A human factors and reliability approach to clinical risk management: Evidence from Italian cases

Similarly to the industrial sector in the late 1980s, nowadays leading organizations in the healthcare sector acknowledge the fact that human errors, adverse events and system failures must be managed and controlled. Whilst Human Reliability Analysis (HRA) has been well-accepted and integrated into safety management processes in other industries, the application of such error techniques to the problem of managing the associated risks in healthcare is rare. The main purpose of this research is to analyse clinical risk management (CRM) and patient safety improvement in Italian healthcare organizations, through human factors and human reliability theories. In particular, the specific objectives are to explore the Italian state-of-the-art in CRM, with regard to organizational and managerial issues; to identify and verify the factors influencing the growth and sharing of the safety culture and to understand and describe the possibility of transferring human reliability methodologies and theories to the domain of healthcare.Six case studies belonging to the Italian scenario have been performed, in order to describe the Italian healthcare system and to identify the key influencing factors of CRM policies.Results obtained from within and cross-case analysis give an empirical contribution to the recent introduction of CRM in the Italian context and a theoretical contribution referring to the framework used to analyse CRM in healthcare organizations, and to the indications which emerged on the key factors influencing CRM.     

Probability distributions of arsenic in soil from brownfield sites in Beijing (China): statistical characterization of the background populations and implications for site assessment studies

A probabilistic analysis was performed on soil arsenic concentration data from 4 brownfield sites at Beijing (Chaoyang and Haidian Districts), involved in environmental assessment studies. The available data sets were processed to provide a statistical characterization of the background populations and differentiate “anomalous data” from the natural range of variation of arsenic concentrations in soil. The site-specific background distributions and the existing wide-scale background values defined for the Beijing area were compared, discussing related implications for the definition of metal contamination soil screening levels (SSLs) in site assessment studies. The statistical analysis of As data sets discriminated site-specific background populations, encompassing 88% to 94% of the sample data, from outliers values, associated with either subsoil natural enrichments or possible anthropogenic releases. Upper Baseline Concentration (UBC) limits (+ 2σ level), including most of the site-specific metal background variability, were derived based on the statistical characterization of the background populations. Sites in the Chaoyang South District area had UBC values in the range 10.4–12.6 mg·kg^-1. These ranges provide meaningful SSL values to be adopted for As in local site assessment studies. Using the wide-scale background value for the Beijing area would have erroneously classified most of the areas in the subject sites as potentially contaminated.     

Spatial–temporal variability of epibenthic assemblages on subtidal biogenic reefs in the northern Adriatic Sea

Spatial distribution and temporal variation of epibenthic assemblages of coralligenous biogenic rocky outcrops occurring in the northern Adriatic Sea (45°04′–45°24′N; 12°23′–12°43′E) were investigated by photographic sampling from 2003 to 2006 at 12 randomly selected sites. The dominant reef-forming organisms were the encrusting calcareous algae (Lithophyllum stictaeforme, Lithothamnion minervae and Peyssonnelia polymorpha), while the main bioeroders were boring sponges (Cliona viridis, C. celata, C. thoosina, C. rhodensis, Piona vastifica) and the bivalve Gastrochaena dubia. Composition of the assemblages varied thorough years and among sites. Spatial heterogeneity, at local and regional scale, prevailed over temporal variation. This variability was related both to the geo-morphological features of the outcrops and to environmental variables. Sites clearly differed in the percent cover of reef builder and bioeroder species while only limited temporal variation within site was found. Some taxa revealed complex intra-site temporal trends. These results provide valuable information on the diversity and variability of epibenthic assemblages of the northern Adriatic coralligenous reefs, essential for the management and conservation of these unique biogenic habitats.     

Self-Organizing Map and clustering algorithms for the analysis of occupational accident databases

Data mining techniques are a powerful method for extracting information from large databases. Among these techniques, clustering and projection of data from high-dimensional spaces hold a main role, since they allow to discover hidden structures in the data set. Following this approach, this paper presents a data analysis method designed to help the management and investigation of occupational accident databases. The purpose is to discover the most common sequences of events leading to accidents for devising preventive actions. To this aim, we developed a two-level approach based on the joint use of the Kohonen’s Self-Organizing Map and the k-means clustering algorithm. This approach allows not only to group the accidents in different classes but also to visualize them in a way understandable for the analyst. The method has been applied with satisfactory results to a large database of occupational accidents occurred in the Italian wood processing industry. A comparison with the Hierarchical Clustering method confirmed the effectiveness of the proposed approach.     

Hydrochemical,isotopic and microbiota characterization of telese mineral waters (Southern Italy)

Environmental Geochemistry and Health - The study deals with the analyses of springs and wells at the base of Montepugliano Hill that represents the SE edge of the wide carbonate Matese massif...     

Palladium recovery from monolithic ceramic capacitors by leaching,solvent extraction and reduction

Journal of Material Cycles and Waste Management - Palladium finds a remarkable use in electronic devices and catalysts; therefore, an efficient and complete recovery from the containing secondary...     

Electrical separation of plastics coming from special waste

Minimisation of waste to landfilling is recognised as a priority in waste management by European rules. In order to achieve this goal, developing suitable technologies for waste recycling is therefore of great importance. To achieve this aim the technologies utilised for mineral processing can be taken into consideration to develop recycling systems. In particular comminution and separation processes can be adopted to recover valuable materials from composite waste. In this work the possibility of recycling pharmaceutical blister packaging has been investigated. A suitable comminution process has been applied in order to obtain the liberation of the plastic and aluminium components. Experiments of electrical separation have been carried out in order to point out the influence of the process parameters on the selections of the different materials and to set up the optimum operating conditions.     

Ivermectin dissipation and movement from feces to soil under field conditions

The aim of this work was to evaluate the fate of ivermectin (IVM) at two concentrations in cattle feces and its movement to the nearby soil and plants. Feces were spiked with IVM at two levels: 3000 ng g^?1 (high group, HG) and 300 ng g^?1 (low group, LG). Artificial dung pats were prepared and deposited in an experimental field area. Feces and underlying soil were sampled up to 60 days post-deposition (dpd). As an additional analysis, grasses growing around the pats were sampled at 30 and 60 dpd. Ivermectin concentrations in all matrices were determined by HPLC. Mean IVM fecal concentrations were in the range between 3901.9 ng g^?1 and 2419.2 ng g^?1 (high group) and 375.3 ng g^?1 and 177.49 ng g^?1 (low group). Mean times for 50% and 90% dissipation were 88.23 and 293.03 days (HG) and 39.1 and 129.9 days (LG). Soil concentrations ranged from 26.1 ng g^?1 to 71.1 ng g^?1 (HG) and 3.4 to 5.9 ng g^?1 (LG); in plants, concentrations were between 71.4 and 380.8 ng g^?1 and 5.40 and 51.8 ng g^?1 in HG and LG, respectively. These results confirm that IVM moves from feces to the underlying soil as well as to nearby plants. The potential risk of detrimental effects on soil organisms and the impact on herbivorous animals should be further evaluated.     

Biological stability assessment of MSW organic fractions by means of respirometric and germination tests

Journal of Material Cycles and Waste Management - Composting is the mostly applied method for recovering the organic waste by producing an organic soil conditioner. Furthermore, the organic...