Risk Management and Healthcare Policy最新文献

Purpose: Alcohol use is a leading risk factor for preventable death, injury, and disease globally. Low sensitivity to the effects of alcohol is influenced by genes and predicts risk for harmful alcohol use and alcohol use disorder (AUD). Alcohol induces effects partly by modulation of gamma-aminobutyric acid receptors type A (GABA_ARs). This study investigates the relationship between genetic variation in GABA_AR subunit genes and individual alcohol sensitivity among French university students.

Patients and methods: The study involved 1,409 French university students (34.5% women; mean age 20.3 years). Alcohol sensitivity was measured by the Self-Rating of the Effects of Alcohol Scale (SRE). SRE-scores from initial drinking, regular drinking, and heavy drinking were investigated for correlations with alcohol consumption and for associations with single nucleotide polymorphisms (SNPs) in GABA_AR subunit genes (GABRA2, GABRG2, GABRA6).

Results: We replicated correlations between low alcohol sensitivity and high alcohol consumption. We further found an association between the minor allele in rs211014 (GABRG2) and higher SRE-scores, linked to dizziness and motor incoordination. Genetic variation in GABRG2 has previously been associated with processes involving motor coordination (alcohol withdrawal, febrile- and epileptic seizures).

Conclusion: The results from our study suggest that genetic variation in GABRG2 may influence alcohol sensitivity, which could inform strategies for assessing risk for harmful alcohol use and AUD.

Introduction: Dual tasking (DT) requires individuals to carry out two actions simultaneously, comparable to how the brain can perform a cognitive function while the body is in motion, which eventually enhances human balance. This paper aims to examine and compare the impact of DT on the risk of falling (ROF) among Saudi female students.

Methods: A cross-sectional design was used. 120 female students were recruited and divided into two groups: literary group (LG) (n = 34) and scientific group (SG) (n = 86). Participants, aged 18-25, had a normal body mass index (BMI) and cognitive and balancing skills. ROF was measured using the Biodex balancing device for balance alone (no DT) and with DT (motor and two cognitive tasks). After three trials, the mean and average were calculated. The ICC calculation showed a reliable result of <0.8. BMI was represented as the mean (M) and standard deviation (SD) for both groups. ROF was compared within and between groups using paired and unpaired T-tests. Mann-Whitney compared the two groups throughout DT. The level of significance was P = 0.05.

Results: There was no significant difference in ROF in SG (P = 0.06) between the performance with and without a DT; on the contrary, LG demonstrated a significant difference (P = 0.001) for the same tests. In addition, the only time there was a significant difference between the two groups was when they performed DT (P = 0.006).

Conclusion: Female students who used critical and analytical thinking and motor performance in their study and daily routine were more balanced and resistant to falling than their peers who did not. This study may improve efficient treatments for fall prevention and balance. Future research could investigate the complex nature of additional DT that may be complicated by gender and BMI outside of the normal range.

Aim: This study examined citizens' knowledge and compliance with COVID-19 standard operating procedures (SOPs), vaccine acceptance and hesitancy, and factors that could influence these behaviors.

Methods: The study that utilised the Lot Quality Assurance Sampling (LQAS) approach was conducted in eight districts of Central Uganda; Kiboga, Kyankwanzi, Mubende, Kasanda, Mityana, Luwero, Nakaseke, and Nakasongola districts. Each district was divided into five supervision areas (SAs). Data were collected from 19 respondents per SA, focusing on women aged 15-49 years and men aged 15 years and above. A satisfactory performance for study indicators was determined by the LQAS decision rules.

Results: There was high awareness of COVID-19, with 98.2% of women and 99.3% of men having heard of the pandemic. However, knowledge of at least four COVID-19 preventive measures was low, reported by only 45.4% of women and 48.6% of men. Adherence to social distancing measures in the previous 24 hours was modest, with 67.2% of men and 66.5% of women complying. There was a pronounced lack of hand hygiene, with only 24.8% of women and 19.0% of men frequently washing their hands or using hand sanitizer. COVID-19 vaccine uptake was relatively high for the first dose, with 83.5% of women and 83.0% of men receiving at least one dose. However, full vaccination coverage was low, at 37.5% for women and 41.5% for men. A hesitancy to get vaccinated was driven by fear of side effects, misinformation, doubts about vaccine effectiveness, long distances and queues, and beliefs that vaccines cause infertility.

Conclusion: While awareness of COVID-19 was high, knowledge of preventative measures was lacking. The low vaccination rates highlight barriers to uptake. A tailored, trust-based messaging approach through community leaders was recommended to address these gaps. Inter-district and inter-SA disparities indicated the need for localized interventions.

Purpose: The effect of the diurnal temperature range (DTR) on human health in diverse geographic areas and the potential confounding factors are not fully understood. Additionally, while a robust association has been reported between temperature and cardiomyopathy (CM), evidence of the impact of DTR is relatively limited. Here, we determined whether an association exists between DTR and CM hospitalisations in vulnerable populations.

Methods: CM admission data (2016-2021) were collected from seven tertiary hospitals in Henan.We used a GAM combined with a distributed lag non-linear model (DLNM) to investigate the delayed effects of DTR on daily hospitalisations for CM.Stratified analysis was performed in subgroups according to sex, age, and season. Attributable fractions (AF) and attributable numbers (AN) were employed to illustrate the disease burden and investigate the association between temperature and DTR.

Results: Overall, 5,757 CM cases were identified. DTR and CM admissions exhibited a non-linear correlation. High DTR (P95: 15.5 °C) and low DTR (P05: 3 °C) increased CM admission risk, with low DTR having a stronger effect. Males and warm seasons were significantly more susceptible to DTR, and low DTR affected youth and adults more than older adults. AF and AN of low DTR on CM admissions were 51% and 2,936, respectively.

Conclusion: Our results revealed a significant association between DTR and CM hospitalisations, providing valuable insights for the development targeted prevention and control measures.

Purpose: The aim of this study is to examine the characteristics of intraoperative nursing near-miss events in interventional operating rooms, systematically identify and analyze associated risks, and propose effective mitigation strategies.

Patients and methods: A retrospective study was conducted using a specially designed survey focused on nursing near-miss events in Interventional operating rooms. Records of intraoperative near-miss events voluntarily reported by medical and nursing staff between January 2023 and March 2024 were analyzed. Grey relational analysis was used to evaluate and identify the associated risk factors.

Results: A total of 81 near-miss events were reported, with the majority (50%) occurring after 8 PM. These events were categorized into 6 main types: medication errors (60.49%), issues with consumables (16.05%), tubing-related incidents (8.64%), specimen handling errors (7.4%), transfer handover issues (4.93%), and patient transport problems (2.46%). Grey relational analysis identified air embolism formation during pressurized fluid administration as the highest risk event (ξ1 = 0.369). The risk factors were ranked as follows: weak coordination ability and lack of responsibility among nurses > operational interruptions > inadequate professional capability > poor communication between medical staff and nurses > equipment malfunction > frequent emergency surgeries and a fast paced working environment.

Conclusion: Medication administration errors are frequently encountered, with air embolisms during pressurized fluid infusion representing the most significant risk. Operational interruptions are major contributors to these errors, often influenced by the coordination skills and professional competencies of nurses. Clinically, it is crucial to enhance the identification and management of near-miss events to reduce the incidence of adverse outcomes during surgical procedures.

Ethanol, a bioactive compound prevalent in both social and industrial applications, is present in alcoholic beverages as well as a range of everyday products. In food, ethanol functions primarily as an additive or a by-product of fermentation, while in pharmaceuticals and cosmetics, it serves as a solvent or preservative. Despite its widespread use, three critical research gaps exist in current literature. First, existing research focuses predominantly on single-sector analyses, overlooking the cumulative effects of cross-sectoral ethanol exposure. Second, despite growing global market integration, there is limited understanding of how cultural and religious requirements influence ethanol-related regulations and product formulations. Third, current economic models fail to integrate both health impact costs and cultural compliance expenses, hindering effective policy development. The World Health Organization has determined that no amount of alcohol consumption can be considered entirely safe, as ethanol's health impacts include contributions to chronic diseases, neurotoxicity, and potential carcinogenic effects. These risks are compounded by the pervasive and often unrecognized presence of ethanol in various products, particularly affecting vulnerable populations. The economic burden associated with alcohol-related issues, including lost productivity and healthcare costs, highlights the necessity for robust public health strategies and stringent regulatory guidelines. This review investigates ethanol's role across multiple domains, emphasizing its presence in food, medicine, cosmetics, and industrial products, and evaluates its broader implications for public health, cultural practices, and economic impact. This review recommend implementing standardized labeling systems, establishing cultural-sensitive alternatives in product formulations, and developing harmonized international guidelines for ethanol use across industries.

Purpose: The Bedside Handover Attitudes and Behaviors questionnaire is a 32-item instrument originally developed in English that enables nurse managers to monitor the consistency of nurses' practice during the implementation of the Nursing Bedside Handover. We aimed to cross-culturally validate this questionnaire for the Portuguese population and to examine its psychometric properties.

Methods: An exploratory-descriptive, quantitative, cross-sectional, and validation study was conducted. A sample of 241 nurses from a Portuguese acute care hospital participated in the field test. The questionnaire was cross-culturally adapted through translation, translation synthesis, and back-translation procedures, an expert committee harmonization, and two pre-tests.

Results: We obtained one factorial solution through exploratory factor analysis that explained 53.5% of the total variance, with 18 items distributed by four components: Direct Engagement, Personal Interaction, Information Sharing, and Individualized Approach. Confirmatory factor analysis supported the four-factor factorial structure of the questionnaire X²/df = 1.440; CFI = 0.0953; GFI = 0.926; RMSEA = 0.043; P[rmsea] < 0.001; MECVI = 1.175). Cronbach's α indicated acceptable reliability for the total questionnaire (α = 0.790). The refinement of the instrument led to the proposal of a new Conceptual Model for Patient Participation in Nursing Bedside Handover.

Conclusion: The questionnaire is valid and reliable for use by Portuguese nurse managers. This adapted version of the BHAB questionnaire can be applied by nurse managers to facilitate the implementation of Nursing Bedside Handover.

Background: Fragmentation of healthcare services has been a central issue, contributing to escalating medical expenditures and service provision, thereby exacerbating the waste of limited medical resources. In response, China has introduced the Sanming Mode, a medical service integration model designed to address these challenges. This study evaluates the model's impact on medical expenditures, service provision, and resource allocation.

Methods: We conducted an interrupted time series analysis on outcome variables related to medical expenditures, service provision, and resource allocation in Sanming City. The dataset encompassed operational data from all public hospitals and community health service institutions in Sanming from January 2016 to November 2019.

Results: Post-reform, the monthly medical expenditures, outpatient visits, and inpatient admissions in Sanming City shifted from a rapid growth trend to a slower growth trend, with slopes decreasing by 0.1%, 1.4%, and 0.5%, respectively. Heterogeneity analysis between hospitals and community health service institutions revealed a more pronounced slowdown in the growth rate of monthly medical expenses in community health service institutions. However, the growth rates for outpatient and inpatient visits in hospitals significantly decreased post-reform, while there was no significant change observed in community health service institutions.

Conclusion: The Sanming Model represents a significant localized attempt to integrate hospital and community health services in China. It effectively curbs the rapid growth of medical expenditures and service provision, thereby reducing the consumption of basic medical insurance funds. The Model enhances the efficiency of medical resource utilization and promotes a shift in service provision from hospitals to community health service institutions, reflecting a trend in resource allocation that concentrates serious illnesses in hospitals while directing minor health issues to community health service institutions. This positive impact promotes the effective integration and rational allocation of medical resources.

Purpose: Health literacy (HL) is crucial in understanding labels of healthcare products. This study aimed to evaluate HL and its impact on comprehending quasi-drug labels, assess consumer perceptions of key label elements and their perceived importance, and provide actionable recommendations for improving label design and health communication.

Methods: An online cross-sectional survey of 500 Korean adults (aged 20-69) was conducted in September 2023 using proportionate stratified sampling based on the 2020 Korean Census. HL was assessed using the Korean Rapid Estimate of Adult Literacy in Medicine (REALM-K). The survey included demographic data, quasi-drug usage patterns, comprehension of 63 quasi-drug terms, and perceptions of label elements. A 5-point Likert scale was used to assess the importance, agreement, and need for improvement of label elements, and statistical analyses included descriptive statistics, chi-square tests, t-tests, Pearson correlation, and logistic regression.

Results: Most participants had inadequate HL (68.4%). Adequate HL is strongly associated with higher comprehension of quasi-drug terms (r = 0.783, p < 0.001). Older age (60-69 years, AOR = 5.97, 95% CI: 1.74-20.48) and adequate HL (AOR = 28.54, 95% CI: 9.68-84.15) positively influenced comprehension. Participants with adequate HL rated the importance of label elements, such as "ingredient name" (mean = 4.02, SD = 0.79, p = 0.015) and "contraindications" (mean = 4.68, SD = 0.57, p < 0.001), higher than those with inadequate HL.

Conclusion: Significant disparities exist in the comprehension and perceived importance of quasi-drug label elements based on HL levels among Korean adults. Findings emphasize the need for targeted strategies, such as using simplified language and visual aids, to enhance label comprehension. These interventions could improve public health outcomes by increasing understanding of quasi-drug information across diverse HL levels. Future research should focus on developing and testing these targeted interventions to bridge the identified comprehension gap.