroja lippuvaltioiden välillä. IMO:n kyvyttömyys puuttua havaittuihin ongelmiin nopeasti ja ottaa sääntelyssä huomioon paikallisia olosuhteita on johtanut siihen, että esimerkiksi Euroopan Unioni on alkanut itse säädellä meriturvallisuutta ja että on olemassa sellaisia alueellisia erityisjärjestelyjä kuin PSSA (particularly sensitive sea area – erityisen herkkä merialue). Merenkulkualalla toimii monenlaisia yrityksiä: toisaalta yrityksiä, jotka pyrkivät toimimaan turvallisesti ja kehittämään turvallisuutta vielä korkeammalle tasolle, ja toisaalta yrityksiä, jotka toimivat niin halvalla kuin mahdollista, eivät välitä turvallisuusseikoista, ja joilla usein on monimutkaiset ja epämääräiset omistusolosuhteet ja joita vahingon sattuessa on vaikea saada vastuuseen. Ongelma on, että kansainvälisellä merenkulkualalla kaikkien yritysten on toimittava samoilla markkinoilla. Vastuuttomien yritysten toiminnan mahdollistavat laivaajat ja muut alan toimijat, jotka suostuvat tekemään yhteistyötä niiden kanssa. Välinpitämätön suhtautuminen turvallisuuteen johtuu osaksi myös merenkulun vanhoillisesta turvallisuuskulttuurista. Verrattaessa meriturvallisuuden sääntelyjärjestelmää kokonaisuutena tehokkaiden ohjauskeinoihin kriteereihin, voidaan todeta, että monien kriteerien osalta nykyistä järjestelmää voidaan pitää tehokkaana ja onnistuneena. Suurimmat ongelmat lienevät sääntelyn toimeenpanossa ja ohjauskeinojen kustannustehokkuudessa. Lippuvaltioiden toimeenpanoon perustuva järjestelmä ei toimi toivotulla tavalla, josta mukavuuslippujen olemassa olo on selvin merkki. Ohjauskeinojen, sekä yksittäisten ohjauskeinojen että vertailtaessa eri ohjauskeinoja keskenään, kustannustehokkuutta on usein vaikea arvioida, minkä seurauksena ohjauskeinojen kustannustehokkuudesta ei ole saatavissa luotettavaa tietoa ja tuloksena voi olla, että ohjauskeino on käytännössä pienen riskin eliminoimista korkealla kustannuksella. Kansainvälisen tason meriturvallisuus- (ja merenkulku-) politiikan menettelytavoiksi on ehdotettu myös muita vaihtoehtoja kuin nykyinen järjestelmä, esimerkiksi monitasoista tai polysentristä hallintojärjestelmää. Monitasoisella hallintojärjestelmällä tarkoitetaan järjestelmää, jossa keskushallinto on hajautettu sekä vertikaalisesti alueellisille tasoille että horisontaalisesti ei-valtiollisille toimijoille. Polysentrinen hallintojärjestelmä menee vielä askeleen pidemmälle. Polysentrinen hallintojärjestelmä on hallintotapa, jonka puitteissa kaikentyyppiset toimijat, sekä yksityiset että julkiset, voivat osallistua hallintoon, siis esimerkiksi hallitukset, edunvalvontajärjestöt, kaupalliset yritykset jne. Kansainvälinen lainsäädäntö määrittelee yleiset tasot, mutta konkreettiset toimenpiteet voidaan päättää paikallisella tasolla eri toimijoiden välisessä yhteistyössä. Tämän tyyppisissä hallintojärjestelmissä merenkulkualan todellinen, kansainvälinen mutta toisaalta paikallinen, toimintaympäristö tulisi otetuksi paremmin huomioon kuin järjestelmässä, joka perustuu kansallisvaltioiden keskenään yhteistyössä tekemään sääntelyyn. Tällainen muutos meriturvallisuuden hallinnassa vaatisi kuitenkin suurta periaatteellista suunnanmuutosta, jollaisen toteutumista ei voi pitää kovin todennäköisenä ainakaan lyhyellä tähtäimellä.

Productivity and Services – Safety Telephone Services for the Elderly

Previous research on productivity is often associated with manufacturing or uses manufacturing definitions of productivity. Marketing research on services has not been satisfied with the manufacturing definitions. No universal definition for service productivity exists. The lack of a universal definition highlights the complexity entailed in the concept of productivity. The objective of this study was to investigate service productivity in situations, where traditional ways are in some cases even not possible or are not enough. In one definition of the productivity of service organisations there is the efficiency of the organisation on the input side and on the output side the customers’ perceived quality or value-in-use. To learn about value-in-use, many methods have been developed. A common practice is to make customer opinion surveys in the form of customer questionnaires and interviews. However, customers cannot always be asked directly, for example, because of impaired cognitive abilities. Such cases include the elderly and children. Furthermore, customer opinion surveys are time consuming. In addition, customers do not always know what kind of services they would benefit from. For the empirical part of the study, a business area was identified where traditional ways of measuring value-in-use are difficult or in some cases even not possible. This business area is safety telephone services. These services are most often used by the elderly. The way to define value-in-use here was to assess how well the services offered met customer expectations. Comparing the services customers asked for and the services provided to them indicated whether customer expectations were met. This study showed that customers had their ideas concerning the contents of the services but many times the services provided did not meet these expectations. Organisational efficiency aspirations can decrease customers’ value-in-use. This study found a solution, in which increasing organisational efficiency would go hand-in-hand with increasing customers’ value-in-use; the result being that the organisations’ needs and the service users’ expectations were in line. Value creation for customers produced organisational efficiency and thus increased productivity. In this study, customer expectations were observed by means of wellness technology. With the help of modern technology, customer expectations can be followed quickly and easily and customers can co-create with the organisation. This type of an approach could be useful even in the development of other services for other ages and in different contexts. If a service organisation decreases the number of personnel and, at the same time, tries to offer services to the same or a larger clientele, customers easily notice the change, which is often negative. To avoid harmful decrease in value-in-use, limitations to the aspiration of efficiency should be implemented – one of such is that the organisation is required to meet certain quality standards defined by experts. The aim is to secure that, as a result of efficiency aspirations in the organisation, the quality of the service offerings does not diminish below mutually agreed standards. Traditionally, when productivity in services has been estimated, organisational efficiency has not been combined with both customer expectations and an expert assessment of quality. This study contributes with novel thinking entitled ‘Relationship Management of the Elderly’. This study handles productivity, expert defined quality and value-in-use in an organisational context, which is practically untouched in previous research studies.

Maritime safety in the Gulf of Finland. Evaluation of the regulatory system

Growing traffic is believed to increase the risk of an accident in the Gulf of Finland. As the consequences of a large oil accident would be devastating in the vulnerable sea area, accident prevention is performed at the international, regional and national levels. Activities of shipping companies are governed with maritime safety policy instruments, which can be categorised into regulatory, economic and information instruments. The maritime regulatory system has been criticised for being inefficient because it has not been able to eliminate the violations that enable accidents. This report aims to discover how maritime governance systems or maritime safety policy instruments could be made more efficient in the future, in order to improve the maritime safety level. The results of the research are based on a literature review and nine expert interviews, with participants from shipping companies, interest groups and authorities. Based on the literature and the interviews, a suggestion can be made that in the future, instead of implementing new policy instruments, maritime safety risks should be eliminated by making the existing system more efficient and by influencing shipping companies’ safety culture and seafarers’ safety related attitudes. Based on this research, it can be stated that the development of maritime safety policy instruments should concentrate on harmonisation, automation and increasing national and cross-border cooperation. These three tasks could be primarily accomplished by developing the existing technology. Human error plays a role in a significant number of maritime accidents. Because of this, improving companies’ safety culture and voluntary activities that go beyond laws are acknowledged as potential ways of improving maritime safety. In the future, maritime regulatory system should be developed into a direction where the private sector has better possibilities to take part in decision-making.

Efficacy, safety, quality control, marketing and regulatory guidelines for herbal medicines (phytotherapeutic agents)

This review highlights the current advances in knowledge about the safety, efficacy, quality control, marketing and regulatory aspects of botanical medicines. Phytotherapeutic agents are standardized herbal preparations consisting of complex mixtures of one or more plants which contain as active ingredients plant parts or plant material in the crude or processed state. A marked growth in the worldwide phytotherapeutic market has occurred over the last 15 years. For the European and USA markets alone, this will reach about $7 billion and $5 billion per annum, respectively, in 1999, and has thus attracted the interest of most large pharmaceutical companies. Insufficient data exist for most plants to guarantee their quality, efficacy and safety. The idea that herbal drugs are safe and free from side effects is false. Plants contain hundreds of constituents and some of them are very toxic, such as the most cytotoxic anti-cancer plant-derived drugs, digitalis and the pyrrolizidine alkaloids, etc. However, the adverse effects of phytotherapeutic agents are less frequent compared with synthetic drugs, but well-controlled clinical trials have now confirmed that such effects really exist. Several regulatory models for herbal medicines are currently available including prescription drugs, over-the-counter substances, traditional medicines and dietary supplements. Harmonization and improvement in the processes of regulation is needed, and the general tendency is to perpetuate the German Commission E experience, which combines scientific studies and traditional knowledge (monographs). Finally, the trend in the domestication, production and biotechnological studies and genetic improvement of medicinal plants, instead of the use of plants harvested in the wild, will offer great advantages, since it will be possible to obtain uniform and high quality raw materials which are fundamental to the efficacy and safety of herbal drugs.

Sleep disorders, sleepiness and traffic safety: a public health menace

Sleep disorders are not uncommon and have been widely reported throughout the world. They have a profound impact on industrialized 24-h societies. Consequences of these problems include impaired social and recreational activities, increased human errors, loss of productivity, and elevated risk of accidents. Conditions such as acute and chronic insomnia, sleep loss, excessive sleepiness, shift-work, jet lag, narcolepsy, and sleep apnea warrant public health attention, since residual sleepiness during the day may affect performance of daily activities such as driving a car. Benzodiazepine hypnotics and zopiclone promote sleep, both having residual effects the following day including sleepiness and reduced alertness. In contrast, the non-benzodiazepine hypnotics zolpidem and zaleplon have no significant next-day residual effects when taken as recommended. Research on the effects of wakefulness-promoting drugs on driving ability is limited. Countermeasures for excessive daytime sleepiness have a limited effect. There is a need for a social awareness program to educate the public about the potential consequences of various sleep disorders such as narcolepsy, sleep apnea, shift-work-related sleep loss, and excessive daytime sleepiness in order to reduce the number of sleep-related traffic accidents.

Efficacy and safety of combined piroxicam, dexamethasone, orphenadrine, and cyanocobalamin treatment in mandibular molar surgery

Third molar extraction is a common procedure frequently accompanied by moderate or severe pain, and involves sufficient numbers of patients to make studies relatively easy to perform. The aim of the present study was to determine the efficacy and safety of the therapeutic combination of 10 mg piroxicam, 1 mg dexamethasone, 35 mg orphenadrine citrate, and 2.5 mg cyanocobalamin (Rheumazin®) when compared with 20 mg piroxicam alone (Feldene®) in mandibular third molar surgery. Eighty patients scheduled for removal of the third molar were included in this randomized and double-blind study. They received (vo) Rheumazin or Feldene 30 min after tooth extraction and once daily for 4 consecutive days. Pain was determined by a visual analogue scale and by the need for escape analgesia (paracetamol). Facial swelling was evaluated with a measuring tape and adverse effects and patient satisfaction were recorded. There was no statistically significant difference in facial swelling between Rheumazin and Feldene (control group). Both drugs were equally effective in the control of pain, with Rheumazin displaying less adverse effects than Feldene. Therefore, Rheumazin appears to provide a better risk/benefit ratio in the mandibular molar surgery. Since the side effects resulting from nonsteroidal anti-inflammatory drug administration are a severe limitation to the routine use of these drugs in clinical practice, our results suggest that Rheumazin can be a good choice for third molar removal treatment.

A safety and feasibility study of cell therapy in dilated cardiomyopathy

The aim of this study was to determine if bone marrow mononuclear cell (BMMC) transplantation is safe for moderate to severe idiopathic dilated cardiomyopathy (IDC). Clinical trials have shown that this procedure is safe and effective for ischemic patients, but little information is available regarding non-ischemic patients. Twenty-four patients with IDC, optimized therapy, age 46 ± 11.6 years, 17 males, NYHA classes II-IV, and left ventricular ejection fraction <35% were enrolled in the study. Clinical evaluation at baseline and 6 months after stem cell therapy to assess heart function included echocardiogram, magnetic resonance imaging, cardiopulmonary test, Minnesota Quality of Life Questionnaire, and NYHA classification. After cell transplantation 1 patient showed a transient increase in enzyme levels and 2 patients presented arrhythmias that were reversed within 72 h. Four patients died during follow-up, between 6 and 12 weeks after therapy. Clinical evaluation showed improvement in most patients as reflected by statistically significant decreases in Minnesota Quality of Life Questionnaire (63 ± 17.9 baseline vs 28.8 ± 16.75 at 6 months) and in class III-IV NYHA patients (18/24 baseline vs 2/20 at 6 months). Cardiopulmonary exercise tests demonstrated increased peak oxygen consumption (12.2 ± 2.4 at baseline vs 15.8 ± 7.1 mL·kg-1·min-1 at 6 months) and walked distance (377.2 ± 85.4 vs 444.1 ± 77.9 m at 6 months) in the 6-min walk test, which was not accompanied by increased left ventricular ejection fraction. Our findings indicate that BMMC therapy in IDC patients with severe ventricular dysfunction is feasible and that larger, randomized and placebo-controlled trials are warranted.

Comparative efficacy and safety of the left versus right radial approach for percutaneous coronary procedures: a meta-analysis including 6870 patients

The radial approach is widely used in the treatment of patients with coronary artery disease. We conducted a meta-analysis of published results on the efficacy and safety of the left and right radial approaches in patients undergoing percutaneous coronary procedures. A systematic search of reference databases was conducted, and data from 14 randomized controlled trials involving 6870 participants were analyzed. The left radial approach was associated with significant reductions in fluoroscopy time [standardized mean difference (SMD)=-0.14, 95% confidence interval (CI)=-0.19 to -0.09; P<0.00001] and contrast volume (SMD=-0.07, 95%CI=-0.12 to -0.02; P=0.009). There were no significant differences in rate of procedural failure of the left and the right radial approaches [risk ratios (RR)=0.98; 95%CI=0.77-1.25; P=0.88] or procedural time (SMD=-0.05, 95%CI=0.17-0.06; P=0.38). Tortuosity of the subclavian artery (RR=0.27, 95%CI=0.14-0.50; P<0.0001) was reported more frequently with the right radial approach. A greater number of catheters were used with the left than with the right radial approach (SMD=0.25, 95%CI=0.04-0.46; P=0.02). We conclude that the left radial approach is as safe as the right radial approach, and that the left radial approach should be recommended for use in percutaneous coronary procedures, especially in percutaneous coronary angiograms.

Role of food safety in procedures adopted for the purchase of minimally processed and fresh vegetables by foodservices

This research was designed to analyze whether the procedures adopted by foodservice establishments for the purchase of minimally processed and fresh vegetables favor the acquisition of safe products. This research investigated the purchasing policies of such establishments, whether self-managed or administered by foodservice contractors, in the municipality of Campinas and its outlying districts. A random sample of thirty-nine establishments participated in the research. The instruments for data collection were pre-tested, and the actual interviews were conducted by trained personnel. Comparative analyses were made using various statistical tests. All of the participating establishments purchase fresh vegetables, although only six of them use minimally processed ones. For most of the establishments, price is at least one of the most important criteria for the selection of a supplier, and they do not normally monitor the safety of the fresh products purchased (51.3%), nor do they make regular technical visits to guarantee quality (46.2%); moreover, most do not carry out a supplier development program. It is suggested that routine technical visits to suppliers should be adopted, as well as the creation of courses, such as those dealing with the safety of vegetables and supplier development, to be offered to foodservices.

Development and Effect Analysis of the Asteri Consultative Auditing Process - Safety and Security Management in Educational Institutions

The Finnish legislation requires for a safe and secure learning environment. However, the comprehensive, risk based safety and security management (SSM) and the management commitment in the implementation and development of the SSM are not mentioned in the legislation. Multiple institutions, operators and researchers have studied and developed safety and security in educational institutions over the past decade. Typically the approach has been fragmented and without bringing up the importance of the comprehensive SSM. The development needs of the safety and security operations in universities have been studied. However, in universities of applied sciences (UASs) and in elementary schools (ESs), the performance level, strengths and weaknesses of the comprehensive SSM have not been studied. The objective of this study was to develop the comprehensive, risk based SSM of educational institutions by developing the new Asteri consultative auditing process and study its effects on auditees. Furthermore, the performance level in the comprehensive SSM in UASs and ESs were studied using Asteri and the TUTOR model developed by the Keski-Uusimaa Department for Rescue Services. In addition, strengths, development needs and differences were identified. In total, 76 educational institutions were audited between the years 2011 and 2014. The study is based on logical empiricism, and an observational applied research design was used. Auditing, observation and an electronic survey were used for data collection. Statistical analysis was used to analyze the collected information. In addition, thematic analysis was used to analyze the development areas of the organizations mentioned by the respondents in the survey. As one of the main contributions, this research presents the new Asteri consultative auditing process. Organizations with low performance levels on the audited subject benefit the most from the Asteri consultative auditing process. Asteri may be usable in many different types of audits, not only in SSM audits. As a new result, this study provides new knowledge on attitudes related to auditing. According to the research findings, auditing may generate negative attitudes and the auditor should take them into account when planning and preparing for audits. Negative attitudes can be compensated by producing added value, objectivity and positivity for the audit and, thus, improve the positive effects of auditing on knowledge and skills. Moreover, as the results of this study shows, auditing safety and security issues do not increase feelings of insecurity, but rather increase feelings of safety and security when using the new Asteri consultative auditing process with the TUTOR model. The results showed that the SSM in the audited UASs was statistically significantly more advanced than that in the audited ESs. However, there is still room for improvement in the ESs and the UASs as the approach to the SSM was fragmented. It can be assumed that the majority of Finnish UASs and ESs do not likely meet the basic level of the comprehensive, risk based the SSM.

Failure modes of passive decay heat removing safety systems of modern nuclear power plants

The purpose of this master’s thesis is to gain an understanding of passive safety systems’ role in modern nuclear reactors projects and to research the failure modes of passive decay heat removal safety systems which use phenomenon of natural circulation. Another purpose is to identify the main physical principles and phenomena which are used to establish passive safety tools in nuclear power plants. The work describes passive decay heat removal systems used in AES-2006 project and focuses on the behavior of SPOT PG system. The descriptions of the main large-scale research facilities of the passive safety systems of the AES-2006 power plant are also included. The work contains the calculations of the SPOT PG system, which was modeled with thermal-hydraulic system code TRACE. The dimensions of the calculation model are set according to the dimensions of the real SPOT PG system. In these calculations three parameters are investigated as a function of decay heat power: the pressure of the system, the natural circulation mass flow rate around the closed loop, and the level of liquid in the downcomer. The purpose of the calculations is to test the ability of the SPOT PG system to remove the decay heat from the primary side of the nuclear reactor in case of failure of one, two, or three loops out of four. The calculations show that three loops of the SPOT PG system have adequate capacity to provide the necessary level of safety. In conclusion, the work supports the view that passive systems could be widely spread in modern nuclear projects.

Finnish Maritime Personnel's Conceptions on Safety Management and Safety Culture

The purpose of this thesis is to explore Finnish maritime personnel’s conceptions of safety management and its relationship with the concept of safety culture. In addition, the aim is to evaluate the impact of the ISM Code on the prevailing safety culture in the Finnish shipping business. A total of 94 interviewees and seven Finnish shipping companies were involved in this study. Thematic interviews were applied as the main research method for the study. The results were analysed qualitatively. The results indicate that maritime safety culture can simultaneously demonstrate features of integration, differentiation and ambiguity. Basically, maritime personnel have a positive attitude towards safety management systems since they consider safety management beneficial and essential in general. However, the study also found considerable criticism among the interviewees. The interviewed maritime personnel did not criticise the ISM Code as such, yet they criticised the way the ISM Code has been applied in practise. In order to understand the multiple perspectives of safety culture more comprehensively, multiple theoretical perspectives and methodological approaches are needed. This study indicates that safety culture and the impacts of the ISM Code should not be unambiguously studied solely quantitative methods or qualitative methods. By examining safety culture from several methodological and theoretical perspectives, one may gain a more versatile and holistic overview of safety culture.