Injury severity of pedestrian crashes in Singapore

Singapore is a highly urbanized city-state country where walking is an important mode of travel. Pedestrians form about 25% of road fatalities every year, making them one of the most vulnerable road user groups in Singapore. Engineering measures like provision of overhead pedestrian crossings and raised zebra crossings tend to address pedestrian safety in general, but there may be occasions where pedestrians are particularly vulnerable so that targeted interventions are more appropriate. The objective of this study is to identify factors and situations that affect the injury severity of pedestrians involved in traffic crashes. Six years of crash data from 2003 to 2008 containing around four thousands pedestrian crashes at roadway segments were analyzed. Injury severity of pedestrians—recorded as slight injury, major injury and fatal—were modeled as a function of roadway characteristics, traffic features, environmental factors and pedestrian demographics by an ordered probit model. Results suggest that the injury severity of pedestrians involved in crashes during night time is higher indicating that pedestrian visibility during night is a key issue in pedestrian safety. The likelihood of fatal or serious injuries is higher for crashes on roads with high speed limit, center and median lane of multi-lane roads, school zones, roads with two-way divided traffic type, and when pedestrians cross the roads. Elderly pedestrians appear to be involved in fatal and serious injury crashes more when they attempt to cross the road without using nearby crossing facilities. Specific countermeasures are recommended based on the findings of this study.

The Alcohol Intervention Training Program (AITP): a response to alcohol misuse in the farming community

Background Farm men and women in Australia have higher levels of problematic alcohol use than their urban counterparts and experience elevated health risks associated with excessive alcohol consumption. The Sustainable Farm Families (SFF) program has worked successfully with farm men and women to address health, well- being and safety and has identified that further research and training is required to understand and address alcohol misuse behaviours. This project will add an innovative component to the program by training health professionals working with farm men and women to discuss and respond to alcohol-related physical and mental health problems. Methods/Design A mixed method design with multi-level evaluation will be implemented following the development and delivery of a training program (The Alcohol Intervention Training Program {AITP}) for Sustainable Farm Families health professionals. Pre-, post- and follow-up surveys will be used to assess both the impact of the training on the knowledge, confidence and skills of the health professionals to work with alcohol misuse and associated problems, and the impact of the training on the attitudes, behaviour and mental health of farm men and women who participate in the SFF project. Evaluations will take a range of forms including self-rated outcome measures and interviews. Discussion The success of this project will enhance the health and well-being of a critical population, the farm men and women of Australia, by producing an evidence-based strategy to assist them to adopt more positive alcohol-related behaviours that will lead to better physical and mental health.

Efficacy of proxy definitions for identification of fatigue/sleep-related crashes : an Australian evaluation

Fatigue/sleepiness is recognised as an important contributory factor in fatal and serious injury road traffic incidents (RTIs), however, identifying fatigue/sleepiness as a causal factor remains an uncertain science. Within Australia attending police officers at a RTI report the causal factors; one option is fatigue/sleepiness. In some Australian jurisdictions police incident databases are subject to post hoc analysis using a proxy definition for fatigue/sleepiness. This secondary analysis identifies further RTIs caused by fatigue/sleepiness not initially identified by attending officers. The current study investigates the efficacy of such proxy definitions for attributing fatigue/sleepiness as a RTI causal factor. Over 1600 Australian drivers were surveyed regarding their experience and involvement in fatigue/sleep-related RTIs and near-misses during the past five years. Driving while fatigued/sleepy had been experienced by the majority of participants (66.0% of participants). Fatigue/sleep-related near misses were reported by 19.1% of participants, with 2.4% being involved in a fatigue/sleep-related RTI. Examination of the characteristics for the most recent event (either a near miss or crash) found that the largest proportion of incidents (28.0%) occurred when commuting to or from work, followed by social activities (25.1%), holiday travel (19.8%), or for work purposes (10.1%). The fatigue/sleep related RTI and near-miss experience of a representative sample of Australian drivers does not reflect the proxy definitions used for fatigue/sleepiness identification. In particular those RTIs that occur in urban areas and at slow speeds may not be identified. While important to have a strategy for identifying fatigue/sleepiness related RTIs proxy measures appear best suited to identifying specific subsets of such RTIs.

Quantitative ultrasound computed tomography imaging of PAGAT radiation dosimetry gel

This research developed and scientifically validated a new ultrasound transmission computed tomography system with the aim of quantitative assessment of a polymer gel dosimeter including dose response verification of ultrasonic parameters of attenuation, velocity and broadband ultrasound attenuation (BUA). This work was the first to investigate and report ultrasound frequency dependent attenuation in a gel dosimeter, demonstrating a dose dependence.

Rodent Models of Conditioned Fear: Behavioral Measures of Fear and Memory

Pavlovian fear conditioning is a robust technique for examining behavioral and cellular components of fear learning and memory. In fear conditioning, the subject learns to associate a previously neutral stimulus with an inherently noxious co-stimulus. The learned association is reflected in the subjects' behavior upon subsequent re-exposure to the previously neutral stimulus or the training environment. Using fear conditioning, investigators can obtain a large amount of data that describe multiple aspects of learning and memory. In a single test, researchers can evaluate functional integrity in fear circuitry, which is both well characterized and highly conserved across species. Additionally, the availability of sensitive and reliable automated scoring software makes fear conditioning amenable to high-throughput experimentation in the rodent model; thus, this model of learning and memory is particularly useful for pharmacological and toxicological screening. Due to the conserved nature of fear circuitry across species, data from Pavlovian fear conditioning are highly translatable to human models. We describe equipment and techniques needed to perform and analyze conditioned fear data. We provide two examples of fear conditioning experiments, one in rats and one in mice, and the types of data that can be collected in a single experiment. © 2012 Springer Science+Business Media, LLC.

Measurement as legitimacy versus legitimacy of measures : Performance evaluation of social enterprise

Purpose The purpose of this paper is to review the growing emphasis on quantifiable performance measures such as social return on investment (SROI) in third sector organisations – specifically, social enterprise – through a legitimacy theory lens. It then examines what social enterprises value (i.e. consider important) in terms of performance evaluation, using a case study approach. Design/methodology/approach Case studies involving interviews, documentary analysis, and observation, of three social enterprises at different life-cycle stages with different funding structures, were constructed to consider “what measures matter” from a practitioner's perspective. Findings Findings highlight a priority on quality outcomes and impacts in primarily qualitative terms to evaluate performance. Further, there is a noticeable lack of emphasis on financial measures other than basic access to financial resources to continue pursuing social goals. Social implications The practical challenges faced by social enterprises – many of which are small to medium sized – in evaluating performance and by implication organisational legitimacy are contrasted with measures such as SROI which are resource intensive and have inherent methodological limitations. Hence, findings suggest the limited and valuable resources of social enterprises would be better allocated towards documenting the actual outcomes and impacts as a first step, in order to evaluate social and financial performance in terms appropriate to each objective, in order to demonstrate organisational legitimacy. Originality/value Findings distinguish between processes which may hold symbolic legitimacy for select stakeholder groups, and processes which hold substantive, cognitive legitimacy for stakeholders more broadly, in the under-researched context of social enterprise.

Promoting a more positive traffic safety culture in Australia : lessons learnt and future directions

Adopting a traffic safety culture approach, this paper identifies and discusses the ongoing challenge of promoting the road safety message in Australia. It is widely acknowledged that mass media and public education initiatives have played a critical role in the significant positive changes witnessed in community attitudes to road safety in the last three to four decades. It could be argued that mass media and education have had a direct influence on behaviours and attitudes, as well as an indirect influence through signposting and awareness raising functions in conjunction with enforcement. Great achievements have been made in reducing fatalities on Australia’s roads; a concept which is well understood among the international road safety fraternity. How well these achievements are appreciated by the general Australian community however, is not clear. This paper explores the lessons that can be learnt from successes in attitudinal and behaviour change in regard to seatbelt use and drink driving in Australia. It also identifies and discusses key challenges associated with achieving further positive changes in community attitudes and behaviours, particularly in relation to behaviours that may not be perceived by the community as dangerous, such as speeding and mobile phone use while driving. Potential strategies for future mass media and public education campaigns to target these challenges are suggested, including ways of harnessing the power of contemporary traffic law enforcement techniques, such as point-to-point speed enforcement and in-vehicle technologies, to help spread the road safety message.

Characteristics of chemotherapy practice in rural and remote area health facilities in Queensland

Objective The overall objective of this study was to document the nature of the chemotherapy nursing practice of rural and remote area nurses in Queensland. Design A questionnaire survey that elicited descriptive quantitative and qualitative data. Setting Forty-seven rural and remote area health facilities in Queensland involved in the administration of chemotherapy. Subjects Sixty-seven Queensland rural and remote area nurses involved in the administration of cytotoxic drugs. Main outcome measures: Characteristics of chemotherapy practice including context of practice, amount and type of chemotherapy administered, logistical problems, level of support from referral centres, policies and procedures, safety issues. Results The results indicate that the risks to nursing staff and the potential for poor patient outcomes are higher than in specialist chemotherapy facilities. This is largely due to the human and material resource constraints characteristic of rural practice. These include a lack of understanding on the part of metropolitan-based health departments and the specialist cancer centres that refer patients to rural areas of the constraints that may adversely influence patient outcomes. Conclusions It is essential that steps are taken to ensure that rural and remote area cancer patients have equitable access to safe and competent chemotherapy care delivered in their choice of context, and the results of this study provide guidance on ways that this can be achieved.

Identifying the determinants of concealed and obvious texting while driving : are they distinct behaviours?

Concealed texting (CT) while driving involves a conscious effort to hide one’s texting while obvious texting (OT) does not involve such efforts to conceal the behaviour. Young drivers are the most frequent users of mobile phones while driving which is associated with heightened crash risk. This study investigated the extent to which CT and OT may be discrete behaviours to ascertain whether countermeasures would need to utilise distinct approaches. An extended Theory of Planned Behaviour (TPB) including moral norm, mobile phone involvement, and anticipated regret guided the research. Participants (n = 171) were aged 17 to 25 years, owned a mobile phone, had a current driver’s licence, and resided in Queensland. A repeated measures MANOVA found significant differences between CT and OT on all standard and extended TPB constructs. Hierarchical multiple regression analyses showed the standard TPB constructs accounted for 68.7% and 54.6% of the variance in intentions to engage in CT and OT, respectively. The extended predictors contributed additional variance in intentions over and above the standard TPB constructs. Further, in the final regression model, differences emerged in the significant predictors of each type of texting. These findings provide initial evidence that CT and OT are distinct behaviours. This distinction is important to the extent that it may influence the nature of advertising countermeasures aimed at reducing/preventing young drivers’ engagement in these risky behaviours.

Traffic safety risks trends and patterns analysis on motorways

Crashes that occur on motorways contribute to a significant proportion (40-50%) of non-recurrent motorway congestion. Hence, reducing the frequency of crashes assist in addressing congestion issues (Meyer, 2008). Analysing traffic conditions and discovering risky traffic trends and patterns are essential basics in crash likelihood estimations studies and still require more attention and investigation. In this paper we will show, through data mining techniques, that there is a relationship between pre-crash traffic flow patterns and crash occurrence on motorways, compare them with normal traffic trends, and that this knowledge has the potentiality to improve the accuracy of existing crash likelihood estimation models, and opens the path for new development approaches. The data for the analysis was extracted from records collected between 2007 and 2009 on the Shibuya and Shinjuku lines of the Tokyo Metropolitan Expressway in Japan. The dataset includes a total of 824 rear-end and sideswipe crashes that have been matched with crashes corresponding traffic flow data using an incident detection algorithm. Traffic trends (traffic speed time series) revealed that crashes can be clustered with regards to the dominant traffic patterns prior to the crash occurrence. K-Means clustering algorithm applied to determine dominant pre-crash traffic patterns. In the first phase of this research, traffic regimes identified by analysing crashes and normal traffic situations using half an hour speed in upstream locations of crashes. Then, the second phase investigated the different combination of speed risk indicators to distinguish crashes from normal traffic situations more precisely. Five major trends have been found in the first phase of this paper for both high risk and normal conditions. The study discovered traffic regimes had differences in the speed trends. Moreover, the second phase explains that spatiotemporal difference of speed is a better risk indicator among different combinations of speed related risk indicators. Based on these findings, crash likelihood estimation models can be fine-tuned to increase accuracy of estimations and minimize false alarms.

End-of-life care pathways for improving outcomes in caring for the dying (Review)

Background This is an updated version of a Cochrane review first published in Issue 1, 2010 of The Cochrane Library. In many clinical areas, integrated care pathways are utilised as structured multidisciplinary care plans that detail essential steps in caring for patients with specific clinical problems. In particular, care pathways for the dying have been developed as a model to improve care of patients who are in the last days of life. The care pathways were designed with an aim of ensuring that the most appropriate management occurs at the most appropriate time and that it is provided by the most appropriate health professional. There have been sustained concerns about the safety of implementing end-of-life care pathways, particularly in the UK. Therefore, there is a significant need for clinicians and policy makers to be informed about the effects of end-of-life care pathways with a systematic review. Objectives To assess the effects of end-of-life care pathways, compared with usual care (no pathway) or with care guided by another end-of-life care pathway across all healthcare settings (e.g. hospitals, residential aged care facilities, community). In particular, we aimed to assess the effects on symptom severity and quality of life of people who are dying; those related to the care such as families, carers and health professionals; or a combination of these. Search Methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 6, 2013), MEDLINE, EMBASE, PsycINFO, CINAHL, review articles and reference lists of relevant articles.We conducted the original search in September 2009, and the updated search in June 2013. Selection Criteria All randomised controlled trials (RCTs), quasi-randomised trial or high-quality controlled before-and-after studies comparing use versus non-use of an end-of-life care pathway in caring for the dying. Data Collection and Analysis Two review authors assessed the results of the searches against the predetermined criteria for inclusion. Main Results The original review identified 920 titles. The updated search found 2042 potentially relevant titles (including the original 920), but no additional studies met criteria for inclusion in the review update. Authors’ Conclusions With sustained concerns about the safety of the pathway implementation and the lack of available evidence on important patient and relative outcomes, recommendations for the use of end-of-life pathways in caring for the dying cannot be made. Since the last version of this review, no new studies met criteria for inclusion in the review update. With recently documented concerns related to the potential adverse effects associated with Liverpool Care Pathway (the most commonly used end-of-life care pathway), we do not recommend decision making based on indirect or low-quality evidence. All health services using end-of-life care pathways are encouraged to have their use of the pathway, to date, independently audited. Any subsequent use should be based on carefully documented evaluations. Large RCTs or other well-designed controlled studies are urgently required for the evaluation of the use of end-of-life care pathways in caring for dying people in various clinical settings. In future studies, outcome measures should include benefits or harms concerning the outcomes of interest in this review in relation to patients, families, carers and health professionals.

V: Rewriting and reclaiming history : an analysis of the emergence of restorative justice in western criminal justice systems

During the last three decades, restorative justice has emerged in numerous localities around the world as an accepted approach to responding to crime. This article, which stems from a doctoral study on the history of restorative justice, provides a critical analysis of accepted histories of restorative practices. It revisits the celebrated historical texts of the restorative justice movement, and re-evaluates their contribution to the emergence of restorative justice measures. It traces the emergence of the term 'restorative justice', and reveals that it emerged in much earlier writings than is commonly thought to be the case by scholars in the restorative justice field. It also briefly considers some 'power struggles' in relation to producing an accepted version of the history of restorative justice, and scholars' attempts to 'rewrite history' to align with current views on restorative justice. Finally, this article argues that some histories of restorative justice selectively and inaccurately portray key figures from the history of criminology as restorative justice supporters. This, it is argued, gives restorative justice a false lineage and operates to legitimise the widespread adoption of restorative justice around the globe.

The ISR and ESR scales : measures of the project manager-stakeholder relationship

In this paper, we develop two stakeholder relationships scales. These scales assess project managers’ perceived competence in establishing and maintaining high quality, effective relationships with people internal to the project as well as those stakeholders who are external to the project. We developed the scales using an online survey study of three hundred and seventy three complex project managers from a sub-set of the Australian Defence Industry. Both the internal stakeholder relationships’ scale and the external stakeholder relationships’ scale demonstrated validity and reliability. This research has implications for the interpersonal work relationships’ literature and the stakeholder management literature. We recommend future research tests these scales with multiple samples, across different project types and project industries. The stakeholder relationships’ scales should be versatile enough to be applied to project management generally but are best suited to large-scale complex project environments.

Does it matter whether friends, parents, or peers drink walk? Identifying which normative influences predict young pedestrian's decisions to walk while intoxicated

Drink walking, that is walking in a public place while intoxicated, is associated with increased risk of injury and fatality. Young people and males are especially prone to engaging in this behaviour, yet little is known about the factors associated with individual’s decisions to drink walk. The present research explores the role of different normative influences (friendship group norm, parent group norm, university peer group norm) and perceived risk, within an extended theory of planned behaviour (TPB) framework, in predicting young people’s self-reported drink walking intentions. One hundred and eighteen young people (aged 17-25 years) completed a survey including sociodemographic measures and extended TPB measures related to drink walking. Overall the extended TPB explained 72.8% of the variance in young people’s intentions to drink walk in the next six months with attitude, perceived behavioural control, friendship group norm, and gender (male) emerging as significant predictors. Males, as compared with females, had higher intentions to drink walk and lower perceptions of risk regarding drink walking. Together, these findings provide a clearer indication of the salient normative influences and gender differences in young pedestrian’s decisions to walk while intoxicated. Such findings can be used to inform future interventions designed to reduce injuries and fatalities associated with drink walking.