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Enhancing Diagnostic and Patient Safety in Healthcare Systems: Key Insights from the World Patient Safety Day 2024 Commemoration in Uganda

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Drug, healthcare and patient safety 2025年 17卷 135-143页

作者： Munanura Turyasiima Prima Maria Niwampeire Martin Ssendyona Balbina Gillian Akot Miriam Acheng Simon Peter Katongole Joseph Okware Juliet Tumwikirize Kenneth Mutesasira Joshua Atepo Robinah Kaitiritimba Joshua Epuitai Benson Tuhwezeine Tumwesigye Gaston Turinawe Robert Mutumba Martin Ndifuna Geofrey Musinguzi Denise Asaba Kemigisa Department of Standards Compliance Accreditation and Patient Protection Ministry of Health Kampala Uganda. Department of Pediatrics and Child Health Kampala International University Kampala Uganda. The Aids Support Organization Kampala Uganda. Division of Health Information Management Ministry of Health Kampala Uganda. Uganda Martyrs University Kampala Uganda. Quality Improvement Office World Health Organization Kampala Uganda. The Uganda National Health Consumers' Organization Kampala Uganda. Department of Nursing Faculty of Health Services Busitema University Mbale Uganda. STD/AIDS Control Program Ministry of Health Kampala Uganda. Johns Hopkins Program for International Education in Gynecology and Obstetrics (Jhpeigo) Kampala Uganda. Department of Disease Control and Environmental Health Makerere University School of Public Health Kampala Uganda.

Background:The 4th World Patient Safety Day (WPSD) 2024 commemoration in Uganda, themed "Improving Diagnosis for Patient Safety", highlighted critical challenges and opportunities in reducing diagnostic errors within healthcare systems. This review synthesizes key insights from the event, focusing on factors contributing to diagnostic inaccuracies, systemic gaps, and actionable strategies for improvement. Methods:Using a qualitative synthesis approach guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ), we analyzed data from a hybrid webinar (210 participants) and a four-day medical camp (600+ patients served). Thematic analysis identified four key areas: (i) factors influencing diagnostic errors, (ii) the role of laboratory and imaging services in diagnosis error prevention, (iii) existing health system interventions, and (iv) patient empowerment in the diagnostic process. Results:Diagnostic errors in Uganda stem from cognitive biases, systemic inefficiencies (eg, understaffing, inadequate equipment), and financial barriers in private healthcare. Strengthening laboratory capacity, digitizing health records, and enhancing provider-patient communication emerged as pivotal solutions. The Ministry of Health's initiatives such as laboratory accreditation, the 5S quality improvement framework, and patient feedback mechanisms demonstrate progress but require scaling. Recommendations:We propose a multi-level approach: (1) national policies for error reporting and patient safety frameworks, (2) expanded supportive supervision and digitization (eg, EHRs with decision support), (3) stricter regulation of private healthcare, and (4) community engagement to improve health literacy and early care-seeking. Conclusion:Reducing diagnostic errors demands systemic reforms, technological integration, and collaborative stakeholder engagement. Uganda's WPSD 2024 insights offer a model for similar low-resource settings to enhance diagnostic accuracy and patient

关键词： Uganda diagnostic errors healthcare quality patient safety world patient safety day

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Enhanced carbon tetrachloride degradation by hydroxylamine in ferrous ion activated calcium peroxide in the presence of formic acid

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Frontiers of environmental Science & Engineering 2020年第2期14卷 75-85页

作者： Wenchao Jiang Ping Tang Zhen Liu Huan He Qian Sui Shuguang Lyu State Environmental Protection Key Laboratory of Environmental Risk Assessment and Control on Chemical Process East China University of Science and TechnologyShanghai 200237China Environmental Engineering and Science Program Department of Chemical and Environmental EngineeringUniversity of CincinnatiCincinnatiOH 45221-0071USA

Hydroxyl radicals(HO*)show low reactivity with perchlorinated hydrocarbons,such as carbon tetrachloride(CT),in conventional Fenton reactions,therefore,the generation of reductive radicals has attracted increasing *** study investigated the enhancement of CT degradation by the synergistic effects of hydroxylamine(HA)and formic acid(FA)(initial[CT]=0.13 mmol/L)in a Fe(il)activated calcium peroxide(CP)fenton *** degradation increased from 56.6%to 99.9%with the addition of 0.78 mmol/L HA to the CP/Fe(II)/FA/CT process in a molar ratio o f 12/6/12/*** results also showed that the presence of HA enhanced the regeneration of Fe(II)from Fe(III),and the production of HO*increased one-fold when employing benzoic acid as the HO****,FA slightly improves the production of HO*.A study of the mechanism confirmed that the carbon dioxide radical(C02·),a strong reductant generated by the reaction between FA and HO*,was the dominant radical responsible for CT *** complete CT dechlorination was achieved in the *** presence of humic acid and chloride ion slightly decreased CT removal,while high doses of bicarbonate and high pH inhibited CT *** study helps us to better understand the synergistic roles of FA and HA for HO·and C02·^-generation and the removal of perchlorinated hydrocarbons in modified Fenton systems.

关键词： Calcium peroxide Hydroxylamine Modified Fenton Reactive oxygen species Perchlorinated hydrocarbon

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SIMULATED AIR LEVELS OF VOLATILE ORGANIC-COMPOUNDS FOLLOWING DIFFERENT METHODS OF INDOOR INSECTICIDE APPLICATION

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environmental SCIENCE & TECHNOLOGY 1995年第3期29卷 673-676页

作者： BUKOWSKI, JA MEYER, LW New Jersey Department of Environmental Protection Pesticide Control Program CN 411 Trenton New Jersey 08625-0411 380 Scotch Road United States

Many general health complaints that may be attributed to indoor insecticide exposure are also consistent with exposure to the volatile organic compounds (VOCs) used as inert ingredients in insecticidal formulations. However, few indoor insecticide labels make ventilation or reentry recommendations that would help to limit exposure to these compounds. The Indoor Air Quality Model developed by the U.S. EPA was used to simulate potential VOC air levels following hypothetical indoor application of emulsifiable concentrate (EC), broadcast aerosol, and aerosol fogger formulations. Estimated VOC levels were highest for foggers and lowest for EC sprays (peak concentrations of 328 and 20.5 mg/m(3), respectively). However, ail three application methods produced indoor air levels that were in the range of values expected to produce health complaints among certain individuals. Three hours of enhanced ventilation decreased air levels by as much as 75-80%. However, enhanced ventilation was most effective when vigorously applied immediately after application.

关键词： ORGANIC compounds AEROSOL sprays & the environment

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POLYCHLORINATED DIBENZO-P-DIOXIN AND DIBENZOFURAN CONTAMINATION AT METAL RECOVERY FACILITIES, OPEN BURN SITES, AND A RAILROAD CAR INCINERATION FACILITY

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environmental SCIENCE & TECHNOLOGY 1995年第3期29卷 677-684页

作者： HARNLY, M STEPHENS, R MCLAUGHLIN, C MARCOTTE, J PETREAS, M GOLDMAN, L Environmental Health Investigations Branch California Department of Health Services (DHS) Berkeley California 94704 United States Hazardous Materials Laboratory currently part of the California Environmental Protection Agency United States Toxic Substances Control Program currently part of the California Environmental Protection Agency United States Currently with the U.S. Environmental Protection Agency United States

Soil and ash surface samples (n = 44) were collected from three historical metal recovery facilities where copper scrap was a dominant feed stream, three sites of open burning where evidence of copper recovery was visible, and from a railroad car incineration facility. Concentrations of polychlorinated dibenzo-p-dioxins (PCDD) and dibenzofurans (PCDF) are in the low parts per billion range with PCDF concentrations significantly lower in samples from the railroad car facility. In fly ash from a copper wire and aluminum scrap recovery facility, PCDD and PCDF concentrations are high, 50 and 460 ppm. Consistent with that cited for other combustion sources, ratios of PCDD to PCDF are mostly greater than 1. However, a lower ratio (0.4), is observed in samples from the railroad car incineration facility. OCDF and OCDD are significantly correlated with 2,3,7,8-TCDD toxicity equivalents (TEQ). These congeners may be inexpensively analyzed and may be useful as indicator chemicals at similar sites and facilities. Further investigations of metal recovery facilities and open burn sites worldwide are necessary.

关键词： Soil pollution Dibenzodioxin Dibenzofurans

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ANALYSIS OF ALKYLATING AGENTS . APPLICATIONS TO AIR POLLUTION

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ANNALS OF THE NEW YORK ACADEMY OF SCIENCES 1969年第A2期163卷 895-&页

作者： SAWICKI, E SAWICKI, CR U. S. Department of Health Education and Welfare Consumer Protection and Environmental Health Service National A ir Pollution Control A dministration Chemical and Physical Research and Development Program Cincinnati Ohio

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TLC-FLUORIMETRIC ANALYSIS FOR ATMOSPHERIC SCOPOLETIN

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MICROCHEMICAL JOURNAL 1969年第3期14卷 437-&页

作者： SAWICKI, E GOLDEN, C U.S. Department of Health Education and Welfare Consumer Protection & Environmental Health Service National Air Pollution Control Administration Chemical and Physical Research and Development Program Cincinnati Ohio 45226 U.S.A.

The evidence for the presence of scopoletin in airborne particulates, house dust, and coffee roast effluents consists of R f values obtained with silica gel thin-layer chromatography and mobility values obtained with paper electrophoresis, as well as fluorescence spectra obtained from the chromatogram and from methanolic, alkaline methanolic, and sulfuric acid solutions. By a procedure involving TLC SPF, scopoletin has been assayed in these various samples. Recovery of scopoletin from enriched airborne particulates was 97%. These various separations and fluorimetric examinations have shown that a large number of unknowns was also present in these samples.

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FLUORIMETRIC AND COLORIMETRIC METHODS OF ANALYSIS FOR HISTAMINE

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MICROCHEMICAL JOURNAL 1970年第1期15卷 25-&页

作者： SAWICKI, E SAWICKI, CR GOLDEN, CC KOBER, T Division of Chemistry and Physics U.S. Department of Health Education and Welfare Consumer Protection and Environmental Health Service National Air Pollution Control Administration Chemical and Physical Research and Development Program Cincinnati Ohio 45226 USA

Reagents useful in analysis of histamine are compared in terms of sensitivity, selectivity, color stability, reproducibility, and simplicity. Some of the procedures are new. Of the colorimetric methods the 4-dimethylaminocinnamaldehyde and the azobenzenediazonium fluoborate methods are the most sensitive and are highly reproducible with good color stability. Under present conditions only the o -phathalaldehyde method has the requisite sensitivity for use in histamine-release studies of aeroallergens. As the basic procedure is improved, analysts should be able to apply some of the other methods in the assay of aeroallergens, coallergens, antiallergens, enhancers, and sensitizers by the histamine-release procedure.

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RAPID FLUORIMETRIC METHODS BY INSTANT THIN-LAYER CHROMATOGRAPHY FOR ASSAY OF PHENALEN-1-ONE AND 7H-BENZ(DE)-ANTHRACEN-7-ONE IN POLLUTED URBAN ATMOSPHERES

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JOURNAL OF CHROMATOGRAPHY 1968年第3-4期37卷 508-&页

作者： ENGEL, CR SAWICKI, E U.S. Department of Health Education and Welfare Consumer Protection and Environmental Health Service National Air Pollution Control Administration Chemical and Physical Research and Development Program 4676 Columbia Parkway Cincinnati Ohio 45226 U.S.A.

Through the use of the glass-fiber paper impregnated with silica gel (called instant thin-layer chromatography, or ITLC), the rapid determination of phenalen-1-one (PO) and 7H-benz( de )anthracen-7-one (BO) is facilitated. Onemethod is introduced for the specific determination of PO, and one method for the determination of both PO and BO at the same time. Both methods are superior to previous methods in terms of speed, selectivity, simplicity, and sensitivity. In addition, they give reasonable accuracy and precision. Samples from urban atmospheres and air pollution source effluents can be analyzed rapidly for PO and BO by these methods. Analysis of one sample of organic extracts would take less than 30 minutes; analysis of a dozen samples would take less than 2 h. For those laboratories without instrumentation the amount of PO and BO can be estimated by eye after separation; eight analyses for either compound can be accomplished in about 20 minutes.

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FLUORESCENCE ANALYSIS IN AIR POLLUTION RESEARCH

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TALANTA 1969年第9期16卷 1231-&页

作者： SAWICKI, E U.S. Department of Health Education and Welfare Consumer Protection and Environmental Health Service National Air Pollution Control Administration Chemical and Physical Research & Development Program 4676 Columbia Parkway Cincinnati Ohio 45226 U.S.A.

Luminescence phenomena are of value in the analysis of air pollutants. The problems arising in the use of excitation and emission spectra under various conditions are discussed. Phenomena such as solvent, pH, and photochemical effects are shown to play an important role in the fluorimetric analysis of air pollutants. Many of the fluorimetric methods used in the trace analysis of organic airborne particulates involve factors such as direct measurement of the separated pollutant on a chromatogram or pherogram, quenching phenomena, scanning, excimer formation, charge-transfer fluorescence, sensitized fluorescence, and photo-oxidation on adsorbent or in solution. In addition, fluorescence assay methods are discussed in terms of selectivity, sensitivity, speed, simplicity, accuracy, precision, interferences, and the relation between concentration and fluorescence intensity.

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Serotype distribution of remaining invasive pneumococcal disease after extensive use of ten-valent and 13-valent pneumococcal conjugate vaccines (the PSERENADE project): a global surveillance analysis

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The Lancet Infectious Diseases 2025年第4期25卷 445-456页

作者： Garcia Quesada, Maria Peterson, Meagan E Bennett, Julia C Hayford, Kyla Zeger, Scott L Yang, Yangyupei Hetrich, Marissa K Feikin, Daniel R Cohen, Adam L von Gottberg, Anne van der Linden, Mark van Sorge, Nina M de Oliveira, Lucia H de Miguel, Sara Yildirim, Inci Vestrheim, Didrik F Verani, Jennifer R Varon, Emmanuelle Valentiner-Branth, Palle Tzanakaki, Georgina Sinkovec Zorko, Nadja Setchanova, Lena P Serhan, Fatima Scott, Kevin J Scott, J Anthony Savulescu, Camelia Savrasova, Larisa Reyburn, Rita Oishi, Kazunori Nuorti, J Pekka Napoli, Daniela Mwenda, Jason M Muñoz-Almagro, Carmen Morfeldt, Eva McMahon, Kimberley McGeer, Allison Mackenzie, Grant A Eugenia León, Maria Ladhani, Shamez N Kristinsson, Karl G Kozakova, Jana Kleynhans, Jackie Klein, Nicola P Kellner, James D Jayasinghe, Sanjay Ho, Pak-Leung Hilty, Markus Harker-Jones, Marcella A Hammitt, Laura L Grgic-Vitek, Marta Gilkison, Charlotte Gierke, Ryan French, Neil Diawara, Idrissa Desmet, Stefanie De Wals, Philippe Dalby, Tine Dagan, Ron Corcoran, Mary Colzani, Edoardo Chanto Chacón, Grettel Castilla, Jesús Camilli, Romina Ang, Michelle Ampofo, Krow Almeida, Samanta C G Alarcon, Pedro Deloria Knoll, Maria Pennington, Kate Krause, Vicki Brandileone, Maria-Cristina Ricketson, Leah Deceuninck, Geneviève Lefebvre, Brigitte Díaz, Janepsy Puentes, Rodrigo Krizova, Pavla Rafai, Eric Toropainen, Maija Viriot, Delphine Ploy, Marie-Cecile Hossain, Ilias Georgakopoulou, Theano Magaziotou, Ioanna Chow, Kin-Hung Erlendsdottir, Helga Mereckiene, Jolita Del Manso, Martina Suga, Shigeru Bigogo, Godfrey Dimina, Elina Swarthout, Todd Nzoyikorera, Néhémie Steens, Anneke Galloway, Yvonne Winje, Brita Chan, Guanhao Thoon, Koh Cheng Avdičová, Mária de Gouveia, Linda du Plessis, Mignon Ciruela, Pilar Sanz, Juan Carlos Guevara, Marcela Lepp, Tiia Amin-Chowdhury, Zahin Macdonald, Laura Pilishvili, Tamara Kobayashi, Miwako Bruden, Dana Pelton, Stephen Sutcliffe, Catherine Aukes, Laurie Byington, Carrie Zintgraff, Jonathan Chamorro, Gustavo Kawabata, Aníbal Celentano, Lucia Rey-Ben Johns Hopkins Bloomberg School of Public Health Baltimore MD United States WHO Geneva Switzerland Centre for Respiratory Diseases and Meningitis National Institute for Communicable Diseases of the National Health Laboratory Service Johannesburg South Africa School of Pathology Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa Reference Laboratory for Streptococci Department of Medical Microbiology University Hospital RWTH Aachen Aachen Germany Medical Microbiology and Infection Prevention Netherlands Reference Laboratory for Bacterial Meningitis Amsterdam UMC University of Amsterdam Amsterdam Netherlands Pan American Health Organization WHO Washington DC United States CIBER de Enfermedades Respiratorias Madrid Spain Epidemiology Department Dirección General de Salud Pública Madrid Spain Department of Pediatrics Yale New Haven Children's Hospital New Haven CT United States Department of Public Health Ministry of Health and Care Services Oslo Norway Division of Global Health Protection Center for Global Health Centers for Disease Control and Prevention Nairobi Kenya Division of Bacterial Diseases National Center for Immunizations and Respiratory Diseases US Centers for Disease Control and Prevention Atlanta GA United States National Reference Centre for Pneumococci Data Research Department Intercommunal Hospital of Créteil Créteil France Infectious Disease Epidemiology and Prevention Statens Serum Institut Copenhagen Denmark National Meningitis Reference Laboratory Department of Public Health Policy School of Public Health University of West Attica Athens Greece Communicable Diseases Centre National Institute of Public Health Ljubljana Slovenia University Multiprofile Hospital for Active Treatment Saint Ivan Rilski Clinical Microbiology Laboratory Sofia Bulgaria Bacterial Respiratory Infection Service Scot

Background: Widespread use of pneumococcal conjugate vaccines (PCVs) has reduced vaccine-type invasive pneumococcal disease (IPD). We describe the serotype distribution of IPD after extensive use of ten-valent PCV (PCV10;Synflorix, GSK) and 13-valent PCV (PCV13;Prevenar 13, Pfizer) globally. Methods: IPD data were obtained from surveillance sites participating in the WHO-commissioned Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project that exclusively used PCV10 or PCV13 (hereafter PCV10 and PCV13 sites, respectively) in their national immunisation programmes and had primary series uptake of at least 70%. Serotype distribution was estimated for IPD cases occurring 5 years or more after PCV10 or PCV13 introduction (ie, the mature period when the serotype distribution had stabilised) using multinomial Dirichlet regression, stratified by PCV product and age group (<5 years, 5–17 years, 18–49 years, and ≥50 years). Findings: The analysis included cases occurring primarily between 2015 and 2018 from 42 PCV13 sites (63 362 cases) and 12 PCV10 sites (6806 cases) in 41 countries. Sites were mostly high income (36 [67%] of 54) and used three-dose or four-dose booster schedules (44 [81%]). At PCV10 sites, PCV10 serotypes caused 10·0% (95% CI 6·3–12·9) of IPD cases in children younger than 5 years and 15·5% (13·4–19·3) of cases in adults aged 50 years or older, while PCV13 serotypes caused 52·1% (49·2–65·4) and 45·6% (40·0–50·0), respectively. At PCV13 sites, PCV13 serotypes caused 26·4% (21·3–30·0) of IPD cases in children younger than 5 years and 29·5% (27·5–33·0) of cases in adults aged 50 years or older. The leading serotype at PCV10 sites was 19A in children younger than 5 years (30·6% [95% CI 18·2–43·1]) and adults aged 50 years or older (14·8% [11·9–17·8]). Serotype 3 was a top-ranked serotype, causing about 9% of cases in children younger than 5 years and 14% in adults aged 50 years or older at both PCV10 and PCV13 sites. Across all age an

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