Submarine landslide megablocks show half of Anak Krakatau island failed on December 22nd, 2018.

As demonstrated at Anak Krakatau on December 22nd, 2018, tsunamis generated by volcanic flank collapse are incompletely understood and can be devastating. Here, we present the first high-resolution characterisation of both subaerial and submarine components of the collapse. Combined Synthetic Aperture Radar data and aerial photographs reveal an extensive subaerial failure that bounds pre-event deformation and volcanic products. To the southwest of the volcano, bathymetric and seismic reflection data reveal a blocky landslide deposit (0.214 ± 0.036 km3) emplaced over 1.5 km into the adjacent basin. Our findings are consistent with en-masse lateral collapse with a volume ≥0.175 km3, resolving several ambiguities in previous reconstructions. Post-collapse eruptions produced an additional ~0.3 km3 of tephra, burying the scar and landslide deposit. The event provides a model for lateral collapse scenarios at other arc-volcanic islands showing that rapid island growth can lead to large-scale failure and that even faster rebuilding can obscure pre-existing collapse.

Strategies to commit senior subcontractor managers in participatory ergonomics interventions.

The commitment of managers is one of the facilitators of participatory ergonomics (PE). However, to achieve this, practical practitioners' strategies vary depending on the organizational context and type of stakeholder and are poorly described in the literature. The purpose of this paper is to describe and to analyze the process and strategies that led to senior managers commitment during a decision-making intervention in a subcontracting context. A reflexive practice method was used to describe strategies implemented during a multi-site research project focusing on musculoskeletal disorders prevention in the meat processing sector. A 3 levels commitment method was developed which included: each subcontractor individually, subcontractors together, and subcontractors with their main contractor. Four strategies from the literature were firstly implemented: the creation of a steering committee, the identification of tendencies to act, the transfer of knowledge and moderation of collective discussion. An additional new strategy based on the sharing of a common interest - knife sharpening and maintenance was necessary to achieve the commitment. These results reinforce the importance of stakeholder strategies commitment in PE. A greater consideration for developing a valid framework is needed.

The application of an industry level participatory ergonomics approach in developing MSD interventions.

Participatory ergonomics projects are traditionally applied within one organisation. In this study, a participative approach was applied across the New Zealand meat processing industry, involving multiple organisations and geographical regions. The purpose was to develop interventions to reduce musculoskeletal disorder (MSD) risk. This paper considers the value of an industry level participatory ergonomics approach in achieving this. The main rationale for a participative approach included the need for industry credibility, and to generate MSD interventions that address industry level MSD risk factors. An industry key stakeholder group became the primary vehicle for formal participation. The study resulted in an intervention plan that included the wider work system and industry practices. These interventions were championed across the industry by the key stakeholder group and have extended beyond the life of the study. While this approach helped to meet the study aim, the existence of an industry-supported key stakeholder group and a mandate for the initiative are important prerequisites for success.

An implementation evaluation of a qualitative culture assessment tool.

Safety culture has been identified as a critical element of healthy and safe workplaces and as such warrants the attention of ergonomists involved in occupational health and safety (OHS). This study sought to evaluate a tool for assessing organisational safety culture as it impacts a common OHS problem: musculoskeletal disorders (MSD). The level of advancement across nine cultural aspects was assessed in two implementation site organisations. These organisations, in residential healthcare and timber processing, enabled evaluation of the tool in contrasting settings, with reported MSD rates also high in both sectors. Interviews were conducted with 39 managers and workers across the two organisations. Interview responses and company documentation were compared by two researchers to the descriptor items for each MSD culture aspect. An assignment of the level of advancement, using a five stage framework, was made for each aspect. The tool was readily adapted to each implementation site context and provided sufficient evidence to assess their levels of advancement. Assessments for most MSD culture aspects were in the mid to upper levels of advancement, although the levels differed within each organisation, indicating that different aspects of MSD culture, as with safety culture, develop at a different pace within organisations. Areas for MSD culture improvement were identified for each organisation. Reflections are made on the use and merits of the tool by ergonomists for addressing MSD risk.

Smoking cessation during pregnancy: the influence of partners, family and friends on quitters and non-quitters.

This research compared pregnant quitters' and non-quitters' accounts of how partners, family and friends influenced their smoking cessation attempts. Qualitative secondary data analysis was carried out on a purposive sample of motivational interview transcripts undertaken by research midwives with pregnant women as part of SmokeChange, a smoking cessation intervention. Interviews with all quitters in the intervention group (n = 12) were analysed comparatively with interviews from a matched sample of non-quitters (n = 12).The discourses of both revealed similarity in how their partners, family and friends influenced their cessation efforts: salient others were simultaneously perceived by both groups of women as providing drivers and barriers to quit attempts; close associates who smoked were often perceived to be as supportive as those who did not. However, women who quit smoking during pregnancy talked more about receiving active praise/encouragement than those who did not. While close associates play an important role in women's attempts to stop smoking during pregnancy, the support they provide varies; further research is needed to develop a better understanding of how key relationships help or hinder cessation during pregnancy.

Submarine mass failures as tsunami sources: their climate control.

Recent research on submarine mass failures (SMFs) shows that they are a source of hazardous tsunamis, with the tsunami magnitude mainly dependent on water depth of failure, SMF volume and failure mechanism, cohesive slump or fragmental landslide. A major control on the mechanism of SMFs is the sediment type, together with its post-depositional alteration. The type of sediment, fine- or coarse-grained, its rate of deposition together with post-depositional processes may all be influenced by climate. Post-depositional processes, termed sediment 'preconditioning', are known to promote instability and failure. Climate may also control the triggering of SMFs, for example through earthquake loading or cyclic loading from storm waves or tides. Instantaneous triggering by other mechanisms such as fluid overpressuring and hydrate instability is controversial, but is here considered unlikely. However, these mechanisms are known to promote sediment instability. SMFs occur in numerous environments, including the open continental shelf, submarine canyon/fan systems, fjords, active river deltas and convergent margins. In all these environments there is a latitudinal variation in the scale of SMFs. The database is limited, but the greatest climate influence appears to be in high latitudes where glacial/interglacial cyclicity has considerable control on sedimentation, preconditioning and triggering. Consideration of the different types of SMFs in the context of their climate controls provides additional insight into their potential hazard in sourcing tsunamis. For example, in the Atlantic, where SMFs are common, the tsunami hazard under the present-day climate may not be as great as their common occurrence suggests.

An analysis of sprain and strain injury data for the New Zealand meat processing industry from national and industry injury surveillance databases.

Data on musculoskeletal disorders (MSD) in meat processing and the tasks in which they occur is limited in the literature. This paper provides a summary of such data from the New Zealand industry. Despite the high incidence of MSD in meat processing in New Zealand, little research has been undertaken to identify and assess high-risk tasks and develop interventions to address them. This paper reports on the initial stages of a 2-year government funded project to address these issues. Findings are presented from the analysis of data from two injury surveillance databases. Accident Compensation Corporation national data claims assisted in defining the industry and indicated factors for further assessment, including consideration of claimants' gender, ethnicity and geographical region. National Injury Database industry data claims helped to identify specific tasks in which MSD are more likely to occur by departments and for the two main animal species processed. These factors have helped shape the assessment of high-risk tasks currently undertaken in the meat processing industry.

The role of contextual factors for musculoskeletal disorders in the New Zealand meat processing industry.

Musculoskeletal disorders (MSD) are the leading cause of occupational injury internationally. In New Zealand, the highest incidence of MSD is in meat processing, accounting for over half the injury compensation costs for the sector. MSD in meat processing have proven highly resistant to physical, micro-level interventions, suggesting a new approach is required. This paper reports on part of a 2-year study looking at MSD in the New Zealand meat processing industry. The qualitative study involved interviews with 237 workers, management, union and safety personnel in 28 processing sites. These data were summarised into a list of contextual factors, which, it is postulated, may create conditions under which greater exposure to physical and psychosocial factors can occur in meat processing. Some of the contextual factors are recognised as problematic by the industry, but have not previously been associated with MSD risk. The paper concludes by reflecting on conducting MSD research with a focus on contextual factors and how this may influence MSD prevention. The manuscript provides industry-based data on MSD risk and outlines the approach used in its collection. Identifying contextual factors and understanding their role in creating MSD risk may help improve the acceptance and effectiveness of MSD interventions in industry.

Randomised controlled trial of home based motivational interviewing by midwives to help pregnant smokers quit or cut down.

OBJECTIVE: To determine whether motivational interviewing--a behavioural therapy for addictions-provided at home by specially trained midwives helps pregnant smokers to quit. DESIGN: Randomised controlled non-blinded trial analysed by intention to treat. SETTING: Clinics attached to two maternity hospitals in Glasgow. PARTICIPANTS: 762/1684 pregnant women who were regular smokers at antenatal booking: 351 in intervention group and 411 in control group. INTERVENTIONS: All women received standard health promotion information. Women in the intervention group were offered motivational interviewing at home. All interviews were recorded. MAIN OUTCOME MEASURES: Self reported smoking cessation verified by plasma or salivary cotinine concentration. RESULTS: 17/351 (4.8%) women in the intervention group stopped smoking (according to self report and serum cotinine concentration < 13.7 ng/ml) compared with 19/411(4.6%) in the control group. Fifteen (4.2%) women in the intervention group cut down (self report and cotinine concentration less than half that at booking) compared with 26 (6.3%) in the control group. Fewer women in the intervention group reported smoking more (18 (5.1%) v 44 (10.7%); relative risk 0.48, 95% confidence interval 0.28 to 0.81). Birth weight did not differ significantly (mean 3078 g v 3048 g). CONCLUSION: Good quality motivational interviewing did not significantly increase smoking cessation among pregnant women.

The Baby Friendly Hospital Initiative and breast feeding rates in Scotland.

OBJECTIVE: To examine the effect of the Baby Friendly Hospital Initiative on breast feeding rates in Scotland. DESIGN: Observational study using an annual survey of progress towards the WHO/UNICEF Baby Friendly Hospital Initiative and routinely collected breast feeding rates gathered on the Guthrie Inborn Errors Screening card at 7 days of postnatal age. SETTING: Scotland, UK, population 5.1 million, with about 53 000 births a year. PARTICIPANTS: All 33 maternity units with over 50 births per annum and 464,246 infants born in Scotland between 1995 and 2002. MAIN OUTCOME MEASURES: Baby Friendly status of each maternity unit at the time of an infant's birth: certificate of commitment, UK standard award, and breast feeding at 7 days postnatal age. RESULTS: Babies born in a hospital with the UK Baby Friendly Hospital Initiative standard award were 28% (p<0.001) more likely to be exclusively breast fed at 7 days of postnatal age than those born in other maternity units after adjustment for mother's age, deprivation, hospital size, and year of birth. From 1995, breast feeding rates had increased significantly faster in hospitals with Baby Friendly status by 2002: 11.39% (95% confidence interval 10.35 to 12.43) v 7.97% (95% confidence interval 7.21 to 8.73). CONCLUSION: Being born in a hospital that held the award increased the chance of being breast fed. All maternity units should be encouraged to undertake the significant strategic and practical changes required to achieve UK Baby Friendly Hospital Initiative standard status.

Constipation and soiling--outcome of treatment at one year.

AIM: To assess the outcome at one year of a cohort of patients referred to outpatient clinics with soiling. METHOD: Retrospective case note audit of 34 children referred to hospital outpatients over a four month period with soiling stated as the main problem in the referral letter. RESULTS: After one year, 29% of the 34 children studied were discharged to patient satisfaction, 38% defaulted from follow up, 24% were still attending outpatient clinics and 9% had been referred back to source. Coexisting pathologies, in particular enuresis and family stress, were found in several of the children. At the time of referral, 44% of new patients and 89% of re-referrals bad symptoms present for longer than 12 months. Only 18% of the children were receiving treatment at the time referral was made. CONCLUSION: Constipation is often undiagnosed until the problem is well established with soiling present, which makes treatment a long and often difficult process. It is necessary to consider the wider social and family issues when managing a child with constipation and soiling. Hospital based general medical and surgical outpatient clinics may not be the ideal setting in which to deal with these problems.

Overnight central and peripheral temperature changes in normal infants.

AIM: To explore the relationship between central and peripheral temperature in normal infants after being put down to sleep. METHODS: Overnight shin and rectal temperatures of 21 normal infants were continuously recorded at home for three nights at 2 wk, 6 wk, 3 mo and 5 mo of age. Parents documented the start and end of feed/nappy changes during the night. RESULTS: An initial fall in rectal temperature was recorded on 149 out of 161 nights. This was linearly correlated with a rise in shin temperature for 106/149 (71%) nights (median R2 = 0.95, lower quartile 0.92, upper quartile 0.97). It was not possible to rule out a change in thermal insulation over the shins as a confounding variable in this strong association. However, a similar inverse relationship was seen between shin and rectal temperature during 111 of 121 (92%) feed/nappy changes. CONCLUSION: The fall in rectal temperature after being put down to sleep may be due to redistribution of heat rather than decreased production or heat loss. If causal, the development in early infancy of an inverse relationship between shin and rectal temperature may be important for cardiovascular homeostasis. Further sleep laboratory work is required to distinguish peripheral temperature changes on falling asleep from those associated with changes in thermal insulation.

A nocturnal enuresis service for a deprived inner city.

AIM: Glasgow is a city where 80% of the most deprived children in Scotland live within 20% of the overall population. Of 168,000 children in Glasgow, an estimated 5000 aged 5-15 y have primary nocturnal enuresis. The aim of this study was to establish a nocturnal enuresis service for Glasgow. METHODS: Needs assessment was performed and the incident cases were documented at school entry healthcare appraisal, at the age of 5 y. A cohort of these children was followed up at 8 y of age and symptom resolution was no better than natural remission. Parents, general practitioners, clinical medical officers and a hospital paediatrician were interviewed face-to-face about their need for a service. RESULTS: Ten of 11 general practitioners expressed a need for a specialist service. Ten school nurse-led local nocturnal enuresis clinics were established. Accommodation, funding, default and managing alarms were major problems. School nurses enjoyed extra training and quickly became skilled therapists. Two research projects highlighted that most children at first attendance did not believe they could ever be dry, which predicted outcome. Deprived families, once motivated, could successfully undertake complex behavioural therapies. CONCLUSION: A comprehensive nocturnal enuresis service begins when children stop using night nappies at the age of 3-4 y. Appropriate waterproof mattress, duvet and pillow coverings should be advocated until 5 y, when desmopressin may be helpful. For continued wetting at the age of 7 y, a local service should be led by a team of well-trained nurses using enuretic alarms.

The role of the New Zealand forest industry injury surveillance system in a strategic ergonomics, safety and health research programme.

Forestry is among the most hazardous of all industry sectors internationally. In New Zealand, highest work-related morbidity and mortality incidence rates are found in the logging sector. The New Zealand Forest Industry Accident Reporting Scheme (ARS) is a forestry injury surveillance system maintained by the Centre for Human Factors and Ergonomics (COHFE). The paper highlights the pivotal role of an industry-wide injury surveillance system in an industry-specific strategic research programme, giving examples of the use of ARS data in identification of priority areas for ergonomics, safety and health research attention, for safety awareness feedback to the industry, and in the evaluation of injury countermeasures. An analysis of injury patterns and trends for one high-risk forestry operation (skid work) is presented to illustrate both the capabilities and limitations of the ARS in its present stage of development.

Central and peripheral temperature change in normal infants.

The purpose was to explore the relationship between the fall in rectal temperature seen in normal infants after being put down to sleep and the concomitant rise in peripheral shin temperature. In this observational study 21 normal infants had continuous overnight peripheral shin and central rectal temperature recorded, for three nights at 2 weeks, 6 weeks, 3 months and 5 months of age. Parents documented the start and end of feed/nappy changing episodes during the night. All recordings were made in the infants' own home. A strong inverse linear correlation (median r2 = 0.95, lower quartile 0.92, upper quartile 0.97) was seen between rectal temperature and shin temperature on falling to sleep when put down on 106 (65%) of 161 nights. On many other nights a significant nonlinear association was present. It was not possible to exclude the process of being put down to sleep as a confounding variable in this strong association. However, a similar inverse relationship between shin and rectal temperature was seen overnight during 111 of 121 (92%) feed/nappy changing episodes. If causal, the development in early infancy of an inverse relationship between shin and rectal temperature may be important for cardiovascular homeostasis. Further sleep laboratory work including video recording is required to separate the peripheral and central temperature changes that take place on falling to sleep from those associated with removal of clothing during a nappy change.

International Child Care Practices Study: infant sleeping environment.

BACKGROUND: The International Child Care Practices Study (ICCPS) has collected descriptive data from 21 centres in 17 countries. In this report, data are presented on the infant sleeping environment with the main focus being sudden infant death syndrome (SIDS) risk factors (bedsharing and infant using a pillow) and protective factors (infant sharing a room with adult) that are not yet well established in the literature. METHODS: Using a standardised protocol, parents of infants were surveyed at birth by interview and at 3 months of age mainly by postal questionnaire. Centres were grouped according to geographic location. Also indicated was the level of SIDS awareness in the community, i.e. whether any campaigns or messages to "reduce the risks of SIDS" were available at the time of the survey. RESULTS: Birth interview data were available for 5488 individual families and 4656 (85%) returned questionnaires at 3 months. Rates of bedsharing varied considerably (2-88%) and it appeared to be more common in the samples with a lower awareness of SIDS, but not necessarily a high SIDS rate. Countries with higher rates of bedsharing appeared to have a greater proportion of infants bedsharing for a longer duration (>5 h). Rates of room sharing varied (58-100%) with some of the lowest rates noted in centres with a higher awareness of SIDS. Rates of pillow use ranged from 4% to 95%. CONCLUSIONS: It is likely that methods of bedsharing differ cross-culturally, and although further details were sought on different bedsharing practices, it was not possible to build up a composite picture of "typical" bedsharing practices in these different communities. These data highlight interesting patterns in child care in these diverse populations. Although these results should not be used to imply that any particular child care practice either increases or decreases the risk of SIDS, these findings should help to inject caution into the process of developing SIDS prevention campaigns for non-Western cultures.

Breastfeeding rates are increasing in Scotland.

OBJECTIVE: To measure the change in prevalence of breastfeeding between 1990/1991 and 1997/1998 in Scotland, using information collected on Guthrie cards when newborn infants are about seven days old. DESIGN: Analysis, by geographic postcode area, health board and maternity unit, for babies born in 1990/1991 and 1997/1998. For 1997, maternity unit and health board breastfeeding rates were also compared after standardisation for maternal age, deprivation and age of infant. SETTING: Scotland. SUBJECTS: 131,759 babies born in 1990/1991 and 118,055 in 1997/1998. RESULTS: In 1990/1991, 46,949 (35.6%) were breastfed as were 49,615 (42.0%) in 1997/1998, an increase of 6.4% (95% CI 6.0, 6.8) over eight years. A 3.8% increase remained after adjustment for change in maternal age. Maternity units with the Baby Friendly award improved 8.1% (95% CI 7.0, 9.2) compared with those with a certificate of commitment 6.1% (95% CI 5.2, 7.0). Other units improved 2.2% (95% C1 1.6, 2.8) no more than estimates due to increase in maternal age. Standardised rates were higher on the East Coast of Scotland 111 (109, 112) than the West or Central Regions 97 (96, 99). CONCLUSION: Breastfeeding has increased over eight years in Scotland. Less than half can be explained by demographic change in maternal age. However present breastfeeding targets are unlikely to be met. Maternity units should be urged to participate fully in the UNICEF U.K. Baby Friendly Initiative. Effective interventions prior to pregnancy are required so that more young men and women want their babies to be breastfed.

Monitoring breastfeeding rates and setting local targets: the Glasgow experience.

OBJECTIVE: The objective was to provide baseline data on infant feeding intention and practice in Glasgow. DESIGN: Information was collected from a prospective cohort of women who booked for maternity care in Glasgow during the months November 1995 and May 1996. Figures on feeding intention and practice were collected at five points from maternity booking until six weeks postnatal age. SETTING: Women were recruited at the four maternity units in Glasgow. Follow-up information was collected at birth, discharge from the maternity hospital at four days, and then at 12 days at home by the community midwife, and finally at six weeks by the health visitor. SUBJECTS: One thousand seven hundred and ninety two women were recruited at maternity booking. Breastfeeding information was available at birth for 1723, at discharge for 1743, at 12 days for 1513, and at six weeks for 1394. Multiple logistic regression determined maternal and infant factors predicting feeding intention and duration. RESULTS: At booking 50% planned to breastfeed. Fifty percent breastfed at birth; by four days the rate had dropped to 42%, by 12 days to 36% and by six weeks to 27%. Five factors: deprivation score, maternal age, parity, maternal smoking and previous breastfeeding experience independently predicted feeding intention. Maternal factors explained differences in breastfeeding rates between the four hospitals. CONCLUSION: Original breastfeeding targets for Glasgow have been revised to take account of local circumstances. An alternative method using routinely collected data is needed to monitor progress.

A pilot study to establish a randomized trial methodology to test the efficacy of a behavioural intervention.

How can pregnant women be helped to stop smoking? This was a pilot study of midwife home-based motivational interviewing. Clients were 100 consecutive self-reported smokers booking at clinics in Glasgow from March to May 1997. Smoking guidance is routinely given at booking. In addition, intervention clients received a median of four home-based motivational interviewing sessions from one specially trained midwife. All sessions (n = 171) were audio-taped and interviews (n = 49) from 13 randomly selected clients were transcribed for content analysis. Three 'experts' assessed intervention quality using a recognized rating scale. Cotinine measurement on routine blood samples confirmed self-reported smoking change from late pregnancy telephone interview. Postnatal telephone questionnaire measured client satisfaction. Focus groups of routine midwives explored acceptability, problems and disruption of normal care. Fisher exact, chi 2 and Mann-Whitney tests compared enrolment characteristics. Two-sample t-tests assessed outcome between groups. Motivational interviewing was satisfactory in more than 75% of transcribed interviews. In this pilot study, self-reported smoking at booking (100 of 100 available) corroborated by cotinine (93 of 100) compared with late pregnancy self-reports (intervention 47 of 48; control 49 of 49) and cotinine (intervention 46 of 48; control 47 of 49) showed no significant difference between groups. Tools have been developed to answer the question: 'Can proactive opportunistic home-based motivational interviewing help pregnant smokers reduce their habit?'.