Current practice regarding risk assessment contemplates the severity and likelihood of risks and employs the use of matrices where these factors are classified and cross-referenced to evaluate risk levels. Depending on the adequacy and reliability of data, the likelihood is estimated with quantitative or qualitative methods; severity is estimated according to experience from past events. This standard technique for assessing risks has been negatively criticised regarding validity and reliability due to effects of cognitive biases and a deterministic view of the possible consequences of risks. Even more, because of the lack of standardisation in risk matrices, a benchmarking across systems and organisations is not feasible. Taking into account the limitations mentioned, as well as the fact that the classification of hazards/causal factors, risk event(s) and consequences always depend on the analyst's view, this study proposes the Safety Risk Avoidance Capability (SAREAC) metric for a defined system. This metric focus on the prevention of risk events and combines quantitative and qualitative parameters referred in the literature but not yet exploited. SAREAC consists of two parts: the influence of hazards and the remaining effects of hazards after implementing or designing controls. Each of the SAREAC parts is calculated through specific steps which they result in a normalized score that allows more reliable comparisons amongst systems or over time. Data from a published risk assessment case study were used to demonstrate the use of SAREAC.
QUESTION: In adults who experience nocturnal leg cramps, does stretching of the calf and hamstring muscles each day just before sleep reduce the frequency and severity of the cramps?DESIGN: A randomised trial with concealed allocation and intention-to-treat analysis.PARTICIPANTS: Eighty adults aged over 55 years with nocturnal leg cramps who were not being treated with quinine.INTERVENTION: The experimental group performed stretches of the calf and hamstring muscles nightly, immediately before going to sleep, for six weeks. The control group performed no specific stretching exercises. Both groups continued other usual activities.OUTCOME MEASURES: Participants recorded the frequency of nocturnal leg cramps in a daily diary. Participants also recorded the severity of the pain associated with nocturnal leg cramps on a 10-cm visual analogue scale. Adverse events were also recorded.RESULTS: All participants completed the study. At six weeks, the frequency of nocturnal leg cramps decreased significantly more in the experimental group, mean difference 1.2 cramps per night (95% CI 0.6 to 1.8). The severity of the nocturnal leg cramps had also decreased significantly more in the experimental group than in the control group, mean difference 1.3 cm (95% CI 0.9 to 1.7) on the 10-cm visual analogue scale.CONCLUSION: Nightly stretching before going to sleep reduces the frequency and severity of nocturnal leg cramps in older adults.
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Purpose: With fierce competition in capturing tourists, it is crucial that destinations be prepared to adapt and to refresh their event portfolio. The purpose of this paper is to look into the decision-making process that led to the development of a new festival in a middle-sized city, Tomar, in Portugal. Design/methodology/approach: This study analyses the creation process of the Knights Templar Festival, in Tomar, a new event focusing on the Templar history of the city. A retrospective outlook on the evolution of the event is given. Primary data were collected via quantitative survey analysis and semi-structured interviews. The theoretical scope is events and placemaking. Findings: The strengths and weaknesses of the region influenced the conception and setting up of this particular event. This awareness is important for cities in meeting the challenges and opportunities that event portfolio diversification calls for. Research limitations/implications: This paper helps us to understand the motives and challenges in establishing a new event in the city, through the analysis of a single case study of a European middle-sized city. Simultaneously, it is a longitudinal in-depth case of the first editions of a new historically focused event. Practical implications: Several practical implications can be derived to the case of Tomar. Overall, it is key that cities align the focus of new events with the city’s identity (as Tomar did). Originality/value: This paper presents an in-depth and longitudinal case study, from the moment of the creation of a new event to its fourth edition, mapping the decision-making process, highlighting the learning curve of the decision makers.
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