A systemic methodology for risk management in healthcare sector

The recent biomedical, technological, and normative changes have led healthcare organizations to the implementation of clinical governance as a way to ensure the best quality of care in an increasingly complex environment. Risk management is one of the most relevant aspects of clinical governance and approaches put forward in literature highlight the necessity to perform comprehensive analyses intended to uncover root causes of adverse events.Contributing to this field, the present paper applies Reason’s theory of failures to work out a systemic methodology to study risks impacting not only directly but also indirectly on patients. Also, the steps of such approach are organized around Human Reliability Assessment phases, in order to take into account the human component of healthcare systems. This framework is able to foster effective decision making about reducing failures and waste and to improve healthcare organizations’ maturity towards risk management.The developed methodology is applied to the pharmacy department of a large Italian hospital. An extensive validation in different healthcare settings is required to fully prove benefits and limitations.     

Work ability in ageing workers suffering from chronic diseases.

The aim of this study was to investigate the work ability in ageing workers suffering from osteoarthritis (OA), coronary heart disease (CHD) or hypertension (H). One hundred and sixty-six OA and 355 CHD/H outpatients were evaluated. The Work Ability Index (WAI) served for work ability assessment. Patients' results were compared with the results of a control group of 225 healthy young workers. Statistical analysis was performed with ANOVA tests. WAI in female and male CHD/H patients was higher than in OA patients (p < .01), better work ability was related to better education (p < .01), white-collar work (p < .01) and better recreation (p < .01); subjective work ability was determined mostly by the objective health status. The promotion of work ability among workers suffering from advanced age-related diseases should be closely related to the promotion of health. It is indicative to improve occupational education and skills, already at an early stage of a disease.     

Age-related thermal strain in men while wearing radiation protective clothing during short-term exercise in the heat.

The aim of the study was to compare heat strain among different age groups of men in protective clothing during short-term physical work. Eight young (20-29 years), 6 middle-aged (41-55 years), and 6 older (58-65 years) men exercised for 30 min on a cycle ergometer (40% V(O2 max)) in 2 hot environments with a similar WBGT (ca. 26 degrees C): once with minimal clothing without infrared radiation (E1), and once with aluminized protective clothing under infrared radiation (E2). All subjects had sedentary jobs, but only the older subjects were physically active in their leisure-time. Body temperatures, heart rate, sweat rate, and subjective feelings were determined during the tests. Higher thermal strain was observed in E2 than in E1. No age-related differences in thermal strain were observed in either experiment indicating that active older men can tolerate short work periods with protective clothing in the heat as well as younger sedentary men.     

超高效液相色谱/电喷雾串联质谱(UPLC/MS/MS)分析全氟代化合物(PFCs)

近年来,在全球范围内的环境和人体血液中检测到全氟代化合物(PFCs)增长的趋势,引起了研究者和有关当局的关注.PFCs同时具有亲水性和疏水性,经常用于地毯、纤维、皮革的处理、纸张和食品包装物等,也是塑料生产、灭火剂、抛光剂和杀虫剂的功能化学品.     

Conducting and delivering integrated research to influence land-use policy: salinity policy in Australia

Researchers can find the process of engaging with policy to be both rewarding and frustrating. In the context of land-use policy, we discuss various aspects of the research-policy nexus, including the various influences of research and policy on land use, the adoption of research results by policy makers, differences between policy and research, and the roles that researchers can play in policy. We present a case study from Australia in which a range of research into land use was integrated to develop an investment framework for policy makers and natural resource managers. We conclude that, to enhance their influence on land-use policy, researchers should strive to: understand the policy maker's perspective, practice excellent communication, be solution oriented, find a champion, avoid appearances of vested interest, and be simple, patient, persistent, resilient, responsive and timely.