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This review article addresses the role of safety professionals in the diffusion strategies for predictive analytics for safety performance. The article explores the models, definitions, roles, and relationships of safety professionals in knowledge application, access, management, and leadership in safety analytics. The article addresses challenges safety professionals face when integrating safety analytics in organizational settings in four operations areas: application, technology, management, and strategy. A review of existing conventional safety data sources (safety data, internal data, external data, and context data) is briefly summarized as a baseline. For each of these data sources, the article points out how emerging analytic data sources (such as Industry 4.0 and the Internet of Things) broaden and challenge the scope of work and operational roles throughout an organization. In doing so, the article defines four perspectives on the integration of predictive analytics into organizational safety practice: the programmatic perspective, the technological perspective, the sociocultural perspective, and knowledge-organization perspective. The article posits a four-level, organizational knowledge-skills-abilities matrix for analytics integration, indicating key organizational capacities needed for each area. The work shows the benefits of organizational alignment, clear stakeholder categorization, and the ability to predict future safety performance.
ABSTRACT
This review article addresses the role of safety professionals in the diffusion strategies for predictive analytics for safety performance. The article explores the models, definitions, roles, and relationships of safety professionals in knowledge application, access, management, and leadership in safety analytics. The article addresses challenges safety professionals face when integrating safety analytics in organizational settings in four operations areas: application, technology, management, and strategy. A review of existing conventional safety data sources (safety data, internal data, external data, and context data) is briefly summarized as a baseline. For each of these data sources, the article points out how emerging analytic data sources (such as Industry 4.0 and the Internet of Things) broaden and challenge the scope of work and operational roles throughout an organization. In doing so, the article defines four perspectives on the integration of predictive analytics into organizational safety practice: the programmatic perspective, the technological perspective, the sociocultural perspective, and knowledge-organization perspective. The article posits a four-level, organizational knowledge-skills-abilities matrix for analytics integration, indicating key organizational capacities needed for each area. The work shows the benefits of organizational alignment, clear stakeholder categorization, and the ability to predict future safety performance.
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SARS-CoV-2 has resulted in a global pandemic within months following its initial detection. South Africa (SA), like many other countries, was not prepared for the impact this novel infection would have on the healthcare system. In this paper, the authors discuss the challenges experienced while facing COVID-19 at a tertiary-level institution in Gauteng province, SA, and the dynamic strategies implemented to deal with the epidemic
Subject(s)
COVID-19 , Health Facilities/therapeutic use , Quality Improvement , South AfricaABSTRACT
Background & objectives: The major limiting factor in the prevention of suicide is the limited knowledge on molecular insights in individuals at risk. Identification of peripheral protein markers which can classify individuals at high-risk of suicide might aid in early diagnosis and effective medical intervention. The aim of the present study was, therefore, to analyze the differential regulation of plasma proteins in individuals with deliberate self-harm compared to controls. Methods: Using two-dimensional gel electrophoresis coupled with matrix-assisted laser desorption-ionization mass spectrometry, differentially expressed plasma proteins were identified in study participants with deliberate self-harm compared to age- and gender-matched controls. The finding was validated using mass spectrometry-based isotope-labelled relative quantification and Western blot analysis in a new set of individuals with deliberate self-harm and controls. Results: The plasma proteomic analysis showed that apolipoprotein A-IV (Apo A-IV ) was downregulated by 2.63-fold (confidence interval: 1.52-4.54) in individuals with deliberate self-harm (n=10) compared to matched controls, which was consistent in mass spectrometry-based relative quantification and Western blot analysis performed in an independent set of individuals with deliberate self-harm (n=18). In addition, plasma levels of total cholesterol, esterified cholesterol and high-density lipoprotein (HDL) were observed to be significantly lower individuals with deliberate self-harm compared to controls. Interpretation & conclusions: Apo A-IV, which plays a crucial role in the esterification of free cholesterol, was found to be downregulated with concomitantly decreased levels of HDL, esterified cholesterol and total cholesterol in individuals with deliberate self-harm compared to matched controls. The present findings might provide a link between the differential regulation of plasma proteins and the previously reported results on altered cholesterol levels in individuals with deliberate self-harm.
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Background & objectives: The haemoglobin (Hb) cut-off is a single value for all populations. It is possible that different populations might have slightly different cut-off values; but, this needs to be evaluated in healthy populations with low possibility of inadequate dietary intakes of haematopoietic nutrients. This study was conducted to assess the existence of race-specific Hb cut-offs for mild anaemia in healthy populations and their potential implications. Methods: In this study the Hb distributions of healthy White, Black, Mexican and Hispanic and Asian non-pregnant women obtained from nine rounds of the National Health and Nutrition Examination Survey (NHANES) and two rounds of National Diet and Nutrition Survey (NDNS), was examined to check the existence of race-specific Hb cut-off for mild anaemia, by standard statistical methods. Results: The mean Hb of Blacks, Mexicans and Hispanics and Asians were lower than Whites, consistent with previous literature. The Hb cut-off for mild anaemia in Asians was lower at 11.22 g/dl. Interpretation & conclusions: Using the Hb cut-off derived in this study in place of the World Health Organization, cut-off of 12 g/dl would result in a 17.9 per cent decrease in the prevalence of anaemia in India. This points to the need for re-examining race-specific cut-off for mild anaemia and points to the need for alternative methods, perhaps linked to risk of unhealthy outcomes.
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Background & objectives: Oxidative stress has been implicated in the pathophysiology of major depressive disorder (MDD), but biomarkers to assess oxidative stress in patients with MDD have yielded ambiguous results. Glutathionyl haemoglobin (GS-Hb) has been reported as a stable and potential biomarker for oxidative stress in various clinical conditions. The objective of the study was to evaluate GS-Hb as a potential biomarker of oxidative stress in patients with MDD through its quantification and to compare the levels of GS-Hb in age- and gender-matched healthy controls. Methods: The levels of GS-Hb were estimated using liquid chromatography coupled to electrospray ionization mass spectrometry in patients diagnosed with MDD and in a subset of patients after six weeks of treatment with selective serotonin reuptake inhibitors (SSRIs). Results: GS-Hb levels in drug-naïve patients with MDD (n=26) were significantly elevated compared to matched healthy controls (n=17). GS-Hb levels were not significantly different between MDD patients with and without co-morbid anxiety disorders. There were no significant differences in GS-Hb levels following six weeks of treatment with SSRIs compared to baseline. Interpretation & conclusions: Compared to controls, GS-Hb level in patients with MDD was significantly elevated, suggestive of increased oxidative stress associated with MDD. However, six weeks of antidepressant treatment was not sufficient to modify the alterations in antioxidant/oxidant system. Further studies need to be done with a large sample of MDD patients with a longer duration of antidepressant treatment.
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Background: Health in school children requires unique attention since they are the future goals in every country. Their disease prevalence and prevention should be updated for the betterment of the society. Materials and Methods: A cross-sectional study was carried out in 6198 children in different areas of Mangalore city in age group 5–16 years. The dental caries status was assessed by Decayed, Missing, and Filled Teeth (DMFT)/dmft index using the World Health Organization criteria 1997. Collected data from each subject was statistically analyzed to know the prevalence of dental caries using two sample T test and Chi square test. Results: The overall dental caries prevalence among school children were 63.5%. In males the entire decayed, filled and missed tooth was 63.9%, 7.05%, 7.02% and in females decayed, missed and filled tooth percentage was 63%, 6.02%, 6.13% respectively. The mean DMFT score among males and female’s population were 2.54 ± 2.84 and 2.50 ± 2.85 respectively. The highest caries prone group was between 5-7 years old (71.8%) and lowest was among 14-16 years old (56.71%). Conclusion: The present study revealed that caries is more prevalent among preschool children compared to other school going age groups.
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Although functional impairment begins with iron deficiency in the absence of anaemia, the development of anaemia heralds a homeostatic dysfunction that impairs daily activity. Iron deficiency anaemia is often the reason for poor physical performance, maternal and child morbidity and referral to a healthcare professional. (1) Women in their reproductive years, pregnant women and children are most vulnerable to develop iron deficiency anaemia (IDA) and will be the focus of this review.
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Recent National Family Health Survey-4 data shows that anaemia continues to be a major public health problem in India. In India much of the anaemia is due to iron deficiency, and women and children are at the greatest risk of anaemia. TheMinistry of Health and Family Welfare took a policy decision, in 2013, to develop the National Iron+ Initiative (NIPI) to address the prevailing iron deficiency anaemia. This initiative covered pregnant and lactating women, children and adolescents. However, the guidelines do not match the current World Health Organization (WHO) guidelines for prevention of iron deficiency anaemia in these population groups. The background evidence for the WHO and NIPI is thus reviewed to come to a common consensus on the optimum recommendation of iron supplementation for the population, while taking into consideration the feasibility of the program, without burdening the groups with iron over-dose. However, from the present review, there is a need for increased number of trials in India that could qualify for a high grade of evidence to support the guidelines of NIPI.
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The prevalence of anemia in India is still unacceptably high at 53.1 % in non-pregnant women, 50.3% in pregnant women, 58.4% in children 6 months and 22.7% in adult men(1) and remains a major public health problem. For screening, tracking as well as monitoring the progress of anemia in both in primary and community health care for public health programs, hemoglobin needs to be estimated accurately.
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Heterotopic ossification (HO) refers to the abnormal formation of bone in soft tissue. Although some of the underlying processes of HO have been described, there are currently no clinical tests using validated biomarkers for predicting HO formation. As such, the diagnosis is made radiographically after HO has formed. To identify potential and novel biomarkers for HO, we used isobaric tags for relative and absolute quantitation (iTRAQ) and high-throughput antibody arrays to produce a semi-quantitative proteomics survey of serum and tissue from subjects with (HO) and without (HO) heterotopic ossification. The resulting data were then analyzed using a systems biology approach. We found that serum samples from subjects experiencing traumatic injuries with resulting HO have a different proteomic expression profile compared to those from the matched controls. Subsequent quantitative ELISA identified five blood serum proteins that were differentially regulated between the HO and HO groups. Compared to HO samples, the amount of insulin-like growth factor I (IGF1) was up-regulated in HO samples, whereas a lower amount of osteopontin (OPN), myeloperoxidase (MPO), runt-related transcription factor 2 (RUNX2), and growth differentiation factor 2 or bone morphogenetic protein 9 (BMP-9) was found in HO samples (Welch two sample t-test; P < 0.05). These proteins, in combination with potential serum biomarkers previously reported, are key candidates for a serum diagnostic panel that may enable early detection of HO prior to radiographic and clinical manifestations.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Biomarkers , Metabolism , Case-Control Studies , Ossification, Heterotopic , Blood , Diagnosis , Metabolism , Proteome , Proteomics , Methods , Systems Biology , MethodsABSTRACT
Objectives: To examine the utility of waist-to-height ratio to identify risk of high blood pressure when compared to body mass index and waist circumference in South Indian urban school children. Design: Secondary data analysis from a cross-sectional study. Settings: Urban schools around Bangalore, India. Participants: 1913 children (58.1% males) aged 6-16 years with no prior history of chronic illness (PEACH study). Methods: Height, weight, waist circumference and of blood pressure were measured. Children with blood pressure ≥90th percentile of age-, sex-, and height-adjusted standards were labelled as having high blood pressure. Results: 13.9% had a high waist-to-height ratio, 15.1% were overweight /obese and 21.7% had high waist circumference. High obesity indicators were associated with an increased risk of high blood pressure. The adjusted risk ratios (95% CI) of high systolic blood pressure with waist-to-height ratio, body mass index and waist circumference were 2.48 (1.76, 3.47), 2.59 (1.66, 4.04) and 2.38 (1.74, 3.26), respectively. Similar results were seen with high diastolic blood pressure. Conclusion: Obesity indicators, especially waist-to-height ratio due to its ease of measurement, can be useful initial screening tools for risk of high blood pressure in urban Indian school children.
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Objectives: Mass distribution of vitamin A supplementation (VAS) and measles vaccination has contributed to the reduction in child mortality in Sierra Leone from 267/1000 in 2005 to 118/1000 in 2010. In May 2012, the twice-yearly Maternal and Child Health Week (MCHW) integrated VAS and supplementary measles vaccination to reach all children 6-59 months in Sierra Leone. Following the MCHW, a Post Event Coverage Survey (PECS) was conducted to validate coverage and assess Adverse Events Following Immunization (AEFI). Methods: Using WHO EPI sampling methodology, 30 clusters were randomly selected with fourteen caregivers of children 6-59 months interviewed per cluster for precision of ±5%. In addition, one health worker was interviewed per cluster with all responses collected via mobile phones using EpiSurveyor. Results: Overall coverage confirmed by campaign card for VAS and measles vaccination was 91.9% and 91.6%, respectively, with no significant differences by age group, sex, religion or occupation. Major reasons given for not receiving VAS and measles vaccination were not knowing about the MCHW or being out of the area. No serious AEFI’s were reported during the MCHW or PECs. Significantly more mild AEFIs (fever, pain at injection site) were reported via PECS (29.1%) than during the MCHW (0.01%) (p<0.0001). Conclusions: The MCHW reached >90% of children in Sierra Leone with equitable coverage. Increased reporting of mild AEFI’s during the PECs may be attributed to delayed onset after measles vaccination and/or direct enquiry from enumerators. While all reported AEFIs were mild, strengthened reporting of AEFIs during/after vaccination campaigns is recommended.
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VO2 max is the maximum amount of oxygen a person can consume and the value does not change despite an increase in workload. There is lack of data evaluating the impact of factors, which could affect VO2 max measurement, particularly in Indian population. The objectives of the present study were (i) to estimate VO2 max in a young healthy Indian population and to compare it with available prediction equations for Indian population (ii) to correlate time to achieve VO2 max with the relative VO2 max (iii) to assess the factors affecting the time to achieve VO2 max measurement (body composition and physical activity level). Twenty healthy adult males (18-30 years) underwent detailed anthropometry, physical activity level and modified Bruce protocol for VO2 max assessment. Breath by breath VO2, VCO2, oxygen saturation, heart rate, blood pressure were measured continuously and following exercise protocol. There was an internal validity between the estimated VO2 max and the maximum heart rate (MHR) (r=0.51, P<0.05). Respiratory rate and tidal volume significantly correlated with VO2 max P<0.01). Linear regression analysis indicated physical activity level (PAL) was a strong predictor of time to reach VO2 max. Out of the 3 prediction equations computed to estimate VO2 max, 2 equations significantly overestimated VO2 max. In Conclusion, physical activity level emerged to be a strong predictor of time to VO2 max. Time to achieve VO2 max is an important factor to be considered when determining VO2 max. There was an overestimation in the VO2 max values derived from predicted equations.
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Ormiscodes amphimone (Fabricius) is a phytophagous moth species known to severely defoliate woody species in Chile and Argentina. Here we document new records of O. amphimonehost associations emphasizing the role of Nothofagus pumilio as its primary host in our study area. This new record for Argentina is highly significant given the economic importance of N. pumilio as a timber resource and the potential of O. amphimone to generate extensive outbreaks.
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Animals , Magnoliopsida/parasitology , Lepidoptera , Argentina , WoodABSTRACT
OBJECTIVE: Patient satisfaction has become an increasingly important component of quality assessment. This cross-sectional study was conducted to assess the psychometric properties of a Patient Satisfaction Questionnaire modified for use in the Sickle Cell Unit, Jamaica. METHODS: A total of 85 persons were interviewed. Construct validity, including exploratory factor analysis and internal reliability were assessed. Data were analysed using SPSS (version 11.5 for Windows) and Intercooled STATA (version 8.2). RESULTS: The Patient Satisfaction Questionnaire modified for use in the Sickle Cell Unit demonstrated good internal reliability for the 'doctors', 'nurses', 'social worker' and 'facilities' subscales (Cronbach's a > 0.70). Exploratory factor analysis revealed only four of the seven 'specific' subscales retaining a single factor, namely the 'nurses', 'facilities', 'appointments'and 'social worker'subscales. Those who attended more frequently gave a statistically significant higher score for 'facilities' and lower score for 'nurses'. However there was no statistically significant difference in the mean scores by age, gender and genotype. The 'general satisfaction' subscale scores showed a significant positive correlation with scores for 'doctors', 'nurses', 'laboratory' and 'facilities' and 'appointments'. CONCLUSION: This preliminary report on the validation of the Patient Satisfaction Questionnaire modified for use in the Sickle Cell Unit reveals it has the potential for serving as a useful tool in the assessment ofpatient satisfaction among sickle cell patients. However, further work is necessary on the instrument.
OBJETIVO: La satisfacción del paciente se ha convertido en un componente cada vez más importante de la evaluación de la calidad. Este estudio transversal se llevó a cabo a fin de evaluar las propiedades psicométricas de una Cuestionario de Satisfacción del Cliente, modificado para su uso en la Unidad de Anemia Falciforme, Jamaica. MÉTODOS: Se entrevistó un total de 85 personas. Se evaluó la validez del constructo, incluyendo el análisis exploratorio de factores y la confiabilidad interna. Los datos fueron analizados utilizando el SPSS (versión 11.5 para Windows) e Intercooled STATA (versión 8.2). RESULTADOS: El Cuestionario de Satisfacción del Cliente para uso en la Unidad de Anemia Falciforme demostró buena confiabilidad interna para las subescalas de 'doctores', 'enfermeras', 'trabajadores sociales'e 'instalaciones'(Cronbach: a > 0.70). El análisis exploratorio de factores reveló solamente cuatro de las siete subescalas "específicas" que retienen un solo factor, a saber, "enfermeras", "instalaciones ", "citas " y "trabajadores sociales ". Aquellos que asistían con mayor frecuencia, arrojaron - desde el punto de vista de las estadísticas - una puntuación significativamente más alta para las "instalaciones", y una puntuación más bajas para las "enfermeras ". Sin embargo, no hubo diferencias estadísticas significativas en las puntuaciones promedio por edad, género o genotipo. Las puntuaciones de subescala de la "satisfacción general" mostraron una correlación significativamente positiva con respecto a las puntuaciones para "doctores", "enfermeras", "laboratorio" e "instalaciones, y "citas". CONCLUSIÓN: Este reporte preliminar sobre la validación del Cuestionario de Satisfacción del Paciente, modificado para su uso en la Unidad de Anemia Falciforme, revela que esta Unidad tiene el potencial necesario para servir como instrumento útil a fin de evaluar el grado de satisfacción del servicio entre los pacientes de anemia falciforme. No obstante, el instrumento requiere ulterior elaboración.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Ambulatory Care Facilities/standards , Patient Satisfaction , Cross-Sectional Studies , Factor Analysis, Statistical , Jamaica , Psychometrics , Quality Assurance, Health Care , Surveys and Questionnaires , Reproducibility of ResultsABSTRACT
BACKGROUND: While yoga is thought to reduce the risk of chronic non-communicable diseases such as diabetes, there are no studies on insulin sensitivity in long term practitioners of yoga. We assessed insulin sensitivity and cardiac autonomic function in long term practitioners of yoga. METHODS: Fifteen healthy, young, male practitioners of yoga were compared with 15 young, healthy males who did not practice yoga matched for body-mass index. Fasting insulin sensitivity was measured in the fasting state by the hyperinsulinaemic-euglycaemic clamp. RESULTS: There were no significant differences between the groups in their anthropometry or body composition. However, the fasting plasma insulin was significantly lower in the yoga group. The yoga group was also more insulin sensitive (yoga 7.82 [2.29] v. control 4.86 [11.97] (mg/[kg.min])/(microU/ml), p < 0.001). While the body weight and waist circumference were negatively correlated with glucose disposal rate in the controls, there were no similar correlations in the yoga group. The yoga group had significantly higher low-frequency power and lower normalized high-frequency power. CONCLUSION: Long term yoga practice (for 1 year or more) is associated with increased insulin sensitivity and attenuates the negative relationship between body weight or waist circumference and insulin sensitivity.
Subject(s)
Adult , Analysis of Variance , Autonomic Nervous System , Body Mass Index , Case-Control Studies , Cross-Sectional Studies , Fasting , Glucose Clamp Technique , Heart , Humans , Insulin/blood , Insulin Resistance , Male , YogaABSTRACT
We report a 38-year-old Syrian woman who presented with progressive breathlessness, hypotension and circulatory collapse. Echocardiogram revealed a large pericardial effusion with evidence of cardiac tamponade. There was a history of secondary amenorrhoea, loss of axillary and pubic hair following childbirth at 28 years of age. Investigations revealed low levels of gonadotrophins, oestrogen, prolactin and thyrotrophin but normal levels of basal and post-synacthen (ACTH) cortisol. An MRI of the sella showed atrophic changes of the pituitary. She was treated with intravenous fluids, dopamine infusion, intravenous hydrocortisone and thyroxine replacement. The clinical suspicion of Sheehan syndrome facilitated early administration of corticosteroids, adequate thyroxine replacement and rapid resolution of pericardial effusion.
Subject(s)
Adult , Cardiac Tamponade/etiology , Echocardiography , Female , Humans , Hypopituitarism/complications , Magnetic Resonance Imaging , Shock/etiologyABSTRACT
BACKGROUND: Rheumatoid arthritis patients who develop refractoriness are left with no alternatives other than leflunomide and costly biological response modifiers. Leflunomide, though effective, was associated with adverse events and has not been extensively studied in the Indian population. AIMS: Determination of safety and efficacy of leflunomide alone and if not useful, in combination with methotrexate in patients refractory to conventional disease-modifying agents. SETTING AND DESIGN: Open labeled clinical trial with leflunomide [100 mg, OD x 3 days followed by 20 mg, OD x 6 months], if no improvement at three months, combined with methotrexate [5-7.5 mg, OD x 3 months] at a tertiary care hospital. MATERIALS AND METHODS: The primary endpoint in the improvement in EULAR criteria and secondary endpoints were patient and physician global evaluation, incidence of remission and biochemical and clinical adverse events. STATISTICAL ANALYSIS: Chi square test or Fisher's exact test and parametric and non-parametric repeat measure ANOVA were used for analysis. RESULTS: Among 84 patients who were included in the study, leflunomide showed improvement and remission in 52 [62%] and 6 [7%] in six months, by intention to treat analysis. Adverse events were observed in 15, discontinuation in 5 and 24 dropped out. With combination in 11 patients, there was improvement and remission in nine [91%] and one [9%] after three months. Adverse events were observed in six and one discontinued. CONCLUSIONS: If regular monitoring of hepatic function and hematological parameters are performed, leflunomide is an effective and safe drug in the Indian population in resistant rheumatoid arthritis patients, especially if used alone.