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Ann Williamson

Publications and source records attributed to Ann Williamson.

17 recordsLinked to original sources
PubMed2006

Feasibility study of a water safety data collection for beaches.

This study examined the feasibility of a methodology for collecting information on water safety on beaches. Previous work showed that lifeguards and lifesavers were unreliable data collectors as they often did not have time to devote to it. The aim of this study was to trial a data collection using dedicated data collectors. The results showed the water safety-related items that could be consistently reported, and those items that were not. Items relating to beach conditions that could be reported were: wave type, tide times, sea conditions, rips and weather and wind conditions. Items associated with rescues that could be reported were: sex, age group, activity before rescue, who performed the rescue, water depth, safety flag location, nearest rescue and rescue equipment. Data collectors could collect some data on an hourly basis especially: exact or best estimates of beach attendance, exact or best estimates of major rescues and rescues, wind direction and first aid used. Some items could not be collected consistently and their inclusion in data collections should be reviewed. These include: exact age, suburb, indigenous status and swimming ability. While the validity of the collected information was not able to be established, the feasibility study showed which items could be practically included in a water safety data collection, but that dedicated data collectors may be needed to maintain a safety data collection on busy or dangerous beaches. This approach together with data collection by water safety professionals at less busy times would be cost-effective.

Australia↗
PubMed2006

Using self-report measures in neurobehavioural toxicology: can they be trusted?

Questionnaires are one of the most common methodologies used in research on neurobehavioural effects in occupational and environmental health, most commonly for gathering information on demographic characteristics, psychological or neurological symptoms, mood state, or exposure to hazards. Questionnaires are self-report measures, so by definition are subjective, although their degree of subjectivity depends on the phenomenon they are measuring. For some phenomena questionnaires are used because they are convenient but the information can be obtained from other sources. For other phenomena questionnaire or self-report is the only way of obtaining the information, for example, feelings and experiences, mood or emotions. Questionnaires are essential tools in psychological and neurobehavioural research as they can tap into aspects of nervous system function that cannot be readily measured in other ways. Despite the obvious need for self-report measures, there are a number of serious issues that threaten their validity as effective indicators of neurobehavioural function. This paper considers the implications of some of the major problems with self-report measures, focusing particularly on current approaches to measurement of symptoms and mood. It includes issues relating to validity of measures such as demand characteristics, malingering and under or over reporting, individual differences and problems of language and question style. It also includes issues relating to the interpretation of self-report measures, the relationship between self-report and performance measures, whether they reflect primary or secondary effects and whether they can be used as diagnostic criteria for neurobehavioural functional effects of occupational or environmental exposure. The paper looks at some of the current approaches to overcoming these problems including using interviews and observational methods and improving psychometric qualities of these measures. Self-report measures are important tools in our arsenal of measures of the neurobehavioural effects of occupational and environmental exposure, but they need to be used with care.

Affect↗
PubMed2006

Longitudinal analyses of nurse staffing and patient outcomes: more about failure to rescue.

BACKGROUND: Numerous studies have examined cross-sectional data to determine the relationships between nurse staffing and patient outcomes. Questions have been raised about some of the studies now in the literature regarding the use of the hospital as the unit of analysis and the cross-sectional design of the studies. Additionally, there is a concern that the primary outcomes being studied are negative. OBJECTIVE: Objectives of this study are to (1) compare the relationships between nurse staffing and positive patient outcomes for 3 adult medical-surgical nursing units in one university teaching hospital across 4 years (16 fiscal quarters); and (2) explore the use of 2 new failure-to-rescue (FTR) rates as outcomes, specifically FTR from medication errors and FTR from decubitus ulcers. DESIGN: This study uses secondary analyses of data viewed retrospectively with a longitudinal repeated-measures design to estimate the relationships between nurse staffing and the outcomes of interest. RESULTS: Accounting for total dollars and case mix, all patient satisfaction measures increased as total hours of care per patient day increased, and as the skill mix became richer (more RN hours/total hours) there was a higher satisfaction with pain management and physical care requests. There was an increase in FTR from medication error as the non-RN (Other) hours of care per patient day increased and there was an increase in FTR from decubitus ulcers as patient severity increased. CONCLUSION: The overall conclusion is that it will likely be necessary to vary staffing hours and staffing mix depending on which positive patient outcome or outcomes you wish to achieve.

Adult↗
PubMed2005

Work-related traffic crashes: a record linkage study.

AIM: To examine the characteristics of work-related traffic crashes involving drivers in New South Wales (NSW), Australia. METHODS: Probabilistic data record linkage were used to merge police crash records and workers compensation data for the period 1998-2002. RESULTS: The record linkage identified 13,124 drivers who were injured or died as a result of work-related traffic crash in New South Wales over the 5-year period. Approximately three quarters of driver casualties occurred during commuting (74.8%) with the rest occurring in the course of work. Male drivers made up around three quarters of these crashes and 93% of those that resulted in a fatality. Transport workers were the most frequent victims of work-related crashes while on duty (20.8%), with drivers of heavy trucks representing about half (48%) of all fatalities resulting from on duty work-related crashes. Nearly 1 in 6 male drivers were speeding at the time of the crash (15%, 95% CI 14.2-15.7) compared to less than 1 in 10 female drivers (9%, 95% CI 8.3-9.8) of female drivers. Male drivers were also significantly more likely to be fatigued at the time of the crash 7.6% (95% CI 7.0-8.2) compared to females 4.2% (95% CI 3.7-4.8). No significant difference was observed in the proportion of crashes involving fatigue between on duty and commuting traffic crashes. CONCLUSIONS: The study demonstrates the value of record linkage techniques in addressing some of the limitations of work-related data systems and in providing a more complete picture of the circumstances of occupational road crashes.

Accidents, Occupational↗
PubMed2004

Working hours, work-life conflict and health in precarious and "permanent" employment.

OBJECTIVE: The expansion of precarious employment in OECD countries has been widely associated with negative health and safety effects. Although many shiftworkers are precariously employed, shiftwork research has concentrated on full-time workers in continuing employment. This paper examines the impact of precarious employment on working hours, work-life conflict and health by comparing casual employees to full-time, "permanent" employees working in the same occupations and workplaces. METHODS: Thirty-nine convergent interviews were conducted in two five-star hotels. The participants included 26 full-time and 13 casual (temporary) employees. They ranged in age from 19 to 61 years and included 17 females and 22 males. Working hours ranged from zero to 73 hours per week. RESULTS: Marked differences emerged between the reports of casual and full-time employees about working hours, work-life conflict and health. Casuals were more likely to work highly irregular hours over which they had little control. Their daily and weekly working hours ranged from very long to very short according to organisational requirements. Long working hours, combined with low predictability and control, produced greater disruption to family and social lives and poorer work-life balance for casuals. Uncoordinated hours across multiple jobs exacerbated these problems in some cases. Health-related issues reported to arise from work-life conflict included sleep disturbance, fatigue and disrupted exercise and dietary regimes. CONCLUSIONS: This study identified significant disadvantages of casual employment. In the same hotels, and doing largely the same jobs, casual employees had less desirable and predictable work schedules, greater work-life conflict and more associated health complaints than "permanent" workers.

Adult↗
PubMed2004

Early predictors of severe lower gastrointestinal bleeding and adverse outcomes: a prospective study.

BACKGROUND & AIMS: Unlike in upper tract bleeding, prognostic factors for ongoing or recurrent bleeding from the lower gastrointestinal tract have not been well-defined. The aim of this study was to identify risk factors for severe lower gastrointestinal bleeding and for significant adverse outcomes. METHODS: All patients seeking attention at a university emergency department for gastrointestinal bleeding were prospectively identified during a 3-year period. Ninety-four of 448 (21%) admitted patients had lower gastrointestinal bleeding. Clinical predictors available in the first hour of evaluation were recorded. The primary outcome, severe lower gastrointestinal bleeding, was defined as gross blood per rectum after leaving the emergency department associated with either abnormal vital signs (systolic blood pressure < 100 mm Hg or heart rate > 100/min) or more than a 2-unit blood transfusion during the hospitalization. Significant adverse outcomes, including death, were tabulated. RESULTS: Thirty-seven patients (39%) had severe lower gastrointestinal bleeding. Independent risk factors for severe lower gastrointestinal bleeding were initial hematocrit </=35% (odds ratio [OR], 6.3; 95% confidence interval [CI], 2.2-16.7); presence of abnormal vital signs (systolic blood pressure < 100 mm Hg or heart rate > 100/min) 1 hour after initial medical evaluation (OR, 4.3; 95% CI, 1.4-12.5); and gross blood on initial rectal examination (OR, 3.9; 95% CI, 1.2-13.2). Nineteen patients (20%) experienced a significant adverse outcome, including 3 deaths. The main independent predictor of adverse outcomes was severe lower gastrointestinal bleeding (OR, 5.3; 95% CI, 1.7-16.5). CONCLUSIONS: Risk factors are available in the first hour of evaluation in the emergency department to identify patients at risk for severe lower gastrointestinal bleeding. Severe lower gastrointestinal bleeding is a significant risk factor for global adverse outcomes.

Adult↗
PubMed2003

Evidence of neurotoxicity in working children in Lebanon.

The potential for exposure to neurotoxicants in Lebanon is high, especially in the absence of strict control and regulatory measures in workplaces. Children working in mechanical and other trade workshops are at significant risk of exposure to organic solvents and as a result at significant risk to develop clinical and subclinical signs of neurotoxicity. This study investigated the association between exposure to solvents and neurobehavioral performance of 10-17 years old working children in comparison to groups of non-exposed working children and non-exposed children at school. A convenience cross-sectional sample of 100 working children (10-17 years) exposed to organic solvents at work, a positive control of 100 non-solvent exposed working children, and a negative control of 100 non-working, non-exposed school children were recruited to the study. The exposed and non-exposed groups were, as far as possible, frequency matched on geographic location of residence and on age. Neurotoxic effects were assessed through a questionnaire and the child's performance on a battery of neurobehavioral tests, which were specifically selected for a non-English speaking population and were tailored to assess the specific modalities of the central nervous system commonly known to be affected by the neurotoxicants identified. Children in the non-exposed groups (working and non-working) performed better than the working exposed group on reaction speed for the choice reaction time, symbol-digit and dual task tracking tests, but accuracy of performance was not affected on these tests. Children in the working exposed group also complained of more headaches, loss of concentration, memory deficits and higher irritability. This study identifies an association between exposure to solvents and lower neurobehavioral performance. Response speed appears to be particularly affected in solvent exposed working children.

Adolescent↗
PubMed2003

Symptom status and health-related quality of life: clinical relevance.

BACKGROUND: Nursing continues to struggle to identify outcomes that measure quality of care. Health-related quality of life (HRQOL) has been identified as an outcome indicator that is sensitive to health-care interventions. However, clinicians remain skeptical about its relevance. AIM: This article discusses the conceptual issues surrounding HRQOL research and provides an example that demonstrates how symptom status can serve as a clinically relevant and measurable dimension of HRQOL. METHODS: The study sample (n = 99) were patients presenting to the emergency department of an academic medical centre in the United States of America (USA) between July 1997 and March 1999 with the diagnosis of gastrointestinal bleeding. The mean age was 57.86 (17.52) years and 62.6% of the sample was male. The Short Form-12 (SF-12) (measurement used for HRQOL) and a 15-item symptom checklist were administered within the first 24 hours following the emergency department visit and by phone 1 month after discharge. RESULTS: Regression analysis controlling for age, gender, haematocrit and comorbidities was used to examine the relationships between symptom status and HRQOL. The analysis suggests that symptom status is a key predictor of HRQOL. STUDY LIMITATIONS: The sample was a relatively small convenience sample from one emergency department in the USA. CONCLUSIONS: Nurses are concerned with improving patients' HRQOL. Certainly, symptoms are amenable to nursing interventions. We provide one example that demonstrates the relationship between symptom status and HRQOL. By tracking and studying trends in the number of symptoms over time we can begin to track HRQOL as an outcome of care. Thus, we conclude that by helping patients manage their symptoms their overall HRQOL would improve.

Aged↗
PubMed2003

Work-related injury in NSW hospitalisation and workers' compensation datasets: a comparative analysis.

OBJECTIVE: To undertake a comparative analysis of the New South Wales (NSW) Inpatient Statistics Collection (ISC) and Workers' Compensation Scheme Statistics (WCSS) for the 1999/2000 financial year in an attempt to evaluate their respective roles in the surveillance and monitoring of work-related injuries in NSW. METHODS: Work-related injuries in ISC were identified mainly by using the ICD-10 activity code and payment status and were compared with injury-related claims reported in WCSS. RESULTS: In 1990/2000, the majority of hospital separations for work-related injury involved males (86.2%) who came into contact with various objects, including machinery and tools, representing the most common mechanisms of injury, and open wounds and fractures of the upper and lower limbs as the most common injury nature/location. Injuries reported in the WCSS were also dominated by males (70%), with muscular stress while handling objects as the most common mechanism of injury and sprain and strain of the lower back as the leading nature/location of injury. The proportion of workers aged 15-19 years in the WCSS (1.2%) was over five times lower than the proportion of the same age group recorded in the ISC. CONCLUSIONS AND IMPLICATIONS: The analysis indicates that the ISC and WCSS complement each other in characterising the burden of work-related injuries in NSW. Linking compensation and outcomes data, including hospital admissions and emergency presentations, will provide a more comprehensive picture of the nature and the factors contributing to work-related injuries. Such data will inform policy and program development aimed at reducing the burden of this type of injury in the community.

Accidents, Occupational↗
PubMed2003

Associations between errors and contributing factors in aircraft maintenance.

In recent years cognitive error models have provided insights into the unsafe acts that lead to many accidents in safety-critical environments. Most models of accident causation are based on the notion that human errors occur in the context of contributing factors. However, there is a lack of published information on possible links between specific errors and contributing factors. A total of 619 safety occurrences involving aircraft maintenance were reported using a self-completed questionnaire. Of these occurrences, 96% were related to the actions of maintenance personnel. The types of errors that were involved, and the contributing factors associated with those actions, were determined. Each type of error was associated with a particular set of contributing factors and with specific occurrence outcomes. Among the associations were links between memory lapses and fatigue and between rule violations and time pressure. Potential applications of this research include assisting with the design of accident prevention strategies, the estimation of human error probabilities, and the monitoring of organizational safety performance.

Accident Prevention↗
PubMed2002

Unsafe acts and unsafe outcomes in aircraft maintenance.

Road safety studies using the Driver Behaviour Questionnaire (DBQ) have provided support for a three-way distinction between violations, skill-based errors and mistakes, and have indicated that a tendency to commit driving violations is associated with an increased risk of accident involvement. The aims of this study were to examine whether the three-way distinction of unsafe acts is applicable in the context of aircraft maintenance, and whether involvement in maintenance safety occurrences can be predicted on the basis of self-reported unsafe acts. A Maintenance Behaviour Questionnaire (MBQ) was developed to explore patterns of unsafe acts committed by aircraft maintenance mechanics. The MBQ was completed anonymously by over 1300 Australian aviation mechanics, who also provided information on their involvement in workplace accidents and incidents. Four factors were identified: routine violations, skill-based errors, mistakes and exceptional violations. Violations and mistakes were related significantly to the occurrence of incidents that jeopardized the quality of aircraft maintenance, but were not related to workplace injuries. Skill-based errors, while not related to work quality incidents, were related to workplace injuries. The results are consistent with the three-way typology of unsafe acts described by Reason et al. (1990) and with the DBQ research indicating an association between self-reported violations and accidents. The current findings suggest that interventions addressed at maintenance quality incidents should take into account the role of violations and mistakes, and the factors that promote them. In contrast, interventions directed at reducing workplace injury are likely to require a focus on skill-based errors.

Accidents, Occupational↗
PubMed2002

Skills, rules and knowledge in aircraft maintenance: errors in context.

Automatic or skill-based behaviour is generally considered to be less prone to error than behaviour directed by conscious control. However, researchers who have applied Rasmussen's skill-rule-knowledge human error framework to accidents and incidents have sometimes found that skill-based errors appear in significant numbers. It is proposed that this is largely a reflection of the opportunities for error which workplaces present and does not indicate that skill-based behaviour is intrinsically unreliable. In the current study, 99 errors reported by 72 aircraft mechanics were examined in the light of a task analysis based on observations of the work of 25 aircraft mechanics. The task analysis identified the opportunities for error presented at various stages of maintenance work packages and by the job as a whole. Once the frequency of each error type was normalized in terms of the opportunities for error, it became apparent that skill-based performance is more reliable than rule-based performance, which is in turn more reliable than knowledge-based performance. The results reinforce the belief that industrial safety interventions designed to reduce errors would best be directed at those aspects of jobs that involve rule- and knowledge-based performance.

Aircraft↗
PubMed2002

Assessing the classification of work-relatedness of fatal incidents: a comparison between Australia, New Zealand and the United States.

As part of a larger study comparing work-related fatal injury of workers in Australia, New Zealand and the United States, an assessment was made of the similarities and differences between the three countries in identifying fatal incidents as work-related or not. The researchers in each country independently classified 333 brief scenarios, describing a variety of fatal incidents, into one of nine categories related to work: worker, bystander, commuter, volunteer, student, suicide, other, unknown and none of the above. Complete agreement with the classification was moderate (62%), but agreement when classifying scenarios as working, not working or unknown was much higher (full agreement for 80% of scenarios; Kappa = 0.71). Only 5% of scenarios were classified differently by all three countries. Other main findings of the study were that there is variation between countries in the interpretation of what is and what is not work-related, and variation in the amount or type of information required to make a definitive classification. Common circumstances described in the scenarios for which there was some disagreement in classification included domestic violence incidents at work, volunteer workers, business trips, social functions connected to work, hobby farmers and some possible bystander incidents that occurred on farms or on the road. The results suggest that, even without the use of standard definitions, comparisons between the datasets of the countries involved in this study can be made with reasonable confidence. However, they also emphasise the importance of minimising ambiguity in the definitions used, and of understanding the manner in which the definitions are applied, when comparing results between studies.

Accidents, Occupational↗
PubMedDate not supplied

The effects of solvent exposure on memory and motor dexterity in working children.

OBJECTIVES: Children working in vehicle spray-painting, mechanical, and other trade workshops are at significant risk of exposure to organic solvents and, as a result, may be at significant risk of developing clinical and subclinical signs of neurotoxicity. This study reports on the association between exposure to solvents and neurobehavioral performance on a number of non-computerized tests for working children exposed to solvents in comparison with nonexposed working children and nonexposed children at school. METHODS: A convenience cross-sectional sample of 300 male children aged 10-17 years was recruited for study. The exposed working group and the two nonexposed groups (working and nonworking school) were matched, as far as possible, on geographic location of residence and age. Neurotoxic effects were assessed through a questionnaire and the child's performance on a selection of neurobehavioral tests. RESULTS: Exposed working children scored worse on the overall neurotoxicity symptoms score (mean=6.8; standard deviation [SD]=3.6) compared with the nonexposed working children (mean=1.3; SD=2.0) and school children (mean=1.2; SD=1.8). Analysis of the non-computerized neurobehavioral tests demonstrated that exposed working children performed significantly worse than the two nonexposed groups on the motor dexterity and memory tests. Results of the mood test showed that exposed working children were more angry and confused than the nonexposed groups. CONCLUSION: There is an association between exposure to solvents and lower neurobehavioral performance, with significant neurobehavioral deficits among children exposed to solvents in comparison with working children not exposed to solvents and nonworking school children. Memory and motor dexterity appear to be particularly affected in solvent-exposed working children.

Adolescent↗