Interventions to prevent needle stick injuries among health care workers

Needle stick injuries (NSIs) are frequently reported as occupational injuries among health care workers. The health effects of a NSI can be significant when blood-to-blood contact occurs from patient to health care worker. The objective of this study was to evaluate whether the number of NSIs decreased among health care workers at risk in one Dutch academic hospital after introduction of injection needles with safety devices in combination with an interactive workshop. In a cluster three-armed randomized controlled trial, 23 hospital divisions (n=796 health care workers) were randomly assigned to a group that was subjected to the use of a 'safety device plus workshop', to a group that was subjected to a 'workshop only' or to a control group with no intervention. The combined intervention of the introduction of needle safety devices and an interactive workshop led to the highest reduction in the number of self-reported NSIs compared to a workshop alone or no intervention. For practice, the use of relatively simple protective needle safety devices and interactive communication are effective measures for reducing NSI's.     

Drivers' safety needs, behavioural adaptations and acceptance of new driving support systems

The aim of this paper is to discuss the contribution of two complementary approaches for designing and evaluating new driver support systems likely to improve the operation and safety of the road traffic system. The first approach is based on detailed analyses of traffic crashes so as to estimate drivers' needs for assistance and the situational constraints that safety functions should address to be efficient. The second approach is based on in depth-analyses of behavioral adaptations induced by the usage of new driver support systems in regular driving situations and on drivers' acceptance of the assistance provided by the systems.     

Biomechanics-based active control of bedding support properties and its influence on sleep

Proper body support plays an import role in the recuperation of our body during sleep. Therefore, this study uses an automatically adapting bedding system that optimises spinal alignment throughout the night by altering the stiffness of eight comfort zones. The aim is to investigate the influence of such a dynamic sleep environment on objective and subjective sleep parameters. The bedding system contains 165 sensors that measure mattress indentation. It also includes eight actuators that control the comfort zones. Based on the measured mattress indentation, body movements and posture changes are detected. Control of spinal alignment is established by fitting personalized human models in the measured indentation. A total of 11 normal sleepers participated in this study. Sleep experiments were performed in a sleep laboratory where subjects slept three nights: a first night for adaptation, a reference night and an active support night (in counterbalanced order). Polysomnographic measurements were recorded during the nights, combined with questionnaires aiming at assessing subjective information. Subjective information on sleep quality, daytime quality and perceived number of awakenings shows significant improvements during the active support (ACS) night. Objective results showed a trend towards increased slow wave sleep. On the other hand, it was noticed that % N1-sleep was significantly increased during ACS night, while % N2-sleep was significantly decreased. No prolonged N1 periods were found during or immediately after steering.     

Introduction: international academic mobility and inequalities

ABSTRACT

Higher education is one of the social fields where inequalities are produced and reproduced. Nevertheless, we still know very little about the ways in which heterogeneities and inequalities have been experienced and interpreted by those involved in international academic mobility. In this introductory editorial, we consider some of the crucial conceptual issues involved in the study of the nexus between inequalities and international academic mobility. First, we argue that it is important to take manifold inequalities into account when examining this nexus. After all, inequalities can be detected at different levels, and the mobility process is structured around multiple heterogeneities rather than by a single one. Second, we discuss how international academic mobility and inequalities attached to it go beyond nation-state borders. Third, we argue it is beneficial to extend the scope of to the mobility process as a whole, as inequalities in opportunities and outcomes are intrinsically connected.     

Estimation of Deprivation Level Functions using a Numerical Rating Scale

Evaluating and quantifying human suffering in humanitarian operations offers an innovative and potentially powerful way to assess the performance of humanitarian logistics (HL) and help build optimization models. Previous studies have suggested deprivation cost as a metric and have estimated deprivation cost functions for water using willingness‐to‐pay. Our study proposes deprivation levels, defined as the degree of human suffering caused by lack of access to a good or service, and estimates deprivation level functions using a numerical rating scale. Analyzing data collected from respondents with and without disaster experience, we find that individuals in the latter category estimate deprivation differently from the beneficiaries of disaster relief. Our study demonstrates that deprivation levels can be expressed as logistic growth functions with a typical S‐shape, and that these can be integrated into HL optimization models to better account for human suffering.     

The Role of Media Exposure on Coordination in the Humanitarian Setting

Despite high demand and resource limitations, humanitarian organizations (HOs) typically do not share resources and/or coordinate in the field. While coordination enhances operational performance and saves costs, the general perception is that it dilutes the media attention that individual organizations might receive, and negatively influences their future donation income. In this study, we empirically unveil the impact of media exposure and operational performance on the donations obtained by HOs. Then, based on the empirical results, we develop a stylized model to characterize the structure of preferred coordination policies with respect to an organization's funding source and main mandate. Our findings shed light on the incentives and dynamics that drive behaviors in humanitarian operations and provide insights for policy makers on designing and implementing mechanisms that encourage humanitarian coordination.     

Estimates of subgroup treatment effects in overall nonsignificant trials: To what extent should we believe in them?

In drug development, it sometimes occurs that a new drug does not demonstrate effectiveness for the full study population but appears to be beneficial in a relevant subgroup. In case the subgroup of interest was not part of a confirmatory testing strategy, the inflation of the overall type I error is substantial and therefore such a subgroup analysis finding can only be seen as exploratory at best. To support such exploratory findings, an appropriate replication of the subgroup finding should be undertaken in a new trial. We should, however, be reasonably confident in the observed treatment effect size to be able to use this estimate in a replication trial in the subpopulation of interest. We were therefore interested in evaluating the bias of the estimate of the subgroup treatment effect, after selection based on significance for the subgroup in an overall “failed” trial. Different scenarios, involving continuous as well as dichotomous outcomes, were investigated via simulation studies. It is shown that the bias associated with subgroup findings in overall nonsignificant clinical trials is on average large and varies substantially across plausible scenarios. This renders the subgroup treatment estimate from the original trial of limited value to design the replication trial. An empirical Bayesian shrinkage method is suggested to minimize this overestimation. The proposed estimator appears to offer either a good or a conservative correction to the observed subgroup treatment effect hence provides a more reliable subgroup treatment effect estimate for adequate planning of future studies.     

Measuring Child Poverty in South Africa: Sensitivity to the Choice of Equivalence Scale and an Updated Profile

This paper offers evidence on the sensitivity of child poverty in South Africa to changes in the adult equivalence scale (AES) and updates the child poverty profile based on the Income and Expenditure Survey 2005/06. Setting the poverty line at the 40th percentile of households calculated with different AESs the scope and composition of child poverty are found to be relatively insensitive to the scale used. The rankings of children of different ages, girls versus boys, racial groupings and children living in rural versus urban areas are unaffected by choice of AES, although some provincial rankings on the poverty headcount measure are. The proportions of children and households ‘correctly’ identified as poor for the full range of scales is extremely high. These findings support the argument that it may be appropriate for profiling poverty in South Africa to use a poverty line based on a per capita welfare measure. For the construction of the child poverty profile, per capita income is used as the welfare indicator with the poverty line set at the 40th percentile of household. The profile suggests that poverty amongst children is more extensive than amongst the population or adults even after the massive injection of transfers into households with poor children through the child support grant. The child poverty headcount, depth and severity are all highest amongst children age 0–4 and lowest amongst those aged 15–17, who are not yet beneficiaries of the grants. They are also highest amongst African and Coloured children. Large variations across provinces remain. The analysis underlines the importance of prioritising children in the fight against poverty, particularly in their earliest years.     

Moroccan women in Madrid: between change and continuity

This article focuses on individual migration and acculturation processes experienced by Moroccan women in the area of Madrid, based on qualitative research conducted in the Spanish capital in 2008. The results show that Moroccan women restructure their daily practices through complex acculturation processes, orienting them towards both the society of origin and that of arrival. They experience a constant struggle in getting to know the traditions of Spanish society, reorienting their former traditions and inventing new solutions. Moroccan women develop new ways of adapting themselves to their situation in Madrid. This acculturation process bridges the continuity with their culture of origin and reflects changes related to the new context. The studied women move in a transnational space with rigid borders, which is intersected by several social categories such as their education, ethnicity and gender, influencing their relative position within this space.     

Family Communication and Adolescent Alcohol Use in Nicaragua,Central America: A Test of Primary Socialization Theory

ABSTRACT

Applying primary socialization theory to a sample of early adolescents from Nicaragua, this study examines direct and indirect associations between family bonding and adolescent alcohol use via substance specific prevention communication (SSPC) and adolescent efficacy. Early adolescents in 7th and 8th grades completed a self-report, cross-sectional survey. Structural equation modeling revealed that family expressiveness was significantly indirectly related to adolescent lifetime alcohol use through SSPC. Results are discussed in relation to primary socialization theory, family communication, and international substance use prevention efforts. This study provides supportive evidence for the important role of positive family communication as a protective factor for early adolescents in Nicaragua.