Creation and Administration of a Chiropractic Program Practical Classroom Preparticipation Screening Aimed to Prevent Student Injuries: A Descriptive Report.

Objective: The purpose of this descriptive report is to describe the development of a preparticipation risk assessment screening process for incoming students prior to participation in practical labs. Methods: A committee at the Palmer College of Chiropractic, Florida met to discuss a health history questionnaire, physical examination process, and course of action to have second-year students use their current knowledge to screen incoming students for possible clinical considerations of practice lab participation. The aim was to identify potential risk factors that may require application modification associated with performing and receiving adjustments and other hands-on lab activities within the curriculum. The preparticipation screening process, focused on general health and curriculum referenced chiropractic clinical considerations, and was created as an expansion of the existing informed consent procedures to screen incoming students prior to participating in palpation, technique, physical examination, and open adjusting labs in the chiropractic program. Any clinical considerations identified during the screening were referred to be fully evaluated by a third-year clinic intern and faculty-licensed chiropractor to maintain classroom safety standards for the students. Referred students were restricted from full classroom lab participation until recommendations from the clinic or outside licensed healthcare providers managing their concerns were received. Results: The program was implemented in April 2022. Eight out of the 48 students evaluated in the first group and 12 of the 81 in the second group had possible clinical considerations to participation and were referred appropriately for a full evaluation. In the third group, 35 out of 146 students with suspected clinical considerations to participation were identified. Of the 55 students referred out, all students are now actively participating in classroom activities. Fifteen have been cleared to return to classroom participation with no restrictions and the remaining 40 students have been released for participation with patient-specific restrictions as directed by their managing health care providers. Conclusion: The preparticipation screening process was implemented as all incoming students since the inception of the process have been screened, referred for evaluation when deemed appropriate, and cleared to participate in labs either with or without restrictions. This process has also demonstrated the possibility of identifying multiple clinical considerations for safe curricular participation while participating in doctor-patient simulated classroom activities. This process may be helpful for new students to recognize the patient history and examination procedures as an important aspect of a patient encounter prior to receiving treatment.

Describing the impact of psychological safety on risk prevention: A threshold model construction.

BACKGROUND: Like other things, psychological safety has a too-much-of-a-good-thing effect on the risk prevention process. There are warranted systematic and theoretical discussions on both positive and negative influences of psychological safety, which provide useful guides to handling potential risks for workers. OBJECTIVE: This study focuses on the psychological safety analysis of work safety for workers in high-risk industries through the construction of a theoretical model, illustrating that a higher level of psychological safety is not better. METHOD: This study explores the impact of workers' psychological safety on the potential risk of work safety by conducting a comprehensive analysis of relevant literature and employing inductive reasoning and analogy methodology. RESULTS: We systematically reviewed the research background and several hypotheses of psychological safety, described the relationship between psychological safety and risk prevention from three levels, and constructed the threshold initial, special, and extended model of psychological safety to reveal the importance of workers' psychological safety when handling potential risks. CONCLUSION: This research effectively describes the influence of high, moderate, and low levels of psychological safety on the risk prevention of work safety, which provides a psychological model guide to developing measures for the improvement of work safety management.

Grading recommendations for enhanced patient safety in sentinel event analysis: the recommendation improvement matrix.

OBJECTIVES: The goal of sentinel event (SE) analysis is to prevent recurrence. However, the rate of SEs has remained constant over the past years. Research suggests this is in part due to the quality of recommendations. Currently, standards for the selection of recommendations are lacking. Developing a method to grade recommendations could help in both designing and selecting interventions most likely to improve patient safety. The aim of this study was to (1) develop a user-friendly method to grade recommendations and (2) assess its applicability in a large series of Dutch perioperative SE analysis reports. METHODS: Based on two grading methods, we developed the recommendation improvement matrix (RIM). Applicability was assessed by analysing all Dutch perioperative SE reports over a 12-month period. After which interobserver agreement was studied. RESULTS: In the RIM, two elements are crucial: whether the recommendation intervenes before or after an SE and whether it eliminates or controls the hazard. Applicability was evaluated in 115 analysis reports, encompassing 161 recommendations. Recommendation quality varied from the highest, category A, to the lowest, category D, with category A accounting for 44%, category B for 35%, category C for 2% and category D for 19% of recommendations. There was a fair interobserver agreement. CONCLUSION: The RIM can be used to grade recommendations in SE analysis and could possibly help in both designing and selecting interventions. It is relatively simple, user-friendly and has the potential to improve patient safety. The RIM can help formulate effective and sustainable recommendations, a second key objective of the RIM is to foster and facilitate constructive dialogue among those responsible for patient safety.

Development of a scoring system to quantify errors from semantic characteristics in incident reports.

OBJECTIVES: Incident reporting systems are widely used to identify risks and enable organisational learning. Free-text descriptions contain important information about factors associated with incidents. This study aimed to develop error scores by extracting information about the presence of error factors in incidents using an original decision-making model that partly relies on natural language processing techniques. METHODS: We retrospectively analysed free-text data from reports of incidents between January 2012 and December 2022 from Nagoya University Hospital, Japan. The sample data were randomly allocated to equal-sized training and validation datasets. We conducted morphological analysis on free text to segment terms from sentences in the training dataset. We calculated error scores for terms, individual reports and reports from staff groups according to report volume size and compared these with conventional classifications by patient safety experts. We also calculated accuracy, recall, precision and F-score values from the proposed 'report error score'. RESULTS: Overall, 114 013 reports were included. We calculated 36 131 'term error scores' from the 57 006 reports in the training dataset. There was a significant difference in error scores between reports of incidents categorised by experts as arising from errors (p<0.001, d=0.73 (large)) and other incidents. The accuracy, recall, precision and F-score values were 0.8, 0.82, 0.85 and 0.84, respectively. Group error scores were positively associated with expert ratings (correlation coefficient, 0.66; 95% CI 0.54 to 0.75, p<0.001) for all departments. CONCLUSION: Our error scoring system could provide insights to improve patient safety using aggregated incident report data.

Conflict-Based safety evaluations at unsignalized intersections using surrogate safety measures.

Conflict-based road safety assessments may provide a deeper insight into the processes leading to crashes compared to assessments solely based on field crash data. The evaluation of road safety is conducted on specific road segments using different surrogate measure of safety indicators, such as temporal, spatial, and kinematic proximity measures, depending on the relevant context and applicability of these measures. Therefore, this study endeavored to develop a methodology by adopting safety measures such as post encroachment time (PET) and conflicting speeds of through vehicles for crossing maneuvers and time to collision (TTC) for rear-end collisions at five unsignalized intersections in urban mixed traffic conditions. Critical conflicts are calculated by calculating a speed variable known as the critical speed, which is based on the braking distance. A study found that the motorized two wheeler (MTW) categories involve the highest proportion of critical conflict with right-turning vehicles, followed by cars, autos, and light commercial vehicle (LCVs). Furthermore, crossing conflicts were modeled as a function using the generalized linear regression approach. The findings revealed that the most significant factors were traffic volume and vehicular composition in a conflicting stream. The unsupervised classification technique k-mean clustering was used to determine the defined severity level threshold for rear-end maneuvers. The result observed was that a TTC threshold of less than 1.15 s was identified as high-risk vehicular interaction. Additional investigation indicated that presence of certain moving vehicle categories, including MTWs and cars, led to a higher proportion of critical crossing conflicts. The conceptualized safety framework can be applied to evaluate safety at unsignalized intersections in the mixed traffic scenarios.

Manual on the proper use of the 211At-labeled PSMA ligand ([211At]PSMA-5) for clinical trials of targeted alpha therapy (1st edition).

Recently, an astatine-labeled prostate-specific membrane antigen (PSMA) ligand ([211At]PSMA-5) has been developed for the targeted alpha therapy of patients with prostate cancer. This manual delineates its physicochemical characteristics to assist healthcare professionals in understanding the α-ray-emitting drug of [211At]PSMA-5 when administered to patients. The safety considerations regarding the handling and use of this drug in clinical trials are outlined, based on the proper usage manual of previous studies. The dose limits, as defined by the guidelines of the International Commission on Radiological Protection (ICRP) and the International Atomic Energy Agency (IAEA), are assessed for patients' caregivers and the general public. According to the calculations provided in this manual, clinical trials involving [211At]PSMA-5 can be safely conducted for these populations even if patients are released after its administration. Moreover, this manual provides comprehensive guidance on the handling of [211At]PSMA-5 for healthcare facilities, and compiles a list of precautionary measures to be distributed among patients and their caregivers. While this manual was created by a research team supported by Ministry of Health, Labour, and Welfare in Japan and approved by Japanese Society of Nuclear Medicine, its applicability extends to healthcare providers in other countries. This manual aims to facilitate conducting clinical trials using [211At]PSMA-5 in patients with prostate cancer.

Decision analysis with IDOCRIW-QUALIFLEX approach in the 2TLq-ROF environment: An application of accident prediction models in Pakistan.

In Pakistan, the assessment of road safety measures within road safety management systems is commonly seen as the most deficient part. Accident prediction models are essential for road authorities, road designers, and road safety specialists. These models facilitate the examination of safety concerns, the identification of safety improvements, and the projection of the potential impact of these modifications in terms of collision reduction. In the context described above, the goal of this paper is to utilize the 2-tuple linguistic q-rung orthopair fuzzy set (2TLq-ROFS), a new and useful decision tool with a strong ability to address uncertain or imprecise information in practical decision-making processes. In addition, for dealing with the multi-attribute group decision-making problems in road safety management, this paper proposes a new 2TLq-ROF integrated determination of objective criteria weights (IDOCRIW)-the qualitative flexible multiple criteria (QUALIFLEX) decision analysis method with a weighted power average (WPA) operator based on the 2TLq-ROF numbers. The IDOCRIW method is used to calculate the weight of attributes and the QUALIFLEX method is used to rank the options. To show the viability and superiority of the proposed approach, we also perform a case study on the evaluation of accident prediction models in road safety management. Finally, the results of the experiments and comparisons with existing methods are used to explain the benefits and superiority of the suggested approach. The findings of this study show that the proposed approach is more practical and compatible with other existing approaches.

Crisis communication in construction: Organizational strategies for worksite fatalities.

INTRODUCTION: The construction industry is high risk and unpredictable, requiring extensive safety preparation, practices, and effectiveness on worksites. While preventative measures are important and well documented, the industry, in general, lacks effective crisis management strategies when safety measures fail. The focus of this study was to evaluate dominant crisis communication and management best practices and adopt those methods into models that could be used following a construction worksite fatality. METHODS: Through literature review, this study acknowledged barriers to crisis management implementation within the construction industry, defined worksite fatalities as a preventable crisis type, identified major organizational implications of a crisis event, determined applicable response strategies following a worksite fatality, and identified major stakeholder groups impacted by fatality events. Prominent communication theories and models that have been used in multiple industries were identified and researched for this study. The literature review revealed general crisis communication theories and models that could be adapted specifically to the construction industry. RESULTS: Two proactive communication models were created from the collected research. These models were designed to be adapted and utilized by construction organizations as a fundamental crisis communication tool and as a basis for individualized crisis management strategies following emergency events. CONCLUSIONS: This study concludes that worksite fatalities are considered a preventable crisis type, with the risk of legal, financial, and reputational damage to an organization. Appropriate response methods include ingratiation, mortification or corrective action strategies which are dependent on an organization's stakeholders, perceived responsibility, reputation, and crisis history. PRACTICAL APPLICATIONS: Construction organizations could apply the models proposed in this study as foundational building blocks in alignment with strategic crisis management planning and safety failure preparation.

Safety: A collective and embedded competency. An ethnographic study of safety practices at an industrial workplace in the Netherlands.

INTRODUCTION: Organizations place strong emphasis on the standardized occupational health and safety procedures to reduce work-related illnesses and workplace accidents. However, standardized procedures are not always followed up in daily work practices. Organizations must cope with the differences between standardized procedures and local adaptation by employees. METHODS: This ethnographic field study at an industrial workplace in the Netherlands provides insights into employees' everyday work practices, how these work practices are shaped, and how they relate to local occupational health and safety procedures. Acknowledging safety as a competency embedded in work practices, as introduced by Gherardi and Nicolini (2002), offers a theoretical point of view for looking beyond the dichotomy of standardization and local adaptations. RESULTS: The results show that a standardized and noncontextualized occupational health and safety management system that focuses on accident-free days and compliance actually leads to ignorance of practical and tacit competences of workers and no learning and improvement of safety procedures can take place. However, our findings also illustrate how employees in their informal everyday work practices reduce the risks produced by the safety system itself. CONCLUSION: Overall, the results indicate that social interactions among employees, leaders, and management within the organization play an important role in workplace safety. The analysis highlights the value of vulnerability and trust in relationships at work to be able to learn and develop safety procedures that align with local demands. PRACTICAL APPLICATIONS: This study emphasizes the need for participatory approaches in creating safer and healthier workplaces. The cocreation of occupational health and safety (OHS) rules and procedures, however, can only function if they are combined with a responsive leadership style.

Exploring nurses' emotional reactions to and reporting of patient-on-nurse workplace violence: A mixed-methods study.

BACKGROUND: Workplace violence, including violent, intimidating, and disruptive acts, commonly occurs in healthcare settings. Type 2 workplace violence in nursing refers to patient/visitor behaviors directed toward clinicians, contributing to physical and psychological harm. Nurse victims often do not report these events to employers or law enforcement, making it challenging to address workplace violence. OBJECTIVES: Our research examined nurse reactions to Type 2 workplace violence by identifying what behaviors they perceived as aggressive and reportable. Specific aims included: 1) developing and testing video vignettes to portray realistic patient aggression scenarios; 2) identifying nurse understandings of aggressive events that prompt affective reactions, and; 3) examining clinical characteristics related to the nurse victim's likelihood to report. DESIGN: Through a sequential mixed-methods design, we qualitatively developed novel video vignettes portraying Type 2 workplace violence to experimentally examine how nurses interpreted them within a quantitative repeated measures survey. METHODS: Two expert nurse research panels (n = 10) created five vignettes, from which nurses (n = 282) completed a survey with 1382 unique responses. Analyses included descriptive statistics and repeated measures ANOVA/regression models. RESULTS: Video vignettes realistically portrayed workplace violence events, eliciting negative emotional responses among nurses that increased in magnitude with statistical significance as the level of displayed aggression escalated. Statistically significant factors influencing nurse reporting of workplace violence included; 1) the level of aggression displayed by the patient; 2) the level of harm received by the nurse; 3) whether the nurse felt the patient's actions were intentional, and; 4) the nurse's perceived frequency of exposure to workplace violence. CONCLUSIONS: Results suggested that nurse victims of Type 2 workplace violence experience depression, anger, fear, and anxiety, which may contribute to long-term mental health consequences. Findings also identified factors related to nurse reporting behaviors, which may help mitigate workplace violence in healthcare settings by informing research and promoting workplace practices that encourage reporting and safety. REGISTRATION: Not registered. TWEETABLE ABSTRACT: Nurse reactions to workplace violence: Video vignettes reveal escalating aggression's impact on reporting. #EndNurseAbuse #WorkplaceViolence.

Network-wide road crash risk screening: A new framework.

Network-wide road crash risk screening is a crucial issue for road safety authorities in governing the impact of road infrastructures over road safety worldwide. Specifically, screening methods, which also enable a proactive approach (i.e., pinpointing critical segments before crashes occur), would be extremely beneficial. Existing literature provided valuable insights on road network screening and crash prediction models. However, no research tried to quantify the risk of crash on the road network by considering its main components together (i.e., probability, vulnerability, and exposure). This study covers this gap by a new framework. It integrates road safety factors, prediction models and a risk-based method, and returns the risk value on each road segment as a function of the probability of a crash occurrence and the related severity as well as the exposure model. Next, road segments are ranked according to the risk value and classified by a five-level scale, to show the parts of road network with the highest crash risk. Experiments show the capability of this framework by integrating base map data, context information, road traffic data and five years of real-world crash data records of the whole non-urban road network of the Province of Brescia (Lombardy Region - Italy). This framework introduces a valid support for road safety authorities to help identify the most critical road segments on the network, prioritise interventions and, possibly, improve the safety performance. Finally, this framework can be incorporated in any safety managerial system.

The effect of intelligent management interventions in intensive care units to reduce false alarms: An integrative review.

Objective: In intensive care units (ICU), frequent false alarms from medical equipment can cause alarm fatigue among nurses, which might lead to delayed or missed responses and increased risk of adverse patient events. This review was conducted to evaluate the effectiveness of intelligent management interventions to reduce false alarms in ICU. Method: Following the framework of Whitmore and Knafl, the reviewers systematically searched six databases: PubMed, EMBASE, CINAHL, OVID, Cochrane Library, and Scopus, and studies included intelligent management of clinical alarms published in the English or Chinese language from the inception of each database to December 2022 were retrieved. The researchers used the PICOS framework to formulate the search strategy, developed keywords, screened literature, and assessed the studies' quality using the Joanna Briggs Institute-Meta-Analysis of Statistics, Assessment, and Review Instrument (JBI-MAStARI). The review was preregistered on PROSPERO (CRD42023411552). Results: Seven studies met the inclusion criteria. The results showed that different interventions for intelligent management of alarms were beneficial in reducing the number of false alarms, the duration of alarms, the response time to important alarms for nurses, and the alarm fatigue levels among nurses. Positive results were found in practice after the application of the novel alarm management approaches. Conclusion: Intelligent management intervention may be an effective way to reduce false alarms. The application of systems or tools for the intelligent management of clinical alarms is urgent in hospitals. To ensure more effective patient monitoring and less distress for nurses, more alarm management approaches combined with artificial intelligence will be needed in the future to enable accurate identification of critical alarms, ensure nurses are responding accurately to alarms, and make a real difference to alarm-ridden healthcare environments.

Performance of large language models on advocating the management of meningitis: a comparative qualitative study.

OBJECTIVES: We aimed to examine the adherence of large language models (LLMs) to bacterial meningitis guidelines using a hypothetical medical case, highlighting their utility and limitations in healthcare. METHODS: A simulated clinical scenario of a patient with bacterial meningitis secondary to mastoiditis was presented in three independent sessions to seven publicly accessible LLMs (Bard, Bing, Claude-2, GTP-3.5, GTP-4, Llama, PaLM). Responses were evaluated for adherence to good clinical practice and two international meningitis guidelines. RESULTS: A central nervous system infection was identified in 90% of LLM sessions. All recommended imaging, while 81% suggested lumbar puncture. Blood cultures and specific mastoiditis work-up were proposed in only 62% and 38% sessions, respectively. Only 38% of sessions provided the correct empirical antibiotic treatment, while antiviral treatment and dexamethasone were advised in 33% and 24%, respectively. Misleading statements were generated in 52%. No significant correlation was found between LLMs' text length and performance (r=0.29, p=0.20). Among all LLMs, GTP-4 demonstrated the best performance. DISCUSSION: Latest LLMs provide valuable advice on differential diagnosis and diagnostic procedures but significantly vary in treatment-specific information for bacterial meningitis when introduced to a realistic clinical scenario. Misleading statements were common, with performance differences attributed to each LLM's unique algorithm rather than output length. CONCLUSIONS: Users must be aware of such limitations and performance variability when considering LLMs as a support tool for medical decision-making. Further research is needed to refine these models' comprehension of complex medical scenarios and their ability to provide reliable information.

Is multiple wavelength diode laser for facial contouring safe?

The multiple wavelength diode laser (MWDL) is a sophisticated device designed to target deeper skin layers by emitting various wavelengths. Its unique feature is the ability to deliver heat to specific depths within the tissue using different wavelengths while simultaneously cooling the skin surface. Recent research by Choi et al. suggests that wavelengths of 755 and 810 nm can induce carbonization in hair follicles, while the 1064 nm wavelength penetrates deeper into tissues. MWDL has been proposed for fat redistribution in aging, but concerns have been raised regarding ocular safety and potential tissue damage, particularly when used near the eyes. Studies have shown ocular injuries during cosmetic laser procedures, emphasizing the need for robust ocular protection and safety protocols. Additionally, there are reports of internal ischemic necrosis and burns, highlighting the importance of precise energy settings and parameter management. While MWDL shows promise, further research and comprehensive guidelines are needed to ensure safe and effective usage in clinical practice.

Maturity of Food Safety Management Systems in the Vietnamese Seafood Processing Industry.

Fifty-nine percent (59%) of the reported food safety issues in Vietnam are related to seafood products, mainly fish and fish products. The international export of seafood products continues to grow due to intensification of the production in the Vietnamese seafood processing industry. To ensure the production of safe food, a company-specific, effective food safety management system is essential. This research explores the maturity of food safety management systems in a convenience sample of the Vietnamese seafood processing industry to identify potential gaps and interventions for improvement. The food safety management system diagnostic instrument was used to assess the context riskiness, maturity of control and assurance activities and food safety performance of 11 companies. Maturity of their food safety management systems was further explored through hierarchical cluster analysis, and the differences in maturity between clusters were statistically tested through Mann-Whitney U tests (nonparametric). The influence of companies' organizational characteristics on the maturity of control and assurance activities was assessed through nonparametric K independent tests. A variability in the maturity of food safety management systems between the eleven Vietnamese companies was measured. Cluster analysis revealed two clusters, Cluster I (six companies) and Cluster II (five companies). The companies in both these clusters operate under a moderate level context riskiness and average to advanced level of food safety performance. However, control and assurance activities are at a lower maturity in Cluster I compared to Cluster II. None of the companies' organizational characteristics (i.e. certification level) have a statistically significant influence on the maturity of control and assurance activities. However, compliance with multiple food safety standards and the presence of physical intervention system(s) have a positive influence on food safety performance.

Patient and family engagement interventions for hospitalized patient safety: A scoping review.

AIM: To summarize existing studies that focused on improving hospitalized patient safety through patient and family engagement interventions to identify priorities and gaps. DESIGN: A scoping review. METHODS: Eight databases and citations of important reviews were searched on 30 September 2022. Two researchers independently screened the records. Then, two researchers extracted the data and cross-checked. The results were synthesized narratively, and a comparison was performed for studies from China and those from other countries. RESULTS: Ninety-eight studies were included. The results indicated that patient and family engagement interventions were applied to decrease the incidence of patient safety incidents, and to improve the healthcare providers' and patients' knowledge, attitude or practice of patient safety. Most studies only engaged patients and families at the direct care level, and the engagement strategies at the organization and health system levels were insufficient. For stakeholders, many studies failed to consider patients' perspectives in intervention design and report taking staff training as a supportive strategy. Healthcare providers, especially nurses, were the main implementers of current interventions. Certain differences were observed between studies from China and those from other countries in the above aspects. CONCLUSIONS: International interest in engaging patient and family for patient safety is growing. Future studies should enhance the patient and family engagement as a partner in various patient safety at the direct care level, and further explore the engagement at the organization and health system levels. RELEVANCE TO CLINICAL PRACTICE: Nurses, as the main formal caregivers for patients, should promote patient and family engagement in patient safety, especially at direct care level. Nurse should also incorporate the perspectives of patients in the design and implementation of interventions. REPORTING METHOD: PRISMA-ScR Checklist.

Food Safety and Management System Audits in Food Retail Chain Stores in Greece.

The present study aimed to assess the performance of food safety management systems in food retail stores via audits to reveal potential areas of improvement and to find out possible corrective actions to suggest to the top management. Two cycles of on-site audits took place in 106 stores to assess the requirements and hygiene conditions. After the first cycle of audits, improvements were suggested to the top management, and a second cycle of audits took place after a reasonable time. In the checklist, we recorded the temperatures of retail refrigerators and the scores from the inspection of hygiene and HACCP documentation. In the A' audit, the percentage of stores that had higher temperatures than the critical limits was equal to 51%, and those temperatures occurred in the refrigerators for salads, followed by the refrigerators for deli meat, yogurts and desserts. In the B' audit, only the refrigerators for salads exhibited percentages that were statistically significant lower (p-value < 0.05), and the stores were improved after the audit. High percentages of high-scoring stores were observed in the A' and B' audit in the inspection of HACCP documentation, although there was not a statistically significant improvement observed (p-value > 0.05). In the hygiene inspection, statistically significant improvement with 95% confidence appeared for "Refrigerator's products appearance", "Storage cleanliness", and "Grocery shelf cleanliness". The highest number of non-conformities without statistically significant improvement was found for "Checking temperatures of the receiving products" and "Labeling of fruit store products", with the percentages being lower than 15% in both of the audit cycles. Many employees of the stores did not check and record the temperatures of receiving products from suppliers. In addition, the storage of spoiled products beneath fresh products for selling in the same refrigerator is not a good practice. Greater efforts must be made by top management and employees to maintain and distribute food products in the best and safest possible hygiene conditions.

The structure of near misses and occupational accidents in the polish construction industry.

Near misses are referred to in literature as precursors of occupational accidents. These events, and their relationships with occupational accidents in various economic sectors have been the subject of research in several countries around the world. In Poland, there has not been a lot of research with regards to near misses in the construction industry, and the published materials are of a very general nature. This article aims to fill the existing research gap regarding the relationship between near misses and occupational accidents in the Polish construction industry. The aim of the research presented in the article was to identify the qualitative and quantitative structure of hazardous events in the construction industry, and to estimate the a posteriori probability of the occurrence of such events. The research was carried out on the basis of information obtained from the hazardous event registration system from a large Polish enterprise that carried out construction works in Poland in the years 2015-2022. Identified dangerous events in the construction industry were divided into two generic groups, i.e. occupational accidents and near misses. Within each group, eight categories of hazardous events were identified, and subcategories were defined within each category. The power of each set and subset of events was then calculated. The posterior probability of the occurrence of events classified into individual sets was estimated using Bayes' theorem. Cross-validation of the obtained results was performed. Conclusions resulting from the conducted analyzes were formulated. The most common category of the analyzed dangerous events in the construction industry is "being hit by objects"; "being run over/falling over" and "work environment". Knowledge of the most common causes of near misses will allow actions that aim to reduce the number of occupational accidents to be determined.

An assessment of exposed syringe inner walls as a route of exposure from hazardous drugs.

INTRODUCTION: Maintaining safe working environments for health care personnel, especially for those who regularly handle hazardous drugs (HDs), is of utmost importance. Studies have shown that when closed system transfer devices (CSTDs) are used with standard open barrel syringes, cyclophosphamide (CP), a commonly used HD, is transferred to the syringe plunger during compounding or administration processes. This contamination can then be transferred to the work environment, endangering workers. PURPOSE: The purpose of this study was to quantify HD contamination of the inner surface of standard open barrel syringes and to compare contamination levels between three commonly used HDs: 5-fluorouracil (5-FU), CP, and ifosfamide (IF). METHODS: Each HD was transferred from a vial to an intravenous (IV) bag using a standard open barrel syringe and Becton, Dickinson and Company (BD) PhaSealTM CSTD connectors. Samples were taken from the inner surface of each of the syringe barrels to measure the amount of HD contamination. Each drug was tested 15 times and compared to a positive control. RESULTS: Significant amounts of each drug were transferred to the inner surfaces of the syringes. The average amounts of each drug measured were: 5-FU, 1327.7 ng (standard deviation [SD] = 873.6 ng); CP, 1074.8 ng (SD = 481.6 ng); and IF, 1700.0 ng (SD = 1098.1 ng). There was no statistically significant difference between the three drugs (p = 0.14). CONCLUSION: This study underscores the presence of HD contamination on standard open barrel syringe inner surfaces after transfer of drug from vial to syringe to IV bag. Such contamination could be spread in the working environment and expose health care workers to harm.

Construction safety influencing factor analysis of bridge-erecting machines based on structural equation modeling.

To reduce the frequency of bridge-erecting machine accidents and ensure construction safety, it is necessary to correctly understand the factors affecting the construction safety of bridge-erecting machines and their relative importance. Through a literature review and a field investigation, 15 factors were identified affecting the construction safety of bridge-erecting machines. Then, questionnaire survey items are established. Structural equation modeling (SEM) was used to build the relationship model among the factors. The model included four aspects-human, mechanical equipment, and environmental safety and management-to discuss the influence of each factor on the safety of bridge-erecting machine construction. Additionally, the relationships between the influencing factors is studied and analyzed. The results show that human, mechanical equipment, and environmental safety and management capacity have significant normal influences on the construction safety of bridge-erecting machines. Human safety has the greatest influence on the construction safety of bridge-erecting machines, followed by management capacity, mechanical equipment safety, and environmental safety. In addition, the four influencing factors have a certain degree of mutual influence.