Safety Department Research Articles

Investigating the Catastrophic Roof Failure of a Fatty Acid Storage Tank: Causes, Mechanisms, and Safety Implications

This paper investigates the catastrophic failure of the roof weld on a carbon steel storage tank at a Fatty Acids plant, which was attributed to pressure overload. The incident resulted in the tank's roof, weighing over 5 tons and spanning 8 meters in diameter, being propelled 25 meters from the tank. Despite installing several safety devices, including pressure regulating valves, pressure indicator controls, and pressure vacuum relief valves, inadequate maintenance led to their malfunction. This study examines the mechanisms and causes behind the failure, highlighting the crucial role of regular maintenance in ensuring the functionality of safety instruments. While neither toxic nor flammable, the plant's compressed air system poses a significant hazard due to the energy stored at slight overpressure, necessitating vigilant management by the safety department. The findings underscore the importance of robust maintenance strategies and procedural adherence to prevent similar incidents, enhancing industrial storage systems' overall safety and reliability.

All On One Page: Getting Daily Meal Ordering Right In A Rehabilitation Setting

Abstract Background Recently the rehabilitation hospital expanded to over 100 beds providing improved access to rehabilitation for older persons in the area. During this time, an increase in incident report forms occurred due to the incorrect provision of diet/fluid to patients at ward level. In collaboration with relevant stakeholders, the Speech and Language Therapy (SLT) and Dietetic teams reviewed the current hospital meal ordering form and process in order to standardise a new system. The aim of this project was to reduce risk for patients and improve collaborative team working and communication. Methods A multidisciplinary team (MDT) approach was adapted involving; SLT, dietitians, catering department, nursing team and the patient quality and safety department. The HSE change framework provided scaffolding for this work. A new Daily Meal Order form was created and approved by the Nutrition Steering Committee and the process was agreed using input from all stakeholders. A pilot was carried out, reviewed and rolled out across the campus. The number of incidents recorded at ward level was used to measure if risk was reduced. A staff survey was conducted to gather feedback on the new system. Results The new Daily Meal Order form is now being used across the campus. Additional checks are completed each day via email to reduce the risk of errors. No incident reports were filed since launching the new form and process. A staff survey showed that all staff feel the new system and form constitutes an improvement, that it saves clinical time and that they would recommend it to others. Conclusion The project aims have been met in reducing patient risk, in line with the HIQA Safer Better Healthcare Programme. It has also improved MDT working and communication. This project is easily replicable to other settings and staff would recommend this approach to others.

Evaluation of Staff Views of the Rapid Assistance with Frailty Team, It’s Perceived Clinical Effectiveness and Potential Areas for Development

Abstract Background The Rapid Assistance with Frailty Team (RAFT) has been operating within our local hospital since 2021. This novel multidisciplinary service aims to support frail older adults during hospital admission, by conducting focused comprehensive geriatric assessments, and providing bespoke support to their primary team. One method of evaluating the impact of the service has been to seek regular feedback from other staff, to guide continuous quality improvement regarding our approach. Methods This service evaluation was registered with the Quality and Patient Safety department locally in January 2024. An online questionnaire was developed to seek feedback from colleagues who would have experience of the service, with a link distributed via email to relevant staff members. Data collection took place over an eight-week period. Results In total, 69 responses from staff were received, and analysed thematically. They demonstrated high degrees of staff satisfaction, with over 76% either agreeing or strongly agreeing that ‘RAFT is a valuable service’. A further 69% of respondents felt that ‘RAFT is helpful in supporting discharge’. The most common expectations were for the team to assist with frailty assessment; support discharge planning; offer MDT input; provide follow-up care; and conduct education. Staff felt the service could be improved through refining the medical input role; provision of an ED service; increased staffing; expanding the discharge planning role; development of referral pathways; and improved communication. Conclusion Following presentation of these findings at our departmental teaching, a service development plan was agreed. This includes organising a focused internal rapid improvement event, with RAFT staff utilising the feedback from this service evaluation to identify how the service can be improved, as well as identifying key performance indicators to evaluate this progress. We will repeat this service evaluation in 6 months’ time, to assess if these interventions have made a meaningful impact.

Estimating Patient Eligibility And Benefit Of Intravenous Zolendronic Acid In Hip Fracture Patients: A Service Evaluation

Abstract Background Low trauma hip fractures are serious and carry an estimated re-fracture rate of 10.6%, leading increased morbidity, mortality and healthcare cost. Intravenous Zolendronic Acid (IVZ) administration following hip fracture reduces re-fracture risk by approximately 23% and is recommended yearly for three years by National Osteoporosis Guidelines Group (NOGG) 2021. However, a significant treatment gap remains with only one-fifth of patients receiving IVZ pre-discharge, due to implementation challenges, such as suboptimal Vitamin D levels and lack of resources for yearly infusions. Recently published consensus guidelines offer practical advice as to how to overcome these barriers. This service evaluation estimates the proportion of hip fracture patients eligible for IVZ; as well as the re-fracture rate, prior to the introduction of a local IVZ pathway. Methods Approval from local Quality and Patient Safety Department was received. Low trauma hip fracture patients were identified from the local Orthogeriatric database (October 2019 to January 2021). Hospital electronic laboratory and radiology software were used to identify renal function on discharge and evidence of further fractures (at six months, 1 year and 3 years). Subjects were deemed potentially eligible for IVZ if they had an estimated glomerular filtration rate (eGFR) of ≥50 mls/min (a proxy for calculated creatinine clearance ≥30mls/min in this patient cohort). Results Of 463 subjects, 384 (82.9%) had an eGFR ≥50. Re-fracture data was collected for 263 eligible subjects. Seventeen (6.5%) re-fractured within six months, 21 (8%) re-fractured within a year and 45 (17.1%) re-fractured at any stage post discharge. Conclusion IVZ treatment is the most efficacious secondary fracture prevention post-hip fracture, and most patients are eligible for this treatment. Implementing IVZ pathways for hip fracture patients may significantly reduce re-fracture rate, however expansion of resources allocated to Orthogeriatrics and Fracture Liaison teams is required to successfully implement inpatient pathways and ongoing care.

Do we consent to change? An evaluation of oral and maxillofacial outpatient department dentoalveolar consent forms

Obtaining informed consent before performing any dentoalveolar procedure is a professional, ethical, and legal obligation. Prior to this work, in this oral and maxillofacial department, no standardised consent process existed for dentoalveolar procedures. A targeted literature review established localised gold standards for dentoalveolar procedures, and retrospective data from 56 dentoalveolar consent forms over a four-week period assessed baseline compliance with these standards. Data analysis identified that risks of dry socket and trismus were documented in only 7% of cases, and maxillary tuberosity fracture was never documented. Thirty-three per cent of lower third molar cases did not include consent for inferior alveolar nerve injury. Findings were discussed in a departmental audit meeting, and a root cause analysis identified memory failure, repetition fatigue, and varying clinician knowledge and experience, as key drivers. The evidence base and localised gold standards were discussed. A standardised, bilingual, triple-copy dentoalveolar consent form was developed, including predefined indications, additional procedures, and risks, in a tick-box format. This form was presented to the Department of Patient Safety and Quality and gained local approval. Cases completed with the new form will now be evaluated against the localised gold standards, with a mixed-methods feedback survey investigating staff and patient opinions. Local processes for obtaining and documenting valid consent for dentoalveolar treatment were found to be inconsistent and frequently inadequate. Fifteen localised gold standards were set, and a new standardised consent form developed, which will be evaluated for effectiveness and acceptability.

Protocol of health screening related to occupational diseases in 100 000 workers in critical sectors: a cross-sectional study with worksite risk assessment

BackgroundOccupational diseases are one of the most important health problems related to employment However, in Malaysia, there are few epidemiological studies discussing these issues, especially among workers in the industry....

Innovation using dynamic balanced scorecard design as an industrial safety management system in a company in the mining metallurgical sector

Over the years, industrial safety management in Peru's metallurgical mining sector has become a business problem with no acceptable solution. Annual statistics reveal an average of 60–70 fatal accidents in companies in this sector. This paper proposes using the Systemic Methodology to Develop and Maintain a Dynamic Balanced Scorecard MSDBSC-EM) to be used in the industrial safety management of the safety department of a Peruvian company in the metallurgical mining sector. This methodology was created at the Instituto Andino de Sistemas - IAS of Peru and combines the criteria of the Balanced Scorecard with the modeling of System Dynamics and contributions of the Soft System Methodology. This proposal demonstrates that dynamic simulation facilitates organizational learning and allows the designing of action plans in the present to manage the future. Also, modeling and computer tools facilitate the development and implementation of prototypes, which can be used to analyze required scenarios through pleasant and easy-to-use environments. In this sense, a dynamic model of key performance indicators of objectives, goals and initiatives was developed and four scenarios (A, B, C and D) were analyzed, from which it can be observed that the degree of commitment and leadership with the Industrial safety affects the increase in the level of preventive culture, which in turn favors the prevention of risks and the achievement of tangible objectives in industrial safety, evident in the drastic decrease in the occurrence of accidents and occupational diseases, and this is achieved to the extent that the personnel have the necessary competencies, which in turn is obtained through constant comprehensive training and the appropriate selection of personnel. On the other hand, the operating budget of the security department is a limiting factor in achieving these criteria. Another important aspect is the degree of existing communication, which affects the increase in the level of preventive culture.

A linguistic Z-number-based dual perspectives information volume calculation method for driving behavior risk evaluation

Driving risk evaluation is a critical task for traffic safety and vehicle insurance. Unfortunately, many existing methods disregard the unknown and uncertain nature of driving behavior in real-world scenarios. In this paper, we formula this task as a multi-criteria group decision-making problem and propose a dual perspective information volume method for evaluating the driving risk score based on linguistic Z-number. Our proposed method accurately captures the uncertainties and reliability of driving behavior by utilizing two fuzzy numbers A and B. The main contributions of our paper are as follows: firstly, we introduce the α-truncation set and the information volume-based utility function and credibility probability model, which form the basis of the vehicle evaluation method. Secondly, we consider cross-information to model the divergence of information between dual perspectives, based on different experts and features. We calculate the credibility value for each perspective using the Z+-based information volume. Thirdly, we present the dual perspective calculation method used to assess driving risk. This method assigns risk scores to individual vehicles based on a utility function. Finally, we conduct a case study using the historical trajectories of vehicles obtained from an insurance company. The results are compared against the damages coefficient. Furthermore, we perform dependability and parameter analysis to demonstrate the effectiveness and superiority of our approach. Our approach provides valuable insights and suggestions for the insurance industry and traffic safety departments in relevant fields.

Unraveling the propagation dynamics of passenger congestion in public transportation systems using big smart card data

We propose a comprehensive framework to explore propagation of passenger crowdedness in public transportation systems using 74.16 million trip chains. A deep learning method HSTGCNT is adopted which firstly models normal spatio-temporal dependencies in time series data, and assigns an anomaly score to new data based on its prediction error. The derived discrete anomaly events are further aggregated into groups based on their spatio-temporal proximity by using a clustering algorithm that binds shared nearest neighbors together based on pairwise correlations. The clustering results uncover several key stages located in a propagation chain, such as a core event, adjacent events with spatio-temporal proximity, or a broadcasting group. Weibo data serves as a third-party dataset to verify the above anomaly clusters. Results show that the framework is effective to detect outlier clusters, with recall value being 0.86. Findings may assist public safety departments in taking pro-active actions to interrupt chaos from broadcasting.

Evaluation of job satisfaction and related factors in wood extraction workers in Gilan province

Introduction: occupational accidents are caused by ignorance of occupational health and safety recommendations, due to the high rate of accidents in the industry of cutting and extracting wood from the forest, this study is necessary to evaluate job satisfaction. Materials and Methods: In this research, job satisfaction was used as a dependent variable and independent variables included age, educational and employment status, type of work, and duration of employment. To determine the conditions of excessive fatigue among forest workers, the index of symptoms of excessive fatigue was used. The number of 100 workers was investigated by a questionnaire, the comparison of independent variables affecting the satisfaction or dissatisfaction of workers with work using discriminant analysis and the Wilks Lambda coefficient, and the comparison of the average opinions of people from different work groups regarding the work situation using Friedman's test was performed. Results: The four variables of duration of employment, age status of workers, employment status, and type of work are suitable for separating two groups satisfied with work and dissatisfied with work. The assessment of complaint rate showed that questions I take care of my family, I am very worried about my health and I am dissatisfied with many things with the highest rates of 84.66%, 70.66%, and 61.33% respectively. They took the complaint to themselves. The results showed that the highest amount of fatigue accumulation index is related to two groups chronic fatigue and general fatigue. The results of the present study show that 47% of forest workers are illiterate in their educational status, which requires a training course for workers to work with cutting tools and machines. The results showed that 41 percent of the people studied liked their jobs. Conclusion: Personal protective equipment is considered a work tool without which it is impossible to do the desired job. Training classes should be held periodically by the safety department for workers and supervisors when needed.

A study of the ideas of future employees of traffic safety departments about the image of a traffic police officer

A study of the ideas of future employees of traffic safety departments about the image of a traffic police officer

Does the ESC chronic coronary syndrome pre-test probability score assist coronary artery disease diagnosis in an advanced nurse practitioner led integrated community chest pain clinic?

Abstract Background The Advanced Nurse Practitioner (ANP) led integrated community chest pain clinic provides an alternative avenue to which GPs can refer patients with non-acute chest pain providing emergency dept. avoidance. The role of the ANP is to differentiate between a non-anginal versus anginal cause. In addition to taking a clinical history, physical assessment and ECG the ANP utilises the 2019 ESC guidelines for chronic coronary syndromes pre-test-probability (PTP) score, to judge if invasive investigation is required. Purpose ANP assessment of chest pain in a community clinic is unique in the Irish healthcare setting. The aim was to assess if angina characteristics & allocated ESC PTP were predictive of coronary artery disease (CAD) diagnosis in a community chest pain cohort. Method A retrospective audit of 144 patients assessed by the ANP in the ICCPC and subsequently referred for coronary angiography was performed. Final diagnosis of was analysed by i. anginal characteristic, ii. ESC PTP, iii. age and sex. Approval was given by the department of quality, safety and risk management. Results The average combined age was 61 years in n=92 Male, and n=51 Female patients. Coronary Artery Disease was diagnosed in 92% (n= 132) of those referred for angiography; obstructive CAD in 38% (n=55) and non-obstructive CAD (NOCAD) in 54% (n=77). The ANP allocated the angina characteristic ‘typical’ in 31% (n=45) cases and 58% (n=26) were diagnosed with obstructive CAD, average PTP of 20%, and 38% (n=17) were diagnoses with NOCAD. In those with ‘typical’ symptoms only two cases resulted in normal coronary arteries. Conversely 34% (n=49) were allocated ‘non-anginal’ symptoms, in whom 28% (n=14) obstructive CAD was detected; 12 cases had an intermediate to high PTP due to age and clinical likelihood. The majority of referrals (57%) were ‘high’ PTP of CAD (≤16%-52%), average 22%. The average PTP was 27% (High) in those diagnosed with CAD versus a PTP of 11% (Intermediate) in those with normal coronaries (n=12). The new category of ‘dyspnoea’ was allocated to 14% (n=20) and resulted in diagnosis of NOCAD (n=12) and (n=5) CAD. Those with dyspnoea as a presenting symptom of CAD were all male with high PTP. Conclusion Pre-test-probability and age are highly correlated, rising with age and defined by sex. The main variable is the ‘angina’ characteristic allocated by the ANP. In this community-based cohort, ‘typical’ symptom allocation by the ANP resulted in a higher PTP and subsequent CAD diagnosis. Clinical suspicion in the ‘low-intermediate risk’ can be further adjusted using the clinical likelihood ratio. The value of the PTP score in predicting CAD is as useful as the ‘angina’ characteristic and clinical likelihood allocated, requiring expert health history taking. This retrospective analysis of coronary angiogram results in this community cohort evidences that the ANP is skilled in utilising the ESC PTP score to assist in the diagnosis of CAD.

Inclusive Leadership in the South African Police Service (SAPS)

The purpose of this article paper is to shed light on the value and possibilities of inclusive leadership in the South African Police Service (SAPS). Background: Gives historical background, emphasizing apartheid's legacy and how it affected the SAPS's connection with the community. Problem Synopsis: identifies the main obstacles to developing inclusive leadership, including prejudice that isn't conscious, a lack of education, and mistrust from the past. Key Takeaways/Results: Makes the case that inclusive leadership builds community trust and is necessary for efficient law enforcement. It will showcase research results that bolster this claim, like higher officer morale and better problem-solving through a variety of viewpoints. Methodology/approach: Although not a research study, the article will cite reliable sources to bolster its claims, including reports, studies, and expert comments. Importance/Repercussions: examines the benefits of having an inclusive SAPS, such as increased community ties, less crime, and an equitable judicial system. The intended audience for this post is anyone who is interested in enhancing police in South Africa. This includes members of the community, police leadership, policymakers in the Department of Safety, and anybody else who is committed to creating a society that is safer and more equitable. This essay seeks to encourage positive change within the SAPS and to start a national dialogue on the value of having a more inclusive and representative police force by highlighting the opportunities and challenges of inclusive leadership.

Evaluation of Hepatitis A and B Seroprevalences in Health-Care Workers.

Viral hepatitis is still a common and important public health problem for health-care workers around the world and in our country. This study was aimed at determining the immunity status of hepatitis B and hepatitis A in order to vaccinate non-immune workers. The population of this cross-sectional descriptive study, which was conducted retrospectively, consists of all health-care workers who applied to the Occupational Health and Safety Department of the hospital between September 1, 2022, and December 31, 2022, for periodic examination. The files of 1652 health-care workers were examined without selecting the sample and these individuals were included in the study. "Annex 2 form," which was delivered to the employees, was used as a data source in the research. Statistical analyses were performed by Statistical Package for the Social Sciences Statistics software (SPSS Inc.; Chicago, IL, USA), version 15.0. In our study, the immunity against hepatitis B in the 18-29 age group, women, singles, and university graduates was statistically significantly higher, and the immunity against hepatitis A of the participants aged 50 and over, men, and primary school graduates was statistically significant and was found to be significantly higher (P <.05). The fact that 90.2% of the participants were immune to hepatitis B and 85.0% of the participants were immune to hepatitis A seems to be related to the success of vaccination programs for health-care workers in our country. It is very important that the immunization status of health-care workers, who are in the high-risk group in terms of infectious diseases, is at the desired level.

Optimizing Patient Safety and Security Management in Zambian Mental Health Facility: A PDSA Quality Improvement Study

Delivering specialized and top-tier psychiatric care necessitates an intricate and well-thought-out plan focusing on the safety and security of both healthcare professionals and patients. In the realm of mental health, particularly in specialized clinics and hospitals where patients may require admission and intricate treatment plans, the safety and security of the healthcare environment are paramount. It is crucial to ensure the comprehensive and tailored protection of mental health workers, particularly those operating in shift patterns. A well-devised strategy can significantly enhance the overall safety and security within a healthcare facility, potentially streamlining operational costs while minimizing both immediate and long-term risks associated with breaches in safety and security protocols. The aim of this research was to bolster safety and security protocols within mental health treatment establishments by identifying and addressing operational hurdles faced by ancillary mental health staff. To achieve this, the study implemented the Plan-Do-Study-Act (PDSA) cycle, a cornerstone methodology in quality management systems. The PDSA cycle’s pragmatic ethos encourages a methodical, iterative approach to integrating new methodologies into any process, particularly those aiming to elevate security and safety standards. This model was specifically employed to refine the functioning of the security and safety department at a private mental health facility in Lusaka, Zambia. The anticipated outcome is that this approach will not only safeguard the immediate and future well-being of healthcare personnel and patients but also foster a holistic and efficient operational environment for mental healthcare services.

#892 Hemodialysis close to home: lessons from 9 years dialysis hubs

Abstract Background and Aims In the Netherlands, more than 18.000 patients are treated with renal replacement therapy (RRT) (end of 2022), of which 5.216 patients with hemodialysis (HD). Only 5% (255 patients) are treated with HD outside a dialysis center, at home. Home HD can be either performed by the patient alone, or with assistance from spouse or other informal caregiver or from a health care professional. When applicable, patients and there (dialysis)partners are trained to perform their treatment independently. Home HD can give more flexibility and independence which could improve quality of life. To make HD close to home available for patients even if their own house is not suitable and to deal with limited resources, such as nursing support, we have started in 2015 to set up small dialysis facilities in collaboration with other healthcare providers, such as nursing homes or general practitioners, and have called them Hubs. By setting up Hubs, we ensure that dialysis remains available close to home for patients who cannot carry out the treatment completely independently or with their own partner, but need help from a care worker. Method We provide an overview of the logistical and technical matters involved in setting up a successful Hub and will discuss the experience so far with 11 Dianet Hubs in the Netherlands. Results Preparatory phase: In the run-up to a new dialysis hub a standard check list is used. The Quality and Safety department supervises the process and translates control measures into cooperation agreements. For a hub to be successful, partnership with local dialysis centers and hospitals is key. Together the best location can be pinpointed. Annual audits are carried out. Patient characteristics and medical back up: Because a Hub is a home HD setting, good stable vascular access is mandatory, together with hemodynamic stability during sessions. However, because the HD population has multiple comorbidities, in case of instability, acute consultation with the referral center is necessary. Protocols guide the health care professional at the Hub in those circumstances. Furthermore, every hub presents new challenges that are embedded in the work processes. Current situation: Eleven dialysis hubs, each accommodating up to 8 patients are in operation in collaboration with a partnering dialysis center. Since 2015, processes have been refined, risks identified and hubs almost continuously occupied. Due to patient factors, sometimes incenter dialysis is necessary, for example in case of access problems. We learned during the pandemic, that accessibility of the dialysis hubs located in (primary) care homes is an important factor to consider when choosing a Hub location. Both patients and partnering dialysis centers feel that our Hubs meet a need for close to home assisted HD. Conclusion With 11 dialysis hubs we have built up a wealth of experience. From employer perspective, deployment of dialysis nurses in hubs is profitable. HD close to home offers patients an alternative for home HD. There is great support within healthcare facilities; they experience the impact of dialysis on patients’ lives. Annual audits guarantee quality and safety.

Chi-square automatic interaction detection (CHAID) analysis of the use of safety goggles and face masks as personal protective equipment (PPE) to protect against occupational biohazards

BackgroundThis study represents the first Spanish investigation to rigorously evaluate compliance with the use of safety goggles and face masks as essential personal protective equipment (PPE) in companies with workplaces involving exposure to biological agents. ObjectivesThis study aimed to examine the degree of use of face masks and safety goggles as personal protective equipment (PPE), the factors that influence their use, and the profile of workers exposed to occupational biological agents in Spanish companies in the health sector, farming sector, meat industry, waste treatment plants, food industry, and veterinary centers. MethodsWe conducted a cross-sectional descriptive study involving 590 Spanish workers from 51 companies. We developed a 34-item questionnaire to assess workers’ perception of risk related to exposure to biological agents in their workplaces. Among the questions, three were designed to measure the degree of use of key protective equipment in sectors with biological agent exposure: protective gloves, safety goggles or face masks. We only analyzed safety goggles and face masks. We performed various statistical analyses, including Cronbach’s alpha, frequency of endorsement, content validity ratio using Lawshe’s method, varimax rotation, the Kaiser-Meyer-Olkin test, and Bartlett’s sphericity test, to assess the internal consistency and reliability of the questionnaire. Additionally, we employed a chi-square automatic interaction detection (CHAID) segmentation analysis, using workers’ responses regarding their attitudes toward safety goggles and face mask usage as PPE for protection against biological risks, with demographic variables as independent factors. ResultsIn the current study, CHAID analysis revealed that workers exposed to group 2 biological agents used more safety goggles and face shields compared with workers exposed to other groups of biological agents. Moreover, workers in laboratories and the food industry used face masks more than workers of other sectors. ConclusionThe CHAID analysis in the current study indicated that workers exposed to biological agents from both group 2 and group 3 demonstrated satisfactory levels of compliance and utilization of protective masks, surpassing their counterparts in terms of usage. Workers in the food and laboratory industries had subpar compliance with preventive measures, and employees from companies with internal health and safety departments exhibited significant adherence to workplace mask usage, safeguarding themselves against biological risks.

Morbidity and Mortality Conferences in Internal Medicine Specialty Training in Japan: A Nationwide Cross-sectional Study.

Objective This study evaluated the implementation status of morbidity and mortality conferences in internal medicine specialty training programs in Japan. Methods This cross-sectional study surveyed hospitals in Japan with certified internal medicine specialty training programs. Program directors or equivalently responsible physicians managing certified internal medicine training programs were invited to participate in this study (n=619). Materials Data were collected using an online questionnaire that included questions about the number of morbidity and mortality conferences, types of cases covered, collaboration of the patient safety section and other health professions, and whether or not the conferences were conducted by a subspecialty department-led or program-based. Results Responses were received from 123 hospitals (19.8% response rate), of which 59 (48%) had some form of internal medicine morbidity and mortality conference in place. The average number per year was 9.63 (standard deviation: 18.12). Hospitals with morbidity and mortality conferences in subspecialty departments held significantly more conferences than X (please define X). Furthermore, the involvement of the patient safety department tended to be associated with holding more conferences. Autopsy rates were significantly higher in hospitals with program-based internal medicine morbidity and mortality conferences than subspecialty-led. Conclusion Internal medicine specialty training hospitals had more morbidity and mortality conferences than previously reported. Program-based morbidity and mortality conferences in internal medicine are associated with higher autopsy rates and may lead to an organizational reporting culture and lifelong learning attitudes that support patient safety. Collaboration with organizational management sections, such as patient safety, would be effective in implementing these conferences in internal medicine training programs.

Epizootic monitoring of rabies incidence in the Vinnytsia region

Today, the entire territory of Ukraine is unfavorable for rabies, as a result of which we have one of the highest levels of rabies incidence among all European countries. Vinnytsia region remains one of the most disadvantaged regions in terms of rabies among both wild and domestic carnivores. However, the reasons for the permanently acute rabies epizootic situation in this territory remain poorly understood. The research materials included statistical data from the Main Department of the State Consumer Service in Vinnytsia region, reports of epizootic surveys of problematic areas regarding rabies; annual reports of food safety and veterinary medicine departments in districts, annual reports of the Vinnytsia Regional State Laboratory of the State Consumer Service, accompanying documents, and materials from primary veterinary records. From 2019 to 2023, 896 animals that died of rabies were found in Vinnytsia region. The most rabies cases among foxes are 427 heads (39 %), among dogs – 29 %. Among cats, 27 % (409 heads); among ruminants – 55 animals (7 %) fell ill and died from rabies. The ratio of conducted studies and positive results has increased in recent years, in 2019–2021 – 18 %, 13 %, 12 %, and in 2022–2023 – 26, 31 %. In 2023, during the examination of pat material from 250 dogs and cats that were received after death at the Vinnytsia Regional State Laboratory of the State Production and Consumer Service, rabies was confirmed in 95 animals, which is 38 % of those examined. Most sick dogs and cats with rabies were in March and October –14–12 animals (27 %). Most foxes with rabies after death were received in November – 12 heads (38 %) from the herd.

Evaluation of Probable Maximum Precipitation (PMP) for West Virginia to Predict Current and Future PMP

Probable maximum precipitation (PMP) is essential for dam design criteria. West Virginia Department of Environmental Protection Dam Safety utilizes the 6-hr, 10-mi2 (26-km2) PMP established by Hydrometeorological Report 51 based on the analysis of extreme rainfall. These PMP are outdated because there have been unaccounted for extreme rainfall events that have occurred since 1978. In addition, a zone of uncertainty around the Appalachian Mountains exists, including West Virginia (WV). The objective of this research was to determine the PMP throughout WV by studying the area of uncertainty and consider rising dew points to predict future PMP. This study created an updated PMP map of WV, focusing on the maximization of the 1942 Smethport, PA storm. A watershed-specific analysis was conducted at all dams in the state with an approximate watershed area of 10-mi2 (26-km2). Current PMP estimations and projections for 2100 were determined. Iso-lines were determined to develop the new updated PMP map for WV that displays current and future PMP estimations. Results suggest that the greatest values of PMP occur in the western region of the state; lowest values of PMP occur in the south-eastern part of the state. The Smethport, PA storm (1942) was considered the governing storm for the entire state; however, it may not apply to the eastern panhandle and Potomac highlands. These regions should be considered for additional analysis. The updated PMP map will be a resource for those involved in dam inspection, repair, design, and modification.