Background Little is known about the nature and reactions to sexual abuse of children with intellectual disability (ID). The aim was to fill this gap. Method Official reports of sexual abuse of children with ID in state care were examined (N = 128) and compared with children without ID (N = 48). Results Clear signs of penetration or genital touching by male (adolescent) peers or (step/foster) fathers were found in most ID reports. Victims often received residential care and disclosed themselves. Type of perpetrator seemed to affect the nature and reaction to the abuse. Cases of children with and without ID seemed to differ in location and reports to police. Conclusions Screening of (foster)homes seems crucial. Residential facilities should find a balance between independence of children and protection. Care providers should be trained in addressing sexual issues and sexual education, accounting for different types of perpetrators (peers/adults). Uniform reporting guidelines are needed.
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Modern safety thinking and models focus more on systemic factors rather than simple cause-effect attributions of unfavourable events on the behaviour of individual system actors. This study concludes previous research during which we had traced practices of new safety thinking practices (NSTPs) in aviation investigation reports by using an analysis framework that includes nine relevant approaches and three safety model types mentioned in the literature. In this paper, we present the application of the framework to 277 aviation reports which were published between 1999 and 2016 and were randomly selected from the online repositories of five aviation authorities. The results suggested that all NSTPs were traceable across the sample, thus followed by investigators, but at different extents. We also observed a very low degree of using systemic accident models. Statistical tests revealed differences amongst the five investigation authorities in half of the analysis framework items and no significant variation of frequencies over time apart from the Safety-II aspect. Although the findings of this study cannot be generalised due to the non-representative sample used, it can be assumed that the so-called new safety thinking has been already attempted since decades and that recent efforts to communicate and foster the corresponding aspects through research and educational means have not yet yielded the expected impact. The framework used in this study can be applied to any industry sector by using larger samples as a means to investigate attitudes of investigators towards safety thinking practices and respective reasons regardless of any labelling of the former as “old” and “new”. Although NSTPs are in the direction of enabling fairer and more in-depth analyses, when considering the inevitable constraints of investigations, it is more important to understand the perceived strengths and weaknesses of each approach from the viewpoint of practitioners rather than demonstrating a judgmental approach in favour or not of any investigation practice.
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The paper presents a framework that through structured analysis of accident reports explores the differences between practice and academic literature as well amongst organizations regarding their views on human error. The framework is based on the hypothesis that the wording of accident reports reflects the safety thinking and models that have been applied during the investigation, and includes 10 aspects identified in the state-of-the-art literature. The framework was applied to 52 air accident reports published by the Dutch Safety Board (DSB) and 45 ones issued by the Australian Transport Safety Bureau (ATSB) from 1999 to 2014. Frequency analysis and statistical tests showed that the presence of the aspects in the accident reports varied from 32.6% to 81.7%, and revealed differences between the ATSB and the DSB approaches to human error. However, in overall safety thinking have not changed over time, thus, suggesting that academic propositions might have not yet affected practice dramatically.
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This paper proposes an amendment of the classification of safety events based on their controllability and contemplates the potential of an event to escalate into higher severity classes. It considers (1) whether the end-user had the opportunity to intervene into the course of an event, (2) the level of end-user familiarity with the situation, and (3) the positive or negative effects of end-user intervention against expected outcomes. To examine its potential, we applied the refined classification to 296 aviation safety investigation reports. The results suggested that pilots controlled only three-quarters of the occurrences, more than three-thirds of the controlled cases regarded fairly unfamiliar situations, and the flight crews succeeded to mitigate the possible negative consequences of events in about 71% of the cases. Further statistical tests showed that the controllability-related characteristics of events had not significantly changed over time, and they varied across regions, aircraft, operational and event characteristics, as well as when fatigue had contributed to the occurrences. Overall, the findings demonstrated the value of using the controllability classification before considering the actual outcomes of events as means to support the identification of system resilience and successes. The classification can also be embedded in voluntary reporting systems to allow end-users to express the degree of each of the controllability characteristics so that management can monitor them over time and perform internal and external benchmarking. The mandatory reports concerned, the classification could function as a decision-making parameter for prioritising incident investigations.
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Over the past two months, the Going Hybrid Publishing group has convened for two days of design sprints. The discussions we had during these sprints were informed by our previous state-of-the-art analysis and survey of relevant tools and practices. This blog post is a recap of two design sprint days, sharing both process and outcomes.
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Abstract Specialist oncology nurses (SONs) have the potential to play a major role in monitoring and reporting adverse drug reactions (ADRs); and reduce the level of underreporting by current healthcare professionals. The aim of this study was to investigate the long term clinical and educational efects of real-life pharmacovigilance education intervention for SONs on ADR reporting. This prospective cohort study, with a 2-year follow-up, was carried out in the three postgraduate schools in the Netherlands. In one of the schools, the prescribing qualifcation course was expanded to include a lecture on pharmacovigilance, an ADR reporting assignment, and group discussion of self-reported ADRs (intervention). The clinical value of the intervention was assessed by analyzing the quantity and quality of ADR-reports sent to the Netherlands Pharmacovigilance Center Lareb, up to 2 years after the course and by evaluating the competences regarding pharmacovigilance of SONs annually. Eighty-eight SONs (78% of all SONs with a prescribing qualifcation in the Netherlands) were included. During the study, 82 ADRs were reported by the intervention group and 0 by the control group. This made the intervention group 105 times more likely to report an ADR after the course than an average nurse in the Netherlands. This is the frst study to show a signifcant and relevant increase in the number of well-documented ADR reports after a single educational intervention. The real-life pharmacovigilance educational intervention also resulted in a long-term increase in pharmacovigilance competence. We recommend implementing real-life, context- and problem-based pharmacovigilance learning assignments in all healthcare curricula.
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Background: In their research reports, scientists are expected to discuss limitations that their studies have. Previous research showed that often, such discussion is absent. Also, many journals emphasize the importance of avoiding overstatement of claims. We wanted to see to what extent editorial handling and peer review affects self-acknowledgment of limitations and hedging of claims.Methods: Using software that automatically detects limitation-acknowledging sentences and calculates the level of hedging in sentences, we compared the submitted manuscripts and their ultimate publications of all randomized trials published in 2015 in 27 BioMed Central (BMC) journals and BMJ Open. We used mixed linear and logistic regression models, accounting for clustering of manuscript-publication pairs within journals, to quantify before-after changes in the mean numbers of limitation-acknowledging sentences, in the probability that a manuscript with zero self-acknowledged limitations ended up as a publication with at least one and in hedging scores.Results: Four hundred forty-six manuscript-publication pairs were analyzed. The median number of manuscripts per journal was 10.5 (interquartile range 6-18). The average number of distinct limitation sentences increased by 1.39 (95% CI 1.09-1.76), from 2.48 in manuscripts to 3.87 in publications. Two hundred two manuscripts (45.3%) did not mention any limitations. Sixty-three (31%, 95% CI 25-38) of these mentioned at least one after peer review. Changes in mean hedging scores were negligible.Conclusions: Our findings support the idea that editorial handling and peer review lead to more self-acknowledgment of study limitations, but not to changes in linguistic nuance.
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