<p> The purpose of this study was to explore and understand the successful prevention and mitigation of workplace violence (WPV) against nurses in the Emergency Department (ED), and to learn what multidisciplinary hospital leaders are doing to accelerate progress. Specifically, the research considers the strategies, policies and actions hospital leaders are using to prevent and mitigate WPV; the positive progress or outcomes that have been realized thus far; what these leaders have learned in the process, and what they aspire to achieve in the future. In the process of exploring why and how positive progress accelerated, it was found that hospital leaders experienced positive progress in WPV prevention and mitigation when their hospitals provided a WPV program utilizing these exemplary strategies: (a) collaborative multidisciplinary partnerships, (b) fully engaged executive support, and (c) operationalized data. It was interesting to note that as multidisciplinary partners and fully engaged executives collaborated, and supported their teams in the process of establishing these WPV initiatives, a culture of respect was catalyzed and WPV initiatives gained momentum. The details of this research highlight that operationalized data&mdash;WPV data put to use in a centralized, customized, evidence-based approach&mdash;appears to have functioned as a key accelerant of positive progress in WPV prevention and mitigation for these hospital leaders. </p><p>

This thesis examines the emerging health and safety regulatory regime in Ghana's nascent upstream petroleum industry putting it in context with the approaches that have evolved in the United Kingdom Continental Shelf and the United States Outer Continental Shelf. The thesis analyses the existing regulatory framework in Ghana in terms both of the architecture and of the orientation of health and safety regulation. As regards the regulatory architecture, it concludes that it is characterised by fragmented agencies under piecemeal legislation. This has resulted in regulatory overlap and lacunae. Also, the regulatory agencies including the emerging upstream regulator are saddled with conflicting missions of resource exploitation and oversight of health and safety. The thesis further demonstrates that these agencies lack decision making independence and therefore cannot provide the independence and visibility required for a robust health and safety regime. Whereas the current regulatory challenge faced by Ghana has been experienced previously in the UKCS and the US OCS, and steps have been taken there to resolve the problem of conflicting functions, the precise approach differs in each case. But the degree to which the principle of separating functions has been observed in each case may be said to correlate with the robustness of the regime in question. As regards regulatory orientation, the thesis concludes that each of the three jurisdictions examined adopts a different approach: Ghana's is basically self-regulatory while the US OCS approach is prescriptive and the UKCS framework is characterised by goal-setting and process regulation. The thesis evaluates the three approaches and concludes that the management-based approach built in to the safety case of the UKCS has proved to be robust against the prescriptive performance-based approach of the US. The thesis therefore proceeds to recommend the adoption of the UK's approach for Ghana so that all the fragmented industry specific agencies and legislation would be replaced with a single independent and visible authority and a single goal setting legislation for occupational health and safety.

Historically society has, at various periods in time, protected the health, safety and welfare of those most disadvantaged by using socially based collective mechanisms. Within the United Kingdom the model used to achieve this collective protection has developed from proscription, under the Factories Acts, to a more self-regulatory and risk based approach advocated by Lord Roben's under the Health and Safety at Work etc. Act 1974 and its relevant statutory provisions. The body tasked with providing examples of good practice and regulating the provisions of the Act, The Health and Safety Executive, advocate a management-led model using the principles of total quality management (TQM). This model is one which purports to focus on a systematic and empowered approach by involving all staff in the evaluation and reduction of systematic error within processes throughout the whole organisation. It can be argued that the contemporary disadvantaged are no longer the children of the industrial revolution but are those members of society who seek employment yet are handicapped by society through disability or impairment- the paradigm of disability. This study sought to explore this paradigm of disability and TQM within the context of two contrasting industrial sectors - the engineering and retail sectors. The study sought to break new ground by exploring whether the TQM model, which advocates system totality, reduction in variation and continuous improvement as fundamental principles, does in fact provide improved cognitive adequacy (a construct of institutional responsibility, communication and problem resolution) within the paradigm of disability. The study used a triangulation methodology to collect qualitative data at the individual and institutional level. This involved a number of phases comprising group discussions, focus groups and self-completed questionnaires (n=1135) by economically active disabled, impaired and handicapped individuals and at the organisational level case study analysis (n=8) and self-completed questionnaires (n=2181) by institutional key players. Although the construct of disability is multifaceted, the study concluded that at the individual level a number of factors were perceived to be ranked higher and as such more important to disabled employees in maintaining their health, safety and welfare. These were further classified into 'software' and 'hardware' domains of a safety management system with institutional social support being most important. Social support comprised support, communication and trust and was perceived to be low at the organisational level. At the institutional or organisational level social support can be measured using the theory of cognitive adequacy comprising responsibility, communication and problem resolution. When measured at the organisational level, via the policy domain, cognitive adequacy was once more concluded to be low or absent. These results applied equally to individuals within both the retail and engineering sectors. The study also concluded that, at the organisational level, safety systems which can be categorised as formal did not exist to meet the needs of the disabled within the organisations studied. This was particularly evident at the policy domain level where it was noted that few companies had included provisions for the allocation of specifically defined responsibility and control. However there existed many informal sub-systems which had developed through group dynamics and personal interrelations. In many cases those tasked with operational responsibility were unaware of such sub-systems. There also existed many barriers within the disability paradigm to both the duty holder and disabled employees meeting specific duties under the Health and Safety at Work etc. Act 1974. In particular communication, both verbal and non-verbal, presented the highest ranked barrier to organisations achieving a high cognitive adequacy condition. Each construct was measured using contingency tables and log-linear analysis to determine any association between TQM and non-TQM organisations for the paradigm of disability. Significant differences in data acquisition, performance measurement and problem resolution existed between TQM and Non-TQM organisations. However in relation to the paradigm of disability, the study concluded that the data supported the null hypothesis that, in the context of the paradigm of disability, no significant differences were exhibited between the safety management systems (SMS) of organisations who had adopted TQM and those that had not. Holistically this study has provided a deeper understanding of the complexity of the disabled paradigm and safety provisions at work.

Failure of Alloy 600 steam generator tubing in Pressurised Water Reactors (PWRs) has prompted the investigation of alloy 690 as an alternative material. Six commercially produced tubes and ten experimentally produced alloys have been examined with varying amounts of carbon, aluminium and titanium. Alloy compositions have been selected to investigate the individual and combined effects of these elements on the microstructure and corrosion behaviour in the environments of corrosion tests and simulated PWR conditions. Alloys were subjected to simulated mill annealing treatments at varied temperatures. Microstructural characterisation using optical and electron microscopy has demonstrated the effects of composition and thermal treatment in controlling grain size and carbide precipitation together with the interdependence between these structural details. Stress corrosion resistance of selected alloy 690 tubes has been examined with samples in an autoclave at fixed temperatures with environments based on pure water, sodium hydroxide and sodium hydroxide + sodium sulphate solutions. Susceptibility to intergranular attack has been related to aluminium contents of the alloy and to thermal treatments given. Results suggest a decreased resistance to IGA when aluminium is increased. Thermal treatments given to the samples appear not to be very significant to the amounts of IGA. The compositions and heat treatments used in the corrosion study were further examined on a dedicated scanning transmission electron microscope in order to correlate the effects of, chromium depletion, nickel enrichment and impurity segregation at grain boundaries, with corrosion characteristics. These results have shown the effect of varying the special thermal treatment temperature and time on the degree of enrichment / depletion / segregation and the corrosion resistance of the alloy. The mechanism of protection afforded by the special thermal treatment can thus be elucidated.

Risk assessment is essential to ensure safety in hospitals. However, hospitals have paid little attention to risk assessment. Several problems have already been identified in the literature about current risk assessment practice, such as inadequate risk assessment guidance and bias in risk scoring. This research aimed to improve current risk assessment practice in hospitals in the National Health Service (NHS) in England. To address this aim, the research investigated current risk assessment practice and designed a new risk assessment approach by the use of mixed methods. One hundred hospitals’ risk assessment documents were reviewed to examine the current recommended risk assessment practice. Seventeen interviews and sixty-one questionnaires were conducted, a risk management system from a single hospital was reviewed, and strategic risks from thirty-four hospitals were reviewed, in order to examine how risks are assessed in actual practice. Following that, the proposed approach was designed by conducting requirements analysis and then evaluated by interviews and questionnaires with ten healthcare staff. The findings of this research reveal that hospitals conduct risk assessments in different ways (i.e. with a focus on individual patient-based, operational and strategic risks). There are also many problems involved in current risk assessment practice regarding both the foundations and use of risk assessment. For example, organisation-wide risk assessments predominantly rely on risk matrices which might lead to wrong risk prioritisation and resource allocation; and risks tend to reflect existing or past problems rather than being proactive. All these reveal a need to improve current risk assessment practice. This research makes an important contribution to the current understanding of risk assessment practice in hospitals by providing extensive evidence on both recommended and actual practice, and proposes a new risk assessment framework. The framework guides healthcare staff on how to conduct risk assessment in a more comprehensive way by encouraging its potential users to consider good risk assessment practice.

Cyclists as vulnerable road users are oftentimes unprotected with exposed human body, can fall easily and sustain serious injuries when encountered collisions, especially with motorists. At roundabouts, accident reduction rate for cyclists is rather uncertain or sometimes less favorable compared to other road users (e.g. motorists, pedestrians). This thesis focuses on advancing the understanding of traffic safety issues for cyclists at roundabouts by identifying concerns faced by cyclists and evaluating their designs to find out which configuration has high or higher safety level towards cyclists. The research approach adopted in this work includes a wide review of relevant literature on cyclist safety and roundabouts and the implementation of empirical research, the latter was carried out through a Case Study in Norrköping city by obtaining cyclist related accident data from Swedish Traffic Accident Data Acquisition database to identify roundabouts with high cyclist-related accidents in the city assisted with PTV Visum Safety tool and fetching traffic volume from city network model operated by Norrköping Municipality for each identified roundabout. The main findings from this research conclude that single-lane roundabouts with separated cycle paths in high traffic volume setting provide better or higher safety performance for cyclists compared to other roundabout configurations.

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A structure is vulnerable if any damage produces consequences which are disproportionate to that damage. Conversely a structure is robust if it can withstand arbitrary damage. The theory of vulnerability developed in this thesis concerns structural form and connectivity. The purpose of the theory is to identify the "weak links" within a structure. A new theory of vulnerability for 3D structures has been developed. An entirely new approach has been derived from the 2D theory developed by Wu, Blockley, Woodman (1993), Yu(1997). New concepts of a graph model for 3D structural systems, 3D structural path and loop, structural round, string pattern of structural round, 3D structural tightness, 3D structural clusters, deterioration hierarchy of structural round etc. have been defined and introduced. A method of combining structural vulnerability analysis with structural response analysis has been developed and illustrated with three examples. 2D structural vulnerability theory as developed most recently by Yu(1997) has also been re-examined and improved. The algorithm for computer implementation of 2D structural vulnerability theory has been greatly improved. The improved algorithm provides a more complete search, always use the most up to date hierarchy and has a special treatment for structure with a mixture of types of joint. In order to create a graphical user interface for SAVE (Structural Analysis for Vulnerability Estimation) (Yu, 1997), some graphical functions have been developed. These graphical functions include: drawing the structure; drawing the cluster formation procedures; drawing the hierarchical presentation; drawing the most vulnerable failure scenarios in the structure. The theory is potentially of use in the design of protection and performance monitoring programmes for safety management and to reduce the risk of overlooking vulnerable failure scenarios

No description available.