Towards making informed decisions on selecting promising work zone safety treatments

Lack of detailed and accurate safety records on incidents in Australian work zones prevents a thorough understanding of the relevant risks and hazards. Consequently it is difficult to select appropriate treatments for improving the safety of roadworkers and motorists alike. This paper outlines development of a conceptual framework for making informed decisions about safety treatments by: 1) identifying safety issues and hazards in work zones; 2) understanding the attitudes and perceptions of both roadworkers and motorists; 3) reviewing the effectiveness of work zone safety treatments according to existing research, and; 4) incorporating local expert opinion on the feasibility and usefulness of the safety treatments. Using data collected through semi-structured interviews with roadwork personnel and online surveys of Queensland drivers, critical safety issues were identified. The effectiveness of treatments for addressing the issues was understood through rigorous literature review and consultations with local road authorities. Promising work zone safety treatments include enforcement, portable rumble strips, perceptual measures to imply reduced lane width, automated or remotely-operated traffic lights, end of queue measures, and more visible and meaningful signage.

Examining the effectiveness of Police-Citizens Youth Clubs on crime prevention and community safety

PCYCs, individually and as a whole, are highly valued in communities across Queensland. Participants in this evaluation identified numerous benefits of PCYCs, including: providing structured low-cost activities for young people and other community groups; developing positive relationships and trust between young people and police; developing young people into effective citizens; providing a safe place for young people and a hub for whole communities; addressing disadvantages faced by young people; and fostering social inclusion. Depending on the particular activities and programs delivered by a branch, PCYCs have the capacity to minimise risk factors and enhance protective factors relating to young people’s involvement in crime. For example, PCYCs can play an important role in strengthening young people’s engagement with education and family. However, the crime prevention and community safety aims of PCYCs, and measures that might work towards these aims are not widely- or well-understood, or appreciated, by those working in and with PCYCs. The key recommendation of this evaluation is therefore that the crime prevention and community safety aims of PCYCs in Queensland need to be better articulated, understood and reflected in the practice of those working in and with PCYCs. A related key finding is that many of the activities and programs currently provided by PCYCs could be better oriented towards the goals of crime prevention and community safety without major resource implications.

Effects of resistance training on measures of muscular strength in people with Parkinson’s disease: A systematic review and meta-analysis

Objective The aim of this systematic review and meta-analysis was to determine the overall effect of resistance training (RT) on measures of muscular strength in people with Parkinson’s disease (PD). Methods Controlled trials with parallel-group-design were identified from computerized literature searching and citation tracking performed until August 2014. Two reviewers independently screened for eligibility and assessed the quality of the studies using the Cochrane risk-of-bias-tool. For each study, mean differences (MD) or standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for continuous outcomes based on between-group comparisons using post-intervention data. Subgroup analysis was conducted based on differences in study design. Results Nine studies met the inclusion criteria; all had a moderate to high risk of bias. Pooled data showed that knee extension, knee flexion and leg press strength were significantly greater in PD patients who undertook RT compared to control groups with or without interventions. Subgroups were: RT vs. control-without-intervention, RT vs. control-with-intervention, RT-with-other-form-of-exercise vs. control-without-intervention, RT-with-other-form-of-exercise vs. control-with-intervention. Pooled subgroup analysis showed that RT combined with aerobic/balance/stretching exercise resulted in significantly greater knee extension, knee flexion and leg press strength compared with no-intervention. Compared to treadmill or balance exercise it resulted in greater knee flexion, but not knee extension or leg press strength. RT alone resulted in greater knee extension and flexion strength compared to stretching, but not in greater leg press strength compared to no-intervention. Discussion Overall, the current evidence suggests that exercise interventions that contain RT may be effective in improving muscular strength in people with PD compared with no exercise. However, depending on muscle group and/or training dose, RT may not be superior to other exercise types. Interventions which combine RT with other exercise may be most effective. Findings should be interpreted with caution due to the relatively high risk of bias of most studies.

Young drivers’ responses to anti-speeding advertisements: Comparison of self-report and objective measures of persuasive processing and outcomes

Objective Self-report measures are typically used to assess the effectiveness of road safety advertisements. However, psychophysiological measures of persuasive processing (i.e., skin conductance response [SCR]) and objective driving measures of persuasive outcomes (i.e., in-vehicle GPS devices) may provide further insights into the effectiveness of these advertisements. This study aimed to explore the persuasive processing and outcomes of two anti-speeding advertisements by incorporating both self-report and objective measures of speeding behaviour. In addition, this study aimed to compare the findings derived from these different measurement approaches. Methods Young drivers (N = 20, Mage = 21.01 years) viewed either a positive or negative emotion-based anti-speeding television advertisement. Whilst viewing the advertisement, SCR activity was measured to assess ad-evoked arousal responses. The RoadScout® GPS device was then installed into participants’ vehicles for one week to measure on-road speed-related driving behaviour. Self-report measures assessed persuasive processing (emotional and arousal responses) and actual driving behaviour. Results There was general correspondence between the self-report measures of arousal and the SCR and between the self-report measure of actual driving behaviour and the objective driving data (as assessed via the GPS devices). Conclusions This study provides insights into how psychophysiological and GPS devices could be used as objective measures in conjunction with self-report measures to further understand the persuasive processes and outcomes of emotion-based anti-speeding advertisements.

Barriers to good occupational health and safety (OHS) practices by small construction firms

The construction industry has long been considered to have unacceptably high injury and fatality rates. Previous research has shown that small construction companies sustain higher injury rates than large companies. However, despite the industry being dominated by a very large number of such small companies, little is known of their occupational health and safety (OHS) needs, practices and constraints. This paper takes a first step in aiming to identify the principal barriers that affect good OHS performance of small construction companies so that effective OHS practices can be developed to improve this in future. The contents of the literature are first summarised, in which three critical barriers to good OHS practice in small construction firms are proposed. They are : cost, time, lack of safety awareness and concern. The results of a questionnaire survey carried out with South East Queensland construction personnel are presented, which largely confirm what is suggested by the literature research and also succeed in providing an indication of their ranking in terms of importance and suggestions for overcoming these barriers. The research results provide a better understanding of the issues that restrict good OHS practice in small construction companies and potential measures for improvement.

Assessing specific deterrence effects of increased speeding penalties using four measures of recidivism

Traffic law enforcement sanctions can impact on road user behaviour through general and specific deterrence mechanisms. The manner in which specific deterrence can influence recidivist behaviour can be conceptualised in different ways. While any reduction in speeding will have road safety benefits, the ways in which a ‘reduction’ is determined deserves greater methodological attention and has implications for countermeasure evaluation more generally. The primary aim of this research was to assess the specific deterrent impact of penalty increases for speeding offences in Queensland, Australia, in 2003 on two cohorts of drivers detected for speeding prior to and after the penalty changes were investigated. Since the literature is relatively silent on how to assess recidivism in the speeding context, the secondary research aim was to contribute to the literature regarding ways to conceptualise and measure specific deterrence in the speeding context. We propose a novel way of operationalising four measures which reflect different ways in which a specific deterrence effect could be conceptualised: (1) the proportion of offenders who re-offended in the follow up period; (2) the overall frequency of re-offending in the follow up period; (3) the length of delay to re-offence among those who re-offended; and (4) the average number of re-offences during the follow up period among those who re-offended. Consistent with expectations, results suggested an absolute deterrent effect of penalty changes, as evidenced by significant reductions in the proportion of drivers who re-offended and the overall frequency of re-offending, although effect sizes were small. Contrary to expectations, however, there was no evidence of a marginal specific deterrent effect among those who re-offended, with a significant reduction in the length of time to re-offence and no significant change in the average number of offences committed. Additional exploratory analyses investigating potential influences of the severity of the index offence, offence history, and method of detection revealed mixed results. Access to additional data from various sources suggested that the main findings were not influenced by changes in speed enforcement activity, public awareness of penalty changes, or driving exposure during the study period. Study limitations and recommendations for future research are discussed with a view to promoting more extensive evaluations of penalty changes and better understanding of how such changes may impact on motorists’ perceptions of enforcement and sanctions, as well as on recidivist behaviour.

Efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis: Results of a randomised placebo-controlled trial (ABILITY-1)

Purpose: To evaluate the efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis (nr-axSpA). Methods: Patients fulfilled Assessment of Spondyloarthritis international Society (ASAS) criteria for axial spondyloarthritis, had a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of ≥ 4, total back pain score of ≥ 4 (10 cm visual analogue scale) and inadequate response, intolerance or contraindication to non-steroidal anti-inflammatory drugs (NSAIDs); patients fulfilling modified New York criteria for ankylosing spondylitis were excluded. Patients were randomised to adalimumab (N=91) or placebo (N=94). The primary endpoint was the percentage of patients achieving ASAS40 at week 12. Efficacy assessments included BASDAI and Ankylosing Spondylitis Disease Activity Score (ASDAS). MRI was performed at baseline and week 12 and scored using the Spondyloarthritis Research Consortium of Canada (SPARCC) index. Results: Significantly more patients in the adalimumab group achieved ASAS40 at week 12 compared with patients in the placebo group (36% vs 15%, p<0.001). Significant clinical improvements based on other ASAS responses, ASDAS and BASDAI were also detected at week 12 with adalimumab treatment, as were improvements in quality of life measures. Inflammation in the spine and sacroiliac joints on MRI significantly decreased after 12 weeks of adalimumab treatment. Shorter disease duration, younger age, elevated baseline C-reactive protein or higher SPARCC MRI sacroiliac joint scores were associated with better week 12 responses to adalimumab. The safety profile was consistent with what is known for adalimumab in ankylosing spondylitis and other diseases. Conclusions: In patients with nr-axSpA, adalimumab treatment resulted in effective control of disease activity, decreased inflammation and improved quality of life compared with placebo. Results from ABILITY-1 suggest that adalimumab has a positive benefit-risk profile in active nr-axSpA patients with inadequate response to NSAIDs.

Nintendo Wii Fit as an adjunct to physiotherapy following lower limb fractures: Preliminary feasibility, safety and sample size considerations

Objective The Nintendo Wii Fit integrates virtual gaming with body movement, and may be suitable as an adjunct to conventional physiotherapy following lower limb fractures. This study examined the feasibility and safety of using the Wii Fit as an adjunct to outpatient physiotherapy following lower limb fractures, and reports sample size considerations for an appropriately powered randomised trial. Methodology Ambulatory patients receiving physiotherapy following a lower limb fracture participated in this study (n = 18). All participants received usual care (individual physiotherapy). The first nine participants also used the Wii Fit under the supervision of their treating clinician as an adjunct to usual care. Adverse events, fracture malunion or exacerbation of symptoms were recorded. Pain, balance and patient-reported function were assessed at baseline and discharge from physiotherapy. Results No adverse events were attributed to either the usual care physiotherapy or Wii Fit intervention for any patient. Overall, 15 (83%) participants completed both assessments and interventions as scheduled. For 80% power in a clinical trial, the number of complete datasets required in each group to detect a small, medium or large effect of the Wii Fit at a post-intervention assessment was calculated at 175, 63 and 25, respectively. Conclusions The Nintendo Wii Fit was safe and feasible as an adjunct to ambulatory physiotherapy in this sample. When considering a likely small effect size and the 17% dropout rate observed in this study, 211 participants would be required in each clinical trial group. A larger effect size or multiple repeated measures design would require fewer participants.

Do motor vehicle crashes arise from single or multiple unique risk processes? An inquiry into crash causes and modelling

Crashes at any particular transport network location consist of a chain of events arising from a multitude of potential causes and/or contributing factors whose nature is likely to reflect geometric characteristics of the road, spatial effects of the surrounding environment, and human behavioural factors. It is postulated that these potential contributing factors do not arise from the same underlying risk process, and thus should be explicitly modelled and understood. The state of the practice in road safety network management applies a safety performance function that represents a single risk process to explain crash variability across network sites. This study aims to elucidate the importance of differentiating among various underlying risk processes contributing to the observed crash count at any particular network location. To demonstrate the principle of this theoretical and corresponding methodological approach, the study explores engineering (e.g. segment length, speed limit) and unobserved spatial factors (e.g. climatic factors, presence of schools) as two explicit sources of crash contributing factors. A Bayesian Latent Class (BLC) analysis is used to explore these two sources and to incorporate prior information about their contribution to crash occurrence. The methodology is applied to the state controlled roads in Queensland, Australia and the results are compared with the traditional Negative Binomial (NB) model. A comparison of goodness of fit measures indicates that the model with a double risk process outperforms the single risk process NB model, and thus indicating the need for further research to capture all the three crash generation processes into the SPFs.

Using smartphones for cycling safety: A survey of riders preferences and interest in new technologies

Cyclists are among the most vulnerable road users. Many recent interventions have aimed at improving their safety on the road, such as the minimum overtaking distance rule introduced in Queensland in 2014. Smartphones offer excellent opportunities for technical intervention for road safety at a limited cost. Indeed, they have a lot of available processing power and many embedded sensors that allow analysing a rider's (or driver's) motion, behaviour, and environment; this is especially relevant for cyclists, as they do not have the space or power allowance that can be found in most motor vehicles. The aim of the study presented in this paper is to assess cyclists’ support for a range of new smartphone-based safety technologies. The preliminary results for an online survey with cyclists recruited from Bicycle Queensland and Triathlon Queensland, with N=191, are presented. A number of innovative safety systems such as automatic logging of incidents without injuries, reporting of dangerous area via a website/app, automatic notification of emergency services in case of crash or fall, and advanced navigation apps were assessed. A significant part of the survey is dedicated to GoSafeCycle, a cooperative collision prevention app based on motion tracking and Wi-Fi communications developed at CARRS-Q. Results show a marked preference toward automatic detection and notification of emergencies (62-70% positive assessment) and GoSafeCycle (61.7% positive assessment), as well as reporting apps (59.1% positive assessment). Such findings are important in the context of current promotion of active transports and highlight the need for further development of system supported by the general public.

Worker views on safety at roadworks

Roadworks in live traffic environments are hazardous to workers and road users alike. In an increasing body of international research literature, roadwork risks and hazards have been comprehensively examined. As in the broader field of road safety research, much of the work rightly takes a quantitative approach to assessing risk and related issues and to addressing the identified risks appropriately. In Australia, however, limited official data constrains the ability of researchers to achieve an in-depth understanding of the situation at state/territory and national levels based on traditional quantitative analyses. One way to enhance and supplement the limited available data is to consult those who are directly involved in roadworks for qualitative information, although such an approach is rarely reported in the roadwork safety arena. As part of the major study focusing on safety at roadworks in Queensland, 66 workers were interviewed about their perceptions and experiences regarding roadwork safety. This paper thus outlines a qualitative examination of workers' perceptions of the causes of roadwork incidents and the effectiveness of hazard mitigation measures. Consistent with findings reported in the literature is the view among workers that speeding is a major hazard and that police enforcement is the most effective countermeasure. Other hazards commonly observed by workers but less frequently reported elsewhere include driver distraction and aggression toward workers, working in poor weather and working at night. Workers mostly suggested educational measures to address distraction and aggression issues, though such measures are only tentatively supported in the literature.

Organisational driving safety systems analysis: Fleet safety situational issues and system gaps

The identification of safety hazards and risks and their associated control measures provides the foundation for any safety program and essentially determines the scope, content and complexity of an effective occupational health and safety management system. In the case of work-related road safety (WRRS), there is a gap within current knowledge, research and practice regarding the holistic assessment of WRRS safety systems and practice. In order to mitigate this gap, a multi-level process tool for assessing WRRS safety systems was developed from extensive consultation, practice and informed by theoretical models and frameworks. Data collection for the Organisational Driving Safety Systems Analysis (ODSSA) tool utilised a case study methodology and included multiple information sources: such as documents, archival records, interviews, direct observations, participant observations, and physical artefacts. Previous trials and application of the ODSSA has indicated that the tool is applicable to a wide range of organisational fleet environments and settings. This paper reports on the research results and effectiveness of the ODSSA tool to assess WRRS systems across a large organisation that recently underwent considerable organisational change, including amalgamation of multiple organisations. The outcomes of this project identified considerable differences in the degree by which the organisation addressed WRRS across their vehicle fleet operations and provided guidelines for improving organisations’ WRRS systems. The ODSSA tool was pivotal in determining WRRS system deficiencies and provided a platform to inform mitigation and improvement strategies.

Observations of road safety behaviours and practices of motorcycle rickshaw drivers in Lahore, Pakistan

Motorcycle Rickshaws (MRs) are an informal paratransit mode in Pakistan. They are locally manufactured and very popular but there are concerns about their crash involvement and overall safety. The first study of the current PhD program revealed that rickshaws (both MRs and auto-rickshaws) were involved in 51,992 road crashes attended by emergency ambulances in Punjab province, Pakistan between 2011-2013. This study aims to examine the road safety behaviours and practices of Motorcycle Rickshaw Drivers (MRDs) that may be contributing to these crashes. MRDs were observed at 12 major signalised intersections in Lahore. Vehicle characteristics and driver behaviours were recorded using a paper-based survey between 9am-7pm for a full week in May 2015. Of the 500 MRDs observed, about 23.4% appeared to be younger than the minimum driver licensing age of 18 years. More than half (52.6%) of the MRDs entered on the red light and 17.4% crossed when the signal was turning from yellow to green or red. MR traffic conflicts were observed in 62.8% of cases and one crash and 15 near-miss crashes were witnessed. Additionally, about half of MRs were overloaded, no MRD wore a helmet, and 3.8% were using a mobile phone while driving. This study provides the first scientific evidence to substantiate public concerns regarding the safety of MRs. It demonstrates that about a quarter of MRDs are underage,almost half of MRs are overloaded and more than half disobey traffic signals. This research could inform authorities to manage MR related transport and road safety issues.

Strengthening local road safety capacity in Cambodia

Road crashes and injuries have become a growing issue worldwide. In 2011, more than 75,000 people died in road crashes in the ten member countries of the Association of South East Asian Nations (ASEAN) and many times this number sustained long term injuries. In 2014, the Asian Development Bank (ADB), funded by the Japan Fund for Poverty Reduction, commenced a package of actions to improve road safety in ASEAN. In 2015, as part of the technical assistance for this project, a Road Safety Advisor was appointed for Cambodia for four months. The assignment produced several primary outputs, which included the organization of national training on traffic law enforcement and road safety management, the conduct of a training needs survey and cost analysis study, and the development of a proposal for strengthening speed management. It is important to note that unlike other ADB technical assistance projects, this assignment adopted a capacity building approach, which promoted and encouraged the local road safety team in the government to step up and take action. The research capacity building approach adopted in this project highlighted the feasibility of increasing participation from existing stakeholders, especially the government in identifying existing human resources, building the capacity of relevant government officials and supporting them to take the ownership of the project. It is hoped that similar outcomes will occur in the other ASEAN countries.

Improving the outcomes of foot and ankle surgery. Professional impact of the Australasian College of Podiatric Surgeons' audit tool

Background Surgery is an example of expanded practice scope that enhances podiatry and incorporates inter-professional collaboration. By 2050 demand for foot and ankle procedures is predicted to rise nationally by 61.9%. Performance management of this increase motivated the development of an online audit tool. Developed in collaboration with the Australasian College of Podiatric Surgeons (ACPS), the ACPS audit tool provides real-time data capture and reporting. It is the first audit tool designed in Australia to support and improve the outcomes of foot and ankle surgery. Methods Audit activity in general, orthopaedic, plastic and podiatric surgery was examined using a case study design. Audit participation enablers and barriers were explored. Case study results guided a Delphi survey of international experts experienced or associated with foot and ankle surgery. Delphi survey-derived consensus informed modification of a generic data set from the Royal Australasian College of Surgeons (RACS). Based on the Delphi survey findings the ACPS online audit tool was developed and piloted. Reliability and validity of data entry and usability of this new tool was then assessed with an online survey. Results The case study found surgeon attitudes and behaviours positively impacted audit participation, and also indicated that audit data should be: (1) available in real time, (2) identify practice change, (3) applicable for safety and quality management, and; (4) useful for peer review discussion. The Delphi process established consensus on audit variables to be captured, including the modified RACS generic data set. 382 cases of foot and ankle surgery were captured across 3 months using the new tool. Data entry was found to be valid and reliable. Real-time outcome reporting and practice change identification impacted positively on safety and quality management and assisted peer review discussion. An online survey showed high levels of usability. Conclusions Surgeon contribution to audit tool development resulted in 100% audit participation. The data from the ACPS audit tool supported the ACPS submission to the Medical Services Advisory Committee to list podiatric surgery under Medicare, an outcome noted by the Federal Minister of Health.