-
Lakartidningen Aug 2023In a recently published thesis, we propose a cultural shift in the assessment of suicide as an incident of severe patient harm, from a focus on errors and an often...
In a recently published thesis, we propose a cultural shift in the assessment of suicide as an incident of severe patient harm, from a focus on errors and an often speculative avoidability, to healthcare's ability of risk management over time. Patient safety work needs to change in line with the development of knowledge in patient safety. This means a cultural change in the view of patient safety, with a clearer focus on healthcare's abilities in risk management and learning. Legislation and regulations regarding healthcare and the supervisory authority need to support this cultural change in assessment and investigations of patient harm. A shift from a focus on errors and deviations to quality and positive outcomes of care, proactive patient safety work, risk management, patient safety culture and management commitment is needed.
Topics: Humans; Patient Safety; Safety Management; Delivery of Health Care; Suicide
PubMed: 37548446
DOI: No ID Found -
Journal of Occupational Health Jan 2024This study sought to examine the association between psychosocial work factors and road traffic crashes (RTCs), and test the differences in psychosocial work factors...
OBJECTIVE
This study sought to examine the association between psychosocial work factors and road traffic crashes (RTCs), and test the differences in psychosocial work factors between minibus and long-bus drivers.
METHODS
This cross-sectional survey employed a convenient sampling method to collect data from 7315 long-distance minibus and long-bus drivers who operate between the Ghanaian cities, Accra and Tema and other parts of the country. The drivers answered a job content questionnaire, psychosocial safety climate scale (PSC-12), work-family conflict scale, and demographic questions on age, education, driving hours, and RTC history.
RESULTS
The correlational analysis showed a significant association between psychosocial work factors and RTCs for the previous 2 years. Hierarchical multiple linear regression found that supervisor support, skill discretion, decision autonomy, psychological demands, PSC, and work-family conflict significantly contributed to explaining RTC rates among the drivers. Also, significant differences were found between minibus and long-bus drivers in driving hours, occurrence of near misses, RTCs, and all psychosocial work factors explored in this study except work-family conflict.
CONCLUSIONS
Psychosocial work factors directly predict RTCs among minibus and long-bus drivers. Policymakers, driver unions, and owners and managers of bus transport businesses should prioritize integrating occupational health and safety into road transport activities. Furthermore, managers and bus owners should use bottom-up communication, provide access to support services and work-family balance initiatives, flexible work schedules, and a supportive work environment to improve road safety.
Topics: Humans; Accidents, Traffic; Automobile Driving; Cross-Sectional Studies; Ghana; Motor Vehicles
PubMed: 38332726
DOI: 10.1093/joccuh/uiad019 -
Journal of Safety Research Dec 2023Up to 38% of crashes between motor vehicles and cyclists involve overtaking and close passes, contributing to a fear of cycling for both current and potential riders....
INTRODUCTION
Up to 38% of crashes between motor vehicles and cyclists involve overtaking and close passes, contributing to a fear of cycling for both current and potential riders. Consequently, most research has focused on the cyclist's perceptions of risk in passing events; but the driver's perceptions may be more influential determinants of passing distances and thus, objective crash risk.
METHOD
In an online cross-sectional survey, participants viewed 24 video clips of naturalistic passing events (external view akin to being a following driver) on urban roads in Queensland, Australia and judged distance and safety for both the portrayed cyclist and the passing driver. The passing events were filmed at a low-speed site (40 km/h speed limit) and a high-speed site (70 km/h speed limit).
RESULTS
The 240 cyclist participants were more likely to rate the pass as unsafe for the portrayed cyclist than the 71 non-cyclist participants. Narrow passing distance, parked vehicles, oncoming vehicles, and higher motor vehicle speeds were significant predictors of rating the pass as unsafe for the portrayed cyclist and the passing driver. In addition, female participants were more likely to rate the pass as unsafe for the driver. Participant age, attitudes toward cyclists and frequency of passing cyclists did not significantly affect safety judgments.
DISCUSSION
Traffic and roadway characteristics largely underlie perceptions of safety for both the cyclist and the driver when passing, even after accounting for passing distance. External, objective factors are more important than attitudes toward cyclists.
PRACTICAL APPLICATIONS
Attempts to improve the subjective and objective safety of passing events may be more successful if their focus is on modifying traffic and roadway characteristics, rather than attempting to change drivers' attitudes toward cyclists. Limitations on motor-vehicle passing speed should be incorporated as part of safe bicycle passing laws.
Topics: Humans; Female; Accidents, Traffic; Automobile Driving; Cross-Sectional Studies; Motor Vehicles; Australia; Bicycling
PubMed: 38081726
DOI: 10.1016/j.jsr.2023.09.007 -
BMC Public Health Dec 2023As a part of the decontamination process after the Fukushima Daiichi Nuclear Power Plant accident of 2011, 1.32 million tonnes of tritium-containing water will be...
Thoughts, perceptions and concerns of coastal residents regarding the discharge of tritium-containing treated water from the Fukushima Daiichi Nuclear Power Plant into the Pacific Ocean.
BACKGROUND
As a part of the decontamination process after the Fukushima Daiichi Nuclear Power Plant accident of 2011, 1.32 million tonnes of tritium-containing water will be discharged from the power plant into the Pacific Ocean. Although radiobiological impacts of the treated water discharge on the public and the environment were reported to be minimal, Tomioka and Okuma locals expressed unease regarding the long-term recovery of their towns, which are economically dependent on the agricultural, fishery, and tourism sectors. This study presents thoughts, perceptions and concerns of Tomioka and Okuma locals regarding the discharge of FDNPP-treated water containing tritium into the Pacific Ocean to facilitate a more inclusive decision-making process that respects local stakeholder interests.
METHODS
Conducted from November to December 2022, surveys were mailed to current residents and evacuees aged 20 years or older registered with the town councils.
RESULTS
Out of 1268 included responses, 71.5% were from those > 65 years. 65.6% were unemployed, 76.2% routinely visited hospitals, and 85.5% did not live with children. 61% did not want to return to Okuma/Tomioka. Anxiety about radiation-related health effects (38.7%), consuming food produced in Okuma/Tomioka (48.0%) and genetic effects (45.3%) were low. >50% reported poor physical and mental health. 40% were acceptive, 31.4% were unsure, and 29.7% objected to the discharge plans. Multinomial regression analysis revealed that, compared to acceptive responders, those who objected were more likely to be female, unemployed, and have anxiety about radiation-related genetic effects and poor mental health. Unsure responders were similarly more likely to be female, anxious about radiation-related genetic effects and have poor mental health.
CONCLUSION
The poor mental health of the locals, connected to high levels of risk perception and anxiety about the loss of economic opportunities related to the discharge plans, must be addressed. The 30-year discharge process could handicap local industries and hamper post-disaster socioeconomic recovery due to the circulation of false rumours among consumers. These results highlight the need to actively involve residents in the towns' recovery process to address local concerns. The focus should be on the judicious combination of transparent science with the human aspect of recovery and narratives highlighting dialogues between local stakeholders and experts to enable the locals and the general public to make informed decisions about their protection and future.
Topics: Child; Humans; Tritium; Fukushima Nuclear Accident; Nuclear Power Plants; Pacific Ocean; Mental Health; Japan
PubMed: 38057746
DOI: 10.1186/s12889-023-17349-1 -
BMC Medical Research Methodology Oct 2023Determining risk factors of single-vehicle run-off-road (SV-ROR) crashes, as a significant number of all the single-vehicle crashes and all the fatalities, may provide...
BACKGROUND
Determining risk factors of single-vehicle run-off-road (SV-ROR) crashes, as a significant number of all the single-vehicle crashes and all the fatalities, may provide infrastructure for quicker and more effective safety measures to explore the influencing and moderating variables in SV-ROR. Therefore, this paper emphasizes utilizing a hybrid of regularization method and generalized path analysis for studying SV-ROR crashes to identify variables influencing their happening and severity.
METHODS
This cross-sectional study investigated 724 highway SV-ROR crashes from 2015 to 2016. To drive the key variables influencing SV-ROR crashes Ridge, Least Absolute Shrinkage and Selection Operator (Lasso), and Elastic net regularization methods were implemented. The goodness of fit of utilized methods in a testing sample was assessed using the deviance and deviance ratio. A hybrid of Lasso regression (LR) and generalized path analysis (gPath) was used to detect the cause and mediators of SV-ROR crashes.
RESULTS
Findings indicated that the final modified model fitted the data accurately with [Formula: see text]= 16.09, P < .001, [Formula: see text]/ degrees of freedom = 5.36 > 5, CFI = .94 > .9, TLI = .71 < .9, RMSEA = 1.00 > .08 (90% CI = (.06 to .15)). Also, the presence of passenger (odds ratio (OR) = 2.31, 95% CI = (1.73 to 3.06)), collision type (OR = 1.21, 95% CI = (1.07 to 1.37)), driver misconduct (OR = 1.54, 95% CI = (1.32 to 1.79)) and vehicle age (OR = 2.08, 95% CI = (1.77 to 2.46)) were significant cause of fatality outcome. The proposed causal model identified collision type and driver misconduct as mediators.
CONCLUSIONS
The proposed HLR-gPath model can be considered a useful theoretical structure to describe how the presence of passenger, collision type, driver misconduct, and vehicle age can both predict and mediate fatality among SV-ROR crashes. While notable progress has been made in implementing road safety measures, it is essential to emphasize that operative preventative measures still remain the most effective approach for reducing the burden of crashes, considering the critical components identified in this study.
Topics: Humans; Accidents, Traffic; Cross-Sectional Studies; Models, Theoretical; Risk Factors; Wounds and Injuries
PubMed: 37803251
DOI: 10.1186/s12874-023-02041-0 -
BMC Geriatrics Dec 2023Driving is a complex behavior that may be affected by early changes in the cognition of older individuals. Early changes in driving behavior may include driving more...
BACKGROUND
Driving is a complex behavior that may be affected by early changes in the cognition of older individuals. Early changes in driving behavior may include driving more slowly, making fewer and shorter trips, and errors related to inadequate anticipation of situations. Sensor systems installed in older drivers' vehicles may detect these changes and may generate early warnings of possible changes in cognition.
METHOD
A naturalistic longitudinal design is employed to obtain continuous information on driving behavior that will be compared with the results of extensive cognitive testing conducted every 3 months for 3 years. A driver facing camera, forward facing camera, and telematics unit are installed in the vehicle and data downloaded every 3 months when the cognitive tests are administered.
RESULTS
Data processing and analysis will proceed through a series of steps including data normalization, adding information on external factors (weather, traffic conditions), and identifying critical features (variables). Traditional prediction modeling results will be compared with Recurring Neural Network (RNN) approach to produce Driver Behavior Indices (DBIs), and algorithms to classify drivers within age, gender, ethnic group membership, and other potential group characteristics.
CONCLUSION
It is well established that individuals with progressive dementias are eventually unable to drive safely, yet many remain unaware of their cognitive decrements. Current screening and evaluation services can test only a small number of individuals with cognitive concerns, missing many who need to know if they require treatment. Given the increasing number of sensors being installed in passenger vehicles and pick-up trucks and their increasing acceptability, reconfigured in-vehicle sensing systems could provide widespread, low-cost early warnings of cognitive decline to the large number of older drivers on the road in the U.S. The proposed testing and evaluation of a readily and rapidly available, unobtrusive in-vehicle sensing system could provide the first step toward future widespread, low-cost early warnings of cognitive change for this large number of older drivers in the U.S. and elsewhere.
Topics: Humans; Aged; Automobile Driving; Cognition; Cognitive Dysfunction; Accidents, Traffic
PubMed: 38097931
DOI: 10.1186/s12877-023-04550-5 -
Accident; Analysis and Prevention Feb 2024Traffic law enforcement is a road safety measure whose effects on accidents or injuries is best described by means of a function rather than a point estimate. An...
Traffic law enforcement is a road safety measure whose effects on accidents or injuries is best described by means of a function rather than a point estimate. An informative function should comprise both increases and decreases in enforcement. Currently available accident modification functions cannot serve this need. A fruitful approach to developing accident modification functions covering both increases and decreases in enforcement is differences-in-differences estimates based on multivariate accident prediction models. The paper explains how to develop such estimates and illustrates them. The interpretation of the results of empirical studies can be informed by a game-theoretic model of the effects of enforcement, previously published in Accident Analysis and Prevention (Bjørnskau and Elvik 1992, 507-520).
Topics: Humans; Law Enforcement; Accidents, Traffic; Automobile Driving; Safety
PubMed: 38039713
DOI: 10.1016/j.aap.2023.107415 -
PloS One 2023The limitations of the tractor virtual test system are evident in various aspects, including model reuse, system expansion, offsite interconnection, and virtual reality...
The limitations of the tractor virtual test system are evident in various aspects, including model reuse, system expansion, offsite interconnection, and virtual reality verification. To address these challenges, a distributed virtual test system for tractors based on the high-level architecture (HLA) is proposed. Involve analyzing the hardware structure and the tractor virtual test system, constructing the system federation and its members, and designing the federated object model (FOM) and simulation object model (SOM) tables. The system integrates multi-domain commercial software and enables real-time virtual testing through TCP/IP interconnection of multiple machines. To evaluate the system's performance, a virtual test of the tractor's reversing clutch engagement performance is conducted. The system's simulation performance and data transmission delay are thoroughly tested and analyzed. The results indicate that when the system's data volume reaches 5000KB, the data delay is 9.7ms, which satisfies the requirement of not exceeding 10ms for tractor virtual testing delay. The virtual test of the reversing clutch power reversal process demonstrates that it lasts 0.7s, with the vehicle speed changing from -3.5km/h to 3.5km/h, the forward gear piston oil pressure increasing from 0MPa to 5MPa, and the peak impact degree reaching 17m/s3. The slip work during the reversing process is measured to be 21kJ. Furthermore, the gray correlation method is employed to compare the virtual test results with the bench test results, confirming their consistency. The power reversal process exhibits relatively smooth speed changes overall. Therefore, the tractor power shift transmission (PST) reversing clutch virtual test model operates effectively within the HLA-based tractor virtual test system.
Topics: Accidents, Occupational; Agriculture; User-Computer Interface; Technology; Software
PubMed: 37871104
DOI: 10.1371/journal.pone.0293229 -
Journal of Environmental Management Oct 2023Land managers around the world are increasingly under pressure to demonstrate that the actions being used to moderate wildfire risk are effective and cost-efficient....
Land managers around the world are increasingly under pressure to demonstrate that the actions being used to moderate wildfire risk are effective and cost-efficient. However, little research to date has focused on determining cost-efficiency of management actions or identified the factors which increase the costs of performing such actions. Here, we aimed to identify the key drivers of cost for fuel management (prescribed burning, mulching, and slashing), fuel breaks, and suppression using data from the state of Victoria, Australia. We utilise generalised additive models to understand how environmental factors, terrain, location, and management decisions influence the cost of implementing wildfire management efforts. These models show that cost per unit declines as the area treated or the area of the fire increases for all four management approaches. Therefore, preventative, and responsive management actions represent economies of scale that reduce in cost with larger treatments. We also found that there were regional differences in the cost of fuel management and fuel breaks, potentially related to the structure of resourcing treatments in each region and the availability of land on which it is feasible to implement management. Cost of suppression per fire increased with the number of fire fighters and when there were more fires occurring concurrently in the landscape. Identifying the key drivers of cost for preventative and responsive management actions could enable managers to allocate resources to these actions more efficiently in future. Understanding drivers of cost-efficiency could be critical for adapting management to shifts in wildfire risk, particularly given climate change will alter the window in which it is safe to apply some preventative fuel management actions and reduce suppression effectiveness.
Topics: Wildfires; Victoria; Fires; Climate Change; Accidents; Forests
PubMed: 37454453
DOI: 10.1016/j.jenvman.2023.118606 -
BMJ Open Nov 2023Bangladesh is currently undergoing an epidemic of road traffic crashes (RTCs). In addition to morbidity and mortality, the economic loss from RTC as per cent of gross...
OBJECTIVE
Bangladesh is currently undergoing an epidemic of road traffic crashes (RTCs). In addition to morbidity and mortality, the economic loss from RTC as per cent of gross domestic product is comparatively higher than in countries with similar socioeconomic conditions. However, trauma care remained poorly developed as a specialty and service delivery mechanism. This study aimed to examine the current situation of in-hospital trauma care after RTCs to inform the design of a comprehensive service for Bangladesh.
DESIGN, SETTING AND PARTICIPANTS
This qualitative study attempted to elicit stakeholders' perceptions and experiences of managing RTCs through in-depth interviews and focus group discussions. Three districts and Dhaka city were selected based on the frequency of occurrence of RTCs. Fifteen in-depth interviews and 5 focus group discussions were conducted with 38 RTC patients, their relatives and community members in the catchment areas of 11 facilities managing trauma patients. Key informant interviews were conducted with 21 service providers and 17 key stakeholders/policy-makers.
RESULTS
Hospital-based trauma care was generally poor in primary and secondary-level facilities. There was no triage area or triage protocol in the emergency rooms, no trained staff for trauma care, no dedicated RTC patient register and scarce life-saving equipment. Only in Dhaka-based tertiary hospitals was trauma care prioritised. These hospitals follow Advanced Trauma Life Support guidelines and maintain an RTC logbook. Emergency diagnostic services were not always available in the hospitals. Most RTC patients were males; the female participants were additionally vulnerable to physical and mental trauma. Affected people avoided taking legal action considering it a lengthy, complicated and ultimately ineffective process.
CONCLUSION
The trauma care services currently available in the studied health facilities are very rudimentary and without the necessary human and financial resources. This needs urgent attention from policymakers, programmers and practitioners to reduce morbidity and mortality from the current epidemic of RTCs in Bangladesh.
Topics: Male; Humans; Female; Bangladesh; Emergency Service, Hospital; Emergency Medical Services; Hospitals; Health Facilities; Accidents, Traffic
PubMed: 37968010
DOI: 10.1136/bmjopen-2023-072850