882 resultados para clinical safety
Resumo:
The growing national and international awareness of the increased representation of serious injuries and fatalities in rural and remote areas is the focus of this paper. Australia was one of the earliest countries to try to address this issue with a targeted national action plan in 1996. This was an important document but the most recent national plan fails to dedicate attention to developing countermeasures for the particular problems of improving road safety in these regions. The findings of a major program of research in Northern Queensland are discussed to stimulate interest and research into potential countermeasures. Specifically, the need to monitor clusters of crashes as a focus for intervention and local ownership is advocated. Taking action towards a national reduction of speed limits on rural roads and investment in proactive research based trials of drink driving countermeasures such as courtesy buses is strongly advocated.
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This case study report describes the stages involved in the translation of research on night-time visibility into standards for the safety clothing worn by roadworkers. Vision research demonstrates that when lights are placed on the moveable joints of the body and the person moves in a dark setting, the phenomenon known as “biological motion or biomotion” occurs, enabling rapid and accurate recognition of the human form although only the lights can be seen. QUT was successful in gaining funding from the Australian Research Council for a Linkage grant due to the support of the predecessors of the Queensland Department of Transport and Main Roads (TMR) to research the biomotion effect in on-road settings using materials that feature in roadworker clothing. Although positive results were gained, the process of translating the research results into policy, practices and standards relied strongly on the supportive efforts of TMR staff engaged in the review and promulgation of national standards. The ultimate result was the incorporation of biomotion marking into AS/NZS 4602.1 2011. The experiences gained in this case provide insights into the processes involved in translating research into practice.
Resumo:
Despite the presence of many regulations governing the operation of heavy vehicles and supply chains in Australia, the truck driving sector continues to have the highest incidence of fatal injuries compared to all other industries. The working environment has been the focus of attention by safety researchers during the past few decades, with particular consideration been given to the concept ‘safety culture’ and how to maintain, modify and advance responses to occupational risk. One important aspect of the heavy industry which sets it apart is the existence of cultural or sub-cultural influences at an industry wide and occupation-specific level rather than organisational level. This paper reports on the findings of stakeholder’s perceptions of the influences of power and control, and culture on industry safety. In-depth structured interviews were conducted during 2011 with Australian industry stakeholders (n=31). The questioning surrounded decision-making processes with regards to identifying risks, self-monitoring and reducing risky activities; as well as how power-affected relationships may influence the operational performance of supply chains and impacts on driver safety. One of the most significant findings from these interviews relates to the notion of power. The perception that the ‘Customer is King’ was widely viewed, with the majority of stakeholders believing that there exists a ‘master slave mentality’ in the industry. There appears to be great frustration in the industry as to the apparent immunity of customers (particularly retail supply chains) to their responsibilities. There was also a strong perception that the customer holds the balance of power by covertly employing remuneration-related incentives and pressures. Smaller trucking companies are perceived as being more vulnerable to the pressure of customer expectations.
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Fire safety design is important to eliminate the loss of property and lives during fire events. Gypsum plasterboard is widely used as a fire safety material in the building industry all over the world. It contains gypsum (CaSO4.2H2O) and Calcium Carbonate (CaCO3) and most importantly free and chemically bound water in its crystal structure. The dehydration of the gypsum and the decomposition of Calcium Carbonate absorb heat, which gives the gypsum plasterboard fire resistant qualities. Currently plasterboard manufacturers use additives such as vermiculite to overcome shrinkage of gypsum core and glass fibre to bridge shrinkage cracks and enhance the integrity of board during calcination and after the loss of paper facings in fires. Past research has also attempted to reduce the thermal conductivity of plasterboards using fillers. However, no research has been undertaken to enhance the specific heat of plasterboard and the points of dehydration using chemical additives and fillers. Hence detailed experimental studies of powdered samples of plasterboard mixed with chemical additives and fillers in varying proportions were conducted. These tests showed the enhancement of specific heat of plasterboard. Numerical models were also developed to investigate the thermal performance of enhanced plasterboards under standard fire conditions. The results showed that the use of these enhanced plasterboards in steel wall systems can significantly improve their fire performance. This paper presents the details of this research and the results that can be used to enhance the fire safety of steel wall systems commonly used in buildings.
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Executive Summary The Australian Psychological Society categorically condemns the practice of detaining child asylum seekers and their families, on the grounds that it is not commensurate with psychological best practice concerning children’s development and mental health and wellbeing. Detention of children in this fashion is also arguably a violation of the UN Convention on the Rights of the Child. A thorough review of relevant psychological theory and available research findings from international research has led the Australian Psychological Society to conclude that: • Detention is a negative socialisation experience. • Detention is accentuates developmental risks. • Detention threatens the bonds between children and significant caregivers. • Detention limits educational opportunities. • Detention has traumatic impacts on children of asylum seekers. • Detention reduces children’s potential to recover from trauma. • Detention exacerbates the impacts of other traumas. • Detention of children from these families in many respects is worse for them than being imprisoned. In the absence of any indication from the Australian Government that it intends in the near future to alter the practice of holding children in immigration detention, the Australian Psychological Society’s intermediate position is that the facilitation of short-term and long-term psychological development and wellbeing of children is the basic tenet upon which detention centres should be audited and judged. Based on that position, the Society has identified a series of questions and concerns that arise directly from the various psychological perspectives that have been brought to bear on estimating the effects of detention on child asylum seekers. The Society argues that, because these questions and concerns relate specifically to improvement and maintenance of child detainees’ educational, social and psychological wellbeing, they are legitimate matters for the Inquiry to consider and investigate. • What steps are currently being taken to monitor the psyc hological welfare of the children in detention? In particular, what steps are being taken to monitor the psychological wellbeing of children arriving from war-torn countries? • What qualifications and training do staff who care for children and their families in detention centres have? What knowledge do they have of psychological issues faced by people who have been subjected to traumatic experiences and are suffering high degrees of anxiety, stress and uncertainty? • What provisions have been made for psycho-educational assessment of children’s specific learning needs prior to their attending formal educational programmes? • who are suffering chronic and/or vicarious trauma as a result of witnessing threatening behaviour whilst in detention? • What provisions have been made for families who have been seriously affected by displacement to participate in family therapy? • What critical incident debriefing procedures are in place for children who have witnessed their parents, other family members, or social acquaintances engaging in acts of self-harm or being harmed while in detention? What psychotherapeutic support is in place for children who themselves have been harmed or have engaged in self- harmful acts while in detention? • What provisions are in place for parenting programmes that provide support for parents of children under extremely difficult psychological and physical circumstances? • What efforts are being made to provide parents with the opportunity to model traditional family roles for children, such as working to earn an income, meal preparation, other household duties, etc.? • What opportunities are in place for the assessment of safety issues such as bullying, and sexual or physical abuse of children or their mothers in detention centres? • How are resources distributed to children and families in detention centres? • What socialization opportunities are available either within detention centres or in the wider community for children to develop skills and independence, engage in social activities, participate in cultural traditions, and communicate and interaction with same-age peers and adults from similar ethnic and religious backgrounds? • What access do children and families have to videos, music and entertainment from their cultures of origin? • What provisions are in place to ensure the maintenance of privacy in a manner commensurate with usual cultural practice? • What is the Government’s rationale for continuing to implement a policy of mandatory detention of child asylum seekers that on the face of it is likely to have a pernicious impact on these children’s mental health? • In view of the evidence on the potential long-term impact of mandatory detention on children, what processes may be followed by Government to avoid such a practice and, more importantly, to develop policies and practices that will have a positive impact on these children’s psychological development and mental health?
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Due to the propensity of fleet incidents, poor organisational survey results and a lack of fleet safety systems, it was evident that Redland City Council were underperforming, experiencing a variety of work related road safety issues and possessed a low fleet safety culture. As a result of an audit process, and the identification of gaps in organisational process within the fleet safety area Redland City Council embarked upon the enormous task of strategically implementing initiatives and improving fleet safety across the organisation. The strategies utilised within the Redland City Council Fleet Safety Initiative were implemented utilising a systematic process and adopted a multi-disciplinary approach to improve overall fleet safety. Organisational initiatives targeting fleet safety aspects have benefited the Council by the development of an improved organisational culture, including safer driver attitudes and behaviour. This paper outlines the road to recovery for Redland City Council in relation to its fleet safety initiatives.
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Despite significant research, there is still little agreement over how to define safety culture or of what it is comprised. Due to this lack of agreement, much of the safety culture research has little more than safety management strategies in common. There is, however, a degree of acceptance of the close relationship between safety culture and organisational culture. Organisational culture can be described using traditional views of culture drawn from the anthropology and cultural psychology literature. However, the safety culture literature rarely ventures beyond organisational culture into discussions of these more traditional concepts of culture. There is a need to discuss how these concepts of culture can be applied to safety culture to provide greater understanding of safety culture and additional means by which to approach safety in the workplace. This review explores how three traditional conceptualisations of culture; the normative, anthropological and pragmatist conceptualisations, can and have been be applied to safety culture. Finally the review proposes a synthesised conceptualisation of safety culture which can be used to provide greater depth and practical applicability of safety culture, by increasing our understanding of the interactions between cultural and contextual variables in a given workplace and the effect they have on safety.
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Unless sustained, coordinated action is generated in road safety, road traffic deaths are poised to rise from approximately 1.3 to 1.9 million a year by 2020 (Krug, 2012). To generate this harmonised response, road safety management agencies are being urged to adopt multisectoral collaboration (WHO, 2009b), which is achievable through the principle of policy integration. Yet policy integration, in its current hierarchical format, is marred by a lack of universality of its interpretation, a failure to anticipate the complexities of coordinated effort, dearth of information about its design and the absence of a normative perspective to share responsibility. This paper addresses this ill-conception of policy integration by reconceptualising it through a qualitative examination of 16 road safety stakeholders’ written submissions, lodged with the Australian Transport Council in 2011. The resulting, new principle of policy integration, Participatory Deliberative Integration, provides a conceptual framework for the alignment of effort across stakeholders in transport, health, traffic law enforcement, relevant trades and the community. With the adoption of Participatory Deliberative Integration, road safety management agencies should secure the commitment of key stakeholders in the development and implementation of, amongst other policy measures, National Road Safety Strategies and Mix Mode Integrated Timetabling.
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Aims: This paper describes the development of a risk adjustment (RA) model predictive of individual lesion treatment failure in percutaneous coronary interventions (PCI) for use in a quality monitoring and improvement program. Methods and results: Prospectively collected data for 3972 consecutive revascularisation procedures (5601 lesions) performed between January 2003 and September 2011 were studied. Data on procedures to September 2009 (n = 3100) were used to identify factors predictive of lesion treatment failure. Factors identified included lesion risk class (p < 0.001), occlusion type (p < 0.001), patient age (p = 0.001), vessel system (p < 0.04), vessel diameter (p < 0.001), unstable angina (p = 0.003) and presence of major cardiac risk factors (p = 0.01). A Bayesian RA model was built using these factors with predictive performance of the model tested on the remaining procedures (area under the receiver operating curve: 0.765, Hosmer–Lemeshow p value: 0.11). Cumulative sum, exponentially weighted moving average and funnel plots were constructed using the RA model and subjectively evaluated. Conclusion: A RA model was developed and applied to SPC monitoring for lesion failure in a PCI database. If linked to appropriate quality improvement governance response protocols, SPC using this RA tool might improve quality control and risk management by identifying variation in performance based on a comparison of observed and expected outcomes.
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Context: Various epidemiological studies have estimated that up to 70% of runners sustain an overuse running injury each year. Although few overuse running injuries have an established cause, more than 80% of running-related injuries occur at or below the knee, which suggests that some common mechanisms may be at work. The question then becomes, are there common mechanisms related to overuse running injuries? Evidence Acquisition: Research studies were identified via the following electronic databases: MEDLINE, EMBASE PsycInfo, and CINAHL (1980–July 2008). Inclusion was based on evaluation of risk factors for overuse running injuries. Results: A majority of the risk factors that have been researched over the past few years can be generally categorized into 2 groups: atypical foot pronation mechanics and inadequate hip muscle stabilization. Conclusion: Based on the review of literature, there is no definitive link between atypical foot mechanics and running injury mechanisms. The lack of normative data and a definition of typical foot structure has hampered progress. In contrast, a large and growing body of literature suggests that weakness of hip-stabilizing muscles leads to atypical lower extremity mechanics and increased forces within the lower extremity while running.
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The International Road Assessment Program (iRAP) is a not-for-profit organisation that works in partnership with governments and non-government organisations in all parts of the world to make roads safe. The iRAP Malaysia pilot study on 3,700km of road identified the potential to save 31,800 deaths and serious injuries over the next 20 years from proven engineering improvements. To help ensure the iRAP data and results are available to planners and engineers, iRAP, together with staff from the Centre for Accident Research and Road Safety – Queensland (CARRS-Q) and the Malaysian Institute of Road Safety Research (MIROS) developed a 5-day iRAP training course that covers the background, theory and practical application of iRAP protocols, with a special focus on Malaysian case studies. Funding was provided by a competitive grant from the Australian-Malaysia Institute.
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Background: Anecdotal evidence from the infrastructure and building sectors highlights issues of alcohol and other drugs (AODs) and its association with safety risk on construction sites. Currently, there is no clear evidence on the prevalence and risk of AOD use among Australian construction workers and there is limited evidential guidance regarding how to effectively address such an issue. Aims: The current research aims to scientifically evaluate the use of AODs within the Australian construction industry in order to reduce the potential resulting safety and performance impacts and engender a cultural change in the workforce. A nationally consistent and collaborative approach across the workforce will be adopted. Methods: A national assessment of the use of AODs was conducted in participating organisations across three states. The World Health Organisation’s Alcohol Use Disorders Identification Test (AUDIT) was used to measure alcohol use. Illicit drug use, ‘readiness to change’, impediments to reducing impairment, feasibility of proposed interventions, and employee attitudes and knowledge regarding AOD was also measured through a combination of survey items and interviews. Through an educative approach and consultation with employers, employees, union groups and leaders in applied AOD research, this assessment was used to inform and support cultural change management of AOD use in the industry. Results: Results (n=494) indicate that as in the general population, a proportion of those sampled in the construction sector may be at risk of hazardous alcohol consumption. A total of 286 respondents (58%) scored above the cut-off cumulative score for risky or hazardous alcohol use. Other drug use was also identified as a major issue. Interview responses and input from all project partners is presented within a guiding principle framework for cultural change. Conclusions: Results support the need for evidence-based, comprehensive and tailored responses in the workplace. This paper will discuss the final results in the context of facilitating cultural change in the construction industry.
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Objective: To examine the context of occupational health and safety related to blood-borne communicable diseases practice. Methods: A case study approach using qualitative semi-structured interviews with five key informants who represented different sectors of the beauty therapy industry in South Australia. Results: Four main themes were identified: (i) exposure to blood and blood-borne communicable diseases; (ii) prevention in practice; (iii) OH&S problems; and (iv) industry needs. Conclusion: Key OH&S issues in the beauty therapy industry include: power relationships between employers and employees, equipment costs, the need for more continuing education, and monitoring of practitioners. Implications: Economic constraints, continuing education, and government regulation of the beauty therapy industry are highlighted as significant areas for further consideration in addressing the OH&S needs of practitioners and their clients.
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Objective: To examine current knowledge and practice of occupational health and safety (OH&S) regarding hepatitis C in beauty therapy practice. Methods: A questionnaire was sent to all beauty therapy practices identified through the Telstra Yellow Pages and distributed via beauty therapy product agencies. Results: 119 questionnaires were completed by employers and employees in 99 beauty therapy practices in metropolitan Adelaide. Beauty therapists reported carrying out many practices that had exposed them to blood in the past. More than 80% of the procedures carried out by beauty therapists in the previous week were reported to have led to exposure to blood. 39.5% of respondents had not received information about OH&S practices related to blood spills and 77.5% of respondents had received no OH&S information about hepatitis C. Knowledge of hepatitis C and its transmission was poor, with 62% of respondents incorrectly identifying the prevalence of hepatitis C and respondents incorrectly identifying sneezing (28%), kissing (46%) and sharing coffee cups (42%) as a modes of transmission. 80% of beauty therapy practices had no OH&S representative. Conclusion: Beauty therapy practice can expose both operator and client to blood and is therefore a potential site for the transmission of blood-borne diseases including hepatitis C. OH&S information is inadequate in this industry and knowledge of hepatitis C is poor.
Resumo:
The decisions people make about medical treatments have a great impact on their lives. Health care practitioners, providers and patients often make decisions about medical treatments without complete understanding of the circumstances. The main reason for this is that medical data are available in fragmented, disparate and heterogeneous data silos. Without a centralised data warehouse structure to integrate these data silos, it is highly unlikely and impractical for the users to get all the information required on time to make a correct decision. In this research paper, a clinical data integration approach using SAS Clinical Data Integration Server tools is presented.