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2.
PLoS One ; 19(4): e0300629, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38557690

RESUMO

Taking the green financial ecosystem composed of innovators, green financial institutions and regulators as the object of research, it explores the issue of how to improve the level of efforts of the three types of subjects and the benefits of risk management in the green financial ecosystem. The optimal level of effort, optimal level of return, and optimal level of return on risk management of green financial ecosystems for innovators, green financial institutions, and regulators under the three modes of No-incentive Contract, Cost-sharing Contract, and Synergistic Cooperation Contract are investigated and analyzed respectively, and verified by numerical simulation analysis. The results show: (1) Compared to the No-incentive Contract, the Cost-sharing Contract and the Synergy Cooperation Contract generate more significant incentives, and returns increase over time in both models. (2) The effort level of the participating subjects under the Synergistic Cooperation Contract is the highest, which can realize the Pareto optimization of the participating subjects and the green financial ecosystem at the same time. The study's findings contribute to a deeper understanding of cooperation among innovators, green financial institutions and regulators in facilitating risk management in green financial ecosystems and provide a realistic reference for risk managers in green financial ecosystems.


Assuntos
Ecossistema , Motivação , Humanos , Gestão de Riscos , Simulação por Computador
3.
PLoS One ; 19(3): e0299956, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38457447

RESUMO

Extreme precipitation usually cause grievous losses&casualties, which varies greatly under different scenarios. This paper took Henan province as an example, it innovatively constructed three different extreme precipitation scenarios and built indicators system of social vulnerability from exposure, sensitivity and resilience based on MOVE framework. Social Vulnerability Indexs(SoVI) were then calculated by mathematical models under three different reoccurrence intervals. The results show that SoVI was low in the west and high in the north. High SoVI areas expanded to the middle and south as recurrence intervals increased. SoVI in each area of Henan province increased along with the recurrence intervals at different growth rates. The larger the recurrence interval was, the faster the SoVI increased. The results indicate SoVI is greatly affected by disaster levels, which need to be incorporated into social vulnerability. This study provides not only a new thought for social vulnerability assessment, but also a reference for the policymakers to formulate related risk management policies.


Assuntos
Desastres , Vulnerabilidade Social , China , Medição de Risco , Gestão de Riscos
4.
PLoS One ; 19(3): e0289857, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38457469

RESUMO

BACKGROUND: Globally, increased occurrences of patient safety incidents have become a public concern. The implementation of Patient safety incidents reporting and learning guidelines is fundamental to reducing preventable patient harm. To improve the implementation of these guidelines in specialised care units in KwaZulu-Natal, the views of healthcare professionals were unearthed. AIM: This study explores the healthcare professionals' views toward the implementation of Patient safety incident reporting and learning guidelines in specialised care units. METHODS: A descriptive, explorative qualitative approach was used to collect qualitative data from healthcare professionals working in specialised care units. The study was conducted in specialised care units of three purposely selected public hospitals in two districts of KwaZulu-Natal. Group discussions and semi-structured interviews were conducted from August to October 2021. Content data analysis was performed using Tesch's method of analysis process. RESULTS: The main themes that emerged during data analysis were; ineffective reporting system affecting the communication of Patient safety incident guidelines, inadequate institutional and management support for the healthcare professionals, insufficient education and training of healthcare professionals, and poor human resources affecting the implementation of Patient Safety Incident guidelines. The findings highlighted that there were more major barriers to the implementation of the Patient safety incident reporting and learning guidelines. CONCLUSION: This study confirmed that the Patient safety incident reporting and learning guidelines are still not successfully implemented in the specialised care units and the barriers to implementation were highlighted. For rigorous implementation in South Africa, the study recommends revised Patient safety incident reporting and learning guidelines, designed in consultation with the frontline healthcare professionals. These must consist of standardised, simple- user-friendly reporting process as well as a better implementation strategy to guide the healthcare professionals. Continuous professional development programmes may play an important role in the facilitation of the implementation process.


Assuntos
Segurança do Paciente , Gestão de Riscos , Humanos , África do Sul , Pesquisa Qualitativa , Pessoal de Saúde
5.
Sci Rep ; 14(1): 6005, 2024 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-38472452

RESUMO

Extensive research into dementia has more recently honed in on several key areas. These areas include the advancement of techniques such as the accumulation of amyloid-ß and tau proteins, the monitoring of cerebral hypometabolism rates etc. The primary objective of this study is to explore the intricate interplay between Alzheimer's disease (AD)-other dementias (D) and various chronic illnesses in terms of time, intensity, and connectivity. In this context, we retrospectively examined data of 149,786 individuals aged 65 and above who received diagnoses of AD and D in the year 2020. At first, logistic regression (LR) analysis has been made with "sex", "age" and "foreigner" (citizenship status) independent variables for AD and D. The LR models shows that while "sex" and "age" variables have a small rate on the risk of developing AD/D, it is detected that being a foreigner increase the risk of AD and D as 69.8% and 88.5% respectively. Besides, the LR models have middle-level success prediction rate for both of the two dependent variables. Additionally, we used the parallel coordinates graphs method within the R Studio to visualize their relationships and connections. The findings of this investigation strongly suggest that AD/D don't stand as isolated conditions, but rather stem from intricate interactions and progressive processes involving diverse chronic diseases over time. Notably, ailments including hypertension, coronary artery disease, diabetes, hyperlipidemia, and psychological disorders, contribute substantially to the emergence of both AD and D. This study highlights that the fight against AD/D can only be possible with next-generation prophylactic interventions that can predict and manage risks. Such an approach holds the potential to potentially lower AD and dementia to levels that are amenable to treatment.


Assuntos
Doença de Alzheimer , Humanos , Doença de Alzheimer/metabolismo , Estudos Retrospectivos , Turquia , Peptídeos beta-Amiloides/metabolismo , Proteínas tau , Gestão de Riscos , Biomarcadores
6.
PLoS One ; 19(3): e0299207, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38466755

RESUMO

This study employs a bivariate EGARCH model to examine the Taiwan Futures Exchange's regular and after-hours trading, focusing on the critical aspects of spillover and expiration effects, as well as volatility clustering and asymmetry. The objective of this study is to observe the impact on the trading sessions in Taiwan by the influences of the European and American markets, focusing on the essential roles of the price discovery function and risk disclosure effectiveness of the regular hours trading. This research is imperative considering the increasing interconnectedness of global financial markets and the need for comprehensive risk assessment for investment strategies. It also examines the hedging behavior of after-hours traders, thereby aiming to contribute to pre-investment analysis by future investors. This examination is vital for understanding the dynamics of after-hours trading and its influence on market stability. Results indicate price continuity between both trading sessions, with regular trading often determining after-hours price ranges. Consequently, after-hours price changes can inform regular trading decisions. This finding highlights the importance of after-hours trading for shaping market expectations. Significant profit potential exists in after-hours trading open interest, which serves speculative and hedging purposes. While regular trading volatility influences after-hours trading, the reverse is not true. This suggests Taiwan market information poses a higher risk impact than European and American market data, emphasizing the unique position of the Taiwan market in the global financial ecosystem. After-hours trading volatility reflects the absorption of international market information and plays a crucial role in advance revelation of risks. This underscores the importance of after-hours trading in global risk management and strategy formulation.


Assuntos
Ecossistema , Investimentos em Saúde , Previsões , Gestão de Riscos , Taiwan
7.
J Patient Saf ; 20(3): 202-208, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38525975

RESUMO

OBJECTIVE: Electronic medication management (EMM) systems have been shown to introduce new patient safety risks that were not possible, or unlikely to occur, with the use of paper charts. Our aim was to examine the factors that contribute to EMM-related incidents and how these incidents change over time with ongoing EMM use. METHODS: Incidents reported at 3 hospitals between January 1, 2010, and December 31, 2019, were extracted using a keyword search and then screened to identify EMM-related reports. Data contained in EMM-related incident reports were then classified as unsafe acts made by users and the latent conditions contributing to each incident. RESULTS: In our sample, 444 incident reports were determined to be EMM related. Commission errors were the most frequent unsafe act reported by users (n = 298), whereas workarounds were reported in only 13 reports. User latent conditions (n = 207) were described in the highest number of incident reports, followed by conditions related to the organization (n = 200) and EMM design (n = 184). Over time, user unfamiliarity with the system remained a key contributor to reported incidents. Although fewer articles to electronic transfer errors were reported over time, incident reports related to the transfer of information between different computerized systems increased as hospitals adopted more clinical information systems. CONCLUSIONS: Electronic medication management-related incidents continue to occur years after EMM implementation and are driven by design, user, and organizational conditions. Although factors contribute to reported incidents in varying degrees over time, some factors are persistent and highlight the importance of continuously improving the EMM system and its use.


Assuntos
Erros de Medicação , Gestão de Riscos , Humanos , Erros de Medicação/prevenção & controle , Segurança do Paciente , Hospitais , Eletrônica
9.
Water Sci Technol ; 89(5): 1264-1281, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38483497

RESUMO

Water treatment public-private partnership (PPP) projects are pivotal for sustainable water management but are often challenged by complex risk factors. Efficient risk management in these projects is crucial, yet traditional methodologies often fall short of addressing the dynamic and intricate nature of these risks. Addressing this gap, this comprehensive study introduces an advanced risk classification prediction model tailored for water treatment PPP projects, aimed at enhancing risk management capabilities. The proposed model encompasses an intricate evaluation of crucial risk areas: the natural and ecological environments, socio-economic factors, and engineering entities. It delves into the complex relationships between these risk elements and the overall risk profile of projects. Grounded in a sophisticated ensemble learning framework employing stacking, our model is further refined through a weighted voting mechanism, significantly elevating its predictive accuracy. Rigorous validation using data from the Jiujiang City water environment system project Phase I confirms the model's superiority over standard machine learning models. The development of this model marks a significant stride in risk classification for water treatment PPP projects, offering a powerful tool for enhancing risk management practices. Beyond accurately predicting project risks, this model also aids in developing effective government risk management strategies.


Assuntos
Meio Ambiente , Gestão de Riscos , Medição de Risco
10.
AMA J Ethics ; 26(3): E248-256, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38446730

RESUMO

Inpatient psychiatric units should be therapeutic environments that support dignity and recovery. When adverse outcomes (eg, self-harm, violence) happen in these settings, clinicians and administrators can face litigation and other pressures to prioritize risk management over supporting patients' access to personal belongings, exercise equipment, and private spaces. This article describes these downward pressures toward sparser, controlling environments in inpatient psychiatric settings as a safety funnel and suggests strategies for balancing safety, humanity, and recovery in these contexts.


Assuntos
Pacientes Internados , Comportamento Autodestrutivo , Humanos , Ciências Humanas , Pessoal Administrativo , Gestão de Riscos
11.
Harefuah ; 163(3): 170-173, 2024 Mar.
Artigo em Hebraico | MEDLINE | ID: mdl-38506359

RESUMO

INTRODUCTION: An adverse event is defined as an unwanted and unexpected occurrence in a medical process that may end in harm to the patient. In the USA the number of deaths due to failures reaches 253,000 per year. In Israel, over 10,000 deaths occur per year due to errors in the medical treatment of hospitalized patients, the third most common cause of death after heart disease and cancer. The main cause of failures in medical diagnosis and treatment is the complexity of the medical profession. A large number of caregivers in different medical disciplines are needed to treat one patient, therefore there are many errors, especially regarding communication between therapists. The Israeli health system has been operating with a budget deficit for many years and an addition of at least NIS 20 billion is needed to bring it to optimal functioning. The number of doctors, nurses, and hospital beds per 1000 inhabitants is significantly less than the average of the OECD countries. When there was a 30% increase in the population of Israel it was necessary to enhance the existing situation, with the addition of 7700 hospital beds, but only 1400 were added. This caused a decrease from 2.1 beds per 1000 residents to 1.8 beds per 1000 residents. There is an urgent need to change the elements of treatment safety in the Ministry of Health's strategic plan. An administration for quality, treatment safety, risk management in medicine, and accreditation should be established which, in addition to the care quality division, will include a safety division with investigation and monitoring units and will prepare strategic improvement plans, and a university-level research institute with researchers, computing, statistics, and information gathering units. The institute will receive all reports of adverse events, results of investigations, inspection committees, control and quality committees, relevant verdicts, and updated literature reviews, for research and systemic learning. Strategic plans will be prepared to prevent failures in diagnosis and medical treatment, leading to a decrease in mortality due to adverse events and the significant expenses involved.


Assuntos
Segurança do Paciente , Gestão de Riscos , Humanos , Israel , Qualidade da Assistência à Saúde
12.
AAPS J ; 26(2): 34, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38485849

RESUMO

ICH Q12 asserts that science- and risk-based approaches are applicable to stability studies supporting Chemistry, Manufacturing and Controls (CMC) post-approval changes (PAC) to enable more timely implementation; however, no guidance or specific examples are provided to demonstrate how prior knowledge of the product can inform the risk assessment for the proposed change(s). Ten diverse case studies are presented in this manuscript to demonstrate how science- and risk-based stability strategies were used to support drug substance and product CMC PAC and lifecycle management activities. The accumulated stability knowledge held by original manufacturers of marketed products is substantial, and different elements of this knowledge base were used to assess the risks and impact of the proposed changes for confident change management. This paper provides ways to leverage science- and risk-based stability strategies as part of the post-approval change-management risk-mitigation strategy, which may enable a reduced stability data commitment and/or a reduced reporting category for change implementation.


Assuntos
Gestão de Riscos , Medição de Risco
13.
J Bus Contin Emer Plan ; 17(3): 220-234, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38424588

RESUMO

From 2017 to 2023, British Columbians experienced four record-breaking wildfire seasons, resulting in reduced air quality, mass evacuations and the destruction of homes, properties and livelihoods. Wildfire risk reduction is vital to breaking the sequence of disaster that has befallen such communities as Kelowna, BC in 2003, Ft. McMurray, AB in 2016, and Lytton, BC in 2021. As the City of Penticton ('the City') is located in a wildfire-prone environment, its Fire Department, FireSmart Team and Emergency Program have worked closely together to facilitate a proactive and comprehensive approach towards reducing the impacts of wildfire on Penticton's neighbourhoods, businesses and residents through a variety of wildfire mitigation initiatives. This paper discusses the City's efforts to achieve a holistic wildfire risk management plan through alignment with the seven disciplines of FireSmart and the four pillars of emergency management, namely: the use of education; land use planning and development considerations; vegetation management; emergency planning; and cross training and interagency cooperation. The paper describes the challenges the City has faced, as well its successes, and provides recommendations to help other local authorities reduce the risk of wildfire in their communities.


Assuntos
Planejamento em Desastres , Incêndios Florestais , Conservação dos Recursos Naturais , Comportamento de Redução do Risco , Gestão de Riscos
14.
Sci Rep ; 14(1): 4045, 2024 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-38374369

RESUMO

Medical Laboratory Equipment (MLE) is one of the most influential means for diagnosing a patient in healthcare facilities. The accuracy and dependability of clinical laboratory testing is essential for making disease diagnosis. A risk-reduction plan for managing MLE is presented in the study. The methodology was initially based on the Failure Mode and Effects Analysis (FMEA) method. Because of the drawbacks of standard FMEA implementation, a Technique for Ordering Preference by Similarity to the Ideal Solution (TOPSIS) was adopted in addition to the Simple Additive Weighting (SAW) method. Each piece of MLE under investigation was given a risk priority number (RPN), which in turn assigned its risk level. The equipment performance can be improved, and maintenance work can be prioritized using the generated RPN values. Moreover, five machine learning classifiers were employed to classify TOPSIS results for appropriate decision-making. The current study was conducted on 15 various hospitals in Egypt, utilizing a 150 MLE set of data from an actual laboratory, considering three different types of MLE. By applying the TOPSIS and SAW methods, new RPN values were obtained to rank the MLE risk. Because of its stability in ranking the MLE risk value compared to the conventional FMEA and SAW methods, the TOPSIS approach has been accepted. Thus, a prioritized list of MLEs was identified to make decisions related to appropriate incoming maintenance and scrapping strategies according to the guidance of machine learning classifiers.


Assuntos
Laboratórios , Gestão de Riscos , Humanos , Egito
15.
Accid Anal Prev ; 199: 107515, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38422879

RESUMO

Risk matrix, a tool for visualizing risk assessment results, is essential to facilitate the risk communication and risk management in risk-based decision-making processes related to new and unexplored socio-technical systems. The use of an appropriate risk matrix is discussed in the literature, but it is overlooked for emerging technologies such as Maritime Autonomous Surface Ships (MASS). In this study, a comprehensive framework for developing a risk matrix based on fuzzy Analytic Hierarchy Process (AHP) is proposed. In this framework, a linear function is defined where the risk index is treated as a response variable, while the probability and consequence indices are explanatory variables, with weights of these two indices representing their importance on given risk level. This significance is assessed by experts and quantified using AHP in interval type 2 fuzzy environment. A continuous risk diagram is then created and converted into a risk matrix that can be improved. To verify the feasibility of the proposed framework, a risk matrix is designed in the context of MASS grounding. The results show that the proposed approach is feasible. Our discussion results can provide new insights for the design of risk matrices and promote the management of MASS navigational risks.


Assuntos
Acidentes de Trânsito , Comunicação , Humanos , Probabilidade , Gestão de Riscos
16.
Drug Discov Ther ; 18(1): 54-59, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38417897

RESUMO

The shift towards community-based care in Japan has led to increased medication assistance for older people by non-medical care staff. These staff members help take pre-packaged medications, apply patches, and administer eye drops. This study assessed the risks associated with such assistance by reviewing medication-related incidents across 106 residential care facilities between April 1, 2015, and March 31, 2016. An analysis of incident reports showed that all incidents were minor, with no serious outcomes. The incidents were categorized into four types: dropped drugs, misdelivery/misuse of medicines, forgetting to take medicines, and loss of medicines, with dropped drugs being the most frequent. Most incidents occurred in the morning and primarily involved residents with intermediate nursing care needs. These findings indicate a low risk of serious incidents because of medication assistance from non-medical staff. However, the frequency and nature of the incidents were influenced by the timing of medication administration and the care needs of the residents. These insights highlight the need for customized approaches to medication assistance, considering the residents' care levels and potentially optimizing medication administration times to improve safety in residential care settings.


Assuntos
Gestão de Riscos , Humanos , Idoso , Japão
17.
Sci Total Environ ; 922: 171112, 2024 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-38387579

RESUMO

Consolidation of multi-domain risk management research is essential for strategies facilitating the concerted government (educational) and population-level (behavioural) actions required to reduce microbial private groundwater contamination. However, few studies to date have synthesised this literature or sought to ascertain the causal generality and extent of supply contamination and preventive responses. In light of the Republic of Ireland (ROI) and Ontario's high reliance and research focus on private wells and consequent utility for empirical comparison, a scoping review of pertinent literature (1990-2022) from both regions was undertaken. The SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) method was employed to inform literature searches, with Scopus and Web of Science selected as primary databases for article identification. The review identified 65 relevant articles (Ontario = 34, ROI = 31), with those investigating well user actions (n = 22) and groundwater quality (n = 28) the most frequent. A markedly higher pooled proportion of private supplies in the ROI exhibited microbial contamination (38.3 % vs. 4.1 %), despite interregional similarities in contamination drivers (e.g., weather, physical supply characteristics). While Ontarian well users demonstrated higher rates of historical (≥ 1) and annual well testing (90.6 % vs. 71.1 %; 39.1 % vs. 8.6 %) and higher rates of historical well treatment (42.3 % vs. 24.3 %), interregional levels of general supply knowledge were analogous (70.7 % vs. 71.0 %). Financial cost, organoleptic properties and residence on property during supply construction emerged as predictors of cognition and behaviour in both regions. Review findings suggest broad interregional similarities in drivers of supply contamination and individual-level risk mitigation, indicating that divergence in contamination rates may be attributable to policy discrepancies - particularly well testing incentivisation. The paucity of identified intervention-oriented studies further highlights the importance of renewed research and policy agendas for improved, targeted well user outreach and incentivised, convenience-based services promoting routine supply maintenance.


Assuntos
Água Subterrânea , Abastecimento de Água , Medição de Risco , Gestão de Riscos , Irlanda , Poços de Água
18.
Drug Saf ; 47(4): 389-400, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38308152

RESUMO

INTRODUCTION: Clinical guidelines can contribute to medication errors but there is no overall understanding of how and where these occur. OBJECTIVES: We aimed to identify guideline-related medication errors reported via a national incident reporting system, and describe types of error, stages of medication use, guidelines, drugs, specialties and clinical locations most commonly associated with such errors. METHODS: Retrospective analysis of reports to the National Reporting and Learning System for England and Wales. A hierarchical task analysis (HTA) was developed, describing expected practice when using guidelines. A free-text search was conducted of medication incident reports (2016-2021) using search terms related to common guidelines. All identified reports linked to moderate-severe harm or death, and a random sample of 5100 no/low-harm reports were coded to describe deviations from the HTA. A random sample of 500 cases were independently double-coded. RESULTS: In total, 28,217 reports were identified, with 608 relating to moderate-severe harm or death. Fleiss' kappa for interrater reliability was 0.46. Of the 5708 reports coded, 642 described an HTA step discrepancy (including four linked to a death), suggesting over 3200 discrepancies in the entire dataset of 28,217 reports. Discrepancies related to finding guidelines (n = 300 reports), finding information within guidelines (n = 166) and using information (n = 176). Discrepancies were most frequently identified for guidelines produced by a local organisation (n = 405), and most occurred during prescribing (n = 277) or medication administration (n = 241). CONCLUSION: Difficulties finding and using information from clinical guidelines contribute to thousands of prescribing and medication administration incidents, some of which are associated with substantial patient harm.


Assuntos
Erros de Medicação , Segurança do Paciente , Humanos , Estudos Retrospectivos , Reprodutibilidade dos Testes , Gestão de Riscos
19.
Zhongguo Yi Liao Qi Xie Za Zhi ; 48(1): 80-84, 2024 Jan 30.
Artigo em Chinês | MEDLINE | ID: mdl-38384222

RESUMO

Through the effective application of Essential Principles of Safety and Performance of Medical Devices and IVD Medical Devices (EP), to continuously improve the corresponding management tools to ensure the safety and effectiveness of medical device in the quality management system, risk management system, evaluation of safety and effectiveness for the supervision departments and manufacturers. The current status of the application of EP and the application issues are analyzed in the study. Take artificial joint products for example, the idea of using EP in quality management system, risk management system and evaluation of safety and effectiveness is investigated, and several thoughts are proposed. Supervision departments should strengthen the unified understanding of EP, develop requirements according to the classification of medical device,and refine specific execution requirements.


Assuntos
Equipamentos e Provisões , Gestão de Riscos , Equipamentos e Provisões/normas
20.
Artigo em Chinês | MEDLINE | ID: mdl-38311956

RESUMO

The risk management in workplace is an important measure to effectively prevent and control the harm of hand-transmitted vibration. Based on the relevant developments at home and abroad, this paper expounds the risk of manual vibration operation in workplace by taking contact assessment and hazard assessment as an example. On this basis, the limit management and hierarchical management related to risk management are discussed, and the existing problems are analyzed.


Assuntos
Exposição Ocupacional , Vibração , Vibração/efeitos adversos , Mãos , Local de Trabalho , Gestão de Riscos
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