A literature review conducted as part of a research project named “Measuring Safety in Aviation – Developing Metrics for Safety Management Systems” revealed several challenges regarding the safety metrics used in aviation. One of the conclusions was that there is limited empirical evidence about the relationship between Safety Management System (SMS) processes and safety outcomes. In order to explore such a relationship, respective data from 7 European airlines was analyzed to explore whether there is a monotonic relation between safety outcome metrics and SMS processes, operational activity and demographic data widely used by the industry. Few, diverse, and occasionally contradictory associations were found, indicating that (1) there is a limited value of linear thinking followed by the industry, i.e., “the more you do with an SMS the higher the safety performance”, (2) the diversity in SMS implementation across companies renders the sole use of output metrics not sufficient for assessing the impact of SMS processes on safety levels, and (3) only flight hours seem as a valid denominator in safety performance indicators. At the next phase of the research project, we are going to explore what alternative metrics can reflect SMS/safety processes and safety performance in a more valid manner
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Background: This paper presents the findings of a pilot research survey which assessed the degree of balance between safety and productivity, and its relationship with awareness and communication of human factors and safety rules in the aircraft manufacturing environment.Methods: The study was carried out at two Australian aircraft manufacturing facilities where a Likertscale questionnaire was administered to a representative sample. The research instrument included topics relevant to the safety and human factors training provided to the target workforce. The answers were processed in overall, and against demographic characteristics of the sample population.Results: The workers were sufficiently aware of how human factors and safety rules influence their performance and acknowledged that supervisors had adequately communicated such topics. Safety and productivity seemed equally balanced across the sample. A preference for the former over the latter wasassociated with a higher awareness about human factors and safety rules, but not linked with safety communication. The size of the facility and the length and type of employment were occasionally correlated with responses to some communication and human factors topics and the equilibrium between productivity and safety.Conclusion: Although human factors training had been provided and sufficient bidirectional communication was present across the sample, it seems that quality and complexity factors might have influencedthe effects of those safety related practices on the safety-productivity balance for specific parts of the population studied. Customization of safety training and communication to specific characteristics of employees may be necessary to achieve the desired outcomes.
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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: The maternity care system in the Netherlands is well known for its support of community-based midwifery. However, regular midwifery practices typically do not offer caseload midwifery care – one-to-one continuity of care throughout pregnancy and birth. Because we know very little about the outcomes for women receiving caseload care in the Netherlands, we compared caseload care with regular midwife-led care, looking at maternal and perinatal outcomes, including antenatal and intrapartum referrals to secondary (i.e., obstetrician-led) care. Methods: We selected 657 women in caseload care and 1954 matched controls (women in regular midwife-led care) from all women registered in the Dutch Perinatal Registry (Perined) who gave birth in 2015. To be eligible for selection the women had to be in midwife-led antenatal care beyond 28 gestational weeks. Each woman in caseload care was matched with three women in regular midwife-led care, using parity, maternal age, background (Dutch or non-Dutch) and region. These two cohorts were compared for referral rates, mode of birth, and other maternal and perinatal outcomes. Results: In caseload midwifery care, 46.9% of women were referred to obstetrician-led care (24.2% antenatally and 22.8% in the intrapartum period). In the matched cohort, 65.7% were referred (37.4% antenatally and 28.3% in the intrapartum period). In caseload care, 84.0% experienced a spontaneous vaginal birth versus 77.0% in regular midwife-led care. These patterns were observed for both nulliparous and multiparous women. Women in caseload care had fewer inductions of labour (13.2% vs 21.0%), more homebirths (39.4% vs 16.1%) and less perineal damage (intact perineum: 41.3% vs 28.2%). The incidence of perinatal mortality and a low Apgar score was low in both groups. Conclusions: We found that when compared to regular midwife-led care, caseload midwifery care in the Netherlands is associated with a lower referral rate to obstetrician-led care – both antenatally and in the intrapartum period – and a higher spontaneous vaginal birth rate, with similar perinatal safety. The challenge is to include this model as part of the current effort to improve the quality of Dutch maternity care, making caseload care available and affordable for more women.
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The sense of safety and security of older people is a widely acknowledged action domain for policy and practice in age-friendly cities. Despite an extensive body of knowledge on the matter, the theory is fragmented, and a classification is lacking. Therefore, this study investigated how older people experience the sense of safety and security in an age-friendly city. A total of four focus group sessions were organised in The Hague comprising 38 older people. Based on the outcomes of the sessions, the sense of safety and security was classified into two main domains: a sense of safety and security impacted by intentional acts and negligence (for instance, burglary and violence), and a sense of safety and security impacted by non-intentional acts (for instance, incidents, making mistakes online). Both domains manifest into three separate contexts, namely the home environment, the outdoor environment and traffic and the digital environment. In the discussions with older people on these derived domains, ideas for potential improvements and priorities were also explored, which included access to information on what older people can do themselves to improve their sense of safety and security, the enforcement of rules, and continuous efforts to develop digital skills to improve safety online. Original article at MDPI; DOI: https://doi.org/10.3390/ijerph19073960
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The inefficiency of maintaining static and long-lasting safety zones in environments where actual risks are limited is likely to increase in the coming decades, as autonomous systems become more common and human workers fewer in numbers. Nevertheless, an uncompromising approach to safety remains paramount, requiring the introduction of novel methods that are simultaneously more flexible and capable of delivering the same level of protection against potentially hazardous situations. We present such a method to create dynamic safety zones, the boundaries of which can be redrawn in real-time, taking into account explicit positioning data when available and using conservative extrapolation from last known location when information is missing or unreliable. Simulation and statistical methods were used to investigate performance gains compared to static safety zones. The use of a more advanced probabilistic framework to further improve flexibility is also discussed, although its implementation would not offer the same level of protection and is currently not recommended.
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This essay explores the notion of resilience by providing a theoretical context and subsequently linking it to the management of safety and security. The distinct worlds of international security, industrial safety and public security have distinct risks as well as distinct ‘core purposes and integrities’ as understood by resilience scholars. In dealing with risks one could argue there are three broad approaches: cost-benefit analysis, precaution and resilience. In order to distinguish the more recent approach of resilience, the idea of adaptation will be contrasted to mitigation. First, a general outline is provided of what resilience implies as a way to survive and thrive in the face of adversity. After that, a translation of resilience for the management of safety and security is described. LinkedIn: https://www.linkedin.com/in/juul-gooren-phd-cpp-a1180622/
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Nurse managers play an important role in implementing patient safety practices in hospitals. However, the influence of their professional background on their clinical leadership behaviour remains unclear. Research has demonstrated that concepts of Bourdieu (dispositions of habitus, capital and field) help to describe this influence. It revealed various configurations of dispositions of the habitus in which a caring disposition plays a crucial role. Objectives: We explore how the caring disposition of nurse middle managers' habitus influences their clinical leadership behaviour in patient safety practices.
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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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Music interventions are used for stress reduction in a variety of settings because of the positive effects of music listening on both physiological arousal (e.g., heart rate, blood pressure, and hormonal levels) and psychological stress experiences (e.g., restlessness, anxiety, and nervousness). To summarize the growing body of empirical research, two multilevel meta-analyses of 104 RCTs, containing 327 effect sizes and 9,617 participants, were performed to assess the strength of the effects of music interventions on both physiological and psychological stress-related outcomes, and to test the potential moderators of the intervention effects. Results showed that music interventions had an overall significant effect on stress reduction in both physiological (d = .380) and psychological (d = .545) outcomes. Further, moderator analyses showed that the type of outcome assessment moderated the effects of music interventions on stress-related outcomes. Larger effects were found on heart rate (d = .456), compared to blood pressure (d = .343) and hormone levels (d = .349). Implications for stress-reducing music interventions are discussed.
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