Designing a public train station shelter to minimise anti-social behaviour and crime in Melbourne’s metropolitan rail environment

The Melbourne metropolitan train network has experienced incidents of anti-social behaviour and crime across the network over recent years. Identification of this problem has lead to design research aimed at exploring ways to minimise anti-social behaviour, improve passenger security and the perceptions of Melbourne’s railway system.A literature review has revealed that good sightlines and visibility, minimised obstructions, sufficient lighting solutions, and controlled access are the principal factors that contribute to a safe and successful station environment. The key findings, used as guidelines, are intended to inform a design process in developing a potential design solution that is novel and adaptable.This paper examines the design and function of a shelter system design concept emerging from the research, and how it might be implemented into Melbourne’s train network in the near future. It is proposed that the system not only deters anti-social behaviour and crime, but also improves the quality of life of patrons at varying railway stations

Reducing variation not function: Lessons from applied route bus design research

Individual bus operators specify vehicles in line with their own unique requirements. Collectively, diversity across vehicle specifications increases costs and lead time and decreases quality in local bus manufacture, paradoxically having negative consequences for the very function that specifications were intended to improve. The vehicle specifications are driven by functional requirements and are therefore difficult to reconcile with manufacturing by simply reducing them. This research set out to develop bus designs balancing user and manufacturer needs.Investigation found that specification diversity results from bus operators determining designs to meet their requirements – resulting in a raft of solutions to the same or similar problems. Two interventions to this situation were formulated; that a higher-specification product could offer equal or better function to bus operators while being of standardised manufacture; and that a system of modular design could be implemented where specification differences were functionally justified.These approaches were tested in the design, manufacture and implementation of a new driver’s area for route buses. It was found to meet the functional requirements of several Australian bus operators while streamlining manufacture. It resulted in a definitive design strategy for the development of better public transport vehicles

Design strategies for mitigating passenger door holding behavior on suburban trains in Paris

The length of time a train is halted at a station is particularly important during service peak periods and short headways. Some passenger behaviors, such as the deliberate holding open of doors, has a detrimental effect upon maintaining short dwell times and service timetable. Mechanical malfunction due to door holding is also a significant contributor to trains having to be removed from service.There is a general absence of literature in the transportation field examining this problem or offering potential solutions. This paper discusses a commissioned research project carried out by Monash University’s Department of Design for the French National Railway (SNCF). The method for this research drew upon techniques from other related disciplines to aid in the formulation of a design strategy to mitigate passenger door holding behavior.Leveraging the physical design of the environment to provoke desired behaviors in people is a technique widely used in various disciplines from large architectural projects to more subtle uses of applied psychology. This paper describes the background to the problem as it manifests itself on SNCF’s network in the Ile-de-France and discusses potential design solutions that may have pertinence for other networks similarly afflicted around the world

An examination of three approaches to metro rolling stock design to ameliorate extended dwell times due to passenger growth and associated crowding.

Increased patronage of suburban rail in many cities of the world has effected network performance. Crowding, especially during peak travel times detrimentally effects dwell times thus reducing network capacity. This paper examines three approaches undertaken by three rail operators to the design of rolling stock in order to ameliorate this problem. Each of the network operations examined in this paper were selected due to their different approaches to the problem but reflecting their own set of circumstances. Stockholm Lokaltrafik AB ran experimental carriages amongst its regular system to determine a new interior carriage design. The Melbourne suburban rail system explored expanding the door vestibule area. The third example, Rio de Janeiro’s Metro, considered both the train interior and platform geometry to reduce dwell times. The research reveals that in each case there is a great deal of pressure to remove seating from the carriage, a policy that often contradicts passenger perceptions of comfort. The purpose of this examination is to inform the design of new rolling stock interiors for future research

Models and metaphors: complexity theory and through-life management in the built environment

Complexity thinking may have both modelling and metaphorical applications in the through-life management of the built environment. These two distinct approaches are examined and compared. In the first instance, some of the sources of complexity in the design, construction and maintenance of the built environment are identified. The metaphorical use of complexity in management thinking and its application in the built environment are briefly examined. This is followed by an exploration of modelling techniques relevant to built environment concerns. Non-linear and complex mathematical techniques such as fuzzy logic, cellular automata and attractors, may be applicable to their analysis. Existing software tools are identified and examples of successful built environment applications of complexity modelling are given. Some issues that arise include the definition of phenomena in a mathematically usable way, the functionality of available software and the possibility of going beyond representational modelling. Further questions arising from the application of complexity thinking are discussed, including the possibilities for confusion that arise from the use of metaphor. The metaphor of a 'commentary machine' is suggested as a possible way forward and it is suggested that an appropriate linguistic analysis can in certain situations reduce perceived complexity

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone