Okuyama, A.; Wagner, C.; Bijnen, A.B.
Background: Speaking up is important for patient safety, but often, health care professionals hesitate to voice concerns. Understanding the influencing factors can help to improve speaking-up behaviour and team communication. This review focused on health care professionals' speaking-up behaviour
Okuyama, A.; Wagner, C.; Bijnen, B.
Background: Speaking up is important for patient safety, but often, health care professionals hesitate to voice concerns. Understanding the influencing factors can help to improve speaking-up behaviour and team communication. This review focused on health care professionals’ speaking-up behaviour
Cunningham, Frances C; Ranmuthugala, Geetha; Plumb, Jennifer; Georgiou, Andrew; Westbrook, Johanna I; Braithwaite, Jeffrey
While there is a considerable corpus of theoretical and empirical literature on networks within and outside of the health sector, multiple research questions are yet to be answered. To conduct a systematic review of studies of professionals' network structures, identifying factors associated with network effectiveness and sustainability, particularly in relation to quality of care and patient safety. The authors searched MEDLINE, CINAHL, EMBASE, Web of Science and Business Source Premier from January 1995 to December 2009. A majority of the 26 unique studies identified used social network analysis to examine structural relationships in networks: structural relationships within and between networks, health professionals and their social context, health collaboratives and partnerships, and knowledge sharing networks. Key aspects of networks explored were administrative and clinical exchanges, network performance, integration, stability and influences on the quality of healthcare. More recent studies show that cohesive and collaborative health professional networks can facilitate the coordination of care and contribute to improving quality and safety of care. Structural network vulnerabilities include cliques, professional and gender homophily, and over-reliance on central agencies or individuals. Effective professional networks employ natural structural network features (eg, bridges, brokers, density, centrality, degrees of separation, social capital, trust) in producing collaboratively oriented healthcare. This requires efficient transmission of information and social and professional interaction within and across networks. For those using networks to improve care, recurring success factors are understanding your network's characteristics, attending to its functioning and investing time in facilitating its improvement. Despite this, there is no guarantee that time spent on networks will necessarily improve patient care.
Okuyama, Ayako; Wagner, Cordula; Bijnen, Bart
Speaking up is important for patient safety, but often, health care professionals hesitate to voice concerns. Understanding the influencing factors can help to improve speaking-up behaviour and team communication. This review focused on health care professionals' speaking-up behaviour for patient safety and aimed at (1) assessing the effectiveness of speaking up, (2) evaluating the effectiveness of speaking-up training, (3) identifying the factors influencing speaking-up behaviour, and (4) developing a model for speaking-up behaviour. Five databases (PubMed, MEDLINE, CINAHL, Web of Science, and the Cochrane Library) were searched for English articles describing health care professionals' speaking-up behaviour as well as those evaluating the relationship between speaking up and patient safety. Influencing factors were identified and then integrated into a model of voicing behaviour. In total, 26 studies were identified in 27 articles. Some indicated that hesitancy to speak up can be an important contributing factor in communication errors and that training can improve speaking-up behaviour. Many influencing factors were found: (1) the motivation to speak up, such as the perceived risk for patients, and the ambiguity or clarity of the clinical situation; (2) contextual factors, such as hospital administrative support, interdisciplinary policy-making, team work and relationship between other team members, and attitude of leaders/superiors; (3) individual factors, such as job satisfaction, responsibility toward patients, responsibility as professionals, confidence based on experience, communication skills, and educational background; (4) the perceived efficacy of speaking up, such as lack of impact and personal control; (5) the perceived safety of speaking up, such as fear for the responses of others and conflict and concerns over appearing incompetent; and (6) tactics and targets, such as collecting facts, showing positive intent, and selecting the person who has
Guerra, Olivia; Kurtz, Donna
Phenomenon: This scoping literature review summarizes current Canadian health science education and training aimed to lessen health gaps between Aboriginal and non-Aboriginal peoples. Keyword searches of peer-reviewed and gray literature databases, websites, and resources recommended by local Aboriginal community members identified 1,754 resources. Using specific inclusion and exclusion criteria, 26 resources relevant to education and training of healthcare professionals and students in Canada were selected. Information included self-assessment for cultural competency/safety skills, advocacy within Canadian healthcare, and descriptions of current programs and training approaches. In spite of increasing awareness and use of cultural competency and safety concepts, few programs have been successfully implemented. Insights: A concerted effort among health science education and training bodies to develop integrated and effective programs could result in comprehensive processes that hasten the Canadian culturally safe healthcare provision, thus reducing the gaps among populations.
Ebben, Remco H A; Vloet, Lilian C M; Speijers, Renate F; Tönjes, Nico W; Loef, Jorik; Pelgrim, Thomas; Hoogeveen, Margreet; Berben, Sivera A A
This systematic review aimed to describe non-conveyance in ambulance care from patient-safety and ambulance professional perspectives. The review specifically focussed at describing (1) ambulance non-conveyance rates, (2) characteristics of non-conveyed patients, (3) follow-up care after non-conveyance, (4) existing guidelines or protocols, and (5) influencing factors during the non-conveyance decision making process. We systematically searched MEDLINE, PubMed, CINAHL, EMBASE, and reference lists of included articles, in June 2016. We included all types of peer-reviewed designs on the five topics. Couples of two independent reviewers performed the selection process, the quality assessment, and data extraction. We included 67 studies with low to moderate quality. Non-conveyance rates for general patient populations ranged from 3.7%-93.7%. Non-conveyed patients have a variety of initial complaints, common initial complaints are related to trauma and neurology. Furthermore, vulnerable patients groups as children and elderly are more represented in the non-conveyance population. Within 24 h-48 h after non-conveyance, 2.5%-6.1% of the patients have EMS representations, and 4.6-19.0% present themselves at the ED. Mortality rates vary from 0.2%-3.5% after 24 h, up to 0.3%-6.1% after 72 h. Criteria to guide non-conveyance decisions are vital signs, ingestion of drugs/alcohol, and level of consciousness. A limited amount of non-conveyance guidelines or protocols is available for general and specific patient populations. Factors influencing the non-conveyance decision are related to the professional (competencies, experience, intuition), the patient (health status, refusal, wishes and best interest), the healthcare system (access to general practitioner/other healthcare facilities/patient information), and supportive tools (online medical control, high risk card). Non-conveyance rates for general and specific patient populations vary. Patients in the non
This report presents safety information about powered industrial trucks. The basic lift truck, the counterbalanced sit down rider truck, is the primary focus of the report. Lift truck engineering is briefly described, then a hazard analysis is performed on the lift truck. Case histories and accident statistics are also given. Rules and regulations about lift trucks, such as the US Occupational Safety an Health Administration laws and the Underwriter`s Laboratories standards, are discussed. Safety issues with lift trucks are reviewed, and lift truck safety and reliability are discussed. Some quantitative reliability values are given.
Dolz-Güerri, F; Gómez-Durán, E L; Martínez-Palmer, A; Castilla Céspedes, M; Arimany-Manso, J
Patient safety is an international public health priority. Ophthalmology scientific societies and organisations have intensified their efforts in this field. As a tool to learn from errors, these efforts have been linked to the management of medical professional liability insurance through the analysis of claims. A review is performed on the improvements in patient safety, as well as professional liability issues in Ophthalmology. There is a high frequency of claims and risk of economic reparation of damage in the event of a claim in Ophthalmology. Special complaints, such as wrong surgery or lack of information, have a high risk of financial compensation and need strong efforts to prevent these potentially avoidable events. Studies focused on pathologies or specific procedures provide information of special interest to sub-specialists. The specialist in Ophthalmology, like any other doctor, is subject to the current legal provisions and appropriate mandatory training in the medical-legal aspects of health care is essential. Professionals must be aware of the fundamental aspects of medical professional liability, as well as specific aspects, such as defensive medicine and clinical safety. The understanding of these medical-legal aspects in the routine clinical practice can help to pave the way towards a satisfactory and safe professional career, and help in increasing patient safety. The aim of this review is to contribute to this training, for the benefit of professionals and patients. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.
Chretien, Katherine C; Tuck, Matthew G
The rise of social media has increased connectivity and blurred personal and professional boundaries, bringing new challenges for medical professionalism. Whether traditional professionalism principles apply to the online social media space remains unknown. The purpose of this synthetic literature review was to characterize the original peer-reviewed research studies published between 1 January 2000-1 November 2014 on online professionalism, to assess methodologies and approaches used, and to provide insights to guide future studies in this area. The investigators searched three databases and performed manual searches of bibliographies to identify the 32 studies included. Most studies originated in the USA. Cross-sectional surveys and analyses of publicly available online content were the most common methodologies employed. Studies covered the general areas of use and privacy, assessment of unprofessional online behaviours, consensus-gathering of what constitutes unprofessional or inappropriate online behaviours, and education and policies. Studies were of variable quality; only around half of survey studies had response rates of 50% or greater. Medical trainees were the most common population studied. Future directions for research include public perspectives of online professionalism, impact on patient trust, and how to use social media productively as medical professionals.
Full Text Available Title of the monograph: Systems Approach to Knowledge Modelling. Authors: dr. Ludmila Dömeová; dr. Milan Houška; dr. Martina Houšková Beránková. Cover designer: Olga Čermáková. Interior designer: Roman Kvasnička. Publisher: Graphical Studio Olga Čermáková, Czech Republic. Place: Hradec Králové, Czech Republic. Year of publication: 2008. Number of pages: 282. Recommended price of the book: 39.90 EUR. First edition. Reviewer : dr. Stanislava Mildeová; Department of Systems Analysis, Faculty of Informatics and Statistics, University of Economics, Prague.
Kangasniemi, Mari; Pakkanen, Piiku; Korhonen, Anne
To conduct an integrative review and synthesize current primary studies of professional ethics in nursing. Professional ethics is a familiar concept in nursing and provides an ethical code for nursing practice. However, little is known about how professional ethics has been defined and studied in nursing science. Systematic literature searches from 1948-February 2013, using the CINAHL, PubMed and Scopus electronic databases to look at previously published peer-reviewed studies. A modified version of Cooper's five-stage integrative review was used to review and synthesize current knowledge. Fourteen papers were included in this research. According to our synthesis, professional ethics is described as an intra-professional approach to care ethics and professionals commit to it voluntarily. Professional ethics consist of values, duties, rights and responsibilities, regulated by national legislation and international agreements and detailed in professional codes. Professional ethics is well established in nursing, but is constantly changing due to internal and external factors affecting the profession. Despite the obvious importance of professional ethics, it has not been studied much in nursing science. Greater knowledge of professional ethics is needed to understand and support nurses' moral decision-making and to respond to the challenges of current changes in health care and society. © 2015 John Wiley & Sons Ltd.
Dupree, Erin; Anderson, Rebecca; McEvoy, Mary Dee; Brodman, Michael
A safety culture requires the highest levels of professionalism. A Code of Professionalism was created in an obstetrics service line as a mechanism to address unprofessional behavior. In this initiative, a multidisciplinary Code of Professionalism was established, with the support of leadership and the employee and nursing unions, to help create a safety culture. In 2005 the Code of Professionalism was introduced to physicians, nurses, and support staff. The U.S. Agency for Healthcare Research and Quality (AHRQ) Patient Safety Culture Survey was used, along with a portion of the Institute for Safe Medication Practices (ISMP) Survey on Workplace Intimidation to measure changes in the safety culture. Data were collected in 2005, 2008, and 2011. One hundred thirty-four reports were made to the committee on professionalism between February 2005 and December 2010. Some 96 (72%) of the reports were submitted by nurses, with physicians accounting for 13%. Seventy-five of the reports (56%) were about unprofessional behavior by physicians and 46 (34%) were about unprofessional nursing behavior. On the AHRQ Patient Safety Culture Survey, statistically significant improvement was shown in the Teamwork Within Units dimension, from 2005 to 2008; the Management Support dimension, from 2005 to 2008; the Organizational Learning dimension, from 2005 to 2008 and also from 2008 to 2011; and the Frequency of Events Reported dimension, from 2008 to 2011. Implementing a multidisciplinary Code of Professionalism can improve the safety culture in a hospital. When leadership sets clear standards and holds physicians and staff to the same standard, improvements in an organization's safety culture can serve as the foundation for the delivery of safer care.
Shivers, Charles H.
Common and unique issues contribute to system failures. This paper touches on the concept of drift to failure as a cautionary message. Managers and leaders, design team members, fabricators and assemblers, analysis and assurance personnel, and others associated with operating and maintaining systems, need to pay attention to identify the manifestation of individual and collective behaviors that might indicate slips in rigor or focus or decisions that might eat away at safety margins as our system drifts to failure. Corrections to drift made during design and development phases may efficiently prevent or mitigate drift problems occurring in the operational phase.
In July 1994, the Executive Director for Operations of the US Nuclear Regulatory Commission (NRC) appointed a Special Review Panel to assess the Differing Professional View or Opinion (DPV/DPO) process, including its effectiveness, how well it is understood by employees, and the organizational climate for having such views aired and properly decided. An additional area within this review was to address the effectiveness of the DPO procedures as they pertain to public access and confidentiality. Further, the Panel was charged with the review of the submittals completed since the last review to identify employees who made significant contributions to the agency or to the public health and safety but had not been adequately recognized for this contribution. The report presents the Special Review Panel`s evaluation of the NRC`s current process for dealing with Differing Professional Views or Opinions. Provided in this report are the results of an employee opinion survey on the process; highlights and suggestions from interviews with individuals who had submitted a Differing Professional View or Opinion, as well as with agency managers directly involved with the Differing Professional Views or Opinions process; and the Special Review Panel`s recommendations for improving the DPV/DPO process.
Martijn, L.M.; Harmsen, M.; Gaal, S.; Mettes, D.G.; Dulmen, S.A. van; Wensing, M.
OBJECTIVE: The study aims to explore whether health care professionals' perceptions of patient safety in their practice were associated with the number of patient safety incidents identified in patient records. SETTING: Seventy primary care practices of general practice, general dental practice,
Al Malki, Adel; Endacott, Ruth; Innes, Kelli
To examine attitudes to patient safety in two intensive care units from the perspective of health care professionals in Saudi Arabia. Despite adverse errors leading to poor patient outcomes, there is a paucity of literature, including staff perceptions, on adverse errors in Saudi Arabian intensive care units. A descriptive cross-sectional design was used. Health professionals (n = 144) completed the safety attitude questionnaire-intensive care unit. The scores from the six safety domains of the safety attitude questionnaire-intensive care unit showed all respondents had a negative attitude towards patient safety, with participants in one intensive care unit scoring lower in all domains. The mean scores across all domains ranged from 47.1 to 70.3 on a 100-point scale, with the lowest score reported in the "perceptions of management" domain. Respiratory therapists reported a significantly higher job satisfaction score than nurses, and physicians rated communication amongst themselves and nurses as high. There are significant challenges for safety culture in this study, with negative attitudes across all domains. Managers may need to review and consider policies relating to safety culture including workforce planning, leadership and patient centred care. Further research into this global health priority is required to contribute to improving patient safety in intensive care units. © 2017 John Wiley & Sons Ltd.
Bori, G; Gómez-Durán, E L; Combalia, A; Trilla, A; Prat, A; Bruguera, M; Arimany-Manso, J
The specialist in orthopaedic and traumatological surgery, like any other doctor, is subject to the current legal provisions while exercising their profession. Mandatory training in the medical-legal aspects of health care is essential. Claims against doctors are a reality, and orthopaedic and traumatological surgery holds first place in terms of frequency of claims according to the data from the General Council of Official Colleges of Doctors of Catalonia. Professionals must be aware of the fundamental aspects of medical professional liability, as well as specific aspects, such as defensive medicine and clinical safety. The understanding of these medical-legal aspects in the routine clinical practice can help to pave the way towards a satisfactory and safe professional career. The aim of this review is to contribute to this training, for the benefit of professionals and patients. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.
Manfrin-Ledet, Linda; Porche, Demetrius J; Eymard, Amanda S
The purpose of this article is to review the nursing literature related to professional boundary violations in nursing. A search was conducted using CINAHL, MEDLINE, Ebscohost, and NCSBN. The key words searched were professional boundaries, boundary violation, boundary crossings, nurse, home health nurses, and home nursing. The search returned over 40 publications related specifically to boundary violations and nursing although only four of them are published research studies and one as a dissertation. Seven common characteristics emerged from the nonresearch nursing articles on professional boundaries: (1) Dual relations/role reversal, (2) Gifts and money, (3) Excessive self-disclosure, (4) Secretive behavior, (5) Excessive attention/overinvolvement, (6) Sexual behavior, and (7) Social media. Additional nursing research is greatly needed in the area of professional boundaries. The nurse-patient relationship should always be maintained for the benefit of the patient and not the personal gain of the nurse. Ongoing education in nursing practice regarding professional boundaries is needed. Nurses need to be mindful of state practice acts, codes of conduct, and employer policies.
Chuang, Chien-Huai; Tseng, Pei-Chi; Lin, Chun-Yu; Lin, Kuan-Han; Chen, Yen-Yuan
Burnout has been described as a prolonged response to chronic emotional and interpersonal stress on the job that is often the result of a period of expending excessive effort at work while having too little recovery time. Healthcare workers who work in a stressful medical environment, especially in an intensive care unit (ICU), may be particularly susceptible to burnout. In healthcare workers, burnout may affect their well-being and the quality of professional care they provide and can, therefore, be detrimental to patient safety. The objectives of this study were: to determine the prevalence of burnout in the ICU setting; and to identify factors associated with burnout in ICU professionals. The original articles for observational studies were retrieved from PubMed, MEDLINE, and Web of Science in June 2016 using the following MeSH terms: "burnout" and "intensive care unit". Articles that were published in English between January 1996 and June 2016 were eligible for inclusion. Two reviewers evaluated the abstracts identified using our search criteria prior to full text review. To be included in the final analysis, studies were required to have employed an observational study design and examined the associations between any risk factors and burnout in the ICU setting. Overall, 203 full text articles were identified in the electronic databases after the exclusion of duplicate articles. After the initial review, 25 studies fulfilled the inclusion criteria. The prevalence of burnout in ICU professionals in the included studies ranged from 6% to 47%. The following factors were reported to be associated with burnout: age, sex, marital status, personality traits, work experience in an ICU, work environment, workload and shift work, ethical issues, and end-of-life decision-making. The impact of the identified factors on burnout remains poorly understood. Nevertheless, this review presents important information, suggesting that ICU professionals may suffer from a high level
Debourgh, Gregory A; Prion, Susan K
Nurses in practice and students in training often fear hurting a patient or doing something wrong. Experienced nurses have developed assessment skills and clinical intuition to recognize and intervene to prevent patient risk and harm. Beginning nursing students have not yet had the opportunity to develop an awareness of patient risk, safety concerns, or a clear sense of their accountability in the nurse role as the primary advocate for patient safety. In this Safety Manifesto, the authors call for educators to critically review their prelicensure curricula for inclusion of teaching and learning activities that are focused on patient safety and offer recommendations for curricular changes with an emphasis on integration of instructional strategies that develop students' skills for clinical reasoning and judgment. Copyright © 2012 Elsevier Inc. All rights reserved.
This report gives a review of investigations into Internet safety and security over the last 10 years. The review covers a number of surveys of Internet usage, of Internet security in general, and of Internet users' awareness of issues related to safety and security. The focus and approach...
Cole, Kerstan Suzanne; Stevens-Adams, Susan Marie; Wenner, Caren A.
Workplace safety has been historically neglected by organizations in order to enhance profitability. Over the past 30 years, safety concerns and attention to safety have increased due to a series of disastrous events occurring across many different industries (e.g., Chernobyl, Upper Big-Branch Mine, Davis-Besse etc.). Many organizations have focused on promoting a healthy safety culture as a way to understand past incidents, and to prevent future disasters. There is an extensive academic literature devoted to safety culture, and the Department of Energy has also published a significant number of documents related to safety culture. The purpose of the current endeavor was to conduct a review of the safety culture literature in order to understand definitions, methodologies, models, and successful interventions for improving safety culture. After reviewing the literature, we observed four emerging themes. First, it was apparent that although safety culture is a valuable construct, it has some inherent weaknesses. For example, there is no common definition of safety culture and no standard way for assessing the construct. Second, it is apparent that researchers know how to measure particular components of safety culture, with specific focus on individual and organizational factors. Such existing methodologies can be leveraged for future assessments. Third, based on the published literature, the relationship between safety culture and performance is tenuous at best. There are few empirical studies that examine the relationship between safety culture and safety performance metrics. Further, most of these studies do not include a description of the implementation of interventions to improve safety culture, or do not measure the effect of these interventions on safety culture or performance. Fourth, safety culture is best viewed as a dynamic, multi-faceted overall system composed of individual, engineered and organizational models. By addressing all three components of
Stolt, Minna; Leino-Kilpi, Helena; Ruokonen, Minka; Repo, Hanna; Suhonen, Riitta
The ethics and value bases in healthcare are widely acknowledged. There is a need to improve and raise awareness of ethics in complex systems and in line with competing needs, different stakeholders and patients' rights. Evidence-based strategies and interventions for the development of procedures and practice have been used to improve care and services. However, it is not known whether and to what extent ethics can be developed using interventions. To examine ethics interventions conducted on healthcare professionals and healthcare students to achieve ethics-related outcomes. A systematic review. Five electronic databases were searched: CINAHL, the Cochrane Library, Philosopher's Index, PubMed and PsycINFO. We searched for published articles written in English without a time limit using the keywords: ethic* OR moral* AND intervention OR program OR pre-post OR quasi-experimental OR rct OR experimental AND nurse OR nursing OR health care. In the four-phased retrieval process, 23 full texts out of 4675 citations were included in the review. Data were analysed using conventional content analysis. Ethical consideration: This systematic review was conducted following good scientific practice in every phase. It is possible to affect the ethics of healthcare practices through professionals and students. All the interventions were educational in type. Many of the interventions were related to the ethical or moral sensitivity of the professionals, such as moral courage and empowerment. A few of the interventions focused on identifying ethical problems or research ethics. Patient-related outcomes followed by organisational outcomes can be improved by ethics interventions targeting professionals. Such outcomes are promising in developing ethical safety for healthcare patients and professionals.
This report contains reviews of operating experiences, selected accident events, and industrial safety performance indicators that document the performance of the major US DOE magnetic fusion experiments and particle accelerators. These data are useful to form a basis for the occupational safety level at matured research facilities with known sets of safety rules and regulations. Some of the issues discussed are radiation safety, electromagnetic energy exposure events, and some of the more widespread issues of working at height, equipment fires, confined space work, electrical work, and other industrial hazards. Nuclear power plant industrial safety data are also included for comparison.
A patient safety learning system (sometimes called a critical incident reporting system) refers to structured reporting, collation, and analysis of critical incidents. To inform a provincial working group's recommendations for an Ontario Patient Safety Event Learning System, a systematic review was undertaken to determine design features that would optimize its adoption into the health care system and would inform implementation strategies. The objective of this review was to address two research questions: (a) what are the barriers to and facilitators of successful adoption of a patient safety learning system reported by health professionals and (b) what design components maximize successful adoption and implementation? To answer the first question, we used a published systematic review. To answer the second question, we used scoping study methodology. Common barriers reported in the literature by health care professionals included fear of blame, legal penalties, the perception that incident reporting does not improve patient safety, lack of organizational support, inadequate feedback, lack of knowledge about incident reporting systems, and lack of understanding about what constitutes an error. Common facilitators included a non-accusatory environment, the perception that incident reporting improves safety, clarification of the route of reporting and of how the system uses reports, enhanced feedback, role models (such as managers) using and promoting reporting, legislated protection of those who report, ability to report anonymously, education and training opportunities, and clear guidelines on what to report. Components of a patient safety learning system that increased successful adoption and implementation were emphasis on a blame-free culture that encourages reporting and learning, clear guidelines on how and what to report, making sure the system is user-friendly, organizational development support for data analysis to generate meaningful learning outcomes
Fermo, Vivian Costa; Radünz, Vera; Rosa, Luciana Martins da; Marinho, Monique Mendes
Objective To identify the attitude of health professionals toward the patient safety culture at a bone marrow transplant unit. Methods Quantitative research approach, cross-sectional survey conducted at a bone marrow transplant unit in Santa Catarina, Brazil. Data were collected using a Safety Attitudes Questionnaire with 33 health professionals in August and September of 2013. A total of 37 attitudes were assessed according to six safety dimensions of patient safety culture. Data were analysed by applying descriptive and inferential statistics, ANOVA and the Kruskal-Wallis test with a p value equal to or under 0.05. Results Attitudes regarding the dimension "job satisfaction" were positive for the patient safety culture, and there was a significant difference between the professionals in this dimension (p-value 0.05). The other dimensions were not assessed positively. Conclusion The attitudes of health professionals toward patient safety must be strengthened.
Pontes, Helena; Clément, Mallorie; Rollason, Victoria
Adverse drug reactions (ADRs) represent an important risk for patients and have a significant economic impact on health systems. ADRs are the fifth most common cause of hospital death, with a burden estimated at 197,000 deaths per year in the EU. This has a societal cost of 79 billion per year. Because of this strong impact in public health, regulatory authorities (RAs) worldwide are implementing new pharmacovigilance legislation to promote and protect public health by reducing the burden of ADRs through the detection of safety signals. Although, traditionally, signal detection activities have mainly been performed based on spontaneous reporting from healthcare professionals and national health RAs, the new pharmacovigilance legislation underlines the relevance of other sources of information (such as scientific literature) for the evaluation of the benefit-risk balance of a certain product. This review aims to highlight the relevance of periodic scientific literature screening in the safety signal detection process. The authors present four practical examples where a safety signal that was detected from a literature report had an impact on the lifecycle of a drug. In addition, based on practical experience of the screening of medical and scientific literature for safety purposes, this article analyses the requirements of the new pharmacovigilance guidelines on literature screening and highlights the need for the implementation of a literature review procedure and the main challenges encountered when performing literature screening for safety aspects.
Danino, Julian; Muzaffar, Jameel; Metcalfe, Chris; Coulson, Chris
Otolaryngology, although patient safety has evolved along similar themes as other surgical specialties; there are several specific high-risk areas. Medical error is a common problem and its human cost is of immense importance. Steps to reduce such errors require the identification of high-risk practice within a complex healthcare system. The commitment to patient safety and quality improvement in medicine depend on personal responsibility and professional accountability.
Zwijnenberg, Nicolien C; Hendriks, Michelle; Hoogervorst-Schilp, Janneke; Wagner, Cordula
By assessing patient safety culture, healthcare providers can identify areas for improvement in patient safety culture. To achieve this, these assessment outcomes have to be relevant and presented clearly. The aim of our study was to explore healthcare professionals' views on the feedback of a patient safety culture assessment. Twenty four hospitals participated in a patient safety culture assessment in 2012. Hospital departments received feedback in a report and on a website. In a survey, we evaluated healthcare professionals' views on this feedback and the effect of additional information about patient safety culture improvement strategies on the appraisal of the feedback. 20 hospitals participated in part I (evaluation of the report), 13 hospitals participated in part II (evaluation of the website). Healthcare professionals (e.g. members of staff and department heads/managers) rated the feedback in the report and on the website positively (average mean on different aspects = 7.2 on a scale from 1 to 10). Interpreting results was sometimes difficult, and information was sometimes lacking, like specific recommendations and improvement strategies. The provision of additional general information on patient safety culture improvement strategies resulted only in a higher appraisal of the attractiveness (lay-out) of the report and the understandability of the feedback report. The majority (84 %) of the healthcare professionals agreed or partly agreed that the feedback on patient safety culture stimulated actions to improve patient safety culture. However, a quarter also stated that although the feedback report provided insight into the patient safety culture, they did not know how to improve patient safety culture in their hospital. Healthcare professionals seem to be positive about the feedback on patient safety culture and its effect on stimulating patient safety culture improvement. To optimally tune feedback on patient safety culture towards healthcare
Full Text Available The review of safety of monoclonal anti-ige-antibodies (xolair — a new medication for the treatment of severe allergic bronchial asthma is presented. Local and system adverse events, originating after injection of medicament in clinical studies and following administration in patients are discussed.Key words: children, bronchial asthma, monoclonal anti Ige antibodies.
Carson, K.V.; Verbiest, M.E.; Crone, M.R.; Brinn, M.P.; Esterman, A.J.; Assendelft, W.J.J.; Smith, B.J.
BACKGROUND: Cigarette smoking is one of the leading causes of preventable death world wide. There is good evidence that brief interventions from health professionals can increase smoking cessation attempts. A number of trials have examined whether skills training for health professionals can lead
Safety and the enforcement of safety regulations and laws in the laboratory is the responsibility of both the stuff and the employees-each assuming his/her share. Safety and health should be an integral part of the planning, preparation, and implementation of any science program. Security, on the other hand, is a top priority ...
Xuanyue, Mao; Yanli, Nie; Hao, Cui; Pengli, Jia; Mingming, Zhang
Quite a number of articles on patient safety culture have been published in recent 10 years to assess the safety culture in hospitals using the Hospital Survey on Patient Safety Culture in many countries. However, until now there have been no relevant studies to investigate the quality of these, and their contribution to present-day thinking. The aim of this study was to explore the areas of theme, and the study design of published research on patient safety culture in literature published in English and Chinese language journals. We searched the major databases, including MEDLINE, EMbase, Chinese Biomedical Literature Database, Chinese Journals Full-text Database, and to analyze the publication years, research themes, authors' affiliations and methodologies of articles published from January 2001 to December 2011. Quality and statistical method were only appraised by classification of study designs. The annual number of published articles on patient safety culture was increasing in the last decade, and the number of articles published in 2010 and 2011 reached its peak with 86 articles accounting for 44.6% of the decade's publication; patient safety culture scale dominated the included literature, accounting for 67.8% of all studies. Cross-sectional studies and commentary reviews were the most popular study designs which took up approximately 95.9% of the included studies with 66.9% (129 articles) and 29.0% (56 articles), respectively. All the included studies on patient safety culture were conducted in the following four institutions: hospitals, geracomium, Veterans Health Administration hospitals, and medical schools. There is a growing change trend in the number of articles on patient safety culture research in recent 10 years, most of which are non-comparative studies. More methodologically rigorous designs are needed to improve research quality on patient safety culture. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of
This book was written to help the environmental and safety student learn about the field and to help the working professional manage hazardous material and waste issues. For example, one issue that will impact virtually all of these people mentioned is the upcoming environmental standardization movement. The International Standards Organization (ISO) is in the process of adding comprehensive environmental and hazardous waste management systems to their future certification requirements. Most industries worldwide will be working hard to achieve this new level of environmental management. This book presents many of the systems needed to receive certification. In order to properly manage hazardous waste, it is important to consider the entire life cycle, including when the waste was a useful chemical or hazardous material. Waste minimization is built upon this concept. Understanding the entire life cycle is also important in terms of liability, since many regulations hold generators responsible from cradle to grave. This book takes the life-cycle concept even further, in order to provide additional insight. The discussion starts with the conception of the chemical and traces its evolution into a waste and even past disposal. At this point the story continues into the afterlife, where responsibility still remains.
The potential public safety impacts from accidents in conceptual fusion power plants were investigated. Fusion was found to have some potential for accidents, as does any energy generating system. Functions of fusion power plants were identified that possess sufficient potential for an accidental release of toxic materials to the environment. An assessment was made of the impact of the potential accidents and recommendations are included for R and D that will allow incorporation of safety concerns in fusion power plant design. This work was based on a review of information available in conceptual design documents of fusion reactor systems.
Freake, Helen; Barley, Val; Kent, Gerry
This paper reviews 54 papers exploring adolescents' own views of their interactions with doctors, mental health workers and other "helping professionals". Twelve global themes emerge repeatedly in the qualitative literature, where adolescents are asked to talk about their preferences or their experiences of receiving help from such professionals.…
Lee, Romee; Heo, Gyeong Mi; Kim, Jinhee
The importance of professional workers' multicultural competence (MC) is increasingly noted in Korea, which is shifting into a multicultural society. This study investigates the current location of the discussion regarding the MC of professional workers in Korea using reviews of existing studies in international and Korean contexts. This paper…
Elliott, Joshua C.
Online professional development offers opportunities for growth to teachers who may not be able to participate otherwise due to constraints. These constraints include, but are not limited to, time and travel distance. This document is a narrative review of relevant literature as it relates to the evolution of teacher professional development. This…
Funes-Artiaga, J; Company, A; Martín-González, L; Triviño-Nolla, C; Contel-Segura, J C
Develop a performance improvement project to introduce safety needle tube holder for venous blood collection after evaluation of the professionals. Reach: Costa Ponent Primary Care Direction and the Hospital Viladecans Hospital from Institute Català de la Salut. Create interdisciplinary group. Design in two phases. First, material selection and assessment of safety devices. Second, implementation and evaluation of the proposed performance improvements. The material was selected using standardized criteria on safety devices, suitability to clinical practice and technical compatibility The assessment was qualitative questionnaire by adapting the Centers for Disease Control and Prevention. We evaluated three types of needles, two of them were evaluated by 54 primary care professionals and one for 12 professionals from the hospital. Good acceptance regarding their interaction with technology and patient safety. It was considered effective safety device. The overall rating was satisfactory. Underutilized the material by hospital professionals. There were no differences regarding sex, the hand size, experience, training you received, and type of needle. It prepared a proposal to come in progressively safety needle tube holder in primary care. The evaluation performed in the hospital it was considered insufficient. Interdisciplinary participation is essential to implement measures to safe care. The safety needle evaluated were effective with respect to security professionals and the patient. The involvement of different levels of the organization have developed a proposal for performance improvement adapted to the needs of our environment.
Pinderup, Pernille; Thylstrup, Birgitte; Hesse, Morten
To review evidence on the effects of training programs in dual diagnosis treatment for mental health professionals. Three databases were searched. Included studies were evaluated by an adapted version of Kirkpatrick’s Training Evaluation Model, which evaluates participant perception of training...... level showed mixed results. Training mental health professionals in dual diagnosis treatment may have a positive effect on professional competencies and clinical practice. Any conclusion regarding the overall training effect is premature due to limitations in study designs. Future studies on the effects...... of dual diagnosis training programs for mental health professionals should involve control groups, validated measures, follow-ups, and patient outcomes....
Conclusion: Considering the importance of safety training, identifying the factors pertinent to agricultural experts' safety attitude would help safety experts to develop and implement strategies in order to reduce occupational accidents in this sector.
Charania, Nadia Ali Muhammad Ali; Ferguson, Diane L; Bay, Esther; Freeland, Barbara S; Bradshaw, Kimberly; Harden, Karen
Nationally, professionalism and safety are key concepts in nursing practice. Although they are traditionally viewed as individual concepts, we believe they are closely linked to and depend on one another. Herein, professionalism and safety are developed as a paired concept with specific indicators. The purpose of this paper is to describe the process used to develop and implement a professionalism and safety Code of Conduct for undergraduate nursing students and to share the end product of this process. Based on input from students, faculty, and health system partners in our academic-service partnership, the current definition and Code include six student behavioral domains: communication, self-awareness, self-care, professional image, responsible learning, and personal accountability. Our Code of Conduct is now a program policy and published in both the Student Handbook and clinical syllabi. Compliance is expected. Still under development are progressive clinical grading rubrics for inclusion in every clinical course. Copyright © 2017 Elsevier Inc. All rights reserved.
Stillo, Michela; Carrillo Santisteve, Paloma; Lopalco, Pier Luigi
Introduction: Between 2006 and 2009, two different human papillomavirus virus (HPV) vaccines were licensed for use: a quadrivalent (qHPVv) and a bivalent (bHPVv) vaccine. Since 2008, HPV vaccination programmes have been implemented in the majority of the industrialized countries. Since 2013, HPV vaccination has been part of the national programs of 66 countries including almost all countries in North America and Western Europe. Despite all the efforts made by individual countries, coverage rates are lower than expected. Vaccine safety represents one of the main concerns associated with the lack of acceptance of HPV vaccination both in the European Union/European Economic Area and elsewhere. Areas covered: Safety data published on bivalent and quadrivalent HPV vaccines, both in pre-licensure and post-licensure phase, are reviewed. Expert opinion: Based on the latest scientific evidence, both HPV vaccines seem to be safe. Nevertheless, public concern and rumors about adverse events (AE) represent an important barrier to overcome in order to increase vaccine coverage. Passive surveillance of AEs is an important tool for detecting safety signals, but it should be complemented by activities aimed at assessing the real cause of all suspect AEs. Improved vaccine safety surveillance is the first step for effective communication based on scientific evidence. PMID:25689872
Winkler, Matt; Abrahams, Alan S; Gruss, Richard; Ehsani, Johnathan P
Toy-related injuries account for a significant number of childhood injuries and the prevention of these injuries remains a goal for regulatory agencies and manufacturers. Text-mining is an increasingly prevalent method for uncovering the significance of words using big data. This research sets out to determine the effectiveness of text-mining in uncovering potentially dangerous children's toys. We develop a danger word list, also known as a 'smoke word' list, from injury and recall text narratives. We then use the smoke word lists to score over one million Amazon reviews, with the top scores denoting potential safety concerns. We compare the smoke word list to conventional sentiment analysis techniques, in terms of both word overlap and effectiveness. We find that smoke word lists are highly distinct from conventional sentiment dictionaries and provide a statistically significant method for identifying safety concerns in children's toy reviews. Our findings indicate that text-mining is, in fact, an effective method for the surveillance of safety concerns in children's toys and could be a gateway to effective prevention of toy-product-related injuries.
Alves, D F S; Guirardello, E B
International studies indicate that job satisfaction and burnout interfere with the safety climate and quality of care. However, no evidence of such relationships is available for Brazilian paediatric hospitals. To assess the correlation and predictive effect of emotional exhaustion and job satisfaction on the perception of professional nurses at paediatric hospitals regarding safety climate and quality of care. Cross-sectional correlational design. The study was conducted with registered nurses, technician and assistant nurses from two Brazilian paediatric hospitals over 3 months in 2013-2014 using instruments to assess safety climate, quality of care, job satisfaction and emotional exhaustion. Data related to 267 professional nurses from 15 inpatient wards and 3 intensive care units were analysed. Overall, the respondents exhibited moderate emotional exhaustion, were satisfied with their jobs and considered the quality of care as good. However, the respondents exhibited low concordance as to the positive perception of the safety climate. The variables, emotional exhaustion and job satisfaction, exhibited significant correlations with safety climate and were considered predictive of the latter. Emotional exhaustion and job satisfaction among professional nurses influence the safety climate at paediatric hospitals. Investments to reduce emotional exhaustion and to improve job satisfaction among professional nurses allocated to paediatric hospitals might contribute to the patients' safety. © 2016 International Council of Nurses.
Robinson, Edward H., III; Curry, Jennifer R.
Institutional review boards (IRBs) are responsible for regulating and safeguarding research with human participants in academic institutions in the United States. The authors explore (a) the historical impetus for IRBs, (b) the ethical values and principles as core components of the review process, and (c) the American Counseling Association's…
Lee, Sang Hoon; Lee, Yeong Hwan; Moon, Seok Hyeong; Sohn, Moon Kyu [Korea Association for Nuclear Technology, Taejon (Korea, Republic of)
Translation and review of five IAEA safety guides as follows : staffing of Nuclear Power Plants and the recruitment, training and authorization of operating personnel (safety series No. 50-SG-01), in-service inspection for Nuclear Power Plants (safety series No. 50-SG-02), operating limits and conditions for Nuclear Power Plants (safety series No. 50-SG-03), commissioning procedures for Nuclear Power Plants (safety series No. 50-SG-04), maintenance of Nuclear Power Plants (safety series No. 50-SG-07)
Bernard, Laurence; Biron, Alain; Lavigne, Geneviève; Frechette, Julie; Bernard, Agnès; Mitchell, Jonathan; Lavoie-Tremblay, Mélanie
The objectives of the study were to: (1) examine the relationships between three different qualitative perceptions of safety culture and the Canadian Patient Safety Climate Survey factors; (2) determine whether these perceptions are associated with different hand hygiene practices. Healthcare-associated infections and safety cultures are a worldwide issue. During the A/H1N1 Influenza pandemic, Europe and North America did not have the same responses. Importantly, healthcare professionals' perceptions can influence patient safety through infection prevention practices like hand hygiene. A cross-sectional design was used with data collected in 2015. The Canadian Patient Safety Culture Survey and hand hygiene observations were gathered from three healthcare centres (two Canadian and one European). Descriptive analyses and ANOVAs were conducted to explore healthcare professionals' safety perceptions and practices. The rates of hand hygiene practices varied widely between the three sites, ranging from 35-77%. One site (Site 3) was found to have the highest scores of management follow-up, feedback about incidents, supervisory leadership for safety, unit learning culture and senior leadership support for safety, and the highest levels of overall patient safety grades for the unit and organization. The quantitative results of this study support the previously described model based on qualitative results: individual culture, blaming culture and collaborative culture. Differences between continents emerged regarding infection prevention practices and the way we qualify infections. The results raise concerns about infection practices and about safety cultures and challenges worldwide. © 2017 John Wiley & Sons Ltd.
Full Text Available "Professions" are work collaborations in which representatives of certain vocations address the life problems of "laypersons." In such relationships, adequate communication between representatives of the profession and laypersons is crucial in addressing their individual problems. Accordingly, "understanding," as well as interactional documentation of this understanding, is of considerable importance. The authors of the present volume, "Understanding in Professional Spheres of Activity," address the documentation of this understanding in certain professional spheres. They examine the requirements for the documentation of such understanding and the forms of documentation used in the fields of doctor-patient communication, counseling communication, and organizational collaboration on a movie set. Conversation analytic as well as ethnographically complemented studies draw further attention to an examination of the interactional level in its socio-structural context, and to that end the study employs a combination of conversational linguistics and sociological research. This contribution is therefore important not only in terms of linguistics but also sociologically. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1203142
Allana Alexandre Cardoso
Full Text Available ABSTRACT Body image is multidimensional, dynamic, and entirely linked to the body in motion, which entails relevant bodily concerns in the routine of professional dancers, who need to maintain their body aesthetics constantly. The objective was summarizing the scientific production on the body image of professional dancers and to understand how they perceive it. This review is composed by seven studies that investigated professional dancers of classical ballet, jazz and contemporary dance. The results demonstrate that even though they are lean and had appropriate body mass index, professional dancers are dissatisfied with their body and wish to be thinner, that is, professional dancers constitute a risk group for the development of eating disorders.
Full Text Available Abstract Many breastfeeding women require and regularly take medicines, especially those available over-the-counter, and the safe use of these is dependent on the advice provided by health professionals such as general practitioners and pharmacists. The primary aim of this review therefore, was to investigate the literature relating to health professionals' and women's knowledge, attitudes and practices towards medication use and safety in breastfeeding. The limited literature that was uncovered identified that general practitioners and pharmacists have poor knowledge, but positive attitudes, and variable practices that are mostly guided by personal experience. They tend to make decisions about the use of a medicine whilst breastfeeding based on the potential 'risk' that it poses to the infant in terms of possible adverse reactions, rather than its 'compatibility' with breast milk. The decision-making process between health professionals and women is usually not a negotiated process, and women are often asked to stop breastfeeding whilst taking a medicine. Women, in turn, are left dissatisfied with the advice received, many choosing not to initiate therapy or not to continue breastfeeding. Some directions for future research have been suggested to address the issues identified in this critical area. This review is important from a societal perspective because many breastfeeding women require and regularly take medications, especially those available without prescription, and the safe use of these is dependent on the advice provided by health professionals, which is ultimately influenced by their knowledge, attitudes and practices. However, there is an absence of high quality evidence from randomised controlled trials on the safety of medications taken during breastfeeding, which naturally would hinder health professionals from appropriately advising women. It is equally important to know about women's experiences of advice received from health
Silva, Darlan dos Santos Damásio; Tavares, Natália Vieira da Silva; Alexandre,Alícia Regina Gomes; Freitas,Daniel Antunes; Brêda,Mércia Zeviani; Albuquerque, Maria Cícera dos Santos; Melo Neto, Valfrido Leão de
Abstract OBJECTIVE Discussing the factors associated with major depression and suicide risk among nursing professionals. METHOD An integrative review in PubMed/MEDLINE, LILACS, SciELO and BDENF databases, between 2003 and 2015. RESULTS 20 published articles were selected, mostly from between 2012 and 2014, with significant production in Brazil. Nursing professionals are vulnerable to depression when young, married, performing night work and having several jobs, and when they have a high l...
Shivers, Charles Herbert; Parker, Nelson C. (Technical Monitor)
This article presents a discussion of the configuration management (CM) and the Data Management (DM) functions and provides a perspective of the importance of configuration and data management processes to the success of system safety activities. The article addresses the basic requirements of configuration and data management generally based on NASA configuration and data management policies and practices, although the concepts are likely to represent processes of any public or private organization's well-designed configuration and data management program.
Rigobello, Mayara Carvalho Godinho; Carvalho, Rhanna Emanuela Fontenele Lima de; Guerreiro, Juliana Magalhães; Motta, Ana Paula Gobbo; Atila, Elizabeth; Gimenes, Fernanda Raphael Escobar
The aim of this study was to assess the patient safety climate from the perspective of healthcare professionals working in the emergency department of a hospital in Brazil. Emergency departments are complex and dynamic environments. They are prone to adverse events that compromise the quality of care provided and reveal the importance of patient safety culture and climate. This was a quantitative, descriptive, cross-sectional study. The Safety Attitudes Questionnaire (SAQ) - Short Form 2006 was used for data collection, validated and adapted into Portuguese. The study sample consisted of 125 participants. Most of the participants were female (57.6%) and had worked in emergency department for more than 10years (56.8%). Sixty-two participants (49.6%) were nursing professionals. The participants demonstrated satisfaction with their jobs and dissatisfaction with the actions of management with regard to safety issues. Participants' perceptions about the patient safety climate were found to be negative. Knowledge of professionals' perceptions of patient safety climate in the context of emergency care helps with assessments of the safety culture, contributes to improvement of health care, reduces adverse events, and can focus efforts to improve the quality of care provided to patients. Copyright © 2017 Elsevier Ltd. All rights reserved.
DiSabatino, A; Biswas, D; DeMicco, M; Fisher, L E; Hafner, R; Haslam, J; Mok, G; Patel, C; Russell, E
This Packaging Review Guide (PRG) provides guidance for Department of Energy (DOE) review and approval of packagings to transport fissile and Type B quantities of radioactive material. It fulfills, in part, the requirements of DOE Order 460.1B for the Headquarters Certifying Official to establish standards and to provide guidance for the preparation of Safety Analysis Reports for Packagings (SARPs). This PRG is intended for use by the Headquarters Certifying Official and his or her review staff, DOE Secretarial offices, operations/field offices, and applicants for DOE packaging approval. This PRG is generally organized at the section level in a format similar to that recommended in Regulatory Guide 7.9 (RG 7.9). One notable exception is the addition of Section 9 (Quality Assurance), which is not included as a separate chapter in RG 7.9. Within each section, this PRG addresses the technical and regulatory bases for the review, the manner in which the review is accomplished, and findings that are generally applicable for a package that meets the approval standards. This Packaging Review Guide (PRG) provides guidance for DOE review and approval of packagings to transport fissile and Type B quantities of radioactive material. It fulfills, in part, the requirements of DOE O 460.1B for the Headquarters Certifying Official to establish standards and to provide guidance for the preparation of Safety Analysis Reports for Packagings (SARPs). This PRG is intended for use by the Headquarters Certifying Official and his review staff, DOE Secretarial offices, operations/field offices, and applicants for DOE packaging approval. The primary objectives of this PRG are to: (1) Summarize the regulatory requirements for package approval; (2) Describe the technical review procedures by which DOE determines that these requirements have been satisfied; (3) Establish and maintain the quality and uniformity of reviews; (4) Define the base from which to evaluate proposed changes in scope
Kougioumtzis, Konstantin; Patriksson, Goran; Strahlman, Owe
This article reviews research on physical education (PE) teachers' professionalization considering their relative position at schools and in the community as well as their control over the lesson formation. The position considers issues of prestige, status and esteem while lesson formation regards constitutional, organizational and physical…
Abbott, Amy A.; Fuji, Kevin T.; Galt, Kimberly A.; Paschal, Karen A.
Nursing students need foundation knowledge and skills to keep patients safe in continuously changing health care environments. A gap exists in our knowledge of the value students place on interprofessional patient safety education. The purpose of this exploratory, mixed methods study was to understand nursing students’ attitudes about the value of an interprofessional patient safety course to their professional development and its role in health professions curricula. Qualitative and quantita...
Ginsburg, Liane; Castel, Evan; Tregunno, Deborah; Norton, Peter G
Enhancing competency in patient safety at entry to practice requires introduction and integration of patient safety into health professional education. As efforts to include patient safety in health professional education increase, it is important to capture new health professionals' perspectives of their own patient safety competence at entry to practice. Existing instruments to measure patient safety knowledge, skills and attitudes have been developed largely to examine the impact of specific patient safety curricular initiatives and the psychometric analyses of the instruments used thus far have been exploratory in nature. Confirmatory factor analytic approaches are used to extensively test the Health Professional Education in Patient Safety Survey (H-PEPSS), a newly designed survey rooted in a patient safety competency framework and designed to measure health professionals' self-reported patient safety competence around the time of entry to practice. The H-PEPSS focuses primarily on the socio-cultural aspects of patient safety including culture, teamwork, communication, managing risk and understanding human factors. Results support a parsimonious six-factor measurement model of health professionals' perceptions of patient safety competency. These results support the validity of a reduced version of the H-PEPSS and suggest it can be appropriately used at or near training completion with a variety of health professional groups. Given increased demands for patient safety competency among health professionals at entry to practice and slow, but emerging changes in health professional education, ongoing research to understand the extent of patient safety competency among health professionals around the time of entry to practice will be important.
Daisy Zanchi de Abreu Botene
Full Text Available This paper is a qualitative descriptive study, which aims to analyze how the academic education concerning hand hygiene contributes to the pediatric patient safety. This research was developed in an university hospital in Southern Brazil, in the pediatric unit, during the period of August to December, 2012. Sixteen healthcare professionals participated (doctors, nurses and physical therapists. A semi-structured interview was used to gather information. Data was organized by the software QSR Nvivo and analyzed using the content analysis technique. The results allowed us to list two thematic categories: "Hand hygiene and healthcare professionals' academic education"; and "Hand hygiene and professional life". The first thematic category will be presented in this paper. It was identified that the academic education contributes in an ineffective way to the creation of a patient safety culture. According to the professionals, there are gaps during the educational process regarding hand hygiene. The topic is treated in an ineffective and not very significant way to the learning and adhesion of hand hygiene in the professional life. It is recommended that, for the internalization of the practice by future professionals, a transversal, continuous and systematical approach is adopted during the professional's training, evaluations concerning the hand hygiene are done throughout the academic life as well as healthcare professors bethink the topic.
Silva, Darlan Dos Santos Damásio; Tavares, Natália Vieira da Silva; Alexandre, Alícia Regina Gomes; Freitas, Daniel Antunes; Brêda, Mércia Zeviani; Albuquerque, Maria Cícera Dos Santos de; Melo, Valfrido Leão de Neto
Discussing the factors associated with major depression and suicide risk among nursing professionals. An integrative review in PubMed/MEDLINE, LILACS, SciELO and BDENF databases, between 2003 and 2015. 20 published articles were selected, mostly from between 2012 and 2014, with significant production in Brazil. Nursing professionals are vulnerable to depression when young, married, performing night work and having several jobs, and when they have a high level of education, low family income, work overload, high stress, insufficient autonomy and a sense of professional insecurity and conflict in the family and workrelationship. Suicide risk was correlated with the presence of symptoms of depression, high levels of emotional exhaustion, depersonalization and low personal accomplishment; characteristics of Burnout Syndrome. Suicide risk among nursing professionals is associated with symptoms of depression and correlated with Burnout Syndrome, which can affect work performance.
Darlan dos Santos Damásio Silva
Full Text Available Abstract OBJECTIVE Discussing the factors associated with major depression and suicide risk among nursing professionals. METHOD An integrative review in PubMed/MEDLINE, LILACS, SciELO and BDENF databases, between 2003 and 2015. RESULTS 20 published articles were selected, mostly from between 2012 and 2014, with significant production in Brazil. Nursing professionals are vulnerable to depression when young, married, performing night work and having several jobs, and when they have a high level of education, low family income, work overload, high stress, insufficient autonomy and a sense of professional insecurity and conflict in the family and workrelationship. Suicide risk was correlated with the presence of symptoms of depression, high levels of emotional exhaustion, depersonalization and low personal accomplishment; characteristics of Burnout Syndrome. CONCLUSION Suicide risk among nursing professionals is associated with symptoms of depression and correlated with Burnout Syndrome, which can affect work performance.
Trier, Hans; Valderas, Jose M; Wensing, Michel; Martin, Helle Max; Egebart, Jonas
Patient involvement has only recently received attention as a potentially useful approach to patient safety in primary care. To summarize work conducted on a scoping review of interventions focussing on patient involvement for patient safety; to develop consensus-based recommendations in this area. Scoping review of the literature 2006-2011 about methods and effects of involving patients in patient safety in primary care identified evidence for previous experiences of patient involvement in patient safety. This information was fed back to an expert panel for the development of recommendations for healthcare professionals and policy makers. The scoping review identified only weak evidence in support of the effectiveness of patient involvement. Identified barriers included a number of patient factors but also the healthcare workers' attitudes, abilities and lack of training. The expert panel recommended the integration of patient safety in the educational curricula for healthcare professionals, and expected a commitment from professionals to act as first movers by inviting and encouraging the patients to take an active role. The panel proposed a checklist to be used by primary care clinicians at the point of care for promoting patient involvement. There is only weak evidence on the effectiveness of patient involvement in patient safety. The recommendations of the panel can inform future policy and practice on patient involvement in safety in primary care.
Full Text Available This paper takes an overall literature review of non-native English-speaking teachers’ professional identity so as to bring forth the issue of “non-native speakership” and to elicit the marginal area of research on this issue. Firstly, it gives an overview description of the definition of “identity” and “professional identity” developed over the years, some related concepts and identity formation process. Then it reviews the empirical works of teacher identity, especially non-native English-speaking teachers’ professional identity. These works include research on teachers’ perception of their English proficiency, their identity construction and development and their own narrative stories. Subjects of these works range from student teachers, novice teachers and experienced teachers. Finally, it concludes that future research on this issue can still further enrich the current literature by means of wider research confines, more diversified research techniques and subjects as well.
Godin, Gaston; Bélanger-Gravel, Ariane; Eccles, Martin; Grimshaw, Jeremy
... interventions targeting healthcare professionals. The aim of this study was to systematically review the published scientific literature about factors influencing health professionals' behaviours based on social cognitive theories...
Boyer, Ivan J; Bergfeld, Wilma F; Heldreth, Bart; Fiume, Monice M; Gill, Lillian J
The Cosmetic Ingredient Review (CIR) is a nonprofit program to assess the safety of ingredients in personal care products in an open, unbiased, and expert manner. Cosmetic Ingredient Review was established in 1976 by the Personal Care Products Council (PCPC), with the support of the US Food and Drug Administration (USFDA) and the Consumer Federation of America (CFA). Cosmetic Ingredient Review remains the only scientific program in the world committed to the systematic, independent review of cosmetic ingredient safety in a public forum. Cosmetic Ingredient Review operates in accordance with procedures modeled after the USFDA process for reviewing over-the-counter drugs. Nine voting panel members are distinguished, such as medical professionals, scientists, and professors. Three nonvoting liaisons are designated by the USFDA, CFA, and PCPC to represent government, consumer, and industry, respectively. The annual rate of completing safety assessments accelerated from about 100 to more than 400 ingredients by implementing grouping and read-across strategies and other approaches. As of March 2017, CIR had reviewed 4,740 individual cosmetic ingredients, including 4,611 determined to be safe as used or safe with qualifications, 12 determined to be unsafe, and 117 ingredients for which the information is insufficient to determine safety. Examples of especially challenging safety assessments and issues are presented here, including botanicals. Cosmetic Ingredient Review continues to strengthen its program with the ongoing cooperation of the USFDA, CFA, the cosmetics industry, and everyone else interested in contributing to the process.
Shivers, C. Herbert
Recall from the Parable of the Boiled Frog, that tossing a frog into boiling water causes the frog to jump out and hop away while placing a frog in suitable temperature water and slowly bringing the water to a boil results in the frog boiling due to not being aware of the slowly increasing danger, theoretically, of course. System safety professionals must guard against allowing dangers to creep unnoticed into their projects and be ever alert to notice signs of impending problems. People have used various phrases related to the idea, most notably, latent conditions, James Reason in Managing the Risks of Organizational Accidents (1, pp 10-11), Drift to Failure, Sydney Dekker (2, pp 82-86) in Resilience Engineering: Chronicling the Emergence of Confused Consensus in Resilience Engineering: Concepts and Precepts, Hollnagel, Woods and Leveson, and normalization of deviance, Diane Vaughan in The Challenger Launch Decision: Risky Technology, Culture, and Deviance at NASA (3). Reason also said, If eternal vigilance is the price of liberty, then chronic unease is the price of safety (1, p 37). Our challenge as system safety professionals is to be aware of the emergence of signals that warn us of slowly eroding safety margins. This paper will discuss how system safety professionals might better perform in that regard.
Carranza, Noemí; Febles, Víctor; Hernández, José A; Bardasano, José L; Monteagudo, José L; Fernández de Aldecoa, José C; Ramos, Victoria
A systematic literature review was carried out to study patient security and possible harmful effects, immunity and interferences on medical devices, and effectiveness and transmission problems in healthcare and hospital environments due to electromagnetic interferences. The objective was to determine already-reported cases of patient security, immunity of medical devices, and transmission/reception failure in order to evaluate safety and security of patients. Literature published in the last 10 years has been reviewed by searching in bibliographic databases, journals, and proceedings of conferences. Search strategies developed in electronic databases identified a total of 820 references, with 50 finally being included. The study reveals the existence of numerous publications on interferences in medical devices due to radiofrequency fields. However, literature on effectiveness, transmission problems and measurements of electromagnetic fields is limited. From the studies collected, it can be concluded that several cases of serious interferences in medical instruments have been reported. Measures of electromagnetic fields in healthcare environments have been also reported, concluding that special protective measures should be taken against electromagnetic interferences by incoming radio waves.
Keyko, Kacey; Cummings, Greta G; Yonge, Olive; Wong, Carol A
Work engagement in professional nursing practice is critically important to consider when addressing key challenges of health systems, including the global nursing shortage, pressures to reduce health care spending, and increasing demands for quality care and positive outcomes for patients. However, research on work engagement in professional nursing practice has not yet been synthesized and therefore, does not provide a sufficient foundation of knowledge to guide practice and further research. The overall aim of this systematic review is to determine what is currently known about the antecedents and outcomes of work engagement in professional nursing practice. Systematic review. The search strategy included eight electronic databases: CINAHL, MEDLINE, PsycINFO, PROQUEST, SCOPUS, Web of Science, EMBASE, and Business Source Complete. The search was conducted in October 2013. Quantitative and qualitative research that examined relationships between work engagement and antecedent or outcome factors was included. Quality assessment, data extractions, and analysis were completed on all included studies. Data extracted from included studies were synthesized through descriptive and narrative synthesis. Content analysis was used to categorize factors into themes and categories. 3621 titles and abstracts were screened and yielded 113 manuscripts for full text review. Full text review resulted in 18 included studies. All factors examined were grouped into either influences or outcomes of work engagement. A total of 77 influencing factors were categorized into 6 themes: organizational climate, job resources, professional resources, personal resources, job demands, and demographic variables. A total of 17 outcomes of work engagement were categorized into 3 themes: performance and care outcomes, professional outcomes, and personal outcomes. Based on the results, we adapted the Job Demands-Resources (JD-R) model and developed the Nursing Job Demands-Resources (NJD-R) model for
Parand, Anam; Soukup, Tayana; Reader, Tom; Sevdalis, Nick
Safety in aviation has often been compared with safety in healthcare. Following a recent article in this journal, the UK government set up an Independent Patient Safety Investigation Service, to emulate a similar well-established body in aviation. On the basis of a detailed review of relevant publications that examine patient safety in the context of aviation practice, we have drawn up a table of comparative features and a conceptual framework for patient safety. Convergence and divergence of safety-related behaviours across aviation and healthcare were derived and documented. Key safety-related domains that emerged included Checklists, Training, Crew Resource Management, Sterile Cockpit, Investigation and Reporting of Incidents and Organisational Culture. We conclude that whilst healthcare has much to learn from aviation in certain key domains, the transfer of lessons from aviation to healthcare needs to be nuanced, with the specific characteristics and needs of healthcare borne in mind. On the basis of this review, it is recommended that healthcare should emulate aviation in its resourcing of staff who specialise in human factors and related psychological aspects of patient safety and staff wellbeing. Professional and post-qualification staff training could specifically include Cognitive Bias Avoidance Training, as this appears to play a key part in many errors relating to patient safety and staff wellbeing. PMID:26770817
Full Text Available Abstract Background This study seeks to broaden current understandings of what patient safety means in mental healthcare and how it is accomplished. We propose a qualitative observational study of how safety is produced or not produced in the complex context of everyday professional mental health practice. Such an approach intentionally contrasts with much patient safety research which assumes that safety is achieved and improved through top-down policy directives. We seek instead to understand and articulate the connections and dynamic interactions between people, materials, and organisational, legal, moral, professional and historical safety imperatives as they come together at particular times and places to perform safe or unsafe practice. As such we advocate an understanding of patient safety 'from the ground up'. Methods/Design The proposed project employs a six-phase data collection framework in two mental health settings: an inpatient unit and a community team. The first four phases comprise multiple modes of focussed, unobtrusive observation of professionals at work, to enable us to trace the conceptualisation and enactment of safety as revealed in dialogue and narrative, use of artefacts and space, bodily activity and patterns of movement, and in the accomplishment of specific work tasks. An interview phase and a social network analysis phase will subsequently be conducted to offer comparative perspectives on the observational data. This multi-modal and holistic approach to studying patient safety will complement existing research, which is dominated by instrumentalist approaches to discovering factors contributing to error, or developing interventions to prevent or manage adverse events. Discussion This ethnographic research framework, informed by the principles of practice theories and in particular actor-network ideas, provides a tool to aid the understanding of patient safety in mental healthcare. The approach is novel in that it
Mulvaney, Caroline A.; Watson, Michael C.; Errington, Gail
Purpose: The aim of this literature review was to examine recent evidence of the impact of safety education for children and young people on unintentional injury rates and to update an earlier review. Evidence was sought that linked safety education for children and young people in schools, centres and other settings with changes in knowledge,…
Bernalte-Martí, Vicente; Orts-Cortés, María Isabel; Maciá-Soler, Loreto
To assess nursing professionals and health care assistants' perceptions, opinions and behaviours on patient safety culture in the operating room of a public hospital of the Spanish National Health Service. To describe strengths and weaknesses or opportunities for improvement according to the Agency for Healthcare Research and Quality criteria, as well as to determine the number of events reported. A descriptive, cross-sectional study was conducted using the Spanish version of the questionnaire Hospital Survey on Patient Safety Culture. The sample consisted of nursing professionals, who agreed to participate voluntarily in this study and met the selection criteria. A descriptive and inferential analysis was performed depending on the nature of the variables and the application conditions of statistical tests. Significance if p < .05. In total, 74 nursing professionals responded (63.2%). No strengths were found in the operating theatre, and improvements are needed concerning staffing (64.0%), and hospital management support for patient safety (52.9%). A total of 52.3% (n = 65) gave patient safety a score from 7 to 8.99 (on a 10 point scale); 79.7% (n = 72) reported no events last year. The total variance explained by the regression model was 0.56 for "Frequency of incident reporting" and 0.26 for "Overall perception of safety". There was a more positive perception of patient safety culture at unit level. Weaknesses have been identified, and they can be used to design specific intervention activities to improve patient safety culture in other nearby operating theatres. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Reiman, T.; Oedewald, P.; Wahlstroem, B. [Technical Research Centre of Finland, VTT (Finland); Rollenhagen, C. [Royal Institute of Technology, KTH, (Sweden); Kahlbom, U. [RiskPilot (Sweden)
Organizational safety reviews are part of the safety management process of power plants. They are typically performed after major reorganizations, significant incidents or according to specified review programs. Organizational reviews can also be a part of a benchmarking between organizations that aims to improve work practices. Thus, they are important instruments in proactive safety management and safety culture. Most methods that have been used for organizational reviews are based more on practical considerations than a sound scientific theory of how various organizational or technical issues influence safety. Review practices and methods also vary considerably. The objective of this research is to promote understanding on approaches used in organizational safety reviews as well as to initiate discussion on criteria and methods of organizational assessment. The research identified a set of issues that need to be taken into account when planning and conducting organizational safety reviews. Examples of the issues are definition of appropriate criteria for evaluation, the expertise needed in the assessment and the organizational motivation for conducting the assessment. The study indicates that organizational safety assessments involve plenty of issues and situations where choices have to be made regarding what is considered valid information and a balance has to be struck between focus on various organizational phenomena. It is very important that these choices are based on a sound theoretical framework and that these choices can later be evaluated together with the assessment findings. The research concludes that at its best, the organizational safety reviews can be utilised as a source of information concerning the changing vulnerabilities and the actual safety performance of the organization. In order to do this, certain basic organizational phenomena and assessment issues have to be acknowledged and considered. The research concludes with recommendations on
Butenko, Samantha; Lockwood, Craig; McArthur, Alexa
Healthcare-associated infections pose a significant risk to patients in acute healthcare settings such as hospitals. Increasingly, patients are encouraged to be active participants and partner with healthcare professionals to positively influence their own safety and overall experience throughout their healthcare journey. Patient-focused safety initiatives include the empowerment of patients to be active partners with healthcare professionals in order to influence the hand hygiene behaviors and compliance of the healthcare professionals providing care to them. Partnering within the context of healthcare, and between the patient and healthcare professional, can be considered as a general concept that involves the empowerment of patients to participate in their care. Terms used to describe patient partnering within healthcare vary and include patient participation, patient-centeredness, patient empowerment and patient engagement. Although patients appear generally to have positive attitudes and intentions about engaging in their safety and partnering in the healthcare setting, their intentions and actual behaviors vary considerably. Patients appear less likely to engage in behaviors that require questioning of the perceived or real authority of healthcare professionals. A patient's intention and subsequent act of partnering with healthcare professionals for hand hygiene compliance by the healthcare professional are influenced by complex internal, external and social factors as well as cultural, behavioral and systematic factors. To determine the best available evidence in relation to the experiences of the patient partnering with healthcare professionals for hand hygiene compliance. The current review considered qualitative (critical or interpretive) papers that included adult in-patients and healthcare professionals (medical and nursing staff), in the acute hospital-care setting. Adult was considered to be any person aged 18 years or over. It should be noted that
Omura, Mieko; Maguire, Jane; Levett-Jones, Tracy; Stone, Teresa Elizabeth
Communication errors have a negative impact on patient safety. It is therefore essential that healthcare professionals have the skills and confidence to speak up assertively when patient safety is at risk. Although the facilitators to and barriers of assertive communication have been the subject of previous reviews, evidence regarding the effectiveness of interventions designed to enhance assertive communication is lacking. Thus, this paper reports the findings from a systematic review of the effectiveness of assertiveness communication training programs for healthcare professionals and students. The objective of this review is to identify, appraise and synthesise the best available quantitative evidence in relation to the effectiveness of assertiveness communication training programs for healthcare professionals and students on levels of assertiveness, communication competence and impact on clinicians' behaviours and patient safety. The databases included: CINAHL, Cochrane library, EMBASE, Informit health collection, MEDLINE, ProQuest nursing and allied health, PsycINFO, Scopus and Web of Science. The search for unpublished studies included: MedNar, ProQuest Dissertations & Theses A&I. Studies published in English from 2001 until 2016 inclusive were considered. The review included original quantitative research that evaluated (a) any type of independent assertiveness communication training program; and (b) programs with assertiveness training included as a core component of team skills or communication training for healthcare professionals and students, regardless of healthcare setting and level of qualification of participants. Studies selected based on eligibility criteria were assessed for methodological quality and the data were extracted by two independent researchers using the Joanna Briggs Institute critical appraisal and data extraction tools. Eleven papers were critically appraised using the Joanna Briggs Institute critical appraisal checklists. Eight
Vaismoradi, Mojtaba; Jordan, Sue; Kangasniemi, Mari
This systematic review aims to synthesise the existing research on how patients participate in patient safety initiatives. Ambiguities remain about how patients participate in routine measures designed to promote patient safety. Systematic review using integrative methods. Electronic databases were searched using keywords describing patient involvement, nursing input and patient safety initiatives to retrieve empirical research published between 2007 and 2013. Findings were synthesized using the theoretical domains of Vincent's framework for analysing risk and safety in clinical practice: "patient", "healthcare provider", "task", "work environment", "organisation & management". We identified 17 empirical research papers: four qualitative, one mixed-method and 12 quantitative designs. All 17 papers indicated that patients can participate in safety initiatives. Improving patient participation in patient safety necessitates considering the patient as a person, the nurse as healthcare provider, the task of participation and the clinical environment. Patients' knowledge, health conditions, beliefs and experiences influence their decisions to engage in patient safety initiatives. An important component of the management of long-term conditions is to ensure that patients have sufficient knowledge to participate. Healthcare providers may need further professional development in patient education and patient care management to promote patient involvement in patient safety, and ensure that patients understand that they are 'allowed' to inform nurses of adverse events or errors. A healthcare system characterised by patient-centredness and mutual acknowledgement will support patient participation in safety practices. Further research is required to improve international knowledge of patient participation in patient safety in different disciplines, contexts and cultures. Patients have a significant role to play in enhancing their own safety while receiving hospital care. This
Séguin, Monique; Bordeleau, Vincent; Drouin, Marc-Simon; Castelli-Dransart, Dolores Angela; Giasson, François
The objective of this study was to review the literature and make suggestions for further investigation into the topic of professionals' reactions following a patient's suicide. An extensive search of the literature has been undertaken using computer database search. Even if findings are heterogenous, most studies suggest limited stress-related or affective-related reactions for the majority of respondents. Whereas, findings with regards to the impact on professional practice are consistent in identifying important consequences in the way professionals conduct their clinical assessment and reach treatment decisions after a patient's suicide. Future research should investigate how this event changes the clinician's personal growth and capacity to establish a therapeutic alliance with other suicidal patients.
Emery, Robert J; Rios, Janelle
Because operational radiation safety professionals can encounter ethical dilemmas in the course of their work, codes of ethics and professional standards of conduct are maintained by the Health Physics Society (HPS) and the American Academy of Health Physics (AAHP). While these works provide valuable guidance, they do not operationalize the types of ethical dilemmas radiation safety practitioners might encounter. For example, consider the ethical conundrum of “dual loyalty,” defined as the situation in which an individual holds simultaneous obligations to two or more parties. In the case of radiation safety, practicing professionals hold obligations to the workers being protected and to the leaders of the organization. If these obligations are in conflict, serious difficulties can arise. The conundrum of dual loyalty is described and a strategy for reducing its effect is discussed. Two other common ethical issues; “confidentiality” and “organizational dissent” are similarly presented. A foundation from which to launch an ongoing dialogue about ethical issues within the radiation safety profession is also proposed.
How does one conduct, measure and record a ‘good’ ethical review of biomedical research? To what extent do ethics committees invoke professionalism in researchers and in themselves, and to what extent do they see competence as adherence to a set of standard operating procedures for ethical review......? Drawing on ethnographic fieldwork with the Forum of Ethics Review Committees of Asia and the Pacific (FERCAP), a capacity-building NGO that runs ethics committee trainings and reviews in the Asia Pacific region, I develop an analysis of ethical review and its effects. I focus on a ‘second-order audit’ run...... by FERCAP, which recognises committees according to a set of standards that are designed to render ‘local’ committees internationally legible. The article adds to a growing comparative literature that expands studies of audit-like measuring and disciplining activities beyond western contexts and enriches...
Burns, Suzanne Perea; Pickens, Noralyn Davel
To explore inter-professional home evaluators' perspectives and needs for building useful and acceptable decision-support tools for the field of home modifications. Twenty semi-structured interviews were conducted with a range of home modification professionals from different regions of the United States. The interview transcripts were analyzed with a qualitative, descriptive, perspective approach. Technology supports current best practice and has potential to inform decision making through features that could enhance home evaluation processes, quality, efficiency and inter-professional communication. Technological advances with app design have created numerous opportunities for the field of home modifications. Integrating technology and inter-professional best practices will improve home safety evaluation and intervention development to meet client-centred and societal needs. Implications for rehabilitation Understanding home evaluators technology needs for home safety evaluations contributes to the development of app-based assessments. Integrating inter-professional perspectives of best practice and technological needs in an app for home assessments improves processes. Novice and expert home evaluators would benefit from decision support systems embedded in app-based assessments. Adoption of app-based assessment would improve efficiency while remaining client-centred.
Caine, Dennis; Goodwin, Brett J; Caine, Caroline G; Bergeron, Glen
The objective of this study was to provide an epidemiological review of the literature concerning ballet injuries affecting pre-professional ballet dancers. The literature search was limited to published peer-reviewed reports and involved an extensive examination of Scopus, SPORTDiscus, and CINAHL. The following search terms were used in various combinations: ballet, injury, epidemiology, risk factor, pre-professional, and intervention. Additional citations were located using the ancestry approach. Unlike some other athletic activities that have been the focus of recent intervention research, there is a paucity of intervention and translational research in pre-professional ballet, and sample sizes have often been small and have not accounted for the multivariate nature of ballet injury. Exposure-based injury rates in this population appear similar to those reported for professional ballet dancers and female gymnasts. A preponderance of injuries affect the lower extremity of these dancers, with sprains and strains being the most frequent type of injury reported. The majority of injuries appear to be overuse in nature. Injury risk factors have been tested in multiple studies and indicate a variety of potential injury predictors that may provide useful guidance for future research.
Bukowski, Ronald M
The vascular endothelial growth factor (VEGF) pathway and the mammalian Target of Rapamycin (mTOR) represent the most frequently exploited targets in renal cell carcinoma (RCC). Temsirolimus is an inhibitor of mTOR, and is a unique ester derivative of sirolimus, a macrocyclic lactone, with improved pharmaceutical properties, including stability and solubility. Temsirolimus binds to the cytoplasmic protein FKBP-12, and the complex binds and inhibits mTOR. This review summarizes the clinical findings and safety of temsirolimus in RCC patients. A Phase III clinical trial has demonstrated that temsirolimus has statistically significant advantages over treatment with IFN-α in RCC patients with poor prognosis, in terms of OS (overall survival), PFS (progression-free survival), and tumor response. Median OS was improved 49% compared to IFN-α, and median PFS was approximately doubled. It is now considered the standard for RCC patients with poor prognostic features. The possibility that this agent is useful in metastatic non-clear cell carcinoma patients has also been suggested by a subset analysis of the pivotal Phase III trial. Studies in untreated favorable and intermediate risk clear cell and refractory mRCC patients are required.
Fleming, Tania; Creedy, Debra K; West, Roianne
Cultural safety in higher education learning and teaching environments is paramount to positive educational outcomes for Aboriginal and/or Torres Strait Islander (hereafter called First Peoples) students. There is a lack of research evaluating the impact of continuing professional development on midwifery academics' awareness of cultural safety. To implement and evaluate a continuing professional development intervention to improve midwifery academics' awareness of cultural safety in supporting First Peoples midwifery students success. A pre-post intervention mixed methods design was used. Academics (n=13) teaching into a Bachelor of Midwifery program agreed to participate. The intervention consisted of two workshops and five yarning circles across a semester. Data included the Awareness of Cultural Safety Scale, self-assessment on cultural safety and perceptions of racism, evaluation of the intervention, participants' journal entries, and researcher's reflections. Responses on the Awareness of Cultural Safety Scale revealed significant improvement in participants' awareness of cultural safety. There was an upward trend in self-assessment ratings. Participants reported high levels of satisfaction with the intervention or workshops and yarning circles. Participants' journal entries revealed themes willingness to participate and learn, confidence as well as anger and distress. Increased awareness of cultural safety can be transformative for midwifery academics. Workshops and yarning circles can support academics in moving beyond a 'sense of paralysis' and engage in challenging conversations to transform their learning and teaching and in turn foster a culturally safe learning and teaching environment for First Peoples midwifery students towards success. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
CESNIK, Vanessa Monteiro; ZERBINI, Thais
Abstract The objective of this study was to review the scientific literature addressing educational actions related to the training of health professionals in sexuality between 2003 and 2013. The results obtained show that college seniors, recent college graduates, or those working in hospitals and other health care facilities are not adequately prepared to meet patients' needs regarding sexuality. Several studies have shown improvement in the health practitioners' ability to deal with patien...
Davis, R; Murphy, M F; Sud, A; Noel, S; Moss, R; Asgheddi, M; Abdur-Rahman, I; Vincent, C
Blood transfusion is one of the major areas where serious clinical consequences, even death, related to patient misidentification can occur. In the UK, healthcare professional compliance with pre-transfusion checking procedures which help to prevent misidentification errors is poor. Involving patients at a number of stages in the transfusion pathway could help prevent the occurrence of these incidents. To investigate patients' willingness to be involved and healthcare professionals' willingness to support patient involvement in pre-transfusion checking behaviours. A cross-sectional design was employed assessing willingness to participate in pre-transfusion checking behaviours (patient survey) and willingness to support patient involvement (healthcare professional survey) on a scale of 1-7. One hundred and ten patients who had received a transfusion aged between 18 and 93 (60 male) and 123 healthcare professionals (doctors, nurses and midwives) involved in giving blood transfusions to patients. Mean scores for patients' willingness to participate in safety-relevant transfusion behaviours and healthcare professionals' willingness to support patient involvement ranged from 4.96-6.27 to 4.53-6.66, respectively. Both groups perceived it most acceptable for patients to help prevent errors or omissions relating to their hospital identification wristband. Neither prior experience of receiving a blood transfusion nor professional role of healthcare staff had an effect on attitudes towards patient participation. Overall, both patients and healthcare professionals view patient involvement in transfusion-related behaviours quite favourably and appear in agreement regarding the behaviours patients should adopt an active role in. Further work is needed to determine the effectiveness of this approach to improve transfusion safety. © 2012 The Authors. Transfusion Medicine © 2012 British Blood Transfusion Society.
This report documents the completion of the formal design review for modifications to the Rotary Mode Core Sampling (RMCS) safety class equipment. These modifications are intended to support core sampling operations in waste tanks requiring flammable gas controls. The objective of this review was to approve the Engineering Change Notices affecting safety class equipment used in the RMCS system. The conclusion reached by the review committee was that these changes are acceptable.
Cresswell, Kathrin; Majeed, Azeem; Bates, David W; Sheikh, Aziz
Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted. We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997-2010). The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS) Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations. Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits. Whilst the potential of clinical decision support systems in improving, in particular, practitioner performance is considerable, such technology may
Full Text Available Identifying, evaluating, and controlling workplace hazards are important functions of safety professionals (SPs. The purpose of this study was to investigate the content and frequency of hazard management dealt by safety professionals in colleges. The authors also explored the effects of organizational factors/individual factors on SPs’ perception of frequency of hazard management. The researchers conducted survey research to achieve the objective of this study. The researchers mailed questionnaires to 200 SPs in colleges after simple random sampling, then received a total of 144 valid responses (response rate = 72%. Exploratory factor analysis indicated that the hazard management scale (HMS extracted five factors, including physical hazards, biological hazards, social and psychological hazards, ergonomic hazards, and chemical hazards. Moreover, the top 10 hazards that the survey results identified that safety professionals were most likely to deal with (in order of most to least frequent were: organic solvents, illumination, other chemicals, machinery and equipment, fire and explosion, electricity, noise, specific chemicals, human error, and lifting/carrying. Finally, the results of one-way multivariate analysis of variance (MANOVA indicated there were four individual factors that impacted the perceived frequency of hazard management which were of statistical and practical significance: job tenure in the college of employment, type of certification, gender, and overall job tenure. SPs within colleges and industries can now discuss plans revolving around these five areas instead of having to deal with all of the separate hazards.
Marina Aleksandrovna Kechina
Full Text Available This article is devoted to studying of the interrelation between psychological safety and professional competence of pedagogical institutions students. The author points out the didactic unit elements of psychological disciplines which mastering forms the notions of the factors and ways of preventing or overcoming their effects. The article enlarges upon the certain sectional branches of psychological science (social and educational ones by means of which the differentiation of “risk” factors of psychological safety deprivation of the students is achieved, it also illustrates the mechanism of mastering-in these factors in the study of the course of “Psychology”. This work is performed by means of active application of humanitarian, psychological and educational technologies, interactive educational methods (i.e., social-and-psychological training, brainstorming, project method, group discussion method, case method in HEIs (Higher Eduction Institutions. The author reveals the importance of determination the psychological “risk” factors of psychological safety deprivation regarding the formation of professional competence of a pedagogical college student.Objective: To determine the “risk” factors of psychological safety deprivation of a Pedagogical college student in the process of formation of professional competence.Methods of the work performance: analysis of psychological and educational literature on the subject of the present study, a comparative analysis of learning didactic unit elements and identifying the “risk” factors of psychological safety deprivation.The work methodology: scientific research works of I.A. Bayeva, N.M. Borytko, and Y.V. Vardanyan.DOI: http://dx.doi.org/10.12731/2218-7405-2013-8-42
Bridgett, Rhianna; Klose, Petra; Duffield, Rob; Mydock, Suni; Lauche, Romy
Despite the recent re-emergence of the process of cupping by athletes, supporting evidence for its efficacy and safety remains scarce. This systematic review aims to summarize the evidence of clinical trials on cupping for athletes. SCOPUS, Cochrane Library, PubMed, AMED, and CNKI databases were searched from their inception to December 10, 2016. Randomized controlled trials on cupping therapy with no restriction regarding the technique, or cointerventions, were included, if they measured the effects of cupping compared with any other intervention on health and performance outcomes in professionals, semi-professionals, and leisure athletes. Data extraction and risk of bias assessment using the Cochrane Risk of Bias Tool were conducted independently by two pairs of reviewers. Eleven trials with n = 498 participants from China, the United States, Greece, Iran, and the United Arab Emirates were included, reporting effects on different populations, including soccer, football, and handball players, swimmers, gymnasts, and track and field athletes of both amateur and professional nature. Cupping was applied between 1 and 20 times, in daily or weekly intervals, alone or in combination with, for example, acupuncture. Outcomes varied greatly from symptom intensity, recovery measures, functional measures, serum markers, and experimental outcomes. Cupping was reported as beneficial for perceptions of pain and disability, increased range of motion, and reductions in creatine kinase when compared to mostly untreated control groups. The majority of trials had an unclear or high risk of bias. None of the studies reported safety. No explicit recommendation for or against the use of cupping for athletes can be made. More studies are necessary for conclusive judgment on the efficacy and safety of cupping in athletes.
Farley, Donna; Zheng, Hao; Rousi, Eirini; Leotsakos, Agnès
Although the importance of training in patient safety has been acknowledged for over a decade, it remains under-utilized and under-valued in most countries. WHO developed the Multi-professional Patient Safety Curriculum Guide to provide schools with the requirements and tools for incorporating patient safety in education. It was field tested with 12 participating schools across the six WHO regions, to assess its effectiveness for teaching patient safety to undergraduate and graduate students in a global variety of settings. The evaluation used a combined prospective/retrospective design to generate formative information on the experiences of working with the Guide and summative information on the impacts of the Guide. Using stakeholder interviews and student surveys, data were gathered from each participating school at three times: the start of the field test (baseline), soon after each school started teaching, and soon after each school finished teaching. Stakeholders interviewed were strongly positive about the Guide, noting that it emphasized universally important patient safety topics, was culturally appropriate for their countries, and gave credibility and created a focus on patient safety at their schools. Student perceptions and attitudes regarding patient safety improved substantially during the field test, and their knowledge of the topics they were taught doubled, from 10.7% to 20.8% of correct answers on the student survey. This evaluation documented the effectiveness of the Curriculum Guide, for both ease of use by schools and its impacts on improving the patient safety knowledge of healthcare students. WHO should be well positioned to refine the contents of the Guide and move forward in encouraging broader use of the Guide globally for teaching patient safety.
Robb, Gillian; Stolarek, Iwona; Wells, Susan; Bohm, Gillian
healthcare are present, this national study of multiple health professional pre-registration education programmes has identified teaching gaps in patient safety and improvement science methods and tools. Failure to address these gaps will compromise the ability of new graduates to successfully implement and sustain improvements.
Farley, Donna; Zheng, Hao; Rousi, Eirini; Leotsakos, Agnès
Introduction Although the importance of training in patient safety has been acknowledged for over a decade, it remains under-utilized and under-valued in most countries. WHO developed the Multi-professional Patient Safety Curriculum Guide to provide schools with the requirements and tools for incorporating patient safety in education. It was field tested with 12 participating schools across the six WHO regions, to assess its effectiveness for teaching patient safety to undergraduate and graduate students in a global variety of settings. Methods The evaluation used a combined prospective/retrospective design to generate formative information on the experiences of working with the Guide and summative information on the impacts of the Guide. Using stakeholder interviews and student surveys, data were gathered from each participating school at three times: the start of the field test (baseline), soon after each school started teaching, and soon after each school finished teaching. Results Stakeholders interviewed were strongly positive about the Guide, noting that it emphasized universally important patient safety topics, was culturally appropriate for their countries, and gave credibility and created a focus on patient safety at their schools. Student perceptions and attitudes regarding patient safety improved substantially during the field test, and their knowledge of the topics they were taught doubled, from 10.7% to 20.8% of correct answers on the student survey. Discussion This evaluation documented the effectiveness of the Curriculum Guide, for both ease of use by schools and its impacts on improving the patient safety knowledge of healthcare students. WHO should be well positioned to refine the contents of the Guide and move forward in encouraging broader use of the Guide globally for teaching patient safety. PMID:26406893
BRADY RAAP, M.C.
This document provides the results of an internal management review of the Tank Waste Remediation System (TWRS) criticality safety program, performed in advance of the DOE/RL assessment for closure of the TWRS Nuclear Criticality Safety Issue, March 1994. Resolution of the safety issue was identified as Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Milestone M-40-12, due September 1999.
Silver, E. G. [ed.
This review journal covers significant developments in the field of nuclear safety. Its scope includes the analysis and control of hazards associated with nuclear energy, operations involving fissionable materials, and the products of nuclear fission and their effects on the environment. Primary emphasis is on safety in reactor design, construction, and operation; however, the safety aspects of the entire fuel cycle, including fuel fabrication, spent-fuel processing, nuclear waste disposal, handling of radioisotopes, and environmental effects of these operations, are also treated.
... an interest in gun safety. Representative stakeholders include, but are not limited to, law... of Justice Programs Review of Gun Safety Technologies AGENCY: National Institute of Justice, JPO, DOJ. ACTION: Notice. SUMMARY: Following the President's Plan to reduce gun violence released on January 16...
Hannula, Leena; Kaunonen, Marja; Tarkka, Marja-Terttu
The objectives of this systematic review were first, to describe how breastfeeding is professionally supported during pregnancy, at maternity hospitals and during the postnatal period. Secondly, to find out how effective interventions are in supporting breastfeeding. Breastfeeding is an effective way to promote the health of infants. In many countries, the rates for breastfeeding remain lower than recommended. Many studies have examined breastfeeding promotion interventions; some of them are successful and some fail. It is important to find effective combinations of support. Systematic review. Search of CINAHL, Medline and Cochrane Central Register databases were conducted for data collection. The search was limited to articles published in Finnish, Swedish and English between the year 2000 and March 2006, focusing on breastfeeding and breastfeeding support interventions. Two reviewers independently analysed 36 articles in the final analysis. Interventions expanding from pregnancy to the intrapartum period and throughout the postnatal period were more effective than interventions concentrating on a shorter period. In addition, intervention packages using various methods of education and support from well-trained professionals are more effective than interventions concentrating on a single method. During pregnancy, the effective interventions were interactive, involving mothers in conversation. The Baby Friendly Hospital Initiative (BFHI) as well as practical hands off -teaching, when combined with support and encouragement, were effective approaches. Postnatally effective were home visits, telephone support and breastfeeding centres combined with peer support. Relevance to clinical practice. Professionals need breastfeeding education and support of their organisations to act as breastfeeding supporters. The BFHI -programme is effective and it would be wise to include the core components of the programme in breastfeeding promotion interventions. Mothers benefit from
García-Basteiro, Alberto L; Alvarez-Pasquín, María-José; Mena, Guillermo; Llupià, Anna; Aldea, Marta; Sequera, Victor-Guillermo; Sanz, Sergi; Tuells, Jose; Navarro-Alonso, José-Antonio; de Arísteguí, Javier; Bayas, José-María
Vacunas.org (http://www.vacunas.org), a website founded by the Spanish Association of Vaccinology offers a personalized service called Ask the Expert, which answers any questions posed by the public or health professionals about vaccines and vaccination. The aim of this study was to analyze the factors associated with questions on vaccination safety and determine the characteristics of questioners and the type of question asked during the period 2008-2010. A total of 1341 questions were finally included in the analysis. Of those, 30% were related to vaccine safety. Questions about pregnant women had 5.01 higher odds of asking about safety (95% CI 2.82-8.93) than people not belonging to any risk group. Older questioners (>50 years) were less likely to ask about vaccine safety compared to younger questioners (OR: 0.44, 95% CI 0.25-0.76). Questions made after vaccination or related to influenza (including H1N1) or travel vaccines were also associated with a higher likelihood of asking about vaccine safety. These results identify risk groups (pregnant women), population groups (older people) and some vaccines (travel and influenza vaccines, including H1N1) where greater efforts to provide improved, more-tailored vaccine information in general and on the Internet are required. Copyright © 2011 Elsevier Ltd. All rights reserved.
Silver, E G [ed.
Nuclear Safety is a review journal that covers significant developments in the field of nuclear safety. Its scope includes the analysis and control of hazards associated with nuclear energy, operations involving fissionable materials, and the products of nuclear fission and their effects on the environment. Primary emphasis is on safety in reactor design, construction, and operation; however, the safety aspects of the entire fuel cycle, including fuel fabrication, spent-fuel processing, nuclear waste disposal, handling of radioisotopes, and environmental effects of these operations, are also treated.
Silver, E G [ed.
Nuclear Safety is a review journal that covers significant development in the field of nuclear safety. Its scope included the analysis and control of hazards associated with nuclear energy, operations involving fissionable materials and the products of nuclear fission and their effects on the environment. Primary emphasis is on safety in reactor design, construction, and operation; however, the safety aspects of the entire fuel cycle, including fuel fabrication, spent-fuel processing, nuclear waste disposal, handling of radioisotopes, and environmental effects of these operations, are also treated. Individual papers have been cataloged separately.
Full Text Available Purpose Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted.Methods We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997–2010. The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations.Results Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits.Conclusions Whilst the potential of clinical decision support systems in improving, in particular
Trautmann, Nancy M.
This article compares peer review in professional versus education settings, summarizing key aspects of scientific peer review and reflecting on how these relate to the process as experienced by students. Consideration of professional peer review benefits educators in two ways. First, systems used for student peer review can employ some of the…
Todd William Loushine
Full Text Available The aim of this paper is to demonstrate a novel assessment method developed to determine if the curriculum from two separate safety degree programs provided sufficient opportunity for students to obtain the knowledge required for professional practice in occupational safety. The method relies on the Board of Certified Safety Professionals (BCSP examination blueprints. In the graduate program case study, over 88% of the BCSP criteria were met through an explicit means and up to 64% through assignments or better. Aggregating criteria into respective subject areas showed that the curriculum covered anywhere from 58% to 100% of the items within each BCSP topic. In the undergraduate case study, over 96% of the BCSP criteria through an explicit means, and 82.8% of knowledge items were assessed in assignments, exams or better. Aggregating criteria into respective subject areas showed that the curriculum covered anywhere from 75% to 100% of the items within each BCSP topic. Once briefed on the results, all faculty/instructors agreed that the approach helped identify strengths and weaknesses in their current curriculum. Most importantly, presentation of results acted as a catalyst for curricular discussions amongst the faculty that resulted in improvement priorities and a better understanding of student learning potential in course assignments. DOI: 10.18870/hlrc.v3i2.113
Girerd-Genessay, I; Michel, P
Used for over a decade, patient safety leadership walkrounds (PSLWs) is a managerial method designed to enhance the implementation of safety measures in hospitals. In order to determine the effect of PSLWs in French hospitals, we reviewed the literature on participant perceptions and the impact of PSLW on the overall culture of safety. We conducted a systematic review of articles assessing the impact of PSLWs on the culture of safety (comparative studies) or the perceptions of caregivers and managers (qualitative studies). Five studies investigating safety culture and three studies investigating participant perception were identified. PSLWs were associated with an improvement in safety culture and the overall safety climate. The presence of caregivers during the PSLWs was important to achieve improvement. PSLWs improved the dialogue between caregivers and managers, and improved knowledge on care safety. Some problems concerning managerial PSLW attendance and counter-productive attitudes have occasionally been reported. PSLWs improve safety culture. Their effectiveness depends on the way they are implemented. They should initially be tested in France to ensure their feasibility and acceptability in our healthcare system. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Gagnon, Marie-Pierre; Ngangue, Patrice; Payne-Gagnon, Julie; Desmartis, Marie
The aim of this systematic review was to synthesize current knowledge of the factors influencing healthcare professional adoption of mobile health (m-health) applications. Covering a period from 2000 to 2014, we conducted a systematic literature search on four electronic databases (PubMed, EMBASE, CINAHL, PsychInfo). We also consulted references from included studies. We included studies if they reported the perceptions of healthcare professionals regarding barriers and facilitators to m-health utilization, if they were published in English, Spanish, or French and if they presented an empirical study design (qualitative, quantitative, or mixed methods). Two authors independently assessed study quality and performed content analysis using a validated extraction grid with pre-established categorization of barriers and facilitators. The search strategy led to a total of 4223 potentially relevant papers, of which 33 met the inclusion criteria. Main perceived adoption factors to m-health at the individual, organizational, and contextual levels were the following: perceived usefulness and ease of use, design and technical concerns, cost, time, privacy and security issues, familiarity with the technology, risk-benefit assessment, and interaction with others (colleagues, patients, and management). This systematic review provides a set of key elements making it possible to understand the challenges and opportunities for m-health utilization by healthcare providers. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
2Pesticide Action Network (PAN) Nexus, Ethiopia;. 3Department of Preventive Medicine, Keck School of Medicine, University of Southern California, USA;. 4Ministry of Labour and Social Affairs, Ethiopia. Review Article. Occupational Health and Safety in Ethiopia: A review of. Situational Analysis and Needs Assessment.
Elmontsri, Mustafa; Almashrafi, Ahmed; Banarsee, Ricky; Majeed, Azeem
To explore the status of patient safety culture in Arab countries based on the findings of the Hospital Survey on Patient Safety Culture (HSPSC). Systematic review. We performed electronic searches of the MEDLINE, EMBASE, CINAHL, ProQuest and PsychINFO, Google Scholar and PubMed databases, with manual searches of bibliographies of included articles and key journals. We included studies that were conducted in the Arab countries that were focused on patient safety culture. 2 reviewers independently verified that the studies met the inclusion criteria and critically assessed the quality of the studies. 18 studies met our inclusion criteria. The review identified that non-punitive response to error is seen as a serious issue which needs to be improved. Healthcare professionals in the Arab countries tend to think that a 'culture of blame' still exists that prevents them from reporting incidents. We found an overall similarity between the reported composite score for dimension of teamwork within units in all of the reviewed studies. Teamwork within units was found to be better than teamwork across hospital units. All of the reviewed studies reported that organisational learning and continuous improvement was satisfactory as the average score of this dimension for all studies was 73.2%. Moreover, the review found that communication openness seems to be a concerning issue for healthcare professionals in the Arab countries. There is a need to promote patient safety culture as a strategy for improving the patient safety in the Arab world. Improving patient safety culture should include all stakeholders, like policymakers, healthcare providers and those responsible for medical education. This review was limited only to English language publications. The varied settings in which the HSPSC was used may have influenced the areas of strengths and weaknesses as healthcare workers' perception of safety culture may differ. Published by the BMJ Publishing Group Limited. For
Full Text Available The effective traffic safety training is a long process; it starts from very young age and continues throughout life. This is not only a process of acquiring knowledge and skills, but also a matter of social importance. Pedagogical forms of education depend on the position of a man in society, respectively, on abilities to percept the environment. The recent investigations of traffic accidents show, that the young drivers generally have poorer than average self-reflection skills. It is therefore important to foster self-reflection skills and attitudes from an early age, especially in matters that relate to road and driving safety. All of staff that have career in traffic safety training (mainly instructors for driving and traffic safety teachers in Europe have their responsibility for decreasing the traffic accidents and incidents by polishing their skills. They work under variety conditions, specific National Lows and Regulations, but the features of their target groups are one and the same. In order to meet the new challenges put by EU Commission they need to have common vision about traffic safety training in Europe, to know what traffic safety means for different age groups, to know what is the best practice of their colleagues, including curricula, methods, training materials, and to be aware their work is very important for traffic safety. Aim of this paper is to present an approach for non-formal instructors for driving and traffic safety teachers training for modernizing their professional capabilities with students form 0 to 30 years old. The investigations and main results are based on the theoretical investigation for hierarchical level of behavior, made by Hatakka for instructors for driving training. The students are divided in four age groups: pre-school children (0-6 years, schoolchildren (7-12 years, teenagers (13-17 years and young adults (18-30 years. For each age group a curriculum is developed according to common EU rules and
Osepchuk, J M
The microwave leakage from current microwave ovens, which are manufactured to meet government emission standards, is reviewed. Typical leakage values imply exposure values well below the most conservative exposure standards in the world. A review of recent developments discloses increasingly stringent government regulation along with advances in techniques for suppression of microwave leakage. The nature of the leakage field is described and studies relating emission to exposure are reviewed. Field survey data are reviewed and it is found that the overwhelming majority of certified ovens in the field show leakage well below permissible limits with an increasing degree of certainty as time goes on. The conclusion is that microwave ovens are not only just as safe as they were in 1973 but they are being accepted as safe under essentially equivalent emission regulations in various countries including those in Eastern Europe.
Robinson, David W.
The most complex space vehicle in history, Space Station Freedom, is well underway to completion, and System Safety is a vital part of the program. The purpose is to summarize and illustrate the progress that over one-hundred System Safety engineers have made in identifying, documenting, and controlling the hazards inherent in the space station. To date, Space Station Freedom has been reviewed by NASA's safety panels through the first six assembly flights, when Freedom achieves a configuration known as Man Tended Capability. During the eight weeks of safety reviews spread out over a year and a half, over 200 preliminary hazard reports were presented. Along the way NASA and its contractors faced many challenges, made much progress, and even learned a few lessons.
Maruyama, Yasushi; Ueno, Tetsu
Ethics education for professionals has become popular in Japan over the last two decades. Many professional schools now require students to take an applied ethics or professional ethics course. In contrast, very few courses of professional ethics for teaching exist or have been taught in Japan. In order to obtain suggestions for teacher education,…
Torijano-Casalengua, María Luisa; Olivera-Cañadas, Guadalupe; Astier-Peña, María Pilar; Maderuelo-Fernández, José Ángel; Silvestre-Busto, Carmen
[corrected] To validate a tool to measure patient safety culture in Spanish primary care professionals. Medical Office Survey on Patient Safety Culture (MOSPSC), from the Agency for Healthcare and Research in Quality (AHRQ). The process has been performed in five steps: original version traslation, conceptual equivalence evaluation, acceptability and viability assessment, content validity and questionnaire test and response analysis and psichometric properties assessment. Primary care. 185 Primary care professionals from different Spanish regions represented the sample test. Frecuency, response pattern and discrimination power of each item. Cronbach's alpha coefficient and dimensions obtained through factor analysis. 17, 8% of respondents answered all the items and 28, 7% of them did not answer, or answered the option "Don't know/Does not apply", to one to four items. All the sentences, with only one exception, present discrimination capacity. Cronbach's alpha coefficient results 0,96 and information is sumarized in 15 factors obtaining the same items in 7 of the total 12 factors in the original questionnaire. Traslated, adapted, extended and validated AHRQ questionnaire is, in this setting, a reliable and useful instrument and it must be used for international comparisons. Copyright © 2012 Elsevier España, S.L. All rights reserved.
Eddy, Kylie; Jordan, Zoe; Stephenson, Matthew
Teamwork is seen as an important element of patient care in acute hospital settings. The complexity of the journey of care for patients highlights the need for health professionals to collaborate and communicate clearly with each other. Health organizations in western countries are committed to improving patient safety through education of staff and teamwork education programs have been integral to this focus. There are no current systematic reviews of the experience of health professionals who participate in teamwork education in acute hospital settings. The objective of this systematic review was to search for the best available evidence on the experiences of health professionals who participate in teamwork education in acute hospital settings. This review considered studies reporting on experiences of registered health professionals who work in acute hospitals. This included medical, nursing and midwifery and allied health professionals. The focus of the meta-synthesis was the experiences and reflections of health professionals who were involved in teamwork education in acute hospital settings. The geographical context for this review was acute hospitals in rural or metropolitan settings in Australia and overseas countries. The review focused on the experiences of health professionals who work in acute hospitals and participated in teamwork education programs. This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.In the absence of research studies, other text such as opinion papers, discussion papers and reports were considered. Studies published in English and from 1990 to 2013 were included in this review. The literature search for relevant papers occurred between 13 September and 26 October 2013. A three-step search strategy was utilized in this review. The databases searched were PubMed, CINAHL, Embase and Scopus. The
Mickan, Sharon; Tilson, Julie K; Atherton, Helen; Roberts, Nia Wyn; Heneghan, Carl
Handheld computers and mobile devices provide instant access to vast amounts and types of useful information for health care professionals. Their reduced size and increased processing speed has led to rapid adoption in health care. Thus, it is important to identify whether handheld computers are actually effective in clinical practice. A scoping review of systematic reviews was designed to provide a quick overview of the documented evidence of effectiveness for health care professionals using handheld computers in their clinical work. A detailed search, sensitive for systematic reviews was applied for Cochrane, Medline, EMBASE, PsycINFO, Allied and Complementary Medicine Database (AMED), Global Health, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. All outcomes that demonstrated effectiveness in clinical practice were included. Classroom learning and patient use of handheld computers were excluded. Quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. A previously published conceptual framework was used as the basis for dual data extraction. Reported outcomes were summarized according to the primary function of the handheld computer. Five systematic reviews met the inclusion and quality criteria. Together, they reviewed 138 unique primary studies. Most reviewed descriptive intervention studies, where physicians, pharmacists, or medical students used personal digital assistants. Effectiveness was demonstrated across four distinct functions of handheld computers: patient documentation, patient care, information seeking, and professional work patterns. Within each of these functions, a range of positive outcomes were reported using both objective and self-report measures. The use of handheld computers improved patient documentation through more complete recording, fewer documentation errors, and increased efficiency. Handheld computers provided easy access to clinical decision support systems and
Albiol, Thierry [CEA Cadarache, St Paul Lez Durance Cedex (France); Arai, Yasuo [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment
This report provides a review of the potential advantages of using actinide nitrides as fuels and/or targets for nuclear waste transmutation. Then a summary of available properties of actinide nitrides is given. Results from irradiation experiments are reviewed and safety relevant aspects of nitride fuels are discussed, including design basis accidents (transients) and severe (core disruptive) accidents. Anyway, as rather few safety studies are currently available and as many basic physical data are still missing for some actinide nitrides, complementary studies are proposed. (author)
... COMMISSION Review of Safety Analysis Reports for Nuclear Power Plants, Introduction AGENCY: Nuclear... subsection to NUREG-0800, ``Standard Review Plan for the Review of Safety Analysis Reports for Nuclear Power..., Standard Review Plan for the Review of Safety Analysis Reports for Nuclear Power Plants: Integral...
Barnes, E; Bullock, A D; Bailey, S E R; Cowpe, J G; Karaharju-Suvanto, T
To summarise findings from a literature review of dentists' engagement in continuing professional development (CPD) and its effects on improving oral health care for patients. The search strategy used key terms in a range of databases and an academic literature search engine, complemented by hand searching and citation follow-up. One hundred and fourteen papers were reviewed. The majority of dentists engaged in CPD. Factors affecting participation included time since graduation, costs, work and home commitments, postgraduate qualification, interest and convenience. Learning needs identification and reflection on practice were rarely evidenced. Common modes of CPD were courses and journal reading; no one delivery method proved more effective. Few papers directly explored recommendations for topics although suggestions related to common areas of error and gaps in knowledge or skill. Studies of CPD effectiveness and impact-on-practice suggested that courses can result in widespread new learning and considerable self-reported change in practice. However, significant barriers to implementing change in workplace practice were noted and included availability of materials, resources and support from colleagues. To ensure high standards of care, alongside recommending core or mandatory topics, more attention should be given to reflection on learning needs, the learner's readiness to engage with education and training and the influence of the workplace environment. © 2013 John Wiley & Sons A/S.
Full Text Available Tadeusz Robak Department of Hematology, Medical University of Lodz and Copernicus Memorial Hospital, Lodz, PolandSafety of Biologics Therapy: Monoclonal Antibodies, Cytokines, Fusion Proteins, Hormones, Enzymes, Coagulation Proteins, Vaccines, Botulinum Toxins (Cham, Switzerland: Springer International Publishing; 2016 by Brian A Baldo from the Molecular Immunology Unit, Kolling Institute of Medical Research, Royal North Shore Hospital of Sydney, and the Department of Medicine, University of Sydney, Australia, is a book that belongs on the shelf of everyone in the field of biologic therapies research and clinical practice. In writing this book, the author’s intention was to produce an up-to-date text book on approved biologic therapies, as far as that is possible in this time of rapidly evolving developments in biotherapeutic research and the introduction of new and novel agents for clinical use.The monograph comprises 610 pages in 13 chapters, each including a summary and further reading suggestions. All chapters include a discussion of basic and clinical material. Well-designed, comprehensive tables and color figures are present throughout the book. The book itself examines the biologic products that have regulatory approval in the USA and/or European Union and that show every indication of remaining important therapies. It covers in great detail all the latest work on peptide hormones and enzymes, monoclonal antibodies, fusion proteins, and cytokine therapies. Beyond that, it also presents the latest information on blood coagulation proteins, vaccines, botulinum neurotoxins, and biosimilars.
Reihlen, Markus; Werr, Andreas
Research on entrepreneurship in professional services is rather limited. We argue that one reason why the two fields of professional services and entrepreneurship have operated in isolation rather than in mutual interaction is an inherent contradiction between the very ideas of entrepreneurship and professionalism. Our perspective on entrepreneurship for this chapter is rather broad, focusing on new venture management and renewal in professional service firms as well as embracing aspects such...
Hunter, Kathleen F; Parke, Belinda; Babb, Maureen; Forbes, Dorothy; Strain, Laurel
The emergency department (ED) is a potentially harmful environment for older adults with dementia, and rural EDs face unique challenges in providing care to this population. The purpose of this study was to understand safety and harm in rural ED transitional care for community dwelling older adults with dementia from the perspective of healthcare professionals (HCPs). An interpretive, descriptive exploratory design from a social ecological perspective was used. Using purposive and snowball sampling, HCPs were recruited from two rural hospital EDs in two Canadian provinces. Data collection involved participant interviews using a semi-structured interview guide. Audio-recorded interviews were transcribed, transcripts coded, and themes identified using constant comparative analysis with thematic coding. A total of 12 HCPs, seven from one province and five from the other, participated in the study. HCPs worked directly in the ED or consulted in the ED from hospital-based social work, rehabilitation and community liaison services. Three themes were identified: physical environment (space, design and equipment), work environment (pressure to perform) and practice environment (family, knowledge and processes). A conceptual model was developed to illustrate how HCPs worked to balance safety and harm for older patients with dementia within a milieu created by the overlapping and synergistically interacting environments. HCPs in rural EDs working at the interface of hospital and community constantly attempt to balance promoting safety and avoiding harm for older adults with dementia. Participants perceived safety broadly, understanding that the consequences of the milieu were created through an interaction between physical, work and practice environments. These consequences related to the physical, cognitive and emotional wellbeing of older adults with dementia and their caregivers. Within the practice environment, participants identified a 'rural advantage' that was tied to
Verbakel, Natasha J; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M
Patient safety culture, described as shared values, attitudes and behavior of staff in a health-care organization, gained attention as a subject of study as it is believed to be related to the impact of patient safety improvements. However, in primary care, it is yet unknown, which effect interventions have on the safety culture. To review literature on the use of interventions that effect patient safety culture in primary care. Searches were performed in PubMed, EMBASE, CINAHL, and PsychINFO on March 4, 2013. Terms defining safety culture were combined with terms identifying intervention and terms indicating primary care. Inclusion followed if the intervention effected patient safety culture, and effect measures were reported. The search yielded 214 articles from which two were eligible for inclusion. Both studies were heterogeneous in their interventions and outcome; we present a qualitative summary. One study described the implementation of an electronic medical record system in general practices as part of patient safety improvements. The other study facilitated 2 workshops for general practices, one on risk management and another on significant event audit. Results showed signs of improvement, but the level of evidence was low because of the design and methodological problems. These studies in general practice provide a first understanding of improvement strategies and their effect in primary care. As the level of evidence was low, no clear preference can be determined. Further research is needed to help practices make an informed choice for an intervention.
Review Article: Socio-Economic Implications of Poor Safety Practices. LC Okoro. Abstract. No abstract. Journal of Medical Laboratory Science Vol.12(2) 2003: 28 - 32. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/jmls.v12i2.35284.
Stratton, Kathleen; Gable, Alicia; McCormick, Marie C
..., and Marie C.McCormick, Editors Immunization Safety Review Committee Board on Health Promotion and Disease Prevention INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Washington, D.C. Copyrightoriginal retained, the be not from cannot book, paper original however, for version formatting, authoritative the typesetting-specific created from the as publ...
Evans, Jim; Heiberger, Scott
Agricultural media merit increased attention in addressing dynamic changes in safety aspects of one of the nation's most hazardous industries. Changes in farming, such as larger-scale, new "niche" enterprises and new technologies, bring new forms of risk to the safety of those who live and work on farms and ranches. At the same time, traditional agricultural media--commercial firms that publish farm periodicals and commercial radio/television stations and networks that provide farm programming--are changing dramatically. In the face of media convergence, these enterprises provide an increasing menu of agricultural information services delivered by print, radio, and television, plus a host of new electronic media. This review of literature addressed the role and importance of commercial agricultural media in the United States, the scope and pattern of their safety coverage, and the opportunities they represent. The review involved searches of 14 bibliographic databases, as well as reference lists of relevant studies and contacts with farm safety experts. Analysis of 122 documents suggested that limited focus has been directed to the role of commercial agricultural media in safety decisions on US farms. Findings revealed that they continue to serve an efficient, early-stage role in creating awareness and interest, providing information, forming attitudes, and stirring consideration of farm safety. Potentials are seen as expanding through the interactive features of social media and other new services offered by these media firms. Findings also identified research needs, 100 farm safety topics for reporting, and opportunities for strengthening safety coverage by commercial agricultural media.
Piening, Sigrid; Haaijer-Ruskamp, Flora M; de Vries, Jonie T N; van der Elst, Menno E; de Graeff, Pieter A; Straus, Sabine M J M; Mol, Peter G M
After market approval, new serious safety issues are regularly identified for drugs that lead to regulatory action to inform healthcare professionals. However, the effectiveness of these safety-related regulatory actions is under question. We currently lack a comprehensive overview of the effects of these drug safety warnings on clinical practice to resolve the debate about their effectiveness. The aim of this systematic review is to provide an overview of studies that assessed the impact of safety warnings. A systematic search was performed for articles assessing the impact of Direct Healthcare Professional Communications or 'Dear Doctor' letters, Black Box Warnings and Public Health Advisories on clinical behaviour published between January 1996 and January 2010. The following variables were extracted: publication year, country, name of the drug, safety issue, specific safety warning (Direct Healthcare Professional Communication/Black Box Warning/Public Health Advisory), effect (intended/unintended) of the safety warning, outcome measure and study design. Papers were checked for several quality aspects. Study data were summarized using descriptive analyses. A total of 50 articles were identified. Two articles assessed two different drugs and were therefore counted twice (n = 52). Thirty-three articles described the impact of safety warnings issued for three drugs and drug groups, i.e. third-generation oral contraceptives, cisapride and selective serotonin reuptake inhibitors. The remaining 19 articles described a broad variety of 14 drugs and drug groups. Twenty-five studies applied an interrupted time series design, 23 a controlled or uncontrolled before/after design, and four articles applied both. None of the articles could rule out the influence of confounding factors. The intended effects were reported in 18 (72%) of the 25 before/after analyses, whereas only 11 (41%) of the 27 interrupted time series analyses reported an impact. Only two (8%) of the
Wallner, Stephanie; Kendall, Patricia; Hillers, Virginia; Bradshaw, Eva; Medeiros, Lydia C
To develop and evaluate the efficacy of an online continuing education course for professionals who provide food safety information to high-risk populations. A 2-credit graduate-level class was converted into six web-based modules (overview of foodborne illness, immunology, pregnancy, human immunodeficiency virus, cancer and transplants, and lifecycle) and offered to nutrition and health professionals. Participants had 8 weeks to complete the modules, pre and post questionnaires, and course evaluation. Those who successfully completed the protocol received six continuing education units from one of three professional associations. Change in knowledge was measured using pre and post questionnaires. Course efficacy was evaluated using a post-course questionnaire. A convenience sample of 140 registered dietitians/dietetic technicians registered, nurses, and extension educators were recruited through professional conferences and electronic mailing lists to take the course. Analysis of variance was used to evaluate differences in knowledge scores for all groups across five main effects (attempt, module, profession, age, and education). Course evaluation responses were used to assess course effectiveness. For each module, knowledge scores increased significantly (POnline continuing education courses, such as "Food Safety Issues for High Risk Populations," seem to be a convenient, effective option for dietetics professionals, nurses, and extension educators seeking knowledge about food safety issues of high-risk populations. Online learning is a promising delivery approach for the continuing education of health professionals.
Knowles, Sarah; Hays, Rebecca; Senra, Hugo; Bower, Peter; Locock, Louise; Protheroe, Jo; Sanders, Caroline; Daker-White, Gavin
Multimorbidity, defined as the presence of two or more long-term conditions, is increasingly common in primary care, and patients with multimorbidity may face particular barriers to quality of care and increased safety risks due to the complexity of managing multiple conditions. Consistent with calls to directly involve service users in improving care, we aimed to use design materials to codesign new interventions to improve safety in primary care. We drew on two established methods-accelerated experience-based codesign and the future workshop approach. We synthesized design materials based on research into the patient experience of safety and multimorbidity in primary care to enable both patients, service users and carers, and primary health-care professionals to propose interventions to improve care. Both patients and professionals prioritized polypharmacy as a threat to safety. Their recommendations for supportive interventions were consistent with Burden of Treatment theory, emphasizing the limited capacity of patients with multimorbidity and the need for services to proactively offer support to reduce the burden of managing complex treatment regimes. The process was feasible and acceptable to participants, who valued the opportunity to jointly propose new interventions. The iterative workshop approach enabled the research team to better explore and refine the suggestions of attendees. Final recommendations included the need for accessible reminders to support medication adherence and medication reviews for particularly vulnerable patients conducted with pharmacists within GP practices. © 2017 The Authors. Health Expectations published by John Wiley & Sons Ltd.
Fernanda Veruska Narciso
Full Text Available ABSTRACT Traffic accidents and resulting injuries and deaths have become a global epidemic. In Brazil, most professional drivers, especially truck drivers, face irregular working hours and can be awake for more than 18 hours/day, which reduces their performance and alertness. In this article, we discuss the laws related to Brazilian professional drivers and their current amendments (No. 12,619/2012 and No. 13,103/2015 in relation to working hours at the wheel and rest breaks, which are vital for the quality of life of drivers and society in general. We note that the new law appears to be less efficient than the previous one as it causes insecurity and concern to the users of the transportation system, drivers, and employers. To restrict and reduce accidents, deaths, and injuries in traffic, appropriate legislation is essential, aiming at the safety of workers and users of highways. The law must also benefit the commercial aspect, strengthening the reduction in production and logistics losses. Additionally, traffic education programs are needed, as well as better supervision in relation to total working hours.
Diego L. Sepúlveda M; Jairo Ramírez G
Objective: to determine the safety conditions of steam boilers in companies associated with a professional risk administra-tion company in Antioquia, Colombia. To this end, their op-eration conditions shall be characterized, the associated risks identified, and their safety level assessed. Methodology:. a descriptive crosssectional study was carried out in twenty companies whose production processes involve boilers. A survey on the conditions for operation was applied on both the maintena...
Kümler, Iben; Nielsen, Dorte Lisbet
enables the reader to overview current knowledge on the efficacy and safety of bevacizumab in breast cancer. Expert opinion: Insight into complex risk-benefit calculations for bevacizumab is missing. In unselected patients with HER2-negative metastatic breast cancer, the risk of serious side effects...... for continued gains in therapy efficacy. Areas covered: The authors review Phase III data concerning the safety of bevacizumab in breast cancer, summarize data on efficacy and discuss the risk:benefit ratio of the drug. The data for this review were obtained by searching in the PubMed database. This review...... of bevacizumab overshadows the benefit of the drug. However, increased response rates and progression-free survival in the majority of Phase III trials suggest that the drug is of benefit in a subgroup of patients. Although requiring close monitoring, most side effects are manageable. Reliable, validated...
Thaynara de Oliveira Silva
Full Text Available The aim of this integrative review was to survey the strategies adopted by health institutions that involve patients in care as a barrier to prevent incidents. A search was conducted in MEDLINE, LILACS, CINAHL and PubMed databases using the descriptors ‘patient safety’, ‘iatrogenic’, ‘medical error’ and ‘involvement’. The review included studies in full text published between 2003 and March 2016 in English, Spanish or Portuguese. It was found that the effective communication and the development of patients’ autonomy are the most advocated strategies. The level of evidence of studies was limited to four and six. The assessment or description of institutional practices involving patients in their safety emerged as a gap in scientific knowledge. The impact of this review is to demonstrate the need for randomized studies to identify effective interventions, directing health institutions towards change in the organizational culture, focusing on safety and patient-centered care.
Under DOE Order 5481.1, Safety Analysis and Review System for DOE Operations, safety analyses are required for DOE projects in order to ensure that: (1) potential hazards are systematically identified; (2) potential impacts are analyzed; (3) reasonable measures have been taken to eliminate, control, or mitigate the hazards; and (4) there is documented management authorization of the DOE operation based on an objective assessment of the adequacy of the safety analysis. This report is intended to provide the DOE Office of Plans and Technology Assessment (OPTA) with an independent evaluation of the adequacy of the ongoing safety analysis effort. As part of this effort, a number of site visits and interviews were conducted, and FE SARS documents were reviewed. The latter included SARS Implementation Plans for a number of FE field offices, as well as safety analysis reports completed for certain FE operations. This report summarizes SARS related efforts at the DOE field offices visited and evaluates the extent to which they fulfill the requirements of DOE 5481.1.
Ahn, Roy; Alpert, Elaine J; Purcell, Genevieve; Konstantopoulos, Wendy Macias; McGahan, Anita; Cafferty, Elizabeth; Eckardt, Melody; Conn, Kathryn L; Cappetta, Kate; Burke, Thomas F
Human trafficking is an increasingly well-recognized human rights violation that is estimated to involve more than 2 million victims worldwide each year. The health consequences of this issue bring victims into contact with health systems and healthcare providers, thus providing the potential for identification and intervention. A robust healthcare response, however, requires a healthcare workforce that is aware of the health impact of this issue; educated about how to identify and treat affected individuals in a compassionate, culturally aware, and trauma-informed manner; and trained about how to collaborate efficiently with law enforcement, case management, and advocacy partners. This article describes existing educational offerings about human trafficking designed for a healthcare audience and makes recommendations for further curriculum development. A keyword search and structured analysis of peer-reviewed and gray literature, conducted in 2011 and 2012, yielded 27 items that provide basic guidance to health professionals on human trafficking. The 27 resources differed substantially in format, length, scope, and intended audience. Topic areas covered by these resources included trafficking definitions and scope, health consequences, victim identification, appropriate treatment, referral to services, legal issues, and security. None of the educational resources has been rigorously evaluated. There is a clear need to develop, implement, and evaluate high-quality education and training programs that focus on human trafficking for healthcare providers. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Snowdon, David A; Leggat, Sandra G; Taylor, Nicholas F
To ensure quality of care delivery clinical supervision has been implemented in health services. While clinical supervision of health professionals has been shown to improve patient safety, its effect on other dimensions of quality of care is unknown. The purpose of this systematic review is to determine whether clinical supervision of health professionals improves effectiveness of care and patient experience. Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Data were extracted on effectiveness of care (process of care and patient health outcomes) and patient experience. Seventeen studies across multiple health professions (medical (n = 4), nursing (n = 7), allied health (n = 2) and combination of nursing, medical and/or allied health (n = 4)) met the inclusion criteria. The clinical heterogeneity of the included studies precluded meta-analysis. Twelve of 14 studies investigating 38,483 episodes of care found that clinical supervision improved the process of care. This effect was most predominant in cardiopulmonary resuscitation and African health settings. Three of six studies investigating 1756 patients found that clinical supervision improved patient health outcomes, namely neurological recovery post cardiopulmonary resuscitation (n = 1) and psychological symptom severity (n = 2). None of three studies investigating 1856 patients found that clinical supervision had an effect on patient experience. Clinical supervision of health professionals is associated with effectiveness of care. The review found significant improvement in the process of care that may improve compliance with processes that are associated with enhanced patient health
Martinez, William; Lehmann, Lisa Soleymani; Thomas, Eric J; Etchegaray, Jason M; Shelburne, Julia T; Hickson, Gerald B; Brady, Donald W; Schleyer, Anneliese M; Best, Jennifer A; May, Natalie B; Bell, Sigall K
Open communication between healthcare professionals about care concerns, also known as 'speaking up', is essential to patient safety. Compare interns' and residents' experiences, attitudes and factors associated with speaking up about traditional versus professionalism-related safety threats. Anonymous, cross-sectional survey. Six US academic medical centres, 2013-2014. 1800 medical and surgical interns and residents (47% responded). Attitudes about, barriers and facilitators for, and self-reported experience with speaking up. Likelihood of speaking up and the potential for patient harm in two vignettes. Safety Attitude Questionnaire (SAQ) teamwork and safety scales; and Speaking Up Climate for Patient Safety (SUC-Safe) and Speaking Up Climate for Professionalism (SUC-Prof) scales. Respondents more commonly observed unprofessional behaviour (75%, 628/837) than traditional safety threats (49%, 410/837); pspeaking up about unprofessional behaviour less commonly (46%, 287/628 vs 71%, 291/410; pspeaking up about unprofessional behaviour compared with traditional safety threats (58%, 482/837 vs 42%, 348/837; pspeak up to an attending physician in the professionalism vignette than the traditional safety vignette, even when they perceived high potential patient harm (20%, 49/251 vs 71%, 179/251; pspeaking up in the traditional safety vignette (OR 1.90, 99% CI 1.36 to 2.66 and 1.46, 1.02 to 2.09, respectively), while only a positive perception of SUC-Prof was associated with speaking up in the professionalism vignette (1.76, 1.23 to 2.50). Interns and residents commonly observed unprofessional behaviour yet were less likely to speak up about it compared with traditional safety threats even when they perceived high potential patient harm. Measuring SUC-Safe, and particularly SUC-Prof, may fill an existing gap in safety culture assessment. 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/.
Gauld, Robin; Horsburgh, Simon
Few studies have sought to measure health professional perceptions of quality and safety across an entire system of public hospitals. Therefore, three questions that gauge different aspects of quality and safety were included in a national New Zealand survey of clinical governance. Three previously used questions were adapted. A total of 41040 registered health professionals employed in District Health Boards were invited to participate in an online survey. Analyses were performed using the R statistical environment. Proportional odds mixed models were used to quantify associations between demographic variables and responses on five-point scales. Relationships between other questions in the survey and the three quality and safety questions were quantified with the Pearson correlation coefficient. A 25% response rate delivered 10303 surveys. Fifty-seven percent of respondents (95% CI: 56-58%) agreed that health professionals in their District Health Board worked together as a team; 70% respondents (95% CI: 69-70%) agreed that health professionals involved patients and families in efforts to improve patient care; and 69% (95% CI: 68-70%) agreed that it was easy to speak up in their clinical area if they perceived a problem with patient care. Correlations showed links between perceptions of stronger clinical leadership and performances on the three questions, as well as with other survey items. The proportional mixed model also revealed response differences by respondent characteristics. The findings suggest positive commitment to quality and safety among New Zealand health professionals and their employers, albeit with variations by district, profession, gender and age, but also scope for improvement. The study also contributes to the literature indicating that clinical leadership is an important contributor to quality improvement. WHAT IS KNOWN ABOUT THE TOPIC? Various studies have explored aspects of healthcare quality and safety, generally within a hospital or
This literature review on the effect of electronic device use on pedestrian safety is part of a research project sponsored by the Office of Behavioral Safety Research in the National Highway Traffic Safety Administration (NHTSA). An extensive literat...
Coventry, Tracey H; Maslin-Prothero, Sian E; Smith, Gilly
To identify the best evidence on the impact of healthcare organizations' supply of nurses and nursing workload on the continuing professional development opportunities of Registered Nurses in the acute care hospital. To maintain registration and professional competence nurses are expected to participate in continuing professional development. One challenge of recruitment and retention is the Registered Nurse's ability to participate in continuing professional development opportunities. The integrative review method was used to present Registered Nurses perspectives on this area of professional concern. The review was conducted for the period of 2001-February 2015. Keywords were: nurs*, continuing professional development, continuing education, professional development, supply, shortage, staffing, workload, nurse: patient ratio, barrier and deterrent. The integrative review used a structured approach for literature search and data evaluation, analysis and presentation. Eleven international studies met the inclusion criteria. Nurses are reluctant or prevented from leaving clinical settings to attend continuing professional development due to lack of relief cover, obtaining paid or unpaid study leave, use of personal time to undertake mandatory training and organizational culture and leadership issues constraining the implementation of learning to benefit patients. Culture, leadership and workload issues impact nurses' ability to attend continuing professional development. The consequences affect competence to practice, the provision of safe, quality patient care, maintenance of professional registration, job satisfaction, recruitment and retention. Organizational leadership plays an important role in supporting attendance at continuing professional development as an investment for the future. © 2015 John Wiley & Sons Ltd.
MacDonald-Wicks, Lesley; Levett-Jones, Tracy
The objective is to identify and assess the effectiveness of tools and methods of teaching communication skills to health professional students in undergraduate and postgraduate programs, to facilitate communication in hospitals, nursing homes and mental health institutions.For this review, effective communication will be defined as that which enhances patient satisfaction, safety, symptom resolution, psychological status, or reduces the impact/burden of disease and/or improved communication skills within undergraduate or postgraduate studentsThe review question is: What is the best available evidence on strategies to effectively teach communication skills to undergraduate and postgraduate medical, nursing and allied health students (nutrition and dietetics, occupational therapy, physiotherapy, speech pathology etc)? Communication is a two-way interaction where information, meanings and feelings are shared both verbally and non-verbally. Effective communication is when the message being conveyed is understood as intended. Effective communication between the health professional and patient is increasingly being recognised as a core clinical skill. Research has identified the far reaching benefits of effective communication skills including enhanced patient satisfaction, patient safety, symptom resolution and improvements in functional and psychological status. Poor communication can result in omitted or misinterpretation of information resulting in declining health of the patient. Despite the importance of effective communication in ensuring positive outcomes for both the patient and health professional, there is concern that contemporary teaching and learning approaches do not always facilitate the development of a requisite level of communication skills, both verbal and written and a difficulty for the current generation of communication skills teachers is that many have not had the experience of being taught communication skills themselves.Studies have shown that
Ohio State Univ., Columbus. National Center for Research in Vocational Education.
One in a series of 127 performance-based teacher education learning packages focusing on specific professional competencies of vocational teachers, this learning module deals with providing for student safety. It consists of four learning experiences. Covered in the individual learning experiences are the following topics: providing for student…
Manzoor Ahmad Shah
Full Text Available Food irradiation is one of the non thermal food processing methods. It is the process of exposing food materials to the controlled amounts of ionizing radiations such as gamma rays, X-rays and accelerated electrons, to improve microbiological safety and stability. Irradiation disrupts the biological processes that lead to decay of food quality. It is an effective tool to reduce food-borne pathogens, spoilage microorganisms and parasites; to extend shelf-life and for insect disinfection. The safety and consumption of irradiated foods have been extensively studied at national levels and in international cooperations and have concluded that foods irradiated under appropriate technologies are both safe and nutritionally adequate. Specific applications of food irradiation have been approved by national legislations of more than 55 countries worldwide. This review aims to discuss the applications of irradiation in food processing with the emphasis on food safety and stability.
Sheibani, Lili; Wing, Deborah A
Induction of labour is a commonly performed procedure around the world. There are various medications used for induction including those commonly used for cervical ripening (prostaglandins) and oxytocin. The ideal agent is one that decreases the time to achieving delivery without compromising maternal or neonatal safety. The 'optimal safe agent' remains undetermined. Areas covered: This article reviews the safety of currently used induction agents. Prostaglandins and oxytocin have proven to be effective in labour induction, and their profiles will be reviewed in this article. We discuss the data that supports combining some of the agents. We also cover the safety of medications used for labour induction in setting of a scarred uterus. Expert Opinion: There is continuous debate about the ideal induction agent: one that balances safety with efficacy. We recommend the practice that there is not one perfect agent for all, and that the clinical scenario and previous obstetric history should be considered before choosing an agent. In the future, pharmacogenomics may show that genetics may affect the individual response and adverse reactions to the various agents.
Mwangi, J W; Kimani, D; Oduor, M
Blood transfusion is always associated with some level of risk. Haemovigilance is a risk monitoring system integral to the practice of transfusion medicine whose ultimate purpose is to improve the quality and safety of transfusion therapy. To examine the contribution of haemovigilance to blood safety, including the approaches that some countries have taken to institute haemovigilance, and explore routes through which countries without such systems can achieve them. The internet and journals on the topic of haemovigilance and development of haemovigilance systems in the English language. Reputable journals on the topic of haemovigilance were examined for abstracts and papers. Abstracts based on known credible and distinguished sources were selected. Information on haemovigilance and the processes of developing haemovigilance in various countries was reviewed. The information from selected papers and abstracts was used for writing this paper. Varying processes for haemovigilance have been adopted by different countries. The more advanced systems have national/regional coordinating mechanisms. Availability of haemovigilance data has given transfusion services a clear understanding of problems associated with transfusion that need to be solved so as to improve transfusion safety. Although countries in sub-Saharan Africa have made considerable progress in enhancing blood safety in the recent past, nationally coordinated haemovigilance systems are lacking. Focus on haemovigilance systems is considered the next frontier to be conquered in enhancing blood safety in the region.
failures. 2 Robert E. Ball . The Fundamentals of Aircraft Combat Survivability Analysis and Design...for Range Safety Reviews, RCC 326-16, February 2016 2-9 Encounter with lightning , lost aileron control Scenario: Failure of a vehicle’s ground...A vehicle operator attempted to find a route between thunderstorms. The vehicle was lost after a lightning strike and apparent encounter with icing
Liu, Yue M.; Xie, Peiying
Objectives: The aim of this review is to evaluate the ocular safety of orthokeratology (OrthoK) treatment of myopia correction and retardation. Data Sources: Clinical studies published in English and Chinese were identified from MEDLINE, EMBASE CNKI, CQVIP, and WANFANG DATA (all from 1980 to April 2015). The reference lists of the studies and the Science Citation Index were also searched. Selection Criteria: Relevant clinical studies including case series, case reports, patient/practitioner s...
Kendrick, Denise; Young, Ben; Mason-Jones, Amanda J; Ilyas, Nohaid; Achana, Felix A; Cooper, Nicola J; Hubbard, Stephanie J; Sutton, Alex J; Smith, Sherie; Wynn, Persephone; Mulvaney, Caroline; Watson, Michael C; Coupland, Carol
In industrialised countries injuries (including burns, poisoning or drowning) are the leading cause of childhood death and steep social gradients exist in child injury mortality and morbidity. The majority of injuries in pre-school children occur at home but there is little meta-analytic evidence that child home safety interventions reduce injury rates or improve a range of safety practices, and little evidence on their effect by social group. We evaluated the effectiveness of home safety education, with or without the provision of low cost, discounted or free equipment (hereafter referred to as home safety interventions), in reducing child injury rates or increasing home safety practices and whether the effect varied by social group. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2009, Issue 2) in The Cochrane Library, MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), ISI Web of Science: Science Citation Index Expanded (SCI-EXPANDED), ISI Web of Science: Social Sciences Citation Index (SSCI), ISI Web of Science: Conference Proceedings Citation Index- Science (CPCI-S), CINAHL (EBSCO) and DARE (2009, Issue 2) in The Cochrane Library. We also searched websites and conference proceedings and searched the bibliographies of relevant studies and previously published reviews. We contacted authors of included studies as well as relevant organisations. The most recent search for trials was May 2009. Randomised controlled trials (RCTs), non-randomised controlled trials and controlled before and after (CBA) studies where home safety education with or without the provision of safety equipment was provided to those aged 19 years and under, and which reported injury, safety practices or possession of safety equipment. Two authors independently assessed study quality and extracted data. We attempted to obtain individual participant level data (IPD) for all included studies and summary data and IPD were simultaneously combined in meta-regressions by social
Boyd, Douglas D
General aviation includes all civilian aviation apart from operations involving paid passenger transport. Unfortunately, this category of aviation holds a lackluster safety record, accounting for 94% of civil aviation fatalities. In 2014, of 1143 general aviation accidents, 20% were fatal compared with 0 of 29 airline mishaps in the United States. Herein, research findings over the past 30 yr will be reviewed. Accident risk factors (e.g., adverse weather, geographical region, post-impact fire, gender differences) will be discussed. The review will also summarize the development and implementation of stringent crashworthiness designs with multi-axis dynamic testing and head-injury protection and its impact on mitigating occupant injury severity. The benefits and drawbacks of new technology and human factor considerations associated with increased general aviation automation will be debated. Data on the safety of the aging general aviation population and increased drug usage will also be described. Finally, areas in which general aviation occupant survival could be improved and injury severity mitigated will be discussed with the view of equipping aircraft with 1) crash-resistant fuel tanks to reduce post-impact conflagration; 2) after-market ballistic parachutes for older aircraft; and 3) current generation electronic locator beacons to hasten site access by first responders.Boyd DD. A review of general aviation safety (1984-2017). Aerosp Med Hum Perform. 2017; 88(7):657-664.
Full Text Available Abstract Background To reduce harm caused by health care is a global priority. Medical students should be able to recognize unsafe conditions, systematically report errors and near misses, investigate and improve such systems with a thorough understanding of human fallibility, and disclose errors to patients. Incorporating the knowledge of how to do this into the medical student curriculum is an urgent necessity. This paper aims to systematically review the literature about patient safety education for undergraduate medical students in terms of its content, teaching strategies, faculty availability and resources provided so as to identify evidence on how to promote patient safety in the curriculum for medical schools. This paper includes a perspective from the faculty of a medical school, a major hospital and an Evidence Based Medicine Centre in Sichuan Province, China. Methods We searched MEDLINE, ERIC, Academic Source Premier(ASP, EMBASE and three Chinese Databases (Chinese Biomedical Literature Database, CBM; China National Knowledge Infrastructure, CNKI; Wangfang Data from 1980 to Dec. 2009. The pre-specified form of inclusion and exclusion criteria were developed for literature screening. The quality of included studies was assessed using Darcy Reed and Gemma Flores-Mateo criteria. Two reviewers selected the studies, undertook quality assessment, and data extraction independently. Differing opinions were resolved by consensus or with help from the third person. Results This was a descriptive study of a total of seven studies that met the selection criteria. There were no relevant Chinese studies to be included. Only one study included patient safety education in the medical curriculum and the remaining studies integrated patient safety into clinical rotations or medical clerkships. Seven studies were of a pre and post study design, of which there was only one controlled study. There was considerable variation in relation to contents
... of Justice Programs Meeting of the Public Safety Officer Medal of Valor Review Board AGENCY: Office... Safety Officer Medal of Valor Review Board (``Board'') to vote on the position of Board Chairperson... Safety Officer Medal of Valor Review Board carries out those advisory functions specified in 42 U.S.C...
... of Justice Programs Meeting of the Public Safety Officer Medal of Valor Review Board AGENCY: Office... meeting via conference call of the Public Safety Officer Medal of Valor Review Board to vote on the... . ] SUPPLEMENTARY INFORMATION: The Public Safety Officer Medal of Valor Review Board carries out those advisory...
... of Justice Programs Meeting of the Public Safety Officer Medal of Valor Review Board AGENCY: Office... meeting via conference call of the Public Safety Officer Medal of Valor Review Board to vote of the... Public Safety Officer Medal of Valor Review Board carries out those advisory functions specified in 42 U...
....820 § 209.501 Review of rail transportation safety and security route analysis. (a) Review of route... analysis does not support the railroad carrier's original selected route, that safety and security... 49 Transportation 4 2010-10-01 2010-10-01 false Review of rail transportation safety and security...
Callahan, Alison; Pernek, Igor; Stiglic, Gregor; Leskovec, Jure; Strasberg, Howard R; Shah, Nigam Haresh
Patterns in general consumer online search logs have been used to monitor health conditions and to predict health-related activities, but the multiple contexts within which consumers perform online searches make significant associations difficult to interpret. Physician information-seeking behavior has typically been analyzed through survey-based approaches and literature reviews. Activity logs from health care professionals using online medical information resources are thus a valuable yet relatively untapped resource for large-scale medical surveillance. To analyze health care professionals' information-seeking behavior and assess the feasibility of measuring drug-safety alert response from the usage logs of an online medical information resource. Using two years (2011-2012) of usage logs from UpToDate, we measured the volume of searches related to medical conditions with significant burden in the United States, as well as the seasonal distribution of those searches. We quantified the relationship between searches and resulting page views. Using a large collection of online mainstream media articles and Web log posts we also characterized the uptake of a Food and Drug Administration (FDA) alert via changes in UpToDate search activity compared with general online media activity related to the subject of the alert. Diseases and symptoms dominate UpToDate searches. Some searches result in page views of only short duration, while others consistently result in longer-than-average page views. The response to an FDA alert for Celexa, characterized by a change in UpToDate search activity, differed considerably from general online media activity. Changes in search activity appeared later and persisted longer in UpToDate logs. The volume of searches and page view durations related to Celexa before the alert also differed from those after the alert. Understanding the information-seeking behavior associated with online evidence sources can offer insight into the information
Young, William; Sobhani, Amir; Lenné, Michael G; Sarvi, Majid
Recent decades have seen considerable growth in computer capabilities, data collection technology and communication mediums. This growth has had considerable impact on our ability to replicate driver behaviour and understand the processes involved in failures in the traffic system. From time to time it is necessary to assess the level of development as a basis of determining how far we have come. This paper sets out to assess the state of the art in the use of computer models to simulate and assess the level of safety in existing and future traffic systems. It reviews developments in the area of road safety simulation models. In particular, it reviews computer models of driver and vehicle behaviour within a road context. It focuses on stochastic numerical models of traffic behaviour and how reliable these are in estimating levels of safety on the traffic network. Models of this type are commonly used in the assessment of traffic systems for capacity, delay and general performance. Adding safety to this assessment regime may allow more comprehensive assessment of future traffic systems. To date the models have focused primarily on vehicular traffic that is, cars and heavy vehicles. It has been shown that these models have potential in measuring the level of conflict on parts of the network and the measure of conflict correlated well with crash statistics. Interest in the prediction of crashes and crash severity is growing and new models are focusing on the continuum of general traffic conditions, conflict, severe conflict, crash and severe crashes. The paper also explores the general data types used to develop, calibrate and validate these models. Recent technological development in in-vehicle data collection, driver simulators and machine learning offers considerable potential for improving the behavioural base, rigour and application of road safety simulation models. The paper closes with some indication of areas of future development. Copyright © 2014. Published
Is professionalism in medicine just another bureaucratic imposition on our practice or a fundamental concept for physicians at all stages in their career? In this review, the historical perspectives of professionalism are explored as well as the what, why, and how questions concerning this topic. The key words "professionalism" and "anesthesia" were used to conduct a search of the PubMed database, the policies and publications of relevant Canadian and international physician regulatory bodies and organizations, historical documents, and other internet publications. Professionalism in anesthesia has a long history. While there are many definitions for professionalism, some very dated, all are based on virtues, behaviour, or professional identity. Professionalism plays a central role in the balance between physician autonomy and social contract, and it has a significant impact on patient safety and medicolegal litigation. Considerable evidence exists to suggest that professionalism must be treated seriously, particularly in these times of social accountability and budgetary pressures.
Kim, Minjin; Ahn, Guk-Hoon; Lee, Choong Sung [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
A PSR for a research reactor became a legal requirement as the Nuclear Safety Act was amended and came into effect in 2014. This paper describes the current status and methodology of the first Periodic Safety Review (PSR) of HANARO that is being performed. The legal requirements, work plan, and process of implementing a PSR are described. Because this is the first PSR for a research reactor, it is our understating that the operating organization and regulatory body should communicate well with each other to complete the PSR in a timely manner. The first PSR of HANARO is under way. In order to achieve a successful result, activities of the operation organization such as scheduling, maintaining consistency in input data for review, and reviewing the PSR reports that will require intensive resources should be well planned. This means the operating organization needs to incorporate appropriate measures to ensure the transfer of knowledge and expertise arising from the PSR via a contractor to the operation organization. It is desirable for the Regulatory Body to be involved in all stage of the PSR to prevent any waste of resources and minimize the potential for a reworking of the PSR and the need for an additional assessment and review as recommended by foreign experts.
Full Text Available Background: This study investigated quality of healthcare services from patients’ perspectives and its relationship with patient safety culture and nurse-physician professional communication. Methods: A cross-sectional study was conducted among 300 surgery patients and 101 nurses caring them in a public hospital in Tabriz–Iran. Data were collected using the service quality measurement scale (SERVQUAL, hospital survey on patient safety culture (HSOPSC and nurse physician professional communication questionnaire. Results: The highest and lowest mean (±SD scores of the patients’ perception on the healthcare services quality belonged to the assurance 13.92 (±3.55 and empathy 6.78 (±1.88 domains,respectively. With regard to the patient safety culture, the mean percentage of positive answers ranged from 45.87% for "non-punitive response to errors" to 68.21% for "organizational continuous learning" domains. The highest and lowest mean (±SD scores for the nurse physician professional communication were obtained for "cooperation" 3.44 (±0.35 and "non participative decision-making" 2.84 (±0.34 domains, respectively. The "frequency of reported errors by healthcare professionals" (B=-4.20, 95% CI = -7.14 to -1.27, P<0.01 and "respect and sharing of information" (B=7.69, 95% CI=4.01 to 11.36, P<0.001 predicted the patients’perceptions of the quality of healthcare services. Conclusion: Organizational culture in dealing with medical error should be changed to non punitive response. Change in safety culture towards reporting of errors, effective communication and teamwork between healthcare professionals are recommended.
Ghahramanian, Akram; Rezaei, Tayyebeh; Abdullahzadeh, Farahnaz; Sheikhalipour, Zahra; Dianat, Iman
Background: This study investigated quality of healthcare services from patients' perspectives and its relationship with patient safety culture and nurse-physician professional communication. Methods: A cross-sectional study was conducted among 300 surgery patients and 101 nurses caring them in a public hospital in Tabriz-Iran. Data were collected using the service quality measurement scale (SERVQUAL), hospital survey on patient safety culture (HSOPSC) and nurse physician professional communication questionnaire. Results: The highest and lowest mean (±SD) scores of the patients' perception on the healthcare services quality belonged to the assurance 13.92 (±3.55) and empathy 6.78 (±1.88) domains,respectively. With regard to the patient safety culture, the mean percentage of positive answers ranged from 45.87% for "non-punitive response to errors" to 68.21% for "organizational continuous learning" domains. The highest and lowest mean (±SD) scores for the nurse physician professional communication were obtained for "cooperation" 3.44 (±0.35) and "non-participative decision-making" 2.84 (±0.34) domains, respectively. The "frequency of reported errors by healthcare professionals" (B=-4.20, 95% CI = -7.14 to -1.27, P<0.01) and "respect and sharing of information" (B=7.69, 95% CI=4.01 to 11.36, P<0.001) predicted the patients'perceptions of the quality of healthcare services. Conclusion: Organizational culture in dealing with medical error should be changed to non-punitive response. Change in safety culture towards reporting of errors, effective communication and teamwork between healthcare professionals are recommended.
Francis, Perry C.
Mental health professionals are faced with increasingly complex ethical decisions that are impacted by culture, personal and professional values, and the contexts in which they and their clients inhabit. This article presents the reasons for developing and implementing multiple ethical decision making models and reviews four models that address…
Gast, Inken; Schildkamp, Kim; van der Veen, Jan T.
Most professional development activities focus on individual teachers, such as mentoring or the use of portfolios. However, new developments in higher education require teachers to work together in teams more often. Due to these changes, there is a growing need for professional development activities focusing on teams. Therefore, this review study…
Gual Llorens, Clara; Velarde Collado, José María; Portell Vidal, Mariona; Boix Ferrando, Pere
To describe the view of faculty who train health and safety professionals on the roles and competencies needed to promote the integration of preventive actions at the company level. We used a Delphi method, in three rounds, on an intentional sample of experts, and asked them to rate the appropriateness, relevance and acceptability of 8 professional roles, on a scale of 1 to 9 points. We also asked them to formulate and rank order the corresponding competencies, in order of importance. Participant responses (n=76, 58% of the initially identified faculty) show a broad consensus when assessing professional roles (over 85% of participants rated two of these roles highly, with scores between 7 and 9) and general agreement on the three most important competencies in terms of knowledge, skills and attitudes to promote the integration of preventive actions. The experts participating in this study agreed that the main roles to be performed by health and safety professionals to promote prevention integration are as advisors and trainers. The competencies considered most important are knowledge about the company activity, its risks and the problems linked to the activity (to know), ability to work in multidisciplinary teams (to know how), and to perform professional duties ethically, with independence and impartiality (to know how to be). Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.
Smith, Valerie; Begley, Cecily M; Clarke, Mike; Devane, Declan
... evidence-based maternity care. The aim of this paper is to offer insight and understanding, through systematic review and thematic analysis, of research into professionals' views on fetal heart rate monitoring during labour...
Barry, M.; Kuijer-Siebelink, W.; Nieuwenhuis, L.; Scherpbier-de Haan, N.D.
BACKGROUND: This literature review investigates what research reports about the contribution that communities of practice (CoPs) can make in the continuing professional development (CPD) of qualified occupational therapists. METHODS: Academic databases (CINAHL, MEDLINE and ERIC) were searched and
Dey, Swatee; Kenneally, Dianna; Odio, Mauricio; Hatzopoulos, Ioannis
A review of the literature on diapers and diaper rash reveals that many clinicians are unfamiliar with modern diaper construction and materials as well as diaper safety testing methods. Typical modern diapers do not contain ingredients of concern such as latex and disperse dyes, but use ingredients such as spandex and pigments with a favorable safety profile. Today's disposable diaper is a high performance product whose carefully designed layers and liners provide optimal urine and feces absorption and an ever more clothing-like and comfortable fit. This is possible due to a variety of specialized polymer materials that provide optimal absorption of urine and feces, thereby minimizing skin exposure. © 2016 The International Society of Dermatology.
Torgerson, Carole; Nielsen, Chantal Pohl; Gascoine, Louise
The quality of the professional development of education and welfare professionals working with children and young people (for example, pre-school teachers or ‘pedagogues’, school teachers, teaching assistants, social workers, psychologists, police officers etc.) is of key importance to policy...... as demonstrated by pre-tests in the outcomes of interest but excluding studies using an instrumental variable approach), including studies using regression discontinuity design. We will search substantively for studies in the fields of education, social welfare and crime and justice....... makers and practitioners in these fields. The general wellbeing of a country’s citizens and the provision of better opportunities in terms of educational and social welfare outcomes (for example, participation in higher education and reduction of anti-social behaviour) have been linked to the quality...
Dombrowski, Stephan U; Campbell, Pauline; Frost, Helen; Pollock, Alex; McLellan, Julie; MacGillivray, Steve; Gavine, Anna; Maxwell, Margaret; O'Carroll, Ronan; Cheyne, Helen; Presseau, Justin; Williams, Brian
Failure to successfully implement and sustain change over the long term continues to be a major problem in health and social care. Translating evidence into routine clinical practice is notoriously complex, and it is recognised that to implement new evidence-based interventions and sustain them over time, professional behaviour needs to change accordingly. A number of theories and frameworks have been developed to support behaviour change among health and social care professionals, and models of sustainability are emerging, but few have translated into valid and reliable interventions. The long-term success of healthcare professional behavioural change interventions is variable, and the characteristics of successful interventions unclear. Previous reviews have synthesised the evidence for behaviour change, but none have focused on sustainability. In addition, multiple overlapping reviews have reported inconsistent results, which do not aid translation of evidence into practice. Overviews of reviews can provide accessible succinct summaries of evidence and address barriers to evidence-based practice. We aim to compile an overview of reviews, identifying, appraising and synthesising evidence relating to sustained social and healthcare professional behaviour change. We will conduct a systematic review of Cochrane reviews (an Overview). We plan to systematically search the Cochrane Database of Systematic Reviews. We will include all systematic reviews of randomised controlled trials comparing a healthcare professional targeted behaviour change intervention to a standard care or no intervention control group. Two reviewers will independently assess the eligibility of the reviews and the methodological quality of included reviews using the ROBIS tool. The quality of evidence within each comparison in each review will be judged based on the GRADE criteria. Disagreements will be resolved through discussion. Effects of interventions will be systematically tabulated and the
Stiegler, Lillian N.
Pica is defined as the compulsive, recurrent consumption of nonnutritive items. Pica behavior often occurs in individuals with developmental disabilities; therefore, education and clinical professionals may be required to participate in various aspects of management, including identification, assessment, and treatment. This article will discuss…
... of Justice Programs Meeting of the Public Safety Officer Medal of Valor Review Board AGENCY: Office... meeting/conference call of the Public Safety Officer Medal of Valor Review Board to vote on recommendations for the 2009-2010 Medal of Valor nominations, review issues relevant to the nomination review...
Gast, Inken; Schildkamp, Kim; van der Veen, Jan T
Most professional development activities focus on individual teachers, such as mentoring or the use of portfolios. However, new developments in higher education require teachers to work together in teams more often. Due to these changes, there is a growing need for professional development activities focusing on teams. Therefore, this review study was conducted to provide an overview of what is known about professional development in teams in the context of higher education. A total of 18 articles were reviewed that describe the effects of professional development in teams on teacher attitudes and teacher learning. Furthermore, several factors that can either hinder or support professional development in teams are identified at the individual teacher level, at the team level, and also at the organizational level.
Bronwen Jane Ackermann
Full Text Available The Sound Practice Project is a five-year study involving baseline evaluation, development and implementation of musician-specific work health and safety initiatives. A cross-sectional population physical and psychological survey and physical assessment were conducted at the same time, with an auditory health assessment conducted later. The results were used to guide the development of a series of targeted interventions, encompassing physical, psychological and auditory health components. This paper provides an overview of the project but focuses on the health findings arising from the cross-sectional survey.377 musicians from the eight professional symphony orchestras in Australia took part in the cross-sectional study (about 70% of eligible musicians. Eighty-four percent (84% of musicians reported past performance-related musculoskeletal disorder (PRMD episodes; 50% were suffering a current PRMD. Of the 63% who returned hearing surveys, 43% believed they had hearing loss, and 64% used earplugs at least intermittently. Noise exposure was found to be high in private practice, although awareness of risk and earplug use in this environment was lower than in orchestral settings. Improved strategic approaches, acoustic screens and recently developed active earplugs were found to provide effective new options for hearing protection. With respect to psychosocial screening, female musicians reported significantly more trait anxiety, music performance anxiety, social anxiety, and other forms of anxiety and depression than male musicians. The youngest musicians were significantly more anxious compared with the oldest musicians. Thirty-three percent (33% of musicians may meet criteria for a diagnosis of social phobia; 32% returned a positive depression screen and 22% for post-traumatic stress disorder. PRMDs and trigger point discomfort levels were strongly associated with increasing severity of psychological issues such as depression and music
Wang, Xin; Shih, Julie; Kuo, Fen-Ju; Ho, Ming-Jung
The Chinese Medical Doctors Association (CMDA) adopted the Charter of Medical Professionalism in the New Millennium (Charter) and published the Chinese Medical Doctor Declaration (Declaration). This is an important step to re-building medical professionalism in China at a time when the commercialization of health care has led to a decline in physician accountability and public trust in the profession. In response, authors have begun to examine and promote medical professionalism in China. This study aims to present the key research themes, identify research gaps and offer recommendations from reviewing the increasing pool of Chinese-language literature on medical professionalism. A scoping review of Chinese language papers was conducted using the China National Knowledge Infrastructure (including China Academic Journals Full-text Database, China Doctoral Dissertations Full-text Database, Masters' Theses Full-text Database, China Core Newspapers Full-text Database, and China Yearbooks Full-text Database) (CNKI) database. Four major research themes were identified in Chinese discourse: (1) teaching professionalism, (2) practicing professionalism, (3) conceptualizing professionalism and (4) assessing professionalism. Overall, authors were concerned with the cultivation of humanism in physicians and emphasized the importance of communication skills to improve the physician-patient relationship in China. They explored the role of traditional Chinese values, such as Confucian and Taoist values, as well as the Communist Party's political values, in promoting professional behaviour. Authors demonstrate increasing interest in medical professionalism in China. The literature is of variable quality and further empirical studies are required in order to evaluate teaching interventions and guide professionalism assessment. A common professionalism framework is absent and could be developed with consideration to China's socio-cultural context.
Mather, Edward C; McNiel, Pattie A
A market-research study conducted in 2000 indicated a need for a degree program in food safety that would cover all aspects of the food system, from production to consumption. Despite this, such a program was not enthusiastically supported by employers, who feared losing their valued employees while they were enrolled in traditional on-campus graduate programs. A terminal professional degree was successfully created, offered, and modified over the succeeding five years. The innovative, non-traditional online program was developed to include a core curriculum and leadership training, with elective courses providing flexibility in specific areas of student interest or need. The resulting Professional Master of Science in Food Safety degree program provides a transdisciplinary approach for the protection of an increasingly complex food system and the improvement of public health. Enrollment in the program steadily increased in the first three years of delivery, with particular interest from industry and government employees. The curriculum provides a platform of subject material from which certificate programs, short-courses, seminars, workshops, and executive training programs may be delivered, not only to veterinarians but also to related food and health specialists. The program has fulfilled a need for adult learners to continue as working professionals in the workforce. The benefit to the employer and to society is an individual with enhanced knowledge and networking and leadership skills.
Business cases are arguments developed to secure management commitment and approval for investment in an intervention. This systematic review evaluated 12 experimental and quasi-experimental studies on occupational health and safety interventions (OHSI) in various settings. The search engines used in this systematic review include PubMed, CINAHL, and Scopus. A cost and benefit analysis of OHSI was completed at the organizational level in these studies. The focus of this analysis included sample, design, theoretical framework, interventional strategies, and threats to validity and outcomes. Positive returns on investment of OHSI outcomes were shown in 10 of the studies. The other two studies concluded that their chosen OHSI were not cost-effective.
Abdul Hafeez Ahmad Hamdi
Full Text Available Eurycoma longifolia (commonly called tongkat ali is a flowering plant in the family Simaroubaceae, native to Indonesia, Malaysia, and, to a lesser extent, Thailand, Vietnam and also Laos. The roots extract of E. longifolia, is a well-known traditional herbal medicine in Asia used for many purposes such as sexual dysfunction, aging, malaria, cancer, diabetes, anxiety, aches, constipation, exercise recovery, fever, increased energy, increased strength, leukemia, osteoporosis, stress, syphilis and glandular swelling. The roots are also used as an aphrodisiac, antibiotic, appetite stimulant and health supplement. It is very important to conserve this valuable medicinal plant for the health benefit of future generations. The purpose of this review article is to evaluate and summarize the existing literatures regarding the efficacy and safety of products which contain E. longifolia as its main ingredient. In summary, based on the literature evaluated in this review article, products which contain tongkat ali showed a clinical benefit on improving erectile dysfunction as well as a good safety profile. We recommend consumers to check the level of the bioactive compound “eurycomanone” as their guide before choosing any E. longifolia product.
Maiorano, Alessandra; Lasalvia, Antonio; Sampogna, Gaia; Pocai, Benedetta; Ruggeri, Mirella; Henderson, Claire
The mass media may increase stigma against people with mental health problems by reinforcing common stereotypes. Media professionals thus represent a target group for antistigma interventions. This paper aims to review available literature on antistigma interventions for mass media professionals, seeking to clarify what kind of interventions have been found to be effective in reducing mental health stigma among mass media professionals. Six electronic databases (MEDLINE, PsycINFO, Embase, Cochrane Reviews Library and Cochrane Central Register of Controlled Trials, Web of Science, and Applied Social Sciences Index & Abstracts) were systematically searched through March 2017 for studies addressing antistigma interventions on mass media professionals. Results: A total of 27 studies on antistigma interventions targeted to media professionals were found. Reviewed articles were classified into 3 categories: media-monitoring projects/reporting guidelines ( n = 23), interventions for educating journalists ( n = 2), and interventions for educating journalism students ( n = 2). Overall, antistigma interventions for media professionals seem to have some effect in improving reporting style, thus providing a more balanced portrayal of people with mental health problems: the most promising interventions are contact-based educational approaches and the provision of guidelines by authoritative institutions. It should be useful to promote and disseminate contact-based educational interventions targeted to journalists and to include specific modules on mental health topics in the training curricula of journalism students. However, as research in the field suffers from several limitations, high-quality studies exploring the long-term effect of antistigma interventions for media professionals are needed.
Lauer, Patricia A.; Christopher, Debra E.; Firpo-Triplett, Regina; Buchting, Francisco
A narrative literature review was conducted to identify the design features of effective short-term face-to-face professional development (PD) events. The 23 reviewed studies described PD with durations of 30 hours or less and involved participants in education or human service-related professions. Design features associated with positive impacts…
Narciso, Fernanda Veruska; Mello, Marco Túlio de
Traffic accidents and resulting injuries and deaths have become a global epidemic. In Brazil, most professional drivers, especially truck drivers, face irregular working hours and can be awake for more than 18 hours/day, which reduces their performance and alertness. In this article, we discuss the laws related to Brazilian professional drivers and their current amendments (No. 12,619/2012 and No. 13,103/2015) in relation to working hours at the wheel and rest breaks, which are vital for the quality of life of drivers and society in general. We note that the new law appears to be less efficient than the previous one as it causes insecurity and concern to the users of the transportation system, drivers, and employers. To restrict and reduce accidents, deaths, and injuries in traffic, appropriate legislation is essential, aiming at the safety of workers and users of highways. The law must also benefit the commercial aspect, strengthening the reduction in production and logistics losses. Additionally, traffic education programs are needed, as well as better supervision in relation to total working hours. RESUMO Acidentes de trânsito com consequentes lesões e mortes têm se tornado uma epidemia em nível mundial. No Brasil, a maioria dos motoristas profissionais, sobretudo motoristas de transporte de cargas, enfrenta jornada de trabalho irregular e permanece acordado por mais de 18 horas/dia, o que reduz seu desempenho e estado de alerta. Neste artigo, discutimos as leis dos motoristas profissionais brasileiros e suas alterações vigentes (nº 12.619/2012 e nº 13.103/2015) em relação às horas de trabalho ao volante e a pausas para descanso, imprescindíveis para a qualidade de vida dos motoristas e para a sociedade em geral. Observamos que a nova legislação se mostra menos eficiente que a anterior por causar insegurança e preocupação aos usuários do sistema de transporte, aos próprios motoristas e aos empregadores. Para restringir e reduzir acidentes
Piening, S.; Haaijer-Ruskamp, F.M.; de Vries, J.T.; van der Elst, M.E.; de Graeff, P.A.; Straus, S.M.; Mol, P.G.
Background: After market approval, new serious safety issues are regularly identified for drugs that lead to regulatory action to inform healthcare professionals. However, the effectiveness of these safety-related regulatory actions is under question. We currently lack a comprehensive overview of
Piening, Sigrid; Haaijer-Ruskamp, Flora M.; de Vries, Jonie T. N.; van der Elst, Menno E.; de Graeff, Pieter A.; Straus, Sabine M. J. M.; Mol, Peter G. M.
Background: After market approval, new serious safety issues are regularly identified for drugs that lead to regulatory action to inform healthcare professionals. However, the effectiveness of these safety-related regulatory actions is under question. We currently lack a comprehensive overview of
Marks, Lawrence B; Adams, Robert D; Pawlicki, Todd; Blumberg, Albert L; Hoopes, David; Brundage, Michael D; Fraass, Benedick A
This report is part of a series of white papers commissioned for the American Society for Radiation Oncology (ASTRO) Board of Directors as part of ASTRO's Target Safely Campaign, focusing on the role of peer review as an important component of a broad safety/quality assurance (QA) program. Peer review is one of the most effective means for assuring the quality of qualitative, and potentially controversial, patient-specific decisions in radiation oncology. This report summarizes many of the areas throughout radiation therapy that may benefit from the application of peer review. Each radiation oncology facility should evaluate the issues raised and develop improved ways to apply the concept of peer review to its individual process and workflow. This might consist of a daily multidisciplinary (eg, physicians, dosimetrists, physicists, therapists) meeting to review patients being considered for, or undergoing planning for, radiation therapy (eg, intention to treat and target delineation), as well as meetings to review patients already under treatment (eg, adequacy of image guidance). This report is intended to clarify and broaden the understanding of radiation oncology professionals regarding the meaning, roles, benefits, and targets for peer review as a routine quality assurance tool. It is hoped that this work will be a catalyst for further investigation, development, and study of the efficacy of peer review techniques and how these efforts can help improve the safety and quality of our treatments.
... of Justice Programs Meeting of the Public Safety Officer Medal of Valor Review Board AGENCY: Bureau... announcement of a meeting (via conference call-in) of the Public Safety Officer Medal of Valor Review Board to... Medal of Valor Review Board carries out those advisory functions specified in 42 U.S.C. 15202. Pursuant...
... of Justice Programs Meeting of the Public Safety Officer Medal of Valor Review Board AGENCY: Bureau.... SUMMARY: This is an announcement of a meeting of the Public Safety Officer Medal of Valor Review Board to review and vote on recommendations for the 2011-2012 Medal of Valor nominations, consider issues relevant...
... of Justice Programs Meeting of the Public Safety Officer Medal of Valor Review Board AGENCY: Office.... SUMMARY: This is an announcement of a meeting of the Public Safety Officer Medal of Valor Review Board to review and vote on recommendations for the 2012-2013 Medal of Valor nominations, consider issues relevant...
... 29 Labor 9 2010-07-01 2010-07-01 false Official Seal of the Occupational Safety and Health Review... HEALTH REVIEW COMMISSION RULES OF PROCEDURE Miscellaneous Provisions § 2200.108 Official Seal of the Occupational Safety and Health Review Commission. The seal of the Commission shall consist of: A gold eagle...
Stanley J. Robboy MD
Full Text Available This retrospective observational study on faculty development analyzes the Duke University Pathology Department’s 18-year experience with a structured mentoring program involving 51 junior faculty members. The majority had MD degrees only (55%. The percentage of young women faculty hires before 1998 was 25%, increasing to 72% after 2005. Diversity also broadened from 9% with varied heritages before 1998 to 37% since then. The mentoring process pivoted on an annual review process. The reviews generally helped candidates focus much earlier, identified impediments they individually felt, and provided new avenues to gain a national reputation for academic excellence. National committee membership effectively helped gain national exposure. Thirty-eight percent of the mentees served on College of American Pathologists (CAP committees, exponential multiples of any other national society. Some used CAP resources to develop major programs, some becoming nationally and internationally recognized for their academic activities. Several faculty gained national recognition as thought leaders for publishing about work initiated to serve administrative needs in the Department. The review process identified the need for more protected time for research, issues with time constraints, and avoiding exploitation when collaborating with other departments. This review identified a rigorous faculty mentoring and review process that included annual career counseling, goal-oriented academic careers, monitored advancement to promotion, higher salaries, and national recognition. All contributed to high faculty satisfaction and low faculty turnover. We conclude that a rigorous annual faculty review program and its natural sequence, promotion, can greatly foster faculty satisfaction.
Masaki Futamura; Thomas, Kim S.; Grindlay, Douglas J.C.; Doney, Elizabeth J.; Donna Torley; Williams, Hywel C.
BACKGROUND: Many research studies have been published on atopic eczema and these are often summarised in systematic reviews (SRs). Identifying SRs can be time-consuming for health professionals, and researchers. In order to facilitate the identification of important research, we have compiled an on-line resource that includes all relevant eczema reviews published since 2000. METHODS: SRs were searched for in MEDLINE (Ovid), EMBASE (Ovid), PubMed, the Cochrane Database of Systematic Reviews, D...
Liu, Yue M; Xie, Peiying
The aim of this review is to evaluate the ocular safety of orthokeratology (OrthoK) treatment of myopia correction and retardation. Clinical studies published in English and Chinese were identified from MEDLINE, EMBASE CNKI, CQVIP, and WANFANG DATA (all from 1980 to April 2015). The reference lists of the studies and the Science Citation Index were also searched. Relevant clinical studies including case series, case reports, patient/practitioner surveys, retrospective and prospective cohort studies, and clinical trials were all included in the review. The material of OrthoK lenses was limited to gas-permeable lens. This review incorporated a total of 170 publications, including 58 English and 112 Chinese literature. The risk of microbial keratitis in overnight OrthoK was similar to that of other overnight modality. The most common complication was corneal staining. Other clinically insignificant side effects included epithelial iron deposit, prominent fribrillary lines, and transient changes of corneal biomechanical properties. There was no long-term effect of OrthoK on corneal endothelium. There is sufficient evidence to suggest that OrthoK is a safe option for myopia correction and retardation. Long-term success of OrthoK treatment requires a combination of proper lens fitting, rigorous compliance to lens care regimen, good adherence to routine follow-ups, and timely treatment of complications.
Objectives: The aim of this review is to evaluate the ocular safety of orthokeratology (OrthoK) treatment of myopia correction and retardation. Data Sources: Clinical studies published in English and Chinese were identified from MEDLINE, EMBASE CNKI, CQVIP, and WANFANG DATA (all from 1980 to April 2015). The reference lists of the studies and the Science Citation Index were also searched. Selection Criteria: Relevant clinical studies including case series, case reports, patient/practitioner surveys, retrospective and prospective cohort studies, and clinical trials were all included in the review. The material of OrthoK lenses was limited to gas-permeable lens. Main Results: This review incorporated a total of 170 publications, including 58 English and 112 Chinese literature. The risk of microbial keratitis in overnight OrthoK was similar to that of other overnight modality. The most common complication was corneal staining. Other clinically insignificant side effects included epithelial iron deposit, prominent fribrillary lines, and transient changes of corneal biomechanical properties. There was no long-term effect of OrthoK on corneal endothelium. Conclusions: There is sufficient evidence to suggest that OrthoK is a safe option for myopia correction and retardation. Long-term success of OrthoK treatment requires a combination of proper lens fitting, rigorous compliance to lens care regimen, good adherence to routine follow-ups, and timely treatment of complications. PMID:26704136
Gholami-Kordkheili, Fatemeh; Wild, Verina; Strech, Daniel
The rising impact of social media on the private and working lives of health care professionals has made researchers and health care institutions study and rethink the concept and content of medical professionalism in the digital age. In the last decade, several specific policies, original research studies, and comments have been published on the responsible use of social media by health care professionals. However, there is no systematic literature review that analyzes the full spectrum of (1) social media-related challenges imposed on medical professionalism and (2) social media-related opportunities to both undermine and improve medical professionalism. The aim of this systematic qualitative review is to present this full spectrum of social media-related challenges and opportunities. We performed a systematic literature search in PubMed (restricted to English and German literature published between 2002 and 2011) for papers that address social media-related challenges and opportunities for medical professionalism. To operationalize "medical professionalism", we refer to the 10 commitments presented in the physicians' charter "Medical professionalism in the new millennium" published by the ABIM Foundation. We applied qualitative text analysis to categorize the spectrum of social media-related challenges and opportunities for medical professionalism. The literature review retrieved 108 references, consisting of 46 original research studies and 62 commentaries, editorials, or opinion papers. All references together mentioned a spectrum of 23 broad and 12 further-specified, narrow categories for social media-related opportunities (n=10) and challenges (n=13) for medical professionalism, grouped under the 10 commitments of the physicians' charter. The accommodation of the traditional core values of medicine to the characteristics of social media presents opportunities as well as challenges for medical professionalism. As a profession that is entitled to self
Schall, Mark C; Sesek, Richard F; Cavuoto, Lora A
To gather information on the (a) types of wearable sensors, particularly personal activity monitors, currently used by occupational safety and health (OSH) professionals; (b) potential benefits of using such technologies in the workplace; and (c) perceived barriers preventing the widespread adoption of wearable sensors in industry. Wearable sensors are increasingly being promoted as a means to improve employee health and well-being, and there is mounting evidence supporting their use as exposure assessment and personal health tools. Despite this, many workplaces have been hesitant to adopt these technologies. An electronic survey was emailed to 28,428 registered members of the American Society of Safety Engineers (ASSE) and 1,302 professionals certified by the Board of Certification in Professional Ergonomics (BCPE). A total of 952 valid responses were returned. Over half of respondents described being in favor of using wearable sensors to track OSH-related risk factors and relevant exposure metrics at their respective workplaces. However, barriers including concerns regarding employee privacy/confidentiality of collected data, employee compliance, sensor durability, the cost/benefit ratio of using wearables, and good manufacturing practice requirements were described as challenges precluding adoption. The broad adoption of wearable technologies appears to depend largely on the scientific community's ability to successfully address the identified barriers. Investigators may use the information provided to develop research studies that better address OSH practitioner concerns and help technology developers operationalize wearable sensors to improve employee health and well-being.
Leggett, W.D.; McShane, W.J. (Westinghouse Hanford Co., Richland, WA (USA)); Liparulo, N.J.; McAdoo, J.D.; Strawbridge, L.E. (Westinghouse Electric Corp., Pittsburgh, PA (USA). Nuclear and Advanced Technology Div.); Toto, G. (Westinghouse Electric Corp., Pittsburgh, PA (USA). Nuclear Services Div.); Fauske, H.K. (Fauske and Associates, Inc., Burr Ridge, IL (USA)); Call, D.W. (Westinghouse Savannah R
Westinghouse Electric Corporation has performed a safety assessment of the Savannah River production reactors (K,L, and P) as requested by the US Department of Energy. This assessment was performed between November 1, 1988, and April 1, 1989, under the transition contract for the Westinghouse Savannah River Company's preparations to succeed E.I. du Pont de Nemours Company as the US Department of Energy contractor for the Savannah River Project. The reviewers were drawn from several Westinghouse nuclear energy organizations, embody a combination of commercial and government reactor experience, and have backgrounds covering the range of technologies relevant to assessing nuclear safety. The report presents the rationale from which the overall judgment was drawn and the basis for the committee's opinion on the phased restart strategy proposed by E.I. du Pont de Nemours Company, Westinghouse, and the US Department of Energy-Savannah River. The committee concluded that it could recommend restart of one reactor at partial power upon completion of a list of recommended upgrades both to systems and their supporting analyses and after demonstration that the organization had assimilated the massive changes it will have undergone.
Greenway, F L; Shanahan, W; Fain, R; Ma, T; Rubino, D
Lorcaserin is a novel selective serotonin 2C receptor agonist indicated by the US Food and Drug Administration for chronic weight management in adults with obesity or overweight with ≥1 comorbidity. The safety and efficacy of lorcaserin were established during two Phase III clinical trials in patients without diabetes (BLOOM and BLOSSOM) and one Phase III clinical trial in patients with type 2 diabetes (BLOOM-DM). Headache was the most common adverse event experienced by patients during all Phase III trials. Additional adverse events occurring in >5% of patients receiving lorcaserin included dizziness, fatigue, nausea, dry mouth and constipation in patients without diabetes, and hypoglycaemia, back pain, cough and fatigue in patients with diabetes. In a pooled analysis of echocardiographic data collected during the three lorcaserin Phase III trials, the incidence of FDA-defined valvulopathy was similar in patients taking lorcaserin and the placebo. Here, the safety profile of lorcaserin at the FDA-approved dose of 10 mg twice daily is reviewed using data from the lorcaserin Phase III programme, with a focus on theoretical adverse events commonly associated with agonists of the serotonin receptor family. Based on the lorcaserin Phase III clinical trial data, lorcaserin is safe and well tolerated in the indicated patient populations. © 2016 World Obesity.
Preckshot, G.G. [Lawrence Livermore National Lab., CA (United States)
The purpose of this paper is to recommend regulatory guidance for reviewers examining real-time performance of computer-based safety systems used in nuclear power plants. Three areas of guidance are covered in this report. The first area covers how to determine if, when, and what prototypes should be required of developers to make a convincing demonstration that specific problems have been solved or that performance goals have been met. The second area has recommendations for timing analyses that will prove that the real-time system will meet its safety-imposed deadlines. The third area has description of means for assessing expected or actual real-time performance before, during, and after development is completed. To ensure that the delivered real-time software product meets performance goals, the paper recommends certain types of code-execution and communications scheduling. Technical background is provided in the appendix on methods of timing analysis, scheduling real-time computations, prototyping, real-time software development approaches, modeling and measurement, and real-time operating systems.
Full Text Available Moxibustion is a traditional medical treatment originating in China. It involves using the heat of burning moxa to stimulate acupoints. It is considered safe and effective and is widely used throughout the world. The increasing use of moxibustion has drawn attention to the procedure’s adverse events (AEs. This review covers a total of 64 cases of AEs associated with moxibustion in 24 articles, reported in six countries. Some evidence of the risks of moxibustion has been found in these cases. AEs include allergies, burns, infection, coughing, nausea, vomiting, fetal distress, premature birth, basal cell carcinoma (BCC, ectropion, hyperpigmentation, and even death. The position, duration, distance between moxa and skin, proficiency of the practitioners, conditions of the patients, presence of smoke, and even the environment of treatment can affect the safety of moxibustion. Improving practitioner skill and regulating operations may reduce the incidence of adverse reactions and improve the security of moxibustion.
Reber, K.C.; Piening, S.; Wieringa, J.E.; Straus, S.M.J.M.; Raine, J.M.; de Graeff, Pauline; Haaijer-Ruskamp, F.M.; Mol, Peter G. M.
Serious safety issues relating to drugs are communicated to health-care professionals via Direct Health-Care Professional Communications (DHPCs). We explored which characteristics determined the impact of DHPCs issued in the Netherlands for ambulatory-care drugs (2001-2008). With multiple linear
The requirements for Westinghouse Hanford independent review of the Preliminary Safety Analysis Report (PSAR) are contained in Section 1.0, Subsection 4.3 of WCH-CM-4-46. Specifically, this manual requires the following: (1) Formal functional reviews of the HWVP PSAR by the future operating organization (HWVP Operations), and the independent review organizations (HWVP and Environmental Safety Assurance, Environmental Assurance, and Quality Assurance); and (2) Review and approval of the HWVP PSAR by the Tank Waste Disposal (TWD) Subcouncil of the Safety and Environmental Advisory Council (SEAC), which provides independent advice to the Westinghouse Hanford President and executives on matters of safety and environmental protection. 7 refs.
Fisher, L.E.; Chou, C.K.; Lloyd, W.R.; Mount, M.E.; Nelson, T.A.; Schwartz, M.W.; Witte, M.C.
The Department of Energy (DOE) has established procedures for obtaining certification of packagings used by DOE and its contractors for the transport of radioactive materials. The principal purpose of this document is to assure the quality and uniformity of PCS reviews and to present a well-defined base from which to evaluate proposed changes in the scope and requirements of reviews. The Packaging Review Guide (PRG) also sets forth solutions and approaches determined to be acceptable in the past in dealing with a specific safety issue or safety-related design area. These solutions and approaches are presented in this form so that reviewers can take consistent and well-understood positions as the same safety issues arise in future cases. An applicant submitting a SARP does not have to follow the solutions or approaches presented. It is also a purpose of the PRG to make information about DOE certification policy and procedures widely available to DOE field offices, DOE contractors, federal agencies, and interested members of the public. 77 refs., 16 figs., 15 tabs.
This article provides a review of current research on human trafficking for mental health practitioners and scholars. In addition to an overview of definitions, causes and processes of trafficking, the article highlights mental health consequences of trafficking along with suggestions for treatment of survivors. Directions for counseling services,…
Craig, Timothy T., Ed.
This document is a collection of papers whose theme is sports safety. Section one, "Government Interest in Sports Safety," includes an article on Washington, D.C.'s focus on sports safety. Section two, "Medical Aspects of Safety in Sports," includes articles regarding the medical basis of restriction from athletics, orthopaedic restrictions, and…
Andrade, S; Bartels, D B; Lange, R; Sandford, L; Gurwitz, J
Metamizole was withdrawn from the market in the United States and several European countries following reports of fatal agranulocytosis among users, but is still available in many countries in Europe, South America and Asia. Over the past several decades, a number of epidemiologic studies have been conducted to quantify the risk of agranulocytosis and other adverse effects associated with metamizole and other non-narcotic analgesics. The objective of this study was to perform a systematic review of the safety of metamizole. Epidemiologic studies published between 1 January 1980 and 15 December 2014 were identified through systematic searches of PubMed and Google Scholar; the reference sections of selected articles were also reviewed to identify potentially relevant studies. Studies included in this review focused on the safety of metamizole, that is on outcomes such as haematologic abnormalities, gastrointestinal bleeding, anaphylaxis and hepatotoxicity. Two study investigators independently reviewed the abstracts and articles to determine relevant studies according to prespecified criteria. A total of 22 articles met the criteria for evaluation. The majority of studies that evaluated agranulocytosis indicated an increased risk associated with metamizole, with relative risk (RR) estimates ranging from 1·5 (95% CI, 0·8-2·7) to 40·2 (95% CI, 14·7-113·3). Findings of three case-control studies do not suggest an association between metamizole and aplastic anaemia. Of the five case-control studies that evaluated the risk of upper gastrointestinal bleeding, four found a statistically significant increased risk associated with metamizole (RR estimates ranging from 1·4 to 2·7). There is insufficient evidence to determine whether metamizole increases the risk of other outcomes (e.g. hepatic effects, anaphylaxis, congenital anomalies). Few studies evaluated the effects of dose, route of administration or duration of therapy. Published studies reported differences in
Shorey, Shefaly; André, Beate; Lopez, Violeta
Globally, perinatal death is on a decline. However, its impact on the healthcare profession is huge. The existing literature focuses on examining perinatal death from parents' perspectives and patient death from the perspectives of nurses and a few doctors in critical care, oncology, and neonatology in the West. Due to the unique setting of maternity units where death is not routinely anticipated, as well as distinctive socio-cultural views surrounding death, there is a need to comprehensively review literature examining the impact of perinatal death on the perspectives of healthcare professionals working in maternity units. To examine available literature on the needs and experiences of healthcare professionals working in maternity units who have experienced perinatal death. A scoping review of published and unpublished data. A systematic literature search from 1st January 1996 to 5th August 2016 was made in the following databases: PubMed, CINAHL, Embase, PsycINFO, ScienceDirect, and Web of Science. Cochrane Library, Joanna Briggs Institute Library of Systematic Reviews, York Centre for Reviews and Dissemination, Open Grey, ProQuest Dissertation and Theses, and Mednar were reviewed for grey literature. A hand search of the reference lists of the included papers was performed. Based on the pre-set inclusion criteria, 1519 articles were screened for their titles and abstracts. Eighty-five full-text papers were reviewed, resulting in 30 papers included for this review. The data were extracted and cross-checked between the reviewers. Any discrepancy between the authors' views would be discussed with a third reviewer until consensus was reached. Thematic analysis was used to categorise the results into themes. Two major themes emerged from the review: the experiences and needs of healthcare professionals. Six subthemes emerged from the experiences of healthcare professionals: 1) psychological impact, 2) physical impact, 3) positive feelings, 4) coping strategies, 5
Moraes, Geraldo Fabiano de Souza; Antunes, Adriana Papini
Due to the high physical and psychological demands of their work, musicians have a high risk of developing a range of health problems. The main causes of musculoskeletal disorders seen in instrumentalists are overuse, nerve compression and focal dystonia. The aim of this paper is to identify the musculoskeletal disorders that most frequently affect professional violinists and violists. 50 articles were read, of which 24 were used. The PEDro scale was used to determine the quality of the articles. The definition of risk factors can help in the development of prevention programs. Playing a musical instrument involves a combination of actions, including rapid, repetitive and complicated movements of the hands and fingers. The chairs used offer no other option than to adapt to the demands of body posture. To achieve the necessary skills to become a musician of a high standard, many hours of training and perfection are required. The neck, shoulder and temporomandibular joints are the most commonly affected areas, due to prolonged flexion of the head and shoulder required to hold the violin. The elbow and fingers are also common sites of disorders. It is necessary to warn musicians of the initial symptoms, and how they can prevent the disorder from worsening. Level I Evidence (Centre for Evidence-Based Medicine, Oxford, UK).
Full Text Available Cisplatin is an effective drug used in the treatment of many cancers, yet its ototoxic potential places cancer patients, exposed to this drug, at risk of hearing loss, thus negatively impacting further on a patient’s quality of life. It is paramount for health care practitioners managing such patients to be aware of cisplatin’s ototoxic properties and the clinical signs to identify patients at risk of developing hearing loss. English peer-reviewed articles from January 1975 to July 2015 were assessed from PubMed, Science Direct, and Ebscohost. Seventy-nine articles and two books were identified for this review, using MeSH terms and keywords such as “ototoxicity”, “cisplatin”, “hearing loss”, and “ototoxicity monitoring”. This review provides an up-to-date overview of cisplatin-associated ototoxicity, namely, its clinical features, incidence rates, and molecular and cellular mechanisms and risk factors, to health care practitioners managing the patient with cancer, and highlights the need for a team-based approach to complement an audiological monitoring programme to mitigate any further loss in the quality of life of affected patients, as there is currently no otoprotective agent recommended routinely for the prevention of cisplatin-associated ototoxicity. It also sets the platform for effective dialogue towards policy formulation and strengthening of health systems in developing countries.
Dixon, Dennis R.; Bergstrom, Ryan; Smith, Marlena N.; Tarbox, Jonathan
Safety skills are an important but often neglected area of training for persons with developmental disabilities (DD). The present study reviewed the literature on teaching safety skills to persons with DD. Safety skills involve a variety of behaviors such as knowing how to cross the street or what to do in case of a house fire. A number of studies…
... COMMISSION Submission for OMB Review; Comment Request: Safety Standard for Cigarette Lighters AGENCY... a collection of information associated with the Commission's safety standard for cigarette lighters... the Safety Standard for Cigarette Lighters, 16 CFR part 1210. One comment was received in response to...
Jorbenadze, T; Shakarashvili, M; Jikia, I; Khvichia, N
An innate intention of subjects to reach the leading position on a regular job scale substantially accentuates the interest to the training study processes. The country that owns well-educated physicians possesses a better chance to attain the superior position in medical managing innovations. The modern scientific knowledge has to invade systematically thus into the ordinary common practice. The ambition to qualify the professional resources via regular training courses is systematically intensified therefore. Any person happens to possess several alternatives for successes in life. The particular important among is the choice of a concrete profession that being motivated by the job dynamics while regulates subjects' activities and intensifies personal interests to the training events. The carrier options of young peoples are influenced by various factors. The most efficient items from appear the family, friends, surroundings, reading literature, television, moviesThe selection of a profession is not finished at all by the university entering: due to life circumstances the dramatic shifts in definite job objectives can occur later. Correctly organized personal trainings along with conventional group exercises, generally, for medical students and young physicians, particularly, can promote the proper choice of fixed carrier aims. Detailed description and showing of appropriate contacts of physicians with patients can enrich the capacities of medical students and young physicians and can improve their behavior in own practice. University study as well as combined group and personal graduate and postgraduate training courses increase the activities of involved persons, intensify the trusts for knowledge and love to the profession, favor the desire to advance the level of theoretical and practical skills, and improve consequently the occupational level.
de Almeida, Jordana Moreira; Luz, Sylvana de Araújo Barros; Ued, Fábio da Veiga
To review the literature in order to evaluate how health professionals promote and support breastfeeding. Studies from the following databases were retrieved: Scopus, PubMed, Medline, Lilacs, SciELO, Web of Science and Cumulative Index to Nursing and Allied Health Literature (Cinahl). The descriptors "breastfeeding", "professional role" and "patient care team" were used in the research. The review was limited to articles in Portuguese, Spanish, and English published between 1997 and 2013. The search retrieved 1,396 studies, 18 of which were selected for being directly relevant to the main question. The review showed that breastfeeding is a challenge for health professionals, regardless of their specialization, as they have to face a demand that requires skill and sensibility, for which they are not prepared. Health professionals have considered breastfeeding a purely instinctive and biological act. Moreover, it is noticeable that many of them possess theoretical expertise on the subject, but lack the practical skills. Health professionals need to be better trained to work on promoting breastfeeding, whether by health and medical schools or by healthcare administrators, in order to consolidate multiprofessional teams committed to maternal-infant health. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.
Full Text Available In light of recent reports showing high incidence of silent cerebral infarcts and organized atrial arrhythmias following radiofrequency (RF atrial fibrillation (AF ablation, a review of its safety aspects is timely. Serious complications do occur during supraventricular tachycardia (SVT ablations and knowledge of their incidence is important when deciding whether to proceed with ablation. Evidence is emerging for the probable role of prophylactic ischemic scar ablation to prevent VT. This might increase the number of procedures performed. Here we look at the various complications of RF ablation and also the methods to minimize them. Electronic database was searched for relevant articles from 1990 to 2015. With better awareness and technological advancements in RF ablation the incidence of complications has improved considerably. In AF ablation it has decreased from 6% to less than 4% comprising of vascular complications, cardiac tamponade, stroke, phrenic nerve injury, pulmonary vein stenosis, atrio-esophageal fistula (AEF and death. Safety of SVT ablation has also improved with less than 1% incidence of AV node injury in AVNRT ablation. In VT ablation the incidence of major complications was 5–11%, up to 3.4%, up to 1.8% and 4.1–8.8% in patients with structural heart disease, without structural heart disease, prophylactic ablations and epicardial ablations respectively. Vascular and pericardial complications dominated endocardial and epicardial VT ablations respectively. Up to 3% mortality and similar rates of tamponade were reported in endocardial VT ablation. Recent reports about the high incidence of asymptomatic cerebral embolism during AF ablation are concerning, warranting more research into its etiology and prevention.
Smith, Kelly; Leyden, James J
The goal of this review was to summarize the available literature covering the safety profiles of oral doxycycline and minocycline. Scientific literature published between 1966 and August 2003 was searched using the MEDLINE, EMBASE, and Biosis databases (search terms: minocycline or doxycycline, each paired with adverse reaction, adverse event, and side effect, and doxycycline or minocycline with the limits English language, human, and clinical trials). Safety information was collected from case reports and clinical trials. Adverse event (AE) rates in the United States were calculated by comparing data from the MedWatch AE reporting program used by the US Food and Drug Administration (FDA) with the number of new prescriptions dispensed for each drug from January 1998 to August 2003. Between 1966 and 2003, a total of 130 and 333 AEs were published in case reports of doxycycline and minocycline, respectively. In 24 doxycycline clinical trials (n = 3833) and 11 minocycline trials (n = 788), the ranges in incidence of AEs were 0% to 61% and 11.7% to 83.3%, respectively. Gastrointestinal AEs were most common with doxycycline; central nervous system and gastrointestinal AEs were most common with minocycline. From January 1998 to August 2003, the FDA MedWatch data contained 628 events for doxycycline and 1099 events for minocycline reported in the United States. Approximately 47,630,000 doxycycline and 15,234,000 minocycline new prescriptions were dispensed in the United States during that period, yielding event rates of 13 per million for doxycycline and 72 per million for minocycline, based on FDA data. Between 1998 and 2003, doxycycline was prescribed 3 times as often as minocycline. The incidence of AEs with either drug is very low, but doxycycline had fewer reported AEs. Although more head-to-head clinical trials are needed for a direct comparison of AE frequency, these preliminary data from separate reports suggest the possibility that AEs may be less likely with
Wittenberg, Yvette; Kwekkeboom, Rick; Staaks, Janneke; Verhoeff, Arnoud; de Boer, Alice
This scoping review focuses on the views of informal caregivers regarding the division of care responsibilities between citizens, governments and professionals and the question of to what extent professionals take these views into account during collaboration with them. In Europe, the normative discourse on informal care has changed. Retreating governments and decreasing residential care increase the need to enhance the collaboration between informal caregivers and professionals. Professionals are assumed to adequately address the needs and wishes of informal caregivers, but little is known about informal caregivers' views on the division of care responsibilities. We performed a scoping review and searched for relevant studies published between 2000 and September 1, 2016 in seven databases. Thirteen papers were included, all published in Western countries. Most included papers described research with a qualitative research design. Based on the opinion of informal caregivers, we conclude that professionals do not seem to explicitly take into account the views of informal caregivers about the division of responsibilities during their collaboration with them. Roles of the informal caregivers and professionals are not always discussed and the division of responsibilities sometimes seems unclear. Acknowledging the role and expertise of informal caregivers seems to facilitate good collaboration, as well as attitudes such as professionals being open and honest, proactive and compassionate. Inflexible structures and services hinder good collaboration. Asking informal caregivers what their opinion is about the division of responsibilities could improve clarity about the care that is given by both informal caregivers and professionals and could improve their collaboration. Educational programs in social work, health and allied health professions should put more emphasis on this specific characteristic of collaboration. © 2017 The Authors. Health and Social Care in the
Golem, Devon L.; Martin-Biggers, Jennifer T.; Koenings, Mallory M.; Davis, Katherine Finn; Byrd-Bredbenner, Carol
Sleep is an essential lifestyle factor that contributes to overall health. The inverse relation between sleep duration and weight status has revealed the importance of sleep in nutritional health. This integrative review builds foundational knowledge with regard to sleep vis-à-vis nutrition by summarizing the importance and process of sleep, current sleep recommendations and trends, as well as lifestyle contributors to poor sleep. Additionally, it details the association between sleep and obesity and potential mechanisms for this association. Furthermore, guidance is offered regarding the incorporation of sleep considerations in nutrition counseling, communication, and research. Like many other lifestyle factors that contribute to nutritional health, sleep needs to be considered when examining weight management and health promotion. PMID:25398735
Golem, Devon L; Martin-Biggers, Jennifer T; Koenings, Mallory M; Davis, Katherine Finn; Byrd-Bredbenner, Carol
Sleep is an essential lifestyle factor that contributes to overall health. The inverse relation between sleep duration and weight status has revealed the importance of sleep in nutritional health. This integrative review builds foundational knowledge with regard to sleep vis-à-vis nutrition by summarizing the importance and process of sleep, current sleep recommendations and trends, as well as lifestyle contributors to poor sleep. Additionally, it details the association between sleep and obesity and potential mechanisms for this association. Furthermore, guidance is offered regarding the incorporation of sleep considerations in nutrition counseling, communication, and research. Like many other lifestyle factors that contribute to nutritional health, sleep needs to be considered when examining weight management and health promotion. © 2014 American Society for Nutrition.
Legere, Laura E; Wallace, Katherine; Bowen, Angela; McQueen, Karen; Montgomery, Phyllis; Evans, Marilyn
Perinatal depression is the most common mental illness experienced by pregnant and postpartum women, yet it is often under-detected and under-treated. Some researchers suggest this may be partly influenced by a lack of education and professional development on perinatal depression among health-care providers, which can negatively affect care and contribute to stigmatization of women experiencing altered mood. Therefore, the aim of this systematic review is to provide a synthesis of educational and professional development needs and strategies for health-care providers in perinatal depression. A systematic search of the literature was conducted in seven academic health databases using selected keywords. The search was limited to primary studies and reviews published in English between January 2006 and May/June 2015, with a focus on perinatal depression education and professional development for health-care providers. Studies were screened for inclusion by two reviewers and tie-broken by a third. Studies that met inclusion criteria were quality appraised and data extracted. Results from the studies are reported through narrative synthesis. Two thousand one hundred five studies were returned from the search, with 1790 remaining after duplicate removal. Ultimately, 12 studies of moderate and weak quality met inclusion criteria. The studies encompassed quantitative (n = 11) and qualitative (n = 1) designs, none of which were reviews, and addressed educational needs identified by health-care providers (n = 5) and strategies for professional development in perinatal mental health (n = 7). Consistently, providers identified a lack of formal education in perinatal mental health and the need for further professional development. Although the professional development interventions were diverse, the majority focused on promoting identification of perinatal depression and demonstrated modest effectiveness in improving various outcomes. This systematic review reveals a
Salyers, Michelle P; Bonfils, Kelsey A; Luther, Lauren; Firmin, Ruth L; White, Dominique A; Adams, Erin L; Rollins, Angela L
Healthcare provider burnout is considered a factor in quality of care, yet little is known about the consistency and magnitude of this relationship. This meta-analysis examined relationships between provider burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) and the quality (perceived quality, patient satisfaction) and safety of healthcare. Publications were identified through targeted literature searches in Ovid MEDLINE, PsycINFO, Web of Science, CINAHL, and ProQuest Dissertations & Theses through March of 2015. Two coders extracted data to calculate effect sizes and potential moderators. We calculated Pearson's r for all independent relationships between burnout and quality measures, using a random effects model. Data were assessed for potential impact of study rigor, outliers, and publication bias. Eighty-two studies including 210,669 healthcare providers were included. Statistically significant negative relationships emerged between burnout and quality (r = -0.26, 95 % CI [-0.29, -0.23]) and safety (r = -0.23, 95 % CI [-0.28, -0.17]). In both cases, the negative relationship implied that greater burnout among healthcare providers was associated with poorer-quality healthcare and reduced safety for patients. Moderators for the quality relationship included dimension of burnout, unit of analysis, and quality data source. Moderators for the relationship between burnout and safety were safety indicator type, population, and country. Rigor of the study was not a significant moderator. This is the first study to systematically, quantitatively analyze the links between healthcare provider burnout and healthcare quality and safety across disciplines. Provider burnout shows consistent negative relationships with perceived quality (including patient satisfaction), quality indicators, and perceptions of safety. Though the effects are small to medium, the findings highlight the importance of effective burnout interventions for
... of Justice Programs Meeting of the Public Safety Officer Medal of Valor Review Board AGENCY: Office...: This is an announcement of a meeting via conference call of the Public Safety Officer Medal of Valor... Medal of Valor Review Board carries out those advisory functions specified in 42 U.S.C. 15202. Pursuant...
Perraudin, Clémence; Bugnon, Olivier; Pelletier-Fleury, Nathalie
To synthesize cost-effectiveness analyses on professional pharmacy services (PPS) performed in Europe in order to contribute to current debates on their funding and reimbursement. Systematic review in PubMed, Embase and the Centre for Reviews and Dissemination databases to identify full economic evaluation studies of PPS in community setting from 2004. Twenty-one studies were included, conducted in the United-Kingdom (n=13), the Netherlands (n=3), Spain (n=2), Belgium (n=1), France (n=1) and Denmark (n=1). PPS to enhance medicine safety (interprofessional meetings to reduce errors, n=2) and access to medicines (minor ailment scheme, n=1) were in favour of their cost-effectiveness in the UK context, but the evidence is not sufficient. Eleven studies assessed PPS to improve treatment outcomes of individual patients-such as pharmaceutical care services, medication review, educational and coaching program, disease support service, medicines management and telephone-based advisory for improving adherence. Findings were contradictory and did not lead to strong conclusion. Screening programs for different diseases showed robust positive results (n=2) as well as smoking cessation services (n=5) and should be considered to be more widely available in accordance with national context. The review provides arguments for the implementation of PPS aiming to improve public health through screening programs and smoking cessation services. However, further full economic evaluations are needed to support or refute the added value of other services. Copyright Â© 2016 Elsevier Ireland Ltd. All rights reserved.
Kok, Laura M.; Huisstede, Bionka M A|info:eu-repo/dai/nl/298688719; Voorn, Veronique M A; Schoones, Jan W.; Nelissen, Rob G H H
Purpose: This study gives a systematic overview of the literature on the occurrence of musculoskeletal complaints in professional instrumental musicians. Methods: A systematic review. Nine literature databases were searched without time limits on June 25, 2015, also the complete index of the journal
Wahl, Otto; Aroesty-Cohen, Eli
A large body of research has documented public attitudes toward people with mental illness. The current attitudes of the people who provide services to those with psychiatric disorders are important to understand, as well. The authors review what studies over the past 5 years reveal about the attitudes of psychiatric professionals. Empirical…
Africa has been losing professionally trained health workers who are the core of the health system of this continent for many years. Faced with an increased burden of disease and coupled by a massive exodus of the health workforce, the health systems of many African nations are risking complete paralysis. Several studies have suggested policy options to reduce brain drain from Africa. The purpose of this paper is to review possible policies, which can stem the impact of health professional brain drain from Africa. A systemic literature review was conducted. Cinahl, Science Direct and PubMed databases were searched with the following terms: health professional brain drain from Africa and policies for reducing impact of brain drain from Africa. References were also browsed for relevant articles. A total of 425 articles were available for the study but only 23 articles met the inclusion criteria. The review identified nine policy options, which were being implemented in Africa, but the most common was task shifting which had success in several African countries. This review has demonstrated that there is considerable consensus on task shifting as the most appropriate and sustainable policy option for reducing the impact of health professional brain drain from Africa.
Full Text Available Africa has been losing professionally trained health workers who are the core of the health system of this continent for many years. Faced with an increased burden of disease and coupled by a massive exodus of the health workforce, the health systems of many African nations are risking complete paralysis. Several studies have suggested policy options to reduce brain drain from Africa. The purpose of this paper is to review possible policies, which can stem the impact of health professional brain drain from Africa. A systemic literature review was conducted. Cinahl, Science Direct and PubMed databases were searched with the following terms: health professional brain drain from Africa and policies for reducing impact of brain drain from Africa. References were also browsed for relevant articles. A total of 425 articles were available for the study but only 23 articles met the inclusion criteria. The review identified nine policy options, which were being implemented in Africa, but the most common was task shifting which had success in several African countries. This review has demonstrated that there is considerable consensus on task shifting as the most appropriate and sustainable policy option for reducing the impact of health professional brain drain from Africa.
Greef, M. de; Pijnenburg, H.M.P.H.M.; Hattum, M.J.C. van; McLeod, B.D.; Scholte, R.H.J.; Valle, J.F. del; Bravo, A.; López, M.
This presentation is based on a systematic review on the association between the parent-professional alliance and outcomes of youth and family care. In child and family social services, parents play an important role (Accurso, Hawley, & Garland, 2013; Chaffin & Bard, 2011). They are either the main
Maxwell, Bruce; Schwimmer, Marina
This article provides a narrative review of the scholarly writings on professional ethics education for future teachers. Against the background of a widespread belief among scholars working in this area that longstanding and sustained research and reflection on the ethics of teaching have had little impact on the teacher education curriculum, the…
Morales, Marie Paz E.
This paper reviews Participatory Action Research as an approach to teacher professional development. It maps the origins of Participatory Action Research (PAR) and discusses the benefits and challenges that have been identified by other researchers in utilizing PAR approaches in conducting research. It draws ideas of combining the features of…
Sibandze, B T; Scafide, K N
Professional nursing values have been acknowledged globally as the foundation of daily nursing care practice. Understanding how nurses identify, comprehend and apply their professional nursing values is an important step towards improving nursing practice and patient care quality. Research has demonstrated that nurses' professional values are cultivated during prelicensure academic education. The aim of this systematic review was to determine how level of education affects professional nursing values of clinical practising nurses. A systematic search of quantitative research published through December 2015 was performed in the following five electronic databases: CINAHL, Cochrane Library, MEDLINE, Web of Science and Religion and Philosophy Collection. The search was not limited to country of origin. The studies were assessed for methodological quality using established criteria. Of 1501 articles identified through the literature search, only seven studies met the inclusion criteria with the majority being of good to high quality. Most of the studies found registered nurses pursuing a bachelor of science in nursing or higher had a greater awareness and application of professional values than nurses with lower levels of academic or non-academic education. Nurses with higher education also embraced professional values as fundamental for quality nursing care practice. Health and academic institutions should support nurses through quality continuing and higher education that reinforces professional values, thus improving the quality of patient care. The level of nurses' education appears to play an important role in developing both an awareness and an integration of professional values into practice. More research is needed to discover methods that may be used to promote nurses' professional values among nurses already practising clinically. © 2017 International Council of Nurses.
Full Text Available The article presents definitions of and approaches to the concept of safety in order to confirm the subjective character of its determination, description, and interpretation. By presenting examples of security statistics and safety-related behaviours, its ambiguity and complexity are revealed. The author draws attention to the media’s attitude towards safety-related incidents. With reference to contemporary scientific knowledge about the methods of improving safety in transportation organizations, the author also suggests that safety improvement initiatives should focus more strongly on facilitating closer cooperation between leaders, superiors and subordinates with different levels of experience.
Twitchett, Emily A; Koutedakis, Yiannis; Wyon, Matthew A
Although classical ballet is an artistic expression through the use of the body, there is a real opportunity to improve and extend the dancer's career by simply applying sports science principles to dance training and performance. Dance training is a long process of physical, intellectual, and psychological preparation, through physical exercise, often beginning in childhood and continuing until retirement. Fitness programs, supplementary to traditional dance classes, have only recently been considered as a part of this process; it may be suggested that this cross-training has generally been avoided thus far because of tradition and a reluctance to follow principles associated with sport. Classical ballet training, rehearsal, and performance do not elicit significant stimulus to result in increased aerobic fitness levels. Therefore, dancers often demonstrate low levels of aerobic fitness even though a strong aerobic foundation is necessary to meet the required workload. Dancers have greater than average range of motion and strength at the hip joint but weaknesses in the upper body, torso, hamstrings, and quadriceps. In the past, dancers have been wary of strength training because they perceive this leads to aesthetically undesirable hypertrophy. Dancers also have low body weights and low percentage body fat. Given that training does not provide the opportunity to expend enough energy to maintain these aesthetic demands, this aesthetic demand may be met by caloric restriction, which may lead to subsequent increased injury risk. It has been hypothesized that a "fit for purpose" body can help improve performance, reduce the risk of injury, and ensure prolonged dance careers. This review aims to explore the extent to which physical fitness components relate to dance performance, in particular classical ballet.
Thaysen-Petersen, D; Bjerring, P; Dierickx, C
, one CT, five UCTs) and limited evidence for laser devices (one diode laser, one UCT). Most studies evaluated short-term hair reduction up to 3 and 6 months following light exposure at different body sites. Hair reduction percentages ranged from 6% to 72% after repetitive treatments. The most......Background Hair removal with professional light-based devices is established as an effective, mainstream treatment. The field of optical home-based hair removal is evolving and movement from control by physicians into hands of consumers warrants understanding efficacy and human safety. Objectives...... To systematically review and evaluate the efficacy and human safety of currently available home-based optical hair removal devices. Methods A comprehensive Pub Med literature search was conducted which systematically identified publications of relevance. Prospective clinical trials were included whether controlled...
Bouwmeester, Hans; Dekkers, Susan; Noordam, Maryvon Y; Hagens, Werner I; Bulder, Astrid S; de Heer, Cees; ten Voorde, Sandra E C G; Wijnhoven, Susan W P; Marvin, Hans J P; Sips, Adriënne J A M
Due to new, previously unknown, properties attributed to engineered nanoparticles many new products are introduced in the agro-food area. Nanotechnologies cover many aspects, such as disease treatment, food security, new materials for pathogen detection, packaging materials and delivery systems. As with most new and evolving technologies, potential benefits are emphasized, while little is known on safety of the application of nanotechnologies in the agro-food sector. This review gives an overview of scientific issues that need to be addressed with priority in order to improve the risk assessment for nanoparticles in food. The following research topics are considered to contribute pivotally to risk assessment of nanotechnologies and nanoparticles in food products. Set a definition for NPs to facilitate regulatory discussions, prioritization of research and exchange of study results. Develop analytical tools for the characterization of nanoparticles in complex biological matrices like food. Establish relevant dose metrics for nanoparticles used for both interpretation of scientific studies as well as regulatory frameworks. Search for deviant behavior (kinetics) and novel effects (toxicity) of nanoparticles and assess the validity of currently used test systems following oral exposure. Estimate the consumer exposure to nanoparticles.
Olaimat, Amin N; Holley, Richard A
Increased consumption, larger scale production and more efficient distribution of fresh produce over the past two decades have contributed to an increase in the number of illness outbreaks caused by this commodity. Pathogen contamination of fresh produce may originate before or after harvest, but once contaminated produce is difficult to sanitize. The prospect that some pathogens invade the vascular system of plants and establish "sub-clinical" infection needs to be better understood to enable estimation of its influence upon risk of human illness. Conventional surface sanitation methods can reduce the microbial load, but cannot eliminate pathogens if present. Chlorine dioxide, electrolyzed water, UV light, cold atmospheric plasma, hydrogen peroxide, organic acids and acidified sodium chlorite show promise, but irradiation at 1 kGy in high oxygen atmospheres may prove to be the most effective means to assure elimination of both surface and internal contamination of produce by pathogens. Pathogens of greatest current concern are Salmonella (tomatoes, seed sprouts and spices) and Escherichia coli O157:H7 on leafy greens (spinach and lettuce). This review considers new information on illness outbreaks caused by produce, identifies factors which influence their frequency and size and examines intervention effectiveness. Research needed to increase our understanding of the factors influencing microbial safety of fresh produce is addressed. Copyright © 2012 Elsevier Ltd. All rights reserved.
Temple, Jennifer L.; Bernard, Christophe; Lipshultz, Steven E.; Czachor, Jason D.; Westphal, Joslyn A.; Mestre, Miriam A.
Caffeine is the most widely consumed psychoactive drug in the world. Natural sources of caffeine include coffee, tea, and chocolate. Synthetic caffeine is also added to products to promote arousal, alertness, energy, and elevated mood. Over the past decade, the introduction of new caffeine-containing food products, as well as changes in consumption patterns of the more traditional sources of caffeine, has increased scrutiny by health authorities and regulatory bodies about the overall consumption of caffeine and its potential cumulative effects on behavior and physiology. Of particular concern is the rate of caffeine intake among populations potentially vulnerable to the negative effects of caffeine consumption: pregnant and lactating women, children and adolescents, young adults, and people with underlying heart or other health conditions, such as mental illness. Here, we review the research into the safety and safe doses of ingested caffeine in healthy and in vulnerable populations. We report that, for healthy adults, caffeine consumption is relatively safe, but that for some vulnerable populations, caffeine consumption could be harmful, including impairments in cardiovascular function, sleep, and substance use. We also identified several gaps in the literature on which we based recommendations for the future of caffeine research. PMID:28603504
Temple, Jennifer L; Bernard, Christophe; Lipshultz, Steven E; Czachor, Jason D; Westphal, Joslyn A; Mestre, Miriam A
Caffeine is the most widely consumed psychoactive drug in the world. Natural sources of caffeine include coffee, tea, and chocolate. Synthetic caffeine is also added to products to promote arousal, alertness, energy, and elevated mood. Over the past decade, the introduction of new caffeine-containing food products, as well as changes in consumption patterns of the more traditional sources of caffeine, has increased scrutiny by health authorities and regulatory bodies about the overall consumption of caffeine and its potential cumulative effects on behavior and physiology. Of particular concern is the rate of caffeine intake among populations potentially vulnerable to the negative effects of caffeine consumption: pregnant and lactating women, children and adolescents, young adults, and people with underlying heart or other health conditions, such as mental illness. Here, we review the research into the safety and safe doses of ingested caffeine in healthy and in vulnerable populations. We report that, for healthy adults, caffeine consumption is relatively safe, but that for some vulnerable populations, caffeine consumption could be harmful, including impairments in cardiovascular function, sleep, and substance use. We also identified several gaps in the literature on which we based recommendations for the future of caffeine research.
Full Text Available Background : Lithium is a first-line treatment for bipolar disorder in all phases, also indicated as add-on drug for unipolar depression and suicide prevention. This study encompasses a broad critical review on the safety and tolerability of lithium for mood disorders. Methods : A computerized search for English written human studies was made in MEDLINE, using the keywords “lithium” and “mood disorders”, starting from July 1993 through July 2013 (n = 416. This initial search aimed to select clinical trials, prospective data, and controlled design studies of lithium treatment for mood disorders reporting adverse effects (n = 36. The final selection yielded 91 studies. Results : The most common general side effects in patients on lithium treatment were thirst, frequent urination, dry mouth, weight gain, fatigue and cognitive complaints. Lithium users showed a high prevalence of hypothyroidism, hyperparathyroidism, and decrease in urinary concentration ability. Reduction of glomerular filtration rate in patients using lithium was also observed, but in a lesser extent. The evidence of teratogenicity associated with lithium use is not well established. Anti-inflammatory non-steroidal drugs, thiazide diuretics, angiotensin-converting enzyme inhibitors, and alprazolam may increase serum lithium and the consequent risk for intoxication. Discussion : Short-term lithium treatment is associated with mild side effects. Medium and long-term lithium treatment, however, might have effects on target organs which may be prevented by periodical monitoring. Overall, lithium is still a safe option for the treatment of mood disorders.
Jennifer L. Temple
Full Text Available Caffeine is the most widely consumed psychoactive drug in the world. Natural sources of caffeine include coffee, tea, and chocolate. Synthetic caffeine is also added to products to promote arousal, alertness, energy, and elevated mood. Over the past decade, the introduction of new caffeine-containing food products, as well as changes in consumption patterns of the more traditional sources of caffeine, has increased scrutiny by health authorities and regulatory bodies about the overall consumption of caffeine and its potential cumulative effects on behavior and physiology. Of particular concern is the rate of caffeine intake among populations potentially vulnerable to the negative effects of caffeine consumption: pregnant and lactating women, children and adolescents, young adults, and people with underlying heart or other health conditions, such as mental illness. Here, we review the research into the safety and safe doses of ingested caffeine in healthy and in vulnerable populations. We report that, for healthy adults, caffeine consumption is relatively safe, but that for some vulnerable populations, caffeine consumption could be harmful, including impairments in cardiovascular function, sleep, and substance use. We also identified several gaps in the literature on which we based recommendations for the future of caffeine research.
Ament, Stephanie M C; de Groot, Jeanny J A; Maessen, José M C; Dirksen, Carmen D; van der Weijden, Trudy; Kleijnen, Jos
To evaluate (1) the state of the art in sustainability research and (2) the outcomes of professionals' adherence to guideline recommendations in medical practice. Systematic review. Searches were conducted until August 2015 in MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and the Guidelines International Network (GIN) library. A snowball strategy, in which reference sections of other reviews and of included papers were searched, was used to identify additional papers. Studies needed to be focused on sustainability and on professionals' adherence to clinical practice guidelines in medical care. Studies had to include at least 2 measurements: 1 before (PRE) or immediately after implementation (EARLY POST) and 1 measurement longer than 1 year after active implementation (LATE POST). The search retrieved 4219 items, of which 14 studies met the inclusion criteria, involving 18 sustainability evaluations. The mean timeframe between the end of active implementation and the sustainability evaluation was 2.6 years (minimum 1.5-maximum 7.0). The studies were heterogeneous with respect to their methodology. Sustainability was considered to be successful if performance in terms of professionals' adherence was fully maintained in the late postimplementation phase. Long-term sustainability of professionals' adherence was reported in 7 out of 18 evaluations, adherence was not sustained in 6 evaluations, 4 evaluations showed mixed sustainability results and in 1 evaluation it was unclear whether the professional adherence was sustained. (2) Professionals' adherence to a clinical practice guideline in medical care decreased after more than 1 year after implementation in about half of the cases. (1) Owing to the limited number of studies, the absence of a uniform definition, the high risk of bias, and the mixed results of studies, no firm conclusion about the sustainability of professionals' adherence to guidelines in medical practice can be drawn
Diego L. Sepúlveda M
Full Text Available Objective: to determine the safety conditions of steam boilers in companies associated with a professional risk administra-tion company in Antioquia, Colombia. To this end, their op-eration conditions shall be characterized, the associated risks identified, and their safety level assessed. Methodology:. a descriptive crosssectional study was carried out in twenty companies whose production processes involve boilers. A survey on the conditions for operation was applied on both the maintenance managers and the boilers’ operators in each company. A hazard risk assessment matrix was made as in-structed in the GTC-45 Colombian technical guide, and an assessment instrument was applied to determine the safety level for each boiler. Results: 70% of the assessed boilers obtained a low score (less than 65 points according to the scale, which has been validated by experts; the remaining boilers obtained an acceptable score (66 to 81 points. It was also found that 85% of the boilers had no operating instructions, and 60% of them did not have any kind of alarm. Conclusions: the stud-ied boilers had poor security conditions, mainly related to the absence of operation protocols, boiler operator training, and poor supervision by competent authorities
Kim, Woong Sik; Choi, Kwang Sik; Choi, Young Sung; Kim, Hho Jung; Kim, Ho Ki [Korea Institute of Nuclear Safety, Taejon (Korea, Republic of)
The goal of regulation is to protect public health and safety as well as environment from radiological hazards that may occur as a result of the use of atomic energy. In September 1994, the Korean government issued the Nuclear Safety Policy Statement (NSPS) to establish policy goals of maintaining and achieving high-level of nuclear safety and also help the public understand the national policy and a strong will of the government toward nuclear safety. It declares the importance of establishing safety culture in nuclear community and also specifies five nuclear regulatory principles (Independence, Openness, Clarity, Efficiency and Reliability) and provides the eleven regulatory policy directions. In 2001, the Nuclear Safety Charter was declared to make the highest goal of safety in driving nuclear business clearer; to encourage atomic energy- related institutions and workers to keep in mind the mission and responsibility for assuring safety; to guarantee public confidence in related organizations. The Ministry of Science and Technology (MOST) also issues Yearly Regulatory Policy Directions at the beginning of every year. Recently, the third Atomic Energy Promotion Plan (2007-2011) has been established. It becomes necessary for the relevant organizations to prepare the detailed plans on such areas as nuclear development, safety management, regulation, etc. This paper introduces a multi-level structure of nuclear safety and regulation policy documents in Korea and presents some improvements necessary for better application of the policies.
Clayton, Judith L; Miller, Kimberly J
Professional organizations and regulatory agencies collaborate on infection prevention and control guidelines to support preventing and controlling infection in the surgical setting. More specifically, regulatory and accrediting agencies, professional associations, and advisory committees create and promote the use of evidence-based recommendations for preventing surgical site infections. Many agencies perform accreditation surveys to ensure compliance with these standards and guidelines. Perioperative personnel can use these resources to implement and sustain essential processes for infection prevention and control and to facilitate staff member compliance with standards, regulations, and best practices. To guide perioperative practice, it is important for nurses to understand the role of these agencies and organizations and the resources each offers to help ensure the best patient outcomes. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Gagnon, Marie-Pierre; Desmartis, Marie; Labrecque, Michel; Car, Josip; Pagliari, Claudia; Pluye, Pierre; Frémont, Pierre; Gagnon, Johanne; Tremblay, Nadine; Légaré, France
This systematic review of mixed methods studies focuses on factors that can facilitate or limit the implementation of information and communication technologies (ICTs) in clinical settings. Systematic searches of relevant bibliographic databases identified studies about interventions promoting ICT adoption by healthcare professionals. Content analysis was performed by two reviewers using a specific grid. One hundred and one (101) studies were included in the review. Perception of the benefits of the innovation (system usefulness) was the most common facilitating factor, followed by ease of use. Issues regarding design, technical concerns, familiarity with ICT, and time were the most frequent limiting factors identified. Our results suggest strategies that could effectively promote the successful adoption of ICT in healthcare professional practices.
Seim, Rikke; Limborg, Hans Jørgen; Jensen, Per Langaa
The development of the internal OHS management is studied in sixty Danish companies, the results indicates an increase in professionalization, where employees - employed specifically with the purpose of managing OHS – are either supplementing or taking over from the mandatory OHS - committees...... leaving the role of employee elected OHS rep as an empty formality without any powers or duties associated with the OHS management and removing initiative and commitment from the OHS reps....
Fleet, Lisa J; Kirby, Fran; Cutler, Sarah; Dunikowski, Lynn; Nasmith, Louise; Shaughnessy, Rita
The idea that health professionals should be accountable to the society they serve is not a new concept and by the 1990 s, the continuing professional development (CPD) of health professionals was being seen as one way in which Canadians' level of health could be improved. The public was, and is still today, increasingly demanding a system that is more responsive to regional and community needs. As a result, there is a need for more health professional education at all stages of the education continuum - undergraduate, postgraduate, and continuing professional development - that meets the health and social needs of the populations being served. The trend is now towards 'socially accountable' health care, meaning that the broader context of CPD must also include the personal, social, and political aspects of health care and as such, involve a widening of accountability to patients, the community, managers and policymakers. CPD planning must take into account local and national priorities as well as personal learning needs. However, the definition of social accountability and the stages at which it is addressed is sometimes vague and this added to the difficulty of identifying relevant studies in the literature. Nonetheless, there were some "best practices" evident via Canadian and American studies which focused on models of socially accountable CPD, as well as examples of interdisciplinary collaboration in Canada, the United States, Australia, Great Britain, and the United Arab Emirates. However, there is a definite need for increased research and publication of such "best practice" initiatives. There is also a need for Canadian health professional schools to facilitate this process by sharing their experiences and resources if possible. An extensive literature review was conducted between January and March 2004. Due to time constraints, it was limited to articles written in the English language. The databases/sources utilized included: Medline (now known as Pubmed
Caroline Mary Hills
Full Text Available Generation Y or Millennials are descriptors for those born between 1982 and 2000. This cohort has grown up in the digital age and is purported to have different learning preferences from previous generations. Students are important stakeholders in identifying their preferred teaching and learning approaches in health professional programs. This study aimed to identify, appraise, and synthesize the best available evidence regarding the teaching and learning preferences of Generation Y health professional students. The review considered any objectively measured or self-reported outcomes of teaching and learning reported from Generation Y health professional student perspectives. In accordance with a previously published Joanna Briggs Institute Protocol, a three-step search strategy was completed. Two research articles (nursing and dental hygiene students and three dissertations (nursing were critically appraised. All studies were cross-sectional descriptive studies. A range of pedagogical approaches was reported, including lecture, group work, and teaching clinical skills. Based on the Joanna Briggs Institute levels of evidence, reviewers deemed the evidence as Level 3. Some generational differences were reported, but these were inconsistent across the studies reviewed. There is, therefore, insufficient evidence to provide specific recommendations for the preferred educational approaches of health professional students and further research is warranted.
Carpenter, K B; Duevel, M A; Lee, P W; Wu, A W; Bates, D W; Runciman, W B; Baker, G R; Larizgoitia, I; Weeks, W B
The World Alliance for Patient Safety was formed to accelerate worldwide research progress towards measurably improving patient safety. Although rates of adverse events have been studied in industrialised countries, little is known about the rates of adverse events in developing and emerging countries. To review the literature on patient safety issues in developing and emerging countries, to identify patient safety measures presently used in these countries and to propose a method of measurably improving patient safety measurement in these countries. Using the Medline database for 1998 to 2007, we identified and reviewed 23 English-language articles that examined patient safety measurement in developing and emerging countries. Results Our review included 12 studies that prospectively measured patient safety and 11 studies that retrospectively measured safety. Two studies used measures of structure and the remaining used process measures, outcome measures or both. Whereas a few studies used surveys or direct observation, most studies used chart audits to measure patient safety. Most studies addressed safety at a single facility. Investigation of patient safety in developing and emerging countries has been infrequent and limited in scope. Establishing fundamental safe patient practices, integrating those processes into routine health services delivery and developing patients' expectations that such processes be present are necessary prerequisites to measuring and monitoring progress towards safe patient care in emerging and developing countries.
Full Text Available Robyn L Saxon,1–3 Marion A Gray,1,2 Florin I Oprescu1,2 1School of Health and Sports Sciences, Faculty of Science, Health, Education and Engineering, 2Cluster for Health Improvement, University of the Sunshine Coast, Sippy Downs, QLD, 3Queensland Health, Brisbane, QLD, Australia Background: Internationally, health care services are under increasing pressure to provide high quality, accessible, timely interventions to an ever increasing aging population, with finite resources. Extended scope roles for allied health professionals is one strategy that could be undertaken by health care services to meet this demand. This review builds upon an earlier paper published in 2006 on the evidence relating to the impact extended scope roles have on health care services. Methods: A systematic review of the literature focused on extended scope roles in three allied health professional groups, ie, physiotherapy, occupational therapy, and speech pathology, was conducted. The search strategy mirrored an earlier systematic review methodology and was designed to include articles from 2005 onwards. All peer-reviewed published papers with evidence relating to effects on patients, other professionals, or the health service were included. All papers were critically appraised prior to data extraction. Results: A total of 1,000 articles were identified by the search strategy; 254 articles were screened for relevance and 21 progressed to data extraction for inclusion in the systematic review. Conclusion: Literature supporting extended scope roles exists; however, despite the earlier review calling for more robust evaluations regarding the impact on patient outcomes, cost-effectiveness, training requirements, niche identification, or sustainability, there appears to be limited research reported on the topic in the last 7 years. The evidence available suggests that extended scope practice allied health practitioners could be a cost-effective and consumer
DiGioia, Jonathan; Watkins, Kari Edison; Xu, Yanzhi; Rodgers, Michael; Guensler, Randall
This paper takes a critical look at the present state of bicycle infrastructure treatment safety research, highlighting data needs. Safety literature relating to 22 bicycle treatments is examined, including findings, study methodologies, and data sources used in the studies. Some preliminary conclusions related to research efficacy are drawn from the available data and findings in the research. While the current body of bicycle safety literature points toward some defensible conclusions regarding the safety and effectiveness of certain bicycle treatments, such as bike lanes and removal of on-street parking, the vast majority treatments are still in need of rigorous research. Fundamental questions arise regarding appropriate exposure measures, crash measures, and crash data sources. This research will aid transportation departments with regard to decisions about bicycle infrastructure and guide future research efforts toward understanding safety impacts of bicycle infrastructure. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.
Silver, E G [ed.
This journal covers significant developments in the field of nuclear safety. Its scope includes the analysis and control of hazards associated with nuclear energy, operations involving fissionable materials, and the products of nuclear fission and their effects on the environment. Primary emphasis is on safety in reactor design, construction, and operation; however, the safety aspects of the entire fuel cycle, including fuel fabrication, spent-fuel processing, nuclear waste disposal, handling of radioisotopes, and environmental effects of these operations, are also treated.
Okeke, Sunday O; Mabuza, Langalibalele H
For optimum delivery of service, an establishment needs to ensure a safe and secure environment. In 2011, the South African government promulgated the National Core Standards for Health Establishments for safety and security for all employees in all establishments. Little is known about whether these standards are being complied to.Aim and setting: To assess the perceptions of health care professionals (HCPs) on safety and security at Odi District Hospital. A sample of 181 out of a total of 341 HCPs was drawn through a systematic sampling method from each HCP category. Data were collected through a self-administered questionnaire. The SPSS® statistical software version 22 was used for data analysis. The level of statistical significance was set at < 0.05. There were more female respondents than male respondents (136; 75.10%). The dominant age group was 28-47 years (114; 57.46%). Perceptions on security personnel, their efficiency and the security system were significantly affirmed (p = 0.0001). The hospital infrastructure, surroundings and plan in emergencies were perceived to be safe (p < 0.0001). The hospital lighting system was perceived as inadequate (p = 0.0041). Only 36 (20.2%) HCPs perceived that hospital authorities were concerned about employees' safety (p < 0.0001). HCPs had positive perceptions regarding the hospital's security system. Except for the negative perceptions of the lighting system and the perceived lack of hospital authorities' concern for staff safety, perceptions of the HCPs on the hospital working environment were positive. The hospital authorities need to establish the basis of negative perceptions and enforce remedial measures to redress them.
Parola, Vitor; Coelho, Adriana; Cardoso, Daniela; Sandgren, Anna; Apóstolo, João
More than ever, the current increasing need for palliative care leads to health professionals providing this type of care which further leads to multiple challenges, and stressful and demanding situations. The multiple challenges of working in palliative care put health professionals working in this context at the risk of burnout. To examine the evidence on the prevalence of burnout among health professionals working in palliative care. The current review included studies that encompass qualified health professionals working in palliative care, caring for patients 18 years of age or older. The current review considered studies reporting on the point prevalence of burnout, measured by a burnout scale, such as, but not limited to, the Maslach Burnout Inventory, Burnout Measure and Copenhagen Burnout Inventory. The current review considered studies conducted in the context of specialist palliative care, more specifically, palliative care units, specialized palliative home care or hospices. The current review considered observational study designs, including prospective and retrospective cohort, case-control and cross-sectional studies. An initial search of MEDLINE (via PubMed) and CINAHL was undertaken, followed by a second search for published and unpublished studies since 1975 in major healthcare-related electronic databases. Studies written in English, Spanish and Portuguese were included. Two independent reviewers assessed the methodological quality of studies using the standardized critical appraisal instrument from the Joanna Briggs Institute. No studies were excluded from the review based on the methodological appraisal. Data were extracted using a data extraction table, taking into account the review questions. Significant differences were found between condition measures, thus we were unable to perform a meta-analysis. Eight cross-sectional studies met the inclusion criteria, with a total of 1406 health professionals. The sample was limited to nurses
Schlossmacher, Roberta; Amaral, Fernando Gonçalves
Identify the prevalence of low back disorders and associated risks, as well as the characteristics and ergonomic factors present in the work of nursing professionals. Systematic review based on the search of terms such as low back pain, professionals, hospital ergonomics, work organization, nursing found in national and international databases. The prevalence of low back pain symptoms was between 14.7% and 72% and the main cause, that is, the transference of the patient from bed to chair, leaded to the profession abandonment as a main consequence. it was possible to conclude that the prevalence of low back injury is high among nursing professionals and its causes are related to occupational factors - physical or psychological, which are in many cases permanent and disabling.
In FY 2009, Federal and State enforcement personnel conducted more than 15,000 compliance reviews (CRs) on individual motor carriers. It is intended that through education, heightened safety regulation awareness, and the enforcement effects of the CR...
In FY 2008, Federal and State enforcement personnel conducted 14,906 compliance reviews (CRs) on individual motor carriers. It is intended that through education, heightened safety regulation awareness, and the enforcement effects of the CR, carriers...
Heaney, Caroline A; Walker, Natalie C; Green, Alison J K; Rostron, Claire L
Sport psychology education has been shown to have a positive impact on the practice of sport injury rehabilitation professionals (SIRPs). The purpose of this paper is to review recommendations relating to such education. The paper presents a review of existing literature relating to the content and mode of delivery for a sport psychology education programme for SIRPs. The review seeks to address four questions: (1) What topic areas do researchers suggest should be integrated into the sport psychology education of SIRPs? (2) What topic areas are currently being recommended by professional bodies? (3) What are the findings of research examining the impact of sport psychology education on SIRPs? and (4) What do researchers recommend to be the most appropriate mode of delivery for sport psychology education for SIRPs? The findings of the review suggest that in order to maximise adherence amongst already qualified SIRPs sport psychology education should be delivered in a flexible short duration package. Additionally three broad areas that sport psychology education should cover emerged: (1) understanding of the psychological impact of injury, (2) interventions and psychological skills/techniques, and (3) referral and professional boundaries. This has important implications for the future training of SIRPs. Copyright © 2014 Elsevier Ltd. All rights reserved.
Hecht, Lars; Buhse, Susanne; Meyer, Gabriele
Basic skills in evidence-based medicine (EbM) are indispensable for healthcare professionals to promote consumer-centred, evidence-based treatment. EbM training courses are complex interventions - a fact that has not been methodologically reflected by previous systematic reviews. This review evaluates the effects of EbM training for healthcare professionals as well as the quality of reporting of such training interventions. We searched PubMed, EMBASE, CINAHL, Cochrane Library, ERIC, Campbell Library and PsycINFO up to 9/2014. Randomised controlled trials, controlled clinical trials as well as before-after trials were included. Authors were contacted in order to obtain missing data. Two independent reviewers extracted data and assessed risk of bias. We reviewed 14.507 articles; n = 61 appeared potentially eligible; n = 13 involving 1,120 participants were included. EbM training shows some impact on knowledge and skills, whereas the impact on practical EbM application remains unclear. Risk of bias of included trials raises uncertainty about the effects. Description of complex interventions was poor. EbM training has some positive effects on knowledge and skills of healthcare professionals. Appropriate methods for development, piloting, evaluation, reporting and implementation of the training should be applied.
Ryall, Tayne; Judd, Belinda K; Gordon, Christopher J
Introduction The use of simulation in health professional education has increased rapidly over the past 2 decades. While simulation has predominantly been used to train health professionals and students for a variety of clinically related situations, there is an increasing trend to use simulation as an assessment tool, especially for the development of technical-based skills required during clinical practice. However, there is a lack of evidence about the effectiveness of using simulation for the assessment of competency. Therefore, the aim of this systematic review was to examine simulation as an assessment tool of technical skills across health professional education. Methods A systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), Medical Literature Analysis and Retrieval System Online (Medline), and Web of Science databases was used to identify research studies published in English between 2000 and 2015 reporting on measures of validity, reliability, or feasibility of simulation as an assessment tool. The McMasters Critical Review for quantitative studies was used to determine methodological value on all full-text reviewed articles. Simulation techniques using human patient simulators, standardized patients, task trainers, and virtual reality were included. Results A total of 1,064 articles were identified using search criteria, and 67 full-text articles were screened for eligibility. Twenty-one articles were included in the final review. The findings indicated that simulation was more robust when used as an assessment in combination with other assessment tools and when more than one simulation scenario was used. Limitations of the research papers included small participant numbers, poor methodological quality, and predominance of studies from medicine, which preclude any definite conclusions. Conclusion Simulation has now been embedded across a range of health professional
Song, Beom-Seok; Choi, Soo-Jeong; Jin, Young-Bae; Park, Jong-Heum; Kim, Jae-Kyung; Byun, Eui-Baek; Kim, Jae-Hun; Lee, Ju-Woon; Kim, Gang-Sung; Marchioni, Eric
2-Alkylcyclobutanones (2-ACBs) are known as unique radiolytic products generated from the major fatty acids and triglycerides in food through only irradiation. Since 1990, studies on the toxicological safety of 2-ACBs have been conducted extensively with synthetic compounds. Mutagenicity tests of 2-ACBs on the microorganisms reviewed in this study clearly indicate that no evidence was observed, while several in vitro studies demonstrated the cytotoxicity of 2-ACBs through cell death. Moreover, the genotoxicity of 2-ACBs was suggested as DNA strand breaks were observed. However, these findings should be interpreted with caution because genotoxicity may result from cytotoxicity, which causes DNA damage or from cell membrane destruction and indirect oxidative DNA damage. Therefore, elucidation of the mechanism of genotoxic effects is needed. With regards to the suggestion of Raul et al. (2002) who showed the promoting effect of colon cancer by the administration of 2-ACBs, further studies are needed to correct some experimental design errors. Moreover, an in-vivo experiment that evaluated the metabolism of 2-ACBs has revealed that 2-dDCB was metabolized into cyclic alcohol and excreted through fecal discharge. In conclusion, it is considered that the ingestion of 2-ACBs through irradiated foods is unlikely to affect the human health. However, more specific studies are required to identify the fate of 2-ACBs in body and the LD50 values. The determination of chronic toxicity by long-term exposure to low concentrations of 2-ACBs has to be evaluated more clearly to determine if these compounds are safe to human.
Kobes, M.; Helsloot, I.; de Vries, B.; Post, J.
The most crucial aspect of a building's safety in the face of fire is the possibility of safe escape. An important precondition is that its fire safety facilities enable independent and adequate fire response performances by the building's occupants. In practice, it appears that the measures
Chauhan, Bhupendrasinh F; Jeyaraman, Maya M; Mann, Amrinder Singh; Lys, Justin; Skidmore, Becky; Sibley, Kathryn M; Abou-Setta, Ahmed M; Zarychanski, Ryan
There is a plethora of interventions and policies aimed at changing practice habits of primary healthcare professionals, but it is unclear which are the most appropriate, sustainable, and effective. We aimed to evaluate the evidence on behavior change interventions and policies directed at healthcare professionals working in primary healthcare centers. Study design: overview of reviews. MEDLINE (Ovid), Embase (Ovid), The Cochrane Library (Wiley), CINAHL (EbscoHost), and grey literature (January 2005 to July 2015). two reviewers independently, and in duplicate, identified systematic reviews, overviews of reviews, scoping reviews, rapid reviews, and relevant health technology reports published in full-text in the English language. two reviewers extracted data pertaining to the types of reviews, study designs, number of studies, demographics of the professionals enrolled, interventions, outcomes, and authors' conclusions for the included studies. We evaluated the methodological quality of the included studies using the AMSTAR scale. For the comparative evaluation, we classified interventions according to the behavior change wheel (Michie et al.). Of 2771 citations retrieved, we included 138 reviews representing 3502 individual studies. The majority of systematic reviews (91%) investigated behavior and practice changes among family physicians. Interactive and multifaceted continuous medical education programs, training with audit and feedback, and clinical decision support systems were found to be beneficial in improving knowledge, optimizing screening rate and prescriptions, enhancing patient outcomes, and reducing adverse events. Collaborative team-based policies involving primarily family physicians, nurses, and pharmacists were found to be most effective. Available evidence on environmental restructuring and modeling was found to be effective in improving collaboration and adherence to treatment guidelines. Limited evidence on nurse-led care approaches were found
Mays, Claire; Valůch, Jaroslav; Perko, Tanja; Daris, Irena; Condi, Chiara; Miśkiewicz, Agnieszka; Zakrzewska, Grazyna; Constantin, Marin; Diaconu, Daniela; Kralj, Metka; Železnik, Nadja
What happens when radiological protection or nuclear safety officials get together with media professionals to talk about public communication on ionizing radiation risks? Do they have common views of the challenges and ways to meet these? This practical article reports on dialogue workshops organized by the EAGLE project in four European countries (France, Poland, Romania, and Slovenia). Common findings are classed and presented by themes, including inter alia: crisis versus everyday communication; mediated versus direct communication; sources, actors, roles and responsibilities; language and format; trust and confidence, balance in reporting and development of risk culture; nuclear industry promotion versus citizen-centered risk communication. The article also presents reflections from an expanded international workshop (RICOMET, June 2015). It echoes the participants in calling for a platform for ongoing dialogue between information sources and transmitters, in the interest of building solid relationships, risk culture and public understanding on ionizing radiation.
Mereu, Alessandra; Sotgiu, Alessandra; Buja, Alessandra; Casuccio, Alessandra; Cecconi, Rosaria; Fabiani, Leila; Guberti, Emilia; Lorini, Chiara; Minelli, Liliana; Pocetta, Giancarlo; Contu, Paolo
According to the Nairobi Call to Action, the growth of practitioners' skills can be favoured by setting accreditation standards and by reorienting professional competencies of current and future health workers. This will make it possible to develop a critical mass of competent practitioners, foster training, and increase visibility of the professional field. Through a review of the literature, the authors offer an overview of competency-based strategies for professional development in health promotion. The main research questions discussed were as follows: Is there a shared definition of public health?; Is there a shared definition of health promotion?; Who are the main stakeholders for public health and health promotion in Europe?; What is the meaning of professional competencies in education and practice for public health and health promotion?; Is there a shared system of professional core competencies in public health and health promotion?;What is common and what is specific between the two systems of professional competencies?; Is it useful and feasible to create specific strategies of professional development for public health and health promotion? A transformative use of competencies makes it possible to inform students, professionals, employers, and political decision-makers about what is expected from a specific profession and its values.
Won, Jaewoong; Lee, Chanam; Forjuoh, Samuel N; Ory, Marcia G
Neighborhood safety is important for older adults' health and wellbeing, but there has not been a synthesis in the literature of what is currently known about this construct. This systematic literature review, following the PRISMA guidelines, focuses on identifying neighborhood safety factors associated with health-related outcomes and behaviors of older adults in the U.S. A search was conducted in 2014 via Academic Search Complete, CINAHL, Embase, MEDLINE, SportDis, and Transportation Databases. Based on our inclusion and exclusion criteria, we identified thirty-two articles for review. Sixteen studies examined health outcomes such as health status, mental health, physical function, morbidity/mortality, and obesity; the other sixteen studies focused on health behaviors, such as physical activity and walking. Four domains of neighborhood safety were identified: overall/general neighborhood safety; crime-related safety; traffic-related safety; and proxies for safety (e.g., vandalism, graffiti). Overall/general neighborhood safety appeared most relevant to mental health and physical function. Traffic-related safety was most pertinent to physical activity, while crime-related safety was more consistently associated with mental health and walking. While all safety variables were significantly associated with mental health, no significant associations were found for obesity. We also found that specific measures or constructs of safety were not applied consistently across the examined studies, making it difficult to compare the results. This review identified several important gaps in the existing studies dealing with neighborhood safety-health relationships among older adults. Further studies are needed that examine the different roles of multidimensional neighborhood safety in promoting the community health, not only in the U.S., but globally. Copyright © 2016 Elsevier Ltd. All rights reserved.
Thomsen, Line Hassall
Has new media made us all journalists now? What makes someone a journalist anyway? Is journalism a profession? And if so, what makes a journalist professional? Today, as traditional journalism is challenged by the ever-changing and ever-increasing media market, journalists and journalism research...... of broadcast journalists. During the writing of my PhD, I had searched in vain for a current reference book that provided a thorough review of the history, meanings and expectations of professionalism in journalism today......Has new media made us all journalists now? What makes someone a journalist anyway? Is journalism a profession? And if so, what makes a journalist professional? Today, as traditional journalism is challenged by the ever-changing and ever-increasing media market, journalists and journalism...... researchers are constantly questioning the professionalism of journalism. Silvio Waisbord's new book provides an excellent exploration of answers to questions such as these. I was particularly curious to read Waisbord's book, having just finished my PhD thesis (Thomsen, 2013) about the professional values...
Talwar, Divya; Tseng, Tung-Sung; Foster, Margaret; Xu, Lei; Chen, Lei-Shih
The completion of the Human Genome Project has enhanced avenues for disease prevention, diagnosis, and management. Owing to the shortage of genetic professionals, genetics/genomics training has been provided to nongenetic health professionals for years to establish their genomic competencies. We conducted a systematic literature review to summarize and evaluate the existing genetics/genomics education programs for nongenetic health professionals. Five electronic databases were searched from January 1990 to June 2016. Forty-four studies met our inclusion criteria. There was a growing publication trend. Program participants were mainly physicians and nurses. The curricula, which were most commonly provided face to face, included basic genetics; applied genetics/genomics; ethical, legal, and social implications of genetics/genomics; and/or genomic competencies/recommendations in particular professional fields. Only one-third of the curricula were theory-based. The majority of studies adopted a pre-/post-test design and lacked follow-up data collection. Nearly all studies reported participants' improvements in one or more of the following areas: knowledge, attitudes, skills, intention, self-efficacy, comfort level, and practice. However, most studies did not report participants' age, ethnicity, years of clinical practice, data validity, and data reliability. Many genetics/genomics education programs for nongenetic health professionals exist. Nevertheless, enhancement in methodological quality is needed to strengthen education initiatives.Genet Med advance online publication 20 October 2016.
Besenius, C; Clark-Carter, D; Nolan, P
Healthcare professionals are key providers of information about antipsychotic medication and may have a significant influence on the decisions that service users make about how their medication is delivered. This systematic review aimed to explore health professionals' attitudes and beliefs towards antipsychotic depot medication. A systematic search of AMED, BNI, CINAHL, EMBASE, HEALTH BUSINESS ELITE, HMIC, MEDLINE and PsycINFO was carried out, as well as hand searches of journals and citation searches. Studies were selected if the terms 'attitudes/beliefs' and 'depot/injection' were included in the title or abstract, if health professionals were participants in the study and if original data were included. The search strategy produced 131 papers. Eight relevant studies were then selected for the review. They included six cross-sectional surveys and two qualitative studies. It was shown that the research carried out is still very sparse. Depots are seen as old fashioned, stigmatizing, causingside effects and being costly, and they are often not prescribed because of a presumed adherence to oral medication. More research needs to be carried out to further explore these issues, to look at the role of non-medical prescribers and explore the relationship between health professionals' attitudes and those of service users.
Włoszczak-Szubzda, Anna; Jarosz, Mirosław J
A dissonance between high 'technical' professionalism of nurses and a relatively low level of patient satisfaction with received care is a phenomenon observed in many countries. Theoretical concept and review of current published studies. Most reviewed studies show that a low level of patient satisfaction occurs in the case of an inadequate interpersonal communication between nurses and patients. Most studies indicate poor effectiveness of shaping communication competences of nurses based on standard education in the area of general psychology and communication knowledge, because this knowledge does not convert itself 'spontaneously' into communication competences during occupational activity. It is necessary to supplement educational programmes for nurses with practical courses in professional interpersonal communication. International experience exchange concerning the shaping of nurses' communication competences may be limited due to cultural, organizational and systems factors.
Gartshore, Emily; Waring, Justin; Timmons, Stephen
In recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes. A scoping review was undertaken to describe the availability of evidence related to care homes' patient safety culture, what these studies focused on, and identify any knowledge gaps within the existing literature. Included papers were each reviewed by two authors for eligibility and to draw out information relevant to the scoping review. Twenty-four empirical papers and one literature review were included within the scoping review. The collective evidence demonstrated that safety culture research is largely based in the USA, within Nursing Homes rather than Residential Home settings. Moreover, the scoping review revealed that empirical evidence has predominantly used quantitative measures, and therefore the deeper levels of culture have not been captured in the evidence base. Safety culture in care homes is a topic that has not been extensively researched. The review highlights a number of key gaps in the evidence base, which future research into safety culture in care home should attempt to address.
Full Text Available Abstract Background In recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes. Methods A scoping review was undertaken to describe the availability of evidence related to care homes’ patient safety culture, what these studies focused on, and identify any knowledge gaps within the existing literature. Included papers were each reviewed by two authors for eligibility and to draw out information relevant to the scoping review. Results Twenty-four empirical papers and one literature review were included within the scoping review. The collective evidence demonstrated that safety culture research is largely based in the USA, within Nursing Homes rather than Residential Home settings. Moreover, the scoping review revealed that empirical evidence has predominantly used quantitative measures, and therefore the deeper levels of culture have not been captured in the evidence base. Conclusions Safety culture in care homes is a topic that has not been extensively researched. The review highlights a number of key gaps in the evidence base, which future research into safety culture in care home should attempt to address.
Starbus, Calvert S.; Donovan, Shawn; Dook, Mike; Palo, Tom
Issues addressed by this program: (1) Complicated roles and responsibilities associated with multi-partner projects (2) Working relationships and communications between all organizations involved in the payload safety process (3) Consistent interpretation and implementation of safety requirements from one project to the rest (4) Consistent implementation of the Tailoring Process (5) Clearly defined NASA decision-making-authority (6) Bring Agency-wide perspective to each ElV payload project. Current process requires a Payload Safety Working Group (PSWG) for eac payload with representatives from all involved organizations.
Legere, Laura E.; Wallace, Katherine; Bowen, Angela; McQueen, Karen; Montgomery, Phyllis; Evans, Marilyn
Background Perinatal depression is the most common mental illness experienced by pregnant and postpartum women, yet it is often under-detected and under-treated. Some researchers suggest this may be partly influenced by a lack of education and professional development on perinatal depression among health-care providers, which can negatively affect care and contribute to stigmatization of women experiencing altered mood. Therefore, the aim of this systematic review is to provide a synthesis of...
Within the context of doing basic research, this paper seeks to answer four major questions: (1) What is the authority structure of science. (2) What is peer review. (3) Where is the interface between basic physics research and standard engineering. and (4) Given the conclusions to the first three questions, what is the role of the QA professional in a basic research environment like Fermilab. 23 refs.
Boon, K; Turner, J
As medical education increasingly acknowledges the importance of the ethical and professional conduct of practitioners, and moves towards more formal assessment of these issues, it is important to consider the evidence base which exists in this area. This article discusses literature about the health needs and problems experienced by medical practitioners as a background to a review of the current efforts in medical education to promote ethical conduct and develop mechanisms for the detection...
Understanding factors that impact on health care professionals' risk perceptions and responses toward Clostridium difficile and meticillin-resistant Staphylococcus aureus: a structured literature review.
Burnett, Emma; Kearney, Nora; Johnston, Bridget; Corlett, Joanne; MacGillivray, Stephen
Clostridium difficile is the most common health care-associated infection. Despite considerable efforts to prevent and manage C difficile, poor clinical practice and nonadherence to policy continues to compromise patient safety. Risk perception research is essential in gaining understanding about how health care professionals respond. A structured literature review examined empirical evidence regarding health care professionals' risk perceptions and responses toward C difficile. Because of limited evidence available, the review was extended to include other health care-associated infections. Only studies related to methicillin-resistant Staphylococcus aureus (MRSA) could be identified. Eleven studies were included. Four were specific to C difficile and 7 to MRSA. All studies found that technical understanding of C difficile was poor and that staff were concerned about risks to patients and themselves. Technical understanding for MRSA, however, was good, and staff were less concerned about their own health. Information provision was perceived to be inadequate and untrustworthy, which included the media. Practice in most studies was poor. There is a need to build on the efforts of risk perception research from other disciplines to understand how health care professionals think and make decisions about C difficile. This can help inform the development of effective management and communication strategies to maximize the quality of care provided. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
McPherson, Kathryn; Kersten, Paula; George, Steve; Lattimer, Val; Breton, Alice; Ellis, Bridget; Kaur, Dawn; Frampton, Geoff
Extending the role of allied health professionals has been promoted as a key component of developing a flexible health workforce. This review aimed to synthesize the evidence about the impact of these roles. A systematic review of extended scope of practice in five groups: paramedics, physiotherapists, occupational therapists, radiographers, and speech and language therapists. The nature and effect of these roles on patients, health professionals and health services were examined. An inclusive approach to searching was used to maximize potential sources of interest including multiple databases, 'grey' literature and subject area experts. An expanded Cochrane Collaboration method was used in view of the anticipated lack of randomized controlled trials and heterogeneity of designs. Papers were only excluded after the search stage for lack of relevance. A total of 355 papers was identified as meeting relevance criteria and 21 studies progressed to full review and data extraction. The primary reason for exclusion from data extraction was that the study included neither qualitative nor quantitative data or because methodological flaws compromised data quality. It was not possible to evaluate any pooled effects as patient health outcomes were rarely considered. A range of extended practice roles for allied health professionals have been promoted and are being undertaken, but their health outcomes have rarely been evaluated. There is also little evidence as to how best to introduce such roles, or how best to educate, support and mentor these practitioners.
Background Prevailing health care structures and cultures restrict intraprofessional communication, inhibiting knowledge dissemination and impacting the translation of research into practice. Virtual communities may facilitate professional networking and knowledge sharing in and between health care disciplines. Objectives This study aimed to review the literature on the use of social media by health care professionals in developing virtual communities that facilitate professional networking, knowledge sharing, and evidence-informed practice. Methods An integrative literature review was conducted to identify research published between 1990 and 2015. Search strategies sourced electronic databases (PubMed, CINAHL), snowball references, and tables of contents of 3 journals. Papers that evaluated social media use by health care professionals (unless within an education framework) using any research design (except for research protocols or narrative reviews) were included. Standardized data extraction and quality assessment tools were used. Results Overall, 72 studies were included: 44 qualitative (including 2 ethnographies, 26 qualitative descriptive, and 1 Q-sort) and 20 mixed-methods studies, and 8 literature reviews. The most common methods of data collection were Web-based observation (n=39), surveys (n=23), interviews (n=11), focus groups (n=2), and diaries (n=1). Study quality was mixed. Social media studied included Listservs (n=22), Twitter (n=18), general social media (n=17), discussion forums (n=7), Web 2.0 (n=3), virtual community of practice (n=3), wiki (n=1), and Facebook (n=1). A range of health care professionals were sampled in the studies, including physicians (n=24), nurses (n=15), allied health professionals (n=14), followed by health care professionals in general (n=8), a multidisciplinary clinical specialty area (n=9), and midwives (n=2). Of 36 virtual communities, 31 were monodiscipline for a discrete clinical specialty. Population uptake by the
Rolls, Kaye; Hansen, Margaret; Jackson, Debra; Elliott, Doug
Prevailing health care structures and cultures restrict intraprofessional communication, inhibiting knowledge dissemination and impacting the translation of research into practice. Virtual communities may facilitate professional networking and knowledge sharing in and between health care disciplines. This study aimed to review the literature on the use of social media by health care professionals in developing virtual communities that facilitate professional networking, knowledge sharing, and evidence-informed practice. An integrative literature review was conducted to identify research published between 1990 and 2015. Search strategies sourced electronic databases (PubMed, CINAHL), snowball references, and tables of contents of 3 journals. Papers that evaluated social media use by health care professionals (unless within an education framework) using any research design (except for research protocols or narrative reviews) were included. Standardized data extraction and quality assessment tools were used. Overall, 72 studies were included: 44 qualitative (including 2 ethnographies, 26 qualitative descriptive, and 1 Q-sort) and 20 mixed-methods studies, and 8 literature reviews. The most common methods of data collection were Web-based observation (n=39), surveys (n=23), interviews (n=11), focus groups (n=2), and diaries (n=1). Study quality was mixed. Social media studied included Listservs (n=22), Twitter (n=18), general social media (n=17), discussion forums (n=7), Web 2.0 (n=3), virtual community of practice (n=3), wiki (n=1), and Facebook (n=1). A range of health care professionals were sampled in the studies, including physicians (n=24), nurses (n=15), allied health professionals (n=14), followed by health care professionals in general (n=8), a multidisciplinary clinical specialty area (n=9), and midwives (n=2). Of 36 virtual communities, 31 were monodiscipline for a discrete clinical specialty. Population uptake by the target group ranged from 1.6% to 29% (n
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Safety Review Document Outline B Appendix B of Part 415 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION....3.4Trajectory and Debris Dispersion Data 4.3.5Flight Hazard Areas and Safety Clear Zones 4.3...
Baldwin, David S.; den Boer, Johan A.; Lyndon, Gavin; Emir, Birol; Schweizer, Edward; Haswell, Hannah
The aim of this review is to summarise the literature on the efficacy and safety of pregabalin for the treatment of generalised anxiety disorder (GAD). Of 241 literature citations, 13 clinical trials were identified that were specifically designed to evaluate the efficacy and safety of pregabalin in
DiCuccio, Margaret Hardt
In the past 13 years since the Institute of Medicine report, To Err is Human, was published, considerable attention was placed on the relationship between patient safety culture and patient outcomes. Research to understand this relationship has been conducted; however, now, it is important to systematically review these studies to determine if there are tools, levels of measure and outcomes that have been shown to result in significant correlations. The purpose of this review is to evaluate the state of research connecting patient safety culture and patient outcomes to determine nurse-sensitive patient outcomes that have been significantly correlated to culture of safety and commonly used tools to measure culture of safety in the studies with significant correlations. Published English only research articles were considered for the review. Only studies that directly measured patient outcomes in relationship to patient safety culture in hospitals involving registered nurses as a participant were included. Evidence of relationships between patient safety culture and patient outcomes exist at the hospital and nursing unit level of analysis; however, the number of studies finding statistically significant correlations particularly using nurse-sensitive outcomes is limited. The findings from this review suggest that there are emerging trends indicating that the specific patient safety culture measurement tools, the level of analysis, and selection of outcome measures are important considerations in study design. More research is needed to determine interventions that improve patient safety culture and outcomes.
The Test of Workplace Essential Skills (TOWES) was developed through a partnership between Bow Valley College and the BC Construction Industry Skills Improvement Council. TOWES assesses essential skill competencies in the areas of reading text, document use and numeracy. Unlike other tests, TOWES uses authentic documents such as catalogues, order forms, labels and schematics that mimic workplace tasks as source material. This paper discussed the results of a pilot project conducted to determine the correlation between the reading, document use and numeracy skill levels of Petroleum Professional Drivers and their potential for having safety incidents. TOWES scores for 231 drivers were analyzed along with demographic information collected during testing, and safety performance data derived from a database of drivers. It was observed that certified drivers who did not meet or exceed the upper end of the reading text standard were 1.58 times more likely to have had an incident than those who did meet the standard, and those who failed to meet the document use standard were 1.69 times more likely to have had an incident. Drivers with higher scores for reading and document use were less likely to have had a spill incident, or an incident when returning from a delivery and unloading. Those with high scores for reading, document use and numeracy were less likely to have any type of incident. Older individuals had poorer skills in all 3 domains, and drivers with more years of formal education had better scores. A significant proportion of the drivers had poor reading text skills, and 95 per cent of the drivers had skill levels below the standards benchmarked for document use. It was concluded that given the costs associated with safety incidents, there is a business case for investment in essential skills assessment and upgrading. 17 refs., 36 tabs., 11 figs.
Full Text Available Abstract Background Although dietary supplements (DS are widely sold in pharmacies, the legal, ethical, and practice responsibilities of pharmacists with respect to these products have not been well defined. This systematic review of pharmacists' attitudes, knowledge, and professional practice behaviours toward DS is intended to inform pharmacy regulators' and educators' decision making around this topic. Methods Eligible studies were identified through a systematic database search for all available years through to March 2006. Articles were analyzed for this review if they included survey data on U.S. or Canadian pharmacists' attitudes, knowledge, or professional practice behaviors toward DS published in 1990 or later. Results Due to the heterogeneity of the data, it was not possible to draw a conclusion with respect to pharmacists' general attitudes toward DS. Approximately equal numbers of pharmacists report positive as well as negative attitudes about the safety and efficacy of DS. There is strong agreement among pharmacists for the need to have additional training on DS, increased regulation of DS, and quality information on DS. In addition, survey data indicate that pharmacists do not perceive their knowledge of DS to be adequate and that pharmacists do not routinely document, monitor, or inquire about patients' use of DS. Despite this, a large proportion of pharmacists reported receiving questions about DS from patients and other health care practitioners. Conclusion Further research is needed to explore the factors that influence pharmacists' beliefs and attitudes about DS, to accurately evaluate pharmacists' knowledge of DS, and to uncover the reasons why pharmacists do not routinely document, monitor, or inquire about patients' use of DS.
Fox, Lanae; Onders, Robert; Hermansen-Kobulnicky, Carol J; Nguyen, Thanh-Nga; Myran, Leena; Linn, Becky; Hornecker, Jaime
An expanding body of literature is examining interprofessional teamwork and its effect in healthcare. To produce capable healthcare professionals prepared to participate in interprofessional roles, teamwork training must begin early in health professional students' training. The focus of this scoping review was to explore interprofessional education (IPE) studies designed to teach and/or assess interprofessional teamwork skills to students from two or more different health professions, to find and describe effective pedagogy and assessment strategies. Using a scoping review methodology, 1,106 abstracts were reviewed by three teams of investigators. Eligibility criteria were inclusion of students in interprofessional teams, an intervention to improve interprofessional teamwork skills and assessment of outcomes related to teamwork. Thirty-three studies met the criteria for inclusion. The literature was varied in terms of study design, teaching methods and assessment measures for interprofessional teamwork. The lack of rigorous, comparable studies in this area makes recommending one teaching method or assessment measure over another difficult. Regardless of teaching method, it appears that most learning activities where interprofessional teams interact result in positive changes in student perceptions and attitudes towards IPE and practice. As health education programs seek to incorporate more interprofessional activities into their respective programs, it is important to review methods and measures that would best fit their individual program. This review highlights the importance of standardising the reporting of methods and outcomes for those who wish to incorporate the studied methods into their curricula.
Full Text Available Abstract Background Significant event analysis (SEA is promoted as a team-based approach to enhancing patient safety through reflective learning. Evidence of SEA participation is required for appraisal and contractual purposes in UK general practice. A voluntary educational model in the west of Scotland enables general practitioners (GPs and doctors-in-training to submit SEA reports for feedback from trained peers. We reviewed reports to identify the range of safety issues analysed, learning needs raised and actions taken by GP teams. Method Content analysis of SEA reports submitted in an 18 month period between 2005 and 2007. Results 191 SEA reports were reviewed. 48 described patient harm (25.1%. A further 109 reports (57.1% outlined circumstances that had the potential to cause patient harm. Individual 'error' was cited as the most common reason for event occurrence (32.5%. Learning opportunities were identified in 182 reports (95.3% but were often non-specific professional issues not shared with the wider practice team. 154 SEA reports (80.1% described actions taken to improve practice systems or professional behaviour. However, non-medical staff were less likely to be involved in the changes resulting from event analyses describing patient harm (p Conclusion The study provides some evidence of the potential of SEA to improve healthcare quality and safety. If applied rigorously, GP teams and doctors in training can use the technique to investigate and learn from a wide variety of quality issues including those resulting in patient harm. This leads to reported change but it is unclear if such improvement is sustained.
Barends, Clemens R. M.; Absalom, Anthony; van Minnen, Baucke; Vissink, Arjan; Visser, Anita
Objectives To systematically review the literature comparing the efficacy and safety of dexmedetomidine and midazolam when used for procedural sedation. Materials and Methods We searched MEDLINE, EMBASE and COCHRANE for clinical trials comparing dexmedetomidine and midazolam for procedural sedation
This report reviews the pedestrian and bicyclist safety research literature in print as of 2007. It summarizes and synthesizes the key studies, evaluates existing knowledge and identifies research gaps and provides recommendations for future directio...
The purpose of this ``living`` Safety Review Plan (SRP) is to describe the products and processes that will be followed to conduct a systematic review of the Accelerator Production of Tritium (APT) Facility Preliminary Safety Analysis Report (PSAR), and subsequently to prepare a draft Safety Evaluation Report (SER) on the PSAR. This plan is prepared for and will be implemented by the APT Independent Safety Review Committee (ISRC) over the period July 1, 1997 through September 30, 1998, in accordance with provisions established in DOE-STD-1104-96. A core team of DOE, INEEL, and AMPARO Corporation engineers and scientists will prepare the initial draft SER with assistance from other ISRC team members on an as needed basis. Guidelines for preparing the draft SER are presented in Section 7 of this SRP. The PSAR reviews will focus exclusively on safety. The ever-present two-part question will be: Does the subject matter have safety significance? If so, does the APT structural, system, component, and/or process engineering design ensure an acceptable margin of safety? The APT mission, efficiency, and cost are not considerations of this plan. A more detailed discussion of the review philosophy is presented in Section 5 of this SRP.
Olympia, Robert P; Brady, Jodi
Approximately 7.6 million high school students in the United States participate in sports. Although most sport-related injuries in adolescents are considered minor emergencies, life-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus and exercise-induced asthma, catastrophic brain injuries, cervical spine injuries, heat- and cold-related illness, blunt chest/abdominal injuries, and extremity fractures resulting in compartment syndrome. Emergency preparedness in athletics involves the identification of and planning for medical services to promote the safety of the athlete, to limit injury, and to provide medical care at the site of practice or competition. Several national organizations have published guidelines for emergency preparedness in school-based athletics. Our article reviews guidelines for emergency preparedness put forth by the Sideline Preparedness collaboration (comprised of 6 major professional associations, including the American Academy of Family Physicians, American Academy of Orthopedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine), the National Athletic Trainers' Association, the American Academy of Pediatrics' Committee on School Health, and the American Heart Association. Additionally, we review published data examining compliance of US high schools with these recommendations for emergency preparedness in school-based athletics, determine deficiencies, and provide recommendations for improvement based on these deficiencies.
Husebø, Sissel Eikeland; Akerjordet, Kristin
To evaluate the impact of multi-professional teamwork (MPTW) and leadership training interventions on patient outcomes in acute hospital settings. Although investigations of teamwork and leadership training in acute hospital settings indicate that such programs can optimize patient outcomes, evidence-based recommendations on the content, duration and frequency of training programs associated with clinical evidence are still absent. Quantitative systematic review. A search was conducted for relevant papers published during the period from 2000-February 2014. Twelve studies met the inclusion criteria and were appraised for quality and a risk-of-bias assessment was conducted. The review used a structured approach for literature search, data evaluation, analysis and presentation. A narrative summary was used to report results. Two MPTW and leadership interventions in stroke units have the greatest impact on patient outcomes in acute hospital settings. The interventions' impact on patient outcomes, explored in the ten remaining studies, is associated with great uncertainty due to several alternative explanations of the findings. Research designs that test such interventions must be improved before recommendations on the ultimate program can be made. This can be achieved by strengthening the design, methodology and descriptions of interventions and the use of more consistent patient outcomes. Building a safety culture adjacent to implementing teamwork and leadership training interventions is essential for improving patient outcomes. © 2016 John Wiley & Sons Ltd.
Prip, Anne; Møller, Kirsten Alling; Nielsen, Dorte Lisbet; Jarden, Mary; Olsen, Marie-Helene; Danielsen, Anne Kjaergaard
Today, cancer care and treatment primarily take place in an outpatient setting where encounters between patients and healthcare professionals are often brief. The aim of this study was to summarize the literature of adult patients' experiences of and need for relationships and communication with healthcare professionals during chemotherapy in the oncology outpatient setting. The systematic literature review was carried out according to PRISMA guidelines and the PICO framework, and a systematic search was conducted in MEDLINE, CINAHL, The Cochrane Library, and Joanna Briggs Institute Evidence Based Practice Database. Nine studies were included, qualitative (n = 5) and quantitative (n = 4). The studies identified that the relationship between patients and healthcare professionals was important for the patients' ability to cope with cancer and has an impact on satisfaction of care, that hope and positivity are both a need and a strategy for patients with cancer and were facilitated by healthcare professionals, and that outpatient clinic visits framed and influenced communication and relationships. The relationship and communication between patients and healthcare professionals in the outpatient setting were important for the patients' ability to cope with cancer. Healthcare professionals need to pay special attention to the relational aspects of communication in an outpatient clinic because encounters are often brief. More research is needed to investigate the type of interaction and intervention that would be the most effective in supporting adult patients' coping during chemotherapy in an outpatient clinic.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Pfirrmann, Daniel; Herbst, Mark; Ingelfinger, Patrick; Simon, Perikles; Tug, Suzan
Context: The incidence of injury for elite youth and professional adult soccer players is an important concern, but the risk factors for these groups are different. Objective: To summarize and compare the injury incidences and injury characteristics of male professional adult and elite youth soccer players. Data Sources: We searched MEDLINE and Web of Science using the search terms elite, international, European, soccer, football, injury, injuries, epidemiology, incidence, prevalence, not female, not American football, and not rugby. We also used the search terms professional for studies on professional adult soccer players and high-level, soccer academy, youth, adolescent, and young for studies on elite youth soccer players. Study Selection: Eligible studies were published in English, had a prospective cohort design, and had a minimum study period of 6 months. To ensure that injury data were assessed in relationship to the athlete's individual exposure, we included only studies that reported on injuries and documented exposure volume. Data Extraction: Two independent reviewers applied the selection criteria and assessed the quality of the studies. Data Synthesis: A total of 676 studies were retrieved from the literature search. Eighteen articles met the inclusion criteria: 6 for elite youth and 12 for professional adult soccer players. Conclusions: Injury rates were higher for matches than for training for both youth and adult players. Youth players had a higher incidence of training injuries than professionals. Efforts must be made to reduce the overall injury rate in matches. Therefore, preventive interventions, such as adequately enforcing rules and focusing on fair play, must be analyzed and developed to reduce match-related injury incidences. Reducing training injuries should be a particular focus for youth soccer players. PMID:27244125
Pelleboer-Gunnink, H A; Van Oorsouw, W M W J; Van Weeghel, J; Embregts, P J C M
Equal access to mainstream healthcare services for people with intellectual disabilities (ID) still requires attention. Although recent studies suggest that health professionals hold positive attitudes towards people with ID, stigmatising attitudes may influence their efforts to serve people with ID in community healthcare practice. To stimulate inclusion in mainstream healthcare services, this systematic review focussed on barriers in attitudes of mainstream health professionals towards people with ID. Five electronic databases were systematically searched and references in full text articles were checked for studies published in the English language between January 1994 and January 2016. A social-psychological triad of cognitive, affective and behavioural dimensions of stigmatising attitudes is used to structure and discuss the results. The literature search generated 2190 records with 30 studies that passed our exclusion criteria. Studies were mostly cross-sectional and of moderate quality. With respect to stigma, a lack of familiarity with and knowledge about people with ID was found. ID was considered as a stable condition not under personal control. Moreover, mainstream health professionals had either low or high expectations of the capabilities of people with ID. Professionals reported stress, lack of confidence, fear and anxiety, a tendency to treat people with ID differently and a lack of supporting autonomy. Stigmatising attitudes towards people with ID appeared to be present among mainstream health professionals. This might affect the ongoing challenges regarding inclusion in mainstream healthcare services. To facilitate inclusion in mainstream healthcare services, it is recommended to include contact and collaboration with experts-by-experience in education programs of health professionals. Future research should progress beyond descriptive accounts of stigma towards exploring relationships between cognitive, affective and behavioural dimensions as
Mol, Peter G M; Straus, Sabine M J M; Piening, Sigrid; de Vries, Jonie T N; de Graeff, Pieter A; Haaijer-Ruskamp, Flora M
As pre-approval trials are inherently limited in assessing the complete benefit-risk profile of a new drug, serious safety issues may emerge once a drug gains widespread use after approval. Regulators face the dilemma of balancing timely market access with the need for complete data on risks. This challenge has led to a life-cycle approach but, so far, few data are available on post-approval safety issues requiring regulatory action. The aim of this study is to determine the frequency, timing and nature of safety issues that necessitated safety-related regulatory action in the form of a Direct Healthcare Professional Communication (DHPC) issued by pharmaceutical companies in collaboration with the Dutch Medicines Evaluation Board during the past decade. All DHPCs issued in the Netherlands from 1 January 1999 to 1 January 2009 were retrospectively collected from the national regulatory authorities. Elapsed time between the approval date and the issue of the DHPC was determined. Characteristics of the action including the nature of the safety issue (according to Medical Dictionary for Regulatory Activities [MedDRA] terminology), type of drug and procedural aspects of the regulatory action taken were reviewed. DHPC characteristics were tabulated and explorative non-parametric tests were performed to study the effect of safety issue, drug class, drug type, orphan drug and first-in-class status on elapsed time from approval to the DHPC. 157 DHPCs were issued concerning 112 different active substances, approximately 9% (112/1200) of active substances available in the Netherlands in 2007. The number of DHPCs issued increased by 2.1 (95% CI 1.2, 3.1; p DHPC was 5.3 years (range 0.13-48 years). No significant trend in elapsed time to DHPC was observed in relation to the studied years (p = 0.06). One-third of all DHPCs were issued in the first 3 years after approval, but 27% (n = 43/157) of the DHPCs were issued 10 or more years after approval. Timing of DHPCs differed
CERN Safety rules and Radiation Protection at CMS The CERN Safety rules are defined by the Occupational Health & Safety and Environmental Protection Unit (HSE Unit), CERN’s institutional authority and central Safety organ attached to the Director General. In particular the Radiation Protection group (DGS-RP1) ensures that personnel on the CERN sites and the public are protected from potentially harmful effects of ionising radiation linked to CERN activities. The RP Group fulfils its mandate in collaboration with the CERN departments owning or operating sources of ionising radiation and having the responsibility for Radiation Safety of these sources. The specific responsibilities concerning "Radiation Safety" and "Radiation Protection" are delegated as follows: Radiation Safety is the responsibility of every CERN Department owning radiation sources or using radiation sources put at its disposition. These Departments are in charge of implementing the requi...
Jørgensen, Kim; Rendtorff, Jacob Dahl
In contemporary Western liberal society, patient participation has become a key goal in psychiatric healthcare treatment. Health professionals must encourage patients to play an active and involved part in their treatment. According to Danish health law, patients have the right to participate in their treatment, and the mental health system therefore needs to be reformed in order to ensure that treatment is based on individual, liberal, values. However, patient participation is not clearly defined, and it is therefore a challenge to transfer it to clinical practice. This integrative review's aims are to explore how professionals perceive the challenges regarding patient participation in the treatment course in mental health care. An integrative review. Seven studies met the inclusion criteria: six employed qualitative methodologies and one utilised a mixed-methods approach. The empirical studies took place in Norway, the UK and Australia, all in a mental health setting. Three themes were identified: 'Patient participation as collaboration between the healthcare professional and patient', 'Challenges to participation' and 'From a professional's perspective - what expectations do patients have when participating in decision-making?' Different synonymous terms describing the patient's active role during treatment - user participation, collaboration, partnership, user involvement and patient participation - are linked to a recovery-oriented approach, shared decision-making, shared ownership and care plans. This integrative review achieves specific knowledge around patient participation, comparing the situation for adult patients with various mental disorders. However, upon reflecting on the included studies, patient participation is not clearly defined, and it is therefore difficult to transfer it to clinical practice. © 2017 Nordic College of Caring Science.
Burrow, Simon; Mairs, Hilary; Pusey, Helen; Bradshaw, Timothy; Keady, John
To understand the motivations and experiences of health and social care professionals undertaking part-time, accredited, continuing professional education in higher education. A review following systematic principles. Systematic searches for literature published between January 2000 and December 2015 using the databases: SCOPUS, Web of Science, Medline, PsychINFO, Social Policy and Practice and CINAHL. Studies were included if they were published in the English language and were qualitative in design, focussing on the motivations and experiences of staff engaged in part-time, accredited, higher education study. Three reviewers appraised the quality of the selected studies. Thirteen qualitative studies were identified for the review. Motivating factors for staff to engage in part-time, accredited, continuing professional development study included: personal and professional drivers, influence of workplace/management and funding and availability. Key themes in relation to how staff experienced study included: the demands of adjusting to the academic requirements of higher education study; the experience of juggling competing demands of study, work and family; and the presence or absence of support for part-time study in the personal and professional arenas. Health and social care professionals experience a number of challenges when engaging in part-time, continuing professional education in higher education institutions. A significant challenge is the juggling of competing demands of study, work and family, and this may have a negative impact on learning. Research is needed to inform how higher education can address the specific learning needs of this population and develop pedagogic approaches that are both responsive to need and support of effective learning. Copyright © 2016 Elsevier Ltd. All rights reserved.
Marshall, Gill, E-mail: email@example.com [Chair in Medical Imaging Education, Research Development Lead, School of Medical Imaging Sciences, Faculty of Health, Medical Sciences and Social Care, University of Cumbria, Lancaster, LA1 3JD (United Kingdom); Sykes, Anne E., E-mail: firstname.lastname@example.org [Directorate of Radiography School of Health, Sport and Rehabilitation Sciences, University of Salford Frederick Road, M6 6PU (United Kingdom)
This paper offers guidance on performing systematic reviews to help up-skill radiographers and other health care professionals. It considers why systematic review is critically important to Radiography. Using a relevant example i.e. to investigate adverse effects related to MRI contrast agents it then examines the features of a systematic review and explains how diagnostic research evidence within a systematic review is evaluated. The paper then discusses the threats to validity of systematic reviews on a step by step basis. Five key steps are considered: Step 1: define the purpose of the review via a well-structured question. Step 2: determine the parameters (eligibility criteria) for a comprehensive systematic literature review that will address the research question. It is the wide range of material reviewed in this way that makes the work a systematic review, rather than an analysis of papers you happen to have. Step 3: Assess the quality of the literature you have found. Generally peer-reviewed papers published on a database such as Medline, which in the example given was established as an eligibility criterion, are considered to be high quality, but the actual impact factor/SCOPUS score of each journal is variable and should be considered. Step 4: Synthesise what the literature has revealed; appropriately extract data and summarise it; identifying any study differences. This requires the use of suitable methods for agreeing and summarising the results. This may involve a meta-analysis to collate the results from several studies. Step 5: interpret the findings to draw inferences from the resulting review and from the results of a meta-analysis if undertaken. This paper then provides a check list for guidance of those involved in writing systematic reviews and finally summarises the paper. A glossary of terms appears at the end of this paper.
Piccirillo, Marilyn L; Taylor Dryman, M; Heimberg, Richard G
Safety behaviors are considered an important factor in the maintenance of social anxiety disorder (SAD). Safety behaviors are typically employed by socially anxious individuals to reduce anxiety in feared social situations. However, by preventing individuals with social anxiety from gathering evidence that would disconfirm their maladaptive beliefs about social situations, the use of safety behaviors ultimately maintains social anxiety over time. Twenty years ago, Wells and colleagues (1995) demonstrated that use of safety behaviors diminishes the efficacy of exposure treatment for SAD, suggesting that reduction in the use of safety behaviors during exposure can enhance treatment response. Research on safety behaviors has expanded considerably since Wells et al.'s seminal publication, and our understanding of the role safety behaviors may play in the maintenance of social anxiety has grown in breadth and depth. In this paper, we present a detailed review of the published research on safety behaviors relevant to social anxiety and social-anxiety-related processes. Finally, we evaluate the impact of safety behaviors on the outcome of treatment for SAD, and we look to the literature on safety behaviors in other anxiety disorders to inform our understanding of use of safety behaviors during exposure and to facilitate future research in SAD. Copyright © 2015. Published by Elsevier Ltd.
van Stenis, A.R. (Arend R.); J. Van Wingerden (Jessica); Tanke, I.K. (Isolde Kolkhuis)
textabstractAlthough, the role of health care professionals is known to have changed over the last years, few formal efforts have been made to examine this change through means of a scientific review. Therefore, the goal of this paper was to investigate the changing role of health care professionals
Capps, Daniel K.; Crawford, Barbara A.; Constas, Mark A.
This review brings together the literature on inquiry-based teaching and learning and science teacher professional development (PD). We present a targeted critical review of research focused specifically on the nature of PD programs purported to emphasize inquiry. Our review analyzes the features of each program and critiques the reported outcomes…
Allen, Jacqui; Ottmann, Goetz; Roberts, Gail
To synthesise research-reporting literature about multi-professional communication between health and social care professionals within transitional care for older people, with particular attention on outcomes, enabling contextual factors and constraints. Older adults experience high rates of morbidity and health care usage, and frequently transit between health services, and community and social care providers. These transition episodes place elders at increased risk of adverse incidents due to poor communication of information. Integrated multi-professional models of care built on enhanced communication have been widely promoted as a strategy to improve transitional care for older people. However, a range of findings exist in the literature to guide service providers and researchers. Comprehensive literature search and review strategies were employed to identify, describe and synthesise relevant studies. Ten databases were searched in addition to Google Scholar. Specified discharge worker roles, multi-professional care coordination teams, and information technology systems promote better service satisfaction and subjective quality of life for older people when compared with standard hospital discharge. Improved multi-professional communication reduces rates of re-admission and length of stay indicating greater cost effectiveness and efficiency for the health and social care systems. Systems of care emphasizing information exchange, education and negotiation between stakeholders facilitate communication in transitional care contexts for older adults. Conversely, lack of dialogue and lack of understanding of others' roles are barriers to communication in transitional care. Enhanced multi-professional communication, transitional pathways, and role clarity are required to improve the quality, sustainability and responsiveness of aged care into the future. Recommendations for further research include: (i) Investigation of pathways promoting person-centred care planning
Levett-Jones, Tracy; Lapkin, Samuel
The objective of this review was to identify, appraise and synthesise the best available evidence for the effectiveness of debriefing as it relates to simulation-based learning for health professionals. Simulation is defined as a technique used to replace or amplify real experiences with guided experiences that evoke or replace substantial aspects of the real world in a fully interactive manner. The use of simulation for health professional education began decades ago with the use of low-fidelity simulations and has evolved at an unprecedented pace. Debriefing is considered by many to be an integral and critical part of the simulation process. However, different debriefing approaches have developed with little objective evidence of their effectiveness. Studies that evaluated the use of debriefing for the purpose of simulation-based learning for health professionals were included. Simulation studies not involving health professionals and those conducted in other settings such as such as military or aviation were excluded. A review protocol outlining the inclusion and exclusion criteria was submitted, peer reviewed by the Joanna Briggs Institute (JBI) for Evidence Based Practice, and approved prior to undertaking the review. A comprehensive search of studies published between January 2000 and September 2011 was conducted across ten electronic databases. Two independent reviewers assessed each paper prior to inclusion or exclusion using the standardised critical appraisal instruments for evidence of effectiveness developed by the Joanna Briggs Institute. Ten randomised controlled trials involving various debriefing methods were included in the review. Meta-analysis was not possible because of the different outcomes, control groups and interventions in the selected studies. The methods of debriefing included: post simulation debriefing, in-simulation debriefing, instructor facilitated debriefing and video-assisted instructor debriefing. In the included studies there
Hamilton, F L; Greaves, F; Majeed, A; Millett, C
Financial incentives are seen as one approach to encourage more systematic use of smoking cessation interventions by healthcare professionals. A systematic review was conducted to examine the evidence for this. Medline, Embase, PsychINFO, Cochrane Library, ISI Web of Science and sources of grey literature were used as data sources. Studies were included if they reported the effects of any financial incentive provided to healthcare professionals to undertake smoking cessation-related activities. Data extraction and quality assessment for each study were conducted by one reviewer and checked by a second. A total of 18 studies were identified, consisting of 3 randomised controlled trials and 15 observational studies. All scored in the mid range for quality. In all, 8 studies examined smoking cessation activities alone and 10 studied the UK's Quality and Outcomes Framework targeting quality measures for chronic disease management including smoking recording or cessation activities. Five non-Quality and Outcomes Framework studies examined the effects of financial incentives on individual doctors and three examined effects on groups of healthcare professionals based in clinics and general practices. Most studies showed improvements in recording smoking status and smoking cessation advice. Five studies examined the impact of financial incentives on quit rates and longer-term abstinence and these showed mixed results. Financial incentives appear to improve recording of smoking status, and increase the provision of cessation advice and referrals to stop smoking services. Currently there is not sufficient evidence to show that financial incentives lead to reductions in smoking rates.
Schwatka, Natalie V; Hecker, Steven; Goldenhar, Linda M
Safety climate measurements can be used to proactively assess an organization's effectiveness in identifying and remediating work-related hazards, thereby reducing or preventing work-related ill health and injury. This review article focuses on construction-specific articles that developed and/or measured safety climate, assessed safety climate's relationship with other safety and health performance indicators, and/or used safety climate measures to evaluate interventions targeting one or more indicators of safety climate. Fifty-six articles met our inclusion criteria, 80% of which were published after 2008. Our findings demonstrate that researchers commonly defined safety climate as perception based, but the object of those perceptions varies widely. Within the wide range of indicators used to measure safety climate, safety policies, procedures, and practices were the most common, followed by general management commitment to safety. The most frequently used indicators should and do reflect that the prevention of work-related ill health and injury depends on both organizational and employee actions. Safety climate scores were commonly compared between groups (e.g. management and workers, different trades), and often correlated with subjective measures of safety behavior rather than measures of ill health or objective safety and health outcomes. Despite the observed limitations of current research, safety climate has been promised as a useful feature of research and practice activities to prevent work-related ill health and injury. Safety climate survey data can reveal gaps between management and employee perceptions, or between espoused and enacted policies, and trigger communication and action to narrow those gaps. The validation of safety climate with safety and health performance data offers the potential for using safety climate measures as a leading indicator of performance. We discuss these findings in relation to the related concept of safety culture and
Butcher, Diane L; MacKinnon, Karen; Bruce, Anne; Gordon, Carol; Koning, Clare
Inter-professional initiatives are prevalent in the healthcare landscape, requiring professionals to collaborate effectively to provide quality patient care. Little attention has been given to intra-professional relationships, where professionals within one disciplinary domain (such as degree and diploma nursing students) collaborate to provide care. New care models are being introduced where baccalaureate and diploma students of a particular discipline (such as nursing, occupational therapy, dentistry or physiotherapy) work closely together in teams to deliver care. Questions thus arise as to how students and educators learn to work on intra-professional teams. To identify and synthesize evidence regarding experiences of pre-licensure health professional students and their educators on intra-professional teams and to draw recommendations to enhance policy and/or curriculum development. Pre-licensure students and educators, focusing on regulated health professions that have had more than one point of entry into practice. Experiences of intra-professional team learning or teaching within various entry-to-practice categories of a particular health-related discipline. Eight qualitative studies were included in the review. Seven studies were descriptive in nature; one study was a critical analysis. A comprehensive search of various databases was conducted between June 2, 2015 and August 16, 2015, and repeated in March 2016. The search considered all studies reported and published from January 1, 2001 to March 7, 2016. Only studies published in English were included in this review. Included papers were of low-to-moderate quality; however, it is important to consider that post-positivist assumptions underpinned much of the primary research, which could explain why researcher positionality and/or influence on the research would not be addressed. Data were extracted using the standardized data extraction tool from the Joanna Briggs Institute Qualitative Assessment and
van Mol, Margo M C; Kompanje, Erwin J O; Benoit, Dominique D; Bakker, Jan; Nijkamp, Marjan D
... in order to preserve their own health. The purpose of this review is to evaluate the literature related to emotional distress among healthcare professionals in the ICU, with an emphasis on the prevalence of burnout and compassion fatigue...
M C van Mol; Erwin J O Kompanje; Dominique D Benoit; Jan Bakker; Marjan D Nijkamp
... in order to preserve their own health. Purpose The purpose of this review is to evaluate the literature related to emotional distress among healthcare professionals in the ICU, with an emphasis on the prevalence of burnout and compassion...
Hamm, Michele P; Chisholm, Annabritt; Shulhan, Jocelyn; Milne, Andrea; Scott, Shannon D; Klassen, Terry P; Hartling, Lisa
To conduct a scoping review of the literature on social media use by health care professionals and trainees. The authors searched MEDLINE, CENTRAL, ERIC, PubMed, CINAHL Plus Full Text, Academic Search Complete, Alt Health Watch, Health Source, Communication and Mass Media Complete, Web of Knowledge, and ProQuest for studies published between 2000 and 2012. They included those reporting primary research on social media use by health care professionals or trainees. Two reviewers screened studies for eligibility; one reviewer extracted data and a second verified a 10% sample. They analyzed data descriptively to determine which social media tools were used, by whom, for what purposes, and how they were evaluated. The authors included 96 studies in their review. Discussion forums were the most commonly studied tools (43/96; 44.8%). Researchers more often studied social media in educational than practice settings. Of common specialties, administration, critical appraisal, and research appeared most often (11/96; 11.5%), followed by public health (9/96; 9.4%). The objective of most tools was to facilitate communication (59/96; 61.5%) or improve knowledge (41/96; 42.7%). Thirteen studies evaluated effectiveness (13.5%), and 41 (42.7%) used a cross-sectional design. These findings provide a map of the current literature on social media use in health care, identify gaps in that literature, and provide direction for future research. Social media use is widespread, particularly in education settings. The versatility of these tools suggests their suitability for use in a wide range of professional activities. Studies of their effectiveness could inform future practice.
Curran, Vernon; Matthews, Lauren; Fleet, Lisa; Simmons, Karla; Gustafson, Diana L; Wetsch, Lyle
Digital, social, and mobile technologies (DSMTs) can support a wide range of self-directed learning activities, providing learners with diverse resources, information, and ways to network that support their learning needs. DSMTs are increasingly used to facilitate learning across the continuum of health professional education (HPE). Given the diverse characteristics of DSMTs and the formal, informal, and nonformal nature of health professional learning, a review of the literature on DSMTs and HPE could inform more effective adoption and usage by regulatory organizations, educators, and learners. A scoping review of the literature was performed to explore the effectiveness and implications of adopting and using DSMTs across the educational continuum in HPE. A data extraction tool was used to review and analyze 125 peer-reviewed articles. Common themes were identified by thematic analysis. Most articles (56.0%) related to undergraduate education; 31.2% to continuing professional development, and 52.8% to graduate/postgraduate education. The main DSMTs described include mobile phones, apps, tablets, Facebook, Twitter, and YouTube. Approximately half of the articles (49.6%) reported evaluative outcomes at a satisfaction/reaction level; 45.6% were commentaries, reporting no evaluative outcomes. Most studies reporting evaluative outcomes suggest that learners across all levels are typically satisfied with the use of DSMTs in their learning. Thematic analysis revealed three main themes: use of DSMTs across the HPE continuum; key benefits and barriers; and best practices. Despite the positive commentary on the potential benefits and opportunities for enhancing teaching and learning in HPE with DSMTs, there is limited evidence at this time that demonstrates effectiveness of DSMTs at higher evaluative outcome levels. Further exploration of the learning benefits and effectiveness of DSMTs for teaching and learning in HPE is warranted.
Lapkin, Samuel; Levett-Jones, Tracy; Gilligan, Conor
The objective of this systematic review was to identify the best available evidence for the effectiveness of university-based interprofessional education for health students. Currently, most health professional education is delivered in a traditional, discipline specific way. This approach is limited in its ability to equip graduates with the necessary knowledge, skills and attitudes for effective interprofessional collaboration and for working as part of a complex health care team. Interprofessional education is widely seen as a way to improve communication between health professionals, ultimately leading to improved patient outcomes. The review included all randomised controlled trials and quasi-experimental studies in which two or more undergraduate or post-graduate health professional groups are engaged in interprofessional education. A three-stage comprehensive search of ten electronic databases as well as grey literature was conducted. Two independent reviewers assessed each paper prior to inclusion using the standardised critical appraisal instruments for evidence of effectiveness developed by the Joanna Briggs Institute. Nine published studies consisting of three randomised controlled trials, five controlled before and after studies and one controlled longitudinal study were included in the review. Student's attitudes and perceptions towards interprofessional collaboration and clinical decision-making can be potentially enhanced through interprofessional education. However, the evidence for using interprofessional education to teach communication skills and clinical skills is inconclusive and requires further investigation. Future randomised controlled studies explicitly focused on interprofessional education with rigorous randomisation procedures, allocation concealment, larger sample sizes, and control groups, would improve the evidence base for interprofessional education. Copyright © 2011 Elsevier Ltd. All rights reserved.
Barbosa, Guilherme Correa; Meneguim, Silmara; Lima, Silvana Andréa Molina; Moreno, Vania
The National Policy of Humanization aims at innovations in health production, management and care with emphasis on permanent education for workers in the Unified Public Health System and training of university students in the health care field. This study aimed to know, through an integrative review of the literature, the scientific production about the National Policy of Humanization and education of health care professionals, from 2002 to 2010. Ten articles were analyzed in thematic strand through three axes: humanization and users caring, humanization and the work process, humanization and training. The articles point to the need to overcome the biological conception, valuing cultural aspects of users. The work process is marked by the devaluation of workers and by users deprived of their rights. The training of health professionals is grounded in health services where the prevailing standards are practices that hinder innovative attitudes.
Cole, Pam C (PNNL); Conover, David R (PNNL)
Codes, standards, and regulations (CSR) governing the design, construction, installation, commissioning, and operation of the built environment are intended to protect the public health, safety, and welfare. While these documents change over time to address new technology and new safety challenges, there is generally some lag time between the introduction of a technology into the market and the time it is specifically covered in model codes and standards developed in the voluntary sector. After their development, there is also a timeframe of at least a year or two until the codes and standards are adopted. Until existing model codes and standards are updated or new ones are developed and then adopted, one seeking to deploy energy storage technologies or needing to verify the safety of an installation may be challenged in trying to apply currently implemented CSRs to an energy storage system (ESS). The Energy Storage System Guide for Compliance with Safety Codes and Standards1 (CG), developed in June 2016, is intended to help address the acceptability of the design and construction of stationary ESSs, their component parts, and the siting, installation, commissioning, operations, maintenance, and repair/renovation of ESS within the built environment.
Houtman, I.L.D.; Kauppinen, K.; Kumpulainen, R.; Goudswaard, A.
This report explores the gender differences in occupational safety and health. There is strong segregation of women and men into different jobs and tasks at work. Both men and women face significant risks. In general, men suffer more accidents and injuries at work than women do, whereas women report
The Road Safety website of The World Bank needs to be redeveloped. The website should reflect the new developments in the work field and the IT policy of The World Bank and support its implementation. The report is meant as a brief business case, describing the target audience, purposes of the site,
Background: The current rapid economic development has brought changes in workplaces in developing countries, including Ethiopia. The organization of occupational health and safety services is not yet resilient enough to handle the growing demands for workers' health in the context of industrialization. There is limited ...
Introduction of genetically modified (GM) foods generated a lot of controversy few years back, now it is the turn of nanofoods. There has been debate on the safety of foods that have been produced directly or indirectly with nanomaterials. Nanoparticles or nanotechnology procedures may be used to make food products, ...
Fan, Arthur Yin; Xu, Jun; Li, Yong-Ming
In the United States and other Western countries, dry needling has been a topic in academic and legal fields. This White Paper is to provide the authoritative information of dry needling versus acupuncture to academic scholars, healthcare professionals, administrators, policymakers, and the general public by providing the authoritative evidence and expertise regarding critical issues of dry needling and reaching a consensus. We conclude that Dr. Travell, Dr. Gunn, Dr. Baldry and others who have promoted dry needling by simply rebranding (1) acupuncture as dry needling and (2) acupuncture points as trigger points (dry needling points). Dry needling simply using English biomedical terms (especially using "fascia" hypothesis) in replace of their equivalent Chinese medical terms. Dry needling is an over-simplified version of acupuncture derived from traditional Chinese acupuncture except for emphasis on biomedical language when treating neuromuscularskeletal pain (dry needling promoters redefined it as "myofascial pain"). Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy (a surgical procedure) instead of manual therapy. Dr. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture's local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients' safety, dry needling practitioners should meet standards required for licensed acupuncturists and physicians.
Imbuing medical professionalism in relation to safety: a study protocol for a mixed-methods intervention focused on trialling an embedded learning approach that centres on the use of a custom designed board game.
Ward, Marie; McAuliffe, Eilish; Ní Shé, Éidín; Duffy, Ann; Geary, Una; Cunningham, Una; Holland, Catherine; McDonald, Nick; Egan, Karen; Korpos, Christian
Professionalism in Relation to Safety). The study results will be disseminated through peer-reviewed publications. © 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.
Bayetti, Clement; Jadhav, Sushrut; Deshpande, Smita N.
Psychiatric practice in India is marked by an increasing gulf between largely urban-based mental health professionals and a majority rural population. Based on the premise that any engagement is a mutually constructed humane process, an understanding of the culture of psychiatry including social process of local knowledge acquisition by trainee psychiatrists is critical. This paper reviews existing literature on training of psychiatrists in India, the cultural construction of their professional identities and autobiographical reflections. The results reveal a scarcity of research on how identities, knowledge, and values are constructed, contested, resisted, sustained, and operationalized through practice. This paper hypothesizes that psychiatric training and practice in India continues to operate chiefly in an instrumental fashion and bears a circular relationship between cultural, hierarchical training structures and patient–carer concerns. The absence of interpretative social science training generates a professional identity that predominantly focuses on the patient and his/her social world as the site of pathology. Infrequent and often superfluous critical cultural reflexivity gained through routine clinical practice further alienates professionals from patients, caregivers, and their own social landscapes. This results in a peculiar brand of theory and practice that is skewed toward a narrow understanding of what constitutes suffering. The authors argue that such omissions could be addressed through nuanced ethnographies on the professional development of psychiatrists during postgraduate training, including the political economies of their social institutions and local cultural landscapes. Further research will also help enhance culturally sensitive epistemology and shape locally responsive mental health training programs. This is critical for majority rural Indians who place their trust in State biomedical care. PMID:28529358
Bayetti, Clement; Jadhav, Sushrut; Deshpande, Smita N
Psychiatric practice in India is marked by an increasing gulf between largely urban-based mental health professionals and a majority rural population. Based on the premise that any engagement is a mutually constructed humane process, an understanding of the culture of psychiatry including social process of local knowledge acquisition by trainee psychiatrists is critical. This paper reviews existing literature on training of psychiatrists in India, the cultural construction of their professional identities and autobiographical reflections. The results reveal a scarcity of research on how identities, knowledge, and values are constructed, contested, resisted, sustained, and operationalized through practice. This paper hypothesizes that psychiatric training and practice in India continues to operate chiefly in an instrumental fashion and bears a circular relationship between cultural, hierarchical training structures and patient-carer concerns. The absence of interpretative social science training generates a professional identity that predominantly focuses on the patient and his/her social world as the site of pathology. Infrequent and often superfluous critical cultural reflexivity gained through routine clinical practice further alienates professionals from patients, caregivers, and their own social landscapes. This results in a peculiar brand of theory and practice that is skewed toward a narrow understanding of what constitutes suffering. The authors argue that such omissions could be addressed through nuanced ethnographies on the professional development of psychiatrists during postgraduate training, including the political economies of their social institutions and local cultural landscapes. Further research will also help enhance culturally sensitive epistemology and shape locally responsive mental health training programs. This is critical for majority rural Indians who place their trust in State biomedical care.
Full Text Available Tayne Ryall,1 Belinda K Judd,2,3 Christopher J Gordon3 1Physiotherapy Department, Canberra Hospital, ACT Health, Canberra, ACT, 2Faculty of Health Sciences, 3Sydney Nursing School, The University of Sydney, Sydney, NSW, Australia Introduction: The use of simulation in health professional education has increased rapidly over the past 2 decades. While simulation has predominantly been used to train health professionals and students for a variety of clinically related situations, there is an increasing trend to use simulation as an assessment tool, especially for the development of technical-based skills required during clinical practice. However, there is a lack of evidence about the effectiveness of using simulation for the assessment of competency. Therefore, the aim of this systematic review was to examine simulation as an assessment tool of technical skills across health professional education.Methods: A systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL, Education Resources Information Center (ERIC, Medical Literature Analysis and Retrieval System Online (Medline, and Web of Science databases was used to identify research studies published in English between 2000 and 2015 reporting on measures of validity, reliability, or feasibility of simulation as an assessment tool. The McMasters Critical Review for quantitative studies was used to determine methodological value on all full-text reviewed articles. Simulation techniques using human patient simulators, standardized patients, task trainers, and virtual reality were included.Results: A total of 1,064 articles were identified using search criteria, and 67 full-text articles were screened for eligibility. Twenty-one articles were included in the final review. The findings indicated that simulation was more robust when used as an assessment in combination with other assessment tools and when more than one simulation scenario was used. Limitations of the
... COMMISSION Final Interim Staff Guidance: Review of Evaluation To Address Gas Accumulation Issues in Safety...-ISG-019 on ``Review of Evaluation to Address Gas Accumulation Issues in Safety Related Systems... is to clarify the NRC staff guidance to address issues of gas accumulation in safety related systems...
Hesselink, G.J.; Berben, S.A.; Beune, T.; Schoonhoven, L.
OBJECTIVES: To systematically review interventions that aim to improve the governance of patient safety within emergency care on effectiveness, reliability, validity and feasibility. DESIGN: A systematic review of the literature. METHODS: PubMed, EMBASE, Cumulative Index to Nursing and Allied Health
Lee, Jung Woon; Moon, B. S.; Park, J. C.; Lee, Y. H.; Oh, I. S.; Lee, H. C. [Korea Atomic Energy Research Institute, Taejeon (Korea)
In this study, a draft of human factors engineering (HFE) safety review procedures (SRP) was developed for the safety review of KNGR based on HFE Safety and Regulatory Requirements and Guidelines (SRRG). This draft includes acceptance criteria, review procedure, and evaluation findings for the areas of review including HFE Program Management, Human Factors Analyses, Human Factors Design, and HFE Verification and Validation, based on Section 15.1 'Human Factors Engineering Design Process' and 15.2 'Control Room Human Factors Engineering' of KNGR Specific Safety Requirements and Chapter 15 'Human Factors Engineering' of KNGR Safety Regulatory Guides. For the effective review, human factors concerns or issues related to advanced HSI design that have been reported so far should be extensively examined. In this study, a total of 384 human factors issues related to the advanced HSI design were collected through our review of a total of 145 documents. A summary of each issue was described and the issues were identified by specific features of HSI design. These results were implemented into a database system. 8 refs., 2 figs. (Author)
Thomas J. Haney
Idaho National Laboratory completes an annual Integrated Safety Management System effectiveness review per 48 CFR 970.5223-1 “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assesses ISMS effectiveness, provides feedback to maintain system integrity, and helps identify target areas for focused improvements and assessments for the following year. Using one of the three Department of Energy (DOE) descriptors in DOE M 450.4-1 regarding the state of ISMS effectiveness during Fiscal Year (FY) 2010, the information presented in this review shows that INL achieved “Effective Performance.”
Happell, Brenda; Byrne, Louise; McAllister, Margaret; Lampshire, Debra; Roper, Cath; Gaskin, Cadeyrn J; Martin, Graham; Wynaden, Dianne; McKenna, Brian; Lakeman, Richard; Platania-Phung, Chris; Hamer, Helen
A systematic review of the published work on consumer involvement in the education of health professionals was undertaken using the PRISMA guidelines. Searches of the CINAHL, MEDLINE, and PsychINFO electronic databases returned 487 records, and 20 met the inclusion criteria. Further papers were obtained through scanning the reference lists of those articles included from the initial published work search (n = 9) and contacting researchers in the field (n = 1). Thirty papers (representing 28 studies) were included in this review. Findings from three studies indicate that consumer involvement in the education of mental health professionals is limited and variable across professions. Evaluations of consumer involvement in 16 courses suggest that students gain insight into consumers' perspectives of: (i) what life is like for people with mental illness; (ii) mental illness itself; (iii) the experiences of admission to, and treatment within, mental health services; and (iv) how these services could be improved. Some students and educators, however, raised numerous concerns about consumer involvement in education (e.g. whether consumers were pursuing their own agendas, whether consumers' views were representative). Evaluations of consumer involvement in education are limited in that their main focus is on the perceptions of students. The findings of this review suggest that public policy expectations regarding consumer involvement in mental health services appear to be slowly affecting the education of mental health professionals. Future research needs to focus on determining the effect of consumer involvement in education on the behaviours and attitudes of students in healthcare environments. © 2013 The Authors; International Journal of Mental Health Nursing © 2013 Australian College of Mental Health Nurses Inc.
Boor, Kathryn J; Wiedmann, Martin; Murphy, Sarah; Alcaine, Sam
Microbes that may be present in milk can include pathogens, spoilage organisms, organisms that may be conditionally beneficial (e.g., lactic acid bacteria), and those that have not been linked to either beneficial or detrimental effects on product quality or human health. Although milk can contain a full range of organisms classified as microbes (i.e., bacteria, viruses, fungi, and protozoans), with few exceptions (e.g., phages that affect fermentations, fungal spoilage organisms, and, to a lesser extent, the protozoan pathogens Cryptosporidium and Giardia) dairy microbiology to date has focused predominantly on bacteria. Between 1917 and 2017, our understanding of the microbes present in milk and the tools available for studying those microbes have changed dramatically. Improved microbiological tools have enabled enhanced detection of known microbes in milk and dairy products and have facilitated better identification of pathogens and spoilage organisms that were not known or well recognized in the early 20th century. Starting before 1917, gradual introduction and refinement of pasteurization methods throughout the United States and many other parts of the world have improved the safety and quality of milk and dairy products. In parallel to pasteurization, others strategies for reducing microbial contamination throughout the dairy chain (e.g., improved dairy herd health, raw milk tests, clean-in-place technologies) also played an important role in improving microbial milk quality and safety. Despite tremendous advances in reducing microbial food safety hazards and spoilage issues, the dairy industry still faces important challenges, including but not limited to the need for improved science-based strategies for safety of raw milk cheeses, control of postprocessing contamination, and control of sporeforming pathogens and spoilage organisms. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Anant D. Patil
Although many atypical antipsychotics are available, there is a need of an atypical antipsychotic effective in all symptom domains of schizophrenia and well tolerated especially for side effects like extrapyramidal side effects, weight gain and blood prolactin elevation. Blonanserin is an atypical antipsychotic which blocks dopamine D2 and serotonin 5HT2A receptors. Its efficacy and safety has been studied in patients with schizophrenia and delirium. Blonanserin is found to be effective and w...
Lapkin, Samuel; Levett-Jones, Tracy; Gilligan, Conor
Background: A key responsibility of universities is to prepare health professional graduates for their roles as effective members of the health care team. Currently, most university-based health professional education is delivered in a traditional, discipline specific way. This approach is limited in its ability to equip graduates with the necessary knowledge, skills and attitudes for effective interprofessional collaboration and for working as part of a complex health care team. Interprofessional education occurs when learners from two or more professional groups learn about, from and with each other. The fundamental premise of interprofessional education is that if health professional students learn together they will be better prepared for interprofessional collaboration ultimately leading to improved patient outcomes.Objective -The objective of this systematic review was to identify the best available evidence for the effectiveness of university-based interprofessional education.Inclusion criteria -The review included all randomised controlled trials and quasi-experimental studies that assessed the effectiveness of interprofessional education in university-based health professional programs. All studies that included two or more undergraduate or post-graduate health professional groups engaged in interprofessional education were considered. Outcome measures included objectively measured or self-reported educational outcomes and/or professional competencies related to interprofessional education as assessed by validated instruments such as the Readiness for Interprofessional Learning Scale and the Interdisciplinary Education Perception Scale. A three-stage comprehensive search strategy was utilised to search across ten electronic databases. English language studies published between January 2000 and February 2011 were considered for inclusion.Methodological quality: Two independent reviewers assessed the methodological quality of each study selected for
Martins, Carlos F.O.; Crepaldi, Roberto; Freire, Enio M., E-mail: email@example.com, E-mail: firstname.lastname@example.org, E-mail: email@example.com [Tecnatom do Brasil Engenharia e Servicos Ltda, Rio de Janeiro, RJ (Brazil); Campello, Sergio A., E-mail: firstname.lastname@example.org [Eletrobras Termonuclear S.A. (ELETRONUCLEAR), Rio de Janeiro, RJ (Brazil)
This paper describes the second Periodic Safety Review (PSR2-A1) of Angra Nuclear Power Station, Unit 1, prepared by Eletrobras Eletronuclear S.A. and Tecnatom do Brasil Engenharia e Servicos Ltda., during Jul.2013-Aug.2014, covering the period of 2004-2013. The site, in Angra dos Reis-RJ, Brazil, comprises: Unit 1, (640 MWe, Westinghouse PWR, operating), Unit 2 (1300 MWe, KWU/Areva, operating) and Unit 3 (1405 MWe, KWU/Areva, construction). The PSR2-A1 attends the Standards 1.26-Safety in Operation of Nuclear Power Plants, Brazilian Nuclear Regulatory Commission (CNEN), and IAEA.SSG.25-Periodic Safety Review of Nuclear Power Plants. Within 18 months after each 10 years operation, the operating organization shall perform a plant safety review, to investigate the evolution consequences of safety code and standards, regarding: Plant design; structure, systems and components behavior; equipment qualification; plant ageing management; deterministic and probabilistic safety analysis; risk analysis; safety performance; operating experience; organization and administration; procedures; human factors; emergency planning; radiation protection and environmental radiological impacts. The Review included 6 Areas and 14 Safety Parameters, covered by 33 Evaluations.After document evaluations and discussions with plant staff, it was generated one General and 33 Specific Guide Procedures, 33 Specific and one Final Report, including: Description, Strengths, Deficiencies, Areas for Improvement and Conclusions. An Action Plan was prepared by Electronuclear for the recommendations. It was concluded that the Unit was operated within safety standards and will attend its designed operational lifetime, including possible life extensions. The Final Report was submitted to CNEN, as one requisite for renewal of the Unit Permanent Operation License. (author)
Schmidt, Denise Rodrigues Costa
The Demand Control model aims to evaluate the occupational stress. This study aimed to know, through an integrative review of the literature, the scientific production about the Demand Control Model to investigation occupational stress among nursing professionals from 2000 to 2011.Of the 16 selected studies, five were published in 2009. Of these studies, 56.25% assessed the Demand and Control dimensions and their correlations with workers' health problems; 37.5% of these studies were related with mental health. The results showed a lack of national publications. We recommend that authors conduct experimental studies to reduce the occupational stress for better conditions of workers' mental health.
Brookes, Kim; Davidson, Patricia; Daly, John; Hancock, Karen
Increasing emphasis on community-based mandates an examination of the community health nurse (CHN). A critical literature review of the CHN role internationally, with an emphasis on Australia, was undertaken in order to understand historical precedents and inform policy and strategic directions for the CHN. A search of the CINAHL, EMBASE, and COCHRANE electronic data-bases from 1982 to June 2002 using community' and 'nursing' as key words and hand searching of books and government reports was undertaken. This search strategy revealed a lack of literature compared with other areas of nursing. Key themes emerging from this review are: (1) an absence of clear role definitions and lack of clarity of roles; (2) variability in educational requirements for CHNs; (3) diminished CHN power in policy decision making; (3) conflicting role expectations between different facets of the health care system; (4) underutilisation and untapped potential of the role of the CHN in the contemporary health care system; (5) the emerging influence of specialist nurses in community based-care; (6) uptake of traditional nursing roles by non-nurses and (7) an absence of a cohesive model of professional development of CHN that is able to articulate with contemporary social, political and economic trends in health care delivery. Community health nursing in Australia has a low professional profile when compared to other nursing specialties. An emerging issue, gleaned from the literature review is the tension and debate between specialist and generalist services. It is apparent from this review that CHN have to more actively participate in research and peer reviewed debate in order to have their voice heard and promote their unique and valuable contribution to the nursing profession and the health care system.
Usher, Kim; Jackson, Debra; Woods, Cindy; Sayers, Jan; Kornhaber, Rachel; Cleary, Michelle
The crystalline form of methamphetamine, commonly known as crystal meth (crystal methamphetamine) or ICE, is a highly-addictive and powerful stimulant. Users of crystal meth often require emergency care, and are associated with a substantial burden of care by emergency care providers. The aim of the present qualitative study was to explore health professionals' experiences of providing care for patients affected by ICE who presented to the emergency department (ED). Nine semistructured interviews were conducted. The major theme, 'staying safe', was revealed, in which participants described their experiences of being exposed to potentially unsafe situations, and their responses to challenging behaviours, including aggression. The findings highlight the need for ED staff to understand the nature of ICE use and its adverse impact on the mental and physical health of users. Furthermore, it is clear that establishing and maintaining safety in the emergency care setting is of utmost importance, and should be a priority for health-care managers. © 2017 Australian College of Mental Health Nurses Inc.
Desmedt, Melissa; Bergs, Jochen; Vertriest, Sonja; Vlayen, Annemie; Schrooten, Ward; Hellings, Johan; Vandijck, Dominique
To give an overview of empirical studies using self-reported instruments to assess patient safety culture in primary care and to synthesize psychometric properties of these instruments. A key condition for improving patient safety is creating a supportive safety culture to identify weaknesses and to develop improvement strategies so recurrence of incidents can be minimized. However, most tools to measure and strengthen safety culture have been developed and tested in hospitals. Nevertheless, primary care is facing greater risks and a greater likelihood of causing unintentional harm to patients. A systematic literature review of research evidence and psychometric properties of self-reported instruments to assess patient safety culture in primary care. Three databases until November 2016. The review was carried out according to the protocol for systematic reviews of measurement properties recommended by the COSMIN panel and the PRISMA reporting guidelines. In total, 1.229 records were retrieved from multiple database searches (Medline = 865, Web of Science = 362 and Embase = 2). Resulting from an in-depth literature search, 14 published studies were identified, mostly originated from Western high-income countries. As these studies come with great diversity in tools used and outcomes reported, comparability of the results is compromised. Based on the psychometric review, the SCOPE-Primary Care survey was chosen as the most appropriate instrument to measure patient safety culture in primary care as the instrument had excellent internal consistency with Cronbach's alphas ranging from 0.70-0.90 and item factor loadings ranging from 0.40-0.96, indicating a good structural validity. The findings of the present review suggest that the SCOPE-Primary Care survey is the most appropriate tool to assess patient safety culture in primary care. Further psychometric techniques are now essential to ensure that the instrument provides meaningful information regarding safety
O'Carroll, Veronica; McSwiggan, Linda; Campbell, Martin
The healthcare setting is a rich learning environment for students to experience interprofessional working (IPW) and interprofessional education (IPE). However, opportunities for IPE are limited, and student experiences of effective IPW are varied. This raises the question of how IPW and IPE are valued by health or social care professionals. A search of the literature was carried out to identify studies of health and social care staff attitudes to IPW and IPE. This review provides a summary of the main factors found to influence attitudes and the strengths and limitations of these studies. Professional background and prior IPE experience were identified as the influencing factors for which there is most evidence. The main limitations of the studies accessed included a focus on the value of IPE for staff, as opposed to students, and a limited number of studies considering the relationship between attitudes to IPW and the value placed on IPE. It is important that health and social care professionals lead by example by working collaboratively and providing students with opportunities for IPE. Identifying the variables influencing attitudes to IPW and IPE may assist in improving IPW and experiences of IPE for students learning in the healthcare setting.
de Lusignan, Simon; Chan, Tom; Theadom, Alice; Dhoul, Neil
Routinely collected clinical data is increasingly used for health service management, audit, and research. Even apparently anonymised data are subject to data protection. The relevant principles were set out in a treaty of the Council of Europe and subsequent policy has been based on these. However, little has been written about implementing policy and the role of health informaticians in this process. To define the elements of an effective implementation policy; the role of the health informatician in protecting processed clinical data. We performed a literature review of bibliographic databases, a manual search of the major medical informatics associations' websites, relevant working groups and an affiliated journal. Fifty-four papers relevant to implementation were identified. The effective implementation of policy requires consideration of technical, organisational, personnel and professional issues. However, there is no clearly defined formula for successful implementation of data protection policy. Patients and professionals need a system they can trust, and processes that can be easily incorporated into everyday practice. The lack of a core generalisable theory or strong professional code in health informatics limits the ability of the health informaticians to implement policy.
Full Text Available The professional profiles and skills related to journalism are adapting to a new paradigm as a consequence of the advent of new technologies - the web 2.0, the end of the monopoly of news production by mass media, etc. This study aims to provide a comprehensive critical mapping of new professional profiles and skills demanded in the field of journalism, based on a scoping review and in-depth interviews with professionals and academics in Spain. The results show a great variety of new profiles and nomenclatures. This is in part because of a significant overlapping in the functions emphasized by them. With regards to skills, the traditional ones are still the most valued by the market, although new competencies are becoming more and more important.
Idaho National Laboratory (INL) performed an Annual Effectiveness Review of the Integrated Safety Management System (ISMS), per 48 Code of Federal Regulations (CFR) 970.5223 1, “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and identified target areas for focused improvements and assessments for fiscal year (FY) 2013. Results of the FY 2012 annual effectiveness review demonstrated that the INL’s ISMS program was significantly strengthened. Actions implemented by the INL demonstrate that the overall Integrated Safety Management System is sound and ensures safe and successful performance of work while protecting workers, the public, and environment. This report also provides several opportunities for improvement that will help further strengthen the ISM Program and the pursuit of safety excellence. Demonstrated leadership and commitment, continued surveillance, and dedicated resources have been instrumental in maturing a sound ISMS program. Based upon interviews with personnel, reviews of assurance activities, and analysis of ISMS process implementation, this effectiveness review concludes that ISM is institutionalized and is “Effective”.
Morello, Renata Teresa; Lowthian, Judy A; Barker, Anna Lucia; McGinnes, Rosemary; Dunt, David; Brand, Caroline
To determine the effectiveness of patient safety culture strategies to improve hospital patient safety climate. Electronic search of the Cochrane Library, OVID Medline, Embase, CINAHL, proQuest and psychinfo databases, with manual searches of quality and safety websites, bibliographies of included articles and key journals. English language studies published between January 1996 and April 2011 that measured the effectiveness of patient safety culture strategies using a quantitative measure of patient safety climate in a hospital setting. Studies included were randomised controlled trials (RCTs), non-RCTs, controlled before and after studies, interrupted time series and historically controlled studies. Data extraction and critical appraisal were conducted by two independent reviewers. Study design, intervention, level of application, setting, study participants, safety climate outcome measures and implementation lessons were extracted from each article. Over 2000 articles were screened, with 21 studies meeting the inclusion criteria, one cluster RCT, seven controlled before and after studies, and 13 historically controlled studies. There was marked methodological heterogeneity amongst studies. Impacts of 11 different strategies were reported. There was some evidence to support that leadership walk rounds (p=0.02) and multi-faceted unit-based programmes (p < 0.05) may have a positive impact on patient safety climate. Despite strong face validity for a variety of patient safety culture strategies, there is limited evidence to support definitive impacts on patient safety climate outcomes. Organisations are advised to consider robust evaluation designs when implementing these potentially resource intensive strategies.
Fu, Xiaping; Ying, Yibin
In recent years, due to the increasing consciousness of food safety and human health, much progress has been made in developing rapid and nondestructive techniques for the evaluation of food hazards, food authentication, and traceability. Near infrared (NIR) spectroscopy and imaging techniques have gained wide acceptance in many fields because of their advantages over other analytical techniques. Following a brief introduction of NIR spectroscopy and imaging basics, this review mainly focuses on recent NIR spectroscopy and imaging applications for food safety evaluation, including (1) chemical hazards detection; (2) microbiological hazards detection; (3) physical hazards detection; (4) new technology-induced food safety concerns; and (5) food traceability. The review shows NIR spectroscopy and imaging to be effective tools that will play indispensable roles for food safety evaluation. In addition, on-line/real-time applications of these techniques promise to be a huge growth field in the near future.
Full Text Available Wilhelm, T. (2013. Professional Penetration Testing: Creating and Learning in a Hacking Lab 2E. Waltham, MA: Syngress, 464 pages, ISBN-10: 1597499935; ISBN-13: 978-1597499934, US$79.99Reviewed by Joshua Bartolomie, CISSP, CEECS, CFCE, DFCP, CRISC, CSMOrganizations often strive for proactive information security programs in an effort to limit occurrence and impact of security breaches. However, traditional security programs run the risk of being unable to provide adequate insight and proactive awareness into real attack vectors that may exist within their organizations. With attack methods and efforts becoming increasingly aggressive, and effective, organizations must take equally assertive measures to protect their critical information and assets. Penetration testing is one of those tools that is often misunderstood, overlooked, and undervalued. A true adversary would not hesitate to exploit every potential to gain entry or cause a disruption to their target.(see PDF for full review
Full Text Available Objectives: Self-management is widely promoted but evidence of effectiveness is limited. Policy encourages health care professionals to support people with long-term conditions to learn self-management skills, yet little is known about the extent to which both parties share a common understanding of self-management. Thus, we compared health care professional and lay understandings of self-management of long-term conditions. Methods: Systematic review and narrative synthesis of qualitative studies identified from relevant electronic databases, hand-searching of references lists, citation tracking and recommendations by experts. Results: In total, 55 studies were included and quality was assessed using a brief quality assessment tool. Three conceptual themes, each with two subthemes were generated: traditional and shifting models of the professional–patient relationship (self-management as a tool to promote compliance; different expectations of responsibility; quality of relationship between health care professional and lay person (self-management as a collaborative partnership; self-management as tailored support and putting self-management into everyday practice (the lived experience of self-management; self-management as a social practice. Conclusion: Self-management was conceptualised by health care professionals as incorporating both a biomedical model of compliance and individual responsibility. Lay people understood self-management in wider terms, reflecting biomedical, psychological and social domains and different expectations of responsibility. In different ways, both deviated from the dominant model of self-management underpinned by the concept of self-efficacy. Different understandings help to explain how self-management is practised and may help to account for limited evidence of effectiveness of self-management interventions.
Full Text Available Background: Professional capacity building (PCB is the focus point in health-related subjects.The present study was conducted to systematically review the existing sexual health training modules for health care providers.Methods: The following keywords were used to search: training, education, professional capacity, practitioner, sexual health, skill education, module, course, package and curriculum.The term MESH is referred to Medical Subject Headings and the following databases were investigated: MEDLINE, EMBASE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL, The Cochrane Library and Web of Science, Scopus, Google Scholar, SID,Magiran, and Iranmedex. All articles from 1980 to 2015 were extracted. Online modules were excluded. Considering that lesson plan was the basis of instruction, the modules were selected based on the characteristics of the lesson plans.Results: A total number of 38 published training modules in the field of sexuality we redetermined. In total, more than half of the modules (58% were designed for medical doctor sand allied health professionals and the remaining (42% were for nurses and midwives. Almost all the modules (97% were introduced and utilized in developed countries, and only 3% were disseminated in developing countries.Conclusion: There are invaluable modules to build professional capacity in the field of sexual health. As a number of modules have been designed for nurses and midwifes, as the first-line health care providers, the use of these groups in sexual counseling and empowerment for sexual health is essential. No sexual health training program was designed in Iran. Therefore, designing such modules according to Iranian culture is strongly recommended.
Corrin, Tricia; Waddell, Lisa; Greig, Judy; Young, Ian; Hierlihy, Catherine; Mascarenhas, Mariola
Recently, attention to chikungunya has increased due to its spread into previously non-endemic areas. Since there is no available treatment or vaccine, most intervention strategies focus on mosquito bite prevention and mosquito control, which require community involvement to be successful. Thus, our objective was to systematically review the global primary literature on the risk perceptions, attitudes, and knowledge of chikungunya among the public and health professionals to inform future research and improve our understanding on which intervention strategies are likely to be successful. Potentially relevant articles were identified through a standardized systematic review (SR) process consisting of the following steps: comprehensive search strategy in seven databases (Scopus, PubMed, CINAHL, CAB, LILACS, Agricola, and Cochrane) and a grey literature search of public health organizations, relevance screening, risk of bias assessment, and data extraction. Two independent reviewers performed each step. Reporting of this SR follows PRISMA reporting guidelines. Thirty-seven relevant articles were identified. The majority of the articles were published since 2011 (83.8%) and reported on studies conducted in Asia (48.7%) and the Indian Ocean Islands (24.3%). The results were separated into four categories: general knowledge and perceptions on chikungunya; perceptions on the risk and severity of chikungunya; knowledge of chikungunya-harboring vectors and transmission; and knowledge, perceptions, and attitudes on mitigation practices. Overall, the systematic review found that risk perceptions, attitudes, and knowledge of chikungunya among the public and health professionals vary across populations and countries and knowledge is higher in areas that have experienced an outbreak. The results suggest that most of the affected populations in this study do not understand mosquito borne diseases or chikungunya and are therefore less likely to protect themselves from mosquito
Taroco, Anderson Luiz Carvalho; Valente, Tania Cristina de Oliveira; Carbogim, Camila Soares
To review literature regarding online educational initiatives in palliative care which are targeted to update health professionals and prepare distance courses suitable for a Brazilian context. 7 databases (PubMed, Cochrane Library, LILACS, SCIELO, CINAHL, Science Direct and Scopus) were reviewed for published papers between January 2004 and August 2014 using the PRISMA methodology. Included studies focused on health professionals and had at least part of the course in a distance learning approach. The UK, the USA, Canada and Australia stood out within the palliative care research papers. Among the 590 articles chosen, only 14 papers were included in this review due to the inclusion criteria. 9 used a mixed approach and 5 used online methods. The length of the courses, however, varied extensively and several methods were found to have been employed for teaching purposes, including videos, audio, images, poetry and simulation cases. Although the literature is abundant in this area, there is limited research exploring the construction process of courses and how they can be applied to countries with limited resources. It is important to highlight, however, that the mixed teaching strategy, which allows for theoretical and practical activities at a low cost, is imperative for countries with limited resources in healthcare. Thus, this review can support new initiatives around the world, particularly in the low-income and middle-income countries. 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/.
Cottreau, Jessica M; Barr, Viktorija O
Antiviral and antifungal use in pregnancy presents challenges because of the paucity of clinical and safety data for many agents in these classes. If untreated, viral and fungal infections can have deleterious effects on both maternal and fetal health. Understanding the use and risks of these medications in pregnancy is vital to provide appropriate care. This article reviews the current literature for the use of antiviral and antifungals, the pharmacokinetics of these agents, and their safety in pregnancy. © 2016 Pharmacotherapy Publications, Inc.
Steel, Amie; Frawley, Jane; Adams, Jon; Diezel, Helene
The professionalisation of doula care and research interest in this area of maternity care/support have both grown internationally in recent years highlighting important broader issues around the access, continuity and delivery of maternity care services. However, no work to date has provided a critical appraisal of the international literature on this topic. In response, this paper presents the first critical review of international empirical literature examining professional doula care for pregnant and birthing women. A database search of AMED, CINAHL, Maternity and Infant Care, and MEDLINE using the search term, "doula" was undertaken. A total of 48 papers published between 1980 and March 2013 involving trained or professional doulas were extracted. Four descriptive categories were identified from the review: 'workforce and professional issues in doula care'; 'trained or professional doula's role and skill'; 'physical outcomes of trained or professional doula care'; and 'social outcomes of trained or professional doula care'. Of the studies evaluating outcomes of doula care, there were a number with design and methodology weaknesses. The review highlights a number of gaps in the research literature including a lack of research examining doula workforce issues; focus upon the experience and perspective of significant stakeholders such as expectant fathers with regard to trained or professional doula care; clinical trials measuring both subjective experiences and physical outcomes of trained or professional doula support; synergy between the design of clinical trials research examining trained or professional doula care and the clinical reality of professional doula practice. It is imperative that key aspects of trained doula care be subject to further rigorous, empirical investigation to help establish an evidence base to guide policy and practice relating to this area of support and care for pregnant and birthing women. © 2014 John Wiley & Sons Ltd.
Vance, Scott A.; Hockert, John
This report, the deliverable for Task 4 of the NA-243 Safeguards by Design Work Plan for Fiscal Year 2009, develops the lessons to be learned for the institutionalization of Safeguards By Design (SBD) from the Department of Energy (DOE) experience developing and implementing DOE-STD-1189, Integration of Safety into the Design Process. This experience was selected for study because of the similarity of the challenges of integrating safety and safeguards into the design process. Development of DOE-STD-1189 began in January 2006 and the standard was issued for implementation in March 2008. The process was much more time consuming than originally anticipated and might not have come to fruition had senior DOE management been less committed to its success. Potentially valuable lessons can be learned from both the content and presentation of the integration approach in DOE-STD-1189 and from the DOE experience in developing and implementing DOE-STD-1189. These lessons are important because the instutionalization of SBD does not yet appear to have the level of senior management commitment afforded development and implementation of DOE-STD-1189.
Stohs, Sidney J; Hartman, Michael J
Moringa oleifera leaves, seeds, bark, roots, sap, and flowers are widely used in traditional medicine, and the leaves and immature seed pods are used as food products in human nutrition. Leaf extracts exhibit the greatest antioxidant activity, and various safety studies in animals involving aqueous leaf extracts indicate a high degree of safety. No adverse effects were reported in association with human studies. Five human studies using powdered whole leaf preparations of M. oleifera have been published, which have demonstrated anti-hyperglycemic (antidiabetic) and anti-dyslipidemic activities. These activities have been confirmed using extracts as well as leaf powders in animal studies. A rapidly growing number of published studies have shown that aqueous, hydroalcohol, or alcohol extracts of M. oleifera leaves possess a wide range of additional biological activities including antioxidant, tissue protective (liver, kidneys, heart, testes, and lungs), analgesic, antiulcer, antihypertensive, radioprotective, and immunomodulatory actions. A wide variety of polyphenols and phenolic acids as well as flavonoids, glucosinolates, and possibly alkaloids is believed to be responsible for the observed effects. Standardization of products is an issue. However, the results of published studies to date involving M. oleifera are very promising. Additional human studies using standardized extracts are highly desirable. © 2015 The Authors Phytotherapy Research Published by John Wiley & Sons Ltd.
Full Text Available BACKGROUND: Many research studies have been published on atopic eczema and these are often summarised in systematic reviews (SRs. Identifying SRs can be time-consuming for health professionals, and researchers. In order to facilitate the identification of important research, we have compiled an on-line resource that includes all relevant eczema reviews published since 2000. METHODS: SRs were searched for in MEDLINE (Ovid, EMBASE (Ovid, PubMed, the Cochrane Database of Systematic Reviews, DARE and NHS Evidence. Selected SRs were assessed against the pre-defined eligibility criteria and relevant articles were grouped by treatment category for the included interventions. All identified systematic reviews are included in the Global Resource of EczemA Trials (GREAT database (www.greatdatabase.org.uk and key clinical messages are summarised here. RESULTS: A total of 128 SRs reviews were identified, including three clinical guidelines. Of these, 46 (36% were found in the Cochrane Library. No single database contained all of the SRs found. The number of SRs published per year has increased substantially over the last thirteen years, and reviews were published in a variety of clinical journals. Of the 128 SRs, 1 (1% was on mechanism, 37 (29% were on epidemiology, 40 (31% were on eczema prevention, 29 (23% were on topical treatments, 31 (24% were on systemic treatments, and 24 (19% were on other treatments. All SRs included searches of MEDLINE in their search methods. One hundred six SRs (83% searched more than one electronic database. There were no language restrictions reported in the search methods of 52 of the SRs (41%. CONCLUSIONS: This mapping of atopic eczema reviews is a valuable resource. It will help healthcare practitioners, guideline writers, information specialists, and researchers to quickly identify relevant up-to-date evidence in the field for improving patient care.
Thomas, Aliki; Menon, Anita; Boruff, Jill; Rodriguez, Ana Maria; Ahmed, Sara
Use of theory is essential for advancing the science of knowledge translation (KT) and for increasing the likelihood that KT interventions will be successful in reducing existing research-practice gaps in health care. As a sociological theory of knowledge, social constructivist theory may be useful for informing the design and evaluation of KT interventions. As such, this scoping review explored the extent to which social constructivist theory has been applied in the KT literature for healthcare professionals. Searches were conducted in six databases: Ovid MEDLINE (1948 - May 16, 2011), Ovid EMBASE, CINAHL, ERIC, PsycInfo, and AMED. Inclusion criteria were: publications from all health professions, research methodologies, as well as conceptual and theoretical papers related to KT. To be included in the review, key words such as constructivism, social constructivism, or social constructivist theories had to be included within the title or abstract. Papers that discussed the use of social constructivist theories in the context of undergraduate learning in academic settings were excluded from the review. An analytical framework of quantitative (numerical) and thematic analysis was used to examine and combine study findings. Of the 514 articles screened, 35 papers published between 1992 and 2011 were deemed eligible and included in the review. This review indicated that use of social constructivist theory in the KT literature was limited and haphazard. The lack of justification for the use of theory continues to represent a shortcoming of the papers reviewed. Potential applications and relevance of social constructivist theory in KT in general and in the specific studies were not made explicit in most papers. For the acquisition, expression and application of knowledge in practice, there was emphasis on how the social constructivist theory supports clinicians in expressing this knowledge in their professional interactions. This scoping review was the first to examine
Taylor, Robert W.; Nash, Sally K.
While technical training and advanced degree's assure proficiency at specific tasks within engineering disciplines, they fail to address the potential for communication breakdown and decision making errors familiar to multicultural environments where language barriers, intimidating personalities and interdisciplinary misconceptions exist. In an effort to minimize these pitfalls to effective panel review, NASA's lead safety engineers to the ISS Safety Review Panel (SRP), and Payload Safety Review Panel (PSRP) initiated training with their engineers, in conjunction with the panel chairs, and began a Panel Resource Management (PRM) program. The intent of this program focuses on the ability to reduce the barriers inhibiting effective participation from all panel attendees by bolstering participants confidence levels through increased communication skills, situational awareness, debriefing, and a better technical understanding of requirements and systems.
Verbeek-van Noord, Inge; de Bruijne, Martine C; Zwijnenberg, Nicolien C; Jansma, Elise P; van Dyck, Cathy; Wagner, Cordula
To evaluate the evidence of the effectiveness of classroom-based Crew Resource Management training on safety culture by a systematic review of literature. Studies were identified in PubMed, Cochrane Library, PsycINFO, and Educational Resources Information Center up to 19 December 2012. The Methods Guide for Comparative Effectiveness Reviews was used to assess the risk of bias in the individual studies. In total, 22 manuscripts were included for review. Training settings, study designs, and evaluation methods varied widely. Most studies reporting only a selection of culture dimensions found mainly positive results, whereas studies reporting all safety culture dimensions of the particular survey found mixed results. On average, studies were at moderate risk of bias. Evidence of the effectiveness of Crew Resource Management training in health care on safety culture is scarce and the validity of most studies is limited. The results underline the necessity of more valid study designs, preferably using triangulation methods.
Idaho National Laboratory (INL) performed an annual Integrated Safety Management System (ISMS) effectiveness review per 48 Code of Federal Regulations (CFR) 970.5223-1, 'Integration of Environment, Safety and Health into Work Planning and Execution.' The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and helped identify target areas for focused improvements and assessments for fiscal year (FY) 2012. The information presented in this review of FY 2011 shows that the INL has performed many corrective actions and improvement activities, which are starting to show some of the desired results. These corrective actions and improvement activities will continue to help change culture that will lead to better implementation of defined programs, resulting in moving the Laboratory's performance from the categorization of 'Needs Improvement' to the desired results of 'Effective Performance.'
gaps that may require attention in areas of OSH services, training, research, exposure assessment, and capacity building. The review study was approved at. Department level through ... machine characterizes manufacturing undertakings. About 85% of the ...... clusters in 21 regions, 1990–2010: a systematic analysis for the ...
which may accumulate in the egg and cause public health hazards. Microbial contamination of eggs in the process of production, handling and marketing has also been of a major public health concern. This paper reviews some of the ways table eggs can get contaminated and become unsafe for human consumption, ...
Rugai, Joseph; Hamiliton-Ekeke, Joy-Telu
In reviewing digital addiction, this paper recognized that digital technology has been useful in various spheres of life and the reach is undeniable, with an "average" user spending long hours on their phone or online daily. These hours increase as new applications are released by various technological companies. The demands of modern…
Dragutinovic, N. & Twisk, D.A.M.
This literature review of traffic education programmes addresses the current practice in evaluation research, the effectiveness of programmes and their constituting components and the differences and similarities with other fields of education. The study leads to a number of conclusions which can be
Panagioti, Maria; Stokes, Jonathan; Esmail, Aneez; Coventry, Peter; Cheraghi-Sohi, Sudeh; Alam, Rahul; Bower, Peter
Background Multimorbidity is increasingly prevalent and represents a major challenge in primary care. Patients with multimorbidity are potentially more likely to experience safety incidents due to the complexity of their needs and frequency of their interactions with health services. However, rigorous syntheses of the link between patient safety incidents and multimorbidity are not available. This review examined the relationship between multimorbidity and patient safety incidents in primary care. Methods We followed our published protocol (PROSPERO registration number: CRD42014007434). Medline, Embase and CINAHL were searched up to May 2015. Study design and quality were assessed. Odds ratios (OR) and 95% confidence intervals (95% CIs) were calculated for the associations between multimorbidity and two categories of patient safety outcomes: ‘active patient safety incidents’ (such as adverse drug events and medical complications) and ‘precursors of safety incidents’ (such as prescription errors, medication non-adherence, poor quality of care and diagnostic errors). Meta-analyses using random effects models were undertaken. Results Eighty six relevant comparisons from 75 studies were included in the analysis. Meta-analysis demonstrated that physical-mental multimorbidity was associated with an increased risk for ‘active patient safety incidents’ (OR = 2.39, 95% CI = 1.40 to 3.38) and ‘precursors of safety incidents’ (OR = 1.69, 95% CI = 1.36 to 2.03). Physical multimorbidity was associated with an increased risk for active safety incidents (OR = 1.63, 95% CI = 1.45 to 1.80) but was not associated with precursors of safety incidents (OR = 1.02, 95% CI = 0.90 to 1.13). Statistical heterogeneity was high and the methodological quality of the studies was generally low. Conclusions The association between multimorbidity and patient safety is complex, and varies by type of multimorbidity and type of safety incident. Our analyses suggest that multimorbidity
Mcculloch, Michael; Nachat, Arian; Schwartz, Jonathan; Casella-Gordon, Vicki; Cook, Joseph
Theoretically, acupuncture in anticoagulated patients could increase bleeding risk. However, precise estimates of bleeding complication rates from acupuncture in anticoagulated patients have not been systematically examined. To critically evaluate evidence for safety of acupuncture in anticoagulated patients. We searched PubMed, EMBASE, the Physiotherapy Evidence Database, and Google Scholar. Of 39 potentially relevant citations, 11 met inclusion criteria: 2 randomized trials, 4 case series, and 5 case reports. Seven provided reporting quality sufficient to assess acupuncture safety in 384 anticoagulated patients (3974 treatments). Minor-moderate bleeding related to acupuncture in an anticoagulated patient occurred in one case: a large hip hematoma, managed with vitamin K reversal and warfarin discontinuation following reevaluation of its medical justification. Blood-spot bleeding, typical for any needling/injection and controlled with pressure/cotton, occurred in 51 (14.6%) of 350 treatments among a case series of 229 patients. Bleeding deemed unrelated to acupuncture during anticoagulation, and more likely resulting from inappropriately deep needling damaging tissue or from complex anticoagulation regimens, occurred in 5 patients. No bleeding was reported in 2 studies (74 anticoagulated patients): 1 case report and 1 randomized trial prospectively monitoring acupuncture-associated bleeding as an explicit end point. Altogether, 1 moderate bleeding event occurred in 3974 treatments (0.003%). Acupuncture appears to be safe in anticoagulated patients, assuming appropriate needling location and depth. The observed 0.003% complication rate is lower than the previously reported 12.3% following hip/knee replacement in a randomized trial of 27,360 anticoagulated patients, and 6% following acupuncture in a prospective study of 229,230 all-type patients. Prospective trials would help confirm our findings.
Report documenting Formal Design Review conducted on portable exhausters used to support rotary mode core sampling of Hanford underground radioactive waste tanks with focus on Safety Class design features and control requirements for flammable gas environment operation and air discharge permitting compliance.
Coleman, J.; Inhaber, H.
As part of its duties in connection with space missions involving nuclear power sources, the Office of Nuclear Safety (ONS) of the Office of Assistant Secretary for Environmental Protection, Safety, and Emergency Preparedness has been assigned the task of reviewing the Overall Safety Manual (OSM) (memo from B.J. Rock to J.R. Maher, December 1, 1982). The OSM, dated July 1981 and in four volumes, was prepared by NUS Corporation, Rockville, Maryland, for the US Department of Energy. The OSM provides many of the technical models and much of the data which are used by (1) space launch contractors in safety analysis reports and (2) the broader Interagency Nuclear Safety Review Panel (INSRP) safety evaluation reports. If fhs interaction between the OSM, contractors, and INSRP is to work effectively, the OSM must be accurate, comprehensive, understandable, and usable.
Full Text Available Abstract Background There is an important gap between the implications of clinical research evidence and the routine clinical practice of healthcare professionals. Because individual decisions are often central to adoption of a clinical-related behaviour, more information about the cognitive mechanisms underlying behaviours is needed to improve behaviour change interventions targeting healthcare professionals. The aim of this study was to systematically review the published scientific literature about factors influencing health professionals' behaviours based on social cognitive theories. These theories refer to theories where individual cognitions/thoughts are viewed as processes intervening between observable stimuli and responses in real world situations. Methods We searched psycINFO, MEDLINE, EMBASE, CIHNAL, Index to theses, PROQUEST dissertations and theses and Current Contents for articles published in English only. We included studies that aimed to predict healthcare professionals' intentions and behaviours with a clear specification of relying on a social cognitive theory. Information on percent of explained variance (R2 was used to compute the overall frequency-weighted mean R2 to evaluate the efficacy of prediction in several contexts and according to different methodological aspects. The cognitive factors most consistently associated with prediction of healthcare professionals' intention and behaviours were documented. Results Seventy eight studies met the inclusion criteria. Among these studies, 72 provided information on the determinants of intention and 16 prospective studies provided information on the determinants of behaviour. The theory most often used as reference was the Theory of Reasoned Action (TRA or its extension the Theory of Planned Behaviour (TPB. An overall frequency-weighted mean R2 of 0.31 was observed for the prediction of behaviour; 0.59 for the prediction of intention. A number of moderators influenced the
Makhni, Eric C; Buza, John A; Byram, Ian; Ahmad, Christopher S
The increased physical demands of professional athletes predispose this patient population to a unique set of injuries typically not seen in the general population. This systematic literature review investigates the nature of injury reporting (both orthopedic and nonorthopedic conditions) in the medical literature of professional athletes in the National Football League (NFL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Hockey League (NHL). Rigorous reporting of sports injuries helps clinicians better understand disease mechanisms relevant to specific sports. The nature of injury reporting will differ within each professional sport and reflect the anatomic emphasis of each sport. An electronic literature search of all publications addressing injuries and medical conditions among professional athletes in the NFL, MLB, NBA, and NHL was conducted using the Pubmed/Medline, Scopus, and Embase databases through January 2013. Retrieved publications were categorized by journal type, medical type, and area of focus. A total of 536 publications met all inclusion criteria. There were a higher number of articles regarding the NFL (n = 211) and MLB (n = 216) when compared with the NBA (n = 34) or NHL (n = 75). The NFL had significantly more articles addressing nonorthopedic injuries/medical issues than were found with the MLB, NBA, or NHL (109 vs 75, 14, 41, respectively). Both the NFL (33 of 109, 30%) and NHL (6 of 41, 15%) had a relatively high percentage of articles regarding concussions/neurology, and MLB had a relatively high percentage of articles dedicated to vascular medicine (13 of 65, 20%). The proportion of publications dedicated to the knee/lower leg were highest in the NFL (29 of 102, 28%) and NBA (9 of 20, 45%), those dedicated to the shoulder/elbow were highest in MLB (113 of 151, 75%), and those dedicated to the hip/pelvis were highest in the NHL (16 of 34, 47%). The number and type of publications vary among the 4
Wilkinson, Helen; Whittington, Richard; Perry, Lorraine; Eames, Catrin
Empathy and burnout are two related yet distinct constructs that are relevant to clinical healthcare staff. The nature of their relationship is uncertain and this review aimed to complete a rigorous, systematic exploration of the literature investigating the relationship between burnout and empathy in healthcare staff. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Search terms (Burnout OR Burn-out OR "Burn out") AND (Empathy OR Empath*) enabled identification of studies investigating burnout and empathy in healthcare staff, using five electronic data bases (MEDLINE, PsycINFO, CINAHL Plus, PubMed, and SCOPUS). Manual searching amongst reference lists of eligible articles was also completed. Databases were searched for studies published in the English language, from inception to February 2017. Key inclusion criteria were: 1) participants who were nurses or medical professionals, 2) full written manuscript in English, 3) use of the Maslach Burnout Inventory to assess burnout and a standardized outcome measure for empathy, 4) quantitative methodology exclusively. Ten eligible studies were reviewed. Of those, seven were conducted in countries where English was not the first language. Eight of the studies provided empirical support for a negative relationship between empathy and burnout. One study provided support for a positive relationship between burnout and empathy. One study reported contradictory evidence with positive and negative correlations between different subscales of the empathy and burnout measures. In general, the quality of the studies was assessed to be good. However, some of the studies failed to provide information pertaining to sample size, with the reporting of data less than adequate from one study. There was consistent evidence for a negative association between burnout and empathy. This review avoided a common English-speaking country bias of some
Du, Wenmin; Guo, Jeff J; Jing, Yonghua; Li, Xing; Kelton, Christina M L
Drug safety and postmarketing surveillance have become important public health issues in China. This study reviews the relatively new drug safety surveillance system in China and compares it with the systems in the United States and Europe. An extensive literature review was conducted in the following four areas: 1) the organizational structure of the State Food and Drug Administration (SFDA) in China; 2) the development of an adverse drug reaction (ADR) monitoring system in China; 3) regulatory issues related to drug safety in China; and 4) similarities and differences between drug safety surveillance in China and surveillance in the United States and Europe. The SFDA oversees an extensive network of drug safety "watchdogs," including the China National Center for ADR Monitoring and 32 regional centers throughout China. China's system has faced a number of recent challenges. It has had to respond quickly to the withdrawal of various high-profile drugs like Vioxx (rofecoxib) and Baycol (cerivastatin) from other markets. Together with China's Ministry of Health, the SFDA has faced several unique drug safety events. Three of those events, involving the injectable form of the heartleaf houttuyinia herb (Yu Xing Cao), Armillarisni A injections, and clindamycin glucose infusions (Xinfu), are discussed. The rapid development of drug safety surveillance in China is manifested in extensive organizational structure, development of large databases, and laws and regulations supporting drug safety. The two major laws are the China Drug Administration Law issued in February 2001 and the Regulation for the Administration of ADR Reporting and Monitoring issued in March 2004. The study also discusses and compares recent developments in drug safety surveillance in the United States and the European Union. These developments will most likely have implications for the Chinese system in the near future. While postmarketing surveillance guidelines are not yet available in China, we
O' Hara, J.M.; Plott, C.; Milanski, J.; Ronan, A.; Scheff, S.; Laux, L.; and Bzostek, J.
The U.S. Nuclear Regulatory Commission's (NRC) conducts human factors engineering (HFE) safety reviews of applicant submittals for new plants and for changes to existing plants. The reviews include the evaluation of the methods and tools (M&T) used by applicants as part of their HFE program. The technology used to perform HFE activities has been rapidly evolving, resulting in a whole new generation of HFE M&Ts. The objectives of this research were to identify the current trends in HFE methods and tools, determine their applicability to NRC safety reviews, and identify topics for which the NRC may need additional guidance to support the NRC's safety reviews. We conducted a survey that identified over 100 new HFE M&Ts. The M&Ts were assessed to identify general trends. Seven trends were identified: Computer Applications for Performing Traditional Analyses, Computer-Aided Design, Integration of HFE Methods and Tools, Rapid Development Engineering, Analysis of Cognitive Tasks, Use of Virtual Environments and Visualizations, and Application of Human Performance Models. We assessed each trend to determine its applicability to the NRC's review by considering (1) whether the nuclear industry is making use of M&Ts for each trend, and (2) whether M&Ts reflecting the trend can be reviewed using the current design review guidance. We concluded that M&T trends that are applicable to the commercial nuclear industry and are expected to impact safety reviews may be considered for review guidance development. Three trends fell into this category: Analysis of Cognitive Tasks, Use of Virtual Environments and Visualizations, and Application of Human Performance Models. The other trends do not need to be addressed at this time.
Nuriane Santos Montezano
Full Text Available The article presents the reality of the new Executive Secretariat professional and its relation to the Strategic Information System. All the concepts were worked out based on the national integrative literature review. The aim was to determine what is the importance of information management and its applicability to the professional context of the Executive Secretariat. The discussion and theoretical reflection showed that the current Executive Secretary professional is prepared for the new organizational dynamics to incorporate technologically execution management information in context. This is another task that gives and confirms its multifunctional character as an important information manager figure in decision-making organizations.
Trier, H.; Valderas, J.M.; Wensing, M.; Martin, H.M.; Egebart, J.
BACKGROUND: Patient involvement has only recently received attention as a potentially useful approach to patient safety in primary care. OBJECTIVE: To summarize work conducted on a scoping review of interventions focussing on patient involvement for patient safety; to develop consensus-based
Smith, Coral; Egunsola, Oluwaseun; Choonara, Imti; Kotecha, Sailesh; Jacqz-Aigrain, Evelyne; Sammons, Helen
To identify the use and adverse drug reactions associated with azithromycin in neonates. Databases MEDLINE (1948-August 2015), EMBASE (1980-August 2015) and Pubmed (August 2015) were searched for studies on azithromycin in neonates. All studies involving neonates (azithromycin for which safety was evaluated. The primary outcome was adverse event (AE) associated with use of azithromycin. Use of azithromycin in neonates was the secondary outcome. A total of 11 articles involving 473 neonates were identified. 371 AEs were reported. Adverse events were mainly respiratory (358/1000 neonate), neurological (273/1000 neonates) and gastrointestinal (196/1000 neonates) in origin. Azithromycin significantly reduced the risk of bronchopulmonary dysplasia (BPD) in extremely premature neonates (RR=0.83, 95% CI 0.71 to 0.98, p=0.02). There was no significant difference in the incidence of elevated liver enzymes between the azithromycin and placebo group (p=0.76). There were four cases of infantile hypertrophic pyloric stenosis (IHPS). Azithromycin significantly reduces the risk of BPD in preterm neonates. The relationship between azithromycin and IHPS requires further investigation. 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/
Full Text Available To identify adverse events (AEs associated with Levetiracetam (LEV in children.Databases EMBASE (1974-February 2015 and Medline (1946-February 2015 were searched for articles in which paediatric patients (≤18 years received LEV treatment for epilepsy. All studies with reports on safety were included. Studies involving adults, mixed age population (i.e. children and adults in which the paediatric subpopulation was not sufficiently described, were excluded. A meta-analysis of the RCTs was carried out and association between the commonly reported AEs or treatment discontinuation and the type of regimen (polytherapy or monotherapy was determined using Chi2 analysis.Sixty seven articles involving 3,174 paediatric patients were identified. A total of 1,913 AEs were reported across studies. The most common AEs were behavioural problems and somnolence, which accounted for 10.9% and 8.4% of all AEs in prospective studies. 21 prospective studies involving 1120 children stated the number of children experiencing AEs. 47% of these children experienced AEs. Significantly more children experienced AEs with polytherapy (64% than monotherapy (22% (p<0.001. Levetiracetam was discontinued in 4.5% of all children on polytherapy and 0.9% on monotherapy (p<0.001, the majority were due to behavioural problems.Behavioural problems and somnolence were the most prevalent adverse events to LEV and the most common causes of treatment discontinuation. Children on polytherapy have a greater risk of adverse events than those receiving monotherapy.
El Turki, Aisha; Smith, Helen; Llewellyn, Carrie; Jones, Christina J
In order to enable fast treatment response to anaphylactic reactions, adrenaline auto-injectors (AAI) have been developed and manufactured. It has been reported in several studies that administration technique is suboptimal. The primary purpose of this study was to review the nature and extent of the deficiencies in administration technique among patients, parents/caregivers and healthcare professionals. Relevant publications were identified between 1998 and 2015 using two search methods: a keyword search in Embase, PubMed, British Nursing Index and Cumulative Index to Nursing and Allied Health Literature and a search of reference lists of relevant articles. Twenty-three studies met the inclusion criteria. Overall, 37% of patients, 32% of parents/caregivers and 21% of healthcare professionals demonstrated correct administration technique. For studies which employed a before-and-after training study design, correct technique was achieved in 77% of patients, 79% of caregivers and 65% of healthcare professionals. The most consistently observed error was the failure to hold the device in place for the recommended time. For patients, factors associated with good technique were being aged over 18 years, trained in AAI administration by an allergist, prescribed an AAI for more than 30 months, having a history of severe anaphylaxis and membership of a support group. For parents/caregivers in addition to those mentioned, being given a training device with which to practice, improved technique. There was wide variation in administration techniques reported. However, studies designed using before-and-after training show that even a brief demonstration and educational intervention can improve technique. Further studies are required to design and pilot acceptable and cost-effective educational materials. 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/.
Full Text Available Objectives: Continuing professional development (CPD is anovel approach to increase professional knowledge and skills. The aim of this study is to explore participants’ characteristics and to understand participants’ views on two rapid review courses (RRCs as part of CPD program, and to assess healthcare providers’ views about the use of internet for accessing medical information.Methods: Data were collected from 150 participants who attended an RRC in Nephrology and Rheumatology as part of an ongoing CME program.Results: Participants’ response rate was 92% and 84.4% in Nephrology and Rheumatology RRCs, respectively. Participants’ Mean Age±SD were 39±2.1 and 41±2.1 years in the Nephrology and Rheumatology courses, respectively. Demographic variables, i.e., age, gender, and specialization showed a significant (p<0.01 impact on the learning objectives of the program. Further, participants reported that the course material had a significant (p<0.02 impacton their knowledge. Finding new medical information was the primary motive to search the internet among all participants. About half of the subjects reported knowledge of their preferred medical education sites and had access at their clinical setup. Barriers to internet use included lack of specific information, difficulty to download contents, and excessive material. Professional association websites, online journals, and CME programs were the most frequently searched sources of information. Most of the subjects reported significant (p<0.02 barriers to find medical resources on the internet and to adequately utilize the currently available medical search engines available in the healthcare system.Conclusion: A discipline specific and integrated CPD programmay have provided dual benefit such as accredited CME hours and a significant change in the participants’ knowledge. There is a need to increase Internet accessibility and capacity in the current healthcare facilities. Future CPD
Azami-Aghdash, Saber; Ebadifard Azar, Farbod; Rezapour, Aziz; Azami, Akbar; Rasi, Vahid; Klvany, Khalil
Nowadays, for quality improvement, measuring patient safety culture (PSC) in healthcare organizations is being increasingly used. The aim of this study was to clarify PSC status in Iranian hospitals using a meta-analysis method. Six databases were searched: PubMed, Scopus, Google Scholar, Cochrane Library, Magiran, SID and IranMedex using the search terms including patient safety, patient safety culture, patient safety climate and combined with hospital (such as "hospital survey on patient safety culture"), measurement, assessment, survey and Iran. A total of 11 articles which conducted using Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire initially were reviewed. To estimate overall PSC status and perform the meta-analyses, Comprehensive Meta-Analysis (CMA) software v. 2 was employed. The overall PSC score based on the random model was 50.1%. "Teamwork within hospital units" dimension received the highest score of PSC (67.4%) and "Non-punitive response to error" the lowest score (32.4%). About 41% of participants in reviewed articles evaluate their hospitals' performance in PSC as 'excellent/very good'. Approximately %52.7 of participants did not report any adverse event in the past 12 months. The results of this study show that Iranian hospitals' performances in PSC were poor. Among the 12 dimensions of HSOPSC questionnaire, the "Non-punitive response to error" achieved the lowest score and could be a priority for future interventions. In this regard, hospitals staff should be encouraged to report adverse event without fear of punitive action.
Overbey, Katie N; Jaykus, Lee-Ann; Chapman, Benjamin J
This article covers the current published literature related to the use of social media in food safety and infectious disease communication. The aim was to analyze literature recommendations and draw conclusions about how best to utilize social media for food safety risk communication going forward. A systematic literature review was conducted, and 24 articles were included for analysis. The inclusion criteria were (i) original peer-reviewed articles and (ii) primary focus on communication through social media about food safety and/or infectious diseases. Studies were coded for themes about social media applications, benefits, limitations, and best practices. Trust and personal beliefs were important drivers of social media use. The wide reach, immediacy, and information gathering capacities of social media were frequently cited benefits. Suggestions for social media best practices were inconsistent among studies, and study designs were highly variable. More evidence-based suggestions are needed to better establish guidelines for social media use in food safety and infectious disease risk communication. The information gleaned from this review can be used to create effective messages for shaping food safety behaviors.
The Commission on Education and Training for Patient Safety has recommended that Health Education England (HEE) review mandatory training and the delivery of continuing professional development (CPD) relating to patient safety (news, March 16). All staff and trainees need to be empowered to raise concerns and they need support from managers to learn about and improve patient safety.
In view of the long-standing deliberate turnover policy of professional category 1 research physicists on fixed-term contracts, a special procedure is defined, distinct from the other professional categories. This procedure takes into account that research physicists stay at CERN for only up to 6 years and that periods of service as Fellow may be counted within these six years.The following procedure has been agreed:1.\tThe review covers research physicists holding fixed-term contracts and having completed at least 4 years of service on 30 June 1999. Prior years as Fellow may be taken into consideration in the specific context.\tAll candidates are informed individually.2.\tThe files of all candidates are considered by search committees. The members of the committees are nominated by the Director-General and comprise members of the senior CERN staff as well as at least one senior external physicist. The committees are free to take up references and to interview the candidates.3.\tIn ord...
Irvine, Susan; Williams, Brett; McKenna, Lisa
Near Peer teaching (NPT) is reported as an effective pedagogical approach to student learning and performance. Studies in medicine, nursing and health sciences have relied mainly on self-reports to describe its benefits, focusing on psychomotor and cognitive aspects of learning. Despite increasing research reports on peer teaching internationally, little is known about the various domains of learning used in assessment of performance and objective learning outcomes of NPT. To determine the domains of learning and assessment outcomes used in NPT in undergraduate health professional education. Quantitative systematic review was conducted in accord with the PRISMA protocol and the Joanna Briggs Institute processes. A wide literature search was conducted for the period 1990-November 2015 of fourteen databases. Grey literature was undertaken from all key research articles. Studies meeting the inclusion criteria were eligible for consideration, including measured learning outcomes of near-peer teaching in undergraduate education in nursing, medicine and health sciences. Set limitations included publications after 1990 (2015 inclusive), English language and objective learning outcomes. A quality appraisal process involving two independent reviewers was used to analyse the data. Of 212 selected articles, 26 were included in the review. Terminology was confusing and found to be a barrier to the review process. Although some studies demonstrated effective learning outcomes resulting from near-peer teaching, others were inconclusive. Studies focused on cognitive and psychomotor abilities of learners with none assessing metacognition, affective behaviours or learning outcomes from quality of understanding. The studies reviewed focused on cognitive and psychomotor abilities of learners. Even though evidence clearly indicates that metacognition and affective behaviours have direct influence on learning and performance, indicating more research around this topic is warranted
... COMMISSION Submission for OMB Review; Comment Request--Virginia Graeme Baker Pool and Spa Safety Act... verify whether pools and spas are in compliance with the Virginia Graeme Baker Pool and Spa Safety Act... inspections per year under the Virginia Graeme Baker Pool and Spa Safety Act. Investigators typically...
... COMMISSION Submission for OMB Review; Comment Request--Safety Standard for Walk-Behind Power Lawn Mowers... approval of a collection of information associated with the Commission's safety standard for walk- behind... required in the Safety Standard for Walk-Behind Power Lawn Mowers (16 CFR Part 1205). Three comments were...
Whiteman, Maura K; Oduyebo, Titilope; Zapata, Lauren B; Walker, Seth; Curtis, Kathryn M
With dramatic improvements in life expectancy for cystic fibrosis (CF) patients, contraception for women with CF has become an important issue. There are theoretical concerns that hormonal contraceptive use among women with CF may impact disease severity or risk for other adverse health outcomes, including thrombosis and poor bone health, as well as concerns that malabsorption or altered drug metabolism might impact contraceptive effectiveness. To evaluate evidence on the safety and effectiveness of contraceptive methods among women with CF. We searched the PubMed database for all articles published from database inception through October 2015. We included studies that examined measures of disease severity, other health outcomes or indicators of contraceptive effectiveness among women with CF initiating or continuing a contraceptive method. Seven studies met our inclusion criteria. Three observational studies of fair to poor quality suggest that use of oral contraceptives (OCs) does not negatively impact CF disease severity, defined as changes in pulmonary function, number of exacerbations or need for intravenous antibiotics. Three small studies of poor quality reported on contraceptive failure among women with CF using combined hormonal contraceptives (combined OCs, patch or ring). One pregnancy was reported in a patch user out of 43 hormonal contraceptive users across all studies. One pharmacokinetic study reported that women with CF achieve steroid hormone plasma concentrations similar to healthy women after ingestion of combined OCs. Limited evidence suggests that hormonal contraceptive use does not negatively impact disease severity among women with CF and that hormonal contraceptive effectiveness is not impaired by CF. Studies were limited by small sample sizes and short duration of follow-up. No studies examined the effect of hormonal contraception on thrombosis or bone health among women with CF. Published by Elsevier Inc.
Bosi, A; Bartolozzi, B
Allogeneic hematopoietic stem cell transplantation (HSCT) represents the first choice of treatment or an important therapeutic option for several diseases, but it is still marked by morbidity and mortality. In contrast, the donation of hematopoietic stem cells (HSCs) is considered to be a safe procedure. The invaluable ethical source of donation and its central role in transplantation implies that the greatest attention be due to the donor and to the donation process through a serious monitoring protocol for donor safety. Both the Joint Accreditation Committee and the European Committee pay particular attention to the notification of adverse events and adverse reactions. Bone marrow donation is a well established procedure, that has now been performed for >30 years. Although it does not require drug administration, there is hospital admission for 1-3 days with 7-10 days off work. The main risk is related to the anesthesia. Pain in the aspiration area, together with astenia are considered to be the most frequent side effects, as shown by the USA National Marrow Donor Program experience in 1,193 donations. In the European Group for Blood and Marrow Transplantation analysis performed between 1993 and 2005 on 27,770 first HSCTs from bone marrow, only 1 fatal event (pulmonary embolism) and 12 serious adverse events were observed. The most frequent adverse events were cardiac. The incidence of adverse events was significantly lower (P donors, which confirms the necessity of accurate attention to donor selection and evaluation in bone marrow donation. Copyright 2010 Elsevier Inc. All rights reserved.
Magrabi, Farah; Aarts, Jos; Nøhr, Christian
OBJECTIVE: To collect and critically review patient safety initiatives for health information technology (HIT). METHOD: Publicly promulgated set of advisories, recommendations, guidelines, or standards potentially addressing safe system design, build, implementation or use were identified...... were aimed at certification in the USA, Canada and Australia. Safety is addressed alongside interoperability in the Australian certification programme but it is not explicitly addressed in the US and Canadian programmes, though conformance with specific functionality, interoperability, security...... and privacy requirements may lead to safer systems. England appears to have the most comprehensive safety management programme for unregulated software, incorporating safety assurance at a local healthcare organisation level based on standards for risk management and user interface design, with national...
Del Prato, Darlene; Bankert, Esther; Grust, Patricia; Joseph, Joanne
Nurse educators are facing the challenge of creating new ways of teaching and facilitating enhanced learning experiences in clinical practice environments that are inherently complex, highly demanding, and unpredictable. The literature consistently reports the negative effects of excess stress and unsupportive relationships on wellbeing, self-efficacy, self-esteem, learning, persistence, and success. However, understanding contributing factors of stress, such as the student’s experiences of uncaring and oppressive interactions, is clearly not adequate. The transformation of nursing education requires a paradigm shift that embraces collegiality, collaboration, caring, and competence for students and the faculty. This paper reviews the literature on stress and its effects on nursing students. Grounded in theory related to stress and human caring, this paper focuses on the clinical environment and faculty-student relationships as major sources of students’ stress and offers strategies for mitigating stress while fostering learning and professional socialization of future nurses. PMID:23745082
Brisson, Daniel; Roll, Susan
There is a growing, multidisciplinary body of evidence on the effects that neighborhoods have on family outcomes. This evidence is important for social workers as we work with clients and communities from a person-in-environment perspective. In this article the authors present findings from a systematic, integrative review of neighborhood effects specifically for crime and safety. Thirty-seven research studies using random samples from urban, U.S. areas between 2002 and 2008 are reviewed. Findings suggest socio-demographic characteristics of neighborhoods and neighborhood processes are both predictive of crime and safety. Further, some neighborhood conditions may affect crime and safety in unexpected ways. Implications for social work practice, neighborhood interventions, and evidence-based practice are discussed.
Lapkin, Samuel; Levett-Jones, Tracy; Gilligan, Conor
Safe medication practices depend upon, not only on individual responsibilities, but also effective communication and collaboration between members of the medication team. However, measurement of these skills is fraught with conceptual and practical difficulties. The aims of this study were to explore the utility of a Theory of Planned Behaviour-based questionnaire to predict health professional students' behavioural intentions in relation to medication safety and collaborative practice; and to determine the contribution of attitudes, subjective norms, and perceived control to behavioural intentions. A descriptive cross-sectional survey based upon the Theory of Planned Behaviour was designed and tested. A convenience sample of 65 undergraduate pharmacy, nursing and medicine students from one semi-metropolitan Australian university were recruited for the study. Participants' behavioural intentions, attitudes, subjective norms, and perceived control to behavioural intentions in relation to medication safety were measured using an online version of the Theory of Planned Behaviour Medication Safety Questionnaire. The Questionnaire had good internal consistency with a Cronbach's alpha of 0.844. The three predictor variables of attitudes, subjective norms, and perceived control accounted for between 30 and 46% of the variance in behavioural intention; this is a strong prediction in comparison to previous studies using the Theory of Planned Behaviour. Data analysis also indicated that attitude was the most significant predictor of participants' intention to collaborate with other team members to improve medication safety. The results from this study provide preliminary support for the Theory of Planned Behaviour-Medication Safety Questionnaire as a valid instrument for examining health professional students' behavioural intentions in relation to medication safety and collaborative practice. Copyright © 2015 Elsevier Ltd. All rights reserved.
Naunton, M.; Al Hadithy, A.F.Y.; Brouwers, J.R.B.J.; Archer, D.F.
Objective: To review the pharmacology, pharmacokinetics, safety, and efficacy of a gel containing estradiol that is applied to the skin. Design: MEDLINE and EMBASE searches were conducted from 1966 to March 2005. Additional references were identified from bibliographies from selected studies in
Elsen, G.A.H. van den; Ahmed, A.I.A.; Lammers, M.; Kramers, C.; Verkes, R.J.; Marck, M.A. van der; Olde Rikkert, M.G.M.
This systematic review aims to integrate the evidence on indications, efficacy, safety and pharmacokinetics of medical cannabinoids in older subjects. The literature search was conducted using PubMed, EMBASE, CINAHL and Cochrane Library. We selected controlled trials including solely older subjects
Haak, L. van den; Alleblas, C.; Nieboer, T.E.; Rhemrev, J.P.; Jansen, F.W.
PURPOSE: This review aims to objectively assess the efficacy and safety of uterine manipulators as reported in scientific literature. Furthermore, it evaluates as to which manipulator best suits which surgical procedure. METHODS: PubMed, Embase, Web of Science, COCHRANE, CINAHL, Academic Search
Van den Haak, L.; Alleblas, C.; Nieboer, T.E.; Rhemrev, J.P.; Jansen, F.W.
Purpose This review aims to objectively assess the efficacy and safety of uterine manipulators as reported in scientific literature. Furthermore, it evaluates as to which manipulator best suits which surgical procedure. Methods PubMed, Embase, Web of Science, COCHRANE, CINAHL, Academic Search
Karen Scott; Deborah Richards; Rajindra Adhikari
...’ personal and health information. Based on a review of the literature, this paper identifies a set of risk and safety features for evaluating mHealth apps and uses those features to conduct a comparative analysis of the 20 most popular mHealth apps...
L.S.G.L. Wauben; J.F. Lange (Johan); R.H.M. Goossens (Richard)
textabstractLessons learned from other high-risk industries could improve patient safety in the operating room (OR). This review describes similarities and differences between high-risk industries and describes current methods and solutions within a system approach to reduce errors in the OR. PubMed
van der Weijden, F.A.; Campbell, S.L.; Dörfer, C.E.; Gonzalez-Cabezas, C.; Slot, D.E.
Background: Oscillating-rotating power toothbrushes have been proven clinically efficacious. To our knowledge, a comprehensive review of all clinical and laboratory investigations solely comparing the safety of these toothbrushes to the standard of care (i.e., manual toothbrushes) has not been
Winokur, Marc A.; Holtan, Amy; Batchelder, Keri E.
Objective: Children in out-of-home placements typically display more educational, behavioral, and psychological problems than do their peers. This systematic review evaluated the effect of kinship care placement compared to foster care placement on the safety, permanency, and well-being of children removed from the home for maltreatment. Methods:…
Elsler, D.; Treutlein, D.; Rydlewska, I.; Frusteri, L.; Krüger, H.; Veerman, T.; Eeckelaert, L.; Roskams, N.; Broek, K. van den; Taylor, T.N.
Objectives: In many European countries, external economic incentives are discussed as a policy instrument to promote occupational safety and health (OSH) in enterprises. This narrative case study review aims to support policy-makers in organizations providing such incentives by supplying information
Steenbruggen, J.G.M.; Borzacchiello, M.T.; Nijkamp, P.; Scholten, H.J.
Problems such as traffic congestion and environmental sustainability are forcing us to review our long-term plans for transport, whose aim should be to develop and improve safety, security and effectiveness of the transportation systems. The consequences of traffic accidents are not only limited to
Dragutinovic, N. & Twisk, D.A.M.
The use of mobile phones while driving has become a road safety concern and has been the focus of various behavioural studies. This literature review analyses studies published in the period 1999-2005, and include simulator studies, closed-track studies and studies on the real road. Although studies
This report reviews the experimental and epidemiologic data related to the carcinogenicity of saccharin. The results of animal studies suggest a species and organ effect. In single-generation studies in rats, mice, hamsters, and monkeys, saccharin did not induce cancer in any organ. In two-generation studies involving rats, however, there was evidence that the incidence of bladder tumors was significantly greater in saccharin-treated males of the second generation than in controls; the development of bladder tumors in rats seems to be a species- and organ-specific phenomenon for which there is currently no explanation. In humans, available evidence indicates that the use of artificial sweeteners, including saccharin, is not associated with an increased risk of bladder cancer. Until there is firm evidence of its carcinogenicity in humans, saccharin should continue to be available as a food additive, and reports of adverse health effects associated with its use should be monitored.
Fu, Yu; McNichol, Elaine; Marczewski, Kathryn; Closs, S José
Chronic back pain is common, and its self-management may be a lifelong task for many patients. While health professionals can provide a service or support for pain, only patients can actually experience it. It is likely that optimum self-management of chronic back pain may only be achieved when patients and professionals develop effective partnerships which integrate their complementary knowledge and skills. However, at present, there is no evidence to explain how such partnerships can influence patients' self-management ability. This review aimed to explore the influence of patient-professional partnerships on patients' ability to self-manage chronic back pain, and to identify key factors within these partnerships that may influence self-management. A systematic review was undertaken, aiming to retrieve relevant studies using any research method. Five databases were searched for papers published between 1980 and 2014, including Cochrane Library, CINAHL, Medline, EMBASE and PsycINFO. Eligible studies were those reporting on patients being supported by professionals to self-manage chronic back pain; patients being actively involved for self-managing chronic back pain; and the influence of patient-professional partnerships on self-management of chronic back pain. Included studies were critically appraised for quality, and findings were extracted and analysed thematically. A total of 738 studies were screened, producing 10 studies for inclusion, all of which happened to use qualitative methods. Seven themes were identified: communication, mutual understanding, roles of health professionals, information delivery, patients' involvement, individualised care and healthcare service. These themes were developed into a model suggesting how factors within patient-professional partnerships influence self-management. Review findings suggest that a partnership between patients and professionals supports patients' self-management ability, and effective communication is a
Keijsers, Carolina J P W; van Hensbergen, Larissa; Jacobs, Lotte; Brouwers, Jacobus R B J; de Wildt, Dick J; ten Cate, Olle Th J; Jansen, Paul A F
The rate of medication errors is high, and these errors can cause adverse drug reactions. Elderly individuals are most vulnerable to adverse drug reactions. One cause of medication errors is the lack of drug knowledge on the part of different health professionals. Medical curricula have changed in recent years, resulting in less education in the basic sciences, such as pharmacology. Our study shows that little curricular time is devoted to geriatric pharmacology and that educational programmes in geriatric pharmacology have not been thoroughly evaluated. While interest in pharmacology education has increased recently, this is not the case for geriatric pharmacology education. Education on geriatric pharmacology should have more attention in the curricula of health professionals, given the often complex pharmacotherapy in elderly patients. Educational topics should be related to the known risk factors of medication errors, such as polypharmacy, dose adjustments in organ dysfunction and psychopharmacotherapeutics. Given the reported high rates of medication errors, especially in elderly patients, we hypothesized that current curricula do not devote enough time to the teaching of geriatric pharmacology. This review explores the quantity and nature of geriatric pharmacology education in undergraduate and postgraduate curricula for health professionals. Pubmed, Embase and PsycINFO databases were searched (from 1 January 2000 to 11 January 2011), using the terms 'pharmacology' and 'education' in combination. Articles describing content or evaluation of pharmacology education for health professionals were included. Education in general and geriatric pharmacology was compared. Articles on general pharmacology education (252) and geriatric pharmacology education (39) were included. The number of publications on education in general pharmacology, but not geriatric pharmacology, has increased over the last 10 years. Articles on undergraduate and postgraduate education for 12
Schilling, Karsten; Bradford, Bobbie; Castelli, Dominique; Dufour, Eric; Nash, J Frank; Pape, Wolfgang; Schulte, Stefan; Tooley, Ian; van den Bosch, Jeroen; Schellauf, Florian
Based on the current weight of evidence of all available data, the risk for humans from the use of nano-structured titanium dioxide (TiO(2)) or zinc oxide (ZnO) currently used in cosmetic preparations or sunscreens is considered negligible. There is a large body of information that when viewed in its entirety is considered as sufficient to demonstrate that these nano-structured ultraviolet (UV) filters, irrespective of various treatments (coatings) or crystalline structure, can be regarded as safe for use at concentrations up to 25% in cosmetic products to protect the skin from harmful effects of solar UV radiation. "Nano" TiO(2) and ZnO formulated in topically applied sunscreen products exist as aggregates of primary particles ranging from 30-150 nm in size. These aggregates are bonded such that the force of sunscreen product application onto the skin would have no impact on their structure or result in the release of primary particles. Multiple studies have shown that under exaggerated test conditions neither nano-structured TiO(2) nor ZnO penetrates beyond the stratum corneum of skin. Further, the distribution and persistence of these nano-structured metal oxides is the same compared to larger pigment-grade (i.e., >100 nm) particles, demonstrating equivalence in the recognition and elimination of such material from the body. Finally, the in vitro genotoxic and photogenotoxic profiles of these nano-structured metal oxides are of no consequence to human health. Whereas the most logical, straightforward conclusion based on data from internationally-recognized guideline studies and current 20+ year history of human use is that nano-structured TiO(2) and ZnO are safe, there will continue to be questions as "nano" conjures images of technology gone awry. Despite this rather sober view, the public health benefits of sunscreens containing nano TiO(2) and/or ZnO outweigh human safety concerns for these UV filters.
Mills, Katie; Harte, Emma; Martin, Adam; MacLure, Calum; Griffin, Simon J; Mant, Jonathan; Meads, Catherine; Saunders, Catherine L; Walter, Fiona M; Usher-Smith, Juliet A
To synthesise data concerning the views of commissioners, managers and healthcare professionals towards the National Health Service (NHS) Health Check programme in general and the challenges faced when implementing it in practice. A systematic review of surveys and interview studies with a descriptive analysis of quantitative data and thematic synthesis of qualitative data. An electronic literature search of MEDLINE, Embase, Health Management Information Consortium, Cumulative Index of Nursing and Allied Health Literature, Global Health, PsycInfo, Web of Science, OpenGrey, the Cochrane Library, NHS Evidence, Google Scholar, Google, ClinicalTrials.gov and the International Standard Randomised Controlled Trial Number registry from 1 January 1996 to 9 November 2016 with no language restriction and manual screening of reference lists of all included papers. Primary research reporting views of commissioners, managers or healthcare professionals on the NHS Health Check programme and its implementation in practice. Of 18 524 citations, 15 articles met the inclusion criteria. There was evidence from both quantitative and qualitative studies that some commissioners and general practice (GP) healthcare professionals were enthusiastic about the programme, whereas others raised concerns around inequality of uptake, the evidence base and cost-effectiveness. In contrast, those working in pharmacies were all positive about programme benefits, citing opportunities for their business and staff. The main challenges to implementation were: difficulties with information technology and computer software, resistance to the programme from some GPs, the impact on workload and staffing, funding and training needs. Inadequate privacy was also a challenge in pharmacy and community settings, along with difficulty recruiting people eligible for Health Checks and poor public access to some venues. The success of the NHS Health Check Programme relies on engagement by those responsible for its
Hesselink, Gijs; Berben, Sivera; Beune, Thimpe; Schoonhoven, Lisette
To systematically review interventions that aim to improve the governance of patient safety within emergency care on effectiveness, reliability, validity and feasibility. A systematic review of the literature. PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Database of Systematic Reviews and PsychInfo were searched for studies published between January 1990 and July 2014. We included studies evaluating interventions relevant for higher management to oversee and manage patient safety, in prehospital emergency medical service (EMS) organisations and hospital-based emergency departments (EDs). Two reviewers independently selected candidate studies, extracted data and assessed study quality. Studies were categorised according to study quality, setting, sample, intervention characteristics and findings. Of the 18 included studies, 13 (72%) were non-experimental. Nine studies (50%) reported data on the reliability and/or validity of the intervention. Eight studies (44%) reported on the feasibility of the intervention. Only 4 studies (22%) reported statistically significant effects. The use of a simulation-based training programme and well-designed incident reporting systems led to a statistically significant improvement of safety knowledge and attitudes by ED staff and an increase of incident reports within EDs, respectively. Characteristics of the interventions included in this review (eg, anonymous incident reporting and validation of incident reports by an independent party) could provide useful input for the design of an effective tool to govern patient safety in EMS organisations and EDs. However, executives cannot rely on a robust set of evidence-based and feasible tools to govern patient safety within their emergency care organisation and in the chain of emergency care. Established strategies from other high-risk sectors need to be evaluated in emergency care settings, using an experimental design with valid outcome measures
Full Text Available Abstract Background Most patients receive healthcare in primary care settings, but relatively little is known about patient safety. Out-of-hours contacts are of particular importance to patient safety. Our aim was to examine the incidence, types, causes, and consequences of patient safety incidents at general practice cooperatives for out-of-hours primary care and to examine which factors were associated with the occurrence of patient safety incidents. Methods A retrospective study of 1,145 medical records concerning patient contacts with four general practice cooperatives. Reviewers identified records with evidence of a potential patient safety incident; a physician panel determined whether a patient safety incident had indeed occurred. In addition, the panel determined the type, causes, and consequences of the incidents. Factors associated with incidents were examined in a random coefficient logistic regression analysis. Results In 1,145 patient records, 27 patient safety incidents were identified, an incident rate of 2.4% (95% CI: 1.5% to 3.2%. The most frequent incident type was treatment (56%. All incidents had at least partly been caused by failures in clinical reasoning. The majority of incidents did not result in patient harm (70%. Eight incidents had consequences for the patient, such as additional interventions or hospitalisation. The panel assessed that most incidents were unlikely to result in patient harm in the long term (89%. Logistic regression analysis showed that age was significantly related to incident occurrence: the likelihood of an incident increased with 1.03 for each year increase in age (95% CI: 1.01 to 1.04. Conclusion Patient safety incidents occur in out-of-hours primary care, but most do not result in harm to patients. As clinical reasoning played an important part in these incidents, a better understanding of clinical reasoning and guideline adherence at GP cooperatives could contribute to patient safety.
Cornelissen, Pieter A; Van Hoof, Joris J; De Jong, Menno D T
In spite of increasing governmental and organizational efforts, organizations still struggle to improve the safety of their employees as evidenced by the yearly 2.3 million work-related deaths worldwide. Occupational safety research is scattered and inaccessible, especially for practitioners. Through systematically reviewing the safety literature, this study aims to provide a comprehensive overview of behavioral and circumstantial factors that endanger or support employee safety. A broad search on occupational safety literature using four online bibliographical databases yielded 27.527 articles. Through a systematic reviewing process 176 online articles were identified that met the inclusion criteria (e.g., original peer-reviewed research; conducted in selected high-risk industries; published between 1980-2016). Variables and the nature of their interrelationships (i.e., positive, negative, or nonsignificant) were extracted, and then grouped and classified through a process of bottom-up coding. The results indicate that safety outcomes and performance prevail as dependent research areas, dependent on variables related to management & colleagues, work(place) characteristics & circumstances, employee demographics, climate & culture, and external factors. Consensus was found for five variables related to safety outcomes and seven variables related to performance, while there is debate about 31 other relationships. Last, 21 variables related to safety outcomes and performance appear understudied. The majority of safety research has focused on addressing negative safety outcomes and performance through variables related to others within the organization, the work(place) itself, employee demographics, and-to a lesser extent-climate & culture and external factors. This systematic literature review provides both scientists and safety practitioners an overview of the (under)studied behavioral and circumstantial factors related to occupational safety behavior. Scientists
Conover, Elizabeth Ann; Jones, Kenneth Lyons
There is ongoing debate about the risks to the fetus associated with maternal binge drinking. This makes it difficult to counsel patients about the potential risks associated with their use of alcohol during pregnancy. This article reviews the literature on animal and human studies regarding binge drinking (four to five drinks at one time in humans, or the equivalent in laboratory animals). Animal studies provide evidence that high doses of alcohol over a short period of time can be more damaging than lower doses over a long period of time. Human data are more inconsistent, especially in terms of the association with malformations. Although neurobehavioral effects are the most commonly reported adverse outcome, some studies do not find such an association. Conclusions are confounded by the design of many studies, which fail to document pattern and total amount of alcohol consumption at one time. In addition, it has been suggested there is a bias against the null effect in publications. Although the evidence in humans is not conclusive, the incidence of binge exposures in pregnancy is high, and it appears prudent to counsel patients to avoid this exposure whenever possible. Women inadvertently exposed to a single binge episode of alcohol early in the first trimester before pregnancy recognition can be reassured that the risks for adverse effects in their baby are likely low if they are able to discontinue use for the duration of the pregnancy. Unfortunately, there may be some residual fetal risk. Copyright © 2012 Wiley Periodicals, Inc.
Garstang, Joanna; Griffiths, Frances; Sidebotham, Peter
The death of a child is a devastating event for parents. In many high income countries, following an unexpected death, there are formal investigations to find the cause of death as part of wider integrated child death review processes. These processes have a clear aim of establishing the cause of death but it is less clear how bereaved families are supported. In order to inform better practice, a literature review was undertaken to identify what is known about what bereaved parents want from professionals following an unexpected child death. This was a mixed studies systematic review with a thematic analysis to synthesize findings. The review included papers from Europe, North America or Australasia; papers had to detail parents' experiences rather than professional practices. The review includes data from 52 papers, concerning 4000 bereaved parents. After a child has died, parents wish to be able to say goodbye to them at the hospital or Emergency Department, they would like time and privacy to see and hold their child; parents may bitterly regret not being able to do so. Parents need to know the full details about their child's death and may feel that they are being deliberately evaded when not given this information. Parents often struggle to obtain and understand the autopsy results even in the cases where they consented for the procedure. Parents would like follow-up appointments from health care professionals after the death; this is to enable them to obtain further information as they may have been too distraught at the time of the death to ask appropriate questions or comprehend the answers. Parents also value the emotional support provided by continuing contact with health-care professionals. All professionals involved with child deaths should ensure that procedures are in place to support parents; to allow them to say goodbye to their child, to be able to understand why their child died and to offer the parents follow-up appointments with appropriate
Macdonald, Marilyn; Lang, Ariella
Chronic Illness represents a growing concern in the western world and individuals living with chronic illness are primarily managed at home by family caregivers. A scoping review of the home-care literature (2004-2009; updated with review articles from 2010 to January 2013) on the topic of the caregiver revealed that this group experiences the following safety-related concerns: caregivers are conscripted to the role, experience economic hardship, risk being abused as well as abusing, and may well become patients themselves. Methodology and methods used in the scoping review are presented as well as a brief overview of the findings. The concepts of risk and safety are defined. Risk Society Theory is introduced and used as a lens to view the findings, and to contribute to an understanding of the construction of risk in contemporary health-care. © 2013 John Wiley & Sons Ltd.
Christie, Janice; Gray, Trish A; Dumville, Jo C; Cullum, Nicky A
Complex wounds such as leg and foot ulcers are common, resource intensive and have negative impacts on patients' wellbeing. Evidence-based decision-making, substantiated by high quality evidence such as from systematic reviews, is widely advocated for improving patient care and healthcare efficiency. Consequently, we set out to classify and map the extent to which up-to-date systematic reviews containing robust evidence exist for wound care uncertainties prioritised by community-based healthcare professionals. We asked healthcare professionals to prioritise uncertainties based on complex wound care decisions, and then classified 28 uncertainties according to the type and level of decision. For each uncertainty, we searched for relevant systematic reviews. Two independent reviewers screened abstracts and full texts of reviews against the following criteria: meeting an a priori definition of a systematic review, sufficiently addressing the uncertainty, published during or after 2012, and identifying high quality research evidence. The most common uncertainty type was 'interventions' 24/28 (85%); the majority concerned wound level decisions 15/28 (53%) however, service delivery level decisions (10/28) were given highest priority. Overall, we found 162 potentially relevant reviews of which 57 (35%) were not systematic reviews. Of 106 systematic reviews, only 28 were relevant to an uncertainty and 18 of these were published within the preceding five years; none identified high quality research evidence. Despite the growing volume of published primary research, healthcare professionals delivering wound care have important clinical uncertainties which are not addressed by up-to-date systematic reviews containing high certainty evidence. These are high priority topics requiring new research and systematic reviews which are regularly updated. To reduce clinical and research waste, we recommend systematic reviewers and researchers make greater efforts to ensure that research
Professor Svanström has spent about forty-five years in the field of Social Medicine and Health and Safety Promotion. His main lines of research and teaching are Injury Epidemiology and Safety Promotion. In the 1960s, he conducted a number of descriptive and analytical studies, and in the 1970s began to address home and occupational injuries. In 1974, he introduced the community approach to safety promotion, encapsulated in the Falköping Model, which has heavily influenced Swedish and international community safety work. Under his leadership of the Research Group on Injury Prevention and Safety Promotion at the Karolinska Institutet in Stockholm, Sweden, more than 30 doctorates have been awarded. His work as Head of the WHO Collaborating Centre on Community Safety Promotion has led to the establishment of Safe Communities worldwide.
Ball, Shane; Halaki, Mark; Orr, Rhonda
To investigate the relationship between training volume and soft tissue injury incidence, and characterise soft tissue injury in rugby union players. A systematic search of electronic databases was performed. The search strategy combined terms covering: training volume and injury, and rugby union, and players of all levels. Medline, SPORTDiscus, Web of Science, Embase, PubMed. Studies were included if they reported: male rugby union players, a clear definition of a rugby union injury, the amount of training volume undertaken by participants, and epidemiological data for soft-tissue injuries including the number or incidence. 15 studies were eligible for inclusion. Overall match and training injury incidence ranged from 3.3 to 218.0 injuries/1000 player match hours and 0.1-6.1 injuries/1000 player training hours, respectively. Muscle and tendon as well as joint (non-bone) and ligament injuries were the most frequently occurring injuries. The lower limb was the most prevalent injury location. Injury incidence was higher in professional rugby union players than non-professional players. Contact events were responsible for the greatest injury incidence. For non-contact mechanisms, running was responsible for the highest injury incidence. Inconsistent injury definitions hindered reliable comparison of injury data. The lack of reporting training volumes in hours per player per week limited the ability to investigate associations between training volume and injury incidence. A higher level of play may result in higher match injury incidence. Muscle and tendon injuries were the most common type of soft tissue injury, while the lower limb was the most common location of injury in rugby union players, and running was responsible for the highest injury incidence during non-contact events. 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/.
Woods, Andrew; Cashin, Andrew; Stockhausen, Lynette
To comprehensively review the Community of Practice literature from nursing contexts to explore whether and how these communities contribute to the social construction of nurse educator professional identity. Due to the wide scope of predominately qualitative literature on the topic, papers were analysed and themed inductively. CINAHL, MEDLINE, COCHRANE, EBSCO databases, Emerald, Proquest & Google Scholar. These online databases were searched for relevant peer-reviewed journal papers in the English language with no date range specified. The search terms 'nurs* educator' and 'nurs* teacher' were combined with each of the terms 'communit* of practice', 'identity' and 'role' resulting in 293 peer-reviewed journal papers. Where abstracts were missing, introductory and background sections were skimmed for related content. Papers that made incidental reference to either professional identity or a Community of Practice were excluded. In total, 63 primary study or discussion papers were found to have a focus on nurse educator identity and/or communities of practice in healthcare contexts. Papers specifically focused on communities of practice in nursing (n=33) could only be found from the last 10 years (2005-2015). Only five of these focused on nurse educators. Community of Practice theory and the professional teaching literature offers collaborative and active ways for nurse educators to further develop their professional identities. Despite the emergence of communities of practice in the nursing literature, further studies are required to explore how such a construct can facilitate the social construction of nurse educator professional identity. Copyright © 2015 Elsevier Ltd. All rights reserved.
Brunero, Scott; Jeon, Yun-Hee; Foster, Kim
Mainstreaming of mental health services has led to an increase in the presentation and care of mental health patients in generalist health settings. The lack of adequate mental health educational preparation of general health professionals (GHP) has been identified as a major barrier to meeting the health-care needs of mental health patients. This study aimed to review and synthesize research evidence on mental health education programmes (MHEP) that have been designed to develop the knowledge, skills, and attitudes of GHP. An integrative literature review was conducted following a search of key electronic databases and hand searching of references of relevant papers, and 25 papers met the study inclusion criteria. Knowledge, skill, and attitudinal improvements in GHP post MHEP were shown in most studies. MHEP that included supervised clinical experience, role play, and case scenarios were reported as being more effective. Issues such as patient participation in education, interprofessional education models, and the willingness, interest and, motivation for GHP to be involved in MHEP warrant further research. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.
Sarah P. Anderson
Full Text Available Work-related musculoskeletal injuries and disorders (WMSD are a significant issue in the health care sector. Allied Health professionals (AHP in this sector are exposed to physical and psychosocial factors associated with increased risk of developing a WMSD. Clarification of relevant hazard and risk factors for AHP is needed to improve understanding and inform WMSD risk management. A systematic analysis of the literature was undertaken to determine prevalence and risk factors for WMSD in AHP. Databases of Ovid MEDLINE, CINAHL (EBSCO, EMBASE and the Cochrane Database of Systematic Reviews were reviewed. This quality of articles was low. Outcome measures were varied, with prevalence rates of WMSD reported from 28% to 96% over a one-year time period. The lower back was the most commonly affected body part. Relevant factors identified with the development of WMSD included inexperience in the role and area of employment. Future research needs to focus on undertaking high quality prospective studies to determine the factors associated with WMSD development in AHP.
Flowerdew, Lynsey; Brown, Ruth; Vincent, Charles; Woloshynowych, Maria
Understanding the nontechnical skills specifically applicable to the emergency department (ED) is essential to facilitate training and more broadly consider interventions to reduce error. The aim of this scoping review is to first identify and then explore in depth the nontechnical skills linked to safety in the ED. The review was conducted in 2 stages. In stage 1, online databases were searched for published empirical studies linking nontechnical skills to safety and performance in the ED. Articles were analyzed to identify key ED nontechnical skills. In stage 2, these key skills were used to generate additional key words, which enabled a second search of the literature to be undertaken and expand on the evidence available for review. In stage 1, 11 articles were retrieved for data analysis and 9 core emergency medicine nontechnical skills were identified. These were communicating, managing workload, anticipating, situational awareness, supervising and providing feedback, leadership, maintaining standards, using assertiveness, and decisionmaking. In stage 2, a secondary search, using these 9 skills and related terms, uncovered a further 21 relevant articles. Therefore, 32 articles were used to describe the main nontechnical skills linked to safety in the ED. This article highlights the challenges of reviewing a topic for which the terms are not clearly defined in the literature. A novel methodological approach is described that provides a structured and transparent process for reviewing the literature in emerging areas of interest. A series of literature reviews focusing on individual nontechnical skills will provide a clearer understanding of how the skills identified contribute to safety in the ED. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.
Full Text Available Purpose: The main purpose of the present study is to conduct a literature review of the contribution made by safety in air transport, based on the existing international academic literature in the field of the social sciences. It primarily attempts to examine and verify the relationship between safety-related concepts (co-occurrence, the link between the different authors (co-authorship and the corresponding citations (co-citations. Methodology: To achieve the established objectives, a systematic literature review (SLR has been conducted using the Scopus database between the years 1990 and 2016, identifying international academic papers related to the research topic of the present study. Findings: It has been verified, on the one hand, that safety in the air transport sector is a field of growing interest, as the number of papers has increased considerably in recent years, thus demonstrating the importance that this topic has acquired over time. On the other hand, however, it must be mentioned that the total quantity of papers related to the topic is low in terms of absolute numbers. The results of the co-occurrence analysis show that the most important aspect of safety is safety management, while the strongest link is between safety management and aircraft accidents, a fact that is foreseeable a priori. Originality/value: The approach used allows a better view of the academic contribution made in relation to safety; this serves as the link among the different elements of the concept studied, and it demonstrates the growing interest in this area.
Feng, Yao-Ze; Sun, Da-Wen
Food safety is a great public concern, and outbreaks of food-borne illnesses can lead to disturbance to the society. Consequently, fast and nondestructive methods are required for sensing the safety situation of produce. As an emerging technology, hyperspectral imaging has been successfully employed in food safety inspection and control. After presenting the fundamentals of hyperspectral imaging, this paper provides a comprehensive review on its application in determination of physical, chemical, and biological contamination on food products. Additionally, other studies, including detecting meat and meat bone in feedstuffs as well as organic residue on food processing equipment, are also reported due to their close relationship with food safety control. With these applications, it can be demonstrated that miscellaneous hyperspectral imaging techniques including near-infrared hyperspectral imaging, fluorescence hyperspectral imaging, and Raman hyperspectral imaging or their combinations are powerful tools for food safety surveillance. Moreover, it is envisaged that hyperspectral imaging can be considered as an alternative technique for conventional methods in realizing inspection automation, leading to the elimination of the occurrence of food safety problems at the utmost.
O, J.M.; Higgins, J.; Stephen Fleger - NRC
The U.S. Nuclear Regulatory Commission (NRC) reviews the human factors engineering (HFE) programs of applicants for nuclear power plant construction permits, operating licenses, standard design certifications, and combined operating licenses. The purpose of these safety reviews is to help ensure that personnel performance and reliability are appropriately supported. Detailed design review procedures and guidance for the evaluations is provided in three key documents: the Standard Review Plan (NUREG-0800), the HFE Program Review Model (NUREG-0711), and the Human-System Interface Design Review Guidelines (NUREG-0700). These documents were last revised in 2007, 2004 and 2002, respectively. The NRC is committed to the periodic update and improvement of the guidance to ensure that it remains a state-of-the-art design evaluation tool. To this end, the NRC is updating its guidance to stay current with recent research on human performance, advances in HFE methods and tools, and new technology being employed in plant and control room design. This paper describes the role of HFE guidelines in the safety review process and the content of the key HFE guidelines used. Then we will present the methodology used to develop HFE guidance and update these documents, and describe the current status of the update program.
Melton, Kristin R; Ni, Yizhao; Tubbs-Cooley, Heather L; Walsh, Kathleen E
Health information technology (HIT) interventions may improve neonatal patient safety but may also introduce new errors. The objective of this review was to evaluate the evidence for use of HIT interventions to improve safety in neonatal care. Evidence for improvement exists for interventions like computerized provider order entry in the neonatal population, but is lacking for several other interventions. Many unique applications of HIT are emerging as technology and use of the electronic health record expands. Future research should focus on the impact of these interventions in the neonatal population. Copyright © 2017 Elsevier Inc. All rights reserved.
Lewis, I.; Watson, B.; Tay, R.; White, K. M.
This paper reviews theoretical and empirical evidence relating to the effectiveness of fear (threat) appeals in improving driver safety. The results of the review highlight the mixed and inconsistent findings that have been reported in the literature. While fear arousal appears important for attracting attention, its contribution to behaviour…
Thaysen-Petersen, D; Bjerring, P; Dierickx, C; Nash, J F; Town, G; Haedersdal, M
Hair removal with professional light-based devices is established as an effective, mainstream treatment. The field of optical home-based hair removal is evolving and movement from control by physicians into hands of consumers warrants understanding efficacy and human safety. To systematically review and evaluate the efficacy and human safety of currently available home-based optical hair removal devices. A comprehensive Pub Med literature search was conducted which systematically identified publications of relevance. Prospective clinical trials were included whether controlled, uncontrolled or randomized and with a sample size of at least 10 individuals. We identified a total of seven studies: one controlled (CT) and six uncontrolled trials (UCTs). No randomized controlled trials (RCT) were recognized. The best evidence was found for IPL (intense pulsed light) (three devices, one CT, five UCTs) and limited evidence for laser devices (one diode laser, one UCT). Most studies evaluated short-term hair reduction up to 3 and 6 months following light exposure at different body sites. Hair reduction percentages ranged from 6% to 72% after repetitive treatments. The most frequently reported side-effect was erythema, but oedema, blistering, crusting and pigment changes were also reported. Theoretical concerns about ocular damage and paradoxical hair growth have not been reported in any of the studies reviewed. Available evidence from prospective, uncontrolled clinical trials indicates short-term hair removal efficacy of currently available home-use light-based hair removal devices. Additional controlled trials will be helpful to substantiate the efficacy and to better predict the incidence of adverse events associated with optical home-use hair removal. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.
C. Schaefer and N. Dupont
“Safety is the highest priority”: this statement from CERN is endorsed by the CMS management. An interpretation of this statement may bring you to the conclusion that you should stop working in order to avoid risks. If the safety is the priority, work is not! This would be a misunderstanding and misinterpretation. One should understand that “working safely” or “operating safely” is the priority at CERN. CERN personnel are exposed to different hazards on many levels on a daily basis. However, risk analyses and assessments are done in order to limit the number and the gravity of accidents. For example, this process takes place each time you cross the road. The hazard is the moving vehicle, the stake is you and the risk might be the risk of collision between both. The same principle has to be applied during our daily work. In particular, keeping in mind the general principles of prevention defined in the late 1980s. These principles wer...
M. Plagge, C. Schaefer and N. Dupont
Fire Safety – Essential for a particle detector The CMS detector is a marvel of high technology, one of the most precise particle measurement devices we have built until now. Of course it has to be protected from external and internal incidents like the ones that can occur from fires. Due to the fire load, the permanent availability of oxygen and the presence of various ignition sources mostly based on electricity this has to be addressed. Starting from the beam pipe towards the magnet coil, the detector is protected by flooding it with pure gaseous nitrogen during operation. The outer shell of CMS, namely the yoke and the muon chambers are then covered by an emergency inertion system also based on nitrogen. To ensure maximum fire safety, all materials used comply with the CERN regulations IS 23 and IS 41 with only a few exceptions. Every piece of the 30-tonne polyethylene shielding is high-density material, borated, boxed within steel and coated with intumescent (a paint that creates a thick co...
Levett-Jones, Tracy; Lapkin, Samuel
Simulation is defined as a technique used to replace or amplify real experiences with guided experiences that evoke or replace substantial aspects of the real world in a fully interactive manner. The use of simulation for educational purposes began decades ago with the use of low-fidelity simulations and has evolved at an unprecedented pace. Debriefing is considered by many to be an integral and critical part of the simulation process. However, different debriefing approaches have developed with little objective evidence of their effectiveness. The aim of this review was to identify, appraise and synthesise the best available evidence for the effectiveness of debriefing as it relates to simulation-based learning for health professionals. This review included any health professional participants regardless of gender, age or profession.Studies that evaluated the use of debriefing for the purpose of simulation-based learning were included.The review included randomised controlled trials.Outcome measures included objectively measured outcomes such as situational awareness, communication skills, teamwork, knowledge acquisition, and performance of psychomotor skills as assessed by validated instruments such the Anaesthesia Non-Technical Skills Scale, the Emergency Response Performance Tool, and the Clinical Simulation Tool. A three-stage comprehensive search strategy was utilised to search across ten electronic databases. English language studies published between January 2000 and September 2011 were considered for inclusion. Two independent reviewers assessed the methodological quality of each study selected for retrieval using standardised Joanna Briggs Institute critical appraisal tools. Data were extracted from studies using the standardised data extraction tool from the Joanna Briggs Institute DATA SYNTHESIS: Meta-analysis was not possible because of the different outcomes, control groups and interventions in the selected studies. Findings are therefore presented in
Full Text Available Nicole Mittmann,1 Marika Koo,1 Nick Daneman,2 Andrew McDonald,3 Michael Baker,4 Anne Matlow,5 Murray Krahn,6 Kaveh Shojania,7 Edward Etchells71Health Outcomes and Pharmaco Economics (HOPE Research Centre, Division of Clinical Pharmacology, 2Division of Infectious Diseases, 3Quality and Patient Safety, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; 4Patient Safety in Ontario, University Health Network, Toronto, ON, Canada; 5Infection Prevention and Control and Patient Safety, Hospital for Sick Children, Toronto, ON, Canada; 6Toronto Health Economics and Technology Assessment (THETA Collaborative, University of Toronto, Toronto, ON, Canada; 7University of Toronto Centre for Patient Safety, Sunnybrook Health Sciences Centre, Toronto, ON, CanadaBackground: Our objective was to determine the quality of literature in costing of the economic burden of patient safety.Methods: We selected 15 types of patient safety targets for our systematic review. We searched the literature published between 2000 and 2010 using the following terms: “costs and cost analysis,” “cost-effectiveness,” “cost,” and “financial management, hospital.” We appraised the methodologic quality of potentially relevant studies using standard economic methods. We recorded results in the original currency, adjusted for inflation, and then converted to 2010 US dollars for comparative purposes (2010 US$1.00 = 2010 €0.76. The quality of each costing study per patient safety target was also evaluated.Results: We screened 1948 abstracts, and identified 158 potentially eligible studies, of which only 61 (39% reported any costing methodology. In these 61 studies, we found wide estimates of the attributable costs of patient safety events ranging from $2830 to $10,074. In general hospital populations, the cost per case of hospital-acquired infection ranged from $2132 to $15,018. Nosocomial bloodstream infection was associated with costs ranging from $2604 to $22
Yang, Hong; Ozbay, Kaan; Ozturk, Ozgur; Xie, Kun
Work zone safety is one of the top priorities for transportation agencies. In recent years, a considerable volume of research has sought to determine work zone crash characteristics and causal factors. Unlike other non-work zone-related safety studies (on both crash frequency and severity), there has not yet been a comprehensive review and assessment of methodological approaches for work zone safety. To address this deficit, this article aims to provide a comprehensive review of the existing extensive research efforts focused on work zone crash-related analysis and modeling, in the hopes of providing researchers and practitioners with a complete overview. Relevant literature published in the last 5 decades was retrieved from the National Work Zone Crash Information Clearinghouse and the Transport Research International Documentation database and other public digital libraries and search engines. Both peer-reviewed publications and research reports were obtained. Each study was carefully reviewed, and those that focused on either work zone crash data analysis or work zone safety modeling were identified. The most relevant studies are specifically examined and discussed in the article. The identified studies were carefully synthesized to understand the state of knowledge on work zone safety. Agreement and inconsistency regarding the characteristics of the work zone crashes discussed in the descriptive studies were summarized. Progress and issues about the current practices on work zone crash frequency and severity modeling are also explored and discussed. The challenges facing work zone safety research are then presented. The synthesis of the literature suggests that the presence of a work zone is likely to increase the crash rate. Crashes are not uniformly distributed within work zones and rear-end crashes are the most prevalent type of crashes in work zones. There was no across-the-board agreement among numerous papers reviewed on the relationship between work zone
De Lyon, Alexander T. C.; Neville, Ross D.; Armour, Kathleen M.
Kinesiology researchers have long had an interest in physical activity, fitness, and health issues and in the professional education and work practices of teachers and coaches. The professional development needs and practices of "fitness professionals," however, have not been a major concern for researchers in the field. The purpose of…
L du toit
Full Text Available In the literature on the evolution of funding approaches there is criticism of traditional funding strategies and the promotion of inclusive models, such as South-South Cooperation (SSC and triangular models. The latter are felt to have a number of advantages. This article has four broad objectives: (i to present a literature review on the evolution of Southern approaches to development co-operation; (ii to indicate examples of current co-operative programmes in health and health professional education in Africa; (iii to assess the advantages and disadvantages of these models; and (iv to mention some emerging issues in monitoring and evaluation. The Boolean logic approach was used to search for applicable literature within three topic layers. Searches were conducted using PubMed, PLoS and other accessible databases. An initial draft of the article was presented to a group of academics and researchers at the Flemish Inter-University Council (VLIR-UOS-Primafamed annual workshop held in August 2010 in Swaziland. Comments and suggestions from the group were included in later versions of the article. It is important to note that the existence of various funding models implemented by a variety of actors makes it difficult to measure their effects. In health and health professional education, however, SSC and triangular models of aid provide conditions for more effective programming through their focus on participation and long-term involvement. With an eye towards evaluating programmes, a number of salient issues are emerging. The importance of context is highlighted.
Keijsers, Carolina J P W; van Hensbergen, Larissa; Jacobs, Lotte; Brouwers, Jacobus R B J; de Wildt, Dick J; ten Cate, Olle Th J; Jansen, Paul A F
AIMS Given the reported high rates of medication errors, especially in elderly patients, we hypothesized that current curricula do not devote enough time to the teaching of geriatric pharmacology. This review explores the quantity and nature of geriatric pharmacology education in undergraduate and postgraduate curricula for health professionals. METHODS Pubmed, Embase and PsycINFO databases were searched (from 1 January 2000 to 11 January 2011), using the terms ‘pharmacology’ and ‘education’ in combination. Articles describing content or evaluation of pharmacology education for health professionals were included. Education in general and geriatric pharmacology was compared. RESULTS Articles on general pharmacology education (252) and geriatric pharmacology education (39) were included. The number of publications on education in general pharmacology, but not geriatric pharmacology, has increased over the last 10 years. Articles on undergraduate and postgraduate education for 12 different health disciplines were identified. A median of 24 h (from 15 min to 4956 h) devoted to pharmacology education and 2 h (1–935 h) devoted to geriatric pharmacology were reported. Of the articles on education in geriatric pharmacology, 61.5% evaluated the teaching provided, mostly student satisfaction with the course. The strength of findings was low. Similar educational interventions were not identified, and evaluation studies were not replicated. CONCLUSIONS Recently, interest in pharmacology education has increased, possibly because of the high rate of medication errors and the recognized importance of evidence-based medical education. Nevertheless, courses on geriatric pharmacology have not been evaluated thoroughly and none can be recommended for use in training programmes. Suggestions for improvements in education in general and geriatric pharmacology are given. PMID:22416832
Crocker, Thomas F; Smith, Jaime K; Skevington, Suzanne M
To examine how accurately proxies evaluate quality of life (QoL) in people they know, using cross-cultural data from the multidimensional, multilingual World Health Organization Quality of Life assessment short-form (the WHOQOL-BREF) and whether accuracy varies by health condition or proxy type (eg, family/professional). Systematic review with meta-analysis: We searched five databases for reports of proxy-completed WHOQOL-BREF scores and aggregated results using a random-effects model. Minimal clinically important difference values were calculated. Analyses included nine studies (1980 dyads) of physical (n = 762) or mental (n = 604) health conditions, or intellectual disability (n = 614), in 10 countries. Mean person-proxy correlations ranged from 0.28 (social QoL) to 0.44 (physical QoL). Proxy measures were underestimates (ie, significantly lower than persons reported for themselves) for social [mean difference (MD) = 4.7, 95% confidence interval (CI): 1.8, 7.6], psychological (MD = 3.7, 95% CI: 0.6, 6.8), and physical (MD = 3.1, 95% CI: 0.6, 5.6) QoL. Underestimates varied significantly between health conditions for social (P Family members assessed psychological and environmental QoL better than professionals. Proxies tend to be imprecise, underestimating QoL, and should be aware of this tendency. Where health care is decided for others, family members' views about QoL should be prioritized. Copyright © 2015 Elsevier Inc. All rights reserved.
= 5) and quantitative (n = 4) as they met the inclusions criteria. The review identified that communication and relationships between health care professionals and patients was important for the patients’ ability to cope with cancer. The communication and relationship also had an impact on patients...
van de Bovenkamp, H.M.; Trappenburg, M.J.
Because family members take on caring tasks and also suffer as a consequence of the illness of the patient, communication between health-care professionals and family members of the patient is important. This review compares communication practices between these two parties in three different parts
Egeberg, Helen M.; McConney, Andrew; Price, Anne
This article reviews the conceptual and empirical research on classroom management to ascertain the extent to which there is consistency between the "advice" found in the research literature and the professional standards for teachers and initial teacher education, in regards to knowledge and perspectives about effective classroom…
Gärtner, Fania R.; Nieuwenhuijsen, Karen; van Dijk, Frank J. H.; Sluiter, Judith K.
Objective: This study aims to inventory aspects of work functioning of nurses and allied health professionals that are affected by common mental disorders. Design: A systematic review of psychological and occupational health literature was performed. Data sources: A sensitive systematic literature
Cleary, Josephine; Doody, Owen
The number of people with intellectual disability living into old age and developing dementia continues to increase. Dementia presents a wide range of challenges for staff due to progressive deterioration. This article presents the findings from a narrative literature review of professional caregivers' experiences of caring for individuals with…
Buswell, Marina; Lumbard, Philip; Prothero, Larissa; Lee, Caroline; Martin, Steven; Fleming, Jane; Goodman, Claire
To synthesise the existing literature on the roles that emergency medical services (EMS) play in unplanned, urgent and emergency care for older people with dementia (OPWD), to define these roles, understand the strength of current research and to identify where the focus of future research should lie. An integrative review of the synthesised reports, briefings, professional recommendations and evidence. English-language articles were included if they made any reference to the role of EMS in the urgent or emergency care of OPWD. Preparatory scoping and qualitative work with frontline ambulance and primary care staff and carers of OPWD informed our review question and subsequent synthesis. Seventeen literature sources were included. Over half were from the grey literature. There was no research that directly addressed the review question. There was evidence in reports, briefings and professional recommendations of EMS addressing some of the issues they face in caring for OPWD. Three roles of EMS could be drawn out of the literature: emergency transport, assess and manage and a 'last resort' or safety net role. The use of EMS by OPWD is not well understood, although the literature reviewed demonstrated a concern for this group and awareness that services are not optimum. Research in dementia care should consider the role that EMS plays, particularly if considering crises, urgent care responses and transitions between care settings. EMS research into new ways of working, training or extended paramedical roles should consider specific needs and challenges of responding to people with dementia. 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/
Chopra, Omesh K. [Argonne National Lab., IL (United States). Environmental Science Division; Diercks, Dwight R. [Argonne National Lab., IL (United States). Nuclear Engineering Division; Ma, David Chia-Chiun [Argonne National Lab., IL (United States). Environmental Science Division; Garud, Yogendra S. [Argonne National Lab., IL (United States). Environmental Science Division
At the request of the United States (U.S.) government, the International Atomic Energy Agency (IAEA) assembled a team of 20 senior safety experts to review the regulatory framework for the safety of operating nuclear power plants in the United States. This review focused on the effectiveness of the regulatory functions implemented by the NRC and on its commitment to nuclear safety and continuous improvement. One suggestion resulting from that review was that the U.S. Nuclear Regulatory Commission (NRC) incorporate lessons learned from periodic safety reviews (PSRs) performed in other countries as an input to the NRC’s assessment processes. In the U.S., commercial nuclear power plants (NPPs) are granted an initial 40-year operating license, which may be renewed for additional 20-year periods, subject to complying with regulatory requirements. The NRC has established a framework through its inspection, and operational experience processes to ensure the safe operation of licensed nuclear facilities on an ongoing basis. In contrast, most other countries do not impose a specific time limit on the operating licenses for NPPs, they instead require that the utility operating the plant perform PSRs, typically at approximately 10-year intervals, to assure continued safe operation until the next assessment. The staff contracted with Argonne National Laboratory (Argonne) to perform a pilot review of selected translated PSR assessment reports and related documentation from foreign nuclear regulatory authorities to identify any potential new regulatory insights regarding license renewal-related topics and NPP operating experience (OpE). A total of 14 PSR assessment documents from 9 countries were reviewed. For all of the countries except France, individual reports were provided for each of the plants reviewed. In the case of France, three reports were provided that reviewed the performance assessment of thirty-four 900-MWe reactors of similar design commissioned between 1978
Elvik, R.; Greibe, Poul
This paper presents a systematic review of studies that have evaluated the effects on road safety of porous asphalt. Porous asphalt is widely used on motorways in Europe, mainly in order to reduce traffic noise and increase road capacity. A meta-analysis was made of six studies, containing a total...... of eighteen estimates of the effect of porous asphalt on accident rates. No clear effect on road safety of porous asphalt was found. All summary estimates of effect indicated very small changes in accident rates and very few were statistically significant at conventional levels. Studies that have evaluated...... of these changes in risk factors on accident occurrence cannot be predicted. On the whole, the research that has been reported so far regarding road safety effects of porous asphalt is inconclusive. The studies are not of high quality and the findings are inconsistent....
Pang, Xiao-Na; Li, Zhao-Jie; Chen, Jing-Yu; Gao, Li-Juan; Han, Bei-Zhong
Standards and regulations related to spirit drinks have been established by different countries and international organizations to ensure the safety and quality of spirits. Here, we introduce the principles of food safety and quality standards for alcoholic beverages and then compare the key indicators used in the distinct standards of the Codex Alimentarius Commission, the European Union, the People's Republic of China, the United States, Canada, and Australia. We also discuss in detail the "maximum level" of the following main contaminants of spirit drinks: methanol, higher alcohols, ethyl carbamate, hydrocyanic acid, heavy metals, mycotoxins, phthalates, and aldehydes. Furthermore, the control measures used for potential hazards are introduced. Harmonization of the current requirements based on comprehensive scope analysis and the risk assessment approach will enhance both the trade and quality of distilled spirits. This review article provides valuable information that will enable producers, traders, governments, and researchers to increase their knowledge of spirit drink safety requirements, control measures, and research trends.
Zanin, Laís Mariano; da Cunha, Diogo Thimoteo; de Rosso, Veridiana Vera; Capriles, Vanessa Dias; Stedefeldt, Elke
This study presents an overview of the relationship between knowledge, attitudes and practices (KAP) of food handlers with training in food safety, in addition to proposing reflections on the training of food handlers, considering its responsibility for food safety and health of consumers. The review was based on the integrative method. The descriptors used were: (food handler), (knowledge, attitudes and practice) and (training). Six databases were searched, 253 articles were consulted and 36 original articles were included. Fifty per cent of the articles pointed that there was no proper translation of knowledge into attitudes/practices or attitudes into practices after training. Knowledge, attitudes and practices of food handlers are important for identifying how efficient training in food safety is allowing prioritize actions in planning training. The evaluation of KAP is the first step to understand the food handler's point of view. After this evaluation other diagnostic strategies become necessary to enhance this understanding. Copyright © 2017. Published by Elsevier Ltd.
Roberts, Matthew John; Perera, Marlon; Lawrentschuk, Nathan; Romanic, Diana; Papa, Nathan; Bolton, Damien
Journal clubs are an essential tool in promoting clinical evidence-based medical education to all medical and allied health professionals. Twitter represents a public, microblogging forum that can facilitate traditional journal club requirements, while also reaching a global audience, and participation for discussion with study authors and colleagues. The aim of the current study was to evaluate the current state of social media-facilitated journal clubs, specifically Twitter, as an example of continuing professional development. A systematic review of literature databases (Medline, Embase, CINAHL, Web of Science, ERIC via ProQuest) was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of Twitter, the followers of identified journal clubs, and Symplur was also performed. Demographic and monthly tweet data were extracted from Twitter and Symplur. All manuscripts related to Twitter-based journal clubs were included. Statistical analyses were performed in MS Excel and STATA. From a total of 469 citations, 11 manuscripts were included and referred to five Twitter-based journal clubs (#ALiEMJC, #BlueJC, #ebnjc, #urojc, #meded). A Twitter-based journal club search yielded 34 potential hashtags/accounts, of which 24 were included in the final analysis. The median duration of activity was 11.75 (interquartile range [IQR] 19.9, SD 10.9) months, with 7 now inactive. The median number of followers and participants was 374 (IQR 574) and 157 (IQR 272), respectively. An overall increasing establishment of active Twitter-based journal clubs was observed, resulting in an exponential increase in total cumulative tweets (R(2)=.98), and tweets per month (R(2)=.72). Cumulative tweets for specific journal clubs increased linearly, with @ADC_JC, @EBNursingBMJ, @igsjc, @iurojc, and @NephJC, and showing greatest rate of change, as well as total impressions per month since establishment. An average of two
Kagina, Benjamin M; Wiysonge, Charles S; Lesosky, Maia; Madhi, Shabir A; Hussey, Gregory D
Safety of vaccines remains a cornerstone of building public trust on the use of these cost-effective and life-saving public health interventions. In some settings, particularly Sub-Saharan Africa, there is a high prevalence of HIV infection and a high burden of vaccine-preventable diseases. There is evidence suggesting that the immunity induced by some commonly used vaccines is not durable in HIV-infected persons, and therefore, repeated vaccination may be considered to ensure optimal vaccine-induced immunity in this population. However, some vaccines, particularly the live vaccines, may be unsafe in HIV-infected persons. There is lack of evidence on the safety profile of commonly used vaccines among HIV-infected persons. We are therefore conducting a systematic review to assess the safety profile of routine vaccines administered to HIV-infected persons. We will select studies conducted in any setting where licensed and effective vaccines were administered to HIV-infected persons. We will search for eligible studies in PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Africa-Wide, PDQ-Evidence and CINAHL as well as reference lists of relevant publications. We will screen search outputs, select studies and extract data in duplicate, resolving discrepancies by discussion and consensus. Globally, immunisation is a major public health strategy to mitigate morbidity and mortality caused by various infectious disease-causing agents. In general, there are efforts to increase vaccination coverage worldwide, and for these efforts to be successful, safety of the vaccines is paramount, even among people living with HIV, who in some situations may require repeated vaccination. Results from this systematic review will be discussed in the context of the safety of routine vaccines among HIV-infected persons. From the safety perspective, we will also discuss whether repeat vaccination strategies may be feasible among HIV-infected persons
Sznitman, Sharon R; Zolotov, Yuval
The use of Cannabis for Therapeutic Purposes (CTP) has recently become legal in many places. These policy and legal modifications may be related to changes in cannabis perceptions, availability and use and in the way cannabis is grown and sold. This may in turn have effects on public health and safety. To better understand the potential effects of CTP legalization on public health and safety, the current paper synthesizes and critically discusses the relevant literature. Twenty-eight studies were identified by a comprehensive search strategy, and their characteristics and main findings were systematically reviewed according to the following content themes: CTP and illegal cannabis use; CTP and other public health issues; CTP, crime and neighbourhood disadvantage. The research field is currently limited by a lack of theoretical and methodological rigorous studies. The review shows that the most prevalent theme of investigation so far has been the relation between CTP and illegal cannabis use. In addition, the literature review shows that there is an absence of evidence to support many common concerns related to detrimental public health and safety effects of CTP legalization. Although lack of evidence provides some reassurance that CTP legalization may not have posed a substantial threat to public health and safety, this conclusion needs to be examined in light of the limitations of studies conducted so far. Furthermore, as CTP policy continues to evolve, including incorporation of greater commercialization, it is possible that the full effects of CTP legalization have yet to take place. Ensuring study quality will allow future research to better investigate the complex role that CTP plays in relation to society at large, and public health and safety in particular. Copyright © 2014 Elsevier B.V. All rights reserved.
Adams, David Z; Gruss, Richard; Abrahams, Alan S
Product issues can cost companies millions in lawsuits and have devastating effects on a firm's sales, image and goodwill, especially in the era of social media. The ability for a system to detect the presence of safety and efficacy (S&E) concerns early on could not only protect consumers from injuries due to safety hazards, but could also mitigate financial damage to the manufacturer. Prior studies in the field of automated defect discovery have found industry-specific techniques appropriate to the automotive, consumer electronics, home appliance, and toy industries, but have not investigated pain relief medicines and medical devices. In this study, we focus specifically on automated discovery of S&E concerns in over-the-counter (OTC) joint and muscle pain relief remedies and devices. We select a dataset of over 32,000 records for three categories of Joint & Muscle Pain Relief treatments from Amazon's online product reviews, and train "smoke word" dictionaries which we use to score holdout reviews, for the presence of safety and efficacy issues. We also score using conventional sentiment analysis techniques. Compared to traditional sentiment analysis techniques, we found that smoke term dictionaries were better suited to detect product concerns from online consumer reviews, and significantly outperformed the sentiment analysis techniques in uncovering both efficacy and safety concerns, across all product subcategories. Our research can be applied to the healthcare and pharmaceutical industry in order to detect safety and efficacy concerns, reducing risks that consumers face using these products. These findings can be highly beneficial to improving quality assurance and management in joint and muscle pain relief. Copyright © 2017 Elsevier B.V. All rights reserved.
Neyarapally, George A; Hammad, Tarek A; Pinheiro, Simone P; Iyasu, Solomon
Objectives Pharmacoepidemiological studies are an important hypothesis-testing tool in the evaluation of postmarketing drug safety. Despite the potential to produce robust value-added data, interpretation of findings can be hindered due to well-recognised methodological limitations of these studies. Therefore, assessment of their quality is essential to evaluating their credibility. The objective of this review was to evaluate the suitability and relevance of available tools for the assessment of pharmacoepidemiological safety studies. Design We created an a priori assessment framework consisting of reporting elements (REs) and quality assessment attributes (QAAs). A comprehensive literature search identified distinct assessment tools and the prespecified elements and attributes were evaluated. Primary and secondary outcome measures The primary outcome measure was the percentage representation of each domain, RE and QAA for the quality assessment tools. Results A total of 61 tools were reviewed. Most tools were not designed to evaluate pharmacoepidemiological safety studies. More than 50% of the reviewed tools considered REs under the research aims, analytical approach, outcome definition and ascertainment, study population and exposure definition and ascertainment domains. REs under the discussion and interpretation, results and study team domains were considered in less than 40% of the tools. Except for the data source domain, quality attributes were considered in less than 50% of the tools. Conclusions Many tools failed to include critical assessment elements relevant to observational pharmacoepidemiological safety studies and did not distinguish between REs and QAAs. Further, there is a lack of considerations on the relative weights of different domains and elements. The development of a quality assessment tool would facilitate consistent, objective and evidence-based assessments of pharmacoepidemiological safety studies. PMID:23015600
Full Text Available The special physical preparation as component of educational-battle to activity of students in the period of flying preparation and its influence on a capacity and safety of flights is shown. A role and value of raid of clock, special physical preparation of students of flying composition in accordance with the specific of military-professional and educational activity is considered. Facilities of the special physical preparation are presented: gymnastics, swimming, ski preparation, track-and-field, special trainings shells. The elements of the system of preparation of students of flying specialities are certain. Components, elements and factors of the special physical preparation in the period of flying preparation of students of different courses, step-up their physical and psychological preparedness are considered. Attention on providing of terms of safety of flights is accented.
Imbuing medical professionalism in relation to safety: a study protocol for a mixed-methods intervention focused on trialling an embedded learning approach that centres on the use of a custom designed board game.
Healthcare organisations have a responsibility for ensuring that the governance of workplace settings creates a culture that supports good professional practice. Encouraging such a culture needs to start from an understanding of the factors that make it difficult for health professionals to raise issues of concern in relation to patient safety. The focus of this study is to determine whether a customised education intervention, developed as part of the study, with interns and senior house officers (SHOs) can imbue a culture of medical professionalism in relation to patient safety and support junior doctors to raise issues of concern, while shaping a culture of responsiveness and learning.
Gong, Yang; Kang, Hong; Wu, Xinshuo; Hua, Lei
Electronic patient safety event reporting (e-reporting) is an effective mechanism to learn from errors and enhance patient safety. Unfortunately, the value of e-reporting system (a software or web server based platform) in patient safety research is greatly overshadowed by low quality reporting. This paper aims at revealing the current status of system features, detecting potential gaps in system design, and accordingly proposing suggestions for future design and implementation of the system. Three literature databases were searched for publications that contain informative descriptions of e-reporting systems. In addition, both online publicly accessible reporting forms and systems were investigated. 48 systems were identified and reviewed. 11 system design features and their frequencies of occurrence (Top 5: widgets (41), anonymity or confidentiality (29), hierarchy (20), validator (17), review notification (15)) were identified and summarized into a system hierarchical model. The model indicated the current e-reporting systems are at an immature stage in their development, and discussed their future development direction toward efficient and effective systems to improve patient safety.
Ernst, E; Pittler, M H
Feverfew (Tanacetum parthenium L.) is a popular herbal remedy often advocated for the prevention of migraine. The aims of this systematic review are to update the evidence from rigorous clinical trials for or against the efficacy of feverfew for migraine prevention and to provide a safety profile of this herbal remedy. Literature searches were performed using the following databases: Medline, Embase, Biosis, CISCOM and the Cochrane Library (all from their inception to December 1999). Only randomized, placebo-controlled, double-blind trials of feverfew mono-preparations for the prevention of migraine in human subjects were included. All articles were read by two independent reviewers. Data were extracted in a pre-defined, standardized fashion. The methodological quality of the trials was evaluated by the Jadad score. For the assessment of safety issues, major reference texts were also consulted. Six trials met the inclusion/exclusion criteria. The majority favour feverfew over placebo. Yet important caveats exist. The data also suggest that feverfew is associated with only mild and transient adverse effects and few other safety concerns. Feverfew is likely to be effective in the prevention of migraine. There are no major safety problems.
Vindrola-Padros, Cecilia; Mertnoff, Rosa; Lasmarias, Cristina; Gómez-Batiste, Xavier
The integration of palliative care (PC) education into medical and nursing curricula has been identified as an international priority. PC education has undergone significant development in Latin America, but gaps in the integration of PC courses into undergraduate and postgraduate curricula remain. The aim of our review was to systematically examine the delivery of PC education in Latin America in order to explore the content and method of delivery of current PC programs, identify gaps in the availability of education opportunities, and document common barriers encountered in the course of their implementation. We carried out a systematic review of peer-reviewed academic articles and grey literature. Peer-reviewed articles were obtained from the following databases: CINAHL Plus, Embase, the Web of Science, and Medline. Grey literature was obtained from the following directories: the International Association for Hospice and Palliative Care's Global Directory of Education in Palliative Care, the Worldwide Hospice Palliative Care Alliance's lists of palliative care resources, the Latin American Association for Palliative Care's training resources, and the Latin American Atlas of Palliative Care. The inclusion criteria were that the work: (1) focused on describing PC courses; (2) was aimed at healthcare professionals; and (3) was implemented in Latin America. The PRISMA checklist was employed to guide the reporting of methods and findings. We found 36 programs that were delivered in 8 countries. Most of the programs were composed of interdisciplinary teams, taught at a postgraduate level, focused on pain and symptom management, and utilized classroom-based methods. The tools for evaluating the courses were rarely reported. The main barriers during implementation included: a lack of recognition of the importance of PC education, a lack of funding, and the unavailability of trained teaching staff. Considerable work needs to be done to improve the delivery of PC
Meckler, Garth; Hansen, Matthew; Lambert, William; O'Brien, Kerth; Dickinson, Caitlin; Dickinson, Kathryn; Van Otterloo, Joshua; Guise, Jeanne-Marie
Studies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events. As part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period. Regression models were used to identify factors associated with increased risk of potentially severe safety events. Patient safety events were categorized as: Unintended injury; Near miss; Suboptimal action; Error; or Management complication ("UNSEMs") and their severity and potential preventability were assessed. Overall, 265 of 378 (70.1%) unique charts contained at least one UNSEM, including 146 (32.8%) errors and 199 (44.7%) suboptimal actions. Sixty-one UNSEMs were categorized as potentially severe (23.3% of UNSEMs) and nearly half (45.3%) were rated entirely preventable. Two factors were associated with heightened risk for a severe UNSEM: (1) age 29 days to 11 months (OR 3.3, 95% CI 1.25-8.68); (2) cases requiring resuscitation (OR 3.1, 95% CI 1.16-8.28). Severe UNSEMs were disproportionately higher among cardiopulmonary arrests (8.5% of cases, 34.4% of severe UNSEMs). During high-risk out-of-hospital care of pediatric patients, safety events are common, potentially severe, and largely preventable. Infants and those requiring resuscitation are important areas of focus to reduce out-of-hospital pediatric patient safety events.
Blauw, Helga; Keith-Hynes, Patrick; Koops, Robin; DeVries, J Hans
As clinical studies with artificial pancreas systems for automated blood glucose control in patients with type 1 diabetes move to unsupervised real-life settings, product development will be a focus of companies over the coming years. Directions or requirements regarding safety in the design of an artificial pancreas are, however, lacking. This review aims to provide an overview and discussion of safety and design requirements of the artificial pancreas. We performed a structured literature search based on three search components-type 1 diabetes, artificial pancreas, and safety or design-and extended the discussion with our own experiences in developing artificial pancreas systems. The main hazards of the artificial pancreas are over- and under-dosing of insulin and, in case of a bi-hormonal system, of glucagon or other hormones. For each component of an artificial pancreas and for the complete system we identified safety issues related to these hazards and proposed control measures. Prerequisites that enable the control algorithms to provide safe closed-loop control are accurate and reliable input of glucose values, assured hormone delivery and an efficient user interface. In addition, the system configuration has important implications for safety, as close cooperation and data exchange between the different components is essential.
Mittmann, Nicole; Koo, Marika; Daneman, Nick; McDonald, Andrew; Baker, Michael; Matlow, Anne; Krahn, Murray; Shojania, Kaveh G; Etchells, Edward
Our objective was to determine the quality of literature in costing of the economic burden of patient safety. We selected 15 types of patient safety targets for our systematic review. We searched the literature published between 2000 and 2010 using the following terms: "costs and cost analysis," "cost-effectiveness," "cost," and "financial management, hospital." We appraised the methodologic quality of potentially relevant studies using standard economic methods. We recorded results in the original currency, adjusted for inflation, and then converted to 2010 US dollars for comparative purposes (2010 US$1.00 = 2010 €0.76). The quality of each costing study per patient safety target was also evaluated. We screened 1948 abstracts, and identified 158 potentially eligible studies, of which only 61 (39%) reported any costing methodology. In these 61 studies, we found wide estimates of the attributable costs of patient safety events ranging from $2830 to $10,074. In general hospital populations, the cost per case of hospital-acquired infection ranged from $2132 to $15,018. Nosocomial bloodstream infection was associated with costs ranging from $2604 to $22,414. There are wide variations in the estimates of economic burden due to differences in study methods and methodologic quality. Greater attention to methodologic standards for economic evaluations in patient safety is needed.
Raftery, J; Bryant, J; Powell, J; Kerr, C; Hawker, S
To review UK guidelines regarding the use of financial incentives for healthcare professionals to become involved in clinical trials, and to survey perceptions and current practice. Electronic databases were searched from inception to June 2006. Interviews were held with NHS healthcare professionals, research managers from the pharmaceutical industry and members of the public. From the searches, 634 identified studies were assessed for inclusion in the systematic review, but only three met the criteria for data extraction. Fifty-eight individuals were interviewed: 38 chief investigators, six non-research active clinicians, eight public and six pharmaceutical managers. Investigators were selected from those funded by the HTA Programme, the other by 'snowballing' and personal contact. The evidence from the literature was limited and inconclusive. In UK guidelines, the issues around payments to clinicians or patients were implied rather than stated, usually linked to discussion of conflict of interest and disclosure of any such conflicts. Developments in NHS research governance had led to increased transparency in all payments for research participation and for payments to be made to NHS Trusts rather than individual clinicians. While reimbursement of costs incurred by research was strongly supported by the interviewees, payments to incentivise recruitment were not. A code of practice was suggested for payments in publicly funded trials, which was closely linked to the principles of Good Clinical Practice in research. Factors such as interest in the topic, scope for patient benefit and good communication were considered more important than payment. Interviews with the general public indicated low levels of awareness of the existence of payments to clinicians linked to patient recruitment in trials, and unanimous support for full disclosure. Interviews with managers in the pharmaceutical industry showed greater familiarity with payments for research involvement. GPs
Piening, Sigrid; de Graeff, Pieter A; Straus, Sabine M J M; Haaijer-Ruskamp, Flora M; Mol, Peter G M
The usefulness and the impact of Direct Healthcare Professional Communications (DHPCs, or 'Dear Doctor letters') in changing the clinical behaviour of physicians have been debated. Changes in the current risk communication methods should preferably be based on the preferences of the healthcare professionals, to optimize the uptake of the message. The aim of this study was to assess whether safety issues are communicated more effectively with an additional e-mail sent by the Dutch Medicines Evaluation Board (MEB) than with the DHPC only. A randomized controlled trial was conducted amongst ophthalmologists and hospital pharmacists in the Netherlands, who were the target group of a DHPC that was issued for pegaptanib, a drug that is administered intra-ocularly in patients with macular degeneration. The intervention group (N = 110) received the pegaptanib DHPC, as well as the MEB e-mail. The control group (N = 105) received the traditional paper-based DHPC only. Two weeks later, the study population received an invitation to fill out an online questionnaire. Questions were asked about the respondents' knowledge and attitude regarding the pegaptanib issue, and any action they had consequently taken. Additional questions were asked about their satisfaction with the DHPC and the e-mail, and their preferred source of such information. Forty respondents (18.6%) completed the questionnaire. Eighty-one percent of the respondents in the intervention group (N = 21) and 47% of the control group (N = 19) correctly indicated that a serious increase in intra-ocular pressure could be caused by pegaptanib injections (Fishers' exact test, p = 0.046). Nine respondents in the intervention group versus none of the control group respondents indicated that they had taken action in response to the pegaptanib safety issue (Fishers' exact test, p = 0.01). The majority of both the intervention group and the control group confirmed that they would like to receive an MEB e-mail with safety
Wareing, A; Buissink, C; Harper, D; Gellert Olesen, M; Soto, M; Braico, S; Van Laer, P; Gremion, I; Rainford, L
The aim of the study was to complete a collaborative review of Radiography continuing professional development (CPD) research material to support the production of European Federation of Radiographer Societies (EFRS) CPD recommendations. A meta-ethnography approach to literature review was applied focussing upon commonalities rather than discrepancies between research outcomes. This facilitated exploration of context across the geographical region of Europe with national variations in CPD governance. The seven phases of the meta-ethnographic approach were followed by two independent experienced researchers. A third researcher mediated the findings which were then explored collaboratively with the EFRS CPD working group for concordance. Phase seven of the meta-ethnography involved interpreting an expression of the synthesis from the previous stages. Six main corroborating themes emerged in this process and following mediation were expressed as themes; knowledge, skills & competency, needs/gap analysis, multi-layered/multi-modal, barriers and drivers; regulation vs autonomy; fostering collaboration - harnessing technology. The primary feature of CPD activity should be the resulting impact - to patients, the service, the profession and the individual; with all stakeholders working in partnership. CPD activity must be flexible/multi-modal to support the changing growth/dynamic workforce. All stakeholders should utilise communication and technology resources and make efforts to improve collaboration between the management, regulators and educators to support Radiographers to develop meaningful CPD. Health services across Europe are under increasing stress and a principal factor going forwards will be managing increasing demands on healthcare staff whilst supporting enhancement of the knowledge, skills and competency base. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.
Kanabar, Dipak J
The antipyretic analgesics, paracetamol, and non-steroidal anti-inflammatory agents NSAIDs are one of the most widely used classes of medications in children. The aim of this review is to determine if there are any clinically relevant differences in safety between ibuprofen and paracetamol that may recommend one agent over the other in the management of fever and discomfort in children older than 3 months of age.
Ward, Jane K; Armitage, Gerry
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.
Benic, Goran I; Wolleb, Karin; Sancho-Puchades, Manuel; Hämmerle, Christoph H F
The purpose of the present systematic review was to evaluate the scientific literature regarding the professional assessment of aesthetics in implant dentistry. An electronic search of Medline database and Cochrane Central Register of Controlled Trials was performed, and complemented by a manual search. Clinical or validation studies (Part 1) and randomized-controlled trials (RCTs) (Part 2) reporting parameters and methods for the assessment of aesthetics were included. The information regarding the assessment of aesthetics was extracted. The methodological quality of RCTs was evaluated by means of the Cochrane Collaboration's Tool for assessing risk of bias. The search yielded 149 and 32 publications in Part 1 and Part 2, respectively. A great diversity with regard to parameters, methods and measurement units used for the assessment of aesthetics was found among the included studies. With respect to time points of assessment there were significant differences between the RCTs. Only two RCTs fulfilled all the criteria of the The Cochrane Collaboration's Tool for assessing risk of bias. Due to the differences of the study designs, parameters and methods used for the assessment of aesthetics, comparisons between studies should be interpreted with caution. Only a limited number of RCTs offer sound evidence on aesthetic outcomes in implant dentistry. © 2012 John Wiley & Sons A/S.
Jefferson, Therese; Klass, Des; Lord, Linley; Nowak, Margaret; Thomas, Gail
Leadership studies which focus on categorising leadership styles have been critiqued for failure to consider the lived experience of leadership. The purpose of this paper is to use the framework of Jepson's model of contextual dynamics to explore whether this framework assists understanding of the "how and why" of lived leadership experience within the nursing profession. Themes for a purposeful literature search and review, having regard to the Jepson model, are drawn from the contemporary and dynamic context of nursing. Government reports, coupled with preliminary interviews with a nurseleadership team, guided selection of contextual issues. The contextual interactions arising from managerialism, existing hierarchical models of leadership and increasing knowledge work provided insights into leadership experience in nursing, in the contexts of professional identity and changing educational and generational profiles of nurses. The authors conclude that employing a contextual frame provides insights in studying leadership experience. The author propose additions to the cultural and institutional dimensions of Jepson's model. The findings have implications for structuring and communicating key roles and policies relevant to nursing leadership. These include the need to: address perceptions around the legitimacy of current nursing leaders to provide clinical leadership; modify hierarchical models of nursing leadership; address implications of the role of the knowledge workers. Observing nursing leadership through the lens of Jepson's model of contextual dynamics confirms that this is an important way of exploring how leadership is enacted. The authors found, however, the model also provided a useful frame for considering the experience and understanding of leadership by those to be led.
Seys, Deborah; Wu, Albert W; Van Gerven, Eva; Vleugels, Arthur; Euwema, Martin; Panella, Massimiliano; Scott, Susan D; Conway, James; Sermeus, Walter; Vanhaecht, Kris
Adverse events within health care settings can lead to two victims. The first victim is the patient and family and the second victim is the involved health care professional. The latter is the focus of this review. The objectives are to determine definitions of this concept, research the prevalence and the impact of the adverse event on the second victim, and the used coping strategies. Therefore a literature research was performed by using a three-step search procedure. A total of 32 research articles and 9 nonresearch articles were identified. The second victim phenomenon was first described by Wu in 2000. In 2009, Scott et al. introduced a detailed definition of second victims. The prevalence of second victims after an adverse event varied from 10.4% up to 43.3%. Common reactions can be emotional, cognitive, and behavioral. The coping strategies used by second victims have an impact on their patients, colleagues, and themselves. After the adverse event, defensive as well as constructive changes have been reported in practice. The second victim phenomenon has a significant impact on clinicians, colleagues, and subsequent patients. Because of this broad impact it is important to offer support for second victims. When an adverse event occurs, it is critical that support networks are in place to protect both the patient and involved health care providers.
Giorgini, Paolo; Rubenfire, Melvyn; Bard, Robert L; Jackson, Elizabeth A; Ferri, Claudio; Brook, Robert D
Although regular aerobic exercise improves overall health, increased physical activity can lead to heightened exposures to a variety of air pollutants. As such, the cardiovascular health benefits of exercise may be abrogated to some degree by the harmful actions of inhaled pollutants. This review aims to provide an up-to-date summary for health professionals of the cardiovascular responses as well as the risks of exercising in air pollution. Aerobic exercise augments the overall inhaled air pollution dose, potentiates the diffusion of pollutants into circulating blood, and augments oxidative stress and inflammation. The inhalation of particulate matter during exercise can raise blood pressure, impair vascular function, and unfavorably affect autonomic balance. Several studies suggest that air pollutants can increase ischemic symptoms and signs during exercise and can even be capable of impairing exercise performance in some scenarios. The overall evidence supports that the risk-to-benefit ratio generally favors that health care providers continue to strongly encourage their patients to perform regular aerobic exercise. Nevertheless, a greater effort should be made to educate patients about the risks of air pollutant exposures during exercise, particularly those at heightened cardiovascular risk. Although no strategy has been directly tested to reduce morbidity and mortality rate, several prudent actions can be taken to lessen the degree of exposures during exercise which may thereby help mitigate the adverse effects of air pollutants on exercise performance and cardiovascular risk.
Del Prato D
Full Text Available Darlene Del Prato1, Esther Bankert2, Patricia Grust1, Joanne Joseph31Department of Nursing and Health Professions; 2Provost; 3Department of Psychology, State University of New York, Institute of Technology, Utica, NY, USAAbstract: Nurse educators are facing the challenge of creating new ways of teaching and facilitating enhanced learning experiences in clinical practice environments that are inherently complex, highly demanding, and unpredictable. The literature consistently reports the negative effects of excess stress and unsupportive relationships on wellbeing, self-efficacy, self-esteem, learning, persistence, and success. However, understanding contributing factors of stress, such as the student's experiences of uncaring and oppressive interactions, is clearly not adequate. The transformation of nursing education requires a paradigm shift that embraces collegiality, collaboration, caring, and competence for students and the faculty. This paper reviews the literature on stress and its effects on nursing students. Grounded in theory related to stress and human caring, this paper focuses on the clinical environment and faculty-student relationships as major sources of students' stress and offers strategies for mitigating stress while fostering learning and professional socialization of future nurses.Keywords: stress, faculty-student relationships, stress management, caring learning environment, incivility
The purpose of this document is to develop an environmental, health and safety (EH and S) assessment and begin a site - specific assessment of these and socio - economic impacts for the magnetohydrodynamics program of the United States Department of Energy. This assessment includes detailed scientific and technical information on the specific EH and S issues mentioned in the MHD Environmental Development Plan. A review of current literature on impact-related subjects is also included. This document addresses the coal-fired, open-cycle MHD technology and reviews and assesses potential EH and S impacts resulting from operation of commercially-installed technology.
Hunt, Farren [Idaho National Lab. (INL), Idaho Falls, ID (United States)
Idaho National Laboratory (INL) performed an Annual Effectiveness Review of the Integrated Safety Management System (ISMS), per 48 Code of Federal Regulations (CFR) 970.5223 1, “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and identified target areas for focused improvements and assessments for Fiscal Year (FY) 2014. Results of the FY 2013 annual effectiveness review demonstrate that the INL’s ISMS program is “Effective” and continually improving and shows signs of being significantly strengthened. Although there have been unacceptable serious events in the past, there has also been significant attention, dedication, and resources focused on improvement, lessons learned and future prevention. BEA’s strategy of focusing on these improvements includes extensive action and improvement plans that include PLN 4030, “INL Sustained Operational Improvement Plan, PLN 4058, “MFC Strategic Excellence Plan,” PLN 4141, “ATR Sustained Excellence Plan,” and PLN 4145, “Radiological Control Road to Excellence,” and the development of LWP 20000, “Conduct of Research.” As a result of these action plans, coupled with other assurance activities and metrics, significant improvement in operational performance, organizational competence, management oversight and a reduction in the number of operational events is being realized. In short, the realization of the fifth core function of ISMS (feedback and continuous improvement) and the associated benefits are apparent.
Glasgow, G P
Low melting temperature bismuth alloys that contain about 20% to 25% lead and 10% cadmium are widely used in radiotherapy to construct shielding blocks. Since 1980, five papers have addressed questions concerning potential metal toxicity, safe shop practices, measurement of airborne vapors and metal particulates, and the results of biological testing of personnel fabricating secondary field shaping blocks. In February, 1990, the Occupational Safety and Health Administration (OSHA), proposed new occupational air concentration safety standards for cadmium and cadmium compounds. This review presents the potential toxicity of the components metals in low melting temperature bismuth lead alloys, reviews the proposed OSHA air concentrations standards, and describes proper practices of shop safety required to minimize the hazards of these metals and other potentially hazardous materials used in the block fabrication process. The review reveals that if proper practices are followed, fabrication of those blocks, including those containing cadmium, should not produce a shop environment that would produce metal toxicity in employees, and radiotherapy mold room personnel are unlikely to generate air concentrations of cadmium that exceed new proposed standards.
Gerusa Clazer Halila
Full Text Available Over-the-counter medicines are available without prescription because of their safety and effectiveness, to treat minor ailments and symptoms. The objective of the study was to analyze the availability and quality of systematic reviews published about nonprescription medicines, identifying the groups for which there are gaps in evidence. We identified published articles through the Cochrane Database of Systematic Review and MEDLINE, from the start of the database until May 2012, using the search terms "nonprescription drugs," "over the counter," and "OTC." We searched for articles that describe systematic reviews addressing the efficacy and safety of drugs dispensed without a prescription, according to the lists published by the Association of the European Self-Medication Industry and in Brazil, in the clinical conditions listed in Groups and Specified Therapeutic Indications. We included 49 articles, 18 articles were of moderate quality and 31 of high quality. Of the studies, 74.5% demonstrated efficacy in favor of the use of drugs evaluated. Of the 24 studies that evaluated safety, 21% showed evidence unfavorable to the drug. Overall, the evidence found in the studies included in the overview is favorable to the use of the drugs evaluated. However, there are gaps in evidence for some therapy groups.
Schwappach, David L B; Gehring, Katrin
To investigate the likelihood of speaking up about patient safety in oncology and to clarify the effect of clinical and situational context factors on the likelihood of voicing concerns. 1013 nurses and doctors in oncology rated four clinical vignettes describing coworkers' errors and rule violations in a self-administered factorial survey (65% response rate). Multiple regression analysis was used to model the likelihood of speaking up as outcome of vignette attributes, responder's evaluations of the situation and personal characteristics. Respondents reported a high likelihood of speaking up about patient safety but the variation between and within types of errors and rule violations was substantial. Staff without managerial function provided significantly higher levels of decision difficulty and discomfort to speak up. Based on the information presented in the vignettes, 74%-96% would speak up towards a supervisor failing to check a prescription, 45%-81% would point a coworker to a missed hand disinfection, 82%-94% would speak up towards nurses who violate a safety rule in medication preparation, and 59%-92% would question a doctor violating a safety rule in lumbar puncture. Several vignette attributes predicted the likelihood of speaking up. Perceived potential harm, anticipated discomfort, and decision difficulty were significant predictors of the likelihood of speaking up. Clinicians' willingness to speak up about patient safety is considerably affected by contextual factors. Physicians and nurses without managerial function report substantial discomfort with speaking up. Oncology departments should provide staff with clear guidance and trainings on when and how to voice safety concerns.
Sauro, Khara M; Wiebe, Natalie; Macrodimitris, Sophie; Wiebe, Samuel; Lukmanji, Sara; Jetté, Nathalie
The epilepsy monitoring unit (EMU) is a valuable resource for optimizing management of persons with epilepsy, but may place patients at risk for adverse events due to withdrawal of treatment and induction of symptoms. The purpose of this study was to synthesize data on the safety and quality of care in EMUs to inform the development of quality indicators for EMUs. A systematic review was conducted according to the Preferred Reporting and Items for Systematic Review and Meta-Analysis (PRISMA) statement. The search strategy, which included broad search terms and synonyms pertaining to the EMU, was run in six medical databases and included conference proceedings. Data abstracted included patient and EMU demographics and quality and safety variables. Study quality was evaluated using a modified 15-item Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Descriptive statistics and meta-analyses were used to describe and synthesize the evidence. The search yielded 7,601 references, of which 604 were reviewed in full text. One-hundred thirty-five studies were included. The quality and safety data came from 181,823 patients and reported on 34 different quality and safety variables. Included studies commonly reported the number of patients (108 studies; median number patients, 171.5), age (49 studies; mean age 35.7 years old), and the reason for admission (34 studies). The most common quality and safety data reported were the utility of the EMU admission (38 studies). Thirty-three studies (24.4%) reported on adverse events, and yielded a pooled proportion of adverse events of 7% (95% confidence interval [CI] 5-9%). The mean quality score was 73.3% (standard deviation [SD] 17.2). This study demonstrates that there is a great deal of variation in the reporting of quality and safety measures and in the quality and safety in EMUs. Study quality also varied considerably from one study to the next. These findings highlight the need to develop
Hunt, Farren J. [Idaho National Lab. (INL), Idaho Falls, ID (United States)
Idaho National Laboratory’s (INL’s) Integrated Safety Management System (ISMS) effectiveness review of fiscal year (FY) 2016 shows that INL has integrated management programs and safety elements throughout the oversight and operational activities performed at INL. The significant maturity of Contractor Assurance System (CAS) processes, as demonstrated across INL’s management systems and periodic reporting through the Management Review Meeting process, over the past two years has provided INL with current real-time understanding and knowledge pertaining to the health of the institution. INL’s sustained excellence of the Integrated Safety and effective implementation of the Worker Safety and Health Program is also evidenced by other external validations and key indicators. In particular, external validations include VPP, ISO 14001, DOELAP accreditation, and key Laboratory level indicators such as ORPS (number, event frequency and severity); injury/illness indicators such as Days Away, Restricted and Transfer (DART) case rate, back & shoulder metric and open reporting indicators, demonstrate a continuous positive trend and therefore improved operational performance over the last few years. These indicators are also reflective of the Laboratory’s overall organizational and safety culture improvement. Notably, there has also been a step change in ESH&Q Leadership actions that have been recognized both locally and complex-wide. Notwithstanding, Laboratory management continues to monitor and take action on lower level negative trends in numerous areas including: Conduct of Operations, Work Control, Work Site Analysis, Risk Assessment, LO/TO, Fire Protection, and Life Safety Systems, to mention a few. While the number of severe injury cases has decreased, as evidenced by the reduction in the DART case rate, the two hand injuries and the fire truck/ambulance accident were of particular concern. Aggressive actions continue in order to understand the causes and
Lee, Yong Hee; Lee, Jung Woon; Park, Jae Chang (and others)
This report describes the research results of human factors assessment on the MMI(Man Machine Interface) equipment as part of Periodic Safety Review(PSR) of Yonggwang Unit no. 1, 2. As MMI is a key factor among human factors to be reviewed in PSR, we reviewed the MMI components of nuclear power plants in aspect of human factors engineering. The availability, suitability, and effectiveness of the MMI devices were chosen to be reviewed. The MMI devices were investigated through the review of design documents related to the MMI, survey of control panels, evaluation of experts, and experimental assessment. Checklists were used to perform this assessment and record the review results. The items mentioned by the expert comments to review in detail in relation with task procedures were tested by experiments with operators' participation. For some questionable issues arisen during this MMI review, operator workload and possibility of errors in operator actions were analysed. The reviewed MMI devices contain MCR(Main Control Room), SPDS(Safety Parameter Display System), RSP(Remote Shutdown Panel), and the selected LCBs(Local Control Boards) importantly related to safety. As results of the assessments, any significant problem challenging the safety was not found on human factors in the MMI devices. However, several small items to be changed and improved in suitability of MMI devices were discovered. An action plan is recommended to accommodate the suggestions and review comments. It will enhance the plant safety on MMI area.
Harrison S. Campbell, Jr.
The relationship between professional sports and cities is an important public policy issue that has received growing attention in the academic literature. Investment in sports facilities is frequently rationalized on the basis of economic impact and positive spillover effects to cities and regions, yet there is mounting suspicion that professional sports have only a marginal impact on their surrounding area. Why are professional sports so important? What factors help explain the recent stadi...
Professional socialisation refers to the acquisition of values, attitudes, skills and knowledge pertaining to a profession. This article reviews the definition and conceptualisation of professional socialisation through anticipatory and formal professional socialisation processes. It describes the core elements of professional ...
Redmond, Elizabeth C; Griffith, Christopher J
Epidemiological data from Europe, North America, Australia, and New Zealand indicate that a substantial proportion of foodborne disease is attributable to improper food preparation practices in consumers' homes. International concern about consumer food safety has prompted considerable research to evaluate domestic food-handling practices. The majority of consumer food safety studies in the last decade have been conducted in the United Kingdom and Northern Ireland (48%) and in the United States (42%). Surveys (questionnaires and interviews), the most frequent means of data collection, were used in 75% of the reviewed studies. Focus groups and observational studies have also been used. One consumer food safety study examined the relationship between pathogenic microbial contamination from raw chicken and observed food-handling behaviors, and the results of this study indicated extensive Campylobacter cross-contamination during food preparation sessions. Limited information about consumers' attitudes and intentions with regard to safe food-handling behaviors has been obtained, although a substantial amount of information about consumer knowledge and self-reported practices is available. Observation studies suggest that substantial numbers of consumers frequently implement unsafe food-handling practices. Knowledge, attitudes, intentions, and self-reported practices did not correspond to observed behaviors, suggesting that observational studies provide a more realistic indication of the food hygiene actions actually used in domestic food preparation. An improvement in consumer food-handling behavior is likely to reduce the risk and incidence of foodborne disease. The need for the development and implementation of food safety education strategies to improve specific food safety behaviors is reviewed in this paper.
Hathaway, Julia; Maibach, Edward W
Through a systematic search of English language peer-reviewed studies, we assess how health professionals and the public, worldwide, perceive the health implications of climate change. Among health professionals, perception that climate change is harming health appears to be high, although self-assessed knowledge is low, and perceived need to learn more is high. Among the public, few North Americans can list any health impacts of climate change, or who is at risk, but appear to view climate change as harmful to health. Among vulnerable publics in Asia and Africa, awareness of increasing health harms due to specific changing climatic conditions is high. Americans across the political and climate change opinion spectra appear receptive to information about the health aspects of climate change, although findings are mixed. Health professionals feel the need to learn more, and the public appears open to learning more, about the health consequences of climate change.
Vanparijs, Jef; Int Panis, Luc; Meeusen, Romain; de Geus, Bas
Cycling, as an active mode of transportation, has well-established health benefits. However, the safety of cyclists in traffic remains a major concern. In-depth studies of potential risk factors and safety outcomes are needed to ensure the most appropriate actions are taken to improve safety. However, the lack of reliable exposure data hinders meaningful analysis and interpretation. In this paper, we review the bicycle safety literature reporting different methods for measuring cycling exposure and discuss their findings. A literature search identified studies on bicycle safety that included a description of how cycling exposure was measured, and what exposure units were used (e.g. distance, time, trips). Results were analyzed based on whether retrospective or prospective measurement of exposure was used, and whether safety outcomes controlled for exposure. We analyzed 20 papers. Retrospective studies were dominated by major bicycle accidents, whereas the prospective studies included minor and major bicycle accidents. Retrospective studies indicated higher incidence rates (IR) of accidents for men compared to women, and an increased risk of injury for cyclists aged 50 years or older. There was a lack of data for cyclists younger than 18 years. The risk of cycling accidents increased when riding in the dark. Wearing visible clothing or a helmet, or having more cycling experience did not reduce the risk of being involved in an accident. Better cyclist-driver awareness and more interaction between car driver and cyclists, and well maintained bicycle-specific infrastructure should improve bicycle safety. The need to include exposure in bicycle safety research is increasingly recognized, but good exposure data are often lacking, which makes results hard to interpret and compare. Studies including exposure often use a retrospective research design, without including data on minor bicycle accidents, making it difficult to compare safety levels between age categories or
Johnson, Mark J; May, Carl R
Translating research evidence into routine clinical practice is notoriously difficult. Behavioural interventions are often used to change practice, although their success is variable and the characteristics of more successful interventions are unclear. We aimed to establish the characteristics of successful behaviour change interventions in healthcare. We carried out a systematic overview of systematic reviews on the effectiveness of behaviour change interventions with a theory-led analysis using the constructs of normalisation process theory (NPT). MEDLINE, CINAHL, PsychINFO and the Cochrane Library were searched electronically from inception to July 2015. Primary and secondary care. Participants were any patients and healthcare professionals in systematic reviews who met the inclusion criteria of having examined the effectiveness of professional interventions in improving professional practice and/or patient outcomes. Professional interventions as defined by the Cochrane Effective Practice and Organisation of Care Review Group. Success of each intervention in changing practice or patient outcomes, and their mechanisms of action. Reviews were coded as to the interventions included, how successful they had been and which NPT constructs its component interventions covered. Searches identified 4724 articles, 67 of which met the inclusion criteria. Interventions fell into three main categories: persuasive; educational and informational; and action and monitoring. Interventions focusing on action or education (eg, Audit and Feedback, Reminders, Educational Outreach) acted on the NPT constructs of Collective Action and Reflexive Monitoring, and reviews using them tended to report more positive outcomes. This theory-led analysis suggests that interventions which contribute to normative restructuring of practice, modifying peer group norms and expectations (eg, educational outreach) and relational restructuring, reinforcing modified peer group norms by emphasising the
Lear, R; Godfrey, A D; Riga, C; Norton, C; Vincent, C; Bicknell, C D
A systems approach to patient safety proposes that a wide range of factors contribute to surgical outcome, yet the impact of team, work environment, and organisational factors, is not fully understood in arterial surgery. The aim of this systematic review is to summarize and discuss what is already known about the impact of system factors on quality and safety in arterial surgery. A systematic review of original research papers in English using MEDLINE, Embase, PsycINFO, and Cochrane databases, was performed according to PRISMA guidelines. Independent reviewers selected papers according to strict inclusion and exclusion criteria, and using predefined data fields, extracted relevant data on team, work environment, and organisational factors, and measures of quality and/or safety, in arterial procedures. Twelve papers met the selection criteria. Study endpoints were not consistent between papers, and most failed to report their clinical significance. A variety of tools were used to measure team skills in five papers; only one paper measured the relationship between team factors and patient outcomes. Two papers reported that equipment failures were common and had a significant impact on operating room efficiency. The influence of hospital characteristics on failure-to-rescue rates was tested in one large study, although their conclusions were limited to the American Medicare population. Five papers implemented changes in the patient pathway, but most studies failed to account for potential confounding variables. A small number of heterogenous studies have evaluated the relationship between system factors and quality or safety in arterial surgery. There is some evidence of an association between system factors and patient outcomes, but there is more work to be done to fully understand this relationship. Future research would benefit from consistency in definitions, the use of validated assessment tools, measurement of clinically relevant endpoints, and adherence to
Full Text Available Roger E Thomas Department of Family Medicine, G012 Health Sciences Center, University of Calgary Medical School, Calgary, AB, Canada Purpose: To review the safety and immunogenicity of yellow fever vaccines. Literature search: The Cochrane Library (including the Cochrane CENTRAL Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the NHS Database of Abstracts of Reviews of Effects; MEDLINE; EMBASE; BIOSIS Previews; Global Health; CAB Abstracts; and the Lilacs Database of Latin American and Caribbean literature were searched for individual studies and systematic reviews through January 1, 2015. Results: Six yellow fever vaccines are currently produced, and they are effective against all seven yellow fever virus strains. There is a 99.2% homology of the genome sequences of the six current vaccines. Four systematic reviews identified very small numbers of serious adverse events. A systematic review (updated of all published cases identified 133 serious adverse events that met the Brighton Collaboration criteria: 32 anaphylactic, 42 neurologic (one death, 57 viscerotropic (25 deaths, and two of both neurologic and viscerotropic SAEs. The Sanofi Pasteur Global Pharmacovigilance database reported 276 million doses of Stamaril™ distributed worldwide and identified 12 reports of yellow fever vaccine-associated viscerotropic disease (YEL-AVD, 24 of yellow fever vaccine-associated neurologic disease (YEL-AND, and 33 reports of anaphylaxis (many already published. The Biomanguinhos manufacturer's database reported 110 million doses distributed worldwide between 1999 and 2009, and the rate of YEL-AND was estimated at 0.084/100,000 doses distributed and YEL-AVD at 0.02/100,000 doses distributed. Conclusion: Reports of serious adverse events are mostly from travelers from developed countries, and there is likely serious underreporting for developing countries. On the basis of the published reports, the yellow fever vaccines are
Lawn, Sharon; Zhi, Xiaojuan; Morello, Andrea
E-learning involves delivery of education through Information and Communication Technology (ITC) using a wide variety of instructional d