The human factors associated with responding to emergency vehicles

Emergency vehicles undertake emergency driving, using lights and sirens, to move rapidly through traffic in response to situations where life and property are at risk. For the emergency driving to be effective, other motorists need to drive in a manner that facilitates their passage. Despite laws to support this, problematic encounters can result in emergency vehicles being unable to get through. The current research expanded on earlier exploratory research into motorists’ encounters with emergency vehicles (Grant, 2010) to examine psychological factors involved with motorists’ responses to emergency vehicles. A construct validity approach was used to develop a scale through which a larger representative sample could be assessed. A qualitative study with emergency service drivers and motorists combined with existing literature to provide the basis for the scale development, and the subsequent testing and refinement resulted in the Responding to Emergency Vehicles Scale (REVS). The data obtained throughout development of the scale, from 1089 participants, were used to investigate psychological factors associated with responding to emergency vehicles and have identified the following overarching factors: Reasons for responding to emergency vehicles; attitudes and beliefs about emergency vehicles/services; appraisal of the encounter and their ability to respond; prior associations with emergency services personnel, or vehicles; and beliefs around punishment. The study also explored participants’ demographic factors relative to their reported driving behaviours during emergency vehicle encounters. Lastly, it identified the needs of the emergency service drivers during encounters, suggesting that existing road safety messages were inconsistent with actual needs of emergency service drivers, and suggested an alternative model of response. Overall, the psychological factors provided an understanding of the participants’ aptitude to be trained to respond more effectively. Their strong pro-social intentions indicated an intention to respond appropriately to emergency vehicles and they were cognisant of the potential consequences of not doing so. Their generally positive views about emergency vehicles as well as associated services, and beliefs in the appropriateness of punishment further supported their willingness to respond appropriately. Finally, participants reported that they were aroused by emergency vehicles encounters, but not stressed to the extent they were incapable of responding. Whilst the research was undertaken from a predominately theoretical lens, the applied nature of the phenomenon under scrutiny yielded findings that can inform policy around responding to emergency vehicles. Specifically, the findings suggest the need to embed explicit training on emergency vehicles within the existing driver training framework. They also recommend amendment to the road safety message used to guide motorists’ actions during encounters with emergency vehicles. Future studies could confirm the appropriateness of the recommended response model with a larger sample of emergency service drivers, and use the REVS to assess larger samples and different driving populations

An exploratory study on the perspectives of Western Australian drivers towards responding to emergency vehicles

Failing to give way to emergency vehicles has resulted in one crash per day on Australian roads (NRMA, 2009), and delayed emergency service responses to situations that constitute a serious threat to life and/or property. With an anticipated population increase in Western Australia (ABS, 2009) this problem will only worsen. Whilst there have been attempts to address the problem through information leaflets and media campaigns, the success of such initiatives is not clear because of a lack of empirical assessment. The little research available in the area, focused on crash scenarios, emergency vehicle drivers, or other non-psychological processes. The current study explored the perspectives of Western Australian drivers on responding to emergency vehicles. Using a qualitative design and in-depth interviews, data were collected from 11 participants who regularly drove in Western Australian. Thematic analysis, within a constructionist framework, was used to identify themes. It was found that participants\u27 responses to emergency vehicles related to their perceptions of emergency services, safety, lawfulness and legitimacy. Individuals with positive views on emergency services indicated a willingness to give way to emergency vehicles. However, the more positive the views the more likely they were to take risks and/or commit unlawful acts attempting to comply with emergency vehicles. Individuals\u27 negative views were more related to perceptions of legitimacy, which decreased their willingness to take risks or commit unlawful acts. Most participants\u27 responses seem to have been affected by a lack of formal or consistent driver education on giving way to emergency vehicles. Overall, their response process was consistent with Lazarus and Folkman\u27s (1984) model of stress and coping. The findings of the current exploratory study make a unique contribution to the body of knowledge in an under-researched area and may be used to inform the development of future measures to further investigate larger and representative samples. Such investigations could inform policy as well as driver education programmes toward enhancing cooperation with emergency vehicles and better public outcomes

A 'symbiosis effect' perspective to understand reverse logistics and household recycling waste systems

Paper presented at 19th ISL, 2014, Ho Chi Minh The essence of the problem with waste is that it is by definition something that is not wanted. We argue here that achieving a sustainable solution requires consideration of both regulatory responsibilities and social norms (Deutz and Frostick, 2009). Landfill costs levy a high financial impact on municipalities due to the environmental directives that compel them to collect and recycle household waste. More efficient and effective systems are therefore crucial for municipalities from both a financial and environmental perspective. Thus, householders and municipalities “symbiotically” working together in a natural system could enhance sustainable living (Fennell and Weaver, 2005; Ehrenreich, 2002). This paper reports on the first two stages of a PhD research study project conducted within the two municipalities in the North of England. This research investigates the relationship between the sustainability and effectiveness of household recycling systems and household recycling behavior, reveals how factors associated with household recycling systems affect household recycling behaviour, and how household recycling behaviour affect the provision of household recycling systems by the local authorities. The main objective is to reveal and explain the interaction and symbiosis. In fact, this study has found that a ‘symbiosis effect’ perspective appears to be a robust framework to bring together effective household waste recycling systems and sustainable development considerations to enhance both sustainability and the economy. Further, the study provides empirical evidence examining both situational and personal factors of households and their interactions, which were previously not well-understood. This study has incorporated behavioural aspects in the reverse logistics process that should help improve the municipalities’ planning processes. Also, municipalities may be more adaptive to the changing behaviour of their constituents and more willing to change their waste and recycling strategies to more sustainable methods. The paper is structured as follows. The literature reviews from multiple lenses of multiple disciplines and research design that accessible for interdisciplinary study and the current findings with discussion as well as conclusion that explain and encapsulate symbiosis effect perspective in understanding reverse logistics and household waste recycling system (HRWS)

Phylogeny-wide analysis of G-protein coupled receptors in social amoebas and implications for the evolution of multicellularity:[version 2; peer review: 2 approved]

G-protein coupled receptors (GPCRs) are seven-transmembrane proteins and constitute the largest group of receptors within eukaryotes. The presence of a large set of GPRCs in the unicellular Amoebozoa was surprising and is indicative of the largely undiscovered environmental sensing capabilities in this group. Evolutionary transitions from unicellular to multicellular lifestyles, like we see in social amoebas, have occurred several times independently in the Amoebozoa, and GPCRs may have been co-opted for new functions in cell-cell communication. Methods We have analysed a set of GPCRs from fully sequenced Amoebozoan genomes by Bayesian inference, compared their phylogenetic distribution and domain composition, and analysed their temporal and spatial expression patterns in five species of dictyostelids. Results We found evidence that most GPCRs are conserved deeply in the Amoebozoa and are probably performing roles in general cell functions and complex environmental sensing. All families of GPCRs (apart from the family 4 fungal pheromone receptors) are present in dictyostelids with family 5 being the largest and family 2 the one with the fewest members. For the first time, we identify the presence of family 1 rhodopsin-like GPCRs in dictyostelids. Some GPCRs have been amplified in the dictyostelids and in specific lineages thereof and through changes in expression patterns may have been repurposed for signalling in multicellular development. Discussion Our phylogenetic analysis suggests that GPCR families 1, 2 and 6 already diverged early in the Amoebozoa, whereas families 3 and 5 expanded later within the dictyostelids. The family 6 cAMP receptors that have experimentally supported roles in multicellular development in dictyostelids ( carA-carD; tasA/B) originated at the root of all dictyostelids and only have weakly associated homologs in Physarum polycephalum. Our analysis identified candidate GPCRs which have evolved in the dictyostelids and could have been co-opted for multicellular development

An investigation of culturally competent terminology in healthcare policy finds ambiguity and lack of definition

© 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia Creative Commons Attribution Non-Commercial-NoDerivs License (CC BY NC ND).Objective : This research explored how the concept of cultural competence was represented and expressed through health policies that were intended to improve the quality and efficacy of healthcare provided to families from culturally marginalised communities, particularly women and children with refugee backgrounds. Method : A critical document analysis was conducted of policies that inform healthcare for families from culturally marginalised communities in two local government areas in South Australia. Results : The analysis identified two major themes: lack of, or inconsistent, definitions of ‘culture’ and ‘cultural competency’ and related terms; and the paradoxical use of language to determine care. Conclusions : Cultural competence within health services has been identified as an important factor that can improve the health outcomes for families from marginalised communities. However, inconsistency in definitions, understanding and implementation of cultural competence in health practice makes it difficult to implement care using these frameworks. Implications : Clearly defined pathways are necessary from health policy to inform culturally competent service delivery. The capacity for policy directives to effectively circumvent the potential deleterious outcomes of culturally incompetent services is only possible when that policy provides clear definitions and instructions. Consultation and partnership are necessary to develop effective definitions and processes relating to cultural competence

Reverse logistics in household recycling and waste systems : a symbiosis perspective.

Purpose – The purpose of this paper is to investigate the proposition that there is a symbiosis effect for exchanges between household waste recycling systems (HWRSs) and household recycling behaviour (HRB) within the reverse logistics (RL) discourse. Design/methodology/approach – The paper contains empirical findings from a two phase, multi-method approach comprising consecutive inductive and deductive investigations. The qualitative and quantitative data underpin exploratory and explanatory findings which broaden and deepen the understanding of this phenomenon. Findings – Analysis identified significant interactions between situational and personal factors, specifically demographic factors, affecting HRB with key factors identified as engagement, convenience, availability and accessibility. Research limitations/implications – Findings confirm the existence of a symbiosis effect between situational and personal factors and inform current research trends in the environmental sciences, behavioural and logistics literature, particularly identifying consumers as being an important pivot point between forward and RL flows. Practical implications – Findings should inform RL-HWRSs design by municipalities looking to more effectively manage MSW and enhance recycling and sustainability. RL practitioners should introduce systems to support recovery of MSW in sympathy with communication and education initiatives to affect HRB and should also appreciate a symbiosis effect in the design of HWRSs. Social implications – The social implications of improved recycling performances in municipalities are profound. Even incremental improvements in the performance of HWRSs can lead to enhanced sustainability through higher recycling rates, reduced diversion of MSW to landfill, decreases in pollution levels, reduced carbon footprints and reduction in depletion of scarce natural resources. Originality/value – The paper marks an early contribution to the study of symbiosis in HWRSs and HRB pertaining to RL. Findings are offered that identify the key situational and personal factors that interact to affect enhanced HWRSs and also offer insights above those available in current multi-disciplinary literature that has largely examined such factors in isolation. Conclusions offer the possibility of an epistemological bridge between the social and natural sciences

Gastrointestinal and liver disease in patients with schizophrenia:A narrative review

Schizophrenia is a severe mental illness which can have a devastating impact on an individual’s quality of life. Comorbidities are high amongst patients and life expectancy is approximately 15 years less than the general population. Despite the well-known increased mortality, little is known about the impact of gastrointestinal and liver disease on patients with schizophrenia. We aimed to review the literature and to make recommendations regarding future care. Literature searches were performed on PubMed to identify studies related to gastrointestinal and liver disease in patients with schizophrenia. High rates of chronic liver disease were reported, with Non-Alcoholic Fatty Liver Disease being of particular concern; antipsychotics and metabolic syndrome were contributing factors. Rates of acute liver failure were low but have been associated with antipsychotic use and paracetamol overdose. Coeliac disease has historically been linked to schizophrenia; however, recent research suggests that a causal link is yet to be proven. Evidence is emerging regarding the relationships between schizophrenia and peptic ulcer disease, inflammatory bowel disease and irritable bowel syndrome; clinical vigilance regarding these conditions should be high. Patients with schizophrenia poorly engage with bowel cancer screening programmes, leading to late diagnosis and increased mortality. Clozapine induced constipation is a significant issue for many patients and requires close monitoring. There is a significant burden of gastrointestinal and liver disease amongst patients with schizophrenia. Better levels of support from all members of the medical team are essential to ensure that appropriate, timely care is provided

Site selection strategy for environmental monitoring in connection with shale-gas exploration: Vale of Pickering, Yorkshire and Fylde, Lancashire

This report outlines the strategies for site selection adopted as part of a baseline environmental monitoring investigation in connection with shale-gas exploration and development in the Vale of Pickering, North Yorkshire. The project forms an extension to an ongoing baseline investigation being carried out in the Fylde, Lancashire, and the current project incorporates an air-quality monitoring component that was not within the original remit of the Fylde study. The DECC-funded investigation is led by the British Geological Survey, and is being carried out as a collaboration with the Universities of Birmingham, Bristol, Liverpool, Manchester and York (National Centre for Atmospheric Science, NCAS) and Public Health England (PHE). The project incorporates work packages in monitoring of water quality, air quality and greenhouse gases, soil gas, ground motion and seismicity, and air radon and is being carried out over the period September 2015 to March 2016. Site selection is a critical consideration in setting up a monitoring programme as chosen sites need to be representative of conditions to be tested. While sites will necessarily be subject to practical constraints (land access agreements, existing infrastructure, geological conditions, cost implications etc), site selection has a large part to play in ensuring collection of quantifiable, unbiased data. This report sets out the rationale for site selection in each of the work packages and the steps taken to ensure defensible site-selection decisions and to minimise the impact of practical constraints

Dual tasking impairments are associated with striatal pathology in Huntington’s disease

Background: Recent findings suggest that individuals with Huntington’s disease (HD) have an impaired capacity to execute cognitive and motor tasks simultaneously, or dual task, which gradually worsens as the disease advances. The onset and neuropathological changes mediating impairments in dual tasking in individuals with HD are unclear. The reliability of dual tasking assessments for individuals with HD is also unclear. Objectives: To evaluate differences in dual tasking performance between individuals with HD (presymptomatic and prodromal) and matched controls, to investigate associations between striatal volume and dual tasking performance, and to determine the reliability of dual tasking assessments. Methods: Twenty individuals with HD (10 presymptomatic and 10 prodromal) and 20 healthy controls were recruited for the study. Individuals undertook four single and dual task assessments, comprising motor (postural stability or force steadiness) and cognitive (simple or complex mental arithmetic) components, with single and dual tasks performed three times each. Participants also undertook a magnetic resonance imaging assessment. Results: Compared to healthy controls, individuals with presymptomatic and prodromal HD displayed significant deficits in dual tasking, particularly cognitive task performance when concurrently undertaking motor tasks (P \u3c 0.05). The observed deficits in dual tasking were associated with reduced volume in caudate and putamen structures (P \u3c 0.05),however, not with clinical measures of disease burden. An analysis of the reliability of dual tasking assessments revealed moderate to high test–retest reliability [ICC: 0.61-0.99] for individuals with presymptomatic and prodromal HD and healthy controls. Conclusions: Individuals with presymptomatic and prodromal HD have significant deficits in dual tasking that are associated with striatal degeneration. Findings also indicate that dual tasking assessments are reliable in individuals presymptomatic and prodromal HD and healthy controls

Protocol for the development of guidance for stakeholder engagement in health and healthcare guideline development and implementation

Stakeholder engagement has become widely accepted as a necessary component of guideline development and implementation. While frameworks for developing guidelines express the need for those potentially affected by guideline recommendations to be involved in their development, there is a lack of consensus on how this should be done in practice. Further, there is a lack of guidance on how to equitably and meaningfully engage multiple stakeholders. We aim to develop guidance for the meaningful and equitable engagement of multiple stakeholders in guideline development and implementation. METHODS: This will be a multi-stage project. The first stage is to conduct a series of four systematic reviews. These will (1) describe existing guidance and methods for stakeholder engagement in guideline development and implementation, (2) characterize barriers and facilitators to stakeholder engagement in guideline development and implementation, (3) explore the impact of stakeholder engagement on guideline development and implementation, and (4) identify issues related to conflicts of interest when engaging multiple stakeholders in guideline development and implementation. DISCUSSION: We will collaborate with our multiple and diverse stakeholders to develop guidance for multi-stakeholder engagement in guideline development and implementation. We will use the results of the systematic reviews to develop a candidate list of draft guidance recommendations and will seek broad feedback on the draft guidance via an online survey of guideline developers and external stakeholders. An invited group of representatives from all stakeholder groups will discuss the results of the survey at a consensus meeting which will inform the development of the final guidance papers. Our overall goal is to improve the development of guidelines through meaningful and equitable multi-stakeholder engagement, and subsequently to improve health outcomes and reduce inequities in health