Building shared situational awareness in surgery through distributed dialogue

Background Failure to convey time-critical information to team members during surgery diminishes members’ perception of the dynamic information relevant to their task, and compromises shared situational awareness. This research reports the dialog around clinical decisions made by team members in the time-pressured and high-risk context of surgery, and the impact of these communications on shared situational awareness. Methods Fieldwork methods were used to capture the dynamic integration of individual and situational elements in surgery that provided the backdrop for clinical decisions. Nineteen semi structured interviews were performed with 24 participants from anaesthesia, surgery, and nursing in the operating rooms of a large metropolitan hospital in Queensland, Australia. Thematic analysis was used. Results: The domain “coordinating decisions in surgery” was generated from textual data. Within this domain, three themes illustrated the dialog of clinical decisions, i.e., synchronizing and strategizing actions, sharing local knowledge, and planning contingency decisions based on priority. Conclusion Strategies used to convey decisions that enhanced shared situational awareness included the use of “self-talk”, closed-loop communications, and “overhearing” conversations that occurred at the operating table. Behaviours’ that compromised a team’s shared situational awareness included tunnelling and fixating on one aspect of the situation.

Problems and awareness of support services among University students

Although Australian universities have allocated significant resources toward the development of student support services, administrators have little systematic information about the problems undergraduate university students experience or students' knowledge about available support services. The author surveyed 441 students in an urban, nonresidential university to examine the prevalence of difficulties associated with learning, sexual harassment, discrimination, emotional distress, health problems, course and career concerns, financial difficulties, and difficulties with lecturers; he also assessed students' knowledge of support services in each of these areas. Course concerns were the most common problem, followed by emotional distress, worry about career choices, financial difficulties, and problems with lecturers. More than half of the students were unaware of the support services available to them to address a range of concerns from sexual harassment and discrimination to emotional distress. Approximately 20% of the students reported having used university counseling or career services. Implications for targeting specific areas for outreach programs are discussed.

The role of, and key considerations for, advertising campaigns and educational awareness workshops within the work-related road safety context

Australian and international evidence suggests that, in the work-related driving context, road crashes account for a substantial number of occupational incidents. In the attempt to reduce injury and improve safety, organisations may implement an array of strategies and interventions ranging from policy development and implementation, vehicle selection and incident monitoring through to education and awareness-raising. This conceptual paper discusses aspects relating to the latter collection of interventions and, in particular, the role, and some key considerations with respect to the content and dissemination, of advertising campaigns and educational awareness workshops. In relation to advertising campaigns, this paper discusses how some of the overarching principles associated with advertising in the broader general community road safety strategy also apply within the work-related road safety context. Specifically, advertising campaigns/materials should be viewed as a key component within a dedicated organisational approach to road (driver) safety. This dedicated approach would need to comprise of a number, and varied array, of strategies. In addition, the content of, and medium/s (e.g., posters) by which to deliver such advertising campaigns, cannot be addressed by a one-size-fits all approach but, rather, requires careful consideration of the needs as well as characteristics of specific organisations and their driver fleet. The paper provides a summary of some key considerations when devising an advertising campaign, including the nature of campaign/message content as well as the processes by which to devise and refine such content. In relation to driver education awareness workshops, this paper outlines the key considerations for delivering a series of workshops specifically aimed at occupational driving within the organisational context. A case study approach will be utilised to demonstrate the manner in which educational awareness workshops can compliment successful advertising campaigns promoting safer work related driving through better risk management practice. Research underpinning the development of driver behaviour modification tools incorporated within the workshops will also be discussed along with the mechanisms utilised to encourage improvements in driver monitoring and behaviour. In an effort to assist organisations with their continual search for cost-effective approaches which may, ultimately, contribute to improvements in driver behaviour and safety, the current paper offers some clear and practical suggestions in relation to the development and dissemination of two types of interventions, advertising campaigns and education awareness workshops.

I know, but I don’t care : how awareness of Queensland’s drug driving testing methods impact upon perceptions of deterrence and offending behaviours

An increasing body of research is highlighting the involvement of illicit drugs in many road fatalities. Deterrence theory has been a core conceptual framework underpinning traffic enforcement as well as interventions designed to reduce road fatalities. Essentially the effectiveness of deterrence-based approaches is predicated on perceptions of certainty, severity, and swiftness of apprehension. However, much less is known about how the awareness of legal sanctions can impact upon the effectiveness of deterrence mechanisms and whether promoting such detection methods can increase the deterrent effect. Nevertheless, the implicit assumption is that individuals aware of the legal sanctions will be more deterred. This study seeks to explore how awareness of the testing method impacts upon the effectiveness of deterrence-based interventions and intentions to drug drive again in the future. In total, 161 participants who reported drug driving in the previous six months took part in the current study. The results show that awareness of testing had a small effect upon increasing perceptions of the certainty of apprehension and severity of punishment. However, awareness was not a significant predictor of intentions to drug drive again in the future. Importantly, higher levels of drug use were a significant predictor of intentions to drug drive in the future. Whilst awareness does have a small effect on deterrence variables, the influence of levels of drug use seems to reduce any deterrent effect.

Contextual models and the non-Newtonian paradigm

Biological systems exhibit a wide range of contextual effects, and this often makes it difficult to construct valid mathematical models of their behaviour. In particular, mathematical paradigms built upon the successes of Newtonian physics make assumptions about the nature of biological systems that are unlikely to hold true. After discussing two of the key assumptions underlying the Newtonian paradigm, we discuss two key aspects of the formalism that extended it, Quantum Theory (QT). We draw attention to the similarities between biological and quantum systems, motivating the development of a similar formalism that can be applied to the modelling of biological processes.

Modelling users' contextual querying behaviour for web image searching

The rapid growth of visual information on Web has led to immense interest in multimedia information retrieval (MIR). While advancement in MIR systems has achieved some success in specific domains, particularly the content-based approaches, general Web users still struggle to find the images they want. Despite the success in content-based object recognition or concept extraction, the major problem in current Web image searching remains in the querying process. Since most online users only express their needs in semantic terms or objects, systems that utilize visual features (e.g., color or texture) to search images create a semantic gap which hinders general users from fully expressing their needs. In addition, query-by-example (QBE) retrieval imposes extra obstacles for exploratory search because users may not always have the representative image at hand or in mind when starting a search (i.e. the page zero problem). As a result, the majority of current online image search engines (e.g., Google, Yahoo, and Flickr) still primarily use textual queries to search. The problem with query-based retrieval systems is that they only capture users’ information need in terms of formal queries;; the implicit and abstract parts of users’ information needs are inevitably overlooked. Hence, users often struggle to formulate queries that best represent their needs, and some compromises have to be made. Studies of Web search logs suggest that multimedia searches are more difficult than textual Web searches, and Web image searching is the most difficult compared to video or audio searches. Hence, online users need to put in more effort when searching multimedia contents, especially for image searches. Most interactions in Web image searching occur during query reformulation. While log analysis provides intriguing views on how the majority of users search, their search needs or motivations are ultimately neglected. User studies on image searching have attempted to understand users’ search contexts in terms of users’ background (e.g., knowledge, profession, motivation for search and task types) and the search outcomes (e.g., use of retrieved images, search performance). However, these studies typically focused on particular domains with a selective group of professional users. General users’ Web image searching contexts and behaviors are little understood although they represent the majority of online image searching activities nowadays. We argue that only by understanding Web image users’ contexts can the current Web search engines further improve their usefulness and provide more efficient searches. In order to understand users’ search contexts, a user study was conducted based on university students’ Web image searching in News, Travel, and commercial Product domains. The three search domains were deliberately chosen to reflect image users’ interests in people, time, event, location, and objects. We investigated participants’ Web image searching behavior, with the focus on query reformulation and search strategies. Participants’ search contexts such as their search background, motivation for search, and search outcomes were gathered by questionnaires. The searching activity was recorded with participants’ think aloud data for analyzing significant search patterns. The relationships between participants’ search contexts and corresponding search strategies were discovered by Grounded Theory approach. Our key findings include the following aspects: - Effects of users' interactive intents on query reformulation patterns and search strategies - Effects of task domain on task specificity and task difficulty, as well as on some specific searching behaviors - Effects of searching experience on result expansion strategies A contextual image searching model was constructed based on these findings. The model helped us understand Web image searching from user perspective, and introduced a context-aware searching paradigm for current retrieval systems. A query recommendation tool was also developed to demonstrate how users’ query reformulation contexts can potentially contribute to more efficient searching.

Emerging technologies and the contextual and contingent experiences of ageing well

Based on a series of interviews of Australians between the ages of 55 and 75 this paper explores the relations between our participants’ attitudes towards and use of communication, social and tangible technologies and three relevant themes from our data: staying active, friends and families, and cultural selves. While common across our participants’ experiences of ageing, these themes were notable for the diverse ways they were experienced and expressed within individual lives and for the different roles technology was used for within each. A brief discussion of how the diversity of our ageing population implicates the design of emerging technologies ends the paper.

Supporting context-aware process design : learnings from a design science study

Recent studies have started to explore context-awareness as a driver in the design of adaptable business processes. The emerging challenge of identifying and considering contextual drivers in the environment of a business process are well understood, however, typical methods and models for business process design do not yet consider this context. In this paper, we describe our work on the design of a method framework and appropriate models to enable a context-aware process design approach. We report on our ongoing work with an Australian insurance provider and describe the design science we employed to develop innovative and useful artifacts as part of a context-aware method framework. We discuss the utility of these artifacts in an application in the claims handling process at the case organization.

One night’s CPAP withdrawal in otherwise compliant OSA patients: marked driving impairment but good awareness of increased sleepiness

Purpose Obstructive sleep apnoea (OSA) patients effectively treated by and compliant with continuous positive air pressure (CPAP) occasionally miss a night’s treatment. The purpose of this study was to use a real car interactive driving simulator to assess the effects of such an occurrence on the next day’s driving, including the extent to which these drivers are aware of increased sleepiness. Methods Eleven long-term compliant CPAP-treated 50–75-year-old male OSA participants completed a 2-h afternoon, simulated, realistic monotonous drive in an instrumented car, twice, following one night: (1) normal sleep with CPAP and (2) nil CPAP. Drifting out of road lane (‘incidents’), subjective sleepiness every 200 s and continuous electroencephalogram (EEG) activities indicative of sleepiness and compensatory effort were monitored. Results Withdrawal of CPAP markedly increased sleep disturbance and led to significantly more incidents, a shorter ‘safe’ driving duration, increased alpha and theta EEG power and greater subjective sleepiness. However, increased EEG beta activity indicated that more compensatory effort was being applied. Importantly, under both conditions, there was a highly significant correlation between subjective and EEG measures of sleepiness, to the extent that participants were well aware of the effects of nil CPAP. Conclusions Patients should be aware that compliance with treatment every night is crucial for safe driving.

Investigating the factors influencing cyclist awareness and behaviour : an on-road study of cyclist situation awareness

Situation awareness, ones understanding of ‘what is going on’, is a critical commodity for road users. Although the concept has received much attention in the driving context, situation awareness in vulnerable road users, such as cyclists, remains unexplored. This paper presents the findings from an exploratory on-road study of cyclist situation awareness, the aim of which was to explore how cyclists develop situation awareness, what their situation awareness comprises, and what the causes of degraded cyclist situation awareness may be. Twenty participants cycled a pre-defined urban on-road study route. A range of data were collected, including verbal protocols, forward scene video and rear video, and a network analysis procedure was used to describe and assess cyclist situation awareness. The analysis produced a number of key findings regarding cyclist situation awareness, including the potential for cyclists’ awareness of other road users to be degraded due to additional situation awareness and decision making requirements that are placed on them in certain road situations. Strategies for improving cyclists’ situation awareness are discussed.

Lane filtering and situation awareness in motorcyclists : an on-road proof of concept study

In Victoria, as in other jurisdictions, there is very little research on the potential risks and benefits of lane filtering by motorcyclists, particularly from a road safety perspective. This on-road proof of concept study aimed to investigate whether and how lane filtering influences motorcycle rider situation awareness at intersections and to address factors that need to be considered for the design of a larger study in this area. Situation awareness refers to road users’ understanding of ‘what is going on’ around them and is a critical commodity for safe performance. Twenty-five experienced motorcyclists rode their own instrumented motorcycle around an urban test route in Melbourne whilst providing verbal protocols. Lane filtering occurred in 27% of 43 possible instances in which there were one or more vehicles in the traffic queue and the traffic lights were red on approach to the intersection. A network analysis procedure, based on the verbal protocols provided by motorcyclists, was used to identify differences in motorcyclist situation awareness between filtering and non-filtering events. Although similarities in situation awareness across filtering and nonfiltering motorcyclists were found, the analysis revealed some differences. For example, filtering motorcyclists placed more emphasis on the timing of the traffic light sequence and on their own actions when moving to the front of the traffic queue, whilst non-filtering motorcyclists paid greater attention to traffic moving through the intersection and approaching from behind. Based on the results of this study, the paper discusses some methodological and theoretical issues to be addressed in a larger study comparing situation awareness between filtering and non-filtering motorcyclists.

A methodology to develop an urban transport disadvantage framework : the case of Brisbane, Australia

Most individuals travel in order to participate in a network of activities which are important for attaining a good standard of living. Because such activities are commonly widely dispersed and not located locally, regular access to a vehicle is important to avoid exclusion. However, planning transport system provisions that can engage members of society in an acceptable degree of activity participation remains a great challenge. The main challenges in most cities of the world are due to significant population growth and rapid urbanisation which produces increased demand for transport. Keeping pace with these challenges in most urban areas is difficult due to the widening gap between supply and demand for transport systems which places the urban population at a transport disadvantage. The key element in mitigating the issue of urban transport disadvantage is to accurately identify the urban transport disadvantaged. Although wide-ranging variables and multi-dimensional methods have been used to identify this group, variables are commonly selected using ad-hoc techniques and unsound methods. This poses questions of whether the current variables used are accurately linked with urban transport disadvantage, and the effectiveness of the current policies. To fill these gaps, the research conducted for this thesis develops an operational urban transport disadvantage framework (UTDAF) based on key statistical urban transport disadvantage variables to accurately identify the urban transport disadvantaged. The thesis develops a methodology based on qualitative and quantitative statistical approaches to develop an urban transport disadvantage framework designed to accurately identify urban transport disadvantage. The reliability and the applicability of the methodology developed is the prime concern rather than the accuracy of the estimations. Relevant concepts that impact on urban transport disadvantage identification and measurement and a wide range of urban transport disadvantage variables were identified through a review of the existing literature. Based on the reviews, a conceptual urban transport disadvantage framework was developed based on the causal theory. Variables identified during the literature review were selected and consolidated based on the recommendations of international and local experts during the Delphi study. Following the literature review, the conceptual urban transport disadvantage framework was statistically assessed to identify key variables. Using the statistical outputs, the key variables were weighted and aggregated to form the UTDAF. Before the variable's weights were finalised, they were adjusted based on results of correlation analysis between elements forming the framework to improve the framework's accuracy. The UTDAF was then applied to three contextual conditions to determine the framework's effectiveness in identifying urban transport disadvantage. The development of the framework is likely to be a robust application measure for policy makers to justify infrastructure investments and to generate awareness about the issue of urban transport disadvantage.

Awesome foursome? The compatibility of situation awareness across drivers, riders, cyclists, and pedestrians

Collisions between distinct road users (e.g. drivers and motorcyclists) make a substantial contribution to the road trauma burden. Although evidence suggests distinct road users interpret the same road situations differently, it is not clear how road users’ situation awareness differs, nor is it clear which differences might lead to conflicts. This article presents the findings from an on-road study which examined driver, cyclist, motorcyclist and pedestrian situation awareness at intersections. The findings suggest that situation awareness at intersection is markedly different across the four road user groups studied, and that some of these differences may create conflicts between the different road users. The findings also suggest that the causes of the differences identified relate to road design and road user experience. In closing, the key role of road design and training in supporting safe interactions between distinct road users is discussed.

Waiting for warning: Driver Situation awareness at rural rail level crossings

Driver behaviour at rail level crossings represents a key area for further research. This paper describes an on-road study comparing novice and experienced driver situation awareness at rural rail level crossings. Participants provided verbal protocols while driving a pre-determined rural route incorporating ten rail level crossings. Driver situation awareness was assessed using a network analysis approach. The analysis revealed key differences between novice and experienced drivers' situation awareness. In particular, the novice drivers seemed to be more reliant on rail level crossing warnings and their situation awareness was less focussed on the environment outside of the rail level crossing. In closing, the implications for rail level crossing safety are discussed.