Aboriginal Practitioners Offer Culturally Safe and Responsive CBT: Response to Commentaries

We appreciate the valuable commentaries that have been provided for our paper “Can CBT be effective for Aboriginal Australians? Perspectives of Aboriginal practitioners trained in CBT.” The international authors identify how CBT, with adaptations by culturally responsive practitioners can be of value for non‐Western and Indigenous peoples. The commentary by Australian psychologists Dudgeon and Kelly questions the value of CBT for Indigenous Australians, terming it a “Western therapy” that is “culturally unresponsive” and “culturally blind.” They also critique the methodology of the study. We argue that CBT can be adapted by culturally competent practitioners to be culturally safe in Australia, as elsewhere. Cultural safety is mostly a function of the therapist, not the therapy. In the Bennett‐Levy et al. (2014) study, CBT was delivered in a culturally responsive way by Aboriginal counsellors within their own communities. CBT is a particularly adaptable and versatile therapy, and embodies principles of empowerment and self‐determination that are central to Indigenous social and emotional well‐being. We are concerned that CBT, which has strong empirical support and has been adapted elsewhere for a range of cultures, including Indigenous cultures, may be being denied to Indigenous Australian clients. There is considerable opportunity to evaluate the effectiveness and versatility of CBT, and variations of its mode of delivery, for all Australians.     

合并精神疾病患者剖宫产术麻醉优化与医患安全保障

合并精神疾病患者接受剖宫产术时,由于此类患者的特殊性,患者以及其家属、医务人员心理表现都有别于普通情况。合理遵守此类患者的如下麻醉方案优化原则：麻醉操作可以实施原则、麻醉效能有效控制原则、避免诱发或加重精神疾病原则、患者无痛和新生儿安全原则、术后镇痛衔接原则、全程心理干预原则和替代麻醉预案制定原则,同时科学制定患者围术期如下管理规章制度：应急程序的及时启动、患者家属及监护人的沟通与知情同意、麻醉前后特定病房或医疗单位的建立和麻醉医疗期间医患合法权益的保障,只有这样医患双方安危和权益才能得到最佳保障。     

Safety perceptions and reported behavior related to cycling in mixed traffic: A comparison between Brisbane and Copenhagen

This study explores the differences in safety perceptions and reported behavior of cyclists in mixed traffic between an emerging cycling city (Brisbane, Australia) and an established cycling city (Copenhagen, Denmark). Perceptions and reported behavior were retrieved from a custom-designed web-based survey administered among cyclists in the two cities. Elicited items concerned perceived risk of infrastructure layouts, fear of traffic, cycling while distracted, use of safety gear, cycling avoidance due to feeling unsafe, and avoidance to cycle in mixed traffic conditions. The data were analyzed with structural equation models. Results show that, in comparison with cyclists in Copenhagen, cyclists in Brisbane perceive mixed traffic infrastructure layouts as less safe, feel more fear of traffic, and are more likely to adopt cycling avoidance as a coping strategy. Results also show that cyclists in Copenhagen tend to use less helmets and to cycle more while being distracted.     

Investigating the individual and organisational predictors of work-related driving crash involvement in Ethiopia

The rate of road traffic injury and death in Ethiopia is at a critical level when compared to rates in high-income countries. Considering the enormity of this issue, research is to identify groups of high-risk road users and the factors contributing to their crash involvement. This study focuses on work-related drivers. This study explores driving behaviour as a mediator of the relationship between organisational and individual attribute factors and self-reported crashes in a sample of 213 work-related drivers in Addis Ababa, Ethiopia. The hypothesised framework identifies driving behaviour as the most proximal determinant of self-reported crashes, and safety values, role overload and self-efficacy as antecedents of driving behaviour. With the exception of the relationship between self-efficacy and driving behaviour, all the hypothesised relationships were supported. We make recommendations for intervention approaches that are theoretically focused and sensitive to the cultural context.     

Similarities between self-reported road safety behavior of teenage drivers and their perceptions concerning road safety behavior of their parents

The study investigated 401 19-year-olds, who were licensed car drivers in Lithuania. The focus of the survey was on the self-reported road safety behaviors of teenage drivers and their perceptions of their parents’ road safety behaviors, in order to assess behavioral similarities between teenagers and their parents. The survey also investigated whether parents and teenagers discuss issues of driving safely, and whether there is an association between these conversations and driving restrictions.According to teenagers’ reporting, road safety behavior of teenage drivers and their parents often is similar: most of them break the speed limit, drive when feeling fatigued, use a cell phone when driving, and do not fasten the seat belt as a passenger in the back seat. The study indicated that there is a positive moderate correlation between road safety behaviors of teenagers and their parents, as reported by the teenagers. A majority of teenagers report that they discuss road safety factors, driving safely and driving behavior with their parents. Based on teenager reports, the parents, who discuss road safety issues with their children, are more likely to apply restrictions on teenagers’ driving.     

Positive organizational behavior and safety in the offshore oil industry: Exploring the determinants of positive safety climate

Much research has now documented the substantial influence of safety climate on a range of important outcomes in safety critical organizations, but there has been scant attention to the question of what factors might be responsible for positive or negative safety climate. The present paper draws from positive organizational behavior theory to test workplace and individual factors that may affect safety climate. Specifically, we explore the potential influence of authentic leadership style and psychological capital on safety climate and risk outcomes. Across two samples of offshore oil-workers and seafarers working on oil platform supply ships, structural equation modeling yielded results that support a model in which authentic leadership exerts a direct effect on safety climate, as well as an indirect effect via psychological capital. This study shows the importance of leadership qualities as well as psychological factors in shaping a positive work safety climate and lowering the risk of accidents.     

Examining the effect of visual treatments on truck drivers’ time-to-arrival judgments of motorcycles at T-intersections

An automobile–motorcycle crash most commonly results when an automobile pulls out of a side road into the path of an oncoming motorcycle and violates the motorcyclist’s right-of-way. One of the reasons for this could be that motorists misjudged the motorcycle arrival time. Motorcyclists are particularly vulnerable to injury in crashes with truck due to substantial differences in vehicle mass, protection degree and speed. We investigated truck drivers’ judgments of motorcycle time-to-arrival (TTA) across a number of visual treatments. Participants watched a series of video clips captured at a T-intersection, and they were instructed to respond by clicking the computer mouse at the time they estimated the front wheels of an oncoming vehicle (motorcycle or car) to reach the T-intersection. The results showed that, at long distance between the target motorcycle and the viewer, the motorcycle with daytime running headlights (DRH) was estimated to arrive sooner than the motorcycle whose motorcyclist wore a black helmet with a reflective sticker. However, the opposite is true at a short distance. We also found that a motorcyclist wearing a white helmet and riding a motorcycle with DRH, as well as a motorcyclist wearing a white helmet and white outfit, would improve truck drivers’ judgment with respect to motorcycle TTA. Consequently, truck drivers would be less likely to pull out into a small gap in front of a motorcycle, resulting in a higher safety margin for the motorcycle.     

Quantifying drivers’ comfort-zone and dread-zone boundaries in left turn across path/opposite direction (LTAP/OD) scenarios

The aim of this study is to quantify drivers’ comfort- and dread-zone boundaries in left-turn-across-path/opposite-direction (LTAP/OD) scenarios. These scenarios account for a large fraction of traffic fatalities world-wide. The comfort zone is a dynamic spatiotemporal envelope surrounding the vehicle, within which drivers feel comfortable and safe. The dread zone, a novel concept, describes a zone with a smaller safety margin that drivers will not voluntarily enter, but can push themselves into when conditions provide additional motivation (e.g., when hurried). Quantifying comfort- and dread-zone boundaries in the context of turning left before or after an oncoming vehicle has the potential to inform and improve both the design and driver acceptance of advanced driver assistance systems (ADAS) and autonomous vehicles.Using a within-subject design, a test-track experiment was conducted with drivers turning an instrumented vehicle left across the path of an oncoming vehicle. The oncoming vehicle was a self-propelled full-sized computer-controlled balloon vehicle going straight at a constant speed (50 km/h). The driver assumed full control of the instrumented vehicle approximately 20 m before the intersection and had to make the decision to turn left before or after the oncoming balloon vehicle. There were two experimental conditions, comfortable driving and hurried driving. Measures for each turn included post-encroachment time (PET), lateral acceleration, and self-reports of comfort and risk. Drivers consistently accepted shorter time gaps and higher lateral accelerations when hurried. We interpret these findings to suggest that drivers invoke two dynamic, contextually-defined safety margins. The first is the comfort-zone boundary, a limit which drivers do not voluntarily cross without extra motives. The second is the dread-zone boundary, a more distant limit which drivers do not voluntarily cross even with extra motives. Grouping the responses (high/low) to the driver behavior questionnaire (DBQ) improved the ability to predict the dread-zone boundary PET given the comfort-zone boundary PET.     

机构伦理视域下安徽省某三级医院不良事件管理策略研究

医疗质量安全一直是国内外共同关注的话题,其中不良事件的管理是医院质量安全的核心议程,而现有的归因和治理模式对不良事件的分析不充分,是对不良事件的“误诊”。通过收集汇总医院不良事件电子上报系统中2 588例事件,从事件发生类型、严重程度、发生人员和变动情况进行系统分析,基于机构伦理逻辑分析医疗机构伦理准则、伦理氛围、伦理激励,尝试从系统层面构建机构伦理视域下不良事件管理策略模型,为医疗质量改进和安全管理提供参考。