Displaying publications 1 - 20 of 55 in total

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  1. Wong WP, Saw PS, Jomthanachai S, Wang LS, Ong HF, Lim CP
    Sci Rep, 2023 Dec 15;13(1):22287.
    PMID: 38097696 DOI: 10.1038/s41598-023-49606-z
    One major issue in pharmaceutical supply chain management is the supply shortage, and determining the root causes of medicine shortages necessitates an in-depth investigation. The concept of risk management is proposed in this study to identify significant risk factors in the pharmaceutical supply chain. Fuzzy failure mode and effect analysis and data envelopment analysis were used to evaluate the risks of the pharmaceutical supply chain. Based on a case study on the Malaysian pharmaceutical supply chain, it reveals that the pharmacy node is the riskiest link. The unavailability of medicine due to unexpected demand, as well as the scarcity of specialty or substitute drugs, pose the most significant risk factors. These risks could be mitigated by digital technology. We propose an appropriate digital technology platform consisting of big data analytics and blockchain technologies to undertake these challenges of supply shortage. By addressing risk factors through the implementation of a digitalized supply chain, organizations can fortify their supply networks, fostering resilience and efficiency, and thereby playing a pivotal role in advancing the Pharma 4.0 era.
    Matched MeSH terms: Risk Management
  2. Afshan S, Razi U, Leong KY, Lelchumanan B, Cheong CWH
    Environ Sci Pollut Res Int, 2023 Dec;30(58):122580-122600.
    PMID: 37971587 DOI: 10.1007/s11356-023-30687-2
    Given the significance of fostering sustainable climate conditions for long-term economic stability and financial resilience, this study probes the connection between climate-related policy ambiguity and its implications for currency valuation. In doing so, the current study investigates the interconnected effects of climate policy on economic policy uncertainty and geopolitical risk with the currency valuation in ASEAN countries. Employing wavelet coherence analysis and partial wavelet coherence analysis, the paper highlights the complex relationships among these factors and their implications for exchange rate fluctuations. Using data from 2000 to 2022, the findings reveal that climate policy uncertainty is an important driver of exchange rate movements, amplifying the impact of economic policy uncertainty and geopolitical risk. Furthermore, the study identifies a vicious cycle between climate policy uncertainty and exchange rates, potentially impacting the region's macroeconomic stability and long-term economic growth. The study presents several policy recommendations to address economic and climate policy uncertainties comprehensively based on the findings. These recommendations include establishing national frameworks for climate risk management, enhancing policy credibility and macroeconomic stability, and promoting regional integration to mitigate the influence of geopolitical risk on exchange rates.
    Matched MeSH terms: Risk Management
  3. Zainuddin SA, Abdullah B, Nasir NAM, Abdullah T, Nawi NC, Patwary AK, et al.
    Environ Sci Pollut Res Int, 2023 Mar;30(12):33756-33766.
    PMID: 36495430 DOI: 10.1007/s11356-022-24385-8
    Global risk concerns spurred a debate regarding empowering an organization's risk management system. Risk assessment, management, and planning are vital for running a firm, but they are not universal. This research investigates how operational risk management is institutionalized in an organization and reveals best practices from a Malaysian government-linked enterprise (GLC). This phenomenological study interviewed 39 risk management officers, executives, and employees. Data are thematically analyzed. Burawoy's Social Theory uses a case study to integrate micro- and macro-organizational elements. The case company's risk management officers, executives, and employees are involved in seven processual factors, according to the analysis. Strong leadership and external consultants, setting up the apparatus and assigning the task to the person in charge, risk framework, risk diagnostic, monitor and measure, developing and nurturing risk management culture, and consistent risk management enforcement and monitoring could explain the institutionalization process of risk management in the organization. Global and local entities have institutionalized risk management. This phenomenological study helps comprehend the role of risk management institutionalization in corporate risk management. This study contributes to a practical implication such as to the GLC. It suggests that top management support and a standard risk framework are necessary for risk management homogeneity. Leaders and frameworks must address organizational processes and capabilities to ensure risk management consistency. This study contributes to the literature on risk management practices in developing nations. The paper concludes with limitations and research recommendations.
    Matched MeSH terms: Risk Management*
  4. Bolan S, Wijesekara H, Tanveer M, Boschi V, Padhye LP, Wijesooriya M, et al.
    Environ Pollut, 2023 Mar 01;320:121077.
    PMID: 36646409 DOI: 10.1016/j.envpol.2023.121077
    Beryllium (Be) is a relatively rare element and occurs naturally in the Earth's crust, in coal, and in various minerals. Beryllium is used as an alloy with other metals in aerospace, electronics and mechanical industries. The major emission sources to the atmosphere are the combustion of coal and fossil fuels and the incineration of municipal solid waste. In soils and natural waters, the majority of Be is sorbed to soil particles and sediments. The majority of contamination occurs through atmospheric deposition of Be on aboveground plant parts. Beryllium and its compounds are toxic to humans and are grouped as carcinogens. The general public is exposed to Be through inhalation of air and the consumption of Be-contaminated food and drinking water. Immobilization of Be in soil and groundwater using organic and inorganic amendments reduces the bioavailability and mobility of Be, thereby limiting the transfer into the food chain. Mobilization of Be in soil using chelating agents facilitates their removal through soil washing and plant uptake. This review provides an overview of the current understanding of the sources, geochemistry, health hazards, remediation practices, and current regulatory mandates of Be contamination in complex environmental settings, including soil and aquatic ecosystems.
    Matched MeSH terms: Risk Management
  5. Xiong J, Domnic Jacob GA, Xiong JG
    Am J Health Behav, 2023 Feb 28;47(1):165-172.
    PMID: 36945091 DOI: 10.5993/AJHB.47.1.17
    Objectives: In this study, we analyzed negative online public opinion in tertiary hospitals and evaluated corresponding risk by applying the Kaiser Model. Methods: Through data and expert group discussion, combined with the hospital's actual negative online public opinion management, we determined the opinions posing higher risk. The hospital's risk questionnaire for negative opinion was designed based on the Kaiser Model. The whole hospital staff was then trained and investigated. An Excel worksheet was used for statistical analysis and risk calculation.Results: According to the ranking of risk value, the top 5 negative online public opinions were drug supply and demand, in-hospital parking, handling of public health emergencies, the service attitude of hospital guidance staff, and interpretation of medical insurance policies. Conclusion: The hospital needs to revise and improve the emergency response plan for negative online public opinion based on the analysis results and reports of opinion risks. This is helpful for strengthening hospital-level emergency training, improving the hospital's ability to manage negative opinion risks, and promoting the hospital to become passive about negative online public opinion.
    Matched MeSH terms: Risk Management*
  6. Zainuddin SA, Abdullah B, Nasir NAM, Abdullah T, Nawi NC, Patwary AK, et al.
    Environ Sci Pollut Res Int, 2023 Feb;30(9):24708-24717.
    PMID: 36344894 DOI: 10.1007/s11356-022-23897-7
    Businesses are becoming more conscious of operational risk management practices due to the COVID-19 pandemic. However, some firms practice risk management without fully comprehending how it might help them and their needs. As a result, companies that practice risk management without realizing it are being controlled by the discipline itself. The goal of this study is to look into the epistemic process of risk management practice in the workplace. This phenomenological study interviewed 39 risk management officers, executives, and employees. Data are thematically analyzed. This study discovered five epistemic processes of risk mapping using Foucault's governmentality paradigm. This phenomenological study, interestingly, revealed the black box of risk management practices, as well as the behavior of risk management officers, executives, and risk owners who preferred to monitor the compliance aspects of risk management practices rather than comprehend the capabilities of risk management that could be used within their strategic planning process. Unaware of this black box, organizational actors were blanketed by the organization's culture of fear, which created the impression that the authority was always watching every word said and every action taken. Practically, this study contributes an improved understanding of the real function of risk management that helps them justify the practice and reduce unnecessary fear. The paper concludes with limitations and research recommendations.
    Matched MeSH terms: Risk Management*
  7. Lee YS, Oh YS, Choi EK, Chern AKC, Jiampo P, Chutinet A, et al.
    Open Heart, 2021 12;8(2).
    PMID: 34857666 DOI: 10.1136/openhrt-2021-001745
    PURPOSE: Dabigatran is a direct thrombin inhibitor approved for stroke prophylaxis in patients with non-valvular atrial fibrillation (NVAF). Real-world data about patient preference, satisfaction and convenience in patients in Asia are not available. The study aimed to explore the perception of patients with newly diagnosed NVAF regarding dabigatran versus vitamin K antagonists (VKAs), when used for stroke prevention.

    PATIENTS AND METHODS: This was a multinational, multicentre, non-interventional study involving 49 sites across 5 countries in South East Asia and South Korea where 934 patients newly diagnosed with NVAF were initiated on either dabigatran (N=591) or VKA (N=343). Data were collected at baseline and over two follow-up visits across 6 months. Treatment satisfaction and patient convenience were evaluated using the Perception on Anticoagulant Treatment Questionnaire-2 (PACT-Q2).

    RESULTS: The mean age of the patients was 65.9±10.4 years, and 64.2% were male. Mean CHA2DS2-VASc score was 2.4±1.5, and mean HAS-BLED score was 1.2±0.9. At baseline, patients initiated on dabigatran had higher stroke risk, bleeding risk, creatinine clearance and proportion of patients with concomitant illnesses compared with patients initiated on VKAs. Treatment convenience was perceived to be significantly better with dabigatran versus VKAs at visits 2 and 3 (p=0.0423 and 0.0287, respectively). Treatment satisfaction was significantly better with dabigatran compared with VKAs at visit 3 (p=0.0300).

    CONCLUSION: In this study, dabigatran is associated with better patient perception in terms of treatment convenience and satisfaction compared with VKAs when used for stroke prevention in newly diagnosed NVAF patients from South East Asia and South Korea.

    TRIAL REGISTRATION NUMBER: NCT02849509.

    PLAIN LANGUAGE SUMMARY: Patient satisfaction with dabigatran versus VKAs in South East Asia. Patients with atrial fibrillation are at high risk of stroke and require anticoagulants for stroke prevention. Two such anticoagulants are dabigatran and VKAs. We wanted to compare the extent of satisfaction and treatment convenience among newly diagnosed patients with atrial fibrillation from the South East Asian region when they were given either dabigatran or VKAs. Consenting patients filled out a standardised questionnaire called the PACT-Q2 over three visits after they were started on either dabigatran (591 patients) or VKAs (343 patients). We found that satisfaction and convenience were significantly higher when patients received dabigatran than when they received VKAs.

    Matched MeSH terms: Risk Management
  8. Tagod M, Adeleke AQ, Moshood TD
    J Safety Res, 2021 06;77:139-150.
    PMID: 34092304 DOI: 10.1016/j.jsr.2021.02.011
    INTRODUCTION: The construction industry in Malaysia has been bedevilled by myriads of risk issues that have hampered its smooth operations in recent times. This paper is an empirical assessment that aims to examine the effect of coercive pressure on the relationship between organizational structure and construction risk management among construction industry in Malaysia.

    METHOD: Based on the proposed model, a quantitative method was employed to obtain data from G7 construction industry operating within the peninsular Malaysia. Out of the 180 copies of questionnaire, 165 copies were properly filled, returned, and used for the analysis. PLS-SEM was used to analyze the obtained data.

    RESULTS: The findings of the study affirmed that specialization, centralization, and management of risk by the construction industry had positive correlation.

    CONCLUSIONS: As anticipated, coercive pressure had positive moderating correlation with both formalization and the management of risk by the construction industry. Similarly, it was also found that in the course of carrying out construction activities, coercive pressure made significant interactive influence on formalization, specialization, and centralization. Practical Applications: Coercive pressure reduced the frequency of accidents among workers in the process of carrying out construction works.

    Matched MeSH terms: Risk Management/organization & administration; Risk Management/statistics & numerical data*
  9. Dhamanti I, Leggat S, Barraclough S, Liao HH, Abu Bakar N
    J Patient Saf, 2021 Jun 01;17(4):e299-e305.
    PMID: 32217924 DOI: 10.1097/PTS.0000000000000622
    OBJECTIVES: Incident reporting is one of the tools used to improve patient safety that has been widely used in health facilities in many countries. Incident reporting systems provide functionality to collect, analyze, and disseminate lessons learned to the wider community, whether at the hospital or national level. The aim of this study was to compare the patient safety incident reporting systems of Taiwan, Malaysia, and Indonesia to identify similarities, differences, and areas for improvement.

    METHODS: We searched the official Web sites and homepages of the responsible leading patient safety agencies of the three countries. We reviewed all publicly available guidelines, regulatory documents, government reports that included policies, guidelines, strategy papers, reports, evaluation programs, as well as scientific articles and gray literature related to the incident reporting system. We used the World Health Organization components of patient safety reporting system as the guidelines for comparison and analyzed the documents using descriptive comparative analysis.

    RESULTS: Taiwan had the most incidents reported, followed by Malaysia and Indonesia. Taiwan Patient Safety Reporting (TPR) and the Malaysian Reporting and Learning System had similar attributes and followed the World Health Organization components for incident reporting. We found differences between the Indonesian system and both of TPR and the Malaysian system. Indonesia did not have an external reporting deadline, analysis and learning were conducted at the national level, and there was a lack of transparency and public access to data and reports. All systems need to establish a clear and structured incident reporting evaluation framework if they are to be successful.

    CONCLUSIONS: Compared with TPR and Malaysian system, the Indonesian patient safety incident reporting system seemed to be ineffective because it failed to acquire adequate national incident reporting data and lacked transparency; these deficiencies inhibited learning at the national level. We suggest further research on the implementation at the hospital level to see how far national guidelines and policy have been implemented in each country.

    Matched MeSH terms: Risk Management*
  10. Narita K, Hoshide S, Tsoi K, Siddique S, Shin J, Chia YC, et al.
    J Clin Hypertens (Greenwich), 2021 03;23(3):575-583.
    PMID: 33527663 DOI: 10.1111/jch.14192
    The incidence of large disasters has been increasing worldwide. This has led to a growing interest in disaster medicine. In this review, we report current evidence related to disasters and coronavirus disease-2019 (COVID-19) pandemic, such as cardiovascular diseases during disasters, management of disaster hypertension, and cardiovascular diseases associated with COVID-19. This review summarizes the time course and mechanisms of disaster-related diseases. It also discusses the use of information and communication technology (ICT) as a cardiovascular risk management strategy to prevent cardiovascular events. During the 2011 Great East Japan Earthquake, we used the "Disaster Cardiovascular Prevention" system that was employed for blood pressure (BP) monitoring and risk management using ICT. We introduced an ICT-based BP monitoring device at evacuation centers and shared patients' BP values in the database to support BP management by remote monitoring, which led to improved BP control. Effective use of telemedicine using ICT is important for risk management of cardiovascular diseases during disasters and pandemics in the future.
    Matched MeSH terms: Risk Management
  11. Dikshit A, Pradhan B, Alamri AM
    Sci Total Environ, 2021 Feb 10;755(Pt 2):142638.
    PMID: 33049536 DOI: 10.1016/j.scitotenv.2020.142638
    Drought forecasting with a long lead time is essential for early warning systems and risk management strategies. The use of machine learning algorithms has been proven to be beneficial in forecasting droughts. However, forecasting at long lead times remains a challenge due to the effects of climate change and the complexities involved in drought assessment. The rise of deep learning techniques can solve this issue, and the present work aims to use a stacked long short-term memory (LSTM) architecture to forecast a commonly used drought measure, namely, the Standard Precipitation Evaporation Index. The model was then applied to the New South Wales region of Australia, with hydrometeorological and climatic variables as predictors. The multivariate interpolated grid of the Climatic Research Unit was used to compute the index at monthly scales, with meteorological variables as predictors. The architecture was trained using data from the period of 1901-2000 and tested on data from the period of 2001-2018. The results were then forecasted at lead times ranging from 1 month to 12 months. The forecasted results were analysed in terms of drought characteristics, such as drought intensity, drought onset, spatial extent and number of drought months, to elucidate how these characteristics improve the understanding of drought forecasting. The drought intensity forecasting capability of the model used two statistical metrics, namely, the coefficient of determination (R2) and root-mean-square error. The variation in the number of drought months was examined using the threat score technique. The results of this study showed that the stacked LSTM model can forecast effectively at short-term and long-term lead times. Such findings will be essential for government agencies and can be further tested to understand the forecasting capability of the presented architecture at shorter temporal scales, which can range from days to weeks.
    Matched MeSH terms: Risk Management
  12. Hasan H, Parker A, Pollard SJT
    Sci Total Environ, 2021 Feb 10;755(Pt 1):142868.
    PMID: 33348485 DOI: 10.1016/j.scitotenv.2020.142868
    We explore the interplay between preventative risk management and regulatory style for the implementation of water safety plans in Malaysia and in England and Wales, two jurisdictions with distinct philosophies of approach. Semi-structured interviews were conducted with 32 water safety professionals in Malaysia, 23 in England and Wales, supported by 6 Focus Group Discussions (n = 53 participants). A grounded theory approach produced insights on the transition from drinking water quality surveillance to preventative risk management. Themes familiar to this type of regulatory transition emerged, including concerns about compliance policy; overseeing the risk management controls of regulatees with varied competencies and funds available to drive change; and the portfolio of interventions suited to a more facilitative regulatory style. Because the potential harm from waterborne illness is high where pathogen exposures occur, the transition to risk-informed regulation demands mature organisational cultures among water utilities and regulators, and a laser-like focus on ensuring risk management controls are delivered within water supply systems.
    Matched MeSH terms: Risk Management
  13. Zheyuan C, Rahman MA, Tao H, Liu Y, Pengxuan D, Yaseen ZM
    Work, 2021;68(3):825-834.
    PMID: 33612525 DOI: 10.3233/WOR-203416
    BACKGROUND: The increasing use of robotics in the work of co-workers poses some new problems in terms of occupational safety and health. In the workplace, industrial robots are being used increasingly. During operations such as repairs, unmanageable, adjustment, and set-up, robots can cause serious and fatal injuries to workers. Collaborative robotics recently plays a rising role in the manufacturing filed, warehouses, mining agriculture, and much more in modern industrial environments. This development advances with many benefits, like higher efficiency, increased productivity, and new challenges like new hazards and risks from the elimination of human and robotic barriers.

    OBJECTIVES: In this paper, the Advanced Human-Robot Collaboration Model (AHRCM) approach is to enhance the risk assessment and to make the workplace involving security robots. The robots use perception cameras and generate scene diagrams for semantic depictions of their environment. Furthermore, Artificial Intelligence (AI) and Information and Communication Technology (ICT) have utilized to develop a highly protected security robot based risk management system in the workplace.

    RESULTS: The experimental results show that the proposed AHRCM method achieves high performance in human-robot mutual adaption and reduce the risk.

    CONCLUSION: Through an experiment in the field of human subjects, demonstrated that policies based on the proposed model improved the efficiency of the human-robot team significantly compared with policies assuming complete human-robot adaptation.

    Matched MeSH terms: Risk Management
  14. de la Rosette J, Laguna P, Álvarez-Maestro M, Eto M, Mochtar CA, Albayrak S, et al.
    Int J Urol, 2020 11;27(11):981-989.
    PMID: 32772434 DOI: 10.1111/iju.14340
    OBJECTIVES: To determine the well-being of urologists worldwide during the coronavirus disease 2019 pandemic, and whether they have adequate personal protective equipment knowledge and supplies appropriate to their clinical setting.

    METHODS: Urologists worldwide completed a Société Internationale d'Urologie online survey from 16 April 2020 until 1 May 2020. Analysis was carried out to evaluate their knowledge about protecting themselves and others in the workplace, including their confidence in their ability to remain safe at work, and any regional differences.

    RESULTS: There were 3488 respondents from 109 countries. Urologists who stated they were moderately comfortable that their work environment offers good protection against coronavirus disease 2019 showed a total mean satisfaction level of 5.99 (on a "0 = not at all" to "10 = very" scale). A large majority (86.33%) were confident about protecting themselves from coronavirus disease 2019 at work. However, only about one-third reported their institution provided the required personal protective equipment (35.78%), and nearly half indicated their hospital has or had limited personal protective equipment availability (48.08%). Worldwide, a large majority of respondents answered affirmatively for testing the healthcare team (83.09%). Approximately half of the respondents (52.85%) across all regions indicated that all surgical team members face an equal risk of contracting coronavirus disease 2019 (52.85%). Nearly one-third of respondents reported that they had experienced social avoidance (28.97%).

    CONCLUSIONS: Our results show that urologists lack up-to-date knowledge of preferred protocols for personal protective equipment selection and use, social distancing, and coronavirus disease 2019 testing. These data can provide insights into functional domains from which other specialties could also benefit.

    Matched MeSH terms: Risk Management/methods; Risk Management/standards
  15. Samsiah A, Othman N, Jamshed S, Hassali MA
    Int J Clin Pharm, 2020 Aug;42(4):1118-1127.
    PMID: 32494990 DOI: 10.1007/s11096-020-01041-0
    Background Medication errors are the most common types of medical errors that occur in health care organisations; however, these errors are largely underreported. Objective This study assessed knowledge on medication error reporting, perceived barriers to reporting medication errors, motivations for reporting medication errors and medication error reporting practices among various health care practitioners working at primary care clinics. Setting This study was conducted in 27 primary care clinics in Malaysia. Methods A self-administered survey was distributed to family medicine specialists, doctors, pharmacists, pharmacist assistants, nurses and assistant medical officers. Main outcome measures Health care practitioners' knowledge, perceived barriers and motivations for reporting medication errors. Results Of all respondents (N = 376), nurses represented 31.9% (n = 120), followed by doctors (n = 87, 23.1%), pharmacists (n = 63, 16.8%), assistant medical officers (n = 53, 14.1%), pharmacist assistants (n = 46, 12.2%) and family medicine specialists (n = 7, 1.9%). Of the survey respondents who had experience reporting medication errors, 56% (n = 62) had submitted medication error reports in the preceding 12 months. Results showed that 41.2% (n = 155) of respondents were classified as having good knowledge on medication error and medication error reporting. The mean score of knowledge was significantly higher among prescribers and pharmacists than nurses, pharmacist assistants and assistant medical officers (p 
    Matched MeSH terms: Risk Management/statistics & numerical data
  16. Lim KS, Fong SL, Thuy Le MA, Ahmad Bazir S, Narayanan V, Ismail N, et al.
    Epilepsy Res, 2020 05;162:106298.
    PMID: 32172144 DOI: 10.1016/j.eplepsyres.2020.106298
    INTRODUCTION: Video-EEG monitoring is one of the key investigations in epilepsy pre-surgical evaluation but limited by cost. This study aimed to determine the efficacy and safety of a 48-hour (3-day) video EEG monitoring, with rapid pre-monitoring antiepileptic drugs withdrawal.

    MATERIAL AND METHODS: This is a retrospective study of epilepsy cases with VEM performed in University Malaya Medical Center (UMMC), Kuala Lumpur, from January 2012 till August 2016.

    RESULTS: A total of 137 cases were included. The mean age was 34.5 years old (range 15-62) and 76 (55.8 %) were male. On the first 24 -h of recording (D1), 81 cases (59.1 %) had seizure occurrence, and 109 (79.6 %) by day 2 (D2). One-hundred and nine VEMs (79.6 %) were diagnostic, in guiding surgical decision or further investigations. Of these, 21 had less than 2 seizures recorded in the first 48 h but were considered as diagnostic because of concordant interictal ± ictal activities, or a diagnosis such as psychogenic non-epileptic seizure was made. Twenty-eight patients had extension of VEM for another 24-48 h, and 11 developed seizures during the extension period. Extra-temporal lobe epilepsy and seizure frequency were significant predictors for diagnostic 48 -h VEM. Three patients developed complications, including status epilepticus required anaesthetic agents (1), seizure clusters (2) with postictal psychosis or dysphasia, and all recovered subsequently.

    CONCLUSIONS: 48-h video EEG monitoring is cost-effective in resource limited setting.

    Matched MeSH terms: Risk Management
  17. Jarrar M, Al-Bsheish M, Dardas LA, Meri A, Sobri Minai M
    Int J Health Plann Manage, 2020 Jan;35(1):104-119.
    PMID: 31271233 DOI: 10.1002/hpm.2822
    PURPOSE: In Malaysia, private healthcare sector has become a major player in delivering healthcare services alongside the government healthcare sector. However, wide disparities in health outcomes have been recorded, and adverse events in these contexts have yet to be explored. The purpose of this study was to explore associations between nurse's ethnicity and experience, hospital size, accreditation, and teaching status with adverse events in Malaysian private hospitals.

    METHODS: A cross-sectional survey was conducted in 12 private hospitals in Malaysia. A total of 652 (response rate = 61.8%) nurses participated in the study. Data were collected using self-administered questionnaire on nurses' characteristic, adverse events and events reporting, and perceived patient safety.

    RESULTS: Patient and family complaints events were the most common adverse events in Malaysian private hospitals as result of increased cost of care (3.24 ± 0.95) and verbal miscommunication (3.52 ± 0.87).

    CONCLUSION: Hospital size, accreditation status, teaching status, and nurse ethnicity had a mixed effect on patient safety, perceived adverse events, and events reporting. Policy makers can benefit that errors are related to several human and system related factors. Several system reforms and multidisciplinary efforts were recommended for optimizing health, healthcare and preventing patient harm.

    Matched MeSH terms: Risk Management/statistics & numerical data
  18. Fatokun O
    Curr Drug Saf, 2020;15(3):181-189.
    PMID: 32538733 DOI: 10.2174/1573403X16666200615144946
    BACKGROUND: While off-label drug use is common and sometimes necessary, it also presents considerable risks. Therefore, measures intended to prevent or reduce the potential exposure to off-label risks have been recommended. However, little is known about community pharmacists' beliefs regarding these measures in Malaysia.

    OBJECTIVES: This study examined community pharmacists' beliefs towards risk minimization measures in off-label drug use in Malaysia and assessed the relationship between perceived risk of off-label drug use and beliefs towards risk minimization measures.

    METHODS: A cross-sectional survey was conducted among 154 pharmacists practicing in randomly selected community pharmacies in Kuala Lumpur and the State of Selangor, Malaysia.

    RESULTS: The majority agreed or strongly agreed that adverse drug events from the off-label drug should be reported to the regulatory authority (90.9%) and the off-label drug should only be used when the benefit outweighs potential risks (88.3%). Less than half (48.1%) agreed or strongly agreed that written informed consent should be obtained before dispensing off-label drugs and a majority (63.7%) agreed or strongly agreed that the informed consent process will be burdensome to healthcare professionals. Beliefs towards risk minimization measures were significantly associated with perceived risk of off-label drug use regarding efficacy (p = 0. 033), safety (p = 0.001), adverse drug rection (p = 0.001) and medication errors (p = 0.002).

    CONCLUSION: The community pharmacists have positive beliefs towards most of the risk minimization measures. However, beliefs towards written informed consent requirements are not encouraging. Enhancing risk perception may help influence positive beliefs towards risk minimization measures.

    Matched MeSH terms: Risk Management/methods
  19. Praveena SM, Mohd Rashid MZ, Mohd Nasir FA, Sze Yee W, Aris AZ
    Ecotoxicol Environ Saf, 2019 Sep 30;180:549-556.
    PMID: 31128553 DOI: 10.1016/j.ecoenv.2019.05.051
    Occurrence of pharmaceutical residues in drinking water has been widely reported in countries that have registered steady economic growth. This can exert concerns among the general consumers, prompting them to explore the potential human health risks associated with continuous exposure to pharmaceuticals. However, such an occurrence is rarely reported in developing or under-developed countries. To give more contexts, this study looked at the presence of nine pharmaceutical residues in drinking water (amoxicillin, caffeine, chloramphenicol, ciprofloxacin, dexamethasone, diclofenac, nitrofurazone, sulfamethoxazole, and triclosan) at Putrajaya residential area in Malaysia. Additionally, the potential health risks associated with contaminated drinking water were investigated. This study has found the presence of pharmaceutical residue concentrations up to 0.38 ng/L, with the highest concentration of caffeine (0.38 ng/L) and the lowest concentration of diclofenac (0.14 ng/L). In comparison, all the nine pharmaceutical residues were substantially lower than previously reported studies. In general, Hazard Quotient (HQ) values indicated that low potential health hazards were present for all age groups. Nevertheless, quantitative occurrences of pharmaceutical residues in drinking water will help guide future toxicological studies to examine other chronic effects, while canvassing for proper framework to look into the water risk management and regulation in Malaysia.
    Matched MeSH terms: Risk Management
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