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

{"title":"REPLY TO COMMENT on \"Population-Level COVID-19 Mortality Trends\".","authors":"Emmanuel O Okoro, Nehemiah A Ikoba, Boluwatife E Okoro, Azibanigha S Akpila, Mumeen O Salihu","doi":"10.1177/09246479251362606","DOIUrl":"https://doi.org/10.1177/09246479251362606","url":null,"abstract":"","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9246479251362606"},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677227","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":"Trend analysis of adverse drug reactions to sedative-hypnotics among residents in Jiangsu Province of China, 2011-2019.","authors":"Jinxia Yu, Ming Li, Hui Xue, Yitao Liu, Lijun Fan, Jianjun Zou, Wei Du","doi":"10.1177/09246479251360682","DOIUrl":"https://doi.org/10.1177/09246479251360682","url":null,"abstract":"<p><p>BackgroundThe safety of sedative-hypnotic drugs represents an underrecognized and crucial public health concern, despite their widespread use.ObjectiveThe objective of this study was to investigate the characteristics and trends of adverse drug reactions (ADRs) to sedative-hypnotics in China.MethodData were extracted from the spontaneous reporting system (SRS) for ADR surveillance in Jiangsu Province. Sedative-hypnotic drugs for ADRs were coded using the Anatomical Therapeutic Chemical classification system. We used the Chinese modification of the International Classification of Diseases, Tenth Revision, to group primary diseases, and the Medical Dictionary for Regulatory Activities to classify the manifestation of ADRs. We analysed the characteristics of ADR reports, including demographic and sedative-hypnotics information, ADR involvement of system organs and clinical manifestations, and cost of ADRs. Joinpoint regression was employed to estimate age-adjusted ADR rates stratified by sex from 2011 to 2019, and the percentage change annualized estimator was used to evaluate trends over time.ResultsA total of 899 reports of ADRs to sedative-hypnotics were found, with 440 (49.1%) males and 459 (50.9%) females. Regarding ADRs to sedative-hypnotics, neurological disorders (310 cases, 34.5%) were the most common. An estimated cost savings of RMB 6031.98-54,287.82 (USD 826.38-7437.43) could be realised if 10%-90% of the ADRs in this study were reduced. The age-adjusted ADRs reporting rates increased significantly from 0.06 to 0.18 per 100,000 population during 2011-2019, representing an annual increase of 14.5% (95% confidence interval 9.4-19.9%; <i>p</i>-value < 0.001). There was a gender difference, with an age-adjusted ADRs annual increase of 14.0% (95% confidence interval 6.6%-21.9%; <i>p</i>-value 0.002) for males and 14.8% (95% confidence interval 7.5%-22.6%; <i>p</i>-value 0.002) for females.ConclusionsReports of sedative-hypnotic ADRs were on the rise during the study period, and there was a gender difference. More rational policies and systems are needed to promote the safe use of sedative-hypnotic drugs.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9246479251360682"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661774","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":"Research evidence for health education in patient safety and research-informed health policy decision-making.","authors":"Liliya Eugenevna Ziganshina","doi":"10.1177/09246479251359481","DOIUrl":"https://doi.org/10.1177/09246479251359481","url":null,"abstract":"","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9246479251359481"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652010","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":"Voices from the frontline: The day-to-day experiences of ambulance service providers.","authors":"Anita Fafa Dartey, Francis Mawougnon Sagbo, Ebenezer Kwesi Obeng, Simon Assah","doi":"10.1177/09246479251358120","DOIUrl":"https://doi.org/10.1177/09246479251358120","url":null,"abstract":"<p><p>BackgroundOne of the principal providers of a 24-hour response to medical crises and trauma-related interventions is ambulance service providers. Despite the crucial roles ambulance services play in providing emergency healthcare, little attention has been paid to their occupational health in developing countries.ObjectiveThe study explored the lived occupational health experiences of ambulance service providers in Ho municipality within the Volta region of Ghana.MethodsThe study utilized a qualitative research approach with an exploratory design, incorporating all ambulance workers with a minimum of one (1) year of experience within the municipality. The sample size was determined by saturation at 15 participants. Employing a purposive sampling technique, the research used a semi-structured interview guide for collecting audio-recorded data. The interviews were transcribed verbatim and analyzed using thematic content analysis.ResultsThe study recognized four main themes and thirteen subthemes, highlighting the demanding tasks of ambulance providers in the Ho Municipality, along with the consequent impact on their well-being and effective coping mechanisms.ConclusionTo increase efficiency and lower the identified occupational health challenges among ambulance service providers, educational programs and in-service training should emphasize preventive and coping mechanisms to mitigate these glaring effects.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9246479251358120"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556563","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":"Rates of successful conceptions according to COVID-19 vaccination status: Data from the Czech Republic.","authors":"Vibeke Manniche, Tomáš Fürst, Max Schmeling, Jonathan D Gilthorpe, Peter Riis Hansen","doi":"10.1177/09246479251353384","DOIUrl":"10.1177/09246479251353384","url":null,"abstract":"<p><p>BackgroundAdverse effects of COVID-19 vaccination on human menstrual cycle characteristics have been observed, but limited data are available on the relationship between COVID-19 vaccination status and birth rates.ObjectivesTherefore, we used nationwide data from the Czech Republic to examine rates of successful conceptions (SCs), that is, conceptions leading to live births 9 months later, for women who were either vaccinated or unvaccinated against COVID-19 before SC.MethodsSummary monthly COVID-19 vaccination and birth data for women in the Czech Republic aged 18-39 years were retrieved for the period from January 2021 to December 2023. The numbers of SCs per month per 1000 women were calculated for preconception-vaccinated or unvaccinated women, respectively, as well as the number of SCs per month per 1000 women for all women aged 18-39 years.ResultsDuring the study period, there were approximately 1,300,000 women aged 18-39 years in the Czech Republic, and the proportion of COVID-19-vaccinated women increased from January 2021 until reaching a steady state of around 70% by the end of 2021. At least from June 2021, SCs per 1000 women were considerably lower for women who were vaccinated, compared to those that were unvaccinated, before SC. Furthermore, SC rates for the vaccinated group were much lower than expected based on their proportion of the total population.ConclusionsIn the Czech Republic, SC rates were substantially lower for women vaccinated against COVID-19 before SC than for those who were not vaccinated. These hypothesis-generating and preliminary results call for further studies of the potential influence of COVID-19 vaccination on human fecundability and fertility.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9246479251353384"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328439","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":"Comparative study of brachytherapy using ring and ovoid applicators in treatment of advanced cervical cancer.","authors":"Reham S Sherif, Hend M Kareem, Reem H El-Gebaly, Mohamed A Shehata, Reham A A Aziz","doi":"10.1177/09246479251353380","DOIUrl":"https://doi.org/10.1177/09246479251353380","url":null,"abstract":"<p><p>BackgroundImage-guided brachytherapy became essential to cervical cancer treatment following chemo-radiotherapy. A variety of applicators including Tandem-Ring (TR) and Tandem-Ovoid (TO) applicators are used to apply brachytherapy.ObjectiveThis study aims to dosimetrically compare TR versus TO applicators by using two different optimization techniques.MethodsBoth applicator sets were applied to the 24 patients. The prescribed dose was 7 Gy/fraction, and the treatment plans were normalized to HR-CTV. Two different optimization techniques are applied, along the four treatment fractions. The first optimization technique was a theoretical assumption that aimed to deliver 7 Gy to 90 % of the volume of the HR-CTV. While the second was the clinical situation which aimed to preserve the organs at risk (OARs) according to the ICRU 89 dose-volume constraints, considering that, 90% of HR-CTV is covered by not less than 90% of the prescribed dose. DVHs were generated, and dosimetric parameters including point A, and D2cc of rectum, bladder, and sigmoid, as well as the dose at different volumes of HR-CTV and IR-CTV, were recorded and compared.ResultsThe results demonstrate that using Ovoid-Tandem applicators achieved significantly higher dose at point A, significantly higher coverage to both HR-CTV and IR-CTV, in addition to significantly better protection to the mean D2cc of the rectum in both optimization techniques. On the other hand, using Ring-Tandem applicators give significantly more protection to the mean D2cc of the bladder, but HR-CTV and IR-CTV have significantly lower coverage.ConclusionOvoid-Tandem and Ring-Tandem applicators are the most common interchangeable intracavitary gynecological applicators. In this study, the results demonstrated that Ovoid-Tandem applicators have the advantages of significantly higher coverage for HR-CTV, and IR-CTV, in addition to more protection for D2cc of the rectum. On the contrary, Ring-Tandem applicators can provide higher protection for D2cc of the bladder, and more comfort to the patients.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9246479251353380"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328438","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":"Paradoxical responses to modified, all-oral shorter treatment of tuberculosis in non-immunocompromised patients: Cases from Armenia.","authors":"Hakob Atshemyan, Naira Khachatryan, Anush Khachatryan, Karen Poghosyan, Narine Mirzoyan","doi":"10.1177/09246479251353401","DOIUrl":"https://doi.org/10.1177/09246479251353401","url":null,"abstract":"<p><p>BackgroundThe previous publications presented paradoxical responses to anti-TB treatment in non-immunocompromised patients. Treatment for extra-pulmonary tuberculosis was associated with the majority of these responses.ObjectivesIn this paper, we present three cases of paradoxical radiological worsening in the HIV-negative patients receiving new modified, all-oral shorter regimens for pulmonary tuberculosis.MethodsThe treatment effectiveness was assessed based on the radiological and bacteriological examinations. Each of the three patients was adherent to treatment.ResultsAnti-TB therapy was effective in all of the cases, evidenced by bacteriological response. After initiation of treatment, the chest X-rays showed increased infiltration in the lungs. The patients continued treatment without adjustments of the shorter regimens. The following chest X-rays revealed positive dynamics. Despite the lack of specific therapeutic interventions to address radiological deterioration, the shorter treatment courses were successful. This means that radiological worsening detected in the middle of shorter treatment does not always indicate that anti-TB chemotherapy is ineffective.ConclusionParadoxical deterioration of chest X-ray findings may happen in HIV-negative patients receiving shorter regimens for rifampicin-resistant pulmonary tuberculosis but this worsening is not a reliable indicator for treatment outcome prediction. Additional therapeutic interventions or modifications of the chemotherapy regimens are not always necessary.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9246479251353401"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319221","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 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}