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  • 文章类型: Review
    背景:自四十多年前成立以来,许多行业都对安全气候进行了研究。随后,大量关于各种工作环境中安全气候的系统文献综述集中在研究趋势和测量尺度上。然而,尽管有这些评论,安全气候如何影响性能的总体情况仍然没有得到很好的理解。本研究回顾了有关安全气候的现有文献,特别是它如何影响安全性能。
    方法:文献检索于2021年3月使用EBSCOhost和WebofScience数据库进行。我们包括英语,同行评审的研究报告了关于安全气候和安全性能的研究结果。我们提取了数据(上下文,理论,安全性能的方法学和定义)来自这些研究,并进行了演绎分析并分类为共同主题。
    结果:确定了一百六十二项安全气候研究。我们发现,在16种类型的行业中进行了安全气候绩效研究,而23种不同的理论解释了安全气候绩效关系。在各种调查中,使用的变量和方法的数量和质量差异很大。安全气候主要用作预测指标,而与安全相关的行为是我们评论的文章中最常见的安全性能定义。当前评论中很少有论文在方法论上很强,这表明,目前关于安全气候和安全绩效之间联系的证据仍然存在共同的方法偏差。
    结论:尽管文献已经提供了证据证明强大的安全气候对安全性能的积极影响,仍然缺乏强有力和令人信服的方法,改善安全环境的因果关系仍然需要证明。
    结论:当前审查的结果为雇主如何在各种环境中改善工作场所的安全环境提供了更好的理解。
    Since its inception more than four decades ago, research on safety climate has been conducted in many industries. Subsequently, a plethora of systematic literature reviews on safety climate in various work environments has focused on research trends and measurement scales. Yet, despite these reviews, the overall picture of how safety climate influences performance is still not well understood. The current study reviews existing literature on safety climate, specifically how it affects safety performance.
    Literature searches were conducted using EBSCOhost and Web of Science databases in March 2021. We included English-language, peer-reviewed studies that reported the results of research done on safety climate and safety performance. We extracted data (contextual, theoretical, methodological and definition of safety performance) from these studies and were deductively analyzed and categorized into common themes.
    One hundred and sixty-two safety climate studies were identified. We found that studies on safety climate-performance were conducted in 16 types of industries while 23 different theories explained the safety climate-performance relationship. The quantity and quality of variables and methods used varied considerably across the surveys. Safety climate is predominantly used as a predictor while safety-related behavior is the most common definition of safety performance among the articles we reviewed. Few papers from the current review were methodologically strong, suggesting that current evidence on the link between safety climate and safety performance still suffers from common method bias.
    Although literature has provided evidence for the positive effect on safety performance via a strong safety climate, strong and convincing methods are still lacking and the causality of an improved safety climate still needs to be demonstrated.
    The findings of the current review offer a better understanding of how employers can improve safety climate in the workplace in various settings.
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  • 文章类型: Journal Article
    对微生物抗微生物剂耐药性基因组学的充分理解将提高对相关病理和公共卫生安全管理的认识。然而,病原体的持续出现和重新出现,包括弧菌,标志着潜在的知识差距。对过程的清楚认识和对下一步趋势的预测要到位,防患于未然,微生物获得抗生素耐药性。因此,这项为期20年(2000年1月1日至2019年12月31日)的系统评价和荟萃分析研究阐明了从环境样本中分离出的弧菌中抗生素耐药基因的患病率和发生率.参与了来自WebofScience和PubMed电子数据库的文章。采用随机效应模型荟萃分析和漏斗图分析数据的异质性和偏倚。共1920个弧菌。本研究中包含的十篇选定的文章报道;其中32.39%的鉴定分离株表现出抗菌素耐药性和相关基因。弧菌中抗生素抗性基因的分布。,在六个国家/地区报告的四环素(TET)占21%,和20%磺酰胺(sul)和β-内酰胺酶(bla)。喹诺酮,四环素和磺胺类耐药基因的患病率为32.97%(95%CI0.18-0.53),而氯霉素,大环内酯类和氨基糖苷类抗性基因的百分比分别为28.67%(95%CI0.15-0.47)和β-内酰胺酶抗性基因的百分比分别为27.93%(95%CI0.11-0.56)。弧菌抗生素抗性基因(V-ARG)分布从分析的数据中没有描绘规则的趋势或模式。因此,需要更多的研究来阐明微生物中抗性决定子分布中的内聚力结构。
    Adequate comprehension of the genomics of microbial resistance to an antimicrobial agent will advance knowledge on the management of associated pathologies and public health safety. However, continued emergences and reemergence of pathogens, including Vibrio species, hallmarks a potential knowledge gap. A clear understanding of the process and forecast of the next trend should be in place to nip in the bud, microbial acquisition of resistance to antibiotics. Therefore, this two-decade (1 January 2000 to 31 December 2019) systematic review and meta-analytical study articulated the prevalence and incidence of antibiotics resistance genes in Vibrio species isolated from environmental samples. Articles from the Web of Science and PubMed electronic databases was engaged. Heterogeneity of the data and bias were analyzed with random effect model meta-analysis and funnel plot. A total of 1920 Vibrio sp. were reported by the ten selected articles included in this study; out of which 32.39% of identified isolates displayed antimicrobial resistance and associated genes. The distribution of antibiotics resistance genes in Vibrio sp., reported within six countries was 21% tetracycline (tet), and 20% sulphonamide (sul) and β-lactamase (bla) respectively. The quinolone, tetracycline and sulfonamide resistance genes showed 32.97% (95% CI 0.18-0.53) prevalence while chloramphenicol, macrolides and aminoglycoside resistance genes are expressed in percentages as 28.67% (95% CI 0.15-0.47) and β-lactamase resistance genes 27.93% (95% CI 0.11-0.56) respectively. The Vibrio antibiotics resistance genes (V-ARG) distribution depicts no regular trend or pattern from the analyzed data. Consequently, more studies would be required to articulate the structure of cohesion in the distribution of the resistance determinants in microbes.
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  • 文章类型: Journal Article
    与药物相关的事件是所有患者群体可预防伤害的主要原因,包括养老院居民。尽管有国家的指导,关于评估药物错误率和评估改变以减少错误率的信息很少。这篇综述探讨了与医学相关的事件的科学和灰色文献,英国养老院变化的因果关系和评估。该研究确定了2951份文件,32进行了分析;其中一些覆盖了多个区域。七个报告率和原因,十一个原因,十一项建议,四个报告了对流程和系统变更的评估。出现了三个领域;1)与医学相关的事件发生率在1%到38%之间,2)事故发生率增加,配方不是片剂或胶囊,范围从12%到50%,取决于配方,3)对旨在减少医疗事件的变革的三项评估。因此,有疗养院医疗相关事件的资料,但没有系统地描述。
    Medicines-related incidents are a leading cause of preventable harm across all patient groups, including care home residents. Despite national guidance, there is little information on assessing medication error rates and evaluating changes to reduce them. This review explored the scientific and gray literature on medicine-related incidents, causation and evaluation of changes in care homes in the United Kingdom. The research identified 2951 documents, 32 analyzed; some of them covered more than one area. Seven reported rate and causes, eleven causes, eleven made recommendations, and four reported the evaluation of changes to processes and systems. Three areas emerged; 1) medicine-related incident rates ranged between 1% and 38%, 2) incident rates increased where formulations were not tablets or capsules ranging from 12% to 50% depending on the formulation, 3) three evaluations of changes aimed at reducing medicine incidents. Therefore, information on medicine-related incidents in care homes is available, but not systematically described.
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  • 文章类型: Journal Article
    目标:补充2020年ANZJPH社论“COVID安全的圣诞老人如何拯救圣诞节”。除了关于SARS-CoV-2/COVID-19的简要更新外,我们还旨在探讨圣诞节对健康的不良影响方面的一些风险,我们称之为“基督”。我们的总体研究问题是:“在科学上,哪些危害与旧的圣诞节必需品(如装饰)相关联,礼物,菜单,还有圣诞老人本人,以及与COVID-19相关的新挑战?“
    方法:我们搜索了PubMed,WebofScience,系统地打开灰色数据库,不系统地打开谷歌。
    结果:36篇相关文章——大部分是病例报告或回顾性分析——记载了Chrishaps。
    结论:总体结果表明,Chrishaps具有不同的形状和外观。对公共卫生的影响:基督构成了潜在的次要公共卫生威胁,每个节日都应牢记。评估和讨论Chrishaps的具体公共卫生影响需要进行系统的风险研究。
    OBJECTIVE: To complement the 2020 ANZJPH editorial \"How COVID-safe Santa can save Christmas\". In addition to a concise update regarding SARS-CoV-2/COVID-19, we aimed to explore some risks of Christmas in terms of adverse health effects, which we call \'Chrishaps\'. Our overall study question was \"which hazards have been scientifically associated with old Christmas essentials such as decoration, gifts, menus, and Santa himself, as well as new challenges associated with COVID-19?\"
    METHODS: We searched the PubMed, Web of Science, and Open Grey databases systematically and Google unsystematically.
    RESULTS: Thirty-six pertinent articles - most of them case reports or retrospective analyses - documented Chrishaps.
    CONCLUSIONS: Overall results suggested that Chrishaps come in different shapes and guises. Implications for public health: Chrishaps pose a potential minor public health threat that should be borne in mind every festive season. Assessing and discussing specific public health implications of Chrishaps requires systematic risk research to be conducted.
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  • 文章类型: Journal Article
    BACKGROUND: The goal of disaster triage at both the prehospital and in-hospital level is to maximize resources and optimize patient outcomes. Of the disaster-specific triage methods developed to guide health care providers, the Simple Triage and Rapid Treatment (START) algorithm has become the most popular system world-wide. Despite its appeal and global application, the accuracy and effectiveness of the START protocol is not well-known.
    OBJECTIVE: The purpose of this meta-analysis was two-fold: (1) to estimate overall accuracy, under-triage, and over-triage of the START method when used by providers across a variety of backgrounds; and (2) to obtain specific accuracy for each of the four START categories: red, yellow, green, and black.
    METHODS: A systematic review and meta-analysis was conducted that searched Medline (OVID), Embase (OVID), Global Health (OVID), CINAHL (EBSCO), Compendex (Engineering Village), SCOPUS, ProQuest Dissertations and Theses Global, Cochrane Library, and PROSPERO. The results were expanded by hand searching of journals, reference lists, and the grey literature. The search was executed in March 2020. The review considered the participants, interventions, context, and outcome (PICO) framework and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Accuracy outcomes are presented as means with 95% confidence intervals (CI) as calculated using the binomial method. Pooled meta-analyses of accuracy outcomes using fixed and random effects models were calculated and the heterogeneity was assessed using the Q statistic.
    RESULTS: Thirty-two studies were included in the review, most of which utilized a non-randomized study design (84%). Proportion of victims correctly triaged using START ranged from 0.27 to 0.99 with an overall triage accuracy of 0.73 (95% CI, 0.67 to 0.78). Proportion of over-triage was 0.14 (95% CI, 0.11 to 0.17) while the proportion of under-triage was 0.10 (95% CI, 0.072 to 0.14). There was significant heterogeneity of the studies for all outcomes (P < .0001).
    CONCLUSIONS: This meta-analysis suggests that START is not accurate enough to serve as a reliable disaster triage tool. Although the accuracy of START may be similar to other models of disaster triage, development of a more accurate triage method should be urgently pursued.
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  • 文章类型: Journal Article
    背景:农药引起的人类中毒长期以来一直被视为严重的公共卫生问题。早在1990年,世界卫生组织(WHO)的一个工作组估计,每年约有100万起无意中的农药中毒,导致约2万人死亡。尽管全球农药使用量有所增加,但三十年来没有全球农药中毒的最新情况。我们的目的是系统地审查无意中,急性农药中毒(UAPP),并估计UAPP的年度全球数量。
    方法:我们对2006年至2018年间发表的科学文献进行了系统评价,并补充了世卫组织的死亡率数据。我们从157份出版物和世界卫生组织死因数据库中提取数据,然后进行了以国家为单位的大纲,并得出了全国UAPP的年度数量。根据粮食及农业组织(粮农组织)定义的区域的国家数字和人口数据,估计了世界范围的UAPP。
    结果:共涵盖141个国家,其中58条来自157条,另外83条来自世卫组织死亡率数据库的数据。摘录的出版物每年报告约740,000例UAPP病例,造成7446例死亡和733,921例非致命病例。在此基础上,我们估计,全球每年发生约3.85亿例UAPP,包括约11,000例死亡。根据全球农业人口约8.6亿,这意味着每年约有44%的农民被农药中毒。估计UAPP病例数量最多的是南亚,其次是东南亚和东非,关于非致命的UAPP。
    结论:我们的研究更新了全球UAPP的过时数据。和其他估计一样,强有力的证据表明,急性农药中毒是一个持续的全球重大公共卫生挑战。有必要认识到非致命UAPP的高负担,特别是农民和农场工人,目前只关注死亡,阻碍了国际社会在风险评估和预防中毒方面的努力。粮农组织理事会实施逐步淘汰高度危险农药的国际建议可以大大减少UAPP的负担。
    BACKGROUND: Human poisoning by pesticides has long been seen as a severe public health problem. As early as 1990, a task force of the World Health Organization (WHO) estimated that about one million unintentional pesticide poisonings occur annually, leading to approximately 20,000 deaths. Thirty years on there is no up-to-date picture of global pesticide poisoning despite an increase in global pesticide use. Our aim was to systematically review the prevalence of unintentional, acute pesticide poisoning (UAPP), and to estimate the annual global number of UAPP.
    METHODS: We carried out a systematic review of the scientific literature published between 2006 and 2018, supplemented by mortality data from WHO. We extracted data from 157 publications and the WHO cause-of-death database, then performed country-wise synopses, and arrived at annual numbers of national UAPP. World-wide UAPP was estimated based on national figures and population data for regions defined by the Food and Agriculture Organization (FAO).
    RESULTS: In total 141 countries were covered, including 58 by the 157 articles and an additional 83 by data from the WHO Mortality Database. Approximately 740,000 annual cases of UAPP were reported by the extracted publications resulting from 7446 fatalities and 733,921 non-fatal cases. On this basis, we estimate that about 385 million cases of UAPP occur annually world-wide including around 11,000 fatalities. Based on a worldwide farming population of approximately 860 million this means that about 44% of farmers are poisoned by pesticides every year. The greatest estimated number of UAPP cases is in southern Asia, followed by south-eastern Asia and east Africa with regards to non-fatal UAPP.
    CONCLUSIONS: Our study updates outdated figures on world-wide UAPP. Along with other estimates, robust evidence is presented that acute pesticide poisoning is an ongoing major global public health challenge. There is a need to recognize the high burden of non-fatal UAPP, particularly on farmers and farmworkers, and that the current focus solely on fatalities hampers international efforts in risk assessment and prevention of poisoning. Implementation of the international recommendations to phase out highly hazardous pesticides by the FAO Council could significantly reduce the burden of UAPP.
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  • 文章类型: Journal Article
    As in any part of the hospital system, safety incidents can occur in the ED. These incidents arguably have a distinct character, as the ED involves unscheduled flows of urgent patients who require disparate services. To aid understanding of safety issues and support risk management of the ED, a comparison of published ED specific incident classification frameworks was performed. A review of emergency medicine, health management and general medical publications, using Ovid SP to interrogate Medline (1976-2016) was undertaken to identify any type of taxonomy or classification-like framework for ED related incidents. These frameworks were then analysed and compared. The review identified 17 publications containing an incident classification framework. Comparison of factors and themes making up the classification constituent elements revealed some commonality, but no overall consistency, nor evolution towards an ideal framework. Inconsistency arises from differences in the evidential basis and design methodology of classifications, with design itself being an inherently subjective process. It was not possible to identify an \'ideal\' incident classification framework for ED risk management, and there is significant variation in the selection of categories used by frameworks. The variation in classification could risk an unbalanced emphasis in findings through application of a particular framework. Design of an ED specific, ideal incident classification framework should be informed by a much wider range of theories of how organisations and systems work, in addition to clinical and human factors.
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  • 文章类型: Journal Article
    移动踏板车是三轮或四轮电动移动装置,经常被行走困难的人使用。它们在驾驶控制方面也不同于电动轮椅,可编程性,座位,和安装方法。鉴于它们越来越受欢迎,以及围绕它们使用的轶事,进行了范围审查,以确定有关机动踏板车的实证研究,并分析其研究设计和目的。数据源包括MedLINE,护理和相关健康文献的累积指数,Embase,心理信息。32项研究符合纳入标准。大多数研究本质上是描述性的,并报告了有关踏板车用户的人口统计信息,踏板车相关活动,和事故。最常见的研究设计是干预前后,然后进行横断面调查和回顾性审查。尽管移动踏板车的使用越来越多,令人惊讶的是,与踏板车相关的研究很少。鉴于该领域大多数研究的性质,需要进一步的经验证据来更好地了解踏板车事故的频率和原因,以及提高用户技能的干预措施的有效性,移动性,和安全。
    Mobility scooters are three- or four-wheeled power mobility devices regularly used by people who have difficulty ambulating. They also differ from power wheelchairs in terms of their driving controls, programmability, seating, and mounting method. Given their growing popularity and anecdotal concerns around their use, a scoping review was undertaken to identify empirical research about mobility scooters and to analyze their study design and purpose. Data sources included MedLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, and PsychINFO. Thirty-two studies met the inclusion criteria. Most studies were descriptive in nature and reported information about scooter users\' demographics, scooter-related activities, and accidents. The most common study design was a pre- and postintervention followed by a cross-sectional survey and retrospective review. Despite the increasing use of mobility scooters, surprisingly little scooter-related research has been conducted. Given the nature of most of the research in this area, further empirical evidence is needed to develop a better understanding about the frequency and causes of scooter accidents and the efficacy of interventions to improve users\' skills, mobility, and safety.
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