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Yes / To summarize studies that have examined patient safety culture (PSC) in maternity units and describe the different purposes, study designs and tools reported in these studies, whilst highlighting gaps in the literature. Methodology: Peer-reviewed studies published in English during 1961-2016 across eight electronic databases were subjected to a narrative literature review. Findings: Among 100 articles considered, 28 met the inclusion criteria. The main purposes for studying PSC were: (a) assessing intervention effects on PSC (n= 17); and (b) assessing PSC level (n=7). Patient safety culture was mostly assessed quantitatively using validated questionnaires (n=23). The Safety Attitude Questionnaire was the most commonly used questionnaire (n=17). Intervention varied from a single action lasting five weeks to a more comprehensive package lasting more than four years. The time between the baseline and the follow-up assessment varied from six months up to 24 months. No study reported measurement or intervention costs, and none incorporated the patient’s voice in assessing PSC. Practical Implications: Assessing PSC in maternity units is feasible using validated questionnaires. Interventions to enhance PSC have not been rigorously evaluated. Future studies should report PSC measurement costs, adopt more rigorous evaluation designs, and find ways to incorporate the patient’s voice. Originality/Value: This review summarized studies examining PSC in a highly important area and highlighted main limitations that future studies should consider.

Yes / A recent initiative in hospital settings is the patient safety huddle (PSH): a brief multidisciplinary meeting held to highlight patient safety issues and actions to mitigate identified risks. The authors studied eight ward teams that had sustained PSHs for over 2 years in order to identify key contributory factors. Methods: Unannounced observations of the PSH on eight acute wards in one UK hospital were undertaken. Interviews and focus groups were also conducted. These were recorded and transcribed for framework analysis. Findings: A range of factors contributes to the sustainability of the PSH including a high degree of belief and consensus in purpose, adaptability, determination, multidisciplinary team involvement, a non-judgemental space, committed leadership and consistent reward and celebration. Conclusion: The huddles studied have developed and been shaped over time through a process of trial and error, and persistence. Overall this study offers insights into the factors that contribute to this sustainability.

Road departure crashes are among the deadliest crash modes in the U.S. each year. In response, automakers have been developing lane departure active safety systems to alert drivers to impending departures. These lane departure warning (LDW) and lane departure prevention (LDP) systems have great potential to reduce the frequency and mitigate the severity of serious lane and road departure crashes. The objective of this thesis was to characterize lane and road departures to better understand the effect of systems such as LDW and LDP on single vehicle road departure crashes. The research includes the following: 1) a characterization of lane departures through analysis of normal lane keeping behavior, 2) a characterization of road departure crashes through the development and validation of a real-world crash database of road departures (NCHRP 17-43 Lite), and 3) develop enhancements to the Virginia Tech LDW U.S. fleetwide benefits model. Normal lane keeping behavior was found to vary with road characteristics such as lane width and road curvature. Consideration of the dynamic driving behaviors observed in the naturalistic driving study (NDS) data is important to avoid LDW false alarms and driver annoyance. Departure characteristics computed in normal driving were much less severe than the departure parameters measured in real-world road departure crashes. The real-world crash data collected in NCHRP 17-43 Lite database was essential in developing enhancements to the existing Virginia Tech LDW fleetwide benefits model. Replacement of regression model predictions with measured crash data and improvement of the injury criteria resulted in an 11-16% effectiveness for road departure crashes, and an 11-15% reduction in seriously injured drivers. / Master of Science / Road departure crashes account for nearly one-third of the roughly 30,000 automobile traffic fatalities in the U.S. each year. Lane departure warning (LDW) and lane departure prevention (LDP) systems are two safety systems developed to reduce the large number of fatalities resulting from road departures. The safety systems warn drivers if the vehicle begins to drift out of the intended lane of travel, and automatically steer the vehicle back into the lane of travel if it continues to drift. While LDW and LDP systems have potential to lower the number of fatal lane and road departure crashes, the technology is not yet a standard feature in production vehicles. There has been a lower than expected acceptance rate, and real-world benefits of the systems have not been published. The research objective for this thesis was to characterize lane and road departures to investigate the effect of these safety systems on road departure crashes. The first section of this thesis analyzed large amounts of time series data recorded from people in normal driving scenarios to model lane keeping behavior in non-crash, drift out of lane departures. We found driving behavior varied with road characteristics such as lane width and road curvature. These dynamic driving behaviors may lead to LDW false alarms and contribute to driver annoyance with the systems. The second portion of this research involved the development and validation of a real-world road departure crash database. The database included key departure parameters such as angle, speed, and road curvature. These parameters were used in the third section of the thesis to enhance the Virginia Tech LDW U.S. fleetwide benefits model, which is a mathematical trajectory simulation model that determines whether or not these road departure crashes could have been prevented if every vehicle in the U.S. was equipped with LDW. We found an effectiveness of 11-16% prevention for road departure crashes, and an 11-15% reduction in serious driver injury.

<p> The lack of adequate equipment and measurement tools in whole-body vibration has imposed significant constraints on what can be measured and what can be investigated in the field. Most current studies are limited to single direction measurements while focusing on simple postures. Besides the limitation in measurement, most of the current biomechanical measures, such as the seat-to-head transmissibility, have discrepancies in the way they are calculated across different labs. Additionally, this field lacks an important measure to quantify the subjective discomfort of individuals, especially when sitting with different postures or in multiple-axis vibration. </p><p> This work begins by explaining discrepancies in measurement techniques and uses accelerometers and motion capture to provide the basis for more accurate measurement during single- and three-dimensional human vibration responses. Building on this concept, a new data collection method is introduced using inertial sensors to measure the human response in whole-body vibration. The results indicate that measurement errors are considerably reduced by utilizing the proposed methods and that accurate measurements can be gathered in multiple-axis vibration. </p><p> Next, a biomechanically driven predictive model was developed to evaluate human discomfort during single-axis sinusoidal vibration. The results indicate that the peak discomfort can be captured with the predictive model during multiple seated postures. The predictive model was then modified to examine human discomfort to whole-body vibration on a larger scale with random vibrations, multiple postures, and multiple vibration directions. The results demonstrate that the predictive measure can capture human discomfort in random vibration and during varying seated postures. </p><p> Lastly, a new concept called effective seat-to-head transmissibility is introduced, which describes how to combine the human body's biodynamic response to vibration from multiple directions. This concept is further utilized to quantify the human response using many different vibration conditions and seated postures during 6D vibration. The results from this study demonstrate how complicated vibrations from multiple-input and multiple-output motions can be resolved into a single measure. The proposed effective seat-to-head transmissibility concept presents an objective tool to gain insights into the effect of posture and surrounding equipment on the biodynamic response of the operators. </p><p> This thesis is timely as advances in seat design for operators are increasingly important with evolving armrests, backrests, and seat suspension systems. The utilization of comprehensive measurement techniques, a predictive discomfort model, and the concept of effective seat-to-head transmissibility, therefore, would be beneficial to the fields of seat/equipment design as well as human biomechanics studies in whole-body vibration.</p>

International Telemetering Conference Proceedings / October 21, 2002 / Town & Country Hotel and Conference Center, San Diego, California / The Air Force Flight Test Center in association with the Range Commanders Council (RCC) Range Safety Group is conducting a program that will explore the next generation of ground-based flight termination technology, known as the Enhanced Flight Termination System (EFTS) program. The first part of the program was successfully concluded in May 2002. The Government is leading this program with support from contractors, academia, and other RCC groups including the Telemetry Group, Frequency Management Group, and Telecommunications and Timing Group. Additionally, the National Security Agency is providing key support along with vendors who design, build and test range safety systems. This paper will discuss details of the design validation and development phases (part two) of the EFTS program. Redesign of flight termination receivers and ground system modification plans will be discussed as well as flight and ground hardware testing objectives.

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published_or_final_version / Nursing Studies / Master / Master of Nursing

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