Market competition and global financial uncertainty have been the principal drivers that impel aviation companies to proceed to budget cuts, including decreases in salary and work force levels, in order to ensure viability and sustainability. Under the concepts of Maslow and Herzberg’s motivation theories, the current paper unfolds the influence of employment cost fluctuations on an aviation organization’s accidents attributed to human error. This study exploited financial and accident data over a period of 13 years, and explored if rates of accidents attributed to human errors of flight, maintenance and ramp crews, correlate with the average employment expenditures (N=13). In addition, the study took into account the relationship between average task load (ratio of flying hours per employee) and accident rates related to human error since task load, as part of total workload, is a constraint of modern complex systems. The results revealed strong correlations amongst accident rates linked to human error with the average employment costs and task load. The use of more specific data per aviation organizational department and professional group may further validate the results of this study. Organizations that seek to explore the 2 association between human error and employment budget and task load might appropriately adapt the approach proposed.
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The aim of this study was to investigate if physiotherapists had knowledge and skills in applying Bobath-based therapy (BB), also referred to as Neurodevelopmental Treatment, in the care of stroke patients and if they generally used the therapy in daily practice. This is because of the important emphasis placed on documenting the extent of the therapy given to the client groups compared in outcome studies measuring the efficacy of therapeutic interventions. The study took place as an intervention check for a large outcome study measuring the effects of BB therapy. BB therapy had been implemented on six wards, whereas six other wards did not use this approach. The physiotherapists (n /38) knowledge and skills in making decisions about applying the BB principles in all wards was measured in two steps. In step 1, the physiotherapists received a questionnaire focusing on their physiotherapy strategy, and Bobath education. In step 2, they received a case vignette describing a stroke patient and questions concerning the content of the physiotherapy provided to this patient. An expert panel judged the therapists responses to the questions of both steps. Of the physiotherapists working in the BB wards, 14 (74%) therapists generally used BB principles, whereas four (21%) therapists did not (one was uncertain). Of the physiotherapists working in the non-BB wards (n /19), three (16%) did use BB therapy whereas 10 (52%) therapists did not use the therapy (six responses were missing). The study showed that within the BB wards, the physiotherapists had followed sufficient BB education, as judged by a panel of experts, and demonstrated the knowledge and skills in applying the BB therapy, whereas in the other wards they did not. BB wards could therefore participate in the experimental group of the study measuring the effects of the Bobath therapy, and the non-BB wards could serve as proper control wards.
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Introduction: From the patient and staff perspective, care delivery for patients experiencing a mental health problem in ambulance and emergency department (ED) settings is challenging. There is no uniform and internationally accepted concept to reflect people with a mental health problem who require emergency care, be it for, or as a result of, a mental health or physical health problem. On initial presentation to the emergency service provider (ambulance or ED), the cause of their healthcare condition/s (mental health and/or physical health) is often initially unknown. Due to this (1) the prevalence and range of underlying causes (mental and/or physical) of the patients presenting condition is unknown; (2) misattribution of physical symptoms to a mental health problem can occur and (3) diagnosis and treatment of the initial somatic complaint and cause(s) of the mental/physical health problem may be hindered.This study will name and define a new concept: 'mental dysregulation' in the context of ambulance and ED settings. Methods and analysis: A Delphi study, informed by a rapid literature review, will be undertaken. For the literature review, a steering group (ie, persons with lived experience, ED and mental health clinicians, academics) will systematically search the literature to provide a working definition of the concept: mental dysregulation. Based on this review, statements will be generated regarding (1) the definition of the concept; (2) possible causes of mental dysregulation and (3) observable behaviours associated with mental dysregulation. These statements will be rated in three Delphi rounds to achieve consensus by an international expert panel (comprising persons with lived experience, clinicians and academics). Ethics and dissemination: This study has been approved by the Medical Ethical Committee of the University of Applied Sciences Utrecht (reference number: 258-000-2023_Geurt van der Glind). Results will be disseminated via peer-reviewed journal publication(s), scientific conference(s) and to key stakeholders.
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Various tools for safety performance measurement have been introduced in order to fulfil the need for safety monitoring in organisations, which is tightly related to their overall performance and achievement of their business goals. Such tools include accident rates, benchmarking, safety culture and climate assessments, cost-effectiveness studies, etc. The current work reviews the most representative methods for safety performance evaluation that have been suggested and applied by a variety of organisations, safety authorities and agencies. This paper discusses several viewpoints of the applicability, feasibility and appropriateness of such tools, based on the viewpoints of managers and safety experts involved in a relevant research that was conducted in a large aviation organisation. The extensive literature cited, the discussion topics, along with the conclusions and recommendations derived, might be considered by any organisation that seeks a realistic safety performance assessment and establishment of effective measurement tools.
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In this paper we present a review of existing aviation safety metrics and we lay the foundation for our four-years research project entitled “Measuring Safety in Aviation – Developing Metrics for Safety Management Systems”. We reviewed state-of-the-art literature, relevant standards and regulations, and industry practice. We identified that the long-established view on safety as absence of losses has limited the measurement of safety performance to indicators of adverse events (e.g., accident and incident rates). However, taking into account the sparsity of incidents and accidents compared to the amount of aviation operations, and the recent shift from compliance to performance based approach to safety management, the exclusive use of outcomes metrics does not suffice to further improve safety and establish a proactive monitoring of safety performance. Although the academia and aviation industry have recognized the need to use activity indicators for evaluating how safety management processes perform, and various process metrics have been developed, those have not yet become part of safety performance assessment. This is partly attributed to the lack of empirical evidence about the relation between safety proxies and safety outcomes, and the diversity of safety models used to depict safety management processes (i.e. root-cause, epidemiological or systemic models). This, in turn, has resulted to the development of many safety process metrics, which, however, have not been thoroughly tested against the quality criteria referred in literature, such as validity, reliability and practicality.
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ICT in intelligente voertuigen levert innovatieve systemen op. Deze innovatieve systemen richten zich op maatschappelijke knelpunten (verkeersveiligheid, milieubelasting en congestie) en consumenten waarde. Recent wordt meer nadruk gelegd op maatschappelijke knelpunten. Vijf (5) a tien (10) jaar geleden werd de nadruk gelegd op het creëren van consumenten waarde. Deze innovatieve systemen moeten wel geaccepteerd worden door de eindgebruikers. Er is nog maar beperkt onderzoek gedaan naar acceptatie van veiligheidssystemen in intelligente voertuigen. Uit literatuuronderzoek komt naar voren dat verschillende vormen van acceptatie gehanteerd worden. Tevens blijkt dat veel onderzoekers spreken over acceptatie maar de acceptatie niet (kunnen) meten. Om inzicht te krijgen in het gedrag en beleving van bestuurders wordt in dit onderzoek voorgesteld om de evolutie van de cruise control (CC) naar adaptive cruise control (ACC) en naar cooperative adaptive cruise control (C-ACC) te gebruiken om acceptatie te voorspellen en te beoordelen. Er zijn bijzonder veel acceptatiemodellen en theorieën. Deze worden in de praktijk veelvuldig gebruikt binnen de Informatie en Communicatie Technologie (ICT). In deze paper wordt een route uitgezet voor het opzetten van een onderzoek waarbij gebruik gemaakt wordt van het UTAUT-acceptatiemodel. Dit onderzoek moet uitwijzen welke criteria de acceptatie beïnvloeden.
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Indecent exposure is often regarded as a nuisance offense and detailed studies into this topic are relatively rare. However, there is consensus that relatively high recidivism rates and risk of escalation to more severe offenses can be of serious concern among these perpetrators. This cohort study aims to increase our general knowledge on the basic characteristics of these offenses and includes all registered police cases of indecent exposure in the Netherlands between 2012 and 2020, including 6741 incidents, involving 4663 suspects and 3808 registered victims. This first study of a large cohort over a long period of time describes the basic characteristics of these incidents, the perpetrators and their victims, and visualizes the results to explore trends over time. Results show that a modal indecent exposure incident is perpetrated by a 25-year-old male, on foot, on a public road, on a Wednesday afternoon in July, masturbating and directing his genitals intentionally toward a 13-year-old girl. The age distribution of victims shows remarkable similarity to victims of sexual assault. Compared to the first year of the period studied, the number of annually reported incidents gradually declined to half in the last year of the study. Findings are discussed in light of the most prominent theories on exhibitionism. Issues and suggestions relevant to apprehension and treatment of perpetrators are identified and discussed.
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In order to achieve a level of community involvement and physical independence, being able to walk is the primary aim of many stroke survivors. It is therefore one of the most important goals during rehabilitation. Falls are common in all stages after stroke. Reported fall rates in the chronic stage after stroke range from 43 to 70% during one year follow up. Moreover, stroke survivors are more likely to become repeated fallers as compared to healthy older adults. Considering the devastating effects of falls in stroke survivors, adequate fall risk assessment is of paramount importance, as it is a first step in targeted fall prevention. As the majority of all falls occur during dynamic activities such as walking, fall risk could be assessed using gait analysis. It is only recent that technology enables us to monitor gait over several consecutive days, thereby allowing us to assess quality of gait in daily life. This thesis studies a variety of gait assessments with respect to their ability to assess fall risk in ambulatory chronic stroke survivors, and explores whether stroke survivors can improve their gait stability through PBT.
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Background: Neurodevelopmental treatment (NDT) is a rehabilitation approach increasingly used in the care of stroke patients, although no evidence has been provided for its efficacy. Objective: To investigate the effects of NDT on the functional status and quality of life (QoL) of patients with stroke during one year after stroke onset. Methods: 324 consecutive patients with stroke from 12 Dutch hospitals were included in a prospective, non-randomised, parallel group study. In the experimental group (n = 223), nurses and physiotherapists from six neurological wards used the NDT approach, while conventional treatment was used in six control wards (n = 101). Functional status was assessed by the Barthel index. Primary outcome was poor outcome, defined as Barthel index ,12 or death after one year. QoL was assessed with the 30 item version of the sickness impact profile (SA-SIP30) and the visual analogue scale. Results: At 12 months, 59 patients (27%) in the NDT group and 24 (24%) in the non-NDT group had poor outcome (corresponding adjusted odds ratio = 1.7 (95% confidence interval, 0.8 to 3.5)). At discharge the adjusted odds ratio was 0.8 (0.4 to 1.5) and after six months it was 1.6 (0.8 to 3.2). Adjusted mean differences in the two QoL measures showed no significant differences between the study groups at six or 12 months after stroke onset. Conclusions: The NDT approach was not found effective in the care of stroke patients in the hospital setting. Health care professionals need to reconsider the use of this approach.
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The transition from adolescence to adulthood also has been described as a window of opportunity or vulnerability when developmental and contextual changes converge to support positive turnarounds and redirections (Masten, Long, Kuo, McCormick, & Desjardins, 2009; Masten, Obradović, & Burt, 2006). The transition years also are a criminological crossroads, as major changes in criminal careers often occur at these ages as well. For some who began their criminal careers during adolescence, offending continues and escalates; for others involvement in crime wanes; and yet others only begin serious involvement in crime at these ages. There are distinctive patterns of offending that emerge during the transition from adolescence to adulthood. One shows a rise of offending in adolescence and the persistence of high crime rates into adulthood; a second reflects the overall age-crime curve pattern of increasing offending in adolescence followed by decreases during the transition years; and the third group shows a late onset of offending relative to the age-crime curve. Developmental theories of offending ought to be able to explain these markedly different trajectories
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