Thesis (M.A.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / The use of emergency lights and sirens as warning devices by ambulances is a hotly debated topic within the Emergency Medical Services. For the last few decades, research has shown that lights and sirens have only a minimal effect on time required to transport patients to the hospital, and essentially no positive effect on patient outcome. Meanwhile, thousands of ambulance crashes occur every year (usually during the operation of lights and sirens), and its possible that's tens of thousands of crashes are occurring as a result of a passing ambulance, though not directly involving the ambulance itself. This paper is meant to provide a thorough review of the science behind the use of lights and sirens, the risks they pose to EMS providers, patients, and the public, and strategies to help curb the cost they pose both in dollars and lives. The available literature on this subject all points to the use of lights and sirens being out dated, ineffective, and dangerous, and yet almost nothing has been done to solve the problems they cause. Continued research and development is needed to help make ambulances safer for their occupants, more effective driver training programs need to be offered to EMS providers, and protocols need to be adopted to limit the unnecessary use of L&S. / 2031-01-01

蒋璐. / "2013年9月". / "2013 nian 9 yue". / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 171-180). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in Chinese and English. / Jiang Lu.

Each year in the United States over 1,000 fatalities occur as a result of collisions with utility poles. In addition, approximately 40% of utility pole crashes result in a non-fatal injury. Moreover, with over 88 million utility poles lining United States highways, it is not feasible to immediately remedy all poles that are potentially unsafe. Utility poles which pose a danger to motorists can, however, be identified and addressed over time in a structured, methodical manner. The goal of this project was to develop a method to identify and prioritize high risk utility poles that are good candidates for remediation as well as develop a standard operating procedure for the relocation of existing utility poles and placement of future utility poles along Massachusetts highways. This research found that the lateral offset, annual average daily traffic and density of the utility poles are major risk factors. Road geometry, however, also impacts the risk. Basic corrective measures such as delineation, placing poles as far from the edge of road as achievable, as well as placing poles a safe distance behind horizontal barriers are all suggested solutions.

Thesis (Ed.M.)--Boston University

The question of how an improved safety performance was achieved and what needs to be done to maintain such a performance is investigated. The is done using the example of a laboratory that turned from a bad and worsening safety performance to the best in the organisation. Aspects of transformational leadership, employee empowerment and incident reporting and investigation were examined as contributing factors. In a survey of the laboratory employees, an independent level of safety culture maturity was found, indicating a successful and complete cultural transformation. High levels of employee empowerment were found. Barriers to incident reporting are suggested. In order to maintain a high level of safety performance, the next higher level of safety culture maturity is suggested, together with other recommendations. Further research is suggested from having identified some key factors describing a group having achieved and seeking to maintain an exemplary safety performance. / Graduate School of Business Leadership / (M.B.A.)

Sustainable Building Design and Engineering is an integrated approach to energy, health, and operational performance. Abu Dhabi, the capital of United Arab Emirates (UAE) is experiencing a phenomenal growth in built environment. In this context, the Abu Dhabi Government has taken initiatives and measures to sustainable building designs development. This research aimed to develop a guideline for the application of performance- based fire-engineering design with sustainable building designs. In addition, it builds a referral information base helping to build sustainable communities, where fire- related fatalities and risks mitigated. Identifying fire safety and sustainability relation, and assessing technical and regulatory challenges with performance-based designs (PBD) in buildings are also part of this study. It also investigated current practices in sustainable building design and fire safety measures applied by Abu Dhabi Civil Defence (ADCD) under the existing construction legislations. The overall results of the study addressed three main areas, namely, sustainability, fire safety, and legality of the construction industry in Abu Dhabi. The data obtained from the case studies, the questionnaire and face-to-face interviews revealed a strong element of misunderstanding regarding the accurate definition of sustainable building design in Abu Dhabi especially among the stakeholders, including the enforcers. This is by pushing towards sustainable design concepts and technologies without taking into consideration the effects on fire safety level from one side and misunderstanding of the local conditions that shape a local definition for building sustainability in Abu Dhabi hot humid climate. Second, the results relating to fire safety measures in Abu Dhabi showed that some factors in the sector of fire safety seemed to affect the accurate application of Performance- Based Design (PBD). These factors were considered as technical and administrative challenges facing the application of PBD and its safety level. Third, the existing local construction legislation and regulations do not support the application of sustainable building design in innovative designs that implementing fire engineering approach. This includes the lack of legislation, disintegration of requirements between building regulators and absence of law enforcement on building owners. The overall findings of this study showed that the application of fire engineering in the innovative sustainable design under the existing construction legislations and culture could have some serious issues to overcome before achieving accepted safety level. In conclusion, there is a common perception that application of sustainable building design can increase fire safety risk. Innovative fire engineering applications compromises on sustainability and vice-versa. A number of similar studies in Abu Dhabi have shown reduction in fire safety on applying performance- based designs. These are challenging issues with the Governments and they are concerned with the local authorities. The building industries in Abu Dhabi need guidelines to find a trade-off between fire safety and sustainability with application of performance based designs.

Politicians and educators have debated the merits of arming U.S. school employees to counteract possible school shootings but have not reached a shared point of view. There are few academic studies that specifically explore arming educators in public school systems. Using the general theory of agenda setting, the purpose of this multiple case study was to explore the perceptions of teachers regarding arming of educators between two independent school systems and consider whether arming educators enhances safety measures. An exploratory design was used in which data from two sample populations were compared: faculty (n = 15) from a school district in Texas, which allows educators to be armed, and faculty (n = 36) from a school district located in Alabama, which does not allow educators to be armed. Data were collected via an online survey and then analyzed using descriptive statistics. Safety procedures at both schools were also examined to assess the impact of arming educators on schools and communities using inductive coding and thematic analysis. Findings indicate that participants were not opposed to being armed if adequate policies and training are put in place. Further, the participants generally indicated they currently perceive that they are safe but welcome additional safety measures to prevent serious incidents from occurring. Finally, findings suggest that arming educators does not violate the generally accepted best practice of 'run, hide, and fight' during critical incidents. Positive social change may be achieved through improvements to school safety in public school systems, and recommendations are made to school district administrators to engage in follow on research to determine appropriate policies and training requirements for educators in their respective districts.

Central line-associated bloodstream infection (CLABSI) has been widely studied because of its impact on patient morbidity, mortality, and overall health care costs. Research has shown that nurses' attitudes and perceptions regarding safety are critical to developing and maintaining clinical environments that are safe, prevent CLABSI, and assure better health outcomes. The practice-focused question for this project sought to determine the safety attitudes exhibited by registered nurses on a medical-surgical unit at the practice site. The Stetler model was used as a framework to guide the study. The Safety Attitude Questionnaire (SAQ) measured attitudes and perceptions regarding teamwork, safety, job satisfaction, management, stress recognition, and working conditions. Respondent understanding of CLABSI prevention was also measured. A nonrandomized purposeful sampling was used to invite nurses to participate in the study. A total of 61 nurses meeting inclusion criteria were invited to participate. Of those invited, 22 completed the survey, resulting in a 36% response rate. The survey consisted of a 36-item SAQ scale and a 5-item CLABSI prevention scale. The level of agreement on the 6 SAQ subscales ranged from a low of 3.3 to a high of 3.9 on a 5-point Likert scale. Perceptions regarding CLABSI prevention were notably higher at 4.26. When responses to specific questions were examined, low agreement was noted for (a) understanding who to direct questions to regarding patient safety, and (b) feeling the levels of staffing were adequate to care for the number of patients served. The number of years in nursing practice was associated with considerable variability in the 6 SAQ subscales. This project promotes positive social change by raising awareness of the safety culture associated with nursing care and for the prevention of CLABSI.

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