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Applying a random parameters Negative Binomial Lindley model to examine multi-vehicle crashes along rural mountainous highways in Malaysia

Rusli R, Haque MM, Afghari AP, King M

Accid Anal Prev, 2018 Oct;119:80-90.
PMID: 30007211 DOI: 10.1016/j.aap.2018.07.006

Road safety in rural mountainous areas is a major concern as mountainous highways represent a complex road traffic environment due to complex topology and extreme weather conditions and are associated with more severe crashes compared to crashes along roads in flatter areas. The use of crash modelling to identify crash contributing factors along rural mountainous highways suffers from limitations in data availability, particularly in developing countries like Malaysia, and related challenges due to the presence of excess zero observations. To address these challenges, the objective of this study was to develop a safety performance function for multi-vehicle crashes along rural mountainous highways in Malaysia. To overcome the data limitations, an in-depth field survey, in addition to utilization of secondary data sources, was carried out to collect relevant information including roadway geometric factors, traffic characteristics, real-time weather conditions, cross-sectional elements, roadside features, and spatial characteristics. To address heterogeneity resulting from excess zeros, three specialized modelling techniques for excess zeros including Random Parameters Negative Binomial (RPNB), Random Parameters Negative Binomial - Lindley (RPNB-L) and Random Parameters Negative Binomial - Generalized Exponential (RPNB-GE) were employed. Results showed that the RPNB-L model outperformed the other two models in terms of prediction ability and model fit. It was found that heavy rainfall at the time of crash and the presence of minor junctions along mountainous highways increase the likelihood of multi-vehicle crashes, while the presence of horizontal curves along a steep gradient, the presence of a passing lane and presence of road delineation decrease the likelihood of multi-vehicle crashes. Findings of this study have significant implications for road safety along rural mountainous highways, particularly in the context of developing countries.

Matched MeSH terms: Safety/statistics & numerical data*
Aesthetic journeys: a review of cosmetic surgery tourism

Pereira RT, Malone CM, Flaherty GT

J Travel Med, 2018 06 01;25(1).
PMID: 29924349 DOI: 10.1093/jtm/tay042

Background: Medical tourism has witnessed significant growth in recent years. The emerging trend towards international travel for cosmetic surgical interventions has not previously been reviewed. The current review aims to critically address the scale and impact of cosmetic surgical tourism and to delineate the complication profile of this form of medical tourism.
Methods: Articles published in the English language on the PubMed database that were relevant to surgical tourism and the complications of elective surgical procedures abroad were examined. Reference lists of articles identified were further scrutinized. The search terms used included combinations of 'surgery abroad', 'cosmetic surgery abroad', 'cosmetic surgery tourism', 'cosmetic surgery complications' and 'aesthetic tourism'.
Results: This article critically reviews the epidemiology of cosmetic surgical tourism and its associated economic factors. Surgical complications of selected procedures, including perioperative complications, are described. The implications for travel medicine practice are considered and recommendations for further research are proposed.
Conclusion: This narrative literature review focuses on the issues affecting travellers who obtain cosmetic surgical treatment overseas. There is a lack of focus in the travel medicine literature on the non-surgery-related morbidity of this special group of travellers. Original research exploring the motivation and pre-travel preparation, including the psychological counselling, of cosmetic surgical tourists is indicated.

Matched MeSH terms: Patient Safety/statistics & numerical data*
Adverse events in Malaysia: Associations with nurse's ethnicity and experience, hospital size, accreditation, and teaching status

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: Patient Safety/statistics & numerical data

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