Advancing safety analytics: A diagnostic framework for assessing system readiness within occupational safety and health.

Big data and analytics have shown promise in predicting safety incidents and identifying preventative measures directed towards specific risk variables. However, the safety industry is lagging in big data utilization due to various obstacles, which may include lack of data readiness (e.g., disparate databases, missing data, low validity) and personnel competencies. This paper provides a primer on the application of big data to safety. We then describe a safety analytics readiness assessment framework that highlights system requirements and the challenges that safety professionals may encounter in meeting these requirements. The proposed framework suggests that safety analytics readiness depends on (a) the quality of the data available, (b) organizational norms around data collection, scaling, and nomenclature, (c) foundational infrastructure, including technological platforms and skills required for data collection, storage, and analysis of health and safety metrics, and (d) measurement culture, or the emergent social patterns between employees, data acquisition, and analytic processes. A safety-analytics readiness assessment can assist organizations with understanding current capabilities so measurement systems can be matured to accommodate more advanced analytics for the ultimate purpose of improving decisions that mitigate injury and incidents.

Concerns of women regarding pregnancy and childbirth during the COVID-19 pandemic.

OBJECTIVE: Better understand knowledge, attitudes and practices of pregnant women and mothers of infants around coronavirus disease 2019 (COVID-19). METHODS: A 58-item electronic survey was distributed to pregnant and postpartum women (infants <12 months) who were >15 years, English-speaking and enrolled in prenatal programs. Data is summarized using central tendency, frequencies and nonparametric statistics. RESULTS: Of 114 (51 % response rate) participants, 82.5 % reported negative changes in mental status measures (e.g. stress, anxious thoughts, changes in sleep patterns). All reported risk-reduction behavior changes (e.g. handwashing/use of sanitizer, social distancing). Significant changes were reported in employment and financial status due to the pandemic. Increases in alcohol consumption among postpartum women were also reported. Few reported changes in prenatal, infant or postpartum healthcare access. CONCLUSION: This study provides initial insight into the knowledge, attitudes and practices of pregnant and postpartum women during the COVID-19 pandemic. This study is limited as participants represent a single Midwest community and social desirability response bias may have impacted responses. However, results may inform future interventions to support pregnant women and mothers of infants during pandemics. PRACTICE IMPLICATIONS: Providers should consider the impact of such events on mental status, access to resources and changes in behaviors.

Cervical Cancer: Evaluation and Management.

Human papillomavirus infection is the precursor for the development of cervical cancer and is detectable in 99.7% of squamous cell carcinoma and adenocarcinoma cases. Early detection of precancerous lesions with Papanicolaou testing remains the primary mechanism for cancer prevention. Once cervical cancer is diagnosed, treatment may involve surgery, radiation therapy, chemotherapy, or a combination. The choice of therapy depends on the stage of disease, lymph node involvement, patient comorbidities, and risk factors for recurrence. Early-stage, microinvasive disease may be treated with surgery alone if margins are negative and there is no lymph node involvement; adjuvant chemoradiation should be considered for other early-stage disease. Locally advanced disease is often treated with chemoradiation. The addition of bevacizumab, an antivascular endothelial growth factor monoclonal antibody, to combination chemotherapy improves survival among patients with recurrent, persistent, or metastatic cervical cancer. Disease stage and lymph node involvement are the most prognostic factors. Pregnancy status and desire to preserve fertility should be considered when developing a treatment strategy. After treatment, close follow-up with a gynecologist-oncologist for pelvic examinations at regular intervals is recommended to assess for recurrence.

Internal jugular vein septic thrombophlebitis (lemierre syndrome) as a complication of pharyngitis.

Sore throat is a common presenting complaint in the outpatient setting. Most cases are nonbacterial in origin, but those that are bacterial are usually the result of group A ß-hemolytic streptococcus. Guidelines exist to help physicians decide whether to treat with an antibiotic. Lemierre syndrome is a dangerous potential sequela of pharyngitis that results in septic thrombophlebitis of the internal jugular (IJ) vein. A high index of suspicion is needed to consider this diagnosis in the workup of pharyngitis and should be aggressively treated once identified. Consideration should be given to completing blood cultures and neck imaging because of clinical suspicion. The case study discussed here illustrates the presentation, evaluation, and treatment of Lemierre syndrome.