Systematic development of a patient safety culture is necessary because lack of quality care leads to human suffering. The aim of this review was to identify evidence of obstetric adverse events (AEs) and near-misses ...Systematic development of a patient safety culture is necessary because lack of quality care leads to human suffering. The aim of this review was to identify evidence of obstetric adverse events (AEs) and near-misses in the context of patient safety. We conducted a search of the published literature from Europe, Australia and the USA in the following databases: Cinahl, Cochrane, Maternity and Infant Care, Ovid, Pro-quest and PubMed, guided by PRISMA procedures. A total of 427 studies were screened, 15 full papers retrieved and nine studies included in the final thematic analysis. The selected papers address a broad spectrum of adverse patient safety events in obstetric care. The themes that emerged were: type of AEs, near-misses and their consequences, strategies to support and improve Patient Safety (PS) and domains related to the WHO Patient Safety competence outcomes. The findings of the first theme were grouped into the following categories: healthcare professionals’ perspectives on ethical conflicts, attributing blame and responsibility, and patients’ perspectives on lack of trust and involvement, as well as medication errors. The second theme, strategies to support interventions to improve PS, was based on two sub-themes: communicating effectively and gaining competence by learning from adverse events, while the third theme was domains related to the WHO Patient Safety competence outcomes. In conclusion, few studies have examined strategies for managing AEs despite the existence of programmes that target the implementation of changes, such as improved teamwork training. In addition to exploring strategies to make safety a priority for patients and healthcare professionals, it is of the utmost importance to improve communication with patients and between professionals in order to maintain and enhance safety. Efforts by organizations and individuals to continuously develop knowledge about the risk of AEs and the use of best practice guidelines are also essential.展开更多
Tricycles form an important part of the intra-city transport system, following the ban placed on motorcycles in Maiduguri, Nigeria. However, no previous studies have been conducted to assess the occurrence of accident...Tricycles form an important part of the intra-city transport system, following the ban placed on motorcycles in Maiduguri, Nigeria. However, no previous studies have been conducted to assess the occurrence of accidents among them. The objective of this study was to determine the prevalence of road accidents, near-misses, and their associated factors among commercial tricycle drivers in Maiduguri. A cross-sectional study was conducted among registered commercial tricycle drivers in Maiduguri who had been in the business for at least a year. Data was collected through face-to-face interviews, using a structured questionnaire, and was subjected to bivariate and multivariate analysis using SPSS. The prevalence of road accidents and near misses were 46% and 50.3% respectively. Only six (3.9%) of respondents who had experienced a near-miss mentioned that they occurred while they were fully awake;during clear weather;and on a smooth, broad, and non-congested road. All the others had experienced the near miss under an unfavourable weather, road, and/or while feeling sleepy. In the bivariate analysis, only psycho-active substance use (χ^2=3.941;df =1;p=0.047) and having experienced more than one near miss (χ^2=31.807;df =1;p<0.001) were significantly associated with having an accidents. However, in the multivariate analysis, having experienced more than one near miss was the only factor which significantly predicted having an accident (OR=2.89 95% CI: 1.64-5.09;p<0.001). There is a need to conduct further intervention studies to determine the effectiveness of intervention measures in reducing accident rates among these tricycle drivers.展开更多
Sea fog is a disastrous weather phenomenon,posing a risk to the safety of maritime transportation.Dense sea fogs reduce visibility at sea and have frequently caused ship collisions.This study used a geographically wei...Sea fog is a disastrous weather phenomenon,posing a risk to the safety of maritime transportation.Dense sea fogs reduce visibility at sea and have frequently caused ship collisions.This study used a geographically weighted regression(GWR)model to explore the spatial non-stationarity of near-miss collision risk,as detected by a vessel conflict ranking operator(VCRO)model from automatic identification system(AIS)data under the influence of sea fog in the Bohai Sea.Sea fog was identified by a machine learning method that was derived from Himawari-8 satellite data.The spatial distributions of near-miss collision risk,sea fog,and the parameters of GWR were mapped.The results showed that sea fog and near-miss collision risk have specific spatial distribution patterns in the Bohai Sea,in which near-miss collision risk in the fog season is significantly higher than that outside the fog season,especially in the northeast(the sea area near Yingkou Port and Bayuquan Port)and the southeast(the sea area near Yantai Port).GWR outputs further indicated a significant correlation between near-miss collision risk and sea fog in fog season,with higher R-squared(0.890 in fog season,2018),than outside the fog season(0.723 in non-fog season,2018).GWR results revealed spatial non-stationarity in the relationships between-near miss collision risk and sea fog and that the significance of these relationships varied locally.Dividing the specific navigation area made it possible to verify that sea fog has a positive impact on near-miss collision risk.展开更多
为了直观展现Near-miss在国内外的研究现状,把握其热点演化路径,同时预测今后的研究趋势,以Web of Science核心合集和CNKI中1995—2020年共计989篇相关文献为研究对象,借助Citespace软件,通过共现图谱、高频词统计、时区图和热词突现等...为了直观展现Near-miss在国内外的研究现状,把握其热点演化路径,同时预测今后的研究趋势,以Web of Science核心合集和CNKI中1995—2020年共计989篇相关文献为研究对象,借助Citespace软件,通过共现图谱、高频词统计、时区图和热词突现等方式对Near-miss在国内外的研究进展进行可视化对比分析。研究结果表明:国内外Near-miss研究在发展趋势、主要研究群体和机构、热点演化路径和前沿趋势等方面均存在一定差异,“风险管理”、“施工安全”和“事故防御”是Near-miss未来的研究趋势。展开更多
The previous research (Danno & Taniguchi, 2015) showed that near-miss incident experience was basically reduced by the Empathy Quotient (EQ) and was disturbed by the Systemizing Quotient (SQ) when the Empathy Quot...The previous research (Danno & Taniguchi, 2015) showed that near-miss incident experience was basically reduced by the Empathy Quotient (EQ) and was disturbed by the Systemizing Quotient (SQ) when the Empathy Quotient was low, based on the Empathizing and Systemizing (E-S) model using a web survey [1]. It means that drivers whose EQ was low and SQ was high had more near-miss incident experience. It suggested that drivers who have a stronger Empathizing function may have stronger hazard perception ability although the Systemizing function may weaken hazard perception ability when Empathizing is weak. And, then, it was revealed that the D score (standard SQ (T) score minus standard EQ (T) score) had a significant effect on the near-miss incident experience. Those results implied that a D score, which is used to classify “E-S types”, should have a relationship with near-miss incident experience, i.e. , hazard perception ability. The EQ and SQ scores were supposed to relate to the cognitive ability to estimate other road users’ mental situations and predict their behavior or to recognize stable laws in traffic situations. The aim of this research was to investigate the relationship between a driver’s visual attention ability (gaze movement) and hazard (near-miss incident) perception ability of different EQ and SQ scores. Drivers’ Real-time Useful Field of View (rUFOV) [2] was measured under normal and hasty driving conditions in a driving simulator which had six scenarios of traffic situation. The result from seven participants who had different EQ and SQ scores showed that a driver’s visual attention ability (gaze movement) corresponds to their scores. This pilot test research revealed a possibility that the individual difference in cognitive trait with E-S model could be a promising tool to understand the mechanism of hazard perception since a D score is used to classify “E-S types”.展开更多
Sepsis,which is life-threatening organ dysfunction resulting from a dysregulated host response to infection,remains a major cause for the admission of pregnant women to the intensive care unit and is one of the leadin...Sepsis,which is life-threatening organ dysfunction resulting from a dysregulated host response to infection,remains a major cause for the admission of pregnant women to the intensive care unit and is one of the leading causes of maternal morbidity and mortality.The obstetric causes include uterine infection,septic abortion,and wound infection.The non-obstetric causes include pyelonephritis and pneumonia.Maternal sepsis may also be from obstetrical critical illness,such as obstetric severe hemorrhage,obstetric(amniotic fluid/pulmonary)embolism,acute fatty liver of pregnancy,and congestive heart failure,cardiopulmonary arrest,and major trauma.The most commonly reported pathogens in maternal sepsis include Escherichia coli,Streptococcus,Staphylococcus,and other gram-negative bacteria.Maternal sepsis may cause intrauterine infection,which results in(1)preterm premature rupture of membranes or preterm labor or birth,(2)cerebral white matter damage or cerebral palsy or neurodevelopmental delay,(3)stillbirth,(4)early-or late-onset sepsis,and(5)perinatal death.The"Hour-1 bundle"should be initiated within the first hour of the recognition of sepsis.The use of early,appropriate antibiotics is crucial in the management of maternal sepsis.Fetal status should be monitored.Appropriate and early source control should be provided.The decision for delivery is often quite complex and should be individualized to each patient’s clinical scenario while taking into consideration the suspected source of infection,maternal status,fetal well-being,and gestational age.Extracorporeal membrane oxygenation has been increasingly used in refractory sepsis during pregnancy and the puerperium.展开更多
基金supported by The Japan Society for Promotion of Science(ID No.S15190)and awards to Professor Elisabeth Severinsson for her work at the Department of Midwifery and Women’s Health at the University of Tokyo.
文摘Systematic development of a patient safety culture is necessary because lack of quality care leads to human suffering. The aim of this review was to identify evidence of obstetric adverse events (AEs) and near-misses in the context of patient safety. We conducted a search of the published literature from Europe, Australia and the USA in the following databases: Cinahl, Cochrane, Maternity and Infant Care, Ovid, Pro-quest and PubMed, guided by PRISMA procedures. A total of 427 studies were screened, 15 full papers retrieved and nine studies included in the final thematic analysis. The selected papers address a broad spectrum of adverse patient safety events in obstetric care. The themes that emerged were: type of AEs, near-misses and their consequences, strategies to support and improve Patient Safety (PS) and domains related to the WHO Patient Safety competence outcomes. The findings of the first theme were grouped into the following categories: healthcare professionals’ perspectives on ethical conflicts, attributing blame and responsibility, and patients’ perspectives on lack of trust and involvement, as well as medication errors. The second theme, strategies to support interventions to improve PS, was based on two sub-themes: communicating effectively and gaining competence by learning from adverse events, while the third theme was domains related to the WHO Patient Safety competence outcomes. In conclusion, few studies have examined strategies for managing AEs despite the existence of programmes that target the implementation of changes, such as improved teamwork training. In addition to exploring strategies to make safety a priority for patients and healthcare professionals, it is of the utmost importance to improve communication with patients and between professionals in order to maintain and enhance safety. Efforts by organizations and individuals to continuously develop knowledge about the risk of AEs and the use of best practice guidelines are also essential.
文摘Tricycles form an important part of the intra-city transport system, following the ban placed on motorcycles in Maiduguri, Nigeria. However, no previous studies have been conducted to assess the occurrence of accidents among them. The objective of this study was to determine the prevalence of road accidents, near-misses, and their associated factors among commercial tricycle drivers in Maiduguri. A cross-sectional study was conducted among registered commercial tricycle drivers in Maiduguri who had been in the business for at least a year. Data was collected through face-to-face interviews, using a structured questionnaire, and was subjected to bivariate and multivariate analysis using SPSS. The prevalence of road accidents and near misses were 46% and 50.3% respectively. Only six (3.9%) of respondents who had experienced a near-miss mentioned that they occurred while they were fully awake;during clear weather;and on a smooth, broad, and non-congested road. All the others had experienced the near miss under an unfavourable weather, road, and/or while feeling sleepy. In the bivariate analysis, only psycho-active substance use (χ^2=3.941;df =1;p=0.047) and having experienced more than one near miss (χ^2=31.807;df =1;p<0.001) were significantly associated with having an accidents. However, in the multivariate analysis, having experienced more than one near miss was the only factor which significantly predicted having an accident (OR=2.89 95% CI: 1.64-5.09;p<0.001). There is a need to conduct further intervention studies to determine the effectiveness of intervention measures in reducing accident rates among these tricycle drivers.
文摘Sea fog is a disastrous weather phenomenon,posing a risk to the safety of maritime transportation.Dense sea fogs reduce visibility at sea and have frequently caused ship collisions.This study used a geographically weighted regression(GWR)model to explore the spatial non-stationarity of near-miss collision risk,as detected by a vessel conflict ranking operator(VCRO)model from automatic identification system(AIS)data under the influence of sea fog in the Bohai Sea.Sea fog was identified by a machine learning method that was derived from Himawari-8 satellite data.The spatial distributions of near-miss collision risk,sea fog,and the parameters of GWR were mapped.The results showed that sea fog and near-miss collision risk have specific spatial distribution patterns in the Bohai Sea,in which near-miss collision risk in the fog season is significantly higher than that outside the fog season,especially in the northeast(the sea area near Yingkou Port and Bayuquan Port)and the southeast(the sea area near Yantai Port).GWR outputs further indicated a significant correlation between near-miss collision risk and sea fog in fog season,with higher R-squared(0.890 in fog season,2018),than outside the fog season(0.723 in non-fog season,2018).GWR results revealed spatial non-stationarity in the relationships between-near miss collision risk and sea fog and that the significance of these relationships varied locally.Dividing the specific navigation area made it possible to verify that sea fog has a positive impact on near-miss collision risk.
文摘为了直观展现Near-miss在国内外的研究现状,把握其热点演化路径,同时预测今后的研究趋势,以Web of Science核心合集和CNKI中1995—2020年共计989篇相关文献为研究对象,借助Citespace软件,通过共现图谱、高频词统计、时区图和热词突现等方式对Near-miss在国内外的研究进展进行可视化对比分析。研究结果表明:国内外Near-miss研究在发展趋势、主要研究群体和机构、热点演化路径和前沿趋势等方面均存在一定差异,“风险管理”、“施工安全”和“事故防御”是Near-miss未来的研究趋势。
文摘The previous research (Danno & Taniguchi, 2015) showed that near-miss incident experience was basically reduced by the Empathy Quotient (EQ) and was disturbed by the Systemizing Quotient (SQ) when the Empathy Quotient was low, based on the Empathizing and Systemizing (E-S) model using a web survey [1]. It means that drivers whose EQ was low and SQ was high had more near-miss incident experience. It suggested that drivers who have a stronger Empathizing function may have stronger hazard perception ability although the Systemizing function may weaken hazard perception ability when Empathizing is weak. And, then, it was revealed that the D score (standard SQ (T) score minus standard EQ (T) score) had a significant effect on the near-miss incident experience. Those results implied that a D score, which is used to classify “E-S types”, should have a relationship with near-miss incident experience, i.e. , hazard perception ability. The EQ and SQ scores were supposed to relate to the cognitive ability to estimate other road users’ mental situations and predict their behavior or to recognize stable laws in traffic situations. The aim of this research was to investigate the relationship between a driver’s visual attention ability (gaze movement) and hazard (near-miss incident) perception ability of different EQ and SQ scores. Drivers’ Real-time Useful Field of View (rUFOV) [2] was measured under normal and hasty driving conditions in a driving simulator which had six scenarios of traffic situation. The result from seven participants who had different EQ and SQ scores showed that a driver’s visual attention ability (gaze movement) corresponds to their scores. This pilot test research revealed a possibility that the individual difference in cognitive trait with E-S model could be a promising tool to understand the mechanism of hazard perception since a D score is used to classify “E-S types”.
基金This research was supported by the Shenzhen Science and Technology Innovation Commission(JCYJ20180228162311024)
文摘Sepsis,which is life-threatening organ dysfunction resulting from a dysregulated host response to infection,remains a major cause for the admission of pregnant women to the intensive care unit and is one of the leading causes of maternal morbidity and mortality.The obstetric causes include uterine infection,septic abortion,and wound infection.The non-obstetric causes include pyelonephritis and pneumonia.Maternal sepsis may also be from obstetrical critical illness,such as obstetric severe hemorrhage,obstetric(amniotic fluid/pulmonary)embolism,acute fatty liver of pregnancy,and congestive heart failure,cardiopulmonary arrest,and major trauma.The most commonly reported pathogens in maternal sepsis include Escherichia coli,Streptococcus,Staphylococcus,and other gram-negative bacteria.Maternal sepsis may cause intrauterine infection,which results in(1)preterm premature rupture of membranes or preterm labor or birth,(2)cerebral white matter damage or cerebral palsy or neurodevelopmental delay,(3)stillbirth,(4)early-or late-onset sepsis,and(5)perinatal death.The"Hour-1 bundle"should be initiated within the first hour of the recognition of sepsis.The use of early,appropriate antibiotics is crucial in the management of maternal sepsis.Fetal status should be monitored.Appropriate and early source control should be provided.The decision for delivery is often quite complex and should be individualized to each patient’s clinical scenario while taking into consideration the suspected source of infection,maternal status,fetal well-being,and gestational age.Extracorporeal membrane oxygenation has been increasingly used in refractory sepsis during pregnancy and the puerperium.
