WorldWideScience

Sample records for incident based reporting

  1. Specialty-based, voluntary incident reporting in neonatal intensive care: description of 4846 incident reports

    NARCIS (Netherlands)

    Snijders, C.; van Lingen, R. A.; Klip, H.; Fetter, W. P. F.; van der Schaaf, T. W.; Molendijk, H. A.; Kok, J. H.; te Pas, E.; Pas, H.; van der Starre, C.; Bloemendaal, E.; Lopes Cardozo, R. H.; Molenaar, A. M.; Giezen, A.; Maat, H. E.; Molendijk, A.; Lavrijssen, S.; Mulder, A. L. M.; de Kleine, M. J. K.; Koolen, A. M. P.; Schellekens, M.; Verlaan, W.; Vrancken, S.; Schotman, L.; van der Zwaan, A.; van der Tuijn, Y.; Tibboel, D.; Kollen, B. J.

    2009-01-01

    OBJECTIVES: To examine the characteristics of incidents reported after introduction of a voluntary, non-punitive incident reporting system for neonatal intensive care units (NICUs) in the Netherlands; and to investigate which types of reported incident pose the highest risk to patients in the NICU.

  2. The evaluation of a web-based incident reporting system.

    Science.gov (United States)

    Kuo, Ya-Hui; Lee, Ting-Ting; Mills, Mary Etta; Lin, Kuan-Chia

    2012-07-01

    A Web-based reporting system is essential to report incident events anonymously and confidentially. The purpose of this study was to evaluate a Web-based reporting system in Taiwan. User satisfaction and impact of system use were evaluated through a survey answered by 249 nurses. Incident events reported in paper and electronic systems were collected for comparison purposes. Study variables included system user satisfaction, willingness to report, number of reports, severity of the events, and efficiency of the reporting process. Results revealed that senior nurses were less willing to report events, nurses on internal medicine units had higher satisfaction than others, and lowest satisfaction was related to the time it took to file a report. In addition, the Web-based reporting system was used more often than the paper system. The percentages of events reported were significantly higher in the Web-based system in laboratory, environment/device, and incidents occurring in other units, whereas the proportions of reports involving bedsores and dislocation of endotracheal tubes were decreased. Finally, moderate injury event reporting decreased, whereas minor or minimal injury event reporting increased. The study recommends that the data entry process be simplified and the network system be improved to increase user satisfaction and reporting rates.

  3. Unit-based incident reporting and root cause analysis: variation at three hospital unit types

    NARCIS (Netherlands)

    Wagner, C.; Merten, H.; Zwaan, L.; Lubberding, S.; Timmermans, D.; Smits, M.

    2016-01-01

    OBJECTIVES: To minimise adverse events in healthcare, various large-scale incident reporting and learning systems have been developed worldwide. Nevertheless, learning from patient safety incidents is going slowly. Local, unit-based reporting systems can help to get faster and more detailed insight

  4. Unit-based incident reporting and root cause analysis: variation at three hospital unit types.

    NARCIS (Netherlands)

    Wagner, C.; Merten, H.; Lubberding, S.; Zwaan, L.; Timmermans, D.; Smits, M.

    2016-01-01

    Objectives To minimise adverse events in healthcare, various large-scale incident reporting and learning systems have been developed worldwide. Nevertheless, learning from patient safety incidents is going slowly. Local, unit-based reporting systems can help to get faster and more

  5. Police Incident Reports Written

    Data.gov (United States)

    Town of Chapel Hill, North Carolina — This table contains incident reports filed with the Chapel Hill Police Department. Multiple incidents may have been reported at the same time. The most serious...

  6. The effect of a workflow-based response system on hospital-wide voluntary incident reporting rates.

    Science.gov (United States)

    Wang, Szu-Chang; Li, Ying-Chun; Huang, Hung-Chi

    2013-02-01

    Hospital incident reporting systems are usually evaluated on their theoretical benefit to the hospital or increase in reporting rates alone. To evaluate a workflow-based response system on staff incident reporting rates. A prospective cohort study of incident reports made by staff members before (2006-2007) and after (2008-2009) the system was implemented on 1 January 2008 at a medical center in southern Taiwan. Pre-system and post-system data were based on 713 129 and 730 176 inpatient days and 160 692 and 168 850 emergency department visits. The addition of a workflow-based response system to a reporting system processing incident reports and intra-hospital responses. Voluntary incident reporting rates and distribution of incident severities. Inpatient reports [9.9 vs. 28.8 per 10 000 patient days; rate ratio (RR): 2.9, 95% confidence interval (CI): 2.7-3.2, P reports (5.9 vs. 19.2 per 10 000 visits, RR: 3.3, 95% CI: 2.6-4.1, P system reported incidents were more evenly distributed over five severity levels than pre-sytem incidents, moving more toward the very severe level (RR: 17.6, 95% CI: 8.4-37.0, P system to the hospital incident reporting system significantly increased hospital-wide voluntary incident report rates at all incident injury levels.

  7. Adult Perpetrator Gender Asymmetries in Child Sexual Assault Victim Selection: Results from the 2000 National Incident-Based Reporting System

    Science.gov (United States)

    McCloskey, Kathy A.; Raphael, Desreen N.

    2005-01-01

    Data from the 2000 National Incident-Based Reporting System (NIBRS) show that while males make up about nine out of every 10 adult sexual assault perpetrators, totaling about 26,878 incidents within the reporting period, females account for about one out of 10 perpetrators, totaling about 1,162 incidents. Male sexual assault perpetrators offend…

  8. SU-E-T-524: Web-Based Radiation Oncology Incident Reporting and Learning System (ROIRLS)

    Energy Technology Data Exchange (ETDEWEB)

    Kapoor, R; Palta, J; Hagan, M [Virginia Commonwealth University, Richmond, VA (United States); National Radiation Oncology Program (10P4H), Richmond, VA (United States); Grover, S; Malik, G [TSG Innovations Inc., Richmond, VA (United States)

    2014-06-01

    Purpose: Describe a Web-based Radiation Oncology Incident Reporting and Learning system that has the potential to improve quality of care for radiation therapy patients. This system is an important facet of continuing effort by our community to maintain and improve safety of radiotherapy.Material and Methods: The VA National Radiation Oncology Program office has embarked on a program to electronically collect adverse events and near miss data of radiation treatment of over 25,000 veterans treated with radiotherapy annually. Software used for this program is deployed on the VAs intranet as a Website. All data entry forms (adverse event or near miss reports, work product reports) utilize standard causal, RT process step taxonomies and data dictionaries defined in AAPM and ASTRO reports on error reporting (AAPM Work Group Report on Prevention of Errors and ASTROs safety is no accident report). All reported incidents are investigated by the radiation oncology domain experts. This system encompasses the entire feedback loop of reporting an incident, analyzing it for salient details, and developing interventions to prevent it from happening again. The operational workflow is similar to that of the Aviation Safety Reporting System. This system is also synergistic with ROSIS and SAFRON. Results: The ROIRLS facilitates the collection of data that help in tracking adverse events and near misses and develop new interventions to prevent such incidents. The ROIRLS electronic infrastructure is fully integrated with each registered facility profile data thus minimizing key strokes and multiple entries by the event reporters. Conclusions: OIRLS is expected to improve the quality and safety of a broad spectrum of radiation therapy patients treated in the VA and fulfills our goal of Effecting Quality While Treating Safely The Radiation Oncology Incident Reporting and Learning System software used for this program has been developed, conceptualized and maintained by TSG Innovations

  9. SU-E-T-524: Web-Based Radiation Oncology Incident Reporting and Learning System (ROIRLS)

    International Nuclear Information System (INIS)

    Kapoor, R; Palta, J; Hagan, M; Grover, S; Malik, G

    2014-01-01

    Purpose: Describe a Web-based Radiation Oncology Incident Reporting and Learning system that has the potential to improve quality of care for radiation therapy patients. This system is an important facet of continuing effort by our community to maintain and improve safety of radiotherapy.Material and Methods: The VA National Radiation Oncology Program office has embarked on a program to electronically collect adverse events and near miss data of radiation treatment of over 25,000 veterans treated with radiotherapy annually. Software used for this program is deployed on the VAs intranet as a Website. All data entry forms (adverse event or near miss reports, work product reports) utilize standard causal, RT process step taxonomies and data dictionaries defined in AAPM and ASTRO reports on error reporting (AAPM Work Group Report on Prevention of Errors and ASTROs safety is no accident report). All reported incidents are investigated by the radiation oncology domain experts. This system encompasses the entire feedback loop of reporting an incident, analyzing it for salient details, and developing interventions to prevent it from happening again. The operational workflow is similar to that of the Aviation Safety Reporting System. This system is also synergistic with ROSIS and SAFRON. Results: The ROIRLS facilitates the collection of data that help in tracking adverse events and near misses and develop new interventions to prevent such incidents. The ROIRLS electronic infrastructure is fully integrated with each registered facility profile data thus minimizing key strokes and multiple entries by the event reporters. Conclusions: OIRLS is expected to improve the quality and safety of a broad spectrum of radiation therapy patients treated in the VA and fulfills our goal of Effecting Quality While Treating Safely The Radiation Oncology Incident Reporting and Learning System software used for this program has been developed, conceptualized and maintained by TSG Innovations

  10. Medication incidents reported to an online incident reporting system.

    LENUS (Irish Health Repository)

    Alrwisan, Adel

    2011-01-15

    AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

  11. What Happened, and Why: Toward an Understanding of Human Error Based on Automated Analyses of Incident Reports. Volume 1

    Science.gov (United States)

    Maille, Nicolas P.; Statler, Irving C.; Ferryman, Thomas A.; Rosenthal, Loren; Shafto, Michael G.; Statler, Irving C.

    2006-01-01

    The objective of the Aviation System Monitoring and Modeling (ASMM) project of NASA s Aviation Safety and Security Program was to develop technologies that will enable proactive management of safety risk, which entails identifying the precursor events and conditions that foreshadow most accidents. This presents a particular challenge in the aviation system where people are key components and human error is frequently cited as a major contributing factor or cause of incidents and accidents. In the aviation "world", information about what happened can be extracted from quantitative data sources, but the experiential account of the incident reporter is the best available source of information about why an incident happened. This report describes a conceptual model and an approach to automated analyses of textual data sources for the subjective perspective of the reporter of the incident to aid in understanding why an incident occurred. It explores a first-generation process for routinely searching large databases of textual reports of aviation incident or accidents, and reliably analyzing them for causal factors of human behavior (the why of an incident). We have defined a generic structure of information that is postulated to be a sound basis for defining similarities between aviation incidents. Based on this structure, we have introduced the simplifying structure, which we call the Scenario as a pragmatic guide for identifying similarities of what happened based on the objective parameters that define the Context and the Outcome of a Scenario. We believe that it will be possible to design an automated analysis process guided by the structure of the Scenario that will aid aviation-safety experts to understand the systemic issues that are conducive to human error.

  12. Fire Incident Reporting Manual

    Science.gov (United States)

    1984-02-01

    the result of an incident that requires (or should require) treatment by a practitioner of medicine , a registered emergency medical technician, or a...UNANNOUNCED AIRCRAFT EMERGENCYS ~~PRIOR TO TAKE OFF OR AFTERLADN 5 FUEL OPERATIONS REQUIRING 1AREING G A FIRE10 ARRESTING GEAR’BARRIER FR . ENGAGEMENTS AND

  13. A web-based incident reporting system and multidisciplinary collaborative projects for patient safety in a Japanese hospital.

    Science.gov (United States)

    Nakajima, K; Kurata, Y; Takeda, H

    2005-04-01

    When patient safety programs were mandated for Japanese health care institutions, a safety culture, a tool for collecting incident reports, an organizational arrangement for multidisciplinary collaboration, and interventional methods for improvement had to be established. Observational study of effects of new patient safety programs. Osaka University Hospital, a large government-run teaching hospital. A voluntary and anonymous web-based incident reporting system was introduced. For the new organizational structure a clinical risk management committee, a department of clinical quality management, and area clinical risk managers were established with their respective roles clearly defined to advance the plan-do-study-act cycle and to integrate efforts. For preventive action, alert procedures, staff education, ward rounds by peers, a system oriented approach for reducing errors, and various feedback channels were introduced. Continuous incident reporting by all hospital staff has been observed since the introduction of the new system. Several error inducing situations have been improved: wrong choice of drug in computer prescribing, maladministration of drugs due to a look-alike appearance or confusion about the manipulation of a medical device, and poor after hours service of the blood transfusion unit. Staff participation in educational seminars has been dramatically improved. Ward rounds have detected problematic procedures which needed to be dealt with. Patient safety programs based on a web-based incident reporting system, responsible persons, staff education, and a variety of feedback procedures can help promote a safety culture, multidisciplinary collaboration, and strong managerial leadership resulting in system oriented improvement.

  14. Elevated incidence rates of diabetes in Peru: report from PERUDIAB, a national urban population-based longitudinal study.

    Science.gov (United States)

    Seclen, Segundo Nicolas; Rosas, Moises Ernesto; Arias, Arturo Jaime; Medina, Cecilia Alexandra

    2017-01-01

    A recent report from a non-nationally representative, geographically diverse sample in four separate communities in Peru suggests an unusually high diabetes incidence. We aimed to estimate the national diabetes incidence rate using PERUDIAB, a probabilistic, national urban population-based longitudinal study. 662 subjects without diabetes, selected by multistage, cluster, random sampling of households, representing the 24 administrative and the 3 (coast, highlands and jungle) natural regions across the country, from both sexes, aged 25+ years at baseline, enrolled in 2010-2012, were followed for 3.8 years. New diabetes cases were defined as fasting blood glucose ≥126 mg/dL or on medical diabetes treatment. There were 49 cases of diabetes in 2408 person-years follow-up. The weighted cumulative incidence of diabetes was 7.2% while the weighted incidence rate was estimated at 19.5 (95% CI 13.9 to 28.3) new cases per 1000 person-years. Older age, obesity and technical or higher education were statistically associated with the incidence of diabetes. Our results confirm that the incidence of diabetes in Peru is among the highest reported globally. The fast economic growth in the last 20 years, high overweight and obesity rates may have triggered this phenomenon.

  15. SU-E-T-469: Implementation of VAs Web-Based Radiotherapy Incident Reporting and Analysis System (RIRAS)

    Energy Technology Data Exchange (ETDEWEB)

    Kapoor, R; Palta, J; Hagan, M [Veteran Health Administration, Richmond, Virginia (United States); Virginia Commonwealth University, Richmond, VA (United States); Malik, G [TSG Innovations Inc. (United States)

    2015-06-15

    Purpose: This Web-based Radiotherapy Incident Reporting and Analysis System (RIRAS) is a tool to improve quality of care for radiation therapy patients. This system is an important facet of continuing effort by our community to maintain and improve safety of radiotherapy.Material and Methods: VA’s National Radiation Oncology Program office has embarked on a program to electronically collect adverse events and good-catch data of radiation treatment of over 25,000 veterans treated with radiotherapy annually. This VA-Intranet based software design has made use of dataset taxonomies and data dictionaries defined in AAPM/ASTRO reports on error reporting. We used proven industrial and medical event reporting techniques to avoid several common problems faced in effective data collection such as incomplete data due to data entry fatigue by the reporters, missing data due to data difficult to obtain or not familiar to most reporters, missing reports due to fear of reprisal etc. This system encompasses the entire feedback loop of reporting an incident, analyzing it for salient details, and developing interventions to prevent it from happening again. The analysis reports with corrective, learning actions are shared with the reporter/facility and made public to the community (after deidentification) as part of the learning process. Results: Till date 50 incident/good catches have been reported in RIRAS and we have completed analysis on 100% of these reports. This is done due to the fact that each reported incidents is investigated and a complete analysis/patient-safety-work-product report is generated by radiation oncology domain-experts. Conclusions Because of the completeness of the data, the system has enabled us to analyze process steps and track trends of major errors which in the future will lead to implementing system wide process improvement steps and safe standard operating procedures for each radiotherapy treatment modality/technique and fulfills our goal of

  16. SU-E-T-469: Implementation of VAs Web-Based Radiotherapy Incident Reporting and Analysis System (RIRAS)

    International Nuclear Information System (INIS)

    Kapoor, R; Palta, J; Hagan, M; Malik, G

    2015-01-01

    Purpose: This Web-based Radiotherapy Incident Reporting and Analysis System (RIRAS) is a tool to improve quality of care for radiation therapy patients. This system is an important facet of continuing effort by our community to maintain and improve safety of radiotherapy.Material and Methods: VA’s National Radiation Oncology Program office has embarked on a program to electronically collect adverse events and good-catch data of radiation treatment of over 25,000 veterans treated with radiotherapy annually. This VA-Intranet based software design has made use of dataset taxonomies and data dictionaries defined in AAPM/ASTRO reports on error reporting. We used proven industrial and medical event reporting techniques to avoid several common problems faced in effective data collection such as incomplete data due to data entry fatigue by the reporters, missing data due to data difficult to obtain or not familiar to most reporters, missing reports due to fear of reprisal etc. This system encompasses the entire feedback loop of reporting an incident, analyzing it for salient details, and developing interventions to prevent it from happening again. The analysis reports with corrective, learning actions are shared with the reporter/facility and made public to the community (after deidentification) as part of the learning process. Results: Till date 50 incident/good catches have been reported in RIRAS and we have completed analysis on 100% of these reports. This is done due to the fact that each reported incidents is investigated and a complete analysis/patient-safety-work-product report is generated by radiation oncology domain-experts. Conclusions Because of the completeness of the data, the system has enabled us to analyze process steps and track trends of major errors which in the future will lead to implementing system wide process improvement steps and safe standard operating procedures for each radiotherapy treatment modality/technique and fulfills our goal of

  17. Evaluation of the Defense Criminal Investigative Organizations’ Defense Incident-Based Reporting System Reporting and Reporting Accuracy

    Science.gov (United States)

    2014-10-29

    certain conditions; (5) confer with the Government attorney assigned to the case; (6) restitution; and (7) information about the conviction, sentencing ...in confinement status. The confinement authority must advise the victim or witness of an inmate’s status, to include length of sentence ... Inmate Status,” for this purpose. The DIBRS requires that the number of victim and witness notifications be reported to DMDC in accordance with The

  18. NEA incident reporting system: Three years' experience

    International Nuclear Information System (INIS)

    Otsuka, Y.; Haeussermann, W.

    1984-01-01

    The paper presents an overview of the NEA Incident Reporting System (IRS) which was set up to collect, assess and disseminate on safety-related incidents in nuclear power plants. The IRS information exchange is significant in two senses. First, it enables regulatory authorities and utilities in participating countries to take appropriate action to prevent the reported mishaps occurring again elsewhere. Secondly, the continuous collection and systematic analysis of such information allows identification of areas of concern where safety research should be strengthened. There are two stages in the IRS information exchange. First, the national IRS Co-ordinator selects information on significant incidents, in accordance with a common reporting threshold, from the abnormal occurrences reported to the regulatory body, to be distributed through the NEA Secretariat. This screening is intended to exclude minor events, so that only significant information is sent to participating countries. Secondly, a group of experts periodically reviews the incidents reported during the preceding twelve months to identify major areas of concern. To assist this process, a computer-based data retrieval system is being developed for IRS incident reports. The paper gives some details of the IRS mechanism and discusses reporting criteria and the information included in a report. Areas of concern derived from reported incidents, an outline of the data retrieval system, and examples of feedback of lessons learned and possibilities for international co-operation are also discussed. (author)

  19. What Happened, and Why: Toward an Understanding of Human Error Based on Automated Analyses of Incident Reports. Volume 2

    Science.gov (United States)

    Ferryman, Thomas A.; Posse, Christian; Rosenthal, Loren J.; Srivastava, Ashok N.; Statler, Irving C.

    2006-01-01

    The objective of the Aviation System Monitoring and Modeling project of NASA's Aviation Safety and Security Program was to develop technologies to enable proactive management of safety risk, which entails identifying the precursor events and conditions that foreshadow most accidents. Information about what happened can be extracted from quantitative data sources, but the experiential account of the incident reporter is the best available source of information about why an incident happened. In Volume I, the concept of the Scenario was introduced as a pragmatic guide for identifying similarities of what happened based on the objective parameters that define the Context and the Outcome of a Scenario. In this Volume II, that study continues into the analyses of the free narratives to gain understanding as to why the incident occurred from the reporter s perspective. While this is just the first experiment, the results of our approach are encouraging and indicate that it will be possible to design an automated analysis process guided by the structure of the Scenario that can achieve the level of consistency and reliability of human analysis of narrative reports.

  20. Childhood Cancer Incidence in India Betweem 2012 and 2014: Report of a Population-based Cancer Registry.

    Science.gov (United States)

    Das, Suman; Paul, Dilip Kumar; Anshu, Kumar; Bhakta, Subhajit

    2017-12-15

    To provide an overview of childhood cancer incidence in India between 2012-2014. Secondary data analysis on age-adjusted rates of cancer incidence for children (0-14 years) were collected from the report of the National Cancer Registry Programme in the year 2016. Age-adjusted rates of childhood cancer incidence ranged from 18.5 per million in the state of Nagaland to 235.3 per million in Delhi for boys. The rates were 11.4 per million in East Khasi Hill district and 152.3 per million in Delhi for girls. Leukemia was the most predominant cancer for both boys and girls. Lymphoma was the second most common cancer in boys, and brain tumors in girls. Childhood cancer incidence is increasing in India compared to population-based cancer registry survey of 2009-2011. Cancers are mostly affecting 0-4 years age group, and there is a rising trend of Non-Hodgkin's lymphoma.

  1. Learning From Incident Reporting? Analysis of Incidents Resulting in Patient Injuries in a Web-Based System in Swedish Health Care.

    Science.gov (United States)

    Ahlberg, Eva-Lena; Elfström, Johan; Borgstedt, Madeleine Risberg; Öhrn, Annica; Andersson, Christer; Sjödahl, Rune; Nilsen, Per

    2017-11-04

    Incident reporting (IR) systems have the potential to improve patient safety if they enable learning from the reported risks and incidents. The aim of this study was to investigate incidents registered in an IR system in a Swedish county council. The study was conducted in the County Council of Östergötland, Sweden. Data were retrieved from the IR system, which included 4755 incidents occurring in somatic care that resulted in patient injuries from 2004 to 2012. One hundred correctly classified patient injuries were randomly sampled from 3 injury severity levels: injuries leading to deaths, permanent harm, and temporary harm. Three aspects were analyzed: handling of the incident, causes of the incident, and actions taken to prevent its recurrence. Of the 300 injuries, 79% were handled in the departments where they occurred. The department head decided what actions should be taken to prevent recurrence in response to 95% of the injuries. A total of 448 causes were identified for the injuries; problems associated with procedures, routines, and guidelines were most common. Decisions taken for 80% of the injuries could be classified using the IR system documentation and root cause analysis. The most commonly pursued type of action was change of work routine or guideline. The handling, causes, and actions taken to prevent recurrence were similar for injuries of different severity levels. Various forms of feedback (information, education, and dialogue) were an integral aspect of the IR system. However, this feedback was primarily intradepartmental and did not yield much organizational learning.

  2. Factors influencing incident reporting in surgical care.

    Science.gov (United States)

    Kreckler, S; Catchpole, K; McCulloch, P; Handa, A

    2009-04-01

    To evaluate the process of incident reporting in a surgical setting. In particular: the influence of event outcome on reporting behaviour; staff perception of surgical complications as reportable events. Anonymous web-based questionnaire survey. General Surgical Department in a UK teaching hospital. Of 203 eligible staff, 55 (76.4%) doctors and 82 (62.6%) nurses participated. Knowledge and use of local reporting system; propensity to report incidents which vary by outcome (harm, no harm, harm prevented); propensity to report surgical complications; practical and psychological barriers to reporting. Nurses were significantly more likely to know of the local reporting system and to have recently completed a report than doctors. The level of harm (F(1.8,246) = 254.2, pvs 53%, z = 4.633, psystems.

  3. [Preliminary results of an anonymous internet-based reporting system for critical incidents in ambulatory primary care].

    Science.gov (United States)

    Brun, A

    2005-03-01

    To learn from errors is not always easy, especially if they happened to others! This paper describes the organization and management of a critical incident reporting system for primary care physicians in Switzerland and reports about the difficulties and experiences during the first 18 months since the start of the program. It seems to be particularly difficult to enhance the attentiveness of physicians for apparently harmless daily critical incidents and to motivate them to report it even in an anonymous reporting system. As incentives for more intensive participation there are the hope for comments on reported cases by other participants and the expectation that reported errors will be avoided by the readers.

  4. Cancer incidence in southwest of iran: first report from khuzestan population-based cancer registry, 2002-2009.

    Science.gov (United States)

    Talaiezadeh, Abdolhassan; Tabesh, Hamed; Sattari, Alireza; Ebrahimi, Shahram

    2013-01-01

    Cancer incidence rates are increasing particularly in developing countries. It is crucial for policy makers to know basic cancer epidemiology in each region to design comprehensive prevention plans. There have hitherto been no population-based data available for cancer in Khuzestan province. The present report is a first from the regional population-based cancer registry for the period of 2002-2009. Data were collected retrospectively reviewing all new cancer patients whom were registered in Khuzestan province cancer registry during an 8-year period (2002-2009). All cases were coded based on the ICD-O-3 coding system and collected data were computerized using SPSS (Chicago, IL) software, version 11.5. The age standardized incidence rates (ASRs) per 100,000 person-year for all cancers were computed using the indirect method of standardization to the world population. During the 8-year study period, 16,801 new cancer cases were registered. Based on the computed ASRs, the five most frequent malignancies in females were breast (26.4 per 100,000), skin (13.6), colorectal (5.72), stomach (4.31) and bladder(4.07) and in males, the five most frequent were skin (16.0 per 100,000), bladder (10.7),prostate (7.64), stomach (7.17), and colorectal (6.32).The ASR for all malignancies in women was 92.5 per 100,000, and that for men was 87.4. The observed patterns from the analysis of Khuzestan cancer registry data will lead to better understanding of the epidemiology of various malignancies in this part ofthe country and consequently provide a useful guide for authorities to make efficacious decisions and policies about a cancer control program for south-west Iran.

  5. High incidence and remission of reported food hypersensitivity in Swedish children followed from 8 to 12?years of age ? a population based cohort study

    OpenAIRE

    Winberg, Anna; Strinnholm, ?sa; Hedman, Linnea; West, Christina E; Perzanowski, Matthew S; R?nmark, Eva

    2014-01-01

    Background Few population-based cohort studies have examined reported food hypersensitivity longitudinally. We investigated prevalence, incidence and remission of perceived food hypersensitivity among schoolchildren from 8 to 12?years of age, and risk factors associated with incidence and remission. Methods A population-based cohort including all 7?8 year-old children in three Swedish towns was recruited in 2006. A total of 2,585 (96% of invited) children participated in a parental questionna...

  6. Reporting Helicopter Emergency Medical Services in Major Incidents

    DEFF Research Database (Denmark)

    Fattah, Sabina; Johnsen, Anne Siri; Sollid, Stephen J M

    2016-01-01

    OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences...

  7. Incident Reporting in Mashhad Hospitals

    Directory of Open Access Journals (Sweden)

    Davoodi R

    2013-10-01

    Full Text Available Objectives: In this study, our aim was to evaluate and classify the voluntary error reports in the hospitals of Mashhad University of Medical Sciences. Patients have the right to receive health care in accordance to the best standards. Health care carries a risk of harm for patient safety, and with respect to today’s stressful systems with a large number of patients, it would be inevitable. The meaning of risk management is to predict adverse events and reduce their occurrence.Materials and Methods: A voluntary medical error reporting form was designed and approved by the clinical governance team of Mashhad Medical University. They were then distributed inside hospitals in the way in which everyone (health providers and patients could access them easily. The forms were collected and classified monthly in all wards. Classification was performed on the base of type, outcome and reporter. Data gathering took place from spring to autumn 2012. The data was analyzed by the SPSS software. Results: 2500 errors were extracted from 1000 voluntary error reporting forms of the 12 hospitals of Mashhad Medical University. The most frequent error type was treatment errors (36% related to drug administration, standard procedures and surgical events. Conclusions: Error reporting as a basic activity has an important role in discovering pitfalls of the health care system. To promote the reporting culture, its non punitive base must become clear for all professors and staff members, because this kind of reporting could lead to fewer medical errors and higher staff awareness about probable errors.

  8. National Fire Incident Reporting System (NFIRS)

    Data.gov (United States)

    Department of Homeland Security — The National Fire Incident Reporting System (NFIRS) is a reporting standard that fire departments use to uniformly report on the full range of their activities, from...

  9. A nationwide medication incidents reporting system in The Netherlands.

    Science.gov (United States)

    Cheung, Ka-Chun; van den Bemt, Patricia M L A; Bouvy, Marcel L; Wensing, Michel; De Smet, Peter A G M

    2011-01-01

    Many Dutch hospitals have established internal systems for reporting incidents. However, such internal systems do not allow learning from incidents that occur in other hospitals. Therefore a multicenter, information technology (IT) supported reporting system named central medication incidents registration (CMR) was developed. This article describes the architecture, implementation and current status of the CMR in The Netherlands and compare it with similar systems in other countries. Adequate IT is required to sufficiently support a multicenter reporting system. The CMR system consists of a website, a database, a web-based reporting form, an application to import reports generated in other reporting systems, an application to generate an overview of reported medication incidents, and a national warning system for healthcare providers. From the start of CMR 90 of all 93 (96.8%) hospitals and 872 of 1948 (44.8%) community pharmacies participated. Between March 2006 and March 2010 the CMR comprised 15,694 reports of incidents. In the period from March 2010 to March 2011, 1642 reports were submitted by community pharmacies in CMR and the hospitals submitted 2517 reports. CMR is similar to various systems in other countries, but it seems to use more IT applications. The CMR is developing into a nationwide reporting system of medication incidents in The Netherlands, in which hospitals, community pharmacies, mental healthcare organizations and general practitioners participate. The architecture of the system met the requirements of a nationwide reporting system across different healthcare providers.

  10. Critical Incident Reporting Systems: Perceived Competing Social ...

    African Journals Online (AJOL)

    The safe operation of complex socio-technical systems is dependent upon the reporting of safety critical incidents by operators within a system. Through the action of reporting, systems develop the capability as a learning organisation to improve human and organisational performance. The aim of the study is therefore to ...

  11. C2-Related Incidents Reported by UAS Pilots

    Science.gov (United States)

    Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

    2016-01-01

    It has been estimated that aviation accidents are typically preceded by numerous minor incidents arising from the same causal factors that ultimately produced the accident. Accident databases provide in-depth information on a relatively small number of occurrences, however incident databases have the potential to provide insights into the human factors of Remotely Piloted Aircraft System (RPAS) operations based on a larger volume of less-detailed reports. Currently, there is a lack of incident data dealing with the human factors of unmanned aircraft systems. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. During each focus group session, a note taker produced a de-identified written record of the incident narratives. At the end of the session, participants reviewed each written incident report, and made edits and corrections as necessary. The incidents were later analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot during the events. A total of 90 incidents were reported. This presentation focuses on incidents that involved the management of the command and control (C2) link. The identified issues include loss of link, interference from undesired transmissions, voice latency, accidental control transfer, and the use of the lost link timer, or lost link OK features.

  12. How to Report a Pesticide Incident Involving Exposures to People

    Science.gov (United States)

    Pesticides incidents must be reported by pesticide registrants. Others, such as members of the public and environmental professionals, would like to report pesticide incidents. This website will facilitate such incident reporting.

  13. High incidence and remission of reported food hypersensitivity in Swedish children followed from 8 to 12 years of age - a population based cohort study.

    Science.gov (United States)

    Winberg, Anna; Strinnholm, Åsa; Hedman, Linnea; West, Christina E; Perzanowski, Matthew S; Rönmark, Eva

    2014-01-01

    Few population-based cohort studies have examined reported food hypersensitivity longitudinally. We investigated prevalence, incidence and remission of perceived food hypersensitivity among schoolchildren from 8 to 12 years of age, and risk factors associated with incidence and remission. A population-based cohort including all 7-8 year-old children in three Swedish towns was recruited in 2006. A total of 2,585 (96% of invited) children participated in a parental questionnaire. The children in two of the towns, n = 1,700 (90% of invited) also participated in skin-prick-testing with airborne allergens. The cohort was followed using the same methods at 11-12 years of age. At study follow up, specific IgE to foods was analyzed in a randomized subset of children (n = 652). The prevalence of perceived food hypersensitivity increased from 21% at 8 years to 26% at 12 years of age. During this four-year-period, the cumulative incidence of food hypersensitivity was high (15%), as was remission (33%). This pattern was particularly evident for hypersensitivity to cow´s milk, while the incidence of hypersensitivity to other foods was lower. Female sex, allergic heredity, current rhinitis and allergic sensitization were associated with the incidence of food hypersensitivity and allergic sensitization was negatively associated with remission. Risk-factor-patterns for both incidence and remission were different for hypersensitivity to milk compared with hypersensitivity to other foods. Generally, the agreement between reported food hypersensitivity and IgE-sensitization to the implicated food was poor. In this longitudinal, population-based cohort-study perceived food hypersensitivity was common among children between ages 8 and 12, often transient and not well correlated with food-specific IgE. While these findings suggest an overestimated prevalence of food hypersensitivity, the public-health-significance remains high as they reflect the perceived reality to which

  14. Physical activity and 10-year incidence of self-reported vertebral fractures in Japanese women: the Japan Public Health Center-based Prospective Study.

    Science.gov (United States)

    Nakamura, K; Kitamura, K; Inoue, M; Sawada, N; Tsugane, S

    2014-11-01

    This study assessed the effects of physical activity on a 10-year incidence of self-reported vertebral fractures in adult women of a large Japanese cohort. Medium levels of strenuous activity and long-duration sedentary activity were associated with a lower incidence of vertebral fractures; association patterns appear to be different from hip fractures. Physical activity helps prevent hip fracture, but little is known about the longitudinal association between physical activity and vertebral fractures. The purpose of this study was to evaluate the effects of physical activity on the 10-year incidence of symptomatic vertebral fractures using data from the Japan Public Health Center-based Prospective Study. Baseline studies were conducted in 1993-1994, and the follow-up study was conducted 10 years later. We analyzed 23,757 women aged 40-69 years. At baseline, physical activity was assessed as a predictor by using a questionnaire. Subjects were asked to report vertebral fractures that occurred during the 10-year follow-up period. Relative risks (RRs) adjusted for confounders were estimated by multiple logistic regression analysis. The 10-year cumulative incidence of vertebral fractures was 0.67%. Those who engaged in strenuous physical activity of <1 h/day had a significantly lower incidence of vertebral fractures than those who did not engage in such activity (RR = 0.52, 95% CI 0.28-0.97), while those engaged in such activity ≥1 h/day did not (RR = 0.82, 95% CI 0.58-1.14). Long-duration sedentary activity was associated with a low incidence of vertebral fractures (P for trend = 0.0002), but the frequencies of sports activities and metabolic equivalents were not (P for trend = 0.0729 and 0.4341, respectively). Strenuous activity and sedentary activity are associated with the incidence of vertebral fractures, although the association may not be linear. The pattern of association between physical activity and vertebral fractures appears to be

  15. Incident Duration Modeling Using Flexible Parametric Hazard-Based Models

    Directory of Open Access Journals (Sweden)

    Ruimin Li

    2014-01-01

    Full Text Available Assessing and prioritizing the duration time and effects of traffic incidents on major roads present significant challenges for road network managers. This study examines the effect of numerous factors associated with various types of incidents on their duration and proposes an incident duration prediction model. Several parametric accelerated failure time hazard-based models were examined, including Weibull, log-logistic, log-normal, and generalized gamma, as well as all models with gamma heterogeneity and flexible parametric hazard-based models with freedom ranging from one to ten, by analyzing a traffic incident dataset obtained from the Incident Reporting and Dispatching System in Beijing in 2008. Results show that different factors significantly affect different incident time phases, whose best distributions were diverse. Given the best hazard-based models of each incident time phase, the prediction result can be reasonable for most incidents. The results of this study can aid traffic incident management agencies not only in implementing strategies that would reduce incident duration, and thus reduce congestion, secondary incidents, and the associated human and economic losses, but also in effectively predicting incident duration time.

  16. Hazmat Yearly Incident Summary Reports - Data Mining Tool

    Data.gov (United States)

    Department of Transportation — Series of Incident data and summary statistics reports produced which provide statistical information on incidents by type, year, geographical location, and others....

  17. Hazmat 10 Year Incident Summary Reports - Data Mining Tool

    Data.gov (United States)

    Department of Transportation — Series of Incident data and summary statistics reports produced which provide statistical information on incidents by type, year, geographical location, and others....

  18. Acute cerebrovascular incident in a young woman: Venous or arterial stroke? – Comparative analysis based on two case reports

    International Nuclear Information System (INIS)

    Sleiman, Katarzyna; Zimny, Anna; Kowalczyk, Edyta; Sąsiadek, Marek

    2013-01-01

    Cerebrovascular diseases are the most common neurological disorders. Most of them are arterial strokes, mainly ischemic, less often of hemorrhagic origin. Changes in the course of cerebral venous thrombosis are less common causes of acute cerebrovascular events. Clinical and radiological presentation of arterial and venous strokes (especially in emergency head CT) may pose a diagnostic problem because of great resemblance. However, the distinction between arterial and venous stroke is important from a clinical point of view, as it carries implications for the treatment and determinates patient’s prognosis. In this article, we present cases of two young women (one with an acute venous infarction, the second with an arterial stroke) who presented with similar both clinical and radiological signs of acute vascular incident in the cerebral cortex. We present main similarities and differences between arterial and venous strokes regarding the etiology, clinical symptoms and radiological appearance in various imaging techniques. We emphasize that thorough analysis of CT (including cerebral vessels), knowledge of symptoms and additional clinical information (e.g. risk factors) may facilitate correct diagnosis and allow planning further diagnostic imaging studies. We also emphasize the importance of MRI, especially among young people, in the differential diagnosis of venous and arterial infarcts

  19. Development of Incident Report Database for Organizational Learning

    Science.gov (United States)

    Otsuka, Yuichi; Abe, Tomotaka; Noguchi, Hiroshi; Makinouchi, Akifumi

    The necessity of an incident reporting system has recently been increasing for hospitals. Japan Council for Quality Health Care (JCQHC) started operating a national incident reporting system to which domestic hospitals would report their incidents. However, the reporting system obtained an additional problem for the hospitals. They managed their own systems which collected reports by papers. The purposes of the reporting systems was to analyze considerable causes involved in incidents to improve the quality of patient safety management. On the contrary, the national reporting system aimed at collecting a statistical tendency of normal incidents. Simultaneously operating the two systems would be too much workload for safety managers. The load may have the managers rest only a short time for summarizing occurrences, not enough for analyzing their causes. However, to the authors' knowledge, there has not been an integrating policy of the two forms to adapt them to practical situations in patient safety management. The scope of this paper is to establish the integrated form in order to use in analyzing the causes of incidents as well as reporting for the national system. We have developed new data base system using XML + XSLT and Java Servlet. The developed system is composed of three computers; DB server , DB client and Data sending server. To investigate usability of the developed system, we conducted a monitoring test by real workers in reporting workplaces. The result of subjective evaluations by examinees was so preferable for the developed system. The results of usability test and the achievement of increasing the number of reports after the introduction can demonstrate the enough effectiveness of the developed system for supporting the activity of patient safety management.

  20. Voluntary Medical Incident Reporting Tool to Improve Physician Reporting of Medical Errors in an Emergency Department

    Directory of Open Access Journals (Sweden)

    Nnaemeka G. Okafor

    2015-12-01

    Full Text Available Introduction: Medical errors are frequently under-reported, yet their appropriate analysis, coupled with remediation, is essential for continuous quality improvement. The emergency department (ED is recognized as a complex and chaotic environment prone to errors. In this paper, we describe the design and implementation of a web-based ED-specific incident reporting system using an iterative process. Methods: A web-based, password-protected tool was developed by members of a quality assurance committee for ED providers to report incidents that they believe could impact patient safety. Results: The utilization of this system in one residency program with two academic sites resulted in an increase from 81 reported incidents in 2009, the first year of use, to 561 reported incidents in 2012. This is an increase in rate of reported events from 0.07% of all ED visits to 0.44% of all ED visits. In 2012, faculty reported 60% of all incidents, while residents and midlevel providers reported 24% and 16% respectively. The most commonly reported incidents were delays in care and management concerns. Conclusion: Error reporting frequency can be dramatically improved by using a web-based, userfriendly, voluntary, and non-punitive reporting system.

  1. Piloting an online incident reporting system in Australasian emergency medicine.

    Science.gov (United States)

    Schultz, Timothy J; Crock, Carmel; Hansen, Kim; Deakin, Anita; Gosbell, Andrew

    2014-10-01

    Medical-specific incident reporting systems are critical to understanding error in healthcare but underreporting by doctors reduces their value. We conducted a pilot study of the implementation of an online ED-specific incident reporting system in Australasian hospitals and evaluated its use. The reporting system was based on the literature and input of experts. Thirty-one hospital EDs were approached to pilot the Emergency Medicine Events Register (EMER). The pilot evaluated: website usage and analytics, reporting behaviours and rates, the quality of information collected in EMER. Semi-structured interviews of three site champions responsible for implementing EMER were conducted. Seventeen EDs expressed interest; however, due to delays and other barriers reporting only occurred at three sites. Over 354 days, the website received 362 unique visitors and 77 incidents. The median time to report was 4.6 min. The reporting rate was 0.07 reports per doctor month, suggesting a reporting rate of 0.08% of ED presentations. Data quality, as measured by the number of completed non-mandatory fields and ability to classify incidents, was very high. The interviews identified enablers (the EMER system, site champions) and barriers (chiefly the context of EM) to EMER uptake. Collecting patient safety information by frontline doctors is essential to actively engage the profession in patent safety. Although the EMER system allowed easy online reporting of high quality incident data by doctors, site recruitment and system uptake proved difficult. System use by ED doctors requires dedicated and conscious effort from the profession. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  2. A nationwide medication incidents reporting system in the netherlands

    NARCIS (Netherlands)

    K.C. Cheung (Ka Chun); P.M.L.A. van den Bemt (Patricia); M.L. Bouvy (Marcel); M.E. Wensing (Michel); P.A. de Smet (Peter)

    2011-01-01

    textabstractObjective Many Dutch hospitals have established internal systems for reporting incidents. However, such internal systems do not allow learning from incidents that occur in other hospitals. Therefore a multicenter, information technology (IT) supported reporting system named central

  3. A nationwide medication incidents reporting system in The Netherlands

    NARCIS (Netherlands)

    Cheung, K.C.; Bemt, P.M. van den; Bouvy, M.L.; Wensing, M.J.P.; Smet, P.A.G.M. de

    2011-01-01

    Objective Many Dutch hospitals have established internal systems for reporting incidents. However, such internal systems do not allow learning from incidents that occur in other hospitals. Therefore a multicenter, information technology (IT) supported reporting system named central medication

  4. Standardizing the classification of abortion incidents: the Procedural Abortion Incident Reporting and Surveillance (PAIRS) Framework.

    Science.gov (United States)

    Taylor, Diana; Upadhyay, Ushma D; Fjerstad, Mary; Battistelli, Molly F; Weitz, Tracy A; Paul, Maureen E

    2017-07-01

    To develop and validate standardized criteria for assessing abortion-related incidents (adverse events, morbidities, near misses) for first-trimester aspiration abortion procedures and to demonstrate the utility of a standardized framework [the Procedural Abortion Incident Reporting & Surveillance (PAIRS) Framework] for estimating serious abortion-related adverse events. As part of a California-based study of early aspiration abortion provision conducted between 2007 and 2013, we developed and validated a standardized framework for defining and monitoring first-trimester (≤14weeks) aspiration abortion morbidity and adverse events using multiple methods: a literature review, framework criteria testing with empirical data, repeated expert reviews and data-based revisions to the framework. The final framework distinguishes incidents resulting from procedural abortion care (adverse events) from morbidity related to pregnancy, the abortion process and other nonabortion related conditions. It further classifies incidents by diagnosis (confirmatory data, etiology, risk factors), management (treatment type and location), timing (immediate or delayed), seriousness (minor or major) and outcome. Empirical validation of the framework using data from 19,673 women receiving aspiration abortions revealed almost an equal proportion of total adverse events (n=205, 1.04%) and total abortion- or pregnancy-related morbidity (n=194, 0.99%). The majority of adverse events were due to retained products of conception (0.37%), failed attempted abortion (0.15%) and postabortion infection (0.17%). Serious or major adverse events were rare (n=11, 0.06%). Distinguishing morbidity diagnoses from adverse events using a standardized, empirically tested framework confirms the very low frequency of serious adverse events related to clinic-based abortion care. The PAIRS Framework provides a useful set of tools to systematically classify and monitor abortion-related incidents for first

  5. 49 CFR 191.9 - Distribution system: Incident report.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Distribution system: Incident report. 191.9... CONDITION REPORTS § 191.9 Distribution system: Incident report. (a) Except as provided in paragraph (c) of... report required by this section need not be submitted with respect to master meter systems or LNG...

  6. The development of an incident event reporting system for nursing students.

    Science.gov (United States)

    Chiou, Shwu-Fen; Huang, Ean-Wen; Chuang, Jen-Hsiang

    2009-01-01

    Incident events may occur when nursing students are present in the clinical setting. Their inexperience and unfamiliarity with clinical practice put them at risk for making mistakes that could potentially harm patients and themselves. However, there are deficiencies with incident event reporting systems, including incomplete data and delayed reports. The purpose of this study was to develop an incident event reporting system for nursing students in clinical settings and evaluate its effectiveness. This study was undertaken in three phases. In the first phase, a literature review and focus groups were used to develop the architecture of the reporting system. In the second phase, the reporting system was implemented. Data from incident events that involved nursing students were collected for a 12-month period. In the third phase, a pre-post trial was undertaken to evaluate the performance of the reporting system. The ASP.NET software and Microsoft Access 2003 were used to create an interactive web-based interface and design a database for the reporting system. Email notifications alerted the nursing student's teacher when an incident event was reported. One year after installing the reporting system, the number of reported incident events increased tenfold. However, the time to report the incident event and the time required to complete the reporting procedures were shorter than before implementation of the reporting system. The incident event reporting system appeared to be effective in more comprehensively reporting the number of incident events and shorten the time required for reporting them compared to traditional written reports.

  7. Designed Incident Reporting System in P2TKN BATAN

    International Nuclear Information System (INIS)

    Supriatna, Piping; Sudarsyamsu S; Bambang S; Karyana, Edy

    2000-01-01

    Incident Reporting System is a routine activating for record all incident of Nuclear Plant Characteristic of the incident Reporting System (IRS) recording can be made locally, regionally or national scope. IRS recording of nuclear activity responsible to Nuclear Safety Technology Development Center (NSTDC). In this report has been designed IRS for nuclear incident in Batan, which the socialization in the field will be done step by step. The first step will be applied in NSTCD scope, the second step will be applied in PPTA Serpong area, and the third step will be applied in Batan area

  8. Patient safety incidents are common in primary care: A national prospective active incident reporting survey.

    Directory of Open Access Journals (Sweden)

    Philippe Michel

    Full Text Available The study objectives were to describe the incidence and the nature of patient safety incidents (PSIs in primary care general practice settings, and to explore the association between these incidents and practice or organizational characteristics.GPs, randomly selected from a national influenza surveillance network (n = 800 across France, prospectively reported any incidents observed each day over a one-week period between May and July 2013. An incident was an event or circumstance that could have resulted, or did result, in harm to a patient, which the GP would not wish to recur. Primary outcome was the incidence of PSIs which was determined by counting reports per total number of patient encounters. Reports were categorized using existing taxonomies. The association with practice and organizational characteristics was calculated using a negative binomial regression model.127 GPs (participation rate 79% reported 317 incidents of which 270 were deemed to be a posteriori judged preventable, among 12,348 encounters. 77% had no consequences for the patient. The incidence of reported PSIs was 26 per 1000 patient encounters per week (95% CI [23‰ -28‰]. Incidents were three times more frequently related to the organization of healthcare than to knowledge and skills of health professionals, and especially to the workflow in the GPs' offices and to the communication between providers and with patients. Among GP characteristics, three were related with an increased incidence in the final multivariable model: length of consultation higher than 15 minutes, method of receiving radiological results (by fax compared to paper or email, and being in a multidisciplinary clinic compared with sole practitioners.Patient safety incidents (PSIs occurred in mean once every two days in the sampled GPs and 2% of them were associated with a definite possibility for harm. Studying the association between organizational features of general practices and PSIs remains a

  9. Automatic Analysis of Critical Incident Reports: Requirements and Use Cases.

    Science.gov (United States)

    Denecke, Kerstin

    2016-01-01

    Increasingly, critical incident reports are used as a means to increase patient safety and quality of care. The entire potential of these sources of experiential knowledge remains often unconsidered since retrieval and analysis is difficult and time-consuming, and the reporting systems often do not provide support for these tasks. The objective of this paper is to identify potential use cases for automatic methods that analyse critical incident reports. In more detail, we will describe how faceted search could offer an intuitive retrieval of critical incident reports and how text mining could support in analysing relations among events. To realise an automated analysis, natural language processing needs to be applied. Therefore, we analyse the language of critical incident reports and derive requirements towards automatic processing methods. We learned that there is a huge potential for an automatic analysis of incident reports, but there are still challenges to be solved.

  10. Serious incidents after death: content analysis of incidents reported to a national database.

    Science.gov (United States)

    Yardley, Iain E; Carson-Stevens, Andrew; Donaldson, Liam J

    2018-02-01

    Objectives To describe serious incidents occurring in the management of patient remains after their death. Design Incidents occurring after patient deaths were analysed using content analysis to determine what happened, why it happened and the outcome. Setting The Strategic Executive Information System database of serious incidents requiring investigation occurring in the National Health Service in England. Participants All cases describing an incident that occurred following death, regardless of the age of the patient. Main outcome measures The nature of the incident, the underlying cause or causes of the incident and the outcome of the incident. Results One hundred and thirty-two incidents were analysed; these related to the storage, management or disposal of deceased patient remains. Fifty-four incidents concerned problems with the storage of bodies or body parts. Forty-three incidents concerned problems with the management of bodies, including 25 errors in postmortem examination, or postmortems on the wrong body. Thirty-one incidents related to the disposal of bodies, 25 bodies were released from the mortuary to undertakers in error; of these, nine were buried or cremated by the wrong family. The reported underlying causes were similar to those known to be associated with safety incidents occurring before death and included weaknesses in or failures to follow protocol and procedure, poor communication and informal working practices. Conclusions Serious incidents in the management of deceased patient remains have significant implications for families, hospitals and the health service more broadly. Safe mortuary care may be improved by applying lessons learned from existing patient safety work.

  11. Clinical incidents involving students on placement: an analysis of incident reports to identify potential risk factors.

    Science.gov (United States)

    Gaida, J E; Maloney, S; Lo, K; Morgan, P

    2015-06-01

    Students are sometimes involved in incidents during clinical training. To the authors' knowledge, no quantitative studies of incidents specifically involving physiotherapy students on clinical placement are available in the literature. A retrospective audit (2008 to 2011) of incident reports involving physiotherapy students was conducted to identify the nature and features of incidents. The study aimed to determine if injuries to a student or patient were more or less likely when the supervisor was in close proximity, and whether students with lower academic performance in their preclinical semester were more likely to be involved in an incident. There were 19 care-delivery-related and three equipment-related incidents. There were no incidents of violent, aggressive or demeaning behaviour towards students. The incident rate was 9.0/100,000 student-hours for third-year students and 6.8/100,000 student-hours for fourth-year students. The majority of incidents (55%) occurred from 11 am to 12-noon and from 3 pm to 3.30 pm. Incidents more often resulted in patient or student injury when the supervisor was not in close proximity (approximately 50% vs approximately 20%), although the difference was not significant (P=0.336). The academic results of students involved in incidents were equivalent to the whole cohort in their preclinical semester {mean 75 [standard deviation (SD) 6] vs 76 (SD 7); P=0.488}. The unexpected temporal clustering of incidents warrants further investigation. Student fatigue may warrant attention as a potential contributor; however, contextual factors, such as staff workload, along with organisational systems, structures and procedures may be more relevant. The potential relationship between supervisor proximity and injury also warrants further exploration. The findings of the present study should be integrated into clinical education curricula and communicated to clinical educators. Copyright © 2014 Chartered Society of Physiotherapy. Published by

  12. SU-E-P-07: Retrospective Analysis of Incident Reports at a Radiology Department: Feedback From Incident Reporting System

    Energy Technology Data Exchange (ETDEWEB)

    Kakinohana, Y; Toita, T; Heianna, J; Murayama, S [School of medicine, University of the Ryukyus, Nishihara-cho, Okinawa (Japan)

    2015-06-15

    Purpose: To provide an overview of reported incidents that occurred in a radiology department and to describe the most common causal source of incidents. Methods: Incident reports from the radiology department at the University of the Ryukyus Hospital between 2008 and 2013 were collected and analyzed retrospectively. The incident report form contains the following items, causal factors of the incident and desirable corrective actions to prevent recurrence of similar incidents. These items allow the institution to investigate/analyze root causes of the incidents and suggest measures to be taken to prevent further, similar incidents. The ‘causal factors of the incident’ item comprises multiple selections from among 24 selections and includes some synonymous selections. In this study, this item was re-categorized into four causal source types: (i) carelessness, (ii) lack of skill or knowledge, (iii) deficiencies in communication, and (iv) external factors. Results: There were a total of 7490 incident reports over the study period and 276 (3.7%) were identified as originating from the radiology department. The most frequent causal source type was carelessness (62%). The other three types showed similar frequencies (10–14%). The staff members involved in incidents indicate three predominant desirable corrective actions to prevent or decrease the recurrence of similar incidents. These are ‘improvement in communication’ (24%), ‘staff training/education’ (19%), and ‘daily medical procedures’ (22%), and the most frequent was ‘improvement in communication’. Even though the most frequent causal factor was related to carelessness, the most desirable corrective action indicated by the staff members was related to communication. Conclusion: Our finding suggests that the most immediate causes are strongly related to carelessness. However, the most likely underlying causes of incidents would be related to deficiencies in effective communication. At our

  13. Pediatric safety incidents from an intensive care reporting system.

    Science.gov (United States)

    Skapik, Julia Lynn; Pronovost, Peter J; Miller, Marlene R; Thompson, David A; Wu, Albert W

    2009-06-01

    Adverse events impose a great burden on patients and the health care system, but not enough is known about how to address incidents involving pediatric patients. This study examined the demographic factors, types of events, contributing system factors, and harm associated with incidents that occur in pediatric intensive care units. Cross-sectional analysis of 2 years of data on all pediatric safety incidents and near misses reported to the voluntary provider-recorded Intensive Care Unit Safety Reporting System in regards to harm and contributing factors. In 464 incidents reported from 23 intensive care units to the Intensive Care Unit Safety Reporting System, patients were physically injured in one third of incidents and harmed in some way in two thirds of incidents. Medication errors were the most common incident type, but were associated with less harm than other event types. Line, tube, and airway events comprised one third of incidents and were associated with more harm than other types. Patient contributing factors were a strong predictor of harm; training and education factors were also commonly cited. In multivariate analysis, patient factors were the strongest predictor of harm adjusting for age, sex, and race. Pediatric patients are commonly harmed in intensive care units. There are several potential ways to improve safety including protocols for high-risk procedures involving lines and tubes, improved monitoring, and staffing, training and communication initiatives. Providers may be able to identify patients at increased risk for harm and intervene to protect patient safety.

  14. Gender Differences in Reporting of Battering Incidences.

    Science.gov (United States)

    Edleson, Jeffrey L.; Brygger, Mary Pat

    1986-01-01

    Examined difference between male and female reports of violence and threats directed by the man toward the woman. In many categories, significantly more women were found at intake to report more threats and violence than their male partners. After extensive intervention these differences were not found in the more severe categories of violence.…

  15. Report of incidence and mortality in China cancer registries, 2009

    Science.gov (United States)

    Zheng, Rongshou; Zhang, Siwei; Zhao, Ping; Li, Guanglin; Wu, Lingyou; He, Jie

    2013-01-01

    Objective The National Central Cancer Registry (NCCR) collected cancer registration data in 2009 from local cancer registries in 2012, and analyzed to describe cancer incidence and mortality in China. Methods On basis of the criteria of data quality from NCCR, data submitted from 104 registries were checked and evaluated. There were 72 registries’ data qualified and accepted for cancer registry annual report in 2012. Descriptive analysis included incidence and mortality stratified by area (urban/rural), sex, age group and cancer site. The top 10 common cancers in different groups, proportion and cumulative rates were also calculated. Chinese population census in 1982 and Segi’s population were used for age-standardized incidence/mortality rates. Results All 72 cancer registries covered a total of 85,470,522 population (57,489,009 in urban and 27,981,513 in rural areas). The total new cancer incident cases and cancer deaths were 244,366 and 154,310, respectively. The morphology verified cases accounted for 67.23%, and 3.14% of incident cases only had information from death certifications. The crude incidence rate in Chinese cancer registration areas was 285.91/100,000 (males 317.97/100,000, females 253.09/100,000), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 146.87/100,000 and 191.72/100,000 with the cumulative incidence rate (0-74 age years old) of 22.08%. The cancer incidence and ASIRC were 303.39/100,000 and 150.31/100,000 in urban areas whereas in rural areas, they were 249.98/100,000 and 139.68/100,000, respectively. The cancer mortality in Chinese cancer registration areas was 180.54/100,000 (224.20/100,000 in males and 135.85/100,000 in females), age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 85.06/100,000 and 115.65/100,000, and the cumulative incidence rate (0-74 age years old) was 12.94%. The cancer mortality

  16. General practitioner reported incidence of Lyme carditis in the Netherlands.

    Science.gov (United States)

    Hofhuis, A; Arend, S M; Davids, C J; Tukkie, R; van Pelt, W

    2015-11-01

    Between 1994 and 2009, incidence rates of general practitioner (GP) consultations for tick bites and erythema migrans, the most common early manifestation of Lyme borreliosis, have increased substantially in the Netherlands. The current article aims to estimate and validate the incidence of GP-reported Lyme carditis in the Netherlands. We sent a questionnaire to all GPs in the Netherlands on clinical diagnoses of Lyme borreliosis in 2009 and 2010. To validate and adjust the obtained incidence rate, medical records of cases of Lyme carditis reported by GPs in this incidence survey were reviewed and categorised according to likelihood of the diagnosis of Lyme carditis. Lyme carditis occurred in 0.2 % of all patients with GP-reported Lyme borreliosis. The adjusted annual incidence was six GP-reported cases of Lyme carditis per 10 million inhabitants, i.e. approximately ten cases per year in 2009 and 2010. We report the first incidence estimate for Lyme carditis in the Netherlands, validated by a systematic review of the medical records. Although Lyme carditis is an uncommon manifestation of Lyme borreliosis, physicians need to be aware of this diagnosis, in particular in countries where the incidence of Lyme borreliosis has increased during the past decades.

  17. Safety culture and learning from incidents: the role of incident reporting and causal analyses

    International Nuclear Information System (INIS)

    Wilpert, B.

    1994-01-01

    Nuclear industry more than any other industrial branch has developed and used predictive risk analysis as a method of feedforward control of safety and reliability. Systematic evaluation of operating experience, statistical documentation of component failures, systematic documentation and analysis of incidents are important complementary elements of feedback control: we are dealing here with adjustment and learning from experience, in particular from past incidents. Using preliminary findings from ongoing research at the Research Center Systems Safety at the Berlin University of Technology the contribution discusses preconditions for an effective use of lessons to be learnt from closely matched incident reporting and in depth analyses of causal chains leading to incidents. Such conditions are especially standardized documentation, reporting and analyzing methods of incidents; structured information flows and feedback loops; abstaining from culpability search; mutual trust of employees and management; willingness of all concerned to continually evaluate and optimize the established learning system. Thus, incident related reporting and causal analyses contribute to safety culture, which is seen to emerge from tightly coupled organizational measures and respective change in attitudes and behaviour. (author) 2 figs., 7 refs

  18. Change in Reported Lyme Disease Incidence in the Northeast and Upper Midwest, 1991-2014

    Data.gov (United States)

    U.S. Environmental Protection Agency — This indicator shows how reported Lyme disease incidence has changed by state since 1991, based on the number of new cases per 100,000 people. The total change has...

  19. Cancer incidence in south-east Nigeria: a report from Nnewi Cancer ...

    African Journals Online (AJOL)

    Background: This study is the first population based cancer incidence report from a cancer registry in south-east Nigeria. Objective: To evaluate the incidence of some invasive cancers in southeast Nigeria. Methodology: We collected all new cases of invasive cancers between 1st January and 31st December, 2013.

  20. Spatial Distribution of Black Bear Incident Reports in Michigan.

    Directory of Open Access Journals (Sweden)

    Jamie E McFadden-Hiller

    Full Text Available Interactions between humans and carnivores have existed for centuries due to competition for food and space. American black bears are increasing in abundance and populations are expanding geographically in many portions of its range, including areas that are also increasing in human density, often resulting in associated increases in human-bear conflict (hereafter, bear incidents. We used public reports of bear incidents in Michigan, USA, from 2003-2011 to assess the relative contributions of ecological and anthropogenic variables in explaining the spatial distribution of bear incidents and estimated the potential risk of bear incidents. We used weighted Normalized Difference Vegetation Index mean as an index of primary productivity, region (i.e., Upper Peninsula or Lower Peninsula, primary and secondary road densities, and percentage land cover type within 6.5-km2 circular buffers around bear incidents and random points. We developed 22 a priori models and used generalized linear models and Akaike's Information Criterion (AIC to rank models. The global model was the best compromise between model complexity and model fit (w = 0.99, with a ΔAIC 8.99 units from the second best performing model. We found that as deciduous forest cover increased, the probability of bear incident occurrence increased. Among the measured anthropogenic variables, cultivated crops and primary roads were the most important in our AIC-best model and were both positively related to the probability of bear incident occurrence. The spatial distribution of relative bear incident risk varied markedly throughout Michigan. Forest cover fragmented with agriculture and other anthropogenic activities presents an environment that likely facilitates bear incidents. Our map can help wildlife managers identify areas of bear incident occurrence, which in turn can be used to help develop strategies aimed at reducing incidents. Researchers and wildlife managers can use similar mapping

  1. Spatial Distribution of Black Bear Incident Reports in Michigan.

    Science.gov (United States)

    McFadden-Hiller, Jamie E; Beyer, Dean E; Belant, Jerrold L

    2016-01-01

    Interactions between humans and carnivores have existed for centuries due to competition for food and space. American black bears are increasing in abundance and populations are expanding geographically in many portions of its range, including areas that are also increasing in human density, often resulting in associated increases in human-bear conflict (hereafter, bear incidents). We used public reports of bear incidents in Michigan, USA, from 2003-2011 to assess the relative contributions of ecological and anthropogenic variables in explaining the spatial distribution of bear incidents and estimated the potential risk of bear incidents. We used weighted Normalized Difference Vegetation Index mean as an index of primary productivity, region (i.e., Upper Peninsula or Lower Peninsula), primary and secondary road densities, and percentage land cover type within 6.5-km2 circular buffers around bear incidents and random points. We developed 22 a priori models and used generalized linear models and Akaike's Information Criterion (AIC) to rank models. The global model was the best compromise between model complexity and model fit (w = 0.99), with a ΔAIC 8.99 units from the second best performing model. We found that as deciduous forest cover increased, the probability of bear incident occurrence increased. Among the measured anthropogenic variables, cultivated crops and primary roads were the most important in our AIC-best model and were both positively related to the probability of bear incident occurrence. The spatial distribution of relative bear incident risk varied markedly throughout Michigan. Forest cover fragmented with agriculture and other anthropogenic activities presents an environment that likely facilitates bear incidents. Our map can help wildlife managers identify areas of bear incident occurrence, which in turn can be used to help develop strategies aimed at reducing incidents. Researchers and wildlife managers can use similar mapping techniques to

  2. Which factors affect reported headache incidences after lumbar myelography?

    International Nuclear Information System (INIS)

    Sand, T.

    1989-01-01

    Nineteen publications were reviewed and subjected to a combined statistical analysis (meta-analysis) regarding the influence of study design factors upon reported headache and total symptom incidences after lumbar iohexol myelography. A significant association was found between reported side effects on one hand and needle diameter, follow-up time and the method of questioning respectively on the other. The combination of long follow-up time and specific questioning and the combination between larger diameter (20G) needles and long follow-up time, both seemed to be strong predictors for reporting high side effect incidences. Nine studies were similarly analyzed regarding the influence of early ambulation and contrast type upon reported headache incidences. Early ambulation significantly increased headache after iohexol or iopamidol lumbar myelography as opposed to metrizamide myelography. (orig.)

  3. Possible solutions for barriers in incident reporting by residents

    NARCIS (Netherlands)

    Martowirono, K.; Jansma, J.D.; van Luijk, S.J.; Wagner, C.; Bijnen, A.B.

    2012-01-01

    Rationale, aims and objectives: Incident reporting can contribute to safer health care. Since the rate of reporting by residents is low, it is useful to investigate which barriers exist and how these can be solved. Methods: Data were collected in a large teaching hospital in the Netherlands. The

  4. Critical Incident Reporting in Anaesthesia: A Prospective Internal Audit

    Directory of Open Access Journals (Sweden)

    Sunanda Gupta

    2009-01-01

    Full Text Available Critical incident monitoring is useful in detecting new problems, identifying near misses′ and analyzing factors or events leading to mishaps, which can be instructive for trainees. This study was aimed at investigating potential risk factors and analyze events leading to pen-operative critical incidents in order to develop a critical incident reporting system. W conducted a one year prospective analysis of voluntarily reported 24- hour-perioperative critical inci-dents, occurring in patients subjected to anaesthesia. During a one year period from December 2006 to December 2007, 14,134 anaesthetics were administered and 112(0.79% critical incidents were reported with complete recov-ery in 71.42%(n=80 and mortality in 28.57% (n=32 cases. Incidents occurred maximally in 0-10 years age (23.21%, ASA 1(61.61%, in general surgery patients (43.75%, undergoing emergency surgery (52.46% and during day time (75.89%. Incidence was more in the operating theatre (77.68%, during maintenance (32.04% and post-operative phase (25.89% and in patients who received general anaesthesia (75.89%. Critical incidents occurred clue to fac-tors related to anaesthesia (42.85%, patient (37.50% and surgery (16.96°lo. Among anaesthesia related critical incidents (42.85% n=48/112, respiratory events were maximum (66.66% mainly at induction (37.5% and emer-gence (43.75%, and factors responsible were human error (85.41%, pharmacological factors (10.41% and equip-ment error (4.17%. Incidence of mortality was 22.6 per10, 000 anaesthetics (32/14,314, mostly attributable to risk factors in patient (59.38% as compared to anaesthesia (25% and surgery (9.38%. There were 8 anaesthesia related deaths (5.6 per 10, 000 anaesthetics where human error (75% attributed to lack of judgment (67.50% was an important causative factor. We conclude that critical incident reporting system may be a valuable part of quality assurance to develop policies to prevent recurrence and enhance patient

  5. Pilot Critical Incident Reports as a Means to Identify Human Factors of Remotely Piloted Aircraft

    Science.gov (United States)

    Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

    2016-01-01

    It has been estimated that aviation accidents are typically preceded by numerous minor incidents arising from the same causal factors that ultimately produced the accident. Accident databases provide in-depth information on a relatively small number of occurrences, however incident databases have the potential to provide insights into the human factors of Remotely Piloted Aircraft System (RPAS) operations based on a larger volume of less-detailed reports. Currently, there is a lack of incident data dealing with the human factors of unmanned aircraft systems. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. During each focus group session, a note taker produced a de-identified written record of the incident narratives. At the end of the session, participants reviewed each written incident report, and made edits and corrections as necessary. The incidents were later analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot during the events. A total of 90 incidents were reported. Human factor issues included the impact of reduced sensory cues, traffic separation in the absence of an out-the-window view, control latencies, vigilance during monotonous and ultra-long endurance flights, control station design considerations, transfer of control between control stations, the management of lost link procedures, and decision-making during emergencies. Pilots participated willingly and enthusiastically in the study

  6. A review and discussion of flight management system incidents reported to the Aviation Safety Reporting System

    Science.gov (United States)

    1992-02-01

    This report covers the activities related to the description, classification and : analysis of the types and kinds of flight crew errors, incidents and actions, as : reported to the Aviation Safety Reporting System (ASRS) database, that can occur as ...

  7. Media actors' perceptions of their roles in reporting food incidents.

    Science.gov (United States)

    Wilson, Annabelle M; Henderson, Julie; Coveney, John; Meyer, Samantha B; Webb, Trevor; Calnan, Michael; Caraher, Martin; Lloyd, Sue; McCullum, Dean; Elliott, Anthony; Ward, Paul R

    2014-12-18

    Previous research has shown that the media can play a role in shaping consumer perceptions during a public health crisis. In order for public health professionals to communicate well-informed health information to the media, it is important that they understand how media view their role in transmitting public health information to consumers and decide what information to present. This paper reports the perceptions of media actors from three countries about their role in reporting information during a food incident. This information is used to present ideas and suggestions for public health professionals working with media during food incidents. Thirty three semi-structured interviews with media actors from Australia, New Zealand and the United Kingdom were conducted and analysed thematically. Media actors were recruited via purposive sampling using a sampling strategy, from a variety of formats including newspaper, television, radio and online. Media actors said that during a food incident, they play two roles. First, they play a role in communicating information to consumers by acting as a conduit for information between the public and the relevant authorities. Second, they play a role as investigators by acting as a public watchdog. Media actors are an important source of consumer information during food incidents. Public health professionals can work with media by actively approaching them with information about food incidents; promoting to media that as public health professionals, they are best placed to provide the facts about food incidents; and by providing angles for further investigation and directing media to relevant and correct information to inform such investigations. Public health professionals who adapt how they work with media are more likely to influence media to portray messages that fit what they would like the public to know and that are in line with public health recommendations and enable consumers to engage in safe and health promoting

  8. Incident reports--correcting processes and reducing errors.

    Science.gov (United States)

    Dunn, Debra

    2003-08-01

    Although it may be human nature to make mistakes, it also is human nature to create solutions, identify alternatives, and meet future challenges. This article describes systems approaches to assessing the ways in which an organization operates and explains the types of failures that cause errors. The steps that guide managers in adapting an incident reporting system that incorporates continuous quality improvement are identified.

  9. Safety Incident Management Team Report for NIMLT Case 50796

    LENUS (Irish Health Repository)

    2017-01-17

    This is a report on the management of a patient safety incident involving BowelScreen and symptomatic colonoscopy services at Wexford General Hospital (WGH). The patient safety incident relates to the work of a Consultant Endoscopist (referred to as Clinician Y) employed by WGH who undertook screening colonoscopies on behalf of the BowelScreen Programme since the commencement of the screening programme in WGH in March 2013. Clinician Y also performed non-screening colonoscopies for the diagnosis of symptomatic patients as part of routine surgical service provision at WGH.\\r\

  10. Safety incidents involving confused and forgetful older patients in a specialised care setting--analysis of the safety incidents reported to the HaiPro reporting system.

    Science.gov (United States)

    Kinnunen-Luovi, Kaisa; Saarnio, Reetta; Isola, Arja

    2014-09-01

    To describe the safety incidents involving confused and forgetful older patients in a specialised care setting entered in the HaiPro reporting system. About 10% of patients experience a safety incident during hospitalisation, which causes or could cause them harm. The possibility of a safety incident during hospitalisation increases significantly with age. A mild or moderate memory disorder and acute confusion are often present in the safety incidents originating with an older patient. The design of the study was action research with this study using findings from one of the first-phase studies, which included qualitative and quantitative analysed data. Data were collected from the reporting system for safety incidents (HaiPro) in a university hospital in Finland. There were 672 reported safety incidents from four acute medical wards during the years 2009-2011, which were scrutinised. Seventy-five of them were linked to a confused patient and were analysed. The majority of the safety incidents analysed involved patient-related accidents. In addition to challenging behaviour, contributing factors included ward routines, shortage of nursing staff, environmental factors and staff knowledge and skills. Nurses tried to secure the patient safety in many different ways, but the modes of actions were insufficient. Nursing staff need evidence-based information on how to assess the cognitive status of a confused patient and how to encounter such patients. The number of nursing staff and ward routines should be examined critically and put in proportion to the care intensity demands caused by the patient's confused state. The findings can be used as a starting point in the prevention of safety incidents and in improving the care of older patients. © 2013 John Wiley & Sons Ltd.

  11. Committee's report on ruthenium fall-out incident

    International Nuclear Information System (INIS)

    Borkowski, C.J.; Crawford, J.H.; Livingston, R.; Ritchie, R.H.; Rupp, A.F.; Taylor, E.H.

    1983-07-01

    Investigations of the fall-out incident of November 11 and 12, 1959, by responsible parties (Health Physics Division and Operations Division personnel) established beyond reasonable doubt that the incident had its origin in the expulsion of particles, heavily contaminated with ruthenium, which had been detached from the walls of the electric fan housing and ducts in the off-gas system associated with the brick stack. All available evidence indicates that the particles were loosened during maintenance work on the exhaust damper and the bearings of the electric fan and were carried up the stack in two bursts as particulate fall-out when this fan was put back into service. Radiographic and chemical analysis showed the activity to be almost entirely ruthenium (Ru 106 ) and its daughter rhodium (Rh 106 ) with very little, if any, strontium being present. This report summarizes the findings and sets forth the conclusions and recommendations of the Committee asked to investigate the incident

  12. Educators' Reports on Incidence of Harassment and Advocacy toward LGBTQ Students

    Science.gov (United States)

    Dragowski, Eliza A.; McCabe, Paul C.; Rubinson, Florence

    2016-01-01

    This study is based on a national survey investigation of 968 educators, who reported the incidence of LGBTQ harassment in schools, and their advocacy efforts on behalf of this population. LGBTQ-related knowledge, attitudes, norms, and perceived ability to advocate were also assessed. Ninety percent of educators reported observing LGBTQ harassment…

  13. Incident reporting behaviours following the Francis report: A cross-sectional survey.

    Science.gov (United States)

    Archer, Gareth; Colhoun, Alison

    2017-11-17

    Previous studies have shown a lack of engagement in the reporting process. There is limited evidence about whether attitudes and behaviours of doctors in the UK towards incident reporting have changed following the events at Mid Staffordshire National Health Service Foundation Trust and the recommendations that followed. We conducted a relatively large survey of doctors, aiming to assess whether doctors recognised incidents and reported them accordingly, along with their behaviours towards reporting and their suggestions of how incident reporting may be improved. A cross-sectional survey of doctors was undertaken in 11 hospitals in the north of England. The participants (n = 581) were invited to take part in an electronic questionnaire. Demographics were obtained, and engagement with the incident reporting process was assessed, including an estimate of the number of incidents which were witnessed but not actually reported. Factors which influenced reporting behaviours were recorded. Free-text comments were encouraged. A mixed method analysis of the responses was performed. Doctors do not appear to be engaging with the incident reporting process-in particular, junior doctors. The main reason given for not completing forms was not having enough time (38.2% of respondents), primarily due to the length and complexity of forms. Many doctors, 43.7%, witnessed more than 5 incidents, but only 13.3% of doctors submitted more than 5 reports. Free text comments revealed 4 themes which impact upon reporting behaviours: organisational issues, form structure, a culture of blame, and a lack of feedback. Several suggestions for improvement were made. Little has changed in the attitudes and behaviours of doctors. Improving incident reporting form structure to make it more user-friendly and improving feedback may engage doctors and lead to an improved safety culture. The way the medical profession reports serious and other incidents still needs to be improved. © 2017 John Wiley

  14. The Thai anesthesia incident monitoring study of perioperative allergic reactions: an analysis of 1996 incidents reports.

    Science.gov (United States)

    Lapisatepun, Worawut; Charuluxananan, Somrat; Kusumaphanyo, Chaiyapruk; Ittichaikulthol, Wichai; Suksompong, Sirilak; Ratanachai, Prapa

    2008-10-01

    Analyze the clinical course, management, outcome, and contributing factors of perioperative allergic reactions in the Thai Anesthesia Incident Monitoring Study (Thai AIMS). A prospective descriptive multicenter study was conducted in 51 hospitals across Thailand Voluntary, anonymous reports of any adverse or undesirable events during the first 24 hours of anesthesia were sent to the Thai AIMS data management unit. Possible perioperative allergic reactions were extracted and examined independently by three peer reviewers. Forty-three reports of possible perioperative allergic reactions from the 2,537 incidents reported to the Thai AIMS (1.6%) were reviewed. There was a female predominance (1.9:1). The most common features were cutaneous manifestations (93%), arterial hypotension (20.1%), and bronchospasm (11.6%) respectively. The severity grades were 69.8% in grade I, 4.7% in grade II, and 25.6% in grade III. The three most suspected causative agents were neuromuscular blocking agents (39.5%, 30.2%-succinylcholine), antibiotics (27.9%), and opioids (18.6%) respectively. All but one responded well to treatment with complete recovery. One patient suffered acute myocardial infarction and had to stay at the hospital for longer than one week. None had further allergic reaction. Perioperative allergic reactions accounted for 1.6% of anesthetic adverse events. The most common features were cutaneous manifestations. A quarter of these were life-threatening but responded well to treatment. The most common suspected causative agent was succinylcholine.

  15. Development and test of a classification scheme for human factors in incident reports

    International Nuclear Information System (INIS)

    Miller, R.; Freitag, M.; Wilpert, B.

    1997-01-01

    The Research Center System Safety of the Berlin University of Technology conducted a research project on the analysis of Human Factors (HF) aspects in incident reported by German Nuclear Power Plants. Based on psychological theories and empirical studies a classification scheme was developed which permits the identification of human involvement in incidents. The classification scheme was applied in an epidemiological study to a selection of more than 600 HF - relevant incidents. The results allow insights into HF related problem areas. An additional study proved that the application of the classification scheme produces results which are reliable and independent from raters. (author). 13 refs, 1 fig

  16. Scrutinizing incident reporting in anaesthesia: why is an incident perceived as critical?

    DEFF Research Database (Denmark)

    Maaløe, R; la Cour, M; Hansen, A

    2006-01-01

    The purpose of the present study was to measure the incidence and type of incidents that occurred in relation to anaesthesia and surgery during a 1-year period in six Danish hospitals. Furthermore, we wanted to identify risk factors for incidents, as well as risk factors for incidents being deemed...

  17. Report of Incidence and Mortality in China Cancer Registries, 2008

    Science.gov (United States)

    Chen, Wan-qing; Zheng, Rong-shou; Zhang, Si-wei; Li, Ni; Zhao, Ping; Li, Guang-lin; Wu, Liang-you

    2012-01-01

    Objective Annual cancer incidence and mortality in 2008 were provided by National Central Cancer Registry in China, which data were collected from population-based cancer registries in 2011. Methods There were 56 registries submitted their data in 2008. After checking and evaluating the data quality, total 41 registries’ data were accepted and pooled for analysis. Incidence and mortality rates by area (urban or rural areas) were assessed, as well as the age- and sex-specific rates, age-standardized rates, proportions and cumulative rate. Results The coverage population of the 41 registries was 66,138,784 with 52,158,495 in urban areas and 13,980,289 in rural areas. There were 197,833 new cancer cases and 122,136 deaths in cancer with mortality to incidence ratio of 0.62. The morphological verified rate was 69.33%, and 2.23% of cases were identified by death certificate only. The crude cancer incidence rate in all areas was 299.12/100,000 (330.16/100,000 in male and 267.56/100,000 in female) and the age-standardized incidence rates by Chinese standard population (ASIRC) and world standard population (ASIRW) were 148.75/100,000 and 194.99/100,000, respectively. The cumulative incidence rate (0–74 years old) was of 22.27%. The crude incidence rate in urban areas was higher than that in rural areas. However, after adjusted by age, the incidence rate in urban was lower than that in rural. The crude cancer mortality was 184.67/100,000 (228.14/100,000 in male and 140.48/100,000 in female), and the age-standardized mortality rates by Chinese standard population (ASMRC) and by world population were 84.36/100,000 and 114.32/100,000, respectively. The cumulative mortality rate (0–74 years old) was of 12.89%. Age-adjusted mortality rates in urban areas were lower than that in rural areas. The most common cancer sites were lung, stomach, colon-rectum, liver, esophagus, pancreas, brain, lymphoma, breast and cervix which accounted for 75% of all cancer incidence. Lung

  18. Discriminating electromagnetic radiation based on angle of incidence

    Science.gov (United States)

    Hamam, Rafif E.; Bermel, Peter; Celanovic, Ivan; Soljacic, Marin; Yeng, Adrian Y. X.; Ghebrebrhan, Michael; Joannopoulos, John D.

    2015-06-16

    The present invention provides systems, articles, and methods for discriminating electromagnetic radiation based upon the angle of incidence of the electromagnetic radiation. In some cases, the materials and systems described herein can be capable of inhibiting reflection of electromagnetic radiation (e.g., the materials and systems can be capable of transmitting and/or absorbing electromagnetic radiation) within a given range of angles of incidence at a first incident surface, while substantially reflecting electromagnetic radiation outside the range of angles of incidence at a second incident surface (which can be the same as or different from the first incident surface). A photonic material comprising a plurality of periodically occurring separate domains can be used, in some cases, to selectively transmit and/or selectively absorb one portion of incoming electromagnetic radiation while reflecting another portion of incoming electromagnetic radiation, based upon the angle of incidence. In some embodiments, one domain of the photonic material can include an isotropic dielectric function, while another domain of the photonic material can include an anisotropic dielectric function. In some instances, one domain of the photonic material can include an isotropic magnetic permeability, while another domain of the photonic material can include an anisotropic magnetic permeability. In some embodiments, non-photonic materials (e.g., materials with relatively large scale features) can be used to selectively absorb incoming electromagnetic radiation based on angle of incidence.

  19. Differences in reported sepsis incidence according to study design: a literature review

    Directory of Open Access Journals (Sweden)

    Saga Elise Mariansdatter

    2016-10-01

    Full Text Available Abstract Background Sepsis and severe sepsis are common conditions in hospital settings, and are associated with high rates of morbidity and mortality, but reported incidences vary considerably. In this literature review, we describe the variation in reported population-based incidences of sepsis and severe sepsis. We also examine methodological and demographic differences between studies that may explain this variation. Methods We carried out a literature review searching three major databases and reference lists of relevant articles, to identify all original studies reporting the incidence of sepsis or severe sepsis in the general population. Two authors independently assessed all articles, and the final decision to exclude an article was reached by consensus. We extracted data according to predetermined variables, including study country, sepsis definition, and data source. We then calculated descriptive statistics for the reported incidences of sepsis and severe sepsis. The studies were classified according to the method used to identify cases of sepsis or severe sepsis: chart-based (i.e. review of patient charts or code-based (i.e. predetermined International Classification of Diseases [ICD] codes. Results Among 482 articles initially screened, we identified 23 primary publications reporting incidence of sepsis and/or severe sepsis in the general population. The reported incidences ranged from 74 to 1180 per 100,000 person-years and 3 to 1074 per 100,000 person-years for sepsis and severe sepsis, respectively. Most chart-based studies used the Bone criteria (or a modification hereof and Protein C Worldwide Evaluation in Severe Sepsis (PROWESS study criteria to identify cases of sepsis and severe sepsis. Most code-based studies used ICD-9 codes, but the number of codes used ranged from 1 to more than 1200. We found that the incidence varied according to how sepsis was identified (chart-based vs. code-based, calendar year, data source, and

  20. [Report of Cancer Incidence and Mortality in China, 2014].

    Science.gov (United States)

    Chen, W Q; Li, H; Sun, K X; Zheng, R S; Zhang, S W; Zeng, H M; Zou, X N; Gu, X Y; He, J

    2018-01-23

    the cumulative incidence rate (0-74 age years old) was 12.00%. The cancer mortality and ASMRC in urban areas were 174.34/100, 000 and 103.49/100, 000, respectively, whereas in rural areas, those were 160.07/100, 000 and 111.57/100, 000, respectively. Lung cancer, gastric cancer, colorectal cancer, liver cancer, female breast cancer, esophageal cancer, thyroid cancer, cervical cancer, encephala and pancreas cancer, were the most common cancers in China, accounting for about 77.00% of the new cancer cases. Lung cancer, liver cancer, gastric cancer, esophageal cancer, colorectal cancer, pancreatic cancer, breast cancer, encephala, leukemia and lymphoma were the leading causes of death and accounted for about 83.36% of cancer deaths. Conclusions: The progression of cancer registry in China develops rapidly in these years, with the coverage of registrations is expanded and the data quality was improved steadily year by year. As the basis of cancer prevention and control program, cancer registry plays an important role in making the medium and long term of anti-cancer strategies in China. As China is still facing the serious cancer burden and the cancer patterns varies differently according to the locations and genders, effective measures and strategies of cancer prevention and control should be implemented based on the practical situation.

  1. Incident investigation team report: K-reactor D20 spill

    Energy Technology Data Exchange (ETDEWEB)

    Enis, E.

    1990-12-31

    This report discusses a spill of approximately 20 gallons of D2O (moderator) which occurred on February 7, 1990, at 0008 hours. The spill occurred while construction was removing process water lines from the 5B heat exchanger at a location referred to as a Rams Horn to allow the heat exchanger to be realigned. The heat exchangers in the other systems (loops) had been successfully disconnected (lines broken) during the previous two months and had been realigned without incident under the control of job plans similar to the System 5 job plan. Construction personnel reacted positively at the time the spill and successfully rebolted and tightened the leaking flanges on 5B and later on the 5A heat exchangers. This initial reaction stopped the leak and prevented a more severe incident. The spill incident resulted in a Site Alert declaration by the Shift Manager at 0220 hours when the Stack Tritium Monitor indicated a tritium release which exceeded the limits specified. After the event it was determined that a Temporary Procedure Change (TPC) to this DPSOL, had been approved and issued in April 1989. Had this TPC been available to the Shift Manager, the alert would not have been declared. Although the environmental impact of this event was negligible with no real radiological consequences minimal, the causal factors and programmatic deficiencies identified by this investigation show significant weakness in some critical areas.

  2. Incident investigation team report: K-reactor D20 spill

    Energy Technology Data Exchange (ETDEWEB)

    Enis, E.

    1990-01-01

    This report discusses a spill of approximately 20 gallons of D2O (moderator) which occurred on February 7, 1990, at 0008 hours. The spill occurred while construction was removing process water lines from the 5B heat exchanger at a location referred to as a Rams Horn to allow the heat exchanger to be realigned. The heat exchangers in the other systems (loops) had been successfully disconnected (lines broken) during the previous two months and had been realigned without incident under the control of job plans similar to the System 5 job plan. Construction personnel reacted positively at the time the spill and successfully rebolted and tightened the leaking flanges on 5B and later on the 5A heat exchangers. This initial reaction stopped the leak and prevented a more severe incident. The spill incident resulted in a Site Alert declaration by the Shift Manager at 0220 hours when the Stack Tritium Monitor indicated a tritium release which exceeded the limits specified. After the event it was determined that a Temporary Procedure Change (TPC) to this DPSOL, had been approved and issued in April 1989. Had this TPC been available to the Shift Manager, the alert would not have been declared. Although the environmental impact of this event was negligible with no real radiological consequences minimal, the causal factors and programmatic deficiencies identified by this investigation show significant weakness in some critical areas.

  3. Establishing national medical imaging incident reporting systems: issues and challenges.

    Science.gov (United States)

    Jones, D Neil; Benveniste, Klee A; Schultz, Timothy J; Mandel, Catherine J; Runciman, William B

    2010-08-01

    Radiology incident reporting systems provide one source of invaluable patient safety data that, when combined with appropriate analysis and action, can result in significantly safer health care, which is now an urgent priority for governments worldwide. Such systems require integration into a wider safety, quality, and risk management framework because many issues have global implications, and they also require an international classification scheme, which is now being developed. These systems can be used to inform global research activities as identified by the World Health Organization, many of which intersect with the activities of and issues seen in medical imaging departments. How to ensure that radiologists (and doctors in general) report incidents, and are engaged in the process, is a challenge. However, as demonstrated with the example of the Australian Radiology Events Register, this can be achieved when the reporting system is integrated with their professional organization and its other related activities (such as training and education) and administered by a patient safety organization. Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. Community pharmacy incident reporting: a new tool for community pharmacies in Canada.

    Science.gov (United States)

    Ho, Certina; Hung, Patricia; Lee, Gary; Kadija, Medina

    2010-01-01

    Incident reporting offers insight into a variety of intricate processes in healthcare. However, it has been found that medication incidents are under reported in the community pharmacy setting. The Community Pharmacy Incident Reporting (CPhIR) program was created by the Institute for Safe Medication Practices Canada specifically for incident reporting in the community pharmacy setting in Canada. The initial development of key elements for CPhIR included several focus-group teleconferences with pharmacists from Ontario and Nova Scotia. Throughout the development and release of the CPhIR pilot, feedback from pharmacists and pharmacy technicians was constantly incorporated into the reporting program. After several rounds of iterative feedback, testing and consultation with community pharmacy practitioners, a final version of the CPhIR program, together with self-directed training materials, is now ready to launch. The CPhIR program provides users with a one-stop platform to report and record medication incidents, export data for customized analysis and view comparisons of individual and aggregate data. These unique functions allow for a detailed analysis of underlying contributing factors in medication incidents. A communication piece for pharmacies to share their experiences is in the process of development. To ensure the success of the CPhIR program, a patient safety culture must be established. By gaining a deeper understanding of possible causes of medication incidents, community pharmacies can implement system-based strategies for quality improvement and to prevent potential errors from occurring again in the future. This article highlights key features of the CPhIR program that will assist community pharmacies to improve their drug distribution system and, ultimately, enhance patient safety.

  5. Longitudinal trends in organophosphate incidents reported to the National Pesticide Information Center, 1995–2007

    Directory of Open Access Journals (Sweden)

    Jenkins Jeffrey J

    2009-04-01

    Full Text Available Abstract Background Regulatory decisions to phase-out the availability and use of common organophosphate pesticides among the general public were announced in 2000 and continued through 2004. Based on revised risk assessments, chlorpyrifos and diazinon were determined to pose unacceptable risks. To determine the impact of these decisions, organophosphate (OP exposure incidents reported to the National Pesticide Information Center (NPIC were analyzed for longitudinal trends. Methods Non-occupational human exposure incidents reported to NPIC were grouped into pre- (1995–2000 and post-announcement periods (2001–2007. The number of total OP exposure incidents, as well as reports for chlorpyrifos, diazinon and malathion, were analyzed for significant differences between these two periods. The number of informational inquiries from the general public was analyzed over time as well. Results The number of average annual OP-related exposure incidents reported to NPIC decreased significantly between the pre- and post-announcement periods (p Conclusion Consistent with other findings, the number of chlorpyrifos and diazinon exposure incidents reported to NPIC significantly decreased following public announcement and targeted regulatory action.

  6. A safety incident reporting system for primary care. A systematic literature review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care

    NARCIS (Netherlands)

    Klemp, Kerstin; Zwart, Dorien; Hansen, Jørgen; Hellebek, Torben; Luettel, Dagmar; Verstappen, Wim; Beyer, Martin; Gerlach, Ferdin M.; Hoffmann, Barbara; Esmail, Aneez

    2015-01-01

    Background: Incident reporting is widely used in both patient safety improvement programmes, and in research on patient safety.Objective: To identify the key requirements for incident reporting systems in primary care; to develop an Internet-based incident reporting and learning system for primary

  7. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics

    NARCIS (Netherlands)

    Maarsingh, Otto R.; Dros, Jacquelien; Schellevis, François G.; van Weert, Henk C.; Bindels, Patrick J.; Horst, Henriette E. van der

    2010-01-01

    Although dizziness in elderly patients is very common in family practice, most prevalence studies on dizziness are community-based and include a study population that is not representative of family practice. The aim of this study was to investigate the prevalence and incidence of dizziness reported

  8. The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies.

    Science.gov (United States)

    Ferris, Mollie; Quan, Samuel; Kaplan, Belle S; Molodecky, Natalie; Ball, Chad G; Chernoff, Greg W; Bhala, Nij; Ghosh, Subrata; Dixon, Elijah; Ng, Siew; Kaplan, Gilaad G

    2017-08-01

    We compared the incidence of appendicitis or appendectomy across the world and evaluated temporal trends. Population-based studies reported the incidence of appendicitis. We searched MEDLINE and EMBASE databases for population-based studies reporting the incidence of appendicitis or appendectomy. Time trends were explored using Poisson regression and reported as annual percent change (APC) with 95% confidence intervals (CI). APC were stratified by time periods and pooled using random effects models. Incidence since 2000 was pooled for regions in the Western world. The search retrieved 10,247 citations with 120 studies reporting on the incidence of appendicitis or appendectomy. During the 21st century the pooled incidence of appendicitis or appendectomy (in per 100,000 person-years) was 100 (95% CI: 91, 110) in Northern America, and the estimated number of cases in 2015 was 378,614. The pooled incidence ranged from 105 in Eastern Europe to 151 in Western Europe. In Western countries, the incidence of appendectomy steadily decreased since 1990 (APC after 1989=-1.54; 95% CI: -2.22, -0.86), whereas the incidence of appendicitis stabilized (APC=-0.36; 95% CI: -0.97, 0.26) for both perforated (APC=0.95; 95% CI: -0.25, 2.17) and nonperforated appendicitis (APC=0.44; 95% CI: -0.84, 1.73). In the 21st century, the incidence of appendicitis or appendectomy is high in newly industrialized countries in Asia (South Korea pooled: 206), the Middle East (Turkey pooled: 160), and Southern America (Chile: 202). Appendicitis is a global disease. The incidence of appendicitis is stable in most Western countries. Data from newly industrialized countries is sparse, but suggests that appendicitis is rising rapidly.

  9. New York integrated incident management system evaluation project final report

    Science.gov (United States)

    2007-03-23

    The Integrated Incident Management System (IIMS) enables incident response personnel to transmit data about an incident to other responders and dispatchers on a real-time basis. When an incident is entered into IIMS, the system uses GPS to identify t...

  10. Effects of patient safety culture interventions on incident reporting in general practice: a cluster randomised trial.

    Science.gov (United States)

    Verbakel, Natasha J; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M

    2015-05-01

    A constructive safety culture is essential for the successful implementation of patient safety improvements. To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. A three-arm cluster randomised trial was conducted in a mixed method study, studying the effect of administering a patient safety culture questionnaire (intervention I), the questionnaire complemented with a practice-based workshop (intervention II) and no intervention (control) in 30 general practices in the Netherlands. The primary outcome, the number of reported incidents, was measured with a questionnaire at baseline and a year after. Analysis was performed using a negative binomial model. Secondary outcomes were quality and safety indicators and safety culture. Mixed effects linear regression was used to analyse the culture questionnaires. The number of incidents increased in both intervention groups, to 82 and 224 in intervention I and II respectively. Adjusted for baseline number of incidents, practice size and accreditation status, the study showed that practices that additionally participated in the workshop reported 42 (95% confidence interval [CI] = 9.81 to 177.50) times more incidents compared to the control group. Practices that only completed the questionnaire reported 5 (95% CI = 1.17 to 25.49) times more incidents. There were no statistically significant differences in staff perception of patient safety culture at follow-up between the three study groups. Educating staff and facilitating discussion about patient safety culture in their own practice leads to increased reporting of incidents. It is beneficial to invest in a team-wise effort to improve patient safety. © British Journal of General Practice 2015.

  11. The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project.

    Science.gov (United States)

    Decker, Wyatt W; Campbell, Ronna L; Manivannan, Veena; Luke, Anuradha; St Sauver, Jennifer L; Weaver, Amy; Bellolio, M Fernanda; Bergstralh, Eric J; Stead, Latha G; Li, James T C

    2008-12-01

    Reported incidences of anaphylaxis range from 3.2 to 20 per 100,000 population. The incidence and trend over time has meaningful public health implications but has not been well characterized because of a lack of a standard definition and deficiencies in reporting of events. We sought to determine the incidence and cause of anaphylaxis over a 10-year period. We performed a population-based incidence study that was conducted in Rochester, Minnesota, from 1990 through 2000. Anaphylaxis episodes were identified on the basis of symptoms and signs of mast cell and basophil mediator release plus mucocutaneous, gastrointestinal tract, respiratory tract, or cardiovascular system involvement. Two hundred eleven cases of anaphylaxis were identified (55.9% in female subjects). The mean age was 29.3 years (SD, 18.2 years; range, 0.8-78.2 years). The overall age- and sex-adjusted incidence rate was 49.8 (95% CI, 45.0-54.5) per 100,000 person-years. Age-specific rates were highest for ages 0 to 19 years (70 per 100,000 person-years). Ingested foods accounted for 33.2% (70 cases), insect stings accounted for 18.5% (39 cases), medication accounted for 13.7% (29 cases), radiologic contrast agent accounted for 0.5% (1 case), "other" causes accounted for 9% (19 cases), and "unknown" causes accounted for 25.1% (53 cases). The "other" group included cats, latex, cleaning agents, environmental allergens, and exercise. There was an increase in the annual incidence rate during the study period from 46.9 per 100,000 persons in 1990 to 58.9 per 100,000 persons in 2000 (P = .03). The overall incidence rate is 49.8 per 100,000 person-years, which is higher than previously reported. The annual incidence rate is also increasing. Food and insect stings continue to be major inciting agents for anaphylaxis.

  12. Loss of Situation Awareness in Pilots: Analysis of Incident Reports

    Science.gov (United States)

    Villeda, Eric B.

    1996-01-01

    Introduction Approximately 75% of all aviation accidents and incidents are attributable to human failures in monitoring, managing, and operating system. Tactical decision errors were found to be a factor in 25 of 37 major US air transport accidents between 1978 and 1990. These two facts demonstrate the inability of some pilots to maintain situation awareness. Situation awareness (SA) is defined as 'the perception of elements in the environment within a volume of time and space, the comprehension of their meaning, and the projection of their status in the near future". Thus, when a pilot loses SA, he or she is unable to ether perceive, comprehend, or project the status of the aircraft. In pilots terms, he or she has 'fallen behind the airplane'. Our study this summer involved an analysis of 190 NASA Aviation Safety Reporting System (ASRS) reports.

  13. SU-F-T-223: Radiotherapy Incident Reporting and Analysis System (RIRAS):Early Experience

    Energy Technology Data Exchange (ETDEWEB)

    Kapoor, R; Palta, J; Hagan, M [National Radiation Oncology Program (10P4H), Dept. of Veterans Affairs, Richmond, VA (United States); Burkett, D; Leidholdt, E [National Health Physics Program (10P4X), Dept. of Veterans Affairs, Little Rock, AR (United States)

    2016-06-15

    Background & Purpose: RIRAS is a web-based information system deployed on the Veterans Health Administration intranet in early 2014 to collect adverse events and good catch data; analyze the causes and contributing factors; and find ways to prevent future occurrences. Material and Methods: Incident learning consists of a feedback loop which starts with reporting an event, followed by analysis of contributing factors, and culminates in the development of a patient safety work product (PSWP) to prevent recurrence. RIRAS permits both anonymous and non-anonymous reporting. Each report is analyzed by a team of medical physicists who are independent of the reporting facility. The analysts usually contact the reporting facilities for additional information. We analyzed all reports and held telephonic interviews (when necessary) with the reporters. We then generated PSWPs with corrective/preventive and learning actions. Anonymous reporting is handled in the same manner, except without the ability to further interview the reporter. Results: In a significant number of reports, the causes and recommended preventive actions were considerably altered by the independent analysis and additional information from the facility. 130 reports have been entered in RIRAS; 9 misadministrations, 83 good catches, 3 anonymous good catches, and 35 earlier reported incidents from FY2005-14. 45% of the reported incidents occurred in the treatment delivery stages, 19% in on-treatment management, and 16% in pre-treatment verification. 80% of the good catches were found in the treatment delivery workflow. Majority of these incidents were due to inconsistent patient setup instructions or documentation, nonadherence to policies and procedures, lax time-out policy, distracted RTTs, and inadequate RTT staffing. Conclusion: RIRAS has identified many areas for improvement and elevated the quality and safety of radiation treatments in the VHA. We found that the ability to learn is significantly

  14. Reporting of Violent and Disruptive Incidents by Public Schools. Report 2005-S-38

    Science.gov (United States)

    New York State Education Department, 2006

    2006-01-01

    The objective of this report was to determine whether the State Education Department (SED) has developed effective processes for (1) ensuring that school districts report violent and disruptive incidents to SED in accordance with State law and regulations, (2) identifying schools that should be designated as persistently dangerous because of their…

  15. Critical Incident-Based Computer Supported Collaborative Learning.

    Science.gov (United States)

    Naidu, Som; Oliver, Mary

    1999-01-01

    Reports on a study of nursing education at the University of Southern Queensland (Australia) that sought to integrate-computer mediated communication, collaborative learning, and reflection on critical incidences to make the most of learning opportunities confronted by learners and practitioners in situ. Discusses learning and instructional…

  16. Pharmacovigilance in oncology: pattern of spontaneous notifications, incidence of adverse drug reactions and under-reporting

    Directory of Open Access Journals (Sweden)

    Marília Berlofa Visacri

    2014-04-01

    Full Text Available The high toxicity and narrow therapeutic window of antineoplastic agents makes pharmacovigilance studies essential in oncology. The objectives of the current study were to analyze the pattern of spontaneous notifications of adverse drug reactions (ADRs in oncology patients and to analyze the incidence of ADRs reported by outpatients on antineoplastic treatment in a tertiary care teaching hospital. To compose the pattern of ADR, the notification forms of reactions in oncology patients in 2010 were reviewed, and the reactions were classified based on the drug involved, mechanism, causality, and severity. To evaluate the incidence of reactions, a questionnaire at the time of chemotherapy was included, and the severity was classified based on the Common Terminology Criteria. The profiles of the 10 responses reported to the Pharmacovigilance Sector were type B, severe, possible, and they were primarily related to platinum compounds and taxanes. When the incidence of reactions was analyzed, it was observed that nausea, alopecia, fatigue, diarrhea, and taste disturbance were the most frequently reported reactions by oncology patients, and the grade 3 and 4 reactions were not reported. Based on this analysis, it is proposed that health professionals should be trained regarding notifications and clinical pharmacists should increasingly be brought on board to reduce under-reporting of ADRs.

  17. Mass-Fatality Incident Preparedness Among Faith-Based Organizations.

    Science.gov (United States)

    Zhi, Qi; Merrill, Jacqueline A; Gershon, Robyn R

    2017-12-01

    Introduction Members of faith-based organizations (FBOs) are in a unique position to provide support and services to their local communities during disasters. Because of their close community ties and well-established trust, they can play an especially critical role in helping communities heal in the aftermath of a mass-fatality incident (MFI). Faith-based organizations are considered an important disaster resource and partner under the National Response Plan (NRP) and National Response Framework; however, their level of preparedness and response capabilities with respect to MFIs has never been evaluated. The purpose of this study was threefold: (1) to develop appropriate measures of preparedness for this sector; (2) to assess MFI preparedness among United States FBOs; and (3) to identify key factors associated with MFI preparedness. Problem New metrics for MFI preparedness, comprised of three domains (organizational capabilities, operational capabilities, and resource sharing partnerships), were developed and tested in a national convenience sample of FBO members. Data were collected using an online anonymous survey that was distributed through two major, national faith-based associations and social media during a 6-week period in 2014. Descriptive, bivariate, and correlational analyses were conducted. One hundred twenty-four respondents completed the online survey. More than one-half of the FBOs had responded to MFIs in the previous five years. Only 20% of respondents thought that roughly three-quarters of FBO clergy would be able to respond to MFIs, with or without hazardous contamination. A higher proportion (45%) thought that most FBO clergy would be willing to respond, but only 37% thought they would be willing if hazardous contamination was involved. Almost all respondents reported that their FBO was capable of providing emotional care and grief counseling in response to MFIs. Resource sharing partnerships were typically in place with other voluntary

  18. Incident and Trafficking Database: New Systems for Reporting and Accessing State Information

    International Nuclear Information System (INIS)

    Dimitrovski, D.; Kittley, S.

    2015-01-01

    The IAEA's Incident and Trafficking Database (ITDB) is the Agency's authoritative source for information on incidents in which nuclear and other radioactive material is out of national regulatory control. It was established in 1995 and, as of June 2014, 126 States participate in the ITDB programme. Currently, the database contains over 2500 confirmed incidents, out of which 21% involve nuclear material, 62% radioactive source and 17% radioactively contaminated material. In recent years, the system for States to report incidents to the ITDB has been evolving — moving from fax-based to secure email and most recently to secure on-line reporting. A Beta version of the on-line system was rolled out this June, offering a simple, yet secure, communication channel for member states to provide information. In addition the system serves as a central hub for information related to official communication of the IAEA with Member States so some communication that is traditionally shared by e-mail does not get lost when ITDB counterparts change. In addition the new reporting system incorporates optional features that allow multiple Member State users to collaboratively contribute toward an INF. States are also being given secure on-line access to a streamlined version of the ITDB. This improves States' capabilities to retrieve and analyze information for their own purposes. In addition, on-line access to ITDB statistical information on incidents is available to States through an ITDB Dashboard. The dashboard contains aggregate information on number and types of incidents, material involved, as well some other statistics related to the ITDB that is typically provided in the ITDB Quarterly reports. (author)

  19. Fire detection and incidents localization based on public information channels and social media

    Science.gov (United States)

    Thanos, Konstantinos-Georgios; Skroumpelou, Katerina; Rizogiannis, Konstantinos; Kyriazanos, Dimitris M.; Astyakopoulos, Alkiviadis; Thomopoulos, Stelios C. A.

    2017-05-01

    In this paper a solution is presented aiming to assist the early detection and localization of a fire incident by exploiting crowdsourcing and unofficial civilian online reports. It consists of two components: (a) the potential fire incident detection and (b) the visualization component. The first component comprises two modules that run in parallel and aim to collect reports posted on public platforms and conclude to potential fire incident locations. It collects the public reports, distinguishes reports that refer to a potential fire incident and store the corresponding information in a structured way. The second module aggregates all these stored reports and conclude to a probable fire location, based on the amount of reports per area, the time and location of these reports. In further the result is entered to a fusion module which combines it with information collected by sensors if available in order to provide a more accurate fire event detection capability. The visualization component is a fully - operational public information channel which provides accurate and up-to-date information about active and past fires, raises awareness about forest fires and the relevant hazards among citizens. The channel has visualization capabilities for presenting in an efficient way information regarding detected fire incidents fire expansion areas, and relevant information such as detecting sensors and reporting origin. The paper concludes with insight to current CONOPS end user with regards to the inclusion of the proposed solution to the current CONOPS of fire detection.

  20. A safety incident reporting system for primary care. A systematic literature review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care.

    Science.gov (United States)

    Klemp, Kerstin; Zwart, Dorien; Hansen, Jørgen; Hellebek, Torben; Luettel, Dagmar; Verstappen, Wim; Beyer, Martin; Gerlach, Ferdin M; Hoffmann, Barbara; Esmail, Aneez

    2015-09-01

    Incident reporting is widely used in both patient safety improvement programmes, and in research on patient safety. To identify the key requirements for incident reporting systems in primary care; to develop an Internet-based incident reporting and learning system for primary care. A literature review looking at the purpose, design and requirements of an incident reporting system (IRS) was used to update an existing incident reporting system, widely used in Germany. Then, an international expert panel with knowledge on IRS developed the criteria for the design of a new web-based incident reporting system for European primary care. A small demonstration project was used to create a web-based reporting system, to be made freely available for practitioners and researchers. The expert group compiled recommendations regarding the desirable features of an incident reporting system for European primary care. These features covered the purpose of reporting, who should be involved in reporting, the mode of reporting, design considerations, feedback mechanisms and preconditions necessary for the implementation of an IRS. A freely available web-based reporting form was developed, based on these criteria. It can be modified for local contexts. Practitioners and researchers can use this system as a means of recording patient safety incidents in their locality and use it as a basis for learning from errors. The LINNEAUS collaboration has provided a freely available incident reporting system that can be modified for a local context and used throughout Europe.

  1. An Evaluation of Departmental Radiation Oncology Incident Reports: Anticipating a National Reporting System

    International Nuclear Information System (INIS)

    Terezakis, Stephanie A.; Harris, Kendra M.; Ford, Eric; Michalski, Jeff; DeWeese, Theodore; Santanam, Lakshmi; Mutic, Sasa; Gay, Hiram

    2013-01-01

    Purpose: Systems to ensure patient safety are of critical importance. The electronic incident reporting systems (IRS) of 2 large academic radiation oncology departments were evaluated for events that may be suitable for submission to a national reporting system (NRS). Methods and Materials: All events recorded in the combined IRS were evaluated from 2007 through 2010. Incidents were graded for potential severity using the validated French Nuclear Safety Authority (ASN) 5-point scale. These incidents were categorized into 7 groups: (1) human error, (2) software error, (3) hardware error, (4) error in communication between 2 humans, (5) error at the human-software interface, (6) error at the software-hardware interface, and (7) error at the human-hardware interface. Results: Between the 2 systems, 4407 incidents were reported. Of these events, 1507 (34%) were considered to have the potential for clinical consequences. Of these 1507 events, 149 (10%) were rated as having a potential severity of ≥2. Of these 149 events, the committee determined that 79 (53%) of these events would be submittable to a NRS of which the majority was related to human error or to the human-software interface. Conclusions: A significant number of incidents were identified in this analysis. The majority of events in this study were related to human error and to the human-software interface, further supporting the need for a NRS to facilitate field-wide learning and system improvement

  2. An Evaluation of Departmental Radiation Oncology Incident Reports: Anticipating a National Reporting System

    Energy Technology Data Exchange (ETDEWEB)

    Terezakis, Stephanie A., E-mail: stereza1@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Harris, Kendra M. [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Ford, Eric [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Department of Radiation Oncology, University of Washington, Seattle, Washington (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); DeWeese, Theodore [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Santanam, Lakshmi; Mutic, Sasa; Gay, Hiram [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States)

    2013-03-15

    Purpose: Systems to ensure patient safety are of critical importance. The electronic incident reporting systems (IRS) of 2 large academic radiation oncology departments were evaluated for events that may be suitable for submission to a national reporting system (NRS). Methods and Materials: All events recorded in the combined IRS were evaluated from 2007 through 2010. Incidents were graded for potential severity using the validated French Nuclear Safety Authority (ASN) 5-point scale. These incidents were categorized into 7 groups: (1) human error, (2) software error, (3) hardware error, (4) error in communication between 2 humans, (5) error at the human-software interface, (6) error at the software-hardware interface, and (7) error at the human-hardware interface. Results: Between the 2 systems, 4407 incidents were reported. Of these events, 1507 (34%) were considered to have the potential for clinical consequences. Of these 1507 events, 149 (10%) were rated as having a potential severity of ≥2. Of these 149 events, the committee determined that 79 (53%) of these events would be submittable to a NRS of which the majority was related to human error or to the human-software interface. Conclusions: A significant number of incidents were identified in this analysis. The majority of events in this study were related to human error and to the human-software interface, further supporting the need for a NRS to facilitate field-wide learning and system improvement.

  3. Incidence et Caracteristiques des Signalements d'Enfants Maltraites: Comparaison Interculturelle (Incidence and Characteristics of Reported Child Abuse: Intercultural Comparisons).

    Science.gov (United States)

    Tourigny, Marc; Bouchard, Camil

    1994-01-01

    Analysis of 953 reports of child abuse in Montreal (Quebec) found the incidence slightly higher among Haitians than French-Canadians. Among Haitians, reporting tended to originate with police or school personnel, and cases consisted mainly of physical abuse. Results suggest that child-rearing practices of Haitian families are in conflict with…

  4. Estimation of incidences of infectious diseases based on antibody measurements

    DEFF Research Database (Denmark)

    Simonsen, J; Mølbak, K; Falkenhorst, G

    2009-01-01

    Owing to under-ascertainment it is difficult if not impossible to determine the incidence of a given disease based on cases notified to routine public health surveillance. This is especially true for diseases that are often present in mild forms as for example diarrhoea caused by foodborne...

  5. Semantic Language and Tools for Reporting Human Factors Incidents Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Incidents related to impaired human performance in space operations can be caused by environmental conditions, situational challenges, and operational deficiencies....

  6. Self-reported incidence of injuries among ballroom dancers | Kuisis ...

    African Journals Online (AJOL)

    Ballroom dancing is an increasingly popular sport around the world. However, unlike other forms of dancing such as ballet and modern, very little is known about the incidence, nature and severity of injuries sustained by dancers. The aims of this study were: 1) to quantify the incidence of injuries 2) to identify the nature of ...

  7. Sci-Fri AM: Quality, Safety, and Professional Issues 06: An Evaluation of Incident Reporting and Learning using the Canadian National System for Incident Reporting – Radiation Treatment

    International Nuclear Information System (INIS)

    Montgomery, Logan; Kildea, John

    2016-01-01

    We report on the development and clinical deployment of an in-house incident reporting and learning system that implements the taxonomy of the Canadian National System for Incident Reporting – Radiation Treatment (NSIR-RT). In producing our new system, we aimed to: Analyze actual incidents, as well as potentially dangerous latent conditions. Produce recommendations on the NSIR-RT taxonomy. Incorporate features to divide reporting responsibility among clinical staff and expedite incident categorization within the NSIR-RT framework. Share anonymized incident data with the national database. Our multistep incident reporting workflow is focused around an initial report and a detailed follow-up investigation. An investigator, chosen at the time of reporting, is tasked with performing the investigation. The investigation feature is connected to our electronic medical records database to allow automatic field population and quick reference of patient and treatment information. Additional features include a robust visualization suite, as well as the ability to flag incidents for discussion at monthly Risk Management meetings and task ameliorating actions to staff. Our system was deployed into clinical use in January 2016. Over the first three months of use, 45 valid incidents were reported; 31 of which were reported as actual incidents as opposed to near-misses or reportable circumstances. However, we suspect there is ambiguity within our centre in determining the appropriate event type, which may be arising from the taxonomy itself. Preliminary trending analysis aided in revealing workflow issues pertaining to storage of treatment accessories and treatment planning delays. Extensive analysis will be undertaken as more data are accrued.

  8. 30 CFR 250.187 - What are MMS' incident reporting requirements?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What are MMS' incident reporting requirements... Reporting Requirements § 250.187 What are MMS' incident reporting requirements? (a) You must report all... other permit issued by MMS, and that are related to operations resulting from the exercise of your...

  9. Incidence of HIV infection at the time of incident reporting,in victims ...

    African Journals Online (AJOL)

    Background: HIV/AIDS epidemic and sexual assault have emerged as the most serious public health problems in South Africa. The country has about 5-million HIV infected individuals. About a million women are raped every year. Objective: To study the incidence of HIV infection in victims of sexual assaults. Methods: This ...

  10. Using incident reports to inform the prevention of medication administration errors.

    Science.gov (United States)

    Härkänen, Marja; Saano, Susanna; Vehviläinen-Julkunen, Katri

    2017-11-01

    To describe ways of preventing medication administration errors based on reporters' views expressed in medication administration incident reports. Medication administration errors are very common, and nurses play important roles in committing and in preventing such errors. Thus far, incident reporters' perceptions of how to prevent medication administration errors have rarely been analysed. This is a qualitative, descriptive study using an inductive content analysis of the incident reports related to medication administration errors (n = 1012). These free-text descriptions include reporters' views on preventing the reoccurrence of medication administration errors. The data were collected from two hospitals in Finland and pertain to incidents that were reported between 1 January 2013 and 31 December 2014. Reporters' views on preventing medication administration errors were divided into three main categories related to individuals (health professionals), teams and organisations. The following categories related to individuals in preventing medication administration errors were identified: (1) accuracy and preciseness; (2) verification; and (3) following the guidelines, responsibility and attitude towards work. The team categories were as follows: (1) distribution of work; (2) flow of information and cooperation; and (3) documenting and marking the drug information. The categories related to organisation were as follows: (1) work environment; (2) resources; (3) training; (4) guidelines; and (5) development of the work. Health professionals should administer medication with a high moral awareness and an attempt to concentrate on the task. Nonetheless, the system should support health professionals by providing a reasonable work environment and encouraging collaboration among the providers to facilitate the safe administration of medication. Although there are numerous approaches to supporting medication safety, approaches that support the ability of individual health

  11. Incidence of Cronobacter sakazakii in Dairy-based Desserts

    Directory of Open Access Journals (Sweden)

    Nagah M. Saad

    2018-04-01

    Full Text Available Cronobacter sakazakii is one of emerging foodborne pathogens around the world. A total of 90 dairy-based desserts samples (ice cream, Muhallabia and rice pudding were examined for detecting C. sakazakii. All samples were submitted for bacteriological examination and confirmed by molecular identification using 16S rRNA gene for C. sakazakii. The bacteriological and molecular examination revealed that the incidence of occurrence of C. sakazakii was 5.55% from the total dairy-based desserts samples, the highest percentage occurred in rice pudding samples (10%, while the incidence of C. sakazakii in ice cream and Muhallabia were 3.33% for each type. The results pointed out that high risk for human may occur by contaminated dairy-based desserts. The hygienic precautions must be taken during the processing of these types of products.

  12. Critical incidents related to cardiac arrests reported to the Danish Patient Safety Database

    DEFF Research Database (Denmark)

    Andersen, Peter Oluf; Maaløe, Rikke; Andersen, Henning Boje

    2010-01-01

    Background Critical incident reports can identify areas for improvement in resuscitation practice. The Danish Patient Safety Database is a mandatory reporting system and receives critical incident reports submitted by hospital personnel. The aim of this study is to identify, analyse and categorize...... critical incidents related to cardiac arrests reported to the Danish Patient Safety Database. Methods The search terms “cardiac arrest” and “resuscitation” were used to identify reports in the Danish Patient Safety Database. Identified critical incidents were then classified into categories. Results One...

  13. The association between patient-reported incidents in hospitals and estimated rates of patient harm.

    Science.gov (United States)

    Bjertnaes, Oyvind; Deilkås, Ellen Tveter; Skudal, Kjersti Eeg; Iversen, Hilde Hestad; Bjerkan, Anne Mette

    2015-02-01

    The aim of this study was to test the association between the rates of patient-reported incidents and patient harm documented in the patient record. The study was a secondary analysis of two national hospital assessments conducted in 2011. Hospital services in Norway. The patient survey was a standard national patient-experience survey conducted at the hospital level for all 63 hospitals in Norway. The medical record review was performed by 47 Global Trigger Tools (GTTs) in all 19 hospital trusts and 4 private hospitals. The two data sets were matched at the unit level, yielding comparable patient experiences and GTT data for 7 departments, 16 hospitals and 11 hospital trusts. No intervention. The correlation at the unit level between the patient-reported incident in hospital instrument (PRIH-I) and estimated rates of patient harm from the GTT. The PRIH-I index was significantly correlated with all patient-reported experience indicators at the individual level, with estimates for all patient harm events (Categories E-I) at the unit level (r = 0.62, P < 0.01), and with estimates of more serious harm events in Categories F-I (r = 0.42, P < 0.05). Patient-reported incidents in hospitals, as measured by the PRIH-I, are strongly correlated with patient harm rates based on the GTT. This indicates that patient-reported incidents are related to patient safety, but more research is needed to confirm the usefulness of patient reporting in the evaluation of patient safety. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  14. Critical incidence reporting systems - an option in equine anaesthesia? Results from a panel meeting.

    Science.gov (United States)

    Hartnack, Sonja; Bettschart-Wolfensberger, Regula; Driessen, Bernd; Pang, Daniel; Wohlfender, Franziska

    2013-11-01

    To provide a brief introduction into Critical Incident Reporting Systems (CIRS) as used in human medicine, and to report the discussion from a recent panel meeting discussion with 23 equine anaesthetists in preparation for a new CEPEF-4 (Confidential Enquiry into Perioperative Equine Fatalities) study. Moderated group discussions, and review of literature. The first group discussion focused on the definition of 'preventable critical incidents' and/or 'near misses' in the context of equine anaesthesia. The second group discussion focused on categorizing critical incidents according to an established framework for analysing risk and safety in clinical medicine. While critical incidents do occur in equine anaesthesia, no critical incident reporting system including systematic collection and analysis of critical incidents is in place. Critical incident reporting systems could be used to improve safety in equine anaesthesia - in addition to other study types such as mortality studies. © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  15. Exploring the Influence of Nurse Work Environment and Patient Safety Culture on Attitudes Toward Incident Reporting.

    Science.gov (United States)

    Yoo, Moon Sook; Kim, Kyoung Ja

    2017-09-01

    The aim of this study was to explore the influence of nurse work environments and patient safety culture on attitudes toward incident reporting. Patient safety culture had been known as a factor of incident reporting by nurses. Positive work environment could be an important influencing factor for the safety behavior of nurses. A cross-sectional survey design was used. The structured questionnaire was administered to 191 nurses working at a tertiary university hospital in South Korea. Nurses' perception of work environment and patient safety culture were positively correlated with attitudes toward incident reporting. A regression model with clinical career, work area and nurse work environment, and patient safety culture against attitudes toward incident reporting was statistically significant. The model explained approximately 50.7% of attitudes toward incident reporting. Improving nurses' attitudes toward incident reporting can be achieved with a broad approach that includes improvements in work environment and patient safety culture.

  16. Sensor, a population-based cohort study on gastroenteritis in the Netherlands: incidence and etiology.

    NARCIS (Netherlands)

    Wit, M.A.S. de; Koopmans, M.P.G.; Kortbeek, L.M.; Wannet, W.J.B.; Vinje, J; Leusden, F. van; Bartelds, A.I.M.; Duynhoven, Y.T.H.P. van

    2001-01-01

    A prospective population-based cohort study with a nested case- control study was conducted to estimate the incidence of gastroenteritis and the associated pathogens in the general Dutch population. Follow-up of two consecutive cohorts was performed by weekly reporting cards from december 1998 to

  17. Documentation of in-hospital falls on incident reports: qualitative investigation of an imperfect process.

    Science.gov (United States)

    Haines, Terry P; Cornwell, Petrea; Fleming, Jennifer; Varghese, Paul; Gray, Len

    2008-12-11

    Incident reporting is the prevailing approach to gathering data on accidental falls in hospitals for both research and quality assurance purposes, though is of questionable quality as staff time pressures, perception of blame and other factors are thought to contribute to under-reporting. This research aimed to identify contextual factors influencing recording of in-hospital falls on incident reports. A qualitative multi-centre investigation using an open written response questionnaire was undertaken. Participants were asked to describe any factors that made them feel more or less likely to record a fall on an incident report. 212 hospital staff from 30 wards in 7 hospitals in Queensland, Australia provided a response. A framework approach was employed to identify and understand inter-relationships between emergent categories. Three main categories were developed. The first, determinants of reporting, describes a hierarchical structure of primary (principle of reporting), secondary (patient injury), and tertiary determinants that influenced the likelihood that an in-hospital fall would be recorded on an incident report. The tertiary determinants frequently had an inconsistent effect. The second and third main categories described environmental/cultural facilitators and barriers respectively which form a background upon which the determinants of reporting exists. A distinctive framework with clear differences to recording of other types of adverse events on incident reports was apparent. Providing information to hospital staff regarding the purpose of incident reporting and the usefulness of incident reporting for preventing future falls may improve incident reporting practices.

  18. Documentation of in-hospital falls on incident reports: Qualitative investigation of an imperfect process

    Directory of Open Access Journals (Sweden)

    Fleming Jennifer

    2008-12-01

    Full Text Available Abstract Background Incident reporting is the prevailing approach to gathering data on accidental falls in hospitals for both research and quality assurance purposes, though is of questionable quality as staff time pressures, perception of blame and other factors are thought to contribute to under-reporting. Methods This research aimed to identify contextual factors influencing recording of in-hospital falls on incident reports. A qualitative multi-centre investigation using an open written response questionnaire was undertaken. Participants were asked to describe any factors that made them feel more or less likely to record a fall on an incident report. 212 hospital staff from 30 wards in 7 hospitals in Queensland, Australia provided a response. A framework approach was employed to identify and understand inter-relationships between emergent categories. Results Three main categories were developed. The first, determinants of reporting, describes a hierarchical structure of primary (principle of reporting, secondary (patient injury, and tertiary determinants that influenced the likelihood that an in-hospital fall would be recorded on an incident report. The tertiary determinants frequently had an inconsistent effect. The second and third main categories described environmental/cultural facilitators and barriers respectively which form a background upon which the determinants of reporting exists. Conclusion A distinctive framework with clear differences to recording of other types of adverse events on incident reports was apparent. Providing information to hospital staff regarding the purpose of incident reporting and the usefulness of incident reporting for preventing future falls may improve incident reporting practices.

  19. 49 CFR 191.15 - Transmission and gathering systems: Incident report.

    Science.gov (United States)

    2010-10-01

    ...-RELATED CONDITION REPORTS § 191.15 Transmission and gathering systems: Incident report. (a) Except as... 49 Transportation 3 2010-10-01 2010-10-01 false Transmission and gathering systems: Incident report. 191.15 Section 191.15 Transportation Other Regulations Relating to Transportation (Continued...

  20. Change in Reported Lyme Disease Incidence in the Northeast and Upper Midwest, 1991-2014

    Science.gov (United States)

    This indicator shows how reported Lyme disease incidence has changed by state since 1991, based on the number of new cases per 100,000 people. The total change has been estimated from the average annual rate of change in each state. This map is limited to the 14 states where Lyme disease is most common, where annual rates are consistently above 10 cases per 100,000. Connecticut, New York, and Rhode Island had too much year-to-year variation in reporting practices to allow trend calculation. For more information: www.epa.gov/climatechange/science/indicators

  1. 49 CFR 225.15 - Accidents/incidents not to be reported.

    Science.gov (United States)

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD ACCIDENTS/INCIDENTS: REPORTS CLASSIFICATION, AND... in or about living quarters not arising from the operation of a railroad; (c) Suicides as determined...

  2. Risk factors for radiotherapy incidents and impact of an online electronic reporting system

    International Nuclear Information System (INIS)

    Chang, David W.; Cheetham, Lynn; Marvelde, Luc te; Bressel, Mathias; Kron, Tomas; Gill, Suki; Tai, Keen Hun; Ball, David; Rose, William; Silva, Linas; Foroudi, Farshad

    2014-01-01

    Background and purpose: To ascertain the rate, type, significance, trends and the potential risk factors associated with radiotherapy incidents in a large academic department. Materials and methods: Data for all radiotherapy activities from July 2001 to January 2011 were reviewed from radiotherapy incident reporting forms. Patient and treatment data were obtained from the radiotherapy record and verification database (MOSAIQ) and the patient database (HOSPRO). Logistic regression analyses were performed to determine variables associated with radiotherapy incidents. Results: In that time, 65,376 courses of radiotherapy were delivered with a reported incident rate of 2.64 per 100 courses. The rate of incidents per course increased (1.96 per 100 courses to 3.52 per 100 courses, p < 0.001) whereas the proportion of reported incidents resulting in >5% deviation in dose (10.50 to 2.75%, p < 0.001) had decreased after the introduction of an online electronic reporting system. The following variables were associated with an increased rate of incidents: afternoon treatment time, paediatric patients, males, inpatients, palliative plans, head-and-neck, skin, sarcoma and haematological malignancies. In general, complex plans were associated with higher incidence rates. Conclusion: Radiotherapy incidents were infrequent and most did not result in significant dose deviation. A number of risk factors were identified and these could be used to highlight high-risk cases in the future. Introduction of an online electronic reporting system resulted in a significant increase in the number of incidents being reported

  3. A Descriptive Analysis of Incidents Reported by Community Aged Care Workers.

    Science.gov (United States)

    Tariq, Amina; Douglas, Heather E; Smith, Cheryl; Georgiou, Andrew; Osmond, Tracey; Armour, Pauline; Westbrook, Johanna I

    2015-07-01

    Little is known about the types of incidents that occur to aged care clients in the community. This limits the development of effective strategies to improve client safety. The objective of the study was to present a profile of incidents reported in Australian community aged care settings. All incident reports made by community care workers employed by one of the largest community aged care provider organizations in Australia during the period November 1, 2012, to August 8, 2013, were analyzed. A total of 356 reports were analyzed, corresponding to a 7.5% incidence rate per client year. Falls and medication incidents were the most prevalent incident types. Clients receiving high-level care and those who attended day therapy centers had the highest rate of incidents with 14% to 20% of these clients having a reported incident. The incident profile indicates that clients on higher levels of care had higher incident rates. Incident data represent an opportunity to improve client safety in community aged care. © The Author(s) 2014.

  4. Sociocultural Factors Influencing Incident Reporting Among Physicians and Nurses: Understanding Frames Underlying Self- and Peer-Reporting Practices.

    Science.gov (United States)

    Hewitt, Tanya; Chreim, Samia; Forster, Alan

    2017-09-01

    Voluntary reporting of incidents is a common approach for improving patient safety. Reporting behaviors may vary because of different frames within and across professions, where frames are templates that individuals hold and that guide interpretation of events. Our objectives were to investigate frames of physicians and nurses who report into a voluntary incident reporting system as well as to understand enablers and inhibitors of self-reporting and peer reporting. This is a qualitative case study-confidential in-depth interviews with physicians and nurses in General Internal Medicine in a Canadian tertiary care hospital. Frames that health care practitioners use in their reporting practices serve as enablers and inhibitors for self-reporting and peer reporting. Frames that inhibit reporting are shared by physicians and nurses, such as the fear of blame frame regarding self-reporting and the tattletale frame regarding peer reporting. These frames are underpinned by a focus on the individual, despite the organizational message of reporting for learning. A learning frame is an enabler to incident reporting. Viewing the objective of voluntary incident reporting as learning allows practitioners to depersonalize incident reporting. The focus becomes preventing recurrence and not the individual reporting or reported on. Physicians and nurses use various frames that bound their views of self and peer incident reporting-further progress should incorporate an understanding of these deep-seated views and beliefs.

  5. Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database.

    Science.gov (United States)

    Cooper, Jennifer; Edwards, Adrian; Williams, Huw; Sheikh, Aziz; Parry, Gareth; Hibbert, Peter; Butlin, Amy; Donaldson, Liam; Carson-Stevens, Andrew

    2017-09-01

    A culture of blame and fear of retribution are recognized barriers to reporting patient safety incidents. The extent of blame attribution in safety incident reports, which may reflect the underlying safety culture of health care systems, is unknown. This study set out to explore the nature of blame in family practice safety incident reports. We characterized a random sample of family practice patient safety incident reports from the England and Wales National Reporting and Learning System. Reports were analyzed according to prespecified classification systems to describe the incident type, contributory factors, outcomes, and severity of harm. We developed a taxonomy of blame attribution, and we then used descriptive statistical analyses to identify the proportions of blame types and to explore associations between incident characteristics and one type of blame. Health care professionals making family practice incident reports attributed blame to a person in 45% of cases (n = 975 of 2,148; 95% CI, 43%-47%). In 36% of cases, those who reported the incidents attributed fault to another person, whereas 2% of those reporting acknowledged personal responsibility. Blame was commonly associated with incidents where a complaint was anticipated. The high frequency of blame in these safety, incident reports may reflect a health care culture that leads to blame and retribution, rather than to identifying areas for learning and improvement, and a failure to appreciate the contribution of system factors in others' behavior. Successful improvement in patient safety through the analysis of incident reports is unlikely without achieving a blame-free culture. © 2017 Annals of Family Medicine, Inc.

  6. Safety and Health Standard 110: Incident/accident reporting and investigation

    Energy Technology Data Exchange (ETDEWEB)

    Sones, K. [West Kootenay Power, BC (Canada)

    1999-10-01

    Incident/accident reporting requirements in effect at West Kootenay Power are discussed. Details provided include definitions of low risk, high risk, and critical events, the incidents to be reported, the nature of the reports, the timelines, the investigation to be undertaken for each type of incident/accident, counselling services available to employees involved in serious incidents, and the procedures to be followed in accidents involving serious injury to non-employees. The emphasis is on the `critical five` high risk events and the procedures relating to them.

  7. Incident reporting by acute pain service at a tertiary care university hospital

    OpenAIRE

    Aliya Ahmed; Muhammad Yasir

    2015-01-01

    Background and Aims: Provision of effective and safe postoperative pain management is the principal responsibility of acute pain services (APSs). Continuous quality assurance is essential for high-quality patient care. We initiated anonymous reporting of critical incidents by APS to ensure continuous quality improvement and here present prospectively collected data on the reported incidents. Our objective was to analyze the frequency and nature of incidents and to see if any harm was caused t...

  8. Using Pareto Analysis with Trend Analysis: Statistical Techniques to Investigate Incident Reports within a Housing System

    Science.gov (United States)

    Luna, Andrew L.

    1998-01-01

    The purpose of this study was to determine trends and difficulties concerning student incident reports within the residence halls as they relate to the incident reporting system from the Department of Housing and Residential Life at a Southeastern Doctoral I Granting Institution. This study used the frequency distributions of each classified…

  9. 77 FR 38747 - Reports by Air Carriers on Incidents Involving Animals During Air Transport

    Science.gov (United States)

    2012-06-29

    ...-2010-0211] RIN 2105-AE07 Reports by Air Carriers on Incidents Involving Animals During Air Transport... incidents involving animals during air transport, 14 CFR 234.13, to expand the reporting requirement to U.S... seats, to expand the definition of ``animal'' to include all cats and dogs transported by the carrier...

  10. Walk the talk: leaders' enacted priority of safety, incident reporting, and error management.

    Science.gov (United States)

    Van Dyck, Cathy; Dimitrova, Nicoletta G; de Korne, Dirk F; Hiddema, Frans

    2013-01-01

    The main goal of the current research was to investigate whether and how leaders in health care organizations can stimulate incident reporting and error management by "walking the safety talk" (enacted priority of safety). Open interviews (N = 26) and a cross-sectional questionnaire (N = 183) were conducted at the Rotterdam Eye Hospital (REH) in The Netherlands. As hypothesized, leaders' enacted priority of safety was positively related to incident reporting and error management, and the relation between leaders' enacted priority of safety and error management was mediated by incident reporting. The interviews yielded rich data on (near) incidents, the leaders' role in (non)reporting, and error management, grounding quantitative findings in concrete case descriptions. We support previous theorizing by providing empirical evidence showing that (1) enacted priority of safety has a stronger relationship with incident reporting than espoused priority of safety and (2) the previously implied positive link between incident reporting and error management indeed exists. Moreover, our findings extend our understanding of behavioral integrity for safety and the mechanisms through which it operates in medical settings. Our findings indicate that for the promotion of incident reporting and error management, active reinforcement of priority of safety by leaders is crucial. Social sciences researchers, health care researchers and health care practitioners can utilize the findings of the current paper in order to help leaders create health care systems characterized by higher incident reporting and more constructive error handling.

  11. A population study of the reported incidence of native joint septic arthritis in the United Kingdom between 1998 and 2013.

    Science.gov (United States)

    Rutherford, Andrew I; Subesinghe, Sujith; Bharucha, Tehmina; Ibrahim, Fowzia; Kleymann, Alexander; Galloway, James B

    2016-12-01

    Septic arthritis is a life-threatening condition with mortality rates of 10-15%. Previous studies in other countries have shown the incidence of septic arthritis may be changing. Our aim was investigate the incidence and pattern of native joint septic arthritis in the UK. We performed an analysis using Hospital Episode Statistics to investigate the reported incidence of septic arthritis in the UK between 1998 and 2013. A total of 54 532 cases of septic arthritis were reported via Hospital Episode Statistics during the timeframe studied. There has been a 43% increase in the reported incidence of septic arthritis, with rates rising from 5.5/100 000 in 1998 to 7.8/100 000 in 2013. The rate increased most rapidly in those >75 years of age (15/100 000 in 1998 and 31/100 000 in 2013). Staphylococcal species were the most frequently reported, followed by Streptococcus Pneumococcus rates were relatively stable, with the exception of a 7-fold spike in reported incidence in 2011. This large population-based study demonstrates that the incidence of septic arthritis is increasing in the UK. Rates are increasing most rapidly in the >75 years age group, which is likely the result of increasing co-morbidities. The clustering of pneumococcal cases has potential public health implications. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Agency procedures for the NRC incident response plan. Final report

    International Nuclear Information System (INIS)

    1983-02-01

    The NRC Incident Response Plan, NUREG-0728/MC 0502 describes the functions of the NRC during an incident and the kinds of actions that comprise an NRC response. The NRC response plan will be activated in accordance with threshold criteria described in the plan for incidents occurring at nuclear reactors and fuel facilities involving materials licensees; during transportation of licensed material, and for threats against facilities or licensed material. In contrast to the general overview provided by the Plan, the purpose of these agency procedures is to delineate the manner in which each planned response function is performed; the criteria for making those response decisions which can be preplanned; and the information and other resources needed during a response. An inexperienced but qualified person should be able to perform functions assigned by the Plan and make necessary decisions, given the specified information, by becoming familiar with these procedures. This rule of thumb has been used to determine the amount of detail in which the agency procedures are described. These procedures form a foundation for the training of response personnel both in their normal working environment and during planned emergency exercises. These procedures also form a ready reference or reminder checklist for technical team members and managers during a response

  13. Decoding incident-to and provider-based billing: ensuring payment and avoiding liability.

    Science.gov (United States)

    Hofstra, Patricia S; Hart, Elinor L

    2012-01-01

    In this increasingly complex world of Medicare reimbursement, physicians must constantly review their billing practices to ensure compliance with all Medicare requirements. "Incident-to" billing and provider-based billing are two areas that present unique challenges for providers, especially those practicing in hospital-owned practices such as hospital outpatient departments. Both incident-to and provider-based billing limit providers' abilities to bill for and receive reimbursement in those practice settings. The Office of Inspector General's 2012 Work Plan Report identified both incident-to billing and place-of-service errors as two of the many areas for investigation and compliance efforts in 2012. This article focuses on identifying the unique point-of-service challenges presented by physicians practicing in hospital outpatient departments or hospital-owned clinics.

  14. Survey of reportable incidents in nuclear power plants in Germany in the year 1992

    International Nuclear Information System (INIS)

    1993-01-01

    In 1992, 223 reportable incidents in German nuclear power plant have been reported. There was no radioactivity release exceeding the maximum permissible limits, and there were no hazardous effects on the population or the environment. There was no incident belonging to category S of the official event scale, requiring urgent notification, while there were two incidents requiring immediate notification. All other incidents reported belonged to category N, the lowest on the scale, requiring normal notification. 216 incidents belonged to category 0 of the INES scale, and 7 to INES category 1 (disturbance). The tabulated survey of the report lists the various events and their position on the INES scale. The reportable events have been analysed thoroughly from various viewpoints, but no systematic pattern of weak points could be detected. (orig./HP) [de

  15. Effectiveness and Sustainability of Education about Incident Reporting at a University Hospital in Japan.

    Science.gov (United States)

    Nakamura, Noriko; Yamashita, Yuichi; Tanihara, Shinichi; Maeda, Chiemi

    2014-07-01

    The aim of this study was to evaluate the effectiveness and sustainability of educational interventions to encourage incident reporting. This was a quasi-experimental design. The study involved nurses working in two gastroenterology surgical wards at Fukuoka University Hospital, Japan. The number of participants on each ward was 26 nurses at baseline. For the intervention group, we provided 15 minutes of education about patient safety and the importance of incident reporting once per month for six months. After the completion of the intervention, we compared incident reporting in the subsequent 12 months for both groups. Questionnaires about reasons/motives for reporting were administered three times, before the intervention, after the intervention, and six months after the intervention for both the intervention group and the control group. For the intervention group, incident reporting during the 6 months after the intervention period increased significantly compared with the baseline. During the same period, the reasons and motives for reporting changed significantly in the intervention group. The increase in reported incidents during the 6- to 12-month period following the intervention was not significant. In the control group, there was no significant difference during follow-up compared with the baseline. A brief intervention about patient safety changed the motives for reporting incidents and the frequency of incidents reported by nurses working in surgical wards in a university hospital in Japan. However, the effect of the education decreased after six months following the education. Regular and long-term effort is required to maintain the effect of education.

  16. [Risk management in the operation room. Results of a pilot project of interdisciplinary "incident reporting"].

    Science.gov (United States)

    Horstmann, R; Hofinger, G; Mäder, M; Gaidzik, P W; Waleczek, H

    2006-08-01

    Methods for error analysis are suitable to increase patients' safety as well as staff satisfaction and may avoid, in a sense of process control, financial damage to the hospital. The aim of the presented pilot study was to establish and evaluate an incident reporting system as a first step towards a new safety culture. In June 2003 an incident reporting system was introduced in the central surgical suite, in which the surgical and anaesthesiologic departments took part as well medical and nursing staff. Besides conceiving a report form, a "board of confidence" was elected, kick-off meetings were held and a baseline study on the basis of industrial psychological knowledge was initialised. The process of creating confidence is arduous and depends elementarily on sincere cooperation of management staff, especially of the heads of the departments. The exclusive participation of only two medical departments led to conflicts. Therefore, after finishing the pilot study, the system was expanded to the whole surgical suite including all operating departments. In order to increase the motivation for the strictly voluntarily participation, the frequency of regular echoes to the staff was optimised. To achieve high acceptance in the whole staff, the board of confidence needs a clearly defined position within the system of quality management. For the first time in Germany an incident reporting system under participation of several medical departments has been installed. After finishing the pilot project, in future we will be able to evaluate changes caused by this system. Simultaneously an electronic database for reported adverse events and strategies to avoid them are being developed based on similar systems in aviation industry. In near future, the system will be of increasing importance likewise for inpatient units and non-operative departments.

  17. Birds oiled during the Amoco Cadiz incident: an interim report

    Energy Technology Data Exchange (ETDEWEB)

    Jones, P.H.; Monnat, J.Y.; Cadbury, C.J.; Stowe, T.J.

    1978-11-01

    More than 4500 oiled birds were collected from beaches in Northwest France and the Channel Islands following the oil spillage from the super tanker Amoco Cadiz in March 1978. Some 33 bird species were recorded oiled. A notable feature of the incident was the high proportion of puffins among the birds known to have been oiled. In normal years, puffins are considered to be relatively uncommon off Brittany in spring, and so the high proportion of this species among the casualties was unexpected. A relatively large number of shags and divers were also oiled. (1 map, 8 references, 2 tables)

  18. Incidence of childhood pneumonia: facility-based surveillance estimate compared to measured incidence in a South African birth cohort study

    Science.gov (United States)

    le Roux, David M; Myer, Landon; Nicol, Mark P; Zar, Heather J

    2015-01-01

    Background Pneumonia is the leading cause of childhood mortality and a major contributor to childhood morbidity, but accurate measurement of pneumonia incidence is challenging. We compared pneumonia incidence using a facility-based surveillance system to estimates from a cohort study conducted contemporaneously in the same community in Cape Town, South Africa. Methods A surveillance system was developed in six public sector primary care clinics and in a regional referral hospital, to detect childhood pneumonia cases. Nurses recorded all children presenting to facilities who met WHO case definitions of pneumonia, and hospital records were reviewed. Estimates of pneumonia incidence and severity were compared with incidence rates based on active surveillance in the Drakenstein Child Health Study. Results From June 2012 until September 2013, the surveillance system detected 306 pneumonia episodes in children under 1 year of age, an incidence of 0.20 episodes/child-year (e/cy) (95% CI 0.17 to 0.22 e/cy). The incidence in the cohort study from the same period was 0.27 e/cy (95% CI 0.23 to 0.32 e/cy). Pneumonia incidence in the surveillance system was almost 30% lower than in the birth cohort; incidence rate ratio 0.72 (95% CI 0.58 to 0.89). In the surveillance system, 18% were severe pneumonia cases, compared to 23% in the birth cohort, rate ratio 0.81 (95% CI 0.55 to 1.18). Conclusions In this setting, facility-based pneumonia surveillance detected fewer cases of pneumonia, and fewer severe cases, compared to the corresponding cohort study. Facility pneumonia surveillance using data collected by local healthcare workers provides a useful estimate of the epidemiology of childhood pneumonia but may underestimate incidence and severity. PMID:26685027

  19. Incidence of childhood pneumonia: facility-based surveillance estimate compared to measured incidence in a South African birth cohort study.

    Science.gov (United States)

    le Roux, David M; Myer, Landon; Nicol, Mark P; Zar, Heather J

    2015-12-18

    Pneumonia is the leading cause of childhood mortality and a major contributor to childhood morbidity, but accurate measurement of pneumonia incidence is challenging. We compared pneumonia incidence using a facility-based surveillance system to estimates from a cohort study conducted contemporaneously in the same community in Cape Town, South Africa. A surveillance system was developed in six public sector primary care clinics and in a regional referral hospital, to detect childhood pneumonia cases. Nurses recorded all children presenting to facilities who met WHO case definitions of pneumonia, and hospital records were reviewed. Estimates of pneumonia incidence and severity were compared with incidence rates based on active surveillance in the Drakenstein Child Health Study. From June 2012 until September 2013, the surveillance system detected 306 pneumonia episodes in children under 1 year of age, an incidence of 0.20 episodes/child-year (e/cy) (95% CI 0.17 to 0.22 e/cy). The incidence in the cohort study from the same period was 0.27 e/cy (95% CI 0.23 to 0.32 e/cy). Pneumonia incidence in the surveillance system was almost 30% lower than in the birth cohort; incidence rate ratio 0.72 (95% CI 0.58 to 0.89). In the surveillance system, 18% were severe pneumonia cases, compared to 23% in the birth cohort, rate ratio 0.81 (95% CI 0.55 to 1.18). In this setting, facility-based pneumonia surveillance detected fewer cases of pneumonia, and fewer severe cases, compared to the corresponding cohort study. Facility pneumonia surveillance using data collected by local healthcare workers provides a useful estimate of the epidemiology of childhood pneumonia but may underestimate incidence and severity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Error-Based Accidents and Security Incidents in Nuclear Materials Management

    International Nuclear Information System (INIS)

    Pond, Daniel J.; Greitzer, Frank L.

    2005-01-01

    Hazard and risk assessments, along with human error analysis and mitigation techniques, have long been mainstays of effective safety programs. These tools have revealed that worker errors contributing to or resulting in accidents are often the consequence of ineffective system conditions, process features, or individual employee characteristics. At Los Alamos National Laboratory (LANL), security, safety, human error, and organizational analysts determined that the system-induced human errors that make accidents more likely also are contributing to security incidents. A similar set of system conditions has been found to underlie deliberate, non-malevolent deviations from proper security practices - termed breaches - that also can result in a security incident. In fiscal-year (FY) 2002, LANL's Security Division therefore established the ESTHER (Enhanced Security Through Human Error Reduction) program to identify and reduce the influence of the factors that underlie employee errors and breaches and, in turn, security incidents. Recognizing the potential benefits of this program and approach, in FY2004 the Department of Energy (DOE) Office of Security Policy (DOE-SO) funded an expansion of ESTHER implementation to the causal assessment and reporting of security incidents at other DOE sites. This presentation will focus on three applications of error/breach assessment and mitigation techniques. One use is proactive, accomplished through the elimination of contributors to error, whereas two are reactive, implemented in response to accidents or security incidents as well as to near misses, to prevent recurrence. The human performance and safety bases of these techniques will be detailed. Associated tools - including computer-based assessment training and web-based incident reporting modules developed by Pacific Northwest National Laboratory - will be discussed

  1. International recommendations for national patient safety incident reporting systems: an expert Delphi consensus-building process.

    Science.gov (United States)

    Howell, Ann-Marie; Burns, Elaine M; Hull, Louise; Mayer, Erik; Sevdalis, Nick; Darzi, Ara

    2017-02-01

    Patient safety incident reporting systems (PSRS) have been established for over a decade, but uncertainty remains regarding the role that they can and ought to play in quantifying healthcare-related harm and improving care. To establish international, expert consensus on the purpose of PSRS regarding monitoring and learning from incidents and developing recommendations for their future role. After a scoping review of the literature, semi-structured interviews with experts in PSRS were conducted. Based on these findings, a survey-based questionnaire was developed and subsequently completed by a larger expert panel. Using a Delphi approach, consensus was reached regarding the ideal role of PSRSs. Recommendations for best practice were devised. Forty recommendations emerged from the Delphi procedure on the role and use of PSRS. Experts agreed reporting system should not be used as an epidemiological tool to monitor the rate of harm over time or to appraise the relative safety of hospitals. They agreed reporting is a valuable mechanism for identifying organisational safety needs. The benefit of a national system was clear with respect to medication error, device failures, hospital-acquired infections and never events as these problems often require solutions at a national level. Experts recommended training for senior healthcare professionals in incident investigation. Consensus recommendation was for hospitals to take responsibility for creating safety solutions locally that could be shared nationally. We obtained reasonable consensus among experts on aims and specifications of PSRS. This information can be used to reflect on existing and future PSRS, and their role within the wider patient safety landscape. The role of PSRS as instruments for learning needs to be elaborated and developed further internationally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Interpreting Incidence from Hospital Based Data Retrieval: A ...

    African Journals Online (AJOL)

    0.6% (as a percentage), whereas incidence being a rate, should have been quoted just as 6.1/1000 live births and not as percentage. As per the definition of incidence given above, incidence rate refers during a given time period in a specified population at risk. The measure most often used is person years and not ...

  3. Automated Generation of Traffic Incident Response Plan Based on Case-Based Reasoning and Bayesian Theory

    Directory of Open Access Journals (Sweden)

    Yongfeng Ma

    2014-01-01

    Full Text Available Traffic incident response plan, specifying response agencies and their responsibilities, can guide responders to take actions effectively and timely after traffic incidents. With a reasonable and feasible traffic incident response plan, related agencies will save many losses, such as humans and wealth. In this paper, how to generate traffic incident response plan automatically and specially was solved. Firstly, a well-known and approved method, Case-Based Reasoning (CBR, was introduced. Based on CBR, a detailed case representation and R5-cycle of CBR were developed. To enhance the efficiency of case retrieval, which was an important procedure, Bayesian Theory was introduced. To measure the performance of the proposed method, 23 traffic incidents caused by traffic crashes were selected and three indicators, Precision P, Recall R, and Indicator F, were used. Results showed that 20 of 23 cases could be retrieved effectively and accurately. The method is practicable and accurate to generate traffic incident response plans. The method will promote the intelligent generation and management of traffic incident response plans and also make Traffic Incident Management more scientific and effective.

  4. Human Factors of Remotely Piloted Aircraft Systems: Lessons from Incident Reports

    Science.gov (United States)

    Hobbs, Alan; Null, Cynthia

    2016-01-01

    An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. A total of 90 incidents were reported. Human factor issues included the impact of reduced sensory cues, traffic separation in the absence of an out-the-window view, control latencies, vigilance during monotonous and ultra-long endurance flights, control station design considerations, transfer of control between control stations, the management of lost link procedures, and decision-making during emergencies.

  5. Operating Experience from Events Reported to the IAEA Incident Reporting System for Research Reactors

    International Nuclear Information System (INIS)

    2015-03-01

    Operating experience feedback is an effective mechanism in providing lessons learned from events and the associated corrective actions to prevent them, helping to improve safety at nuclear installations. The Incident Reporting System for Research Reactors (IRSRR), which is operated by the IAEA, is an important tool for international exchange of operating experience feedback for research reactors. The IRSRR reports contain information on events of safety significance with their root causes and lessons learned which help in reducing the occurrence of similar events at research reactors. To improve the effectiveness of the system, it is essential that national organizations demonstrate an appropriate interest for the timely reporting of events important to safety and share the information in the IRSRR database. At their biennial technical meetings, the IRSRR national coordinators recommended collecting the operating experience from the events reported to the IRSRR and disseminating it in an IAEA publication. This publication highlights the root causes, safety significance, lessons learned, corrective actions and the causal factors for the events reported to the IRSRR up to September 2014. The publication also contains relevant summary information on research reactor events from sources other than the IRSRR, operating experience feedback from the International Reporting System for Operating Experience considered relevant to research reactors, and a description of the elements of an operating experience programme as established by the IAEA safety standards. This publication will be of use to research reactor operating organizations, regulators and designers, and any other organizations or individuals involved in the safety of research reactors

  6. 76 FR 54004 - Agency Information Collection (Report of Medical, Legal, and Other Expenses Incident to Recovery...

    Science.gov (United States)

    2011-08-30

    ... VA Form 21-8416b to report compensation awarded by another entity or government agency for personal... incident to the injury or death, or incident to the collection or recovery of the compensation may be... direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. BILLING CODE 8320-01...

  7. Brief Report: Incidence of and Risk Factors for Autistic Disorder in Neonatal Intensive Care Unit Survivors.

    Science.gov (United States)

    Matsuishi, Toyojiro; Yamashita, Yushiro; Ohtani, Yasuyo; Ornitz, Edward; Kuriya, Norikazu; Murakami, Yoshihiko; Fukuda, Seiichi; Hashimoto, Takeo; Yamashita, Fumio

    1999-01-01

    Analysis of the incidence of autistic disorder (AD) among 5,271 children in a neonatal intensive care unit in Japan found that 18 children were later diagnosed with AD, an incidence more than twice as high as previously reported. Children with AD had a significantly higher history of the meconium aspiration syndrome than the controls. (Author/DB)

  8. Learning from Errors: Critical Incident Reporting in Nursing

    Science.gov (United States)

    Gartmeier, Martin; Ottl, Eva; Bauer, Johannes; Berberat, Pascal Oliver

    2017-01-01

    Purpose: The purpose of this paper is to conceptualize error reporting as a strategy for informal workplace learning and investigate nurses' error reporting cost/benefit evaluations and associated behaviors. Design/methodology/approach: A longitudinal survey study was carried out in a hospital setting with two measurements (time 1 [t1]:…

  9. The incidence of ulcerative colitis (1995-2011) and Crohn's disease (1995-2012) - Based on nationwide Danish registry data

    DEFF Research Database (Denmark)

    Nørgård, Bente Mertz; Nielsen, Jan; Fonager, Kirsten

    2014-01-01

    BACKGROUND AND AIMS: The incidence of ulcerative colitis (UC) and Crohn's disease (CD) has increased during the 20th century in North America and Western Europe. However, there are conflicting reports whether the incidence has declined, stabilized or even continued to increase. No nationwide Danish...... data on the incidence of UC and CD exist after 1992, and therefore we studied the incidence of UC (1995 through 2011) and CD (1995 through 2012). METHODS: Based on data from the Danish National Patient Registry we identified patients recorded with a first time diagnosis of UC or CD in the study periods....... Among these - patients were only included in the study as incident cases if they had at least one more discharge diagnosis of UC/CD or at least three subsequent outpatient visits. RESULTS: We identified 17,500 patients with UC and 7863 patients with CD. The mean incidence rate for UC in 1995-1998 was 14...

  10. The United States Department of Energy (DOE) Computerized Accident/Incident Reporting System (CAIRS)

    International Nuclear Information System (INIS)

    Briscoe, G.J.

    1993-01-01

    The Department of Energy's (DOE) Computerized Accident/Incident Reporting System (CAIRS) is a comprehensive data base containing more than 50,000 investigation reports of injury/illness, property damage and vehicle accident cases representing safety data from 1975 to the present for more than 150 DOE contractor organizations. A special feature is that the text of each accident report is translated using a controlled dictionary and rigid sentence structure called Factor Relationship and Sequence of Events (FRASE) that enhances the ability to retrieve specific types of information and to perform detailed analyses. DOE summary and individual contractor reports are prepared quarterly and annually. In addition, ''Safety Performance Profile'' reports for individual organizations are prepared to provide advance information to appraisal teams, and special topical reports are prepared for areas of concern such as an increase in the number of security injuries or environmental releases. The data base is open to all DOE and Contractor registered users with no access restrictions other than that required by the Privacy Act

  11. EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

    Science.gov (United States)

    DeFraia, Gary S

    2013-01-01

    Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

  12. SU-E-T-511: Inter-Rater Variability in Classification of Incidents in a New Incident Reporting System

    International Nuclear Information System (INIS)

    Pappas, D; Reis, S; Ali, A; Kapur, A

    2015-01-01

    Purpose To determine how consistent the results of different raters are when reviewing the same cases within the Radiation Oncology Incident Learning System (ROILS). Methods Three second-year medical physics graduate students filled out incident reports in spreadsheets set up to mimic ROILS. All students studied the same 33 cases and independently entered their assessments, for a total of 99 reviewed cases. The narratives for these cases were obtained from a published International Commission on Radiological Protection (ICRP) report which included shorter narratives selected from the Radiation Oncology Safety Information System (ROSIS) database. Each category of questions was reviewed to see how consistent the results were by utilizing free-marginal multirater kappa analysis. The percentage of cases where all raters shared full agreement or full disagreement was recorded to show which questions were answered consistently by multiple raters for a given case. The consistency among the raters was analyzed between ICRP and ROSIS cases to see if either group led to more reliable results. Results The categories where all raters agreed 100 percent in their choices were the event type (93.94 percent of cases 0.946 kappa) and the likelihood of the event being harmful to the patient (42.42 percent of cases 0.409 kappa). The categories where all raters disagreed 100 percent in their choices were the dosimetric severity scale (39.39 percent of cases 0.139 kappa) and the potential future toxicity (48.48 percent of cases 0.205 kappa). ROSIS had more cases where all raters disagreed than ICRP (23.06 percent of cases compared to 15.58 percent, respectively). Conclusion Despite reviewing the same cases, the results among the three raters was widespread. ROSIS narratives were shorter than ICRP, which suggests that longer narratives lead to more consistent results. This study shows that the incident reporting system can be optimized to yield more consistent results

  13. SU-E-T-511: Inter-Rater Variability in Classification of Incidents in a New Incident Reporting System

    Energy Technology Data Exchange (ETDEWEB)

    Pappas, D; Reis, S; Ali, A [Hofstra University, Hempstead, NY (United States); Kapur, A [Long Island Jewish Medical Center, New Hyde Park, NY (United States)

    2015-06-15

    Purpose To determine how consistent the results of different raters are when reviewing the same cases within the Radiation Oncology Incident Learning System (ROILS). Methods Three second-year medical physics graduate students filled out incident reports in spreadsheets set up to mimic ROILS. All students studied the same 33 cases and independently entered their assessments, for a total of 99 reviewed cases. The narratives for these cases were obtained from a published International Commission on Radiological Protection (ICRP) report which included shorter narratives selected from the Radiation Oncology Safety Information System (ROSIS) database. Each category of questions was reviewed to see how consistent the results were by utilizing free-marginal multirater kappa analysis. The percentage of cases where all raters shared full agreement or full disagreement was recorded to show which questions were answered consistently by multiple raters for a given case. The consistency among the raters was analyzed between ICRP and ROSIS cases to see if either group led to more reliable results. Results The categories where all raters agreed 100 percent in their choices were the event type (93.94 percent of cases 0.946 kappa) and the likelihood of the event being harmful to the patient (42.42 percent of cases 0.409 kappa). The categories where all raters disagreed 100 percent in their choices were the dosimetric severity scale (39.39 percent of cases 0.139 kappa) and the potential future toxicity (48.48 percent of cases 0.205 kappa). ROSIS had more cases where all raters disagreed than ICRP (23.06 percent of cases compared to 15.58 percent, respectively). Conclusion Despite reviewing the same cases, the results among the three raters was widespread. ROSIS narratives were shorter than ICRP, which suggests that longer narratives lead to more consistent results. This study shows that the incident reporting system can be optimized to yield more consistent results.

  14. Incidence of Self-Reported Diabetes in New York City, 2002, 2004, and 2008

    Science.gov (United States)

    Chamany, Shadi; Driver, Cynthia R.; Kerker, Bonnie; Silver, Lynn

    2012-01-01

    Introduction Prevalence and incidence of diabetes among adults are increasing in the United States. The purpose of this study was to estimate the incidence of self-reported diabetes in New York City, examine factors associated with diabetes incidence, and estimate changes in the incidence over time. Methods We used data from the New York City Community Health Survey in 2002, 2004, and 2008 to estimate the age-adjusted incidence of self-reported diabetes among 24,384 adults aged 18 years or older. Multiple logistic regression analysis was performed to examine factors associated with incident diabetes. Results Survey results indicated that the age-adjusted incidence of diabetes per 1,000 population was 9.4 in 2002, 11.9 in 2004, and 8.6 in 2008. In multivariable-adjusted analysis, diabetes incidence was significantly associated with being aged 45 or older, being black or Hispanic, being overweight or obese, and having less than a high school diploma. Conclusion Our results suggest that the incidence of diabetes in New York City may be stabilizing. Age, black race, Hispanic ethnicity, elevated body mass index, and low educational attainment are risk factors for diabetes. Large-scale implementation of prevention efforts addressing obesity and sedentary lifestyle and targeting racial/ethnic minority groups and those with low educational attainment are essential to control diabetes in New York City. PMID:22698175

  15. Plutonium Reclamation Facility incident response project progress report

    Energy Technology Data Exchange (ETDEWEB)

    Austin, B.A.

    1997-11-25

    This report provides status of Hanford activities in response to process deficiencies highlighted during and in response to the May 14, 1997, explosion at the Plutonium Reclamation Facility. This report provides specific response to the August 4, 1997, memorandum from the Secretary which requested a progress report, in 120 days, on activities associated with reassessing the known and evaluating new vulnerabilities (chemical and radiological) at facilities that have been shut down, are in standby, are being deactivated or have otherwise changed their conventional mode of operation in the last several years. In addition, this report is intended to provide status on emergency response corrective activities as requested in the memorandum from the Secretary on August 28, 1997. Status is also included for actions requested in the second August 28, 1997, memorandum from the Secretary, regarding timely notification of emergencies.

  16. Investigation and evaluation of cracking incidents in piping in pressurized water reactors. Technical report

    International Nuclear Information System (INIS)

    1980-09-01

    This report summarizes an investigation of known cracking incidents in pressurized water reactor plants. Several instances of cracking in feedwater piping in 1979, together with reported cases of stress corrosion cracking at Three Mile Island Unit 1, led to the establishment of the third Pipe Crack Study Group. Major differences between the scope of the third PCSG and the previous two are: (1) the emphasis given to systems safety implications of cracking, and (2) the consideration given all cracking mechanisms known to affect PWR piping, including the failure of small lines in secondary safety systems. The present PCSG reviewed existing information on cracking of PWR pipe systems, either contained in written records of collected from meetings in the United States, and made recommendations in response to the PCSG charter questions and to othe major items that may be considered to either reduce the potential for cracking or to improve licensing bases

  17. A population-based study of retinoblastoma incidence and survival in Argentine children.

    Science.gov (United States)

    Moreno, Florencia; Sinaki, Banafsheh; Fandiño, Adriana; Dussel, Verónica; Orellana, Liliana; Chantada, Guillermo

    2014-09-01

    An increased incidence of retinoblastoma in some developing countries has been reported but no conclusive data are available from population-based studies at national level. To report the incidence and survival of retinoblastoma in Argentina from the National Pediatric Cancer Registry (ROHA) and the influence of socio-economical indicators on outcome. Cases reported to the ROHA (2000-2009) were analyzed. Incidence rates were calculated using National Vital Statistics and survival was estimated. The extended human development index (EHDI) was used as a socio-economical indicator. With 438 patients reported, an incidence of 5.0 cases per million children 0-14 years old (95% CI 3.5-6.4) was calculated. Median age at diagnosis was significantly higher for children from provinces with lower EHDI; (24 vs. 35 months for unilateral, (P = 0.003) and 9 versus 11.5 months for bilateral retinoblastoma (P = 0.027). The 3-year probability of survival was 0.87 and 0.94 for unilateral and bilateral retinoblastoma, respectively. Residents in provinces with higher EHDI had a better 3-year survival (0.93 vs. 0.77 for lower EHDI, P < 0.0001). Probability of survival was higher for patients treated at tertiary level institutions (P = 0.0015). The combination of low EHDI residence province with no treatment at a tertiary institution was associated with the worst survival outcome. For both, unilateral and bilateral disease, children who died were in average diagnosed at older age. The incidence of retinoblastoma in Argentina is comparable to that of developed countries. Retinoblastoma is diagnosed later and survival is lower in the less developed areas of the country. © 2014 Wiley Periodicals, Inc.

  18. Incident reporting by acute pain service at a tertiary care university hospital

    Directory of Open Access Journals (Sweden)

    Aliya Ahmed

    2015-01-01

    Conclusion: Reporting of untoward incidents and their regular analysis by APS is recommended to ensure high-quality patient care and to provide guidance in making teaching strategies and guidelines to improve patient safety.

  19. Department of Veterans Affairs - Monthly Report to Congress of Data Incidents (April 2014)

    Data.gov (United States)

    Department of Veterans Affairs — This is a monthly report that the VA Office of Information Technology provides to congress about data incidents that took place during the month (April 2014). The...

  20. Analysis of immediate transfusion incidents reported in a regional blood bank

    Directory of Open Access Journals (Sweden)

    Adriana Lemos de Sousa Neto

    2011-10-01

    Full Text Available BACKGROUND: Blood transfusion is imperative when treating certain patients; however, it is not risk free. In addition to the possible transmission of contagious infectious diseases, incidents can occur immediately after transfusion and at a later time. AIMS: This study aimed to examine the immediate transfusion incidents reported in a regional blood bank in the state of Minas Gerais between December 2006 and December 2009. A retrospective quantitative epidemiological study was conducted. Data were obtained from 202 transfusion incident reports of 42 health institutions served by the blood bank. Data processing and analysis were carried out using the Statistical Package for the Social Sciences (SPSS software. RESULTS: The rate of immediate transfusion incidents reported in the period was 0.24%; febrile non-hemolytic reactions were the most common type of incident (56.4%. The most frequent clinical manifestations listed in transfusion incident reports were chills (26.9% and fever (21.6%. There was a statistically significant association (p-value < 0.05 between the infusion of platelet concentrates and febrile non-hemolytic reactions and between fresh frozen plasma and febrile non-hemolytic reaction. The majority (73.3% of transfused patients who suffered immediate transfusion incidents had already been transfused and 36.5% of the cases had previous transfusion incident reports. CONCLUSIONS: Data from the present study corroborate the implementation of new professional training programs aimed at blood transfusion surveillance. These measures should emphasize prevention, identification and reporting of immediate transfusion incidents aiming to increase blood transfusion quality and safety.

  1. Identifying Predictive Factors for Incident Reports in Patients Receiving Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Elnahal, Shereef M., E-mail: selnaha1@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Blackford, Amanda [Department of Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Smith, Koren; Souranis, Annette N.; Briner, Valerie; McNutt, Todd R.; DeWeese, Theodore L.; Wright, Jean L.; Terezakis, Stephanie A. [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States)

    2016-04-01

    Purpose: To describe radiation therapy cases during which voluntary incident reporting occurred; and identify patient- or treatment-specific factors that place patients at higher risk for incidents. Methods and Materials: We used our institution's incident learning system to build a database of patients with incident reports filed between January 2011 and December 2013. Patient- and treatment-specific data were reviewed for all patients with reported incidents, which were classified by step in the process and root cause. A control group of patients without events was generated for comparison. Summary statistics, likelihood ratios, and mixed-effect logistic regression models were used for group comparisons. Results: The incident and control groups comprised 794 and 499 patients, respectively. Common root causes included documentation errors (26.5%), communication (22.5%), technical treatment planning (37.5%), and technical treatment delivery (13.5%). Incidents were more frequently reported in minors (age <18 years) than in adult patients (37.7% vs 0.4%, P<.001). Patients with head and neck (16% vs 8%, P<.001) and breast (20% vs 15%, P=.03) primaries more frequently had incidents, whereas brain (18% vs 24%, P=.008) primaries were less frequent. Larger tumors (17% vs 10% had T4 lesions, P=.02), and cases on protocol (9% vs 5%, P=.005) or with intensity modulated radiation therapy/image guided intensity modulated radiation therapy (52% vs 43%, P=.001) were more likely to have incidents. Conclusions: We found several treatment- and patient-specific variables associated with incidents. These factors should be considered by treatment teams at the time of peer review to identify patients at higher risk. Larger datasets are required to recommend changes in care process standards, to minimize safety risks.

  2. 77 FR 69925 - Assessment of Hazardous Materials Incident Data Collection, Analysis, Reporting, and Use

    Science.gov (United States)

    2012-11-21

    ... for an assessment to improve the collection, analysis, reporting, and use of data related to accidents... Department to conduct an assessment to improve the collection, analysis, reporting, and use of data related... improving the collection, analysis, reporting, and use of data related to accidents and incidents involving...

  3. Population-based epidemiology and incidence of distal femur fractures

    DEFF Research Database (Denmark)

    Elsoe, Rasmus; Ceccotti, Adriano Axel; Larsen, Peter

    2018-01-01

    The literature lacks recent epidemiological studies on the incidence, trauma mechanism and fracture classification of distal femur fractures. The aim of the present study was to provide up-to-date information concerning the incidence of distal femur fractures in a large and complete population...

  4. Causes of General Aviation Weather-Related, Non-Fatal Incidents: Analysis Using NASA Aviation Safety Reporting System Data

    Science.gov (United States)

    2010-09-01

    Certified Flight Instructor-Instrument CFIT Controlled flight into terrain FAA U.S. Federal Aviation Administration FBO Fixed-base operator FSS Flight...William R. Knecht Michael Lenz Civil Aerospace Medical Institute Federal Aviation Administration Oklahoma City, OK 73125 September 2010 Final Report...Causes of General Aviation Weather- Related, Non-Fatal Incidents: Analysis Using NASA Aviation Safety Reporting System Data DOT/FAA/AM-10/13 Office

  5. Cancer incidence in Morocco: report from Casablanca registry 2005 ...

    African Journals Online (AJOL)

    Introduction: Few population-based cancer registries are in place in developing countries. In order to know the burden of cancer in Moroccan population, cancer registry initiative was put in place in the Casablanca district, the biggest city of Morocco. Methods: The data collected covers 3.6 millions inhabitant and included ...

  6. In situ simulation: Taking reported critical incidents and adverse events back to the clinic

    DEFF Research Database (Denmark)

    Juul, Jonas; Paltved, Charlotte; Krogh, Kristian

    2014-01-01

    improve patient safety if coupled with training and organisational support2. Insight into the nature of reported critical incidents and adverse events can be used in writing in situ simulation scenarios and thus lead to interventions that enhance patient safety. The patient safety literature emphasises...... well-developed non-technical skills in preventing medical errors3. Furthermore, critical incidents and adverse events reporting systems comprise a knowledgebase to gain in-depth insights into patient safety issues. This study explores the use of critical incidents and adverse events reports to inform...... in situ simulation to improve patient safety. Design and purpose The study uses a case study design of in situ simulation training tailored to two emergency departments in the Central Denmark Region. We aim to: - Develop a model that integrates critical incidents and adverse events, a contextual needs...

  7. Statistical analysis of incidents reported in the Greek Petrochemical Industry for the period 1997-2003

    International Nuclear Information System (INIS)

    Konstandinidou, Myrto; Nivolianitou, Zoe; Markatos, Nikolaos; Kiranoudis, Chris

    2006-01-01

    This paper makes an analysis of all reported accidents and incidents in the Greek Petrochemical Industry for the period spanning from 1997 to 2003. The work performed is related to the analysis of important parameters of the incidents, their inclusion in a database adequately designed for the purposes of this analysis and an importance assessment of this reporting scheme. Indeed, various stakeholders have highlighted the importance of a reporting system for industrial accidents and incidents. The European Union has established for this purpose the Major Accident Reporting System (MARS) for the reporting of major accidents in the Member States. However, major accidents are not the only measure that can characterize the safety status of an establishment; neither are the former the only events from which important lessons can be learned. Near misses, industrial incidents without major consequences, as well as occupational accidents could equally supply with important findings the interested analyst, while statistical analysis of these incidents could give significant insight in the understanding and the prevention of similar incidents or major accidents in the future. This analysis could be more significant, if each industrial sector was separately analyzed, as the authors do for the petrochemical sector in the present article

  8. Investigation of reactor incident reports with regard to human malfunctions as far as these had an effect on the incident history

    International Nuclear Information System (INIS)

    Hoffmann, E.

    1984-01-01

    The study has the aim to examine by means of a human failure analysis the operation of a nuclear power plant with regard to its weak points, in order to deduce by this starting-points for operational improvements. Contrary to most studies published on this subject and which are often based on free-hand hypotheses and plausibility studies here, the experience gained in the operation is systematically examined with regard to human malfunction and their deeper causes, i.e. on the experience which was founded on some 1,000 collected reports on incidents. (orig./GL) [de

  9. Patient safety incidents involving neuromuscular blockade: analysis of the UK National Reporting and Learning System data from 2006 to 2008.

    Science.gov (United States)

    Arnot-Smith, J; Smith, A F

    2010-11-01

    Neuromuscular blockade is a powerful anaesthetic tool that has the potential for significant adverse outcomes. We sought to explore the national picture by analysing incidents relating to neuromuscular blockade in anaesthesia from the National Reporting and Learning System from England and Wales between 2006 and 2008. We searched the database of incidents using SNOMED CT search terms and reading the free text of relevant incidents. There were 231 incidents arising from the use or reversal of neuromuscular blocking agents. The main themes identified were: non-availability of drugs (45 incidents, 19%), possible unintentional awareness under general anaesthesia (42 incidents, 18%), potential allergic reaction (31 incidents, 13%), problems with reversal of blockade (13 incidents, 6%), storage (13 incidents, 6%) and prolonged apnoea (11 incidents, 5%). We make recommendations to reduce human error in the use of neuromuscular blocking agents and on future incident reporting in anaesthesia. © 2010 The Authors. Anaesthesia © 2010 The Association of Anaesthetists of Great Britain and Ireland.

  10. Incident reporting: Its role in aviation safety and the acquisition of human error data

    Science.gov (United States)

    Reynard, W. D.

    1983-01-01

    The rationale for aviation incident reporting systems is presented and contrasted to some of the shortcomings of accident investigation procedures. The history of the United State's Aviation Safety Reporting System (ASRS) is outlined and the program's character explained. The planning elements that resulted in the ASRS program's voluntary, confidential, and non-punitive design are discussed. Immunity, from enforcement action and misuse of the volunteered data, is explained and evaluated. Report generation techniques and the ASRS data analysis process are described; in addition, examples of the ASRS program's output and accomplishments are detailed. Finally, the value of incident reporting for the acquisition of safety information, particularly human error data, is explored.

  11. Incidence of multiple sclerosis in the Republic of Ireland: A prospective population-based study.

    Science.gov (United States)

    O'Connell, K; Tubridy, N; Hutchinson, M; McGuigan, C

    2017-04-01

    Multiple sclerosis (MS) incidence and prevalence is increasing worldwide, with a disproportionally higher rate in women. Recent studies have questioned the presence of a latitudinal gradient in Europe. Ireland is a high prevalence country for MS with a previously reported North-South gradient making it ideal to further explore this concept. In this study we prospectively determined the incidence rate of newly diagnosed MS in Ireland over a 12-month period and demonstrated the presence of a North-South gradient. A national prospective population-based observational study was performed to ascertain all new cases of MS diagnosed from 1st March 2014 - 28th February 2015 in the Ireland. Within the main study there was a smaller nested cohort study to explore clinical outcomes with a view to future prospective follow-up of this cohort. Sources of case ascertainment included neurologists, MS nurse specialists and MS support services. The Irish census 2011 was used to obtain population statistics and the incidence rate was age-standardized to a European Standardised Population (ESP 2011). The North-South gradient was assessed, by comparing incidence rates between northern and southern counties. 292 patients fulfilled the inclusion criteria equating to an age-standardised incidence rate (A-SIR) of 6/100,000 (95% CI: 5.3-6.6); for women the rate was 8.7/100,000 (95% CI: 7.7-9.6) and for men 3.3/100,000 (95% CI: 3.0-3.7). The female to male sex ratio was 2.7:1. Mean age at diagnosis amongst the RRMS group was 37 years (SD: 9.6) and 55 years (SD: 7.7) in the PPMS group; there were no gender differences associated with age of diagnosis. Onset was progressive in 10% of cases. A significant difference was seen in incidence rates between the northern region (A-SIR: 9.6×10 5 , CI: 6.9-12.3) and the southern region (A-SIR: 5.1×10 5 , CI: 3.8-6.3) (Z-score =3.34, pIreland and shows that Ireland has a high incidence rate, comparable with the rest of the British Isles, with a

  12. Acquisition and analysis of road incidents based on vehicle dynamics.

    Science.gov (United States)

    Naude, Claire; Serre, Thierry; Dubois-Lounis, Maxime; Fournier, Jean-Yves; Lechner, Daniel; Guilbot, Michèle; Ledoux, Vincent

    2017-03-09

    Because motor vehicle crashes have decreased during the last decade in many countries in the world and are more diffuse, local authorities have difficulties to define road safety policies. An experiment with 51 cars of public fleets equipped with a specific Event Data Recorder was carried out in France during one year. The purposes of this research were to evaluate if incident data (critical driving situations) help to understand crashes, and to explore a new way for road infrastructure safety diagnosis. The analysis of 339 genuine incidents and 1237 simple events recorded illustrates the potentiality of such an experiment and provides: some insights about conditions in which incidents occur, a general overview of their distribution according to different road layouts, as well as information on the different levels of accelerations reached. It can be noticed that there is an overrepresentation of incidents in right curves compared to left curves. The simple events involving mostly the infrastructure could be used to detect road defects. Genuine incidents where the vehicle is subjected to important dynamic demands, related to potentially unsafe driving situations, can be used to improve knowledge of the motor vehicle crashes thanks to incident mechanisms analysis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Quality review of an adverse incident reporting system and root cause analysis of serious adverse surgical incidents in a teaching hospital of Scotland

    Directory of Open Access Journals (Sweden)

    Khorsandi Maziar

    2012-08-01

    Full Text Available Abstract Background A significant proportion of surgical patients are unintentionally harmed during their hospital stay. Root Cause Analysis (RCA aims to determine the aetiology of adverse incidents that lead to patient harm and produce a series of recommendations, which would minimise the risk of recurrence of similar events, if appropriately applied to clinical practice. A review of the quality of the adverse incident reporting system and the RCA of serious adverse incidents at the Department of Surgery of Ninewells hospital, in Dundee, United Kingdom was performed. Methods The Adverse Incident Management (AIM database of the Department of Surgery of Ninewells Hospital was retrospectively reviewed. Details of all serious (red, sentinel incidents recorded between May 2004 and December 2009, including the RCA reports and outcomes, where applicable, were reviewed. Additional related information was gathered by interviewing the involved members of staff. Results The total number of reported surgical incidents was 3142, of which 81 (2.58% cases had been reported as red or sentinel. 19 of the 81 incidents (23.4% had been inappropriately reported as red. In 31 reports (38.2% vital information with regards to the details of the adverse incidents had not been recorded. In 12 cases (14.8% the description of incidents was of poor quality. RCA was performed for 47 cases (58% and only 12 cases (15% received recommendations aiming to improve clinical practice. Conclusion The results of our study demonstrate the need for improvement in the quality of incident reporting. There are enormous benefits to be gained by this time and resource consuming process, however appropriate staff training on the use of this system is a pre-requisite. Furthermore, sufficient support and resources are required for the implementation of RCA recommendations in clinical practice.

  14. Based on Agent Model and K-Core Decomposition to Analyze the Diffusion of Mass Incident in Microblog

    Directory of Open Access Journals (Sweden)

    Jun Pan

    2017-01-01

    Full Text Available Mass incidents, which may influence the stability and security of the society in China, are getting more and more attentions not only from policy makers but also from Chinese social researchers. Catching the diffusion mechanism is believed to be critical to understand essential of these mass incidents since message dissemination plays important roles in every stage of mass incident. Recently, online social networks including Weibo (Chinese Twitter become more and more popular in China. There are reports showing that Weibo discussion has accompanied the processes of most mass incidents happening in China in these few years. So, in this paper, we aim at introducing K-Core decomposition method from complex network to the analysis on how to manage the diffusion of mass incident in Weibo based on agent based model which can simulate Weibo user’s actions when mass incident happens. This work can help people understand how mass incident messages spread across the network. And then, people may have better strategy to manage the diffusion of mass incidents.

  15. Direct comparison of first-contact versus longitudinal register-based case finding in the same population : early evidence that the incidence of schizophrenia may be three times higher than commonly reported

    NARCIS (Netherlands)

    Hogerzeil, S. J.; van Hemert, A. M.; Rosendaal, F. R.; Susser, E.; Hoek, H. W.

    2014-01-01

    Background. The incidence of schizophrenia is commonly estimated by screening for psychosis among subjects presenting to psychiatric services. This approach (using a first-contact sampling frame) cannot account for cases that did not meet criteria for schizophrenia at first contact. We compared the

  16. A cross-sectional mixed methods study protocol to generate learning from patient safety incidents reported from general practice

    OpenAIRE

    Carson-Stevens, Andrew; Hibbert, Peter; Avery, Anthony; Butlin, Amy; Carter, Ben; Cooper, Alison; Evans, Huw Prosser; Gibson, Russell; Luff, Donna; Makeham, Meredith; McEnhill, Paul; Panesar, Sukhmeet S; Parry, Gareth; Rees, Philippa; Shiels, Emma

    2015-01-01

    INTRODUCTION: Incident reports contain descriptions of errors and harms that occurred during clinical care delivery. Few observational studies have characterised incidents from general practice, and none of these have been from the England and Wales National Reporting and Learning System. This study aims to describe incidents reported from a general practice care setting.METHODS AND ANALYSIS: A general practice patient safety incident classification will be developed to characterise patient s...

  17. Incident reporting by acute pain service at a tertiary care university hospital

    Science.gov (United States)

    Ahmed, Aliya; Yasir, Muhammad

    2015-01-01

    Background and Aims: Provision of effective and safe postoperative pain management is the principal responsibility of acute pain services (APSs). Continuous quality assurance is essential for high-quality patient care. We initiated anonymous reporting of critical incidents by APS to ensure continuous quality improvement and here present prospectively collected data on the reported incidents. Our objective was to analyze the frequency and nature of incidents and to see if any harm was caused to patients. Material and Methods: Data were collected from January 1, 2012 to September 30, 2013. An incident related to pain management was defined as An incident that occurs in a patient receiving pain management supervised by APS, and causes or has the potential to cause harm or affects patient safety. A form was filled including incident type, personnel involved, any harm caused, and steps taken to rectify it. Frequencies and percentages were computed for categorical variables. Results: A total of 2042 patients were seen and 442 (21.64%) incidents reported during the study period, including documentation errors (136/31%), noncompliance with protocols (113/25.56%), wrong combination of drugs (56/12.66%), premature discontinuation (74/16.72%), prolonged delays in change of syringes (27/6.10%), loss to follow-up (19/4.29%), administration of contraindicated drugs (9/2.03%), catheter pull-outs (6/1.35%), and faulty equipment (2/0.45%). Steps were taken to rectify the errors accordingly. No harm was caused to any patient. Conclusion: Reporting of untoward incidents and their regular analysis by APS is recommended to ensure high-quality patient care and to provide guidance in making teaching strategies and guidelines to improve patient safety. PMID:26702208

  18. Incident reporting in dentistry: Clinical supervisor's awareness, practice and perceived barriers.

    Science.gov (United States)

    AlBlaihed, R M; AlSaeed, M I; Abuabat, A A; Ahsan, S H

    2017-12-21

    The significance of patient safety and risk management in dentistry has surfaced as dental settings bear delicate procedures carried out by teams utilising numerous devices and tools in complex environments. Our aim is to assess awareness, practice, attitude and perceived barriers of reporting incidents amongst dental clinical supervisors working at dental colleges in Riyadh, Saudi Arabia. The objectives are as follows: (i) Determine if correlations exist between socio-demographic data and supervisors' awareness, practice, attitude and perceived barriers. (ii) Identify most common perceived barriers. An online questionnaire was sent to the 450 clinical supervisors working at five dental colleges of Riyadh. The collected data included items assessing the awareness, practice and attitude of reporting students' incidents along with the perceived barriers. A response rate of (60.1% n = 264 of 450) was established. The majority of the respondents (62.9% n = 166) were aware of the incident reporting policy. Yet, only (35.4% n = 93) of them had completed an incident reporting form before. Most of the participants (90.5% n = 239) agreed on the necessity of reporting student's incidents, but only (67.0% n = 177) agreed on the necessity of reporting well-handled incidents. The possible negative relationship with students was the most agreed on barrier to reporting. This study shows that certain demographics of supervisors had significant relationship with their awareness, attitude, perceived barriers and practice. Awareness of the policy and form was linked to the increase in supervisors' practice, although they tend to report verbally rather than in writing. The possible negative relationship with students was the most common perceived barrier. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Incidence and pattern of 12 years of reported transfusion adverse events in Zimbabwe: A retrospective analysis

    NARCIS (Netherlands)

    Mafirakureva, Nyashadzaishe; Khoza, Star; Mvere, David A.; Chitiyo, McLeod E.; Postma, Maarten J.; Van Hulst, Marinus

    2014-01-01

    Background. Haemovigilance hinges on a systematically structured reporting system, which unfortunately does not always exist in resource-limited settings. We determined the incidence and pattern of transfusion-related adverse events reported to the National Blood Service Zimbabwe. Materials and

  20. 77 FR 53779 - Reports by Air Carriers on Incidents Involving Animals During Air Transport

    Science.gov (United States)

    2012-09-04

    ... Involving Animals During Air Transport AGENCY: Office of the Secretary (OST), Department of Transportation... period of an NPRM on the reporting of incidents involving animals during air transport that was published... animal during air transport. The NPRM proposed to: (1) Expand the reporting requirement to U.S. carriers...

  1. 76 FR 72850 - Adjustment of Monetary Threshold for Reporting Rail Equipment Accidents/Incidents for Calendar...

    Science.gov (United States)

    2011-11-28

    ... increase, as keeping the 2011 threshold in place would not allow it to keep pace with the increasing dollar... (DOT). ACTION: Final rule. SUMMARY: This rule increases the rail equipment accident/incident reporting... reflect cost increases that have occurred since the reporting threshold was last published in December of...

  2. Integrating incident data from five reporting systems to assess patient safety: making sense of the elephant.

    Science.gov (United States)

    Levtzion-Korach, Osnat; Frankel, Allan; Alcalai, Hanna; Keohane, Carol; Orav, John; Graydon-Baker, Erin; Barnes, Janet; Gordon, Kathleen; Puopulo, Anne Louise; Tomov, Elena Ivanova; Sato, Luke; Bates, David W

    2010-09-01

    A study was conducted to examine and compare information gleaned from five different reporting systems within one institution: incident reporting, patient complaints, risk management, medical malpractice claims, and executive walk rounds. These data sources vary in the timing of the reporting (retrospective or prospective), severity of the events, and profession of the reporters. A common methodology was developed for classifying incidents. Data specific to each incident were abstracted from each system and then categorized using the same framework into one of 23 categories. Overall, there was little overlap, although each reporting system identified important safety issues. Communication problems were common among patient complaints and malpractice claims; malpractice claims' leading category was clinical judgement. Walk rounds identified issues with equipment and supplies. Adverse event reporting systems highlighted identification issues, especially mislabelled specimens. The frequency of contributions of reports by provider group varied substantially by system. Physicians accounted for 50% of risk management reports, but in adverse event reporting, where nurses were the main reporters, physicians accounted for only 2.5% of reports. Complaints and malpractice claims come primarily from patients. The five reporting systems each identified different yet complementary patient safety issues. To obtain a comprehensive picture of their patient safety problems and to develop priorities for improving safety, hospitals should use a broad portfolio of approaches and then synthesize the messages from all individual approaches into a collated and cohesive whole.

  3. Medication incidents related to automated dose dispensing in community pharmacies and hospitals--a reporting system study.

    Directory of Open Access Journals (Sweden)

    Ka-Chun Cheung

    Full Text Available INTRODUCTION: Automated dose dispensing (ADD is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may introduce new safety issues. This descriptive study provides insight into the nature and consequences of medication incidents related to ADD, as reported by healthcare professionals in community pharmacies and hospitals. METHODS: The medication incidents that were submitted to the Dutch Central Medication incidents Registration (CMR reporting system were selected and characterized independently by two researchers. MAIN OUTCOME MEASURES: Person discovering the incident, phase of the medication process in which the incident occurred, immediate cause of the incident, nature of incident from the healthcare provider's perspective, nature of incident from the patient's perspective, and consequent harm to the patient caused by the incident. RESULTS: From January 2012 to February 2013 the CMR received 15,113 incidents: 3,685 (24.4% incidents from community pharmacies and 11,428 (75.6% incidents from hospitals. Eventually 1 of 50 reported incidents (268/15,113 = 1.8% were related to ADD; in community pharmacies more incidents (227/3,685 = 6.2% were related to ADD than in hospitals (41/11,428 = 0.4%. The immediate cause of an incident was often a change in the patient's medicine regimen or relocation. Most reported incidents occurred in two phases: entering the prescription into the pharmacy information system and filling the ADD bag. CONCLUSION: A proportion of incidents was related to ADD and is reported regularly, especially by community pharmacies. In two phases, entering the prescription into the pharmacy information system and filling the ADD bag, most incidents occurred. A change in the patient's medicine regimen or relocation was the immediate causes of an

  4. Community-based incidence rate of cardiovascular disease and mortality in 50-75 year old adults.

    Science.gov (United States)

    López-Suárez, A; Bascuñana-Quirell, A; Elvira-González, J; Beltrán-Robles, M; Aboza-Lobatón, A; Solís-Díaz, R

    2013-01-01

    Updated information on the incidence of the principal cardiovascular diseases (CVD) and cardiovascular mortality is not available in Spain. We have studied the incidence rate of new cases of myocardial infarction, heart failure, stroke and cardiovascular mortality in the adult population in Sanlúcar de Barrameda (Spain). A community-based prospective follow-up study was conducted. The study enrolled 858 participants aged 50-75 years who were randomly selected from the population and followed-up for 5 years. Age and gender-adjusted incidence rates of cardiovascular disease and cardiovascular mortality were calculated, obtaining complete information for 855 participants. Prognostic risk factors of new cases of cardiovascular disease were obtained using Cox proportional hazard modeling. The community-based incidence rate of heart failure was 455/100.000 persons-year. The incidence of myocardial infarction, stroke and cardiovascular mortality (506, 216 and 225/100.000 persons-year, respectively) was also very elevated. Male gender, family history of early cardiovascular disease, diabetes, hypertension and sedentary life style were independent risk factors of cardiovascular disease. The community-based incidence rate of heart failure in Sanlúcar de Barrameda (Spain) is very high, and it is the first to be reported in Spain. The incidence of myocardial infarction is among the highest in Spain. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  5. Sensitivity of routine system for reporting patient safety incidents in an NHS hospital: retrospective patient case note review.

    Science.gov (United States)

    Sari, Ali Baba-Akbari; Sheldon, Trevor A; Cracknell, Alison; Turnbull, Alastair

    2007-01-13

    To evaluate the performance of a routine incident reporting system in identifying patient safety incidents. Two stage retrospective review of patients' case notes and analysis of data submitted to the routine incident reporting system on the same patients. A large NHS hospital in England. 1006 hospital admissions between January and May 2004: surgery (n=311), general medicine (n=251), elderly care (n=184), orthopaedics (n=131), urology (n=61), and three other specialties (n=68). Proportion of admissions with at least one patient safety incident; proportion and type of patient safety incidents missed by routine incident reporting and case note review methods. 324 patient safety incidents were identified in 230/1006 admissions (22.9%; 95% confidence interval 20.3% to 25.5%). 270 (83%) patient safety incidents were identified by case note review only, 21 (7%) by the routine reporting system only, and 33 (10%) by both methods. 110 admissions (10.9%; 9.0% to 12.8%) had at least one patient safety incident resulting in patient harm, all of which were detected by the case note review and six (5%) by the reporting system. The routine incident reporting system may be poor at identifying patient safety incidents, particularly those resulting in harm. Structured case note review may have a useful role in surveillance of routine incident reporting and associated quality improvement programmes.

  6. A study of cases reported as incidents in a public hospital from 2011 to 2014.

    Science.gov (United States)

    Göttems, Leila Bernarda Donato; Santos, Maria do Livramento Gomes Dos; Carvalho, Paloma Aparecida; Amorim, Fábio Ferreira

    2016-01-01

    Analyzing incidents reported in a public hospital in the Federal District, Brasilia, according to the characteristics and outcomes involving patients. A descriptive and retrospective study of incidents reported between January 2011 and September 2014. 209 reported incidents were categorized as reportable occurrences (n = 22, 10.5%), near misses (n = 16, 7.7%); incident without injury (n = 4, 1.9%) and incident with injury (adverse events) (n = 167, 79.9%). The average age of patients was 44 years and the hospitalization time until the moment of the incident was on average 38.5 days. Nurses were the healthcare professionals who most reported the incidents (n = 55, 67%). No outcomes resulted in death. Incidents related to blood/hemoderivatives, medical devices/equipment, patient injuries and intravenous medication/fluids were the most frequent. Standardizing the reporting processes and enhancing participation by professionals in managing incidents is recommended. Analisar os incidentes notificados em um hospital público do Distrito Federal, segundo as características e os desfechos quando envolveram pacientes. Estudo descritivo e retrospectivo dos incidentes notificados entre janeiro de 2011 e setembro de 2014. Notificados 209 incidentes categorizados em ocorrência comunicável (n = 22, 10,5%), quase evento (n = 16, 7,7%), incidente sem dano (n = 4, 1,9%) e incidente com dano (eventos adversos) (n = 167, 79,9%). A idade média dos pacientes foi de 44 anos e o tempo da internação até o momento do incidente teve média de 38,5 dias. Os enfermeiros foram os que mais notificaram (n = 55, 67%). Nenhum desfecho resultou em morte. Os incidentes relacionados a sangue/hemoderivados, dispositivos/equipamento médico, acidentes do doente e medicação/fluidos endovenosos foram os mais frequentes. Recomenda-se padronizar os processos de notificação e potencializar a participação dos profissionais no manejo dos incidentes.

  7. Incidence of type 1 diabetes in China, 2010-13: population based study.

    Science.gov (United States)

    Weng, Jianping; Zhou, Zhiguang; Guo, Lixin; Zhu, Dalong; Ji, Linong; Luo, Xiaoping; Mu, Yiming; Jia, Weiping

    2018-01-03

    To estimate the incidence of type 1 diabetes in all age groups in China during 2010-13. Population based, registry study using data from multiple independent sources. National registration system in all 505 hospitals providing diabetes care, and communities of patients with diabetes in 13 areas across China, covering more than 133 million person years at risk, approximately 10% of the whole population. 5018 people of all ages with newly diagnosed type 1 diabetes and resident in the study areas from 1 January 2010 to 31 December 2013. Incidence of type 1 diabetes per 100 000 person years by age, sex, and study area. Type 1 diabetes was doctor diagnosed and further validated by onsite follow-up. Completeness of case ascertainment was assessed using the capture mark recapture method. 5018 cases of newly diagnosed type 1 diabetes were ascertained: 1239 participants were aged China was 1.01 (95% confidence interval 0.18 to 1.84). Incidence per 100 000 persons years by age group was 1.93 (0.83 to 3.03) for 0-14 years, 1.28 (0.45 to 2.11) for 15-29 years, and 0.69 (0.00 to 1.51) for ≥30 years, with a peak in age group 10-14 years. The incidence in under 15s was positively correlated with latitude (r=0.88, PChina occurred among adults. The incidence of type 1 diabetes in Chinese children was among the lowest reported in the study. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. The incidence of inflammatory bowel disease in Northern China: a prospective population-based study.

    Directory of Open Access Journals (Sweden)

    Hong Yang

    Full Text Available AIMS & BACKGROUNDS: Although inflammatory bowel diseases (IBD are emerging and increasing in China, epidemiologic data are rarely available. This study was to investigate the epidemiological and clinical characteristics of IBD in Northern China. METHODS: This is a prospective, population-based study of incidence of IBD in Daqing, Heilongjiang province of Northern China from March 1, 2012 to February 28, 2013. All incident patients with IBD were clinically identified by IBD specialist group from five main General Hospitals covering the healthcare service for 1,343,364 residents in the urban areas of Daqing. IBD cases included in this study were followed-up for three months for diagnosis confirmation. RESULTS: A total of 27 new IBD cases including 25 cases of ulcerative colitis (UC and 2 cases of Crohn's disease (CD were identified. The population at risk was 1,343,364 person years. Age-adjusted incidence for total IBD, CD and UC were 1.77, 0.13, and 1.64 per 100,000 population, respectively. A male predominance was found in CD patients (male to female ratio was 2 ∶ 0. In contrast, no obvious gender predominance was found in UC patients (male to female ratio was 1 ∶ 1.1. CD patients were diagnosed at an average age of 39.5 years. The main disease phenotypes of UC were distal colitis with a 24% of proctitis and 56% of left-sided colitis. The mean diagnostic age of UC patients was 48.9 years. CONCLUSIONS: This is the first report on the incidence of IBD in the Northern Chinese population. A lower incidence of IBD, similar male predominance for CD, similar disease phenotype of UC, and lower disease activity was observed in Daqing compared to that in Southern China.

  9. Sensationalization of reports of the Kashiwazaki-Kariwa nuclear power plant incident. A search for top stories in Japanese newspapers

    International Nuclear Information System (INIS)

    Nakajima, Tatsuo

    2009-01-01

    The purpose of this study is to clarify whether reports of nuclear accidents, particularly the damage done by the 2007 Niigata-ken Chuetsu-Oki earthquake to the Kashiwazaki-Kariwa nuclear power plant in Niigata, Japan, tend to be exaggerated by national media. News related to the Kashiwazaki incident was compared with that for nine other high-profile accidents in Japan, including the 1999 JCO critical accident and the 2005 JR-West Fukuchiyama Line derailment. Articles were extracted from four national newspapers in Japan, focusing on the 30 issues immediately following each accident. The numbers of articles and top stories related to the relevant accidents appearing on the front pages of the newspapers were counted. Based on these numbers, the Kashiwazaki incident was reported at a level similar to the JCO accident and Fukuchiyama line derailment in some newspapers, although these two accidents were more serious than the Kashiwazaki incident. This suggests that at least some newspapers in Japan sensationalized reports of the Kashiwazaki incident. (author)

  10. Survey to identify depth of penetration of critical incident reporting systems in Austrian healthcare facilities.

    Science.gov (United States)

    Sendlhofer, Gerald; Eder, Harald; Leitgeb, Karina; Gorges, Roland; Jakse, Heidelinde; Raiger, Marianne; Türk, Silvia; Petschnig, Walter; Pregartner, Gudrun; Kamolz, Lars-Peter; Brunner, Gernot

    2018-01-01

    Incident reporting systems or so-called critical incident reporting systems (CIRS) were first recommended for use in health care more than 15 years ago. The uses of these CIRS are highly variable among countries, ranging from being used to report critical incidents, falls, or sentinel events resulting in death. In Austria, CIRS have only been introduced to the health care sector relatively recently. The goal of this work, therefore, was to determine whether and specifically how CIRS are used in Austria. A working group from the Austrian Society for Quality and Safety in Healthcare (ASQS) developed a survey on the topic of CIRS to collect information on penetration of CIRS in general and on how CIRS reports are used to increase patient safety. Three hundred seventy-one health care professionals from 274 health care facilities were contacted via e-mail. Seventy-eight respondents (21.0%) completed the online survey, thereof 66 from hospitals and 12 from other facilities (outpatient clinics, nursing homes). In all, 64.1% of the respondents indicated that CIRS were used in the entire health care facility; 20.6% had not yet introduced CIRS and 15.4% used CIRS only in particular areas. Most often, critical incidents without any harm to patients were reported (76.9%); however, some health care facilities also use their CIRS to report patient falls (16.7%), needle stick injuries (17.9%), technical problems (51.3%), or critical incidents involving health care professionals. CIRS are not yet extensively or homogeneously used in Austria. Inconsistencies exist with respect to which events are reported as well as how they are followed up and reported to health care professionals. Further recommendations for general use are needed to support the dissemination in Austrian health care environments.

  11. The non-technical skills used by anaesthetic technicians in critical incidents reported to the Australian Incident Monitoring System between 2002 and 2008.

    Science.gov (United States)

    Rutherford, J S; Flin, R; Irwin, A

    2015-07-01

    The outcome of critical incidents in the operating theatre has been shown to be influenced by the behaviour of anaesthetic technicians (ATs) assisting anaesthetists, but the specific non-technical skills involved have not been described. We performed a review of critical incidents (n=1433) reported to the Australian Incident Monitoring System between 2002 and 2008 to identify which non-technical skills were used by ATs. The reports were assessed if they mentioned anaesthetic assistance or had the boxes ticked to identify "inadequate assistance" or "absent supervision or assistance". A total of 90 critical incidents involving ATs were retrieved, 69 of which described their use of non-technical skills. In 20 reports, the ATs ameliorated the critical incident, whilst in 46 they exacerbated the critical incident, and three cases had both positive and negative non-technical skills described. Situation awareness was identified in 39 reports, task management in 23, teamwork in 21 and decision-making in two, but there were no descriptions of issues related to leadership, stress or fatigue management. Situation awareness, task management and teamwork appear to be important non-technical skills for ATs in the development or management of critical incidents in the operating theatre. This analysis has been used to support the development of a non-technical skills taxonomy for anaesthetic assistants.

  12. Describing individual incidents of sexual abuse: a review of research on the effects of multiple sources of information on children's reports.

    Science.gov (United States)

    Roberts, K P; Powell, M B

    2001-12-01

    For successful prosecution of child sexual abuse, children are often required to provide reports about individual, alleged incidents. Although verbally or mentally rehearsing memory of an incident can strengthen memories, children's report of individual incidents can also be contaminated when they experience other events related to the individual incidents (e.g., informal interviews, dreams of the incident) and/or when they have similar, repeated experiences of an incident, as in cases of multiple abuse. Research is reviewed on the positive and negative effects of these related experiences on the length, accuracy, and structure of children's reports of a particular incident. Children's memories of a particular incident can be strengthened when exposed to information that does not contradict what they have experienced, thus promoting accurate recall and resistance to false, suggestive influences. When the encountered information differs from children's experiences of the target incident, however, children can become confused between their experiences-they may remember the content but not the source of their experiences. We discuss the implications of this research for interviewing children in sexual abuse investigations and provide a set of research-based recommendations for investigative interviewers.

  13. Patient safety incidents associated with tracheostomies occurring in hospital wards: a review of reports to the UK National Patient Safety Agency.

    Science.gov (United States)

    McGrath, B A; Thomas, A N

    2010-09-01

    Tracheostomies are increasingly common in hospital wards due to the rising use of percutaneous and surgical tracheostomies in critical care and bed pressures in these units. Hospital wards may lack appropriate infrastructure to care for this vulnerable group and significant patient harm may result. To identify and analyse tracheostomy related incident reports from hospital wards between 1 October 2005 and 30 September 2007, and to make recommendations to improve patient safety based on the recurrent themes identified. The study was performed between August 2008 and August 2009. 968 tracheostomy related critical incidents reported to the National Patient Safety Agency over the 2 year period, identified by key letter searches, were analysed. Incidents were categorised to identify common themes, and root cause analysis attempted where possible. In the 453 incidents where patients were directly affected, 338 (75%) were associated with some identifiable patient harm, of which 83 (18%) were associated with more than temporary harm. In 29 incidents (6%) some intervention was required to maintain life, and in 15 cases the incident may have contributed to the patient's death. Equipment was involved in 176 incidents and 276 incidents involved tracheostomies becoming blocked or displaced. By identifying and analysing themes in incident reports associated with tracheostomies, recommendations can be made to improve safety for this group of patients. These recommendations include improvements in infrastructure, competency and training, equipment provision, and in communication.

  14. Properties of incident reporting systems in relation to statistical trend and pattern analysis

    International Nuclear Information System (INIS)

    Kalfsbeek, H.W.; Arsenis, S.P.

    1990-01-01

    This paper describes the properties deemed desirable for an incident reporting system in order to render it useful for extracting valid statistical trend and pattern information. The perspective under which a data collection system is seen in this paper is the following: data are essentially gathered on a set of variables describing an event or incident (the items featuring on a reporting format) in order to learn about (multiple) dependencies (called interactions) between these variables. Hence, the necessary features of the data source are highlighted and potential problem sources limiting the validity of the results to be obtained are identified. In this frame, important issues are the reporting completeness, related to the reporting criteria and reporting frequency, and of course the reporting contents and quality. The choice of the report items (the variables) and their categorization (code dictionary) may influence (bias) the insights gained from trend and pattern analyses, as may the presence or absence of a structure for correlating the reported issues within an incident. The issues addressed in this paper are brought in relation to some real world reporting systems on safety related events in Nuclear Power Plants, so that their possibilities and limitations with regard to statistical trend and pattern analysis become manifest

  15. Analysis of Incident and Accident Reports and Risk Management in Spine Surgery.

    Science.gov (United States)

    Kobayashi, Kazuyoshi; Imagama, Shiro; Ando, Kei; Hida, Tetsuro; Ito, Kenyu; Tsushima, Mikito; Ishikawa, Yoshimoto; Matsumoto, Akiyuki; Morozumi, Masayoshi; Nishida, Yoshihiro; Nagao, Yoshimasa; Ishiguro, Naoki

    2017-08-01

    A review of accident and incident reports. To analyze prevalence, characteristics, and details of perioperative incidents and accidents in patients receiving spine surgery. In our institution, a clinical error that potentially results in an adverse event is usually submitted as an incident or accident report through a web database, to ensure anonymous and blame-free reporting. All reports are analyzed by a medical safety management group. These reports contain valuable data for management of medical safety, but there have been no studies evaluating such data for spine surgery. A total of 320 incidents and accidents that occurred perioperatively in 172 of 415 spine surgeries were included in the study. Incidents were defined as events that were "problematic, but with no damage to the patient," and accidents as events "with damage to the patient." The details of these events were analyzed. There were 278 incidents in 137 surgeries and 42 accidents in 35 surgeries, giving prevalence of 33% (137/415) and 8% (35/415), respectively. The proportion of accidents among all events was significantly higher for doctors than non-doctors [68.0% (17/25) vs. 8.5% (25/295), P < 0.01] and in the operating room compared with outside the operating room [40.5% (15/37) vs. 9.5% (27/283), P < 0.01]. There was no significant difference in years of experience among personnel involved in all events. The major types of events were medication-related, line and tube problems, and falls and slips. Accidents also occurred because of a long-term prone position, with complications such as laryngeal edema, ulnar nerve palsy, and tooth damage. Surgery and procedures in the operating room always have a risk of complications. Therefore, a particular effort is needed to establish safe management of this environment and to provide advice on risk to the doctor and medical care team. 4.

  16. HIV incidence from the first population-based cohort study in India.

    Science.gov (United States)

    Dandona, Lalit; Kumar, G Anil; Lakshmi, Vemu; Ahmed, G Md Mushtaq; Akbar, Mohammed; Ramgopal, Sri P; Sudha, Talasila; Alary, Michel; Dandona, Rakhi

    2013-07-17

    Understanding about who acquires new HIV infection and the determinants of why some persons get infected and others do not is fundamental to controlling HIV in the population. We assess HIV incidence and its associations in the population of a high HIV burden district in Andhra Pradesh state in southern India by a population-based longitudinal cohort study. We re-surveyed a population-based cohort of 12,617 adults in Guntur district of Andhra Pradesh for which we had reported a baseline HIV prevalence of 1.72% (rural 1.64%, urban 1.89%) among the 15-49 years age group in 2004-2005. We conducted interviews to assess risk behaviour and performed HIV testing again in 2010-2011. We assessed the rate of new HIV infection and its associations using multiple logistic regression. The participation rate in the follow-up was 74.9% and 63.9% of the baseline rural and urban samples, respectively. Over a mean follow-up of 5.63 years, the incidence of HIV was 1.26 per 1000 person-years (95% CI 0.83-1.69), after adjusting for slight compositional bias in the follow-up sample. The incidence per 1000 person-years was higher among rural men (1.68) than urban men (0.85), and among rural women (1.28) than urban women (0.54). The strongest association with incidence was a HIV positive spouse in the baseline for both men (odds ratio 266, 95% CI 62-1137) and women (odds ratio 28, 95% CI 9-88). Among men the other significant associations with HIV incidence were frequent use of condom for sex over the past 6 months, non-circumcision, more than one lifetime woman sex partner or ever visited sex worker, and transport-related occupation; for women the other significant associations were having had HIV testing other than antenatal check-up, previously married but currently not, and tobacco use. These first population-based cohort incidence data from India suggest that rural areas of high HIV burden states would need more attention to prevent new HIV infections, and that spouses of HIV

  17. Patient safety incidents from acupuncture treatments: a review of reports to the National Patient Safety Agency.

    Science.gov (United States)

    Wheway, Jayne; Agbabiaka, Taofikat B; Ernst, Edzard

    2012-01-01

    Acupuncture is frequently employed to treat chronic pain syndromes or other chronic conditions. Nevertheless, there is a growing literature on adverse events (AEs) from treatments including pneumothorax, cardiac tamponade and spinal cord injury. Acupuncture is provided in almost all NHS pain clinics and by an increasing number of GP's and physiotherapists. Considering acupuncture's popularity, its safety has become an important public health issue. To evaluate the harm caused to patients through acupuncture treatments within NHS organisations. The National Reporting and Learning System (NRLS) database was searched for incidents reported from 1st January 2009 to 31st December 2011. The free text fields of all reports received from all healthcare settings and specialties were searched for the keyword 'acupuncture'. All relevant incidents were reviewed to provide a qualitative theme of the harm to patients. 468 patient safety incidents were identified; 325 met our inclusion criteria for analysis. Adverse events reported include retained needles (31%), dizziness (30%), loss of consciousness/unresponsive (19%), falls (4%), Bruising or soreness at needle site (2%), Pneumothorax (1%) and other adverse reactions (12%). The majority (95%) of the incidents were categorised as low or no harm. A number of AEs are recorded after acupuncture treatments in the NHS but the majority is not severe. However, miscategorisation and under-reporting may distort the overall picture. Acupuncture practitioners should be aware of, and be prepared to manage, any significant harm from treatments.

  18. Physical activity and incidence of sarcopenia: the population-based AGES—Reykjavik Study

    Science.gov (United States)

    Mijnarends, Donja M.; Koster, Annemarie; Schols, Jos M. G. A.; Meijers, Judith M. M.; Halfens, Ruud J. G.; Gudnason, Vilmundur; Eiriksdottir, Gudny; Siggeirsdottir, Kristin; Sigurdsson, Sigurdur; Jónsson, Pálmi V.; Meirelles, Osorio; Harris, Tamara

    2016-01-01

    Background: the prevalence of sarcopenia increases with age. Physical activity might slow the rate of muscle loss and therewith the incidence of sarcopenia. Objective: to examine the association of physical activity with incident sarcopenia over a 5-year period. Design: data from the population-based Age, Gene/Environment, Susceptibility–Reykjavik Study were used. Setting: people residing in the Reykjavik area at the start of the study. Subjects: the study included people aged 66–93 years (n = 2309). Methods: the amount of moderate–vigorous physical activity (MVPA) was assessed by a self-reported questionnaire. Sarcopenia was identified using the European Working Group on Sarcopenia in Older People algorithm, including muscle mass (computed tomography imaging), grip strength (computerised dynamometer) and gait speed (6 m). Results: mean age of the participants was 74.9 ± 4.7 years. The prevalence of sarcopenia was 7.3% at baseline and 16.8% at follow-up. The incidence proportion of sarcopenia over 5 years was 14.8% in the least-active individuals and 9.0% in the most-active individuals. Compared with the least-active participants, those reporting a moderate–high amount of MVPA had a significantly lower likelihood of incident sarcopenia (OR = 0.64, 95% CI 0.45–0.91). Participants with a high amount of MVPA had higher baseline levels of muscle mass, strength and walking speed, but baseline MVPA was not associated with the rate of muscle loss. Conclusion: a higher amount of MVPA seems to contribute to counteracting the development of sarcopenia. To delay the onset of sarcopenia and its potential adverse outcomes, attention should be paid to increasing physical activity levels in older adults. PMID:27189729

  19. Cumulative incidence of postoperative severe pain at Hospital Universitario San Jose, Popayan. Preliminar report

    Directory of Open Access Journals (Sweden)

    Ingrid Muñoz

    2013-12-01

    Full Text Available Introduction: Postoperative pain remains as a problem. National studies report incidences of 31% for moderate and 22% for severe pain. Inadequate analgesia is related to dissatisfaction and adverse outcomes. The aim of this study was to describe the incidence and characteristics of the postoperative pain in the post-anesthesia care unit (PACU at Hospital Universitario San José of Popayán (HUSJ in patients undergoing general anesthesia during the first postoperative hour. Methods: Cohort study. We recruited patients attending PACU and undergoing procedures using general anesthesia, between 18 and 70 years. Using a standardized collection form medical history, demographic data, medical history, anesthetic management, intraoperative analgesia and postoperative pain assessment by verbal and numerical pain scale (1-10 were recorded. Postoperative outcome data were also collected in the PACU. Results: The incidence of severe postoperative pain at 10 minutes was 12.3% 95%CI [7.1-18.2] (19 patients. Within 30 minutes of assessment 4.5% 95%CI [1.3-8.4] (7 patients and 1.9% 60 minutes 95%CI [0-4.5] (3 patients. 48.7% required rescue analgesic at PACU. Incidence of postoperative nausea and vomiting (PONV was significantly different in patients requiring rescue analgesic. Conclusion: The incidence of severe postoperative pain in the first postoperative hour at HUSJ is close to 12% and it decreases as time goes by. Patients requiring rescue analgesic have a higher incidence of postoperative complications such as PONV.

  20. Automating the Identification of Patient Safety Incident Reports Using Multi-Label Classification.

    Science.gov (United States)

    Wang, Ying; Coiera, Enrico; Runciman, William; Magrabi, Farah

    2017-01-01

    Automated identification provides an efficient way to categorize patient safety incidents. Previous studies have focused on identifying single incident types relating to a specific patient safety problem, e.g., clinical handover. In reality, there are multiple types of incidents reflecting the breadth of patient safety problems and a single report may describe multiple problems, i.e., it can be assigned multiple type labels. This study evaluated the abilty of multi-label classification methods to identify multiple incident types in single reports. Three multi-label methods were evaluated: binary relevance, classifier chains and ensemble of classifier chains. We found that an ensemble of classifier chains was the most effective method using binary Support Vector Machines with radial basis function kernel and bag-of-words feature extraction, performing equally well on balanced and stratified datasets, (F-score: 73.7% vs. 74.7%). Classifiers were able to identify six common incident types: falls, medications, pressure injury, aggression, documentation problems and others.

  1. Lessons learnt from incidents involving the airway and breathing reported from Australasian emergency departments.

    Science.gov (United States)

    Crock, Carmel; Hansen, Kim; Fogg, Toby; Cahill, Angela; Deakin, Anita; Runciman, William B

    2018-02-01

    To review incident reports relating to problems encountered during the ED management of patients with 'airway or breathing' problems, with the aim of finding and highlighting common themes within these rare events, and making recommendations to further improve patient safety in the areas in which deficiencies have been identified. Thematic analysis of 36 incidents reported from Australasian EDs, which were related to problems with airway and breathing. In all, 51 problems were identified among the 36 incidents related to airway and/or breathing. Fourteen involved clinical decision-making, 11 equipment, nine communication, seven intubation, five surgical access and five pneumothorax. Eight incidents involved children and there were nine deaths within hours or days. Recommendations for improving preparedness of ED staff and facilities have been made for each of the problem areas identified with respect to clinical practice, equipment, communication and clinical process. Analysis of incidents from the Australasian Emergency Medicine Events Register allows clusters of like-events to be identified and characterised, providing the possibility of getting a better idea of how problems present and progress, with some information about contributing factors, characteristics and context. This will pave the way for earlier and better detection of life-threatening problems and the development and reinforcement of preventive and corrective strategies. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  2. Effects of patient safety culture interventions on incident reporting in general practice: a cluster randomised trial

    NARCIS (Netherlands)

    Verbakel, N.J.; Langelaan, M.; Verheij, T.J.M.; Wagner, C.; Zwart, D.L.M.

    2015-01-01

    Background: A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim: To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting: A three-arm cluster randomised trial

  3. Effects of patient safety culture interventions on incident reporting in general practice: a cluster randomised trial.

    NARCIS (Netherlands)

    Verbakel, N.J.; Langelaan, M.; Verheij, T.J.M.; Wagner, C.; Zwart, D.L.M.

    2015-01-01

    Background A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting A three-arm cluster randomised trial was

  4. Effects on incident reporting after educating residents in patient safety: a controlled trial.

    NARCIS (Netherlands)

    Jansma, J.D.; Wagner, C.; Kate, R.W. ten; Bijnen, A.B.

    2011-01-01

    Background: Medical residents are key figures in delivering health care and an important target group for patient safety education. Reporting incidents is an important patient safety domain, as awareness of vulnerabilities could be a starting point for improvements. This study examined effects of

  5. 76 FR 34812 - Proposed Information Collection (Report of Medical, Legal, and Other Expenses Incident to...

    Science.gov (United States)

    2011-06-14

    ... report compensation awarded by another entity or government agency for personal injury or death. Such... injury or death, or incident to the collection or recovery of the compensation may be deducted from the..., Program Analyst, Enterprise Records Service. BILLING CODE 8320-01-P ...

  6. Parasitic fibroid: case report and novel approach in reducing incidence of future cases

    OpenAIRE

    Sukainah S.; Nasir TK; Zulkifli K.; Roziana R.

    2016-01-01

    We report a case of parasitic fibroid which developed less than 1 year following laparoscopic myomectomy using power morcellation. Following this case, a novel approach in reducing the incidence of future parasitic fibroid is described. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000): 2836-2839

  7. Effects on incident reporting after educating residents in patient safety: a controlled study

    NARCIS (Netherlands)

    Jansma, J.D.; Wagner, C.; ten Kate, R.W.; Bijnen, A.B.

    2011-01-01

    Background: Medical residents are key figures in delivering health care and an important target group for patient safety education. Reporting incidents is an important patient safety domain, as awareness of vulnerabilities could be a starting point for improvements. This study examined effects of

  8. Samplings performed after the incident which occurred on the Penly (76) nuclear site. Analysis report

    International Nuclear Information System (INIS)

    Bernollin, A.; Josset, M.

    2012-01-01

    This report presents and comments measurements performed on different spots around the Penly nuclear site after an incident occurred there. Measurements have been performed on grass. Several artificial and natural radio-elements have been searched. It appeared that no artificial radionuclide was present in the samples

  9. 75 FR 51953 - Notification and Reporting of Aircraft Accidents or Incidents and Overdue Aircraft, and...

    Science.gov (United States)

    2010-08-24

    ... definition of ``unmanned aircraft accident'' and requiring that operators notify the NTSB of accidents... cases, to complete NTSB Form 6120.1, ``Pilot/Operator Accident/ Incident Report,'' as described in 49... that a similar maximum weight for unmanned aircraft is logical, captures those aircraft that pose a...

  10. Systems analysis of voluntary reported anaesthetic safety incidents occurring in a university teaching hospital.

    Science.gov (United States)

    McMillan, Matthew W; Lehnus, Kristina S

    2018-01-01

    To identify factors contributing to the development of anaesthetic safety incidents. Prospective, descriptive, voluntary reporting audit of safety incidents with subsequent systems analysis. All animals anaesthetized in a multispecies veterinary teaching hospital from November 2014 to October 2016. Peri-anaesthetic incidents that risked or caused unnecessary harm to an animal were reported by anaesthetists alongside animal morbidity and mortality data. A modified systems analysis framework was used to identify contributing factors from the following categories: Animal and Owner, Task and Technology, Individual, Team, Work Environmental, and Organizational and Management. The outcome was graded using a simple descriptive scale. Data were analysed using Pearson's Chi-Square test for association and univariable and multivariable logistic regression analysis. Totally, 3379 anaesthetics were performed during the audit period. Of these, 174 incident reports were analysed, 163 of which impacted safe veterinary care and 26 incidents were considered to have had major or catastrophic outcomes. Incident outcome was believed to have been limited by anaesthetist intervention in 104 (63.8%) cases. Various factors were identified as: Individual in 123 (70.7%), Team in 108 (62.1%), Organizational and Management in 94 (54.0%), Task and Technology in 80 (46.0%), Work Environmental in 53 (30.5%) and Animal and Owner in 36 (20.7%) incidents. Individual factors were rarely seen in isolation. Significant associations were identified between Experience and Supervision, X 2 (1, n=174)=54177, p=0.001, Failure to follow a standard operating procedure and Task Management, X 2 (2, n=174)=11318, p=0.001, and Staffing and Poor Scheduling, X 2 (1, n=174)=36742, p=0.001. Animal Condition [odds ratio (OR)=16210, 95% confidence interval (CI)=5573-47147)] and anaesthetist Decision Making (OR=3437, 95% CI=1184-9974) were risk factors for catastrophic and major outcomes. Individual factors contribute

  11. Incidence and outcomes of bulimia nervosa : a nationwide population-based study

    NARCIS (Netherlands)

    Keski-Rahkonen, A.; Hoek, H. W.; Linna, M. S.; Raevuori, A.; Sihvola, E.; Bulik, C. M.; Rissanen, A.; Kaprio, J.

    Background. Little is known about the epidemiology of bulimia nervosa outside clinical settings. We report the incidence, prevalence and outcomes of bulimia nervosa using for the first time a nationwide Study design. Method. To assess the incidence and natural course and outcomes of DSM-IV bulimia

  12. Radioactive Materials Packaging (RAMPAC) Radioactive Materials Incident Report (RMIR). RAMTEMP users manual

    International Nuclear Information System (INIS)

    Tyron-Hopko, A.K.; Driscoll, K.L.

    1985-10-01

    The purpose of this document is to familiarize the potential user with RadioActive Materials PACkaging (RAMPAC), Radioactive Materials Incident Report (RMIR), and RAMTEMP databases. RAMTEMP is a minor image of RAMPAC. This reference document will enable the user to access and obtain reports from databases while in an interactive mode. This manual will be revised as necessary to reflect enhancements made to the system

  13. Improvement in the incident reporting and investigation procedures using process excellence (DMAI2C) methodology

    International Nuclear Information System (INIS)

    Miles, Elizabeth N.

    2006-01-01

    In 1996, Health and Safety introduced an incident investigation process called Learning to Look ( C) to Johnson and Johnson. This process provides a systematic way of analyzing work-related injuries and illness, uncovers root cause that leads to system defects, and points to viable solutions. The process analyzed involves three steps: investigation and reporting of the incident, determination of root cause, and development and implementation of a corrective action plan. The process requires the investigators to provide an initial communication for work-related serious injuries and illness as well as lost workday cases to Corporate Headquarters within 72h of the incident with a full investigative report to follow within 10 days. A full investigation requires a written report, a cause-result logic diagram (CRLD), a corrective action plan (CAP) and a report of incident costs (SafeCost) all due to be filed electronically. It is incumbent on the principal investigator and his or her investigative teams to assemble the various parts of the investigation and to follow up with the relevant parties to ensure corrective actions are implemented, and a full report submitted to Corporate executives. Initial review of the system revealed that the process was not working as designed. A number of reports were late, not signed by the business leaders, and in some instances, all cause were not identified. Process excellence was the process used to study the issue. The team used six sigma DMAI 2 C methodologies to identify and implement system improvements. The project examined the breakdown of the critical aspects of the reporting and investigation process that lead to system errors. This report will discuss the study findings, recommended improvements, and methods used to monitor the new improved process

  14. Determinants of medication incident reporting, recovery, and learning in community pharmacies: a conceptual model.

    Science.gov (United States)

    Boyle, Todd A; Mahaffey, Thomas; Mackinnon, Neil J; Deal, Heidi; Hallstrom, Lars K; Morgan, Holly

    2011-03-01

    Evidence suggests that the underreporting of medication errors and near misses, collectively referred to as medication incidents (MIs), in the community pharmacy setting, is high. Despite the obvious negative implications, MIs present opportunities for pharmacy staff and regulatory authorities to learn from these mistakes and take steps to reduce the likelihood that they reoccur. However, these activities can only take place if such errors are reported and openly discussed. This research proposes a model of factors influencing the reporting, service recovery, and organizational learning resulting from MIs within Canadian community pharmacies. The conceptual model is based on a synthesis of the literature and findings from a pilot study conducted among pharmacy management, pharmacists, and pharmacy technicians from 13 community pharmacies in Nova Scotia, Canada. The purpose of the pilot study was to identify various actions that should be taken to improve MI reporting and included staff perceptions of the strengths and weaknesses of their current MI-reporting process, desired characteristics of a new process, and broader external and internal activities that would likely improve reporting. Out of the 109 surveys sent, 72 usable surveys were returned (66.1% response rate). Multivariate analysis of variance found no significant differences among staff type in their perceptions of the current or new desired system but were found for broader initiatives to improve MI reporting. These findings were used for a proposed structural equation model (SEM). The SEM proposes that individual-perceived self-efficacy, MI process capability, MI process support, organizational culture, management support, and regulatory authority all influence the completeness of MI reporting, which, in turn, influences MI service recovery and learning. This model may eventually be used to enable pharmacy managers to make better decisions. By identifying risk factors that contribute to low MI

  15. Improving incidence estimation in practice-based sentinel surveillance networks using spatial variation in general practitioner density

    Directory of Open Access Journals (Sweden)

    Cécile Souty

    2016-11-01

    Full Text Available Abstract Background In surveillance networks based on voluntary participation of health-care professionals, there is little choice regarding the selection of participants’ characteristics. External information about participants, for example local physician density, can help reduce bias in incidence estimates reported by the surveillance network. Methods There is an inverse association between the number of reported influenza-like illness (ILI cases and local general practitioners (GP density. We formulated and compared estimates of ILI incidence using this relationship. To compare estimates, we simulated epidemics using a spatially explicit disease model and their observation by surveillance networks with different characteristics: random, maximum coverage, largest cities, etc. Results In the French practice-based surveillance network – the “Sentinelles” network – GPs reported 3.6% (95% CI [3;4] less ILI cases as local GP density increased by 1 GP per 10,000 inhabitants. Incidence estimates varied markedly depending on scenarios for participant selection in surveillance. Yet accounting for change in GP density for participants allowed reducing bias. Applied on data from the Sentinelles network, changes in overall incidence ranged between 1.6 and 9.9%. Conclusions Local GP density is a simple measure that provides a way to reduce bias in estimating disease incidence in general practice. It can contribute to improving disease monitoring when it is not possible to choose the characteristics of participants.

  16. Enhancing Police Responses to Domestic Violence Incidents: Reports From Client Advocates in New South Wales.

    Science.gov (United States)

    Goodman-Delahunty, Jane; Crehan, Anna Corbo

    2016-07-01

    In an online survey about experiences with the police complaint system, 239 client advocates described a recent incident in which a client with grounds to lodge a complaint declined to do so. Almost one third of those incidents involved domestic violence. Thematic analysis of case descriptions revealed that many police did not take domestic violence reports seriously. A typology of problematic police conduct was developed. Many officers failed to observe current procedures and appeared to lack knowledge of relevant laws. Citizens feared retaliatory victimization by police and/or perceived that complaining was futile. Implications of these findings are reviewed in light of procedural justice theory. © The Author(s) 2015.

  17. System Safety Assessment Based on Past Incidents in Oil and Gas Industries: A Focused Approach in Forecasting of Minor, Severe, Critical, and Catastrophic Incidents, 2010–2015

    Directory of Open Access Journals (Sweden)

    Praveen Patel

    2016-01-01

    Full Text Available Accident in an occupation which occurred due to series of repetitive minor incidents within the working environment. This work demonstrates the critical system safety assessment based on various incidents that took place to the different system and subsystem of two Indian oil refineries in five years of span 2010 to 2015. The categorization of incidents and hazard rate function of each incident category were classified and calculated. The result of Weibull analysis estimators in the form of scale and shape parameters provides useful information of incidents forecasting and their patterns in a particular time.

  18. RO-ILS: Radiation Oncology Incident Learning System: A report from the first year of experience.

    Science.gov (United States)

    Hoopes, David J; Dicker, Adam P; Eads, Nadine L; Ezzell, Gary A; Fraass, Benedick A; Kwiatkowski, Theresa M; Lash, Kathy; Patton, Gregory A; Piotrowski, Tom; Tomlinson, Cindy; Ford, Eric C

    2015-01-01

    Incident learning is a critical tool to improve patient safety. The Patient Safety and Quality Improvement Act of 2005 established essential legal protections to allow for the collection and analysis of medical incidents nationwide. Working with a federally listed patient safety organization (PSO), the American Society for Radiation Oncology and the American Association of Physicists in Medicine established RO-ILS: Radiation Oncology Incident Learning System (RO-ILS). This paper provides an overview of the RO-ILS background, development, structure, and workflow, as well as examples of preliminary data and lessons learned. RO-ILS is actively collecting, analyzing, and reporting patient safety events. As of February 24, 2015, 46 institutions have signed contracts with Clarity PSO, with 33 contracts pending. Of these, 27 sites have entered 739 patient safety events into local database space, with 358 events (48%) pushed to the national database. To establish an optimal safety culture, radiation oncology departments should establish formal systems for incident learning that include participation in a nationwide incident learning program such as RO-ILS. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  19. National critical incident reporting systems relevant to anaesthesia: a European survey.

    Science.gov (United States)

    Reed, S; Arnal, D; Frank, O; Gomez-Arnau, J I; Hansen, J; Lester, O; Mikkelsen, K L; Rhaiem, T; Rosenberg, P H; St Pierre, M; Schleppers, A; Staender, S; Smith, A F

    2014-03-01

    Critical incident reporting is a key tool in the promotion of patient safety in anaesthesia. We surveyed representatives of national incident reporting systems in six European countries, inviting information on scope and organization, and intelligence on factors determining success and failure. Some systems are government-run and nationally conceived; others started out as small, specialty-focused initiatives, which have since acquired a national reach. However, both national co-ordination and specialty enthusiasts seem to be necessary for an optimally functioning system. The role of reporting culture, definitional issues, and dissemination is discussed. We make recommendations for others intending to start new systems and speculate on the prospects for sharing patient safety lessons relevant to anaesthesia at European level.

  20. Application examples of the reports of the NEA Incident Reporting System of the OECD and evolution of the system

    International Nuclear Information System (INIS)

    Libmann, J.

    1989-06-01

    Some reports of the work group no. 1 of the Nuclear Installations Security Committee of NEA, are summarized. An example of the report coding system concerning human factors, is given. The aim of the study is to improve the report contents as well as the coding system. In this case, a fast data selection is possible, and allows an efficient analysis of a particular situation. Moreover, the corrective procedures of the nuclear installation conception or operation can be easily modified, by the national organisations. Due to the improvements in quality, the opinion of the member countries on the incident reporting systems efficiency was enhanced [fr

  1. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics

    NARCIS (Netherlands)

    Maarsingh, O.R.; Dros, J.; Schellevis, F.G.; van Weert, H.C.; Bindels, P.J.; van der Horst, H.E.

    2010-01-01

    Background: Although dizziness in elderly patients is very common in family practice, most prevalence studies on dizziness are community-based and include a study population that is not representative of family practice. The aim of this study was to investigate the prevalence and incidence of

  2. Towards Incidence Management in 5G Based on Situational Awareness

    Directory of Open Access Journals (Sweden)

    Lorena Isabel Barona López

    2017-01-01

    Full Text Available The fifth generation mobile network, or 5G, moves towards bringing solutions to deploying faster networks, with hundreds of thousands of simultaneous connections and massive data transfer. For this purpose, several emerging technologies are implemented, resulting in virtualization and self-organization of most of their components, which raises important challenges related to safety. In order to contribute to their resolution, this paper proposes a novel architecture for incident management on 5G. The approach combines the conventional risk management schemes with the Endsley Situational Awareness model, thus improving effectiveness in different aspects, among them the ability to adapt to complex and dynamical monitoring environments, and countermeasure tracking or the role of context when decision-making. The proposal takes into account all layers for information processing in 5G mobile networks, ranging from infrastructure to the actuators responsible for deploying corrective measures.

  3. Medical students' perceptions of a novel institutional incident reporting system : A thematic analysis.

    Science.gov (United States)

    Gordon, Morris; Parakh, Dillan

    2017-10-01

    Errors in healthcare are a major patient safety issue, with incident reporting a key solution. The incident reporting system has been integrated within a new medical curriculum, encouraging medical students to take part in this key safety process. The aim of this study was to describe the system and assess how students perceived the reporting system with regards to its role in enhancing safety. Employing a thematic analysis, this study used interviews with medical students at the end of the first year. Thematic indices were developed according to the information emerging from the data. Through open, axial and then selective stages of coding, an understanding of how the system was perceived was established. Analysis of the interview specified five core themes: (1) Aims of the incident reporting system; (2) internalized cognition of the system; (3) the impact of the reporting system; (4) threshold for reporting; (5) feedback on the systems operation. Selective analysis revealed three overriding findings: lack of error awareness and error wisdom as underpinned by key theoretical constructs, student support of the principle of safety, and perceptions of a blame culture. Students did not interpret reporting as a manner to support institutional learning and safety, rather many perceived it as a tool for a blame culture. The impact reporting had on students was unexpected and may give insight into how other undergraduates and early graduates interpret such a system. Future studies should aim to produce interventions that can support a reporting culture.

  4. Assessing the external validity of model-based estimates of the incidence of heart attack in England: a modelling study

    Directory of Open Access Journals (Sweden)

    Peter Scarborough

    2016-11-01

    Full Text Available Abstract Background The DisMod II model is designed to estimate epidemiological parameters on diseases where measured data are incomplete and has been used to provide estimates of disease incidence for the Global Burden of Disease study. We assessed the external validity of the DisMod II model by comparing modelled estimates of the incidence of first acute myocardial infarction (AMI in England in 2010 with estimates derived from a linked dataset of hospital records and death certificates. Methods Inputs for DisMod II were prevalence rates of ever having had an AMI taken from a population health survey, total mortality rates and AMI mortality rates taken from death certificates. By definition, remission rates were zero. We estimated first AMI incidence in an external dataset from England in 2010 using a linked dataset including all hospital admissions and death certificates since 1998. 95 % confidence intervals were derived around estimates from the external dataset and DisMod II estimates based on sampling variance and reported uncertainty in prevalence estimates respectively. Results Estimates of the incidence rate for the whole population were higher in the DisMod II results than the external dataset (+54 % for men and +26 % for women. Age-specific results showed that the DisMod II results over-estimated incidence for all but the oldest age groups. Confidence intervals for the DisMod II and external dataset estimates did not overlap for most age groups. Conclusion By comparison with AMI incidence rates in England, DisMod II did not achieve external validity for age-specific incidence rates, but did provide global estimates of incidence that are of similar magnitude to measured estimates. The model should be used with caution when estimating age-specific incidence rates.

  5. Criteria for classification and reporting of fire incidences in nuclear power plants of India

    International Nuclear Information System (INIS)

    Kapoor, R.K.

    1998-01-01

    Is is important that all fires in and around fire effective neighbourhood of Nuclear Power Plant (NPP) should be promptly reported (Reportable fires) and investigated. However, the depth of investigation and the range of authorities to whom the individual fire incidence need to be reported depends upon the severity of fire. In case of conventional non-chemical industries, the severity of fire depends mainly on the extent of loss caused by fire on property and the burn injury to persons. In case of NPP, two additional losses viz, release of radioactivity to working/public environment and the risk to safety related systems of NPP due to fire assume greater importance. This paper describes the criteria used in NPPs of India for classification of reportable fire incidences into four categories, viz. Insignificant, small, medium and large fires. It also gives the level of investigation depending upon the severity of fire. The fire classification scheme is explained in this paper with the help of worked out examples and two incidences of fire in Indian NPPs. (author)

  6. Nuclear power plant operating experiences from the IAEA / Nea incident reporting system 2002-2005

    International Nuclear Information System (INIS)

    2006-01-01

    The Incident Reporting System (IRS) is an essential element of the international operating experience feedback system for nuclear power plants. The IRS is jointly operated and managed by the Nuclear Energy Agency (NEA), a semi-autonomous body within the Organisation for Economic Co-operation and Development (OECD), and the International Atomic Energy Agency (IAEA), a specialized agency within the United Nations System. (author)

  7. Self-reported physical work exposures and incident carpal tunnel syndrome

    Science.gov (United States)

    Dale, Ann Marie; Gardner, Bethany T.; Zeringue, Angelique; Strickland, Jaime; Descatha, Alexis; Franzblau, Alfred; Evanoff, Bradley

    2015-01-01

    Background To prospectively evaluate associations between self-reported physical work exposures and incident carpal tunnel syndrome (CTS). Methods Newly employed workers (n=1,107) underwent repeated nerve conduction studies (NCS), and periodic surveys on hand symptoms and physical work exposures including average daily duration of wrist bending, forearm rotation, finger pinching, using vibrating tools, finger/thumb pressing, forceful gripping, and lifting >2 pounds. Multiple logistic regression models examined relationships between peak, most recent, and time-weighted average exposures and incident CTS, adjusting for age, gender, and body mass index. Results 710 subjects (64.1%) completed follow-up NCS; 31 incident cases of CTS occurred over 3 year follow-up. All models describing lifting or forceful gripping exposures predicted future CTS. Vibrating tool use was predictive in some models. Conclusions Self-reported exposures showed consistent risks across different exposure models in this prospective study. Workers’ self-reported job demands can provide useful information for targeting work interventions. PMID:25223617

  8. National Incident Management System (NIMS) Standards Review Panel Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.; Shebell, Peter; Schwartz, Deborah S.; Judd, Kathleen S.; Gelston, Gariann M.

    2006-02-07

    The importance and need for full compliant implementation of NIMS nationwide was clearly demonstrated during the Hurricane Katrina event, which was clearly expressed in Secretary Chertoff's October 4, 2005 letter addressed to the State's governors. It states, ''Hurricane Katrina was a stark reminder of how critical it is for our nation to approach incident management in a coordinated, consistent, and efficient manner. We must be able to come together, at all levels of government, to prevent, prepare for, respond to, and recover from any emergency or disaster. Our operations must be seamless and based on common incident management doctrine, because the challenges we face as a nation are far greater than capabilities of any one jurisdiction.'' The NIMS is a system/architecture for organizing response on a ''national'' level. It incorporations ICS as a main component of that structure (i.e., it institutionalizes ICS in NIMS). In a paper published on the NIMS Website, the following statements were made: ''NIMS represents a core set of doctrine, principles, terminology, and organizational processes to enable effective, efficient and collaborative incident management at all levels. To provide the framework for interoperability and compatibility, the NIMS is based on a balance between flexibility and standardization.'' Thus the NIC is challenged with the need to adopt quality SDO generated standards to support NIMS compliance, but in doing so maintain the flexibility necessary so that response operations can be tailored for the specific jurisdictional and geographical needs across the nation. In support of this large and complex challenge facing the NIC, the Pacific Northwest National Laboratory (PNNL) was asked to provide technical support to the NIC, through their DHS Science and Technology ? Standards Portfolio Contract, to help identify, review, and develop key standards for NIMS compliance. Upon

  9. An analysis of critical incidents relevant to pediatric anesthesia reported to the UK National Reporting and Learning System, 2006-2008.

    Science.gov (United States)

    MacLennan, Andrew I; Smith, Andrew F

    2011-08-01

    We aimed to identify and analyze critical incidents relating to pediatric anesthesia from the National Reporting and Learning System (NRLS) in England and Wales. Critical incident reporting plays a key role in learning from problems and so enhancing patient safety. There has been no previous analysis of pediatric anesthetic incidents in the NRLS. We obtained potentially relevant records from the UK National Patient Safety Agency. Eligible incidents were classified according to patient age, degree of harm sustained, and clinical category. A total of 606 incidents met the inclusion criteria. Six deaths were reported and 48 incidents resulted in severe harm. In many reports, sufficient detail was lacking for a full understanding of what had happened. However, the broad focus of the NRLS revealed a wide spectrum of clinical and organizational incidents relating to pediatric anesthesia. Medication issues predominated (35.6%), notably inadvertent duplication of dosing in operating theater and ward. Airway/ventilation incidents formed 18.8% of the total, cardiovascular incidents 5.9%, and equipment-related incidents (failure or unavailability) 15.7%. Communication and organizational problems made up 8.6% of reports. We make a number of recommendations for practice. In addition, anesthetists should be encouraged to take ownership and contribute high-quality descriptions of incidents to national systems. © 2010 Blackwell Publishing Ltd.

  10. Reporting Crime Victimizations to the Police and the Incidence of Future Victimizations: A Longitudinal Study.

    Science.gov (United States)

    Ranapurwala, Shabbar I; Berg, Mark T; Casteel, Carri

    2016-01-01

    Law enforcement depends on cooperation from the public and crime victims to protect citizens and maintain public safety; however, many crimes are not reported to police because of fear of repercussions or because the crime is considered trivial. It is unclear how police reporting affects the incidence of future victimization. To evaluate the association between reporting victimization to police and incident future victimization. We conducted a retrospective cohort study using National Crime Victimization Survey 2008-2012 data. Participants were 12+ years old household members who may or may not be victimized, were followed biannually for 3 years, and who completed at least one follow-up survey after their first reported victimization between 2008 and 2012. Crude and adjusted generalized linear mixed regression for survey data with Poisson link were used to compare rates of future victimization. Out of 18,657 eligible participants, 41% participants reported to their initial victimization to police and had a future victimization rate of 42.8/100 person-years (PY) (95% CI: 40.7, 44.8). The future victimization rate of those who did not report to the police (59%) was 55.0/100 PY (95% CI: 53.0, 57.0). The adjusted rate ratio comparing police reporting to not reporting was 0.78 (95%CI: 0.72, 0.84) for all future victimizations, 0.80 (95% CI: 0.72, 0.90) for interpersonal violence, 0.73 (95% CI: 0.68, 0.78) for thefts, and 0.95 (95% CI: 0.84, 1.07) for burglaries. Reporting victimization to police is associated with fewer future victimization, underscoring the importance of police reporting in crime prevention. This association may be attributed to police action and victim services provisions resulting from reporting.

  11. Classic Kaposi's sarcoma in Jews living in Israel, 1961-1989: a population-based incidence study.

    Science.gov (United States)

    Iscovich, J; Boffetta, P; Winkelmann, R; Brennan, P; Azizi, E

    1998-10-22

    The incidence of classic Kaposi's sarcoma (CKS) has been reported to be high in Jewish populations, mostly born in Eastern Europe. To describe the incidence on CKS in Israeli Jews and to determine differences in incidence according to their geography origin. We analysed data on 1098 incident CKS cases with known country of origin occurring between 1961 and 1989 in the Jewish Israeli population. Reporting systems were the Israel Cancer Registry, the medical documentation of all-Kaposi's sarcoma cases and the registry of HIV-seropositive patients. Patients who were seropositive for HIV were excluded from the study population. Population figures for groups of migrants and natives were derived from census surveys (1961, 1972, 1983) and inter-census estimates based on the population registry. The overall age-standardized rate of CKS was 16.9 per million in men and 6.3 per million in women. The ratio between genders remained stable during the study period. In both genders, there was a steep increase in CKS incidence between the late 1960s (age-standardized rates per million: 8.0 in men and 2.2 in women) and the early 1970s (17.9 in men and 6.7 in women). No further increase was present after 1971. Overall, immigrants experienced a relative risk (RR) of 1.17 [95% confidence interval (CI) 0.90-1.521 compared with Jews born in Israel. Immigrants from Morocco, Algeria and Tunisia had the highest incidence (RR 2.01; 95% CI 1.52-2.65) compared with Jews born in Israel, followed by those born in Iraq (RR 1.74; CI 95% 1.27-2.37). The lowest incidence was experienced by immigrants from Iran (RR 0.37; CI 95% 0.18-0.77) and from Central European countries (RR 0.45; CI 95% 0.30-0.66). Immigrants from other countries in Asia, Africa, the Americas and Europe had similar rates as Jews born in Israel. Israeli Jews present one of the highest incidences of CKS reported from developed countries. The incidence varies according to geographical origin. Countries surrounding the Mediterranean

  12. Association between population density and reported incidence, characteristics and outcome after out-of-hospital cardiac arrest in Sweden.

    Science.gov (United States)

    Strömsöe, A; Svensson, L; Claesson, A; Lindkvist, J; Lundström, A; Herlitz, J

    2011-10-01

    To describe the reported incidence of out of hospital cardiac arrest (OHCA) and the characteristics and outcome after OHCA in relation to population density in Sweden. All patients participating in the Swedish Cardiac Arrest Register between 2008 and 2009 in (a) 20 of 21 regions (n=6457) and in (b) 165 of 292 municipalities (n=3522) in Sweden, took part in the survey. The regional population density varied between 3 and 310 inhabitants per km(2) in 2009. In 2008-2009, the number of reported cardiac arrests varied between 13 and 52 per 100,000 inhabitants and year. Survival to 1 month varied between 2% and 14% during the same period in different regions. With regard to population density, based on municipalities, bystander CPR (p=0.04) as well as cardiac etiology (p=0.002) were more frequent in less populated areas. Ambulance response time was longer in less populated areas (ppopulation density and survival to 1 month after OHCA or incidence (adjusted for age and gender) of OHCA. There was no significant association between population density and survival to 1 month after OHCA or incidence (adjusted for age and gender) of OHCA. However, bystander CPR, cardiac etiology and longer response times were more frequent in less populated areas. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. A Population-Based Study of the Incidence of Acute Spinal Cord Infarction.

    Science.gov (United States)

    Qureshi, Adnan I; Afzal, Mohammad Rauf; Suri, M Fareed K

    2017-06-01

    There is a paucity of reliable data regarding incidence of acute spinal cord infarction in population-based studies. To determine the incidence of acute spinal cord infarction using a population-based design. Medical records and neuroimaging data of all patients with acute spinal cord infarction from Stearns and Benton Counties, Minnesota, between January 1, 2010 and May 31, 2014 were reviewed. Patients with a first-time diagnosis of spinal cord infarction were categorized as primary or secondary depending upon underlying etiology identified. We calculated the incidences of primary and secondary spinal cord infarction adjusted for age and sex based on the 2010 US census (189,093 resident populations). The age- and sex-adjusted incidence of spinal cord infarction was 3.1 [95% confidence interval (CI) 1.6-7.2] per100,000 person-years. The age- and sex-adjusted incidence of primary and secondary spinal cord infarction was 1.5 [95% CI 0.6-3.6] and 1.6 [95% CI 0.6-3.6] per 100,000 person-years, respectively. The age-adjusted incidences among men and women were 1.5 [95%CI 0.6-3.7] and 4.6 [95% CI 2.2-8.7] per 100,000 person-years, respectively. No case fatality was observed at one month. We provide incidence rates for acute spinal cord infarction to assist in future studies and resource allocation.

  14. Nuclear power plant operating experiences from the IAEA/NEA Incident Reporting System 1999-2002

    International Nuclear Information System (INIS)

    2003-01-01

    Incident reporting has become an increasingly important aspect of the operation and regulation of all public health and safety-related industries. Diverse industries such as aeronautics, chemicals, pharmaceuticals and explosives all depend on operating experience feedback to provide lessons learned about safety. The Incident Reporting System (IRS) is an essential element of the system for feeding back international operating experience for nuclear power plants. IRS reports contain information on events of Safety significance with important lessons learned. These experiences assist in reducing or eliminating recurrence of events at other plants. The IRS is jointly operated and managed by the Nuclear Energy Agency (NEA), a semi-autonomous body within the Organisation for Economic Co-operation and Development (OECD), and the International Atomic Energy Agency (IAEA). It is important that sufficient national resources be allocated to enable timely and high quality reporting of events important to safety, and to share these events in the IRS database. The first report, which covered the period July 1996 - June 1999, was widely acclaimed and encouraged both agencies to prepare this second report in order to highlight important lessons learned from around 300 events reported to the IRS for the period July 1999 - December 2002. Several areas were selected in this report to show the range of important topics available in the IRS. These include different types of failure in a variety of plant systems, as well as human performance considerations. This report is primarily aimed at senior officials in industry and government who have decision-making roles in the nuclear power industry

  15. To what extent are adverse events found in patient records reported by patients and healthcare professionals via complaints, claims and incident reports?

    Directory of Open Access Journals (Sweden)

    van der Wal Gerrit

    2011-02-01

    Full Text Available Abstract Background Patient record review is believed to be the most useful method for estimating the rate of adverse events among hospitalised patients. However, the method has some practical and financial disadvantages. Some of these disadvantages might be overcome by using existing reporting systems in which patient safety issues are already reported, such as incidents reported by healthcare professionals and complaints and medico-legal claims filled by patients or their relatives. The aim of the study is to examine to what extent the hospital reporting systems cover the adverse events identified by patient record review. Methods We conducted a retrospective study using a database from a record review study of 5375 patient records in 14 hospitals in the Netherlands. Trained nurses and physicians using a method based on the protocol of The Harvard Medical Practice Study previously reviewed the records. Four reporting systems were linked with the database of reviewed records: 1 informal and 2 formal complaints by patients/relatives, 3 medico-legal claims by patients/relatives and 4 incident reports by healthcare professionals. For each adverse event identified in patient records the equivalent was sought in these reporting systems by comparing dates and descriptions of the events. The study focussed on the number of adverse event matches, overlap of adverse events detected by different sources, preventability and severity of consequences of reported and non-reported events and sensitivity and specificity of reports. Results In the sample of 5375 patient records, 498 adverse events were identified. Only 18 of the 498 (3.6% adverse events identified by record review were found in one or more of the four reporting systems. There was some overlap: one adverse event had an equivalent in both a complaint and incident report and in three cases a patient/relative used two or three systems to complain about an adverse event. Healthcare professionals

  16. Section based traffic detection on motorways for incident management

    NARCIS (Netherlands)

    Noort, M. van; Klunder, G.

    2007-01-01

    Current vehicle detection on motorways is based generally on either inductive loop systems or various alternatives such as video cameras. Recently, we encountered two new developments that take a different approach: one from The Netherlands using microwave sensors, and the other from Sweden using

  17. Increasing incidence of pyogenic spondylodiscitis: a 14-year population-based study.

    Science.gov (United States)

    Kehrer, Michala; Pedersen, Court; Jensen, Thøger G; Lassen, Annmarie T

    2014-04-01

    Smaller studies indicate that the incidence of pyogenic spondylodiscitis is increasing, possible related to a growing elderly population. Data supporting this is sparse, and we therefore studied patient characteristics and changes in spondylodiscitis incidence 1995-2008. In a population-based study we identified all patients aged ≥18 years treated for pyogenic spondylodiscitis in Funen County, Denmark (population 483 123). Annual incidences were determined. Demographics, symptoms and diagnostic methods were recorded. We found 192 cases: median age 66.6 years; 57.3% men; 76.6% culture positive cases. Staphylococcus aureus was the most common pathogen (55.1%). During 1995-2008 the overall incidence, incidence of culture negative cases, and incidence of cases due to S. aureus increased 2.2-5.8, 0.3-1.8, and 1.6-2.5 cases per 100 000 person years, respectively. The elderly had the highest incidence compared to those aged ≤70 years (rate ratio for men 5.9 (95% CI: 4.2-8.5) and for women 3.5 (95% CI: 2.3-5.3)). During 1995-2008 the overall incidence of S. aureus and culture negative cases of spondylodiscitis increased and remained highest among the elderly. Whether the increase is real or is a result of improved diagnostic methods and workup remains unknown. Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  18. Medication incident reporting in residential aged care facilities: Limitations and risks to residents’ safety

    Directory of Open Access Journals (Sweden)

    Tariq Amina

    2012-11-01

    Full Text Available Abstract Background Medication incident reporting (MIR is a key safety critical care process in residential aged care facilities (RACFs. Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a design MIR artefacts that facilitate identification of the root causes of medication incidents, b integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes.

  19. Changing incidence of diverticular disease of the colon in Korea : a serial radiologic study (report III)

    Energy Technology Data Exchange (ETDEWEB)

    Kwoen, Young Teck; Han, Sung Il; Chung, Soo Kyo; Bahk, Yong Whee [Catholic University Medical College, Seoul (Korea, Republic of)

    1988-10-15

    Diverticular disease of the colon (DDC), the most common affliction in developed countries, increases in incidence. It is an acquired disease where overactivity of smooth muscle of the colon causes mucosa and sub mucosa to herniate through the muscle layer of the bowel. Starting from 1964, we have periodically carried out radiologic survey to acertain the tendency of DDC to gradually increase in the Koreans. Initially Kim reported the incidence to be 0.2% in 1964 but the incidence in 1979 increased to 2.5% as reported by Chung et al. As the third survey on the series of the study on DDC, we have recently reviewed 1,859 consecutive new cases of double contrast barium enemas performed at the department of radiology, Kangnam St. Mary's Hospital, Catholic University Medical College during the 5 year's period from Feb. 1983 to May 1987. The results were as follows. 1. The present study revealed an incidence 6.0% of DDC, 7.2% in male and 5.0% in female. 2. The distribution of diverticular was 37.0% in cecum, 39.0% in ascending colon, 13.6% in transverse colon, 6.2% in descending colon, 3.7% in sigmoid colon. 3. The mean number of diverticular was 5. 4. The average age of patients with DDC was 50.5 years. From the present study, it has emerged that the diverticular disease of the colon in the Koreans is definitely on gradual increase with a significant change in the site of predominant involvement from the right to the left colon.

  20. Changing incidence of diverticular disease of the colon in Korea : a serial radiologic study (report III)

    International Nuclear Information System (INIS)

    Kwoen, Young Teck; Han, Sung Il; Chung, Soo Kyo; Bahk, Yong Whee

    1988-01-01

    Diverticular disease of the colon (DDC), the most common affliction in developed countries, increases in incidence. It is an acquired disease where overactivity of smooth muscle of the colon causes mucosa and sub mucosa to herniate through the muscle layer of the bowel. Starting from 1964, we have periodically carried out radiologic survey to acertain the tendency of DDC to gradually increase in the Koreans. Initially Kim reported the incidence to be 0.2% in 1964 but the incidence in 1979 increased to 2.5% as reported by Chung et al. As the third survey on the series of the study on DDC, we have recently reviewed 1,859 consecutive new cases of double contrast barium enemas performed at the department of radiology, Kangnam St. Mary's Hospital, Catholic University Medical College during the 5 year's period from Feb. 1983 to May 1987. The results were as follows. 1. The present study revealed an incidence 6.0% of DDC, 7.2% in male and 5.0% in female. 2. The distribution of diverticular was 37.0% in cecum, 39.0% in ascending colon, 13.6% in transverse colon, 6.2% in descending colon, 3.7% in sigmoid colon. 3. The mean number of diverticular was 5. 4. The average age of patients with DDC was 50.5 years. From the present study, it has emerged that the diverticular disease of the colon in the Koreans is definitely on gradual increase with a significant change in the site of predominant involvement from the right to the left colon.

  1. Nuclear medicine incident reporting in Australia: control charts and notification rates inform quality improvement.

    Science.gov (United States)

    Larcos, G; Collins, L T; Georgiou, A; Westbrook, J I

    2015-06-01

    Australia has a statutory incident reporting system for radiopharmaceutical maladministrations, but additional research into registry data is required for the purpose of quality improvement in nuclear medicine. We (i) used control charts to identify factors contributing to special cause variation (indicating higher than expected rates) in maladministrations and (ii) evaluated the impact of heterogeneous notification criteria and extent of underreporting among jurisdictions and individual facilities, respectively. Anonymised summaries of Australian Radiation Incident Register reports permitted calculation of national monthly maladministration notification rates for 2007-2012 and preparation of control charts. Multivariate logistic regression assessed the association of population, insurance and regulatory characteristics with maladministration notifications in each Australian State and Territory. Maladministration notification rates from two facilities with familiarity of notification processes and commitment to radiation protection were compared with those elsewhere. Special cause variation occurred in only 3 months, but contributed to 21% of all incidents (42 of 197 patients), mainly because of 'clusters' of maladministrations (n = 24) arising from errors in bulk radiopharmaceutical dispensing. Maladministration notification rates varied significantly between jurisdictions (0 to 12.2 maladministrations per 100 000 procedures (P < 0.05)) and individual facilities (31.7 vs 5.8 per 100 000; χ(2) = 40; 1 degree of freedom, P < 0.001). Unexpected increases in maladministration notifications predominantly relate to incident 'clusters' affecting multiple patients. The bulk preparation of radiopharmaceuticals is a vulnerable process and merits additional safeguards. Maladministration notification rates in Australia are heterogeneous. Adopting uniform maladministration notification criteria among States and Territories and methods to overcome underreporting are

  2. Recommendations for Nuclear Medicine Technologists Drawn from an Analysis of Errors Reported in Australian Radiation Incident Registers.

    Science.gov (United States)

    Kearney, Nicole; Denham, Gary

    2016-12-01

    When a radiation incident occurs in nuclear medicine in Australia, the incident is reported to the relevant state or territory authority, which performs an investigation and sends its findings to the Australian Radiation Protection and Nuclear Safety Agency. The agency then includes these data in its Australian Radiation Incident Register and makes them available to the public as an annual summary report on its website. The aim of this study was to analyze the radiation incidents included in these annual reports and in the publically available state and territory registers, identify any recurring themes, and make recommendations to minimize future incidents. A multidisciplinary team comprising a nuclear medicine technologist, a radiation therapist, and a diagnostic radiographer analyzed all nuclear medicine technology-, radiation therapy-, and diagnostic radiography-related incidents recorded in the Australian Radiation Incident Register and in the registers of New South Wales, Western Australia, Victoria, South Australia, and Tasmania between 2003 and 2015. Each incident was placed into 1 of 18 categories, and each category was examined to determine any recurring causes of the incidents. We analyzed 209 nuclear medicine incidents. Their primary cause was failure to comply with time-out protocols (85.6%). By analyzing both the causes and the rates of radiation incidents, we were able to recommend ways to help prevent them from being repeated. Information drawn from the Australian Radiation Incident Register and 5 state registers has revealed steps that can be taken by any nuclear medicine department to prevent repetition of the incidents that have already occurred. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  3. EUB post-incident report : Celtic Exploration Ltd. well servicing incident : blowout and fire, August 9, 2005

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-02-06

    A blowout and fire occurred on August 9, 2005 at a sour oil well during a routine well completion operation. The Alberta Energy and Utilities Board (EUB) was notified by Celtic Exploration Ltd., the well operator which implemented the emergency response plan (ERP). The 21 residents in the area were evacuated along with 100 campers from a nearby provincial park. The release concentration of hydrogen sulphide from the well was 4.5 moles/kilomole. The well was brought under control the next day by pumping calcium chloride water down the well. The evacuees were allowed to return. One fatality and 2 injuries were sustained by workers at the site and the service rig was destroyed by fire. Celtic assessed the incident as an uncontrollable event. The EUB conducted an investigation that focused on the cause of the incident, the risk to public safety, environmental impacts, and the conservation of the resource. The worker fatalities and injuries are being investigated by the Alberta Human Resources and Employment, Workplace Health and Safety. It was determined that the blowout was caused by an explosion within the swab tree assembly at the top of the well. An explosive situation was created when a mix of hydrocarbons and air was ignited. However, the source of ignition could not be definitively determined. The EUB also assessed the implementation of Celtic's ERP and the actions taken to manage the incident. The EUB determined that while several ERP measures were managed appropriately, some specific elements were deficient, particularly communication during the incident. About 228 cubic metres of contaminated soil was removed from the well lease to a waste site. The total production loss is estimated at 4 m{sup 3} of oil and 12,000 m{sup 3} of raw solution gas. Four follow-up actions that Celtic has committed to were described along with the EUB's directive 033 regarding well servicing and completions operations and requirements regarding the potential for explosive

  4. Creating European guidelines for Chiropractic Incident Reporting and Learning Systems (CIRLS: relevance and structure

    Directory of Open Access Journals (Sweden)

    Wangler Martin

    2011-04-01

    Full Text Available Abstract Background In 2009, the heads of the Executive Council of the European Chiropractors' Union (ECU and the European Academy of Chiropractic (EAC involved in the European Committee for Standardization (CEN process for the chiropractic profession, set out to establish European guidelines for the reporting of adverse reactions to chiropractic treatment. There were a number of reasons for this: first, to improve the overall quality of patient care by aiming to reduce the application of potentially harmful interventions and to facilitate the treatment of patients within the context of achieving maximum benefit with a minimum risk of harm; second, to inform the training objectives for the Graduate Education and Continuing Professional Development programmes of all 19 ECU member nations, regarding knowledge and skills to be acquired for maximising patient safety; and third, to develop a guideline on patient safety incident reporting as it is likely to be part of future CEN standards for ECU member nations. Objective To introduce patient safety incident reporting within the context of chiropractic practice in Europe and to help individual countries and their national professional associations to develop or improve reporting and learning systems. Discussion Providing health care of any kind, including the provision of chiropractic treatment, can be a complex and, at times, a risky activity. Safety in healthcare cannot be guaranteed, it can only be improved. One of the most important aspects of any learning and reporting system lies in the appropriate use of the data and information it gathers. Reporting should not just be seen as a vehicle for obtaining information on patient safety issues, but also be utilised as a tool to facilitate learning, advance quality improvement and to ultimately minimise the rate of the occurrence of errors linked to patient care. Conclusions Before a reporting and learning system can be established it has to be clear

  5. Patient-safety-related hospital deaths in England: thematic analysis of incidents reported to a national database, 2010-2012.

    Science.gov (United States)

    Donaldson, Liam J; Panesar, Sukhmeet S; Darzi, Ara

    2014-06-01

    Hospital mortality is increasingly being regarded as a key indicator of patient safety, yet methodologies for assessing mortality are frequently contested and seldom point directly to areas of risk and solutions. The aim of our study was to classify reports of deaths due to unsafe care into broad areas of systemic failure capable of being addressed by stronger policies, procedures, and practices. The deaths were reported to a patient safety incident reporting system after mandatory reporting of such incidents was introduced. The UK National Health Service database was searched for incidents resulting in a reported death of an adult over the period of the study. The study population comprised 2,010 incidents involving patients aged 16 y and over in acute hospital settings. Each incident report was reviewed by two of the authors, and, by scrutinising the structured information together with the free text, a main reason for the harm was identified and recorded as one of 18 incident types. These incident types were then aggregated into six areas of apparent systemic failure: mismanagement of deterioration (35%), failure of prevention (26%), deficient checking and oversight (11%), dysfunctional patient flow (10%), equipment-related errors (6%), and other (12%). The most common incident types were failure to act on or recognise deterioration (23%), inpatient falls (10%), healthcare-associated infections (10%), unexpected per-operative death (6%), and poor or inadequate handover (5%). Analysis of these 2,010 fatal incidents reveals patterns of issues that point to actionable areas for improvement. Our approach demonstrates the potential utility of patient safety incident reports in identifying areas of service failure and highlights opportunities for corrective action to save lives.

  6. Patient-safety-related hospital deaths in England: thematic analysis of incidents reported to a national database, 2010-2012.

    Directory of Open Access Journals (Sweden)

    Liam J Donaldson

    2014-06-01

    Full Text Available BACKGROUND: Hospital mortality is increasingly being regarded as a key indicator of patient safety, yet methodologies for assessing mortality are frequently contested and seldom point directly to areas of risk and solutions. The aim of our study was to classify reports of deaths due to unsafe care into broad areas of systemic failure capable of being addressed by stronger policies, procedures, and practices. The deaths were reported to a patient safety incident reporting system after mandatory reporting of such incidents was introduced. METHODS AND FINDINGS: The UK National Health Service database was searched for incidents resulting in a reported death of an adult over the period of the study. The study population comprised 2,010 incidents involving patients aged 16 y and over in acute hospital settings. Each incident report was reviewed by two of the authors, and, by scrutinising the structured information together with the free text, a main reason for the harm was identified and recorded as one of 18 incident types. These incident types were then aggregated into six areas of apparent systemic failure: mismanagement of deterioration (35%, failure of prevention (26%, deficient checking and oversight (11%, dysfunctional patient flow (10%, equipment-related errors (6%, and other (12%. The most common incident types were failure to act on or recognise deterioration (23%, inpatient falls (10%, healthcare-associated infections (10%, unexpected per-operative death (6%, and poor or inadequate handover (5%. Analysis of these 2,010 fatal incidents reveals patterns of issues that point to actionable areas for improvement. CONCLUSIONS: Our approach demonstrates the potential utility of patient safety incident reports in identifying areas of service failure and highlights opportunities for corrective action to save lives.

  7. Strabismus Incidence in a Danish Population-Based Cohort of Children

    DEFF Research Database (Denmark)

    Torp-Pedersen, Tobias; Boyd, Heather A; Skotte, Line

    2017-01-01

    Importance: To our knowledge, there have been few population-based studies of strabismus incidence conducted. Our population-based study provides valuable data for health services planning and identifying research needs. Objective: To determine the incidence and age distribution of strabismus...... age at the detection of strabismus, overall and by subtype. Results: The study cohort included 96 842 children born between 1996 and 2008 who are predominantly Caucasian and is composed of approximately 30% of births in Denmark, with a boy-girl ratio of 51:49. Overall, 1309 cases of strabismus were...... identified in the cohort. We found an overall cumulative strabismus incidence of 2.56% (95% CI, 2.42-2.69) at 7 years. The overall incidence was similar among boys and girls. Two hundred sixteen participants (16.5%) (95% CI, 14.5-18.6) had congenital esotropia, 177 (13.5%) (95% CI, 11.7-15.5) had fully...

  8. Pesticide exposure and self-reported incident depression among wives in the Agricultural Health Study.

    Science.gov (United States)

    Beard, John D; Hoppin, Jane A; Richards, Marie; Alavanja, Michael C R; Blair, Aaron; Sandler, Dale P; Kamel, Freya

    2013-10-01

    Depression in women is a public health problem. Studies have reported positive associations between pesticides and depression, but few studies were prospective or presented results for women separately. We evaluated associations between pesticide exposure and incident depression among farmers' wives in the Agricultural Health Study, a prospective cohort study in Iowa and North Carolina. We used data on 16,893 wives who did not report physician-diagnosed depression at enrollment (1993-1997) and who completed a follow-up telephone interview (2005-2010). Among these wives, 1054 reported physician diagnoses of depression at follow-up. We collected information on potential confounders and on ever use of any pesticide, 11 functional and chemical classes of pesticides, and 50 specific pesticides by wives and their husbands via self-administered questionnaires at enrollment. We used inverse probability weighting to adjust for potential confounders and to account for possible selection bias induced by the death or loss of 10,639 wives during follow-up. We used log-binomial regression models to estimate risk ratios and 95% confidence intervals. After weighting for age at enrollment, state of residence, education level, diabetes diagnosis, and drop out, wives' incident depression was positively associated with diagnosed pesticide poisoning, but was not associated with ever using any pesticide. Use of individual pesticides or functional or chemical classes of pesticides was generally not associated with wives' depression. Among wives who never used pesticides, husbands' ever use of individual pesticides or functional or chemical classes of pesticides was generally not associated with wives' incident depression. Our study adds further evidence that high level pesticide exposure, such as pesticide poisoning, is associated with increased risk of depression and sets a lower bound on the level of exposure related to depression, thereby providing reassurance that the moderate levels

  9. Can Patient Safety Incident Reports Be Used to Compare Hospital Safety? Results from a Quantitative Analysis of the English National Reporting and Learning System Data.

    Directory of Open Access Journals (Sweden)

    Ann-Marie Howell

    Full Text Available The National Reporting and Learning System (NRLS collects reports about patient safety incidents in England. Government regulators use NRLS data to assess the safety of hospitals. This study aims to examine whether annual hospital incident reporting rates can be used as a surrogate indicator of individual hospital safety. Secondly assesses which hospital characteristics are correlated with high incident reporting rates and whether a high reporting hospital is safer than those lower reporting hospitals. Finally, it assesses which health-care professionals report more incidents of patient harm, which report more near miss incidents and what hospital factors encourage reporting. These findings may suggest methods for increasing the utility of reporting systems.This study used a mix methods approach for assessing NRLS data. The data were investigated using Pareto analysis and regression models to establish which patients are most vulnerable to reported harm. Hospital factors were correlated with institutional reporting rates over one year to examine what factors influenced reporting. Staff survey findings regarding hospital safety culture were correlated with reported rates of incidents causing harm; no harm and death to understand what barriers influence error disclosure.5,879,954 incident reports were collected from acute hospitals over the decade. 70.3% of incidents produced no harm to the patient and 0.9% were judged by the reporter to have caused severe harm or death. Obstetrics and Gynaecology reported the most no harm events [OR 1.61(95%CI: 1.12 to 2.27, p<0.01] and pharmacy was the hospital location where most near-misses were captured [OR 3.03(95%CI: 2.04 to 4.55, p<0.01]. Clinicians were significantly more likely to report death than other staff [OR 3.04(95%CI: 2.43 to 3.80 p<0.01]. A higher ratio of clinicians to beds correlated with reduced rate of harm reported [RR = -1.78(95%Cl: -3.33 to -0.23, p = 0.03]. Litigation claims per bed were

  10. Associations between serum uric acid levels and the incidence of nonfatal stroke: a nationwide community-based cohort study.

    Science.gov (United States)

    Kamei, Keita; Konta, Tsuneo; Hirayama, Atsushi; Ichikawa, Kazunobu; Kubota, Isao; Fujimoto, Shouichi; Iseki, Kunitoshi; Moriyama, Toshiki; Yamagata, Kunihiro; Tsuruya, Kazuhiko; Narita, Ichiei; Kondo, Masahide; Shibagaki, Yugo; Kasahara, Masato; Asahi, Koichi; Watanabe, Tsuyoshi

    2017-06-01

    Hyperuricemia is an established risk factor for cardiovascular events and mortality. This study investigated the association between serum uric acid and the incidence of nonfatal stroke in a Japanese community-based population. We used a nationwide database of 155,322 subjects (aged 40-73, male 39 %) who participated in the annual "Specific Health Check and Guidance in Japan" checkup from 2008 to 2010. We examined the relationship between the quintiles of serum uric acid levels at baseline and the incidence of nonfatal stroke during a 2-year study period using self-reported data. The crude incidence of nonfatal stroke was significantly associated with serum uric acid levels at baseline, showing the lowest values in subjects with the 3rd quintile (Q3: men, 5.0-5.6; women, 3.8-4.3) of uric acid levels (mg/dL) and the highest values in subjects with the highest quintile (Q5: men ≥7.1, women ≥5.5) both in men and women (P uric acid levels for incident stroke was high, irrespective of characteristics such as age, sex, and renal function. This study has shown that serum uric acid is independently associated with the incidence of nonfatal stroke in the general Japanese population.

  11. Identifying medication error chains from critical incident reports: a new analytic approach.

    Science.gov (United States)

    Huckels-Baumgart, Saskia; Manser, Tanja

    2014-10-01

    Research into the distribution of medication errors usually focuses on isolated stages within the medication use process. Our study aimed to provide a novel process-oriented approach to medication incident analysis focusing on medication error chains. Our study was conducted across a 900-bed teaching hospital in Switzerland. All reported 1,591 medication errors 2009-2012 were categorized using the Medication Error Index NCC MERP and the WHO Classification for Patient Safety Methodology. In order to identify medication error chains, each reported medication incident was allocated to the relevant stage of the hospital medication use process. Only 25.8% of the reported medication errors were detected before they propagated through the medication use process. The majority of medication errors (74.2%) formed an error chain encompassing two or more stages. The most frequent error chain comprised preparation up to and including medication administration (45.2%). "Non-consideration of documentation/prescribing" during the drug preparation was the most frequent contributor for "wrong dose" during the administration of medication. Medication error chains provide important insights for detecting and stopping medication errors before they reach the patient. Existing and new safety barriers need to be extended to interrupt error chains and to improve patient safety. © 2014, The American College of Clinical Pharmacology.

  12. Patient involvement in patient safety: Protocol for developing an intervention using patient reports of organisational safety and patient incident reporting

    Science.gov (United States)

    2011-01-01

    Background Patients have the potential to provide a rich source of information on both organisational aspects of safety and patient safety incidents. This project aims to develop two patient safety interventions to promote organisational learning about safety - a patient measure of organisational safety (PMOS), and a patient incident reporting tool (PIRT) - to help the NHS prevent patient safety incidents by learning more about when and why they occur. Methods To develop the PMOS 1) literature will be reviewed to identify similar measures and key contributory factors to error; 2) four patient focus groups will ascertain practicality and feasibility; 3) 25 patient interviews will elicit approximately 60 items across 10 domains; 4) 10 patient and clinician interviews will test acceptability and understanding. Qualitative data will be analysed using thematic content analysis. To develop the PIRT 1) individual and then combined patient and clinician focus groups will provide guidance for the development of three potential reporting tools; 2) nine wards across three hospital directorates will pilot each of the tools for three months. The best performing tool will be identified from the frequency, volume and quality of reports. The validity of both measures will be tested. 300 patients will be asked to complete the PMOS and PIRT during their stay in hospital. A sub-sample (N = 50) will complete the PMOS again one week later. Health professionals in participating wards will also be asked to complete the AHRQ safety culture questionnaire. Case notes for all patients will be reviewed. The psychometric properties of the PMOS will be assessed and a final valid and reliable version developed. Concurrent validity for the PIRT will be assessed by comparing reported incidents with those identified from case note review and the existing staff reporting scheme. In a subsequent study these tools will be used to provide information to wards/units about their priorities for patient

  13. Patient involvement in patient safety: Protocol for developing an intervention using patient reports of organisational safety and patient incident reporting

    Directory of Open Access Journals (Sweden)

    Armitage Gerry

    2011-05-01

    Full Text Available Abstract Background Patients have the potential to provide a rich source of information on both organisational aspects of safety and patient safety incidents. This project aims to develop two patient safety interventions to promote organisational learning about safety - a patient measure of organisational safety (PMOS, and a patient incident reporting tool (PIRT - to help the NHS prevent patient safety incidents by learning more about when and why they occur. Methods To develop the PMOS 1 literature will be reviewed to identify similar measures and key contributory factors to error; 2 four patient focus groups will ascertain practicality and feasibility; 3 25 patient interviews will elicit approximately 60 items across 10 domains; 4 10 patient and clinician interviews will test acceptability and understanding. Qualitative data will be analysed using thematic content analysis. To develop the PIRT 1 individual and then combined patient and clinician focus groups will provide guidance for the development of three potential reporting tools; 2 nine wards across three hospital directorates will pilot each of the tools for three months. The best performing tool will be identified from the frequency, volume and quality of reports. The validity of both measures will be tested. 300 patients will be asked to complete the PMOS and PIRT during their stay in hospital. A sub-sample (N = 50 will complete the PMOS again one week later. Health professionals in participating wards will also be asked to complete the AHRQ safety culture questionnaire. Case notes for all patients will be reviewed. The psychometric properties of the PMOS will be assessed and a final valid and reliable version developed. Concurrent validity for the PIRT will be assessed by comparing reported incidents with those identified from case note review and the existing staff reporting scheme. In a subsequent study these tools will be used to provide information to wards/units about their

  14. Incidence of delayed union one year after peri-acetabular osteotomy based on computed tomography.

    Science.gov (United States)

    Akiho, Shunsuke; Kinoshita, Koichi; Matsunaga, Ayumi; Ishii, Satohiro; Seo, Hajime; Nishio, Jun; Yamamoto, Takuaki

    2017-10-10

    Pubic bone nonunion and delayed union are reported as post-operative complications after peri-acetabular osteotomy (PAO). However, few studies have determined the incidence of delayed union using computed tomography (CT) scans. This study aimed to determine the incidence of delayed union at one year after PAO using X-ray and CT scans. We performed a retrospective review of 150 hips in 132 consecutive patients with acetabular dysplasia who underwent PAO between January 2012 and June 2016 and evaluated 107 hips for which pelvic CT scans taken at one year after PAO were available. Clinical evaluations included age at surgery, weight, body mass index (BMI) and history. Radiographic evaluations were to assess pubic, ischial and iliac delayed union at one year post-operatively. Based on X-ray analysis, the incidence of delayed union in the pubic, ischial and iliac bones was 11.2% (12 hips), 5.6% (6 hips) and 0% (0 hips), respectively, and20.6% (22 hips), 8.4% (9 hips) and 0% (0 hips), respectively, based on CT scans. The incidence of delayed union of the pubis and ischium at one year after PAO according to CT scans was higher than that based on X-ray imaging. CT scans are useful in patients with some symptoms at the osteotomy site. Level III.

  15. Can Patient Safety Incident Reports Be Used to Compare Hospital Safety? Results from a Quantitative Analysis of the English National Reporting and Learning System Data.

    Science.gov (United States)

    Howell, Ann-Marie; Burns, Elaine M; Bouras, George; Donaldson, Liam J; Athanasiou, Thanos; Darzi, Ara

    2015-01-01

    The National Reporting and Learning System (NRLS) collects reports about patient safety incidents in England. Government regulators use NRLS data to assess the safety of hospitals. This study aims to examine whether annual hospital incident reporting rates can be used as a surrogate indicator of individual hospital safety. Secondly assesses which hospital characteristics are correlated with high incident reporting rates and whether a high reporting hospital is safer than those lower reporting hospitals. Finally, it assesses which health-care professionals report more incidents of patient harm, which report more near miss incidents and what hospital factors encourage reporting. These findings may suggest methods for increasing the utility of reporting systems. This study used a mix methods approach for assessing NRLS data. The data were investigated using Pareto analysis and regression models to establish which patients are most vulnerable to reported harm. Hospital factors were correlated with institutional reporting rates over one year to examine what factors influenced reporting. Staff survey findings regarding hospital safety culture were correlated with reported rates of incidents causing harm; no harm and death to understand what barriers influence error disclosure. 5,879,954 incident reports were collected from acute hospitals over the decade. 70.3% of incidents produced no harm to the patient and 0.9% were judged by the reporter to have caused severe harm or death. Obstetrics and Gynaecology reported the most no harm events [OR 1.61(95%CI: 1.12 to 2.27), preport death than other staff [OR 3.04(95%CI: 2.43 to 3.80) preported [RR = -1.78(95%Cl: -3.33 to -0.23), p = 0.03]. Litigation claims per bed were significantly negatively associated with incident reports. Patient satisfaction and mortality outcomes were not significantly associated with reporting rates. Staff survey responses revealed that keeping reports confidential, keeping staff informed about

  16. The role of patient simulation and incident reporting in the development and evaluation of medical devices and the training of their users

    DEFF Research Database (Denmark)

    Dieckmann, P; Rall, M; Østergaard, Doris

    2009-01-01

    We describe how simulation and incident reporting can be used in combination to make the interaction between people, (medical) technology and organisation safer for patients and users. We provide the background rationale for our conceptual ideas and apply the concepts to the analysis of an actual...... incident report. Simulation can serve as a laboratory to analyse such cases and to create relevant and effective training scenarios based on such analyses. We will describe a methodological framework for analysing simulation scenarios in a way that allows discovering and discussing mismatches between...... conceptual models of the device design and mental models users hold about the device and its use. We further describe how incident reporting systems can be used as one source of data to conduct the necessary needs analyses - both for training and further needs for closer analysis of specific devices or some...

  17. Identifying and Embedding Common Indicators of Compromise in Virtual Machines for Lab-Based Incident Response Education

    Science.gov (United States)

    2015-09-01

    artifacts for indicators of compromise and prominent incident investigative tools. These scenarios will help facilitate the educational experience...distribution is unlimited IDENTIFYING AND EMBEDDING COMMON INDICATORS OF COMPROMISE IN VIRTUAL MACHINES FOR LAB-BASED INCIDENT RESPONSE EDUCATION ...AND SUBTITLE IDENTIFYING AND EMBEDDING COMMON INDICATORS OF COMPROMISE IN VIRTUAL MACHINES FOR LAB-BASED INCIDENT RESPONSE EDUCATION 5. FUNDING

  18. Atherosclerosis profile and incidence of cardiovascular events: a population-based survey

    Directory of Open Access Journals (Sweden)

    Bullano Michael F

    2009-09-01

    Full Text Available Abstract Background Atherosclerosis is a chronic progressive disease often presenting as clinical cardiovascular disease (CVD events. This study evaluated the characteristics of individuals with a diagnosis of atherosclerosis and estimated the incidence of CVD events to assist in the early identification of high-risk individuals. Methods Respondents to the US SHIELD baseline survey were followed for 2 years to observe incident self-reported CVD. Respondents had subclinical atherosclerosis if they reported a diagnosis of narrow or blocked arteries/carotid artery disease without a past clinical CVD event (heart attack, stroke or revascularization. Characteristics of those with atherosclerosis and incident CVD were compared with those who did not report atherosclerosis at baseline but had CVD in the following 2 years using chi-square tests. Logistic regression model identified characteristics associated with atherosclerosis and incident events. Results Of 17,640 respondents, 488 (2.8% reported having subclinical atherosclerosis at baseline. Subclinical atherosclerosis was associated with age, male gender, dyslipidemia, circulation problems, hypertension, past smoker, and a cholesterol test in past year (OR = 2.2 [all p Conclusion Self-report of subclinical atherosclerosis identified an extremely high-risk group with a >25% risk of a CVD event in the next 2 years. These characteristics may be useful for identifying individuals for more aggressive diagnostic and therapeutic efforts.

  19. Identifying patient safety problems associated with information technology in general practice: an analysis of incident reports.

    Science.gov (United States)

    Magrabi, Farah; Liaw, Siaw Teng; Arachi, Diana; Runciman, William; Coiera, Enrico; Kidd, Michael R

    2016-11-01

    To identify the categories of problems with information technology (IT), which affect patient safety in general practice. General practitioners (GPs) reported incidents online or by telephone between May 2012 and November 2013. Incidents were reviewed against an existing classification for problems associated with IT and the clinical process impacted. 87 GPs across Australia. Types of problems, consequences and clinical processes. GPs reported 90 incidents involving IT which had an observable impact on the delivery of care, including actual patient harm as well as near miss events. Practice systems and medications were the most affected clinical processes. Problems with IT disrupted clinical workflow, wasted time and caused frustration. Issues with user interfaces, routine updates to software packages and drug databases, and the migration of records from one package to another generated clinical errors that were unique to IT; some could affect many patients at once. Human factors issues gave rise to some errors that have always existed with paper records but are more likely to occur and cause harm with IT. Such errors were linked to slips in concentration, multitasking, distractions and interruptions. Problems with patient identification and hybrid records generated errors that were in principle no different to paper records. Problems associated with IT include perennial risks with paper records, but additional disruptions in workflow and hazards for patients unique to IT, occasionally affecting multiple patients. Surveillance for such hazards may have general utility, but particularly in the context of migrating historical records to new systems and software updates to existing systems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Blindness incidence in Germany. A population-based study from Württemberg-Hohenzollern.

    Science.gov (United States)

    Krumpaszky, H G; Lüdtke, R; Mickler, A; Klauss, V; Selbmann, H K

    1999-01-01

    Few data on the incidence of blindness in Germany are available. We analysed causes of legal blindness for the region Württemberg-Hohenzollern (population 5.5 million) in order to help fill in this gap. Population-based investigation on the incidence of legal blindness (visual acuity <1/50) based on materials from the social services. Age-dependent blindness incidences were modelled via logistic regression models. 647 blind persons were newly registered in 1994 (blindness incidence 11.6/100,000). The blindness incidence is moderate in infants (4.5/100,000) and decreases further during childhood. At the age of 20 years, the incidence again rises to the former level and remains relatively constant. After the age of 60 years, the incidence increases sharply: 5-year odds ratios are 1.76 (CI: 1.68-1. 85) in women and 1.72 (CI: 1.60-1.84) in men. The blindness incidence is higher in women, 15.6/100,000, compared to 12.2/100,000 in men. The major causes of blindness are: macular degeneration, 3. 92/100,000; diabetic retinopathy, 2.01/100,000; glaucoma, 1.6/100, 000; high myopia, 0.77/100,000; optic atrophy, 0.68/100,000; central nervous system-triggered blindness; 0.56/100,000, and tapetoretinal degenerations, 0.52/100,000. Due to monetary incentives for the blind persons, social service files offer accurate and complete data. Besides macular degeneration, glaucoma and diabetic retinopathy are major causes of blindness. Thus, this study suggests further blindness prevention activities for diabetic retinopathy and glaucoma.

  1. Incidence of anogenital warts in Germany: a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Mikolajczyk Rafael T

    2010-12-01

    Full Text Available Abstract Background Human papilloma virus (HPV types 6 and 11 account for 90 percent of anogenital warts (AGW. Assessment of a potential reduction of the incidence of AGW following introduction of HPV vaccines requires population-based incidence rates. The aim of this study was to estimate incidence rates of AGW in Germany, stratified by age, sex, and region. Additionally, the medical practitioner (gynaecologist, dermatologist, urologist etc. who made the initial diagnosis of AGW was assessed. Methods Retrospective cohort study in a population aged 10 to 79 years in a population-based healthcare insurance database. The database included more than 14 million insurance members from all over Germany during the years 2004-2006. A case of AGW was considered incident if a disease-free period of twelve months preceded the diagnosis. To assess regional variation, analyses were performed by federal state. Results The estimated incidence rate was 169.5/100,000 person-years for the German population aged 10 to 79 years. Most cases occurred in the 15 to 40 years age group. The incidence rate was higher and showed a peak at younger ages in females than in males. The highest incidence rates for both sexes were observed in the city-states Berlin, Hamburg and Bremen. In females, initial diagnosis of AGW was most frequently made by a gynaecologist (71.7%, whereas in males, AGW were most frequently diagnosed by a dermatologist (44.8% or urologist (25.1%. Conclusions Incidence of AGW in Germany is comparable with findings for other countries. As expected, most cases occurred in the younger age groups. The frequency of diagnoses of AGW differs between sexes and women and men receive treatment by doctors of different specialties.

  2. Merkel cell carcinoma: Current US incidence and projected increases based on changing demographics.

    Science.gov (United States)

    Paulson, Kelly G; Park, Song Youn; Vandeven, Natalie A; Lachance, Kristina; Thomas, Hannah; Chapuis, Aude G; Harms, Kelly L; Thompson, John A; Bhatia, Shailender; Stang, Andreas; Nghiem, Paul

    2018-03-01

    Merkel cell carcinoma (MCC) incidence rates are rising and strongly age-associated, relevant for an aging population. Determine MCC incidence in the United States and project incident cases through the year 2025. Registry data were obtained from the SEER-18 Database, containing 6600 MCC cases. Age- and sex-adjusted projections were generated using US census data. During 2000-2013, the number of reported solid cancer cases increased 15%, melanoma cases increased 57%, and MCC cases increased 95%. In 2013, the MCC incidence rate was 0.7 cases/100,000 person-years in the United States, corresponding to 2488 cases/year. MCC incidence increased exponentially with age, from 0.1 to 1.0 to 9.8 (per 100,000 person-years) among age groups 40-44 years, 60-64 years, and ≥85 years, respectively. Due to aging of the Baby Boomer generation, US MCC incident cases are predicted to climb to 2835 cases/year in 2020 and 3284 cases/year in 2025. We assumed that the age-adjusted incidence rate would stabilize, and thus, the number of incident cases we projected might be an underestimate. An aging population is driving brisk increases in the number of new MCC cases in the United States. This growing impact combined with the rapidly evolving therapeutic landscape warrants expanded awareness of MCC diagnosis and management. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  3. Cancer incidence in North West Algeria (Mascara) 2000-2010: results from a population-based cancer registry

    Science.gov (United States)

    Benarba, Bachir; Meddah, Boumedienne; Hamdani, Houria

    2014-01-01

    Cancer is a leading cause of death worldwide accounting for 7.4 million deaths. Cancer has become a major public health concern in Algeria. The aim of the present study was to estimate cancer incidence in Mascara Province based on the population-based cancer registry. We analyzed data from the cancer registry of Mascara covering all cancer cases diagnosed by all methods and included in the registry from 1st January 2000 to 31st December 2010. The results are presented as incidence rates of cases by site, sex, age, and crude rate. Age-standardized rates per 100,000 person-years (ASRs) were calculated, using the direct method of standardization to the world population. A total of 1875 cases of invasive cancer were recorded. The mean age of diagnosis for all cancers was 52.66 ± 0.5 in men and 59.18 ± 0.6 in women. The ASR for all cancers in females was 27.8 per 100,000, and that for males was 23.6 per 100,000. The most important finding of the present study was the high incidence of liver cancer among males and females in Mascara. Among females, breast cancer was the most frequently reported followed by Cervix uteri, liver and colon. The most frequent cancer types in males were lung, colon, esophagus and stomach and liver. Cancer incidence in Mascara province was lower than that reported in other national and regional registries. Findings of the present study revealed high incidence of liver cancer in the province, the highest in Algeria, suggesting high prevalence of risk factors. PMID:26417294

  4. Risk Factors for Sexual Violence in the Military: An Analysis of Sexual Assault and Sexual Harassment Incidents and Reporting

    Science.gov (United States)

    2017-03-01

    harassment and sexual assault. 17 III. DATA AND METHODOLOGY In this chapter, I describe the data used for the empirical analysis and the construction...THE MILITARY: AN ANALYSIS OF SEXUAL ASSAULT AND SEXUAL HARASSMENT INCIDENTS AND REPORTING by William C. Souder, III March 2017 Thesis Advisor...ASSAULT AND SEXUAL HARASSMENT INCIDENTS AND REPORTING 5. FUNDING NUMBERS 6. AUTHOR(S) William C. Souder, III 7. PERFORMING ORGANIZATION NAME(S) AND

  5. Insulin, hospitals and harm: a review of patient safety incidents reported to the National Patient Safety Agency.

    Science.gov (United States)

    Cousins, David; Rosario, Catherine; Scarpello, John

    2011-02-01

    Patient safety incidents involving insulin are frequent and cause considerable distress to people with diabetes and anxieties to their families and carers. This article describes an analysis of the National Reporting and Learning System database of patient safety incidents concerning insulin reported from NHS providers in England and Wales over six years. The main causes are discussed and the ongoing developments by the National Patient Safety Agency and partner organisations to reduce insulin errors are described.

  6. Sarcoidosis in Denmark 1980-1994. A registry-based incidence study comprising 5536 patients

    DEFF Research Database (Denmark)

    Byg, Keld-Erik; Milman, Nils; Hansen, Stig

    2003-01-01

    BACKGROUND AND AIM: To evaluate the incidence of sarcoidosis in Denmark 1980-1994. METHODS: Patients with a diagnosis of sarcoidosis were identified from the Danish National Patient Registry. The file contained information about the year in which the diagnosis was reported, gender, age, and resid...

  7. Patient-reported safety incidents in older patients with long-term conditions: a large cross-sectional study.

    Science.gov (United States)

    Panagioti, Maria; Blakeman, Thomas; Hann, Mark; Bower, Peter

    2017-05-30

    Increasing evidence suggests that patient safety is a serious concern for older patients with long-term conditions. Despite this, there is a lack of research on safety incidents encountered by this patient group. In this study, we sought to examine patient reports of safety incidents and factors associated with reports of safety incidents in older patients with long-term conditions. The baseline cross-sectional data from a longitudinal cohort study were analysed. Older patients (n=3378 aged 65 years and over) with a long-term condition registered in general practices were included in the study. The main outcome was patient-reported safety incidents including availability and appropriateness of medical tests and prescription of wrong types or doses of medication. Binary univariate and multivariate logistic regression analyses were undertaken to examine factors associated with patient-reported safety incidents. Safety incidents were reported by 11% of the patients. Four factors were significantly associated with patient-reported safety incidents in multivariate analyses. The experience of multiple long-term conditions (OR=1.09, 95% CI 1.05 to 1.13), a probable diagnosis of depression (OR=1.36, 95% CI 1.06 to 1.74) and greater relational continuity of care (OR=1.28, 95% CI 1.08 to 1.52) were associated with increased odds for patient-reported safety incidents. Perceived greater support and involvement in self-management was associated with lower odds for patient-reported safety incidents (OR=0.95, 95% CI 0.93 to 0.97). We found that older patients with multimorbidity and depression are more likely to report experiences of patient safety incidents. Improving perceived support and involvement of patients in their care may help prevent patient-reported safety incidents. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Design of a system for detecting and reporting security incidents and adverse events in thyroid and parathyroid surgery

    Directory of Open Access Journals (Sweden)

    José Luis PARDAL-REFOYO

    2016-03-01

    Full Text Available Introduction: Patient safety is defined as the reduction of risk of unnecessary harm associated with healthcare. Up to 9.3% of patients admitted into a hospital present some adverse event related to the assistance. This can cause damage to the patient, more instrumentation, increased morbidity, increased hospital stay and increased cost. To identify, record and analyze adverse events is necessary to have an incident reporting system. Objective: Developing a local system for reporting security incidents and adverse events in surgery of the thyroid gland. Method: A working group was formed with representatives from all units related to the process of thyroidectomy, checkpoints were established, checklists for each control point were designed, a strategic analysis of the group's activity was performed, a literature review was done in order to identify the major incident reporting systems, the items that the incident report form must have were identified and the form was designed. Results: The incident report form collects data on the patient, the communicator and the incident (type, cause, consequence, severity, frequency, risk matrix. It has a first paragraph with narrative sections and a second with drop-down lists. The form is accessible only to the working group for voluntary use. Conclusions: The purpose of the reporting system is learning and prevention.

  9. Incidence of hand eczema in a population-based twin cohort

    DEFF Research Database (Denmark)

    Lerbaek, A; Kyvik, Kirsten Ohm; Ravn, H

    2007-01-01

    BACKGROUND: Population-based studies on the incidence of hand eczema are sparse. OBJECTIVES: The aim of this prospective follow-up study was to determine the incidence rate of hand eczema in a population-based twin cohort. Secondly, the role of genetic factors and other potential risk factors...... 1.4-4.1). Also, significantly increased IRRs were found for positive patch test, atopic dermatitis, and wet work. CONCLUSIONS: Hand eczema is still a frequent disease and genetic factors are confirmed important risk factors. Positive patch test, atopic dermatitis and wet work were associated...... with an increased risk, whereas no association with age, sex, smoking or alcohol was found...

  10. IAEA/NEA incident reporting system (IRS). Reporting guidelines. Feedback from safety related operating experience for nuclear power plants

    International Nuclear Information System (INIS)

    1998-01-01

    The Incident Reporting System (IRS) is an international system jointly operated by the International Atomic Energy Agency (IAEA) and the Nuclear Energy Agency of the Organisation for Economic Cooperation and Development (OECD/NEA). The fundamental objective of the IRS is to contribute to improving the safety of commercial nuclear power plants (NPPs) which are operated worldwide. This objective can be achieved by providing timely and detailed information on both technical and human factors related to events of safety significance which occur at these plants. The purpose of these guidelines, which supersede the previous IAEA Safety Series No. 93 (Part II) and the NEA IRS guidelines, is to describe the system and to give users the necessary background and guidance to enable them to produce IRS reports meeting a high standard of quality while retaining the high efficiency of the system expected by all Member States operating nuclear power plants. These guidelines have been jointly developed and approved by the NEA/IAEA

  11. A theory of the cancer age-specific incidence data based on extreme value distributions

    Directory of Open Access Journals (Sweden)

    Luis Soto-Ortiz

    2012-03-01

    Full Text Available The incidence of cancers varies with age, if normalized this is called the age-specific incidence. A mathematical model that describes this variation should provide a better understanding of how cancers develop. We suggest that the age-specific incidence should follow an extreme value distribution, based on three widely accepted assumptions: (1 a tumor develops from a single cell, (2 many potential tumor progenitor cells exist in a tissue, and (3 cancer is diagnosed when the first of these many potential tumor cells develops into a tumor. We tested this by comparing the predicted distribution to the age-specific incidence data for colon and prostate carcinomas collected by the Surveillance, Epidemiology and End Results network of 17 cancer registries. We found that colon carcinoma age-specific incidence data is consistent with an extreme value distribution, while prostate carcinomas age-specific incidence data generally follows the distribution. This model indicates that both colon and prostate carcinomas only occur in a subset of the population (22% for prostate and 13.5% for colon. Because of their very general nature, extreme value distributions might be applicable to understanding other chronic human diseases.

  12. Analysis of Aviation Safety Reporting System Incident Data Associated with the Technical Challenges of the Atmospheric Environment Safety Technology Project

    Science.gov (United States)

    Withrow, Colleen A.; Reveley, Mary S.

    2014-01-01

    This study analyzed aircraft incidents in the NASA Aviation Safety Reporting System (ASRS) that apply to two of the three technical challenges (TCs) in NASA's Aviation Safety Program's Atmospheric Environment Safety Technology Project. The aircraft incidents are related to airframe icing and atmospheric hazards TCs. The study reviewed incidents that listed their primary problem as weather or environment-nonweather between 1994 and 2011 for aircraft defined by Federal Aviation Regulations (FAR) Parts 121, 135, and 91. The study investigated the phases of flight, a variety of anomalies, flight conditions, and incidents by FAR part, along with other categories. The first part of the analysis focused on airframe-icing-related incidents and found 275 incidents out of 3526 weather-related incidents over the 18-yr period. The second portion of the study focused on atmospheric hazards and found 4647 incidents over the same time period. Atmospheric hazards-related incidents included a range of conditions from clear air turbulence and wake vortex, to controlled flight toward terrain, ground encounters, and incursions.

  13. Isolated hemihyperplasia (hemihypertrophy): report of a prospective multicenter study of the incidence of neoplasia and review.

    Science.gov (United States)

    Hoyme, H E; Seaver, L H; Jones, K L; Procopio, F; Crooks, W; Feingold, M

    1998-10-02

    Hemihyperplasia is characterized by asymmetric growth of cranium, face, trunk, limbs, and/or digits, with or without visceral involvement. It may be an isolated finding in an otherwise normal individual, or it may occur in several syndromes. Although isolated hemihyperplasia (IHH) is of unknown cause, it may represent one end of the clinical spectrum of the Wiedemann-Beckwith syndrome (WBS). Uniparental paternal disomy of 11p15.5 or altered expression of insulin-like growth factor 2 (IGF2) from the normally silent maternal allele have been implicated as causes of some cases of WBS. IHH and other mild manifestations of WBS may represent patchy overexpression of the IGF2 gene following defective imprinting in a mosaic fashion. The natural history of IHH varies markedly. An association among many overgrowth syndromes and a predisposition to neoplasia is well recognized. Heretofore the risk for tumor development in children with IHH was unknown. We report on the results of a prospective multicenter clinical study of the incidence and nature of neoplasia in children evaluated because of IHH. One hundred sixty-eight patients were ascertained. A total of 10 tumors developed in nine patients, for an overall incidence of 5.9%. Tumors were of embryonal origin (similar to those noted in other overgrowth disorders), including Wilms tumor, hepatoblastoma, adrenal cell carcinoma, and leiomyosarcoma of the small bowel in one case. These data support a tumor surveillance protocol for children with IHH similar to that performed in other syndromes associated with overgrowth.

  14. A cross-sectional mixed methods study protocol to generate learning from patient safety incidents reported from general practice.

    Science.gov (United States)

    Carson-Stevens, Andrew; Hibbert, Peter; Avery, Anthony; Butlin, Amy; Carter, Ben; Cooper, Alison; Evans, Huw Prosser; Gibson, Russell; Luff, Donna; Makeham, Meredith; McEnhill, Paul; Panesar, Sukhmeet S; Parry, Gareth; Rees, Philippa; Shiels, Emma; Sheikh, Aziz; Ward, Hope Olivia; Williams, Huw; Wood, Fiona; Donaldson, Liam; Edwards, Adrian

    2015-12-01

    Incident reports contain descriptions of errors and harms that occurred during clinical care delivery. Few observational studies have characterised incidents from general practice, and none of these have been from the England and Wales National Reporting and Learning System. This study aims to describe incidents reported from a general practice care setting. A general practice patient safety incident classification will be developed to characterise patient safety incidents. A weighted-random sample of 12,500 incidents describing no harm, low harm and moderate harm of patients, and all incidents describing severe harm and death of patients will be classified. Insights from exploratory descriptive statistics and thematic analysis will be combined to identify priority areas for future interventions. The need for ethical approval was waivered by the Aneurin Bevan University Health Board research risk review committee given the anonymised nature of data (ABHB R&D Ref number: SA/410/13). The authors will submit the results of the study to relevant journals and undertake national and international oral presentations to researchers, clinicians and policymakers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Incidence, associations, and evaluation of sixth nerve palsy using a population-based method.

    Science.gov (United States)

    Patel, Sanjay V; Mutyala, Srinivas; Leske, David A; Hodge, David O; Holmes, Jonathan M

    2004-02-01

    To determine the incidence of sixth nerve palsy in a population-based study, with particular emphasis on associated coexisting medical conditions and to use these data to develop a management algorithm. Retrospective, population-based case series. All residents of Olmsted County, Minnesota, USA, diagnosed with sixth nerve palsy between January 1, 1978 and December 31, 1992. All cases were identified by using the Rochester Epidemiology Project medical records linkage system, which captures all patient-physician encounters in Olmsted County. The entire medical record of each patient was reviewed to confirm the diagnosis, document county residency, and to determine associated medical conditions. We used stringent predetermined criteria to define diabetes mellitus and hypertension as associations. Incidence rates were adjusted to the age and gender distribution of the 1990 white population in the United States. Etiology or systemic associations of the palsy. We identified 137 new cases of sixth nerve palsy over the 15-year period. The age- and gender-adjusted annual incidence of sixth nerve palsy was 11.3/100 000 (95% confidence interval, 9.3-13.2/100 000). Causes and associations were: undetermined (26%), hypertension alone (19%), coexistent hypertension and diabetes (12%), trauma (12%), multiple sclerosis (7%), neoplasm (5%), diabetes alone (4%), cerebrovascular accident (4%), postneurosurgery (3%), aneurysm (2%), and other (8%). When sixth nerve palsy was the presenting sign in cases of neoplasm (n = 1) and aneurysm (n = 3), history and examination revealed the presence of other neurologic symptoms or signs. We provide population-based data on the incidence of sixth nerve palsy with a notably lower incidence of neoplasm and higher incidence of diabetes and hypertension than previous institution-based series. We suggest that patients with nontraumatic neurologically isolated sixth nerve palsy may undergo a focused medical evaluation followed by close observation

  16. Interpreting adverse drug reaction (ADR) reports as hospital patient safety incidents.

    Science.gov (United States)

    Davies, Emma C; Green, Christopher F; Mottram, David R; Pirmohamed, Munir

    2010-07-01

    Adverse drug reactions (ADRs) are a reporting category in the National Patient Safety Agency (NPSA) incident reporting system, though the Medicines and Healthcare Products Regulatory Agency (MHRA) pharmacovigilance system is the more established method for collecting ADR data. The majority of ADRs were shown to be of moderate risk to the patient, though some have a severe or catastrophic impact. Classification and reporting of ADRs according to NPSA guidance is possible but offers limited additional value to efforts to improve patient safety over and above the Yellow Card Scheme. In the UK, the National Patient Safety Agency (NPSA) includes adverse drug reactions as a reporting category, while the MHRA Yellow Card Scheme also collects data regarding adverse drug reactions (ADRs). In this study, we aimed to assess ADRs using NPSA criteria and discuss the resulting implications. ADRs identified in a 6-month prospective study of 3695 inpatient episodes were assessed according to their impact on the patient and on the organization, using tools developed by the NPSA. Seven hundred and thirty-three (100%) ADRs were assessed. In terms of impact on the patient, 537 (73.3%) were categorized as 'low' (minor treatment), 181 (24.7%) as 'moderate' (moderate increase in treatment, no permanent harm), 14 (1.91%) as 'severe' (permanent harm) and 1 (0.14%) was categorized as 'catastrophic' (direct cause of death). In terms of impact on the organization, none was categorized as 'no harm/no risk', 508 (69.3%) as 'insignificant', 188 (25.6%) as 'minor', 25 (3.4%) as 'moderate', 12 (1.6%) as 'major' and none was classed as 'catastrophic'. Less than 2% of ADRs would be eligible for detailed analysis according to the NPSA guidance. The ADRs that cause incidents of greater significance relate to bleeding, renal impairment and Clostridium difficile infection. Classification of ADRs according to NPSA guidance offers limited additional value over and above that offered by the Yellow Card

  17. Municipality Level Simulations of Dengue Fever Incidence in Puerto Rico Using Ground Based and Remotely Sensed Climate Data

    Science.gov (United States)

    Quattrochi, Dale A.; Morin, Cory

    2015-01-01

    Dengue fever (DF) is caused by a virus transmitted between humans and Aedes genus mosquitoes through blood feeding. In recent decades incidence of the disease has drastically increased in the tropical Americas, culminating with the Pan American outbreak in 2010 which resulted in 1.7 million reported cases. In Puerto Rico dengue is endemic, however, there is significant inter-annual, intraannual, and spatial variability in case loads. Variability in climate and the environment, herd immunity and virus genetics, and demographic characteristics may all contribute to differing patterns of transmission both spatially and temporally. Knowledge of climate influences on dengue incidence could facilitate development of early warning systems allowing public health workers to implement appropriate transmission intervention strategies. In this study, we simulate dengue incidence in several municipalities in Puerto Rico using population and meteorological data derived from ground based stations and remote sensing instruments. This data was used to drive a process based model of vector population development and virus transmission. Model parameter values for container composition, vector characteristics, and incubation period were chosen by employing a Monte Carlo approach. Multiple simulations were performed for each municipality and the results were compared with reported dengue cases. The best performing simulations were retained and their parameter values and meteorological input were compared between years and municipalities. Parameter values varied by municipality and year illustrating the complexity and sensitivity of the disease system. Local characteristics including the natural and built environment impact transmission dynamics and produce varying responses to meteorological conditions.

  18. Ventilator-Related Adverse Events: A Taxonomy and Findings From 3 Incident Reporting Systems

    Science.gov (United States)

    Pham, Julius Cuong; Williams, Tamara L; Sparnon, Erin M; Cillie, Tam K; Scharen, Hilda F; Marella, William M

    2016-01-01

    BACKGROUND: In 2009, researchers from Johns Hopkins University's Armstrong Institute for Patient Safety and Quality; public agencies, including the FDA; and private partners, including the Emergency Care Research Institute and the University HealthSystem Consortium (UHC) Safety Intelligence Patient Safety Organization, sought to form a public-private partnership for the promotion of patient safety (P5S) to advance patient safety through voluntary partnerships. The study objective was to test the concept of the P5S to advance our understanding of safety issues related to ventilator events, to develop a common classification system for categorizing adverse events related to mechanical ventilators, and to perform a comparison of adverse events across different adverse event reporting systems. METHODS: We performed a cross-sectional analysis of ventilator-related adverse events reported in 2012 from the following incident reporting systems: the Pennsylvania Patient Safety Authority's Patient Safety Reporting System, UHC's Safety Intelligence Patient Safety Organization database, and the FDA's Manufacturer and User Facility Device Experience database. Once each organization had its dataset of ventilator-related adverse events, reviewers read the narrative descriptions of each event and classified it according to the developed common taxonomy. RESULTS: A Pennsylvania Patient Safety Authority, FDA, and UHC search provided 252, 274, and 700 relevant reports, respectively. The 3 event types most commonly reported to the UHC and the Pennsylvania Patient Safety Authority's Patient Safety Reporting System databases were airway/breathing circuit issue, human factor issues, and ventilator malfunction events. The top 3 event types reported to the FDA were ventilator malfunction, power source issue, and alarm failure. CONCLUSIONS: Overall, we found that (1) through the development of a common taxonomy, adverse events from 3 reporting systems can be evaluated, (2) the types of

  19. Incidence and prevalence of mental disorders among immigrants and native Finns: a register-based study.

    Science.gov (United States)

    Markkula, Niina; Lehti, Venla; Gissler, Mika; Suvisaari, Jaana

    2017-12-01

    Migrants appear to have a higher risk of mental disorders, but findings vary across country settings and migrant groups. We aimed to assess incidence and prevalence of mental disorders among immigrants and Finnish-born controls in a register-based cohort study. A register-based cohort study of 184.806 immigrants and 185.184 Finnish-born controls (1.412.117 person-years) was conducted. Information on mental disorders according to ICD-10 was retrieved from the Hospital Discharge Register, which covers all public health care use. The incidence of any mental disorder was lower among male (adjusted HR 0.82, 95% CI 0.77-0.87) and female (aHR 0.76, 95% CI 0.72-0.81) immigrants, being lowest among Asian and highest among North African and Middle Eastern immigrants. The incidence of bipolar, depressive and alcohol use disorders was lower among immigrants. Incidence of psychotic disorders was lower among female and not higher among male immigrants, compared with native Finns. Incidence of PTSD was higher among male immigrants (aHR 4.88, 95% CI 3.38-7.05). The risk of mental disorders varies significantly across migrant groups and disorders and is generally lower among immigrants than native Finns.

  20. A gender-based incidence study of workplace violence in psychiatric and forensic settings.

    Science.gov (United States)

    Hatch-Maillette, Mary A; Scalora, Mario J; Bader, Shannon M; Bornstein, Brian H

    2007-01-01

    Limited data exist analyzing the role of gender in workplace violence in health care settings. This study examined whether different types of threatening incidents with patients (physical, verbal, sexual, or posturing) were salient to male versus female staff across psychiatric settings (inpatient forensic, inpatient acute/chronic psychiatric, and outpatient psychiatric). Results indicated that although women disproportionately experienced sexualized threats, they were not more likely to report such incidents as salient and threatening. The study also assessed the extent to which situational variables contributed to staff's feelings of threat. Results showed that rapport with the patient, quality of relationships with coworkers, and presence of coworkers in the area were not significantly related to how threatened staff felt in a recent threatening incident. Findings are discussed within the context of staff training and organizational benefits.

  1. A Decade of Child-Initiated Family Violence: Comparative Analysis of Child-Parent Violence and Parricide Examining Offender, Victim, and Event Characteristics in a National Sample of Reported Incidents, 1995-2005

    Science.gov (United States)

    Walsh, Jeffrey A.; Krienert, Jessie L.

    2009-01-01

    This article examines 11 years (1995-2005) of National Incident Based Reporting System data comparing victim, offender, and incident characteristics for two types of child-initiated family violence: child-parent violence (CPV) and parricide. The objective is to better understand the victim-offender relationship for CPV and parricide and to…

  2. Incidence of inflammatory bowel disease in Iceland 1995 - 2009. A nationwide population-based study.

    Science.gov (United States)

    Björnsson, Sigurður; Tryggvason, Friðrik Þór; Jónasson, Jón G; Cariglia, Nick; Örvar, Kjartan; Kristjánsdóttir, Sjöfn; Stefansson, Tryggvi

    2015-01-01

    We analyzed the incidence of inflammatory bowel disease (IBD) in Iceland for the period 1995-2009. New cases of ulcerative colitis (UC) and Crohn's disease (CD) were retrieved by thorough review of all small and large intestinal pathology reports with any type of inflammation from all the pathology departments in Iceland for the period 1995-2009. All suspicious new cases of IBD were then scrutinized retrospectively by examination of their clinical records. A total of 1175 cases of IBD were diagnosed, 884 UC, 279 CD and 12 IBD unclassified. The crude annual incidence of UC was 20.5/100,000, increasing from 18.1 the first 5-year period to 22.1 the last 5-year period. The crude annual incidence of CD was 6.5/100,000, 6.7 the first 5-year period and 6.6 the last 5-year period. This study shows statistically significant increase in the incidence of UC during the study period. The incidence of CD has however remained stable.

  3. Measuring the association between artemisinin-based case management and malaria incidence in southern Vietnam, 1991-2010.

    Science.gov (United States)

    Peak, Corey M; Thuan, Phung Duc; Britton, Amadea; Nguyen, Tran Dang; Wolbers, Marcel; Thanh, Ngo Viet; Buckee, Caroline O; Boni, Maciej F

    2015-04-01

    In addition to being effective, fast-acting, and well tolerated, artemisinin-based combination therapies (ACTs) are able to kill certain transmission stages of the malaria parasite. However, the population-level impacts of ACTs on reducing malaria transmission have been difficult to assess. In this study on the history of malaria control in Vietnam, we assemble annual reporting on malaria case counts, coverage with insecticide-treated nets (ITN) and indoor residual spraying (IRS), and drug purchases by provincial malaria control programs from 1991 to 2010 in Vietnam's 20 southern provinces. We observe a significant negative association between artemisinin use and malaria incidence, with a 10% absolute increase in the purchase proportion of artemisinin-containing regimens being associated with a 29.1% (95% confidence interval: 14.8-41.0%) reduction in slide-confirmed malaria incidence, after accounting for changes in urbanization, ITN/IRS coverage, and two indicators of health system capacity. One budget-related indicator of health system capacity was found to have a smaller association with malaria incidence, and no other significant factors were found. Our findings suggest that including an artemisinin component in malaria drug regimens was strongly associated with reduced malaria incidence in southern Vietnam, whereas changes in urbanization and coverage with ITN or IRS were not. © The American Society of Tropical Medicine and Hygiene.

  4. 77 FR 71354 - Adjustment of Monetary Threshold for Reporting Rail Equipment Accidents/Incidents for Calendar...

    Science.gov (United States)

    2012-11-30

    ... Procedures) (64 FR 28545 (May 26, 1999)) as required by the National Environmental Policy Act (42 U.S.C. 4321..., Notice No. 5] RIN 2130-ZA10 Adjustment of Monetary Threshold for Reporting Rail Equipment Accidents... monetary reporting threshold based on the formula discussed in detail and adopted, after notice and comment...

  5. Feasibility and reliability of PRISMA-Medical for specialty-based incident analysis

    NARCIS (Netherlands)

    Snijders, C.; van der Schaaf, T.; Klip, H.; van Lingen, R.A.; Fetter, W.P.F.; Molendijk, H.A.

    2009-01-01

    Aims and objectives: In this study, the feasibility and reliability of the Prevention Recovery Information System for Monitoring and Analysis (PRISMA)-Medical method for systematic, specialty-based analysis and classification of incidents in the neonatal intensive care unit (NICU) were determined.

  6. Feasibility and reliability of PRISMA-medical for specialty-based incident analysis

    NARCIS (Netherlands)

    Snijders, C.; van der Schaaf, T. W.; Klip, H.; van Lingen W P F Fetter, R. A.; Molendijk, A.; Kok, J. H.; te Pas, E.; Pas, H.; van der Starre, C.; Bloemendaal, E.; Cardozo, Lopes; Molenaar, A. M.; van Lingen, R. A.; Maat, H. E.; Lavrijssen, S.; Mulder, A. L. M.; de Kleine, M. J. K.; Koolen, A. M. P.; Schellekens, M.; Verlaan, W.; Vrancken, S.; Fetter, W. P. F.; Schotman, L.; van der Zwaan, A.; van der Tuijn, Y.; Tibboel, D.

    2009-01-01

    AIMS AND OBJECTIVES: In this study, the feasibility and reliability of the Prevention Recovery Information System for Monitoring and Analysis (PRISMA)-Medical method for systematic, specialty-based analysis and classification of incidents in the neonatal intensive care unit (NICU) were determined.

  7. 32 CFR 634.52 - Search incident to impoundment based on criminal activity.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Search incident to impoundment based on criminal activity. 634.52 Section 634.52 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Impounding...

  8. Incidence, aetiology and injury characteristics of traumatic spinal cord injury in Stockholm, Sweden: A prospective, population-based update.

    Science.gov (United States)

    Joseph, Conran; Andersson, Nina; Bjelak, Sapko; Giesecke, Kajsa; Hultling, Claes; Nilsson Wikmar, Lena; Phillips, Julie; Seiger, Åke; Stenimahitis, Vasilios; Trok, Katarzyna; Åkesson, Elisabet; Wahman, Kerstin

    2017-05-16

    To update the incidence rate, aetiology and injury characteristics of acutely-injured adults with traumatic spinal cord injury in Stockholm, Sweden, using international standards of reporting. Prospective, (regional) population-based observation. Forty-nine consecutively enrolled individuals. A surveillance system of newly-injured adults with traumatic spinal cord injury was implemented for an 18-month period. The International Spinal Cord Injury Core Data Set was used to collect data on those who survived the first 7 days post-injury. After an 18-month period, 49 incident cases were registered, of whom 45 were included in this study. The crude incidence rate was 19.0 per million, consisting mainly of men (60%), and the mean age of the cohort was 55 years (median 58). Causes of injury were almost exclusively limited to falls and transport-related events, accounting for 58% and 40% of cases, respectively. The incidence has remained stable when compared with the previous study; however, significant differences exist for injury aetiology (p = 0.004) and impairment level (p = 0.01) in that more fall- and transport-related spinal cord injury occurred, and a larger proportion of persons was left with resultant tetraplegia, in the current study, compared with more sport-related injuries and those left with paraplegia in the previous study. The incidence rate appeared to remain stable in Stockholm, Sweden. However, significant changes in injury aetiology and impairment-level post injury were found, compared with the previous study. There remains a need for developing fall-related prevention strategies in rehabilitation settings as well as in population-based programmes.

  9. The association of statin use with reduced incidence of venous thromboembolism: a population-based cohort study.

    Science.gov (United States)

    Lassila, Riitta; Jula, Antti; Pitkäniemi, Janne; Haukka, Jari

    2014-11-05

    Venous thromboembolism (VTE) continues to be a frequent medical emergency requiring rapid recognition so as to reach diagnosis and initiate anticoagulation therapy. The use of statins in addition to reducing the incidence of arterial thrombosis for decreasing the incidence and reoccurrence of VTE is reported. The aim of our study was to explore the association between statin usage and the incidence of new VTE at the population level during a 10-year follow-up. Population-based historic cohort. The Health 2000 Survey was based on a nationally representative sample. 8028 individuals aged 30 years or over in Finland. The primary end point event was the first ever hospitalisation due to one of the following causes: pulmonary embolism (International Classification of Diseases-10 I26), cerebral venous non-pyogenic thrombosis (I63.6), or venous thrombosis (I80.9-189). The preselected explanatory variables applied to the Poisson regression model were statin usage (no/yes) during follow-up (2000-2011) and several baseline data (age, sex; usage of blood glucose lowering drugs, vitamin K antagonists and antiplatelet agents). We observed 136 VTE events, the incidence of 1.72 (95% CI 1.44 to 2.04) per 1000 person-years. Current statin usage did not associate with the incidence of VTE according to the univariate model (rate ratio (RR) 0.93, 0.56 to 1.52), but when adjusted with baseline variables (age, sex, medications) the RR declined to 0.60 (0.36 to 1.00, p=0.04). Statin use offers protection against first ever VTE events and appears as a primary prevention tool in patients without anticoagulation or antiplatelet medication. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Low HIV incidence in pregnant and postpartum women receiving a community-based combination HIV prevention intervention in a high HIV incidence setting in South Africa.

    Directory of Open Access Journals (Sweden)

    Geoffrey Fatti

    Full Text Available Young Southern African women have the highest HIV incidence globally. Pregnancy doubles the risk of HIV acquisition further, and maternal HIV acquisition contributes significantly to the paediatric HIV burden. Little data on combination HIV prevention interventions during pregnancy and lactation are available. We measured HIV incidence amongst pregnant and postpartum women receiving a community-based combination HIV prevention intervention in a high HIV incidence setting in South Africa.A cohort study that included HIV-uninfected pregnant women was performed. Lay community-based workers provided individualized HIV prevention counselling and performed three-monthly home and clinic-based individual and couples HIV testing. Male partners were referred for circumcision, sexually transmitted infections or HIV treatment as appropriate. Kaplan-Meier analyses and Cox's regression were used to estimate HIV incidence and factors associated with HIV acquisition.The 1356 women included (median age 22.5 years received 5289 HIV tests. Eleven new HIV infections were detected over 828.3 person-years (PY of follow-up, with an HIV incidence rate of 1.33 infections/100 PY (95% CI: 0.74-2.40. Antenatally, the HIV incidence rate was 1.49 infections/100 PY (95% CI: 0.64-2.93 and postnatally the HIV incidence rate was 1.03 infections/100 PY (95% CI: 0.33-3.19. 53% of male partners received HIV testing and 66% of eligible partners received referral for circumcision. Women within known serodiscordant couples, and women with newly diagnosed HIV-infected partners, adjusted hazard ratio (aHR = 32.7 (95% CI: 3.8-282.2 and aHR = 126.4 (95% CI: 33.8-472.2 had substantially increased HIV acquisition, respectively. Women with circumcised partners had a reduced risk of incident HIV infection, aHR = 0.22 (95% CI: 0.03-1.86.Maternal HIV incidence was substantially lower than previous regional studies. Community-based combination HIV prevention interventions may reduce high

  11. Mindfulness-based stress reduction teachers, practice characteristics, cancer incidence, and health: a nationwide ecological description.

    Science.gov (United States)

    Robb, Sara Wagner; Benson, Kelsey; Middleton, Lauren; Meyers, Christine; Hébert, James R

    2015-02-14

    Studies have demonstrated the potential of the Mindfulness-Based Stress Reduction (MBSR) program to improve the condition of individuals with health outcomes such as hypertension, diabetes, and chronic pain; improve psychological well-being; reduce stress levels; and increase survival among cancer patients. To date, only one study has focused on the effect of long-term meditation on stress, showing a positive protective relationship. However, the relationship between meditation and cancer incidence remains unexplored. The objective of this study was to describe the state-level relationship between MBSR instructors and their practices and county-level health outcomes, including cancer incidence, in the United States. This ecologic study was performed using geospatial mapping and descriptive epidemiology of statewide MBSR characteristics and overall health, mental health state rankings, and age-adjusted cancer incidence rates. Weak to moderate state-level correlations between meditation characteristics and colorectal and cervical cancer incidence were detected, with states with more meditation (e.g., more MBSR teachers per population) correlated with a decreased cancer incidence. A negative correlation was detected between lung & bronchus cancer and years teaching MBSR only. Moderate positive correlations were detected between Hodgkin's Lymphoma and female breast cancer in relation to all meditation characteristics. Statistically significant correlations with moderate coefficients were detected for overall health ranks and all meditation characteristics, most strongly for total number of years teaching MBSR and total number of years of general meditation practice. Our analyses might suggest that a relationship exists between the total number of MBSR teachers per state and the total number of years of general meditation practice per state, and colorectal and cervical cancer incidence. Positive correlations were observed with overall health rankings. Despite this study

  12. Wheelchair incidents

    NARCIS (Netherlands)

    Drongelen AW van; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM

    2002-01-01

    This RIVM study was performed to gain insight into wheelchair-related incidents with powered and manual wheelchairs reported to the USA FDA, the British MDA and the Dutch Center for Quality and Usability Research of Technical Aids (KBOH). The data in the databases do not indicate that incidents with

  13. Analysis of mass incident diffusion in Weibo based on self-organization theory

    Science.gov (United States)

    Pan, Jun; Shen, Huizhang

    2018-02-01

    This study introduces some theories and methods of self-organization system to the research of the diffusion mechanism of mass incidents in Weibo (Chinese Twitter). Based on the analysis on massive Weibo data from Songjiang battery factory incident happened in 2013 and Jiiangsu Qidong OJI PAPER incident happened in 2012, we find out that diffusion system of mass incident in Weibo satisfies Power Law, Zipf's Law, 1/f noise and Self-similarity. It means this system is the self-organization criticality system and dissemination bursts can be understood as one kind of Self-organization behavior. As the consequence, self-organized criticality (SOC) theory can be used to explain the evolution of mass incident diffusion and people may come up with the right strategy to control such kind of diffusion if they can handle the key ingredients of Self-organization well. Such a study is of practical importance which can offer opportunities for policy makers to have good management on these events.

  14. Does the implementation of an electronic prescribing system create unintended medication errors? A study of the sociotechnical context through the analysis of reported medication incidents

    Directory of Open Access Journals (Sweden)

    Hodson James

    2011-05-01

    Full Text Available Abstract Background Even though electronic prescribing systems are widely advocated as one of the most effective means of improving patient safety, they may also introduce new risks that are not immediately obvious. Through the study of specific incidents related to the processes involved in the administration of medication, we sought to find out if the prescribing system had unintended consequences in creating new errors. The focus of this study was a large acute hospital in the Midlands in the United Kingdom, which implemented a Prescribing, Information and Communication System (PICS. Methods This exploratory study was based on a survey of routinely collected medication incidents over five months. Data were independently reviewed by two of the investigators with a clinical pharmacology and nursing background respectively, and grouped into broad types: sociotechnical incidents (related to human interactions with the system and non-sociotechnical incidents. Sociotechnical incidents were distinguished from the others because they occurred at the point where the system and the professional intersected and would not have occurred in the absence of the system. The day of the week and time of day that an incident occurred were tested using univariable and multivariable analyses. We acknowledge the limitations of conducting analyses of data extracted from incident reports as it is widely recognised that most medication errors are not reported and may contain inaccurate data. Interpretation of results must therefore be tentative. Results Out of a total of 485 incidents, a modest 15% (n = 73 were distinguished as sociotechnical issues and thus may be unique to hospitals that have such systems in place. These incidents were further analysed and subdivided into categories in order to identify aspects of the context which gave rise to adverse situations and possible risks to patient safety. The analysis of sociotechnical incidents by time of day and day of

  15. Lessons learnt from the development of the Patient Safety Incidents Reporting an Learning System for the Spanish National Health System: SiNASP.

    Science.gov (United States)

    Vallejo-Gutiérrez, Paula; Bañeres-Amella, Joaquim; Sierra, Eduardo; Casal, Jesús; Agra, Yolanda

    2014-01-01

    To describe the development process and characteristics of a patient safety incidents reporting system to be implemented in the Spanish National Health System, based on the context and the needs of the different stakeholders. Literature review and analysis of most relevant reporting systems, identification of more than 100 stakeholder's (patients, professionals, regional governments representatives) expectations and requirements, analysis of the legal context, consensus of taxonomy, development of the software and pilot test. Patient Safety Events Reporting and Learning system (Sistema de Notificación y Aprendizajepara la Seguridad del Paciente, SiNASP) is a generic reporting system for all types of incidents related to patient safety, voluntary, confidential, non punitive, anonymous or nominative with anonimization, system oriented, with local analysis of cases and based on the WHO International Classification for Patient Safety. The electronic program has an on-line form for reporting, a software to manage the incidents and improvement plans, and a scoreboard with process indicators to monitor the system. The reporting system has been designed to respond to the needs and expectations identified by the stakeholders, taking into account the lessons learned from the previous notification systems, the characteristics of the National Health System and the existing legal context. The development process presented and the characteristics of the system provide a comprehensive framework that can be used for future deployments of similar patient safety systems. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  16. Reporting medical device safety incidents to regulatory authorities: An analysis and classification of technology-induced errors.

    Science.gov (United States)

    Palojoki, Sari; Saranto, Kaija; Lehtonen, Lasse

    2017-07-01

    The European Union Medical Device Directive 2007/47/EC1 defines software with a medical purpose as a medical device. The implementation of health information technology suffers from patient safety problems that require effective post-market surveillance. The purpose of this study was to review, classify and discuss the incident data submitted to a nationwide database of the Finnish National Competent Authority with other forms of data. We analysed incident reports submitted to the authority database by users of electronic health records from 2010 to 2015. We identified 138 valid reports. Adverse events associated with electronic health record vulnerabilities, clustered around certain error types, cause serious harm and occur in all types of healthcare settings. The low rate of reported incidents raises questions about not only the challenges associated with medical software oversight but also the obstacles for reporting.

  17. Health status and quality of life reported by incident patients after 1 year on haemodialysis or peritoneal dialysis.

    Science.gov (United States)

    Kutner, Nancy G; Zhang, Rebecca; Barnhart, Huiman; Collins, Allan J

    2005-10-01

    It has been suggested that there are no large differences in the quality of life of incident patients starting on haemodialysis (HD) and peritoneal dialysis (PD), but few studies have addressed this issue. Association of modality with incident patients' health status and quality of life scores was investigated with propensity score (PS) analysis and also with traditional multivariable regression analyses. We compared patient reported health status and quality of life scores after 1 year of therapy in 455 HD and 413 PD patients who participated in a national study, stayed on the same modality and had complete socio-demographic and clinical information needed to create a PS indicating their expected probability of starting on PD. One year scores on the majority of health status and quality of life measures were not significantly different for HD and PD patients within propensity-matched quintiles. PD patients' scores were higher than HD patients' scores on effects of kidney disease, burden of kidney disease, staff encouragement and satisfaction with care in some quintiles, and traditional regression analyses confirmed that dialysis modality was associated with patients' scores on these variables. This study provides support for making the choice of PD more widely available as an option to patients initiating chronic dialysis therapy. Patient lifestyle opportunities associated with use of PD, a home-based and self-care therapy, may also apply to home-based HD or in-centre self-care HD. Patients' expectations regarding treatment and their attitudes toward management of their health may interact with treatment modality to shape patient-reported experience on dialysis; this is an important focus for future studies.

  18. Cancer incidence and mortality in China in 2013: an analysis based on urbanization level

    OpenAIRE

    Chen, Wanqing; Zheng, Rongshou; Zhang, Siwei; Zeng, Hongmei; Zuo, Tingting; Xia, Changfa; Yang, Zhixun; He, Jie

    2017-01-01

    Objective To explore the cancer patterns in areas with different urbanization rates (URR) in China with data from 255 population-based cancer registries in 2013, collected by the National Central Cancer Registry (NCCR). Methods There were 347 cancer registries submitted cancer incidence and deaths occurred in 2013 to NCCR. All those data were checked and evaluated based on the NCCR criteria of data quality, and qualified data from 255 registries were used for this analysis. According to the p...

  19. 12 CFR 250.181 - Reports of change in control of bank management incident to a merger.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Reports of change in control of bank management... change in control of bank management incident to a merger. (a) A State member bank has inquired whether Pub. L. 88-593 (78 Stat. 940) requires reports of change in control of bank management in situations...

  20. Incidence and survival trends in oligodendrogliomas and anaplastic oligodendrogliomas in the United States from 2000 to 2013: a CBTRUS Report.

    Science.gov (United States)

    Achey, Rebecca L; Khanna, Vishesh; Ostrom, Quinn T; Kruchko, Carol; Barnholtz-Sloan, Jill S

    2017-05-01

    Measuring tumor-specific trends in incidence is necessary to elucidate tumor-type contribution to overall cancer burden in the US population. Recently, there have been conflicting reports concerning the incidence of oligodendrogliomas (OD) and anaplastic oligodendrogliomas (AOD). Therefore, our goal was to examine trends in OD and AOD incidence and survival by age, gender and race. Data was analyzed from the Central Brain Tumor Registry of the United States (CBTRUS) from 2000 to 2013. Age-adjusted incidence rates per 100,000 person-years with 95% confidence intervals (CI) and annual percent changes (APCs) with 95% CI were calculated for OD and AOD by age, sex and race. Survival rates were calculated for age, sex and race using a subset of the CBTRUS data. OD and AOD incidence peaked at 36-40 and 56-60 years, respectively. AOD:OD ratio increased up to age 75. Overall, OD and AOD incidence decreased [OD: APC -3.2 (2000-2013), AOD: -6.5 (2000-2007)]. OD incidence was highest in Whites but decreased significantly (2000-2013: APC -3.1) while incidence in Black populations did not significantly decrease (2000-2013: APC -1.6). Survival rates decreased with advancing age for OD, while persons aged 0-24 had the lowest survival for AOD. The current study reports a decrease in overall OD and AOD incidence from 2000 to 2013. Furthermore, AOD makes up an increasing proportion of oligodendroglial tumors up to age 75. Lower AOD survival in 0-24 years old may indicate molecular differences in pediatric cases. Thus, surveillance of tumor-specific trends by age, race and sex can reveal clinically relevant variations.

  1. First-Ever Stroke and Transient Ischemic Attack Incidence and 30-Day Case-Fatality Rates in a Population-Based Study in Argentina

    DEFF Research Database (Denmark)

    Bahit, M Cecilia; Coppola, Mariano L; Riccio, Patricia M

    2016-01-01

    BACKGROUND AND PURPOSE: Epidemiological data about stroke are scarce in low- and middle-income Latin-American countries. We investigated annual incidence of first-ever stroke and transient ischemic attack (TIA) and 30-day case-fatality rates in a population-based setting in Tandil, Argentina....... METHODS: We prospectively identified all first-ever stroke and TIA cases from overlapping sources between January 5, 2013, and April 30, 2015, in Tandil, Argentina. We calculated crude and standardized incidence rates. We estimated 30-day case-fatality rates. RESULTS: We identified 334 first-ever strokes.......1% (95% CI, 14.2-36.6) for intracerebral hemorrhage, and 1.9% (95% CI, 0.4-5.8) for TIA. CONCLUSIONS: This study provides the first prospective population-based stroke and TIA incidence and case-fatality estimate in Argentina. First-ever stroke incidence was lower than that reported in previous Latin...

  2. Risk factors and their combined effects on the incidence rate of subarachnoid hemorrhage--a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Miikka Korja

    Full Text Available BACKGROUND: Prospective studies on the risk factors for subarachnoid hemorrhage (SAH are limited. Moreover, the effect of risk factors on the incidence rates of SAH is not well known about. AIMS: In this study, we aimed to identify risk factors for SAH and characterize subgroups in a population with a high incidence of SAH. METHODS: After recording multiple potential risk factors for SAH at the time of enrollment, first ever SAH events between 1972 and 2009 were recorded through the nationwide Causes of Death Register and Hospital Discharge Register for the population-based cohort of 64 349 participants, who participated in the National FINRISK Study between 1972 and 2007 in Finland. RESULTS: During the follow-up time of 1.26 million person-years (median 17.9 years, range 0 to 37.9 years, 437 persons experienced fatal or non-fatal SAH. Crude SAH incidence was 34.8 (95% confidence interval: 31.7-38.2 per 100 000 person-years among ≥ 25-year-old persons. Female sex, high blood pressure values and current smoking were confirmed as risk factors for SAH. Previous myocardial infarction, history of premature stroke (any kind in mother and elevated cholesterol levels in men were identified as new risk factors for SAH. Depending on the combination of risk factors, SAH incidence varied between 8 and 171 per 100 000 person-years. CONCLUSIONS: New and previously reported risk factors appear to have a much stronger association with the incidence of SAH than is ordinarily seen in cardiovascular diseases. Risk factor assessments may facilitate the identification of high-risk persons who should be the focus of preventive interventions.

  3. Risk Factors and Their Combined Effects on the Incidence Rate of Subarachnoid Hemorrhage – A Population-Based Cohort Study

    Science.gov (United States)

    Korja, Miikka; Silventoinen, Karri; Laatikainen, Tiina; Jousilahti, Pekka; Salomaa, Veikko; Hernesniemi, Juha; Kaprio, Jaakko

    2013-01-01

    Background Prospective studies on the risk factors for subarachnoid hemorrhage (SAH) are limited. Moreover, the effect of risk factors on the incidence rates of SAH is not well known about. Aims In this study, we aimed to identify risk factors for SAH and characterize subgroups in a population with a high incidence of SAH. Methods After recording multiple potential risk factors for SAH at the time of enrolment, first ever SAH events between 1972 and 2009 were recorded through the nationwide Causes of Death Register and Hospital Discharge Register for the population-based cohort of 64 349 participants, who participated in the National FINRISK Study between 1972 and 2007 in Finland. Results During the follow-up time of 1.26 million person-years (median 17.9 years, range 0 to 37.9 years), 437 persons experienced fatal or non-fatal SAH. Crude SAH incidence was 34.8 (95% confidence interval: 31.7–38.2) per 100 000 person-years among ≥25-year-old persons. Female sex, high blood pressure values and current smoking were confirmed as risk factors for SAH. Previous myocardial infarction, history of premature stroke (any kind) in mother and elevated cholesterol levels in men were identified as new risk factors for SAH. Depending on the combination of risk factors, SAH incidence varied between 8 and 171 per 100 000 person-years. Conclusions New and previously reported risk factors appear to have a much stronger association with the incidence of SAH than is ordinarily seen in cardiovascular diseases. Risk factor assessments may facilitate the identification of high-risk persons who should be the focus of preventive interventions. PMID:24040058

  4. Sources of unsafe primary care for older adults: a mixed-methods analysis of patient safety incident reports.

    Science.gov (United States)

    Cooper, Alison; Edwards, Adrian; Williams, Huw; Evans, Huw P; Avery, Anthony; Hibbert, Peter; Makeham, Meredith; Sheikh, Aziz; J Donaldson, Liam; Carson-Stevens, Andrew

    2017-09-01

    older adults are frequent users of primary healthcare services, but are at increased risk of healthcare-related harm in this setting. to describe the factors associated with actual or potential harm to patients aged 65 years and older, treated in primary care, to identify action to produce safer care. a cross-sectional mixed-methods analysis of a national (England and Wales) database of patient safety incident reports from 2005 to 2013. 1,591 primary care patient safety incident reports regarding patients aged 65 years and older. we developed a classification system for the analysis of patient safety incident reports to describe: the incident and preceding chain of incidents; other contributory factors; and patient harm outcome. We combined findings from exploratory descriptive and thematic analyses to identify key sources of unsafe care. the main sources of unsafe care in our weighted sample were due to: medication-related incidents e.g. prescribing, dispensing and administering (n = 486, 31%; 15% serious patient harm); communication-related incidents e.g. incomplete or non-transfer of information across care boundaries (n = 390, 25%; 12% serious patient harm); and clinical decision-making incidents which led to the most serious patient harm outcomes (n = 203, 13%; 41% serious patient harm). priority areas for further research to determine the burden and preventability of unsafe primary care for older adults, include: the timely electronic tools for prescribing, dispensing and administering medication in the community; electronic transfer of information between healthcare settings; and, better clinical decision-making support and guidance. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  5. Learning to Detect Traffic Incidents from Data Based on Tree Augmented Naive Bayesian Classifiers

    Directory of Open Access Journals (Sweden)

    Dawei Li

    2017-01-01

    Full Text Available This study develops a tree augmented naive Bayesian (TAN classifier based incident detection algorithm. Compared with the Bayesian networks based detection algorithms developed in the previous studies, this algorithm has less dependency on experts’ knowledge. The structure of TAN classifier for incident detection is learned from data. The discretization of continuous attributes is processed using an entropy-based method automatically. A simulation dataset on the section of the Ayer Rajah Expressway (AYE in Singapore is used to demonstrate the development of proposed algorithm, including wavelet denoising, normalization, entropy-based discretization, and structure learning. The performance of TAN based algorithm is evaluated compared with the previous developed Bayesian network (BN based and multilayer feed forward (MLF neural networks based algorithms with the same AYE data. The experiment results show that the TAN based algorithms perform better than the BN classifiers and have a similar performance to the MLF based algorithm. However, TAN based algorithm would have wider vista of applications because the theory of TAN classifiers is much less complicated than MLF. It should be found from the experiment that the TAN classifier based algorithm has a significant superiority over the speed of model training and calibration compared with MLF.

  6. High incidence of Campylobacter concisus in gastroenteritis in North Jutland, Denmark: a population-based study.

    Science.gov (United States)

    Nielsen, H L; Ejlertsen, T; Engberg, J; Nielsen, H

    2013-05-01

    The incidence of non-thermophilic Campylobacter species was assessed in an unselected population-based study in a mixed urban and rural community in North Jutland, Denmark. In a 2-year study period, 11,314 faecal samples from 8302 patients with gastroenteritis were cultured with supplement of the filter method. We recovered a high incidence of Campylobacter concisus (annual incidence 35/100,000 inhabitants), almost as high as the common Campylobacter jejuni/coli. In contrast, there was a very low incidence of other non-thermophilic Campylobacter species, such as Campylobacter upsaliensis. Campylobacter concisus was, unlike C. jejuni/coli, found more frequently among small children (<1 year) and the elderly (≥ 65 years). Around 10% of the patients with C. consisus had co-infections dominated by Clostridium difficile and Salmonella enterica, whereas co-infections occurred in about 5% of C. jejuni/coli patients. We observed a seasonal variation in C. jejuni/coli with a peak incidence in late summer months and autumn, whereas there was an almost constant monthly prevalence of C. concisus. Among patients participating in a questionnaire sub-study, there was a higher degree of close contacts with animals, especially dogs, as well as a higher travel exposure among C. jejuni/coli patients compared with C. concisus patients. We did not culture any C. concisus in stool samples from a small cohort of healthy individuals. Future studies have to focus on the clinical follow-up and the long-term risk of inflammatory bowel diseases in C. concisus-positive patients. We conclude that there is a high incidence of C. concisus in Denmark. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

  7. Can patients report patient safety incidents in a hospital setting? A systematic review.

    Science.gov (United States)

    Ward, Jane K; Armitage, Gerry

    2012-08-01

    Patients are increasingly being thought of as central to patient safety. A small but growing body of work suggests that patients may have a role in reporting patient safety problems within a hospital setting. This review considers this disparate body of work, aiming to establish a collective view on hospital-based patient reporting. This review asks: (a) What can patients report? (b) In what settings can they report? (c) At what times have patients been asked to report? (d) How have patients been asked to report? 5 databases (MEDLINE, EMBASE, CINAHL, (Kings Fund) HMIC and PsycINFO) were searched for published literature on patient reporting of patient safety 'problems' (a number of search terms were utilised) within a hospital setting. In addition, reference lists of all included papers were checked for relevant literature. 13 papers were included within this review. All included papers were quality assessed using a framework for comparing both qualitative and quantitative designs, and reviewed in line with the study objectives. Patients are clearly in a position to report on patient safety, but included papers varied considerably in focus, design and analysis, with all papers lacking a theoretical underpinning. In all papers, reports were actively solicited from patients, with no evidence currently supporting spontaneous reporting. The impact of timing upon accuracy of information has yet to be established, and many vulnerable patients are not currently being included in patient reporting studies, potentially introducing bias and underestimating the scale of patient reporting. The future of patient reporting may well be as part of an 'error detection jigsaw' used alongside other methods as part of a quality improvement toolkit.

  8. Parent-reported otorrhea in children with tympanostomy tubes: incidence and predictors.

    Directory of Open Access Journals (Sweden)

    Thijs M A van Dongen

    Full Text Available PURPOSE: Although common in children with tympanostomy tubes, the current incidence of tympanostomy tube otorrhea (TTO is uncertain. TTO is generally a sign of otitis media, when middle ear fluid drains through the tube. Predictors for otitis media are therefore suggested to have predictive value for the occurrence of TTO. OBJECTIVE: To determine the incidence of TTO and its predictors. METHODS: We performed a cohort study, using a parental web-based questionnaire to retrospectively collect data on TTO episodes and its potential predictors from children younger than 10 years of age with tympanostomy tubes. RESULTS: Of the 1,184 children included in analyses (total duration of time since tube placement was 768 person years with a mean of 7.8 months per child, 616 children (52% experienced one or more episodes of TTO. 137 children (12% had TTO within the calendar month of tube placement. 597 (50% children had one or more acute TTO episodes (duration <4 weeks and 46 children (4% one or more chronic TTO episodes (duration ≥4 weeks. 146 children (12% experienced recurrent TTO episodes. Accounting for time since tube placement, 67% of children developed one or more TTO episodes in the year following tube placement. Young age, recurrent acute otitis media being the indication for tube placement, a recent history of recurrent upper respiratory tract infections and the presence of older siblings were independently associated with the future occurrence of TTO, and can therefore be seen as predictors for TTO. CONCLUSIONS: Our survey confirms that otorrhea is a common sequela in children with tympanostomy tubes, which occurrence can be predicted by age, medical history and presence of older siblings.

  9. Semantic Language and Tools for Reporting Human Factors Incidents, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Incidents related to impaired human performance in space operations can be caused by environmental conditions, situational challenges, and operational deficiencies....

  10. Semantic Language and Tools for Reporting Human Factors Incidents, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Incidents related to impaired human performance in space operations can be caused by environmental conditions, situational challenges, and operational deficiencies....

  11. Exposure to ambient air pollution and the incidence of dementia: A population-based cohort study.

    Science.gov (United States)

    Chen, Hong; Kwong, Jeffrey C; Copes, Ray; Hystad, Perry; van Donkelaar, Aaron; Tu, Karen; Brook, Jeffrey R; Goldberg, Mark S; Martin, Randall V; Murray, Brian J; Wilton, Andrew S; Kopp, Alexander; Burnett, Richard T

    2017-11-01

    Emerging studies have implicated air pollution in the neurodegenerative processes. Less is known about the influence of air pollution, especially at the relatively low levels, on developing dementia. We conducted a population-based cohort study in Ontario, Canada, where the concentrations of pollutants are among the lowest in the world, to assess whether air pollution exposure is associated with incident dementia. The study population comprised all Ontario residents who, on 1 April 2001, were 55-85years old, Canadian-born, and free of physician-diagnosed dementia (~2.1 million individuals). Follow-up extended until 2013. We used population-based health administrative databases with a validated algorithm to ascertain incident diagnosis of dementia as well as prevalent cases. Using satellite observations, land-use regression model, and an optimal interpolation method, we derived long-term average exposure to fine particulate matter (≤2.5μm in diameter) (PM 2.5 ), nitrogen dioxide (NO 2 ), and ozone (O 3 ), respectively at the subjects' historical residences based on a population-based registry. We used multilevel spatial random-effects Cox proportional hazards models, adjusting for individual and contextual factors, such as diabetes, brain injury, and neighborhood income. We conducted various sensitivity analyses, such as lagging exposure up to 10years and considering a negative control outcome for which no (or weaker) association with air pollution is expected. We identified 257,816 incident cases of dementia in 2001-2013. We found a positive association between PM 2.5 and dementia incidence, with a hazard ratio (HR) of 1.04 (95% confidence interval (CI): 1.03-1.05) for every interquartile-range increase in exposure to PM 2.5 . Similarly, NO 2 was associated with increased incidence of dementia (HR=1.10; 95% CI: 1.08-1.12). No association was found for O 3 . These associations were robust to all sensitivity analyses examined. These estimates translate to 6.1% of

  12. Incidence of Dermatomyositis and Clinically Amyopathic Dermatomyositis: A Population-Based Study in Olmsted County, Minnesota

    Science.gov (United States)

    Reeder, Margo J.; Wetter, David A.; Li, Xujian; Davis, Mark D. P.

    2010-01-01

    Objective To identify new and existing cases of dermatomyositis and its subtypes in Olmsted County, Minnesota, from 1976 through 2007, and to establish a population-based estimate of the incidence and prevalence of dermatomyositis and amyopathic dermatomyositis. Design Retrospective population-based study. Setting Community-based epidemiology project. Patients Using the Rochester Epidemiology Project, patients with a diagnosis of dermatomyositis were identified. Main Outcome Measures Incidence of dermatomyositis and clinically amyopathic dermatomyositis; risk of malignancy in clinically amyopathic dermatomyositis. Results Of the 29 patients identified, 6 (21%) of these had the clinically amyopathic subtype of dermatomyositis, and 22 (76%) were female. Overall age- and sex-adjusted incidence (95% confidence interval) of dermatomyositis including all subtypes was 9.63 (6.09-13.17) per 1,000,000 and was 2.08 (0.39-3.77) per 1,000,000 for clinically amyopathic dermatomyositis. Age- and sex-adjusted prevalence was 21.42 (13.07-29.77) per 100,000. Eight patients (28%) had a malignancy during the study period; risk of malignancy (odds ratio) for classic dermatomyositis compared with clinically amyopathic dermatomyositis was 4.61 but was not statistically significant (0.22-96.09) (P=.44). Conclusions Dermatomyositis is a rare disease, and clinically amyopathic dermatomyositis represents an estimated 20% of all dermatomyositis cases. Larger population-based studies are needed to estimate the risk of malignancy associated with subtypes of dermatomyositis, particularly clinically amyopathic dermatomyositis. PMID:20083689

  13. [Breast cancer incidence related with a population-based screening program].

    Science.gov (United States)

    Natal, Carmen; Caicoya, Martín; Prieto, Miguel; Tardón, Adonina

    2015-02-20

    To compare breast cancer cumulative incidence, time evolution and stage at diagnosis between participants and non-participant women in a population-based screening program. Cohort study of breast cancer incidence in relation to participation in a population screening program. The study population included women from the target population of the screening program. The source of information for diagnostics and stages was the population-based cancer registry. The analysis period was 1999-2010. The Relative Risk for invasive, in situ, and total cancers diagnosed in participant women compared with non-participants were respectively 1.16 (0.94-1.43), 2.98 (1.16-7.62) and 1.22 (0.99-1.49). The Relative Risk for participants versus non-participants was 2.47 (1.55-3.96) for diagnosis at stagei, 2.58 (1.67-3.99) for T1 and 2.11 (1.38-3.23) for negative lymph node involvement. The cumulative incidence trend had two joint points in both arms, with an Annual Percent of Change of 92.3 (81.6-103.5) between 1999-2001, 18.2 (16.1-20.3) between 2001-2005 and 5.9 (4.0-7.8) for the last period in participants arm, and 72.6 (58.5-87.9) between 1999-2001, 12.6 (7.9-17.4) between 2001-2005, and 8.6 (6.5-10.6) in the last period in the non-participant arm. Participating in the breast cancer screening program analyzed increased the in situ cumulative cancer incidence, but not the invasive and total incidence. Diagnoses were earlier in the participant arm. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  14. [Patient safety -- mission for the future: The importance of Critical Incident Reporting Systems (CIRS) in clinical practice].

    Science.gov (United States)

    Maas, Matthias; Güß, Tim

    2014-07-01

    Every day patients experience harm due to errors and complications. To improve this situation, patient safety is increasingly becoming important in the treatment process. One aspect to increase patient safety is the Critical Incident Reporting System (CIRS). Observers and members of the care team are given the opportunity to anonymously report critical incidents and thus allow an analysis by an evaluation team. The goal is not to sanction the behavior of an individual, but to identify particular structural and organizational sources of error and to derive improvements. © Georg Thieme Verlag Stuttgart · New York.

  15. Dengue incidence in urban and rural Cambodia: results from population-based active fever surveillance, 2006-2008.

    Directory of Open Access Journals (Sweden)

    Sirenda Vong

    Full Text Available BACKGROUND: Dengue vaccines are now in late-stage development, and evaluation and robust estimates of dengue disease burden are needed to facilitate further development and introduction. In Cambodia, the national dengue case-definition only allows reporting of children less than 16 years of age, and little is known about dengue burden in rural areas and among older persons. To estimate the true burden of dengue in the largest province of Cambodia, Kampong Cham, we conducted community-based active dengue fever surveillance among the 0-to-19-year age group in rural villages and urban areas during 2006-2008. METHODS AND FINDINGS: Active surveillance for febrile illness was conducted in 32 villages and 10 urban areas by mothers trained to use digital thermometers combined with weekly home visits to identify persons with fever. An investigation team visited families with febrile persons to obtain informed consent for participation in the follow-up study, which included collection of personal data and blood specimens. Dengue-related febrile illness was defined using molecular and serological testing of paired acute and convalescent blood samples. Over the three years of surveillance, 6,121 fever episodes were identified with 736 laboratory-confirmed dengue virus (DENV infections for incidences of 13.4-57.8/1,000 person-seasons. Average incidence was highest among children less than 7 years of age (41.1/1,000 person-seasons and lowest among the 16-to-19-year age group (11.3/1,000 person-seasons. The distribution of dengue was highly focal, with incidence rates in villages and urban areas ranging from 1.5-211.5/1,000 person-seasons (median 36.5. During a DENV-3 outbreak in 2007, rural areas were affected more than urban areas (incidence 71 vs. 17/1,000 person-seasons, p<0.001. CONCLUSION: The large-scale active surveillance study for dengue fever in Cambodia found a higher disease incidence than reported to the national surveillance system, particularly

  16. Dengue Incidence in Urban and Rural Cambodia: Results from Population-Based Active Fever Surveillance, 2006–2008

    Science.gov (United States)

    Vong, Sirenda; Khieu, Virak; Glass, Olivier; Ly, Sowath; Duong, Veasna; Huy, Rekol; Ngan, Chantha; Wichmann, Ole; Letson, G. William; Margolis, Harold S.; Buchy, Philippe

    2010-01-01

    Background Dengue vaccines are now in late-stage development, and evaluation and robust estimates of dengue disease burden are needed to facilitate further development and introduction. In Cambodia, the national dengue case-definition only allows reporting of children less than 16 years of age, and little is known about dengue burden in rural areas and among older persons. To estimate the true burden of dengue in the largest province of Cambodia, Kampong Cham, we conducted community-based active dengue fever surveillance among the 0-to-19–year age group in rural villages and urban areas during 2006–2008. Methods and Findings Active surveillance for febrile illness was conducted in 32 villages and 10 urban areas by mothers trained to use digital thermometers combined with weekly home visits to identify persons with fever. An investigation team visited families with febrile persons to obtain informed consent for participation in the follow-up study, which included collection of personal data and blood specimens. Dengue-related febrile illness was defined using molecular and serological testing of paired acute and convalescent blood samples. Over the three years of surveillance, 6,121 fever episodes were identified with 736 laboratory-confirmed dengue virus (DENV) infections for incidences of 13.4–57.8/1,000 person-seasons. Average incidence was highest among children less than 7 years of age (41.1/1,000 person-seasons) and lowest among the 16-to-19–year age group (11.3/1,000 person-seasons). The distribution of dengue was highly focal, with incidence rates in villages and urban areas ranging from 1.5–211.5/1,000 person-seasons (median 36.5). During a DENV-3 outbreak in 2007, rural areas were affected more than urban areas (incidence 71 vs. 17/1,000 person-seasons, pdengue fever in Cambodia found a higher disease incidence than reported to the national surveillance system, particularly in preschool children and that disease incidence was high in both rural

  17. Dengue incidence in urban and rural Cambodia: results from population-based active fever surveillance, 2006-2008.

    Science.gov (United States)

    Vong, Sirenda; Khieu, Virak; Glass, Olivier; Ly, Sowath; Duong, Veasna; Huy, Rekol; Ngan, Chantha; Wichmann, Ole; Letson, G William; Margolis, Harold S; Buchy, Philippe

    2010-11-30

    Dengue vaccines are now in late-stage development, and evaluation and robust estimates of dengue disease burden are needed to facilitate further development and introduction. In Cambodia, the national dengue case-definition only allows reporting of children less than 16 years of age, and little is known about dengue burden in rural areas and among older persons. To estimate the true burden of dengue in the largest province of Cambodia, Kampong Cham, we conducted community-based active dengue fever surveillance among the 0-to-19-year age group in rural villages and urban areas during 2006-2008. Active surveillance for febrile illness was conducted in 32 villages and 10 urban areas by mothers trained to use digital thermometers combined with weekly home visits to identify persons with fever. An investigation team visited families with febrile persons to obtain informed consent for participation in the follow-up study, which included collection of personal data and blood specimens. Dengue-related febrile illness was defined using molecular and serological testing of paired acute and convalescent blood samples. Over the three years of surveillance, 6,121 fever episodes were identified with 736 laboratory-confirmed dengue virus (DENV) infections for incidences of 13.4-57.8/1,000 person-seasons. Average incidence was highest among children less than 7 years of age (41.1/1,000 person-seasons) and lowest among the 16-to-19-year age group (11.3/1,000 person-seasons). The distribution of dengue was highly focal, with incidence rates in villages and urban areas ranging from 1.5-211.5/1,000 person-seasons (median 36.5). During a DENV-3 outbreak in 2007, rural areas were affected more than urban areas (incidence 71 vs. 17/1,000 person-seasons, pdengue fever in Cambodia found a higher disease incidence than reported to the national surveillance system, particularly in preschool children and that disease incidence was high in both rural and urban areas. It also confirmed the

  18. Increasing incidence of base of tongue cancers from 2000 to 2010 due to HPV

    DEFF Research Database (Denmark)

    Garnaes, E; Kiss, K; Andersen, L

    2015-01-01

    BACKGROUND: We assessed the development in the number of new base of tongue squamous-cell carcinoma (BSCC) cases per year in eastern Denmark from 2000 to 2010 and whether HPV may explain any observable increased incidence. METHODS: We performed HPV DNA PCR and p16 immunohistochemistry analysis...... for all (n=210) BSCCs registered in the Danish Head and Neck Cancer Group (DAHANCA) and the Danish Pathology Data Bank, and genotyped all HPV-positive specimens with amplicon-based next-generation sequencing. RESULTS: The overall crude incidence of BSCCs increased significantly significant increase...... in the number of HPV-positive BSCCs (8.1% per year), whereas the number of HPV-negative BSCCs did not increase significantly. The overall HPV prevalence was 51%, with HPV16 as the predominant HPV type.(5.4% per year) during the study period. This was explained by a CONCLUSIONS: The increased number of HPV...

  19. Cancer Incidence in Egypt: Results of the National Population-Based Cancer Registry Program

    Directory of Open Access Journals (Sweden)

    Amal S. Ibrahim

    2014-01-01

    Full Text Available Background. This paper aims to present cancer incidence rates at national and regional level of Egypt, based upon results of National Cancer Registry Program (NCRP. Methods. NCRP stratified Egypt into 3 geographical strata: lower, middle, and upper. One governorate represented each region. Abstractors collected data from medical records of cancer centers, national tertiary care institutions, Health Insurance Organization, Government-Subsidized Treatment Program, and death records. Data entry was online. Incidence rates were calculated at a regional and a national level. Future projection up to 2050 was also calculated. Results. Age-standardized incidence rates per 100,000 were 166.6 (both sexes, 175.9 (males, and 157.0 (females. Commonest sites were liver (23.8%, breast (15.4%, and bladder (6.9% (both sexes: liver (33.6% and bladder (10.7% among men, and breast (32.0% and liver (13.5% among women. By 2050, a 3-fold increase in incident cancer relative to 2013 was estimated. Conclusion. These data are the only available cancer rates at national and regional levels of Egypt. The pattern of cancer indicated the increased burden of liver cancer. Breast cancer occupied the second rank. Study of rates of individual sites of cancer might help in giving clues for preventive programs.

  20. A prospective video-based analysis of injury situations in elite male football: football incident analysis.

    Science.gov (United States)

    Arnason, Arni; Tenga, Albin; Engebretsen, Lars; Bahr, Roald

    2004-09-01

    The mechanisms for football injuries are largely unknown. To describe the characteristics of injury situations in elite male football using a video-based method called football incident analysis. Prospective cohort study. During the 1999 season, videotapes from 52 matches in the Icelandic elite football league were reviewed. Incidents (N = 95) were recorded when the match was interrupted by the referee because of a suspected injury. Team physical therapists recorded injuries prospectively (N = 28 time-loss injuries). Duels caused 84 of the incidents, mostly tackling duels (n = 54). The exposed player's attention appeared to be focused away from the opponent in 93% of the cases. The 3 main mechanisms observed were (1) breakdown attacks, tackling from the side or the front, attention focused on the ball (24%); (2) defensive tackling duels, attention focused on the ball or low ball control (20%); and (3) heading duels, attention focused on the ball in the air (13%). Most incidents and injuries occurred during breakdown attacks and when a player was involved in tackling duels. Player attention appeared to be focused mainly on the ball, not on the opponent challenging him to gain ball possession.

  1. Assessment of Evidence Base from Medical Debriefs Data on Space Motion Sickness Incidence and Treatment

    Science.gov (United States)

    Younker, D.R.; Daniels, V.R.; Boyd, J.L.; Putcha, L.

    2008-01-01

    An objective of this data compilation and analysis project is to examine incidence and treatment efficacy of common patho-physiological disturbances during spaceflight. Analysis of medical debriefs data indicated that astronauts used medications to alleviate symptoms of four major ailments for which astronauts received treatment for sleep disturbances, space motion sickness (SMS), pain (headache, back pain) and sinus congestion. In the present data compilation and analysis project on SMS treatment during space missions, subject demographics (gender, age, first-time or repeat flyer), incidence and severity of SMS symptoms and subjective treatment efficacy from 317 crewmember debrief records were examined from STS-1 through STS-89. Preliminary analysis of data revealed that 50% of crew members reported SMS symptoms on at least one flight and 22% never experienced it. In addition, there were 387 medication dosing episodes reported, and promethazine was the most commonly used medication. Results of analysis of symptom check lists, medication use/efficacy and gender and flight record differences in incidence and treatment efficacy will be presented. Evidence gaps for treatment efficacy along with medication use trend analysis will be identified.

  2. 29 CFR 1904.39 - Reporting fatalities and multiple hospitalization incidents to OSHA.

    Science.gov (United States)

    2010-07-01

    ... to OSHA. 1904.39 Section 1904.39 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY... fatalities and multiple hospitalization incidents to OSHA. (a) Basic requirement. Within eight (8) hours... Administration (OSHA), U.S. Department of Labor, that is nearest to the site of the incident. You may also use...

  3. Comparison of the prevalence and characteristics of inpatient adverse events using medical records review and incident reporting.

    Science.gov (United States)

    Macharia, W M; Muteshi, C M; Wanyonyi, S Z; Mukaindo, A M; Ismail, A; Ekea, H; Abdallah, A; Tole, J M; Ngugi, A K

    2016-09-08

    Information on adverse events (AEs) in hospitalised patients in developing countries is scanty. To compare the magnitude and characteristics of inpatient AEs in a tertiary, not-for-profit healthcare facility in Kenya, using medical records review and incident reporting. Estimation of prevalence was done using incidents reported in 2010 from a random sample of medical records for hospital admissions. Nurse reviewers used 18 screening criteria, followed by physician reviewers to confirm occurrence. An AE was defined as an unexpected clinical event (UE) associated with death, disability or prolonged hospitalisation not explained by the disease condition. The kappa statistic was used to estimate inter-rater agreement, and analysis was done using logistic regression. The study identified 53 UEs from 2 000 randomly selected medical records and 33 reported UEs from 23 026 admissions in the index year. The prevalences of AEs from medical records review and incident reports were 1.4% (95% confidence interval (CI) 0.9 - 2.0) and 0.03% (95% CI 0.012 - 0.063), respectively. Compared with incident reporting, review of medical records identified more disability (13.2% v. 0%; p=0.03) and prolonged hospital stays (43.4% v. 18.2%; p=0.02). Review of medical records is preferable to incident reporting in determining the prevalence of AEs in health facilities with limited inpatient quality improvement experience. Further research is needed to determine whether staff education and a positive culture change through promotion of non-punitive UE reporting or a combination of approaches would improve the comprehensiveness of AE reporting.

  4. Development of a theoretical framework of factors affecting patient safety incident reporting: a theoretical review of the literature.

    Science.gov (United States)

    Archer, Stephanie; Hull, Louise; Soukup, Tayana; Mayer, Erik; Athanasiou, Thanos; Sevdalis, Nick; Darzi, Ara

    2017-12-27

    The development and implementation of incident reporting systems within healthcare continues to be a fundamental strategy to reduce preventable patient harm and improve the quality and safety of healthcare. We sought to identify factors contributing to patient safety incident reporting. To facilitate improvements in incident reporting, a theoretical framework, encompassing factors that act as barriers and enablers ofreporting, was developed. Embase, Ovid MEDLINE(R) and PsycINFO were searched to identify relevant articles published between January 1980 and May 2014. A comprehensive search strategy including MeSH terms and keywords was developed to identify relevant articles. Data were extracted by three independent researchers; to ensure the accuracy of data extraction, all studies eligible for inclusion were rescreened by two reviewers. The literature search identified 3049 potentially eligible articles; of these, 110 articles, including >29 726 participants, met the inclusion criteria. In total, 748 barriers were identified (frequency count) across the 110 articles. In comparison, 372 facilitators to incident reporting and 118 negative cases were identified. The top two barriers cited were fear of adverse consequences (161, representing 21.52% of barriers) and process and systems of reporting (110, representing 14.71% of barriers). In comparison, the top two facilitators were organisational (97, representing 26.08% of facilitators) and process and systems of reporting (75, representing 20.16% of facilitators). A wide range of factors contributing to engagement in incident reporting exist. Efforts that address the current tendency to under-report must consider the full range of factors in order to develop interventions as well as a strategic policy approach for improvement. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Risk Factors for Incident Diabetes in a Cohort Taking First-Line Nonnucleoside Reverse Transcriptase Inhibitor-Based Antiretroviral Therapy.

    Science.gov (United States)

    Karamchand, Sumanth; Leisegang, Rory; Schomaker, Michael; Maartens, Gary; Walters, Lourens; Hislop, Michael; Dave, Joel A; Levitt, Naomi S; Cohen, Karen

    2016-03-01

    Efavirenz is the preferred nonnucleoside reverse transcriptase inhibitor (NNRTI) in first-line antiretroviral therapy (ART) regimens in low- and middle-income countries, where the prevalence of diabetes is increasing. Randomized control trials have shown mild increases in plasma glucose in participants in the efavirenz arms, but no association has been reported with overt diabetes. We explored the association between efavirenz exposure and incident diabetes in a large Southern African cohort commencing NNRTI-based first-line ART. Our cohort included HIV-infected adults starting NNRTI-based ART in a private sector HIV disease management program from January 2002 to December 2011. Incident diabetes was identified by the initiation of diabetes treatment. Patients with prevalent diabetes were excluded. We included 56,298 patients with 113,297 patient-years of follow-up (PYFU) on first-line ART. The crude incidence of diabetes was 13.24 per 1000 PYFU. Treatment with efavirenz rather than nevirapine was associated with increased risk of developing diabetes (hazard ratio 1.27 (95% confidence interval (CI): 1.10-1.46)) in a multivariate analysis adjusting for age, sex, body mass index, baseline CD4 count, viral load, NRTI backbone, and exposure to other diabetogenic medicines. Zidovudine and stavudine exposure were also associated with an increased risk of developing diabetes. We found that treatment with efavirenz, as well as stavudine and zidovudine, increased the risk of incident diabetes. Interventions to detect and prevent diabetes should be implemented in ART programs, and use of antiretrovirals with lower risk of metabolic complications should be encouraged.

  6. Incidence and Clinical Outcomes of Inflammatory Bowel Disease in South Korea, 2011-2014: A Nationwide Population-Based Study.

    Science.gov (United States)

    Jung, Yoon Suk; Han, Minkyung; Kim, Won Ho; Park, Sohee; Cheon, Jae Hee

    2017-08-01

    The incidence of inflammatory bowel disease (IBD) is increasing in East Asia; however, population-based data from this region are lacking. We conducted a nationwide, population-based study to examine the incidence and disease course of IBD in South Korea. Using the National Health Insurance claims data, we collected data on patients diagnosed with IBD [10,049 with ulcerative colitis (UC) and 5595 with Crohn's disease (CD)] from 2011 to 2014. During the study period, the average annual incidence of UC was 5.0 per 10 5 , while that of CD was 2.8 per 10 5 . Among patients with UC, the cumulative rates of surgery 1 and 4 years after diagnosis were 1.0 and 2.0%; those among patients with CD were 9.0 and 13.9%, respectively. The 1- and 4-year cumulative rates of moderate- to high-dose corticosteroid use were, respectively, 26.6 and 45.2% among patients with UC, and 29.9 and 50.8% among those with CD. Similarly, the 1- and 4-year cumulative rates of immunomodulator use were 14.1 and 26.4% among patients with UC, and 58.3 and 76.1% among those with CD, respectively. With regard to biologic use, the 1- and 4-year cumulative rates were 3.0 and 9.0% among patients with UC, and 11.1 and 31.7% among those with CD, respectively. The recent incidence of IBD in South Korea has been the highest in East Asia. Patients who had been diagnosed recently with IBD showed lower rates of surgery and higher rates of immunomodulator and biologic use compared to those reported ever in South Korea.

  7. Racial disparities in incidence and outcome in multiple myeloma: a population-based study

    OpenAIRE

    Waxman, Adam J.; Mink, Pamela J.; Devesa, Susan S.; Anderson, William F.; Weiss, Brendan M.; Kristinsson, Sigurdur Y.; McGlynn, Katherine A.; Landgren, Ola

    2010-01-01

    Multiple myeloma (MM) is the most common hematologic malignancy in blacks. Some prior studies suggest inferior survival in blacks; others suggest similar survival. Using the original 9 Surveillance, Epidemiology, and End Results registries, we conducted a large-scale population-based study including 5798 black and 28 939 white MM patients diagnosed 1973-2005, followed through 2006. Age-adjusted incidence rates, disease-specific survival, and relative survival rates were calculated by race, ag...

  8. Incidence of Incisional Hernia after Cesarean Delivery: A Register-Based Cohort Study

    OpenAIRE

    Aabakke, Anna J. M.; Krebs, Lone; Ladelund, Steen; Secher, Niels J.

    2014-01-01

    OBJECTIVE: To estimate the incidence of incisional hernias requiring surgical repair after cesarean delivery over a 10-year period. METHODS: This population- and register-based cohort study identified all women in Denmark with no history of previous abdominal surgery who had a cesarean delivery between 1991 and 2000. The cohort was followed from their first until 10 years after their last cesarean delivery within the inclusion period or until the first of the following events: hernia repair, ...

  9. Recent events in NPPs and incident reporting system (IRS) activity. Working material

    International Nuclear Information System (INIS)

    1996-01-01

    The IAEA convened the 1996 Joint Meeting to Exchange Information on Recent Events in Nuclear Power Plants and the Technical Committee-Annual Meeting of the Incident Reporting System (IRS) national co-ordinators, organized jointly with the Nuclear Energy Agency (NEA) of the OECD in Paris, France from 22-26 April 1996. These consecutive meetings took place at the OECD Headquarters, 2 rue Andre Pascal. The main objective of the first meeting (22-24 April 1996) was to exchange and discuss information on recent events which occurred in NPPs. The second meeting (25-26 April 1996) was devoted to the IAEA and NEA activity in the framework of the IRS. The main issues of the programme at the meetings were as follows: in-depth discussion on NPP recent events, presented by the participants; panel discussion on operational safety experience issues identified by the participants; IAEA and NEA activities on IRS subjects in 1995-1996 and plans for the future; issues from the inter-agency's IRS Advisory Committee. Annexes I and II provide more information on the programme at the meetings. A list of participants is given in Annex III (50 participants from 22 countries and 3 international organization). Annexes IV and V provide information on national presentations on recent events. Figs, tabs

  10. A population-based, incidence cohort study of mid-back pain after traffic collisions

    DEFF Research Database (Denmark)

    Johansson, M S; Boyle, E; Hartvigsen, Jan

    2015-01-01

    , depression or others) has been investigated previously; however, knowledge about traffic collision-related MBP is lacking. The study objectives were to describe the incidence, course of recovery and prognosis of MBP after traffic collisions, in terms of global self-reported recovery. METHODS: Longitudinal......BACKGROUND: Traffic collisions often result in a wide range of symptoms included in the umbrella term whiplash-associated disorders. Mid-back pain (MBP) is one of these symptoms. The incidence and prognosis of different traffic injuries and their related conditions (e.g. neck pain, low back pain......: These findings show that MBP is common after traffic collisions, may result in a long recovery process and that a range of biopsychosocial factors are associated with recovery....

  11. Increasing incidence of nutritional rickets: a population-based study in Olmsted County, Minnesota.

    Science.gov (United States)

    Thacher, Tom D; Fischer, Philip R; Tebben, Peter J; Singh, Ravinder J; Cha, Stephen S; Maxson, Julie A; Yawn, Barbara P

    2013-02-01

    To determine temporal trends in incidence and risk factors of nutritional rickets in a community-based population. Rochester Epidemiology Project data were used to identify all children (aged rickets, vitamin D deficiency, hypovitaminosis D, rachitis, osteomalacia, genu varum, genu valgum, craniotabes, hypocalcemia, hypocalcemic seizure, and tetany. Record abstraction was performed to select individuals with radiographic confirmation of rickets. Age- and sex-matched controls were identified for the evaluation of risk factors. The main outcome measure was radiographic evidence of rickets without identifiable inherited, genetic, or nonnutritional causes. Incidence rates were calculated using Rochester Epidemiology Project census data. Of 768 children with eligible diagnostic codes, 23 had radiographic evidence of rickets; of these, 17 children had nutritional rickets. All 17 children were younger than 3 years, and 13 (76%) were of nonwhite race/ethnicity. Clinical presentation included poor growth (n=12), leg deformity (n=8), motor delay (n=5), leg pain (n=3), weakness (n=3), and hypocalcemia or tetany (n=2). The incidence of nutritional rickets in children younger than 3 years was 0, 2.2, 3.7, and 24.1 per 100,000 for the decades beginning in 1970, 1980, 1990, and 2000, respectively (P=.003 for incidence trend). Nutritional rickets was associated with black race, breast-feeding, low birth weight, and stunted growth (Prickets remains rare, but its incidence has dramatically increased since 2000. Not all cases of rickets can be attributed to vitamin D deficiency. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  12. Incidence and time trends of Herpes zoster in rheumatoid arthritis: a population-based cohort study

    Science.gov (United States)

    Veetil, Bharath Manu Akkara; Myasoedova, Elena; Matteson, Eric L.; Gabriel, Sherine E.; Green, Abigail B.; Crowson, Cynthia S.

    2012-01-01

    Objective To determine the incidence, time trends, risk factors and severity of herpes zoster (HZ) in a population-based incidence cohort of patients with rheumatoid arthritis (RA) compared to a group of individuals without RA from the same population. Methods All residents of Olmsted County, MN who first fulfilled 1987 American College of Rheumatology criteria for RA between 1/1/1980 and 12/31/2007 and a cohort of similar residents without RA were assembled and followed by retrospective chart review until death, migration, or 12/31/2008. Results There was no difference in the presence of HZ prior to RA incidence/index date between the cohorts (p=0.85). During follow-up 84 patients with RA (rate: 12.1 per 1000 person-years) and 44 subjects without RA (rate: 5.4 per 1000 person-years) developed HZ. Patients with RA were more likely to develop HZ than those without RA (hazard ratio: 2.4; 95% confidence interval: 1.7, 3.5). Patients diagnosed with RA in 1995–2007 had a higher likelihood of developing HZ than those diagnosed in 1980–1994. Erosive disease, previous joint surgery, use of hydroxychloroquine and corticosteroids were significantly associated with the development of HZ in RA, while the use of methotrexate or biologic agents was not. Complications of HZ occurred at a similar rate in both cohorts. Conclusion The incidence of HZ is increased in RA and has risen in recent years. The increasing incidence of HZ in more recent years is also noted in the general population. RA disease severity is associated with development of HZ. PMID:23281295

  13. Population-Based Incidence Rates of First-Ever Stroke in Central Vietnam.

    Science.gov (United States)

    Yamanashi, Hirotomo; Ngoc, Mai Quang; Huy, Tran Van; Suzuki, Motoi; Tsujino, Akira; Toizumi, Michiko; Takahashi, Kensuke; Thiem, Vu Dinh; Anh, Dang Duc; Anh, Nguyen Thi Hien; Tho, Le Huu; Maeda, Takahiro; Cox, Sharon E; Yoshida, Lay-Myint; Ariyoshi, Koya

    2016-01-01

    Stroke incidence data with methodologically acceptable design in Southeast Asia countries is limited. This study aimed to determine incidence of age-, sex- and subtype-specific first-ever stroke (FES) in Vietnam. We conducted a hospital-based retrospective study, targeting all stroke cases hospitalized at a solo-provider hospital in our study site of Nha Trang from January 2009 to December 2011 with International Classification of Diseases, 10th revision (ICD-10) codes I60-69. We calculated positive predictive values (PPVs) of each ICD-10-coded stroke by conducting a detailed case review of 190 randomly selected admissions with ICD-10 codes of I60-I69. These PPVs were then used to estimate annual incident stroke cases from the computerized database. National census data in 2009 was used as a denominator. 2,693 eligible admissions were recorded during the study period. The crude annual incidence rate of total FES was 90.2 per 100,000 population (95% CI 81.1-100.2). The age-adjusted incidence of FES was 115.7 (95% CI 95.9-139.1) when adjusted to the WHO world populations. Importantly, age-adjusted intracerebral hemorrhage was as much as one third of total FES: 36.9 (95% CI 26.1-51.0). We found a considerable proportion of FES in Vietnam to be attributable to intracerebral hemorrhage, which is as high or exceeding levels seen in high-income countries. A high prevalence of improperly treated hypertension in Vietnam may underlie the high prevalence of intracerebral hemorrhagic stroke in this population.

  14. Incidence and progression of geographic atrophy: observations from a population-based cohort.

    Science.gov (United States)

    Joachim, Nichole; Mitchell, Paul; Kifley, Annette; Rochtchina, Elena; Hong, Thomas; Wang, Jie Jin

    2013-10-01

    To examine early age-related macular degeneration (AMD) lesion characteristics and risk factors associated with the long-term development and progression of geographic atrophy (GA). Population-based cohort. Of 3654 participants aged ≥49 years in the Blue Mountains Eye Study, 75.8%, 76.7%, and 56.1% of survivors attended the 5-, 10-, and 15-year follow-up examinations, respectively. Retinal photographs were taken at each visit. Incident GA was confirmed using a side-by-side grading method. Computer planimetry was used to measure the area involved by GA. Fast and slow/normal progression rates were defined as GA area enlargement by ≥2 and <2 mm(2)/year, respectively. Incident GA was estimated using the Kaplan-Meier product-limit method. Early AMD lesion characteristics were assessed for association with GA incidence using eye-specific data and generalized estimating equation models adjusting for age, current smoking, and presence of risk alleles of the complement factor H (CFH) or age-related maculopathy susceptibility 2 (ARMS2) genes, genotyped or imputed using genome-wide scan data. Incidence and progression of GA. By excluding 41 subjects with GA at baseline, of 2503 participants at risk of GA, incident pure GA (without coexisting neovascular AMD lesions) was confirmed in 57 participants, with a 15-year incidence of 3.6%. Baseline early AMD lesion characteristics associated with GA incidence included drusen type (soft indistinct: odds ratio [OR], 59.0; 95% confidence interval [CI], 20.4-171.0; reticular drusen: OR, 13.9; 95% CI, 4.0-47.6); drusen location within a 500-μm radius of the fovea (OR, 15.1; 95% CI, 7.4-30.8); drusen area greater than 375 μm in diameter (OR, 10.1; 95% CI, 4.0-25.6); presence of retinal pigment epithelial depigmentation (OR, 9.0; 95% CI, 4.1-19.8); or hyperpigmentation (OR, 12.0; 95% CI, 6.1-23.5), referenced to subjects with no or hard drusen only. Fast progression was more frequent among current smokers at baseline, subjects with

  15. Differences Between Methods of Detecting Medication Errors: A Secondary Analysis of Medication Administration Errors Using Incident Reports, the Global Trigger Tool Method, and Observations.

    Science.gov (United States)

    Härkänen, Marja; Turunen, Hannele; Vehviläinen-Julkunen, Katri

    2016-03-24

    This study aimed to compare medication administration errors detected by 3 different methods in terms of severity, type, and contributing factors. The study was performed in one university hospital in Finland. A convenience sample of medication administration errors (n = 451) reported on incident reports or detected by reviewing randomly selected patient records via the Global Trigger Tool method and direct observations of patient record reviews were collected for reanalysis. The severity of the medication administration errors, the types thereof, and factors contributing to such errors were reclassified using the National Coordinating Council for Medication Error Reporting and Prevention's taxonomy of medication errors. The observational method revealed fewer medication errors that were more likely to cause harm to patients than did the incident reports or the Global Trigger Tool method. The incident reports and the Global Trigger Tool method mainly revealed wrong doses, whereas most medication administration errors in the observational data were errors involving the use of the incorrect technique. In addition, each method produced different information regarding the factors contributing to medication administration errors. Based on the study's findings and the limitations of each method, a combination of different methods should be used to discover representative information concerning medication administration errors. To increase medication administration safety, advanced multiprofessional collaboration, effective communication, adequate skills, more systematic medication processes, and distraction-free work environments are needed.

  16. Review of methodologies for analysis of safety incidents at NPPs. Final report of a co-ordinated research project 1998-2001

    International Nuclear Information System (INIS)

    2002-03-01

    The safe operation of nuclear power plants around the world and the prevention of incidents in these installations remain key concerns for the nuclear community. In this connection, the feedback of operating experience plays a major role: every nuclear power plant or nuclear utility needs to have a system in place for collecting information on unusual events, whether these are incidents or merely deviations from normal operation. Reporting to the regulatory body of important events and lessons learned is normally carried out through the national reporting schemes based on regulatory reporting requirements. The most important lessons learned are further shared internationally, through, for example, the Joint IAEA/NEA Incident Reporting System (IRS) or the event information exchange of the World Association of Nuclear Operators (WANO). In order to properly assess the event, an adequate event investigation methodology has to be applied, which leads to the identification of correct root causes. Once these root causes have been ascertained, appropriate corrective actions can be established and corresponding lessons can be drawn. The overall goal of root cause analysis is the prevention of events or their recurrence and thus the overall improvement in plant safety. In 1998, the IAEA established a co-ordinated research project with the objective of exploring root cause methodologies and techniques currently in use in Member States, evaluating their strengths and limitations and developing criteria for appropriate event investigation methodologies. This report is the outcome of four years of co-ordinated research which involved 15 national and international research organizations

  17. Status Update on the NCRP Scientific Committee SC 5-1 Report: Decision Making for Late-Phase Recovery from Nuclear or Radiological Incidents - 13450

    International Nuclear Information System (INIS)

    Chen, S.Y.

    2013-01-01

    In August 2008, the U.S. Department of Homeland Security (DHS) issued its final Protective Action Guide (PAG) for radiological dispersal device (RDD) and improvised nuclear device (IND) incidents. This document specifies protective actions for public health during the early and intermediate phases and cleanup guidance for the late phase of RDD or IND incidents, and it discusses approaches to implementing the necessary actions. However, while the PAG provides specific guidance for the early and intermediate phases, it prescribes no equivalent guidance for the late-phase cleanup actions. Instead, the PAG offers a general description of a complex process using a site-specific optimization approach. This approach does not predetermine cleanup levels but approaches the problem from the factors that would bear on the final agreed-on cleanup levels. Based on this approach, the decision-making process involves multifaceted considerations including public health, the environment, and the economy, as well as socio-political factors. In an effort to fully define the process and approach to be used in optimizing late-phase recovery and site restoration following an RDD or IND incident, DHS has tasked the NCRP with preparing a comprehensive report addressing all aspects of the optimization process. Preparation of the NCRP report is a three-year (2010-2013) project assigned to a scientific committee, the Scientific Committee (SC) 5-1; the report was initially titled, Approach to Optimizing Decision Making for Late- Phase Recovery from Nuclear or Radiological Terrorism Incidents. Members of SC 5-1 represent a broad range of expertise, including homeland security, health physics, risk and decision analysis, economics, environmental remediation and radioactive waste management, and communication. In the wake of the Fukushima nuclear accident of 2011, and guided by a recent process led by the White House through a Principal Level Exercise (PLE), the optimization approach has since

  18. Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis.

    Science.gov (United States)

    de Boer, Jacoba; Lok, Anja; Van't Verlaat, Ellen; Duivenvoorden, Hugo J; Bakker, Arnold B; Smit, Bert J

    2011-07-01

    This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively affect health care practitioners' behaviors toward patients. Nurses and doctors often cope by working part time or switching jobs. Hospital administrators and health care practitioners themselves may underestimate the effects of work-related critical incidents. Relevant online databases were searched for original research published from inception to 2009 and manual searches of the Journal of Traumatic Stress, reference lists, and the European Traumatic Stress Research Database were conducted. Two researchers independently decided on inclusion and study quality. Effect sizes were estimated using standardized mean differences with 95% confidence intervals. Consistency was evaluated, using the I(2)-statistic. Meta-analysis was performed using the random effects model. Eleven studies, which included 3866 participants, evaluated the relationship between work-related critical incidents and post-traumatic stress symptoms. Six of these studies, which included 1695 participants, also reported on the relationship between work-related critical incidents and symptoms of anxiety and depression. Heterogeneity among studies was high and could not be accounted for by study quality, character of the incident, or timing of data collection. Pooled effect sizes for the impact of work-related critical incidents on post-traumatic stress symptoms, anxiety, and depression were small to medium. Remarkably, the effect was more pronounced in the longer than in the shorter term. In conclusion, this meta-analysis supports the hypothesis that work-related critical incidents are positively related to post-traumatic stress symptoms, anxiety, and depression in hospital-based health care professionals

  19. Design and Testing of BACRA, a Web-Based Tool for Middle Managers at Health Care Facilities to Lead the Search for Solutions to Patient Safety Incidents.

    Science.gov (United States)

    Carrillo, Irene; Mira, José Joaquín; Vicente, Maria Asuncion; Fernandez, Cesar; Guilabert, Mercedes; Ferrús, Lena; Zavala, Elena; Silvestre, Carmen; Pérez-Pérez, Pastora

    2016-09-27

    Lack of time, lack of familiarity with root cause analysis, or suspicion that the reporting may result in negative consequences hinder involvement in the analysis of safety incidents and the search for preventive actions that can improve patient safety. The aim was develop a tool that enables hospitals and primary care professionals to immediately analyze the causes of incidents and to propose and implement measures intended to prevent their recurrence. The design of the Web-based tool (BACRA) considered research on the barriers for reporting, review of incident analysis tools, and the experience of eight managers from the field of patient safety. BACRA's design was improved in successive versions (BACRA v1.1 and BACRA v1.2) based on feedback from 86 middle managers. BACRA v1.1 was used by 13 frontline professionals to analyze incidents of safety; 59 professionals used BACRA v1.2 and assessed the respective usefulness and ease of use of both versions. BACRA contains seven tabs that guide the user through the process of analyzing a safety incident and proposing preventive actions for similar future incidents. BACRA does not identify the person completing each analysis since the password introduced to hide said analysis only is linked to the information concerning the incident and not to any personal data. The tool was used by 72 professionals from hospitals and primary care centers. BACRA v1.2 was assessed more favorably than BACRA v1.1, both in terms of its usefulness (z=2.2, P=.03) and its ease of use (z=3.0, P=.003). BACRA helps to analyze incidents of safety and to propose preventive actions. BACRA guarantees anonymity of the analysis and reduces the reluctance of professionals to carry out this task. BACRA is useful and easy to use.

  20. Effects of patient safety culture interventions on incident reporting in general practice : A cluster randomised trial a cluster randomised trial

    NARCIS (Netherlands)

    Verbakel, Natasha J.; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M

    2015-01-01

    Background: A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim: To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting: A three-arm cluster randomised trial

  1. Which aspects of safety culture predict incident reporting behavior in neonatal intensive care units? A multilevel analysis

    NARCIS (Netherlands)

    Snijders, Cathelijne; Kollen, Boudewijn J.; van Lingen, Richard A.; Fetter, Willem P. F.; Molendijk, Harry; Kok, J. H.; te Pas, E.; Pas, H.; van der Starre, C.; Bloemendaal, E.; Lopes Cardozo, R. H.; Molenaar, A. M.; Giezen, A.; van Lingen, R. A.; Maat, H. E.; Molendijk, A.; Snijders, C.; Lavrijssen, S.; Mulder, A. L. M.; de Kleine, M. J. K.; Koolen, A. M. P.; Schellekens, M.; Verlaan, W.; Vrancken, S.; Fetter, W. P. F.; Schotman, L.; van der Zwaan, A.; van der Tuijn, Y.; Tibboel, D.; van der Schaaf, T. W.; Klip, H.; Kollen, B. J.

    2009-01-01

    OBJECTIVES: Safety culture assessments are increasingly used to evaluate patient-safety programs. However, it is not clear which aspects of safety culture are most relevant in understanding incident reporting behavior, and ultimately improving patient safety. The objective of this study was to

  2. The Diffuse Involvement of Bilateral Breasts in the Incidence of Burkitt's Lymphoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Su; Lee, Sa Rah; Yang, Woo Ick; Kim, Eun Kyung [Yonsei University College of Medicine, Seoul (Korea, Republic of); Jung, Hae Kyoung [CHA University, Bundang CHA Hospital, Seongnam (Korea, Republic of)

    2009-12-15

    The incidence of Burkitt's lymphoma involving both breasts is rare. We report such a case that was diagnosed by a core biopsy of a hypoechoic lesion visualized from the ultrasonographic results of a patient that was clinically suspected of mastitis.

  3. Simulation analysis of route diversion strategies for freeway incident management : final report.

    Science.gov (United States)

    1995-02-01

    The purpose of this project was to investigate whether simulation models could : be used as decision aids for defining traffic diversion strategies for effective : incident management. A methodology was developed for using such a model to : determine...

  4. Airborne incidents : an econometric analysis of severity, December 19, 2014 : Final report

    Science.gov (United States)

    2014-12-19

    Airborne loss of separation incidents occur when an aircraft breaches the defined separation limit (vertical and/or horizontal) with another aircraft or terrain imposed by Air Traffic Control. Identifying conditions that lead to more severe loss of s...

  5. Baseline neuropsychiatric symptoms and the risk of incident mild cognitive impairment: a population-based study.

    Science.gov (United States)

    Geda, Yonas E; Roberts, Rosebud O; Mielke, Michelle M; Knopman, David S; Christianson, Teresa J H; Pankratz, Vernon S; Boeve, Bradley F; Sochor, Ondrej; Tangalos, Eric G; Petersen, Ronald C; Rocca, Walter A

    2014-05-01

    The authors conducted a prospective cohort study to estimate the risk of incident mild cognitive impairment in cognitively normal elderly (aged ≥70 years) individuals with or without neuropsychiatric symptoms at baseline. The research was conducted in the setting of the population-based Mayo Clinic Study of Aging. A classification of normal cognitive aging, mild cognitive impairment, and dementia was adjudicated by an expert consensus panel based on published criteria. Hazard ratios and 95% confidence intervals were computed using Cox proportional hazards model, with age as a time scale. Baseline Neuropsychiatric Inventory Questionnaire data were available for 1,587 cognitively normal persons who underwent at least one follow-up visit. The cohort was followed to incident mild cognitive impairment (N=365) or censoring variables (N=179) for a median of 5 years. Agitation (hazard ratio=3.06, 95% CI=1.89-4.93), apathy (hazard ratio=2.26, 95% CI=1.49-3.41), anxiety (hazard ratio=1.87, 95% CI=1.28-2.73), irritability (hazard ratio=1.84, 95% CI=1.31-2.58), and depression (hazard ratio=1.63, 95% CI=1.23-2.16), observed initially, increased risk for later mild cognitive impairment. Delusion and hallucination did not. A secondary analysis, limited in significance by the small number of study participants, showed that euphoria, disinhibition, and nighttime behaviors were significant predictors of nonamnestic mild cognitive impairment but not amnestic mild cognitive impairment. By contrast, depression predicted amnestic mild cognitive impairment (hazard ratio=1.74, 95% CI=1.22-2.47) but not nonamnestic mild cognitive impairment. An increased incidence of mild cognitive impairment was observed in community-dwelling elderly adults who had nonpsychotic psychiatric symptoms at baseline. These baseline psychiatric symptoms were of similar or greater magnitude as biomarkers (genetic and structural MRI) in increasing the risk of incident mild cognitive impairment.

  6. Base of Tongue Tuberculosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Carlos Chiesa Estomba

    2015-05-01

    Full Text Available Introduction: Tuberculosis is an infectious disease that has displayed increasing incidence in the last decades. It is estimated that up to 20% of tuberculosis cases affect extra-pulmonary organs. In the ENT area, soft palate and tongue are the least probable locations.   Case Report A 62-year-old female with a history of rheumatoid arthritis and treatment with corticosteroids and Adalimumab, developed a foreign body sensation in the pharynx accompanied by a sore throat and halitosis. The laryngoscopy with a 70 degree rigid telescope showed an ulcerated hypertrophic lesion in the right vallecula of about 2-3 cm in the base of the tongue. Acid-alcohol resistant bacilli were found positive for M. tuberculosis, through the Ziehl Neelsen method and Löwenstein culture the patient was treated with tuberculostatic medication. Conclusion:  TB is a possible diagnosis when in the presence of an ulcerated lesion at the base of the tongue, accompanied by sore throat, dysphagia, or foreign body sensation.

  7. Estimating the incidence reporting rates of new influenza pandemics at an early stage using travel data from the source country.

    Science.gov (United States)

    Chong, K C; Fong, H F; Zee, C Y

    2014-05-01

    During the surveillance of influenza pandemics, underreported data are a public health challenge that complicates the understanding of pandemic threats and can undermine mitigation efforts. We propose a method to estimate incidence reporting rates at early stages of new influenza pandemics using 2009 pandemic H1N1 as an example. Routine surveillance data and statistics of travellers arriving from Mexico were used. Our method incorporates changes in reporting rates such as linearly increasing trends due to the enhanced surveillance. From our results, the reporting rate was estimated at 0·46% during early stages of the pandemic in Mexico. We estimated cumulative incidence in the Mexican population to be 0·7% compared to 0·003% reported by officials in Mexico at the end of April. This method could be useful in estimation of actual cases during new influenza pandemics for policy makers to better determine appropriate control measures.

  8. A cross-national comparison of incident reporting systems implemented in German and Swiss hospitals.

    Science.gov (United States)

    Manser, Tanja; Imhof, Michael; Lessing, Constanze; Briner, Matthias

    2017-06-01

    This study aimed to empirically compare incident reporting systems (IRS) in two European countries and to explore the relationship of IRS characteristics with context factors such as hospital characteristics and characteristics of clinical risk management (CRM). We performed exploratory, secondary analyses of data on characteristics of IRS from nationwide surveys of CRM practices. The survey was originally sent to 2136 hospitals in Germany and Switzerland. Persons responsible for CRM in 622 hospitals completed the survey (response rate 29%). None. Differences between IRS in German and Swiss hospitals were assessed using Chi2, Fisher's Exact and Freeman-Halton-Tests, as appropriate. To explore interrelations between IRS characteristics and context factors (i.e. hospital and CRM characteristics) we computed Cramer's V. Comparing participating hospitals across countries, Swiss hospitals had implemented IRS earlier, more frequently and more often provided introductory IRS training systematically. German hospitals had more frequently systematically implemented standardized procedures for event analyses. IRS characteristics were significantly associated with hospital characteristics such as hospital type as well as with CRM characteristics such as existence of strategic CRM objectives and of a dedicated position for central CRM coordination. This study contributes to an improved understanding of differences in the way IRS are set up in two European countries and explores related context factors. This opens up new possibilities for empirically informed, strategic interventions to further improve dissemination of IRS and thus support hospitals in their efforts to move patient safety forward. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  9. Technology-related medication errors in a tertiary hospital: a 5-year analysis of reported medication incidents.

    Science.gov (United States)

    Samaranayake, N R; Cheung, S T D; Chui, W C M; Cheung, B M Y

    2012-12-01

    Healthcare technology is meant to reduce medication errors. The objective of this study was to assess unintended errors related to technologies in the medication use process. Medication incidents reported from 2006 to 2010 in a main tertiary care hospital were analysed by a pharmacist and technology-related errors were identified. Technology-related errors were further classified as socio-technical errors and device errors. This analysis was conducted using data from medication incident reports which may represent only a small proportion of medication errors that actually takes place in a hospital. Hence, interpretation of results must be tentative. 1538 medication incidents were reported. 17.1% of all incidents were technology-related, of which only 1.9% were device errors, whereas most were socio-technical errors (98.1%). Of these, 61.2% were linked to computerised prescription order entry, 23.2% to bar-coded patient identification labels, 7.2% to infusion pumps, 6.8% to computer-aided dispensing label generation and 1.5% to other technologies. The immediate causes for technology-related errors included, poor interface between user and computer (68.1%), improper procedures or rule violations (22.1%), poor interface between user and infusion pump (4.9%), technical defects (1.9%) and others (3.0%). In 11.4% of the technology-related incidents, the error was detected after the drug had been administered. A considerable proportion of all incidents were technology-related. Most errors were due to socio-technical issues. Unintended and unanticipated errors may happen when using technologies. Therefore, when using technologies, system improvement, awareness, training and monitoring are needed to minimise medication errors. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  10. An analysis of patient safety incidents associated with medications reported from critical care units in the North West of England between 2009 and 2012.

    Science.gov (United States)

    Thomas, A N; Taylor, R J

    2014-07-01

    Incident reporting is promoted as a key tool for improving patient safety in healthcare. We analysed 2238 patient safety incidents involving medications submitted from up to 29 critical care units each year in the North West of England between 2009 and 2012; 452 (20%) of these incidents led to harm to patients. Although 1461 (65%) incidents were judged to have been preventable, there was no reduction in the rate of incidents per 1000 days between 2009 and 2012 (5.9 in 2009, 6.6 in 2012). Furthermore, in the 2012 data, there were wide variations in the incident rates between units, the median (IQR [range]) rate per 1000 patient days for individual units being 6.8 (3.8-11.0 [1.3-37.1]). The variation in the percentage that could have been avoided was narrower, with a median (IQR [range]) of 70% (61-80% [38-100%]). The most commonly reported drugs were noradrenaline (161 incidents, 92 with harm), heparins (153 incidents, 29 with harm), morphine (131 incidents, 14 with harm) and insulin (111 incidents, 54 with harm). The administration of drugs was the stage in the process where incidents were most commonly reported; it was also the stage most likely to harm patients. We conclude that the wide range in reported rates between units, and the scope for preventing many incidents, suggest that quality improvement initiatives could improve medication safety in the units studied. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

  11. Prevalence and incidence of HIV in a rural community-based HIV vaccine preparedness cohort in Masaka, Uganda.

    Directory of Open Access Journals (Sweden)

    Eugene Ruzagira

    Full Text Available Local HIV epidemiology data are critical in determining the suitability of a population for HIV vaccine efficacy trials. The objective of this study was to estimate the prevalence and incidence of, and determine risk factors for HIV transmission in a rural community-based HIV vaccine preparedness cohort in Masaka, Uganda.Between February and July 2004, we conducted a house-to-house HIV sero-prevalence survey among consenting individuals aged 18-60 years. Participants were interviewed, counseled and asked to provide blood for HIV testing. We then enrolled the HIV uninfected participants in a 2-year HIV sero-incidence study. Medical evaluations, HIV counseling and testing, and sample collection for laboratory analysis were done quarterly. Sexual risk behaviour data was collected every 6 months.The HIV point prevalence was 11.2%, and was higher among women than men (12.9% vs. 8.6%, P = 0.007. Risk factors associated with prevalent HIV infection for men were age <25 years (aOR = 0.05, 95% CI 0.01-0.35 and reported genital ulcer disease in the past year (aOR = 2.17, 95% CI 1.23-3.83. Among women, being unmarried (aOR = 2.59, 95% CI 1.75-3.83 and reported genital ulcer disease in the past year (aOR = 2.40, 95% CI 1.64-3.51 were associated with prevalent HIV infection. Twenty-one seroconversions were recorded over 2025.8 person-years, an annual HIV incidence of 1.04% (95% CI: 0.68-1.59. The only significant risk factor for incident HIV infection was being unmarried (aRR = 3.44, 95% CI 1.43-8.28. Cohort retention after 2 years was 87%.We found a high prevalence but low incidence of HIV in this cohort. HIV vaccine efficacy trials in this population may not be feasible due to the large sample sizes that would be required. HIV vaccine preparatory efforts in this setting should include identification of higher risk populations.

  12. Analysis of Aviation Safety Reporting System Incident Data Associated With the Technical Challenges of the Vehicle Systems Safety Technology Project

    Science.gov (United States)

    Withrow, Colleen A.; Reveley, Mary S.

    2014-01-01

    This analysis was conducted to support the Vehicle Systems Safety Technology (VSST) Project of the Aviation Safety Program (AVsP) milestone VSST4.2.1.01, "Identification of VSST-Related Trends." In particular, this is a review of incident data from the NASA Aviation Safety Reporting System (ASRS). The following three VSST-related technical challenges (TCs) were the focus of the incidents searched in the ASRS database: (1) Vechicle health assurance, (2) Effective crew-system interactions and decisions in all conditions; and (3) Aircraft loss of control prevention, mitigation, and recovery.

  13. Charcot-Marie-Tooth disease in Denmark: a nationwide register-based study of mortality, prevalence and incidence

    Science.gov (United States)

    Vaeth, Signe; Vaeth, Michael; Andersen, Henning; Christensen, Rikke; Jensen, Uffe Birk

    2017-01-01

    Objectives Charcot-Marie-Tooth disease (CMT) is the most common inherited disorder of the peripheral nervous system, yet no studies have compared the mortality in patients with CMT with that of the general population, and prevalence estimates vary considerably. We performed a nationwide register-based study to investigate the prevalence, incidence and mortality of CMT in Denmark. Design We used the Danish National Patient Registry to select all records with primary diagnostic codes for CMT between 1977 and 2012 given at a neurological, neurophysiological, paediatric or clinical genetic clinic. The prevalence was estimated by 31 December 2012, and the incidence rate was calculated based on data from 1988 to 2012. We calculated a standardised mortality ratio (SMR) and an absolute excess mortality rate (AER) stratified according to age categories and disease duration. Results A total of 1534 patients (652 women) were identified. The prevalence proportion was 22.5 per 100 000 (95% CI 21.2 to 23.7) and the incidence rate was 0.98 (95% CI 0.93 to 1.04) per 100 000 person-years. The SMR was 1.36 (95% CI 1.21 to 1.53), and the AER was 4.87 per 1000 person-years (95% CI 2.77 to 6.96). We found a significantly higher SMR in cases below 50 years of age, and in cases with disease duration of more than 10 years. Conclusions We found a reduced life expectancy among patients diagnosed with CMT. To our knowledge, this is the first study of CMT to use nationwide register-based data, and the first to report an SMR and an AER. PMID:29101144

  14. Swedish snuff and incidence of cardiovascular disease. A population-based cohort study

    Directory of Open Access Journals (Sweden)

    Hedblad Bo

    2009-05-01

    Full Text Available Abstract Background The relationship between smoking and an increased incidence of cardiovascular diseases is well known. Whether smokeless tobacco (snuff is related to myocardial infarction (MI or stroke is still controversial. Aim of this study was to explore whether snuff users have an increased incidence of MI or stroke. Methods A total of 16 754 women and 10 473 men (aged 45–73 years, without history of cardiovascular disease (CVD, belonging to the population-based "Malmö Diet and Cancer" study were examined. Incidence of MI and stroke were monitored over 10.3 years. Results Snuff was used by 737 (7.0% men and 75 (0.4% women, respectively. Among men, snuff was significantly associated with low occupation level, single civil status, high BMI and with current and former smoking. In women, snuff was associated with lower systolic blood pressure. A total of 964 individuals (3.5%, i.e.544 men (5.3% and 420 (2.5% women suffered a MI during the follow-up period. The corresponding numbers of incident stroke cases were 1048, i.e. 553 men (5.3% and 495 (3.0% women, respectively. Snuff was not associated with any statistically significant increased risk of MI or stroke in men or women. The relative risks (RR in male snuff users compared to non-users were 1.05 (95% confidence interval (CI: 0.8–1.4, p = 0.740 for incident MI and 0.97 (0.7–1.4, p = 0.878 for stroke, after taking age and potential confounders into account. In women none of the 420 (2.5% women who were snuff users had a MI and only one suffered a stroke during the follow-up. Conclusion Several life-style risk factors were more prevalent in snuff-users than in non-users. However, the present study does not support any relationship between snuff and incidence of cardiovascular disease in men.

  15. Social determinants of health predict state incidence of HIV and AIDS: a short report.

    Science.gov (United States)

    Zeglin, Robert J; Stein, J Paul

    2015-01-01

    There are approximately 1.2 million people living with HIV/AIDS (PLWHA) in the USA. Each year, there are roughly 50,000 new HIV diagnoses. The World Health Organization Commission on Social Determinants of Health (CSDH) identified several social determinants of health and health inequity (SDH) including childcare, education, employment, gender equality, health insurance, housing, and income. The CSDH also noted the significant impact the SDH can have on advocacy for social change, social interventions to reduce HIV prevalence, and health monitoring. The current analysis evaluated the predictive ability of five SDH for HIV and AIDS incidence on the state level. The SDH used in the analysis were education, employment, housing, income, and insurance; other SDH were not included because reliable and appropriate state-level data were not available. The results of multiple regression analyses indicate that the use of these five SDH create statistically significant models predicting HIV incidence (adjusted R(2) = .54) and AIDS incidence (adjusted R(2) = .37) and account for a sizable portion of the variance for each. Stepwise variable selection reduced the necessary SDH to two: (1) education and (2) housing. These models are also statistically significant and account for a notable portion of variance in HIV incidence (adjusted R(2) = .55) and AIDS incidence (adjusted R(2) = .40). These outcomes demonstrate that state-level SDH, particularly education and housing, offer significant explanatory power regarding HIV and AIDS incidence rates. Congruent with the recommendations of the CSDH, the results of the current analysis suggest that state-sponsored policy and social interventions should consider and target SDH, especially education and housing, in attempts to reduce HIV and AIDS incidence rates.

  16. Serum Uric Acid Levels and Risk of Incident Hypertriglyceridemia: A Longitudinal Population-based Epidemiological Study.

    Science.gov (United States)

    Zheng, Rongjiong; Ren, Ping; Chen, Qingmei; Yang, Tianmeng; Chen, Changxi; Mao, Yushan

    2017-09-01

    Hypertriglyceridemia is one of lipid metabolism abnormalities; however, it is still debatable whether serum uric acid is a cause or a consequence of hypertriglyceridemia. We performed the study to investigate the longitudinal association between serum uric acid levels and hypertriglyceridemia. The study included 4190 subjects without hypertriglyceridemia. The subjects had annual health examinations for 8 years to assess incident hyperglyceridemia, and the subjects were divided into groups based on the serum uric acid quartile. Cox regression models were used to analyze the risk factors of development hypertriglyceridemia. During follow-up, 1461 (34.9%) subjects developed hypertriglyceridemia over 8 years of follow-up. The cumulative incidence of hypertriglyceridemia was 28.2%, 29.1%, 36.9%, and 45.6% in quartile 1,2,3 and 4, respectively ( P for trend uric acid levels were independently and positively associated with the risk of incident hypertriglyceridemia. Hypertriglyceridemia has become a serious public health problem. This longitudinal study demonstrates that high serum uric acid levels increase the risk of hypertriglyceridemia. © 2017 by the Association of Clinical Scientists, Inc.

  17. Temporal Trends in the Incidence and Natural History of Diverticulitis: A Population-Based Study

    Science.gov (United States)

    Bharucha, Adil E.; Parthasarathy, Gopanandan; Ditah, Ivo; Fletcher, J. G.; Ewelukwa, Ofor; Pendlimari, Rajesh; Yawn, Barbara P.; Melton, L. Joseph; Schleck, Cathy; Zinsmeister, Alan R.

    2015-01-01

    Background & Aims Data on the incidence and natural history of diverticulitis are largely hospital-based and exclude the majority of diverticulitis patients, who are treated in an outpatient setting for uncomplicated diverticulitis. We assessed temporal trends in the epidemiology of diverticulitis in the general population. Methods Through the Rochester Epidemiology Project we reviewed the records of all individuals with a diagnosis of diverticulitis from 1980–2007 in Olmsted County, Minnesota. Results In 1980–1989 the incidence of diverticulitis was 115/100,000 person-years, which increased to 188/100,000 in 2000–2007 (Pdiverticulitis episodes, 22% and 55% had a recurrence, respectively. This recurrence rate was greater in younger people (hazard ratio [HR] per decade 0.63; 95% confidence interval [CI], 0.59–0.66) and women (HR 0.68; 95% CI, 0.58–0.80). Complications were seen in 12%; this rate did not change over time. Recurrent diverticulitis was associated with a decreased risk of complications (Pdiverticulitis was lower in older people (Pdiverticulitis did not change from 1980–2007. Conclusions The incidence of diverticulitis has increased by 50% in 2000–2007 compared to 1990–1999, and more so in younger people. Complications are relatively uncommon. Recurrent diverticulitis is frequent but typically uncomplicated. Younger people with diverticulitis had less severe disease, more recurrence, and better survival. PMID:26416187

  18. Preemptive antibiotic treatment based on gram staining reduced the incidence of ARDS in mechanically ventilated patients.

    Science.gov (United States)

    Matsushima, Asako; Tasaki, Osamu; Shimizu, Kentaro; Tomono, Kazunori; Ogura, Hiroshi; Shimazu, Takeshi; Sugimoto, Hisashi

    2008-08-01

    Ventilator-associated pneumonia (VAP) is one of the major complications in the intensive care unit. VAP sometimes results in acute respiratory distress syndrome (ARDS), and the associated mortality is high. We hypothesized that preemptive antibiotic therapy based on results of bedside gram staining would reduce the incidence of VAP. Patients who were endotracheally intubated in our intensive care unit for more than 72 hours were included. Patients younger than 16 years of age or patients died because of brain death were excluded. The study was divided into two periods. During the first period, we used antibiotics according to the American Thoracic Society guidelines. During the second period, antibiotics were given according to the results of bedside gram staining even before radiographic infiltrate appeared. One hundred twenty-eight patients and 133 patients were included in the first and second periods, respectively. The incidence of VAP was significantly decreased in the second period (first period, 22%; second period, 9%, p gram staining significantly reduced the incidences of VAP and ARDS without an increase in the use of antibiotics.

  19. Temporal Trends in the Incidence and Natural History of Diverticulitis: A Population-Based Study.

    Science.gov (United States)

    Bharucha, Adil E; Parthasarathy, Gopanandan; Ditah, Ivo; Fletcher, J G; Ewelukwa, Ofor; Pendlimari, Rajesh; Yawn, Barbara P; Melton, L Joseph; Schleck, Cathy; Zinsmeister, Alan R

    2015-11-01

    Data on the incidence and natural history of diverticulitis are largely hospital-based and exclude the majority of diverticulitis patients, who are treated in an outpatient setting for uncomplicated diverticulitis. We assessed temporal trends in the epidemiology of diverticulitis in the general population. Through the Rochester Epidemiology Project we reviewed the records of all individuals with a diagnosis of diverticulitis from 1980 to 2007 in Olmsted County, Minnesota, USA. In 1980-1989, the incidence of diverticulitis was 115/100,000 person-years, which increased to 188/100,000 in 2000-2007 (Pdiverticulitis episodes, 22% and 55% had a recurrence, respectively. This recurrence rate was greater in younger people (hazard ratio (HR) per decade 0.63; 95% confidence interval (CI), 0.59-0.66) and women (HR 0.68; 95% CI, 0.58-0.80). Complications were seen in 12%; this rate did not change over time. Recurrent diverticulitis was associated with a decreased risk of complications (Pdiverticulitis was lower in older people (Pdiverticulitis did not change from 1980 to 2007. The incidence of diverticulitis has increased by 50% in 2000-2007 compared with 1990-1999, and more so in younger people. Complications are relatively uncommon. Recurrent diverticulitis is frequent but typically uncomplicated. Younger people with diverticulitis have less severe disease, more recurrence, and better survival.

  20. GRAPH-BASED POST INCIDENT INTERNAL AUDIT METHOD OF COMPUTER EQUIPMENT

    Directory of Open Access Journals (Sweden)

    I. S. Pantiukhin

    2016-05-01

    Full Text Available Graph-based post incident internal audit method of computer equipment is proposed. The essence of the proposed solution consists in the establishing of relationships among hard disk damps (image, RAM and network. This method is intended for description of information security incident properties during the internal post incident audit of computer equipment. Hard disk damps receiving and formation process takes place at the first step. It is followed by separation of these damps into the set of components. The set of components includes a large set of attributes that forms the basis for the formation of the graph. Separated data is recorded into the non-relational database management system (NoSQL that is adapted for graph storage, fast access and processing. Damps linking application method is applied at the final step. The presented method gives the possibility to human expert in information security or computer forensics for more precise, informative internal audit of computer equipment. The proposed method allows reducing the time spent on internal audit of computer equipment, increasing accuracy and informativeness of such audit. The method has a development potential and can be applied along with the other components in the tasks of users’ identification and computer forensics.

  1. Increasing prevalence and high incidence of celiac disease in elderly people: a population-based study.

    Science.gov (United States)

    Vilppula, Anitta; Kaukinen, Katri; Luostarinen, Liisa; Krekelä, Ilkka; Patrikainen, Heikki; Valve, Raisa; Mäki, Markku; Collin, Pekka

    2009-06-29

    Celiac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease (CDb) and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s). The study based on prevalence figures in 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed with small bowel biopsy. Within three years the prevalence of CDb increased from 2.13 to 2.34%, and that of CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and three were asymptomatic. The incidence of celiac disease in 2002-2005 was 0.23%, giving an annual incidence of 0.08% in this population. The prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the disorder is therefore warranted.

  2. Increasing prevalence and high incidence of celiac disease in elderly people: A population-based study

    Directory of Open Access Journals (Sweden)

    Vilppula Anitta

    2009-06-01

    Full Text Available Abstract Background Celiac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease (CDb and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s. Methods The study based on prevalence figures in 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed with small bowel biopsy. Results Within three years the prevalence of CDb increased from 2.13 to 2.34%, and that of CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and three were asymptomatic. The incidence of celiac disease in 2002–2005 was 0.23%, giving an annual incidence of 0.08% in this population. Conclusion The prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the disorder is therefore warranted.

  3. The Contemporary Incidence and Sequelae of Rhabdomyolysis Following Extirpative Renal Surgery: A Population Based Analysis.

    Science.gov (United States)

    Gelpi-Hammerschmidt, Francisco; Tinay, Ilker; Allard, Christopher B; Su, Li-Ming; Preston, Mark A; Trinh, Quoc-Dien; Kibel, Adam S; Wang, Ye; Chung, Benjamin I; Chang, Steven L

    2016-02-01

    We evaluate the contemporary incidence and consequences of postoperative rhabdomyolysis after extirpative renal surgery. We conducted a population based, retrospective cohort study of patients who underwent extirpative renal surgery with a diagnosis of a renal mass or renal cell carcinoma in the United States between 2004 and 2013. Regression analysis was performed to evaluate 90-day mortality (Clavien grade V), nonfatal major complications (Clavien grade III-IV), hospital readmission rates, direct costs and length of stay. The final weighted cohort included 310,880 open, 174,283 laparoscopic and 69,880 robotic extirpative renal surgery cases during the 10-year study period, with 745 (0.001%) experiencing postoperative rhabdomyolysis. The presence of postoperative rhabdomyolysis led to a significantly higher incidence of 90-day nonfatal major complications (34.7% vs 7.3%, p rhabdomyolysis (incidence risk ratio 1.83, 95% CI 1.56-2.15, p rhabdomyolysis (vs laparoscopic approach, OR 2.43, p rhabdomyolysis (p rhabdomyolysis developing. Our study confirms that postoperative rhabdomyolysis is an uncommon complication among patients undergoing extirpative renal surgery, but has a potentially detrimental impact on surgical morbidity, mortality and costs. Male gender, comorbidities, obesity, prolonged surgery (more than 5 hours) and a robotic approach appear to place patients at higher risk for postoperative rhabdomyolysis. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  4. Application of an aviation model of incident reporting and investigation to the neurosurgical scenario: method and preliminary data.

    Science.gov (United States)

    Ferroli, Paolo; Caldiroli, Dario; Acerbi, Francesco; Scholtze, Maurizio; Piro, Alfonso; Schiariti, Marco; Orena, Eleonora F; Castiglione, Melina; Broggi, Morgan; Perin, Alessandro; DiMeco, Francesco

    2012-11-01

    Incident reporting systems are universally recognized as important tools for quality improvement in all complex adaptive systems, including the operating room. Nevertheless, introducing a safety culture among neurosurgeons is a slow process, and few studies are available in the literature regarding the implementation of an incident reporting system within a neurosurgical department. The authors describe the institution of an aviation model of incident reporting and investigation in neurosurgery, focusing on the method they have used and presenting some preliminary results. In 2010, the Inpatient Safety On-Board project was developed through cooperation between a team of human factor and safety specialists with aviation backgrounds (DgSky team) and the general manager of the Fondazione Istituto Neurologico Carlo Besta. In 2011, after specific training in safety culture, the authors implemented an aviation-derived prototype of incident reporting within the Department of Neurosurgery. They then developed an experimental protocol to track, analyze, and categorize any near misses that happened in the operating room. This project officially started in January 2012, when a dedicated team of assessors was established. All members of the neurosurgical department were asked to report near misses on a voluntary, confidential, and protected form (Patient Incident Reporting System form, Besta Safety Management Programme). Reports were entered into an online database and analyzed by a dedicated team of assessors with the help of a facilitator, and an aviation-derived root cause analysis was performed. Since January 2012, 14 near misses were analyzed and classified. The near-miss contributing factors were mainly related to human factors (9 of 14 cases), technology (1 of 14 cases), organizational factors (3 of 14 cases), or procedural factors (1 of 14 cases). Implementing an incident reporting system is quite demanding; the process should involve all of the people who work within

  5. Automated classification of free-text pathology reports for registration of incident cases of cancer.

    Science.gov (United States)

    Jouhet, V; Defossez, G; Burgun, A; le Beux, P; Levillain, P; Ingrand, P; Claveau, V

    2012-01-01

    Our study aimed to construct and evaluate functions called "classifiers", produced by supervised machine learning techniques, in order to categorize automatically pathology reports using solely their content. Patients from the Poitou-Charentes Cancer Registry having at least one pathology report and a single non-metastatic invasive neoplasm were included. A descriptor weighting function accounting for the distribution of terms among targeted classes was developed and compared to classic methods based on inverse document frequencies. The classification was performed with support vector machine (SVM) and Naive Bayes classifiers. Two levels of granularity were tested for both the topographical and the morphological axes of the ICD-O3 code. The ability to correctly attribute a precise ICD-O3 code and the ability to attribute the broad category defined by the International Agency for Research on Cancer (IARC) for the multiple primary cancer registration rules were evaluated using F1-measures. 5121 pathology reports produced by 35 pathologists were selected. The best performance was achieved by our class-weighted descriptor, associated with a SVM classifier. Using this method, the pathology reports were properly classified in the IARC categories with F1-measures of 0.967 for both topography and morphology. The ICD-O3 code attribution had lower performance with a 0.715 F1-measure for topography and 0.854 for morphology. These results suggest that free-text pathology reports could be useful as a data source for automated systems in order to identify and notify new cases of cancer. Future work is needed to evaluate the improvement in performance obtained from the use of natural language processing, including the case of multiple tumor description and possible incorporation of other medical documents such as surgical reports.

  6. Trend analysis of cancer incidence in Japan using data from selected population-based cancer registries.

    Science.gov (United States)

    Katanoda, Kota; Ajiki, Wakiko; Matsuda, Tomohiro; Nishino, Yoshikazu; Shibata, Akiko; Fujita, Manabu; Tsukuma, Hideaki; Ioka, Akiko; Soda, Midori; Sobue, Tomotaka

    2012-02-01

    Population-based cancer registries are operated by over 80% of prefectures in Japan. However, only a limited proportion of the registries can provide long-term incidence data. Here, we aimed to establish a method for monitoring cancer incidence trends in Japan using data from selected prefectures. Based on the availability of long-term (≥ 20 years) high-quality data, we collected incidence data from five prefectures (Miyagi, Yamagata, Fukui, Osaka, and Nagasaki), which included an annual average of 54,539 primary cancer cases diagnosed between 1985 and 2004. Cancer mortality data for 1995-2004 were obtained from the vital statistics. Representativeness and homogeneity of the trends were examined by funnel plot analysis of log-linear regression coefficients calculated for the most recent 10 years of data (1995-2004) of age-standardized rates (ASR). The ASR of incidence for five prefectures in total (5-pref total) showed a significant decrease, with an annual percent change (APC) of -1.0 (95% confidence interval [CI] -1.4: -0.6) for males and -0.4 (95% CI -0.8: -0.1) for females. Excluding data from Osaka (4-pref total) reversed the decreasing trend; the corresponding APC was +0.4 (95% CI -0.2: +1.0) for males and +0.7 (95% CI +0.5: +0.9) for females. The APCs for the ASR of mortality for the 4-pref total (males, -1.5; females, -1.3) were more representative of nationwide data (males, -1.4 [95% CI -1.7: -1.2]; females, -1.1 [95% CI -1.4: -0.9]) than those for the 5-pref total (males, -1.7; females, -1.4). We conclude that using data from Miyagi, Yamagata, Fukui, and Nagasaki prefectures, with continuous monitoring of the representativeness of the data, is a provisionally relevant way to evaluate cancer incidence trends in Japan. © 2011 Japanese Cancer Association.

  7. An information value based analysis of physical and climatic factors affecting dengue fever and dengue haemorrhagic fever incidence

    Directory of Open Access Journals (Sweden)

    Tripathi Nitin

    2005-06-01

    Full Text Available Abstract Background Vector-borne diseases are the most dreaded worldwide health problems. Although many campaigns against it have been conducted, Dengue Fever (DF and Dengue Haemorrhagic Fever (DHF are still the major health problems of Thailand. The reported number of dengue incidences in 1998 for the Thailand was 129,954, of which Sukhothai province alone reported alarming number of 682. It was the second largest epidemic outbreak of dengue after 1987. Government arranges the remedial facilities as and when dengue is reported. But, the best way to control is to prevent it from happening. This will be possible only when knowledge about the relationship of DF/DHF with climatic and physio-environmental agents is discovered. This paper explores empirical relationship of climatic factors rainfall, temperature and humidity with the DF/DHF incidences using multivariate regression analysis. Also, a GIS based methodology is proposed in this paper to explore the influence of physio-environmental factors on dengue incidences. Remotely sensed data provided important data about physical environment and have been used for many vector borne diseases. Information Values (IV method was utilised to derive influence of various factors in the quantitative terms. Researchers have not applied this type of analysis for dengue earlier. Sukhothai province was selected for the case study as it had high number of dengue cases in 1998 and also due to its diverse physical setting with variety of land use/land cover types. Results Preliminary results demonstrated that physical factors derived from remotely sensed data could indicate variation in physical risk factors affecting DF/DHF. A composite analysis of these three factors with dengue incidences was carried out using multivariate regression analysis. Three empirical models ER-1, ER-2 and ER-3 were evaluated. It was found that these three factors have significant relation with DF/DHF incidences and can be related to

  8. Factors affecting incidence of dry socket: a prospective community-based study.

    Science.gov (United States)

    Parthasarathi, Krishnan; Smith, Andrew; Chandu, Arun

    2011-07-01

    Dry socket, or alveolar osteitis, can occur because of the removal of teeth. No clear etiology has been acknowledged; however, numerous risk factors have been proposed and tested. We report on the results of a prospective, multicenter study of the incidence and factors affecting the occurrence of alveolar osteitis at the Royal Dental Hospital of Melbourne and Community Dental Clinics in Melbourne, Australia. Ethics approval was gained from the University of Melbourne and Dental Health Services Victoria. The data were analyzed in a descriptive fashion, and the factors affecting alveolar osteitis were assessed using logistic regression analysis. The incidence of alveolar osteitis was 2.3% of all teeth extracted, with 4.2% of all patients experiencing alveolar osteitis in a public dental setting. Multivariate analysis revealed operator experience, perioperative crown and root fractures, periodontal disease, posterior teeth, and, interestingly, the use of mental health medications to be significant independent risk factors for the development of alveolar osteitis. No alveolar osteitis was reported in patients taking antibiotics, the oral contraceptive pill, bisphosphonates, or oral steroid drugs. Smoking and extraction technique (either operative or nonoperative) were also not found to significantly affect the development of alveolar osteitis. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Global stability and attractivity of a network-based SIS epidemic model with nonmonotone incidence rate

    Science.gov (United States)

    Wei, Xiaodan; Liu, Lijun; Zhou, Wenshu

    2017-03-01

    In this paper, we study the global stability and attractivity of the endemic equilibrium for a network-based SIS epidemic model with nonmonotone incidence rate. The model was introduced in Li (2015). We prove that the endemic equilibrium is globally asymptotically stable if α (a parameter of this model) is sufficiently large, and is globally attractive if the transmission rate λ satisfies λ/λc ∈(1 , 2 ] , where λc is the epidemic threshold. Some numerical experiments are also presented to illustrate the theoretical results.

  10. Safety analysis of fusion reactors pertaining to nuclear incidents and accidents. Final report

    International Nuclear Information System (INIS)

    Raeder, J.; Weller, A.; Wolf, R.; Jin, X.; Boccaccini, L.V.; Stieglitz, R.; Carloni, D.; Pistner, C.; Herb, J.

    2013-11-01

    The BfS gave the projekt partners IPP, KIT, Oeko-Institut e. V., and GRS the order to carry out a literature study on the topic of safety of fusion power plants regarding nuclear incidents and accidents. In the framework of this study the actual status of science and technology of the safety concept of fusion power plants should be determined and the applicability of the nuclear safety regulations hitherto developed for nuclear power plants checked. For future commercial fusion power plants today only conceptional designs exist. The most advanced conceptual study for a future fusion power plant is the European Power Plant Conceptual Study (PPCS) from the year 2005, which is based on the tokamak principle. In this study also fundamental aspects of the safety concept of nuclear fusion are treated. Hereby several different conceptual approaches are discussed, which differ among others also in the lay-out approaches relevant for the safety of a facility like for instance the choice of the breeding concept or the materials for the blanket/divertor structure and the coolants. The safety concept of nuclear fusion is oriented on safety concepts for facilities with radioactive inventory. It is based on the concept of tiered safety levels. In order to check whether for the nuclear fusion a safety concept comparable with the nuclear fission at all is necessary, in a first step it was considered, which consequences are possible at a postulated release o large parts of the radioactive inventory of a fusion power plant. Such a worst-case scenario was compared with a corresponding, postulated release of large parts of the radioactive inventory of a nuclear power plant. As scale hereby served the radiological criterion, at the transgression of which in the environment of the facility an evacuation would be necessary. In a next step the transferability of the safety concept of the tiered safety levels of nuclear technology to the fusion was checked. Beside events transferable from

  11. EP&R Standards Project Report: Technical Review of National Incident Management Standards

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.

    2007-04-24

    The importance and necessity for a fully developed and implemented National Incident Management System (NIMS) has been demonstrated in recent years by the impact of national events such as Hurricane Katrina in 2005. Throughout the history of emergency response to major disasters, especially when multiple response organizations are involved, there have been systemic problems in the consistency and uniformity of response operations. Identifying national standards that support the development and implementation of NIMS is key to helping solve these systemic problems. The NIMS seeks to provide uniformity and consistency for incident management by using common terminology and protocols that will enable responders to coordinate their efforts to ensure an efficient response.

  12. Masking in reports of "most serious" events: bias in estimators of sports injury incidence in Canadian children

    Directory of Open Access Journals (Sweden)

    A. Gupta

    2016-08-01

    Full Text Available Introduction: Surveys that collect information on injuries often focus on the single "most serious" event to help limit recall error and reduce survey length. However, this can mask less serious injuries and result in biased incidence estimates for specific injury subcategories. Methods: Data from the 2002 Health Behaviour in School-aged Children (HBSC survey and from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP were used to compare estimates of sports injury incidence in Canadian children. Results: HBSC data indicate that 6.7% of children report sustaining a sports injury that required an emergency department (ED visit. However, details were only collected on a child's "most serious" injury, so children who had multiple injuries requiring an ED visit may have had sports injuries that went unreported. The rate of 6.7% can be seen to be an underestimate by as much as 4.3%. Corresponding CHIRPP surveillance data indicate an incidence of 9.9%. Potential masking bias is also highlighted in our analysis of injuries attended by other health care providers. Conclusion: The "one most serious injury" line of questioning induces potentially substantial masking bias in the estimation of sports injury incidence, which limits researchers' ability to quantify the burden of sports injury. Longer survey recall periods naturally lead to greater masking. The design of future surveys should take these issues into account. In order to accurately inform policy decisions and the direction of future research, researchers must be aware of these limitations.

  13. Association of hormone therapy and incident gout: population-based case-control study.

    Science.gov (United States)

    Bruderer, Saskia G; Bodmer, Michael; Jick, Susan S; Meier, Christoph R

    2015-12-01

    This study aims to assess the odds of developing incident gout in association with the use of postmenopausal estrogen-progestogen therapy, according to type, timing, duration, and route of administration of estrogen-progestogen therapy. We conducted a retrospective population-based case-control analysis using the United Kingdom-based Clinical Practice Research Datalink. We identified women (aged 45 y or older) who had a first-time diagnosis of gout recorded between 1990 and 2010. We matched one female control with each case on age, general practice, calendar time, and years of active history in the database. We used multivariate conditional logistic regression to calculate odds ratios (ORs) with 95% CIs (adjusted for confounders). The adjusted OR for gout with current use of oral formulations of opposed estrogens (estrogen-progestogen) was 0.69 (95% CI, 0.56-0.86) compared with never use. Current use was associated with a decreased OR for gout in women without renal failure (adjusted OR, 0.71; 95% CI, 0.57-0.87) and hypertension (adjusted OR, 0.62; 95% CI, 0.44-0.87) compared with never use. Tibolone was associated with a decreased OR for gout (adjusted OR, 0.77; 95% CI, 0.63-0.95) compared with never use. Estrogens alone did not alter the OR for gout. Current use of oral opposed estrogens, but not unopposed estrogens, is associated with a decreased OR for incident gout in women without renal failure and is more pronounced in women with hypertension. Use of tibolone is associated with a decreased OR for incident gout. The decreased OR for gout may be related to the progestogen component rather than the estrogen component.

  14. A non-invasive risk score for predicting incident diabetes among rural Chinese people: A village-based cohort study.

    Directory of Open Access Journals (Sweden)

    Jiangping Wen

    Full Text Available To develop a new non-invasive risk score for predicting incident diabetes in a rural Chinese population.Data from the Handan Eye Study conducted from 2006-2013 were utilized as part of this analysis. The present study utilized data generated from 4132 participants who were ≥30 years of age. A non-invasive risk model was derived using two-thirds of the sample cohort (selected randomly using stepwise logistic regression. The model was subsequently validated using data from individuals from the final third of the sample cohort. In addition, a simple point system for incident diabetes was generated according to the procedures described in the Framingham Study. Incident diabetes was defined as follows: (1 fasting plasma glucose (FPG ≥ 7.0 mmol/L; or (2 hemoglobin A1c (HbA1c ≥ 6.5%; or (3 self-reported diagnosis of diabetes or use of anti-diabetic medications during the follow-up period.The simple non-invasive risk score included age (8 points, Body mass index (BMI (3 points, waist circumference (WC (7 points, and family history of diabetes (9 points. The score ranged from 0 to 27 and the area under the receiver operating curve (AUC of the score was 0.686 in the validation sample. At the optimal cutoff value (which was 9, the sensitivity and specificity were 74.32% and 58.82%, respectively.Using information based upon age, BMI, WC, and family history of diabetes, we developed a simple new non-invasive risk score for predicting diabetes onset in a rural Chinese population, using information from individuals aged 30 years of age and older. The new risk score proved to be more optimal in the prediction of incident diabetes than most of the existing risk scores developed in Western and Asian countries. This score system will aid in the identification of individuals who are at risk of developing incident diabetes in rural China.

  15. Effect of a Culture-Based Screening Algorithm on Tuberculosis Incidence in Immigrants and Refugees Bound for the United States

    Science.gov (United States)

    Liu, Yecai; Posey, Drew L.; Cetron, Martin S.; Painter, John A.

    2015-01-01

    Background Before 2007, U.S.-bound immigrants and refugees were screened for tuberculosis (TB) by a smear-based algorithm that could not diagnose smear-negative and culture-positive TB. In 2007, the Centers for Disease Control and Prevention began to implement a culture-based algorithm. Objective To evaluate the effect of the culture-based algorithm on preventing the importation of TB to the United States by immigrants and refugees from foreign countries. Design Population-based, cross-sectional study. Setting Panel physician sites for overseas medical examination. Patients Immigrants and refugees with TB. Measurements Comparison of the increase of smear-negative and culture-positive TB cases diagnosed overseas among immigrants and refugees by the culture-based algorithm with the decline of reported TB cases among foreign-born persons within 1 year after arrival in the United States from 2007 to 2012. Results Of the 3 212 421 arrivals of immigrants and refugees from 2007 to 2012, 1 650 961 (51.4%) were screened by the smear-based algorithm and 1 561 460 (48.6%) were screened by the culture-based algorithm. Among the 4032 TB cases diagnosed by the culture-based algorithm, 2195 (54.4%) were smear-negative and culture-positive. Before implementation (2002 to 2006), the annual number of reported TB cases among foreign-born persons within 1 year after arrival was relatively constant (range, 1424 to 1626 cases; mean, 1504 cases) but decreased from 1511 to 940 cases during implementation (2007 to 2012). During the same period, the annual number of smear-negative and culture-positive TB cases diagnosed overseas among U.S.-bound immigrants and refugees by the culture-based algorithm increased from 4 in 2007 to 629 in 2012. Limitation This analysis did not control for the decline in new arrivals of nonimmigrant visitors to the United States and the decrease of incidence of TB in their countries of origin. Conclusion Implementation of the culture-based algorithm in U

  16. Learning from incident reports in the Australian medical imaging setting: handover and communication errors.

    Science.gov (United States)

    Hannaford, N; Mandel, C; Crock, C; Buckley, K; Magrabi, F; Ong, M; Allen, S; Schultz, T

    2013-02-01

    To determine the type and nature of incidents occurring within medical imaging settings in Australia and identify strategies that could be engaged to reduce the risk of their re-occurrence. 71 search terms, related to clinical handover and communication, were applied to 3976 incidents in the Radiology Events Register. Detailed classification and thematic analysis of a subset of incidents that involved handover or communication (n=298) were undertaken to identify the most prevalent types of error and to make recommendations about patient safety initiatives in medical imaging. Incidents occurred most frequently during patient preparation (34%), when requesting imaging (27%) and when communicating a diagnosis (23%). Frequent problems within each of these stages of the imaging cycle included: inadequate handover of patients (41%) or unsafe or inappropriate transfer of the patient to or from medical imaging (35%); incorrect information on the request form (52%); and delayed communication of a diagnosis (36%) or communication of a wrong diagnosis (36%). The handover of patients and clinical information to and from medical imaging is fraught with error, often compromising patient safety and resulting in communication of delayed or wrong diagnoses, unnecessary radiation exposure and a waste of limited resources. Corrective strategies to address safety concerns related to new information technologies, patient transfer and inadequate test result notification policies are relevant to all healthcare settings. Handover and communication errors are prevalent in medical imaging. System-wide changes that facilitate effective communication are required.

  17. Learning from incident reports in the Australian medical imaging setting: handover and communication errors

    Science.gov (United States)

    Mandel, C; Crock, C; Buckley, K; Magrabi, F; Ong, M; Allen, S; Schultz, T

    2013-01-01

    Objective: To determine the type and nature of incidents occurring within medical imaging settings in Australia and identify strategies that could be engaged to reduce the risk of their re-occurrence. Methods: 71 search terms, related to clinical handover and communication, were applied to 3976 incidents in the Radiology Events Register. Detailed classification and thematic analysis of a subset of incidents that involved handover or communication (n=298) were undertaken to identify the most prevalent types of error and to make recommendations about patient safety initiatives in medical imaging. Results: Incidents occurred most frequently during patient preparation (34%), when requesting imaging (27%) and when communicating a diagnosis (23%). Frequent problems within each of these stages of the imaging cycle included: inadequate handover of patients (41%) or unsafe or inappropriate transfer of the patient to or from medical imaging (35%); incorrect information on the request form (52%); and delayed communication of a diagnosis (36%) or communication of a wrong diagnosis (36%). Conclusion: The handover of patients and clinical information to and from medical imaging is fraught with error, often compromising patient safety and resulting in communication of delayed or wrong diagnoses, unnecessary radiation exposure and a waste of limited resources. Corrective strategies to address safety concerns related to new information technologies, patient transfer and inadequate test result notification policies are relevant to all healthcare settings. Advances in knowledge: Handover and communication errors are prevalent in medical imaging. System-wide changes that facilitate effective communication are required. PMID:23385994

  18. Development in incidence of breast cancer in non-screened Danish women, 1973-2002--a population-based study

    DEFF Research Database (Denmark)

    Fuglede, Niels; Langballe, Oline; Svendsen, Anne Louise

    2006-01-01

    The authors report on the incidence rates of breast cancer overall and by histology in a population of unscreened women constituting approximately 80% of the total population of women in Denmark from 1973-2002, utilizing the files of the nationwide Danish Cancer Registry. The age-specific incidence...... that these changes were not attributable to a birth cohort effect. Although lobular breast cancer incidence increased more than ductal breast cancer incidence, this was only observed in the first decade after the introduction of the ICD-O system in Denmark and probably is attributable to this, whereas we observed...... rates of breast cancer increased throughout the period, and further, marked changes in the age-specific incidence pattern were observed, where the plateau and change of slope around the age of 46-48 in 1973-1981 shifted to around age 64-66 years in 1994-2002. Age-period-cohort modeling indicated...

  19. Diagnostic performance of line-immunoassay based algorithms for incident HIV-1 infection

    Directory of Open Access Journals (Sweden)

    Schüpbach Jörg

    2012-04-01

    Full Text Available Abstract Background Serologic testing algorithms for recent HIV seroconversion (STARHS provide important information for HIV surveillance. We have previously demonstrated that a patient's antibody reaction pattern in a confirmatory line immunoassay (INNO-LIA™ HIV I/II Score provides information on the duration of infection, which is unaffected by clinical, immunological and viral variables. In this report we have set out to determine the diagnostic performance of Inno-Lia algorithms for identifying incident infections in patients with known duration of infection and evaluated the algorithms in annual cohorts of HIV notifications. Methods Diagnostic sensitivity was determined in 527 treatment-naive patients infected for up to 12 months. Specificity was determined in 740 patients infected for longer than 12 months. Plasma was tested by Inno-Lia and classified as either incident ( Results The 10 best algorithms had a mean raw sensitivity of 59.4% and a mean specificity of 95.1%. Adjustment for overrepresentation of patients in the first quarter year of infection further reduced the sensitivity. In the preferred model, the mean adjusted sensitivity was 37.4%. Application of the 10 best algorithms to four annual cohorts of HIV-1 notifications totalling 2'595 patients yielded a mean IIR of 0.35 in 2005/6 (baseline and of 0.45, 0.42 and 0.35 in 2008, 2009 and 2010, respectively. The increase between baseline and 2008 and the ensuing decreases were highly significant. Other adjustment models yielded different absolute IIR, although the relative changes between the cohorts were identical for all models. Conclusions The method can be used for comparing IIR in annual cohorts of HIV notifications. The use of several different algorithms in combination, each with its own sensitivity and specificity to detect incident infection, is advisable as this reduces the impact of individual imperfections stemming primarily from relatively low sensitivities and

  20. The incidence of fibromyalgia and its associated comorbidities: a population-based retrospective cohort study based on International Classification of Diseases, 9th Revision codes.

    Science.gov (United States)

    Weir, Peter T; Harlan, Gregory A; Nkoy, Flo L; Jones, Spencer S; Hegmann, Kurt T; Gren, Lisa H; Lyon, Joseph L

    2006-06-01

    The epidemiology of fibromyalgia is poorly defined. The incidence of fibromyalgia has not been determined using a large population base. Previous studies based on prevalence data demonstrated that females are 7 times more likely to have fibromyalgia than males and that the peak age for females is during the childbearing years. We have calculated the incidence rate of fibromyalgia in a large, stable population and determined the strength of association between fibromyalgia and 7 comorbid conditions. We conducted a retrospective cohort study of a large, stable health insurance claims database (62,000 nationwide enrollees per year). Claims from 1997 to 2002 were examined using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes to identify fibromyalgia cases (ICD code 729.1) and 7 predetermined comorbid conditions. A total of 2595 incident cases of fibromyalgia were identified between 1997 and 2002. Age-adjusted incidence rates were 6.88 cases per 1000 person-years for males and 11.28 cases per 1000 person-years for females. Females were 1.64 times (95% confidence interval = 1.59-1.69) more likely than males to have fibromyalgia. Patients with fibromyalgia were 2.14 to 7.05 times more likely to have one or more of the following comorbid conditions: depression, anxiety, headache, irritable bowel syndrome, chronic fatigue syndrome, systemic lupus erythematosus, and rheumatoid arthritis. Females are more likely to be diagnosed with fibromyalgia than males, although to a substantially smaller degree than previously reported, and there are strong associations for comorbid conditions that are commonly thought to be associated with fibromyalgia.

  1. [Predicting Incidence of Hepatitis E in Chinausing Fuzzy Time Series Based on Fuzzy C-Means Clustering Analysis].

    Science.gov (United States)

    Luo, Yi; Zhang, Tao; Li, Xiao-song

    2016-05-01

    To explore the application of fuzzy time series model based on fuzzy c-means clustering in forecasting monthly incidence of Hepatitis E in mainland China. Apredictive model (fuzzy time series method based on fuzzy c-means clustering) was developed using Hepatitis E incidence data in mainland China between January 2004 and July 2014. The incidence datafrom August 2014 to November 2014 were used to test the fitness of the predictive model. The forecasting results were compared with those resulted from traditional fuzzy time series models. The fuzzy time series model based on fuzzy c-means clustering had 0.001 1 mean squared error (MSE) of fitting and 6.977 5 x 10⁻⁴ MSE of forecasting, compared with 0.0017 and 0.0014 from the traditional forecasting model. The results indicate that the fuzzy time series model based on fuzzy c-means clustering has a better performance in forecasting incidence of Hepatitis E.

  2. Incidence and determinants of acute diarrhoea in Malaysia: a population-based study.

    Science.gov (United States)

    Gurpreet, K; Tee, G H; Amal, N M; Paramesarvathy, R; Karuthan, C

    2011-04-01

    Acute diarrhoea is a major health problem in many parts of the world, contributing to about 1.8 million deaths globally. The objectives of the study were to assess the incidence, determinants, and severity of acute diarrhoea in the population. A nation-wide cross-sectional survey involving about 57,000 respondents was conducted via face-to-face interview among eligible respondents of all ages. An acute diarrhoeal episode was defined as having three or more episodes of loose stools in any 24-hour period within the past four weeks before the interview. The severity was measured by duration of acute diarrhoea and associated symptoms. The variables tested as determinants were age, sex, ethnicity, the highest educational level, total monthly household income, and locality. Univariate, bivariate and multivariate procedures meant for complex study design were used in the analyses. The four-week incidence of acute diarrhoea was 5% [95% confidence interval (CI) 4.8-5.2]. The incidence of acute diarrhoea among the estimated population was the highest among young adults aged 20-29 years, Other Bumiputras (the pre-dominant ethnic group in East Malaysia), those with tertiary-level of education, those earning a monthly household income of less than RM 400, and rural dwellers. Only age, ethnicity, the highest level of education attained, and locality were significantly associated with acute diarrhoea in bivariate analysis. In multivariate analysis, these four variables were found to be the determinants of acute diarrhoea. Sex and monthly household income were excluded from the model. The mean duration of acute diarrhoea was 2.0 days (standard deviation 1.3). Forty-six percent of the respondents reported stomach cramps as an associated symptom. The findings revealed that acute diarrhoea is still a major public-health concern in Malaysia and grossly under-notified. There is a need for intensification of public-health intervention efforts to reduce the incidence of acute diarrhoea

  3. Risk factors for sexual violence in the military: an analysis of sexual assault and sexual harassment incidents and reporting

    OpenAIRE

    Souder, William C., III

    2017-01-01

    Approved for public release; distribution is unlimited Using the 2014 RAND Military Workplace Study, this thesis studies the effects of demographics, prior victimization, deployment status, and workplace characteristics—specifically, command climate, leadership and training quality—on both incidence and reporting of sexual assault and sexual harassment. Sexual assault consists of a nonconsensual sexual act coupled with a use of force or threat thereof that is likely to cause physical harm ...

  4. Data Mining and the Twitter Platform for Prescribed Burn and Wildfire Incident Reporting with Geospatial Applications

    Science.gov (United States)

    Endsley, K.; McCarty, J. L.

    2012-12-01

    Data mining techniques have been applied to social media in a variety of contexts, from mapping the evolution of the Tahrir Square protests in Egypt to predicting influenza outbreaks. The Twitter platform is a particular favorite due to its robust application programming interface (API) and high throughput. Twitter, Inc. estimated in 2011 that over 2,200 messages or "tweets" are generated every second. Also helpful is Twitter's semblance in operation to the short message service (SMS), better known as "texting," available on cellular phones and the most popular means of wide telecommunications in many developing countries. In the United States, Twitter has been used by a number of federal, state and local officials as well as motivated individuals to report prescribed burns in advance (sometimes as part of a reporting obligation) or to communicate the emergence, response to, and containment of wildfires. These reports are unstructured and, like all Twitter messages, limited to 140 UTF-8 characters. Through internal research and development at the Michigan Tech Research Institute, the authors have developed a data mining routine that gathers potential tweets of interest using the Twitter API, eliminates duplicates ("retweets"), and extracts relevant information such as the approximate size and condition of the fire. Most importantly, the message is geocoded and/or contains approximate locational information, allowing for prescribed and wildland fires to be mapped. Natural language processing techniques, adapted to improve computational performance, are used to tokenize and tag these elements for each tweet. The entire routine is implemented in the Python programming language, using open-source libraries. As such, it is demonstrated in a web-based framework where prescribed burns and/or wildfires are mapped in real time, visualized through a JavaScript-based mapping client in any web browser. The practices demonstrated here generalize to an SMS platform (or any short

  5. Aplanatic telescopes based on Schwarzschild optical configuration: from grazing incidence Wolter-like x-ray optics to Cherenkov two-mirror normal incidence telescopes

    Science.gov (United States)

    Sironi, Giorgia

    2017-09-01

    At the beginning of XX century Karl Schwarzschild defined a method to design large-field aplanatic telescopes based on the use of two aspheric mirrors. The approach was then refined by Couder (1926) who, in order to correct for the astigmatic aberration, introduced a curvature of the focal plane. By the way, the realization of normal-incidence telescopes implementing the Schwarzschild aplanatic configuration has been historically limited by the lack of technological solutions to manufacture and test aspheric mirrors. On the other hand, the Schwarzschild solution was recovered for the realization of coma-free X-ray grazing incidence optics. Wolter-like grazing incidence systems are indeed free of spherical aberration, but still suffer from coma and higher order aberrations degrading the imaging capability for off-axis sources. The application of the Schwarzschild's solution to X-ray optics allowed Wolter to define an optical system that exactly obeys the Abbe sine condition, eliminating coma completely. Therefore these systems are named Wolter-Schwarzschild telescopes and have been used to implement wide-field X-ray telescopes like the ROSAT WFC and the SOHO X-ray telescope. Starting from this approach, a new class of X-ray optical system was proposed by Burrows, Burg and Giacconi assuming polynomials numerically optimized to get a flat field of view response and applied by Conconi to the wide field x-ray telescope (WFXT) design. The Schwarzschild-Couder solution has been recently re-discovered for the application to normal-incidence Cherenkov telescopes, thanks to the suggestion by Vassiliev and collaborators. The Italian Institute for Astrophysics (INAF) realized the first Cherenkov telescope based on the polynomial variation of the Schwarzschild configuration (the so-called ASTRI telescope). Its optical qualification was successfully completed in 2016, demonstrating the suitability of the Schwarzschild-like configuration for the Cherenkov astronomy requirements

  6. Incidence of incisional hernia after cesarean delivery: a register-based cohort study.

    Directory of Open Access Journals (Sweden)

    Anna J M Aabakke

    Full Text Available OBJECTIVE: To estimate the incidence of incisional hernias requiring surgical repair after cesarean delivery over a 10-year period. METHODS: This population- and register-based cohort study identified all women in Denmark with no history of previous abdominal surgery who had a cesarean delivery between 1991 and 2000. The cohort was followed from their first until 10 years after their last cesarean delivery within the inclusion period or until the first of the following events: hernia repair, death, emigration, abdominal surgery, or cesarean delivery after the inclusion period. For women who had a hernia repair, hospital records regarding the surgery and previous cesarean deliveries were tracked and manually analyzed to validate the relationship between hernia repair and cesarean delivery. Data were analyzed with a competing risk analysis that included each cesarean delivery. RESULTS: We identified 57,564 women who had had 68,271 cesarean deliveries during the inclusion period. During follow-up, 134 of these women had a hernia requiring repair. Of these 68 (51% [95% CI 42-60%] were in a midline incision although the transverse incision was the primary approach at cesarean delivery during the inclusion period. The cumulated incidence of a hernia repair within 10 years after a cesarean delivery was 0.197% (95% CI 0.164-0.234%. The risk of a hernia repair was higher during the first 3 years after a cesarean delivery, with an incidence after 3 years of 0.157% (95% CI 0.127-0.187%. CONCLUSIONS: The overall risk of an incisional hernia requiring surgical repair within 10 years after a cesarean delivery was 2 per 1000 deliveries in a population in which the transverse incision was the primary approach at cesarean delivery.

  7. Incidence of skin cancer among Nagasaki atomic bomb survivors; Preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Sadamori, Naoki; Mine, Mariko; Hori, Makoto (Nagasaki Univ. (Japan). School of Medicine) (and others)

    1990-09-01

    Among a total of 65,268 Nagasaki atomic bomb survivors recorded in the Scientific Data Center of Atomic Bomb Disaster, Nagasaki University School of Medicine, 140 cases with skin cancer were collected from 31 hospitals in Nagasaki City from 1961 through 1987. Subsequently, these cases of skin cancer in Nagasaki atomic bomb survivors were statistically analyzed in relation to the estimated distance from the hypocenter by age, sex, histology and latent period. The results were as follows: (1) A high correlation was observed between the incidence of skin cancer and the distance from the hypocenter. (2) The incidence of skin cancer in Nagasaki atomic bomb survivors now appears to be increasing in relation to exposure distance. (3) Among 140 cases, basal cell epithelioma was observed in 67 cases (47.9%) and squamous cell carcinoma in 43 cases (30.7%). (author).

  8. Changes in Incidence and Antifungal Drug Resistance in Candidemia: Results From Population-Based Laboratory Surveillance in Atlanta and Baltimore, 2008–2011

    Science.gov (United States)

    Cleveland, Angela Ahlquist; Farley, Monica M.; Harrison, Lee H.; Stein, Betsy; Hollick, Rosemary; Lockhart, Shawn R.; Magill, Shelley S.; Derado, Gordana; Park, Benjamin J.; Chiller, Tom M.

    2015-01-01

    Background Candidemia is common and associated with high morbidity and mortality; changes in population-based incidence rates have not been reported. Methods We conducted active, population-based surveillance in metropolitan Atlanta, Georgia, and Baltimore City/County, Maryland (combined population 5.2 million), during 2008–2011. We calculated candidemia incidence and antifungal drug resistance compared with prior surveillance (Atlanta, 1992–1993; Baltimore, 1998–2000). Results We identified 2675 cases of candidemia with 2329 isolates during 3 years of surveillance. Mean annual crude incidence per 100 000 person-years was 13.3 in Atlanta and 26.2 in Baltimore. Rates were highest among adults aged ≥65 years (Atlanta, 59.1; Baltimore, 72.4) and infants (aged candidemia epidemiology over the past 2 decades. Adults aged ≥65 years replaced infants as the highest incidence group; adjusted incidence has declined significantly in infants. Use of antifungal prophylaxis, improvements in infection control, or changes in catheter insertion practices may be contributing to these declines. Further surveillance for antifungal resistance and efforts to determine effective prevention strategies are needed. PMID:22893576

  9. Incidence and Natural History of Idiopathic Chronic Inflammatory Demyelinating Polyneuropathy: A Population-Based Study in Iceland.

    Science.gov (United States)

    Hafsteinsdottir, Brynhildur; Olafsson, Elias

    2016-01-01

    We report a population-based study conducted in Iceland to determine the incidence, clinical characteristics and prognosis of idiopathic chronic inflammatory demyelinating polyneuropathy (CIDP) during a 21-year period. Cases were identified from the records of all practicing neurologists in the country, the only neurology department in the country and both neurophysiology laboratories. All index cases met the 2010 European Federation of Neurological Societies/Peripheral Nerve Society criteria for CIDP. Nineteen individuals fulfilled the diagnostic criteria during the study period. The average annual incidence was 0.3/100,000 (95% CI 0.04-2.47). There were 14 men (74%) in a gender ratio of 1:2.8. The mean age at diagnosis was 57 (range 19-81 years): women, 36 years and men, 63 years; p = 0.0006. The disease course was remitting-relapsing in 21% and chronic progressive or monophasic in 79%. The average length of follow-up was 6.9 years. The standardized mortality ratio for the 21-year study period was 0.9 (95% CI 0.3-2.2). We believe we have identified all diagnosed with CIDP in Iceland during a 21-year period. Many had no or only limited disease progression over the years and mortality is not increased compared with the general population. © 2016 S. Karger AG, Basel.

  10. Who Benefits from Student Aid? The Economic Incidence of Tax-Based Federal Student Aid

    Science.gov (United States)

    Turner, Nicholas

    2012-01-01

    Federal benefit programs, including federal student aid, are designed to aid targeted populations. Behavioral responses to these programs may alter the incidence of their benefits, a possibility that receives less attention in the literature compared to tax incidence. I demonstrate the importance of benefit incidence analysis by showing that the…

  11. Thyroid cancer incidence among Asian immigrants to Ontario, Canada: A population-based cohort study.

    Science.gov (United States)

    Shah, Baiju R; Griffiths, Rebecca; Hall, Stephen F

    2017-09-01

    The highest rates of thyroid cancer are observed in Pacific Island nations as well as Australia and Asian countries bordering the Pacific. The objective of this study was to determine the risk for thyroid cancer among immigrants to Canada from Southeast and East Asia compared with immigrants from other regions and nonimmigrants. This was a population-based, longitudinal cohort study using health care administrative data to examine all residents of Ontario without pre-existing thyroid cancer. Individuals were followed from January 1997 or 5 years after they became eligible for health care coverage in Ontario, whichever came later. Patients were followed until March 2015 for incident-differentiated thyroid cancer, and then for recurrence. The study followed 14,659,733 individuals for a median of 17 years. Thyroid cancer incidence was 43.8 cases per 100,000 person-years among Southeast Asian immigrants, 28.6 cases per 100,000 person-years among East Asian immigrants, 21.5 cases per 100,000 person-years among other immigrants, and 14.5 cases per 100,000 person-years among nonimmigrants. Incidence was highest among immigrants from the Philippines (52.7 cases per 100,000 person-years), South Korea (33.5 cases per 100,000 person-years), and China (30.0 cases per 100,000 person-years). Adjusted hazard ratios for thyroid cancer compared with nonimmigrants were 2.66 (95% confidence interval, 2.48-2.84) for Southeast Asian immigrants, 1.87 (95% confidence interval, 1.75-2.00) for East Asian immigrants, and 1.51 (95% confidence interval, 1.45-1.57) for other immigrants. Immigrants were more likely to have papillary histology and stage I cancer. East Asian immigrants, but not Southeast Asian immigrants, had a lower risk of recurrence (hazard ratio, 0.73 [95% confidence interval, 0.57-0.94] and 1.01 [95% confidence interval, 0.81-1.26], respectively). Immigrants from Southeast and East Asia had markedly higher thyroid cancer incidence than nonimmigrants. At particularly elevated

  12. Seventy Years of Asthma in Italy: Age, Period and Cohort Effects on Incidence and Remission of Self-Reported Asthma from 1940 to 2010.

    Directory of Open Access Journals (Sweden)

    Giancarlo Pesce

    Full Text Available It is well known that asthma prevalence has been increasing all over the world in the last decades. However, few data are available on temporal trends of incidence and remission of asthma.To evaluate the rates of asthma incidence and remission in Italy from 1940 to 2010.The subjects were randomly sampled from the general Italian population between 1991 and 2010 in the three population-based multicentre studies: ECRHS, ISAYA, and GEIRD. Individual information on the history of asthma (age at onset, age at the last attack, use of drugs for asthma control, co-presence of hay-fever was collected on 35,495 subjects aged 20-84 and born between 1925-1989. Temporal changes in rates of asthma incidence and remission in relation to age, birth cohort and calendar period (APC were modelled using Poisson regression and APC models.The average yearly rate of asthma incidence was 2.6/1000 (3,297 new cases among 1,263,885 person-years. The incidence rates have been linearly increasing, with a percentage increase of +3.9% (95%CI: 3.1-4.5, from 1940 up to the year 1995, when the rates begun to level off. The stabilization of asthma incidence was mainly due to a decrease in the rates of atopic asthma after 1995, while non-atopic asthma has continued to increase. The overall rate of remission was 43.2/1000person-years, and it did not vary significantly across generations, but was associated with atopy, age at asthma onset and duration of the disease.After 50 years of a continuous upward trend, the rates of asthma incidence underwent a substantial stabilization in the late 90s. Despite remarkable improvements in the treatment of asthma, the rate of remission did not change significantly in the last seventy years. Some caveats are required in interpreting our results, given that our estimates are based on self-reported events that could be affected by the recall bias.

  13. Incidents in transport of radioactive materials for civil use: IRSN draws lessons from events reported between 1999 and 2007

    International Nuclear Information System (INIS)

    2008-01-01

    Some 900,000 packages of radioactive materials for civil use are transported each year in France. The great majority of these shipments involve radioactive materials used in the fields of medicine, pharmaceuticals, industry or property. Transport of radioactive materials linked to the nuclear fuel cycle actually represents only 15% of transport. A great variety of material is transported, differing in weight (from a few grams to tens of tons), form, activity and packaging. The associated risks are also different: radioactive contamination, external exposure to ionising radiation, chemical risk etc. In its role of technical support to safety and radioprotection authorities, IRSN's mission is to assess the design, manufacturing, testing and use of packaging and transport systems. The Institute is also involved in the management and analysis of events that occur during transport of radioactive materials. To assist with this, the IRSN manages a database which lists reported deviations, anomalies, incidents and accidents (known in a generic way as 'events') relating to transport. With an aim of reduction of the risks related to transport, the feedback resulting from the thorough analysis of the notified events is capitalized by IRSN, just as the feedback of the assessments of the safety analysis reports of the various package designs. Based on these feedbacks, IRSN proposes axes of improvement relating to package designs and transport operations, and regulatory evolutions, as well as priority topics for the inspections carried out by the French Nuclear safety authority (ASN). The IRSN has carried out a transversal analysis of all events in transport of radioactive materials that occurred in France from 1999 to 2007 as listed in its database (i.e. 901 events). For each event, some 70 parameters have been recorded from the analysis of the notifications and reports of the events, transmitted by the operators (type of event, type of package, level on the INES scale). This

  14. Computer-based systems important to safety (COMPSIS) - Reporting guidelines

    International Nuclear Information System (INIS)

    1999-07-01

    The objective of this procedure is to help the user to prepare an COMPSIS report on an event so that important lessons learned are most efficiently transferred to the database. This procedure focuses on the content of the information to be provided in the report rather than on its format. The established procedure follows to large extend the procedure chosen by the IRS incident reporting system. However this database is built for I and C equipment with the purpose of the event report database to collect and disseminate information on events of significance involving Computer-Based Systems important to safety in nuclear power plants, and feedback conclusions and lessons learnt from such events. For events where human performance is dominant to draw lessons, more detailed guidance on the specific information that should be supplied is spelled out in the present procedure. This guidance differs somewhat from that for the provision of technical information, and takes into account that the engineering world is usually less familiar with human behavioural analysis than with technical analysis. The events to be reported to the COMPSIS database should be based on the national reporting criteria in the participating member countries. The aim is that all reports including computer based systems that meet each country reporting criteria should be reported. The database should give a broad picture of events/incidents occurring in operation with computer control systems. As soon as an event has been identified, the insights and lessons learnt to be conveyed to the international nuclear community shall be clearly identified. On the basis of the description of the event, the event shall be analyzed in detail under the aspect of direct and potential impact to plant safety functions. The first part should show the common involvement of operation and safety systems and the second part should show the special aspects of I and C functions, hardware and software

  15. Low incidence of adjacent segment disease after posterior lumbar interbody fusion with minimum disc distraction: A preliminary report.

    Science.gov (United States)

    Makino, Takahiro; Honda, Hirotsugu; Fujiwara, Hiroyasu; Yoshikawa, Hideki; Yonenobu, Kazuo; Kaito, Takashi

    2018-01-01

    A retrospective review of prospectively collected data. To investigate the incidence of radiographic and symptomatic adjacent segment disease (ASD) and identify possible risk factors for ASD after posterior lumbar interbody fusion (PLIF) with minimum disc distraction by selecting low-height interbody cages. Excessive disc space distraction is reportedly 1 of the risk factors for ASD after PLIF; however, the incidence and other risk factors of ASD after PLIF with minimum disc distraction remain unclear. Forty-one consecutive patients who underwent PLIF at L4-L5 and were postoperatively followed up for a minimum of 2 years were included. The height and shape (box or bullet shape) of interbody cages was determined according to the disc height and morphology of the intervertebral space assessed on preoperative computed tomography scans to avoid excessive distraction. The incidence of radiographic and symptomatic ASD was evaluated and all demographic and radiographic parameters were compared between patients with and without ASD. Multivariate logistic regression analysis was performed to identify risk factors for ASD among the variables with P < .20 in univariate analysis. The overall incidence of ASD was 12.2% (5/41 patients): radiographic ASD, 7.3% (3 patients); symptomatic ASD, 4.9% (2 patients). Multivariate analysis revealed preoperative retrolisthesis of L3 on extension as the sole risk factor for ASD after PLIF with minimum disc distraction (odds ratio, 2.13; 95% confidence interval, 1.00-4.05; P = .049). The incidence of ASD in this study was lower than that of ASD in our previous study about PLIF with distraction of disc space (12.2% vs. 31.8%). Minimum disc distraction by selection of low-height interbody cages is a simple and effective method to prevent ASD at the surgeons' discretion, although preexisting retrolisthesis at the adjacent upper segment should be taken into consideration. Copyright © 2017 The Authors. Published by Wolters Kluwer Health

  16. The importance of critical incident reporting – and how to do it

    Directory of Open Access Journals (Sweden)

    Tim Fetherston

    2015-09-01

    Full Text Available If you asked a group of people whether you were more likely to die from an accident when you were in hospital or when you were travelling, either by air or by car, most people would probably say that it was safer to be in hospital. In fact, this couldn’t be further from the truth. If you are a patient, you are a hundred times more likely to die from a critical incident or error in hospital than you are in a transport accident.

  17. Incidence of register-based diabetes 10 years after a stepwise diabetes screening programme

    DEFF Research Database (Denmark)

    Rasmussen, S. S.; Johansen, Nanna; Witte, D. R.

    2016-01-01

    –2006, a diabetes screening programme based on the Danish diabetes risk score and measures of HbA1c and glucose was carried out in Danish general practices. The present study includes 13,249 individuals with low diabetes risk scores and 22,726 with high diabetes risk scores but no diabetes according to WHO 1999......Aims/hypothesis: Screening programmes for type 2 diabetes inevitably find more people at high risk of developing diabetes than people with undiagnosed prevalent diabetes. We describe the incidence of diabetes for risk groups according to advancement in a screening process. Methods: In 2001...... glucose value, respectively. For each step in the screening algorithm, the risk of developing diabetes was higher than in the previous step. Conclusions/interpretation: The risk of developing clinical diabetes in people who screen negative for diabetes depends on the level of risk stratification...

  18. Catalog of data bases and reports

    Energy Technology Data Exchange (ETDEWEB)

    Burtis, M.D. (comp.)

    1992-04-01

    The Catalog of Data Bases and Reports provides information about the many reports and other materials made available by the US Department of Energy's Global Change Research Program (GCRP). It is divided into six sections plus an author and a title index: (1) Research plans and budget summaries (2) technical reports; (3) workshops, proceedings, and reports; (4) other reports; (5) USDA reports on response of vegetation to carbon dioxide; and, (6) numeric data packages and computer model packages.

  19. Catalog of data bases and reports

    Energy Technology Data Exchange (ETDEWEB)

    Burtis, M.D. [comp.

    1992-04-01

    The Catalog of Data Bases and Reports provides information about the many reports and other materials made available by the US Department of Energy`s Global Change Research Program (GCRP). It is divided into six sections plus an author and a title index: (1) Research plans and budget summaries (2) technical reports; (3) workshops, proceedings, and reports; (4) other reports; (5) USDA reports on response of vegetation to carbon dioxide; and, (6) numeric data packages and computer model packages.

  20. Incidence, Etiology and Risk Factors for Travelers' Diarrhea during a Hospital Ship-Based Military Humanitarian Mission: Continuing Promise 2011.

    Directory of Open Access Journals (Sweden)

    Jessica M Hameed

    Full Text Available Travelers' diarrhea (TD is the most common ailment affecting travelers, including deployed U.S. military. Continuing Promise 2011 was a 5-month humanitarian assistance/disaster response (HA/DR military and non-governmental organization training mission aboard the hospital ship USNS Comfort, which deployed to Central and South America and the Caribbean between April and September 2011. Enhanced TD surveillance was undertaken during this mission for public health purposes. Passive surveillance (clinic visits, active surveillance (self-reported questionnaires, and stool samples were collected weekly from shipboard personnel. Descriptive statistics and multivariate-logistic regression methods were used to estimate disease burden and risk factor identification. Two polymerase chain reaction methods on frozen stool were used for microbiological identification. TD was the primary complaint for all clinic visits (20% and the leading cause of lost duties days due to bed rest confinement (62%, though underreported, as the active self-reported incidence was 3.5 times higher than the passive clinic-reported incidence. Vomiting (p = 0.002, feeling lightheaded or weak (p = 0.005, and being a food handler (p = 0.017 were associated with increased odds of lost duty days. Thirty-eight percent of self-reported cases reported some amount of performance impact. Based on the epidemiological curve, country of exercise and liberty appeared to be temporally associated with increased risk. From the weekly self-reported questionnaire risk factor analysis, eating off ship in the prior week was strongly associated (adjusted odds ratio [OR] 2.4, p<0.001. Consumption of seafood increased risk (aOR 1.7, p = 0.03, though consumption of ice appeared protective (aOR 0.3, p = 0.01. Etiology was bacterial (48%, with enterotoxigenic Escherichia coli as the predominant pathogen (35%. Norovirus was identified as a sole pathogen in 12%, though found as a copathogen in an additional 6

  1. Incidence, Etiology and Risk Factors for Travelers' Diarrhea during a Hospital Ship-Based Military Humanitarian Mission: Continuing Promise 2011.

    Science.gov (United States)

    Hameed, Jessica M; McCaffrey, Ramona L; McCoy, Andrea; Brannock, Tracy; Martin, Gregory J; Scouten, William T; Brooks, Krista; Putnam, Shannon D; Riddle, Mark S

    2016-01-01

    Travelers' diarrhea (TD) is the most common ailment affecting travelers, including deployed U.S. military. Continuing Promise 2011 was a 5-month humanitarian assistance/disaster response (HA/DR) military and non-governmental organization training mission aboard the hospital ship USNS Comfort, which deployed to Central and South America and the Caribbean between April and September 2011. Enhanced TD surveillance was undertaken during this mission for public health purposes. Passive surveillance (clinic visits), active surveillance (self-reported questionnaires), and stool samples were collected weekly from shipboard personnel. Descriptive statistics and multivariate-logistic regression methods were used to estimate disease burden and risk factor identification. Two polymerase chain reaction methods on frozen stool were used for microbiological identification. TD was the primary complaint for all clinic visits (20%) and the leading cause of lost duties days due to bed rest confinement (62%), though underreported, as the active self-reported incidence was 3.5 times higher than the passive clinic-reported incidence. Vomiting (p = 0.002), feeling lightheaded or weak (p = 0.005), and being a food handler (p = 0.017) were associated with increased odds of lost duty days. Thirty-eight percent of self-reported cases reported some amount of performance impact. Based on the epidemiological curve, country of exercise and liberty appeared to be temporally associated with increased risk. From the weekly self-reported questionnaire risk factor analysis, eating off ship in the prior week was strongly associated (adjusted odds ratio [OR] 2.4, prisk (aOR 1.7, p = 0.03), though consumption of ice appeared protective (aOR 0.3, p = 0.01). Etiology was bacterial (48%), with enterotoxigenic Escherichia coli as the predominant pathogen (35%). Norovirus was identified as a sole pathogen in 12%, though found as a copathogen in an additional 6%. Despite employment of current and targeted

  2. Explanation and Elaboration of the Standards of Reporting of Neurological Disorders Checklist: A Guideline for the Reporting of Incidence and Prevalence Studies in Neuroepidemiology.

    Science.gov (United States)

    Bennett, Derrick A; Brayne, Carol; Feigin, Valery L; Barker-Collo, Suzanne; Brainin, Michael; Davis, Daniel; Gallo, Valentina; Jetté, Nathalie; Karch, André; Kurtzke, John F; Lavados, Pablo M; Logroscino, Giancarlo; Nagel, Gabriele; Preux, Pierre-Marie; Rothwell, Peter M; Svenson, Lawrence W

    2015-01-01

    Incidence and prevalence studies of neurological disorders play an extremely important role in hypothesis-generation, assessing the burden of disease and planning of health services. However, the assessment of disease estimates is hindered by the poor quality of reporting for such studies. We developed the Standards of Reporting of Neurological Disorders (STROND) guideline in order to improve the quality of reporting of neurological disorders from which prevalence, incidence, and outcomes can be extracted for greater generalisability. The guideline was developed using a 3-round Delphi technique in order to identify the 'basic minimum items' important for reporting, as well as some additional 'ideal reporting items.' An e-consultation process was then used in order to gauge opinion by external neuroepidemiological experts on the appropriateness of the items included in the checklist. The resultant 15 items checklist and accompanying recommendations were developed using a similar process and structured in a similar manner to the Strengthening of the Reporting of Observational Studies in Epidemiology checklist for ease of use. This paper presents the STROND checklist with an explanation and elaboration for each item, as well as examples of good reporting from the neuroepidemiological literature. The introduction and use of the STROND checklist should lead to more consistent, transparent and contextualised reporting of descriptive neuroepidemiological studies that should facilitate international comparisons, and lead to more accessible information for multiple stakeholders, ultimately supporting better healthcare decisions for neurological disorders.

  3. Incidence of invasive salmonella disease in sub-Saharan Africa: a multicentre population-based surveillance study.

    Science.gov (United States)

    Marks, Florian; von Kalckreuth, Vera; Aaby, Peter; Adu-Sarkodie, Yaw; El Tayeb, Muna Ahmed; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Biggs, Holly M; Bjerregaard-Andersen, Morten; Breiman, Robert F; Campbell, James I; Cosmas, Leonard; Crump, John A; Espinoza, Ligia Maria Cruz; Deerin, Jessica Fung; Dekker, Denise Myriam; Fields, Barry S; Gasmelseed, Nagla; Hertz, Julian T; Van Minh Hoang, Nguyen; Im, Justin; Jaeger, Anna; Jeon, Hyon Jin; Kabore, Leon Parfait; Keddy, Karen H; Konings, Frank; Krumkamp, Ralf; Ley, Benedikt; Løfberg, Sandra Valborg; May, Jürgen; Meyer, Christian G; Mintz, Eric D; Montgomery, Joel M; Niang, Aissatou Ahmet; Nichols, Chelsea; Olack, Beatrice; Pak, Gi Deok; Panzner, Ursula; Park, Jin Kyung; Park, Se Eun; Rabezanahary, Henintsoa; Rakotozandrindrainy, Raphaël; Raminosoa, Tiana Mirana; Razafindrabe, Tsiriniaina Jean Luco; Sampo, Emmanuel; Schütt-Gerowitt, Heidi; Sow, Amy Gassama; Sarpong, Nimako; Seo, Hye Jin; Sooka, Arvinda; Soura, Abdramane Bassiahi; Tall, Adama; Teferi, Mekonnen; Thriemer, Kamala; Warren, Michelle R; Yeshitela, Biruk; Clemens, John D; Wierzba, Thomas F

    2017-03-01

    Available incidence data for invasive salmonella disease in sub-Saharan Africa are scarce. Standardised, multicountry data are required to better understand the nature and burden of disease in Africa. We aimed to measure the adjusted incidence estimates of typhoid fever and invasive non-typhoidal salmonella (iNTS) disease in sub-Saharan Africa, and the antimicrobial susceptibility profiles of the causative agents. We established a systematic, standardised surveillance of blood culture-based febrile illness in 13 African sentinel sites with previous reports of typhoid fever: Burkina Faso (two sites), Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar (two sites), Senegal, South Africa, Sudan, and Tanzania (two sites). We used census data and health-care records to define study catchment areas and populations. Eligible participants were either inpatients or outpatients who resided within the catchment area and presented with tympanic (≥38·0°C) or axillary temperature (≥37·5°C). Inpatients with a reported history of fever for 72 h or longer were excluded. We also implemented a health-care utilisation survey in a sample of households randomly selected from each study area to investigate health-seeking behaviour in cases of self-reported fever lasting less than 3 days. Typhoid fever and iNTS disease incidences were corrected for health-care-seeking behaviour and recruitment. Between March 1, 2010, and Jan 31, 2014, 135 Salmonella enterica serotype Typhi (S Typhi) and 94 iNTS isolates were cultured from the blood of 13 431 febrile patients. Salmonella spp accounted for 33% or more of all bacterial pathogens at nine sites. The adjusted incidence rate (AIR) of S Typhi per 100 000 person-years of observation ranged from 0 (95% CI 0-0) in Sudan to 383 (274-535) at one site in Burkina Faso; the AIR of iNTS ranged from 0 in Sudan, Ethiopia, Madagascar (Isotry site), and South Africa to 237 (178-316) at the second site in Burkina Faso. The AIR of iNTS and typhoid

  4. ACE Inhibitor-Induced Angioedema of the Intestine: Case Report, Incidence, Pathophysiology, Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Gavin Oudit

    2001-01-01

    Full Text Available A case report of fosinopril-induced angioedema of the intestine with a chronic course accompanied by multiple acute exacerbations is described. Angiotensin-converting enzyme (ACE inhibitor-induced angioedema of the intestine (AIAI occurs in a minority of patients taking an ACE inhibitor. The clinical presentation encompasses acute abdominal symptoms, pronounced bowel edema and ascites with occasional facial and/or oropharyngeal swelling. AIAI is diagnosed based on the temporal relationship between the symptomatic presentation and drug use, absence of alternative diagnoses including other causes of angioedema, and the prompt resolution of symptoms upon discontinuation of the ACE inhibitor. Prompt radiological investigation (abdominal computerized tomography and/or ultrasound is critical in making an early diagnosis and in preventing unnecessary surgical intervention. There is a female predominance of AIAI, which may reflect the interaction of estradiol with the various pathways involved in the pathophysiology of AIAI. Management of AIAI consists mainly of conservative measures and discontinuation of the ACE inhibitor. Angiotensin II receptor antagonists should not be considered as appropriate alternatives. Awareness and knowledge of AIAI are important because of the increasing use of ACE inhibitors, current delays in making the diagnosis, obvious management strategies once the diagnosis is made and the dysutility of alternative diagnoses, which may lead to considerable morbidity. AIAI must be considered in patients taking ACE inhibitors who develop gastrointestinal complaints irrespective of the duration of the therapy.

  5. Forecasting the Incidence of Mumps in Zibo City Based on a SARIMA Model.

    Science.gov (United States)

    Xu, Qinqin; Li, Runzi; Liu, Yafei; Luo, Cheng; Xu, Aiqiang; Xue, Fuzhong; Xu, Qing; Li, Xiujun

    2017-08-17

    This study aimed to predict the incidence of mumps using a seasonal autoregressive integrated moving average (SARIMA) model, and provide theoretical evidence for early warning prevention and control in Zibo City, Shandong Province, China. Monthly mumps data from Zibo City gathered between 2005 and 2013 were used as a training set to construct a SARIMA model, and the monthly mumps in 2014 were defined as a test set for the model. From 2005 to 2014, a total of 8722 cases of mumps were reported in Zibo City; the male-to-female ratio of cases was 1.85:1, the age group of 1-20 years old accounted for 94.05% of all reported cases, and students made up the largest proportion (65.89%). The main serious endemic areas of mumps were located in Huantai County, Linzi District, and Boshan District of Zibo City. There were two epidemic peaks from April to July and from October to January in next year. The fitted model SARIMA (0, 1, 1) (0, 1, 1) 12 was established (AIC = 157.528), which has high validity and reasonability. The SARIMA model fitted dynamic changes of mumps in Zibo City well. It can be used for short-term forecasting and early warning of mumps.

  6. Incident Reporting to Improve Patient Safety: The Effects of Process Variance on Pediatric Patient Safety in the Emergency Department.

    Science.gov (United States)

    OʼConnell, Karen J; Shaw, Kathy N; Ruddy, Richard M; Mahajan, Prashant V; Lichenstein, Richard; Olsen, Cody S; Funai, Tomohiko; Blumberg, Stephen; Chamberlain, James M

    2018-04-01

    Medical errors threaten patient safety, especially in the pediatric emergency department (ED) where overcrowding, multiple handoffs, and workflow interruptions are common. Errors related to process variance involve situations that are not consistent with standard ED operations or routine patient care. We performed a planned subanalysis of the Pediatric Emergency Care Applied Research Network incident reporting data classified as process variance events. Confidential deidentified incident reports (IRs) were collected and classified by 2 independent investigators. Events categorized as process variance were then subtyped for severity and contributing factors. Data were analyzed using descriptive statistics. The study intention was to describe and measure reported medical errors related to process variance in 17 EDs in the Pediatric Emergency Care Applied Research Network from 2007 to 2008. Between July 2007 and June 2008, 2906 eligible reports were reviewed. Process variance events were identified in 15.4% (447/2906). The majority were related to patient flow (35.4%), handoff communication (17.2%), and patient identification errors (15.9%). Most staff involved included nurses (47.9%) and physicians (28%); trainees were infrequently reported. The majority of events did not result in harm (65.7%); 17.9% (80/447) of cases were classified as unsafe conditions but did not reach the patient. Temporary harm requiring further treatment or hospitalization was reported in 5.6% (25/447). No events resulted in permanent harm, near death, or death. Contributing factors included human factors (92.1%), in particular handoff communication, interpersonal skills, and compliance with established procedures, and system-level errors (18.1%), including unclear or unavailable policies and inadequate staffing levels. Although process variance events accounted for approximately 1 in 6 reported safety events, very few led to patient harm. Because human and system-level factors contributed to

  7. Asthma Status and Risk of Incident Myocardial Infarction: A Population-Based Case-Control Study.

    Science.gov (United States)

    Bang, Duk Won; Wi, Chung-Il; Kim, Eun Na; Hagan, John; Roger, Veronique; Manemann, Sheila; Lahr, Brian; Ryu, Euijung; Juhn, Young J

    2016-01-01

    The role of asthma status and characteristics of asthma in the risk of myocardial infarction (MI) are poorly understood. We determined whether asthma and its characteristics are associated with risk of MI. The study was designed as a population-based retrospective case-control study, which included all eligible incident MI cases between November 1, 2002, and May 31, 2006, and their matched controls. Asthma was ascertained using predetermined criteria. Active (current) asthma was defined as the occurrence of asthma-related episodes (asthma symptoms, use of asthma medications, unscheduled medical or emergency department visit, or hospitalization for asthma) within 1 year before MI index date. There were 543 eligible incident MI cases during the study period. Of the 543 MI cases, 81 (15%) had a history of asthma before index date of MI, whereas 52 of 543 controls (10%) had such a history (adjusted odds ratio [OR]: 1.68; 95% CI: 1.06-2.66) adjusting for risk factors for MI and comorbid conditions (excluding chronic obstructive lung disease). Although inactive asthma did not increase the risk of MI, individuals with active asthma had a higher odds of MI, compared with those without asthma (adjusted OR: 3.18; 95% CI: 1.57-6.44) without controlling for chronic obstructive pulmonary disease (COPD). After adjusting for COPD, although asthma overall was no longer statistically significant (adjusted OR: 1.34, 95% CI: 0.84-2.15), active asthma still was associated (adjusted OR: 2.33, 95% CI: 1.12-4.82). Active asthma is an unrecognized risk factor for MI. Further studies are needed to assess the role of asthma control and medications in the risk of MI. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Self-reported sleep disturbance and incidence of dementia in ageing men.

    Science.gov (United States)

    Luojus, Maria K; Lehto, Soili M; Tolmunen, Tommi; Brem, Anna-Katharine; Lönnroos, Eija; Kauhanen, Jussi

    2017-04-01

    Sleep disturbance is suggested to contribute to the development of dementia. However, prospective longitudinal data from middle-aged populations are scarce. We investigated a population-based sample of 2386 men aged 42-62 years at baseline during 1984-1989. Participants having a history of mental illnesses, psychiatric medication, Parkinson's disease or dementia within 2 years after baseline (n=296) were excluded. Difficulty falling asleep or maintaining sleep, sleep duration and daytime tiredness were enquired. Dementia diagnoses (n=287) between 1984 and 2014 were obtained through linkage with hospital discharge, national death and special reimbursement registers. Cox proportional hazards analyses were performed for all dementias, and separately for Alzheimer's disease (n=234) and other phenotypes (n=53). Additional analyses were performed on a subsample of an apolipoprotein E ( APOE ) genotype-tested population (n=1199). The risk ratio for dementia was 1.58 (95% CI 1.10 to 2.27) in men with frequent sleep disturbance after adjustments for age, examination year, elevated depressive symptoms, physical activity, alcohol consumption, cumulative smoking history, systolic blood pressure, body mass index, low-density lipoprotein and high-density lipoprotein cholesterol, high-sensitivity C reactive protein, cardiovascular disease history, education years and living alone. Daytime tiredness and sleep duration were not associated with dementia in adjusted analysis. In the APOE subsample, both APOE ε4 genotype and frequent sleep disturbance were associated with increased dementia risk, but in the interaction analysis they had no joint effect. Self-reported frequent sleep disturbance in middle-aged men may relate to the development of dementia in later life. Having an APOE ε4 genotype did not affect the relationship. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Report on state liability for radioactive materials transportation incidents: A survey of laws

    International Nuclear Information System (INIS)

    1989-10-01

    The purpose of this report is to provide a synopsis of the liability laws of the Southern States Energy Board's (SSEB's) 16 member states. It begins by briefly reviewing potential sources of liability, immunity from liability, waiver of immunity, and statutes of limitation, followed by liability laws of member states. The report was prepared by reviewing legal literature pertaining to governmental liability, with particular emphasis on nuclear waste transportation, including law review articles, legal treatises, technical reports, state statutes and regulations

  10. Patient safety incident reports related to traditional Japanese Kampo medicines: medication errors and adverse drug events in a university hospital for a ten-year period.

    Science.gov (United States)

    Shimada, Yutaka; Fujimoto, Makoto; Nogami, Tatsuya; Watari, Hidetoshi; Kitahara, Hideyuki; Misawa, Hiroki; Kimbara, Yoshiyuki

    2017-12-21

    Kampo medicine is traditional Japanese medicine, which originated in ancient traditional Chinese medicine, but was introduced and developed uniquely in Japan. Today, Kampo medicines are integrated into the Japanese national health care system. Incident reporting systems are currently being widely used to collect information about patient safety incidents that occur in hospitals. However, no investigations have been conducted regarding patient safety incident reports related to Kampo medicines. The aim of this study was to survey and analyse incident reports related to Kampo medicines in a Japanese university hospital to improve future patient safety. We selected incident reports related to Kampo medicines filed in Toyama University Hospital from May 2007 to April 2017, and investigated them in terms of medication errors and adverse drug events. Out of 21,324 total incident reports filed in the 10-year survey period, we discovered 108 Kampo medicine-related incident reports. However, five cases were redundantly reported; thus, the number of actual incidents was 103. Of those, 99 incidents were classified as medication errors (77 administration errors, 15 dispensing errors, and 7 prescribing errors), and four were adverse drug events, namely Kampo medicine-induced interstitial pneumonia. The Kampo medicine (crude drug) that was thought to induce interstitial pneumonia in all four cases was Scutellariae Radix, which is consistent with past reports. According to the incident severity classification system recommended by the National University Hospital Council of Japan, of the 99 medication errors, 10 incidents were classified as level 0 (an error occurred, but the patient was not affected) and 89 incidents were level 1 (an error occurred that affected the patient, but did not cause harm). Of the four adverse drug events, two incidents were classified as level 2 (patient was transiently harmed, but required no treatment), and two incidents were level 3b (patient was

  11. Incidence of self-reported brain injury and the relationship with substance abuse: findings from a longitudinal community survey

    Directory of Open Access Journals (Sweden)

    Butterworth Peter

    2010-03-01

    Full Text Available Abstract Background Traumatic or serious brain injury (BI has persistent and well documented adverse outcomes, yet 'mild' or 'moderate' BI, which often does not result in hospital treatment, accounts for half the total days of disability attributed to BI. There are currently few data available from community samples on the incidence and correlates of these injuries. Therefore, the study aimed to assess the 1 incidence of self-reported mild (not requiring hospital admission and moderate (admitted to hospital brain injury (BI, 2 causes of injury 3 physical health scores and 4 relationship between BI and problematic alcohol or marijuana use. Methods An Australian community sequential-cohort study (cohorts aged 20-24, 40-44 and 60-64 years at wave one used a survey methodology to assess BI and substance use at baseline and four years later. Results Of the 7485 wave one participants, 89.7% were re-interviewed at wave two. There were 56 mild (230.8/100000 person-years and 44 moderate BI (180.5/100000 person-years reported between waves one and two. Males and those in the 20-24 year cohort had increased risk of BI. Sports injury was the most frequent cause of BI (40/100 with traffic accidents being a greater proportion of moderate (27% than mild (7% BI. Neither alcohol nor marijuana problems at wave one were predictors of BI. BI was not a predictor of developing substance use problems by wave two. Conclusions BI were prevalent in this community sample, though the incidence declined with age. Factors associated with BI in community samples differ from those reported in clinical samples (e.g. typically traumatic brain injury with traffic accidents the predominate cause. Further, detailed evaluation of the health consequences of these injuries is warranted.

  12. Fall incidence in Germany: results of two population-based studies, and comparison of retrospective and prospective falls data collection methods.

    Science.gov (United States)

    Rapp, Kilian; Freiberger, Ellen; Todd, Chris; Klenk, Jochen; Becker, Clemens; Denkinger, Michael; Scheidt-Nave, Christa; Fuchs, Judith

    2014-09-20

    Fall incidence differs considerably between studies and countries. Reasons may be differences between study samples or different assessment methods. The aim was to derive estimates of fall incidence from two population-based studies among older community-living people in Germany and compare retrospective and prospective falls data collection methods. Data were derived from the 2008-11 wave of the German health interview and examination survey for adults (DEGS1), and the Activity and Function of the Elderly in Ulm study (ActiFE-Ulm). Data collection took place in community facilities (DEGS1) or participants' homes (ActiFE-Ulm). Participation rates were 42% (newly recruited) and 64% (panel component) in DEGS1 and 19.8% in ActiFE-Ulm. Self-report retrospective fall data covering the previous 12 month period in DEGS1 and ActiFE-Ulm were collected, but only ActiFE-Ulm used prospective 12 month fall calendars. The incidence of 'any fall' and 'recurrent falls' were calculated for both methods. Fall rates increased with age in men but not women. The ActiFE-Ulm prospectively assessed incidence (95% confidence interval) in women and men aged 65- collection of prospective data gives similar rates to the cheaper retrospective report method.

  13. Incidents analysis

    International Nuclear Information System (INIS)

    Francois, P.

    1996-01-01

    We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs

  14. Completeness of histopathology reporting of melanoma in a high-incidence geographical region.

    Science.gov (United States)

    Thompson, B; Austin, R; Coory, M; Aitken, J F; Walpole, E; Francis, G; Fritschi, L

    2009-01-01

    Appropriate histopathology reporting helps to ensure effective therapy and prognosis. To examine compliance with clinical practice guidelines for histopathology reports of melanomas. A sample of melanoma histopathology reports in Queensland was audited for inclusion of recommended information. The quality of documentation was constructed and multivariate analysis used to determine factors affecting the quality of reporting practices. Documentation of the most important features of melanoma was high: clear diagnosis (99.8%; 95% CI 98.6-100), thickness (99.8%; 95% CI 98.6-100), comment on adequacy of excision (87.9%; 95% CI 84.9-91.0) and measurement of margins (91.9%; 95% CI 88.8-91.4). Overall reporting of ulceration and regression was of lesser completeness (83.0 and 77.8%, respectively) and these features were more likely to be reported by high-volume laboratories (p < 0.001 and p = 0.037, respectively). This trend was not apparent for other features. Fewer than 50% of reports documented mitotic rate per square millimetre, predominant cell type, microsatellites, growth phase and desmoplasia. Awareness of current reporting practices and identification of areas in which insufficiencies exist enable the revision of systems and potential improvements to the transfer of information to treating clinicians. Copyright 2008 S. Karger AG, Basel.

  15. Effect of a culture-based screening algorithm on tuberculosis incidence in immigrants and refugees bound for the United States: a population-based cross-sectional study.

    Science.gov (United States)

    Liu, Yecai; Posey, Drew L; Cetron, Martin S; Painter, John A

    2015-03-17

    Before 2007, immigrants and refugees bound for the United States were screened for tuberculosis (TB) by a smear-based algorithm that could not diagnose smear-negative/culture-positive TB. In 2007, the Centers for Disease Control and Prevention implemented a culture-based algorithm. To evaluate the effect of the culture-based algorithm on preventing the importation of TB to the United States by immigrants and refugees from foreign countries. Population-based, cross-sectional study. Panel physician sites for overseas medical examination. Immigrants and refugees with TB. Comparison of the increase of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees by the culture-based algorithm with the decline of reported cases among foreign-born persons within 1 year after arrival in the United States from 2007 to 2012. Of the 3 212 421 arrivals of immigrants and refugees from 2007 to 2012, a total of 1 650 961 (51.4%) were screened by the smear-based algorithm and 1 561 460 (48.6%) were screened by the culture-based algorithm. Among the 4032 TB cases diagnosed by the culture-based algorithm, 2195 (54.4%) were smear-negative/culture-positive. Before implementation (2002 to 2006), the annual number of reported cases among foreign-born persons within 1 year after arrival was relatively constant (range, 1424 to 1626 cases; mean, 1504 cases) but decreased from 1511 to 940 cases during implementation (2007 to 2012). During the same period, the annual number of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees bound for the United States by the culture-based algorithm increased from 4 to 629. This analysis did not control for the decline in new arrivals of nonimmigrant visitors to the United States and the decrease of incidence of TB in their countries of origin. Implementation of the culture-based algorithm may have substantially reduced the incidence of TB among newly arrived, foreign-born persons in

  16. Increased incidence of Mycoplasma pneumoniae infections detected by laboratory-based surveillance in Denmark in 2010

    DEFF Research Database (Denmark)

    Rasmussen, J N; Voldstedlund, M; Andersen, R L

    2010-01-01

    In Denmark recurrent epidemics of Mycoplasma pneumoniae infections have been described since the 1950s at intervals of approximately four to six years. The latest epidemic occurred in 2004/05 followed by two years of high incidence and more than three years of low incidence. Due to a recent incre...

  17. A nationwide registry-based cohort study of incidence of tonsillectomy in Denmark, 1991-2012

    DEFF Research Database (Denmark)

    Juul, Marie Louise; Rasmussen, Eva Rye; Rasmussen, Stig Hebbelstrup Rye

    2018-01-01

    , and by the age of 20, 7.7% of the Danish people has had a tonsillectomy. There were significant regional differences in the number of tonsillectomies. CONCLUSION: The incidence rate of tonsillectomies in Denmark decreased significantly in the study period, but with great regional variance.......OBJECTIVE: To update tonsillectomy incidence rates in Denmark and identify whether the incidence rates vary between geographical areas in the country during the period 1991-2012. DESIGN: This was a retrospective nationwide cohort study using data from the comprehensive Danish patient registries...... tonsillectomies were conducted, and the overall incidence of tonsillectomy decreased significantly over time. The overall annual incidence of tonsillectomies decreased from 155.7 per 100 000 inhabitants in 1991 to 129.4 per 100 000 inhabitants in 2012. In 1991, 5.5% of tonsillectomies were performed in office...

  18. Nonapnea sleep disorders and incident chronic kidney disease: a population-based retrospective cohort study.

    Science.gov (United States)

    Huang, Shih-Ting; Lin, Cheng-Li; Yu, Tung-Min; Yang, Te-Cheng; Kao, Chia-Hung

    2015-01-01

    Nonapnea sleep disorders (NASDs) are associated with an increased risk of stroke, diabetes, and hypertension. No longitudinal study has yet examined the association between NASD and chronic kidney disease (CKD) by using epidemiologic study methods. To test this hypothesis, we examined the effect of NASD on the incidence of CKD in a large population-based retrospective cohort study. Based on a retrospective cohort study of a general population sample of 128 to 436 patients in the Taiwan National Health Insurance Research Database from January 1, 1998 to December 31, 2001, 42 to 812 NASD patients were followed up for 10.2 ± 3.12 years, and additional 85 to 624 individuals had no NASD at baseline. The International Classification of Diseases, Ninth Revision, Clinical Modification was used to identify the diagnosis of disease. Cox proportional hazard regression models were used to assess the association between NASD and subsequent CKD risk. The incidence rate of CKD was significantly higher in the NASD cohort than in the comparison cohort (2.68 vs 1.88 per 1000 person-years, respectively). After we adjusted for age, sex, and comorbidities, the risk of developing CKD was significant for patients with NASD (adjusted hazard ratio [HR] = 1.13; 95% confidence interval [CI] = 1.05-1.22; P types of NASDs, patients with sleep disturbance associated disorders had a 14% increased risk of developing CKD (95% CI = 1.03-1.26; P < 0.01), whereas patients with insomnia had a 13% increased risk of subsequent CKD (95% CI = 1.02-1.25; P < 0.05) compared with the non-NASD cohort. Kaplan-Meier survival analysis indicated that the CKD-free rate was 1% lower in the NASD cohort than in the comparison cohort (log-rank test, P < 0.0001). Our study provides evidence that patients with NASD have an increased risk of developing subsequent CKD compared with patients without NASD; men, elderly people, and patients with concomitant comorbidities are at the greatest

  19. Colorectal cancer liver metastases - a population-based study on incidence, management and survival.

    Science.gov (United States)

    Engstrand, Jennie; Nilsson, Henrik; Strömberg, Cecilia; Jonas, Eduard; Freedman, Jacob

    2018-01-15

    Colorectal cancer (CRC) is a leading cause of cancer-associated deaths with liver metastases developing in 25-30% of those affected. Previous data suggest a survival difference between right- and left-sided liver metastatic CRC, even though left-sided cancer has a higher incidence of liver metastases. The aim of the study was to describe the liver metastatic patterns and survival as a function of the characteristics of the primary tumour and different combinations of metastatic disease. A retrospective population-based study was performed on a cohort of patients diagnosed with CRC in the region of Stockholm, Sweden during 2008. Patients were identified through the Swedish National Quality Registry for Colorectal Cancer Treatment (SCRCR) and additional information on intra- and extra-hepatic metastatic pattern and treatment were retrieved from electronic patient records. Patients were followed for 5 years or until death. Factors influencing overall survival (OS) were investigated by means of Cox regression. OS was compared using Kaplan-Meier estimations and the log-rank test. Liver metastases were diagnosed in 272/1026 (26.5%) patients within five years of diagnosis of the primary. Liver and lung metastases were more often diagnosed in left-sided colon cancer compared to right-sided cancer (28.4% versus 22.1%, p = 0.029 and 19.7% versus 13.2%, p = 0.010, respectively) but the extent of liver metastases were more extensive for right-sided cancer as compared to left-sided (p = 0.001). Liver metastatic left-sided cancer, including rectal cancer, was associated with a 44% decreased mortality risk compared to right-sided cancer (HR = 0.56, 95% CI: 0.39-0.79) with a 5-year OS of 16.6% versus 4.3% (p < 0.001). In liver metastatic CRC, the presence of lung metastases did not significantly influence OS as assessed by multivariate analysis (HR = 1.11, 95% CI: 0.80-1.53). The worse survival in liver metastatic right-sided colon cancer could possibly be

  20. Reporting of suicide and trespass incidents by online media in the United States.

    Science.gov (United States)

    2017-03-01

    The reporting of a suicide death in the media has the potential to increase imitative suicide attempts for vulnerable individuals : who read the article, a phenomenon known as suicide contagion or the Werther effect. Organizations around the wo...

  1. Department of the Navy Suicide Incident Report (DONSIR): Preliminary Findings January-June 1999

    National Research Council Canada - National Science Library

    Hourani, Laurel

    1999-01-01

    .... The purposes of the DONSIR are to standardize the review and reporting process on Navy and Marine Corps suicides, and to develop a database to be used to identify risk factors and improve prevention...

  2. A human error taxonomy for analysing healthcare incident reports: assessing reporting culture and its effects on safety perfomance

    DEFF Research Database (Denmark)

    Itoh, Kenji; Omata, N.; Andersen, Henning Boje

    2009-01-01

    The present paper reports on a human error taxonomy system developed for healthcare risk management and on its application to evaluating safety performance and reporting culture. The taxonomy comprises dimensions for classifying errors, for performance-shaping factors, and for the maturity...

  3. Cancer incidence in indigenous people in Australia, New Zealand, Canada, and the USA: a comparative population-based study.

    Science.gov (United States)

    Moore, Suzanne P; Antoni, Sébastien; Colquhoun, Amy; Healy, Bonnie; Ellison-Loschmann, Lis; Potter, John D; Garvey, Gail; Bray, Freddie

    2015-11-01

    Indigenous people have disproportionally worse health and lower life expectancy than their non-indigenous counterparts in high-income countries. Cancer data for indigenous people are scarce and incidence has not previously been collectively reported in Australia, New Zealand, Canada, and the USA. We aimed to investigate and compare, for the first time, the cancer burden in indigenous populations in these countries. We derived incidence data from population-based cancer registries in three states of Australia (Queensland, Western Australia, and the Northern Territory), New Zealand, the province of Alberta in Canada, and the Contract Health Service Delivery Areas of the USA. Summary rates for First Nations and Inuit in Alberta, Canada, were provided directly by Alberta Health Services. We compared age-standardised rates by registry, sex, cancer site, and ethnicity for all incident cancer cases, excluding non-melanoma skin cancers, diagnosed between 2002 and 2006. Standardised rate ratios (SRRs) and 95% CIs were computed to compare the indigenous and non-indigenous populations of each jurisdiction, except for the Alaska Native population, which was compared with the white population from the USA. We included 24 815 cases of cancer in indigenous people and 5 685 264 in non-indigenous people from all jurisdictions, not including Alberta, Canada. The overall cancer burden in indigenous populations was substantially lower in the USA except in Alaska, similar or slightly lower in Australia and Canada, and higher in New Zealand compared with their non-indigenous counterparts. Among the most commonly occurring cancers in indigenous men were lung, prostate, and colorectal cancer. In most jurisdictions, breast cancer was the most common cancer in women followed by lung and colorectal cancer. The incidence of lung cancer was higher in indigenous men in all Australian regions, in Alberta, and in US Alaska Natives than in their non-indigenous counterparts. For breast cancer

  4. Incidence of pneumonia in nursing home residents with dementia in the Netherlands: an estimation based on three differently designed studies.

    Science.gov (United States)

    Zomer, T P; VAN DER Maaden, T; VAN Gageldonk-Lafeber, A B; DE Greeff, S C; VAN DER Steen, J T; Verhoef, L

    2017-08-01

    Pneumonia leads to considerable morbidity and mortality in nursing home residents with dementia. We assessed pneumonia incidence based on data from three different studies: (1) real-time national surveillance of healthcare-associated infections in nursing home residents in 2009-2015; (2) a randomized controlled trial in 2012-2015 to assess effects of a practical guideline in nursing home residents with dementia and pneumonia; and (3) a study in 2007-2010 to assess quality of dying in newly admitted nursing home residents with dementia. In national surveillance data, pneumonia incidence was calculated separately for psychogeriatric and somatic beds, as a proxy for residents with and without dementia. Weekly pneumonia incidence was significantly lower per 1000 psychogeriatric beds (3·9; 95% confidence interval (CI) 3·2-4·6) compared with 1000 somatic beds (5·7; 95% CI 5·1-6·3). Annual incidence per 1000 psychogeriatric beds was similar in national surveillance (range 78·9-117·1) and the trial (range 71·0-94·3), and significantly higher in newly admitted dementia residents (range 267·3-363·2). The incidence was highest during the first months after admission when compared with residents with longer stay. In conclusion, follow-up of pneumonia in newly admitted dementia residents may result in higher incidence, possibly due to higher risk in this population.

  5. Cancer incidence in the vicinity of nuclear power plants in Taiwan: a population-based study.

    Science.gov (United States)

    Wang, Shiow-Ing; Yaung, Chih-Liang; Lee, Long-Teng; Chiou, Shang-Jyh

    2016-01-01

    Numerous antinuclear demonstrations reveal that the public is anxious about the potential health effects caused by nuclear power plants. The purpose of this study is to address the question "Is there a higher cancer incidence rate in the vicinity of nuclear power plants in Taiwan?" The Taiwan Cancer Registry database from 1979 to 2003 was used to compare the standardized incidence rate of the top four cancers with strong evidence for radiation risks between the "plant-vicinity" with those "non-plant-vicinity" groups. All cancer sites, five-leading cancers in Taiwan, and gender-specific cancers were also studied. We also adopted different observation time to compare the incidence rate of cancers between two groups to explore the impact of the observation period. The incidences of leukemia, thyroid, lung, and breast cancer were not significantly different between two groups, but cervix uteri cancer showed higher incidence rates in the plant-vicinity group. The incidence of cervical cancer was not consistently associated with the duration of plant operation, according to a multiyear period comparison. Although there was higher incidence in cervix cancer in the plant-vicinity group, our findings did not provide the crucial evidence that nuclear power plants were the causal factor for some cancers with strong evidence for radiation risks.

  6. Integrating Data From the UK National Reporting and Learning System With Work Domain Analysis to Understand Patient Safety Incidents in Community Pharmacy.

    Science.gov (United States)

    Phipps, Denham L; Tam, W Vanessa; Ashcroft, Darren M

    2017-03-01

    To explore the combined use of a critical incident database and work domain analysis to understand patient safety issues in a health-care setting. A retrospective review was conducted of incidents reported to the UK National Reporting and Learning System (NRLS) that involved community pharmacy between April 2005 and August 2010. A work domain analysis of community pharmacy was constructed using observational data from 5 community pharmacies, technical documentation, and a focus group with 6 pharmacists. Reports from the NRLS were mapped onto the model generated by the work domain analysis. Approximately 14,709 incident reports meeting the selection criteria were retrieved from the NRLS. Descriptive statistical analysis of these reports found that almost all of the incidents involved medication and that the most frequently occurring error types were dose/strength errors, incorrect medication, and incorrect formulation. The work domain analysis identified 4 overall purposes for community pharmacy: business viability, health promotion and clinical services, provision of medication, and use of medication. These purposes were served by lower-order characteristics of the work system (such as the functions, processes and objects). The tasks most frequently implicated in the incident reports were those involving medication storage, assembly, or patient medication records. Combining the insights from different analytical methods improves understanding of patient safety problems. Incident reporting data can be used to identify general patterns, whereas the work domain analysis can generate information about the contextual factors that surround a critical task.

  7. Minimum incidence of adult invasive pneumococcal disease in Blantyre, Malawi an urban african setting: a hospital based prospective cohort study.

    Science.gov (United States)

    Bar-Zeev, Naor; Mtunthama, Neema; Gordon, Stephen B; Mwafulirwa, Gershom; French, Neil

    2015-01-01

    Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV) programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old) population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI): 53.7, 62.7) per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7) mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5) per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9). We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population level indirect

  8. Minimum incidence of adult invasive pneumococcal disease in Blantyre, Malawi an urban african setting: a hospital based prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Naor Bar-Zeev

    Full Text Available Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI: 53.7, 62.7 per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7 mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5 per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9. We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population

  9. European downstream oil industry safety performance. Statistical summary of reported incidents 2009

    International Nuclear Information System (INIS)

    Burton, A.; Den Haan, K.H.

    2010-10-01

    The sixteenth such report by CONCAWE, this issue includes statistics on workrelated personal injuries for the European downstream oil industry's own employees as well as contractors for the year 2009. Data were received from 33 companies representing more than 97% of the European refining capacity. Trends over the last sixteen years are highlighted and the data are also compared to similar statistics from related industries. In addition, this report presents the results of the first Process Safety Performance Indicator data gathering exercise amongst the CONCAWE membership.

  10. The incidence of and mortality from leukaemias in the UK: a general population-based study

    OpenAIRE

    Bhayat, Fatima; Das-Gupta, Emma; Smith, Chris; McKeever, Tricia; Hubbard, Richard

    2009-01-01

    Abstract Background The acute and chronic leukaemias constitute about 2.5% of all newly diagnosed malignancies and kill over 4000 people/year in the UK, yet there is little accurate up-to-date data on how the incidence of and mortality from leukaemias vary with socio-economic status in the UK. We aimed to quantify the incidence of and mortality from leukaemias in the UK and their variation with gender, age, year of diagnosis as well as socio-economic status. Methods All incident cases of leuk...

  11. Snakebites in Two Rural Districts in Lao PDR: Community-Based Surveys Disclose High Incidence of an Invisible Public Health Problem.

    Directory of Open Access Journals (Sweden)

    Inthanomchanh Vongphoumy

    Full Text Available The Lao PDR (Laos is one of the least developed countries in Asia with an estimated 25% of the population living in poverty. It is the habitat of some highly venomous snakes and the majority of the population earns their living from agricultural activities. Under these circumstances the incidence of snakebites is expected to be high.Two cross-sectional, community-based surveys were performed in Champone and Phin district, Savannakhet province, Lao PDR to estimate snakebite incidence. Multistage random sampling was used. In the first stage approximately 40% of all villages in each district were randomly selected. In the second stage 33% of all households in each village were randomly chosen. Members of the selected households were interviewed about snakebites during the previous 12 months.Thirty-five of 9856 interviewees reported a snakebite in a 12 month period in Champone district and 79 of 7150 interviewees in Phin district. The estimated incidence is 355 snakebites per 100,000 persons per year and 1105 per 100,000 in Champone and Phin district respectively. All snakebite victims received treatment by traditional healers or self-treatment at home and nobody went to a hospital. Incidence of snakebites, calculated on the basis of hospital records of 14 district hospitals and Savannakhet provincial hospital, ranged from 3 to 14 cases per 100,000 persons per year between 2012 and 2014.Incidence of snakebites is high in rural communities in Laos with significant regional differences. Poverty most likely contributes significantly to the higher number of snakebites in Phin district. Hospital statistics profoundly underestimates snakebite incidence, because the majority of snakebite victims receive only treatment by traditional healers or self-treatment in their village. There is an urgent need to train medical staff and students in management of snakebite patients and make snake antivenom available to cope effectively with this important public

  12. Incidence of Cancer in Shenzhen, Guangdong Province during 2001–2015: A Retrospective Population-Based Study

    Directory of Open Access Journals (Sweden)

    Zhongyu Xu

    2017-09-01

    Full Text Available Cancer is a serious public health issue and the leading cause of death around the world. This article aimed to estimate the cancer incidence and the trend in standardized cancer incidence in Shenzhen, Guangdong province, South China during 2001–2015 by analyzing the cancer data of the population-based cancer registry in Shenzhen. Data were collected from the cancer registry in Shenzhen, which was conducted during 2001–2015. In this registry, the crude incidence rates, age-specific incidence rates, age-standardized incidence rates and cumulative incidence rates were calculated in every five years. Trends for standardized incidence rates of cancers were analyzed by using the joinpoint regression analysis. In total, 33,374.3 thousand person-years (17,593.9 thousand for males and 15,780.4 thousand for females were monitored over this time period. The number of new cancer cases during 2001–2015 was 59,218 (30,144 and 29,074 for males and females, respectively. The crude incidence during 2001–2005 was 136.44 per 100,000 persons, while the age-standardized rates by Chinese standard population (ASR-China and by world standard population (ASR-world were 165.13 and 212.48 per 100,000 persons, respectively. The crude incidence during 2006–2010 was 179.01 per 100,000 persons, while the ASR-China and ASR-world were 168.08 and 214.44 per 100,000 persons, respectively. The crude incidence during 2011–2015 was 196.53 per 100,000 persons, while the ASR-China and ASR-world were 171.44 and 219.99 per 100,000 persons, respectively. During 2001 and 2015, the joinpoint regression analysis showed that the ASR-China of cancer had an overall increase of 0.96% per year and 0.84% per year for males and females respectively, although both of these values (males and females were non-significant increases. The leading cancer types during 2011–2015 were lung, colorectal, thyroid gland, breast, liver, stomach, cervix, nasopharynx, leukemia and lymphoma. For males

  13. Self-Reported Snoring Frequency and Incidence of Cardiovascular Disease: The Circulatory Risk in Communities Study (CIRCS)

    Science.gov (United States)

    Nagayoshi, Mako; Tanigawa, Takeshi; Yamagishi, Kazumasa; Sakurai, Susumu; Kitamura, Akihiko; Kiyama, Masahiko; Okada, Takeo; Maeda, Kenji; Ohira, Tetsuya; Imano, Hironori; Sato, Shinichi; Iso, Hiroyasu

    2012-01-01

    Background Although associations between snoring and cardiovascular disease have been reported in several prospective studies, there is limited evidence from Asian populations. The objective of this study was to determine if there is an association between self-reported snoring frequency and the incidence of cardiovascular disease in Japanese. Methods The subjects were 2350 men and 4163 women aged 40 to 69 years who lived in 3 communities in Japan. All subjects were participants in the Circulatory Risk in Communities Study (CIRCS) and were followed for 6 years. Incidence of cardiovascular disease during the follow-up period comprised events of myocardial infarction, angina pectoris, sudden cardiac death and stroke. Results During the 6-year follow-up period, 97 participants (56 men and 41 women) had cardiovascular events. After adjustment for potential confounding factors, self-reported snoring frequency was associated with an increased risk of cardiovascular events among women but not men. The hazard ratios (95% CI) for cardiovascular events were 0.9 (0.4–2.0) for sometimes snoring and 2.5 (1.0–6.1) for everyday snoring in women and 0.7 (0.3–1.3) and 1.0 (0.5–2.1), respectively, in men. Further adjustment for body mass index attenuated the association in women; the respective hazard ratios for cardiovascular events were 0.9 (0.4–1.9) and 2.1 (0.9–5.4). Conclusions Self-reported habitual snoring was associated with increased risk of cardiovascular events among Japanese women. Overweight may partly mediate this association. PMID:22447210

  14. How often are patients harmed when they visit the computed tomography suite? A multi-year experience, in incident reporting, in a large academic medical center

    International Nuclear Information System (INIS)

    Mansouri, Mohammad; Aran, Shima; Shaqdan, Khalid W.; Abujudeh, Hani H.

    2016-01-01

    Our goal is to present our multi-year experience in incident reporting in CT in a large medical centre. This is an IRB-approved, HIPAA-compliant study. Informed consent was waived for this study. The electronic safety incident reporting system of our hospital was searched for the variables from April 2006 to September 2012. Incident classifications were diagnostic test orders, ID/documentation, safety/security/conduct, service coordination, surgery/procedure, line/tube, fall, medication/IV safety, employee general incident, environment/equipment, adverse drug reaction, skin/tissue and diagnosis/treatment. A total of 1918 incident reports occurred in the study period and 843,902 CT examinations were performed. The rate of safety incident was 0.22 % (1918/843,902). The highest incident rates were due to adverse drug reactions (652/843,902 = 0.077 %) followed by medication/IV safety (573/843,902 = 0.068 %) and diagnostic test orders (206/843,902 = 0.024 %). Overall 45 % of incidents (869/1918) caused no harm and did not affect the patient, 33 % (637/1918) caused no harm but affected the patient, 22 % (420/1918) caused temporary or minor harm/damage and less than 1 % (10/1918) caused permanent or major harm/damage or death. Our study shows a total safety incident report rate of 0.22 % in CT. The most common incidents are adverse drug reaction, medication/IV safety and diagnostic test orders. (orig.)

  15. Integrating data from the UK national reporting and learning system with work domain analysis to understand patient safety incidents in community pharmacy

    OpenAIRE

    Phipps, Denham L.; Tam, W. Vanessa; Ashcroft, Darren

    2017-01-01

    OBJECTIVES: To explore the combined use of a critical incident database and work domain analysis to understand patient safety issues in a health-care setting. METHOD: A retrospective review was conducted of incidents reported to the UK National Reporting and Learning System (NRLS) that involved community pharmacy between April 2005 and August 2010. A work domain analysis of community pharmacy was constructed using observational data from 5 community pharmacies, technical documentation, and a ...

  16. 75 FR 75911 - Adjustment of Monetary Threshold for Reporting Rail Equipment Accidents/Incidents for Calendar...

    Science.gov (United States)

    2010-12-07

    ...)) as required by the National Environmental Policy Act (42 U.S.C. 4321 et seq.), other environmental..., Notice No. 3] RIN 2130-ZA04 Adjustment of Monetary Threshold for Reporting Rail Equipment Accidents.... Notice and Comment Procedures and Effective Date In this rule, FRA has recalculated the monetary...

  17. 78 FR 77601 - Adjustment of Monetary Threshold for Reporting Rail Equipment Accidents/Incidents for Calendar...

    Science.gov (United States)

    2013-12-24

    ... required by the National Environmental Policy Act (42 U.S.C. 4321 et seq.), other environmental statutes..., Notice No. 6] RIN 2130-ZA12 Adjustment of Monetary Threshold for Reporting Rail Equipment Accidents..., or be subject to notice and comment. In 1996 FRA adopted a new method for calculating the monetary...

  18. 75 FR 922 - Notification and Reporting of Aircraft Accidents or Incidents and Overdue Aircraft, and...

    Science.gov (United States)

    2010-01-07

    ... language of the reporting requirement will achieve the NTSB's objective of receiving notification of any... recognizes that ``substantial risk of collision'' is somewhat subjective, but the infinite variety of... protect the public interest. The NTSB cannot delegate such responsibilities to external organizations...

  19. Childhood cancer incidence and survival in Japan and England: A population-based study (1993-2010).

    Science.gov (United States)

    Nakata, Kayo; Ito, Yuri; Magadi, Winnie; Bonaventure, Audrey; Stiller, Charles A; Katanoda, Kota; Matsuda, Tomohiro; Miyashiro, Isao; Pritchard-Jones, Kathy; Rachet, Bernard

    2018-02-01

    The present study aimed to compare cancer incidence and trends in survival for children diagnosed in Japan and England, using population-based cancer registry data. The analysis was based on 5192 children with cancer (age 0-14 years) from 6 prefectural cancer registries in Japan and 21 295 children diagnosed in England during 1993-2010. Differences in incidence rates between the 2 countries were measured with Poisson regression models. Overall survival was estimated using the Kaplan-Meier method. Incidence rates for Hodgkin lymphoma, renal tumors and Ewing sarcomas in England were more than twice as high as those in Japan. Incidence of germ cell tumors, hepatic tumors, neuroblastoma and acute myeloid leukemia (AML) was higher in Japan than in England. Incidence of all cancers combined decreased in Japan throughout the period 1993 to 2010, which was mainly explained by a decrease in registration of neuroblastoma in infants. For many cancers, 5-year survival improved in both countries. The improvement in survival in chronic myeloid leukemia (CML) was particularly dramatic in both countries. However, 5-year survival remained less than 80% in 2005-2008 in both countries for AML, brain tumors, soft tissue sarcomas, malignant bone tumors and neuroblastoma (age 1-14 years). There were significant differences in incidence of several cancers between countries, suggesting variation in genetic susceptibility and possibly environmental factors. The decrease in incidence for all cancers combined in Japan was related to the cessation of the national screening program for neuroblastoma. The large improvement in survival in CML coincided with the introduction of effective therapy (imatinib). © 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

  20. Patient safety incidents associated with obesity: a review of reports to the National Patient Safety Agency and recommendations for hospital practice.

    Science.gov (United States)

    Booth, C M A; Moore, C E; Eddleston, J; Sharman, M; Atkinson, D; Moore, J A

    2011-10-01

    The incidence and prevalence of obesity are increasing world wide. In the UK, obesity governmental strategy has primarily focused on prevention measures, with less focus on the demands of treating obese patients in hospital. Increasing service demand by obese patients coupled with a lack of adequate provision for care of these patients may lead to an increase in patient safety incidents. By classifying patient safety incidents associated with obesity reported to the National Patient Safety Agency, this report aims to identify areas for improvement in the quality and safety of care of the obese patient. A search of the National Reporting and Learning System database was conducted for all incidents caused by or relating to obesity for the period 1 January 2005 to 31 August 2008. The keywords 'obesity', 'overweight', 'BMI' (body mass index), and 'bariatric' were used. The relevant free text fields of the resulting set of incidents were then searched for the terms designed to isolate incidents occurring in anaesthesia, critical care, and surgery. Reported incidents were analysed and subsequently categorised to identify incident themes. Levels of harm were also established. 555 patient safety incidents were identified; 388 met inclusion criteria for analysis. 148 incidents were related to assessment, diagnosis or treatment, 213 related to infrastructure and 27 related to staffing. The majority of incidents were classified as no or low harm. Three deaths were reported, all within the domain of anaesthesia. This report identifies that the majority of safety incidents associated with obesity were related to infrastructure, suggesting that there is inadequate provision in place for the care of obese patients. While levels of harm were mostly low, the occurrence of incidents resulting in severe harm or death highlights the specific dangers associated with the care of the obese patient. A global approach to improving the safety of care delivery for obese patients is

  1. High incidence of community-acquired pneumonia among rapidly aging population in Japan: a prospective hospital-based surveillance.

    Science.gov (United States)

    Takaki, Masahiro; Nakama, Takahiro; Ishida, Masayuki; Morimoto, Hitomi; Nagasaki, Yuka; Shiramizu, Rina; Hamashige, Naohisa; Chikamori, Masayuki; Yoshida, Laymyint; Ariyoshi, Koya; Suzuki, Motoi; Morimoto, Konosuke

    2014-01-01

    The age-group-specific incidence and etiological patterns of community-acquired pneumonia (CAP) have not been fully established in Japan. A 2-year prospective surveillance was conducted in Kochi city, Western Japan. All CAP patients aged ≥15 years who visited a community-based hospital were enrolled in the study. Clinical samples were examined by conventional bacterial culture and urinary antigen tests, and 6 bacterial pathogens and 16 respiratory viruses were identified from sputum samples by multiplex polymerase chain reaction assays. The age-group-specific incidence of CAP was estimated using a population-based data set of the total number of outpatients in the whole city. Ninety of the 131 enrolled patients, 68.7% were positive for respiratory pathogens. Streptococcus pneumoniae was the leading bacterial pathogen identified (28.2%). Respiratory viruses were identified in 36 patients (27.5%), and human entero-rhinovirus was the most common (13.3%) among them. The estimated overall incidence of adult CAP in Kochi was 9.6 per 1,000 person-years (PY); the estimated age group-specific incidence was 3.4, 10.7, and 42.9 per 1,000 PY for those aged 15-64, 65-74, and ≥75 years, respectively. The high incidence of CAP in these rural city of Japan, probably reflects the substantial aged population. S. pneumoniae and respiratory viruses play important roles in CAP in all age groups.

  2. Incidence Rate of Community-Acquired Sepsis Among Hospitalized Acute Medical Patients-A Population-Based Survey

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Laursen, Christian B; Jensen, Thøger Gorm

    2015-01-01

    OBJECTIVE:: Sepsis is a frequent cause of admission, but incidence rates based on administrative data have previously produced large differences in estimates. The aim of the study was to estimate the incidence of community-acquired sepsis based on patients' symptoms and clinical findings at arrival...... to define the presence of systemic inflammatory response syndrome and organ dysfunction. MEASUREMENTS AND MAIN RESULTS:: Incidence rate of sepsis of any severity. Among 8,358 admissions to the medical emergency department, 1,713 patients presented with an incident admission of sepsis of any severity, median...... age 72 years (5-95%; range, 26-91 yr), 793 (46.3%) were men, 728 (42.5%) presented with a Charlson comorbidity index greater than 2,621 (36.3%) were admitted with sepsis, 1,071 (62.5%) with severe sepsis, and 21 (1.2%) with septic shock. Incidence rate was 731/100,000 person-years at risk (95% CI, 697...

  3. Increasing Incidence of Hospitalization for Stroke and Transient Ischemic Attack in Young Adults: A Registry-Based Study.

    Science.gov (United States)

    Tibæk, Maiken; Dehlendorff, Christian; Jørgensen, Henrik S; Forchhammer, Hysse B; Johnsen, Søren P; Kammersgaard, Lars P

    2016-05-11

    Studies have reported increasing incidence of ischemic stroke in adults younger than 50 to 55 years. Information on temporal trends of other stroke subtypes and transient ischemic attack (TIA) is sparse. The aim of this study was to investigate temporal trends of the incidence of hospitalizations for TIA and stroke including sex- and subtype-specific trends in young adults aged 15 to 30 years. From the Danish National Patient Register, we identified all cases of first-ever stroke and TIA (age 15-30 years) in Denmark, who were hospitalized during the study period of 1994 to 2012. Incidence rates and estimated annual percentage changes (EAPCs) were estimated by using Poisson regression. During the study period, 4156 cases of first-ever hospitalization for stroke/TIA were identified. The age-standardized incidence rates of hospitalizations for stroke increased significantly (EAPC 1.83% [95% CI 1.11-2.55%]) from 11.97/100 000 person-years (PY) in 1994 to 16.77/100 000 PY in 2012. TIA hospitalizations increased from 1.93/100 000 PY in 1994 to 5.81/100 000 PY in 2012 and after 2006 more markedly in men than in women (EAPC 16.61% [95% CI 10.45-23.12%]). The incidence of hospitalizations for ischemic stroke was markedly lower among men, but increased significantly from 2006 (EAPC 14.60% [95% CI 6.22-23.63%]). The incidences of hospitalizations for intracerebral hemorrhage and subarachnoid hemorrhage remained stable during the study period. The incidence rates of first-time hospitalizations for ischemic stroke and TIA in young Danish adults have increased substantially since the mid 1990s. The increase was particularly prominent in the most recent years. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  4. Preliminary report on operational guidelines developed for use in emergency preparedness and response to a radiological dispersal device incident.

    Energy Technology Data Exchange (ETDEWEB)

    Yu, C.; Cheng, J.-J.; Kamboj, S.; Domotor, S.; Wallo, A.; Environmental Science Division; DOE

    2006-12-15

    This report presents preliminary operational guidelines and supporting work products developed through the interagency Operational Guidelines Task Group (OGT). The report consolidates preliminary operational guidelines, all ancillary work products, and a companion software tool that facilitates their implementation into one reference source document. The report is intended for interim use and comment and provides the foundation for fostering future reviews of the operational guidelines and their implementation within emergency preparedness and response initiatives in the event of a radiological dispersal device (RDD) incident. The report principally focuses on the technical derivation and presentation of the operational guidelines. End-user guidance providing more details on how to apply these operational guidelines within planning and response settings is being considered and developed elsewhere. The preliminary operational guidelines are categorized into seven groups on the basis of their intended application within early, intermediate, and long-term recovery phases of emergency response. We anticipate that these operational guidelines will be updated and refined by interested government agencies in response to comments and lessons learned from their review, consideration, and trial application. This review, comment, and trial application process will facilitate the selection of a final set of operational guidelines that may be more or less inclusive of the preliminary operational guidelines presented in this report. These and updated versions of the operational guidelines will be made available through the OGT public Web site (http://ogcms.energy.gov) as they become finalized for public distribution and comment.

  5. Creating European guidelines for Chiropractic Incident Reporting and Learning Systems (CIRLS): relevance and structure

    OpenAIRE

    Wangler, Martin; Fujikawa, Ricardo; Hestbæk, Lise; Michielsen, Tom; Raven, Timothy J; Thiel, Haymo W; Zaugg, Beatrice

    2011-01-01

    Abstract Background In 2009, the heads of the Executive Council of the European Chiropractors' Union (ECU) and the European Academy of Chiropractic (EAC) involved in the European Committee for Standardization (CEN) process for the chiropractic profession, set out to establish European guidelines for the reporting of adverse reactions to chiropractic treatment. There were a number of reasons for this: first, to improve the overall quality of patient care by aiming to reduce the application of ...

  6. Determinants of self-reported bystander behavior in cyberbullying incidents amongst adolescents.

    Science.gov (United States)

    DeSmet, Ann; Veldeman, Charlene; Poels, Karolien; Bastiaensens, Sara; Van Cleemput, Katrien; Vandebosch, Heidi; De Bourdeaudhuij, Ilse

    2014-04-01

    This study explores behavioral determinants of self-reported cyberbullying bystander behavior from a behavioral change theoretical perspective, to provide levers for interventions. Nine focus groups were conducted with 61 young adolescents (aged 12-16 years, 52% girls). Assertive defending, reporting to others, providing advice, and seeking support were the most mentioned behaviors. Self-reported bystander behavior heavily depended on contextual factors, and should not be considered a fixed participant role. Bystanders preferred to handle cyberbullying offline and in person, and comforting the victim was considered more feasible than facing the bully. Most prevailing behavioral determinants to defend or support the victim were low moral disengagement, that the victim is an ingroup member, and that the bystander is popular. Youngsters felt they received little encouragement from their environment to perform positive bystanding behavior, since peers have a high acceptance for not defending and perceived parental support for defending behavior is largely lacking. These results suggest multilevel models for cyberbullying research, and interventions are needed. With much previous research into cyberbullying insufficiently founded in theoretical models, the employed framework of the Integrative Model and Social Cognitive Theory may inspire future studies into bystander behavior.

  7. Incidence of lumbar spondylolysis in the general population in Japan based on multidetector computed tomography scans from two thousand subjects.

    Science.gov (United States)

    Sakai, Toshinori; Sairyo, Koichi; Takao, Shoichiro; Nishitani, Hiromu; Yasui, Natsuo

    2009-10-01

    Epidemiological analysis using CTs. To investigate the true incidence of lumbar spondylolysis in the general population in Japan. Although there have been several reports on the incidence of lumbar spondylolysis, they had some weakness. One of them concerns the subjects investigated, because the incidence of lumbar spondylolysis varies considerably, and some patients are asymptomatic. In addition, most of the past studies used plain radiograph films or skeletal investigation. Therefore, the past reported incidence may not correspond to that of the general population. We reviewed the computed tomography (CT) scans of 2000 subjects (age: 20-92 years) who had undergone abdominal and pelvic CT on a single multidetector CT scanner for reasons unrelated to low back pain. We reviewed them for spondylolysis, spondylolytic spondylolisthesis, and spina bifida occulta (SBO) in the lumbosacral region. The grade (I-IV) of spondylolisthesis was measured using midsagittal reconstructions. Lumbar spondylolysis was found in 117 subjects (5.9%). Their male-female ratio was 2:1. Multiple-level spondylolysis was found in 5 subjects (0.3%). Among these 117 subjects, there were 124 vertebrae with spondylolysis. Of them, 112 (90.3%) corresponded to L5, and 26 (21.0%) had unilateral spondylolysis.SBO was found in 154 subjects. Of them, 25 had spondylolysis (16.2%), whereas, in 1846 subjects without SBO, 92 had spondylolysis (5.0%). The incidence of spondylolysis among the patients with SBO was significantly higher than that in subjects without SBO (Odd ratio was 3.7-fold).Of 124 vertebrae with spondylolysis, 75 (60.5%) showed low-grade (Meyerding grade I or II) spondylolisthesis, and no subject presented high-grade spondylolisthesis. Spondylolisthesis was found in 74.5% of the subjects with bilateral spondylolysis, and in 7.7% of those with unilateral spondylolysis. The incidence of lumbar spondylolysis in the Japanese general population was 5.9% (males: 7.9%, females: 3.9%).

  8. Report on Pairing-based Cryptography

    Science.gov (United States)

    Moody, Dustin; Peralta, Rene; Perlner, Ray; Regenscheid, Andrew; Roginsky, Allen; Chen, Lily

    2015-01-01

    This report summarizes study results on pairing-based cryptography. The main purpose of the study is to form NIST’s position on standardizing and recommending pairing-based cryptography schemes currently published in research literature and standardized in other standard bodies. The report reviews the mathematical background of pairings. This includes topics such as pairing-friendly elliptic curves and how to compute various pairings. It includes a brief introduction to existing identity-based encryption (IBE) schemes and other cryptographic schemes using pairing technology. The report provides a complete study of the current status of standard activities on pairing-based cryptographic schemes. It explores different application scenarios for pairing-based cryptography schemes. As an important aspect of adopting pairing-based schemes, the report also considers the challenges inherent in validation testing of cryptographic algorithms and modules. Based on the study, the report suggests an approach for including pairing-based cryptography schemes in the NIST cryptographic toolkit. The report also outlines several questions that will require further study if this approach is followed. PMID:26958435

  9. Report on Pairing-based Cryptography.

    Science.gov (United States)

    Moody, Dustin; Peralta, Rene; Perlner, Ray; Regenscheid, Andrew; Roginsky, Allen; Chen, Lily

    2015-01-01

    This report summarizes study results on pairing-based cryptography. The main purpose of the study is to form NIST's position on standardizing and recommending pairing-based cryptography schemes currently published in research literature and standardized in other standard bodies. The report reviews the mathematical background of pairings. This includes topics such as pairing-friendly elliptic curves and how to compute various pairings. It includes a brief introduction to existing identity-based encryption (IBE) schemes and other cryptographic schemes using pairing technology. The report provides a complete study of the current status of standard activities on pairing-based cryptographic schemes. It explores different application scenarios for pairing-based cryptography schemes. As an important aspect of adopting pairing-based schemes, the report also considers the challenges inherent in validation testing of cryptographic algorithms and modules. Based on the study, the report suggests an approach for including pairing-based cryptography schemes in the NIST cryptographic toolkit. The report also outlines several questions that will require further study if this approach is followed.

  10. A comparison of self-report and antiretroviral detection to inform estimates of antiretroviral therapy coverage, viral load suppression and HIV incidence in Kwazulu-Natal, South Africa.

    Science.gov (United States)

    Huerga, Helena; Shiferie, Fisseha; Grebe, Eduard; Giuliani, Ruggero; Farhat, Jihane Ben; Van-Cutsem, Gilles; Cohen, Karen

    2017-09-29

    Accurately identifying individuals who are on antiretroviral therapy (ART) is important to determine ART coverage and proportion on ART who are virally suppressed. ART is also included in recent infection testing algorithms used to estimate incidence. We compared estimates of ART coverage, viral load suppression rates and HIV incidence using ART self-report and detection of antiretroviral (ARV) drugs and we identified factors associated with discordance between the methods. Cross-sectional population-based survey in KwaZulu-Natal, South Africa. Individuals 15-59 years were eligible. Interviews included questions about ARV use. Rapid HIV testing was performed at the participants' home. Blood specimens were collected for ARV detection, LAg-Avidity HIV incidence testing and viral load quantification in HIV-positive individuals. Multivariate logistic regression models were used to identify socio-demographic covariates associated with discordance between self-reported ART and ARV detection. Of the 5649 individuals surveyed, 1423 were HIV-positive. Median age was 34 years and 76.3% were women. ART coverage was estimated at 51.4% (95%CI:48.5-54.3), 53.1% (95%CI:50.2-55.9) and 56.1% (95%CI:53.5-58.8) using self-reported ART, ARV detection and both methods combined (classified as ART exposed if ARV detected and/or ART reported) respectively. ART coverage estimates using the 3 methods were fairly similar within sex and age categories except in individuals aged 15-19 years: 33.3% (95%CI:23.3-45.2), 33.8% (95%CI:23.9-45.4%) and 44.3% (95%CI:39.3-46.7) using self-reported ART, ARV detection and both methods combined. Viral suppression below 1000cp/mL in individuals on ART was estimated at 89.8% (95%CI:87.3-91.9), 93.1% (95%CI:91.0-94.8) and 88.7% (95%CI:86.2-90.7) using self-reported ART, ARV detection and both methods combined respectively. HIV incidence was estimated at 1.4 (95%CI:0.8-2.0) new cases/100 person-years when employing no measure of ARV use, 1.1/100PY (95%CI:0

  11. Incidence and risk of chronic obstructive pulmonary disease in a Korean community-based cohort

    Directory of Open Access Journals (Sweden)

    Leem AY

    2018-02-01

    Full Text Available Ah Young Leem,1 Boram Park,2 Young Sam Kim,1 Ji Ye Jung,1 Sungho Won2 1Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, 2Department of Epidemiology and Biostatistics, School of Public Health, Seoul National University, Seoul, Korea Purpose: COPD is a leading cause of morbidity and mortality. However, few studies have used spirometry to investigate its incidence, especially in Asia. In the present study, we analyzed the incidence and risk factors of COPD using a community cohort database in Korea. Patients and methods: The study included 6,517 subjects aged 40–69 years from the Ansung–Ansan cohort database I–III (2001–2006. We calculated the crude incidence rate and the standardized incidence rate corrected for the Korean general population and the world population with COPD. We also determined the relative risks (RRs for incident COPD and the attributable risks. Results: In total, 329 new COPD cases were diagnosed during follow-up. The overall crude incidence rate per 100,000 person-years was 1,447. The standardized incidence rate corrected for the Korean general population was 1,550; this value was higher in men and increased with increasing age. Risk factors for incident COPD were age ≥60 years (adjusted RR [aRR] =2.52 vs age <60 years, male sex (aRR =2.02 vs female, heavy smoking (≥20 pack-years; aRR =2.54 vs never smoker, and lowest income group (first quartile; aRR =2.03 vs fourth quartile. The adjusted attributable risk was highest for education level of high school or lower (44.9%, followed by smoking history (25.8%, income (22.9%, and sex (12.0%. Conclusion: In Korea, 15.5/1,000 people are diagnosed with COPD annually. The incidence rate increases with increasing age, heavier smoking, and decreasing income, with a higher rate in men than in women. Keywords: chronic obstructive pulmonary disease, incidence rate, relative

  12. Men's and Women's Health Beliefs Differentially Predict Coronary Heart Disease Incidence in a Population-Based Sample

    Science.gov (United States)

    Korin, Maya Rom; Chaplin, William F.; Shaffer, Jonathan A.; Butler, Mark J.; Ojie, Mary-Jane; Davidson, Karina W.

    2013-01-01

    Objective: To examine gender differences in the association between beliefs in heart disease preventability and 10-year incidence of coronary heart disease (CHD) in a population-based sample. Methods: A total of 2,688 Noninstitutionalized Nova Scotians without prior CHD enrolled in the Nova Scotia Health Study (NSHS95) and were followed for 10…

  13. 31 CFR 560.540 - Exportation of certain services and software incident to Internet-based communications.

    Science.gov (United States)

    2010-07-01

    ....540 Exportation of certain services and software incident to Internet-based communications. (a) To the....S. persons, wherever located, to persons in Iran of software necessary to enable the services... indirect exportation of services or software with knowledge or reason to know that such services or...

  14. 31 CFR 538.533 - Exportation of certain services and software incident to Internet-based communications.

    Science.gov (United States)

    2010-07-01

    ....533 Exportation of certain services and software incident to Internet-based communications. (a) To the....S. persons, wherever located, to persons in Sudan of software necessary to enable the services... indirect exportation of services or software with knowledge or reason to know that such services or...

  15. Incidence of symptomatic osteochondritis dissecans lesions of the knee : A population-based study in Olmsted County

    NARCIS (Netherlands)

    Pareek, A.; Sanders, T. L.; Wu, I. T.; Larson, D. R.; Saris, D. B.F.; Krych, A.J.

    2017-01-01

    Objective: To (1) define population-based incidence of knee Osteochondritis dissecans (OCD) lesions using the population of Olmsted County, (2) examine trends over time, and (3) evaluate rate of surgical management over time. Method: Study population included 302 individuals who were diagnosed with

  16. Confirmation of the reported association of clonal chromosomal mosaicism with an increased risk of incident hematologic cancer.

    Directory of Open Access Journals (Sweden)

    Ursula M Schick

    Full Text Available Chromosomal abnormalities provide clinical utility in the diagnosis and treatment of hematologic malignancies, and may be predictive of malignant transformation in individuals without apparent clinical presentation of a hematologic cancer. In an effort to confirm previous reports of an association between clonal mosaicism and incident hematologic cancer, we applied the anomDetectBAF algorithm to call chromosomal anomalies in genotype data from previously conducted Genome Wide Association Studies (GWAS. The genotypes were initially collected from DNA derived from peripheral blood of 12,176 participants in the Group Health electronic Medical Records and Genomics study (eMERGE and the Women's Health Initiative (WHI. We detected clonal mosaicism in 169 individuals (1.4% and large clonal mosaic events (>2 mb in 117 (1.0% individuals. Though only 9.5% of clonal mosaic carriers had an incident diagnosis of hematologic cancer (multiple myeloma, myelodysplastic syndrome, lymphoma, or leukemia, the carriers had a 5.5-fold increased risk (95% CI: 3.3-9.3; p-value = 7.5×10(-11 of developing these cancers subsequently. Carriers of large mosaic anomalies showed particularly pronounced risk of subsequent leukemia (HR = 19.2, 95% CI: 8.9-41.6; p-value = 7.3×10(-14. Thus we independently confirm the association between detectable clonal mosaicism and hematologic cancer found previously in two recent publications.

  17. Cancer incidence predictions in the North of Portugal: keeping population-based cancer registration up to date.

    Science.gov (United States)

    Castro, Clara; Antunes, Luís; Lunet, Nuno; Bento, Maria José

    2016-09-01

    Decision making towards cancer prevention and control requires monitoring of trends in cancer incidence and accurate estimation of its burden in different settings. We aimed to estimate the number of incident cases in northern Portugal for 2015 and 2020 (all cancers except nonmelanoma skin and for the 15 most frequent tumours). Cancer cases diagnosed in 1994-2009 were collected by the North Region Cancer Registry of Portugal (RORENO) and corresponding population figures were obtained from Statistics Portugal. JoinPoint regression was used to analyse incidence trends. Population projections until 2020 were derived by RORENO. Predictions were performed using the Poisson regression models proposed by Dyba and Hakulinen. The number of incident cases is expected to increase by 18.7% in 2015 and by 37.6% in 2020, with lower increments among men than among women. For most cancers considered, the number of cases will keep rising up to 2020, although decreasing trends of age-standardized rates are expected for some tumours. Cervix was the only cancer with a decreasing number of incident cases in the entire period. Thyroid and lung cancers were among those with the steepest increases in the number of incident cases expected for 2020, especially among women. In 2020, the top five cancers are expected to account for 82 and 62% of all cases diagnosed in men and women, respectively. This study contributes to a broader understanding of cancer burden in the north of Portugal and provides the basis for keeping population-based incidence estimates up to date.

  18. Springtime Peaks and Christmas Troughs: A National Longitudinal Population-Based Study into Suicide Incidence Time Trends in the Netherlands

    Directory of Open Access Journals (Sweden)

    Emma Hofstra

    2018-02-01

    Full Text Available BackgroundTime trends are one of the most studied phenomena in suicide research; however, evidence for time trends in the Dutch population remains understudied. Insight into time trends can contribute to the development of effective suicide prevention strategies.MethodsTime trends in national daily and monthly data of 33,224 suicide events that occurred in the Netherlands from 1995 to 2015 were examined, as well as the influence of age, gender, and province, in a longitudinal population-based design with Poisson regression analyses and Bayesian change point analyses.ResultsSuicide incidence among Dutch residents increased from 2007 until 2015 by 38%. Suicide rates peak in spring, up to 8% higher than in summer (p < 0.001. Suicide incidence was 42% lower at Christmas, compared to the December-average (IRR = 0.580, p < 0.001. After Christmas, a substantial increase occurred on January 1, which remained high during the first weeks of the new year. Suicide