Smartphone-integrated visual inspection for enhancing agricultural product quality and safety: a review.

The increasing emphasis on the quality and safety of agricultural products, which are vital to global trade and consumer health, has driven the innovation of cost-effective, convenient, and rapid smart detection technologies. Smartphones, with their interdisciplinary functionalities, have become valuable tools in quantification and analysis research. Acting as portable, affordable, and user-friendly analytical devices, smartphones are equipped with high-resolution cameras, displays, memory, communication modules, sensors, and operating systems (Android or IOS), making them powerful, palm-sized remote computers. This review delves into how visual inspection technology and smartphones have enhanced the quality and safety of agricultural products over the past decade. It also evaluates the key features and limitations of existing smart rapid inspection methods for agricultural products and anticipates future advancements, offering insights into the application of smart rapid inspection technology in agriculture.

Ten Years of Quality Monitoring of Abdominal Organ Procurement in the Netherlands and Its Impact on Transplant Outcome.

In this study, 10 years of procurement quality monitoring data were analyzed to identify potential risk factors associated with procurement-related injury and their association with long-term graft survival. All deceased kidney, liver, and pancreas donors from 2012 to 2022 and their corresponding recipients in the Netherlands were retrospectively included. The incidence of procurement-related injuries and potential risk factors were analyzed. Of all abdominal organs procured, 23% exhibited procurement-related injuries, with a discard rate of 4.0%. In kidneys and livers, 23% of the grafts had procurement-related injury, with 2.5% and 4% of organs with procurement-related injury being discarded, respectively. In pancreas procurement, this was 27%, with a discard rate of 24%. Male donor gender and donor BMI >25 were significant risk factors for procurement-related injury in all three abdominal organs, whereas aberrant vascularization was significant only for the kidney and liver. In the multivariable Cox regression analyses, procurement-related injury was not a significant predictor for graft failure (kidney; HR 0.99, 95% CI 0.75-1.33, p = 0.99, liver; HR 0.92, 95% CI 0.66-1.28, p = 0.61, pancreas: HR 1.16; 95% CI 0.16-8.68, p = 0.88). The findings of this study suggest that transplant surgeons exhibited good decision-making skills in determining the acceptability and repairability of procurement-related injuries.

A system for developing reasonable adjustments to the application of the National Safety and Quality Health Service Standards for adult patients with intellectual disability in Australian hospital settings.

The Australian Commission of Safety and Quality in Health Care mandates the application of the eight National Safety and Quality Health Service Standards to minimise high-risk adverse events in hospital settings for all Australian patients. It acknowledges that adults with intellectual disability require reasonable adjustments to the application of the standards to optimise the impact of the quality and safety measures for this group. The paper proposes a system whereby reasonable adjustments can be developed for this population. First, particular criteria, items or actions of a standard are selected for the formulation of reasonable adjustments. Second, the adjustments are broken down into categories of alterations to usual knowledge, process, content and organisation involved in compliance with the chosen aspect of the standard. Third, the categories of reasonable adjustments are simultaneously influenced and shaped by aspects of living with intellectual disability, disability supports and a health-disability sectoral interface.

Invited review: Role of Bacillus licheniformis in the dairy industry-Friends or foes?

Bacillus licheniformis is one of the major spore-forming bacteria with great genotypic diversity in raw milk, dairy ingredients, and final dairy products; it is found throughout the dairy-processing continuum. Although being widely used as a probiotic strain, this species also serves as a potential risk in the dairy industry based on its roles in foodborne illness and dairy spoilage. Biofilm formation of B. licheniformis, combined with the heat resistance of its spores, make it impossible to prevent the presence of B. licheniformis in final dairy products by using traditional cleaning and disinfection procedures. Despite the extensive efforts to identify B. licheniformis in various dairy samples, no reviews have been written on both hazards and benefits of this sporeformer. This review discusses the prevalence of B. licheniformis from raw milk to commercial dairy products, biofilm formation and spoilage potential of B. licheniformis, and possible prevention methods. In addition, the potential benefits of B. licheniformis in the dairy industry are also summarized.

Quality and Accountability of ChatGPT in Health Care in Low- and Middle-Income Countries: Simulated Patient Study.

Using simulated patients to mimic 9 established noncommunicable and infectious diseases, we assessed ChatGPT's performance in treatment recommendations for common diseases in low- and middle-income countries. ChatGPT had a high level of accuracy in both correct diagnoses (20/27, 74%) and medication prescriptions (22/27, 82%) but a concerning level of unnecessary or harmful medications (23/27, 85%) even with correct diagnoses. ChatGPT performed better in managing noncommunicable diseases than infectious ones. These results highlight the need for cautious AI integration in health care systems to ensure quality and safety.

Digital Maturity as a Predictor of Quality and Safety Outcomes in US Hospitals: Cross-Sectional Observational Study.

BACKGROUND: This study demonstrates that digital maturity contributes to strengthened quality and safety performance outcomes in US hospitals. Advanced digital maturity is associated with more digitally enabled work environments with automated flow of data across information systems to enable clinicians and leaders to track quality and safety outcomes. This research illustrates that an advanced digitally enabled workforce is associated with strong safety leadership and culture and better patient health and safety outcomes. OBJECTIVE: This study aimed to examine the relationship between digital maturity and quality and safety outcomes in US hospitals. METHODS: The data sources were hospital safety letter grades as well as quality and safety scores on a continuous scale published by The Leapfrog Group. We used the digital maturity level (measured using the Electronic Medical Record Assessment Model [EMRAM]) of 1026 US hospitals. This was a cross-sectional, observational study. Logistic, linear, and Tweedie regression analyses were used to explore the relationships among The Leapfrog Group's Hospital Safety Grades, individual Leapfrog safety scores, and digital maturity levels classified as advanced or fully developed digital maturity (EMRAM levels 6 and 7) or underdeveloped maturity (EMRAM level 0). Digital maturity was a predictor while controlling for hospital characteristics including teaching status, urban or rural location, hospital size measured by number of beds, whether the hospital was a referral center, and type of hospital ownership as confounding variables. Hospitals were divided into the following 2 groups to compare safety and quality outcomes: hospitals that were digitally advanced and hospitals with underdeveloped digital maturity. Data from The Leapfrog Group's Hospital Safety Grades report published in spring 2019 were matched to the hospitals with completed EMRAM assessments in 2019. Hospital characteristics such as number of hospital beds were obtained from the CMS database. RESULTS: The results revealed that the odds of achieving a higher Leapfrog Group Hospital Safety Grade was statistically significantly higher, by 3.25 times, for hospitals with advanced digital maturity (EMRAM maturity of 6 or 7; odds ratio 3.25, 95% CI 2.33-4.55). CONCLUSIONS: Hospitals with advanced digital maturity had statistically significantly reduced infection rates, reduced adverse events, and improved surgical safety outcomes. The study findings suggest a significant difference in quality and safety outcomes among hospitals with advanced digital maturity compared with hospitals with underdeveloped digital maturity.

Recent advances in activated water systems for the postharvest management of quality and safety of fresh fruits and vegetables.

Over the last three decades, decontamination management of fresh fruits and vegetables (FFVs) in the packhouses and along the supply chains has been heavily dependent on chemical-based wash. This has resulted in the emergence of resistant foodborne pathogens and often the deposition of disinfectant byproducts on FFVs, rendering them unacceptable to consumers. The management of foodborne pathogens, microbial contaminants, and quality of FFVs are a major concern for the horticultural industries and public health. Activated water systems (AWS), such as electrolyzed water, plasma-activated water, and micro-nano bubbles, have gained significant attention from researchers over the last decade due to their nonthermal and nontoxic mode of action for microbial inactivation and preservation of FFVs quality. The aim of this review is to provide a comprehensive summary of recent progress on the application of AWS and their effects on quality attributes and microbial safety of FFVs. An overview of the different types of AWS and their properties is provided. Furthermore, the review highlights the chemistry behind generation of reactive species and the impact of AWS on the quality attributes of FFVs and on the inactivation/reduction of spoilage and pathogenic microbes (in vivo or in vitro). The mechanisms of action of microorganism inactivation are discussed. Finally, this work highlights challenges and limitations for commercialization and safety and regulation issues of AWS. The synergistic prospect on combining AWS for maximum microorganism inactivation effectiveness is also considered. AWS offers a potential alternative as nonchemical interventions to maintain quality attributes, inactivate spoilage and pathogenic microorganisms, and extend the shelf-life for FFVs.

Antimicrobial resistomes in food chain microbiomes.

The safety and integrity of the global food system is in a constant state of flux with persistent chemical and microbial risks. While chemical risks are being managed systematically, microbial risks pose extra challenges. Antimicrobial resistant microorganism and persistence of related antibiotic resistance genes (ARGs) in the food chain adds an extra dimension to the management of microbial risks. Because the food chain microbiome is a key interface in the global health system, these microbes can affect health in many ways. In this review, we systematically summarize the distribution of ARGs in foods, describe the potential transmission pathway and transfer mechanism of ARGs from farm to fork, and discuss potential food safety problems and challenges. Modulating antimicrobial resistomes in the food chain facilitates a sustainable global food production system.

Overview of advanced technologies for volatile organic compounds measurement in food quality and safety.

Food quality and nutrition have received much attention in recent decades, thanks to changes in consumer behavior and gradual increases in food consumption. The demand for high-quality food necessitates stringent quality assurance and process control measures. As a result, appropriate analytical tools are required to assess the quality of food and food products. VOCs analysis techniques may meet these needs because they are nondestructive, convenient to use, require little or no sample preparation, and are environmentally friendly. In this article, the main VOCs released from various foods during transportation, storage, and processing were reviewed. The principles of the most common VOCs analysis techniques, such as electronic nose, colorimetric sensor array, migration spectrum, infrared and laser spectroscopy, were discussed, as well as the most recent research in the field of food quality and safety evaluation. In particular, we described data processing algorithms and data analysis captured by these techniques in detail. Finally, the challenges and opportunities of these VOCs analysis techniques in food quality analysis were discussed, as well as future development trends and prospects of this field.

Novel sequential and simultaneous infrared-accelerated drying technologies for the food industry: Principles, applications and challenges.

Infrared drying (IRD) is considered an innovative drying solution for the food industry with advantages of energy-saving potentials, reduced drying time and production cost-effectiveness. However, IRD also suffers from drawbacks such as weak penetrative ability, and product overheating and burning. Therefore, over the years, significant progress has been made to overcome these shortcomings by developing infrared-accelerated drying (IRAD) technology based on the combination of IRD with other drying technologies. Although several reviews have been published on IRD, no review focusing on IRAD is yet available. The current review presents up-to-date knowledge and findings on the applications of IRAD technologies for enhancing the quality and safety of food. The fundamental principles and characteristics of IRAD, energy-saving potentials, simulation and optimization approaches for enhancing efficiency, and developments in various acceleration approaches by combining with other drying techniques for achieving better end-products are discussed, and challenges and future work for developing the novel accelerated drying technology are also presented. Due to the synergistic effects of sequential or simultaneous combined drying methods, the total drying time and energy required are drastically lowered with most IRAD technologies, and consequently there are significant improvements in the sensory, nutritional, and safety attributes of dried food products with better appearance and quality. The development of multi-wavelength IRAD systems based on infrared absorption bands, and the incorporation of novel sensing techniques for real-time monitoring during drying will further enhance process efficiency and food quality and safety.

Critical review and recent advances of 2D materials-Based gas sensors for food spoilage detection.

Many people around the world are concerned about meat safety and quality, which has resulted in the ongoing advancement of packaged food technology. Since the emergence of graphene in 2004, the number of studies on layered two-dimensional materials (2DMs) for applications ranging from food packaging to meat quality monitoring has been expanding quickly. Recently, scientists have been working hard to develop a novel class of 2DMs that keep the good things about graphene but don't have zero bandgaps at room temperature. Much work has been done on layered transition metal dichalcogenides (TMDCs) like different metal sulfides and selenides for meat spoilage gas sensors. This review looks at (i) the main indicators of meat spoilage and (ii) the detection methods that can be used to find out if meat has been spoiled, such as chemiresistive, electrochemical, and optical methods. (iii) the role of 2DMs in meat spoilage detection and (iv) the emergence of advanced methods for selective classification of target analytes in meat/food spoilage detection in recent years. Thus, this review demonstrates the potential scope of 2DMs for developing intelligent sensor systems for food and meat spoilage detection with high viability, simplicity, cost-effectiveness, and other multipurpose tools.

Development and External Validation of an Artificial Intelligence Model for Identifying Radiology Reports Containing Recommendations for Additional Imaging.

BACKGROUND. Reported rates of recommendations for additional imaging (RAIs) in radiology reports are low. Bidirectional encoder representations from transformers (BERT), a deep learning model pretrained to understand language context and ambiguity, has potential for identifying RAIs and thereby assisting large-scale quality improvement efforts. OBJECTIVE. The purpose of this study was to develop and externally validate an artificial intelligence (AI)-based model for identifying radiology reports containing RAIs. METHODS. This retrospective study was performed at a multisite health center. A total of 6300 radiology reports generated at one site from January 1, 2015, to June 30, 2021, were randomly selected and split by 4:1 ratio to create training (n = 5040) and test (n = 1260) sets. A total of 1260 reports generated at the center's other sites (including academic and community hospitals) from April 1 to April 30, 2022, were randomly selected as an external validation group. Referring practitioners and radiologists of varying sub-specialties manually reviewed report impressions for presence of RAIs. A BERT-based technique for identifying RAIs was developed by use of the training set. Performance of the BERT-based model and a previously developed traditional machine learning (TML) model was assessed in the test set. Finally, performance was assessed in the external validation set. The code for the BERT-based RAI model is publicly available. RESULTS. Among a total of 7419 unique patients (4133 women, 3286 men; mean age, 58.8 years), 10.0% of 7560 reports contained RAI. In the test set, the BERT-based model had 94.4% precision, 98.5% recall, and an F1 score of 96.4%. In the test set, the TML model had 69.0% precision, 65.4% recall, and an F1 score of 67.2%. In the test set, accuracy was greater for the BERT-based than for the TML model (99.2% vs 93.1%, p < .001). In the external validation set, the BERT-based model had 99.2% precision, 91.6% recall, an F1 score of 95.2%, and 99.0% accuracy. CONCLUSION. The BERT-based AI model accurately identified reports with RAIs, outperforming the TML model. High performance in the external validation set suggests the potential for other health systems to adapt the model without requiring institution-specific training. CLINICAL IMPACT. The model could potentially be used for real-time EHR monitoring for RAIs and other improvement initiatives to help ensure timely performance of clinically necessary recommended follow-up.

Grading pharmacists' risk of complaints to a regulator: A retrospective cohort study.

Background: Tools to grade risk of complaint to a regulatory board have been developed for physicians but not for other health practitioner groups, including pharmacists. We aimed to develop a score that classified pharmacists into low, medium and high risk categories. Methods: Registration and complaint data were sourced from Ontario College of Pharmacists for January 2009 to December 2019. We undertook recurrent event survival analysis to predict lodgement of a complaint. We identified those variables that were associated with a complaint and included these in a risk score which we called PRONE-Pharm (Predicted Risk of New Event for Pharmacists). We assessed diagnostic accuracy and used this to identify thresholds that defined low, medium and high risk. Results: We identified 3,675 complaints against 17,308 pharmacists. Being male (HR = 1.72), older age (HR range 1.43-1.54), trained internationally (HR = 1.62), ≥1 prior complaint (HR range 2.83-9.60), and complaints about mental health or substance use (HR = 1.91), compliance with conditions (HR = 1.86), fees and servicing (HR = 1.74), interpersonal behaviour or honesty (HR = 1.40), procedures (HR = 1.75) and treatment or communication or other clinical issues (HR = 1.22) were all associated with lodgement of a complaint. When converted into the PRONE-Pharm risk score, pharmacists were assigned between 0 and 98 points with higher scores closely associated with higher probability of a complaint. A score of ≥25 had sufficient accuracy for classifying medium-risk pharmacists (specificity = 87.0%) and ≥45 for high-risk pharmacists (specificity = 98.4%). Conclusion: Distinguishing isolated incidents from persistent problems poses a significant challenge for entities responsible for the regulation of pharmacists and other health practitioners. The diagnostic properties of PRONE-Pharm (minimizing the false positives) means that the risk score is useful for "ruling-out" low risk pharmacists using routinely collected regulatory data. PRONE-Pharm may be useful when used alongside interventions appropriately matched to a pharmacist's level of risk.

Scale up of anaesthesia services in underserved rural Tanzania.

BACKGROUND: Because of critical shortage of physician anaesthesiologists, the government of Tanzania adopted a task shifting strategy for provision of anaesthesia services. This paper describes the results of an operational study designed to increase the number of anaesthesia providers for emergency obstetric surgeries in order to reduce maternal and perinatal mortality in underserved rural Tanzania. METHODS: In 2016 a before-after cohort study was conducted in seven health centres in rural Tanzania. Five health centres received an intervention and two were selected to track secular trends (control group). Ten associate clinicians, i.e. assistant medical officers, clinical officers, and nurse midwives, from five health centres were trained in anaesthesia skills for emergency obstetric surgeries for three months followed by quarterly supportive supervision, mentoring and teleconsultation to reinforce skills. Primary and secondary outcome measures included Caesarean delivery (CD) rate, quality and safety of anaesthesia, and uptake of the educational program for anaesthesia. RESULTS: Out of the 2,179 CDs performed in the intervention facilities from 2016 to 2019, two women died from complications of anaesthesia. The risk of death from anaesthetic complications was 0.9 per 1000 CD (95% CI 0.1-3.3. The risk of death was not established in the control group because of inadequate documentation and records keeping. The proportion of CD performed under spinal anaesthesia in intervention facilities doubled from 28% (60/214 with 95% CI 22-35) at baseline (July 2014 - June 2016) to 57% (558/971 with 95% CI of 54-61) in year three (July 2018 - June 2019), while in the control group increased by only 40% from 19% (92/475 with 95% CI of 16-23) at baseline and 27% (68/251 with 95% CI of 22-33) in year three. In 2020I, this educational training program was then adopted by the government with minor content changes and increasing duration of training to six months. CONCLUSIONS: This three month educational training program for associate clinicians in anaesthesia, complemented by supportive supervision, can increase the CD rate to one that fills the "unmet need" and the proportion of operations performed under spinal anaesthesia, the gold standard technique for CD. The program can be used to meet the urgent demand for anaesthesia services in other underserved areas in Africa.

Outcomes for 41 260 pediatric surgical patients with opioid-free anesthesia: One center's experience.

BACKGROUND: Opioid use is common and associated with side effects and risks. Consequently, analgesic strategies to reduce opioid utilization have been developed. Regional anesthesia and multimodal strategies are central tenets of enhanced recovery pathways and facilitate reduced perioperative opioid use. Opioid-free anesthesia (OFA) protocols eliminate all intraoperative opioids, reserving opioids for postoperative rescue treatment. Systematic reviews show variable results for OFA. METHODS: In a series of Quality Improvement (QI) projects, multidisciplinary teams developed interventions to test and spread OFA first in our ambulatory surgery center (ASC) and then in our hospital. Outcome measures were tracked using statistical process control charts to increase the adoption of OFA. RESULTS: Between January 1, 2016, and September 30, 2022, 19 872 of 28 574 ASC patients received OFA, increasing from 30% to 98%. Post Anesthesia Care Unit (PACU) maximum pain score, opioid-rescue rate, and postoperative nausea and vomiting (PONV) treatment all decreased concomitantly. The use of OFA now represents our ambulatory standard practice. Over the same timeframe, the spread of this practice to our hospital led to 21 388 of 64 859 patients undergoing select procedures with OFA, increasing from 15% to 60%. Opioid rescue rate and PONV treatment in PACU decreased while hospital maximum pain scores and length of stay were stable. Two procedural examples with OFA benefits were identified. The use of OFA allowed relaxation of adenotonsillectomy admission criteria, resulting in 52 hospital patient days saved. Transition to OFA for laparoscopic appendectomy occurred concomitantly with a decrease in the mean hospital length of stay from 2.9 to 1.4 days, representing a savings of >500 hospital patient days/year. CONCLUSIONS: These QI projects demonstrated that most pediatric ambulatory and select inpatient surgeries are amenable to OFA techniques which may reduce PONV without worsening pain.

Interpreting and coding causal relationships for quality and safety using ICD-11.

Many circumstances necessitate judgments regarding causation in health information systems, but these can be tricky in medicine and epidemiology. In this article, we reflect on what the ICD-11 Reference Guide provides on coding for causation and judging when relationships between clinical concepts are causal. Based on the use of different types of codes and the development of a new mechanism for coding potential causal relationships, the ICD-11 provides an in-depth transformation of coding expectations as compared to ICD-10. An essential part of the causal relationship interpretation relies on the presence of "connecting terms," key elements in assessing the level of certainty regarding a potential relationship and how to proceed in coding a causal relationship using the new ICD-11 coding convention of postcoordination (i.e., clustering of codes). In addition, determining causation involves using documentation from healthcare providers, which is the foundation for coding health information. The coding guidelines and examples (taken from the quality and patient safety domain) presented in this article underline how new ICD-11 features and coding rules will enhance future health information systems and healthcare.

Quality and safety education for nurses: A bibliometric analysis.

PURPOSE: Since its origin in the United States in 2005, Quality and Safety Education for Nurses (QSEN) has guided nurses' preparation for alleviating preventable harm and improving quality safe care. QSEN's value is illustrated through specific inclusion in the competency-based 2021 American Association for Colleges of Nursing (AACN) Essentials. The purpose of this bibliometric analysis is to explore publication patterns of the extant QSEN literature to assess QSEN's spread and global penetration and to map the available knowledge and data regarding quality and safety education for nurses. DESIGN: Bibliometric analysis. METHOD: Two QSEN investigators and two health science librarians completed database searches to identify articles with keywords QSEN or Quality and safety education for nursing. Inclusion criteria were (1) QSEN-specific and (2) published in a peer-reviewed journal. Using PRISMA screening, the final sample included 221 articles between 2007 and 2021. RESULTS: Average annual QSEN publications was 14.5 articles; the highest was 26 publications in 2017. Article types were 84 research, 77 descriptive/reviews, 28 quality improvement projects or case studies, 20 statements, and 12 editorials. Focus analysis revealed 165 education articles, 35 clinical practice, 17 professional development, and 4 leadership/administration. Fourteen journals published three or more; eight were education journals. Nine topic clusters indicated areas of publication focus, including clinical teaching, simulations, performance, context, and criteria of analysis, factors of efficacy, innovation and advanced practice, patient care and outcomes, academic concepts, and research frameworks. CONCLUSIONS: Results reveal far less QSEN penetration for guiding professional practice, research measuring outcomes and impact, and global collaboration to examine cultural implications for diversity and inclusion. Results present future recommendations to assure all nurses worldwide have access to competency development to alleviate preventable healthcare harm. CLINICAL RELEVANCE: Originating in the United States (US), the QSEN project provided the seminal framework for transforming education and practice through defining the six quality and safety competencies (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics) essential to alleviate preventable healthcare harm. Results reveal opportunities to advance QSEN penetration in developing professional practice, guiding research measuring outcomes and impact, and extending global collaboration to examine cultural implications for diversity and inclusion.

Compliance with clinical guidelines increases the safety of vacuum-assisted delivery.

BACKGROUND: Vacuum-assisted delivery (VAD) is a common and safe obstetric procedure. However, occasionally serious complications may occur. Clinical guidelines and College Statements have been developed to reduce the risk of serious adverse events. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) College Statement C-Obs 16 has not been evaluated to see if advice improves outcomes. AIM: The aim was to evaluate whether compliance with RANZCOG College Statement C-Obs 16 advice reduced the risk of serious adverse outcomes, specifically clinically significant subgaleal haemorrhage and major birth trauma. MATERIALS AND METHODS: Retrospective audit of VADs in a level five hospital (NSW Maternity and Neonatal capability framework) from January 2020 to 2021. RESULTS: There were 1960 women who delivered in the study period, of whom 252 (12.8%) delivered by vacuum, and complete data were available from 241 cases. Statement compliance was observed in 81%. The main deviation from Statement compliance was pulls exceeding three. Statement compliance was associated with a significant reduction in the incidence of subgaleal haemorrhage (0% vs 11%, P = 0.0002), major birth trauma (3% vs 22%, P = 0.0001), requirement for neonatal resuscitation (14% vs 35%, P = 0.0026) and Apgar scores at one minute less than six (5% vs 22% P = 0.0006). Statement compliance was associated with a significant reduction in maternal blood loss at delivery (388 mL vs 438 mL, P = 0.01). Noncompliance with Statement advice was observed significantly more often in pregnancy complicated by gestational diabetes (3% vs 15%, P = 0.02) and birth requiring instrument change (4% vs 13% P = 0.031). CONCLUSION: Compliance with a College Statement is associated with lower rates of subgaleal haemorrhage and major neonatal trauma. The main deviation from compliance was pulls in excess of three. Keyword: birth trauma, clinical guidelines, quality and safety in healthcare, subgaleal haemorrhage, vacuum delivery.

Oxygen Sensor-Based Respirometry and the Landscape of Microbial Testing Methods as Applicable to Food and Beverage Matrices.

The current status of microbiological testing methods for the determination of viable bacteria in complex sample matrices, such as food samples, is the focus of this review. Established methods for the enumeration of microorganisms, particularly, the 'gold standard' agar plating method for the determination of total aerobic viable counts (TVC), bioluminescent detection of total ATP, selective molecular methods (immunoassays, DNA/RNA amplification, sequencing) and instrumental methods (flow cytometry, Raman spectroscopy, mass spectrometry, calorimetry), are analyzed and compared with emerging oxygen sensor-based respirometry techniques. The basic principles of optical O2 sensing and respirometry and the primary materials, detection modes and assay formats employed are described. The existing platforms for bacterial cell respirometry are then described, and examples of particular assays are provided, including the use of rapid TVC tests of food samples and swabs, the toxicological screening and profiling of cells and antimicrobial sterility testing. Overall, O2 sensor-based respirometry and TVC assays have high application potential in the food industry and related areas. They detect viable bacteria via their growth and respiration; the assay is fast (time to result is 2-8 h and dependent on TVC load), operates with complex samples (crude homogenates of food samples) in a simple mix-and-measure format, has low set-up and instrumentation costs and is inexpensive and portable.

Assessment of nurse's perceived just culture: a cross-sectional study.

BACKGROUND: The non-punitive approach to error investigation in most safety culture surveys have been relatively low. Most of the current patient safety culture measurement tools also lack the ability to directly gauge concepts important to a just culture (i.e. perceptions of fairness and trust). The purpose of this study is to assess nurses' perceptions of the six just culture dimensions using the validated Just Culture Assessment Tool (JCAT). METHODS: This descriptive, cross-sectional study was conducted between November and December 2020. Data from 212 staff nurses in a large referral hospital in Qatar were collected. A validated, self-reported survey called the JCAT was used to assess the perception of the just culture dimensions including feedback and communication, openness of communication, balance, quality of event reporting process, continuous improvement, and trust. RESULTS: The study revealed that the overall positive perception score of just culture was (75.44%). The strength areas of the just culture were "continuous improvement" dimension (88.44%), "quality of events reporting process" (86.04%), followed by "feedback and communication" (80.19%), and "openness of communication" (77.55%) The dimensions such as "trust" (68.30%) and "balance" (52.55%) had a lower positive perception rates. CONCLUSION: A strong and effective just culture is a cornerstone of any organization, particularly when it comes to ensuring safety. It places paramount importance on encouraging voluntary error reporting and establishing a robust feedback system to address safety-related events promptly. It also recognizes that errors present valuable opportunities for continuous improvement. Just culture is more than just a no-blame practice. By prioritizing accountability and responsibility among front-line workers, a just culture fosters a sense of ownership and a commitment to improve safety, rather than assigning blame.