Impact of a crime prevention ordinance for small retail establishments.

BACKGROUND: Ordinances requiring the implementation of robbery prevention measures have been enacted at the city level in many jurisdictions. We evaluated the impact of an ordinance requiring crime prevention measures on subsequent crime rates. METHODS: Crime reports for robbery and aggravated assault from January 2006 through December 2015 were linked to randomly-selected convenience stores and small retail grocers in Houston (n = 293). Store characteristics and compliance with a list of safety measures were collected by surveyors in 2011. Generalized linear mixed models were used to compare rates of crime before and after the implementation of the ordinance. RESULTS: Robberies decreased significantly after the ordinance went into effect (rate ratio = 0.38; 95% confidence interval 0.29-0.51). No individual safety measure was associated with decreased robbery rates. No similar decrease was observed for aggravated assault. CONCLUSIONS: City ordinances mandating crime prevention measures can be effective. We could not parse out the effectiveness of individual elements, suggesting a comprehensive approach may be more effective.

Implementation of adverse event reporting for medical devices, India.

PROBLEM: Rapid growth in the use of medical devices has drawn attention to gaps in the systematic monitoring of medical device-associated adverse events in India. APPROACH: Implementation of national regulations on medical devices started in January 2018. Supported by a nationwide network of monitoring centres, the Indian Pharmacopoeia Commission coordinates adverse event reports from manufacturers, legal representatives and patients or users. The commission follows-up and reviews reports with subject expert groups and sends recommendations on necessary action to the national regulatory authority. LOCAL SETTING: Before 2015, no systematic structure was in place to collate adverse events associated with medical devices. Several reports of deaths and hospitalization due to faulty hip implants, cardiac stents and poor-quality devices prompted the health ministry to launch the materiovigilance programme. RELEVANT CHANGES: From July 2015 to October 2019, the commission received 1931 adverse event reports, mostly from marketing authorization holders; 1277 were serious events. Reporting increased markedly after 2017. Cardiac stents were the most reported device (926 events; 47.95%). To encourage a culture of reporting, the commission has raised awareness about the programme among stakeholders, developed user-friendly reporting tools and guidelines, and conducted training for hospital personnel on medical device adverse event reporting. LESSONS LEARNT: Regular training to stakeholders develops a sense of responsibility towards reporting medical device adverse events and ensures quality data reporting. Reporters must be assured that reporting adverse events does not have any legal implications for them and given acknowledgement of their role in high-quality device associated adverse event reporting.

Legal perspectives on black box recording devices in the operating environment.

BACKGROUND: A video and medical data recorder in the operating theatre is possible, but concerns over privacy, data use and litigation have limited widespread implementation. The literature on legal considerations and challenges to overcome, and guidelines related to use of data recording in the surgical environment, are presented in this narrative review. METHODS: A review of PubMed and Embase databases and Cochrane Library was undertaken. International jurisprudence on the topic was searched. Practice recommendations and legal perspectives were acquired based on experience with implementation and use of a video and medical data recorder in the operating theatre. RESULTS: After removing duplicates, 116 citations were retrieved and abstracts screened; 31 articles were assessed for eligibility and 20 papers were finally included. According to the European General Data Protection Regulation and US Health Insurance Portability and Accountability Act, researchers are required to make sure that personal data collected from patients and healthcare professionals are used fairly and lawfully, for limited and specifically stated purposes, in an adequate and relevant manner, kept safe and secure, and stored for no longer than is absolutely necessary. Data collected for the sole purpose of healthcare quality improvement are not required to be added to the patient's medical record. CONCLUSION: Transparency on the use and purpose of recorded data should be ensured to both staff and patients. The recorded video data do not need to be used as evidence in court if patient medical records are well maintained. Clear legislation on data responsibility is needed to use the medical recorder optimally for quality improvement initiatives.

ANTECEDENTES: Es posible instalar un sistema de video y grabación de datos médicos en el quirófano, pero su implementación se ha visto limitada por las dudas relativas a la privacidad, uso de datos y aspectos de litigio. Estas dudas deberían superarse, motivo por el que en este trabajo se proponen unas guías sobre el uso de sistemas de registro en el ambiente quirúrgico. MÉTODOS: Se realizó una revisión en las bases de datos Pubmed y Embase y de la Biblioteca Cochrane. Se buscó la jurisprudencia internacional sobre el tema. Se establecieron unas recomendaciones prácticas y de las perspectivas legales adquiridas a través de la experiencia de la implementación y el uso de sistemas de video y registro de datos médicos en el quirófano. RESULTADOS: Se obtuvieron 116 referencias, de las que una vez eliminadas las duplicadas (n = 5) y revisados los resumenes, 31 artículos cumplían los criterios de eligibilidad. En el estudio final se incluyeron 20 artículos. De acuerdo con la Ley Orgánica de Protección de Datos (General Data Protection Regulation, GDRP) y la Ley de Transferencia y Responsabilidad de Seguro Médico (Health Insurance Portability and Accountability Act, HIPAA), los investigadores deben asegurar que los datos personales recopilados pertenecientes a los pacientes y profesionales de la salud se utilicen de manera justa y legal, con fines definidos y bien establecidos, de manera adecuada y relevante, y mantenidos a resguardo y almacenados no más tiempo del estrictamente necesario. No es necesario que los datos recopilados con el único propósito de mejorar la calidad de la atención médica se agreguen a la historia clínica del paciente. CONCLUSIÓN: Se debe asegurar por parte del personal sanitario como del paciente, la transparencia tanto en la utilización como en el objetivo de los datos almacenados. Los datos registrados en video no es necesario que sean usados como evidencia en procesos judiciales si la historia clínica de los pacientes cumple los estandares establecidos. Se precisa una legislación clara sobre la responsabilidad de los datos para la utilización óptima de los registros médicos en las iniciativas de mejora de la calidad.

Are current EU policies on GMOs justified?

The European Court of Justice's recent ruling that the new techniques for crop development are to be considered as genetically modified organisms under the European Union's regulations exacerbates the need for a critical evaluation of those regulations. The paper analyzes the regulation from the perspective of moral and political philosophy. It considers whether influential arguments for restrictions of genetically modified organisms provide cogent justifications for the policies that are in place, in particular a pre-release authorization requirement, mandatory labelling, and de facto bans (in the form of withholding or opting out of authorizations). It is argued that arguments pertaining to risk can justify some form of pre-release authorization scheme, although not necessarily the current one, but that neither de facto bans nor mandatory labelling can be justified by reference to common arguments concerning naturalness, agricultural policy (in particular the promotion of organic farming), socio-economic effects, or consumers' right to choose.

Exploring the system capacity to meet occupational health and safety needs: the case of the ready-made garment industry in Bangladesh.

BACKGROUND: Since the 2013 Rana Plaza incident in Bangladesh, the government of Bangladesh has been under pressure to improve health and safety conditions for workers in the ready-made garment industry. Its efforts have focused heavily on structural safety of the buildings but have largely ignored broader occupational health system issues. This qualitative study explores contextual factors and system challenges that create barriers for ensuring a healthy and safe workplace in the ready-made garment industry in Bangladesh. METHODS: Data were collected through key informant interviews (n = 14) with government officials from the Department of Inspection for Factories and Establishments (DIFE), factory employers, factory doctors and representatives from the Bangladesh Garment Manufacturers and Exporters Association (BGMEA). A thematic analysis was conducted using Atlas-ti v 5.2. RESULTS: A thematic analysis suggests that the capacity of the DIFE to provide adequate occupational health services remains a problem. There is a shortage of both appropriately trained staff and equipment to monitor occupational health and safety in factories and to gather useful data for evidence-based decision-making. Another barrier to effective occupational health and safety of workers is the lack of cooperation by employers in recording data on workers' health and safety problems. Finally, government officials have limited resources and power to enforce compliance with regulations. Such deficiencies threaten the health and safety of this important, largely female, working population. CONCLUSION: This case example focused on the valuable ready-made garment industry sector of Bangladesh's economy. It identifies the critical need for occupational health system strengthening. Specifically system capacity needs to be improved by both increasing human resources for in-factory hazards and health monitoring, regulatory inspection, enforcement, and improved training of government officials around monitoring and reporting.

Warning Statements and Safety Practices Among Manufacturers and Distributors of Electronic Cigarette Liquids in the United States.

Introduction: Prior to the US Food and Drug Administration's (FDA) regulation of electronic cigarettes and warning statements related to nicotine addiction, there was no critical examination of manufacturer/distributor voluntary practices that could potentially inform FDA actions aimed to protect consumers. This study examined the content of warning statements and safety characteristics of electronic cigarette liquid bottles using a national sample. Methods: Research staff randomly selected four electronic cigarette liquid manufacturers/distributors from four US geographic regions. Staff documented the characteristics of product packaging and content of warning statements on 147 electronic cigarette liquids (0-30 mg/ml of nicotine) purchased online from 16 manufacturers/distributors in April of 2016. Results: Data showed that 97.9% of the electronic cigarette liquid bottles included a warning statement, most of which focused on nicotine exposure rather than health. Only 22.4% of bottles used a warning statement that indicated the product "contained nicotine." Of bottles that advertised a nicotine-based concentration of 12 mg/ml, 26% had a warning statements stated that the product "contains nicotine." None of the statements that indicated that the product "contained nicotine" stated that nicotine was "addictive." All bottles had a safety cap and 12% were in plastic shrink-wrap. Fifty-six percent of the websites had a minimum age requirement barrier that prevented under-aged persons from entering. Conclusions: Most manufacturers/distributors printed a warning statement on electronic cigarette liquid bottles, but avoided warning consumers about the presence and the addictiveness of nicotine. Studies are needed to examine manufacturer/distributor modifications to product packaging and how packaging affects consumer behaviors. Implications: These data can inform future FDA requirements related to the packaging and advertising of e-cigarette liquids; regulation related to the content of warning statements, including exposure warning statements, which are not currently mandated; and requirements on websites or language on packaging to help manufacturers adhere to the minimum age of purchase regulation. The data can also be used to help FDA develop additional guidance on the framing of statements on packaging that helps consumers make informed decisions about purchasing the product or protecting young people from use or unintentional exposure to the product.

The effects of the lower ignition propensity cigarettes standard in Estonia: time-series analysis.

BACKGROUND: In 2011, the lower ignition propensity (LIP) standard for cigarettes was implemented in the European Union. Evidence about the impact of that safety measure is scarce. OBJECTIVE: The aim of this paper is to examine the effects of the LIP standard on fire safety in Estonia. METHODS: The absolute level of smoking-related fire incidents and related deaths was modelled using dynamic time-series regression analysis. The data about house fire incidents for the 2007-2013 period were obtained from the Estonian Rescue Board. RESULTS: Implementation of the LIP standard has reduced the monthly level of smoking-related fires by 6.2 (p<0.01, SE=1.95) incidents and by 26% (p<0.01, SE=9%) when estimated on the log scale. Slightly weaker evidence was found about the fatality reduction effects of the LIP regulation. All results were confirmed through counterfactual models for non-smoking-related fire incidents and deaths. CONCLUSIONS: This paper indicates that implementation of the LIP cigarettes standard has improved fire safety in Estonia.

Improving patient safety in Libya: insights from a British health system perspective.

Purpose Patient safety programmes aim to make healthcare safe for both patients and health professionals. The purpose of this paper is to explore the UK's patient safety improvement programmes over the past 15 years and explore what lessons can be learnt to improve Libyan healthcare patient safety. Design/methodology/approach Publications focusing on UK patient safety were searched in academic databases and content analysed. Findings Several initiatives have been undertaken over the past 15 years to improve British healthcare patient safety. Many stakeholders are involved, including regulatory and professional bodies, educational providers and non-governmental organisations. Lessons can be learnt from the British journey. Practical implications Developing a national patient safety strategy for Libya, which reflects context and needs is paramount. Above all, Libyan patient safety programmes should reference internationally approved guidelines, evidence, policy and learning from Britain's unique experience. Originality/value This review examines patient safety improvement strategies adopted in Britain to help developing country managers to progress local strategies based on lessons learnt from Britain's unique experience.

Filling Voice Promotion Gaps in Healthcare through a Comparative Analysis of Error Reporting and Learning Systems and Open Communication and Disclosure Policies in the United States and Germany.

Voice in healthcare is crucial because of its ability to improve organizational performance and prevent medical errors. This paper contends that a comparative analysis of voice promotion in the American and German healthcare industries can strengthen a culture of safety in both countries. It provides a brief introduction to the concept of voice in healthcare, including its impact on safety culture, barriers to voice, and the dual influences of confidentiality and transparency on voice promotion policies. It then examines the theoretical basis, practical workings, and legal aspects of voluntary error reporting and error disclosure as avenues for exercising voice in the U.S. and Germany. Finally, it identifies transferable practices that can remedy shortcomings in each country's voice promotion policy.

Medical immobilization as impairment of bodily organ functions within the meaning of the Polish Penal Code - consultative problems and a proposal for a method of judicial and medical evaluation.

AIM OF THE STUDY: The aim of the paper is analysis of the impact of immobilization treatment of "less severe" motor organ injuries affecting soft tissues on the position of medical experts and court decisions in crimes against health. We also analysed the attitude of courts to expert opinions and present a proposal for a model of judicial and medical opinion in such cases. MATERIAL AND METHODS: In the study, we analysed judgments of the criminal divisions of common courts, in which the use of medical immobilization of a given part of the body or lack thereof could have an impact on the degree of health impairment determined by the medical expert. RESULTS: Some experts consider medical immobilization to be tantamount to an impairment of the function of a body organ, and the courts rarely reject such opinions. For some experts, the key is not the actual function of the immobilized part of the musculoskeletal system after 7 days from injury, but the immobilization treatment itself, and not the time it takes. In addition, experts determine the severity of injuries when immobilization is/is not used. CONCLUSIONS: The degree of health impairment, as defined in the Penal Code, should be determined by a medical check-up carried out 7 days after the injury, with an assessment of its "biological" effects, and not by the use of immobilization treatment and the time for which it is maintained.

Agricultural anaerobic digestion power plants in Ireland and Germany: policy and practice.

The process of anaerobic digestion (AD) is valued as a carbon-neutral energy source, while simultaneously treating organic waste, making it safer for disposal or use as a fertilizer on agricultural land. The AD process in many European nations, such as Germany, has grown from use of small, localized digesters to the operation of large-scale treatment facilities, which contribute significantly to national renewable energy quotas. However, these large AD plants are costly to run and demand intensive farming of energy crops for feedstock. Current policy in Germany has transitioned to support funding for smaller digesters, while also limiting the use of energy crops. AD within Ireland, as a new technology, is affected by ambiguous governmental policies concerning waste and energy. A clear governmental strategy supporting on-site AD processing of agricultural waste will significantly reduce Ireland's carbon footprint, improve the safety and bioavailability of agricultural waste, and provide an indigenous renewable energy source. © 2016 Society of Chemical Industry.

From sanctioning culture to safety culture: Let's stop making errors on error.

The punitive culture continues to prevail in health care organizations that rely primarily on functional systems hierarchies based on conformity. This type of culture is recognized as a major source of an unacceptable number of medical errors. The safety culture has emerged as an imperative to improve the quality and safety of patient care, but also as a shield against the judgments targeted towards the caregivers (doctor and / or nurse) involved in an undesirable event. The safety culture allows a broader view of the error by analyzing both system failures and staff incompetence. Therefore, it places caregivers in their workplace with mutual interactions and protects them from "second victim" status. It is imperative to have a reflection on the safety culture that constitutes a proof of transparency and openness towards society about the mistake that remains taboo. This attitude will avoid the risk of "judicialization of health".

["Even the best law will never replace reflection in the field"]. / « La meilleure des lois ne fera jamais l'économie d'une réflexion sur le terrain ¼.

Implemented in 2006 by the French minister for health, the resource centres for people working with sex offenders (CRIAVS) provide support for professionals and non-professionals, concerned with transgressive sexual behaviour. They offer tools for legal, health and social professionals to facilitate the supervision of sex offenders. Florent Cochez, a psychiatrist and medical examiner, manager of the Aquitaine CRIAVS, describes in this interview the missions of these regional structures, their link with court-ordered therapy and his practice.

Workplace violence and hospital security programs: regulatory compliance, program benchmarks, innovative strategies.

The authors describe the issue of workplace violence in hospitals, a New Jersey state law and regula- tions regarding workplace vio- lence in healthcare, and some innovative strategies that are being utilized to help reduce the occurrence and risk of violence. The authors also discuss compli- ance with the New Jersey regula- tions.

Welding Safety Best Practices.

Welders must be protected from electric shock, welding fumes, fire, and injuries that can be caused by insufficient PPE.

The Main Biological Hazards in Animal Biosafety Level 2 Facilities and Strategies for Control.

Concern about the biological hazards involved in microbiological research, especially research involving laboratory animals, has increased in recent years. Working in an animal biosafety level 2 facility (ABSL-2), commonly used for research on infectious diseases, poses various biological hazards. Here, the regulations and standards related to laboratory biosafety in China are introduced, the potential biological hazards present in ABSL-2 facilities are analyzed, and a series of strategies to control the hazards are presented.

An expert system for the quantification of fault rates in construction fall accidents.

INTRODUCTION: Expert witness reports, prepared with the aim of quantifying fault rates among parties, play an important role in a court's final decision. However, conflicting fault rates assigned by different expert witness boards lead to iterative objections raised by the related parties. This unfavorable situation mainly originates due to the subjectivity of expert judgments and unavailability of objective information about the causes of accidents. As a solution to this shortcoming, an expert system based on a rule-based system was developed for the quantification of fault rates in construction fall accidents. The aim of developing DsSafe is decreasing the subjectivity inherent in expert witness reports. METHODOLOGY: Eighty-four inspection reports prepared by the official and authorized inspectors were examined and root causes of construction fall accidents in Turkey were identified. Using this information, an evaluation form was designed and submitted to the experts. Experts were asked to evaluate the importance level of the factors that govern fall accidents and determine the fault rates under different scenarios. Based on expert judgments, a rule-based expert system was developed. The accuracy and reliability of DsSafe were tested with real data as obtained from finalized court cases. RESULT: DsSafe gives satisfactory results.

Understanding the ANSI Z358.1-2014 Standard for Plumbed and Portable Eyewash Stations.

The ANSI Z358.1-2014 standard serves as a benchmark within the United States and also internationally to help protect workers from eye injuries from caustic and corrosive substances.