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Gómez-Moreno C, Vélez-Vélez E, Garrigues Ramón M, Rojas Alfaro M, García-Carpintero Blas E. Patient safety in surgical settings: A study on the challenges and improvement strategies in adverse event reporting from a nursing perspective. J Clin Nurs 2024; 33:2324-2336. [PMID: 38308406 DOI: 10.1111/jocn.17047] [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: 08/04/2023] [Revised: 12/06/2023] [Accepted: 01/19/2024] [Indexed: 02/04/2024]
Abstract
AIMS To explore adverse event reporting in the surgical department through the nurses' experiences and perspectives. DESIGN An exploratory, descriptive qualitative study was conducted with a theoretical-methodological orientation of phenomenology. METHODS In-depth interviews were conducted with 15 nurses, followed by an inductive thematic analysis. RESULTS Themes include motives for reporting incidents, consequences, feelings and motivational factors. Key facilitators of adverse event reporting were effective communication, knowledge sharing, a non-punitive culture and superior feedback. CONCLUSION The study underscores the importance of supportive organisational culture for reporting, communication and feedback mechanisms, and highlights education and training in enhancing patient safety. IMPLICATIONS It suggests the need for strategies that foster incident reporting, enhance patient safety and cultivate a supportive organisational culture. IMPACT This study provides critical insights into adverse event reporting in surgical departments from nurses' lived experience, leading to two primary impacts: It offers specific solutions to improve adverse event reporting, which is crucial for surgical departments to develop more effective and tailored reporting strategies. The research underscores the importance of an open, supportive culture in healthcare, which is vital for transparent communication and effective reporting, ultimately advancing patient safety. REPORTING METHOD The study followed the Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines. PATIENTS OR PUBLIC CONTRIBUTION No patients or public contribution.
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Affiliation(s)
- Cristina Gómez-Moreno
- Fundación Jiménez Díaz School of Nursing - Health Research Institute-Fundación, Jiménez Díaz University Hospital - UAM (IIS-FJD, UAM), Madrid, Spain
| | - Esperanza Vélez-Vélez
- Fundación Jiménez Díaz School of Nursing - Health Research Institute-Fundación, Jiménez Díaz University Hospital - UAM (IIS-FJD, UAM), Madrid, Spain
| | - Marta Garrigues Ramón
- Fundación Jiménez Díaz School of Nursing - Health Research Institute-Fundación, Jiménez Díaz University Hospital - UAM (IIS-FJD, UAM), Madrid, Spain
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En-Naaoui A, Kaicer M, Aguezzoul A. A novel decision support system for proactive risk management in healthcare based on fuzzy inference, neural network and support vector machine. Int J Med Inform 2024; 186:105442. [PMID: 38564960 DOI: 10.1016/j.ijmedinf.2024.105442] [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: 08/17/2023] [Revised: 03/05/2024] [Accepted: 03/29/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The nature of activities practiced in healthcare organizations makes risk management the most crucial issue for decision-makers, especially in developing countries. New technologies provide effective solutions to support engineers in managing risks. PURPOSE This study aims to develop a Decision Support System (DSS) adapted to the healthcare constraints of developing countries that enables the provision of decisions about risk tolerance classes and prioritizations of risk treatment. METHODS Failure Modes and Effects Analysis (FMEA) is a popular method for risk assessment and quality improvement. Fuzzy logic theory is combined with this method to provide a robust tool for risk evaluation. The fuzzy FMEA provides fuzzy Risk Priority Number (RPN) values. The artificial neural network is a powerful algorithm used in this study to classify identified risk tolerances. The risk treatment process is taken into consideration in this study by improving FMEA. A new factor is added to evaluate the feasibility of correcting the intolerable risks, named the control factor, to prioritize these risks and start with the easiest. The new factor is combined with the fuzzy RPN to obtain intolerable risk prioritization. This prioritization is classified using the support vector machine. FINDINGS Results prove that our DSS is effective according to these reasons: (1) The fuzzy-FMEA surmounts classical FMEA drawbacks. (2) The accuracy of the risk tolerance classification is higher than 98%. (3) The second fuzzy inference system developed (the control factor for intolerable risks with the fuzzy RPN) is useful because of the imprecise situation. (4) The accuracy of the fuzzy-priority results is 74% (mean of testing and training data). CONCLUSIONS Despite the advantages, our DSS also has limitations: There is a need to generalize this support to other healthcare departments rather than one case study (the sterilization unit) in order to confirm its applicability and efficiency in developing countries.
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Affiliation(s)
- Amine En-Naaoui
- Department of Mathematics, Ibn Tofail University, Kenitra, Morocco; National Institute of Oncology, Ibn Sina University Hospital Center, Rabat, Morocco.
| | - Mohammed Kaicer
- Department of Mathematics, Ibn Tofail University, Kenitra, Morocco.
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Leri AC, Hettithanthri O, Bolan S, Zhang T, Unrine J, Myneni S, Nachman DR, Tran HT, Phillips AJ, Hou D, Wang Y, Vithanage M, Padhye LP, Jasemi Zad T, Heitz A, Siddique KHM, Wang H, Rinklebe J, Kirkham MB, Bolan N. Bromine contamination and risk management in terrestrial and aquatic ecosystems. J Hazard Mater 2024; 469:133881. [PMID: 38422740 DOI: 10.1016/j.jhazmat.2024.133881] [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] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/18/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Abstract
Bromine (Br) is widely distributed through the lithosphere and hydrosphere, and its chemistry in the environment is affected by natural processes and anthropogenic activities. While the chemistry of Br in the atmosphere has been comprehensively explored, there has never been an overview of the chemistry of Br in soil and aquatic systems. This review synthesizes current knowledge on the sources, geochemistry, health and environmental threats, remediation approaches, and regulatory guidelines pertaining to Br pollution in terrestrial and aquatic environments. Volcanic eruptions, geothermal streams, and seawater are the major natural sources of Br. In soils and sediments, Br undergoes natural cycling between organic and inorganic forms, with bromination reactions occurring both abiotically and through microbial activity. For organisms, Br is a non-essential element; it is passively taken up by plant roots in the form of the Br- anion. Elevated Br- levels can limit plant growth on coastal soils of arid and semi-arid environments. Br is used in the chemical industry to manufacture pesticides, flame retardants, pharmaceuticals, and other products. Anthropogenic sources of organobromine contaminants in the environment are primarily wastewater treatment, fumigants, and flame retardants. When aqueous Br- reacts with oxidants in water treatment plants, it can generate brominated disinfection by-products (DBPs), and exposure to DBPs is linked to adverse human health effects including increased cancer risk. Br- can be removed from aquatic systems using adsorbents, and amelioration of soils containing excess Br- can be achieved by leaching, adding various amendments, or phytoremediation. Developing cost-effective methods for Br- removal from wastewater would help address the problem of toxic brominated DBPs. Other anthropogenic organobromines, such as polybrominated diphenyl ether (PBDE) flame retardants, are persistent, toxic, and bioaccumulative, posing a challenge in environmental remediation. Future research directives for managing Br pollution sustainably in various environmental settings are suggested here.
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Affiliation(s)
- Alessandra C Leri
- Department of Natural Sciences, Marymount Manhattan College, 221 E 71st St., New York, NY 10021, United States.
| | - Oshadi Hettithanthri
- Ecosphere Resilience Research Centre, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, 10250, Sri Lanka
| | - Shiv Bolan
- UWA School of Agriculture and Environment, The University of Western Australia, Perth, Western Australia 6009, Australia; The UWA Institute of Agriculture, The University of Western Australia, Perth, Western Australia 6009, Australia; Healthy Environments And Lives (HEAL) National Research Network, Canberra, Australia
| | - Tao Zhang
- Beijing Key Laboratory of Farmland Soil Pollution Prevention-Control and Remediation, College of Resources and Environmental Sciences, China Agricultural University, Beijing 100193, People's Republic of China
| | - Jason Unrine
- Department of Plant and Soil Sciences, University of Kentucky, Lexington, KY 40546, United States; Kentucky Water Research Institute, University of Kentucky, Lexington, KY 40506, United States
| | - Satish Myneni
- Department of Geosciences, Princeton Univ., Princeton, NJ 08544, United States
| | - Danielle R Nachman
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States
| | - Huu Tuan Tran
- Laboratory of Ecology and Environmental Management, Science and Technology Advanced Institute, Van Lang University, Ho Chi Minh City, Viet Nam; Faculty of Applied Technology, School of Technology, Van Lang University, Ho Chi Minh City, Viet Nam
| | - Ankur J Phillips
- Department of Microbiology, College of Basic Sciences and Humanities, Govind Ballabh Pant University of Agriculture and Technology, Pantnagar, Uttarakhand 263145, India
| | - Deyi Hou
- School of Environment, Tsinghua University, Beijing 100084, People's Republic of China
| | - Yidong Wang
- School of Environment, Tsinghua University, Beijing 100084, People's Republic of China
| | - Meththika Vithanage
- Ecosphere Resilience Research Centre, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, 10250, Sri Lanka; UWA School of Agriculture and Environment, The University of Western Australia, Perth, Western Australia 6009, Australia; Sustainability Cluster, University of Petroleum and Energy Studies, Dehradun, India
| | - Lokesh P Padhye
- Department of Civil and Environmental Engineering, Faculty of Engineering, The University of Auckland, Auckland 1010, New Zealand
| | - Tahereh Jasemi Zad
- Department of Civil and Environmental Engineering, Faculty of Engineering, The University of Auckland, Auckland 1010, New Zealand
| | - Anna Heitz
- Curtin Water Quality Research Centre, Department of Chemistry, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Kadambot H M Siddique
- UWA School of Agriculture and Environment, The University of Western Australia, Perth, Western Australia 6009, Australia; The UWA Institute of Agriculture, The University of Western Australia, Perth, Western Australia 6009, Australia
| | - Hailong Wang
- Biochar Engineering Technology Research Center of Guangdong Province, School of Environmental and Chemical Engineering, Foshan University, Foshan, Guangdong 528000, People's Republic of China; Key Laboratory of Soil Contamination Bioremediation of Zhejiang Province, Zhejiang A&F University, Hangzhou, Zhejiang 311300, People's Republic of China
| | - Jörg Rinklebe
- University of Wuppertal, School of Architecture and Civil Engineering, Institute of Foundation Engineering, Water, and Waste-Management, Laboratory of Soil, and Groundwater-Management, Pauluskirchstraße 7, Wuppertal 42285, Germany
| | - M B Kirkham
- Department of Agronomy, Throckmorton Plant Sciences Center, Kansas State University, Manhattan, KS 66506, United States
| | - Nanthi Bolan
- UWA School of Agriculture and Environment, The University of Western Australia, Perth, Western Australia 6009, Australia; The UWA Institute of Agriculture, The University of Western Australia, Perth, Western Australia 6009, Australia; Healthy Environments And Lives (HEAL) National Research Network, Canberra, Australia
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Fan C, Montewka J, Zhang D, Han Z. A framework for risk matrix design: A case of MASS navigation risk. Accid Anal Prev 2024; 199:107515. [PMID: 38422879 DOI: 10.1016/j.aap.2024.107515] [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: 08/31/2022] [Revised: 12/11/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
Risk matrix, a tool for visualizing risk assessment results, is essential to facilitate the risk communication and risk management in risk-based decision-making processes related to new and unexplored socio-technical systems. The use of an appropriate risk matrix is discussed in the literature, but it is overlooked for emerging technologies such as Maritime Autonomous Surface Ships (MASS). In this study, a comprehensive framework for developing a risk matrix based on fuzzy Analytic Hierarchy Process (AHP) is proposed. In this framework, a linear function is defined where the risk index is treated as a response variable, while the probability and consequence indices are explanatory variables, with weights of these two indices representing their importance on given risk level. This significance is assessed by experts and quantified using AHP in interval type 2 fuzzy environment. A continuous risk diagram is then created and converted into a risk matrix that can be improved. To verify the feasibility of the proposed framework, a risk matrix is designed in the context of MASS grounding. The results show that the proposed approach is feasible. Our discussion results can provide new insights for the design of risk matrices and promote the management of MASS navigational risks.
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Affiliation(s)
- Cunlong Fan
- College of Transport & Communications, Shanghai Maritime University, 1550 Haigang Avenue, Shanghai 201306, PR China; School of Transportation and Logistics Engineering, Wuhan University of Technology, 1040 Heping Avenue, Wuhan, Hubei 430063, PR China; Department of Marine Technology, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - Jakub Montewka
- Gdańsk University of Technology, Gdańsk, Poland; Waterborne Transport Innovation, Gdańsk, Poland
| | - Di Zhang
- School of Transportation and Logistics Engineering, Wuhan University of Technology, 1040 Heping Avenue, Wuhan, Hubei 430063, PR China; State Key Laboratory of Maritime Technology and Safety, Wuhan University of Technology, 1040 Heping Avenue, Wuhan, Hubei 430063, PR China; Inland Port and Shipping Industry Research Co., Ltd. of Guangdong Province, PR China.
| | - Zhepeng Han
- School of Transportation and Logistics Engineering, Wuhan University of Technology, 1040 Heping Avenue, Wuhan, Hubei 430063, PR China
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Dirks A, Florez M, Torche F, Young S, Slizgi B, Getz K. Comprehensive Assessment of Risk-Based Quality Management Adoption in Clinical Trials. Ther Innov Regul Sci 2024; 58:520-527. [PMID: 38366107 DOI: 10.1007/s43441-024-00618-5] [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: 08/24/2023] [Accepted: 01/08/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Risk-based monitoring (RBM) and risk-based quality management (RBQM) offer a compelling approach to increase efficiency, speed and quality in clinical trials by prioritizing and mitigating risks related to essential safety and efficacy data. Since 2013, the FDA and EMA have encouraged the use of RBM/RBQM, however adoption has been slow with limited understanding of the barriers to adoption. METHODS The Tufts Center for the Study of Drug Development conducted an online survey among pharmaceutical, biotechnology, and contract research organizations and gathered 206 responses on 32 distinct RBQM practices. RESULTS On average, companies implemented RBQM in 57% of their clinical trials. Lower levels of adoption were observed among companies conducting fewer than 25 trials annually (48%) compared to those conducting more than 100 trials annually (63%). Primary barriers to adoption include lack of organizational knowledge and awareness, mixed perceptions of the value proposition of RBQM, and poor change management planning and execution. Insights into improving the level of adoption are discussed.
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Affiliation(s)
- Abigail Dirks
- Tufts Center for the Study of Drug Development, Tufts School of Medicine, Boston, MA, USA.
| | - Maria Florez
- Tufts Center for the Study of Drug Development, Tufts School of Medicine, Boston, MA, USA
| | | | | | - Brian Slizgi
- Price Waterhouse Coopers (PWC), London, United Kingdom
| | - Kenneth Getz
- Tufts Center for the Study of Drug Development, Tufts School of Medicine, Boston, MA, USA
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Altuhaifa F, Al Tuhaifa D. Developing an Ontology Representing Fall Risk Management Domain Knowledge. J Med Syst 2024; 48:47. [PMID: 38662184 DOI: 10.1007/s10916-024-02062-2] [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: 05/29/2023] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
Ontologies serve as comprehensive frameworks for organizing domain-specific knowledge, offering significant benefits for managing clinical data. This study presents the development of the Fall Risk Management Ontology (FRMO), designed to enhance clinical text mining, facilitate integration and interoperability between disparate data sources, and streamline clinical data analysis. By representing major entities within the fall risk management domain, the FRMO supports the unification of clinical language and decision-making processes, ultimately contributing to the prevention of falls among older adults. We used Ontology Web Language (OWL) to build the FRMO in Protégé. Of the seven steps of the Stanford approach, six steps were utilized in the development of the FRMO: (1) defining the domain and scope of the ontology, (2) reusing existing ontologies when possible, (3) enumerating ontology terms, (4) specifying the classes and their hierarchy, (5) defining the properties of the classes, and (6) defining the facets of the properties. We evaluated the FRMO using four main criteria: consistency, completeness, accuracy, and clarity. The developed ontology comprises 890 classes arranged in a hierarchical structure, including six top-level classes with a total of 43 object properties and 28 data properties. FRMO is the first comprehensively described semantic ontology for fall risk management. Healthcare providers can use the ontology as the basis of clinical decision technology for managing falls among older adults.
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Affiliation(s)
- Fatimah Altuhaifa
- School of Computing and Information Technology, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia.
- Saudi Arabia Ministry of Higher Education, Riyadh, Saudi Arabia.
| | - Dalal Al Tuhaifa
- Microbiology laboratory department, Maternity and Children's Hospital, Al Imam Ali Ibn Abi Talib St, Al Muraikabat, Dammam, 32253, Saudi Arabia.
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Mooney S, Lavallee S, O'Dwyer J, Majury A, O'Neill E, Hynds PD. Private groundwater contamination and risk management: A comparative scoping review of similarities, drivers and challenges across two socio-economically developed regions. Sci Total Environ 2024; 922:171112. [PMID: 38387579 DOI: 10.1016/j.scitotenv.2024.171112] [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: 12/10/2023] [Revised: 02/13/2024] [Accepted: 02/18/2024] [Indexed: 02/24/2024]
Abstract
Consolidation of multi-domain risk management research is essential for strategies facilitating the concerted government (educational) and population-level (behavioural) actions required to reduce microbial private groundwater contamination. However, few studies to date have synthesised this literature or sought to ascertain the causal generality and extent of supply contamination and preventive responses. In light of the Republic of Ireland (ROI) and Ontario's high reliance and research focus on private wells and consequent utility for empirical comparison, a scoping review of pertinent literature (1990-2022) from both regions was undertaken. The SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) method was employed to inform literature searches, with Scopus and Web of Science selected as primary databases for article identification. The review identified 65 relevant articles (Ontario = 34, ROI = 31), with those investigating well user actions (n = 22) and groundwater quality (n = 28) the most frequent. A markedly higher pooled proportion of private supplies in the ROI exhibited microbial contamination (38.3 % vs. 4.1 %), despite interregional similarities in contamination drivers (e.g., weather, physical supply characteristics). While Ontarian well users demonstrated higher rates of historical (≥ 1) and annual well testing (90.6 % vs. 71.1 %; 39.1 % vs. 8.6 %) and higher rates of historical well treatment (42.3 % vs. 24.3 %), interregional levels of general supply knowledge were analogous (70.7 % vs. 71.0 %). Financial cost, organoleptic properties and residence on property during supply construction emerged as predictors of cognition and behaviour in both regions. Review findings suggest broad interregional similarities in drivers of supply contamination and individual-level risk mitigation, indicating that divergence in contamination rates may be attributable to policy discrepancies - particularly well testing incentivisation. The paucity of identified intervention-oriented studies further highlights the importance of renewed research and policy agendas for improved, targeted well user outreach and incentivised, convenience-based services promoting routine supply maintenance.
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Affiliation(s)
- S Mooney
- School of Architecture, Planning & Environmental Policy, University College Dublin, Ireland.
| | - S Lavallee
- Center for Tobacco and the Environment, San Diego State University, San Diego, CA, United States
| | - J O'Dwyer
- School of Biological, Earth and Environmental Sciences, University College Cork, Cork, Ireland; Environmental Research Institute, University of Cork, Cork, Ireland; Irish Centre for Research in Applied Geosciences (iCRAG), University College Dublin, Dublin, Ireland
| | - A Majury
- School of Environmental Studies, Queen's University, Kingston, Ontario, Canada; Public Health Ontario, Kingston, Ontario, Canada
| | - E O'Neill
- School of Architecture, Planning & Environmental Policy, University College Dublin, Ireland; UCD Earth Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - P D Hynds
- Irish Centre for Research in Applied Geosciences (iCRAG), University College Dublin, Dublin, Ireland; Environmental Sustainability & Health Institute, Technological University Dublin, Dublin, Ireland
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Daujatas DM, Eischen E, Quinn AL. REMS: Time to reevaluate. Am J Health Syst Pharm 2024; 81:e206-e207. [PMID: 38146990 DOI: 10.1093/ajhp/zxad338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Indexed: 12/27/2023] Open
Affiliation(s)
| | - Edward Eischen
- Northwestern Medicine Palos Hospital, Palos Heights, IL, USA
| | - Andrea L Quinn
- Northwestern Medicine Palos Hospital, Palos Heights, IL, USA
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Li H, Zhang C, Li L, Liu T, Zhang L, Hao J, Sun J. Bibliometric and visualization analysis of risk management in the doctor-patient relationship: A systematic quantitative literature review. Medicine (Baltimore) 2024; 103:e37807. [PMID: 38640335 PMCID: PMC11029958 DOI: 10.1097/md.0000000000037807] [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] [Received: 07/20/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/21/2024] Open
Abstract
OBJECTIVES This paper analyzed the research on risk management in the doctor-patient relationship (DPR) based on a systematic quantitative literature review approach using bibliometric software. It aims to uncover potential information about current research and predict future research hotspots and trends. METHODS We conducted a comprehensive search for relevant publications in the Scopus database and the Web of Science Core Collection database from January 1, 2000 to December 31, 2023. We analyzed the data using CiteSpace 6.2.R2 and VOSviewer 1.6.19 software to examine the annual number of publications, countries/regions, journals, citations, authors, and keywords in the field. RESULTS A total of 553 articles and reviews that met the criteria were included in this study. There is an overall upward trend in the number of publications issued; in terms of countries/regions, the United States and the United Kingdom are the largest contributors; Patient Education and Counseling is the most productive journal (17); Physician communication and patient adherence to treatment: a meta-analysis is the most cited article (1637); the field has not yet to form a stable and obvious core team; the analysis of high-frequency keywords revealed four main research directions: the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor-patient risk characteristics; the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor-patient risk characteristics; the keyword burst analysis revealed several shifts in the research hotspots for risk management in the DPR, suggesting that chronic disease management, is a future research direction for the continued development of risk management in the DPR. CONCLUSIONS The visualization analysis of risk management literature in the DPR using CiteSpace and VOSviewer software provides insights into the current research status and highlights future research directions.
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Affiliation(s)
- Hui Li
- Health Management College, Anhui Medical University, Hefei, China
| | - Chenchen Zhang
- First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Limin Li
- Health Management College, Anhui Medical University, Hefei, China
| | - Tong Liu
- Health Management College, Anhui Medical University, Hefei, China
| | - Liping Zhang
- School of Marxism, Anhui Medical University, Hefei, China
| | - Jiqing Hao
- First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Jiangjie Sun
- Health Management College, Anhui Medical University, Hefei, China
- Clinical Medical College, Anhui Medical University, Hefei, China
- School of Management, Hefei University of Technology, Hefei, China
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Parikh P, Penfield J, Juaire M. Automatic identification of incidents involving potential serious injuries and fatalities (PSIF). Sci Rep 2024; 14:8091. [PMID: 38582954 PMCID: PMC10998882 DOI: 10.1038/s41598-024-58824-y] [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: 10/27/2023] [Accepted: 04/03/2024] [Indexed: 04/08/2024] Open
Abstract
Safety incidents have always been a crucial risk in work spaces, especially industrial sites. In the last few decades, significant efforts have been dedicated to incident control measures to reduce the rate of safety incidents. Despite all these efforts, the rate of decline in serious injuries and fatalities (SIFs) has been considerably lower than the rate of decline for non-critical incidents. This observation has led to a change of risk reduction paradigm for safety incidents. Under the new paradigm, more focus has been allocated to reducing the rate of critical/SIF incidents, as opposed to reducing the count of all incidents. One of the challenges in reducing the number of SIF incidents is the proper identification of the risk prior to materialization. One of the reasons for risk identification being a challenge is that companies usually only focus on incidents where SIF did occur reactively, and incidents that did not cause SIF but had the potential to do so go unnoticed. Identifying these potentially significant incidents, referred to as potential serious injuries and fatalities (PSIF), would enable companies to work on identifying critical risk and taking steps to prevent them preemptively. However, flagging PSIF incidents requires all incident reports to be analyzed individually by experts and hence significant investment, which is often not affordable, especially for small and medium sized companies. This study is aimed at addressing this problem through machine learning powered automation. We propose a novel approach based on binary classification for the identification of such incidents involving PSIF (potential serious injuries and fatalities). This is the first work towards automatic risk identification from incident reports. Our approach combines a pre-trained transformer model with XGBoost. We utilize advanced natural language processing techniques to encode an incident record comprising heterogeneous fields into a vector representation fed to XGBoost for classification. Moreover, given the scarcity of manually labeled incident records available for training, we leverage weak labeling to augment the label coverage of the training data. We utilize the F2 metric for hyperparameter tuning using Tree-structured Parzen Estimator to prioritize the detection of PSIF records over the avoidance of non-PSIF records being mis-classified as PSIF. The proposed methods outperform several baselines from other studies on a significantly large test dataset.
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Affiliation(s)
- Pulkit Parikh
- VelocityEHS, 222 Merchandise Mart Plaza, Suite 1750, Chicago, IL, 60654, USA.
| | - Julia Penfield
- VelocityEHS, 222 Merchandise Mart Plaza, Suite 1750, Chicago, IL, 60654, USA
| | - Marc Juaire
- VelocityEHS, 222 Merchandise Mart Plaza, Suite 1750, Chicago, IL, 60654, USA
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Lafarge L. What We Do, What We Say, What We Don't Say: Confidentiality In The Publication Of Clinical Writing. Psychoanal Q 2024; 93:77-103. [PMID: 38578266 DOI: 10.1080/00332828.2024.2316219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/21/2023] [Indexed: 04/06/2024]
Abstract
Questions concerning analysts' publication of material from the analyses of their patients have troubled the field of psychoanalysis since its inception. Disguise inevitably distorts the clinical material and is often insufficient to protect the patient from recognition. Asking the patient's consent for publication intrudes upon and alters the analytic process. While analysts have largely reached a consensus about the need for anonymity in published material, there is still considerable debate about the necessity for obtaining patients' consent when using their material for publication. In this paper, I will trace the evolving meanings of disguise, and particularly of consent, in the analytic literature. I will place a particular emphasis upon the differing theoretical belief systems that underlie the analyst's decision to ask consent from her patient or not to do so, and I will argue that, although decisions on asking consent remain a complex matter, such coherent belief systems should play an important part in analysts' decisions regarding consent. I will illustrate my thought processes and some clinical situations with brief examples, and I will conclude with some practical recommendations, with the hope that these will stimulate further discussion in the analytic community.
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Garmendia D, Weidner A, Venton L, Pal T. BPI24-012: Comparing Cancer Risk Management Between Females With Truncating CHEK2 1100delC Versus Missense CHEK2 I157T Variants. J Natl Compr Canc Netw 2024; 22:BPI24-012. [PMID: 38580255 DOI: 10.6004/jnccn.2023.7304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Affiliation(s)
| | - Anne Weidner
- 1Vanderbilt University Medical Center, Nashville, TN
| | | | - Tuya Pal
- 1Vanderbilt University Medical Center, Nashville, TN
- 2Vanderbilt-Ingram Cancer Center, Nashville TN
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13
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Affiliation(s)
- Andrew Barton
- Nurse Consultant, IV Therapy and Vascular Access, Frimley Health NHS Foundation Trust, and Chair, NIVAS
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14
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Richardson M, Thatcher A. State of science: refitting the human to nature. Ergonomics 2024; 67:582-596. [PMID: 37498051 DOI: 10.1080/00140139.2023.2236340] [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: 03/29/2023] [Accepted: 07/10/2023] [Indexed: 07/28/2023]
Abstract
Environmental institutions are realising that the human-nature relationship is a tangible target for a sustainable future. Societal change of that relationship is a challenge involving modifications to both systems and human behaviours. We argue that as Human Factors and Ergonomics (HFE) focusses on relationships, interfaces and systems it is well placed to contribute. After introducing the state of HFE and nature connectedness science an analysis of areas of HFE and human-nature connectedness themes is used to consider current work and future opportunities. We conclude that despite decades-old calls to action, HFE is embedded in a dated paradigm and has had little positive contribution to the human-nature relationship. However, HFE is well placed to create sustainable communities, designed to create a new relationship with nature. To do this, HFE needs to recognise that it should move on from solely fitting the task to the human, to refitting the human to nature.Practitioner Summary: A more sustainable human-nature relationship can be achieved through applying HFE approaches. HFE expertise in human characteristics, systems, people and technology can be applied at differing scales with various social-economic and technical factors to address key themes in our failing relationship with nature.Abbreviations: HFE: Human Factors and Ergonomics; IPBES: Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services; STAMP: System-Theoretic Accident Model and Processes; CWA: Cognitive Work Analysis; NET-HARMS: NETworked Hazard Analysis and Risk Management System; NbS: Nature-based System.
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Affiliation(s)
| | - Andrew Thatcher
- Department of Psychology, University of the Witwatersrand, Johannesburg, South Africa
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15
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Kotsopoulos J, Gronwald J, Huzarski T, Møller P, Pal T, McCuaig JM, Singer CF, Karlan BY, Aeilts A, Eng C, Eisen A, Bordeleau L, Foulkes WD, Tung N, Couch FJ, Fruscio R, Neuhausen SL, Zakalik D, Cybulski C, Metcalfe K, Olopade OI, Sun P, Lubinski J, Narod SA. Bilateral Oophorectomy and All-Cause Mortality in Women With BRCA1 and BRCA2 Sequence Variations. JAMA Oncol 2024; 10:484-492. [PMID: 38421677 PMCID: PMC10905374 DOI: 10.1001/jamaoncol.2023.6937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/22/2023] [Indexed: 03/02/2024]
Abstract
Importance Preventive bilateral salpingo-oophorectomy is offered to women at high risk of ovarian cancer who carry a pathogenic variant in BRCA1 or BRCA2; however, the association of oophorectomy with all-cause mortality has not been clearly defined. Objective To evaluate the association between bilateral oophorectomy and all-cause mortality among women with a BRCA1 or BRCA2 sequence variation. Design, Setting, and Participants In this international, longitudinal cohort study of women with BRCA sequence variations, information on bilateral oophorectomy was obtained via biennial questionnaire. Participants were women with a BRCA1 or BRCA2 sequence variation, no prior history of cancer, and at least 1 follow-up questionnaire completed. Women were followed up from age 35 to 75 years for incident cancers and deaths. Cox proportional hazards regression was used to estimate the hazard ratios (HRs) and 95% CIs for all-cause mortality associated with a bilateral oophorectomy (time dependent). Data analysis was performed from January 1 to June 1, 2023. Exposures Self-reported bilateral oophorectomy (with or without salpingectomy). Main Outcomes and Measures All-cause mortality, breast cancer-specific mortality, and ovarian cancer-specific mortality. Results There were 4332 women (mean age, 42.6 years) enrolled in the cohort, of whom 2932 (67.8%) chose to undergo a preventive oophorectomy at a mean (range) age of 45.4 (23.0-77.0) years. After a mean follow-up of 9.0 years, 851 women had developed cancer and 228 had died; 57 died of ovarian or fallopian tube cancer, 58 died of breast cancer, 16 died of peritoneal cancer, and 97 died of other causes. The age-adjusted HR for all-cause mortality associated with oophorectomy was 0.32 (95% CI, 0.24-0.42; P < .001). The age-adjusted HR was 0.28 (95% CI, 0.20-0.38; P < .001) and 0.43 (95% CI, 0.22-0.90; P = .03) for women with BRCA1 and BRCA2 sequence variations, respectively. For women with BRCA1 sequence variations, the estimated cumulative all-cause mortality to age 75 years for women who had an oophorectomy at age 35 years was 25%, compared to 62% for women who did not have an oophorectomy. For women with BRCA2 sequence variations, the estimated cumulative all-cause mortality to age 75 years was 14% for women who had an oophorectomy at age 35 years compared to 28% for women who did not have an oophorectomy. Conclusions and Relevance In this cohort study among women with a BRCA1 or BRCA2 sequence variation, oophorectomy was associated with a significant reduction in all-cause mortality.
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Affiliation(s)
- Joanne Kotsopoulos
- Women’s College Research Institute, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Huzarski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Pål Møller
- Department of Tumour Biology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Tuya Pal
- Vanderbilt-Ingram Cancer Center, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jeanna M. McCuaig
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Christian F. Singer
- Department of Obstetrics and Gynecology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Beth Y. Karlan
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles
| | - Amber Aeilts
- Comprehensive Cancer Center, Division of Human Genetics, The Ohio State University Medical Center, Columbus
| | - Charis Eng
- Genomic Medicine Institute and Center for Personalized Genetic Healthcare, Cleveland Clinic, Cleveland, Ohio
| | - Andrea Eisen
- Sunnybrook Odette Cancer Center, Department of Medical Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Louise Bordeleau
- Department of Oncology, Juravinski Cancer Centre and McMaster University, Hamilton, Ontario, Canada
| | - William D. Foulkes
- McGill Program in Cancer Genetics, Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Nadine Tung
- Cancer Risk and Prevention Program, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Fergus J. Couch
- Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Susan L. Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Dana Zakalik
- Grosfeld Cancer Genetics Center, Beaumont Health, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Kelly Metcalfe
- Women’s College Research Institute, University of Toronto, Toronto, Ontario, Canada
- Bloomberg School of Nursing, University of Toronto, Toronto, Ontario, Canada
| | | | - Ping Sun
- Women’s College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Jan Lubinski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Steven A. Narod
- Women’s College Research Institute, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Deering K, Wagstaff C, Williams J, Bermingham I, Pawson C. Ontological insecurity of inattentiveness: Conceptualizing how risk management practices impact on patient recovery when admitted to an acute psychiatric hospital. Int J Ment Health Nurs 2024; 33:420-430. [PMID: 37882636 DOI: 10.1111/inm.13245] [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] [Received: 05/26/2023] [Revised: 10/02/2023] [Accepted: 10/09/2023] [Indexed: 10/27/2023]
Abstract
Risk management which assesses and mitigates risks such as suicide and violence is under scrutiny, particularly within psychiatric inpatient settings. Restrictive practices, which result from risk assessment, such as observations, physical restraint and ward seclusion can impact negatively on patient recovery, hindering abilities to develop a meaningful life that emphasizes purpose, hope and autonomy, despite experiencing mental distress. Yet, less is known about the impact from the patient's perspective when first admitted to hospital, a period which among other reasons may come with increasing risk management practices owing to the clinical uncertainties about patient risks. In this grounded theory study, we explore the impact on recovery, interviewing 15 adult participants with patient experiences of being in an acute hospital. The main theme of the study, termed a core category with a grounded theory, was identified as "ontological insecurity of inattentiveness". This highlighted a staff inattentiveness with involving patients with risk management and explaining the purposes of the practice, which raised insecurities about what was happening to the patients when admitted to hospital. Four subcategories support the core category; discounting the patients' experiences to gain a meaningful grasp of risk management, ambiguity about risk management rules, particularly the reasons around their use, forebodingness to the hospital environment and, management from afar, with patients feeling scrutinized from observations without a voice to offer different views. It is hoped these findings will add to the field of patient involvement in psychiatric inpatient settings, proposing attempts to raise understanding and inclusivity of risk management, starting when first admitted to hospital.
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Affiliation(s)
- Kris Deering
- Nursing Academy, University of Exeter, Exeter, UK
| | - Chris Wagstaff
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Jo Williams
- School of Nursing and Midwifery, University of the West of England, Blackberry Hill, Bristol, UK
| | - Ivor Bermingham
- Service user and carer involvement coordinator, Southwest of England, England
| | - Chris Pawson
- Psychology Department, University of the West of England, Frenchay Campus, Bristol, UK
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Alam E, Collins AE, Islam ARMT, Paul A, Islam MK. Change in cyclone disaster vulnerability and response in coastal Bangladesh. Disasters 2024; 48:e12608. [PMID: 37574656 DOI: 10.1111/disa.12608] [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] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
The number of deaths owing to tropical cyclones in Bangladesh has significantly reduced. Category 4 Cyclone Gorky in 1991 and Sidr in 2007 caused 147,000 and 4,500 deaths respectively, whereas Category 1 Cyclone Mora in 2017 resulted in six. Face-to-face interviews with 362 residents, participant observation, and focus-group discussions answer a research question about how change in coastal areas has contributed to this outcome. The study considered institutional approaches of disaster risk management through legal frameworks, administrative arrangements, cyclone preparedness activities, cyclone detection and early warning dissemination, construction of shelter centres, strengthening of various types of coastal embankments, paved roads, and pre-cyclone evacuation. The findings indicate significant improvement in house structures and design, income levels and diversification, education, awareness, individual capacity, poverty reduction, and lowering dependency on agriculture-based earning. Furthermore, the availability of mobile telephones, radio, television, and social media platforms enhanced social connectivity and greater gender equality and empowerment helped to facilitate disaster preparedness, evacuation, and response.
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Affiliation(s)
- Edris Alam
- Associate Researcher, Faculty of Resilience, Rabdan Academy, Abu Dhabi, United Arab Emirates
- Professor, Department of Geography and Environmental Studies, University of Chittagong, Bangladesh
| | - Andrew E Collins
- Professor, Department of Geography and Environmental Sciences, Northumbria University, United Kingdom
| | - Abu Reza Md Towfiqul Islam
- Associate Professor, Department of Disaster Management, Begum Rokeya University
- Professor, Department of Development Studies, Daffodil International University, Bangladesh
| | - Alak Paul
- Professor, Department of Geography and Environmental Studies, University of Chittagong, Bangladesh
| | - Md Kamrul Islam
- Assistant Professor, Department of Civil and Environmental Engineering, College of Engineering, King Faisal University, Saudi Arabia
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Trivedi MS, Armstrong KA. Increasing the Uptake of Cancer Risk Management Strategies for Women With BRCA1/2 Sequence Variations. JAMA Oncol 2024; 10:435-436. [PMID: 38421667 DOI: 10.1001/jamaoncol.2023.5186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
- Meghna S Trivedi
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Katrina A Armstrong
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
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Lubinski J, Kotsopoulos J, Moller P, Pal T, Eisen A, Peck L, Karlan BY, Aeilts A, Eng C, Bordeleau L, Foulkes WD, Tung N, Couch FJ, Fruscio R, Ramon y Cajal T, Singer CF, Neuhausen SL, Zakalik D, Cybulski C, Gronwald J, Huzarski T, Stempa K, Dungan J, Cullinane C, Olopade OI, Metcalfe K, Sun P, Narod SA. MRI Surveillance and Breast Cancer Mortality in Women With BRCA1 and BRCA2 Sequence Variations. JAMA Oncol 2024; 10:493-499. [PMID: 38421676 PMCID: PMC10905376 DOI: 10.1001/jamaoncol.2023.6944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/08/2023] [Indexed: 03/02/2024]
Abstract
Importance Magnetic resonance imaging (MRI) surveillance is offered to women with a pathogenic variant in the BRCA1 or BRCA2 gene who face a high lifetime risk of breast cancer. Surveillance with MRI is effective in downstaging breast cancers, but the association of MRI surveillance with mortality risk has not been well defined. Objective To compare breast cancer mortality rates in women with a BRCA1 or BRCA2 sequence variation who entered an MRI surveillance program with those who did not. Design, Setting, and Participants Women with a BRCA1 or BRCA2 sequence variation were identified from 59 participating centers in 11 countries. Participants completed a baseline questionnaire between 1995 and 2015 and a follow-up questionnaire every 2 years to document screening histories, incident cancers, and vital status. Women who had breast cancer, a screening MRI examination, or bilateral mastectomy prior to enrollment were excluded. Participants were followed up from age 30 years (or the date of the baseline questionnaire, whichever was later) until age 75 years, the last follow-up, or death from breast cancer. Data were analyzed from January 1 to July 31, 2023. Exposures Entrance into an MRI surveillance program. Main Outcomes and Measures Cox proportional hazards modeling was used to estimate the hazard ratios (HRs) and 95% CIs for breast cancer mortality associated with MRI surveillance compared with no MRI surveillance using a time-dependent analysis. Results A total of 2488 women (mean [range] age at study entry 41.2 [30-69] years), with a sequence variation in the BRCA1 (n = 2004) or BRCA2 (n = 484) genes were included in the analysis. Of these participants, 1756 (70.6%) had at least 1 screening MRI examination and 732 women (29.4%) did not. After a mean follow-up of 9.2 years, 344 women (13.8%) developed breast cancer and 35 women (1.4%) died of breast cancer. The age-adjusted HRs for breast cancer mortality associated with entering an MRI surveillance program were 0.20 (95% CI, 0.10-0.43; P < .001) for women with BRCA1 sequence variations and 0.87 (95% CI, 0.10-17.25; P = .93) for women with BRCA2 sequence variations. Conclusion and Relevance Results of this cohort study suggest that among women with a BRCA1 sequence variation, MRI surveillance was associated with a significant reduction in breast cancer mortality compared with no MRI surveillance. Further studies of women with BRCA2 sequence variations are needed to ascertain these women obtain the same benefits associated with MRI surveillance.
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Affiliation(s)
- Jan Lubinski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Joanne Kotsopoulos
- Women’s College Research Institute, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Pal Moller
- Institute of Cancer Research, Department of Tumour Biology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Tuya Pal
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Andrea Eisen
- Department of Medical Oncology, Odette Cancer Center, University of Toronto, Toronto, Ontario, Canada
| | - Larissa Peck
- Bhalwani Familial Cancer Clinic, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Beth Y. Karlan
- Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, California
| | - Amber Aeilts
- Comprehensive Cancer Center, Division of Human Genetics, The Ohio State University Medical Center, Columbus
| | - Charis Eng
- Genomic Medicine Institute, Center for Personalized Genetic Healthcare, Cleveland Clinic, Cleveland, Ohio
| | - Louise Bordeleau
- Department of Oncology, Juravinski Cancer Centre, Hamilton, Ontario, Canada
| | - William D. Foulkes
- McGill Program in Cancer Genetics, Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Nadine Tung
- Cancer Risk and Prevention Program, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Fergus J. Couch
- Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Robert Fruscio
- Department of Medicine and Surgery, University of Milano-Bicocca, IRCCS San Gerardo, Monza, Italy
| | | | - Christian F. Singer
- Department of Obstetrics and Gynecology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Susan L. Neuhausen
- Division of Biomarkers of Early Detection and Prevention, City of Hope, Duarte, California
| | - Dana Zakalik
- Cancer Genetics Program, Beaumont Hospital, Royal Oak, Michigan
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Huzarski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Klaudia Stempa
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | | | | | | | - Kelly Metcalfe
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Bloomberg School of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Ping Sun
- Women’s College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Steven A. Narod
- Women’s College Research Institute, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Venema DM, Hester A, Clapper K, Kennel V, Quigley P, Reames C, Skinner A. Description and Implications of Falls in Patients Hospitalized Due to COVID-19. J Nurs Care Qual 2024; 39:121-128. [PMID: 37350615 DOI: 10.1097/ncq.0000000000000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
BACKGROUND Many hospital quality indicators, including falls, worsened during the COVID-19 pandemic. Patients hospitalized with COVID-19 may be at risk for falling due to the disease itself, patient characteristics, or aspects of care delivery. PURPOSE To describe and explore falls in patients hospitalized with COVID-19. METHODS We pooled data from 107 hospitalized adult patients who fell between March 2020 and April 2021. Patients who fell had a current, pending, or recent diagnosis of COVID-19. We analyzed patient characteristics, fall circumstances, and patient and organizational contributing factors using frequencies, the chi-square test, and Fisher's exact test. RESULTS Patient contributing factors included patients' lack of safety awareness, impaired physical function, and respiratory concerns. Organizational contributing factors related to staff and the isolation environment. CONCLUSIONS Recommendations for managing fall risk in patients hospitalized with COVID-19 include frequent reassessment of risk, consideration of respiratory function as a risk factor, ongoing patient education, assisted mobility, and adequate staff training.
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Affiliation(s)
- Dawn M Venema
- Author Affiliations: Departments of Health and Rehabilitation Sciences (Dr Venema) and Allied Health Professions Education, Research, and Practice (Dr Kennel and Ms Skinner), College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska; HD Nursing Patient Safety Organization, Benton, Arkansas (Dr Hester); Inpatient Rehab Services (Ms Clapper) and Nursing Professional Practice and Development (Ms Reames), Nebraska Medicine, Omaha, Nebraska; and Patricia A. Quigley Nurse Consultant, LLC, St Petersburg, Florida (Dr Quigley)
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Jones MD, Liu S, Powell F, Samsor A, Ting FCR, Veliotis N, Wong YM, Franklin BD, Garfield S. Exploring the Role of Guidelines in Contributing to Medication Errors: A Descriptive Analysis of National Patient Safety Incident Data. Drug Saf 2024; 47:389-400. [PMID: 38308152 PMCID: PMC10954937 DOI: 10.1007/s40264-024-01396-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/04/2024]
Abstract
INTRODUCTION Clinical guidelines can contribute to medication errors but there is no overall understanding of how and where these occur. OBJECTIVES We aimed to identify guideline-related medication errors reported via a national incident reporting system, and describe types of error, stages of medication use, guidelines, drugs, specialties and clinical locations most commonly associated with such errors. METHODS Retrospective analysis of reports to the National Reporting and Learning System for England and Wales. A hierarchical task analysis (HTA) was developed, describing expected practice when using guidelines. A free-text search was conducted of medication incident reports (2016-2021) using search terms related to common guidelines. All identified reports linked to moderate-severe harm or death, and a random sample of 5100 no/low-harm reports were coded to describe deviations from the HTA. A random sample of 500 cases were independently double-coded. RESULTS In total, 28,217 reports were identified, with 608 relating to moderate-severe harm or death. Fleiss' kappa for interrater reliability was 0.46. Of the 5708 reports coded, 642 described an HTA step discrepancy (including four linked to a death), suggesting over 3200 discrepancies in the entire dataset of 28,217 reports. Discrepancies related to finding guidelines (n = 300 reports), finding information within guidelines (n = 166) and using information (n = 176). Discrepancies were most frequently identified for guidelines produced by a local organisation (n = 405), and most occurred during prescribing (n = 277) or medication administration (n = 241). CONCLUSION Difficulties finding and using information from clinical guidelines contribute to thousands of prescribing and medication administration incidents, some of which are associated with substantial patient harm.
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Affiliation(s)
- Matthew D Jones
- Department of Life Sciences, University of Bath, Bath, BA2 7AY, UK.
| | | | - Freyja Powell
- Department of Life Sciences, University of Bath, Bath, BA2 7AY, UK
| | - Asma Samsor
- Department of Life Sciences, University of Bath, Bath, BA2 7AY, UK
| | | | | | - Yin Mei Wong
- Department of Life Sciences, University of Bath, Bath, BA2 7AY, UK
| | - Bryony Dean Franklin
- UCL School of Pharmacy, London, UK
- Centre for Medication Safety and Service Quality, Pharmacy Department, Imperial College Healthcare NHS Trust, London, UK
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22
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Kinlay M, Zheng WY, Burke R, Juraskova I, Ho LMR, Turton H, Trinh J, Baysari MT. An Analysis of Incident Reports Related to Electronic Medication Management: How They Change Over Time. J Patient Saf 2024; 20:202-208. [PMID: 38525975 DOI: 10.1097/pts.0000000000001204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
OBJECTIVE Electronic medication management (EMM) systems have been shown to introduce new patient safety risks that were not possible, or unlikely to occur, with the use of paper charts. Our aim was to examine the factors that contribute to EMM-related incidents and how these incidents change over time with ongoing EMM use. METHODS Incidents reported at 3 hospitals between January 1, 2010, and December 31, 2019, were extracted using a keyword search and then screened to identify EMM-related reports. Data contained in EMM-related incident reports were then classified as unsafe acts made by users and the latent conditions contributing to each incident. RESULTS In our sample, 444 incident reports were determined to be EMM related. Commission errors were the most frequent unsafe act reported by users (n = 298), whereas workarounds were reported in only 13 reports. User latent conditions (n = 207) were described in the highest number of incident reports, followed by conditions related to the organization (n = 200) and EMM design (n = 184). Over time, user unfamiliarity with the system remained a key contributor to reported incidents. Although fewer articles to electronic transfer errors were reported over time, incident reports related to the transfer of information between different computerized systems increased as hospitals adopted more clinical information systems. CONCLUSIONS Electronic medication management-related incidents continue to occur years after EMM implementation and are driven by design, user, and organizational conditions. Although factors contribute to reported incidents in varying degrees over time, some factors are persistent and highlight the importance of continuously improving the EMM system and its use.
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Affiliation(s)
- Madaline Kinlay
- From the Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney
| | | | | | - Ilona Juraskova
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | | | | | - Jason Trinh
- Pharmacy Services, Sydney Local Health District
| | - Melissa T Baysari
- From the Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney
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Cui Z, Lu S, Liu J. Research on risk management incentive strategy based on the green financial ecosystem. PLoS One 2024; 19:e0300629. [PMID: 38557690 PMCID: PMC10984479 DOI: 10.1371/journal.pone.0300629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Taking the green financial ecosystem composed of innovators, green financial institutions and regulators as the object of research, it explores the issue of how to improve the level of efforts of the three types of subjects and the benefits of risk management in the green financial ecosystem. The optimal level of effort, optimal level of return, and optimal level of return on risk management of green financial ecosystems for innovators, green financial institutions, and regulators under the three modes of No-incentive Contract, Cost-sharing Contract, and Synergistic Cooperation Contract are investigated and analyzed respectively, and verified by numerical simulation analysis. The results show: (1) Compared to the No-incentive Contract, the Cost-sharing Contract and the Synergy Cooperation Contract generate more significant incentives, and returns increase over time in both models. (2) The effort level of the participating subjects under the Synergistic Cooperation Contract is the highest, which can realize the Pareto optimization of the participating subjects and the green financial ecosystem at the same time. The study's findings contribute to a deeper understanding of cooperation among innovators, green financial institutions and regulators in facilitating risk management in green financial ecosystems and provide a realistic reference for risk managers in green financial ecosystems.
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Affiliation(s)
- ZhongPing Cui
- School of Economics, Shenyang University of Technology, Shenyang, China
| | - Shuang Lu
- School of Economics, Shenyang University of Technology, Shenyang, China
| | - JinRong Liu
- Liaoning Zhixing Valley Technology Co., LTD, Shenyang, China
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24
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Reidy M, O'Dea A. An Analysis of the contributing factors to Paediatric Patient Safety Incidents in Emergency Departments. Ir Med J 2024; 117:926. [PMID: 38526079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
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25
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Kizaki H, Yamamoto D, Maki H, Masuko K, Konishi Y, Satoh H, Hori S, Sawada Y. Medication incidents associated with the provision of medication assistance by non-medical care staff in residential care facilities. Drug Discov Ther 2024; 18:54-59. [PMID: 38417897 DOI: 10.5582/ddt.2023.01073] [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] [Indexed: 03/01/2024]
Abstract
The shift towards community-based care in Japan has led to increased medication assistance for older people by non-medical care staff. These staff members help take pre-packaged medications, apply patches, and administer eye drops. This study assessed the risks associated with such assistance by reviewing medication-related incidents across 106 residential care facilities between April 1, 2015, and March 31, 2016. An analysis of incident reports showed that all incidents were minor, with no serious outcomes. The incidents were categorized into four types: dropped drugs, misdelivery/misuse of medicines, forgetting to take medicines, and loss of medicines, with dropped drugs being the most frequent. Most incidents occurred in the morning and primarily involved residents with intermediate nursing care needs. These findings indicate a low risk of serious incidents because of medication assistance from non-medical staff. However, the frequency and nature of the incidents were influenced by the timing of medication administration and the care needs of the residents. These insights highlight the need for customized approaches to medication assistance, considering the residents' care levels and potentially optimizing medication administration times to improve safety in residential care settings.
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Affiliation(s)
| | | | | | | | | | - Hiroki Satoh
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
| | - Satoko Hori
- Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Yasufumi Sawada
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
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26
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McCaig L, Nowak S, Abbott A, Carhart J, McMahon ME, Debie E, Li H, Maina F, Ji AJ, Fu M, Wu Y, Lennard A, Mazzeo T, Wolfe C, Timpano R, Babayan Y, Gruenig L. Science- and Risk-Based Stability Strategies to Support Product Lifecycle Changes. AAPS J 2024; 26:34. [PMID: 38485849 DOI: 10.1208/s12248-024-00903-z] [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: 10/03/2023] [Accepted: 02/27/2024] [Indexed: 03/19/2024] Open
Abstract
ICH Q12 asserts that science- and risk-based approaches are applicable to stability studies supporting Chemistry, Manufacturing and Controls (CMC) post-approval changes (PAC) to enable more timely implementation; however, no guidance or specific examples are provided to demonstrate how prior knowledge of the product can inform the risk assessment for the proposed change(s). Ten diverse case studies are presented in this manuscript to demonstrate how science- and risk-based stability strategies were used to support drug substance and product CMC PAC and lifecycle management activities. The accumulated stability knowledge held by original manufacturers of marketed products is substantial, and different elements of this knowledge base were used to assess the risks and impact of the proposed changes for confident change management. This paper provides ways to leverage science- and risk-based stability strategies as part of the post-approval change-management risk-mitigation strategy, which may enable a reduced stability data commitment and/or a reduced reporting category for change implementation.
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Affiliation(s)
- Lori McCaig
- Pfizer Inc, 21823 30Th Drive SE, Bothell, Washington, 98021, USA
| | - Steven Nowak
- AbbVie, 1 N Waukegan Rd. Bldg. AP50; Dept PA71, North Chicago, Illinois, 60064, USA.
| | - Alexander Abbott
- Oral Product Development, Pharmaceutical Technology & Development, Operations, AstraZeneca, Silk Road Business Park, Macclesfield, Cheshire, SK10 2NA, UK
| | - Jenny Carhart
- Takeda Development Center Americas, Inc. 95 Hayden Ave, Lexington, Massachusetts, 02421, USA
| | - Megan E McMahon
- Pfizer Inc, Eastern Point Road, Groton, Connecticut, 06340, USA
| | - Elke Debie
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Hanlin Li
- Vertex Pharmaceuticals, 50 Northern Avenue, Boston, Massachusetts, 02210, USA
| | - Francis Maina
- AbbVie, 1401 Sheridan Road, North Chicago, Illinois, 60064, USA
| | - Andrea J Ji
- Genentech Inc, 1 DNA Way, South San Francisco, California, 94080, USA
| | - Mingkun Fu
- Sumitomo Pharma America, 84 Waterford Drive, Marlborough, Massachusetts, 01752, USA
| | - Yan Wu
- Merck & Co, 2000 Galloping Hill Road, Kenilworth, New Jersey, 07033, USA
| | - Andrew Lennard
- Amgen Ltd, 4, Uxbridge Business Park, Sanderson Road, Uxbridge, UB8 1DH, UK
| | - Tony Mazzeo
- Bristol Myers Squibb, 1 Squibb Drive, New Brunswick, New Jersey, 08903, USA
| | - Chad Wolfe
- Eli Lilly & Company, Lilly Corporate Center, Indianapolis, Indiana, 46285, USA
| | - Robert Timpano
- Pfizer Inc, Eastern Point Road, Groton, Connecticut, 06340, USA
| | - Yelizaveta Babayan
- Eli Lilly & Company, Lilly Corporate Center, Indianapolis, Indiana, 46285, USA
| | - Lars Gruenig
- CSL Behring, CSL Behring AG, Wankdorfstrasse 10, CH-3014, Bern, Switzerland
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27
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Yiğit T, Ata N, Dinçer M, Ülgü MM, Birinci Ş, Ayvalı MO. Insights from Turkey's big data: unraveling the preventability, pathogenesis, and risk management of Alzheimer's disease (AD). Sci Rep 2024; 14:6005. [PMID: 38472452 PMCID: PMC10933367 DOI: 10.1038/s41598-024-56702-1] [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: 10/17/2023] [Accepted: 03/09/2024] [Indexed: 03/14/2024] Open
Abstract
Extensive research into dementia has more recently honed in on several key areas. These areas include the advancement of techniques such as the accumulation of amyloid-β and tau proteins, the monitoring of cerebral hypometabolism rates etc. The primary objective of this study is to explore the intricate interplay between Alzheimer's disease (AD)-other dementias (D) and various chronic illnesses in terms of time, intensity, and connectivity. In this context, we retrospectively examined data of 149,786 individuals aged 65 and above who received diagnoses of AD and D in the year 2020. At first, logistic regression (LR) analysis has been made with "sex", "age" and "foreigner" (citizenship status) independent variables for AD and D. The LR models shows that while "sex" and "age" variables have a small rate on the risk of developing AD/D, it is detected that being a foreigner increase the risk of AD and D as 69.8% and 88.5% respectively. Besides, the LR models have middle-level success prediction rate for both of the two dependent variables. Additionally, we used the parallel coordinates graphs method within the R Studio to visualize their relationships and connections. The findings of this investigation strongly suggest that AD/D don't stand as isolated conditions, but rather stem from intricate interactions and progressive processes involving diverse chronic diseases over time. Notably, ailments including hypertension, coronary artery disease, diabetes, hyperlipidemia, and psychological disorders, contribute substantially to the emergence of both AD and D. This study highlights that the fight against AD/D can only be possible with next-generation prophylactic interventions that can predict and manage risks. Such an approach holds the potential to potentially lower AD and dementia to levels that are amenable to treatment.
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Affiliation(s)
- Talip Yiğit
- Faculty of Economics and Administrative Sciences, Istanbul 29 Mayıs University, Ümraniye, İstanbul, Turkey.
| | - Naim Ata
- General Directorate of Health Information System, Turkish Ministry of Health, Ankara, Turkey
| | - Murat Dinçer
- Faculty of Economics and Administrative Sciences, Istanbul 29 Mayıs University, Ümraniye, İstanbul, Turkey
| | - M Mahir Ülgü
- General Directorate of Health Information System, Turkish Ministry of Health, Ankara, Turkey
| | | | - M Okan Ayvalı
- General Directorate of Health Information System, Turkish Ministry of Health, Ankara, Turkey
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Chiu CL, Chang TH, Hsiao IF, Chiou DS. The price continuity, return and volatility spillover effects of regular and after-hours trading. PLoS One 2024; 19:e0299207. [PMID: 38466755 PMCID: PMC10927114 DOI: 10.1371/journal.pone.0299207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/07/2024] [Indexed: 03/13/2024] Open
Abstract
This study employs a bivariate EGARCH model to examine the Taiwan Futures Exchange's regular and after-hours trading, focusing on the critical aspects of spillover and expiration effects, as well as volatility clustering and asymmetry. The objective of this study is to observe the impact on the trading sessions in Taiwan by the influences of the European and American markets, focusing on the essential roles of the price discovery function and risk disclosure effectiveness of the regular hours trading. This research is imperative considering the increasing interconnectedness of global financial markets and the need for comprehensive risk assessment for investment strategies. It also examines the hedging behavior of after-hours traders, thereby aiming to contribute to pre-investment analysis by future investors. This examination is vital for understanding the dynamics of after-hours trading and its influence on market stability. Results indicate price continuity between both trading sessions, with regular trading often determining after-hours price ranges. Consequently, after-hours price changes can inform regular trading decisions. This finding highlights the importance of after-hours trading for shaping market expectations. Significant profit potential exists in after-hours trading open interest, which serves speculative and hedging purposes. While regular trading volatility influences after-hours trading, the reverse is not true. This suggests Taiwan market information poses a higher risk impact than European and American market data, emphasizing the unique position of the Taiwan market in the global financial ecosystem. After-hours trading volatility reflects the absorption of international market information and plays a crucial role in advance revelation of risks. This underscores the importance of after-hours trading in global risk management and strategy formulation.
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Affiliation(s)
- Chien-Liang Chiu
- Department of Banking and Finance, Tamkang University, New Taipei City, Taiwan
| | - Ting-Huan Chang
- Department of Finance, Chien Hsin University of Science and Technology, Taoyuan, Taiwan
| | - I-Fan Hsiao
- Department of Banking and Finance, Chinese Culture University, Taipei City, Taiwan
| | - De-Shin Chiou
- Department of Banking and Finance, Tamkang University, New Taipei City, Taiwan
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29
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Braine MF, Kearnes M, Khan SJ. Quality and risk management frameworks for biosolids: An assessment of current international practice. Sci Total Environ 2024; 915:169953. [PMID: 38215849 DOI: 10.1016/j.scitotenv.2024.169953] [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: 07/06/2023] [Revised: 12/11/2023] [Accepted: 01/04/2024] [Indexed: 01/14/2024]
Abstract
Biosolids, a product of wastewater treatment, provide a valuable resource, but to optimize the use of this resource it is necessary to manage risks posed to public health and the environment. Key requirements include identifying contaminant sources and providing barriers to ensure containment and treatment while maintaining the viability and value of biosolids products. Responsibility for managing biosolids is the remit of many stakeholders but primarily it rests with private and public wastewater facilities. The global variabilities in the way biosolids resources are acknowledged, applied, and managed are substantial. For example, some countries are increasing incineration because of their ability to remove contaminants while others have experienced a proportional decrease in incineration dependent on industrial resources or regarding resource recovery costs and needs. Some jurisdictions focus on energy recovery and others on land application. A risk management framework is a tool that may provide a suitable holistic approach to biosolids management. With this focus, current instruments in practice globally to manage biosolids were assessed for the degree to which they have adopted a risk management framework. To form a basis for this assessment a set of criteria was established by concept mapping several internationally recognized standards. Guidelines for a range of developed and developing countries were then assessed against these criteria. That process enabled the identification of which current practices were holistic in terms of applying biosolids risk management principles from production to end-use. Through this process, risk management gaps and vulnerabilities were identified. The results reveal that the incorporation of risk standards into risk management frameworks around the world is variable for the presence of risk criteria and the scale of detail provided. Contaminant concentrations need perspective within the changing risk landscape for stakeholders and the environment while jointly the opportunities and contaminant challenges require solutions that balance risks.
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Affiliation(s)
- Marilyn F Braine
- Water Research Centre, School of Civil and Environmental Engineering, University of New South Wales, NSW 2052, Australia
| | - Matthew Kearnes
- School of Humanities & Language, University of New South Wales, NSW 2052, Australia
| | - Stuart J Khan
- Water Research Centre, School of Civil and Environmental Engineering, University of New South Wales, NSW 2052, Australia; School of Civil Engineering, University of Sydney, NSW 2006, Australia.
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30
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Zhou X, Zhang Y, Wang W, Li X, Yang H, Sun Y. Social vulnerability assessment under different extreme precipitation scenarios: A case study in Henan Province, China. PLoS One 2024; 19:e0299956. [PMID: 38457447 PMCID: PMC10923475 DOI: 10.1371/journal.pone.0299956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/19/2024] [Indexed: 03/10/2024] Open
Abstract
Extreme precipitation usually cause grievous losses&casualties, which varies greatly under different scenarios. This paper took Henan province as an example, it innovatively constructed three different extreme precipitation scenarios and built indicators system of social vulnerability from exposure, sensitivity and resilience based on MOVE framework. Social Vulnerability Indexs(SoVI) were then calculated by mathematical models under three different reoccurrence intervals. The results show that SoVI was low in the west and high in the north. High SoVI areas expanded to the middle and south as recurrence intervals increased. SoVI in each area of Henan province increased along with the recurrence intervals at different growth rates. The larger the recurrence interval was, the faster the SoVI increased. The results indicate SoVI is greatly affected by disaster levels, which need to be incorporated into social vulnerability. This study provides not only a new thought for social vulnerability assessment, but also a reference for the policymakers to formulate related risk management policies.
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Affiliation(s)
- Xiaobing Zhou
- School of Business Administration, Henan Polytechnic University, Jiaozuo, China
- School of Emergency Management, Henan Polytechnic University, Jiaozuo, China
- Security and Emergency Management Research Center, Henan Polytechnic University, Jiaozuo, China
| | - Yongling Zhang
- School of Business Administration, Henan Polytechnic University, Jiaozuo, China
| | - Wei Wang
- School of Business Administration, Henan Polytechnic University, Jiaozuo, China
| | - Xin Li
- School of Emergency Management, Henan Polytechnic University, Jiaozuo, China
| | - Huanhuan Yang
- School of Emergency Management, Henan Polytechnic University, Jiaozuo, China
| | - Yiting Sun
- School of Emergency Management, Henan Polytechnic University, Jiaozuo, China
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31
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Gqaleni TMH, Mkhize SW. Barriers to implementing patient safety incident reporting and learning guidelines in specialised care units, KwaZulu-Natal: A qualitative study. PLoS One 2024; 19:e0289857. [PMID: 38457469 PMCID: PMC10923419 DOI: 10.1371/journal.pone.0289857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/06/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Globally, increased occurrences of patient safety incidents have become a public concern. The implementation of Patient safety incidents reporting and learning guidelines is fundamental to reducing preventable patient harm. To improve the implementation of these guidelines in specialised care units in KwaZulu-Natal, the views of healthcare professionals were unearthed. AIM This study explores the healthcare professionals' views toward the implementation of Patient safety incident reporting and learning guidelines in specialised care units. METHODS A descriptive, explorative qualitative approach was used to collect qualitative data from healthcare professionals working in specialised care units. The study was conducted in specialised care units of three purposely selected public hospitals in two districts of KwaZulu-Natal. Group discussions and semi-structured interviews were conducted from August to October 2021. Content data analysis was performed using Tesch's method of analysis process. RESULTS The main themes that emerged during data analysis were; ineffective reporting system affecting the communication of Patient safety incident guidelines, inadequate institutional and management support for the healthcare professionals, insufficient education and training of healthcare professionals, and poor human resources affecting the implementation of Patient Safety Incident guidelines. The findings highlighted that there were more major barriers to the implementation of the Patient safety incident reporting and learning guidelines. CONCLUSION This study confirmed that the Patient safety incident reporting and learning guidelines are still not successfully implemented in the specialised care units and the barriers to implementation were highlighted. For rigorous implementation in South Africa, the study recommends revised Patient safety incident reporting and learning guidelines, designed in consultation with the frontline healthcare professionals. These must consist of standardised, simple- user-friendly reporting process as well as a better implementation strategy to guide the healthcare professionals. Continuous professional development programmes may play an important role in the facilitation of the implementation process.
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Affiliation(s)
- T. M. H. Gqaleni
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Sipho W. Mkhize
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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32
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Chen M, Zhang Y, Ji W, Chen Q, Li Y, Long T, Wang L. Source identification and exposure risk management for soil arsenic in urban reclamation areas with high background levels: A case study in a coastal reclamation site from the Pearl River Delta, China. J Hazard Mater 2024; 465:133294. [PMID: 38134697 DOI: 10.1016/j.jhazmat.2023.133294] [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: 10/05/2023] [Revised: 11/22/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
Urbanization involving the excavation and reuse of arsenic-bearing geological materials may pose human health risks. We investigated the distribution and sources of soil arsenic at a coastal reclamation site in the Pearl River Delta, China, and proposed risk management strategies. Analysis of 899 soil samples revealed an average of 58.97 mg/kg arsenic, with a maximum of 1450 mg/kg, mainly in fill material obtained from a local island. Integrative analysis combining reclamation history, regional geology, and bedrock mineralogy conclusively identified hydrothermally altered arsenic-bearing sulfide minerals within extensively fractured bedrock as the primary source of arsenic. Physical weathering and anthropogenic rock blasting produced discrete arsenic-rich particles that were directly transported into soils during land reclamation and accumulated to potential hazardous levels. Oral, dermal, and inhalation pathways were identified as primary exposures for future populations. Integrated engineering and institutional controls, coupled with long-term monitoring, were recommended to mitigate risks. The results highlight the importance of identifying specific geogenic and anthropogenic sources that contribute to heavy metal enrichment of soils in reclaimed areas where native bedrock naturally contains elevated level of metals, supporting evidence-based best practices for risk management and future land use.
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Affiliation(s)
- Meng Chen
- Nanjing Institute of Environmental Sciences, Ministry of Ecology and Environment of the People's Republic of China, Nanjing 210042, China
| | - Yuting Zhang
- Guangdong Key Laboratory of Contaminated Environmental Management and Remediation, Guangdong Provincial Academy of Environmental Science, Guangzhou 510045, China
| | - Wenbing Ji
- Nanjing Institute of Environmental Sciences, Ministry of Ecology and Environment of the People's Republic of China, Nanjing 210042, China
| | - Qiang Chen
- Nanjing Institute of Environmental Sciences, Ministry of Ecology and Environment of the People's Republic of China, Nanjing 210042, China
| | - Yan Li
- Nanjing Institute of Environmental Sciences, Ministry of Ecology and Environment of the People's Republic of China, Nanjing 210042, China
| | - Tao Long
- Nanjing Institute of Environmental Sciences, Ministry of Ecology and Environment of the People's Republic of China, Nanjing 210042, China.
| | - Lei Wang
- Nanjing Institute of Environmental Sciences, Ministry of Ecology and Environment of the People's Republic of China, Nanjing 210042, China.
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Yang R, Feng J, Tang J, Sun Y. Risk assessment and classification prediction for water environment treatment PPP projects. Water Sci Technol 2024; 89:1264-1281. [PMID: 38483497 PMCID: wst_2024_052 DOI: 10.2166/wst.2024.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Water treatment public-private partnership (PPP) projects are pivotal for sustainable water management but are often challenged by complex risk factors. Efficient risk management in these projects is crucial, yet traditional methodologies often fall short of addressing the dynamic and intricate nature of these risks. Addressing this gap, this comprehensive study introduces an advanced risk classification prediction model tailored for water treatment PPP projects, aimed at enhancing risk management capabilities. The proposed model encompasses an intricate evaluation of crucial risk areas: the natural and ecological environments, socio-economic factors, and engineering entities. It delves into the complex relationships between these risk elements and the overall risk profile of projects. Grounded in a sophisticated ensemble learning framework employing stacking, our model is further refined through a weighted voting mechanism, significantly elevating its predictive accuracy. Rigorous validation using data from the Jiujiang City water environment system project Phase I confirms the model's superiority over standard machine learning models. The development of this model marks a significant stride in risk classification for water treatment PPP projects, offering a powerful tool for enhancing risk management practices. Beyond accurately predicting project risks, this model also aids in developing effective government risk management strategies.
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Affiliation(s)
- Ruijia Yang
- Business School, Hohai University, Nanjing 211100, China E-mail:
| | - Jingchun Feng
- Business School, Hohai University, Nanjing 211100, China; Jiangsu Provincial Collaborative Innovation Center of World Water Valley, Water Ecological Civilization, Nanjing 211100, China
| | - Jiansong Tang
- Graduate School of Informatics, Osaka Metropolitan University, Osaka 559-8531, Japan
| | - Yong Sun
- School of Public Administration, Guangzhou University, Guangzhou 510006, China
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Niv Y, Tal Y. [THE IMPACT OF REGULATION AND CENTRAL MANAGEMENT ON PATIENT SAFETY IN ISRAEL]. Harefuah 2024; 163:170-173. [PMID: 38506359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
INTRODUCTION An adverse event is defined as an unwanted and unexpected occurrence in a medical process that may end in harm to the patient. In the USA the number of deaths due to failures reaches 253,000 per year. In Israel, over 10,000 deaths occur per year due to errors in the medical treatment of hospitalized patients, the third most common cause of death after heart disease and cancer. The main cause of failures in medical diagnosis and treatment is the complexity of the medical profession. A large number of caregivers in different medical disciplines are needed to treat one patient, therefore there are many errors, especially regarding communication between therapists. The Israeli health system has been operating with a budget deficit for many years and an addition of at least NIS 20 billion is needed to bring it to optimal functioning. The number of doctors, nurses, and hospital beds per 1000 inhabitants is significantly less than the average of the OECD countries. When there was a 30% increase in the population of Israel it was necessary to enhance the existing situation, with the addition of 7700 hospital beds, but only 1400 were added. This caused a decrease from 2.1 beds per 1000 residents to 1.8 beds per 1000 residents. There is an urgent need to change the elements of treatment safety in the Ministry of Health's strategic plan. An administration for quality, treatment safety, risk management in medicine, and accreditation should be established which, in addition to the care quality division, will include a safety division with investigation and monitoring units and will prepare strategic improvement plans, and a university-level research institute with researchers, computing, statistics, and information gathering units. The institute will receive all reports of adverse events, results of investigations, inspection committees, control and quality committees, relevant verdicts, and updated literature reviews, for research and systemic learning. Strategic plans will be prepared to prevent failures in diagnosis and medical treatment, leading to a decrease in mortality due to adverse events and the significant expenses involved.
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Affiliation(s)
- Yaron Niv
- Adelson Faculty of Medicine, Ariel University, MALNAS - Patient Safety
- Risk Management Education Center, Ariel University
| | - Yossi Tal
- MALNAS - Patient Safety
- Risk Management Education Center, Ariel University
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35
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Cho KJ, Kim KH, Choi J, Yoo D, Kim J. External Validation of Deep Learning-Based Cardiac Arrest Risk Management System for Predicting In-Hospital Cardiac Arrest in Patients Admitted to General Wards Based on Rapid Response System Operating and Nonoperating Periods: A Single-Center Study. Crit Care Med 2024; 52:e110-e120. [PMID: 38381018 PMCID: PMC10876170 DOI: 10.1097/ccm.0000000000006137] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
OBJECTIVES The limitations of current early warning scores have prompted the development of deep learning-based systems, such as deep learning-based cardiac arrest risk management systems (DeepCARS). Unfortunately, in South Korea, only two institutions operate 24-hour Rapid Response System (RRS), whereas most hospitals have part-time or no RRS coverage at all. This study validated the predictive performance of DeepCARS during RRS operation and nonoperation periods and explored its potential beyond RRS operating hours. DESIGN Retrospective cohort study. SETTING In this 1-year retrospective study conducted at Yonsei University Health System Severance Hospital in South Korea, DeepCARS was compared with conventional early warning systems for predicting in-hospital cardiac arrest (IHCA). The study focused on adult patients admitted to the general ward, with the primary outcome being IHCA-prediction performance within 24 hours of the alarm. PATIENTS We analyzed the data records of adult patients admitted to a general ward from September 1, 2019, to August 31, 2020. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Performance evaluation was conducted separately for the operational and nonoperational periods of the RRS, using the area under the receiver operating characteristic curve (AUROC) as the metric. DeepCARS demonstrated a superior AUROC as compared with the Modified Early Warning Score (MEWS) and the National Early Warning Score (NEWS), both during RRS operating and nonoperating hours. Although the MEWS and NEWS exhibited varying performance across the two periods, DeepCARS showed consistent performance. CONCLUSIONS The accuracy and efficiency for predicting IHCA of DeepCARS were superior to that of conventional methods, regardless of whether the RRS was in operation. These findings emphasize that DeepCARS is an effective screening tool suitable for hospitals with full-time RRS, part-time RRS, and even those without any RRS.
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Affiliation(s)
- Kyung-Jae Cho
- Department of Research and Development, VUNO, Seoul, Republic of Korea
| | - Kwan Hyung Kim
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jaewoo Choi
- Department of Research and Development, VUNO, Seoul, Republic of Korea
| | - Dongjoon Yoo
- Department of Research and Development, VUNO, Seoul, Republic of Korea
- Department of Critical Care Medicine and Emergency Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Jeongmin Kim
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
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Patil SD, Chalikwar SS. A brief review on application of design of experiment for the analysis of pharmaceuticals using HPLC. Ann Pharm Fr 2024; 82:203-228. [PMID: 38159721 DOI: 10.1016/j.pharma.2023.12.011] [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: 08/05/2023] [Revised: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
The quality pioneer Dr. Joseph M. Juran first proposed the idea of quality by design. According to him, pharmaceutical quality by design is an organised approach to product development that starts with predetermined goals and places an emphasis on product, process understanding, control based on reliable science and quality risk management. The quality of a product or process can typically be affected by a number of input elements. Design of experiments has been employed widely recently to understand the impacts of multidimensional and interactions of input parameters on the output responses of analytical procedures and pharmaceutical goods. Depending on the design of experiments objectives, screening, characterization, or optimization of the process and formulation, a variety of designs, such as factorial or mixture, can be used. The most popular designs used in the stage of screening or factor selection are the 2-Level Factorial and Plackett-Burman designs, both of which have two levels for each factor (k), both economical and effective, and in optimization widely used designs in this step are full factorial at three levels, central composite, Box-Behnken design. The analysis of variance, regression significance, and lack of fit of the regression model were some of the key topics covered in the discussion of the main components of multiple regression model adjustment. Design of experiments is thus the primary element of the formulation and analytical quality by design. The details about design of experiments used for the analysis of pharmaceutical formulation using HPLC.
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Affiliation(s)
- Sachin D Patil
- Department of Pharmaceutics and Quality Assurance, R.C. Patel Institute of Pharmacy, Shirpur 425405, Maharashtra State, India
| | - Shailesh S Chalikwar
- Department of Industrial Pharmacy and Quality Assurance, R.C. Patel Institute of Pharmaceutical Education and Research, Shirpur 425405, Maharashtra State, India.
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37
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Edwards ML, Morris NP. How Inpatient Psychiatric Units Can Be Both Safe and Therapeutic. AMA J Ethics 2024; 26:E248-256. [PMID: 38446730 DOI: 10.1001/amajethics.2024.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Inpatient psychiatric units should be therapeutic environments that support dignity and recovery. When adverse outcomes (eg, self-harm, violence) happen in these settings, clinicians and administrators can face litigation and other pressures to prioritize risk management over supporting patients' access to personal belongings, exercise equipment, and private spaces. This article describes these downward pressures toward sparser, controlling environments in inpatient psychiatric settings as a safety funnel and suggests strategies for balancing safety, humanity, and recovery in these contexts.
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Affiliation(s)
- Matthew L Edwards
- Assistant professor of psychiatry and an assistant training director of the General Psychiatry Residency Program in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine in Stanford, California
| | - Nathaniel P Morris
- Assistant professor of clinical psychiatry in the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco
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Lian J, Li J, Xu K, Bin L. The impact of tropical cyclones and water conservancy projects on island's flash floods. Environ Sci Pollut Res Int 2024; 31:23162-23177. [PMID: 38418780 DOI: 10.1007/s11356-024-32613-6] [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] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
The analysis of the influencing factors of flash floods, one of the most destructive natural disasters, is the basis of scientific disaster prevention and mitigation. There is little research considering the influence of tropical cyclones (TCs) and water conservancy projects on flash floods, which cannot be ignored in the island areas where flash floods often occur due to the complex influence of various factors. In this study, under the pressure-state-response framework (PSR framework), the factors affecting the distribution of flash floods on Hainan Island, China, from 1970 to 2010 were quantitatively analyzed by using the geographical detector method. By dividing the time period, give full play to the advantages of the PSR framework and show the evolution process of various factors. Different from inland areas, extreme precipitation and tropical cyclones play a major role in the spatial distribution of flash floods on Hainan Island, China, and the driving force of tropical cyclones is 1.1 times that of extreme precipitation on average. Medium-sized reservoirs play the greatest role in the prevention of flash floods on Hainan Island, and their driving forces reach 0.38 times of extreme precipitation on average, followed by large-sized reservoirs and small-sized reservoirs. Large-sized reservoirs are limited in quantity and have limited effectiveness in preventing flash floods on Hainan Island. Therefore, in the forecasting and risk management of flash flood in the island area, more attention should be paid to the impact of extreme precipitation and TCs, and the role of medium-sized reservoir should be fully exerted.
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Affiliation(s)
- Jijian Lian
- State Key Laboratory of Hydraulic Engineering Intelligent Construction and Operation, Tianjin University, Tianjin, 300350, China
- School of Civil Engineering, Tianjin University, Tianjin, 300350, China
| | - Jinxuan Li
- State Key Laboratory of Hydraulic Engineering Intelligent Construction and Operation, Tianjin University, Tianjin, 300350, China
- School of Civil Engineering, Tianjin University, Tianjin, 300350, China
| | - Kui Xu
- State Key Laboratory of Hydraulic Engineering Intelligent Construction and Operation, Tianjin University, Tianjin, 300350, China.
- School of Civil Engineering, Tianjin University, Tianjin, 300350, China.
| | - Lingling Bin
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, 300387, China
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Visvanathan R, Lange K, Selvam J, Dollard J, Boyle E, Jones K, Ingram K, Shibu P, Wilson A, Ranasinghe DC, Karnon J, Hill KD. Findings from three methods to identify falls in hospitals: Results from the Ambient Intelligent Geriatric Management system fall prevention trial. Australas J Ageing 2024; 43:199-204. [PMID: 37861202 DOI: 10.1111/ajag.13245] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE To (a) compare characteristics of patients who fall with those of patients who did not fall; and (b) characterise falls (time, injury severity and location) through three fall reporting methods (incident system reports, medical notes and clinician reports). METHODS A substudy design within a stepped-wedge clinical trial was used: 3239 trial participants were recruited from two inpatient Geriatric Evaluation and Management Units and one general medicine ward in two Australian states. To compare the characteristics of patients who had fallen with those who had not, descriptive tests were used. To characterise falls through three reporting methods, bivariate logistic regressions were used. RESULTS Patients who had fallen were more likely than patients who had not fallen to be cognitively impaired (51% vs. 29%, p < 0.01), admitted with falls (38% vs. 28%, p = 0.01) and have poor health outcomes such as prolonged length of stay (24 [16-34] vs. 12 [8-19] days [IQR], p < 0.01) and less likely to be discharged directly to the community (62% vs. 47%, p < 0.01). Most falls were captured from medical notes (93%), with clinician (71%) and incident reports (68%) missing 21%-25% of falls. The proportion of injurious falls identified through incident reports was higher than medical records or clinician reports (40% vs. 34% vs. 37%). CONCLUSIONS This study reaffirms the need to improve reporting falls in incident systems and at clinical handover to the team leader. Research should continue to use more than one method of identifying falls, but include data from medical records. Many falls cause injury, resulting in poor health outcomes.
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Affiliation(s)
- R Visvanathan
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Woodville South, Adelaide, South Australia, Australia
- Faculty of Health and Medical Sciences, Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - K Lange
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - J Selvam
- Faculty of Health and Medical Sciences, Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - J Dollard
- Faculty of Health and Medical Sciences, Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - E Boyle
- School of Allied Health, Curtin University, Western Australia, Perth, Australia
| | - K Jones
- School of Allied Health, Curtin University, Western Australia, Perth, Australia
| | - K Ingram
- Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - P Shibu
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Woodville South, Adelaide, South Australia, Australia
| | - A Wilson
- College of Medicine and Public Health, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - D C Ranasinghe
- School of Computer Science, University of Adelaide, Adelaide, South Australia, Australia
| | - J Karnon
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - K D Hill
- School of Allied Health, Curtin University, Western Australia, Perth, Australia
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Victoria, Australia
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40
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Stahl RG, Boxall ABA, Brix KV, Landis WG, Stauber JL, Moe SJ. Incorporating climate change model projections into ecological risk assessments to help inform risk management and adaptation strategies: Synthesis of a SETAC Pellston Workshop®. Integr Environ Assess Manag 2024; 20:359-366. [PMID: 38124219 DOI: 10.1002/ieam.4883] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
The impacts of global climate change are not yet well integrated with the estimates of the impacts of chemicals on the environment. This is evidenced by the lack of consideration in national or international reports that evaluate the impacts of climate change and chemicals on ecosystems and the relatively few peer-reviewed publications that have focused on this interaction. In response, a 2011 Pellston Workshop® was held on this issue and resulted in seven publications in Environmental Toxicology and Chemistry. Yet, these publications did not move the field toward climate change and chemicals as important factors together in research or policy-making. Here, we summarize the outcomes of a second Pellston Workshop® on this topic held in 2022 that included climate scientists, environmental toxicologists, chemists, and ecological risk assessors from 14 countries and various sectors. Participants were charged with assessing where climate models can be applied to evaluating potential exposure and ecological effects at geographical and temporal scales suitable for ecological risk assessment, and thereby be incorporated into adaptive risk management strategies. We highlight results from the workshop's five publications included in the special series "Incorporating Global Climate Change into Ecological Risk Assessments: Strategies, Methods and Examples." We end this summary with the overall conclusions and recommendations from participants. Integr Environ Assess Manag 2024;20:359-366. © 2023 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).
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Affiliation(s)
| | | | | | - Wayne G Landis
- Western Washington University, Bellingham, Washington, USA
| | - Jenny L Stauber
- CSIRO, Sydney, New South Wales, Australia
- La Trobe University, Wodonga, Victoria, Australia
| | - S Jannicke Moe
- Norwegian Institute for Water Research (NIVA), Oslo, Norway
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41
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Cains MG, Desrousseaux AOS, Boxall ABA, Molander S, Molina-Navarro E, Sussams J, Critto A, Stahl RG, Rother HA. Environmental management cycles for chemicals and climate change, EMC 4 : A new conceptual framework contextualizing climate and chemical risk assessment and management. Integr Environ Assess Manag 2024; 20:433-453. [PMID: 38044542 DOI: 10.1002/ieam.4872] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/21/2023] [Revised: 10/24/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023]
Abstract
The environmental management cycles for chemicals and climate change (EMC4 ) is a suggested conceptual framework for integrating climate change aspects into chemical risk management. The interaction of climate change and chemical risk brings together complex systems that are imperfectly understood by science. Making management decisions in this context is therefore difficult and often exacerbated by a lack of data. The consequences of poor decision-making can be significant for both environmental and human health. This article reflects on the ways in which existing chemicals management systems consider climate change and proposes the EMC4 conceptual framework, which is a tool for decision-makers operating at different spatial scales. Also presented are key questions raised by the tool to help the decision-maker identify chemical risks from climate change, management options, and, importantly, the different types of actors that are instrumental in managing that risk. Case studies showing decision-making at different spatial scales are also presented highlighting the conceptual framework's applicability to multiple scales. The United Nations Environment Programme's development of an intergovernmental Science Policy Panel on Chemicals and Waste has presented an opportunity to promote and generate research highlighting the impacts of chemicals and climate change interlinkages. Integr Environ Assess Manag 2024;20:433-453. © 2023 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).
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Affiliation(s)
- Mariana G Cains
- National Center for Atmospheric Research, Boulder, Colorado, USA
| | | | | | - Sverker Molander
- Environmental Systems Analysis, Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden
| | - Eugenio Molina-Navarro
- Department of Geology, Geography and Environment, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | | | - Andrea Critto
- Department of Environmental Sciences Informatics and Statistics, University Ca' Foscari of Venice, Venice, Italy
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Chen H, Carley DS, Muñoz-Carpena R, Ferruzzi G, Yuan Y, Henry E, Blankinship A, Veith TL, Breckels R, Fox G, Luo Y, Osmond D, Preisendanz HE, Tang Z, Armbrust K, Costello K, McConnell LL, Rice P, Westgate J, Whiteside M. Incorporating the benefits of vegetative filter strips into risk assessment and risk management of pesticides. Integr Environ Assess Manag 2024; 20:454-464. [PMID: 37527952 DOI: 10.1002/ieam.4824] [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: 12/12/2022] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/03/2023]
Abstract
The pesticide registration process in North America, including the USA and Canada, involves conducting a risk assessment based on relatively conservative modeling to predict pesticide concentrations in receiving waterbodies. The modeling framework does not consider some commonly adopted best management practices that can reduce the amount of pesticide that may reach a waterbody, such as vegetative filter strips (VFS). Currently, VFS are being used by growers as an effective way to reduce off-site movement of pesticides, and they are being required or recommended on pesticide labels as a mitigation measure. Given the regulatory need, a pair of multistakeholder workshops were held in Raleigh, North Carolina, to discuss how to incorporate VFS into pesticide risk assessment and risk management procedures within the North American regulatory framework. Because the risk assessment process depends heavily on modeling, one key question was how to quantitatively incorporate VFS into the existing modeling approach. Key outcomes from the workshops include the following: VFS have proven effective in reducing pesticide runoff to surface waterbodies when properly located, designed, implemented, and maintained; Vegetative Filter Strip Modeling System (VFSMOD), a science-based and widely validated mechanistic model, is suitable for further vetting as a quantitative simulation approach to pesticide mitigation with VFS in current regulatory settings; and VFSMOD parametrization rules need to be developed for the North American aquatic exposure assessment. Integr Environ Assess Manag 2024;20:454-464. © 2023 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).
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Affiliation(s)
- Huajin Chen
- Bayer Crop Science, Chesterfield, Missouri, USA
| | - Danesha Seth Carley
- NSF Center of Integrated Pest Management, North Carolina State University, Raleigh, North Carolina, USA
| | - Rafael Muñoz-Carpena
- Department of Agricultural & Biological Engineering, University of Florida, Gainesville, Florida, USA
| | - Giulio Ferruzzi
- Natural Resources Conservation Service, US Department of Agriculture, Portland, Oregon, USA
| | - Yongping Yuan
- Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - Eric Henry
- BASF, Research Triangle Park, North Carolina, USA
| | - Amy Blankinship
- Office of Pesticide Programs, US Environmental Protection Agency, Washington, District of Columbia, USA
| | - Tamie L Veith
- Agricultural Research Service, US Department of Agriculture, University Park, Pennsylvania, USA
| | - Ross Breckels
- Pest Management Regulatory Agency, Health Canada, Ottawa, Ontario, Canada
| | - Garey Fox
- Department of Biological and Agricultural Engineering, North Carolina State University, Raleigh, North Canada, USA
| | - Yuzhou Luo
- California Department of Pesticide Regulation, Sacramento, California, USA
| | - Deanna Osmond
- Department of Crop and Soil Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Heather E Preisendanz
- Department of Agricultural and Biological Engineering, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Zhenxu Tang
- Bayer Crop Science, Chesterfield, Missouri, USA
| | - Kevin Armbrust
- Department of Environmental Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Kevin Costello
- Office of Pesticide Programs, US Environmental Protection Agency, Washington, District of Columbia, USA
| | | | | | - Johnny Westgate
- Pest Management Regulatory Agency, Health Canada, Ottawa, Ontario, Canada
| | - Mélanie Whiteside
- Pest Management Regulatory Agency, Health Canada, Ottawa, Ontario, Canada
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43
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Wang S, Cao B, Bai R, Liu G. Mid-long term boundary dynamic optimization of open-pit coal mine considering coal price fluctuation. PLoS One 2024; 19:e0296932. [PMID: 38394262 PMCID: PMC10890747 DOI: 10.1371/journal.pone.0296932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/20/2023] [Indexed: 02/25/2024] Open
Abstract
The delineation of the open-pit mining boundary, particularly in the context of medium to long-term planning, forms the foundation of mining design. However, due to the non-linear and dynamic nature of the economic and technical parameters influencing boundary delineation, determining the optimal mining boundary can be exceedingly challenging. Currently, most boundary optimization methods assume that block parameters remain fixed, which results in enterprises assuming a certain level of risk when facing changes in internal and external conditions. In this regard, this paper introduces the concept of "achievement degree" to reflect the risk associated with the results of boundary design. Using coal prices as an example, this article applies the predicted coal price curve to boundary optimization adjustments by specifying the "achievement degree" requirements for various time periods, thereby facilitating risk-controlled and economically optimal boundary decisions. Taking the illustrative case of an idealized small-scale inclined coal seam open-pit mine, adjustments to the boundary closely track variations in coal prices, further enhancing returns. The results demonstrate that the method proposed in this paper can increase overall revenue by approximately 51.15% within the forecast period, while effectively managing risks.
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Affiliation(s)
- Shuai Wang
- College of Mining, Liaoning Technical University, Fuxin, Liaoning, China
| | - Bo Cao
- College of Mining, Liaoning Technical University, Fuxin, Liaoning, China
| | - Runcai Bai
- College of Mining, Liaoning Technical University, Fuxin, Liaoning, China
| | - Guangwei Liu
- College of Mining, Liaoning Technical University, Fuxin, Liaoning, China
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Hung KKC, MacDermot MK, Hui TSI, Chan SY, Mashino S, Mok CPY, Leung PH, Kayano R, Abrahams J, Wong CS, Chan EYY, Graham CA. Mapping study for health emergency and disaster risk management competencies and curricula: literature review and cross-sectional survey. Global Health 2024; 20:15. [PMID: 38383465 PMCID: PMC10880341 DOI: 10.1186/s12992-023-01010-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/21/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND With the increasing threat of hazardous events at local, national, and global levels, an effective workforce for health emergency and disaster risk management (Health EDRM) in local, national, and international communities is urgently needed. However, there are no universally accepted competencies and curricula for Health EDRM. This study aimed to identify Health EDRM competencies and curricula worldwide using literature reviews and a cross-sectional survey. METHODS Literature reviews in English and Japanese languages were performed. We searched MEDLINE, EMBASE, CINAHL (English), and the ICHUSHI (Japanese) databases for journal articles published between 1990 and 2020. Subsequently, a cross-sectional survey was sent to WHO Health EDRM Research Network members and other recommended experts in October 2021 to identify competency models and curricula not specified in the literature search. RESULTS Nineteen studies from the searches were found to be relevant to Health EDRM competencies and curricula. Most of the competency models and curricula were from the US. The domains included knowledge and skills, emergency response systems (including incident management principles), communications, critical thinking, ethical and legal aspects, and managerial and leadership skills. The cross-sectional survey received 65 responses with an estimated response rate of 25%. Twenty-one competency models and 20 curricula for managers and frontline personnel were analyzed; managers' decision-making and leadership skills were considered essential. CONCLUSION An increased focus on decision-making and leadership skills should be included in Health EDRM competencies and curricula to strengthen the health workforce.
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Affiliation(s)
- Kevin K C Hung
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
- Collaborating Centre for Oxford University and Chinese University of Hong Kong for Disaster and Medical Humanitarian Response (CCOUC), JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Makiko K MacDermot
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Theresa S I Hui
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Suet Yi Chan
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Sonoe Mashino
- Research Institute of Nursing Care for People and Community, University of Hyogo, Akashi, 673-8588, Japan
| | - Catherine P Y Mok
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Pak Ho Leung
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Ryoma Kayano
- World Health Organization Centre for Health Development, Kobe, 651-0073, Japan
| | - Jonathan Abrahams
- Monash University Disaster Resilience Initiative, Monash University, Clayton, Australia
| | - Chi Shing Wong
- Collaborating Centre for Oxford University and Chinese University of Hong Kong for Disaster and Medical Humanitarian Response (CCOUC), JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Y Y Chan
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
- Collaborating Centre for Oxford University and Chinese University of Hong Kong for Disaster and Medical Humanitarian Response (CCOUC), JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Colin A Graham
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
- Collaborating Centre for Oxford University and Chinese University of Hong Kong for Disaster and Medical Humanitarian Response (CCOUC), JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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Tran TK, Nguyen MK, Lin C, Hoang TD, Nguyen TC, Lone AM, Khedulkar AP, Gaballah MS, Singh J, Chung WJ, Nguyen DD. Review on fate, transport, toxicity and health risk of nanoparticles in natural ecosystems: Emerging challenges in the modern age and solutions toward a sustainable environment. Sci Total Environ 2024; 912:169331. [PMID: 38103619 DOI: 10.1016/j.scitotenv.2023.169331] [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: 09/27/2023] [Revised: 11/21/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
In today's era, nanoparticles (NPs) have become an integral part of human life, finding extensive applications in various fields of science, pharmacy, medicine, industry, electronics, and communication. The increasing popularity of NP usage worldwide is a testament to their tremendous potential. However, the widespread deployment of NPs unavoidably leads to their release into the environmental matrices, resulting in persistence in ecosystems and bioaccumulation in organisms. Understanding the environmental behavior of NPs poses a significant challenge due to their nanoscale size. Given the current environmental releases of NPs, known negative consequences, and the limited knowledge available for risk management, comprehending the toxicity of NPs in ecosystems is both awaiting and crucial. The present review aims to unravel the potential environmental influences of nano-scaled materials, and provides in-depth inferences of the current knowledge and understanding in this field. The review comprehensively summarizes the sources, fate, transport, toxicity, health risks, and remediation solutions associated with NP pollution in aquatic and soil ecosystems. Furthermore, it addresses the knowledge gaps and outlines further investigation priorities for the sustainable control of NP pollution in these environments. By gaining a holistic understanding of these aspects, we can work toward ensuring the responsible and sustainable use of NPs in today's fast-growing world.
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Affiliation(s)
- Thien-Khanh Tran
- Advanced Applied Sciences Research Group, Dong Nai Technology University, Bien Hoa City 76100, Viet Nam; Faculty of Technology, Dong Nai Technology University, Bien Hoa City 76100, Viet Nam
| | - Minh-Ky Nguyen
- Faculty of Environment and Natural Resources, Nong Lam University, Hamlet 6, Linh Trung Ward, Thu Duc City, Ho Chi Minh City 700000, Viet Nam; Ph.D. Program in Maritime Science and Technology, National Kaohsiung University of Science and Technology, Kaohsiung 81157, Taiwan.
| | - Chitsan Lin
- Ph.D. Program in Maritime Science and Technology, National Kaohsiung University of Science and Technology, Kaohsiung 81157, Taiwan; Department of Marine Environmental Engineering, National Kaohsiung University of Science and Technology, Kaohsiung 81157, Taiwan
| | - Tuan-Dung Hoang
- School of Chemistry and Life Science, Hanoi University of Science and Technology, No. 1 Dai Co Viet, Hai Ba Trung, Hanoi 100000, Viet Nam; Vietnam National University, Hanoi, VNU Town, Hoa Lac, Thach That District, Hanoi 155500, Viet Nam
| | - Thanh-Cong Nguyen
- Faculty of Technology, Dong Nai Technology University, Bien Hoa City 76100, Viet Nam
| | - Aasif Mohmad Lone
- Department of Civil Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Akhil Pradiprao Khedulkar
- Department of Biomedical Engineering and Environmental Science, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Mohamed S Gaballah
- CAS Key Laboratory of Urban Pollutant Conversion, Department of Environmental Science and Engineering, University of Science and Technology of China, Hefei 230026, China; School of Engineering and Technology, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Jagpreet Singh
- Department of Chemistry, University Centre for Research and Development, Chandigarh University, Gharuan, Mohali, 140413, India
| | - W Jin Chung
- Department of Civil & Energy System Engineering, Kyonggi University, Suwon 16227, South Korea
| | - D Duc Nguyen
- Department of Civil & Energy System Engineering, Kyonggi University, Suwon 16227, South Korea; Institute of Applied Technology and Sustainable Development, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Viet Nam.
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46
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Saleh N, Gamal O, Eldosoky MAA, Shaaban AR. An integrative approach to medical laboratory equipment risk management. Sci Rep 2024; 14:4045. [PMID: 38374369 PMCID: PMC10876531 DOI: 10.1038/s41598-024-54334-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/12/2024] [Indexed: 02/21/2024] Open
Abstract
Medical Laboratory Equipment (MLE) is one of the most influential means for diagnosing a patient in healthcare facilities. The accuracy and dependability of clinical laboratory testing is essential for making disease diagnosis. A risk-reduction plan for managing MLE is presented in the study. The methodology was initially based on the Failure Mode and Effects Analysis (FMEA) method. Because of the drawbacks of standard FMEA implementation, a Technique for Ordering Preference by Similarity to the Ideal Solution (TOPSIS) was adopted in addition to the Simple Additive Weighting (SAW) method. Each piece of MLE under investigation was given a risk priority number (RPN), which in turn assigned its risk level. The equipment performance can be improved, and maintenance work can be prioritized using the generated RPN values. Moreover, five machine learning classifiers were employed to classify TOPSIS results for appropriate decision-making. The current study was conducted on 15 various hospitals in Egypt, utilizing a 150 MLE set of data from an actual laboratory, considering three different types of MLE. By applying the TOPSIS and SAW methods, new RPN values were obtained to rank the MLE risk. Because of its stability in ranking the MLE risk value compared to the conventional FMEA and SAW methods, the TOPSIS approach has been accepted. Thus, a prioritized list of MLEs was identified to make decisions related to appropriate incoming maintenance and scrapping strategies according to the guidance of machine learning classifiers.
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Affiliation(s)
- Neven Saleh
- Electrical Communication and Electronic Systems Engineering Department, Faculty of Engineering, October University for Modern Sciences and Arts (MSA), 6th of October City, Giza, Egypt.
- Systems and Biomedical Engineering Department, Higher Institute of Engineering, Shorouk Academy, Al Shorouk City, Cairo, Egypt.
| | - Omnia Gamal
- Biomedical Engineering Department, Faculty of Engineering, Helwan University, Cairo, Egypt
| | - Mohamed A A Eldosoky
- Biomedical Engineering Department, Faculty of Engineering, Helwan University, Cairo, Egypt
| | - Abdel Rahman Shaaban
- Systems and Biomedical Engineering Department, Higher Institute of Engineering, Shorouk Academy, Al Shorouk City, Cairo, Egypt
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47
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Liu K, Wang S, Chen B, Wang H. Quantifying the direct and indirect impacts of urban waterlogging using input‒output analysis. J Environ Manage 2024; 352:120068. [PMID: 38215593 DOI: 10.1016/j.jenvman.2024.120068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 12/20/2023] [Accepted: 01/05/2024] [Indexed: 01/14/2024]
Abstract
Increasingly frequent urban waterlogging disasters are having profound social and economic consequences. An appropriate and integrated evaluation of the total economic impacts of such disasters is crucial for achieving effective urban disaster risk management and sustainable development. However, existing metrics are inadequate for measuring the economic impacts of rainfall events of different intensities and their ripple effects across regions. Moreover, their ecological impacts have received insufficient attention. To address these gaps, we developed an integrated assessment framework for analyzing urban waterlogging losses and evaluating their various impacts. Taking Beijing as a case study, we used the InfoWorks ICM model to simulate urban waterlogging disaster risks, quantified direct economic losses, and assessed their environmental impacts. Additionally, we estimated indirect economic losses using input-output analysis and explored spillover effects. The results revealed increasing trends of direct economic losses and environmental losses corresponding to a longer return period. We observed synergies between these losses and their spatial heterogeneity. However, indirect impacts far outweighed direct impacts, with the former being 2.43 times larger than the latter. The cascading effect resulting from damage to infrastructure was also particularly pronounced. The industrial and spatial heterogeneity of interregional impacts was striking, with eastern provinces evidencing the most significant effects. By mapping the transmission paths of disaster losses along industrial chains and across regions, this study provides inputs that could assist policymakers in developing more effective measures for preventing and mitigating urban waterlogging disasters.
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Affiliation(s)
- Keling Liu
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing, 100875, China
| | - Saige Wang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing, 100875, China
| | - Bin Chen
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing, 100875, China.
| | - Hao Wang
- Faculty of Architecture, Civil and Transportation Engineering, Beijing University of Technology, Beijing, 100124, China
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48
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Ruangpan L, Vojinovic Z, Plavšić J, Curran A, Rosic N, Pudar R, Savic D, Brdjanovic D. Economic assessment of nature-based solutions to reduce flood risk and enhance co-benefits. J Environ Manage 2024; 352:119985. [PMID: 38184870 DOI: 10.1016/j.jenvman.2023.119985] [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: 08/07/2023] [Revised: 12/01/2023] [Accepted: 12/27/2023] [Indexed: 01/09/2024]
Abstract
Flooding is expected to increase due to climate change, urbanisation, and land use change. To address this issue, Nature-Based Solutions (NBSs) are often adopted as innovative and sustainable flood risk management methods. Besides the flood risk reduction benefits, NBSs offer co-benefits for the environment and society. However, these co-benefits are rarely considered in flood risk management due to the inherent complexities of incorporating them into economic assessments. This research addresses this gap by developing a comprehensive methodology that integrates the monetary analysis of co-benefits with flood risk reduction in economic assessments. In doing so, it aspires to provide a more holistic view of the impact of NBS in flood risk management. The assessment employs a framework based on life-cycle cost-benefit analysis, offering a systematic and transparent assessment of both costs and benefits over time supported by key indicators like net present value and benefit cost ratio. The methodology has been applied to the Tamnava basin in Serbia, where significant flooding occurred in 2014 and 2020. The methodology offers valuable insights for practitioners, researchers, and planners seeking to assess the co-benefits of NBS and integrate them into economic assessments. The results show that when considering flood risk reduction alone, all considered measures have higher costs than the benefits derived from avoiding flood damage. However, when incorporating co-benefits, several NBS have a net positive economic impact, including afforestation/reforestation and retention ponds with cost-benefit ratios of 3.5 and 5.6 respectively. This suggests that incorporating co-benefits into economic assessments can significantly increase the overall economic efficiency and viability of NBS.
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Affiliation(s)
- Laddaporn Ruangpan
- Faculty of Applied science, Delft University of Technology, Delft, the Netherlands; Department of Water Supply, Sanitation and Environmental Engineering, IHE Delft Institute for Water Education, Delft, the Netherlands.
| | - Zoran Vojinovic
- Department of Water Supply, Sanitation and Environmental Engineering, IHE Delft Institute for Water Education, Delft, the Netherlands; Faculty of Civil Engineering, University of Belgrade, Belgrade, Serbia; College for Engineering, Mathematics and Physical Sciences, University of Exeter, UK
| | - Jasna Plavšić
- Faculty of Civil Engineering, University of Belgrade, Belgrade, Serbia
| | - Alex Curran
- HKV lijn in water B.V., Delft, the Netherlands
| | - Nikola Rosic
- Faculty of Civil Engineering, University of Belgrade, Belgrade, Serbia
| | | | - Dragan Savic
- College for Engineering, Mathematics and Physical Sciences, University of Exeter, UK; KWR Water Research Institute, the Netherlands
| | - Damir Brdjanovic
- Faculty of Applied science, Delft University of Technology, Delft, the Netherlands; Department of Water Supply, Sanitation and Environmental Engineering, IHE Delft Institute for Water Education, Delft, the Netherlands
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49
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Brignon JM, Vergnaud JC, Andres S, Mombelli E, Rambolarimanana T. Can "Hazard-Cost-Effectiveness Analysis" improve the risk management of chemicals under REACH? Regul Toxicol Pharmacol 2024; 147:105561. [PMID: 38246306 DOI: 10.1016/j.yrtph.2024.105561] [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: 10/04/2023] [Revised: 12/05/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024]
Abstract
Cost-Effectiveness Analysis (CEA) is a decision-making framework to prioritize policy decisions for chemicals. Differences in hazard profiles among chemicals are not integrated in CEA under the EU REACH Regulation, which could limit its relevance. Another concern is that two different economic decision support methods (CEA for chemicals considered as PBTs or vPvBs from a regulatory perspective and Cost Benefit Analysis (CBA) for others) are used under REACH. To address this situation, we define "Hazard" CEA by integrating a hazard score, based on persistence, bioaccumulation and (eco)toxicity, in the effect indicator of CEA. We test different designs and parameterizations of Hazard-CEA on a set of past socio-economic assessments under REACH for PBT and non-PBT chemicals. Weighing and thresholds in hazard scores do not have a significant impact on the outcome of Hazard-CEA but the design of the hazard scoring method does. We suggest using an integrated and unweighted scoring method with a multiplicative formulation based on the notion of risk. Hazard-CEA could be used for both PBT and non-PBT chemicals, to use a single method in REACH and therefore improve consistency in policy decisions. Our work also suggests that using Hazard-CEA could help make decision easier.
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Affiliation(s)
- Jean-Marc Brignon
- INERIS, Parc Technologique ALATA, BP 2, 60550, Verneuil-en-Halatte, France.
| | | | - Sandrine Andres
- INERIS, Parc Technologique ALATA, BP 2, 60550, Verneuil-en-Halatte, France
| | - Enrico Mombelli
- INERIS, Parc Technologique ALATA, BP 2, 60550, Verneuil-en-Halatte, France
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50
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Li A. Human error risk prioritization in crane operations based on CPT and ICWGT. PLoS One 2024; 19:e0297120. [PMID: 38300943 PMCID: PMC10833522 DOI: 10.1371/journal.pone.0297120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/27/2023] [Indexed: 02/03/2024] Open
Abstract
Human error plays a significant role in crane safety. To increase the accuracy and rationality of human error risk prioritization for crane operations, this study proposes a risk prioritization model for human errors in crane operations based on the cumulative prospect theory (CPT) and the improved combination weighting model of game theory (ICWGT). The ICWGT integrates the risk-factor weights obtained via subjective and objective methods. Trapezoidal fuzzy numbers are used to describe experts' uncertainty information. Then, the CPT is applied to handle the assessment of experts' risk attitudes in the decision process. The human error risk ranking of crane operations is obtained according to the overall prospect values calculated using the CPT. A case study of human error in overhead crane operations was conducted, and sensitivity and comparison analyses confirmed the feasibility of the proposed model. The proposed ranking mechanism for human error risk priority in crane operations is helpful for crane risk management.
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Affiliation(s)
- Aihua Li
- College of Mechanical Engineering, Yancheng Institute of Technology, Yancheng, 224051, Jiangsu, China
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