The International journal of risk & safety in medicine最新文献

{"title":"Perceptions of occupational exposure and adherence to safety measures of handling systemic anti-cancer therapy (SACT) among oncology nurses at the national cancer institute, Sri Lanka.","authors":"Nsasn Senarath, D De Silva, Rwmwk Rathnayake, Ssp Warnakulasuriya, Mkdl Meegoda, S S Jayasinghe","doi":"10.1177/09246479251346172","DOIUrl":"https://doi.org/10.1177/09246479251346172","url":null,"abstract":"<p><p>BackgroundChemotherapy is a well-known treatment modality against cancer. Occupational exposure to chemotherapy and related adverse effects are widely reported. Safe handling is vital in the reduction of possible risks.ObjectiveTo assess perceptions of occupational exposure and adherence to safety measures of handling Systemic Anti-Cancer Therapy (SACT) among nurses.MethodsA phenomenological study was carried out using a semi-structured, in-depth interviewer guide following the Health Belief Model (HBM) components. The study adopted a purposive sampling method, and data was collected until it reached the saturation point. A thematic analysis was carried out, preserving the study's trustworthiness.ResultsThe nurse's main role was to administer chemotherapy. The primary learning sources were clinical experience and follow-up with seniors. Nurses accept that they are occupationally exposed to chemotherapy and believe that safety measures are protective against exposure. Surgical gloves and masks were common PPE, and chemotherapy-specific masks and gowns were mainly used in mixing drugs. Staffing, safe work practices, separate waste disposal, and seniors' guidance are identified as protective measures. Headache, vomiting, hair loss, skin irritation, and miscarriages were commonly perceived as adverse effects of handling SACT.ConclusionsAn increased patient count, frequent complex doses, a lack of PPE and facilities, and discomfort with PPE might increase exposure.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9246479251346172"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restoring TADS: RIAT reanalysis of the Treatment for Adolescents with Depression Study.","authors":"Natalie Aboustate, Jon Jureidini, Richard Woodman, Joanna Le Noury, Julie Klau, Elia Abi-Jaoude, Melissa Raven","doi":"10.1177/09246479251337879","DOIUrl":"https://doi.org/10.1177/09246479251337879","url":null,"abstract":"<p><p>BackgroundThe Treatment for Adolescents with Depression Study (TADS) continues to influence international clinical practice guidelines for adolescent depression.ObjectiveWe assessed TADS' effectiveness and harms through a Restoring Invisible and Abandoned Trials (RIAT)-led reanalysis.MethodsTADS was a phase-three multicentre, parallel four-arm randomised controlled superiority trial that randomised adolescents (<i>n</i> = 439) to fluoxetine alone (FLX), CBT alone (CBT), open-label fluoxetine plus CBT (COMB) or placebo pill alone (PBO) over 12 weeks. COMB and CBT groups were unblinded to their treatment allocation. Primary outcomes were the Children's Depression Rating Scale-Revised (CDRS-R) and Clinical Global Impression-Improvement scale (CGI-I).ResultsOur ITT reanalysis showed a significant decrease in CDRS-R at 12 weeks in COMB compared with PBO (-6.65; <i>p</i> < 0.001) and CBT (-7.63, <i>p</i> < 0.001), but not FLX (-4.07, <i>p</i> = 0.063). There was no difference between FLX, CBT and PBO. There was a higher proportion of CGI-I responders in COMB (73.72% [SE 4.43]) compared with all other arms: FLX (64.16% [SE 4.76]), CBT (51.06% [SE 5.29]) and PBO (38.76% [SE 4.87]; all <i>p</i> < 0.001); FLX had more responders than PBO (<i>p</i> = 0.004). 369 adverse events were reported for 171 participants, with 66% occurring in those taking fluoxetine. We found 32 serious adverse events (22 in those taking fluoxetine), which varied from original authors' reporting.ConclusionsOur reanalysis replicated the original investigators' reporting that COMB demonstrated the most robust outcomes and that FLX was not superior to PBO. In contrast to the original TADS Team's reporting, there was a higher level of harm uncovered in allocation groups taking fluoxetine, including 11 unreported suicide-related adverse events. Overall, the marked increase in harms among participants taking fluoxetine warrants further circumspection when prescribing it to adolescents.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9246479251337879"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of healthcare workers about medical errors: A cross-sectional study in a tertiary hospital in Jordan.","authors":"Rania Ali Albsoul, Muhammad Ahmed Alshyyab, Luay Abdallah, Ghaleb Naser Eskeiker, Yazan Faisal Al-Bukhari, Rahmeh Al-Asmar, Mohammad Aljahalin, Gerard FitzGerald, Abdel-Hady El-Gilany","doi":"10.1177/09246479251346181","DOIUrl":"https://doi.org/10.1177/09246479251346181","url":null,"abstract":"<p><p>BackgroundPatient safety is a global public health issue. It aims to reduce medical errors to ensure patients' health and achieve the best possible outcomes.PurposeThis study aims to examine the perceptions of healthcare workers about medical errors in a tertiary hospital in Jordan.Methodology/approachThe descriptive-analytical cross-sectional study included 246 healthcare workers in a tertiary hospital in Jordan. Systematic random sampling technique was used to select the participants. Data were collected using a questionnaire that was used in previous literature. The Statistical Package for the Social Sciences Software (SPSS), version 27, was used to analyze the data. Descriptive and inferential statistics were used to address research objectives.ResultsThe majority of the participants were females and had a bachelor's degree. Human error, lack of resources and failure of the communication system were the most frequently reported causes of errors (38.2%, 32.5%, and 30.0%, respectively). The findings show that disclosure of patient errors was perceived by 78% of the participants as a method to reduce the effect of medical errors on patient health. Raising awareness and training were perceived as the most impactful way in which hospitals could reduce medical errors. Reporting errors was stated by 52% of the respondents as a method to deal with medical errors. However, the commonest barriers to reporting errors were identified as culture (38.2%) and a long complicated process of errors reporting (28.9%). The emergency department was reported as the commonest place for medical errors occurrence.ConclusionThe findings revealed the experience of a Jordanian hospital regarding medical errors. Healthcare organizations and policymakers can utilize the findings presented in this paper to reduce medical errors, therefore promoting quality healthcare and patient safety.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9246479251346181"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SSRI antidepressants and perceived loss of lean muscle in men: A qualitative exploration of some online anecdotal concerns.","authors":"Nicholas Norman Adams","doi":"10.1177/09246479251346445","DOIUrl":"https://doi.org/10.1177/09246479251346445","url":null,"abstract":"<p><p>BackgroundThis study examines anecdotal reports from online discussion forums suggesting possible links between SSRI antidepressants and loss of lean muscle mass, particularly in men. Given limited existing scientific research, this study bolsters academic discourse.ObjectiveDo self-reported experiences from internet forums indicate a perceived connection between SSRI use and muscle mass reductions?MethodA Google keyword search identified 202 posts from 14 randomly selected online antidepressant discussion forums. Posts were collected and thematically analysed.ResultsForum users reported difficulties in maintaining or gaining lean muscle after commencing SSRI treatment. Key themes included frustration, confusion, and attempts to rationalise perceived changes.ConclusionFindings suggest an area for further exploration, regarding the physiological impact of SSRIs on muscle composition. While reports remain anecdotal, they highlight concerns immediately relevant to both patients and healthcare professionals. As the study is based on self-reported experiences from anonymous sources, findings lack scientific validation but highlight requirements for further studies to explore prevalence and broader applicability. Research observations spotlight a need for further, structured clinical research to investigate possible effects of SSRIs on muscle mass.Future research should include controlled clinical trials and longitudinal studies to examine a potential association in more detail.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9246479251346445"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approach to the management of COVID-19 patients: When home care can represent the best practice.","authors":"Gerardo Tricarico,&nbsp;Valter Travagli","doi":"10.3233/JRS-210064","DOIUrl":"https://doi.org/10.3233/JRS-210064","url":null,"abstract":"<p><strong>Background: </strong>The pandemic that began around February 2020, caused by the viral pathogen SARS-CoV-2 (COVID-19), has still not completed its course at present in June 2022.</p><p><strong>Objective: </strong>The open research to date highlights just how varied and complex the outcome of the contagion can be.</p><p><strong>Method: </strong>The clinical pictures observed following the contagion present variabilities that cannot be explained completely by the patient's age (which, with the new variants, is rapidly changing, increasingly affecting younger patients) nor by symptoms and concomitant pathologies (which are no longer proving to be decisive in recent cases) in relation to medium-to-long term sequelae. In particular, the functions of the vascular endothelium and vascular lesions at the pre-capillary level represent the source of tissue hypoxia and other damage, resulting in the clinical evolution of COVID-19.</p><p><strong>Results: </strong>Keeping the patient at home with targeted therapeutic support, aimed at not worsening vascular endothelium damage with early and appropriate stimulation of endothelial cells, ameliorates the glycocalyx function and improves the prognosis and, in some circumstances, could be the best practice suitable for certain patients.</p><p><strong>Conclusion: </strong>Clinical information thus far collected may be of immense value in developing a better understanding of the present pandemic and future occurrences regarding patient safety, pharmaceutical care and therapy liability.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"249-259"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40479514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global pandemic vaccine development, production and distribution challenges for the world population.","authors":"Rade Injac","doi":"10.3233/JRS-227019","DOIUrl":"https://doi.org/10.3233/JRS-227019","url":null,"abstract":"<p><strong>Background: </strong>The new type of virus (SARS-CoV-2 or COVID-19) from Coronaviridae family, discovered in 2019, caused a global pandemic with several massive lock-downs around the globe. Science and politicians became the center of world attention, receiving many questions without having clear answers. The hopes of many rested on vaccine development, which was done fast, facing novel challenges such as the massive production and distribution for several billions of people.</p><p><strong>Objective: </strong>In this paper, the global reaction to the pandemic is reviewed along with some critical comments.</p><p><strong>Method: </strong>Different groups, including nations, took part in global lockdowns, while vaccine development was running in parallel without having enough capacity for some of the biggest medical demands in history. This review will bring together views from all interested groups in this pandemic crisis.</p><p><strong>Results: </strong>The Western world waited too long (4 months), after the first case was confirmed in China, to introduce lock-down and safety measures. On the other side, vaccine development was done too fast to give clear long-term safety profiles of the medications developed. Due to the focus on development, it was overlooked that production and distribution of sterile products such as vaccines might have limitations globally. Usually when such limitations occur, power comes to the surface. Therefore, buyers who had power will get the vaccines they need first. However, we should recognize the economic impact that directly influenced healthcare funding. All of this will lead to post-crisis challenges, including depression, violence, suicide, migration, and many other social problems.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic is a test for all of us, which many governments, industries and non-state actors are failing. It is a perfect \"general probe\" to detect some of the weaknesses of the current structure of global health. If politics and science do not work together to make a global production plan for vaccines and learn from this pandemic, then all of the lives lost were for nothing.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"235-248"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40309510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restoring the two pivotal fluoxetine trials in children and adolescents with depression.","authors":"Peter C Gøtzsche,&nbsp;David Healy","doi":"10.3233/JRS-210034","DOIUrl":"https://doi.org/10.3233/JRS-210034","url":null,"abstract":"<p><strong>Background: </strong>Fluoxetine was approved for depression in children and adolescents based on two placebo-controlled trials, X065 and HCJE, with 96 and 219 participants, respectively.</p><p><strong>Objective: </strong>To review these trials, which appear to have been misreported.</p><p><strong>Methods: </strong>Systematic review of the clinical study reports and publications. The primary outcomes were the efficacy variables in the trial protocols, suicidal events, and precursors to suicidality or violence.</p><p><strong>Results: </strong>Essential information was missing and there were unexplained numerical inconsistencies. (1) The efficacy outcomes were biased in favour of fluoxetine by differential dropouts and missing data. The efficacy on the Children's Depression Rating Scale-Revised was 4% of the baseline score, which is not clinically relevant. Patient ratings did not find fluoxetine effective. (2) Suicidal events were missing in the publications and the study reports. Precursors to suicidality or violence occurred more often on fluoxetine than on placebo. For trial HCJE, the number needed to harm was 6 for nervous system events, 7 for moderate or severe harm, and 10 for severe harm. Fluoxetine reduced height and weight over 19 weeks by 1.0 cm and 1.1 kg, respectively, and prolonged the QT interval.</p><p><strong>Conclusions: </strong>Our reanalysis of the two pivotal trials showed that fluoxetine is unsafe and ineffective.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"385-408"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40479513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and benefit issues are problems we all face.","authors":"I Ralph Edwards,&nbsp;Marie Lindquist","doi":"10.3233/JRS-228001","DOIUrl":"https://doi.org/10.3233/JRS-228001","url":null,"abstract":"","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"209"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40609323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}