Perceived safety, quality and cultural competency of maternity care for culturally and linguistically diverse women in Queensland

Various policies, plans, and initiatives have been implemented to provide safe, quality, and culturally competent care to patients within Queensland’s healthcare system. A series of models of maternity care are available in Queensland that range from standard public care to private midwifery care. The current study aimed to determine whether identifying as Culturally or Linguistically Diverse (CALD) was associated with the perceived safety, quality, and cultural competency of maternity care from a consumer perspective, and to identify specific needs and preferences of CALD maternity care consumers. Secondary analysis of data collected in the Having a Baby in Queensland Survey 2012 was used to compare the experiences of 655 CALD women to those of 4049 non-CALD women in Queensland, Australia, across three stages of maternity care: pregnancy, labour and birth, and after birth. After adjustment for model of maternity care received and socio-demographic characteristics, CALD women were significantly more likely than non-CALD women to experience suboptimal staff technical competence in pregnancy, overall perceived safety in pregnancy and labour/birth, and interpersonal sensitivity in pregnancy and labour/birth. Approximately 50% of CALD women did not have the choice to use a translator or interpreter, or the gender of their care provider, during labour and birth. Thirteen themes of preferences and needs of CALD maternity care consumers based on ethnicity, cultural beliefs, or traditions were identified, however, these were rarely met. Findings imply that CALD women in Queensland experience disadvantageous maternity care with regards to perceived staff technical competence, safety, and interpersonal sensitivity, and receive care that lacks cultural competence. Improved access to support persons, continuity and choice of carer, and staff availability and training is recommended.

A new approach to the cloud-based heterogeneous MapReduce placement problem

Guaranteeing Quality of Service (QoS) with minimum computation cost is the most important objective of cloud-based MapReduce computations. Minimizing the total computation cost of cloud-based MapReduce computations is done through MapReduce placement optimization. MapReduce placement optimization approaches can be classified into two categories: homogeneous MapReduce placement optimization and heterogeneous MapReduce placement optimization. It is generally believed that heterogeneous MapReduce placement optimization is more effective than homogeneous MapReduce placement optimization in reducing the total running cost of cloud-based MapReduce computations. This paper proposes a new approach to the heterogeneous MapReduce placement optimization problem. In this new approach, the heterogeneous MapReduce placement optimization problem is transformed into a constrained combinatorial optimization problem and is solved by an innovative constructive algorithm. Experimental results show that the running cost of the cloud-based MapReduce computation platform using this new approach is 24:3%-44:0% lower than that using the most popular homogeneous MapReduce placement approach, and 2:0%-36:2% lower than that using the heterogeneous MapReduce placement approach not considering the spare resources from the existing MapReduce computations. The experimental results have also demonstrated the good scalability of this new approach.

Road safety and pavement management: A case study of Tanzania

The implementation of pavement management seems to ignore road safety, with its focus being mainly on infrastructure condition. Safety management as part of pavement management should consider various means of reducing the frequency of vehicle crashes by allocating corrective measures to mitigate accident exposure, as well as reduce accident severity and likelihood. However, it is common that lack of accident records and crash contributing factors impedes incorporating safety into pavement management. This paper presents a case study for the initial development of pavement management systems considering data limitations for 3000 km of Tanzania’s national roads. A performance based optimization utilizes indices for safety and surface condition to allocate corrective measures. A modified Pareto analysis capable of accounting for annual performance and of balancing resources to achieve good surface condition and low levels of safety was applied. Tradeoff analysis for the case study found the need to assign 30% relevance to condition and 70% to road safety. Safety and condition deficiencies were corrected within 5 years with the majority of improvements dedicated to surface treatments and some geometric corrections. Large investments for correcting geometric issues were observed in years two and three if more money was made available.

[await full-text]Evaluation of QAS Workplace Health and Safety Action Plan

This report identifies the outcomes of a program evaluation of the five year Workplace Health and Safety Strategy (2012-2017), specifically, the engagement component within the Queensland Ambulance Service. As part of the former Department of Community Safety, their objective was to work towards harmonising the occupational health and safety policies and process to improve the workplace culture. The report examines and assess the process paths and resource inputs into the strategy, provides feedback on progress to achieving identified goals as well as identify opportunities for improvements and barriers to progress. Consultations were held with key stakeholders within QAS and focus groups were facilitated with managers and health and safety representatives of each Local Area Service Network.

The practical potential of self-advocacy for improving safety outcomes for school-aged workers

Young workers are over-represented in workplace injury statistics and there is growing interest in addressing their vulnerability and safety exposure. Such concerns have been raised within a broader discursive framework of responsibilisation which has seen a transfer of responsibility for workplace safety from employer to worker. This article examines the potential for self-advocacy as a strategy for improving the safety of young workers through the provision of resources to articulate and act on workplace rights. The study utilises data derived from 48 group interviews involving 216 high school students (13–16 years of age) at 19 high schools in Queensland, Australia, who were asked to discuss their knowledge and experience of workplace rights and responsibilities. The limitations of the safety self-advocacy approach are explored, including the social, developmental and organisational issues that might affect the ability or willingness of school-aged workers to self-advocate. The findings reveal that the notion of self-advocacy is internalised by young people before they even enter the formal labour market but that in practice, attempts by young people to enact rights to safety are often dismissed or undermined.

Compliance with seafood safety standards within the Vietnamese finfish capture distribution chain

This thesis examined the level of food safety compliance with government regulations and investigated routes of microbiological contaminations in raw finfish within Vietnamese domestic seafood distribution chains. Findings from direct observation, microbiological analysis and employee surveys were synthesized to identify the main factors affecting food safety and hygiene practices of fish distributors. The studies produced clear recommendations for food safety management in the domestic distribution chains. The findings may contribute to national efforts to decrease the risks of fish-borne illness for consumers in Vietnam.

Reviewing in-vehicle systems to improve fuel efficiency and road safety

Road transport plays a significant role in various industries and mobility services around the globe and has a vital impact on our daily lives. However it also has serious impacts on both public health and the environment. In-vehicle feedback systems are a relatively new approach to encouraging driver behavior change for improving fuel efficiency and safety in automotive environments. While many studies claim that the adoption of eco-driving practices, such as eco-driving training programs and in-vehicle feedback to drivers, has the potential to improve fuel efficiency, limited research has integrated safety and eco-driving. Therefore, it is crucial to understand the human factors related theories and practices which will inform the design of an in-vehicle Human Machine Interface (HMI) that could provide real-time driver feedback and consequently improve both fuel efficiency and safety. This paper provides a comprehensive review of the current state of published literature on in-vehicle systems to identify and evaluate the impact of eco-driving and safety feedback systems. This paper also discusses how these factors may conflict with one another and have a negative effect on road safety, while also exploring possible eco-driving practices that could encourage more sustainable, environmentally-conscious and safe driving behavior. The review revealed a lack of comprehensive theoretical research integrating eco-driving and safe driving, and no current available HMI covering both aspects simultaneously. Furthermore, the review identified that some eco-driving in-vehicle systems may enhance fuel efficiency without compromising safety. The review has identified a range of concepts which can be developed to influence driver acceptance of safety and eco-driving systems within the area of HMI. This can promote new research aimed at enhancing our understanding of the relationship between eco-driving and safety from the human factors viewpoint. This provides a foundation for developing innovative, persuasive and acceptable in-vehicle HMI systems to improve fuel efficiency and road safety.

Effectiveness of electrocardiographic guidance in CVAD tip placement

Background International standard practice for the correct confirmation of the central venous access device is the chest X-ray. The intracavitary electrocardiogram-based insertion method is radiation-free, and allows real-time placement verification, providing immediate treatment and reduced requirement for post-procedural repositioning. Methods Relevant databases were searched for prospective randomised controlled trials (RCTs) or quasi RCTs that compared the effectiveness of electrocardiogram-guided catheter tip positioning with placement using surface-anatomy-guided insertion plus chest X-ray confirmation. The primary outcome was accurate catheter tip placement. Secondary outcomes included complications, patient satisfaction and costs. Results Five studies involving 729 participants were included. Electrocardiogram-guided insertion was more accurate than surface anatomy guided insertion (odds ratio: 8.3; 95% confidence interval (CI) 1.38; 50.07; p=0.02). There was a lack of reporting on complications, patient satisfaction and costs. Conclusion The evidence suggests that intracavitary electrocardiogram-based positioning is superior to surface-anatomy-guided positioning of central venous access devices, leading to significantly more successful placements. This technique could potentially remove the requirement for post-procedural chest X-ray, especially during peripherally inserted central catheter (PICC) line insertion.

Cultural factors: Understanding culture to design organisation structures and systems to optimise safety

Safety culture is a term with numerous definitions in the literature. Many authors advocate a prescriptive approach to safety culture in which if an organisation has certain levels of externally prescribed systems and structures in place it has a “good safety culture”. Conversely, other researchers suggest an anthropological approach of exploring deep meanings and understandings present within an organisation’s workforce. In a recent published review, the authors presented an alternative view to safety culture, in which the anthropological aspects of safety culture interact with the structures and systems in place within an organisation to result in behavioural patterns. This can be viewed as a human factors approach to safety culture in which, through understanding the specific interactions between the culture of a workforce and external organisational elements, organisational structures and systems can be optimised in order to shape worker behaviour and improve safety. This paper presents findings from a recent investigation of safety culture in the Australian heavy vehicle (transport) industry. Selected results are discussed to explore how understanding culture can provide direction to the optimisation of organisational structures and systems to match worker culture and thus improve safety. Specifically the value placed on personal experience and stories, as well as on both time and money are discussed, and interventions that are suited to these aspects of the culture are discussed. These findings demonstrate the importance of shifting beyond mere prescriptive and interpretive approaches to safety culture and instead to focus on the interaction between cultural and contextual elements to optimise organisational structures and systems.

Left on the side of the road? A review of deterrence-based theoretical developments in road safety

Deterrence-based initiatives form a cornerstone of many road safety countermeasures. This approach is informed by Classical Deterrence Theory, which proposes that individuals will be deterred from committing offences if they fear the perceived consequences of the act, especially the perceived certainty, severity and swiftness of sanctions. While deterrence-based countermeasures have proven effective in reducing a range of illegal driving behaviours known to cause crashes such as speeding and drink driving, the exact level of exposure, and how the process works, remains unknown. As a result the current study involved a systematic review of the literature to identify theoretical advancements within deterrence theory that has informed evidence-based practice. Studies that reported on perceptual deterrence between 1950 and June 2015 were searched in electronic databases including PsychINFO and ScienceDirect, both within road safety and non-road safety fields. This review indicated that scientific efforts to understand deterrence processes for road safety were most intense during the 1970s and 1980s. This era produced competing theories that postulated both legal and non-legal factors can influence offending behaviours. Since this time, little theoretical progression has been made in the road safety arena, apart from Stafford and Warr's (1993) reconceptualisation of deterrence that illuminated the important issue of punishment avoidance. In contrast, the broader field of criminology has continued to advance theoretical knowledge by investigating a range of individual difference-based factors proposed to influence deterrent processes, including: moral inhibition, social bonding, self-control, tendencies to discount the future, etc. However, this scientific knowledge has not been directed towards identifying how to best utilise deterrence mechanisms to improve road safety. This paper will highlight the implications of this lack of progression and provide direction for future research.

Translating road safety research on night-time visibility to the context of mining

In recent years a significant amount of research has been undertaken in collision avoidance and personnel location technology in order to reduce the number of incidents involving pedestrians and mobile plant equipment which are a high risk in underground coal mines. Improving the visibility of pedestrians to drivers would potentially reduce the likelihood of these incidents. In the road safety context, a variety of approaches have been used to make pedestrians more conspicuous to drivers at night (including vehicle and roadway lighting technologies and night vision enhancement systems). However, emerging research from our group and others has demonstrated that clothing incorporating retroreflective markers on the movable joints as well as the torso can provide highly significant improvements in pedestrian visibility in reduced illumination. Importantly, retroreflective markers are most effective when positioned on the moveable joints creating a sensation of “biological motion”. Based only on the motion of points on the moveable joints of an otherwise invisible body, observers can quickly recognize a walking human form, and even correctly judge characteristics such as gender and weight. An important and as yet unexplored question is whether the benefits of these retroreflective clothing configurations translate to the context of mining where workers are operating under low light conditions. Given that the benefits of biomotion clothing are effective for both young and older drivers, as well as those with various eye conditions common in those >50 years reinforces their potential application in the mining industry which employs many workers in this age bracket. This paper will summarise the visibility benefits of retroreflective markers in a biomotion configuration for the mining industry, highlighting that this form of clothing has the potential to be an affordable and convenient way to provide a sizeable safety benefit. It does not involve modifications to vehicles, drivers, or infrastructure. Instead, adding biomotion markings to standard retroreflective vests can enhance the night-time conspicuity of mining workers by capitalising on perceptual capabilities that have already been well documented.

Inside the black box of food safety: A qualitative study of ‘non-compliance’ among food businesses

Issue addressed The paper examines the meanings of food safety among food businesses deemed non-compliant and considers the need for an ‘insider perspective’ to inform a more nuanced health promotion practice. Methods In-depth interviews were conducted with 29 food business operators who had been recently deemed ‘non-compliant’ through Council inspection. Result Paradoxically, these ‘non-compliers’ revealed a strong belief in the importance of food safety as well as a desire to comply with the regulations as communicated to them by Environmental Health Officers (EHOs). Conclusions The evidence base of food safety is largely informed by the science of food hazards, yet there is a very important need to illuminate the ‘insider’ experience of food businesses doing food safety on a daily basis. This requires a more socially nuanced appreciation of food businesses beyond the simple dichotomy of compliant/ non-compliant. So what? Armed with a deeper understanding of the social context surrounding food safety practice, it is anticipated that a more balanced, collaborative mode of food safety health promotion could develop which could add to the current signature model of regulation.

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.

Are dietetics educators' attitudes to assessment a barrier to expanding placement opportunities? Results of a Delphi study

Aim Assessment of entry-level health professionals is complex, especially in the work-based setting, placing additional pressures on these learning environments. The present study aims to gain understanding and ideally consensus regarding the setting for assessment of all elements of competence for entry-level dietitians across Australia. Methods Seventy-five experienced academic and practitioner assessors were invited to participate in an online Delphi survey. The 166 entry-level performance criteria of the competency standards for dietitians formed the basis of the questions in the survey, with rating on which ones could be assessed in the practice setting, those which could be assessed in a classroom/university setting and which could be assessed in either setting. Forty-three of 75 invited assessors responded to the first round of the Delphi. A second modified survey was sent to the 43 participants with 34 responding. Results Consensus was achieved for the assessment setting for 86 (52%) of the performance criteria after two rounds of surveying. The majority of these performance criteria achieved consensus at round one (n = 44) and were deemed to be best assessed in the practice setting (n = 55). This study highlighted the perspectives of assessors and their preference for the work-based setting for assessment. Conclusions To reduce the focus on work-based settings as the only place for competence-based assessment of health professionals, there is a need to support individual and organisational change through challenging existing norms around assessment.