Objectives: Current study explores the potential of the safety rating scale in order to determine the surplus value for evidence based practise. This study wants to contribute to this knowledge gape by exploring the safety scale by analysing the change between two safety ratings. First, the absolute change in safety is investigated. Secondly the study explores to what extent family background characteristics and case management characteristics determine the extent of change in perceived safety. Materials and Methods: The study analysed 105 Dutch child protection cases who had registration files with filled out LIRIK checklist, Action Plan and additional baseline safety and end safety measure as perceived by case managers. Results: On average perceived safety increased from an insufficient level to sufficient level. Significant regression coefficients with larger changes for primary school children (6 - 12 years) and lower changes for children within the ‘socio economic problems cluster’. The results reveal significant vulnerability for preschool children and families attending the socio-economic cluster due to limited improvement. Conclusion: According to this study the safety measure can be of value to outcome monitoring. The safety measure is a practical measure that reflects on the current state of safety within a family according to professionals and can be used on several occasions during case management. In addition, on aggregated level pre and post measures can be analysed for quality management purpose. Further exploration of this measure is needed. Publishers article: https://www.ecronicon.com/ecpe/ECPE-10-00873.php
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Background: In postoperative pain treatment patients are asked to rate their pain experience on a single uni-dimensional pain scale. Such pain scores are also used as indicator to assess the quality of pain treatment. However, patients may differ in how they interpret the Numeric Rating Scale (NRS) score. Objectives: This study examines how patients assign a number to their currently experienced postoperative pain and which considerations influence this process. Methods: A qualitative approach according to grounded theory was used. Twenty-seven patients were interviewed one day after surgery. Results: Three main themes emerged that influenced the Numeric Rating Scale scores (0–10) that patients actually reported to professionals: score-related factors, intrapersonal factors, and the anticipated consequences of a given pain score. Anticipated consequences were analgesic administration—which could be desired or undesired—and possible judgements by professionals. We also propose a conceptual model for the relationship between factors that influence the pain rating process. Based on patients’ score-related and intrapersonal factors, a preliminary pain score was ‘‘internally’’ set. Before reporting the pain score to the healthcare professional, patients considered the anticipated consequences (i.e., expected judgements by professionals and anticipation of analgesic administration) of current Numeric Rating Scale scores. Conclusions: This study provides insight into the process of how patients translate their current postoperative pain into a numeric rating score. The proposed model may help professionals to understand the factors that influence a given Numeric Rating Scale score and suggest the most appropriate questions for clarification. In this way, patients and professionals may arrive at a shared understanding of the pain score, resulting in a tailored decision regarding the most appropriate treatment of current postoperative pain, particularly the dosing and timing of opioid administration.
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As part of their SMS, aviation service providers are required to develop and maintain the means to verify the safety performance of their organisation and to validate the effectiveness of safety risk controls. Furthermore, service providers must verify the safety performance of their organisation with reference to the safety performance indicators and safety performance targets of the SMS in support of their organisation’s safety objectives. However, SMEs lack sufficient data to set appropriate safety alerts and targets, or to monitor their performance, and no other objective criteria currently exist to measure the safety of their operations. The Aviation Academy of the Amsterdam University of Applied Sciences therefore took the initiative to develop alternative safety performance metrics. Based on a review of the scientific literature and a survey of existing safety metrics, we proposed several alternative safety metrics. After a review by industry and academia, we developed two alternative metrics into tools to help aviation organisations verify the safety performance of their organisations.The AVAV-SMS tool measures three areas within an organisation’s Safety Management System:• Institutionalisation (design and implementation along with time and internal/external process dependencies).• Capability (the extent to which managers have the capability to implement the SMS).• Effectiveness (the extent to which the SMS deliverables add value to the daily tasks of employees).The tool is scalable to the size and complexity of the organisation, which also makes it useful for small and medium-sized enterprises (SMEs). The AVAS-SCP tool also measures three areas in the organisation’s safety culture prerequisites to foster a positive safety culture:• Organisational plans (whether the company has designed/documented each of the safety cultureprerequisites).• Implementation (the extent to which the prerequisites are realised by the managers/supervisors acrossvarious organisational levels).• Perception (the degree to which frontline employees perceive the effects of managers’ actions relatedto safety culture).We field-tested these tools, demonstrating that they have adequate sensitivity to capture gaps between Work-as-Imagined (WaI) and Work-as-Done (WaD) across organisations. Both tools are therefore useful to organisations that want to self-assess their SMS and safety culture prerequisite levels and proceed to comparisons among various functions and levels and/or over time. Our field testing and observations during the turn-around processes of a regional airline confirm that significant differences exist between WaI and WaD. Although these differences may not automatically be detrimental to safety, gaining insight into them is clearly necessary to manage safety. We conceptually developed safety metrics based on the effectiveness of risk controls. However, these could not be fully field-tested within the scope of this research project. We recommend a continuation of research in this direction. We also explored safety metrics based on the scarcity of resources and system complexity. Again, more research is required here to determine whether these provide viable solutions.
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Phosphorus is an essential element for life, whether in the agricultural sector or in the chemical industry to make products such as flame retardants and batteries. Almost all the phosphorus we use are mined from phosphate rocks. Since Europe scarcely has any mine, we therefore depend on imported phosphate, which poses a risk of supply. To that effect, Europe has listed phosphate as one of its main critical raw materials. This creates a need for the search for alternative sources of phosphate such as wastewater, since most of the phosphate we use end up in our wastewater. Additionally, the direct discharge of wastewater with high concentration of phosphorus (typically > 50 ppb phosphorus) creates a range of environmental problems such as eutrophication . In this context, the Dutch start-up company, SusPhos, created a process to produce biobased flame retardants using phosphorus recovered from municipal wastewater. Flame retardants are often used in textiles, furniture, electronics, construction materials, to mention a few. They are important for safety reasons since they can help prevent or spread fires. Currently, almost all the phosphate flame retardants in the market are obtained from phosphate rocks, but SusPhos is changing this paradigm by being the first company to produce phosphate flame retardants from waste. The process developed by SusPhos to upcycle phosphate-rich streams to high-quality flame retardant can be considered to be in the TRL 5. The company seeks to move further to a TRL 7 via building and operating a demo-scale plant in 2021/2022. BioFlame proposes a collaboration between a SME (SusPhos), a ZZP (Willem Schipper Consultancy) and HBO institute group (Water Technology, NHL Stenden) to expand the available expertise and generate the necessary infrastructure to tackle this transition challenge.
