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The effects of host-parasite interactions can be measured in ecologically relevant ways through behavioural indicators based on foraging theory. These include, assessing how parasites alter foraging aptitudes, harvest rates, and risk management of foragers. Consequences of infection can be measured from individuals to ecosystems. At the individual level, sick animals need to trade-off finding food with remaining safe from predators, while potentially facing debilitating effects from infection. This potentially results in reduced foraging efficiencies, compromised risk awareness, and increased apprehension. To investigate this, we assessed how a Mycoplasma bacterial infection impacted individual Allenby’s gerbils’ foraging aptitudes, resource harvest rates, and anti-predator responses. We monitored individuals through three stages, from uninfected, to acutely (newly) and finally chronically (long term) infected. We identified three distinct responses. While acutely infected, some individuals increased their foraging effort in patches and spent less time vigilant. This may reflect increased future value of food for these individuals. Some individuals immediately reduced their foraging effort and displayed increased apprehension while acutely infected. This likely reflects a lethargy, where sick individuals are compromised in their ability to harvest seeds efficiently while also remaining vigilant. As all individuals became progressively sicker with a chronic infection, their foraging declined and apprehension levels increased. Two individuals employed a ‘grab and go’ foraging strategy to minimize time spent in patches. Foraging costs of long-term infection increase dramatically over time. These findings point to some behavioural plasticity in response to initial infection, yet the consequences of long-term infection are similar for all individuals. [ABSTRACT FROM AUTHOR]

In clinical work with families in which a young person is at real and significant risk of self‐harm or even death by suicide, predictable emotional triangles both within the family and within the treating system intensify. As understandable fear and worry in parents and clinicians rises in response to potential risk, these emotionally driven relational processes become even more rigid. This typically results in a reduction in cognitive and behavioural flexibility, which can potentially and unwittingly increase the risk of self‐harm by suicide. This article outlines some basic principles pertaining to the notion of emotional triangles, a central concept in Bowen family systems theory; its relevance for clinicians working with suicidal youth and their families; and its application to the context of a community child and youth mental health service. Practical application of theory to clinical work is demonstrated through clinical vignettes that describe the work of two clinicians and their clinical supervisor. The authors reflect on their understanding of the development of emotional triangles in the vignettes presented alongside their efforts to navigate these triangles through the regulation of their own anxiety and more objective thinking. [ABSTRACT FROM AUTHOR]

Motivation Purpose Approach and methods Findings Policy Implications Close to a third of the world's population and more than 80% of people living in extreme poverty live in contexts of fragility. With agencies such as the OECD and UNDP conceiving of such places in terms of multiple and serious risks, the framing has come to be one of pathology: fragile contexts are defined by deficits with respect to idealized governance and sustainable development goals. In consequence, development options are locked into managing risks—confining opportunities to develop potential.Can strategic foresight unlock the development potential of fragile societies?Because there is still little documentation of foresight initiatives in contexts of fragility, the approach here is theoretical and conceptual. We draw on literature from the fields of fragility, foresight, and cognition, as well as insights from expert exchanges and roundtables.It is uncertainty, not risk, that lies at the heart of fragility—an insight that challenges standard decision‐making. With the latter being based on analogical reasoning, it cannot be logically applied under conditions of uncertainty. If, instead, we adopt an heuristic for decision‐making that acknowledges uncertainty to not only entail risk but also opportunity, strategic foresight is well‐placed to help revive development.First, fragility has to be reframed to acknowledge the centrality of uncertainty, not risk, in approaching fragility. Whilst evidence from the past is important, scrutinizing past paradigms and envisioning different futures is crucial.Second, strategic foresight can help uncover fragile societies’ capacities and potential. It can help shift from analyses dominated by a concern with lacks and deficits, to analyses which seek relative strengths and opportunities. Just as strong states are not strong in every respect, fragile states may have more to offer than meets the eye.Third, debates need to be more open, less ideologically laden. Dominant thinking on fragility is rife with seemingly imperturbable underpinnings: for example, the mantra that “without peace there can be no development, and without development there can be no peace.” While such propositions contain some truth, treating them as absolute and universally applicable, limits both thinking and policy options. Strategic foresight is well placed to provide a fresh view on fragility. [ABSTRACT FROM AUTHOR]

The relationship between companies’ sustainable operation and their financial performance is currently a key area of research. However, the question arises: how does environmental, social, and governance (ESG) assessment affect firms’ economic efficiency? The authors focused on equity markets to investigate the relationship between the top 100 ESG rated US companies and their stock market performance in 2022 and 2023. They investigated whether returns, risk indicators and sectoral affiliation affect ESG scores. The results indicated that the stock real returns have no impact on the ESG score, and ESG valuations have no impact on stock market performance. There was, however, a negative relationship between the standard deviation of returns and ESG scores, which suggests that more stable and less risky companies tend to have a higher ESG ranking than their more volatile counterparts. There was also a significant relationship between sector position and ESG score only for the 2022 dataset. [ABSTRACT FROM AUTHOR]

Purpose: Obesity's prevalence is rising in women of reproductive age worldwide and has become the most common medical condition at this age group. Besides, its occurrence is also rising during pregnancy. This condition not only increases the risk of noncommunicable diseases on the mother, such as cardiovascular disease and diabetes, but also transfers this risk to the offspring. Methods: This is a narrative review based on scientific and review articles on the matter. Results: Obesity is associated with an increased risk of gestational diabetes mellitus, gestational hypertension and preeclampsia, venous thromboembolism, infection, and mental health problems. Furthermore, it has an impact on the progress of labor and induction matters. Regarding offspring outcomes, it is related to higher incidence of congenital anomalies, perinatal mortality, and the occurrence of large for gestational age newborns. Still, it has implications on cardiometabolic risk and neurodevelopment in offspring. Conclusion: It is, therefore, imperative to encourage the adoption of healthy lifestyles, especially in the peri-conception and interpregnancy periods. Likewise, there must be support in the multidisciplinary monitoring of these pregnant women to minimize associated complication rates. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To better understand the areas of risk that may become apparent across the life course of dementia • To recognise the ethical issues posed by trying to eliminate the risk of harm for people living with dementia • To consider how the principles of safeguarding apply to risk management in dementia care. What constitutes a risk for a person living with dementia may be perceived and prioritised differently by nurses from varying clinical backgrounds. Furthermore, risk may be perceived differently according to the context. This article outlines some of the social, psychological and physical risk factors relevant to people living with dementia across the life course of the condition. It is important that nurses understand their role in identifying, assessing and managing risk and are aware of the resources, policies, legislation and processes designed to support decision-making and minimise the risk of harm to people living with dementia, their families and carers. The authors hope that this article will support nurses to become more confident in identifying risk while encouraging them to adopt a proactive and person-centred approach to risk assessment and management. [ABSTRACT FROM AUTHOR]

Overnight radiology (ONR) is necessary for providing timely patient care but poses unique professional and personal challenges to the radiologists. Maintaining a sustainable, long-term overnight radiology program hinges on the retention of radiologists who grasp the institutional workflow and can adeptly navigate inherent disruptions while consistently delivering high-quality patient care. Design of radiology shifts can significantly impact the performance and well-being of radiologists, with downstream implications for patient care and risk management. We provide a narrative review of literature to make recommendations for optimally designing ONR shifts, with a focus on professional and personal challenges pertinent to overnight radiologists and system-based risk mitigation strategies. [ABSTRACT FROM AUTHOR]

This paper describes an assessment framework tool to analyze the performance of nature-based solutions (NBS) for hydro-meteorological risk management. The tool is based on multi-criteria decision analysis within the context of NBSs, an umbrella concept currently in focus that promotes nature and provides ecological and socio-economic benefits. The proposed tool includes the selection and application of key performance indicators (KPIs) for the co-benefits and costs associated with the implementation of NBSs. To ensure high societal impact, the tool relies on a participatory approach. Stakeholder preferences are taken into account within the assessment process. As such, the assessment framework can be used as a design and selection tool for NBSs and other alternative measures, including grey and hybrid solutions. The proposed procedure can be adapted to the specific socio-environmental context and hydro-meteorological risk by tailoring the set of relevant KPIs. The assessment framework is useful for monitoring the implemented measures and to document their effectiveness. The methodology provides quantitative and transparent documentation of hydro-meteorological risk management processes, useful for decision- and policy-makers, and stakeholders dealing with NBS measures. [ABSTRACT FROM AUTHOR]

Aims: To synthesize the available evidence to better understand the effectiveness of interventions to prevent or delay hyperglycaemia and Type 2 diabetes mellitus (T2DM) postnatally in women with current or previous gestational diabetes mellitus (GDM). Methods: We searched five databases up to December 2020 for primary peer‐reviewed articles reporting postpartum glycaemic outcomes in women with (previous) GDM following pharmacological or lifestyle intervention. Outcomes were relative risk of T2DM or continuous measures of glycaemia, change or at follow‐up. A minimum of two studies evaluating the same intervention‐outcome combination were needed to conduct meta‐analyses, otherwise studies were described narratively. Meta‐regression was used to evaluate whether associations varied by additional variables. We assessed risk of bias using the Critical Appraisal Skills Programme checklist. PROSPERO record CRD42018102380. Results: We included 31 studies in the review with a total sample size of 8624 participants, and 26 studies in meta‐analyses. Two‐thirds of studies followed up participants at 1 year or less. Pharmacological interventions were associated with reduced risk of T2DM (0.80 [95% CI 0.64–1.00], n = 6 studies), as were lifestyle interventions albeit with a smaller effect size (0.88 [95% CI 0.76–1.01], n = 12 studies). Dietary and physical activity interventions were associated with a small reduction in fasting plasma glucose, particularly in longer interventions, but inconsistent effects were seen for other continuous outcomes. Conclusions: Although possibly due to chance, interventions to reduce hyperglycaemia after GDM may be effective. Future research should improve understanding of how interventions affect glucose control and how to optimise interventions for this population. [ABSTRACT FROM AUTHOR]

Agricultural microinsurance is a promising risk management tool for smallholder farmers. However, adoption rates remain low and only a small share of farmers renew their policy after the first period. With the increasing availability of cell phones, mobile-delivered insurance is gaining importance on the market. As for any agricultural microinsurance, it is essential for the longevity of a mobile-delivered insurance scheme to retain a solid customer base. To date, it is unknown what drives the decision to renew a mobile-delivered agricultural microinsurance policy. We address this question by performing mean comparisons and logistic regressions based on primary data collected from 479 smallholder farmers in Mali who purchased a mobile-delivered weather index-based insurance in 2020. Results show that the level of satisfaction with the insurance product was considerably higher among farmers who renewed. We found low levels of understanding of the product among all clients, but especially among those who did not renew. Both factors were confirmed as drivers for renewal. Consistent with previous findings, receiving a payout had the strongest effect on the decision to renew. We conclude that additional measures to foster client satisfaction as well as to promote understanding of agricultural insurance among smallholder farmers are highly recommended. [ABSTRACT FROM AUTHOR]

This brief article summarizes five trends and issues discussed during a moderated panel and round table discussion at the Association for Experiential Education (AEE) Symposium on Experiential Education Research (SEER) in November 2023. The aim of this session was to expand on prior documented trends and disseminate current experiential and outdoor education (EOE) trends, issues, and related research. These are only a few of the many EOE trends and issues but they represent both meta trends/issues and program-specific trends. This session was designed for scholars and practitioners who teach, provide program administration, and/or conduct research and evaluation efforts for EOE and related disciplines. Topics included cultural representation in the outdoors, trauma and mental health trends, safety II: a new view of risk management, nature and outdoor programming, and whether college outdoor orientation leaders should be paid. We hope that you, the reader, are inspired to consider what trends and issues are impacting your work and explore areas for future research. [ABSTRACT FROM AUTHOR]

This qualitative study explores the opportunities and challenges of collaboration experienced by social workers and police officers when dealing with cases of intimate partner violence (IPV) and stalking. The study aims to examine their collaborative approaches in risk assessment and risk management by identifying the structures, supports, and foundations crucial for effective collaboration. Our data, collected from twelve interviews and one focus group interview with social workers and police officers, reveals that collaboration was facilitated by assigning specific roles to involved parties, proximity, structure and professionalism. These key factors emerged as crucial and contributing to the effectiveness of the collaborative efforts. Practitioners should consider integrating these key elements into their practices to enhance and improve collaboration when addressing cases of IPV and stalking. The study underscores the need for a well-defined framework and support structures to optimise the collaborative response to such complex and sensitive issues. [ABSTRACT FROM AUTHOR]

Clinical laboratories face limitations in implementing advanced quality control (QC) methods with existing systems. This study aimed to develop a web-based application to addresses this gap, and improve QC practices.QC Constellation, a web application built using Python 3.11, integrates various statistical QC modules. These include Levey-Jennings charts with Westgard rules, sigma-metric calculations, exponentially weighted moving average (EWMA) and cumulative sum (CUSUM) charts, and method decision charts. Additionally, it offers a risk-based QC section and a patient-based QC module aligning with modern QC practices. The codes and the web application links for QC Constellation were shared at https://github.com/hikmetc/QC_Constellation, and http://qcconstellation.com, respectively.Using synthetic data, QC Constellation demonstrated effective implementation of Levey-Jennings charts with user-friendly features like checkboxes for Westgard rules and customizable moving averages graphs. Sigma-metric calculations for hypothetical performance values of serum total cholesterol were successfully performed using allowable total error and maximum allowable measurement uncertainty goals, and displayed on method decision charts. The utility of the risk-based QC module was exemplified by assessing QC plans for serum total cholesterol, showcasing the application’s capability in calculating risk-based QC parameters including maximum unreliable final patient results, risk management index, and maximum run size and offering risk-based QC recommendations. Similarly, the patient-based QC and optimization modules were demonstrated using simulated sodium results.In conclusion, QC Constellation emerges as a pivotal tool for laboratory professionals, streamlining the management of quality control and analytical performance monitoring, while enhancing patient safety through optimized QC processes. [ABSTRACT FROM AUTHOR]

Energy markets are crucial for integrating Distributed Energy Resources (DER) into modern power grids. However, this integration presents challenges due to the inherent variability and decentralized nature of DERs, as well as poorly adapted regulatory environments. This paper proposes a medium-term decision-making approach based on a comprehensive suite of computational tools for integrating DERs into Colombian energy markets. The proposed framework consists of modular tools that are aligned with the operation of a Commercial Virtual Power Plant (CVPP). The tools aim to optimize participation in bilateral contracts and short-term energy markets. They use forecasting, uncertainty management, and decision-making modules to create an optimal portfolio of DER assets. The suite's effectiveness and applicability are demonstrated and analyzed through its implementation with heterogeneous DER assets across various operational scenarios. [ABSTRACT FROM AUTHOR]

India, one of the most dynamic ancient civilizations, possesses a multitude of historical artifacts, with 37 of its notable architectural structures recognized as UNESCO World Heritage Sites. Yet, the ever-changing climate, especially air pollution, expedites the natural deterioration of historic sites and diminishes their aesthetic appeal, causing socio-economic damage. With this in mind, the current study aims to offer a logical scientific foundation for the implications of air pollution, seasonal shifts, and COVID-19 on 14 significant historical places in India during the year 2019-20. Delhi, among the cities most severely affected by atmospheric pollution, recorded an alarming air quality index (AQI) of 102–141, which can intensify the risk of cultural sites to corrode and deteriorate. Analysis reveals that the winter season had elevated levels of NO2 and particle pollution (PM2.5, PM10), whereas summer had the higher levels of O3. Throughout the 5-month lockdown period, ozone levels exhibited an elevation, contrasting with the reduction observed in other air parameters. Notably, there was a substantial 70% decrease in particulate matter concentration, which had previously remained stable over the course of the year. Variations in geographic locales and anthropogenic influences contribute significantly to the dose-response statistics, revealing an unprecedented elevation in corrosion risks to historical limestone and sandstone structures across target sites. Moreover, the research addresses available Governmental initiatives, and effective strategies designed to safeguard heritage sites against the corrosion and material degradation, offering a comprehensive exploration of protective measures. Thereby, the current research is centred on establishing a foundational understanding of the impact of air pollution on cultural heritage, utilizing a comparison to the year with the lowest air pollution levels, which can aid policymakers in enhancing risk management and implementing a robust national mandate for the preservation of cultural heritage sites against corrosion. [ABSTRACT FROM AUTHOR]

We present and solve an optimal asset allocation problem under a weighted limited expected loss (WLEL) constraint. This formulation encompasses the risk management problem with a limited expected loss (LEL) constraint as a specialized instance and offers a pertinent internal risk management instrument for firms. We observe that a WLEL constraint makes the optimizing investor pursue less volatile payoffs than the unconstrained Merton solution. Compared to the LEL-constrained problem with the same weighted default threshold, the WLEL optimal terminal wealth displays a less dispersed distribution with a smaller variance, suggesting a more secure risk management framework. Conducting a comprehensive equilibrium analysis in the presence of a WLEL risk manager, we validate the relatively conservative investment approach undertaken by the WLEL manager. Subsequently, we expand our findings to encompass broader incomplete market settings, wherein the uniqueness of the equivalent local martingale measure is not assured. [ABSTRACT FROM AUTHOR]

Objective: To determine the utilization of risk-reducing strategies and screening protocols for ovarian cancer in female BRCA1/2 carriers. Methods: This study was a sub-analysis of female participants from a larger multicenter, cross-sectional survey of BRCA1/2 mutation carriers unaffected by cancer. The questionnaire was administered electronically via email at four institutions located in the northeast United States. Data were analyzed with Fisher's exact test. Results: The survey was completed by 104 female BRCA mutation carriers. BRCA subtypes included 54.3% BRCA2, 41.0% BRCA1, and 2.9% both. The age at which patients underwent genetic testing varied 21.2% were 18–24 years, 25.0% were 25–34 years, 29.8% were 35–44 years, and 24.0% were 45 years or older. Nearly, all respondents (97.1%) reported that a provider had discussed risk-reducing surgeries. Of the 79 females who underwent genetic testing before 45 years of age, 53.2% reported that a health care provider recommended taking combined oral contraceptive pills (COCs) to reduce their risk of ovarian cancer, and, of these women, 88.1% chose to use them. COCs were offered at higher rates among women who were younger at the age of genetic testing (18–24: 86%, 25–34: 62%, 35–44: 23%; p < 0.0001). Approximately half (55.8%) of the respondents reported having been offered increased screening for possible early detection of ovarian cancer, of which 81.0% chose to undergo screening. The majority utilized a combination of transvaginal ultrasound and serum CA125 measurements. There were no differences observed in screening utilization based on BRCA mutation type. Conclusion: In our cohort of female BRCA mutation carriers, risk-reducing surgery was offered to almost all women, whereas only half were offered risk-reducing medication and/or increased screening. Further investigation is needed to identify barriers to the utilization of risk-reducing strategies among this high-risk population. [ABSTRACT FROM AUTHOR]

In an era of globalization full of uncertainty, companies are faced with various risks that can disrupt the smooth running of operations and even threaten their sustainability. The aim of this research is to analyze the role of risk management in increasing company resilience. This study used qualitative research methods. The data collection technique in this research is literature study. The data that has been collected is then analyzed in three stages, namely data reduction, data presentation and drawing conclusions. The research results show that the role of risk management in increasing company resilience is as a tool to identify, measure and manage potential risks that can have a negative impact on the company's strategic targets. Implementing risk management can help companies build resilience against risks that can disrupt operations, protect organizational assets, reduce losses, increase compliance with applicable regulations, laws or standards, and optimize opportunities. Implementing risk management can be done through several steps, such as risk identification, risk evaluation and risk management. [ABSTRACT FROM AUTHOR]

This study investigates the volatility of gold prices by applying the Generalized Autoregressive Conditional Heteroskedasticity (GARCH) model and extending it with the GARCH-M model, incorporating the Federal Reserve's interest rate as an external variable. The GARCH(1,1) model revealed a positive average daily return for gold, with high sensitivity to recent price changes, indicated by the significant estimation of mu and a high alpha1 value. The persistence of past volatility on current volatility is reflected by a beta1 value close to one. In the GARCH-M model development, a significant negative relationship was found between the Federal Reserve's interest rates and gold returns, suggesting that an increase in the Federal Reserve's interest rates could potentially decrease gold returns. An increase in the Log Likelihood value and improvements in information criteria such as the Akaike Information Criterion (AIC) and the Bayesian Information Criterion (BIC) indicate that the GARCH-M model provides a better fit than the GARCH(1,1) model that uses only gold price data. The study concludes that macroeconomic factors like the Federal Reserve's interest rates play a crucial role in influencing gold price volatility, and these findings can aid investors and portfolio managers in devising more effective risk management strategies. Additionally, the findings contribute to financial theory by highlighting the importance of multivariate models in the analysis of asset price volatility. [ABSTRACT FROM AUTHOR]

The study assessed the risk management implementation and the degree of likelihood and severity of risks affecting the Department of Tourism-Accredited hotels in Region VIII. In addition, it took into account if there is a significant difference between the perspectives of middle management and rank-and-file employees and the significant relationship of risk management implementation and likelihood and severity of risks and its facilitating and impeding factors. To attain these, the study utilized both quantitative framework through survey and a qualitative method through interview. Sixteen hotels participated the study. Overall, establishments demonstrated an implemented category yet presence of variability suggests the need for continuous improvement in implementation. As to likelihood and severity of risks it is perceived as "unlikely to happen" yet "very severe" suggesting to roll-out proactive measures. It showed significant difference in viewpoints where the middle management have a better grasps of risk management than the rank-and-file employees. While for the test of significant relationship it has a clear negative correlation while no significant correlation was found between risk management and severity of risks. It revealed themes reactive approach rather than proactive risk management where these hotels need to embody a culture of proactive culture, employee education and training, budget allocation and get rid of being resistance to change and lack of cooperation to enhanced strategies to risk management. Based on the findings, a comprehensive risk management plan anchored to ISO 31000-2018 will be helpful to lessen the vulnerability to various risks to safeguard its stakeholders especially it guests. [ABSTRACT FROM AUTHOR]

Background: The risk management program will run well with commitment and good management. This study aims to describe the experience of nurse managers in implementing risk management in hospitals. Research methodology: this study used a descriptive qualitative approach. The data collection technique used Focus Group Interviews with 12 nurse managers consisting of 1 Head of Sub Installation, 7 Head nurses, and 4 Team Leaders. Interviews were carried out three times, and each implementation consisted of four participants. Analysis using thematic content and consolidation for reporting qualitative research (COREQ) was used as a guide to research reporting. The research found three inhibiting factors in implementing risk management: 1) Busyness, 2) Lack of knowledge, and 3) Lack of structured monitoring and evaluation. Conclusion: The active participation of nurse managers in implementing risk management is very influential in the successful implementation of risk management in hospitals. Good time management, increasing the level of knowledge, and supported by a systematic risk management monitoring-evaluation system means that risk management will be carried out well. [ABSTRACT FROM AUTHOR]

Tailings storage facilities (TSFs) impound mining waste behind dams to ensure public safety, but failure incidents have prompted calls for more robust monitoring programs. Satellite-based interferometric synthetic aperture radar (InSAR) has grown in popularity due to its ability to remotely detect millimeter-scale displacements in most urban and some natural terrains. However, there remains a limited understanding of whether InSAR can be as accurate or representative as on-the-ground instruments, whether failures can be predicted in advance using InSAR, and what variables govern the quality and reliability of InSAR results. To address these gaps, we analyze open-source, medium-resolution Sentinel-1 data to undertake a ground-truth assessment at a test site and a forensic analysis of five failure cases. We use a commercial software with an automated Persistent Scatterer (PS) workflow (SARScape Analytics) for all case study sites except one and a proprietary algorithm (SqueeSAR) with a dual PS and Distributed Scatterer (DS) algorithm for the ground-truth site and one forensic case. The main goal is to deliver practical insights regarding the influence of algorithm/satellite selection, environmental conditions, site activity, coherence thresholds, satellite-dam geometry, and failure modes. We conclude that Sentinel-1 InSAR can serve as a hazard-screening tool to help guide where to undertake targeted investigations; however, most potential failure modes may not exhibit InSAR-detectable accelerations that could assist with time-of-failure prediction in real time. As such, long-term monitoring programs should ideally be integrated with a combination of remote sensing and field instrumentation to best support engineering practice and judgment. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this work was to assess failures in the advanced prescription of parenteral anticancer agents in an adult day oncology care unit with more than 100 patients per day. Methods: An a priori descriptive analysis was carried out by using the risk matrix approach. After defining the scope in a multidisciplinary meeting, we determined at each step the failure modes (FMs), their effects (E) and their associated causes (C). A severity score (S) was assigned to all effects and a probability of occurrence (O) to all causes. These S and O indicators, were used to obtain a criticality index (CI) matrix. We assessed the risk control (RC) of each failure in order to define a residual criticality index (rCI) matrix. Results: During risk analysis, 14 FMs were detected, and 61 scenarios were identified considering all possible effects and causes. Nine situations (15%) were highlighted with the maximum CI, 18 (30%) with a medium CI, and 34 (55%) with a negligible CI. Nevertheless, among all these critical situations, only three (5%) had an rCI to process (i.e., missed dose adjustment, multiple prescriptions and abnormal biology data); the others required monitoring only. Clinicians' and pharmacists' knowledge of these critical situations enables them to manage the associated risks. Conclusions: Advanced prescription of injectable anticancer drugs appears to be a safe practice for patients when combined with risk management. The major risks identified concerned missed dose adjustment, prescription duplication and lack of consideration for abnormal biology data. [ABSTRACT FROM AUTHOR]

Summary: Nowadays, the adoption of digital technologies getting a significant pace. It has the potential to improve the existing dynamics of the food supply chains and improve its transparency. Many times, uncertainties prevail in the food supply chain performance systems, which cause amplification of risk. These uncertainties are due to a lack of product traceability mechanisms in the food supply chains. Hence, it becomes vital to harness the potential of digital technologies like the Internet of Things, Blockchain, and common digital platforms to improve the flow of information and products in the food supply chain. The presented work is aimed at assessing the impact of digital technologies on risk identification and its mitigation in the food supply chain dynamics. For the same, risks are assessed relative to its mitigation strategy by the two‐stage methodology of preference rating approach. Here, the impacts of risk under consideration are quantified relative to every risk mitigation strategy for a better depiction of the potential of digital transformation of the food supply chain. It yields the broadening of its implication perspectives at operational, strategic and tactical levels of the food supply chain and makes them future‐ready. [ABSTRACT FROM AUTHOR]

SUMMARY: Teenagers often present in crisis with risk issues, mainly risk to self but sometimes risk to others. Adolescent violence is commonplace and is not just the remit of adolescent forensic psychiatry. Clinicians may lack confidence assessing risk of violence and can neglect vital areas that are essential to reduce risk. Use of structured violence risk assessments enables the multi-agency professional network to formulate a young person's presentation and their violence in a holistic way and consequently develop targeted risk management plans addressing areas such as supervision, interventions and case management to reduce the risk of future violence. Of the several validated tools developed for young people, the Structured Assessment of Violence Risk – Youth (SAVRY™) is that most used by UK-based forensic adolescent clinicians. This article outlines the epidemiology, causes and purposes of violence among adolescents; discusses types of risk assessment tool; explores and deconstructs the SAVRY; and presents a fictitious risk formulation. [ABSTRACT FROM AUTHOR]

AbstractResearch has shown that controlling worker exposure to engineered nanomaterials (ENMs) helps to reduce the exposure risk to employees in workplaces. This study aimed to identify the available evidence on the effectiveness of various control methods used in the workplace to reduce worker exposure to ENMs. The search was conducted in databases—Medline, OVID, Scopus, Science Direct, Web of Science, and Cochrane and the gray literature published from January 2010 to December 2022. The search keywords included ENM controls and their efficiency in workplace environments. Of the 152 studies retrieved, 22 were included in the review. The control measures in the review included (1) substitution controls; (2) engineering measures (i.e., isolation, direct source extraction, and wetting technologies); (3) personal protective equipment; and (4) administrative and work practices. The study results indicate that the above-mentioned control measures were effective in reducing ENM exposures. This information can be used to help employers choose the most effective controls for their workplaces. [ABSTRACT FROM AUTHOR]

Background: Compensation for medical damage liability disputes (CMDLD) seriously hinders the healthy development of hospitals and undermines the harmony of the doctor-patient relationships (DPR). Risk management in the DPR has become an urgent issue of the day. The study aims to provide a comprehensive description of CMDLD in China and explore its influencing factors, and make corresponding recommendations for the management of risks in the DPR. Methods: This study extracted data from the China Judgment Online - the official judicial search website with the most comprehensive coverage. Statistical analysis of 1,790 litigation cases of medical damage liability disputes (COMDLD) available from 2015 to 2021. Results: COMDLD generally tended to increase with the year and was unevenly distributed by regions; the compensation rate was 52.46%, the median compensation was 134,900 yuan and the maximum was 2,234,666 yuan; the results of the single factor analysis showed that there were statistically significant differences between the compensation for different years, regions, treatment attributes, and trial procedures (P < 0.05); the correlation analysis showed that types of hospitals were significantly negatively associated with regions (R=-0.082, P < 0.05); trial procedures were significantly negatively correlated with years (R=-0.484, P < 0.001); compensat- ion was significantly positively correlated with years, regions, and treatment attributes (R = 0.098–0.294, P < 0.001) and negatively correlated with trial procedures (R=-0.090, P < 0.01); regression analysis showed that years, treatment attributes, and regions were the main factors affecting the CMDLD (P < 0.05). Conclusions: Years, regions, treatment attributes, and trial procedures affect the outcome of CMDLD. This paper further puts forward relevant suggestions and countermeasures for the governance of doctor-patient risks based on the empirical results. Including rational allocation of medical resources to narrow the differences between regions; promoting the expansion and sinking of high-quality resources to improve the level of medical services in hospitals at all levels; and developing a third-party negotiation mechanism for medical disputes to reduce the cost of medical litigation. [ABSTRACT FROM AUTHOR]

The object of research is stakeholder and risk management processes in the projects of housing and communal services providers. In conditions of constant change and uncertainty, such management becomes key to ensuring the success and sustainability of projects in this area. The problem addressed by the study is the development and analysis of an integrated model that combines stakeholder management with risk management, with an emphasis on innovation and performance improvement. The essence of the obtained results is the identification of key points of interaction between stakeholders and risks, as well as the development of complex strategies for their effective management. The model is based on a combination of qualitative and quantitative methods of analysis, including structural-logical analysis, SWOT analysis, as well as the use of expert evaluation methods. The results are explained by the need for a deeper integrated approach to stakeholder and risk management, especially in the context of housing and communal services (HCS), where the interaction between these elements directly affects the success of projects. This approach allows not only to identify potential problems at an early stage, but also to respond to them more effectively. The innovativeness of the proposed model lies not only in its comprehensive approach to the analysis and management of stakeholders and risks, but also in the possibility of its scaling and adaptation to various conditions and projects in the field of housing. The application of this model includes the intensive use of modern analytical tools, which contributes to more accurate forecasting of risks and more effective solving of problems related to stakeholders. This, in turn, allows utilities providers to increase the quality and reliability of the services provided, strengthening trust and satisfaction among users. Also, the model provides for the active involvement of stakeholders in the project management process, which ensures greater openness, transparency of actions and the ability to quickly adapt to changing market conditions. The research results can be used in practice in the field of housing and public utilities to optimize project management, increase their efficiency, and reduce risks. This will be especially relevant in cases where an integrated approach to management is needed, considering both the requirements and expectations of stakeholders, as well as potential risks. [ABSTRACT FROM AUTHOR]

One-Health is an umbrella term that integrates the health of the environment, humans and non-human animals. This approach is applied here to elucidate the impact of non-native invasive species on aquaculture and food security. Despite inherent biases against these species, a better understanding of their characteristics allows for the identification of those of greatest concern, minimizing the risk of food shortages and infectious diseases. This review summarises the positive and negative impacts of non-native species, delineating the specific areas they may impact. Additionally, this review gives an insight to the expertise and stakeholders that would need to be included if a "One-Health" approach were to be implemented by policymakers to better control non-native species. Detailed examples illustrate the consequences of non-native species on trophic dynamics, ecosystem health, water chemistry, and human health, emphasizing the importance of managing them within a multidimensional framework. The "One-Health" approach is explained, and suggestions are made on how certain non-native species could be used to contribute to food security in low- and middle-income countries. Furthermore, recommendations are made to promote a more inclusive management strategy. [ABSTRACT FROM AUTHOR]

The purpose of the research was to create and validate a safety performance decision-making tool to transform a reactive safety model into a predictive, decision-making tool, specific to large, collegiate Title 14 of the Code of Federal Regulations (CFR) Part 141 flight training organizations, to increase safety and aid in operational decision-making. Using Monte Carlo simulation, the study conducted simulation runs based on true operational ranges to simulate the operating conditions possible within large, collegiate CFR Part 141 flight training organizations with varying levels of controllable resources in terms of personnel (Aviation Maintenance Technicians and Instructor Pilots) and expenditures (active flight students and available aircraft). The study compared the output from three different Verification Scenarios. ANOVA testing indicated no significant differences appeared among the three different groups. Four What-if Scenarios were conducted by manipulating the controllable inputs. Changes to the controllable inputs are reflected by variations to the outputs demonstrating the utility and potential for the safety performance decision-making tool. The outputs could be utilized by safety personnel and administrators to make more informed safety-related decisions without expending unnecessary resources. [ABSTRACT FROM AUTHOR]

Products and services are developed to realize chances on the market. Often, development teams are focusing primarily on the potential chances rather than on the corresponding risks of new products and services. However, it is possible to integrate the product and service quality risks early into the development procedures for a balanced and holistic view. The integration enables systematic mitigation and quality assurance actions to handle the risks. The article analyzes the literature related to quality risk approaches, identifies mature and generally applicable product and service risk approaches, and gives selected approach examples about its methodical evolution and how it can be integrated into the development procedures including soft‐skills development such as employee awareness and systematical training within organizations. A case study in the Group IT of the Volkswagen AG is discussed. [ABSTRACT FROM AUTHOR]

The climate crisis significantly impacts the health and well-being of older adults, both directly and indirectly. This issue is of growing concern in Canada due to the country's rapidly accelerating warming trend and expanding elderly population. This article serves a threefold purpose: (i) outlining the impacts of the climate crisis on older adults, (ii) providing a descriptive review of existing policies with a specific focus on the Canadian context, and (iii) promoting actionable recommendations. Our review reveals the application of current strategies, including early warning systems, enhanced infrastructure, sustainable urban planning, healthcare access, social support systems, and community engagement, in enhancing resilience and reducing health consequences among older adults. Within the Canadian context, we then emphasize the importance of establishing robust risk metrics and evaluation methods to prepare for and manage the impacts of the climate crisis efficiently. We underscore the value of vulnerability mapping, utilizing geographic information to identify regions where older adults are most at risk. This allows for targeted interventions and resource allocation. We recommend employing a root cause analysis approach to tailor risk response strategies, along with a focus on promoting awareness, readiness, physician training, and fostering collaboration and benchmarking. These suggestions aim to enhance disaster risk management for the well-being and resilience of older adults in the face of the climate crisis. [ABSTRACT FROM AUTHOR]

There has been growing awareness in recent years of the wide‐ranging negative impacts that counter‐terrorism measures and sanctions impose on humanitarian action. Drawing on semi‐structured interviews with the staff of international non‐governmental organisations (INGOs), this paper examines these impacts on INGOs based in the United Kingdom. This is a context where a particularly complex array of laws, policies, and regulatory regimes have emerged alongside an increasingly hostile political and media setting for INGOs, creating an environment characterised by uncertainty. The paper shows that counter‐terrorism measures and sanctions are leading INGOs to adopt more conservative approaches to partnership in areas controlled by proscribed groups, undermining broader commitments to the localisation agenda. The analysis reveals that perceptions of risk within INGOs vary considerably, but that despite this, INGOs have developed strategies to reduce the impacts of counter‐terrorism measures, which over time, have led to improved coordination, and in some instances, a willingness to push back against regulations. [ABSTRACT FROM AUTHOR]

Key content: In obstetrics and gynaecology, things often 'go well' because clinicians make sensible adaptations in response to situations to ensure safety, often within a highly pressurised environment.The adaptations and performance variables that are made under these complex circumstances are not explicitly understood.Understanding the performance variability of clinicians as well as the environmental context that enables good or successful outcomes may bring awareness of how to build adaptive capacities and capabilities in clinicians when working in unpredictable and unanticipated highly pressurised environments. Learning objectives: To be aware of the current research in safety‐II and the concept of resilience engineering in illustrating the nature of adaptations that happen in complex clinical contexts.To understand the concept of capability mindfulness, which can help clinicians to focus on their environment and to be alert and aware of correcting errors before they occur.To be aware of these concepts (behaviour and skills) through the lens of 'what went well' in clinicians' responses to unforeseen and unpredictable situations. [ABSTRACT FROM AUTHOR]

This study aims to test for detecting a change point in the conditional quantile of general location-scale time series models. This issue is quite important in risk management because the conditional quantile is utilized to measure the value-at-risk or expected shortfall of financial assets. In this paper, we design two types of cumulative sum tests based on the conditional quantiles. Their limiting null distributions are derived under regularity conditions, together with consistency of the proposed tests under the alternative. Monte Carlo simulations demonstrate the good performance of the proposed tests in terms of both stability and power for various time series settings. A real data analysis using the daily returns of the Brent Oil futures also confirms the validity of the tests in real-world applications. [ABSTRACT FROM AUTHOR]

A notable portion of men who have sex with men engage in exchange sex—i.e. the trading of sex for money, drugs, shelter or other material goods. Despite the risks for physical and sexual violence, threatening behaviour and robbery that male sex workers confront, very little is known about their experiences of such actions by clients. To gain more insight into male sex workers' experiences of interpersonal violence, we analysed qualitative interview data from 180 men who have sex with men from 8 US cities who engaged in sex work with clients they had met primarily through dating/hookup websites and apps. Participants discussed their experiences of a range of untoward behaviours by clients including physical violence, sexual violence, threats and robbery. Healthcare and social services providers can play a significant role in violence prevention among male sex workers. The decriminalisation of sex work could also potentially reduce the risks many sex workers face by facilitating their reporting of harms suffered. [ABSTRACT FROM AUTHOR]

Biomarkers are essential for clinical risk management in anorexia nervosa (AN). Biomarkers can inform decisions regarding AN treatment at specific steps during the therapeutic cycle. Biomarker research will help to define subgroups of people with AN and guide decisions on individually tailored therapies, including psychotherapy. Anti-hypothalamus autoantibodies, cytokines, and metabolically relevant hormones such as insulin and leptin may be novel future drug targets for the treatment of AN. Pharmacogenetic testing and therapeutic drug monitoring are available for research and clinical application in AN, but they are usually not utilized in clinical practice. In anorexia nervosa (AN), measurable biological parameters can inform the process of treating patients. Such biomarkers include established laboratory parameters as well as a range of potential future biomarkers, including genetic, metabolomic, microbiomic, endocrine, immunological, hematological, electrophysiological, and neuroimaging parameters. In this opinion article we discuss how these biomarkers can support diagnosic and therapeutic processes at specific steps during the AN treatment cycle, that is, the diagnosis, diagnostic specification, risk management, choice of therapy, therapy monitoring, and treatment review. History-taking, physical and neuropsychological examination, clinical observation, and judgment about treatment success by the patient, their carers, and members of the multidisciplinary team are essential to interpret laboratory and imaging data appropriately and to assess the full clinical picture. [ABSTRACT FROM AUTHOR]

Background: Interprofessional training wards (ITW) are increasingly being integrated into teaching and training concepts in visceral surgery clinics. Objective: How safe is patient care on an ITW in visceral surgery? Material and methods: Data collection took place from November 2021 to December 2022. In this nonrandomized prospective evaluation study the frequency and severity of adverse events (AE) in 3 groups of 100 patients each in a tertiary referral center hospital for visceral surgery were investigated. The groups consisted of patients on the ITW and on the conventional ward before and after implementation of the ITW. The Global Trigger Tool (GTT) was used to search for AE. Simultaneously, a survey of the treatment was conducted according to the Picker method to measure patient reported outcome. Results: Baseline characteristics and clinical outcome parameters of the patients in the three groups were comparable. The GTT analysis found 74 nonpreventable and 5 preventable AE in 63 (21%) of the patients and 12 AE occurred before the hospital stay. During the hospital stay 50 AE occurred in the operating theater and 17 on the conventional ward. None of the five preventable AE (in 1.7% of the patients) was caused by the treatment on the ITW. Patients rated the safety on the ITW better than in 90% of the hospitals included in the Picker benchmark cohort and as good as on the normal ward. Conclusion: The GTT-based data as well as from the patients' point of view show that patient care on a carefully implemented ITW in visceral surgery is safe. [ABSTRACT FROM AUTHOR]

There is a ubiquitous problem with medical errors and the concomitant costs it brings in terms of human suffering and financial loss for patients, families, and caregivers. Professional caregivers, including physicians, nurses, and others who have made clinical errors normally will fall under the risk management and quality improvement policies of the organization at which they are employed and subsequent investigation and response occurs internally. Sometimes further consequences can entail the caregiver being named as a defendant or codefendant in a civil lawsuit, and sometimes the caregiver can have professional licensure restricted or even revoked. More rarely, a caregiver can be prosecuted in a criminal legal action. When criminal prosecution occurred, it was usually for purposeful wrongdoing such as fraud, diversion of drugs, or even the intentional or reckless killing of elderly or other vulnerable people. The recent criminal prosecution of a Tennessee nurse for the reckless series of mistakes that led to the death of a single patient opens new considerations for nurses, physicians, and all caregivers, along with hospitals and healthcare systems that employ and/or work with them. The "dynamic tension" of encouraging all caregivers to own up to mistakes with patients as quickly as possible in healthcare organizations seems to be especially challenged now by the Vaught decision. This was mitigated somewhat by a relatively lenient sentence ordered by the judge in this noteworthy case. [ABSTRACT FROM AUTHOR]

Risk management which assesses and mitigates risks such as suicide and violence is under scrutiny, particularly within psychiatric inpatient settings. Restrictive practices, which result from risk assessment, such as observations, physical restraint and ward seclusion can impact negatively on patient recovery, hindering abilities to develop a meaningful life that emphasizes purpose, hope and autonomy, despite experiencing mental distress. Yet, less is known about the impact from the patient's perspective when first admitted to hospital, a period which among other reasons may come with increasing risk management practices owing to the clinical uncertainties about patient risks. In this grounded theory study, we explore the impact on recovery, interviewing 15 adult participants with patient experiences of being in an acute hospital. The main theme of the study, termed a core category with a grounded theory, was identified as "ontological insecurity of inattentiveness". This highlighted a staff inattentiveness with involving patients with risk management and explaining the purposes of the practice, which raised insecurities about what was happening to the patients when admitted to hospital. Four subcategories support the core category; discounting the patients' experiences to gain a meaningful grasp of risk management, ambiguity about risk management rules, particularly the reasons around their use, forebodingness to the hospital environment and, management from afar, with patients feeling scrutinized from observations without a voice to offer different views. It is hoped these findings will add to the field of patient involvement in psychiatric inpatient settings, proposing attempts to raise understanding and inclusivity of risk management, starting when first admitted to hospital. [ABSTRACT FROM AUTHOR]

Monitoring quality control for a laboratory or network with multiple instruments measuring the same analyte is challenging. We present a retrospective assessment of a method to detect medically significant out-of-control error conditions across a group of instruments measuring the same analyte. The purpose of the model was to ensure that results from any of several instruments measuring the same analytes in a laboratory or a network of laboratories provide comparable results and reduce patient risk. Limited literature has described how to manage QC in these very common situations. Single Levey–Jennings control charts were designed using peer group target mean and control limits for five common clinical chemistry analytes in a network of eight analyzers in two different geographical sites. The QC rules used were 13s/22s/R4s, with the mean being a peer group mean derived from a large population of the same instrument and the same QC batch mean and a group CV. The peer group data used to set the target means and limits were from a quality assurance program supplied by the instrument supplier. Both statistical and clinical assessments of significance were used to evaluate QC failure. Instrument bias was continually monitored. It was demonstrated that the biases of each instrument were not statistically or clinically different compared to the peer group's average over six months from February 2023 until July 2023. Over this period, the error rate determined by the QC model was consistent with statistical expectations for the 13s/22s/R4s rule. There were no external quality assurance failures, and no detected error exceeded the TEa (medical impact). Thus, the combined statistical/clinical assessment reduced unnecessary recalibrations and the need to amend results. This paper describes the successful implementation of a quality control model for monitoring a network of instruments, measuring the same analytes and using externally provided quality control targets. The model continually assesses individual instrument bias and imprecision while ensuring all instruments in the network meet clinical goals for quality. The focus of this approach is on detecting medically significant out-of-control error conditions. [ABSTRACT FROM AUTHOR]

This paper studies a framework of Reliable Capacitated Facility Location Problem with Single source constraint, which allows us to capture the mental account management problem for a bank under uncertain environment. In the problem, each facility, corresponding to a financial product, has limited capacity and may fail randomly, which represents that the product fails to reach the threshold level of return. Each customer, corresponding to a mental account, is served by a single primary facility or product, and its demands, or the setting goals, can be split on several backup facilities or alternative investments with redundant capacity. With the operation, a portion of the satisfaction can still be met by the backup facilities when the primary service of a customer fails. We formulate a mixed integer programming model for the problem and design a Lagrangian relaxation based solution algorithm, which sophisticatedly exploits the structure of the model and transfers the complicated relaxation problems into 0–1 knapsack problems to reduce the complexity. A local search procedure is also incorporated into the algorithm to enhance the accuracy of small- and large-scale computation. Finally, a real-life case of mental accounting is investigated to illustrate the application of the decision model. [ABSTRACT FROM AUTHOR]

In this paper we introduce the Intensive Mobile Treatment (IMT) model, which arose from a 2016 New York City initiative to engage individuals who were "falling through the cracks" of the mental health, housing, and criminal justice systems. People who are referred to IMT often have extensive histories of trauma. They experience structural racism and discrimination within systems and thus can present as distrustful of treatment teams. We detail the structure of the program as we practice it at our non-profit agency and outline the psychodynamic concepts that inform our work with challenging populations. We acknowledge IMT's role in engaging in advocacy and addressing social justice in our work. We also discuss how through this model we are able to both mitigate and tolerate risk in participants with difficult-to-manage behaviors. This is typically a long-term, non-linear process. We address how this impacts the team dynamic as a whole and explain how with long-term, trusting therapeutic relationships, participants can change and grow over time. We also explain the ways in which our non-billing model plays an integral role in the treatment we are able to provide and identify several challenges and areas for program growth. In outlining our model and its methodology, we hope to empower other practitioners to adapt IMT to other settings beyond the New York City area. [ABSTRACT FROM AUTHOR]

This paper proposes a hybrid conceptual and performance assessment integrated dispute risk system that enables construction professionals to evaluate, track, and manage construction disputes. It establishes a correlation between dispute-contributing factors and their respective preconstruction stages, facilitating early dispute detection and mitigation before the construction phase. This method can be applied to gauge the effectiveness of the preconstruction phase in relation to its influence on the emergence of disputes. Through an extensive literature review, expert interviews, and the Delphi technique, 48 key risk factors were identified and categorized into four groups. Eighteen experts were selected using purposive sampling, and their survey responses were checked for normality and reliability using the Shapiro–Wilk test and Cronbach's alpha. The Delphi method was employed to reach a consensus among the panelists after two rounds of evaluation, using the nonparametric statistical parameters, such as Kendall's coefficient of concordance and chi-squared. Subsequently, the interrater agreement (IRA) was measured, and the dispute factors were ranked. Based on the ranking results, a novel integrated hybrid system was formulated that synergistically combines a hybrid conceptual and performance assessment framework with a fuzzy logic–structural equation model (SEM). The proposed hybrid system includes two key components: a unique conceptual and performance assessment framework and a hybrid model that combines fuzzy logic and SEM. This combined approach captures uncertainty and ambiguity in assessing dispute risks related to probability and severity, providing a more precise evaluation of disputes in construction projects. Additionally, the introduction of new dispute categories specifically targeting the preconstruction phase proactively deals with potential disputes before the construction begins. This advanced integrated hybrid system can be an effective preconstruction assessment tool for evaluating and managing various dispute factors, enabling project managers to proactively assess, manage, and mitigate construction disputes between project parties. [ABSTRACT FROM AUTHOR]

This review paper presents an analysis of safety practices in chemical laboratories. It encompasses a systematic exploration of various facets including risk assessment, hazard mitigation, and the implementation of safety protocols. Emphasis is placed on the critical role of continuous education and training, advocating a proactive safety culture, and adapting to technological advancements. Additionally, the paper underscores the importance of adhering to regulatory standards, promoting exceeding baseline compliance toward establishing best practices in laboratory safety. This comprehensive approach highlights the dynamic, multifaceted nature of laboratory safety, positioning it as a fundamental aspect of scientific research. [ABSTRACT FROM AUTHOR]

The objective of the article was to describe the importance of a good technically and economically planned process for purchasing a rail vehicle. Compliance with this process with safety standards and energy efficiency is crucial regarding effectiveness in the long-life cycle cost of a rail vehicle. Methods that were used focused on audit and document analysis. In the result based on a specific audit of a railway company, some non-compliances were found, and it was methodically proven that they are significant risk factors in terms of performing such processes in the future. Major conclusions regarded the importance of fulfilling legal requirements of SMS for purchase purposes, involvement of a safety engineer post in this process, and usage of technical feedback regarding previous operation of railway vehicles and operational findings from the past. The transport policy of the EU and other developed countries sets ambitious goals for reducing energy consumption in transportation activities, which is linked to the aim of reducing environmental burdens. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? What does the paper add to existing knowledge? What are the implications for practice? Introduction Aim Method Results Discussion Implications for Practice Inpatient mental health settings pose unique challenges for patient safety, in part because psychiatric disorders are well‐known risk factors for self‐harm and suicide. Ward staff follow protocols to try and keep patients safe including carrying out in‐person safety checks, usually every 15 min, but patients unfortunately still find opportunities to harm themselves. A vision‐based patient monitoring system (VBPMS) is a contact‐free technology that can help mental health nurses to monitor patients in hospital more effectively. For example, the tool alerts staff to situations where a patient might need assistance, like when they spend a long period of time in their ensuite bathroom. Research has shown that the VBPMS can support staff to prevent safety incidents from occurring and a recent study found a decrease in self‐harm after the tool was implemented at one NHS mental health trust. This paper presents data from five NHS mental health trusts and suggests that the VBPMS can consistently help staff to prevent self‐harm on acute mental health wards. Managing self‐harm behaviours is a challenge for mental health nursing staff. Standard safety protocols are not effective enough – staff need new ways to monitor patients. In general hospitals, technology is used every day to support care. This research shows that the VBPMS can be used to improve patient safety in mental health hospitals. Self‐harm is sadly relatively common in mental health inpatient settings, and the effectiveness and appropriateness of strategies used to prevent it have long been disputed. The use of vision‐based patient monitoring systems (VBPMS) has been shown to improve various safety outcomes. Their potential to support staff in preventing inpatient self‐harm warrants further exploration.This research investigated whether implementing a VBPMS—as an adjunct to existing clinical practice—within acute inpatient services at five NHS England mental health trusts led to reductions in self‐harm.Five quasi‐experimental studies assessed the number of bedroom self‐harm incidents, across 12 adult wards, before and 5–12 months after a VBPMS was deployed. Percentage changes were calculated. Four studies used control groups and were included in a fixed‐effect meta‐analysis.In the meta‐analysis, a significant inverse‐weighted average relative risk percentage change of −38.9% was recorded. For the study with no control groups, reductions in self‐harm were seen across all wards (range: −9.1% to −29.8%).This research demonstrates that VBPMS can support clinicians to create safer ward environments by preventing incidents of self‐harm from occurring.The results provide preliminary support for wider rollout of the technology on acute mental health wards. [ABSTRACT FROM AUTHOR]