A review of medical error taxonomies: A human factors perspective

Although a large number of medical error taxonomies have been published, there is little evidence to suggest that these taxonomies have been systematically compared. This paper describes a study comparing 26 medical error taxonomies using a human factors perspective. The taxonomies were examined to determine if they classified systemic factors of medical errors and if they utilized theoretical error concepts in their classifications. Scope of classification was also examined. It was found that two-thirds of the taxonomies classified systemic factors of medical errors and only a third utilized theoretical error concepts. Medical error taxonomies based on theoretical error concepts were more likely to be generic in applicability and also more likely to classify systemic factors and psychological error mechanisms of medical errors. In addition to terminology, the medical error taxonomies also varied in terms of domain-specificity, granularity, and developmental process. Different medical error taxonomies provide different information; how these differences affect medical error management needs to be investigated.     

Gathering “wild” food in the city: rethinking the role of foraging in urban ecosystem planning and management

Recent “green” planning initiatives envision food production, including urban agriculture and livestock production, as desirable elements of sustainable cities. We use an integrated urban political ecology and human–plant geographies framework to explore how foraging for “wild” foods in cities, a subversive practice that challenges prevailing views about the roles of humans in urban green spaces, has potential to also support sustainability goals. Drawing on research from Baltimore, New York City, Philadelphia, and Seattle, we show that foraging is a vibrant and ongoing practice among diverse urban residents in the USA. At the same time, as reflected in regulations, planning practices, and attitudes of conservation practitioners, it is conceptualised as out of place in urban landscapes and an activity to be discouraged. We discuss how paying attention to urban foraging spaces and practices can strengthen green space planning and summarise opportunities for and challenges associated with including foragers and their concerns.     

Healthcare utilization and costs among older adult female drivers and former drivers

PurposeThis study compared the healthcare utilization and costs for specific types of medical services among older adult women who currently drive and those who no longer drive.MethodsThis study included 347 women aged 65 or older who were either former (had stopped driving) or current drivers, randomly sampled from a large U.S. health plan to participate in a telephone survey, and who had automated health records with healthcare utilization and cost data. Bivariate analyses and generalized linear modeling were used to examine associations between driving status and healthcare utilization and costs.ResultsAdjusting for age, income, and marital status, former drivers were more likely than current drivers to use mental health care services (RR = 3.37; 95% CI: 1.03, 10.98). Former drivers also tended to use more inpatient (RR = 1.85; 95% CI: 0.88, 3.87) and emergency services (RR = 1.89; 95% CI: 0.96, 3.70), but results did not reach statistical significance. Total annual healthcare costs in 2005 were almost twice as high for former drivers compared with current drivers ($13,046 vs. $7,054; mean difference = $5,992; 95% CI: -$360, $12,344), although this relationship was not statistically significant (CR = 1.61; 95% CI: 0.88, 2.96).Impact on IndustryFormer drivers were more than three times as likely as current drivers to use mental health services, and tended to use more emergency and inpatient services. Further research on factors that potentially mediate the relationship between driving status and health service use is warranted.     

Protective factors associated with young passenger intervening in risky driving situations

IntroductionWhile the negative influence of passengers on driving is usually studied, young passengers may protect against young drivers' crash involvement by speaking out and trying to stop unsafe driving behavior. This study sought to examine psychosocial constructs of young passengers who are likely to intervene in their friends' risky driving.MethodUniversity students aged 17 to 25 years who were single (n = 123) or in a romantic relationship (n = 130) completed an online survey measuring protective factors.ResultsThe combination of individual, friend and (for participants in a relationship) romantic partner protective factors predicted self-reported passenger intervening intentions.Impact on IndustrySince peer passengers often increase young drivers' crash risk, research on passenger intervening has significant implications for road safety strategies. The findings provide support for the operationalization of protective factors in strategies that target passenger intervening behavior.