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

{"title":"Misguided medical insurance and government policies in the opioid epidemic: A chart review and NARX score analysis.","authors":"Leon Margolin, Juscelino F Colares, Sanford Lefkowitz, Richard Ancowitz, Sanford Rosenblum","doi":"10.1177/09246479251360693","DOIUrl":"10.1177/09246479251360693","url":null,"abstract":"<p><p>BackgroundDespite the investment of significant effort and resources, our country remains exposed to an alarming risk of opioid overdoses due to opioid addiction.ObjectiveThis study demonstrates the impact of misguided medical insurance and government policies on the opioid epidemic.MethodsThis is a retrospective chart review study of 142 patients who were denied access to care by insurance companies (CareSource, Molina, Aetna, government regulators, and contractors). The study provides a systematic analysis of the risk stratification of these patients based on the NARX score, prescribed medications, and OARRS report analysis.ResultsPatients who were denied access to care by the major insurance carriers in Ohio, CareSource, Aetna, and Molina had an average high NARX score of 309.8-310.5 range. The review of the prescribing provider lists on Ohio Automated RX Reporting System reports showed that, in most occasions, patients had significant difficulty in finding a qualified pain provider for 3 months or more.ConclusionReview of denied-care patient NARX scores shows, conclusively, that very high-risk patients were affected the most. These misguided medical insurance and government policies have exposed the most vulnerable and high-risk patients to significant risk of mortality and morbidity.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"31-39"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12901678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does psychiatry need alternatives to ECT?","authors":"David Healy","doi":"10.1177/09246479251381512","DOIUrl":"10.1177/09246479251381512","url":null,"abstract":"","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"8"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133410","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":"Interpreting Cortrak™ feeding tube position: Safety assessment of manufacturer training guides.","authors":"Stephen J Taylor, Kaylee R Sayer, Jules Brown","doi":"10.1177/09246479251377592","DOIUrl":"10.1177/09246479251377592","url":null,"abstract":"<p><p>BackgroundExpert Cortrak™ guided-tube placement attains near-zero pneumothorax risk versus 0.52% in 'blind' tube placement. Conversely, in low-use Cortrak centres, insufficient training and misinterpretation results in undetected lung misplacement and pneumothorax in 0.10% versus 0.013% for blind placement.ObjectiveDetermine whether manufacturer training guides enable safe interpretation of tube position.MethodsManufacturer guidance was compared to the evidence-based lung-oesophagus, gastrointestinal flexure system (LOGIFS). Manufacturer text and figures were analysed to determine whether it is possible to objectively interpret tube position by organ or its position within an organ.ResultsManufacturer descriptions are subjective, precluding definitive interpretation of tube position: 1. Lung: No information on the trace angle and distance of deviation from the sagittal midline or receiver or expected trace pattern to warn of misplacement; 2: Stomach: Gastric flexures are not described therefore a tube's entry, safe position and exit are unknown; 3. Intestine: Manufacturer terms cannot differentiate tube passage into the intestine from retroflexion back to the stomach. Failure to describe the superior- and inferior-duodenal or duodeno-jejunal (DJ) flexures means that intestinal position is not known. Guides only partially describe artefact traces caused by receiver misalignment but not how to correct the receiver position based on the trace.ConclusionsLack of objective information to interpret traces and correct for artefacts, combined with mandating tube withdrawal, risks misinterpreting tube position and repeated or failed tube placement, respectively. Manufacturer guides should be substituted with published, evidence-based guides.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"67-77"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133427","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":"Assessment of nanomedicines and nanosimilars: Clinical pharmacists' knowledge and regulatory gaps.","authors":"Courtney Fella, Mike Isles, John Hertig","doi":"10.1177/09246479251382360","DOIUrl":"10.1177/09246479251382360","url":null,"abstract":"<p><p>BackgroundNon-Biological Complex Drugs (NBCDs), including nanomedicines, are characterized by complex manufacturing processes. The slightest change in this process can lead to changes in the efficacy, safety, and quality of the product. New legislation to be adopted in the EU will help ensure a proper regulatory assessment which will improve patient safety. Meanwhile, there is currently no robust integrated curriculum on the use and interchangeability of nanomedicines and their respective follow-on medicine, commonly referred to as nanosimilars. Nanomedicines have been available in the EU since 1996. As the patents of these medicines expire, it is important that healthcare professionals are suitably prepared for future interchangeability programs.ObjectivesTo analyze clinical pharmacists' understanding of nanomedicines, nanosimilars, and the requirements needed to prepare the clinical ground to ensure safe and optimum interchangeability.MethodsA fourteen-question survey was constructed for clinical pharmacists in Germany, Italy, and Portugal, comprising a variety of hospital sizes and specializations. A combination of numerical ranking, yes/no, and open-ended questions was utilized.Results20 pharmacists in Germany, 9 in Italy, and 20 in Portugal completed the survey in entirety. On a scale ranging from 0 to 10, the three countries combined indicated an understanding of nanomedicines as 3.69 and their understanding of nanosimilars as 2.92. Open-ended prompts contained statements indicating the lack of clinical familiarity, regulations/policies provided, and the additional resources they would like to receive.ConclusionThe survey confirmed the need for more guidance from health-system institutions, medical agencies, and pharmaceutical manufacturers. Respondents desired opportunities to learn from webinars, newsletters, guidelines, and/or informational sessions.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"87-94"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133377","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":"Comment on \"Rates of successful conceptions according to COVID-19 vaccination status: Data from the Czech Republic\".","authors":"Chiaki Suda","doi":"10.1177/09246479251377034","DOIUrl":"10.1177/09246479251377034","url":null,"abstract":"","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"152-153"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025130","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":"Follow-up on test referrals and results: Whose responsibility is it?","authors":"Yael Keshet, Ariela Popper-Giveon, Tamar Adar","doi":"10.1177/09246479251401360","DOIUrl":"10.1177/09246479251401360","url":null,"abstract":"<p><p>BackgroundInadequate test follow-up is a major patient safety concern which can have implications for missed or delayed diagnosis and treatment. The community medicine setting poses challenges for test follow-up, which involves ensuring patient performance, receiving information about abnormal results, and informing patients.ObjectiveThis research aimed to learn how community physicians perceive and cope with test follow-up.MethodsIn-depth interviews were conducted with 20 community physicians: 10 family physicians and 10 other specialists.FindingsThe potential for inadequate follow-up on tests emerged from the interviews as a significant risk factor for patients. According to interviewees, inadequate follow-up includes both ensuring that referred tests are performed and receiving and informing patients about abnormal results. It stems from heavy workloads, poor communication between family physicians and specialists, and patients being treated by multiple physicians. The coping strategies employed by physicians, such as encouraging patients to perform tests, contacting patients, documenting follow-ups, and using the healthcare organization's information technology alert system, are described as insufficiently effective.ConclusionsSuggestions are made for enhancing the responsibility of all parties in order to improve the management of test referrals follow-up, ensure that physicians receive the test results, and thus reduce the incidence of adverse events.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"120-130"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644800","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":"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":"270-280"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","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":"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":"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":"307-312"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","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 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":"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":"238-247"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","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":"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":"10.1177/09246479251362606","url":null,"abstract":"","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"314-316"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","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}