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Vasconcelos BM, Santos CJDO, Soeiro A, Barkokébas Junior B. Analysis of occupational accidents for safety design. Work 2024:WOR220613. [PMID: 38578909 DOI: 10.3233/wor-220613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Safety design covers proactive actions as it analyzes accident risks early in the enterprise life cycle, and considers the designer acting on accident prevention as a member of the construction team. OBJECTIVE This paper proposes an accident investigation to establish links between accident causes and design to support Prevention through Design (PtD) tools. METHODS This article analyzed more than a thousand severe and fatal accident cases in the construction sector. A systematic analysis method was structured based on descriptions of accident causes and measures that could be taken to avoid accidents. RESULTS Analyzing the severe and fatal accidents, the safety measures implemented in the project design could avoid at least 23.6% of the events. As a result, the architectural and structural designs were more effective in accident prevention. The reference percentages and the design types that are more effective in preventing accidents are analyzed through a representative sample of the analysis of the accident. CONCLUSIONS This research contributes to applying safety guidelines in design projects, directly assisting in project and construction management.
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Affiliation(s)
- Bianca M Vasconcelos
- Polytechnic School of the University of Pernambuco, Madalena, Recife, PE, Brazil
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2
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Hoe J, Profyri E, Kemp C, Manela M, Webster L, Anthony J, Costafreda S, Arrojo F, Souris H, Livingston G. Risk assessment for people living with dementia: a systematic review. Int Psychogeriatr 2024; 36:263-288. [PMID: 38053362 DOI: 10.1017/s1041610223004398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVE This systematic review identified key components of risk assessment for people with dementia, examined attitudes toward risk identification and risk assessment, and appraised existing risk assessment tools. METHODS Systematic searches of five databases on two platforms (EBSCO, OVID) and gray literature databases (Open Grey, Base) were conducted. Studies were screened for inclusion based on predetermined eligibility criteria and quality assessed using the Mixed Methods Appraisal Tool. Findings were tabulated and synthesized using thematic synthesis. RESULTS Our review found people with dementia, their family carers, and healthcare professionals differed in how risk is conceptualized, with views being shaped by media perceptions, personal experiences, socio-cultural influences, dementia knowledge, and dementia severity. We found that mobilization (causing falls inside and getting lost outside) is the most frequently identified risk factor. Our findings show people with dementia are generally risk-tolerant, while healthcare professionals may adopt risk-averse approaches because of organizational requirements. We found factors that disrupt daily routines, living and caring arrangements, medication management, and unclear care pathways contribute toward adverse risk events. We discovered that most studies about risk and risk assessment scales did not consider insight of the person with dementia into risks although this is important for the impact of a risk. No risk instrument identified had sufficient evidence that it was useful. CONCLUSION Accurate risk assessment and effective communication strategies that include the perspectives of people with dementia are needed to enable risk-tolerant practice. No risk instrument to date was shown to be widely acceptable and useful in practice.
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Affiliation(s)
- Juanita Hoe
- Geller Institute of Ageing and Memory, University of West London, London, UK
- School of Health Sciences, University of London, London, UK
| | - Elena Profyri
- School of Health Sciences, University of London, London, UK
| | - Charlotte Kemp
- School of Health Sciences, University of London, London, UK
| | - Monica Manela
- UCL Division of Psychiatry, University College London, Maple House, London, UK
| | - Lucy Webster
- UCL Division of Psychiatry, University College London, Maple House, London, UK
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
| | - Justine Anthony
- School of Health Sciences, University of London, London, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Sergi Costafreda
- UCL Division of Psychiatry, University College London, Maple House, London, UK
- Camden, and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Frank Arrojo
- Alzheimer's Society Research Network, Alzheimer's Society, London, UK
| | - Helen Souris
- Camden, and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
- Dementia Clinical Network, NHS England and NHS Improvement (London Region, London, UK
| | - Gill Livingston
- UCL Division of Psychiatry, University College London, Maple House, London, UK
- Camden, and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
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3
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Wang X, Liu L, Wang L, Cao W, Guo D. An application of BWM for risk control in reverse logistics of medical waste. Front Public Health 2024; 12:1331679. [PMID: 38344233 PMCID: PMC10853444 DOI: 10.3389/fpubh.2024.1331679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
The pollution posed by medical waste complicate the procedures of medical waste logistics (MWL), and the increasingly frequent occurrence of public health emergencies has magnified the risks posed by it. In this study, the authors established an index of the factors influencing the risks posed by MWL along five dimensions: the logistics business, emergency capacity, equipment, personnel, and management. The best-worst case method was used to identify the critical risk-related factors and rank them by importance. Following this, we assessed the risk posed by MWL in four major cities in China as an example and propose the corresponding measures of risk control. The results showed that the linking of business processes was the most important factor influencing the risk posed by MWL. The other critical risk-related factors included the location of the storage site, the capacity for emergency transportation, measures to manage emergencies, and the safety of packaging. Of the cities considered, Beijing was found to be a high-risk city, and its MWL needed to be improved as soon as possible in light of the relevant critical risks. Shanghai, Guangzhou, and Shenzhen were evaluated as general-risk cities, which meant that the risks of MWL were not a priority in these areas, and the other goals of urban development should be comprehensively considered during the long-term planning for MWL in these municipalities.
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Affiliation(s)
- Xiaozhu Wang
- School of Healthcare Technology, Dalian Neusoft University of Information, Dalian, China
| | - Long Liu
- School of Healthcare Technology, Dalian Neusoft University of Information, Dalian, China
| | - Lingyu Wang
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, China
| | - Wenjun Cao
- Department of Thoracic Surgery, Zhongshan Hospital Affiliated to Dalian University, Dalian, China
| | - Di Guo
- School of Information and Business Management, Dalian Neusoft University of Information, Dalian, China
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4
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Wang Y, Ram S(S, Scahill S. Risk identification and prediction of complaints and misconduct against health practitioners: a scoping review. Int J Qual Health Care 2024; 36:mzad114. [PMID: 38155372 PMCID: PMC10791111 DOI: 10.1093/intqhc/mzad114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/17/2023] [Accepted: 12/26/2023] [Indexed: 12/30/2023] Open
Abstract
Identifying the risk and predicting complaints and misconduct against health practitioners are essential for healthcare regulators to implement early interventions and develop long-term prevention strategies to improve professional practice and enhance patient safety. This scoping review aims to map out existing literature on the risk identification and prediction of complaints and misconduct against health practitioners. This scoping review followed Arksey and O'Malley's five-stage methodological framework. A comprehensive literature search was conducted on MEDLINE, EMBASE, and CINAHL databases and finished on the same day (6 September 2021). Articles meeting the eligibility criteria were charted and descriptively analysed through a narrative analysis method. The initial search generated 5473 articles. After the identification, screening, and inclusion process, 81 eligible studies were included for data charting. Three key themes were reported: methods used for identifying risk factors and predictors of the complaints and misconduct, synthesis of identified risk factors and predictors in eligible studies, and predictive tools developed for complaints and misconduct against health practitioners. The findings reveal that risk identification and prediction of complaints and misconduct are complex issues influenced by multiple factors, exhibiting non-linear patterns and being context specific. Further efforts are needed to understand the characteristics and interactions of risk factors, develop systematic risk prediction tools, and facilitate the application in the regulatory environment.
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Affiliation(s)
- Yufeng Wang
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Sanyogita (Sanya) Ram
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Shane Scahill
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland 1023, New Zealand
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5
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Mikhno NV, Evstafeva YV, Khodakova OV, Polikarpova YA. [The measurement of risks of health damage under provision of primary medical sanitary care]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2023; 31:1384-1389. [PMID: 38142339 DOI: 10.32687/0869-866x-2023-31-6-1384-1389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/30/2023] [Indexed: 12/25/2023]
Abstract
The organization and implementation of quality management system in medical organization based on internal quality control and safety of medical activities, permits to implement continuous improvement of organization functioning, to eliminate errors or undesirable occurrences as well as to prevent causes of premature mortality and to contribute into increasing of indicator of life expectancy.The implementation of risk-oriented approach in management of medical organization within the framework of internal quality control and safety of medical activities is actual and necessary condition in accordance with adopted regulatory legal acts. Currently, in the healthcare system there are no developed and approved methods of developing infrastructure of risk management in medical organization. The purpose of the study: to apply the FMEA analysis and Pareto diagram technologies to quantify and rank risks of health harm in development of organizational and managerial decision-making. The sociological method was applied to identify violations in provision of medical care, including their frequency and possible risks. The FMEA analysis was implemented to each undesirable occurrence (risk), considering frequency of its occurrence. The priority number of risk (PMR) is calculated and risk register is compiled. The Pareto diagram construction technology made it possible to assess significance and to build risk matrix.
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Affiliation(s)
- N V Mikhno
- The Federal State Budget Educational Institution of Higher Education "The Chita State Medical Academy" of Minzdrav of Russia, 672000, Chita, Russia,
| | - Yu V Evstafeva
- The Federal State Budget Educational Institution of Higher Education "The Chita State Medical Academy" of Minzdrav of Russia, 672000, Chita, Russia
| | - O V Khodakova
- The Federal State Budget Institution "The Central Research Institute for Health Organization and Informatics" of Minzdrav of Russia, 127254, Moscow, Russia
| | - Yu A Polikarpova
- The State Institution of Health Care "The Chita Central District Hospital", 672000, Chita, Russia
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Gao Y, Wu C, Zhai X, Niu M, Bai Z, Song H, Zhao X, Wang J, Xiao X. Aripiprazole-induced liver injury: a spontaneous reporting database study. Front Pharmacol 2023; 14:1226386. [PMID: 37693913 PMCID: PMC10483809 DOI: 10.3389/fphar.2023.1226386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/11/2023] [Indexed: 09/12/2023] Open
Abstract
Background: There have been individual case reports of aripiprazole in recent years, both domestically and internationally, but no analysis of the characteristics of the occurrence of adverse reactions/events of drug-induced liver injury with aripiprazole using spontaneous reports has been seen. Methods: Using a retrospective study approach, the 452 adverse reaction/event reports of aripiprazole-induced liver injury collected by the China Adverse Drug Reaction Monitoring System from 1 January 2012 to 31 December 2016 were analyzed and evaluated, and exploring it's the clinical characteristics and related risk factors for liver injury occurrence. Results: Among 452 cases of aripiprazole-induced liver injury ADR/ADE reports, there were 121 cases classified as serious, accounting for 26.8% of the total. There were 250 male and 202 female patients, with a male-to-female ratio of 1.24:1. The age of patients ranged from 11 to 77 years old, with an average age of (34.56 ± 12.81) years old, and a high proportion of young adults in the total population. Some patients had used the drug off-label or at a higher than recommended dosage. The onset of liver injury was generally within 15-90 days after continuous use, while some patients are also accompanied by nausea, vomiting, and weight gain. 70% of the combined drug instructions listed that may cause liver injury. Conclusion: In clinical practice, healthcare professionals should pay closely attention to the adverse reactions and risk factors of liver injury caused by aripiprazole. If there are potential risk factors for liver injury, early and regular monitoring of liver function should be carried out to reduce the occurrence of adverse reactions.
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Affiliation(s)
- Yunjuan Gao
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Chengzhao Wu
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xingran Zhai
- Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ming Niu
- Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhaofang Bai
- Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Haibo Song
- National Center for Adverse Drug Reaction Monitoring, Beijing, China
| | - Xu Zhao
- Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jiabo Wang
- Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Xiaohe Xiao
- Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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7
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Cheng S, Wang J. Deep learning method for risk identification of autonomous bus operation considering image data augmentation strategies. Traffic Inj Prev 2023; 24:232-236. [PMID: 36787202 DOI: 10.1080/15389588.2023.2171727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The autonomous bus is a key application scenario for autonomous driving technology. Identifying the risk of autonomous bus operation is of great significant to improve road traffic safety and promote the large-scale application of autonomous driving technology. METHODS For the purpose of risk identification, the actual operation data for autonomous buses in Shanghai were converted into 3 kinds of grayscale images and 1 kind of radar image from a temporal-spatial perspective, and a deep learning convolutional neural network, AlexNet, was applied for image recognition. This article uses several image data augmentation strategies to address the problem of uneven distribution of samples and compares the effectiveness of different strategies. RESULTS The optimal accuracy (ACC) of the risk identification was 90.4%, the optimal true positive rate (TPR) was 83.7%, and the optimal false negative rate (FPR) was 94.58%. The accuracy of risk identification using AlexNet was higher based on the sample containing Fourier images. In addition, risk identification accuracy based on grayscale images was higher than that based on radar images. CONCLUSIONS Autonomous buses were found to be vulnerable to risks in areas such as turning sections and intersections. In addition, the results show that the Fourier transform, an image augmentation strategy, can effectively solve the uneven sample distribution problem, and the length of the input time series has an impact on the accuracy of the risk identification.
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Affiliation(s)
- Sijie Cheng
- Key Laboratory of Transport Industry of Big Data Application Technologies for Comprehensive Transport, Beijing Jiaotong University, Beijing, China
| | - Jiangfeng Wang
- Key Laboratory of Transport Industry of Big Data Application Technologies for Comprehensive Transport, Beijing Jiaotong University, Beijing, China
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Zhang Z, Zeng Y, Huang Z, Liu J, Yang L. Multi-Source Data Fusion and Hydrodynamics for Urban Waterlogging Risk Identification. Int J Environ Res Public Health 2023; 20:2528. [PMID: 36767894 PMCID: PMC9915001 DOI: 10.3390/ijerph20032528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
The complex formation mechanism and numerous influencing factors of urban waterlogging disasters make the identification of their risk an essential matter. This paper proposes a framework for identifying urban waterlogging risk that combines multi-source data fusion with hydrodynamics (MDF-H). The framework consists of a source data layer, a model parameter layer, and a calculation layer. Using multi-source data fusion technology, we processed urban meteorological information, geographic information, and municipal engineering information in a unified computation-oriented manner to form a deep fusion of a globalized multi-data layer. In conjunction with the hydrological analysis results, the irregular sub-catchment regions are divided and utilized as calculating containers for the localized runoff yield and flow concentration. Four categories of source data, meteorological data, topographic data, urban underlying surface data, and municipal and traffic data, with a total of 12 factors, are considered the model input variables to define a real-time and comprehensive runoff coefficient. The computational layer consists of three calculating levels: total study area, sub-catchment, and grid. The surface runoff inter-regional connectivity is realized at all levels of the urban road network when combined with hydrodynamic theory. A two-level drainage capacity assessment model is proposed based on the drainage pipe volume density. The final result is the extent and depth of waterlogging in the study area, and a real-time waterlogging distribution map is formed. It demonstrates a mathematical study and an effective simulation of the horizontal transition of rainfall into the surface runoff in a large-scale urban area. The proposed method was validated by the sudden rainstorm event in Futian District, Shenzhen, on 11 April 2019. The average accuracy for identifying waterlogging depth was greater than 95%. The MDF-H framework has the advantages of precise prediction, rapid calculation speed, and wide applicability to large-scale regions.
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Affiliation(s)
- Zongjia Zhang
- School of Environment, Harbin Institute of Technology, Harbin 150001, China
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen 518055, China
| | - Yiping Zeng
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen 518055, China
| | - Zhejun Huang
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen 518055, China
| | - Junguo Liu
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China
- Henan Provincial Key Laboratory of Hydrosphere and Watershed Water Security, North China University of Water Resources and Electric Power, Zhengzhou 450046, China
| | - Lili Yang
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen 518055, China
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Yi S, Li X, Chen W. A Classification System for the Sustainable Management of Contaminated Sites Coupled with Risk Identification and Value Accounting. Int J Environ Res Public Health 2023; 20:1470. [PMID: 36674224 PMCID: PMC9859188 DOI: 10.3390/ijerph20021470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Currently, site contamination is considered to be a sustained, international environmental challenge, and there is an urgent practical need to build a core theoretical system and technical methodology for the sustainable risk management of soil contamination, together with its prevention and control. We aim to improve the risk management of contaminated sites in the post-remediation era, in line with the current trend of sustainable development. The work is based on the theory of sustainability science and the eco-environmental zoning system., In this study, we build a conceptual model that can be used to classify the sustainable performance of contaminated sites in terms of risk management in line with the existing environmental management system for contaminated sites in China. To provide a scientific decision-making basis and technical support for the refined classification management of soil environments in China during the 14th Five-Year Plan period, five typical contaminated sites were selected for a quantitative evaluation by applying multi-technical approaches, including sociological, economic and statistical methods. The results showed that the sustainable performance of contaminated sites with regard to management was affected not only by pollution risk factors but also by potential utility benefits. Specified management strategies should be developed according to different levels of sustainability so as to achieve the goals of improving land use efficiency and enhancing urban functions.
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Affiliation(s)
- Shiyi Yi
- Laboratory of Soil Environmental Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- College of Resource and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xiaonuo Li
- College of Resource and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Weiping Chen
- Laboratory of Soil Environmental Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- College of Resource and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
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Muscaritoli M, Bar-Sela G, Battisti NML, Belev B, Contreras-Martínez J, Cortesi E, de Brito-Ashurst I, Prado CM, Ravasco P, Yalcin S. Oncology-Led Early Identification of Nutritional Risk: A Pragmatic, Evidence-Based Protocol (PRONTO). Cancers (Basel) 2023; 15:cancers15020380. [PMID: 36672329 PMCID: PMC9856655 DOI: 10.3390/cancers15020380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/22/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023] Open
Abstract
Nutritional issues, including malnutrition, low muscle mass, sarcopenia (i.e., low muscle mass and strength), and cachexia (i.e., weight loss characterized by a continuous decline in skeletal muscle mass, with or without fat loss), are commonly experienced by patients with cancer at all stages of disease. Cancer cachexia may be associated with poor nutritional status and can compromise a patient's ability to tolerate antineoplastic therapy, increase the likelihood of post-surgical complications, and impact long-term outcomes including survival, quality of life, and function. One of the primary nutritional problems these patients experience is malnutrition, of which muscle depletion represents a clinically relevant feature. There have been recent calls for nutritional screening, assessment, treatment, and monitoring as a consistent component of care for all patients diagnosed with cancer. To achieve this, there is a need for a standardized approach to enable oncologists to identify patients commencing and undergoing antineoplastic therapy who are or who may be at risk of malnutrition and/or muscle depletion. This approach should not replace existing tools used in the dietitian's role, but rather give the oncologist a simple nutritional protocol for optimization of the patient care pathway where this is needed. Given the considerable time constraints in day-to-day oncology practice, any such approach must be simple and quick to implement so that oncologists can flag individual patients for further evaluation and follow-up with appropriate members of the multidisciplinary care team. To enable the rapid and routine identification of patients with or at risk of malnutrition and/or muscle depletion, an expert panel of nutrition specialists and practicing oncologists developed the PROtocol for NuTritional risk in Oncology (PRONTO). The protocol enables the rapid identification of patients with or at risk of malnutrition and/or muscle depletion and provides guidance on next steps. The protocol is adaptable to multiple settings and countries, which makes implementation feasible by oncologists and may optimize patient outcomes. We advise the use of this protocol in countries/clinical scenarios where a specialized approach to nutrition assessment and care is not available.
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Affiliation(s)
- Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
| | - Gil Bar-Sela
- Oncology Department, Emek Medical Center, Afula 1834111, Israel
| | - Nicolo Matteo Luca Battisti
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
- Breast Cancer Research Division, The Institute of Cancer Research, London SW3 6JJ, UK
| | - Borislav Belev
- Clinical Hospital Center Zagreb, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | | | - Enrico Cortesi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Carla M. Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Paula Ravasco
- Faculty of Medicine and Centre for Interdisciplinary Research in Health (CIIS-UCP), Universidade Católica Portuguesa, 1649-023 Lisbon, Portugal
- Centre for Interdisciplinary Research Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, 2829-511 Almada, Portugal
| | - Suayib Yalcin
- Department of Medical Oncology, Institute of Cancer, Hacettepe University, Ankara 06800, Turkey
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Oliveira VS, Santos CJDO, Vasconcelos BM. Digital tools for prevention through design application: A systematic review. Work 2023; 76:1345-1356. [PMID: 37355927 DOI: 10.3233/wor-220603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Prevention through Design (PtD) is a safety initiative that increases the ability of eliminating risks before construction. Implementing digital tools for PtD is an innovative way to help identify embedded risk in design phase by automating a process that is currently time consuming and extensively dependent on designers' experience. However, there is a lack of known digital safety tools available to professionals. OBJECTIVE The aim of this article is to systematically review published research on the development of digital tools for PtD in order to point out existing processes and limitations. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines were used to search publications in Scopus database. Initially, 148 publications were found, but after applying the filters, thirteen publications were read and included in this review. RESULTS Quantitative results showed few publications and quantitative results detailed the studied digital tools workings and what limitations prevent their full implementation by designers. CONCLUSION Although 53.84% of methods are automatic, existing barriers such as the inability to consider schedule, and to provide a complete database challenge the validity of these tools. Therefore, PtD still poses a research gap for future research on safety matters.
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Muacevic A, Adler JR, Appan SV, Kathamuthu K, Ahmed ME. A Practical Tool for Risk Management in Clinical Laboratories. Cureus 2022; 14:e32774. [PMID: 36686107 PMCID: PMC9853920 DOI: 10.7759/cureus.32774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Risk management constitutes an essential component of the Quality Management System (QMS) of medical laboratories. The international medical laboratory standard for quality and competence, International Standards Organization (ISO) 15189, in its 2012 version, specified risk management for the first time. Since then, there has been much focus on this subject. We authors aimed to develop a practical tool for risk management in a clinical laboratory that contains five major cyclical steps: risk identification, quantification, prioritization, mitigation, and surveillance. The method for risk identification was based on a questionnaire that was formulated by evaluating five major components of laboratory processes, namely i) Specimen, ii) Test system, iii) Reagent, iv) Environment, and v) Testing. All risks that would be identified using the questionnaire can be quantified by calculating the risk priority number (RPN) using the tool, failure modes, and effects analysis (FMEA). Based on the calculated RPN, identified risks then shall be prioritized and mitigated. Based on our collective laboratory management experience, we authors also enlisted and scheduled a few process-specific quality assurances (QA) activities. The listed QA activities intend to monitor new risk emergence and re-emergence of those previously mitigated ones. We authors believe that templates of risk identification, risk quantification, and risk surveillance presented in this article will serve as ready references for supervisors of clinical laboratories.
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Kheir O, Jacoby A, Verwulgen S. Risk Identification and Analysis in the Development of Medical Devices Among Start-Ups: Towards a Broader Risk Management Framework. Med Devices (Auckl) 2022; 15:349-363. [PMID: 36158728 PMCID: PMC9507292 DOI: 10.2147/mder.s375977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/05/2022] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Whilst risk management has become fundamental in the development of medical devices, enforced by regulations and international standards, there is still no comprehensive model that explains how risk management in medical devices' development should be tackled, especially with regard to the type of risks that should be addressed. Risk management in the medical devices' development field is currently focused on technical risks, comprising product, usability, and development process risks, in alignment with standards' requirements and regulations, without giving enough attention to non-technical risks, which include business and project risks. Start-ups within this heavily regulated domain have a key role in the innovation process, yet they suffer a structural lack of tangible, such as financial capacity, and intangible resources such as development, risk management, and regulations' compliance. Nonetheless, they can still optimize their risk identification coverage beyond the enforced requirements to increase their products' chances of success. METHODS A set of qualitative interviews, serving the adopted grounded theory building research method, with seven start-ups who are involved in the development, commercialization, and quality control of medical devices was accomplished. The purpose was to determine the applied risk management practices and most importantly identify the risk types covered by them. Since every start-up is a project by itself, a sample of project risks, as identified by the project management institute, was utilized to scope the risk coverage and flag missing non-technical risks by the participating start-ups. RESULTS Un-identified risk types, lack of involvement of the right teams, and other related loopholes were presented. DISCUSSION A list of requirements was developed and sketched in a user-friendly risk management framework, which is believed to be crucial in helping start-ups attain successful, safe, and regulatory compliant medical devices production, is shared in the discussion and proposed framework section of this paper.
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Affiliation(s)
- Omar Kheir
- Product Development, University of Antwerp, Antwerp, Belgium
| | - Alexis Jacoby
- Product Development, University of Antwerp, Antwerp, Belgium
| | - Stijn Verwulgen
- Product Development, University of Antwerp, Antwerp, Belgium
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14
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Jalkanen K, Järvenpää R, Tilles-Tirkkonen T, Martikainen J, Aarnio E, Männikkö R, Rantala E, Karhunen L, Kolehmainen M, Harjumaa M, Poutanen K, Ermes M, Absetz P, Schwab U, Lakka T, Pihlajamäki J, Lindström J. Comparison of Communication Channels for Large-Scale Type 2 Diabetes Risk Screening and Intervention Recruitment: Empirical Study. JMIR Diabetes 2021; 6:e21356. [PMID: 34499036 PMCID: PMC8461532 DOI: 10.2196/21356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 11/26/2020] [Accepted: 07/13/2021] [Indexed: 01/19/2023] Open
Abstract
Background Clinical trials have shown that type 2 diabetes (T2D) is preventable through lifestyle interventions targeting high-risk people. Nevertheless, large-scale implementation of risk identification followed by preventive interventions has proven to be challenging. Specifically, recruitment of participants into preventive interventions is an important but often overlooked part of the intervention. Objective This study aims to compare the reach and yield of different communication channels to engage people at increased risk of T2D to fill in a digital screening questionnaire, with emphasis on reaching those at most risk. The participants expressing their willingness to participate is the final step in the risk screening test, and we aim to determine which channels had the most participants reach this step. Methods We established a stepwise web-based T2D risk screening tool with automated feedback according to the T2D risk level and, for those who were eligible, an invitation to participate in the StopDia prevention intervention study conducted in a primary health care setting. The risk estimate was based on the Finnish Diabetes Risk Score; history of repeatedly measured high blood glucose concentration; or, among women, previous gestational diabetes. We used several channels to invite people to the StopDia web-based screening tool, and respondents were classified into 11 categories based on the channel through which they reported having learned about StopDia. The demographics of respondents reached via different communication channels were compared using variance analysis. Logistic regression was used to study the respondents’ likelihood of progressing through risk screening steps. Results A total of 33,399 persons started filling the StopDia screening tool. Of these, 86.13% (28,768/33,399) completed the test and named at least one communication channel as the source of information about StopDia. Altogether, 26,167 persons filled in sufficient information to obtain risk estimates. Of them, 53.22% (13,925/26,167) were at increased risk, 30.06% (7866/26,167) were men, and 39.77% (10,136/25,485) had low or middle education levels. Most frequently mentioned channels were workplace (n=6817), social media or the internet (n=6712), and newspapers (n=4784). The proportion of individuals at increased risk was highest among those reached via community pharmacies (415/608, 68.3%) and health care (1631/2535, 64.33%). The communication channel reaching the largest percentage of interested and eligible men (1353/3979, 34%) was relatives or friends. Health care (578/1069, 54.07%) and radio or television (225/487, 46.2%) accounted for the largest proportion of people with lower education. Conclusions Communication channels reaching a large number of people, such as social media and newspapers, were the most effective channels for identifying at-risk people. Personalized approaches increased the engagement of men and less-educated people. Community pharmacies and health care services reached people with a particularly high T2D risk. Thus, communication and recruitment channels should be selected and modified based on the intended target group. International Registered Report Identifier (IRRID) RR2-10.1186/s12889-019-6574-y
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Affiliation(s)
- Kari Jalkanen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Riia Järvenpää
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tanja Tilles-Tirkkonen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Janne Martikainen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Emma Aarnio
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Reija Männikkö
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Eeva Rantala
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.,VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Leila Karhunen
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Marjukka Kolehmainen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Marja Harjumaa
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Kaisa Poutanen
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Miikka Ermes
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Pilvikki Absetz
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Timo Lakka
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Clinical Nutrition and Obesity Center, Kuopio University Hospital, Kuopio, Finland
| | - Jussi Pihlajamäki
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Clinical Nutrition and Obesity Center, Kuopio University Hospital, Kuopio, Finland
| | - Jaana Lindström
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
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15
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Li Y, Xiang P, You K, Guo J, Liu Z, Ren H. Identifying the Key Risk Factors of Mega Infrastructure Projects from an Extended Sustainable Development Perspective. Int J Environ Res Public Health 2021; 18:ijerph18147515. [PMID: 34299966 PMCID: PMC8304175 DOI: 10.3390/ijerph18147515] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022]
Abstract
Mega infrastructure projects (MIPs) have become increasingly important to the realization of sustainable development in China. Sustainable development is a process of dynamic balance, and coordinating the triple bottom line (the environmental, social, and economic dimensions) will enable more sustainable development of MIPs. However, previous studies have lacked consideration of coordination when applying sustainable development principles to the systematic identification of risks to MIPs. The goals of this study were to clarify the definition and dimensions of the sustainable development of MIPs and to identify the key risks of MIPs. A literature review was performed to extend the definition of sustainable development of MIPs by combining the triple bottom line with a fourth coordination dimension. A conceptual model of MIP risk identification was then proposed from an extended sustainable development perspective, 22 sustainability elements and 75 risk factors were identified, and the key risk factors were determined based on the interview responses and fuzzy set theory. The results show that economic risks have a high probability, social risks have a high loss, environmental risks have an intermediate probability and loss, and coordination risks have the greatest impact. In addition, the three most important key risk factors were found to be construction and installation cost overruns, land acquisition and resettling cost overruns, and information sharing with the public. Identifying key risk factors can provide information to help stakeholders understand the risk factors associated with MIPs and formulate reasonable risk response strategies.
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Affiliation(s)
- Yuanli Li
- School of Management Science and Real Estate, Chongqing University, Chongqing 400045, China; (Y.L.); (K.Y.); (J.G.); (H.R.)
| | - Pengcheng Xiang
- School of Management Science and Real Estate, Chongqing University, Chongqing 400045, China; (Y.L.); (K.Y.); (J.G.); (H.R.)
- International Research Center for Sustainable Built Environment, Chongqing University, Chongqing 400045, China
- Construction Economics and Management Research Center, Chongqing University, Chongqing 400045, China
- Correspondence:
| | - Kairui You
- School of Management Science and Real Estate, Chongqing University, Chongqing 400045, China; (Y.L.); (K.Y.); (J.G.); (H.R.)
| | - Jin Guo
- School of Management Science and Real Estate, Chongqing University, Chongqing 400045, China; (Y.L.); (K.Y.); (J.G.); (H.R.)
| | - Zhaowen Liu
- Faculty of Civil Engineering and Geosciences, Delft University of Technology, Stevinweg 1, 2628 CN Delft, The Netherlands;
| | - Hong Ren
- School of Management Science and Real Estate, Chongqing University, Chongqing 400045, China; (Y.L.); (K.Y.); (J.G.); (H.R.)
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16
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Guyon-Harris KL, Carell R, DeVlieger S, Humphreys KL, Huth-Bocks AC. The emotional tone of child descriptions during pregnancy is associated with later parenting. Infant Ment Health J 2021; 42:731-739. [PMID: 34255348 DOI: 10.1002/imhj.21936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION How parents think and feel about their young children has implications for the parent-child relationship. We examined prospective associations between prenatal descriptions of the unborn child's personality and later parenting behavior. METHODS Pregnant women (N = 120; mean age = 26.16, SD = 5.71) were recruited in their third trimester for a longitudinal study. The sample is demographically diverse and predominantly economically disadvantaged. During prenatal interviews, women described their unborn child's personality, from which positive and negative emotion words were coded. Parenting behavior was coded 12 months postpartum (n = 105 for longitudinal analyses). RESULTS Use of positive and negative words was negatively correlated (r = -.34, p < .001). Greater use of positive words to describe the unborn child's personality was associated with higher observed sensitivity, warmth, and engagement during mother-infant interactions, whereas negative words were associated with higher interference and lower levels of sensitivity. Mothers who used anxiety- and/or anger-related words to describe their unborn child, relative to mothers who did not, demonstrated higher interference and lower warmth and sensitivity. CONCLUSION Descriptions of a child's personality before the child is born were associated with postnatal parenting behavior. Prenatal interventions that address negative thoughts and feelings regarding the child may be beneficial for promoting positive parenting postnatally.
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Affiliation(s)
| | - Regan Carell
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Shana DeVlieger
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kathryn L Humphreys
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
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17
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Piqueras P, Ballester A, Durá-Gil JV, Martinez-Hervas S, Redón J, Real JT. Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review. Front Psychol 2021; 12:631179. [PMID: 34305707 PMCID: PMC8299753 DOI: 10.3389/fpsyg.2021.631179] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity is characterized by the accumulation of an excessive amount of fat mass (FM) in the adipose tissue, subcutaneous, or inside certain organs. The risk does not lie so much in the amount of fat accumulated as in its distribution. Abdominal obesity (central or visceral) is an important risk factor for cardiovascular diseases, diabetes, and cancer, having an important role in the so-called metabolic syndrome. Therefore, it is necessary to prevent, detect, and appropriately treat obesity. The diagnosis is based on anthropometric indices that have been associated with adiposity and its distribution. Indices themselves, or a combination of some of them, conform to a big picture with different values to establish risk. Anthropometric indices can be used for risk identification, intervention, or impact evaluation on nutritional status or health; therefore, they will be called anthropometric health indicators (AHIs). We have found 17 AHIs that can be obtained or estimated from 3D human shapes, being a noninvasive alternative compared to X-ray-based systems, and more accessible than high-cost equipment. A literature review has been conducted to analyze the following information for each indicator: definition; main calculation or obtaining methods used; health aspects associated with the indicator (among others, obesity, metabolic syndrome, or diabetes); criteria to classify the population by means of percentiles or cutoff points, and based on variables such as sex, age, ethnicity, or geographic area, and limitations.
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Affiliation(s)
- Paola Piqueras
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Alfredo Ballester
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Juan V. Durá-Gil
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Sergio Martinez-Hervas
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Josep Redón
- Department of Internal Medicine, Hospital Clínico de Valencia, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular and Renal Risk Research Group, Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), University of Valencia, Valencia, Spain
| | - José T. Real
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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18
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Patterson VC, Pencer A, Pavlova B, Awadia A, MacKenzie LE, Zwicker A, Drobinin V, Howes Vallis E, Uher R. Youth Experience Tracker Instrument: A self-report measure of developmental antecedents to severe mental illness. Early Interv Psychiatry 2021; 15:676-685. [PMID: 32575146 DOI: 10.1111/eip.13007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 05/12/2020] [Accepted: 05/24/2020] [Indexed: 11/29/2022]
Abstract
AIM We sought to examine the structure, internal consistency, convergent and criterion validity of the Youth Experience Tracker Instrument (YETI), a new brief self-report measure designed to facilitate early identification of risk for severe forms of mental illness, including major depressive disorder, bipolar disorder, and schizophrenia. METHODS We collected 716 YETIs from 315 individuals aged 8 to 27 with and without familial risk of severe mental illness. The YETI measures six developmental antecedents that precede and predict serious forms of mental illness: affective lability, anxiety, basic symptoms, depressive symptoms, psychotic-like experiences, and sleep. A battery of concurrent questionnaires and interviews measured the same constructs. RESULTS The best-fitting bifactor model supported the validity of both total score and antecedent-specific subscales. Internal consistency was high for the total score (ω = 0.94) and subscales (ω = 0.80-0.92; ρ = 0.72). The total score captured the majority of information from the 26 YETI items (hierarchical omega ωh = 0.74). Correlations of YETI subscales with established measures of the same constructs (r = 0.45-0.80) suggested adequate convergent validity. We propose cut-offs with high negative predictive values to facilitate efficient risk screening. CONCLUSION The YETI, a brief self-report measure of antecedents, provides an alternative to using multiple longer instruments. Future research may examine the predictive validity of the YETI for the onset of major mood and psychotic disorders.
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Affiliation(s)
- Victoria C Patterson
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.,IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Alissa Pencer
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.,IWK Health Centre, Halifax, Nova Scotia, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Barbara Pavlova
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Alim Awadia
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Lynn E MacKenzie
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Alyson Zwicker
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Vladislav Drobinin
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.,Department of Medical Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Emily Howes Vallis
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rudolf Uher
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.,IWK Health Centre, Halifax, Nova Scotia, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Medical Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
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19
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Mason K, Geist M, Kuo R, Marshall D, Wines JD. Clergy as Suicide Prevention Gatekeepers. J Pastoral Care Counsel 2021; 75:84-91. [PMID: 34137332 DOI: 10.1177/1542305020974997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
801 U.S. Catholic, Jewish and Protestant clergy reported on their suicide gatekeeping activities. Using vignettes, they identified suicide risk and selected interventions for three risk levels. Two-thirds of the sample who provide counseling reported at least one contact from a suicidal person per year. Clergy were significantly more concurrent with experts in identifying risk and selecting interventions with high risk but deviated more from the experts with low and medium risk. Most reported needing more training.
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Affiliation(s)
- Karen Mason
- Counseling Department, Gordon-Conwell Theological Seminary, USA
| | - Monica Geist
- Mathematics Department, Front Range Community College, USA
| | - Richard Kuo
- Counseling Department, Gordon-Conwell Theological Seminary, USA
| | - Day Marshall
- Counseling Department, Gordon-Conwell Theological Seminary, USA
| | - James D Wines
- Fernside Addiction Recovery, McLean Hospital/Harvard Medical School, USA
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20
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Willcox-Pidgeon S, Franklin RC, Leggat PA, Devine S. Epidemiology of unintentional fatal drowning among migrants in Australia. Aust N Z J Public Health 2021; 45:255-262. [PMID: 33900674 DOI: 10.1111/1753-6405.13102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/01/2020] [Accepted: 02/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to describe the epidemiology and risk factors contributing to drowning among migrants in Australia. METHODS A total population retrospective epidemiological study of unintentional drowning deaths in Australia between 1 July 2009 and 30 June 2019 of people born outside Australia (migrants). Cases were extracted from the National Coronial Information System. Descriptive statistics, chi-square and relative risk were calculated. Crude drowning rates were based on country of birth and population in Australia. RESULTS There were 572 migrant deaths over the study period, 28.9% of total drowning deaths, 82.9% were male. Twenty-one per cent were aged 25-34 years and 40.8% had lived in Australia for 20+ years. Migrants at highest risk of drowning were from: South Korea (2.63/100,000 95%CI: 0.85-8.25), Taiwan (2.29/100,000 95%CI: 0.27-13.44), and Nepal (2.15/100,000 95%CI: 0.23-11.55). Migrants were more likely to drown when around rocks (p<0.001) compared with Australian-born people, who most frequently drowned in rivers (p<0.001). CONCLUSIONS Migrants are not over-represented in drowning statistics. However, unique trends were found for drowning among migrants based on country of birth and length of time in Australia. Implications for public health: Holistic drowning prevention strategies and policies are required to effectively lower drowning risk among migrant communities.
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Affiliation(s)
- Stacey Willcox-Pidgeon
- Royal Life Saving Society - Australia, New South Wales.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
| | - Richard C Franklin
- Royal Life Saving Society - Australia, New South Wales.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
| | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Susan Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
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21
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Pumpa KL, Dalton J, Mara JK, Zhang Y, Yip D. Identifying women at risk of weight gain after a breast cancer diagnosis: Results from a cohort of Australian women. Health Promot J Austr 2021; 33:138-147. [PMID: 33638874 DOI: 10.1002/hpja.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 11/10/2022] Open
Abstract
ISSUES ADDRESSED This study aimed to identify risk factors associated with weight gain post a diagnosis of breast cancer in a cohort of Australian women. METHODS In this retrospective clinical audit, objectively measured weight, age and menopause status, treatment type/s, grade, stage, oestrogen receptor and progesterone receptor (PR) status were extracted for 73 breast cancer patients from an ongoing breast cancer treatment quality assurance project. Weight gain or loss was classified as a body mass increase or decrease of ≥5% of weight at diagnosis. RESULTS When compared to weight at diagnosis, 57% of patients maintained, 22% gained, and 21% lost weight at 24 months post-diagnosis. Factors associated with weight gain were a diagnosis of grade II (P < .001) or grade III (P < .001) compared to grade I breast cancer, and refusal of radiotherapy (P < .001). Factors associated with weight loss were being postmenopausal compared to premenopausal (P = .033), PR positive compared to PR negative (P < .001), refusal of chemotherapy (P < .001) and radiotherapy recommended (P < .001). CONCLUSIONS The maintenance of weight in a majority of women in this cohort is a novel finding. Early identification of women at risk of weight gain post a breast cancer diagnosis can assist health professionals identify, and therefore assisting patients in the prevention and management of weight gain and associated sequela. Investigating the weight-related communications between a patient and specialist, their access to allied health professionals and social support may assist in understanding the overall positive changes in this cohort.
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Affiliation(s)
- Kate L Pumpa
- Discipline of Sport & Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | | | - Jocelyn K Mara
- Discipline of Sport & Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Yanping Zhang
- Quality Assurance Project, ACT and SE NSW Breast Cancer Treatment Group, ACT Health, Canberra, ACT, Australia
| | - Desmond Yip
- Department of Medical Oncology, The Canberra Hospital. ANU Medical School, Australian National University, Canberra, ACT, Australia
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22
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Lei J, Sun T, Jiang Y, Wu P, Fu J, Zhang T, McGrath E. Risk Identification of Bronchopulmonary Dysplasia in Premature Infants Based on Machine Learning. Front Pediatr 2021; 9:719352. [PMID: 34485204 PMCID: PMC8415969 DOI: 10.3389/fped.2021.719352] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
Bronchopulmonary dysplasia (BPD) is one of the most common complications in premature infants. This disease is caused by long-time use of supplemental oxygen, which seriously affects the lung function of the child and imposes a heavy burden on the family and society. This research aims to adopt the method of ensemble learning in machine learning, combining the Boruta algorithm and the random forest algorithm to determine the predictors of premature infants with BPD and establish a predictive model to help clinicians to conduct an optimal treatment plan. Data were collected from clinical records of 996 premature infants treated in the neonatology department of Liuzhou Maternal and Child Health Hospital in Western China. In this study, premature infants with congenital anomaly, premature infants who died, and premature infants with incomplete data before the diagnosis of BPD were excluded from the data set. After exclusion, we included 648 premature infants in the study. The Boruta algorithm and 10-fold cross-validation were used for feature selection in this study. Six variables were finally selected from the 26 variables, and the random forest model was established. The area under the curve (AUC) of the model was as high as 0.929 with excellent predictive performance. The use of machine learning methods can help clinicians predict the disease so as to formulate the best treatment plan.
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Affiliation(s)
- Jintao Lei
- School of Science, Guangxi University of Science and Technology, Liuzhou, China
| | - Tiankai Sun
- School of Science, Guangxi University of Science and Technology, Liuzhou, China
| | - Yongjiang Jiang
- Department of Neonatology, Liuzhou Maternity and Child Health Care Hospital, Liuzhou, China
| | - Ping Wu
- Department of Pharmacy, Chengdu First People's Hospital Chengdu Integrated TCM Western Medicine Hospital, Chengdu, China
| | - Jinjian Fu
- Department of Preventive Medicine, Liuzhou Maternity and Child Health Care Hospital, Liuzhou, China
| | - Tao Zhang
- School of Science, Guangxi University of Science and Technology, Liuzhou, China
| | - Eric McGrath
- Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, United States
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Wu W, Huo Y, Ding X, Zhou Y, Gu S, Gao Y. Identification of the risks in CAR T-cell therapy clinical trials in China: a Delphi study. Ther Adv Med Oncol 2020; 12:1758835920966574. [PMID: 33149770 PMCID: PMC7580145 DOI: 10.1177/1758835920966574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/13/2020] [Indexed: 11/16/2022] Open
Abstract
Aims: Within the past few years, there has been tremendous growth in clinical trials of chimeric antigen receptor (CAR) T-cell therapies. Unlike those of many small-molecule pharmaceuticals, CAR T-cell therapy clinical trials are fraught with risks due to the use of live cell products. The aim of this study is to reach a consensus with experts on the most relevant set of risks that practically occur in CAR T-cell therapy clinical trials. Methods: A Delphi method of consensus development was used to identify the risks in CAR T-cell therapy clinical trials, comprising three survey rounds. The expert panel consisted of principal investigators, clinical research physicians, members of institutional ethics committees, and Good Clinical Practice managers. Results: Of the 24 experts invited to participate in this Delphi study, 20 participants completed Round 1, Round 2, and Round 3. Finally, consensus (defined as >80% agreement) was achieved for 54 risks relating to CAR T-cell clinical trials. Effective interventions related to these risks are needed to ensure the proper protection of subject health and safety. Conclusion: The Delphi method was successful in gaining a consensus on risks relevant to CAR T-cell clinical trials in a geographically diverse expert association. It is hoped that this work can benefit future risk-based quality management in clinical trials and can potentially promote the better development of CAR T-cell therapy products.
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Affiliation(s)
- Weijia Wu
- Department of Clinical Pharmacy and Pharmaceutical Management, School of Pharmacy, Fudan University, Shanghai, China
| | - Yan Huo
- National Institution of Food and Drug Control, National Medical Products Administration, Beijing, China
| | - Xueying Ding
- Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee
| | - Yuhong Zhou
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shengying Gu
- Clinical Research Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Gao
- Department of Clinical Pharmacy and Pharmaceutical Management, School of Pharmacy, Fudan University, Pudong District, Shanghai, 200433, China
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Duggan W, Moran D, Challacombe B. Sepsis in urology - where are we now? And where are we going? Scand J Urol 2020; 54:438-442. [PMID: 32677532 DOI: 10.1080/21681805.2020.1792546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
CONTEXT There has been heightened public awareness of the important issue of sepsis in the lay press in recent years with a focus on rapid detection and treatment. Within the field of Urology, how good are we at identifying, preventing and managing sepsis? Review: Reducing the morbidity and mortality associated with sepsis requires a multi-faceted approach including heightening awareness, prevention, early recognition of deterioration, escalation of care when necessary, implementation of antibiotic stewardship and the development of novel anti-microbial treatment strategies. DISCUSSION We review some of the aspects of sepsis management within our field that are working effectively and others that could potentially be optimised.
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Affiliation(s)
- William Duggan
- Department of Urology, Guys and St. Thomas' NHS Foundation Trust, London, UK
| | - Diarmaid Moran
- Department of Urology, St. Vincent's University Hospital, Dublin, Ireland
| | - Ben Challacombe
- Department of Urology, Guys and St. Thomas' NHS Foundation Trust, London, UK
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Anderson T, Busby JS, Rouncefield M. Understanding the Ecological Validity of Relying Practice as a Basis for Risk Identification. Risk Anal 2020; 40:1383-1398. [PMID: 32220145 DOI: 10.1111/risa.13475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/06/2020] [Accepted: 03/05/2020] [Indexed: 06/10/2023]
Abstract
Understanding the reliability of hazardous organizations and their protective systems is central to understanding the risk they produce. Work on "high reliability organization" has done much to illuminate the conditions in which social organization becomes reliable in highly demanding conditions. But risk depends just as much on how relying entities do their relying as it does on the reliability of the entities they rely on. Patterns of relying are often opaque in sociotechnical systems, and processes of relying and being relied on are mutually influencing in complex ways, so the relationship between relying and risk may not be at all obvious. This study was an attempt to study relying as a social practice, in particular analyzing how it had ecological validity in a social organization-how practice was responsive to the conditions in which it took place. This involved observational fieldwork and inductive, qualitative analysis on an offshore oil and gas production platform that was nearing the end of its design life and undergoing refurbishment. The analysis produced four main categories of ecological validity: responsiveness to formal organization, responsiveness to situational contingency, responsiveness to information asymmetry, and responsiveness to sociomateriality. This ecological validity of relying practice should be a primary focus of risk identification, assessing how relying can become mismatched to reliability in certain ways, both when relying practice is responsive to circumstances and when it is not.
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Affiliation(s)
- T Anderson
- Blue Stream Consulting Ltd, East Lodge, Edenhall, Penrith, Cumbria, UK
| | - J S Busby
- Department of Management Science, Lancaster University, Lancaster, UK
| | - M Rouncefield
- School of Computing and Communications, Lancaster University, Lancaster, UK
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Ondersma SJ, Chang G, Blake-Lamb T, Gilstad-Hayden K, Orav J, Beatty JR, Goyert GL, Yonkers KA. Accuracy of five self-report screening instruments for substance use in pregnancy. Addiction 2019; 114:1683-1693. [PMID: 31216102 PMCID: PMC8407406 DOI: 10.1111/add.14651] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/27/2019] [Accepted: 05/07/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS The accuracy of current screening instruments for identification of substance use in pregnancy is unclear, particularly given methodological shortcomings in existing research. This diagnostic accuracy study compared five existing instruments for ability to identify illicit drug, opioid and alcohol use, under privacy expectations consistent with applied practice and using a gold standard incorporating toxicological analysis. DESIGN Prospective cross-sectional screening accuracy study. SETTING Three sites encompassing four prenatal care clinics in the United States. PARTICIPANTS Convenience sample of 1220 racially, ethnically and socio-economically diverse pregnant women aged 18 years and over. MEASUREMENTS In Phase I, participants completed the five screening instruments in counterbalanced order. Instruments included the Substance Use Risk Profile-Pregnancy (SURP-P), CRAFFT (acronym for five-item screener with items related to car, relax, alone, forget, friends and trouble), 5Ps (parents, peers, partner, pregnancy, past), Wayne Indirect Drug Use Screener (WIDUS) and the National Institute on Drug Abuse (NIDA) Quick Screen. In Phase II, participants provided a urine sample and completed a calendar recall-based interview regarding substance use. These screeners were tested, using receiver operating characteristic (ROC) analysis and accuracy statistics, against a reference standard consisting of substance use in three classes (illicit drugs, opioids and alcohol), considered positive if use was evident via 30-day calendar recall or urine analysis. FINDINGS Three hundred and fifteen of 1220 participants (26.3%) met reference standard criteria for positivity. The single-item screening questions from the NIDA Quick Screen showed high specificity (0.99) for all substances, but very poor sensitivity (0.10-0.27). The 5Ps showed high sensitivity (0.80-0.88) but low specificity (0.35-0.37). The CRAFFT, SURP-P and 5Ps had the highest area under the curve (AUC) for alcohol (0.67, 0.66 and 0.62, respectively), and the WIDUS had the highest AUC for illicit drugs and opioids (0.70 and 0.69, respectively). Performance of all instruments varied significantly with race, site and economic status. CONCLUSIONS Of five screening instruments for substance use in pregnancy tested (Substance Use Risk Profile-Pregnancy (SURP-P), CRAFFT, 5Ps, Wayne Indirect Drug Use Screener (WIDUS) and the National Institute on Drug Abuse (Quick Screen), none showed both high sensitivity and high specificity, and area under the curve was low for nearly all measures.
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Affiliation(s)
- Steven J. Ondersma
- Merrill Palmer Skillman Institute and Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Grace Chang
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Tiffany Blake-Lamb
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - John Orav
- Department of Medicine (Biostatistics) and Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Jessica R. Beatty
- Merrill Palmer Skillman Institute and Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Gregory L. Goyert
- Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, MI, USA
| | - Kimberly A. Yonkers
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,,Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA
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Bi F, Hu H, Tu W. [Research on Fault Risk Identification and Control of CT Simulator Based on FMEA]. Zhongguo Yi Liao Qi Xie Za Zhi 2019; 43:303-306. [PMID: 31460728 DOI: 10.3969/j.issn.1671-7104.2019.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the high-risk fault risk of CT simulator and the main causes of the risk, and to put forward effective risk management strategies. METHODS The failure mode and effect analysis method was used to identify and control the operational fault risk of CT simulator. RESULTS 5 major fault components, 8 fault failure models and 17 failure causes were analyzed. The top 5 failure causes are:anode target surface burn caused by direct scanning without warming up the tube (590.4), tube failure (518.2), burnout of joints caused by aging of high voltage cables (424.2), motor carbon brush wear (304.8) and belt break (296.4). CONCLUSIONS The failure mode and effect analysis method can effectively identify the risk of equipment failure, and thus specifically formulate risk management and control measures to ensure the normal operation of equipment and the safety of doctors and patients.
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Affiliation(s)
- Fan Bi
- Dept. of Oromaxillofacial Head and Neck Oncology, the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011
| | - Haisheng Hu
- Dept. of Oromaxillofacial Head and Neck Oncology, the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011
| | - Wenyong Tu
- Dept. of Oromaxillofacial Head and Neck Oncology, the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011
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Abstract
Current risk identification practices applied to patient safety in healthcare are insufficient. The situation can be improved, however, by studying systems approaches broadly and successfully utilised in other safety-critical industries, such as aviation and chemical industries. To illustrate this, this paper first investigates current risk identification practices in the healthcare field, and then examines the potential of systems approaches. A systems-based approach, called the Risk Identification Framework (RID Framework), is then developed to enhance improvement in risk identification. Demonstrating the strengths of using multiple inputs and methods, the RID Framework helps to facilitate the proactive identification of new risks. In this study, the potential value of the RID Framework is discussed by examining its application and evaluation, as conducted in a real-world healthcare setting. Both the application and evaluation of the RID Framework indicate positive results, as well as the need for further research. Practitioner Summary: The findings in this study provide insights into how to make a better amalgamation of risk identification inputs to the safer design and more proactive risk management of healthcare delivery systems, which have been an increasing research interest amongst human factor professionals and ergonomists.
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Affiliation(s)
- M. C. Emre Simsekler
- Khalifa University of Science and Technology, Department of Industrial and Systems Engineering, Abu Dhabi, 127788, UAE
- University College London, School of Management, London, E14 5AA, UK
- Corresponding Author: M. C. Emre Simsekler, Khalifa University of Science and Technology, Department of Industrial and Systems Engineering, P.O. Box 127788, Abu Dhabi, United Arab Emirates, , T: +971 (0)2 501 8410, F: +971 (0)2 447 2442
| | - James R. Ward
- University of Cambridge, Engineering Department, Engineering Design Centre, Cambridge, CB2 1PZ, UK
| | - P. John Clarkson
- University of Cambridge, Engineering Department, Engineering Design Centre, Cambridge, CB2 1PZ, UK
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29
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Yang H, Song YQ, Hu YM, Chen FX, Zhang R. [Using sequential indicator simulation method to define risk areas of soil heavy metals in farmland.]. Ying Yong Sheng Tai Xue Bao 2018; 29:1695-1704. [PMID: 29797904 DOI: 10.13287/j.1001-9332.201805.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The heavy metals in soil have serious impacts on safety, ecological environment and human health due to their toxicity and accumulation. It is necessary to efficiently identify the risk area of heavy metals in farmland soil, which is of important significance for environment protection, pollution warning and farmland risk control. We collected 204 samples and analyzed the contents of seven kinds of heavy metals (Cu, Zn, Pb, Cd, Cr, As, Hg) in Zengcheng District of Guangzhou, China. In order to overcame the problems of the data, including the limitation of abnormal values and skewness distribution and the smooth effect with the traditional kriging methods, we used sequential indicator simulation method (SISIM) to define the spatial distribution of heavy metals, and combined Hakanson index method to identify potential ecological risk area of heavy metals in farmland. The results showed that: (1) Based on the similar accuracy of spatial prediction of soil heavy metals, the SISIM had a better expression of detail rebuild than ordinary kriging in small scale area. Compared to indicator kriging, the SISIM had less error rate (4.9%-17.1%) in uncertainty evaluation of heavy-metal risk identification. The SISIM had less smooth effect and was more applicable to simulate the spatial uncertainty assessment of soil heavy metals and risk identification. (2) There was no pollution in Zengcheng's farmland. Moderate potential ecological risk was found in the southern part of study area due to enterprise production, human activities, and river sediments. This study combined the sequential indicator simulation with Hakanson risk index method, and effectively overcame the outlier information loss and smooth effect of traditional kriging method. It provided a new way to identify the soil heavy metal risk area of farmland in uneven sampling.
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Affiliation(s)
- Hao Yang
- College of Natural Resources and Environment, South China Agricultural University, Guang-zhou 510642, China.,Key Laboratory of Construction Land Improvement, Ministry of Land and Resources, Guangzhou 510642,China
| | - Ying Qiang Song
- College of Natural Resources and Environment, South China Agricultural University, Guang-zhou 510642, China
| | - Yue Ming Hu
- College of Natural Resources and Environment, South China Agricultural University, Guang-zhou 510642, China.,Key Laboratory of Construction Land Improvement, Ministry of Land and Resources, Guangzhou 510642,China.,Guangdong Province Engineering Research Center for Land Information Technology, Guangzhou 510642, China.,Guangdong Province Key Laboratory for Land Use and Consolidation, Guangzhou 510642, China
| | - Fei Xiang Chen
- College of Natural Resources and Environment, South China Agricultural University, Guang-zhou 510642, China.,Key Laboratory of Construction Land Improvement, Ministry of Land and Resources, Guangzhou 510642,China
| | - Rui Zhang
- College of Natural Resources and Environment, South China Agricultural University, Guang-zhou 510642, China.,Key Laboratory of Construction Land Improvement, Ministry of Land and Resources, Guangzhou 510642,China
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30
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Metallinou MM, Log T. Health Impacts of Climate Change-Induced Subzero Temperature Fires. Int J Environ Res Public Health 2017; 14:E814. [PMID: 28726752 DOI: 10.3390/ijerph14070814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 07/15/2017] [Accepted: 07/17/2017] [Indexed: 11/16/2022]
Abstract
General fire risk and the special risk related to cold climate cellulosic drying processes are outlined. Four recent subzero temperatures fires are studied with respect to health impacts: a wooden village fire, a single wood structure fire, a wildland urban interface (WUI) fire and a huge wildland fire. The health impacts range from stress related to loss of jobs, psychological effects of lost possessions, exposure to smoke and heat as well as immediate, or delayed, loss of lives. These four fires resulted in 32 fatalities, 385 persons hospitalized for shorter or longer periods, 104 structures lost and 1015 km² of wildland burned north of, and just south of, the Arctic Circle. It is shown that the combination of subzero temperature dry weather, strong winds, changing agricultural activities and declining snowpack may lead to previously anticipated threats to people and the environment. There are reasons to believe that these fires are a result of the ongoing climate changes. Risk impacts are discussed. Rural districts and/or vulnerable populations seem to be most affected. Training methods to identify and better monitor critical fire risk parameters are suggested to mitigate the health impacts of a possibly increasing number of such fires.
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Abstract
BACKGROUND In healthcare, a range of methods are used to improve patient safety through risk identification within the scope of risk management. However, there is no evidence determining what trust-level guidance exists to support risk identification in healthcare organisations. This study therefore aimed to determine such methods through the content analysis of trust-level risk management documents. METHOD Through Freedom of Information Act, risk management documents were requested from each acute, mental health and ambulance trust in the East of England region of NHS for content analysis. Received documents were also compared with guidance from other safety-critical industries to capture differences between the documents from those industries, and learning points to the healthcare field. RESULTS A total of forty-eight documents were received from twenty-one trusts. Incident reporting was found as the main method for risk identification. The documents provided insufficient support for the use of prospective risk identification methods, such as Prospective Hazard Analysis (PHA) methods, while the guidance from other industries extensively promoted such methods. CONCLUSION The documents provided significant insight into prescribed risk identification practice in the chosen region. Based on the content analysis and guidance from other safety-critical industries, a number of recommendations were made; such as introducing the use of PHA methods in the creation and revision of risk management documents, and providing individual guidance on risk identification to promote patient safety further.
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Affiliation(s)
- M C Emre Simsekler
- University College London, Department of Management Science and Innovation, London, UK
| | - Alan J Card
- Evidence-Based Health Solutions, LLC, Notre Dame, IN, USA
| | - James R Ward
- University of Cambridge, Department of Engineering, Engineering Design Centre, Cambridge, UK
| | - P John Clarkson
- University of Cambridge, Department of Engineering, Engineering Design Centre, Cambridge, UK
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Abstract
Catholic, Jewish and Protestant clergy (n = 801) completed a survey to identify predictors of clergy's ability to fulfill a suicide gatekeeper role. Exploratory backward stepwise regression identified predictors of risk identification including suicide knowledge, religion, conducting suicide funerals, having an attitude that people have a right to die, age, and race. Predictors of ability to intervene include suicide knowledge, training, religion, right to die attitude, and ethnicity. Recommendations include more suicide training and clergy self-care.
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Gephart SM, Spitzer AR, Effken JA, Dodd E, Halpern M, McGrath JM. Discrimination of GutCheck(NEC): a clinical risk index for necrotizing enterocolitis. J Perinatol 2014; 34:468-75. [PMID: 24651734 DOI: 10.1038/jp.2014.37] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 01/28/2014] [Accepted: 02/05/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Better measures are needed to identify infants at risk for developing necrotizing enterocolitis (NEC) and facilitate communication about risk across transitions. Although NEC is multi-factorial, quantification of composite risk for NEC in an individual infant is not clearly defined. The objective of this study was to describe the derivation, validation and calibration testing of a novel clinical NEC risk index, GutCheck(NEC). Individual risk factors were weighted to assess composite odds of developing NEC. GutCheck(NEC) is designed to improve communication about NEC risk and coordination of care among clinicians across an infant's clinical course. STUDY DESIGN On the basis of a synthesis of research evidence about NEC risk and an e-Delphi study including 35 neonatal experts, we identified NEC risk factors believed by the experts to be most relevant for a NEC risk index, then applied a logistic model building process to derive and validate GutCheck(NEC). De-identified data from the Pediatrix BabySteps Clinical Data Warehouse (discharge date 2007 to 2011) were split into three samples for derivation, validation and calibration. By comparing infants with medical NEC, surgical NEC and those who died to infants without NEC, we derived the logistic model using the un-matched derivation set. Discrimination was then tested in a case-control matched validation set and an un-matched calibration set using receiver operating characteristic curves. RESULT Sampled from a cohort of 58 820 infants, the randomly selected derivation set (n=35 013) revealed nine independent risk factors (gestational age, history of packed red blood cell transfusion, unit NEC rate, late-onset sepsis, multiple infections, hypotension treated with inotropic medications, Black or Hispanic race, outborn status and metabolic acidosis) and two risk reducers (human milk feeding on both days 7 and 14 of life, and probiotics). Unit NEC rate carried the most weight in the summed score. Validation using a 2:1 matched case-control sample (n=360) demonstrated fair to good discrimination. In the calibration set (n=23 447), GutCheck(NEC) scores (range 0 to 58) discriminated those infants who developed surgical NEC (area under the curve (AUC)=0.84, 95% confidence interval (CI) 0.82 to 0.84) and NEC leading to death (AUC=0.83, 95% CI 0.81 to 0.85), more accurately than medical NEC (AUC= 0.72, 95% CI 0.70 to 0.74). CONCLUSION GutCheck(NEC) represents weighted composite risk for NEC and discriminated infants who developed NEC from those who did not with very good accuracy. We speculate that targeting modifiable NEC risk factors could reduce national NEC prevalence.
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Dean BB, Kindermann SL, Carson T, Gavin J, Frerking M, Bergren MD. Healthe Kids: an assessment of program performance and participation. J Sch Nurs 2014; 30:430-9. [PMID: 24668318 DOI: 10.1177/1059840514527622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Many states in the United States have mandated school health screenings for early identification and referral to professional services for a set of health conditions. Healthe Kids, a community-based program, began offering school-based health screenings to Missouri elementary schools in March 2007. The purpose of the article is to provide a description of the Healthe Kids program, including the team members, screening process, and the program's underlying technology. Further, we present data gathered during the first 5 years of the Healthe Kids program in Kansas City, Missouri, and describe improvements to the program from lessons learned and implications to school nurses and health care delivery.
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Affiliation(s)
| | | | - Tabetha Carson
- Cerner Corporation, Kansas City, MO, USA Cerner Corporation, Culver City, CA, USA Healthe Kids Institute, Kansas City, MO, USA College of Nursing, University of Illinois, Chicago, IL, USA
| | - Jan Gavin
- Healthe Kids Institute, Kansas City, MO, USA
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Abstract
Pennsylvania's response to adolescent suicide is its Student Assistance Program (SAP). SAP has been funded for 27 years although no statewide outcome studies using case-level data have been conducted. This study used logistic regression to examine drug-/alcohol-related behaviors and suspensions of suicidal students who participated in SAP. Of the 46 services, 10 best predicted (p<.01) that these undesirable outcomes would cease. Although no study subjects died by suicide, 42 of 374,626 referred students did die by suicide. Suicidal students who did not participate had double the rate of suicide of suicidal participants of SAP. Students referred for other reasons also killed themselves. Further work must be done to assess all referred students for suicide risk, examine educational outcomes, monitor substance-related crimes and overdoses, and examine school-related factors postmortem. Evidence from this study can be used by researchers to plan future studies and by Pennsylvania's school nurses when planning services.
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Affiliation(s)
- Virginia Sue Biddle
- 1Department of Psychiatry and Human Behavior, Thomas Jefferson University, Philadelphia, PA, USA
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Abstract
Toxicologic pathology relies on many disciplines of toxicology and basic sciences and often requires other fields and skills such as biostatistics, study design, guidelines, and knowledge of Good Laboratory Practices (GLP) regulations. Pathology is an integrative discipline where specific training and experience are required in order to integrate chemical or biological structures, molecular biology, physiology, and morphology for candidate selection and early development of a test article and to help in the design of appropriate preclinical/toxicology studies. Experience does matter and successful learning is determined by personal behavior; pathologists who not only read slides but research their topics and keep current with the literature are apt to be successful.
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Abstract
Pathology Working Groups (PWG) are a specialized form of review consisting of a panel of expert pathologists who provide an independent, unbiased assessment of specific questions concerning study results. PWGs may concentrate on pivotal studies with controversial end points, address questions that are of concern to a regulatory agency, or compare the results of multiple studies that may have been conducted and evaluated by different laboratories and/or pathologists. The PWG does not review the entire study but always includes a preliminary review by a peer review pathologist. The PWG chairperson needs to thoroughly understand the issue in question, reviews all relevant data and study results, and is responsible for the organization and conduct of the PWG. The members of the PWG examine coded slides without knowledge of treatment group or previous diagnosis and arrive at a consensus diagnosis by majority vote. Once the results are decoded, the PWG evaluates the results and provides discussion and conclusions that are reflected in the final PWG report. Specific examples of PWG issues are provided.
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Affiliation(s)
- Peter C Mann
- 1Experimental Pathology Laboratories Northwest, Seattle, Washington, USA
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Puntila R, Vilizzi L, Lehtiniemi M, Copp GH. First application of FISK, the Freshwater Fish Invasiveness Screening Kit, in northern Europe: example of southern Finland. Risk Anal 2013; 33:1397-1403. [PMID: 23711016 DOI: 10.1111/risa.12069] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The climatic conditions of north temperate countries pose unique influences on the rates of invasion and the potential adverse impacts of non-native species. Methods are needed to evaluate these risks, beginning with the pre-screening of non-native species for potential invasives. Recent improvements to the Fish Invasiveness Scoring Kit (FISK) have provided a means (i.e., FISK v2) of identifying potentially invasive non-native freshwater fishes in virtually all climate zones. In this study, FISK is applied for the first time in a north temperate country, southern Finland, and calibrated to determine the appropriate threshold score for fish species that are likely to pose a high risk of being invasive in this risk assessment area. The threshold between "medium" and "high" risk was determined to be 22.5, which is slightly higher than the original threshold for the United Kingdom (i.e., 19) and that determined for a FISK application in southern Japan (19.8). This underlines the need to calibrate such decision-support tools for the different areas where they are employed. The results are evaluated in the context of current management strategies in Finland regarding non-native fishes.
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Affiliation(s)
- Riikka Puntila
- Department of Environmental Sciences, University of Helsinki, Finland
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Avital I, Langan RC, Summers TA, Steele SR, Waldman SA, Backman V, Yee J, Nissan A, Young P, Womeldorph C, Mancusco P, Mueller R, Noto K, Grundfest W, Bilchik AJ, Protic M, Daumer M, Eberhardt J, Man YG, Brücher BL, Stojadinovic A. Evidence-based Guidelines for Precision Risk Stratification-Based Screening (PRSBS) for Colorectal Cancer: Lessons learned from the US Armed Forces: Consensus and Future Directions. J Cancer 2013; 4:172-92. [PMID: 23459409 PMCID: PMC3584831 DOI: 10.7150/jca.5834] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 02/01/2013] [Indexed: 12/16/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common cause of cancer-related death in the United States (U.S.), with estimates of 143,460 new cases and 51,690 deaths for the year 2012. Numerous organizations have published guidelines for CRC screening; however, these numerical estimates of incidence and disease-specific mortality have remained stable from years prior. Technological, genetic profiling, molecular and surgical advances in our modern era should allow us to improve risk stratification of patients with CRC and identify those who may benefit from preventive measures, early aggressive treatment, alternative treatment strategies, and/or frequent surveillance for the early detection of disease recurrence. To better negotiate future economic constraints and enhance patient outcomes, ultimately, we propose to apply the principals of personalized and precise cancer care to risk-stratify patients for CRC screening (Precision Risk Stratification-Based Screening, PRSBS). We believe that genetic, molecular, ethnic and socioeconomic disparities impact oncological outcomes in general, those related to CRC, in particular. This document highlights evidence-based screening recommendations and risk stratification methods in response to our CRC working group private-public consensus meeting held in March 2012. Our aim was to address how we could improve CRC risk stratification-based screening, and to provide a vision for the future to achieving superior survival rates for patients diagnosed with CRC.
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Affiliation(s)
- Itzhak Avital
- 1. Bon Secours Cancer Institute, Richmond VA ; 2. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD ; 3. United States Military Cancer Institute, Bethesda, MD ; 4. INCORE, International Consortium of Research Excellence of the Theodor-Billroth-Academy, Munich, Germany
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Rhodes KV, Kothari CL, Dichter M, Cerulli C, Wiley J, Marcus S. Intimate partner violence identification and response: time for a change in strategy. J Gen Intern Med 2011; 26:894-9. [PMID: 21404130 PMCID: PMC3138975 DOI: 10.1007/s11606-011-1662-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 10/26/2010] [Accepted: 02/07/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND While victims of intimate partner violence (IPV) present to health care settings for a variety of complaints; rates and predictors of case identification and intervention are unknown. OBJECTIVE Examine emergency department (ED) case finding and response within a known population of abused women. DESIGN Retrospective longitudinal cohort study. SUBJECTS Police-involved female victims of IPV in a semi-rural Midwestern county. MAIN MEASURES We linked police, prosecutor, and medical record data to examine characteristics of ED identification and response from 1999-2002; bivariate analyses and logistic regression analyses accounted for the nesting of subjects' with multiple visits. RESULTS IPV victims (N = 993) generated 3,426 IPV-related police incidents (mean 3.61, median 3, range 1-17) over the 4-year study period; 785 (79%) generated 4,306 ED visits (mean 7.17, median 5, range 1-87), which occurred after the date of a documented IPV assault. Only 384 (9%) ED visits occurred within a week of a police-reported IPV incident. IPV identification in the ED was associated with higher violence severity, being childless and underinsured, more police incidents (mean: 4.2 vs 3.3), and more ED visits (mean: 10.6 vs 5.5) over the 4 years. The majority of ED visits occurring after a documented IPV incident were for medical complaints (3,378, 78.4%), and 72% of this cohort were never identified as victims of abuse. IPV identification was associated with the day of a police incident, transportation by police, self-disclosure of "domestic assault," and chart documentation of mental health and substance abuse issues. When IPV was identified, ED staff provided legally useful documentation (86%), police contact (50%), and social worker involvement (45%), but only assessed safety in 33% of the women and referred them to victim services 25% of the time. CONCLUSION The majority of police-identified IPV victims frequently use the ED for health care, but are unlikely to be identified or receive any intervention in that setting.
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Affiliation(s)
- Karin V Rhodes
- Department Of Emergency Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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