International Journal of Risk & Safety in Medicine - Volume 13, issue 1
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The International Journal of Risk and Safety in Medicine is concerned with rendering the practice of medicine as safe as it can be; that involves promoting the highest possible quality of care, but also examining how those risks which are inevitable can be contained and managed.
This is not exclusively a drugs journal. Recently it was decided to include in the subtitle of the journal three items to better indicate the scope of the journal, i.e. patient safety, pharmacovigilance and liability and the Editorial Board was adjusted accordingly. For each of these sections an Associate Editor was invited. We especially want to emphasize patient safety. Our journal wants to publish high quality interdisciplinary papers related to patient safety, not the ones for domain specialists. For quite some time we have also been devoting some pages in every issue to what we simply call WHO news. This affinity with WHO underlines both the International character of the journal and the subject matter we want to cover. Basic research, reports of clinical experience and overviews will all be considered for publication, but since major reviews of the literature are often written at the invitation of the Editorial Board it is generally advisable to consult with the Editor in advance. Submission of news items will be appreciated, as will be the contribution of letters on topics which have been dealt with in the journal.
Abstract: Screening criteria for carbohydrate metabolism problems during pregnancy include the use of specified historic risk factors, which are generally considered to be inadequate. The value of these historic risk factors in a population characterized by a high prevalence of carbohydrate metabolism problems is investigated. The study identified biological characteristics such as elderly maternal age, a high maternal BMI, and multiparity as significant risk factors for the development of GDM. A previous history of Caesarean delivery or macrosomia was similarly associated. There appeared to be no association with a history of previous early pregnancy or perinatal loss, or congenital anomalies. Women…identified to have G‐IGT did not show any significant clinical risk factors. The risk factors for the development of GDM are shown to have a high specificity and negative predictive value, but overall low sensitivity and positive predictive value when used in isolation. These features suggest that while the historic risk criteria are not ideal screening tools, they still have an important role in situations where routine screening with an oGTT is unavailable or impractical provided they are used in combination.
Keywords: Gestational diabetes, risk factors, health care screening
Abstract: Aim: To determine the prevalence of seat belt (SB) use and proper headrest (HR) position by car drivers in Lebanon. Methods: After adequate training of ten volunteers, the mean of visual reliability of the position of the HR in relation to the driver’s head, compared to a slide ruler, were 89% and 97% for the horizontal and vertical positions, respectively. The first six cars dropping at eight four‐way busy intersections in 5 Mohafazats (states) were observed for the position of the HR and use of SB. Results: Two thousand one hundred and five car drivers were observed. Only 9.4% of…the drivers observed use the SB. Only 32% of the drivers had the HR adequately adjusted in both planes. Characteristics of the population using the SB and HR correctly are presented. Conclusions: HR and SB are underutilized by drivers in Lebanon. Actions to improve the proper use of these safety devices are needed.
Abstract: To evaluate the incidence and course of fever following DTP vaccination we prospectively studied 430 healthy infants who received the four doses of vaccine at ages 2, 4, 6 and 12 months. Each infant was followed one week before and three days after immunization. Mothers were instructed to record rectal temperature every six hours after each vaccine dose for a minimum of seven measurements (including baseline). After all vaccine doses, body temperature peaked at 12 hours and decreased steadily thereafter. The highest temperature was observed after the fourth dose. A temperature of 38°C or higher was found in 47.1, 55.7,…56.7 and 49.8% of doses 1 to 4, respectively. Fever following DTP vaccination appears in approximately half of the infants, peaks 12 hours after vaccination, and is highest after the fourth dose. Physicians should know the characteristics of the febrile reaction to successive doses of DTP vaccine and inform parents accordingly.
Abstract: While an operational definition for the term disease is lacking in traditional medicine, consensus indicates that it infers observable and measurable abnormalities in anatomy, chemistry, and physiology as causative for an observed cluster of symptoms. However, the term disease in psychiatry and psychology has a very different historical usage. It has been used when no systemic etiology has been indicated, it has been used politically for addictions, it has been used for the mere belief that a cluster of symptoms must be a disease because the symptoms are bizarre, and it has been used to justify crude medically based treatments,…such as electroshock, lobotomies, involuntary commitments, and the sale of powerful drugs. With the advent of new medical machines, such as CAT scans, PET scans, and MRI’s, a large volume of poorly conducted and questionable research has been pouring fourth to find diseases as a justification to promote psychotropic drugs. Politics and economics has replaced quality science. This article attempts to operationally define the term disease in order to promote qualitative and ethical research in psychology and psychiatry. The implications for such a definition will hopefully mean improved research, diagnosis and treatment in the mental health sciences.