No / To investigate the cross-cultural validity of international Dutch-English comparisons when using the Dutch Rivermead Mobility Index (RMI), and the intra-test reliability and construct validity of the Dutch RMI. METHODS: Cross-cultural validity was studied in a combined data-set of Dutch and English patients undergoing rehabilitation after stroke, who were assessed with the Dutch version of the RMI and the original English RMI, respectively. Mokken scale analysis was used to investigate unidimensionality, monotone homogeneity model fit, and differential item functioning between the Dutch and the English RMI. Intra-test reliability and construct validity were studied in the Dutch patients by calculating the reliability coefficient and correlating the Dutch RMI and the Dutch Barthel Index. RESULTS: The RMI was completed for Dutch (n = 200) and English (n = 420) patients after stroke. The unidimensionality and monotone homogeneity model fit of the RMI were excellent: combined Dutch-English data-set (coefficient H = 0.91); Dutch data-set (coefficient H = 0.93); English data-set (coefficient H = 0.89). No differential item functioning was found between the Dutch and the English RMI. The intra-test reliability of the Dutch RMI was excellent (coefficient rho = 0.97). In a sub-sample of patients (n = 91), the Dutch RMI correlated strongly with the Dutch Barthel Index (Spearman's correlation coefficient rho = 0.84). CONCLUSION: The Dutch RMI allows valid international Dutch-English comparisons, and has excellent intra-test reliability and construct validity.

No / To test the hypothesis that the incidence of animal bites increases at the time of a full moon. Design: Retrospective observational analysis. Setting: Accident and emergency department at a general hospital in an English city. Subjects: 1621 consecutive patients, irrespective of age and sex. Main outcome measures: Number of patients who attended an accident and emergency department during 1997 to 1999 after being bitten by an animal. The number of bites in each day was compared with the lunar phase in each month. Results: The incidence of animal bites rose significantly at the time of a full moon. With the period of the full moon as the reference period, the incidence rate ratio of the bites for all other periods of the lunar cycle was significantly lower (P <0.001). Conclusions: The full moon is associated with a significant increase in animal bites to humans.

No / The College of Radiographers has called for ‘Red Dot’ schemes to evolve and has recommended the development of radiographer commenting. The implementation of a radiographer comment scheme assumes that radiographers previously participating in ‘red dot’ schemes have been accurately recognising radiographic abnormalities and are, therefore, able to comment upon, and describe, such radiographic appearances. Research evidence to support such an assumption is sparse. This study compares the ability of radiographers attending a short course on musculoskeletal trauma to ‘red dot’ and comment on A&E radiographic appearances. Methods: This study adopted a pre-test, post-test approach. One hundred and twenty one radiographers attending a short course on musculoskeletal trauma (Bradford Red Dot Course) were invited to undertake an assessment of their ability to recognise (‘red dot’) and describe (comment upon) radiographic abnormalities at the start and end of the short course. Results: One hundred and fifteen radiographers (n = 115/121; 95.0%) completed both the pre- and post-training assessments. Post-training mean scores per case improved on average by 9.8% [p = 0.012; 95% CI: 2.4, 17.1] for ‘red dots’ and 12.7% [p = 0.007; 95% CI: 3.8, 21.5] for commenting. However, the difference between mean ‘red dot’ and commenting scores remained similar with mean radiographer comment scores being 13.7% less than mean ‘red dot’ scores pre-training and 10.8% less post-training. Conclusions: The results of this study indicate that the accuracy of radiographer comments was significantly reduced when compared to the accuracy of ‘red dots’ for the same radiographic images. The clinical significance of these findings for departments wanting to move from a ‘red dot’ system to a radiographer commenting scheme is that without appropriate training and audit, the quality of service and assistance to the A&E department could be significantly reduced.

The United Kingdom (UK) construction industry is one of the worst industries in the UK in terms of health and safety (H&amp;S) performance. Numerous injuries, deaths, dangerous occurrences and work related illnesses are reported annually in the industry, and these are associated with huge economic and social costs which make the need for H&amp;S improvement inevitable. The pursuit of improvement has triggered studies into construction accident causation which have emphasised the need to pay attention to underlying accident causal factors which emanate from the pre-construction stage in order to have sustained improvement in H&amp;S. Construction project features (CPFs), such as nature of project, method of construction, site restriction, procurement method, project duration, level of construction, design complexity, and subcontracting, which are organisational, physical, and operational characteristics of projects emanating from pre-construction decisions fall in this category of underlying causal factors. However, despite the significance of underlying causal factors to H&amp;S, not much attention by way of research has been given to CPFs. As a result, insight into how CPFs influence accident occurrence, the degree of their inherent potential to influence accident occurrence (i.e. their potential to cause accident) and their associated degree of H&amp;S risk (i.e. the likelihood of accident occurrence due to CPFs) remain elusive in the extant construction H&amp;S literature. This research was thus undertaken to empirically investigate the mechanism by which CPFs influence accident occurrence and assess their degree of potential to influence accident occurrence and their associated H&amp;S risk. Adopting a mixed method approach, the accident causal influence of CPFs was investigated. Following a conceptualisation of how CPFs influence accident occurrence based on systems models of accident causation, a qualitative inquiry involving semi-structured interviews with experienced construction professionals was undertaken to provide empirical verification of the conceptualised view. Subsequent to the qualitative inquiry, a questionnaire survey was undertaken to elicit relevant data from experienced professionals in construction management roles to enable the assessment of the degree of potential of CPFs to influence accident occurrence and their associated H&amp;S risk. From the analysis of data, it was found that CPFs, emanating from pre-construction decisions, influence accident occurrence by their inherent introduction of certain associated H&amp;S issues (which can be termed as proximal accident factors) into the construction phase of projects to give rise to accidents. There are also causal interactions between CPFs and the proximal factors which can reduce or increase the presence of proximal factors. CPFs have varying degrees of potential to influence accident occurrence which can generally be high or moderate and is influenced by: the extent to which their proximal factor(s) is common (in other words prevalent) within them; and the degree of potential of the proximal factor(s) to influence accident occurrence. Where CPFs apply on a project, they are generally associated with medium risk or high risk. Whereas with medium-risk CPFs some risk control measures would suffice in mitigating risk, with high-risk CPFs substantial measures are required. As a consolidation of the research findings, a toolkit, called CRiMT, has been developed. CRiMT provides H&amp;S risk information regarding CPFs and it has the potential of assisting pre-construction project participants in managing the accident causal influence of CPFs from the early stage of project procurement. In view of the findings, the accident causal influence of CPFs should thus not be ignored or underestimated in construction project delivery. Pre-construction project participants, especially those whose decisions determine CPFs, ought to take into consideration the H&amp;S effects of CPFs when making decisions which determine CPFs. Also, pre-construction project participants ought to plan and implement commensurate risk control measures in the early stage of projects to eliminate or mitigate the H&amp;S risk posed by CPFs.

Traditional personality research on accident behavior has produced conflicting opinions as to the traits that describe the "accident-prone" personality type. Other research has shown that psychosocial life stress, while partially determining the temporal onset of a variety of illnesses, may also be a factor contributing to increased accident liability. This study examined the role of temporary and stress-producing life changes in groups of accident-free and accident-involved industrial employees. The accident sample was found to have significantly higher stress over baseline during the period of accident involvement, but generally lower pre-accident levels than the non-accident sample. A cause-effect analysis of the data from within the accident-involved sample proved inconclusive. Several implications for future research and managerial actions to alleviate stress were also discussed.

L’objet de cette thèse est de penser le corps à partir de l’expérience particulière qu’est l’accident.L’enjeu s’avère triple : i) élaborer un questionnement philosophique sur le corps en situation de handicap accidentel ; ii) replacer ce questionnement dans le champ des théories du handicap et des notions d’« identité » et de « reconstruction de soi » ; iii) traiter du corps en tant que suppor tidentitaire à la fois « naturel » et « construit » et envisager ainsi de manière renouvelée la question de la représentation et du rapport au corps. Cette approche conçoit le handicap non seulement à partir de ses conséquences mais aussi à partir de ses causes, et en particulier d’une cause possible : l’accident. Les questions fondamentales qui la sous-tendent sont les suivantes : qu’est qu’un accident ? Quel est le rapport entre la volonté, la responsabilité, et l’accident corporel ? Qu’est-ce qui rend le corps accidenté si insupportable ? L’impact des blessures sur le grand accidenté ouvre en effet un questionnement spécifique : Comment ce corps abîmé va-t-il être perçu et accepté par les autres et par l’individu lui-même ? Comment ce dernier va-t-il éprouver le passage d’un corps « valide » à un corps« handicapé », d’un corps « normal » à un corps « différent » ? Un individu peut-il concilier deux acceptions de son corps correspondant à un « avant » et à un « après » accident ? Comment vivre avec, dans, par un nouveau corps ? Pour traiter ces questions, ce travail philosophique mobilise les points de vue sociologique, anthropologique, éthique et médical sur le handicap accidentel. / The purpose of this thesis is to think about the body in light of the particular experience that is theaccident. The aim is threefold: i) to develop a philosophical inquiry on the accidentally disabled body;ii) to situate this inquiry with respect to theories of disability, of "identity", and of "selfreconstruction";iii) to treat the body as a medium of identity that is both "natural" and "constructed",and thus consider the question of the representation of the body from a new perspective. Thisapproach looks at disability not only from the point of view of its consequences, but also of its causes,and in particular of one possible cause: the accident. The fundamental questions in this investigationare the following: What is an accident? What is the relationship between the will, responsibility, andpersonal injury? What makes the injured body so unbearable? The impact of the damage on theseverely injured opens a specific line of questioning: How will the injured body be perceived andaccepted by others and by the individual itself? How will that person experience the transition from an"able" to a "disabled" body, from a "normal" body to a "different" body? Can a person reconcile thetwo senses of the body corresponding to a "before" and an "after" the accident? How to live with andin a new body? To address these issues, this philosophical work brings to bear views on accidentaldisability from sociology, anthropology, and medical ethics.

Plusieurs analyses ont tenté d’analyser l’accident de Fukushima Dai Ichi. Ces publications proposent surtout des mesures préventives et mobilisent des approches classiques de la sécurité nucléaire. Ainsi, l’aspect humain de la gestion de la crise en temps réel trouve peu de place.Les auditions par le Gouvernement de Yoshida, le directeur de la centrale, permettent de combler ce vide. Nous les considérons comme un récit de vie, dans lequel le directeur dépeint son vécu en situation extrême. Durant quatre jours, le collectif autour de lui fait face à des conditions d’intervention extrêmement entravées et avec des ressources très limitées. Malgré une menace de leur intégrité physique, psychologique et sociale, ils parviennent à surmonter la difficulté et à éviter le pire.Le concept de "coping" désigne justement les efforts effectués dans des situations stressantes. Ces efforts dépendent de la représentation que l’individu a de la situation. Dès lors, une approche qualitative du récit de Yoshida nous permet d’étudier les stratégies de coping mobilisées pendant l’accident et les différents facteurs qui les ont influencés. Nos résultats montrent que si ces stratégies sont actives au début de la crise, l’impossibilité d’agir et le tarissement des ressources rendent Yoshida passif et le plongent dans des considérations morbides. L’anticipation et l’élaboration de solutions alternatives laissent leur place à la résignation.D’autre part, hormis les explications techniques et opérationnelles, le directeur nous décrit dans son récit les conditions émotionnelles, cognitives et relationnelles de la gestion de l’accident. Il rend hommage à ses travailleurs qui sont décrits comme des héros méconnus. La construction du récit de vie lui permet de réhabiliter son collectif en se représentant comme membre d’un groupe ayant sauvé le Japon en prenant des risques inouïs, sans être soutenu.Les récits de vie nous donnent un accès aux événements tels qu’ils ont été vécus. Ils nous éclairent sur les ressorts qui permettent aux organisations de redéfinir leur action dans des situations à la fois dangereuses et urgentes. Ils remettent ainsi l’humain au centre des analyses des accidents. / The Fukushima Dai Ichi nuclear accident was analysed in many publications. These studies followed classical approaches and focused on drawing lessons to improve nuclear facilities’ preventive measures. Therefore, the human aspect of the crisis management is not addressed enough.The hearings of the plant’s superintendent Yoshida by the Government’s inquiry Committee may help us tackle this issue. We consider that the transcriptions of the hearings are a life narrative of superintendent Yoshida. This narrative depicts his experience throughout an extreme situation. During four days, the workers around him dealt with extremely harsh conditions and had very limited resources available. Despite the threat to their physical, psychological and social integrity, they managed to overcome the hardship and prevented the worse from happening.Coping is a notion that refers to the specific efforts carried out to adjust to stressful situations. These efforts depend on the representation the individual forms of the situation. A qualitative study of Yoshida’s narrative allows us then to understand coping strategies carried out and the individual and contextual factors that came into play. We found that coping strategies were active after the arrival of the tsunami, but with the scarcity of resources and the impossibility to intervene on the reactors, Yoshida became more passive and began having morbid thoughts. As the crisis unfolded, anticipation and elaboration of alternative solutions left room to resignation.The narrative provides us technical and operational explanations, but Yoshida also describes emotional, cognitive and relational aspects of the crisis management. He pays tribute to the workers depicted as unsung heroes. The construction of his life narrative allows him to rehabilitate his collective of workers that took incredible risks to save Japan with very little support.Life narratives provide us with events as they have been experienced. They highlight the mechanisms that help organisations redefine their action in dangerous and urgent situations. Life narratives help us put the human back at the centre of accidents analyses.

Ce travail repose sur des observations de terrain montrant que des salariés vont s’orienter ou non vers un arrêt de travail suite à un même type d’accident du travail de gravité mineure. De plus, les statistiques nationales décrivent une tendance à la baisse pour les accidents du travail mais l’absentéisme est en hausse (CNAM, 2016 ; Ayming-Kantar TNS, 2016). Ces données posent donc la question de la nature de la relation entre l’accident et l’arrêt de travail. L’objectif de cette thèse était d’explorer dans quelle mesure l’arrêt de travail serait expliqué par les états de stress et les stratégies de coping des salariés accidentés. En référence au modèle Self-Regulatory Executive Function – S-REF (Wells & Matthews, 1994), un objectif dans ce travail de thése est d'explorer dans quelle mesure les croyances métacognitives constitueraient des facteurs pouvant expliquer les états de stress, et leur gestion, après une période d'arrêt de travail. En référence à ce modèle, nous postulions alors que les salariés, en arrêt de travail, développeraient un syndrome cognitif attentionnel – CAS (Wells, 1995). Nous avons réalisé trois études testant trois hypothèses principales : 1) les salariés absents suite à un accident du travail présentent un profil métacognitif particulier impliquant des croyances métacognitives positives et négatives sur l’inquiétude, et activent préférentiellement des stratégies de coping émotionnelles ou d’évitement (étude 1) ; 2) les salariés absents suite à un accident du travail ont construit une représentation de l’accident du travail plus menaçante que les salariés qui ne se sont pas absentés (étude 2) ; 3) la probabilité de s'arrêter de travailler, dans les jours suivant l'accident, serait prédite par l'état affectif des salariés après l'accident (i.e., inquiétude, dissociation et détresse péritraumatiques) ainsi que par leurs stratégies de coping (étude 3). Nos résultats montrent que les salariés ayant vécu un accident du travail ne présentent pas de profil métacognitif différent selon qu’ils aient eu un arrêt de travail ou non (étude 1). Les stratégies de coping sont prédites par les croyances métacognitives ayant trait à l’inquiétude ; les stratégies de coping centrées sur le problème sont moins utilisées par les salariés ayant eu un arrêt de travail suite à leur accident du travail (étude 1). La représentation de l’accident du travail ne présente pas un caractére menaçant supérieur chez les salariés qui ont eu un arrêt de travail (étude 2). Enfin, les résultats de l’étude 3 montrent que la probabilité d’être en arrêt de travail suite à un accident du travail est uniquement prédite par une faible propension à l’usage des stratégies de coping centrées sur le problème. Nos principaux résultats indiquent que le stress ressenti par les victimes d’accident est influencé par les croyances métacognitives positives et négatives sur l’inquiétude (études 1 et 2). Nos travaux ne montrent pas de différence dans le profil métacognitif entre les salariés absents et non absents après un accident du travail. L’utilisation des stratégies de coping centrées sur le problème serait le principal corrélat (étude 1) et prédicteurs (étude 3) de l’absentéisme des salariés accidentés. L'ensemble de ces résultats plaide en faveur d'une approche de l'arrêt de travail appuyée sur la modélisation transactionnelle du stress, afin de mieux comprendre ce phénomène et proposer des méthodes de prise en charge innovantes des salariés ayant vécu un accident du travail. / This work is based on field observations showing that employees will or will not move to a work stoppage following the same type of work accident of minor gravity. In addition, national statistics describe a downward trend for work-related accidents, but absenteeism is on the rise (CNAM, 2016; Ayming-Kantar TNS, 2016). These data therefore pose the question of the nature of the relationship between the accident and the work stoppage. The aim of this thesis was to explore to what extent the work stoppage would be explained by stress states and coping strategies of injured employees. Referring to the Self-Regulatory Executive Function Model - S-REF (Wells & Matthews, 1994), one goal of this thesis work is to explore the extent to which metacognitive beliefs are factors that may explain stress states, and their management, after a period of work stoppage. In reference to this model, we postulated that employees who were off work would develop a Cognitive Attentional Syndrome - CAS (Wells, 1995). We conducted three studies testing three main hypotheses: 1) Employees who are absent following an occupational accident have a particular metacognitive profile implying positive and negative metacognitive beliefs about anxiety, and preferentially activate emotional coping or avoidance strategies (study 1); 2) Employees who were absent due to a work accident built a more threatening occupational accident representation than employees who did not miss (study 2); 3) The probability of stopping work in the days following the accident would be predicted by the affective state of the employees after the accident (i.e., worry, peritraumatic dissociation and distress) as well as by their coping strategies (study 3). Our results show that employees who have had an accident at work do not have a different metacognitive profile, depending on whether they have had a work stoppage or not (study 1). Coping strategies are predicted by metacognitive beliefs about worry; coping strategies centered on the problem are less used by employees who have had a work stoppage following their work accident (study 1). The representation of the industrial accident does not present a higher threat character for employees who have had a work stoppage (study 2). Finally, the results of study 3 show that the probability of being off work due to an accident at work is only predicted by a low propensity to use coping strategies centered on the problem. Our main findings indicate that the stress experienced by accident victims is influenced by positive and negative metacognitive beliefs about worry (studies 1 and 2). Our work shows no difference in the metacognitive profile between absent and absent employees after an accident at work. The use of coping strategies centered on the problem would be the main correlate (study 1) and predictor (study 3) of absenteeism of injured employees. All these results argue in favor of a work stoppage approach based on transactional stress model, in order to better understand this phenomenon and propose innovative methods of care for employees who have suffered an occupational accident.

Contrôles d’accès, profilage commercial, numérisation des dossiers médicaux, mais aussi capteurs de radioactivité, de polluants atmosphériques, etc. sont autant de dispositifs de surveillance qui se multiplient. Ils sont l’objet de fortes critiques, que ce soit pour en dénoncer les effets nocifs ou pour réclamer leur renforcement. Cette thèse contribue à expliquer ces gestes critiques différenciés qui participent à l’actualisation de nos sociétés de surveillance et du risque. Elle propose une analyse qui réinscrit les pratiques de surveillance dans leurs contextes organisationnels, sociaux et pratiques, à partir de deux dispositifs : la prévention des accidents (dite sécurité) et la prévention des actes de malveillance (dite sûreté) dans le milieu ferroviaire en France. La recherche montre qu’en dépit de l’éloignement des problèmes considérés, les professionnels devant surveiller sont confrontés à des enjeux pratiques similaires. La thèse éprouve ce résultat d’abord d’un point de vue historique, en montrant que les premiers gestionnaires ferroviaires du XIXe siècle ont géré ces deux problèmes à partir d’un même dispositif disciplinaire. Après une spécification de ces enjeux au XXe siècle, l’analyse sociologique des pratiques actuelles souligne ensuite un rapprochement des mondes professionnels de la sécurité et de la sûreté ferroviaires, autour de la « gestion du risque ». Dans les deux cas, l’une des activités principales des professionnels de la sécurité et de la sûreté est de se séparer de certaines données, collectées dans leurs pratiques de surveillance. À partir de ces résultats, la thèse se propose de renouveler pour partie l’analyse des pratiques de surveillance. L’attention que la plupart des travaux sur la surveillance portent aux processus d’accumulation des données masque de fait les processus d’omission, de mise à l’écart ou de destruction de données. La thèse plaide alors pour une attention aux deux processus, d’accumulation et de séparation, pour mieux comprendre et pouvoir renouveler la critique des pratiques de surveillance / The proliferation of surveillance devices such as access controls, customers profiling, medical records digitalization, as well as radioactivity or atmospheric sensors, have become the target of strong criticism. NGOs, professionals, and researchers have all denounced their harmful effects or called for them to be reinforced. This thesis seeks to explain these diverse and critical opinions that shape the actualization of the risk society and of the surveillance society. It offers an analysis that rewrites surveillance practices in their practical, social and organizational context from two perspectives: the prevention of both accidents (known as safety) and malicious acts (known as security) in the French railway system. This research demonstrates that despite the remoteness of the issues in question, monitoring professionals face similar practical challenges. This thesis tests this result from an historical point of view by demonstrating that the first rail administrator during 19th century dealt with these two problems using the same disciplinary measures. After much specification of these issues during 20th century, sociological analysis of current measures has highlighted a relation between railway safety and security focused on the notion of "risk management". In both case studies, one of the main activities of safety and security professionals is to dispose of data collected during their surveillance measures. Based on these results, the thesis offers to partly renew surveillance practices analysis. Most research within the field of surveillance studies focuses on the processes related to the collecting of data, their social and political impacts that overshadows the omission, exclusion and destruction of data. The thesis calls for more focus on both the process of collection and separation of data to better understand and renew the critical approach of the practices of surveillance

The aim of this research is to investigate characteristics of accident denominators across age groups in mining and associated process industries in the Port Hedland region of Western Australia. Emphasis has been focussed on comparing young, inexperienced groups with older, more experienced groups. A literature review revealed some key contributors to accidents among younger workers, in particular, those who had only recently entered the workforce. The review also revealed contributors impacting accidents regarding other age groups over a wide range of industry types. From these findings an accident construct model and questionnaire were designed to identify contributing and mitigating denominators which input to accidents occurring across the defined age groups.