Incident Reporting Systems: How did we get here and where should we go? a narrative review

Since the authoring of the seminal report by the Institute of Medicine (IOM) “To Err is Human: Building a Safer Health System” in 2000, there has been an increased focus on patient safety and the responsibility born by the healthcare system to reduce what are known as adverse events (AE). One of the recommendations of the IOM report was the establishment and development of Incident Reporting System (IRS) that would track AE resulting in serious injury and death. The Joint Commission in the USA similarly requires all hospitals have and use an IRS. The objective of this review is to explore barriers and feature of IRS and patient safety.    &nbsp

The crisis, disasters and catastrophes afflicting Yemen and its people

It would be inaccurate to state that Yemen’s difficulties began with the current civil war in September of 2014. While the war brought about its own list of insurmountable tribulations, it also exacerbated already present disasters. This article explores the many dynamics that have led to what has been referred to as the world’s worst humanitarian crisis (1). These include war, internal displacement, economic disaster, healthcare collapse, outbreaks in refugee camps, vaccination concerns, malnutrition, food insecurity, water sparsity, and infectious disease catastrophes. Along with accurate depictions of what is happening on the ground, this article suggests a few potential solutions worth investigating further, ranging from national and international efforts. With an ever-changing climate, this article serves to provide the most up to date impression of the current crisis and disasters

Analysis of Factors and Medical Errors Involved in Patient Complaints in a European Emergency Department

Introduction: Patients’ complaints from Emergency Departments (ED) are frequent and can be used as a quality assurance indicator. Objective: Factors contributing to patients’ complaints (PCs) in the emergency department were analyzed.  Methods: It was a retrospective cohort study, the qualitative variables of patients’ complaints visiting ED of a university hospital were compared with Chi-Square and t test tests. Results: Eighty-five PC were analyzed. The factors contributing to PC were: communication (n=26), length of stay (LOS) (n=24), diagnostic errors (n=21), comfort and privacy issues (n=7), pain management (n=6), inappropriate treatment (n=6), delay of care and billing issues (n=3). PCs were more frequent when patients were managed by residents, during night shifts, weekends, Saturdays, Mondays, January and June. Moreover, the factors contributing to diagnostic errors were due to poor communication, non-adherence to guidelines and lack of systematic proofreading of X-rays. In 98% of cases, disputes were resolved by apology and explanation and three cases resulted in financial compensation. Conclusion: Poor communication, LOS and medical errors are factors contributing to PCs. Improving communication, resolving issues leading to slow health care provision, adequate staffing and supervision of trainees may reduce PCs

Analysis of Factors and Medical Errors Involved in Patient Complaints in a European Emergency Department

Introduction: Patients’ complaints from Emergency Departments (ED) are frequent and can be used as a quality assurance indicator. Objective: Factors contributing to patients’ complaints (PCs) in the emergency department were analyzed.  Methods: It was a retrospective cohort study, the qualitative variables of patients’ complaints visiting ED of a university hospital were compared with Chi-Square and t test tests. Results: Eighty-five PC were analyzed. The factors contributing to PC were: communication (n=26), length of stay (LOS) (n=24), diagnostic errors (n=21), comfort and privacy issues (n=7), pain management (n=6), inappropriate treatment (n=6), delay of care and billing issues (n=3). PCs were more frequent when patients were managed by residents, during night shifts, weekends, Saturdays, Mondays, January and June. Moreover, the factors contributing to diagnostic errors were due to poor communication, non-adherence to guidelines and lack of systematic proofreading of X-rays. In 98% of cases, disputes were resolved by apology and explanation and three cases resulted in financial compensation. Conclusion: Poor communication, LOS and medical errors are factors contributing to PCs. Improving communication, resolving issues leading to slow health care provision, adequate staffing and supervision of trainees may reduce PCs

Chronic Health Crises and Emergency Medicine in War-torn Yemen, Exacerbated by the COVID-19 Pandemic

Introduction: Much of Yemen’s infrastructure and healthcare system has been destroyed by the ongoing civil war that began in late 2014. This has created a dire situation that has led to food insecurity, water shortages, uncontrolled outbreaks of infectious disease and further failings within the healthcare system. This has greatly impacted the practice of emergency medicine (EM), and is now compounded by the coronavirus disease 2019 (COVID-19) global pandemic. Methods: We conducted a systematic review of the current state of emergency and disaster medicine in Yemen, followed by unstructured qualitative interviews with EM workers, performed by either direct discussion or via phone calls, to capture their lived experience, observations on and perceptions of the challenges facing EM in Yemen. We summarize and present our findings in this paper. Results: Emergency medical services (EMS) in Yemen are severely depleted. Across the country as a whole, there are only 10 healthcare workers for every 10,000 people – less than half of the WHO benchmark for basic health coverage – and only five physicians, less than one third the world average; 18% of the country’s 333 districts have no qualified physicians at all. Ambulances and basic medical equipment are in short supply. As a result of the ongoing war, only 50% of the 5056 pre-war hospitals and health facilities are functional. In June 2020, Yemen recorded a 27% mortality rate of Yemenis who were confirmed to have COVID-19, more than five times the global average and among the highest in the world at that time. Conclusion: In recent years, serious efforts to develop an advanced EM presence in Yemen and cultivate improvements in EMS have been stymied or have failed outright due to the ongoing challenges. Yemen’s chronically under-resourced healthcare sector is ill-equipped to deal with the additional strain of COVID-19

When COVID-19 hit Yemen: dealing with the pandemic in a country under pressure from the world’s worst humanitarian crisis

A recent history of internal conflict in Yemen has left the country in shambles, with much of its infrastructure and healthcare system destroyed. The UN considers the situation in Yemen to be the world’s worst humanitarian crisis, with more than 80% of the population – 24 million people, including 12 million children – dependent on humanitarian aid for basic needs including food and clean water, as well as healthcare. In the aftermath of a devastating civil war, the spread of COVID-19 has hit the country hard, exacerbating an already dire situation in which the Yemeni people face daily challenges from food insecurity, lack of sanitation infrastructure, continuing conflict and outbreaks of infectious disease. A cholera outbreak, ongoing since 2016, has claimed nearly 1.5 million lives. The situation is made worse by a lack of medical equipment and, most recently, the COVID-19 pandemic. With only 50% of Yemeni hospitals and medical facilities in full working condition, the country is in desperate need of medical equipment, healthcare workers and money to ensure conditions do not deteriorate further in the coming months

Artificial intelligence literacy among university students: a comparative transnational survey

Artificial intelligence (AI) literacy is a crucial aspect of media and information literacy (MIL), regarded not only as a human right but also as a fundamental requirement for societal advancement and stability. This study aimed to provide a comprehensive, cross-border perspective on AI literacy levels by surveying 1,800 university students from four Asian and African nations. The findings revealed significant disparities in AI literacy levels based on nationality, scientific specialization, and academic degrees, while age and gender did not show notable impacts. Malaysian participants scored significantly higher on the AI literacy scale than individuals from other countries. The results indicated that various demographic and academic factors influenced respondents’ perceptions of AI and their inclination to utilize it. Nationality and academic degree were identified as the most influential factors, followed by scientific specialization, with age and gender exerting a lesser influence. The study highlights the necessity of focusing research efforts on the detailed dimensions of the AI literacy scale and examining the effects of previously untested intervening variables. Additionally, it advocates for assessing AI literacy levels across different societal segments and developing the appropriate measurements

Prevalence and Knowledge, Attitude, and Practices of Hepatitis B Virus Among Dental Students at the University of Science and Technology, Aden, Yemen

Introduction: Infection with the hepatitis B virus (HBV) continues to be a serious global public health concern, impacting a substantial proportion of the worldwide population. This study investigates the prevalence of HBV and assesses knowledge, attitudes, and practices (KAP) among dental students at the University of Science and Technology (UST) in Aden, Yemen. Methods: A cross-sectional study design was conducted among 186 dental students at the University of Science and Technology, Aden, Yemen. Blood samples were screened for HBV using ELISA, and a pre-tested questionnaire assessed KAP. Results: A significant majority (89.2%) of participants reported awareness of HBV, indicating a baseline understanding of the infection. Knowledge levels were good (41%), moderate (41.9%), and poor (16.1%). Attitudes were almost positive (64.5%), while practices were poor (31.2%), moderate (54.8%), and good (14%). None of the 142 students who provided blood samples tested positive for HBV.  Conclusion: This study reveals significant knowledge gaps among UST dental students regarding HBV. Despite recognizing the disease\u27s severity, misconceptions persisted. Targeted educational interventions are needed to enhance HBV awareness among future healthcare professionals

a subanalysis of causes and risk factors from the Global Burden of Disease Study 2021

Funding Information: The research reported in this publication was funded by the Gates Foundation. Publisher Copyright: © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Decades of steady improvements in life expectancy in Europe slowed down from around 2011, well before the COVID-19 pandemic, for reasons which remain disputed. We aimed to assess how changes in risk factors and cause-specific death rates in different European countries related to changes in life expectancy in those countries before and during the COVID-19 pandemic. Methods: We used data and methods from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to compare changes in life expectancy at birth, causes of death, and population exposure to risk factors in 16 European Economic Area countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, and Sweden) and the four UK nations (England, Northern Ireland, Scotland, and Wales) for three time periods: 1990–2011, 2011–19, and 2019–21. Changes in life expectancy and causes of death were estimated with an established life expectancy cause-specific decomposition method, and compared with summary exposure values of risk factors for the major causes of death influencing life expectancy. Findings: All countries showed mean annual improvements in life expectancy in both 1990–2011 (overall mean 0·23 years [95% uncertainty interval [UI] 0·23 to 0·24]) and 2011–19 (overall mean 0·15 years [0·13 to 0·16]). The rate of improvement was lower in 2011–19 than in 1990–2011 in all countries except for Norway, where the mean annual increase in life expectancy rose from 0·21 years (95% UI 0·20 to 0·22) in 1990–2011 to 0·23 years (0·21 to 0·26) in 2011–19 (difference of 0·03 years). In other countries, the difference in mean annual improvement between these periods ranged from –0·01 years in Iceland (0·19 years [95% UI 0·16 to 0·21] vs 0·18 years [0·09 to 0·26]), to –0·18 years in England (0·25 years [0·24 to 0·25] vs 0·07 years [0·06 to 0·08]). In 2019–21, there was an overall decrease in mean annual life expectancy across all countries (overall mean –0·18 years [95% UI –0·22 to –0·13]), with all countries having an absolute fall in life expectancy except for Ireland, Iceland, Sweden, Norway, and Denmark, which showed marginal improvement in life expectancy, and Belgium, which showed no change in life expectancy. Across countries, the causes of death responsible for the largest improvements in life expectancy from 1990 to 2011 were cardiovascular diseases and neoplasms. Deaths from cardiovascular diseases were the primary driver of reductions in life expectancy improvements during 2011–19, and deaths from respiratory infections and other COVID-19 pandemic-related outcomes were responsible for the decreases in life expectancy during 2019–21. Deaths from cardiovascular diseases and neoplasms in 2019 were attributable to high systolic blood pressure, dietary risks, tobacco smoke, high LDL cholesterol, high BMI, occupational risks, high alcohol use, and other risks including low physical activity. Exposure to these major risk factors differed by country, with trends of increasing exposure to high BMI and decreasing exposure to tobacco smoke observed in all countries during 1990–2021. Interpretation: The countries that best maintained improvements in life expectancy after 2011 (Norway, Iceland, Belgium, Denmark, and Sweden) did so through better maintenance of reductions in mortality from cardiovascular diseases and neoplasms, underpinned by decreased exposures to major risks, possibly mitigated by government policies. The continued improvements in life expectancy in five countries during 2019–21 indicate that these countries were better prepared to withstand the COVID-19 pandemic. By contrast, countries with the greatest slowdown in life expectancy improvements after 2011 went on to have some of the largest decreases in life expectancy in 2019–21. These findings suggest that government policies that improve population health also build resilience to future shocks. Such policies include reducing population exposure to major upstream risks for cardiovascular diseases and neoplasms, such as harmful diets and low physical activity, tackling the commercial determinants of poor health, and ensuring access to affordable health services. Funding: Gates Foundation.publishersversionpublishe

Global, Regional, and National Burden of Nontraumatic Subarachnoid Hemorrhage

Importance: Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure. Objective: To estimate the worldwide burden of SAH. Design, setting, and participants: Based on the repeated cross-sectional Global Burden of Disease (GBD) 2021 study, the global burden of SAH in 1990 to 2021 was estimated. Moreover, the SAH burden was compared with other diseases, and its associations with 14 individual risk factors were investigated with available data in the GBD 2021 study. The GBD study included the burden estimates of nontraumatic SAH among all ages in 204 countries and territories between 1990 and 2021. Exposures: SAH and 14 modifiable risk factors. Main outcomes and measures: Absolute numbers and age-standardized rates with 95% uncertainty intervals (UIs) of SAH incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) as well as risk factor-specific population attributable fractions (PAFs). Results: In 2021, the global age-standardized SAH incidence was 8.3 (95% UI, 7.3-9.5), prevalence was 92.2 (95% UI, 84.1-100.6), mortality was 4.2 (95% UI, 3.7-4.8), and DALY rate was 125.2 (95% UI, 110.5-142.6) per 100 000 people. The highest burden estimates were found in Latin America, the Caribbean, Oceania, and high-income Asia Pacific. Although the absolute number of SAH cases increased, especially in regions with a low sociodemographic index, all age-standardized burden rates decreased between 1990 and 2021: the incidence by 28.8% (95% UI, 25.7%-31.6%), prevalence by 16.1% (95% UI, 14.8%-17.7%), mortality by 56.1% (95% UI, 40.7%-64.3%), and DALY rate by 54.6% (95% UI, 42.8%-61.9%). Of 300 diseases, SAH ranked as the 36th most common cause of death and 59th most common cause of DALY in the world. Of all worldwide SAH-related DALYs, 71.6% (95% UI, 63.8%-78.6%) were associated with the 14 modeled risk factors of which high systolic blood pressure (population attributable fraction [PAF] = 51.6%; 95% UI, 38.0%-62.6%) and smoking (PAF = 14.4%; 95% UI, 12.4%-16.5%) had the highest attribution. Conclusions and relevance: Although the global age-standardized burden rates of SAH more than halved over the last 3 decades, SAH remained one of the most common cardiovascular and neurological causes of death and disabilities in the world, with increasing absolute case numbers. These findings suggest evidence for the potential health benefits of proactive public health planning and resource allocation toward the prevention of SAH