Personality disorders

This chapter explains the main categories of personality disorders and their diagnosis.Nursing interventions are described, and challenges working with people who have personality disorders are discussed.Limitations in our understanding of personality disorders, and problems of categorisation, diagnosis and treatment are also discussed.

Wellness programs at firefighter and police workplaces : a systematic review

Objectives This systematic review summarizes the literature on the health effects of wellness programs at police and firefighter workplaces. The review also considers process outcomes and economic evaluations of such programs. Methods A systematic search of articles published from January 1, 2000 through September 1, 2012 in 13 databases was conducted. Data on 7 studies from 9 articles were extracted. An assessment of the methodological quality of the studies was conducted. Results Studies showed acceptable completion rates and high satisfaction with programs, but mixed results for changes in individual outcomes. Conclusion Empirical evidence for effective health and wellness programs in police and firefighter populations is scarce. Better evaluation and documentation of such programs is needed to advance this field of research.

Organizational work-related road safety situational analysis: More than just an audit tool

Although safety statistics indicate that road crashes are the most common form of work-related fatalities, many organizations fail to treat company vehicles in the same manner as other physical safety hazards within the workplace. Traditionally, work-related road safety has targeted primarily driver-related issues and not adequately addressed organizational processes, such as the organizations’ safety system and risk management processes and practice. This inadequacy generally stems from a lack of specific contextual knowledge and basic requirements to improve work-related road safety, including the supporting systems to ensure any intervention strategy or initiative’s ongoing effectiveness. Therefore, informed by previous research and based on a case study methodology, the Organizational Work-Related Road Safety Situational Analysis was developed to assess organizations’ current work-related road safety system, including policy, procedures, processes and practice. The situational analysis tool is similar to a safety audit however is more comprehensive in detail, application and provides sufficient evidence to enable organizations to mitigate and manage their work-related road safety risks. In addition, data collected from this process assists organizations in making informed decisions regarding intervention strategy design, development, implementation and ongoing effectiveness. This paper reports on the effectiveness of the situational analysis tool to assess WRRS systems across five differing and diverse organizations; including gas exploration and mining, state government, local government, and not for profit/philanthropy. The outcomes of this project identified considerable differences in the degree by which the organizations’ addressed work-related road safety across their vehicle fleet operations and provides guidelines for improving organizations’ work-related road safety systems.

Plasma nanofabrication and nanomaterials safety

The fast advances in nanotechnology have raised increasing concerns related to the safety of nanomaterials when exposed to humans, animals and the environment. However, despite several years of research, the nanomaterials safety field is still in its infancy owing to the complexities of structural and surface properties of these nanomaterials and organism-specific responses to them. Recently, plasma-based technology has been demonstrated as a versatile and effective way for nanofabrication, yet its health and environment-benign nature has not been widely recognized. Here we address the environmental and occupational health and safety effects of various zero- and one-dimensional nanomaterials and elaborate the advantages of using plasmas as a safe nanofabrication tool. These advantages include but are not limited to the production of substrate-bound nanomaterials, the isolation of humans from harmful nanomaterials, and the effective reforming of toxic and flammable gases. It is concluded that plasma nanofabrication can minimize the hazards in the workplace and represents a safe way for future nanofabrication technologies.

Chemical and bioanalytical assessment of coal seam gas associated water

A comprehensive study was undertaken involving chemical (inorganic and organic) and bioanalytical (a suite of 14 in vitro bioassays) assessments of coal seam gas (coal bed methane) associated water (CSGW) in Queensland, Australia. CSGW is a by-product of the gas extraction process and is generally considered as water of poor quality. This was done to better understand what is known about the potential biological and environmental effects associated with the organic constituents of CSGW in Australia. In Queensland, large amounts of associated water must be withdrawn from coal seams to allow extraction of the gas. CSGW is disposed of via release to surface water, reinjected to groundwater or reused for irrigation of crops or pasture, supplied for power station cooling and or reinjected specifically to augment drinking water aquifers. Groundwater samples were collected from private wells tapping into the Walloon Coal Measures, the same coal aquifer exploited for coal seam gas production in the Surat Basin, Australia. The inorganic characteristics of these water samples were almost identical to the CSGW entering the nearby gas company operated Talinga-Condabri Water Treatment Facility. The water is brackish with a pH of 8 to 9, high sodium, bicarbonate and chloride concentrations but low calcium, magnesium and negligible sulphate concentrations. Only low levels of polyaromatic hydrocarbons (PAHs) were detected in the water samples, and neither phenols nor volatile organic compounds were found. Results from the bioassays showed no genotoxicity, protein damage, or activation of hormone receptors (with the exception of the estrogen receptor). However, five of the 14 bioassays gave positive responses: an arylhydrocarbon-receptor gene activation assay (AhR-CAFLUX), estrogenic endocrine activity (ERα-CALUX), oxidative stress response (AREc32), interference with cytokine production (THP1-CPA) and non-specific toxicity (Microtox). The observed effects were benchmarked against known water sources and were similar to secondary treated wastewater effluent, stormwater and surface water. As mixture toxicity modelling demonstrated, the detected PAHs explained less than 5% of the observed biological effects.

Food safety : maximising impact by understanding the food business context

In Australia there are 5.4 million cases of food-borne illness annually which costs the community $1.2 billion per annum (Department of Health and Ageing 2006). As a co-regulator in food safety, local government has a significant interest in ensuring adherence to good food safety practices. This research project involved focus groups or interviews with food business operators and young food handlers to explore their food safety understanding, attitudes, practices and the organisational culture in which they participated. By its nature qualitative research is not intended to provide definitive generalizable findings. Rather the advantage of a small sample size qualitative study is to provide depth rather than breadth. Thus the findings here provide insight into the complexities and nuances of food safety regulation in a manner which a large scale quantitative study could not.

Food safety strategy template : supporting information

A strategy sets out the actions an organisation intends to take to achieve a particular goal, such as improved food safety practices. The development of a strategy allows the organisation to review and improve their existing operations, identify and implement new strategies, prioritise actions and strategically allocate resources to maximise efficiency and effectiveness. Implementing a holistic food safety strategy will help local governments continually improve their performance in this area. To support local governments develop a holistic food safety strategy a customisable template has been developed as part of the research project ‘Food Safety: Maximising Impact by Understanding the Food Business Context’ (more information about the research project is available online at www.acelg.org.au/foodsafety).

Food safety strategy template

A customisable template for councils developing a food safety strategy.

Improving the railway’s understanding of accident causation through an integrated approach to human factors analysis and technical safety data recording

This paper describes a safety data recording and analysis system that has been developed to capture safety occurrences including precursors using high-definition forward-facing video from train cabs and data from other train-borne systems. The paper describes the data processing model and how events detected through data analysis are related to an underlying socio-technical model of accident causation. The integrated approach to safety data recording and analysis insures systemic factors that condition, influence or potentially contribute to an occurrence are captured both for safety occurrences and precursor events, providing a rich tapestry of antecedent causal factors that can significantly improve learning around accident causation. This can ultimately provide benefit to railways through the development of targeted and more effective countermeasures, better risk models and more effective use and prioritization of safety funds. Level crossing occurrences are a key focus in this paper with data analysis scenarios describing causal factors around near-miss occurrences. The paper concludes with a discussion on how the system can also be applied to other types of railway safety occurrences.

Beyond the barriers : road construction safety issues from the office and the roadside

Conceptually, the management of safety at roadworks can be seen in a three level framework. At the regulatory level, roadworks operate at the interface between the work environment, governed by workplace health and safety regulations, and the road environment, which is subject to road traffic regulations and practices. At the organizational level, national, state and local governments plan and purchase road construction and maintenance which are then delivered in-house or tendered out to large construction companies who often subcontract multiple smaller companies to supply services and labor. At the operational level, roadworks are difficult to isolate from the general public, hindering effective occupational health and safety controls. This study, from the State of Queensland, Australia, examines how well this tripartite framework functions. It includes reviews of organizational policy and procedures documents; interviews with 24 subject matter experts from various road construction and maintenance organizations, and on-site interviews with 66 road construction personnel. The study identified several factors influencing the translation of safety policies into practice including the cost of safety measures in the context of competitive tendering, lack of firm evidence of the effectiveness of safety measures, and pressures to minimize disruption to the travelling public.

Training needs research applied to the development of a standardised incident investigator training framework

In response to the rail industry lacking a consistently accepted standard of minimal training to perform incident investigations, the Australasian rail industry requested the development of a unified approach to investigator training. This paper details how the findings from a training needs analysis were applied to inform the development of a standardised training package for rail incident investigators. Data from job descriptions, training documents and subject matter experts sourced from 17 Australasian organisations were analysed and refined to yield a draft set of 10 critical competencies. Finally the draft of critical competencies was reviewed by industry experts to verify the accuracy and completeness of the competency list and to consider the most appropriate level of qualification for training development. The competencies identified and the processes described to translate research into an applied training framework in this paper, can be generalised to assist practitioners and researchers in developing industry approved standardised training packages.

First results of a major study on safety at Queensland roadworks

The Centre for Accident Research and Road Safety – Queensland (CARRS-Q) is conducting a 3-year program of research, titled Integrating Technological and Organisational Approaches to Enhance the Safety of Roadworkers. The program is funded by the Australian Research Council (ARC), with support from industry partners Leighton Contractors, GHD, Queensland Transport and Main Roads (TMR), and the Australian Workers Union (AWU). This multidisciplinary project involves working together to enhance roadworker safety by: • Investigating the real and perceived dangers at roadworks. • Strengthening organisational policies and practices for roadworker safety. • Testing innovative initiatives to improve driver behaviour at roadworks. • Developing safety management models spanning different regulatory frameworks. The project outcomes will include the following benefits: • Practical and theoretical contributions at industry and academic levels for developing effective interventions/strategies to improve safety in road construction. • Development of new measures to evaluate effectiveness of policy and organisational interventions to produce behavioural change among organisations involved in roadworks. • Improved safety and productivity in urban and rural areas of Australia as a result of facilitating the delivery of road improvements. This paper presents an overview of the research conducted to date as part of the overall program. The paper concentrates on issues relevant to moving vehicles, although the research recognises the importance of other hazards and risks associated with roadworks and construction projects generally.

Influence of visible work activity on drivers’ speed choice at roadworks

Vehicle traffic through roadwork sites creates a hazardous work environment, with speed limit noncompliance a major contributor to the high risk and high severity of roadwork crashes. This paper examines responses to an online survey to better understand the factors underlying drivers’ work zone speed choices. Drivers’ stated speed choice was compared between two photographs of the same work zone section – one with workers and machinery present and another with no visible activity. Drivers also provided comments on any aspect of roadwork safety they thought was important. A paired t-test of stated speed choice revealed that significantly lower mean speeds were nominated when workers and machinery were clearly present and active (41.7 vs 53.5 km/h, p<0.01). Participants expressed concern about roadwork signage and reduced speed limits being left in place when there was no apparent work activity. Driver perceptions, and thus compliance, may be improved through technological and operational changes.

Proactive safety assessment in roadwork zones : a synthesis of surrogate measures of safety

Work zone safety studies have traditionally relied on historical crash records—an approach which is reactive in nature as it requires crashes to accumulate first before taking any preventive actions. However, detailed and accurate data on work zone crashes are often not available, as is the case for Australian road work zones. The lack of reliable safety records and the reactive nature of the crash-based safety analysis approach motivated this research to seek alternative and proactive measures of safety. Various surrogate measures of safety have been developed in the traffic safety literature including time to collision, time to accident, gap time, post encroachment time, required deceleration rate, proportion of stopping distances, lateral distance to departure, and time to departure. These measures express how close road-user(s) are from a potential crash by analysing their movement trajectories. A review of this fast-growing literature is presented in this paper from the viewpoint of applying the measures to untangle work zone safety issues. The review revealed that the use of the surrogate measures is very limited for analysing work zone safety, although numerous studies have used these measures for analysing safety in other parts of the road network, such as intersections and motorway ramps. There exist great opportunities for adopting this proactive safety assessment approach to transform work zone safety for both roadworkers and motorists.

Profiling contextual factors which influence safety in heavy vehicle industries

A significant proportion of worker fatalities within Australia result from truck-related incidents. Truck drivers face a number of health and safety concerns. Safety culture, viewed here as the beliefs, attitudes and values shared by an organisation’s workers, which interact with their surrounding context to influence behaviour, may provide a valuable lens for exploring safety-related behaviours in heavy vehicle operations. To date no major research has examined safety culture within heavy vehicle industries. As safety culture provides a means to interpret experiences and generate behaviour, safety culture research should be conducted with an awareness of the context surrounding safety. The current research sought to examine previous health and safety research regarding heavy vehicle operations to profile contextual factors which influence health and safety. A review of 104 peer-reviewed papers was conducted. Findings of these papers were then thematically analysed. A number of behaviours and scenarios linked with crashes and non-crash injuries were identified, along with a selection of health outcomes. Contextual factors which were found to influence these outcomes were explored. These factors were found to originate from government departments, transport organisations, customers and the road and work environment. The identified factors may provide points of interaction, whereby culture may influence health and safety outcomes.