Factors associated with lost time injury among paramedics in Victoria, Australia

Background: The dynamic and uncontrolled nature of paramedic work frequently exposes these workers to physical and psychological injury. Often paramedic injury rates are estimated based on national injury surveillance data or compensation databases. These data sources tend to only capture cases of a more serious nature and overlook the broader factors that contribute to injury. This limits our understanding of the true burden of paramedic injury and the characteristics associated with increased injury severity. Objectives: To describe the incidence and proportions of paramedic occupational injury in Victoria, Australia, and to determine the injury-related characteristics associated with lost time from work. Methods: A retrospective analysis of paramedic injury report data from the single state-wide ambulance service in Victoria, Australia–Ambulance Victoria. Injuries reported between 1 January 2015 and 30 June 2020 were included. Chi-square tests of independence were used to explore shift and injury characteristic variables that may be associated with time lost from work. Results: Over the study period, 7,591 paramedic injuries were reported that met the inclusion criteria, of which 2,124 (28%) resulted in lost time from work. The cumulative incidence of paramedic injury was 333.8 injuries per 1,000 FTE workers per year, and the rate of lost time injury was 93.0 per 1,000 FTE workers per year. Musculoskeletal injuries were the most frequently reported injury type irrespective of lost time status. Manual handling followed by psychological stressors were the two leading mechanisms of injury based on incidence. Psychological injury was associated with lost time from work (X2= 384.2, p &lt; 0.001). Conversely, injury to the head and neck (X2= 7.5, p = 0.006), and upper limb injuries (X2= 104.5, p &lt; 0.001), were more strongly associated with no lost time from work. Conclusions: Paramedics working in Victoria have a higher rate of work-related injury than other Australian workers. Injury-related factors that are often overlooked, such as time, shift type, location, and injury characteristics, all contribute to an increased risk of lost time injury. An understanding of the factors that contribute to an increase in injury severity may facilitate the development and targeting of appropriate interventions.</p

Safe system in practice:a study of practitioner awareness, support and implementation

In 2004, Australian jurisdictions adopted the Safe System approach to address road trauma. This approach seeks to prevent crashes on the road through harm minimisation principles that include a shared responsibility for safety. As an early adopter, the Victorian Government has encouraged practitioners, through guidance material and public policy, to implement Safe System. Yet, limited information exists regarding the degree of awareness of, or support for, the Safe System by individuals, whose role it is to influence and create the road safety outcomes expected by society. To understand practitioner awareness, perceptions and implementation of Safe System, an online survey was developed. Findings from completed surveys (n=469) indicate that one quarter of practitioners were unaware of the Safe System concept. Practitioners who had heard of Safe System, broadly agreed with the approach and believed that it positively contributed to their work. Importantly, practitioners believed that they were implementing Safe System and were likely to continue to do so in the future. A small subset of practitioners was not supportive of the approach, which alongside the low levels of awareness presents an additional challenge to policy implementation. Victoria’s experience highlights to other jurisdictions seeking to apply Safe System that active and sustained engagement with practitioners is required to ensure they are aware of the concept, collectively understand it and are clear when, where and how it is to be implemented.</p

The End of Speed Traps and Ticket Quotas: Re-framing and Reforming Traffic Cameras to Increase Support

The U.S. public is skeptical of speed cameras because they are seen as revenue generators. Many cities do indeed raise funds via traffic tickets, although they are primarily issued by police officers, not cameras. Ironically, cameras are poor long-term sources of revenue and therefore can directly address revenue concerns. Our survey of the U.S. public shows concerns about revenue are associated with greater opposition to cameras and greater distrust of the government. We find that re-framing cameras as a tool to prevent revenue-oriented ticketing increases public support. Finally, we recommend several institutional changes to help gain and maintain support

Change blindness as a tool for investigating compensation in hemianopia

Hemianopic visual field loss is blindness or reduction in one half of the visual field caused by damage to the visual cortex or visual pathways. Despite these significant impairments, there is evidence that individuals with hemianopia appear to compensate to varying degrees in everyday functional activities such as driving. Using a driving-related task based on the change blindness paradigm, this research investigated compensation in hemianopic field loss. Thirty-one cases with hemianopic and quadrantanopic visual field loss and thirty-one matched controls participated in the study. Of interest was whether individuals with hemianopia could accurately respond to targets across the blind and seeing regions of visual space. The focus here was to describe the characteristics of scanpaths used by individuals with hemianopic field loss, and it was expected that successful performance on the change blindness task would be associated with altered scanpaths, suggesting compensation. In addition, the study investigated the relationship between performance on the change blindness task and cognitive and vision tests commonly used in driving research and assessment. The general approach was to compare the characteristics of individuals with hemianopia who performed well with those who did not; and ultimately to identify the variables that best predicted performance on the change blindness task. Three key findings emerged. Firstly, it was found that although the cases as a group performed more poorly than controls overall, a subset of the hemianopic group were able to accurately identify changing targets in both their blind and seeing regions. Thus, the capacity to respond to targets in areas with no visual function suggests that this subset of cases were able to compensate well for their visual field defect on this task. Consistent with previous research, the study found that as a group, the hemianopic cases searched the scenes differently to controls. In general, the search patterns of hemianopic cases were characterised by an increased number of fixations with smaller saccade amplitudes. However, further analysis revealed different patterns of scanpaths amongst the hemianopic cases, not previously reported in the literature. Those who compensated for their field loss (fewer errors) searched the scenes differently to those who did not. Specifically, those who compensated made fewer fixations and had longer saccade amplitudes, closely matching those of the controls; however the spatial scanpaths used to reach the target were markedly different to the controls. In contrast, the cases who performed poorly on the task made more fixations with smaller saccades relative to controls, but searched the scenes using similar spatial paths, suggesting that spatial scanpath is a key mechanism underpinning compensation on this task. Performance on the change blindness task was best explained by age and selected cognitive assessments, including Trails B and the Motor Free Visual Perception Test (Visual Closure Subtest), whereas measures of visual function, including the extent of field loss, did not predict performance well. These results suggest that age and cognitive function were more predictive of the ability to compensate for visual field loss on the change blindness task than measures of visual function. This research represents the first attempt to link attentional processing with eye movements and compensation for hemianopic field loss in naturalistic driving scenes. Outcomes of this research provide new evidence describing the characteristics of scanpaths associated with successful compensatory performance in hemianopia. The findings highlight the usefulness of the change blindness task for discriminating those individuals who were able to successfully compensate. Further research is recommended to explore the utility of the driving-related change blindness task as a suitable screening assessment for visual fitness to drive with hemianopic field loss

Change blindness as a tool for investigating compensation in hemianopia

Hemianopic visual field loss is blindness or reduction in one half of the visual field caused by damage to the visual cortex or visual pathways. Despite these significant impairments, there is evidence that individuals with hemianopia appear to compensate to varying degrees in everyday functional activities such as driving. Using a driving-related task based on the change blindness paradigm, this research investigated compensation in hemianopic field loss. Thirty-one cases with hemianopic and quadrantanopic visual field loss and thirty-one matched controls participated in the study. Of interest was whether individuals with hemianopia could accurately respond to targets across the blind and seeing regions of visual space. The focus here was to describe the characteristics of scanpaths used by individuals with hemianopic field loss, and it was expected that successful performance on the change blindness task would be associated with altered scanpaths, suggesting compensation. In addition, the study investigated the relationship between performance on the change blindness task and cognitive and vision tests commonly used in driving research and assessment. The general approach was to compare the characteristics of individuals with hemianopia who performed well with those who did not; and ultimately to identify the variables that best predicted performance on the change blindness task. Three key findings emerged. Firstly, it was found that although the cases as a group performed more poorly than controls overall, a subset of the hemianopic group were able to accurately identify changing targets in both their blind and seeing regions. Thus, the capacity to respond to targets in areas with no visual function suggests that this subset of cases were able to compensate well for their visual field defect on this task. Consistent with previous research, the study found that as a group, the hemianopic cases searched the scenes differently to controls. In general, the search patterns of hemianopic cases were characterised by an increased number of fixations with smaller saccade amplitudes. However, further analysis revealed different patterns of scanpaths amongst the hemianopic cases, not previously reported in the literature. Those who compensated for their field loss (fewer errors) searched the scenes differently to those who did not. Specifically, those who compensated made fewer fixations and had longer saccade amplitudes, closely matching those of the controls; however the spatial scanpaths used to reach the target were markedly different to the controls. In contrast, the cases who performed poorly on the task made more fixations with smaller saccades relative to controls, but searched the scenes using similar spatial paths, suggesting that spatial scanpath is a key mechanism underpinning compensation on this task. Performance on the change blindness task was best explained by age and selected cognitive assessments, including Trails B and the Motor Free Visual Perception Test (Visual Closure Subtest), whereas measures of visual function, including the extent of field loss, did not predict performance well. These results suggest that age and cognitive function were more predictive of the ability to compensate for visual field loss on the change blindness task than measures of visual function. This research represents the first attempt to link attentional processing with eye movements and compensation for hemianopic field loss in naturalistic driving scenes. Outcomes of this research provide new evidence describing the characteristics of scanpaths associated with successful compensatory performance in hemianopia. The findings highlight the usefulness of the change blindness task for discriminating those individuals who were able to successfully compensate. Further research is recommended to explore the utility of the driving-related change blindness task as a suitable screening assessment for visual fitness to drive with hemianopic field loss

Development and Application of a Scale to Measure Station Design Quality for Personal Safety

Crime on public transport is a major concern for society and authorities, and many security measures have been adopted in public transport facilities, like stations, to reduce crime and improve the perception of passenger safety. However, a scale to measure the design quality of public transport facilities on the basis of crime prevention through environmental design (CPTED) principles has not yet been developed. This paper presents the results of a research program to develop a unified measure of the overall design quality of train stations in terms of the main elements of CPTED: surveillance, access control or target hardening (deterring access to potential targets; a term used in the security industry), maintenance, territoriality, and activity support. In this study, a scale has been developed and applied to four stations in suburban Melbourne, Victoria, Australia. The scores illustrate the overall station design quality and highlight elements of the stations that could be improved to enhance safety. Areas for future research and implications for practice are explored