Driver attitude and attribution : implications for accident prevention

This study involved self-completion questionnaire-based surveys in which a total of almost 1800 respondents took part. Attributional bias identified by previous research in relation to drivers' causal attributions for road accidents (Preston & Harris, 1965; Clay, 1987) was more fully explored with the aid of both objectively and subjectively culpable driver samples. Banks et al (1977) demonstrated the utility of distinguishing drivers according to culpability in relation to accident fatalaties. The current study examined the utility of distinguishing subjectively culpable, non-culpable, and non-accident driver groups in relation to road accidents with a variety of consequences, in relation to factors which may predispose drivers to accident involvement. This study involved a large sample of drivers who were representative of the general population of licenced drivers in Britain, and specifically focussed samples which allowed the influence of objective and subjective culpability to be ascertained, while a relatively small cross-cultural survey allowed a focus on young drivers (up to 25 years), involving Victorian (Australian) licenced drivers and a sub-sample of young British drivers drawn from the main British sample. The main objectives of the current study were to evaluate drivers' awareness of their potential for active accident avoidance, exploring attribution issues raised by previous research and examining factors which may contribute to road accidents in relation to self-reported accident involvement and culpability and their implications for accident prevention. The main findings were that drivers seemed to have a tendency to attribute more responsibility to "other drivers" than to themselves for accidents in which they had been involved, and to consider that such other drivers had more scope for accident avoidance than they did themselves. Such tendencies, although very considerably reduced, were not eradicated within the driver group deemed culpable by traffic police investigative teams. These findings were broadly consistent with those of Clay (1987) and Preston & Harris (1965), suggesting a lack of awareness of personal influence on accident occurrence, at least to some degree, with implications for accident prevention, the quality of social interaction in the driving environment (Knapper & Cropley, 1980), and the driver's potential to learn from experience. Perhaps more importantly, the other major finding was that clear distinctions could nonetheless be made between drivers in accordance with self-reported accident involvement and culpability in relation to driver affect/state, self-perception, attributions for accident causation, and attitudinal/behavioural tendencies, in a manner which seemed to be meaningful in terms of driver susceptibility to accident risk. Ile pattern of response for accident involvement and culpability effects was then examined in relation to the norms which emerged for age and sex, while the effects of driving experience duration and intensity were examined separately. The second point of focus on any distinctive features of younger driver risk, also allowed assessment of generalizability of findings across cultures, to some degree. The findings appear to have considerable implications for the development of effective accident prevention strategies, while suggesting that further exploration of drivers' causal attribution bias in relation to road accidents and distinctions between drivers according to subjective culpability may offer considerable safety benefits

A review of evidence on non-invasive prenatal diagnosis (NIPD) : tests for fetal RHD genotype

This report concentrates on three main areas. First and foremost, we set the background context for RhD NIPD in prenatal care. While the methodology chapter describes how the literature review was carried out and how additional information was collected, the second chapter provides an overview of the key issues associated with pregnancy of RhD negative women. We present background information based on publications from 1997 to 2006 which describe the genetic condition and its prevalence (RhD negativity) in populations, as well as the frequency of cases of sensitisation and HDN (haemolytic disease of the newborn). We also discuss current service provision for RhD negative women in a number of European countries and look at how the NIPD test might be set within current service contexts

Models for providing improved care in residential care homes: a thematic literature review

This Annotated Bibliography is one output from a review of the available research evidence to support improved care in residential care homes as the needs of older people intensify. Key findings The review identified extremely little published evidence on residential care homes; the research base is almost exclusively related to provision of care in nursing homes. Much of this research is from the US or other non-UK sources. Although it could be argued that some findings are generalisable to the UK residential care context, a systematic process is required to identify which. The literature often makes no distinction between nursing and residential homes; use of generic terms such as ‘care home’ should be avoided. There is considerable international debate in the quality improvement literature about the relationship between quality of care and quality of life in nursing and residential homes. Measures of social care, as well as clinical care, are needed. The centrality of the resident’s voice in measuring quality of life must be recognised. Ethnic minority residents are almost entirely absent from the quality improvement literature. Some clinical areas, internationally identified as key in terms of quality e.g. palliative care, are absent in the general nursing and residential home quality improvement literature. Others such as mental health (dementia and depression), diabetes, and nutrition are present but not fully integrated. Considerable evidence points to a need for better management of medication in nursing homes. Pharmacist medication reviews have shown a positive effect in nursing homes. It is unclear how this evidence might relate to residential care. There is evidence that medical cover for nursing and residential care home residents is suboptimal. Care could be restructured to give a greater scope for proactive and preventive interventions. General practitioners' workload in care homes may be considered against quality-of-care measures. There is US literature on the relationship between nurse staffing and nursing care home quality, with quality measured through clinical-based outcomes for residents and organisational outcomes. Conclusions are difficult to draw however due to inconsistencies in the evidencebase. Hospital admission and early discharge to nursing homes research may not be generalisable to residential care. The quality of inter-institutional transfers and ensuring patient safety across settings is important. To date research has not considered transfer from residential to nursing home care. The literature on district nurse and therapist roles in care homes includes very little research on residential care. Partnership working between district nurses and care home staff appears largely to occur by default at present. There is even less research evidence on therapist input to care homes. Set against the context outlined above, the international literature provides evidence of a number of approaches to care improvement, primarily in nursing homes. These include little discussion of cost-effectiveness other than in telecare. Research is needed in the UK on care improvement in residential homes

An overview of the research evidence on ethnicity and communication in healthcare

• The aim of the present study was to identify and review the available research evidence on 'ethnicity and communication' in areas relevant to ensuring effective provision of mainstream services (e.g. via interpreter, advocacy and translation services); provision of services targeted on communication (e.g. speech and language therapy, counselling, psychotherapy); consensual/ participatory activities (e.g. consent to interventions), and; procedures for managing and planning for linguistic diversity

Review of the occupational health and safety of Britain’s ethnic minorities

This report sets out an evidence-based review on work-related health and safety issues relating to black and minority ethnic groups. Data included available statistical materials and a systematic review of published research and practice-based reports. UK South Asians are generally under-represented within the most hazardous occupational groups. They have lower accident rates overall, while Black Caribbean workers rates are similar to the general population; Bangladeshi and Chinese workers report lowest workplace injury rates UK South Asian people exhibit higher levels of limiting long-term illness (LLI) and self reported poor health than the general population while Black Africans and Chinese report lower levels. Ethnic minority workers with LLI are more likely than whites to withdraw from the workforce, or to experience lower wage rates. Some of these findings conflict with evidence of differentials from USA, Europe and Australasia, but there is a dearth of effective primary research or reliable monitoring data from UK sources. There remains a need to improve monitoring and data collection relating to black and ethnic minority populations and migrant workers. Suggestions are made relating to workshops on occupational health promotion programmes for ethnic minorities, and ethnic minority health and safety 'Beacon' sites

Optimising the use of ICTs by health & social care professionals in the community

This research was commissioned as part of the Department of Health's Information and Communication Technology (ICT) Research Initiative, to identify ways in which ICTs might provide benefits to health and social care professionals working across boundaries and to the clients/ patients that they serve. The project aimed to examine the use of existing ICTs in supporting isolated users in the community (principally professionals but also lay users), and to consider ways in which use of such ICTs might be improved, focusing initially on non-person identifiable information. A single patient group was selected as the main focus of the study - older people (and their carers). This group was chosen because the needs of older people and their carers reflect those of the wider isolated populations served by health and social welfare professionals in terms of their clinical, psychological and social care needs. Other isolated groups might include the physically disabled, the mentally ill, or those socially and potentially service isolated through geography, lifestyles or other factors. Older people would be represented in all these categories. Therefore, a study focusing on the information needs of professionals who support older patients or clients should provide findings that are generalisable to other groups, such as those mentioned above. Furthermore, it was evident that this is an important group on which to focus in terms of inter-agency working because of the various policy initiatives that aim to enhance working between professionals across the health and social care interface in relation to older people

Ethnicity : UK colorectal cancer screening pilot : final report

27. In summary, the overall evaluation of the UK Pilot has demonstrated that key parameters of test and programme performance observed in randomised studies of FOBt screening can be repeated in population-based pilot programmes. However, our study provides strong evidence of very low CRC screening uptake for ethnic groups in the Pilot area. This is coupled with a very low uptake of colonoscopy for individuals from ethnic groups with a positive FOBt result. 28. It has long been acknowledged that a diverse population may require diverse responses. Following the implementation of the Race Relations Amendment Act 2000, there has been a statutory duty laid upon all NHS agencies to ‘have due regard to the need to eliminate unlawful discrimination’, and to make explicit consideration of the implications for racial equality of every action or policy. 29. Because the observed overall outcomes in the UK Pilot generally compare favourably with the results of previous randomised trials of FOBt screening, the main Evaluation Group has concluded that benefits observed in the trials should be repeatable in a national roll-out. 30. However, our study indicates that any national colorectal cancer screening programme would need to very carefully consider the implications of ethnicity for roll-out, and develop a strategic plan on how best to accommodate this at both a national and local level. Based on our findings, consideration will clearly need to be given to improved access and screening service provision for ethnic minorities. 31. In order to ensure adequate CRC screening provision for a diverse UK population, and to address the explicit implications for racial equality highlighted by our findings, interventions now urgently need to be evaluated to improve access for ethnic minorities. This work should be undertaken as part of the second round of CRC screening currently underway in the English Pilot